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.

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

Dietary and lifestyle approaches for achieving remission of type 2 diabetes

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

For too long the medical profession has considered type 2 diabetes (T2D) a chronic, progressive and life-long condition. Now we know better. Prediabetes and T2D are not only preventable but remission can be achieved in most people through diet and lifestyle interventions. The strength of evidence is such that the American College of Lifestyle Medicine have created a ‘Bill of Rights’ for people with T2D, outlining their right to be offered diet and lifestyle support, with the aim of achieving remission.

Remission is when a person achieves a HbA1C level less than 6.5% (48 mmol/mol) measured at least 3 months after stopping glucose-lowering medication.

How it all began – delaying the onset of type 2 diabetes

It has long been recognised that weight loss is the key to preventing T2D in people at high risk. The seminal study demonstrating the efficacy of lifestyle interventions was published in 2002. It compared usual care with metformin (a diabetes medication) or lifestyle interventions, aiming for 7% weight loss and at least 150 minutes of physical activity per week. Although both interventions were effective, the lifestyle intervention was more effective than metformin, reducing the development of T2D over a 3 year period by 58% compared to the control group. Metformin reduced the risk by 31%.

Longer follow-up of this study has confirmed the ability of lifestyle interventions to significantly prevent or delay the development of T2D.

This knowledge is now embedded into the NHS, and everyone with a diagnosis of pre-diabetes or at high risk of developing T2D can be referred to their local Diabetes Prevention Programme. The dietary approach is generally consistent with recommendations from the Eatwell Guide, the UK dietary guideline. The programme is effective and cost effective.

It is worth noting that recent research has shown that prevention of progression to T2D can be achieved without weight loss. The key is altering body composition and fat distribution leading to improved insulin sensitivity, β-cell function and increments in β-cell-GLP-1 sensitivity. Liver and pancreatic fat can be reduced by improving diet quality, without necessarily achieving weight loss.

How to achieve diabetes remission

There are several approaches for achieving diabetes remission, with weight loss being the key objective. In general, the more intensive the lifestyle intervention, the greater the weight loss and the higher the chances of achieving remission.

Although all pillars of lifestyle medicine are important, the most important remains the dietary intervention. Any diet that achieves weight loss will be effective. The important questions are how acceptable and sustainable the dietary changes are and whether the diet supports long-term health goals, such as preventing cardiovascular diseases, cancer and kidney disease.

Remission is achieved through reduction in liver and pancreatic fat, which then restores pancreatic beta-cell function. This requires around 15% weight loss to reduce weight below the ‘personal fat threshold’ (the amount of fat that is stored safely subcutaneously before it ‘spills over’ into the organs i.e. liver, pancreas and muscle cells). Duration of diabetes is also important, with remission more difficult in those who have had the disease for longer than 8 years.

Low calorie, meal replacements

Professor Roy Taylor is the pioneer behind the low calorie, meal replacement approach. The DIRECT study was practice changing as it showed that T2D remission was achievable in a primary care setting. The intervention involved withdrawal of antidiabetic and antihypertensive drugs, total diet replacement (825-853 kcal/day formula diet for 3-5 months), stepped food reintroduction (2-8 weeks), and structured support for long-term weight loss maintenance. At 12 months, 46% of participants had achieved remission. The chance of remission was directly related to the amount of weight loss achieved, with 83% of those losing 15kg or more being successful.

The effectiveness of this approach diminishes over time. At 2 year follow up, 36% of participants remained in remission and at 5 years, 27%. This highlights that long term success requires a sustainable dietary approach, otherwise weight gain is inevitable.

The NHS has now adopted this approach with the NHS Type 2 Diabetes Path to Remission Programme.

Low carbohydrate diets

Low-carb diets have become popular and are being championed in the UK. The approach makes sense to some extent. Carbohydrates are converted by the body into glucose. If the supply of carbs in the diet is limited, blood glucose levels will fall. And so it does. But this approach addresses the symptom (high blood glucose) and not the underlying cause (insulin resistance caused by intracellular fat accumulation) of T2D.

Low-carb diets can support weight loss, mainly due to the fact that the diet is naturally restrictive and also results in the elimination of many commonly consumed ultra-processed, carbohydrate-rich foods; white bread, cakes, pastries, and sugar-sweetened beverages.

Side-effects of a low-carb diet

Concerns arise when carbs are replaced by animal sources of protein and fat, whilst restricting healthy fibre-rich foods such as certain fruit, starchy vegetables, whole grains and legumes. This way of eating results in elevated LDL-cholesterol levels, increasing the long-term risk of atherosclerotic cardiovascular disease. Animal-based diets also increase the risk of cancer and all-cause mortality.

Dr Kevin Hall, an internationally renowned, former researcher at the National Institute of Health is famous for conducting metabolic ward studies. His work has demonstrated that a low-carb, high fat diet elevates markers of inflammation, LDL-cholesterol levels and promotes insulin resistance. When he compared an animal-based, low-carb diet to a plant-based diet, both led to improvements in fasting glucose and insulin levels, but the plant-based diet resulted in greater weight and body fat loss and improvements in cholesterol levels. The animal-based, low-carb group lost mainly water weight and muscle mass, developed a degree of insulin resistance and a rise in LDL-cholesterol levels. The animal-based low-carb diet improved triglyceride levels, which worsened on the plant-based diet.

International consensus on low-carb diets

The National Lipid Association in the US and Scientific Advisory Committee on Nutrition in the UK have reviewed the evidence for low-carb diets. They have both concluded that although there may be some benefits for short-term weight loss, there is no evidence that low-carb diets are superior to other dietary approaches for weight loss. However, there are concerns that an animal-based, low-carb diet that restricts healthy carbohydrate-rich foods will result in elevated LDL-cholesterol levels, worsen cardiovascular health and negatively impact the health of the gut microbiome. Both reviews make it clear that healthy diet patterns are centred around fruits, vegetables, whole grain, beans, nuts and seeds.

Whole food plant-based diet

There are a number of studies demonstrating the effectiveness of a healthy vegan or whole food plant-based diet for the treatment of type 2 diabetes. This is in part due to the fact that a plant-based diet is effective at supporting weight loss, because the diet is naturally high in fibre and lower in energy density compared to animal-based diets. Having said that, a high fibre diet may be effective at improving insulin resistance even without weight loss.

A randomised study of a low-fat vegan diet, without portion or calorie control, resulted in better glycaemic control, with reduction in the need for medication and insulin, when compared to the American Diabetes Association diet. The mechanisms explaining the benefits include reduction in visceral fat, hence restoration of insulin sensitively, along with a reduction in oxidative stress. A plant-based meal results in increased post-prandial incretin and insulin secretion when compared to a meat-based meal, suggesting that plant-based diets may be able to improve beta cell pancreatic function in patients with T2D. Incretin hormones are a group of gut hormones (including glucagon-like peptide-1) that are released after eating and stimulate the release of insulin, thus decreasing blood glucose levels. In people with type 2 diabetes, this incretin effect is reduced or absent.

