Study links vegan fake meat to increased cardiac deaths, experts say plant-based diet could improve health

Replacing meat and dairy with plant-based alternatives may not be as easy a health change as you might think.

Eating fresh vegetables has been linked to a lower risk of cardiovascular disease, but you might want to rethink how many vegan burgers and cakes you eat.

Scientists found that choosing ultra-processed plant-based products such as vegan sausages and burgers, cakes and crisps meant to replace animal products was linked to a 15% higher risk of suffering a heart attack or stroke.

This is according to the results of an analysis of the diets of more than 118,000 participants in the UK Biobank study.

Ultra-processed foods, high in fat, salt and sugar, have long been blamed for increasing the risk of heart attack and stroke.

Now, a study published in The Lancet Regional Health Europe suggests that these risks also exist with plant-based UPFs, with high intakes associated with a 15 percent increased risk of cardiac death.

The study, which involved experts from Imperial College London,More than 118,000 British people aged 40 to 69 had their eating habits assessed over at least two days.

Scientists classify foods into plant-based products like fruits, vegetables, grains, bread, cakes and sweets, and animal-based products like fish, poultry, red meat, eggs and dairy products.

The two groups were then further divided into ultra-processed (UPF) and non-ultra-processed.

This data was then linked to hospital and death records to obtain information on cardiovascular disease.

People who ate a lot of ultra-processed plant-based foods had a 7% higher risk of developing cardiovascular disease and a 15% higher risk of death compared to vegetarians who ate fewer such foods.

A 10% increase in intake of unprocessed vegetarian foods, such as fresh fruits and vegetables, was found to reduce the risk of heart disease by 8%.

Vegetarians, who ate the least amount of UPF, had a fifth fewer deaths from heart disease and a 13 percent reduction overall in deaths from cardiovascular disease, which is caused by the buildup of fatty deposits in the arteries.

“Fresh plant-based foods such as fruit, vegetables, whole grains and legumes are known to have important health and environmental benefits,” said study co-author Dr Ester Vamos from the Imperial College London School of Public Health.

“Although ultra-processed foods are often marketed as health foods, this large-scale study suggests that ultra-processed plant-based foods have no protective health benefits and may actually be linked to poorer health outcomes.”

Scientists suggest that food additives and industrial pollutants in these foods may cause oxidative stress and inflammation.

He added that nutritional guidelines that recommend a plant-based diet and reduced meat intake should also promote the importance of avoiding UPFs for heart health.

Study author Dr Fernanda Lauber, an expert in preventive medicine at the University of Sao Paulo in Brazil, said this was the first time that ultra-processed plant-based foods had been shown to be associated with an increased risk of cardiovascular disease.

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“Despite being plant-based, these foods may contribute to risk factors such as dyslipidemia and hypertension due to their composition and processing methods,” she said.

“Food additives and industrial contaminants found in these foods may cause oxidative stress and inflammation, further exacerbating the risk.”

“Our findings therefore support a shift towards more processed, plant-based food choices to improve cardiovascular health.”

But independent experts said it was important that the findings were put into context.

They stressed that the research lumped together all plant-based UPFs, including potato chips, cakes, sweets and other fatty foods known to be bad for heart health.

Prof Gunter Kuhnle, an expert in nutrition and food science at the University of Reading, said: “The latest findings on ultra-processed foods are not surprising because ‘ultra-processed plant-based foods’ include foods that are well known to have negative health effects – namely foods high in sugar, fat and salt.”

“These foods include, for example, pastries, breads and cakes, confectionery and soft drinks, whose health effects were well known even before the concept of ultra-processing became widespread,” he added.

“This may cause confusion for the general reader, as they may mistakenly think of plant-based alternatives to animal-based foods, such as plant-based beverages or meat substitutes. However, these foods only appear to contribute a small proportion of the total ‘UPF’ intake in this study,” emphasizes Professor Kuhnle.

It’s also “not surprising” that eating more minimally processed foods, such as fruits and vegetables, is good for heart health, he added.

Dr Duane Mellor, dietitian and spokesman for the British Dietetic Association, also said consideration needed to be given to the way the study was designed.

“The study looked at the impact of all plant-based ultra-processed foods, including plant-based meat alternatives, but these only accounted for 0.2% of the energy intake from ultra-processed foods in participants followed up over the course of the study,” he said.

“The main foods considered to be ultra-processed plant-based foods were processed baked goods such as packaged breads, pastries, cakes, biscuits, potato chips and soft drinks,” he said.

Dr Mellor added: “This study may therefore highlight the issue that many non-animal foods, such as biscuits, crisps, confectionery and soft drinks, although technically plant-based, are not seen by the majority of people as essential to a healthy diet.”

“So it’s important to emphasize that just because a food or drink is technically plant-based doesn’t mean it’s healthy.”

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Dr Hilda Mulroney, a nutrition and health expert from London Metropolitan University, said the findings would “send out ripples”.

“This is an area worth exploring,” she said, “and I don’t subscribe to the assumption that just because something is ‘plant-based’ it is automatically healthy.”

“But when people hear ‘plant-based,’ I don’t think they think of bread or cereal. Rather, they think of alternatives to meat, fish and dairy.”

She added: “Some people might think the message from this study is that all ultra-processed, plant-based foods are bad for your health, but in fact I think what the evidence from this study shows is that unhealthy diets are associated with an increased risk of chronic disease.”

Dr Mulroney also believes the study has limitations.

She said: “The study can only show an association, not prove causation. It also relies entirely on the NOVA classification system, which has raised a number of concerns – in particular that it assumes the health impact of foods is based solely on their degree of processing, rather than their nutritional content.”

“For example, breakfast cereals are classified as ultra-processed foods and should be avoided according to the authors’ theory, yet according to the UK NDNS, breakfast cereals have been found to make an important contribution to the intake of several nutrients.”

UPF refers to foods that have been modified in various ways to extend their shelf life, make them more appealing to consumers, or both.

An easy way to tell if a food is UPF is if it contains unrecognizable colourings, sweeteners, preservatives and other ingredients that you probably won’t find in your kitchen cupboard.

Another clue is the amount of fat, salt and sugar lurking within each pack, and UPF typically contains high amounts of fat, salt and sugar.