ZOE Science & Nutrition - Is plant-based meat healthy? What the research shows with Prof. Christopher Gardner

Episode Date: June 6, 2024

Meat consumption continues to be high in both the US and the UK. Yet many governments advise reducing meat consumption, particularly red meat, due to both environmental and health concerns.  In this episode, we delve into the sizzling world of meat alternatives. They promise sustainability, animal welfare, and better health. Buzzwords like "plant-based" and "meat-free" proudly adorn their packaging. But are they actually healthy? Or should we consider them as ultra-processed foods and avoid them? Christopher Gardner is a Professor of Medicine at Stanford University and the Director of the Stanford Prevention Research Centre, and a world-leading expert in how the food that we eat impacts our health.  🌱 Try our new plant based wholefood supplement - Daily 30 *Naturally high in copper which contributes to normal energy yielding metabolism and the normal function of the immune system Learn how your body responds to food 👉 zoe.com/podcast for 10% off Follow ZOE on Instagram. Timecodes: 00:00 Introduction 01:25 Quickfire questions 03:50 What is a meat alternative? 05:22 What's driving the trend for more alternatives? 07:47 Should you eat less red meat? 08:38 What is in meat alternatives? 10:22 Traditional meats vs meat alternatives 13:41 Are meat alternatives ultra-processed? 14:47 Latest scientific studies 23:56 What were the findings? 29:48 Is the quality of the protein as good as real meat? 34:00 Are meat alternatives healthy? 38:53 Are whole food based meat alternatives healthier? 40:05 What are the practical tips around meat alternatives? 43:21 How do ultra-processed foods come into this? 45:23 What are other ways people can transition away from red meat? 50:33 What are the differences between bad and good quality meat? 📚 Books from our ZOE Scientists: Every Body Should Know This by Dr Federica Amati Food For Life by Prof. Tim Spector Fibre Fuelled by Dr Will Bulsiewicz Studies referenced in today’s episode:  Study With Appetizing Plantfood—Meat Eating Alternative Trial (SWAP-MEAT), published in American Journal of Clinical Nutrition. SWAP-MEAT Athlete (study with appetizing plant-food, meat eating alternatives trial) a randomized crossover trial, published in Nutrition Journal. Have feedback or a topic you'd like us to cover? Let us know here. Episode transcripts are available here.

Welcome to ZOE, Science and Nutrition, where world-leading scientists explain how their research can improve your health. Today, we delve into the sizzling world of meat alternatives. And the question on everyone's plate, are they better or worse for your health than their animal-based counterparts? In grocery stores and restaurants across the globe, meat alternatives are becoming increasingly popular. Buzzwords like plant-based and meat-free proudly adorn their packaging. And promises of sustainability, animal welfare and better health cause many of us to now make the switch.

But beyond these promotions, where does the real truth lie? I'm thrilled to have Professor Christopher Gardner back on the show today. Christopher is a professor of medicine at Stanford University and the director of the Stanford Prevention Research Center. He's a world leader in understanding how these meat alternatives really impact our health. As the debate between traditional meats, meat alternatives, and whole plant foods heats up, prepare for some surprising revelations in today's episode. Christopher, thank you for joining me today. It's a pleasure to be here. Fun topic.

Well, I know that we've basically got the world expert on actually running tests on meat alternatives today, so I am excited. And to start with, as always, we have our quickfire round of questions. You know the drill. Yes or no, or if you have to, a one-sentence answer. Go. Have you changed your mind about meat alternatives? No. Should most people be eating less meat to improve their health? Yes.

Are most meat alternatives ultra-processed? No. Is the quality of the protein in meat alternatives as good as the protein in meat? Yes. Okay, and you can have a whole sentence here. What's the most surprising thing you've come across while studying the impact of meat alternatives on people's health? The amount of media hype, misinformation, disinformation,

polarized views one way or the other. So everybody sort of disagrees on this, do they? Yes. And are we going to get to the answer today? Oh, the answer is coming. Well, look, Christopher, it's always a pleasure to have you back on the show with us. I know that our listeners always tell us how much they love hearing you talk about something, particularly when it's one of the things you've actually been doing your own randomized control trials on.

And I think today's episode promises to be another big hit because this is one of the topics that we have had one of the most questions from our listeners about. Interesting. And I think that's because if they're listening to these podcasts, they're hearing a lot of people say, you know what, you should be eating less meat than, you know, the amounts that you were growing up with. Can we just start actually with what is a meat alternative?

Yeah. So you could say tofu and tempeh are meat alternatives. Right. And that's not what we're talking about today. You could say our Boca burger and Gardein burger, like there are some old plant-based burger substitutes that go back 30, 40 years that aren't very controversial. This didn't come up then. Why is it coming up now? And those are things I would call as like a bean burger or something like that. Textured vegetable protein, which is extracted from soy. I think this

will help make the distinction. I believe those older products were made for the market of vegetarians who were seeking something like a burger and didn't have an option for themselves, and someone created one. I think the meat alternatives that we're talking about today are meant for meat eaters. They were designed to be as close to meat as possible so that instead of being a source for vegetarians would be a hook to get someone to eat less meat and have a plant based alternative. So it's a sort of one for one swap for what you were eating for something and with something that's going to hopefully taste. I've actually seen these ads around, you know, you really liked your pork sausages. Here's this plant version that's going to taste just the same and it looks the same, but it's healthier for you. Yes. And so there's clearly been a surge of interest in these meat alternatives.

And I understand that there's a lot more being sold as well. What's driving this trend? The reason is because we're not seeing as much of a drop in meat consumption as is needed. So we need more alternatives, different alternatives to those than we already had. I think I saw that in the U.S., the amount of beef that's being eaten is sort of at an all-time high. So that has not seen a big decline, for example. To be honest, there has been a decline in red meat over the last 30 or 40 years. But if you look at any kind of FAO, Food and Agricultural Organization, graphic of meat consumption across countries in the world, U.S. is number one, highest consumer.

