CoChat
Sign Up
Cited by 78Nutritional Studies and DietAgriculture Sustainability and Environmental ImpactDiet and metabolism studies

Effects of vegan diets on cardiometabolic health: A systematic review and meta‐analysis of randomized controlled trials

Open access
Termannsen, Anne‐Ditte, Clemmensen, Kim Katrine Bjerring, Thomsen, Jonas Mark, Nørgaard, Ole, Díaz, Lars Jorge, Torekov, Signe Sørensen, Quist, Jonas Salling, Færch, Kristine·2022·Obesity Reviews
DOI 10.1111/obr.13462PMC PMC9540559
Open this paper in CoChat — free accountOpen PDF

Abstract

Summary: In parallel with an increased focus on climate changes and carbon footprint, the interest in plant‐based diets and its potential health effects have increased over the past decade. The objective of this systematic review and meta‐analysis was to examine the effect of vegan diets (≥12 weeks) on cardiometabolic risk factors in people with overweight or type 2 diabetes. We identified 11 trials (796 participants). In comparison with control diets, vegan diets reduced body weight (−4.1 kg, 95% confidence interval (CI) −5.9 to −2.4, p < 0.001), body mass index (BMI) (−1.38 kg/m 2, 95% CI −1.96 to −0.80, p < 0.001), glycated hemoglobin (HbA 1c) (−0.18% points, 95% CI −0.29 to −0.07, p = 0.002), total cholesterol (−0.30 mmol/L, 95% CI −0.52 to −0.08, p = 0.007), and low‐density lipoprotein cholesterol (−0.24 mmol/L, 95% CI −0.40 to −0.07, p = 0.005). We identified no effect on blood pressure, high‐density lipoprotein cholesterol, and triglycerides. We found that adhering to vegan diets for at least 12 weeks may be effective in individuals with overweight or type 2 diabetes to induce a meaningful decrease in body weight and improve glycemia. Some of this effect may be contributed to differences in the macronutrient composition and energy intake in the vegan versus control diets. Therefore, more research is needed regarding vegan diets and cardiometabolic health.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1111/obr.13462

Cites

17 of 17 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Our results corroborate a previous finding showing that eating a vegan diet can improve cardiovascular health.

    “Our results corroborate a previous finding showing that eating a vegan diet can improve cardiovascular health.28”

    From Cardiometabolic Effects of Omnivorous vs Vegan Diets in Identical Twins: A Randomized Clinical Trial (2023) · cites this paper as [28]

    The Discussion (Main findings) reports improvements in total cholesterol and LDL-C with vegan diets in people with overweight or type 2 diabetes, supporting a potential cardiovascular benefit. The claim is broader than the evidence: the review reports cardiometabolic risk markers, not cardiovascular health outcomes, and found no effect on blood pressure. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • Most studies examining vegan diets have been epidemiologic examinations, with a few reported clinical studies.

    “Most studies17,18 examining vegan diets have been epidemiologic examinations, with a few reported clinical studies.19,20”

    From Cardiometabolic Effects of Omnivorous vs Vegan Diets in Identical Twins: A Randomized Clinical Trial (2023) · cites this paper as [20]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 47

