Skip to main content
Top
Published in: Nutrition Journal 1/2013

Open Access 01-12-2013 | Research

The Netherlands Cohort Study – Meat Investigation Cohort; a population-based cohort over-represented with vegetarians, pescetarians and low meat consumers

Authors: Anne MJ Gilsing, Matty P Weijenberg, R Alexandra Goldbohm, Pieter C Dagnelie, Piet A van den Brandt, Leo J Schouten

Published in: Nutrition Journal | Issue 1/2013

Login to get access

Abstract

Background

Vegetarian diets have been associated with lower risk of chronic disease, but little is known about the health effects of low meat diets and the reliability of self-reported vegetarian status. We aimed to establish an analytical cohort over-represented with vegetarians, pescetarians and 1 day/week meat consumers, and to describe their lifestyle and dietary characteristics. In addition, we were able to compare self-reported vegetarians with vegetarians whose status has been confirmed by their response on the extensive food frequency questionnaire (FFQ).

Study methods

Embedded within the Netherlands Cohort Study (n = 120,852; including 1150 self-reported vegetarians), the NLCS-Meat Investigation Cohort (NLCS-MIC) was defined by combining all FFQ-confirmed-vegetarians (n = 702), pescetarians (n = 394), and 1 day/week meat consumers (n = 1,396) from the total cohort with a random sample of 2–5 days/week- and 6–7 days/week meat consumers (n = 2,965 and 5,648, respectively).

Results

Vegetarians, pescetarians, and 1 day/week meat consumers had more favorable dietary intakes (e.g. higher fiber/vegetables) and lifestyle characteristics (e.g. lower smoking rates) compared to regular meat consumers in both sexes. Vegetarians adhered to their diet longer than pescetarians and 1 day/week meat consumers. 75% of vegetarians with a prevalent cancer at baseline had changed to this diet after diagnosis. 50% of self-reported vegetarians reported meat or fish consumption on the FFQ. Although the misclassification that occurred in terms of diet and lifestyle when merely relying on self-reporting was relatively small, the impact on associations with disease risk remains to be studied.

