The Health Effects of Vegan and Vegetarian Diets

There seem to be a lot of people who are highly confident that veg*n diets are either very good for human health or very bad for it. Because studies about the health effects of veg*nism often contradict each other, and show different conclusions based on the thing being measured (bone mineral density, BMI, lifespan, etc.), it’s possible to collect a bunch of studies that agree with your view, and then present these as though there is unanimous scientific agreement that veg*nism is awesome/terrible for health.

Nutrition research is often a confusing mess of studies that contradict each other, because nutrition is complicated and hard to run good studies on. RCTs are often infeasible for studying long-term dietary changes. (“Thanks for signing up for our study! Please refrain from eating animal products for the next decade.”) Systematic reviews aren’t perfect by any means, but can help weed out poorer studies and aggregate the results from what’s left. When I first became a vegetarian a few years ago I put together a list of systematic reviews on the topic. Below is an updated list. (Disclaimer: As noted above, nutrition science is hard to do well. A lot of the reviews use observational studies. Apply appropriate amounts of salt.)

Type 2 Diabetes
https://etd.ohiolink.edu/!etd.send_file?accession=ucin1288377444&disposition=inline
Meta analysis on 3 RCTs and 1 crossover controlled trial found that a vegetarian diet helped type 2 diabetes management. The vegetarian diet decreased HbA1C, weight, total cholesterol, and LDL cholesterol significantly more than the control diet. No significant difference in fasting glucose were found.

http://journals.lww.com/ijebh/Abstract/2014/09000/The_effects_of_vegetarian_diets_on_diabetes.22.aspx
Meta-analysis on 6 RCTs. The vegetarian diets had significant benefits when measuring HbA1c and HDL. Found no significant effect on fasting plasma glucose, cholesterol, triglycerides, LDL, and weight. The effectiveness of vegetarian diets were related to their fiber content.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4221319/
Consumption of vegetarian diets is associated with a significant reduction in HbA1c and a non-significant reduction in fasting blood glucose concentration.

http://download.springer.com/static/pdf/195/art%253A10.1007%252Fs00125-009-1481-x.pdf?auth66=1422218783_8d1cf4693c29ad4c51a578f4b67267dd&ext=.pdf
Veg*n diets decrease the risk of developing type 2 diabetes, maybe.

Bone Mineral Density
http://ajcn.nutrition.org/content/90/4/943.full.pdf+html
Veg*n diets are associated with a decrease in bone mineral density, but the effect size is very small. Vegans should be more concerned about bone mineral density than lactoovovegetarians. The effect was only significant for women.

Vitamin and Mineral Deficiencies
http://www.ncbi.nlm.nih.gov/pubmed/23595983
Dietary zinc intakes and serum zinc concentrations are lower in veg*ns.

http://www.ncbi.nlm.nih.gov/pubmed/23298782
Veg*ns are at increased risk for vitamin B12 deficiencies.

Pregnancy
http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.13280/abstract
The research is pretty crappy, but as far as we can tell veg*n diets seem safe for pregnant women, as long as attention is paid to vitamin and mineral intake.

Colorectal Cancer/Colorectal Adenomas
http://www.termedia.pl/Journal/-19/pdf-15186-10
“High-frequency red meat intake is an important factor increasing the risk of colorectal cancer development.”

http://cebp.aacrjournals.org/content/10/5/439.full.pdf+html
The relationship between meat consumption and colorectal cancers is positive, but might be confounded.

http://link.springer.com/article/10.1007/s10552-012-0139-z#page-1
“These results indicate an elevated risk of colorectal adenomas with intake of red and processed meat, but further prospective studies are warranted.”

Also see first study under “Other Cancers” section.

Other Cancers
https://www.duo.uio.no/handle/10852/28677
“More studies are needed, particularly large population-based case-control and cohort studies to confirm some of these findings and for those sites investigated by too few studies to date. However, for some of the most investigated sites, including breast, lung, esophagus, pancreas and stomach, it seems likely that reducing meat consumption will be an important goal in decreasing cancer risk. For colorectal cancer it seems very likely that reducing meat consumption will decrease the risk.”

http://jech.bmj.com/content/65/Suppl_1/A16.1.short
Higher consumption of red meat and processed meat is associated with higher risk of esophageal cancer, while higher consumption of fish intake is associated with lower risk.

Blood Pressure
http://archinte.jamanetwork.com/article.aspx?articleID=1832195
People who follow vegetarian diets have lower blood pressure.

Cholesterol
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0092609
Found no evidence that plasma HDL levels differ in vegetarians and non-vegetarians.

— — —

Conclusions: Someone that is certain that veg*n diets are awesome/terrible for health is overconfident. The research is messy, but it seems likely that veg*n diets have some benefits for things like type 2 diabetes management and decreasing cancer risk. On the flip side, veg*n diets likely increase the risk of vitamin and mineral deficiencies in people who aren’t careful.

Advertisements
This entry was posted in Eloise and tagged , , , , . Bookmark the permalink.

3 Responses to The Health Effects of Vegan and Vegetarian Diets

  1. drethelin says:

    I think a key point most people forget is the importance of macronutrients and vitamins compared to broader classifications like “vegan” “paleo” and whatnot.

    Like

  2. jefftk says:

    I’m surprised not to see anything about effects on the heart, aside from there being no effect on cholesterol, because I see this often in the media. Did you overlook it, are the studies not good, or am I just wrong that people usually think this?

    Like

    • sanerthanlasagna says:

      Yes, I’ve also heard this repeated, but it was harder to find systematic reviews about this than other topics for some reason. Maybe the belief comes from people extrapolating from the “saturated fat causes heart disease” thing? In any case, I took another look for this specifically and found two reviews:

      http://www.ncbi.nlm.nih.gov/pubmed/25149402
      Observational studies. They see evidence of “modest cardiovascular benefits” linked to a vegetarian diet, but only in the studies involving Seventh Day Adventists. Maybe there’s something different about Seventh Day Adventists’ vegetarian diets, or something different in their genetic makeup (seems implausible because there are lots of people entering and leaving the group, I think), or some other confounding issue.

      http://circ.ahajournals.org/content/121/21/2271.short
      “Consumption of processed meats, but not red meats, is associated with higher incidence of coronary heart disease and diabetes mellitus.” So the relevant thing seems to be not how much meat in general, but what kind. There might be issues with confounders again here though.

      Like

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s