The health benefits of nuts and seeds

By Isabelle Sadler, PBHP UK Research Assistant and MSc Nutrition Student

Nuts and seeds are a fundamental part of a plant-based diet, providing a rich source of protein, unsaturated fats and several micronutrients. They’re also a great way to increase fibre intake, which is associated with a decreased incidence in mortality from several common chronic diseases.

There is growing evidence for the beneficial and protective effects of consuming nuts and seeds regularly, especially for cardiovascular health. Studies have demonstrated that eating a handful of nuts at least 5 days a week can increase lifespan by around 2 years. However, there is a global underconsumption of nuts, and this food group represents one of the largest gaps between recommended intake and current consumption levels. Not eating enough nuts and seeds is also one of the leading dietary risk factors for disease burden globally.

Nuts and seeds in healthy dietary patterns

Various dietary patterns have been developed to promote good health, such as the Planetary Health, Mediterranean, Portfolio, Dietary Approaches to Stop Hypertension (DASH), and Whole-Food Plant-Based (WFPB) dietary patterns. These diets share several core, healthy components, one of these being nuts and seeds!

The Portfolio diet is a plant-based eating pattern that is designed to lower cholesterol. It includes nuts and seeds as one of several cholesterol lowering foods, alongside plant protein, viscous fibre sources, phytosterols, and plant unsaturated fat sources. A higher plant-based Portfolio Diet Score has been associated with a 14% lower risk of cardiovascular disease, coronary heart disease, and stroke in 3 prospective cohort studies, as well as a more favourable blood lipid and inflammatory profile.

Similarly, regular nut consumption is a key component of the Mediterranean-style dietary pattern. In a randomised trial in people with raised cardiovascular disease risk, a Mediterranean diet with added nuts, compared to control diet, reduced the risk of cardiovascular disease, type 2 diabetes, cognitive decline, and other adverse health outcomes.

The EAT-Lancet Commission Planetary Health Diet also recommends consuming 50g of nuts per day (tree nuts and peanuts). In a systematic review and meta analysis including a total of over 2.21 million participants, this dietary pattern was associated with a significantly reduced odds of diabetes, CVD, cancer and mortality.

Cardiovascular health

Some of the strongest evidence for the health benefits of nuts and seeds is related to a reduced risk of cardiovascular disease and its risk factors.

In a systematic review and meta-analysis, consuming the high versus lowest quantity of nuts and seeds was associated with a reduced risk of cardiovascular disease, cardiovascular mortality, coronary heart disease, and coronary heart disease mortality. A smaller, but still relevant, risk reduction was also seen for stroke.

The reduction in risk of cardiovascular disease could, in part, be due to the impact that consuming nuts and seeds can have on blood lipids. In the same meta-analysis as above, intake of nuts (median ~50 g/day) lowered total cholesterol by 0.15 mmol/L and LDL-cholesterol by 0.13 mmol/L. These findings are supported by a comprehensive review of the literature, which studied 19 systematic reviews and meta-analyses of randomised controlled trials. Across the trials, there was a consistent beneficial effect of total nuts and tree nuts, including walnuts, almonds, cashews, peanuts, and pistachios, for decreasing total cholesterol by 0.09 to 0.28 mmol/L, LDL-cholesterol by 0.09 to 0.26 mmol/L, and triglycerides by 0.05 to 0.17 mmol/L. One of the included reviews also examined the effect of nuts on apolipoproteins and found a significant reduction in apolipoprotein B of 0.042 g/L, across 13 trials.

Nuts and seeds can also lower the risk of high blood pressure, a leading driver of cardiovascular disease. Flaxseeds are particularly notable for their blood pressure lowering effect, with an effect size worthy of use in people with hypertension.

Why are nuts and seeds so good for us?

Nuts and seeds are a rich source of monounsaturated and polyunsaturated fats, as well as plant protein, dietary fibre, phytosterols and polyphenols. Individually, these nutrients are beneficial for health and may, for example, have modest cholesterol-lowering effects. However, when they are combined within the natural matrix of a nut or seed, their effects appear to be even greater, contributing to the reductions in LDL-cholesterol observed in studies of regular nut consumption.

We know that the favourable fatty acid profile of nuts contributes to improvements in blood lipids, particularly when nuts replace foods high in saturated fat. Evidence has also demonstrated that phytosterols contribute to the cholesterol-lowering effects of nuts and seeds. Phytosterols interfere with cholesterol absorption in the intestinal lumen, helping to lower blood cholesterol levels. The phytosterol content of nuts varies, with pistachios, almonds, and walnuts containing some of the highest amounts.

Nuts and seeds also provide important micronutrients, including magnesium, zinc, iron, calcium, copper, phosphorus, potassium, selenium, vitamin E, and B vitamins. Together, these nutrients support several aspects of health, including cardiovascular function, immune health, bone health, and protection against oxidative stress. Nuts also contain a relatively high amount of L-arginine, which has cardiovascular health benefits.

The array of healthy nutrients in nuts together with the fact that they are likely to be replacing less healthy foods in the diet results in reduced mortality from all causes and from cardiovascular diseases, cancer, respiratory diseases and infectious diseases.

Are nuts associated with weight gain?

Despite the mounting evidence for the health benefits of nuts, concerns persist that they may contribute to weight gain due to their high energy density. Nuts are known to have a high fat content, making up at least 40% of their total energy content, ranging from around 44% in pistachios and cashews to 76% in macadamia nuts.

This may be a barrier for increasing the consumption levels of nuts in line with healthy eating recommendations, as they are seen as more energy dense and more likely to contribute to weight gain compared to other healthy foods.

Despite this concern, robust evidence from a systematic review and meta-analysis suggests that the opposite might even be true. Across six cohort studies, nuts were associated with lower incidence of overweight/obesity and across 86 randomised controlled trials, researchers found no adverse effect of nuts on body weight.

There are a number of reasons why nuts are not associated with weight gain. The high protein and fibre content and the need for prolonged chewing may contribute to an increased feeling of fullness. Not all of the fat in nuts is absorbed and unsaturated fats may result in a greater thermogenic effect (the increase in the metabolic rate that occurs after eating a meal/food) than saturated fats.

Best nuts and seeds to include in a plant-based diet

All nuts and seeds can contribute to a healthy dietary pattern and provide a wide range of beneficial nutrients. Including a variety is likely to provide the greatest nutritional benefit, as different nuts and seeds contain different combinations of unsaturated fats, fibre, vitamins, minerals, and phytochemicals.

For individuals following a plant-based diet, flaxseeds, chia seeds, hemp seeds, and walnuts are particularly valuable additions due to their content of alpha-linolenic acid (ALA), an essential omega-3 fatty acid. ALA is essential because we must obtain it from our diet. Daily requirements of ALA can be met by eating a tablespoon of chia seeds or ground flaxseeds (linseeds), two tablespoons of hemp seeds or six walnut halves.

