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ABSTRACT: Background
Plant-based diets are associated with a lower risk of cardiovascular diseases; however, little is known how the healthiness of the diet may be associated with blood pressure (BP). We aimed to modify three plant -based diet indices: overall plant-based diet index (PDI), healthy PDI (hPDI), and unhealthy PDI (uPDI) according to country-specific dietary guidelines to enable use across populations with diverse dietary patterns - and assessed their associations with BP.Design
We used cross-sectional data including 4,680 men and women ages 40-59y in Japan, China, the United Kingdom, and the United States from the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP). During four visits, eight BP measurements, and four 24-h dietary recalls were collected. Multivariable regression coefficients were estimated, pooled, weighted, and adjusted extensively for lifestyle/dietary confounders.Results
Modified PDI was not associated with BP. Consumption of hPDI higher by 1SD was inversely associated with systolic (-0.82 mm Hg;95% CI:-1.32,-0.49) and diastolic BP (-0.49 mm Hg; 95% CI:-0.91, -0.28). In contrast, consumption of an uPDI was directly associated with systolic (0.77 mm Hg;95% CI:0.30,1.20). Significant associations between hPDI with BP were attenuated with separate adjustment for vegetables and whole grains; associations between uPDI and BP were attenuated after adjustment for refined grains, sugar-sweetened beverages, and meat.Conclusion
An hPDI is associated with lower BP while a uPDI is adversely related to BP. Plant-based diets rich in vegetables and whole grains and limited in refined grains, sugar-sweetened beverages, and total meat may contribute to these associations. In addition to current guidelines, the nutritional quality of consumed plant foods is as important as limiting animal-based components.Trial registration number
The observational INTERMAP study was registered at www.clinicaltrials.gov as NCT00005271.
SUBMITTER: Aljuraiban G
PROVIDER: S-EPMC7841826 | biostudies-literature | 2020 Dec
REPOSITORIES: biostudies-literature
Aljuraiban Ghadeer G Chan Queenie Q Gibson Rachel R Stamler Jeremiah J Daviglus Martha L ML Dyer Alan R AR Miura Katsuyuki K Wu Yangfeng Y Ueshima Hirotsugu H Zhao Liancheng L Van Horn Linda L Elliott Paul P Oude Griep Linda M LM
BMJ nutrition, prevention & health 20200708 2
<h4>Background</h4>Plant-based diets are associated with a lower risk of cardiovascular diseases; however, little is known how the healthiness of the diet may be associated with blood pressure (BP). We aimed to modify three plant -based diet indices: overall plant-based diet index (PDI), healthy PDI (hPDI), and unhealthy PDI (uPDI) according to country-specific dietary guidelines to enable use across populations with diverse dietary patterns - and assessed their associations with BP.<h4>Design</ ...[more]