Do the Health Impacts of Ultra-Processed Foods Apply to Plant-Based Meat Alternatives?

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If the only ultra-processed food that appears to be killing people is meat, then plant-based meats may be the solution to the ultra-processed foods problem.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

In two Harvard cohorts, researchers followed about a hundred thousand men and women for decades, and found that high consumption of ultra-processed foods is associated with dying earlier––which provides support for limiting consumption of certain types of ultra-processed foods for long-term health: in particular, processed meat/poultry/seafood, which generally showed the strongest and most consistent associations with mortality. So here, the negative, life-shortening effects of ultra-processed foods was really mostly talking about the negative, life-shortening effects of processed meats––like burgers, chicken nuggets, and fish sticks. But the association between more ultra-processed foods and higher mortality appears to be present even among vegetarians.

Yes, plant-based diets, which reduce or avoid eggs, dairy, fish, and other meats, have been linked to a reduced risk of various chronic diseases, including our leading killer—cardiovascular disease. But that doesn’t mean you can live off vegan doughnuts. Non-ultra-processed plant foods, like fruits and vegetables, are associated with lower risk of disease, but ultra-processed foods, like Oreos and Mountain Dew, are associated with higher risks. So, dietary guidelines shouldn’t just tell people to cut down on meat and other animal-sourced foods, but also to cut down on junk. No big surprise, but this is how the paper was reported on: “The hidden health hazards of vegan sausages.” “Vegan fake meats are linked to increase in heart deaths.” What? If you look at the study, meat alternatives only made up 0.2 percent of their diet. In the study, 39.4 percent of their diet was composed of ultra-processed plant foods, but only about one 500th of their intake was meat alternatives. The study participants were eating 30 times more pastries. Aren’t those more likely to be the culprit in the relationship between ultra-processed foods and disease? They ate 14 times more French fries and candy. Even four times more vodka and other hard liquor. But how much clickbait are you going to get telling people vodka and cream puffs aren’t good for you?

If you really want to see if meat alternatives were an issue, you’d have to run more granular studies that separate out meat alternatives for analysis. This study on obesity had an eclectic category of ultra-processed “fruits and vegetables” that included meat alternatives along with powdered soup and fruit compote, and there was no tie to obesity. The culprits were mostly soda, ice cream, mayonnaise, baloney, fish sticks, and the like. But ideally, we’d have a study big enough to completely separate out plant-based meat.

If only there were some epic study. And indeed, here it is, the EPIC study. More than a quarter million people were followed for more than a decade. Yes, higher consumption of ultra-processed foods increases the risk of cancer and cardiometabolic multimorbidity, like cardiovascular disease and diabetes. Yes, but which ultra-processed foods? It’s the animal-based ultra-processed foods, like processed meat, and soda. There was no associated risk with ultra-processed breads and cereals or plant-based meat.

And when it comes to diabetes, plant-based meats and milks appeared to cut the risk of developing diabetes in half. Animal-based products were associated with more than twice the risk. Plant-based alternatives were associated with less than half. The authors concluded that higher consumption of ultra-processed foods may increase the risk of cancer and other diseases. But their data really only show that the consumption of foods of animal origin and soft drinks is associated with such a risk, which is like, duh. Indeed, if you go back and exclude the animal-based foods and sodas, the relationship between ultra-processed foods and these multiple diseases disappears. So, the only ultra-processed food that appears to be killing people is meat. In that case, instead of being a contributor, plant-based meats may be the solution to the ultra-processed food problem.

The only other ultra-processed study that separated out plant-based meats looked at telomere length, which is used to measure cellular aging. Their study found that a higher consumption of total ultra-processed foods was associated with a shorter telomere length, which is a sign of accelerated aging. However, some subclasses may be associated with longer telomere length, suggesting slower aging. And the class of foods associated with the longest telomeres? Vegetarian alternatives—plant-based meat.

There have been other population studies on plant-based meats. This one found that those who ate plant-based meat daily appeared to cut their risk of hip fracture in half, compared to those eating it less than once a week. Schoolchildren who eat plant-based meats appear to have half the odds of being overweight compared to those eating regular meat. And girls who eat more meat start their periods at an earlier age, which may help explain why childhood meat consumption is linked to breast cancer later in life, since the earlier you start your period, the higher your lifetime risk. In contrast, those eating plant-based meats appear able to delay the onset of menstruation by nine months.

But observational studies like these can’t ever prove cause-and-effect. For that you need interventional trials. There have been 10 published up through 2023, and a few more since then. I did a video on the Stanford SWAP-MEAT study that showed swapping out a few servings a day of meat for plant-based meat alternatives for two months significantly decreased circulating levels of the microbiome toxin TMAO, as well as lowered LDL cholesterol and body weight. But there have been about a dozen other studies, including this four-year long randomized clinical trial, in which people with diabetes and ailing kidneys were randomized to replace half their animal protein intake with an ultra-processed plant-based meat replacement called TVP.

The researchers saw significant improvements in blood sugar control, cholesterol, triglycerides, inflammation, and significant improvements in their kidney function. I’ll cover all these studies. Stay tuned.

Please consider volunteering to help out on the site.

