Alexander Vonderschmidt

Plant-based dietary patterns are associated with improved cardiometabolic health, including lower concentrations of serum low-density lipoprotein cholesterol, blood pressure, adiposity, inflammation, and lower risk of cardiovascular disease. However, some studies report modestly reduced high-density lipoprotein (HDL) cholesterol concentrations in populations following plant-based diets (e.g., vegan or vegetarian), whereas other studies show null associations. This has created uncertainty about whether these changes in HDL cholesterol reflect clinically meaningful harm or a neutral physiologic response. This review examines the significance of lower HDL cholesterol in the context of plant-based diets and broader cardiometabolic risk. We describe plausible mechanistic pathways, including lower saturated fat and cholesterol intake, reduced apolipoprotein A-I secretion and HDL production, and formation of smaller HDL particles that are cleared more rapidly. We suggest that modest HDL cholesterol reductions observed with healthy and appropriately planned plant-based diets should be interpreted within the broader context of net cardiometabolic benefit rather than as an isolated reason for clinical concern. However, substantial heterogeneity across studies—in both results and methodology, including variation in the definitions of plant-based diets—limits causal directionality and interpretation of reported diet–disease associations. Future analyses should improve diet classification and comparator selection, while controlling for weight change and macronutrient composition to isolate any potential effects of plant-based diets on HDL-related outcomes.

Baker K, Vonderschmidt A. Interpreting lower HDL cholesterol in plant-based diets: mechanisms and clinical implications. Adv Nutr. 2026;17(9):100708. doi:10.1016/j.advnut.2026.100708

© 2026 · CC BY-NC-ND 4.0

Shifting diets away from high levels of meat and dairy is increasingly considered an important part of climate mitigation, yet the best pathways for achieving these reductions without compromising nutrition, health or affordability remain unclear. Here, in a representative sample of Scottish adults, we evaluate 33 pathways to meeting the UK Climate Change Committee’s recommendations to reduce meat and dairy consumption by 20% by 2030, increasing to a 35% reduction in meat by 2050. The pathways incorporate existing dietary guidance, and modelled outcomes include intakes of 54 nutrients, obesity, type 2 diabetes, cardiovascular disease, all-cause mortality, diet costs, greenhouse gas emissions, freshwater use, land use and eutrophication. Nearly all pathways were estimated to benefit most nutritional, health and environmental outcomes without increasing diet costs. Benefits were greater when reductions targeted high consumers of red meat and when meat and dairy were replaced gram for gram with foods such as vegetables, beans, eggs and plant-based dairy alternatives.

Kennedy J, Clark M, Stewart C, Runions R, Vonderschmidt A, Frank SM, Scarborough P, Comrie F, McDonald A, McNeill G, Alexander P, Jaacks LM. Reduced meat and dairy consumption improves health, environmental and most nutritional outcomes without increasing diet costs among Scottish adults. Nat Food. 2026;7(7):711-721. doi:10.1038/s43016-026-01384-3

© 2026 · CC BY 4.0

Background. Evidence suggests dietary shifts away from animal-sourced toward plant-based foods benefit health and the environment. Although the United Kingdom’s (UK) meat consumption has decreased, further efforts are required to meet national targets. Novel plant- and fungi-based foods (NPBFs) could offer a straightforward alternative to animal-sourced foods with a similar sensory experience. However, their impact on nutrition, the environment, and cost remains unclear.

Objectives. We aimed to identify trade-offs and co-benefits of substituting specific animal-sourced foods with NPBFs in a UK minimally accepted “basic basket” (baseline) stratified by gender.

Methods. Nine new baskets were created to assess the nutritional, environmental, and cost outcomes by substituting either all processed meats, milk, or yogurt with NPBFs (most popular, nutritionally balanced, inexpensive). Foods from the “basic basket” were matched with the UK food composition table. NPBF nutritional data were collected from UK supermarkets using Open Food Facts. All foods were matched with dietary environmental footprints (greenhouse gas emissions, water, and land use). Prices were manually collected from UK supermarkets.

