Plant-based diets, legumes, and prevalence of cardiometabolic risk factors in the NutriNet-Santé cohort.

PURPOSE

Legumes are protein-rich foods with health benefits and low environmental impact. This study investigated associations between legume consumption, in isolation or as part of plant-based dietary patterns, and cardiometabolic risk factors.

METHODS

This cross-sectional study used a subsample of the NutriNet-Santé cohort who completed three 24-hour dietary recalls at baseline (2009-2011) and underwent clinical and biochemical examinations (2011-2014, N = 16,358). Multivariable-adjusted Poisson regression analyses estimated prevalence ratios (PR) for associations between legume consumption and low high-density lipoprotein (HDL) cholesterol, elevated waist circumference, blood pressure, blood glucose, serum triglycerides, total cholesterol, or low-density lipoprotein (LDL) cholesterol. Associations with healthy and unhealthy plant-based diet indices were also assessed, stratified by ultra-processed food consumption or sex.

RESULTS

High compared to low legume consumption was not significantly associated with lower prevalence of low HDL (PR: 1.18, 95% CI: 0.90; 1.53), elevated waist circumference (PR: 1.01, 95% CI: 0.90; 1.14), blood pressure (PR: 1.01, 95% CI: 0.93; 1.11), blood glucose (PR: 1.13, 95% CI: 0.92; 1.40), serum triglycerides (PR: 1.00, 95% CI: 0.76; 1.30), total cholesterol (PR: 0.97, 95% CI: 0.81; 1.15), or LDL cholesterol (PR: 0.93, 95% CI: 0.79; 1.08). However, adherence to the healthy plant-based diet index was associated with lower prevalences of all risk factors, and the opposite for the unhealthy plant-based diet index. Associations were not modified by ultra-processed food consumption or sex.

CONCLUSIONS

Dietary patterns rich in legumes, whole grains, fruits, vegetables, and nuts were associated with lower prevalences of cardiometabolic risk factors, while legumes in isolation were not.