How a Vegan’s Arteries Compare to a Runner’s

Image Credit: Oscar Rethwill / Flickr. This image has been modified.

Comparing Vegans’ Arteries to Runners’

We know from the work of Drs. Dean Ornish and Caldwell B. Esselstyn Jr. that switching to a plant-based diet can reverse heart disease, opening up arteries in some cases without drugs or surgery. We can’t wait until our first heart attack to start eating healthy, though, because our first symptom of heart disease may be our last (See China Study on Sudden Cardiac Death). Fifty percent of men and 64% of women who die suddenly from coronary heart disease have no previous symptoms.

To predict the risk of dying from a heart attack, we can measure risk factors such as cholesterol levels and blood pressure. But wouldn’t it be nice to actually see what’s going on inside our arteries before it’s too late? Our imaging technologies are so good now that we can, but the required dose of radiation delivered to one’s chest is so high that a young woman getting just a single scan may increase her lifetime risk of breast cancer and lung cancer by between around 1% and 4%. More on the radiation risks associated with diagnostic procedures in Cancer Risk From CT Scan Radiation and Do Dental X-Rays Cause Brain Tumors?

Our carotid arteries, though, which connect our heart to our brain, come close enough to the surface in our necks that we can visualize the arterial wall using harmless sound waves (ultrasound). Carotid artery wall thickness is what was measured in the study I profiled in Eggs vs. Cigarettes in Atherosclerosis. How do the arteries of those eating plant-based diets compare to those eating the standard American diet? Researchers gathered up some vegans to find out.

In the video, Arteries of Vegans vs. Runners, you can see the thickness of the inner wall of the carotid arteries where the atherosclerotic plaque (considered a predictor of all-cause and cardiovascular mortality) builds up in the standard American diet group. This same inner layer was significantly slimmer in vegans, but so were the vegans themselves. Those eating the standard American diet were, on average, overweight with a BMI over 26 while the vegans were a trim 21—about 36 pounds lighter on average.

So maybe the only reason those eating meat, eggs, and dairy had thickened arterial walls was because they were overweight—maybe the diet per se had nothing to do with it. To solve the riddle one would have to find a group of people still eating the standard American diet, but as slim as vegans. To find a group that trim, researchers had to use long-distance endurance athletes, who ate the standard American diet, but ran an average of 48 miles per week for 21 years. Both the vegans and the conventional diet group were sedentary—less than an hour of exercise a week.

As you can see in the video, the average thickness of endurance runners’ carotid arteries is between that of sedentary vegans and omnivores. It appears that if we run an average of about a thousand miles every year we can rival some couch potato vegans. But that doesn’t mean we can’t do both.

Another comparison between athletes and plant-eaters can be found in Is It the Diet, the Exercise, or Both? It compares cancer-fighting abilities with a similar result.

None of this is to disparage exercise, which is critical for a variety of important reasons, immunity (Preserving Immune Function in Athletes With Nutritional Yeast), breast health (Exercise & Breast Cancer), and brain protection (Reversing Cognitive Decline). So diet and exercise, not or exercise. My physical activity comes from walking while I work: Standing Up for Your Health.

Not all studies showed vegans have superior arterial form and function. Find out why in my video Vitamin B12 Necessary for Arterial Health.

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my videos for free by clicking here and watch my full 2012 – 2015 presentations Uprooting the Leading Causes of Death, More than an Apple a Day, From Table to Able, and Food as Medicine.


Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.

32 responses to “Comparing Vegans’ Arteries to Runners’

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  1. I’d like to comment on “…but the required dose of radiation delivered to one’s chest is so high that a young woman getting just a single scan may increase her lifetime risk of breast cancer and lung cancer by between around 1% and 4%.” However, mammograms are considered the ‘gold standard’ in breast cancer prevention, yet they are sources of ionizing radiation–the very cause of cancers! When will MDs, the cancer industry and healthcare insurance providers realize that there is a more effective and totally non-radiation-producing breast screening test available for women that is FDA approved? It’s Thermography, which detects heat from cancer cells and, therefore, can provide cancer-detection information much sooner than a mammogram can.
    Also, can yearly mammograms be one of the ‘unrealized’ causes of lung cancers in women who don’t smoke? Just a thought.

    1. And when you bring along some vitamins and food onto the airplane, it all gets x-rayed in security. Then you eat it! And the food and vitamins absorb radiation 1000s feet in sky, then you eat it. Fast from food when flying? Buy supplements at store when back on ground?

