Vegetarian diets are consistent with most recommendations for healthy eating.
They emphasize plant-based foods, in particular fruits, vegetables, legumes, nuts,
and vegetable oils, no meat, and little processed food. Typically, they are low in
total fat, low in saturated fat, high in fiber, and plant protein replaces animal protein.
Assessing the role of diet in the health outcomes for vegetarians is complicated by
their often-major differences in other health-conscious lifestyle behaviors such as
avoidance of smoking, high levels of physical activity, and low incidence of overweight
and obesity. Determining their impact is also complicated by the variety of
vegetarian diets that are consumed around the world, including by pesco-vegetarians
(who also consume fish); lacto-ovo-vegetarians (who also consume milk and
eggs); and strict vegans (who consume no animal products). Not much is known
about possible differences in health outcomes between these differing vegetarian
As Katz and Meller and Hu have noted, the scientific literature on plant-based
diets supports the conclusion that they have favorable effects on a wide array of
health outcomes. They improve blood lipids (lower LDL-C and non-
HDL-C), facilitate weight loss, and help prevent various cardiovascular diseases
and cancers and provide the benefits of a high intake of fiber. The long-term
Nurses’ Health Study and the Health Professionals Follow-up Study found that intake
of plant protein was associated with lower cardiovascular and all-cause mortality.
203 Diets high in animal protein, especially processed red meat (but not fish and
poultry), were associated with higher cardiovascular mortality, but perhaps only in
those with one or more lifestyle-related health risk factors.
Populations in low-resource settings with vegetarian or mostly plant-based dietary
patterns have been observed to have low cardiovascular and cancer disease risk.204
205 206 Similar observations have been made about groups with vegetarian diets in
the U.S., such as Seventh Day Adventists.207 208 A meta-analysis of seven studies
relating to CVD mortality and vegetarian diets found that heart disease mortality
was 29% lower in vegetarians than in non-vegetarians.
The Oxford Vegetarian Study was a prospective study of 6,000 vegetarians and
5,000 non-vegetarian control subjects in the U. K. between 1980 and 1984. The
study found that vegans had the lowest total cholesterol and LDL-C; vegetarians
and fish eaters had similar intermediate values and meat-eaters the highest. Meat
and cheese consumption was associated with high, and dietary fiber intake was
associated with low total cholesterol levels. After 12 years of follow-up (and adjusting
for smoking, body mass index, and social class), death rates from all causes
were 20% lower and cancer deaths 39% lower in non-meat-eaters than in meat-eaters.
Greater intakes of total animal fat, saturated animal fat, and dietary cholesterol
were associated with increased mortality from heart disease.
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