Vegetarian diets and incidence of diabetes in the Adventist Health Study-2

Nutr Metab Cardiovasc Dis. 2013 Apr;23(4):292-9. doi: 10.1016/j.numecd.2011.07.004. Epub 2011 Oct 7.

Abstract

Aim: To evaluate the relationship of diet to incident diabetes among non-Black and Black participants in the Adventist Health Study-2.

Methods and results: Participants were 15,200 men and 26,187 women (17.3% Blacks) across the U.S. and Canada who were free of diabetes and who provided demographic, anthropometric, lifestyle and dietary data. Participants were grouped as vegan, lacto ovo vegetarian, pesco vegetarian, semi-vegetarian or non-vegetarian (reference group). A follow-up questionnaire after two years elicited information on the development of diabetes. Cases of diabetes developed in 0.54% of vegans, 1.08% of lacto ovo vegetarians, 1.29% of pesco vegetarians, 0.92% of semi-vegetarians and 2.12% of non-vegetarians. Blacks had an increased risk compared to non-Blacks (odds ratio [OR] 1.364; 95% confidence interval [CI], 1.093-1.702). In multiple logistic regression analysis controlling for age, gender, education, income, television watching, physical activity, sleep, alcohol use, smoking and BMI, vegans (OR 0.381; 95% CI 0.236-0.617), lacto ovo vegetarians (OR 0.618; 95% CI 0.503-0.760) and semi-vegetarians (OR 0.486, 95% CI 0.312-0.755) had a lower risk of diabetes than non-vegetarians. In non-Blacks vegan, lacto ovo and semi-vegetarian diets were protective against diabetes (OR 0.429, 95% CI 0.249-0.740; OR 0.684, 95% CI 0.542-0.862; OR 0.501, 95% CI 0.303-0.827); among Blacks vegan and lacto ovo vegetarian diets were protective (OR 0.304, 95% CI 0.110-0.842; OR 0.472, 95% CI 0.270-0.825). These associations were strengthened when BMI was removed from the analyses.

Conclusion: Vegetarian diets (vegan, lacto ovo, semi-) were associated with a substantial and independent reduction in diabetes incidence. In Blacks the dimension of the protection associated with vegetarian diets was as great as the excess risk associated with Black ethnicity.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • African Americans
  • Aged
  • Asian Americans
  • Canada / epidemiology
  • Chi-Square Distribution
  • Diabetes Mellitus / epidemiology*
  • Diabetes Mellitus / ethnology
  • Diabetes Mellitus / prevention & control*
  • Diet, Vegetarian* / ethnology
  • European Continental Ancestry Group
  • Female
  • Hispanic Americans
  • Humans
  • Incidence
  • Indians, North American
  • Life Style
  • Logistic Models
  • Male
  • Middle Aged
  • Nutritional Status* / ethnology
  • Oceanic Ancestry Group
  • Odds Ratio
  • Prognosis
  • Prospective Studies
  • Protestantism*
  • Risk Assessment
  • Risk Factors
  • Risk Reduction Behavior
  • Surveys and Questionnaires
  • Time Factors
  • United States / epidemiology