Sesame seeds and tahini provide a useful source of calcium and zinc, while pumpkin seeds are rich in iron and zinc. Brazil nuts are notable for their selenium content, with just two nuts often providing enough selenium to meet daily requirements, though content can vary depending on where they’re grown. Almonds and hazelnuts are rich in vitamin E, and pistachios and walnuts provide particularly high levels of phytosterols, which may contribute to cholesterol lowering.

Nut and sesame allergy

Tree nut and peanut allergies are among the most common food allergies and can range from mild to severe. Individuals with a diagnosed allergy should continue to avoid the foods they are allergic to and seek guidance from their healthcare professionals regarding safe food choices.

For information on introducing peanuts safely to infants and children, please refer to the factsheet on our website.

Allergy to sesame is also increasing and is one of the 14 allergens that are mandated to be listed on food products when present.

Top tips for incorporating nuts and seeds into the diet

• Enjoy a handful of your favourite nuts as a quick and delicious snack, choosing mostly unsalted and minimally processed nuts and seeds is recommended where possible.
• Making your own homemade trail mix using unsalted nuts, seeds, and dried fruit can be a simple way to have a ready-to-go snack
• Sprinkle nuts and seeds on top of soups, salads, stir-fries, oatmeal and cereal. For example, sesame seeds on stir fries and curries, pumpkin seeds on salads.
• Blend seeds such as flax, chia, or hemp into smoothies
• Use nut butters to top off a snack, such as peanut butter with apple slices, almond butter on whole grain toast, or a tahini sauce drizzled over roasted vegetables
• Incorporate nuts into savoury meals. For example, walnuts can be added to lentil bolognese, cashews can create creamy sauces, and mixed nuts can be used in nut roasts or veggie burgers.
• Use nuts and seeds such as pistachios and pine nuts to make homemade pestos, dips, and salad dressings
• Add nuts and seeds to home baking, such as breads, muffins, flapjacks, and granola, or experiment with nut flours in baking recipes

PBHP Members book club

Sunday 12th July 2026, 7pm BST

Our next book club discussion will be about:

Food Intelligence by Kevin Hall.

Not a member? Please join us here.

Global Healthy Hospital Network webinar

June 10th 4pm BST/5pm CEST

Healthy food alone is not enough. It also has to look good, taste good, and feel meaningful to the people eating it.

Our next Healthy Hospital Food Network webinar brings together two inspiring speakers to explore how taste can support the transformation of food in hospitals and other care settings. From whole-food approaches and chef education to taste architecture and cooking techniques, the session will showcase concrete ideas for making nutritious meals more appealing and more successful in practice.

🔹Bettina Campolucci is a plant-based chef and wellness educator. She will share insights from the Chefs’ Manifesto, highlighting the power of whole foods, humble vegetables, legumes, chef training, and recipe development to improve menus and strengthen food quality in institutional settings.

🔹Jaroslav Guzanic is a Research & Private Chef, Founder of Taste of Central Europe, Swiss Network for Food Education and Co-Lead of the NNEdPro Europe Regional Network. He will focus on answering “how can we cultivate taste’ and share practical solutions for hospital kitchens that connect flavour, appearance, food bioactives, cooking methods, and multisensory experiences.

Following the two speaker inputs, participants are invited to join a 25-minute discussion on what it takes to implement these ideas in real kitchen environments.

Join us for an exchange on how healthier food can become more attractive, more delicious, and more feasible in healthcare.

Benefits of a Plant-Based Diet

By Dr Shireen Kassam, Director of Plant-Based Health Professionals UK

A plant-based diet is one that focuses on the consumption of fruit, vegetables, whole grains, beans, nuts and seeds, whilst minimising or avoiding animal-derived and processed foods. There is no precise medical definition of a ‘plant-based diet’, and it includes vegan (100% plant-based), vegetarian and flexitarian diet patterns. Most people consider a plant-based diet one where at least 85% of calories are derived from plant foods. There are numerous benefits to this way of eating and it is healthy and safe to do so at all stages of life.

So, what are some of the expected benefits?

Maintaining a healthy weight

A healthy diet is the main way to maintain a healthy weight. A plant-based diet consists predominantly of foods which are lower in energy density, yet packed full of essential nutrients. People following a 100% plant-based or vegan diet tend to have an overall lower body mass index when compared to people following non-vegan dietary patterns.

One of the most important nutrients for maintaining a healthy weight is fibre and this is only found in plant foods. Fibre not only keeps you feeling full for longer, but it also promotes a healthy gut microbiome, which in turn positively impacts body weight.

On a plant-based diet, you can usually eat to fullness without overly worrying about portion control or calorie counting. You are also less likely to gain weight over time. This is certainly true when you concentrate on eating minimally processed plant foods, as close to nature as possible.

Reducing the risk of high blood pressure

High blood pressure or hypertension is a leading cause of illness, especially heart disease, a major cause of death in the UK. Yet for most people it is possible to maintain a normal blood pressure throughout life by adopting healthy lifestyle habits. These include regular physical activity, avoiding tobacco smoking and alcohol consumption, sleeping well and managing stress.

When it comes to diet, plant-based diets are best for maintaining a healthy blood pressure and can have a similar blood pressure lowering effect to medications. A vegan diet may have the greatest beneficial impact on blood pressure, in part due to the association with lower body weight.

There are certain foods and nutrients within a plant-based diet that stand out in their ability to reduce blood pressure. These include whole grains, legumes and nuts and seeds. Nitrate-rich vegetables, such as leafy greens and beetroot, including beetroot juice, dilate the blood vessels and reduce blood pressure. Flaxseed and hibiscus tea are also useful additions.

Minimising salt / sodium consumption is essential for maintaining a healthy blood pressure although it is worth noting that most salt in the diet comes from ultra-processed foods rather than the salt used in cooking or for flavouring. Increasing the intake of potassium by eating more fruit and vegetables benefits blood pressure control. For those trying to cut down on salt (sodium chloride), switching to potassium chloride salt, may be beneficial, although caution is required for people with chronic kidney disease and those taking medications that elevate blood potassium levels.

Reducing the risk of high cholesterol

As animal-sourced foods are progressively removed from the diet, blood cholesterol levels fall. People who eat a vegan or 100% plant-based diet, tend to have the lowest cholesterol levels of all diet patterns. This is because a plant-based diet avoids or minimises ‘nutrients’ that increase blood cholesterol, namely saturated fat, and to a lesser extent dietary cholesterol. It also emphasises nutrients that naturally keep blood cholesterol low, such as fibre and unsaturated fatty acids.

Some standout foods for lowering cholesterol that are part of the Portfolio diet are nuts and seeds, plant protein (chickpeas, soya, beans), foods high in viscous fibre, plant sterols and oils high in monounsaturated fatty acids, such as extra virgin olive oil.

Reducing the risk of type 2 diabetes

Type 2 diabetes is driven by insulin resistance, a condition caused by the abnormal accumulation of fat inside the muscle, liver and pancreatic cells. This fat accumulation inhibits the action of insulin and thus leads to elevated blood glucose levels.

