Papers

Dietary habits and mortality in 11 000 vegetarians and health conscious people: results of a 17 year follow up

^a Imperial Cancer Research Fund, Cancer Epidemiology Unit, Radcliffe Infirmary, Oxford OX2 6HE, ^b Department of Public Health and Policy, London School of Hygiene & Tropical Medicine, London WC1E 7HT, ^c Centre for Applied Public Health Medicine, University of Wales College of Medicine, Cardiff CF1 3NW

Correspondence to: Dr Key.

Abstract

Objective: To investigate the association of dietary habits with mortality in a cohort of vegetarians and other health conscious people.
Design: Observational study.
Setting: United Kingdom.
Subjects: 4336 men and 6435 women recruited through health food shops, vegetarian societies, and magazines.
Main outcome measures: Mortality ratios for vegetarianism and for daily versus less than daily consumption of wholemeal bread, bran cereals, nuts or dried fruit, fresh fruit, and raw salad in relation to all cause mortality and mortality from ischaemic heart disease, cerebrovascular disease, all malignant neoplasms, lung cancer, colorectal cancer, and breast cancer.
Results: 2064 (19%) subjects smoked, 4627 (43%) were vegetarian, 6699 (62%) ate wholemeal bread daily, 2948 (27%) ate bran cereals daily, 4091 (38%) ate nuts or dried fruit daily, 8304 (77%) ate fresh fruit daily, and 4105 (38%) ate raw salad daily. After a mean of 16.8 years follow up there were 1343 deaths before age 80. Overall the cohort had a mortality about half that of the general population. Within the cohort, daily consumption of fresh fruit was associated with significantly reduced mortality from ischaemic heart disease (rate ratio adjusted for smoking 0.76 (95% confidence interval 0.60 to 0.97)), cerebrovascular disease (0.68 (0.47 to 0.98)), and for all causes combined (0.79 (0.70 to 0.90)).
Conclusions: In this cohort of health conscious individuals, daily consumption of fresh fruit is associated with a reduced mortality from ischaemic heart disease, cerebrovascular disease, and all causes combined.

This article has been cited by other articles:

