With so many meat alternatives and plant-based burgers on the market, they are often the first stop on the road to eating a more plant-based diet. But as has been widely reported these meatless patties are often full of more ingredients and hard-to-pronounce additives than junk food. So, we want to know: Are plant-based burgers actually better for you? Or are they just another form of junk food? We cut to the chase and ask Dr. Kim Williams, Head of the Cardiology Department at Rush Medical Center in Chicago, and Past President of the American College of Cardiology: Meatless meat: Harmful or harmless? A good idea as an alternative to beef and pork, or a greater evil on your heart health? Are they okay as part of a "transition" diet to help you move away from meat and dairy? Or should you jump right into the whole food, plant-based approach and get your protein from legumes like chickpeas and other vegetable sources?

Elysabeth Alfano: There’s been lots of news about the Impossible Burger and Beyond Meat and whether or not they are healthy for you. Some vegan food is not very processed at all, like tempeh, which I love, and tofu which is processed to a small degree, and then we’ve got really processed foods, like plant-based burgers, and sausages.

When people exit a meat-based diet, they hop over from burger to plant-based burger: a like-for-like exchange. Tell me about that kind of transition diet. Do you recommend it? What kind of ratio do you like to see between processed foods and whole foods?

Dr. Kim Williams: The number [of plant-based processed foods] has increased from 1970 when there were only two or three to 2015 where they were four hundred fifty, and even more now.

EA: The increase in plant-based items stems from studies saying don’t eat red meat and the health effects of red meat.

DKW: And embedded in those studies are several themes. If I could break it down into four simple ones: It’s cholesterol. It is the presence of saturated fat and trans fats as well. There is TMAO, which is a four-letter word that everyone needs to know. And the last one is heme iron.

Okay, so let’s start with heme iron. Heme iron is the kind of iron that’s so easily absorbed that if you were a vampire and you drank a pint of blood, all that iron would get into your bloodstream and go into your bone marrow and help you make new red blood cells and make them really strong and everything. The problem is that iron is oxidized. Chemically sitting in the heme molecule, oxidized, and when that comes out it actually upsets plaques. It grows plaques and it upsets them and creates reactive oxygen species.

So, there was one study from the NIH and AARP saying that it’s heme iron and nitrates and nitrites that are killing all the Americans and causing this mortality. We put that in one bucket, don’t eat heme iron.

The next one is TMAO, trimethylamine oxide. It’s a four-letter word, again please look it up if you haven’t seen it. It is a toxic compound that is actually in fish already. It works as antifreeze for fish. But if you eat sources of choline, which is eggs, meat, cheese, animal products, choline gets into your GI system. And if you have certain bacteria, which are common in people who eat animal products and not so much in vegans, those bacteria will take those substrates and turn them into trimethylamine, which then your liver, at a rate determined by your genetics, will turn that trimethylamine into trimethylamine oxide, or TMAO.

TMAO does everything you don't want in your cardiovascular system. It actually creates plaque. It makes plaques rupture. It makes platelets, the sticky things you try to fight with aspirin when you have heart disease. It makes those platelets clump. And in fact, if you compare a person with a high TMAO level versus the one that doesn’t if you have a high TMAO level and you’re on aspirin you’re no better than a person who has a low TMAO level not taking aspirin. You’re in trouble, okay?

So, the funniest part about that is that people are trying probiotics or antibiotics, they’re trying to change their gut microbiome around to be healthier. Well, you could just not eat animal products such as meat, fish, and eggs, and your TMAO level would go down dramatically.

So, we’ve got heme iron and TMAO, those are the new ones. Plus, saturated fat and cholesterol. So when you look at the Beyond or these new meats, some of them are actually made with [plant] heme iron.

EA: Impossible Foods contains heme iron, which is what makes it taste so real

DKW: Yes, and that’s why it looks bloody and tastes bloody because it has heme. Now it’s a "phyto" or plant-based heme, meaning that it comes from a fungus and not from an animals. They have modified bacteria if I have the methodology correctly. So, I’m worried about the [plant] heme iron.

EA: Although it does come from another source, it’s a plant-based heme iron, not animal heme iron.

DKW: Right but does it still have oxidized iron? That’s the question. And obviously, there are no long-term studies of that because it’s relatively new. So, you have the heme iron concern. There should be no TMAO whatsoever from that. The next one would be the cholesterol, absolutely not.

Someone actually sent a note to me saying plants make cholesterol. Really? And I checked his reference, he was absolutely right. It was nanograms of it. That’s a billionth of a gram. So apparently if you eat enough plants you may by mistake make actual cholesterol. But for all intents and purposes, it’s certainly like creating zero milligrams.

But then you do have the saturated fat in these products. Some plant-based products have just as much saturated fat as a Big Mac or Whopper. And so, if you’re trying to avoid saturated fat, that’s probably not the thing that you’re looking to eat on a regular basis. The other concern that was brought up about the plant-based burgers is that they are high in sodium, but if you have 600mg of sodium and you don’t eat any the rest of the day you’re probably okay. So you have to decide what is your priority in choosing them.

In conclusion, a plant-based burger is not going to have TMAO or cholesterol, or animal heme, three factors that can most damage your health. It also isn’t going to have antibiotics or hormones like meat often contains.  A plant-based burger is going to be the same on saturated fat and protein and it will have significant sodium, but it will also have some fiber–and meat, of course, has no fiber.

It’s a lot to digest-literally and figuratively-but in moderation, the plant-based burgers at least don’t have the most destructive of all these elements, which are heme iron, cholesterol, and TMAO. Therefore they are better for you, although clearly not as good for you as a bowl of naked kale. So while you probably don’t want to have them every day, it is nice to know that this transitional food can get you over the hump from a meat-based diet to a whole foods plant-based diet and also be a solid option at parties and restaurants!

For the full interview, click here.

Elysabeth Alfano is a plant-based business consultant and helps people transition to a plant-based diet. Follow her @ElysabethAlfano on all platforms and at ElysabethAlfano.com