Association of time-restricted eating versus a whole-food plant-based diet with metabolic syndrome biomarkers: Results from NHANES 2013–2018

This study utilizes data from the National Health and Nutrition Examination Survey (NHANES) 2014–2018 (n = 29,400) to investigate the association of a whole-food plant-based diet (WFPBD) versus time-restricted eating (TRE) with the components of metabolic syndrome (MetS) and selected macronutrients (carbohydrates, protein, and fiber). Moderation of a WFPBD in the presence of TRE on MetS and its components was assessed. Finally, potential mediation of central adiposity (i.e., waist circumference) on significant associations was evaluated. Key findings indicate that adherence to a WFPBD is significantly associated with beneficial changes in MetS biomarkers in the adjusted model, including lower waist circumference (OR: 0.96, p < 0.001), hyperglycemia (OR: 0.99, p = 0.04), hypertension (OR: 0.97, p < 0.001), low HDL (OR: 0.97, p < 0.001), and MetS risk (OR: 0.97, p < 0.001). No significant moderation effects were detected. Central adiposity mediated up to 51% of the observed significant associations. Our research contributes to the growing body of evidence on the role of a WFPBD in managing MetS and cardiometabolic health. It underscores the potential of a WFPBD in comparison to TRE for the prevention and management of MetS, and suggests potential mechanisms, such as high fiber consumption and reductions in central adiposity, that may explain observed relationships and inform future research.