Vegetarian diet and likelihood of becoming centenarians in Chinese adults aged 80 y or older: a nested case-control...

Inverse associations of vegetarian diet with morbidity and mortality have been observed; however, the role of vegetarian diet on exceptional longevity remains unrevealed.

This study aims to examine the association between a vegetarian diet and likelihood of becoming a centenarian in adults aged ≥80 y.

This prospective nested case-control study included 5203 participants aged 80+ y from the Chinese Longitudinal Healthy Longevity Survey, a nationally representative cohort initiated in 1998. Participants were classified as omnivores and vegetarians, and further into vegetarian subgroups (pesco-vegetarians, ovo-lacto-vegetarians, and vegans) based on consumption of animal-derived foods. The primary outcome was living to 100 y old by the end of follow-up (2018). Multivariable unconditional logistic regression models were used to evaluate the association analysis.

The study identified 1459 centenarians and matched them with 3744 noncentenarians (who had deceased before reaching 100 y). Relative to omnivores, vegetarians had a lower likelihood of becoming centenarians [odds ratio (OR): 0.81, 95% confidence interval (CI): 0.69, 0.96], and similar patterns were observed for vegans (OR: 0.71, 95% CI: 0.54, 0.98), but not for pesco-vegetarians (OR: 0.84, 95% CI: 0.64, 1.09) and ovo-lacto-vegetarians (OR: 0.86, 95% CI: 0.67, 1.09). The significant association was seen in individuals with BMI <18.5 kg/m² (OR: 0.72, 95% CI: 0.57, 0.91), but not for those with BMI ≥18.5 kg/m² (OR: 0.92, 95% CI: 0.73, 1.17) (P-interaction = 0.08).

Targeting individuals of advanced age (80+ y) in China, we found that individuals following a vegetarian diet had a lower likelihood of becoming centenarians relative to omnivores, underscoring the importance of a balanced, high-quality diet with animal- and plant-derived food composition for exceptional longevity, especially in the underweight oldest-old.