Klara Kalocsay, Head of Research Strategy & Nutritionist
A recent prospective cohort study published in the Lancet that analysed the diet of 126,842 UK residents between 2009 and 2012, has linked increased consumption of plant-based ultra-processed foods to a 7% increase in the risk of heart disease. This has garnered inaccurate media attention, which suggests that some journalists haven’t read the original study.
It is important to highlight a key point not mentioned in the media articles: that ‘meat alternatives’ made up the smallest share of the participant’s total dietary contributions in the entire study. Meat alternatives only contributed 0.2% of the participant’s total energy intake—unsurprising as the diet data was collected over 12 years ago, before plant-based meat alternatives experienced a rise in popularity seven years later.
The highest proportion of ultra processed dietary contributions came from ‘industrialised packaged breads’ (9.9% of total energy intake) and ‘pastries, buns and cakes’ (6.9% of total energy intake). These are foods the average consumer wouldn’t consider to be key components of a healthy diet to begin with, however these foods haven’t been a particular focus of most media articles covering the study.
Given that plant-based meat alternatives were only represented in a fraction of the study’s data, it is curious that most media coverage implied that they were the main focus of the study. The answer may lie in a press release promoting the research, which led with a stock image of plant-based meat alternatives—despite not mentioning them in the body of the release.
This view is backed up by Dr Duane Mellor, a dietitian and spokesperson for British Dietetic Association said about the study, “This is an interesting paper—unfortunately people could possibly assume from the press release that the association with cardiovascular disease risk is specific to meat and dairy replacement plant-based foods such as plant-based sausages, nuggets and burgers. This is not what the paper shows. It explored the effects of all plant based ultra-processed foods—although this included plant-based meat alternatives, these only made up 0.2% of the energy from ultra-processed foods consumed by participants who were followed during the study. The main foods which were considered as plant-based ultra-processed foods were processed baked foods including packaged breads, pastries and cake and biscuits along with crisps and soft drinks.
“So this study possibly highlights the problem that many foods that do not contain animal products, which includes biscuits, crisps, confectionary and soft drinks, are technically plant-based, but would not be considered essential as part of a healthy diet by the majority of people.”
Others have commented on the misrepresentation of the study’s findings, pointing out that correlation is not causation. According to Dr Hilda Mulrooney, from London Metropolitan University, “The study remains limited to showing associations and causality cannot be demonstrated. It also relies entirely on the NOVA classification system and a number of concerns about this have been raised—particularly that it assumes that the health implications of a foodstuff are based only on the degree of processing, rather than their nutritional content.”
She continued, “Although some may assume the message of this study is that all ultra-processed plant-based foods are bad for health, I think that in fact what the evidence in the study actually shows is that poor diets are associated with increased risk of chronic diseases.”
Beyond concerns around media misunderstanding or misrepresenting the findings of this study, remains the underlying issue around the way that consumption of foods and their impact on health is studied.
This area of research is important and requires ongoing investigation, and this new study adds to the growing body of evidence that higher consumption of ultra-processed foods as a whole is linked to higher incidence of poor health outcomes.
However, this study also demonstrates the strong need for nuance and consideration of nutritional content—in addition to level of processing—in study design, to help separate and identify the foods that are causing poor health outcomes from those that are .
An earlier prospective cohort study published in The Lancet in late 2023, which analysed ultra-processed food consumption broken down into nine different categories, found that consumption of only certain and not all ultra-processed foods was linked with poor health outcomes, demonstrating the value of increased detail and nuance when investigating this topic. More research utilising similar study designs is needed to deepen our understanding and communication of this complex area of concern for nutritionists, manufacturers and consumers alike.
With meat alternatives only making up a fraction of this study, the widescale misrepresentation of the study’s findings highlights the importance of considered science communication when disseminating complex topics to a general audience, as well as the requirement for due diligence by media.