Plant-based diet index | Plant Based Health Professionals UK (2024)

Much of what we know about diet, nutrition and health comes from prospective cohort studies, which follow large groups of people, usually healthy at baseline, for a number of years and analyse associations between dietary intake and health outcomes (incidence of chronic disease and causes of death). Dietary information is usually collected in the form of afood frequency questionnaire(FFQ), which is a list of foods and beverages with response categories to indicate usual frequency of consumption over the time period queried (usually the past 1 year). To assess the total diet, the number of foods and beverages assessed typically ranges from 80 to 120. There are a few prospective cohort studies that have a significant number of vegan and vegetarians such as theAdventist Health Studiesand theEPIC-Oxford study. However, most prospective cohort studies do not include a significant proportion of vegan and vegetarians. Therefore, to study the effects of the consumption of whole plant foods on health, researchers have developed the provegetarian score or plant-based diet index (PDI) — a way of scoring the data collected from FFQs. This plant-based scoring system gives the consumption of plant foods positive marks and the consumption of any animal-derived foods negative markers. Unhealthy plant foods, such as refined grains and sugar and processed foods can also be given negative marks in what is termed an unhealthy plant-based diet index (uPDI).

Plant-based diet index | Plant Based Health Professionals UK (1)

The table above shows the positive and negative marks given to foods in the plant-based diet index. Healthy plant foods are given positive marks and unhealthy plant foods and animal-derived foods are given a negative mark. The first time this sort of scoring was used was in the reanalysis of the PREDIMED study (1), a randomised study of a Mediterranean-style diet high in olive oil or nuts compared to the control diet, which was supposed to be low in fat (but wasn’t). The reanalysis showed that the benefits of the Mediterranean-style diet were really down to the high consumption of whole plant foods and those that consumed a diet with a high plant-based diet score/index had the lowest risk of death from cardiovascular disease. Since that study, a number of prospective cohort studies have shown that participants whose diet has a high PDI have a significant reduction in risk of coronary heart disease (2), cancer (3), type 2 diabetes (4), kidney failure (5), weight grain (6)stroke (7) and even a lower risk of death (8). These studies have also shown that a diet with a high uPDI is associated with an increased risk of all these chronic diseases, even if there is a low consumption of animal-derived foods. Table 2 shows that change in risk associated with high adherence to the PDI and whether it healthy or not healthy.

Plant-based diet index | Plant Based Health Professionals UK (2)

So, in summary, look out for studies that analyse diet data using the PDI to better understand the association between plant-based diets and health. This overcomes the issue of the limited number of studies available in vegans and vegetarians and also provides a way of analysing diet quality.

Plant-based diet index | Plant Based Health Professionals UK (3)

1) A provegetarian food pattern and reduction in total mortality in the Prevención con Dieta Mediterránea (PREDIMED) study.The American Journal of Clinical Nutrition, Volume 100, Issue suppl_1, 1 July 2014, Pages 320S–328S,https://doi.org/10.3945/ajcn.113.071431

2) Healthful and Unhealthful Plant-Based Diets and the Risk of Coronary Heart Disease in U.S. Adults. J Am Coll Cardiol. 2017;70(4):411–22.http://dx.doi.org/10.1016/j.jacc.2017.05.047

3) Association between a pro plant‐based dietary score and cancer risk in the prospective NutriNet‐santé cohort. International Journal of Cancer, 2018, Volume 143, Issue 9 pages 2168–2176.https://doi.org/10.1002/ijc.31593

4) Plant-Based Dietary Patterns and Incidence of Type 2 Diabetes in US Men and Women: Results from Three Prospective Cohort Studies.PLOS Medicine (2016) 13(6): e1002039.https://doi.org/10.1371/journal.pmed.1002039

5) Plant-Based Diets and Incident CKD and Kidney Function. CJASN May 2019, 14 (5) 682–691; DOI:https://doi.org/10.2215/CJN.12391018

6) Satija, A.et al. (2019) ‘Changes in intake of plant-based diets and weight change: results from 3 prospective cohort studies’,The American Journal of Clinical Nutrition, Volume 110, Issue 3, Pages 574–582,https://doi.org/10.1093/ajcn/nqz049

7) Quality of Plant-Based Diet and Risk of Total, Ischemic, and Hemorrhagic Stroke. Neurology Apr 2021, 96 (15) e1940-e1953; DOI:10.1212/WNL.0000000000011713

8) Changes in Plant-Based Diet Quality and Total and Cause-Specific Mortality. Circulation. 2019;140:979–991

Plant-based diet index | Plant Based Health Professionals UK (2024)

FAQs

Can you eat eggs on a plant-based diet? ›

Eggs can and should be part of a plant-based diet, and these five suggestions showcase how easy it is to incorporate the incredible egg into your plant-forward dishes.

