MedUni Vienna's Center for Public Health: veganism is not synonymous with increased health

Being vegan is not a health-conscious diet and leads to an increased consumption of hyper-processed foods. Those are the conclusions of a study recently published in the scientific journal Nutrients, and they highlight a discrepancy between the appearance and the reality of vegan diets. There is a significant public perception that vegan people are health-conscious. However, the research group led by Maria Wakolbinger and Sandra Haider from MedUni Vienna’s Center for Public Health examined vegans’ dietary patterns in combination with their exercise behaviour. The analysis showed that vegans do more sports and physical activity than the rest of the population, which can distort studies that seek to assess the relationship between health and our diets exclusively. A balanced diet and sufficient physical activity are known to have positive health effects, but the relationship between a vegan diet and physical activity levels is understudied.

To investigate this gap in the literature, researchers conducted a cross-sectional online survey among 516 vegan participants with an average age of 28 who had been vegan for at least three months when the study began. We know that members of the vegan lifestyle do sport and physical activity more often than average. However, this group’s widespread consumption of industrially processed foods cannot be classified as beneficial for health. The benefits of plant-based food for health are well known, but the degree of processing of the food consumed must also be taken into account in this area. In fact, despite the health benefits of a plant-based diet, not all vegan foods can be considered healthy. Refined grains, sugar-sweetened beverages, snacks, and confectionery can be considered “plant-based” as their ingredients are derived from plants but are still classified as ultra-processed foods. These ultra-processed products may also be found in modern plant-based diets or veganism, and their consumption is associated with higher all-cause mortality.

A cross-sectional study found that not all vegetarian diets are necessarily healthy due to the potential negative effects of ultra-processed foods on nutritional quality, as vegans had the highest consumption of ultra-processed foods compared to meat eaters. Another study further demonstrated that vegan diets vary substantially in diet quality, with some vegan diets consisting of large quantities of processed and ultra-processed foods. According to a cross-sectional survey of Brazilian vegetarians and vegans, 41% of vegans drank sugary beverages daily. Additionally, it discovered a link between eating ultra-processed foods and a greater risk of becoming overweight in vegans and vegetarians. Few published studies have addressed the aspect of vegan diet heterogeneity, but those that do indicate that vegan diets vary in quality significantly.

In this new study, the research team identified two dietary patterns in the vegan lifestyle: the “convenience” and the “health-conscious” group. The identified “convenience” dietary pattern represented 53%, and it was characterized by higher consumption of processed fish and meat alternatives, vegan savoury snacks, processed foods, sauces and condiments, cakes and biscuits, sweets and desserts, convenience meals and snacks, fruit juices/smoothies, and refined grains. By contrast, the “health-conscious” dietary pattern represented 47%, and it was characterized by higher consumption of vegetables, fruits, protein alternatives such as tofu, dairy alternatives, potatoes, whole grains, vegetable oils and fats, and cooking with fresh ingredients and creating recipes.

“The negative effects of industrially processed foods on health have now been clearly proven in studies,” Maria Wakolbinger, lead author of the study, emphasizes. “People who eat a mixed diet have a 29% higher risk of all-cause mortality, overweight or obesity by up to 51%. The answers about nutrition showed that vegan is not to be equated with ‘healthy’“. The study also proved that the vegan population is heterogeneous concerning exercise behaviour. People with a convenience dietary pattern had significantly higher odds of sitting more and not achieving aerobic physical activity or strength training recommendations than those with a health-conscious dietary pattern. This study suggests the heterogeneity of vegan diets and that dietary patterns must be differentiated, as they also differ in the level of physical activity. “The extent of exercise among vegans is higher overall than that of the average population in Austria. As our study showed, however, the health-conscious group does significantly more exercise than those people who can be assigned to the convenience eating pattern,” first author Sandra Haider explains. Veganism is a plant-based diet with the most stringent restrictions, excluding all animal-source foods and by-products. Especially in high-income countries, the vegan population is increasing due to its popularity. For example, Austria’s population share of vegans is 2%. The term “pudding vegetarianism” has been established for variants of vegetarian nutrition that are unfavourable to health, in which instead of meat, there are a lot of sweets on the menu. “Accordingly, the convenience food pattern we determined could be described as ‘pudding veganism’,” Maria Wakolbinger and Sandra Haider summarize. Given the boom in the vegan meat market and dairy alternatives, which in Europe is worth 1.7 billion euros, the contribution of this study is important to increase awareness that veganism is not synonymous with increased health.