Plant-Based Foods, Even If Ultraprocessed, Can Reduce Risk of Diabetes

Switching animal products with plant-based alternatives—even foods classified as ultraprocessed like bread, veggie burgers, and cereals—can help reduce the risk of type 2 diabetes and heart disease, according to a new review published by investigators in BMJ Nutrition, Prevention & Health.^1,2

The observations challenge the long-standing belief that all ultraprocessed foods—including those plant-based in nature—can contribute to the incidence of diabetes and other adverse health outcomes. Even opting for a plant-based, although ultraprocessed, alternative is significantly healthier vs consuming ultraprocessed animal products, artificially and sugar-sweetened beverages, and fats.^1,2

Hana Kahleova, MD, PhD, lead author of the review and director of clinical research at the Physicians Committee for Responsible Medicine, noted in an interview with Pharmacy Times that pharmacists can play a major role in counseling patients about nutrition’s role in disease treatment and prevention. When filling a prescription for type 2 diabetes or any other cardiovascular condition, an opportunity presents itself to discuss the importance of a healthy diet and lifestyle.

“For pharmacists, the key takeaway is that the source of the food matters at least as much as the degree of processing,” Kahleova explained. “Encouraging patients to reduce meat and dairy and shift toward plant-based foods—such as fruits, vegetables, grains, and beans—can meaningfully improve cardiometabolic health alongside standard medical therapy.

Major Differences Apparent Between Animal- and Plant-Based Products and Diabetes Risk

Kahleova and her team searched the PubMed database to include studies in the analysis; after parsing 309 records, 14 papers—including 12 prospective studies and 2 randomized clinical trials—were included. Seven prospective studies that reported the association between consumption of specific ultraprocessed food categories and diabetes risk were included. Universally, ultraprocessed food consumption increased the risk of type 2 diabetes, but major differences were observed between the various food groups.^1,2

One 2023 analysis demonstrated a reduced association between ultraprocessed breads and cereals and diabetes risk compared with animal-based foods and artificially sweetened products. A larger cohort study, featuring 7 European countries, confirmed an increased risk of multimorbidity associated with ultraprocessed food consumption overall, with a particularly higher risk for animal products and sugar-sweetened beverages. Once again, ultraprocessed cereals and breads attenuated the risk.¹

A sample of the US population was analyzed in the Atherosclerosis Risk in Communities Study. The investigators found that, in the highest quartile consumption ranges of sweetened beverages, ultraprocessed meats, and sugary snacks, there was an associated 29%, 21%, and 16% heightened risk of diabetes, respectively, compared with the lowest quartile. Comparatively, baked goods and ice cream were associated with a lower risk of diabetes, at 12% each.¹

Ultraprocessed Food Differences Can Alter Cardiovascular Risk

The investigators also examined the associations between ultraprocessed food consumption and cardiovascular risk. In one study of 3042 men and women from Greece, artificially sweetened and sugar-sweetened beverages, spreads, and sauces had a positive association with cardiometabolic multimorbidity. However, for breads and cereals, an inverse association was observed.¹

Furthermore, in the Atherosclerosis Risk in Communities Study, which included 8293 participants for a cardiovascular risk analysis, those in the highest quartile of consumption of sugar-sweetened beverages, red meat, and margarine had a 16%, 10%, and 6% higher risk of incident hypertension, respectively, compared with the lowest quartile. On the other hand, those with high intake of cold breakfast cereal and dairy had a 10% and 11% lower risk of incident hypertension.¹

Where Pharmacists Fit In: Insights From Hana Kahleova, MD, PhD

A key counseling point that pharmacists must include in discussions with patients is an emphasis on dietary patterns rather than perfection, according to Kahleova. The review highlights that plant-based foods are not nutritionally identical, necessitating greater consideration of healthful dietary choices.

Kahleova notes that foods like fruits, vegetables, whole grains, and legumes “should form the foundation of the diet,” due to harboring naturally high levels of fiber and protective nutrients. Concurrently, common processed, plant-based foods like breads, plant milks, breakfast cereals, and plant-based meat options can lower the risk of diabetes when they replace animal products and serve as “practical, affordable, and familiar” alternatives.

“Rather than discouraging foods solely based on processing level, pharmacists can help patients understand that plant-based choices, even when processed, are generally preferable to animal-based products high in saturated fat and cholesterol,” Kahleova said in the interview.

Kahleova provided a series of key counseling points that pharmacists can relay to patients either with diabetes or at risk of diabetes development. Dietary changes should be explained as an adjunct—not a full replacement—of medical therapy; pharmacists are critical to ensuring that patients receive the full breadth of treatment benefits through both eating a healthier diet and being prescribed effective medical interventions. Pharmacists can explain to patients that medications can treat the symptoms of cardiometabolic disease, whereas diet addresses the underlying causes of such disease. They can also recommend simple, realistic substitutions of animal products in favor of plant-based alternatives, like replacing a cheeseburger with a veggie burger or using plant-based milks instead of dairy milk.

“By reinforcing that dietary improvements may enhance medication effectiveness and potentially reduce long-term medication burden, pharmacists can motivate patients while emphasizing the importance of ongoing monitoring and collaboration with their health care team,” Kahleova said.

REFERENCES

1. Kahleova H, Himmelfarb J, Barnard ND. Not all ultra-processed foods are created equal: a review. BMJ Nutr Prev Health. Published online January 5, 2026. doi:10.1136/bmjnph-2025-001358

2. Replacing animal products with plant-based foods—even ultra-processed ones—reduces diabetes and heart disease risk, finds new review. News release. Physicians Committee for Responsible Medicine. January 20, 2026. Accessed January 27, 2026. https://www.eurekalert.org/news-releases/1113290