These rates took into account factors including socioeconomic status and a family history of dementia.

Unprocessed meats weren’t off the hook, either. Eating a full serving of steak, lamb, or other unprocessed meat each day was associated with a 16% higher risk of subjective cognitive decline (the perception of one’s own memory worsening).

The good news? Swapping nutrient-rich nuts and legumes for one daily serving of processed red meats was associated not only with a 19% lower risk of dementia but also with a 21% lower risk of subjective cognitive decline and a slower rate of cognitive aging.

Why Red Meat May Harm Brain Health

Several biological factors may explain the connections. Previous research demonstrates that consuming red meat boosts the body’s concentration of trimethylamine N-oxide (TMAO), a harmful compound produced by gut bacteria. Elevated TMAO levels appear to increase neuroinflammation and damage the blood-brain barrier, potentially contributing to cognitive impairment.

Additionally, studies have linked meat-heavy diets with cardiovascular diseases. These conditions may contribute to an increased risk of cognitive decline and dementia by reducing blood flow to the brain, changing brain structure, triggering inflammation, and promoting the buildup of harmful proteins.

“Dietary guidelines tend to focus on reducing risks of chronic conditions like heart disease and diabetes, while cognitive health is less frequently discussed, despite being linked to these diseases,” says corresponding author Daniel Wang, M.D., Sc.D., of the Channing Division of Network Medicine at Brigham and Women’s Hospital, a founding member of the Mass General Brigham health care system. Wang says he hopes that the results will “encourage greater consideration of the connection between diet and brain health.”

The Bottom Line

The Harvard study doesn’t prove that red and processed meat cause dementia; other lifestyle factors may have played a role, and the study’s population was unique in that all participants were health care professionals. However, the new research adds to growing evidence that what we eat plays a big role in how our brains age—and that a plant-forward diet may offer protection against cognitive decline.

To learn more about a whole-food, plant-based diet, visit our Plant-Based Primer. For meal-planning support, check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path.

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The Dietary Guidelines not only counsel individual Americans on how to eat; they also set budgeting priorities for the millions of dollars that the U.S. government invests in food programs. The federal government redevelops the Dietary Guidelines every five years, under the guidance of the Dietary Guidelines Advisory Committee (DGAC). This year’s committee is made up of 20 nutrition and public health experts, who say that they arrived at their 2025–2030 recommendations using a scientifically rigorous, multi-year process to “examine the relationship between diet and health across all life stages.”

A Shift Toward Plant-Based Proteins

In addition to recommending more plant-forward, nutrient-dense eating patterns overall, the committee specifically recommends updating the Dietary Guidelines so that plant-based sources of protein are listed before animal-based sources—a reprioritization in line with a trove of research linking animal protein with adverse health outcomes, including higher rates of Type 2 diabetes and early death. The recommended guidelines would also expand the number of plant-based foods considered to be “protein foods.” Under the current guidelines, the only plant foods categorized as such are soy products, nuts, and seeds. The new recommendation would add beans, peas, and lentils to this group, and list them, along with soy products, ahead of meat (including poultry), eggs, and seafood.

Neal Barnard, M.D., president of the Physicians Committee for Responsible Medicine, a public health advocacy nonprofit of 17,000 doctors, praises the shift in priorities. “If these recommendations are included in the 2025–2030 Dietary Guidelines for Americans, it will increase the consumption of healthy plant-based sources of protein like beans, peas, lentils, and other legumes, which can help Americans maintain healthy weight, lower blood pressure, and improve heart health,” says Barnard. “Highlighting these foods is important because they are lower in saturated fat than meat, eggs, and seafood while also containing fiber, a nutrient of which many Americans are not eating enough.”

Reducing Sodium and Rethinking Dairy

Throughout the report, the DGAC emphasizes the importance of consuming foods in nutrient-dense (i.e., whole) or less-processed forms, without added sugars, saturated fat, and sodium. It also calls on the U.S. government to set mandatory sodium reduction targets for commercial food manufacturers, instead of the voluntary targets that are in place now.

Taking a page out of Canada’s book, the DGAC also recommends making water the drink of choice in the new guidelines—a significant change, given the Dietary Guidelines’ history of promoting dairy. “There are no nutrients in dairy milk that cannot be found in other food sources,” Barnard says, noting that dairy products are the leading source of saturated fat in the American diet. During the last Dietary Guidelines update, in 2020, the American Medical Association called for meat and dairy to be deemed optional, writing in a statement that “dairy and meat products are promoted in federal nutrition policies even though they are not nutritionally required.”

