• 1993-2001年间,英国48188名没有缺血性心脏病、中风、心绞痛的参与者根据其饮食信息分为三组:肉食者、鱼食者、素食者;
  • 在18.1年的随访期间,共记录2820例缺血性心脏病,1072例中风;
  • 校正混杂因素后,鱼食者和素食者比肉食者的缺血性心脏病风险分别低13%和22%,相当于素食者的缺血性心脏病病例在10年内会比肉食者少10例/1000人;
  • 素食者的总中风率比肉食者高20%,主要是出血性卒中,相当于10年内每1000人增加3例总卒中。
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Risks of ischaemic heart disease and stroke in meat eaters, fish eaters, and vegetarians over 18 years of follow-up: results from the prospective EPIC-Oxford study



2019-09-04, Article

Abstract & Authors:展开

Objective : To examine the associations of vegetarianism with risks of ischaemic heart disease and stroke.
Design : Prospective cohort study.
Setting : The EPIC-Oxford study, a cohort in the United Kingdom with a large proportion of non-meat eaters, recruited across the country between 1993 and 2001.
Participants: 48 188 participants with no history of ischaemic heart disease, stroke, or angina (or cardiovascular disease) were classified into three distinct diet groups: meat eaters (participants who consumed meat, regardless of whether they consumed fish, dairy, or eggs; n=24 428), fish eaters (consumed fish but no meat; n=7506), and vegetarians including vegans (n=16 254), based on dietary information collected at baseline, and subsequently around 2010 (n=28 364).
Main outcome measures : Incident cases of ischaemic heart disease and stroke (including ischaemic and haemorrhagic types) identified through record linkage until 2016.
Results : Over 18.1 years of follow-up, 2820 cases of ischaemic heart disease and 1072 cases of total stroke (519 ischaemic stroke and 300 haemorrhagic stroke) were recorded. After adjusting for sociodemographic and lifestyle confounders, fish eaters and vegetarians had 13% (hazard ratio 0.87, 95% confidence interval 0.77 to 0.99) and 22% (0.78, 0.70 to 0.87) lower rates of ischaemic heart disease than meat eaters, respectively (P<0.001 for heterogeneity). This difference was equivalent to 10 fewer cases of ischaemic heart disease (95% confidence interval 6.7 to 13.1 fewer) in vegetarians than in meat eaters per 1000 population over 10 years. The associations for ischaemic heart disease were partly attenuated after adjustment for self reported high blood cholesterol, high blood pressure, diabetes, and body mass index (hazard ratio 0.90, 95% confidence interval 0.81 to 1.00 in vegetarians with all adjustments). By contrast, vegetarians had 20% higher rates of total stroke (hazard ratio 1.20, 95% confidence interval 1.02 to 1.40) than meat eaters, equivalent to three more cases of total stroke (95% confidence interval 0.8 to 5.4 more) per 1000 population over 10 years, mostly due to a higher rate of haemorrhagic stroke. The associations for stroke did not attenuate after further adjustment of disease risk factors.
Conclusions : In this prospective cohort in the UK, fish eaters and vegetarians had lower rates of ischaemic heart disease than meat eaters, although vegetarians had higher rates of haemorrhagic and total stroke.

First Authors:
Tammy Y N Tong

Correspondence Authors:
Tammy Y N Tong

All Authors:
Tammy Y N Tong,Paul N Appleby,Kathryn E Bradbury,Aurora Perez-Cornago,Ruth C Travis,Robert Clarke,Timothy J Key

British Medical Journal期刊

Vegetarian diets and health

Mark A Lawrence, Sarah A McNaughton,2019-09-04