Review of the plant-based nutrition and lifestyle medicine news August 2026

This month I cover evidence on diet and kidney health, ultra-processed plant-based diets, nutrition & GLP-1 medications, healthy habits for brain & heart health PLUS the looming food security crisis.

Meat-free diets reduce the risk of kidney disease

Studies on plant-based diets have consistently shown benefits for kidney health. This is likely to be because plant-based diets reduce the risk of the main risk factors that lead to chronic kidney disease (CKD), namely high blood pressure and type 2 diabetes and also beneficial impacts on the gut microbiome.

This new analysis from the UK Biobank study analysed the risk of CKD according to diet pattern. The study included 416,584 participants who were classified into five dietary groups: high meat eaters, low meat eaters, poultry eaters, pescatarians, and vegetarians. The vegetarian group included a small number of vegans (367).

During the almost 13 years of follow-up, 23,084 participants developed CKD among them 90% had normal kidney function at baseline, while 3% and 7% had CKD stage 1 and 2, respectively. The risk of developing CKD was higher in people with a high BMI and with type 2 diabetes. Participants following a vegetarian diet were more likely to be female, younger, have a lower BMI, a higher baseline eGFR (better kidney function), and a higher educational attainment compared to high meat eaters. Compared to high meat eaters, vegetarians had a 19% lower risk of developing CKD. Other diet groups had a marginal reduction in risk compared to high meat eaters.

These results are in line with previous findings and also support the fact that plant-based diets are recommended in guidance for prevention and management of CKD. Numerous potential mechanisms are likely to explain these findings. Plant-based diets result in higher fibre intake, a more favourable macro and micro-nutrients intake (higher potassium, lower phosphate) and healthier gut microbiome. The authors of this new study recognise that despite the evidence, clinical practice has been slow to adapt due to outdated concerns regarding potassium, phosphorus, or protein quality.

We are pleased to have collaborated with the BDA renal specialist group to create three factsheets – for people with CKD, on dialysis and with a transplant. You can also listen to this excellent episode of the In a Nutshell podcast, which shares the story of Cade Morant who has had a kidney transplant and has benefited greatly from adopting a plant-based diet.

Concerns about ultra-processed foods in a plant-based diet are overstated.

Another hugely useful analysis from the UK Biobank study, which included 124,836 participants aged 40–70 years. The main study question was whether the ultra-processed food (UPF) content of a plant-based diet impacted health outcomes, specifically risk of cardiovascular disease (CVD), type 2 diabetes, cancer and mortality. The researchers examined the impact of a healthy and unhealthy plant-based diet, as defined by the plant-based diet index, and assessed whether these diet patterns were high or low in UPFs. Prior studies from this research group have already shown that a healthy plant-based diet significantly reduces the risk of chronic diseases and mortality.

The results showed that regardless of UPF content, adherence to a more plant-based diet was associated with a lower risk of mortality, type 2 diabetes and CVD. The associations were slightly stronger when the plant-based diet was low in UPFs. There was no association with cancer risk, other than with adherence to an unhealthy plant-based, which increased the risk of cancer.

Regarding individual foods, higher intakes of fruit, vegetables, nuts, tea/coffee, and fish/seafood were associated with lower all-cause mortality and type 2 diabetes. Fruit, legumes, and vegetarian protein alternatives were linked to lower cancer incidence. Whole grain intake was inversely associated with type 2 diabetes risk and all-cause mortality.

Higher intakes of refined grains, potatoes (particularly when contributing from UPFs), and sugar-sweetened beverages were associated with higher risks of mortality, type 2 diabetes and CVD. Higher meat intake was associated with higher risk of type 2 diabetes regardless of processing level and with higher CVD risk when consumed primarily as low-UPF foods. Higher animal fat intake was associated with higher CVD risk. No significant associations were found for fruit juice, sweets/desserts, eggs, or other miscellaneous animal-based foods.

Overall, the results suggest that the nutrient profile of a food is more important than the degree of processing. In the context of a plant-based diet, the benefits to health are apparent regardless of the UPF content. Some UPFs, such as those made from whole grains, fortified plant drinks and meat-alternatives, can be included as part of an overall healthy plant-based dietary pattern.

Interestingly, a pre-print paper has been made available that proposes guidelines for manufacturers to reformulate plant-based meat alternatives to a consistent, healthy standard. Researchers propose minimum and maximum standards for protein, energy density, fibre salt, sugar, saturated fat, iron and vitamin B12. If adopted, this could support a healthier transition away from eating meat.

