Plant-based meat alternatives and cardiometabolic health: a systematic review and meta-analysis

IF 6.5 1区医学 Q1 NUTRITION & DIETETICS

American Journal of Clinical Nutrition Pub Date : 2025-02-01 DOI:10.1016/j.ajcnut.2024.12.002

Rubén Fernández-Rodríguez , Bruno Bizzozero-Peroni , Valentina Díaz-Goñi , Miriam Garrido-Miguel , Gabriele Bertotti , Alberto Roldán-Ruiz , Miguel López-Moreno

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Abstract

Background

Plant-based meat alternatives (PBMAs) are emerging in global markets. However, the effects of substituting meat for PBMAs on cardiometabolic health are uncertain.

Objectives

This study aimed to determine the effects of replacing meat consumption by PBMAs on cardiometabolic parameters in adults.

Methods

Five databases were systematically explored from inception to July 2024, searching for RCTs assessing the effects of replacing meat consumption by PBMAs on cardiometabolic parameters in adults without cardiovascular diseases. Meta-analyses were conducted when ≥4 studies addressed the same outcome (i.e. blood lipids, blood pressure, fasting glucose, and body weight). Pooled raw mean differences (MDs) with their 95% CIs were estimated using a random-effects method. Sensitivity analyses were conducted to assess the robustness of our estimates.

Results

Eight publications from 7 RCTs comprising 369 adults (60% females; mean age range: 24–61 y) were included. The substitution of PBMAs for meat was associated with significant reductions in LDL-cholesterol: −0.25 mmol/L (95% CI: −0.42, −0.08 mmol/L; I² = 65.8%; n = 7), total cholesterol (TC): −0.29 mmol/L (95% CI: −0.52, −0.06 mmol/L; I² = 64.8.%; n = 6), and body weight: −0.72 kg (95% CI: −1.02, −0.42 kg; I² = 0%; n = 5). No significant changes were shown in HDL-cholesterol, triglycerides, blood pressure, or fasting glucose concentrations. Sensitivity analyses considering mycoprotein-based alternatives showed a significant reduction in LDL-cholesterol (MD: −0.37 mmol/L; 95% CI: −0.61, −0.13 mmol/L; I² = 52.5%; n = 4), and TC (MD: −0.39 mmol/L; 95% CI: −0.56, −0.21 mmol/L; I² = 0%; n = 4).

Conclusions

Our findings suggest substituting PBMAs for meat for ≤8 wk lowered TC (6%), LDL-cholesterol (12%), and body weight (1%) in adults without cardiovascular diseases. PBMAs may facilitate the transition to a plant-based diet, but long-term studies are needed to evaluate their cardiometabolic effects.

This trial was registered at PROSPERO as CRD42024556191.

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植物性肉类替代品与心脏代谢健康：系统回顾和荟萃分析。

背景：植物性肉类替代品（pbma）正在全球市场上兴起。然而，用肉类代替pbma对心脏代谢健康的影响尚不确定。目的：确定用PBMAs代替肉类消费对成人心脏代谢参数的影响。方法：系统地检索了5个数据库，从建立到2024年7月，寻找随机对照试验（rct），评估用pbma代替肉类消费对无心血管疾病成年人心脏代谢参数的影响。当至少有四项研究涉及相同的结果（即血脂、血压、空腹血糖和体重）时，进行荟萃分析。使用随机效应方法估计汇总原始平均差异（MDs）及其95%置信区间（ci）。进行敏感性分析以评估我们估计的稳健性。结果：来自7项随机对照试验的8篇出版物，包括369名成年人(60%为女性；平均年龄24-61岁)。用pbma替代肉类与低密度脂蛋白胆固醇（LDL-c）显著降低相关：-0.25 mmol/L (95%CI: -0.42, -0.08；I2 = 65.8%；n = 7)，总胆固醇（TC）： -0.29 mmol/L (95%CI: -0.52, -0.06；I2 = 64.8.%；n = 6)，体重：-0.72 kg (95%CI: -1.02, -0.42；I2 = 0%；n = 5)。高密度脂蛋白、胆固醇、甘油三酯、血压或空腹血糖均未见显著变化。考虑以真菌蛋白为基础的替代品的敏感性分析显示LDL-c显著降低(MD = -0.37 mmol/L, 95%CI: -0.61, -0.13；I2 = 52.5%；n = 4)和TC (MD = -0.39 mmol/L, 95%CI: -0.56, -0.21；I2 = 0%；结论：我们的研究结果表明，在没有心血管疾病的成年人中，用pbma代替肉类长达8周可降低TC（6%）、LDL-c（12%）和体重（1%）。pbma可能促进向植物性饮食的过渡，但需要长期研究来评估其心脏代谢作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Clinical Nutrition 医学-营养学

CiteScore

12.40

自引率

4.20%

发文量

332

审稿时长

38 days

期刊介绍： American Journal of Clinical Nutrition is recognized as the most highly rated peer-reviewed, primary research journal in nutrition and dietetics.It focuses on publishing the latest research on various topics in nutrition, including but not limited to obesity, vitamins and minerals, nutrition and disease, and energy metabolism. Purpose: The purpose of AJCN is to: Publish original research studies relevant to human and clinical nutrition. Consider well-controlled clinical studies describing scientific mechanisms, efficacy, and safety of dietary interventions in the context of disease prevention or health benefits. Encourage public health and epidemiologic studies relevant to human nutrition. Promote innovative investigations of nutritional questions employing epigenetic, genomic, proteomic, and metabolomic approaches. Include solicited editorials, book reviews, solicited or unsolicited review articles, invited controversy position papers, and letters to the Editor related to prior AJCN articles. Peer Review Process: All submitted material with scientific content undergoes peer review by the Editors or their designees before acceptance for publication.