Abstract TH920: Plant-based Diet Quality and Cardiometabolic Biomarkers in Pregnant U.S. Women

Introduction: Evidence suggests that high quality plant-based diets are associated with favorable cardiometabolic outcomes. However, there is no consensus on the optimal measure to assess the quality of plant-based diet. Furthermore, little is known about how plant-based diet quality relates to cardiometabolic health in pregnant women. Hypothesis: We assessed the hypothesis that plant-based diet quality is associated with cardiometabolic biomarkers in pregnant women, with “healthy” plant foods linked to more favorable biomarker profiles. Methods: Data from pregnant women who participated in seven cycles (2005 to 2020 pre-pandemic) of the cross-sectional National Health and Nutrition Examination Survey (NHANES) were used to calculate six independent plant-based diet quality indices. Multivariable log-linear regression models were used to assess associations between these indices and cardiometabolic biomarkers, adjusting for age, race/ethnicity, education, and ratio of family income to poverty. Results: Dietary and cardiometabolic biomarker data were available for 580 pregnant women. Higher plant-based diet quality index values, independent of the index used, were positively associated with high-density lipoprotein cholesterol (HDL-C) concentrations, and negatively associated with triglyceride (TG)/HDL-C ratios. Additionally, those indices that accounted for plant foods quality were also associated with lower fasting insulin and TG concentrations, and homeostatic model assessment for insulin resistance (HOMA-IR). Conclusions: In this NHANES cohort of pregnant women, higher values of all plant-based diet indices were associated with more favorable biomarkers of cardiometabolic health. Those plant-based diet indices that emphasized the quality of plant foods rather than penalizing the inclusion of animal foods were more strongly associated with cardiometabolic health biomarkers.