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  • Original Article
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Total cardiovascular risk profile of Taiwanese vegetarians

European Journal of Clinical Nutrition volume 62, pages 138–144 (2008)Cite this article

Abstract

Background:

Although the health benefits of vegetarian diets have been well documented among Western population, there are geographic differences of vegetarian diets and the health benefits of the Taiwanese vegetarian diet have not been studied extensively. In addition to conventional risk factors, homocysteine and high-sensitivity C-reactive protein (hs-CRP) levels have been found to predict first atherothrombotic events. We undertook this study to examine the total risk profile of Taiwanese vegetarians.

Methods:

A total of 198 healthy subjects (99 vegetarians and 99 omnivores) were recruited. Fasting blood samples were analyzed for glucose, cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), white blood cell count, hs-CRP and homocysteine.

Results:

There was no significant difference in age, body mass index, blood glucose, white blood cell count, triglyceride and HDL-C between the two groups. The vegetarian group had significantly more females (65.7 vs 46.5%); lower body weight (58.66±11.13 vs 62.88±12.24 kg); shorter height (159.14±7.88 vs 162.53 ±8.14 cm); lower total cholesterol (184.74±33.23 vs 202.01±41.05 mg/dl); and lower LDL-C (119.63±31.59 vs 135.89±39.50 mg/dl). Hs-CRP was significantly lower (0.14±0.23 vs 0.23±0.44 mg/dl, P=0.025), whereas homocysteine was significantly higher (10.97±6.69 vs 8.44±2.50 μmol/l, P=0.001) in vegetarians than omnivores.

Conclusions:

Taiwanese vegetarians have lower total cholesterol, LDL-C and hs-CRP levels, and higher homocysteine levels than omnivores. Owing to different predictive value of each risk factor, the Taiwanese vegetarians had a better cardiovascular risk profile than omnivores. Whether the Taiwanese vegetarian diet should be supplemented with vitamin B12 to lower serum homocysteine level remains to be addressed.

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References

  • Albert MA, Glynn RJ, Ridker PM (2003). Plasma concentration of C-reactive protein and the calculated Framingham coronary heart disease risk score. Circulation 108, 161–165.

    Article  CAS  Google Scholar 

  • Benetos A, Thomas F, Bean KE, Guize L (2003). Why cardiovascular mortality is higher in treated hypertensives versus subjects of the same age, in the general population. J Hypertens 21, 1635–1640.

    Article  CAS  Google Scholar 

  • Chang JB, Chu NF, Shen MH, Wu DM, Liang YH, Shieh SM (2003). Determinants and distributions of plasma total homocysteine concentrations among school children in Taiwan. Eur J Epidemiol 18, 33–38.

    Article  CAS  Google Scholar 

  • Clarke R, Stansbie D (2001). Assessment of homocysteine as a cardiovascular risk factor in clinical practice. Ann Clin Biochem 38, 624–632.

    Article  CAS  Google Scholar 

  • Danesh J, Collins R, Appleby P, Peto R (1998). Association of fibrinogen, C-reactive protein, albumin, or leukocyte count with coronary heart disease. JAMA 279, 1477–1482.

    Article  CAS  Google Scholar 

  • Fakhrzadeh H, Ghotbi S, Pourebrahim R, Nouri M, Heshmat R, Bandarian F et al. (2006). Total plasma homocysteine, folate, and vitamin B12 status in healthy Iranian adults: the Tehran homocysteine survey (2003–2004)/a cross-sectional population based study. BMC Public Health 6, 29.

    Article  Google Scholar 

  • Harpel PC (1997). Homocysteine, atherogenesis and thrombosis. Fibrinolysis Proteol 11, S77–S80.

    Article  Google Scholar 

  • Herrmann W, Schorr H, Oberid R, Geisel J (2003). Vitamin B-12 status, particularly holotranscobalamin II and methylmalonic acid concentrations, and hyperhomocysteinemia in vegetarians. Am J Clin Nutr 78, 131–136.

