What we know
How do plant-based and animal-based diets compare for health?
Short answer: closer than the argument suggests, and not in one direction. On the outcomes measured in large groups, people eating plant-based diets have less heart disease and about the same all-cause mortality as the meat eaters they were compared with — but the same British cohort shows them with more stroke, and its vegans with more than twice the hip fracture rate. Our reading is that what replaces the meat matters more than whether the meat is there. And the strongest-sounding argument for either side is usually an argument from mechanism, which is the one kind of argument this page shows going badly wrong.
This entry takes one question about food and health and answers it from dated sources. Sentences marked as claims carry their source, the date we checked it and the date the source was checked. Everything else on the page is our own writing, and it is not a claim. The page does not tell anyone what to eat, and no product in our directory is given a health attribute anywhere in it.
Entry checked · no person approved the sentences in this entry · What this does not show
Filed under plant-based
This entry is long enough to read in parts. Each section below has its own page.
The floor
You do not need animal products to eat well if you are an adult, not pregnant or breastfeeding, and your diet is planned. You do need B12, from a supplement or from fortified food. It is also worth paying attention to protein (how much, its quality, and the amino acid lysine), iodine, iron, zinc, calcium, vitamin D, and the omega-3 fats EPA and DHA. The protein part of this entry explains why. Pregnancy, infancy and childhood are outside the sources behind this page.
In our reading of the large cohorts, a well-built diet with animal protein and a well-built one without are close to each other on heart disease and on death from any cause. They are not close on everything: in a British cohort, vegetarians had 20% more stroke than meat eaters, and vegans more than twice the rate of hip fracture. Among US health professionals, those who scored highest for less healthy plant foods had 32% more coronary heart disease than those who scored lowest, and those who scored highest for healthy plant foods had 25% less. No study we hold makes that comparison for diets that include meat. We read the evidence as saying that what replaces the meat matters more than whether the meat is there, though in the US study behind it, the links between protein source and death appeared only in people with at least one unhealthy habit, such as smoking, heavy drinking, excess weight or inactivity.
We do not print a nutrition figure for any food in our directory. We hold that data for none of them. We would rather say so than imply a check we have not made.
What this does not show
This is the block we require on every entry that could be read as saying something about an outcome. All twelve elements apply here, because this entry makes outcome claims throughout.
- 1. Dates
- Every source was retrieved on 20 September 2026 and each factual sentence carries the date we checked the copy behind it. The underlying studies span 1994 to 2026, and the dates matter: EPIC-Oxford recruited between 1993 and 2001, the Nurses' Health Study began in 1980, and the EAT-Lancet reference diet is the 2025 revision of a 2019 report. A 1997 relative risk and a 2025 one are not interchangeable, and the sentence dates are how you tell them apart.
- 2. What kind of evidence this is
- Mostly prospective cohort studies, in which people report what they eat and are followed for years. Some are randomised trials: the antioxidant and vitamin E trials, the calcium and fractures trials, the fat-substitution trials, PREDIMED, and the muscle protein synthesis studies, which measured a short-term marker in two dozen people rather than an outcome. Two are systematic reviews of observational studies, two are umbrella reviews, two are position statements from professional bodies, and the EAT-Lancet material is a modelled projection. No randomised trial in this entry assigned anyone to a vegan or an omnivorous diet and followed them for a health outcome.
- 3. Who was studied and who was not
- The big cohorts are United States health professionals, British adults recruited through vegetarian and vegan societies, Seventh-day Adventists in North America, Swedish adults in three counties, Dutch national diet surveys and UK Biobank participants. The muscle protein studies were 24 healthy young men each. The calcium trials were people over 50. The oldest-old evidence comes from 20 vegetarians and 6 vegans aged 72 to 80. Pregnancy, infancy and childhood are not studied here at all, and no cohort in this entry measured a person's diet and their genes, medication or medical history well enough to say what any of these associations mean for one individual.
- 4. The comparator
- This is the element most often missing from health writing, so it is stated for every claim. "Vegetarian" in EPIC-Oxford means the vegetarians and vegans combined. The plant-based diet indices compare extreme deciles of adherence within the same cohort, not plant-eaters against meat-eaters. The fat findings are almost all substitution findings: they describe what happened when one nutrient replaced another at the same calorie level, not what happened when people ate less of it. The protein findings compare specific gram amounts of one protein against another. Where a claim says "compared with", that phrase is doing real work.
