GradedHealth

Does a vegan diet lower cholesterol and help you lose weight?

Trials find vegan diets cut weight by about 2.5-4 kg and LDL cholesterol by 0.2-0.3 mmol/L versus a usual diet, with a smaller edge over other healthy diets.

Published October 2026

Short answer

Yes, modestly. In trials lasting 12 weeks or more, vegan diets lowered weight by roughly 2.5-4 kg and LDL cholesterol by about 0.2-0.3 mmol/L more than a usual diet - mainly in people with overweight or type 2 diabetes. Evidence grade B (Moderate). Meta-analyses of randomised trials consistently find about 2.5-4 kg more weight loss and 0.2-0.3 mmol/L lower LDL than a usual diet; downgraded for small, unblinded trials with funding ties (weight) and because LDL is a blood marker rather than heart disease (cholesterol).

Key takeaways

  • In pooled randomised trials, vegan diets lowered body weight by about 2.5 to 4 kg more than a usual diet, with the clearest results in people who have overweight or type 2 diabetes [1][2].
  • LDL ('bad') cholesterol fell by about 0.2 to 0.3 mmol/L versus an omnivorous diet, and total cholesterol by a similar amount [3][4].
  • Against another healthy diet the extra benefit is smaller: Cochrane found little or no cholesterol difference against other prescribed diets, and a 2-year trial found no extra weight loss versus a low-fat omnivorous diet [4][5].
  • No vegan trial has measured heart attacks or strokes, and observational studies link vegan diets to a higher rate of hip fracture, so bone health and nutrients such as vitamin B12, calcium, vitamin D and iodine need attention [4][6][7].

The short version

The short answer is yes, but modestly: in randomised trials, going vegan lowered body weight by about 2.5 to 4 kg and LDL ("bad") cholesterol by about 0.2 to 0.3 mmol/L more than a usual diet, with the clearest evidence in adults who have overweight or type 2 diabetes [1][3][2]. The advantage is smaller against another healthy diet, and a vegan diet needs planning: unsupplemented vegans tend to run low on vitamin B12 and iodine, and observational studies link vegan diets to a higher rate of hip fracture [4][7][6].

What the studies show

What was tested. A vegan diet contains no meat, fish, eggs, dairy or honey [4]. The versions tested were built on vegetables, fruit, whole grains, pulses, nuts and seeds [8], from low-fat vegan diets [9] to a vegan take on the Mediterranean diet [10].

Weight. A 2022 meta-analysis pooled 11 randomised trials of vegan diets lasting at least 12 weeks in 796 adults with overweight or type 2 diabetes: body weight fell 4.1 kg more than in the control groups and BMI 1.38 kg/m2 more [1]. A 2023 umbrella review of meta-analyses put the general-population difference at 2.52 kg across 8 trials, rated moderate certainty [2], and a 2016 meta-analysis of 12 trials (1,151 people) found 2.02 kg more weight loss with vegetarian diets overall and 2.52 kg in its vegan subgroup [11]. Trials of vegetarian diets in people with or at high risk of heart disease found 3.4 kg more weight loss across 20 trials and 1,878 people [12]. The largest single vegan trial followed 244 adults with overweight for 16 weeks: the low-fat vegan group lost 5.9 kg while the group asked to make no diet changes lost none [9]. Among 22 pairs of identical twins, the twin on the vegan diet lost 1.9 kg more than the twin on a healthy omnivorous diet over 8 weeks [13].

Cholesterol. A 2023 meta-analysis of 30 randomised trials found vegetarian and vegan diets lowered total cholesterol by 0.34 mmol/L and LDL cholesterol by 0.30 mmol/L (about 12 mg/dL) compared with an omnivorous diet, with similar effects across age, continent, health status and study duration [3]. In people with overweight or type 2 diabetes, LDL fell by 0.24 mmol/L [1]. Cochrane's 2021 review of vegan diets found total cholesterol 0.24 mmol/L and LDL 0.22 mmol/L lower than no or minimal intervention, rated moderate certainty, and the umbrella review found apolipoprotein B, another blood fat, lower across 7 trials [4][2]. In the twin study, LDL fell 13.9 mg/dL more in the vegan twins [13].

