The “Eat by Color” Approach to Increase Fruit and Vegetable Intake

I mentioned on the podcast that among the six areas of focus in lifestyle medicine, nutrition is the first step towards lifestyle change. I have written an article about nutrition, particularly a whole-food, plant-based diet. In that article, I mentioned how to start and eat the colors of the rainbow.

In this article, I will discuss the food items that represent the colors of the rainbow and its benefits. This way, you will have an idea on your food choices and would be most likely to choose functional foods. Functional foods are dietary components that provide health benefits beyond basic nutrients.

Health Benefits

We have been taught since we were kids to eat fruits and vegetables because these foods contain not only vitamins and minerals but also phytonutrients. Phytonutrients are bioactive plant-derived compounds associated with positive health effects. Phytonutrients are pleiotropic, meaning they do have multiple effects on our cells’ structure and function. And because of this, phytonutrients are helpful in preventing chronic diseases.

Not only that, anti-inflammatory plant compounds like polyphenols and other phytochemicals help offset toxicity from pollutants.

Also, a study among 12,285 Australian adults showed an increased intake of fruits and vegetables had a favorable impact on their psychological well-being. Another study in New Zealand showed that those who ate more fruits and vegetables for more than thirteen consecutive days flourished in their daily lives with high levels of well-being, intense feelings of curiosity and creativity compared with adults who ate less fruits and vegetables.

And there are numerous studies that showed intake of fruits and vegetables is associated with reducing chronic disease risk. One of them is a study which introduced the term “phytochemical index” in 2004. Phytochemical index is the percent of dietary calories from foods rich in phytochemicals. A high phytochemical index shows favorable effects on preventing weight gain, along with improved lipid levels, and lowered risk of hypertension and breast cancer.

Low Phytonutrient Intake

However, even though we know that eating fruits and vegetables is a part of a healthy diet, people continue to have a low intake of these nutrients below the recommended dietary allowance called “phytonutrient gap”.

To visualize this phytonutrient gap, a study showed that eight out of ten Americans fall short of the recommended daily allowance for each color of phytonutrients especially the purple/blue foods. Another study showed that only nine percent of American adults met the recommended daily allowance for vegetables and only twelve percent met the recommended daily allowance for fruits.

The “Eat by Color” Approach to Increase Fruit and Vegetable Intake

Although eating recommended quantities of fruits and vegetables continues to be a challenge among most people, it is much easier to adopt a qualitative color approach rather than a quantitative serving approach.

The concept of eating by colors of the rainbow seems to be an effective strategy for people in improving their diet. It can also be implemented across all ages.

For easy reference and memory, each color is associated with some general related health benefits. Each color corresponds to foods, phytonutrient content, and benefits which were determined based on research publications.

Red Foods and Inflammation

Red foods are high in phytonutrients such as astaxanthin, lycopene, ascorbic acid (vitamin C), fisetin, and other classes of anthocyanins which exhibit anti-inflammatory properties and immune-modulating activities. Examples of red foods are cherries, tomatoes, red bell pepper, watermelon, grapefruit, apples, pomegranate, strawberries, cranberries, and raspberries.

Orange Foods and Reproductive Health

Orange foods share common properties with the red ones with respect to their antioxidant properties. The main difference is the carotenoids associated with orange such as beta-carotene and beta-cryptoxanthin. These carotenoids exhibit endocrine-regulating activities and have a role in fertility.

Also, a 3-year study in more than a thousand men and women showed that greater intake of dietary carotenoids in orange foods was associated with reduced risk of insulin resistance.

Examples of orange foods are carrots, pumpkin, sweet potatoes, squash, and cantaloupe.

Yellow Foods and Digestion

Yellow foods contain bioflavonoids that benefit the gastrointestinal tract and digestion. Various soluble, insoluble, and prebiotic fibers found in these foods impede the release of simple carbohydrates into the bloodstream thereby lowering the glycemic index. These foods may also provide the raw materials required as an energy substrate to be used by the gut microbiome.

Examples of yellow foods are ginger, mangoes, pineapples, bananas, and citrus fruits like lemons.

Green Foods and Cardiovascular Health

Green foods contain vitamin K, folate, magnesium, potassium, and naturally occurring nitrates and folates that benefit our cardiovascular health. Green leafy vegetables are also abundant in polyphenols which may differentially affect cardiometabolic risk factors. Leafy greens (such as spinach, watercress, celery, chervil, lettuce, and rocket) and cruciferous vegetables (such as cauliflower, broccoli, and kale) are just examples of green foods. Research shows that cardiovascular disease risk could be reduced by 15.8% with “almost everyday” consumption of green leafy vegetables.

