Vegetarian Diet Linked to Lower Heart Disease, But Higher Stroke Risks

By Kelly Young

Edited by Susan Sadoughi, MD

Vegetarians and pescatarians (people who eat fish, but not meat) are at lower risk for ischemic heart disease, but vegetarians have elevated stroke risk, according to a large cohort study in The BMJ.

Roughly 48,000 adults in the U.K. provided information on their diet. During an average 18-year follow-up, there were roughly 2800 cases of ischemic heart disease and 1100 stroke cases.

Pescatarians and those who were vegetarian or vegan had lower risks for ischemic heart disease than meat eaters (hazard ratios, 0.87 for fish eaters, 0.78 for vegetarians). However, vegetarians had higher rates of total stroke (HR, 1.20) and hemorrhagic stroke (HR, 1.43) than meat eaters. Stroke risk wasn't elevated among pescatarians.

The authors estimate that vegetarians had 10 fewer cases of ischemic heart disease and three more cases of stroke per 1000 population over 10 years than meat eaters. Editorialists write: "Vegetarians and others should keep the reported stroke risk in perspective... It is based on results from just one study, and the increase is modest relative to meat eaters."

The authors don't offer a direct explanation for the observed association with stroke other than raising the possibility that lower circulating levels of several nutrients, including essential fatty acids, could play a role.