Is The Impossible Burger Healthy For You?

Is The Impossible Burger Healthy For the Planet?

Vegan BurgerAmericans love their meat. In 2018 we averaged over 200 pounds of meat per person. If we just focus on beef, we eat about 54 pounds per year. That’s equivalent to four quarter pounders a week!

But we are also getting the message that too much meat, especially red meat, may be bad for us. Nearly 40% of us are trying to eat a more plant-based diet.

The problem is that we love the convenience of fast food restaurants, and we love our burgers. Plus, in the past the meatless burgers on the market were, in a word, disappointing. Their taste and texture left something to be desired. You really needed to be committed to a plant-based diet to eat them in place of a regular burger.

That all changed a few years ago with the introduction of the and new generation of meatless burgers – the Impossible Burger and the Beyond Burger. They had the taste and texture of a real burger, but they were completely plant-based. What wasn’t to like?

  • Both companies claimed that their meatless burgers were healthier for the planet than regular burgers. For example, Impossible Food’s mission statement is: “Animal agriculture occupies almost half the land on earth, consumes a quarter of our freshwater, and destroys our ecosystems. So, we’re doing something about it: We’re making meat using plants, so that we never have to use animals again”.
  • Neither company claims their burgers are healthier for you. However, because their burgers are plant-based, the almost universal assumption has been that they are healthier than regular burgers.

Since their introduction they have taken the world by storm. You can find them in almost every supermarket and in many of your favorite fast food restaurants. Now that they are omnipresent, it is perhaps time to step back and take a closer look at this new generation of meatless burgers. In this article, I will ask two questions:

  • Are they healthier for you than regular burgers?
  • Are they healthier for the planet than regular burgers?

For the sake of simplicity, I will focus on the Impossible Burger with occasional comparisons with the Beyond Burger. It is beyond the scope of this article to compare these burgers with the many other meatless burgers that are now starting to flood the marketplace.

What’s In The Impossible Burger?

  • When we think of a burger, the first thing we think of is protein. The Impossible Burger gets its protein from soy, while the Beyond Burger gets its protein from peas.

Coconut OilHowever, soy and pea protein don’t give you the mouth feel, flavor, red color, and texture of a beef burger.

  • The mouth feel of a burger comes from its saturated fat. Both the Impossible Burger and Beyond Burger use coconut oil as their source of saturated fat.
    • Coconut oil has gained a reputation as a “healthier” saturated fat. However, as I have discussed in my book, “Slaying The Food Myths”, we have no long term studies on the health effects of diets high in coconut oil. We don’t really know whether it is healthier than other saturated fats.
  • The taste and color of a beef burger come from its heme content. Heme does not occur in the parts of plants we eat. However, heme is involved in nitrogen fixation, so it is found in the roots of some legumes.
    • The Impossible Burger has genetically engineered yeast to produce a type of heme called leghemoglobin that is found in soy roots. The Beyond Burger uses beet juice extract and annatto for the color and unspecified “natural flavor” for the flavor.
  • To get the texture of a beef burger, both the Impossible Burger and the Beyond Burger use maltodextrin, modified food starch, and a variety of other ingredients. They are both highly processed foods.
  • Iron is another important nutrient you expect to get from a beef burger. The Impossible Burger contains 4.5 mg of iron and the Beyond Burger contains 5.4 mg of iron.
    • However, that is only part of the story. When iron is attached to a heme molecule, it is more efficiently absorbed by our bodies. Beef burgers and the Impossible Burger contain heme iron. The Beyond Burger does not.
  • In addition, the Impossible Burger adds in the vitamins, including B12, that we would expect to get from a beef burger. The Beyond Burger does not.

What Are The Pluses Of The Impossible Burger?

thumbs upThere are some definite pluses for the Impossible Burger and Beyond Burger:

  • Both the Impossible Burger and Beyond Burger are made from plant-based ingredients rather than from meat.
  • Both are cholesterol free.
  • Both contain modest amounts of fiber (3 grams for the Impossible Burger and 2 grams for the Beyond Burger), while a meat burger contains none.
  • Both are good sources of iron, and the iron in the Impossible Burger is heme-iron, which is efficiently absorbed by our bodies.