- 5. The adjustment set, and what changed when it was expanded
- The cohort findings are adjusted for age, smoking, alcohol, physical activity, energy intake and other diet and lifestyle factors, and the adjustment sets differ between studies and are not reproduced here. Two adjustments matter enough to name in the sentences themselves: in EPIC-Oxford, adjusting for self-reported cholesterol, blood pressure, diabetes and body mass index moved the ischaemic heart disease result from 0.78 to 0.90, while the stroke result did not move at all; and the fracture associations in the same cohort attenuated slightly but remained significant after adjustment for dietary calcium and total protein.
- 6. Uncertainty as reported
- Every effect size above carries the interval its source printed. Several touch or cross 1.00 and are labelled as such: the vegan all-cause mortality interval in the Adventist cohort (0.73 to 1.01), the fully adjusted ischaemic heart disease interval in EPIC-Oxford (0.81 to 1.00) and the monounsaturated fat substitution result in the saturated fat analysis (0.90 to 1.01). Where a pooled estimate is reported, the heterogeneity is given as well, and in one case — milk and mortality — the heterogeneity was so large that the authors declined to pool at all.
- 7. What no source here can say about a product
- Nothing in this entry measures any food in our directory, any brand, any product, any portion as sold or any price. The analogues analysed in one study were bought in the Netherlands in March 2023 and are not identified by brand. No sentence here is a statement about a specific product, and no sentence here should be read as one.
- 8. Counter-signals
- Carried beside the benefits rather than after them: the higher stroke rate in EPIC-Oxford vegetarians, which did not attenuate; the higher hip fracture rate in the same cohort's vegans, which survived adjustment; the null results for saturated fat in the observational review and the very low certainty its authors assigned; the small effect on all-cause mortality in the fat trials against the larger one in the cohorts; the Adventist vegan interval that includes 1.00; and the guideline panel that read the red-meat evidence and recommended no change.
- 9. Adequacy caveats
- A plant-based diet can be adequate in aggregate and inadequate for a particular person, and this entry names the nutrients at issue rather than saying "adequate": vitamin B12, iodine, iron, zinc, calcium, vitamin D, omega-3 EPA and DHA, and protein amount, protein quality and lysine. The measured shortfalls in long-term older vegetarians and vegans were in calcium, zinc, vitamin B12 and vitamin D, plus iron and folate in vegans. Pregnancy, infancy and childhood are outside what this entry can support: the sources retrieved for it do not cover them, and the EAT-Lancet summary's own caveat on bioavailability is quoted above.
- 10. What we did not check
- The full 2025 EAT-Lancet report could not be read: its Lancet record carries no abstract and the article is behind the publisher's paywall, so every EAT-Lancet sentence here quotes the Commission's own summary report instead. Paywalled full texts of the cohort papers were not read, so each claim rests on the abstract as retrieved on 20 September 2026 and not on the paper's tables or supplements. No retraction check was run beyond what Europe PMC reports, and no later replication was sought. Nothing was bought, and no person was interviewed. No clinician has reviewed any of it.
- 11. What would change it
- A randomised trial assigning people to a vegan or an omnivorous diet and following a health outcome would change the shape of this page rather than a sentence on it. A corrected or retracted source would retire the sentences that rest on it. The two most likely single changes are a replication of the EPIC-Oxford fracture finding in a cohort with better measured calcium and protein intake, and a trial of protein intake in older adults that measures function rather than a short-term marker.
- 12. What is not on this page
- Some sentences written for this entry are not here. They are left out when their source could not be retrieved, when the source did not carry the point the sentence made, when the source contradicted it, or when the wording was too hedged to state plainly. Nothing here rises above its sources: the sentences that did are not on the page. The full list of what was written and left out is in this entry's record, not on this page.