Once submitted to the USDA and Health and Human Services Department, the DGAC’s full report will be available here. In the meantime, you can view a presentation of the committee’s forthcoming recommendations here.

To learn more about a whole-food, plant-based diet, visit our Plant-Based Primer. For meal-planning support, check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path.

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Conducted by researchers at Ohio State University’s College of Public Health, the analysis looked at the self-reported diets of a nationally representative group of more than 34,000 American adults who participated in the National Health and Nutrition Examination Survey. Researchers scored each participant’s diet using the dietary inflammatory index (DII), a tool designed to assess inflammation in the diet. The index ranges from -9 to 8, with a score of 0 indicating a neutral diet, lower than 0 indicating an anti-inflammatory diet, and higher than 0 indicating a pro-inflammatory diet.

After completing their assessment, they found that 57% of participants had inflammatory diets. Thirty-four percent had anti-inflammatory diets, and the remaining 9% ate diets with a neutral impact on inflammation. The findings were published in the journal Public Health Nutrition on Sept. 27.

“The overall balance of diet is most important,” the study’s lead author, Rachel Meadows, said in a statement. “Even if you’re eating enough fruits or vegetables, if you’re having too much alcohol or red meat, then your overall diet can still be pro-inflammatory.”

Because factors such as financial adversity can limit access to fruits, vegetables, and other healthy foods, Meadows’ team was also interested in identifying how socio-economic factors correlated with dietary inflammation. They found that Black Americans, men, younger adults, and people with lower education and income were more likely than average to have pro-inflammatory diets.

What Is the Dietary Inflammatory Index?

First developed a decade ago, the dietary inflammatory index (DII) is based on more than 50 years of scientific research around the ways foods and other dietary components, including alcohol, spices, and tea, influence inflammatory markers, such as C-reactive protein.

According to the DII, garlic, turmeric, ginger, and high-fiber foods (i.e., whole grains, fruits, beans, and vegetables) are highly anti-inflammatory. By contrast, the DII indicates that meat, vegetable oils, and refined carbohydrates are pro-inflammatory.

A 2021 umbrella review including data from more than 4 million participants found that the DII was a useful predictor of health outcomes, with pro-inflammatory diets leading to higher rates of chronic diseases.

“Moving toward a diet with less inflammation could have a positive impact on a number of chronic conditions, including diabetes, cardiovascular disease and even depression and other mental health conditions,” Meadows said.

Inflammation is a necessary tool for healing the body from infection and injury, but excess inflammation can lead to serious health problems over time. Healthy lifestyle choices can prevent and mitigate this type of inflammation.

“There are a lot of factors that contribute to chronic inflammation, and they all interact—even sleep is a key component,” said Meadows. “Diet can be used as a tool to combat that.”

To learn more about a whole-food, plant-based diet, visit our Plant-Based Primer. For meal-planning support, check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path.

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Do Smoothies Cause Blood Sugar Spikes?

Fruits and veggies are high in natural sugars that, unlike refined sugar, come packaged with fiber and all sorts of other health-promoting nutrients. Fiber helps the body digest natural sugars at a healthy rate, avoiding steep spikes (and subsequent crashes) in blood glucose levels. That’s an important distinction because over time, repeated spikes in blood glucose can increase the likelihood of cardiovascular disease and insulin resistance.

Historically, one concern that some doctors and nutritionists have voiced around smoothies is that blending fruit might break down its fiber and change the way we digest it, leading to blood sugar spikes. A 1977 study seemed to bear out this concern, finding that consuming pureed apples caused sharper spikes in blood sugar than eating apple slices (but smaller spikes than drinking apple juice).

But more recent research paints a more complex picture. Some fruits, such as mango, have been found to have a similar effect on blood glucose whether eaten blended or whole. Other fruits actually produce a smaller blood sugar spike when blended. “Smoothies don’t necessarily cause the hyperglycemic response that we used to think,” says whole-food, plant-based physician Thomas Campbell, M.D., co-author of The China Study. “It seems in some circumstances that the glycemic response is maybe even better.”

