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Published in: Current Nutrition Reports 4/2019

01-12-2019 | Diabetes | Gastroenterology, Critical Care, and Lifestyle Medicine (SA McClave, Section Editor)

Multiple Health Benefits and Minimal Risks Associated with Vegetarian Diets

Authors: Jason P. Rocha, Janese Laster, Bhavyata Parag, Nihar U. Shah

Published in: Current Nutrition Reports | Issue 4/2019

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Abstract

Purpose of Review

Understand the current prevalence, health benefits, and health risks of vegetarian diets.

Recent Findings

Since the publishing of the Adventist Health Study 2 in 2013, there have been several prospective diet studies demonstrating and challenging the health benefits and risks of the vegetarian diet.

Summary

The definition of the vegetarian diet has become more specific over time and requires standardization for research purposes. Despite an uptrend in sales rates of plant-based foods per year, a 2018 Gallup poll showed overall stagnation of the percentage of self-reported vegetarians and vegans compared to percentages obtained 6 years prior. Compared to the Adventist Health Study, more recent vegetarian diet studies have demonstrated significant although smaller risk reductions for mortality in cardiovascular disease, cerebrovascular disease, diabetes mellitus, and chronic kidney disease. Recent studies have correlated certain food groups with early death or increased longevity. In addition, the vegetarian health risks of deficiencies of protein, omega-3 fatty acids, vitamin D, vitamin B12, iron, calcium, and zinc are explored.
Literature
5.
go back to reference Raphaely T, Marinova D, Crisp G, Panayotov J. Flexitarianism (Flexible or part-time vegetarianism): A user-based dietary choice for improved wellbeing. Int J User Driven Healthc. 2013;3(3):34–58.CrossRef Raphaely T, Marinova D, Crisp G, Panayotov J. Flexitarianism (Flexible or part-time vegetarianism): A user-based dietary choice for improved wellbeing. Int J User Driven Healthc. 2013;3(3):34–58.CrossRef
7.
go back to reference Pilis W, Stec K, Zych M, Pilis A. Health benefits and risk associated with adopting a vegetarian diet. Rocz Panstw Zakl Hig. 204; 65(1):9–14. Pilis W, Stec K, Zych M, Pilis A. Health benefits and risk associated with adopting a vegetarian diet. Rocz Panstw Zakl Hig. 204; 65(1):9–14.
9.
go back to reference Leahya E, Lyonsa S, Tola RSJ. An estimate of the number of vegetarians in the world. Econ Soc Res Instit. 2010;340:1–44. Leahya E, Lyonsa S, Tola RSJ. An estimate of the number of vegetarians in the world. Econ Soc Res Instit. 2010;340:1–44.
10.
go back to reference Juan W, Yamini S, Britten P. Food intake patterns of self-identified vegetarians among the U.S. population, 2007-2010. Proc Food Sci. 2015;4:86–93.CrossRef Juan W, Yamini S, Britten P. Food intake patterns of self-identified vegetarians among the U.S. population, 2007-2010. Proc Food Sci. 2015;4:86–93.CrossRef
14.
go back to reference Benatar JR, Stewart RAH. Cardiometabolic risk factors in vegans; a meta-analysis of observational studies. PLoS ONE. 13(12):e0209086.CrossRef Benatar JR, Stewart RAH. Cardiometabolic risk factors in vegans; a meta-analysis of observational studies. PLoS ONE. 13(12):e0209086.CrossRef
15.
go back to reference 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(3):680–6.CrossRef 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(3):680–6.CrossRef
