Share on PinterestNot all plant-based meat alternatives are considered healthy. Anastasiya Mihailovna/Getty Images
- A new study finds that while many plant-based foods are healthy for the heart, many are not.
- The study concluded that eating a diet high in unhealthy plant-based foods was associated with a higher level of a key heart attack biomarker.
- Plant-based meat substitutes can be high in sodium and heavily processed, both of which are unhealthy for the heart.
A new study confirms that healthy plant-based foods can be beneficial for the heart. However, not all plant-based foods qualify as healthy, and the study finds that those foods can be just as damaging to the heart as their non-plant-based counterparts.
The authors of the study assessed associations between plant diets of various qualities and a trio of critical cardiac biomarkers.
For many people who choose not to eat animal-based foods for moral reasons, the potential health benefits of a plant-based diet may be considered a happy byproduct or even a reward. The study suggests that this is not necessarily incorrect, as long as one considers that the rules that apply to healthy eating in general also apply to plant-based foods.
The study, conducted by researchers at Johns Hopkins University, analyzed data from 7,708 participants in the 1999–2004 National Health and Nutrition Examination Survey (NHANES). Participants were ages 20 years or older and had no history of heart disease.
During interviews taken throughout the NHANES survey, participants reported their food intake for a previous 24-hour period, as blood samples were taken to measure the relevant biomarkers.
This study’s biomarkers of concern were cardiac troponin T, cardiac troponin I, and N-terminal pro-B-type natriuretic peptide. Troponins are indicators of cardiac muscle damage, which is a sign of myocardial infarction or heart attack. The peptide is associated with heart failure.
Up to 50% of individuals with no apparent history of cardiac issues have subclinical levels of troponins. While these levels are not of immediate concern, they may be interpreted as a warning sign of potential future issues.
The researchers used the U.S. Department of Agriculture’s MyPyramid Equivalents 2.0 database to sort each reported food into one of three categories:
- healthy plant-based food
- unhealthy plant-based food
- animal-based food.
The analysis revealed that adherence to a healthy plant-based diet was associated with a 49% lower likelihood of having elevated levels of cardiac troponin I.
People following an unhealthy plant-based diet had a 65% greater chance of elevated levels of cardiac troponin I.
The authors of the study found no strong association with either healthy or unhealthy plant-based foods and cardiac troponin T or N-terminal pro-B-type natriuretic peptide.
The study is published in the American Journal of Preventive Cardiology.
Is plant-based meat healthier than animal products?
“Plant-based foods are not automatically healthier than their animal-product-based counterparts,” said Michelle Routhenstein, who is a registered dietitian specializing in heart disease.
“While many plant-based diets can reduce cardiovascular risk due to their nutritional profile, such as being low in saturated fat, high in fiber, high in potassium, magnesium, calcium, and antioxidants, not all plant-based foods share these benefits,” she added.
Jayne Morgan, MD, cardiologist at Hello Heart, pointed out that “meat substitutes are frequent unhealthy culprits hidden within plant-based diets, and can actually be quite high in sodium, additives, and saturated fats, often from coconut oil.
“Coconut oil or palm oil are often added for texture. These are high in saturated fat, which may raise LDL (‘bad’) cholesterol and contribute to heart disease risk. In fact, some plant-based burgers can actually have the similar amounts of saturated fat (6-8 grams) as a beef patty,” Morgan said.
Routhenstein noted that these saturated fats can potentially promote insulin resistance as well.
How much salt is in plant-based meat?
“Further, many plant-based meats are heavily seasoned to mimic meat flavors. This often means very high sodium levels, which is a major contributor to hypertension. A plain chicken breast might have 70 mg of sodium [in four ounces of chicken], while a processed plant burger could have 400–600 mg of sodium!”
— Jayne Morgan, MD
The issue with processed food, regardless of source
“Some plant-based substitutes may be highly processed,” Routhenstein said, “and include ingredients that can actually harm heart health. This applies regardless of whether the food is plant- or animal-based.”
“The level of processing is a critical factor in determining how healthy they are for your heart,” cautioned Morgan. “When it comes to heart health, it’s not just about what you eat, but also how processed the food is.”
“Bottom line, highly processed foods — whether plant-based or animal-based — tend to be worse for heart health than whole or minimally processed foods.”
— Jayne Morgan, MD
Processing may include additives such as methylcelluose, modified starches, carrageenan, and gums that may trigger inflammation or gut issues impacting the microbiome.
Processing also takes away beneficial components of natural foods such as isolated proteins, diminishing the nutritional profile of whole food sources such as lentils or beans.
What does a healthy plant-based diet look like?
“The goal,” stated Morgan, “is to always maximize nutrients that protect the heart.”
If you are looking to replace animal proteins, Routhenstein said to “look for foods low in saturated fat and sodium, with minimal additives and preservatives. Choose whole food ingredients that are rich in protein, fiber, and phytonutrients to meet your goals — such as beans, legumes, tofu, and tempeh.”
To avoid processed foods, “Be on the alert for long ingredient lists full of additives or ‘natural flavorings.’ In fact, the word ‘natural’ is often a red flag,” Morgan warned.
“Choose unsalted or lightly salted options whenever possible. Seek recognizable foods, i.e., whole foods — and remember that fiber helps to lower cholesterol. Lentils, chickpeas, and black beans are good options. Look for oils such as olive, avocado, or canola. Avoid coconut or palm oils, saturated fats, sodium, and additives.”
— Jayne Morgan, MD
