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Mortality in vegetarians and non-vegetarians: a collaborative analysis of 8300 deaths among 76,000 men and women in five prospective studies

Published online by Cambridge University Press:  01 March 1998

Timothy J Key ,
Gary E Fraser ,
Margaret Thorogood ,
Paul N Appleby ,
Valerie Beral ,
Gillian Reeves ,
Michael L Burr ,
Jenny Chang-Claude ,
Rainer Frentzel-Beyme  and
Jan W Kuzma
...Show all authors
Timothy J Key*
Affiliation:
Imperial Cancer Research Fund, Cancer Epidemiology Unit, Oxford OX2 6HE, UK
Gary E Fraser
Affiliation:
Center for Health Research, Loma Linda University, Loma Linda, USA
Margaret Thorogood
Affiliation:
Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
Paul N Appleby
Affiliation:
Imperial Cancer Research Fund, Cancer Epidemiology Unit, Oxford OX2 6HE, UK
Valerie Beral
Affiliation:
Imperial Cancer Research Fund, Cancer Epidemiology Unit, Oxford OX2 6HE, UK
Gillian Reeves
Affiliation:
Imperial Cancer Research Fund, Cancer Epidemiology Unit, Oxford OX2 6HE, UK
Michael L Burr
Affiliation:
Centre for Applied Public Health Medicine, University of Wales College of Medicine, Cardiff, UK
Jenny Chang-Claude
Affiliation:
Division of Epidemiology, Deutsches Krebsforschungszentrum, Heidelberg, Germany
Rainer Frentzel-Beyme
Affiliation:
Bremer Institut für Präventionsforschung und Sozialmedizin, Bremen, Germany
Jan W Kuzma
Affiliation:
Department of Biostatistics and Epidemiology, Loma Linda University, Loma Linda, USA
Jim Mann
Affiliation:
Department of Human Nutrition, University of Otago, Dunedin, New Zealand
Klim McPherson
Affiliation:
Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
*
*Corresponding author: E-mail key@icrf.icnet.uk.
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Abstract

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Objective:

To compare the mortality rates of vegetarians and non-vegetarians.

Design:

Collaborative analysis using original data from five prospective studies. Death rate ratios for vegetarians compared to non-vegetarians were calculated for ischaemic heart disease, cerebrovascular disease, cancers of the stomach, large bowel, lung, breast and prostate, and for all causes of death. All results were adjusted for age, sex and smoking. A random effects model was used to calculate pooled estimates of effect for all studies combined.

Setting:

USA, UK and Germany.

Subjects:

76, 172 men and women aged 16–89 years at recruitment. Vegetarians were those who did not eat any meat or fish (n = 27,808). Non-vegetarians were from a similar background to the vegetarians within each study.

Results:

After a mean of 10.6 years of follow-up there were 8330 deaths before the age of 90 years, including 2264 deaths from ischaemic heart disease. In comparison with non-vegetarians, vegetarians had a 24% reduction in mortality from ischaemic heart disease (death rate ratio 0.76, 95% CI 0.62–0.94). The reduction in mortality among vegetarians varied significantly with age at death: rate ratios for vegetarians compared to non-vegetarians were 0.55 (95% CI 0.35—0.85), 0.69 (95% CI 0.53–0.90) and 0.92 (95% CI 0.73–1.16) for deaths from ischaemic heart disease at ages <65, 65–79 and 80–89 years, respectively. When the non-vegetarians were divided into regular meat eaters (who ate meat at least once a week) and semi-vegetarians (who ate fish only or ate meat less than once a week), the ischaemic heart disease death rate ratios compared to regular meat eaters were 0.78 (95% CI 0.68–0.89) in semi-vegetarians and 0.66 (95% CI 0.53–0.83) in vegetarians (test for trend P<0.001). There were no significant differences between vegetarians and non-vegetarians in mortality from the other causes of death examined.

Conclusion:

Vegetarians have a lower risk of dying from ischaemic heart disease than non-vegetarians.

