Plant-Based Diet Indices in Relation to Novel Cardiovascular Risk Factors, Major Adverse Cardiovascular Events, and Novel Anthropometric Indices in Patients With Type 2 Diabetes Publisher Pubmed



Mahjourian MM ; Nasliesfahani E ; Zeinalabedini M ; Seyedmahalleh MH ; Salehi Z ; Azadbakht L
Source: Scientific Reports Published:2026

Abstract

This study aimed to investigate the association between adherence to plant-based dietary patterns and (i) novel risk factors for cardiovascular disease (CVD), (ii) major adverse cardiovascular events (MACE), and (iii) novel anthropometric indices among patients with type 2 diabetes. This cross-sectional study included a randomly selected sample of 490 adults with type 2 diabetes. Dietary intake was assessed using a validated food frequency questionnaire (FFQ), and three plant-based diet indices were calculated: the overall Plant-Based Diet Index (PDI), the healthful PDI (hPDI), and the unhealthful PDI (uPDI). Novel cardiovascular risk factors, including Castelli Risk Index 1 (CRI-1), Castelli Risk Index 2 (CRI-2), lipid accumulation product (LAP), atherogenic index of plasma (AIP), and CHOLINDEX (CI), were evaluated. MACE were defined as the occurrence of myocardial infarction, stroke, hospitalization due to heart failure, angioplasty, or bypass surgery. Novel anthropometric indices assessed included the Body Roundness Index (BRI), Abdominal Volume Index (AVI), and A Body Shape Index (ABSI). Associations between plant-based diet indices and study outcomes were analyzed using multivariable logistic regression models. Higher adherence to uPDI was associated with elevated AVI (OR = 1.64; 95% CI: 1.01–2.65; P = 0.042). Participants in the highest tertile of the hPDI had significantly lower CI (OR = 0.42; 95% CI: 0.23–0.76; P = 0.004) and CRI-2 (OR = 0.43; 95% CI: 0.23–0.76; P = 0.004). Moreover, greater adherence to the PDI was associated with a reduced likelihood of bypass surgery (OR = 0.49; 95% CI: 0.24–0.99; P = 0.044). Greater adherence to hPDI was associated with more favorable CVD risk profiles, whereas higher uPDI was linked to increased AVI. Additionally, higher overall PDI was associated with reduced odds of bypass surgery. These associations require confirmation in prospective studies. © The Author(s) 2025.