Mortality in British vegetarians: results from the European Prospective Investigation into Cancer and Nutrition (EPIC-Oxford).

BACKGROUND Few prospective studies have examined the mortality of vegetarians. OBJECTIVE We present results on mortality among vegetarians and nonvegetarians in the European Prospective Investigation into Cancer and Nutrition (EPIC-Oxford). DESIGN We used a prospective study of men and women recruited throughout the United Kingdom in the 1990s. RESULTS Among 64,234 participants aged 20-89 y for whom diet group was known, 2965 had died before age 90 by 30 June 2007. The death rates of participants are much lower than average for the United Kingdom. The standardized mortality ratio for all causes of death was 52% (95% CI: 50%, 54%) and was identical in vegetarians and in nonvegetarians. Comparing vegetarians with meat eaters among the 47,254 participants who had no prevalent cardiovascular disease or malignant cancer at recruitment, the death rate ratios adjusted for age, sex, smoking, and alcohol consumption were 0.81 (95% CI: 0.57, 1.16) for ischemic heart disease and 1.03 (95% CI: 0.90, 1.16) for all causes of death. CONCLUSIONS The mortality of both the vegetarians and the nonvegetarians in this study is low compared with national rates. Within the study, mortality from circulatory diseases and all causes is not significantly different between vegetarians and meat eaters, but the study is not large enough to exclude small or moderate differences for specific causes of death, and more research on this topic is required.

[1]  D. Jacobs,et al.  Food, plant food, and vegetarian diets in the US dietary guidelines: conclusions of an expert panel. , 2009, The American journal of clinical nutrition.

[2]  J. Lampe.  Is equol the key to the efficacy of soy foods? , 2009, The American journal of clinical nutrition.

[3]  A. Lanou.  Should dairy be recommended as part of a healthy vegetarian diet? Counterpoint. , 2009, The American journal of clinical nutrition.

[4]  B. Lönnerdal.  Soybean ferritin: implications for iron status of vegetarians. , 2009, The American journal of clinical nutrition.

[5]  I. Mangat.  Do vegetarians have to eat fish for optimal cardiovascular protection? , 2009, The American journal of clinical nutrition.

[6]  A. Carlsson-kanyama,et al.  Potential contributions of food consumption patterns to climate change. , 2009, The American journal of clinical nutrition.

[7]  W. Craig.  Health effects of vegan diets. , 2009, The American journal of clinical nutrition.

[8]  D. Jacobs,et al.  Food synergy: an operational concept for understanding nutrition. , 2009, The American journal of clinical nutrition.

[9]  Nazmus Saquib,et al.  Dietary change and reduced breast cancer events among women without hot flashes after treatment of early-stage breast cancer: subgroup analysis of the Women's Healthy Eating and Living Study. , 2009, The American journal of clinical nutrition.

[10]  G. Fraser,et al.  Serum 25-hydroxyvitamin D status of vegetarians, partial vegetarians, and nonvegetarians: the Adventist Health Study-2. , 2009, The American journal of clinical nutrition.

[11]  J. Sabaté,et al.  Walnuts and fatty fish influence different serum lipid fractions in normal to mildly hyperlipidemic individuals: a randomized controlled study. , 2009, The American journal of clinical nutrition.

[12]  E. Ros.  Nuts and novel biomarkers of cardiovascular disease. , 2009, The American journal of clinical nutrition.

[13]  I. Elmadfa,et al.  Vitamin B-12 and homocysteine status among vegetarians: a global perspective. , 2009, The American journal of clinical nutrition.

[14]  A. Roddam,et al.  Cancer incidence in vegetarians: results from the European Prospective Investigation into Cancer and Nutrition (EPIC-Oxford). , 2009, The American journal of clinical nutrition.

[15]  J. Sabaté,et al.  Nuts and health outcomes: new epidemiologic evidence. , 2009, The American journal of clinical nutrition.

[16]  S. Bent,et al.  The relation of alpha-linolenic acid to the risk of prostate cancer: a systematic review and meta-analysis. , 2009, The American journal of clinical nutrition.

[17]  A. Wu,et al.  Perspectives on the soy-breast cancer relation. , 2009, The American journal of clinical nutrition.

[18]  K. Shankar,et al.  The health implications of soy infant formula. , 2009, The American journal of clinical nutrition.

[19]  G. Fraser.  Vegetarian diets: what do we know of their effects on common chronic diseases? , 2009, The American journal of clinical nutrition.

[20]  Joan Sabaté,et al.  Diet and the environment: does what you eat matter? , 2009, The American journal of clinical nutrition.

[21]  B. Shukitt-Hale,et al.  Modulation of cognition and behavior in aged animals: role for antioxidant- and essential fatty acid-rich plant foods. , 2009, American Journal of Clinical Nutrition.

