Mortality Rates of Vegetarians and Vegans

January 10th, 2016 by Jack Norris RD

A paper came out in December reporting mortality rates of different diet groups from the large EPIC-Oxford study containing 60,310 people from the UK  (1).

The mortality rate before age 90 was no different between vegetarians (including vegans) and regular meat-eaters (1.02, 0.94-1.10). Vegetarians had lower rates of mortality from pancreatic cancer (0.48, 0.28-0.82) and lymphatic cancer (0.50, 0.32-0.79). Semi-vegetarians had lower rates of death from pancreatic cancer (0.55, 0.36-.86). Pesco-vegetarians had lower death rates from all cancers (0.82, 0.70-0.97) but higher rates of cardiovascular disease (1.22, 1.02-1.46).

In the main analysis (in the paragraph above), some participants were recategorized based on a change in their diet over the course of the study which included over one million person-years of follow-up. The researchers did a second analysis in which participants who changed their diets were removed, and found an 8% reduced risk of early death in vegetarians that was just statistically significant (0.92, 0.84-0.99). Limiting the results further, to deaths before age 75, strengthened the finding (0.86, 0.77-0.97).

When vegans were separated from other vegetarians, there were no statistically significant differences in mortality rates for the six main categories of death. Eliminating participants who had changed diet categories didn’t significantly change the results for vegans. There were only 166 vegan deaths as distinct from 1,929 deaths in the entire cohort; meaning that reaching statistical significance was going to be unlikely.

Results above were not adjusted for differences in body mass index (BMI); such adjustments were performed but they didn’t change the results substantially.

The fact that vegetarians didn’t have lower rates of death from heart disease in this study is surprising given that a 2013 report from EPIC-Oxford showed a highly statistically significant, 31% reduction in heart disease incidence among vegetarians (0.69, 0.58-0.82). This discrepancy as well as the lower death rates for vegetarians before age 75, but not before age 90, might be explained by cases of nonfatal heart disease leading to effective treatment.

See the link in the reference for a free copy of the paper. For results of other similar studies, please see Disease Rates of Vegetarians and Vegans.


1. Appleby PN, Crowe FL, Bradbury KE, Travis RC, Key TJ. Mortality in vegetarians and comparable nonvegetarians in the United Kingdom. Am J Clin Nutr. 2016 Jan;103(1):218-30. | link

Ginny on Fire

January 10th, 2016 by Jack Norris RD

In the last month, Ginny Messina, MPH, RD has put out a number of great articles for vegans to check out:

Vegan Diets and Orthorexia: How Should Activists Respond?

Lettuce and Bacon and the Environment: Some Thoughts for Vegan Activists

Will a Vegetarian Diet Make You Depressed?

Your Vegan New Year’s Diet: Don’t Forget the Protein

Dr. Greger on Vitamin C and Cancer Treatment

January 10th, 2016 by Jack Norris RD

Dr. Michael Greger has some very interesting videos on the history of using vitamin C for cancer treatment:

Intravenous Vitamin C for Terminal Cancer Patients

Vitamin C Supplements for Terminal Cancer Patients

He also recently ran two very interesting videos discussing the role of fiber in weight loss:

Are There Foods With Negative Calories?

Eating More to Weigh Less

Increase the Number of Vegans…By Two!

November 29th, 2015 by Jack Norris RD

Some of my readers might not be aware that my day job is Executive Director of Vegan Outreach.

Vegan Outreach persuades people to go vegan by visiting college campuses throughout the USA, Canada, Mexico, Australia and New Zealand, giving our hard-hitting booklets about modern animal farming to students, persuading many of them to leave animals off their plates.

We also have a large Vegan Mentor Program and a Vegan Living & Advocacy Blog to help aspiring, new, or veteran vegans. In fact, now is a great time to sign up for our blog as we’re about to start doing vegan product giveaways!2015-08-01 Norris Jack ARNC

Right now, your donation to Vegan Outreach will be doubled–meaning you will persuade twice as many people to go vegan by donating now!

