Researchers have recently published a study in the JAMA Network Open Journal investigating the link between a healthful plant-based diet and mortality risk. As the popularity of plant-based diets continues to rise, it is believed that such diets may offer numerous health benefits, including a lower likelihood of developing cardiovascular disease, diabetes, and mortality.
Although research suggests that limiting intake of animal-based and processed plant-based foods in a healthful plant-based diet can decrease risks of chronic diseases, a comprehensive assessment of the quality of such diets in relation to mortality risk is still needed.
To determine the potential correlation between healthful and unhealthful plant-based diet (PBD) patterns and their association with mortality rates and major chronic diseases, the researchers in this study analyzed data from the UK Biobank. This prospective study consisted of a population-based sample of over 500,000 individuals aged between 40 and 69 years who attended one of the 22 assessment centers in England, Wales, and Scotland between 2006 and 2010, where they underwent a thorough baseline assessment. To develop the healthful PBD index (hPDI) and the unhealthful PBD index (uPDI), the study utilized the Oxford WebQ instrument to analyze the average food consumption derived from at least two 24-hour dietary evaluations.
The hPDI and uPDI were scored based on a system that assigned positive scores to healthy plant-based foods and negative scores to less healthy plant-based foods and animal-derived foods. The uPDI was scored in opposition to the hPDI, with the intakes of food groups exceeding zero portions categorized into quartiles. The study participants were then grouped into quartiles based on their consumption of each food group and assigned scores ranging from 2 to 5.
The subsample of the study consisted of 126,394 individuals out of the 502,411 participants who had accessible data from at least two dietary recalls at baseline, along with pertinent covariates. This subsample comprised 70,618 females and 55,776 males, with an average age of 56.1 years. Over a follow-up period ranging from 10.6 to 12.2 years, the study recorded 5,627 deaths, 6,890 cases of cardiovascular disease, 8,939 cases of cancer, and 4,751 cases of fractures.
The study found that the distribution of hPDI and uPDI scores among the study population was normal, ranging from 31 to 84 and 28 to 82 points. Those with higher hPDI scores were more likely to be female, have a lower body mass index (BMI), be of advanced age, report no medication intake, have no chronic health conditions, exhibit lower alcohol consumption, and have a higher level of education compared to those with lower hPDI scores.
The study employed multivariable-adjusted models to examine the association between hPDI scores and all-cause mortality. The results revealed that individuals with higher hPDI scores had a 16% lower likelihood of all-cause mortality compared to those with lower scores.
On the other hand, those who received higher scores on the uPDI scale were found to have a 23% increased likelihood of mortality from any cause. The study also found that increased adherence to the hPDI was associated with a 7% decrease in the likelihood of developing cancer. Conversely, individuals with higher uPDI scores exhibited a 10% greater risk of developing cancer. However, the study did not find any significant correlations between the hPDI or uPDI and frequently diagnosed cancers such as prostate, breast, and colorectal cancers.
The study utilized multivariable models to identify the association between hPDI and uPDI scores and the risk of cardiovascular diseases. It was found that increased hPDI scores were associated with decreased risks of total ischemic stroke, myocardial infarction, and CVD, with corresponding hazard ratios of 0.84, 0.86, and 0.92. Conversely, elevated uPDI scores were positively correlated with an increased susceptibility to ischemic stroke, myocardial infarction, and total CVD, as evidenced by hazard ratios of 1.23, 1.17, and 1.21, respectively.
The study did not find any significant correlations between the hPDI or uPDI and the likelihood of experiencing a hemorrhagic stroke. Additionally, the study indicated no significant correlations between the hPDI or uPDI and the risks of total and site-specific fractures.
The study’s findings suggested that adopting a healthful plant-based diet can lower the risks of total cardiovascular diseases, cancer, and overall mortality. However, an eating pattern that is predominantly composed of plant-based foods, with an increased consumption of sugary beverages, snacks, desserts, refined grains, potatoes, and fruit juices, was found to be associated with an elevated risk of chronic diseases.
The study also highlighted the importance of prioritizing the consumption of nutritious plant-based foods for promoting overall health and preventing cardiovascular diseases, irrespective of an individual’s genetic predisposition to the disease. The study’s findings provide evidence in favor of adopting a wholesome plant-based diet for this purpose.
However, the study also emphasized the need for further research to evaluate the association between plant-based diets and the risk of significant chronic illnesses in more diverse ethnic, racial, and cultural groups.
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