Another randomised study using a whole food plant-based diet and physical activity intervention was conducted in the Marshall Islands, where the prevalence of T2D is particularly high. Compared to standard medical care, the results demonstrated that the intervention was able to improve glycaemic control, body weight, waist circumference and inflammation. It also reduced the need for glucose-lowering and cardiovascular medications and induced T2D remission in some participants.

There is now international consensus that a whole food, plant-predominant eating plan is a core component of lifestyle medicine interventions for preventing, treatment and achieving remission of T2D.

What about fruit?

Fruit is demonised in some circles since it is high in sugar/fructose and can elevate blood sugar levels. This can be a problem for people with insulin resistance but healthy individuals, who are insulin sensitive can easily handle this sugar load. However, even in people with T2D, evidence shows that eating fruit can improve glucose control and therefore should continue to be included in the diet. Berries are a particularly useful addition and even dried fruit can benefit glucose regulation. Of note, it’s generally best to limit fruit juice in the diet.

Low-carb, plant-based diet

Diet quality is more important than macronutrient ratios. Nonetheless, some people may favour a low-carb diet, which can support cardiometabolic health when centred around plant sources of protein and fat.

Low-carb plant-based diets have been studied in clinical trials. Dr David Jenkins is the creator of the so-called ‘Eco-Atkins’ diet. This low-carb plant-based diet, emphasising protein and fat from gluten and soya products, nuts and vegetable oils, was found to be more effective in lowering blood lipid levels compared to a higher carb, low-fat vegetarian diet. In people with T2D, a low-carb plant-based diet and higher carb vegetarian diet were equally effective for weight loss and blood pressure reduction.

Plant-based diets support overall health

An important aspect of diabetes care is prevention of other chronic conditions. Diabetes is a leading cause of chronic kidney disease, while cardiovascular disease remains the leading cause of death in people with diabetes. Plant-based diets have been shown to be effective at managing cardiovascular risk factors, including hypertension and elevated blood lipids.  Plant-based diets are also effective at reducing the incidence and progression of chronic kidney disease and maintaining a healthy gut microbiome. A systematic review found that plant-based diets were not only able to improve weight and glycaemic control, but were associated with improved psychological health and quality of life.

Physical activity

Regular physical activity meeting international recommendations is hugely beneficial for people with pre-diabetes and T2D. A variety of exercises can be useful, so finding one that is enjoyable and sustainable is key. Resistance training that leads to improvements in muscle strength is also important for improving insulin sensitivity and regulating glucose.

Top tips for achieving diabetes remission

1. If you have a diagnosis of pre-diabetes or T2D, speak to your doctor about lifestyle interventions to help achieve remission.
2. Make sure to get professional advice before changing your diet or altering your medications.
3. Eat a diet centred around fruit, vegetables, whole grains, beans, nuts and seeds. If eating a meat-free diet you need to supplement with vitamin B12, and vitamin D if sunlight exposure is inadequate.
4. Limit consumption of foods high in saturated fat, salt and sugar.
5. Do not fear eating fruit – they are a very healthy food group.
6. Take part in regular physical activity, including strength exercises. Do a variety of different exercises, but importantly, ones that you enjoy.

Resources

Read the PBHP UK factsheet on type 2 diabetes.

NICE guidelines – Type 2 diabetes management.

American College of Endocrinology consensus statement on the management of diabetes.

Canadian Diabetes Association review of plant-based diets for diabetes.

American College of Lifestyle Medicine consensus statement on type 2 diabetes remission.

Lifestyle Interventions for Treatment and Remission of Type 2 Diabetes and Prediabetes in Adults: A Clinical Practice Guideline From the American College of Lifestyle Medicine

Preventing type 2 diabetes

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

How does type 2 diabetes develop?

T2D is characterised by insulin resistance, when the body can no longer respond to increasing levels of insulin secreted by the pancreas. Cells become resistant to insulin when they accumulate abnormal amounts of fat, usually as a consequence of being overweight or obese. This results in elevation of blood glucose. Persistently high levels of blood glucose damage cells and organs. It should be remembered that high blood glucose is the symptom and not the cause of type 2 diabetes.

It is interesting to note the concept of a ‘personal fat threshold’. That is, each person has a different capacity to store fat under the skin. When this storage has reached capacity, it spills over and leads to accumulation of fat inside the cells of the liver, pancreas and muscle, making them resistant to the effects of insulin. This is why people of seemingly normal body weight can still develop T2D, because they have exceeded their personal fat threshold.

Insulin resistance is implicated in a number of other chronic diseases, including atherosclerosis and cardiovascular disease, dementia, polycystic ovary syndrome and even cancer.

What are the risk factors for type 2 diabetes?

Type 2 diabetes is predominantly caused by modifiable lifestyle behaviours, with 70% of this risk linked to dietary factors. A Western-style diet pattern, high in animal-sourced and highly processed foods, is the leading risk factor. Other risk factors include obesity, lack of physical activity, smoking and alcohol consumption. Emerging risks include sleep disturbance and psychological stress. These risk factors usually drive increases in body weight, which in term promotes the development of T2D.

It’s worth noting that being of South Asian origin is a distinct risk factor, with T2D occurring more frequently and around a decade earlier than in White populations. This is thought to be due to the lower ‘personal fat threshold’ due to a genetic propensity to lay down visceral fat at lower body weights.

Preventing of type 2 diabetes

Healthy diets

The key to preventing diabetes is to maintain a healthy body weight by addressing dietary and lifestyle risk factors. The consensus supports a fibre-rich plant-rich or fully plant-based diet for lowering the risk of T2D. In the Adventist Health Study-2, vegans had a 49% decreased risk of T2D compared to non-vegetarians and this represented the lowest risk of all the diet patterns compared. In the EPIC-Oxford study, those avoiding meat had around a 50% reduced risk of T2D when compared with regular meat eaters. However, the effect was reduced once results were adjusted for body weight. The fish eaters had the lowest incidence of T2D, but it should be noted that this group was small and results in the literature have been inconsistent. In the Tzu Chi Health Study from Taiwan, vegetarians had a 35% reduction in the risk of developing T2D, and converting from a non-vegetarian to vegetarian diet during the follow-up was associated with a 53% reduction in risk.

