Can plant-based food swaps cut your risk of heart disease? (2024)

News outlets have reported that swapping animal-based foods for plant-based foods can lower your risk of heart disease and diabetes. We go behind the headlines to check the claims.

Published 15 January 2024

According to research published in BMC Medicine, switching from meat and dairy to plant-based foods such as whole grains, beans, nuts, olive oil, fruits and vegetables may significantly lower the risk of cardiovascular diseases, such as coronary heart disease,and type 2 diabetes.

The researchers, based in Germany, reviewed 37 studies carried out up to March 2023. They only considered studies with generally healthy participants who switched from animal-based to plant-based food. Participants in each study were also observed long term to see if they developed cardiovascular disease or type 2 diabetes, or if they died from any cause during the study.

They noticed a clear improvement in risk when processed meats such as ham, bacon, hamburgers and sausages were swapped for nuts or legumes. The risk of cardiovascular disease was 25 per cent lower when daily processed meat was swapped for daily nuts or legumes. There was also a 20 per cent drop in the risk of type 2 diabetes and of dying from any cause when switching daily processed meat for daily nuts.

In addition, replacing one egg per day with nuts was linked to a 17 per cent lower risk of cardiovascular disease, and replacing it with nuts or whole grains was associated with a 20 per cent lower risk of type 2 diabetes.

There was no clear evidence that swapping poultry, fish or shellfish for nuts or legumes reduced the risk of cardiovascular disease. However, swapping poultry for whole grains did mean a 13 per cent lower risk of type 2 diabetes.

What do the researchers say?

The researchers conclude that shifting from animal-based to plant-based foods showed a beneficial link with heart health and diabetes risk. They also note that the strongest link was seen when processed meats were replaced with nuts, legumes and whole grains. and whole grains.

Study lead Dr Sabrina Schlesinger, of the German Diabetes Centre in Düsseldorf, said: “Many people start the day with an egg or fry-up for breakfast, but the results of this analysis suggest it might be better to replace these foods with plant-based foods. There is also evidence that people could benefit from replacing poultry with plant-based foods, although there was little evidence for replacing dairy.”

In the paper, the authors call for more studies to be done to help fill gaps in our understanding. Meat and dairy replacement products have become very popular, but no studies on them were available for the review. The researchers also had to treat dairy products as one group in the absence of studies looking at specific types of dairy like milk, yogurt and cheese.

The BHF verdict

When it comes to lowering our risk of heart and circulatory diseases, we already know that most of us could benefit from reducing how much red and processed meat we eat. This research supports this. In the UK, government guidelines are to try and limit red and processed meat to no more than 70g a day, which is about three slices of ham, two slices of bacon or one small beef burger. The guidelines also recommend choosing plant-based proteins more often.

A well-balanced vegetarian or vegan diet can be a healthy way to eat, but you don’t have to exclude meat completely to benefit. A traditional Mediterranean diet has been linked to a reduced risk of heart and circulatory diseases. This includes meat, but in small amounts, with more plant-based proteins such as lentils, nuts and seeds as well as fish.

If you want to reduce the amount of red and processed meat that you eat you could start by including a vegetarian meal each week or by substituting some of the red or processed meat you eat with pulses. We’ve got some great recipes on our recipe finderso take a look for some inspiration.

How good was the research?

The researchers used two related methods called systematic review and meta-analysis. In systematic reviews, several studies which looked at the same research question are grouped together and analysed in a structured way. Meta-analysis is the statistical method used in a systematic review to combine the findings of those studies. High-quality systematic reviews are often more trustworthy than each study taken alone.

This was the first systematic review and meta-analysis to summarise the connection between swapping animal-based for plant-based foods and the risk of cardiovascular disease, type 2 diabetes and death. One strength of the research was its use of the ‘GRADE’ method, which is a systematic approach to rate the certainty of the results. This helped the researchers know how confident to be about their findings.

However, there were also limitations. Due to the observational nature of the studies, it’s impossible to know whether the food swaps directly led to improved heart and metabolic health. While the researchers adjusted for factors such as physical activity, alcoholintake and smoking, they may have missed other factors known as ‘confounders’ that contributed to the outcomes.

How good was the media coverage?

This research was covered in news outlets including The Guardian, The Daily Mail and The Mirror.

The Guardian headline was accurate: “Plant-based swaps may cut diabetes and heart disease risk, major review finds.” The article gave a balanced summary of the research, drawing attention to its main findings while also highlighting its weaknesses.

The Mirror headline was: “Easy breakfast swap could slash your risk of a heart attack” and The Daily Mail headline was: “Don't go to work on an egg - have a handful of nuts instead! Scientists say simple breakfast swap could slash your risk of a heart attack.”

Both headlines call attention to eggs as the main food swap to know about, when swapping processed meats had the greatest impact on heart health, type 2 diabetes risk and death from any cause. In addition, the headlines mention heart attack risk but the research focused on heart disease and diabetes risk.

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