    2. Indeed, they do know the truth. It has been accurately stated that if a woman continues to get her annual mammograms, doctors will eventually find cancer … Because the accumulated result of mammograms IS cancer. Never forget that cancer is a 200 billion dollar (plus) per year industry. If cancers are suddenly cured, do we honestly think that the thousands of oncologists will go to work at Home Depot and the countless huge cancer hospitals will be converted to seminaries and hotels? The proliferation and propagation of cancer buys too many mansions, yachts, airplanes, chemotherapy drugs, GMO farms, Da Vinci machines and Mercedes to be defeated in this day and age.

    3. Just curious, where did you get the info that thermography can be more effective and find cancer earlier? Because what I’ve read has said the opposite, that it is in fact less effective. However, I would love to be believe your claim and see some evidence to the contrary.

      1. This site would recommend after a mammogram eating some dried ginger and lemon balm lemonade. Perhaps after a mammogram the patient could eat some beets, garlic, broccoli, apples, lemonade, cranberries, ginger, tumeric with pepper, cloves, oregano, rosemary, chamomile, white tea with lemon, matcha, dandelion tea, peanuts, pecans, walnuts, nori sheets, mushrooms, black beans, and black raspberries. I think it is very important to note that persons administering the mammograms are very likely to get cancer for the same reason. Mammograms are a major cause of breast cancer? While they are highly recommended for prevention? That must be what holds women to the health they have.

      2. She read it on some radical misinformed “Occupy Movement” type website. Therefore, it MUST be factual… and even more authoritative than the peer-reviewed reproducible independent clinical studies that contradict her conjecture.

    4. Well, Catherine… since you’re the one claiming that Thermography is “more effective for women” at detecting breast cancer, perhaps you should cite a continuum of peer-reviewed reproducible clinical studies validating it. If not, your entire post amounts to hyperbole and unfounded opinion. This is a website about facts and clinical studies, not erroneous opinion.

  2. As a home health nurse I visited a male who was 65 years old and had run 29 marathons in his life. He had started feeling short of breath and his doctors though maybe it was his asthma flaring up. His PCP sent him to a cardiologist for a heart work up and he ended up in the hospital for a 5 vessel cardiac bypass. I didn’t have the opportunity to ask him what his diet consisted of but I’m sure he was not on a whole foods plant based diet with very little added oil.

    1. Diane: Great post. Now-a-days, people equate skinny and active with healthy. While those are two ingredients that help lower someone’s risk factors, they by no means indicate a healthy individual. It’s like saying that vegan = healthy without specifying more details about the vegan part of the diet. Your story helps to make the point. Thanks.

    2. I always thought large amounts of vigorous exercise were better than less and easy exercise. But James O’Keefe (cardiologist) and others have written papers documenting mechanical heart issues and also increased artery plaque buildup for those participating in extreme/long-endurance exercise. These weren’t necessarily low-fat athletes, so I can imagine why increased blood flow of fatty blood would increase plaque buildup, but the mechanical failures of the heart later in life bother me a bit. I’d be willing to bet that vegan marathoners don’t have the save plaque buildup, but the mechanical bit is interesting. I played soccer intensely for a couple hours a day when I was in my teens.

      O’Keefe talks about it in this TED talk:

      Scientific Papers:

      Also, see this post (especially his points 5 & 6) by Jeff Novick (McDougall Dietician, in the discussion boards):

      1. The O’Keefe video was interesting but the better video was “The most important lesson from 83,000 brain scans” by Daniel Amen. I want to know what the reversing brain damage Brain Smart Program is.

  3. Dr. Greger. I’d be interested to know what your cardiac risk factor stats look like. I am 61 y/o with a BMI of 21. Total cholesterol 146. HDL 70. Trigycerides 40. My preferred forms of exercise are resistance tubes, especially for developing upper body strength, and something you once mentioned with a chuckle: whole body vibration. I can tell you that it is no joke, assuming you have the proper equipment. On Black Friday last I purchased a Hypervibe machine. Believe me when I tell you you won’t be laughing if you try doing pushups and squats for ten minutes at 17 G’s. There is mounting evidence that brief, high intensity exercise is more beneficial than prolonged “cardio”. Plus, as the editor of Ironman Magazine put it, “you look better when you’re naked”.

    1. Thanks for saying brief high intensity exercise is better than high endurance exercise. I think this might be because you are more likely to do it. Just running three laps a day can cut your heart disease risk in half. The only thing is, there was a way to get people to keep the exercise up. They called it a cure for many illnesses. Recommendations for one half hour of high intensity exercise made many people give it up entirely, and for their lives. With a HDL reading of 70, you are unlikely to die any time and may make it to 100 or later, your thinness will also grant you long life,

    2. The main questions:
      1) you must consult your doctor for high intense exercises
      2) How much time do you have to do exercises?
      3) How many days in a week you can train?
      4) Do your body prepare for high intense exercise? high risk of injuries
      Is boring for you walk or run, or train at the same rhythm?
      High intense exercises disturb your sleep?

