Nutritionally complete plant-based diet

Plant-based diets and cardiovascular health.

Type of study: literature review

Number of citations: 352

Year: 2018

Authors: A. Satija, F. Hu

Journal: Trends in cardiovascular medicine

Journal ranking: Q1

Key takeaways: Plant-based diets, rich in whole grains, fruits, vegetables, and nuts, are associated with lower risk of cardiovascular outcomes and intermediate risk factors.

The Effectiveness of Plant-Based Diet on Cardiovascular Health

Type of study: systematic review

Number of citations: 0

Year: 2025

Authors: J. Yeboawaa

Journal: Premier Journal of Cardiology

Journal ranking: brak

Key takeaways: Plant-based diets effectively reduce cardiovascular disease risk and improve overall cardiovascular health, but may have potential adverse effects due to nutrient deficiencies and long-term adherence challenges.

Abstract: Cardiovascular disease (CVD) is the most prevalent cause of death globally. Thus, there is a need for extensive research on the various ways to prevent and manage it effectively. This review would establish the effectiveness of a plant-based diet on cardiovascular health based on recent studies such as randomized clinical trials (RCTs), cohort studies, and systematic reviews. Most recent studies have analyzed the impact of plant-based diets on cardiovascular health. These diets primarily consist of fruits, vegetables, nuts, whole grains, and seeds. Some of the main benefits of plant-based meals on cardiovascular health include an improved lipid profile, better control of blood pressure, and a reduction in systemic inflammation. The methodology adopted in this review is that of a critical analysis of the peer-reviewed literature published within the last decade. It encompasses literature that directly measures the effects of plant-based diets on various cardiovascular outcomes such as cholesterol levels, blood pressure, arterial stiffness, and inflammatory markers. Plant-based diets are related to lower low-density lipoprotein (LDL) cholesterol and lower blood pressure, with an improvement in endothelial function in subjects. Moreover, plant-based diets exert anti-inflammatory and antioxidant properties and, thereby, lower the rate of oxidative stress, which is one of the major factors in causing or worsening atherosclerosis. The major mechanisms proposed to explain the positive effects of plant-based diets on cardiovascular health include improvements in lipid metabolism, enhancements of vascular function, and reductions in inflammatory responses. These support the fact that, on the whole, plant-based diets contribute to immense positive differences for people experiencing CVD or others who seek avoidance of the disease. However, deficiencies in some nutrients and challenging long-term adherence are the potential adverse effects. Overall, evidence indicates that plant-based diets are a valuable, non-pharmacologic option in reducing CVD risk and improve overall cardiovascular health.

Cardio-Metabolic Benefits of Plant-Based Diets

Type of study:

Number of citations: 296

Year: 2017

Authors: H. Kahleová, Susan M Levin, N. Barnard

Journal: Nutrients

Journal ranking: Q1

Key takeaways: Plant-based diets can reduce the risk of cardio-metabolic diseases by 40%, cerebral vascular disease by 29%, and type 2 diabetes by half.

Abstract: Cardio-metabolic disease, namely ischemic heart disease, stroke, obesity, and type 2 diabetes, represent substantial health and economic burdens. Almost one half of cardio-metabolic deaths in the U.S. might be prevented through proper nutrition. Plant-based (vegetarian and vegan) diets are an effective strategy for improving nutrient intake. At the same time, they are associated with decreased all-cause mortality and decreased risk of obesity, type 2 diabetes, and coronary heart disease. Evidence suggests that plant-based diets may reduce the risk of coronary heart disease events by an estimated 40% and the risk of cerebral vascular disease events by 29%. These diets also reduce the risk of developing metabolic syndrome and type 2 diabetes by about one half. Properly planned vegetarian diets are healthful, effective for weight and glycemic control, and provide metabolic and cardiovascular benefits, including reversing atherosclerosis and decreasing blood lipids and blood pressure. The use of plant-based diets as a means of prevention and treatment of cardio-metabolic disease should be promoted through dietary guidelines and recommendations.

The Role of Specific Components of a Plant-Based Diet in Management of Dyslipidemia and the Impact on Cardiovascular Risk

Type of study: literature review

Number of citations: 179

Year: 2020

Authors: E. Trautwein, S. McKay

Journal: Nutrients

Journal ranking: Q1

Key takeaways: A predominantly plant-based diet, rich in vegetable fats, dietary fibers, and phytonutrients, can lower blood lipids and reduce cardiovascular disease risk.

Abstract: Convincing evidence supports the intake of specific food components, food groups, or whole dietary patterns to positively influence dyslipidemia and to lower risk of cardiovascular diseases (CVD). Specific macro- and micro-components of a predominantly plant-based dietary pattern are vegetable fats, dietary fibers, and phytonutrients such as phytosterols. This review summarizes the current knowledge regarding effects of these components on lowering blood lipids, i.e., low-density lipoprotein cholesterol (LDL-C) and on reducing CVD risk. The beneficial role of a plant-based diet on cardiovascular (CV) health has increasingly been recognized. Plant-based dietary patterns include a Mediterranean and Nordic diet pattern, the dietary approaches to stop hypertension (DASH), and Portfolio diet, as well as vegetarian- or vegan-type diet patterns. These diets have all been found to lower CVD-related risk factors like blood LDL-C, and observational study evidence supports their role in lowering CVD risk. These diet patterns are not only beneficial for dyslipidemia management and prevention of CVD but further contribute to reducing the impact of food choices on environmental degradation. Hence, the CV health benefits of a predominantly plant-based diet as a healthy and environmentally sustainable eating pattern are today recommended by many food-based dietary as well as clinical practice guidelines.

Plant‐Based Diets Are Associated With a Lower Risk of Incident Cardiovascular Disease, Cardiovascular Disease Mortality, and All‐Cause Mortality in a General Population of Middle‐Aged Adults

Type of study: non-rct observational study

Number of citations: 280

Year: 2019

Authors: Hyunju Kim, L. Caulfield, V. García-Larsen, L. Steffen, J. Coresh, C. Rebholz

Journal: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

Journal ranking: Q1

Key takeaways: Plant-based diets, higher in plant foods and lower in animal foods, are associated with a lower risk of cardiovascular disease, cardiovascular disease mortality, and all-cause mortality in middle-aged adults.

Abstract: Background Previous studies have documented the cardiometabolic health benefits of plant‐based diets; however, these studies were conducted in selected study populations that had narrow generalizability. Methods and Results We used data from a community‐based cohort of middle‐aged adults (n=12 168) in the ARIC (Atherosclerosis Risk in Communities) study who were followed up from 1987 through 2016. Participants’ diet was classified using 4 diet indexes. In the overall plant‐based diet index and provegetarian diet index, higher intakes of all or selected plant foods received higher scores; in the healthy plant‐based diet index, higher intakes of only the healthy plant foods received higher scores; in the less healthy plant‐based diet index, higher intakes of only the less healthy plant foods received higher scores. In all indexes, higher intakes of animal foods received lower scores. Results from Cox proportional hazards models showed that participants in the highest versus lowest quintile for adherence to overall plant‐based diet index or provegetarian diet had a 16%, 31% to 32%, and 18% to 25% lower risk of cardiovascular disease, cardiovascular disease mortality, and all‐cause mortality, respectively, after adjusting for important confounders (all P<0.05 for trend). Higher adherence to a healthy plant‐based diet index was associated with a 19% and 11% lower risk of cardiovascular disease mortality and all‐cause mortality, respectively, but not incident cardiovascular disease (P<0.05 for trend). No associations were observed between the less healthy plant‐based diet index and the outcomes. Conclusions Diets higher in plant foods and lower in animal foods were associated with a lower risk of cardiovascular morbidity and mortality in a general population.

Association between Plant-Based Dietary Patterns and Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

Type of study: meta-analysis

Number of citations: 65

Year: 2021

Authors: Zuo Hua Gan, Huey Chiat Cheong, Y. Tu, Po-Hsiu Kuo

Journal: Nutrients

Journal ranking: Q1

Key takeaways: Higher adherence to plant-based diets is associated with a lower risk of cardiovascular disease and coronary heart disease, but not stroke, but not stroke incidence.

Abstract: Plant-based diets, characterized by a higher consumption of plant foods and a lower consumption of animal foods, are associated with a favorable cardiovascular disease (CVD) risk, but evidence regarding the association between plant-based diets and CVD (including coronary heart disease (CHD) and stroke) incidence remain inconclusive. A literature search was conducted using the PubMed, EMBASE and Web of Science databases through December 2020 to identify prospective observational studies that examined the associations between plant-based diets and CVD incidence among adults. A systematic review and a meta-analysis using random effects models and dose–response analyses were performed. Ten studies describing nine unique cohorts were identified with a total of 698,707 participants (including 137,968 CVD, 41,162 CHD and 13,370 stroke events). Compared with the lowest adherence, the highest adherence to plant-based diets was associated with a lower risk of CVD (RR 0.84; 95% CI 0.79–0.89) and CHD (RR 0.88; 95% CI 0.81–0.94), but not of stroke (RR 0.87; 95% CI 0.73–1.03). Higher overall plant-based diet index (PDI) and healthful PDI scores were associated with a reduced CVD risk. These results support the claim that diets lower in animal foods and unhealthy plant foods, and higher in healthy plant foods are beneficial for CVD prevention. Protocol was published in PROSPERO (No. CRD42021223188).

Plant-Based Diets for Cardiovascular Safety and Performance in Endurance Sports

Type of study: literature review

Number of citations: 105

Year: 2019

Authors: N. Barnard, David M. Goldman, James F. Loomis, H. Kahleová, Susan M Levin, Stephen Neabore, Travis Batts

Journal: Nutrients

Journal ranking: Q1

Key takeaways: Plant-based diets may reduce cardiovascular risk factors and offer performance advantages for endurance athletes by promoting lean body composition, improving vascular flow, and reducing inflammation.

Abstract: Studies suggest that endurance athletes are at higher-than-average risk for atherosclerosis and myocardial damage. The ability of plant-based regimens to reduce risk and affect performance was reviewed. The effect of plant-based diets on cardiovascular risk factors, particularly plasma lipid concentrations, body weight, and blood pressure, and, as part of a healthful lifestyle, reversing existing atherosclerotic lesions, may provide a substantial measure of cardiovascular protection. In addition, plant-based diets may offer performance advantages. They have consistently been shown to reduce body fat, leading to a leaner body composition. Because plants are typically high in carbohydrate, they foster effective glycogen storage. By reducing blood viscosity and improving arterial flexibility and endothelial function, they may be expected to improve vascular flow and tissue oxygenation. Because many vegetables, fruits, and other plant-based foods are rich in antioxidants, they help reduce oxidative stress. Diets emphasizing plant foods have also been shown to reduce indicators of inflammation. These features of plant-based diets may present safety and performance advantages for endurance athletes. The purpose of this review was to explore the role of nutrition in providing cardioprotection, with a focus on plant-based diets previously shown to provide cardiac benefits.

Plant-Based Diets for Cardiovascular Disease Prevention: All Plant Foods Are Not Created Equal

Type of study: literature review

Number of citations: 142

Year: 2019

Authors: E. Hemler, F. Hu

Journal: Current Atherosclerosis Reports

Journal ranking: Q1

Key takeaways: Plant-based diets can provide cardiovascular benefits when planned appropriately and include high-quality foods, but complete elimination of meat or animal products is not necessary for optimal health.

