TY - JOUR
T1 - Vegetarian diet, Seventh Day Adventists and risk of cardiovascular mortality
T2 - A systematic review and meta-analysis
AU - Kwok, Chun Sing
AU - Umar, Saadia
AU - Myint, Phyo K.
AU - Mamas, Mamas A.
AU - Loke, Yoon K.
PY - 2014/10/20
Y1 - 2014/10/20
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84905873620&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2014.07.080
DO - 10.1016/j.ijcard.2014.07.080
M3 - Article
AN - SCOPUS:84905873620
SN - 0167-5273
VL - 176
SP - 680
EP - 686
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 3
ER -