Combined results from the Nurses’ Health Study and the Health Professionals follow-up study have shown that those eating a healthy plant-based diet (not necessarily vegan or vegetarian) composed of predominantly whole grain, fruits, vegetables, nuts, seeds and unsaturated fats, have a significantly reduced risk of T2D. A diet that emphasised plant foods and was low in animal foods was associated with a 20% reduction in the risk of T2D. Consumption of a plant-based diet that included specifically healthy whole plant foods was associated with a larger decrease (34%) in risk, while consumption of a plant-based diet high in less healthy plant foods (processed foods and refined grains, potatoes and fruit juice) was associated with a 16% increased risk of T2D. There was a dose relationship between the consumption of healthy whole plant foods and the reduction in risk of diabetes – the more plant foods consumed the lower the risk. The study suggests that increasing intake of healthy plant foods while moderately reducing intake of some animal foods, especially red and processed meats, could be beneficial for diabetes prevention.

Encouragingly, a further updated analysis from the same study cohort showed that improvement in diet quality over time can reduce the risk of developing T2D.  Every 10% increase in adherence to a healthy plant-based diet reduces subsequent risk of diabetes by 7-9%. The converse was also true with a 10% decrease in plant-based diet quality resulting in a subsequent 12–23% higher risk of diabetes. This provides hope that diet change is beneficial regardless of age.

It is also worth noting that healthy plant-based diets can reduce the risk of gestational diabetes, which is also a significant risk factor for future development of T2D.

How plant-based diets prevent T2D

Plant-based diets are well known for supporting a healthier body weight. Interestingly, an analysis from the UK Biobank cohort showed that reductions in body mass index was only partly responsible for the reduction in risk of T2D, with additional benefits of a healthy plant-based diet coming from lower levels of inflammation and improved kidney and liver function.

The benefits of plant-based foods for diabetes prevention are the high fibre content, the low glycaemic index of certain plant-based foods, high levels of phytonutrients and antioxidants and low levels of saturated fat.

Antioxidants such as polyphenols may inhibit glucose absorption, stimulate insulin secretion, reduce hepatic glucose output, and enhance glucose uptake. Fibre maintains a more consistent blood sugar level and is fermented by intestinal bacteria to produce short-chain fatty acids, which also improves the glucose response, insulin signalling, and insulin sensitivity. Fibre reduces the energy density of foods, promotes satiety, and has been associated with maintaining a more healthy weight, which in turn promotes insulin sensitivity.

Can you eat too much fruit?

People often worry about consuming ‘too much fruit’ when it comes to diabetes prevention. The confusion arises with the fact that fruit contains fructose and fructose consumption is associated with an increased risk of chronic disease.

However, when fructose is present in whole fruit, combined with fibre and micronutrients, there is no detrimental effect on health outcomes. Quite the opposite. An analysis from the EPIC study analysed fruit and vegetable consumption in 9754 participants with and 13, 662 participants without type 2 diabetes. The novel aspect of this study was that plasma biomarkers of fruit and vegetable consumption were measured, such as vitamin C and carotenoids, to give a more accurate indication of consumption. The results showed that fruit and vegetable consumption was associated with a significantly reduced risk of T2D, in the order of 20-30%, and that even small to moderate increases in consumption were beneficial. Numerous other studies have confirmed the benefits of fruit consumption for multiple health outcomes, including T2D. Even dried fruit can provide benefits.

Meat consumption and type 2 diabetes

Consuming protein from animal sources has consistently been associated with an increased risk of T2D. Red meat, processed meat and poultry consumption is associated with a 8-15% increased risk. In the EPIC study, a dose-response was demonstrated with every 5% of calories derived from animal protein being associated with a 30% increased risk of developing T2D..

In contrast, when food substitutions were examined in the Nurses Health Study and Health Professionals Follow-up Study, one serving of nuts, low-fat dairy, and whole grains per day substituted for one serving of red meat per day was associated with a 16–35% lower risk of T2D.

How does meat increase the risk of type 2 diabetes?

Ultra-processed foods and type 2 diabetes

High intakes of ultra-processed foods (UPFs) are contributing to the burden of chronic disease, including increasing the risk of T2D. However, not all UPFs are equally harmful and some, such as whole grain bread and cereals, are associated with good health outcomes. The most harmful subtypes are processed meat, sugar-sweetened beverages and foods and snacks high in saturated fat, salt and free sugars. UPFs increase the risk of T2D when they contribute to excess calorie intake, thus driving overweight and obesity. In addition, consumption of fructose, in the form of table sugar and high fructose corn syrup, when in excess of calorie requirements, increases the production of triglycerides, contributing to obesity and also the accumulation of fat in the  liver and muscle cells, promoting insulin resistance.

Physical activity

Meeting international recommendations for physical activity, 150 minutes of moderate intensity activity and strengthening activity at least twice per week, is associated with a lower risk of T2D. Studies show that any level of physical activity is better than none, the more the better, with benefits throughout the lifespan. In a large UK-based cohort study, the equivalent of a daily 20-min brisk walk was associated with an almost 20% reduction in risk of T2D. In addition, sedentary lifestyles, such as long periods of time sitting watching TV, at the computer or driving, are also increase the risk of T2D.

Physical activity helps to maintain a healthy weight, reduces the accumulation of fat in the organs such as the liver and muscles, promotes insulin sensitivity, reduces inflammation and supports the health of the gut microbiome.

Other healthy habits

Avoiding cigarette smoking or quitting if you are a smoker is associated with a lower risk of T2D. Although the data on alcohol consumption and diabetes risk is mixed, for overall health, including for cardiovascular health and cancer prevention, it is best not to drink alcohol.

Regular and sufficient sleep aiming for 7-9 hours a day is important, with less and more hours of sleep impacting the risk of T2D. Managing stress, time in nature, and fostering healthy relationships and reducing loneliness all contribute to overall health and may reduce diabetes risk.

Top tips of preventing diabetes

• Eat a diet centred around fruit, vegetables, whole grains, beans, nuts and seeds. If eating a meat-free diet you need to supplement with vitamin B12, and vitamin D if sunlight exposure is inadequate.
• Limit consumption of foods high in saturated fat, salt and sugar.
• Take part in regular physical activity, including strength exercises. Do a variety of different exercises, but importantly, ones that you enjoy.
• Reduce time sitting by taking regular movement breaks.
• Aim to sleep 7-9 hours a day, keeping your sleep routine as regular as you can.
• Avoid cigarette smoking and drinking alcohol.
• Prioritise time in nature and spending time with friends, family and your companion animals.

