Table 1.
Summary of characteristics of prospective cohort studies assessing the association between vegetarian dietary patterns and major cardiovascular outcomes.
| References | Cohort | Country | No. of participants | % vegetarians | Outcomes | No. of cases | Person-years | Age range, years | Mean follow-up, years (dates) | Diet assessment method to determine vegetarian status | Exposure | Methods of outcome assessment | NOS quality score | Funding source |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Crowe et al. (35) | EPIC—Oxford | UK | 10,602 (M) 33,959 (W) | 34 | Incident CHD | 1,235 | 517,960 | 20–89 | 11.6 (1993–2009) | Validated 130-item FFQ and global questions about meat, fish, dairy, and eggsf | Vegetarian/ vegan vs. non-vegetarian | Medical record linkage | 7 | Agencya |
| Chang- Claude et al. (36) | Heidelberg Study | Germany | 858 (M) 1,046 (W) | 61.2 | CVD + CHD mortality | 255 (CVD) 72 (CHD) | NR | 10–85 | 21 (1976–1999) | FFQ included meat, fish, dairy, and eggs | Vegetarian/ vegan vs. non-vegetarian | Death certificates | 6 | NR |
| Orlich et al. (37) | AHS-2 | USA | 25,105 (M) 48, 203 (W) | 28.9 | CVD + CHD mortality | 987 (CVD) 372 (CHD) | NR | 57b | 5.79 (2002–2009) | Validated >200-item FFQg | Vegetarian/ vegan vs. non-vegetariand | National Death Index | 6 | Agencya |
| Key et al. (38) | Adventist Mortality Study | USA | 8,994 (M) 15,544 (W) | 41.8 | CHD + stroke mortality | 598 (CHD) 182 (Stroke) | 138, 304 | 35–80 | 5.5 (1960–1965) | 21-item FFQ | Vegetarian vs. non-vegetarian | Medical record linkage | 6 | Agencya |
| Key et al. (38) | AHS-1 | USA | 12, 214 (M) 16, 738 (W) | 27.6 | CHD + stroke mortality | 921 (CHD) 317 (Stroke) | 320, 818 | 25–89 | 11.1 (1976–1988) | >60-item FFQ | Vegetarian vs. non-vegetarian | Medical record linkage | 6 | Agencya |
| Key et al. (34) | EPIC—Oxford | UK | 11, 324 (M) 35, 930 (W) | 34 | CVD, CHD + stroke mortality | 479 (CVD) 213 (CHD) 159 (Stroke) | 506, 620 | 20–89 | 8–14c (1993–2007) | Validated 130-item FFQ and global questions about meat, fish, dairy and eggsf | Vegetarian/ vegan vs. non-vegetariane | Medical record linkage | 7 | Agencya |
| Appleby et al. (39) | Oxford Vegetarian Study | UK | 4,174 (M) 6,871 (W) | 42 | CVD, CHD + stroke mortality | 469 (CVD) 250 (CHD) 125 (Stroke) | NR | 16–89 | 17.6 (1980–2000) | Never ate meat or fish statement | Vegetarian vs. non-vegetarian | Medical record linkage | 5 | Agencya |
| Appleby et al. (39) | Health Food Shoppers | UK | 4,325 (M) 6,411 (W) | 43 | CVD, CHD + stroke mortality | 1,117 (CVD) 562 (CHD) 330 (Stroke) | NR | 16–89 | 18.7 (1973–1999) | “Are you vegetarian?” question | Vegetarian vs. non-vegetarian | Medical record linkage | 6 | Agencya |
AHS-1, Adventist Health Study-1; AHS-2, Adventist Health Study-2; CHD, coronary heart disease; CVD, cardiovascular disease; EPIC, European Prospective Investigation Into Cancer; FFQ, food frequency questionnaire; M, men; NR, not reported; NOS, Newcastle-Ottawa Scale; USA, United States; UK, United Kingdom; W, women.
Agency funding is that from government, university or not-for-profit health agency sources.
Mean age.
Range of years of follow-up.
Reported disease associations for other forms of vegetarianism in original publication (i.e., vegan, lacto-ovo, pescatarian, semi-vegetarian); only overall vegetarian diet included in current analysis.
Reported disease associations for pescatarians in original publication; combined vegetarian and vegan diet data included in current analysis.
Vegetarian dietary pattern determined by 4 global questions relating to never eating meat, fish, dairy or eggs or by intake of relevant food items reported in FFQ (first 1,300 participants); FFQ validated for nutrients only.
Vegetarian dietary pattern determined by intake of food items of animal origin reported on FFQ; FFQ validated for animal foods/food groups.