How do you get a healthy person to try eating a plant-based diet? You tell them about all the recent studies that indicate that plant-based eating is better for your heart, reduces the risk of cancer and diabetes, liver disease and depression, as well as Alzheimer’s disease and death from ALL causes!

The latest research study, published in the Journal of the American Heart Association, shows that plant-based diets are associated with a lower risk of not only heart disease but ALL causes of mortality in a general population of middle-aged adults. In other words, everyone can benefit from this way of eating, not just those who already have heart disease. When you think you’re eating healthy, you have to ask yourself, “Is my diet the healthiest it could be?” If you aren’t eating mostly plant-based whole foods, new science tells us: You could be doing better, to be your overall healthiest.

According to the study: Those who eat more animal products and refined carbs were 32% more likely to die of heart disease and up to 25% more likely to die of all causes during the course of the study. So if you want to give yourself the best chances of living longer, eat plant-based (but we also suggest you still wear your seatbelt!). 

Eating Healthy to Stay Healthy

To answer the question: “Why eat plant-based?”, we decided to take a look at the top health studies that show plant-based eating is, in fact, better for you. We found no fewer than 50 research studies to share and paired these down to the 22 we felt were most relevant to The Beet's audience. We tried to get it down to 20, but the Diet Coke study just was too memorable to cut. (As Diet Coke lovers ourselves, this one struck a little close to home.) Read on for the stroke/diet soda connection!

The Vegan Cardiologist Will See You Now

Other than having a heart attack, what does it take to get someone to change their diet? Dr. Freeman, an associate professor in the Division of Cardiology and Department of Medicine at National Jewish Medical Center in Denver and an advisor to The Beet, and is known as the Vegan Cardiologist, has seen plenty of super-fit endurance athletes who are strong, active and asymptomatic come into his office with underlying heart disease, and suddenly, no matter how healthy they think they're eating, he has their attention. The lucky ones get to his office in time to change their diet and repair and reverse their heart disease. Others have a cardiac arrest on the mountain, on their bikes, in the wilderness and don't have a chance to recover, and it’s their friends and family who become aware of the silent killer that heart disease can be. Consider this your wake up call.

Why Should a "Healthy" Person Eat Plant-Based?

“Eventually, even someone who is active, fit and healthy appearing, if they are not eating right, they have a heart attack,” Freeman says, when asked how can a fit, active and asymptomatic person be convinced to change their diet. “The reason that people who are healthy, active, and fit don’t eat this way is they believe they are living healthy. Eventually, they have a heart attack, and they end up in my office,” Freeman says with complete confidence. It makes sense: 48 percent of Americans have heart disease,  according to an American Heart Association Study, and many of them appear healthy or have no symptoms before their first problem arises, on a health test or other event.

Freeman has seen seemingly fit guys who climb 14,000-foot peaks or mountain bike up mountains at altitude and then have mysterious chest pains, unaware they had any trace of heart disease. They don’t think they are the profile of a heart patient since they are neither overweight nor sedentary.  ”If you exercise but are not eating healthy, you will end up in a doctor’s office eventually. You have to be active and eat healthy to avoid heart disease. If you do one or the other, heart disease is fairly inevitable.”

Many people tell themselves: “I’m eating healthy,” Freeman adds. But then they have a health event, and are forced to ask themselves if that is the “best version of healthy” there is? Dr. Freeman is in the business of demonstrating that the best version of healthy is a plant-based diet. He is asked to speak around the country to educate doctors and the public about the importance of going plant-based for heart health. His compilation of research supports a plant-based diet for disease prevention and healthy living. Here's the lineup of his favorite studies that show the healthiest way to eat is a whole-food, plant-based diet. For the full list go to vegancardiologist.com.

Feel free to repeat these facts and cite this research to anyone who will listen, at your next party, or wherever the conversation comes up of why you’re eating plant-based!

First, the Scariest Stat: Half of Americans Have Heart Disease! 

The prevalence of cardiovascular disease (comprised of cardiovascular heart disease, heart failure, stroke, and hypertension) in adults over 20 years of age is 48% overall (121.5 million in 2016) and increases with advancing age in both males and females, according to the latest research. Now for the studies:

1. We Eat Poorly, and We Eat the Absolute Worst at Work

We eat junk at work. It's almost as if all our healthy intentions fly out the window the minute we walk into the office. In fact, nearly one-quarter of working adults (23.4%) eat junk food at the office, and the foods they ate averaged 1,292 kcal per person per week, according to the Journal of the Academy of Nutrition and Dietetics

Most common grabs at your desk: Pizza, sugary soft drinks, cookies or brownies, cakes and pies, and candy. That "birthday party" ritual of cupcakes? It's slowly killing us. The Healthy Eating Index scores suggest that work foods are high in empty calories, sodium, and refined grains and low in whole grains and fruit. 

