Research from the Cleveland Clinic has found that a plant-based diet could be more effective than even the American Heart Association’s recommended five-food-groups diet for reducing childhood heart disease.

The research, led by Cleveland Clinic pediatrician Michael Macknin, tested 28 obese children between the ages of 9 and 18 that had high cholesterol levels. For four weeks, 14 of the children ate the American Heart Association diet, while the other half ate a vegan, plant-based diet.

Children on the plant-based diet were found to have significantly lower weight, systolic blood pressure and total cholesterol numbers, and improved mid-arm circumference, body mass index and level of low-density lipoprotein (LDL) cholesterol. They also had lower levels of insulin and two heart disease markers, myeloperoxidase and high-sensitivity C-reactive protein—all indicating improvements in their cardiovascular health.

By comparison, children on the American Heart Association diet saw significantly lower weight, waist circumference, mid-arm circumference and myeloperoxidase levels, indicating enhanced immunity, but did not exhibit the other improvements.

“As the number of obese children with [unhealthy] high cholesterol continues to grow, we need to have effective lifestyle modifications to help them reverse their risk factors for heart disease,” says Macknin. “Cardiovascular disease begins in childhood. If we can see such significant improvements in a four-week study, imagine the potential for improving long-term health into adulthood if a whole population of children began to eat these diets regularly.”