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A healthy plant-based diet is favorably associated with cardiometabolic risk factors among participants of South Asian ancestry.

BACKGROUND
Plant-based diets are recommended for chronic disease prevention, yet there has been little focus on plant-based diet quality among participants of South Asian ancestry who consume a predominantly plant-based diet.


OBJECTIVE
We evaluated cross-sectional and prospective associations between plant-based diet quality and cardiometabolic risk among participants of South Asian ancestry who are living in the US.


DESIGN
We included 891 participants of South Asian ancestry who completed the baseline visit in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study. The prospective analysis included 735 participants who completed exam 2 (∼5 y after baseline). Plant-based diet quality was assessed using 3 indices - an overall plant-based diet index (PDI) that summarizes the consumption of plant foods, a healthful PDI (hPDI) that measures consumption of healthy plant foods, and an unhealthful PDI (uPDI) that reflects consumption of less-healthy plant foods.


RESULTS
At baseline, the PDI was inversely associated with fasting glucose. We observed an inverse association between PDI and hPDI with HOMA-IR, LDL-C, weight, and BMI (all P<0.05). Higher scores on the hPDI, but not PDI, were associated with lower glycated hemoglobin, higher adiponectin, lower visceral fat area and pericardial fat volume. Each 5-unit higher hPDI was associated with a lower likelihood of fatty liver (odds ratio [OR] 0.76 [95% CI: 0.64, 0.90]), and obesity (OR 0.88 [95% confidence interval (CI): 0.80, 0.97]). There were no associations between uPDI and cardiometabolic risk. Prospectively, after covariate adjustment for baseline values, each 5-unit higher hPDI was associated with an 18% lower risk of incident type 2 diabetes (OR 0.82 [95% CI: 0.67, 1.00]).


CONCLUSIONS
A higher intake of healthful plant-based foods was associated with a favorable cardiometabolic risk profile. Dietary recommendations to lower chronic disease risk among participants of South Asian ancestry should focus on the quality of plant-based foods.