Blue-Purple Foods and Cognition

Blue-purple foods contain polyphenols, flavonoids, procyanidins, flavonols, and phenolic acids that assist with learning, cognition, memory, and mood. Flavonoids contribute to the maintenance of proper brain function and blood flow. Blueberries, blackberries, red grapes, red wine, and purple yams are just examples of blue-purple foods.

Other Colors

Although this article advocates to eat the colors of the rainbow, it doesn’t mean that we disregard other colors like brown and white. In fact, there are healthy brown and white foods available around us.

Brown Foods

Brown foods contain potassium, fiber, beta-glucans, lignans, and epigallocatechin gallate which may reduce the risk of coronary heart disease and some types of cancer and maintain a healthy digestive tract. Examples of brown foods are whole wheat breads, cereals, bran, oats, barley and rye.

White Foods

White foods contain glucosinolates, polyphenols, protein, fiber, B vitamins, potassium and iron. Glucosinolates provide protection against cancer. Polyphenols play an important role in managing inflammation. Examples of white foods are turnips, jicama, garlic, onion, and white beans.

Practical Ways to Get More Colorful Fruits and Vegetables

Counting colors rather than servings or calories may be more effective to engage in long-term lifestyle change. You could track your “eating by color” by creating check boxes each time you fulfill a daily requirement.

As mentioned in my previous article, one way to start a whole-food, plant-based diet is to build a meal around salads. Try incorporating each color in a salad and see if this works for you. Also, why not try adding one new fruit or vegetable every week to expand your choices?

Another way to promote higher intake of fruits and vegetables is to eat more meals at home rather than eat out. Although there are vegan, vegetarian, or farm-to-table restaurants in cities, most of them are rare in other areas. Not only will you adhere more to a whole-food plant-based diet eating at home, you will also be sure that your food is safely prepared.

Conclusion

Eating fruits and vegetables has numerous benefits. However, most people continue to consume less fruits and vegetables than what is recommended. That is why it is important to encourage more people to eat more of these foods. One way to do this is to associate each color with health benefits, rather than counting calories or any index. This way, people would not only remember and could relate easily to the health properties of fruits and vegetables but also sample a variety of foods in the process.

So the next time you pick any one of the fruits and vegetables, remember that it is not only bursting with color and flavor, but also contains phytonutrients that improve your health.

If you are not yet ready to go 100% on a whole-food plant-based diet or if you are interested to start, feel free to schedule a consultation. I will help and work with you to make changes at whatever pace you are comfortable with. There is a health program that might suit your needs. Or if you want to hear from me talk about Lifestyle Medicine, feel free to listen to the podcast or reach out by using the contact form below.

Source:

Minich, Deanna M. 2019. “A Review of the Science of Colorful, Plant-Based Food and Practical Strategies for ‘Eating the Rainbow.’” Journal of Nutrition and Metabolism 2019 (no data): 1–19.

Understanding Sleep in Lifestyle Medicine

Overview

Ever since I re-launched this website, I started discussing Lifestyle Medicine as a medical discipline and started the six areas of focus with nutrition. Each area of focus is important in itself and these should go along with the others. So enumerating them does not mean that is the order or a pattern to be followed. The next area of focus of Lifestyle Medicine I am going to share today is about sleep.

Isn’t it funny that although everyone sleeps, it is difficult for us to define precisely what sleep is? Try asking people randomly what sleep means to them and you will get different answers. Yet, and this is a reality, sleep is a human activity that almost everyone takes for granted.

Sleep Health and World Sleep Day

Last month, World Sleep Day® was celebrated. Yes, there is such a thing. It is held every Friday before Spring Vernal Equinox each year. For this year, it was held last March 19th. This annual event is intended to be a celebration of sleep and at the same time, create a call to action on important issues related to sleep which includes medicine, education, productivity, driving, and other social aspects of human life.

It goes to show that Sleep Health is being recognized as a component of Lifestyle Medicine. Sleep Health or sleep medicine is relatively new in the field of Lifestyle Medicine that scientific studies and related literature on sleep health are limited. Be that as it may, this article is going to provide you an overview of the key issues associated with sleeping habits and how to incorporate this knowledge into your own lifestyle for better health.

Definition of Sleep

Sleep is a body and mind activity which is natural, recurring, and reversible. It is characterized by altered consciousness, decreased responsiveness to external stimuli, inhibited senses, reduced muscular activity, reduced interactions with surroundings, rapid eye movement, and dreams. It is associated with a typical posture of lying down with eyes closed. Scientists say that during sleep there are brain wave activity changes, as well as changes in the rate of breathing, heart rate, body temperature and other physiological functions. Also, sleep is relatively easy to reverse which distinguishes it apart from coma and other disorders of consciousness.