Plant-based diets, including vegetarian and vegan diets, are associated with a significantly lower risk of type 2 diabetes, in part, but not exclusively due to the beneficial impact on body weight. Plant-based diets are also central to the treatment of type 2 diabetes, and in some can induce remission.

Reducing the risk of heart disease

The main risk factors for heart disease are being an unhealthy weight, high blood pressure, high cholesterol and type 2 diabetes. Avoiding these conditions significantly reduces the risk of heart disease. So it is not surprising that plant-based diets, including vegetarian and vegan diets, are associated with lower rates of heart disease.

It is worth noting that not all plant-based diets are created equal. To optimise health outcomes, a plant-based diet needs to be composed mainly of minimally processed, whole foods. A plant-based diet that is high in refined grains, free sugar and ultra-processed foods can be as bad as a meat-heavy diet and does not benefit health.

Reducing the risk of cancer

The causes of cancer are varied and complex. Eating a plant-based diet is one of several healthy habits that is associated with a lower risk of cancer. This is because you avoid foods associated with a higher risk of cancer, such as processed and red meat, and instead focus on foods and nutrients that reduce cancer risk. These include fibre, whole grains, fruit and vegetables and soya foods.

In general, meat-free diets, both vegetarian and vegan, have been associated with a lower overall risk of cancer of around 15%. In part, because of the association with a healthier body weight, but also because of the associations with lower inflammation and a healthier gut microbiome.

Surprising benefits

There is a long list of health benefits of plant-based eating that may surprise you. Some are listed below:

• Lower risk of urinary tract infections, as most infections are derived from bacteria carried in meat.
• Improvements in menstrual pain in women.
• Improvements in menopausal symptoms, especially when emphasising soya foods.
• Lower risk of fatty liver disease because it is naturally low in saturated fat and high in fibre-rich foods.
• Lower use of insulin in people with type 1 diabetes.
• Lower in cost by a third, compared to the typical Western diet.
• Lower medical costs and lower use of prescribed medications.

Best for planetary health

Without a healthy planet there are no healthy people.

The climate and ecological crises are now directly affecting human health globally. One of the main drivers is our food system. Animal agriculture is a major cause of greenhouse gas emissions, biodiversity loss, land, water and air pollution, land use change and more. The most impactful action we can take as individuals is to remove animal-sourced foods from the diet and instead eat a plant-based diet. Without exception, the production of all plant foods has significantly less impact on the environment than animal-sourced foods. There is now international consensus that if we want to meet our climate and nature goals, we need a global transition to a plant-based food system.

The Planetary Health Diet, devised by the Eat-Lancet Commission, provides a global framework for a healthy diet that will keep the food system within planetary boundaries. It is a diet that is composed of more than 85% plant-based foods, with animal-sourced foods greatly limited and not considered essential.

Concluding remarks

The positive impacts of a plant-based diet far outweigh any perceived downsides. There are additional huge benefits to our animal kin who find themselves living their entire lives in factory farms. Like with all diet patterns, a plant-based diet needs to be appropriately planned. If adopting a vegetarian or vegan diet, supplementation with vitamin B12 is essential.

Plant-based diets are full of abundance and flavour, can be adapted to all traditional and cultural diet patterns, and are a joy to adopt.

Resources

Plant-Based Eatwell Guide

Plant-Based on a Budget

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

Healthy life expectancy is at an all time low in the UK, yet healthy habits support better liver, cardiovascular and brain health. Plus more food industry shenanigans.

Healthy life expectancy in the UK at an all time low

A sobering start to this month’s review. A new report from The Health Foundation finds that healthy life expectancy – the average number of years a person would expect to live in good health – is at an all time low in the UK. Over the last decade it has fallen by 2 years, making it 60.7 years for males and 60.9 years for females.

Even more alarming is that the gap in healthy life expectancy between the most and least deprived deciles in England is now 19.4 years for males and 20.3 years for females. Healthy life expectancy fell more rapidly for females than for males, raising concerns about the worsening trend of women’s health.

Of 21 high-income countries, the UK is one of only five that saw healthy life expectancy fall between 2011 and 2021, and had the second steepest decline. The UK now ranks 20th with only the United States having a lower healthy life expectancy.

This has not been caused by the COVID-19 pandemic as life expectancy has largely remained stable in the UK and other similar countries have seen healthy life expectancy remain stable or improve. Rather, it is a reflection of lifestyle and socioeconomic factors, which are of course inextricably linked.

The authors conclude ‘the UK’s trajectory is not inevitable, but the result of policy choices and underlying conditions that have left the population, particularly among working-age adults, more vulnerable to ill health.’

This should be a wake up call to ensure the UK can offer citizens a minimum standard of living (i.e. housing, education, jobs) and access to healthy behaviours (diet and nutrition, physical activity and avoiding tobacco and alcohol).

New Lancet Commission on liver health

This second Lancet commission on liver health raises awareness of lifestyle factors that are driving liver disease across Europe. Alcohol and unhealthy diets are the key drivers of liver-related mortality (from cirrhosis and liver cancer) and eliminating these risk factors would almost half the burden of liver disease.

The major dietary factors remain excess consumption of saturated fat (mainly from animal-sourced foods), and added or free sugars, such as fructose or sucrose in foods and sugar sweetened beverages. These dietary factors are usually associated with excess calorie intake and overweight/obesity, which in turn causes liver dysfunction.

The commission makes it clear that unhealthy behaviours are primarily related to the environments we live in rather than a failure of individual will power and thus Government and policy makers need to focus on shaping healthy living environments.

Food insecurity is compounding the problem as more people are relying on cheaper, energy-dense, high-fat, high-sugar, low-nutrient foods, leading to an overall decline in dietary quality.

Check out our factsheet on diet and lifestyle for liver health.

Sleep, nutrition and physical activity important for cardiovascular health

This study investigated the combined impact of three healthy behaviours – sleep, nutrition and physical activity – on cardiovascular health. The researchers analysed data on 53,424 participants in the UK Biobank study. Sleep and physical activity information was collected from a wearable, wrist accelerometry data. Dietary intake was assessed once at baselines using a self-reported questionnaire.

Over the 8.0-year follow-up period, 2034 major adverse cardiovascular events (MACE) occurred, comprising 932 myocardial infarctions, 584 strokes, and 518 heart failure events.

The results showed that 8-9.4 hours of sleep per day, 42-104 minutes of moderate to vigorous physical activity per day and a high diet quality score was associated with a 57% lower risk of a MACE. Even small increments towards ideal healthy habits was beneficial with the combination of an additional 10 min/day of sleep, 5 min/day of physical activity and 3 extra points on the diet quality score (equivalent to an extra one-fourth cup of vegetables) associated with a 10% lower risk of MACE.

The authors conclude ‘These findings highlight the need for integrated multi-behaviour lifestyle prevention trials to evaluate the effectiveness of small, achievable lifestyle changes for MACE prevention.’

Read our article on plant-based diets and cardiovascular disease.

Plant-based diets and risk of dementia

Studies on diet and dementia risk are increasingly demonstrating a consistent theme. Diets rich in whole plant foods and lower in animal-sourced and ultra-processed foods are associated with a reduce risk. This is in part because plant-rich diets reduce the risk of hypertension, obesity, type 2 diabetes, dyslipidaemia, condition which increase the risk of dementia.

