The association between plant-based diet indices and risk of mortality in patients with cirrhosis: a cohort study

Background: Following a plant-based diet is associated with a wide range of health benefits. The current study aimed to investigate the association between plant-based diet indices, specifically the plant-based diet index (PDI), healthful PDI (hPDI), and unhealthful PDI (uPDI) and risk of mortality in cirrhotic patients.

Methods: This cohort study included a total of 121 patients with cirrhosis, who were followed for four years. Plant-based diet indices were calculated based on a validated semi-quantitative food frequency questionnaire consisting of 168 items. The Hazard ratio (HR) with their corresponding 95% confidence intervals (CIs) were estimated using the Cox proportional risk models.

Results: During 414 person-year of follow-up, 43 deaths (7 women, 36 men) were documented. After adjusting all confounders, it has been found that the PDI (HR _{T3 vs. T1} = 0.16, 95% CI = 0.03-0.89, P trend = 0.024) and hPDI (HR _{T3 vs. T1} = 0.04, 95% CI = 0.02-0.61, P trend = 0.020) were inversely associated with the risk of mortality. While uPDI was directly associated with a significant increase in mortality risk (HR _{T3 vs. T1} = 8.74, 95% CI = 0.33-17.14, P trend = 0.018). The 4-year survival rate among patients showed a significant relationship with all three indices.

Conclusions: Our findings highlight that higher scores of PDI and hPDI can significantly reduce the risk of mortality in patients with cirrhosis, while a significant increase in mortality risk was found in those with higher uPDI. However, confirmation of these findings requires further studies.