The Anatomy and Physiology of Sleep

For many centuries, physicians used to believe that sleep was a period of physical and mental inactivity only to realize over the last 60 years that the brain remains active during sleep. In fact, several brain structures are involved in sleep.

The brain’s hypothalamus contains nerve cells that control sleep and waking up. Within the hypothalamus is the suprachiasmatic nucleus (SCN) that receives information about light exposure directly from the eyes and controls your behavioral rhythm. The brain stem (includes the pons, medulla, and midbrain) communicates with the hypothalamus to control the transitions between wake and sleep. A brain chemical called GABA is produced in the hypothalamus and the brain stem. It reduces the activity of arousal centers. The pons and medulla send signals to the limbs and other body muscles to relax so that you don’t involuntarily act out your dreams while sleeping. The thalamus which relays information from the senses to the cerebral cortex becomes quiet, letting you tune out the external world. During REM sleep, the thalamus sends the cerebral cortex images, sounds, and other sensations which make your dreams come alive. The amygdala becomes active during REM sleep because it processes the emotions. The pineal gland receives signals from the suprachiasmatic nucleus (SCN) which increases the production of melatonin, a hormone that puts you to sleep once it gets dark. The basal forebrain promotes sleep and wakefulness, while a part of the midbrain acts as an arousal system. Release of adenosine, a chemical by-product of cellular energy consumption supports your sleep drive.

There are two basic types of sleep: the non-REM sleep and the rapid eye movement (REM) sleep.

The first stage of sleep is a non-REM sleep that changes over from your wakefulness then it slows down to your sleep. This lasts for only several minutes, thus it is short. It is characterized by a relatively light sleep. Your heartbeat, breathing, and eye movements are slow. Your skeletal muscles start to relax with occasional twitches. Your brain waves begin to slow down, too.

The second stage of sleep is also a non-REM sleep which is a period of light sleep before entering the deeper sleep. Your heartbeat and breathing are slow, your body cools down, your skeletal muscles relax even further, and your eye movements stop. Your brain wave activity slows down but with brief bursts of electrical activity. Most of your sleep cycles happen at this stage more than in any other stages.

The third stage of sleep is a non-REM sleep characterized by a period of deep sleep that you need to feel refreshed in the morning. It occurs during the first half of the night and has a longer period. Your heartbeat and breathing are slow at their lowest levels during sleep. Your skeletal muscles are relaxed. This is the stage where it would be difficult to wake you up. Your brain waves become even slower.

REM sleep occurs within the first 90 minutes after you fall asleep. Your eyes move rapidly from side to side behind closed eyelids. Your brain wave activities seem closer to that of your wakefulness. Your breathing becomes faster and irregular, and your heartbeat and blood pressure increase to near waking levels because most of your dreaming occurs at this stage. The arm and leg muscles become temporarily paralyzed preventing you from acting out your dreams.

Process C and Process S

There are two body mechanisms that work together to regulate your sleep: the Circadian regulation (Process C) and homeostatic control (Process S). Although there are other factors affecting your sleep, understanding these two processes will help you strive towards a consistent sleep schedule.

Process C refers to your internal clock, regulated by the suprachiasmatic nucleus (SCN) of the hypothalamus. This clock regulates and controls your 24-hour sleep-wake cycle via the influence of light and melatonin. In the absence of light, as during the evening, melatonin is produced by your body promoting sleep but in the presence of light, your production of melatonin ceases, signaling your brain that it is daytime and you need to wake up. However, your behavior can override these natural signals. For example, bright lights at night shut down your production of melatonin, delaying your sleep until late hours of the night.

Process S promotes your sleep based on the previous amount of time that you spent awake. During wakefulness your brain accumulates substances that promote sleep, when you sleep these substances are cleared up and you feel alert again. This process is particularly important when you take naps in the afternoon, because you deplete the sleep promoting substances and you are not able to fall asleep at a reasonable time in the evening. The best sleep is when you synchronize your sleep/wake times to your internal clock and find a perfect equilibrium between your Process C and Process S.

Why Do We Sleep?

There are numerous theories on why you sleep and no theory will ever be proven correct. However, sleep may be explained by two or more of these theories. By understanding why you sleep, you will learn to respect sleep as a body function and enjoy its benefits rather than taking it for granted.

Inactivity Theory

Also known as the Adaptive or Evolutionary Theory, this suggests that inactivity at night is an adaptation and means to survive especially when you would be vulnerable.

Energy Conservation Theory

According to this theory, sleep reduces your demand for energy and your energy expenditure during the day especially at times when you are not in search of food. This is because your body temperature and caloric demand decreases while sleeping. Studies show that energy metabolism goes down by 10 percent during sleep. This supports the opinion that sleep helps organisms conserve their energies.

