Here's some more references from Medline:
Thorogood M. Mann J. Appleby P. McPherson K.
Department of Public Health and Policy, London School of Hygiene and Tropical
Medicine.
Risk of death from cancer and ischaemic heart disease in meat and non-meat
eaters [see comments].
BMJ. 308(6945):1667-70, 1994 Jun 25.
OBJECTIVE--To investigate the health consequences of a vegetarian diet by
examining the 12 year mortality of non-meat eaters and meat
eating controls. DESIGN--Prospective observational study in which members of
the non-meat eating cohort were asked to nominate friends or relatives as
controls. SETTING--United Kingdom. SUBJECTS--6115 non-meat eaters identified
through the Vegetarian Society of the United Kingdom and the news media (mean
(SD) age 38.7 (16.8) years) and 5015 controls who were meat eaters (39.3
(15.4) years). MAIN OUTCOME MEASURES--Standardised mortality
ratios for cancer, ischaemic heart disease, and total
mortality in the two cohorts and death rate ratio in the
non-meat eaters compared with meat eaters after adjustment for potentially
confounding variables. RESULTS--Standardised mortality
ratios (taking the value among the general population as 100) for ischaemic
heart disease were 51 (95% confidence interval 38 to 66) for meat eaters and
28 (20 to 38) for non-meat eaters (P < 0.01). Values for all cancers were 80
(64 to 98) and 50 (39 to 62) for meat eaters and non-meat eaters
respectively. After adjustment for the effects of smoking, body mass index,
and socioeconomic status death rate ratios in non-meat eaters compared with
meat eaters were 0.72 (0.47 to 1.10) for ischaemic heart disease and 0.61
(0.44 to 0.84) for all cancers. CONCLUSIONS--The reduced
mortality from cancer among those not eating meat is not
explained by lifestyle related risk factors, which have a low prevalence
among vegetarians. No firm conclusion can be made about deaths from ischaemic
heart disease. These data do not justify advice to exclude meat from the diet
since there are several attributes of a vegetarian diet apart from not eating
meat which might reduce the risk.
Chang-Claude J. Frentzel-Beyme R.
Division of Epidemiology, German Cancer Research Centre, Heidelberg.
Dietary and lifestyle determinants of mortality among German
vegetarians.
International Journal of Epidemiology. 22(2):228-36, 1993 Apr.
Lifestyle characteristics of a cohort of 1904 Germans adhering mainly to a
vegetarian diet were examined in relation to their mortality
after 11 years of follow-up. Poisson regression modelling was performed to
consider the simultaneous effects of different variables on
mortality from all causes, cancer (ICD 140-208) and
cardiovascular diseases (ICD 390-459). Compared to a low level of
self-reported physical activity, those with a medium or high level of
activity experienced only half the mortality from all causes
and from cardiovascular diseases. Physical activity showed no beneficial
effect for cancer mortality in this cohort. The body mass
index (BMI) was an independent risk factor for mortality
among men but essentially unrelated to mortality among
women. Those in the middle third of the BMI distribution experienced the
lowest mortality. A negative association between BMI and
cancer mortality lost statistical significance when the
first 5 years of follow-up were deleted, suggesting that a lower BMI was a
consequence of prevalent disease. Both the duration of
vegetarianism and the vegetarian status (strict versus
moderate) showed a moderate effect on all cause and cancer
mortality. A longer duration of
vegetarianism (> or = 20 years) was associated with a lower
risk, pointing to a real protective effect of this lifestyle. A lower risk of
death among moderate vegetarians suggests that sound nutritional planning may
be more important than absolute avoidance of meat.
McMichael AJ.
Vegetarians and longevity: imagining a wider reference
population [editorial; comment] [see comments].
Epidemiology. 3(5):389-91, 1992 Sep.
Chang-Claude J. Frentzel-Beyme R. Eilber U.
Department of Epidemiology, German Cancer Research Center, Heidelberg.
Mortality pattern of German vegetarians after 11 years of
follow-up [see comments].
Epidemiology. 3(5):395-401, 1992 Sep.
A cohort of 1,904 vegetarians and persons leading a health-conscious
life-style in the Federal Republic of Germany was identified in 1978. After a
follow-up of 11 years, mortality from all causes was reduced
by one-half compared with the general population [the standardized
mortality ratio (SMR) was 0.44 for men, 0.53 for women].
