Review of the plant-based nutrition and lifestyle medicine news May 2026
Healthy life expectancy is at an all time low in the UK, yet healthy habits support better liver, cardiovascular and brain health. Plus more food industry shenanigans.
Photo by Jannis Brandt on Unsplash
Healthy life expectancy in the UK at an all time low
A sobering start to this month’s review. A new report from The Health Foundation finds that healthy life expectancy – the average number of years a person would expect to live in good health – is at an all time low in the UK. Over the last decade it has fallen by 2 years, making it 60.7 years for males and 60.9 years for females.
Even more alarming is that the gap in healthy life expectancy between the most and least deprived deciles in England is now 19.4 years for males and 20.3 years for females. Healthy life expectancy fell more rapidly for females than for males, raising concerns about the worsening trend of women’s health.
Of 21 high-income countries, the UK is one of only five that saw healthy life expectancy fall between 2011 and 2021, and had the second steepest decline. The UK now ranks 20th with only the United States having a lower healthy life expectancy.
This has not been caused by the COVID-19 pandemic as life expectancy has largely remained stable in the UK and other similar countries have seen healthy life expectancy remain stable or improve. Rather, it is a reflection of lifestyle and socioeconomic factors, which are of course inextricably linked.
The authors conclude ‘the UK’s trajectory is not inevitable, but the result of policy choices and underlying conditions that have left the population, particularly among working-age adults, more vulnerable to ill health.’
This should be a wake up call to ensure the UK can offer citizens a minimum standard of living (i.e. housing, education, jobs) and access to healthy behaviours (diet and nutrition, physical activity and avoiding tobacco and alcohol).
New Lancet Commission on liver health
This second Lancet commission on liver health raises awareness of lifestyle factors that are driving liver disease across Europe. Alcohol and unhealthy diets are the key drivers of liver-related mortality (from cirrhosis and liver cancer) and eliminating these risk factors would almost half the burden of liver disease.
The major dietary factors remain excess consumption of saturated fat (mainly from animal-sourced foods), and added or free sugars, such as fructose or sucrose in foods and sugar sweetened beverages. These dietary factors are usually associated with excess calorie intake and overweight/obesity, which in turn causes liver dysfunction.
The commission makes it clear that unhealthy behaviours are primarily related to the environments we live in rather than a failure of individual will power and thus Government and policy makers need to focus on shaping healthy living environments.
Food insecurity is compounding the problem as more people are relying on cheaper, energy-dense, high-fat, high-sugar, low-nutrient foods, leading to an overall decline in dietary quality.
Check out our factsheet on diet and lifestyle for liver health.
Sleep, nutrition and physical activity important for cardiovascular health
This study investigated the combined impact of three healthy behaviours – sleep, nutrition and physical activity – on cardiovascular health. The researchers analysed data on 53,424 participants in the UK Biobank study. Sleep and physical activity information was collected from a wearable, wrist accelerometry data. Dietary intake was assessed once at baselines using a self-reported questionnaire.
Over the 8.0-year follow-up period, 2034 major adverse cardiovascular events (MACE) occurred, comprising 932 myocardial infarctions, 584 strokes, and 518 heart failure events.
The results showed that 8-9.4 hours of sleep per day, 42-104 minutes of moderate to vigorous physical activity per day and a high diet quality score was associated with a 57% lower risk of a MACE. Even small increments towards ideal healthy habits was beneficial with the combination of an additional 10 min/day of sleep, 5 min/day of physical activity and 3 extra points on the diet quality score (equivalent to an extra one-fourth cup of vegetables) associated with a 10% lower risk of MACE.
The authors conclude ‘These findings highlight the need for integrated multi-behaviour lifestyle prevention trials to evaluate the effectiveness of small, achievable lifestyle changes for MACE prevention.’
Read our article on plant-based diets and cardiovascular disease.
