Author: Christian Maino Vieytes, Doctoral Student, Division of Nutritional Sciences, University of Illinois at Urbana-Champaign
Lifestyle Medicine and Plant-based Diet
The field of lifestyle medicine has seen an explosion over the last decade. Along with it, we have seen a surge in the interest and pursuit of plant-based diets in popular culture. You may catch a former National Football League tight-end, Tony Gonzalez, touting the gains he has made using plant protein from pistachios in a recent television advertisement. Gonzalez, one of several NFL players to adopt a plant-based diet, has received considerable attention for his shift in dietary intake. Plant based-diets are based on the principle that one should minimize their consumption of animal-derived products. Advocates of the lifestyle point to a tripod of evidence and rationales for this way of living: i) the effects on human health, ii) the impact on the global environment, and iii) animal rights. Let’s explore the first two tenets a little further.
The benefits of a plant-based diet are well documented in the scientific body of literature. Compared to their omnivorous counterparts, vegans and vegetarians have substantially reduced rates of chronic illnesses such as heart disease, stroke, diabetes, and certain cancers (1,2). These trends have been observed in various populations over time, and the biological explanations for them are understood, owing to controlled laboratory experiments. Those getting the majority of their daily calories from plant-derived components are understood to have lower circulating levels of factors in the blood called ‘cytokines’, which are a measure of inflammation (think of inflammation as similar to a bruise) in the body (3,4). Many of the chronic illnesses that burden human beings are defined by high levels of cytokines—or high levels of inflammation—in the blood.
Additionally, there are several components in foods that protect against disease. Dietary fiber, which is not found in any animal-derived product but is abundant in the plant kingdom, has been associated with numerous health benefits, from preventing disease to weight loss (5–7). There are so many advantages to higher fiber consumption that scientists continue to find benefits in an ongoing fashion! Additional factors in plant-based foods include vitamins, minerals, and what nutrition scientists call ‘phytochemicals’—or plant-derived compounds. These are chemicals found exclusively in plants (that is where we get the ‘phyto’ prefix from) and provide a host of benefits to the human body’s cells and systems. The adage goes that you should aim to ‘eat the rainbow’ at every meal. Consuming plants with a profound and diverse set of colors is sure to provide you with a large dose of these components and augment your health.
We are rarely critical about where our food comes from. However, this is an important question. Many people fail to recognize the carbon footprint that their food choices leave behind. The decisions we make related to what we choose to put in our mouths three times a day have profound environmental consequences. A byproduct of our agricultural system is the inevitable pollution and habitat destruction that comes along with it (8). Diets that focus the primary bulk of the calories consumed on plant-based items are understood to provide a more sustainable solution (one of several solutions needed) to the climate crisis (9). The water footprint is also striking. It is now generally understood that minimizing the consumption of animal products can substantially reduce global water use (10,11). The water required to produce 1 kg of beef may be upwards of 20 times the amount needed to yield an equivalent 1 kg of whole grain (12).
Holism is at the center of why many choose to undertake a plant-based lifestyle. Some people may see themselves as not separate from their food or the planet or the source of their food. Similarly, the field of lifestyle medicine has adopted a similar framework. Lifestyle medicine’s core philosophy is guided by an embrace of the human body as a whole object and not just a collection of different parts (organs, limbs, etc.). The current medical system elevates the idea of medical specialization, where we see many doctors who deal with different organ systems and who help us solve distinct issues.
Moreover, the current medical system focuses, primarily on ‘tertiary prevention, meaning dealing with an ailment after it has developed. Though primary prevention (preventing disease or conditions before they arise) has become more popular in recent times, this is still far from the culture practiced in the United States (13). Lifestyle medicine’s aim is to put primary prevention and holism at the center of the patient care plan. Practitioners that specialize in this field work closely with patients on behavioral factors such as diet, exercise, alcohol and tobacco use, stress-relief, mind-body methods, and even spirituality (14).
The Take-Home Message
What you put on your plate three times a day is crucial. It is essential for your personal health, but the consequences extend to realms beyond ourselves and affect the rest of humanity. The goal should not be to eliminate the consumption of animal products entirely (unless, of course, you are ready and willing to!) but to minimize them in your diet. One will find that as you crowd your plate with more vegetables, whole grains, fruits, and legumes, it only becomes easier to eat more of those foods, and you will be helping your body prevent and fight illness as well as combat the devastating effects of climate change. Go eat some plants!