And I know that it's also very high in the U.K. and Canada and Australia. So it's a similar sort of situation, but I agree with the States, particularly high on this. Amazing how high it is. Yes. remember like you know you know many years ago you know you're in you're in new york and i remember people telling me to me you know like part of the american dream was that you know their parents or grandparents were were really poor and they were coming from italy or ireland or wherever it was and you could hardly ever get meat because you couldn't afford it and part of this dream was you were going to be able to get red meat every day. This was this amazing luxury and this great thing to be able to get by coming to America.

And I'd like to add that if China and India start eating as much red meat as we do in the US from a global perspective, we are screwed environmentally, right? And so this aspiration of GDP going up, what happens? People eat more meat. The U.S. should cut back. Oh, we're not the biggest total contributor to this. There's these other countries. Well, China and India are so big. If they emulate this, we are screwed. So we need to eat less. And we don't have to give it all up. Can't be number one here. So coming back to what you said about why the surge in interest, you're basically saying, look, people aren't US are vegetarians. So 95% are eating meat and they need to eat less. And we're not moving the needle very much. And for people who aren't really familiar with this, what's the view today in 2024 about why you should reduce red meat? Because I

think this is still something that many people find controversial. Yeah. So it's a good source of protein, but we really do not have a protein deficiency issue, even among vegetarians and vegans. Red meat has high saturated fat that raises LDL cholesterol. That's one of the number one risk factors for heart disease, which is one of the number one causes of death in the U.S. Red meat has no fiber. We really are deficient in fiber in the diet. We meet about half of the U.S. dietary guidelines for that. It's critical for a healthy microbiome, and red meat doesn't contribute to that. So less red meat, replace it with more plants. So help us understand what these new meat alternatives are, like what's in them. So the two ones that I'm most familiar with are Beyond

and Impossible. I know there's many others. The idea is taking some kind of bean, Beyond uses pea and Impossible uses soy. And instead of making a soy burger or a bean burger, extracting the protein. And I don't know the exact process. I think sometimes it's called an extrusion. They're taking the proteins and through heat and pressure, they're unfolding and refolding them away in some ways, like food engineers are doing this, so that when you bite into it, it feels muscly and sinewy, like sinews of muscles. So it replicates the feel of this. So one is that mouth taste. Interestingly, I was years ago present at one of the design kitchens for these,

and they said, you're welcome to have a tasting here. And they were all huddled around the grill. And I said, I'm just over here at the table waiting to taste it. What are you guys all huddled around the grill for? I said, we're watching and we're smelling and we want to hear it when it hits the griddle. And we want to see the color when it's flipped. And we want to smell the aromatics coming off while it's cooking. And they were trying to replicate every aspect of the process. I said, aren't you just worried about the taste? No, no, no. Our goal is actually to make the entire experience

as close to a beef burger experience as we can. That's really interesting. I was stunned, actually, at taking all those different aspects into account. That's really interesting. stack up against your traditional meat? Well, you'd have to do a trial, but I'm going to back up and tell you why I did a trial. So picture this. I'm at home and three different times, I saw a full page ad in the New York Times, full page with pictures of two products and a list of ingredients by the Consumer Freedom Choice Group, something like that, as like who paid for this advertisement, which as I understand it, I believe is funded by the Cattlemen's Association or something like that,

but it's some more ambiguous, benign name. And basically the message in each one said, this is like dog food. Why would you eat this? It's like a full page ad to compare these new things to dog food really and and so they were saying they were looking at these uh these alternative meats and saying like there's all this stuff this is basically dog food and it has coconut fat which is saturated so it will raise your ldl cholesterol it has high sodium so it will raise your LDL cholesterol. It has high sodium, so it will raise your blood pressure. And it's ultra-processed, so you will gain weight eating these. And I'm sorry, but a light bulb went off over my head, and I said, that is my superpower. I design randomized trials to answer questions. This is an answerable question. Like Like I can't always tell you who lives or dies. That takes a long time to figure out. But if you're going to make claims about

blood chemistry and weight, oh my God, that's what I do for a living. This would be such an easy trial to do. And so we designed a trial so that we could compare or we could test the effect of this. But the important thing is against what? So we compared it against red meat. Just before we go into this, because I absolutely want to go to this. It's so cool that you've done this full study. I just want to spend a minute on why anyone would think that these meat alternatives wouldn't be much better. Because you might say, I mean, they're coming from plants.

And, you know, we know that there's all this evidence that plants are healthier than red meat. If you were saying like, here's a bunch of beans, you wouldn't have done a study, would you? Because you'd be like, well, I don't need to do a study. There are so many studies done. I know that if you were to eat a plate full of like a variety of beans versus the red meat, you're going to be healthier in a few months. It won't taste like meat. So those meat eaters might not want to make the change, but you'd know it was healthier. So what is it that made you think, hmm, it's not so obvious whether or not these meat alternatives are a great thing for you to switch to? Saturated fat, sodium, and processing. Those are the three factors. And talk for a minute,

because we've talked a little bit about ultra-processed in some of our other episodes. And I think that some people listening, their ears will have perked up when you said, like, they take these peas and they extract the proteins and they reshape it. That sounds like this idea of ultra-processed food. And if Tim was here, he'd be like, you know, I really don't like that.

I feel it has all of these things. Why are people worrying? Why does that sort of trigger for people some concern about that aspect? Well, you have the recent book in the UK about ultra-processed food. So Kevin Hall, a great scientist in the US, did this wonderful study with about 20 people, two weeks each for a four-week study, where they did both an ultra-processed arm and a minimally processed arm. It's very clever.

