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Fontes T, Lopes S, Menezes R, Esgalhado M, Monteiro Rodrigues L, Ferreira-Pêgo C. Exploring Vegetarian and Omnivorous Approaches to Cardiovascular Risk and Body Composition. Nutrients 2024; 16:2013. [PMID: 38999761 PMCID: PMC11243008 DOI: 10.3390/nu16132013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Revised: 06/19/2024] [Accepted: 06/20/2024] [Indexed: 07/14/2024] Open
Abstract
The role of nutrition in preventing non-communicable diseases has been widely studied in recent years, with indications that non-animal-based diets might improve body composition and therefore bring multiple health benefits. For all of these reasons, the main purpose was to compare body composition and metabolic status between vegetarian and omnivorous individuals and relate these values with cardiovascular risk. The present analysis included 176 participants (61 vegetarians and 115 omnivores). Body composition was assessed using a dual-energy X-ray absorptiometry, biochemical parameters obtained from capillary blood, and the 10-year cardiovascular risk (10RCVD) calculated by the QRISK3 score. No statistical differences were found between groups regarding body composition. Concerning metabolic markers, vegetarian individuals showed reduced values of total cholesterol, LDL cholesterol, and non-HDL cholesterol (p < 0.05). There were no differences in 10RCVD between groups. In both diets, moderate correlations between groups were found for cardiovascular risk and visceral adipose tissue. Our results suggest that the vegetarian regimen might be associated with better cardiometabolic biomarkers and better cardiovascular health, although controversial with the body composition trends observed. In conclusion, the results suggest that cardiovascular risk appears to be more influenced by body composition, mainly fat tissue, over dietary patterns itself.
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Affiliation(s)
- Tatiana Fontes
- CBIOS-Universidade Lusófona's Research Center for Biosciences and Health Technologies, Av. Campo Grande 376, 1749-024 Lisbon, Portugal
| | - Sofia Lopes
- CBIOS-Universidade Lusófona's Research Center for Biosciences and Health Technologies, Av. Campo Grande 376, 1749-024 Lisbon, Portugal
| | - Regina Menezes
- CBIOS-Universidade Lusófona's Research Center for Biosciences and Health Technologies, Av. Campo Grande 376, 1749-024 Lisbon, Portugal
| | - Marta Esgalhado
- CBIOS-Universidade Lusófona's Research Center for Biosciences and Health Technologies, Av. Campo Grande 376, 1749-024 Lisbon, Portugal
| | - Luís Monteiro Rodrigues
- CBIOS-Universidade Lusófona's Research Center for Biosciences and Health Technologies, Av. Campo Grande 376, 1749-024 Lisbon, Portugal
| | - Cíntia Ferreira-Pêgo
- CBIOS-Universidade Lusófona's Research Center for Biosciences and Health Technologies, Av. Campo Grande 376, 1749-024 Lisbon, Portugal
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Capodici A, Mocciaro G, Gori D, Landry MJ, Masini A, Sanmarchi F, Fiore M, Coa AA, Castagna G, Gardner CD, Guaraldi F. Cardiovascular health and cancer risk associated with plant based diets: An umbrella review. PLoS One 2024; 19:e0300711. [PMID: 38748667 PMCID: PMC11095673 DOI: 10.1371/journal.pone.0300711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 03/04/2024] [Indexed: 05/19/2024] Open
Abstract
CONTEXT Cardiovascular diseases (CVDs) and cancer are the two main leading causes of death and disability worldwide. Suboptimal diet, poor in vegetables, fruits, legumes and whole grain, and rich in processed and red meat, refined grains, and added sugars, is a primary modifiable risk factor. Based on health, economic and ethical concerns, plant-based diets have progressively widespread worldwide. OBJECTIVE This umbrella review aims at assessing the impact of animal-free and animal-products-free diets (A/APFDs) on the risk factors associated with the development of cardiometabolic diseases, cancer and their related mortalities. DATA SOURCES PubMed and Scopus were searched for reviews, systematic reviews, and meta-analyses published from 1st January 2000 to 31st June 2023, written in English and involving human subjects of all ages. Primary studies and reviews/meta-analyses based on interventional trials which used A/APFDs as a therapy for people with metabolic diseases were excluded. DATA EXTRACTION The umbrella review approach was applied for data extraction and analysis. The revised AMSTAR-R 11-item tool was applied to assess the quality of reviews/meta-analyses. RESULTS Overall, vegetarian and vegan diets are significantly associated with better lipid profile, glycemic control, body weight/BMI, inflammation, and lower risk of ischemic heart disease and cancer. Vegetarian diet is also associated with lower mortality from CVDs. On the other hand, no difference in the risk of developing gestational diabetes and hypertension were reported in pregnant women following vegetarian diets. Study quality was average. A key limitation is represented by the high heterogeneity of the study population in terms of sample size, demography, geographical origin, dietary patterns, and other lifestyle confounders. CONCLUSIONS Plant-based diets appear beneficial in reducing cardiometabolic risk factors, as well as CVDs, cancer risk and mortality. However, caution should be paid before broadly suggesting the adoption of A/AFPDs since the strength-of-evidence of study results is significantly limited by the large study heterogeneity alongside the potential risks associated with potentially restrictive regimens.
