People with cardiometabolic disorders—such as obesity, diabetes and heart disease—could increase their chances of living longer by adopting a healthy plant-based diet, according to a study being presented at the American College of Cardiology's Annual Scientific Session (ACC.25).
While previous studies have assessed the benefits of plant-based diets in a general population, this new study is the first to focus on their benefits in people with cardiometabolic disorders, which are rising in prevalence worldwide and bring an increased risk of premature death.
"Among populations with cardiometabolic disorders, higher adherence to a healthful plant-based diet was significantly associated with a lower risk of total, cardiovascular and cancer mortality," said Zhangling Chen, MD, PhD, of the Department of Cardiovascular Medicine at the Second Xiangya Hospital of Central South University in Changsha, China, and the study's lead author. "More intake of healthy plant-based foods, less intake of unhealthy plant-based foods and less intake of animal-based foods are all important."
Cardiometabolic disorders stem from a variety of genetic, environmental and lifestyle factors and affect the health of the cardiovascular system and how the body processes food. While some medications can help manage these disorders, diet and other lifestyle factors are key in preventing the progression to serious forms of heart disease and cancer that are associated with cardiometabolic disorders.
Researchers analyzed data from nearly 78,000 people with cardiometabolic disorders who participated in large prospective studies in the United Kingdom, United States and China. The pooled datasets included 55,000 adults from the U.K. Biobank (UKB) between 2006-2022, 18,000 U.S. adults from the National Health and Nutrition Examination Study (NHANES) between 1999-2018 and almost 4,500 Chinese adults from the Chinese Longitudinal Healthy Longevity Study (CLHLS) between 2006-2018.
Based on their responses to 24-hour dietary recall interviews or dietary questionnaires at baseline, researchers assigned each participant a score on two indexes. People who reported a diet high in healthy plant-based foods such as vegetables, fruits, whole grains, legumes, tea and coffee scored higher on the healthful plant-based diet index, while those who reported a diet higher in refined grains, potatoes, sugar-sweetened beverages and animal-based foods scored higher on the unhealthful.
Overall, closer adherence to a healthful plant-based diet was associated with a 17% to 24% lower risk of death from any cause, cardiovascular disease or cancer, while closer adherence to an unhealthful plant-based diet brought a 28% to 36% increased risk of death from any cause, cardiovascular disease or cancer.
For the analysis, researchers adjusted for confounding factors such as demographics, dietary and lifestyle factors. Results were consistent across subgroups by age, race, sex, smoking, alcohol intake, body mass index and physical activity. They were also consistent in people with different types of cardiometabolic disorders and in people from the U.K., U.S. and Chinese cohorts when these groups were analyzed separately, even though the U.K. and U.S. groups were significantly younger, with an average age of 57 years and 59 years, respectively, compared with the Chinese group, which had an average age of 84 years.
In a separate study that only used NHANES data and did not focus on people with cardiometabolic disorders, the same research group found that a greater adherence to a healthy beverage pattern was associated with a lower risk of premature death. They defined a healthy beverage pattern as one high in tea, coffee and low-fat milk and low in alcohol, whole-fat milk, fruit juice and sugar-sweetened and artificially sweetened beverages.
"These findings may help individuals with cardiometabolic disorders make heathier lifestyle choices," Chen said. "It is important to identify and develop cost-effective strategies to promote health among individuals with cardiometabolic disorders."
For both studies, the researchers said that dietary data were self-reported by study participants at baseline and not assessed again, so the studies were not able to reflect any dietary changes participants may have made. They added that some potentially confounding factors were difficult to eliminate and suggested that additional prospective studies in diverse global populations would help to strengthen the evidence and confirm the importance of healthy food and beverage consumption patterns in broader populations.
Chen will present the studies, "Associations Between Plant-Based Diets and Total Mortality Among Participants with Cardiometabolic Disorders" and "Associations of a Healthy Beverage Score with All-Cause and Cause-Specific Mortality among U.S. Adults: A Nationwide Cohort Study," on Saturday, March 29, 2025, at 3:30 p.m. CT / 20:30 UTC in South Hall.
ACC.25 will take place March 29-31, 2025, in Chicago, bringing together cardiologists and cardiovascular specialists from around the world to share the newest discoveries in treatment and prevention. Follow @ACCinTouch , @ACCMediaCenter and #ACC25 for the latest news from the meeting.
The American College of Cardiology (ACC) is the global leader in transforming cardiovascular care and improving heart health for all. As the preeminent source of professional medical education for the entire cardiovascular care team since 1949, ACC credentials cardiovascular professionals in over 140 countries who meet stringent qualifications and leads in the formation of health policy, standards and guidelines. Through its world-renowned family of JACC Journals, NCDR registries, ACC Accreditation Services, global network of Member Sections, CardioSmart patient resources and more, the College is committed to ensuring a world where science, knowledge and innovation optimize patient care and outcomes. Learn more at ACC.org .
