Can a vegetarian diet protect against heart failure?

Can a vegetarian diet protect against heart failure?

Heart disease affects around 523 million people annually and is the leading cause of death worldwide, with 18.6 million deaths from heart disease reported in 2019 (1).

It is also a major cause of disability. The number of people with a disability due to heart disease has more than doubled in the past 30 years (1).

Fortunately, you can influence your heart disease risk through many healthy, modifiable behaviors, including what you eat (although diet not The only factor affecting the risk of heart disease).

Experts suggest that a higher intake of fruits, vegetables, whole grains, nuts, seeds, and legumes, and a lower intake of saturated fat, salt, refined sugar, and processed meat may help reduce the risk of heart disease (2And 3).

Plant foods appear to be particularly beneficial for heart health, which has led some to suggest that a plant-based diet may offer significant protection against heart disease (3And 4).

In this article, I will explore the potential links between a plant-based diet and heart health to determine whether a (mostly) vegetarian or vegan diet can help reduce heart disease risk.

A plant-based diet can include several different ways of eating. However, all types of plant-based diets generally involve little or no animal foods, including meat, fish, dairy, eggs, or foods with these ingredients.

The label “plant-based” can refer to both vegetarian and vegan diets, and to some extent, even semi-vegetarian diets, as long as the bulk of the foods eaten are of plant origin (3And 5).

Plant-based diets as a whole have been consistently linked to a lower risk of heart disease (3And 6And 7And 8).

Reviews of observational studies indicate that people who eat plant-based foods may benefit from an 8 to 32% lower chance of developing or dying from heart disease compared to omnivores (3And 7And 8).

Interestingly, this benefit appeared to be stronger in younger versus older participants, male versus female, and in those who followed a plant-based diet for longer versus shorter periods of time (3).

However, keep in mind that the link between plant-based diets and heart disease is currently mostly observational. This means that it has not yet been examined by randomized control trials (RCTs), the gold standard in scientific research.

However, several randomized controlled trials show that a plant-based diet may significantly reduce heart disease risk factors, such as total cholesterol and low-density lipoprotein cholesterol (LDL or “bad”) cholesterol, compared to a diet containing meat or eggs. or dairy products (3).

People who follow a vegetarian diet also tend to have lower blood pressure and better blood sugar levels than people who follow carnivorous diets—both of which are additional risk factors for heart disease (3).

It should be noted that while individual studies comparing plant-based diets to omnivorous diets often report benefits for the heart, a recent review that combined the results of several studies suggests that the evidence remains weak due to a lack of High quality studies (9).

The same review also notes that vegetarians may have an increased risk of stroke by up to 35% compared to omnivores. Results appear to vary depending on the type of stroke as well as the overall quality of the plant-based diet consumed (9And 10And 11).

However, several other studies have found no link between a vegetarian or vegan diet and stroke risk — or a decreased rather than increased stroke risk. Therefore, more research is needed on this topic before strong conclusions can be made (11And 12And 13And 14).


Plant-based diets appear to reduce some risk factors for heart disease and are generally associated with a lower risk of developing or dying from heart disease when compared to diets containing animal foods. Many of the studies are of low quality, however, and more research is needed.

Vegetarian diets tend to focus on foods that are naturally low in calories and high in fiber, two traits that can help you maintain a healthy weight (3).

Furthermore, plant foods tend to be low in saturated fats and high in trans fats.

A diet rich in unsaturated fats and low in saturated fats may help reduce inflammation, lower bad (LDL) cholesterol, and increase high-density lipoprotein (HDL or “good”) cholesterol, thereby improving risk factors for heart disease (3).

Replacing saturated fats with monounsaturated and polyunsaturated fats may improve insulin sensitivity and help reduce the risk of type 2 diabetes, which is also a risk factor for heart disease (3And 16And 17).

This trade-off also appears to help your body maintain healthy arteries and veins, enabling it to repair better when necessary (3And 16And 17).

Additionally, a vegetarian diet tends to be rich in soluble fiber, a type of fiber that may help lower cholesterol levels and promote better blood sugar management (3And 18).

Plant-based foods are usually rich in antioxidants and other beneficial plant compounds that help reduce inflammation and protect the heart and body from damage (3).

These compounds may also help lower blood pressure and reduce the possibility of blood clots, thus reducing the overall risk of stroke (3).

Furthermore, vegan diets do not actually contain heme iron. Consumption of large amounts of heme iron has been reported as a potential risk factor for heart disease (3And 19And 20And 21).

