Welcome to the systematic reviews and meta-analysis section of our evidence library, where we compile the highest-quality research that evaluates the overall effect of plant-based diets on health and chronic disease management.
This page focuses on the top tier of the evidence pyramid, showcasing studies that synthesize data from multiple individual studies to provide comprehensive conclusions about the impact of plant-based diets. Systematic reviews carefully assess and aggregate evidence from a range of studies, while meta-analyses apply statistical methods to combine results and offer a more precise estimate of effect sizes. These studies provide the most reliable evidence available, offering a broader view of how plant-based diets contribute to outcomes such as weight loss, heart health, diabetes management, and disease prevention. # of systematic reviews and meta-analyses included = 10
Case Studies | Case-Control Studies | Cross-Sectional | Cohort Studies | Clinical Trials & RCTs |
This page is organized by systematic reviews and meta-analyses examining observational studies and those examining clinical and randomized controlled trials. # of systematic reviews and meta-analyses included = 8.
This systematic review and meta-analysis of 86 cross-sectional and 10 cohort prospective studies. Meta-analysis found that vegetarians had a 25% lower risk of ischemic heart disease incidence and mortality and had a 8% lower risk of cancer incidence. Vegans had a 15% lower risk of cancer incidence. PubMed
This systematic review and meta-analysis of 10 prospective studies including 9 cohorts of 698,707 participants found that those with the highest adherence to a plant-based diet pattern were at 16% lower risk of cardiovascular disease (CVD) and 12% lower risk of coronary heart disease (CHD)compared to those with the lowest adherence. Higher adherence to a plant-based dietary pattern and a healthy plant-based dietary pattern were associated with significantly lower risk of CVD. PubMed
A meta-analysis of 13 studies (410,085 participants) found that greater adherence to plant-based dietary patterns was inversely associated with cardiovascular mortality (8% lower risk) and CVD incidence (10% lower risk). Healthful plant-based diets were associated with a 13% lower risk of CVD incidence, while unhealthful plant-based diets were linked to a higher risk of cardiovascular mortality. Vegetarians had a 19% lower risk of CVD incidence but showed no significant difference in CVD mortality or stroke risk compared to meat-eater. PubMed
A large meta-analysis of cohort and case-control studies involving over 3 million people found that plant-based diets significantly reduce the risk of digestive system cancers. Across these studies, people who followed plant-based eating patterns had an 18% lower risk in cohort studies and a 30% lower risk in case-control studies compared to those consuming more animal products. The strongest protective effects were seen for pancreatic (29% lower risk), colorectal (24%), rectal (16%), and colon (12%) cancers. These findings suggest that adopting a plant-based diet may be a powerful strategy for reducing the risk of digestive cancers. PubMed
A systematic review and meta-analysis of 76 prospective observational studies (2,230,443 participants) found an inverse relationship between adherence to plant-based dietary patterns and the risk of T2D (18% lower), CVD (10% lower), cancer (9% lower), and all-cause mortality (16% lower). The protective effects were stronger when diets emphasized healthy plant-based foods (e.g., vegetables, fruits, whole grains, and legumes), while unhealthy plant-based diets were associated with increased disease risk. PubMed
This systematic review and meta-analysis examined 37 studies across 24 cohorts to assess the health benefits of substituting animal-based foods with plant-based options, focusing on cardiovascular disease (CVD), type 2 diabetes (T2D), and all-cause mortality. The results showed that replacing animal foods like red meat, processed meat, eggs, and dairy with plant foods such as nuts, legumes, whole grains, and olive oil was linked to a lower risk of CVD, T2D, and death from all causes. For example, replacing processed meat with nuts was associated with a 27% lower risk of CVD, and substituting red meat with whole grains was linked to a 10% lower risk of T2D. PubMed
This systematic review and meta-analysis of 28 cohort and case-control studies with over 2.21 million participants found that following the EAT-Lancet diet—a predominantly plant-based diet rich in vegetables, fruits, whole grains, legumes, nuts, and unsaturated fats—significantly reduced the risk of major diseases. Adherence to this diet was linked to a 22% lower risk of diabetes, 16% lower cardiovascular disease mortality, 17% lower all-cause mortality, and 14% lower cancer mortality. The results were statistically robust, with no evidence of publication bias. These findings reinforce the health benefits of plant-based eating in lowering chronic disease risk and promoting longevity. PubMed
This systematic review and meta-analysis of controlled trials included 7 trials at least 3-weeks in length which assessed the Portfolio diet, a plant-based diet emphasizing known cholesterol-lowering foods in a total of n = 439 participants with hyperlipidemia. The plant-based diet effectively improved blood lipid profile compared to the National Cholesterol Education Program (NCEP) Step II diet alone. PubMed
This systematic review and meta-analysis of 15 intervention studies (17 diet groups) found that prescribing vegetarian diets for at least four weeks led to an average weight loss of 7.5 lbs (3.4 kg) when including all participants, even those who didn’t fully follow the diet (intention-to-treat analysis), and 10.1 lbs (4.6 kg) when only counting those who completed the study (completer analysis). Greater weight loss occurred in participants with higher starting weight, fewer women, older age, longer study duration, or when weight loss was a study goal. Despite some differences across studies, the findings support vegetarian diets for weight management.. PubMed
This meta-analysis included 46 trials that examined the relationship between soy protein intake and LDL cholesterol (the "bad" cholesterol) found soy protein decreased LDL cholesterol by 3-4% PubMed
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