    Article  CAS  Google Scholar 

  • Huang YC, Chang SJ, Chiu YT, Chang HH, Cheng CH (2003). The status of plasma homocysteine and related B-vitamins in healthy young vegetarians and nonvegetarians. Eur J Nutr 42, 84–90.

    Article  CAS  Google Scholar 

  • Hung CJ, Huang PC, Lu SC, Li YH, Huang HB, Lin BF et al. (2002). Plasma homocysteine levels in Taiwanese vegetarians are higher than those of omnivores. J Nutr 132, 152–158.

    Article  CAS  Google Scholar 

  • Jialal I, Devaraj S, Venugopal SK (2004). C-reactive protein: risk marker or mediator in atherothrombosis. Hypertension 44, 6–11.

    Article  CAS  Google Scholar 

  • Klag MJ, Ford DE, Mead LA, He J, Whelton PK, Liang KY et al. (1993). Serum cholesterol in young men and subsequent cardiovascular disease. N Engl J Med 328, 313–318.

    Article  CAS  Google Scholar 

  • Krajèovioèvá-Kudláèková M, Blazicek P, Kopcova J, Bdderova A, Babinska K (2000). Homocysteine levels in vegetarians versus omnivores. Ann Nutr Metab 44, 135–138.

    Article  Google Scholar 

  • Krajèovioèvá-Kudláèková M, Šimonèiè R, Béderová A, Ondreièka R, Klvanová J (1994). Selected parameters of lipid metabolism in young vegetarians. Ann Nutr Metab 38, 331–335.

    Article  Google Scholar 

  • Kuller LH, Tracy RP, Shaten J, Meilahn EN (1996). Relationship of C-reactive protein and coronary heart disease in the MRFIT nested case-control study. Multiple risk factor intervention trial. Am J Epidemiol 144, 537–547.

    Article  CAS  Google Scholar 

  • Kuo CS, Lai NS, Ho LT, Lin CL (2004). Insulin sensitivity in Chinese ovo-lactovegetarians compared with omnivores. Eur J Clin Nutr 58, 312–316.

    Article  CAS  Google Scholar 

  • Lim HS, Heo YR (2002). Plasma total homocysteine, folate, and vitamin B12 status in Korean adults. J Nutr Sci Vitaminol 48, 290–297.

    Article  CAS  Google Scholar 

  • Lin CL (1997). Vegetarianism(Review). Tzu Chi Med J 9, 81–89.

    Google Scholar 

  • Lin CL, Fan TC, Gueng MK (2001). Vascular dilatory functions of ovo-lactovegetarians compared with omnivores. Atherosclerosis 158, 247–251.

    Article  CAS  Google Scholar 

  • Lin CL, Huang JF, Lin YC, Huang CY, Lin PY (1997). Acceptability of lacto-ovovegetarian diet by patients at Tzu-Chi general hospital. Tzu Chi Med J 9, 199–206.

    Google Scholar 

  • Lu SC, Wu WH, Lee CA, Chou HF, Lee HR, Huang PC (2000). LDL of Taiwanese vegetarians are less oxidizable than those of omnivores. J Nutr 130, 1591–1596.

    Article  CAS  Google Scholar 

  • Mendall MA, Strachan DP, Butland BK, Ballam L, Morris J, Sweetnam PM et al. (2000). C-reactive protein: relation to total mortality, cardiovascular mortality and cardiovascular risk factors in men. Eur Heart J 21, 1584–1590.

    Article  CAS  Google Scholar 

  • Nagyová A, Kudláèková M, Granèièová E, Magálová T (1998). LDL oxidizability and antioxidative status of plasma in vegetarians. Ann Nutr Metab 42, 328–332.

    Article  Google Scholar 

  • Pan WH, Chin CJ, Sheu CT, Lee MH (1993). Haemostatic factors and blood lipids in young Buddhist vegetarians and omnivores. Am J Clin Nutr 58, 354–359.

    Article  CAS  Google Scholar 

  • Rajaram S (2003). The effect of vegetarian diet, plant foods, and phytochemicals on hemostasis and thrombosis. Am J Clin Nutr 78, 552S–558S.

