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.

  • Original Article
  • Published:

Lipids and cardiovascular/metabolic health

Serum concentrations of cholesterol, apolipoprotein A-I and apolipoprotein B in a total of 1694 meat-eaters, fish-eaters, vegetarians and vegans

European Journal of Clinical Nutrition volume 68, pages 178–183 (2014)Cite this article

Subjects

A Corrigendum to this article was published on 07 October 2015

Abstract

Background/Objectives:

The objective of this study was to describe serum lipid concentrations, including apolipoproteins A-I and B, in different diet groups.

Subjects/Methods:

A cross-sectional analysis of a sample of 424 meat-eaters, 425 fish-eaters, 423 vegetarians and 422 vegans, matched on sex and age, from the European Prospective Investigation into Cancer and Nutrition-Oxford cohort. Serum concentrations of total, and high-density lipoprotein (HDL) cholesterol, as well as apolipoproteins A-I and B were measured, and serum non-HDL cholesterol was calculated.

Results:

Vegans had the lowest body mass index (BMI) and the highest and lowest intakes of polyunsaturated and saturated fat, respectively. After adjustment for age, alcohol and physical activity, compared with meat-eaters, fish-eaters and vegetarians, serum concentrations of total and non-HDL cholesterol and apolipoprotein B were significantly lower in vegans. Serum apolipoprotein A-I concentrations did not differ between the diet groups. In males, the mean serum total cholesterol concentration was 0.87 nmol/l lower in vegans than in meat-eaters; after further adjustment for BMI this difference was 0.76 nmol/l. In females, the difference in total cholesterol between these two groups was 0.60 nmol/l, and after further adjustment for BMI was 0.55 nmol/l.

Conclusions:

In this study, which included a large number of vegans, serum total cholesterol and apolipoprotein B concentrations were lower in vegans compared with meat-eaters, fish-eaters and vegetarians. A small proportion of the observed differences in serum lipid concentrations was explained by differences in BMI, but a large proportion is most likely due to diet.

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

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

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

Similar content being viewed by others

References

  1. Lewington S, Whitlock G, Clarke R, Sherliker P, Emberson J, Halsey J et al. Blood cholesterol and vascular mortality by age, sex, and blood pressure: a meta-analysis of individual data from 61 prospective studies with 55 000 vascular deaths. Lancet 2007; 370: 1829–1839.

    Article  Google Scholar 

  2. Walldius G, Jungner I, Holme I, Aastveit AH, Kolar W, Steiner E . High apolipoprotein B, low apolipoprotein A-I, and improvement in the prediction of fatal myocardial infarction (AMORIS study): a prospective study. Lancet 2001; 358: 2026–2033.

    Article  CAS  Google Scholar 

  3. Sniderman AD, Williams K, Contois JH, Monroe HM, McQueen MJ, de Graaf J et al. A meta-analysis of low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and apolipoprotein B as markers of cardiovascular risk. Circ Cardiovasc Qual Outcomes 2011; 4: 337–345.

    Article  Google Scholar 

  4. Di Angelantonio E, Gao P, Pennells L, Kaptoge S, Caslake M, Thompson A et al. Lipid-related markers and cardiovascular disease prediction. JAMA 2012; 307: 2499–2506.

    CAS  PubMed  Google Scholar 

  5. Lee HY, Woo J, Chen ZY, Leung SF, Peng XH . Serum fatty acid, lipid profile and dietary intake of Hong Kong Chinese omnivores and vegetarians. Eur J Clin Nutr 2000; 54: 768–773.

    Article  CAS  Google Scholar 

  6. Thorogood M, Carter R, Benfield L, McPherson K, Mann JI . Plasma lipids and lipoprotein cholesterol concentrations in people with different diets in Britain. Br Med J (Clin Res Ed) 1987; 295: 351–353.

    Article  CAS  Google Scholar 

  7. 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. Public Health Nutr 2003; 6: 259–269.

    Article  Google Scholar 

  8. Holland B, Welch A, Unwin I, Buss D, Paul A . McCance and Widdownson's the Composition of Food. Royal Society of Chemistry: Cambridge, UK, 1991.