Plant-based diets and risk of dementia
Studies on diet and dementia risk are increasingly demonstrating a consistent theme. Diets rich in whole plant foods and lower in animal-sourced and ultra-processed foods are associated with a reduce risk. This is in part because plant-rich diets reduce the risk of hypertension, obesity, type 2 diabetes, dyslipidaemia, condition which increase the risk of dementia.
This new study aimed to investigate the impact of plant-based dietary patterns on the risk of dementia in ethnically diverse population. Data from the Multiethnic Cohort Study, based in Hawaii and California (primarily Los Angeles County), was analysis and includes African American, Japanese American, Latino, Native Hawaiian, and White participants who completed food frequency questionnaires at baseline (1993-1996; age 45-75 years) and at 10-year follow-up (2003-2008). Dietary data were scored according to overall plant-based diet, healthy plant-based diet and unhealthy plant-based diet index. You can read more about the plant-based diet index here.
The results showed that participants most adherent to an overall plant-based diet and a healthy plant-based diet had a 12% and 7% reduced risk of dementia, respectively. Adherence to an unhealthy plant-based diet was associated with a 6% increased risk.
Researchers were also able to assess the impact of dietary change over time. Participants who changed their diet to a more unhealthy plant-based diet over the follow up period had a 25% increased risk of dementia, whereas participants who improved their diet quality over time had a 11% lower risk.
The findings were overall consistent across age groups, race and ethnicity and APOEℇ4 carrier status.
The researchers explored changes in intake of individuals food groups. A large decrease in 4 of the 7 healthy plant food groups (whole grains, vegetable oils, nuts, and tea/coffee) was associated with a higher risk of dementia by 11%–15%. Of the 4 less healthy plant food groups, only increased consumption of added sugars was associated with a 12% higher risk of dementia. Of the 5 animal food groups, a large decrease in egg consumption was associated with a 12% higher risk of ADRD. Increase in consumption of animal fats and meat were associated with an increased risk of dementia.
Overall, the study supports the findings of other similar studies, that increasing the consumption of healthy plant foods, whilst reducing the consumption of animal-sourced foods and limiting unhealthy plant-based foods is helpful for reducing the risk of dementia. The reasons for these finding are multiple, including the presence of nutrients within plant foods such as fibre, vitamins and minerals that help maintain cardiovascular health, normal blood lipid levels and help prevent diabetes.
The finding on eggs is interesting as other studies have also found that egg consumption is associated with a lower risk of dementia, including this new analysis of the Adventist Health Study-2. But, and there is a big BUT. The results from the Adventist Health Study showed that substituting eggs for nuts/seeds or legumes in the diet was associated with a similarly reduced risk of Alzheimer’s disease.
In my view, there is nothing special about eggs. The nutrients that are thought to support better brain health include, omega-3 fats, vitamin B12, choline and lutein and zeaxanthin-carotenoids. All the nutrients in eggs can be adequately sourced from plants, fortified foods or in the case of vitamin B12, from a supplement. Of note, several nutrients in eggs, such as omega-3 fats and vitamin B12 are fed to chickens. It is no different for humans to obtain these nutrients from their original source without having to eat eggs.
Most populations globally are not consuming sufficient legumes and nuts, even if traditionally their diets have been mostly plant-based, like in India. For this reason it is more difficult to assess the impact of legume and nut consumption on brain health or other aspects of health for that matter. If people are not consuming these foods, observational studies can’t assess the impact on health. What we do know from multiple studies is that substituting animal-sourced foods, including eggs, for legumes and nuts, consistently has a positive impact on health, including a reduced risk of premature mortality.
Brain health is dependent on many other factors. Learn more in our article on diet and lifestyle and brain health.
Limiting ultraprocessed foods and optimising fibre intake.
Two new review articles are worth reading. The first is a consensus on ultraprocessed foods and cardiovascular health from the European Society on Cardiology. Diets high in UPFs are associated with negative health outcomes, including cardiovascular diseases. However, not all UPFs are created equal and the classification itself does not tell you about the nutritional value of the foods.
