Nutritional update for physicians: plant-based diets

Philip J Tuso, Mohamed H Ismail, Benjamin P Ha, Carole Bartolotto, Philip J Tuso, Mohamed H Ismail, Benjamin P Ha, Carole Bartolotto

Abstract

The objective of this article is to present to physicians an update on plant-based diets. Concerns about the rising cost of health care are being voiced nationwide, even as unhealthy lifestyles are contributing to the spread of obesity, diabetes, and cardiovascular disease. For these reasons, physicians looking for cost-effective interventions to improve health outcomes are becoming more involved in helping their patients adopt healthier lifestyles. Healthy eating may be best achieved with a plant-based diet, which we define as a regimen that encourages whole, plant-based foods and discourages meats, dairy products, and eggs as well as all refined and processed foods. We present a case study as an example of the potential health benefits of such a diet. Research shows that plant-based diets are cost-effective, low-risk interventions that may lower body mass index, blood pressure, HbA1C, and cholesterol levels. They may also reduce the number of medications needed to treat chronic diseases and lower ischemic heart disease mortality rates. Physicians should consider recommending a plant-based diet to all their patients, especially those with high blood pressure, diabetes, cardiovascular disease, or obesity.

References

    1. HBO Documentary Films. Institute of Medicine of the National Academies. Centers for Disease Control and Prevention. National Institutes of Health. Michael and Susan Dell Foundation. Kaiser Permanente . The weight of the nation [documentary] New York, NY: Home Box Office, Inc; 2012. Available from: .
    1. Witters D. More than 15% obese in nearly all US metro areas [monograph on the Internet] Washington, DC: Gallup Wellbeing; 2012. Mar 7, [cited 2012 Oct 6]. Available from: .
    1. US Department of Health and Human Services . The surgeon general’s call to action to prevent and decrease overweight and obesity [monograph on the Internet] Rockville, MD: US Department of Health and Human Services, Public Health Service, Office of the Surgeon General; 2001. [cited 22 Jan 2013]. Available from: .
    1. Lea EJ, Crawford D, Worsley A. Public views of the benefits and barriers to the consumption of a plant-based diet. Eur J Clin Nutr. 2006 Jul;60(7):828–37. DOI: .
    1. [homepage on the Internet] Alexandria, VA: US Department of Agriculture, Center for Nutrition Policy and Promotion; [cited 2013 Jan 31]. Available from: .
    1. Ito H, Ishida H, Takeuchi Y, et al. Long-term effects of metformin on blood glucose control in non-obese patients with type 2 diabetes mellitus. Nutr Metab (Lond) 2010 Nov 12;7:83. DOI: .
    1. Sigal RJ, Kenny GP, Boulé NG, et al. Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: a randomized trial. Ann Intern Med. 2007 Sep 18;147(6):357–69.
    1. Blaney D, Diehl H. The optimal diet: the official CHIP cookbook. Hagerstown, MD: Autumn House Publishing; 2009. Jan 1,
    1. McDougall JA, McDougall M. The new McDougall cookbook: 300 delicious ultra-low-fat recipes. New York, NY: Plume; 1997. Jan 1, 1997.
    1. Ornish D, Brown SE, Scherwitz LW, et al. Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial. Lancet. 1990 Jul 21;336(8708):129–33. DOI: .
    1. Ornish D, Scherwitz LW, Billings JH, et al. Intensive lifestyle changes for reversal of coronary heart disease. JAMA. 1998 Dec 16;280(23):2001–7. DOI: .
    1. Esselstyn CB., Jr . Prevent and reverse heart disease: q & a with Caldwell B Esselstyn, Jr, MD [monograph on the Internet] Lyndhurst, OH: Prevent and Reverse Heart Disease; [cited 2012 Oct 6]. Available from: .
    1. Berkow SE, Barnard N. Vegetarian diets and weight status. Nutr Rev. 2006 Apr;64(4):175–88. DOI: .
    1. Farmer B, Larson BT, Fulgoni VL, 3rd, Rainville AJ, Liepa GU. A vegetarian dietary pattern as a nutrient-dense approach to weight management: an analysis of the national health and nutrition examination survey 1999–2004. J Am Diet Assoc. 2011 Jun;111(6):819–27. DOI: .
    1. Wang Y, Beydoun MA. Meat consumption is associated with obesity and central obesity among US adults. Int J Obes (Lond) 2009 Jun;33(6):621–8. DOI: .
    1. Rosell M, Appleby P, Spencer E, Key T. Weight gain over 5 years in 21,966 meat-eating, fish-eating, vegetarian, and vegan men and women in EPIC-Oxford. Int J Obes (Lond) 2006 Sep;30(9):1389–96. DOI: .
    1. Tonstad S, Butler T, Yan R, Fraser GE. Type of vegetarian diet, body weight, and prevalence of type 2 diabetes. Diabetes Care. 2009 May;32(5):791–6. DOI: .
    1. Sabaté J, Wien M. Vegetarian diets and childhood obesity prevention. Am J Clin Nutr. 2010 May;91(5):1525S–1529S. DOI: .
    1. Snowdon DA, Phillips RL. Does a vegetarian diet reduce the occurrence of diabetes? Am J Public Health. 1985 May;75(5):507–12. DOI: .
    1. Vang A, Singh PN, Lee JW, Haddad EH, Brinegar CH. Meats, processed meats, obesity, weight gain and occurrence of diabetes among adults: findings from Adventist Health Studies. Ann Nutr Metab. 2008;52(2):96–104. DOI: .