Among the 858 men, 111 deaths were observed, with 255 expected; among the
1,046 women, 114 deaths were observed, with 215 expected. The lowest
mortality was found for cardiovascular diseases (SMR = 0.39
for men, 0.46 for women); in particular, for ischemic heart diseases,
mortality was reduced to one-third of that expected. Cancer
mortality was reduced by one-half in men (SMR = 0.48), but
only by one-quarter in women (SMR = 0.74). The deficit in cancer deaths was
mainly observed for lung cancer and gastrointestinal cancers in males and for
gastrointestinal cancers in females. Deaths from diseases of the respiratory
and digestive systems were also reduced by about 50%. An excess of deaths
occurred only for anemia. When the strict and the moderate vegetarians were
analyzed separately, the strongest differential was found for ischemic heart
diseases, which were much less frequent among strict vegetarians for both
sexes. Some nondietary factors, such as higher socioeconomic status, virtual
absence of smoking, and lower body mass index, may also have contributed to
the lower mortality of the study participants.
Lindsted K. Tonstad S. Kuzma JW.
School of Public Health, Loma Linda University, CA 92350.
Body mass index and patterns of mortality among Seventh-day
Adventist men.
International Journal of Obesity. 15(6):397-406, 1991 Jun.
This study examines the relationship between body mass index (BMI) and
26-year mortality among 8828 nonsmoking, nondrinking
Seventh-day Adventist men, including 439 who were very lean (BMI less than 20
kg/m2). The adjusted relative risk comparing the lowest BMI quintile (less
than 22.3) to the highest (greater than 27.5 kg/m2) was 0.70 (95 percent CI
0.63-0.78) for all cause mortality, 0.60 (95 percent CI
0.43-0.85) for cerebrovascular mortality, and 0.80 (95
percent CI 0.61-1.04) for cancer mortality. Very lean men
did not show increased mortality. To assess whether the
protective effect associated with low BMI is modified by increasing age, the
product term between BMI and attained age (age at the end of follow-up or at
death) was included as a time-dependent covariate. For ischemic heart disease
mortality, age-specific estimates of the relative risk for
the lowest quintile relative to the highest ranged from 0.32 (95 percent CI,
0.19-0.52) at age 50 to 0.71 (95 percent CI, 0.56-0.89) at age 90.
Interaction was also seen for the next lowest quintile (22.4-24.2). There was
a significant trend of increasing mortality with increasing
BMI for all endpoints studied. For cancer and cerebrovascular
mortality the P-values for trend were 0.0001 and 0.001
respectively. For the other endpoints the P-values were less than 0.0001.
Thus, there was no evidence for a J-shaped relationship between BMI and
mortality in males. While the protective effect associated
with the lowest BMI quintile decreased with increasing age for ischemic heart
disease mortality, it remained greater than one at all ages.
The relatively large number of subjects who were lean by choice, rather than
as a result of preclinical disease or smoking, may explain these findings.
Dwyer JT.
Tufts University School of Medicine, New England Medical Center Hospital,
Boston, MA 02111.
Health aspects of vegetarian diets. [Review] [342 refs]
American Journal of Clinical Nutrition. 48(3 Suppl):712-38, 1988 Sep.
Recent studies of vegetarian diets and their effects on morbidity and
mortality are reviewed. Vegetarian diets are heterogeneous
as are their effects on nutritional status, health, and
longevity. Mortality rates are similar or
lower for vegetarians than for nonvegetarians. Risks of dietary deficiency
disease are increased on vegan but not on all vegetarian diets. Evidence for
decreased risks for certain chronic degenerative diseases varies. Both
vegetarian dietary and lifestyle practices are involved. Data are strong that
vegetarians are at lesser risk for obesity, atonic constipation, lung cancer,
and alcoholism. Evidence is good that risks for hypertension, coronary artery
disease, type II diabetes, and gallstones are lower. Data are only fair to
poor that risks of breast cancer, diverticular disease of the colon, colonic
cancer, calcium kidney stones, osteoporosis, dental erosion, and dental
caries are lower among vegetarians. Reduced risks for chronic degenerative
diseases can also be achieved by manipulations of omnivorous diets and
lifestyles. [References: 342]
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