Trajectories of plant-based diet indices and the associated risk of hypertension among Chinese adults: a cohort study based on the China Health and Nutrition Survey 2004–2015

Abstract Background Plant-based diets have been found to be associated with hypertension. Dietary intake is a dynamic and changing process that can be better characterized by trajectories of dietary indices. However, the associations between plant-based diet trajectories and hypertension over time r...

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Main Authors: Yajie Zhao, Qian Gao, Junyan Zhang, Juping Wang, Tetsuya Araki, Junkang Zhao
Format: Article
Language:English
Published: BMC 2024-12-01
Series:Nutrition Journal
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Online Access:https://doi.org/10.1186/s12937-024-01053-w
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author Yajie Zhao
Qian Gao
Junyan Zhang
Juping Wang
Tetsuya Araki
Junkang Zhao
author_facet Yajie Zhao
Qian Gao
Junyan Zhang
Juping Wang
Tetsuya Araki
Junkang Zhao
author_sort Yajie Zhao
collection DOAJ
description Abstract Background Plant-based diets have been found to be associated with hypertension. Dietary intake is a dynamic and changing process that can be better characterized by trajectories of dietary indices. However, the associations between plant-based diet trajectories and hypertension over time remained unknown. Methods We used data from the China Health and Nutrition Survey 2004–2015 to analyze a cohort of Chinese adults ≥ 18 years of age who had no hypertension at baseline. Plant-based diets were measured by an overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI) based on three 24-hour recalls. Trajectories of PDI, hPDI, and uPDI (2004 to 2011) were identified using group-based trajectory modeling. The associations between trajectories of PDIs and the risk of new-onset hypertension were estimated using Cox proportional hazard models. Results We identified three trajectories for PDI, two for hPDI, and four for uPDI among the 2853 participants with a mean follow-up of 9.6 years. Compared with the PDI “low and stable” class, the PDI “high and decreasing” class had a 23% decreased risk (HR: 0.77; 95% CI: 0.62–0.95) of hypertension. There was no significant association with PDI “low and increasing” class. Compared with the hPDI “low and stable” class, the hPDI “high and stable” class had a 24% decreased risk (HR: 0.76; 95%CI: 0.64–0.91). For uPDI trajectories, compared with the “low and decreasing” class, the “high and increasing,” “high and stable,” and “low and increasing” classes had increased risks of 43% (HR: 1.43; 95% CI: 1.06–1.94), 77% (HR: 1.77; 95% CI: 1.26–2.49), and 72% (HR: 1.72; 95% CI: 1.26–2.33), respectively. Conclusions This study underscores the importance of maintaining high intakes of healthful plant-based diets and low intakes of unhealthful plant-based diets overtime for hypertension prevention.
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spelling doaj-art-11f5b73498ab40a9b2a315fcfd3b56b72024-12-08T12:19:16ZengBMCNutrition Journal1475-28912024-12-0123111110.1186/s12937-024-01053-wTrajectories of plant-based diet indices and the associated risk of hypertension among Chinese adults: a cohort study based on the China Health and Nutrition Survey 2004–2015Yajie Zhao0Qian Gao1Junyan Zhang2Juping Wang3Tetsuya Araki4Junkang Zhao5Laboratory of International Agro-Informatics, Department of Global Agricultural Sciences, Graduate School of Agricultural and Life Sciences, The University of TokyoDepartment of Health Statistics, School of Public Health, Shanxi Medical UniversityShanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi HospitalDepartment of Health Statistics, School of Public Health, Shanxi Medical UniversityLaboratory of International Agro-Informatics, Department of Global Agricultural Sciences, Graduate School of Agricultural and Life Sciences, The University of TokyoShanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi HospitalAbstract Background Plant-based diets have been found to be associated with hypertension. Dietary intake is a dynamic and changing process that can be better characterized by trajectories of dietary indices. However, the associations between plant-based diet trajectories and hypertension over time remained unknown. Methods We used data from the China Health and Nutrition Survey 2004–2015 to analyze a cohort of Chinese adults ≥ 18 years of age who had no hypertension at baseline. Plant-based diets were measured by an overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI) based on three 24-hour recalls. Trajectories of PDI, hPDI, and uPDI (2004 to 2011) were identified using group-based trajectory modeling. The associations between trajectories of PDIs and the risk of new-onset hypertension were estimated using Cox proportional hazard models. Results We identified three trajectories for PDI, two for hPDI, and four for uPDI among the 2853 participants with a mean follow-up of 9.6 years. Compared with the PDI “low and stable” class, the PDI “high and decreasing” class had a 23% decreased risk (HR: 0.77; 95% CI: 0.62–0.95) of hypertension. There was no significant association with PDI “low and increasing” class. Compared with the hPDI “low and stable” class, the hPDI “high and stable” class had a 24% decreased risk (HR: 0.76; 95%CI: 0.64–0.91). For uPDI trajectories, compared with the “low and decreasing” class, the “high and increasing,” “high and stable,” and “low and increasing” classes had increased risks of 43% (HR: 1.43; 95% CI: 1.06–1.94), 77% (HR: 1.77; 95% CI: 1.26–2.49), and 72% (HR: 1.72; 95% CI: 1.26–2.33), respectively. Conclusions This study underscores the importance of maintaining high intakes of healthful plant-based diets and low intakes of unhealthful plant-based diets overtime for hypertension prevention.https://doi.org/10.1186/s12937-024-01053-wPlant-based diet indicesTrajectoriesHypertensionChina Health and Nutrition SurveyCohort
spellingShingle Yajie Zhao
Qian Gao
Junyan Zhang
Juping Wang
Tetsuya Araki
Junkang Zhao
Trajectories of plant-based diet indices and the associated risk of hypertension among Chinese adults: a cohort study based on the China Health and Nutrition Survey 2004–2015
Nutrition Journal
Plant-based diet indices
Trajectories
Hypertension
China Health and Nutrition Survey
Cohort
title Trajectories of plant-based diet indices and the associated risk of hypertension among Chinese adults: a cohort study based on the China Health and Nutrition Survey 2004–2015
title_full Trajectories of plant-based diet indices and the associated risk of hypertension among Chinese adults: a cohort study based on the China Health and Nutrition Survey 2004–2015
title_fullStr Trajectories of plant-based diet indices and the associated risk of hypertension among Chinese adults: a cohort study based on the China Health and Nutrition Survey 2004–2015
title_full_unstemmed Trajectories of plant-based diet indices and the associated risk of hypertension among Chinese adults: a cohort study based on the China Health and Nutrition Survey 2004–2015
title_short Trajectories of plant-based diet indices and the associated risk of hypertension among Chinese adults: a cohort study based on the China Health and Nutrition Survey 2004–2015
title_sort trajectories of plant based diet indices and the associated risk of hypertension among chinese adults a cohort study based on the china health and nutrition survey 2004 2015
topic Plant-based diet indices
Trajectories
Hypertension
China Health and Nutrition Survey
Cohort
url https://doi.org/10.1186/s12937-024-01053-w
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