It would take too much time to go into the details. But they were comparing themselves to themselves over this time. And after eating two weeks of each, they gained weight when they were eating the ultra-processed foods and lost weight when they're eating the minimally processed foods. And so that was the evidence for a weight issue that would come up. And we already know about saturated fat and sodium. So it was all plausible that these things could have been bad for you. So you decided, you know what, we should do a proper study. Tell us about the study. Well, because my question is always instead of what? So actually, I want to jump to the

punchline at the end, which is we did this study and we published the results and they said, oh my God, you have some positive results here. Do you mean you want people to eat these instead of lentils and beans? I said, that's not the question. They got made to replace red meat. So the question is, are they better than red meat for these things? So we designed a study that would compare the plant-based meats to these red meats and wrestled with a number of decisions. So by the time we get to the end, I want to make sure all the listeners agree or appreciate this is only one study. It's only one type of people. They're generally healthy people. Part of the struggle at first is you only get to pick one dose. So Jonathan, what dose would you pick? If you were trying to compare this, let's talk about duration and dose,

would this be once a week? That probably wouldn't be enough to move the needle. Once a day, would that be enough to move the needle? How about all you get to eat is plant-based meat or red meat all day long, every day. That's too much. Where in the middle would you pick? Do you have any idea? I'm thinking twice a day. Yeah, we did two servings a day. I was thinking about our interview with Walter Willard. He said he grew up eating meat breakfast, lunch, and dinner. So I was thinking that's maybe a little less than that, but you would like to have it quite often. And so now, sorry, I'm going to put you on the spot again.

Guess what proportion of calories that might be. If you had two servings of the meat, not counting the buns that went on the burgers or anything like that, just the meat, have any idea what proportion of calories that would be? I actually have no idea. 10 or 14, it's 25% of calories. Okay, so quite a lot of your calories. But not the majority. Yeah. So 75% of what you're eating is what you normally eat. So in my mind, this is always, it's funny, I don't think people appreciate how much

we struggle with that decision, because once you make it, you're stuck with it. So if it was too low, you might not find anything because it wasn't enough to see a signal be generated. And if it was too high, people would say, that's insane, no one could ever eat that much. What a stupid study. So you have to balance it that way. And of course, it would be really nice to know who lived or died.

So what would be the duration of this study? Let's see, how long could I get people to eat this? Well, our primary outcome in this study was listed on ct.gov. That's clinicaltrials.gov. When you have one of these studies, you have to pre-register it to say what you're looking at. We want to look at trimethylamine oxide, which let's talk about that later. But for now, TMAO, that was the primary outcome, but also weight and blood pressure and cholesterol, because that's what a lot of the claims in the newspaper ads were highlighting as being problematic. So we're collecting blood and, ooh, we even collected poop to be looking at that.

And so we decided, ah, well, if we're looking at TMAO and cholesterol and blood pressure, it doesn't need to be that long. Let's make it eight weeks each. Let's make it a crossover study. So everyone is their own control. So we weren't really expecting these to lead to any weight change. And just to explain that for everybody, because I think it means that everyone actually did both. So you could see for each individual what happened when they're on the normal meat and what happened to them on this like meat alternative. So you really could compare for each of them the difference, which is, I think, it's a sort of gold standard, isn't it, for these sorts of things. And then we describe what type of study. We say it's a randomized controlled trial.

But if they're doing both, why is it randomized? They're randomized to order. So some people do red meat first and some people do the beyond meat first, but they all do both. And so you get to see how that works. For eight weeks, that was plenty of time to figure out what this was. And so that was, we'll just stop there. The design is crossover study in 40 people, four, eight weeks with two servings a day. Hi, I want to take a quick break here and tell you about something new we've created, a free guide that will kickstart your journey to better gut health. Now, if you're a regular listener of this podcast, you're no doubt already aware of how important the gut microbiome is. It's responsible for so much, from digestion to immune support and even our mental well-being. As we've heard many times on this show, and as our members know through using Zoe, we feed our gut microbiome through the variety of foods that we eat. And in return, our microbes give us this wealth of health

benefits. So how can you nurture your gut in the best way? Which food swaps can you try to nourish those good bacteria? What does a high-fiber shopping list look like? Our free gut health guide shares it all. Emails and actionable tips that are designed to put you in control of your gut health. To get yours for free, simply go to zoe.com slash gut guide. And I think one thing for our listeners to understand, which I think often surprises them is it's actually normal for these sorts of interventional studies to have really small

number of people because you get this ethical approval, which says like this, how many people do you need to have, right, in order to get results, because it wouldn't be ethical to like get more people to do this than you need. And actually, when you do these sorts of designs, which are very intensive, you don't actually need that many people to measure this result, because it's controlled over a short period of time. Especially if you're on control. So a big advantage of a crossover study is everybody has their own control. So you are the same height as yourself and the same weight and age as yourself. So that means even though it's a relatively small number of people because of this design, which is very hard to manage, not many people do these sorts of randomized control trials, it means that the results tell you something that really has some validity, which is a tease to, so what did you find out? No, we have to talk more. There's still another issue.