Results. Dietary environmental footprints decreased in all new baskets (‒0.39% to ‒6.94%). Nutritional outcomes varied across new baskets, with most substitutions aligned with recommended weekly averages. Baskets with the most nutritionally balanced NPBFs showed minimal nutritional differences compared to the baseline. Notable micronutrient reductions occurred when replacing milk with the most inexpensive alternative. Nearly all dairy alternative substitutions lowered food basket costs, except for the most popular plant-based drink. All plant-based meats increased the cost.

Conclusions. When the nutritional quality of individual NPBFs is considered, single-targeted replacements of specific animal-sourced foods by NPBFs present a powerful opportunity for health and environmental benefits, especially over processed meats. Without policies to improve NPBFs’ affordability, such a shift at the population level is unlikely, missing an opportunity to drive progress toward net zero and health targets.

Nájera Espinosa S, Zarate-Ortiz AG, Hadida G, Tereza da Silva J, Vonderschmidt A, Esievo EM, Carr T, Reuzé A, Scheelbeek P. Novel plant and fungi-based alternatives support nutritional adequacy of diets and reduce their environmental impacts. Curr Dev Nutr. 2026;10(4):107669. doi:10.1016/j.cdnut.2026.107669

© 2026 · CC BY 4.0

• The children of women given high doses of vitamin D during pregnancy are less likely to develop wheeze (a whistling sound heard on exhalation, due to lower airway swelling, inflammation, or constriction) than children whose mothers did not take vitamin D in pregnancy.
• Vitamin D treatment in early childhood may have little effect on preventing asthma or wheeze, though we are uncertain of these results.
• We are very uncertain about the evidence for any unwanted effects of vitamin D treatment in pregnant or breastfeeding women or young children.

Patchen BK, Best CM, Boiteau J, Solvik BS, Vonderschmidt A, Xu J, Cohen RT, Cassano PA. Vitamin D supplementation in pregnant or breastfeeding women or young children for preventing asthma. Cochrane Database Syst Rev. 2025;(8):CD013396. doi:10.1002/14651858.CD013396.pub2

Plain language summary · © 2025 The Cochrane Collaboration

This Cochrane Review was published in the Cochrane Database of Systematic Reviews 2025, Issue 8. Cochrane Reviews are regularly updated as new evidence emerges and in response to feedback, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Cochrane Review.

In light of nationalist trends, disruptions to global food supply chains and efforts to concurrently promote sustainable diets, we assess national capacities to achieve dietary guidelines based on domestic production alone. Over a third of all countries cannot meet self-sufficiency for more than two of the seven essential food groups. Low self-sufficiency and overdependence on a few countries for imports threaten their capability to respond to global shocks, particularly for small states.

Stehl J, Vonderschmidt A, Vollmer S, Alexander P, Jaacks LM. Gap between national food production and food-based dietary guidance highlights lack of national self-sufficiency. Nat Food. 2025;6(6):571-576. doi:10.1038/s43016-025-01173-4

© 2025 · CC BY 4.0

Reducing meat consumption can help improve environmental and health outcomes, yet the effect of specific meat-reducing strategies is context dependent. Here, using decomposition analysis of National Diet and Nutrition Survey data (2008–2009 to 2018–2019), we found that in the United Kingdom, reduced meat portions had the largest impact on total meat consumption decline (52%), followed by fewer meat-eating days (24%), fewer meat consumers (17%) and fewer meat-eating meal occasions (7%). Understanding meat consumption behaviour patterns is key for more effective policies.

Vonderschmidt A, Jaacks LM, Alexander P, Green R, Bellows AL, Stewart C. Smaller meat portions contribute the most to reducing meat consumption in the United Kingdom. Nat Food. 2024;5(12):982-987. doi:10.1038/s43016-024-01070-2

© 2024 · CC BY 4.0

The foods we eat in Scotland contribute to greenhouse gas (GHG) emissions. Different foods have different GHG emissions, and therefore dietary transitions can play a role in meeting net zero emission targets. The Climate Change Committee’s Scottish progress review in December 2022 included a call to change Scottish diets.

