Evidence-Based Nutrient Recommendations

Stroke Rates of Vegetarian Health Professionals

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by Jack Norris, RD

In 2019, EPIC-Oxford released a report finding a lower rate of ischemic heart disease among vegetarians (HR 0.78, CI 0.70-0.87), but a higher rate of stroke (HR 1.20, CI 1.02-1.40). The higher rate of stroke was mostly due to hemorrhagic stroke (Tong, 2019).

A 2020 study combined two Taiwanese prospective cohorts and found that vegetarians had a lower risk of both ischemic and hemorrhagic stroke (Chiu, 2020).

A new study has been released also finding that vegetarians don’t have a higher risk of stroke (Baden, 2021). The study combined data from women in the Nurses Health Study (1984-2016) and Nurses Health Study II (1991-2012), and from men in the Health Professionals Follow-Up Study (1986-2012). Participants were resurveyed about their diet and other variables every 2 years; the number of vegetarians increased as the study progressed. Vegetarians were defined as reporting meat and/or fish intake of 0 or < 1 time per month.

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Vegetarians had an insignificant trend toward a lower rate of stroke that was ameliorated with the fully adjusted model. It seems plausible that the fully adjusted model was over-adjusted, wiping out any negative impacts of eating meat.

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The subtype of stroke wasn’t analyzed due to the small number of cases among vegetarians. Personal correspondence with the lead author confirmed that the adjustments were based on the most recent biennial updated information for these variables.

More information on the EPIC-Oxford and Taiwanese vegetarians study can be found in our article, Vegetarian Cohorts.

Abbreviations: CI – 95% confidence interval • HR – hazard ratio

References

Baden MY, Shan Z, Wang F, Li Y, Manson JE, Rimm EB, Willett WC, Hu FB, Rexrode KM. Quality of Plant-based Diet and Risk of Total, Ischemic, and Hemorrhagic Stroke. Neurology. 2021 Mar 10:10.1212/WNL.0000000000011713

Chiu THT, Chang HR, Wang LY, Chang CC, Lin MN, Lin CL. Vegetarian diet and incidence of total, ischemic, and hemorrhagic stroke in 2 cohorts in Taiwan.Neurology. 2020 Mar 17;94(11):e1112-e1121.

Tong TYN, Appleby PN, Bradbury KE, et al. Risks of ischaemic heart disease and stroke in meat eaters, fish eaters, and vegetarians over 18 years of follow-up: results from the prospective EPIC-Oxford study. BMJ. 2019 Sep 4;366:l4897.

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