Plant-Based Diets and Risk of Multimorbidity: The Health and Retirement Study

Veronica Vega-Cabello; Maymona Al Hinai; Humberto Yévenes-Briones; Francisco Felix Caballero; Esther Lopez-García; Ana Baylin

doi:10.1016/j.tjnut.2024.04.037

Plant-Based Diets and Risk of Multimorbidity: The Health and Retirement Study

J Nutr. 2024 May 4:S0022-3166(24)00240-2. doi: 10.1016/j.tjnut.2024.04.037. Online ahead of print.

Authors

Veronica Vega-Cabello¹, Maymona Al Hinai², Humberto Yévenes-Briones¹, Francisco Felix Caballero¹, Esther Lopez-García³, Ana Baylin⁴

Affiliations

¹ Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autonoma de Madrid, Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Instituto de Salud Carlos III, Madrid, Spain.
² Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, United States; Department of Food Science and Human Nutrition, Sultan Qaboos University College of Agriculture and Marine Science, Muscat, Oman.
³ Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autonoma de Madrid, Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Instituto de Salud Carlos III, Madrid, Spain; IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain.
⁴ Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, United States. Electronic address: abaylin@umich.edu.

PMID: 38705471
DOI: 10.1016/j.tjnut.2024.04.037

Abstract

Background: Plant-based diets have gained attention due to their beneficial effects against major chronic diseases, although their association with multimorbidity is mostly unknown.

Objectives: We examined the association between the healthful (hPDI) and unhealthful plant-based diet indices (uPDI) with multimorbidity among middle-aged and older adults from the United States.

Methods: Data on 4262 adults aged >50 y was obtained from the 2012-2020 Health and Retirement Study (HRS) and 2013 Health Care and Nutrition Study (HCNS). Food consumption was collected at baseline with a food frequency questionnaire and 2 PDIs were derived: the hPDI, with positive scores for healthy plant foods and reverse scores for less healthy plant foods and animal foods; and the uPDI, with only positive scoring for less healthy plant foods. Complex multimorbidity, defined as ≥3 coexistent conditions, was ascertained from 8 self-reported conditions: hypertension, diabetes, cancer, chronic lung disease, heart disease, stroke, arthritis, and depression. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs).

Results: After a median follow-up of 7.8 y, we documented 1202 incident cases of multimorbidity. Compared with the lowest quartile, higher adherence to the hPDI was inversely associated with multimorbidity (HR for quartile 3: 0.77; 95% CI: 0.62, 0.96 and HR for quartile 4: 0.79; 95% CI, 0.63, 0.98; P-trend = 0.02). In addition, a 10-point increment in the hPDI was associated with a 11% lower incidence of multimorbidity (95% CI: 1, 20%). No significant associations were found for the uPDI after adjusting for sociodemographic and lifestyle factors.

Conclusions: Higher adherence to the hPDI was inversely associated with multimorbidity among middle-aged and older adults. Plant-based diets that emphasize consumption of high-quality plant foods may help prevent the development of complex multimorbidity.

Keywords: chronic disease; diet quality; multimorbidity; older adults; plant-based diet.