What Are The Minuses of the Impossible Burger?

thumbs downThere are, however, some definite minuses as well.

  • Both the Impossible Burger and Beyond Burger are high in saturated fat. The Impossible Burger is higher in saturated fat and the Beyond Burger contains the same amount of saturated fat as a real burger. That’s important because the latest advisory of the American Heart Association warns that saturated fat increases our risk of heart disease (I have discussed this finding in detail in a previous issue of “Health Tips From the Professor”).
    • The saturated fat in both burgers comes from coconut oil. However, as I discussed above, we don’t know whether coconut oil is better or worse for us than other saturated fats. The relevant studies have not been done.
  • Both the Impossible and Beyond burgers are high in sodium. They have almost 5-times more sodium than a beef burger.
  • The heme in red meat catalyzes the formation of N-nitroso compounds in our gut which increase the risk of colon cancer. We do not know whether the form of heme added to Impossible Burgers catalyzes the same reaction, but it is likely.
  • Both plant-based burgers are low in protein compared to a beef burger (~20 grams versus 27 grams). On the other hand, 20 grams of protein is reasonable for a single meal.
  • The plant proteins used for these burgers (soy for the Impossible Burger and pea for the Beyond Burger) are highly processed. They lack the phytonutrients found in the unprocessed proteins.
    • The isoflavones found in soy are thought to decrease the risk of cancer and osteoporosis.
    • The phytonutrients found in peas have antioxidant and anti-inflammatory benefits. They are also thought to decrease the risk of certain cancers.
  • The Impossible Burger is GMO. The leghemoglobin is produced by genetically engineered yeast, and the soy is also GMO.
  • Neither the Impossible Burger nor Beyond Burger are certified organic. Organic certification refers to how the plant was grown. Both burgers are highly processed. Many of the ingredients in both burgers came from factories, not farms.

Is The Impossible Burger Healthy For You?

Eating Impossible BurgerNow, it is time to return to the original question: “Is the Impossible Burger healthy for you?” Since it is plant-based, it would be easy to assume that it is healthier than a burger made from beef. However, when you look more closely, it is not clear that it is healthier.

The manufacturers of the Impossible Burger and similar burgers have gone to the laboratory and have been successful at creating meatless burgers with the taste, mouth feel, and texture of real burgers. However, these improvements have come with a price.

  • The Impossible Burger and similar burgers are higher in saturated fat than a beef burger. This means they may be just as likely to increase the risk of heart disease as a beef burger.
  • The Impossible Burger contains as much heme as a beef burger, which means it may be just as likely to increase the risk of cancer as a beef burger.
  • The Impossible Burger and similar burgers are highly processed. That means:
    • The plant proteins no longer contain the phytonutrients thought to be responsible for some of their health benefits.
    • They also don’t contain the vitamins you would expect to find associated with the plant proteins.
  • The Impossible Burger and similar burgers are not organic. Even worse, the Impossible Burger is GMO.

On balance, we can’t really assume the Impossible Burger is any healthier than the beef burgers it replaces. Plus, if you include the usual condiments and add fries and a soft drink, any slight health benefits of the Impossible Burger will be lost.

It would be much healthier to choose a bean burger. They don’t taste like beef, but many of them are quite tasty. Plus, if you do some label reading, you can find ones that use only whole, unprocessed ingredients.

For example, I looked up the Organic Sunshine brand South West Black Bean burgers. It only provides half as much protein as an Impossible Burger, but all the ingredients are organic, non-GMO, and minimally processed. Note: I am not recommending a particular brand. However, with a little research I am confident you can find a healthy meatless burger with a taste you will enjoy.

Is The Impossible Burger Healthy For the Planet?

impossible burger good for planetNow, let’s look at the second question: “Is the Impossible Burger healthy for the planet?” The answer to this question seems obvious. As the Impossible Burger company states in their mission statement: “Animal agriculture occupies almost half the land on earth, consumes a quarter of our freshwater, and destroys our ecosystems”. It seems logical that any meatless burger would be an improvement.

If we are talking about a minimally processed black bean burger, like the one I described above, the answer is a clear yes. It is healthier for the planet. However, when you look more closely at the Impossible Burger, the answer isn’t as clear.

