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35 4 Am J C /in N u ir 1993 :5 8 :354-9 . P rin ted in U SA . 1993 Am erican Soc ie ty fo r C lin ica l N utrition

Hem osta tic fa c to rs and b lood lip id s in young B uddh is tvege ta ria ns and om n ivo re s 3H en -H a rm i P an , C lz ia -Jung C h in , C hin - T on S hezi, an d . in -H siz in g L ee

AB STRACT A com parison w as m ade be tw een the hem o-s ta tic an d lip id pro file s o fSS young C hinese B uddh is t v eg eta rians(23 m en . 3 2 wom en ) and 59 C hinese m ed ica l s tuden ts (2 0 m en .39 w om en) aged 20-30 y . T he m odern Buddh ist vege tar ian d ie tis h igh in carb ohydrate (6 3 o fenergy in m en . 58 in w om en)and has a h igh po ly unsatu rated -sa tu ra ted fa tty ac id ra tio . w ithm odera te fa t co n ten t (25 fo r m en . 3 0 fo r w om en) . R ice an dsoybean p ro te in s a re the m ajo r p ro tein sources. T h is s tudy dem -ons tra ted tha t th e m ajo r b eneficia l ef fects o fa m odern Buddh is tvege ta rian d iet a re o n b lo od con cen tra tions of cho leste ro l. thera tio o f apo lipopro tein A -I to apo lipop ro te in B . g lucose . anduric ac id . bu t n o t on m ost hem osta tic fac to rs s tu d ied . w h ichinc lu ded fib r in ogen . fac to r V II fac to r V III and p lasm inogen .V ege ta rian m en had s ign ifican tly h ig her concen tra tio ns of an -tith rom bin III than nonvege ta rian m en . Am J C /in N u trI 9 9 3 : 5 8: 3 5 4 -9 .

KEY W ORDS Cho les te ro l. trig lyceride . apo lipo pro te ins.g lucose . u ric ac id . fib rin ogen . fac to r V II fac to r V III an ti-th rom bin II I. p lasm ino gen . B uddh is t vege ta rian

IntroductionEpidem io log ic stud ies (1 -3 ) h av e dem onstra ted tha t the risk

of ca rd iov ascu la r d iseases in Sev en th -day A dven tists is low erthan tha t in om nivores. D iffe rences in b lood lip ids be tw een thesevege ta rian s and om nivo res have been w ell s tud ied (4 -9 ) andvege ta rian s in genera l have low er se rum cho leste ro l and low -dens ity -lip opro te in (LD L ) cho leste ro l than om nivores . T h isphenom enon h as been partia lly exp la in ed by a h igh d ie ta rypo lyun sa tu ra ted -satu rated fa tty acid ra tio (P :S ). low d ie ta ry fa tand cho les tero l in tak es. h igh fibe r in tak e . and prim arily p lan tp ro te in sources.

F ew stu d ies have exam ined the b lood lip id pro file o f m od ernBuddh ist vege ta rians, w hose d ie t has a h igh P :S and a m od eratefa t con ten t, and has rice and soybean as th e m ajo r p ro teinsources. E ven less atten tion has b een g iven to Buddh ist v eg e-ta rian s hem osta tic p ro file s . P rospec tive s tu d ies such as theNo rthw ick Park H eart stud y (N PHS ) and the Fram ing ham studyhave ind ica ted tha t h igher co ncen tra tion s o f fib r in ogen , fac to rVII and fac to r V III are assoc ia ted w ith in creased risk o f co r-o nary heart d iseases ( 1 0 , 1 1 ). How ever, re la tion s be tw een d ie tan d hem ostatic facto rs hav e no t been w ell s tud ied ( 1 2-1 6).

