IJCS | Volume 32, Nº6, November / December 2019

630 Table 5 - Comparison of anthropometric and biochemical parameters between vegetarians and omnivores Variables Vegetarians Omnivores p-value Mean ± SD or median (1 st Q – 3 rd Q) Mean ± SD or median (1 st Q – 3 rd Q) Weight (kg) 60.8 (56.7 - 69.4) 71.1 (58.0 - 75.4) 0.038* b WC (cm) 81.8 ± 8.2 87.8 ± 10.9 0.003* a BMI (kg/m 2 ) 22.4 (20.9 - 23.8) 24.6 (21.7 - 26.1) 0.001* b Glycemia (mg/dL) 81.0 (78.0 - 85.0) 85.0 (82.5 – 89.0) 0.004* b Insulin (Uu/mL) 5.1 (3.6 - 6.8) 6.4 (4.4 - 9.2) 0.035* b HOMA-IR 1 .0 (0.8 - 1.4) 1.3 (0.9 - 1.8) 0.021* b TC (mg/dL) 170.4 ± 35.8 176.0 ± 33.5 0.447 a HDL-c (mg/dL) 54.9 ± 14.4 47.3 ± 12.3 0.008* a LDL-c (mg/dL) 99.8 ± 26.9 108.6 ± 28.4 0.127 a TG (mg/dL) 71.0 (63.5 - 99.0) 84.5 (67.0 – 122.0) 0.104 b *p < 0.05. a : Student’s t-test (mean ± standard deviation); b : Mann-Whitney test (median [1 st Q – 3 rd Q]. 1 st Q: first quartile; 3 rd Q: third quartile; WC: waist circumference; BMI: body mass index; TC: total cholesterol; HDL-c: high density lipoprotein; LDL: low density lipoprotein; TG: triglycerides. Pimentel et al. Nutritional status and vegetarians Int J Cardiovasc Sci. 2019;32(6):623-634 Original Article 3). It has been suggested that vegetarians and vegans usually adopt eating habits that are consonant with healthy eating recommendations and may offer advantages in terms of weight control, prevention of hypertension, and ultimately lower mortality from NCDs. 28 In addition, an association between a BMI > 27.5 kg/m 2 and a lower incidence of deaths from cardiovascular diseases was reported. 29 With respect to weight control as a strategy for health protection, in a cohort study, Rosell et al. 30 evaluated weight gain in vegetarian and non-vegetarian individuals over a five-year period. Using logistic regression adjusted bymean age, the authors observed that the lowest weight gain was seen among semi-vegetarian, vegetarian and veganwomen and those who, during follow-up, changed to a diet with no animal food. Philipps et al. 31 observed for 6 months individuals who had recently become vegetarian; at the end of the follow-up period, significant changes were found in the percentage of body fat, biceps and triceps skinfolds and WC. Analysis of data from the Australian Longitudinal Study on Women’s Health, which included 9,113 women aged between 22 and 27 years revealed a prevalence of 3% and 10% of vegetarians and semi- vegetarians (consumed fish or poultry), respectively. Compared with non-vegetarians, vegetarians and semi-vegetarians were leaner according to BMI and tended to exercise more. 32 Data from the American population-based study NHANES 1994-2000 suggested that vegetarian diets naturally lead to weight loss and weight control, 31,33 have higher nutrient density (nutrient/kcal), higher whole-grain content, lower saturated fatty acids and lower salt. On the other hand, the study also showed that vegetarians consumed a less calories per day (mean of 363 kcal/day) than omnivores. One may presume that vegetarians have a healthier life style regardless of dietary factors, including lower prevalence of smoking and sedentary habits, and higher intake of vitamins and dietary supplements. This “health consciousness”, 30,32 combined with the substitution of animal-derived foods with vegetable foods would promote a more efficient weight control, indicated by lower BMI and WC, 10,27,30 and consequently lower cardiovascular risk. 26,27 Visceral fat deposition makes the abdominal visceral obesity a greater risk factor for cardiovascular disease and disturbances in glycemia-insulin homeostasis compared with generalized obesity. It is also associated with hypertension, dyslipidemias, fibrinolysis and progression of atherosclerosis. 33