Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Diet and body mass index in 38 000 EPIC-Oxford meat-eaters, fish-eaters, vegetarians and vegans

International Journal of Obesity volume 27, pages 728–734 (2003)Cite this article

Abstract

OBJECTIVE: To compare body mass index (BMI) in four diet groups (meat-eaters, fish-eaters, vegetarians and vegans) in the Oxford cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Oxford) and to investigate lifestyle and dietary factors associated with any observed differences.

DESIGN: Cross-sectional analysis of self-reported dietary, anthropometric and lifestyle data.

PARTICIPANTS: A total of 37 875 healthy men and women aged 20–97 y participating in EPIC-Oxford.

RESULTS: Age-adjusted mean BMI was significantly different between the four diet groups, being highest in the meat-eaters (24.41 kg/m2 in men, 23.52 kg/m2 in women) and lowest in the vegans (22.49 kg/m2 in men, 21.98 kg/m2 in women). Fish-eaters and vegetarians had similar, intermediate mean BMI. Differences in lifestyle factors including smoking, physical activity and education level accounted for less than 5% of the difference in mean age-adjusted BMI between meat-eaters and vegans, whereas differences in macronutrient intake accounted for about half of the difference. High protein (as percent energy) and low fibre intakes were the dietary factors most strongly and consistently associated with increasing BMI both between and within the diet groups.

CONCLUSIONS: Fish-eaters, vegetarians and especially vegans had lower BMI than meat-eaters. Differences in macronutrient intakes accounted for about half the difference in mean BMI between vegans and meat-eaters. High protein and low fibre intakes were the factors most strongly associated with increasing BMI.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Rent or buy this article

Get just this article for as long as you need it

$39.95

Learn more

Prices may be subject to local taxes which are calculated during checkout

Figure 1

References

  1. Joint Health Surveys Unit on behalf of the Department of Health. Health Survey for England: Cardiovascular Disease '98. The Stationery Office: London; 1999.

  2. Bourn, J . Tackling obesity in England. Report by the Comptroller and Auditor General, The National Audit Office. The Stationery Office: London; 2001.

  3. Troiano RP, Frongillo EAJ, Sobal J, Levitsky DA . The relationship between body weight and mortality: a quantitative analysis of combined information from existing studies. Int J Obes Relat Metab Disord 1996; 20: 63–75.

    CAS  PubMed Central  Google Scholar 

  4. Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath CWJ . Body-mass index and mortality in a prospective cohort of US adults. N Engl J Med 1999; 341: 1097–1105.

    Article  CAS  Google Scholar 

  5. Appleby PN, Thorogood M, Mann JI, Key TJ . The Oxford Vegetarian Study: an overview. Am J Clin Nutr 1999; 70: 525S–531S.

    Article  CAS  PubMed  Google Scholar 

  6. Haddad EH, Berk LS, Kettering JD, Hubbard RW, Peters WR . Dietary intake and biochemical, hematologic, and immune status of vegans compared with nonvegetarians. Am J Clin Nutr 1999; 70: 586S–593S.

    Article  CAS  Google Scholar 

  7. Millet P, Guilland JC, Fuchs F, Klepping J . Nutrient intake and vitamin status of healthy French vegetarians and nonvegetarians. Am J Clin Nutr 1989; 50: 718–727.

    Article  CAS  Google Scholar 

  8. Davey GK, Spencer EA, Appleby PN, Allen NE, Knox KH, Key TJ . EPIC-Oxford: lifestyle characteristics and nutrient intakes in a cohort of 33,883 meat-eaters and 31,546 non meat-eaters in the UK. Publ Health Nutr 2003, in press.

  9. Chan W, Brown J, Buss DH . Miscellaneous foods. Fourth supplement to McCance and Widdowson's The composition of foods, 5th edn. Royal Society of Chemistry: Cambridge; 1994.

    Google Scholar 

  10. Chan W, Brown J, Lee SM, Buss DH . Meat, poultry and game. Fifth supplement to McCance and Widdowson's The composition of foods, 5th edn. Royal Society of Chemistry: Cambridge; 1995.

    Google Scholar 

  11. Chan W, Brown J, Church SM, Buss DH . Meat products and dishes. Sixth supplement to McCance and Widdowson's The composition of foods, 5th edn. Royal Society of Chemistry: Cambridge; 1996.

    Google Scholar 

  12. Holland B, Unwin ID, Buss DH . Milk products and eggs. Fourth supplement to McCance and Widdowson's The composition of foods, 4th edn. Royal Society of Chemistry: Cambridge; 1989.

    Google Scholar 

  13. Holland B, Welch AA, Unwin ID, Buss DH, Paul AA, Southgate DAT . McCance and Widdowson's The composition of foods, 5th edn. Royal Society of Chemistry: Cambridge; 1991.

    Google Scholar 

  14. Holland B, Unwin ID, Buss DH . Vegetables, herbs and spices. Fifth supplement to McCance and Widdowson's The composition of foods, 4th edn. Royal Society of Chemistry: Cambridge; 1991.

    Google Scholar 

  15. Holland B, Unwin ID, Buss DH . Fruit and nuts. First supplement to McCance and Widdowson's The composition of foods, 5th edn. Royal Society of Chemistry: Cambridge; 1992.

    Google Scholar 

  16. Holland B, Welch AA, Buss DH . Vegetable dishes. Second supplement to McCance and Widdowson's The composition of foods, 5th edn. Royal Society of Chemistry: Cambridge; 1992.