Restorative Theory

This theory is based on the belief that sleep restores what your body has lost while you are awake. It provides a time for your body to repair and rejuvenate. There are findings that show muscle growth, tissue repair, protein synthesis, and growth hormone release happen during sleep.

Brain Plasticity Theory

This theory is based on findings that sleep is correlated to changes in the structure and organization of the brain known as brain plasticity. Its connection to sleep has critical roles especially in the brain development among infants and young children and with adults as well. This is seen in the effect sleep deprivation on learning and performance of various activities.

While these theories do not directly answer the question why you sleep, it does set the stage for putting sleep in a new context and generating new knowledge about this essential body activity.

How much sleep do we need?

Some people prefer going to bed early while others have a preference for staying up late. But as mentioned earlier, children need to get more sleep which is essential for proper growth and development. As you age, sleep influences your immune system, memory, attention, hunger, mood, response time, and many other body functions.

The CDC has recommended the number of hours of sleep for every age group. Refer to the image below:

Although individual sleep needs and patterns may vary, most adults usually need seven to nine hours of sleep. If you feel refreshed and energized upon waking up, you are getting enough sleep. But if you’re not, you probably feel sleepy, tired, sluggish, clumsy, forgetful, and even cranky.

The Sleep-Work-Life Balance Challenge

You have twenty-four hours in a day and one-third of that is allotted for sleep and the other two-thirds are for your activities during wakefulness. That two-thirds of a day is still divided into your working hours (mainly, your job) and your time for other activities of daily living (family, personal time, exercise, meals, commute, etc.).

But have you reflected on how you spend your twenty-four hours? Some of you may say no probably because you are too focused on your priorities like your job, or your family’s needs. A few of you would say yes because it has been your habit to track down what you’re doing.

Here is a challenge for you: For one week, try to take note of how many hours of sleep, work, and other activities of daily living you spend in a day. At the end of the week, count the number of hours you spent on sleep. If you get less than fifty hours of sleep in a week, reflect if you felt tired or sluggish most of your waking hours. Most likely you will answer yes and unaware that you already show signs of sleep deprivation.

Here is an example from a journal that shows the sleep-work-life balance:

Impact of Lifestyle and Technology Developments on Sleep

You are living in modern times, and that means you are too busy to sleep. It is increasingly difficult for you to sleep with so many things vying for your attention.

Screens

You might be spending many hours in front of your television set everyday. Americans spend more than four hours on average watching TV. That is more than three hundred hours a year spent staring at a bright television screen.

Social Media

Your social media keeps you from getting sleep because you are glued to your smartphones texting, chatting, or engaging on your different social media accounts even on bed.

Work

You value their work that there are times you bring home some of it. Now, you are probably working from home. Both setups affect your sleeping routines. Not only that, the concept of 24/7 company work shifts, or even working on a different time zone affects your sleep and can cause a sleep disorder called shift work sleep disorder.

Travel

Jet lag is characterized by difficulty of falling asleep during or after a flight, disrupted sleep, and loss of appetite. Although your friends may tag you as a jet-setter, the negative effects on your health is not “cool”.

Smoking

You already know that smoking is bad for your health. But smoking also affects sleep. A study shows that smokers sleep less and the quality of their sleep is lower as compared to non-smokers.

Substance Abuse

Some of you might take alcohol or medications just to get some sleep. Others take drugs so as not to fall asleep. These substances affect your sleeping routines severely and also lower the quality of the sleep over time.

Chronic Diseases and Sleep Deprivation

Sleep deprivation is a cumulative effect of not obtaining adequate sleep. It adversely affects the body, brain, mood and cognitive functions and impacts all aspects of health. Excessive daytime sleepiness, fatigue, clumsiness, and weight gain or loss are just several signs of sleep deprivation

Sleep deprivation can also increase your risk of vehicular accidents because lack of sleep can slow down your reaction time and decreased alertness. Also, when you don’t get enough sleep, your ability to fight infection may decrease.

We’ve been saying that chronic diseases are becoming top causes of death and illnesses. And I’ve been advocating that Lifestyle Medicine can reverse these chronic diseases. One of the areas of focus in Lifestyle Medicine is sleep. Therefore, there should be an interest in the role of sleep health in the management of chronic diseases. As per the National Heart, Lung and Blood Institute, insufficient sleep has been linked to the development and management of type 2 diabetes, cardiovascular disease, obesity, and depression.

Diabetes

Studies show that people who habitually slept for only a few hours are not able to process glucose. It seems that sleep duration and sleep quality could be predictors of Hemoglobin A1c levels, an important marker of blood sugar control. This could mean that they are most likely to develop type 2 diabetes. Therefore, it is suggested to optimize your sleep duration and quality in order to improve your blood sugar.