In 2020, a study published in the journal Nutrients looked at blood sugar levels in participants after consuming raspberries and passionfruit in whole and smoothie form and found that the smoothies caused lower blood sugar spikes relative to the whole fruits. A similar study in 2022 involving blackberries and apples found that an apple-berry smoothie produced a significantly lower glycemic response than the whole fruits. In both studies, the researchers suspected that the seeded fruits might be the key. “Grinding the seeds in blackberries during the blending process may have released additional fiber, polyphenols, fats, and protein that would not otherwise be released during [chewing] or normal digestive processes when the fruit is consumed in whole form,” the authors noted.

The Calorie-Density Factor

Despite the encouraging findings regarding smoothies and blood sugar, Matthew Lederman, M.D., co-author of The Forks Over Knives Plan, says that the recent research is “hardly a reason to start blending all your fruit.”

Pure fruits and vegetables, whether in blended or whole form, are both healthy, Lederman says. “But the main concern with smoothies is that drinking calories can lead to consuming more calories than if you were to chew whole fruit,” says Lederman. “Excess calories, not a minor glucose difference, are the bigger issue for most people.”

“Don’t drink your calories” is a common refrain in the whole-food, plant-based community, as a number of studies have found that consuming calories in liquid form, such as fruit juices, makes it easier to go overboard on calories. Research on smoothies, which fall somewhere between liquid and solid, is more sparse.

A 2009 study out of Penn State University had healthy adults consume an equal amount of calories via apple slices, applesauce, and apple juice before a meal to see how the different forms impacted mealtime calorie intake. They found that, after eating apple slices, participants tended to eat fewer calories during a meal than they did after eating applesauce. If they drank apple juice, even with added fiber, they ate as many calories at mealtime as they did when they had no snack or beverage beforehand.

In 2018, a study compared whole fruit versus smoothies when it comes to satiation—the feeling of fullness after a meal. As expected, participants reported feeling fuller after eating whole fruit than after drinking the smoothie equivalent. Yet, interestingly, participants did not end up consuming more calories after the smoothie than after the whole fruit. (The study was funded by a smoothie company, but the authors note that this did not influence their research.)

Barbara Rolls, Ph.D.,—author of Volumetrics and co-author of the Penn State study that compared apples, applesauce, and juice—says more research is needed to understand how blending fruits impacts satiation, but in general, taking more time to eat helps the brain register feelings of fullness.

“The chewing and the rate of eating are key—that, I think, is part of why we found the apple slices to reduce intake, to be more satiating than the applesauce or the beverages,” says Rolls. “Also, the perception of volume affects intake.”

“You might not feel as ‘full’ with smoothies [as with whole plant foods],” says Shilpa Ravella, M.D., gastroenterologist and author of A Silent Fire: The Story of Inflammation, Diet, and Disease. “But the difference isn’t as marked as, say, if you eat refined junk foods versus whole foods.”

The Bottom Line

In a country where 9 in 10 adults aren’t eating enough fruits and vegetables, smoothies offer a healthful, easy way to up produce intake. “[Smoothies are] great for people who might not otherwise have time to sit down and chew the same amount of plant foods, or people who are looking for the convenience of being able to add a fair amount of leafy greens and other vegetables, berries, spices, etc., into one meal pretty easily,” says Ravella.

Lederman and Campbell recommend opting for whole plant foods as much as possible, having smoothies only occasionally, and making them at home, with whole plant food ingredients including leafy greens.

“The closer to the original form, the better,” says Rolls. “But on the other hand, if people won’t eat [whole fruits and vegetables] in the original form, and they will eat [smoothies], then that’s better” than not having fruits or vegetables at all.

To learn more about a whole-food, plant-based diet, visit our Plant-Based Primer. For meal-planning support, check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path.

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Beyond crowding out inflammatory foods such as processed meats and refined grains, fiber-rich foods help curb chronic inflammation in a variety of ways. Here’s how fiber works its magic.

1. Fiber Feeds Healthy Gut Bacteria

As much as 80% of the immune system resides in the gut barrier lining your intestinal walls. Prebiotic fiber acts as food for the beneficial gut bacteria so they can multiply, increasing the healthy diversity of the microbiome and suppressing inflammatory microbes. “When you [feed] these [beneficial] microbes, they do a number of magical things,” Bulsiewicz says.

For example, when fiber reaches your intestines, the gut microbes produce short-chain fatty acids (SCFAs), which have the capacity to heal your gut barrier in a cycle that renews every three to four days. A healthy gut barrier acts like a bouncer for your body, letting in nutrients and ushering pathogens, toxins, and other inflammation-causing undesirables straight to the exit.

