Cardiology, Diet, Medical News

Plant-based diets associated with significantly lower cardiovascular risk, according to new meta-analysis

New research shows that diets consisting of larger amounts of plant-based foods are associated with a markedly lower cardiovascular risk. Those who consumed large amounts of vegetables (400g) were associated with a reduction of CHD mortality of up to 34%.

Cardiovascular disease (CVD) is the leading cause of death and disability worldwide. Dietary habits increase cardiovascular risk through an effect of key indicators such as serum cholesterol, plasma lipids, plasma glucose, blood pressure, body weight, and diabetes, according to research. However, there is still debate about what diet is best for cardiovascular health.

According to a recently published meta-analysis out of the University of Naples, which included 99 studies, eating a plant-based diet with a focus on consuming whole foods and avoiding foods of animal origin significantly lowers the risk of cardiovascular disease.

Gabriele Riccardi, a professor of endocrinology and metabolic diseases at the University of Naples and co-author of this meta-analysis, stated, ​​“According to the available evidence, the recommended dietary pattern should limit the consumption of red and processed meat and replace it, in part, with other protein sources, mainly legumes and nuts, but also dairy, fish, poultry and eggs.”

Based on the analysis, the authors recommended eating fish/shellfish a maximum of four times per week, while limiting poultry and dairy to three times a week, and avoiding red meats when possible. However, research does support that small amounts of cheese and yogurt each week can protect from CVD, although this is not essential for a healthy diet. 

The paper states, “Five out of six meta-analyses of observational prospective studies on the association between vegetable consumption and CHD have reported a significant inverse association; an 8–18% lower incidence of CHD events has been found in people consuming large amounts of vegetables, with a maximal reduction (nearly 18–21%) associated with a daily consumption of 400 g (i.e. two servings per day); for this amount, the reduction of CHD mortality has been reported to be 34%.”

Due to the increased global prevalence of CVD, many randomized clinical trials have been conducted to evaluate factors that lead to atherosclerosis. However, these studies don’t always produce consistent results, mainly due to methodological limitations. For this reason, systematic reviews and meta-analyses are important for accurately determining the general sentiment of the associated body of research. The researchers’ focus was to review the correlation of certain food groups and CVD/mortality on studies published up to August 31st, 2020. 

The buildup of lipids, cholesterol, and other chemicals in and on the walls of your arteries is known as atherosclerosis. Plaque is the term for this accumulation. The blood vessel wall hardens as plaque builds up, which reduces blood flow by narrowing the lumen within the artery. The amount of oxygen and other nutrients reaching the body is reduced as a result. Atherosclerosis can be prevented by living and maintaining a healthy lifestyle.

The authors conclude that, “The evidence reviewed indicates that diets with a higher intake of plant-based foods—limiting the consumption of refined cereals and starchy foods—are associated with a markedly lower cardiovascular risk in comparison with diets including predominantly animal foods.”


The study was published in Cardiovascular Research, on July 6th, 2021.

Abstract. This review aims at summarizing updated evidence on cardiovascular disease (CVD) risk associated with consumption of specific food items to substantiate dietary strategies for atherosclerosis prevention. A systematic search on PubMed was performed to identify meta-analyses of cohort studies and RCTs with CVD outcomes. The evidence is highly concordant in showing that, for the healthy adult population, low consumption of salt and foods of animal origin, and increased intake of plant-based foods—whole grains, fruits, vegetables, legumes, and nuts—are linked with reduced atherosclerosis risk. The same applies for the replacement of butter and other animal/tropical fats with olive oil and other unsaturated-fat-rich oil. Although the literature reviewed overall endorses scientific society dietary recommendations, some relevant novelties emerge. With regard to meat, new evidence differentiates processed and red meat—both associated with increased CVD risk—from poultry, showing a neutral relationship with CVD for moderate intakes. Moreover, the preferential use of low-fat dairies in the healthy population is not supported by recent data, since both full-fat and low-fat dairies, in moderate amounts and in the context of a balanced diet, are not associated with increased CVD risk; furthermore, small quantities of cheese and regular yogurt consumption are even linked with a protective effect. Among other animal protein sources, moderate fish consumption is also supported by the latest evidence, although there might be sustainability concerns. New data endorse the replacement of most high glycemic index (GI) foods with both whole grain and low GI cereal foods. As for beverages, low consumption not only of alcohol, but also of coffee and tea is associated with a reduced atherosclerosis risk while soft drinks show a direct relationship with CVD risk. This review provides evidence-based support for promoting appropriate food choices for atherosclerosis prevention in the general population.

Gabriele Riccardi, Annalisa Giosuè, Ilaria Calabrese, Olga Vaccaro, Dietary recommendations for prevention of atherosclerosis, Cardiovascular Research, 2021;, cvab173, doi:10.1093/cvr/cvab173

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