A Systematic Review of the Association Between Vegan Diets and Risk of Cardiovascular Disease.
Cocco, Mafalda Tasso de Almeida Ribeiro Reis
The Journal of nutrition
American Society for Nutrition
MetadataShow full item record
Kaiser, J., van Daalen, K. R., Thayyil, A., Cocco, M. T. d. A. R. R., Caputo, D., & Oliver-Williams, C. (2021). A Systematic Review of the Association Between Vegan Diets and Risk of Cardiovascular Disease.. The Journal of nutrition, 151 (6), 1539-1552. https://doi.org/10.1093/jn/nxab037
Abstract Background: Plant-based diets are gaining increasing attention globally due to their environmental benefits and perceived health-protective role. Furthermore, a vegan diet may have cardiovascular benefits; however, evidence remains conflicting and insufficiently assessed. Objective: We evaluated the utility of the vegan diet in cardiovascular disease (CVD) prevention. Methods: We conducted a systematic review of original studies which evaluated the association between vegan diets and cardiovascular outcomes. Five databases were searched through October 31, 2020. Four investigators independently screened the full texts for inclusion, assessed quality, and extracted data from published reports. This study is registered with PROSPERO, CRD42019146835. Results: Seven out of the 5,729 identified records were included, comprising over 73,000 participants, including at least 7,661 vegans. Three studies, with at least 73,426 individuals (including at least 7,380 vegans), examined the risk of primary cardiovascular events (total CVD, CHD, acute MI, 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), but had lower common carotid artery intima-media thickness in another study (0·56 ± 0·1 mm vs 0·74 ± 0·1 mm, respectively; P < 0·001) and 0-52% lower rates in 3 studies of recurrent CVD events. In one study, endothelial function did not differ between vegans and non-vegans. Using the GRADE approach, low to very low strength/quality of evidence was found due to observational studies and down-grading of randomized controlled trial evidence due to risk-of-bias. Conclusions: Among the Western populations studied, current evidence weakly demonstrates associations between vegan diets and risk of CVDs, with the direction of associations varying with the specific CVD tested. However, few studies were identified and more high-quality research on this topic is needed.
Homerton College, University of Cambridge, Gates Cambridge, University of Cambridge, the UK Medical Research Council (MR/L003120/1), the British Heart Foundation (RG/13/13/30194; RG/18/13/33946) and the National Institute for Health Research (Cambridge Biomedical Research Centre at the Cambridge University Hospitals NHS Foundation Trust).
British Heart Foundation (RG/13/13/30194)
British Heart Foundation (RG/18/13/33946)
Embargo Lift Date
External DOI: https://doi.org/10.1093/jn/nxab037
This record's URL: https://www.repository.cam.ac.uk/handle/1810/317188
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