Okay, so what should I pick for red meat? And I should clarify that for the Beyond Meat products that we were using, it's not just burgers. So they make burger. They make a ground beef substitute. They make sausages. And at the ground beef substitute. They make sausages. And at the time they had a chicken option. And so we didn't want people to get bored. Humans like variety. So they got a mixture of those and we had to go get real meat. So by the way, we're buying these and then delivering the Beyond Meat products. And then we have to go get our red meat from somewhere. So do

we go to the least expensive place we can find? Or no, we go to a San Francisco delivery service that specializes in organic, regenerative farming, pasture-raised. We really tried to get good quality. I'm guessing from the way you said that, you went for this one, not sort of the off the back of the truck red meat. Yeah. So we didn't want to get criticized at the end by saying, oh, you compare it to lousy meat. So it's not really valid. No, we compared it head to head with good quality meat. And I think you said that there was a funding disclosure that you wanted to mention as we discuss this. Yeah, this is funded by Beyond Meat. So I am an industry shill. I'm not sure the NIH would have funded this for me, the National Institutes of Health in the US. They

tend to not be very good about funding nutrition studies. But I approached Ethan Brown from Beyond Meat. And I have to say, I was totally impressed in the very beginning. I said, you do know that this might not work. If you fund this, it might show that it's worse, or at least that it doesn't work. And he was pretty straightforward. He said, you know, if this raises cholesterol, or if this doesn't work, then I want to reformulate. I'm ready for the answer, whatever you got. Okay, so we get ready, and we do this. And I think it was actually 38 people signed up for this study study and 36 finished, both arms, so we have fabulous retention. They did eat more than two servings a day. They ate, on average, two and a half servings a day, equal, like totally equal between the two groups. So we have this

internal validity of the trial that they did what we wanted them to do. We have a whole table in the research paper of what they were getting. And this is an important first step to look at. So yes, Beyond Meat uses coconut fat that has saturated fat in it, the type that raises LDL cholesterol, but less than the animal meat. So yes, it has saturated fat, but it has less. They do have more sodium in their burgers and their ground beef, but it turned out the people getting real meat salted their real meat. Beyond Meat has some sausages that have a lot of sodium, and the red meat sources had a lot of sodium in their sausages. The sodium was virtually identical. Okay, the Beyond Meat products had fiber, and red meat has no fiber,

because it came from peas. The protein was virtually identical between the two. One was all plant protein, one was animal protein in the products, which turned out to be half of their protein for the day. So these two servings a day that we were providing, that's 25% of their calories, was half of the protein for the day for these. So I'm trying to point out, you know, if I looked ahead at the time at these, I would have said, well, the Beyond has less saturated fat and more fiber. That should lower LDL cholesterol. Why are the newspapers

saying this? That's why I'm testing it. And they have the same amount of sodium, so it shouldn't do anything there. And we're giving them the same number of calories. Their weight shouldn't change. All right. You're teasing me too much now. What happened? So the primary outcome, this trimethylamine oxide thing that I should explain, went down. And this is not a tough lift. So red meat has choline and carnitine in it, two molecules, that the microbiome converts to this thing called trimethylamine oxide, which is considered to be a heart disease risk factor

that has inflammatory immune problem functions to it. And so the TMAO was lower on the plant-based meat. And that wasn't a huge surprise at all. The LDL cholesterol dropped more than I thought it would have, like 10 milligrams per deciliter in the plant-based meat relative to the animal meat. The blood pressure was not different between the two groups. And actually, the most statistically significant finding was weight. The weight dropped by about a kilo or two pounds in the plant-based eaters, even though we didn't have a caloric difference from checking all their diets and what they were eating, they were roughly the same calorie levels when we provided them. So

I was not expecting the weight to change, and I can't explain why it did. But a funny thing is why it was statistically significant, given that it's not really a clinically relevant amount, it's just a couple pounds. The reason it was statistically significant is almost every single person was one or two pounds lower on the plant-based meat for eight weeks than the other one. So when you're trying to get statistical significance, a big factor in here is how variable was the response. So there was something positive that people were getting by switching out the red meat to this? Every single person was just a little bit lighter, which is completely contrary to what was found in the Kevin Hall study, the one that I mentioned earlier, when the ultra-processed raised it. But for that study that he did, all the food was ultra-processed or all the food was minimally processed.

This is just the burger part. This is just 25% of the calories and 75% are the things that they were normally eating. Let me clarify one point. We did say, so we only provided the red meat or the beyond meat. We didn't provide the buns for the burgers. So if you had been a participant, we would have said, so do you like whole wheat buns or white buns? We want you to have the whole wheat, but we realize you might

like white buns better. If you have white buns on one phase of this, you have to have white buns on the other. We want you to have an heirloom tomato on your burger from the farmer's market. But if you have a store-bought crappy tomato on one burger, you have to have it on the other burger. So what we ask everybody is that you have, other than these meat products, you keep everything else the same within reason. So everything else was the same, and we drew up all this nutritional data. And so it really shouldn't be a surprise. TMAO was lower.

LDL cholesterol was lower. Weight was a surprise. And not a surprise that blood pressure wasn't any different. So three wins for plant-based over red meat if we're talking about health. Three things they were getting slammed for in the press was, it's going to raise your cholesterol, raise your blood pressure, and you're going to be heavier. None of those were found in our study. So Christopher, what's your verdict? Does that mean that it is healthy to swap

from red meat to one of these? Yes, it is healthier. These are standard clinical measures that we have and it won. And so that's my job is to do these tests. So I think the follow-on, I have many different follow-on questions. I mean, one is you tested one particular brand of meat alternative, in part because it sounds like they were willing to fund your study. Yes. Would you expect them to be wildly different? And also this was, you know, as always, it's a few years ago now. Like, would you expect them to be wildly different?