2. Keeps Visceral Fat in Check

The SCFAs produced by fiber-fed microbes trigger the release of a gut hormone called GLP-1— the same hormone mimicked in Ozempic and other popular weight-loss drugs—that sends the message to your brain that you’re full. This may be why clinical studies have found that higher-fiber diets are linked to significantly lower body weight. High-fiber diets are also tied to lower levels of visceral fat, the deep fat that wraps around the inner abdominal organs and “churns out ‘hidden’ inflammation at all hours of the day,” says Shilpa Ravella, M.D., gastroenterologist and author of A Silent Fire: The Story of Inflammation, Diet, and Disease. A study in the journal Gut found that faster gut transit time and a healthy microbiome, both byproducts of fiber, are associated with lower levels of visceral fat.

3. Promotes Healthy Blood Vessels

High cholesterol levels and hypertension injure the endothelial cells that line the blood vessels supplying blood to and from the heart. As the body attempts to heal these wounds, it triggers an inflammatory immune response. Studies have found that higher-fiber diets are linked to lower cholesterol and blood pressure, sparing the cardiovascular system this strain and inflammation. Soluble fiber, which is abundant in plant foods, especially beans, green peas, apples, and avocados, actually binds to cholesterol in the small intestine, sweeping it out of the body before it can get into your bloodstream.

A healthy gut barrier, courtesy of fiber, also limits the release of bacterial endotoxins, thus limiting vascular inflammation. “We need to be eating a wide variety of plants in order to optimize the gut microbiome and to be able to prevent or treat inflammation in the body,” Ravella says.

4. Regulates Blood Sugar

Spikes in blood sugar trigger an immune response, causing the body to produce more inflammatory molecules. Because of its physical structure, fiber slows blood sugar absorption and blunts glucose spikes. “This is why eating fruit is not the same thing as eating candy,” says Bulsiewicz. And by producing SCFAs, fiber stimulates receptors in the body that help increase sensitivity to insulin, the hormone released by your pancreas in response to sugar.

In a study published in the journal Nature in February 2024, researchers measured the metabolic responses in 1,000 people after eating a meal. The microbiome was one of the most meaningful predictors of insulin sensitivity, “more powerful than your body shape, more powerful than your age, more powerful than the meal you just ate, and way more important than your genetics and gender,” Bulsiewicz says.

Other Inflammation Fighters

Alongside a fiber-rich diet, keep these strategies in your inflammation-fighting toolbox.

Eat fermented foods

In a 2021 randomized controlled trial out of Stanford University, people who added fermented foods to their daily diet increased microbiota diversity and decreased inflammatory markers.

Exercise

Even when it doesn’t lead to weight loss, regular exercise increases the diversity of the microbiome, decreases inflammatory visceral fat, and reduces inflammatory cytokines.

Manage stress

Chronic stress leads to chronic low-level inflammation. Keep stress in check by getting enough sleep, nurturing social connections, and incorporating practices such as meditation and yoga.

To learn more about a whole-food, plant-based diet, visit our Plant-Based Primer. For meal-planning support, check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path.

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A joint undertaking between researchers at the University of Bologna in Italy and the Stanford University School of Medicine, the comprehensive review, published last week in PLOS One, looked at meta-analyses from 2000 to 2023 to evaluate the impact of vegetarian and vegan diets on the risk of cancer and cardiometabolic diseases. After pooling data from 48 meta-analyses involving hundreds of thousands of participants across a range of demographics (including children), the researchers noted some overarching trends: Vegetarians and vegans were significantly less likely to develop cardiovascular disease and cancer. They also tended to have better cardiometabolic health overall, with less inflammation, lower blood pressure, lower cholesterol, and leaner BMIs than people who ate meat.

“Overall, vegetarian and vegan diets are significantly associated with better lipid profile, glycemic control, body weight/BMI, inflammation, and lower risk of ischemic heart disease and cancer,” the authors wrote.

Plant-based diets appeared especially beneficial for preventing prostate and gastrointestinal cancers. Among omnivores, those who ate a lot of red processed meats saw a higher risk of gastrointestinal cancers. “Our umbrella review seems consistent with other primary evidence that links the consumption of red processed meats to an increased risk of cancers of the gastrointestinal tract,” the authors noted.

What Makes This Review so Significant?

