{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T16:51:21Z","timestamp":1771260681305,"version":"3.50.1"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T00:00:00Z","timestamp":1721001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>There is limited research on the relationship between the frequency of plant-based food intake and the risk of cardiovascular disease (CVD) among elderly Chinese. This study aims to evaluate the association between plant-based dietary index (PDI) and CVD risks, providing evidence for elderly Chinese to reduce CVD risks by increasing the frequency of plant-based food consumption.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study analyzed data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) 2011\u20132018, employing a multivariate modified Poisson regression model, trend tests, and restricted cubic spline (RCS) analysis to assess the linear and non-linear relationship between the PDI and CVD risks. Subgroup analyses and interaction tests were conducted to evaluate the robustness and population-specificity of the results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study included a total of 1,414 elderly Chinese, and at the end of follow-up, 487 participants had developed CVD. The multivariate modified Poisson regression model revealed a negative association between PDI and CVD risks [RR\u2009=\u20090.983, 95%CI\u2009=\u2009(0.970, 0.997)]. Similarly, the multivariate trend test (<jats:italic>p<\/jats:italic>\u2009=\u20090.031) and RCS analysis (<jats:italic>P<\/jats:italic> for nonlinear\u2009=\u20090.600) indicated a linear relationship between PDI and CVD risks. Subgroup analyses showed that the relationship between PDI and CVD risk was not influenced by gender, BMI, smoking, alcohol use, or exercise.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The PDI was negatively correlated with CVD risks, indicating that increasing the frequency of plant-based food intake in the diet may reduce CVD risks among elderly Chinese.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnut.2024.1440025","type":"journal-article","created":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T15:46:30Z","timestamp":1721058390000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Increasing the frequency of plant-based food intake in daily diets reduces the risk of cardiovascular disease among elderly Chinese: a cohort study"],"prefix":"10.3389","volume":"11","author":[{"given":"Xin-Zheng","family":"Hou","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qian","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qian-Yu","family":"Lv","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying-Tian","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lan-Lan","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xue-Jiao","family":"Ye","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen-Yan","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan-Fei","family":"Lv","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shi-Han","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,7,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1126\/science.1250542","article-title":"Is low fertility really a problem? Population aging, dependency, and consumption","volume":"346","author":"Lee","year":"2014","journal-title":"Science"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1186\/s12877-021-02393-6","article-title":"Gender discrepancy in the predictive effect of metabolic syndrome and its components on newly onset cardiovascular disease in elderly from rural China","volume":"21","author":"Yu","year":"2021","journal-title":"BMC Geriatr"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1007\/s00038-017-1012-3","article-title":"Burden of cardiovascular diseases in the eastern Mediterranean region, 1990-2015: findings from the global burden of disease 2015 study","volume":"63","year":"2018","journal-title":"Int J Public Health"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1186\/s12992-021-00683-7","article-title":"Does the medical insurance system play a real role in reducing catastrophic economic burden in elderly patients with cardiovascular disease in China? Implication for accurately targeting vulnerable characteristics","volume":"17","author":"Ma","year":"2021","journal-title":"Glob Health"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"2197","DOI":"10.1016\/S0140-6736(12)61689-4","article-title":"Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the global burden of disease study 2010","volume":"380","author":"Murray","year":"2012","journal-title":"Lancet"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1186\/1471-2458-14-877","article-title":"An update on the prevalence of metabolic syndrome and its associated factors in rural Northeast China","volume":"14","author":"Yu","year":"2014","journal-title":"BMC Public Health"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"664","DOI":"10.1111\/jch.12378","article-title":"Prehypertension in rural northeastern China: results from the Northeast China rural cardiovascular health study","volume":"16","author":"Li","year":"2014","journal-title":"J Clin Hypertens (Greenwich)"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e017728","DOI":"10.1161\/JAHA.120.017728","article-title":"Relation of different fruit and vegetable sources with incident cardiovascular outcomes: a systematic review and Meta-analysis of prospective cohort studies","volume":"9","author":"Zurbau","year":"2020","journal-title":"J Am Heart Assoc"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1088","DOI":"10.1093\/eurpub\/ckad131","article-title":"Dietary fruits and vegetables and risk of cardiovascular diseases in elderly Chinese","volume":"33","author":"Wang","year":"2023","journal-title":"Eur J Pub Health"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e021515","DOI":"10.1161\/JAHA.121.021515","article-title":"Relationship between a plant-based dietary portfolio and risk of cardiovascular disease: findings from the Women's Health Initiative prospective cohort study","volume":"10","author":"Glenn","year":"2021","journal-title":"J Am Heart Assoc"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e020718","DOI":"10.1161\/JAHA.120.020718","article-title":"Plant-centered diet and risk of incident cardiovascular disease during young to middle adulthood","volume":"10","author":"Choi","year":"2021","journal-title":"J Am Heart Assoc"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1017\/S1041610221000168","article-title":"Excessive sleep increased the risk of incidence of cognitive impairment among older Chinese adults: a cohort study based on the Chinese longitudinal healthy longevity survey (CLHLS)","volume":"34","author":"Zhang","year":"2022","journal-title":"Int Psychogeriatr"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1619","DOI":"10.1016\/S0140-6736(17)30548-2","article-title":"Survival, disabilities in activities of daily living, and physical and cognitive functioning among the oldest-old in China: a cohort study","volume":"389","author":"Zeng","year":"2017","journal-title":"Lancet"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1016\/j.jad.2021.08.093","article-title":"Associations