Ultra-processed plant-based food substitutes: nutritional, metabolic, and health risks associated with replacing animal-derived foods

Plant-based substitutes (PBS) represent a rapidly expanding market segment intended to replace animal-derived products. Although these products are frequently marketed as healthier alternatives, many are classified as ultra-processed foods, and evidence regarding their long-term health implications remains limited. This thesis contends that ultra-processed PBS often provide only partial nutritional replacement and may pose health risks, depending on the foods they replace. The thesis assesses the nutritional composition of ultra-processed PBS compared with animal-derived foods and evaluates both metabolic and non-metabolic health risks associated with their consumption. The evidence indicates that PBS frequently contain higher sodium levels, lower protein quality, and reduced bioavailability of key micronutrients compared to animal-derived counterparts. These compositional limitations are associated with adverse metabolic outcomes, including impaired glycemic control, increased cardiovascular risk, and chronic low-grade inflammation, which are partly mediated by industrial additives that alter the composition of the gut microbiota. Critically, the health impact of substitution depends on context: replacing red meat may confer selective cardiovascular benefits, yet the elevated sodium and industrial additives may offset these gains in certain populations. Consumer perception is further complicated by "health halo" effects, which may disproportionately influence lower-income populations and obscure distinctions between whole-food dietary patterns and engineered substitutes. This thesis highlights the importance of distinguishing between minimally processed plant foods and ultra-processed PBS when evaluating the health implications of plant-based diets. It also underscores the need for standardized classification systems for ultra-processing and for further long-term research to better understand the health effects of these products.