Do Vegetarians Live Longer?

Written by Dr. Steve Chaney on . Posted in Vegetarian Diet

What Are The Health Benefits Of A Vegetarian Diet?

Author: Dr. Stephen Chaney

“Vegetarians don’t live longer, it just seems that way.” Many of you have probably heard that joke, but is it true? Are vegetarians healthier? Do vegetarians live longer? Is meat going to kill you? Let’s take a deep dive into the pros and cons of vegetarianism.

What Is Vegetarianism?

Vegetarianism encompasses a wide range of diets. At one extreme is the vegan diet. Vegans eat only plant derived foods. They don’t eat fish, meat, milk, eggs, or honey. It also goes without saying they eat only whole foods (whole grains, plant proteins, and fruits & vegetables) and avoid things like sodas, sugary foods, junk foods, and convenience foods. The most extreme form of veganism, popularized by such recent movies as “Eating You Alive” and “What the Health,” also eliminates all oils. This keeps fat at <10% of total calories.

do vegetarians live longerTo avoid confusion, I will refer to this as a “very low fat vegan diet.”  I will use the term “vegan diet” to refer to the more common veganism that includes vegetable oils in the diet. The vegan diet is still 100% plant based. It is also still relatively low in fat, generally in the 20-30% range. Since the fat comes from plants, it is predominantly the healthy monounsaturated and polyunsaturated fats.

Lacto-ovo vegetarians add low fat dairy foods and eggs to a plant based diet. The Ornish diet is a modified lacto-ovo vegetarian diet that also eliminates all oils and keeps fat at <10% of calories. Pesco-vegetarians add fish to a plant based diet, and semi-vegetarians add limited amounts of meat to a plant based diet.

Can Vegetarian Diets Reverse Atherosclerosis?

Let me start with studies on the very low fat vegan and Ornish diets. In addition to the diet, both programs emphasize regular exercise and stress reduction practices. Adherents to both plans generally achieve a serum total cholesterol of 150 or less. The Ornish diet and lifestyle program was designed to reduce the risk of cardiovascular disease, and it has been very well studied from that perspective. In studies of patients with severe atherosclerosis (clogged arteries) for periods of up to 5 years, the Ornish program results in a significant reduction in the degree of atherosclerosis (unclogs the arteries), inflammation, cardiac events (heart attack, stroke, etc.), and cardiac deaths (H.S. Dod et al, American Journal of Cardiology, 105: 362-367, 2010 ). vegetarianism good for the heartStudies with the very low fat vegan diet are more limited, but suggest that it also reverses atherosclerosis and reduces cardiac deaths (C.B. Esselstyn et al, Journal of Family Practice, 63: 356-364, 2014 ).

Before moving on to other forms of vegetarianism, let me make the point that these are the only diets that have been shown to actually reverse atherosclerosis. That is a big deal.

 

The Seventh-Day Adventist Studies

Perhaps the largest group of studies on the health effects of vegetarians has been conducted on the Seventh-day Adventist population located in Southern California. Seventh-day Adventists believe that “God calls us to care for our bodies, treating them with the respect a divine creation deserves.” The Adventist church advocates a vegan diet consisting of legumes, whole grains, nuts, fruits, and vegetables. However, it allows personal choice, so a significant number of Adventists choose lacto-ovo vegetarian, pesco-vegetarian, or semi-vegetarian diets.

That diversity has not only allowed studies of the Adventist population to not only compare a vegetarian diet to the standard American diet of the non-Adventist population living in the same area, but also to compare the various forms of vegetarian diets. There are dozens of published studies and several reviews on this topic. I will cite only the most recent review here (L.T. Le  and J. Sabate, Nutrients, 6: 2131-2147, 2014 ), but I will provide a complete list in my upcoming book.

This and other reviews have concluded that vegetarians weigh less, have less inflammation, have lower cholesterol levels and have lower risk of diabetes, heart disease, and hypertension than non-vegetarians. When we compare the various forms of vegetarianism, vegan diets appear to offer somewhat greater protection against obesity, hypertension, diabetes, and cardiovascular mortality than lacto-ovo and semi-vegetarian diets. The health benefits of vegetarian diets also seem to be somewhat greater for men than for women. One might speculate that might be because the average American male has a worse diet than the average American female. So, when men adopt a vegetarian diet, it may represent a greater improvement.

