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The Association Between Plant

来源：泰然健康网时间：2026年02月07日 23:04

The Association Between Plant-Based Diet Indices and Obesity and Metabolic Diseases in Chinese Adults: Longitudinal Analyses From the China Health and Nutrition Survey

Bo Chen et al. Front Nutr. 2022.

Abstract

Background: A wide range of health benefits are associated with consuming a diet high in plant-based foods. Diet quality can be accurately assessed using plant-based diet indices, however there is inadequate evidence that plant-based diet indices are linked to obesity, hypertension, and type 2 diabetes (T2D), especially in Chinese cultures who have traditionally consumed plant-rich foods.

Methods: The data came from the China Nutrition and Health Survey. Overall, 11,580 adult participants were enrolled between 2004 and 2006 and followed up until 2009 or 2015 (follow-up rate: 73.4%). Dietary intake was assessed across three 24-h recalls, and two plant-based dietary indices [overall plant-based diet indice (PDI) and healthy plant-based diet indice (hPDI)] were calculated using China Food Composition Code and categorized into quintiles. The study's endpoints were overweight/obesity, hypertension, and T2D. The Hazard ratio (HR) and dose-response relationship were assessed using the Cox proportional risk model and restricted cubic splines. The areas under the curve of the receiver operating characteristic curve analyses were used to evaluate the predictive performance of the PDI and hPDI.

Results: During the median follow-up period of more than 10 years, 1,270 (33.4%), 1,509 (31.6%), and 720 (11.5%) participants developed overweight / obesity, hypertension, and T2D, respectively. The higher PDI score was linked with a reduced risk of overweight/obesity [HR: 0.71 (95% CI: 0.55-0.93), P-trend <0.001], hypertension [HR: 0.63 (95% CI: 0.51-0.79), P-trend <0.001], and T2D [HR: 0.79 (95% CI: 0.72-0.87), P-trend <0.001]. The hPDI score was inversely associated with overweight/obesity [HR: 0.79 (95% CI: 0.62-0.98), P-trend = 0.02] and T2D [HR: 0.84 (95% CI: 0.75-0.93), P-trend = 0.001]. In the aged <55-year-old group, subgroup analysis indicated a significant negative association between PDI/hPDI and overweight/obesity, hypertension, and T2D. There was no significant difference in the areas under the curve of the fully adjusted obesity, hypertension, and diabetes prediction models between PDI and hPDI.

Conclusion: The PDI and hPDI scores were very similar in application in Chinese populations, and our findings highlight that adherence to overall plant-based diet index helps to reduce the risk of T2D, obesity, and hypertension in Chinese adults who habitually consume plant-based foods, especially for those aged <55 year. Further understanding of how plant-based diet quality is associated with chronic disease will be needed in the future, which will help develop dietary strategies to prevent diabetes, hypertension, and related chronic diseases.

Keywords: China Health and Nutrition Survey; healthy plant-based diet index; longitudinal analyses; obesity and metabolic diseases; plant-based diet index.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1

Participant flow diagram.

Figure 2

Adjusted hazard ratios and 95% confidence intervals for incident overweight/obesity, hypertension and type 2 diabetes according to the continuous PDI and hPDI. Adjusted for age, urban and rural, sex, total energy intake, education, physical activity, smoking status, alcohol drinking, baseline systolic and diastolic blood pressure, and BMI. BMI, body mass index; T2DM, type 2 diabetes mellitus.

Figure 3

(A–C) Receiver-operating characteristic curves for PDI and hPDI predicting incident overweight/obesity, hypertension and type 2 diabetes. ModelPDI and ModelhPDI: Adjusted for age, urban and rural, total energy intake, education, physical activity, smoking status, alcohol drinking, baseline systolic and diastolic blood pressure, and BMI. AUC: area under curve.

References

Danaei G, Finucane MM, Lin JK, Singh GM, Paciorek CJ, Cowan MJ, et al. National, regional, and global trends in systolic blood pressure since 1980: systematic analysis of health examination surveys and epidemiological studies with 786 country-years and 5.4 million participants. Lancet. (2011) 377:568–77. 10.1016/S0140-6736(10)62036-3 - DOI - PubMed Sung H, Siegel RL, Torre LA, Pearson-Stuttard J, Islami F, Fedewa SA, et al. Global patterns in excess body weight and the associated cancer burden. CA Cancer J Clin. (2019) 69:88–112. 10.3322/caac.21499 - DOI - PubMed GBD 2017 Diet Collaborators. Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. (2019) 393:1958–72. 10.1016/S0140-6736(19)30041-8 - DOI - PMC - PubMed Haider LM, Schwingshackl L, Hoffmann G, Ekmekcioglu C. The effect of vegetarian diets on iron status in adults: a systematic review and meta-analysis. Crit Rev Food Sci Nutr. (2018) 58:1359–74. 10.1080/10408398.2016.1259210 - DOI - PubMed Oussalah A, Levy J, Berthezène C, Alpers DH, Guéant JL. Health outcomes associated with vegetarian diets: an umbrella review of systematic reviews and meta-analyses. Clin Nutr. (2020) 39:3283–307. 10.1016/j.clnu.2020.02.037 - DOI - PubMed