{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T20:55:30Z","timestamp":1793134530769,"version":"4.5.0"},"reference-count":45,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Department of Agriculture, Food and the Marine and The Department of Agriculture, Environment and Rural Affairs","award":["2021R546"],"award-info":[{"award-number":["2021R546"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Increasing our intake of plant-based protein may help improve both population and planetary health. A systematic synthesis of randomized controlled trials is needed to clarify evidence on the effects of increased plant-based protein intake.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the effects of partially replacing animal-based protein with plant-based protein in healthy adult cohorts for any outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>On December 5, 2024, 3 databases were searched (PubMed, Cochrane, Embase). Articles were included for evaluation if the partial replacement of animal-based protein with plant-based sources was assessed for any outcome in a healthy adult cohort (mean or median age between 18 and 65\u2009years) in a randomized controlled trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Extraction<\/jats:title>\n                    <jats:p>Articles were screened at title, abstract, and full-text levels independently by 2 researchers. Results were extracted and synthesized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Analysis<\/jats:title>\n                    <jats:p>Risk of bias was assessed using the Cochrane Risk-of-Bias tool, version 2.0. Four dietary interventions reported in 7 articles were included in the final analysis. Three articles obtained a low risk-of-bias result, and the remaining 4 were identified to have \u201csome concerns.\u201d Vitamin B12 status was reduced significantly in those consuming diets with the highest proportion of plant-based protein, whereas the status of other micronutrients (specifically, folate, iron, and vitamin\u2009D) was not affected. Mixed evidence was reported on the impact on bone and mineral metabolism. Improvements in cardiovascular risk biomarkers (low-density lipoprotein cholesterol, total cholesterol, and body weight) were observed in those consuming higher proportions of plant-based protein. One study reported that the diet with reduced meat also was associated with reduced estimated greenhouse gas emissions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Replacing animal protein with some plant-based sources may improve certain biomarkers of cardiovascular disease risk and reduce the environmental impact of dietary intake. Mixed findings for nutrient status and bone and mineral metabolism highlight the need for further research to support integration of sustainable diets into food-based dietary guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>PROSPERO registration No. CRD42024584913.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/nutrit\/nuag058","type":"journal-article","created":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T12:38:31Z","timestamp":1774096711000},"source":"Crossref","is-referenced-by-count":3,"title":["Partially Replacing Animal-Based Protein Foods With Plant-Based Protein Foods: A Systematic Review of Randomized Controlled Trials in Healthy Adults"],"prefix":"10.1093","author":[{"given":"Aoife","family":"Courtney","sequence":"first","affiliation":[{"name":"UCD School of Agriculture and Food Science, Institute of Food and Health, University College Dublin , Dublin 4 ,","place":["Ireland"]},{"name":"UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin , Dublin 4 ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebekah","family":"Sweeney","sequence":"additional","affiliation":[{"name":"UCD School of Agriculture and Food Science, Institute of Food and Health, University College Dublin , Dublin 4 ,","place":["Ireland"]},{"name":"UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin , Dublin 4 ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Breige","family":"McNulty","sequence":"additional","affiliation":[{"name":"UCD School of Agriculture and Food Science, Institute of Food and Health, University College Dublin , Dublin 4 ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Wallace","sequence":"additional","affiliation":[{"name":"UCD School of Agriculture and Food Science, Institute of Food and Health, University College Dublin , Dublin 4 ,","place":["Ireland"]},{"name":"UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin , Dublin 4 ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7711-7499","authenticated-orcid":false,"given":"Lorraine","family":"Brennan","sequence":"additional","affiliation":[{"name":"UCD