Diet, lifestyle and immune health

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

The role of the gut microbiome

Seventy percent of our immune system resides in our gut. It’s pretty incredible to think that the trillions of bacteria and other organisms in the intestine play such an important role in maintaining health. We understand the most about the bacteria in the large intestine and these bacteria are involved in regulating and educating the immune system. When provided with the right nourishment, healthy bacteria can flourish and are able to make compounds such as short chain fatty acids that are essential to the functioning of the immune system. These signalling molecules can activate cells of the immune system and communicate with other organs such as the brain and lungs, thus regulating their immune systems too. In addition, gut bacteria are involved in making vitamins and hormones that are required for good health.

What factors affect our immune system?

There are a number of factors that impact the health of the gut microbiome and the immune system in general. Some we have control over and others we don’t. For example, ageing results in a decline in the functioning of immune cells. At the same time, ageing immune cells release inflammatory compounds, resulting in chronic low level inflammation, known as ‘inflammaging’. Together, these changes increase the risk of severe infections and chronic conditions associated with inflammation, such as cardiovascular diseases, cancer and degenerative diseases of the brain. 

However, there are a number of modifiable risk factors that can positively impact the immune system and can be addressed by adopting healthy habits. These include all six pillars of lifestyle medicine.

Nutrition and immune health

The main foods associated with a healthy immune system are fruit, vegetables, whole grains, beans, nuts and seeds. This is because they contain important nutrients that have been shown to support the health of the gut microbiome and the functioning of immune cells.

Eat the rainbow 

Fruit and vegetables are packed full of antioxidants, anti-inflammatory compounds and an array of phytonutrients, which all act to support immune health. Making sure your diet is varied and includes foods with an array of different colours will ensure you are consuming a wide range of beneficial nutrients.

Vitamin C is an essential component of the diet and only found in fruits and vegetables. An adequate intake is required for optimal functioning of the immune system, and we should aim for around 100mg per day. Top food sources of vitamin C include red and green peppers, oranges, kiwi fruit and broccoli.

Vitamin D, more a hormone than a vitamin, plays an important role in maintaining a healthy immune system. The main source of vitamin D is from the action of sunlight on the skin. If sun exposure is inadequate, like in the winter months in the UK, then supplementation is recommended.  

Micronutrients such as selenium and zinc are important for immune health. Two brazil nuts a day will take care of your selenium needs and it is also found in whole grains, beans and seeds. Foods rich in zinc include whole grains, beans and nuts. Soaking grains and beans before cooking can increase the bioavailability of zinc and other nutrients in the food.

Herbs and spices in various forms have some of the highest concentrations of antioxidant compounds and also contain a number of beneficial compounds that support the immune system. Many show anti-infective properties, at least in the laboratory. So use a variety of herbs and spices liberally in cooking every day. Turmeric and its active component, Curcumin, has an array of health promoting effects. This includes anti-inflammatory, antioxidant and anti-infective properties. A number of studies have shown that curcumin has activity against different viruses.

Fibre

Fibre, only found in plant-based foods, is crucial for maintaining the health of the gut microbiome, which in turn helps maintain a functional immune system. Fibre is a type of carbohydrate that is not fully digested by the body and makes its way down to the large intestine and is used as fuel by the resident bacteria. A plant-based diet, especially a vegan diet, has been shown to be associated with better gut health and a greater abundance of bacteria that produce short chain fatty acids.

Changing your diet to being more plant-based can have beneficial effects on the gut microbiome in a matter of days to weeks. Adults should be aiming to consume 30g of fibre per day. 

What about prebiotics and probiotics?

Prebiotics are food for your gut bacteria. They are generally foods that are high in non-digestible fibre such as whole grains, bananas, greens, onions, garlic, soya beans and artichokes.

Probiotics are foods that contain live bacteria or yeast, usually because they have been fermented. This includes foods such as sauerkraut, kimchi, tempeh, miso, water and coconut kefir. Some plant-based yogurts also contain live cultures.

Most people in good health do not benefit from taking a probiotic supplement but including plenty of prebiotic and probiotic foods can improve the health of the gut microbiome and hence support immune health.

Good quality sleep

Sleep is essential for maintaining immune health. Inadequate sleep results in low-grade inflammation and adversely affects metabolic health and increases the risk of degenerative diseases. We should aim to get between 7–9 hours of sleep per night. To help ensure good quality sleep, the following can help:-

• maintain a regular sleep schedule;
• avoid daytime naps and if you do nap keep this to less than 30 minutes;
• make sure your bedroom is at a cool temperature, around 15–19 degrees Celsius;
• ensure a dark room without noise;
• avoid bright lights in the evening and expose yourself to sunlight in the morning;
• avoid heavy, carbohydrate-loaded meals 2–3 hours before bedtime;
• minimise screen-time/use of electronic devices in the evenings and avoid after 9pm;
• avoid caffeinated drinks after 2pm and eliminate alcohol.

Physical activity

There are so many benefits to being physically active and meeting international recommendations for both aerobic and strength-building exercises. Physical activity enhances the function of immune cells, reduces inflammation and amplifies the immune response to infections.

Any additional movement you can add to your daily routine is beneficial, even everyday household activities such as cleaning and gardening counts. Combining physical activity with time in nature may be even more beneficial as being in nature has been shown to enhance immune cell function.

Managing stress

Experiencing stress is a normal part of life and an acute stress response can temporarily strengthen the immune system. However, chronic stress and the persistent elevation of the stress hormone cortisol leads to immune dysregulation, immune suppression and promotes inflammation. This leads to increased susceptibility to infections, an increased risk of autoimmune conditions and may even increase the risk of developing cancer.

Having tools at hand to manage stress is really useful. This can include regular physical activity, spending time in nature, mindfulness activities such as meditation or yoga, and prioritising time with loved ones.

Avoid alcohol and cigarette smoking

Both alcohol and smoking impair the function of the immune system. There is no safe limit of alcohol to consume, so it’s best not to drink. Similarly, it is well established that smoking tobacco adversely affects all aspects of our health and significantly reduces life expectancy by an average of 10 years. It is never too late to quit alcohol or smoking and there is free support available from the NHS.

Lifestyle habits and autoimmune conditions

Dysfunction of the immune system can lead to autoimmune conditions. That is when the immune system ‘attacks’ normal cells. This manifests in different ways depending on where in the body this takes place. For example, the immune system can attack joints leading to rheumatoid arthritis, or the central nervous system causing multiple sclerosis.

The good news is that even if you have an autoimmune condition, there is emerging evidence that adopting a plant-based diet and other healthy habits can have a hugely positive impact on symptom severity and reducing the reliance on medication. This has been demonstrated in the Plants for Joints study in people with rheumatoid arthritis and observed in people living with multiple sclerosis.

