In recent years, the plant-based diet has gained momentum as a beneficial lifestyle choice, not only for overall health, but also for promoting heart health. With the shift toward more plant-centric eating, researchers have increasingly investigated how plant-based diets impact cardiovascular health. Danna Hunnes, PhD, senior dietitian at Ronald Reagan UCLA Medical Center, and Zhaoping Li, MD, PhD, director of the Center for Human Nutrition and a professor of medicine at UCLA, share insights on the complex connections between plant-based diets and heart health.
The protective power of plant-based diets
“There’s lots of data to support that a whole-food, plant-based diet is really good for heart health,” Dr. Hunnes says. “The more you eat animal products, which displace whole food, plant-based foods, the worse off your cardiovascular health.” By choosing a diet focused on whole, minimally processed plant-based foods, individuals can experience meaningful improvements in their heart health and overall well-being.
One significant mechanism underlying these benefits is the high fiber content in plant-based foods, such as beans, lentils and vegetables.
“Fiber acts like a vacuum cleaner for our arteries and veins, helping to sweep away bad fats and LDL cholesterol,” Dr. Hunnes explains. This process can lower cholesterol levels and reduce the buildup of fatty deposits in blood vessels, which are primary contributors to heart disease.
HDL cholesterol and heart disease prevention
When discussing heart health, cholesterol is a critical factor. Cholesterol itself is not inherently harmful; in fact, our bodies require it to build cells. However, too much LDL (low-density lipoprotein) cholesterol, often called “bad cholesterol,” can lead to blockages in arteries. HDL (high-density lipoprotein) cholesterol, known as “good cholesterol,” plays a protective role by carrying excess cholesterol back to the liver, where it can be broken down.
Plant-based diets, especially those rich in fiber, are associated with improvements in the LDL-to-HDL cholesterol ratio. Dr. Li notes that plant-based foods don’t contain cholesterol, which is only present in animal-based products. However, she also cautions that even a plant-based diet can be unbalanced if it includes too many refined carbohydrates or processed foods.
“It’s not just about avoiding animal products,” Dr. Li adds. “We should be focusing on whole, unprocessed plant foods like vegetables, fruits and legumes.”
Omega-3s: The role of ALA, DHA and EPA in heart health
Omega-3 fatty acids are essential for heart health, and the specific types of omega-3s — ALA, DHA and EPA — each play different roles in the body. ALA (alpha-linolenic acid) is a plant-based omega-3 found in foods like flaxseed and chia seeds. DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid), on the other hand, are more commonly found in fish and fish oil.
Dr. Hunnes highlights the potential benefits of ALA, explaining that “flax oil significantly reduced the incidence of arrhythmias,” according to several studies she reviewed. While ALA can be converted to DHA and EPA in the body, the conversion process is relatively inefficient, so it’s essential to include a variety of plant-based omega-3 sources for those following a strictly plant-based diet.
Dr. Hunnes notes that “there has not been supportive evidence that [fish oil] is helpful for heart health,” suggesting that plant-based omega-3s may offer similar benefits without relying on animal products.
Whole foods vs. processed plant-based options
A plant-based diet is not necessarily synonymous with heart health, as Dr. Li points out.
“It should be plant-based, whole food — colorful vegetables and legumes, that would be the best,” she explains. “They’re not the same as bread and pasta, rice and cereal.”
In other words, plant-based doesn’t mean vegan junk food. To truly reap the benefits of a plant-based diet, Dr. Li advises focusing on whole foods and avoiding processed options that can be high in sugars, unhealthy fats and refined grains.
Moreover, Dr. Li highlights that although plant-based foods are typically no cholesterol, some plant-based diets can still lead to high cholesterol levels by increasing our body own cholesterol synthesis if they include excessive carbohydrates or unhealthy fats.
“Most of the cholesterol in our body is produced by the liver, not from dietary cholesterol,” she says, adding that excess carbs or fats can still increase cholesterol levels.
Balancing macronutrients
For those transitioning to a plant-based diet, getting a balance of macronutrients — proteins, fats and carbohydrates — can be a challenge.
“Most plant-based protein foods are not having all the essential amino acids our body needs,” explains Dr. Li. “You need a mix, like kidney beans one day and brown rice the next, to meet your protein needs.”
Ensuring a diverse array of plant foods can help meet protein requirements and avoid deficiencies.
To support heart health specifically, Dr. Hunnes recommends fiber-rich foods such as whole grains, beans, vegetables and fruits, which help manage blood sugar levels and promote satiety. A balance of healthy fats, such as those from avocados, nuts and olive oil, is also key.
Taking small steps toward a heart-healthy plant-based diet
Transitioning to a plant-based diet doesn’t mean going full-vegan or vegetarian overnight. Dr. Li recommends that people who don’t want to commit fully can still benefit by incorporating more plant-based foods.
“The higher the health risk, the more reasons to incorporate more plant-based foods,” she says. “It’s beneficial to everyone, particularly those with a high risk for heart disease.”
Both Dr. Hunnes and Dr. Li underscore the importance of guidance when making dietary changes, especially for individuals with specific health concerns.
“It’s important to have a trained physician or dietitian give you guidance to ensure that you’re getting the nutrients you need, particularly when eliminating animal products from the diet, Dr. Li advises.
A pathway to better heart health
Ultimately, the correlation between plant-based diets and heart health is well-supported by research, yet it requires a thoughtful approach. By prioritizing whole, fiber-rich foods, managing macronutrient intake and choosing healthy fat sources, a plant-based diet can play a powerful role in promoting cardiovascular health.
As Dr. Hunnes concludes, “Your overall health, including heart health, will be better on a whole-food, plant-based diet than with animal products.”
