Vegetarian diet and likelihood of becoming centenarians in Chinese adults aged 80 y or older: a nested case-control study.
Level 4 - case-series / case-control
Prospective nested case-control study
PubMed 41391640 · doi:10.1016/j.ajcnut.2025.101136
What was done
This prospective nested case-control study analyzed 5,203 participants aged 80 years or older from the Chinese Longitudinal Healthy Longevity Survey (1998–2018). Participants were classified as omnivores or vegetarians (further categorized into pesco-vegetarians, ovo-lacto-vegetarians, and vegans) based on animal-derived food consumption. Multivariable unconditional logistic regression evaluated the association between diet type and reaching age 100, comparing 1,459 centenarians with 3,744 controls who died before reaching age 100.
What was found
Compared with omnivores, vegetarians had lower odds of becoming centenarians (OR: 0.81, 95% CI: 0.69, 0.96). By subgroup, vegans showed a significantly lower likelihood (OR: 0.71, 95% CI: 0.54, 0.98), whereas associations 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) were not statistically significant. The inverse association was statistically significant among individuals with BMI <18.5 kg/m² (OR: 0.72, 95% CI: 0.57, 0.91), but not among those with BMI ≥18.5 kg/m² (OR: 0.92, 95% CI: 0.73, 1.17; P-interaction = 0.08).
Why it matters
While vegetarian diets are generally associated with reduced morbidity earlier in life, these findings suggest that completely avoiding animal-derived foods in late life (age 80+) may reduce the likelihood of reaching extreme longevity, especially among underweight oldest-old adults.
Limits
The observational nested case-control design cannot rule out reverse causation (e.g., poor health, dental issues, or frailty leading to dietary changes) or residual confounding. Dietary assessment was based on animal food consumption categories rather than full nutrient or caloric metrics. The cohort included only Chinese adults aged 80+, limiting generalizability to younger age groups or other populations.
Cited by
- supports A 2025 case-control study from China found that vegans and vegetarians were less likely to reach age 100 than meat eaters.