• Dauchet, L., Amouyel, P., Hercberg, S., Dallongeville, J. (2006). Fruit and Vegetable Consumption and Risk of Coronary Heart Disease: A Meta-Analysis of Cohort Studies. J. Nutr. 136: 2588-2593 [Abstract] [Full text]  
• Zarraga, I. G.E., Schwarz, E. R. (2006). Impact of Dietary Patterns and Interventions on Cardiovascular Health. Circulation 114: 961-973 [Full text]  
• Dauchet, L., Amouyel, P., Dallongeville, J. (2005). Fruit and vegetable consumption and risk of stroke: A meta-analysis of cohort studies. Neurology 65: 1193-1197 [Abstract] [Full text]  
• Walker, A., Walker, B. (2005). Why is there disinterest in the appreciation of beneficial dietary recommendations?. Am. J. Clin. Nutr. 81: 197-197 [Full text]  
• Jenkins, D. J., Kendall, C. W., Marchie, A., Augustin, L. S. (2005). Reply to A Walker and B Walker. Am. J. Clin. Nutr. 81: 197-198 [Full text]  
• Genkinger, J. M., Platz, E. A., Hoffman, S. C., Comstock, G. W., Helzlsouer, K. J. (2004). Fruit, Vegetable, and Antioxidant Intake and All-Cause, Cancer, and Cardiovascular Disease Mortality in a Community-dwelling Population in Washington County, Maryland. Am J Epidemiol 160: 1223-1233 [Abstract] [Full text]  
• Hung, H.-C., Joshipura, K. J., Jiang, R., Hu, F. B., Hunter, D., Smith-Warner, S. A., Colditz, G. A., Rosner, B., Spiegelman, D., Willett, W. C. (2004). Fruit and Vegetable Intake and Risk of Major Chronic Disease. JNCI J Natl Cancer Inst 96: 1577-1584 [Abstract] [Full text]  
• Link, L. B., Potter, J. D. (2004). Raw versus Cooked Vegetables and Cancer Risk. Cancer Epidemiol. Biomarkers Prev. 13: 1422-1435 [Abstract] [Full text]  
• Dragsted, L. O, Pedersen, A., Hermetter, A., Basu, S., Hansen, M., Haren, G. R, Kall, M., Breinholt, V., Castenmiller, J. J., Stagsted, J., Jakobsen, J., Skibsted, L., Rasmussen, S. E, Loft, S., Sandstrom, B. (2004). The 6-a-day study: effects of fruit and vegetables on markers of oxidative stress and antioxidative defense in healthy nonsmokers. Am. J. Clin. Nutr. 79: 1060-1072 [Abstract] [Full text]  
• Walker, A R P, Walker, B F, Segal, I (2004). Some puzzling situations in the onset, occurrence and future of coronary heart disease in developed and developing populations, particularly such in sub-Saharan Africa. The Journal of the Royal Society for the Promotion of Health 124: 40-46 [Abstract]  
• Singh, P. N, Sabate, J., Fraser, G. E (2003). Does low meat consumption increase life expectancy in humans?. Am. J. Clin. Nutr. 78: 526S-532 [Abstract] [Full text]  
• Key, T. J, Appleby, P. N, Davey, G. K, Allen, N. E, Spencer, E. A, Travis, R. C (2003). Mortality in British vegetarians: review and preliminary results from EPIC-Oxford. Am. J. Clin. Nutr. 78: 533S-538 [Abstract] [Full text]  
• Holmquist, C., Larsson, S., Wolk, A., de Faire, U. (2003). Multivitamin Supplements Are Inversely Associated with Risk of Myocardial Infarction in Men and Women--Stockholm Heart Epidemiology Program (SHEEP). J. Nutr. 133: 2650-2654 [Abstract] [Full text]  
• Johnsen, S. P, Overvad, K., Stripp, C., Tjonneland, A., Husted, S. E, Sorensen, H. T (2003). Intake of fruit and vegetables and the risk of ischemic stroke in a cohort of Danish men and women. Am. J. Clin. Nutr. 78: 57-64 [Abstract] [Full text]  
• Herrmann, W., Schorr, H., Obeid, R., Geisel, J. (2003). Vitamin B-12 status, particularly holotranscobalamin II and methylmalonic acid concentrations, and hyperhomocysteinemia in vegetarians. Am. J. Clin. Nutr. 78: 131-136 [Abstract] [Full text]  
• McCullough, M. L, Feskanich, D., Stampfer, M. J, Giovannucci, E. L, Rimm, E. B, Hu, F. B, Spiegelman, D., Hunter, D. J, Colditz, G. A, Willett, W. C (2002). Diet quality and major chronic disease risk in men and women: moving toward improved dietary guidance. Am. J. Clin. Nutr. 76: 1261-1271 [Abstract] [Full text]  
• LIPSHULTZ, S. E., FISHER, S. D., LAI, W. W., MILLER, T. L. (2001). Cardiovascular Monitoring and Therapy for HIV-Infected Patients. Ann. N. Y. Acad. Sci. 946: 236-273 [Abstract] [Full text]  
• Hininger, I. A., Meyer-Wenger, A., Moser, U., Wright, A., Southon, S., Thurnham, D., Chopra, M., Van Den Berg, H., Olmedilla, B., Favier, A. E., Roussel, A.-M. (2001). No Significant Effects of Lutein, Lycopene or {beta}-Carotene Supplementation on Biological Markers of Oxidative Stress and LDL Oxidizability in Healthy Adult Subjects. J. Am. Coll. Nutr. 20: 232-238 [Abstract] [Full text]  
• Barringer, T.D. (2001). Dietary fats in the prevention of coronary heart disease: the need for more clinical trials. Eur Heart J Suppl 3: D79-D84 [Abstract]  
• Smith-Warner, S. A., Spiegelman, D., Yaun, S.-S., Adami, H.-O., Beeson, W. L., van den Brandt, P. A., Folsom, A. R., Fraser, G. E., Freudenheim, J. L., Goldbohm, R. A., Graham, S., Miller, A. B., Potter, J. D., Rohan, T. E., Speizer, F. E., Toniolo, P., Willett, W. C., Wolk, A., Zeleniuch-Jacquotte, A., Hunter, D. J. (2001). Intake of Fruits and Vegetables and Risk of Breast Cancer: A Pooled Analysis of Cohort Studies. JAMA 285: 769-776 [Abstract] [Full text]  
