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


METHODS
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.


CONCLUSIONS
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.
Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK. francesca.crowe@ceu.ox.ac.uk
Francesca L
FL
Crowe
Paul N
PN
Appleby
Ruth C
RC
Travis
Timothy J
TJ
Key
D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D002755:Choice Behavior; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D014676:Diet, Vegetarian; D004739:England / Q000453:epidemiology; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D005518:Food Preferences; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D008019:Life Style; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology*; D009369:Neoplasms / Q000453:epidemiology; D009752:Nutritional Status; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D012907:Smoking / Q000009:adverse effects; D011795:Surveys and Questionnaires; D044465:White People
D008078:Cholesterol, LDL