  • As coconut oil has increased in popularity massive areas of untouched, forested land have been cleared for coconut plantations.
    • These forested areas provide an essential ecosystem for animals and provide natural storm protection by absorbing rainwater. Therefore, coconut oil, like beef, also destroys our ecosystems.
    • In addition, many of the coconut plantations use large amounts of chemical fertilizers which contribute to phosphate pollution and algae overgrowth in lakes, rivers, and coastal ocean areas. This also degrades our environment.
  • The Impossible Burgers and similar meatless burgers contain many highly processed ingredients. Each of these ingredients imposes its own environmental burden. For example:
    • Coconut oil is often processed with hexane, which is categorized as a hazardous air pollutant by the Environmental Protection Agency.
    • In addition, coconut oil is primarily grown in the Philippines, Indonesia, and India. Transporting it to this country generates significant greenhouse gas emissions.
    • And, of course, coconut oil represents only one of the many highly processed ingredients in the Impossible Burger and similar meatless burgers.

In short, the Impossible Burger may be slightly healthier for the planet than a beef burger, but it is much less environmentally friendly than your typical, minimally processed, bean burger.

The Bottom Line

Two weeks ago, I wrote about recent headlines claiming that the best advice for the American public was to eat as much red meat as they like. I looked at the study behind the headlines and pointed out the many flaws in that study.

Last week I wrote about headlines claiming that red meat was just as heart healthy as white meat. I looked at the study behind the headlines and showed it was an excellent example of how the beef industry influences the design of clinical trials to minimize the health risks of red meat. It is also an example of how the media misleads and confuses the public about the effect of nutrition on their health.

What the studies I reviewed the last two weeks really showed was that very small amounts (2-3 ounces) of very lean red meat is probably OK as part of a healthy diet like the Mediterranean diet. Larger servings of fattier cuts of red meat as part of the typical American diet is problematic.

However, if you love your burgers, what are you to do? Are the meatless burgers like the Impossible Burger and Beyond Burger that are showing up in your favorite fast food restaurants the answer? Specifically, you are probably asking:

  • Is the Impossible Burger, and similar burgers, healthy for you?
  • Is the Impossible Burger, and similar burgers, healthy for the planet?

I looked at the composition, pluses, and minuses of this new generation of meatless burgers in this article. The bottom line is:

  • On balance, the Impossible Burger is only slightly healthier than the beef burgers it replaces. And, if you include the usual condiments and add fries and a soft drink, any slight health benefits of the Impossible Burger will be lost.

It would be much healthier to choose a bean burger. They don’t taste like beef, but many of them are quite tasty. Plus, if you do some label reading, you can find ones that are organic, non-GMO, and use only whole, unprocessed ingredients.

  • Similarly, the Impossible Burger may be slightly healthier for the planet than a beef burger, but it is much less environmentally friendly than your typical, minimally processed, bean burger.

For more details, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Is Red Meat As Healthy As White Meat?

The Lies of the Beef Industry

Eating Red MeatLast week I wrote about a recent review claiming that the evidence for the health risks of red meat consumption was so weak that the best advice for the American public was to eat as much of it as they like. I pointed out the many flaws in that study.

  • One of the flaws was that the review discounted dozens of association studies showing a link between red meat consumption and disease and relied instead on randomized controlled trials. Normally, that would be a good thing, but…
  • The association studies looked at health outcomes and had hundreds of thousands of participants. They found clear links between red meat consumption and increased risk of heart disease and cancer.
  • The randomized controlled trials looked at blood parameters like LDL cholesterol and averaged less than 500 participants. These studies were too small to provide meaningful results, and, not surprisingly, the results were conflicting. Some linked red meat consumption to increased risk, while others did not.

Because they had discounted evidence from association studies, the authors of the review concluded that the overall evidence was weak.

This week I want to address why the evidence from randomized controlled trials for health risks of red meat is so weak. More importantly, I want to highlight the role of the beef industry in making sure the evidence on the health risks of red meat consumption is weak.

I will also point out the role of the media in this process because they are equally complicit in spreading misleading information about the health risks of red meat consumption.

