ArticleAmerican journal of preventive cardiology2025
Association of plant-based diets with subclinical cardiovascular disease in U.S. adults, 1999-2004.
Article in American journal of preventive cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Dietary patterns currently recommended for cardiovascular health often emphasize the consumption of plant foods. Methods: We included 7,708 participants from the National Health and Nutrition Examination Survey 1999-2004 aged ≥20 years who were not pregnant and did not have a self-reported history of cardiovascular disease. Dietary intake was assessed using a 24-hour dietary recall. All plant-based dietary indices [overall plant-based diet index (PDI), healthy PDI (hPDI), and unhealthy PDI (uPDI)] were analyzed by quartiles and cardiac biomarkers [cardiac troponin T (cTnT), cardiac troponin I (cTnI), and N-terminal pro-B-type natriuretic peptide (NT-proBNP)] were categorized as elevated versus non-elevated using clinical cutpoints. We used logistic regression models progressively adjusted for confounders to study the associations between each plant-based diet index and elevated cardiac biomarkers. All analyses used appropriate survey weights to account for the complex study design. Results: Mean age was 45 years old, 46 % were male, and 74 % were non-Hispanic White. After adjustment for sociodemographic characteristics, lifestyle behaviors, and measures of health status, there was an inverse association between adherence to hPDI (quartile 4 vs. quartile 1) and elevated cTnI (OR: 0.52, 95 % CI: 0.30, 0.90; p-trend <0.01) and a positive association between uPDI and elevated cTnI (OR for quartile 4 vs. 1: 1.65, 95 % CI: 1.10, 2.46; p-trend=0.04). There were no significant associations between plant-based diet indices and elevated cTnT or NT-proBNP. Conclusion: Higher adherence to a healthy plant-based diet was inversely associated with elevated cTnI and higher adherence to an unhealthy plant-based diet was positively associated with elevated cTnI in a nationally representative sample of U.S. adults. Supporting access to and adoption of healthy plant-based diets may be a useful strategy for promoting population-level cardiovascular health.
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