Plant-based meat alternatives don’t appear to offer cardiovascular health benefits for Asians – RCT
Researchers in Singapore found that a plant-based meat analogues diet did not show significant cardiometabolic health benefits for Asians compared to an omnivorous diet, prompting a need to relook at the composition and nutrition profile of plant-based alternatives.
“In conclusion, despite the emergence of plant-based meat analogues as a source of alternative protein foods within the global food system, the results of the current study do not substantiate superior cardiometabolic health benefits of plant-based meat analogues compared to an omnivorous diet composed of animal-based meats,” wrote the researchers in The American Journal of Clinical Nutrition.
“Along with the other cardiometabolic health outcomes measured and contrary to our research hypothesis, we failed to substantiate any clear benefits for plant-based meat analogues on cardiometabolic health, as compared to the corresponding animal-based meat diet.”
With the growing popularity of plant-based meat analogues, an examination of their effects on health is warranted in an Asian population. Additionally, a recent meta-analysis concluded that a replacement of red meat with other animal-based white meats and/or plant-based protein sources such as soy may not confer beneficial effects on glycemic regulation, which is crucial in managing diabetes. The researchers thus found it crucial to investigate the impact of consuming an omnivorous animal-based meat diet compared to a plant-based meat diet on cardiometabolic health among adults with elevated risk of diabetes in Singapore.
From June 2022, researchers recruited ethnic Chinese males and females from 30 to 70 years old across Singapore for an 8-week parallel design RCT. The participants were without diabetes but had a profile of raised blood glucose and thus more prone to metabolic diseases. The participants were also non-vegan or non-vegetarian and consumed protein-rich foods daily.
Eighty-two participants were allocated into two groups: 40 were allocated to the plant-based meat analogue diet group and 42 to the animal-based meat diet group.
Over 8 weeks, participants substituted their usual protein-rich foods with fixed quantities of either animal-based meats or their corresponding plant-based meat analogues provided by the research team. All foods were sourced from independent retailers that were unaffiliated with the study sponsor and research team. To address the issue that plant-based meat analogues tend to be highly processed, the selection of corresponding animal-based foods consists of similarly processed frozen foods like sausages, chicken nuggets, and burger patties. This is to prevent outcome bias that may stem from one group of foods being more processed than the other.
During the trial period, a subset of the study participants volunteered for optional components of the RCT. Thirty-seven took part in an additional 14-day continuous glucose monitoring, and 40 took part in two sessions of 24-hour ambulatory blood pressure monitoring.
At the end of 8 weeks, the researchers analysed the following data: LDL-cholesterol levels, cardiometabolic risk factors and dietary information, ambulatory blood pressure measurements and glucose levels.
It was found that there was an increase in dietary trans-fat among the participants in the animal-based meat diet; In the plant-based meat analogue diet group, there was an increase in dietary fibre, sodium and potassium; There were no significant effects on the lipoprotein profile, including LDL-cholesterol; Nocturnal diastolic blood pressure was markedly increased in the animal-based group and was lower in the plant-based group; Fructosamine (a blood test used to measure average blood glucose levels) and beta-cell function (performance of insulin-producing cells) improved for both groups. Glycemic homeostasis (maintenance of glucose levels) was better regulated in the animal-based diet group. The plant-based analogue meat diet had no significant effect on the other outcomes examined.
“A plant-based meat analogues diet did not show widespread cardiometabolic health benefits compared with omnivorous diets over 8 weeks,” observed the researchers.
Furthermore, for those who underwent the continuous glucose monitoring, glycemic management was more effective in the animal-based meat group. This could be linked to lower carbohydrate intake and increased protein consumption compared with the plant-based group.
“Although protein bioavailability was not evaluated at present, emerging evidence suggests attenuated digestion and absorption of plant-based meat analogue proteins compared to animal-based meats, which can in turn differentially influence insulin secretion and the production of various gut hormones. This was linked to several factors including the higher molecular weight and poorer solubility of plant-proteins, anti-nutritional factors, as well as food matrix complexity which may impair protein digestibility, absorption, and thus indirectly influence glycemic response,” explained the researchers.
The 24-hour ambulatory blood pressure assessments likewise revealed modest improvements after an animal-based meat diet and not a plant-based meat analogue diet.
“These findings suggest that despite the well-documented health benefits of traditional plant-based diets, their health benefits should not be conflated with plant-based meat analogue diets which are distinct in both their nutrition, as well as its impact on cardiometabolic disease risk,” said the researchers.
Plant-based meat analogues are processed to mimic animal-based meat, while traditional plant-based foods typically consist of minimally processed whole foods that are consistently associated with improved cardiometabolic health.
“Dietary incorporation of PBMAs in particular may influence nutritional intake and potentially compromise glycemic management. This suggests that assumptions of health benefits from consuming a PBMD may not be directly extrapolated to those consuming a PBD. However, this creates an opportunity and stimulus for the food industry to re-evaluate the production of next generation PBMAs with improved nutritional attributes and bioaccessibility. The inclusion of nutrition to the current focus on organoleptic properties and sustainability will be beneficial to both the manufacturers and the consumers in this Asian population and globally,” concluded the researchers.
Source: The American Journal of Clinical Nutrition
DOI: https://doi.org/10.1016/j.ajcnut.2024.04.006
“Plant-Based Meat Analogs and Their Effects on Cardiometabolic Health: An 8-Week Randomized Controlled Trial Comparing Plant-Based Meat Analogs With Their Corresponding Animal-Based Foods”
Authors: Darel Wee Kiat Toh, Amanda Simin Fu et al.
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