Unless you live in isolation from supermarkets, you've likely heard of plant-based meats—products made from plant-derived ingredients like legumes, grains, oilseeds, and fungi, designed to replace animal meats. While these products have been on the market for some time, they have evolved significantly over the years regarding nutritional profile and sensory characteristics.
According to a 2022 article in the Future Foods Journal, plant-based meats fall into several categories based on their technological development:
- Traditional meat substitutes made exclusively from fresh, minimally processed ingredients, e.g., lentil burgers
- 1st generation meat substitutes, marketed since 1990 and produced using dry textured vegetable protein with a fibrous and spongy texture.
- 2nd generation meat substitutes, the most recent products on the market with sensory characteristics, such as color, flavor, and aroma, are very similar to products of animal origin.
Interestingly, 2nd generation substitutes surged during the pandemic but have seen declining sales since 2023.
One of the possible explanations for this problem is price, as highlighted by Alex Frederic, senior emerging technology analyst at Pitchbook in Fortune:
“Plant-based proteins [are] listed typically at a price premium, and typically when you’re talking about traditional beef, a 30% to 40% price premium, so I think that’s a very challenging sell in this inflationary environment.”
In addition to cost, the Washington Post raises other concerns: plant-based meats still do not replicate the taste of animal-derived meats, and being classified as ultra-processed products, many consumers may believe them unhealthy.
As we have discussed extensively at ACSH, labeling a food as ultra-processed simply indicates that it has undergone several processing stages, which is not necessarily detrimental to health. Nonetheless, the academic debate about the health consequences of substituting animal-derived proteins with plant-based meats continues.
A narrative review published in the Canadian Journal of Cardiology aims to shed light on the existing evidence regarding the cardioprotective benefits of plant-based meat alternatives (PBMAs).
Heart and PBMAs
To answer whether PBMAs offer cardioprotection, they conducted a comprehensive literature search encompassing various aspects of PBMAs, including nutritional composition and clinical trials where they were used as dietary interventions.
There is a significant challenge in characterizing the nutritional diversity among PBMA brands. For instance, the Impossible Foods burger contained 6g of saturated fat (SFA), 370 mg of sodium, and 5g fiber. Dr. Praeger's Perfect Burger had 1g of SFA, 530 mg of sodium, and 3g of fiber. Since sodium and SFAs may increase risk, while polyunsaturated fatty acids and fiber may decrease risk, the observed nutritional variations among brands complicate assessing their potential long-term health impacts.
However, a 2022 review analyzing several international markets suggests that PBMAs generally offer a more favorable nutritional profile for reducing CVD risk than meats.
- Lower energy density (calories per gram of food)
- Reduced total fat and saturated fat (SFA) content
- Lower concentration of zinc and vitamin B12 compared to meat of animal origin
- Suitable concentrations of folate, niacin, iron, and copper
- Similar protein content to animal-derived versions
- Higher sodium content
- Increased fiber concentration
While PBMAs boast higher fiber and lower SFA content, concerns arise regarding their high sodium content, potentially raising blood pressure and offsetting potential benefits. Additionally, two studies conducted in the United States found that lean cuts of meat provide comparable or even lower amounts of SFA, total calories, and sodium, indicating that PBMAs may only surpass fattier cuts of meat and their processed counterparts.
Their systematic review and meta-analysis of 12 randomized control trials (RCT) involving volunteers with cardiometabolic risk factors suggested that PBMAs could reduce total cholesterol, LDL, and triglycerides but not fasting blood glucose, blood pressure, and body weight. However, the authors caution that these findings are limited by the
- High variability in diets used among control groups across studies, sometimes maintaining participants' usual diets.
- Implementation of a variety of PBMA types in some studies, potentially affecting cardiovascular disease (CVD) risk factors.
- The second-largest effect size for total cholesterol came from a non-randomized clinical trial that did not report values for ApoB, a more precise marker of cardiovascular risk than total cholesterol or LDL.
