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The Balance of Health

Claim

Vegetarian and vegan diets are associated with lower cholesterol and around a quarter lower relative risk of ischaemic heart disease.

People eating plant-based diets have fewer heart attacks on average. Trials show these diets lower cholesterol, which supports a causal link.

Last reviewed
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Status
sample

Sample data. The figures and sources on this page are demonstration records showing how evidence will be presented. They are approximate and have not yet been through our review process. Read about how we will verify evidence.

Moderate evidenceHow ratings work

Why this rating: Consistent observational evidence supported by trials on intermediate markers, but no long-term trials of heart attacks themselves, and vegetarians differ in other healthy habits.

Supported by good-quality studies that point the same way, but with gaps: fewer studies, mostly observational data, or some inconsistency.

25% lower relative risk
Lower risk of ischaemic heart disease in vegetarians (relative)Multiple countries, 2017. Source: Dinu et al. (2017). SampleRelative risk from observational cohorts. Absolute differences are smaller and depend on baseline risk.

Explanation

Large cohort studies find lower rates of heart disease in vegetarians. Randomised trials show that switching to a vegetarian diet lowers LDL cholesterol, a known cause of heart disease.

The relative reduction of about 25% translates into a smaller absolute reduction, because most people's baseline risk over a decade is modest.

Limitations
  • Confounding by lifestyle; few studies isolate vegan diets from vegetarian.
Methodology
  • Meta-analysis of cohort studies for disease outcomes; meta-analysis of randomised trials for cholesterol.

Sources for this claim

Each source links to our record of what it found, its limitations and what we used it for, with a link to the original.

  1. 1
    Vegetarian, vegan diets and multiple health outcomes: a systematic review with meta-analysis of observational studies

    Monica Dinu, Rosanna Abbate, Gian Franco Gensini et al. (2017). Critical Reviews in Food Science and Nutrition.

    Meta AnalysisMeta AnalysisModerate evidenceSampleView original ↗
  2. 2
    Effects of vegetarian diets on blood lipids: a systematic review and meta-analysis of randomized controlled trials

    Fenglei Wang, Jusheng Zheng, Bo Yang et al. (2015). Journal of the American Heart Association.

    Meta AnalysisRandomised Controlled TrialModerate evidenceSampleView original ↗