This meta-analysis of 13 prospective cohort studies found that greater adherence to a plant-based diet was associated with a 10% and an 8% lower risk of cardiovascular disease incidence and mortality, respectively.
In 2016, approximately 17.6 million deaths worldwide were attributed to cardiovascular disease (CVD), an increase of 14.5% from 2006. Diet represents an important modifiable risk factor for CVD, and increasing evidence suggests potential cardiovascular benefits of plant-based diets. However, conflicting results are also available, which may be related to how studies have defined vegetarian or vegan diets based on the exclusion of animal foods. Additionally, classification methods have failed to account for the opposing health effects of various plant-based foods such as refined grains and sugars.
This meta-analysis of 13 prospective cohort studies investigated the association between plant-based diets and CVD in 410,085 participants (mean age range of 38 to 67). Plant-based diets were defined as eating patterns that emphasized a high intake of plant-based foods and either limited or eliminated the intake of animal products. Thus, studies involving both vegetarian and vegan diets were included. Studies were also included if they assessed the plant-based diet of the participants using various forms of the plant-based dietary index (PDI), such as the healthful PDI (hPDI) and unhealthful PDI (uPDI).
The primary outcomes were cardiovascular mortality, CVD (a composite endpoint meant to measure coronary heart disease including nonfatal or fatal heart attack, heart failure, and definite or probable stroke), and stroke.
The greatest adherence to an overall plant-based dietary pattern was associated with an 8% and 10% reduced risk of CVD mortality and CVD incidence, respectively, compared to the lowest adherence. In the subgroup analysis, the greatest adherence to the hPDI was associated with a 13% lower risk of CVD compared to the lowest adherence, but there was no association with CVD mortality. For the uPDI, the greatest adherence to an unhealthful diet was associated with a 5% greater risk of CVD mortality compared to the lowest adherence, but there was no association with CVD. A vegetarian diet was associated with a 19% lower risk of CVD compared with regular meat consumption.
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