Abstract: Purpose of ReviewPlant-based diets have been widely promoted for cardiovascular disease (CVD) risk reduction. This review discusses the various definitions of plant-based diets and summarizes their associations with CVD risk, specifically distinguishing between healthy and unhealthy plant-based diets.Recent FindingsDespite wide variation in definition, most studies suggest that plant-based diets are generally beneficial for cardiovascular health. Many previous studies have defined plant-based diets by the complete exclusion of meat or animal products, while others have accounted for plant-based diets including moderate amounts of animal-source foods. Only a few studies have considered the healthfulness of the specific plant foods included in these dietary patterns. In these studies, plant-based diets containing higher amounts of healthy foods such as whole grains, fruits, vegetables, nuts, legumes, oils, tea, and coffee are associated with lower CVD risk. However, plant-based diets including higher amounts of less healthy plant foods, such as refined grains, potatoes/fries, and foods and beverages high in added sugar, are linked to increased risk.SummaryA wide spectrum of plant-based diets can be nutritionally adequate and confer cardiovascular benefits, as long as they are planned appropriately and include high-quality foods. Contrary to popular belief, plant-based diets do not have to be vegan or vegetarian. For most people, complete elimination of meat or animal products is unrealistic and not necessary for cardiovascular health. Quality of the specific components of plant-based diets is also important to consider, as not all plant-source foods have beneficial cardiovascular effects. Healthy plant-based diets can be customized to fit individual and cultural preferences and, with large-scale adoption, could concurrently mitigate threats to both human and environmental health.

P-544. Whole Food Plant-Based Diet for HIV-Associated Reduction in Cardiovascular Risk: A Pilot Randomized Clinical Trial (PLANT-HART)

Type of study: rct

Number of citations: 0

Year: 2025

Authors: Carolina Martínez-Loya, Ruth Selene Favela Ortiz, Alejandra Vargas-Castañeda, Mariana Seijas-Vasquez, Jesus Pérez-Castilla

Journal: Open Forum Infectious Diseases

Journal ranking: Q1

Key takeaways: A plant-based diet may reduce cardiovascular risks in HIV-positive individuals, with both groups showing significant reductions in blood pressure and potential benefits for weight and cholesterol management.

Abstract: Abstract Background Globally, 39 million people are affected by HIV, most of whom are on antiretroviral therapy (ART), which increases cardiovascular risks. Guidelines lack specific dietary recommendations for this population, though plant-based diets may reduce these risks. This pilot study (NCT05796882), to our knowledge, is the first to explore the effects of a plant-based diet on cardiovascular risk in HIV-positive individuals.Table 1. Differences in variables for both groups combined and their statistical significance. Paired sample analysis. Methods This randomized controlled pilot clinical trial, conducted in Mexico, involved HIV-positive adults on stable ART, aged 30-60, with a body mass index > 25 and ≥ 1 cardiovascular risk factor. Exclusion criteria included: acquired immunodeficiency syndrome, major cardiovascular events, substance abuse, and ART non-adherence. Of 150 invited, 21 consented and 10 completed the 8-week intervention. Outcomes were analyzed using non-parametric tests (Wilcoxon Sign-rank and Mann-Whitney U). The ethics committee approved; all participants provided informed consent. Results Ten male participants (mean age 40.3 ± 8.2) were divided into a plant-based diet (PBD, n=4) and a nutritional standard care (NSC, n=6) group. After 8 weeks, reductions in cardiovascular risk were observed; the NSC group experienced a -0.9% in Framingham Hard Coronary Risk (p=0.2) and the PBD group a -0.1% (p=0.1). Blood pressure decreased significantly in both groups: systolic blood pressure decreased by 15.2 mmHg (p=0.01) and diastolic blood pressure by -7.3 mmHg (p=0.02) (Table 1). The PBD group also showed reductions in weight (-700g, p=0.7), body fat percentage (-0.9%, p=1.0), tricipital fold (-3mm, p=0.06), total cholesterol (-32.0 mg/dL, p=0.1) and LDL cholesterol (-39.7 mg/dL, p=0.2), though not statistically significant. Conclusion This pilot study suggests that a plant-based diet may reduce cardiovascular risks in HIV-positive individuals. Both groups were significant for reducing systolic and diastolic blood pressure. The plant-based diet can potentially be beneficial for weight and cholesterol management. Despite a small sample size and adherence challenges, regular follow-ups and dietary self-reports enhanced compliance, underscoring the need for larger, comprehensive studies to confirm these findings. Disclosures All Authors: No reported disclosures

Plant Based Diet and Its Effect on Cardiovascular Disease

Type of study: literature review

Number of citations: 36

Year: 2023

Authors: Salman Salehin, Peter Rasmussen, S. Mai, Muhammad Mushtaq, M. Agarwal, S. Hasan, Shahran Salehin, Muhammad Raja, S. Gilani, W. Khalife

Journal: International Journal of Environmental Research and Public Health

Journal ranking: Q2

Key takeaways: A plant-based diet has been shown to improve cardiovascular outcomes, reducing morbidity and mortality in various clinical studies.

Abstract: Cardiovascular disease remains the leading cause of death globally and here in the United States. Diet has a major impact on the pathogenesis of atherosclerosis and subsequent cardiovascular morbidity and mortality. An unhealthy diet is the most significant potential behavioral and modifiable risk factor for ischemic heart disease. Despite these established facts, dietary interventions are far less frequent than pharmaceutical and procedural interventions in the management of cardiovascular disease. The beneficial effects of a plant-based diet on cardiovascular morbidity and mortality have been demonstrated in a number of recent clinical studies. The significant findings of each study are discussed in this review article, highlighting the role of a healthy plant-based diet in improving cardiovascular outcomes. From a clinician’s standpoint, the knowledge and understanding of the facts and data points from these recent clinical studies would ensure more effective patient counseling on the substantial benefits of dietary interventions.

The Role of Dietary Potassium in the Cardiovascular Protective Effects of Plant-Based Diets.

Type of study:

Number of citations: 2

Year: 2023

Authors: Olgert Bardhi, Deborah J Clegg, B. Palmer

Journal: Seminars in nephrology

Journal ranking: Q1

Key takeaways: Plant-based diets rich in potassium may provide cardiorenal protective effects, improving kidney and cardiovascular hemodynamics and overall metabolic health.

Plant-Based Nutrition: An Essential Component of Cardiovascular Disease Prevention and Management

Type of study: literature review

Number of citations: 67

Year: 2017

Authors: Hena Patel, S. Chandra, Sarah Alexander, J. Soble, K. Williams

Journal: Current Cardiology Reports

Journal ranking: Q1

Key takeaways: Plant-based diets, high in fruits, vegetables, nuts, and whole grains, significantly lower the risk of cardiovascular disease and its risk factors.

Abstract: Purpose of ReviewThis review aims to summarize and discuss the role of plant-based nutrition as an adjunct to the management of cardiovascular disease (CVD). Discussion of nutrition and the benefits of a plant-based diet should be highlighted during healthcare provider visits as an essential part of the overall CVD prevention and management care plan.Recent FindingsEvidence from prospective cohort studies indicates that a high consumption of predominantly plant-based foods, such as fruit and vegetables, nuts, and whole grains, is associated with a significantly lower risk of CVD. The protective effects of these foods are likely mediated through their multiple beneficial nutrients, including mono- and polyunsaturated fatty acids, omega-3 fatty acids, antioxidant vitamins, minerals, phytochemicals, fiber, and plant protein. In addition, minimizing intake of animal proteins has been shown to decrease the prevalence of CVD risk factors.SummarySubstantial evidence indicates that plant-based diets can play an important role in preventing and treating CVD and its risk factors. Such diets deserve more emphasis in dietary recommendations.

The Effect of a Vegan Diet on the Cardiovascular System

Type of study:

Number of citations: 20

Year: 2023

Authors: Michail Koutentakis, S. Surma, Sylwester Rogula, K. Filipiak, A. Gąsecka

Journal: Journal of Cardiovascular Development and Disease

Journal ranking: Q1

Key takeaways: A vegan diet may improve cardiovascular health by reducing BMI, cholesterol, inflammation, and blood pressure, but may have smaller amounts of certain nutrients.

Abstract: The vegan diet, often known as a plant-rich diet, consists primarily of plant-based meals. This dietary approach may be beneficial to one’s health and the environment and is valuable to the immune system. Plants provide vitamins, minerals, phytochemicals, and antioxidants, components that promote cell survival and immune function, allowing its defensive mechanisms to work effectively. The term “vegan diet” comprises a range of eating patterns that prioritize nutrient-rich foods such as fruits and vegetables, legumes, whole grains, nuts, and seeds. In comparison to omnivorous diets, which are often lower in such products, the vegan diet has been favorably connected with changes in cardiovascular disease (CVD) risk markers such as reduced body mass index (BMI) values, total serum cholesterol, serum glucose, inflammation, and blood pressure. Reduced intake of low-density lipoprotein (LDL), saturated fat, processed meat, and greater consumption of fiber and phytonutrients may improve cardiovascular health. However, vegans have much smaller amounts of nutrients such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), selenium, zinc, iodine, and vitamin B12, compared to non-vegans, which may lead to detrimental cardiovascular effects. This review aims to present the effect of plant-based diets (PBDs), specifically vegan diets, on the cardiovascular system.

Plant-Based Diets and Cardiovascular Disease in Older Adults: An Integrative Literature Review

Type of study: systematic review

Number of citations: 0

Year: 2024

Authors: Tricia R VanCleef, Amy Hutchens

Journal: Biological Research For Nursing

Journal ranking: Q1

Key takeaways: Plant-based diets show potential in reducing cardiovascular disease risk factors and mortality in older adults.

Abstract: Cardiovascular disease (CVD) is the leading cause of mortality globally, disproportionately impacting older adults. Plant-based diets (PBDs) have emerged as a dietary strategy to mitigate CVD risk, characterized by foods derived from plants and minimal to no animal-derived foods. This integrative review assesses the effectiveness of PBDs for improving CVD risk factors in older adults. A search was conducted in CINAHL, PubMed, and Medline databases for studies of PBDs and CVD risk factors in individuals aged 65 years and older. Quality assessment was performed using the Mixed Methods Appraisal Tool (MMAT). Seventeen publications were analyzed, 7 experimental and 10 non-experimental. All studies showed at least one positive association between PBDs and cardiovascular health in older adults. Findings highlighted significant associations between PBD adherence and reductions in key CVD risk factors, such as low-density lipoprotein cholesterol (LDL-C), blood pressure, and body mass index (BMI), alongside potential benefits in reducing coronary artery calcium and enhancing endothelial function and serum isoflavone concentrations. There is evidence for the potential of PBDs as an effective dietary strategy to prevent the onset and progression of CVD in older adults and reduce the risk of CVD mortality. This review indicates the need for further research. Larger randomized control trials focused on older adults may strengthen the evidence base and guide healthcare recommendations. PBDs should be considered as a part of holistic CVD prevention and management strategies for older adults, encouraging dietary patterns that are rich in fruits, vegetables, legumes, beans, nuts, seeds, and whole grains.

Influence of Plant-Based Diet on the Cardiovascular System: A Narrative Review

Type of study: literature review

Number of citations: 0

Year: 2023

Authors: Gurusha Jangid, Helen A.O. Popoola-Samuel, Kausalya Goda, F. Anamika, Vasundhara Gupta, S. Kanagala, Ripudaman Munjal

Journal: Cardiology in Review

Journal ranking: Q2

Key takeaways: A well-balanced plant-based diet can lower the risk of cardiovascular diseases due to high fiber content, antioxidants, and polyunsaturated fatty acids, but may be low in essential nutrients.

