Plant-based diets and cardiovascular risk factors

a comparison of flexitarians, vegans and omnivores in a cross-sectional study

authored by
Anja Bruns, Theresa Greupner, Josefine Nebl, Andreas Hahn

Background: The growing trend towards conscious and sustainable dietary choices has led to increased adoption of flexitarian diets, characterised by plant-based eating habits with occasional consumption of meat and processed meat products. However, the cardiovascular disease (CVD) risk factors associated with flexitarian diets compared to both vegans and omnivores remain underexplored. Methods: In this cross-sectional study, 94 healthy participants aged 25–45 years, categorized into long-term flexitarians (FXs ≤ 50 g/day of meat and meat products, n = 32), vegans (Vs, no animal products, n = 33), and omnivores (OMNs ≥ 170 g/day of meat and meat products, n = 29) were included. Various CVD risk factors were measured, including fasting blood samples for metabolic biomarkers, body composition analysis via bioimpedance, blood pressure measurements, arterial stiffness evaluated through pulse wave velocity (PWV) and metabolic syndrome (MetS) severity was determined using browser-based calculations (MetS-scores). Dietary intake was assessed using a Food Frequency Questionnaire (FFQ), diet quality was calculated with the Healthy Eating Index-flexible (HEI-Flex), while physical activity levels were recorded using the validated Freiburger questionnaire. Results: The data showed that FXs and Vs had more beneficial levels of insulin, triglycerides, total cholesterol, and LDL cholesterol compared to OMNs. Notably, FXs revealed the most favorable MetS-score results based on both BMI and waistline, and better PWV values than Vs and OMNs. In addition, FXs and Vs reported higher intake rates of vegetables, fruit, nuts/seeds and plant-based milk alternatives. Conclusion: The flexitarian diet appears to confer cardiovascular benefits. While Vs had the most favorable results overall, this study supports that reducing meat and processed meat products intake, as in flexitarianism, may contribute to CVD risk factor advantages.

Institute of Food Science and Human Nutrition
Nutrition Physiology and Human Nutrition Section
BMC nutrition
No. of pages
Publication date
Publication status
Peer reviewed
ASJC Scopus subject areas
Medicine (miscellaneous), Endocrinology, Diabetes and Metabolism, Nutrition and Dietetics, Public Health, Environmental and Occupational Health
Sustainable Development Goals
SDG 3 - Good Health and Well-being
Electronic version(s) (Access: Open)