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

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

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

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.

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).

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.