Healthy lifestyle behaviours support better cardiovascular health

Elevated blood cholesterol (or more accurately, elevated apoB-containing lipoprotein) is the key driver of atherosclerotic CVD, which remains the leading cause of death globally. LDL-cholesterol is the most commonly measured biomarker and is a key modifiable risk factor. A new report from the Global Burden of Disease finds that elevated LDL-cholesterol results in 3.6 million deaths (6% of global mortality) and 90.7 million years spent in ill health (3.2% of disability adjusted life years). One-third of the global LDL-C burden is in India and China. Despite progress in managing CVD risk factors, because of population growth and ageing, global burden has risen and mainly shouldered by middle-income countries.

This brings me onto highlighting the results of the CENTURY (Comprehensive LifEstyle ModificatioN, Optimal Pharmacological Treatment and Utilizing PET Imaging for Quantifying and Managing Stable CoronaRy ArterY Disease) trial. This randomised study in people with chronic but stable coronary artery disease aimed to test the impact of a combined approach to management. That is, intensive healthy lifestyle modification strategy, maximal medical treatment of all risk factors and coronary intervention (stents reserved for severely reduced coronary flow capacity, guided by PET scan.

1028 people were randomised and followed the assigned protocol for 5 years and then followed up for a further 11 years. The lifestyle intervention included personalised dietary modification in line with a heart healthy diet, weight management and exercise regimens. A multi-disciplinary team of professionals, trained specifically for the study, managed each patient over 1.5–2 hours per clinic visit every 2 to 6 months. The frequency of visits was determined by adherence to the intervention and review of biomarker data. These sessions were reinforced by 24/7 on-call access to a member of the trials team.

The results showed that the intervention reduced death by 42.7%, death, myocardial infarction by 37%, revascularisation by 35.1% and MACE (major adverse cardiovascular events) by 31.4% compared to standard care with benefits extending beyond the study period.

This study demonstrates the power of combining lifestyle medicine interventions alongside standard pharmaceutical and surgical treatments for improving health outcomes in coronary heart disease. In people with established diseases, the lifestyle intervention needs to be suitably intensive to have the desired impact.

Lifestyle interventions are effective for maintaining brain health

One of the most well-known lifestyle intervention study in people with cognitive impairment is the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) study. This examined the effects of a two-year comprehensive lifestyle intervention in 1,269 adults (60-77 years old) who were at high risk of cognitive decline. The intervention group received the following intervention: a diet intervention based on the Finnish Nutrition Recommendations (emphasises whole plant foods and minimises animal-derived and processed foods), regular aerobic exercise and resistance training, cognitively challenging computer programmes, and intensive management of metabolic and vascular risk factors. The control group received standard care (simply advice to eat healthily and exercise). After 2 years, the intervention group had a significantly higher score in overall cognitive performance.

Twenty years later, we have the report of a similar intervention conducted in 11 Latin American countries. The LatAm-FINGERS Initiative for Cognitive Change study aimed to investigate the feasibility of a culturally adapted, multi-domain, systematic lifestyle intervention and its effects on global cognitive function in at-risk older adults (aged 60–77 years).

The intervention included, dietary counselling and support based on the Mediterranean- Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) diet. This dietary pattern emphasises plant-based foods, especially leafy greens, whole grains, beans, nuts and berries, but also allows for the inclusion of animal-sourced foods. Physical activity was intended on four days per week, including warm up and cool down, coordination and balance, stretching, strength training, aerobic exercise, and relaxation. There was computer-based cognitive training four times per week and management of CVD risk factors

The study randomised 1065 participants, 75% of whom were women. Compared to regular health advice, the study demonstrated that a 2-year systematic multidomain lifestyle intervention improved global cognition, episodic memory, executive function, and processing speed in older adults at risk of cognitive decline.

Given that the burden of dementia is rising fastest in low and middle-income, this study provides actionable evidence that could be scaled to try and support better brain health with ageing.

Another prior study to know about is the Alzheimer’s Association U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk (U.S. POINTER). This was a two-year randomised clinical trial, which included 2111 participants, and evaluated whether lifestyle interventions that simultaneously targeted many risk factors could protect cognitive function in older adults who were at increased risk for cognitive decline. The results showed that the combination of regular physical activity, improved nutrition (MIND diet), cognitive and social challenge, and health monitoring improved cognitive function in diverse populations in communities across the United States.

Nutrition support for people on weight loss medications

The efficacy of GLP-1 receptor agonists and dual GLP-1–GIP receptor agonists have revolutionised the treatment of people living with obesity. However, it has become clear that supportive care measures are just as important as the medications themselves for longer term health outcomes. Regarding nutrition, nutrient intake needs to be maintained despite a reduced appetite in order to prevent malnutrition. Protein intake needs to be higher than general recommendations. Gastrointestinal side effects need to be managed. Physical activity, especially resistance exercise is important too. There have been several consensus statements already published. This new one comes from European specialist societies.

