Vegan and vegetarian diets are associated with lower concentrations of lipids such as blood cholesterol. Because some lipids cause atherosclerosis when they accumulate along the arterial walls, following these diets can reduce the risk of suffering from certain cardiovascular diseases. This is the conclusion of an analysis of 30 clinical studies conducted over the past 40 years, just published in the European Heart Journal. The researchers, led by Ruth Frikke-Schmidt of the University of Copenhagen, frame the relevance of their findings within the United Nations’ agenda for sustainable development, which proposes to reduce premature mortality from non-communicable diseases by a third, such as cancer or heart disease.
As a possible explanation for the effect of meat-free diets, the study points to higher consumption of polyunsaturated fat and fiber and lower consumption of saturated and total fat. However, they don’t discount the fact that the weight loss associated with these diets could also explain the results. They also point out that, in addition to diet, genetics are a significant factor in how much lipids build up in the arteries. For this reason, many people, despite following lifestyle recommendations, need statins to keep their cholesterol levels within a healthy range. In the study, the authors write that the combination of statins and plant-based diets will likely have a synergistic effect and that vegetarian diets may allow for reduced consumption of these drugs.
Pablo Alonso Coello, a researcher at the Cochrane Ibero-American Center in Barcelona, says this study more or less confirms what we knew [about these diets], which improve the lipid profile, but questions the authors who skip to talk about health impacts. There are no data on cardiovascular outcomes, she says. There are no clinical studies reporting on relevant cardiovascular outcomes such as heart attacks, cardiovascular mortality, or stroke, only observational studies. Alonso cites another analysis of 40 studies with more than 35,000 participants, recently published in BMJ extension, who noted that the non-vegetarian Mediterranean diet and fat reduction have the strongest evidence when it comes to reducing cardiovascular problems. In the same analysis, two diets considered vegetarian did not fare so well, the researcher adds. He notes that strict vegan or vegetarian diets can be problematic for at-risk populations, such as pregnant women or children, because they require good planning and supplements.
In a statement published by the Science Media Center, Tom Sanders, emeritus professor of nutrition and dietetics at Kings College London, noted that large studies with cholesterol-lowering drugs show that a 1 mmol reduction in LDL cholesterol is associated with a 10% reduction in cardiovascular disease (CVD) and a 20% reduction in CVD events. For the specialist, the results of the study suggest that a plant-based diet could reduce the mortality rate from cardiovascular disease by 3% and the impact of non-fatal cardiovascular events by 6%. These findings are consistent with observational studies finding vegetarians/vegans have a lower incidence of ischemic heart disease but not stroke, he concludes.
Another important aspect of the results is the type of vegetarian diet followed. A diet high in fruits, vegetables, and whole grains may be beneficial, but not one that includes refined flours, such as some breads or pastas, or one that is high in fat and salt, as is the case with some ultra-processed vegetarian foods. In these cases, as with all types of ultra-processed foods, frequent consumption is harmful to health.
The results published by European Heart Journal point to possible heart health benefits of vegan and vegetarian diets, which had been observed previously. An American Heart Association guide looking at heart-healthy eating practices ranked these diets fourth. The highest score went to the Dietary Approaches to Stop Hypertension (DASH) diet, a low-salt diet rich in fruits, vegetables, whole grains, low-fat dairy products and lean proteins. It was followed by the Mediterranean diet, the pescatarian diet, in which protein comes from fish and seafood, and a vegetarian diet that includes eggs and dairy products. All of these healthy diets have in common an abundance of fruits, vegetables and whole grains, even if they are not strictly vegetarian.
In addition to the possible cardiovascular benefits, the study authors also note the environmental benefits of a population-level shift toward plant-based diets.
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