Comment on “Plant-based diet and risk of arthritis: a nationwide cohort study of the Chinese elderly population” by H. Zhang, J. Liang, Y. Han, J. Tian, Y. Tu, R. Fan, W. Zhu, Z. Zhang and H. Zhao, Food & Function, 2025, 16, 6576

Abstract

Zhang et al. recently reported that higher adherence to plant-based diets was associated with a reduced risk of arthritis in older Chinese adults. However, “arthritis” includes heterogeneous conditions, primarily rheumatoid arthritis (RA) and osteoarthritis (OA), which may respond differently to diet. Using data from 12,125 older adults in the Chinese Longitudinal Healthy Longevity Survey, we focused on OA-specific risk by excluding participants with self-reported or suspected RA. Contrary to protective effects in RA, higher adherence to overall and healthful plant-based diets was associated with increased OA risk, particularly among adults aged ≥75 years. Food-item analyses suggested that vegetables, tea, preserved vegetables, and garlic were linked to higher OA risk, whereas eggs, milk, and beans were protective. These findings underscore the need for disease-specific dietary guidance.