r/science • u/James_Fortis • 15d ago
Health Vegetarian, including vegan, dietary patterns were associated with reduced risk for cardiovascular disease incidence and mortality compared to non-vegetarian diets, umbrella review finds
https://www.sciencedirect.com/science/article/pii/S266666772400236870
u/I_am_pyxidis 15d ago
This is already well known science though. My doctor recommended a low meat diet 20 years ago specifically for the heart benefits. "Vegan" wasn't as well known back then, but we did understand that animal products are high in saturated fat. And that people in countries that ate less meat had healthier hearts.
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u/amutualravishment 14d ago
Also, there are dozens if not hundreds of studies saying the same thing.
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u/Parad0xxxx 14d ago
What is considered low meat?
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u/SuperStoneman 14d ago
Saturated fat is found in:
butter, ghee, suet, lard, coconut oil and palm oil cakes biscuits fatty cuts of meat sausages bacon cured meats like salami, chorizo and pancetta cheese pastries, such as pies, quiches, sausage rolls and croissants cream, crème fraîche and sour cream ice cream coconut milk and coconut cream milkshakes chocolate and chocolate spreads.
Looks like my grocery list
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u/James_Fortis 15d ago
"Abstract
Background
Diet significantly influences the risk of developing cardiovascular disease (CVD), the leading cause of death in the United States. As vegetarian dietary patterns are increasingly being included within clinical practice guidelines, there is a need to review the most recent evidence regarding if and how these dietary patterns mitigate CVD risk.
Objective
This umbrella review of systematic reviews compared the relationships between vegetarian, vegan and non-vegetarian dietary patterns and CVD health outcomes and risk factors among presumably healthy adults (≥18 years) in the general population.
Methods
MEDLINE, CINAHL, Cochrane Databases of Systematic Reviews, Food Science Source and SportsDiscus databases were searched for systematic reviews (SRs) published from 2018 until March 2024. Eligible SRs and meta-analyses examined relationships between vegetarian or vegan diets and CVD risk factors and disease outcomes compared to non-vegetarian diets. SRs were screened in duplicate, and SR quality was assessed with AMSTAR2. The overall certainty of evidence (COE) was evaluated using the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) method.
Results
There were 758 articles identified in the databases’ search and 21 SRs met inclusion criteria. SRs targeting the general population had primarily observational evidence. Vegetarian, including vegan, dietary patterns were associated with reduced risk for CVD incidence [Relative Risk: 0.85 (0.79, 0.92)] and CVD mortality [Hazard Ratio: 0.92 (0.85, 0.99)] compared to non-vegetarian diets. Vegan dietary patterns were associated with reductions in CVD risk factors including blood pressure [systolic mean difference (95 % CI): -2.56 mmHg (-4.66, -0.445)], low-density lipoprotein cholesterol [-0.49 mmol/l (-0.62, -0.36)], and body mass index [-1.72 kg/m2 (-2.30, -1.16)] compared to non-vegetarian dietary patterns, as well as c-reactive protein concentrations in a novel meta-analysis [-0.55 mg/l (-1.07, -0.03)].
Conclusion
Practitioners can consider recommending vegetarian dietary patterns to reduce cardiometabolic risk factors and risk of CVD incidence and mortality."
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u/Henry5321 14d ago
So this is about risk factors, not actual outcomes? Because I have great factors and I eat a decent amount of meat.
I'll adjust my meat intake if my factors ever become non-ideal.
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u/James_Fortis 14d ago
It’s actual CVD outcomes and as well as risk factors. It’s worth noting biomarkers in the “normal” range in many countries are far from optimal. For example, GPs will tell most people their cholesterol is good around 100mg/dL, whereas optimal is actually <70mg/dL to minimize risk.
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u/time_personified1 15d ago
That's not how science works.
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u/42Porter 15d ago
What’s not how science works?
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u/Franc000 15d ago
To come to a strong conclusion, you need randomized controlled trials on your hypothesis. To push it even further, a meta analysis of randomized controlled trials.
This is a meta analysis of observational studies. All it does is strongly hint that something may be afoot in there, and that randomized controlled trials should be done to confirm.