The reviews also looked at the nutritional adequacy of vegetarian diets. Vegetarian diets in general are very rich in antioxidants, most B vitamins, and polyphenols. Nutrients of concern for vegan diets are vitamin B12, vitamin D, calcium, iron, zinc, and long chain omega-3 fatty acids. Of those, vitamin B12 and long-chain omega-3 fatty acids are the ones most likely to require supplementation. Adequate levels of the other nutrients can be achieved by a well-designed vegan diet.

I would add protein to the list. Don’t misunderstand me. It is possible to get adequate protein on a vegetarian diet that includes beans and other legumes as a protein source. However, vegan advocates have been telling people they get all the protein they need from broccoli and other vegetables. That is incredibly bad advice, especially for seniors who are likely to suffer from sarcopenia (age related loss of muscle mass). Broccoli only provides 3 grams of protein per serving. You would need 15 servings to meet the protein RDA for women and almost 19 servings for men. Unfortunately, I often run across seniors who think they are getting all the protein they need from green salads and steamed vegetables. The bad advice from vegan advocates may be condemning them to unnecessary frailty in their old age.

What about the health claims of the low carbohydrate diets? Most of those “health benefits” are inferred from changes in blood parameters that occur over the first few weeks or months someone adopts those diets. There are no long-term data showing that low carbohydrate diets reduce the prevalence of diabetes, heart disease or cancer. Moreover, the few studies that compare low carbohydrate and vegetarian diets suggest the vegetarian diet is superior. For example, a recent study (M. Miller et al, Journal of the American Dietetic Association, 109: 713-717, 2009 ) compared the Atkins diet (the granddaddy of the low carb diets) with the Ornish diet. People on the low-fat Ornish diet had significantly lower LDL-cholesterol, apoB, and C-reactive protein (a marker of inflammation) and had better arterial function than people on the high fat Atkins diet.

Do Vegetarians Live Longer?

What about the original question. Do vegetarians live longer? The answer isn’t clear. The Adventist Health Studies have reported that Adventist men live 6-7 years longer and Adventist women live ~4 years longer than their non-Adventist neighbors. However, the Adventist population may have other characteristics that contribute to their longevity. I will cover that in the section on “Blue Zones” in my upcoming book. In contrast, a very recent Australian study(S. Mihrshahi et al, Preventive Medicine, 97: 1-7, 2017 ) concluded that all-cause mortality was virtually identical for vegetarians and non-vegetarians. However, the authors of this study speculated that vegetarians in Australia have become less healthy in recent years because they are now consuming more high-sugar, processed “vegetarian” foods. Remember what I said about “Big Food Inc.” not being your friend.

What Does This Mean For You?

do vegetarians live longer or notThere are a few simple take-home messages from the research on the various forms of a vegetarian diet:

  • The Ornish diet and the very low fat vegan diet are the only diets shown to reverse atherosclerosis. If you have serious heart disease and would like to minimize your reliance on drugs and surgery, you should consider them. You will, of course, want to let your doctor know what you are doing.
  • Vegetarians are leaner and significantly healthier than non-vegetarians.
  • Vegans are slightly healthier than lacto-ovo and semi-vegetarians, but even vegetarians who include some dairy, eggs & meat in a primarily plant-based diet are much healthier than most Americans.
  • Vegetarians may not live longer, but they do live healthier longer.

There are also several subtle, but equally important, implications from these studies:

  • You can forget the claims you must be a vegan purist to obtain any health benefits from vegetarianism.If you watch movies like “Eating You Alive” or “What the Health”, you are led to believe you will suffer terrible health consequences if you add any dairy, eggs, or meat to a vegan diet. In fact, the evidence for reversing atherosclerosis is stronger for the Ornish diet, which is a lacto-ovo-vegetarian diet, than it is for a pure vegan diet. For several other health outcomes, the vegan diet is slightly more effective, but both lacto-ovo-vegetarian and semi-vegetarian diets are much healthier than the standard American diet.
  • Vegetarian diets are whole food diets.If you start adding in processed and convenience foods, even if they are labeled “vegan,” you are likely to lose all the health benefits of a vegetarian diet.
  • You can forget claims that you get all the protein you need from vegetables like broccoli. That is incredibly bad advice which is likely to condemn seniors to unnecessary frailty in old age.
  • You can forget the claims that you must avoid carbs at all costs. The proponents of the low carb diets will tell you that recommendations to limit fat are based on a lie. They tell you that fat is good for you and carbs will cause you to gain weight, increase inflammation, and increase your risk of diabetes, heart disease, and cancer. You are told to avoid grains and any other foods containing carbohydrate, including some fruits and vegetables. The “danger” of carbohydrates is only true for the refined grains, sugary sodas and junk foods in the standard American diet. Vegetarian diets emphasize whole grains, fruits and vegetables. They are high in carbohydrate and low in fat, and they reduce weight, inflammation, diabetes, heart disease, and some cancers.
  • You can forget most claims of weight loss. Most low carb diets tout rapid initial weight loss. Unfortunately, most of that weight comes back a year or two later. Only vegetarian diets are associated with lower weight over a period of many years.