• Walker, A.R.P. (2001). With increasing ageing in Western populations, what are the prospects for lowering the incidence of coronary heart disease?. QJM 94: 107-112 [Abstract] [Full text]  
• Krauss, R. M., Eckel, R. H., Howard, B., Appel, L. J., Daniels, S. R., Deckelbaum, R. J., Erdman, J. W. Jr, Kris-Etherton, P., Goldberg, I. J., Kotchen, T. A., Lichtenstein, A. H., Mitch, W. E., Mullis, R., Robinson, K., Wylie-Rosett, J., St. Jeor, S., Suttie, J., Tribble, D. L., Bazzarre, T. L. (2001). AHA Scientific Statement: AHA Dietary Guidelines: Revision 2000: A Statement for Healthcare Professionals From the Nutrition Committee of the American Heart Association. J. Nutr. 131: 132-146 [Full text]  
• Voorrips, L. E., Goldbohm, R. A., van Poppel, G., Sturmans, F., Hermus, R. J. J., van den Brandt, P. A. (2000). Vegetable and Fruit Consumption and Risks of Colon and Rectal Cancer in a Prospective Cohort Study The Netherlands Cohort Study on Diet and Cancer. Am J Epidemiol 152: 1081-1092 [Abstract] [Full text]  
• Krauss, R. M., Eckel, R. H., Howard, B., Appel, L. J., Daniels, S. R., Deckelbaum, R. J., Erdman, J. W. Jr, Kris-Etherton, P., Goldberg, I. J., Kotchen, T. A., Lichtenstein, A. H., Mitch, W. E., Mullis, R., Robinson, K., Wylie-Rosett, J., St. Jeor, S., Suttie, J., Tribble, D. L., Bazzarre, T. L. (2000). AHA Dietary Guidelines : Revision 2000: A Statement for Healthcare Professionals From the Nutrition Committee of the American Heart Association. Stroke 31: 2751-2766 [Full text]  
• Krauss, R. M., Eckel, R. H., Howard, B., Appel, L. J., Daniels, S. R., Deckelbaum, R. J., Erdman, J. W. Jr, Kris-Etherton, P., Goldberg, I. J., Kotchen, T. A., Lichtenstein, A. H., Mitch, W. E., Mullis, R., Robinson, K., Wylie-Rosett, J., St. Jeor, S., Suttie, J., Tribble, D. L., Bazzarre, T. L. (2000). AHA Dietary Guidelines : Revision 2000: A Statement for Healthcare Professionals From the Nutrition Committee of the American Heart Association. Circulation 102: 2284-2299 [Full text]  
• Appel, L. J., Miller, E. R. III, Jee, S. H., Stolzenberg-Solomon, R., RD, , Lin, P.-H., Erlinger, T., Nadeau, M. R., Selhub, J. (2000). Effect of Dietary Patterns on Serum Homocysteine : Results of a Randomized, Controlled Feeding Study. Circulation 102: 852-857 [Abstract] [Full text]  
• Alderson, T. S. J., Ogden, J. (1999). What do mothers feed their children and why?. Health Educ Res 14: 717-727 [Abstract] [Full text]  
• Willett, W. C (1999). Convergence of philosophy and science: the Third International Congress on Vegetarian Nutrition. Am. J. Clin. Nutr. 70: 434S-438 [Abstract] [Full text]  
• Kushi, L. H, Meyer, K. A, Jacobs, D. R Jr (1999). Cereals, legumes, and chronic disease risk reduction: evidence from epidemiologic studies. Am. J. Clin. Nutr. 70: 451S-458 [Abstract] [Full text]  
• Key, T. J, Fraser, G. E, Thorogood, M., Appleby, P. N, Beral, V., Reeves, G., Burr, M. L, Chang-Claude, J., Frentzel-Beyme, R., Kuzma, J. W, Mann, J., McPherson, K. (1999). Mortality in vegetarians and nonvegetarians: detailed findings from a collaborative analysis of 5 prospective studies. Am. J. Clin. Nutr. 70: 516S-524 [Abstract] [Full text]  
• Nieman, D. C (1999). Physical fitness and vegetarian diets: is there a relation?. Am. J. Clin. Nutr. 70: 570S-575 [Abstract] [Full text]  
• Haddad, E. H, Sabate, J., Whitten, C. G (1999). Vegetarian food guide pyramid: a conceptual framework. Am. J. Clin. Nutr. 70: 615S-619 [Abstract] [Full text]  
• Ravin, N. D., Mohandas, K.M., Cummings, J. H., Southgate, D. A.T., Heaton, K. W., Lewis, S. J., Madar, Z., Stark, A., Camire, M. E., Fuchs, C. S., Willett, W. C. (1999). Dietary Fiber and Colorectal Cancer. NEJM 340: 1924-1926 [Full text]  
• de Lorgeril, M., Salen, P., Martin, J.-L., Monjaud, I., Delaye, J., Mamelle, N. (1999). Mediterranean Diet, Traditional Risk Factors, and the Rate of Cardiovascular Complications After Myocardial Infarction : Final Report of the Lyon Diet Heart Study. Circulation 99: 779-785 [Abstract] [Full text]  
• Tjonneland, A., Gronbæk, M., Stripp, C., Overvad, K. (1999). Wine intake and diet in a random sample of 48763 Danish men and women. Am. J. Clin. Nutr. 69: 49-54 [Abstract] [Full text]  
• Nuttall, S.L., Dunne, F., Kendall, M.J., Martin, U. (1999). Age-independent oxidative stress in elderly patients with non-insulin-dependent diabetes mellitus. QJM 92: 33-38 [Abstract] [Full text]  
• Dhahbi, J. M., Mote, P. L., Tillman, J. B., Walford, R. L., Spindler, S. R. (1997). Dietary Energy Tissue-Specifically Regulates Endoplasmic Reticulum Chaperone Gene Expression in the Liver of Mice. J. Nutr. 127: 1758-1764 [Abstract] [Full text]  
• Ness, A R, Powles, J W, Morgan, J. F., Key, T. J A, Appleby, P. N, Thorogood, M., Burr, M. L (1997). Dietary habits and mortality in vegetarians and health conscious people. BMJ 314: 148-148 [Full text]  
• Gillman, M. W (1996). Enjoy your fruits and vegetables. BMJ 313: 765-766 [Full text]  

Rapid Responses:

Read all Rapid Responses

Congratulations

Fruitarian Network
bmj.com, 31 Aug 1999 [Full text]