{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:10:02Z","timestamp":1788862202484,"version":"build-2803163510"},"reference-count":69,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"IMPORTANCE<\/jats:title>Plant-based diets are known to improve cardiometabolic risk in the general population, but their effects on people at high risk of cardiovascular diseases (CVDs) remain inconclusive.<\/jats:p><\/jats:sec>OBJECTIVE<\/jats:title>To assess the association of vegetarian diets with major cardiometabolic risk factors, including low-density lipoprotein cholesterol (LDL-C), hemoglobin A1c<\/jats:sub> (HbA1c<\/jats:sub>), systolic blood pressure (SBP), and body weight in people with or at high risk of CVDs.<\/jats:p><\/jats:sec>DATA SOURCES<\/jats:title>This meta-analysis was registered before the study was conducted. Systematic searches performed included Embase, MEDLINE, CINAHL, and CENTRAL from inception until July 31, 2021.<\/jats:p><\/jats:sec>STUDY SELECTION<\/jats:title>Eligible randomized clinical trials (RCTs) that delivered vegetarian diets in adults with or at high risk of CVDs and measured LDL-C, HbA1c<\/jats:sub> or SBP were included. Of the 7871 records screened, 29 (0.4%; 20 studies) met inclusion criteria.<\/jats:p><\/jats:sec>DATA EXTRACTION AND SYNTHESIS<\/jats:title>Two reviewers independently extracted data including demographics, study design, sample size, and diet description, and performed risk of bias assessment. A random-effects model was used to assess mean changes in LDL-C, HbA1c<\/jats:sub>, SBP, and body weight. The overall certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool.<\/jats:p><\/jats:sec>MAIN OUTCOMES AND MEASURES<\/jats:title>Mean differences between groups in changes (preintervention vs postintervention) of LDL-C, HbA1c<\/jats:sub>, and SBP; secondary outcomes were changes in body weight and energy intake.<\/jats:p><\/jats:sec>RESULTS<\/jats:title>Twenty RCTs involving 1878 participants (range of mean age, 28-64 years) were included, and mean duration of intervention was 25.4 weeks (range, 2 to 24 months). Four studies targeted people with CVDs, 7 focused on diabetes, and 9 included people with at least 2 CVD risk factors. Overall, relative to all comparison diets, meta-analyses showed that consuming vegetarian diets for an average of 6 months was associated with decreased LDL-C, HbA1c<\/jats:sub>, and body weight by 6.6 mg\/dL (95% CI, \u221210.1 to \u22123.1), 0.24% (95% CI, \u22120.40 to \u22120.07), and 3.4 kg (95% CI, \u22124.9 to \u22122.0), respectively, but the association with SBP was not significant (\u22120.1 mm Hg; 95% CI, \u22122.8 to 2.6). The GRADE assessment showed a moderate level of evidence for LDL-C and HbA1c<\/jats:sub> reduction.<\/jats:p><\/jats:sec>CONCLUSIONS AND RELEVANCE<\/jats:title>In this study, consuming a vegetarian diet was associated with significant improvements in LDL-C, HbA1c<\/jats:sub> and body weight beyond standard therapy in individuals at high risk of CVDs. Additional high-quality trials are warranted to further elucidate the effects of healthy plant-based diets in people with CVDs.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.25658","type":"journal-article","created":{"date-parts":[[2023,7,25]],"date-time":"2023-07-25T15:44:44Z","timestamp":1690299884000},"page":"e2325658","source":"Crossref","is-referenced-by-count":62,"title":["Vegetarian Dietary Patterns and Cardiometabolic Risk in People With or at High Risk of Cardiovascular Disease"],"prefix":"10.1001","volume":"6","author":[{"given":"Tian","family":"Wang","sequence":"first","affiliation":[{"name":"Charles Perkins Centre, Faculty of Medicine and Health School of Life and Environmental Sciences, School of Mathematics and Statistics, University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia M.","family":"Kroeger","sequence":"additional","affiliation":[{"name":"Charles Perkins Centre, Faculty of 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