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Make Sure Your Vegetarian Diet Is High Quality

Research suggests that people who follow a high-quality vegetarian diet live longer with fewer complications.

A vegetarian diet can be beneficial, but the quality of the diet matters. A meta-analysis of 25 randomized controlled trials covering more than 3.5 million participants found that there can be a big difference in outcomes depending on diet quality (Food & Function, May 19, 2025).

How a Plant-Based Diet Affects Your Health:

In this meta-analysis, the investigators compared healthy versions of vegetarian diets, rich in whole grains, legumes, vegetables, nuts and fruit, to unhealthy versions, stuffed with fried plant foods, sweets and refined grains. Healthy eaters were 19 percent less likely to develop any kind of cardiovascular disease and 21 percent less likely to develop coronary heart disease. they also had a 25 percent lower risk for cognitive dysfunction. People on the unhealthy diets, on the other hand, had higher risks for cardiovascular disease and cognitive dysfunction. You can read more about this study in Examine.com, which scans and summarizes health research.

The scientists concluded:

“Our study suggests that adherence to hPDI is associated with favourable health outcomes in middle-aged and elderly people, except for hemorrhagic stroke.”

So far as we could tell, the risk for hemorrhagic stroke was not affected by diet in this analysis. Keep reading for previous research on this topic.

Do Vegetarians Live Longer?

Researchers who want to know more about the value of vegetarianism often study groups that avoid eating meat, such as Seventh Day Adventists. Many Seventh-Day Adventists are vegetarian, but not all.

Scientists studying 88,400 Seventh-Day Adventists have found that those following a vegetarian diet were less likely to die during the eight or so years of follow-up (American Journal of Clinical Nutrition, Oct. 2024). Specifically, vegetarians were partially protected from kidney failure, infections, diabetes, and some forms of heart disease.

On the other hand, avoiding all animal protein was not universally beneficial. Older vegetarians were more susceptible to stroke and dementia.

What About Diet Quality?

Even vegetarians need to pay attention to the quality of the food they eat. Harvard researchers who have tracked the dietary habits and health of more than 125,000 men and women for decades found that those who followed high-quality plant-based diets controlled their weight better. Such diets are rich in vegetables, fruits, nuts, seed and whole grains.

Conversely, those whose diets contained more fries, refined grains and sweetened beverages and snacks were significantly more likely to gain weight. The scientists presented their data at the Society for Nutrition annual meeting, Nutrition 2018, Boston, June 10, 2018.

Following a Vegetarian Diet for Better Health:

Another study of South Asians living in the US found that those following a vegetarian diet had fewer risk factors for diabetes and heart disease (Society for Nutrition annual meeting, Nutrition 2018, Boston, June 10, 2018). Although the vegetarians consumed more carbohydrates, they had lower body mass index and smaller waist circumferences. They also had lower fasting glucose and LDL cholesterol levels, suggesting healthier metabolism.

More Data on Quality Vegetarian Diets:

Additional studies from Brazil and the Netherlands found that people relying on plant protein more than animal protein had lower risks of cardiovascular disease (Society for Nutrition annual meeting, Nutrition 2018, Boston, June 10, 2018). Here again, though, the best diets contain minimally processed foods. Those food choices tend to be richer in fiber, minerals and vitamins than highly processed foods.

When recommending changes in dietary patterns, nutrition experts do better if they pay attention to cultural preferences. One year-long study in South Carolina found that African-American volunteers consumed a higher quality diet if it contained vegan soul food (Nutrition Research, Aug. 2024).

Learn More:

If you would like to learn more about where to get protein in a vegetarian diet, you may wish to listen to our interview with Dr. Christopher Gardner. It is Show 1126: Can You Find Your Best Diet? Another interview that might interest you is Show 1051: How Can Vegetarians Get All the Nutrients They Need?

Citations
  • Zhang S et al, "Associations between plant-based diets and cardiovascular disease, frailty, and cognitive dysfunction in middle and old age: a systematic review and meta-analysis of cohort studies." Food & Function, May 19, 2025. DOI: 10.1039/d4fo03384a
  • Abris GP et al, "Cause-specific and all-cause mortalities in vegetarian compared with those in nonvegetarian participants from the Adventist Health Study-2 cohort." American Journal of Clinical Nutrition, Oct. 2024. DOI: 10.1016/j.ajcnut.2024.07.028
  • Hu EA et al, "Adherence to a culturally adapted soul food vegan diet among African American adults increases diet quality compared to an omnivorous diet in the NEW Soul Study." Nutrition Research, Aug. 2024. DOI: 10.1016/j.nutres.2024.01.010
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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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