School of Agriculture and Food Science, Institute of Food and Health, University College Dublin , Dublin 4 ,","place":["Ireland"]},{"name":"UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin , Dublin 4 ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"2026042415092450600_nuag058-B1","author":"United Nations","year":"2025"},{"key":"2026042415092450600_nuag058-B2","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1016\/S0140-6736(18)31788-4","article-title":"Food in the Anthropocene: the EAT-Lancet Commission on healthy diets from sustainable food systems","volume":"393","author":"Willett","year":"2019","journal-title":"Lancet"},{"key":"2026042415092450600_nuag058-B3","author":"Food and Agriculture Organisation of the United Nations","year":"2012"},{"key":"2026042415092450600_nuag058-B4","author":"World Health Organisation","year":"2019"},{"key":"2026042415092450600_nuag058-B5","doi-asserted-by":"publisher","first-page":"e234714","DOI":"10.1001\/jamanetworkopen.2023.4714","article-title":"Association of healthful plant-based diet adherence with risk of mortality and major chronic diseases among adults in the UK","volume":"6","author":"Thompson","year":"2023","journal-title":"JAMA Netw Open"},{"key":"2026042415092450600_nuag058-B6","doi-asserted-by":"publisher","first-page":"979","DOI":"10.1161\/CIRCULATIONAHA.119.041014","article-title":"Changes in plant-based diet quality and total and cause-specific mortality","volume":"140","author":"Baden","year":"2019","journal-title":"Circulation"},{"key":"2026042415092450600_nuag058-B7","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1016\/j.jacc.2017.05.047","article-title":"Healthful and unhealthful plant-based diets and the risk of coronary heart disease in U.S. adults","volume":"70","author":"Satija","year":"2017","journal-title":"J Am Coll Cardiol"},{"key":"2026042415092450600_nuag058-B8","doi-asserted-by":"publisher","first-page":"e1002039","DOI":"10.1371\/journal.pmed.1002039","article-title":"Plant-based dietary patterns and incidence of type 2 diabetes in US men and women: results from three prospective cohort studies","volume":"13","author":"Satija","year":"2016","journal-title":"PLoS Med"},{"key":"2026042415092450600_nuag058-B9","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1186\/s12937-023-00877-2","article-title":"Associations between plant-based dietary patterns and risks of type 2 diabetes, cardiovascular disease, cancer, and mortality\u2013a systematic review and meta-analysis","volume":"22","author":"Wang","year":"2023","journal-title":"Nutr J"},{"key":"2026042415092450600_nuag058-B10","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1016\/j.ajcnut.2024.01.014","article-title":"Impact of consuming an environmentally protective diet on micronutrients: a systematic literature review","volume":"119","author":"Leonard","year":"2024","journal-title":"Am J Clin Nutr"},{"key":"2026042415092450600_nuag058-B11","doi-asserted-by":"publisher","first-page":"724","DOI":"10.1038\/s43016-021-00358-x","article-title":"Global greenhouse gas emissions from animal-based foods are twice those of plant-based foods","volume":"2","author":"Xu","year":"2021","journal-title":"Nat Food"},{"key":"2026042415092450600_nuag058-B12","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1038\/s43016-023-00795-w","article-title":"Vegans, vegetarians, fish-eaters and meat-eaters in the UK show discrepant environmental impacts","volume":"4","author":"Scarborough","year":"2023","journal-title":"Nat Food"},{"key":"2026042415092450600_nuag058-B13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jclepro.2014.12.008","article-title":"Environmental impact of dietary change: a systematic review","volume":"91","author":"Hallstr\u00f6m","year":"2015","journal-title":"J Clean Prod"},{"key":"2026042415092450600_nuag058-B14","doi-asserted-by":"publisher","first-page":"1614","DOI":"10.3390\/nu14081614","article-title":"Plant-based dietary patterns for human and planetary health","volume":"14","author":"Gibbs","year":"2022","journal-title":"Nutrients"},{"key":"2026042415092450600_nuag058-B15","doi-asserted-by":"publisher","first-page":"518","DOI":"10.1038\/nature13959","article-title":"Global diets link environmental sustainability and human health","volume":"515","author":"Tilman","year":"2014","journal-title":"Nature"},{"key":"2026042415092450600_nuag058-B16","doi-asserted-by":"publisher","first-page":"S275","DOI":"10.1093\/advances\/nmy117","article-title":"Plant-based diets for personal, population, and planetary health","volume":"10","author":"Hemler","year":"2019","journal-title":"Adv Nutr"},{"key":"2026042415092450600_nuag058-B17","author":"World Health