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ORIGINAL RESEARCH article

Front. Nutr.
Sec. Nutritional Epidemiology
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1518519
This article is part of the Research Topic Nutritional Epidemiology: Advances in the Analysis of Healthy and Sustainable Dietary Patterns View all 3 articles

Plant-based diets and total and cause-specific mortality: a meta-analysis of prospective studies

Provisionally accepted
Qiwang Mo Qiwang Mo Jizhongrong Wu Jizhongrong Wu Yi Lu Yi Lu Xiao Zhang Xiao Zhang *
  • Shengzhou People’s Hospital, Shaoxing, Zhejiang Province, China

The final, formatted version of the article will be published soon.

    Objective: The adherence to plant-based diets has been shown to positively impact longevity by reducing the incidence and severity of lifestyle-related diseases. Previous studies on the association of plant-based dietary pattern, as evaluated by plant-based dietary index (PDI), healthy plant-based dietary index (hPDI) and unhealthy plant-based dietary index (uPDI), with mortality risk have reported inconsistent results. We performed the present meta-analysis to summarize evidence on this association and to quantify the potential dose-response relationship based on all available cohort studies. Methods: A comprehensive literature search and systematic review of relevant articles up to October 2024 was performed in PubMed and Scopus. The summary risk estimates (RR) with 95% confidence interval (CI) for the highest versus the lowest category of PDIs, hPDIs and uPDIs were calculated. Dose-response meta-analysis was also performed for studies reporting categorical risk estimates for at least three quantitative levels of PDIs, hPDIs and uPDIs. Results: A total of 11 eligible cohort studies (13 datasets) were eventually included in this meta-analysis. Participants in the highest quintile of both the PDI and hPDI had a significantly decreased risk of all-cause mortality (pooled HRPDI = 0.85; 95% CI: 0.80-0.90; pooled HRhPDI = 0.86; 95% CI: 0.81-0.92) compared to participants in the lowest quintile. In contrast, the highest uPDI was associated with an increased risk of mortality (pooled HRuPDI = 1.20; 95% CI: 1.11-1.31). Dose-response meta-analysis showed that there was a nonlinear relationship between PDI or hPDI level and all-cause mortality (p = 0.001 and p < 0.001 for nonlinearity, respectively). No evidence of a nonlinear relationship was observed for uPDI (p = 0.596 for nonlinearity). Conclusions: Greater adherence to PDI or hPDI dietary pattern was associated with a lower risk of mortality, whereas uPDI dietary pattern was positively associated with mortality risk. Thus, promoting a plant-based dietary pattern may be a key strategy in improving public health and reducing the burden of diet-related mortality.

    Keywords: Plant-based diet, Mortality, cardiovascular disease, Cancer, cohort, Meta-analysis

    Received: 28 Oct 2024; Accepted: 07 Jan 2025.

    Copyright: © 2025 Mo, Wu, Lu and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Xiao Zhang, Shengzhou People’s Hospital, Shaoxing, 312400, Zhejiang Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.