Risk of death from cancer and ischaemic heart disease in meat and non-meat eaters

BMJ 1994;308:1667-1670 (25 June)

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Risk of death from cancer and ischaemic heart disease in meat and non-meat eaters

M Thorogood, J Mann, P Appleby, K McPherson

Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London WC1E 7HT Department of Human Nutrition, University of Otago, PO Box 56, Dunedin, New Zealand Department of Public Health and Primary Care, University of Oxford, Oxford OX2 6HE Correspondence to: Professor Mann.

Abstract

Objective : To investigate the health consequences of a vegetariandiet by examining the 12 year mortality of non-meat eaters andmeat eating controls.
Design : Prospective observational study in which members ofthe non-meat eating cohort were asked to nominate friends orrelatives as controls.
Setting : United Kingdom.
Subjects : 6115 non-meat eaters identified through the VegetarianSociety 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 cohortsand death rate ratio in the non-meat eaters compared with meateaters after adjustment for potentially confounding variables.
Results : Standardised mortality ratios (taking the value amongthe general population as 100) for ischaemic heart disease were51 (95% confidence interval 38 to 66) for meat eaters and 28(20 to 38) for non- meat eaters (P<0.01). Values for allcancers were 80 (64 to 98) and 50 (39 to 62) for meat eaters20andnon-meat eaters respectively. After adjustment20for the effectsof smoking, body mass index, and socioeconomic status deathrate ratios in non-meat eaters compared with meat eaters were0.72 (0.47 to 1.10) for ischaemic heart disease and 0.61 (0.44to 0.84) for all cancers.
Conclusions : The reduced mortality from cancer among thosenot eating meat is not explained by lifestyle related risk factors,which have a low prevalence among vegetarians. No firm conclusioncan be made about deaths from ischaemic heart disease. Thesedata do not justify advice to exclude meat from the diet sincethere are several attributes of a vegetarian diet apart fromnot eating meat which might reduce the risk.

Clinical implications

Clinical implications
Cancers and ischaemic heart disease are the main causes of death in adults and are partly related to diet
Previous studies have suggested reduced mortality from cancers and ischaemic heart disease in vegetarians, but the results could have been explained by reduced levels of several risk factors among vegetarians
In this study the 40% reduction in cancer mortality in non-meat eaters compared with meat eaters could not be explained by differences in smoking habits, obesity, and socioeconomic status
Some attributes of the vegetarian diet seem to have a beneficial effect on premature mortality
The results do not justify advice to exclude meat since several features of a vegetarian diet apart from not eating meat might reduce the risk

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Risk of death in meat and non-meat eaters: R West
BMJ 1994 309: 955. [Extract] [Full Text]

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