Conclusion & Clinical Practice Flashcards
(20 cards)
Core take-home in one sentence?
Diet quality, not just plant quantity, drives CVD risk: hPDI helps pre-diabetes, uPDI harms both pre-diabetes & diabetes.
What HR quantified uPDI harm in pre-diabetes?
Eating the most unhealthy plant foods raised cardiovascular risk by roughly one-sixth compared with the least unhealthy pattern.
What HR quantified uPDI harm in diabetes?
In people with diabetes, the same unhealthy pattern pushed risk up by about one-seventh.
Protective hPDI HR in pre-diabetes?
A high-quality plant diet lowered risk by roughly one-eighth among those with pre-diabetes.
Was hPDI protective in diabetes?
No – the risk was basically unchanged; the diet neither helped nor harmed in this group.
Overall PDI link with CVD?
Null: no meaningful association in either group.
Key dietary mediator driving uPDI harm in diabetes?
Low whole-grain intake explained just over one-third of the excess risk.
Key dietary mediator in pre-diabetes hPDI benefit?
Lower sugary-drink intake accounted for roughly one-third of the benefit.
Top biomarker mediator for uPDI → CVD?
Cystatin C (kidney function marker) explained the largest share of the excess risk.
Practical food swaps to raise hPDI score?
Replace sugary drinks & refined grains with water/tea and whole-grains; add legumes, nuts, fruit, veg.
First clinical priority for patients w/ diabetes?
Cut ultra-processed plant foods and boost whole-grains to blunt uPDI risk.
Why personalise advice for pre- vs diabetes?
hPDI benefit showed only in pre-diabetes; diabetes may require tighter glycaemic & renal focus.
Guideline consistency check – ESC 2023?
ESC already backs more whole-grains, nuts, legumes & fewer sugary drinks—aligns with hPDI.
Barrier: cost perception – rebuttal?
Whole-grain oats, frozen veg & pulses are low-cost; focus on unprocessed staples vs pricey meat-alternatives.
Barrier: portion-size ambiguity – solution?
Translate quintiles into servings (e.g., ≥ 3 half-cup whole-grain portions per day).
Examiner Q: “Why no hPDI effect in diabetes?” – soundbite
Advanced metabolic & renal damage may blunt benefit; cystatin C hints at a kidney-cardio pathway.
Examiner Q: “Clinical action if resources limited?”
Start with one high-impact swap: replace sugary drinks with water or unsweetened tea.
Public-health tweet-length message?
“Not all plant diets protect: skip sugary, refined plants; go whole-grain & veg-rich for heart health—especially if pre-diabetic.”
Implementation tip for dietitians
Use a traffic-light list: green = whole-grains, legumes, nuts; amber = juice, potatoes; red = SSBs, sweets.
Lightning mantra to memorise
“Whole-grains in, SSBs out – uPDI shouts danger!”
