Association between plant-based diets and blood pressure in the INTERMAP study.
Daviglus, Martha L
Dyer, Alan R
Van Horn, Linda
INTERMAP Research Group
BMJ Nutr Prev Health
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Aljuraiban, G., Chan, Q., Gibson, R., Stamler, J., Daviglus, M. L., Dyer, A. R., Miura, K., et al. (2020). Association between plant-based diets and blood pressure in the INTERMAP study.. BMJ Nutr Prev Health, 3 (2), 133-142. https://doi.org/10.1136/bmjnph-2020-000077
BACKGROUND: Plant-based diets are associated with a lower risk of cardiovascular diseases; however, little is known how the healthiness of the diet may be associated with blood pressure (BP). We aimed to modify three plant -based diet indices: overall plant-based diet index (PDI), healthy PDI (hPDI), and unhealthy PDI (uPDI) according to country-specific dietary guidelines to enable use across populations with diverse dietary patterns - and assessed their associations with BP. DESIGN: We used cross-sectional data including 4,680 men and women ages 40-59y in Japan, China, the United Kingdom, and the United States from the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP). During four visits, eight BP measurements, and four 24-h dietary recalls were collected. Multivariable regression coefficients were estimated, pooled, weighted, and adjusted extensively for lifestyle/dietary confounders. RESULTS: Modified PDI was not associated with BP. Consumption of hPDI higher by 1SD was inversely associated with systolic (-0.82 mm Hg;95% CI:-1.32,-0.49) and diastolic BP (-0.49 mm Hg; 95% CI:-0.91, -0.28). In contrast, consumption of an uPDI was directly associated with systolic (0.77 mm Hg;95% CI:0.30,1.20). Significant associations between hPDI with BP were attenuated with separate adjustment for vegetables and whole grains; associations between uPDI and BP were attenuated after adjustment for refined grains, sugar-sweetened beverages, and meat. CONCLUSION: An hPDI is associated with lower BP while a uPDI is adversely related to BP. Plant-based diets rich in vegetables and whole grains and limited in refined grains, sugar-sweetened beverages, and total meat may contribute to these associations. In addition to current guidelines, the nutritional quality of consumed plant foods is as important as limiting animal-based components. TRIAL REGISTRATION NUMBER: The observational INTERMAP study was registered at www.clinicaltrials.gov as NCT00005271.
INTERMAP Research Group
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)
National Institute for Health Research (NIHRDH-IS-BRC-1215-20014)
External DOI: https://doi.org/10.1136/bmjnph-2020-000077
This record's URL: https://www.repository.cam.ac.uk/handle/1810/311723
Attribution-NonCommercial 4.0 International
Licence URL: https://creativecommons.org/licenses/by-nc/4.0/