英国牛津大学Tammy Y N Tong小组的一项最新研究，分析了肉食者、鱼食者和素食者患缺血性心脏病和中风的风险。 2019年9月4日，《英国医学杂志》在线发表了这一成果。

近年来，素食饮食越来越受欢迎，部分原因是人们认为素食有益健康，以及对环境和动物的关切。2008-2012年度调查显示，英国大约有170万素食和纯素食者。有证据表明，素食者与非素食者相比，可能有不同的疾病风险。为了探究不同饮食习惯的人（肉食者、鱼食者和素食者）突发缺血性心脏病和中风的风险，研究组进行了18年的随访，并对缺血性心脏病和中风进行了独立风险评估。

1993年至2001年，该项EPIC-Oxford研究在英国招募了48188名非肉食者。这些没有缺血性心脏病、中风或心绞痛病史的参与者，被分为三个不同的饮食组：肉食者（参与者吃肉，不论是否吃鱼、奶制品还是鸡蛋，24428人），鱼食者（吃鱼但不吃肉，7506人）和素食者（包括纯素食者，16254人）。在基线时和2010年前后收集饮食信息，共28364人。截至2016年，通过记录分析缺血性心脏病和中风病例。

在18年的随访中，研究共记录到2820例缺血性心脏病、1072例中风的发生。鱼食者和素食者的缺血性心脏病发病率，分别比肉食者低13%和22%，相当于10年内每1000名素食者中的缺血性心脏病患者，比肉食者少10例。另一方面，素食者的中风患病率比肉食者高出20%，相当于10年内每1000名素食者中的中风患者，比肉食者多3例。综上，尽管素食者的中风率较高，但鱼食者和素食者的缺血性心脏病发病率均显著低于肉食者。

附：英文原文

Title: Risks of ischaemic heart disease and stroke in meat eaters, fish eaters, and vegetarians over 18 years of follow-up: results from the prospective EPIC-Oxford study

Author: Tammy Y N Tong, Paul N Appleby, Kathryn E Bradbury, Aurora Perez-Cornago, Ruth C Travis, Robert Clarke, Timothy J Key

Issue&Volume: 4 September 2019

Abstract:

Objective To examine the associations of vegetarianism with risks of ischaemic heart disease and stroke.

Design Prospective cohort study.

Setting The EPIC-Oxford study, a cohort in the United Kingdom with a large proportion of non-meat eaters, recruited across the country between 1993 and 2001.

Participants 48 188 participants with no history of ischaemic heart disease, stroke, or angina (or cardiovascular disease) were classified into three distinct diet groups: meat eaters (participants who consumed meat, regardless of whether they consumed fish, dairy, or eggs; n=24 428), fish eaters (consumed fish but no meat; n=7506), and vegetarians including vegans (n=16 254), based on dietary information collected at baseline, and subsequently around 2010 (n=28 364).

Main outcome measures Incident cases of ischaemic heart disease and stroke (including ischaemic and haemorrhagic types) identified through record linkage until 2016.

Results Over 18.1 years of follow-up, 2820 cases of ischaemic heart disease and 1072 cases of total stroke (519 ischaemic stroke and 300 haemorrhagic stroke) were recorded. After adjusting for sociodemographic and lifestyle confounders, fish eaters and vegetarians had 13% (hazard ratio 0.87, 95% confidence interval 0.77 to 0.99) and 22% (0.78, 0.70 to 0.87) lower rates of ischaemic heart disease than meat eaters, respectively (P<0.001 for heterogeneity). This difference was equivalent to 10 fewer cases of ischaemic heart disease (95% confidence interval 6.7 to 13.1 fewer) in vegetarians than in meat eaters per 1000 population over 10 years. The associations for ischaemic heart disease were partly attenuated after adjustment for self reported high blood cholesterol, high blood pressure, diabetes, and body mass index (hazard ratio 0.90, 95% confidence interval 0.81 to 1.00 in vegetarians with all adjustments). By contrast, vegetarians had 20% higher rates of total stroke (hazard ratio 1.20, 95% confidence interval 1.02 to 1.40) than meat eaters, equivalent to three more cases of total stroke (95% confidence interval 0.8 to 5.4 more) per 1000 population over 10 years, mostly due to a higher rate of haemorrhagic stroke. The associations for stroke did not attenuate after further adjustment of disease risk factors.

Conclusions In this prospective cohort in the UK, fish eaters and vegetarians had lower rates of ischaemic heart disease than meat eaters, although vegetarians had higher rates of haemorrhagic and total stroke.

DOI: 10.1136/bmj.l4897

Source: https://www.bmj.com/content/366/bmj.l4897