Can a plant-based diet ‘reverse’ heart disease?

Could eating a strict low-fat vegetarian or vegan diet really ‘reverse’ coronary heart disease, and if so should everyone be eating this way?

BHF dietitian Victoria Taylor says:

The idea that a low-fat vegetarian or vegan diet could ‘reverse’ heart disease has been circulating for more than 20 years. This way of eating has become more popular in the last couple of years. It has lots of benefits, but the truth is more complex than headlines suggest.

We know that changing your diet and lifestyle, as well as taking prescribed medications, will help slow the progression of coronary heart disease, but reversal is another matter. Research into a strict low-fat plant-based diet originated in the 1980s, in a very small study of 22 people. It found that four participants had a reversal of the disease in their arteries after following this diet. This is interesting, but the results needed to be confirmed in larger and longer-term studies.

We know that changing your diet and lifestyle, as well as taking prescribed medications, will help slow the progression of coronary heart disease, but reversal is another matter

A study published in 2014 looked at 198 patients to further investigate whether eating a strict plant-based diet could stop or reverse heart disease. It found of the 177 patients who stuck to the diet, the majority reported a reduction in symptoms and 22 per cent had disease reversal confirmed by test results.

But that study didn’t just rule out animal products – it also cut out added oils, processed foods, sugar, refined carbohydrates, excess salt, fruit juice, avocado, and nuts. Physical activity was also encouraged and prescribed medication continued.

Participants in the 2014 study had all heard about the earlier study and wanted to follow a plant-based diet to reduce heart disease, so they were already motivated to change their diet. This is an important point, as the level of restriction required for this diet could make it difficult to stick to. They were also given information about suitable recipes, how to read food labels so they could choose foods that fit the diet, and how to make sure the diet met their nutritional needs.

This is still a small study – much larger numbers of people would be needed for official guidelines to be changed. We also don’t know what would have happened if they had followed a diet with a similar nutritional profile, but including animal products like low-fat milk, fish and lean meat. This means we can’t be sure whether cutting out animal products or the overall nutritional content of the diet was important, or what role was played by physical activity and weight loss (most participants lost significant amounts of weight).

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Should I switch to a plant-based diet?

For a diet to be plant-based it needs the majority of the food included to come from plant sources, and we should all be eating more foods like fruit and vegetables, wholegrains and plant-based sources of protein like beans, lentils, nuts and seeds.

But that doesn’t mean this way of eating can’t include any food from animal sources. Plant-based diets include a range of dietary patterns and both the traditional Mediterranean diet and the UK government’s Eatwell guide can be described as plant-based, even though they may also still contain some meat, fish and dairy products. However, a vegan diet which excludes all animal products would also be an example of a plant-based diet.

Remember, a plant-based diet isn’t automatically healthy… It’s still important to read food labels and understand what you are eating

So switching to a plant based diet doesn’t necessarily need to mean a radical change to your eating habits. A Mediterranean-style diet, which includes plenty of fruit, veg, pulses and fish, and only small amounts of meat, may be easier to follow than a strict vegan diet. It’s also linked to lower rates of heart disease than a conventional Western diet.

However, a vegan diet may suit some people and when well-balanced this can also be a healthy way to eat. But the more foods that we exclude from our diets, the harder it is to balance our eating. So, if it’s going to be a long-term change to veganism, rather than the odd meal, make sure you understand what you need to include in your diet to get the range of nutrients that you need.

Remember, plant-based foods also aren’t automatically healthy. Too much saturated fat, sugar and salt from any source can harm your health. There are an increasing number of manufactured plant-based snack foods available, from cupcakes and coconut yoghurts to vegan burgers, pizzas and nuggets. It’s still important to read food labels and understand what you are eating.

• Get Victoria’s view on the Vegan Before Six diet.
• Read our complete guide to diets and learn how to keep special diets balanced.
• Learn how to make your meals more Mediterranean with our swaps interactive.

Meet the expert

Victoria Taylor is a registered dietitian with 20 years’ experience. Her work for the NHS focused on weight management and community programmes for the prevention of cardiovascular disease. She leads the BHF’s work on nutrition.

Last updated April 2023

What to read next…

Are vegan diets good for your heart?

