This article shows that fish eaters and vegetarians had lower rates of heart attacks than meat eaters, but vegetarians had higher rates of stroke. ~ Dr. Broussard
Risks of Ischemic Heart Disease and Stroke in Meat Eaters, Fish Eaters, and Vegetarians
September 25, 2019
- TAKE-HOME MESSAGE
The EPIC-Oxford prospective cohort study examined incident cases of ischemic heart disease and stroke in 48,188 participants with no history of cardiovascular disease or stroke who were classified as meat eaters, fish eaters, and vegetarians (including vegans) over an 18.1-year period. UK National Health Service data were used to detect medical events. To classify participants into dietary categories at baseline, a questionnaire was used that was distributed to general practices and by mail targeted to specific populations. In an adjusted analysis, there were significantly lower rates of ischemic heart disease in fish eaters and vegetarians versus meat eaters (HR, 0.87 and HR, 0.78, respectively). Including self-reported body mass index, diabetes, high blood cholesterol, and high blood pressure partly attenuated these associations. Rates of total stroke were higher in vegetarians than meat eaters (HR, 1.20). This difference was primarily due to higher rates of hemorrhagic stroke (HR, 1.43). - Rates of ischemic heart disease and stroke were found to be affected by types of meat included or excluded from the diet, but further studies are needed that investigate additional variables (such as circulating vitamin B12 levels) to better understand the causes of the identified associations.
Abstract
OBJECTIVE
To examine the associations of vegetarianism with risks of ischaemic heart disease and stroke.
DESIGN
Prospective cohort study.
SETTING
The EPIC-Oxford study, a cohort in the United Kingdom with a large proportion of non-meat eaters, recruited across the country between 1993 and 2001.
PARTICIPANTS
48 188 participants with no history of ischaemic heart disease, stroke, or angina (or cardiovascular disease) were classified into three distinct diet groups: meat eaters (participants who consumed meat, regardless of whether they consumed fish, dairy, or eggs; n=24 428), fish eaters (consumed fish but no meat; n=7506), and vegetarians including vegans (n=16 254), based on dietary information collected at baseline, and subsequently around 2010 (n=28 364).
MAIN OUTCOME MEASURES
Incident cases of ischaemic heart disease and stroke (including ischaemic and haemorrhagic types) identified through record linkage until 2016.
RESULTS
Over 18.1 years of follow-up, 2820 cases of ischaemic heart disease and 1072 cases of total stroke (519 ischaemic stroke and 300 haemorrhagic stroke) were recorded. After adjusting for sociodemographic and lifestyle confounders, fish eaters and vegetarians had 13% (hazard ratio 0.87, 95% confidence interval 0.77 to 0.99) and 22% (0.78, 0.70 to 0.87) lower rates of ischaemic heart disease than meat eaters, respectively (P<0.001 for heterogeneity). This difference was equivalent to 10 fewer cases of ischaemic heart disease (95% confidence interval 6.7 to 13.1 fewer) in vegetarians than in meat eaters per 1000 population over 10 years. The associations for ischaemic heart disease were partly attenuated after adjustment for self reported high blood cholesterol, high blood pressure, diabetes, and body mass index (hazard ratio 0.90, 95% confidence interval 0.81 to 1.00 in vegetarians with all adjustments). By contrast, vegetarians had 20% higher rates of total stroke (hazard ratio 1.20, 95% confidence interval 1.02 to 1.40) than meat eaters, equivalent to three more cases of total stroke (95% confidence interval 0.8 to 5.4 more) per 1000 population over 10 years, mostly due to a higher rate of haemorrhagic stroke. The associations for stroke did not attenuate after further adjustment of disease risk factors.
CONCLUSIONS
In this prospective cohort in the UK, fish eaters and vegetarians had lower rates of ischaemic heart disease than meat eaters, although vegetarians had higher rates of haemorrhagic and total stroke.