1 -lam es et a l ( I 2) fo und tha t B ritish v eg eta rians had low erco ncen tra tion s than NPH S nonvege ta rians o f no t on ly fac to r

V II b u t a lso o f f ib rino lv tic ac tiv ity and an tith rom bin III. In th eC aerph illy stud ( 1 3 ) a ll o f the asso cia tions be tw een m ajo r nu-trien ts and hem osta tic fac to rs w ere . in g en eral. ve ry w eak . Po s-itive assoc ia tions w ere observed fo r f ib er and po lyunsa tu ra tedfa tty ac ids w ith an tith rom bin II I. in con tras t to the find ings o fH aines e t a l. M ille r e t a l (14) sh ow ed in a sm all s tudy tha t a d ie tw ith 7 0 o f energy as fa t inc reased th e b lood co ncen tration offac to r V II b u t no t tha t o ffib rinogen . fac to r X . o r p ro th rom bin .A carbohydra te - and fa t-m odified d ie t w as sh ow n to redu ce co n-cen tra tions o f fac to r V II fac to r V III an d fac to r X bu t tora ise fib rino lv tic ac tiv ity ( 1 5) . A high-fibe r d ie t w as also shownto reduce concen tra tions of fac to r V II an d fac to r X bu t no neo fthe abov e in te rv en tion s dem ons tra ted any effec t on fib rinogencon cen tration . T o unders tand th e re la tions be tw een d ie t andhem o sta tic fac to rs . ou r stud y com pared hem ostatic and lip idpro files be tw een young Chin ese om nivores and Chinese B uddh is tvege ta r ians .

Sub jec ts and m ethod sR ecru itm en t w as carr ied ou t in la te Sep tem ber 1991 am ong

a ll stud en ts (2 00 w om en . 10 0 m en) in Y uan-G uan Buddh istC o lleg e. C hun li. T ao yuan . and am ong the jun io rs an d sen io rs(1 10 w om en . 1 50 m en) o f the D epartm en ts o f N u rsing andM edicine in the N ation al D efen se M edica l Schoo l. T a ipe i. T a i-w an . T he fo llow in g crite ria w ere u sed fo r the in itia l sc reen ing :sub jec ts 1) w ere aged < 30 y . 2 ) had no h is to ry o f hyp ertens ion .co ronary heart d iseases. o r d iabe tes, 3) were nonsm okers , 4 )w er e n on dr in ke rs . 5) sho u ld have ea ten a vege ta rian d iet fo r > 2y (vege ta rians). an d 6) w ere n o t tak ing asp irin . S ix ty vege tar ians(23 m en . 3 7 wom en) and 143 om n iv ores (101 m en . 4 2 wom en)m et the criteria . A ll qua lified fem ale v eg e ta rians and om nivo resw ere asked to partic ipa te and agreed . Am ong 101 om nivoro us

I F rom the Institu te o f B iom edical S c iences . A cadem ia S in ica : theIn stitu te o f P ub lic H ea lth and D epartm en t o f A gricu ltu ra l C hem is try .N a tio na l T a iw an U niversity M edica l Schoo l: and the G radu ate In stitu teo f H om e E conom ics. P riva te C hinese C ultu re U niversity , T a ip ei, T a iw an ,R epub lic o f C hina .

2 Supported b y the Ins titu te o fB iom ed ica l Sc iences, A cad em ia S in ica .T a iw an . R epub lic o f C hina .

3 A ddress rep rin t reques ts to W -H Pan . Ins titu te o f B iom edical S c i-ences . A cadem ia S in ica . T a ipe i I 15 . T a iw an . R epub lic o f C hina .

R ece ived A ugu st 14 . 1992 .A ccep ted fo r pub lica tion F ebruary 2 4 . 19 93 .

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BL O O D FAC T O R S IN BUDDH IST VE G E T AR IAN S 355m en 20 w ere random ly se lec ted to partic ipate . In f o rm ed -co nsen tf o rm s w ere signed by all partic ipan ts . T h e s tudy pro toco l w asappro v ed as eth ical w hen the re search pro posal w as rev iew ed .O ne om n iv o re and f iv e v eg etarian w om en q u it schoo l duringthe s tudy period . T w o om n iv o rous w om en w ere dro pped b ecausew e f ailed to ob tain c itrated b loo d sam p les accord ing to th e pro -toco l desc ribed be low . T h is s tudy f inally in clud ed 55 v ege tarian s(2 3 m en , 3 2 w om en ) and 59 om n iv o res (20 m en , 3 9 w om en ) .

