Plant-based meat alternatives and cardiometabolic health: a systematic review and meta-analysis

Rubén Fernández-Rodríguez; Bruno Bizzozero-Peroni; Valentina Díaz-Goñi; Miriam Garrido-Miguel; Gabriele Bertotti; Alberto Roldán-Ruiz; Miguel López-Moreno

doi:10.1016/j.ajcnut.2024.12.002

Plant-based meat alternatives and cardiometabolic health: a systematic review and meta-analysis

Am J Clin Nutr. 2024 Dec 7:S0002-9165(24)01428-X. doi: 10.1016/j.ajcnut.2024.12.002. Online ahead of print.

Authors

Rubén Fernández-Rodríguez¹, Bruno Bizzozero-Peroni², Valentina Díaz-Goñi³, Miriam Garrido-Miguel⁴, Gabriele Bertotti⁵, Alberto Roldán-Ruiz⁵, Miguel López-Moreno⁵

Affiliations

¹ Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain.
² Health and Social Research Center, Faculty of Nursing, Universidad de Castilla-La Mancha, Cuenca, Spain; Instituto Superior de Educación Física, Universidad de la República, Rivera, Uruguay. Electronic address: Bruno.Bizzozero@uclm.es.
³ Health and Social Research Center, Faculty of Nursing, Universidad de Castilla-La Mancha, Cuenca, Spain.
⁴ Health and Social Research Center, Faculty of Nursing, Universidad de Castilla-La Mancha, Cuenca, Spain; Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Cuenca, Spain; Faculty of Nursing, Universidad de Castilla-La Mancha, Albacete, Spain.
⁵ Diet, Planetary Health and Performance, Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo, Madrid, Spain; School of Physiotherapy, Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain.

PMID: 39653176
DOI: 10.1016/j.ajcnut.2024.12.002

Abstract

Background: Plant-based meat alternatives (PBMAs) are emerging in global markets. However, the effects of substituting meat for PBMAs on cardiometabolic health are uncertain.

Objectives: This study aimed to determine the effects of replacing meat consumption by PBMAs on cardiometabolic parameters in adults.

Methods: Five databases were systematically explored from inception to July 2024, searching for RCTs assessing the effects of replacing meat consumption by PBMAs on cardiometabolic parameters in adults without cardiovascular diseases. Meta-analyses were conducted when ≥4 studies addressed the same outcome (i.e. blood lipids, blood pressure, fasting glucose, and body weight). Pooled raw mean differences (MDs) with their 95% CIs were estimated using a random-effects method. Sensitivity analyses were conducted to assess the robustness of our estimates.

Results: Eight publications from 7 RCTs comprising 369 adults (60% females; mean age range: 24-61 y) were included. The substitution of PBMAs for meat was associated with significant reductions in LDL-cholesterol: -0.25 mmol/L (95% CI: -0.42, -0.08 mmol/L; I² = 65.8%; n = 7), total cholesterol (TC): -0.29 mmol/L (95% CI: -0.52, -0.06 mmol/L; I² = 64.8.%; n = 6), and body weight: -0.72 kg (95% CI: -1.02, -0.42 kg; I² = 0%; n = 5). No significant changes were shown in HDL-cholesterol, triglycerides, blood pressure, or fasting glucose concentrations. Sensitivity analyses considering mycoprotein-based alternatives showed a significant reduction in LDL-cholesterol (MD: -0.37 mmol/L; 95% CI: -0.61, -0.13 mmol/L; I² = 52.5%; n = 4), and TC (MD: -0.39 mmol/L; 95% CI: -0.56, -0.21 mmol/L; I² = 0%; n = 4).

Conclusions: Our findings suggest substituting PBMAs for meat for ≤8 wk lowered TC (6%), LDL-cholesterol (12%), and body weight (1%) in adults without cardiovascular diseases. PBMAs may facilitate the transition to a plant-based diet, but long-term studies are needed to evaluate their cardiometabolic effects. This trial was registered at PROSPERO as CRD42024556191.

Keywords: cardiovascular disease; diet; meat substitutes; planetary health; plant-based meat food.