Plant-based meat alternatives may be good for your heart

Replacing meat with plant-based meat alternatives (PBMAs) may improve cardiovascular disease risk factors, including low-density lipoprotein cholesterol (LDL-C), according to a review of randomized controlled trials.

According to the authors, long-term randomized controlled trials and prospective cohort studies evaluating cardiovascular disease, including myocardial infarction and stroke, are needed to draw definitive conclusions.

“Based on intermediate cardiovascular endpoints such as lipids, triglycerides, blood pressure and other cardiovascular disease risk factors, our conclusion is that plant-based meat is a healthy alternative to animal meat,” said Dr. Ehud Ull, professor of medicine at the University of British Columbia and endocrinologist at St. Paul's Hospital in Vancouver, British Columbia, Canada. Medscape Medical News.

“But we also find that there is a lack of clinical outcome trials to definitively determine whether plant-based meat is healthy or not. But everything points to it being beneficial for the cardiovascular system,” Ull said.

review Now published On June 25th Canadian Journal of Cardiology.

Ultra-Processed Foods

PBMA is a meat imitation food that contains ingredients such as protein derivatives extracted from soy, pea, wheat and fungi. As more Canadians limit or eliminate meat from their diets, some are choosing to eat PBMA instead.

But most PBMAs are classified as ultra-processed foods, which are made primarily from substances extracted from whole foods, such as sugar, salt, oils and proteins, or they may be made in a lab with flavorings and colorings. This classification has left the public and medical professionals questioning the potential health effects of PBMAs, Ur says.

“One of the concerns is that these products are highly processed and highly processed is perceived as bad. So are we substituting one risk for another?” he said.

To further elucidate this question, Dr. Ull's team, led by Dr. Matthew Nagra of the Vancouver Naturopathic Clinic in Vancouver, British Columbia, Canada, evaluated the literature on PBMA and its health effects.

“The plant-based meat market has seen significant growth in recent years, with more and more Canadians enjoying plant-based burgers, but surprisingly little is known about how these meat alternatives affect health, particularly cardiovascular disease risk,” Nagra said in a statement. “So we decided to review the available literature on the subject to review what we currently know and to point the way for future research.”

Low in saturated fat and cholesterol

The researchers evaluated literature published between 1970 and 2023 on PBMAs, their content, nutritional profile, and effects on cardiovascular disease risk factors such as cholesterol levels and blood pressure.

The study found that compared to meat, PBMA has less saturated fat, less cholesterol, more dietary fiber, more carbohydrates, fewer calories, less monounsaturated fat, more polyunsaturated fat, and more sodium.

Additionally, several randomized controlled trials have shown that PBMA reduces total cholesterol and LDL-C, apolipoprotein B-100, weight, and waist circumference. Although some products contain high sodium content, PBMA has not been shown to increase blood pressure.

“Currently available evidence does not suggest that aspects of PMBA that may be of concern (e.g., food processing or high sodium content) negate its potential cardiovascular benefits,” the researchers wrote.

Unfortunately, there are no long-term studies evaluating how these alternative foods affect the risk of developing a myocardial infarction or stroke. Similarly, there is little research on the health benefits of common components of PBMA, such as wheat gluten.

Clarifying these important questions would require large-scale clinical trials involving large numbers of patients and significant costs, Ull said. “Pharmaceutical companies can afford to do large-scale clinical trials to get their drugs approved, even if it's costly. But these plant-based meats are produced by companies with little capacity to do clinical outcome trials. Such trials would need to be done by the National Institutes of Health in the United States, or the National Research Council in Canada,” Ull said.

Ull added that there are many reasons to avoid eating meat: “There are ethical reasons for killing animals. Then there's the issue of global warming. Meat is very expensive as food energy. The biggest impact you can have as an individual on global warming is by not eating meat. Then there's the personal health debate, and this is where our research comes in. For people who like the taste of meat and have a hard time giving up meat eating, PBMAs allow them to have a reasonably diverse diet,” Ull said.

Are eggs good for your health?

Meat alternatives may be beneficial for people who want to reduce their risk of cardiovascular disease, says J. David Spence, M.D., professor emeritus of neurology and clinical pharmacology at the University of Western Ontario in London, Ontario, Canada. Accompanying editorial.

“Eating too much meat and egg yolk increases the risk of cardiovascular disease, and it can be difficult for patients to learn to reduce their meat intake and avoid egg yolks. If they can find alternatives that are tasty and enjoyable, that's a good thing,” Spence said. Medscape Medical News.

“In addition to plant-based meat substitutes, the use of egg substitutes could significantly reduce the risk of cardiovascular disease,” he said.

Spence noted that two large egg yolks contain 474 mg of cholesterol, nearly double the amount found in a Hardee's Monster Thickburger (265 mg).

Cholesterol increases plasma levels of toxic metabolites of the gut microbiome, such as trimethylamine N-oxide (TMAO). Plasma levels of TMAO increase in proportion to egg consumption, and TMAO has adverse effects on arteries, Spence said.

“Eggs are gross and anyone at risk of cardiovascular disease should not eat them, but people don't realise this because egg marketing is so effective. Egg yolks are gross. The Egg Marketing Board is very effective at convincing people that eggs are good for you, but they're not. The only people who should probably eat eggs are starving people in Africa,” he said.

Spence recommends using egg substitutes such as Egg Beaters or Better Eggs instead of eggs, and says it's not too late to make the switch. “This is a mistake people make, but you can actually improve your arteries,” he says.

No funding sources for this study were reported. Ur and Spence reported no relevant financial relationships.