  1. [1]Ruby MB. Vegetarianism. A blossoming field of study. Appetite. 2012; 58(1): 141‐ 150. doi: 10.1016/j.appet.2011.09.019 22001025 · DOI
  2. [2]Atwoli L, Baqui AH, Benfield T, et al. Call for emergency action to limit global temperature increases, restore biodiversity, and protect health. BMJ. 2021; 374: 1‐ 3. PMC8414196 34483099
  3. [3]Turner‐McGrievy GM, Leach AM, Wilcox S, Frongillo EA. Differences in environmental impact and food expenditures of four different plant‐based diets and an omnivorous diet: results of a randomized, controlled intervention. J Hunger Environ Nutr. 2016; 11(3): 382‐ 395. doi: 10.1080/19320248.2015.1066734 · DOI
  4. [4]Springmann M, Wiebe K, Mason‐D'Croz D, Sulser TB, Rayner M, Scarborough P. Health and nutritional aspects of sustainable diet strategies and their association with environmental impacts: a global modelling analysis with country‐level detail. Lancet Planet Heal. 2018; 2(10): e451‐ e461. doi: 10.1016/S2542-5196(18)30206-7 PMC6182055 30318102 · DOI
  5. [5]Craig WJ, Mangels AR. Position of the American Dietetic Association: vegetarian diets. J Am Diet Assoc. 2009; 109(7): 1266‐ 1282. doi: 10.1016/j.jada.2009.05.027 19562864 · DOI
  6. [6]Craig WJ. Health effects of vegan diets. Am J Clin Nutr. 2009; 89(5): 1627S‐ 1633S. doi: 10.3945/ajcn.2009.26736N 19279075 · DOI · Paper page
  7. [7]Benatar JR, Stewart RAH. Cardiometabolic risk factors in vegans; a meta‐analysis of observational studies. PLoS ONE. 2018; 13(12): 1‐ 23. PMC6301673 30571724
  8. [8]Naghshi S, Sadeghi O, Willett WC, Esmaillzadeh A. Dietary intake of total, animal, and plant proteins and risk of all cause, cardiovascular, and cancer mortality: systematic review and dose‐response meta‐analysis of prospective cohort studies. BMJ. 2020; 370: 1‐ 17. doi: 10.1136/bmj.m2412 PMC7374797 32699048 · DOI · Paper page
  9. [11]Toumpanakis A, Turnbull T, Alba‐Barba I. Effectiveness of plant‐based diets in promoting well‐being in the management of type 2 diabetes: a systematic review. BMJ Open Diabetes Res Care. 2018; 6(1): 1‐ 10. doi: 10.1136/bmjdrc-2018-000534 PMC6235058 30487971 · DOI
  10. [12]Yokoyama Y, Barnard ND, Levin SM, Watanabe M. Vegetarian diets and glycemic control in diabetes: a systematic review and meta‐analysis. Cardiovasc Diagn Ther. 2014; 4(5): 373‐ 382. 25414824 PMC4221319
  11. [13]Yokoyama Y, Nishimura K, Barnard ND, et al. Vegetarian diets and blood pressure: a meta‐analysis. JAMA Intern Med. 2014; 174(4): 577‐ 587. doi: 10.1001/jamainternmed.2013.14547 24566947 · DOI · Paper page
  12. [15]Yokoyama Y, Levin SM, Barnard ND. Association between plant‐based diets and plasma lipids: a systematic review and meta‐analysis. Nutr Rev. 2017; 75(9): 683‐ 698. doi: 10.1093/nutrit/nux030 28938794 PMC5914369 · DOI
  13. [17]Kahleova H, Petersen KF, Shulman GI, et al. Effect of a low‐fat vegan diet on body weight, insulin sensitivity, postprandial metabolism, and intramyocellular and hepatocellular lipid levels in overweight adults: a randomized clinical trial. JAMA Netw Open. 2020; 3(11): 1‐ 14. doi: 10.1001/jamanetworkopen.2020.25454 PMC7705596 33252690 · DOI · Paper page
  14. [18]Barnard ND, Scialli AR, Turner‐McGrievy G, Lanou AJ, Glass J. The effects of a low‐fat, plant‐based dietary intervention on body weight, metabolism, and insulin sensitivity. Am J Med. 2005; 118(9): 991‐ 997. doi: 10.1016/j.amjmed.2005.03.039 16164885 · DOI
  15. [19]Rock CL, Flatt SW, Pakiz B, et al. Weight loss, glycemic control, and cardiovascular disease risk factors in response to differential diet composition in a weight loss program in type 2 diabetes: a randomized controlled trial. Diabetes Care. 2014; 37(6): 1573‐ 1580. doi: 10.2337/dc13-2900 24760261 PMC4392939 · DOI · Paper page
  16. [20]Barnard ND, Cohen J, Jenkins DJA, et al. A low‐fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes. Diabetes Care. 2006; 29(8): 1777‐ 1783. doi: 10.2337/dc06-0606 16873779 · DOI · Paper page
