Covid-19 Research

Perspective

Double-Blind RCTs for Plant-Based Diets- When Science Misses the Point

Journal of Biomedical Research & Environmental Sciences article abstract with citation details, DOI, publication dates, subject areas, full text links, and references.

View DOI Submit Manuscript

Article Details

Publication record, authors, dates, abstract, and full text access.

Open Access
Article Type Perspective
Subject Medicine Group
OCLC JBRES Record
Dasaad Mulijono
Issue: Volume7-Issue4
Pages: 1-7
Received: 2025-12-26
Accepted: 2026-04-13
Published: 2026-04-14

Abstract

Randomised Controlled Trials (RCTs), particularly those utilising a Double-Blind (DBRCT) design, are the gold standard in medical research. However, applying this model to dietary interventions-especially Plant-Based Diets (PBDs)-poses considerable methodological and ethical challenges. The inability to blind participants, adherence variability, and the prolonged time horizon required to observe dietary effects render DBRCTs impractical for PBD research. Despite a growing body of evidence from observational studies, case series, and non-blinded interventional trials demonstrating the efficacy of PBDs in managing Coronary Heart Disease (CHD), widespread scepticism persists within the medical community. Criticisms often cite small sample sizes, observational designs, and perceived researcher bias, compounded by peer reviewers' resistance, industry influence, and systemic biases in scientific publishing.
Against this backdrop, the Cardiology Centre at Bethsaida Hospital, Tangerang, Indonesia, has pioneered the integration of PBDs into standard cardiovascular care since 2018, under the leadership of Prof. Dasaad Mulijono (DM). This initiative represents the first formal adoption of PBD in Indonesia's hospital setting. Over nearly six years, our clinical data show significant outcomes including hypertension reversal, Type 2 Diabetes (T2D) remission, LDL-C reduction without advanced lipid-lowering agents, sustainable weight loss, renal function improvement, enhanced heart failure parameters, regression of atherosclerosis, and a markedly low restenosis rate following Drug-Coated Balloon (DCB) angioplasty. These real-world results support the feasibility, scalability, and transformative potential of PBDs in reversing or stabilising chronic diseases, particularly in low- and middle-income country contexts where cost-effective, preventive strategies are urgently needed.
We argue for a more inclusive and context-sensitive approach to evaluating nutritional interventions-one that recognises the limitations of traditional RCT models and values the cumulative weight of diverse forms of clinical evidence. Bridging the gap between empirical success and academic acceptance is critical to expanding the role of plant-based nutrition in modern medicine.

FullText HTML FullText PDF DOI: 10.37871/jbres2290 Crossmark

Certificate of Publication

Certificate of Publication

Copyright

© 2026 Mulijono D. Distributed under Creative Commons CC-BY 4.0 Creative CommonsAttribution

How to cite this article

Mulijono D. Double-Blind RCTs for Plant-Based Diets- When Science Misses the Point. J Biomed Res Environ Sci. 2026 Apr 14; 7(4): 7. Doi: 10.37872/jbres2290

Subject area(s)