1. Eat a diet high in fibre-rich foods, including fruit, vegetables, whole grains, beans, nuts and seeds.
2. Aim to get nutrients from food rather than supplements. The exceptions are Vitamin D if you are not getting sufficient sunlight and vitamin B12 if you are eating a meat-free diet.
3. Prioritise sleep, aiming for 7-9 hours per night.
4. Add movement to your day, aiming for 150 minutes of moderately vigorous activity per week and at least two sessions of strength-building exercises.
5. Avoid smoking and alcohol. Drink mainly water for thirst. Tea and coffee are both healthy additions to the diet.
6. Incorporate stress-relieving activities into your daily routine.
7. Prioritise time in nature and time with loved ones.
8. It is never too late. Even if you have a health condition related to the immune system, healthy habits can make a big difference.

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

This month sees an update to several national guidelines, all emphasising plant-rich diets and exercise, plus lifestyle interventions for Parkinson’s, diet and cancer and fasting for Crohn’s disease.

New lipid guidelines and dietary guidelines to improve cardiovascular health

The new dyslipidaemia guideline from the American College of Cardiology, American Heart Association, and nine other medical associations that replaces the 2018 guide, places renewed emphasis on lifestyle practices as the foundation of cardiovascular disease prevention, while recognising that pharmacotherapy is often required to reach increasingly stringent lipid targets.

A key message is the importance of a life-course approach. Elevated atherogenic lipoproteins over time drive cardiovascular risk, so early intervention, particularly through healthy behaviours, is essential. These include heart-healthy eating, regular physical activity, maintaining a healthy weight, good sleep, stress management, and avoidance of tobacco.

A heart-healthy diet is recommended to reduce cardiovascular events, while dietary supplements are not advised due to limited and inconsistent evidence of benefit. Physical activity is also emphasised, both for modest lipid improvements and broader cardiovascular protection.

The guideline recognises that behaviour change requires support. Referral to dietitians and use of multidisciplinary care are encouraged, particularly in higher-risk individuals such as those with severe hypertriglyceridaemia.

Despite this strong focus on lifestyle practices, drug therapy, especially statins, remains central. Lower LDL-cholesterol targets, particularly in secondary prevention, mean that many patients will require combination therapy alongside lifestyle measures. It also includes lowering the screening and treatment age from 40 to 30.

The American Heart Association (AHA) has also updated its dietary guidance for cardiovascular health and is notably different from the recently released Dietary Guidelines for Americans. The AHA reinforces that overall dietary patterns, rather than individual nutrients, are central to cardiovascular health. Poor diet quality remains a leading contributor to cardiovascular disease, and the guideline emphasises that adopting and sustaining a heart-healthy dietary pattern across the life course is fundamental to prevention.

At its core, the guidance promotes a predominantly plant-based, minimally processed way of eating. This includes a high intake of vegetables and fruits, whole grains, legumes, nuts, and seeds, alongside healthy sources of protein, whilst limiting red and especially processed meat. There is a clear emphasis on replacing saturated fats, found in animal fats and tropical oils, with unsaturated fats from plant oils and whole foods, reflecting strong evidence for improvements in LDL-cholesterol and cardiovascular risk. Healthy protein sources mainly focus on beans and pulses and also include fish.

A major focus is the quality of foods rather than just macronutrient composition. The guideline strongly encourages shifting away from ultraprocessed foods, and towards minimally processed foods that retain their natural structure and nutrient profile. Similarly, it highlights the importance of reducing added sugars, particularly from sugar-sweetened beverages, and lowering sodium intake, both of which have well-established links to cardiovascular risk.

Energy balance is also central, with maintaining a healthy body weight through alignment of diet and physical activity identified as a key determinant of cardiometabolic health. Physical activity is therefore integrated into the dietary framework rather than treated separately.

Importantly, the guidance challenges common misconceptions around supplements and single “superfoods.” Nutritional needs should be met primarily through whole dietary patterns, which provide fibre, micronutrients, and bioactive compounds that work synergistically. In most individuals, a high-quality diet removes the need for supplementation. The exception being a meat-free diet that requires supplementation with vitamin B12 (through fortified foods or supplements).

Alcohol guidance is rightly more cautious than in previous iterations. The statement advises against initiating alcohol consumption for health reasons and recommends limiting intake due to uncertain cardiovascular benefit and clear risks across a range of health outcomes.

A useful article on trending cardiovascular nutritional controversies covers evidence for and against beef tallow, ultraprocessed foods, full-fat dairy, seed oils, medium chain triglyceride (MCT) oils, seafood, and alternative sweeteners. In short, the paper concludes that beef tallow is harmful to health as it raises LDL-cholesterol levels. There is insufficient evidence to choose high-fat over low-fat dairy (remembering that dairy is not required in the diet). Ultraprocessed foods should be limited in the diet, favouring minimally processed, whole foods instead. Seed oils benefit cardiometabolic health and can be part of a heart-healthy diet, but they should not be heated to excessive temperatures or repeatedly heated. MCT oils may have a role in certain rare medical conditions, but the evidence does not support promotion in the general population. It reminds us that coconut oil is not an MCT and is not considered heart healthy. Seafood (or should we say sea animals) are considered a beneficial component of the diet, but there are increasing concerns around environmental contamination of these foods. Articifical sweetners (aspartame, advantame, acesulfame potassium, neotame, saccharin, and sucralose), natural sweeteners (monk fruit extract and stevia) and sugar alcohols (erythritol, mannitol, sorbitol, and xylitol) have an overall negative impact on health, although they may be healthier to consume that sugar-sweetened beverages. The healthiest choices is to stick to consuming water, tea and coffee.

Vegetarian and vegan diets and cancer incidence

This 2026 systematic review and meta-analysis provides a comprehensive assessment of vegetarian and vegan diets in relation to cancer risk, drawing on prospective cohort studies across multiple populations and cancer types.

Overall, vegetarian diets are associated with a modest but consistent reduction in total cancer incidence, with around a 13% lower risk compared to non-vegetarian diets. This reduction extends across several specific cancers, with the strongest associations seen for cancers of the digestive system, particularly stomach and colorectal cancers, as well as pancreatic cancer. There are also smaller but statistically significant reductions in breast cancer, especially postmenopausal breast cancer, alongside bladder cancer, melanoma, and non-Hodgkin lymphoma.

For vegan diets, the evidence base is more limited but broadly consistent in direction. Vegan diets are associated with a larger reduction in total cancer risk, in the range of around 20–25%, and a reduced risk of breast cancer. However, findings for colorectal and prostate cancer are less clear, reflecting the smaller number of studies available.

The authors conclude that the evidence linking vegetarian diets to lower risk of total cancer, colorectal cancer, colon cancer, and breast cancer is “probable,” while for other cancers it is considered suggestive but less certain due to limited data. For vegan diets, the evidence is currently more limited overall.