This new study aimed to investigate the impact of plant-based dietary patterns on the risk of dementia in ethnically diverse population. Data from the Multiethnic Cohort Study, based in Hawaii and California (primarily Los Angeles County), was analysis and includes African American, Japanese American, Latino, Native Hawaiian, and White participants who completed food frequency questionnaires at baseline (1993-1996; age 45-75 years) and at 10-year follow-up (2003-2008). Dietary data were scored according to overall plant-based diet, healthy plant-based diet and unhealthy plant-based diet index. You can read more about the plant-based diet index here.

The results showed that participants most adherent to an overall plant-based diet and a healthy plant-based diet had a 12% and 7% reduced risk of dementia, respectively. Adherence to an unhealthy plant-based diet was associated with a 6% increased risk.

Researchers were also able to assess the impact of dietary change over time. Participants who changed their diet to a more unhealthy plant-based diet over the follow up period had a 25% increased risk of dementia, whereas participants who improved their diet quality over time had a 11% lower risk.

The findings were overall consistent across age groups, race and ethnicity and APOEℇ4 carrier status.

The researchers explored changes in intake of individuals food groups. A large decrease in 4 of the 7 healthy plant food groups (whole grains, vegetable oils, nuts, and tea/coffee) was associated with a higher risk of dementia by 11%–15%. Of the 4 less healthy plant food groups, only increased consumption of added sugars was associated with a 12% higher risk of dementia. Of the 5 animal food groups, a large decrease in egg consumption was associated with a 12% higher risk of ADRD. Increase in consumption of animal fats and meat were associated with an increased risk of dementia.

Overall, the study supports the findings of other similar studies, that increasing the consumption of healthy plant foods, whilst reducing the consumption of animal-sourced foods and limiting unhealthy plant-based foods is helpful for reducing the risk of dementia. The reasons for these finding are multiple, including the presence of nutrients within plant foods such as fibre, vitamins and minerals that help maintain cardiovascular health, normal blood lipid levels and help prevent diabetes.

The finding on eggs is interesting as other studies have also found that egg consumption is associated with a lower risk of dementia, including this new analysis of the Adventist Health Study-2. But, and there is a big BUT. The results from the Adventist Health Study showed that substituting eggs for nuts/seeds or legumes in the diet was associated with a similarly reduced risk of Alzheimer’s disease.

In my view, there is nothing special about eggs. The nutrients that are thought to support better brain health include, omega-3 fats, vitamin B12, choline and lutein and zeaxanthin-carotenoids. All the nutrients in eggs can be adequately sourced from plants, fortified foods or in the case of vitamin B12, from a supplement. Of note, several nutrients in eggs, such as omega-3 fats and vitamin B12 are fed to chickens. It is no different for humans to obtain these nutrients from their original source without having to eat eggs.

Most populations globally are not consuming sufficient legumes and nuts, even if traditionally their diets have been mostly plant-based, like in India. For this reason it is more difficult to assess the impact of legume and nut consumption on brain health or other aspects of health for that matter. If people are not consuming these foods, observational studies can’t assess the impact on health. What we do know from multiple studies is that substituting animal-sourced foods, including eggs, for legumes and nuts, consistently has a positive impact on health, including a reduced risk of premature mortality.

Brain health is dependent on many other factors. Learn more in our article on diet and lifestyle and brain health.

Limiting ultraprocessed foods and optimising fibre intake.

Two new review articles are worth reading. The first is a consensus on ultraprocessed foods and cardiovascular health from the European Society on Cardiology. Diets high in UPFs are associated with negative health outcomes, including cardiovascular diseases. However, not all UPFs are created equal and the classification itself does not tell you about the nutritional value of the foods.

This consensus statement recommends that in clinical practice, we should support patients to remove or greatly limit processed meat, packages snacks and sugar-sweetened beverages in the diet, whilst prioritising fibre-rich plant-based foods. Any shift towards a more plant-based diet is better for health. Encouraging home cooking, considering meal timings and the context in which meals are eaten – earlier in the day, mindfully and slowly – is also important.

The document does not discuss plant-based meat or dairy alternatives which is a shame as these are increasingly included in country-based dietary guidelines and growing numbers of people are actively reducing the consumption of animal-sourced foods for environmental and ethical reasons.

The second is a review on dietary fibre, which remains one of the most under-consuming nutrients in the modern diet.. Despite decades of evidence linking fibre-rich diets with lower rates of cardiovascular disease, type 2 diabetes, obesity and bowel disorders, fibre intake across industrialised nations remains far below recommended levels. In the UK, only 4% of children and adults meet recommended daily intakes.

The authors explore the difference between intrinsic fibre found naturally within whole plant foods and functional fibre added to processed foods or sold as supplements. While both may have physiological effects, the evidence consistently shows that the greatest health benefits come from consuming minimally processed plant foods such as vegetables, fruits, legumes, nuts and whole grains. These foods contain fibre within an intact plant matrix alongside polyphenols, antioxidants and other protective compounds that work together to support health.

A central theme of the paper is the relationship between fibre and the gut microbiome. Different fibres influence microbial composition and metabolism in highly specific ways, particularly through the production of short-chain fatty acids, compounds known to support gut integrity, immune function and metabolic health. However, not all fibres are equal. The physiological effects depend on their structure, fermentability and viscosity, as well as the food matrix in which they are delivered. This may explain why fibre supplements and fortified foods often produce less consistent and less comprehensive benefits than whole plant foods.

The review also highlights the limitations of highly processed diets and cautions against relying solely on isolated fibre ingredients to solve a population-wide fibre deficit. Targeted fibre fortification and supplementation may help in certain contexts, they cannot replicate the broad clinical benefits seen with diets centred on minimally processed plant foods.

The authors emphasise that improving fibre intake requires more than individual behaviour change. Public policy, food reformulation, labelling initiatives and better access to affordable plant foods will all be necessary to create healthier food environments.

Keto diets and LDL-cholesterol

Although low-carbohydrate, animals-based diets, including the ketogenic diet (KD), remain outwith consensus, some clinicians and high profile influencers continue to recommend this way of eating. In the short-term there may be some benefits, but concerns remain about long-term health outcomes. In part, because diets high in saturated fat and low in fibre lead to elevated LDL-cholesterol (LDL-C) and apolipoprotein B levels and thus a higher risk of atherosclerotic cardiovascular disease (ASCVD).

This new review focuses on KD-induced elevation of LDL-C in people with normal body mass index, exploring potential mechanisms underlying this phenotype, and discusses implications for ASCVD risk and management.

The bottom line is that keto diets can result in large elevations in LDL-C. The authors state ‘there is currently no established evidence that individuals with marked LDL-C elevations on KDs are protected from LDL-mediated atherogenesis’ and they suggest that reintroducing carbohydrates is a useful strategy for reducing LDL-C levels. If a person wants to continue a KD despite the dyslipidaemia, then cholesterol lowering medication may need to be instituted.

