Cardiovascular disease is currently the leading cause of death globally, resulting in more than 18 million deaths annually. The United Nations’ Sustainable Development Agenda aims to reduce premature deaths caused by non-communicable diseases, including cardiovascular disease, by one-third by 2030. 

How can a plant-based diet help? It turns out, there is a significant connection between vegetarian and vegan diets and lower levels of cholesterol and fats in the bloodstream, according to a comprehensive analysis of randomized trials conducted since 1982. 

The new study’s findings, published in the European Heart Journal, suggest that plant-based diets can play a crucial role in reducing the incidence of blocked arteries and lowering the risk of heart and blood vessel diseases such as heart attacks and strokes.

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The study was led by Professor Ruth Frikke-Schmidt, Chief Physician at the Rigshospitalet—the largest public and teaching hospital in Copenhagen, Denmark—along with medical student Caroline Amalie Koch and Dr. Emilie Westerlin Kjeldsen. It examined 30 randomized trials involving 2,372 participants. 

These trials, published between 1982 and 2022, assessed the impact of vegetarian or vegan diets compared to omnivorous diets on various cholesterol markers, including total cholesterol, LDL cholesterol (often referred to as “bad” cholesterol), triglycerides, and apolipoprotein B (apoB) levels, which helps to carry fat and cholesterol around the body. 

Notably, previous meta-analyses on this topic did not consider the influence of factors such as continent, age, body mass index, and health status, nor did they specifically investigate the effect of diet on apoB concentrations.

Plant-based diet lowers cholesterol levels

The results indicated that vegetarian and vegan diets were associated with a 14 percent reduction in apoB levels, which are indicative of artery-clogging lipoproteins. This reduction is equivalent to about one-third of the impact of cholesterol-lowering medications like statins and could result in a 7 percent decrease in the risk of cardiovascular disease for individuals maintaining a plant-based diet for five years. 

However, the study authors note that combining statins with plant-based diets could potentially have a synergistic effect and yield even greater benefits.

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The researchers also emphasized the importance of adopting vegetarian or vegan diets from an early age, as doing so could significantly reduce the risk of cardiovascular diseases caused by blocked arteries.

“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,” Frikke-Schmidt said in a statement.

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

The 30 trials included participants who were randomly assigned to follow either a vegetarian or vegan diet or continue with their omnivorous diet, which included meat and dairy products. The duration of these diets varied from 10 days to five years, with an average of 29 weeks.

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Compared to those following an omnivorous diet, individuals adhering to plant-based diets experienced an average 7 percent reduction in total cholesterol levels, a 10 percent decrease in LDL cholesterol levels, and a 14 percent decrease in apoB levels.

Frikke-Schmidt noted that significant effects were observed in both vegetarian and vegan diets, regardless of the participants’ weight. “We saw significant effects from both vegetarian and vegan diets and people ranging from a normal weight to obese,” Frikke-Schmidt said.

Benefits of a plant-based diet

In addition to lowering the risk of many life-threatening diseases, there is growing concern about the environmental impact of our dietary choices. Recent systematic reviews have highlighted that shifting populations in high-income countries towards plant-based diets can reduce greenhouse gas emissions by 35 percent to 49 percent. 

The study underscores the robust evidence that plant-based diets offer health benefits for individuals of various sizes, ages, and health conditions. Frikke-Schmidt stressed the need for a varied, plant-rich diet, along with a preference for water as the beverage of choice.

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“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,” Frikke-Schmidt said. “We should be eating a varied, plant-rich diet, not too much, and quenching our thirst with water.”

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