    Article  CAS  Google Scholar 

  • Refsum H, Nurk E, Smith AD, Ueland PM, Gjesdal CG, Bjelland I et al. (2006). The Hordaland Homocysteine Study: a community-based study of homocysteine, its determinants, and associations with disease. J Nutr 136, 1731S–1740S.

    Article  CAS  Google Scholar 

  • Ridker PM, Brown NJ, Vaughan DE, Harrison DG, Mehta JL (2004). Established and emerging plasma biomarkers in the prediction of first atherothrombotic events. Circulation 109, IV6–IV19.

    PubMed  Google Scholar 

  • Ridker PM, Cushman M, Stampfer MJ, Tracy RP, Hennekens CH (1997). Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med 336, 973–979.

    Article  CAS  Google Scholar 

  • Ridker PM, Hennekens CH, Buring JE, Rifai N (2000). C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N Engl J Med 342, 836–843.

    Article  CAS  Google Scholar 

  • Schnyder G, Roffi M, Flammer Y, Pin R, Hess OM (2002). Effect of homocysteine-lowering therapy with folic acid, vitamin B12, and vitamin B6 on clinical outcome after percutaneous coronary intervention: the Swiss Heart study: a randomized controlled trial. JAMA 288, 973–979.

    Article  CAS  Google Scholar 

  • Selhub J (2006). The many facets of hyperhomocysteinemia:studies from the Framingham cohorts. J Nutr 136, 1726S–1730S.

    Article  CAS  Google Scholar 

  • Su TC, Jeng JS, Wang JD, Torng PL, Chang SJ, Chen CF et al. (2006). Homocysteine, circulating vascular cell adhesion molecule and carotid atherosclerosis in postmenopausal vegetarian women and omnivores. Atherosclerosis 184, 356–362.

    Article  CAS  Google Scholar 

  • Szeto YT, Kwok TCY, Benzie IFF (2004). Effects of a long-term vegetarian diet on biomarkers of antioxidant status and cardiovascular disease risk. Nutrition 20, 863–866.

    Article  CAS  Google Scholar 

  • Taskin G, Yilmaz Sipahi E, Yildirimkaya M, Nadirler F, Halloran M, Ayoglu FN et al. (2006). Plasma total homocysteine levels in a healthy Turkish population sample. Acta Cardiol 61, 35–42.

    Article  Google Scholar 

  • The Homocysteine Studies Collaboration (2002). Homocysteine and risk of ischemic heart disease and stroke. JAMA 288, 2015–2022.

    Article  Google Scholar 

  • Tzeng MS, Kao MD, Yeh WT, Pan WH (1999). Food consumption frequency and eating habit among Taiwanese-NAHSIT 1993-1996. Nutr Sci J 24, 59–80.

    CAS  Google Scholar 

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Acknowledgements

The present study was supported by grant DTCRD 93(2)-08 from The Buddhist Dalin Tzu Chi General Hospital, Chia-Yi, Taiwan, Republic of China.

The authors are grateful for the statistical assistance of Jing-Er Chou, PhD of the National Yunlin University of Science and Technology.

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Authors and Affiliations

  1. Department of Internal Medicine, Section of Cardiology, Buddhist Dalin Tzu Chi General Hospital, Chia-Yi, Taiwan

    C-W Chen, T-K Lin, C-T Lin, B-C Chen & C-L Lin

  2. College of Medicine, Tzu Chi University, Hualien, Taiwan

    C-W Chen & C-L Lin

  3. Section of Family Medicine, Buddhist Dalin Tzu Chi General Hospital, Chia-Yi, Taiwan

    Y-L Lin

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  1. C-W Chen
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Correspondence to C-L Lin.

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Guarantor: C-L Lin.

Contributors: C-WC provided the initial idea and drafted the manuscript, C-LL reviewed the literature, developed the design and revised the manuscript; all authors subsequently collected, analyzed the data and have seen and approved the final revised version.

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We declare that we have no conflict of interest.

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Chen, CW., Lin, YL., Lin, TK. et al. Total cardiovascular risk profile of Taiwanese vegetarians. Eur J Clin Nutr 62, 138–144 (2008). https://doi.org/10.1038/sj.ejcn.1602689

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