Dr Tammy Y N Tong PhD Cancer Epidemiology Unit Nuffield Department of Population Health University of Oxford, Oxford, UK

Vegetarians: Less Heart Disease, More Strokes

MedicalResearch.com Interview with:

Dr Tammy Y N Tong PhD Cancer Epidemiology Unit Nuffield Department of Population Health University of Oxford, Oxford, UK

Dr. Tong

Dr Tammy Y N Tong PhD
Cancer Epidemiology Unit
Nuffield Department of Population Health
University of Oxford, Oxford, UK

MedicalResearch.com: What is the background for this study?

Response: Vegetarian and vegan diets have become increasingly popular in recent years, partly due to the perceived health benefits, but also concerns about the environment and animal welfare. However, the full extent of the potential health benefits and hazards of these diets is not well understood. Previous studies have suggested that vegetarians have a lower risk of coronary heart disease than non-vegetarians, but data from large studies are limited, and little has been reported on the difference in risk of stroke.

MedicalResearch.com: What are the main findings? 

Response: To address this research gap, we followed-up 48,188 participants in the EPIC-Oxford study for an average of 18 years, and compared the risk of both coronary heart disease and stroke in people of different diet groups.

We found that within this cohort, people who were pescetarians and vegetarians (including vegans) had 13% and 22% lower risks of coronary heart disease, respectively, than the meat eaters. Conversely, the vegetarians may have a higher risk of total stroke (20%) than the meat eaters, which was mostly due to a higher risk of haemorrhagic stroke. In absolute terms, this was equivalent to 10 fewer cases of coronary heart disease and 3 more cases of total stroke in the vegetarians than the meat eaters, in every 1000 people consuming these diets over 10 years.

MedicalResearch.com: What should readers take away from your report?

Response: Our study suggests that vegetarians had a lower risk of coronary heart disease but a higher risk of stroke. However, in terms of absolute differences, the magnitude of the lower risk of coronary heart disease exceeded the higher risk of stroke, which is related to the fact that coronary heart disease is a more common condition than stroke. These findings should be confirmed in further research, and evidence on other health outcomes associated with vegetarian or vegan diets should also be considered when appraising the overall health of these diets.

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: This is the first study to report a higher risk of stroke in vegetarians than meat eaters, therefore, further studies are needed to determine whether these findings are applicable or generalizable to other populations. In addition, further research is needed to determine the mechanisms which may explain these differences. The lower risk of coronary heart disease in pescetarians and vegetarians are likely, at least partly, explained by the lower BMI, blood pressure, blood cholesterol, or rate of diabetes in these diet groups. The reasons for the higher risks of haemorrhagic and total stroke in vegetarians is less clear, although recent evidence has suggested that it might be related to the lower circulating levels of cholesterol or levels of several nutrients (e.g. vitamin B12) in vegetarians than meat eaters, which needs further investigation.

Any disclosures? I have nothing to disclose.



 2019 Sep 4;366:l4897. doi: 10.1136/bmj.l4897.

Risks of ischaemic heart disease and stroke in meat eaters, fish eaters, and vegetarians over 18 years of follow-up: results from the prospective EPIC-Oxford study.

Tong TYN, Appleby PN, Bradbury KE, Perez-Cornago A, Travis RC, Clarke R, Key TJ.


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Last Updated on September 10, 2019 by Marie Benz MD FAAD