Conclusion

We established an analytical cohort over-represented with persons at the lower end of the meat consumption spectrum which should facilitate prospective studies of major cancers and causes of death using ≥20.3 years of follow-up.
Appendix
Available only for authorised users
Literature
1.
go back to reference Fox N, Ward K: Health, ethics and environment: a qualitative study of vegetarian motivations. Appetite. 2008, 50: 422-429. 10.1016/j.appet.2007.09.007.CrossRefPubMed Fox N, Ward K: Health, ethics and environment: a qualitative study of vegetarian motivations. Appetite. 2008, 50: 422-429. 10.1016/j.appet.2007.09.007.CrossRefPubMed
2.
go back to reference FAO: World Agriculture: Towards 2030/2050. Interim Report: Prospects for Food, Nutrition, Agriculture and Major Commodity Groups. 2006, Rome: Global Perspective Studies Unit, Food and Agriculture Organization of the United Nations FAO: World Agriculture: Towards 2030/2050. Interim Report: Prospects for Food, Nutrition, Agriculture and Major Commodity Groups. 2006, Rome: Global Perspective Studies Unit, Food and Agriculture Organization of the United Nations
3.
go back to reference Gill M: Meat production in developing countries. Proc Nutr Soc. 1999, 58: 371-376. 10.1017/S002966519900049X.CrossRefPubMed Gill M: Meat production in developing countries. Proc Nutr Soc. 1999, 58: 371-376. 10.1017/S002966519900049X.CrossRefPubMed
4.
go back to reference Steinfeld H: The livestock revolution–a global veterinary mission. Vet Parasitol. 2004, 125: 19-41. 10.1016/j.vetpar.2004.05.003.CrossRefPubMed Steinfeld H: The livestock revolution–a global veterinary mission. Vet Parasitol. 2004, 125: 19-41. 10.1016/j.vetpar.2004.05.003.CrossRefPubMed
5.
go back to reference Beeson WL, Mills PK, Phillips RL, Andress M, Fraser GE: Chronic disease among Seventh-day Adventists, a low-risk group. Rationale, methodology, and description of the population. Cancer. 1989, 64: 570-581. 10.1002/1097-0142(19890801)64:3<570::AID-CNCR2820640303>3.0.CO;2-4.CrossRefPubMed Beeson WL, Mills PK, Phillips RL, Andress M, Fraser GE: Chronic disease among Seventh-day Adventists, a low-risk group. Rationale, methodology, and description of the population. Cancer. 1989, 64: 570-581. 10.1002/1097-0142(19890801)64:3<570::AID-CNCR2820640303>3.0.CO;2-4.CrossRefPubMed
6.
go back to reference Butler TL, Fraser GE, Beeson WL, Knutsen SF, Herring RP, Chan J, Sabate J, Montgomery S, Haddad E, Preston-Martin S, et al: Cohort profile: The Adventist Health Study-2 (AHS-2). Int J Epidemiol. 2008, 37: 260-265. 10.1093/ije/dym165.CrossRefPubMed Butler TL, Fraser GE, Beeson WL, Knutsen SF, Herring RP, Chan J, Sabate J, Montgomery S, Haddad E, Preston-Martin S, et al: Cohort profile: The Adventist Health Study-2 (AHS-2). Int J Epidemiol. 2008, 37: 260-265. 10.1093/ije/dym165.CrossRefPubMed
7.
go back to reference Frentzel-Beyme R, Claude J, Eilber U: Mortality among German vegetarians: first results after five years of follow-up. Nutr Cancer. 1988, 11: 117-126. 10.1080/01635588809513978.CrossRefPubMed Frentzel-Beyme R, Claude J, Eilber U: Mortality among German vegetarians: first results after five years of follow-up. Nutr Cancer. 1988, 11: 117-126. 10.1080/01635588809513978.CrossRefPubMed
8.
go back to reference Appleby PN, Thorogood M, Mann JI, Key TJ: The Oxford Vegetarian Study: an overview. Am J Clin Nutr. 1999, 70: 525S-531S.PubMed Appleby PN, Thorogood M, Mann JI, Key TJ: The Oxford Vegetarian Study: an overview. Am J Clin Nutr. 1999, 70: 525S-531S.PubMed
9.
