What are the benefits of a high fruit, plant-based diet with limited animal protein (meat or shellfish) consumption, defined as less than one time per week?

From the Guidelines

A high fruit, plant-based diet with meat or shellfish consumed less than once weekly is strongly recommended due to its association with a significant reduction in all-cause mortality and cardiovascular mortality, as supported by the 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease 1. This dietary pattern has been consistently associated with lower risk of chronic diseases, including heart disease, type 2 diabetes, and certain cancers. The key benefits of this diet include:

• Reduced risk of all-cause mortality, with a 41% reduction in mortality rate noted in the PREDIMED cohort with the highest vegetarian score 1
• Lower risk of cardiovascular mortality, with a 30% reduction in the combined endpoint of MI, stroke, or cardiovascular mortality in the PREDIMED trial 1
• Improved blood lipid profiles and vascular function, with regular nut consumption shown to improve endothelial function and reduce total cholesterol, LDL, and triglycerides 1
• Promotion of a diverse gut microbiome, with plant-based diets associated with greater gut microbial diversity and more favorable changes in the microbiota 1
• Reduced chronic inflammation, with plant foods rich in anti-inflammatory compounds that may reduce chronic inflammation, a contributor to many diseases
• Environmental sustainability and adequate nutrition, with a focus on whole foods rather than processed plant products, and consideration of a vitamin B12 supplement if animal product consumption is very limited. The evidence from the 2019 ACC/AHA guideline and the perspective on modernizing the definition of protein quality 1 supports the benefits of a high fruit, plant-based diet with limited animal product consumption, making it a recommended dietary pattern for reducing morbidity, mortality, and improving quality of life.

From the Research

Benefits of a High Fruit Plant-Based Diet with Limited Meat or Shellfish Consumption

• A high fruit plant-based diet with meat or shellfish consumption less than once a week may have several health benefits, including:
  • Lower risk of certain diseases such as ischemic heart disease, diabetes, and diverticular disease 2
  • Lower BMI, serum LDL cholesterol, and blood pressure compared to regular meat-eaters 2
  • Higher intakes of dietary fiber, vitamin E, and other beneficial nutrients 3
• However, it is also important to note that a plant-based diet may have some potential risks, such as:
  • Lower intakes of certain micronutrients like vitamin B12, vitamin D, calcium, and iodine, particularly in vegans 2, 3
  • Higher risk of stroke, bone fractures, and other health conditions if not properly planned 2

Nutritional Considerations

• A well-planned high fruit plant-based diet with limited meat or shellfish consumption can provide adequate nutrition, but it is essential to:
  • Ensure sufficient intake of protein, omega-3 fatty acids, iron, and zinc from plant-based sources 3
  • Consider supplementation or fortification of certain nutrients like vitamin B12, vitamin D, and omega-3 fatty acids if necessary 3, 4, 5
• Omega-3 fatty acids, in particular, have been shown to have potential benefits for cardiovascular health, although the evidence is mixed 4, 5, 6

Cardiovascular Health

• Some studies suggest that omega-3 fatty acids may slightly reduce the risk of coronary heart disease mortality and events, as well as reduce serum triglycerides 4, 5
• However, other studies have found little or no effect of omega-3 fatty acids on cardiovascular health, and the evidence is not yet conclusive 4, 5, 6