Healthy plant-based diet confers longer-lasting cardiometabolic benefits in obesity
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Although a vegetarian diet may improve cardiometabolic health, researchers reported that obese individuals may need to do more than cut meat from their diets.
Research presented at the European Society of Cardiology Congress showed that the quality of an obese individual’s plant-based diet and the person’s ability to adhere to healthy dietary choices was correlated with their ability to maintain healthy long-term metabolic changes, especially in women.
“Prior research has shown that women tend to eat more plant-based foods and less animal-based products than men,” Matina Kouvari, MSc, PhD(c), clinical nutritionist and dietitian at Harokopio University in Athens, Greece, said in a press release. “But our study suggests that this does not guarantee healthier food choices and in turn better health status.”
For this 10-year prospective study, investigators evaluated 2,020 obese adults on a vegetarian diet with no prior CVD. During a follow-up assessment, the researchers evaluated metabolic status (presence of NCEP ATP III (2005) metabolic syndrome components, excluding waist circumference) in addition to quality of the patients’ vegetarian diet. The primary outcome was the patient achieving metabolically healthy obesity.
Patients were assigned to categories based on the quality of their plant-based diet.
According to the study, a healthful diet was characterized by high consumption of fruits and vegetables, whole grains, nuts, legumes, oils, and tea or coffee. An unhealthful plant-based diet was associated with elevated intake of juices, sugar sweetened beverages, refined grains, potatoes and sweets.
Overall, metabolically healthy obesity was achieved in 4.8% of the cohort (4.9% men; 4.7% women; P = .198) while 28.2% presented as metabolically benign.
Over the trial period, 45% of metabolically healthy men and 54% of women changed to a metabolically unhealthy obese status (P = .04).
Moreover, investigators observed an inverse relationship between indices for a quality plant-based and 10-year transition to metabolically unhealthy status among men (HR = 0.63; 95% CI, 0.41-0.95). However, the same association only reached borderline significance for women (HR = 0.82; 95% CI, 0.67-1.09).
Only participants in the healthful plant-based diet category retained their metabolically healthy status, with a stronger association among women (HR for women = 0.55; 0.37-0.84; HR for men = 0.79; 95% CI, 0.64-1.03).
The metabolically aggravating impact of an unhealthy plant-based diet was strong among women (HR = l.68; 95% CI, 1.23-1.99) compared with the healthier diet.
Kouvari said in the release that the results cannot be generalized to people without obesity.
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Kouvari M, et al. Abstract 81495. Presented at: European Society of Cardiology Congress; Aug. 29-Sept. 1, 2020 (virtual meeting).
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