    Google Scholar 

  17. Holland B, Brown J, Buss DH . Fish and fish products. Third supplement to McCance and Widdowson's The composition of foods, 5th edn. Royal Society of Chemistry: Cambridge; 1993.

    Google Scholar 

  18. Holland B, Unwin ID, Buss DH . Cereals and cereal products. Third supplement to McCance and Widdowson's The composition of foods, 4th edn. Royal Society of Chemistry: Cambridge; 1998.

    Google Scholar 

  19. Dietary reference values for food energy and nutrients for the United Kingdom. Report of the Panel on Dietary Reference Values of the Committee on Medical Aspects of Food Policy. Rep Health Soc Subj (Lond) 1991; 41: 1–210.

  20. Stata Corporation. Stata statistical software. [Release 7.0]. Stata Press: College Station, TX, 2001.

  21. Appleby PN, Thorogood M, Mann JI, Key TJ . Low body mass index in non-meat eaters: the possible roles of animal fat, dietary fibre and alcohol. Int J Obes Relat Metab Disord 1998; 22: 454–460.

    Article  CAS  Google Scholar 

  22. Key T, Davey G . Prevalence of obesity is low in people who do not eat meat [letter]. BMJ 1996; 313: 816–817.

    Article  CAS  PubMed  Google Scholar 

  23. Spencer EA, Appleby PN, Davey GK, Key TJ . Validity of self-reported height and weight in 4808 EPIC-Oxford participants. Publ Health Nutr 2002; 5: 561–566.

    Article  Google Scholar 

  24. Bost L, Dong W, Hedges B, Primatesta P, Prior G, Purdon S, di Salvo P . In: Prescott-Clarke P, Primatesta P (eds). Health survey for England 1995, Volume I: Findings. The Stationery Office: London; 1997.

    Google Scholar 

  25. Trichopoulou A, Gnardellis C, Benetou V, Lagiou P, Bamia C, Trichopoulos D . Lipid, protein and carbohydrate intake in relation to body mass index. Eur J Clin Nutr 2002; 56: 37–43.

    Article  CAS  Google Scholar 

  26. Bolton-Smith C, Woodward M . Dietary composition and fat to sugar ratios in relation to obesity. Int J Obes Relat Metab Disord 1994; 18: 820–828.

    CAS  Google Scholar 

  27. Rolland-Cachera MF, Deheeger M, Bellisle F . Nutrient balance and android body fat distribution: why not a role for protein? Am J Clin Nutr 1996; 64: 663–664.

    Article  CAS  Google Scholar 

  28. Rolland-Cachera MF, Deheeger M, Bellisle F . Nutrient balance and body composition. Reprod Nutr Dev 1997; 37: 727–734.

    Article  CAS  Google Scholar 

  29. Alfieri MA, Pomerleau J, Grace DM, Anderson L . Fiber intake of normal weight, moderately obese and severely obese subjects. Obes Res 1995; 3: 541–547.

    Article  CAS  Google Scholar 

  30. Kromhout D, Bloemberg B, Seidell JC, Nissinen A, Menotti A . Physical activity and dietary fiber determine population body fat levels: the Seven Countries Study. Int J Obes Relat Metab Disord 2001; 25: 301–306.

    Article  CAS  Google Scholar 

  31. Miller WC, Niederpruem MG, Wallace JP, Lindeman AK . Dietary fat, sugar, and fiber predict body fat content [see comments]. J Am Dietetic Assoc 1994; 94: 612–615.

    Article  CAS  Google Scholar 

  32. Burton-Freeman B . Dietary fiber and energy regulation. J Nutr 2000; 130: 272S–275S.

    Article  CAS  Google Scholar 

  33. Howarth NC, Saltzman E, Roberts SB . Dietary fiber and weight regulation. Nutr Rev 2001; 59: 129–139.

    Article  CAS  Google Scholar 

  34. Albrink MJ . Dietary fiber, plasma insulin, and obesity. Am J Clin Nutr 1978; 31: S277–S279.

    Article  CAS  Google Scholar 

  35. Baer DJ, Rumpler WV, Miles CW, Fahey GCJ . Dietary fiber decreases the metabolizable energy content and nutrient digestibility of mixed diets fed to humans. J Nutr 1997; 127: 579–586.

    Article  CAS  Google Scholar 

  36. Bingham SA, Gill C, Welch A et al. Validation of dietary assessment methods in the UK arm of EPIC using weighed records, and 24-hour urinary nitrogen and potassium and serum vitamin C and carotenoids as biomarkers. Int J Epidemiol 1997; 26(Suppl 1): S137–S151.

    Article  Google Scholar 

Download references

Acknowledgements

We thank all the participants in EPIC-Oxford and all the research staff who have worked on this study. EPIC-Oxford is supported by Cancer Research UK, the Medical Research Council and the Europe Against Cancer Programme of the Commission of the European Community.

Author information

Authors and Affiliations

  1. Cancer Research UK Epidemiology Unit, University of Oxford, Oxford, UK

    E A Spencer, P N Appleby, G K Davey & T J Key

Authors
  1. E A Spencer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P N Appleby
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G K Davey
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. T J Key
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to E A Spencer.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Spencer, E., Appleby, P., Davey, G. et al. Diet and body mass index in 38 000 EPIC-Oxford meat-eaters, fish-eaters, vegetarians and vegans. Int J Obes 27, 728–734 (2003). https://doi.org/10.1038/sj.ijo.0802300

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0802300

Keywords

  • body mass index
  • diet
  • vegetarian
  • vegan

This article is cited by

Search

Advanced search

Quick links