There is “strong and consistent evidence” that a plant-based or vegetarian diet is beneficial for heart health, preventing and even reversing atherosclerosis and reducing other risk factors for cardiovascular disease, such as blood pressure, weight and blood lipids.
This is according to the authors of a review that gathered results from multiple clinical trials and observational studies.
Defining a plant-based diet as one high in fruit, vegetables, grains, pulses and nuts (with most vegetarians also eating dairy and eggs), the authors say a vegetarian or vegan diet is associated with a 40% reduction in the risk of death from cardiovascular disease; a 40% reduction in the risk of coronary heart disease; and is linked to either fully or partially opening blocked arteries in up to 91% of patients.
According to the World Health Organisation, an unhealthy diet, tobacco, limited physical activity and excessive alcohol all increase the risk of dying from a non-communicable disease (NCD), and nearly half of NCD deaths worldwide are attributable to cardiovascular disease – equivalent to around 17.9 million.
Useful 'transition foods'
Director of clinical research at the US-based Physicians Committee for Responsible Medicine and study author Hana Kahleova, Ph.D, M.D. said a "whole-food, plant-based" diet is the healthiest option. “And the less processed the foods are, the better.”
However, plant-based meat replacements made from soy, wheat or pea protein, for instance, with added flavours, colours and texturisers are useful, she added.
“Processed plant-based foods like veggie sausage, bacon or vegan cheese can be useful for some to use as transition foods, because they provide the taste of the animal products people are accustomed to consuming, with fewer health risks," she told FoodNavigator.
“While they may not be as healthful as whole plant foods, they’re often much lower in cholesterol, fat, and saturated fat than animal-based foods.”
Processed plant proteins could also be a ‘gateway’ to a healthier diet as a whole.
“Often, as people experiment more with plant foods, their taste buds change, and they rely less on these processed foods and more on whole plant foods. There are also many great plant-based replacements made from healthful, whole foods, for example veggie burgers made with beans, rice, and vegetables.”
'The science is clear'
Kahleova’s message to the food industry? Embrace the science and the trend.
“The science is clear that plant-based foods are beneficial for our health, and more and more consumers are starting to seek out plant-based products. It would be valuable for […] the health of consumers if manufacturers embraced this trend and begin to offer more ready-to-eat products made from plants that are as natural as possible and full of flavour,” she said.
The EPIC-Oxford study showed a 32% lower risk of coronary heart disease (CHD) compared with non-vegetarians.
A 2012 meta-analysis by Huang et al of seven studies with a total of 124,706 participants showed “significantly lower mortality” from CHD in vegetarians compared with non-vegetarians.
The review notes that a healthy diet and lifestyle reduces the risk for a heart attack by 81 to 94% while medications achieve a reduction of around 20 to 30%.
Kahleova said: "A plant-based diet has the power to not only prevent heart disease, but also manage and sometimes even reverse it - something no drug has ever done."
The researchers call for further research to explore the role of different components of plant-based diets, as well as more randomised clinical trials.
Source: Progress in Cardiovascular Diseases
“Vegetarian Dietary Patterns and Cardiovascular Disease”
Published online 22 May 2018, DOI: https://doi.org/10.1016/j.pcad.2018.05.002
Authors: Hana Kahleova, Susan Levin, Neal D. Barnard