T h e m acro nu trien t and f atty ac id com p osition s o f the d ie tw ere asse ssed b y w e igh ing th e f ood an d by ch em ical analy sis.B reak f ast, lunch , and d inner w ere se rv ed in the schoo l d in in ghall. A ll f oods se rv ed w ere w e igh ed b ef o re an d af te r m eals f o r3 con secu tiv e day s on tw o occasion s that w ere 1 .5 m o apart.Partic ipan ts also com p le ted a reco rd o f w hat they ate ev ery daydu ring the abov e day s, in c lud ing f oods p rov ided by th e k itchenand the snack s eaten be tw een m eals. T hree se rv ing s o f ev eryf oo d item p rov ided by th e k itchen w ere co llec ted , w e ighed , andcom b ined . A ll f oo ds w ere f reez e -d ried and g round up . C hem icalanaly s is (17 ) w as earned o u t to m easure the am ou n t o f en ergy .p ro tein , f at, carbohy drate. and crud e f ib er. T he f atty ac id p ro f ileo f ev ery f ood item w as de te rm ined by gas ch rom atography (18 )af te r hex ane ex trac tion . Fo od -com p osition tab le s ( 1 9 -20 ) w ereused to calcu late the nu trien t con ten ts o f th e snack s. D aily d ie tarym acronu trien ts , f atty ac id s , an d am ou n ts o f c ru de f ib er f o r eachind iv idual w ere calcu lated by add in g the nu trien t co n ten ts o fth e m eals and the snack s . D ie tary cho le s tero l w as calcu lated byus in g f ood -com position tab les . T he m ean nu trien t in tak e perday f or each ind iv idual w as calcu lated by av eragin g daily in tak esf o rth e6 d .

Fasting v enous b lo od sam p le s w ere also co llec ted on tw o oc -cas ion s 1 .5 m o apart f o r each su b ject. A sm all b u tte rf ly n eed le(no . 2 1 : N issho C o rp . O sak a, Japan ) w as used f o r pu nc tu re tom in im iz e traum a. N o m ore than one punc tu re w as con sidereda success f u l co llec tion . T he f irst 1 0 m L o f b lo od w as co llec tedin to a tube con tain ing sod ium heparin (S herw ood M ed ical, S tL ou is ). A f te r the tou rn ique t w as re leased . tw o precoo led tub esw ith 4 .5 m L so d ium citrate (B ec ton D ick in so n , R u therf o rd , N J)w ere f illed w ith in 30 s f o r each . A ll sam p le s w ere k ep t at 4 #{ 176 } Cf o r 2 0 m m to 1 h un til c en trif ug ation , th en sam p le s w ere spunf o r 1 5 m m at 300 0 x g at 4 #{ 176} C.f te r separation , p lasm a sam ple sw ere s to red at -7 0 #{ 176} Cn til chem ical analy sis w as perf o rm ed .Pro th rom b in tim e (PT ), ac tiv ated partial th rom bo -p lastin tim e(A PT T ), f ac to r V II f ac to r V I II an tith rom b in III, and p las-m inog en w ere m easured in sod ium c itrated p lasm a, w ith in 1m o o f b lo od d raw ing by u sing an A u tom ated C oagu latio n L ab -o rato ry 300Plu s (In s trum en tation L aborato ry , M ilan o , Italy ).

B lood con cen tration s o f ch o le ste ro l, trig ly cerid e, g lucose , anduric ac id w ere m easured in h eparin iz ed p lasm a by us ing a M on -arch C h em is try 2 000 (In s trum en tatio n L ab orato ry , L ex ing ton ,M A ). C o ncen tration s o f apo lipopro tein s A -I and B w ere m ea-su red b y n ephe lom e tric im m unoassay by us ing an au tom atedA rray Pro te in S y s tem (B eck m an In s trum en ts In c. B rea, C A ) .M easurem en ts o f lip id com ponen ts w ere com p le ted w ith in 2m o o f b lo od draw ing .

