Plant-based Diet and Adiposity Over Time in a Middle-aged and Elderly Population

Abstract

Background: We aimed to explore whether adhering to a more plant-based diet, beyond strict vegan or vegetarian diets, may help prevent adiposity in a middle-aged and elderly population. Methods: We included 9,633 participants from the Rotterdam Study, a prospective cohort in the Netherlands. Dietary data were collected using food-frequency questionnaires at baseline of three subcohorts of the Rotterdam Study (1989–1993, 2000–2001, 2006–2008). We created a plant-based diet index by giving plant-based foods positive scores and animal-based foods reverse scores. A higher score on the index reflected an overall more plant-based and less animal-based diet. Data on anthropometrics and body composition (using dual energy X-ray absorptiometry) were collected every 3–5 years from 1989 to 2016. We used multivariable linear mixed models to analyze the associations. Results: In the 9,633 participants, baseline plant-based diet score ranged from 21.0 to 73.0 with a mean ± SD of 49.0 ± 7.0. In multivariable-adjusted analyses, higher adherence to a plant-based diet was associated with lower BMI, waist circumference, fat mass index, and body fat percentage across a median follow-up period of 7.1 years (per 10 points higher score, BMI: β = −0.70 kg/m2 [95% CI = −0.81, −0.59]; waist circumference: −2.0 cm [−2.3, −1.7]; fat mass index: −0.66 kg/m2 [−0.80, −0.52]; body fat percentage: −1.1 points [−1.3, −0.84]). Conclusions: In this population-based cohort of middle-aged and elderly participants, a higher adherence to a more plant-based, less animal-based diet was associated with less adiposity over time, irrespective of general healthfulness of the specific plant- and animal-based foods.

A 10‐year longitudinal study on the associations between changes in plant‐based diet indices, anthropometric parameters and blood lipids in a Flemish adult population

“…These conflicting results may be explained by the different methods used. The sample size in the Chen et al study was larger and only baseline measurement of dietary intake were available, whereas in the present study food intake was measured at both test moments.…”

Objectives, design and main findings until 2020 from the Rotterdam Study

“…We observed that a more plant-based diet and a lower intake of animal protein are associated with lower insulin resistance over time and lower risk of diabetes, independent of other lifestyle and dietary factors [205,389]. In other analyses we studied several pathways that may link nutrition or physical activity to diabetes risk and metabolic health, such as adiposity [390], inflammatory pathways [391,199] or DNA methylation [392][393][394][395].…”

Dietary protein intake and all-cause and cause-specific mortality: results from the Rotterdam Study and a meta-analysis of prospective cohort studies

“…For the current analysis within the Rotterdam Study, of the 14,926 participants who participated at baseline, we had dietary data available for 9701. Main reasons for absence of valid dietary data among the 5225 participants were: no dietary data available (n = 4890) including not having received dietary assessment because of logistic reasons, living in a resident home for elderly or suspected dementia, and not having completed the dietary assessment; or excluded as invalid dietary data (n = 335) defined as an estimated energy intake of < 500 or > 5000 kcal/day) [18,19]. From these 9701 participants, we further excluded 1914 participants with CVD, diabetes, or cancer at baseline, and 1 participant without follow-up data on mortality, leaving 7786 participants for the main analyses (Supplemental Figure 1).…”