Metabolomic signature for Planetary Health Diet adherence: implications for cardiovascular disease risk in the Doetinchem cohort study

Abstract

The planetary health diet (PHD) recommends to limit the intake of animal sourced foods and starchy vegetables and recommends high intake of plant-based foods. Adherence to the PHD has been associated with a lower risk of cardiovascular diseases (CVDs). However, the underlying biological mechanism of this relation is unknown. In our study we develop a metabolomic signature based on the PHD-score of participants, and investigate whether this metabolomic signature is associated with CVD.

Data of 4088 participants (mean age 55.6 (9.90), 48.0% men (n= 1963)) from the Doetinchem Cohort study were used. The PHD-score was assessed using a validated food frequency questionnaire (FFQ). Metabolites were measured at the Nightingale platform, Finland. Least absolute shrinkage and selection operator (LASSO) was used to identify the metabolomic signature (round 4, R4) based on the PHD-score (R4). Cox regression analyses were used to examine association between the identified metabolomic signature and 10-year incidence CVD (R5- 6).

We identified a metabolomic signature, comprised of 45 metabolites. The signature consisted mainly of relative lipoprotein concentrations, but also fatty acids, amino acids, ketone bodies, glycolysis related metabolites, metabolites involved in fluid balance, lipoprotein subclasses, other lipids, and metabolites involved in inflammation. In Cox regressions, the metabolomic signature showed a borderline significant association with CVD incidence after adjustment for age, sex, educational level, and lifestyle factors (smoking, alcohol consumption, and physical activity) [HR = 0.851 (95% CI: 0.704 – 1.029)].

We identified a metabolomic signature which reflects the adherence to the Planetary Health Diet. In Cox regression the metabolomic signature showed borderline significance after adjustment for age, sex, educational level, and lifestyle factors (smoking, alcohol consumption, and physical activity).