Vegetarian Diet Is Associated with Lower Cholesterol Levels, According to Meta-Analysis in Nutrition Reviews

WASHINGTON—A new dietary review of 49 observational and controlled studies finds plant-based vegetarian diets, especially vegan diets, are associated with lower levels of total cholesterol, including lower levels of HDL and LDL cholesterol, compared to omnivorous diets. The meta-analysis appears as an online advance in Nutrition Reviews.

The study authors—Yoko Yokoyama, Ph.D., M.P.H., Susan Levin, M.S., R.D., C.S.S.D., and Neal Barnard, M.D., F.A.C.C.—reviewed 30 observational studies and 19 clinical trials.

They find:

• A plant-based vegetarian diet is associated with total cholesterol that’s 29.2 mg/dL lower in observational studies. In clinical trials, a plant-based diet lowers total cholesterol by 12.5 mg/dL.
• In observational studies, a plant-based vegetarian diet is associated with a 22.9 mg/dL reduction in LDL cholesterol and a 3.6 mg/dL reduction in HDL cholesterol, compared to control groups following an omnivorous diet.
• In clinical trials, a plant-based vegetarian diet lowers LDL cholesterol by 12.2 mg/dL and reduces HDL cholesterol by 3.4 mg/dL, compared to control groups following an omnivorous, low-fat, calorie-restricted, or a conventional diabetes diet.
• A plant-based vegetarian diet is not associated with statistically significant changes in triglyceride levels in observational studies or in clinical trials.

The authors predict the strong correlation between vegetarian diets and lower cholesterol levels may be due to the association a plant-based diet has with a lower body weight, a reduced intake of saturated fat, and an increased intake of plant foods, like vegetables, fruits, legumes, nuts, and whole grains, which are naturally rich in components such as soluble fiber, soy protein, and plant sterols.  

The study authors hypothesize that the lower total, HDL, and LDL cholesterol levels observed in the longitudinal studies is likely due to long-term adherence to plant-based eating patterns and changes in body composition.

“To make any form of health care work and to truly power economic mobility, we have to get healthy,” says Levin. “The first place to start is by building meals around nutrient-packed, plant-based foods, which fit into nearly every cultural template, taste preference, and budget.”

The study authors also note hyperlipidemia, or elevated cholesterol and triglycerides, is often underdiagnosed and undertreated.

A 10 percent increase in the prevalence of treatment for elevated cholesterol can prevent 8,000 deaths each year. Physicians can take small steps, like those proposed by the National Cholesterol Education Program Adult Treatment Panel 3, which include assessing heart disease risk, making lifestyle and dietary recommendations, and assessing the need for future follow-up appointments and pharmaceutical interventions, which could prevent approximately 20,000 heart attacks, 10,000 cases of coronary heart disease, and save almost $3 billion in medical costs each year.

To request a copy of the study or to request an interview with a study author, please contact  JMcVey [at] pcrm.org (Jeanne Stuart McVey), Media Relations Manager, 202-527-7316, 202-686-2210, ext. 316.