In summary, a pure vegan diet is probably the healthiest form of vegetarianism, but it is difficult to follow. Vegetarian diets that are primarily plant based, but contain small amounts of dairy, eggs, or meat are also very healthy, and may be easier for the average American to follow.

 

The Bottom Line

 

Vegetarianism encompasses a wide range of diets. The standard vegan diet is entirely plant-based. There is a very low fat version of the vegan diet that also eliminates all oils. Lacto-ovo-vegetarian diets include some dairy and eggs. Semi-vegetarian diets include some meat. The Ornish diet is a very low fat version of the lacto-ovo-vegetarian diet.

There are a few simple take-home messages from the research on the various forms of a vegetarian diet:

  • The Ornish diet and the very low fat vegan diet are the only diets shown to reverse atherosclerosis.
  • Vegetarians are leaner and significantly healthier than non-vegetarians.
  • Vegans are slightly healthier than lacto-ovo– and semi-vegetarians, but even vegetarians who include some dairy, eggs & meat in a primarily plant-based diet are much healthier than most Americans.
  • In a head to head comparison, the Ornish diet was significantly healthier than the Atkins diet.
  • Vegetarians may not live longer, but they do live healthier longer.

There are also several subtle, but equally important, implications from these studies:

  • You can forget the claims you must be a vegan purist to obtain any health benefits from vegetarianism. Primarily plant-based diets with small amounts of dairy, eggs or meat are also very healthy.
  • Vegetarian diets are whole food diets. If you start adding in processed and convenience foods, even if they are labeled “vegan,” you are likely to lose all the health benefits of a vegetarian diet.
  • You can forget claims that you get all the protein you need from vegetables like broccoli. That is incredibly bad advice which is likely to condemn seniors to unnecessary frailty in old age.
  • You can forget the claims that you must avoid carbs at all costs. That is only true for the refined grains, sugary sodas and junk foods in the standard American diet. Vegetarian diets are high in carbohydrate, low in fat, and  very healthy.
  • You can forget most claims of weight loss. Only vegetarian diets are associated with lower weight over a period of many years.

In summary, a pure vegan diet is probably the healthiest form of vegetarianism, but it is difficult to follow. Vegetarian diets that are primarily plant based, but contain small amounts of dairy, eggs, or meat are also very healthy, and may be easier for the average American to follow.

For more details, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Comments (6)

  • eroca

    |

    What a refreshing common sense overview. I do not hesitate to share this REAL NEWS. Thanks, Dr Chaney, I appreciate your wisdom.

    Can you imagine living a world not poisoned and also having the great innovations to manage bringing up our vibration?

    Keep on keeping on, thank you.

    Reply

  • Caroline

    |

    Having studied Oriental Medicine with several, I found them sick more, and their teeth, lacking calcium,turning grey to black. Some were thin but others were FAT. What bothered me was treating their babies and small children on either a vegan or vegetarian diet. The plant protein does not have the same health effect on the body. Even Dr. Scala, a vegan, ate a hamburger patty monthly simply because red meat does many health needs in the body, especially getting calcium to the bones. In all my years as a health consultant, I would never ever recommend a vegan/vegetarian diet as too risky with good vibrant health. They do tend to eat more sweets and way too much fruit which is hard on the liver, AND they never want to hear about good nutrition and I think this means they will never (and many have not) make great Chinese medicine whether at Master’s level and definitely NOT at the doctoral level and we are obliged to talk nutrition in CA as acupuncturists but many avoid talking nutrition. Sure glad I studied nutrition because at 80 and my spouse at 85 we are in great condition due to Shaklee nutrients and eating what our bodies need and want. AND we have good teeth, complexion, energy and don’t look our ages (vanity is good!) and I started Youth just less than 3 weeks ago due to product delays but am noticing some good happenings already.

    Reply

  • Caroline

    |

    Sad to say but the Adventists I knew for years both died of cancer and not pretty deaths either. The vegans I studied with wound up with darken teeth and one with absolutely black teeth, gray hair in their 30’s and constantly down with something. Sorry, but the body does need red meat for many purposes. We grow and eat a lot veggies along with good proteins and thus far in our “older years” have our teeth, I have very little gray hair, and we have energy! Those vegans I knew had been getting FAT and not a lot of energy. We have choices for sure, but I will stick to a diet that gives real health including some flesh and not just all veggies which ruin the yin/yang of soil in which to grow them healthily. We use no chemicals on our garden nor trees either.

