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

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 regar...

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Main Authors: Matthew J. Landry, Katelyn E. Senkus, A Reed Mangels, Nanci S. Guest, Roman Pawlak, Sudha Raj, Deepa Handu, Mary Rozga
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:American Journal of Preventive Cardiology
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666667724002368
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author Matthew J. Landry
Katelyn E. Senkus
A Reed Mangels
Nanci S. Guest
Roman Pawlak
Sudha Raj
Deepa Handu
Mary Rozga
author_facet Matthew J. Landry
Katelyn E. Senkus
A Reed Mangels
Nanci S. Guest
Roman Pawlak
Sudha Raj
Deepa Handu
Mary Rozga
author_sort Matthew J. Landry
collection DOAJ
description 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.
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spelling doaj-art-a2935f0f2d20405ea74b7b769940fce12024-12-11T05:57:42ZengElsevierAmerican Journal of Preventive Cardiology2666-66772024-12-0120100868Vegetarian dietary patterns and cardiovascular risk factors and disease prevention: An umbrella review of systematic reviewsMatthew J. Landry0Katelyn E. Senkus1A Reed Mangels2Nanci S. Guest3Roman Pawlak4Sudha Raj5Deepa Handu6Mary Rozga7Department of Population Health and Disease Prevention, University of California, Program in Public Health, 856 Health Sciences Rd., Irvine, CA 92697, United StatesDepartment of Human Nutrition, The University of Alabama, Tuscaloosa, AL, United States; USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030, United StatesRetired, 190 Walnut Avenue, Santa Cruz, CA 95060, United StatesDepartment of Nutritional Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, CanadaDepartment of Nutrition Science, East Carolina University, Greenville, NC 27858, United StatesDepartment of Nutrition and Food Studies, David B Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY 13214, United StatesEvidence Analysis Center, Academy of Nutrition and Dietetics, 120 S. Riverside Plaza, Suite 2190, Chicago, IL 60606-6995, United StatesDepartment of Nutrition and Food Studies, David B Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY 13214, United States; Corresponding author.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.http://www.sciencedirect.com/science/article/pii/S2666667724002368VegetariansVegansDietary patternsCardiovascular diseasesSystematic reviewUmbrella review
spellingShingle Matthew J. Landry
Katelyn E. Senkus
A Reed Mangels
Nanci S. Guest
Roman Pawlak
Sudha Raj
Deepa Handu
Mary Rozga
Vegetarian dietary patterns and cardiovascular risk factors and disease prevention: An umbrella review of systematic reviews
American Journal of Preventive Cardiology
Vegetarians
Vegans
Dietary patterns
Cardiovascular diseases
Systematic review
Umbrella review
title Vegetarian dietary patterns and cardiovascular risk factors and disease prevention: An umbrella review of systematic reviews
title_full Vegetarian dietary patterns and cardiovascular risk factors and disease prevention: An umbrella review of systematic reviews
title_fullStr Vegetarian dietary patterns and cardiovascular risk factors and disease prevention: An umbrella review of systematic reviews
title_full_unstemmed Vegetarian dietary patterns and cardiovascular risk factors and disease prevention: An umbrella review of systematic reviews
title_short Vegetarian dietary patterns and cardiovascular risk factors and disease prevention: An umbrella review of systematic reviews
title_sort vegetarian dietary patterns and cardiovascular risk factors and disease prevention an umbrella review of systematic reviews
topic Vegetarians
Vegans
Dietary patterns
Cardiovascular diseases
Systematic review
Umbrella review
url http://www.sciencedirect.com/science/article/pii/S2666667724002368
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