This page is general information about published research. It is not medical advice, and it is not a substitute for advice from a qualified health professional. No clinician-patient relationship exists, and we do not know your diet, your medications, your test results, your medical conditions or your history. Talk to a health professional before changing your diet if you are pregnant or breastfeeding, feeding an infant or child, over 65, taking medication, living with a medical condition, or if you have been diagnosed with a nutrient deficiency or have a history of disordered eating. The evidence described is about groups and diets, not about you, and not about any product listed on this site. If you are unwell, contact a health professional; in an emergency, call 911. No clinician reviewed this entry. It is a compilation of published sources by this site.
Our position
Written by Find My Next Bite · 20 September 2026
We built this page around an argument we expected to lose, and it partly did. The argument was that an appropriately constructed vegan diet is no worse than an appropriately constructed animal-based diet. On heart disease and on all-cause mortality, that holds: the plant-based cohorts do as well or slightly better, and the substitution findings — replacing processed red meat in particular — are the largest and most consistent effects in the whole entry. On stroke and on bone, it does not hold. EPIC-Oxford found vegetarians with 20% more total stroke and vegans with more than twice the hip fracture rate of meat eaters, and neither signal went away when the analysis was tightened. A page that reported the first half and not the second would be the kind of page this project exists to not be.
The other half of the argument was that there is very little benefit to eating more meat, and that survives better, with one honest qualification. The cohort evidence for red and processed meat is small in size and low in certainty, and the panel that looked hardest at it recommended no change at all. But "low certainty" cuts both ways: it means the benefit of eating less is not firmly established, not that the meat is harmless. The finding we would defend most strongly is the least dramatic one — swap refined carbohydrate for whole grains and fibre, and the effect is graded higher than anything else on the page.
The reason this entry is built the way it is, though, is the mechanism question, because it is the mistake we would otherwise have made. Cow's milk is a good source of calcium, and the reasoning from that fact to stronger bones is clean enough to write in one line. When it was measured, dietary calcium turned out not to be associated with fracture, calcium supplements produced small changes in a marker that did not reach the outcome, and the largest trial evidence led a national body to recommend against the supplement for most older women. The same thing happened to antioxidants, where two large trials found more cancer rather than less, and to vitamin E, where a third found more prostate cancer. A mechanism tells you what to test. It does not tell you the answer, and in nutrition it has several times told the wrong one loudly.
What we would want a reader to take from the page is not a diet. It is that the comparison has a shape: plant-based eating as measured does better on the arteries and no better or worse on dying of anything, worse on bleeding into the brain and on broken hips, and adequate on protein only if somebody has thought about where the protein is coming from — which is a harder thing to do at 76 than at 24. Every one of those sentences has a number and a date behind it on this page, and every one of them would change if a better study came along.
Every change this site makes to a sentence it has published is recorded, dated, at Corrections and revisions — what it said before, what it says now, and which kind of change it is. Nothing here is rewritten quietly.
Where to go next
If you came here to understand, the directory is where the useful part starts: the same dated discipline, pointed at things a person can put on a plate. Ordinary links on this site earn us no commission, and no product, maker or merchant paid for a mention in this entry.
Read what we know about other foods →
No food in the directory carries a health attribute, and this entry does not give one. The evidence here is about dietary patterns measured in groups of people; it cannot tell you that any particular product is good for you, and the studies behind it measured nobody's shopping.
Every source this entry cites
This page carries no numbered sentences of its own: the 8 sections do, and each one lists the sources it uses with the date we checked them. What follows is the whole bibliography in one place, so a reader can see at a glance what the entry stands on.
