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Childhood obesity is a widespread health problem in Australia. Overweight in childhood can lead to adult overweight and the development of risk factors for cardiovascular disease (CVD). Effective strategies for reducing childhood obesity are urgently required. A vegetarian diet has been shown to be an effective prophylactic to many lifestyle diseases in the adult population and may therefore be beneficial in children. However the metabolic demands of adolescents are different to adults and the impact of a vegetarian diet on CVD markers in this demographic is not certain. We compared key physiological and biochemical markers of health against responses to a modified, Schools Physical Activity and Nutrition Survey (SPANS) using one-way and two-way Analysis of Variance. 215 adolescents (14-15yrs) from 5 Adventist secondary schools in the Sydney and Hunter regions of New South Wales, Australia, participated in this study. Adolescents consuming predominantly vegetarian foods showed significantly better scores on markers of cardiovascular health, including, body mass index (BMI), waist circumference, Cholesterol/High density lipoprotein ratio and low density lipoprotein. Adolescents consuming nuts more than once per week, also showed lower scores for BMI and serum glucose irrespective of their vegetarian status. Markers of general health including haemoglobin and average height were not different between groups; however a lower serum level of vitamin B12 was apparent in the vegetarian cohort. Surprisingly, exercise on its own was not statistically associated with any of the risk factors tested suggesting that diet may be the most significant factor in promoting health in this age group.