The Association between a Vegetarian Diet and Cardiovascular Disease (CVD) Risk Factors in India: The Indian Migration Study

Abstract

BackgroundStudies in the West have shown lower cardiovascular disease (CVD) risk among people taking a vegetarian diet, but these findings may be confounded and only a minority selects these diets. We evaluated the association between vegetarian diets (chosen by 35%) and CVD risk factors across four regions of India.MethodsStudy participants included urban migrants, their rural siblings and urban residents, of the Indian Migration Study from Lucknow, Nagpur, Hyderabad and Bangalore (n = 6555, mean age-40.9 yrs). Information on diet (validated interviewer-administered semi-quantitative food frequency questionnaire), tobacco, alcohol, physical history, medical history, as well as blood pressure, fasting blood and anthropometric measurements were collected. Vegetarians ate no eggs, fish, poultry or meat. Using robust standard error multivariate linear regression models, we investigated the association of vegetarian diets with blood cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL), triglycerides, fasting blood glucose (FBG), systolic (SBP) and diastolic blood pressure (DBP).ResultsVegetarians (32.8% of the study population) did not differ from non-vegetarians with respect to age, use of smokeless tobacco, body mass index, and prevalence of diabetes or hypertension. Vegetarians had a higher standard of living and were less likely to smoke, drink alcohol (p<0.0001) and were less physically active (p = 0.04). In multivariate analysis, vegetarians had lower levels of total cholesterol (β = −0.1 mmol/L (95% CI: −0.03 to −0.2), p = 0.006), triglycerides (β = −0.05 mmol/L (95% CI: −0.007 to −0.01), p = 0.02), LDL (β = −0.06 mmol/L (95% CI: −0.005 to −0.1), p = 0.03) and lower DBP (β = −0.7 mmHg (95% CI: −1.2 to −0.07), p = 0.02). Vegetarians also had decreases in SBP (β = −0.9 mmHg (95% CI: −1.9 to 0.08), p = 0.07) and FBG level (β = −0.07 mmol/L (95% CI: −0.2 to 0.01), p = 0.09) when compared to non-vegetarians.ConclusionWe found beneficial association of vegetarian diet with cardiovascular risk factors compared to non-vegetarian diet.

A comparative study of metabolic profile, anthropometric parameters among vegetarians and non-vegetarians- do vegetarian diet have a cardio protective role?

“…15 In Indian Migration Study, a study of rural and urban adult population, mean aged 40+ years, across four regions and 18 states of India, it was found that vegetarians had lower levels of lipids and blood pressure supporting the hypothesis that a vegetarian diet has potential cardiovascular health benefits. 4 These findings are in par with our study were total cholesterol levels were lower among vegetarians.…”

“…4 There has been a rapid increase in coronary artery disease (CAD) in most Asian countries; however, there is no consensus of opinion on diet and lifestyle guidelines and desirable levels of risk factors for prevention of CAD in these countries. 5 The proportion of deaths due to CVDs in Asians may be about 15% and in India CVD accounts for 53.5% of mortality.…”

“…5 The proportion of deaths due to CVDs in Asians may be about 15% and in India CVD accounts for 53.5% of mortality. 1,4 A constellation of modifiable (smoking, hypertension, diabetes mellitus, anthropometric parameters, metabolic parameters like lipid profile) and non-modifiable factors (age, gender) interact together to substantially increase the risk of CVD.…”

“…7 Also, evidence is present to show that vegetarian diet plays significant role in vascular protection and consumption of vegetarian diet reduces the risk of CVD. 4,8 Vegetarian diet is known to lower serum cholesterol and low density lipoprotein (LDL) levels and hence reduces risk of atherosclerosis.…”

Recommended Dietary Pattern to Achieve Adherence to the American Heart Association/American College of Cardiology (AHA/ACC) Guidelines: A Scientific Statement From the American Heart Association

“…[37][38][39] Some trials have reported lowering of high-density lipoprotein cholesterol concentrations and the ratio of total cholesterol to high-density lipoprotein. 40 Vegetarian dietary patterns are characterized as predominantly including fruits, vegetables, whole grains, and nuts, similar to the DASH diet.…”