E rro rs in m easu rem en t rep roduc ib ility f o r cho le s te ro l, u ricac id , g lucose , ap o lip opro te in A -I, apo lipo pro te in B , f ib rinogen ,P T , a n d A P T T w er e < 2.5%. T h e CV s f o r trig ly ce ride , f ac to rV I I f ac to r V I II an tith rom b in III, and p lasm in ogen w ere 4 .1% ,3 .2% , 8 .7% , 6 .7% , and 5 . 1% , respec tiv e ly . T h e m easurem en tsm ade on sam p le s co llec ted on tw o o ccas io n s w ere av erag ed f o r

each ind iv idual. T h e av erage w as used in s tatis tical analy s is.Pearson co rre lation , S tuden ts t tes t. an d D uncan s m u ltip le -range te st w ere used f o r data analy s is. A naly se s w ere d one byus ing the 5.45 (S A S In stitu te Inc . C ary , N C ) com pu te r so f tw areprogram.

R e s u l t sCharacteristics o f B ud dh ist vegetarians a nd o mn ni vo re. s

T a b le 1 g iv es the h eigh t, w e igh t, e x e rc ise tim e , and s leep tim ef o r the v eg etarian s an d om n iv o res. T here w ere no s ig n if ican tdif f erence s f o r m en or w om en f or the se characte rist ics. H ow ev er,th e av erag e age o f the v ege tarian m en w as 2 y o ld er and theav erag e age o f the v ege tarian w om en w as 4 y o lder than the irom n iv o rou s coun te rparts . M ean bod y m ass index w as s ign if i-can tly h igh er in v ege tarian m en than in om niv orous m en. T heed ucation al lev el, no t inc lud ing presen t en ro llm en t, w as low erin v eg etarian s than om n iv o res . T h e m ean tim e on a v eg etariand iet w as 5 .5 y f o r m en and 6 .7 y f o r w om en .D ietar i i ntake

In m en . om n iv o res con sum ed sign if ican tly m ore f at and pro -te in and le ss carboh y drate th an v eg e tarian s (T ab le 2 ) . T h e r e w asn o s ig n if ican t d if f e rence in en ergy in tak e be tw een th e tw o g roupso fm en . In w om en , v ege tarian s consum ed m ore energy and car-bohy d rate , bu t the re w as no d if f e rence in f at and p ro te in in tak esbe tw een th e tw o g roups o fw om en . In the v eg etarian s d ie t, car-bohy d rate p rov ided 57% and 62% o f energy f o r m en andw om en , re sp ec tiv e ly . and pro te in con trib u ted 12% o f energy .Fat p rov id ed 24 .7% an d 29 .5% o f the energy f o r v ege tarian m enand w om en , re spec tiv e ly . In om n iv o res, 4 7% and 52% of energ yw as f rom carbohy d rate f o r m en an d w om en , re spec tiv e ly . A p -p rox im ate ly 15% o f energ y w as f rom pro te in . Fat p rov ided 33%and 3 7% of energy f o r om n iv o rous m en and w om en , re sp ectiv e ly .T he P:S in v ege tarian s (3 .4 f o r m en . 3 .3 f o r w om en ) w as m o rethan th ree tim es that in om n iv o res ( 1 .3 f o r m en and w om en ) .V ege tarian s co nsum ed sign if ican tly le s s satu rated f atty ac id s andm onou nsatu rated f atty ac id s , bu t m ore po ly un satu rated f attyac ids th an d id om niv ore s. T h ere w as som e e ico sap en taenoicac id (EPA ) an d docosahex aeno ic ac id (D H A ) in the d ie t o f th eom n iv o res, b u t no ne in that o f th e B udd h ist v eg etarian s . D ie tarycho le s te ro l co ncen tration s o f the v eg e tarian m en and w om enw ere s ign if ican tly low er than those o f om n iv o res .Plasma l ip ids. apol ipopr oteins, gl ucose. and uric acid

