Eating more plant-based foods is often linked to better heart health, but a new study suggests that what kind of plant-based foods you eat matters just as much as how many.
Researchers from INRAE, Inserm, Université Sorbonne Paris Nord and Cnam found that adults whose diets were rich in minimally processed plant-based foods of high nutritional quality had about a 40% lower risk of cardiovascular disease compared with those who ate more animal-based foods. But that benefit disappeared, and even reversed, when plant-based diets were built around ultraprocessed foods like packaged snacks, sweetened cereals and ready-made meals.
The findings, published in The Lancet, are based on data from more than 63,000 adults in the French NutriNet-Santé cohort who were followed for an average of nine years. Participants regularly completed detailed dietary questionnaires, allowing researchers to assess not only how plant- or animal-focused their diets were but also how nutritious and processed their food choices were.
Adults with diets rich in higher-quality plant foods, those lower in salt, sugar and fat and with little or no industrial processing, had a 40% lower risk of developing cardiovascular disease. By contrast, those who ate large amounts of ultraprocessed plant-based foods of lower nutritional quality had about a 40% higher risk.
The researchers noted that their findings highlight the importance of considering both the nutritional quality and the degree of processing when evaluating the health impact of plant-based diets.
Ultraprocessed foods (sometimes referred to under the NOVA classification) typically include products that have been heavily reformulated, such as chips, candy, sweetened drinks, flavored yogurts and some plant-based convenience foods. These foods can vary widely in their nutritional value and researchers emphasize that processing itself isn’t always harmful. Many nutritious items, including fortified soy milk, whole-grain bread and canned beans, are processed in ways that make them safe, accessible and shelf-stable.
The study’s findings underscore that heart-healthy, plant-forward diets focus on whole or lightly processed foods, like fresh, frozen or canned fruits and vegetables without added salt or sugar, whole grains, legumes and nuts, rather than relying heavily on packaged products designed for convenience.
This research was conducted as part of the CaPulCo project and funded by a grant from the French National Research Agency. The NutriNet-Santé study is supported by the French Ministry of Solidarity and Health, Santé Publique France, INRAE, Inserm, CNAM, CRESS and Université Sorbonne Paris Nord.