Click here to donate.

Thank you!

– Jack Norris, RD

Dr. Greger: Latest in Clinical Nutrition – Volume 28

November 29th, 2015 by Jack Norris RD

Dr. Michael Greger has released his Latest in Clinical Nutrition – Volume 28. It can be ordered as a digital download or a DVD.

In discussing Volume 28, Dr. Greger says, “Alternative medicine practitioners continue to treat thousands of cancer patients with vitamin C, but why isn’t it the standard of care in mainstream medicine? Has it been successfully debunked or is it a Big Pharma conspiracy to suppress the truth?”

Find out in Volume 28!

Lower Risk of Prostate Cancer among Vegans

November 29th, 2015 by Jack Norris RD

The Adventist Health Study-2 has published results of their study on prostate cancer risk among various diet groups after 7.8 years of follow-up.

Vegans were shown to have a 34% lower risk of being diagnosed with prostate cancer than regular meat-eaters. The other diet groups were not found to be statistically different than regular meat-eaters. Here are the confidence intervals:

  • Non-Veg: 1.00
  • Semi-Veg: 1.18 (.91, 1.54)
  • Pesco: 1.07 (.88, 1.31)
  • Lacto-Ovo: .96 (.83, 1.12)
  • Vegan: .66 (.50, .87)

The results were adjusted for age, race, family history, education, screening, caloric intake, and body mass index. There were 2,140 vegans in the study.

A similar trend was found when looking only at African American participants, but the results didn’t reach statistical significance.

Among those diagnosed with advanced prostate cancer (as distinct from all types of prostate cancer) vegans had a 30% reduced risk, but it wasn’t statistically significant.

The authors speculated on a number of mechanisms that could be responsible for the lower rates among vegans:

  • Lower levels of insulin-like growth factor 1
  • Lower insulin resistance
  • Lower calcium intakes increasing the need for the conversion of vitamin D into its active form which might reduce prostate cancer
  • Reduced inflammation due to higher antioxidant intakes
  • Increased soy consumption which has been linked to lower prostate cancer risk (with a large number of possible mechanisms)

I have updated the prostate cancer section of the article, Cancer, Vegetarianism, and Diet.


If you like my posts, please like my posts! Or share them!

I am very grateful for donations of any amount (click here).

Purchase anything through these links and gets a percentage:

Pangea – The Vegan Store
Vegan for Life by Jack Norris & Ginny Messina

Thank you!

Methylcobalamin & Adenosylcobalamin: Consolidated

November 11th, 2015 by Jack Norris RD

It’s raining B12!

I have consolidated all the information from my blog and regarding the benefits and drawbacks of supplementing with the co-enzyme forms, methylcobalamin and adenosylcobalamin, over cyanocobalamin.

Click here: Methylcobalamin & Adenosylcobalamin


If you like my posts, please like my posts! Or share them!

I am very grateful for donations of any amount (click here).

Purchase anything through these links and JackNorrisRD gets a percentage:

Pangea – The Vegan Store
Vegan for Life by Jack Norris & Ginny Messina

Thank you!

Two B12 Deficiency Cases

November 11th, 2015 by Jack Norris RD

I have updated the page, Individual Cases of Deficiency, with two recent cases below. In the past, readers have asked me to post these when they come out, so I will continue to do so.

Biyani S, Jha SK, Pandey S, Shukla R. Acute bilateral useless hand syndrome: a rare presenting manifestation of vitamin B12 deficiency. BMJ Case Rep. 2015 Oct 16;2015. | link

A 38-year-old man, “strict vegetarian,” developed “useless hand syndrome.” Laboratory tests showed vitamin B12 deficiency. He was given B12 injection and after 8 weeks was free of symptoms.

Førland ES, Lindberg MJ. [Severe macrocytic anaemia and secondary hyperparathyroidism in a vegan]. Ugeskr Laeger. 2015 Aug 10;177(33). | link

“In this case report we present a 39-year-old male vegan with severe macrocytic anaemia due to vitamin B12 deficiency as well as secondary hyperparathyroidism due to severe vitamin D deficiency.”

