Risk of hospitalization or death from ischemic heart disease among British vegetarians and nonvegetarians: results from the EPIC-Oxford cohort study
Open accessAbstract
Background Few previous prospective studies have examined differences in incident ischemic heart disease (IHD) risk between vegetarians and nonvegetarians.Objective The objective was to examine the association of a vegetarian diet with risk of incident (nonfatal and fatal) IHD.Design A total of 44,561 men and women living in England and Scotland who were enrolled in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Oxford study, of whom 34% consumed a vegetarian diet at baseline, were part of the analysis. Incident cases of IHD were identified through linkage with hospital records and death certificates. Serum lipids and blood pressure measurements were available for 1519 non cases, who were matched to IHD cases by sex and age. IHD risk by vegetarian status was estimated by using multivariate Cox proportional hazards models.Results After an average follow-up of 11.6 y, there were 1235 IHD cases (1066 hospital admissions and 169 deaths). Compared with nonvegetarians, vegetarians had a lower mean BMI [in kg/m(2); -1.2 (95% CI: -1.3, -1.1)], non-HDL-cholesterol concentration [-0.45 (95% CI: -0.60, -0.30) mmol/L], and systolic blood pressure [-3.3 (95% CI: -5.9, -0.7) mm Hg]. Vegetarians had a 32% lower risk (HR: 0.68; 95% CI: 0.58, 0.81) of IHD than did nonvegetarians, which was only slightly attenuated after adjustment for BMI and did not differ materially by sex, age, BMI, smoking, or the presence of IHD risk factors.Conclusion Consuming a vegetarian diet was associated with lower IHD risk, a finding that is probably mediated by differences in non-HDL cholesterol, and systolic blood pressure.
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The EPIC-Oxford study found a 32% lower 11-year CHD incidence (95% CI: 19%-42%) among vegetarians relative to non-vegetarians.
“The EPIC-Oxford study, one of the few studies to examine the association of a vegetarian diet with CHD incidence in addition to mortality, found a 32% lower 11-year CHD incidence (95% CI: 19%–42%) among vegetarians relative to non-vegetarians.(8)”
From Healthful and Unhealthful Plant-Based Diets and the Risk of Coronary Heart Disease in U.S. Adults (2017) · cites this paper as [8]
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 [8]
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 [8]
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- Authors
- Crowe, F. L., Appleby, P. N., Travis, R. C., & Key, T. J.
- Affiliations
- University of Oxford (GB)
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2013-03
- Volume
- 97
- Issue
- 3
- Pages
- 597-603
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W2163334433
- Cited by
- 263
- References
- 24
- Citations by year
- 2026: 10 · 2025: 12 · 2024: 19 · 2023: 21 · 2022: 22 · 2021: 18 · 2020: 24 · 2019: 28 · 2018: 23 · 2017: 22 · 2016: 17 · 2015: 15 · 2014: 21 · 2013: 11
- FWCI
- 21.76
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Cancer Research UK
- 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, ischemic heart disease, cardiovascular risk, non-HDL cholesterol, systolic blood pressure, body mass index, hospitalization, mortality
- MeSH terms
- Adult, Blood Pressure, Choice Behavior, England, Feeding Behavior, Female, Follow-Up Studies, Food Preferences, Hospitalization, Humans, Life Style, Cholesterol, LDL, Male, Middle Aged, Neoplasms, Nutritional Status, Prospective Studies, Surveys and Questionnaires, Risk Factors, Scotland, Smoking, Diet, Vegetarian, Cohort Studies, Body Mass Index, Incidence, Proportional Hazards Models, Myocardial Ischemia, White People
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