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. 2024 Jan 8:10:1305755.
doi: 10.3389/fnut.2023.1305755. eCollection 2023.

The association between plant-based diet indices and metabolic syndrome: a systematic review and dose-response meta-analysis

Ali Nikparast  1   2 , Elahe Etesami  3   4 , Jamal Rahmani  4 , Nazgoli Rafiei  2 , Matin Ghanavati  5
Affiliations

The association between plant-based diet indices and metabolic syndrome: a systematic review and dose-response meta-analysis

Ali Nikparast et al. Front Nutr. .

Abstract

Aim/introduction: The prevalence of metabolic syndrome (MetS) and its components have markedly increased worldwide. Among lifestyle factors introduced to lower the risk of MetS, healthy dietary patterns have gained considerable attention. This study aimed to assess the association between adherence to plant-based diet indices including O-PDI (overall plant-based diet index), H-PDI (healthy plant-based diet index), U-PDI (unhealthy plant-based diet index), and risk of MetS development.

Methods: To find related observational studies which assessed the association between Plant-based Diet indices and risk of MetS development, PubMed/Medline, Scopus, and Web of Science databases were searched from January 2016 to November 2023. A random effects model was used to estimate pooled odds ratios (OR) and 95% confidence intervals (95% CI). To assess the heterogeneity of included studies, the I2 index was used.

Results: Nine studies including 34,953 participants from the initial 288 studies were recognized to include in this meta-analysis study. According to pooled analysis, there was a significant relationship between the adherence to H-PDI and the lower risk of MetS (ES: 0.81; 95% CI: 0.67, 0.97; I2 = 77.2%, p < 0.001), while greater adherence to U-PDI was associated with 27% increases in the risk of MetS (ES: 1.27; 95% CI: 1.05, 1.54; I2 = 76.8%, p < 0.001). According to our analysis of the association between adherence to PDIs and the risk of MetS components, greater adherence to O-PDI and H-PDI was significantly associated with a higher risk of elevated FBS and obesity, respectively. As well, greater adherence to U-PDI was significantly associated with a higher risk of obesity, hypertriglyceridemia, low HDL-C, and elevated FBS.

Conclusion: Our results highlighted the importance of food choices in the context of a plant-based dietary pattern, indicating that adherence to unhealthy plant-based dietary patterns rich in less healthful carbohydrates may induce the risk of MetS development.

Systematic review registration: PROSPERO CRD42023428981.

Keywords: PDI; dose–response; metaanalysis; metabolic syndrome; metabolic syndrome components; plant-based diet index.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of included studies.
Figure 2
Figure 2
Dose-response curves from the random-effect meta-analysis of plant-based diet indices and odds of metabolic syndrome. (A) The dose-response association between overall plant-based diet index and odds of metabolic syndrome. (B) The dose-response association between healthy plant-based diet index and odds of metabolic syndrome. (C) The dose-response association between unhealthy plant-based diet index and odds of metabolic syndrome.
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