Do Vegetarians Live Longer?

A recent article in JAMA Internal Medicine would certainly make it appear that way. Researchers from Loma Linda University recruited more than 73,000 Seventh Day Adventists (the university is an Adventist-affiliated school) and asked detailed questions about dietary and other lifestyle habits, including tobacco and alcohol use, degree of exercise, income, and education level.

Enrollees were divided into non-vegetarians and vegetarians. Then the vegetarians were subdivided into vegans (no animal products whatsoever), lacto-ovo vegetarians (dairy and egg allowed), pesco-vegetarians (dairy, egg, and fish allowed), and so-called partial vegetarians (pesco and “some” meat). The population was then tracked over the next six years, during with 2,570 deaths occurred.

To cut to the chase, there were significantly fewer deaths among any of the four vegetarian subgroups than among the carnivores, leading researchers to conclude that being a vegetarian was associated with longevity.

But, like everything else in life, the issue is more complicated than it might appear. In fact, the accompanying editorial by a physician who’s a vegetarian himself is troubled by labeling “vegetarian” the two large groups in the study who are clearly not–namely, the pesco-vegetarians and “partial” vegetarians. When you make these eating styles part of a study you’ve got a cadre of what I’d call healthy eaters, including those following the Mediterranean Diet or simply shopping carefully and steering clear of junk food.

Then there are “good” and “bad” vegetarians (more on this later), which may explain how a similar study in the UK failed to differentiate longevity benefits between the veg and the non-veg.

More on the Adventists

The JAMA article really should have included more detail about Seventh Day Adventists. To my knowledge there is no religion on the planet more oriented toward health and wellness. The Seventh Day Adventist Health Message starts with Old Testament references to healthful living. Ellen G. White, a founder of the Adventist movement in the 19th century, wrote extensively on the necessity of healthful living as a religious and moral obligation to God. Her Eight Laws of Health include not only nutrition, but exercise, fresh air, pure water, sunlight, rest, temperance (wine with dinner is okay), and trust in God.

White later brought a holistic physician, John H. Kellogg, MD, into her fold. He would build the immensely successful health sanitarium in Battle Creek, Michigan, while his brother, W.K. Kellogg, founded the cereal company whose products then and now are a staple of a vegetarian breakfast. Today the Adventist Health System operates hospitals and medical centers around the country, their programs still oriented toward prevention.

More than a decade ago, an immense research project concluded that Seventh Day Adventists were living longer than the rest of us. While much credit was certainly given to Law #1: nutrition, participants were also following Ellen White’s other seven laws. In other words, if longevity is your goal you could become an Adventist or simply recognize there’s more to long life than taking a pledge and announcing you’ve become a vegetarian.

As a side note, to me what’s especially interesting about the Adventists is their reliance on natural medicine. The church publishes an array of do-it-yourself health books, with treatment advice on dozens of illnesses that incorporates diet, herbs, prescriptive living, and prayer. Adventists are willing to use conventional medicine when needed (it’s the Jehovah’s Witnesses who won’t take blood transfusions), but often consult one of their natural medicine health guides before ringing up their doctor.

A country road, my patients, and inattentive vegetarianism

Down the road from my cabin in Western Illinois lives a married Adventist couple solidly into their 80s. He’s our local go-to guy for small construction projects, like enclosing your porch or putting on a new roof. She (this is true) is his assistant. Her vegetable garden is the envy of the town, and you’d guess their age as late 60s at best.

The point I wish to make is that Seventh Day Adventists are a unique group of vegetarians, and yes, while the study purports to conclude that vegetarians “live longer” and that you’d better consider vegetarianism if longevity is your goal, this is simplistic thinking, especially given who the researchers label “vegetarian.”

From my vantage point, there’s no difference between vegetarians as broadly classified in this study and the typical WholeHealth Chicago patient or Health Tip reader who buys food carefully (cutting back on factory-farmed meat and eating more fish, fresh fruit, and veggies.) As a group, you exercise when you can, think about reducing stress, know the value of sunlight and fresh air, and, if not religious, generally consider yourselves spiritual.

This brings me to the study of UK vegetarians and why there seemed to be no discernible longevity benefit from their diet choice. By and large, the British vegetarians chose their path because of a philosophical commitment to not harm animals. That in itself is fine, but apparently this led to what one of my nutritionists calls “inattentive vegetarianism,” or what I call “Twinkie and Diet Coke” vegetarianism. Yes, you’re a veggie, but not paying attention to much else.

Among the inattentive vegetarians, for example, we routinely see pretty significant vitamin deficiencies, especially B-12 and D, both of which are now definitely linked to chronic disease. Inattentive vegetarians are frequently shocked when they discover they’ve gained weight (generally, it’s the pasta) or they feel tired, their cuts seem to heal slowly, and they’re prone to colds and flu.

The last veggie burger I endured was basically a glop of grain mashed into a burger shape, deep fried, slathered with egg-free mayonnaise, served on an oversized, refined white-flour bun, and garnished with a leaf of iceberg lettuce and a sliver of tomato. It was accompanied by a mound of French fries and more mayo.

As the Adventists teach us, good health is our personal responsibility. It’s more than agonizing about becoming a vegetarian. It’s about paying attention

Be well,
David Edelberg, MD