Aging and Chronic Disease
Provegetarian diets (i.e. preference for plant-derived foods) have been associated with a reduced risk of long-term weight gain and could be more easily embraced than strict vegetarian diets. However, not all plant-derived foods are equally healthy. The objective was to identify the association between provegetarian food patterns and the incidence of overweight/obesity.
Methods : The analysis included 11,554 participants with a baseline BMI < 25 kg/m2 from the SUN (Seguimiento Universidad de Navarra/University of Navarra Follow-up) prospective, open-recruitment cohort. Food consumption was assessed using a 136-item validated food-frequency questionnaire. A provegetarian food pattern (FP) was built by assigning positive scores to plant foods and reverse scores to animal foods as proposed by Martínez-González et al (2014). We also created a healthful provegetarian FP where healthy plant foods (fruits, vegetables, whole grains, nuts, legumes and olive oil) were positively weighted but less-healthy plant foods (juices, potatoes, refined grains, pastries and other vegetable oils) and animal foods were negatively weighted. To build an unhealthful provegetarian FP, less-healthy plant foods were positively weighted and animal and healthy plant foods were negatively weighted as suggested by Satija et al (2017). Participants were categorized into energy-adjusted quintiles of the different versions of a provegetarian FP. We calculated adjusted hazard ratios (HR) of overweight/obesity (BMI ≥ 25 kg/m2) and their 95% confidence intervals (CI).
A total of 2320 new cases of overweight or obesity were identified after a median follow-up of 10.3 years. Higher baseline conformity with the overall provegetarian FP was inversely associated with overweight/obesity (multivariable-adjusted HR comparing extreme quintiles: 0.86; 95% CI: 0.74, 0.99; p-trend: 0.061). This inverse association was stronger for the healthful version (HR: 0.82; 95% CI: 0.72, 0.95; p trend: 0.001) and was not apparent for the unhealthful version (HR: 1.07; 95% CI: 0.94, 1.23; p trend: 0.363).
Among relatively young graduates, better conformity with a healthy provegetarian diet was associated with a reduced risk of overweight/obesity, whereas no consistent trend was found for a FP that emphasized less-healthy plant foods.
Funding Sources :
The SUN Project has been supported by the Institute of Health Carlos III, the European Regional Development Fund, the Navarra Regional Government, and the University of Navarra.