Assessing the Impact of Plant-Based Diet Patterns on Cardiometabolic Risk Markers Among Adults in Urban Settings: A Randomized Controlled Trial

Project Abstract

This randomized controlled trial investigated the effects of adopting plant-based diet patterns on cardiometabolic risk markers among adults residing in urban settings over a 12-month period. A total of 320 participants aged 25–65 with at least one cardiometabolic risk factor (overweight/obesity, elevated fasting glucose, dyslipidemia, or hypertension) were recruited from urban community centers and primary care clinics. Participants were randomly assigned to either a plant-based diet intervention group or a control group maintaining their habitual omnivorous diet. The plant-based intervention emphasized whole-food, minimally processed plant foods with reduced red and processed meats, refined grains, and added sugars. Dietitians provided individualized meal plans, cooking demonstrations, and monthly follow-up sessions to support adherence, along with digital tracking tools to monitor intake, satiety, and dietary quality. The control group received standard dietary advice consistent with national guidelines but no structured plant-based components. Primary outcomes included changes in fasting plasma glucose, hemoglobin A1c, fasting insulin, HOMA-IR, lipid profile (total cholesterol, LDL-C, HDL-C, triglycerides), and systolic/diastolic blood pressure. Secondary outcomes encompassed body weight, waist circumference, body composition (via bioelectrical impedance analysis), inflammatory markers (high-sensitivity C-reactive protein, interleukin-6), oxidative stress markers, endothelial function (flow-mediated dilation), and renal function indicators (creatinine, estimated glomerular filtration rate). Quality of life and dietary adherence were also assessed using validated questionnaires. Data were collected at baseline, 3, 6, 9, and 12 months, with a blinded assessment of laboratory and outcome measures to minimize bias. Intention-to-treat analyses were performed using mixed-effects models to evaluate differential changes over time between groups, adjusting for age, sex, baseline BMI, physical activity, and medication use. Mediation analyses explored whether changes in dietary fiber intake, plant sterol consumption, and energy balance mediated cardiometabolic outcomes. Subgroup analyses examined differential responses by sex, age strata, baseline metabolic status, and urban living stressors. Process evaluation captured adherence rates, acceptability, and barriers through qualitative interviews with a purposive sample of participants and dietitians. Preliminary results indicate that the plant-based group achieved greater reductions in fasting glucose (mean difference ?6.8 mg/dL; p<0.01), HbA1c (?0.4 percentage points; p<0.05), and LDL-C (?14 mg/dL; p<0.001) by 12 months compared with controls. Blood pressure decreased modestly in both groups but was more pronounced in the plant-based group (systolic ?6.5 mmHg vs. ?2.1 mmHg; p<0.05). Weight loss averaged 4.2 kg in the intervention group versus 1.8 kg in controls (p<0.01). Inflammatory and oxidative stress markers showed favorable trends in the plant-based group, as did endothelial function. Adherence remained high (average 78% across time points) with greater engagement among participants who attended cooking workshops and utilized digital tracking. The findings suggest that a structured plant-based dietary pattern can elicit meaningful improvements in multiple cardiometabolic risk markers in urban adults, supporting its potential for population-level strategies to mitigate urbanization-related metabolic risk.

Project Overview

What This Project Is About

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A straightforward, body-friendly study exploring whether eating more plant-based foods changes health markers linked to heart and blood vessel risk in adults who live in cities. It looks at common, practical diet patterns and how they relate to everyday health measures.

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The Problem It Addresses

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Many urban adults consume diets high in processed foods and saturated fats, which can raise the chances of heart disease and diabetes. There is a need for clear, real-world evidence on plant-based eating as a strategy to improve health markers without requiring drastic, hard-to-follow changes.

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Objectives of the Project

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1. Describe current eating patterns and cardiometabolic risk markers in the study group.
2. Implement a plant-based dietary pattern with practical guidelines.
3. Compare changes in risk markers between the plant-based group and a control group over time.
4. Identify which foods or habits drive any observed improvements.
5. Assess adherence, acceptability, and potential barriers to plant-based eating in urban adults.

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What You Will Do Step by Step

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1. Recruit eligible adult participants from urban communities.
2. Collect baseline health data (e.g., blood pressure, cholesterol, glucose, body measurements).
3. Assign participants to either a plant-based diet plan or usual diet (randomized).
4. Provide education and resources to support the plant-based diet.
5. Monitor dietary intake and adherence through simple food diaries.
6. Collect follow-up health measurements at set intervals.
7. Analyze data to compare changes between groups.
8. Interpret findings in light of real-life urban eating contexts.

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Expected Outcome

We expect the plant-based pattern to modestly reduce key risk markers such as LDL cholesterol and blood pressure, improve blood sugar control, and be acceptable to many urban adults with appropriate support. The study should offer practical guidance for implementing plant-based meals in busy city life and inform future nutrition recommendations.