Around half a million British people are now vegan, according to the Vegan Society. In the US, there’s been a 300% increase in the number of American vegans in the past 15 years.

There are many reasons why people may adopt a vegan diet, such as animal welfare, sustainability or to lose weight. Another reason that’s often touted is that vegan diets are good for your heart, and can not only prevent heart disease, but even reverse it.

But as our latest review found, this isn’t necessarily true. In fact, we found that there is currently little evidence to suggest a vegan diet protects the heart, or can reverse heart disease.

The good and the bad

This isn’t to say that vegan diets don’t have benefits. Large amounts of whole grains, alongside fruit and veg, means that vegans consume more fibre than omnivores (people who eat meat products, alongside fruit and vegetables). And research shows people who eat a high fibre diet are less likely to develop heart disease.

Eating lots of fruit and veg also means consuming plenty of phytonutrients, which are natural chemicals found in plants. Some research suggests these have inflammatory and antioxidant properties, which may help prevent damage to cells in the body. Since vegans eat more fruit and veg on average, they should benefit more.

And a vegan diet is linked to a host of other health advantages that should benefit heart health, including a lower weight, lower blood pressure and lower levels of bad cholesterol.

But unless it’s carefully constructed, a vegan diet can easily lack vital nutrients. For example, vegan diets may contain lower amounts of certain omega-3 fatty acids, which are easily found in seafood. This may mean vegans aren’t getting the heart benefits of omega-3 fatty acids, such as lower blood pressure and reduced risk of heart attacks.

People eating a vegan diet will need to ensure they’re getting enough vitamins and minerals.
Nina Firsova/ Shutterstock

Some minerals and vitamins are also harder to come by for vegans without supplementation. Levels of selenium, iodine and vitamin B12 are lower in vegans compared to non-vegans, which can be detrimental to their heart health. Low levels of these minerals and vitamins can also lead to thyroid problems, muscle disorders and anaemia.

Heart health

Our team wanted to know whether vegan diets really do lower the risk of developing heart attacks or strokes. To do this, we needed to look through all the current evidence that has investigated this. This would allow us to develop a conclusion based on all the current data out there.

But although veganism is growing in popularity, vegans still make up a small fraction of any population. As such, few studies out there have looked at the effects of a vegan diet of any length on heart health. We could only find three – although in total they were large studies, with data on more than 73,000 people combined, and more than 7,000 vegans.

None of the studies found vegans were protected against heart disease, heart attacks or stroke compared to omnivores. Unfortunately, there was even a suggestion that vegans may be more likely to have an ischaemic stroke, which are caused by a blood clot in the brain. But it’s uncertain whether the vegan diet itself really did increase risk of this type of stroke, or if this was just coincidence.

Our study also looked at whether a vegan diet could benefit people who already had heart disease. One study showed that veganism could be beneficial and may potentially stop or reverse heart disease. The researchers found that people who started a vegan diet and stuck with it for more than three years were six times less likely to have another serious heart problem or stroke than those who started but didn’t continue with a vegan diet. That’s only one out of 177 vegans, compared to 13 out of 21 non-vegans, who became ill again. But as this was a relatively small sample we’d ideally want a much bigger study to double check this.

The other two studies didn’t show any benefit or reversal of heart disease in people who started a vegan diet. However, the participants of these studies only followed a vegan diet for two or six months – making it difficult to truly see a long-term impact. But one of the benefits of following the vegan diet for six months was that participants ended up with lower cholesterol and lost more weight than those on an omnivore diet.

Overall, our review has found that there isn’t evidence to back up the claims that veganism is good for your heart. But that is partly because there are few studies – and only 361 people in the studies we looked at became vegans after developing heart disease. Participants in two of the studies were only vegan for less than six months, which may not be long enough to see a large effect on heart disease.

But veganism may have other health benefits. Vegans have been found to have a healthier weight and lower blood glucose levels than those who consume meat and dairy. They are also less likely to develop cancer, high blood pressure and diabetes. But its effect on heart disease, the leading cause of death worldwide, really needs to be better understood.