V ege tarian w om en b u t no t v eg e tarian m en had low er u ricac id and g lucose v alues than om n iv o res (T a b le 3 ) . T h e r e w a sno s ign if ican t d if f e rence in p lasm a trig ly cerid es b etw een v ege -tarian s and om n iv o res. Om n iv orous p lasm a cho le s te ro l w ash igher than that o f v ege tarian s in b o th m en (0 .64 m m ol/L ) andw om en (0 .9 3 m m ol/L ). T he ratio o f apo lipop ro te in A -I to Bw as also h ig her in v eg e tarian s than in om n iv o res, sign if ican tlyso in w om en . In te rm s o f ind iv id ual ap o lip opro te in s (A -I an dB ), v ege tarian w om en h ad a s ign if ican tly h igher ap o lipopro te inA -I concen tration (by 17 .6 m m o l/L ) th an om n iv o rous w om en .T he ir ap o lip opro te in B concen tration s w ere n o t sign if ican tly d if -f e ren t. V eg etarian m en had a sign if ican tly low er apo lipopro teinB b u t no t ap o lip opro te in A -I concen tration th an om n iv o rousm en . V ege tarian m en had h igher concen tratio n s than v ege tarian

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35 6 PAN ET ALTABLE ICharac te ristic s o f the sub jec ts

M en W om en

Vege ta r ian Omnivore Vege ta r ian Omnivore(m l - 23 ) (n = 20 ) (n = 32 ) (n = 39 )

A ge (y ) 22 .6 44*f 20 .6 4. 1 24 .8 4 .0 20 .3 4. 1H eig h t (m ) 168 .1 4. 9 171 .7 4 .1 1 58 .5 6 . 1 1 6 1 . 1 4 . 1W eigh t ( kg ) 56 .4 6 .5 62 .7 3. 7 50 .4 8 .0 53 .7 5. 9Body m ass ind ex * 20 .0 2 .3 t 21 .3 1. 2 20 .1 2. 8 20 .7 2. 6E xe rcis e tim e (h /d ) 0 .6 9 0 .46 0 .67 0 .67 0 .90 0 .90 0 .68 0 .68S leep in g tim e (h /d ) 6. 4 0 .7 6 .1 0. 5 7. 0 0. 8 6. 8 0. 8Y ears v eg e ta rian 5 .5 4 .6 t 0 6. 7 6 .2 j 0P re vio us e du ca tio n

E lem en ta ry schoo l I (4 )11 0 (0 ) 3 (9 ) 0 (0 )Jun io r h igh schoo l I 1 (48) 0 (0 ) 7 (2 2) 0 (0)Senior h ig h sc ho ol 10 (44) 0 (0 ) 18 (56 ) 0 (0 )Col lege 1 (4 ) 20 (1 00) 3 (9 ) 39 (100 )* .\; SD .t Sign ifican tly d iffe ren t from om nivoro us m en , P < 0 .05 .: S ig n ifican tly d iffe ren t from om nivo res (com parisons w ere m ade w ith in sex g roups o n ly ), P < 0 .001 . In k g/m 2.II n, percen t o f sub jec ts fo r th e ca tegory in p aren th eses.

w om en of g lucose , u ric ac id , and trig lyceride . bu t low er co n-cen tra tions ofapo lipo pro te in A -I and B and low er A -I-B ra tios .S im ila rly , om nivoro us m en had s ig n ifican tly h igh er u ric ac idco ncen tra tion s th an om nivorou s w om en , bu t low er apo lipop ro -te in A -I c on cen tr atio ns .

H emostati c fa( tQ r cThere w ere n o sign if ican t d ifferen ces be tw een vege ta rian an d

om nivorou s m en in PT . and A PTT . and con cen trations of fi-b rin ogen , fac to r V II fac to r V III and p lasm ino gen (T ab le 4 ).O n the o th er hand , vege ta rian w om en had a sign ifican tly h igh erfac to r V III concen tra tio n and shor te r APTT values than the irom nivoro us cou n terparts. V ege ta rian w om en had h igher co n-cen tra tions of fib rinogen an d fac to r V III and low er concen tra -tions o f an tith rom b in III than vege ta rian m en . In om nivores ,w om en also had a h igher fib rinog en v alue than m en . D esp iteth e d iffe rence in hem ostatic fac to rs, m en and w om en did no td iffe r sign ifican tly in th e ir tw o c lo tting -tim e m easurem en ts.