    Google Scholar 

  9. Holland B, Brown J, Buss D . Fish and Fish Products: Third supplement to McCance and Widdowson’s the Composition of Foods. Royal Society of Chemistry: Cambridge, UK, 1993.

    Google Scholar 

  10. Holland B, Unwin I, Buss D . Cereals and Cereal Products: Third Supplement to McCance and Widdowson’s the Composition of Foods. Royal Society of Chemistry: Cambridge, UK, 1988.

    Google Scholar 

  11. Holland B, Unwin I, Buss D . Milk Products and Eggs: Fourth Supplement to McCance and Widdowson’s the Composition of Foods. Royal Society of Chemistry: Cambridge, UK, 1989.

    Google Scholar 

  12. Holland B, Unwin I, Buss D . Vegetables, Herbs and Spices: Fifth supplement to McCance and Widdowson’s the Composition of Foods. Royal Society of Chemistry: Cambridge, UK, 1991.

    Google Scholar 

  13. Holland B, Unwin I, Buss D . Fruit and Nuts: First supplement to McCance and Widdowson’s the Composition of Foods. Royal Society of Chemistry: Cambridge, UK, 1992.

    Google Scholar 

  14. Holland B, Welch A, Buss D . Vegetable Dishes: Second supplement to McCance and Widdowson’s the Composition of Foods. Royal Society of Chemistry: Cambridge, UK, 1992.

    Google Scholar 

  15. Chan W, Brown J, Buss D . Miscellaneous Foods: Fourth supplement to McCance and Widdowson’s the Composition of Foods. Royal Society of Chemistry: Cambridge, UK, 1994.

    Google Scholar 

  16. Chan W, Brown J, Church S, Buss D . Meat Products and Dishes: Sixth supplement to McCance and Widdowson’s the Composition of Foods. Royal Society of Chemistry: Cambridge, UK, 1996.

    Google Scholar 

  17. Chan W, Brown J, Lee S, Buss D . Meat, Poultry and Game: Fifth supplement to McCance and Widdowson’s the Composition of Foods. Royal Society of Chemistry: Cambridge, UK, 1995.

    Google Scholar 

  18. Spencer EA, Appleby PN, Davey GK, Key TJ . Validity of self-reported height and weight in 4808 EPIC-Oxford participants. Public Health Nutr 2002; 5: 561–565.

    Article  Google Scholar 

  19. Wareham NJ, Jakes RW, Rennie KL, Schuit J, Mitchell J, Hennings S et al. Validity and repeatability of a simple index derived from the short physical activity questionnaire used in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Public Health Nutr 2003; 6: 407–413.

    Article  Google Scholar 

  20. The InterAct Consortium. Validity of a short questionnaire to assess physical activity in 10 European countries. Eur J Epidemiol 2012; 27: 15–25.

    Article  Google Scholar 

  21. Willett WC . Issues in analysis and presentation of dietary data. Nutritional Epidemiology 2nd edn. Oxford University Press: New York, NY, USA, 1998, pp 321–346.

    Chapter  Google Scholar 

  22. Famodu AA, Osilesi O, Makinde YO, Osonuga OA . Blood pressure and blood lipid levels among vegetarian, semi-vegetarian, and non-vegetarian native Africans. Clin Biochem 1998; 31: 545–549.

    Article  CAS  Google Scholar 

  23. Walden RT, Schaefer LE, Lemon FR, Sunshine A, Wynder EL . Effect of environment on the serum cholesterol-triglyceride distribution among Seventh-Day Adventists. Am J Med 1964; 36: 269–276.

    Article  CAS  Google Scholar 

  24. Hardinge MG, Stare FJ . Nutritional studies of vegetarians. II. Dietary and serum levels of cholesterol. Am J Clin Nutr 1954; 2: 83–88.

    Article  CAS  Google Scholar 

  25. West RO, Hayes OB . Diet and serum cholersterol levels. A comparision between vegetarians and nonvegetarians in a Seventh-day Adventist group. Am J Clin Nutr 1968; 21: 853–862.