You might be asking: “How does the beef industry influence clinical trials to produce outcomes supporting their message that red meat is perfectly healthy?” “Surely they can’t convince reputable scientists to falsify their results.”

  • The answer is they don’t need to convince scientists to falsify their results. They just need to influence the design of the experiments so the results will be to their liking.” I will give two examples of that in this article.

Next you might be wondering: “What is the role of the media in this? Surely they just report what the scientific publication says.” Don’t be deceived. The media isn’t interested in accuracy. They are interested in generating the largest possible audience. They know controversy attracts an audience. They are looking for “man bites dog” headlines even if it isn’t true.

  • If you actually read the studies, you discover that reputable scientists always discuss the weaknesses and flaws in their study. The media either doesn’t read the publication or ignores the weaknesses. Instead they focus on the most controversial headline they can craft. I will give some examples of that as well.

Is Red Meat As Healthy As White Meat?

Red Meat Vs White MeatFor years we have been told that red meat increases our risk of heart disease because it is high in saturated fats. We’ve been told that white meat and plant proteins are better alternatives.

But the latest headlines claim that red meat is just as heart healthy as white meat. You are probably wondering what to believe. Let’s examine the study behind the headline and ask two important questions?

  1. Did the beef industry influence the study?
  2. Did the media distort the study in their reporting?

I will start by reporting the study design and the results of the studies without comment. Then I will discuss how the beef industry influenced the design of the study to produce misleading results.

The Headlines Said: “Red Meat and White Meat Are Equally Heart Healthy.” The study behind the headlines was a 4-week study (N Bergeron et al, American Journal of Clinical Nutrition, 110: 24-33, 2019) comparing equivalent amounts of red meat, white meat, and non-meat protein on LDL levels. It did report that red meat and white meat raised LDL cholesterol levels to the same extent, but here is what the headlines didn’t tell you:

  • The authors of this study are heavily funded by the dairy and beef industries. I will point out the implications of this funding below.
  • 4 weeks is a very short time. This study provides no information on the long-term effects of red meat versus white meat consumption.
  • The study only measured LDL and related lipoproteins. It did not measure heart disease outcomes. LDL and lipoprotein levels are only one indicator of heart disease risk. Thus, they are imperfect predictors of heart disease risk. I will point out why that is important below as well.
  • The study was performed at two levels of saturated fat – low (7% of calories) and high (14% of calories).

At the low level of saturated fat, only the leanest cuts of red meat (top round and top sirloin) were used to keep saturated fat low in the red meat group. High fat dairy foods were added to the non-meat protein group to increase saturated fat content. Thus, all 3 groups consumed the same amount of saturated fat.

At the high level of saturated fat, butter and high-fat dairy foods were added to the white meat and non-meat protein groups to increase saturated fat content. Once again, saturated fat content was identical in all 3 groups.

Here were the results:High Cholesterol

  • LDL and related lipoproteins were higher for the high saturated fat group than the low saturated fat group. Nothing new here. This is consistent with dozens of previous studies. We know that saturated fat increases LDL cholesterol levels when other aspects of the diet are kept constant.
  • In both the low and high saturated fat groups, red and white meat raised LDL cholesterol to the same extent. In other words, when saturated fat levels are held constant, red meat and white meat raise cholesterol levels to the same extent.

In interpreting that statement, you need to remember the study design.

    • In the low saturated fat group, only two cuts of red meat were low enough in saturated fat for a direct comparison to white meat.
    • In the high saturated fat group, butter and high fat dairy had to be added to white meat so it could be compared to red meat.

Obviously, this is not the real world. 95% of the red meat the average American consumes is higher in saturated fat than most white meat.

The authors concluded “The findings…based on lipid and lipoprotein effects, do not provide evidence for choosing white over red meat for reducing heart disease risk”. That conclusion is clearly inaccurate.