16.
go back to reference •• Kwok CS, Gulati M, Michos ED, Potts J, Wu P, Watson L, et al. Dietary components and risk of cardiovascular disease and all-cause mortality: a review of evidence from meta-analyses. Eur J Prev Cardiol. 2019;0(00):1–15 Large systematic review and meta-analysis of studies assessed a quality-grade examining the relative risk of all-cause mortality and cardiovascular disease per standard food item. •• Kwok CS, Gulati M, Michos ED, Potts J, Wu P, Watson L, et al. Dietary components and risk of cardiovascular disease and all-cause mortality: a review of evidence from meta-analyses. Eur J Prev Cardiol. 2019;0(00):1–15 Large systematic review and meta-analysis of studies assessed a quality-grade examining the relative risk of all-cause mortality and cardiovascular disease per standard food item.
18.
go back to reference Lara KM, Levitan EB, Gutierrez OM, Shikany JM, Safford MM, Judd SE, et al. Plant-based diet lowers risk of heart failure. J Am Coll Cardiol. 2019;73(16):2036–45.CrossRef Lara KM, Levitan EB, Gutierrez OM, Shikany JM, Safford MM, Judd SE, et al. Plant-based diet lowers risk of heart failure. J Am Coll Cardiol. 2019;73(16):2036–45.CrossRef
21.
go back to reference Wang Z-M, Zhao D, Nie Z-L, et al. Flavonol intake and stroke risk: a meta-analysis of cohort studies. Nutrition. 2014;30(5):518–23.CrossRef Wang Z-M, Zhao D, Nie Z-L, et al. Flavonol intake and stroke risk: a meta-analysis of cohort studies. Nutrition. 2014;30(5):518–23.CrossRef
22.
go back to reference Threapleton DE, Greenwood DC, Evans CEL, et al. Dietary fiber intake and risk of first stroke: a systematic review and meta-analysis. Stroke. 2013;44(5):1360–8.CrossRef Threapleton DE, Greenwood DC, Evans CEL, et al. Dietary fiber intake and risk of first stroke: a systematic review and meta-analysis. Stroke. 2013;44(5):1360–8.CrossRef
24.
go back to reference Chen G-C, Lu D-B, Pang Z, Liu Q-F. Vitamin C intake, circulating vitamin C and risk of stroke: a meta-analysis of prospective studies. J Am Heart Assoc. 2013;2(6):e000329.CrossRef Chen G-C, Lu D-B, Pang Z, Liu Q-F. Vitamin C intake, circulating vitamin C and risk of stroke: a meta-analysis of prospective studies. J Am Heart Assoc. 2013;2(6):e000329.CrossRef
27.
go back to reference Orlich, et al. Vegetarian dietary patterns and mortality in Adventist Health Study 2. JAMA Intern Med. 2013;173(13):1230–8.CrossRef Orlich, et al. Vegetarian dietary patterns and mortality in Adventist Health Study 2. JAMA Intern Med. 2013;173(13):1230–8.CrossRef
28.
go back to reference Chiu THT, Pan WH, Lin MN, et al. Vegetarian diet, change in diet patterns, and diabetes risk: a prospective study. Nut Dia. 2018;12(8). Chiu THT, Pan WH, Lin MN, et al. Vegetarian diet, change in diet patterns, and diabetes risk: a prospective study. Nut Dia. 2018;12(8).
34.
go back to reference •• Schwingshackl L, Schwedhelm C, Hoffmann G, Lampousi A, Knüppel S, Iqbal K, et al. Food groups and risk of all-cause mortality: a systematic review and meta-analysis of prospective studies. The Am J of Clin Nutr. 2017;105(6):1462–73 Very large systematic review and meta-analysis of all prospective studies examining the relative risk of all-cause mortality per serving of standard food-group per day. •• Schwingshackl L, Schwedhelm C, Hoffmann G, Lampousi A, Knüppel S, Iqbal K, et al. Food groups and risk of all-cause mortality: a systematic review and meta-analysis of prospective studies. The Am J of Clin Nutr. 2017;105(6):1462–73 Very large systematic review and meta-analysis of all prospective studies examining the relative risk of all-cause mortality per serving of standard food-group per day.