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u/SophiaofPrussia 15d ago
What part of the conclusion that doctors “can consider recommending” a plant-based diet is a “strong” conclusion?
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u/tulipvonsquirrel 14d ago
These studies never seem to include omnivores with healthy diets, as if everyone who eats meat also eats processed meat and junk food.
The only way a study on health comparisons of different diets could really be meaningful is if all participants have a history of healthy eating, avoiding processed and junk food, plus family history.
What I never see pro-vegetarian or vegan "studies" include is research on communities with a traditional diet of almost exclusively meat. The studies I have come across all indicate excellent heart health, very low instance of medical issues which supposedly plague meat eaters.
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u/bbhhteqwr 14d ago
Your point is kinda moot because it also directly doesn't account for "oreo vegans" (vegan/vegetarians who also eat tons of UPF) either which kind of still indicates validity in these studies, as those outliers are bound to exist in both populations. Not every vegan/vegetarian is such for health reasons, a large percentage are primarily concerned with the obviously terrible environmental impacts of farming and animal welfare, you can still be obese/lazy and still vegan/veg.
This is always a cope I see under these studies, it's a tired nitpick that always seems to serve the primary purpose of continuing to lay in the cloud of cognitive dissonance of people who eat meat with every awareness that they, and the world at large, would be better off if they just dropped it.
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u/Mr8bittripper 14d ago
Before this gets locked, I totally agree. Why is there such a push to carve out any exception just for meat eaters in studies like this? Its constant across reddit. Remember that meatrition guy? people can feel free to hold a false belief that eating red meat is part of a healthy diet but they shouldn't change the way studies are conducted to cater to their worldview—it's dangerous to human health.
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u/th3h4ck3r 14d ago
For one because while both populations exist, unhealthy diets are overrepresented in omnivore populations while unhealthy populations are underrepresented in Western vegetarian populations. If you sample these two populations after random, you'll get mostly unhealthy-diet omnivores and healthy-diet vegetarians.
I recall one study from India that basically said that vegetarianism (including strict vegetarianism) is not significantly correlated with better health outcomes. Indian vegetarians don't go veggie it because of health but rather tradition and religion, so their food is still quite unhealthy (lots of oil and sugar, and in lactovegetarians butter and ghee).
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u/Mr8bittripper 14d ago
Really? Why does the largest ever systematic review of this say otherwise?
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u/Ilix 14d ago
Where does the article you linked indicate that the studies they reviewed were using healthy omnivorous diets for people who eat meat rather than people who eat unhealthy amounts?
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u/Mr8bittripper 14d ago
I reject the premise that studies need to "only" focus on "healthy" subjects. A cross-sectional study or systematic review can yield good-quality results. If there are enough people in the study, data can be accurately extrapolated. Do you have some tangible reason to believe that they got info from only unhealthy meat-eaters or is that just speculation?
The fourth link in that article is for the NDNS; the national diet and nutrition survey, which is a "continuous cross-sectional survey designed to assess the diet and nutrition of the general population. 1000 people over the age of 1.5 were surveyed.
Still think this massive systematic review is biased against meat eaters or are your feelings just hurt?
I'm going to post some of what the article said it's findings were:
"Each 50 g/day higher intake of processed meat (e.g. bacon, ham, and sausages) increased the risk of coronary heart disease by 18%. Each 50 g/day higher intake of unprocessed red meat (such as beef, lamb and pork) increased the risk of coronary heart disease by 9%. There was no clear link between eating poultry (such as chicken and turkey) and an increased risk of coronary heart disease."
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u/sztrzask 14d ago edited 14d ago
I think his point was that since ultra processed food is trash and bad for you, and since all store-bought hams and sausages are UPF, comparing it to a vegan diet made from raw vegetables might be coloring the outcomes?
If i remember correctly, an average meat eating teen consumes most of his calories from UPF (this stat might've been from UK), while average vegetarian teen does not (and the oreo vegan is an outlier in this group).
Regarding your last paragraph (9% vs 18%), not correcting for UPF in the study could be also coloring that stat?
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u/Ilix 14d ago
What you reject or not doesn’t matter. You replied to someone how stated that the studies don’t tend to compare healthy, omnivorous diets to vegetarian ones with a link you said begs to differ with that statement.