  17. [21]Meex RCR, Blaak EE, van Loon LJC. Lipotoxicity plays a key role in the development of both insulin resistance and muscle atrophy in patients with type 2 diabetes. Obes Rev. 2019; 20(9): 1205‐ 1217. 31240819 PMC6852205
  18. [22]Jesch ED, Carr TP. Food ingredients that inhibit cholesterol absorption. Prev Nutr Food Sci. 2017; 22(2): 67‐ 80. 28702423 PMC5503415
  19. [23]Naumann S, Haller D, Eisner P, Schweiggert‐Weisz U. Mechanisms of interactions between bile acids and plant compounds—a review. Int J Mol Sci. 2020; 21(18): 1‐ 20. PMC7555273 32899482
  20. [24]Barnard ND, Scialli AR, Bertron P, Hurlock D, Edmonds K, Talev L. Effectiveness of a low‐fat vegetarian diet in altering serum lipids in healthy premenopausal women. Am J Cardiol. 2000; 85(8): 969‐ 972. doi: 10.1016/S0002-9149(99)00911-X 10760336 · DOI
  21. [25]Rouse IL, Armstrong BK, Beilin LJ, Vandongen R. Blood‐pressure‐lowering effect of a vegetarian diet: controlled trial in normotensive subjects. Lancet. 1983; 1(8314–8315): 5‐ 10. doi: 10.1016/S0140-6736(83)91557-X 6129380 · DOI · Paper page
  22. [26]Aburto NJ, Hanson S, Gutierrez H, Hooper L, Elliott P, Cappuccio FP. Effect of increased potassium intake on cardiovascular risk factors and disease: systematic review and meta‐analyses. BMJ. 2013; 346: 1‐ 19. PMC4816263 23558164
  23. [29]Lefebvre C, Glanville J, Briscoe S, et al. Technical supplement to Chapter 4: searching for and selecting studies. In: Higgins JPT, Thomas J, Chandler J, et al., eds. Cochrane Handbook for Systematic Reviews of Interventions Version 6.2 (Updated February 2021). Cochrane; 2021. https://www.training.cochrane.org/handbook
  24. [30]Barnard ND, Levin SM, Gloede L, Flores R. Turning the waiting room into a classroom: weekly classes using a vegan or a portion‐controlled eating plan improve diabetes control in a randomized translational study. J Acad Nutr Diet. 2018; 118(6): 1072‐ 1079. doi: 10.1016/j.jand.2017.11.017 29398571 · DOI
  25. [31]Lee YM, Kim SA, Lee IK, et al. Effect of a brown rice based vegan diet and conventional diabetic diet on glycemic control of patients with type 2 diabetes: a 12‐week randomized clinical trial. PLoS ONE. 2016; 11(6): 1‐ 14. doi: 10.1371/journal.pone.0155918 PMC4890770 27253526 · DOI
  26. [33]Bunner AE, Wells CL, Gonzales J, Agarwal U, Bayat E, Barnard ND. A dietary intervention for chronic diabetic neuropathy pain: a randomized controlled pilot study. Nutr Diabetes. 2015; 5(5): 1‐ 6. doi: 10.1038/nutd.2015.8 PMC4450462 26011582 · DOI
  27. [34]Hanas R, John G. 2010 Consensus statement on the worldwide standardization of the hemoglobin A1C measurement. Diabetes Care. 2010; 33(8): 1903‐ 1904. doi: 10.2337/dc10-0953 20519665 PMC2909083 · DOI
  28. [36]Lefebvre C, Glanville J, Briscoe S, et al. Chapter 4: searching for and selecting studies. In: Higgins JPT, Thomas J, Chandler J, et al., eds. Cochrane Handbook for Systematic Reviews of Interventions Version 6.2 (Updated February 2021). Cochrane; 2021. https://www.training.cochrane.org/handbook
  29. [37]Higgins JPT, Li T, Deeks JJ. Chapter 6: choosing effect measures and computing estimates of effect. In: Higgins JPT, Thomas J, Chandler J, et al., eds. Cochrane Handbook for Systematic Reviews of Interventions Version 6.2 (Updated February 2021). Cochrane; 2021. https://www.training.cochrane.org/handbook
  30. [38]The Cochrane Collaboration 2020. Review Manager (RevMan) [Computer program]. Version 5.4.
  31. [40]Turner‐McGrievy GM, Davidson CR, Wingard EE, Wilcox S, Frongillo EA. Comparative effectiveness of plant‐based diets for weight loss: a randomized controlled trial of five different diets. Nutrition. 2015; 31(2): 350‐ 358. 25592014