Abstract: A plant-based diet (PBD) includes multiple dietary patterns such as vegetarianism, veganism, lacto-ovo-vegetarianism, etc. A well-balanced PBD has positive effects on body mass index, hyperlipidemia, and type 2 diabetes, and it is associated with decreased risk of cardiovascular diseases. Due to its high fiber content, which lowers levels of low-density lipoprotein cholesterol, high antioxidant content, which prevents capillary wall damage; the presence of polyunsaturated fatty acids, which have an anti-inflammatory effect, improvement in glucose homeostasis through improved insulin sensitivity, and impact on the gut microbiota, it has been proven to be beneficial for the heart. Despite their possible benefits, PBDs can be low in essential nutrients such as vitamin B12, zinc, vitamin D, iodine, and amino acids. This review aims to analyze the influence of PBDs on the cardiovascular system and associated disease progression.

Associations of Dietary Intake with Cardiovascular Risk in Long-Term “Plant-Based Eaters”: A Secondary Analysis of a Cross-Sectional Study

Type of study:

Number of citations: 5

Year: 2024

Authors: Boštjan Jakše, Uroš Godnov, Z. Fras, Nataša Fidler Mis

Journal: Nutrients

Journal ranking: Q1

Key takeaways: A long-term plant-based diet rich in whole grains, fruits, and legumes can improve cardiovascular health, while plant-based fast food and pasta may increase uric acid levels.

Abstract: A plant-based diet rich in whole foods and fiber is beneficial for cardiovascular (CV) health. This impact is often linked to specific food groups and their preparation methods, reflecting the overall dietary pattern. However, research on the long-term effects of a carefully designed plant-based diet on adults transitioning from a typical Western lifestyle is limited. Notably, studies on people managing CV risk factors effectively are scarce. As part of a cross-sectional study, we examined 151 individuals committed to a long-term, well-designed plant-based diet and active lifestyle. We investigated how specific food groups and macronutrient intake are related to various CV health markers. In this secondary analysis, our comprehensive approach encompassed several methods: 3-day weighted dietary records, fasting blood lipid and blood pressure measurements, body composition assessments, and evaluations of lifestyle status. We adjusted our analysis for multiple variables, such as age, sex, current body mass index, smoking status, physical activity, and time (years) following the plant-based diet. Our findings revealed several associations between macronutrient intake (per 50 g) and CV risk markers, although these associations were generally weak. Individuals who consumed more whole grains and fruits had lower levels of total, low-density lipoprotein (LDL-C), and high-density lipoprotein (HDL-C) cholesterol. We also found associations between the intake of legumes and nuts/seeds and reduced HDL-C levels. These findings suggested that these food groups might influence the lipid profile, contributing to CV health in a plant-based diet. A greater intake of spices/herbs was associated with lower uric acid levels, while diets rich in plant-based fast food and pasta (made from white flour) were associated with higher uric acid levels. A greater intake of various macronutrients, such as fiber, carbohydrates (from whole-food sources), proteins, and different types of fats (saturated fatty acids [SFAs], monounsaturated fatty acids [MUFAs], and polyunsaturated fatty acids [PUFAs]), was associated with lower levels of total cholesterol, LDL-C (only for carbohydrates), and HDL-C. We found a unique negative correlation between PUFA intake and LDL-C, suggesting that PUFAs might significantly affect LDL-C levels. In contrast, increased fiber, protein and SFA consumption were associated with increased uric acid levels. These findings support the impact of dietary patterns on CV risk factors, highlighting that even small amounts of unhealthy food groups can significantly influence specific CV risk markers, regardless of the overall diet.

The Effect of a Plant-based Diets on the Cardiovascular System in Geriatric Patients – Review

Type of study:

Number of citations: 1

Year: 2021

Authors: Klaudia Kmiecik, Oskar Dąbrowski, K. Kędziora–Kornatowska

Journal: Journal of Health Study and Medicine

Journal ranking: brak

Key takeaways: Plant-based diets positively impact the cardiovascular system, reducing the risk of hypertension, heart disease, type 2 diabetes, lowers cholesterol, and helps reduce blood pressure in geriatric patients.

Abstract: Abstract Cardiovascular disease is one of the most common causes of death in developed countries and its incidence increases with age. The group of cardiovascular diseases includes different disease entities. Most of them are associated with the atherosclerotic process in the blood vessels. One of the most important methods of preventing atherosclerosis and its complications is proper nutrition, rich in polyunsaturated vegetable oils and low in saturated fatty acids. Many research results confirm the positive effect of a plant-based diet on the circulatory system. A well-balanced diet based on plant-based products reduces the risk of hypertension, heart disease, prevents type 2 diabetes, lowers cholesterol and helps to reduce blood pressure. Vegetarian eating patterns can reduce cardiovascular disease mortality by 30%. In addition, the plant-based diet is the only dietary pattern that has shown cessation and reversal of atherosclerotic plaque. Today, plant-based diets are becoming more popular and are increasingly used as a means of preventing and treating cardio-metabolic diseases.

The Association of Plant-Based Diet With Cardiovascular Disease and Mortality: A Meta-Analysis and Systematic Review of Prospect Cohort Studies

Type of study: meta-analysis

Number of citations: 71

Year: 2021

Authors: Jingxuan Quek, Grace Y. Lim, W. Lim, C. Ng, W. Z. So, J. Toh, Xin-Hui Pan, Y. Chin, M. Muthiah, S. Chan, R. Foo, James Yip, N. Neelakantan, M. Chong, P. Loh, N. Chew

Journal: Frontiers in Cardiovascular Medicine

Journal ranking: Q2

Key takeaways: Healthful plant-based diets are associated with a lower risk of cardiovascular mortality and cardiovascular disease incidence, while unhealthful plant-based diets may increase cardiovascular mortality.

Abstract: Background: The association between plant-based diets and cardiovascular disease (CVD) remains poorly characterized. Given that diet represents an important and a modifiable risk factor, this study aimed to assess (1) the relationships between the impact of adherence to plant-based diets on cardiovascular mortality, incident CVD, and stroke; (2) if associations differed by adherence to healthful and less healthful plant-based diets. Methods and Findings: MEDLINE and EMBASE databases were searched up to May 2021. Studies assessing CVD outcomes with relation to plant-based dietary patterns or according to plant-based dietary indices (PDI) were included. A meta-analysis of hazard ratios (HR) was conducted using DerSimonian and Laird random effects model. Thirteen studies involving 410,085 participants were included. Greater adherence to an overall plant-based dietary pattern was significantly associated with a lower risk of cardiovascular mortality (pooled HR: 0.92, 95% CI: 0.86–0.99 p = 0.0193, I2 = 88.5%, N = 124,501) and a lower risk of CVD incidence (pooled HR: 0.90, 95% CI: 0.82–0.98, p = 0.0173, I2 = 87.2%, N = 323,854). Among the studies that used PDI, unhealthful plant-based diets were associated with increased risk of cardiovascular mortality (pooled HR: 1.05, 95% CI: 1.01–1.09, p = 0.0123, I2 = 0.00%, N = 18,966), but not CVD incidence. Conversely, healthful plant-based diets were associated with decreased CVD incidence (pooled HR: 0.87, 95% CI: 0.80–0.95, p = 0.0011, I2 = 57.5%, N = 71,301), but not mortality. Vegetarians also had significantly lower CVD incidence (HR: 0.81, 95% CI: 0.72–0.91, p = 0.0004, I2 = 22.2%, N = 16,254), but similar CVD mortality or stroke risk when compared to the meat-eaters. Conclusion: To date, this comprehensive study examines the effects of a plant-based diet on major clinical endpoints using more holistic PDIs. These findings highlight the favorable role of healthful plant-based foods in reducing cardiovascular mortality and CVD.

Genetic susceptibility, plant-based dietary patterns, and risk of cardiovascular disease.

Type of study: non-rct observational study

Number of citations: 38

Year: 2020

Authors: Y. Heianza, Tao Zhou, Dianjianyi Sun, F. Hu, J. Manson, L. Qi

Journal: The American journal of clinical nutrition

Journal ranking: Q1

Key takeaways: Higher adherence to healthy plant-based diets may decrease the incidence of cardiovascular disease, regardless of genetic susceptibility.

Abstract: BACKGROUND Plant-based dietary patterns may be related to better cardiovascular profiles. Whether a healthy plant-based dietary index is predictive of future cardiovascular disease (CVD) across people with different genetic susceptibility remains uncertain. OBJECTIVE We investigated associations of adherence to healthy plant-based diets with the incidence of CVD considering the genetic susceptibility. METHODS This prospective cohort study included a total of 156,148 adults initially free of CVD and cancer. We calculated a healthful plant-based diet index (healthful-PDI) in which healthy plant foods received positive scores, and less healthy plant foods and animal foods received reverse scores. Genetic risk scores (GRSs) for myocardial infarction (MI) and stroke were calculated to assess interactions between healthful-PDI and GRSs. RESULTS During 5 y of follow-up, we observed 1812 incident cases of CVD. Higher healthful-PDI was associated with a lower CVD risk [HR per 10-unit increment: 0.87 (95% CI: 0.81, 0.93) after adjusting for demographic, lifestyle, and other dietary factors (model 1); HR 0.90 (0.84, 0.97) after further adjusting for obesity and metabolic factors (model 2)]. The risk of CVD was gradually decreased in association with higher adherence to healthful-PDI, regardless of genetic susceptibility. The inverse associations of healthful-PDI with CVD were consistently observed in people with low GRS-MI [HR 0.85 (95% CI: 0.76, 0.94) in model 1; HR 0.88 (0.79, 0.97) in model 2] and those with high GRS-MI [HR 0.91 (0.82, 0.99) in model 1; HR 0.94 (0.86, 1.04) in model 2], without significant interactions (Pinteraction = 0.59 in model 1; Pinteraction = 0.66 in model 2). Similarly, higher healthful-PDI was related to a lower risk of CVD, regardless of low/high GRS-stroke. CONCLUSION Adherence to healthy plant-based diets may be associated with a decreased incidence of CVD in the entire population, suggesting that plant-based dietary patterns may modify the risk of CVD, regardless of genetic susceptibility.

Effect of Plant-Based Diets on Gut Microbiota: A Systematic Review of Interventional Studies

Type of study: systematic review

Number of citations: 51

Year: 2023

Authors: Shaneerra Raajlynn Kaur Sidhu, Chin Wei Kok, Thubasni Kunasegaran, A. Ramadas

Journal: Nutrients

Journal ranking: Q1

Key takeaways: Plant-based diets show short- to moderate-term benefits on gut microbiome composition and health measurements, but more research is needed to fully understand their effects.

Abstract: Plant-based diets have grown increasingly popular across the globe, mainly for their health and environmental benefits. Several studies have identified a link between plant-based diets and the decreased risk of developing cardiovascular diseases, obesity, and other health issues. We systematically reviewed human interventions to identify the relationship between various plant-based food items and the gut microbiome, alongside the biochemical and anthropometric measurements as secondary findings. The study selection process was completed using the COVIDENCE platform. Overall, 203 studies were identified, of which 101 were chosen for title and abstract screening by two independent authors. Following this process, 78 studies were excluded, and the full texts and the reference lists of the remaining 23 records were reviewed using the review eligibility criteria. A manual search yielded five additional articles. In the end, 12 studies were included in the systematic review. We found evidence for short- to moderate-term beneficial effects of plant-based diets versus conventional diets (duration ≤ 13 months) on gut microbiome composition and biochemical and anthropometric measurements in healthy participants as well as obese, cardiovascular, and rheumatoid arthritis patients. However, contradictory results were observed for Enterobacteriaceae, at the family level, and for Faecalibacterium and Coprococcus, at the genus level, of gut microbiome composition. The relationship between plant-based diets and the gut microbiome, alongside their underlying metabolic and inflammatory effects, remains largely unexplored. Hence more interventional studies are needed to address these questions.

