Vegan Diets Aren’t Automatically ‘Healthy,’ Prioritizing Nutrients Is Key

New research found that eating only plant-based foods does not guarantee a reduced risk of health conditions—ultimately, it depends on how certain nutrients are prioritized.

With all the buzz about the benefits of eating more plants, it's easy to assume that going vegan automatically means eating well for health. But a new study reveals that's not always the case. According to a March 2023 study in JAMA Network Open, sticking to only plant-based foods does not guarantee a reduced risk of conditions like cardiovascular disease or cancer—or even a lower risk of death overall.

Instead, reaping the benefits of a vegan diet likely depends not just on eliminating animal products, but on how you do so.

The study, conducted by researchers in the United Kingdom, analyzed the self-reported diets of over 126,000 people for a period of up to 12.2 years. The team of researchers scored participants’ plant-based diets as either healthful or unhealthful, based on intakes of 17 food groups. (The food groups included whole grains, fruits, vegetables, legumes and vegetarian protein alternatives, dairy, sweets, and more.)

Though the researchers did find that a certain type of vegan diet (one low in "unhealthful" foods like sugary drinks, refined grains, potatoes, desserts, and fruit juices) was associated with reduced risk of chronic disease and overall mortality, diets with higher levels of these foods appeared to have the opposite effect. The higher the "unhealthful" score of a vegan diet, the more likely its adherents were to experience cardiovascular disease, cancer, and death.

In fact, those with the highest level of unhealthful vegan diets had a 23% higher risk of death from any health-related cause.

While the study did have some limitations—such as the fact that it relied on only two 24-hour dietary assessments—experts say it's an important call for more awareness around following a vegan diet in a healthy way.

Just because a food's ingredients are derived from plants doesn't mean it's good for you. Oreos and high-voltage energy drinks are famously vegan, for example.

If the majority of a vegan diet stems from highly processed foods, that's a major red flag. "Consuming ultra-processed foods can contribute to an unhealthy vegan diet," vegan nutrition expert Haley Bishoff, RDN, of Rūtsu Nutrition told Health.

"Prepackaged foods such as cookies, chips, and even some vegan meat alternatives can be considered ultra-processed foods."

Consuming ultra-processed foods can contribute to an unhealthy vegan diet.

Bishoff emphasized that the occasional vegan treat isn't a one-way ticket to heart disease or cancer. Rather, she encouraged looking at an overall dietary pattern. "It's the overconsumption of these highly processed foods, vegan or not, that can increase your risk of type 2 diabetes, cancer, and cardiovascular disease. As cliché as it sounds, balance and moderation are key."

So what are vegans to do if processed convenience foods are (mostly) off the table? A healthy vegan diet includes plenty of whole, minimally processed plant foods, Bonnie Newlin, MS, RD, LDN, of Crave Nourishment told Health.

"Prioritize eating fiber from fruits, vegetables, and unrefined grains. Pay attention to sodium, saturated fat, and the number of ingredients and additives on the nutrition label," she recommended. "Be mindful of adding different colors of fruits and vegetables to your plate. Each color in these plant foods is associated with a slightly different nutritional benefit."

Design by Health

Besides containing high amounts of concerning nutrients like saturated fat and sodium, Newlin emphasized that many processed plant-based foods also come with a host of harmful additives. "Many consumers look at the nutrient information and forget to consider the harm that additives may be contributing to their overall health and waistline."

According to Newlin, one place to start is by looking for artificial sweeteners, often added to vegan yogurts, fruit desserts, and even vegetable blends. "These sweeteners are harmful to the microbiome because they disrupt the balance of good gut bacteria when they are consumed often. They’re commonly listed under names like sucralose, aspartame, saccharin, and neotame," she explained.

Other popular additives to be cautious of, Newlin said, include potassium bromate, butylated hydroxyanisole (BHA), and butylated hydroxytoluene (BHT), frequently found in plant-based foods like bread, noodles, cereals, and grain snacks.

"The Environmental Working Group reports that these additives are linked to changes in immunity and a higher risk of cancer," she noted. By sticking as much as possible to whole foods like fruits, vegetables, legumes, and whole grains, you’ll avoid these additives.

There's no official handbook for doing a vegan lifestyle "right"—so navigating the course toward healthy plant-based eating can be challenging. Several pitfalls are common. For starters, don't fall for the falsehood that all plant-based foods are nutritious.

As demonstrated in the JAMA Network Open research, foods like refined grains and sugar-sweetened beverages, though plant-based, could ultimately contribute to chronic disease.

The best way to identify a vegan food's healthy status is to read the labels of the foods you’re purchasing. "Highly processed plant-based foods are typically very high in sodium, saturated fat, added sugar, additives, and can have an ingredient list a mile long. It's best to stick with foods that are minimally processed and have ingredients you can pronounce," Newlin suggested.

To get the most out of a plant-based diet, Bishoff recommends consulting with a registered dietitian who specializes in vegan nutrition. "This can help the transition go much smoother by tailoring to your individual lifestyle and preventing nutritional gaps along the way," she said.

To determine whether a vegan diet is helping you reach your health goals, consider how your chosen foods make you feel on a daily basis.

"A few ways to know if you’re eating a healthy vegan diet is that you’ll experience more consistent energy levels, regular bowel movements, and satiety from meals," Bishoff concluded. "Getting regular blood work with your physician can be another great way to monitor your progress."

Thompson AS, Tresserra-Rimbau A, Karavasiloglou N, et al. Association of healthful plant-based diet adherence with risk of mortality and major chronic diseases among adults in the UK. JAMA Netw Open. 2023;6(3):e234714-e234714. doi:10.1001/jamanetworkopen.2023.4714