Cited by 139Nutritional Studies and DietLipoproteins and Cardiovascular HealthAgriculture Sustainability and Environmental Impact

Effect of Plant Protein on Blood Lipids: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

Open access
Li, Siying S., Blanco Mejia, Sonia, Lytvyn, Lyubov, Stewart, Sarah E., Viguiliouk, Effie, Ha, Vanessa, de Souza, Russell J., Leiter, Lawrence A. +3 more·2017·Journal of the American Heart Association

Abstract

Background: There is a heightened interest in plant‐based diets for cardiovascular disease prevention. Although plant protein is thought to mediate such prevention through modifying blood lipids, the effect of plant protein in specific substitution for animal protein on blood lipids remains unclear. To assess the effect of this substitution on established lipid targets for cardiovascular risk reduction, we conducted a systematic review and meta‐analysis of randomized controlled trials using the Grading of Recommendations Assessment, Development, and Evaluation system. Methods and Results: MEDLINE , EMBASE , and the Cochrane Registry were searched through September 9, 2017. We included randomized controlled trials of ≥3 weeks comparing the effect of plant protein in substitution for animal protein on low‐density lipoprotein cholesterol, non–high‐density lipoprotein cholesterol, and apolipoprotein B. Two independent reviewers extracted relevant data and assessed risk of bias. Data were pooled by the generic inverse variance method and expressed as mean differences with 95% confidence intervals. Heterogeneity was assessed (Cochran Q statistic) and quantified (I 2 statistic). The overall quality (certainty) of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation system. One‐hundred twelve randomized controlled trials met the eligibility criteria. Plant protein in substitution for animal protein decreased low‐density lipoprotein cholesterol by 0.16 mmol/L (95% confidence interval, −0.20 to −0.12 mmol/L; P <0.00001; I 2 =55%; moderate‐quality evidence), non–high‐density lipoprotein cholesterol by 0.18 mmol/L (95% confidence interval, −0.22 to −0.14 mmol/L; P <0.00001; I 2 =52%; moderate‐quality evidence), and apolipoprotein B by 0.05 g/L (95% confidence interval, −0.06 to −0.03 g/L; P <0.00001; I 2 =30%; moderate‐quality evidence). Conclusions: Substitution of plant protein for animal protein decreases the established lipid targets low‐density lipoprotein cholesterol, non–high‐density lipoprotein cholesterol, and apolipoprotein B. More high‐quality randomized trials are needed to improve our estimates. Clinical Trial Registration: URL : http://www.clinicaltrials.gov . Unique identifier: NCT 02037321.

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 · 10.1161/jaha.117.006659

Cites

184 of 184 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?

  • A larger body of evidence from randomized clinical trials suggests that vegetarian and other plant-based dietary patterns lower weight and improve lipid management, glucose metabolism, blood pressure, and cardiometabolic health.

    “A larger body of evidence from randomized clinical trials suggests that vegetarian and other plant-based dietary patterns lower weight29,30,31 and improve lipid management,30,32,33 glucose metabolism,33,34 blood pressure,35,36,37 and cardiometabolic health.38”
  • In a systematic review and meta-analysis of 112 randomized clinical trials across adults with and without hyperlipidemia, plant protein consumption reduced markers of cardiovascular disease compared with animal protein, including lower LDL cholesterol, non-HDL cholesterol, and apolipoprotein B.

    “In this systematic review and meta-analysis of 112 randomized clinical trials across adults with and without hyperlipidemia, the authors demonstrated reduced markers of cardiovascular disease in favor of plant protein over animal protein consumption [72].”

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

2 retracted

Flagged first, then by citations

5 of the 189 references couldn’t be matched to a known paper.

Research works printed but not linked: 6

  1. [92]Laidlaw M, Mercer NJH. Serum cholesterol, triglyceride and lipoprotein response in hypercholesterolemic males to replacement of cow's milk with a soy beverage. Fed Proc. 1985; 44(5):No. 6360.
  2. [103]Markova MHS, Sucher S, Pivovarova O, Pfeiffer A. Metabolic and molecular effects of a high‐protein diet in subjects with type 2 diabetes. Diabetologia. 2015; 58: S335.
  3. [106]Mercer NJH, Carroll KK, Giovannetti PM. Effects on human plasma lipids of substituting soybean protein isolate for milk protein in the diet. Nutr Rep Int. 1987; 35: 279– 287.
  4. [124]Steele MG. The effect on serum cholesterol levels of substituting milk with a soya beverage. Aust J Nutr Diet. 1992; 49: 24– 28.
  5. [146]Wolfe BM, Giovannetti PM. Elevation of VLDL‐cholesterol during substitution of soy protein for animal protein in diets of hypercholesterolemic Canadians. Nutr Rep Int. 1985; 32: 1057– 1065.
  6. [168]Kohls KJ, Kies C, Fox HM. Blood serum lipid levels of humans given arginine, lysine and tryptophan supplements without food. Nutr Rep Int. 1987; 35: 5– 11.

Cited by

Sorted by citations

Authors
Li, S. S., Blanco Mejia, S., Lytvyn, L., Stewart, S. E., Viguiliouk, E., Ha, V., de Souza, R. J., Leiter, L. A., Kendall, C. W. C., Jenkins, D. J. A., & Sievenpiper, J. L.
Affiliations
  • St. Michael's Hospital (CA)
  • Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada
Corresponding author
Sievenpiper, John L.
Venue
Journal of the American Heart Association
Published
2017-12-02
Volume
6
Issue
12
ISSN
2047-9980 (ISSN-L)
OpenAlex
W2776826800
Cited by
139
References
189
Citations by year
2026: 12 · 2025: 21 · 2024: 23 · 2023: 20 · 2022: 20 · 2021: 19 · 2020: 10 · 2019: 11 · 2018: 3
FWCI
1.07
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • Journal of the American Heart Association (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • PepsiCo
  • World Health Organization
  • General Mills
  • Coca-Cola Foundation
  • Danone
  • Almond Board of California
  • Advanced Foods and Materials Network
  • McMaster University
  • Saskatchewan Pulse Growers
  • Diabetes Canada
  • Canadian Nutrition Society
  • Canola Council of Canada
  • Loblaw Companies Limited
  • Danish Cancer Society Research Center
  • Peanut Institute
  • Government of Canada
  • Canadian Foundation for Dietetic Research
  • European Foundation for the Study of Diabetes
  • European Association for the Study of Diabetes
  • International Nut and Dried Fruit Council
  • Health Canada
  • Canadian Institutes of Health Research (129920)
  • Agriculture and Agri-Food Canada
  • Institute of Nutrition, Metabolism and Diabetes (129920)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Physical Sciences › Environmental Science › Ecology › Agriculture Sustainability and Environmental Impact
Keywords
plant proteins, serum lipids, LDL cholesterol, non-HDL cholesterol, apolipoprotein B, cardiovascular disease prevention, plant-based diet, dietary intervention, cardiovascular risk reduction, dyslipidemia, hypertriglyceridemia, hypercholesterolemia, hyperhomocysteinemia, homocysteine
MeSH terms
Cardiovascular Diseases, Humans, Lipids, Plant Proteins, Randomized Controlled Trials as Topic

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