Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jun 1;151(6):1539-1552.
doi: 10.1093/jn/nxab037.

A Systematic Review of the Association Between Vegan Diets and Risk of Cardiovascular Disease

Jeenan Kaiser  1   2 , Kim R van Daalen  3 , Arjun Thayyil  4 , Mafalda Tasso de Almeida Ribeiro Reis Cocco  4 , Daniela Caputo  5 , Clare Oliver-Williams  3   6   7
Affiliations

A Systematic Review of the Association Between Vegan Diets and Risk of Cardiovascular Disease

Jeenan Kaiser et al. J Nutr. .

Abstract

Background: Plant-based diets are gaining attention globally due to their environmental benefits and perceived health-protective role. A vegan diet may have cardiovascular benefits; however, evidence remains conflicting and insufficiently assessed.

Objectives: We evaluated the utility of the vegan diet in cardiovascular disease (CVD) prevention.

Methods: We conducted a systematic review of studies evaluating the association between vegan diets and cardiovascular outcomes. We searched 5 databases (Ovid MEDLINE, EMBASE, Web of Science, Scopus, and OpenGrey) through 31 October 2020. Four investigators independently screened the full texts for inclusion, assessed quality, and extracted data from published reports.

Results: Out of the 5729 identified records, 7 were included, comprising over 73,000 participants, of whom at least 7661 were vegans. Three studies, with at least 73,426 individuals (including at least 7380 vegans), examined risks of primary cardiovascular events (total CVD, coronary heart disease, acute myocardial infarction, total stroke, hemorrhagic stroke, and ischemic stroke) in individuals who followed a vegan diet compared to those who did not. None of the studies reported a significantly increased or decreased risk of any cardiovascular outcome. One study suggested that vegans were at greater risk of ischemic stroke compared to individuals who consumed animal products (HR, 1.54; 95% CI, 0.95-2.48). Yet in another study, vegans showed lower common carotid artery intima-media thickness (0.56 ± 0.1 mm vs. 0.74 ± 0.1 mm in controls; P < 0.001), and in 3 studies of recurrent CVD events, vegans had 0-52% lower rates. Furthermore, endothelial function did not differ between vegans and nonvegans. Using the Grading of Recommendations Assessment, Development and Evaluation approach, evidence was deemed to be of low to very low strength/quality.

Conclusions: Among the Western populations studied, evidence weakly demonstrates associations between vegan diets and risk of CVDs, with the direction of associations varying with the specific CVD outcome tested. However, more high-quality research on this topic is needed. This study was registered at PROSPERO as CRD42019146835.

Keywords: cardiovascular disease; carotid artery intima-media thickness; coronary artery disease; coronary heart disease; dietary interventions; ischemic attack; plant-based; public health; stroke; vegan.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
Study selection process. Hard cardiovascular end points included total cardiovascular disease, coronary heart disease, acute myocardial infarction, total stroke, hemorrhagic stroke, and ischemic stroke. Intermediate cardiovascular end points included carotid artery intima-media thickness and endothelial function.
See this image and copyright information in PMC

References

    1. Springmann M, Wiebe K, Mason-D'Croz D, Sulser TB, Rayner M, Scarborough P. Health and nutritional aspects of sustainable diet strategies and their association with environmental impacts: a global modelling analysis with country-level detail.Lancet Planet Health. 2018;2:e451–61. - PMC - PubMed
    1. Poore J, Nemecek T. Reducing food's environmental impacts through producers and consumers. Science. 2018;360:987–92. - PubMed
    1. Berners-Lee M, Hoolohan C, Cammack H, Hewitt CN. The relative greenhouse gas impacts of realistic dietary choices. Energy Policy. 2012;43:184–90.
    1. Gonzalez Fischer C, Garnett T. Plates, pyramids and planets: developments in national healthy and sustainable dietary guidelines: a state of play assessment. FAO;. 2016, Food and Agriculture Organization of the United Nationsand The Food Climate Research Network, The University of Oxford, Oxford.
    1. Birt C, Buzeti T, Grosso G, Justesen L, Lachat C, Lafranconi A, Mertanen E, Rangelov N, Sarlio-Lähteenkorvaet S. Healthy and sustainable diets for European countries 2. 2017, European Public Health Association - EUPHA, Utrecht The Netherlands.

Publication types