go back to reference Davey GK, Spencer EA, Appleby PN, Allen NE, Knox KH, Key TJ: EPIC-Oxford: lifestyle characteristics and nutrient intakes in a cohort of 33 883 meat-eaters and 31 546 non meat-eaters in the UK. Public Health Nutr. 2003, 6: 259-269.CrossRefPubMed Davey GK, Spencer EA, Appleby PN, Allen NE, Knox KH, Key TJ: EPIC-Oxford: lifestyle characteristics and nutrient intakes in a cohort of 33 883 meat-eaters and 31 546 non meat-eaters in the UK. Public Health Nutr. 2003, 6: 259-269.CrossRefPubMed
10.
go back to reference Burr ML, Sweetnam PM: Vegetarianism, dietary fiber, and mortality. Am J Clin Nutr. 1982, 36: 873-877.PubMed Burr ML, Sweetnam PM: Vegetarianism, dietary fiber, and mortality. Am J Clin Nutr. 1982, 36: 873-877.PubMed
11.
go back to reference Key TJ, Fraser GE, Thorogood M, Appleby PN, Beral V, Reeves G, Burr ML, Chang-Claude J, Frentzel-Beyme R, Kuzma JW, et al: Mortality in vegetarians and nonvegetarians: detailed findings from a collaborative analysis of 5 prospective studies. Am J Clin Nutr. 1999, 70: 516S-524S.PubMed Key TJ, Fraser GE, Thorogood M, Appleby PN, Beral V, Reeves G, Burr ML, Chang-Claude J, Frentzel-Beyme R, Kuzma JW, et al: Mortality in vegetarians and nonvegetarians: detailed findings from a collaborative analysis of 5 prospective studies. Am J Clin Nutr. 1999, 70: 516S-524S.PubMed
12.
go back to reference Tonstad S, Stewart K, Oda K, Batech M, Herring RP, Fraser GE: Vegetarian diets and incidence of diabetes in the Adventist Health Study-2. Nutr Metab Cardiovasc Dis. 2013, 23: 292-299. 10.1016/j.numecd.2011.07.004.CrossRefPubMed Tonstad S, Stewart K, Oda K, Batech M, Herring RP, Fraser GE: Vegetarian diets and incidence of diabetes in the Adventist Health Study-2. Nutr Metab Cardiovasc Dis. 2013, 23: 292-299. 10.1016/j.numecd.2011.07.004.CrossRefPubMed
13.
go back to reference Rizzo NS, Sabate J, Jaceldo-Siegl K, Fraser GE: Vegetarian dietary patterns are associated with a lower risk of metabolic syndrome: the adventist health study 2. Diabetes Care. 2011, 34: 1225-1227. 10.2337/dc10-1221.CrossRefPubMedPubMedCentral Rizzo NS, Sabate J, Jaceldo-Siegl K, Fraser GE: Vegetarian dietary patterns are associated with a lower risk of metabolic syndrome: the adventist health study 2. Diabetes Care. 2011, 34: 1225-1227. 10.2337/dc10-1221.CrossRefPubMedPubMedCentral
14.
go back to reference Key TJ, Appleby PN, Spencer EA, Travis RC, Allen NE, Thorogood M, Mann JI: Cancer incidence in British vegetarians. Br J Cancer. 2009, 101: 192-197. 10.1038/sj.bjc.6605098.CrossRefPubMedPubMedCentral Key TJ, Appleby PN, Spencer EA, Travis RC, Allen NE, Thorogood M, Mann JI: Cancer incidence in British vegetarians. Br J Cancer. 2009, 101: 192-197. 10.1038/sj.bjc.6605098.CrossRefPubMedPubMedCentral
15.
go back to reference Fraser GE: Diet, Life Expectancy, and Chronic Disease. Studies of Seventh-day Adventists and Other Vegetarians. 2003, New York: Oxford University Press Fraser GE: Diet, Life Expectancy, and Chronic Disease. Studies of Seventh-day Adventists and Other Vegetarians. 2003, New York: Oxford University Press
17.
go back to reference Ferdowsian HR, Barnard ND: Effects of plant-based diets on plasma lipids. Am J Cardiol. 2009, 104: 947-956. 10.1016/j.amjcard.2009.05.032.CrossRefPubMed Ferdowsian HR, Barnard ND: Effects of plant-based diets on plasma lipids. Am J Cardiol. 2009, 104: 947-956. 10.1016/j.amjcard.2009.05.032.CrossRefPubMed
18.
go back to reference Pettersen BJ, Anousheh R, Fan J, Jaceldo-Siegl K, Fraser GE: Vegetarian diets and blood pressure among white subjects: results from the Adventist Health Study-2 (AHS-2). Public Health Nutr. 2012, 1-8. Pettersen BJ, Anousheh R, Fan J, Jaceldo-Siegl K, Fraser GE: Vegetarian diets and blood pressure among white subjects: results from the Adventist Health Study-2 (AHS-2). Public Health Nutr. 2012, 1-8.