    Article  CAS  Google Scholar 

  26. Fernandes DK, de Arruda CE, Sakugava SN . Relation between dietary and circulating lipids in lacto-ovo vegetarians. Nutr Hosp 2011; 26: 959–964.

    Google Scholar 

  27. Chen CW, Lin YL, Lin TK, Lin CT, Chen BC, Lin CL . Total cardiovascular risk profile of Taiwanese vegetarians. Eur J Clin Nutr 2008; 62: 138–144.

    Article  CAS  Google Scholar 

  28. Teixeira RCM, Molina MCB, Zandonade E, Mill JG . Cardiovascular risk in vegetarians and omnivores: a comparative study. Arq Bras Cardiol 2007; 89: 237–244.

    Article  CAS  Google Scholar 

  29. De Biase SG, Fernandes SFC, Gianini RJ, Duarte JLG . Vegetarian diet and cholesterol and triglycerides levels. Arq Bras Cardiol 2007; 88: 35–39.

    Article  CAS  Google Scholar 

  30. Li D . Relationship between the concentrations of plasma phospholipid stearic acid and plasma lipoprotein lipids in healthy men. Clin Sci 2001; 100: 25–32.

    Article  CAS  Google Scholar 

  31. Voight BF, Peloso GM, Orho-Melander M, Frikke-Schmidt R, Barbalic M, Jensen MK et al. Plasma HDL cholesterol and risk of myocardial infarction: a Mendelian randomisation study. Lancet 2012; 380: 572–580.

    Article  CAS  Google Scholar 

  32. Whitlock G, Lewington S, Sherliker P, Clarke R, Emberson J, Halsey J et al. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet 2009; 373: 1083–1096.

    Article  Google Scholar 

  33. Clarke R, Frost C, Collins R, Appleby P, Peto R . Dietary lipids and blood cholesterol: quantitative meta-analysis of metabolic ward studies. BMJ 1997; 314: 112–117.

    Article  CAS  Google Scholar 

  34. Mensink RP, Zock PL, Kester AD, Katan MB . Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials. Am J Clin Nutr 2003; 77: 1146–1155.

    Article  CAS  Google Scholar 

  35. Brown L, Rosner B, Willett WW, Sacks FM . Cholesterol-lowering effects of dietary fibre: a meta-analysis. Am J Clin Nutr 1999; 69: 30–42.

    Article  CAS  Google Scholar 

  36. Crowe FL, Appleby PN, Travis RC, Key TJ . Risk of hospitalization or death from ischemic heart disease among British vegetarians and nonvegetarians: results from the EPIC-Oxford cohort study. Am J Clin Nutr 2013; 97: 597–603.

    Article  CAS  Google Scholar 

  37. Key TJ, Appleby PN, Davey GK, Allen NE, Spencer EA, Travis RC . Mortality in British vegetarians: review and preliminary results from EPIC-Oxford. Am J Clin Nutr 2003; 78: 533S–538SS.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We thank the participants of EPIC-Oxford for their contribution to the study. We also acknowledge Wolfson Laboratories, Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford for the measurement of serum lipid concentrations. This study was funded by Cancer Research UK. The funder played no role in designing or conducting the study or in the collection, management, analysis and interpretation of the data, nor did they have any input into the preparation, review or approval of this manuscript.

Author information

Authors and Affiliations

  1. Department of Population Health, Cancer Epidemiology Unit, University of Oxford, Oxford, UK

    K E Bradbury, F L Crowe, P N Appleby, J A Schmidt, R C Travis & T J Key

Authors
  1. K E Bradbury
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. F L Crowe
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P N Appleby
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J A Schmidt
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. R C Travis
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. T J Key
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to K E Bradbury.

Ethics declarations

Competing interests

TJK is a member of the Vegan Society, UK. The other authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bradbury, K., Crowe, F., Appleby, P. et al. Serum concentrations of cholesterol, apolipoprotein A-I and apolipoprotein B in a total of 1694 meat-eaters, fish-eaters, vegetarians and vegans. Eur J Clin Nutr 68, 178–183 (2014). https://doi.org/10.1038/ejcn.2013.248

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ejcn.2013.248

Keywords

This article is cited by

Search

Advanced search

Quick links