New England Journal of Medicine suggests plant protein beats animal protein

New findings show plants contain all essential amino acids, in contrast to mistaken long-held belief
New findings show plants contain all essential amino acids, in contrast to mistaken long-held belief

Plant-based proteins have major health advantages over animal-based proteins, according to a New England Journal of Medicine letter to the editor by Neal D. Barnard, MD, published Aug. 1, 2024. New findings show that all plants contain all essential amino acids, in contrast to the common but mistaken belief that plants lack one or more amino acids. Of the 20 amino acids that are the building blocks of protein, nine cannot be produced by the human body. All are found in plant sources.

“In addition, plant-based proteins are associated with reduced mortality compared with animal proteins,” says Dr. Barnard, president of the Physicians Committee for Responsible Medicine, a nonprofit public health advocacy organization, and adjunct professor of medicine at the George Washington University School of Medicine and Health Sciences in Washington, D.C. “A major Harvard study showed that when plant-based proteins are consumed instead of protein from beef, poultry, fish, dairy products, or eggs, mortality is reduced.”

People drawing their nutrition from plant-based diets enjoy a reduced risk of diabetes, obesity, heart disease, and cancer. Even so, people on any diet should pay attention to their need for vitamin B12 and other nutrients.

The letter was published in response to a New England Journal of Medicine article introducing a new series on nutrition. “Many people are now shifting to plant-based diets, and their nutrition improves in the process,” Dr. Barnard says. 

The impact of lifestyle and diet on Rheumatoid Arthritis

Holistic approach to care
Holistic approach to care

The 16-week Plants for Joints trial investigated the effects of a multidisciplinary lifestyle intervention in people with RA compared to usual care. The intervention was based on a whole-food, plant-based diet alongside physical activity and stress management. Previous reports showed this intervention significantly reduced the 28-joint disease activity score (DAS28) compared to usual care alone.2,3 To expand on this, the researchers wanted to determine the long-term effectiveness of the intervention, specifically about disease activity after 2 years.

After the initial 16-week randomised period, the control group also received the intervention, and participants were followed for 2 years with biannual visits and six adherence-promoting webinars annually. People with DAS28 <2.6 also received a protocol as a suggested approach to tapering their antirheumatic medication – under the supervision of their rheumatologist – and any treatment changes were recorded.

62% of the original trial completers also completed the 2-year follow-up. Those who discontinued most often indicated that this was because they were too busy, unreachable, or did not permit for the second year of the extension study.

The long-term results showed that improvement in DAS28 was maintained for 2 years after completing the intervention – and was significantly lower compared to baseline. Tender joint count and general health components of the DAS28 also improved significantly, although there was no significant difference in the erythrocyte sedimentation rate and swollen joint count compared to baseline. Results were similar in people who completed the 2-year extension study versus those who discontinued prematurely.

Of the 39 participants who completed their follow-up and used disease-modifying antirheumatic medication, 44% could decrease or stop, 26% had stable usage, and 31% had increased medication. Of those with stable or decreased medication compared to baseline, 65% had improved DAS28.

After the 2-year follow-up, HDL cholesterol increased, and C-reactive protein (CRP) remained significantly lower compared to baseline values—although there was no longer a significant difference in weight, waist circumference, LDL cholesterol, or HbA1c.

These findings indicate that intensive lifestyle modifications can be effective in the long term for people with RA.