19.
go back to reference Vinnari M, Montonen J, Harkanen T, Mannisto S: Identifying vegetarians and their food consumption according to self-identification and operationalized definition in Finland. Public Health Nutr. 2009, 12: 481-488. 10.1017/S1368980008002486.CrossRefPubMed Vinnari M, Montonen J, Harkanen T, Mannisto S: Identifying vegetarians and their food consumption according to self-identification and operationalized definition in Finland. Public Health Nutr. 2009, 12: 481-488. 10.1017/S1368980008002486.CrossRefPubMed
20.
go back to reference Haddad EH, Tanzman JS: What do vegetarians in the United States eat?. Am J Clin Nutr. 2003, 78: 626S-632S.PubMed Haddad EH, Tanzman JS: What do vegetarians in the United States eat?. Am J Clin Nutr. 2003, 78: 626S-632S.PubMed
21.
go back to reference van den Brandt PA, Goldbohm RA, Van't Veer P, Volovics A, Hermus RJ, Sturmans F: A large-scale prospective cohort study on diet and cancer in The Netherlands. J Clin Epidemiol. 1990, 43: 285-295. 10.1016/0895-4356(90)90009-E.CrossRefPubMed van den Brandt PA, Goldbohm RA, Van't Veer P, Volovics A, Hermus RJ, Sturmans F: A large-scale prospective cohort study on diet and cancer in The Netherlands. J Clin Epidemiol. 1990, 43: 285-295. 10.1016/0895-4356(90)90009-E.CrossRefPubMed
22.
go back to reference Goldbohm RA, van den Brandt PA, Brants HA, van't Veer P, Al M, Sturmans F, Hermus RJ: Validation of a dietary questionnaire used in a large-scale prospective cohort study on diet and cancer. Eur J Clin Nutr. 1994, 48: 253-265.PubMed Goldbohm RA, van den Brandt PA, Brants HA, van't Veer P, Al M, Sturmans F, Hermus RJ: Validation of a dietary questionnaire used in a large-scale prospective cohort study on diet and cancer. Eur J Clin Nutr. 1994, 48: 253-265.PubMed
23.
go back to reference Willett WC: Implications of total energy intake for epidemiologic studies of breast and large-bowel cancer. Am J Clin Nutr. 1987, 45: 354-360.PubMed Willett WC: Implications of total energy intake for epidemiologic studies of breast and large-bowel cancer. Am J Clin Nutr. 1987, 45: 354-360.PubMed
24.
go back to reference Fraser GE: Vegetarian diets: what do we know of their effects on common chronic diseases?. Am J Clin Nutr. 2009, 89: 1607S-1612S. 10.3945/ajcn.2009.26736K.CrossRefPubMedPubMedCentral Fraser GE: Vegetarian diets: what do we know of their effects on common chronic diseases?. Am J Clin Nutr. 2009, 89: 1607S-1612S. 10.3945/ajcn.2009.26736K.CrossRefPubMedPubMedCentral
25.
go back to reference de Bakker E, Dagevos H: Reducing Meat Consumption in Today’s Consumer Society: questioning the Citizen-Consumer Gap. J Agric Environ Ethics. 2012, 25: 877-894. 10.1007/s10806-011-9345-z.CrossRef de Bakker E, Dagevos H: Reducing Meat Consumption in Today’s Consumer Society: questioning the Citizen-Consumer Gap. J Agric Environ Ethics. 2012, 25: 877-894. 10.1007/s10806-011-9345-z.CrossRef
26.
go back to reference Gilsing AM, Crowe FL, Lloyd-Wright Z, Sanders TA, Appleby PN, Allen NE, Key TJ: Serum concentrations of vitamin B12 and folate in British male omnivores, vegetarians and vegans: results from a cross-sectional analysis of the EPIC-Oxford cohort study. Eur J Clin Nutr. 2010, 64: 933-939. 10.1038/ejcn.2010.142.CrossRefPubMedPubMedCentral Gilsing AM, Crowe FL, Lloyd-Wright Z, Sanders TA, Appleby PN, Allen NE, Key TJ: Serum concentrations of vitamin B12 and folate in British male omnivores, vegetarians and vegans: results from a cross-sectional analysis of the EPIC-Oxford cohort study. Eur J Clin Nutr. 2010, 64: 933-939. 10.1038/ejcn.2010.142.CrossRefPubMedPubMedCentral
27.