  • The study did not measure heart disease outcomes. It measured only LDL cholesterol and related lipoprotein levels. That is just one factor in determining heart disease risk. The significance of that statement will be explained below.
  • Red meat and white meat raised LDL cholesterol levels to the same extent only when saturated fat is held constant. We know that most red meat is higher in saturated fat than white meat and saturated fat raises LDL cholesterol levels. In fact, the study confirmed that the high-fat red meats most people consume raised LDL cholesterol more than white meats.
  • The accurate conclusion to this study would have been: “Most red meat raises LDL cholesterol more than white meat, which suggests red meat may increase heart disease risk compared to white meat.”
  • Did I mention that the authors are heavily funded by the beef industry?

What About TMAO And Heart Disease Risk?

heart diseaseInterestingly, the authors also looked at another risk factor for heart disease in the same study, something called TMAO. I have discussed the relationship between red meat, TMAO, and heart disease risk in a previous issue of “Health Tips From the Professor”).

Let me summarize briefly here:

  • Red meat has 10-50-fold higher concentrations of a compound called L-carnitine than white meat.
  • Meat eaters have a very different population of gut bacteria than people who eat a primarily plant-based diet. It is not clear whether that is due to the meat or the loss of plant foods that meat displaces from the diet.
  • The gut bacteria of meat eaters convert L-carnitine to trimethylamine (TMA), which the liver then converts to trimethylamine N-oxide (TMAO).
  • The gut bacteria of people consuming a primarily plant-based do not convert L-carnitine to TMA, so no TMAO is formed. For example, in one study investigators fed an 8-ounce sirloin steak to meat eaters and to vegetarians. The meat eaters ended up with high levels of TMAO in their blood. The vegetarians had little or no TMAO in their blood.
  • High levels of TMAO are associated with atherosclerosis, increased risk of heart attacks, and death. Therefore, TMAO is considered an independent risk factor for heart disease.

The authors of the study comparing red meat and white meat also found that blood TMAO levels were two-fold higher in the red meat group than in the other two groups and this was independent of dietary saturated fat. However, rather than publishing this in the same paper where it might have interfered with their message that red and white meat affect heart disease risk to the same extent, the authors chose to publish these data in a separate paper (Z.Wang, European Heart Journal, 40: 7: 583-594, 2018).

Did I mention the authors are heavily funded by the beef industry?

Is Red Meat Healthy As Part Of A Mediterranean Diet?

Mediterranean Diet FoodsLet me briefly touch on one other study funded by the beef industry. The headlines said: “You may not have to give up red meat. It is healthy as part of a Mediterranean diet.”

The study (LE O’Connor et al, American Journal of Clinical Nutrition, 108: 33-40, 2018) behind the headlines did report that lean beef and pork did not raise LDL cholesterol levels when they were included in a Mediterranean diet. However, it is important to look at what the headlines didn’t tell you.

  • The red meat group consumed only 2.4 ounces of red meat a day. We aren’t talking about 8-ounce steaks or a rack of pork ribs here.
  • The red meat group ate only the very leanest (tenderloin) cuts of beef or pork.
  • On a positive note, while it wasn’t measured in this study, it is likely that TMAO levels would be relatively low because the subjects were consuming a primarily plant-based diet. They were consuming 7 servings of vegetables, 4 servings of fruit, and 4 servings of whole grains each day.
  • Similarly, red meat has several components that appear to increase cancer risk. However, they can be largely neutralized by various plant foods. This is something I have discussed in more detail in my book “Slaying The Food Myths”.

In summary, it would have been more accurate to conclude that very small, very lean servings of red meat may be healthy as part of a primarily plant-based diet like the Mediterranean diet.

The Lies Of The Beef Industry

LiesBoth these studies utilized the very leanest cuts of red meat so they could conclude that red meat is healthy. This is a common design of studies funded by the beef industry. Rather than looking at the health effects of the high fat red meats most people consume, the studies focus only on the leanest cuts of meat.

The studies appear to be designed to purposely mislead the American public. Let’s look at how that happens. When studies like these are incorporated into larger meta-analyses or reviews, investigators often look at the conclusions, not at the experimental design.

Meta-analyses and reviews are only as good as the studies they include, a concept referred to as “Garbage in – Garbage Out”. That is what happened with the review and recommendations I discussed last week. The review relied heavily on short-term randomized controlled trials.