The authors conclude ‘The absence of long-term outcome data should not be interpreted as evidence of cardiovascular safety in these patients’.

It seems crazy to me that people want to adopt KDs when fibre-rich, plant-based diets have so many benefits for both short and long-term health.

Animal-based versus plant-based protein for muscle protein synthesis

This new systematic review and meta-analysis of 12 studies found that animal-based proteins confer a small but significant advantage in stimulating muscle protein synthesis (MPS) compared to plant-based proteins. Most animal protein data were derived from milk-based sources, while plant proteins were from a variety of different sources.

However, the interpretation is more nuanced. The observed advantage of animal protein was mostly seen in older adults (>65 years), whereas younger individuals showed comparable MPS responses regardless of protein source. MPS responses were observed for young and older adults regardless of resistance exercise or not.

The authors suggest that this age-related difference may be related to the lower leucine content typically found in plant-based proteins. Leucine is a key regulator of MPS and can be rate limiting if not consumed in sufficient amounts. In older adults, anabolic resistance (blunted MPS response to stimuli such as protein and exercise) means that higher per-meal leucine intake is required to effectively stimulate MPS. This could be mitigated by increasing total protein intake or fortifying plant proteins with additional leucine.

Of note, this meta-analysis assessed acute MPS responses rather than long-term changes in muscle mass but overall the data suggests that both plant and animal-based protein can support muscle synthesis providing daily intake is sufficient (approximately 1.6 g/kg). It should also be noted that most of the participants in the included studies were male and so the generalisability to females is uncertain.

Greenwashing by meat & dairy companies and meat industry research funding

Two different but related papers highlight how environmental claims and climate promises by the meat and dairy companies are best classified as ‘greenwashing’ and how meat industry funding of scientific research more often than not finds in favour of eating meat.

The first paper analysed the environmental commitments and claims of 33 of the world’s largest meat and dairy companies. 1233 environmental claims were identified of which 68% (841) were climate-related. 98% of the claims were categorised as Greenwashing i.e. no clear or achievable plan to reach the target.

The second paper included 500 studies investigating the health impacts of meat consumption. 78 (15.6%) reported industry involvement. Studies linked to the meat industry were 16 times more likely to report positive findings about meat consumption with a significant association between meat industry funding and the study conclusion.

These two studies demonstrate the typical industry playbook allowing ‘business as usual’ to continue. It mirrors the tactics of the tobacco and alcohol industry. Fund the scientists and the research; cast doubt and perpetuate misinformation; pretend to care but continue to promote a product that harms; renege on commitments that would improve health and the environment. This has all been eloquently summarised in a fantastic report by Changing Markets – Big Meat and Dairy’s narratives to derail climate action.

Additional papers of interest

Exposure to plastics is of increasing concern as there are associations with negative health impacts. A new intervention study has shown that limiting consumption of highly processed foods, plastic food packaging and canned goods, and minimising plastic touch points during production – from farm to fork – can reduce urinary excretion of phthalates and bisphenols (chemicals associated with plastic exposure). This provides actionable evidence for individuals who are looking to reduce ingestion of plastic.

We know that many chronic conditions are driven by the same undying mechanisms. This is recognised now by the fact that the combination of heart, kidney and metabolic conditions (diabetes and obesity) is known as cardiovascular-kidney-metabolic syndrome, or CKM syndrome. These same chronic condition are known to increase the risk of cancer. A new large retrospective analysis from Japan that includes almost 1.4 million people finds that people with CKM syndrome have an increased risk of multiple cancer types and the risk increases as the stage of CKM worsens. Thus preventing CKM syndrome should also reduce cancer incidence.

Diet and lifestyle practices are essential for cancer prevention but can also have a positive impact even after a cancer diagnosis. This new short report finds that in a large cohort of cancer survivors in the US, adherence to healthy lifestyle practices has not changed much over time. However, people who received counselling on lifestyle factors were more likely to engage in these positive behaviours. This once again highlights the need for lifestyle medicine to be incorporated into all aspects of primary and secondary healthcare.

Processed meat consumption is associated with a number of health harms according to this new umbrella review that summarises existing systematic reviews and meta-analyses. Eating 50g/d was associated with a 72% higher risk of gastric cancer, 17% higher risk of colorectal cancer, 4% higher risk of prostate cancer, and an 8% higher risk of chronic obstructive pulmonary disease. There is no safe limit of consumption and therefore zero is the optimal amount to include in the diet.

Last but not least, our very own research paper published in BMJ Nutrition, Prevention and Health from the team at Plant-Based Health Professionals UK in collaboration with Dr Dagfinn Aune. Consumption of legumes and soya is associated with a reduction in the risk of hypertension. Read more here.

See you back in June!

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Plant-based diets for the prevention and treatment of cardiovascular diseases

By Michael Metoudi, RD

What is cardiovascular disease?

Cardiovascular disease (CVD) defines a group of disorders affecting the heart and blood vessels. The most common type is coronary heart disease (CHD), characterised by the narrowing of blood vessels and reduced blood flow to the heart. If left untreated, it develops into other serious types of CVDs such as arrhythmias (irregular heartbeats), angina (chest pain), and eventually leading to myocardial infarction (heart attack) and heart failure. Other major types of CVDs include hypertension and cerebrovascular disease, such as stroke, both of which have significantly increased in the UK during the past two decades.

CVDs remain the commonest cause of illness and death worldwide. Alarmingly, the overall rates of heart disease have dramatically increased in younger people, suggesting that it is not just a disease confined to old age.

Risk factors for cardiovascular diseases

 The main drivers of CVD are lifestyle-related and are mostly modifiable. These include:

 1) Behaviour or lifestyle risks: such as poor dietary patterns, high in salt and low in whole plant foods; smoking; physical inactivity; and alcohol use.

 2) Metabolic risks: such as high systolic blood pressure, obesity, high LDL-cholesterol and fasting blood glucose and diabetes.

 3) Environmental risk: including air pollution.

Other emerging modifiable lifestyle factors include high stress levels, poor sleep and social isolation and loneliness.  Genetics appear to be responsible for 40-60% of the risk for CVD. However, diet and lifestyle interventions can offset genetic risk for CVD by almost one half in susceptible individuals.

Cardiovascular disease risk factors

The evidence for whole-food plant-based diets in cardiovascular diseases

Prevention and Treatment

Poor diet quality represents the number one lifestyle risk factor for CVD, responsible for up to half of all cardiometabolic disease-related deaths.

Some of the strongest evidence supporting a whole food plant-based diet (WFPBD) for CVD relates to the prevention and treatment of CHD. Studies as far back as the 1950s have shown that predominantly and exclusively plant-based diets reduce CVD risk.

Two landmark cohort studies include the Framingham Heart study and the Seven Countries study, first linking diet quality (plant vs. animal fat) to CHD risk. Fast forward and we have over 75 years of data from meta-analyses of large prospective cohort studies consistently showing a reduced risk of CHD, overall CVD, their primary risk factors and CVD mortality in those following a plant-based diet. These studies include data from participants that follow vegetarian or vegan diets such as the EPIC-Oxford and Adventist Health studies showing just under 30% reduction for CHD.

