Healthy diets also have protective effects for those at a normal weight

There are major health reasons to care about what you eat beyond how much you weigh. Everyone dies from some cause eventually but reducing probability from the top causes of death statistically increases life span at a population level. Specific dietary patterns have been shown to be protective against cancer, heart disease, and diabetes in experiments controlled for BMI. Across many studies, greater consumption of Mediterranean diet foods (fruit, vegetables, legumes, nuts, and whole grains) have been found to reduce disease incidence, while consumption of Western diet foods (red meats, processed meats, sugar, and refined grains) has been found to increase disease incidence. A few examples below:

  • A meta-analysis of 45 studies including information on 786,000 participants found high whole grain consumption was associated with reduced risk of coronary heart disease, cardiovascular disease, total cancer, and all cause mortality as well as mortality from respiratory disease, infections, diabetes, and all non-cardiovascular, non-cancer causes combined. In the analysis, all studies adjusted for BMI suggesting an association independent of BMI [1].
  • In the 2009 Adventist Health Study-2 of 60,000 surveyed participants, after adjusting for age, sex, ethnicity, income, physical activity, TV watching, sleep habits, alcohol use and BMI, vegans, lacto-ovo vegetarians, pesco vegetarians, and semi-vegetarians had a lower risk of type 2 diabetes than nonvegetarians. Vegans had the lowest risk [2].
  • A meta-analysis of 22 studies found higher consumption of fruits, vegetables, and soy play a protective role in breast cancer with little change in results among studies adjusted for BMI [3].
  • A meta-analysis of 14 cohort studies containing over 1.9 million participants found legume consumption protective against colorectal cancer when adjusted for red meat consumption, vegetable consumption and BMI [4].
  • A meta-analysis of 12 case control and cohort studies found a Western Diet was associated with increased incidence of prostate cancer while a Mediterranean diet was associated with decreased incidence. 9 of the 12 studies included BMI as an adjusted variable for risk analysis and all 12 looked in to BMI as a potential confounder of risk [5].

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