Plant-based dietary patterns in relation to mortality among older adults in China

Chen, Hui; Shen, Jie; Xuan, Jiaqi; Zhu, Anna; Ji, John S.; Liu, Xiaoran; Cao, Yaying; Zong, Geng; Zeng, Yi; Wang, Xiaoxi; Yuan, Changzheng

doi:10.1038/s43587-022-00180-5

Cited by 41 publications

(39 citation statements)

References 46 publications

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“…Based on the previous literature [ 16 , 28 , 29 ], the PDI was calculated by food frequency, with scores of 5, 4, 3 and 1, respectively, for consumption of plant foods every day, ≥1 time per week, 1–3 times per month, or rarely or never (positive scores); for consumption of animal foods, the scores were 1, 3, 4 and 5, respectively (reverse scores) [ 28 ]. PDI values ranging from 12 to 60 for each participant indicated the sum of the scores of all food categories/groups.…”

Section: Methodsmentioning

confidence: 99%

Higher Adherence to Plant-Based Diet Lowers Type 2 Diabetes Risk among High and Non-High Cardiovascular Risk Populations: A Cross-Sectional Study in Shanxi, China

2023

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This study aimed to investigate the association between the plant-based diet index (PDI) score and T2D risk among residents of Shanxi Province, China, and explore whether the association was influenced by different levels of cardiovascular risk. A total of 50,694 participants aged 35–75 years were recruited between 2017 and 2019, and they were further divided into the high cardiovascular risk population (HCRP; n = 17,255) and the non-high cardiovascular risk population (non-HCRP; n = 33,439). The PDI was calculated based on food frequency from a food frequency questionnaire (FFQ). Incident T2D was defined based on elevated plasma glucose (≥7 mmol/L) or hypoglycemic medicine use. We investigated the association of the PDI andT2D risk using a two-level generalized estimating equation and restricted cubic splines model. The results showed that quartile 4 of the PDI indicated significantly reduced T2D risk in the total population (OR: 0.83; 95% CI: 0.75–0.92), HCRP (OR: 0.80; 95% CI: 0.71–0.91), and non-HCRP (OR: 0.80; 95% CI: 0.74–0.87) compared with corresponding quartile 1 (OR = 1). In stratified analysis, the negative associations between PDI and T2D risk were stronger in the total population with the elderly (age > 60 years), BMI < 24, and men, and in the non-HCRP with men and BMI 24–28, and in the HCRP with the elderly and BMI < 24 than those with corresponding subgroups (pinteraction < 0.05). Linear curves were observed for the total population and non-HCRP, but an L-shaped association was observed for the HCRP. Therefore, our results suggest that higher PDI scores may effectively attenuate the T2D risk in the Chinese population and non-HCRP, and a beneficial association of PDI with T2D risk was observed in the HCRP at a certain threshold level. Longitudinal studies and intervention trials are required to validate our study findings.

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Section: Methodsmentioning

confidence: 99%

Higher Adherence to Plant-Based Diet Lowers Type 2 Diabetes Risk among High and Non-High Cardiovascular Risk Populations: A Cross-Sectional Study in Shanxi, China

2023

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“…Each participant’s dietary information was collected using a simplified food frequency questionnaire (FFQ). The questionnaire has been broadly used, with its reliability and validity both well-supported [ 28 , 40 , 42 , 43 , 44 ]. The simplified FFQ in the CLHLS included 16 food groups which are commonly consumed in China.…”

Section: Methodsmentioning

confidence: 99%

“…Using this dietary data, we computed the PDI, the hPDI, and the uPDI to evaluate the overall PBD pattern, the healthful PBD pattern, and the unhealthful PBD pattern, respectively [ 28 , 29 , 40 ]. Intake frequencies of the 16 food groups were assigned a score between 1 and 5.…”

Section: Methodsmentioning

confidence: 99%

“…Recent research further defined three plant-based diet indices (PDIs), including the overall plant-based diet index (PDI), the healthful plant-based diet index (hPDI), and the unhealthful plant-based diet index (uPDI), so as to consider the dietary quality of a PBD. For instance, the PDI assesses alignment with diets higher in plant-based foods and lower in animal-based foods, the hPDI emphasizes a high consumption of healthful plant-based foods and a low consumption of unhealthful plant-based foods, and the uPDI is the opposite of the hPDI in that it emphasizes a high consumption of unhealthful plant-based foods within the context of an overall PBD [ 28 , 29 , 30 ]. Previous research has shown that healthful plant-based foods (e.g., fresh vegetables and fresh fruits) were related to better neurological health, while unhealthful plant-based foods (e.g., preserved vegetables and added sugars) were related to poor neurological health [ 27 , 31 ].…”

Section: Introductionmentioning

confidence: 99%

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Association of Body Mass Index and Plant-Based Diet with Cognitive Impairment among Older Chinese Adults: A Prospective, Nationwide Cohort Study