The paper also explores potential mechanisms. Part of the observed benefit appears to be mediated through lower body weight, as vegetarian and vegan diets are associated with reduced adiposity, an established risk factor for several cancers. However, this explains only part of the effect. Independent dietary factors are likely important, including higher intakes of fibre, whole grains, fruits, and vegetables, and lower consumption of red and processed meat. These dietary differences may influence cancer risk through effects on inflammation, insulin resistance, hormonal pathways, and the gut microbiome.

Overall, the findings support the conclusion that more plant-based dietary patterns, including vegetarian and vegan diets, are associated with a lower risk of several cancers. While further research is needed, particularly in vegan populations and across a wider range of cancers, the evidence adds to the growing case for plant-based diets as a central component of cancer prevention.

Fasting mimicking diet in Crohn’s disease

The fasting-mimicking diet (FMD) is a short, periodic, plant-based dietary intervention designed to reproduce the metabolic effects of prolonged fasting while still providing limited nourishment. Typically followed for five consecutive days each month, it is plant-based, low in calories, protein and sugars, and relatively higher in unsaturated fats. Developed and extensively studied by Dr Valter Longo and colleagues, earlier work has shown that FMD can reduce systemic inflammation, improve metabolic health, and promote cellular repair processes. Preclinical studies have also demonstrated effects on gut microbiota, immune regulation, and intestinal regeneration, providing a strong rationale for testing this approach in inflammatory bowel disease.

This 2026 randomised controlled trial evaluates the effects of FMD in adults with mild-to-moderate Crohn’s disease. Participants were assigned either to continue their usual diet or to undertake three monthly cycles of a 5-day FMD, returning to their habitual diet between cycles. 60-70% of participants were also receiving medications for Crohn’s disease.

The findings are notable. Around 70% of participants in the FMD group achieved a clinical response, compared with approximately 44% in the control group, and nearly two-thirds achieved clinical remission. These improvements were seen early, with benefits emerging after just a single 5-day cycle. Alongside symptomatic improvement, there were reductions in objective markers of inflammation, particularly faecal calprotectin, supporting a genuine anti-inflammatory effect.

The intervention also led to improvements in patient-reported outcomes and quality of life, suggesting that the clinical benefits translated into meaningful day-to-day improvements for patients. Although endoscopic data were limited, early signals pointed towards possible improvements in mucosal healing.

Mechanistically, the study provides insight into how FMD may work. The diet was associated with reductions in pro-inflammatory lipid mediators and downregulation of key inflammatory cytokines, including TNF, IL-1β and IL-18. These findings are consistent with earlier research showing that fasting-like states can suppress inflammatory pathways, enhance autophagy, and promote tissue repair. Additional mechanisms may include beneficial shifts in the gut microbiome and increased production of ketone bodies, which have anti-inflammatory effects.

From a practical perspective, the appeal of FMD lies in its feasibility. Unlike many dietary interventions that require continuous restriction, FMD involves only five days of dietary change per month, allowing individuals to maintain their usual eating pattern for the remainder of the time. Adherence in the study was relatively high, and the intervention was generally well tolerated, with mild symptoms such as fatigue and headache being the most common side effects.

There are, however, important limitations. The study was relatively small and open-label, and most participants had mild disease, which may limit generalisability. The benefits also appeared to diminish after a washout period, suggesting that ongoing cycles may be needed to sustain the effect.

Overall, this trial adds to a growing body of evidence that dietary interventions can have clinically meaningful effects in inflammatory conditions.

Updated guidelines on resistance training for adults

This 2026 American College of Sports Medicine position stand makes a compelling case that resistance training should be considered a fundamental component of health for all adults, not just those interested in fitness or performance. Drawing on a large body of evidence (130 systematic reviews and data from more than 30,000 people), it shows that resistance training improves muscle strength, muscle mass, power, endurance, balance, and overall physical function. These changes translate into meaningful real-world benefits, including improved ability to perform daily activities, maintain independence with ageing, and reduce the risk of falls. Beyond musculoskeletal health, resistance training is also associated with reduced mortality and lower risk of cardiovascular disease, cancer, and type 2 diabetes, alongside benefits for mental health and sleep.

A key message is that resistance training does not need to be complex to be effective. Many different approaches can deliver similar benefits, and the most important factor is consistency over time. The guideline emphasises that programmes should be tailored to the individual to support adherence, taking into account preferences, confidence, and practical barriers. This represents a shift away from rigid, highly structured prescriptions towards a more flexible and inclusive approach.

For most adults, a practical starting point is to engage in resistance training at least twice per week, targeting all major muscle groups. Exercises can be performed using free weights, machines, resistance bands, or body weight, making the approach accessible in a range of settings, including at home. A small number of sets per exercise is sufficient to begin with, and intensity can be progressed gradually as confidence and strength improve. For those aiming to build strength, using relatively heavier loads and focusing on controlled movements through a full range of motion is effective. For improving muscle mass, increasing overall training volume over time is important, while for enhancing power and functional performance, incorporating faster, more dynamic movements with moderate loads can be beneficial.

Importantly, the guideline challenges several common misconceptions. Training to exhaustion is not necessary to achieve results, and no single type of equipment or programme is superior for all individuals. Complex programming strategies offer little additional benefit for most people compared with simpler approaches. Resistance training is also considered safe for healthy adults across the lifespan when introduced progressively, countering the perception that it is inherently risky or only suitable for younger individuals.

Read this short summary, including advice from the lead author.

Physical activity for public health in the 21st century

This 2026 Nature Medicine paper reframes physical activity as a central pillar of public health while challenging the persistent assumption that it is simply a matter of individual choice. It highlights that despite overwhelming evidence of benefit, global levels of physical activity have not meaningfully improved, with a substantial proportion of adults still failing to meet recommended levels. The authors argue that this stagnation reflects not a lack of awareness, but deeper structural and societal barriers.

A key contribution of the paper is its focus on inequality. Patterns of physical activity vary markedly across countries, genders, and socioeconomic groups, with the greatest disparities seen between wealthier men in high-income settings and poorer women in low-income settings. These differences are not incidental; they reflect unequal access to safe environments, time, cultural acceptance, and financial resources. In this context, physical activity is better understood as something shaped by opportunity rather than simply motivation.

The paper also broadens the scope of why physical activity matters. While traditionally emphasised for cardiovascular and metabolic health, it is shown to have wide-ranging effects across physical and mental health, including immune function, mental wellbeing, and cancer outcomes. This reinforces its role as a foundational determinant of overall health, rather than a niche behavioural factor.

