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Lifestyle determinants and mortality in German vegetarians and health-conscious persons: results of a 21-year follow-up.

Abstract

BACKGROUND

The long-term observation of vegetarians in affluent countries can provide insight into the relative effects of a vegetarian diet and lifestyle factors on mortality.

METHODS

A cohort study of vegetarians and health-conscious persons in Germany was followed-up prospectively for 21 years, including 1,225 vegetarians and 679 health-conscious nonvegetarians. Standardized mortality ratios compared with the German general population were calculated for all causes and specific causes. Within the cohort, Poisson regression modeling was used to investigate the joint effects of several risk factors on overall and cause-specific mortality.

RESULTS

Standardized mortality ratios for all-cause mortality was significantly below 100: 59 [95% confidence interval (95% CI), 54-64], predominantly due to a deficit of deaths from circulatory diseases. Within the cohort, vegetarian compared with nonvegetarian diet had no effect on overall mortality [rate ratio (RR), 1.10; 95% CI, 0.89-1.36], whereas moderate and high physical activity significantly reduced risk of death (RR, 0.62, 0.64), adjusted for age, sex, smoking, alcohol intake, body mass index, and educational level. Vegetarian diet was however associated with a reduced RR of 0.70 (95% CI, 0.41-1.18) for ischemic heart disease, which could partly be related to avoidance of meat.

CONCLUSIONS

Both vegetarians and nonvegetarian health-conscious persons in this study have reduced mortality compared with the general population. Within the study, low prevalence of smoking and moderate or high level of physical activity but not strictly vegetarian diet was associated with reduced overall mortality. The nonsignificant reduction in mortality from ischemic heart diseases in vegetarians compared with health-conscious persons could be explained in part by avoidance of meat intake.

Authors+Show Affiliations

Division of Clinical Epidemiology, German Cancer Research Center, Im Neuenheimer Feld 280, D-69120 Heidelberg, Germany. j.chang-claude@dkfz-heidelberg.deNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15824171

Citation

Chang-Claude, Jenny, et al. "Lifestyle Determinants and Mortality in German Vegetarians and Health-conscious Persons: Results of a 21-year Follow-up." Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, vol. 14, no. 4, 2005, pp. 963-8.
Chang-Claude J, Hermann S, Eilber U, et al. Lifestyle determinants and mortality in German vegetarians and health-conscious persons: results of a 21-year follow-up. Cancer Epidemiol Biomarkers Prev. 2005;14(4):963-8.
Chang-Claude, J., Hermann, S., Eilber, U., & Steindorf, K. (2005). Lifestyle determinants and mortality in German vegetarians and health-conscious persons: results of a 21-year follow-up. Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, 14(4), pp. 963-8.
Chang-Claude J, et al. Lifestyle Determinants and Mortality in German Vegetarians and Health-conscious Persons: Results of a 21-year Follow-up. Cancer Epidemiol Biomarkers Prev. 2005;14(4):963-8. PubMed PMID: 15824171.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lifestyle determinants and mortality in German vegetarians and health-conscious persons: results of a 21-year follow-up. AU - Chang-Claude,Jenny, AU - Hermann,Silke, AU - Eilber,Ursula, AU - Steindorf,Karen, PY - 2005/4/13/pubmed PY - 2005/6/29/medline PY - 2005/4/13/entrez SP - 963 EP - 8 JF - Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology JO - Cancer Epidemiol. Biomarkers Prev. VL - 14 IS - 4 N2 - BACKGROUND: The long-term observation of vegetarians in affluent countries can provide insight into the relative effects of a vegetarian diet and lifestyle factors on mortality. METHODS: A cohort study of vegetarians and health-conscious persons in Germany was followed-up prospectively for 21 years, including 1,225 vegetarians and 679 health-conscious nonvegetarians. Standardized mortality ratios compared with the German general population were calculated for all causes and specific causes. Within the cohort, Poisson regression modeling was used to investigate the joint effects of several risk factors on overall and cause-specific mortality. RESULTS: Standardized mortality ratios for all-cause mortality was significantly below 100: 59 [95% confidence interval (95% CI), 54-64], predominantly due to a deficit of deaths from circulatory diseases. Within the cohort, vegetarian compared with nonvegetarian diet had no effect on overall mortality [rate ratio (RR), 1.10; 95% CI, 0.89-1.36], whereas moderate and high physical activity significantly reduced risk of death (RR, 0.62, 0.64), adjusted for age, sex, smoking, alcohol intake, body mass index, and educational level. Vegetarian diet was however associated with a reduced RR of 0.70 (95% CI, 0.41-1.18) for ischemic heart disease, which could partly be related to avoidance of meat. CONCLUSIONS: Both vegetarians and nonvegetarian health-conscious persons in this study have reduced mortality compared with the general population. Within the study, low prevalence of smoking and moderate or high level of physical activity but not strictly vegetarian diet was associated with reduced overall mortality. The nonsignificant reduction in mortality from ischemic heart diseases in vegetarians compared with health-conscious persons could be explained in part by avoidance of meat intake. SN - 1055-9965 UR - https://www.unboundmedicine.com/medline/citation/15824171/Lifestyle_determinants_and_mortality_in_German_vegetarians_and_health_conscious_persons:_results_of_a_21_year_follow_up_ L2 - http://cebp.aacrjournals.org/cgi/pmidlookup?view=long&pmid=15824171 DB - PRIME DP - Unbound Medicine ER -