  32. [41]Higgins JPT, Savović J, Page MJ, Elbers RG, Sterne JAC. Chapter 8: assessing risk of bias in a randomized trial. In: Higgins JPT, Thomas J, Chandler J, et al., eds. Cochrane Handbook for Systematic Reviews of Interventions Version 6.2 (Updated February 2021). Cochrane; 2021. https://www.training.cochrane.org/handbook
  33. [42]Balshem H, Helfand M, Schünemann HJ, et al. GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol. 2011; 64(4): 401‐ 406. 21208779
  34. [46]Guyatt GH, Oxman AD, Kunz R, et al. GRADE guidelines: 7. Rating the quality of evidence—inconsistency. J Clin Epidemiol. 2011; 64(12): 1294‐ 1302. doi: 10.1016/j.jclinepi.2011.03.017 21803546 · DOI · Paper page
  35. [47]Guyatt GH, Oxman AD, Kunz R, et al. GRADE guidelines: 8. Rating the quality of evidence—indirectness. J Clin Epidemiol. 2011; 64(12): 1303‐ 1310. doi: 10.1016/j.jclinepi.2011.04.014 21802903 · DOI · Paper page
  36. [48]Deeks J, Higgins J, Altman D. Chapter 10: analysing data and undertaking meta‐analyses. In: Higgins JPT, Thomas J, Chandler J, et al., eds. Cochrane Handbook for Systematic Reviews of Interventions Version 6.2 (Updated February 2021). Cochrane; 2021. https://www.training.cochrane.org/handbook
  37. [50]Barnard ND, Alwarith J, Rembert E, et al. A Mediterranean diet and low‐fat vegan diet to improve body weight and cardiometabolic risk factors: a randomized, cross‐over trial. J Am Coll Nutr. 2021; 41: 1‐ 13. doi: 10.1080/07315724.2020.1869625 33544066 · DOI · Paper page
  38. [51]Jenkins DJA, Wong JMW, Kendall CWC, et al. Effect of a 6‐month vegan low‐carbohydrate (‘Eco‐Atkins’) diet on cardiovascular risk factors and body weight in hyperlipidaemic adults: a randomised controlled trial. BMJ Open. 2014; 4(2): 1‐ 11. PMC3918974 24500611
  39. [52]Mishra S, Xu J, Agarwal U, Gonzales J, Levin S, Barnard ND. A multicenter randomized controlled trial of a plant‐based nutrition program to reduce body weight and cardiovascular risk in the corporate setting: the GEICO study. Eur J Clin Nutr. 2013; 67(7): 718‐ 724. doi: 10.1038/ejcn.2013.92 23695207 PMC3701293 · DOI
  40. [53]Ferdowsian HR, Barnard ND, Hoover VJ, et al. A multicomponent intervention reduces body weight and cardiovascular risk at a GEICO corporate site. Am J Health Promot. 2010; 24(6): 384‐ 387. doi: 10.4278/ajhp.081027-QUAN-255 20594095 · DOI
  41. [55]Turner‐McGrievy GM, Barnard ND, Scialli AR. A two‐year randomized weight loss trial comparing a vegan diet to a more moderate low‐fat diet. Obesity. 2007; 15(9): 2276‐ 2281. doi: 10.1038/oby.2007.270 17890496 · DOI · Paper page
  42. [56]Barnard ND, Scialli AR, Turner‐McGrievy G, Lanou AJ. Acceptability of a low‐fat vegan diet compares favorably to a step II diet in a randomized, controlled trial. J Cardiopulm Rehabil. 2004; 24(4): 229‐ 235. doi: 10.1097/00008483-200407000-00004 15286527 · DOI
  43. [59]Wheeler ML, Fineberg SE, Fineberg NS, Gibson RG, Hackward LL. Animal versus plant protein meals in individuals with type 2 diabetes and microalbuminuria. Effects on renal, glycemic, and lipid parameters. Diabetes Care. 2002; 25(8): 1277‐ 1282. doi: 10.2337/diacare.25.8.1277 12145221 · DOI
  44. [60]Astrup A. Energy metabolism and obesity. In: Mela D, ed. Food, Diet and Obesity. Woodhead Publishing Ltd; 2005: 58‐ 75. doi: 10.1533/9781845690540.1.58 · DOI
  45. [63]Bechthold A, Boeing H, Tetens I, Schwingshackl L, Nöthlings U. Perspective: food‐based dietary guidelines in Europe‐scientific concepts, current status, and perspectives. Adv Nutr. 2018; 9(5): 544‐ 560. doi: 10.1093/advances/nmy033 30107475 PMC6140433 · DOI
  46. [64]Kristensen NB, Madsen ML, Hansen TH, et al. Intake of macro‐ and micronutrients in Danish vegans. Nutr J. 2015; 14: 1‐ 10. doi: 10.1186/s12937-015-0103-3 26518233 PMC4628270 · DOI · Paper page
  47. [65]Karanicolas PJ, Farrokhyar F, Bhandari M. Blinding: who, what, when, why, how? Can J Surg. 2010; 53(5): 345‐ 348. 20858381 PMC2947122

