Nutrition Hotline

Reed Mangels, PhD, RD

QUESTION: Who are healthier: vegans or vegetarians?
BI, via e-mail

ANSWER: This is a difficult question to answer since there is so much individual variability. For example, a person may have become vegan to help treat a disease. That person may not be as healthy as someone who is not vegan but does not have a chronic disease. It is even difficult to look at two studies, one examining vegans and one examining vegetarians, and make conclusions about which diet is healthier since the groups studied may be different ages or sexes, or contain individuals with genetic predispositions or other factors that could influence their health. Our best bet is to examine studies that compare vegans and vegetarians of similar ages. There is a limited number of these types of studies. In some cases, it is difficult to draw conclusions since the number of subjects, especially vegan subjects, is small.

QUESTION: Are vegan diets healthier?

ANSWER: Vegan diets are generally markedly lower in cholesterol than vegetarian diets. According to the studies, vegans also tend to eat less saturated fat and more fiber than vegetarians. Some studies have found that vegan diets are slightly lower in calories and protein and higher in carbohydrates than vegetarian diets. A study of African-Ameri-can Seventh-day Adventists in the US found that vegans had lower intakes of sodium, vitamin D, vitamin B12, and calcium. Female vegans had higher intakes of vitamin C and vitamin A than female vegetarians, while male vegans had lower intakes of these vitamins than did male vegetarians. This suggests that vegan diets have many positive attributes like lower cholesterol, fat, saturated fat, and higher fiber. However, lower intakes of some vitamins and calcium imply a need to be more aware of sources of these nutrients.

QUESTION: Are vegans at lower risk for heart disease?

ANSWER: Certainly, dietary factors like lower intakes of saturated fat reduce the risk of developing heart disease. Older studies comparing vegans and lacto-ovo vegetarians have found that the risk of heart disease among vegans is even lower than among vegetarians. More recently, the Oxford Vegetarian Study found that both vegans and vegetarians in the UK had lower blood cholesterol levels and LDL-cholesterol levels than meat eaters, but vegans had lower levels than vegetarians. The researchers predicted that, based on blood cholesterol levels, the incidence of heart disease might be 24% lower in lifelong vegetarians and 57% lower in lifelong vegans compared to meat eaters. Other studies have also found that vegans had slightly lower levels of blood cholesterol, LDL-cholesterol, HDL-cholesterol, and triglycerides, although differences are not always statistically significant. Some studies have found no difference in lipid levels in vegetarians and vegans.

QUESTION: Are vegans at A lower risk for cancer?

ANSWER: Only a very limited number of studies have examined this question. Vegans have lower concentrations of potentially colon cancer-causing bile acids. Male vegans appear to have lower levels of a growth factor that can increase risk of developing prostate cancer than do vegetarians. In a study that combined data from five smaller studies, vegans appeared to have lower death rates from colorectal cancer, breast cancer, and prostate cancer, and higher death rates from stomach cancer and lung cancer, than did vegetarians. However, please keep in mind that the limited number of vegans makes it impossible to draw firm conclusions.

QUESTION: Do vegans have lower blood pressure or lower body weight?

ANSWER: Several studies have shown that vegans tend to be leaner, a factor that may reduce risk of developing hypertension. However, studies comparing vegans and vegetarians have generally found that in both groups, blood pressures are similar.

QUESTION: Do vegans have a lower risk of developing osteoporosis?

ANSWER: Premenopausal vegan and vegetarian women have been reported to have similar bone densities, suggesting that vegans and vegetarians have a similar risk of developing osteoporosis. Older vegan women (age 60 to 90 years) had lower bone densities than older vegetarian women. Lower intakes of calcium and vitamin D in vegans raise concern about long-term bone health, although the recent availability of soymilks and rice milks that are fortified with calcium and vitamin D may lead to increased intake of these nutrients.

If you are interested in a listing of the references used in this comparison, please send a request via e-mail to [email protected] or send a SASE to

The Vegetarian Resource Group
PO Box 1463
Baltimore, MD 21203