Changes in plant-based diet quality and health-related quality of life in women

Few studies have evaluated the association between a healthful plant-based diet and health-related quality of life (HRQoL). We followed 50 290 women in the Nurses' Health Study (NHS; 1992-2000) and 51 784 women in NHSII (1993-2001) for 8 years to investigate changes in plant-based diet quality in relation to changes in physical and mental HRQoL. Plant-based diet quality was assessed by three plant-based diet indices: overall plant-based diet index (PDI), healthful PDI (hPDI) and unhealthful PDI (uPDI). Physical and mental HRQoL were measured by physical component score (PCS) and mental component score (MCS) of the 36-Item Short Form Health Survey. Diet was assessed 2 years before the HRQoL measurements and both were updated every 4 years. The associations between 4-year changes in PDIs and HRQoL were evaluated. Each 10-point increase in PDI was associated with an improvement of 0 center dot 07 (95 % CI 0 center dot 01, 0 center dot 13) in PCS and 0 center dot 11 (95 % CI 0 center dot 05, 0 center dot 16) in MCS. A 10-point increase in hPDI was associated with an increment of 0 center dot 13 (95 % CI 0 center dot 08, 0 center dot 19) in PCS and 0 center dot 09 (95 % CI 0 center dot 03, 0 center dot 15) in MCS. Conversely, a 10-point increase in uPDI was associated with decreases in PCS and MCS (-0 center dot 07 (95 % CI -0 center dot 12, -0 center dot 02) and -0 center dot 10 (95 % CI -0 center dot 16, -0 center dot 05), respectively). Compared with a stable diet, an increase in hPDI was significantly associated with improvements in physical HRQoL in older women and with mental HRQoL in younger women. In conclusion, adherence to a healthful plant-based diet was modestly associated with improvements in both physical and mental dimensions of HRQoL.