Letters

Dietary habits and mortality in vegetarians and health conscious people

BMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7074.148 (Published 11 January 1997) Cite this as: BMJ 1997;314:148

Several uncertainties still exist

  1. A R Ness, Wellcome training fellow in epidemiologya,
  2. J W Powles, University lecturer in public health medicinea
  1. a Department of Community Medicine, University of Cambridge, Cambridge CB2 2SR
  2. b Department of Mental Health Sciences, St George's Hospital Medical School, London SW17 0RE
  3. c Imperial Cancer Research Fund, Cancer Epidemiology Unit, Radcliffe Infirmary, Oxford OX2 6HE
  4. d Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London WC1E 7HT
  5. e Centre for Applied Public Health Medicine, University of Wales College of Medicine, Cardiff CF1 3NW

    Editor–We believe that some of the issues raised in Timothy J A Key and colleagues' study of dietary habits and mortality in 11 000 vegetarians and health conscious people1 and in the accompanying commentary by Matthew W Gillman2 deserve more attention.

    Firstly, the published literature on fruit and vegetables and cardiovascular disease is more extensive than Gillman suggests. When we reviewed the literature we located 10 ecological studies, three case-control studies, and 16 cohort studies reporting measures of association between intake of fruit and vegetables (or intake of nutrients mainly obtained from fruit and vegetables) and coronary heart disease, and we located five ecological studies, one case-control study, and eight cohort studies for stroke.3

    Secondly, other cohorts at low risk have failed to show a protective association between intake of fruit and vegetables and cardiovascular disease (for example, a study of 26 473 Seventh Day Adventists followed up for six years showed null findings for fruit).4

    Thirdly, while existing knowledge may …

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