Vegan Diets and Heart Health

The Academy of Nutrition and Dietetics (AND) publishes—in addition to their peer-reviewed journal—a glossy bi-monthly magazine with short articles on food and nutrition topics. It’s a nice magazine (although needless to say, the content doesn’t always make me very happy.)

The latest issue is devoted to vegan diets. I was invited to write an 800-word article on vegan diets and heart health for the magazine’s website, which you can read here. Unfortunately, they omitted the references I included with the article (it’s for dietitians, after all) so I’ll list them at the end of this post for those who are interested.

You can also read an article on the website that actually links to Vegan Outreach. I love this since you don’t find too many links to animal advocacy sites in AND publications!

Here are the citations for my heart disease article:

Crowe FL, Appleby PN, Travis RC, Key TJ. Risk of hospitalization or death from ischemic heart disease among British vegetarians and nonvegetarians: results from the EPIC-Oxford cohort study. Am J Clin Nutr 2013;97:597-603.

Fraser GE. Associations between diet and cancer, ischemic heart disease, and all- cause mortality in non-Hispanic white California Seventh-day Adventists. Am J Clin Nutr 1999;70:532S-538S.

Orlich MJ PS, Sabate J, Jaceldo-Siegl K, Fan J, Knutsen S, Beeson L, Fraser G. Vegetarian dietary patterns and mortality in Adventist Health Study-2. JAMA Intern Med 2013.

Spencer EA, Appleby PN, Davey GK, Key TJ. Diet and body mass index in 38000 EPIC-Oxford meat-eaters, fish-eaters, vegetarians and vegans. Int J Obes Relat Metab Disord 2003;27:728-34.

Goff LM, Bell JD, So PW, Dornhorst A, Frost GS. Veganism and its relationship with insulin resistance and intramyocellular lipid. Eur J Clin Nutr 2005;59:291-8.

Koebnick C, Garcia AL, Dagnelie PC, et al. Long-term consumption of a raw food diet is associated with favorable serum LDL cholesterol and triglycerides but also with elevated plasma homocysteine and low serum HDL cholesterol in humans. J Nutr 2005;135:2372-8.

Kornsteiner M, Singer I, Elmadfa I. Very low n-3 long-chain polyunsaturated fatty acid status in Austrian vegetarians and vegans. Ann Nutr Metab 2008;52:37-47.

Newby PK, Tucker KL, Wolk A. Risk of overweight and obesity among semivegetarian, lactovegetarian, and vegan women. Am J Clin Nutr 2005;81:1267-74.

Haddad EH, Berk LS, Kettering JD, Hubbard RW, Peters WR. Dietary intake and biochemical, hematologic, and immune status of vegans compared with nonvegetarians. Am J Clin Nutr 1999;70:586S-593S.

Allen NE, Appleby PN, Davey GK, Key TJ. Hormones and diet: low insulin-like growth factor-I but normal bioavailable androgens in vegan men. Br J Cancer 2000;83:95-7.

Allen NE, Appleby PN, Davey GK, Kaaks R, Rinaldi S, Key TJ. The Associations of Diet with Serum Insulin-like Growth Factor I and Its Main Binding Proteins in 292 Women Meat-Eaters, Vegetarians, and Vegans. Cancer Epidemiol Biomarkers Prev 2002;11:1441-8.

Appleby PN, Davey GK, Key TJ. Hypertension and blood pressure among meat eaters, fish eaters, vegetarians and vegans in EPIC-Oxford. Public Health Nutr 2002;5:645-54.

Davey GK, Spencer EA, Appleby PN, Allen NE, Knox KH, Key TJ. EPIC-Oxford: lifestyle characteristics and nutrient intakes in a cohort of 33 883 meat-eaters and 31 546 non meat-eaters in the UK. Public Health Nutr 2003;6:259-69.

Bissoli L, Di Francesco V, Ballarin A, et al. Effect of vegetarian diet on homocysteine levels. Ann Nutr Metab 2002;46:73-9.

Li D, Sinclair A, Mann N, et al. The association of diet and thrombotic risk factors in healthy male vegetarians and meat-eaters. Eur J Clin Nutr 1999;53:612-9.

Toohey ML, Harris MA, DeWitt W, Foster G, Schmidt WD, Melby CL. Cardiovascular disease risk factors are lower in African-American vegans compared to lacto-ovo-vegetarians [see comments]. J Am Coll Nutr 1998;17:425-34.

De Biase SG, Fernandes SF, Gianini RJ, Duarte JL. Vegetarian diet and cholesterol and triglycerides levels. Arq Bras Cardiol 2007;88:35-9.

Fraser GE. Vegetarian diets: what do we know of their effects on common chronic diseases? Am J Clin Nutr 2009;89:1607S-1612S.

Pettersen BJ, Anousheh R, Fan J, Jaceldo-Siegl K, Fraser GE. Vegetarian diets and blood pressure among white subjects: results from the Adventist Health Study-2 (AHS-2). Public Health Nutr 2012:1-8.

Ramos SC, Fonseca FA, Kasmas SH, et al. The role of soluble fiber intake in patients under highly effective lipid-lowering therapy. Nutr J 2011;10:80.

