Highlights
- •Vegetarian diet is potentially associated with reduced ischaemic heart disease.
- •The benefits of a vegetarian diet are most apparent among Seventh-Day Adventist.
- •Reductions in all-cause mortality were not replicated in the non-Adventist studies.
- •Evidence supporting a vegetarian diet is driven by Seventh-Day Adventists studies.
- •The effect of vegetarian diet in other non-Adventist cohorts remains unproven.
Abstract
Background
Dietary interventions are an important component of cardiovascular risk factor management
although their impact on cardiovascular risk and mortality remains uncertain. We have
studied influence of a vegetarian diet on cardiovascular risk and mortality.
Methods
We searched MEDLINE and EMBASE for comparative studies that evaluated clinical outcomes
associated with vegetarian diet as compared to non-vegetarian controls or the general
population. Relevant studies were pooled using random effects meta-analysis for risk
of death, ischaemic heart disease (IHD) and cerebrovascular disease. We conducted
subgroup analysis according to specific type of cohort (e.g. Seventh Day Adventist
[SDA]) and gender.
Results
Eight studies met the inclusion criteria with 183,321 participants (n = 183,321). There was significant heterogeneity in all the meta-analyses, particularly
evident with the studies of SDA. In all instances, we found that SDA studies showed
greater effect size as compared to non-SDA studies: death (RR 0.68 95% CI 0.45–1.02
vs RR 1.04 95% CI 0.98–1.10), ischaemic heart disease (IHD) (RR 0.60 95% CI 0.43–0.80
vs RR 0.84 95% CI 0.74–0.96) and cerebrovascular disease (RR 0.71 95% CI 0.41–1.20
vs RR 1.05 95% CI 0.89–1.24). Sex specific analyses showed that IHD was significantly
reduced in both genders but risk of death and cerebrovascular disease was only significantly
reduced in men.
Conclusions
Data from observational studies indicates that there is modest cardiovascular benefit,
but no clear reduction in overall mortality associated with a vegetarian diet. This
evidence of benefit is driven mainly by studies in SDA, whereas the effect of vegetarian
diet in other cohorts remains unproven.
Keywords
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Article info
Publication history
Published online: August 04, 2014
Accepted:
July 24,
2014
Received:
May 8,
2014
Identification
Copyright
© 2014 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
