The Association of Plant-Based Diet With Cardiovascular Disease and Mortality: A Meta-Analysis and Systematic Review of Prospect Cohort Studies - PubMed (original) (raw)
doi: 10.3389/fcvm.2021.756810. eCollection 2021.
Grace Lim 2, Wen Hui Lim 1, Cheng Han Ng 1, Wei Zheng So 1, Jonathan Toh 1, Xin Hui Pan 1, Yip Han Chin 1, Mark D Muthiah 1 3 4, Siew Pang Chan 1 5, Roger S Y Foo 1 5, James Yip 1 5, Nithya Neelakantan 6, Mary F F Chong 6, Poay Huan Loh 5, Nicholas W S Chew 5
Affiliations
- PMID: 34805312
- PMCID: PMC8604150
- DOI: 10.3389/fcvm.2021.756810
The Association of Plant-Based Diet With Cardiovascular Disease and Mortality: A Meta-Analysis and Systematic Review of Prospect Cohort Studies
Jingxuan Quek et al. Front Cardiovasc Med. 2021.
Abstract
Background: The association between plant-based diets and cardiovascular disease (CVD) remains poorly characterized. Given that diet represents an important and a modifiable risk factor, this study aimed to assess (1) the relationships between the impact of adherence to plant-based diets on cardiovascular mortality, incident CVD, and stroke; (2) if associations differed by adherence to healthful and less healthful plant-based diets. Methods and Findings: MEDLINE and EMBASE databases were searched up to May 2021. Studies assessing CVD outcomes with relation to plant-based dietary patterns or according to plant-based dietary indices (PDI) were included. A meta-analysis of hazard ratios (HR) was conducted using DerSimonian and Laird random effects model. Thirteen studies involving 410,085 participants were included. Greater adherence to an overall plant-based dietary pattern was significantly associated with a lower risk of cardiovascular mortality (pooled HR: 0.92, 95% CI: 0.86-0.99 p = 0.0193, I 2 = 88.5%, N = 124,501) and a lower risk of CVD incidence (pooled HR: 0.90, 95% CI: 0.82-0.98, p = 0.0173, I 2 = 87.2%, N = 323,854). Among the studies that used PDI, unhealthful plant-based diets were associated with increased risk of cardiovascular mortality (pooled HR: 1.05, 95% CI: 1.01-1.09, p = 0.0123, I 2 = 0.00%, N = 18,966), but not CVD incidence. Conversely, healthful plant-based diets were associated with decreased CVD incidence (pooled HR: 0.87, 95% CI: 0.80-0.95, p = 0.0011, I 2 = 57.5%, N = 71,301), but not mortality. Vegetarians also had significantly lower CVD incidence (HR: 0.81, 95% CI: 0.72-0.91, p = 0.0004, I 2 = 22.2%, N = 16,254), but similar CVD mortality or stroke risk when compared to the meat-eaters. Conclusion: To date, this comprehensive study examines the effects of a plant-based diet on major clinical endpoints using more holistic PDIs. These findings highlight the favorable role of healthful plant-based foods in reducing cardiovascular mortality and CVD.
Keywords: cardiovascular disease; heart disease; plant-based diets; vegans; vegetarians.
Copyright © 2021 Quek, Lim, Lim, Ng, So, Toh, Pan, Chin, Muthiah, Chan, Foo, Yip, Neelakantan, Chong, Loh and Chew.
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
PRISMA flow diagram.
Figure 2
Cardiovascular mortality by healthful PDI (hPDI) and unhealthful PDI.
References
- World Heath Organisation . Cardiovascular Diseases (CVDs) (2021). Available online at: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases... (accessed June 20, 2021)
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