{
  "abstract": "Aims: To examine the associations of the overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI) with all-cause mortality in older Chinese adults with data-adapted early-stage cardiovascular-kidney-metabolic (CKM) syndrome (stages 0–2).\n\nMethods and results: We analyzed data from 5,872 participants aged ≥65 years from the 2008 wave of the China Longitudinal Healthy Longevity Survey (CLHLS) with data-adapted CKM stages 0–2 and no prevalent cardiovascular disease. Dietary intake was assessed using a validated food frequency questionnaire. Mortality was ascertained through March 2019. Cox proportional hazards models and restricted cubic spline analyses were used. During a median follow-up of 108 months, 2,870 deaths occurred. In multivariable-adjusted models, each 1-point increase in hPDI was associated with a 1.1% lower mortality risk (HR = 0.989, 95% CI: 0.982–0.995; p < 0.001), whereas each 1-point increase in uPDI was associated with a 1.2% higher mortality risk (HR = 1.012, 95% CI: 1.006–1.019; p < 0.001). Compared with the lowest quartile, the highest hPDI quartile had a 13.2% lower mortality risk (HR = 0.868, 95% CI: 0.783–0.961), and the highest uPDI quartile had a 19.2% higher risk (HR = 1.192, 95% CI: 1.060–1.340). Stratified estimates suggested numerically stronger associations in CKM stages 1–2 than in stage 0; however, formal interaction tests did not reach statistical significance (p = 0.062 for hPDI and p = 0.824 for uPDI), indicating limited evidence of effect modification.\n\nConclusion: Higher adherence to a healthful plant-based diet was associated with lower all-cause mortality, whereas higher adherence to an unhealthful plant-based diet was associated with higher mortality among older Chinese adults with data-adapted early-stage CKM syndrome. The overall PDI was not independently associated with mortality after adjustment, underscoring that plant-based dietary quality, rather than plant-based eating per se, is the relevant exposure.",
  "abstract_shown": true,
  "affiliations": [
    "Chengdu University of Traditional Chinese Medicine , ,",
    "Department of Neurology, The 925th Hospital of PLA Joint Logistics Support Force , ,",
    "Nanjing University of Chinese Medicine , ,",
    "Guangzhou University of Chinese Medicine , ,",
    "Department of Cardiology, The 982th Hospital of PLA Joint Logistics Support Force , , ,"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Shipeng Zhang"
    },
    {
      "affs": [
        1
      ],
      "name": "Enjie Tang"
    },
    {
      "affs": [
        2
      ],
      "name": "Yanjie Jiang"
    },
    {
      "affs": [
        0
      ],
      "name": "Kun Zhu"
    },
    {
      "affs": [
        0
      ],
      "name": "Xiulian Zhuang"
    },
    {
      "affs": [
        0
      ],
      "name": "Hanyu Wang"
    },
    {
      "affs": [
        3
      ],
      "name": "Xingyi He"
    },
    {
      "affs": [
        2
      ],
      "name": "Yan Lu"
    },
    {
      "affs": [
        0
      ],
      "name": "Qinxiu Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Xueying Li"
    },
    {
      "affs": [
        4
      ],
      "name": "Jiaqing Song"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9ff3xgjf9vhnf.bib",
  "cited_by": 0,
  "doi": "10.3389/fnut.2026.1915953",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13721378/?tool=EBI",
  "id": "9ff3xgjf9vhnf",
  "issns": [
    "2296-861X"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13721378",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2739|Nutritional Studies and Diet"
    ]
  ],
  "openalex": "W7222495404",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13721378/pdf/?tool=EBI",
  "pmcid": "PMC13721378",
  "pmid": "42965082",
  "published": "2026-10-16",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/9ff3xgjf9vhnf.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:21:36Z",
      "native_id": "PMC:PMC13721378",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13721378"
    },
    {
      "first_seen": "2026-11-03T12:22:05Z",
      "native_id": "PMC13721378",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fnut.2026.1915953"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2739|Nutritional Studies and Diet",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "The associations between healthful and unhealthful plant-based dietary patterns and all-cause mortality among older Chinese adults with data-adapted early-stage cardiovascular-kidney-metabolic syndrome (stages 0–2): a prospective cohort study from the CLHLS",
  "title_text": "The associations between healthful and unhealthful plant-based dietary patterns and all-cause mortality among older Chinese adults with data-adapted early-stage cardiovascular-kidney-metabolic syndrome (stages 0–2): a prospective cohort study from the CLHLS",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T12:22:05Z",
  "url": "https://research.draconitic.com/paper/9ff3xgjf9vhnf",
  "venue": "Frontiers in nutrition",
  "versions": []
}