Plant-based Meat Alternatives Study Spotlight Take-Away with Chef Dr. Mike

by Michael S. Fenster, MD

“One can talk good and shower down roses, but it’s the receiver that has to walk through the thorns, and all its false expectations.”
― Anthony Liccione

Plant-based meat alternatives, or PBMAs, came with a bold promise: Red Meat for the Masses. All the primal satisfaction of a hearty, meaty meal and none of the guilt. Even bolder was the promise of better health through the consumption of more plant-based comestibles. But that’s all they ever were—promises, hypotheticals based on extrapolations founded on assumptions. And they came with a patched-over Achilles’ heel: PBMAs are among the most ultra-processed of ultra-processed foods. A purported strength of a plant-based approach to diet is that it tends to emphasize whole, natural foods and thus decreases the amount of ultra-processed foods consumed. PBMAs as a healthy dietary option turn that strategy on its head, in effect, arguing that the ultra-processing means nothing as long as it is plant-based. This week’s study examined that proposition, at least over an eight-week period.

The Study:

  • The study consisted of 89 participants from Singapore, aged 30 to 70 with an elevated risk of type II diabetes.
  • The average participant age was 59, and the group was 61 percent female.
  • Participants were split into two groups: 45 participants consumed PBMAs and 44 participants consumed animal-based protein.
  • Results were available from 82 participants (40 from the plant-based group and 42 from the animal-based group).
  • The study was conducted from June 2022 to January 2023 and consisted of an eight-week intervention period for each participant.
  • The study measured cardiometabolic measures of health such as diastolic blood pressure, LDL-cholesterol, and glycemic homeostasis.

The Take-Away:

  • At the end of eight weeks, the PBMA-based diet did not exhibit any cardiometabolic health benefits compared to an omnivorous diet.
  • Specifically, there were no statistically significant effects on the lipid profile, including LDL-cholesterol.
  • The PBMA group noted a statistically significant decrease in diastolic blood pressure (from 78 ± 9 mmHg to 76 ± 8 mmHg) compared to the animal protein group, which exhibited no change in diastolic blood pressure readings (77 ± 12 mmHg).
  • No differences were observed in systolic blood pressure.
  • No differences were observed in high-sensitivity C-reactive protein (CRP) measurements.
  • Following the eight-week intervention, no difference was observed in the Framingham 10-year cardiovascular disease risk assessment.
  • No differences were noted between the groups with respect to glycemic variability and glycemic control.
  • There were no differences in weight or BMI between the groups over the intervention period.

The Caveat:
This is an important study because it is one of the first attempts to critically evaluate the hypothesized (and promised) benefits of PBMAs. There is a concentrated effort to encourage the public to consume foods such as PBMAs over those found in a more traditional omnivorous diet. Proponents emphasize environmental concerns, animal welfare, and potential human health benefits to drive utilization. This study and commentary focus on the latter.

The study’s findings are consistent with others that continue to point to the detrimental health effects of ultra-processing. PBMAs, by their nature, require the destruction of the plants’ naturally occurring food matrix (often soy, cassava, or pea) and reassembly involving protein isolates. This is in direct contradistinction to traditional methods of producing plant-based, high-protein foods like tofu or tempeh. The PBMAs the participants ate consisted of Impossible Beef (Impossible Foods), OmniMeat Mince (OmniFoods), Chickened Out Chunks (The Vegetarian Butcher), Beyond Burger (Beyond Meat), Beyond Sausage Original Brat (Beyond Meat) and Little Peckers (The Vegetarian Butcher).

Critically, during the study, the participants who were not consuming their protein through PBMAs received six sources of animal protein, including beef mince, pork mince, chicken breast, burger patty, sausage, and chicken nuggets. Thus, throughout all phases of the study, the majority of participants likely consumed some form of UPF. Therefore, one of the unanswered questions that arises out of the study is: What are the health effects of a diet based on PBMAs versus a diet based on non-ultra-processed animal protein sources (e.g., grass-finished bison or wild-caught salmon)?

The fact that there is no demonstrable benefit in cardiometabolic risk factors (at least in this study) despite shifting to a completely plant-based approach argues against much of the current push by many health and governmental agencies. Clearly, more data is needed beyond one relatively small, ethnically homogeneous study. Nonetheless, such findings do suggest alternate hypotheses. Firstly, it is possible that there exists no intrinsic health benefit to a plant-based diet versus an omnivorous one. Perhaps more likely, and more ominous, is that the ultra-processing of food introduces potentially detrimental effects irrespective of whether the initial food matrix is animal or plant-based. As neuroscientist Abhijit Naskar sagely observed, “One thing you must know about science and technology. No science, no technology, is superior to nature. To assume otherwise is to invite doom.”

The Study:
Darel Wee Kiat Toh, Amanda Simin Fu, Kervyn Ajay Mehta, Nicole Yi Lin Lam, Sumanto Haldar, Christiani Jeyakumar Henry. Plant-based meat analogues (PBMAs) and their effects on cardiometabolic health: An 8-week randomized controlled trial comparing PBMAs with their corresponding animal-based foods. The American Journal of Clinical Nutrition. 2024.

Additional Resources:
Naskar, Abhijit. Find A Cause Outside Yourself: Sermon of Sustainability. 1st Edition Publishing. 2022.

Richter CK, Skulas-Ray AC, Champagne CM, Kris-Etherton PM. Plant protein and animal 690 proteins: Do they differentially affect cardiovascular disease risk? Adv Nutr. 2015;6:712–28. 

Satija A, Bhupathiraju SN, Spiegelman D, Chiuve SE, Manson JE, Willett W, Rexrode KM, 687 Rimm EB, Hu FB. Healthful and unhealthful plant-based diets and the risk of coronary heart 688 disease in U.S. adults. J Am Coll Cardiol. 2017;70:411–22.

Tso R, Forde CG. Unintended consequences: Nutritional impact and potential pitfalls of 698 switching from animal- to plant-based foods. Nutrients. 2021;13:2527.

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