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J Nutr Sci. 2019 Feb 21;8:e6. doi: 10.1017/jns.2019.1. eCollection 2019.

Association between vegetarian diets and cardiovascular risk factors in non-Hispanic white participants of the Adventist Health Study-2.

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Center for Nutrition, Healthy Lifestyle, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA 92354, USA.
Adventist Health Study-2, School of Public Health, Loma Linda University, Loma Linda, CA 92354, USA.


The association between dietary patterns and CVD risk factors among non-Hispanic whites has not been fully studied. Data from 650 non-Hispanic white adults who participated in one of two clinical sub-studies (about 2 years after the baseline) of the Adventist Health Study-2 (AHS-2) were analysed. Four dietary patters were identified using a validated 204-item semi-quantitative FFQ completed at enrolment into AHS-2: vegans (8·3 %), lacto-ovo-vegetarians (44·3 %), pesco-vegetarians (10·6 %) and non-vegetarians (NV) (37·3 %). Dietary pattern-specific prevalence ratios (PR) of CVD risk factors were assessed adjusting for confounders with or without BMI as an additional covariable. The adjusted PR for hypertension, high total cholesterol and high LDL-cholesterol were lower in all three vegetarian groups. Among the lacto-ovo-vegetarians the PR were 0·57 (95 % CI 0·45, 0·73), 0·72 (95 % CI 0·59, 0·88) and 0·72 (95 % CI 0·58, 0·89), respectively, which remained significant after additionally adjusting for BMI. The vegans and the pesco-vegetarians had similar PR for hypertension at 0·46 (95 % CI 0·25, 0·83) and 0·62 (95 % CI 0·42, 0·91), respectively, but estimates were attenuated and marginally significant after adjustment for BMI. Compared with NV, the PR of obesity and abdominal adiposity, as well as other CVD risk factors, were significantly lower among the vegetarian groups. Similar results were found when limiting analyses to participants not being treated for CVD risk factors, with the vegans having the lowest mean BMI and waist circumference. Thus, compared with the diet of NV, vegetarian diets were associated with significantly lower levels of CVD risk factors among the non-Hispanic whites.


AHS-2, Adventist Health Study-2; Adventist Health Study-2; BP, blood pressure; Bio-MRS, Biologic Manifestations of Religion Study; Cardiovascular risk factors; DBP, diastolic blood pressure; DM, diabetes mellitus; Diets; Disease prevalence; EPIC, European Prospective Investigation into Cancer and Nutrition; FBG, fasting blood glucose; HDL-C, HDL-cholesterol; HR, hazard ratio; LDL-C, LDL-cholesterol; LOV, lacto-ovo-vegetarian; Lipids; MDS, Mediterranean Diet Score; NV, non-vegetarian; PR, prevalence ratio; PV, pesco-vegetarian; SBP, systolic blood pressure; TC, total cholesterol; VG, vegan; Vegetarian dietary patterns; WC, waist circumference

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