Vegetarian and vegan diets are both associated with a reduced risk of cardiovascular disease (CVD) caused by blocked arteries, according to a new systematic review and meta-analysis published in European Heart Journal.[1]
The study’s authors reviewed data from 30 randomized controlled trials (RCTs) performed between January 1980 and October 2022. All RCTs were focused on examining how plant-based diets compared to diets that include meat when it comes to blood lipids and lipoprotein levels.
The 30 RCTs included nearly 2,400 patients. Overall, following a vegetarian or vegan diet was linked to key reductions in total cholesterol, low-density lipoprotein cholesterol (LDL-C) and apolipoprotein B (apoB). This was a consistent trend across all ages, body mass indexes and study designs.
“We found that vegetarian and vegan diets were associated with a 14% reduction in all artery-clogging lipoproteins as indicated by apoB,” senior author Ruth Frikke-Schmidt, chief physician of the Rigshospitalet in Denmark, said in a statement from the European Society of Cardiology. “This corresponds to a third of the effect of taking cholesterol-lowering medications such as statins, and would result in a 7% reduction in the risk of CVD in someone who maintained a plant-based diet for five years. Statin treatment is superior to plant-based diets in reducing fats and cholesterol levels. However, one regimen does not exclude the other, and combining statins with plant-based diets is likely to have a synergistic effect, resulting in an even larger beneficial effect.”
Frikke-Schmidt also noted that plant-based diets can be beneficial for the environment, reducing greenhouse gases by a significant amount.
“Plant-based diets are key instruments for changing food production to more environmentally sustainable forms, while at the same time reducing the burden of cardiovascular disease,” she said. “We should be eating a varied, plant-rich diet, not too much, and quenching our thirst with water.”
Kevin C. Maki, PhD, an adjunct professor with the department of applied health science at the Indiana University School of Public Health, and Carol F. Kirkpatrick, PhD, a clinical lipid specialist with Idaho State University, wrote a separate editorial for European Heart Journal about these findings.[2] While the two authors said it “is not surprising” that vegan and vegetarian diets were associated with these benefits, they also noted that there were certain limitations to the research, including the small sample sizes seen in a majority of the RCTs. Larger, longer studies are still needed, they added, so more can be learned about the impact of following a plant-based diet.
“In summary, the results … add to the body of evidence supporting favorable effects of healthy vegan and vegetarian dietary patterns on circulating levels of LDL-C and atherogenic lipoproteins, which would be expected to reduce atherosclerotic CVD risk,” Maki and Kirkpatrick wrote. “While it is not necessary to entirely omit foods such as meat, poultry, and fish/seafood to follow a recommended dietary pattern, reducing consumption of such foods is a reasonable option for those who prefer to do so.”
The full systematic review and meta-analysis is available here. The editorial from Maki and Kirkpatrick is available here.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.