Association between plant-based diet and different types of obesity
ZHOU Mengyi1, SU Danting2, HE Mengjie2, XU Peiwei2, HAN Dan2, HUANG Lichun2, ZHANG Ronghua2
1. Scchool of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang 310053, China; 2. Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang 310051, China
Abstract：Objective To investigate the association between plant-based diet and different types of obesity, so as to provide references for obesity prevention. Methods Residents aged 35-75 years from 33 counties (cities, districts) in Zhejiang Province were selected as study subjects using a multistage stratified random sampling method between April and December 2024. Demographic information and living behaviors were collected using questionnaire surveys. Height, weight and waist circumference were measured, and body mass index (BMI) was calculated. BMI ≥28.0 kg/m2 was defined as obesity, waist circumference ≥90 cm in males or ≥85 cm in females was defined as central obesity, and individual with obesity who also had central obesity was defined as having compound obesity. Food intake over a 3-day period was collected using the consecutive 3-day 24-hour dietary recall method. The plant diet index (PDI), healthful plant diet index (HPDI), and unhealthful plant diet index (UPDI) were calculated, and categorized into quintiles (Q1-Q5) based on their distribution. Association between the PDI, PDI, UPDI and different types of obesity were analyzed using multivariable logistic regression models. Results A total of 4 882 individuals were surveyed, including 2 233 males (45.74%) and 2 649 females (54.26%). The average age was (55.42±12.14) years. There were 537 individuals of obesity, 1 718 individuals of central obesity, and 500 individuals of compound obesity, with detection rates of 11.00%, 35.19%, and 10.24%, respectively. Multivariable logistic regression analysis showed that, after adjusting for demographic information and living behaviors, compared with Q1 group, HPDI Q5 group showed a 29.6% lower risk of obesity (OR=0.704, 95%CI: 0.525-0.943) and a 32.1% lower risk of compound obesity (OR=0.679, 95%CI: 0.502-0.918). Conversely, the UPDI Q5 group exhibited a 39.5% higher risk of obesity (OR=1.395, 95%CI: 1.032-1.886) and a 39.8% higher risk of compound obesity (OR=1.398, 95%CI: 1.025-1.907). No statistically significant association was found between PDI and obesity, central obesity, and compound obesity (all P>0.05). As HPDI increased, the risks of obesity and compound obesity showed decreasing trends; as UPDI increased, the risks of obesity and compound obesity showed increasing trends (all Ptrend<0.05). Conclusion A healthful plant-based diet is associated with reduced risks of obesity and compound obesity, while an unhealthful plant-based diet is associated with increased risks of obesity and compound obesity.
周梦怡, 苏丹婷, 何梦洁, 徐沛维, 韩丹, 黄李春, 章荣华. 植物性饮食与不同肥胖类型的关联研究[J]. 预防医学, 2025, 37(8): 773-778.
ZHOU Mengyi, SU Danting, HE Mengjie, XU Peiwei, HAN Dan, HUANG Lichun, ZHANG Ronghua. Association between plant-based diet and different types of obesity. Preventive Medicine, 2025, 37(8): 773-778.
[1] World Health Organization.Obesity and overweight[EB/OL].[2025-07-27].https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight. [2] 中国居民营养与慢性病状况报告(2020年)[J].营养学报,2020,42(6):521. Report on nutrition and chronic disease status of Chinese residents(2020)[J].Acta Nutrimenta Sinica,2020,42(6):521.(in Chinese) [3] SUN J,RUAN Y T,XU N N,et al.The effect of dietary carbohydrate and calorie restriction on weight and metabolic health in overweight/obese individuals:a multi-center randomized controlled trial[J].BMC Med,2023,21(1):1-12. [4] HARGREAVES S M,ROSENFELD D L,MOREIRA A V B,et al.Plant-based and vegetarian diets:an overview and definition of these dietary patterns[J].Eur J Nutr,2023,62(3):1109-1121. [5] MAMBRINI S P,PENZAVECCHIA C,MENICHETTI F,et al.Plant-based and sustainable diet:a systematic review of its impact on obesity[J].Obes Rev,2025,26(6):1-13. [6] 汪紫薇,陈慧媛,朱晓华.中国居民膳食结构的区域差异及其健康效应[J].地理科学,2023,43(10):1825-1836. WANG Z W,CHEN H Y,ZHU X H.Regional differences and health effects of dietary pattern of Chinese residents[J].Sci Geogr Sin,2023,43(10):1825-1836.(in Chinese) [7] World Health Organization.WHO guidelines on physical activity and sedentary behaviour[R].Geneva:WHO,2020. [8] 中华人民共和国国家卫生和计划生育委员会.成人体重判定:WS/T 428—2013[S].