Or do you feel that the sets of alternatives that are designed to sort of taste like meat actually are quite similar? Yeah, I mean, the rationale for this is that beans and peas and legumes have the best protein in the plant world. And so most of them making that kind of alternative are using some kind of beans. So again, Impossible uses soy and Beyond uses pea. They're more similar than different. I will say I did a garlic study at one point that didn't work and a farmer called me out. I used real garlic. And he said, by the way, I grow 99 varieties of garlic. Did you test them all? I said, no. I tested one, but I tested like the most popular one in the US. I said, I don't believe your results because you didn't test all 99. There probably are

dozens of plant-based burgers. If you really wanted to test them all, it would become unwieldy. You couldn't test them all. I always need grant money though. So if anybody wants me to test them all, I could keep going. But fundamentally, this seems like a good guide to thinking about the meat alternatives that you might find on your grocery store. Yeah. And hope the listeners appreciate that when you do this, you have to pick one dose, one duration, one type of person, one set of outcomes. And all you got to do is say, ah, but what about half as much? Well, I don't know that answer. I'd have to run that study. What about people

who had high cholesterol to begin with? Yeah, I didn't pick that either. Technically, that could be another answer, but I can only answer one sort of narrow question at a time. So this isn't the end-all be-all answer, but there were no studies like this before we did it. Now, I want to come back to the question that we asked at the beginning about the quality of the protein, because this came up a lot. One of the reasons I think that people eat red meat is they feel like they're getting this quality protein and they're worried about that. And you're saying that the protein here is sort of extracted from a particular bean. Is the quality of the protein in the meat alternative as good as the protein that you're getting from the real meat? Yeah.

So I would like to rely on a very popular Zoe podcast where I did my protein rant to show that. There is a whole podcast on that, I agree, if people want to get into it. But for this particular topic, because there we were talking about whole foods, and here you're talking about this ultra-processed thing that some scientists created in a lab. So I think it's a fair question. How does that compare with the protein you would get from a red meat? So the protein in beans and plants is more abundant and closer to the amino acid profile. So the amino acids are the building blocks of protein.

There's 20 of them. We all need all 20. Not just all 20, but we need them in specific proportions. And sort of a myth that's out there in the protein world is that plants are missing some of those, and they're not. All plants have all 20 amino acids. The critique that is fair is that some of the amino acids are not in ideal proportions, which means some of them would run out sooner than you need them to run out if you are only just barely meeting your daily requirement. But the truth is most Americans get much more protein than they need for the day. And so the exact distribution isn't quite as important.

So this was plenty of protein. They were getting plenty of protein to build muscle, to maintain muscle. It was easily adequate what they were getting from these burgers. And so, which means they're getting, you're saying it's not necessarily exactly the same profile of these sort of amino acids as in like a steak, say, but it gives you everything that you need. So you just really don't need to worry about it. The red meat is better, but only if you're at a low enough total protein that each proportion has to be perfect. If you're getting a much higher total protein than you need, the proportions don proportion has to be perfect. If you're getting a much higher total protein than you need, the proportions don't have to be perfect. And would there be

anybody there for who you might be worried about? So I think I've heard on other podcasts that, for example, as you get more elderly, your ability to absorb protein is worse, or there will be people thinking about, I don't know, I'm pregnant, or I'm doing lots and lots of exercise. I'm doing sports at a very serious level, where you would worry about the difference, therefore, between this red meat and these meat alternatives. Yeah, plausible. But for most people, they're getting more than enough, even athletes, even older people. At some level, that would kick in, but probably not for these people in the study and probably not for most of your listeners. Okay. So most people, even if they are like older, you don't think they should certainly worry about that. It's pretty good protein and it's a lot of protein in beans.

Got it. So then I think the other question I think that naturally we want to come on to is, you did this great study, you were comparing like the difference between meat and meat alternatives. If I had a choice between my meat alternative and moving to something else, like how good is that switch to the meat alternative? Yeah, well, I've been trying to get people to eat more beans and more plants for 30 years and don't really feel like I've made much of a dent. So for me, I'm not ever looking for one answer in nutrition. I'm looking for dozens. Because for different people, there are different priorities and motivations. I'm kind of hoping these plant-based meats will be a gateway drug to legumes.

Like, yes, I made that switch and now I'm going to try lentils. I was going to say, and what is a legume? Yeah, legumes is the overarching family name for beans, peas, lentils, chickpeas, pulses, like that whole family. And it sounds like you're saying those would be a lot healthier as a swap than these meat alternatives? They would have more fiber. They wouldn't be processed. Yes.

And just for a quick follow-up, we've published another study since then. Instead of looking at cardiovascular risk factors, we were looking at young athletes. Tell us about that. Who are always super conscious about their protein. They're like obsessed with protein. So we got runners and weightlifters, 12 each. And we had them do the same thing, except we added a third arm. And the third arm was going vegan.

Okay. So it was all beans and grains and things like that. That is a radical shift from eating red meat twice a day. And so we timed their runs. We made a composite score. We added together a bench press, a lateral pull down where you pull down from above. Christopher's doing great explanations visually, by the way, if you're only on audio. No, sorry, I didn't mean to.

Keep going, Christopher. You can't see me under the table, but now I'm doing my leg press. So sort of three standard measures that people who do resistance training work out. And we looked at a percent change in those. And the resistance trainers lifted just as much weight and the runners ran just as fast, but not faster on the plant-based meats. But I want to clarify who we picked for this. It's kind of funny.

For years, I've wanted to work with Stanford athletes, and the coaches will never let me touch their teams. Like, stay away. We compete. Don't mess with their diet. Okay. And they all seem to think their athletes need a ton of protein. The population we picked for this was recreational athletes.