For Intervention studies involving the primary prevention of CVD, the PREDIMED study showed that a Mediterranean diet pattern, supplemented with olive oil or nuts in those at high risk, reduced stroke and overall CVD events by at least one third. The more recent OMNIVEG study showed even greater benefits for heart disease risk factors for those following a vegan Mediterranean-style diet compared to the traditional Mediterranean diet.

When it comes to the treatment of established heart disease (secondary prevention), there are consistent and significant improvements in CVD risk factors including reduced blood lipids levels, blood pressure and markers of glycaemic control in people following a vegan or vegetarian diet.

The Lifestyle Heart Study, a randomised lifestyle intervention trial involved 48 patients with established CAD. This study showed that a predominantly WFPBD, low in fat, together with other lifestyle interventions (exercise, smoking cessation and stress management) resulted in 82% of patients showing regression of their arterial CHD in the intervention arm of the study, after 5 years of follow-up.

Importance of diet quality

Studies that consider diet quality, using the plant-based diet index, such as the Nurses’ Health Study and the Health Professionals Follow-up study, also find a similar risk reduction in CVD in those eating the highest portions of whole plant foods.

High adherence to a healthy plant-based diet is associated with a 14% reduction in CHD and a 10% reduction in overall CVD risk. Conversely, following an unhealthy plant-based diet, high in ultra-processed foods, refined grains, free sugars, unhealthy fats, and salt, can increase the risk of CVD and CVD Mortality.

When substituting animal foods for plant foods, such as nuts, legumes or whole grains, there is a significant reduction in CVD risk by as much as 30%. Fish consumption has also shown to reduce CVD risk up to 8%, but only in types with a high omega-3 fat content, suggesting this to be the primary cardioprotective factor. Adequate sources of omega-3 can be obtained in whole plant foods such as flaxseeds, chia seeds, walnuts, hemp hearts and soya.

Mechanisms that drive cardiovascular diseases

 At the core (or heart!) of CVD is the development of atherosclerosis, the build up of plaque inside the arteries. These plaques are made up of predominantly fat, cholesterol, calcium and debris of cells from the immune system. Over time, these plaques harden, narrow the arteries, limit blood flow to the heart and organs and give rise to the collective symptoms of CVD. Plaque rupture leads to the formation of a blood clot, resulting in a myocardial infarction and/or stroke.

Atherosclerosis begins when specific lipoproteins, that transport lipids in the circulation (e.g cholesterol), become trapped beneath the endothelium that lines the blood vessels. Lipoproteins linked to this process include ApoB-containing lipoproteins, particularly LDL-cholesterol. Their retention within the arterial wall leads to an inflammatory reaction which drives the formation and growth of atherosclerotic plaques.

It is of great concern that the development of these plaques does not just occur later in life but appears to form even from early childhood.

Atherosclerosis development in Cardiovascular Disease

How whole-food plant-based diets reduce cardiovascular diseases

Lowering blood pressure

High blood pressure, or hypertension, is the biggest risk factor for CVD. Several studies demonstrate the benefits of plant-predominant diets in reducing hypertension, with the DASH diet (Dietary Approaches to Stop Hypertension) most extensively studied. The core components of the DASH diet are fibre-rich plant foods and thus following a vegan or 100% plant-based diet has well-established benefits for lowering blood pressure. As the intake of animal-sourced foods are lowered and plant-based foods are increased, the greater the benefits for blood pressure lowering. Specific beneficial foods include  whole grains foods, fruit and vegetables, and legumes.

WFPBDs are beneficial because of the abundance of dietary potassium, a mineral that is necessary for maintaining muscle function but also relaxing blood vessels, thereby reducing blood pressure. WFPBDs are naturally lower in salt, a major risk factor for hypertension. They are also higher in fibre, a nutrient consistently associated with blood-pressure lowering effects

Reducing blood and dietary lipids

Elevated blood lipids, especially LDL cholesterol, Lipoprotein (a)(LP(a)), a genetically-determined lipoprotein, and triglycerides are major risk factors for CVD. In general, the lower the levels of these lipids, the better for prevention and managing CVD. Saturated fat intake is the main determinant of LDL-cholesterol levels, with dietary cholesterol having a smaller, but still an important impact.

Vegetarians and vegans consistently have lower LDL-cholesterol levels than omnivores. There is a great deal of evidence based on the Portfolio diet, a combination of five plant-based food groups designed to lower cholesterol. These include plant sources of protein, nuts and seeds, sources of soluble fibre (oats, barley, psyllium), plant sterols and oils high in monounsaturated fats, such as extra virgin olive oil. (see our factsheet here). Despite  Lp(a) being genetically determined, plant-based diets have also shown to reduce levels by as much as 16% in 4 weeks.

WFPBDs have a variable impact on blood triglycerides. However, fibre-rich plant foods have shown to significantly reduce levels, particularly nuts (rich in omega-3 fats) and whole grains. Minimising intake of free sugars and refined grains is also important.

Reducing inflammation and improving endothelial function

Plant-based diets lower the risk of CVD by reducing inflammation.  Vegan and vegetarian diets as well as the Mediterranean diet were ranked highest for reducing C-reactive protein (hsCRP), a primary marker of inflammation that is linked to CVD by promoting atherosclerosis and endothelial dysfunction. Vegan and vegetarian diets appear to reduce other important circulating biomarkers of inflammation linked to CVD.

Whole plant foods have also directly been shown to improve endothelial function, especially through foods such as fruits, vegetables, soya, nuts and seeds, cocoa, and tea.

Blood glucose control and diabetes

Elevated blood glucose and type 2 diabetes almost doubles the risk of CVD, especially heart failure, heart attack and stroke. WFPBDs have shown to significantly reduce the risk of type 2 diabetes as well as having a role in the clinical treatment of type 2 diabetes. Emerging evidence also shows their role in the management of type 1 diabetes.

Modulating the microbiome

The gut microbiome is linked to a host of different diseases, with CVD being no exception. Specific species of gut bacteria appear to be responsible for an increased or decreased risk of CVD. Certain bacteria that metabolize compounds from carnitine, found in red meat and eggs produce trimethylamine (TMA), a molecule which gets converted to trimethylamine N-oxide (TMAO) within the liver. TMAO is linked to CVD risk. It can alter how cholesterol is metabolised by the body by disrupting reverse cholesterol transport and reducing its excretion, promoting lipid deposition, which accelerates atherosclerosis. Predominantly plant-based diets have shown to directly shift populations of gut bacteria from TMAO producers to beneficial bacteria that metabolise fibre and produce short chain fatty acids (SCFAs) that regulate blood pressure and reduce inflammation. Vegan diets in particular have gut microbiome signatures that are associated with improved cardiometabolic health.

