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A randomized crossover trial on the effect of plant-based compared with animal-based meat on trimethylamine-N-oxide and cardiovascular disease risk factors in generally healthy adults: Study With Appetizing Plantfood-Meat Eating Alternative Trial (SWAP-MEAT).

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Crimarco, Anthony, Springfield, Sparkle, Petlura, Christina, Streaty, Taylor, Cunanan, Kristen, Lee, Justin, Fielding-Singh, Priya, Carter, Matthew M, Topf, Madeline A, Wastyk, Hannah C, Sonnenburg, Erica D, Sonnenburg, Justin L, Gardner, Christopher D·2020·The American Journal of Clinical Nutrition

DOI 10.1093/ajcn/nqaa203PMC PMC7657338

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Abstract

BACKGROUND Despite the rising popularity of plant-based alternative meats, there is limited evidence of the health effects of these products. OBJECTIVES We aimed to compare the effect of consuming plant-based alternative meat (Plant) as opposed to animal meat (Animal) on health factors. The primary outcome was fasting serum trimethylamine-N-oxide (TMAO). Secondary outcomes included fasting insulin-like growth factor 1, lipids, glucose, insulin, blood pressure, and weight. METHODS SWAP-MEAT (The Study With Appetizing Plantfood-Meat Eating Alternatives Trial) was a single-site, randomized crossover trial with no washout period. Participants received Plant and Animal products, dietary counseling, lab assessments, microbiome assessments (16S), and anthropometric measurements. Participants were instructed to consume ≥2 servings/d of Plant compared with Animal for 8 wk each, while keeping all other foods and beverages as similar as possible between the 2 phases. RESULTS The 36 participants who provided complete data for both crossover phases included 67% women, were 69% Caucasian, had a mean ± SD age 50 ± 14 y, and BMI 28 ± 5 kg/m2. Mean ± SD servings per day were not different by intervention sequence: 2.5 ± 0.6 compared with 2.6 ± 0.7 for Plant and Animal, respectively (P = 0.76). Mean ± SEM TMAO concentrations were significantly lower overall for Plant (2.7 ± 0.3) than for Animal (4.7 ± 0.9) (P = 0.012), but a significant order effect was observed (P = 0.023). TMAO concentrations were significantly lower for Plant among the n = 18 who received Plant second (2.9 ± 0.4 compared with 6.4 ± 1.5, Plant compared with Animal, P = 0.007), but not for the n = 18 who received Plant first (2.5 ± 0.4 compared with 3.0 ± 0.6, Plant compared with Animal, P = 0.23). Exploratory analyses of the microbiome failed to reveal possible responder compared with nonresponder factors. Mean ± SEM LDL-cholesterol concentrations (109.9 ± 4.5 compared with 120.7 ± 4.5 mg/dL, P = 0.002) and weight (78.7 ± 3.0 compared with 79.6 ± 3.0 kg, P < 0.001) were lower during the Plant phase. CONCLUSIONS Among generally healthy adults, contrasting Plant with Animal intake, while keeping all other dietary components similar, the Plant products improved several cardiovascular disease risk factors, including TMAO; there were no adverse effects on risk factors from the Plant products.This trial was registered at clinicaltrials.gov as NCT03718988.

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Authors: Crimarco, A., Springfield, S., Petlura, C., Streaty, T., Cunanan, K., Lee, J., Fielding-Singh, P., Carter, M. M., Topf, M. A., Wastyk, H. C., Sonnenburg, E. D., Sonnenburg, J. L., & Gardner, C. D.
Affiliations: Stanford Medicine (US)
Chan Zuckerberg Biohub San Francisco (US)
Corresponding author: Gardner, Christopher D
ORCID: Crimarco, Anthony
Springfield, Sparkle
Streaty, Taylor
Cunanan, Kristen
Lee, Justin
Carter, Matthew M
Wastyk, Hannah C
Sonnenburg, Erica D
Sonnenburg, Justin L
Gardner, Christopher D
Venue: The American Journal of Clinical Nutrition
Publisher: Elsevier BV
Published: 2020-11
Volume: 112
Issue: 5
Pages: 1188-1199
ISSN: 0002-9165 (ISSN-L)
DOI: 10.1093/ajcn/nqaa203
PMC: PMC7657338
OpenAlex: W3048835825
Semantic Scholar: baef07f6f9c782d052a8d345e0a079a125a67535
Cited by: 286
References: 46
Citations by year: 2026: 39 · 2025: 52 · 2024: 56 · 2023: 51 · 2022: 44 · 2021: 33 · 2020: 11
FWCI: 26.06
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 820 d)
Locations: American Journal of Clinical Nutrition (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: Beyond Meat Inc.
National Heart, Lung, and Blood Institute (T32HL007034)
Stanford Clinical and Translational Science
NIH (UL1 TR001085)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Physical Sciences › Environmental Science › Ecology › Agriculture Sustainability and Environmental Impact
Life Sciences › Agricultural and Biological Sciences › Animal Science and Zoology › Meat and Animal Product Quality
Keywords: animal meat, trimethylamine N-oxide, cardiovascular risk factors, gut microbiota, insulin-like growth factor I, LDL cholesterol, blood pressure, insulin resistance, nutrition counseling, meat consumption, order effects, dietary intervention, dietary adherence
MeSH terms: Adult, Animals, Cardiovascular Diseases, Cattle, Chickens, Female, Humans, Male, Meat, Methylamines, Middle Aged, Risk Factors, Diet, Vegetarian, Exercise, Cross-Over Studies

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A randomized crossover trial on the effect of plant-based compared with animal-based meat on trimethylamine-N-oxide and cardiovascular disease risk factors in generally healthy adults: Study With Appetizing Plantfood-Meat Eating Alternative Trial (SWAP-MEAT).

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