Cause-specific and all-cause mortalities in vegetarian compared to non-vegetarian participants from the Adventist Health Study-2 cohort.
chronic disease
healthy diet
longevity
nervous system-associated causes of death
plant-based diet
Journal
The American journal of clinical nutrition
ISSN: 1938-3207
Titre abrégé: Am J Clin Nutr
Pays: United States
ID NLM: 0376027
Informations de publication
Date de publication:
02 Aug 2024
02 Aug 2024
Historique:
received:
07
12
2023
revised:
15
05
2024
accepted:
30
07
2024
medline:
5
8
2024
pubmed:
5
8
2024
entrez:
4
8
2024
Statut:
aheadofprint
Résumé
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.
Sections du résumé
BACKGROUND
BACKGROUND
There have been mixed results reported internationally when associating vegetarian dietary patterns with all-cause and cause-specific mortalities.
OBJECTIVE
OBJECTIVE
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.
METHODS
METHODS
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.
RESULTS
RESULTS
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.
CONCLUSIONS
CONCLUSIONS
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.
Identifiants
pubmed: 39098708
pii: S0002-9165(24)00652-X
doi: 10.1016/j.ajcnut.2024.07.028
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest ☒ The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The authors have no conflicts of interest to report.