And to join, you had to have been exercising regularly for two to five years. And I think the average was five years. Like they had always run and they had always lifted weights just for their health. Like these are people who go to the gym or run three times a week, which is more generalizable than elite athletes. So I'm not after the elite athlete here. I'm just after the folks who regularly work out and listen to the bro science on social media that says how much protein you need. And actually, we had some interesting preconceptions. The resistance trainers thought they would lose muscle and lift less. The runners actually thought they

might do better because a plant-based diet has more carbs. And I think they're more aware of their energy storage for their runs. Anyway, both of those outcomes for the 12 people, it's not a huge trial, but again, a crossover. Everybody did all three. So they're comparing their running time and their lifting capacity across the three arms. They were only four weeks each. That's another downside. Maybe something else would have happened if we had gone longer, but no difference. So we published the paper that not only was the plant-based alternative meat equal, but so was the vegan. And you're saying, hey, when you're bench pressing on beans, amazingly, instead of steak, you're still able to bench press just as much at the end of the month than with the steak. Am I understanding that right?

And in a table, you could see that sort of the plant-based alternative meat was in the middle for a lot of these things. So there was a little less protein than the animal meat, but more than the plant-based meat, which had the least protein. The vegan arm had the most carbohydrate. The animal meat had the least carbohydrate. And the plant-based meat alternatives was in the middle. For all kinds of measures, it would go in the direction you expect for carbohydrate,

fiber, saturated fat, cholesterol. And the protein was sort of the most fun. The vegans got less protein, they lifted just as much weight, and they ran just as fast because they were getting more than enough protein. Which is back to something that you've discussed with me on another podcast that we're basically being sold this idea that we're all sort of protein depleted. And I feel like everything in the grocery store now says like high protein or extra protein. And actually you're saying, even for these people who are working out a lot compared to most of us in the States or the UK or wherever, they were just fine moving from the red meat to the beans. Now, I guess what they

didn't answer was whether or not the beans were healthier, because here you were looking more about those sort of exercise things. You weren't looking back to sort of cardiovascular risk, you know, like heart disease or diabetes or things like that. And it would have been harder to see in the second study because these are young, fit athletes. So they don't really have high cholesterol or high blood sugar or high other things they were fit young people now i've heard tim talk about his excitement about more sort of mushroom based or fermented like almost bacterial style meat alternatives on the grounds that they're not ultra processed.

They're like a whole food that's just put together, probably tastes a little less perfectly like meat, which I guess is what you were testing, but don't have those concerns. If someone was thinking here and saying, you know, I am really interested in improving my health, which I think many of the listeners hear that that's where they're trying to get to. So they're open-minded to potentially changing, but they do want to still have that meat taste. What would your expectations be there with that? Would you expect them to be a more healthy alternative to these sorts of meat alternatives or not necessarily? Yeah, I think there's, yeah, that sounds more whole food based. If it's mushroom based,

it'll have a lot less protein. I'm not sure they need the protein, but for those who are obsessed with protein, these plant-based alternative meats do have a very similar amount of protein. Mushrooms, not so much. Hi, I want to take a really quick break with you. I hope you're enjoying today's episode with Christopher and rethinking your relationship with meat and meat alternatives. Now, making this show takes a lot of time. We think it's well worth it, all in the name of improving your health.

And what I ask in return is this. Please send a link to this podcast to someone you think would benefit. Thank you and enjoy the rest of the show. So I'd love to sort of switch in a way to like practical advice based on this. You know, I think it's brilliant to understand that this is real and it looks like, you know, for people who are eating, you know, quite a lot of meat in their diet today, which, you know, many of us are, there is definitely a place for these meat alternatives. So if someone was thinking about switching from meat to meat

alternatives, what should they look out for when they're buying these products? And are there any sort of red flags that would help you to think about it? Because I feel that there's more and more and more of these alternatives being advertised. Yeah. And right now, I'm actually chair of the American Heart Association's Nutrition Committee, and we're working on a statement about ultra-processed foods. And as we go through this and try to explain it and take a position on it, there's really two components to those foods. And one is the physical processing. So here's the bean. I like soybean as an example. Soybean is the whole bean. Tempeh is pretty much the whole bean that's been fermented and stuck together. Soy milk is processed. Tofu comes from the soy milk, so it's further processed.

And then you've got soy protein isolate that you add. So you've taken the protein away from the whole bean. You can't even recognize the bean anymore, right? And then you're sort of hitting the ultra-processed. So one is the physical processing. But in the ultra-processed world, a big part of this is ingredients. It is preservatives, stabilizers, colorants, emulsifiers. So I think what the consumer can do is look at this list of ingredients. So you'll find some of these plant-based meats have one or two of those additives or preservatives in it. But if they look, it's mostly just plain foods other than the pea protein or the soy protein that's extracted. I'm sure in other ones there's a long list.

So we added red dye number three, and we added this preservative, and we added that emulsifier, and we added this other thing. And so that's their challenge. So I would suggest they look to see the thing that has what Marion Nessel, who's a very well-known nutrition scientist in the US, she says, avoiding ultra-processed foods mean you should try to pick things where you could find the ingredients in the store to make it at home. And so it sounds like you're saying, I just wanted to play that back. Like one part is the processing. So the reality is that all

of those things have like this isolated pea protein, like you can't find that in your kitchen. So that one part is like, in all of these things, that is this sort of ultra processing you can't get otherwise. And the second thing is all the things you're adding on top of other things that you've never heard of.

And these are like, you know, when you talk about these additives and preservatives and emulsifiers that again, you wouldn't find in your kitchen. And I've heard some of our guests talk about some of the concerns about how this might interact with our microbiome. Yeah. Yeah, absolutely. For the world of ultra-processed food, to be honest, there's a huge overlap in salt-added sugar and saturated fat. Many of the addictive

ultra-processed foods have those. And a lot of people are questioning, do we really need this new categorization? Aren't these foods just high in the nutrients that we've been telling people to avoid? And the answer has been no. Part of it is the physical processing, and part of it is all the additives that go beyond salt, sugar, and saturated fat. So just to make sure I've got that, what you're saying, because I think this is still a live debate amongst nutritional scientists is my impression. Yes.