- Association of Animal and Plant Protein Intake With All-Cause and Cause-Specific Mortality. JAMA Internal Medicine. prospective cohort study. Open the source ↗
Checked 19 September 2026. - Association of Healthy Predominantly Plant-Based Diet with Reduced Cardiovascular Disease Incidence and Mortality and Development of Novel Heart-Protective Diet Index. Nutrients. systematic review and meta-analysis. Open the source ↗
Checked 19 September 2026. - Association of Specific Dietary Fats With Total and Cause-Specific Mortality. JAMA Internal Medicine. prospective cohort study. Open the source ↗
Checked 19 September 2026. - Association of Vegetarian and Vegan Diets with Cardiovascular Health: An Umbrella Review of Meta-Analysis of Observational Studies and Randomized Trials. Nutrients. umbrella review. Open the source ↗
Checked 19 September 2026. - Calcium intake and bone mineral density: systematic review and meta-analysis. The BMJ. systematic review and meta-analysis. Open the source ↗
Checked 19 September 2026. - Calcium intake and risk of fracture: systematic review. The BMJ. systematic review. Open the source ↗
Checked 19 September 2026. - Carbohydrate quality and human health: a series of systematic reviews and meta-analyses. The Lancet. systematic review and meta-analysis. Open the source ↗
Checked 19 September 2026. - Cheese intake in large amounts lowers LDL-cholesterol concentrations compared with butter intake of equal fat content. The American Journal of Clinical Nutrition. randomised crossover trial. Open the source ↗
Checked 19 September 2026. - Dietary fat intake and the risk of coronary heart disease in women. The New England Journal of Medicine. prospective cohort study. Open the source ↗
Checked 19 September 2026. - Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association. Circulation. position paper. Open the source ↗
Checked 19 September 2026. - Dietary intake of total, animal, and plant proteins and risk of all cause, cardiovascular, and cancer mortality: systematic review and dose-response meta-analysis of prospective cohort studies. The BMJ. systematic review and meta-analysis. Open the source ↗
Checked 19 September 2026. - Dietary Protein and Amino Acids in Vegetarian Diets-A Review. Nutrients. narrative review. Open the source ↗
Checked 19 September 2026. - EAT-Lancet Commission Summary Report 2025: the healthy, sustainable and just food systems report in clear language. EAT-Lancet Commission (EAT Forum). commission report. Open the source ↗
Checked 19 September 2026. - Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease. The New England Journal of Medicine. randomised trial. Open the source ↗
Checked 19 September 2026. - Effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat: a systematic review and meta-analysis of randomized controlled trials. PLOS Medicine. systematic review and meta-analysis of randomised trials. Open the source ↗
Checked 19 September 2026. - Egg consumption and risk of cardiovascular disease: three large prospective US cohort studies, systematic review, and updated meta-analysis. The BMJ. prospective cohort studies. Open the source ↗
Checked 19 September 2026. - Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. JAMDA. position paper. Open the source ↗
Checked 19 September 2026. - Examining widely held propositions on human dietary protein needs and benefits: a critical review of the science that shapes both the data and our understanding of an essential macronutrient. Critical Reviews in Food Science and Nutrition. critical review. Open the source ↗
Checked 19 September 2026. - Food groups and risk of all-cause mortality: a systematic review and meta-analysis of prospective studies. The American Journal of Clinical Nutrition. systematic review and meta-analysis. Open the source ↗
Checked 19 September 2026. - From Single Foods to Whole Diets: A Critical Framework for Protein Quality Assessment Accounting for Complementarity and Matrix Effects. Comprehensive Reviews in Food Science and Food Safety. critical review. Open the source ↗
Checked 19 September 2026. - Healthful and Unhealthful Plant-Based Diets and the Risk of Coronary Heart Disease in U.S. Adults. Journal of the American College of Cardiology. prospective cohort study. Open the source ↗
Checked 19 September 2026. - Intake of individual saturated fatty acids and risk of coronary heart disease in US men and women: two prospective longitudinal cohort studies. The BMJ. prospective cohort study. Open the source ↗
Checked 19 September 2026. - Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies. The BMJ. systematic review and meta-analysis. Open the source ↗
Checked 19 September 2026. - Long-Term Vegetarian and Vegan Diets in Older Adults Are Associated With Inadequate Intakes of Protein and Micronutrients. The Journal of Nutrition. cohort analysis. Open the source ↗