Motion graphics by Avo Media

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

In two Harvard cohorts, researchers followed about a hundred thousand men and women for decades, and found that high consumption of ultra-processed foods is associated with dying earlier––which provides support for limiting consumption of certain types of ultra-processed foods for long-term health: in particular, processed meat/poultry/seafood, which generally showed the strongest and most consistent associations with mortality. So here, the negative, life-shortening effects of ultra-processed foods was really mostly talking about the negative, life-shortening effects of processed meats––like burgers, chicken nuggets, and fish sticks. But the association between more ultra-processed foods and higher mortality appears to be present even among vegetarians.

Yes, plant-based diets, which reduce or avoid eggs, dairy, fish, and other meats, have been linked to a reduced risk of various chronic diseases, including our leading killer—cardiovascular disease. But that doesn’t mean you can live off vegan doughnuts. Non-ultra-processed plant foods, like fruits and vegetables, are associated with lower risk of disease, but ultra-processed foods, like Oreos and Mountain Dew, are associated with higher risks. So, dietary guidelines shouldn’t just tell people to cut down on meat and other animal-sourced foods, but also to cut down on junk. No big surprise, but this is how the paper was reported on: “The hidden health hazards of vegan sausages.” “Vegan fake meats are linked to increase in heart deaths.” What? If you look at the study, meat alternatives only made up 0.2 percent of their diet. In the study, 39.4 percent of their diet was composed of ultra-processed plant foods, but only about one 500th of their intake was meat alternatives. The study participants were eating 30 times more pastries. Aren’t those more likely to be the culprit in the relationship between ultra-processed foods and disease? They ate 14 times more French fries and candy. Even four times more vodka and other hard liquor. But how much clickbait are you going to get telling people vodka and cream puffs aren’t good for you?

If you really want to see if meat alternatives were an issue, you’d have to run more granular studies that separate out meat alternatives for analysis. This study on obesity had an eclectic category of ultra-processed “fruits and vegetables” that included meat alternatives along with powdered soup and fruit compote, and there was no tie to obesity. The culprits were mostly soda, ice cream, mayonnaise, baloney, fish sticks, and the like. But ideally, we’d have a study big enough to completely separate out plant-based meat.

If only there were some epic study. And indeed, here it is, the EPIC study. More than a quarter million people were followed for more than a decade. Yes, higher consumption of ultra-processed foods increases the risk of cancer and cardiometabolic multimorbidity, like cardiovascular disease and diabetes. Yes, but which ultra-processed foods? It’s the animal-based ultra-processed foods, like processed meat, and soda. There was no associated risk with ultra-processed breads and cereals or plant-based meat.

And when it comes to diabetes, plant-based meats and milks appeared to cut the risk of developing diabetes in half. Animal-based products were associated with more than twice the risk. Plant-based alternatives were associated with less than half. The authors concluded that higher consumption of ultra-processed foods may increase the risk of cancer and other diseases. But their data really only show that the consumption of foods of animal origin and soft drinks is associated with such a risk, which is like, duh. Indeed, if you go back and exclude the animal-based foods and sodas, the relationship between ultra-processed foods and these multiple diseases disappears. So, the only ultra-processed food that appears to be killing people is meat. In that case, instead of being a contributor, plant-based meats may be the solution to the ultra-processed food problem.

The only other ultra-processed study that separated out plant-based meats looked at telomere length, which is used to measure cellular aging. Their study found that a higher consumption of total ultra-processed foods was associated with a shorter telomere length, which is a sign of accelerated aging. However, some subclasses may be associated with longer telomere length, suggesting slower aging. And the class of foods associated with the longest telomeres? Vegetarian alternatives—plant-based meat.

There have been other population studies on plant-based meats. This one found that those who ate plant-based meat daily appeared to cut their risk of hip fracture in half, compared to those eating it less than once a week. Schoolchildren who eat plant-based meats appear to have half the odds of being overweight compared to those eating regular meat. And girls who eat more meat start their periods at an earlier age, which may help explain why childhood meat consumption is linked to breast cancer later in life, since the earlier you start your period, the higher your lifetime risk. In contrast, those eating plant-based meats appear able to delay the onset of menstruation by nine months.

But observational studies like these can’t ever prove cause-and-effect. For that you need interventional trials. There have been 10 published up through 2023, and a few more since then. I did a video on the Stanford SWAP-MEAT study that showed swapping out a few servings a day of meat for plant-based meat alternatives for two months significantly decreased circulating levels of the microbiome toxin TMAO, as well as lowered LDL cholesterol and body weight. But there have been about a dozen other studies, including this four-year long randomized clinical trial, in which people with diabetes and ailing kidneys were randomized to replace half their animal protein intake with an ultra-processed plant-based meat replacement called TVP.

The researchers saw significant improvements in blood sugar control, cholesterol, triglycerides, inflammation, and significant improvements in their kidney function. I’ll cover all these studies. Stay tuned.

Please consider volunteering to help out on the site.

Motion graphics by Avo Media

Doctor's Note

This is the video I mentioned: Are Beyond Meat Plant-Based Meat Alternatives Healthy?

If you missed the previous videos in this series, check out: 

Stay tuned for the rest of this extended video series on ultra-processed foods, coming out over the next several months.

If you don’t want to wait for each video to be released, we’ve compiled all the information into a brand-new book, Ultra-Processed Foods: Concerns, Controversies, and Exceptions.

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