Vegetarian diet, Seventh Day Adventists and risk of cardiovascular mortality: A systematic review and meta-analysis
Vegetarian diet, Seventh Day Adventists and risk of cardiovascular mortality: A systematic review and meta-analysis
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DOI：
10.1016/j.ijcard.2014.07.080
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发表时间：
2014-10-20
影响因子：
3.5
通讯作者：
Loke, Yoon K.
中科院分区：
文献类型：
--
作者：
Kwok, Chun Shing;Umar, Saadia;Loke, Yoon K.
背景：饮食干预是心血管危险因素管理的重要组成部分，尽管其对心血管风险和死亡率的影响尚不确定。我们研究了素食对心血管风险和死亡率的影响。方法：我们在MEDLINE和EMBASE中检索比较研究，以评估素食与非素食对照者或一般人群的临床结果。相关研究采用随机效应meta分析对死亡、缺血性心脏病（IHD）和脑血管疾病的风险进行汇总。我们根据特定的队列类型（如基督复临安息日会[SDA]）和性别进行了亚组分析。结果：8项研究符合纳入标准，共有183321名受试者（n = 183321）。所有的meta分析都存在显著的异质性，尤其是SDA的研究。在所有情况下，我们发现与非SDA研究相比，SDA研究显示出更大的效应大小：死亡（RR 0.68 95% CI 0.45-1.02 vs RR 1.04 95% CI 0.98-1.10），缺血性心脏病（IHD） （RR 0.60 95% CI 0.43-0.80 vs RR 0.84 95% CI 0.74-0.96）和脑血管疾病（RR 071 95% CI 0.41-1.20 vs RR 1.05 95% CI 0.89-124）。性别特异性分析表明，IHD在两性中均显著降低，但死亡和脑血管疾病的风险仅在男性中显著降低。结论：来自观察性研究的数据表明，素食对心血管有一定的益处，但没有明显降低与素食相关的总死亡率。这一益处的证据主要来自SDA的研究，而素食对其他人群的影响仍未得到证实。2014爱思唯尔爱尔兰有限公司版权所有。
Background: Dietary interventions are an important component of cardiovascular risk factor management although their impact on cardiovascular risk and mortality remains uncertain. We have studied influence of a vegetarian diet on cardiovascular risk and mortality.Methods: We searched MEDLINE and EMBASE for comparative studies that evaluated Clinical outcomes associated with vegetarian diet as compared to non vegetarian controls or the general population. Relevant studies were pooled using random effects meta analysis for risk of death, ischaemic heart disease (IHD) and cerebrovascular disease. We conducted subgroup analysis according to specific type of cohort (e g. Seventh Day Adventist [SDA]) and gender.Results: Eight studies met the inclusion criteria with 183,321 participants (n = 183,321). There was significant heterogeneity in all the meta analyses, particularly evident with the studies of SDA. In all instances, we found that SDA studies showed greater effect size as compared to non-SDA studies: death (RR 0.68 95% CI 0.45-1.02 vs RR 1.04 95% CI 0.98-1.10), ischaemic heart disease (IHD) (RR 0.60 95% CI 0.43-0.80 vs RR 0.84 95% CI 0.74-0.96) and cerebrovascular disease (RR 071 95% CI 0.41-1.20 vs RR 1.05 95% CI 0.89-124). Sex specific analyses showed that IHD was significantly reduced in both genders but risk of death and cerebrovascular disease was only significantly reduced in men.Conciusions: Data from observational studies indicates that there is modest cardiovascular benefit, but no clear reduction in overall mortality associated with a vegetarian diet. This evidence of benefit is driven mainly by studies in SDA, whereas the effect of vegetarian diet in other cohorts remains unproven. (C) 2014 Elsevier Ireland Ltd. All rights reserved.