Health

Best diet for heart health revealed in huge analysis


Vegetarian and vegan diets may slash levels of cholesterol and fat in the blood, a study suggests.

Researchers in Denmark say their findings, which analysed data from studies involving more than 2,000 people, suggest plant-based diets reduce the risk of developing blocked arteries.

In turn, the chance of having a heart attack or strokes is also squashed. 

Study author Professor Ruth Frikke-Schmidt said a meat-free diet ‘corresponds to a third of the effect’ of taking cholesterol-lowering statins, which is ‘really substantial’.

Statins, one of the most commonly prescribed drugs, is taken by around eight million Brits and 40million Americans.

Researchers in Denmark say their findings, which analysed data from studies involving more than 2,000 people, suggest plant-based diets reduce the risk of developing blocked arteries

Researchers in Denmark say their findings, which analysed data from studies involving more than 2,000 people, suggest plant-based diets reduce the risk of developing blocked arteries

The researchers looked at 30 trials with a total of 2,372 participants, published between 1982 and 2022.

They looked at their levels of ‘good’ and ‘bad’ cholesterol, triglycerides — a type of fat found in the blood — and apoliprotein B (apoB), which is a protein that helps to carry fat and cholesterol in blood.

Data for those following vegetarian and vegan diets were compared against those who followed an omnivorous diet, which includes meat, fish and dairy.

The length of time on the diets ranged from 10 days to five years, with an average of 29 weeks.

The findings, published in the European Heart Journal, show those who followed a plant-based diet had an average reduction in total cholesterol levels of 7 per cent from levels measured at the start of the studies.

There was also a 10 per cent reduction in bad cholesterol levels and a 14 per cent reduction in apoB levels.

The researchers used data from statins trials to estimate that maintaining a diet for five years would cut the risk of cardiovascular disease by seven per cent, while following the diet for 15 years could slash the risk by a fifth.

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Professor Frikke-Schmidt, chief physician at the Rigshospitalet in Copenhagen, told BBC News: ‘That corresponds to a third of the effect of a cholesterol-lowering statin [pill] – so that’s really substantial.’

However, she urged those taking statins and following a plant-based diet not to come off the drugs.

Statins are offered to those with high levels of ‘bad’ cholesterol, which can lead to a hardening and narrowing of the arteries and cardiovascular disease. They work by lowering the production of this type of cholesterol in the liver. 

She said: ‘Statin treatment is superior to plant-based diets in reducing fats and cholesterol levels.

‘However, one regimen does not exclude the other, and combining statins with plant-based diets is likely to have a synergistic effect, resulting in an even larger beneficial effect.

‘If people start eating vegetarian or vegan diets from an early age, the potential for reducing the risk of cardiovascular disease caused by blocked arteries is substantial.

‘Importantly, we found similar results across continents, ages, different ranges of body mass index, and among people in different states of health.’

The effect was seen for both vegetarian and vegan diets and in people ranging from a healthy weight to obese, regardless of their age and underlying health conditions. 

Professor Frikke-Schmidt added: ‘Populations globally are ageing and, as a consequence, the cost of treating age-related diseases such as atherosclerotic cardiovascular disease is increasing.

Meat, eggs and milk provide key nutrients such as high-quality protein, fatty acids, iron, calcium, zinc, selenium and vitamin B12, a UN report found

Meat, eggs and milk provide key nutrients such as high-quality protein, fatty acids, iron, calcium, zinc, selenium and vitamin B12, a UN report found

‘Plant-based diets are key instruments for changing food production to more environmentally sustainable forms, while at the same time reducing the burden of cardiovascular disease.

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‘We should be eating a varied, plant-rich diet, not too much, and quenching our thirst with water.’

What should a balanced diet look like? 

Meals should be based on potatoes, bread, rice, pasta or other starchy carbohydrates, ideally wholegrain, according to the NHS

Meals should be based on potatoes, bread, rice, pasta or other starchy carbohydrates, ideally wholegrain, according to the NHS

  • Eat at least 5 portions of a variety of fruit and vegetables every day. All fresh, frozen, dried and canned fruit and vegetables count;
  • Base meals on potatoes, bread, rice, pasta or other starchy carbohydrates, ideally wholegrain;
  • 30 grams of fibre a day: This is the same as eating all of the following: 5 portions of fruit and vegetables, 2 whole-wheat cereal biscuits, 2 thick slices of wholemeal bread and large baked potato with the skin on;
  • Have some dairy or dairy alternatives (such as soya drinks) choosing lower fat and lower sugar options;
  • Eat some beans, pulses, fish, eggs, meat and other proteins (including 2 portions of fish every week, one of which should be oily);
  • Choose unsaturated oils and spreads and consuming in small amounts;
  • Drink 6-8 cups/glasses of water a day;
  • Adults should have less than 6g of salt and 20g of saturated fat for women or 30g for men a day.

Source: NHS Eatwell Guide 

Diets that incorporate some meat, such as the Mediterranean diet, has been shown to boost heart health and lower the risk of developing type 2 diabetes, high blood pressure and raised cholesterol.

Those following the diet eat lots of vegetables, fruit, beans and wholegrains, with moderate amounts of fish, white meat and low-fat dairy. 

Professor Frikke-Schmidt admitted that she follows a mainly plant-based diet with some chicken and white fish.

She said meat did not have to be excluded but emphasised that a diet high in plant products is ‘good for both health and the environment’.

The team noted that the vegetarian and vegan participants in the study followed healthy diets packed with vegetables, fruits, nuts, pulses and wholegrains.

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Professor Aedin Cassidy, chair nutrition and preventive medicine from Queen’s University Belfast, warned that ‘not all plant-based diets are equal’.

‘Those including refined carbohydrates, processed foods high in fat/salt’ would still be unhealthy, she told the BBC.

Supermarket shelves are packed with ultra-processed vegan foods, such as vegan bacon, mayonnaise and ready meals.

And a major review by the United Nations this month concluded that vegan diets are ‘less healthy’ than those including meat, eggs and milk. 

It found that animal products are ‘crucial sources of much-needed nutrients’ that are hard to find in a meat-free diet, such as protein, iron and calcium. 

Dr Duane Mellor, a leading dietitian from Aston University, said those considering a change in their diet should discuss it with a health professional to ensure it is nutritionally adequate and address their health concern.

Tracy Parker, senior dietitian at the British Heart Foundation, said: ‘This study only looked at people eating strict vegan and vegetarian diets over a short period of time, and some people can find it hard to consistently follow these diets long-term.

‘Some may find it easier to follow a Mediterranean-style diet that features plenty of fruit, vegetables, pulses, wholegrains, fish, eggs and low fat dairy, with only small amounts of meat.

‘If you want to make healthy changes to your diet, a great place to start is the Eatwell guide, which is the basis for our healthy eating recommendations in the UK.’



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