Plant-based diets are best – or are they?

Robert H. Shmerling, MD, Robert H. Shmerling, MD

Harvard Health Publishing – A new study, published in the medical journal The BMJ, raises the possibility that despite the health benefits demonstrated by past research, plant-based diets could come with a previously unrecognized health risk.

Researchers in the United Kingdom analyzed the risk of stroke and other health problems over two decades among nearly 50,000 people based on the diets they followed. The types of stroke were also analyzed, including bleeding into the brain (hemorrhagic stroke) and nonbleeding stroke (ischemic stroke).

Compared with meat-eaters:

• rates of heart disease (such as angina or heart attack) were 13% lower in pescatarians
• rates of heart disease were 22% lower in vegetarians
• rates of stroke were 20% higher among vegetarians. However, the overall risk was small, equal to three extra cases per 1,000 people over 10 years.
• the higher stroke risk among vegetarians was mostly due to hemorrhagic stroke [A hemorrhagic stroke is when blood from an artery begins bleeding into the brain. This happens when a weakened blood vessel bursts and bleeds into the surrounding brain. Pressure from the leaked blood damages brains cells, and, as a result, the damaged area is unable to function properly. – Medical News Today]
• the higher stroke risk was not observed among pescatarians.

If confirmed, these findings will complicate the way we look at plant-based diets. Are there serious and underappreciated downsides to these diets that should make us think twice about choosing them? Or is the increased risk of stroke heavily outweighed by cardiac and other health benefits?

This study is also a reminder that the health impact of a particular intervention (such as diet) may not be easy to predict or explain. In most cases, the risk of stroke and heart disease tend to rise or fall together, but that wasn’t the case in this research …

The bottom line

If the findings of this new research stand the test of time (and future study), a key question will be: how does a vegetarian diet increase the risk of stroke? Understanding how one’s diet impacts the risk of stroke and other disease will be crucial in future dietary recommendations and other preventive measures and treatments.

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