Plasma metabolomic profiles of plant-based dietary indices reveal potential pathways for metabolic syndrome associations
Journal article, 2023

Background and aims: Plant-based dietary patterns have been associated with improved health outcomes. This study aims to describe the metabolomic fingerprints of plant-based diet indices (PDI) and examine their association with metabolic syndrome (MetS) and its components in a Danish population. Methods: The MAX study comprised 676 participants (55% women, aged 18-67 y) from Copenhagen. Sociodemographic and dietary data were collected using questionnaires and three 24-h dietary recalls over one year (at baseline, and at 6 and 12 months). Mean dietary intakes were computed, as well as overall PDI, healthful (hPDI) and unhealthful (uPDI) scores, according to food groups for each plant-based index. Clinical variables were also collected at the same time points in a health examination that included complete blood tests. MetS was defined according to the International Diabetes Federation criteria. Plasma metabolites were measured using a targeted metabolomics approach. Metabolites associated with PDI were selected using random forest models and their relationships with PDIs and MetS were analyzed using generalized linear mixed models. Results: The mean prevalence of MetS was 10.8%. High, compared to low, hPDI and uPDI scores were associated with a lower and higher odd of MetS, respectively [odds ratio (95%CI); hPDI: 0.56 (0.43–0.74); uPDI: 1.61 (1.26–2.05)]. Out of 411 quantified plasma metabolites, machine-learning metabolomics fingerprinting revealed 13 metabolites, including food and food-related microbial metabolites, like hypaphorine, indolepropionic acid and lignan-derived enterolactones. These metabolites were associated with all PDIs and were inversely correlated with MetS components (p < 0.05). Furthermore, they had an explainable contribution of 12% and 14% for the association between hPDI or uPDI, respectively, and MetS only among participants with overweight/obesity. Conclusions: Metabolites associated with PDIs were inversely associated with MetS and its components, and may partially explain the effects of plant-based diets on cardiometabolic risk factors.


Metabolic syndromes

Cardiovascular risk factors

Plant-based diet


Dietary patterns


Fabian Lanuza

University of Barcelona

Centro de Investigación Biomédica en Red Sobre Fragilidad y Envejecimiento Saludable

Tomás Meroño

Centro de Investigación Biomédica en Red Sobre Fragilidad y Envejecimiento Saludable

University of Barcelona

Raul Zamora-Ros

Institut d'Investigació Biomedica de Bellvitge

University of Barcelona

Nicola P. Bondonno

Edith Cowan University

Danish Cancer Research Society Center

Agneta Rostgaard-Hansen

Danish Cancer Research Society Center

Alex Sánchez-Pla

University of Barcelona

Berta Miro

University of Barcelona

Francesc Carmona-Pontaque

University of Barcelona

Gabriele Riccardi

University of Naples Federico II

Anne Tjønneland

Danish Cancer Research Society Center

Rikard Landberg

Chalmers, Life Sciences, Food and Nutrition Science

Jytte Halkjær

Danish Cancer Research Society Center

Cristina Andres-Lacueva

Centro de Investigación Biomédica en Red Sobre Fragilidad y Envejecimiento Saludable

University of Barcelona


0021-9150 (ISSN) 18791484 (eISSN)

Vol. 382 117285

Optimal kost utifrån metabotyp för hälsa och vällevnad

Formas (2016-00314), 2016-01-01 -- 2021-12-31.

Subject Categories

Endocrinology and Diabetes

Public Health, Global Health, Social Medicine and Epidemiology

Nutrition and Dietetics





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