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Affiliation(s)
- Angelo Capodici
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum–University of Bologna, Bologna, Italy
- Interdisciplinary Research Center for Health Science, Sant’Anna School of Advanced Studies, Pisa, Tuscany, Italy
| | - Gabriele Mocciaro
- Department of Biochemistry, University of Cambridge, Cambridge, United Kingdom
| | - Davide Gori
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum–University of Bologna, Bologna, Italy
| | - Matthew J. Landry
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Alice Masini
- Department of Translational Medicine, University of Eastern Piedmont, (UNIUPO), Novara, Italy
| | - Francesco Sanmarchi
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum–University of Bologna, Bologna, Italy
| | - Matteo Fiore
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum–University of Bologna, Bologna, Italy
| | - Angela Andrea Coa
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum–University of Bologna, Bologna, Italy
| | - Gisele Castagna
- Department of Biomedical and Neuromotor Science, Alma Mater Studiorum–University of Bologna, Bologna, Italy
| | - Christopher D. Gardner
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Federica Guaraldi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma Neurochirurgia Ipofisi—Pituitary Unit, Bologna, Italy
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Petermann-Rocha F, Ho FK. Vegetarians: Past, Present, and Future Regarding Their Diet Quality and Nutritional Status. Nutrients 2023; 15:3587. [PMID: 37630777 PMCID: PMC10459486 DOI: 10.3390/nu15163587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
The term "vegetarian" usually refers to individuals who exclude meat, fish, poultry and/or their derived products from their diet [...].
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Affiliation(s)
- Fanny Petermann-Rocha
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago 8370068, Chile
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow G12 8TA, UK
| | - Frederick K. Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow G12 8TB, UK;
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Pieczyńska K, Rzymski P. Health Benefits of Vegetarian and Mediterranean Diets: Narrative Review. POL J FOOD NUTR SCI 2022. [DOI: 10.31883/pjfns/156067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Chen P, Zhao Y, Chen Y. A vegan diet improves insulin resistance in individuals with obesity: a systematic review and meta-analysis. Diabetol Metab Syndr 2022; 14:114. [PMID: 35964120 PMCID: PMC9375406 DOI: 10.1186/s13098-022-00879-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/21/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND A vegan diet has benefits on weight reduction and on the parameters of glucose and lipid metabolism. This meta-analysis aimed to investigate the efficacy of plant-based diets on insulin resistance and blood lipids in patients with obesity. METHODS PubMed, Embase, and the Cochrane Library were searched for available papers published up to March 2021. The primary outcome was insulin resistance which was assessed by Homeostasis Model Assessment Insulin Resistance (HOMA-IR), other metabolic parameters measures including the pre/post-diet changes in triglycerides, HDL-cholesterol, total cholesterol, LDL-cholesterol. All analyses were performed using the random-effects model. RESULTS Six studies (seven datasets) were included. Compared with baseline, the plant-based diet improved the HOMA-IR (SMD = 1.64, 95%CI 0.95, 2.33; I2 = 91.8%, Pheterogeneity < 0.001), total cholesterol (SMD = 2.51, 95% CI 0.88, 4.13; I2 = 98.0%, Pheterogeneity < 0.001), HDL-cholesterol (SMD = 1.55, 95% CI 0.66, 2.44; I2 = 92.0%, Pheterogeneity < 0.001), and LDL-cholesterol (SMD = 2.50, 95% CI 1.30, 3.70; I2 = 94.4%, Pheterogeneity < 0.001), but not the triglycerides (SMD = - 0.62, 95% CI - 1.92, 0.68; I2 = 97.8%, Pheterogeneity < 0.001). The sensitivity analyses showed that the results were robust. CONCLUSIONS In obese individuals with insulin resistance, a vegan diet improves insulin resistance and dyslipidemia, except for triglycerides.