The Impact of Plant-Based Dietary Patterns on Cancer-Related Outcomes: A Rapid Review and Meta-Analysis

Type of study: meta-analysis

Number of citations: 65

Year: 2020

Authors: E. Molina-Montes, E. Salamanca-Fernández, B. García-Villanova, María-José Sánchez

Journal: Nutrients

Journal ranking: Q1

Key takeaways: Plant-based diets may prevent negative cancer-related outcomes, but more research is needed to confirm their effectiveness before and after cancer diagnosis.

Abstract: Long-term cancer survivors represent a sizeable portion of the population. Plant-based foods may enhance the prevention of cancer-related outcomes in these patients. We aimed to synthesize the current evidence regarding the impact of plant-based dietary patterns (PBDPs) on cancer-related outcomes in the general population and in cancer survivors. Considered outcomes included overall cancer mortality, cancer-specific mortality, and cancer recurrence. A rapid review was conducted, whereby 2234 original articles related to the topic were identified via Pubmed/Medline. We selected 26 articles, which were classified into studies on PBDPs and cancer outcomes at pre-diagnosis: vegan/vegetarian diet (N = 5), provegetarian diet (N = 2), Mediterranean diet (N = 13), and studies considering the same at post-diagnosis (N = 6). Pooled estimates of the associations between the aforementioned PBDPs and the different cancer outcomes were obtained by applying random effects meta-analysis. The few studies available on the vegetarian diet failed to support its prevention potential against overall cancer mortality when compared with a non-vegetarian diet (e.g., pooled hazard ratio (HR) = 0.97; 95% confidence interval (CI): 0.88–1.06). The insufficient number of studies evaluating provegetarian index scores in relation to cancer mortality did not permit a comprehensive assessment of this association. The association between adherence to the Mediterranean diet and cancer mortality reached statistical significance (e.g., pooled HR = 0.84; 95% CI: 0.79–0.89). However, no study considered the influence of prognostic factors on the associations. In contrast, post-diagnostic studies accounted for prognostic factors when assessing the chemoprevention potential of PBDPs, but also were inconclusive due to the limited number of studies on well-defined plant-based diets. Thus, whether plant-based diets before or after a cancer diagnosis prevent negative cancer-related outcomes needs to be researched further, in order to define dietary guidelines for cancer survivors.

Plant-based diets and the risk of lung cancer: a large prospective cohort study

Type of study: non-rct observational study

Number of citations: 2

Year: 2025

Authors: Wei Wei, Shuyuan Wang, Zhen Yuan, Yifan Ren, Jiaxing Wu, Xiaohui Gao, Rong Wang, Jianxiong Li

Journal: European Journal of Nutrition

Journal ranking: Q1

Key takeaways: Higher plant-based diet adherence is associated with a lower lung cancer risk, supporting potential benefits for lung cancer prevention.

Abstract: Plant-based diets are increasingly recognized for cancer prevention, yet their specific impact on lung cancer (LC) risk remains insufficiently examined. This study aims to assess the relationship between plant-based diets adherence and the incidence of LC. Data from the Prostate, Lung, Colorectal, and Ovarian cancer screening trial were analyzed. The plant-based diet index (PDI) was developed to assess adherence to plant-based diets. Multivariable Cox regression model was performed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Restricted cubic spline (RCS) model was performed to examine risk across the PDI spectrum. Prespecified subgroup analyses identified potential modifiers, and sensitivity analyses tested the association's robustness. Of the 98,459 participants included, 1,642 developed LC over an average follow-up of 8.83 years. Higher PDI scores were associated with a lower LC risk (HR quartile 4 vs. 1: 0.75, 95% CI: 0.65–0.87, P trend < 0.001), evident in both non-small cell lung cancer (HR quartile 4 vs. 1: 0.76, 95% CI: 0.65–0.88, P trend < 0.001) and small cell lung cancer (HR quartile 4 vs. 1: 0.73, 95% CI: 0.49–1.09, P trend = 0.046). RCS analyses further confirmed these relationships. The association was stronger among participants with lower BMI, smokers, those without a history of emphysema or diabetes, those without a family history of LC, and those with lower physical activity (all P trend < 0.001). Sensitivity analyses consistently supported these findings. Our findings reveal an inverse correlation between PDI and LC risk, supporting the potential benefits of plant-based diets in LC prevention. ClinicalTrials.gov ID: NCT00339495 (URL: https://www.clinicaltrials.gov/study/NCT00339495 ).

Plant-Based and Ketogenic Diets As Diverging Paths to Address Cancer: A Review.

Type of study: literature review

Number of citations: 35

Year: 2022

Authors: U. Shah, N. Iyengar

Journal: JAMA oncology

Journal ranking: Q1

Key takeaways: Plant-based diets are more effective than ketogenic diets in reducing cancer risk and improving metabolic disorders in survivors.

Abstract: Importance As the incidence of cancer and metabolic disorders, such as obesity, concurrently rise, there has been increasing awareness of the pervasive effect of nutrition. The whole foods plant-based diet (WFPBD) and ketogenic diet (KD) have gained popularity in oncology, and this topic is increasingly permeating clinical dialogue. Observations Dietary intake is associated with multiple pathways involved in carcinogenesis and tumor progression. Consumption of a plant-enriched diet is associated with reduced cancer incidence and is recommended by dietary guidelines for cancer prevention. Despite a starkly different nutrient composition, a WFPBD and KD can be associated with weight loss, decreased inflammation, and decreased insulin levels. In addition, a WFPBD is associated with increased fiber, phytochemicals, and butyrate levels and decreased insulin-like growth factor 1 levels, whereas a KD exerts potential anticancer effects by increasing β hydroxybutyrate levels. A KD may be of interest in select, less common settings, such as tumors treated with phosphatidylinositol 3-kinase inhibitors, which induce hyperinsulinemia and hyperglycemia. Completed interventional trials have focused on increasing fruit and vegetable intake or reducing fat intake but have not specifically tested WFPBD or KD for cancer prevention or treatment. Currently available data support plant-based diets as opposed to KD as part of a lifestyle associated with reduced cancer risk. In the postdiagnosis setting, there are currently no rigorously tested approaches that support the recommendation of any diet to treat cancer. Conclusions and Relevance The results of this review suggest that the collective evidence supports plant-enriched diets vs KD for the reduction of cancer risk and the improvement of metabolic disorders in survivors. Additional prospective randomized clinical trials are needed to encourage use of dietary modification across the cancer continuum. Rigorous trial designs that adapt classical oncologic end points may identify populations that are likely to benefit from starkly contrasting diets. Current data support prioritization of plant-based diets, and future data could further personalize dietary recommendations in cancer populations.

Plant-Based Diets and Cancer Prognosis: a Review of Recent Research

Type of study: systematic review

Number of citations: 30

Year: 2022

Authors: Luisa Hardt, Y. Mahamat-Saleh, D. Aune, S. Schlesinger

Journal: Current Nutrition Reports

Journal ranking: Q1

Key takeaways: Postdiagnosis plant-based diets may improve prognosis in cancer survivors, with benefits observed for colorectal, breast, and prostate cancers.

Abstract: Abstract Purpose of Review Although plant-based diets are recommended for cancer prevention, their role in cancer survival is still uncertain. The purpose of this systematic review is to summarize the association between postdiagnosis plant-based diets and prognosis in cancer survivors. Recent Findings There is indication that higher intake of plant-based foods was associated with improved prognosis in cancer survivors. For colorectal cancer survival, a better prognosis was observed for a high intake of whole grains and fibre. For breast cancer survival, a higher intake of fruit, vegetable and fibre and a moderate intake of soy/isoflavone were associated with beneficial outcomes. A higher vegetable fat intake was related to improved prognosis in prostate cancer survivors. Summary Emerging evidence suggests benefits of postdiagnosis plant-based diets on prognosis in cancer survivors. However, given the high heterogeneity between studies, further research in cancer survivors, considering clinical factors (e.g. treatment, stage) and methodological aspects (e.g. timing of dietary assessment), is needed.

Plant-Based Diets and Cancer Risk: What is the Evidence?

Type of study: literature review

Number of citations: 27

Year: 2022

Authors: V. DeClercq, Jacob T. Nearing, E. Sweeney

Journal: Current Nutrition Reports

Journal ranking: Q1

Key takeaways: Plant-based diets are associated with a decreased overall cancer risk, but future research should address inconsistencies in dietary assessment methods and focus on underrepresented groups.

Abstract: Purpose of ReviewThe purpose of this review is to summarize the recent (past 5 years) available evidence regarding the association between plant-based diets on cancer risk from clinical trials and observational studies. Biological mechanisms and gaps in the current literature will also be discussed.Recent FindingsThere is a lack of intervention studies but there are abundant observational studies assessing the association between plant-based diets and cancer risk, including multiple longitudinal cohort studies and similar data from case–control studies that demonstrate a decreased overall cancer risk with plant-based diets. Case–control studies support a decreased risk of colorectal and breast cancers with plant-based diets, but results for specific cancers remain inconsistent in cohort studies.SummaryCurrent evidence from observational studies indicates an inverse association between plant-based diets and overall cancer risk. Future research should include intervention studies, address inconsistencies in dietary assessment methods and provide greater detail on underrepresented groups.

Systematic review of the impact of a plant-based diet on prostate cancer incidence and outcomes

Type of study: systematic review

Number of citations: 25

Year: 2022

Authors: N. Gupta, Hiten D Patel, Jacob Taylor, J. Borin, K. Jacobsohn, Stacey A. Kenfield, S. Eggener, Carrie Price, Meena Davuluri, N. Byrne, T. Bivalacqua, S. Loeb

Journal: Prostate Cancer and Prostatic Diseases

Journal ranking: Q1

Key takeaways: A plant-based diet can improve short-term prostate cancer outcomes and general health, while reducing prostate cancer risk or showing no significant difference.

The Relationship Between Plant-Based Diet and Risk of Digestive System Cancers: A Meta-Analysis Based on 3,059,009 Subjects

Type of study: meta-analysis

Number of citations: 53

Year: 2022

Authors: Yujie Zhao, Junyi Zhan, Yongsen Wang, Dongli Wang

Journal: Frontiers in Public Health

Journal ranking: Q1

Key takeaways: Plant-based diets are protective against digestive system cancers, with no significant differences between various types of cancer.

Abstract: Background and Objectives Diets containing red or processed meat are associated with a growing risk of digestive system cancers. Whether a plant-based diet is protective against cancer needs a high level of statistical evidence. Methods We performed a meta-analysis of five English databases, including PubMed, Medline, Embase, Web of Science databases, and Scopus, on October 24, 2021 to identify published papers. Cohort studies or case-control studies that reported a relationship between plant-based diets and cancers of the digestive system were included. Summary effect-size estimates are expressed as Risk ratios (RRs) or Odds ratios (ORs) with 95% confidence intervals and were evaluated using random-effect models. The inconsistency index (I2) and τ2 (Tau2) index were used to quantify the magnitude of heterogeneity derived from the random-effects Mantel-Haenszel model. Results The same results were found in cohort (adjusted RR = 0.82, 95% CI: 0.78–0.86, P < 0.001, I2 = 46.4%, Tau2 = 0.017) and case-control (adjusted OR = 0.70, 95% CI: 0.64–0.77, P < 0.001, I2 = 83.8%, Tau2 = 0.160) studies. The overall analysis concluded that plant-based diets played a protective role in the risk of digestive system neoplasms. Subgroup analyses demonstrated that the plant-based diets reduced the risk of cancers, especially pancreatic (adjusted RR = 0.71, 95% CI: 0.59–0.86, P < 0.001, I2 = 55.1%, Tau2 = 0.028), colorectal (adjusted RR = 0.76, 95% CI: 0.69–0.83, P < 0.001, I2 = 53.4%, Tau2 = 0.023), rectal (adjusted RR = 0.84, 95% CI: 0.78–0.91, P < 0.001, I2 = 1.6%, Tau2 = 0.005) and colon (adjusted RR = 0.88, 95% CI: 0.82–0.95, P < 0.001, I2 = 0.0%, Tau2 = 0.000) cancers, in cohort studies. The correlation between vegan and other plant-based diets was compared using Z-tests, and the results showed no difference. Conclusions Plant-based diets were protective against cancers of the digestive system, with no significant differences between different types of cancer. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022322276, Identifier: CRD42022322276.

