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Swapping animal-based for plant-based foods associated with reduced risk of mortality and cardiometabolic diseases

Swapping animal-based foods such as processed or red meat and eggs for plant-based foods such as nuts, legumes, and whole grains is associated with reduced risk of death and health conditions such as cardiovascular disease and type 2 diabetes. This systematic review, published in BMC Medicine, provides further support for an overall shift from animal- to plant-based diets to promote better health.

Sabina Schlesinger, Lukas Schwingshackl and colleagues summarised findings from 37 publications, including 24 prospective cohort studies that had analysed the associations between substituting animal-based foods (including red and process meat, poultry, fish and shellfish, eggs, and dairy) for plant-based foods (including legumes, nuts, whole and refined grains, fruit and vegetables, and oils) and health. The health impacts assessed included overall cardiovascular disease — including cardiovascular disease incidence and mortality, and coronary heart disease, heart attack, and stroke incidence — type 2 diabetes incidence and mortality, and all-cause mortality. Information on diet was mostly collected via food frequency questionnaires.

The authors report that overall incidence of cardiovascular disease was 27 percent reduced when 50 grams of processed meat per day was swapped with between 28 and 50 grams of nuts per day. Swapping processed meat for 50 grams per day of legumes was associated with a 23 percent reduction in cardiovascular disease, while replacing one egg per day with between 25 and 28 grams of nuts was associated with a 17 percent reduced risk. However, there was no clear evidence that replacing poultry and fish or seafood with nuts or legumes reduced the risk of cardiovascular disease.

Swapping 50 grams per day of processed meat for between 10 and 28 grams of nuts was associated with a 22 percent reduction in type 2 diabetes incidence. Replacing one egg per day with 30 grams of whole grains or 10 grams of nuts was associated with a 21 percent and 18 percent reduction respectively. Additionally, replacing 50 grams per day of processed meat with 28 to 50 grams of nuts was associated with a 21 percent reduction in all-cause mortality.

The authors highlight that there were relatively few suitable studies to include in some of the meta-analyses, and that further research is needed to confirm these findings. Future research could additionally investigate the relationship between meat and dairy replacement products with health.


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Notes to editor:

1. Research article:

“Substitution of animal‑based with plant‑based foods on cardiometabolic health and all‑cause mortality: a systematic review and meta‑analysis of prospective studies”
BMC Medicine 2023
DOI: 10.1186/s12916-023-03093-1
The article is available at the journal website.

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