Discu s s i onYoung Buddh ist vege ta rians b lood lip id s an d hem osta tic fac-

to rs w ere com pared w ith those ofom n iv orous m ed ica l stud en tso f s im ila r age . T he m od ern B uddh is t vege ta rian d ie t is sim ila rto the usua l C h in ese d ie t in te rm s of m ea l pa tte rn , cook ingm ethod s, cho ice ofs tap le (p rim arily rice ), and fru it and vege tab leconsum ption . T he m ajo r d ifferen ce arises from th e B uddh is tdoc trine tha t it is fo rb idden to k ill an y liv in g b eing s. N o flesh isinc luded in the d ie t. M ilk is a llow ed , b u t w as no t con sum ed inla rg e am ounts by the vege ta rian s w e stud ied . So ybean p rodu ctsa re the m ajo r subs titu te fo r a ll an im al p rod uc ts: the re fo re , theprim ary pro te in sources o f the vege ta rians w ere rice an d so ybeanprodu cts . T he num ber ofex changes se rv ed to the vege ta rians in

th is study w as 1 5 and 3 .5 fo r r ice and soyb ean p roduc ts , re -sp ect ive ly . w h ere as that s erv ed to th e om nivores w as 14 and 1 .

In genera l, vege ta rian s consum ed 7% less fa t, 10% m o re car-boh ydra te . and 3% less p ro te in than d id om n iv ores. Th e P -Sra tios o f bo th om n iv ores and vege ta rian s w ere h ig h com paredw ith tha t o f N o rth Am er ican popu lations . T he P :S of the veg-e ta rians w as m ore than th ree tim es tha t o f the om nivo res. Asubs tan tia l d iffe ren ce (400 m g /d) in d ie ta ry cho leste ro l ex is tedbe tw een th e tw o groups .

Th e da ta ind ica te tha t the om n iv ores had s ign ifican tly h igh ercon cen tra tions of p lasm a cho les te ro l, g lucose. and uric ac idsand h ig her ratios o f apo lipop ro te in A -I to B than vege ta rians.H ow ev er , in te rm s of hem osta tic fac to rs, B uddh is t vege ta riansw ere no t be tter o ff th an om nivores in genera l.

L oca l stud ies on Buddh is t vege ta rian s in T a iw an have d em -onstra ted low er cho leste ro l (2 1 , 22) and trig lyceride (2 2) co n-cen tra tions in v eg e ta rians than in om nivores . S tud ies in Seven th -day Adven tis ts h ave sh ow n tha t veg eta rian s in g ene ral h av e low e rch o les te ro l an d LD L cho leste ro l (4 -9 , 23). In B urslem et a lss tudy (24), bo th apo lipo pro te in A -I and B -l00 co ncen tra tion sw ere low er in th e v eg eta rians . H ow ever, in our s tu dy , con cen -tra tions o fapo lipopro tein A -I w ere no t low er in vege ta rian m enand w om en than in the ir om nivoro us cou n te rparts. O n the con-tra ry , th e apo lipop ro te in A -I concen tra tio n w as m uch h igher inv eg eta rian w om en than in om nivo rous w om en . Joop e t a l (25)dem ons trated in a hum an s tudy tha t so y pro te in in com parisonw ith casein cou ld s ig n ifican tly inc rease HD L cho les te ro l.W hereas soy pro te in m ay in crease p lasm a apo lipopro te in A -I ,it is no t c lear w hy th ere w as a sex d if fe rence in the apo lip opro te inresponse to a vege ta rian d ie t. T h is sex d iffe rence rem ain ed afte rag e and body m ass index w ere ad jus ted fo r. O ther com pon en tso f soybean pro duc ts su ch as phy to es trogen , sapo n in , phy tic acid ,an d so y fibe r m ay a lso con tribu te to the benefic ial e ffec ts

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* c SD . M eans w i th the same letter superscript are not si gni f i cantl y di f f erent, P = 0.05 ( D uncan s mul ti ple- range test).

