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J Nutr. 2019 Apr 1;149(4):676-686. doi: 10.1093/jn/nxy301.

Change in Plant-Based Diet Quality Is Associated with Changes in Plasma Adiposity-Associated Biomarker Concentrations in Women.

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Departments of Nutrition, Harvard TH Chan School of Public Health, Boston, MA.
Departments of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA.
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA.



A healthful plant-based diet is associated with lower risk of cardiometabolic diseases. However, it is still unclear whether such benefits are due to its favorable effects on adiposity-associated biomarkers.


We investigated the associations between biomarkers and 3 plant-based diet indices: an overall plant-based diet index (PDI); a healthful plant-based diet index (hPDI); and an unhealthful plant-based diet index (uPDI).


In the Nurses' Health Study II, 831 women [baseline mean age: 45 y; body mass index (BMI, kg/m2): 24.6] were randomly selected from those who provided 2 blood samples in 1996-1999 and 2010-2011 to measure plasma concentrations of adiponectin, leptin, soluble leptin receptor (sOB-R), insulin, retinol-binding protein-4, high-sensitivity C-reactive protein (hsCRP), and interleukin-6 (IL-6). Plant-based diet indices were derived from semiquantitative food frequency questionnaires assessed at each blood collection. Linear mixed models were used to evaluate cross-sectional associations, and general linear models were used to evaluate longitudinal associations.


In cross-sectional analyses with multivariable adjustment including BMI, higher hPDI was associated with lower concentrations of leptin, insulin, and hsCRP, and higher adiponectin and sOB-R concentrations (biomarker differences per 10-point higher hPDI: -7.2%, -10.0%, -13.6%, 3.0%, and 1.9%, respectively; P ≤ 0.025). A higher uPDI was associated with higher concentrations of leptin and insulin (4.4% and 4.8%, respectively; P ≤ 0.048). In longitudinal analyses with multivariable adjustment including weight change, an increase in hPDI (improved plant-based diet quality) was inversely associated with changes in leptin and hsCRP (biomarker changes per 10-point hPDI increase: -7.7% and -17.8%, respectively; P ≤ 0.005), whereas an increase in uPDI (worsened plant-based diet quality) was positively associated with changes in leptin, hsCRP, and IL-6 (10.1%, 13.5%, and 12.4%, respectively; P ≤ 0.021).


Adherence to a healthful plant-based diet is associated with favorable long-term changes in adiposity-associated biomarker concentrations in women.


biomarker; healthful plant-based diet; inflammation; obesity; plant-based diet index

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