    Reply

    • Dr. Steve Chaney

      |

      Dear Caroline, One can always pick individual stories to “prove” or “disprove” any diet. What I report on is clinical studies. They provide evidence for what diet works best for most people.. If you have been following “Health Tips From the Professor” for a while, you would know that I also recommend primarily plant-based diets that include some animal protein, like the Mediterranean or DASH diets.
      Dr. Chaney

      Reply

  • Diana

    |

    I enjoyed reading this article. I am part of the Vegan Living Group here on Long Island. Most “Pure Vegans” I know have become so because of animal Advocacy-To save the animals, the rainforest and other Eco environmental factors. We know that Factory farming and even Grass fed smaller farming are ruining the environment. (Cowspiracy is a film that shows us the ills of factory farming.) A lot of these consciencious people eat oreos and tofudogs and other processed vegan foods. So I dont like the label Vegan because it doesnt necessarily mean healthy . I prefer the term Whole Foods Plant Based inspired by Dr T Colin Campbell and Dr. Essylstein featured in films such as Forks over knives and Plant Pure Nation. Although I myself am not 100% consistant, when I am-I feel amazing. Thank You.

    Reply

    • Dr. Steve Chaney

      |

      Dear Diana,
      You are right. Any diet can be corrupted if we start eating processed foods and goodies. Whole unprocessed, foods are the cornerstone of any healthy diet.
      Dr. Chaney

      Reply

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Latest Article

Can Plant-based Diets Be Unhealthy?

Posted September 10, 2019 by Dr. Steve Chaney

Do Plant-Based Diets Reduce Heart Disease Deaths?

Author: Dr. Stephen Chaney

 

plant-based diets vegetablesPlant-based diets have become the “Golden Boys” of the diet world. They are the diets most often recommended by knowledgeable health and nutrition professionals. I’m not talking about all the “Dr. Strangeloves” who pitch weird diets in books and the internet. I am talking legitimate experts who have spent their life studying the impact of nutrition on our health.

Certainly, there is an overwhelming body of evidence supporting the claim that plant-based diets are healthy. Going on a plant-based diet can help you lower blood pressure, inflammation, cholesterol and triglycerides. People who consume a plant-based diet for a lifetime weigh less and have decreased risk of heart disease, diabetes, and cancer.

But, can a plant-based diet be unhealthy? Some people consider a plant-based diet to simply be the absence of meat and other animal foods. Is just replacing animal foods with plant-based foods enough to make a diet healthy?

Maybe not. After all, sugar and white flour are plant-based food ingredients. Fake meats of all kinds abound in our grocery stores. Some are very wholesome, but others are little more than vegetarian junk food. If you replace animal foods with plant-based sweets, desserts, and junk food, is your diet really healthier?

While the answer to that question seems obvious, very few studies have asked that question. Most studies on the benefits of plant-based diets have compared population groups that eat a strictly plant-based diet (Seventh-Day Adventists, vegans, or vegetarians) with the general public. They have not looked at variations in plant food consumption within the general public. Nor have they compared people who consume healthy and unhealthy plant foods.

This study (H Kim et al, Journal of the American Heart Association, 8:e012865, 2019) was designed to fill that void.

 

How Was The Study Done?

plant-based diets studyThis study used data collected from 12,168 middle aged adults in the ARIC (Atherosclerosis Risk in Communities) study between 1987 and 2016.

The participant’s usual intake of foods and beverages was assessed by trained interviewers using a food frequency questionnaire at the time of entry into the study and again 6 years later.

Participants were asked to indicate the frequency with which they consumed 66 foods and beverages of a defined serving size in the previous year. Visual guides were provided to help participants estimate portion sizes.

The participant’s adherence to a plant-based diet was assessed using four different well-established plant-based diet scores. For the sake of simplicity, I will include 3 of them in this review.

  • The PDI (Plant-Based Diet Index) categorizes foods as either plant foods or animal foods. A high PDI score means that the participant’s diet contains more plant foods than animal foods. A low PDI score means the participant’s diet contains more animal foods than plant foods.
  • The hPDI (healthy plant-based diet index) is based on the PDI but emphasizes “healthy” plant foods. A high hPDI score means that the participant’s diet is high in healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, coffee and tea) and low in animal foods.
  • The uPDI (unhealthy plant-based diet index) is based on the PDI but emphasizes “unhealthy” plant foods. A high uPDI score means that the participant’s diet is high in unhealthy plant foods (refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts) and low in animal foods.

