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Mortality in vegetarians and comparable nonvegetarians in the United Kingdom.
Am J Clin Nutr. 2016 Jan; 103(1):218-30.AJ

Abstract

BACKGROUND

Vegetarians and others who do not eat meat have been observed to have lower incidence rates than meat eaters of some chronic diseases, but it is unclear whether this translates into lower mortality.

OBJECTIVE

The purpose of this study was to describe mortality in vegetarians and comparable nonvegetarians in a large United Kingdom cohort.

DESIGN

The study involved a pooled analysis of data from 2 prospective studies that included 60,310 persons living in the United Kingdom, comprising 18,431 regular meat eaters (who ate meat ≥5 times/wk on average), 13,039 low (less-frequent) meat eaters, 8516 fish eaters (who ate fish but not meat), and 20,324 vegetarians (including 2228 vegans who did not eat any animal foods). Mortality by diet group for each of 18 common causes of death was estimated with the use of Cox proportional hazards models.

RESULTS

There were 5294 deaths before age 90 in >1 million y of follow-up. There was no significant difference in overall (all-cause) mortality between the diet groups: HRs in low meat eaters, fish eaters, and vegetarians compared with regular meat eaters were 0.93 (95% CI: 0.86, 1.00), 0.96 (95% CI: 0.86, 1.06), and 1.02 (95% CI: 0.94, 1.10), respectively; P-heterogeneity of risks = 0.082. There were significant differences in risk compared with regular meat eaters for deaths from circulatory disease [higher in fish eaters (HR: 1.22; 95% CI: 1.02, 1.46)]; malignant cancer [lower in fish eaters (HR: 0.82; 95% CI: 0.70, 0.97)], including pancreatic cancer [lower in low meat eaters and vegetarians (HR: 0.55; 95% CI: 0.36, 0.86 and HR: 0.48; 95% CI: 0.28, 0.82, respectively)] and cancers of the lymphatic/hematopoietic tissue [lower in vegetarians (HR: 0.50; 95% CI: 0.32, 0.79)]; respiratory disease [lower in low meat eaters (HR: 0.70; 95% CI: 0.53, 0.92)]; and all other causes [lower in low meat eaters (HR: 0.74; 95% CI: 0.56, 0.99)]. Further adjustment for body mass index left these associations largely unchanged.

CONCLUSIONS

United Kingdom-based vegetarians and comparable nonvegetarians have similar all-cause mortality. Differences found for specific causes of death merit further investigation.

Authors+Show Affiliations

Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom tim.key@ceu.ox.ac.uk.

Pub Type(s)

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

Language

eng

PubMed ID

26657045

Citation

Appleby, Paul N., et al. "Mortality in Vegetarians and Comparable Nonvegetarians in the United Kingdom." The American Journal of Clinical Nutrition, vol. 103, no. 1, 2016, pp. 218-30.
Appleby PN, Crowe FL, Bradbury KE, et al. Mortality in vegetarians and comparable nonvegetarians in the United Kingdom. Am J Clin Nutr. 2016;103(1):218-30.
Appleby, P. N., Crowe, F. L., Bradbury, K. E., Travis, R. C., & Key, T. J. (2016). Mortality in vegetarians and comparable nonvegetarians in the United Kingdom. The American Journal of Clinical Nutrition, 103(1), 218-30. https://doi.org/10.3945/ajcn.115.119461
Appleby PN, et al. Mortality in Vegetarians and Comparable Nonvegetarians in the United Kingdom. Am J Clin Nutr. 2016;103(1):218-30. PubMed PMID: 26657045.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mortality in vegetarians and comparable nonvegetarians in the United Kingdom. AU - Appleby,Paul N, AU - Crowe,Francesca L, AU - Bradbury,Kathryn E, AU - Travis,Ruth C, AU - Key,Timothy J, Y1 - 2015/12/09/ PY - 2015/07/15/received PY - 2015/10/15/accepted PY - 2015/12/15/entrez PY - 2015/12/15/pubmed PY - 2016/5/3/medline KW - diet KW - mortality KW - nonvegetarian KW - vegan KW - vegetarian SP - 218 EP - 30 JF - The American journal of clinical nutrition JO - Am J Clin Nutr VL - 103 IS - 1 N2 - BACKGROUND: Vegetarians and others who do not eat meat have been observed to have lower incidence rates than meat eaters of some chronic diseases, but it is unclear whether this translates into lower mortality. OBJECTIVE: The purpose of this study was to describe mortality in vegetarians and comparable nonvegetarians in a large United Kingdom cohort. DESIGN: The study involved a pooled analysis of data from 2 prospective studies that included 60,310 persons living in the United Kingdom, comprising 18,431 regular meat eaters (who ate meat ≥5 times/wk on average), 13,039 low (less-frequent) meat eaters, 8516 fish eaters (who ate fish but not meat), and 20,324 vegetarians (including 2228 vegans who did not eat any animal foods). Mortality by diet group for each of 18 common causes of death was estimated with the use of Cox proportional hazards models. RESULTS: There were 5294 deaths before age 90 in >1 million y of follow-up. There was no significant difference in overall (all-cause) mortality between the diet groups: HRs in low meat eaters, fish eaters, and vegetarians compared with regular meat eaters were 0.93 (95% CI: 0.86, 1.00), 0.96 (95% CI: 0.86, 1.06), and 1.02 (95% CI: 0.94, 1.10), respectively; P-heterogeneity of risks = 0.082. There were significant differences in risk compared with regular meat eaters for deaths from circulatory disease [higher in fish eaters (HR: 1.22; 95% CI: 1.02, 1.46)]; malignant cancer [lower in fish eaters (HR: 0.82; 95% CI: 0.70, 0.97)], including pancreatic cancer [lower in low meat eaters and vegetarians (HR: 0.55; 95% CI: 0.36, 0.86 and HR: 0.48; 95% CI: 0.28, 0.82, respectively)] and cancers of the lymphatic/hematopoietic tissue [lower in vegetarians (HR: 0.50; 95% CI: 0.32, 0.79)]; respiratory disease [lower in low meat eaters (HR: 0.70; 95% CI: 0.53, 0.92)]; and all other causes [lower in low meat eaters (HR: 0.74; 95% CI: 0.56, 0.99)]. Further adjustment for body mass index left these associations largely unchanged. CONCLUSIONS: United Kingdom-based vegetarians and comparable nonvegetarians have similar all-cause mortality. Differences found for specific causes of death merit further investigation. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/26657045/Mortality_in_vegetarians_and_comparable_nonvegetarians_in_the_United_Kingdom_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.115.119461 DB - PRIME DP - Unbound Medicine ER -