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Affiliation(s)
- Peng Chen
- Department of Pediatrics, The Second Hospital of Jilin University, Changchun, China
| | - Ying Zhao
- Department of Endocrinology, The Second Hospital of Jilin University, No. 218, Ziqiang Street, Nanguan District, Changchun, China
| | - Yan Chen
- Department of Endocrinology, The Second Hospital of Jilin University, No. 218, Ziqiang Street, Nanguan District, Changchun, China.
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Marino M, Martini D, Ciappellano S, Brusamolino A, Gardana C, Battezzati A, Riso P, Porrini M, Bo CD. Cobalamin status is negatively correlated with vascular endothelial (VE)-cadherin in vegetarian and vegan women with a vitamin B12 deficiency. Nutr Res 2022; 105:126-137. [DOI: 10.1016/j.nutres.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 06/28/2022] [Accepted: 07/11/2022] [Indexed: 10/17/2022]
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Quek J, Lim G, Lim WH, Ng CH, So WZ, Toh J, Pan XH, Chin YH, Muthiah MD, Chan SP, Foo RSY, Yip J, Neelakantan N, Chong MFF, Loh PH, Chew NWS. The Association of Plant-Based Diet With Cardiovascular Disease and Mortality: A Meta-Analysis and Systematic Review of Prospect Cohort Studies. Front Cardiovasc Med 2021; 8:756810. [PMID: 34805312 PMCID: PMC8604150 DOI: 10.3389/fcvm.2021.756810] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 09/24/2021] [Indexed: 12/17/2022] Open
Abstract
Background: The association between plant-based diets and cardiovascular disease (CVD) remains poorly characterized. Given that diet represents an important and a modifiable risk factor, this study aimed to assess (1) the relationships between the impact of adherence to plant-based diets on cardiovascular mortality, incident CVD, and stroke; (2) if associations differed by adherence to healthful and less healthful plant-based diets. Methods and Findings: MEDLINE and EMBASE databases were searched up to May 2021. Studies assessing CVD outcomes with relation to plant-based dietary patterns or according to plant-based dietary indices (PDI) were included. A meta-analysis of hazard ratios (HR) was conducted using DerSimonian and Laird random effects model. Thirteen studies involving 410,085 participants were included. Greater adherence to an overall plant-based dietary pattern was significantly associated with a lower risk of cardiovascular mortality (pooled HR: 0.92, 95% CI: 0.86–0.99 p = 0.0193, I2 = 88.5%, N = 124,501) and a lower risk of CVD incidence (pooled HR: 0.90, 95% CI: 0.82–0.98, p = 0.0173, I2 = 87.2%, N = 323,854). Among the studies that used PDI, unhealthful plant-based diets were associated with increased risk of cardiovascular mortality (pooled HR: 1.05, 95% CI: 1.01–1.09, p = 0.0123, I2 = 0.00%, N = 18,966), but not CVD incidence. Conversely, healthful plant-based diets were associated with decreased CVD incidence (pooled HR: 0.87, 95% CI: 0.80–0.95, p = 0.0011, I2 = 57.5%, N = 71,301), but not mortality. Vegetarians also had significantly lower CVD incidence (HR: 0.81, 95% CI: 0.72–0.91, p = 0.0004, I2 = 22.2%, N = 16,254), but similar CVD mortality or stroke risk when compared to the meat-eaters. Conclusion: To date, this comprehensive study examines the effects of a plant-based diet on major clinical endpoints using more holistic PDIs. These findings highlight the favorable role of healthful plant-based foods in reducing cardiovascular mortality and CVD.
