Vegetarian diet, Seventh Day Adventists and risk of cardiovascular mortality: a systematic review and meta-analysis
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.
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A recent meta-analysis found vegetarians experiencing a 29% lower risk of CHD mortality (95% CI: 13%-43%) relative to non-vegetarians.
“A recent meta-analysis found similar results with vegetarians experiencing a 29% lower risk of CHD mortality (95% CI: 13%–43%) relative to non-vegetarians.(6)”
From Healthful and Unhealthful Plant-Based Diets and the Risk of Coronary Heart Disease in U.S. Adults (2017) · cites this paper as [6]
Plant-based diets have been associated with a lower risk of various diseases, including coronary heart disease.
“Plant-based diets have been associated with a lower risk of various diseases,(1–3) including coronary heart disease (CHD),(4–9) the leading global cause of death.(10)”
From Healthful and Unhealthful Plant-Based Diets and the Risk of Coronary Heart Disease in U.S. Adults (2017) · cites this paper as [6]
Prior studies have defined plant-based diets as vegetarian diets, which exclude some or all animal foods.
“With the exception of a recent investigation,(3) prior studies(4–9) have defined plant-based diets as ‘vegetarian’ diets, which constitute a family of dietary patterns that exclude some or all animal foods.”
From Healthful and Unhealthful Plant-Based Diets and the Risk of Coronary Heart Disease in U.S. Adults (2017) · cites this paper as [6]
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- Authors
- Kwok, C. S., Umar, S., Myint, P. K., Mamas, M. A., & Loke, Y. K.
- Affiliations
- University of Manchester (GB)
- University of Aberdeen (GB)
- University of East Anglia (GB)
- Venue
- International Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2014-10
- Volume
- 176
- Issue
- 3
- Pages
- 680-686
- ISSN
- 0167-5273 (ISSN-L)
- OpenAlex
- W2045876595
- Cited by
- 205
- References
- 31
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 14 · 2023: 24 · 2022: 22 · 2021: 28 · 2020: 24 · 2019: 26 · 2018: 23 · 2017: 15 · 2016: 9 · 2015: 8 · 2014: 1
- FWCI
- 1.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- UEA Digital Repository (University of East Anglia) (submittedVersion)
- Funders
- National Institute for Health and Care Research (ACF-2013-06-001)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Physical Sciences › Environmental Science › Ecology › Agriculture Sustainability and Environmental Impact
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- vegetarian diet, Seventh-day Adventists, cardiovascular mortality, ischemic heart disease, cerebrovascular disease, cardiovascular risk, sex differences, dietary intervention
- MeSH terms
- Cardiovascular Diseases, Female, Humans, Male, Risk Factors, Sex Factors, Diet, Vegetarian, Protestantism
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