35.
go back to reference Mihrashahi S, Ding D, Gale J, et al. Vegetarian diet and all-cause mortality: evidence from a large population based Australian cohort – the 45 and Up study. Prev Med. 2017;97:1–7.CrossRef Mihrashahi S, Ding D, Gale J, et al. Vegetarian diet and all-cause mortality: evidence from a large population based Australian cohort – the 45 and Up study. Prev Med. 2017;97:1–7.CrossRef
36.
go back to reference Aasheim ET, Sharp JS, Appleby PN, et al. Tinned fruit consumption and mortality in three prospective cohorts. PLoS One. 2015;10:e0117796.CrossRef Aasheim ET, Sharp JS, Appleby PN, et al. Tinned fruit consumption and mortality in three prospective cohorts. PLoS One. 2015;10:e0117796.CrossRef
37.
go back to reference Yang Q, Zhang Z, Gregg EW, et al. Added sugar intake and cardiovascular diseases mortality among US adults. JAMA Intern Med. 2014;30341:1–9. Yang Q, Zhang Z, Gregg EW, et al. Added sugar intake and cardiovascular diseases mortality among US adults. JAMA Intern Med. 2014;30341:1–9.
38.
go back to reference National Toxicology Program. Draft NTP research report on the CLARITY-BPA core study: a perinatal and chronic extended-dose-range study of bisphenol A in rats. NTP RR 9, vol. 9. Research Triangle Park: National Toxicology Program; 2018. p. 1–249. National Toxicology Program. Draft NTP research report on the CLARITY-BPA core study: a perinatal and chronic extended-dose-range study of bisphenol A in rats. NTP RR 9, vol. 9. Research Triangle Park: National Toxicology Program; 2018. p. 1–249.
39.
go back to reference Barr SI, Chapman GE. Perceptions and practices of self-defined current vegetarian, former vegetarian, and nonvegetarian women. J Am Diet Assoc. 2002;102(3):354–60.CrossRef Barr SI, Chapman GE. Perceptions and practices of self-defined current vegetarian, former vegetarian, and nonvegetarian women. J Am Diet Assoc. 2002;102(3):354–60.CrossRef
40.
go back to reference Metherel AH, Chouinard-Watkins R, Trépanier MO, Lacombe RJS, Bazinet RP. Retroconversion is a minor contributor to increases in eicosapentaenoic acid following docosahexaenoic acid feeding as determined by compound specific isotope analysis in rat liver. Nutr Metab (Lond). 2017;14:75. https://doi.org/10.1186/s12986-017-0230-2.CrossRef Metherel AH, Chouinard-Watkins R, Trépanier MO, Lacombe RJS, Bazinet RP. Retroconversion is a minor contributor to increases in eicosapentaenoic acid following docosahexaenoic acid feeding as determined by compound specific isotope analysis in rat liver. Nutr Metab (Lond). 2017;14:75. https://​doi.​org/​10.​1186/​s12986-017-0230-2.CrossRef
41.
42.
go back to reference Cardwell G, Bornman JF, James AP, Black LJ. A review of mushrooms as a potential source of dietary vitamin D. Nutrients. 2018;10(10):1498.CrossRef Cardwell G, Bornman JF, James AP, Black LJ. A review of mushrooms as a potential source of dietary vitamin D. Nutrients. 2018;10(10):1498.CrossRef
43.
go back to reference Armas LAG, Hollis BW, Heaney RP. Vitamin D2 is much less effective than vitamin D3 in humans. J Clin Endocrinol Metab. 2004;89:5387–91.CrossRef Armas LAG, Hollis BW, Heaney RP. Vitamin D2 is much less effective than vitamin D3 in humans. J Clin Endocrinol Metab. 2004;89:5387–91.CrossRef