Cardiovascular Disease

Persons with sleep apnea, a sleep disorder, have an increased risk for a number of cardiovascular diseases like hypertension, stroke, coronary heart disease and irregular heartbeats. Also, sleep apnea and atherosclerosis share some characteristics suggesting that sleep apnea may be an indicator of cardiovascular disease.

Obesity

Research shows that obesity is linked to metabolic changes during a short sleep. Studies conducted also revealed an association between short sleep duration and excess body weight particularly in children. Sleep in childhood and adolescence is important for brain development and insufficient sleep among children may adversely affect the function of the hypothalamus which regulates appetite and food energy expenditure.

Depression

There is a complex relationship between sleep and depression. While sleep deprivation has been held as a sign of depression, recent research indicates that symptoms may decrease once sufficient sleep is restored. The study further suggests that it is important to assess the sleep sufficiency of persons with depression and to monitor symptoms of depression among persons with a sleep disorder.

Lifestyle Medicine’s Focus on Sleep

Lifestyle Medicine encourages a systematic approach to lifestyle issues including nutrition, exercise, and stress management. It also emphasizes heightened sensitivity to environmental factors in general and sleep health.

However, conventional medicine’s approach to sleep disorders falls short because they encourage reliance on sedative-hypnotics. This has taught us much about the biomedical view of sleep but it has forgotten the sleeper.

Lifestyle Medicine reduces this reliance on sedatives by (1) restoring our regard for you, the sleeper; (2) significantly expanding the range of effective interventions; and (3) reframing sleep health as a lifestyle issue.

Personalization begins by complementing standard evaluation procedures with an invitation to tell your personal “sleep stories.” Lifestyle Medicine emphasizes the importance of the doctor-patient partnership in healing. It also acknowledges your natural inclination to heal. Lifestyle Medicine has the wide range of evidence-based interventions available for sleep health in terms of sleep aids, relaxation practices, and alternative medical systems. Utilizing these interventions can help address overreliance on prescription and over-the-counter sleep medications. In recent years, practices that have long been staples of Lifestyle Medicine, such as yoga, mindfulness meditation, and breathing exercises, are finding acceptance in more mainstream medicine.

Tips to a Better Sleep

If you are having problems sleeping, here are a few tips:

1. Establish a regular bedtime and waking time. If you need to set an alarm, that’s fine, just don’t snooze.

2. Do not exceed 45 minutes of nap or daytime sleep. If you do, you may not be able to follow your established bedtime.

3. Do not smoke and do not drink excessive alcohol four hours before bedtime.

4. No coffee, tea, soda, or chocolate six hours before bedtime.

5. You are allowed to take a light healthy snack before bedtime but avoid eating heavy, creamy, spicy, or sugary foods four hours before bedtime.

6. If you think exercise will put you to sleep, you’re wrong. You are encouraged to exercise regularly but not before bedtime.

7. It also helps to have a short tepid or warm shower before bedtime.

8. Use a comfortable bed and keep your room well-ventilated. Your bed is for sleeping and should not be used for work. If you’re working at home in the bedroom, make sure that your workstation is away from the bed.

9. Turn off the lights and block out the noise.

Conclusion

Sleep Health is relatively new just as Lifestyle Medicine. Sleep, which is a natural body activity, should never be taken for granted because insufficient sleep could lead to sleep disorders and impact chronic diseases.

If you are having problems with your sleep, feel free to schedule a consultation. I will help and work with you to make changes at whatever pace you are comfortable with. There is a health program that might suit your needs. If you want to hear from me discuss more about Lifestyle Medicine, feel free to listen to my podcast. If you want to be updated with news and features from this website, subscribe to my newsletter or reach out using the contact forms below.

Sources:

American Sleep Association. 2017. “Sleep Deprivation: Symptoms, Causes, Treatments.” American Sleep Association. May 12, 2017.

Centers for Disease Control and Prevention. 2019a. “How Much Sleep Do I Need?” Centers for Disease Control and Prevention. 2019.

———. 2019b. “Sleep and Chronic Disease.” Centers for Disease Control and Prevention. 2019.

DePietro, MaryAnn. n.d. “Why Is Sleep Important?” American Sleep Association. Accessed March 29, 2021.

Division of Sleep Medicine. 2019. “The Characteristics of Sleep.” Healthy Sleep. Harvard Medical School. 2019.

———. n.d. “Why Do We Sleep, Anyway?” Healthy Sleep. Division of Sleep Medicine at Harvard Medical School. Accessed April 8, 2021.

Levy Andersen, Monica, and Sergio Tufik. 2015. “Sleep and the Modern Society.” Journal of Sleep Disorders & Therapy Volume 4 (Issue 5): 131.

Naiman, Rubin. 2015. “Integrative Medicine Approaches to Insomnia.” Sleep Review. Medqor. August 17, 2015.

