Ferdowsian and Barnard have presented important information about populations following plant-based diets, particularly vegetarian (VEG) and vegan, suggesting that they are at lower risk for ischemic heart disease mortality.

We conducted 2 studies in Latin American populations, taking into account that immigrants coming from Europe, Asia, and Africa in several waves have contributed to defining communities with the original profile not only in terms of genetics but also with respect to several nutritional habits and lifestyles. We analyzed the relation between the type of diet and cardiovascular disease risk factors in VEG, semivegetarian (SVEG), and omnivorous (OMN) Peruvian and Brazilian subjects, showing results in accordance with those obtained by Ferdowsian and Barnard. For the 2 studies, we defined VEG as no consumption of animal flesh, SVEG as the consumption of 1 to 3 servings of animal flesh/week, and OMN as the daily consumption of animal flesh. In the Peruvian population included in the Lima Study, we measured blood pressure and body mass index in 105 VEGs, 34 SVEGs, and 45 OMN subjects and found that only 2.9% of the VEGs were confirmed to be hypertensive, compared to 13.3% of the OMN subjects (p <0.05). In addition, body weight and body mass index were lower in VEGs (57.6 kg and 23.7 kg/m ² ) and SVEGs (58.4 kg and 23.7 kg/m ² ) compared with OMN subjects (64.4 kg and 26.5 kg/m ² ) (p <0.05). Analysis of a subsample of this study involving 38 VEGs, 15 SVEGs, and 31 OMN subjects disclosed lower total cholesterol/high-density lipoprotein cholesterol ratios in SVEGs and VEGs (4.4 and 4.7 respectively) compared to OMN subjects (5.6) (p <0.05) and lower low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratios in SVEGs and VEGs (both 3.0) compared with OMN subjects (3.7) (p <0.05).

In the Sao Paulo Study, 136 of 1,345 volunteers (aged 20 to 55 years) from the Adventist Church of São Paulo, Brazil, were divided into 3 groups: VEG (n = 65), SVEG (n = 30), and OMN (n = 41). We found that (1) the mean systolic blood pressure for VEGs (109.45 mm Hg) was significantly lower than for SVEGs (116.1 mm Hg) (p = 0.05) and OMN subjects (121.44 mm Hg) (p <0.001), (2) the mean diastolic blood pressure for VEGs (71.78 mm Hg) was also significantly lower than for SVEGs (78.73 mm Hg) (p = 0.001) and OMN subjects (80.96 mm Hg) (p <0.001), (3) the mean serum total cholesterol for VEGs (167 mg/dl) was significantly lower than for OMN subjects (188 mg/dl) (p = 0.006), (4) the mean serum low-density lipoprotein cholesterol for VEGs (92 mg/dl) was significantly lower than for OMN subjects (107 mg/dl) (p = 0.03), and (5) the prevalence of hypercholesterolemia (total cholesterol ≥200 mg/dl) was significantly higher in the OMN group (41.46%) compared with the SVEG (16.67%) (p = 0.03) and VEG (21.54%) (p = 0.05) groups.

From these 2 studies, we concluded that VEG subjects are exposed to a lesser degree of cardiovascular risk factors compared with OMN subjects and that SVEGs, a group that has been neglected in previous studies, are at an intermediate level of exposure.