**Background:** Plant-based (PB) foods have seen a 49% increase in sales in Europe from 2018 to 2020, driven by health, animal welfare, and environmental concerns. While PB diets are associated with favorable health outcomes, PB alternatives to meat and dairy can be ultra-processed and may differ substantially in nutritional quality from their animal-based (AB) counterparts. This study aimed to comprehensively characterize the nutritional composition, processing degree, and ecological impact of PB meat and dairy alternatives on the Spanish market compared to AB analogues.
**Methods:** Nutritional data were collected from Open Food Facts and supermarket websites between March and May 2022 (with additional PB beverage data collected in November 2022). After applying inclusion/exclusion criteria, 917 food items remained: 544 PB foods (313 milk alternatives, 134 meat alternatives, 64 pate alternatives, 21 cheese alternatives, 12 yoghurt alternatives) and 373 AB foods (204 milks, 121 meat products, 16 pate, 16 cheese, 16 yoghurt). Variables collected included energy, total fat, saturated fat, carbohydrates, sugars, protein, fiber, salt, ingredients, additives, and nutrition/health claims. Nutri-Score, NOVA (processing degree), and Eco-Score were assessed. Non-parametric tests (Kruskal-Wallis, Wilcoxon rank sum) were used for comparisons; p-values <0.05 were considered significant.
**Key Results:** PB milk alternatives had lower energy than whole milk (e.g., almond milk: 29 kcal/100mL; oat milk: 48 kcal/100mL; soy milk: 42 kcal/100mL vs. whole milk: 63 kcal/100mL, p<0.001) and lower saturated fat (0.2-0.3 g vs. 2.4 g in whole milk). However, PB milks had higher carbohydrate content (oat milk: 8.3 g/100mL vs. whole milk: 4.6 g/100mL, p<0.001) and sugars (oat milk: 5.5 g vs. whole milk: 4.6 g, p<0.001). Protein content varied widely among PB milks: soy milk (3.1 g/100mL) matched cow milk (~3.1 g), while almond milk (0.7 g) and oat milk (1.1 g) were significantly lower (p<0.001). Fiber was present only in PB milks (0.5-0.6 g/100mL).
PB meat alternatives (median 177 kcal/100g) had similar energy to chicken hamburgers (158 kcal) but lower than pork sausages (225 kcal). PB meat had significantly lower saturated fat (1.4 g/100g) than all AB meats (range 2.35-6.9 g, p<0.001) and contained fiber (4.0 g/100g) while AB meats had none. However, PB meat had higher carbohydrates (9.05 g vs. 1.0-2.5 g in AB meats, p<0.001). Protein content of PB meat (14 g/100g) was comparable to AB meats (13-16 g).
PB cheese alternatives had high energy (311 kcal/100g) and saturated fat (14 g/100g), similar to AB cheese (272 kcal, 12.5 g saturated fat). PB cheese had significantly lower protein (2 g vs. 17 g, p<0.001) and higher carbohydrates (19 g vs. 1.25 g, p<0.001) and salt (1.6 g vs. 1.06 g, p=0.03).
Regarding Nutri-Score, 93% of PB milk alternatives were classified A or B. Among other PB foods, ~60% were A or B, ~30% C, and ~10% D. However, NOVA classification revealed that 43.8% of PB milk alternatives and 22.4% of PB meat alternatives were ultra-processed (NOVA 4). Eco-Score was available for 85% of PB milk alternatives but rarely for other PB foods (>95% missing for meat and pate alternatives).
Common ingredients in PB meat alternatives included soy (72%), wheat (22%), and pea/chickpea flour (20%). PB cheese alternatives frequently contained coconut oil (52%) and starch (67%). Nutrition claims were present in a minority of products: calcium (34% of milk alternatives), protein (21% of PB foods), and fiber (16% of PB foods).
**Clinical Implications:** PB alternatives are not uniformly healthier than AB foods. While they offer advantages in fiber content and often lower saturated fat, many are ultra-processed and provide less protein. PB cheese alternatives are particularly concerning due to high saturated fat content. Consumers should be advised to read nutrition labels carefully, and policymakers should consider requiring processing-level information on labels alongside Nutri-Score. The study is limited by reliance on label data rather than chemical analysis, and by incomplete NOVA and Eco-Score data for many products.