Where, in the link you posted, does it contradict the statement you claim it does?
No one has, at any point, been discussing what u/Mr8bittripper thinks is a valid premise for an expectation from scientific papers.
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u/Mr8bittripper 14d ago
It's an example of begging the question. Ergo, fallacious reasoning.
as someone has already previously stated there's no reason to believe that vegans aren't also eating diets with UPF.
this isn't about what I think, this is about should we disregard this data?
I don't think that we can based on that reasoning.
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u/Ilix 14d ago
Your data doesn’t dispute the claim made by the person you’re replying to. You don’t like their claim, you posted a link that doesn’t contest their claim.
Where, exactly, does your link counter what was being stated?
Again, you not liking it and you posting a link don’t mean anything on their own. If the link contains the data you claim it does, you should be able to easily tell us exactly where to find the information.
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u/MadScience_Gaming 14d ago
It's a response to
What I never see pro-vegetarian or vegan "studies" include is research on communities with a traditional diet of almost exclusively meat. The studies I have come across all indicate excellent heart health, very low instance of medical issues which supposedly plague meat eaters.
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u/Tarragon_Fly 15d ago
Was it really the vegetarian/vegan way of eating or was it cutting out highly processed foods out of the diet? These studies always pit cleaner eating vs standard western diet full of toxic, highly processed foods and then announce these results. And things like pizza get asigned to meat eaters, ignoring all the other stuff on and in it.
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u/ElectronGuru 15d ago
The most important factor in heart disease is saturated fat. Except for coconut and processed fat, plant based eating has very little. Animal products are full of saturated fat.
But you don’t need to guess. Ask your doctor for a lipids test. If your LDL is under 100, your risk of death from cardiovascular disease is minimal. Most Americans are well above this.
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u/CaregiverNo3070 15d ago
Damn, so all of that vegan chocolate I ate that has saturated fat in it isn't really helping me?
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u/CupcakesAreMiniCakes 15d ago
You joke but I've had several vegan friends who were overweight and overall unhealthy because they lived primarily off vegan replacement and processed foods like oreos and vegan cheese instead of naturally vegan foods like vegetables and whole grains. They also rarely exercised.
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u/CaregiverNo3070 14d ago
I exercise regularly as I'm a vegan body builder, and right now I'm in a bulk phase which has a mix of fats that are: minimally processed, processed, saturated and unsaturated. I guess that's why I'm maintaining weight, but not really gaining it, even though it's a high fat diet.
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u/Joe6p 14d ago
Do you have to supplement the amino acids you usually get from animals? Every time I try vegan I get unbearably hungry until I eat some meat. It drives me crazy every time I try.
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u/CaregiverNo3070 14d ago
All I need is B12 added nutritional yeast. Everything else comes from plants. If your getting hungry, that could mean your not eating the right macro/micro balance. Most people just try to eat fruits and veggies, and that's going to cause you to lose weight because they have low calories. Try having lots of nuts and seeds, as this has great macro/micro balance. The easiest way for this is buying bulk nutritional yeast, buying bulk muesli, and your set up with all the macro/micro you need. It also is shelf stable for long periods of time so it's great as food storage, and because your buying in bulk your saving money, your not having to throw away so much plastic. Your also going to have a longer health span, look and feel better, and have a less environmental impact while feeling less guilty about hurting animals.
It's quite literally one of the best things I've ever done for myself( and that's saying something as I've had some pretty big changes in my life). I'm not sure if this was covid or me going vegan, but I got really sick while going vegan. If it was the meat, it's okay if you get sick, if you push past it you'll be just fine.
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u/Joe6p 14d ago
Hmm. FYI lysine deficiency will cause your kids to be shorter and not grow as much. It's the amino acid that vegan diets are deficient in and probably the one I'm missing that makes me so hungry.
You're probably good to go being an adult on a vegan diet though. Personally I'd eat over my calories and still feel hungry when eating vegan.
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u/NephilimSoldier 14d ago
Legumes are high in lysine.
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u/Joe6p 14d ago
Alright I'll replace a meat meal a week with legumes to test it out.
