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HomeEditor's PickEven obese vegetarians who smoke and drink have healthier biomarkers than meat-eaters

Even obese vegetarians who smoke and drink have healthier biomarkers than meat-eaters

Vegetarians have a healthier biomarker profile than meat-eaters, and this applies to adults of any age and weight, and is also unaffected by smoking and alcohol consumption, according to a study in over 166,000 UK adults, according to research presented at the online European Congress on Obesity (ECO).

Biomarkers can have bad and good health effects, promoting or preventing cancer, cardiovascular and age-related diseases, and other chronic conditions, and have been widely used to assess the effect of diets on health. However, evidence of the metabolic benefits associated with being vegetarian is unclear.

To understand whether dietary choice can make a difference to the levels of disease markers in blood and urine, researchers from the University of Glasgow did a cross-sectional study analysing data from 177,723 healthy participants (aged 37-73 years) in the UK Biobank study, who reported no major changes in diet over the last five years.

Participants were categorised as either vegetarian (do not eat red meat, poultry or fish; 4,111 participants) or meat-eaters (166,516 participants) according to their self-reported diet. The researchers examined the association with 19 blood and urine biomarkers related to diabetes, cardiovascular diseases, cancer, liver, bone and joint health, and kidney function.

Even after accounting for potentially influential factors including age, sex, education, ethnicity, obesity, smoking, and alcohol intake, the analysis found that compared to meat-eaters, vegetarians had significantly lower levels of 13 biomarkers, including: total cholesterol; low-density lipoprotein (LDL) cholesterol — the so-called 'bad cholesterol; apolipoprotein A (linked to cardiovascular disease), apolipoprotein B (linked to cardiovascular disease); gamma-glutamyl transferase (GGT) and alanine aminotransferase (AST) — liver function markers indicating inflammation or damage to cells; insulin-like growth factor (IGF-1; a hormone that encourages the growth and proliferation of cancer cells); urate; total protein; and creatinine (marker of worsening kidney function).

However, vegetarians also had lower levels of beneficial biomarkers including high-density lipoprotein 'good' (HDL) cholesterol, and vitamin D and calcium (linked to bone and joint health). In addition, they had significantly higher level of fats (triglycerides) in the blood and cystatin-C (suggesting a poorer kidney condition).

No link was found for blood sugar levels (HbA1c), systolic blood pressure, aspartate aminotransferase (AST; a marker of damage to liver cells) or C-reactive protein (CRP; inflammatory marker).

"Our findings offer real food for thought," says Dr Carlos Celis-Morales, who led the research. "As well as not eating red and processed meat which have been linked to heart diseases and some cancers, people who follow a vegetarian diet tend to consume more vegetables, fruits, and nuts which contain more nutrients, fibre, and other potentially beneficial compounds. These nutritional differences may help explain why vegetarians appear to have lower levels of disease biomarkers that can lead to cell damage and chronic disease."

The authors point out that although their study was large, it was observational, so no conclusions can be drawn about direct cause and effect. They also note several limitations including that they only tested biomarker samples once for each participant, and it is possible that biomarkers might fluctuate depending on factors unrelated to diet, such as existing diseases and unmeasured lifestyle factors. They also note that were reliant on participants to report their dietary intake using food frequency questionnaires, which is not always reliable.


Study details:

Differences in health-related biomarkers profile of vegetarians and meat-eaters: A cross-sectional analysis of the UK Biobank study

Poster study at European Association for the Study of Obesity Congress, May 2021

Authors: Boonpor, J; Petermann Rocha; Parra Soto; Ho; Gray; Celis Morales,




Biomarkers have been widely used to assess the effect of diets on health.
However, evidence of the metabolic benefits associated with being vegetarian is
inconclusive. The aim of this study was, therefore, to investigate the associations of
vegetarian and meat-eater with 19 health-related biomarkers in healthy adults.


This is a cross-sectional study used data from the UK Biobank study and
included 177,723 healthy participants (free of comorbidities) and who reported no major
changes in diet in the last five years). Type of diet was self-reported and categorised as
vegetarians (n=4,111) and meat-eaters (n=166,516). Nineteen blood and urine biomarkers
related to diabetes, hypertension, cardiovascular diseases, cancer, liver and renal function
were included. The association between vegetarians and biomarkers was examined using
multiple linear regression and presented as standardised beta coefficients.


Compared to meat-eaters, vegetarians had a significantly lower concentration for
14 biomarkers including total cholesterol (-0.21 standard deviation (sd)), LDL (-0164 sd),
HDL (-0.05 sd), lipoproteins A (-0.01 sd), lipoprotein B (-0.04 sd), liver function markers
(GGT: -3.54, and ALT:-1.53 SD), IGF-1 (-1.34 sd), vitamin D (-6.35 sd), urate (-12.2 sd), total
protein (-0.29 sd), creatinine (-6.07 sd), CRP (-0.10 sd) and calcium (-0.007 sd). However,
we found that vegetarians have a significantly high concentration of triglycerides (0.15) and
cystatin-C (0.04 sd). No association were found for HbA1c, systolic blood pressure and AST.
These findings were independent of socio-demographic factors, alcohol consumption,
smoking and adiposity.


Vegetarians have a more favourable biomarkers profile than meat-eaters.
These associations were independent of adiposity and other socio-demographics and
lifestyle-related confounding factors.


Full Poster study at ECO (Open access)


See also from the MedicalBrief archives:


Vegetarians and vegans: Lower heart disease risk, higher risk of stroke


Academy of Nutrition and Dietetics highlights health benefits of vegetarian diet

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