2. Follow Just These 5 Lifestyle Habits for Your Best Bet

In a study that spanned 34 years and watched a population of 78,865 women and 44,354 men participating in the famous Nurses’ Health Study (NHS) and Health Professionals Study found five factors that were most important for long life. Do more and you live longer, do less and you die sooner.

  1. Not smoking: Obvious, and yet...some people can't or won't quit. It's time to quit.
  2. Having a Normal BMI: (18.5-24.9 kg/m2), which is true even of athletes.
  3. Doing 30+ minutes of moderate to vigorous physical activity per day: Minimum.
  4. Drinking a moderate amount of alcohol: No more than 10 drinks per week.
  5. Following a Healthy Diet: which we define as mostly whole-food, plant-based.

For those who followed none of the five: Their life expectancy at age 50 was 29 years for women and 25.5 years for men. 

For those who followed all five: They had a life expectancy at age 50 projected to be 43.1 years for women and 37.6 years for men.

Those who followed all five were 74% less likely to die during the study period. 

3. How Quickly Can You See Results When You Clean Up Your Act?

It only takes four weeks (one month!) to change your body's heart-healthy markers! One month is enough to see significant drops in measurable health indicators like cholesterol, blood pressure and lipids in your blood. In a study of 31 participants following a low-fat whole-food plant-based diet, in just four weeks: 

  • Significant reductions were observed for high blood pressure
  • A drop in serum lipids, often a precursor to plaque and blockage
  • A reduction in total medication usage and some took no meds at all

Other cardiovascular risk factors improved: Weight loss, smaller waist circumference, lower resting heart rate, and all blood markers for heart disease.

4. Cooked Meat and Blood Pressure: Skip the Well-Done BBQ

Meat eaters: Don't order it well-done, or better yet don't order it at all. A follow-up study of 32,925 women from the NHS and 53,852 women from the Nurses' Health Study II (NHSII) and 17,104 men from the Health Professionals Study found that eating well-done meat and hypertension were linked. 

Open flame and/or high-temperature cooking and high “doneness” level for both red and white meat is associated with an increased risk of hypertension by 15% or more. (This was true of fish as well.) The results were consistent, regardless of the amount of meat consumption.

So if you still eat meat, don’t overcook it or order it well done, since you’re adding extra harmful carcinogens, and increasing your risk of hypertension, known as the "silent killer." Meanwhile, another study links cooked meat and cancer risks. Better yet, order the veggie burger, the bean burger, or try a cauliflower steak. 

5. Preventing Heart Disease by Choosing More Plants

You can move the needle by 80 percent, just by living healthy. Genes are like light switches: you can actually turn them on or off depending on your choices.  “Healthy lifestyle choices may reduce the risk of myocardial infarction (a heart attack) by more than 80%, with nutrition playing a key role” according to a recent study.

A vegetarian diet reduces cardiovascular disease mortality and the risk of coronary heart disease by 40%, this study found.

Want to reverse heart disease? It's doable on a plant-based diet. Plant-based diets are the only dietary pattern to have shown to reverse symptoms of heart disease. Blocked arteries are unblocked, either partially or fully, in as many as 91% of patients who try it. Meanwhile, hypertension risk drops by 34%. (Doctors often see patients who are surgical candidates who try to eat plant-based in advance of the surgery and then find that they have reversed their blockage through diet alone.)

6. A Plant-Based Diet Beats Out the American Heart Association Diet

Want the full deets on how to live longer and not die prematurely of all causes? Here is the full story on that study we mentioned at the top of this article:

In a study of 100 participants with cardiovascular artery disease, eating a more plant-based diet was shown to be better for heart health and led to a lower risk of dying from a heart attack, stroke or other cardiovascular disease, and the results were better than other "heart-healthy" diets that include lean meat, fish and dairy, according to new research published in the Journal of the American Heart Association.

People who ate the most plant-based foods overall showed a range of benefits:

  • 16% lower risk of having a cardiovascular disease such as heart attacks, stroke, heart failure, and other conditions;
  • 32% lower risk of dying from cardiovascular disease and
  • 25% lower risk of dying from any cause compared to those who ate the least amount of plant-based foods.

7. The Mediterranean Diet is Good, But...

In a review of 25,994 women over 12 years from the Women’s Health Study, researchers measured 40 biomarkers and found: Those who most closely followed the Mediterranean diet had up to 28% less cardiovascular disease. Remember that this is a mostly plant-based diet. At the least, follow the Mediterranean diet of whole plants and vegetables, grains, seeds, nuts, olive oil and fish. Want to do even better? See The Portfolio Diet, below.