While a number of studies have linked plant-based diets with improved health outcomes, the new PLOS One report is particularly compelling because it’s an umbrella review. Primary research, such as observational studies and randomized clinical trials, gather essential data. Meta-analyses synthesize previously published studies to identify meaningful associations. Umbrella reviews go a step further, synthesizing meta-analyses to offer a comprehensive summary of available evidence.

The authors acknowledge the review’s limitations, such as potential confounding variables within the observational studies. “It should be remarked that, in the majority of the cases, people adopting plant-based diets are more prone to engage in healthy lifestyles that include regular physical activity, reduction/avoidance of sugar-sweetened beverages, alcohol and tobacco,” they noted.

Still, based on their findings, they conclude that plant-based diets are “one of the effective preventive strategies for the two most impactful chronic diseases on human health in the 21st century.”

To learn more about a whole-food, plant-based diet, visit our Plant-Based Primer. For meal-planning support, check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path.

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For the comprehensive review, published in the British medical journal BMJ, researchers pooled data from 14 studies, which encompassed 9,888,373 participants in all, to look at connections between ultra-processed foods (UPFs) and different health outcomes, including Type 2 diabetes, anxiety, cancer, and early death. For their definition of ultra-processed foods, the researchers referred to the NOVA system, which classifies foods according to their level of processing. They included only studies published within the last three years, and excluded any studies that received funding from manufacturers of UPFs.

Upon completing their analyses, they found that consumption of highly processed foods was linked to a higher risk of 32 of the 45 adverse health outcomes under investigation. The researchers noted that the most convincing evidence involved mental health and cardiometabolic health: Participants who ate more highly processed foods were 53% more likely to suffer from anxiety and/or depression and 50% more likely to die of cardiovascular disease. They were also 12% more likely to have Type 2 diabetes.

Harmful to All of the Body’s Systems

In an editorial appearing in the same issue of BMJ, Carlos A. Monteiro, who developed the NOVA food classification system used in this and numerous other nutrition studies, commented on the findings: “Overall, the authors found that diets high in ultra-processed food may be harmful to most—perhaps all—body systems.”

Also known as highly processed foods, UPFs make up more than 50% of daily calories consumed in the U.S. Common examples include sweetened breakfast cereals, salty snack foods, soda, and store-bought pastries. UPFs have come under increased scrutiny in recent years, with other studies linking diets high in these foods to dementia and inflammatory bowel disease, among other issues. Made primarily with synthesized and extracted ingredients, UPFs tend to be high in calories, sugar, salt, and fat and low in fiber and other nutrients.

To learn more about a whole-food, plant-based diet, visit our Plant-Based Primer. For meal-planning support, check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path.

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In a study published last week in ERJ Open Research, researchers analyzed data from more than 14,000 people to evaluate whether the amount of plant-based foods versus animal-based foods in one’s diet could influence the risk of developing obstructive sleep apnea (OSA), a disorder in which the upper airway becomes partially or completely blocked during sleep. Left untreated, OSA can cause chronic sleep deprivation and raise the risk of heart disease, irregular heart rhythms, Type 2 diabetes, and other conditions.

For the study, researchers used data from the National Health and Nutrition Survey (NHANES), a long-term project that collects diet and health information from participants on an ongoing basis.

The researchers scored each participant’s diet based on their reported intake of “healthy” plant-based foods, “unhealthy” plant-based foods, and animal-based foods. To isolate the impact of diet quality, the analysis adjusted for factors such as age, calorie intake, tobacco and alcohol use, and the presence of cardiovascular disease, cancer, and diabetes.

The Findings

The study found that participants who ate more “healthy” plant-based foods and more plant-based foods in general were 17% and 19% less likely to develop sleep apnea, respectively, compared with participants who ate fewer of these foods. The biggest difference was seen among male participants: Men whose diets were the most plant-based were 29% less likely to develop sleep apnea than those who ate the least plant-based.

While plant-based diets overall were associated with decreased sleep-apnea risks, participants who reported eating the highest amounts of unhealthy plant-based foods saw a 22% increase in risk.

In considering what might explain these trends, the study authors point out that low-fat, high-fiber plant-based diets have been linked to lower rates of obesity and inflammation. Excess body weight can increase pressure on upper airways, and obesity is a prime risk factor for obstructive sleep apnea. It’s estimated that 70% of people diagnosed with the condition are obese, and that 40% of obese people have sleep apnea.