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Affiliation(s)
- Jingxuan Quek
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Grace Lim
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Wen Hui Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Cheng Han Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wei Zheng So
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jonathan Toh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xin Hui Pan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yip Han Chin
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Mark D Muthiah
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore.,National University Centre for Organ Transplantation, National University Health System, Singapore, Singapore
| | - Siew Pang Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Cardiology, National University Heart Centre, National University Hospital, Singapore, Singapore
| | - Roger S Y Foo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Cardiology, National University Heart Centre, National University Hospital, Singapore, Singapore
| | - James Yip
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Cardiology, National University Heart Centre, National University Hospital, Singapore, Singapore
| | - Nithya Neelakantan
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore, Singapore
| | - Mary F F Chong
- Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore, Singapore
| | - Poay Huan Loh
- Department of Cardiology, National University Heart Centre, National University Hospital, Singapore, Singapore
| | - Nicholas W S Chew
- Department of Cardiology, National University Heart Centre, National University Hospital, Singapore, Singapore
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Shared genetic etiology between Parkinson's disease and blood levels of specific lipids. NPJ PARKINSONS DISEASE 2021; 7:23. [PMID: 33674605 PMCID: PMC7935855 DOI: 10.1038/s41531-021-00168-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 02/01/2021] [Indexed: 12/16/2022]
Abstract
Parkinson’s disease (PD) is characterized by the degeneration of dopaminergic neurons in the substantia nigra and the formation of Lewy bodies. The mechanisms underlying these molecular and cellular effects are largely unknown. Previously, based on genetic and other data, we built a molecular landscape of PD that highlighted a central role for lipids. To explore which lipid species may be involved in PD pathology, we used published genome-wide association study (GWAS) data to conduct polygenic risk score-based analyses to examine putative genetic sharing between PD and blood levels of 370 lipid species and lipid-related molecules. We found a shared genetic etiology between PD and blood levels of 25 lipids. We then used data from a much-extended GWAS of PD to try and corroborate our findings. Across both analyses, we found genetic overlap between PD and blood levels of eight lipid species, namely two polyunsaturated fatty acids (PUFA 20:3n3-n6 and 20:4n6), four triacylglycerols (TAG 44:1, 46:1, 46:2, and 48:0), phosphatidylcholine aa 32:3 (PC aa 32:3) and sphingomyelin 26:0 (SM 26:0). Analysis of the concordance—the agreement in genetic variant effect directions across two traits—revealed a significant negative concordance between PD and blood levels of the four triacylglycerols and PC aa 32:3 and a positive concordance between PD and blood levels of both PUFA and SM 26:0. Taken together, our analyses imply that genetic variants associated with PD modulate blood levels of a specific set of lipid species supporting a key role of these lipids in PD etiology.
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How to protect both health and food system sustainability? A holistic 'global health'-based approach via the 3V rule proposal. Public Health Nutr 2020; 23:3028-3044. [PMID: 32758320 DOI: 10.1017/s136898002000227x] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To define a generic diet to protect human health and food system sustainability based on three dimensions: animal:plant ratio, degree of food processing and food diversity. DESIGN/SETTING The percentages of maximum animal and ultra-processed energy content were evaluated from scientific papers (Web of Science database) and reports from international scientific institutions. Then, a weekly French standard diet, including these percentages and food diversity (≥42 different foods), was designed to calculate adequacy to nutritional needs. RESULTS Based on traditional and scientifically based healthy diets, and on foresight scenarios for sustainable diets at horizon 2050, a median daily animal energy content intake of 15 % was found to be protective towards both human health and environment. Based on epidemiological studies associating ultra-processed energy consumption with increased overweight/obesity risk, a precautionary threshold of approximately 15 % ultra-processed energy content was observed. The French diet allows addressing all nutritional needs and other nutritional indicators such as maximum salt and simple sugar consumption, α-linolenic acid:linoleic acid ratio and essential amino acids. This diet was named the '3V rule' for Végétal (plant), Vrai (real) and Varié (varied, if possible organic, local and seasonal). This generic diet can be adapted according to regional traditions and environmental characteristics. Excluding only one dimension of it would threaten both health and food system sustainability. CONCLUSIONS Tending towards a 3V-based diet, while respecting local constraints, should allow preserving human health, environment (greenhouse gas emissions, pollution, deforestation, etc.), small farmers, animal welfare and biodiversity, culinary traditions and socioeconomics (including an alleviation of public health cost).