Consensus Guidelines for reducing Cardiovascular disease

Conclusion

There is an abundance of high quality evidence supporting a WFPBD  for the prevention and treatment of CVDs. It addresses the root causes, whilst simultaneously providing the core nutrients that not only protect the heart and blood vessels, but do not contain the dietary components from animal foods that are directly linked to CVD risk, development and progression.

Why nurses can lead the shift towards a plant-based transition

Gio’s reflection for Nurse Week and International Nurses Day 12th May 2026.

By Giovanna Dicandia

As nurses, advocacy is at the very heart of our profession. We are trusted voices at the bedside, in communities, and increasingly within healthcare leadership and systems change. During International Nurses Week, it feels especially important to recognise the powerful role nurses can play in advocating for a sustainable, inclusive, plant-rich diet within our hospitals.

Nurses are often the healthcare professionals who spend the most time with patients, carers, and families. We see firsthand the impact that food has on health, recovery, dignity, and wellbeing. We also witness the growing burden of diet‑related chronic disease – conditions that are not only affecting individual lives but placing unsustainable pressure on the NHS. Advocating for healthier, plant-rich food in hospitals is not a “nice to have”; it is a clinical, ethical, and environmental imperative.

Hospital food sends a powerful message. When our healthcare institutions serve meals high in processed meat and low in whole-plant foods, it undermines the prevention messages we share with patients every day. Conversely, offering nutritious, culturally inclusive, and appealing plant-rich meals normalises healthy choices, supports recovery, and signals that healthcare is aligning practice with evidence.

Nurses are uniquely positioned to champion this change. Our role includes speaking up both for patients who need meals that respect cultural, religious, ethical, and medical needs, and for populations disproportionately affected by poor diet and environmental harm. A plant rich approach can be inclusive, affordable, and adaptable across cultures, while also supporting planetary health and the NHS’s net ‑zero commitments.

At PBHP UK, we see nurses leading this shift in practical and meaningful ways: influencing ward practices, contributing to menu discussions, supporting colleagues with evidence-based nutrition knowledge, and helping patients feel confident with plant‑rich meals during and after hospital stays. Nurses are also powerful role models – what we advocate for in our professional practice often shapes wider attitudes within teams and institutions.

Most recently we want to celebrate the work of Siew Yin, one of our PBHP UK nurses who led a fantastic plant-powered eating initiative in her local NHS hospital. With the support of a multidisciplinary team, the campaign sparked genuine curiosity and engagement among staff. Over 160 colleagues took part in a quiz, many asking to learn more about plant-based nutrition or to access the webinar playback led by Dr S. Kassam, Founder and Director of PBHP UK. A live “Lunch and Learn” session on plant-powered eating attracted strong attendance, and staff were signposted to practical resources, including culinary medicine training and a 21-day plant-based challenge. The initiative also included the provision of healthy, plant-based snacks, helping to start conversations and normalise plant-rich choices at work. It’s a great example of how nurse leadership, supported by teamwork, can turn education into meaningful cultural change within healthcare.

Siew Yin says: “I was driven to run this campaign so that my colleagues could fully grasp the power of plant-based eating – for their own well-being and for the health of our planet. As an advocate, the real joy came from seeing people benefit from the facts. Knowing that better choices stem from better understanding made the experience deeply fulfilling.”

Advocating for plant-rich food is not about perfection or removing choice. It is about ensuring that the healthiest, most sustainable option is the easy, inclusive option – especially in places dedicated to healing.

This Nurses Week, let us celebrate nurses as compassionate leaders in creating a healthcare system that truly promotes health of people, communities and the planet. Through our voices, our values, and our daily actions, nurses can lead the change we so much need for the benefits of everyone and the planet we inhabit.

Spread the word – we need more nurses on board!

Join PBHP UK as a member – lots of benefits and lots of exciting things to come! To learn more or to get involved, please contact Giovanna, PBHP UK Nurse Lead, at giovanna@pbhp.uk.

PBHP Members book club

Sunday May 10th 6.30pm GMT

Our next book club discussion will be about:

We Cook Plants by Sarah Bentley. Sarah will also be joining for a live discussion.

Not a member? Please join us here.

As global hypertension rates continue to rise – could soy and legumes be the answer?

The prevalence of hypertension has increased by 115% in over three decades, but new research suggests that higher consumption of these plant-foods could lower this risk.

New findings from a systematic review and meta-analysis published in the BMJ Nutrition, Prevention & Health journal has found a higher daily intake of soy and legumes is linked to a lower risk of developing high blood pressure.

These findings have considerable implications for public health guidance, given the current landscape of hypertension globally. High blood pressure affects an estimated 1.4 billion people worldwide and is a leading risk factor for cardiovascular diseases such as heart attack, stroke, and kidney disease all of which contribute to millions of preventable deaths each year.

Previous studies have shown that consumption of legumes and soy foods is associated with lower risk of overall cardiovascular disease, but specific research examining the relationship between legume and soy consumption relationship and hypertension needed to be systematically quantified.

The research team at Plant-Based Health Professionals UK (PBHP UK), supported by Dr Dagfinn Aune from Imperial College London, searched various medical databases for peer-reviewed research studies on the topic up until June 2025. This resulted in nine research publications representing eleven prospective cohort studies being included in the meta-analysis. Five studies were from the United States, four from Asia, two from Europe. Eight studies included both men and women, two studies included only women, and one study included only men. The number of participants ranged from 1,152 to 88,475 and across the studies the number of cases of hypertension ranged from 144 to 35,375.

The highest vs lowest intake of legumes and soy was associated with a 16% and 18% lower risk of developing high blood pressure, respectively. In the linear dose-response analyses there was a 12% and a 24% lower risk per 100g day of legumes and soy, respectively. 100g of legumes/soy is equivalent to a serving size of approximately 1 cup or 5-6 tablespoons of cooked beans, chickpeas, lentils, soybeans or a palm-size serving of tofu).

There was a clear dose-response relationship between increasing intakes of legumes and lower hypertension risk with a 30% reduction in risk at an intake of ~170 g/day, while for soy there was a 28-29% reduction in risk at 60-80 g/day, with no further reduction in risk at higher intakes.

When using grading criteria from the World Cancer Research Fund to evaluate the likelihood of a causal relationship between legumes and soy and hypertension, the researchers considered the evidence to be ‘supportive of a probable causal relationship between both legume and soy intake and a reduced risk of hypertension’.

There are many reasons why legumes and soy might contribute to lower hypertension risk – including their content of minerals, fibre and bioactive compounds. Legumes and soy are also high in potassium, magnesium dietary fibre all of which are associated with lower rates of hypertension.

Prior research by PBHP UK has shown that consumption of whole grains lowers the  risk of hypertension and Dr Aune has also shown that higher intakes of fruit and vegetables is also beneficial. The team is currently reviewing the available data on nuts and hypertension. All in all, the evidence strongly supports plant-rich diets for reducing the burden of this leading cause of ill health.

We are at a real watershed moment for both ecological and human health. The 2025 EAT-Lancet Commission report underscores, once again, that how we produce and consume food is central to addressing the twin crises of chronic disease and environmental degradation. It reinforces that dietary patterns richer in whole plant foods – such as legumes, whole grains, fruits, vegetables, and nuts – are associated not only with improved health outcomes, but also with reduced pressure on climate systems, biodiversity, and natural resources.