However, this is problematic. Because of the way they are designed, industry funded studies tend to find no adverse effects of consuming red meat. Independently funded studies tend to find adverse health effects from red meat. If you throw them all together without considering how the experiments were designed, the studies cancel each other out.

On that basis the authors of the review concluded that the evidence for red meat adversely affecting health outcomes was weak and recommended that everyone could continue consuming red meat. (That is a recommendation that virtually every health organization and top expert in the field have rejected for the reasons I summarized last week).

The beef industry doesn’t have to influence the design of every study, just enough studies to confuse the science and confuse the media.

The Complicity Of The Media

newspaper heallinesUnfortunately, the media is equally guilty of misleading the public. As I said above, the media is interested in attracting an audience, not in accuracy. For example:

  • The headlines describing the first study should have said: “Saturated fat raises LDL cholesterol levels”. But everyone knows that. Headlines like that are non-controversial. They don’t attract readers.
  • The headlines describing that study could have said: “Very lean cuts of red meat don’t raise LDL levels any more than white meat”. That would have been accurate, but that wouldn’t attract readers either. Most Americans prefer high fat cuts of red meat. They aren’t interested in reading articles suggesting they should change what they are eating.
  • Similarly, the headlines describing the second study should have said: “Very small amounts of very lean red meat may be healthy as part of a Mediterranean diet.”
  • In fact, the authors of both studies admitted in their discussions that they could not extrapolate their findings to the effects of higher-fat red meats. The media ignored those statements. Presumably, they decided the American public didn’t want to hear that message.
  • The first study also found that LDL and related lipoprotein levels were lower for the non-meat protein group than the red and white meat groups at both saturated fat levels. In fact, the main conclusion of the authors was: “The findings are in keeping with recommendations promoting diets with a high proportion of plant foods.” Somehow the media completely ignored that finding.

When the media consistently misleads the public about what constitutes a healthy diet, it leads to confusion. Confusion leads to inaction. At a time when so many Americans are suffering from preventable diseases, this is inexcusable.

Is Red Meat Healthy?

red meat heart healthyLet’s return to the question I posed last week: “Is red meat healthy?” Most of what I say below is identical to what I said last week. However, with the information I provided in the article above it may be easier to understand.

  • The saturated fat in red meat is associated with increased heart disease risk.
  • Red meat increases blood levels of TMAO, which is associated with increased heart disease risk.
  • The heme iron in red meat can be converted in the gut to N-nitroso compounds, which are associated with increased risk of cancer.
  • Benzopyrene and heterocyclic amines are formed when red meat is cooked. And they are associated with increased risk of cancer.

As I said last week, “There are too many studies that show a strong association between red meat consumption and disease risk to give red meat a clean bill of health. We can’t say red meat is healthy with any confidence.”

However, that doesn’t mean we need to eliminate red meat from our diet. As described above, the health risks of red meat are determined by the type of red meat consumed, the amount of red meat consumed, and the overall composition of our diet. For example:

  • Very lean cuts of red meat contain no more saturated fat than white meat.
  • Primarily plant-based diets alter our gut bacteria in such a way that production of TMAO and N-nitroso compounds are decreased.
  • Diets high in plant fiber sweep benzopyrene and heterocyclic amines out of our intestine before they can cause much damage.

So, what does that mean to you?

  • If you are thinking in terms of a juicy 8-ounce steak with a baked potato and sour cream, red meat may increase your risk of disease.
  • However, if you are thinking of 2-3 ounces of very lean steak in a vegetable stir fry or a green salad, red meat is probably OK.
  • If you are thinking about the very leanest cuts of red meat, they are probably just as healthy as white meat.

What About Grass Fed Beef?

Of course, one question I am frequently asked is: “What about grass fed beef? Is it healthier than conventionally raised beef?” Grass fed beef does have a slightly healthier fat profile. It is modestly lower in saturated fat and modestly higher in omega-3 fats. However, grass feeding doesn’t affect TMAO, N-Nitroso, benzopyrene, and heterocyclic amine formation.

  • That means the 8-ounce steak is only slightly less unhealthy and the 2-3 ounces of steak in a green salad only slightly healthier when you substitute grass-fed for conventionally raised beef. It’s probably not worth the extra cost.

