Heart Disease: Plant-Based Ultra-Processed Foods May Raise Risk

“The results of this study do not surprise me,” Michelle Routhenstein, preventive cardiology dietitian at Entirely Nourished, said. “I have seen many people who are on a vegan diet have high cholesterol or even suffer from a cardiovascular event, and the details of their diet is an integral part in evaluating how truly heart healthy it is.”

Rothenstein said many vegan products available on the market today are rich in saturated fat and sodium, yet they are deficient in heart-protective nutrients.

She said this imbalance contributes to elevated cardiometabolic indicators such as high blood pressure, elevated cholesterol levels, and insulin resistance, which increases the risk of heart disease.

The increased risk of heart disease and early death associated with these foods has a lot to do with how they are processed.

“The processing and cooking methods used in the production of ultra-processed plant-based foods can lead to the formation of advanced glycation end products (AGEs),” Rothenstein explained.

AGEs are harmful compounds that form when sugars react with proteins or fats during high-heat cooking processes.

Rothenstein said excessive consumption of AGEs has been linked to inflammation, oxidative stress, and an increased risk of cardiovascular diseases.

Like Rothenstein, Nichola Ludlam-Raine, dietitian and author of How Not to Eat Ultra-Processed, agreed that the results of this study are concerning but not surprising.

She said plant-based ultra-processed foods negatively impact heart health for several reasons.

“Firstly, they can still be high in salt and ‘free sugar,’ which can lead to high blood pressure, obesity, and diabetes,” she said. “Secondly, they may still be high in saturated fat or contain trans fats, which can have a detrimental impact on blood cholesterol levels.”

In addition, Ludlam-Raine pointed out that the level of processing involved strips away nutrients such as fiber, vitamins, and minerals.

They’re also easy to overeat.

“The concoction of emulsifiers, flavorings, modified starches, and preservatives can lead to passive overconsumption and even an altered gut microbiome. The latter can influence everything from mood to the immune system,” she said.

Beyond cardiovascular health, overconsuming plant-based ultra-processed foods can lead to other problems, including type 2 diabetes.

“Diets high in ultra-processed foods (80% or more) can lead to high blood pressure due to excess salt, digestive issues due to a lack of fiber, metabolic syndrome due to high levels of sugars and bad fats, as well as inflammation of the gut in susceptible people,” Ludlam-Raine said.

Rothenstein shared similar concerns and added that overeating plant-based ultra-processed foods can “also potentially lead to nutrient deficiencies in one’s diet.”

With clever marketing, it can be difficult to tell what’s good for us and what isn’t. This may be especially true when eating plant-based foods.

It’s easy to assume that all plant-based foods are healthy. However, if you’re following a plant-based diet, there are certain things you should aim to limit or avoid.

Ludlam-Rain said ultra-processed foods are those that have been heavily modified and have a long list of ingredients.

“Foods with often unrecognizable ingredients or additives likely indicate high processing levels and that the food is ultra-processed, and could be high in calories, fat, sugar and salt, and low in fiber and nutrients,” she said.

She suggests that people avoid foods that contain a “concoction” of additives, such as emulsifiers, modified starches, and artificial flavorings.

These can be tricky to spot on a label. Routhenstein said some common ingredients to limit include:

• Aspartame
• Sodium benzoate
• Flavor enhancers
• Thickeners such as carrageenan
• Emulsifiers like lecithin
• Antioxidants like butylated hydroxyanisole (BHA) and butylated hydroxytoluene (BHT)

These foods can be found in vegan meat substitutes, flavored plant-based beverages, vegan cheese, and packaged snacks.

To transition to a healthier plant-based diet, Routhenstein recommended incorporating whole, minimally processed foods abundant in nutrients and balanced with lean protein, complex carbohydrates, and healthy fats.

This includes lean protein sources such as soy, beans, and legumes, along with an abundance of colorful vegetables, leafy greens, and whole grains like quinoa and barley, as well as healthy fats like nuts and seeds.

Ludlam-Raine agreed and advised prioritizing whole, minimally processed foods and cooking at home as much as possible.

“Always make more than you need so you can enjoy leftovers the following day,” she suggested. “If you are vegan, consider including foods fortified with vitamin B12 and iron, as well as calcium and iodine, in addition to an omega 3 supplement based on algae.”

When it comes to diet, you might find it increasingly difficult to decipher what is good for you and what is not. Plant-based doesn’t always equal healthy, especially when those foods are ultra-processed.

Ultimately, whether you’re eating plant-based or not, Routhenstein said, “Be cautious of health claims and marketing buzzwords on packaging, as they may not always reflect the true nutritional quality of a product. Focus on the ingredient list and nutrition label so you can make informed choices.”