Asked why the “healthy” plant-based diet appeared to confer slightly less benefit than the general plant-based diet, study author Yohannes Adama Melaku, Ph.D., said the modest difference might be attributed to several factors. “It’s possible that the broader variety of foods in a general [plant-based diet] offers a wider range of nutrients and phytochemicals, which may contribute to this effect,” said Melaku. “Additionally, the way ‘healthy’ is defined in the hDPI [healthy plant-based diet index] might exclude certain plant foods that have beneficial properties for reducing sleep apnea risk.” (Notably, all of the plant-based foods deemed “unhealthy” were ultraprocessed foods except for one: potatoes. Because of their starch content, the hPDI lumps potatoes in with refined grains—but recent research is challenging that designation.)

Plant-Based Diets for Sleep Apnea: Mounting Evidence

The study adds to a growing body of evidence that a healthy plant-based diet may not only reduce the risk of developing sleep apnea but also help relieve symptoms in those who already have the disorder.

In a small interventional study published last year, 14 patients with OSA switched from a standard American diet to a whole-food, plant-based diet for three weeks; at the end of the study, participants reported reductions in sleepiness that were comparable to those seen with the use of stimulant medications commonly prescribed for OSA. The study authors speculated that this may be because WFPB diets are very low in saturated fat, which is abundant in the standard American diet and has been associated with daytime sleepiness.

A 2021 study of more than 9,000 participants found that people who reported eating fruit at least once a day were 26% less likely to suffer from OSA than those who reported eating fruit just three times a week or less. This was after adjusting for body mass index and other confounding variables. A review published earlier this month looked at available research on plant-rich diets and sleep and concluded that “plant-rich diets, characterized by their high fiber content, melatonin precursors, isoflavones and positive effects on the gut microbiome, hold promise in improving sleep quality and addressing sleep-related disorders, including OSA and obesity-associated sleep disturbances.”

It’s estimated that 30 million Americans have OSA, but only 6 million have been officially diagnosed. People suffering from OSA typically wake up multiple times every hour throughout the night, but they’re roused so briefly that they often have no recollection of it later on. Snoring and daytime sleepiness are hallmarks of the disorder, though some people will experience no noticeable symptoms. OSA is most often diagnosed through polysomnography (sleep study).

To learn more about a whole-food, plant-based diet, visit our Plant-Based Primer. For meal-planning support, check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path.

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The meta-analysis, led by Germany-based diabetes researchers and published in the November 2023 issue of BMC Medicine, analyzed data from 37 studies that included, collectively, more than 500,000 participants over an average of 19 years. The goal was to identify links between diet and cardiometabolic health outcomes.

After adjusting for calorie intake, alcohol use, smoking, and other factors, the researchers found that replacing one daily portion of processed meat with whole grains correlated with a 36% lower risk of cardiovascular disease. Swapping in nuts for the processed meat was associated with a 27% reduction in CVD risk, while legumes were associated with a 23% reduction.

While the biggest gains were seen when swapping out processed meat, the researchers found that eating whole plant foods in lieu of red meat, dairy, and eggs also appeared to confer benefits. For instance, replacing a single serving of eggs with whole grains was associated with a 21% reduction in Type 2 diabetes risk. Replacing that same serving of eggs with nuts, meanwhile, translated to a 17% reduction in CVD, an 18% reduction in Type 2 diabetes, and a 15% reduction in all-cause mortality.

“Our findings suggest that a shift in diet from a high consumption of animal-based foods, especially red and processed meat, to plant-based foods (e.g., nuts, legumes, and whole grains) is associated with a lower risk of all-cause mortality, CVD, and T2D,” the authors concluded.

Every Portion Counts

The analysis adds to the growing body of evidence that even relatively modest shifts toward a healthy plant-based diet can pay dividends. A 2020 study found that eating just one additional daily serving of fruits and vegetables was associated with a 25% lower risk of Type 2 diabetes. Two 2021 studies found dose-response relationships between healthy plant-based dietary patterns and a reduction in CVD risk. Other studies have found the inverse to be true, as well, linking added servings of red and processed meat with incremental upticks in CVD and T2D risk.

To learn more about a whole-food, plant-based diet, visit our Plant-Based Primer. For meal-planning support, check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path.

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What Is CKM Syndrome?

CKM syndrome is a systemic disorder characterized by reduced function in the kidneys, metabolism, and heart. By defining the syndrome, the AHA aims to highlight the interconnected nature of obesity, insulin resistance, chronic kidney disease, and cardiovascular disease; increase prevention; and encourage health care providers across different specialties to work together and embrace more holistic patient care approaches.

