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Review
. 2024 Sep 28:20:100868.
doi: 10.1016/j.ajpc.2024.100868. eCollection 2024 Dec.

Vegetarian dietary patterns and cardiovascular risk factors and disease prevention: An umbrella review of systematic reviews

Matthew J Landry  1 , Katelyn E Senkus  2   3 , A Reed Mangels  4 , Nanci S Guest  5 , Roman Pawlak  6 , Sudha Raj  7 , Deepa Handu  8 , Mary Rozga  7
Affiliations
Review

Vegetarian dietary patterns and cardiovascular risk factors and disease prevention: An umbrella review of systematic reviews

Matthew J Landry et al. Am J Prev Cardiol. .

Abstract

Background: Diet significantly influences the risk of developing cardiovascular disease (CVD), the leading cause of death in the United States. As vegetarian dietary patterns are increasingly being included within clinical practice guidelines, there is a need to review the most recent evidence regarding if and how these dietary patterns mitigate CVD risk.

Objective: This umbrella review of systematic reviews compared the relationships between vegetarian, vegan and non-vegetarian dietary patterns and CVD health outcomes and risk factors among presumably healthy adults (≥18 years) in the general population.

Methods: MEDLINE, CINAHL, Cochrane Databases of Systematic Reviews, Food Science Source and SportsDiscus databases were searched for systematic reviews (SRs) published from 2018 until March 2024. Eligible SRs and meta-analyses examined relationships between vegetarian or vegan diets and CVD risk factors and disease outcomes compared to non-vegetarian diets. SRs were screened in duplicate, and SR quality was assessed with AMSTAR2. The overall certainty of evidence (COE) was evaluated using the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) method.

Results: There were 758 articles identified in the databases' search and 21 SRs met inclusion criteria. SRs targeting the general population had primarily observational evidence. Vegetarian, including vegan, dietary patterns were associated with reduced risk for CVD incidence [Relative Risk: 0.85 (0.79, 0.92)] and CVD mortality [Hazard Ratio: 0.92 (0.85, 0.99)] compared to non-vegetarian diets. Vegan dietary patterns were associated with reductions in CVD risk factors including blood pressure [systolic mean difference (95 % CI): -2.56 mmHg (-4.66, -0.445)], low-density lipoprotein cholesterol [-0.49 mmol/l (-0.62, -0.36)], and body mass index [-1.72 kg/m2 (-2.30, -1.16)] compared to non-vegetarian dietary patterns, as well as c-reactive protein concentrations in a novel meta-analysis [-0.55 mg/l (-1.07, -0.03)].

Conclusion: Practitioners can consider recommending vegetarian dietary patterns to reduce cardiometabolic risk factors and risk of CVD incidence and mortality.

Keywords: Cardiovascular diseases; Dietary patterns; Systematic review; Umbrella review; Vegans; Vegetarians.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Mary Rozga reports financial support was provided by Academy of Nutrition and Dietetics. Mary Rozga reports financial support was provided by Academy of Nutrition and Dietetics Foundation. Mary Rozga reports financial support was provided by Academy of Nutrition and Dietetics Vegetarian Nutrition Dietetic Practice Group. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig 1
Fig. 1
PRISMA flow diagram for new systematic reviews which included searches of databases and registers only.
Fig 2
Fig. 2
Summary of findings table demonstrating the relationships between (A) Vegetarian and (B) Vegan diets compared to non-vegetarian diets on outcomes of interest.
Fig 3
Fig. 3
Evidence on the impact of vegetarian dietary patterns for the general population to aid in shared decision-making with clients.
Central Illustration
Central Illustration
Summary of umbrella review examining the impact of vegetarian dietary patterns on cardiovascular risk factors and disease prevention for the general population.
See this image and copyright information in PMC

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