Cited by

Sorted by citations

Authors
Termannsen, A., Clemmensen, K. K. B., Thomsen, J. M., Nørgaard, O., Díaz, L. J., Torekov, S. S., Quist, J. S., & Færch, K.
Affiliations
  • University of Copenhagen (DK)
  • Copenhagen University Hospital (DK)
Corresponding author
Termannsen, Anne‐Ditte
ORCID
Venue
Obesity Reviews
Publisher
Wiley
Published
2022-06-07
Volume
23
Issue
9
Pages
e13462-e13462
ISSN
  • 1467-7881 (ISSN-L)
  • 1467-789X
DOI
10.1111/obr.13462
PMC
PMC9540559
OpenAlex
W4281759579
Cited by
78
References
17
Citations by year
2026: 18 · 2025: 19 · 2024: 21 · 2023: 17 · 2022: 3
FWCI
2.98
Type
journal article
Language
en
Open access
Licence
Locations
  • Obesity Reviews (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by-nc-nd)
Funders
  • Steno Diabetes Center Copenhagen (SDCC 3.G, SDCC 3. B Epidemiology)
  • Novo Nordisk Fonden (NNF16SA0024126-1, NNF16OC0019968, NNF20SA0064142)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Physical Sciences › Environmental Science › Ecology › Agriculture Sustainability and Environmental Impact
  • Health Sciences › Medicine › Physiology › Diet and metabolism studies
Keywords
vegan diet, plant-based diet, cardiometabolic risk factors, overweight, type 2 diabetes, weight loss, HbA1c, glycemic control, LDL cholesterol, total cholesterol, blood pressure, macronutrient composition, energy intake
MeSH terms
Diet, Vegan, Body Weight, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Humans, Cholesterol, HDL, Randomized Controlled Trials as Topic, Overweight

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review