The findings – published in an international news journal – came from a meta-analysis (a study that groups all results from small studies) of 30 generally short, small, randomized controlled trials published between 1982 and 2022.
In separate studies, researchers randomly assigned some people to continue eating an omnivorous diet (meat, dairy and plants) and other people to either a vegetarian diet or a vegetarian diet – for about 7 months on average.
At the end of this period, those who ate a plant-based diet had lower blood fat levels than those who ate an omnivorous diet.
Specifically, they had 7% lower total cholesterol, 10% lower low-density lipoprotein (LDL) cholesterol (or “bad” cholesterol), and 14% lower apolipoprotein B (apoB) levels.
ApoB is the main protein found in LDL cholesterol and can be used as another marker of cardiovascular disease.
There was no significant difference between triglycerides, the other type of fat associated with high levels of heart attack and stroke.
“Vegetarian and vegetarian diets were associated with a 14% reduction in all artery-clogging lipoproteins as indicated by apolipoprotein B,” senior author Ruth Fricke-Schmidt, MD, PhD, of the University of Copenhagen, said in a news release.
“This corresponds to a third of the effect of taking cholesterol-lowering drugs such as statins,” he said, “and a 7% reduction in the risk of cardiovascular disease in people who maintain a plant-based diet for five years.”
Combining statins with a plant-based diet would likely produce a greater (synergistic) effect, he hypothesized.
Importantly, the results were similar for different age groups, body mass index and health status living on different continents.
“If people start eating a vegetarian or vegan diet from an early age,” Fricke-Schmidt said, “the potential to reduce the risk of cardiovascular disease caused by blocked arteries is substantial.”
Additionally, recent studies have shown that if the population of high-income countries shifted to a plant-based diet, it could reduce net greenhouse gas emissions by 35% to 49%, he noted.
Not all plant-based diets are created equal
In an editorial, Indiana University’s Kevin C. Maki, PhD, and Carol Kirkpatrick, MPH, PhD, of Idaho State University, write that the new study adds to the evidence supporting a healthy vegetarian and vegan diet in reducing the risk of heart disease. stroke
“While it is not necessary to completely eliminate foods such as meat, poultry, and fish/seafood to follow the recommended dietary pattern,” they noted, “reducing consumption of such foods is a reasonable option for those who choose to do so.”
Other experts who were not involved in the research agreed, according to comments they made to the UK Science Media Centre.
“Although a vegetarian and vegan diet can be very healthy and beneficial in terms of cardiovascular risk, it is important that it is well-planned so that it includes few nutrients, including iron, iodine, vitamin B12 and vitamin D.” says Duane Mellor, PhD, with Aston University in Birmingham, UK
Some people “may find it easier to follow a Mediterranean-style diet that’s high in fruits, vegetables, legumes, whole grains, fish, eggs, and low-fat dairy, with only a small amount of meat,” says Tracy Parker, a heart health dietitian. . with the British Heart Foundation in London.
“There is substantial evidence that this type of diet can help reduce your risk of heart and circulatory disease by improving cholesterol and blood pressure levels, reducing inflammation, and controlling blood glucose levels.”
“Not all plant-based diets are created equal,” notes Edin Cassidy, PhD, of Queen’s University in Belfast, UK. He said that a healthy diet characterized by fruits, vegetables and whole grains improves health, but “other plant foods (including processed foods such as refined carbohydrates, high fat/salt etc.)” do not.
This well-done analysis of 30 clinical trials involved more than 2,000 people and “highlights the value of a vegetarian diet in reducing the risk of heart attack or stroke by lowering blood cholesterol levels,” said Robert Storey, MD, University of Sheffield, UK.
But “people inherit a tendency for their livers to make too much cholesterol, which means that high cholesterol is more strongly influenced by our genes (DNA) than our diet,” he said.
“This explains why statins are needed to stop cholesterol production in people who are at higher risk or already suffer from heart attack, stroke or other illnesses related to cholesterol build-up in the blood vessels.”
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