北京:中国标准出版社,2013. National Health and Family Planning Commission of the People's Republic of China. Criteria of weight for adults:WS/T 428—2013[S].Beijing:Standards Press of China,2013.(in Chinese) [9] 潘姚佳,傅方琳,韩正,等.肥胖类型与心血管代谢性共病的关系:基于不同性别的中年居民[J].中国全科医学,2025,28(18):2285-2293. PAN Y J,FU F L,HAN Z,et al.Correlation of the type of obesity with the cardiometabolic multimorbidity:a study in male and female middle-aged residents in Anhui Province[J].Chin Gen Pract,2025,28(18):2285-2293.(in Chinese) [10] SATIJA A,BHUPATHIRAJU S N,RIMM E B,et al.Plant-based dietary patterns and incidence of type 2 diabetes in US men and women:results from three prospective cohort studies[J].PLoS Med,2016,13(6):1-18. [11] 何梦洁,黄李春,苏丹婷,等.浙江省成年人群肥胖流行现状[J].预防医学,2021,33(2):162-164. HE M J,HUANG L C,SU D T,et al.Prevalence of obesity among adults in Zhejiang Province[J].China Prev Med J,2021,33(2):162-164.(in Chinese) [12] 张伟伟,吴同浩,马进,等.江苏省35~75岁居民肥胖和中心性肥胖现况调查[J].预防医学,2019,31(9):886-890,896. ZHANG W W,WU T H,MA J,et al.Cross-sectional study on obesity and central obesity among 35-75 year-old people in Jiangsu Province[J].China Prev Med J,2019,31(9):886-890,896.(in Chinese) [13] 郭向娇,李建彬,刘建勋,等.郑州市成人中心性肥胖现况及影响因素调查[J].预防医学,2019,31(11):1147-1149. GUO X J,LI J B,LIU J X,et al.Prevalence and influencing factors of central obesity among adults in Zhengzhou City[J].China Prev Med J,2019,31(11):1147-1149.(in Chinese) [14] CAREY M T,MILLAR S R,ELLIOTT P S,et al.Plant-based diet adherence is associated with metabolic health status in adults living with and without obesity[J].Eur J Nutr,2024,63(6):2235-2246. [15] KOEDER C,ALZUGHAYYAR D,ANAND C,et al.The healthful plant-based diet index as a tool for obesity prevention:the healthy lifestyle community program cohort 3 study[J].Obes Sci Pract,2022,9(3):296-304. [16] SIDHU S R K,KOK C W,KUNASEGARAN T,et al.Effect of plant-based diets on gut microbiota:a systematic review of interventional studies[J/OL].Nutrients,2023,15(6)[2025-07-27].https://doi.org/10.3390/nu15061510. [17] THOMAS M S,CALLE M,FERNANDEZ M L.Healthy plant-based diets improve dyslipidemias,insulin resistance,and inflammation in metabolic syndrome.A narrative review[J].Adv Nutr,2023,14(1):44-54. [18] TIMM M,OFFRINGA L C,VAN KLINKEN B J,et al.Beyond insoluble dietary fiber:bioactive compounds in plant foods[J/OL].Nutrients,2023,15(19)[2025-07-27].https://doi.org/10.3390/nu15194138. [19] JUNG S,PARK S.Positive association of unhealthy plant-based diets with the incidence of abdominal obesity in Korea:a comparison of baseline,most recent,and cumulative average diets[J/OL].Epidemiol Health,2022,44[2025-07-27].https://doi.org/10.4178/epih.e2022063. [20] WEICKERT M O,PFEIFFER A F H.Impact of dietary fiber consumption on insulin resistance and the prevention of type 2 diabetes[J].J Nutr,2018,148(1):7-12. [21] RAVICHANDRAN G,LAKSHMANAN D K,ARUNACHALAM A,et al.Food obesogens as emerging metabolic disruptors;a toxicological insight[J/OL].J Steroid Biochem Mol Biol,2022,217[2025-07-27].https://doi.org/10.1016/j.jsbmb.2021.106042. [22] ASOUDEH F,MOUSAVI S M,KESHTELI A H,et al.The association of plant-based dietary pattern with general and abdominal obesity:a large cross-sectional study[J].J Diabetes Metab Disord,2023,22(1):469-477. [23] 焦莹莹,姜红如,李惟怡,等.2018年中国15个省(自治区、直辖市)18~64岁成年居民差异化地域膳食模式特征[J].卫生研究,2023,52(1):11-19. JIAO Y Y,JIANG H R,LI W Y,et al.Analysis of differentiated regional dietary patterns of adults aged 18-64 years in 15 provinces(autonomous regions,municipalities)in 2018[J].J Hygiene Res,2023,52(1):11-19.(in Chinese) [24] 马志敏,郝晓燕,王东阳,等.中国膳食模式的特征、分布及其与健康相关性研究进展[J].食品工业科技,2023,44(10):396-405. MA Z M,HAO X Y,WANG D Y,et al.Evolution and distribution of dietary patterns in China and the research progress of its correlation with health[J].Sci Technol Food Ind,2023,44(10):396-405.(in Chinese) [25] KIM H,LEE K,REBHOLZ C M,et al.Association between unhealthy plant-based diets and the metabolic syndrome in adult men and women:a population-based study in South Korea[J].Br J Nutr,2021,125(5):577-590. [26] FAROOQ A,KNEZ W L,KNEZ K,et al.Gender differences in fat distribution and inflammatory markers among Arabs[J/OL].Mediators Inflamm,2013[2025-07-27].http://dx.doi.org/10.1155/2013/497324. [27] KHARATY S,HARRINGTON J M,MILLAR S R,et al.Plant-based dietary indices and biomarkers of chronic low-grade inflammation:a cross-sectional analysis of adults in Ireland[J].Eur J Nutr,2023,62(8):3397-3410.