Cardiovascular health and cancer risk associated with plant based diets: An umbrella review

Type of study: systematic review

Number of citations: 15

Year: 2024

Authors: Angelo Capodici, Gabriele Mocciaro, Davide Gori, Matthew J. Landry, A. Masini, Francesco Sanmarchi, Matteo Fiore, A. Coa, Gisele Castagna, Christopher D. Gardner, Federica Guaraldi

Journal: PLOS ONE

Journal ranking: Q1

Key takeaways: Plant-based diets may reduce cardiometabolic risk factors, cardiovascular diseases, cancer risk, and mortality, but caution is needed due to study heterogeneity and potential risks.

Abstract: Context Cardiovascular diseases (CVDs) and cancer are the two main leading causes of death and disability worldwide. Suboptimal diet, poor in vegetables, fruits, legumes and whole grain, and rich in processed and red meat, refined grains, and added sugars, is a primary modifiable risk factor. Based on health, economic and ethical concerns, plant-based diets have progressively widespread worldwide. Objective This umbrella review aims at assessing the impact of animal-free and animal-products-free diets (A/APFDs) on the risk factors associated with the development of cardiometabolic diseases, cancer and their related mortalities. Data sources PubMed and Scopus were searched for reviews, systematic reviews, and meta-analyses published from 1st January 2000 to 31st June 2023, written in English and involving human subjects of all ages. Primary studies and reviews/meta-analyses based on interventional trials which used A/APFDs as a therapy for people with metabolic diseases were excluded. Data extraction The umbrella review approach was applied for data extraction and analysis. The revised AMSTAR-R 11-item tool was applied to assess the quality of reviews/meta-analyses. Results Overall, vegetarian and vegan diets are significantly associated with better lipid profile, glycemic control, body weight/BMI, inflammation, and lower risk of ischemic heart disease and cancer. Vegetarian diet is also associated with lower mortality from CVDs. On the other hand, no difference in the risk of developing gestational diabetes and hypertension were reported in pregnant women following vegetarian diets. Study quality was average. A key limitation is represented by the high heterogeneity of the study population in terms of sample size, demography, geographical origin, dietary patterns, and other lifestyle confounders. Conclusions Plant-based diets appear beneficial in reducing cardiometabolic risk factors, as well as CVDs, cancer risk and mortality. However, caution should be paid before broadly suggesting the adoption of A/AFPDs since the strength-of-evidence of study results is significantly limited by the large study heterogeneity alongside the potential risks associated with potentially restrictive regimens.

Healthful and Unhealthful Plant-Based Diets and Risk of Breast Cancer in U.S. Women: Results from the Nurses' Health Studies

Type of study: non-rct observational study

Number of citations: 33

Year: 2021

Authors: A. Romanos-Nanclares, W. Willett, B. Rosner, L. Collins, F. Hu, E. Toledo, A. Eliassen

Journal: Cancer Epidemiology, Biomarkers & Prevention

Journal ranking: Q1

Key takeaways: Adherence to a healthful plant-based diet may reduce the risk of breast cancer, especially among women with estrogen receptor-negative tumors.

Abstract: Background: Plant-based diets have been associated with lower risk of various diseases, including type 2 diabetes, cardiovascular disease, and other cardiometabolic risk factors. However, the association between plant-based diet quality and breast cancer remains unclear. Methods: We prospectively followed 76,690 women from the Nurses' Health Study (NHS, 1984–2016) and 93,295 women from the NHSII (1991–2017). Adherence to an overall plant-based diet index (PDI), a healthful PDI (hPDI), and an unhealthful PDI (uPDI) was assessed using previously developed indices. Cox proportional hazards models were used to estimate HR and 95% confidence intervals (CI) for incident invasive breast cancer. Results: Over 4,841,083 person-years of follow-up, we documented 12,482 incident invasive breast cancer cases. Women with greater adherence to PDI and hPDI were at modestly lower risk of breast cancer [(HRQ5 vs. Q1, 0.89; 95% CI, 0.84–0.95); (HRQ5 vs. Q1, 0.89; 95% CI, 0.83–0.94)]. We observed significant heterogeneity by estrogen receptor (ER) status, with the strongest inverse association between hPDI and breast cancer observed with ER-negative tumors [HRQ5 vs. Q1, 0.77; 95% CI, 0.65–0.90; Ptrend < 0.01]. We also found an inverse association between extreme quintiles of healthy plant foods and ER-negative breast cancer [HR, 0.74; 95% CI, 0.61–0.88; Ptrend < 0.01]. Conclusions: This study provides evidence that adherence to a healthful plant-based diet may reduce the risk of breast cancer, especially those that are more likely to be aggressive tumors. Impact: This is the first prospective study investigating the relation between healthful and unhealthful plant-based dietary indices and risk of total and subtype-specific breast cancer.

Role of a Whole Plant Foods Diet in Breast Cancer Prevention and Survival.

Type of study:

Number of citations: 1

Year: 2025

Authors: Mariana Del Carmen Fernández-Fígares Jiménez

Journal: Journal of the American Nutrition Association

Journal ranking: brak

Key takeaways: A whole plant foods diet, consisting of whole fruits, vegetables, and grains, is optimal for breast cancer prevention and survival by reducing inflammation, insulin resistance, and sex hormone bioavailability.

Abstract: Breast cancer (BC) is one of the leading causes of death and morbidity among women worldwide. Epidemiologic evidence shows that the risk of BC and other chronic diseases decreases as the proportion of whole plant foods increases, while the proportion of animal foods (fish, meat, poultry, eggs, seafood, and dairy products) and non-whole plant foods (e.g., refined grains, added sugars, French fries) in the diet decreases. Whole plant foods include fruits, vegetables, roots, tubers, whole grains, legumes, nuts, and seeds from which no edible part has been removed and to which no non-whole food been added. A whole plant foods diet lowers insulin resistance, inflammation, excess body fat, cholesterol, and insulin-like growth factor 1 and sex hormone bioavailability; it also increases estrogen excretion, induces favorable changes in the gut microbiota, and may also favorably affect mammary microbiota composition and decrease the risk of early menarche, all contributing to reduced BC incidence, recurrence, and mortality. This review explores the connection between a whole plant foods diet and BC risk and mortality as well as the potential mechanisms involved. Additionally, this diet is compared with other dietary approaches recommended for BC. A whole plant foods diet seems the optimal dietary pattern for BC and overall disease prevention as it exclusively consists of whole plant foods which, based on existing evidence, lead to the best health outcomes.

Breast Cancer Prevention with a Plant-Based Diet

Type of study:

Number of citations: 1

Year: 2020

Authors: A. Strombom

Journal: Cancer Therapy & Oncology International Journal

Journal ranking: brak

Key takeaways: A plant-based diet may reduce the risk of breast cancer and recurrence, while also reducing common comorbidities in post-menopausal women.

Abstract: Diet may be an independent risk factor for breast cancer, along with alcohol, physical activity, BMI and smoking. Several epidemiological studies show a decreased risk of breast cancer for vegetarians and vegans. Studies show an increased risk in women exposed to heterocyclic amines (HCAs), polyaromatic hydrocarbons (PAHs) and persistent organic pollutants (POPs). POPs resist environmental degradation and accumulate in animal adipose tissue, while PAHs and HCAs are produced during cooking of meat. In addition to reducing their exposure to these carcinogenic compounds, those following a plant-based diet benefit from the increased consumption of phytochemicals and fiber found in plant foods. In particular, studies show that soy may reduce the risk of breast cancer and breast cancer recurrence, due to its isoflavone content. Dietary fiber also reduces the risk of breast cancer, most likely by affecting estrogen levels. Most breast cancer patients tend to be older. The plant-based diet can reduce the risk of common comorbidities in post-menopausal women such as type II diabetes, coronary artery disease, arthritis, hypertension and thyroid disease. The plant-based diet is safe and has no adverse reactions or contraindications. It presents a valuable additional therapeutic measure to chemotherapy, radiation and surgery which will continue as standard of care.

Post-diagnostic reliance on plant-compared with animal-based foods and all-cause mortality in omnivorous long-term colorectal cancer survivors.

Type of study: non-rct observational study

Number of citations: 18

Year: 2021

Authors: I. Ratjen, J. Enderle, G. Burmeister, M. Koch, U. Nöthlings, J. Hampe, W. Lieb

Journal: The American journal of clinical nutrition

Journal ranking: Q1

Key takeaways: An overall plant-based diet is inversely associated with all-cause mortality in long-term colorectal cancer survivors.

Abstract: BACKGROUND Plant-rich diets are associated with lower cardiometabolic risks and longer survival in the general population, but their association with mortality in cancer survivors is still unclear. OBJECTIVES We aimed to examine the associations of 3 postdiagnostic plant-based diet indices with all-cause mortality in omnivorous long-term colorectal cancer (CRC) survivors. METHODS Diet was assessed with FFQs at a median of 6 years after diagnosis in 1404 CRC survivors (56% male; median age, 69 years) in a Northern German prospective cohort study. An overall, a healthful plant-based, and an unhealthful plant-based diet index were derived by scoring intakes of animal foods reversely and intakes of healthy (whole grains, vegetables, fruits, legumes, nuts, oils, tea/coffee) and less healthy plant foods (refined grains, fruit juices, sugar-sweetened beverages, potatoes, sweets/desserts) positively or reversely, depending on the index. Vital status follow-up was conducted via population registries. Cox proportional hazards regression was applied to estimate HRs for all-cause mortality according to plant-based diet adherence. RESULTS Within 7 years (median) after diet assessment, 204 deaths occurred. The overall plant-based diet index displayed a significant, inverse association with all-cause mortality (HR per 10-point increase in diet index, 0.72; 95% CI, 0.57-0.91). Although not statistically significant, higher healthful plant-based diet scores showed a strong tendency towards lower mortality (HR, 0.82; 95% CI, 0.67-1.01). The unhealthful plant-based diet index was associated with higher mortality, but lost statistical significance after multivariable adjustment (HR, 1.19; 95% CI, 0.96-1.48). A subgroup analysis revealed that the tendency towards a positive association of the unhealthful plant-based diet with mortality was restricted to less physically active individuals (<95 metabolic equivalent of task hours/week). CONCLUSIONS An overall plant-based diet was inversely associated with all-cause mortality in long-term CRC survivors. However, more research is needed to further disentangle the impacts of different qualities of plant-based diets on cancer survivors' health.

