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Association between plant-based diets and the risk of coronary heart disease predicted using the Framingham Risk Score in Korean men: data from the HEXA cohort study
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Khongorzul Ganbat, Bayarmaa Nasan Ulzii, Sangah Shin
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Epidemiol Health. 2024;e2024035. Published online February 28, 2024
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DOI: https://doi.org/10.4178/epih.e2024035
[Accepted]
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 Abstract
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Abstract
OBJECTIVES
This study investigated the potential correlation between 4 plant-based diet indices and the predicted risk of coronary heart disease (CHD) in Korean men using the Framingham Risk Score.
METHODS The study included 12,356 male participants (aged ≥40 years) from the Health Examinees Study. Dietary intake was estimated using a validated food frequency questionnaire. Four plant-based diet indices were measured, including the overall plant-based diet index, the healthy plant-based diet index (hPDI), the unhealthy plant-based diet index (uPDI), and the pro-vegetarian diet index. Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for the predicted 10-year risk of CHD.
RESULTS The study found that individuals in the highest hPDI quintile had a 19% lower risk score for CHD based on the Framingham Risk Score (model 3, HR=0.801; 95% CI, 0.689–0.930, p for trend=0.0105). In stratified analyses, the highest pro-vegetarian diet index was associated with a lower risk score for CHD in physically active individuals (HR=0.740; 95% CI, 0.588–0.931; p for interaction=0.020). Conversely, the highest uPDI was associated with the highest risk score for CHD in those with a body mass index of ≥25 kg/m² and a waist circumference ≥90 cm.
CONCLUSIONS This prospective cohort study highlights the positive role of adhering to a high hPDI diet in the prevention of CHD in Korean men. Further prospective studies are needed to determine the association between various plant-based diet indices and the risk of CHD in Asian populations with different dietary habits.
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Summary
Korean summary
본 연구는 한국 남성의 관상 동맥 심장 질환(CHD) 위험을 줄이는데 있어서 식이 패턴, 특히 건강한 식물성 식이 지수의 역할이 중요함을 강조한다. 높은 hPDI지수를 가진 사람이 CHD 위험이 유의미하게 19% 감소하는 것은 건강한 식물성 기반 식단 선택이 심혈관 건강에 미칠 수 있는 잠재된 영향력을 강조한다.
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