Sunday, August 25, 2013

Nutritional Update for Physicians: Plant-Based Diets

Nutritional Update for Physicians: Plant-Based Diets

This article contains a pretty good discussion of the differences between a whole foods plant-based diet (health-promoting) and vegan or vegetarian diets (not necessarily health-promoting).   The whole foods plant-based diet is defined by what it includes (whole plant foods, emphasizing vegetables, fruits, nuts, and seeds, plus B12 and sun exposure), whereas vegan diets are defined by what they exclude (animal products) with no restrictions on what they include within the plant realm and no specific attention to nutritional adequacy.  Thus a vegan diet can include refined oils, hydrogenated oils, large amounts of saturated fats (tropical), refined carbohydrates, and so on, and the vegan does not necessarily eat recommended levels of fruits, vegetables, nuts, or seeds, get sun exposure, take vitamin B12, have a reasonable essential fatty acid balance, or pay any attention to getting adequate intakes of energy or other essential nutrients.  The incorrect conflation of these two can lead one to confuse their health effects. 

While many vegans do eat whole foods plant-based diets to some extent, not all do, and the inclusion of the latter in data sets defined by exclusion (no animal products) can confound results of research.  Keeping this in mind, it remains remarkable that, as reviewed in this article, a significant number of studies have provided evidence that people eating vegan or plant-based diets have significantly reduced risks of obesity, diabetes, cardiovascular disease, hypertension, and overall mortality.

The article also leads off with a case study of an individual prescribed a plant-based diet, with a report of the positive health effects.

5 comments:

Charles Grashow said...

It appears that the 63 year old patient in question was NOT taken off stains. Your thoughts.

Also - what % of your food intake should be in fats (nuts, nut oils avocado, olives, olive oil, etc.)

Rex said...

It's good to see these kinds of articles being circulated...

A whole-foods, plant-based diet is certainly optimal for humans...However, this is not enough to ensure good health for the population at large. The recommendations must become more specific based on constitutional body type and symptoms, and flexible. In addition, it is my belief that Americans tend to respond better to maximum and minimum amounts than to gray terms such as "in moderation" or "small amounts" or "2-3 servings" which are too subjective to be clearly understood. In keeping with traditional Chinese medicine, WFPB diets should be composed of cooked foods, with a maximum of 1 ounce of nuts/seeds OR 1 tbsp of added unrefined oil or butter/ghee per day. Meat can be safely consumed in 2-3 ounce portions 2-4 meals a week. Cheese counts as a portion of meat. And so on. These kinds of limitations would really help clear ambiguity. In addition, there are still certain factions that need to tow the line IMHO: the raw community, high-fat low-carbers, fruitarians, the anti-grain community, the paleo people, those who refuse to adopt whole grains as their major source of calories because of fears of phytic acid and antinutrients, etc.

In short, WFPB is a good start, but simply improving the quality of the food is insufficient...People were eating a WFPB diet for millions of years and still suffered from a litany of health problems...Being truly happy and healthy requires more specific directives and a revival of traditional methods of diagnosis and treatments...much of that has been lost, but it's not completely gone...

Jack LaBear said...

Let me try this idea out on you Rex:
It is not possible to be truly happy and healthy no matter what you eat ;-)

Rex said...

Jack LaBear: lol

You may be right...and some people seem quite happy even though their diets are far from optimal...I admit that the link between diet and mood/cognition can be very "fuzzy." Having said that, I do think that a WFPB diet that is customized to one's physical constitution and needs will undoubtedly grant excellent physical health...it will also make lasting happiness more likely...In any case, I have found that all of this requires hard work and discipline...more than many people are willing to accept...

tomR said...

Don - there are plant-based diets (by volume and importance mostly plants), that don't exclude animal based products, but treat them as indispensible part of the package.

For example the latest one of these is a diet by Terri Wahls. Officially Called "Wahls Paleo" and "Paleo+".

Maybe the biggest strategical mistake for your group was to define "Vegetarian" as negative emotions towards consuming meat, rather than maximizing vegetables in the diet?