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. 2021 Mar 21;42(12):1136-1143.
doi: 10.1093/eurheartj/ehaa939.

Vegetarians, fish, poultry, and meat-eaters: who has higher risk of cardiovascular disease incidence and mortality? A prospective study from UK Biobank

Fanny Petermann-Rocha  1   2 , Solange Parra-Soto  1   2 , Stuart Gray  2 , Jana Anderson  1 , Paul Welsh  2 , Jason Gill  2 , Naveed Sattar  2 , Frederick K Ho  1 , Carlos Celis-Morales  1   2   3   4 , Jill P Pell  1
Affiliations

Vegetarians, fish, poultry, and meat-eaters: who has higher risk of cardiovascular disease incidence and mortality? A prospective study from UK Biobank

Fanny Petermann-Rocha et al. Eur Heart J. .

Abstract

Aims: To compare the incidence and mortality risk for cardiovascular diseases (CVD) [CVD and also ischaemic heart disease (IHD), myocardial infarction (MI), stroke, and heart failure (HF)] among people with different types of diets-including vegetarians, fish eaters, fish and poultry eaters, and meat-eaters-using data from UK Biobank.

Methods and results: A total of 422 791 participants (55.4% women) were included in this prospective analysis. Using data from a food frequency questionnaire, four types of diets were derived. Associations between types of diets and health outcomes were investigated using Cox proportional hazard models. Meat-eaters comprised 94.7% of the cohort and were more likely to be obese than other diet groups. After a median follow-up of 8.5 years, fish eaters, compared with meat-eaters, had lower risks of incident CVD {hazard ratios (HR): 0.93 [95% confidence intervals (CI): 0.88-0.97]}, IHD [HR: 0.79 (95% CI: 0.70-0.88)], MI [HR: 0.70 (95% CI: 0.56-0.88)], stroke [HR: 0.79 (95% CI: 0.63-0.98)] and HF [HR: 0.78 (95% CI: 0.63-0.97)], after adjusting for confounders. Vegetarians had lower risk of CVD incidence [HR: 0.91 (95% CI: 0.86-0.96)] relative to meat-eaters. In contrast, the risk of adverse outcomes was not different in fish and poultry eaters compared with meat-eaters. No associations were identified between types of diets and CVD mortality.

Conclusion: Eating fish rather than meat or poultry was associated with a lower risk of a range of adverse cardiovascular outcomes. Vegetarianism was only associated with a lower risk of CVD incidence.

Keywords: Cardiovascular diseases; Incidence; Meat; Mortality; Vegetarians.

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Figures

None
Graphical abstract
Figure 1
Figure 1
Associations between types of diets and incident cardiovascular diseases. Data presented as adjusted hazard ratio and its 95% confidence interval by types of diets. Meat-eaters were used as the reference group. All analyses were performed using a 2-year landmark analysis, excluding participants who experienced events within the first 2 years of follow-up: 24 343 for overall cardiovascular disease incidence (4504 ischaemic heart disease, 1026 myocardial infarction, 689 strokes, and 600 heart failure). Analyses were adjusted by age, sex, deprivation, ethnicity, comorbidities, smoking, alcohol intake, total sedentary time, physical activity, and body mass index.
Take home figure
Take home figure
Associations between types of diets and incident cardiovascular diseases.
See this image and copyright information in PMC

Comment in

  • Should we all go pesco-vegetarian?
    Estruch R, Sacanella E, Ros E. Estruch R, et al. Eur Heart J. 2021 Mar 21;42(12):1144-1146. doi: 10.1093/eurheartj/ehaa1088. Eur Heart J. 2021. PMID: 33393612 No abstract available.

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