Association between plant-based diets and blood pressure in the INTERMAP study.
Association between plant-based diets and blood pressure in the INTERMAP study.
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DOI：
10.1136/bmjnph-2020-000077
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发表时间：
2020-12
影响因子：
--
通讯作者：
INTERMAP Research Group
中科院分区：
文献类型：
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作者：
Aljuraiban G;Chan Q;Gibson R;Stamler J;Daviglus ML;Dyer AR;Miura K;Wu Y;Ueshima H;Zhao L;Van Horn L;Elliott P;Oude Griep LM;INTERMAP Research Group
以植物为基础的饮食与心血管疾病的风险较低有关;然而，人们对饮食的健康如何与血压（BP）相关知之甚少。我们的目标是根据国家特定的饮食指南修改三种植物性饮食指数：总体植物性饮食指数（PDI），健康PDI（hPDI）和不健康PDI（uPDI），以使其能够在具有不同饮食模式的人群中使用-并评估其与BP的相关性。我们使用了来自MAcro/微量营养素和血压国际研究（INTERMAP）的横断面数据，包括日本、中国、英国和美国4，680名年龄在40- 59岁之间的男性和女性。在四次访问期间，收集了八次BP测量和四次24小时饮食回忆。对多变量回归系数进行估计、汇总、加权，并对生活方式/饮食混杂因素进行广泛调整。改良PDI与血压无相关性。1 SD时hPDI消耗量较高与收缩压（-0.82 mm Hg;95% CI：-1.32，-0.49）和舒张压（-0.49 mm Hg; 95% CI：-0.91，-0.28）呈负相关。相反，uPDI的消耗与收缩压直接相关（0.77 mm Hg;95% CI：0.30，1.20）。通过对蔬菜和全谷物进行单独调整，hPDI与BP之间的显着相关性减弱;在对精制谷物、含糖饮料和肉类进行调整后，uPDI与BP之间的相关性减弱。hPDI与较低的BP相关，而uPDI与BP负相关。富含蔬菜和全谷物的植物性饮食，以及有限的精制谷物、含糖饮料和全肉饮食可能会导致这些关联。除了目前的指导方针，消费植物性食品的营养质量与限制动物性成分同样重要。观察性INTERMAP研究在www.clinicaltrials.gov注册为NCT 00005271。
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. 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. 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. 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. The observational INTERMAP study was registered at www.clinicaltrials.gov as NCT00005271.