Association of Healthful Plant-based Diet Adherence With Risk of Mortality and Major Chronic Diseases Among Adults in the UK

Thompson, Alysha S; Tresserra‐Rimbau, Anna; Karavasiloglou, Nena; Jennings, Amy; Cantwell, Marie; Hill, Claire; Pérez-Cornago, Aurora; Bondonno, Nicola P.; Murphy, Neil; Rohrmann, Sabine; Cassidy, Aedín; Kühn, Tilman

doi:10.1001/jamanetworkopen.2023.4714

Cited by 83 publications

(43 citation statements)

References 48 publications

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“…Therefore, it is possible that the PDI does not fully represent participants’ habitual dietary intake (72). Despite this, the PDIs have previously been shown to have good reproducibility over time (73). Thirdly, hospital inpatient and death registry data were used to ascertain incident CKD cases, but not primary care data.…”

Section: Discussionmentioning

confidence: 99%

Adherence to a healthful plant-based diet and risk of chronic kidney disease among individuals with diabetes: A prospective cohort study

Thompson,

Tresserra-Rimbau,

Jennings

et al. 2024

Preprint

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Background: Chronic kidney disease (CKD) is highly prevalent among people with diabetes. While identifying modifiable risk factors to prevent a decline in kidney function among those living with diabetes is pivotal, there is limited evidence on dietary risk factors for CKD. In this study we examined the associations between healthy and less healthy plant-based diets (PBDs) and the risk of CKD among those with diabetes, and to identify potential underlying mechanisms. Methods: We conducted a prospective analysis among 7,747 UK Biobank participants with prevalent diabetes. Multivariable Cox proportional hazard regression models were used to examine the associations between healthful and unhealthful PBDs and the risk of CKD. Causal mediation analyses were further employed to explore the underlying mechanisms of the observed associations. Results: Among 7,747 study participants with diabetes, 1,030 developed incident CKD over 10.2 years of follow-up. Higher adherence to a healthy PBD was associated with a 24% lower CKD risk (HRQ4 versus Q1: 0.76 [95%CI: 0.63-0.92], ptrend = 0.002), while higher adherence to an unhealthy PBD was associated with a 35% higher risk (HRQ4 versus Q1: 1.35 [95%CI: 1.11-1.65], ptrend = 0.006). The observed associations were predominantly mediated by markers of body fatness (proportion mediated: 11-25%) and kidney function (23-89%). Conclusions: In this prospective cohort study of middle-aged adults with diabetes, adherence to a healthy PBD was associated with lower CKD risk, whereas adherence to an unhealthy PBD was associated with a higher CKD risk. Associations were primarily mediated by markers of lower body fatness and improved kidney function.

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Section: Discussionmentioning

confidence: 99%

Adherence to a healthful plant-based diet and risk of chronic kidney disease among individuals with diabetes: A prospective cohort study

Thompson,

Tresserra-Rimbau,

Jennings

et al. 2024

Preprint

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“…We calculated an overall plant‐based diet index (PDI), a healthful plant‐based diet index (hPDI), and an unhealthful plant‐based diet index (uPDI) following the method described in previous studies 18,25‐27 . The three indices were calculated using 17 food groups that were created based on nutrient and culinary similarities.…”

Section: Methodsmentioning

confidence: 99%

“…24 We calculated an overall plant-based diet index (PDI), a healthful plant-based diet index (hPDI), and an unhealthful plant-based diet index (uPDI) following the method described in previous studies. 18,[25][26][27] The three indices were calculated using 17 food groups that were created based on nutrient and culinary similarities. These food groups were further classified into three groups as follows: healthy plant foods (wholegrains, fruits, vegetables, nuts, legumes and vegetarian protein alternatives, and tea and coffee), unhealthy plant foods (fruit juices, refined grains, potatoes, sugar-sweetened beverages, sweets, and desserts), and animal foods (animal fat, dairy, eggs, fish or seafood, meat, and miscellaneous animal-derived foods).…”

Section: Dietary Assessment and Calculation Of Plant-based Diet Indicesmentioning

confidence: 99%

Plant‐Based Dietary Patterns and Parkinson's Disease: A Prospective Analysis of the UK Biobank

