Lindberg et al., 2024

Highlights

• Meat alternatives have a lower environmental impact than beef and pork products.
• Meat alternatives are lower in total and saturated fat, cholesterol, zinc and vitamin B12.
• Meat alternatives are higher in carbohydrates, sugar, fibre, salt/sodium, iron and calcium.
• Meat alternatives contain more ingredients, additives and allergens than meat products.
• Meat alternative consumption was not associated with any adverse health outcomes.

Abstract

Background

The promotion of dietary shifts towards reduced meat consumption and increased plant protein consumption, has resulted in increased availability and consumption of meat alternatives which are products made from non-meat proteins to replicate the organoleptic and functional properties of meat. However, a knowledge gap exists on the impact of the production and consumption of these products on the environment and human health.

Scope and approach

This systematic review aims to address this research gap by evaluating the literature on the ingredient composition, environmental, nutritional and health impact of meat alternatives compared to meat. Five databases, reference lists and web alerts were searched to identify articles published from 2011 to 2023. 54 articles were included in this systematic review.

Key findings and conclusions

Meat alternatives have a lower environmental impact than beef and pork and similar impact to chicken. Compared to meat, meat alternatives contain more ingredients, allergens and food additives. Overall, meat alternatives had lower contents of total and saturated fat, zinc and vitamin B12, and higher contents of carbohydrates, sugars, dietary fibre, salt/sodium, iron and calcium than comparable meat products. Protein contents were comparable or lower for meat alternatives depending on the category. A limited number of single test meal studies and short-term trials investigated the impact of meat alternative consumption on health outcomes, with no adverse effects observed. Further research examining the impact of meat alternative consumption on health outcomes is needed to better understand the role of these foods (if any) in healthy and sustainable dietary patterns.

Micronutrients

Average iron and calcium contents were comparable or significantly higher in meat alternatives compared to meat products within the same category (Table 5). Meat alternatives contributed more to reference intakes for iron and calcium than meat products in 2/3 (67%) (Bryngelsson et al., 2022; Pointke & Pawelzik, 2022) and 5/5 (100%) studies respectively (Cole et al., 2022; De Marchi et al., 2021; Harnack et al., 2022; Pointke & Pawelzik, 2022; van Vliet et al., 2021).

Iron intake/prevalence of adequacies was reduced in meat substitution scenarios in 2/3 modelling studies (67%) (Table 6), with the difference statistically significant in one study (P < 0.05) (Salomé et al., 2021) and non-significant (P > 0.05) in the other (Farsi et al., 2022; Salomé et al., 2021). When 100% of meat was replaced with fortified meat alternatives, iron intakes were significantly higher than the baseline diet containing meat (Farsi et al., 2022). The third study (33%) reported higher iron intakes in a meat replacement scenario, however the statistical significance of this difference was not calculated (Tyszler et al., 2014). Calcium intakes/prevalence of adequacies increased in 100% meat substitution scenarios in 2/2 (100%) modelling studies which measured this (Mertens et al., 2020; Salomé et al., 2021).

Meat products contributed more to the recommended daily intake of vitamin B12 in 2/3 (67%) studies which measured this using data from ingredient listings, nutritional content on pack and food composition databases (Harnack et al., 2022, Pointke and Pawelzik, 2022), with no significant differences to contributions observed in the third study (33%) (Bryngelsson et al., 2022). Contributions of meat alternatives vs. meat to recommended daily intake for zinc was dependant on the products compared, with meat-based mince and sausages contributing significantly more to recommended intakes than meat alternatives (Harnack et al., 2022; Pointke & Pawelzik, 2022), whilst meat alternative burgers and salami contributed significantly more to recommendations than meat-based products (Pointke & Pawelzik, 2022).

Modelling showed zinc and vitamin B12 intakes/prevalence of adequacies reduced in 3/3 (100%), (Mertens et al., 2020; Salomé et al., 2021; Tyszler et al., 2014) and 4/4 (100%) (Farsi et al., 2022; Mertens et al., 2020; Salomé et al., 2021; Tyszler et al., 2014) studies respectively when meat was replaced with meat alternatives (Table 6).

Meat alternatives or diet scenarios with meat alternatives had higher contents or contributed more to nutritional intakes for vitamins A (Cole et al., 2022), B1 (Harnack et al., 2021; Tyszler et al., 2014; van Vliet et al., 2021), B2 (riboflavin) (Bryngelsson et al., 2022; Harnack et al., 2021; Tyszler et al., 2014; van Vliet et al., 2021), B3 (niacin) (van Vliet et al., 2021), B7 (biotin) (Pointke et al., 2022), B9 (folate) (Bryngelsson et al., 2022; Harnack et al., 2021; Pointke & Pawelzik, 2022; van Vliet et al., 2021), vitamin D (Cole et al., 2022), E (Harnack et al., 2021; Pointke & Pawelzik, 2022; Shin et al., 2022) and K (Harnack et al., 2021; Pointke & Pawelzik, 2022) than meat products/diets scenarios. However, one study reported lower contributions from meat alternatives to vitamin A, B1 and B3 intakes (Pointke & Pawelzik, 2022). Mixed results were observed for content and contribution towards nutritional intakes for vitamins B2 (Pointke & Pawelzik, 2022), B6 (Harnack et al., 2021; Pointke & Pawelzik, 2022; Tyszler et al., 2014; van Vliet et al., 2021) and vitamin C (Cole et al., 2022).

Regarding minerals, potassium (De Marchi et al., 2021), phosphorus (De Marchi et al., 2021; Harnack et al., 2021; Pointke & Pawelzik, 2022; van Vliet et al., 2021), magnesium (De Marchi et al., 2021; Harnack et al., 2021; Pointke & Pawelzik, 2022), copper (Harnack et al., 2021; Pointke & Pawelzik, 2022) and manganese contents were higher for meat alternatives than meat products (Harnack et al., 2021). Meat products contributed more to selenium (Harnack et al., 2021; Tyszler et al., 2014) and pantothenic acid intake than meat alternatives (Harnack et al., 2021; Pointke & Pawelzik, 2022). Meat alternatives with the significantly higher vitamin and mineral contents were mostly mycoprotein (Svarc et al., 2022) or soy-based (Fresán, Mejia et al., 2019; Svarc et al., 2022) with nut-based alternatives containing significantly higher niacin contents (Fresán, Mejia, et al., 2019) and cold cuts containing the highest iodine contents (Svarc et al., 2022).

Nine studies used nutritional scores for assessment of meat alternatives and comparable meat products. The scores used included, France’s Nutri-Score (Cutroneo et al., 2022; Pointke & Pawelzik, 2022; Smetana et al., 2021), the Australian health star rating (HSR) (Curtain et al., 2019), nutritional density score (NDS) (Sturtewagen et al., 2016), Nutrient Density Unit (Saget et al., 2021), a score based on the UK’s Nutrient Profiling Model (Alessandrini et al., 2021), the UK’s Ofcom-score (Petersen et al., 2021) and a score based on macronutrient content (De Keyzer et al., 2012). All nine studies (100%) reported mostly better scores for meat alternatives and sometimes comparable scores.