Cited by 203Nutritional Studies and DietAgriculture Sustainability and Environmental ImpactDietary Effects on Health

Association of Healthful Plant-based Diet Adherence With Risk of Mortality and Major Chronic Diseases Among Adults in the UK

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Thompson, Alysha S., Tresserra-Rimbau, Anna, Karavasiloglou, Nena, Jennings, Amy, Cantwell, Marie, Hill, Claire, Perez-Cornago, Aurora, Bondonno, Nicola P. +4 more·2023·JAMA Network Open

Abstract

Importance: Plant-based diets have gained popularity for both environmental and health reasons, but a comprehensive assessment of their quality in relation to risk of mortality and major chronic diseases is lacking. Objective: To examine whether healthful vs unhealthful plant-based dietary patterns are associated with mortality and major chronic diseases among UK adults. Design, Setting, and Participants: This prospective cohort study used data from adults in the UK Biobank, a large-scale population-based study. Participants were recruited between 2006 and 2010 and followed up using record linkage data until 2021; follow-up for different outcomes ranged between 10.6 and 12.2 years. Data analysis was conducted from November 2021 to October 2022. Exposures: Adherence to a healthful vs unhealthful plant-based diet index (hPDI vs uPDI) derived from 24-hour dietary assessments. Main Outcomes and Measures: The main outcomes were hazard ratios (HRs) and 95% CIs of mortality (overall and cause specific), cardiovascular disease (CVD [total, myocardial infarction, ischemic stroke, and hemorrhagic stroke]), cancer (total, breast, prostate, and colorectal), and fracture (total, vertebrae, and hip) across quartiles of hPDI and uPDI adherence. Results: This study included 126 394 UK Biobank participants. They had a mean (SD) age of 56.1 (7.8) years; 70 618 (55.9%) were women. The majority of participants (115 371 [91.3%]) were White. Greater adherence to the hPDI was associated with lower risks of total mortality, cancer, and CVD, with HRs (95% CIs) of 0.84 (0.78-0.91), 0.93 (0.88-0.99), and 0.92 (0.86-0.99), respectively, for participants in the highest hPDI quartile compared with the lowest. The hPDI was also associated with lower risks of myocardial infarction and ischemic stroke, with HRs (95% CIs) of 0.86 (0.78-0.95) and 0.84 (0.71-0.99), respectively. By contrast, higher uPDI scores were associated with higher risks of mortality, CVD, and cancer. The associations observed did not show heterogeneity across strata of sex, smoking status, body mass index, or socioeconomic status or with polygenic risk scores (specifically with regard to CVD end points). Conclusions and Relevance: The findings of this cohort study of middle-aged UK adults suggest that a diet characterized by high-quality plant-based foods and lower intakes of animal products may be beneficial for health, irrespective of established chronic disease risk factors and genetic predisposition.

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  • Abundant evidence from observational and intervention studies indicates that vegan diets are associated with improved cardiovascular health and decreased risk of cardiovascular disease.

    “Abundant evidence from observational and intervention studies7,8,9,10,11,12,13 indicates that vegan diets are associated with improved cardiovascular health and decreased risk of cardiovascular disease, likely because of the higher daily consumption of vegetables and fruits, legumes, whole grains and nuts, and seeds compared with other different types of dietary patterns.14”

    From Cardiometabolic Effects of Omnivorous vs Vegan Diets in Identical Twins: A Randomized Clinical Trial (2023) · cites this paper as [12]

    The Introduction (page unavailable) reports lower risks of ischemic heart disease and CVD mortality among people following vegan or vegetarian diets, and the Discussion reports lower CVD risk with healthful plant-based diets. The paper does not report intervention findings supporting the claim, and it cautions that plant-based diets are not beneficial regardless of composition. (LLM, conf=0.85)

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Research works printed but not linked: 2

  1. [8]World Health Organization. Plant-Based Diets and Their Impact on Health, Sustainability and the Environment: A Review of the Evidence. World Health Organization European Office for the Prevention and Control of Noncommunicable Diseases; 2021.
  2. [21]Thompson DJ, Wells D, Selzam S,. UK Biobank release and systematic evaluation of optimised polygenic risk scores for 53 diseases and quantitative traits. medRxiv. Preprint posted online August 1, 2022. doi: 10.1101/2022.06.16.22276246 · DOI · Paper page

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Authors
Thompson, A. S., Tresserra-Rimbau, A., Karavasiloglou, N., Jennings, A., Cantwell, M., Hill, C., Perez-Cornago, A., Bondonno, N. P., Murphy, N., Rohrmann, S., Cassidy, A., & Kühn, T.
Affiliations
  • Queen's University Belfast (GB)
  • Institute for Global Food Security, School of Biological Sciences, Queen’s University, Belfast, United Kingdom
  • University of Zurich (CH)
  • Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
  • Edith Cowan University (AU)
  • Centre international de recherche sur le cancer (FR)
Corresponding author
Cassidy, Aedín
Venue
JAMA Network Open
Published
2023-03-28
Volume
6
Issue
3
Pages
e234714
ISSN
2574-3805 (ISSN-L)
OpenAlex
W4361224334
Cited by
203
References
44
Citations by year
2026: 45 · 2025: 73 · 2024: 60 · 2023: 25
FWCI
51.97
Type
journal article
Language
en
Open access
Licence
other-oa
Locations
  • JAMA Network Open (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Portal (Queen's University Belfast) (acceptedVersion, other-oa)
  • Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, cc-by-nc-nd)
  • Australasian Journal of Paramedicine (submittedVersion, cc-by)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion, cc-by)
  • Zurich Open Repository and Archive (University of Zurich)
Funders
  • World Health Organization
  • Wellcome Trust
  • Scottish Government
  • Department for the Economy
  • Cancer Research UK (29017)
  • National Institute for Health and Care Research
  • British Heart Foundation
  • Northwest Regional Development Agency
  • Medical Research Council
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Physical Sciences › Environmental Science › Ecology › Agriculture Sustainability and Environmental Impact
  • Health Sciences › Medicine › Physiology › Dietary Effects on Health
Keywords
plant-based diet, healthful plant-based diet index, unhealthful plant-based diet index, dietary habits, mortality, cardiovascular disease, cancer, fracture, myocardial infarction, ischemic stroke, hemorrhagic stroke, breast cancer, prostate cancer, colorectal cancer, UK Biobank, dietary adherence, UK adults, fracture risk
MeSH terms
Animals, United Kingdom, Myocardial Infarction, Neoplasms, Plants, Prospective Studies, Diet, Vegetarian, Cohort Studies

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