Blood sugar and blood pressure. In people with type 2 diabetes, vegetarian and vegan diets lowered HbA1c - a marker of average blood sugar over recent weeks - by about 0.2 to 0.4 percentage points across four meta-analyses, with one rating the evidence moderate [14][15][12][1]. Blood pressure is less convincing: Cochrane and a 2024 review found no clear effect [4][16], while two older meta-analyses found small falls of roughly 1 to 3 mmHg, larger in people whose systolic pressure started at 130 mmHg or above [17][18].

Against other diets. Cochrane found little or no cholesterol difference when a vegan diet was compared with another prescribed diet [4], and a 2-year trial in 159 African American adults found the same weight and cholesterol changes on a vegan diet and a low-fat omnivorous "soul food" diet [5]. One 16-week crossover trial in 62 adults went the other way: the vegan diet produced 6.0 kg more weight loss and 15.3 mg/dL more LDL reduction than a Mediterranean diet, though blood pressure fell more on the Mediterranean diet [19].

Heart disease. No vegan trial has measured heart attacks, strokes or deaths [4]. Prospective cohorts that followed 844,175 people link vegetarian diets to about 15% lower risk of cardiovascular disease and 21% lower risk of ischaemic heart disease; the vegan-specific estimate for ischaemic heart disease was 18% lower, but its confidence interval just included no difference [20].

The nuances

Most of the evidence comes from adults with overweight, type 2 diabetes or high heart risk, and from supported programmes - classes, follow-up and sometimes delivered meals - rather than from simply deciding to eat vegan [1][12][5][13]. The trials were small and unblinded, and several had funding ties, including one vegan meta-analysis whose authors worked for or held shares in food and drug companies [1].

Two things the diet does not fix on its own are vitamin B12 and bone health [7][6]. First, vitamin B12: compared with omnivores, vegans in a meta-analysis of 17 studies had lower blood B12 and higher homocysteine, a marker of deficiency, and supplements improved every marker measured [7]. A review of 141 studies found vegans had the lowest intakes of vitamin B12, calcium and iodine [8], and in one study a third of vegans had iodine excretion below the WHO threshold for severe deficiency [21]. Second, bones: pooling four cohorts of 529,672 people, vegans had a 75% higher rate of hip fracture than meat-eaters, although the evidence was rated very low certainty [6], and an earlier analysis of 20 studies found lower bone density in vegans and vegetarians [22]. In the trials read here, side effects were absent or minor [4].

For contrast, the plant-free carnivore diet sits at the opposite extreme and has no randomised trials behind it [23].

What this means for you

If you eat a typical omnivorous diet and your goal is weight or LDL cholesterol, the trials suggest a planned vegan diet can shift both, modestly, over 12 weeks to 2 years [1][3]. If you already eat a healthy diet such as a Mediterranean-style one, the extra benefit may be small or absent, and blood pressure may favour the Mediterranean pattern [4][5][19].

Whatever version you choose, plan the nutrients that vegan diets typically under-supply - vitamin B12 supplements or fortified foods, calcium, vitamin D and iodine - and keep bone health in mind, especially in pregnancy, breastfeeding and childhood [24][7][6]. People taking diabetes medication should talk to their doctor first, because blood sugar can fall enough that doses need review [14]. The full picture is on the vegan diet topic page.

Go deeper

  • Vegan Diet — Going vegan helped adults lose weight - about 2.5 to 4 kg more than a usual diet in randomised trials - and lowered LDL cholesterol by about 0.2 to 0.3 mmol/L,…
  • Mediterranean Diet — Eating a Mediterranean-style diet - built on olive oil, nuts, fish, vegetables, legumes and whole grains - reduced heart attacks and strokes in large randomise…
  • Carnivore Diet — Small, uncontrolled studies suggest some people lose weight and improve their blood sugar on an all-meat, plant-free diet, at least in the short term.
  • Nuts — Nuts lower LDL cholesterol a little in trials and, in trials lasting more than three weeks, do not appear to cause weight gain.

