Sunday, 14 September, 2025
A major new study has followed 407,618 adults across six European countries for around 11 years, tracking the development of cancer, heart disease, and type 2 diabetes. Researchers examined how closely participants adhered to a healthful, plant-based diet and how that related to the onset of multiple health conditions.
The project was led by Reynalda Córdova, a nutritional epidemiologist at the University of Vienna, working with colleagues across Europe. Their analysis focused on real-world eating patterns, combining two large datasets to assess long-term effects.
Chronic diseases often occur together, a phenomenon clinicians call multimorbidity. Preventing multiple serious conditions not only reduces the burden on individuals and families but also eases pressure on healthcare systems. In public health, even modest reductions in disease incidence are significant, as risks compound when illnesses cluster.
The study used the term “cardiometabolic” to describe heart and metabolic problems that frequently intersect with cancer risk. By examining the co-occurrence of conditions rather than single diagnoses, the researchers sought to understand how disease accumulates over time.
Participants were drawn from the EPIC study and the UK Biobank, two major cohort projects that link lifestyle and health records. Diet quality was measured using a healthful plant-based diet index, which rewards high consumption of vegetables, fruit, whole grains, legumes, nuts, and coffee, while penalising refined grains, sweets, and animal products. A separate unhealthful plant-based diet index scores higher for refined plant foods and sugary drinks, reflecting differences in plant food quality.
The researchers estimated hazard ratios to express how much risk changed with each 10-point increase in the diet score, adjusting for age, sex, smoking, physical activity, and alcohol consumption. They also considered the sequence of health events to mirror how disease accumulates in real life.
Across the combined cohorts, 6,604 participants developed two of the three illnesses during follow-up. A 10-point increase in the healthful plant diet score was associated with an 11% lower risk in the EPIC study and a 19% lower risk in the UK Biobank. Among adults younger than 60, the hazard ratio was 0.71, compared with 0.86 for those aged 60 or older, indicating a stronger association in midlife. The unhealthful plant diet score showed a positive association in the UK Biobank but no clear link in EPIC, highlighting that not all plant-rich diets are equally beneficial.
“A healthy plant-based diet might reduce the burden of multimorbidity of cancer and cardiometabolic diseases among middle-aged and older adults,” concluded Córdova. The healthful diet emphasises vegetables, fruit, whole grains, beans, nuts, and coffee, while limiting refined carbohydrates, sweets, and red or processed meat. In contrast, the unhealthful score rises with sodas, sweets, white bread, and other refined foods that displace fibre-rich, nutrient-dense options.
The study aligns with previous research. A Lancet review linked higher fibre intake with lower risk of non-communicable diseases and improved glycaemic control. Fibre also supports gut microbes that produce short-chain fatty acids, which help maintain metabolic and immune balance. Other evidence associates plant-based eating with lower risk of type 2 diabetes, particularly when diets emphasise healthful plant foods. Lower weight, reduced inflammation, and better insulin sensitivity likely explain much of the benefit.
The authors note some limitations. Diet was self-reported and may change after a diagnosis, potentially weakening associations. Unmeasured factors could also influence results. The inconsistency of the unhealthful score between EPIC and UK Biobank suggests that context, measurement methods, and cultural differences in diet matter. Nonetheless, the overall patterns are consistent with prior literature, reinforcing confidence in the findings.
Importantly, the research does not call for total exclusion of animal products. Instead, it highlights dietary patterns in which plant-based foods predominate while refined and animal-derived foods are limited. Even small improvements in diet quality can be realistic, sustainable, and aligned with widely recommended approaches for lifelong health.
The study is published in The Lancet Healthy Longevity.
Comments
A major new study has followed 407,618 adults across six European countries for around 11 years, tracking the development of cancer, heart disease, and type 2 diabetes. Researchers examined how closely participants adhered to a healthful, plant-based diet and how that related to the onset of multiple health conditions.
The project was led by Reynalda Córdova, a nutritional epidemiologist at the University of Vienna, working with colleagues across Europe. Their analysis focused on real-world eating patterns, combining two large datasets to assess long-term effects.
Chronic diseases often occur together, a phenomenon clinicians call multimorbidity. Preventing multiple serious conditions not only reduces the burden on individuals and families but also eases pressure on healthcare systems. In public health, even modest reductions in disease incidence are significant, as risks compound when illnesses cluster.
The study used the term “cardiometabolic” to describe heart and metabolic problems that frequently intersect with cancer risk. By examining the co-occurrence of conditions rather than single diagnoses, the researchers sought to understand how disease accumulates over time.
Participants were drawn from the EPIC study and the UK Biobank, two major cohort projects that link lifestyle and health records. Diet quality was measured using a healthful plant-based diet index, which rewards high consumption of vegetables, fruit, whole grains, legumes, nuts, and coffee, while penalising refined grains, sweets, and animal products. A separate unhealthful plant-based diet index scores higher for refined plant foods and sugary drinks, reflecting differences in plant food quality.
The researchers estimated hazard ratios to express how much risk changed with each 10-point increase in the diet score, adjusting for age, sex, smoking, physical activity, and alcohol consumption. They also considered the sequence of health events to mirror how disease accumulates in real life.
Across the combined cohorts, 6,604 participants developed two of the three illnesses during follow-up. A 10-point increase in the healthful plant diet score was associated with an 11% lower risk in the EPIC study and a 19% lower risk in the UK Biobank. Among adults younger than 60, the hazard ratio was 0.71, compared with 0.86 for those aged 60 or older, indicating a stronger association in midlife. The unhealthful plant diet score showed a positive association in the UK Biobank but no clear link in EPIC, highlighting that not all plant-rich diets are equally beneficial.
“A healthy plant-based diet might reduce the burden of multimorbidity of cancer and cardiometabolic diseases among middle-aged and older adults,” concluded Córdova. The healthful diet emphasises vegetables, fruit, whole grains, beans, nuts, and coffee, while limiting refined carbohydrates, sweets, and red or processed meat. In contrast, the unhealthful score rises with sodas, sweets, white bread, and other refined foods that displace fibre-rich, nutrient-dense options.
The study aligns with previous research. A Lancet review linked higher fibre intake with lower risk of non-communicable diseases and improved glycaemic control. Fibre also supports gut microbes that produce short-chain fatty acids, which help maintain metabolic and immune balance. Other evidence associates plant-based eating with lower risk of type 2 diabetes, particularly when diets emphasise healthful plant foods. Lower weight, reduced inflammation, and better insulin sensitivity likely explain much of the benefit.
The authors note some limitations. Diet was self-reported and may change after a diagnosis, potentially weakening associations. Unmeasured factors could also influence results. The inconsistency of the unhealthful score between EPIC and UK Biobank suggests that context, measurement methods, and cultural differences in diet matter. Nonetheless, the overall patterns are consistent with prior literature, reinforcing confidence in the findings.
Importantly, the research does not call for total exclusion of animal products. Instead, it highlights dietary patterns in which plant-based foods predominate while refined and animal-derived foods are limited. Even small improvements in diet quality can be realistic, sustainable, and aligned with widely recommended approaches for lifelong health.
The study is published in The Lancet Healthy Longevity.
Comments