8. The Portfolio Diet is Better

Go nuts on nuts. The Portfolio Diet is a plant-based approach that includes daily consumption of at least 45 grams of nuts, at least 50 grams of plant protein like tofu and beans, and at least 20 grams of viscous fiber (veggies) and 2 grams of plant sterols. For nut lovers, this is very good news.

The Portfolio Diet was developed for patients needing to lower cholesterol and it worked. The Portfolio Diet was shown to lower cholesterol as well as statin use. Portfolio improved blood pressure and glucose metabolism, decreasing inflammation and reducing the 10-year risk of heart disease by 13 percent, according to a review of controlled trials by doctors in Toronto

9. What We Learned from the Mount Abu Open Heart Trial

In a study of 123 heart patients who were asked to follow a low-fat, high-fiber vegetarian diet, daily moderate aerobic exercise and practice stress-management exercises found that they could reverse cardiac disease through lifestyle changes alone.

During the study, over nearly seven years, doctors measured 360 coronary lesions and found that those patients with the most dietary adherence saw their lesions improve. Over 90% of the patients showed a trend towards regression of heart disease, and more than half of the lesions improved by more than 10 absolute percentage points. This shows diet and exercise and stress management can reverse disease in those patients who stick with the program.

10. Processed Food Might Kill You

Drop that bag of chips. In a study of 44,551 participants that tracked overall mortality rates showed that the more ultra-processed foods someone eats, the more like they are to die. This measured increased intake of salt, sugar, and saturated fat and factored in a decreased fiber intake. The researchers defined ultra-processed foods as food ready-to-eat or made mostly from ingredients combined with additives: Fast foods, chips, and cookies that have an endless shelf life.

For every 10% increase in ultra-processed food, the study found a 14% increased risk of death from hypertension, cancer, obesity, and dyslipidemia, which is defined as is an abnormal amount of lipids, such as triglycerides, cholesterol, and fat in the blood—not the stuff of healthy hearts. 

11. Fiber is Very Good for You, and It's Only in Plants

Fast fact: Plants have fiber, animals don't. (Animals have skeletons, ligaments and tendons and muscles that hold them upright, not the fibrous structures found in plants.) In a review of 185 studies and 58 clinical trials that looked at the equivalent of 135 million "person-years" and a total of 4,635 adult participants, fiber was a big factor in patients lowering their cardiovascular markers.

When comparing high fiber and lower fiber diets (plant-based versus meat-centric), observational data suggests that people lowered their risk of heart disease and death by up to 30% on a high-fiber diet. They also saw a drop in mortality from strokes and type 2 diabetes and colorectal cancer. The greatest gain in health was a diet of fiber 25-29 grams of fiber per day. Oatmeal for breakfast is a great way to start, since one cup has 8 grams of fiber—eat that and you're one-quarter of the way there. 

12. Antioxidants Matter! But Skip the Supplements

Eat your antioxidants—don't swallow a pill. The benefits are best when they come in the package of whole fruits and veggies. Dr. Freeman calls these "nature's fast food." Carry dried fruit with your or leave fresh fruit in sight in your kitchen since you're likely to reach for what's there.

A recent analysis of 41 studies measured mortality rates and diet. Higher concentrations of antioxidants, including vitamin C, lycopene, beta-carotene and selenium were associated with a lower risk for all-cause mortality. Hungry? Grab an orange.

13. Ketogenic Diets are Very, Very Bad for You

Everyone loves keto diets—but they are terrible for your heart health long-term. In a review of subjects who had survived their first heart attack, those who followed a low-carb diet had a 30% higher mortality risk compared to those who didn't eat that way. Meaning if you follow a keto diet after a heart attack, you have a one-third increased risk of dying. 

In another study of 900 elderly Swedish men, those who ate a carb-restricted diet (keto style) were 19% more likely to die and 44% more likely to have heart disease. (So what to eat? Whole foods, and if the carbs you eat come in the form of fruits and vegetables, you will likely lose weight too.)

Women studied also had similar outcomes. Women 40- to 75-years-old without heart disease or cancer or diabetes who ate a low-carb, high animal product diet were 23% more likely to die than those who ate a mostly veggie diet. Conclusion: A low-carb diet from plant or animal sources increases the risk of mortality.

14. Worried about Diabetes? A Whole Food, Plant-Based Diet Prevents It

A review of 11 trials on plant-based diets in diabetics showed: Plant-based diets focused on whole foods (read: no processed foods) improved well-being overall when compared to dietary interventions from various diabetes associations.

Subjects reported less pain and saw improvements in levels of depression, weight loss, and overall quality of life. They also lowered their cholesterol and HbA1c levels. Adherence to this diet was higher among participants, which suggests this diet was more easily followed, as well.

