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Association of plant-based diet with cardiometabolic multimorbidity trajectory: A prospective study in UK Biobank
Shimin Chen1, Chao Chen1, Li Lin1
1School of Public Health, Guangdong Medical University, Dongguan, 523808 Guangdong, China.
Insights
Plant-based diets, particularly healthy plant-based diets (hPDI), significantly reduce the risk of developing cardiometabolic diseases (CMD) and progressing to cardiometabolic multimorbidity (CMM). Adherence to plant-based eating patterns is linked to lower incidence of FCMD and CMM.
Area of Science:
- Nutritional Epidemiology
- Cardiovascular Health
- Chronic Disease Progression
Background:
- Plant-based diets are linked to reduced risk of individual cardiometabolic diseases (CMDs).
- The impact of plant-based diets on the progression to first-occurrence cardiometabolic disease (FCMD), cardiometabolic multimorbidity (CMM), and mortality is not fully understood.
Purpose of the Study:
- To investigate the association between plant-based dietary patterns and the risk of developing FCMD, CMM, and mortality.
- To examine how different plant-based diet indices influence disease trajectories.
Main Methods:
- Analysis of UK Biobank data from 83,610 participants without baseline CMDs.
- Utilized multi-state models to assess plant-based diet indices (PDI, hPDI, uPDI) and their impact on disease progression over a median follow-up of 15.61 years.
Main Results:
- Higher adherence to overall PDI and hPDI was associated with a reduced risk of transitioning from health to FCMD and CMM.
- hPDI showed a particularly strong inverse association with the risk of transitioning to FCMD.
- Plant-based indices demonstrated differential effects on the transition to diabetes as an FCMD.
Conclusions:
- High adherence to PDI and hPDI reduces the risk of transitioning from CMD-free status to FCMD, especially for diabetes.
- Plant-based diets are associated with a lower risk of progressing to CMM.
- Further research is needed to explore the association of hPDI and uPDI with mortality risk.
Background:
Plant-based diets have been consistently associated with a lower risk of several individual cardiometabolic diseases (CMDs). However, whether such dietary patterns differentially influence the progression from health to first-occurrence cardiometabolic disease (FCMD), cardiometabolic multimorbidity (CMM), and ultimately mortality remains unclear.
Methods:
The present study analyzed data from 83,610 participants in the UK Biobank cohort who were not diagnosed with diabetes, ischaemic heart disease (IHD), or stroke at baseline. Multi-state models were employed to examine the impact of plant-based diets on trajectories of cardiometabolic multimorbidity.
Results:
During a median follow-up period of 15.61 years, the median age of the participants at baseline was 57 years (IQR: 50 years-62 years), 42.72% were male. 9298 participants developed at least one CMD, 1,045 participants progressed to CMM, and 4169 participants ultimately died. The finding of the multi-state model suggest that, compared with Q1, both the overall plant-based diet index (PDI)[HR (95%CI): 0.88 (0.83, 0.94) for baseline to FCMD, 0.85 (0.83, 0.94) for baseline to CMM] and the healthy plant-based diet index (hPDI) [HR (95%CI): 0.60 (0.41, 0.89) for baseline to FCMD, 0.79 (0.53, 1.17) for baseline to CMM] were negatively associated with the risk of transitioning from health to FCMD and CMM. When grouping FCMD into disease-specific analyses, it was found that the three plant-based indices also exerted differential effects on the transition from health to diabetes.
Conclusion:
In the progression of CMM, high adherence of PDI and hPDI has been demonstrated to reduce the risk of transitioning from CMD-free to FCMD, particularly in diabetes, and lowers the risk of CMM with a much lower incidence risk from CMD-free to CMM compared to CMD-free to FCMD. The present study hypothesizes that both hPDI and unhealthy plant-based index (uPDI) are associated with the risk from baseline to death.
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