Organisation","year":"2021"},{"key":"2026042415092450600_nuag058-B18","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1038\/s43016-022-00531-w","article-title":"Global food-miles account for nearly 20% of total food-systems emissions","volume":"3","author":"Li","year":"2022","journal-title":"Nat Food"},{"key":"2026042415092450600_nuag058-B19","doi-asserted-by":"publisher","first-page":"1704S","DOI":"10.3945\/ajcn.2009.26736AA","article-title":"Potential contributions of food consumption patterns to climate change","volume":"89","author":"Carlsson-Kanyama","year":"2009","journal-title":"Am J Clin Nutr"},{"key":"2026042415092450600_nuag058-B20","doi-asserted-by":"publisher","first-page":"e977","DOI":"10.1016\/S2542-5196(22)00246-7","article-title":"Environmental sustainability in national food-based dietary guidelines: a global review","volume":"6","author":"James-Martin","year":"2022","journal-title":"Lancet Planet Health"},{"key":"2026042415092450600_nuag058-B21","doi-asserted-by":"publisher","first-page":"3503","DOI":"10.1016\/j.clnu.2020.11.035","article-title":"Intake and adequacy of the vegan diet. A systematic review of the evidence","volume":"40","author":"Bakaloudi","year":"2021","journal-title":"Clin Nutr"},{"key":"2026042415092450600_nuag058-B22","doi-asserted-by":"publisher","first-page":"e2344457","DOI":"10.1001\/jamanetworkopen.2023.44457","article-title":"Cardiometabolic effects of omnivorous vs vegan diets in identical twins: a randomized clinical trial","volume":"6","author":"Landry","year":"2023","journal-title":"JAMA Netw Open"},{"key":"2026042415092450600_nuag058-B23","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"2026042415092450600_nuag058-B24","author":"Higgins"},{"key":"2026042415092450600_nuag058-B25","doi-asserted-by":"publisher","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"2026042415092450600_nuag058-B26","doi-asserted-by":"publisher","first-page":"943","DOI":"10.3390\/nu12040943","article-title":"Replacing animal-based proteins with plant-based proteins changes the composition of a whole Nordic diet-a randomised clinical trial in healthy Finnish adults","volume":"12","author":"Paivarinta","year":"2020","journal-title":"Nutrients"},{"key":"2026042415092450600_nuag058-B27","doi-asserted-by":"publisher","first-page":"1188","DOI":"10.1093\/ajcn\/nqaa203","article-title":"A randomized crossover trial on the effect of plant-based compared with animal-based meat on trimethylamine-N-oxide and cardiovascular disease risk factors in generally healthy adults: Study With Appetizing Plantfood-Meat Eating Alternative Trial (SWAP-MEAT)","volume":"112","author":"Crimarco","year":"2020","journal-title":"Am J Clin Nutr"},{"key":"2026042415092450600_nuag058-B28","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1093\/jn\/nxaa264","article-title":"Partial replacement of animal proteins with plant proteins for 12 weeks accelerates bone turnover among healthy adults: a randomized clinical trial","volume":"151","author":"Itkonen","year":"2021","journal-title":"J Nutr"},{"key":"2026042415092450600_nuag058-B29","doi-asserted-by":"publisher","first-page":"1391","DOI":"10.1007\/s00394-021-02729-3","article-title":"Replacing dietary animal-source proteins with plant-source proteins changes dietary intake and status of vitamins and minerals in healthy adults: a 12-week randomized controlled trial","volume":"61","author":"Pellinen","year":"2022","journal-title":"Eur J Nutr"},{"key":"2026042415092450600_nuag058-B30","doi-asserted-by":"publisher","first-page":"e82","DOI":"10.1017\/jns.2022.84","article-title":"Assessing the effects of alternative plant-based meats v. animal meats on biomarkers of inflammation: a secondary analysis of the SWAP-MEAT randomized crossover trial","volume":"11","author":"Crimarco","year":"2022","journal-title":"J Nutr Sci"},{"key":"2026042415092450600_nuag058-B31","doi-asserted-by":"publisher","first-page":"1357","DOI":"10.1093\/ajcn\/nqab414","article-title":"Replacing meat with alternative plant-based products (RE-MAP): a randomized controlled trial of a multicomponent behavioral intervention to reduce meat consumption","volume":"115","author":"Bianchi","year":"2022","journal-title":"Am J Clin Nutr"},{"key":"2026042415092450600_nuag058-B32","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1017\/S0007114523001514","article-title":"Effects of partial replacement of red and processed meat with non-soya legumes on bone and mineral metabolism and amino acid intakes in BeanMan randomised clinical trial","volume":"131","author":"Itkonen","year":"2024","journal-title":"Br J Nutr"},{"key":"2026042415092450600_nuag058-B33","doi-asserted-by":"publisher","first-page":"29","DOI":"10.3390\/nu14010029","article-title":"Nutrient