Cancer Prevention with Nutrition and Lifestyle

Type of study:

Number of citations: 44

Year: 2019

Authors: E. Kerschbaum, V. Nüssler

Journal: Visceral Medicine

Journal ranking: Q2

Key takeaways: A balanced plant-based diet with limited fast foods, sugar-sweetened drinks, red meat, and alcohol can prevent 30-50% of all cancer cases.

Abstract: Background: Although the crucial role of nutrition on wellbeing was known several hundreds of years ago in ancient healing methods such as traditional Chinese medicine, it often plays a minor role in modern society. However, 30–50% of all cancer cases are preventable by following a healthy diet and lifestyle, in accordance with the World Cancer Research Fund (WCRF) cancer prevention recommendations. Summary: In addition to maintaining a healthy weight and being physically active, a balanced plant-based diet with limited amounts of fast foods, sugar-sweetened drinks, red meat, and alcohol is recommended for enhancing health. Such a way of life helps to prevent both cancer and other noncommunicable diseases (NCDs) because of the common risk factors. Although these facts are widely known, the figures are still alarming. Only a fraction of the population follows the WCRF recommendations. Key Message: Urgent policy action is needed to promote healthy ways of living and to create health-enhancing environments to effectively reduce the risk of cancer and NCDs.

The association between plant-based dietary patterns and risk of breast cancer: a case–control study

Type of study:

Number of citations: 46

Year: 2021

Authors: Somaye Rigi, Seyed Mohammad Mousavi, Sanaz Benisi-kohansal, L. Azadbakht, Ahmad Esmaillzadeh

Journal: Scientific Reports

Journal ranking: Q1

Key takeaways: Greater adherence to plant-based diets, particularly those containing more healthy plant foods, is associated with a reduced risk of breast cancer, while unhealthful plant-based diets increase the risk.

The role of plant-based nutrition in cancer prevention

Type of study:

Number of citations: 38

Year: 2018

Authors: M. Madigan, Elisa Karhu

Journal: Journal of Unexplored Medical Data

Journal ranking: brak

Key takeaways: Plant-based nutrition significantly protects against various cancers and chronic diseases, offering a significant benefit to current medical therapies and offering a disease-modifying tool for disease management.

Abstract: Plant-based nutrition has been shown to protect against the 15 leading causes of death in the world, including many cancers, and may offer benefits as a disease modifying tool to improve the management and treatment of these conditions. Results on the effects of plant-based nutrition on breast, prostate, colorectal and gastrointestinal cancers have been the most extensively studied, and thus have the most published supporting evidence thus far. Whole foods plant-based diets have shown to significantly protect against these cancers, as well as additional cancers and other chronic disease states. Nutritional interventions in the prevention of various cancers offer a significant benefit to currently used medical therapies, and should be employed more often as an adjunct to first-line medical therapy. Although the effects of diet are becoming more well-known and the role of diet and lifestyle factors in health and disease is gaining more attention and emphasis, the benefits or detriments are still underestimated and undervalued.

The Impact of Modern Dietary Practices on Cancer Risk and Progression: A Systematic Review

Type of study: systematic review

Number of citations: 5

Year: 2023

Authors: Stephanie Nagy, Stephanie N Petrosky, Michelle Demory Beckler, Marc M. Kesselman

Journal: Cureus

Journal ranking: brak

Key takeaways: Dietary interventions, such as the Mediterranean, ketogenic, and plant-based diets, can effectively reduce cancer risk and progression across various cancer types.

Abstract: Cancer is a leading cause of mortality around the world, despite continued advancements in the management of cancer. Recent research efforts have shifted to evaluating the role that modifiable risk factors play in cancer risk and development, as diet and nutrition have been found to play a significant role in the onset and progression of cancer. As a result, there has been an increasing focus on the impact of dietary modifications on preventing the onset, progression, and reoccurrence of cancer. In this systematic review, data were collected on three common diets, the Mediterranean diet (MD), ketogenic diet (KD), and plant-based diet, to gain insight into the application of these three dietary modification approaches for risk prevention and limitation of cancer burden. Initially, 4,397 articles were identified from three databases (Ovid, Web of Science, and CINHAL). After removing studies based on the exclusion criteria, only 23 studies were eligible to be included in the systematic review of which 15 evaluated the MD, four assessed the ketogenic diet, and four evaluated the plant-based diet. Each article was considered for its methods, procedures, and findings. The findings indicate that dietary interventions may effectively reduce the odds of cancer development and the advancement of diagnosed cancers. With the introduction of the MD, KD, and plant-based diets, significant improvements in lowering cancer development, recurrence-free status, and limiting tumor growth were noted across numerous cancer types. Currently, the MD has been extensively studied in the literature, and amongst the widest variety of cancer types. Additional information and evaluation are required on the ketogenic and plant-based diets to fully understand their impact on the cancer burden across a wider subset of cancers. Clinicians should evaluate and recommend nutritional adaptations to their patients to limit the development of specific cancers and as an adjunctive therapy to traditional pharmacological treatment options for patients with diagnosed cancers.

Dietary Restrictions and Cancer Prevention: State of the Art

Type of study:

Number of citations: 1

Year: 2025

Authors: G. Caprara, Rani Pallavi, Shalini Sanyal, P. Pelicci

Journal: Nutrients

Journal ranking: Q1

Key takeaways: Dietary restrictions, such as limiting red/processed meat, sugars, processed foods, and alcohol, may have cancer-preventive potential through effects on specific signaling pathways.

Abstract: Worldwide, almost 10 million cancer deaths occurred in 2022, a number that is expected to rise to 16.3 million by 2040. Primary prevention has long been acknowledged as a crucial approach to reducing cancer incidence. In fact, between 30 and 50 percent of all tumors are known to be preventable by eating a healthy diet, staying active, avoiding alcohol, smoking, and being overweight. Accordingly, many international organizations have created tumor prevention guidelines, which underlie the importance of following a diet that emphasizes eating plant-based foods while minimizing the consumption of red/processed meat, sugars, processed foods, and alcohol. However, further research is needed to define the relationship between the effect of specific diets or nutritional components on cancer prevention. Interestingly, reductions in food intake and dietetic restrictions can extend the lifespan of yeast, nematodes, flies, and rodents. Despite controversial results in humans, those approaches have the potential to ameliorate health via direct and indirect effects on specific signaling pathways involved in cancer onset. Here, we describe the latest knowledge on the cancer-preventive potential of dietary restrictions and the biochemical processes involved. Molecular, preclinical, and clinical studies evaluating the effects of different fasting strategies will also be reviewed.

Plant-based diets and the risk of pancreatic cancer: a large prospective multicenter study.

Type of study:

Number of citations: 13

Year: 2023

Authors: Guochao Zhong, Zhi Li, Aijun You, Qian Zhu, Chun-Rui Wang, Penghui Yang

Journal: The American journal of clinical nutrition

Journal ranking: Q1

Key takeaways: Adherence to a healthy plant-based diet lowers the risk of pancreatic cancer, while adherence to a less healthy plant-based diet increases the risk.

Plant‐based diet associated with better quality of life in prostate cancer survivors

Type of study: non-rct observational study

Number of citations: 5

Year: 2024

Authors: Stacy Loeb, Qi Hua, Scott R Bauer, Stacey A. Kenfield, Alicia K Morgans, June M. Chan, Erin L. Van Blarigan, Alaina H Shreves, L. Mucci

Journal: Cancer

Journal ranking: Q1

Key takeaways: A plant-based diet is associated with better quality of life for prostate cancer survivors.

Abstract: Plant‐based diets have many health benefits, including a lower risk of fatal prostate cancer, and greater environmental sustainability. However, less is known regarding the impact of plant‐based diets on quality of life among individuals diagnosed with prostate cancer. The authors' objective was to examine the relationship between plant‐based diet indices postdiagnosis with quality of life.

The Safe and Effective Use of Plant-Based Diets with Guidelines for Health Professionals

Type of study: literature review

Number of citations: 186

Year: 2021

Authors: W. Craig, A. R. Mangels, Ujué Fresán, K. Marsh, Fayth L. Miles, Angela V. Saunders, E. Haddad, Celine E Heskey, Patricia Johnston, E. Larson-Meyer, M. Orlich

Journal: Nutrients

Journal ranking: Q1

Key takeaways: Plant-based diets are safe and effective for preventing and treating chronic diseases, with benefits ranging from cardiovascular disease to cancer, and osteoporosis.

Abstract: Plant-based diets, defined here as including both vegan and lacto-ovo-vegetarian diets, are growing in popularity throughout the Western world for various reasons, including concerns for human health and the health of the planet. Plant-based diets are more environmentally sustainable than meat-based diets and have a reduced environmental impact, including producing lower levels of greenhouse gas emissions. Dietary guidelines are normally formulated to enhance the health of society, reduce the risk of chronic diseases, and prevent nutritional deficiencies. We reviewed the scientific data on plant-based diets to summarize their preventative and therapeutic role in cardiovascular disease, cancer, diabetes, obesity, and osteoporosis. Consuming plant-based diets is safe and effective for all stages of the life cycle, from pregnancy and lactation, to childhood, to old age. Plant-based diets, which are high in fiber and polyphenolics, are also associated with a diverse gut microbiota, producing metabolites that have anti-inflammatory functions that may help manage disease processes. Concerns about the adequate intake of a number of nutrients, including vitamin B12, calcium, vitamin D, iron, zinc, and omega-3 fats, are discussed. The use of fortified foods and/or supplements as well as appropriate food choices are outlined for each nutrient. Finally, guidelines are suggested for health professionals working with clients consuming plant-based diets.

Healthy plant-based diets improve dyslipidemias, insulin resistance, and inflammation in metabolic syndrome. A narrative review

Type of study: literature review

Number of citations: 62

Year: 2022

Authors: M. Thomas, M. Calle, Maria‐Luz L Fernandez

Journal: Advances in Nutrition

Journal ranking: Q1

Key takeaways: Plant-based diets can improve metabolic syndrome symptoms by reducing dyslipidemias, insulin resistance, and inflammation.

Cross-sectional associations between healthy and unhealthy plant-based diets and metabolic syndrome in three distinct French populations, a meta-analysis.

Type of study: meta-analysis

Number of citations: 0

Year: 2025

Authors: C. Prioux, S. Wagner, L. Fezeu, V. Deschamps, C. Verdot, J. Baudry, M. Touvier, Serge Herberg, J. Nazare, A. Hoge, J. Ferreira, Patrick Rossignol, N. Girerd, Sopio Tatulashvili, Emmanuelle Kesse-Guyot, B. Allès

Journal: The British journal of nutrition

Journal ranking: Q1

Key takeaways: Higher contributions of healthy plant foods in plant-based diets are associated with protective effects against metabolic syndrome, particularly in women.

Abstract: Prior studies have shown that plant-based diets are associated with lower cardiovascular risk. However, these diets encompass a large diversity of foods with contrasted nutritional quality that may differentially impact health. We aimed to investigate the pooled cross-sectional association between metabolic syndrome (MetS), its components, and healthy and unhealthy plant-based diet indices (hPDI and uPDI), using data from two French cohorts and one representative study from the French population. This study included 16,358 participants from the NutriNet-Santé study, 1,769 participants from the Esteban study and 1,565 participants from the STANISLAS study who underwent a clinical visit. The MetS was defined according to the International Diabetes Federation definition. The associations between these plant-based diet indices and MetS were estimated by multivariable Poisson and logistic regression models, stratified by gender. Meta-analysis enabled the computation of a pooled Prevalence Ratio. A higher contribution of healthy plant foods (higher hPDI) was associated with a lower probability of having MetS (PRmen: 0.85; 95% CI: 0.75-0.94, PRwomen: 0.72; 95% CI: 0.67-0.77), elevated waist circumferences and elevated blood pressure. In women, a higher hPDI was associated with a lower probability of having elevated triglycerides, low HDL-cholesterolemia and hyperglycemia; and a higher contribution of unhealthy plant foods was associated with a higher prevalence of MetS (PRwomen: 1.13; 95% CI: 1.01-1.26) and elevated triglycerides. A greater contribution of healthy plant floods was associated with protective effects on metabolic syndrome, especially in women. Gender differences should be further investigated in relation to the current sustainable nutrition transition.