Tresserra‐Rimbau,

Thompson,

Bondonno

et al. 2023

Movement Disorders

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BackgroundPlant‐based diets have been associated with a lower risk of several chronic diseases, but the relationship with PD is unknown.ObjectivesWe examined the association of three different plant‐based diets with PD incidence in the UK Biobank cohort.MethodsWe conducted a prospective study among 126,283 participants from the UK Biobank cohort. Three plant‐based diet indices (overall plant‐based diet index, PDI; healthful plant‐based diet index, hPDI; and unhealthful plant‐based diet index, uPDI) were derived from 24‐hour dietary recalls based on 17 food groups. Multivariable Cox regression models were used to estimate the risk of PD across quartiles of the PDIs and for each of the food groups that constituted the score. Further analyses were carried out to assess potential heterogeneity in associations between hPDI and PD across strata of some hypothesized effect modifiers.ResultsDuring 11.8 years of follow‐up (1,490,139 person‐years), 577 cases of PD incidence were reported. After multivariable adjustment, participants in the highest hPDI and overall PDI quartile had lower risk of PD (22% and 18%, respectively), whereas a higher uPDI was associated with a 38% higher PD risk. In food‐based analyses, higher intakes of vegetables, nuts, and tea were associated with a lower risk of PD (28%, 31% and 25%, respectively). Stratifying by Polygenic Risk Score (PRS), results were significant only for those with a lower PRS for PD.ConclusionsFollowing a healthful plant‐based diet and in particular the inclusion of readily achievable intakes of vegetables, nuts and tea in the habitual diet are associated with a lower risk of PD. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

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“…Plant-based diets contain a diverse family of dietary patterns, which encourage a reduced consumption of animal foods . Abundant evidence from observational and intervention studies indicates that vegan diets are associated with improved cardiovascular health and decreased risk of cardiovascular disease, likely because of the higher daily consumption of vegetables and fruits, legumes, whole grains and nuts, and seeds compared with other different types of dietary patterns …”

Section: Introductionmentioning

confidence: 99%

Cardiometabolic Effects of Omnivorous vs Vegan Diets in Identical Twins

Landry,

Ward,

Cunanan

et al. 2023

JAMA Netw Open

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ImportanceIncreasing evidence suggests that, compared with an omnivorous diet, a vegan diet confers potential cardiovascular benefits from improved diet quality (ie, higher consumption of vegetables, legumes, fruits, whole grains, nuts, and seeds).ObjectiveTo compare the effects of a healthy vegan vs healthy omnivorous diet on cardiometabolic measures during an 8-week intervention.Design, Setting, and ParticipantsThis single-center, population-based randomized clinical trial of 22 pairs of twins (N = 44) randomized participants to a vegan or omnivorous diet (1 twin per diet). Participant enrollment began March 28, 2022, and continued through May 5, 2022. The date of final follow-up data collection was July 20, 2022. This 8-week, open-label, parallel, dietary randomized clinical trial compared the health impact of a vegan diet vs an omnivorous diet in identical twins. Primary analysis included all available data.InterventionTwin pairs were randomized to follow a healthy vegan diet or a healthy omnivorous diet for 8 weeks. Diet-specific meals were provided via a meal delivery service from baseline through week 4, and from weeks 5 to 8 participants prepared their own diet-appropriate meals and snacks.Main Outcomes and MeasuresThe primary outcome was difference in low-density lipoprotein cholesterol concentration from baseline to end point (week 8). Secondary outcome measures were changes in cardiometabolic factors (plasma lipids, glucose, and insulin levels and serum trimethylamine N-oxide level), plasma vitamin B12 level, and body weight. Exploratory measures were adherence to study diets, ease or difficulty in following the diets, participant energy levels, and sense of well-being.ResultsA total of 22 pairs (N = 44) of twins (34 [77.3%] female; mean [SD] age, 39.6 [12.7] years; mean [SD] body mass index, 25.9 [4.7]) were enrolled in the study. After 8 weeks, compared with twins randomized to an omnivorous diet, the twins randomized to the vegan diet experienced significant mean (SD) decreases in low-density lipoprotein cholesterol concentration (−13.9 [5.8] mg/dL; 95% CI, −25.3 to −2.4 mg/dL), fasting insulin level (−2.9 [1.3] μIU/mL; 95% CI, −5.3 to −0.4 μIU/mL), and body weight (−1.9 [0.7] kg; 95% CI, −3.3 to −0.6 kg).Conclusions and RelevanceIn this randomized clinical trial of the cardiometabolic effects of omnivorous vs vegan diets in identical twins, the healthy vegan diet led to improved cardiometabolic outcomes compared with a healthy omnivorous diet. Clinicians can consider this dietary approach as a healthy alternative for their patients.Trial RegistrationClinicalTrials.gov Identifier: NCT05297825

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Association of Healthful Plant-based Diet Adherence With Risk of Mortality and Major Chronic Diseases Among Adults in the UK

Cited by 83 publications

References 48 publications

Adherence to a healthful plant-based diet and risk of chronic kidney disease among individuals with diabetes: A prospective cohort study

Adherence to a healthful plant-based diet and risk of chronic kidney disease among individuals with diabetes: A prospective cohort study

Plant‐Based Dietary Patterns and Parkinson's Disease: A Prospective Analysis of the UK Biobank

Cardiometabolic Effects of Omnivorous vs Vegan Diets in Identical Twins

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