Keywords

VegetarianMortalityIschaemic heart diseaseColorectal cancer

Information

Type
Research Article
Information
Public Health Nutrition , Volume 1 , Issue 1 , March 1998 , pp. 33 - 41
Copyright
Copyright © The Nutrition Society 1998

References

1Dwyer, JT. Health aspects of vegetarian diets. Am. J. Clin. Nutr. 1988; 48 (suppl): 712S–38S.CrossRefGoogle ScholarPubMed
2Thorogood, M. The epidemiology of vegetarianism and health. Nutr. Res. Rev. 1995; 8: 179–92.CrossRefGoogle ScholarPubMed
3Snowdon, DA, Phillips, RL, Fraser, GE. Meat consumption and fatal ischemic heart disease. Prev. Med. 1984; 13: 490–500.CrossRefGoogle ScholarPubMed
4Fraser, GE, Sabaté, J, Beeson, WL, Strahan, TM. A possible protective effect of nut consumption on risk of coronary heart disease. Arch. Intern. Med. 1992; 152: 1416–24.CrossRefGoogle ScholarPubMed
5Burr, ML, Butland, BK. Heart disease in British vegetarians. Am. J. Clin. Nutr. 1988; 48: 830–2.CrossRefGoogle ScholarPubMed
6Chang-Claude, J, Frentzel-Beyme, R, Eilber, U. Mortality pattern of German vegetarians after 11 years of follow-up. Epidemiology 1992; 3: 395–401.CrossRefGoogle ScholarPubMed
7Thorogood, M, Mann, J, Appleby, P, McPherson, K. Risk of death from cancer and ischaemic heart disease in meat and non-meat eaters. Br. Med. J. 1994; 308: 1667–71.CrossRefGoogle ScholarPubMed
8Potter, JD. Nutrition and colorectal cancer. Cancer Causes Control 1996; 7: 127–46.CrossRefGoogle ScholarPubMed
9Boyd, NF, Martin, LJ, Noffel, M, Lockwood, GA, Tritchler, DL. A meta-analysis of studies of dietary fat and breast cancer risk. Br. J. Cancer 1993; 68: 627–36.CrossRefGoogle ScholarPubMed
10Key, TJA. Risk factors for prostate cancer. Cancer Surv. 1995; 23: 63–77.Google ScholarPubMed
11Snowdon, DA, Phillips, RL, Choi, W. Diet, obesity, and risk of fatal prostate cancer. Am. J. Epidemiol. 1984; 120: 244–50.CrossRefGoogle ScholarPubMed
12Phillips, RL, Snowdon, DA. Dietary relationships with fatal colorectal cancer among Seventh-day Adventists. J. Natl. Cancer Inst. 1985; 74: 307–17.Google ScholarPubMed
13Mills, PK, Annegers, JF, Phillips, RL. Animal product consumption and subsequent fatal breast cancer risk among Seventhday Adventists. Am. J. Epidemiol. 1988; 127: 440–53.CrossRefGoogle ScholarPubMed
14Key, TJ, Fraser, GE, Thorogood, M, et al. Mortality in vegetarians and non-vegetarians: detailed findings from a collaborative analysis of five prospective studies. Am. J. Clin. Nutr. 1998; in press.Google Scholar
15Burr, ML, Sweetnam, PM. Vegetarianism. dietary fiber, and mortality. Am. J. Clin. Nutr. 1982; 36: 873–7.CrossRefGoogle ScholarPubMed
16Coleman, MP, Hermon, C, Douglas, A. Person-years (PYRS). A Fortran program for cohort study analysis. LARC Internal Report No. 89. WHO, LARC Lyon 1989.Google Scholar
17DerSimonian, R, Laird, N. Meta-analysis in clinical trials. Control Clin. Trials 1986; 7: 177–88.CrossRefGoogle ScholarPubMed
18Phillips, RL, Garlinkel, L, Kuzma, JW, Beeson, WL, Lotz, T, Brin, B. Mortality among California Seventh-Day Adventists for selected cancer sites. J. Natl. Cancer Inst. 1980; 65: 1037–107.Google ScholarPubMed
19Key, TJA, Thorogood, M, Appleby, PN, Burr, ML. Dietary habits and mortality in 11000 vegetarians and health conscious people: results of a 17-year follow-up. Br. Med. J. 1996; 313: 775–9.CrossRefGoogle Scholar
