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Original article 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
Khongorzul Ganbatorcid , Bayarmaa Nasan Ulziiorcid , Sangah Shinorcid
Epidemiol Health 2024;e2024035
DOI: https://doi.org/10.4178/epih.e2024035 [Accepted]
Published online: February 28, 2024
Chung-Ang University, Anseong, Korea
Corresponding author:  Sangah Shin,
Email: ivory8320@cau.ac.kr
Received: 16 November 2023   • Revised: 30 January 2024   • Accepted: 20 February 2024
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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.


Epidemiol Health : Epidemiology and Health