ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutritional Epidemiology
Association of Healthy Plant-Based Diet-Lifestyle Score with Obesity-Related Cancer Incidence and Mortality: A Prospective Cohort Study in the UK Biobank
- JY
Jinzhou Yu 1
- QZ
QIANG ZHANG 1
- QZ
Qianyu Zhou 1
- JS
Jifeng Sun 2
- BH
Buwei He 3
- ZW
Zhaohan Wang 4
- ZG
Ziqiu Guo 5
- ML
Mengting Liu 1
- MZ
Mingyang Zhao 1
- TW
Tong Wanyan 1
- YW
Yulong Wan 1
- HY
Hua Ye 1,6
- CS
Changqing Sun 1
1. Zhengzhou University, Zhengzhou, China
2. De Anza College, Cupertino, United States
3. University of South Carolina, Columbia, United States
4. Corona del Mar Middle and High School, Newport Beach, United States
5. The University of Hong Kong School of Nursing, Hong Kong, Hong Kong, SAR China
6. Henan Key Laboratory of Tumor Epidemiology and Henan International Joint Laboratory of Tumor Biomarkers and Molecular Imaging, Zhengzhou, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Abstract
Background: Evidence regarding the combined influence of healthy plant-based dietary patterns and lifestyle behaviours on obesity-related cancer outcomes remains limited. We prospectively investigated the associations of the healthy plant-based diet-lifestyle (hPDI-Lifestyle) score with obesity-related cancer incidence and mortality in the UK Biobank. Methods: Among 104,713 eligible participants, 93,763 were included in the primary complete-case analyses. The hPDI-Lifestyle score integrated healthy plant-based dietary quality, physical activity, smoking status, and sleep duration. Restricted cubic spline analyses were used to examine dose-response relationships, and Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for the three outcomes, including sex-stratified analyses. Several sensitivity analyses were conducted to assess the robustness of the findings. Results: During median follow-up periods of 16.3, 15.0, and 15.1 years, respectively, 2,258 incident obesity-related cancers, 1,095 obesity-related cancer deaths, and 6,215 all-cause deaths were documented. Higher hPDI-Lifestyle scores were associated with lower risks of obesity-related cancer mortality and all-cause mortality. For obesity-related cancer incidence, an inverse association was observed overall, whereas sex-stratified analyses showed no statistically significant association among women. Compared with participants in the lowest tertile, those in the highest tertile had lower risks of obesity-related cancer incidence (HR: 0.82, 95% CI: 0.74–0.92), obesity-related cancer-specific mortality (HR: 0.66, 95% CI: 0.56–0.77), and all-cause mortality (HR: 0.64, 95% CI: 0.60–0.68). Each 1-SD increment in the hPDI-Lifestyle score was associated with 8%, 18%, and 22% lower risks of obesity-related cancer incidence, obesity-related cancer-specific mortality, and all-cause mortality, respectively. Conclusions: Higher hPDI-Lifestyle scores were associated with lower risks of obesity-related cancer incidence, cancer-specific mortality, and all-cause mortality. These findings require confirmation in more representative populations and intervention studies before preventive implications can be established.
Summary
Keywords
Cancer mortality, healthy plant-based diet, lifestyle score, obesity-related cancer, UK Biobank
Received
28 June 2026
Accepted
21 August 2026
Copyright
© 2026 Yu, ZHANG, Zhou, Sun, He, Wang, Guo, Liu, Zhao, Wanyan, Wan, Ye and Sun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Hua Ye; Changqing Sun
Disclaimer
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.