Sexual Dimorphism in Cardiovascular Disease Risk and Risk Factors Among Vegetarians: an Exploration of the Potential Mechanisms.

purpose of the reviewThe goal of this review is to explore the potential mechanisms behind the observed phenomenon of sexual dimorphism in cardiovascular disease (CVD) risk among vegetarians. To date, research has primarily focused on the association between vegetarian diets and CVD risk factors and events. However, few publications have explored gender differences in the point estimates of risk of CVD in vegetarians. Current data suggest that following a vegetarian diet is associated with a larger CVD risk reduction in males. RECENT

findingsAlthough not a completely novel observation, recent systematic reviews have reported sexual dimorphism in CVD outcomes among vegetarians. Data regarding other conditions of which metabolic dysfunction is a fundamental component, such as metabolic syndrome and diabetes, provide insight into potential mechanisms that may explain differences in CVD risk among male and female vegetarians. Evidence from observational studies suggests that a vegetarian diet is cardioprotective for both men and women. Differences in the point estimates of relative risk of major CVD outcomes for both genders when compared with their respective omnivorous counterparts raise the question of whether or not the benefits may be attenuated in women and whether this difference may be due to a combination of several behavioral and biological factors. Differences in dietary intake patterns and hormonal shifts which affect inflammation, body fat distribution, and metabolic syndrome risk have adverse effects on women as they age. Clinical trials comparing CVD outcomes in men and women who follow a vegetarian diet are needed to confirm the observed dimorphism in cohort studies and to elucidate the potential mechanisms that may explain this phenomenon. Currently, studies assessing the impact of other cardioprotective dietary interventions, such as the Mediterranean diet, indicate that there may be a physiological basis for the divergent outcomes of men and women who are given the same dietary intervention. Further research investigating the dietary habits of males and females, as well as other potential confounding lifestyle factors, is needed.