This consensus statement recommends that in clinical practice, we should support patients to remove or greatly limit processed meat, packages snacks and sugar-sweetened beverages in the diet, whilst prioritising fibre-rich plant-based foods. Any shift towards a more plant-based diet is better for health. Encouraging home cooking, considering meal timings and the context in which meals are eaten – earlier in the day, mindfully and slowly – is also important.
The document does not discuss plant-based meat or dairy alternatives which is a shame as these are increasingly included in country-based dietary guidelines and growing numbers of people are actively reducing the consumption of animal-sourced foods for environmental and ethical reasons.
The second is a review on dietary fibre, which remains one of the most under-consuming nutrients in the modern diet.. Despite decades of evidence linking fibre-rich diets with lower rates of cardiovascular disease, type 2 diabetes, obesity and bowel disorders, fibre intake across industrialised nations remains far below recommended levels. In the UK, only 4% of children and adults meet recommended daily intakes.
The authors explore the difference between intrinsic fibre found naturally within whole plant foods and functional fibre added to processed foods or sold as supplements. While both may have physiological effects, the evidence consistently shows that the greatest health benefits come from consuming minimally processed plant foods such as vegetables, fruits, legumes, nuts and whole grains. These foods contain fibre within an intact plant matrix alongside polyphenols, antioxidants and other protective compounds that work together to support health.
A central theme of the paper is the relationship between fibre and the gut microbiome. Different fibres influence microbial composition and metabolism in highly specific ways, particularly through the production of short-chain fatty acids, compounds known to support gut integrity, immune function and metabolic health. However, not all fibres are equal. The physiological effects depend on their structure, fermentability and viscosity, as well as the food matrix in which they are delivered. This may explain why fibre supplements and fortified foods often produce less consistent and less comprehensive benefits than whole plant foods.
The review also highlights the limitations of highly processed diets and cautions against relying solely on isolated fibre ingredients to solve a population-wide fibre deficit. Targeted fibre fortification and supplementation may help in certain contexts, they cannot replicate the broad clinical benefits seen with diets centred on minimally processed plant foods.
The authors emphasise that improving fibre intake requires more than individual behaviour change. Public policy, food reformulation, labelling initiatives and better access to affordable plant foods will all be necessary to create healthier food environments.
Keto diets and LDL-cholesterol
Although low-carbohydrate, animals-based diets, including the ketogenic diet (KD), remain outwith consensus, some clinicians and high profile influencers continue to recommend this way of eating. In the short-term there may be some benefits, but concerns remain about long-term health outcomes. In part, because diets high in saturated fat and low in fibre lead to elevated LDL-cholesterol (LDL-C) and apolipoprotein B levels and thus a higher risk of atherosclerotic cardiovascular disease (ASCVD).
This new review focuses on KD-induced elevation of LDL-C in people with normal body mass index, exploring potential mechanisms underlying this phenotype, and discusses implications for ASCVD risk and management.
The bottom line is that keto diets can result in large elevations in LDL-C. The authors state ‘there is currently no established evidence that individuals with marked LDL-C elevations on KDs are protected from LDL-mediated atherogenesis’ and they suggest that reintroducing carbohydrates is a useful strategy for reducing LDL-C levels. If a person wants to continue a KD despite the dyslipidaemia, then cholesterol lowering medication may need to be instituted.
The authors conclude ‘The absence of long-term outcome data should not be interpreted as evidence of cardiovascular safety in these patients’.
It seems crazy to me that people want to adopt KDs when fibre-rich, plant-based diets have so many benefits for both short and long-term health.
Animal-based versus plant-based protein for muscle protein synthesis
This new systematic review and meta-analysis of 12 studies found that animal-based proteins confer a small but significant advantage in stimulating muscle protein synthesis (MPS) compared to plant-based proteins. Most animal protein data were derived from milk-based sources, while plant proteins were from a variety of different sources.
However, the interpretation is more nuanced. The observed advantage of animal protein was mostly seen in older adults (>65 years), whereas younger individuals showed comparable MPS responses regardless of protein source. MPS responses were observed for young and older adults regardless of resistance exercise or not.