And so it's really interesting you're leading this new committee for, remind me what you said the name was? Yeah, it's the American Heart Association's Nutrition Committee. We write papers and make scientific advisories on- So that sounds pretty official. Pretty official. And so it sounds like you are actively addressing this question about what is ultra process. And you're saying it's not just, I guess what I grew up with as a kid saying junk food is food that's got like lots of fat in it and salt and sugar. It's this new realization that it's got these other things in it you can't find in your kitchen.

I hear Tim talk about it. It's like food-like object or something, I think he even calls it. It's not really necessarily food as we understood it. And it sounds like you're saying you're of the view that there's something real about that. There is, but multiple domains and some, I think what happens in the ultra-processed world at this point, using the NOVA criteria, as soon as it has one or two of these you fall into ultra processed but picture one that has 20 of those and one that has two i'm pretty sure the one that has 20 i'd be more concerned about so coming back to my initial question and i probably

got a bit overexcited and pulled us around you're saying like you're looking on the back of the pack and you'll see you might see one which basically just looks like things in your kitchen with maybe the addition of your pea protein that feels to you a lot better than one that has lots of different preservatives and emulsifiers. And that's sort of what you should be looking out for. And then you find one that has none and it's a lentil black bean burger and you bring it home and the meat eater in your family says, I'm not eating that. That doesn't look or taste like the burger that I wanted. Oh, I'll have this other one that looks and tastes like it. Oh, no way you fooled me. It's not. Well, I would love to talk a bit about the next

stage. You said, I love this idea that it might be the gateway drug to move you from eating meat. Let's say someone's listening and saying like, I've had some of that. And actually I'd like to go further on my transition away from meat, but actually there's things about meat that I did really like, you know, the taste in my mouth. You know, let's say that someone is saying I am more like open-minded to make changes, but I'm not quite ready to just have a salad for the rest of my life. What would you be advising? And I seem to remember at one point you might've opened a restaurant instead of becoming a nutritional scientist. So tell me, what are the other ways that you could maybe transition away from this red meat and maybe to somewhere even healthier? Yeah. Well, it is true. Mushrooms,

in this particular case, depend like cooking up a portobello mushroom can feel sort of meaty for that person. You can grill a portobello mushroom. Tempeh is great. So I put tempeh in a lot of my dishes. I think lots of people listening won't know what tempeh is. Could you explain? Yeah. So it's a fermented soybean product. Interesting how they wrap it up. It's wrapped very tightly in plastic and I can't find it in all the stores that I shop in. But when you open this up, it tends to be about six to eight inches in length, about a half an inch thick and about four inches wide. You can slice it like you would meat and it holds together in something that you put it in.

If you were to slice up tofu it's like that looks like a marshmallow why am i eating so what is tofu soy it's just soy before so tempeh is like this there's this tofu sort of fermented yeah but that's so the tofu doesn't look you can't see the bean so when you're cutting the tempeh you can see oh wow that's beans stuck together you can really see the whole bean, that's beans stuck together. You can really see the whole bean, whereas the tofu before it was tofu was milk. So they had boiled and mashed the soybeans to make the milk, and then they coagulated the milk and got the tofu. So tofu or tempeh or mushrooms, but really the whole bean family is probably the best place to go,

whether that's a soup or a hummus. It's filling. It's got a lot of fiber. It's got a lot of nutrients in it. It's low in saturated fat. And the fat that it does have is unsaturated, the good stuff. So lots of those. I mean, we also have plant-based milks. We have plant-based cheeses. I haven't tested those yet, but there really are a lot of really exciting products out there where I would always want you to have the whole food. I'm not recommending that. Oh, like I'm never going to say these are healthy unless you ask me compared to what. So just to make sure I've got that, you're sort of saying, hey, if you can go beyond the meat alternative that's sort of wrapped up to look like meat, there are interesting you jumped to something that most people won't have heard of, right? Tempeh, which is the non-ultra processed food. Therefore, sort of, you know, it's a non-ultra processed food variety that you could have. You also talked

about mushrooms and then sort of beans in general. You're saying, hey, look, if you were able to make the shift towards those being a bigger part of your diet, you're going to have a bigger impact on improving your health. Yes. I mean, partly that's because we have data. People have been eating beans and mushrooms for thousands of years. They've only been eating this new genre of plant-based meats for years. So we don't know who lives or dies here. So for now, all we can look at is clinical measures that change quickly, like blood values or those types of intermediate markers. We have the data on the beans and the other things and what it does to clinical markers and that people on a more plant-based diet live longer,

freer of heart disease and other chronic diseases. Yes. And part of that presumably is you're getting much more fiber and all these other complex chemicals in the plants that you weren't neither getting in the meat, but also these meat alternatives because of the way their process, they're not having some of this complexity in this sort of food for your microbiome and things like this. And just to add one other dimension, because I'm working on a book and I found this really fascinating publication of, okay, yes, the red meat only has red meat. That's

the only ingredient. But what went into making that red meat? The antibiotics, the corn and soy that they were growing for livestock feed, all these other preservatives, all these things that went into the food and the water that they were eating. We'll talk about that for a minute, because you said that you looked for like the best red meat in America. And I think for listeners outside of the States, you know, there are definitely differences in countries to do with what the rules are about red meat. And I think that, you know, the rules in the States are less strict than in many other countries. And so what might have been in the red meat, I guess is what I'm saying. If you hadn't gone to your special supplier of grass fed meat, like what else might have been in that red meat that you might

