A Provegetarian Food Pattern Emphasizing Preference for Healthy Plant-Derived Foods Reduces the Risk of Overweight/Obesity in the SUN Cohort

• Main Authors: Clara Gómez-Donoso, Miguel Ángel Martínez-González, J. Alfredo Martínez, Alfredo Gea, Julen Sanz-Serrano, Federico J. A. Perez-Cueto, Maira Bes-Rastrollo
• Format: Article
• Language: English
• Published: MDPI AG 2019-07-01
• Series: Nutrients
• Subjects: overweight; obesity; dietary patterns; vegetarian; provegetarian; epidemiology; nutrition; prospective cohort study
• Online Access: https://www.mdpi.com/2072-6643/11/7/1553

Provegetarian diets (i.e., preference for plant-derived foods but not exclusion of animal foods) have been associated with a reduced risk of long-term weight gain and could be more easily embraced than strict vegetarian diets. However, not all plant-derived foods are equally healthy. In the “Seguimiento Universidad de Navarra” (SUN) cohort, we prospectively evaluated the association between different provegetarian food patterns and the incidence of overweight/obesity in 11,554 participants with initial body mass index <25 kg/m². A provegetarian food pattern (FP) was built by assigning positive scores to plant foods and reverse scores to animal foods. A healthful and an unhealthful provegetarian FP, which distinguished between healthy (fruits/vegetables/whole grains/nuts/legumes/olive oil/coffee) and less-healthy plant foods (fruit juices/potatoes/refined grains/pastries/sugary beverages), were also built. A total of 2320 new cases of overweight or obesity were identified after a median follow-up of 10.3 years. Higher baseline conformity with the overall provegetarian FP was inversely associated with overweight/obesity (HR comparing extreme quintiles: 0.85; 95% CI: 0.75 to 0.96; p-trend: 0.014). This association was stronger for the healthful FP (HR: 0.78; 95% CI: 0.67 to 0.90; p-trend: <0.001) and was not apparent for the unhealthful FP (HR: 1.07; 95% CI: 0.92 to 1.23; p-trend: 0.551). In a large prospective cohort of relatively young adults, better conformity with a healthy provegetarian diet was associated with a reduced long-term risk of overweight/obesity, whereas no consistent trend was found for a FP that emphasized less-healthy plant foods.