National Heart, Lung and Blood Institute. 2018. “Sleep Deprivation and Deficiency | National Heart, Lung, and Blood Institute (NHLBI).” Nih.gov. November 5, 2018.

Office of Communications and Public Liaison. 2019. “Brain Basics: Understanding Sleep.” National Institute of Neurological Disorders and Stroke. National Institutes of Health. 2019.

World Sleep Society. n.d. “World Sleep Day.” World Sleep Day. World Sleep Society. Accessed March 29, 2021. https://worldsleepday.org/.

Why Lifestyle Medicine Advocates Whole-Food Plant-Based Diet

Overview

One of the areas of focus on Lifestyle Medicine is nutrition. When you hear the word “nutrition”, isn't it that the first thing that enters your mind is food because it nourishes you?

Food is a vital part of our culture and traditions. We celebrate birthdays, anniversaries, weddings, and other festivities with food. Daily, we socially connect over food like having a cup of tea with a friend or telling a story to your family while having dinner. Thus, for us, food represents so many things. Yet, how ironic that the food that is supposed to nourish us is becoming one of the factors that could kill us.

This article will explain why it is so and why Lifestyle Medicine advocates a whole-food plant-based diet.

Food

As mentioned earlier, food is something that nourishes and sustains us. If we read the Bible, God has given instructions on what and what not to eat. Over the course of history, man learned to use heat (it could mean fire and/or spices), salt, sugar, and fat in food. Also, man learned how to preserve foods to make it last a little longer.

However, as the world becomes industrialized and modern, so do our methods of food preparation and preservation. Mechanical processes of food packaging became fast and food manufacturing became a booming business. What used to take hours to prepare and to cook could be served in an instant. What used to be served hot on a plate could now be bought frozen to be microwaved for a few seconds just before serving.

The government, on the other hand, promoted food groups (from the Go, Grow, and Glow foods, to the Food Pyramid, up to the My Plate food groups) to encourage every household to be conscious of food and nutrition.

Then enter advertising and promotions, the most powerful influencer of all time. Through advertising people could make choices on what food to buy or eat and where to buy it from. Yet, almost 70% of Americans are either overweight or obese and majority of the causes of death are lifestyle-related.

A lot of people are gaining weight because of the meals they are choosing to eat. The gourmet recipes that are often demonstrated by chefs on television contain high amounts of fat, sugar, and salt. We don’t really get a lot of representation on media of foods that are much healthier to us. As a result, what we’re seeing on media has been influenced by the companies wanting to make profits and sell their products rather than what foods that we need to eat.

This is rather a challenging issue.

Forks Over Knives

For those who haven’t read about my story, I used to be overweight, had diabetes, gastric bloating, and sinus allergy. My husband, who is also a physician, had gouty arthritis, asthma, high cholesterol, diabetes, hypertension, sleep apnea, and obesity.

One evening in August 2017, we just had dinner. I finished tidying up the kitchen and proceeded to our home office to watch this Filipino TV series that I've been following for some time. After a few minutes, I stood up to go and get something from the kitchen and passed by my husband who was sitting at our formal dining table and watching what I thought was a movie. I stopped and asked him what he was watching.

"Forks over Knives," he said. "I think you'll like this one because it talks about food and healthy eating which reverse chronic disease.”

It intrigued me, especially when I saw Dr. Michael Greger in that documentary. I attended Dr. Greger's two-hour presentation, bought his book "How Not to Die," but I didn't actually read it. I sat beside my husband and together watched the documentary.

Forks Over Knives became a light bulb that switched us on into a different attitude towards food. At first, we had many doubts. We never heard about this in medical school or in our medical training. But after so many years of making serious changes to our diet and practicing everything we know in medicine, we felt nothing helped. So what is there to lose if we try switching to the whole-food plant-based diet?

Whole-Food Plant-Based Diet

The definition of what constitutes a whole-food, plant-based diet is vague. It is not necessarily a set diet like what most popular diets are but it is more of a lifestyle.

In September 2018, the American College of Lifestyle Medicine (ACLM) issued an official position statement on the role of diet in Lifestyle Medicine. They recommend on eating a predominantly plant-based food such as vegetables, fruits, whole grains, legumes, nuts and seeds for the treatment, reversal and prevention of lifestyle-related chronic disease. For chronic lifestyle-related diseases the best treatment is intensive lifestyle change which could restore health and wholeness.

Based on the ACLM’s recommendation, the whole-food, plant-based (WFPB) diet follows these basic principles:

• WFPB diet focuses on vegetables, fruits, whole grains, legumes, seeds, and nuts. These should make up the majority of what you eat rather than having them as secondary ingredients or garnishes.