Next week I will return with the answer to another question I get a lot. “If plant protein is good for me, what about all those meatless burgers that are popping up in my favorite fast food restaurants. Are they healthy?”

The Bottom Line

Last week I wrote about a recent review claiming that the evidence for the health risks of red meat consumption was so weak that the best advice for the American public was to eat as much of it as they like. I pointed out the many flaws in that study.

This week I provided two examples of how the beef industry influences the design of clinical trials to minimize the health risks of red meat and the media misleads the public about what the studies showed.

The bottom line is that red meat likely has no adverse health effects only if you are consuming very small amounts of very lean red meat in the context of a primarily plant-based diet. Unfortunately, this is not the message you are getting from the media and from Dr. Strangelove’s health blog.

As for grass-fed beef, it is only modestly healthier than conventionally raised beef for reasons I have given in the article above. It’s probably not worth the extra cost.

Next week I will return with the answer to another question I get a lot. “If plant protein is good for me, what about all those plant-based burgers that are popping up in my favorite fast food restaurants. Are they healthy?” Stay tuned.

For more details, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 

 

Can Plant-based Diets Be Unhealthy?

Do Plant-Based Diets Reduce Heart Disease Deaths?

Author: Dr. Stephen Chaney

 

plant-based diets vegetablesPlant-based diets have become the “Golden Boys” of the diet world. They are the diets most often recommended by knowledgeable health and nutrition professionals. I’m not talking about all the “Dr. Strangeloves” who pitch weird diets in books and the internet. I am talking legitimate experts who have spent their life studying the impact of nutrition on our health.

Certainly, there is an overwhelming body of evidence supporting the claim that plant-based diets are healthy. Going on a plant-based diet can help you lower blood pressure, inflammation, cholesterol and triglycerides. People who consume a plant-based diet for a lifetime weigh less and have decreased risk of heart disease, diabetes, and cancer.

But, can a plant-based diet be unhealthy? Some people consider a plant-based diet to simply be the absence of meat and other animal foods. Is just replacing animal foods with plant-based foods enough to make a diet healthy?

Maybe not. After all, sugar and white flour are plant-based food ingredients. Fake meats of all kinds abound in our grocery stores. Some are very wholesome, but others are little more than vegetarian junk food. If you replace animal foods with plant-based sweets, desserts, and junk food, is your diet really healthier?

While the answer to that question seems obvious, very few studies have asked that question. Most studies on the benefits of plant-based diets have compared population groups that eat a strictly plant-based diet (Seventh-Day Adventists, vegans, or vegetarians) with the general public. They have not looked at variations in plant food consumption within the general public. Nor have they compared people who consume healthy and unhealthy plant foods.

This study (H Kim et al, Journal of the American Heart Association, 8:e012865, 2019) was designed to fill that void.

 

How Was The Study Done?

plant-based diets studyThis study used data collected from 12,168 middle aged adults in the ARIC (Atherosclerosis Risk in Communities) study between 1987 and 2016.

The participant’s usual intake of foods and beverages was assessed by trained interviewers using a food frequency questionnaire at the time of entry into the study and again 6 years later.

Participants were asked to indicate the frequency with which they consumed 66 foods and beverages of a defined serving size in the previous year. Visual guides were provided to help participants estimate portion sizes.

The participant’s adherence to a plant-based diet was assessed using four different well-established plant-based diet scores. For the sake of simplicity, I will include 3 of them in this review.

  • The PDI (Plant-Based Diet Index) categorizes foods as either plant foods or animal foods. A high PDI score means that the participant’s diet contains more plant foods than animal foods. A low PDI score means the participant’s diet contains more animal foods than plant foods.
  • The hPDI (healthy plant-based diet index) is based on the PDI but emphasizes “healthy” plant foods. A high hPDI score means that the participant’s diet is high in healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, coffee and tea) and low in animal foods.
  • The uPDI (unhealthy plant-based diet index) is based on the PDI but emphasizes “unhealthy” plant foods. A high uPDI score means that the participant’s diet is high in unhealthy plant foods (refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts) and low in animal foods.

For statistical analysis the scores from the various plant-based diet indices were divided into 5 equal groups. In each case, the group with the highest score consumed the most plant foods and least animal foods. The group with the lowest score consumed the least plant foods and the most animal foods.