    3. There isn’t any evidence to support the vibration machines. I had a company try and get me to endorse its use but the research is lacking.

  4. It is interesting subject you brought up Dr. Gregor.
    I am Internist who has been Vegan for 12 years. i have intolerance to Statins and my baseline Total Cholestrol was 356. with LDL of 234. I have been offering CIMT test from office for last 7 years. 7 years ago despite Vegan diet my LDL was still 140. My CIMT at age 58 indicated that i had arteries of 54 years old. Which was a pleasant surprise but I did not know the reason until 3years later at age 61, when i rechecked my CIMT and found my arteries were of someone 45 years old.
    At the same time I checked CIMT on a dentist friend who had run in more than 30 marathons. He had a LDL of 109 and weighed the same as I. We are same age.His artery age was 71.Shocked I took Diet history and found that since he ran 40-50 miles a week to maintain weight he used large amount of whey protein and Ice Cream.That convinced me and several others of colleagues benefits of Vegan diet.

    1. Do you think Vegans live longer? If so how much longer? If the benefit is that stark, how do we not give into temptation and eat animal products like yogurt and chicken for taste? I had heard the probiotics in yoguart could make you live longer.

      1. Yes indeed.Studies show vegans may gain 3.7 years to 6.5 years depending upon which study you look
        at.Difference tends to decrease by the 9th decade of life.But more important than longer life expectancy
        is quality of life.Vegans and vegetarians suffer from fewer heart attacks and strokes in the 60’s and also have lower risk of disabling conditions such as osteoarthritis.
        As far as probiotics ae concerned i have not come across any scientific evidence of that..

        1. Thank you very much! By being a vegan I could gain 3.7 to 6.5 years of life. That may be on top of being a vegetarian, because according to the Lora Dunning University, vegetarians live 8 or more years longer than other Californians if you’re a man or 4 years longer if you’re a woman. Did you know that donating blood can add ten years to your life as a man? It causes an enormous drop in blood pressure all month and removes a lot of Iron and “spent” or malfunctioning proteins. I wish I had the will power to eat vegan all year and donate blood every month. This site shows that eating vegan is the healthiest path. There are other avenues to longevity. It is thought that people live longer with regards to how close they are to the center of a country or the capitol. For instance, white men live more than ten years longer than average in D.C. and there are more black 100 year olds there than anywhere else. Having sex and being married can add years to your life, and being a mother drops a woman’s risk of all cancer of her reproductive tract. Swimming is so good for you that it should be part of any life, as is reading and meditating. I am going to find the ideal path to long life with this website in mind.

      2. Matthew Smith: Here is another study that should interest you (from PCRM Breaking News):

        “Vegetarian diets can extend life expectancy, according to early findings from the Adventist Health Study-2. Vegetarian men live to an average of 83.3 years, compared with nonvegetarian men who live to an average of 73.8 years. And vegetarian women live to an average of 85.7 years, which is 6.1 years longer than nonvegetarian women. This study is ongoing and includes more than 96,000 participants. The results further indicate vegan diets to be healthful and associated with a lower body weight (on average 30 lbs. lower than that of meat eaters), and lower risk of diabetes, compared with diets that include animal products.

        Fraser G, Haddad E. Hot Topic: Vegetarianism, Mortality and Metabolic Risk: The New Adventist Health Study. Report presented at: Academy of Nutrition and Dietetic (Food and Nutrition Conference) Annual Meeting; October 7, 2012: Philadelphia, PA.

        Also, note that Dr. Greger is working on a book right now on this very topic. So, we should be getting some awesome data/ideas on longevity when he is done.

        1. Thank you very much for your reply! I have found great help from your site here. I think it is not just diet that can add to life but also lifestyle choices:
          Meditating can add ten years to your life.
          Swimming can add ten years to your life.
          Being married,can ten years to your life.
          Listening to classical music can add many years to your life.
          Going to Church or Temple or prayer group can add ten years to your life

          What would happen if you did all of them and were a vegan?