In an RCT involving healthy men and women aged 21 to 65 years with BMIs of 20 to 35 kg/m², participants were randomized into two parallel groups: one with a high saturated fat (SFA) intake, 13–14% of energy from respective diets; and low SFA intake, 7–8% of energy. Within these groups, participants were further randomized to one of three dietary interventions, providing similar nutrient values but differing proteins: a red or white meat diet or a plant-based protein diet including legumes, nuts, isoflavone-free soy [1], and PBMAs. After completing a 4-week intervention, participants underwent a wash-out period [2] before starting the next intervention cycle until completing all three.
- Participants in the high SFA group had higher levels of total cholesterol, LDL, and ApoB than those in the low SFA group.
- Regardless of SFA intake, participants who consumed red and white meat also showed elevations in total cholesterol, LDL-C, and ApoB compared to those eating PBMAs.
- There were no significant differences observed among protein sources concerning blood pressure and plasma glucose levels
Although research has not exclusively focused on PBMAs, replacing meat with plant-based protein sources may improve blood lipid concentrations regardless of saturated fat (SFA) intake.
While there is a lack of long-term research specifically on PBMAs and cardiovascular events, the authors conclude that consumption of plant-based proteins is associated with a reduced risk of cardiovascular disease (CVD). In contrast, animal-based proteins have a neutral or potentially harmful impact. Moreover, consumption of red and processed meats is consistently linked to an increased risk of CVD.
However, it's important to note that these analyses cannot be directly extrapolated to assert that replacing animal proteins with popular PBMAs would yield the same benefits; these studies predominantly utilized grains and nuts as sources of plant-based protein—foods less commonly consumed in Western populations.
Commercially available PBMAs generally offer a cardioprotective nutritional profile relative to meat, with lower SFA and higher fiber content per serving. Nevertheless, there are still gaps in understanding the long-term effects of PBMAs on CVD risk, and due to significant nutritional variability among different brands of these products, generalizing results from conducted RCTs is challenging.
While the article provides valuable insights, it's important to note that it is a narrative review which aims to persuade readers of the authors' viewpoint.
Setting that aside, three conclusions can be drawn from the authors' work:
- Replacing certain meat products like sausages and fatty cuts with plant-based meat alternatives appears to be a healthier choice due to their superior nutritional profile.
- Replacing lean cuts of meat and white meat may not confer cardiovascular benefits.
- It is crucial to recognize that a "healthy diet" extends beyond substituting one type of protein for another. PBMAs may offer cardioprotective effects; however, daily consumption does not guarantee benefits. A healthful diet involves portion sizes and overall composition.
Except for certain harmful ingredients like trans fats, when consumed in moderation, most foods should not pose significant health risks for healthy individuals. While the nutritional profile of plant-based meat alternatives may still improve, industry advancements, driven by consumer demand or stricter regulations, may lead to healthier formulations.
1] Isoflavone-free soy is a compound belonging to the class of phytoestrogens, which has a structure similar to human estrogen.
[2] Wash-out period: a break in treatment to reduce the effects of the body's intervention.
Sources: Animal vs Plant-Based Meat: A Hearty Debate. Canadian Journal of Cardiology. DOI: 10.1016/j.cjca.2023.11.005
Effects of red meat, white meat, and nonmeat protein sources on atherogenic lipoprotein measures in the context of low compared with high saturated fat intake: a randomized controlled trial. Am J Clin Nutr. DOI: 10.1093/ajcn/nqz035.
Meat substitutes – past, present, and future of products available in Brazil: changes in the nutritional profile. Future Foods. DOI: 10.1016/j.fufo.2022.100133
Plant-based animal product alternatives are healthier and more environmentally sustainable than animal products. Future Foods. DOI: 10.1016/j.fufo.2022.100174
The big problem with plant-based meat: The ‘meat’ part The Washington Post
