Risk of hospitalization or death from ischemic heart disease among British vegetarians and nonvegetarians: results from the EPIC-Oxford cohort study

• Published in: The American journal of clinical nutrition 2013-03, Vol.97 (3), p.597-603
• Main Authors: Crowe, Francesca L, Appleby, Paul N, Travis, Ruth C, Key, Timothy J
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; blood lipids; Blood Pressure; Body Mass Index; Cardiovascular disease; Choice Behavior; cholesterol; Cholesterol, LDL - blood; clinical nutrition; Cohort Studies; death; Diet, Vegetarian; England - epidemiology; Feeding Behavior; Feeding. Feeding behavior; Female; Follow-Up Studies; Food Preferences; Fundamental and applied biological sciences. Psychology; Hospitalization; Humans; Incidence; Ischemia; Life Style; Male; men; Middle Aged; Mortality; myocardial ischemia; Myocardial Ischemia - epidemiology; Neoplasms - epidemiology; Nutritional Status; Proportional Hazards Models; Prospective Studies; risk; Risk Factors; Scotland - epidemiology; Smoking - adverse effects; Surveys and Questionnaires; systolic blood pressure; vegetarian diet; Vegetarianism; Vertebrates: anatomy and physiology, studies on body, several organs or systems; White People; women
• ISSN: 0002-9165; 1938-3207
• DOI: 10.3945/ajcn.112.044073

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 noncases, 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/m2; −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.