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Objectives: To examine the association of changes in plant-based diet consumption with all-cause mortality among older adults in China. Design: Cohort study. Setting: This cohort study of 11 years used data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a long-term, nationwide survey covering 23 provinces in China. Participants: A total of 7843 older participants aged ≥60 years were included in this study. Measurements: Changes in plant-based diets consumption (2008–2011) were assessed by 3 graded plant-based diet indices, including an overall plant-based diet index (PDI), a healthful plant-based diet index (hPDI), and an unhealthful plant-based diet index (uPDI). The main outcome was all-cause mortality. Multivariable-adjusted Cox proportional-hazards models were fitted to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) of mortality for changes in PDI, hPDI, and uPDI. Results: A total of 7843 participants (mean [SD] age, 82.2 [10.9] years; 3588 [45.7%] men) were included in this study. During a median (IQR) of 9 (5–10) years of follow-up, 3749 deaths were documented. Compared with older adults whose plant-based diet indices were relatively stable, older adults with the greatest decrease (quintile 1) in PDI, hPDI, and uPDI had respectively 32% (95% CI, 19%–47%) higher, 21% (95% CI, 9%–33%) higher, and 10% (95% CI, 4%–21%) lower risk of death. Compared with older adults whose diet indices were relatively stable, older adults with the greatest increase (quintile 5) in uPDI had a 13% higher risk of death (95% CI, 1%–21%), while no significant associations of the increased PDI and hPDI with all-cause mortality were observed. Conclusion: Maintaining the consumption of overall and healthful plant-based diets, and decreasing the consumption of an unhealthful plant-based diet can be beneficial in preventing or delaying premature death among Chinese older adults. |