The Role of Plant-Based Nutrition and Exercise in Metabolic Syndrome: A Narrative Review

Type of study: systematic review

Number of citations: 0

Year: 2025

Authors: James Stavitz, Ryan Porcelli, Jennifer Gentile

Journal: Nutrients

Journal ranking: Q1

Key takeaways: Plant-based nutrition and structured exercise, when combined, effectively manage metabolic syndrome, promoting long-term metabolic health.

Abstract: Background/Objectives: Metabolic syndrome (MetS) is a prevalent health condition characterized by central obesity, insulin resistance, hypertension, and dyslipidemia, increasing the risk of cardiovascular disease and type 2 diabetes. Lifestyle interventions, particularly plant-based nutrition and exercise, are essential for managing MetS. While both strategies are well-documented independently, their synergistic effects remain less explored. This narrative review integrates findings from both domains to evaluate their combined impact on metabolic syndrome. The review examines the individual and combined impacts of plant-based nutrition and exercise on MetS-related metabolic dysfunction. Methods: A comprehensive review of 114 peer-reviewed studies was conducted to assess the role of plant-based diets and structured physical activity in improving insulin sensitivity, lipid profiles, inflammation, and weight management. Studies investigating the mechanisms through which dietary components and exercise modalities influence metabolic health were analyzed, along with behavioral and psychological factors affecting long-term adherence. Results: Plant-based diets, particularly those high in fiber, polyphenols, and healthy fats, improve glucose metabolism, reduce inflammation, and enhance cardiovascular health. Exercise complements these benefits by increasing insulin sensitivity, promoting fat oxidation, and improving lipid metabolism. When combined, plant-based nutrition and exercise provide superior metabolic outcomes, including greater reductions in visceral adiposity, improved endothelial function, and enhanced glycemic control. Conclusions: Plant-based nutrition and structured exercise are effective strategies for managing MetS. Their synergistic effects highlight the importance of integrated lifestyle interventions for long-term metabolic health.

The Influence of Plant-Based Diets on Metabolic Syndrome

Type of study: systematic review

Number of citations: 1

Year: 2024

Authors: Inês Fernandes, M. Mariana, Margarida Lorigo, E. Cairrão

Journal: Diabetology

Journal ranking: Q2

Key takeaways: Plant-based diets have a positive impact on metabolic syndrome and contribute to prevention and improved cardiovascular and metabolic markers, when including healthy foods.

Abstract: The magnification of Western eating habits has contributed to a large increase in the development of several diseases and conditions, namely cardiovascular disease, obesity, dyslipidemia, and hyperglycemia. These are part of a cluster of metabolic factors involved in metabolic syndrome. However, there are new dietary patterns more focused on the consumption of plant-based foods. Thus, the aim of this review was to investigate the impact of plant-based diets on metabolic syndrome and to achieve the inflammatory mediators and the antioxidant effects involved in this potential health benefits effect. Advanced research was performed for articles published in the last 10 years, which were analyzed and selected according to the defined inclusion and exclusion criteria. Of the articles analyzed, the majority supported the positive impact of plant-based diets on metabolic syndrome. Furthermore, several studies also showed that these diets appear to have an anti-inflammatory and antioxidant role. Thus, plant-based diets appear to have health benefits, contributing to the prevention of metabolic syndrome, and improving the cardiovascular and metabolic markers’ profile, mainly when including healthy foods. The total exclusion of animal source foods (especially meat and fish) from the diet, as well as the consumption of processed and additive plant-based foods, may contribute to an increased prevalence of metabolic syndrome.

Association of time-restricted eating versus a whole-food plant-based diet with metabolic syndrome biomarkers: Results from NHANES 2013–2018

Type of study:

Number of citations: 0

Year: 2025

Authors: Faiza Kalam, Velarie Y. Ansu-Baidoo, R. Akasheh, Christine E S Jovanovic

Journal: Academia Nutrition and Dietetics

Journal ranking: brak

Key takeaways: A whole-food plant-based diet is significantly associated with beneficial changes in metabolic syndrome biomarkers, including lower waist circumference, hyperglycemia, hypertension, low HDL, and reduced MetS risk, with central adiposity mediating up to 51% of these associations.

Abstract: This study utilizes data from the National Health and Nutrition Examination Survey (NHANES) 2014–2018 (n = 29,400) to investigate the association of a whole-food plant-based diet (WFPBD) versus time-restricted eating (TRE) with the components of metabolic syndrome (MetS) and selected macronutrients (carbohydrates, protein, and fiber). Moderation of a WFPBD in the presence of TRE on MetS and its components was assessed. Finally, potential mediation of central adiposity (i.e., waist circumference) on significant associations was evaluated. Key findings indicate that adherence to a WFPBD is significantly associated with beneficial changes in MetS biomarkers in the adjusted model, including lower waist circumference (OR: 0.96, p < 0.001), hyperglycemia (OR: 0.99, p = 0.04), hypertension (OR: 0.97, p < 0.001), low HDL (OR: 0.97, p < 0.001), and MetS risk (OR: 0.97, p < 0.001). No significant moderation effects were detected. Central adiposity mediated up to 51% of the observed significant associations. Our research contributes to the growing body of evidence on the role of a WFPBD in managing MetS and cardiometabolic health. It underscores the potential of a WFPBD in comparison to TRE for the prevention and management of MetS, and suggests potential mechanisms, such as high fiber consumption and reductions in central adiposity, that may explain observed relationships and inform future research.

Plant-Based Nutrition: Exploring Health Benefits for Atherosclerosis, Chronic Diseases, and Metabolic Syndrome—A Comprehensive Review

Type of study: literature review

Number of citations: 51

Year: 2023

Authors: Humberto Peña-Jorquera, Valeska Cid-Jofré, L. Landaeta-Díaz, Fanny Petermann-Rocha, M. Martorell, H. Zbinden-Foncea, G. Ferrari, Carlos Jorquera-Aguilera, C. Cristi‐Montero

Journal: Nutrients

Journal ranking: Q1

Key takeaways: A plant-based diet may help prevent and treat chronic diseases by targeting underlying causes and enhancing health outcomes for individuals and populations.

Abstract: Atherosclerosis, chronic non-communicable diseases, and metabolic syndrome are highly interconnected and collectively contribute to global health concerns that reduce life expectancy and quality of life. These conditions arise from multiple risk factors, including inflammation, insulin resistance, impaired blood lipid profile, endothelial dysfunction, and increased cardiovascular risk. Adopting a plant-based diet has gained popularity as a viable alternative to promote health and mitigate the incidence of, and risk factors associated with, these three health conditions. Understanding the potential benefits of a plant-based diet for human health is crucial, particularly in the face of the rising prevalence of chronic diseases like diabetes, hypertension, dyslipidemia, atherosclerosis, and cancer. Thus, this review focused on the plausible advantages of consuming a type of food pattern for the prevention and/or treatment of chronic diseases, emphasizing the dietary aspects that contribute to these conditions and the evidence supporting the benefits of a plant-based diet for human health. To facilitate a more in-depth analysis, we present separate evidence for each of these three concepts, acknowledging their intrinsic connection while providing a specific focus on each one. This review underscores the potential of a plant-based diet to target the underlying causes of these chronic diseases and enhance health outcomes for individuals and populations.

Plant-based diets and metabolic syndrome: Evaluating the influence of diet quality

Type of study:

Number of citations: 11

Year: 2022

Authors: Lydia McGrath, M. Fernandez

Journal: Journal of Agriculture and Food Research

Journal ranking: Q1

Key takeaways: Adherence to a healthful plant-based diet is associated with lower weight and higher HDL cholesterol in individuals with metabolic syndrome.

Effects of Plant-Based Diets on Outcomes Related to Glucose Metabolism: A Systematic Review

Type of study: systematic review

Number of citations: 23

Year: 2020

Authors: Christina Osland Johannesen, H. F. Dale, C. Jensen, G. Lied

Journal: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy

Journal ranking: Q2

Key takeaways: A plant-based diet may improve glycemic control in individuals with type 2 diabetes mellitus and obesity, but data is conflicting and no clear conclusions can be drawn on the effects of different plant-based diets.

Abstract: Abstract According to the rising prevalence of obesity and metabolic disorders leading to impaired glucose metabolism, effective strategies to prevent and/or delay the onset of disease are of great need. A plant-based diet has been suggested as an effective lifestyle change that may reduce the degree of obesity and improve outcomes related to glucose metabolism. This systematic review aimed to evaluate the effect of a plant-based diet on outcomes related to glucose metabolism. A literature search was conducted in the database PubMed until January 30, 2020. Randomized controlled trials investigating the effect of a plant-based dietary intervention on outcomes related to glucose metabolism in human subjects compared to an omnivorous diet were eligible for inclusion. Of 65 publications identified, nine trials on subjects with overweight/obesity, type 2 diabetes mellitus, or cardiovascular disease were included. Five studies reported that the plant-based intervention significantly improved markers of glycemic control from baseline to end point, of which four revealed a significant improvement in the intervention group compared to the control intervention. The remaining four studies did not observe a significant effect of a plant-based intervention on outcomes related to glucose metabolism. Our findings suggest that a shift to a plant-based diet may lead to favorable effects on glycemic control in individuals diagnosed with type 2 diabetes mellitus and/or obesity. The data were however somewhat conflicting, and the included trials reported results based on different intervention diets and study populations. Overall, no clear conclusions regarding effects of different plant-based diets can be drawn based on the current findings alone.

The effects of plant-based diets on the body and the brain: a systematic review

Type of study: systematic review

Number of citations: 250

Year: 2019

Authors: E. Medawar, E. Medawar, S. Huhn, A. Villringer, A. Villringer, A. Witte

Journal: Translational Psychiatry

Journal ranking: Q1

Key takeaways: Plant-based diets show short- to moderate-term benefits on weight, metabolism, and inflammation, but their effects on brain health and cognitive functions remain largely unexplored.

Plant based diet and cardio-metabolic disease

Type of study: systematic review

Number of citations: 0

Year: 2020

Authors: J. Dąbrowska, M. Wójcik, Joanna Borowik, Kinga Kuśmierczuk, Halina Pieciewicz-Szczęsna

Journal: Journal of Education, Health and Sport

Journal ranking: brak

Key takeaways: Plant-based diets can positively affect cardiovascular health and reduce the risk of cardio-metabolic diseases, offering a nonpharmaceutical approach to prevent and treat these diseases.