One of the most important insights is the distinction between different domains of physical activity, particularly between leisure-time activity and work- or place-based activity. Leisure-time activity, such as walking, cycling, sport, or exercise, is typically performed by choice, in safer environments, and at intensities and durations that are more consistently associated with health benefits. In contrast, work-related or necessity-based activity, such as manual labour, domestic work, or physically demanding jobs, is often repetitive, prolonged, and performed under conditions of low autonomy, limited recovery, and sometimes physical risk. The paper highlights that these forms of activity do not confer the same health benefits and may, in some cases, be associated with adverse outcomes, a phenomenon sometimes referred to as the “physical activity paradox.”

This distinction has important implications. Public health messaging that treats all movement as equivalent risks obscuring the lived realities of those whose physical activity is driven by necessity rather than choice. For individuals in physically demanding occupations, the issue is not insufficient activity but rather the quality, context, and physiological burden of that activity. Conversely, those with sedentary occupations may have the time and resources to engage in beneficial leisure-time activity, reinforcing health inequalities.

In response, the authors propose a shift towards a systems-based model of “physical activity for health and wellbeing.” This approach recognises that activity patterns are shaped by the environments in which people live and work. Factors such as urban design, transport systems, workplace structures, safety, and social norms all influence whether individuals are able to engage in health-promoting activity.

The practical implication is that improving population health will require more than advising individuals to exercise. It will depend on creating conditions that make beneficial forms of physical activity accessible, safe, and integrated into daily life. This includes designing cities that support walking and cycling, ensuring equitable access to green space, addressing gender and socioeconomic barriers, and rethinking workplace environments to reduce harmful physical demands while enabling healthier movement patterns.

A case for lifestyle interventions in Parkinson’s Disease

Parkinson’s disease is a progressive neurodegenerative disorder characterised by motor symptoms such as tremor, rigidity, and slowed movement, alongside a wide range of non-motor features including cognitive impairment, sleep disturbance, depression, and autonomic dysfunction. While traditionally managed with pharmacological therapies, there is growing recognition that lifestyle factors play a central role in influencing symptoms, quality of life, and potentially disease progression.

This paper presents a comprehensive review of a “wellness prescription” for Parkinson’s disease, advocating a shift from a reactive, medicalised model of care to a proactive, patient-centred approach grounded in lifestyle medicine. It adopts a biopsychosocial framework, placing the individual at the centre and emphasising that everyday behaviours, particularly exercise, diet, sleep, mental health, and social engagement, are integral to outcomes.

Among lifestyle interventions, physical activity has the strongest evidence base. Regular exercise improves core motor symptoms such as mobility, balance, strength, and gait, and also benefits non-motor symptoms including sleep, pain, cognition, anxiety, and depression. There is emerging evidence that it may influence disease progression. Current guidance supports early and sustained engagement in a combination of aerobic, resistance, balance, and flexibility training. Importantly, enjoyment and adherence are key, with activities such as dance, tai chi, and group exercise offering both physical and psychosocial benefits.

Diet is increasingly recognised as an important modifiable factor in both the risk and progression of Parkinson’s disease. Nutritional challenges are common, with a substantial proportion of individuals at risk of malnutrition due to motor difficulties, gastrointestinal dysfunction, reduced appetite, and interactions with medications such as levodopa. Beyond these practical considerations, dietary patterns appear to influence disease biology. Mediterranean-style and plant-rich diets, high in fruits, vegetables, whole grains, legumes, nuts, seeds, and olive oil, are associated with a lower risk of developing Parkinson’s disease, a later age of onset, slower progression, and reduced mortality. Diet may also exert effects through the gut microbiome, with higher-quality diets linked to increased production of anti-inflammatory metabolites. Although randomised trial data remain limited, current evidence supports a predominantly plant-based, Mediterranean-style dietary pattern as the most beneficial approach.

Other aspects of lifestyle are also critical. Sleep disturbance is common and contributes to poorer cognitive and mental health outcomes, with interventions such as sleep hygiene, light exposure, and behavioural therapies offering benefit. Mental health is central to overall wellbeing, with proactive strategies, including exercise, mindfulness, and social engagement, helping to reduce depression and anxiety, which are highly prevalent in Parkinson’s disease. Mind–body approaches such as yoga, meditation, and tai chi show evidence of improving both motor and non-motor symptoms, as well as reducing stress and inflammation.

The paper also highlights the importance of social connection and a sense of purpose. Social isolation is common and associated with worse outcomes, while engagement in meaningful activities and supportive communities can improve quality of life and potentially influence disease trajectory. Broader aspects of wellbeing, including sexual health, general medical care, and self-management skills, are also emphasised as essential components of a holistic approach.

Overall, the review argues that lifestyle interventions should be considered core to the management of Parkinson’s disease rather than optional adjuncts. It calls for a fundamental shift towards integrating exercise, diet, and other lifestyle strategies into routine care from diagnosis, empowering individuals to take an active role in their health and supporting a more holistic approach to living well with Parkinson’s disease.

Half the calories from crops lost in feeding farm animals

The global food system is a major driver of climate change, biodiversity loss, and water use, yet it fails to deliver equitable nutrition. As highlighted in UK government food security reports, rising food insecurity alongside diet-related disease reflects systemic inefficiency rather than a lack of production. This paper examines how effectively global croplands are used to produce food for human consumption.

The central finding is that only around half of the calories grown on croplands are ultimately available to feed people. While global crop production increased significantly between 2010 and 2020, much of this growth was diverted towards feeding farm animals and non-food uses such as biofuels, rather than direct human consumption. As a result, gains in food availability have lagged behind increases in production.

A major source of inefficiency is the conversion of crops into animal products, particularly beef. Large quantities of feed are required to produce relatively small amounts of meat, meaning most of the original calories are lost from the food system. The greatest loss of calories (39.7%) is through production of beef, which only provides 9% of animal-sourced calories (excluding fish).

The scale of this loss is substantial. Croplands produce enough calories to feed far more people than the current global population, yet nearly half of this potential is lost through inefficient use. Shifting towards more plant-based diets or even replacing beef could significantly increase the number of people that could be fed.

Overall, the paper argues that the challenge is not producing more food, but using what we already produce more effectively. We have the ability to ensure every person on this planet has sufficient calories and nutrients to live healthy lives, we just need to ensure there is equitable distribution of food.

Plant-based alternatives to animals foods to improve planetary health

This new paper, Novel Plant and fungi-based Alternatives Support Nutritional Adequacy of Diets and Reduce Their Environmental Impacts, provides important evidence that plant-based meat and dairy alternatives can play a practical and effective role in supporting a shift away from animal-sourced foods, without compromising overall diet quality.