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Oussalah A, Levy J, Berthezène C, Alpers DH, Guéant JL. Health outcomes associated with vegetarian diets: An umbrella review of systematic reviews and meta-analyses. Clin Nutr 2020; 39:3283-3307. [PMID: 32204974 DOI: 10.1016/j.clnu.2020.02.037] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 02/22/2020] [Accepted: 02/28/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Several meta-analyses evaluated the association between vegetarian diets and health outcomes. To integrate the large amount of the available evidence, we performed an umbrella review of published meta-analyses that investigated the association between vegetarian diets and health outcomes. METHODS We performed an umbrella review of the evidence across meta-analyses of observational and interventional studies. PubMed, Embase, Cochrane Database of Systematic Reviews, and ISI Web of Knowledge. Additional articles were retrieved from primary search references. Meta-analyses of observational or interventional studies that assessed at least one health outcome in association with vegetarian diets. We estimated pooled effect sizes (ESs) using four different random-effect models: DerSimonian and Laird, maximum likelihood, empirical Bayes, and restricted maximum likelihood. We assessed heterogeneity using I2 statistics and publication bias using funnel plots, radial plots, normal Q-Q plots, and the Rosenthal's fail-safe N test. RESULTS The umbrella review identified 20 meta-analyses of observational and interventional research with 34 health outcomes. The majority of the meta-analyses (80%) were classified as moderate or high-quality reviews, based on the AMSTAR2 criteria. By comparison with omnivorous diets, vegetarian diets were associated with a significantly lower concentration of blood total cholesterol (pooled ES = -0.549 mmol/L; 95% CI: -0.773 to -0.325; P < 0.001), LDL-cholesterol (pooled ES = -0.467 mmol/L; 95% CI: -0.600 to -0.335); P < 0.001), and HDL-cholesterol (pooled ES = -0.082 mmol/L; 95% CI: -0.095 to -0.069; P < 0.001). In comparison to omnivorous diets, vegetarian diets were associated with a reduced risk of negative health outcomes with a pooled ES of 0.886 (95% CI: 0.848 to 0.926; P < 0.001). In comparison to omnivores, Seventh-day Adventists (SDA) vegetarians had a significantly reduced risk of negative health outcomes with a pooled ES of 0.721 (95% CI: 0.625 to 0.832; P < 0.001). Non-SDA vegetarians had no significant reduction of negative health outcomes when compared to omnivores (pooled ES = 0.973; 95% CI: 0.873 to 1.083; P = 0.51). Vegetarian diets were associated with harmful outcomes on one-carbon metabolism markers (lower concentrations of vitamin B12 and higher concentrations of homocysteine), in comparison to omnivorous diets. CONCLUSIONS Vegetarian diets are associated with beneficial effects on the blood lipid profile and a reduced risk of negative health outcomes, including diabetes, ischemic heart disease, and cancer risk. Among vegetarians, SDA vegetarians could represent a subgroup with a further reduced risk of negative health outcomes. Vegetarian diets have adverse outcomes on one-carbon metabolism. The effect of vegetarian diets among pregnant and lactating women requires specific attention. Well-designed prospective studies are warranted to evaluate the consequences of the prevalence of vitamin B12 deficiency during pregnancy and infancy on later life and of trace element deficits on cancer risks. PROSPERO REGISTRATION NUMBER CRD42018092470.