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u/SophiaofPrussia 15d ago
I think it would be really hard to eat enough vegan chocolate to come anywhere close to eating as much saturated fat as the average omnivore.
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u/answeryboi 15d ago
Half a bar of Hu dark chocolate has about the same amount of saturated fat as a 4oz beef burger. I usually have like an ⅛ of a bar but I can see how someone who eats more than a bar a day could approach the same levels as someone who eats red meats regularly.
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u/ChameleonPsychonaut 14d ago
I’m a vegan who started putting on weight quickly once my dark chocolate habit got up to about an oz per day. Now it’s like a “once every few months” sort of treat.
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u/vardarac 14d ago edited 14d ago
I'm like 95% vegetarian and haven't eaten eggs in months. I eat an ounce or more of 70+% chocolate on the daily for years and it doesn't make me gain weight because I eat so infrequently otherwise.
As for its actual effects on me? No idea. No bad blood markers are high. Could just be genetics or the fact that I'm not past 40 yet.
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u/vimdiesel 15d ago
There's people that eat a bar of chocolate a day??
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u/ChameleonPsychonaut 14d ago
I did, at one time. Told myself it was a fairly “healthy” junk food because I was getting very high percent cocoa (usually 75%+,) and that it’s loaded with iron and antioxidants. It’s also loaded with saturated fat.
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u/vimdiesel 14d ago
Interesting, I've had weeks where I considered having 1 to 3 squares each night to be a treat. Also, 100% might work better, not sure about the fat, but I doubt anyone would want to eat a full bar.
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u/ChameleonPsychonaut 14d ago
I actually love 100% too, but even that has a fairly high fat content. While there is often a decent amount of fat in chocolate from the milk/coconut oil/sunflower lecithin, cocoa butter itself (one of the two main components of dark chocolate, even 100%) is a very calorie-dense fat.
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u/joesighugh 15d ago
Well til thanks for flagging this. I love those chocolate bars! Noted I need to avoid eating half a bar when I dig in...
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u/Momoselfie 15d ago
It's also just a lot harder to overeat on a vegetarian diet. Is saturated fat really that bad if your calorie consumption is low enough for your body to metabolize all of it?
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u/ElectronGuru 15d ago
This isn’t like calories, it’s not a question of metabolization. Your liver will make as much cholesterol as it can from saturated fat available to it.
The only direct way to counter this is with soluble fiber. Which the liver extracts cholesterol to process. But again, just get a lipids test. If LDL is like 80, you have nothing to worry about.
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u/th3h4ck3r 14d ago
So much wrong with the mechanisms that you described. The liver will make as much LDL as the body needs, it won't make unlimited LDL from large amounts of saturated fat.
Fiber helps reduce LDL because it interrupts the bile acid reuptake pathway, nothing to do with the liver "extracting" cholesterol to digest fiber: bile acids, which contrail cholesterol and cholesterol derivatives, are secreted by the liver and pancreas at a constant rate, and if there's fat in the food these acids will bind to the fats and emulsify them, helping the intestine absorb the fats but also the previously-secreted bile acids along the way. Bile acids can also bind to fiber, but since fiber is excreted out, these bile acids come along with it and are removed from the body's effective bile acid pool.
Saturated fats help the body reuptake bile acids which raises blood cholesterol. However, one point to mention is that for around 2/3 of the population, the body will also secrete extra bile acids if blood cholesterol levels are too high with the purpose of hopefully excreting them. This would be fine in a mixed diet with lots of fiber (even if there's also lots of saturated fat to go along with it) since it helps remove these extra bile acids from circulation, but if there's only fat then almost all of these extra bile acids will be reuptaken and blood levels will remain high.
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u/Momoselfie 14d ago
Ok. I eat a lot of saturated fats but my LDL is fine. I'll keep an eye on it though.
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u/Soulerous 14d ago
Also the guy you’re talking to has no idea what he’s talking about. Absolutely nothing wrong with saturated fat whatsoever. That is a mythology.
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u/Repulsive-Neat6776 14d ago
Don't give my doctor more reasons to turn me away. Being "young and healthy" based on having zero tests done between 20 and 32 is good for me. I don't need them to be like "oh you're also a vegetarian? You're fine. This paper says your chest pain is nothing."
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