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The ABCs of a Whole-Food,Plant-Based Diet Reshma Shah, MD, MPH

Updated: Nov 14, 2019

Nutrition information these days can be overwhelming, if not downright confusing. Every expert seems to offer a different opinion. One day they proclaim that cholesterol is bad for our health and the next, there is a decree that “butter is back.” With conflicting headlines like these, it’s easy to understand why we are all so confused in answering the simple question of what should I eat? The broader question, though, is what way of eating optimizes health? A diet that priortizes health should be nutritionally adequate, meeting our macro- and micro-nutrient needs, while at the same time reducing the risk of diet-associated disease. There are lots of “diets” out there, ranging from vegetarian, vegan and raw, to South Beach, Atkins and Paleo. A vast amount of research overwhelmingly suggests that a whole-food, plant-based (WFPB) diet is the path to optimal health and well-being, not only for ourselves but our world.

The simplest definition of a WFPB diet is that it aims to maximize the consumption of nutrient-dense plant foods while minimizing processed foods, oils and animal foods. It encourages a lot of vegetables, fruits, beans, lentils, soybeans, seeds and nuts, and is generally low in fat.

Some people also refer to a WFPB diet as a vegan diet, but the two aren’t necessarily the same. If you eat a WFPB diet that is completely devoid of animal foods such as meat, fish, poultry, eggs and dairy, then you are also following a vegan diet. However, if you eat a vegan diet, again devoid of all animal-based products, you may not be following a WFPB diet. For instance, an Oreo cookie would be considered a vegan food because it is entirely devoid of animal products, but it would NOT be considered WFPB because it is heavily processed.

In terms of optimizing health, the term WFPB may be preferable to the term vegan, because it encompasses the foods to be included vs. focusing solely on the foods to be excluded. 

Personally, the journey towards adopting a plant-based diet has been slow going for me. It began, not in medical school or residency training as one might think, but as I began having children. I started paying more attention. I started becoming more curious. I started learning. I started making different choices. I decided to learn more about nutrition, and this growing awareness followed me into my patient exam rooms, and the way I spoke to families about food, nutrition and health also began to shift. This kind of shift can seem overwhelming and daunting, and so I aim to promote progress over perfection.

Simply deciding to lean in towards plants is a great first step. Transitioning to a plant-based lifestyle is a long-term solution that is health-promoting, sustainable and humane.


Health benefits of the WFPB diet: A vast amount of research has been conducted, from impressive cohort studies to randomized trials, supporting the extensive health benefits of a WFPB diet. Most of the leading causes of death in the U.S. are preventable and related to what we eat.

The number one cause of death in the United States for both men and women is heart disease. The standard American diet, which is full of saturated fat, processed foods and refined grains, is associated with an increased risk of heart disease. The best way to avoid heart disease when it comes to our diets is to prevent atherosclerosis by limiting the amount of saturated and trans fats as well as cholesterol in our diet and maximizing fiber: more plants and fewer animal-based foods.

In general, vegans and vegetarians have lower rates of heart disease. Switching to a plant-based diet has been proven to be an effective diet for patients already suffering from heart disease. 

The number two cause of death in the United States is cancer, and more than 1500 people die in the US each day from cancer. Many studies have elaborated on the protective role of a vegetarian or vegan diet in the risk of cancer development. Just last year, the World Health Organization (WHO) published a report that classified red meat as a probable carcinogen (in the same category as DDT and glyphosate) and processed meats as carcinogenic (in the same category as tobacco and asbestos). Additionally, in one of the largest epidemiological studies on cancer, close to 70,000 people were followed to examine the link between dietary patterns and cancer incidence. The findings revealed that vegan diets confer the lowest overall risk of cancer. Another major disease that affects a growing number of Americans and which is increasing in prevalence in developing countries is diabetes. It is a leading cause of blindness and the number one cause of kidney failure. Having diabetes doubles your risk of heart disease and stroke. The rates of diabetes in the U.S. are climbing quickly, and it is projected that by the year 2050, one out of every three Americans will have diabetes. The good news is that the WFPB diet (either vegetarian or vegan) can be hepful in treating Type 2 diabetes and can also be useful in preventing its occurrence in the first place. There are many more health benefits to following a WFPB diet, including lower rates of obesity and lower blood pressure. Research suggests a WFPB diet also plays a beneficial role in preventing a variety of inflammatory diseases, depression, Parkinson’s and Alzheimer’s disease. Stay tuned to learn more about additional advantages of the WFPB diet—to add to the myriad benefits I've already discussed—in my next posts.


Resources

Barnard ND, Cohen J, Jenkins DJ, et al. "A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial." The American Journal of Clinical Nutrition. 2009;89(5):1588S-1596S. www.ncbi.nlm.nih.gov/pubmed/19339401

Centers for Disease Control and Prevention: www.cdc.gov/

Esselstyn CB Jr, Gendy G, Doyle J, Golubic M, Roizen MF. "A way to reverse CAD?" The Journal of Family Practice. 2014 Jul;63(7):356-364b. www.ncbi.nlm.nih.gov/pubmed/25198208

Orlich, Michael J, and Gary E Fraser. “Vegetarian Diets in the Adventist Health Study 2: A Review of Initial Published Findings.” The American Journal of Clinical Nutrition. 100.1 (2014): 353S–358S. www.ncbi.nlm.nih.gov/pmc/articles/PMC4144107/

Ornish, Dean et al. "Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial." Lancet. 1990 Jul 21;336(8708):129-33. www.ncbi.nlm.nih.gov/pubmed/1973470

Satija, Amika et al. "Healthful and Unhealthful Plant-Based Diets and the Risk of Coronary Heart Disease in U.S. Adults." Journal of the American College of Cardiology, Volume 70, Issue 4, July 2017 www.onlinejacc.org/content/70/4/411?download=true&sso=1&sso_redirect_count=3&access_token=

Tonstad S. "Vegetarian diets and incidence of diabetes in the Adventist Health Study-2." Nutrition, metabolism, and cardiovascular diseases: 2013;23(4):292-299. www.nmcd-journal.com/article/S0939-4753(11)00170-0/fulltext

World Health Organization, IARC Monographs Evaluate Consumption of Red Meat and Processed Meat: www.iarc.fr/en/media-centre/pr/2015/pdfs/pr240_E.pdf

Physician's Committee for Responsible Medicine: www.pcrm.org


Reshma Shah, MD, MPH

Dr. Reshma Shah is a board-certified pediatric physician. She obtained her undergraduate and graduate degrees from Johns Hopkins University and her medical degree from Drexel University College of Medicine. She has more than a decade of experience in primary care pediatrics and has served as an assistant clinical professor at a Rainbow Babies and Children's Hospital, a leading children's hospital in Cleveland, Ohio. She currently cares for patients at Santa Clara Valley Medical Center and is an affiliate clinical instructor at Stanford University School of Medicine. In addition to clinical practice, Reshma has a strong interest in family health and wellness, with a focus on plant-based nutrition. She completed a certification program in Plant-Based Nutrition through the T. Colin Campbell Center for Nutrition Studies and eCornell as well as a Professional Plant-Based Nutrition Cooking certification through Rouxbe Cooking School. In her spare time, Reshma enjoys yoga, traveling with her family, and of course, cooking!


www.thefamily-table.com/ facebook.com/The-Family-Table Instagram @reshmashah


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