Galisteo M, Duarte J, Zarzuelo A. Effects of dietary fibers on disturbances clustered in the metabolic syndrome. J Nutr Biochem 2008;19:71-84.

Kishimoto Y, Wakabayashi S, Takeda H. Hypocholesterolemic effect of dietary fiber: relation to intestinal fermentation and bile acid excretion. J Nutr Sci Vitaminol (Tokyo) 1995;41:151-61.

Jenkins DJ, Mirrahimi A, Srichaikul K, et al. Soy protein reduces serum cholesterol by both intrinsic and food displacement mechanisms. J Nutr 2010;140:2302S-2311S.

Li SH, Liu XX, Bai YY, et al. Effect of oral isoflavone supplementation on vascular endothelial function in postmenopausal women: a meta-analysis of randomized placebo-controlled trials. Am J Clin Nutr 2010;91:480-6.

Mann NJ, Li D, Sinclair AJ, et al. The effect of diet on plasma homocysteine concentrations in healthy male subjects. Eur J Clin Nutr 1999;53:895-9.

Herrmann W, Schorr H, Obeid R, Geisel J. Vitamin B-12 status, particularly holotranscobalamin II and methylmalonic acid concentrations, and hyperhomocysteinemia in vegetarians. Am J Clin Nutr 2003;78:131-6.

Antoniades C, Antonopoulos AS, Tousoulis D, Marinou K, Stefanadis C. Homocysteine and coronary atherosclerosis: from folate fortification to the recent clinical trials. Eur Heart J 2009;30:6-15.

Rosell MS, Lloyd-Wright Z, Appleby PN, Sanders TA, Allen NE, Key TJ. Long-chain n-3 polyunsaturated fatty acids in plasma in British meat-eating, vegetarian, and vegan men. Am J Clin Nutr 2005;82:327-34.

Ornish D, Brown SE, Scherwitz LW, et al. Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial. Lancet 1990;336:129-33.

Jenkins DJ, Wong JM, Kendall CW, et al. The effect of a plant-based low-carbohydrate (“Eco-Atkins”) diet on body weight and blood lipid concentrations in hyperlipidemic subjects. Arch Intern Med 2009;169:1046-54.

 

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6 Responses to Vegan Diets and Heart Health

  1. brenda July 4, 2013 at 2:43 pm #

    I was glad to see you mentioned some of Dr Jenkins work. He is an ardent vegan and a lot of his recent work focuses on dietary change to improve cholesterol and diabetes.
    We need more researchers pointing out the health benefits of healthy vegetarian/vegan diets. Problem is there is not a lot of funding for studies in this area of research (it’s not latest ‘it’ thing) so researchers need to be creative.

  2. Richard July 6, 2013 at 12:36 pm #

    Great article, Ginny. I’d like to point out that the Ornish program results in 40% reduction in LDL cholesterol in average patients in 12-weeks. This is comparable to high-dose statin therapy. Ornish knows this best, but my recollection of his study is that the patients whose arteries became more healed also showed more reduction in LDL cholesterol. I think it’s fair to say that most of the benefits of the Ornish program is mediated by the LDL lowering potential of the diet.

    In regards to the latest 7th day adventist cohort. Vegan males showed the lowest mortality, however the follow-up was very short (6 years) and may explain the lack of benefit among women. Another concern is related to the fact that observational studies addressing the association between diet and blood cholesterol and cardiovascular disease dating back to at least the early 1950s have been complicated by reverse causation. It is well documented that people will lower intake of cholesterol and saturated fat in response to elevated blood cholesterol. This is known to bias studies towards finding an association between a higher intake of cholesterol and saturated fat and lower blood cholesterol levels. This would also likely similarly bias the results for the association between intake of cholesterol and saturated fat and the risk of cardiovascular disease. Those adventists whose health was starting to decline at the beginning of the survey may have chosen more stringent vegan approach thus biasing the findings towards the null. Other possibility is that people initially in the vegan category have changed their diet towards more omnivorous which would have, again, biased the associations towards the null.

  3. veganlinda July 25, 2013 at 5:27 am #

    I am teaching a mini course on veganism this fall for our homeschooling academy. Most of the kids are not veg in the group. I was wondering if there is a curriculum already created to help with teaching 6th grade and up kids about vegan nutrition? Thanks!

  4. Andy September 12, 2013 at 8:52 am #

    >Unfortunately, they omitted the references I included with the article
    > (it’s for dietitians, after all)

    I’m having trouble reading your tone here. Shouldn’t all dietitians have some sense of the evidence base for their recommendations? Doesn’t that involve reading scholarly papers at least sometimes?

  5. Nancy October 30, 2013 at 7:12 am #

    I couldn’t find anywhere else to ask this question, so I’ll ask it here. I’m an over-60 vegan and have been vegan for 2 years. I just had my annual “wellness” exam and was distressed to learn my lipid profile has gone up in all areas! I do eat more carbs than I should (tortillas with Earth Balance margarine), which, I understand, could account for the rise in triglycerides, but I have not had any animal products and I monitor that carefully by not eating out. Is there somewhere I can find information on this? My commitment to veganism is ethical, so cheating is not a reason for the increase. What gives?

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