Abstract
OBJECTIVE: To investigate the association of dietary habits with mortality in a cohort of vegetarians and other health conscious people. DESIGN: Observational study. SETTING: United Kingdom. SUBJECTS: 4336 men and 6435 women recruited through health food shops, vegetarian societies, and magazines. MAIN OUTCOME MEASURES: Mortality ratios for vegetarianism and for daily versus less than daily consumption of wholemeal bread, bran cereals, nuts or dried fruit, fresh fruit, and raw salad in relation to all cause mortality and mortality from ischaemic heart disease, cerebrovascular disease, all malignant neoplasms, lung cancer, colorectal cancer, and breast cancer. RESULTS: 2064 (19%) subjects smoked, 4627 (43%) were vegetarian, 6699 (62%) ate wholemeal bread daily, 2948 (27%) ate bran cereals daily, 4091 (38%) ate nuts or dried fruit daily, 8304 (77%) ate fresh fruit daily, and 4105 (38%) ate raw salad daily. After a mean of 16.8 years follow up there were 1343 deaths before age 80. Overall the cohort had a mortality about half that of the general population. Within the cohort, daily consumption of fresh fruit was associated with significantly reduced mortality from ischaemic heart disease (rate ratio adjusted for smoking 0.76 (95% confidence interval 0.60 to 0.97)), cerebrovascular disease (0.68 (0.47 to 0.98)), and for all causes combined (0.79 (0.70 to 0.90)). CONCLUSIONS: In this cohort of health conscious individuals, daily consumption of fresh fruit is associated with a reduced mortality from ischaemic heart disease, cerebrovascular disease, and all causes combined.
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Selected References
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- Block G., Patterson B., Subar A. Fruit, vegetables, and cancer prevention: a review of the epidemiological evidence. Nutr Cancer. 1992;18(1):1–29. doi: 10.1080/01635589209514201. [DOI] [PubMed] [Google Scholar]
- Burkitt D. P. Some diseases characteristic of modern Western civilization. Br Med J. 1973 Feb 3;1(5848):274–278. doi: 10.1136/bmj.1.5848.274. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Burr M. L., Bates C. J., Fehily A. M., St Leger A. S. Plasma cholesterol and blood pressure in vegetarians. J Hum Nutr. 1981 Dec;35(6):437–441. [PubMed] [Google Scholar]
- Burr M. L., Butland B. K. Heart disease in British vegetarians. Am J Clin Nutr. 1988 Sep;48(3 Suppl):830–832. doi: 10.1093/ajcn/48.3.830. [DOI] [PubMed] [Google Scholar]
- Burr M. L., Sweetnam P. M. Vegetarianism, dietary fiber, and mortality. Am J Clin Nutr. 1982 Nov;36(5):873–877. doi: 10.1093/ajcn/36.5.873. [DOI] [PubMed] [Google Scholar]
- Chang-Claude J., Frentzel-Beyme R., Eilber U. Mortality pattern of German vegetarians after 11 years of follow-up. Epidemiology. 1992 Sep;3(5):395–401. doi: 10.1097/00001648-199209000-00003. [DOI] [PubMed] [Google Scholar]
- Enstrom J. E., Kanim L. E., Klein M. A. Vitamin C intake and mortality among a sample of the United States population. Epidemiology. 1992 May;3(3):194–202. doi: 10.1097/00001648-199205000-00003. [DOI] [PubMed] [Google Scholar]
- Gaziano J. M., Manson J. E., Branch L. G., Colditz G. A., Willett W. C., Buring J. E. A prospective study of consumption of carotenoids in fruits and vegetables and decreased cardiovascular mortality in the elderly. Ann Epidemiol. 1995 Jul;5(4):255–260. doi: 10.1016/1047-2797(94)00090-g. [DOI] [PubMed] [Google Scholar]
- Gillman M. W., Cupples L. A., Gagnon D., Posner B. M., Ellison R. C., Castelli W. P., Wolf P. A. Protective effect of fruits and vegetables on development of stroke in men. JAMA. 1995 Apr 12;273(14):1113–1117. doi: 10.1001/jama.1995.03520380049034. [DOI] [PubMed] [Google Scholar]