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Affiliation(s)
- Abderrahim Oussalah
- University of Lorraine, INSERM UMR_S 1256, Nutrition, Genetics, and Environmental Risk Exposure (NGERE), Faculty of Medicine of Nancy, F-54000, Nancy, France; Department of Molecular Medicine, Division of Biochemistry, Molecular Biology, and Nutrition, University Hospital of Nancy, F-54000, Nancy, France; Reference Center for Inborn Errors of Metabolism (ORPHA67872), University Hospital of Nancy, F-54000, Nancy, France.
| | - Julien Levy
- University of Lorraine, INSERM UMR_S 1256, Nutrition, Genetics, and Environmental Risk Exposure (NGERE), Faculty of Medicine of Nancy, F-54000, Nancy, France
| | - Clémence Berthezène
- University of Lorraine, INSERM UMR_S 1256, Nutrition, Genetics, and Environmental Risk Exposure (NGERE), Faculty of Medicine of Nancy, F-54000, Nancy, France
| | - David H Alpers
- Department of Internal Medicine, Washington University School of Medicine, St Louis, MO, 63130, USA
| | - Jean-Louis Guéant
- University of Lorraine, INSERM UMR_S 1256, Nutrition, Genetics, and Environmental Risk Exposure (NGERE), Faculty of Medicine of Nancy, F-54000, Nancy, France; Department of Molecular Medicine, Division of Biochemistry, Molecular Biology, and Nutrition, University Hospital of Nancy, F-54000, Nancy, France; Reference Center for Inborn Errors of Metabolism (ORPHA67872), University Hospital of Nancy, F-54000, Nancy, France.
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Wang F, Zheng J, Yang B, Jiang J, Fu Y, Li D. Effects of Vegetarian Diets on Blood Lipids: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc 2015; 4:e002408. [PMID: 26508743 PMCID: PMC4845138 DOI: 10.1161/jaha.115.002408] [Citation(s) in RCA: 174] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 09/09/2015] [Indexed: 01/24/2023]
Abstract
BACKGROUND Vegetarian diets exclude all animal flesh and are being widely adopted by an increasing number of people; however, effects on blood lipid concentrations remain unclear. This meta-analysis aimed to quantitatively assess the overall effects of vegetarian diets on blood lipids. METHODS AND RESULTS We searched PubMed, Scopus, Embase, ISI Web of Knowledge, and the Cochrane Library through March 2015. Studies were included if they described the effectiveness of vegetarian diets on blood lipids (total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglyceride). Weighted mean effect sizes were calculated for net changes by using a random-effects model. We performed subgroup and univariate meta-regression analyses to explore sources of heterogeneity. Eleven trials were included in the meta-analysis. Vegetarian diets significantly lowered blood concentrations of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and non-high-density lipoprotein cholesterol, and the pooled estimated changes were -0.36 mmol/L (95% CI -0.55 to -0.17; P<0.001), -0.34 mmol/L (95% CI -0.57 to -0.11; P<0.001), -0.10 mmol/L (95% CI -0.14 to -0.06; P<0.001), and -0.30 mmol/L (95% CI -0.50 to -0.10; P=0.04), respectively. Vegetarian diets did not significantly affect blood triglyceride concentrations, with a pooled estimated mean difference of 0.04 mmol/L (95% CI -0.05 to 0.13; P=0.40). CONCLUSIONS This systematic review and meta-analysis provides evidence that vegetarian diets effectively lower blood concentrations of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and non-high-density lipoprotein cholesterol. Such diets could be a useful nonpharmaceutical means of managing dyslipidemia, especially hypercholesterolemia.