go back to reference Craig WJ, Mangels AR: Position of the American Dietetic Association: vegetarian diets. J Am Diet Assoc. 2009, 109: 1266-1282.CrossRefPubMed Craig WJ, Mangels AR: Position of the American Dietetic Association: vegetarian diets. J Am Diet Assoc. 2009, 109: 1266-1282.CrossRefPubMed
28.
go back to reference The Commission of the European Communities: Commission Directive 2008/100/EC of 28 October 2008 amending Council Directive 90/496/EEC on nutrition labelling for foodstuffs as regards recommended daily allowances, energy conversion factors and definitions. Off J Eur Union. 2008, 51: 285-295. The Commission of the European Communities: Commission Directive 2008/100/EC of 28 October 2008 amending Council Directive 90/496/EEC on nutrition labelling for foodstuffs as regards recommended daily allowances, energy conversion factors and definitions. Off J Eur Union. 2008, 51: 285-295.
29.
go back to reference Hurrell R, Egli I: Iron bioavailability and dietary reference values. Am J Clin Nutr. 2010, 91: 1461S-1467S. 10.3945/ajcn.2010.28674F.CrossRefPubMed Hurrell R, Egli I: Iron bioavailability and dietary reference values. Am J Clin Nutr. 2010, 91: 1461S-1467S. 10.3945/ajcn.2010.28674F.CrossRefPubMed
30.
go back to reference Frentzel-Beyme R, Chang-Claude J: Vegetarian diets and colon cancer: the German experience. Am J Clin Nutr. 1994, 59: 1143S-1152S.PubMed Frentzel-Beyme R, Chang-Claude J: Vegetarian diets and colon cancer: the German experience. Am J Clin Nutr. 1994, 59: 1143S-1152S.PubMed
31.
go back to reference Patterson RE, Neuhouser ML, Hedderson MM, Schwartz SM, Standish LJ, Bowen DJ: Changes in diet, physical activity, and supplement use among adults diagnosed with cancer. J Am Diet Assoc. 2003, 103: 323-328.PubMed Patterson RE, Neuhouser ML, Hedderson MM, Schwartz SM, Standish LJ, Bowen DJ: Changes in diet, physical activity, and supplement use among adults diagnosed with cancer. J Am Diet Assoc. 2003, 103: 323-328.PubMed
32.
go back to reference Pekmezi DW, Demark-Wahnefried W: Updated evidence in support of diet and exercise interventions in cancer survivors. Acta Oncol. 2011, 50: 167-178. 10.3109/0284186X.2010.529822.CrossRefPubMed Pekmezi DW, Demark-Wahnefried W: Updated evidence in support of diet and exercise interventions in cancer survivors. Acta Oncol. 2011, 50: 167-178. 10.3109/0284186X.2010.529822.CrossRefPubMed
33.
go back to reference Snowdon DA: Animal product consumption and mortality because of all causes combined, coronary heart disease, stroke, diabetes, and cancer in Seventh-day Adventists. Am J Clin Nutr. 1988, 48: 739-748.PubMed Snowdon DA: Animal product consumption and mortality because of all causes combined, coronary heart disease, stroke, diabetes, and cancer in Seventh-day Adventists. Am J Clin Nutr. 1988, 48: 739-748.PubMed
34.
go back to reference Kuzma JW, Lindsted KD: Determinants of eight-year diet recall ability. Epidemiology. 1990, 1: 386-391. 10.1097/00001648-199009000-00009.CrossRefPubMed Kuzma JW, Lindsted KD: Determinants of eight-year diet recall ability. Epidemiology. 1990, 1: 386-391. 10.1097/00001648-199009000-00009.CrossRefPubMed
Metadata
Title
The Netherlands Cohort Study – Meat Investigation Cohort; a population-based cohort over-represented with vegetarians, pescetarians and low meat consumers
Authors
Anne MJ Gilsing
Matty P Weijenberg
R Alexandra Goldbohm
Pieter C Dagnelie
Piet A van den Brandt
Leo J Schouten
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Nutrition Journal / Issue 1/2013
Electronic ISSN: 1475-2891
DOI
https://doi.org/10.1186/1475-2891-12-156

Other articles of this Issue 1/2013

Nutrition Journal 1/2013 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.