Plant-Based Diets, Ultra-Processed Foods, and Risks of Mortality and Major Chronic Diseases: A Prospective Cohort...

Area of Science:

• Nutritional Epidemiology
• Public Health Nutrition
• Chronic Disease Prevention

Background:

• Plant-based diets (PBDs) are associated with reduced mortality and chronic disease risks.
• The influence of ultra-processed food (UPF) content on these associations is unclear.
• This study investigates UPF's role in PBD-associated health outcomes, considering nutrient quality.

Purpose of the Study:

• To examine if UPF content modifies the association between PBDs and risks of mortality and major chronic diseases.
• To assess the impact of nutrient quality alongside UPF content in PBDs.

Main Methods:

• Prospective cohort study of 124,836 UK Biobank participants (aged 40-70).
• Dietary intake assessed via 24-h recall; four modified Plant-Based Diet Indices (PDIs) created (high/low UPF, healthy/unhealthy).
• Follow-up for mortality, type 2 diabetes (T2DM), cardiovascular disease (CVD), and cancer using Cox models.

Main Results:

• Higher adherence to healthy PBDs (hPDI), irrespective of UPF content, correlated with 8-28% lower all-cause mortality and T2DM risk.
• High-UPF hPDI linked to 11% lower CVD risk; no clear association for low-UPF hPDI.
• Nutrient quality was comparable between high- and low-UPF hPDI patterns.

Conclusions:

• Healthful PBDs offer benefits regardless of UPF content.
• Overall PBD quality, rather than processing level, may be paramount for chronic disease prevention.