Journal Article

Quality of plant-based diets in relation to all-cause and cardiovascular disease mortality in US adults with sarcopenia: a population-based study

Qiu, Jianjun, Ge, Xiaoxu, Fu, Qingge, Ge, Shuo, Liu, Shaoyang, Zhang, Lei, Shi, Jixiang

2025

Overview

Purpose This observational study aimed to examine the relationship between three plant-based diet (PBD) indices and the risk of all-cause and cardiovascular disease (CVD) mortality in patients with sarcopenia. Methods Adults with sarcopenia from the 1999–2006 and 2011–2018 National Health and Nutrition Examination Survey were included. A total plant-based diet index (PDI), a healthful PDI (hPDI) and an unhealthful PDI (uPDI) were created based on 17 food groups and were assessed for their associations with all-cause and CVD mortality risk using Cox proportional hazards regression models, restricted cubic spine analysis, and interaction analysis. Results A total of 684 (222 from CVD) deaths were documented in 2218 participants (mean age 51.36 years; 53.90% men) during a median follow-up of 117 months. Compared with the lowest quartile, the hazard ratios (HR) and 95% confidence intervals (CI) for all-cause mortality in the highest quartile were 0.49 (0.33–0.75) for total PDI, 0.27 (0.19–0.39) for hPDI, and 1.85 (1.30–2.65) for uPDI. Similarly, for CVD mortality, the HRs and 95% CIs in the highest quartile were 0.29 (0.12–0.69) for total PDI, 0.30 (0.18–0.50) for hPDI, and 2.65 (1.21–5.77) for uPDI, compared to the lowest quartile. The protective associations of hPDI with all-cause and CVD mortality were more pronounced in participants younger than 45 years. Conclusion Higher adherence to PDI and hPDI is associated with a lower risk of all-cause and CVD mortality, whereas higher adherence to uPDI is linked to an increased risk of mortality in US adults with sarcopenia.

• Publisher: Springer International Publishing,Springer Nature B.V
• Subject: Adult / Aged / Cardiovascular disease / Cardiovascular Diseases - mortality / Cardiovascular Diseases - prevention & control / Diet, Plant-Based - adverse effects / Diet, Plant-Based - methods / Diet, Plant-Based - statistics & numerical data / Female / Geriatrics/Gerontology / Humans / Male / Medicine / Medicine & Public Health / Middle Aged / Mortality / Nutrition Surveys - statistics & numerical data / Plant-based foods / Proportional Hazards Models / Risk Factors / Sarcopenia / Sarcopenia - complications / Sarcopenia - diet therapy / Sarcopenia - mortality / United States - epidemiology