Public Health Nutrition

Research Papers

Vegetarian diets and cardiovascular risk factors in black members of the Adventist Health Study-2

Gary Frasera1 c1, Sozina Katulia1, Ramtin Anousheha2, Synnove Knutsena1, Patti Herringa3 and Jing Fana4

a1 Department of Biostatics, Loma Linda University, 24951 North Circle Drive, NH 2005, Loma Linda, CA 92350, USA

a2 Internal Medicine, VA Loma Linda Healthcare System, Loma Linda, CA, USA

a3 Health Promotion and Education, Loma Linda University, Loma Linda, CA, USA

a4 Adventist Health Study, Loma Linda University, Loma Linda, CA, USA


Objective To compare cardiovascular risk factors between vegetarians and non-vegetarians in black individuals living in the USA.

Design A cross-sectional analysis of a sub-set of 592 black women and men enrolled in the Adventist Health Study-2 (AHS-2) cohort of Seventh-day Adventists.

Setting Members of the AHS-2 cohort, who lived in all states of the USA and provinces of Canada.

Subjects Black/African-American members of two sub-studies of AHS-2 where blood and physiological measurements were obtained.

Results Of these women and men, 25 % were either vegan or lacto-ovo-vegetarians (labelled ‘vegetarian/vegans’), 13 % were pesco-vegetarian and 62 % were non-vegetarian. Compared with non-vegetarians, the vegetarian/vegans had odds ratios for hypertension, diabetes, high blood total cholesterol and high blood LDL-cholesterol of 0·56 (95 % CI 0·36, 0·87), 0·48 (95 % CI 0·24, 0·98), 0·42 (95 % CI 0·27, 0·65) and 0·54 (95 % CI 0·33, 0·89), respectively, when adjusted for age, gender, education, physical activity and sub-study. Corresponding odds ratios for obesity in vegetarian/vegans and pesco-vegetarians, compared with non-vegetarians, were 0·43 (95 % CI 0·28, 0·67) and 0·47 (95 % CI 0·27, 0·81), respectively; and for abdominal obesity 0·54 (95 % CI 0·36, 0·82) and 0·50 (95 % CI 0·29, 0·84), respectively. Results for pesco-vegetarians did not differ significantly from those of non-vegetarians for other variables. Further adjustment for BMI suggested that BMI acts as an intermediary variable between diet and both hypertension and diabetes.

Conclusions As with non-blacks, these results suggest that there are sizeable advantages to a vegetarian diet in black individuals also, although a cross-sectional analysis cannot conclusively establish cause.

(Received April 08 2013)

(Revised November 18 2013)

(Accepted November 21 2013)

(Online publication March 17 2014)


  • Vegetarian diet;
  • Cardiovascular risks;
  • Blacks;
  • Adventists


c1 Corresponding author: Email