15. Raspberries: Magic Bullet for Diabetes?

Frozen raspberries given to 32 participants with pre-diabetes showed this powerful little fruit is a surprisingly effective medicine. In the study, participants were given either 1 cup, 2 cups, or no raspberries consumed and tracked insulin resistance.

Those who ate 2 cups of raspberries saw the most improvement in blood sugar control when compared to those who consumed fewer or no raspberries. 

16. Change Your Gut Health in Just Two Weeks

Gut bacteria was measured in a study of 248 participants followed over a two-week short-term dietary intervention and in just 14 days on a high-veggie plant-based diet, the body's microbiome changed to be healthier, more diverse, and produce the "good bacteria" that have anti-inflammatory effects on the body.

Those who consumed more fruits, vegetables, and grains improved gut bacterial diversity when compared to those who did not increase these foods. Higher-fiber diets increase bacteria associated with anti-inflammatory compounds linked to improved glucose tolerance and metabolism.

That means in just two weeks of plant-based eating, your gut health changes to produce bacteria that fight inflammation, so you feel less bloated in the short-term,  and long-term your gut bacteria can contribute to a reduction in your lifetime risk of heart disease. 

17. More On Gut Health and Heart Disease:  Hello, TMAO

When you eat meat, the bacteria in your gut produces a metabolite called trimethylamine (TMA), which is processed in the liver into trimethylamine oxide (TMAO), which alters cholesterol metabolism. When present in the body in increased levels, TMAO is linked to atherosclerosis, chronic kidney disease, and heart failure. TMAO is a driver of cholesterol and plaque. 

In a study of 113 participants who were fed red meat, white meat, or no meat daily, their TMAO levels shot up: Discontinuation of eating red meat reduces TMAO within just four weeks. The key takeaway: It doesn't take long to lower your cholesterol levels once you cut out red meat. 

18. A Plant-Forward Diet Reduces Stroke

In a review study of 306,473 men and women aged 40 to 73 years recruited between 2006 and 2010 and followed for nearly seven years, those with an unfavorable lifestyle were 66% more likely to have a stroke independent of genetic risk.

In the lowest-risk category for strokes were those who followed a healthy lifestyle (defined as not smoking, eating a healthy diet high in fruit, vegetables, and low in processed meats and red meats), with a body mass index of less than 30 and who exercised two or more times a week. If you have strokes in your family, go plant-based. 

19. Women & Diet Soda and Risk of Stroke

Women who consumed two or more artificially sweetened beverages per day had the following outcome in a study of stroke risk: 

  • 23% more stroke
  • 31% more ischemic stroke
  • 29% more heart attack
  • 16% more death

Those who consumed two or more artificially sweetened beverages daily were shown to have doubled their stroke risk, with obese women without previous heart disease or diabetes being two times as likely to have a clot-caused stroke; and African-American women without previous heart disease or diabetes were shown to be nearly four times as likely to have a clot-caused stroke. Take this as your cue to drink more water.

20.  A Fiber-Rich Diet Means Less Depression

In a study of 16,807 adults ages 20 years or older, those who ate 21 grams of fiber per day from fruits and vegetables were 40 percent less likely to exhibit depressive symptoms, compared with those who consumed less fiber.

So if you're having a tough week or feeling low for any reason, add more plants to your plate, choose fruit for snacks, and stay away from boxed cookies, bagged chips and anything that if left on the shelf would stay fresh longer than a loaf of fresh-baked bread. The best food for your mood: Fruits and veggies, nuts, grains and seeds.

21. Diet and Depression, Part 2

In a meta-analysis of 41 studies on diet and depression, researchers found a direct correlation between mood and food:

  • Eating high amounts of processed meats and trans fats found in junk foods increased incidence rates for clinical depression. 
  • Eating healthy foods such as vegetables, nuts, and fruits helped regulate emotions in patients experiencing depression, among other protective effects. 
  • The benefit of a healthy diet results in a 25% reduction of depression, and a lower dietary inflammatory index, which benefits your mind and body.

22. Alzheimer’s and a Mostly Plant-Based Diet

In a study of 70 participants between the ages of 30 and 60 who consumed more plant-based foods (defined as a Mediterranean-style diet) showed fewer Alzheimer’s disease-related biomarker changes on their brain scans when compared to those who did not follow the diet as closely. So if you want to avoid Alzheimer's or dementia, remember to eat more plants!

Bottom Line: You can't change your genes but you can change how your body and brain express those genes: a concept called epigenetics. Think of genes as a light switch and the food you eat as your chance to turn the switch on or off. The research shows we can do this by getting good sleep, exercising daily, reducing our stress by doing things that bring us joy, and eating a mostly plant-based diet of whole foods.