Plant-Based Meat Alternatives Provide a Practical, Nutritionally Sound Way to Boost Plant Protein Intake

By Virginia Messina, MPH, RD

In the early part of the 20th century, Americans consumed approximately equal amounts of plant and animal protein, according to disappearance data from that period.⁹ Today, however, populations in high-income countries, including the United States, derive twice as much protein from animal food as from plants.^6,7 Efforts to shift towards more plant protein in these countries reflect growing concerns about both environmental^1,2and health^3-5 impacts of different protein-rich foods. There is also a need to identify more healthful sources of plant protein since, in the U.S., the major contributor of plant protein to the diet is refined grains.⁸

The Nutritional Value of Legumes

Legumes, such as soybeans and pulses, which include dry beans and lentils, represent a healthy, economical, and sustainable source of plant protein. These foods are unique in that they provide both protein and fiber–a 100g serving of cooked dry beans provides >8g protein and >7g fiber¹⁰–making them an especially valuable addition to the diet for Americans who consume roughly half the recommended fiber intake.¹¹ In addition, legumes are good sources of several vitamins and minerals.¹⁰

Low Legume Intake in the U.S. and Globally

Legumes remain greatly underutilized in American diets. According to an analysis of the National Health and Nutrition Examination Survey (1999-2016), Americans get only about 2% of total protein and 6% of plant protein from legumes,⁸ with little change over the past 20 years. Globally, intake is somewhat higher but still modest, providing just 6% of protein worldwide although consumption varies regionally.¹² Average global pulse consumption is only 21g per capita per day, without change over the past three decades, according to the Food and Agriculture Organization.¹² Barriers to greater consumption include the time and effort required for preparation and the gastrointestinal disturbances experienced by some individuals when first incorporating legumes into their diet.¹³ Even with major public health initiatives, it is unlikely legume intake will substantially increase in the near future.

Rise of Plant-Based Meat Alternatives (PBMAs)

Plant-based meat alternatives (PBMAs) derived from legumes offer a promising and convenient way to increase plant protein intake beyond traditional legume preparations. Plant protein-rich foods, such as tofu and tempeh, have been consumed in place of meat for centuries. Products designed to more closely mimic meat, and often made from soy or peanuts, have been available for more than 100 years. Recently, a new generation of PBMAs has entered the market. These PBMAs have been created to more closely mimic the organoleptic properties–the taste and texture of meat–than earlier iterations. They are typically comprised of a concentrated protein source, usually pea, soy, or wheat, along with fat, binding and flavoring agents, and colorants.

This new generation of PBMAs was initially met with enthusiasm, and became widely available in grocery stores and restaurants, including fast food chains. However, more recently, the industry has faced challenges, including higher costs, a trend toward the promotion of meat consumption by some social media wellness influencers, and, most importantly, concerns about the processed nature of PBMAs.¹⁴

PBMAs and the Ultra-Processed Food Debate

Many food classification systems include a category of highly processed or ultra-processed foods (UPFs),^15,16 but the Nova food classification system, developed in 2009, is the one used most often to define UPFs in research settings.^15,16 Nova classifies any food using a concentrated source of protein as ultra-processed.

Although total UPF intake is associated with a range of adverse health outcomes,¹⁷ this does not mean that PBMAs should be avoided. Notably, Nova’s list of UPFs includes a wide range of dissimilar foods that includes everything from pastries to flavored yogurt (a food that has earned eligibility for a qualified health claim and reduced risk of type 2 diabetes, according to limited scientific evidence).¹⁸ While observational studies consistently link total UPF intake to adverse health effects,¹⁷ subgroups of UPFs have differentially affected health outcomes. Much of the association between total UPF intake and adverse health is driven by a few subcategories, especially processed meat and sugar-sweetened beverages.

In contrast, PBMAs are typically not associated with increased risks–a point recently recognized by the Scientific Advisory Committee on Nutrition in the UK¹⁹–and are sometimes associated with benefits. For example, an analysis of the UK Biobank data found a higher total UPF consumption was associated with a shorter leukocyte telomere length (LTL) (a shorter LTL is reflective of aging), whereas intake of vegetarian alternative UPFs such as PBMAs was associated with longer LTL.²⁰

Clinical Research Suggests PBMA Health Benefits

Clinical research provides evidence that PBMAs can support health and help allay concerns. A Stanford University study by Crimarco et al.²¹ found that in comparison to meat, PBMAs reduced body weight, LDL cholesterol, and trimethylamine oxide levels, a putative cardiovascular disease risk factor. For this study, participants in random order consumed either ~2.5 servings/day of meat or PBMAs for eight weeks and then switched to the opposite diet.

In contrast to the results of this study, a similarly designed study in Singapore²² failed to find differences in a range of health outcomes between meat and PBMAs. The researchers responsible for this work cited differences in the nutrient content of the PBMAs used in their study versus the Stanford study as reasons for the differing findings. This highlights the importance of nutrient content, rather than the extent of processing. Notably, even in the Singapore study, PBMAs–despite their Nova classification as ultra-processed–did not perform worse than meat.

Comparing PBMAs with Meat Products

UPFs are generally less healthy versions of the relatively healthy foods they are intended to replace. For example, ultra-processed chicken nuggets often replace less processed forms of chicken. In contrast, plant-based burgers serve as a replacement for red meat and processed meat.

It can be argued that the ideal replacement for red and processed meat is whole legumes, but since these foods have met some resistance among consumers, PBMAs remain a reasonable alternative. In addition, PBMAs have the advantage of potentially being fortified with an array of shortfall nutrients in plant-based diets.

A Practical Path to Balanced Protein Intake

PBMAs differ quite markedly in nutrient content, depending upon the protein and fat sources and especially the level of vitamin and mineral fortification. It is important to consider these factors when using PBMAs as a main source of protein, particularly since some products are relatively high in sodium.²³Overall, however, the evidence indicates that in high-income countries, PBMAs represent a nutritionally sound and convenient way to increase plant protein intake. In most instances, consuming just four or five servings of PBMAs per week can bring the plant to animal protein ratio of the diet to approximately 1:1.²⁴

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PLANT-BASED MEAT ALTERNATIVES PROVIDE A PRACTICAL, NUTRITIONALLY SOUND WAY TO BOOST PLANT PROTEIN INTAKE

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