With the rise in popularity of plant-based diets, plant-based meat alternatives are becoming widespread in the market. A new review suggests that these foods may be more heart-healthy than their animal meat counterparts.
Introduction
There has been an increase in the amount of plant-based meat alternatives (PBMAs) available on the market over the last number of years, and this is expected to continue to grow as consumer demand continues to grow (1). Accordingly, questions about the healthfulness of these products have emerged and, if you have been following the tabloids lately, you will have seen that these foods have been getting a bad rap.
You’ll be happy to know that we don’t need to get our information from the tabloids; there are studies investigating the potential health implications of swapping animal meats for PBMAs. A recent review has nicely summarised all available research on the impact of eating PBMAs in place of animal meats on heart health, to help us understand this topic more clearly (2).
Two of the market leaders in the PBMA space: Beyond Meat and Impossible Foods. Image source: Scripps News.
What Are Plant-Based Meat Alternatives?
PBMAs are products designed to mimic the taste and sensory properties of animal meats. This is where they get their name as alternatives (or replacements) to meat. They are often composed of multiple ingredients, with their main protein-based ingredients coming from either soy, non-soy legumes (e.g., pea protein), mycoprotein (i.e., a fungus used in Quorn products), vital wheat gluten (also known as seitan), or a combination of these ingredients (2). In addition, their main fat source is usually a tropical oil (e.g., coconut oil, palm oil) or a non-tropical oil (e.g., olive oil, rapeseed oil, sunflower oil, etc.) (2). Because these foods tend to also contain some additives and flavourings, they’re often classified as ultra-processed foods. If you want to know why I don’t believe this to be a bad thing necessarily, read our earlier article on that topic.
Nutrient Composition
One of the difficulties in determining the health effects of swapping animal meats for PBMAs is that the nutrient composition of PBMAs ranges massively between products (2,3). Take a look at Figure 1, for example, where we see 2 PBMAs that vary considerably in their saturated fat and fibre composition. This variation has important implications for heart health: PBMAs higher in saturated fat and lower in fibre would be expected to be less heart healthy than those lower in saturated fat and higher in fibre. Therefore, it is difficult to make blanket statements about the healthfulness of PBMAs without specifying the product in question. With that said, PBMAs are generally lower in saturated fat and cholesterol, and higher in fibre and carbohydrate, than animal meats. In addition, they tend to be lower in calories, while the quantity of protein and sodium in PBMAs (relative to animal meats) varies depending on the specific product (2).
Figure 1. Nutrient composition of certain PBMAs relative to beef (2).
Are Plant-Based Meat Alternatives Healthy?
In the available (but limited) literature, PBMAs consistently lower total and low-density lipoprotein (LDL) cholesterol, and less consistently lower another important risk factor for heart disease known as apolipoprotein B, as well as body weight and waist circumference (Figure 2) (2). However, PBMAs do not tend to reduce blood pressure relative to animal meats (2).
Figure 2. Graphical abstract of the review paper from Nagra et al. (2) looking at the nutrient composition of PBMAs and their impact on risk markers of heart health (compared to animal meats).
To think a little deeper about whether PBMAs are indeed ‘healthy’ (or not), there are 3 helpful concepts to consider. These are:
The independent health effects of the food (which is driven from its ingredients/nutrient composition)
The dose (i.e., how much is eaten)
What they’re replacing (i.e., what we are not eating when eating this food)
In terms of point number 1, it seems likely that PBMAs made from soy protein and unsaturated oils (e.g., olive oil, rapeseed oil) would be best for heart health. This is because these ingredients can independently lower LDL cholesterol and greater intakes are associated with a lower risk of heart disease and other chronic diseases (2). Other ingredients, like pea protein, mycoprotein, and seitan have less evidence for health benefits, although there is some evidence that pea protein- and mycoprotein-based PBMAs can lower risk factors for heart disease when eaten in place of animal meats (2).
With regard to point number 2, it is probably wise that PBMAs are not eaten so regularly that they replace other healthful foods (e.g., fruits, vegetables, beans/lentils) in the diet. This nicely links to point number 3: the replacement effect. It is possible that eating PBMAs in place of animal meats may be a better move for heart health, but eating PBMAs in place of foods like fruits, vegetables, or beans/lentils is likely to be a less healthful move.
