Large vegan cohorts in China -- cohort studies
This is just a note that there have been some recent PubMed-indexed journal articles that reported adverse health effects - and in some cases beneficial ones - for large groups (thousands) of vegans in China.
The cohort studies are Chinese Longitudinal Healthy Longevity Survey (CLHLS) and China Kadoorie Biobank (CKB) as well as (only one paper) Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH).In my opinion, these "vegans" were not actually vegans - or to put it another way "vegans by choice". And I doubt that any population groups (some individuals maybe yes) with severe financial restrictions would never eat any animal products at all - unless it is a situation of starvation.
These cohort studies did to intend to assess vegans or vegan status and did not assess dietary intake in detail (simplified explanation).
For many months, a manuscript of ours on this topic has been (and still is) under peer review.
Since then at least three new papers have been published including these same cohort studies from China.
This one:
- This one reports on CLHLS. Yaqi Li, Kaiyue Wang, Yuebin Lv, Guliyeerke Jigeer, Yilun Huang, Xiuhua Shen, Xiaoming Shi, Xiang Gao: Vegetarian diet and likelihood of becoming centenarians in Chinese adults aged 80 y or older: a nested case-control study. Am J Clin Nutr . 2026 Feb;123(2):101136. doi: 10.1016/j.ajcnut.2025.101136. Epub 2025 Dec 12., https://pubmed.ncbi.nlm.nih.gov/41391640/
... and this one:
- This one reports on various studies, including CLHLS. Zhuo Song, Zijie He, Xuan Wang, Chaofang Lei, Mingli Ding, Zhijia Sun, Jigang Cao, Gang Ren, Yupeng Di: A gradient risk of cognitive impairment with vegetarian diets in older adults: highest for vegan and potential benefit for pescatarian. Food Res Int . 2026 Apr 1:229:118455, doi: 10.1016/j.foodres.2026.118455. Epub 2026 Jan 23., https://pubmed.ncbi.nlm.nih.gov/41763779/
- This one reports on CLHLS data and reports "vegan-flexitarians" (definition: "vegan-flexitarian: meat, fish, eggs, and dairy all ≤ three times per month"). Xixing Xu, Afei Qin, Shasha Wang: Flexitarian dietary patterns and neuropsychiatric multimorbidity among the oldest-old in China. Front Nutr. 2026 May 11:13:1789764. doi: 10.3389/fnut.2026.1789764. eCollection 2026. DOI: 10.3389/fnut.2026.1789764, https://pubmed.ncbi.nlm.nih.gov/42199759/ ... This one found "Flexitarian dietary patterns were also linked to increased odds of depression (OR 1.20, 95% CI 1.09-1.33) and cognitive impairment (OR 1.29, 95% CI 1.10-1.50) when examined separately, with the strongest associations seen in vegan-flexitarians" - which makes perfect sense, if "vegan-flexitarians" are very malnourished people with vitamin B12 deficiency. This shouldn't be misinterpreted to mean that (actual) vegans in China are not in good health. ... The prevalence of "vegan-flexitarians" was 6.5% (see their Table 1). ...
More importantly, vegan nutrition education for actual vegans in China is now very important, as this group seems to be growing, and vitamin B12 deficiency must be avoided.