For statistical analysis the scores from the various plant-based diet indices were divided into 5 equal groups. In each case, the group with the highest score consumed the most plant foods and least animal foods. The group with the lowest score consumed the least plant foods and the most animal foods.

The health outcomes measured in this study were heart disease events, heart disease deaths, and all-cause deaths. Again, for the sake of simplicity, I will only include 2 of these outcomes (heart disease deaths and all-cause deaths) in this review. The data on deaths were obtained from state death records and the National Death Index. (Yes, your personal information is available on the web even after you die.)

 

Do Plant-Based Diets Reduce Heart Disease Deaths?

plant-based diets reduce heart deathsThe participants in this study were followed for an average of 25 years.

The investigators looked at heart disease deaths over the 25 years and compared people with the highest intake of plant foods to people with the highest intake of red meat and other animal foods. The results were:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, coffee and tea) had a 19-32% lower risk of dying from heart disease than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods (refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts) had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

When the investigators looked at all-cause deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had an 11-25% lower risk of dying from any cause than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

What Else Did The Study Show?

The investigators made a couple of other interesting observations:

  • The association of the overall diet with heart disease and all-cause deaths was stronger than the association of individual food components. This underscores the importance of looking at the effect of the whole diet on health outcomes rather than the “magic” foods you hear about on Dr. Strangelove’s Health Blog.
  • Diets with the highest amount of healthy plant foods were associated with higher intake of carbohydrates, plant protein, fiber, and micronutrients, including potassium, magnesium, iron, vitamin A, vitamin C, folate, and lower intake of saturated fat and cholesterol.
  • Diets with the highest amount of unhealthy plant foods were associated with higher intake of calories and carbohydrates and lower intake of fiber and micronutrients.

The last two observations may help explain some of the health benefits of plant-based diets.

 

Can Plant-Based Diets Be Unhealthy?

plant-based diets unhealthy cookiesNow, let’s return to the question I asked at the beginning of this article: “Can plant-based diets be unhealthy?” Although some previous studies have suggested that unhealthy plant-based diets might increase the risk of heart disease, this study did not show that.

What this study did show was that an unhealthy plant-based diet was no better for you than a diet containing lots of red meat and other animal foods.

If this were the only conclusion from this study, it might be considered a neutral result. However, this result clearly contrasts with the data from this study and many others showing that both plant-based diets in general and healthy plant-based diets reduce the risk of heart disease deaths and all-cause deaths compared to animal-based diets.

The main message from this study is clear.

  • Replacing red meat and other animal foods with plant foods can be a healthier choice, but only if they are whole, minimally processed plant foods like whole grains, fruits, vegetables, nuts, legumes, coffee and tea.
  • If the plant foods are refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts, all bets are off. You may be just as unhealthy as if you kept eating a diet high in red meat and other animal foods.

There is one other subtle message from this study. This study did not compare vegans with the general public. Everyone in the study was the general public. Nobody in the study was consuming a 100% plant-based diet.

For example:

  • The group with the highest intake of plant foods consumed 9 servings per day of plant foods and 3.6 servings per day of animal foods.
  • The group with the lowest intake of plant foods consumed 5.4 servings per day of plant foods and 5.6 servings per day of animal foods.

In other words, you don’t need to be a vegan purist to experience health benefits from adding more whole, minimally processed plant foods to your diet.

 

The Bottom Line

A recent study analyzed the effect of consuming plant foods on heart disease deaths and all-cause deaths over a 25-year period.

When the investigators looked at heart disease deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had a 19-32% lower risk of dying from heart disease than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

When the investigators looked at all-cause deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had an 11-25% lower risk of dying from any cause than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

The main message from this study is clear.

  • Replacing red meat and other animal foods with plant foods can be a healthier choice, but only if they are whole, minimally processed plant foods like whole grains, fruits, vegetables, nuts, legumes, coffee and tea.
  • If the plant foods are refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts, all bets are off. You may be just as unhealthy as if you kept eating a diet high in red meat and other animal foods.

A more subtle message from the study is that you don’t need to be a vegan purist to experience health benefits from adding more whole, minimally processed plant foods to your diet. The people in this study were not following some special diet. The only difference was that some of the people in this study ate more plant foods and others more animal foods.

For more details on the study, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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