- Gramenzi A., Gentile A., Fasoli M., Negri E., Parazzini F., La Vecchia C. Association between certain foods and risk of acute myocardial infarction in women. BMJ. 1990 Mar 24;300(6727):771–773. doi: 10.1136/bmj.300.6727.771. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hertog M. G., Feskens E. J., Hollman P. C., Katan M. B., Kromhout D. Dietary antioxidant flavonoids and risk of coronary heart disease: the Zutphen Elderly Study. Lancet. 1993 Oct 23;342(8878):1007–1011. doi: 10.1016/0140-6736(93)92876-u. [DOI] [PubMed] [Google Scholar]
- Kahn H. A., Phillips R. L., Snowdon D. A., Choi W. Association between reported diet and all-cause mortality. Twenty-one-year follow-up on 27,530 adult Seventh-Day Adventists. Am J Epidemiol. 1984 May;119(5):775–787. doi: 10.1093/oxfordjournals.aje.a113798. [DOI] [PubMed] [Google Scholar]
- Khaw K. T., Barrett-Connor E. Dietary potassium and stroke-associated mortality. A 12-year prospective population study. N Engl J Med. 1987 Jan 29;316(5):235–240. doi: 10.1056/NEJM198701293160502. [DOI] [PubMed] [Google Scholar]
- Knekt P., Reunanen A., Järvinen R., Seppänen R., Heliövaara M., Aromaa A. Antioxidant vitamin intake and coronary mortality in a longitudinal population study. Am J Epidemiol. 1994 Jun 15;139(12):1180–1189. doi: 10.1093/oxfordjournals.aje.a116964. [DOI] [PubMed] [Google Scholar]
- Law M. R., Wald N. J., Wu T., Hackshaw A., Bailey A. Systematic underestimation of association between serum cholesterol concentration and ischaemic heart disease in observational studies: data from the BUPA study. BMJ. 1994 Feb 5;308(6925):363–366. doi: 10.1136/bmj.308.6925.363. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mills P. K., Annegers J. F., Phillips R. L. Animal product consumption and subsequent fatal breast cancer risk among Seventh-day Adventists. Am J Epidemiol. 1988 Mar;127(3):440–453. doi: 10.1093/oxfordjournals.aje.a114821. [DOI] [PubMed] [Google Scholar]
- Mills P. K., Beeson W. L., Phillips R. L., Fraser G. E. Dietary habits and breast cancer incidence among Seventh-day Adventists. Cancer. 1989 Aug 1;64(3):582–590. doi: 10.1002/1097-0142(19890801)64:3<582::aid-cncr2820640304>3.0.co;2-v. [DOI] [PubMed] [Google Scholar]
- Pandey D. K., Shekelle R., Selwyn B. J., Tangney C., Stamler J. Dietary vitamin C and beta-carotene and risk of death in middle-aged men. The Western Electric Study. Am J Epidemiol. 1995 Dec 15;142(12):1269–1278. doi: 10.1093/oxfordjournals.aje.a117594. [DOI] [PubMed] [Google Scholar]
- Phillips R. L., Garfinkel L., Kuzma J. W., Beeson W. L., Lotz T., Brin B. Mortality among California Seventh-Day Adventists for selected cancer sites. J Natl Cancer Inst. 1980 Nov;65(5):1097–1107. [PubMed] [Google Scholar]
- Potter J. D. Risk factors for colon neoplasia--epidemiology and biology. Eur J Cancer. 1995 Jul-Aug;31A(7-8):1033–1038. doi: 10.1016/0959-8049(95)00125-3. [DOI] [PubMed] [Google Scholar]
- Puska P., Iacono J. M., Nissinen A., Korhonen H. J., Vartianinen E., Pietinen P., Dougherty R., Leino U., Mutanen M., Moisio S. Controlled, randomised trial of the effect of dietary fat on blood pressure. Lancet. 1983 Jan 1;1(8314-5):1–5. doi: 10.1016/s0140-6736(83)91556-8. [DOI] [PubMed] [Google Scholar]
- Rao D. N., Ganesh B., Desai P. B. Role of reproductive factors in breast cancer in a low-risk area: a case-control study. Br J Cancer. 1994 Jul;70(1):129–132. doi: 10.1038/bjc.1994.261. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Snowdon D. A., Phillips R. L., Fraser G. E. Meat consumption and fatal ischemic heart disease. Prev Med. 1984 Sep;13(5):490–500. doi: 10.1016/0091-7435(84)90017-3. [DOI] [PubMed] [Google Scholar]
- Thorogood M., Mann J., Appleby P., McPherson K. Risk of death from cancer and ischaemic heart disease in meat and non-meat eaters. BMJ. 1994 Jun 25;308(6945):1667–1670. doi: 10.1136/bmj.308.6945.1667. [DOI] [PMC free article] [PubMed] [Google Scholar]