20Vandenbroucke, JP. Should you eat meat, or are you confounded by methodological debate? Br. Med. J. 1994; 308: 1671.CrossRefGoogle ScholarPubMed
21Fraser, GE. Diet and coronary heart disease: beyond dietary fats and low-density-lipoprotein cholesterol. Am. J. Clin. Nutr. 1994: 59 (suppl): 1117S–23S.CrossRefGoogle ScholarPubMed
22Burr, ML, Bates, CJ, Fehily, AM, StLeger, AS. Plasma cholesterol and blood pressure in vegetarians. J. Hum. Nutr. 1981; 35: 437–41.Google ScholarPubMed
23Thorogood, M, Carter, R, Benfield, L, McPherson, K, Mann, JI. Plasma lipids and lipoprotein cholesterol concentrations in people with different diets in Britain. Br. Med. J. 1987; 295: 351–3CrossRefGoogle ScholarPubMed
24Malter, M, Schriever, G, Eilber, U. Natural killer cells, vitamins, and other blood components of vegetarian and omnivorous men. Nutr. Cancer 1989; 12: 271–8.CrossRefGoogle ScholarPubMed
25West, RO, Hayes, OB. Diet and serum cholesterol levels. A comparison between vegetarians and nonvegetarians in a Seventh-day Adventist group. Am. J. Clin. Nutr. 1968; 21: 853–62.CrossRefGoogle Scholar
26Law, MR, Wald, NJ, Wu, T, Hackshaw, A, Bailey, A. Systematic underestimation of association between serum cholesterol concentration and ischaemic heart disease in observational studies: data from the BUPA study. Br. Med. J. 1994; 308: 363–62.CrossRefGoogle ScholarPubMed
27Kinlen, LJ. Meat and fat consumption and cancer mortality: a study of strict religious orders in Britain. Lancet 1982; 1: 946–9.CrossRefGoogle ScholarPubMed
28Willett, WC, Stampfer, MJ, Colditz, GA, Rosner, BA, Speizer, FE. Relation of meat, fat, and fibre intake to the risk of colon cancer in a prospective study among women. N. Engl. J. Med. 1990; 323: 1664–72.CrossRefGoogle Scholar
29Giovannucci, E, Rimm, EB, Stampfer, MJ, et al. Intake of fat, meat, and fiber in relation to risk of colon cancer in men. Cancer Res. 1994; 54: 2390–7.Google ScholarPubMed
30Bostick, RM, Potter, JD, Kushi, LH, et al. Sugar, meat, and fat intake and non-dietary risk factors for colon cancer incidence in Iowa women. Cancer Causes Control 1994; 5: 38–52.CrossRefGoogle ScholarPubMed
31Goldbohm, RA, van den Brandt, PA, van't Veer, P, et al. A prospective cohort study on the relation between meat consumption and the risk of colon cancer. Cancer Res. 1994; 54: 718–23.Google ScholarPubMed
32Thun, MJ, Calle, EE, Namboodiri, MM, et al. Risk factors for fatal colon cancer in a large prospective study. J. Natl. Cancer Inst. 1992; 84: 1491–500.CrossRefGoogle Scholar
33Tuyns, AJ, Haelterman, MKaaks, R. Colorectal cancer and the intake of nutrients: oligosaccharides are a risk factor, fats are not. A case-control study in Belgium. Nutr. Cancer 1987; 10: 108–96.CrossRefGoogle Scholar
34Mills, PK, Beeson, WL, Phillips, RL, Fraser, GE. Dietary habits and breast cancer incidence among Seventh-day Adventists. Cancer 1989; 64: 582–90.3.0.CO;2-V>CrossRefGoogle ScholarPubMed
35Rao, DN, Ganesh, B, Desai, PB. Role of reproductive factors in breast cancer in a low-risk area: a case-control study. Br. J. Cancer 1994; 70: 129–32.CrossRefGoogle Scholar
36Hunter, DJ, Spiegelman, D, Adami, H-0, et al. Cohort studies of fat intake and the risk of breast cancer –a pooled analysis. N. Engl. J. Med. 1996; 334: 356–61.CrossRefGoogle ScholarPubMed