Dietary and Lifestyle Patterns and Their Associations with Cardiovascular and Inflammatory Biomarkers in Vegans, Vegetarians, Pescatarians, and Omnivores: A Cross-Sectional Study

<b>Background:</b> Plant-based diets are associated with reduced cardiometabolic risk, yet the influence of lifestyle behaviors on these benefits remains insufficiently understood. <b>Objective:</b> To assess the combined impact of dietary patterns and lifestyle behaviors on body composition, lipid profiles, and inflammatory biomarkers in healthy young adults. <b>Methods:</b> In this cross-sectional study, 155 participants aged 18-39 years were categorized into four dietary groups: vegans (<i>n</i> = 48), vegetarians (<i>n</i> = 49), pescatarians (<i>n</i> = 23), and omnivores (<i>n</i> = 35). Body composition was measured using bioelectrical impedance analysis. Blood samples were analyzed for lipid parameters, apolipoproteins, lipoprotein(a), and inflammatory markers (IL-6, TNF-α, and hsCRP). Participants were further stratified based on behavioral factors, including physical activity, sleep duration, smoking, and alcohol consumption. <b>Results:</b> Vegans demonstrated the lowest body fat and visceral adipose tissue, along with the second-highest skeletal muscle mass. Significant intergroup differences were observed in total cholesterol (<i>p</i> = 0.032), HDL-C (<i>p</i> = 0.006), and triacylglycerols (<i>p</i> = 0.005). Among vegans, suboptimal lifestyle behaviors were associated with elevated LDL-C, non-HDL-C, and homocysteine levels (<i>p</i> < 0.05). Positive correlations were identified between ApoB and BMI (r = 0.517) and between IL-6 and waist-to-hip ratio (ρ = 0.499). <b>Conclusions:</b> A vegan diet, when combined with healthy lifestyle behaviors, is associated with favorable body composition and lipid profiles. Regardless of dietary pattern, maintaining a healthy body weight and minimizing visceral adiposity are essential for reducing cardiovascular and inflammatory risk. These research findings underscore the importance of integrating high-quality plant-based diets with lifestyle modifications and advanced modeling approaches.