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Mortality in vegetarians and nonvegetarians: detailed findings from a collaborative analysis of 5 prospective studies^1,2,3

¹ From the Imperial Cancer Research Fund, Cancer Epidemiology Unit, Oxford, United Kingdom; the Center for Health Research and the Department of Biostatistics and Epidemiology, Loma Linda University, CA; the Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London; the Centre for Applied Public Health Medicine, University of Wales College of Medicine, Cardiff, United Kingdom; the Division of Epidemiology, Deutsches Krebsforschungszentrum, Heidelberg, Germany; the Bremer Institut für Präventionsforschung und Sozialmedizin, Bremen, Germany; the Department of Human Nutrition, University of Otago, Dunedin, New Zealand.

We combined data from 5 prospective studies to compare the death rates from common diseases of vegetarians with those of nonvegetarians with similar lifestyles. A summary of these results was reported previously; we report here more details of the findings. Data for 76172 men and women were available. Vegetarians were those who did not eat any meat or fish (n = 27808). Death rate ratios at ages 16–89 y were calculated by Poisson regression and all results were adjusted for age, sex, and smoking status. A random-effects model was used to calculate pooled estimates of effect for all studies combined. There were 8330 deaths after a mean of 10.6 y of follow-up. Mortality from ischemic heart disease was 24% lower in vegetarians than in nonvegetarians (death rate ratio: 0.76; 95% CI: 0.62, 0.94; P < 0.01). The lower mortality from ischemic heart disease among vegetarians was greater at younger ages and was restricted to those who had followed their current diet for >5 y. Further categorization of diets showed that, in comparison with regular meat eaters, mortality from ischemic heart disease was 20% lower in occasional meat eaters, 34% lower in people who ate fish but not meat, 34% lower in lactoovovegetarians, and 26% lower in vegans. There were no significant differences between vegetarians and nonvegetarians in mortality from cerebrovascular disease, stomach cancer, colorectal cancer, lung cancer, breast cancer, prostate cancer, or all other causes combined.

Key Words: Vegetarians • vegans • mortality • ischemic heart disease • colorectal cancer • breast cancer • prostate cancer

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