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The Evidence

Page 09

Plant-based diets and heart disease

The heart-disease evidence is genuinely good for plant-based eating, and honest reporting includes the one finding that cut the other way: stroke.

Vegan Brief Evidence last reviewed July 2, 2026

This is a summary of the cited evidence, not medical advice.

  • Heart disease Lower risk
  • Stroke One cohort found higher
  • Evidence EPIC-Oxford, AHS-2

EPIC-Oxford: lower heart disease, higher stroke

EPIC-Oxford followed meat eaters, fish eaters, and vegetarians in the UK for 18 years. The headline result favors plant-based eating on heart disease. This is open-access research, so we can quote its conclusion directly.

Primary source 01 / 05

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.

Tong and colleagues University of Oxford EPIC-Oxford, BMJ, 2019

The heart-disease effect was sizeable.

Primary source 02 / 05

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.

Tong and colleagues University of Oxford EPIC-Oxford, BMJ, 2019

We report the whole finding, including the part that is not convenient. The same study found more strokes.

Primary source 03 / 05

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.

Tong and colleagues University of Oxford EPIC-Oxford, BMJ, 2019

Adventist Health Study 2: lower mortality

A large US cohort, Adventist Health Study 2, looked at how vegetarian patterns tracked with death rates. Its conclusion:

Primary source 04 / 05

Vegetarian diets are associated with lower all-cause mortality and with some reductions in cause-specific mortality. Results appeared to be more robust in males.

Orlich and colleagues Loma Linda University Adventist Health Study 2, JAMA Internal Medicine, 2013

The all-cause mortality hazard ratio was 0.88 for vegetarians overall, and 0.85 for vegans, versus non-vegetarians. The authors state the bottom line without inflating it.

Primary source 05 / 05

In conclusion, in a large American cohort, we found that vegetarian dietary patterns were associated with lower mortality.

Orlich and colleagues Loma Linda University Adventist Health Study 2, JAMA Internal Medicine, 2013

Both are observational, so they show association, not proof of cause. Read together they point the same way on heart disease and longevity, and they flag stroke as the thing to watch. That is the state of the evidence, good news and caveat in the same frame.

  • Omega-3s on a vegan diet Flax and walnuts give you the parent omega-3. Turning it into the ones your brain and heart use is inefficient, which is where algae oil comes in.
  • Calcium and bone health on a vegan diet This is the page where being on veganism's side means telling you the uncomfortable finding: vegans break more bones in the data, and calcium is the lever that moves it.
  • Does soy mess with your hormones? The soy-wrecks-your-hormones story is one of the most repeated food myths going, and the review evidence just does not support it.
  • Plant-based diets and type 2 diabetes Vegetarians and vegans get type 2 diabetes far less often, and a vegan diet helps manage it, though the trial effect on blood sugar is real and modest, not a cure.
  • Plant-based diets and blood pressure Plant-based eating lowers blood pressure by a few millimetres of mercury, small for one person but the kind of shift that moves population risk.
  • Plant-based diets and longevity One large cohort found vegetarians die at lower rates; another found no difference. The honest answer on longevity is that the evidence is split.
  • Plant-based diets and cancer risk Going plant-based nudges cancer risk down, mostly through what you stop eating. The overall effect is real, modest, and easy to oversell in either direction.
  • Plant-based diets, gout and kidney stones For gout and kidney stones, cutting meat is one of the cleaner wins in nutrition. Vegetarians formed about a third fewer stones, and plant purines never earned their bad reputation.
  • Plant-based diets and cholesterol If a diet has one signature effect on the blood, for plant-based eating it is cholesterol. Low saturated fat plus high fibre pushes LDL down, and the trials back it up.

Frequently asked

Do plant-based diets lower heart-disease risk?

EPIC-Oxford found fish eaters and vegetarians had lower rates of ischaemic heart disease than meat eaters, equivalent to 10 fewer cases per 1000 people over 10 years for vegetarians. Adventist Health Study 2 found vegetarian dietary patterns associated with lower all-cause mortality.

Is there a downside in the data?

Yes. The same EPIC-Oxford study found vegetarians had 20% higher rates of total stroke than meat eaters, mostly from haemorrhagic stroke. Both studies are observational, so they show association rather than proof of cause.

The primary sources

The documents this page quotes. Read them yourself.

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