          I really like that you shared this study. I am surprised that the vegetarians lived that much longer. It must be more of a benefit than just being a devoted Adventist. Perhaps they both have a benefit. Is Dr. Greger interested in demography? They study lifespan and population ecology in humans. Where would people go to live the longest? Current thinking says Washington D.C. for white men, perhaps because it is the center of our society. Many Asians in Hawaii make that the longest lived state in America. I would ask if Indians living near the capitol of India live longest, since they are at the capitol of a vegetarian society. Where are people the tallest? The healthiest? The smartest? The hardest working? The longest lived? These are the questions of a demographer. I think it is based on how close you live to a federal banking institute. Vegetarianism seems to have the same kind of benefit as being a demographer or cultural treasure.

      3. Matthew do you eat animal products everyday? Once I actually gave them up I wasn’t temped. It’s funny but if I inadvertently eat something with animal, like mashed potatoes the butter tastes rancid to me. Nasty.

        1. Yes, I eat animal products everyday. I every now and then I am tempted by them when really I am demonstrating that it is healthier to not eat them. I would love to be a vegetarian again. I have switched to soy milk in cereal and brown rice instead of white. It is divine. I have lost weight eating less meat and taking the fenugreek supplement. I have found a better quality of life for myself by naming the healthiest plant foods when I repent. Amla, Nori, Mushrooms, black raspberry, and all in the center of my intestines, if I repent them there, help me to feel as healthy as when I was a younger man, a vegetarian. Dr. Greger said the plant based diet can give the benefit of the reduced calorie diet. I am interested in getting the benefit of being a vegan, with no Cholesterol and low Saturated Fat. Thank you for showing me why less meat you eat the less you like it. I eat whole grain cheerioes with flax seed and soy protein powder as milk, grapefruit, a blueberry greek yougart with extra blueberries, a pot of matcha tea, and then I try to eat beans, nuts, and whole grain. I make a snack of nori, a half mushroom, almonds, walnuts, dark chocolate, kiwi, dried blueberries, golden raisins, and dried pomegrante or ginger for long life. I am interested in finding what I would like for lunch and dinner that doesn’t have meat or animal in it. Designing meals with Orac and cancer reduction in mind saves me time and money. When you eat meat, I think, the IGF-1 spike causes you to get hungrier and hungrier. Thank your expertise.

  5. Is it healthier to do moderate exercise of slightly elevated heart rate rather than interval bouts of intense heart zone targeted exercise?

    Lately Ive seen claims that moderate bouts (not extreme) of high intensive exercise causes a negative stress response in the body (more ageing). I wonder if they body assumes yr running from a predator.

    In contrast, Ive been told to target high heart rate because my legs feel fatigued when I walk up 3 flights of stairs. I stand most of the day and walk instead of drive. My diet is low fat whole fat vegan with raw nuts and flax seed oil.

  6. Dr. Greger, I have a question about nutritional yeast: I recently noticed that one of the brands sold at my local store had a Proposition 65 label on it. Alarmed, I called the company to find out why. They explained that nutritional yeast has low levels of lead and that they are required by law to label it for Prop 65 in California. They claimed that the lead levels are too low to harm anyone, and also that other brands of nutritional yeast contain lead but that they aren’t being labeled. I really can’t imagine eating something with enough lead in it that it has to be labeled. What is the deal?

  7. Will going vegan affect my performance in endurance sports?

    I am a 22 year old Law student who grew up in Zimbabwe but lives in London. I do a lot of endurance sports; last year I ran an ultra marathon in the arctic circle and have done three marathons in under 3 hours. I cut out all processed food three years ago, but still ate chicken fish and eggs. After reading How Not to Die and The China Study three months ago, I transitioned to a whole foods plant-based diet. I haven’t eaten any animal products for 12 weeks and feel great. I am doing my first Ironman this summer in Canada and have been approached by many people in the endurance sports community saying that if I go vegan now I might jeopardise my health. I tell them about Brendan Brazier and his success as a triathlete but usually the answer is ‘yes, but your body is not used to it’, which has begun to worry me. I have read so many conflicting articles about the subject and I don’t know if it will actually be bad for my health, or negatively affect my performance as an athlete who has run on high animal protein for years. Has Dr. Greger got any info on this?

    1. If you feel better, that is all you need to know.
      There are so many incredibly dumb people on this planet. You are luckily not one of them, you can think for yourself by gathering new evidence and what sources they come from.
      Most can’t. Most are sheep and rather believe a McDonalds commercial than from an nutrition expert.

      I have been vegan for 3 years. Still I hear stupid comments like; “you don’t get enough omega 3”.
      I went home and googled “vegan omega 3 sources”. What came up? TONS of food. It’s impossible to not get omega 3.

      So don’t believe the sheeps. Believe guys like Dr. Greger and yourself.

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