Fang

Turner‐McGrievy

et al. 2022

Nutrients

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To examine the association of body mass index (BMI) and a plant-based diet (PBD) with cognitive impairment in older adults, this cohort study used data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a national, community-based, longitudinal, prospective study in China. Cognitive function was evaluated via the Mini-Mental State Examination (MMSE). Diet was assessed using a simplified food frequency questionnaire (FFQ), and PBD patterns were estimated using the overall plant-based diet index (PDI), the healthful plant-based diet index (hPDI), and the unhealthful plant-based diet index (uPDI). BMI was measured objectively during the physical examination. Cox proportional hazard models and restricted cubic spline analyses were used. A total of 4792 participants with normal cognition at baseline were included, and 1077 participants were identified as having developed cognitive impairment during the 24,156 person-years of follow-up. A reverse J-shaped association was observed between BMI and cognitive impairment (p = 0.005 for nonlinearity). Participants who were overweight (HR = 0.79; 95% CI 0.66–0.95) and obese (HR = 0.72; 95% CI 0.54–0.96) had a decreased risk of cognitive impairment, while those who were underweight (HR = 1.42; 95% CI 1.21–1.66) had an increased risk. Lower PDI, lower hPDI, and higher uPDI were associated with an increased risk of cognitive impairment (HR = 1.32; 95% CI 1.16–1.50 for PDI; HR = 1.46; 95% CI 1.29–1.66 for hPDI; HR = 1.21; 95% CI 1.06–1.38 for uPDI). The protective effect of being overweight on cognitive impairment was more pronounced among participants with a higher PDI (HR = 0.74; 95% CI 0.57–0.95) than those with a lower PDI (HR = 0.87; 95% CI 0.67–1.12), among participants with a higher hPDI (HR = 0.73; 95% CI 0.57–0.94) than those with a lower hPDI (HR = 0.93; 95% CI 0.72–1.10), and among participants with a lower uPDI (HR = 0.61; 95% CI 0.46–0.80) than those with a higher uPDI (HR = 1.01; 95% CI 0.80–1.27). Our results support the positive associations of overweight status, obesity, an overall PBD, and a healthful PBD with cognitive function in older adults. A lower adherence to an overall PBD, a healthful PBD, and a higher adherence to an unhealthful PBD may attenuate the protective effect of being overweight on cognitive function.

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“…Dietary intake was measured through a simplified food frequency questionnaire (FFQ) by face-to-face interview. The simplified FFQ in CLHLS has been recognized and used in previous studies [ 22 , 23 ]. Participants were asked how often they had consumed mushrooms and algae over the previous year and at age 60, respectively.…”

Section: Methodsmentioning

confidence: 99%

Association of Mushrooms and Algae Consumption with Mortality among Chinese Older Adults: A Prospective Cohort Study

Shen

et al. 2022

Nutrients

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Mushrooms and algae are important sources of dietary bioactive compounds, but their associations with mortality remain unclear. We examined the association of mushrooms and algae consumption with subsequent risk of all-cause mortality among older adults. This study included 13,156 older adults aged 65 years and above in the Chinese Longitudinal Healthy Longevity Survey (2008–2018). Consumption of mushrooms and algae at baseline and age of 60 were assessed using a simplified food frequency questionnaire (FFQ). We used Cox proportional hazards models to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). During 74,976 person-years of follow-up, a total of 8937 death cases were documented. After adjustment for demographic, lifestyle, and other dietary factors, participants who consumed mushrooms and algae at least once per week had a lower risk of all-cause mortality than rare consumers (0–1 time per year) (HR = 0.86; 95% CI: 0.80–0.93). Compared to participants with rare intake at both age 60 and the study baseline (average age of 87), those who maintained regular consumptions over time had the lowest hazard of mortality (HR = 0.86; 95%CI: 0.76–0.98). Our findings supported the potential beneficial role of long-term consumption of mushrooms and algae in reducing all-cause mortality among older adults. Further studies are warranted to evaluate the health benefit for longevity of specific types of mushrooms and algae.

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Plant-based dietary patterns in relation to mortality among older adults in China

Cited by 41 publications

References 46 publications

Higher Adherence to Plant-Based Diet Lowers Type 2 Diabetes Risk among High and Non-High Cardiovascular Risk Populations: A Cross-Sectional Study in Shanxi, China

Higher Adherence to Plant-Based Diet Lowers Type 2 Diabetes Risk among High and Non-High Cardiovascular Risk Populations: A Cross-Sectional Study in Shanxi, China

Association of Body Mass Index and Plant-Based Diet with Cognitive Impairment among Older Chinese Adults: A Prospective, Nationwide Cohort Study

Association of Mushrooms and Algae Consumption with Mortality among Chinese Older Adults: A Prospective Cohort Study

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