Plant-based meat alternatives may be healthier for the heart than meat, despite being ultra-processed, a new report suggests.
A review of previous studies, published Wednesday in the Canadian Journal of Cardiology, found that replacing meat from a variety of animal sources with plant-based alternatives improves heart disease risk factors, including total cholesterol, LDL cholesterol and body weight.
“Plant-based meat is clearly a healthy alternative that is associated with reduced risk factors for cardiovascular disease,” said Dr. Ehud Ull, lead author of the study and professor of medicine at the University of British Columbia in Vancouver.
The new study, which examined studies published between 1970 and 2023, also found that meat alternatives vary widely in nutritional aspects, such as the amount of sodium and saturated fat they contain.
One clinical trial cited by the researchers found that when participants consumed plant-based alternatives, they experienced a 13% reduction in total cholesterol, a 9% reduction in LDL cholesterol, a 53% reduction in triglycerides, and an 11% increase in HDL cholesterol.
Uhl and his colleagues looked at two burger brands, one from an older generation and one from a newer generation that tasted more like beef. The older generation burger contained 6 percent of the recommended daily intake of saturated fat, while the new company's burger contained 30 percent. Similarly, the older generation burger contained 0 percent cholesterol, while the new brand's burger contained 27 percent.
The new report adds a new dimension to the question of how plant-based burgers might affect health.
Most meat alternatives are highly processed. Ultra-processed foods tend to be low in fiber and high in salt, sugar and additives, and have been linked to a higher risk of heart disease and premature death.
A study published this month in the Lancet Regional Health Europe found that eating ultra-processed, plant-based foods, including meat substitutes, may increase the risk of heart attack and stroke, although the study didn't directly compare the meat substitutes to real meat.
Ull countered that not all ultra-processed foods are unhealthy and the word shouldn't be “deadly” to food.
“Processing in itself isn't necessarily a bad thing,” Ull says. “It's true that these plant-based meats are highly processed, but that doesn't mean they're high in saturated fats or certain carbohydrates that can lead to harmful outcomes.”
What's needed are randomized trials looking at heart attacks and strokes in people who eat meat alternatives compared with regular meat eaters, Uhl said.
“Obviously, it might be difficult to do a double-blind study because people might be able to tell if they're eating meat or a meat substitute,” he said, “but some of the newer plant-based meats have flavors that are very close to real meat.”
Recommendation
Dr. Walter Willett, a professor of epidemiology and nutrition at the Harvard T.H. Chan School of Public Health, said that while some plant-based alternatives may be better for your heart than meat, “generally your best option is to eat whole foods.”
According to Willett, the healthiest whole foods are a combination of:
Nuts, seeds, soybeans and other legumes, whole grains, vegetables, fruits, liquid vegetable oils such as olive oil
A vegetarian or pescatarian diet “includes moderate amounts of dairy, eggs and fish about twice a week,” Willett said.
But not everyone is ready for that, “so I think there's room for what we call ultra-processed foods,” he said.
He pointed to a study published in the American Journal of Clinical Nutrition in 2020, in which participants consumed meat for eight weeks and then consumed a plant-based meat alternative for another eight weeks.
When participants consumed the meat alternatives, “their cholesterol and blood pressure went down by about 10 percent, which is a pretty big change,” Willett said. “Just because it falls under the definition of ultra-processed doesn't mean it's bad.”
Marie-Pierre St. Onge, an associate professor of nutritional medicine at Columbia University Irving Medical Center, says it's important to consider that plant-based meat alternatives come in many varieties, including different brands that contain different amounts of saturated fat.
“Consumers need to be more educated and educated about nutrition labels,” St. Onge said. “If a plant-based burger is providing 35 to 40 percent of your daily sodium intake, it's not good for someone with high blood pressure.”
Dr. Anu Lalla, director of heart failure research at Mount Sinai Fuster Heart Hospital in New York, said longer follow-up studies were needed to determine whether plant-based meat alternatives were healthier.
“Understanding plant-based diet programs and their long-term effects requires a concerted effort, as has been done with the Mediterranean diet,” Lara said.
To make healthier choices, she suggested looking at meat alternative labels for the following:
Sodium content Amount of saturated fat Protein sources such as pea and soy Gluten (for sensitive individuals) Artificial sweeteners
People are desperate to find an easy fix and try to pinpoint a specific diet, but one food won't make your entire diet healthier, Lara says.
“You need to take a holistic approach that includes a balanced diet rich in fruits and vegetables and exercise,” she said.
