Do all vegetarians have a lower cardiovascular risk? A prospective study

Petermann-Rocha, F., Celis-Morales, C. , Pell, J. P. and Ho, F. K. (2023) Do all vegetarians have a lower cardiovascular risk? A prospective study. Clinical Nutrition, 42(3), pp. 269-276. (doi: 10.1016/j.clnu.2023.01.010) (PMID:36716619)

Abstract

Background Vegetarian diets are heterogeneous; therefore, the health benefits may not be the same for all vegetarians. This study aimed to compare the cardiovascular risk associated with vegetarian diets that meet existing health guidelines with those that do not, as well as diets that include red meat. Methods 391,124 participants (55.5% women) from UK Biobank prospective population-based study were included. Using data from a food frequency questionnaire, participants were categorised into Lacto-vegetarian or meat-eaters. Then, both groups were dichotomised into a healthier and less healthy group using an unweighted score based on current UK guidelines. Ischemic heart disease (IHD) and myocardial infarction (MI) incidence – both separately and as a composite of major adverse cardiovascular events (MACE) – were the outcomes included. Associations between types of diets and health outcomes were investigated using Cox proportional hazard models adjusted for confounder factors. Results After a median follow-up of 10.4 years, there were 40,048 MACE. When the analyses were adjusted for prevalent morbidity and lifestyle factors, people who followed healthier vegetarian and meat-eater diets had 18% (95% CI: 0.73 to 0.92) and 5% (95% CI: 0.93 to 0.97) lower risk of MACE than less healthy meat-eaters. Similar patterns were identified for the individual outcomes included, with the strongest association observed for MI among individuals in the same healthier categories. None of these associations was significant for less healthy vegetarian diets. Conclusions Vegetarian diets are heterogeneous and the cardiovascular risk varied accordingly. Future studies should consider the overall dietary patterns of vegetarians rather than just based on meat consumption. Guidelines advocating a plant-based diet need to stress the importance of overall diet quality in addition to the reduction of meat.

• Item Type: Articles
• Additional Information: This research has been conducted using the UK Biobank resource under application number 7155. UK Biobank was established by the Wellcome Trust medical charity, Medical Research Council, Department of Health, Scottish Government and the Northwest Regional Development Agency. It has also had funding from the Welsh Assembly Government and the British Heart Foundation.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Pell, Professor Jill and Celis, Dr Carlos and Ho, Dr Frederick and Petermann-Rocha, Mrs Fanny
• Authors: Petermann-Rocha, F., Celis-Morales, C., Pell, J. P., and Ho, F. K.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
• Journal Name: Clinical Nutrition
• Publisher: Elsevier
• ISSN: 0261-5614
• ISSN (Online): 1532-1983
• Published Online: 12 January 2023
• Copyright Holders: Copyright © 2023 The Authors
• First Published: First published in Clinical Nutrition 42(3): 269-276
• Publisher Policy: Reproduced under a Creative Commons License