Operational Differences in Plant-Based Diet Indices Affect the Ability to Detect Associations with Incident Hypertension in Middle-Aged US Adults.

TitleOperational Differences in Plant-Based Diet Indices Affect the Ability to Detect Associations with Incident Hypertension in Middle-Aged US Adults.
Publication TypeJournal Article
Year of Publication2020
AuthorsKim H, Rebholz CM, Garcia-Larsen V, Steffen LM, Coresh JJ
Secondary AuthorsCaulfield LE
JournalJ Nutr
Volume150
Issue4
Pagination842-850
Date Published2020 04 01
ISSN1541-6100
KeywordsCohort Studies, Diet, Vegetarian, Female, Food Analysis, Humans, Hypertension, Male, Middle Aged, Nutritional Status, United States
Abstract

BACKGROUND: Several distinct plant-based diet indices (PDIs) have been developed to characterize adherence to plant-based diets.

OBJECTIVE: We contrasted 5 PDIs in a community-based cohort by assessing characteristics of the diet and evaluating whether these PDIs are associated with risk of incident hypertension.

METHODS: Using FFQ data from adults (45-64 y, n = 8041) without hypertension at baseline in the Atherosclerosis Risk in Communities (ARIC) Study, we scored participants' diets using the overall PDI (oPDI), healthy PDI (hPDI), less healthy (unhealthy) PDI (uPDI), provegetarian diet index, and PDI from the Rotterdam Study (PDI-Rotterdam). For the oPDI, provegetarian diet, and PDI-Rotterdam, higher intakes of all or selected plant foods received higher scores. For the hPDI, higher intakes of plant foods identified as healthful received higher scores. For the uPDI, higher intakes of less healthy plant foods received higher scores. All indices scored higher intakes of animal foods lower. We examined agreement between indices, and whether scores on these indices were associated with risk of hypertension using Cox proportional hazard models.

RESULTS: The PDIs were moderately-to-strongly correlated and largely ranked subjects consistently, except for the uPDI. Over a median follow-up of 13 y, 6044 incident hypertension cases occurred. When adjusted for sociodemographic characteristics, other dietary factors, and health behaviors, the highest compared with the lowest quintile for adherence to the oPDI, hPDI, and provegetarian diet was associated with a 12-16% lower risk of hypertension (all P-trend

CONCLUSIONS: In middle-aged US adults, despite moderate agreement in ranking subjects across PDIs, operational differences can affect the ability to detect diet-disease associations, such as hypertension.

DOI10.1093/jn/nxz275
Alternate JournalJ Nutr
PubMed ID31722418
PubMed Central IDPMC7138677
Grant ListHHSN268201700001I / HL / NHLBI NIH HHS / United States
HHSN268201700002I / HL / NHLBI NIH HHS / United States
HHSN268201700003I / HL / NHLBI NIH HHS / United States
HHSN268201700004I / HL / NHLBI NIH HHS / United States
HHSN268201700005I / HL / NHLBI NIH HHS / United States
K01 DK107782 / DK / NIDDK NIH HHS / United States
R21 HL143089 / HL / NHLBI NIH HHS / United States