Welcome to the prospective cohort studies section of our evidence library, where we present research that follows groups of individuals over time to examine the impact of plant-based diets on long-term health outcomes.
This page focuses on studies at the upper mid-tier of the evidence pyramid, which track the dietary habits and health outcomes of large groups of individuals over an extended period. Prospective cohort studies are designed to observe how plant-based diets influence the development of chronic conditions such as heart disease, diabetes, and obesity. By tracking participants over time, these studies can provide stronger evidence of associations between diet and health outcomes, helping to identify trends and potential causal relationships. While not as definitive as randomized controlled trials, these studies contribute valuable insights into the long-term benefits of plant-based eating.
# of prospective studies included = 5
Case Studies | Case-Control Studies | Cross-Sectional | Clinical Trials & RCTs | Systematic Reviews & Meta-Analysis
This longitudinal comparative study followed 84 patients who had been treated for coronary heart disease, comparing cardiovascular risk changes across three groups: those in the Ornish Heart Disease Reversing Program (a low-fat, whole-food, plant-based diet), traditional cardiac rehabilitation (which typically includes a standard heart-healthy diet with moderate fat), and a control group with no formal dietary or lifestyle intervention. After 6 months, the plant-based diet group showed significantly greater reductions in angina, BMI, blood pressure, total cholesterol, LDL, and glucose compared to both other groups, highlighting the program’s superior impact on CVD risk. PubMed
This longitudinal comparative study followed 84 heart disease patients over six months to assess the impact of the Ornish Program (low-fat, plant-based diet), traditional cardiac rehab, or no rehab on psychosocial risk factors and quality of life. The Ornish group saw significant improvements in all 12 measured outcomes (psychosocial risk factors and quality of life variables), while the rehab group improved in 7 and the control group in 6. These findings suggest that intensive lifestyle modification programs may have the greatest benefits for mental well-being and quality of life in heart disease patients.. PubMed
This cohort study, part of the CARDIA study, followed 4,946 young adults (ages 18-30) for 32 years to see if plant-centered diets were linked to a lower risk of cardiovascular disease (CVD). The researchers found that both long-term adherence to a plant-based diet and making changes towards such a diet were associated with a significantly lower risk of developing CVD, coronary heart disease, and hypertension-related CVD. Specifically, the highest adherence to the plant-centered diet was linked to a 52% lower risk of CVD, and a 13-year improvement in diet quality was associated with a 61% lower risk. PubMed
The ATTICA study followed 2,020 adults in Greece for about 10 years to examine how plant-based diet quality affects cardiovascular disease (CVD) risk. Participants with the highest adherence to a healthful plant-based diet had a 68% lower risk of developing CVD compared to those with the lowest adherence (HR 0.32, 95% CI 0.16-0.63, p = 0.003). However, not all plant-based diets were beneficial—higher intake of unhealthful plant foods was linked to increased CVD risk. These findings highlight the importance of diet quality, as plant-based diets rich in whole, minimally processed foods may help prevent heart disease. PubMed
This cohort study explored the relationship between a vegetarian diet and the incidence of gouty arthritis among 76,972 participants in Taiwan, using data from the MJ Health Survey and National Health Insurance Research Database. The results showed that vegetarians had a significantly lower risk of developing gouty arthritis compared to non-vegetarians (hazard ratio = 0.87). After adjusting for potential confounders, vegetarians were found to have a decreased incidence of gout, suggesting that a vegetarian diet, rich in vegetables, fruits, and soy products, may offer protection against gouty arthritis. PubMed
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