Hey Doc! Are Plant-Based Meat Alternatives Healthy?
Eating more plant-based foods and eating less animal based foods has been described as a “win win situation” for our health and the environment. We know that shifting from animal foods to healthful plant-based foods is associated with lower risk of chronic diseases (diabetes, heart disease, cancer and obesity) and total mortality (death), but how do plant-based meat alternatives (PBMAs) fit into this? According to a recently published study by Curtain et al, there are over 4400 PBMA products worldwide that are designed to mimic the taste, texture and appearance of their animal based counterparts. These PBMAs are marketed toward consumers who eat meat in hopes they will choose the plant-based version. One of the most common questions that I get asked is “are these PBMAs healthy?” In order to answer this question, we first must go one step further and ask ourselves, “in comparison to what?”
For example, one of the most popular PBMAs is burgers. These products are different from your run of the mill “veggie burgers” which don’t have the same mouthfeel as a beef patty. On a recent grocery trip, I took two pictures of nutrition facts labels for two popular brands of PBMA burger and one for a grass-fed beef burger. Her is how they compare side by side:
When strictly looking at the label, the total and saturated fat in this specific brand of beef patty vs the Beyond Meat burger isn’t that much different. The Impossible burger has less total fat compared to the beef burger and Beyond Meat burger, but more saturated fat overall. The Beyond Meat burger and Impossible burger are higher in sodium as this is added during the processing of these burgers. Both Beyond Meat burger and Impossible burger have more grams of protein & fiber with no cholesterol. Fiber is inherently not found in animal based foods and cholesterol is inherently not found in plant-based foods. There is more iron in the plant-based burgers but we know that iron is more readily absorbed from meat (heme iron), however, the Impossible burger does contain genetically engineered “heme,” soy leghemoglobin. At this time we don’t have studies that compare the Impossible burger to its other PBMA counterparts to determine if there is a change in iron absorption. The genetically engineered heme was created to give it a more “meaty” flavor.
As you can see, these are just a few of the brands of PBMAs out there, which makes the comparison aspect exceptionally challenging.
There is a paucity of research studies comparing PBMA to their animal counterparts and evaluating health outcomes. However there is one recently published study called the SWAP-MEAT trial. In this small (36 participants completed study) 16 week clinical trial, healthy omnivores ate at least two servings a day of PBMA (provided by Beyond Meat, included several varieties) or the animal based equivalent for 8 weeks and then swapped to the opposite group for another 8 weeks. They were asked to keep the rest of their day to day eating and physical activity the same.
The study found a statistically significant decrease in LDL cholesterol (decrease on average of 11 points) and weight (decrease on average of 1 kg) which were lower during the PBMA consumption phase of the trial. Larger trials comparing a variety of PBMA to their animal based counterparts are needed.
Another recently published study by Curtain et al profiled and compared PBMAs with equivalent meat products available in Australian supermarkets. The authors specifically looked at nutrition composition of the PBMAs to comparable animal products. The paper found that PBMAs compared to their meat counterparts tended to be lower in overall calories, higher in carbohydrates, sugar and fiber. The sodium (salt) content varied widely & was generally higher in plant based meat minces. Less than a quarter of the PBMAs products were fortified with iron, vitamin B12 or zinc.
Another common question I get is, are PBMAs considered processed? The answer to this is yes, and some meet the criteria of ultra-processed according to the NOVA food classification system. They don’t really resemble the “whole foods” they are derived from (for example, soy protein concentrate).
On the flip side, one can‘t forget that the World Health Organization’s International Agency for Research on Cancer classifying processed meat as carcinogenic to humans and red meat as “probably carcinogenic” to humans. Red and processed meat consumption is also associated with an increased risk of colorectal cancer in a recently published large prospective cohort study.
Some may argue that beef is “just one ingredient” i.e not processed, but it is one ingredient whose production takes an immense amount of resources and thus I think an even more compelling reason to substitute sources of animal based products with PBMAs is for planetary health. By the year 2050, there will be 10 billion people on this Earth that need to be fed sustainably without further destroying our planet.
The EAT-Lancet Commission, a group of 37 scientists from 16 countries published the EAT-Lancet report in Jan 2019, the FIRST full scientific review of what constitutes a healthy diet from a sustainable food system, and which actions can support and speed up food system transformation. The key analysis of this report shows that a “safe operating space for food systems” requires a substantial shift toward a planetary healthy eating pattern, reduction in food loss and food waste, in addition to improvements in food production. A planetary healthy eating pattern includes a diversity of plant-based foods, lower amounts of animal sourced foods, & limited amounts of refined grains, ultra-processed foods and added sugars. The commission projects that shifting to a more planetary sustainable diet could prevent 11 million deaths per year.
With all this said, the overall composition dietary pattern matters! I wouldn’t consider a dietary pattern that solely incorporates PBMAs as the primary source of plant-based foods as healthy in and of itself but it does have a role to play. I think at the end of the day, no matter what dietary pattern you follow, a diet rich in whole plant-foods such as fruits, vegetables, beans, legumes, nuts, seeds, and whole grains is definitely healthful and this fact is what should be emphasized.
My final thoughts: As a physician, I am in an unique position to not only advocate for a healthful dietary pattern for disease prevention and treatment but also for the health of our planet. This is why I don’t demonize PBMAs because I do think they can play a role as a “stepping stone” to help individuals who want to eat less meat. Enjoyability of day to day eating is CRUCIAL to making healthful lifelong changes. I am not here to tell you exactly what to eat, but I hope to inspire you to make healthy eating habits no matter what dietary pattern you follow. In alignment with this goal, incorporating healthful plant-based foods is beneficial in a number of ways. I view PMBAs as a “tool” in the tool box of taking steps toward a more healthful eating pattern. Going 0 to 60 doesn’t work for most, and that’s the truth.
Sources:
Bradbury et al. “Diet and Colorectal Cancer in UK Biobank: A prospective study. International Journal of Epidemiology, Volume 49, Issue 1, February 2020, Pages 246–258
Crimarco et al. SWAP MEAT trial. Am J Clin Nutr 2020; 112: 1188–1199
Curtain, F. Grafenauer S. “Plant-Based Meat Substitutes in the Flexitarian Age: An Audit of Products on Supermarket Shelves” Nutrients 2019
Hu, Frank. “Can Plant-Based Meat Alternatives Be Part of a Healthy and Sustainable Diet?” JAMA Oct 2019. 1547–1548
The EAT Lancet Report
