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Are vegans healthier than meat eaters? Better on the heart, worse on bones, and not clearly longer-lived

Gregory Knox
November 3, 2026
7 mins

On heart disease, mostly yes. On living longer, neither big study we read found vegans clearly outliving comparable meat eaters. An Oxford review found vegetarians, vegans included, had a lower risk of ischemic heart disease than non-vegetarians from a similar background, and similar overall mortality. British vegans also broke more hips.

Read only the abstract of the 2024 Adventist Health Study-2 mortality paper, which followed 88,400 Seventh-day Adventists in the US and Canada through 2015, and vegans were among the groups with lower total mortality. The results section is narrower. Men and women combined, a vegan diet was not associated with all-cause mortality, and vegan men had lower mortality at younger ages only. The lower overall death rate the paper reports belongs to its vegetarians as a whole, a group that counts semivegetarians as well as vegans, and even that was estimated at 11% below nonvegetarians at age 65 and inside a range that includes no difference at 85 (our arithmetic from the hazard ratios).

Where vegans come out ahead

The Academy of Nutrition and Dietetics spells out the mechanism. Its 2016 position paper credits low saturated fat and high intakes of vegetables, fruits, whole grains, legumes, soy, nuts and seeds with lower total and LDL cholesterol and better blood sugar control, and the same paper says vegans need reliable B12 from fortified foods or supplements, which is where our vegan B12 guide picks up.

The cholesterol part has been tested on people who share their DNA. In a 2023 trial, 22 pairs of identical twins were split for 8 weeks, one twin to a healthy vegan diet and the other to a healthy omnivorous one. Relative to their omnivore siblings, the vegan twins’ LDL cholesterol fell by 13.9 mg/dL and their fasting insulin by 2.9 μIU/mL, and they lost 1.9 kg (about 4 lb, our conversion) more weight. Meals came by delivery for the first 4 weeks, after which both groups cooked for themselves.

EPIC-Oxford, which followed 48,188 British adults for about 18 years, found 22% less ischemic heart disease (our arithmetic from the hazard ratio) among vegetarians, vegans included, than among meat eaters, which the authors put at 10 fewer cases for every 1,000 people over 10 years. On cancer, a 2017 meta-analysis found a 15% lower incidence of cancer overall among vegans, while noting the result came from a limited number of studies.

Where they come out behind

The same British paper that found less heart disease found 20% more strokes (our arithmetic) in the same group, 3 more cases for every 1,000 people over 10 years, mostly from bleeding in the brain. The Adventist paper measured something different, deaths rather than cases, and found a higher stroke death rate at 85 among its vegetarians as a whole.

Hip fractures are where vegans come off worst. In EPIC-Oxford, fish eaters and vegetarians had about a quarter more hip fractures than meat eaters (our arithmetic), while vegans had a hip fracture risk 2.31 times that of meat eaters, equal to 14.9 more hip fractures per 1,000 people over 10 years, and 43% more fractures overall (our arithmetic), after adjusting for socio-economic factors, lifestyle and body mass index. The gap held, slightly smaller, when the researchers also adjusted for calcium and total protein intake, so it is not simply a story about protein, a question we take apart in whether vegans get enough protein. The authors conclude that bone health in vegans requires further research.

Do vegans live longer than meat eaters?

Not clearly, in either big study we read. The Oxford analysis pooled two cohorts, 60,310 people including 2,228 vegans counted among the vegetarians, and found no significant difference in deaths from all causes between diet groups. Its conclusion is that UK vegetarians and comparable nonvegetarians have similar all-cause mortality. In the Adventist cohort, vegans on their own showed no all-cause difference either.

The word comparable is where the case against a vegan advantage lives. Appleby and Key say overall mortality is similar for vegetarians and comparable non-vegetarians, while vegetarian groups compare favorably with the general population. The Adventist authors describe their own nonvegetarians as a generally health-conscious population, which gives only a moderate contrast with the vegetarians. On that reading, the advantage people credit to the diet shows up against the population at large and fades against meat eaters who look after themselves.

The case for the diet answers from the same Adventist data. Even against those health-conscious meat eaters, the vegetarian group as a whole had a lower estimated death rate at 65, and vegan men had lower mortality at younger ages. Two large analyses, and we do not think either side has the last word yet.

Do doctors recommend a vegan diet?

Dietitians did, in 2016. The Academy of Nutrition and Dietetics’ position then was that appropriately planned vegetarian diets, vegan diets included, are healthful and nutritionally adequate and may help prevent and treat certain diseases. It called them appropriate at every stage of life, pregnancy and infancy included. That position was in effect until December 31, 2021, and the Academy’s 2025 position on vegetarian diets covers adults only; our piece on whether a vegan diet is safe for kids covers what that leaves for children. The twins study ends on a softer note, saying clinicians can consider a vegan diet as a healthy alternative for their patients.

Our line rests only on the papers above. The heart evidence favors vegetarians and vegans, with less ischemic heart disease in the cohorts and lower LDL cholesterol in a short twins trial. The lifespan evidence we read does not show vegans outliving comparable meat eaters. If you are vegan and wondering about your bones, that is a conversation to have with your doctor.

The part we are least sure about is stroke. The Adventist authors offer one possible mechanism for the higher stroke risk in their oldest vegans and lacto-ovo vegetarians, almost no intake of long-chain omega-3 fats and low levels in the body without supplements, and they call the evidence on whether those fats protect against fatal stroke suggestive but mixed. Whether that makes an omega-3 supplement worth taking is a question the papers here do not settle, and our guide to veganism without supplements is where we argue the supplement question out.

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Gregory Knox

Gregory has been vegan since 2012 and came to it as a sceptic. He believed a balanced diet needed meat and dairy, so he read the studies and the books until he was sure it didn't. He still reads them, and turns what he finds into plain answers on food, ingredients, supplements and health questions. He also runs the technical side of Vegan Pots. Not a doctor, just very thorough.