Nutrition

References

  1. Ornish D, Scherwitz LW, Billings JH, Brown SE, Gould KL, et al. Intensive lifestyle changes for reversal of coronary heart disease. JAMA. 1998 Dec 16;280(23):2001-2007. doi:10.1001/jama.280.23.2001. Erratum in: JAMA. 1999 Apr 21;281(15):1380. PMID:9863851.
  2. Esselstyn CB Jr, Gendy G, Doyle J, Golubic M, Roizen MF. A way to reverse CAD? J Fam Pract. 2014 Jul;63(7):356-364. PMID:25198208.
  3. Katz DL. Plant-based diets for reversing disease and saving the planet: past, present, and future. Adv Nutr. 2019 Nov 1;10(Suppl 4):S304-S307. doi:10.1093/advances/nmy124. PMID:31728489; PMCID:PMC6855967.
  4. Massera D, Zaman T, Farren GE, Ostfeld RJ. A whole-food plant-based diet reversed angina without medications or procedures. Case Rep Cardiol. 2015;2015:978906. doi:10.1155/2015/978906. PMID:25755896; PMCID:PMC4338379.
  5. Kerley CP. A review of plant-based diets to prevent and treat heart failure. Card Fail Rev. 2018 May;4(1):54-61. doi:10.15420/cfr.2018:1:1. PMID:29892479; PMCID:PMC5971679.
  6. Tuso P, Stoll SR, Li WW. A plant-based diet, atherogenesis, and coronary artery disease prevention. Perm J. 2015 Winter;19(1):62-67. doi:10.7812/TPP/14-036. PMID:25431999; PMCID:PMC4315380.
  7. Mehta P, Tawfeeq S, Padte S, Sunasra R, Desai H, et al. Plant-based diet and its effect on coronary artery disease: a narrative review. World J Clin Cases. 2023 Jul 16;11(20):4752-4762. doi:10.12998/wjcc.v11.i20.4752. PMID:37583985; PMCID:PMC10424050.
  8. Peña-Jorquera H, Cid-Jofré V, Landaeta-Díaz L, Petermann-Rocha F, Martorell M, et al. Plant-based nutrition: exploring health benefits for atherosclerosis, chronic diseases, and metabolic syndrome—a comprehensive review. Nutrients. 2023 Jul 21;15(14):3244. doi:10.3390/nu15143244. PMID:37513660; PMCID:PMC10386413.
  9. David S, Khandhar PB. Double-blind study. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan.
  10. Gholizadeh E, Ayremlou P, Nouri Saeidlou S. The association between dietary pattern and coronary artery disease: a case-control study. J Cardiovasc Thorac Res. 2020;12(4):294-302. doi:10.34172/jcvtr.2020.48. PMID:33510878; PMCID:PMC7828759.
  11. Salehin S, Rasmussen P, Mai S, Mushtaq M, Agarwal M, et al. Plant-based diet and its effect on cardiovascular disease. Int J Environ Res Public Health. 2023 Feb 14;20(4):3337. doi:10.3390/ijerph20043337. PMID:36834032; PMCID:PMC9963093.
  12. Fabbri A, Lai A, Grundy Q, Bero LA. The influence of industry sponsorship on the research agenda: a scoping review. Am J Public Health. 2018 Nov;108(11):e9-e16. doi:10.2105/AJPH.2018.304677. PMID:30252531; PMCID:PMC6187765.
  13. Storz MA. Is there a lack of support for whole-food, plant-based diets in the medical community? Perm J. 2019;23:18-068. doi:10.7812/TPP/18-068. PMID:30589405; PMCID:PMC6307547.
  14. Alcorta A, Porta A, Tárrega A, Alvarez MD, Vaquero MP. Foods for plant-based diets: challenges and innovations. Foods. 2021 Feb 1;10(2):293. doi:10.3390/foods10020293. PMID:33535684; PMCID:PMC7912826.
  15. Viroli G, Kalmpourtzidou A, Cena H. Exploring benefits and barriers of plant-based diets: health, environmental impact, food accessibility and acceptability. Nutrients. 2023 Nov 8;15(22):4723. doi:10.3390/nu15224723. PMID:38004117; PMCID:PMC10675717.
  16. Clark BE, Pope L, Belarmino EH. Personal bias in nutrition advice: a survey of health professionals' recommendations regarding dairy and plant-based dairy alternatives. PEC Innov. 2022;1:100005. doi:10.1016/j.pecinn.2021.100005.
  17. Espinosa R, Arpinon T, Maginot P, Demange S, Peureux F. Removing barriers to plant-based diets: assisting doctors with vegan patients. J Behav Exp Econ. 2024;109:102175. doi:10.1016/j.socec.2024.102175.
Publish with JBRES — Peer-reviewed, multidisciplinary Open Access with rapid review, DOI, and global visibility.
Double-Blind CrossRef DOI Discoverable
Submit Manuscript Membership