PS. I encourage you to check out the Instagram page of the lead author of this review paper, Dr. Matthew Nagra, as well as the Substack page of Shaun Ward, a co-author on this review paper. They are both terrific science communicators!
There are other considerations in this 'debate' not covered by this review paper (2), which was chiefly concerned with heart health. For example, while high meat intakes may not be the best option for heart health, meat does provide important nutrients like iron, zinc, and vitamin B12 to the diet. So eating PBMAs in place of animal meats may increase the risk of nutrient deficiencies if the PBMAs are not able to match the meats they replace for these critical nutrients. For example, PBMAs were often lower in vitamin B12 compared to their animal meat counterparts in a 2023 audit of PBMA products available on the UK and Irish market (4).
Luckily, it is possible to create PBMAs that are nutritionally optimal, and that can prevent potential nutrient shortfalls in a very low-meat diet (5). This fact underscores the need for mandatory policies on PBMA nutrient composition, so that industry is forced to create nutrient-dense PBMAs. Such products could represent a means to reduce heart disease risk (relative to animal meats), provide critical nutrients to the diet, and reduce the environmental impact of the diet (as PBMAs have a lower environmental footprint compared to animal meats (6)).
Summary
Overall, the literature suggests that eating PBMAs in place of animal meats may be a wiser choice for heart health. However, this will depend on the specific PBMA eaten and the type of meat being replaced. Eating PBMAs made from soy protein and unsaturated fats, that are low in salt, high in fibre, and that contain comparable amounts of critical nutrients that are high in meat (e.g., iron, zinc, vitamin B12), would seem to be the best option.
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Thanks for reading!
Patrick Elliott, BSc, MPH
Health and Nutrition Science Communication Officer at Training121
Instagram: @just.health.info
Twitter/X: @PatrickElliott0
References
(1) Statista. Volume of the meat substitutes market worldwide from 2019 to 2029. 2024. Available at: https://www.statista.com/statistics/1276467/worldwide-meat-substitute-consumption/
(2) Nagra M, Tsam F, Ward S, Ur E. Animal vs Plant-Based Meat: A Hearty Debate. Can J Cardiol. 2024:S0828-282X(23)01882-2. Available at: https://onlinecjc.ca/article/S0828-282X(23)01882-2/fulltext
(3) Marchese LE, Hendrie GA, McNaughton SA, Brooker PG, Dickinson KM, Livingstone KM. Comparison of the nutritional composition of supermarket plant-based meat and dairy alternatives with the Australian Food Composition Database. J Food Compos Anal. 2024;129:106017. Available at: https://www.sciencedirect.com/science/article/pii/S0889157524000516
(4) Lindberg L, Woodside JV, Vogan H, Campbell N, Fitzgerald H, Walton J, Nugent AP. Micronutrient Content of Plant-Based Meat Alternatives Available in the UK and Ireland: Product Audits (2021 and 2023). Proceedings. 2023;91(1):256. Available at: https://www.mdpi.com/2504-3900/91/1/256
(5) Salomé M, Mariotti F, Dussiot A, Kesse-Guyot E, Huneau JF, Fouillet H. Plant-based meat substitutes are useful for healthier dietary patterns when adequately formulated - an optimization study in French adults (INCA3). Eur J Nutr. 2023;62(4):1891–901. Available at: https://link.springer.com/article/10.1007/s00394-023-03117-9
(6) Nájera Espinosa S, Hadida G, Jelmar Sietsma A, Alae-Carew C, Turner G, Green R, Pastorino S, Picetti R, Scheelbeek P. Mapping the evidence of novel plant-based foods: a systematic review of nutritional, health, and environmental impacts in high-income countries. Nutr Rev. 2024:nuae031. Available at: https://academic.oup.com/nutritionreviews/advance-article/doi/10.1093/nutrit/nuae031/7656938
Technical Terms
Statistical significance: This is a term to describe the likelihood of whether a finding in a study is a ‘real’ finding, or if it is the result of chance. Statistical significance is denoted by a p-value, which is usually set at a significance (alpha) level of 0.05. This means that if a result is significant at this level (p≤0.05), we can say that the probability of getting a value as or more extreme than the observed value (under the assumption that the null hypothesis is true) is less than 5%. In other words, it is more likely that this finding is not the result of chance than if the p-value was >0.05 (although this is not always the case).
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