- Meat replacements made from plants have become more popular.
- Research is ongoing about the potential benefits of consuming plant-based meat alternatives.
- Data from a systematic review and meta-analysis suggests that short-term use of plant-based meat alternatives may help lower ‘bad’ cholesterol, total cholesterol, and weight.
Plant-based meat alternatives mimic aspects of meat but are made of plants. A systematic review and meta-analysis published in The American Journal of Clinical Nutrition examined how plant-based meat alternatives impact aspects of cardiometabolic health.
The findings suggest that switching out meat for plant-based meat alternatives for 8 weeks or less may help lower total cholesterol by approximately 6% and low-density lipoprotein (LDL) cholesterol, also known as “bad” cholesterol, by approximately 12% in adults without cardiovascular disease.
The authors conclude that using plant-based meat alternatives might help people transition to plant-based diets but that researchers need to conduct long-term studies to truly examine the cardiometabolic effects of plant-based meat alternatives.
Recent data suggest that consuming more plant and less animal protein could help lower the risk for cardiovascular disease and coronary heart disease.
The current review notes that there has been recent interest in eating less meat and switching to more plant-based foods for health and environmental reasons. As this research notes, plant-based meat alternatives “are designed to mimic the appearance, aroma, flavor, texture, and other eating experiences of meat and meat products.”
Plant-based meat alternatives have varying nutritional value; many are considered ultra-processed foods. However, this label can also be applied to many meat products.
For this analysis, researchers wanted to focus on data from randomized controlled trials to look at the impact of plant-based meat alternatives on cardiometabolic parameters in adults without cardiovascular diseases.
Researchers used several databases to identify relevant studies. They excluded studies that focused on traditional plant-based meat alternatives like tofu, which are minimally processed meat replacements and “not designed to resemble meat.”
They also excluded studies that used insect-based meat alternatives or cultured meat. They did include mycoprotein products, a meat alternative derived from high-protein fungi.
Researchers assessed the studies for risk of bias in five different domains. The final review included data from eight publications covering seven randomized controlled trials. In all, they were able to look at data from 369 adults.
The studies compared diets with plant-based meat alternatives to typical diets with animal-based meat consumption. Researchers conducted meta-analyses when four or more studies examined the same health outcome.
Researchers identified three factors primarily affected by plant-based meat alternative consumption: total cholesterol, LDL cholesterol, and weight. LDL cholesterol is often called “bad” cholesterol, as it can increase the risk of heart disease and stroke.
The results suggest that switching out meat for plant-based meat alternatives for eight weeks or less may help lower cholesterol by 6.6% and LDL cholesterol by 12.1%.
Overall, the intervention of plant-based meat alternatives only reduced weight by 1%, so it did not reach a level of clinically significant weight loss.
Additionally, the weight loss reductions were only observed in two randomized controlled trials that had overweight participants. Researchers did not observe a difference in weight among participants who had normal body mass indexes.
Researchers did not observe effects on HDL “good” cholesterol, triglycerides, blood pressure, or concentrations of fasting blood sugar.
Sensitivity analyses looking at just mycoprotein-based substitutes, which are derived from mushrooms, found that mycoprotein-based foods appeared to significantly help reduce total cholesterol and LDL cholesterol.
Researchers note that mycoprotein products tend to have higher levels of fiber, lower saturated fat, and higher unsaturated fat than other plant-based meat alternatives.
Ching Jian, PhD, a researcher fellow at the Human Microbiome Research Program, University of Helsinki in Finland, with a background in gut microbiota, metagenomics, dietary interventions, and functional foods, who was not involved in this review, told Medical News Today that it was “well-conducted and provides much-needed insights into the health effects of plant-based meat alternatives, particularly regarding cholesterol levels.”
“The findings suggest that short-term (1–8 weeks) consumption of plant- and fungal-based meat alternatives significantly reduces total and LDL cholesterol in adults, without impacting other cardiometabolic risk factors. Notably, the study also alleviates concerns about potential blood pressure increases due to the salt content of some of these products. However, while the observed weight reduction was statistically significant, it is not clinically meaningful (approximately 1%).”
– Ching Jian, PhD
Since this review looked at the short-term use of plant-based meat alternatives, it cannot speak to the potential long-term effects.
For example, researchers acknowledge that the short time frame may have been inadequate to evaluate the long-term effects of plant-based meat alternatives on other risk factors, such as blood sugar.
There is a possibility that the trials were not “adequately powered to detect statistically significant differences in cardiometabolic disease risk factors.”
These data focused on adults who did not have cardiovascular diseases, so the findings may not be generalizable to other groups. Additionally, the trials were only out of three countries, so data from other countries may be useful in future research.
Thirdly, the research included a small number of trials, and these trials had fairly small sample sizes.
There was also a small number of studies included in the meta-analyses, and researchers did not conduct any meta-regression or publication bias analyses. The authors were also not able to conduct meta-analyses on certain variables like insulin because of the lack of available data.
Manufacturers of plant-based meat alternatives funded seven of the eight publications, which could lead to bias in the results. Researchers were unable to do a conflict of interest sensitivity analysis because of the small number of studies.
Researchers further identified varying levels of bias risk among the publications, and three were identified as having a high bias risk. The main struggle with bias was because double-blinding was not possible with the intervention.
There was also variety regarding the nutrient profiles of the plant-based meat alternatives. The authors noted that plant-based meat alternatives may not all have the same effects on cardiovascular parameters.
The authors acknowledged that what meat the substitute is replacing may influence the cardiometabolic effects and that the effect on weight loss may differ based on the study population.
It is important to note that all the included studies had limitations and were different from one another. More research may be required to look at various cardiometabolic factors and how plant-based meat alternatives may affect them.
Jian also noted the following limitations of the research:
“The number of available [randomized control trials, namely seven] is still low, with most studies being industry-funded. All mycoprotein-based studies were based on Quorn products, whereas fungal-based meat alternatives are more diverse. The research lacks representation from diverse populations—only one study included Asian participants, and there is no data on children or older adults. Long-term health effects remain unknown, highlighting the need for independent, publicly funded studies, particularly as consumer interest in these products continues to grow.”
Overall, the data observed in the review show how the short-term use of plant-based meat alternatives may improve cholesterol levels.
The scientific director of the Charles Perkins Centre at the University of Sydney in Australia, Luigi Fontana, MD, PhD, FRACP, who was not involved in the review, told MNT that “we already knew that whole, minimally processed plant-based diets can significantly reduce cholesterol levels, primarily due to their high fiber and sterol content, and low-saturated fat.”
Fontana noted that this study expands our understanding of this relationship by demonstrating that even ultra-processed plant-based meat alternatives might positively affect cholesterol levels when they replace animal-based meat products.
These data highlight the potential short-term benefits of these plant-based meat alternatives. The review authors suggest that they could help people transition to plant-based diets. They point out in their discussion the superiority of whole plant foods to plant-based meat alternatives.
Jian also emphasized that, “for healthy adults, these products can be a useful transition food toward a more whole-food, plant-based diet.”
“While they can be beneficial in the short term, whole, minimally processed plant foods remain the preferred long-term choice due to their more balanced nutrient profile. For vulnerable populations, it’s important to ensure that these products meet their specific nutritional needs,” he concluded.
