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Meta-Analysis
. 2021 Aug 29;13(9):3019.
doi: 10.3390/nu13093019.

Risk of Incident Stroke among Vegetarians Compared to Nonvegetarians: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

Jing-Wun Lu  1 , Luo-Hua Yu  2 , Yu-Kang Tu  3   4 , Hung-Yu Cheng  1 , Li-Yu Chen  5 , Ching-Hui Loh  6   7 , Tai-Li Chen  8
Affiliations
Meta-Analysis

Risk of Incident Stroke among Vegetarians Compared to Nonvegetarians: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

Jing-Wun Lu et al. Nutrients. .

Abstract

Vegetarian dietary patterns provide health benefits for cardiovascular health; however, the studies examining the association of vegetarian diets with stroke incidence showed inconsistent findings. We systematically evaluated the risk of incident stroke among vegetarians (diets excluding meat, poultry, fish, and seafood) compared among nonvegetarians. A systematic search of PubMed, EMBASE, Cochrane Library, and Web of Science was performed until 20 May 2021. Prospective cohort studies comparing the risk estimates for incident stroke between vegetarians and nonvegetarians were included. Of 398 articles identified in the database search, data from seven cohort studies (408 total stroke cases in 29,705 vegetarians and 13,026 total stroke cases in 627,728 nonvegetarians) were included. The meta-analysis revealed no significant association between adhering to the vegetarian dietary patterns and the risk of incident stroke (HR = 0.86; 95% CI = 0.67-1.11; I2 = 68%, n = 7). Subgroup analyses suggested that studies conducted in Asia and those with a mean baseline age of participants 50-65 years showed a lower risk of stroke in vegetarians. Moreover, no significant association between vegetarian diets and the risk of ischemic stroke (HR = 0.56; 95% CI = 0.22-1.42; I2 = 82%, n = 3) or hemorrhagic stroke (HR = 0.77; 95% CI = 0.19-3.09; I2 = 85%, n = 2) was found. To be conclusive, no strong relationship between vegetarian diets and the incidence of stroke was observed. Given the limited certainty of evidence from NutriGrade, future well-designed studies are warranted to provide solid evidence on this topic.

Keywords: cerebrovascular disease; nutritional status and vegetarian; plant diets; stroke; vegan; vegetarian; vegetarian and health.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Forest plot showing the association of a vegetarian diet and the risk of incident stroke. The meta-analysis illustrated no association between a vegetarian diet and the risk of incident stroke. CI, confidence interval; IV, inverse variance; SE, standard error.
Figure 2
Figure 2
Forest plots showing the associations of a vegetarian diet and the risks of ischemic and hemorrhagic stroke. The meta-analysis showed that there was no association between a vegetarian diet and the risk of ischemic stroke or hemorrhagic stroke. CI, confidence interval; IV, inverse variance; SE, standard error.
See this image and copyright information in PMC

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