The health outcomes measured in this study were heart disease events, heart disease deaths, and all-cause deaths. Again, for the sake of simplicity, I will only include 2 of these outcomes (heart disease deaths and all-cause deaths) in this review. The data on deaths were obtained from state death records and the National Death Index. (Yes, your personal information is available on the web even after you die.)

 

Do Plant-Based Diets Reduce Heart Disease Deaths?

plant-based diets reduce heart deathsThe participants in this study were followed for an average of 25 years.

The investigators looked at heart disease deaths over the 25 years and compared people with the highest intake of plant foods to people with the highest intake of red meat and other animal foods. The results were:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, coffee and tea) had a 19-32% lower risk of dying from heart disease than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods (refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts) had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

When the investigators looked at all-cause deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had an 11-25% lower risk of dying from any cause than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

What Else Did The Study Show?

The investigators made a couple of other interesting observations:

  • The association of the overall diet with heart disease and all-cause deaths was stronger than the association of individual food components. This underscores the importance of looking at the effect of the whole diet on health outcomes rather than the “magic” foods you hear about on Dr. Strangelove’s Health Blog.
  • Diets with the highest amount of healthy plant foods were associated with higher intake of carbohydrates, plant protein, fiber, and micronutrients, including potassium, magnesium, iron, vitamin A, vitamin C, folate, and lower intake of saturated fat and cholesterol.
  • Diets with the highest amount of unhealthy plant foods were associated with higher intake of calories and carbohydrates and lower intake of fiber and micronutrients.

The last two observations may help explain some of the health benefits of plant-based diets.

 

Can Plant-Based Diets Be Unhealthy?

plant-based diets unhealthy cookiesNow, let’s return to the question I asked at the beginning of this article: “Can plant-based diets be unhealthy?” Although some previous studies have suggested that unhealthy plant-based diets might increase the risk of heart disease, this study did not show that.

What this study did show was that an unhealthy plant-based diet was no better for you than a diet containing lots of red meat and other animal foods.

If this were the only conclusion from this study, it might be considered a neutral result. However, this result clearly contrasts with the data from this study and many others showing that both plant-based diets in general and healthy plant-based diets reduce the risk of heart disease deaths and all-cause deaths compared to animal-based diets.

The main message from this study is clear.

  • Replacing red meat and other animal foods with plant foods can be a healthier choice, but only if they are whole, minimally processed plant foods like whole grains, fruits, vegetables, nuts, legumes, coffee and tea.
  • If the plant foods are refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts, all bets are off. You may be just as unhealthy as if you kept eating a diet high in red meat and other animal foods.

There is one other subtle message from this study. This study did not compare vegans with the general public. Everyone in the study was the general public. Nobody in the study was consuming a 100% plant-based diet.

For example:

  • The group with the highest intake of plant foods consumed 9 servings per day of plant foods and 3.6 servings per day of animal foods.
  • The group with the lowest intake of plant foods consumed 5.4 servings per day of plant foods and 5.6 servings per day of animal foods.

In other words, you don’t need to be a vegan purist to experience health benefits from adding more whole, minimally processed plant foods to your diet.

 

The Bottom Line

A recent study analyzed the effect of consuming plant foods on heart disease deaths and all-cause deaths over a 25-year period.

When the investigators looked at heart disease deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had a 19-32% lower risk of dying from heart disease than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

When the investigators looked at all-cause deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had an 11-25% lower risk of dying from any cause than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

The main message from this study is clear.

  • Replacing red meat and other animal foods with plant foods can be a healthier choice, but only if they are whole, minimally processed plant foods like whole grains, fruits, vegetables, nuts, legumes, coffee and tea.
  • If the plant foods are refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts, all bets are off. You may be just as unhealthy as if you kept eating a diet high in red meat and other animal foods.

A more subtle message from the study is that you don’t need to be a vegan purist to experience health benefits from adding more whole, minimally processed plant foods to your diet. The people in this study were not following some special diet. The only difference was that some of the people in this study ate more plant foods and others more animal foods.

For more details on the study, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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