intake and status in adults consuming plant-based diets compared to meat-eaters: a systematic review","volume":"14","author":"Neufingerl","year":"2021","journal-title":"Nutrients"},{"key":"2026042415092450600_nuag058-B34","doi-asserted-by":"publisher","first-page":"1359","DOI":"10.1080\/10408398.2016.1259210","article-title":"The effect of vegetarian diets on iron status in adults: a systematic review and meta-analysis","volume":"58","author":"Haider","year":"2018","journal-title":"Crit Rev Food Sci Nutr"},{"key":"2026042415092450600_nuag058-B35","doi-asserted-by":"publisher","first-page":"1606","DOI":"10.3390\/nu12061606","article-title":"Vegans, vegetarians, and omnivores: how does dietary choice influence iodine intake? A systematic review","volume":"12","author":"Eveleigh","year":"2020","journal-title":"Nutrients"},{"key":"2026042415092450600_nuag058-B36","doi-asserted-by":"publisher","first-page":"943","DOI":"10.3945\/ajcn.2009.27521","article-title":"Effect of vegetarian diets on bone mineral density: a Bayesian meta-analysis","volume":"90","author":"Ho-Pham","year":"2009","journal-title":"Am J Clin Nutr"},{"key":"2026042415092450600_nuag058-B37","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/nutrit\/nuy045","article-title":"Veganism, vegetarianism, bone mineral density, and fracture risk: a systematic review and meta-analysis","volume":"77","author":"Iguacel","year":"2019","journal-title":"Nutr Rev"},{"key":"2026042415092450600_nuag058-B38","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1385\/JCD:7:1:1","article-title":"Official positions of the International Society for Clinical Densitometry","volume":"7","author":"Leib","year":"2004","journal-title":"J Clin Densitom"},{"key":"2026042415092450600_nuag058-B39","doi-asserted-by":"publisher","first-page":"2609","DOI":"10.1093\/eurheartj\/ehad211","article-title":"Vegetarian or vegan diets and blood lipids: a meta-analysis of randomized trials","volume":"44","author":"Koch","year":"2023","journal-title":"Eur Heart J"},{"key":"2026042415092450600_nuag058-B40","doi-asserted-by":"publisher","first-page":"756810","DOI":"10.3389\/fcvm.2021.756810","article-title":"The association of plant-based diet with cardiovascular disease and mortality: a meta-analysis and systematic review of prospect cohort studies","volume":"8","author":"Quek","year":"2021","journal-title":"Front Cardiovasc Med"},{"key":"2026042415092450600_nuag058-B41","doi-asserted-by":"publisher","first-page":"1715","DOI":"10.1161\/CIR.0000000000001146","article-title":"Popular dietary patterns: alignment with American Heart Association 2021 dietary guidance: a scientific statement from the American Heart Association","volume":"147","author":"Gardner","year":"2023","journal-title":"Circulation"},{"key":"2026042415092450600_nuag058-B42","doi-asserted-by":"publisher","first-page":"e472","DOI":"10.1161\/CIR.0000000000001031","article-title":"2021 Dietary guidance to improve cardiovascular health: a scientific statement from the American Heart Association","volume":"144","author":"Lichtenstein","year":"2021","journal-title":"Circulation"},{"key":"2026042415092450600_nuag058-B43","author":"World Health Organisation. Healthy Diet Fact Sheet","year":"2020"},{"key":"2026042415092450600_nuag058-B44","doi-asserted-by":"publisher","first-page":"e0165797","DOI":"10.1371\/journal.pone.0165797","article-title":"The impacts of dietary change on greenhouse gas emissions, land use, water use, and health: a systematic review","volume":"11","author":"Aleksandrowicz","year":"2016","journal-title":"PLoS One"},{"key":"2026042415092450600_nuag058-B45","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1038\/s41558-023-01605-8","article-title":"Future warming from global food consumption","volume":"13","author":"Ivanovich","year":"2023","journal-title":"Nat Clim Change"}],"container-title":["Nutrition Reviews"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/nutritionreviews\/advance-article-pdf\/doi\/10.1093\/nutrit\/nuag058\/68156031\/nuag058.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/nutritionreviews\/advance-article-pdf\/doi\/10.1093\/nutrit\/nuag058\/68156031\/nuag058.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T19:09:29Z","timestamp":1777057769000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/nutritionreviews\/advance-article\/doi\/10.1093\/nutrit\/nuag058\/8662103"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,24]]},"references-count":45,"URL":"https:\/\/doi.org\/10.1093\/nutrit\/nuag058","relation":{},"ISSN":["0029-6643","1753-4887"],"issn-type":[{"value":"0029-6643","type":"print"},{"value":"1753-4887","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,24]]},"article-number":"nuag058"}}