Vegetarian Diets: Less Heart Disease, but More Strokes?

Vegetarians and pescatarians have a lower risk of ischemic heart disease than individuals who eat meat. However, vegetarians have a higher risk of hemorrhagic and total stroke, according to the results of a recent study.

Although there is evidence that vegetarians may have different disease risks than individuals who eat meat, data is limited, according to the researchers.

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For this reason, they conducted a prospective cohort study involving 48,188 participants in the United Kingdom recruited between 1993 and 2001. All participants had no history of ischemic heart disease, stroke, or angina, and were classified based on diet: meat eaters (n = 24,428), fish eaters (who consumed fish but no meat; n = 7506), and vegetarians (including vegans; n = 28,364).

Over 18.1 years of follow up, 2820 cases of ischemic heart disease and 1072 cases of total stroke (including 519 ischemic stroke and 300 hemorrhagic stroke) occurred. Overall, vegetarians and fish eaters had 22% (hazard ratio [HR] 0.78) and 13% (HR 0.87) lower rates of ischemic heart disease than meat eaters, respectively. This was partially attenuated after adjustment for self-reported high blood cholesterol, high blood pressure, diabetes, and body mass index.

However, vegetarians had 20% higher rates of total stroke (HR 1.20) than meat eaters, due primarily to hemorrhagic stroke.

“Future work should include further measurements of circulating levels of cholesterol subfractions, vitamin B12, amino acids, and fatty acids in the cohort to identify which factors might mediate the observed associations. Additional studies in other large-scale cohorts with a high proportion of non-meat eaters are needed to confirm the generalizability of these results and assess their relevance for clinical practice and public health,” the researchers concluded.

—Michael Potts

Reference:

Tong TYN, Appleby PN, Bradbury KE, et al. 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 [published online September 4, 2019]. BMJ. doi: https://doi.org/10.1136/bmj.l4897.