References

  1. Effects of vegan diets on cardiometabolic health: A systematic review and meta-analysis of randomized controlled trials.. Obes Rev, 2022.
  2. Evidence of a vegan diet for health benefits and risks - an umbrella review of meta-analyses of observational and clinical studies.. Crit Rev Food Sci Nutr, 2023.
  3. Vegetarian or vegan diets and blood lipids: a meta-analysis of randomized trials.. Eur Heart J, 2023.
  4. Vegan dietary pattern for the primary and secondary prevention of cardiovascular diseases.. Cochrane Database Syst Rev, 2021.
  5. Effect of a Plant-Based vs Omnivorous Soul Food Diet on Weight and Lipid Levels Among African American Adults: A Randomized Clinical Trial.. JAMA Netw Open, 2023.
  6. Vegetarian and Vegan Diets and the Risk of Hip Fracture in Adults: A Systematic Review and Meta-analysis.. Nutr Rev, 2026.
  7. A systematic review and meta-analysis of functional vitamin B12 status among adult vegans.. Nutr Bull, 2024.
  8. Nutrient Intake and Status in Adults Consuming Plant-Based Diets Compared to Meat-Eaters: A Systematic Review.. Nutrients, 2021.
  9. Effect of a Low-Fat Vegan Diet on Body Weight, Insulin Sensitivity, Postprandial Metabolism, and Intramyocellular and Hepatocellular Lipid Levels in Overweight Adults: A Randomized Clinical Trial.. JAMA Netw Open, 2020.
  10. Vegan versus traditional Mediterranean diet effects on cardiometabolic outcomes in women with fibromyalgia:FIBROVEG study.. Nutrition, 2026.
  11. Vegetarian Diets and Weight Reduction: a Meta-Analysis of Randomized Controlled Trials.. J Gen Intern Med, 2016.
  12. Vegetarian Dietary Patterns and Cardiometabolic Risk in People With or at High Risk of Cardiovascular Disease: A Systematic Review and Meta-analysis.. JAMA Netw Open, 2023.
  13. Cardiometabolic Effects of Omnivorous vs Vegan Diets in Identical Twins: A Randomized Clinical Trial.. JAMA Netw Open, 2023.
  14. Vegetarian and Vegan Dietary Patterns to Treat Adult Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.. Adv Nutr, 2024.
  15. Effects of Vegetarian or Vegan Diets on Glycemic and Cardiometabolic Health in Type 2 Diabetes: A Systematic Review and Meta-analysis.. Nutr Rev, 2025.
  16. Effects of vegetarian diets on blood lipids, blood glucose, and blood pressure: a systematic review and meta-analysis.. Food Funct, 2024.
  17. Effects of Vegetarian Diets on Blood Pressure Lowering: A Systematic Review with Meta-Analysis and Trial Sequential Analysis.. Nutrients, 2020.
  18. The Effect of Vegan Diets on Blood Pressure in Adults: A Meta-Analysis of Randomized Controlled Trials.. Am J Med, 2019.
  19. A Mediterranean Diet and Low-Fat Vegan Diet to Improve Body Weight and Cardiometabolic Risk Factors: A Randomized, Cross-over Trial.. J Am Nutr Assoc, 2022.
  20. Vegetarian and vegan diets and the risk of cardiovascular disease, ischemic heart disease and stroke: a systematic review and meta-analysis of prospective cohort studies.. Eur J Nutr, 2023.
  21. Vitamin and Mineral Status in a Vegan Diet.. Dtsch Arztebl Int, 2020.
  22. Veganism, vegetarianism, bone mineral density, and fracture risk: a systematic review and meta-analysis.. Nutr Rev, 2019.
  23. Carnivore Diet: A Scoping Review of the Current Evidence, Potential Benefits and Risks.. Nutrients, 2026.
  24. Vegan nutrition: a preliminary guide for health professionals.. Crit Rev Food Sci Nutr, 2024.