Summary
This prospective study examined whether following a vegetarian diet influences the likelihood of reaching exceptional longevity (100 years) among adults aged 80 and older in China. Using data from the Chinese Longitudinal Healthy Longevity Survey, researchers analyzed 5,203 participants, including 1,459 centenarians and 3,744 individuals who died before age 100.
Participants were categorized as omnivores or vegetarians, with vegetarian subgroups including pesco-vegetarians, ovo-lacto-vegetarians, and vegans. Results showed that vegetarians overall had a lower likelihood of becoming centenarians compared with omnivores. A similar pattern was observed for vegans, while the associations for pesco-vegetarians and ovo-lacto-vegetarians were not statistically significant. The reduced likelihood of reaching 100 years was mainly observed among underweight individuals (BMI <18.5) and not among those with normal or higher BMI.
Overall, the study suggests that among the oldest adults in China, following a vegetarian diet was associated with a lower probability of reaching 100 years, highlighting the potential importance of a balanced diet including both plant and animal foods for exceptional longevity, particularly in underweight elderly individuals.
PMID: 41391640
DOI: 10.1016/j.ajcnut.2025.101136
Abstract
Background: Inverse associations of vegetarian diet with morbidity and mortality have been observed; however, the role of vegetarian diet on exceptional longevity remains unrevealed.
Objectives: This study aims to examine the association between a vegetarian diet and likelihood of becoming a centenarian in adults aged ≥80 y.
Methods: This prospective nested case-control study included 5203 participants aged 80+ y from the Chinese Longitudinal Healthy Longevity Survey, a nationally representative cohort initiated in 1998. Participants were classified as omnivores and vegetarians, and further into vegetarian subgroups (pesco-vegetarians, ovo-lacto-vegetarians, and vegans) based on consumption of animal-derived foods. The primary outcome was living to 100 y old by the end of follow-up (2018). Multivariable unconditional logistic regression models were used to evaluate the association analysis.
Results: The study identified 1459 centenarians and matched them with 3744 noncentenarians (who had deceased before reaching 100 y). Relative to omnivores, vegetarians had a lower likelihood of becoming centenarians [odds ratio (OR): 0.81, 95% confidence interval (CI): 0.69, 0.96], and similar patterns were observed for vegans (OR: 0.71, 95% CI: 0.54, 0.98), but not for pesco-vegetarians (OR: 0.84, 95% CI: 0.64, 1.09) and ovo-lacto-vegetarians (OR: 0.86, 95% CI: 0.67, 1.09). The significant association was seen in individuals with BMI <18.5 kg/m2 (OR: 0.72, 95% CI: 0.57, 0.91), but not for those with BMI ≥18.5 kg/m2 (OR: 0.92, 95% CI: 0.73, 1.17) (P-interaction = 0.08).
Conclusions: Targeting individuals of advanced age (80+ y) in China, we found that individuals following a vegetarian diet had a lower likelihood of becoming centenarians relative to omnivores, underscoring the importance of a balanced, high-quality diet with animal- and plant-derived food composition for exceptional longevity, especially in the underweight oldest-old.