44.
go back to reference Holick MF, Biancuzzo RM, Chen TC, Klein EK, Young A, Bibuld D, et al. Vitamin D2 is as effective as vitamin D3 in maintaining circulating concentrations of 25-hydroxyvitamin D. J Clin Endocrinol Metab. 2008;93:677–81.CrossRef Holick MF, Biancuzzo RM, Chen TC, Klein EK, Young A, Bibuld D, et al. Vitamin D2 is as effective as vitamin D3 in maintaining circulating concentrations of 25-hydroxyvitamin D. J Clin Endocrinol Metab. 2008;93:677–81.CrossRef
45.
go back to reference Baig JA, Sheikh SA, Islam I, Kumar M. Vitamin D status among vegetarians and non-vegetarians. J Ayub Med Coll Abbottabad. 2013;25(1-2):152–5.PubMed Baig JA, Sheikh SA, Islam I, Kumar M. Vitamin D status among vegetarians and non-vegetarians. J Ayub Med Coll Abbottabad. 2013;25(1-2):152–5.PubMed
48.
go back to reference Madry E, Lisowska A, Grebowiec P, Walkowiak J. The impact of vegan diet on B-12 status in healthy omnivores: five-year prospective study. Acta Sci Pol Technol Aliment. 2012;11(2):209–13.PubMed Madry E, Lisowska A, Grebowiec P, Walkowiak J. The impact of vegan diet on B-12 status in healthy omnivores: five-year prospective study. Acta Sci Pol Technol Aliment. 2012;11(2):209–13.PubMed
49.
go back to reference Jung SB, Nagaraja V, Kapur A, Eslick GD. Association between vitamin B12 deficiency and long-term use of acid-lowering agents: a systematic review and meta-analysis. Internal Medicine J. 2015;45(4):409–16.CrossRef Jung SB, Nagaraja V, Kapur A, Eslick GD. Association between vitamin B12 deficiency and long-term use of acid-lowering agents: a systematic review and meta-analysis. Internal Medicine J. 2015;45(4):409–16.CrossRef
52.
55.
go back to reference Sliwinska A, Luty J. Aleksandrowicz- Wrona E. Iron status and dietary iron intake in vegetarians. Adv Clin Exp Med. 2018;27(10):1383–9.CrossRef Sliwinska A, Luty J. Aleksandrowicz- Wrona E. Iron status and dietary iron intake in vegetarians. Adv Clin Exp Med. 2018;27(10):1383–9.CrossRef
57.
go back to reference Pawlak R, Berger J, Hines I. Iron status of vegetarian adults: a review of literature. Am J Lifestyle Med. 2018;12(6):486–98.CrossRef Pawlak R, Berger J, Hines I. Iron status of vegetarian adults: a review of literature. Am J Lifestyle Med. 2018;12(6):486–98.CrossRef
58.
go back to reference Stoffel NU, Cercamondi CI, Brittenham PG, et al. Iron absorption from oral iron supplements given on consecutive versus alternate days and as single morning doses versus twice-daily split dosing in iron-depleted women: two open-label, randomized controlled trials. Lancet Haematology. 2017;4(11):PE524–33. https://doi.org/10.1016/S2352-3026(17)30182-5.CrossRef Stoffel NU, Cercamondi CI, Brittenham PG, et al. Iron absorption from oral iron supplements given on consecutive versus alternate days and as single morning doses versus twice-daily split dosing in iron-depleted women: two open-label, randomized controlled trials. Lancet Haematology. 2017;4(11):PE524–33. https://​doi.​org/​10.​1016/​S2352-3026(17)30182-5.CrossRef
Metadata
Title
Multiple Health Benefits and Minimal Risks Associated with Vegetarian Diets
Authors
Jason P. Rocha
Janese Laster
Bhavyata Parag
Nihar U. Shah
Publication date
01-12-2019
Publisher
Springer US
Published in
Current Nutrition Reports / Issue 4/2019
Electronic ISSN: 2161-3311
DOI
https://doi.org/10.1007/s13668-019-00298-w

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