Vegetarians and fish eaters have a lower risk for ischemic heart disease compared with meat eaters, and vegetarians have a higher risk for stroke, according to a study published online in The BMJ.

Tammy Y.N. Tong, from the University of Oxford in the United Kingdom, and colleagues conducted a prospective cohort study to examine the correlations of vegetarianism with risks for ischemic heart disease and stroke among 48,188 participants who were classified as meat eaters (24,428 individuals), fish eaters (7,506 individuals), or vegetarians, including vegans (16,254 individuals).

The researchers identified 2,820 cases of ischemic heart disease and 1,072 cases of total stroke during 18.1 years of follow-up.

Fish eaters and vegetarians had a reduced risk for ischemic heart disease versus meat eaters after adjustment for sociodemographic and lifestyle confounders (hazard ratios, 0.87 [95 percent confidence interval (CI), 0.77 to 0.99] and 0.78 [95 percent CI, 0.70 to 0.87], respectively).

The difference was equivalent to 10 fewer cases of ischemic heart disease per 1,000 population (95 percent CI, 6.7 to 13.1 fewer cases) over 10 years. After adjustment for self-reported high blood cholesterol, high blood pressure, diabetes, and body mass index, the correlations were partially attenuated (hazard ratio, 0.90; 95 percent CI, 0.81 to 1.00 in vegetarians with all adjustments). In contrast, the risk for total stroke was increased for vegetarians (hazard ratio, 1.20; 95 percent CI, 1.02 to 1.40), mostly due to a higher rate of haemorrhagic stroke; the correlation was not attenuated after adjustment for disease risk factors.

“Additional studies in other large scale cohorts with a high proportion of non-meat eaters,” the authors advised, “are needed to confirm the generalizability of these results and assess their relevance for clinical practice and public health.”


REFERENCE: Tong et al: Risks of ischaemic heart disease and stroke in meat eaters, fish eaters, and vegetarians over 18 years of follow-up: results from the prospective EPIC-Oxford study;