Plant-Based Diet Linked to Lower Rates of All-Cause Mortality, Cardiovascular Disease

A new study is adding more credibility to those who support switching to plant-based diet for the improvement of heart health. 



Results from the National Institute of Health-sponsored study revealed those who ate the most plant-based food had a 16% lower risk of having cardiovascular disease (CVD), 32% lower risk of dying from CVD, and 25% lower risk of all-cause mortality.

“Our findings underscore the importance of focusing on your diet,” said lead investigator Casey Rebholz, PhD, assistant professor of epidemiology at Johns Hopkins Bloomberg School of Medicine. “There might be some variability in terms of individual foods, but to reduce cardiovascular disease risk people should eat more vegetables, nuts, whole grains, fruits, legumes and fewer animal-based foods.”

Investigators conducted an observational study that included a total of 12,168 adults between the ages of 45 and 64 from the Atherosclerosis Risk in Communities (ARIC) study that were assessed via a 66-item semiquantitative Willet Food frequency questionnaire. Primary outcome measures of the study were all-cause mortality and incident CVD. Incident CVD was defined as composite outcome of coronary heart disease, stroke, and heart failure.

Based on responses to the questionnaire, investigators created and then assigned participants to distinct groups based upon their plant-based diet scores. The 4 types of plant diet scores included included overall plant-based diet index (PDI), healthy plant-based diet (hPDI), unhealthy plant-based diet index (uPDI), and provegetarian diet index.

In the PDI and provegetarian diet index, higher intakes of all or selected plant foods received higher scores. Higher intakes of only the healthy plant foods received higher scores in the healthy plant-based diet index. In the less healthy plant-based diet index, higher intakes of only the less healthy plant foods received higher scores. Among all indexes, higher intakes of animal-based foods received lower scores.

Upon analyses, investigators found that Cox proportional hazards models showed participants in the highest versus lowest quintile for adherence to PDI or provegeterian diet had a 16% lower risk of CVD after adjusting for potential confounders. This same group had a 31% to 32% lower risk of CVD-mortaltiy and an 18% to 25% lower risk of all-cause mortality.

Investigators noted that higher adherence to hPDI was associated with an 11% lower risk of all-cause mortality and a 19% lower risk of CVD-mortality, but not incident CVD. No associations were observed between the uPDI and study outcomes. 


Rebholz points to the results as an example point to the importance of healthy compared to unhealthy plant-based foods. Rebholz calls for future studies to investigate the relationship quality of plant foods with CVD and death risks.

“Our findings underscore the importance of focusing on your diet,” Rebholz said. “There might be some variability in terms of individual foods, but to reduce cardiovascular disease risk people should eat more vegetables, nuts, whole grains, fruits, legumes and fewer animal-based foods.”

The study, “Plant-Based Diets Are Associated With a Lower Risk of Incident Cardiovascular Disease, Cardiovascular Disease Mortality, and All-Cause Mortality in a General Population of Middle-Aged Adults,” was published online in the Journal of the American Heart Association.