Abstract: Introduction : Modern lifestyle, especially diet have a great impact on health. The number of people suffering from conditions related to lifestyle is growing rapidly. Illnesses related to lifestyle, specifically to diet are large health and economic burdens, which makes them the leading priorities of our time. Coronary heart disease (CHD), stroke, type 2 diabetes, and obesity are some of cardio-metabolic diseases related to diet.  Plant-based diets are dietary patterns in which  a high intake of plant food is emphasized  and the intake of animal products is limited. Plant based diet was associated with decreased risk of cardio-metabolic disease. The aim of the study : The purpose of this systemic review was to collect and analyse current data of plant based diet and its effect on health. Material and method : Standard criteria were used to review the literature data. The search of articles in the PubMed and Google Scholar database was carried out using the following keywords: plant based diet, vegetarian diet, cardiovascular disease, type 2 diabetes, hypercholesterolemia. Description of the state of knowledge : Red meat and, especially processed meat, is source of cholesterol, saturated fatty acids, and sodium, which makes it a risk factors for metabolic disorders.  Healthy plant based diet can positively affect cardiovascular health in many ways. High fiber content makes those diets  low in energy density, flavonoids that are present in fruits and vegetables and also high content of antioxidants. Plant based diet was also shown to be helpful in reducing weight. Summary : Many risk factors of cardio-metabolic disease are related to our lifestyle and dietary choices . Changes towards plant based diet can be beneficial for our health in many ways. Healthy plant based diet should be considered as a nonpharmaceutical approach to prevent and treat cardio-metabolic diseases.

Implications of Plant Foods in Weight Management: Focus on Metabolic Health

Type of study: literature review

Number of citations: 1

Year: 2022

Authors: J. Jurek

Journal: Journal of Biomedical Research &amp; Environmental Sciences

Journal ranking: brak

Key takeaways: Adopting a plant-based diet rich in whole, unprocessed foods can improve metabolic health, lower inflammation, and promote weight loss, potentially reducing chronic disease risk.

Abstract: Plant foods are important component of human diet and they are excellent source health-promoting compounds, such as amino acids, dietary fibers, complex carbohydrates, unsaturated fatty acids, as well as minerals and vitamins which have been shown to increase vitality and subsequently reduce risk of chronic disease. Importantly, eatable plants despite relatively low caloric value are nutrient-dense foods, which are rich in various phytochemicals, such as polyphenols, that have been found to be beneficial for improving metabolic health, in particular lowering systemic inflammation, increasing antioxidant capability and promoting weight loss. To date, epidemiological evidence consistently demonstrated a beneficial impact of adopting plant-based dietary lifestyle characterized by increased intake of whole unprocessed foods, including fresh vegetables and fruits, whole grains, pulses and legumes as well as nuts and seeds, in expense of processed meats, refined carbohydrates and added sugar foods, have potential to reduce risk of high burden diseases, such type 2 diabetes, obesity or cardiovascular disease. Consequently, to assess the most applicable composition of plant-based diets for achieving metabolic improvements, nutritional value of consumed plants should be evaluated. Therefore, accounting for differences in phytochemical content of various fruits, vegetables, grains, pulses, nuts and seeds the main aim of this literature review is to assess the recent clinical evidence of their contribution to weight management, and reduction of risk factors implicated in development of chronic conditions, such as cardiovascular diseases, diabetes or obesity.

Possible Biochemical Processes Underlying the Positive Health Effects of Plant-Based Diets—A Narrative Review

Type of study: literature review

Number of citations: 23

Year: 2021

Authors: Z. Szabó, V. Koczka, Tamas Marosvolgyi, É. Szabó, Eszter Frank, É. Polyák, K. Fekete, A. Erdélyi, Zsófia Verzár, M. Figler

Journal: Nutrients

Journal ranking: Q1

Key takeaways: Plant-based diets, rich in antioxidants and phytochemicals, may improve health by reducing TMAO formation, decreasing IGF-1 levels, and altering signaling pathways.

Abstract: Plant-based diets are becoming more popular for many reasons, and epidemiological as well as clinical data also suggest that a well-balanced vegan diet can be adopted for the prevention, and in some cases, in the treatment of many diseases. In this narrative review, we provide an overview of the relationships between these diets and various conditions and their potential biochemical background. As whole plant foods are very rich in food-derived antioxidants and other phytochemicals, they have many positive physiological effects on different aspects of health. In the background of the beneficial health effects, several biochemical processes could stand, including the reduced formation of trimethylamine oxide (TMAO) or decreased serum insulin-like growth factor 1 (IGF-1) levels and altered signaling pathways such as mechanistic target of rapamycin (mTOR). In addition, the composition of plant-based diets may play a role in preventing lipotoxicity, avoiding N-glycolylneuraminic acid (Neu5Gc), and reducing foodborne endotoxin intake. In this article, we attempt to draw attention to the growing knowledge about these diets and provide starting points for further research.

A Whole Food Plant-Based Diet Is Effective for Weight Loss: The Evidence

Type of study:

Number of citations: 29

Year: 2020

Authors: M. Greger

Journal: American Journal of Lifestyle Medicine

Journal ranking: Q2

Key takeaways: A whole food, plant-based diet is the most effective and sustainable method for weight loss, promoting health benefits such as preventing and reversing chronic diseases like type 2 diabetes and hypertension.

Abstract: What does the best available balance of scientific evidence show is the optimum way to lose weight? Calorie density, water content, protein source, and other components significantly influence the effectiveness of different dietary regimes for weight loss. By “walling off your calories,” preferentially deriving your macronutrients from structurally intact plant foods, some calories remain trapped within indigestible cell walls, which then blunts the glycemic impact, activates the ileal brake, and delivers prebiotics to the gut microbiome. This may help explain why the current evidence indicates that a whole food, plant-based diet achieves greater weight loss compared with other dietary interventions that do not restrict calories or mandate exercise. So, the most effective diet for weight loss appears to be the only diet shown to reverse heart disease in the majority of patients. Plant-based diets have also been found to help treat, arrest, and reverse other leading chronic diseases such as type 2 diabetes and hypertension, whereas low-carbohydrate diets have been found to impair artery function and worsen heart disease, the leading killer of men and women in the United States. A diet centered on whole plant foods appears to be a safe, simple, sustainable solution to the obesity epidemic.

Plant-based diets and incident metabolic syndrome: Results from a South Korean prospective cohort study

Type of study:

Number of citations: 82

Year: 2020

Authors: Hyunju Kim, Kyueun Lee, C. Rebholz, Jihye Kim

Journal: PLoS Medicine

Journal ranking: Q1

Key takeaways: Higher consumption of healthy plant-based foods is associated with lower risk of developing metabolic syndrome, while higher consumption of less-healthy plant-based foods increases the risk of developing MetS.

Abstract: Background Prior studies have shown that plant-based diets are associated with lower risk of cardiovascular risk factors and incident cardiovascular disease, but risks differed by quality of plant-based diets. No prospective studies have evaluated the associations between different types of plant-based diets and incident metabolic syndrome (MetS) and components of MetS. Furthermore, limited evidence exists in Asian populations who have habitually consumed a diet rich in plant foods for a long period of time. Methods and findings Analyses were based on a community-based cohort of 5,646 men and women (40–69 years of age at baseline) living in Ansan and Ansung, South Korea (2001–2016) without MetS and related chronic diseases at baseline. Dietary intake was assessed using a validated food frequency questionnaire. Using the responses in the questionnaire, we calculated 4 plant-based diet indices (overall plant-based diet index [PDI], healthful plant-based diet index [hPDI], unhealthful plant-based diet index [uPDI], and pro-vegetarian diet index). Higher PDI score represented greater consumption of all types of plant foods regardless of healthiness. Higher hPDI score represented greater consumption of healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, tea and coffee) and lower consumption of less-healthy plant foods (refined grains, potatoes, sugar-sweetened beverages, sweets, salty foods). Higher uPDI represented lower consumption of healthy plant foods and greater consumption of less-healthy plant foods. Similar to PDI, higher pro-vegetarian diet score represented greater consumption of plant foods but included only selected plant foods (grains, fruits, vegetables, nuts, legumes, potatoes). Higher scores in all plant-based diet indices represented lower consumption of animal foods (animal fat, dairy, eggs, fish/seafood, meat). Over a median follow-up of 8 years, 2,583 participants developed incident MetS. Individuals in the highest versus lowest quintile of uPDI had 50% higher risk of developing incident MetS, adjusting for demographic characteristics and lifestyle factors (hazard ratio [HR]: 1.50, 95% CI 1.31–1.71, P-trend < 0.001). When we further adjusted for body mass index (BMI), those in the highest quintile of uPDI had 24%–46% higher risk of 4 out of 5 individual components of MetS (abdominal obesity, hypertriglyceridemia, low high-density lipoprotein [HDL], and elevated blood pressure) (P-trend for all tests ≤ 0.001). Greater adherence to PDI was associated with lower risk of elevated fasting glucose (HR: 0.80, 95% CI 0.70–0.92, P-trend = 0.003). No consistent associations were observed for other plant-based diet indices and MetS. Limitations of the study may include potential measurement error in self-reported dietary intake, inability to classify a few plant foods as healthy and less-healthy, lack of data on vegetable oil intake, and possibility of residual confounding. Conclusions In this study, we observed that greater adherence to diets consisting of a high intake of refined carbohydrates, sugars, and salty foods in the framework of plant-based diets was associated with an elevated risk of MetS. These results suggest that considering the quality of plant foods is important for prevention of MetS in a population that habitually consumes plant foods.

Association between plant-based diets and metabolic health status in adolescents with overweight and obesity

Type of study:

Number of citations: 12

Year: 2022

Authors: Elahe Mokhtari, Saeideh Mirzaei, A. Asadi, M. Akhlaghi, P. Saneei

Journal: Scientific Reports

Journal ranking: Q1

Key takeaways: Adolescents with healthy plant-based diets have lower odds of metabolically unhealthy obesity, while unhealthy plant-based diets are directly associated with metabolically unhealthy obesity in Iran.

Effects of a Plant-Based Diet with Whole Eggs or Egg Substitute on Parameters of Metabolic Syndrome, Plasma Choline, and TMAO Concentrations

Type of study: rct

Number of citations: 0

Year: 2022

Authors: M. Thomas, M. Puglisi, M. Fernandez

Journal: IECN 2022

Journal ranking: brak

Key takeaways: A plant-based diet with whole eggs increases plasma choline and HDL cholesterol, both beneficial for individuals with metabolic syndrome.

Abstract: Plant-based (PB) diets typically result in a lowering of total and LDL cholesterol. Eggs could complement the PB diet by increasing HDL cholesterol. In this randomized, controlled crossover intervention, we recruited 30 participants (49.3 ± 8 year) with metabolic syndrome (MetS) who followed a PB diet for 13 weeks. A registered dietitian advised all subjects on food selection and followed them through the whole intervention to ensure compliance. Participants underwent a 2-week washout with no eggs or spinach (sources of dietary choline) for 2 week and were randomly allocated to consume spinach (70 g) with either two eggs (EGG) or the equivalent amount of egg substitute (SUB) for breakfast for 4 weeks. After a 3-week washout, they were allocated to the alternate breakfast. We hypothesized that whole egg intake (EGG) would increase plasma choline and result in better improvement in parameters of metabolic syndrome. In total, 24 participants (13 women/11 men) finished the intervention. Plasma lipids, glucose, anthropometrics, liver enzymes, insulin, plasma choline, and TMAO were assessed at baseline and the end of each intervention. Compared with the SUB breakfast, we observed a significant decrease in body weight (p < 0.02) and a significant increase in HDL cholesterol (p < 0.025) following the EGG breakfast. There were no differences in plasma LDL, triglycerides, glucose, insulin, or blood pressure. Plasma choline was higher in both treatments (p < 0.01), compared with baseline (8.3 ± 2.1 nmol/mL). However, choline values were higher in EGG (10.54 ± 2.8 nmol/L), compared with SUB (9.47 ± 2.7 mmol/L) p < 0.025. These results indicate that consuming a plant-based diet in combination with whole eggs results in increases in plasma choline and in HDL cholesterol, both of which are beneficial for individuals with MetS.