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Mortality in vegetarians and comparable nonvegetarians in the
United Kingdom 2016
Paul N Appleby, Francesca L Crowe, Kathryn E Bradbury, Ruth C Travis, and Timothy J Key*
Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
ABSTRACT
Background: Vegetarians and others who do not eat meat have been
observed to have lower incidence rates than meat eaters of some chronic
diseases, but it is unclear whether this translates into lower mortality.
Objective: The purpose of this study was to describe mortality in
vegetarians and comparable nonvegetarians in a large United Kingdom cohort.
Design: The study involved a pooled analysis of data from 2 prospective studies that included 60,310 persons living in the United Kingdom, comprising 18,431 regular meat eaters (who ate meat
$5 times/wk on average), 13,039 low (less-frequent) meat eaters,
8516 fish eaters (who ate fish but not meat), and 20,324 vegetarians
(including 2228 vegans who did not eat any animal foods).
Mortality by diet group for each of 18 common causes of death was estimated
with the use of Cox proportional hazards models.
Results: There were 5294 deaths before age 90 in .1 million y of
follow-up. There was no significant difference in overall (all-cause)
mortality between the diet groups: HRs in low meat eaters, fish
eaters, and vegetarians compared with regular meat eaters were
0.93 (95% CI: 0.86, 1.00), 0.96 (95% CI: 0.86, 1.06), and 1.02
(95% CI: 0.94, 1.10), respectively; P-heterogeneity of risks =
0.082.
There were significant differences in risk compared with
regular meat eaters for deaths from circulatory disease [higher in
fish eaters (HR: 1.22; 95% CI: 1.02, 1.46)]; malignant cancer [lower
in fish eaters (HR: 0.82; 95% CI: 0.70, 0.97)], including pancreatic
cancer [lower in low meat eaters and vegetarians (HR: 0.55; 95%
CI: 0.36, 0.86 and HR: 0.48; 95% CI: 0.28, 0.82, respectively)] and
cancers of the lymphatic/hematopoietic tissue [lower in vegetarians
(HR: 0.50; 95% CI: 0.32, 0.79)]; respiratory disease [lower in low
meat eaters (HR: 0.70; 95% CI: 0.53, 0.92)]; and all other causes
[lower in low meat eaters (HR: 0.74; 95% CI: 0.56, 0.99)]. Further
adjustment for body mass index left these associations largely
unchanged.
Conclusions: United Kingdom–based vegetarians and comparable
nonvegetarians have similar all-cause mortality. Differences found
for specific causes of death merit further investigation. Am J
Clin Nutr 2016;103:218–30
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