[22]  J. Lampe.  Interindividual differences in response to plant-based diets: implications for cancer risk. , 2009, The American journal of clinical nutrition.

[23]  P. Newby.  Plant foods and plant-based diets: protective against childhood obesity? , 2009, The American journal of clinical nutrition.

[24]  Gabrielle Turner-McGrievy,et al.  A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial. , 2009, The American journal of clinical nutrition.

[25]  P. Martin,et al.  Geophysics and nutritional science: toward a novel, unified paradigm. , 2009, The American journal of clinical nutrition.

[26]  J. Sabaté,et al.  Fifth International Congress on Vegetarian Nutrition. Preface. , 2009, The American journal of clinical nutrition.

[27]  C. Weaver.  Should dairy be recommended as part of a healthy vegetarian diet? Point. , 2009, The American journal of clinical nutrition.

[28]  Frank Mueller,et al.  Preface , 2009, 2009 IEEE International Symposium on Parallel & Distributed Processing.

[29]  S. Preston‐Martin,et al.  Cohort profile: The Adventist Health Study-2 (AHS-2). , 2008, International journal of epidemiology.

[30]  A. Roddam,et al.  Phytanic acid: measurement of plasma concentrations by gas–liquid chromatography–mass spectrometry analysis and associations with diet and other plasma fatty acids , 2008, British Journal of Nutrition.

[31]  T. Key,et al.  Long-chain n-3 polyunsaturated fatty acids in plasma in British meat-eating, vegetarian, and vegan men. , 2005, The American journal of clinical nutrition.

[32]  Steven Hawken,et al.  Preventive cardiologyAbstractsEffect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): Case-control study , 2004 .

[33]  S. Grundy,et al.  Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. , 2004, Arteriosclerosis, thrombosis, and vascular biology.

[34]  T. Key,et al.  EPIC–Oxford:lifestyle characteristics and nutrient intakes in a cohort of 33 883 meat-eaters and 31 546 non meat-eaters in the UK , 2003, Public Health Nutrition.

[35]  N E Day,et al.  European Prospective Investigation into Cancer and Nutrition (EPIC): study populations and data collection , 2002, Public Health Nutrition.

[36]  Majid Ezzati,et al.  For Personal Use. Only Reproduce with Permission from the Lancet Publishing Group , 2022 .

[37]  Cliona Ni Mhurchu,et al.  Coronary heart disease and body mass index: a systematic review of the evidence from larger prospective cohort studies. , 2002, Seminars in vascular medicine.

[38]  T. Key,et al.  Hypertension and blood pressure among meat eaters, fish eaters, vegetarians and vegans in EPIC–Oxford , 2002, Public Health Nutrition.

[39]  T. Key,et al.  Mortality in British vegetarians , 2002, Public Health Nutrition.

[40]  V. Beral,et al.  Mortality in vegetarians and nonvegetarians: detailed findings from a collaborative analysis of 5 prospective studies. , 1999, The American journal of clinical nutrition.

[41]  T. Key,et al.  Oestradiol and sex hormone-binding globulin in premenopausal and post-menopausal meat-eaters, vegetarians and vegans , 1999, British Journal of Cancer.

[42]  T. Key,et al.  Prevalence of obesity is low in people who do not eat meat , 1996, BMJ.

[43]  T. Key,et al.  Dietary habits and mortality in 11 000 vegetarians and health conscious people: results of a 17 year follow up , 1996, BMJ.

[44]  S A Bingham,et al.  Validation of weighed records and other methods of dietary assessment using the 24 h urine nitrogen technique and other biological markers , 1995, British Journal of Nutrition.

[45]  N E Day,et al.  Comparison of dietary assessment methods in nutritional epidemiology: weighed records v. 24 h recalls, food-frequency questionnaires and estimated-diet records , 1994, British Journal of Nutrition.

[46]  P. Grambsch,et al.  Proportional hazards tests and diagnostics based on weighted residuals , 1994 .

[47]  K. McPherson,et al.  Risk of death from cancer and ischaemic heart disease in meat and non-meat eaters , 1994, BMJ.

[48]  W. L. Beeson,et al.  Chronic disease among seventh‐day adventists, a low‐risk group. Rationale, methodology, and description of the population , 1989, Cancer.

[49]  H. Crawley.  Food Portion Sizes , 1988 .

[50]  M. Burr,et al.  Vegetarianism, dietary fiber, and mortality. , 1982, The American journal of clinical nutrition.

[51]  L. Garfinkel,et al.  Mortality among California Seventh-Day Adventists for selected cancer sites. , 1980, Journal of the National Cancer Institute.

[52]  A. Paul,et al.  McCance and Widdowson's 'The composition of foods': dietary fibre in egg, meat and fish dishes. , 1979, Journal of human nutrition.