WHO evidence review on plant-based diets

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The European Regional Office of the World Health Organisation has released a fact sheet reviewing the evidence for the impact of plant-based diets on health and sustainability. The document was released in response to increasing discussion of the concept of “plant based” foods and diets in the European region. They define such diets as “emphasizing foods derived from plant sources coupled with lower consumption or exclusion of animal products”.

In Europe, non-communicable diseases (NCDs) are the major health concern, with cardiovascular disease alone accounting for more than half of all European deaths. Many NCDs can be linked to diet, and specifically to low consumption of vegetables and fruit. Indeed, in more than half of the European countries, daily vegetable and fruit consumption recommendations are not met.

Several studies have identified the reduced burden of many NCDs, especially diabetes, in the vegetarian and vegan population. They note the generally lower BMI and all-round healthier lifestyle of individuals who choose these diets as a contributing factor, as well as the diets themselves.

Reductions in NCDs from more balanced diets would be expected to have benefits for health, and thus reduce health-care expenditure. Environmentally, there may be benefits to reducing the impacts associated with high consumption of animal-sourced foods, such as greenhouse gas emissions and biodiversity loss.

The greatest risks associated with increasingly plant-based diets are for nutrient intakes. The fact sheet encourages proper planning of these diets to account for the reduced supply and bioavailability of nutrients such as iron, vitamin A, B12 and D, and zinc, as well as choosing foods fortified or supplemented with these nutrients.

The authors also warn against blanket associations between plant-based and healthy. Many highly or ultra-processed foods are plant-based, but not all such foods can be described as healthy. Examples such as imitation meats and milks are given, as highly processed plant-based foods containing added sugars, flavours, colours, emulsifiers, and salt. Little is currently known about the nutritional or health impacts of such foods if forming a major part of the diet, as this is still an emerging product group.

The report concludes that the adoption of plant-based diets can be beneficial, and that even incremental changes towards such diets may have benefits. They recommend that foods in such a diet be chosen that are minimally processed and ensure adequate nutrient intakes. Increasing vegetable and fruit consumption, particularly for those not meeting recommendations, should certainly be a target for European authorities.

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