What is the PDI diet index? ›

The PDI is a measure of adherence to a plant-based diet in general, while hPDI and uPDI are measures of adherence to a healthy and unhealthy plant-based diet, respectively. To date, these plant-based diet scores have been used mostly in large cohort studies.

What is the downside of a plant-based diet? ›

While a well-balanced plant-based diet can provide a wide range of nutrients, certain essential nutrients are more abundant in animal-derived foods. Plant-based diets can sometimes lead to nutritional deficiencies such as vitamin B12, iron, zinc, calcium, and omega-3 fatty acids.

What is the plant-based diet quality index? ›

This plant-based scoring system gives the consumption of plant foods positive marks and the consumption of any animal-derived foods negative markers. Unhealthy plant foods, such as refined grains and sugar and processed foods can also be given negative marks in what is termed an unhealthy plant-based diet index (uPDI).

Can you eat bananas on a plant-based diet? ›

Foods like olive oil, bleached flour, refined sugar and white rice, even though they are plant-based, are all processed foods and are not included in a WFPB diet. Plant-based means that the food you eat comes from plants, including: Fruits – apples, strawberries, grapes, pineapple, bananas, mango.

Is pasta OK on a plant-based diet? ›

Pasta dishes make an excellent option for those adhering to a plant-based diet for several reasons. To start, pasta is a natural plant-based food made simply from grain, and it is also and easy food to incorporate other plant-based foods into, like veggies and beans.

What is an unhealthy plant-based diet? ›

Using the NOVA classification system, which categorizes food products according to the extent of industrial processes they undergo, “junk” foods can include many plant-based products, such as: commercially-produced breads, pastries, cakes, and cookies. carbonated beverages. pre-packaged snacks.

What is the inflammatory eating index? ›

Dietary Inflammatory Index (DII)® Calculation. DII is a scoring algorithm to classify individuals' diets according to their inflammatory potential. A modified and updated version of DII developed by Shivappa et al. [17] was used in this study.

Can I eat cheese on a plant-based diet? ›

Following a plant-based diet means saying goodbye to all animal products — including lean meat and dairy products such as milk, yogurt, cheese and ice cream.

What foods should you avoid on a plant-based diet? ›

You'll restrict grains and foods made with them, such as bread and pasta. You also limit starchy vegetables like potatoes and corn, as well as beans and legumes. And you'll cut high-sugar tropical fruits such as pineapple, mango, and bananas, as well as fruit juices and sweets.

What country has the most plant-based diet? ›

India. Three of India's major religions — Hinduism, Buddhism, and Jainism — teach the practice of ahimsa, or non-violence towards all beings. Because of this religious tradition, India has the highest percentage of vegetarians out of all the countries in the world.

What are the best plant-based foods for gut health? ›

According to registered dietitian Jennifer Navaroli Hunter, MPH, RD, LDN, this is partly because plant-based whole foods are high in fiber, which the healthy gut bacteria feed on. She recommends consuming a “rainbow” of plant-based foods, like berries, kale, chickpeas, oats, and brown rice, for optimal gut health.

What is a 100% plant-based diet? ›

Both meal plans have made headlines for their health benefits in recent years, and while they are similar, there are some key differences: Vegan diets eliminate all animal products, while plant-based diets do not necessarily eliminate animal products but focus on eating mostly plants, such as fruits, vegetables, nuts, ...

What are vegans who eat eggs called? ›

Contrary to belief, a trend among some vegans involves the inclusion of certain types of eggs into their diet. This 'veggan' diet, as it is known, is not truly vegan – instead, it is called ovo-vegetarian.

Are potatoes on a plant-based diet? ›

The definition of a plant-based diet can depend on who you ask. Generally, it is an eating style that emphasizes real, whole foods that come from plants, including: Vegetables: kale, spinach, tomatoes, cauliflower, potatoes, squash, etc. Whole grains: brown rice, oats, quinoa, barley, etc.

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