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Vegetarian dietary patterns and mortality in Adventist Health Study 2.
JAMA Intern Med 2013; 173(13):1230-8JIM

Abstract

IMPORTANCE

Some evidence suggests vegetarian dietary patterns may be associated with reduced mortality, but the relationship is not well established.

OBJECTIVE

To evaluate the association between vegetarian dietary patterns and mortality.

DESIGN

Prospective cohort study; mortality analysis by Cox proportional hazards regression, controlling for important demographic and lifestyle confounders.

SETTING

Adventist Health Study 2 (AHS-2), a large North American cohort.

PARTICIPANTS

A total of 96,469 Seventh-day Adventist men and women recruited between 2002 and 2007, from which an analytic sample of 73,308 participants remained after exclusions.

EXPOSURES

Diet was assessed at baseline by a quantitative food frequency questionnaire and categorized into 5 dietary patterns: nonvegetarian, semi-vegetarian, pesco-vegetarian, lacto-ovo-vegetarian, and vegan.

MAIN OUTCOME AND MEASURE

The relationship between vegetarian dietary patterns and all-cause and cause-specific mortality; deaths through 2009 were identified from the National Death Index.

RESULTS

There were 2570 deaths among 73,308 participants during a mean follow-up time of 5.79 years. The mortality rate was 6.05 (95% CI, 5.82-6.29) deaths per 1000 person-years. The adjusted hazard ratio (HR) for all-cause mortality in all vegetarians combined vs nonvegetarians was 0.88 (95% CI, 0.80-0.97). The adjusted HR for all-cause mortality in vegans was 0.85 (95% CI, 0.73-1.01); in lacto-ovo-vegetarians, 0.91 (95% CI, 0.82-1.00); in pesco-vegetarians, 0.81 (95% CI, 0.69-0.94); and in semi-vegetarians, 0.92 (95% CI, 0.75-1.13) compared with nonvegetarians. Significant associations with vegetarian diets were detected for cardiovascular mortality, noncardiovascular noncancer mortality, renal mortality, and endocrine mortality. Associations in men were larger and more often significant than were those in women.

CONCLUSIONS AND RELEVANCE

Vegetarian diets are associated with lower all-cause mortality and with some reductions in cause-specific mortality. Results appeared to be more robust in males. These favorable associations should be considered carefully by those offering dietary guidance.

Authors+Show Affiliations

School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA. morlich@llu.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

23836264

Citation

Orlich, Michael J., et al. "Vegetarian Dietary Patterns and Mortality in Adventist Health Study 2." JAMA Internal Medicine, vol. 173, no. 13, 2013, pp. 1230-8.
Orlich MJ, Singh PN, Sabaté J, et al. Vegetarian dietary patterns and mortality in Adventist Health Study 2. JAMA Intern Med. 2013;173(13):1230-8.
Orlich, M. J., Singh, P. N., Sabaté, J., Jaceldo-Siegl, K., Fan, J., Knutsen, S., ... Fraser, G. E. (2013). Vegetarian dietary patterns and mortality in Adventist Health Study 2. JAMA Internal Medicine, 173(13), pp. 1230-8. doi:10.1001/jamainternmed.2013.6473.
Orlich MJ, et al. Vegetarian Dietary Patterns and Mortality in Adventist Health Study 2. JAMA Intern Med. 2013 Jul 8;173(13):1230-8. PubMed PMID: 23836264.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vegetarian dietary patterns and mortality in Adventist Health Study 2. AU - Orlich,Michael J, AU - Singh,Pramil N, AU - Sabaté,Joan, AU - Jaceldo-Siegl,Karen, AU - Fan,Jing, AU - Knutsen,Synnove, AU - Beeson,W Lawrence, AU - Fraser,Gary E, PY - 2013/7/10/entrez PY - 2013/7/10/pubmed PY - 2013/10/29/medline SP - 1230 EP - 8 JF - JAMA internal medicine JO - JAMA Intern Med VL - 173 IS - 13 N2 - IMPORTANCE: Some evidence suggests vegetarian dietary patterns may be associated with reduced mortality, but the relationship is not well established. OBJECTIVE: To evaluate the association between vegetarian dietary patterns and mortality. DESIGN: Prospective cohort study; mortality analysis by Cox proportional hazards regression, controlling for important demographic and lifestyle confounders. SETTING: Adventist Health Study 2 (AHS-2), a large North American cohort. PARTICIPANTS: A total of 96,469 Seventh-day Adventist men and women recruited between 2002 and 2007, from which an analytic sample of 73,308 participants remained after exclusions. EXPOSURES: Diet was assessed at baseline by a quantitative food frequency questionnaire and categorized into 5 dietary patterns: nonvegetarian, semi-vegetarian, pesco-vegetarian, lacto-ovo-vegetarian, and vegan. MAIN OUTCOME AND MEASURE: The relationship between vegetarian dietary patterns and all-cause and cause-specific mortality; deaths through 2009 were identified from the National Death Index. RESULTS: There were 2570 deaths among 73,308 participants during a mean follow-up time of 5.79 years. The mortality rate was 6.05 (95% CI, 5.82-6.29) deaths per 1000 person-years. The adjusted hazard ratio (HR) for all-cause mortality in all vegetarians combined vs nonvegetarians was 0.88 (95% CI, 0.80-0.97). The adjusted HR for all-cause mortality in vegans was 0.85 (95% CI, 0.73-1.01); in lacto-ovo-vegetarians, 0.91 (95% CI, 0.82-1.00); in pesco-vegetarians, 0.81 (95% CI, 0.69-0.94); and in semi-vegetarians, 0.92 (95% CI, 0.75-1.13) compared with nonvegetarians. Significant associations with vegetarian diets were detected for cardiovascular mortality, noncardiovascular noncancer mortality, renal mortality, and endocrine mortality. Associations in men were larger and more often significant than were those in women. CONCLUSIONS AND RELEVANCE: Vegetarian diets are associated with lower all-cause mortality and with some reductions in cause-specific mortality. Results appeared to be more robust in males. These favorable associations should be considered carefully by those offering dietary guidance. SN - 2168-6114 UR - https://www.unboundmedicine.com/medline/citation/23836264/Vegetarian_dietary_patterns_and_mortality_in_Adventist_Health_Study_2_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2013.6473 DB - PRIME DP - Unbound Medicine ER -