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Cited by 437Nutritional Studies and DietAgriculture Sustainability and Environmental ImpactCardiovascular Health and Risk Factors

Plant-Based Diets Are Associated with a Lower Risk of Incident Cardiovascular Disease, Cardiovascular Disease Mortality, and All-Cause Mortality in a General Population of Middle-Aged Adults

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Kim, Hyunju, Caulfield, Laura E., Garcia‐Larsen, Vanessa, Steffen, Lyn M., Coresh, Josef, Rebholz, Casey M.·2019·Journal of the American Heart Association
DOI 10.1161/jaha.119.012865PMC PMC6759882
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Abstract

Background Previous studies have documented the cardiometabolic health benefits of plant-based diets; however, these studies were conducted in selected study populations that had narrow generalizability. Methods and Results We used data from a community-based cohort of middle-aged adults (n=12 168) in the ARIC (Atherosclerosis Risk in Communities) study who were followed up from 1987 through 2016. Participants' diet was classified using 4 diet indexes. In the overall plant-based diet index and provegetarian diet index, higher intakes of all or selected plant foods received higher scores; in the healthy plant-based diet index, higher intakes of only the healthy plant foods received higher scores; in the less healthy plant-based diet index, higher intakes of only the less healthy plant foods received higher scores. In all indexes, higher intakes of animal foods received lower scores. Results from Cox proportional hazards models showed that participants in the highest versus lowest quintile for adherence to overall plant-based diet index or provegetarian diet had a 16%, 31% to 32%, and 18% to 25% lower risk of cardiovascular disease, cardiovascular disease mortality, and all-cause mortality, respectively, after adjusting for important confounders (all P<0.05 for trend). Higher adherence to a healthy plant-based diet index was associated with a 19% and 11% lower risk of cardiovascular disease mortality and all-cause mortality, respectively, but not incident cardiovascular disease (P<0.05 for trend). No associations were observed between the less healthy plant-based diet index and the outcomes. Conclusions Diets higher in plant foods and lower in animal foods were associated with a lower risk of cardiovascular morbidity and mortality in a general population.

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  • Monounsaturated fatty acids and polyunsaturated fatty acids, in forms of olive oil, nuts and seeds in plant-based dietary regimens, may function as the driving force for amelioration of glucose metabolism, insulin sensitivity, blood lipids, and cardiovascular disease risk in diabetic individuals or the general population.

    “Monounsaturated fatty acids (MUFAs) and polyunsaturated fatty acids (PUFAs), in forms of olive oil, nuts and seeds in plant-based dietary regimens, may function as the driving force for the amelioration of glucose metabolism, insulin sensitivity, blood lipids and CVD risk, observed either in diabetic individuals [17,40,41] or in the general population [42].”

    From Mediterranean diet nutrients to turn the tide against insulin resistance and related diseases (2020) · cites this paper as [42]

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  1. [26]Micha R, Wallace SK, Mozaffarian D. Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus. Circulation. 2010; 121: 2271– 2283. 20479151 PMC2885952

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Authors
Kim, H., Caulfield, L. E., Garcia‐Larsen, V., Steffen, L. M., Coresh, J., & Rebholz, C. M.
Affiliations
  • Johns Hopkins University (US)
  • Center for Human Nutrition Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore MD
  • University of Minnesota (US)
Corresponding author
Rebholz, Casey M.
ORCID
Venue
Journal of the American Heart Association
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2019-08-20
Volume
8
Issue
16
Pages
e012865-e012865
ISSN
2047-9980 (ISSN-L)
DOI
10.1161/jaha.119.012865
PMC
PMC6759882
OpenAlex
W2964742986
Cited by
437
References
45
Citations by year
2026: 46 · 2025: 64 · 2024: 76 · 2023: 61 · 2022: 63 · 2021: 83 · 2020: 38 · 2019: 5
FWCI
43.49
Type
journal article
Language
en
Open access
Licence
cc-by-nc-nd
Locations
  • Journal of the American Heart Association (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • Spiral (Imperial College London) (submittedVersion, other-oa)
Funders
  • National Heart, Lung, and Blood Institute (HHSN268201700004I, R21HL143089, HHSN268201700001I, HHSN268201700005C, HHSN268201700003I, HHSN268201700005I, HHSN268201700001C, HHSN268201700002I, HHSN268201700003C, HHSN268201700002C, HHSN268201700004C)
  • National Institute of Diabetes and Digestive and Kidney Diseases (K01DK107782)
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 › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
Keywords
plant-based diet, cardiovascular disease, cardiovascular mortality, all-cause mortality, plant-based foods, animal food, middle-aged adults, Atherosclerosis Risk in Communities Study
MeSH terms
Diet, Healthy, Cardiovascular Diseases, Cause of Death, Diet, Female, Humans, Male, Middle Aged, Mortality, United States, Diet, Vegetarian, Cohort Studies, Incidence, Proportional Hazards Models

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