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Cited by 36Nutritional Studies and DietAgriculture Sustainability and Environmental ImpactCardiovascular Health and Risk Factors

A Systematic Review of the Association Between Vegan Diets and Risk of Cardiovascular Disease

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Kaiser, Jeenan, van Daalen, Kim R, Thayyil, Arjun, Cocco, Mafalda Tasso de Almeida Ribeiro Reis, Caputo, Daniela, Oliver-Williams, Clare·2021·The Journal of Nutrition
DOI 10.1093/jn/nxab037PMC PMC8169813
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Abstract

BACKGROUND: Plant-based diets are gaining attention globally due to their environmental benefits and perceived health-protective role. A vegan diet may have cardiovascular benefits; however, evidence remains conflicting and insufficiently assessed. OBJECTIVES: We evaluated the utility of the vegan diet in cardiovascular disease (CVD) prevention. METHODS: We conducted a systematic review of studies evaluating the association between vegan diets and cardiovascular outcomes. We searched 5 databases (Ovid MEDLINE, EMBASE, Web of Science, Scopus, and OpenGrey) through 31 October 2020. Four investigators independently screened the full texts for inclusion, assessed quality, and extracted data from published reports. RESULTS: Out of the 5729 identified records, 7 were included, comprising over 73,000 participants, of whom at least 7661 were vegans. Three studies, with at least 73,426 individuals (including at least 7380 vegans), examined risks of primary cardiovascular events (total CVD, coronary heart disease, acute myocardial infarction, total stroke, hemorrhagic stroke, and ischemic stroke) in individuals who followed a vegan diet compared to those who did not. None of the studies reported a significantly increased or decreased risk of any cardiovascular outcome. One study suggested that vegans were at greater risk of ischemic stroke compared to individuals who consumed animal products (HR, 1.54; 95% CI, 0.95-2.48). Yet in another study, vegans showed lower common carotid artery intima-media thickness (0.56 ± 0.1 mm vs. 0.74 ± 0.1 mm in controls; P < 0.001), and in 3 studies of recurrent CVD events, vegans had 0-52% lower rates. Furthermore, endothelial function did not differ between vegans and nonvegans. Using the Grading of Recommendations Assessment, Development and Evaluation approach, evidence was deemed to be of low to very low strength/quality. CONCLUSIONS: Among the Western populations studied, evidence weakly demonstrates associations between vegan diets and risk of CVDs, with the direction of associations varying with the specific CVD outcome tested. However, more high-quality research on this topic is needed. This study was registered at PROSPERO as CRD42019146835.

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  • Abundant evidence from observational and intervention studies indicates that vegan diets are associated with improved cardiovascular health and decreased risk of cardiovascular disease.

    “Abundant evidence from observational and intervention studies7,8,9,10,11,12,13 indicates that vegan diets are associated with improved cardiovascular health and decreased risk of cardiovascular disease, likely because of the higher daily consumption of vegetables and fruits, legumes, whole grains and nuts, and seeds compared with other different types of dietary patterns.14”

    From Cardiometabolic Effects of Omnivorous vs Vegan Diets in Identical Twins: A Randomized Clinical Trial (2023) · cites this paper as [7]

    The Introduction reports beneficial changes in cardiovascular risk factors among vegans, supporting the improved-health portion of the claim. But the Abstract Results report no significant reduction in primary cardiovascular outcomes, and the Abstract Conclusions characterize the evidence as weak and varying by outcome. The claim overstates the evidence for decreased cardiovascular disease risk. (LLM, conf=0.89)

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Cited by

Sorted by citations

Authors
Kaiser, J., van Daalen, K. R., Thayyil, A., Cocco, M. T. D. A. R. R., Caputo, D., & Oliver-Williams, C.
Affiliations
  • University of Alberta (CA)
  • University of Cambridge (GB)
  • National Institute for Health and Care Research (GB)
ORCID
Venue
The Journal of Nutrition
Publisher
Elsevier BV
Published
2021-06
Volume
151
Issue
6
Pages
1539-1552
ISSN
0022-3166 (ISSN-L)
DOI
10.1093/jn/nxab037
PMC
PMC8169813
OpenAlex
W3141998928
Cited by
36
References
7
Citations by year
2026: 5 · 2025: 2 · 2024: 11 · 2023: 10 · 2022: 7 · 2021: 1
FWCI
1.29
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Nutrition (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
  • UK Medical Research Council (MR/L003120/1)
  • British Heart Foundation (RG/13/13/30194, RG/18/13/33946)
  • National Institute for Health Research
  • Homerton College, University of Cambridge
  • Gates Cambridge Scholarship (OPP1144)
  • Gates Foundation
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
vegan diet, plant-based diet, cardiovascular disease, coronary artery disease, myocardial infarction, stroke, ischemic stroke, carotid intima-media thickness, endothelial function, cardiovascular risk, cardiovascular disease prevention
MeSH terms
Diet, Vegan, Heart Disease Risk Factors, Cardiovascular Diseases, Humans, Stroke, Carotid Intima-Media Thickness

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