    1. Barnard ND, Cohen J, Jenkins DJ, et al. A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes. Diabetes Care. 2006 Aug;29(8):1777–83. DOI: .
    1. de Lorgeril M, Salen P, Martin JL, Monjaud I, Delaye J, Mamelle N. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation. 1999 Feb;99(6):779–85. DOI: .
    1. Key TJ, Fraser GE, Thorogood M, et al. Mortality in vegetarians and non-vegetarians: a collaborative analysis of 8300 deaths among 76,000 men and women in five prospective studies. Public Health Nutr. 1998 Mar;1(1):33–41. DOI: .
    1. Appleby PN, Thorogood M, McPherson K, Mann JI. Associations between plasma lipid concentrations and dietary, lifestyle and physical factors in the Oxford Vegetarian Study. J Hum Nutr Diet. 1995 Oct;8(5):305–14. DOI: .
    1. Fraser GE. Vegetarian diets: what do we know of their effects on common chronic diseases? Am J Clin Nutr. 2009;89(5):1607S–1612S. DOI: Erratum in: Am J Clin Nutr 2009 Jul;90(1):248. DOI: .
    1. Report of the Dietary Guidelines Advisory Committee on the dietary guidelines for Americans, 2010: to the Secretary of Agriculture and the Secretary of Health and Human Services. Washington, DC: Agriculture Research Service, US Department of Agriculture, US Department of Health and Human Services; 2010. May,
    1. Takahashi Y, Sasaki S, Okubo S, Hayashi M, Tsugane S. Blood pressure change in a free-living population-based dietary modification study in Japan. J Hypertens. 2006 Mar;24(3):451–8. DOI: .
    1. Singh PN, Sabaté J, Fraser GE. Does low meat consumption increase life expectancy in humans? Am J Clin Nutr. 2003 Sep;78(3 Suppl):526S–532S.
    1. Campbell TC, Campbell TM., II . The China study: the most comprehensive study of nutrition ever conducted and the startling implications for diet, weight loss and long-term health. Dallas, TX: BenBella Books; 2006. May 11,
    1. Sinha R, Cross AJ, Graubard BI, Leitzmann MF, Schatzkin A. Meat intake and mortality: a prospective study of over half a million people. Arch Intern Med. 2009 Mar 23;169(6):562–71. DOI: .
    1. Huang T, Yang B, Zheng J, Li G, Wahlqvist ML, Li D. Cardiovascular disease mortality and cancer incidence in vegetarians: a meta-analysis and systematic review. Ann Nutr Metab. 2012;60(4):233–40. DOI: .
    1. [web page on the Internet]. Soybeans, mature seeds, raw. New York, NY: Condé Nast; 2012. [cited 2012 Oct 6]. Available from: .
    1. Young VR, Pellett PL. Plant proteins in relation to human protein and amino acid nutrition. Am J Clin Nutr. 1994 May;59(5 Suppl):1203S–1212S.
    1. Pipe EA, Gobert CP, Capes SE, Darlington GA, Lampe JW, Duncan AM. Soy protein reduces serum LDL cholesterol and the LDL cholesterol: HDL cholesterol and apolipoprotein B: apolipoprotein A-I ratios in adults with type 2 diabetes. J Nutr. 2009 Sep;139(9):1700–6. DOI: .
    1. Koh WP, Wu AH, Wang R, et al. Gender-specific associations between soy and risk of hip fracture in the Singapore Chinese Health Study. Am J Epidemiol. 2009 Oct 1;170(7):901–9. DOI: .
    1. Shu XO, Zheng Y, Cai H, et al. Soy food intake and breast cancer survival. JAMA. 2009 Dec 9;302(22):2437–43. DOI: .
    1. Yan L, Spitznagel EL. Soy consumption and prostate cancer risk in men: a revisit of a meta-analysis. Am J Clin Nutr. 2009 Apr;89(4):1155–63. DOI: .
    1. Waldmann A, Koschizke JW, Leitzmann C, Hahn A. Dietary iron intake and iron status of German female vegans: results of the German vegan study. Ann Nutr Metab. 2004;48(2):103–8. DOI: .
    1. Craig WJ, Mangels AR, American Dietetic Association Position of the American Dietetic Association: vegetarian diets. J Am Diet Assoc. 2009 Jul;109(7):1266–82. DOI: .
    1. Donaldson MS. Metabolic vitamin B12 status 1on a mostly raw vegan diet with follow-up using tablets, nutritional yeast, or probiotic supplements. Ann Nutr Metab. 2000;44(5–6):229–34. DOI: .
    1. Dietary supplement fact sheet: vitamin B12 [monograph on the Internet] Bethesda, MD: National Institutes of Health, Office of Dietary Supplements; 2011. Jun 24, [cited 2013 Jan 31. Available from: .
    1. Appleby P, Roddam A, Allen N, Key T. Comparative fracture risk in vegetarians and non-vegetarians in EPIC-Oxford. Eur J Clin Nutr. 2007 Dec;61(12):1400–6. DOI: .
    1. Weaver CM, Plawecki KL. Dietary calcium: adequacy of a vegetarian diet. Am J Clin Nutr. 1994 May;59(5 Suppl):1238S–1241S.
    1. Dietary supplement fact sheet: vitamin D [monograph on the Internet] Bethesda, MD: National Institutes of Health, Office of Dietary Supplements; 2011. Jun 24, [cited 2013 Jan 31. Available from: .
    1. Rosell MS, Lloyd-Wright Z, Appleby PN, Sanders TA, Allen NE, Key TJ. Long-chain n-3 polyunsaturated fatty acids in plasma in British meat-eating, vegetarian, and vegan men. Am J Clin Nutr. 2005 Aug;82(2):327–34.
    1. Davis BC, Kris-Etherton PM. Achieving optimal essential fatty acid status in vegetarians: current knowledge and practical implications. Am J Clin Nutr. 2003 Sep;78(3 Suppl):640S–646S.

Source: PubMed

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