Two primary components of CKM are metabolic syndrome and chronic kidney disease. Characterized by abdominal obesity, high blood sugar, and hypertension, metabolic syndrome can lead to heart and blood vessel problems, making the development of cardiovascular disease subtypes such as coronary heart disease, cerebrovascular disease, peripheral artery disease, cardiac arrhythmias, and heart failure more likely. It can even lead to Type 2 diabetes, increasing the risk of developing kidney and vascular diseases.

Chronic kidney disease also raises the likelihood of heart and blood vessel problems. In fact, cardiovascular disease is the most common cause of death among chronic kidney disease patients. According to AHA’s advisory, just 10% of those with chronic kidney disease survive long enough to reach kidney failure. The authors noted that chronic kidney disease is a proinflammatory condition that, in addition to contributing to heart and blood vessel problems, can lead to complications like anemia and bone mineral metabolism issues that exacerbate cardiovascular disease. Meanwhile, heart problems, particularly heart failure, can contribute to chronic kidney disease. And issues with blood vessels, such as atherosclerosis, can affect kidney blood vessels, leading to resistant hypertension and kidney failure.

The Stages of CKM Syndrome

Recognizing that early detection represents an opportunity for intervention, the authors outlined the following five stages of CKM syndrome.

• Stage 0: In Stage 0 of CKM, a person is not overweight or obese and does not have chronic kidney disease, cardiovascular disease, metabolic risk factors, or impaired glucose tolerance. This stage is most common among young children, adolescents, and young adults. AHA recommends that school programs encourage healthy eating and physical activity to help reduce weight gain and improve heart health. For young adults, avoiding weight gain can reduce the likelihood of developing CKM syndrome risk factors, including metabolic syndrome and prediabetes or diabetes.
• Stage 1: Individuals are overweight or suffer from obesity, abdominal obesity, and/or dysfunctional adipose tissue without the presence of other metabolic risk factors or chronic kidney disease. They may also have impaired glucose tolerance or prediabetes.
• Stage 2: Conditions include hypertension, Type 2 diabetes, metabolic syndrome, and/or chronic kidney disease.
• Stage 3: This stage focuses on individuals who show signs of subclinical atherosclerotic cardiovascular disease (encompassing such conditions as coronary artery disease, peripheral artery disease, carotid artery disease, and aortic disease) or heart failure along with CKM syndrome risk factors or chronic kidney disease.
• Stage 4: This stage includes patients with clinical cardiovascular disease with excess body fat and other metabolic risk factors and/or chronic kidney disease. It is divided into two subgroups: 4a for those without kidney failure and 4b for those with kidney failure. Individuals may have previously suffered a stroke, heart attack, or heart failure.

“The main takeaway from my perspective is the fact that there really is no prevention; there’s only intervention,” says Columbus Batiste, MD, FACC, FSCAI, co-founder of Healthy Heart Nation. “Everyone is at risk for disease. The way [the AHA] characterized it was not ‘healthy and normal,’ and then stage one. [Instead] they say, ‘CKM Stage 0.’ I think that sets the tone.”

Still, Batiste says, “I would love for them to go a little bit more in-depth with a lot of the strong data we know about the benefits of a whole-food, plant-based diet.”

For example, a 2021 meta-analysis of nearly 100 studies found that diets focused on plant-based foods that limit consumption of refined cereals and starches are associated with a lower cardiovascular risk than diets that include mostly animal foods. Additionally, increasing your alkali intake by eating a diet rich in fruits and vegetables may help reduce urinary markers of kidney damage in stage 2 chronic kidney disease patients.

But diet is just one part of the equation: Batiste also emphasizes the critical role exercise plays in helping individuals reduce excess belly fat. The Centers for Disease Control and Prevention recommend adults aim for at least 150 minutes of exercise per week, or 30 minutes a day for five days a week.

“I always like to tell patients that it’s about lifestyle exercise,” Batiste says. “That means gardening, that means sweeping, it means vacuuming, it means climbing stairs. … Simple things actually add up to an awful lot, so a person doesn’t have to engage in hour-long brutal workouts to still glean the benefit of just basic, simple walking.”

To learn more about a whole-food, plant-based diet, visit our Plant-Based Primer. For meal-planning support, check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path.

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