FIGURE 2.

Conceptual pathways linking plant-based diets, HDL cholesterol, and cardiometabolic risk. This figure summarizes plausible pathways through which the adoption of a healthy plant-based dietary pattern may influence lipid markers and overall cardiometabolic risk. Plant-based diets may improve atherogenic lipid markers through lower saturated fat and dietary cholesterol intake, higher fiber and phytosterol intake, and changes in body weight. Modest reductions in HDL cholesterol may occur in some settings, particularly with lower total fat intake, higher-carbohydrate substitution, or short-term weight loss, but should not be interpreted in isolation. Clinical interpretation should prioritize apoB, non–HDL cholesterol, LDL cholesterol, triglycerides, insulin resistance, weight trajectory, and, where available, markers of HDL function. The dashed arrow indicates that lower HDL cholesterol may require contextual interpretation rather than implying an adverse effect. apoB, apolipoprotein B.