Vegan versus Mediterranean diet for a healthy heart

When it comes to protecting your heart, what you eat plays a major role. Two of the most popular heart-healthy eating plans are the vegan diet and the Mediterranean diet. But which one is better for your heart — and your overall health?

Let’s break down the differences, benefits and what the research says.

Vegan versus Mediterranean diet comparison

Both diets emphasize whole, plant-based foods, but they differ in key ways.

Vegan diet explained

• excludes all animal products, including meat, dairy, eggs, and honey
• focuses on fruits, vegetables, legumes, whole grains, nuts, and seeds
• naturally cholesterol-free and low in saturated fat

Mediterranean diet explained

• inspired by traditional eating habits in countries like Greece and Italy
• includes plant-based foods, plus moderate amounts of fish, poultry, dairy, and olive oil
• limits red meat and processed foods

Key differences

• The vegan diet is entirely plant-based and excludes all animal products.
• The Mediterranean diet is more flexible, allowing moderate intake of red meat, fish, poultry, dairy, and healthy fats like olive oil. 
• Protein in a vegan diet comes from legumes, soy, and grains, while the Mediterranean diet includes red meat, fish, poultry, and dairy as additional sources.

Which diet is healthier for your heart?

A 2023 Stanford identical twin study found that a vegan diet led to greater reductions in LDL (“bad”) cholesterol, insulin levels, and body weight compared to a whole foods-based diet that included meat. But studies show that both diets are heart-healthy. 

The diet cardiologists and dietitians recommend

Most cardiologists support either diet, depending on the patient’s needs and preferences. Both are rich in fiber, antioxidants and anti-inflammatory foods — key factors in preventing heart disease. As we often tell patients, the best diet is the one you will incorporate into your life, long term.

Benefits of the vegan diet

• contains no cholesterol and very little saturated fat
• high in fiber, which helps lower LDL cholesterol
• may lead to greater weight control and improved insulin sensitivity
• associated with lower risk of hypertension and type 2 diabetes

Advantages of the Mediterranean diet

• rich in omega-3 fatty acids from fish
• includes heart-healthy fats like olive oil
• easier to follow for many people due to its flexibility
• linked to lower risk of heart disease and stroke

Nutritional gaps or potential drawbacks

Fish, dairy, and smaller portions of meat and poultry can contribute to healthy vitamin B12 intake. Vitamin B12 is an important nutrient for heart health because it breaks down homocysteine, an amino acid that can increase the risk of stroke and heart disease when its levels are high. Fish is high in healthy omega-3 fatty acids which are associated with cardiovascular health.

People who opt for a vegan diet need to be mindful about including certain nutrients, as their diets may lack vitamin B12, iron, calcium, and omega-3s fatty acids.

Vegans wanting to incorporate vitamin B12 in their diets, may need to take supplements or eat fortified foods like soy milk, cereals and nutritional yeast. Vegans can get omega-3 fatty acids by incorporating walnuts, chia seeds, edamame, flaxseeds and seaweed. 

Can you combine aspects of both diets?

Yes! Many experts recommend a plant-forward Mediterranean approach — emphasizing fruits, vegetables, legumes, nuts, seeds, and whole grains while limiting animal products. You can adopt a mostly vegan diet and occasionally include fish or fermented dairy for added heart benefits.

Additional health benefits

Both diets offer more than just heart protection. There are indications that both diets can improve brain health. One study showed that people who adhere to one of these diets may see fewer signs of Alzheimer’s. In addition, both diets have been linked to improved blood sugar control, which can prevent diabetes and even reduce the risk of some forms of cancer. 

Monitoring your heart health and diet

No matter which diet you choose, it’s important to monitor your heart health. Talk to your doctor about:

• heart screenings, such as a calcium scan
• cholesterol, glucose, and blood pressure checks
• symptoms like chest pain, fatigue, or shortness of breath

Early detection and lifestyle changes can make a big difference in preventing heart disease.