Associations between plant-based dietary indices and dietary acid load with cardiovascular risk factors among diabetic p
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ORIGINAL ARTICLE
Associations between plant-based dietary indices and dietary acid load with cardiovascular risk factors among diabetic patients Elnaz Daneshzad 1
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& Farzaneh Jahangir & Javad Heshmati & Bagher Larijani & Pamela J. Surkan & Leila Azadbakht
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Received: 22 January 2020 / Accepted: 10 August 2020 # Research Society for Study of Diabetes in India 2020
Abstract Aim To study how a plant-based diet and dietary acid load (DAL) are related to cardiovascular disease (CVD) risk factors among type 2 diabetic women. Methods In this cross-sectional study, a validated food frequency questionnaire was used to assess the dietary intake of 230 diabetic women. We created a plant-based dietary index (PDI), healthy PDI (hPDI), and unhealthy PDI (uPDI). DAL was calculated based on potential renal acid load (PRAL) and net endogenous acid production (NEAP). Results Patients in the highest tertile of PDI had lower fasting blood sugar (146.74 ± 6.16 vs. 152.87 ± 6.09, p = 0.009) and lower 2-h postprandial glucose (181.76 ± 7.03 vs. 203.01 ± 6.94, p = 0.002). Patients in the highest tertile of PDI were at lower risk of high waist circumference in a crude model (odd ratios: 0.43; 95% CI: 0.19; 0.96, p = 0.039); however, this association did not reach statistical significant after adjustment for confounders. Conclusion Our study suggests that plant-based dietary indices and DAL are not associated with CVD risk factors among diabetic patients. Keywords Dietary acid load . The plant-based dietary index . Cardiovascular risk factors . Diabetic patients . NEAP . PRAL
Introduction Diabetes is a chronic metabolic disorder and an independent risk factor for cardiovascular diseases (CVD) [1]. Poor glycemic Electronic supplementary material The online version of this article (https://doi.org/10.1007/s13410-020-00862-z) contains supplementary material, which is available to authorized users. * Leila Azadbakht [email protected] 1
Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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Department of Nutritional Science, School of Nutritional Science and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
control can lead to micro- and macrovascular complications as well as cardiovascular events [2]. CVD is a major cause of death throughout the world [3]. Ischemic heart disease, hypertensive heart disease, and other cardiovascular diseases rank as the first, fourth, and ninth most common causes of mortality in Iran [4], respectively. Worldwide, it is projected that diabetes prevalence will rise to 10.1% by 20
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