BLOOD FACTORS IN BUDDH IST VEG ETARIAN S 357TA BL E 2D ai l y intakes of macronutr ients and fat ty acids*

M en W omenV egetari an Omnivore V egetari an Omnivore

(n = 2 3 ) (n = 20) (n = 3 2) (n = 39)Energy (I d) 8.7 4.1 8.9 1.5 7.9 1St 6.3 1.2Protei n(g) 61.3 l2.l t 78.1 13.8 58.2 11.3 59.9 11.3Fat (g) 57.7 l 3.l t 78.2 13.3 61.1 1 1.0 62.0 13.8Carbohydrate (g) 324.9 53.0 280.1 53.5 270.5 60.9t 178.0 35.9Crude f i ber (g) 5.6 2.4 5.8 2.5 4.9 l.5 6 .5 3.2Saturated f atty acid (g) 9.0 2 . Ot 1 8 . 5 3 . 5 1 0 . 0 2 . 4 t 1 4 . 9 2. 3

Palm i ti c (g) 6.0 l .4t 12.0 2.2 6.6 1St 9.7 1.5Steari c (g) 2.4 0.5t 4.8 0.9 2.6 0.6t 3.8 0.6

M onounsaturated fatty aci d (g) 12.2 3.l t 20.2 4.7 12.7 2.5t 16.9 3.3M y ristol eic (g) 0.15 0.04t 0.85 0.21 0.16 0.03t 0.77 0.18Palm i tol eic (g) 0.07 0.02t 1.40 0.33 0.07 0.O l t 1.23 0.26Olei c(g) 12.8 3.O t 21.2 3.7 13.7 2.7t 16.51 2.7

Pol yunsaturated fatty acid (g) 30.0 7.4 25.9 4. 7 31.8 5.9t 19.2 3 . 3L inoleic (g) 25.2 6.6 19.1 3.9 26.3 4.9t 14.6 3.0L inolenic(g) 3.6 l .l 2.7 0.7 3.7 0.8t 2.3 0.5Ei cosapentaenoi c (g) O t 0.06 0.02 O t 0.07 0.03D ocosahexaenoic (g) O t 0. 1 3 0.04 O t 0. 13 0.03Cholesterol (mg) 8.7 8.1 433.8 93.Ot 14.1 11.6 407.7 95.9t

P:S 3.4 0.5 1.3 0.1 3.3 0.5 1.3 0 . 2* i SD . P:S, ratio of pol yunsaturated to saturated fatty aci ds.tt Signi f i cantl y di f f erent f rom omnivores w i thi n sex group: tP < 0.001, jP < 0.05, P < 0.01.

of a vegetari an diet on l i pi d metabol i sm and to the sex di f - derl i ne i fw e adjusted for age and body mass index . Our f i ndi ngsf erence (26). on f actor V I I are not consi stent w i th those of o thers ( 1 2, 13)

I n our compari son of hemostati c f actors, the anti thrombin w ho found that a high concentrati on of f actor V I I w as associatedIII va lu e of th e vege tar ian m en w as higher than that of omni - w i th a high- f at d iet. T hi s could be due in par t to the f act thatvorous men, i n agreement w i th the f indi ngs of Rogers et al ( 1 3). the major di etary di f f erence betw een the young omniv ores andHowever, w e did not observe thi s di f f erence in w omen, and our B uddhi st vegetari ans i n T aiw an i s i n the P:S and cholesteroltw o clott i ng- time measurements did not di f f er betw een vegetar- i ntake. T he percentage contri buti on of f at to total energy di f f eredian and omniv orous men. I t i s al so not clear w hy vegetari an by < 10% betw een the tw o groups. I n a study by M i l l er et alw omen had signi f i cantly hi gher concentrati ons of f actor V I I I (14) . a di f f erence of 60% (70% fat vs 10% fat) caused a signi f i -and shorter A PTT . A major know n determ inant of f actor V I I I cantl y hi gher f actor V I I acti v i ty . On the other hand. a recenti s bl ood type. People w i th blood type 0 have a low er concen- i nterventi on study in young adul ts w i th 8% reducti on i n dietary -tration of f actor V I I I than others (27, 28) . Our resul ts f or con- f at content demonstrated unchanged concentrati ons of hemo-centrations of f actor V I I I w ere consi stent w i th or w i thout ad- stati c f actors (29). Fehi l y et al (30) f ound that i ntake of cerealj ustment f or bl ood type. H owever, the si gni f i cance became bor- f i ber w as negati vel y associated w i th concentrati on of f ibri nogen.

