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Protocol for a systematic review and meta-analysis: to investigate the association of adherence to plant-based diets with cardiovascular disease risk

Background: Plant-based diets (PBDs) are characterised as healthy dietary patterns that emphasise the intake of plant foods and limit the intake of animal foods. The Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets are common examples of healthy dietary patterns that are mainly plant based. There are different dietary pattern analysis approaches and scoring systems available to construct indices that measure adherence to a dietary pattern. Nutritional epidemiology studies necessitate the use of appropriate dietary indices when investigating diet-disease associations. Methods: This systematic review protocol was developed according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis protocols (PRISMA-P) guidelines. PubMed–Medline, Scopus and relevant biomedical databases within EBSCOhost will be searched up to August 2021 using relevant key words. Two reviewers will independently screen the identified records and review the eligible full texts for inclusion. Discrepancies will be resolved by consensus or through discussion with a third reviewer. Appropriate meta-analysis will be performed where possible and consistency of the findings checked through subgroup analysis. Heterogeneity across studies will be assessed and quantified, and publication bias investigated. Relevant sensitivity analyses will be performed to substantiate the robustness of the study findings. Conclusion: Currently, there is some inconsistency in defining and measuring adherence to a PBD across study populations. In addition to this, a lack of global data on the association between adherence to a PBD and CVD risk. This systematic review could aid in promoting the worldwide uptake of these findings for policy and practice purposes. This research will use previously published studies; and therefore, will not require ethical approval.