Heme iron is generally found in animal foods such as red meat, fish, poultry, and seafood, while plant foods typically contain non-heme iron (22).

In addition to non-heme iron, plant foods are naturally rich in many vitamins. This combination appears to be particularly beneficial in reducing the risk of death from heart disease (19).

Other factors to consider are sodium, nitrate, and nitrite that are commonly used to preserve processed meats.

Consuming these preservatives has been linked to high blood pressure, as well as to narrowing, hardening or enlargement of blood vessels — all of which increase the risk of heart disease (3).

Sodium, nitrate, and nitrite also appear to reduce your body’s ability to respond to insulin, the hormone that helps manage blood sugar levels by delivering sugar from your blood into your blood cells (3).

In contrast, insulin resistance may increase the likelihood of suffering from poor blood sugar management, another risk factor for heart disease (23).

Finally, plant-based diets may also reduce the risk of heart disease through their effect on gut bacteria. However, more research is needed to confirm this (3).

Learn more about the potential health benefits of consuming less meat here.


Vegetarian diets tend to be naturally rich in fiber and antioxidants, but low in calories, heme iron, and saturated fat. This balance may protect your heart by reducing certain risk factors for heart disease.

The likelihood that a plant-based diet will reduce the risk of heart disease will largely depend on its quality. The following tips may help support your health if you choose to try a plant-based diet.

Choose minimally processed foods when possible

Plant-based diets rich in fruits, vegetables, whole grains, legumes, nuts, seeds, and other processed plant foods have been linked to a minimal risk of heart disease (8).

On the other hand, plant-based diets rich in sweetened beverages, refined grains, sweets, and highly processed plant foods have been linked to higher risks of heart disease or death (5And 8And 24).

Therefore, in order to get the most benefits from your vegan diet, you should ensure that it consists of primarily minimally processed plant foods, if possible.

In practice, this might look like this:

  • They often choose whole grains instead of refined grains
  • Often choose beans, peas, tofu or tempeh rather than alternatives to processed meat
  • Including good amounts of fresh fruits and vegetables in your diet
  • Eat good amounts of nuts and seeds

(Remember: the term “processed foods” includes a variety of products, many of which are more convenient and less expensive than other foods. Not all processed foods are considered unhealthy or harmful.)

Supplement to fill nutritional gaps

I also encourage you to consider using supplements or fortified foods to meet your nutritional requirements if you struggle to meet them from your vegetarian diet alone (25).

Deficiencies of certain nutrients, such as adequate vitamin B12, may help explain the association between plant-based diets and an increased risk of stroke found in some studies (11).

Some nutrients to pay special attention to in a vegetarian diet include vitamin B12, iodine, iron, calcium, zinc, selenium, and omega-3 fatty acids (25And 26And 27).

Be sure to speak with a medical professional before starting to take supplements or change your diet, if possible. A registered dietitian can help you figure out how to modify your diet in a way that makes it easier to meet your nutritional requirements while eating plant-based.

You don’t have to go all-vegan to reap the heart benefits

Your diet does not need to completely exclude all animal products so that you can enjoy the heart-healthy benefits.

In general, the higher the proportion of plant foods in the diet, the higher the degree of protection (3And 28).

However, you don’t have to give up animal products to lower your risk of heart disease.

Research indicates that healthy plant-based diets, such as plant-based diets and the Mediterranean diet, which are rich in plant foods, can significantly reduce the risk of heart disease and may help improve other aspects of health as well (5And 29And 30And 31And 32).

Learn more about the differences between vegetarian, vegan, and fish diets here.

If you choose to include meat in your diet, the American Heart Association recommends preferring fish and lean meat over red or processed meat (2).


To get the most heart benefits from your plant-based diet, it’s usually best to choose foods with minimal processing and limit red or processed meat. You can also consider using supplements if you need to.

A plant-based diet appears to be effective in reducing risk factors for heart disease and is generally associated with a lower likelihood of exposure or death from heart-related issues, but more research is needed because many of the current studies are flawed.

Additionally, not all plant-based diets are equally effective in promoting heart health.

To get the most benefits, make sure your diet includes good amounts of fruits, vegetables, whole grains, legumes, nuts and seeds and doesn’t rely on refined grains, sweetened drinks, and highly processed plant foods.

Keep in mind that you don’t need to cut out all animal foods to experience heart-healthy benefits. However, the more plant foods in your diet, the better the protection against heart disease.

2022-05-10 14:02:18

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