TA BL E 3M ean plasm a glucose. ur ic aci d, and l i pi ds i n v egetari ans and omniv ores*

M en W omen

V egetari an Omnivore V egetari an Omnivore(n = 23) (n = 20) (n = 32) (n = 38)

G lucose (mmol /L ) 4.54 0.44a 4.40 0.22a 3.82 0.5 1 b 4.38 0.3 1 aUr i c a c i d ( mmo l / L ) 3 6 9 4 8 3 5 7 3 0 2 2 6 5 9C 2 5 8 54E T ri gl y ceri de (mmol /L ) 0.77 0.24a 0.75 020ab 0.57 0.25c 0.62 0.27Cholesterol (mmol /L ) 3.52 0 4 6 b 4.16 0.71a 3.50 0 7 8 b 4.43 0.69aA pol i poprotei n A -I (mo1/L ) 43.64 521 b 44.29 S.64 66.39 14.36a 48.82 654L A pol i poprotei n B ( zmol /L ) 0.95 0. 1 7 1 .09 0.23 1 .2 1 0.33a 1 . 10 0.23 aRati o ofA -I to B 2.48 07b 2 . 1 4 04b 2 . 9 9 0 . 8 k 2 . 3 5 0 . 5

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35 8 PA N ET A LTA BL E 4M ean hemostati c f actors i n vegetari ans and omnivores*

M en W omenV egetarian Omni vore V egetarian Omnivore

(,1 = 23) (n = 20) (n = 3 1 ) (ii = 38)PT (s) 12.7 0.4 12.5 04ab 12.4 05ab 12.3 04bAPTT (5) 28.8 3 0 a b 29.5 2.8a 28.5 2#{149}7b 30.2 2.8aFibrinogen(g/L) 2.1 0.4 2.1 O .3 2.4 0.4a 2.5 0.4aFactor V I I (% ) 91.1 9 7 a b 88.0 141b 97.6 l5.0 93.4 15#{216}abFactor V II l ((v ,) 1 1 0. 2 380b 105.3 22. 1 b I 32. 1 343 1 10.7 32. 1 bA nti thrombin I I I (( I 1 0.9 l 2.7a 103.3 14.1 99.4 1 16b 103.3 I l .5 Pl a s m n oge n ( %) 1 1 0 . 0 l 5 . 6 a I 1 2 . 2 l 2 . 2 a 1 0 8 . 7 l 6 . 8 a 1 13 . 7 l 5. 3a

* . SD . PT , prothrombin tim e: A PTT , acti vated parti al thromboplasti n time. M eans w i th the same l etter superscr ipt are not signi f i cant l ydifferent, P 0.05 (D uncan s mul tip le-range test) .

Buddhi st vegetar ians in thi s study did not consume more f i bert han o mni vor es.

I n agreement w i th other f i ndi ngs ( 10, 1 1, 3 1 ), w omen had amuch higher concentrati on of f i bri nogen than did men, i rre-specti ve of thei r di ets. I t i s w el l know n that w omen have a muchlow er ri sk of developing cardi ovascular di seases than men. Ourf i ndi ng higher f i bri nogen concentrations i n w omen impl i es thatal though hemostasi s i s associated w i th the development of car -di ovascular diseases. hemostasi s and l i pi d metabol i sm probabl yw ork together i n the pathogenesi s of cardiovascular di seases. I naddi ti on, tw o clott i ng-time measurements did not di f f er signi f -icantl y by sex group.

I n conclusi on, thi s study demonstrated that the major bene-f i ci al ef f ects of the modern B uddhi st vegetari an diet i n y oungpeople are on blood concentrati ons of cholesterol , gl ucose, anduri c aci d and on the ratio of apol ipoprotei n A -I to B , but noton most of hemostati c f uncti ons studied. T he subjects studiedin the present study w ere al l i n thei r 20s. T he ef f ect of a B uddhi stvegetari an diet on hemostatic f uncti ons f or m iddle-aged or el -derl y subjects needs further study . #{163}3

M any thank s are due to the teachers and students at the N ati onalM edi cal D efense M edi cal School and at Y uan-Guan Buddhi st Col l ege.parti cularl y to Y aw -T ong Shieh for his enthusiasti c support.

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