of body mass index, waist circumference and waist-to-height ratio with cognitive impairment among Chinese older adults: based on the CLHLS","volume":"295","author":"Ren","year":"2021","journal-title":"J Affect Disord"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1167","DOI":"10.1016\/j.hlc.2023.06.862","article-title":"Interrelation of chronic lung disease and cardiovascular disease based on two National Prospective Cohort Studies","volume":"32","author":"Ren","year":"2023","journal-title":"Heart Lung Circ"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"100372","DOI":"10.1016\/j.lanwpc.2021.100372","article-title":"Interaction between plant-based dietary pattern and air pollution on cognitive function: a prospective cohort analysis of Chinese older adults","volume":"20","author":"Zhu","year":"2022","journal-title":"Lancet Regional Health Western Pacific"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"8","DOI":"10.3390\/nu8050271","article-title":"Reproducibility and relative validity of a short food frequency questionnaire in 9-10 year-old children","volume":"8","author":"Saeedi","year":"2016","journal-title":"Nutrients"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1186\/1475-2891-11-65","article-title":"Reliability and relative validity of a food frequency questionnaire to assess food group intakes in New Zealand adolescents","volume":"11","author":"Wong","year":"2012","journal-title":"Nutr J"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1079\/PHN2003524","article-title":"Is 'five-a-day' an effective way of increasing fruit and vegetable intakes?","volume":"7","author":"Ashfield-Watt","year":"2004","journal-title":"Public Health Nutr"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"702","DOI":"10.1093\/aje\/kwh090","article-title":"A modified poisson regression approach to prospective studies with binary data","volume":"159","author":"Zou","year":"2004","journal-title":"Am J Epidemiol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"e994","DOI":"10.1016\/S2468-2667(22)00110-4","article-title":"Healthy lifestyle and life expectancy at age 30 years in the Chinese population: an observational study","volume":"7","author":"Sun","year":"2022","journal-title":"Lancet Public Health"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1588","DOI":"10.1016\/j.jacc.2005.11.074","article-title":"Prevalence of the metabolic syndrome and its relation to cardiovascular disease in an elderly Chinese population","volume":"47","author":"He","year":"2006","journal-title":"J Am Coll Cardiol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1080\/10641963.2019.1649682","article-title":"The association of four-limb blood pressure differences with cardiovascular risk factors and target organ changes in elderly Chinese: the northern Shanghai study","volume":"42","author":"Yu","year":"2020","journal-title":"Clin Exp Hypertens"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1866","DOI":"10.1161\/HYPERTENSIONAHA.122.19587","article-title":"Control of blood pressure and risk of cardiovascular disease and mortality in elderly Chinese: a real-world prospective cohort study","volume":"79","author":"Wang","year":"2022","journal-title":"Hypertension"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1169","DOI":"10.1093\/ajcn\/82.6.1169","article-title":"Associations of plant food, dairy product, and meat intakes with 15-y incidence of elevated blood pressure in young black and white adults: the coronary artery risk development in young adults (CARDIA) study","volume":"82","author":"Steffen","year":"2005","journal-title":"Am J Clin Nutr"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"e13595","DOI":"10.1111\/jfbc.13595","article-title":"Macrotyloma uniflorum a plant food alleviates the metabolic syndrome through modulation of adipokines and PPARs","volume":"45","author":"R","year":"2021","journal-title":"J Food Biochem"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1825","DOI":"10.1093\/ajcn\/87.6.1825","article-title":"Associations between microalbuminuria and animal foods, plant foods, and dietary patterns in the multiethnic study of atherosclerosis","volume":"87","author":"Nettleton","year":"2008","journal-title":"Am J Clin Nutr"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"2005","DOI":"10.1016\/j.mayocp.2022.06.008","article-title":"Plant-based diets and all-cause and cardiovascular mortality in a Nationwide cohort in Spain: the ENRICA study","volume":"97","author":"Delgado-Velandia","year":"2022","journal-title":"Mayo Clin Proc"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"5718","DOI":"10.1016\/j.clnu.2021.10.013","article-title":"Plant-based diet quality and the risk of total and disease-specific mortality: a population-based prospective study","volume":"40","author":"Kim","year":"2021","journal-title":"Clin Nutr"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1332","DOI":"10.1056\/NEJMoa1501451","article-title":"Fresh fruit consumption and major cardiovascular disease in China","volume":"374","author":"Du","year":"2016","journal-title":"N Engl J Med"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1956","DOI":"10.1177\/2047487319894685","article-title":"Tea consumption and the risk of atherosclerotic cardiovascular disease and all-cause mortality: the China-PAR project","volume":"27","author":"Wang","year":"2020","journal-title":"Eur J Prev Cardiol"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"e0137178","DOI":"10.1371\/journal.pone.0137178","article-title":"Nut consumption and cardiovascular risk in older Chinese: the Guangzhou biobank cohort study","volume":"10","author":"Sun","year":"2015","journal-title":"PLoS One"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"500","DOI":"10.1016\/j.advnut.2023.03.007","article-title":"Commonalities among dietary recommendations from 2010 to 2021 clinical practice guidelines: a Meta-epidemiological study from the American College of Lifestyle Medicine","volume":"14","author":"Cara","year":"2023","journal-title":"Adv Nutr"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"8","DOI":"10.3390\/nu8060359","article-title":"Protein consumption and the elderly: what is the optimal level of intake?","volume":"8","author":"Baum","year":"2016","journal-title":"Nutrients"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1038\/s41598-023-27974-w","article-title":"The negative association between serum albumin levels and coronary heart disease risk in adults over 45 years old: a cross-sectional survey","volume":"13","author":"Hou","year":"2023","journal-title":"Sci Rep"}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2024.1440025\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T15:46:34Z","timestamp":1721058394000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2024.1440025\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,15]]},"references-count":35,"alternative-id":["10.3389\/fnut.2024.1440025"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2024.1440025","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,15]]},"article-number":"1440025"}}