Mapping the evidence of novel plant-based foods: a systematic review of nutritional, health, and environmental impacts in high-income countries

Abstract

Context: Shifting from current dietary patterns to diets rich in plant-based (PB) foods and lower in animal-based foods (ABFs) is generally regarded as a suitable strategy to improve nutritional health and reduce environmental impacts. Despite the recent growth in supply of and demand for novel plant-based foods (NPBFs), a comprehensive overview is lacking.

Objectives: This review provides a synthesis of available evidence, highlights challenges, and informs public health and environmental strategies for purposeful political decision-making by systematically searching, analyzing, and summarizing the available literature.

Data sources: Five peer-reviewed databases and grey literature sources were rigorously searched for publications.

Data extraction: Study characteristics meeting the inclusion criteria regarding NPBF nutrient composition and health and environmental outcomes in high-income countries were extracted.

Data analysis: Fifty-seven peer-reviewed and 36 grey literature sources were identified; these were published in 2016-2022. NPBFs typically have substantially lower environmental impacts than ABFs, but the nutritional contents are complex and vary considerably across brands, product type, and main primary ingredient. In the limited evidence on the health impacts, shifts from ABFs to PB meats were associated with positive health outcomes. However, results were mixed for PB drinks, with links to micronutrient deficiencies.

Conclusion: If carefully selected, certain NPBFs have the potential to be healthier and nutrient-rich alternatives to ABFs and typically have smaller environmental footprints. More disaggregated categorization of various types of NPBFs would be a helpful step in guiding consumers and key stakeholders to make informed decisions. To enable informed policymaking on the inclusion of NPBFs in dietary transitions as part of a wider net-zero and health strategy, future priorities should include nutritional food standards, labelling, and subdivisions or categorizations of NPBFs, as well as short- and long-term health studies evaluating dietary shifts from ABFs to NPBFs and standardized environmental impact assessments, ideally from independent funders.

Keywords: climate change; climate change mitigation; dairy substitutes; diet change; environmental sustainability; health; meat substitutes; novel plant-based foods; plant-based; sustainable diets.

Figure 1

Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart of systematic review process reporting nutrient composition, and environmental and health outcomes of novel plant-based products in high-income countries. Abbreviations: IPCC, Intergovernmental Panel on Climate Change.

Figure 2

Macronutrient, sodium, and energy content in plant-based meat and drink alternatives in their respective food group based on main primary ingredient (ie, predominant or core food item on the ingredient list) compared with meat and poultry, and dairy, respectively. Data were limited to raw products only. Abbreviation: M, median of each category.

Figure 3

Reduction of environmental impacts by respective funding source. Calculated as a percentage difference between each novel plant-based (PB) product (by product type and food group based on main primary ingredient [ie, predominant or core food item on the ingredient list]) in comparison with their respective reported baseline (eg, dairy milk and cheese, meat and poultry). See Supplementary file 3 in the Supporting Information online for detailed information on the baseline used for each reference. Data were limited to raw products only. Studies reporting data on cooked PB products also found reductions in environmental impacts.

Figure 4

Reduction of environmental outcomes and their associated nutrient outcomes of novel plant-based foods (NPBFs) compared with baseline (eg, dairy milk and cheese, meat and poultry), expressed in percentage difference. The y-axis shows the increase or decrease of the nutrient content (energy, fiber, sodium, and saturated fat) in comparison with baseline; and the x-axis shows the reduction (or increase) of the environmental categories. Three environmental categories are reported: greenhouse gas emissions (circles), land use (triangles), and blue-water use (squares). Three NPBFs are reported: plant-based (PB) cheese alternatives (brown), PB meat alternatives (purple), and PB drinks (orange). PB yogurts were not included due to the limited amount of data. See Supplementary file 2 in the Supporting Information online for detailed information on the baseline used for each reference. Data were limited to raw products only.

Figure 5

Estimated fruit, vegetable, legume, and nut content (%) in each novel plant-based foods product from time-stamped data from UK supermarkets. Panels show (a) plant-based (PB) drink alternatives; (b) PB meat alternatives; (c) PB cheese alternatives; and (d) PB yogurt alternatives.