The Association of Plant-Based Diet With Cardiovascular Disease and Mortality: A Meta-Analysis and Systematic Review of Prospect Cohort Studies

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 cardiova...

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Autores principales:	Jingxuan Quek, Grace Lim, Wen Hui Lim, Cheng Han Ng, Wei Zheng So, Jonathan Toh, Xin Hui Pan, Yip Han Chin, Mark D. Muthiah, Siew Pang Chan, Roger S. Y. Foo, James Yip, Nithya Neelakantan, Mary F. F. Chong, Poay Huan Loh, Nicholas W. S. Chew
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	vegetarians vegans heart disease cardiovascular disease plant-based diets Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/b67b16e57952497e8071813d6cf3d8e8
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spelling	oai:doaj.org-article:b67b16e57952497e8071813d6cf3d8e82021-11-05T10:31:22ZThe Association of Plant-Based Diet With Cardiovascular Disease and Mortality: A Meta-Analysis and Systematic Review of Prospect Cohort Studies2297-055X10.3389/fcvm.2021.756810https://doaj.org/article/b67b16e57952497e8071813d6cf3d8e82021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.756810/fullhttps://doaj.org/toc/2297-055XBackground: 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, I2 = 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, I2 = 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, I2 = 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, I2 = 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, I2 = 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.Jingxuan QuekGrace LimWen Hui LimCheng Han NgWei Zheng SoJonathan TohXin Hui PanYip Han ChinMark D. MuthiahMark D. MuthiahMark D. MuthiahSiew Pang ChanSiew Pang ChanRoger S. Y. FooRoger S. Y. FooJames YipJames YipNithya NeelakantanMary F. F. ChongPoay Huan LohNicholas W. S. ChewFrontiers Media S.A.articlevegetariansvegansheart diseasecardiovascular diseaseplant-based dietsDiseases of the circulatory (Cardiovascular) systemRC666-701ENFrontiers in Cardiovascular Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	vegetarians vegans heart disease cardiovascular disease plant-based diets Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	vegetarians vegans heart disease cardiovascular disease plant-based diets Diseases of the circulatory (Cardiovascular) system RC666-701 Jingxuan Quek Grace Lim Wen Hui Lim Cheng Han Ng Wei Zheng So Jonathan Toh Xin Hui Pan Yip Han Chin Mark D. Muthiah Mark D. Muthiah Mark D. Muthiah Siew Pang Chan Siew Pang Chan Roger S. Y. Foo Roger S. Y. Foo James Yip James Yip Nithya Neelakantan Mary F. F. Chong Poay Huan Loh Nicholas W. S. Chew The Association of Plant-Based Diet With Cardiovascular Disease and Mortality: A Meta-Analysis and Systematic Review of Prospect Cohort Studies
description	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, I2 = 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, I2 = 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, I2 = 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, I2 = 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, I2 = 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.
format	article
author	Jingxuan Quek Grace Lim Wen Hui Lim Cheng Han Ng Wei Zheng So Jonathan Toh Xin Hui Pan Yip Han Chin Mark D. Muthiah Mark D. Muthiah Mark D. Muthiah Siew Pang Chan Siew Pang Chan Roger S. Y. Foo Roger S. Y. Foo James Yip James Yip Nithya Neelakantan Mary F. F. Chong Poay Huan Loh Nicholas W. S. Chew
author_facet	Jingxuan Quek Grace Lim Wen Hui Lim Cheng Han Ng Wei Zheng So Jonathan Toh Xin Hui Pan Yip Han Chin Mark D. Muthiah Mark D. Muthiah Mark D. Muthiah Siew Pang Chan Siew Pang Chan Roger S. Y. Foo Roger S. Y. Foo James Yip James Yip Nithya Neelakantan Mary F. F. Chong Poay Huan Loh Nicholas W. S. Chew
author_sort	Jingxuan Quek
title	The Association of Plant-Based Diet With Cardiovascular Disease and Mortality: A Meta-Analysis and Systematic Review of Prospect Cohort Studies
title_short	The Association of Plant-Based Diet With Cardiovascular Disease and Mortality: A Meta-Analysis and Systematic Review of Prospect Cohort Studies
title_full	The Association of Plant-Based Diet With Cardiovascular Disease and Mortality: A Meta-Analysis and Systematic Review of Prospect Cohort Studies
title_fullStr	The Association of Plant-Based Diet With Cardiovascular Disease and Mortality: A Meta-Analysis and Systematic Review of Prospect Cohort Studies
title_full_unstemmed	The Association of Plant-Based Diet With Cardiovascular Disease and Mortality: A Meta-Analysis and Systematic Review of Prospect Cohort Studies
title_sort	association of plant-based diet with cardiovascular disease and mortality: a meta-analysis and systematic review of prospect cohort studies
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/b67b16e57952497e8071813d6cf3d8e8
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The Association of Plant-Based Diet With Cardiovascular Disease and Mortality: A Meta-Analysis and Systematic Review of Prospect Cohort Studies

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