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Affiliation(s)
- Fenglei Wang
- Department of Food Science and NutritionZhejiang UniversityHangzhouChina
| | - Jusheng Zheng
- Department of Food Science and NutritionZhejiang UniversityHangzhouChina
| | - Bo Yang
- Department of Food Science and NutritionZhejiang UniversityHangzhouChina
| | - Jiajing Jiang
- Department of Food Science and NutritionZhejiang UniversityHangzhouChina
| | - Yuanqing Fu
- Department of Food Science and NutritionZhejiang UniversityHangzhouChina
| | - Duo Li
- Department of Food Science and NutritionZhejiang UniversityHangzhouChina
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Kwok CS, Umar S, Myint PK, Mamas MA, Loke YK. Vegetarian diet, Seventh Day Adventists and risk of cardiovascular mortality: a systematic review and meta-analysis. Int J Cardiol 2014; 176:680-6. [PMID: 25149402 DOI: 10.1016/j.ijcard.2014.07.080] [Citation(s) in RCA: 111] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 07/24/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Dietary interventions are an important component of cardiovascular risk factor management although their impact on cardiovascular risk and mortality remains uncertain. We have studied influence of a vegetarian diet on cardiovascular risk and mortality. METHODS We searched MEDLINE and EMBASE for comparative studies that evaluated clinical outcomes associated with vegetarian diet as compared to non-vegetarian controls or the general population. Relevant studies were pooled using random effects meta-analysis for risk of death, ischaemic heart disease (IHD) and cerebrovascular disease. We conducted subgroup analysis according to specific type of cohort (e.g. Seventh Day Adventist [SDA]) and gender. RESULTS Eight studies met the inclusion criteria with 183,321 participants (n=183,321). There was significant heterogeneity in all the meta-analyses, particularly evident with the studies of SDA. In all instances, we found that SDA studies showed greater effect size as compared to non-SDA studies: death (RR 0.68 95% CI 0.45-1.02 vs RR 1.04 95% CI 0.98-1.10), ischaemic heart disease (IHD) (RR 0.60 95% CI 0.43-0.80 vs RR 0.84 95% CI 0.74-0.96) and cerebrovascular disease (RR 0.71 95% CI 0.41-1.20 vs RR 1.05 95% CI 0.89-1.24). Sex specific analyses showed that IHD was significantly reduced in both genders but risk of death and cerebrovascular disease was only significantly reduced in men. CONCLUSIONS Data from observational studies indicates that there is modest cardiovascular benefit, but no clear reduction in overall mortality associated with a vegetarian diet. This evidence of benefit is driven mainly by studies in SDA, whereas the effect of vegetarian diet in other cohorts remains unproven.
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Affiliation(s)
- Chun Shing Kwok
- Cardiovascular Institute, University of Manchester, Manchester, UK.
| | - Saadia Umar
- Central Manchester Foundation Trust, Manchester, UK
| | - Phyo K Myint
- School of Medicine & Dentistry, University of Aberdeen, Foresterhill, Aberdeen, UK
| | - Mamas A Mamas
- Cardiovascular Institute, University of Manchester, Manchester, UK
| | - Yoon K Loke
- Norwich Medical School, University of East Anglia, Norwich, UK
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Abstract
OBJECTIVE The present study assessed the effects of vegetarian and omnivorous diets on HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), TAG and the ratio of HDL-C to total cholesterol (TC) by gender. DESIGN HDL-C, LDL-C, TAG and HDL-C:TC were compared among three diet groups (vegan, ovo-lacto vegetarian and omnivorous). Multivariate linear regression analysis was performed to examine factors significantly and independently associated with vegetarian status and to estimate the β value of lipid profiles for the diet groups. Settings A cross-sectional study. Data were obtained from the Taiwanese Survey on the Prevalence of Hyperglycemia, Hyperlipidemia and Hypertension (TwSHHH). SUBJECTS The study comprised included 3257 men and 3551 women. RESULTS After adjusting for confounders, vegan and ovo-lacto vegetarian diets lowered LDL-C levels (β=-10.98, P=0.005 and β=-7.12, P=0.025, respectively) in men compared with omnivorous diet. There was a significant association between HDL-C and vegan diet (β=-6.53, P=0.004). In females, the β values of HDL-C, TAG and HDL-C:TC were -5.72 (P<0.0001), 16.51 (P=0.011) and -0.02 (P=0.012) for vegan diet, and -4.86 (P=0.002), 15.09 (P=0.008) and -0.01 (P=0.026) for ovo-lacto vegetarian diet, when compared with omnivorous diet. CONCLUSIONS Vegan diet was associated with lower HDL-C concentrations in both males and females. Because the ovo-lacto vegetarian diet was effective in lowering LDL-C, it may be more appropriate for males.
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