Association between dietary phytochemical index, cardiometabolic risk factors and metabolic syndrome in Switzerland. The CoLaus study

Magda Gamba; Zayne M Roa-Diaz; Peter Francis Raguindin; Marija Glisic; Arjola Bano; Taulant Muka; Oscar H Franco; Pedro Marques-Vidal

doi:10.1016/j.numecd.2023.07.018

Association between dietary phytochemical index, cardiometabolic risk factors and metabolic syndrome in Switzerland. The CoLaus study

Nutr Metab Cardiovasc Dis. 2023 Nov;33(11):2220-2232. doi: 10.1016/j.numecd.2023.07.018. Epub 2023 Jul 17.

Authors

Magda Gamba¹, Zayne M Roa-Diaz², Peter Francis Raguindin³, Marija Glisic⁴, Arjola Bano⁵, Taulant Muka⁶, Oscar H Franco⁷, Pedro Marques-Vidal⁸

Affiliations

¹ Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Bern, Switzerland. Electronic address: magda.gamba@ispm.unibe.ch.
² Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Bern, Switzerland.
³ Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland; Swiss Paraplegic Research, Nottwil, Switzerland; Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
⁴ Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland; Swiss Paraplegic Research, Nottwil, Switzerland.
⁵ Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland; Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
⁶ Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
⁷ Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland; Department of Global Public Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
⁸ Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.

PMID: 37598028
DOI: 10.1016/j.numecd.2023.07.018

Abstract

Background and aims: Plant-based diets are associated with reduced cardiometabolic risk factors (CRFs) and lower risk of metabolic syndrome (MetS), probably via phytochemicals acting synergistically. However, dietary phytochemical content estimation is challenging; therefore, the dietary phytochemical index (DPI) was proposed as a practical way to assess total dietary phytochemical content from phytochemical-rich foods (PRFs). We evaluated the association between DPI with CRFs and MetS and its components.

Methods and results: Cross-sectional analysis of 2009-2012 data of Colaus cohort study (Lausanne, Switzerland), including 3879 participants (mean age 57.6 ± 10.4 years, 53.5% women). Dietary intake was assessed via a validated food frequency questionnaire. DPI was calculated as the total energy intake percentage obtained from PRFs consumption and assessed as quartiles. Associations were determined using multivariable linear and logistic regression for CRFs and MetS, respectively. Median DPI value was 25.5 (interquartile range: 17.7-34.6). After multivariable-adjusted analyses, significant inverse associations were observed between the last two highest DPI quartiles and waist circumference (WC), body mass index (BMI), insulin, leptin, and hs-CRP. No significant associations were observed for MetS or its components except for central obesity, as subjects in the highest DPI quartile had lower odds (OR: 0.78; 95% CI: 0.62, 0.97) than those in lowest quartile.

Conclusion: A diet high in PRFs assessed via DPI is associated with lower WC, BMI, insulin, leptin, hs-CRP values, and lower odds of central obesity, indicating a potential protective effect of phytochemical intake on these CRFs and highlighting the importance of high PRFs intake in promoting cardiometabolic health.

Keywords: Cardiometabolic risk factors; Dietary phytochemical index; Metabolic syndrome; Phytochemical-rich foods.