• WFPB diet emphasizes whole, minimally-processed foods. For example, choose a food item made from whole potatoes rather than made from potato flour. Or prefer freshly-squeezed orange juice rather than the one you bought from the store.

• WFPB diet limits or avoids animal products like dairy, eggs, and honey. Your head may be shaking but you'll see later why.

• WFPB diet excludes refined foods like added sugars, white flour, and processed oils.

• WFPB diet pays attention to food quality. As much as possible, food should be locally sourced and organic whenever possible.

Because plant-based diets vary depending on the amount of animal products are present in their diet, the WFPB diet is often confused with vegan or vegetarian diets. Although similar in some ways, these diets are not the same.

Vegetarian diets exclude all meat and poultry from their diets, but some vegetarians may eat eggs, seafood or dairy. Vegan diets abstain not just from meat and poultry but also from any animal products, including dairy, seafood, eggs and honey. The WFPB diet, on the other hand, avoids all meat, poultry, animal products, eggs, milk and dairy products, and seafoods. Unlike the vegan diet, the WFPBD pays special attention to a high fiber diet and avoids (if not limit) intake of of any processed foods, oil, sugar, artificial sweeteners, and salt.

The Science Behind It

Before I proceed to discuss more about the WFPB diet, let me go back to the Forks Over Knives documentary.

One of the doctors featured in the documentary was Dr. Colin Campbell of Cornell University’s nutritional science department. In the mid-1960s Dr. Campbell was giving more protein to millions of malnourished children in the Philippines. To keep costs down he and his colleagues decided not to use animal-based protein. The program was beginning to show success but then Dr. Campbell stumbled upon two studies.

The first study centered on affluent families in the Philippines who were relatively eating high amounts of animal-based foods and at the same time their children were found to be susceptible to getting liver cancer.

The second study (and this blew my mind) came from a scientific paper published in a little-known Indian medical journal. It detailed work that had been done on a population of experimental rats that were first exposed to a carcinogen called aflatoxin. Then, these rats were fed a diet of casein, the main protein found in milk. They tested the effect of protein on the development of cancer. They used different levels of protein: one group were fed 20% protein out of the total calories and the other group were fed a much lower level of 5%. The result showed that those rats fed with 20% protein developed cancer, while the other rats that were fed with 5% protein did not.

This Indian study together with what Dr. Campbell had learned about increased liver cancers in children eating animal-based foods combined to create a decisive moment in his work. If you have time to watch Forks Over Knives, you’ll see how a whole-food plant-based diet could reverse chronic diseases and why you should limit or avoid animal meat and by-products.

Your Food Choices in the WFPB Diet

For simplicity, let us group the foods in the WFPB diet into six:

Vitamins & Minerals:

• Vegetables: kale, spinach, tomatoes, broccoli, cauliflower, carrots, asparagus, peppers, etc.

Proteins:

• Legumes: green peas, chickpeas, lentils, peanuts, black beans, etc.

• Seeds, nuts and nut butters: almonds, cashews, macadamia nuts, pumpkin seeds, sunflower seeds, etc.

• Unsweetened plant-based milks: soy milk, almond milk, cashew milk, etc.

• Plant-based protein: tofu, tempeh, tahini, mushrooms, etc.

Carbohydrates:

• Starchy vegetables: potatoes, sweet potatoes, taro, yam, etc.

• Whole grains: brown rice, oats, quinoa, wheat, barley, etc.

Fats:

• Healthy fats: avocados, nuts, seeds

Sugars:

• Fruits: berries, citrus fruits, pears, peaches, pineapple, bananas, etc.

Others:

• Spices, herbs and seasonings: basil, rosemary, turmeric, curry, black pepper, salt, etc.

• Condiments: salsa, mustard, nutritional yeast, soy sauce, vinegar, lemon juice, etc.

• Beverages: coffee, tea, water, natural fruit juices

You will see that everything our body needs is found on plants. All you have to do is to mix and match these items to suit your needs and taste. Also, you can start substituting these items for animal-based products that you were used to. For example, choose soya or almond milk over cow’s milk.

How To Transition

Transitioning to a whole-foods, plant-based diet doesn’t have to be difficult. You don’t have to go 100% immediately. Even just by taking one step at a time, such as replacing one meat-based meal a week with a vegetarian meal, would do. Here are some tips to help you get started.

• Start building a meal around a salad. Fill a bowl with salad greens such as Romaine lettuce, iceberg lettuce, spinach, or any other leafy greens. Add an assortment of other vegetables like carrots, cucumber, bell peppers, onions, beans, peas, or tofu. Season with fresh or dried herbs and make your own salad dressing.

• If you’re already used to eating salads, eat lots of other vegetables, too. Fill half of your plate with vegetables during lunch and dinner. Make sure to include as much as the colors of the rainbow in choosing vegetables. Each food color is rich in certain vitamins and minerals which other colors don’t have as much.

