Changes in Plant-Based Diet Quality and Total and Cause-Specific Mortality.

Area of Science:

• Nutrition Science
• Epidemiology
• Public Health

Background:

• Plant-based diets are linked to reduced risks of type 2 diabetes mellitus and cardiovascular disease (CVD).
• Recommendations often cite health and environmental advantages of plant-based eating patterns.
• The impact of changes in plant-based diet quality on mortality risk is not well understood.

Purpose of the Study:

• To examine the association between 12-year changes in plant-based diet quality and subsequent total and cause-specific mortality.
• To assess the impact of overall, healthful, and unhealthful plant-based diet indices on mortality outcomes.

Main Methods:

• Utilized data from the Nurses' Health Study (NHS) and Health Professionals Follow-Up Study (HPFS) with 49,407 women and 25,907 men, respectively.
• Assessed 12-year changes (1986-1998) in plant-based diet quality using three indices: overall PDI, healthful PDI, and unhealthful PDI.
• Employed multivariable-adjusted Cox proportional-hazards models to analyze mortality (1998-2014) in participants free from CVD and cancer at baseline.

Main Results:

• Greatest increases in overall and healthful plant-based diet indices were associated with lower total mortality (HRs 0.95 and 0.90, respectively).
• Significant increases in unhealthful plant-based diet index correlated with higher total mortality (HR 1.12).
• A 10-point increase in overall and healthful PDI was linked to 7% and 9% lower CVD mortality, respectively, while unhealthful PDI increased CVD mortality risk by 8%.

Conclusions:

• Enhancing plant-based diet quality over a decade is associated with reduced risks of total and cardiovascular disease mortality.
• Conversely, increased adherence to an unhealthful plant-based diet pattern elevates the risk of total and cardiovascular disease mortality.
• Findings underscore the critical role of dietary patterns in long-term health and survival.