Using a realistic UK “basic basket” that reflects how people actually eat, the authors modelled small, achievable changes, replacing processed meats, milk, or yogurt with plant-based alternatives, and assessed the impact on nutrition, environmental outcomes, and cost.

A key finding is that targeted substitutions with plant-based alternatives can maintain nutritional adequacy across the whole diet. Despite concerns about these foods being ultra-processed, most products assessed were classified as “healthy” using nutrient profiling models, and overall diets continued to meet recommended nutrient intakes in most scenarios . In some cases, nutritional quality even improved, with increases in fibre and reductions in energy intake and saturated fat, particularly when replacing processed meats. While certain micronutrients such as iodine or vitamin B12 may be lower in some products, these differences had minimal impact when considered within the context of the whole diet.

The environmental benefits were consistent and meaningful. Across all substitution scenarios, greenhouse gas emissions, land use, and water use decreased, even with relatively small dietary changes . This reinforces the idea that shifting away from animal products, even partially, can contribute significantly to climate and sustainability goals.

Importantly, the study highlights that plant-based alternatives offer a realistic pathway for change. Unlike whole food plant-based diets, these products are designed to mimic the taste, texture, and convenience of meat and dairy, helping to overcome common behavioural barriers such as familiarity, cooking skills, and social norms. The modelling approach, focusing on single, incremental substitutions, reflects how people actually change their diets, rather than assuming complete dietary overhauls.

Cost remains a key limitation. While plant-based dairy alternatives were often comparable or cheaper, plant-based meat alternatives were consistently more expensive, which may limit accessibility and uptake, particularly among lower-income groups. The authors emphasise that without policy action to improve affordability, the full public health and environmental potential of these foods may not be realised.

Overall, this study makes a strong case that plant-based meat and dairy alternatives can serve as a useful and pragmatic bridge in dietary transition. When carefully selected, they enable reductions in animal food consumption while maintaining nutritional adequacy and delivering environmental benefits, supporting a gradual and achievable move towards more sustainable, plant-forward diets.

Read this article for more information about plant-based meat alternatives.

Updated food-based dietary guidelines from the Netherlands

The new Dutch dietary guidelines are bold, taking both health and planetary sustainability into consideration.

The core of the “Wheel of Five” remains unchanged but there has been an update to quantities of various food groups. The recommendations include:

• Eating Plenty of vegetables, fruit, legumes, and whole grains
• Limiting intake of salt, saturated fat, and sugar
• Increasing legumes intake to 250g per week
• Reducing meat consumption from a maximum of. 500g to 300g/week (with ≤100g red meat). This is less red meat than recommended in the Eat-Lancet Planetary Health Diet.
• Halving cheese intake from 40g to 20g per day
• Whilst still including dairy, encouraging alternating with fortified plant-based alternatives.

These guidelines demonstrate real leadership from the Dutch Government, helping to put scientific evidence into action. We hope the UK Government follow suit.

See you back in May.

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The power of healthy habits for people living with multiple sclerosis

Multiple Sclerosis (MS) is an autoimmune condition affecting the brain and the spinal cord. Conventional pharmaceutical treatments slow the progression but rarely reverse and cannot cure the disease. People living with MS often explore diet and lifestyle interventions as a means of managing their symptoms and reducing reliance on medication and increasingly, lifestyle interventions are recognised as beneficial by medical professionals.

The impact of diet on multiple sclerosis 

We know that people living with MS can benefit from increasing the proportion and variety of healthy plant foods in the diet i.e. fruit, vegetables, whole grains, beans, nuts and seeds, whilst limiting or avoiding animal-derived and processed foods. 

Dr Roy Swank, a pioneer of dietary approaches in MS, used a diet low in saturated fat that limited meat consumption and emphasised fruit and vegetable consumption. His observational study is the longest ever reported on diet and MS, following his patients for up to 34 years. The results suggested that patients adhering to his dietary protocol had significantly less neurological disability and longer lives. 

Subsequent studies have shown that these positive results are likely to be explained by the fact that a plant-based diet is rich in nutrients that reduce inflammation and thus leading to improvements in symptoms. In contrast diets high in meat and saturated fats promote inflammation and in general worsen symptoms and quality of life. Dairy may also have a negative impact on symptoms.

The impact of the gut microbiome

Growing evidence suggests that the health of the gut microbiome is a key factor in the development and progression of MS, especially given its importance in maintaining a healthy immune system. Diet is the main determinant of gut health, with a fibre and polyphenol-rich plant-based diet being essential. Meat heavy diets reduce the number of healthy bacterial species in the gut and thus adversely affect the immune system. In contrast plant-based diets support the growth of a variety of healthy gut bacteria, which are associated with better immune health and lower levels of inflammation. 

A randomised study demonstrated that the adoption of a plant-rich, anti-inflammatory diet led to reduced levels of inflammation in the gut of people with MS and that this was also associated with improvements in visual symptoms.

Specific nutrients to emphasise

People living with MS may benefit from higher blood levels of vitamin D, aiming for 100-150nmol/l. This will usually require supplementation, along with judicious exposure to the sun.

Long-chain omega-3 fatty acid supplementation in some, but not all, studies has been shown to reduce fatigue, relapse rate and disability. This can be in the form of high potency fish oil or cold pressed flaxseed oil (20-40mls daily). 

Healthy lifestyle habits

Alongside a healthy, fibre-rich diet, all aspects of lifestyle are important for reducing symptom burden and disability and improving quality of life in people with MS. Regular physical activity, managing stress using mindfulness and meditation techniques, adequate sleep and avoiding tobacco and other toxins all support better health and wellbeing in people with MS. 

Programs such as ‘Overcoming MS’, which support people to adopt healthy lifestyle habits have been hugely valuable. They provide community and purpose along with essential information.

Inspiring hope

To raise awareness of the power of healthy habits, we published two case histories highlighting the remarkable potential of lifestyle changes, including a whole food plant-based diet, to improve symptoms and quality of life, allowing for the discontinuation of medication. This is not the first report of such successes. Dr Saray Stancic, a US-based physician has also previously charted her experience of reversing severe disability from MS using a whole food plant-based diet and lifestyle approach. 

We fully appreciate that not all people living with MS can expect to have such positive results, but these same lifestyle habits are key for reducing the longer term risk of cardiovascular disease and certain cancers, conditions with a higher incidence in people living with MS.

Resources

PBHP UK factsheet on multiple sclerosis

Healing from the Inside Out: Managing autoimmune disease with a whole-food plant-based diet by Karen Lee

Vegfest Free Birmingham 2026

Saturday April 25th 2026 10am – 7pm
at Edgbaston Cricket Ground Edgbaston Rd, Birmingham B5 7QU

Plant-Based Health Professionals UK will be holding a panel discussion and a stall at VegFest free.