- Segovia-Siapco G, Sabaté J. Health and sustainability outcomes of vegetarian dietary patterns: a revisit of the EPIC-Oxford and the Adventist Health Study-2 cohorts. Eur J Clin Nutr. 2019 Jul;72(S1):60–70. https://pubmed.ncbi.nlm.nih.gov/30487555/
- Fraser GE. Associations between diet and cancer, ischemic heart disease, and all-cause mortality in non-Hispanic white California Seventh-day Adventists. Am J Clin Nutr. 1999 Sep 1;70(3):532s–8s. https://pubmed.ncbi.nlm.nih.gov/10479227/
- Shah B, Newman JD, Woolf K, Ganguzza L, Guo Y, Allen N, et al. Anti‐Inflammatory Effects of a Vegan Diet Versus the American Heart Association–Recommended Diet in Coronary Artery Disease Trial. J Am Heart Assoc [Internet]. 2018 Dec 4 [cited 2020 Nov 18];7(23). Available from: https://www.ahajournals.org/doi/10.1161/JAHA.118.011367 https://pubmed.ncbi.nlm.nih.gov/30571591/
- Sutliffe JT, Wilson LD, de Heer HD, Foster RL, Carnot MJ. C-reactive protein response to a vegan lifestyle intervention. Complement Ther Med. 2015 Feb;23(1):32–7.https://www.ahajournals.org/doi/10.1161/JAHA.118.011367
- Bradbury KE, Appleby PN, Key TJ. Fruit, vegetable, and fiber intake in relation to cancer risk: findings from the European Prospective Investigation into Cancer and Nutrition (EPIC). Am J Clin Nutr. 2014 Jul;100 Suppl 1:394S-8S. https://pubmed.ncbi.nlm.nih.gov/24920034/
- Katcher HI, Kunselman AR, Dmitrovic R, Demers LM, Gnatuk CL, Kris-Etherton PM, et al. Comparison of hormonal and metabolic markers after a high-fat, Western meal versus a low-fat, high-fiber meal in women with polycystic ovary syndrome. Fertil Steril. 2009 Apr;91(4):1175–82. https://pubmed.ncbi.nlm.nih.gov/18331737/
- Anderson JW, Baird P, Davis Jr RH, Ferreri S, Knudtson M, Koraym A, et al. Health benefits of dietary fiber. Nutr Rev. 2009 Apr;67(4):188–205. https://pubmed.ncbi.nlm.nih.gov/19335713/
- Marlow HJ, Hayes WK, Soret S, Carter RL, Schwab ER, Sabaté J. Diet and the environment: does what you eat matter? Am J Clin Nutr. 2009 May 1;89(5):1699S-1703S. https://pubmed.ncbi.nlm.nih.gov/19339399/
- Sabaté J, Soret S. Sustainability of plant-based diets: back to the future. Am J Clin Nutr. 2014 Jul 1;100(suppl_1):476S-482S. https://pubmed.ncbi.nlm.nih.gov/24898222/
- Harris F, Moss C, Joy EJM, Quinn R, Scheelbeek PFD, Dangour AD, et al. The Water Footprint of Diets: A Global Systematic Review and Meta-analysis. Adv Nutr. 2019 Sep 6;nmz091. https://europepmc.org/article/pmc/pmc7442390
- Vanham D, Mekonnen MM, Hoekstra AY. The water footprint of the EU for different diets. Ecol Indic. 2013 Sep;32:1–8. http://ayhoekstra.nl/pubs/Vanham-et-al-2013a.pdfhttp://ayhoekstra.nl/pubs/Vanham-et-al-2013a.pdf
- Weindl I, Bodirsky BL, Rolinski S, Biewald A, Lotze-Campen H, Müller C, et al. Livestock production and the water challenge of future food supply: Implications of agricultural management and dietary choices. Glob Environ Change. 2017 Nov;47:121–32. file:///C:/Users/12176/Downloads/MAgPIE_4_-_A_modular_open_source_framework_for_mod.pdf
- Bodai BI, Nakata TE, Wong WT, Clark DR, Lawenda S, Tsou C, et al. Lifestyle Medicine: A Brief Review of Its Dramatic Impact on Health and Survival. Perm J. 2018;22:17–025. https://pubmed.ncbi.nlm.nih.gov/29035175/
- Kushner RF, Sorensen KW. Lifestyle medicine: the future of chronic disease management. Curr Opin Endocrinol Diabetes Obes. 2013 Oct;20(5):389–95. https://pubmed.ncbi.nlm.nih.gov/23974765/