Introduction: Evidence suggests that high quality plant-based diets are associated with favorable cardiometabolic outcomes. However, there is no consensus on the optimal measure to assess the quality of plant-based diet. Furthermore, little is known about how plant-based diet quality relates to cardiometabolic health in pregnant women. Hypothesis: We assessed the hypothesis that plant-based diet quality is associated with cardiometabolic biomarkers in pregnant women, with “healthy” plant foods linked to more favorable biomarker profiles. Methods: Data from pregnant women who participated in seven cycles (2005 to 2020 pre-pandemic) of the cross-sectional National Health and Nutrition Examination Survey (NHANES) were used to calculate six independent plant-based diet quality indices. Multivariable log-linear regression models were used to assess associations between these indices and cardiometabolic biomarkers, adjusting for age, race/ethnicity, education, and ratio of family income to poverty. Results: Dietary and cardiometabolic biomarker data were available for 580 pregnant women. Higher plant-based diet quality index values, independent of the index used, were positively associated with high-density lipoprotein cholesterol (HDL-C) concentrations, and negatively associated with triglyceride (TG)/HDL-C ratios. Additionally, those indices that accounted for plant foods quality were also associated with lower fasting insulin and TG concentrations, and homeostatic model assessment for insulin resistance (HOMA-IR). Conclusions: In this NHANES cohort of pregnant women, higher values of all plant-based diet indices were associated with more favorable biomarkers of cardiometabolic health. Those plant-based diet indices that emphasized the quality of plant foods rather than penalizing the inclusion of animal foods were more strongly associated with cardiometabolic health biomarkers.
Shi et al. (Tue,) studied this question.