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@ARTICLE{Crdova:304087,
      author       = {R. Córdova and J. Kim and A. S. Thompson and H. Noh and S.
                      Shah and C. C. Dahm and C. F. Jensen and L. Mellemkjær and
                      A. Tjønneland and V. Katzke$^*$ and C. Le Cornet$^*$ and C.
                      El-Khoury and M. B. Schulze and G. Masala and C. Agnoli and
                      V. Simeon and R. Tumino and F. Ricceri and W. M. M.
                      Verschuren and Y. T. van der Schouw and C. Castro-Espin and
                      M.-J. Sánchez and A. Aizpurua and D. Rodríguez Palacios
                      and M. Guevara and K. Papier and T. Y. N. Tong and I.
                      Huybrechts and K.-H. Wagner and K. Matta and N.
                      Papadimitriou and A. Heath and D. Aune and M. J. Gunter and
                      P. Ferrari and T. Kühn and H. Freisling},
      title        = {{P}lant-based dietary patterns and age-specific risk of
                      multimorbidity of cancer and cardiometabolic diseases: a
                      prospective analysis.},
      journal      = {The lancet / Healthy longevity},
      volume       = {nn},
      issn         = {2666-7568},
      address      = {London},
      publisher    = {Elsevier},
      reportid     = {DKFZ-2025-01755},
      pages        = {nn},
      year         = {2025},
      note         = {epub},
      abstract     = {It is currently unknown whether plant-based dietary
                      patterns influence disease progression to multimorbidity
                      after an initial non-communicable disease, and whether the
                      associated risk of multimorbidity varies with age. This
                      study aimed to investigate associations of plant-based diets
                      with the risk of multimorbidity, defined as the
                      co-occurrence of at least two chronic diseases in an
                      individual (either cancer at any site, cardiovascular
                      disease, or type 2 diabetes).This prospective cohort study
                      used data from EPIC and UK Biobank across six European
                      countries, with participants aged 35-70 years at
                      recruitment. We excluded participants from these cohorts who
                      had cancer, cardiovascular disease, or type 2 diabetes at
                      baseline or those with missing data on diet or health
                      outcomes. Data on dietary habits were assessed either at
                      baseline through a validated dietary questionnaire about
                      habits in the previous 12 months or through several 24-h
                      recall questionnaires during approximately a year of
                      follow-up. Multistate modelling with Cox regression was used
                      to estimate the risk of multimorbidity according to a
                      healthful plant-based diet index (hPDI) and, separately, an
                      unhealthful plant-based diet index (uPDI). Risk differences
                      in adults younger than 60 years and those age 60 years and
                      older were estimated.407 618 participants (226 324 from EPIC
                      and 181 294 from UK Biobank) were included in this study.
                      During a median follow-up time of 10·9 years in EPIC and
                      11·4 years in UK Biobank, 6604 cancer-cardiometabolic
                      multimorbidity events occurred in both cohorts combined. A
                      ten-point increment of the hPDI score was associated with a
                      lower risk of multimorbidity, with a hazard ratio (HR) of
                      0·89 $(95\%$ CI 0·83-0·96) in EPIC and 0·81
                      (0·76-0·86) in UK Biobank. This inverse association was
                      marginally weaker in older adults than in middle-aged adults
                      in both cohorts. In UK Biobank, a ten-point increment of the
                      hPDI score was associated with multivariable-adjusted HRs of
                      0·71 $(95\%$ CI 0·65-0·79) in adults younger than 60
                      years and 0·86 (0·80-0·92) in those aged 60 years and
                      older (pinteraction=0·0016). The respective HRs in EPIC
                      were 0·86 $(95\%$ CI 0·78-0·95) and 0·92 (0·84-1·02;
                      pinteraction=0·32). A higher adherence to an unhealthy
                      plant-based diet was positively associated with
                      multimorbidity risk in UK Biobank (HR per ten-point
                      increment of uPDI 1·22, $95\%$ CI 1·16-1·29), but this
                      was not replicated in EPIC (1·00, 0·94-1·08).A healthy
                      plant-based diet might reduce the burden of multimorbidity
                      of cancer and cardiometabolic diseases among middle-aged and
                      older adults.The Korean Government (Ministry of Science and
                      ICT).},
      cin          = {C020 / C180},
      ddc          = {610},
      cid          = {I:(DE-He78)C020-20160331 / I:(DE-He78)C180-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40845891},
      doi          = {10.1016/j.lanhl.2025.100742},
      url          = {https://inrepo02.dkfz.de/record/304087},
}