These new findings published in the BMJ point to a clear opportunity: increasing legume and soy consumption could help reshape dietary guidance and strengthen global efforts to address the global burden of hypertension.

So how can we incorporate these new research findings and increase our daily intake of legume and soy foods?

When it comes to breakfast ideas, making a simple tofu scramble (150g serving) or overnight oats with fortified soy yoghurt (150 grams) or 200mls of a soya-based dairy alternative is an easy way of getting more legumes and soy in the morning. For lunch, a coronation chickpea sandwich might be a great way to recreate a popular British classic. For dinner, why not try a traditional chickpea or tofu curry or even lentil lasagna using 1 cup measure of each legume type. And for some snack/dessert ideas, why not make a simple silken tofu chocolate mousse by just blending together 100 grams melted dark chocolate, 340 grams silken tofu and 2 tablespoons maple syrup. Can also add 1 tsp orange extract. Easy, delicious way to add tofu/soy into your diet and great for the whole family.

Don’t forget we have a huge range of educational resources on our website including our hypertension factsheet which you can share with colleagues, friends and family.

One of the researchers of this new meta-analysis, Michael Metoudi, RD, M.Sc, will be speaking at our upcoming Nutrition and Lifestyle Medicine Conference on all things plant-power and hypertension – secure your place now!

Plant Power: Soy and Legumes Connected to Lower Hypertension Risk

Date: 08 May 2026 

A new systematic review and meta-analysis published in the BMJ Nutrition, Prevention & Health journal has found that a higher daily intake of soy and legumes is linked to a lower risk of developing high blood pressure.

Key highlights:

• Eleven prospective cohort studies across 3 continents were included in the analysis, with the number of participants ranging from 1,152 to 88,475, including both men and women.
• A probable causal relationship was found between both legume and soy intake and a reduced risk of developing hypertension based on the World Cancer Research Fund grading criteria.
• The optimal intake appears to be up to 170 grams for legumes and 60-80 grams for soy foods per day for reducing the risk of hypertension.

Hypertension is one of the most significant global health challenges faced to date – affecting an estimated 1.4 billion people worldwide. It is a leading risk factor for cardiovascular diseases such as heart attack, stroke, and kidney disease, contributing to millions of preventable deaths each year. The prevalence of hypertension has significantly increased from 66 million cases in 1990 to over 1.28 billion cases in 2019, representing a 115% increase over three decades. Given the higher rates of hypertension in low and middle-income countries, these trends raise further concerns around already growing health inequalities.

Previous studies have shown that consuming legumes and soy foods is associated with a lower risk of overall cardiovascular disease, but specific research has remained limited when examining the relationship between legumes and soy consumption and the risk of hypertension.

The researchers from Plant-Based Health Professionals UK, supported by Dr Dagfinn Aune from Imperial College London conducted a systematic review and meta-analysis, searching several scientific and medical databases for all relevant peer-reviewed research studies on the topic up until June 2025. This resulted in 9 high quality publications with eleven prospective cohort studies being included in the meta-analysis. Five studies were from the United States, four from Asia and two from Europe. Eight studies included both men and women, two studies included only women, and one study included only men. The number of participants ranged from 1,152 to 88,475 across the studies and the number of cases of hypertension ranged from 144 to 35,375.

The pooled results among the studies together first showed that the highest vs lowest intake of legumes and soy consumed was associated with a 16% and 18% lower risk of developing high blood pressure. Further results from a linear dose-response analysis revealed a 12% and a 24% lower risk for every 100 grams of legumes and soy consumed per day.  One-hundred grams of legumes or soy foods is equivalent to a serving size of approximately 1 cup or 5-6 tablespoons of cooked beans, chickpeas, lentils, soybeans/edamame or a palm-size serving of tofu.

There was a clear dose-response relationship between increasing intakes of legumes and lower hypertension risk with a 30% reduction in risk at an intake of up to 170 grams per day. While for soy there was a 28-29% reduction in risk at 60-80 grams per day, with no further reduction in risk at higher intakes.

When using a grading classification from the World Cancer Research Fund to evaluate the likelihood of a causal relationship between legumes and soy and hypertension, the researchers considered the evidence to be ‘supportive of a probable causal relationship between both legume and soy intake and a reduced risk of hypertension’.

The researchers explain that there are many reasons why legumes and soy might contribute to lower hypertension risk, including their content of minerals, fibre and bioactive compounds. Legumes and soy are high in potassium, magnesium and dietary fibre, all of which are linked with lower rates of hypertension.

Additionally, recent studies have suggested that the fermentation of soluble fibre from legumes and soy foods produce short-chain fatty acids that influence blood vessel dilation and result in lower blood pressure.  Legume and soy intake might also indirectly impact hypertension risk as they are both linked to lower risk of obesity, which is itself a primary risk factor for hypertension.

Michael Metoudi, the lead author of the study concluded that: “These findings are very encouraging. They are however based on observational evidence which is one limitation in nutrition research and further well-designed randomised controlled trials might be needed to further confirm a direct effect on legumes and soy in lowering hypertension. There were also natural differences between the included studies such as different populations and the types of legumes and soy foods consumed which may have impacted how these results might be applied across different groups and legume types. I believe however the strength of these findings could have a major positive impact on public health given how hypertension has sky-rocketed in recent years, particularly within the UK and how these results showed meaningful reductions in the risk of developing high blood pressure. Adding such simple, affordable and sustainable foods into our day, whether it be a serving of the classic beans on toast for lunch and a delicious serving of chickpea or tofu curry for dinner could have a significant impact on hypertension and reduce the risk of the world’s leading chronic disease”.

A previously published meta-analysis from the same research group has demonstrated that whole grain consumption can also lower the risk of hypertension. They are also currently reviewing data on the role of nuts in hypertension risk. These data further highlight how other plant-based foods also lower the risk of developing hypertension over time.

Given the alarming global prevalence of hypertension, these findings have significant implications for public health guidance. The recently published 2025 EAT-Lancet Commission highlighted the latest evidence for healthy, sustainable and just food systems – maintaining legume intake recommendations at at least 75 grams a day. Current legume intake across Europe and the UK remains far below dietary recommendations, at around 15 grams per day and will need to increase substantially to support both population health and the health of the planet.

The findings of this research therefore support dietary recommendations to increase the intake of legumes in the general population.

Notes for editors:

Plant-Based Health Professionals UK is a Community Interest Company dedicated to improving human and planetary health through evidence-based whole-food plant-based nutrition and lifestyle medicine. By educating healthcare professionals and the public, it supports the prevention and management of chronic disease while recognising the interconnected health of people, animals, and the environment.

Research: Legume and soy consumption and the risk of hypertension: a systematic review and dose–response meta-analysis of prospective studies Doi:10.1136/bmjnph-2025-001449
Journal: BMJ Nutrition Prevention & Health

For more information please e-mail: media@pbhp.uk