This report examines current evidence on dietary patterns and their associated emissions to establish a baseline understanding of the climate impact of food consumed in Scotland.

Jaacks L, Frank S, Vonderschmidt A, Stewart C, Runions R, Kennedy J, McNeill G, Alexander P. Understanding the Climate Impact of Food Consumed in Scotland. ClimateXChange; 2024. doi:10.7488/era/4343

Executive summary, p. 1 · © 2024 The University of Edinburgh · Noncommercial reuse

Dairy, especially cheese, is associated with high levels of greenhouse gas emissions. Accurate estimates of dairy consumption are therefore important for monitoring dietary transition targets. Previous studies found that disaggregating the meat out of composite foods significantly impacts estimates of meat consumption. Our objective was to determine whether disaggregating the dairy out of composite foods impacts estimates of dairy consumption in Scotland. Approximately 32% of foods in the UK Nutrient Databank contain some dairy. In the 2021 Scottish Health Survey, mean daily intakes of dairy with and without disaggregation of composite foods were 238.6 and 218.4 g, respectively. This translates into an 8% underestimation of dairy consumption when not accounting for dairy in composite foods. In particular, milk was underestimated by 7% and cheese and butter by 50%, whereas yogurt was overestimated by 15% and cream by 79%. Failing to disaggregate dairy from composite foods may underestimate dairy consumption.

Jaacks LM, Amoutzopoulos B, Runions R, Vonderschmidt A, McNeill G, Comrie F, McDonald A, Page P, Stewart C. Disaggregation of dairy in composite foods in the United Kingdom. Curr Dev Nutr. 2024;8(8):103774. doi:10.1016/j.cdnut.2024.103774

© 2024 · CC BY 4.0

Overall, this research provides further evidence of poor diet in Scotland and additional justification for work to improve dietary intakes in general. Most people should be able to get the micronutrients they need by consuming a healthy, balanced diet as depicted by the Eatwell Guide. However, the majority of the population in Scotland do not have a diet similar to the Eatwell Guide, and meat and dairy are therefore relatively more important in the diet as an important source of nutrients. The modelling demonstrated that the 20% reduction in all meat can be achieved by cutting intakes of high consumers of red and red processed meat only to 60g, which would help ensure that insufficiencies in intake do not become more widespread in the population. The research has also shown that it is possible to mitigate the negative impact of a shift away from meat and dairy on nutrient intakes, with careful consideration of replacements.

Comrie F, Jaacks L, Kennedy J, McDonald A, McNeill G, Runions R, Stewart C, Vonderschmidt A. Approaches to Modelling Impact of Reduction in Meat and Dairy Consumption on Nutrient Intakes and Disease Risk. Food Standards Scotland; 2024. Accessed September 18, 2026. https://www.foodstandards.gov.scot/science-and-evidence/modelling-the-impact-of-reductions-in-meat-and-dairy-consumption-on-nutrient-intakes-and-disease-risk

Conclusions, p. 124 · © Crown copyright. Contains public sector information licensed under the Open Government Licence v3.0.

Overall, the FBS is a crucial dataset that has been used internationally to inform research and policy. In some cases, these data are the only dietary information available for countries and are often used as a proxy for consumption.¹¹ For researchers using the FBS to investigate dietary trends or for modelling purposes, transparency of the methods used to calculate FBS indicators is essential. Users of the FBS need to be aware of the potential inconsistencies created by the change in methodology. Unadjusted aggregation of data from before and after 2014 can and has skewed food supply trends, for example inverting the trends.¹⁰ We argue that these issues should be more widely reported and understood to avoid inaccurate conclusions being drawn from research using these data, with the potential to lead to incorrect policy advice and decisions.

Vonderschmidt A, Arendarczyk B, Jaacks LM, Bellows AL, Alexander P. Analysis combining the multiple FAO food balance sheet datasets needs careful treatment. Lancet Planet Health. 2024;8(2):e69-e71. doi:10.1016/S2542-5196(23)00276-0

Excerpt, p. e70 · © 2024 · CC BY 4.0