Checked 19 September 2026. - Milk Consumption and Mortality from All Causes, Cardiovascular Disease, and Cancer: A Systematic Review and Meta-Analysis. Nutrients. systematic review and meta-analysis. Open the source ↗
Checked 19 September 2026. - Milk intake and risk of mortality and fractures in women and men: cohort studies. The BMJ. prospective cohort studies. Open the source ↗
Checked 19 September 2026. - Perspective: Vegan Diets for Older Adults? A Perspective On the Potential Impact On Muscle Mass and Strength. Advances in Nutrition. perspective. Open the source ↗
Checked 19 September 2026. - Plant Proteins: Assessing Their Nutritional Quality and Effects on Health and Physical Function. Nutrients. review. Open the source ↗
Checked 19 September 2026. - Post-prandial muscle protein synthesis rates following the ingestion of pea-derived protein do not differ from ingesting an equivalent amount of milk-derived protein in healthy, young males. European Journal of Nutrition. randomised trial. Open the source ↗
Checked 19 September 2026. - Potato Protein Ingestion Increases Muscle Protein Synthesis Rates at Rest and during Recovery from Exercise in Humans. Medicine & Science in Sports & Exercise. randomised trial. Open the source ↗
Checked 19 September 2026. - Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts. The New England Journal of Medicine. randomised trial. Open the source ↗
Checked 19 September 2026. - Red and Processed Meat Consumption and Risk for All-Cause Mortality and Cardiometabolic Outcomes: A Systematic Review and Meta-analysis of Cohort Studies. Annals of Internal Medicine. systematic review and meta-analysis. Open the source ↗
Checked 19 September 2026. - Reduction in saturated fat intake for cardiovascular disease. Cochrane Database of Systematic Reviews. systematic review. Open the source ↗
Checked 19 September 2026. - Replacing Animal Meat with Plant-Based Meat Alternatives: The Impact of Protein Quality on Protein Adequacy in the Dutch Diet. Current Developments in Nutrition. modelling study. Open the source ↗
Checked 19 September 2026. - Risks of ischaemic heart disease and stroke in meat eaters, fish eaters, and vegetarians over 18 years of follow-up: results from the prospective EPIC-Oxford study. The BMJ. prospective cohort study. Open the source ↗
Checked 19 September 2026. - Saturated Fats Compared With Unsaturated Fats and Sources of Carbohydrates in Relation to Risk of Coronary Heart Disease: A Prospective Cohort Study. Journal of the American College of Cardiology. prospective cohort study. Open the source ↗
Checked 19 September 2026. - Shifting to Plant-Based Protein Diets Alters Nutrient Adequacy Across Age Groups: A Dutch Dietary Modeling Study. Nutrients. modelling study. Open the source ↗
Checked 19 September 2026. - The amino acid composition of commercially available vegan meat and dairy analogues. British Journal of Nutrition. product analysis. Open the source ↗
Checked 19 September 2026. - The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. The New England Journal of Medicine. randomised trial. Open the source ↗
Checked 19 September 2026. - The Muscle Protein Synthetic Response to the Ingestion of a Plant-Derived Protein Blend Does Not Differ from an Equivalent Amount of Milk Protein in Healthy Young Males. The Journal of Nutrition. randomised trial. Open the source ↗
Checked 19 September 2026. - The Planetary Health Diet. EAT-Lancet Commission (EAT Forum). commission page. Open the source ↗
Checked 19 September 2026. - Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses. The BMJ. umbrella review. Open the source ↗
Checked 19 September 2026. - Unprocessed Red Meat and Processed Meat Consumption: Dietary Guideline Recommendations From the Nutritional Recommendations (NutriRECS) Consortium. Annals of Internal Medicine. guideline recommendations. Open the source ↗
Checked 19 September 2026. - Vegetarian and vegan diets and risks of total and site-specific fractures: results from the prospective EPIC-Oxford study. BMC Medicine. prospective cohort study. Open the source ↗
Checked 19 September 2026. - Vegetarian dietary patterns and mortality in Adventist Health Study 2. JAMA Internal Medicine. prospective cohort study. Open the source ↗
Checked 19 September 2026. - Vegetarian, vegan diets and multiple health outcomes: A systematic review with meta-analysis of observational studies. Critical Reviews in Food Science and Nutrition. systematic review with meta-analysis. Open the source ↗
Checked 19 September 2026. - Vitamin D, Calcium, or Combined Supplementation for the Primary Prevention of Fractures in Community-Dwelling Adults: US Preventive Services Task Force Recommendation Statement. JAMA. recommendation statement. Open the source ↗
Checked 19 September 2026. - Vitamin E and the risk of prostate cancer: the Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA. randomised trial. Open the source ↗
Checked 19 September 2026.