Plant-based diet index and all-cause and cause‑specific mortality: a prospective study

• Published in: Food & function 2025
• Main Authors: Xu, Xin, Yan, Minqing, Huo, Sijun, Meng, Shuai, yuan, changzheng, Wang, Ping
• Format: Article
• Language: English
• ISSN: 2042-6496; 2042-650X
• DOI: 10.1039/D4FO04242E

Background: A plant-based dietary pattern has been recently suggested to have health benefits. However, its relation to mortality is not completely consistent in prior studies. We aimed to investigate whether plant-based diet was associated with lower death risk in Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening study. Methods: We included 91,414 participants from the PLCO study. Dietary data were collected by a diet history questionnaire (DHQ). We used three plant-based diet indices including an overall plant-based diet index (PDI), a healthful plant-based diet index (hPDI), and an unhealthful plant-based diet index (uPDI). Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazard regression model. Results: During a median of 17.1 years of follow-up, we documented 19,456 deaths, including 5,489 deaths from cardiovascular disease (CVD) and 6,172 deaths from cancer. Comparing the highest versus lowest quintiles of PDI, the multivariable-adjusted HR of all-cause mortality was 0.83 (95% CI 0.79-0.87, P for trend < 0.001). Those in the highest quintile of PDI also had lower risks of CVD mortality (HR 0.87, 95% CI 0.79-0.94, P for trend < 0.001) and cancer mortality (HR 0.89, 95% CI 0.82-0.96, P for trend < 0.001) compared to those in the lowest quintile. Participants in the highest quintile of hPDI had a decreased risk of all-cause and cause-specific mortality, whereas participants with the highest uPDI scores had an increased death risk. Conclusion: greater adherence to a plant-based dietary pattern was significantly associated with lower all-cause and cause-specific mortality.