Are plant-based alternatives healthier? A two-dimensional evaluation from nutritional and processing standpoints.

BACKGROUND: Plant-Based Alternative Products (PBAPs) to meat and dairy are increasingly available. Their relative nutritional quality in comparison to animal-based homologs is poorly documented. OBJECTIVE: To characterize and evaluate the plant-based alternatives available on the market in Spain in comparison to animal products in terms of their nutritional composition and profile, and degree of processing. METHODS: Nutritional information for PBAPs and homologs were obtained from the Spanish 'Veggie base', branded food composition database. Five PBAPs categories (cheese, dairy products, eggs, meat, and fish, n = 922) were compared to animal-based processed (n = 922) and unprocessed (n = 381) homologs, using the modified version of the Food Standard Agency Nutrient Profiling System (FSAm-NPS score) and NOVA classification criteria. RESULTS: Compared to processed or unprocessed animal food, PBAPs contain significantly higher sugar, salt, and fiber. PBAPs for fish, seafood, and meat were lower in protein and saturated fatty acids. Overall, 68% of PBAPs, 43% of processed and 75% of unprocessed animal-homologs had Nutri-Score ratings of A or B (most healthy). About 17% of PBAPs, 35% of processed and 13% of unprocessed animal-based food were in Nutri-Score categories D or E (least healthy). Dairy, fish, and meat alternatives had lower FSAm-NPS scores (most healthy), while cheese alternatives scored higher (least healthy) than animal-based homologs. Unprocessed fish and meat were healthier than similar PBAPs based on FSAm-NPS criteria. Approximately 37% of PBAPs and 72% of processed animal-based products were ultra-processed food (NOVA group 4). Within the ultra-processed food group, Nutri-Score varied widely. CONCLUSIONS: Most PBAPs had better nutrient profile than animal-based homologs. However, cheese, fish and meats PBAPs had poorer nutrient profile and were more processed. Given the high degree of processing and variable nutritional profile, PBAPs require a multi-dimensional evaluation of their health impact.