Introduction: Being overweight, with a body mass index (BMI) ≥25, is associated with multiple comorbidities, including chronic kidney disease (CKD). A plant-based diet, such as a vegetarian or lacto-ovo vegetarian diet, serves as a preventive strategy for CKD in patients. We hypothesized that a vegetarian diet lowers the occurrence of CKD in overweight subjects. Methods: The retrospective study was performed in Taipei Tzu Chi Hospital by a self-paid health exam. Age younger than 40 years old and the subjects without sufficient biochemical or hematologic results were excluded. The incidence of CKD was evaluated according to the self-reported eating habits (vegetarians, lacto-ovo vegetarians, or omnivores), overweight (with a BMI ≥25 or higher abdominal circumference [>90 cm in males or >80 cm in females]) or not, or other biochemical or hematologic parameters. The interaction between different factors for the development of CKD was analyzed by structural equation modeling (SEM). Results: Among these 6,567 subjects, the subjects with lacto-ovo vegetarian diet had a lower incidence of CKD than those with other dietary habits such as vegans and omnivores. The incidence of overweight was the highest in the omnivore group. The lacto-ovo vegetarian group had a lower risk of CKD occurrence than the omnivore group. After adjusting for age and sex in SEM, the lacto-ovo vegetarian diet lowered the risk of CKD for those with a high BMI or a higher triglyceride (TG)/high-density lipoprotein (HDL) ratio. Conclusion: Lacto-ovo vegetarian dietary habits are associated with a lower occurrence of CKD in obese patients. The mitigating effect of the lacto-ovo vegetarian diet was due to the hazard of a higher BMI and TG/HDL ratio.

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