What is interesting about all the recent recommendations is that a plant-based diet makes a very good option for people on weight loss medications. This is because plant-based diets are high in nutrients, including fibre, and can help combat concerns about micronutrient deficiency. They can easily be designed to meet higher protein intakes of 1-1.5g/kg, with the inclusion of soya-based protein powders if protein supplementation is needed. They are a source of healthy fats if nuts, avocado and extra-virgin olive oil are included. They can also help combat some of the gastrointestinal side effects e.g. fibre for constipation, low-fat foods for nausea and reflux.

A new opinion piece makes just this case in an article called, ‘The Pharmacological Window Hypothesis: How Emerging Obesity Medications May Realize Decades of Plant-Forward Dietary Recommendations’. The authors argue that the reduction in ‘food noise’ whilst on the medications is the right opportunity to support the adoption of healthier food behaviours. There is some evidence that cravings for less healthy foods are diminished, whilst desire for healthier foods, such as fruit and vegetables emerges. Given that the ideal scenario is for people to be able to stop the medication once the desired weight loss has been achieved, using the medication period to foster healthy and sustainable food behaviours makes a lot of sense. Plant-based diets also have the benefit of supporting better cardiometabolic health, gut health and reducing the risk of cancer, which would be expected to lead to improved long-term health outcomes.

An excellent guide to plant-based nutrition whilst on weight-loss medication has been written by Proveg International.

Food security and shifting food behaviours

Food security is at the forefront of people’s minds. The UK has now had five heat waves this year and most of the country is in a drought. Crop yields are significantly lower than expected, grass to feed farm animals is not growing and winter food stores are already being used up. Cows are producing less milk in the heat, the health of pigs and chickens in animal factories is even more horrendous and fishes are adversely affected in warmer waters. Fruit and vegetables that the UK grow are smaller in size and there are concerns that nutrient density of crops is being adversely affected. The rest of the world is also facing similar challenges, compounded by the continues geopolitical situation. An excellent new report from the Food Foundation highlights how underinvestment in horticulture has meant we rely heavily on imported fruit and vegetables, further threatening food security. At the same time, the UK does not have any food reserves. This makes collapse of the UK food system a real and present threat.

What are the potential solutions? As soon as possible the UK and globally need to shift to a food system that prioritises horticulture and the production of fruit, vegetables, whole grains, legumes, nuts and seeds. Currently, 50% of crops grown are fed to animals and most of these calories are then lost. For every 100 calories of grain fed to animals, only 3 to 25 calories return as meat, milk or eggs. If we moved away from raising animals for food, we could reduce food-related greenhouse gas emission by 60% and in the UK, free up land almost the size of Scotland. This would provide us with more land to return to nature, to restore biodiversity and to store carbon.

Professor Paul Behrens is a leading academic in the UK whose research centres on food systems. His work confirms the need to transition to a plant-based food system. His prior research published in 2022 showed that if the UK and Europe adopted the Planetary Health Diet (mostly plant-based), this would not only benefit planetary and human health but could also help absorb interruptions in the international food supply resulting from the Ukraine-Russia war. It would also result in reduced fertilizer use, water consumption and GHG emissions whilst increasing carbon sequestration.

Prof Behren’s latest paper examines where in the food system long-term carbon and biodiversity losses are occurring. The study demonstrates animal-sourced foods drive 59% of carbon and 71% of biodiversity losses associated with global food production. Beef and dairy production alone accounts for 41% of the biodiversity damage and 29% of total carbon loss because of the huge amounts of land required. These losses are concentrated on just one-third of the World’s farmland.

I wholeheartedly agree that farmers are central to this food system transition and the Government needs to support them. But the latest announcement by the UK Government falls short by not clearly articulating what needs to happen to build back food security and resilience. We do not need to keep ‘livestock fed’. We need to support farmers to transition into horticulture production and restore farmland back to nature.

We can match support for horticultural farming with increased demand for plant-based foods, just like the Danish have done in their Plant-Based Action Plan. We know that choice architecture and behavioural nudges can support people to choose more plant-based meals. A useful randomised cluster study validating this approach was able to show that increasing the availability of vegetarian meals served in seven canteens increased the likelihood of selecting a vegetarian meal by 41%, There were environmental benefits (reduction in per meal greenhouse gas emissions) and improved nutritional quality of meals (reduction in saturated fat, salt and calories of vegetarian dishes) without any detrimental effect on business-related outcomes such as meals sold, dinner satisfaction, food waste and income.

The myth that healthy plant-based diets are more expensive is once again dispelled by a new study by Madre Brava. Their report finds that transitioning to the Planetary Health Diet (in Germany) would save consumers over £1000 per year. As food prices in general continue to rise, due to climate change disruption and geopolitical unrest, prior research from Madre Brava shows that the gap in price between meat and beans in the UK has widened, making plant sources of protein the most economical choice.

Be sure to be prepared for continued food system disruption and keep extra supplies at home. The best foods to store are dried whole grains and beans and tinned/frozen fruit and vegetables.

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