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

Abstract

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 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.

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.

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  • Authors+Show Affiliations

    ,

    Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK. francesca.crowe@ceu.ox.ac.uk

    , ,

    Source

    MeSH

    Adult
    Blood Pressure
    Body Mass Index
    Choice Behavior
    Cholesterol, LDL
    Cohort Studies
    Diet, Vegetarian
    England
    European Continental Ancestry Group
    Feeding Behavior
    Female
    Follow-Up Studies
    Food Preferences
    Hospitalization
    Humans
    Incidence
    Life Style
    Male
    Middle Aged
    Myocardial Ischemia
    Neoplasms
    Nutritional Status
    Proportional Hazards Models
    Prospective Studies
    Risk Factors
    Scotland
    Smoking
    Surveys and Questionnaires

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    23364007

    Citation

    Crowe, Francesca L., et al. "Risk of Hospitalization or Death From Ischemic Heart Disease Among British Vegetarians and Nonvegetarians: Results From the EPIC-Oxford Cohort Study." The American Journal of Clinical Nutrition, vol. 97, no. 3, 2013, pp. 597-603.
    Crowe FL, Appleby PN, Travis RC, et al. Risk of hospitalization or death from ischemic heart disease among British vegetarians and nonvegetarians: results from the EPIC-Oxford cohort study. Am J Clin Nutr. 2013;97(3):597-603.
    Crowe, F. L., Appleby, P. N., Travis, R. C., & Key, T. J. (2013). Risk of hospitalization or death from ischemic heart disease among British vegetarians and nonvegetarians: results from the EPIC-Oxford cohort study. The American Journal of Clinical Nutrition, 97(3), pp. 597-603. doi:10.3945/ajcn.112.044073.
    Crowe FL, et al. Risk of Hospitalization or Death From Ischemic Heart Disease Among British Vegetarians and Nonvegetarians: Results From the EPIC-Oxford Cohort Study. Am J Clin Nutr. 2013;97(3):597-603. PubMed PMID: 23364007.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Risk of hospitalization or death from ischemic heart disease among British vegetarians and nonvegetarians: results from the EPIC-Oxford cohort study. AU - Crowe,Francesca L, AU - Appleby,Paul N, AU - Travis,Ruth C, AU - Key,Timothy J, Y1 - 2013/01/30/ PY - 2013/2/1/entrez PY - 2013/2/1/pubmed PY - 2013/4/16/medline SP - 597 EP - 603 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 97 IS - 3 N2 - 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 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. 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. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/23364007/full_citation L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.112.044073 DB - PRIME DP - Unbound Medicine ER -