The authors suggest that this age-related difference may be related to the lower leucine content typically found in plant-based proteins. Leucine is a key regulator of MPS and can be rate limiting if not consumed in sufficient amounts. In older adults, anabolic resistance (blunted MPS response to stimuli such as protein and exercise) means that higher per-meal leucine intake is required to effectively stimulate MPS. This could be mitigated by increasing total protein intake or fortifying plant proteins with additional leucine.
Of note, this meta-analysis assessed acute MPS responses rather than long-term changes in muscle mass but overall the data suggests that both plant and animal-based protein can support muscle synthesis providing daily intake is sufficient (approximately 1.6 g/kg). It should also be noted that most of the participants in the included studies were male and so the generalisability to females is uncertain.
Greenwashing by meat & dairy companies and meat industry research funding
Two different but related papers highlight how environmental claims and climate promises by the meat and dairy companies are best classified as ‘greenwashing’ and how meat industry funding of scientific research more often than not finds in favour of eating meat.
The first paper analysed the environmental commitments and claims of 33 of the world’s largest meat and dairy companies. 1233 environmental claims were identified of which 68% (841) were climate-related. 98% of the claims were categorised as Greenwashing i.e. no clear or achievable plan to reach the target.
The second paper included 500 studies investigating the health impacts of meat consumption. 78 (15.6%) reported industry involvement. Studies linked to the meat industry were 16 times more likely to report positive findings about meat consumption with a significant association between meat industry funding and the study conclusion.
These two studies demonstrate the typical industry playbook allowing ‘business as usual’ to continue. It mirrors the tactics of the tobacco and alcohol industry. Fund the scientists and the research; cast doubt and perpetuate misinformation; pretend to care but continue to promote a product that harms; renege on commitments that would improve health and the environment. This has all been eloquently summarised in a fantastic report by Changing Markets – Big Meat and Dairy’s narratives to derail climate action.
Additional papers of interest
Exposure to plastics is of increasing concern as there are associations with negative health impacts. A new intervention study has shown that limiting consumption of highly processed foods, plastic food packaging and canned goods, and minimising plastic touch points during production – from farm to fork – can reduce urinary excretion of phthalates and bisphenols (chemicals associated with plastic exposure). This provides actionable evidence for individuals who are looking to reduce ingestion of plastic.
We know that many chronic conditions are driven by the same undying mechanisms. This is recognised now by the fact that the combination of heart, kidney and metabolic conditions (diabetes and obesity) is known as cardiovascular-kidney-metabolic syndrome, or CKM syndrome. These same chronic condition are known to increase the risk of cancer. A new large retrospective analysis from Japan that includes almost 1.4 million people finds that people with CKM syndrome have an increased risk of multiple cancer types and the risk increases as the stage of CKM worsens. Thus preventing CKM syndrome should also reduce cancer incidence.
Diet and lifestyle practices are essential for cancer prevention but can also have a positive impact even after a cancer diagnosis. This new short report finds that in a large cohort of cancer survivors in the US, adherence to healthy lifestyle practices has not changed much over time. However, people who received counselling on lifestyle factors were more likely to engage in these positive behaviours. This once again highlights the need for lifestyle medicine to be incorporated into all aspects of primary and secondary healthcare.
Processed meat consumption is associated with a number of health harms according to this new umbrella review that summarises existing systematic reviews and meta-analyses. Eating 50g/d was associated with a 72% higher risk of gastric cancer, 17% higher risk of colorectal cancer, 4% higher risk of prostate cancer, and an 8% higher risk of chronic obstructive pulmonary disease. There is no safe limit of consumption and therefore zero is the optimal amount to include in the diet.
Last but not least, our very own research paper published in BMJ Nutrition, Prevention and Health from the team at Plant-Based Health Professionals UK in collaboration with Dr Dagfinn Aune. Consumption of legumes and soya is associated with a reduction in the risk of hypertension. Read more here.
See you back in June!
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