Cause-specific and all-cause mortalities in vegetarian compared to non-vegetarian participants from the Adventist Health Study-2 cohort.

Publication date: Aug 02, 2024

There have been mixed results reported internationally when associating vegetarian dietary patterns with all-cause and cause-specific mortalities. To extend our previous results by evaluating, with a larger number of deaths (N=12515), cause-specific mortalities comparing different vegetarian types to non-vegetarians. This prospective study used data from the Adventist Health Study-2 cohort. Mortality was ascertained between study baseline, 2002-2007 and follow-up through 2015. Dietary data were collected at baseline using a validated quantitative food frequency questionnaire and then categorized into five dietary patterns: non-vegetarian, semi-vegetarian, pesco-vegetarian, lacto-ovo-vegetarian, and vegan. Main outcomes and measures include all-cause and cause-specific mortalities using Cox proportional hazards regression models and competing risk methods. The analytic sample included 88400 participants who provided 971424 person-years of follow-up. We report results as estimated at ages 65 and 85 years due to age-dependence of many hazard ratios (HR’s). Compared to non-vegetarians, vegetarians had lower risks of mortality (HR’s and 95% confidence interval – 95% CI at age 65; followed by same at age 85 years in parentheses), overall (0. 89[0. 83,0. 95];0. 98[0. 91,1. 04]), from renal failure (0. 52[0. 38,0. 70]; 0. 65[0. 55,0. 76]), infectious disease (0. 57[0. 40,0. 82];0. 90[0. 70,1. 17]), diabetes (0. 51[0. 33,0. 78]; 0. 69[0. 53,0. 88]), select cardiac (0. 75[0. 65,0. 87]; 0. 89[0. 83,0. 95]), and ischemic heart disease causes (0. 730. 59,0. 90]; 0. 84[0. 75,0. 94]). Vegans, lacto-ovo-vegetarians and pesco-vegetarians were also observed to have lower risks of total mortality and several similar cause-specific mortalities. However, higher cause-specified neurological mortalities were observed among older vegetarians (estimated at age 85 years), specifically stroke (HR=1. 17[1. 02,1. 33]), dementia (HR=1. 13[1. 00,1. 27]), and Parkinson’s Disease (HR=1. 37[0. 98,1. 91]). Results in Black subjects for vegetarian/nonvegetarian comparisons largely followed the same trends, but HR’s were less precise due to smaller numbers. Vegetarian diets are associated with lower risk for all-cause and many cause-specific mortalities, especially among males and in younger subjects. However, higher risks were observed among older vegetarians for stroke and dementia. These results need further support and investigation.

Concepts Keywords
Diabetes chronic disease
Models healthy diet
Vegetarians longevity
plant-based diet

Semantics

Type Source Name
disease MESH renal failure
disease MESH infectious disease
pathway REACTOME Infectious disease
disease MESH ischemic heart disease
disease MESH causes
disease MESH stroke
disease MESH dementia
disease MESH Parkinson’s Disease
disease MESH chronic disease
disease MESH causes of death

Original Article

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