Vegetarian Nutrition (VN) DPG Public Library

Neuenschwander M, Stadelmaier J, Eble J, et al.
Journal: BMC Medicine
Published: 2023

Key Points

• Study design: Systematic review and meta-analysis of 37 publications including 24 prospective cohorts.

• Aim: This study aimed to determine the association between substituting animal-based foods with plant-based foods and cardiometabolic health outcomes, including cardiovascular diseases (CVD), type 2 diabetes (T2D), and all-cause mortality.

• Cardiovascular disease outcome:

  • Replacing processed meat with the following plant foods resulted in a significantly lower risk of CVD:

    • Nuts: 27% lower risk (95%CI, 0.59 to 0.91, n_cohorts = 8).

    • Legumes: 23% lower risk (95%CI, 0.68 to 0.87, n_cohorts = 8).

    • Whole grains: 36% lower risk (95%CI, 0.54 to 0.75, n_cohorts = 7).

  • Substituting eggs with nuts and butter with olive oil also showed a 17% (95%CI, 0.78 to 0.89, n_cohorts =8) and 4% (95%CI, 0.95 to 0.98, n_cohorts = 3) lower risk of total CVD respectively.

  • There was an indication that replacing red meat with nuts, unprocessed red meat with nuts or legumes, poultry with nuts, and eggs with legumes may also be associated with a lower risk of total CVD.

• Type 2 Diabetes (T2D) outcomes:

  • Replacing red meat with nuts, whole grains, or processed meat with nuts showed a lower risk of T2D incidence.

  • Substituting poultry with whole grains and eggs with nuts or whole grains was associated with a reduced T2D risk.

• All-Cause Mortality outcomes:

  • Replacing red meat, processed meat, dairy, poultry, eggs, and butter with plant-based options like nuts, legumes, whole grains, and olive oil was linked to a reduced risk of all-cause mortality.

• Quality of evidence: The study assessed the certainty of evidence using the GRADE approach, indicating moderate certainty for some associations, while others had low or very low certainty.

• Significance: This is the first study to summarize the relationships between substituting animal-based with plant-based foods and cardiometabolic outcomes including CVD, CHD, T2D, and all-cause mortality.

Conclusion

The findings suggest that shifting from animal-based to plant-based foods is beneficially associated with cardiometabolic health and a reduced risk of all-cause mortality. It emphasizes the potential health benefits of adopting a plant-based diet.

Editor’s Note: This study is useful for advocating simple swaps and emphasizing that better nutrition is not all-or-nothing, but that every time a whole plant-based food is chosen over an animal-based food, this is a good bet for better health. More research is needed to evaluate swapping dairy, fish, and poultry with whole plant-based foods and to evaluate swapping animal-based foods with plant-based meat and dairy replacements.