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Researchers have found that cardiovascular benefits of plant-based diets depend heavily on food quality and level of processing after studying over 63,000 adults over nearly a decade. While diets rich in whole, minimally processed plant foods significantly reduced heart disease risk, those dominated by ultra-processed plant foods offered no protection—and in some cases increased risk by as much as 40%.

Studies done earlier found that high consumption of ultra-processed foods is associated with a greater likelihood of cardiovascular disease. Other studies suggest that plant-based diets can lower this risk, but only when foods are nutritionally balanced and consumed in appropriate proportions. To better understand this relationship, scientists besides distinguishing plant and animal foods also evaluated nutritional quality—such as fat, sugar, salt, vitamin, and mineral content—as well as the degree of industrial processing.

The study showed that dietary intake was assessed using repeated online questionnaires covering at least three days, allowing researchers to precisely classify food choices.

The findings showed that participants who consumed more high-quality, minimally processed plant foods—such as fruits, vegetables, and other nutrient-dense options low in sugar, fat, and salt—had about a 40% lower risk of developing cardiovascular disease compared with those who ate fewer nutritious plant foods and more animal-based products.

In contrast, individuals whose diets included large amounts of ultra-processed plant foods did not experience cardiovascular benefits, even when those foods appeared nutritionally favourable. Products such as industrial wholemeal breads, packaged soups, ready-made pasta dishes, and pre-prepared salads with dressings failed to reduce heart disease risk.

The highest risk was observed among adults whose diets were dominated by ultra-processed plant foods of low nutritional quality, including crisps, sugary drinks, sweetened breakfast cereals, confectionery, and savoury biscuits. Their cardiovascular disease risk was approximately 40% higher than that of individuals consuming mostly minimally processed, high-quality plant foods.

Overall, the study conveys the message that cardiovascular protection comes from eating plant foods that are both nutrient-rich and minimally processed, rather than relying on ultra-processed plant-based alternatives. In short, plant-based diets are not inherently heart-healthy. 

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