Plant-based diet indices and lipoprotein particle subclass profiles: A cross-sectional analysis of middle- to older-aged adults

Patrick S Elliott; Janas M Harrington; Seán R Millar; James D Otvos; Ivan J Perry; Catherine M Phillips

doi:10.1016/j.atherosclerosis.2023.117190

Plant-based diet indices and lipoprotein particle subclass profiles: A cross-sectional analysis of middle- to older-aged adults

Atherosclerosis. 2023 Sep:380:117190. doi: 10.1016/j.atherosclerosis.2023.117190. Epub 2023 Jul 27.

Authors

Patrick S Elliott¹, Janas M Harrington², Seán R Millar², James D Otvos³, Ivan J Perry², Catherine M Phillips⁴

Affiliations

¹ School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Ireland.
² School of Public Health, University College Cork, Cork, Ireland.
³ Lipoprotein Metabolism Laboratory, Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
⁴ School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Ireland; School of Public Health, University College Cork, Cork, Ireland. Electronic address: catherine.phillips@ucd.ie.

PMID: 37552902
DOI: 10.1016/j.atherosclerosis.2023.117190

Abstract

Background and aims: Plant-based diets (PBDs) are associated with favourable lipid profiles and cardiometabolic outcomes. However, limited data regarding PBD indices (PDIs) and lipoprotein subclasses exist. We examined overall PDI, healthful PDI (hPDI) and unhealthful PDI (uPDI) associations with lipid and lipoprotein profiles.

Methods: This cross-sectional analysis includes 1,986 middle- to older-aged adults from the Mitchelstown Cohort. The PDI, hPDI and uPDI scores were calculated from validated food frequency questionnaires. Higher PDI, hPDI and uPDI scores indicate a more PBD, healthful PBD and unhealthful PBD, respectively. Lipoprotein particle size and subclass concentrations were measured using nuclear magnetic resonance spectroscopy. Relationships between PDIs and lipid and lipoprotein profiles were examined via correlation and regression analyses adjusted for covariates.

Results: In fully adjusted regression analyses, higher PDI scores were associated with lower high-density lipoprotein (HDL) cholesterol concentrations and more triglyceride-rich lipoprotein and small very low-density lipoprotein (VLDL) particles. Higher hPDI scores were negatively associated with non-HDL cholesterol concentrations, large VLDL and small HDL particles, the Lipoprotein Insulin Resistance Index (LP-IR) score and VLDL particle size. Higher uPDI scores were associated with lower HDL cholesterol and greater triglyceride concentrations and more medium and large VLDL, total LDL, small LDL and total non-HDL particles, less large LDL and large HDL particles, a greater LP-IR score, greater VLDL particle size and smaller LDL and HDL particle size.

Conclusions: This study provides novel evidence regarding associations between PBD quality and lipoprotein subclasses. A more unhealthful PBD was robustly associated with a more pro-atherogenic lipoprotein profile.

Keywords: Cardiometabolic disease; Diet quality; Lipids; Lipoproteins; Plant foods; Plant-based diets; Subclasses.