just generally be eating if you're ordering it from a restaurant somewhere, wherever you live? Right. I mean, just to pick a really simple one. So grass-fed beef has more omega-3, which is a hot topic in the world of nutrition, this highly unsaturated fatty acid, than 99% of the meat that goes through a concentrated animal feeding operation. So other nutrients, other lack of some, presence of others, so that the standard U.S. meat is not pasture-raised and organic and regeneratively grown. That is a very, very small percentage of the meat in the US. Maybe not in Korea where Kobe beef is very carefully raised and it's traditional and they take immense pride

in that. I don't think we have immense pride in American meat. And I think one of the things that I've heard a number of people talk about is the antibiotics that are going into the meat in our diet is still existing in the food that we eat. And therefore, we're tending to eat a whole bunch of antibiotics, which is obviously designed to kill bacteria. And we have a lot of bacteria inside us in a completely unintended way. Yeah. It's not so much, I don't think, that the antibiotics are still present and we're eating it and absorbing it. But in doing that to the animals and seeing runoff from the water that they're using, yeah, the connection is not necessarily as direct as you are eating

antibiotics, but there is a connection. This is not my area of specialization, but if you look at, if you're trying to track antibiotic use, 80%, I think it might be down to 70% in the US, goes to livestock, and only 20% to 30% is what humans are eating. And we're coming up with these MRSAs, the resistant bacteria. We're running out of antibacterial solutions in the U.S. because more and more people have become resistant to them. Doctors have been saying for years, we need to stop that part, giving it to the animals. So Christopher, just to wrap up,

what's your one key piece of advice that you'd want our listeners to walk away with from this episode? Yep, eat whole foods first, but along the way to that path, consider instead of what. So are these plant-based alternative meats good or bad for you? It needs to be in terms of instead of what. And if you are a regular American eating a lot of the meat that's available in the US, and you wanted to focus on clinical measures, those plant-based alternative meats in our study, which is only one, had better health outcomes. Amazing. Well, I would like to try and do a quick summary of all of this, Christopher. So I think

we started by saying what are meat alternatives? And the key to understand is they're designed for someone who is a meat eater and wants to swap out to something that still tastes like the meat they're used to doing. And looks and smells, and it's super familiar and not very threatening. And you ended up doing a study on one of these particular, which was Beyond, who did help fund that. And I think you described in our bit of beginning, you know, you have all of these protections to try not to be biased, but of course you want to disclose it because of that. They use beans in all of these in order because they're really high in protein. They are ultra processed, which means that they have to extract these particular proteins and do sort of magical scientific things to them in order to make them

taste like meat and be as close as possible to meat. And you did this very elegant study comparing the effects of people eating like a high quality red meat and these meat alternatives. And it was pretty clear that actually the health benefits of these meat alternatives were better. And you talked about TMAO falling, which apparently is a risk factor from red meat, and I have no idea what that means, but also LDL dropping, which is something that comes up often, and indeed that there was a small amount of weight loss for these people, that anyone worrying about getting the wrong protein from these meat alternatives really shouldn't worry, in large part because basically almost no one should be worrying about whether they're getting enough protein if they are eating

like a regular diet in the States. Most people are getting too much. And you did this really elegant study in fact with athletes where you compared not only these meat alternatives but actually also what happened if you went vegan and it turns out that these athletes were working out a lot were able to perform just as well even on a vegan diet which had significantly less protein than the meat it was the same with the meat alternative so in all these cases, worrying about the protein, unless maybe you're an Olympic athlete or something, just doesn't seem worth worrying about, or unless you're in a really extreme case where

you're really not eating enough food and you're elderly. So what you describe, I think, is very niche situations. And then we talked a bit about, does that mean that these meat alternatives are like really healthy and everyone listening to this should start eating them and i think and christopher's pulling a face here as i said it because i think the answer is no you're saying like it's a great maybe gateway drug as you put it to transition from this like really meat-centric diet to something that's much healthier but actually actually, if you can go towards eating much more whole foods, then actually you're going to get so much more because these foods are

still ultra-processed. You talked a little bit about this new work you're doing, really defining ultra-processed foods for the American Health Association, because it's clear that this is something we really need to start worrying about. And I think you gave some examples there for like, if you're willing to go further than mushrooms being a way to replace meat and still tasting quite meat-like, it's going to get you a lot further. Or tempeh, which is fermented soybean, which definitely was new to me in the last sort of 18 months. And I've had that experience. It's definitely much more, I would say chickeny or something like that. I don't think it's going to get anyone who's really out for that experience of a full steak. And that in general, if you could move towards many more beans as one of those things that gives you all of this fiber and

everything else, you're going to really get to a much healthier place. So it might be better, but just swapping from red meat to these meat alternatives does not mean that suddenly you're going to live another decade of healthy years. And we won't get into it because it's the wrap up, but I'm into motivations for making dietary changes and keeping them. And classes that I teach at Stanford for students, they're very interested in environmental sustainability and animal rights and welfare. The plant-based alternative meats totally win

for both of those. So health is a very important component, but there would be other reasons to do it as well. Christopher, thank you so much. That was really clear and amazing to talk to someone who's actually done the studies themselves instead of quoting somebody else's. Thanks for being here. Always fun. Been a pleasure. Bye-bye. Bye-bye. It's really been an eye-opener to hear from Christopher whether we should eat or avoid meat alternatives. Nutrition is a complicated topic,

so I hope his advice will really help you next time you're in the grocery store. Now, if you want to go one step further, you can get personalized advice and support to help you pick the best foods for you. Zoe can help you feel better now and live healthier in the years to come, backed by real clinical studies. To learn more and get 10% off your membership, simply go to zoe.com slash podcast. As always, I'm your host, Jonathan Wolfe. Zoe Science and Nutrition is produced by Yellow Hewins Martin, Richard Willen, and Tilly Fulford. The Zoe Science and Nutrition podcast is not medical advice. It's for general informational purposes only. See you next time.