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To your health: a new selection of vegan dishes and desserts in the catalog

The line of vegan desserts – a separate song and pride of VkusVill – contains almost 300 items that are constantly updated with new interesting sweets. Moreover, many of them came to taste and fell in love with those who did not exclude animal products from their diet. This means that a variety of desserts from the “Sweets” section, such hits as vegan tiramisu or carrot cake with pecans, have earned the love of customers not only for their composition, but for their originality and taste. Try our new desserts line and share your opinion.

Orange-Mango Heart Cake is an elegant dessert in the shape of a faceted heart made from herbal ingredients: coconut milk and oil, cashew nuts and orange juice. And at the heart of the delicacy is juicy mango puree. And the cake does not contain white sugar: syrups from Jerusalem artichoke and dates add flavor.

Sofushka, October 31, 2022: “I really liked the cake! Both mousse and filling. Maybe not everyone understands mousse desserts, so there are such different reviews. I really want it to be in a permanent assortment).

• 1

  Vegan tart “Caramel with nuts”

  Crumbly tartlet with delicate cream, viscous caramel and glazed crunchy nuts: walnuts, hazelnuts and almonds.
  The dough is made from gluten-free flour: rice and corn. Place cor…

  100 g

Caramel with Nuts Tartlet — crumbly basket filled with delicate cream, viscous caramel and glazed crunchy nuts: walnuts, hazelnuts and almonds. The dough is made using gluten-free flour – rice and corn.

Larisa, October 20, 2022: “The rich taste of nuts and caramel combined with a tartlet (no wheat flour) is a real treat for the taste buds. I liked it very much))) Thank you VkusVill”.

Cake “Two Chocolates” — it contains cashew nuts, date syrup, water, pulp and coconut oil, cocoa mass and cocoa powder, rice flour, buckwheat, corn and flax flour. And what does it look like!

Katerina, October 31, 2022: “Great cake! How long have I been looking for a vegan cake like Three Chocolates, there are two … but the taste is amazing! Delicious, soaked chocolate cake and the most delicate two layers of milk chocolate and, it seemed to me, praline, they are just like classic cheeses, but they are made of cashews! I am delighted and now I will try to repeat it . .. so, apparently, I will buy it more than once to unravel the recipe).”

Vegan Lemon Cheesecake is made without animal ingredients, flour or refined sugar. Instead of a cheese base – coconut, instead of shortcrust pastry – a nut crust, and for sweetness – Jerusalem artichoke syrup. Delicate and airy, with a charming lemon sourness. just like a real cheesecake.

Natalia, October 30, 2022: “Sweets are fine. For me, it’s not fat at all, because I eat nuts every day and I’m used to vegetable fat. These are masterpiece products with the right composition. I just adore BB because I eat deliciously, I feel good and I don’t deny myself anything, and I don’t gain weight. The life of VV definitely decorates. The guys are great fellows.”

And here’s what you can put in your bag as a healthy snack in case you want something tasty.

• 1

  Chickpea biscuits

  These crispy biscuits can be included in even the most strict diet! Because it does not contain any gluten, no animal ingredients, no refined sugar. A light sweetness in taste is the merit of Jerusalem artichoke syrup…

  100 g

Ingredients: chickpea flour, millet flour, dried sunflower kernel, Jerusalem artichoke syrup ( Jerusalem artichoke tubers, drinking water), amaranth flour.

Maria, October 29, 2022: “Cool cookies! as part of three types of super healthy crops, amaranth, chickpeas, millet, bright taste, no sugar, a lot of protein. I definitely recommend it.”

• 1

  Bar “Coconut-cashew”

  Bar made with granola, dried cranberries, coconut flakes, oatmeal, cashew nuts and rice balls. No added preservatives or flavors.
  Dried fruit and nut bars are rich in…

  35 g

Made with granola, dried cranberries, coconut flakes, oatmeal, cashews and rice balls without added preservatives or flavors. And at an affordable price.

Anna, October 21, 2022: “Coconut is just a bomb, crunchy nuts, and most importantly, healthy!”

• 1

  Chocolate “Oatmeal” with maltitol and stevia

  Chocolate with vegetable composition, delicate milky-creamy taste and exquisite aroma of natural vanilla. Made with oat milk and does not contain refined sugar: healthier instead…

  65 g

The plant-based alternative to milk chocolate is made with oat milk and does not contain refined sugar, instead using the healthier sweeteners maltitol and stevia.