Plant-based diets — vegetarian and vegan — can reduce blocked arteries and lower the risk of heart conditions and high cholesterol, according to a study published in the journal European Heart Journal.
The team analysed 30 clinical trials between 1982 and 2022 involving over 2300 participants. Participants either had a vegetarian/vegan diet or a more traditional omnivore diet, and researchers analysed total cholesterol, LDL cholesterol (often known as bad cholesterol), triglycerides (fat found in the blood), and apolipoprotein B (a protein that carries fat and cholesterol in the body).
Comparing omnivore and plant-based diets, people who followed a plant-based diet had lower cholesterol levels (reduced by 7%), LDL cholesterol (reduced by 10%), and apo B levels (reduced by 14%).
“We found that vegetarian and vegan diets were associated with a 14% reduction in all artery-clogging lipoproteins as indicated by apolipoprotein B. 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 cardiovascular disease 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,” said Professor Ruth Frikke-Schmidt, Chief Physician at the Rigshospitalet in Copenhagen, Denmark. “If people start eating vegetarian or vegan diets from an early age, the potential for reducing the risk of cardiovascular disease caused by blocked arteries is substantial. Importantly, we found similar results across continents, ages, different ranges of body mass index, and among people in different states of health.”
In addition, the researchers found that plant-based diets can be good for the environment. “Recent systematic reviews have shown that if the populations of high-income countries shift to plant-based diets, this can reduce net emissions of greenhouse gases by between 35% to 49%. Our study provides robust evidence that plant-based diets are good for our health for people of different sizes, ages, and health conditions,” said Prof. Frikke-Schmidt. “Furthermore, populations globally are aging and, as a consequence, the cost of treating age-related diseases such as atherosclerotic cardiovascular disease is increasing. 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. We should be eating a varied, plant-rich diet, not too much, and quenching our thirst with water.”
This is the largest review of different diets to date and one of the few to include measurements of apoB. However, the authors highlight that more extensive studies with longer durations are needed, as well as the use of other markers, such as for inflammation and insulin resistance.
Koch CA, Kjeldsen EW, Frikke-Schmidt R. Vegetarian or vegan diets and blood lipids: a meta-analysis of randomized trials. Eur Heart J. 2023 May 24:ehad211. doi: 10.1093/eurheartj/ehad211. Epub ahead of print. PMID: 37226630.