• Another way for you to transition to the WFPB diet is to cook a vegetarian meal at least once a week. Remember #MeatlessMonday? You can start having your own meals around beans, whole grains, and vegetables. Try substituting tofu and mushrooms for meat.

• Vegetables like cucumber, carrots, and jicama can be eaten as a healthy snack. You can also start with plant-based dips like hummus, salsa, or guacamole.

• Change the way you perceive meat as the source of protein. As I've mentioned earlier, plants do have proteins, too. Start by having a smaller portion of meat and use it as a garnish or flavor instead of making the meat as the dish’s main ingredient.

• Choose good fats. Start using olive oil, and nut butters. Soon, you'll discover that plant-based fats and oils are not as "heavy" as animal fat or lard.

• Breakfast should include whole grains. Start with oatmeal or quinoa. Add some nuts or seeds, fresh or dried fruits, and plant-based milk.

• Try other cooking methods. Learn how to cook using different methods like steaming, blanching, grilling, braising, or stir-frying to preserve their flavor and nutrients. As much as possible, avoid deep-frying.

• For dessert, eat a fruit. Let fruits be your source of natural sugars. Eat whatever fruits in season.

The Benefits

Eating a whole-food plant-based diet has its benefits.

• Weight Loss - The high fiber content of the WFPB diet plus the avoidance of processed foods is already a winning combination in weight loss. Cutting out soda, candies, fast food, and refined grains is already a powerful weight loss plan in itself.

• Lower Risk and Reduced Symptoms of Chronic Diseases - Plant-based diets have a higher number of antioxidants and compounds that have been shown to reduce the risk of developing diabetes or to slow the progression of Alzheimer’s disease. Same is true with heart diseases and cancers.

• Protection of the Environment - Adopting sustainable eating habits can help reduce the greenhouse effect, water consumption and land used for factory farming, which are all factors in global warming and degradation of the environment.

• Assistance to our Local Farmers - Reducing the number of animal products in your diet and purchasing local, sustainable produce helps drive the local economy. This reduces the reliance on factory farming which is an unsustainable method of food production.

Conclusion

The food industry has spent lots of money experimenting what particular food combinations and marketing strategies are going to make us most likely to buy their products. It is easy to become quite attached to these foods, not only because we are already used to it but also because to go without them gives us withdrawal effects. Thus, when transitioning to a whole-food plant-based diet, many would ask, “How should I do it?” or “Do I go slowly or do I simply go cold turkey?” It depends very much on who you are and what you are trying to achieve.

The whole-food part is just telling us that nature has provided us with food. Let us try and respect the food in the way nature provides us rather than processing it by adding preservatives, flavorings, colorings, etc. For example, with grains, the more we refine them and make them into flour, the more they bypass our natural digestive system so that we get rapid rises of blood sugar by eating white flour products as opposed to a whole grain bread.

The plant-based part is telling us to choose foods from plants and avoiding animal products. As I've said earlier, you don’t have to go 100% in an instant. Replace one meat-based meal a week with vegetables and test the waters. Try it out and see how it feels.

And most importantly, you have to love yourself. There is no point beating yourself up, then feeling you're a failure, and eventually giving up. Lifestyle change is recognizing that life is challenging but hopeful as long as there is time. Let time work with you rather than against you. Gently nurture yourself and decide how you want to go forward.

Also, get support. It’s great when you can do it with other people. Finding someone else who is interested in joining you along the journey would help you achieve the lifestyle change you’re desiring for.

If you are not yet ready to go 100% on a whole-food plant-based diet, feel free to schedule a consultation. I will help and work with you to make changes at whatever pace you are comfortable with. There is a health program that might suit your needs. Or if you want to hear from me discuss more about Lifestyle Medicine, feel free to listen to my podcast. If you want to be updated with news and features from this website, subscribe to my newsletter or reach out using the contact forms below.

Sources:

American College of Lifestyle Medicine. 2018. “Position Statement for Treatment and Potential Reversal of Disease.” PR Web, September 25, 2018.

Flower, Meridee. 2020. “Why Adopt the Whole Food Plant Based Diet?” Atticus Health. October 27, 2020.

Fulkerson, Lee. 2011. “Forks over Knives.” Documentary film. https://www.forksoverknives.com/. https://www.forksoverknives.com/the-film/.

Kubala, Jillian. 2018. “Whole-Foods, Plant-Based Diet: A Detailed Beginner’s Guide.” Healthline. June 12, 2018.

McManus, Katherine. 2018. “What Is a Plant-Based Diet and Why Should You Try It? - Harvard Health Blog.” Harvard Health Publishing, Harvard Medical School. September 27, 2018.