Vegan Health & Fitness Magazine: Vegans Need B12

November 8th, 2015 by Jack Norris RD

Over the past couple of years a number of readers and colleagues have contacted me about the apparent stance of Vegan Health & Fitness Magazine (VHFM) that vegans do not need to supplement with vitamin B12. People have contacted the magazine about this issue but they have not modified their position.

Currently, VHFM has an article, The Science is in: B12, by Brian Acree, which has been available for some time (no publication date is listed).

Despite the name of the article, Acree suggests that the science is actually not in. He argues that we have no definitive answers, but that if vegans eat a variety of plant foods, including foods like seaweed, we’ll be fine.

Acree bases his argument mostly on research from the Watanabe group, research that I detail in B12 in Plant Foods.

Acree says, “Of particular interest is the fact that Watanabe cited two studies that showed that vegans who consumed nori and/or chlorella (the green substance in all green vegetables) had serum vitamin B-12 concentrations ‘twice as high as those not consuming these algae.'”

Acree appears to be mistaking the algae, chlorella, for the molecule chlorophyll and, because of this mistake, seems to be suggesting that all green vegetables contain B12. But in reality, chlorophyll has nothing to do with vitamin B12.

Readers of this blog probably remember that just a couple weeks ago, and after this article by Acree was published, the first study came out indicating that chlorella has B12 activity (see Chlorella Shown to Have B12 Activity in Humans—Caution Warranted).

As for nori, in the one study looking at nori’s B12 activity in humans, it didn’t have any (more info).

In 2014, VHFM ran an article by Deobrah Nasmyth that pointed out that the editor of VHFM, Brenda Carey, doesn’t take B12 supplements or eat fortified foods and hasn’t developed B12 deficiency. Acree also uses his own personal lack of B12 deficiency symptoms as evidence that vegans don’t need to supplement with B12.

The problem with this reasoning is that unless you’re getting your methylmalonic acid and homocysteine levels checked, there’s no way for someone to know they don’t have B12 deficiency.

The study on chlorella mentioned above shows that many vegans come down with vitamin B12 deficiency due to a lack of vitamin B12 in the diet. Long periods of mild B12 deficiency are linked with dementia, and poor bone health in vegans.

And even if some vegans don’t develop vitamin B12 deficiency or obvious symptoms, too many vegans do develop them and sometimes with horrible consequences (see the Background section of Vitamin B12: Are You Getting It).

It’s not worth risking people’s health in order to make a philosophical statement and I hope to see Vegan Health & Fitness take a more responsible position regarding vitamin B12.

New Supplement with Vegan K2, D3, and “Chondroitin” Available

November 5th, 2015 by Jack Norris RD

Vegetology, the makers of Vitashine vegan vitamin D3 have a new vegan supplement out for joints, Joint-vie. They sent me three bottles along with three bottles of their vegan omega 3 supplement Opti3 Omega-3 EPA & DHA. Other than some free products occasionally, I get no compensation from Vegetology.

Two tablets of Joint-vie include 400 IU vitamin D, 200 mg of calcium, 187.5 mg of magnesium, 80 mg of vitamin C, 37.5 µg of vitamin K2, 500 mg of vegan glucosamine, and 425 of a vegan version of chondroitin (called Phytodroitin).

In 2011, I wrote an article, Glucosamine and Chondroitin. My conclusion was that the therapies have not been shown to be generally effective. But that said, I think it’s great that there’s now a vegan version for people who want to try it and especially for those who would otherwise buy chondroitin made from shark cartilage.

It’s also good to have a vegan vitamin K2 product other than natto. I couldn’t tell from the label what version of K2 Joint-vie contains.

As always, here are my Daily Recommendations for the nutrients I think all vegans need to be aware of.

I won’t be able to give any recommendations for any individuals regarding these supplements. Chris from Vegetology will probably be tracking any comments on this blog post so I will let him answer any specific questions people have.