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.
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.
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.
Starchy vegetables: potatoes, sweet potatoes, taro, yam, etc.
Whole grains: brown rice, oats, quinoa, wheat, barley, etc.
Healthy fats: avocados, olive oil, coconut oil, sesame oil, etc.
Fruits: berries, citrus fruits, pears, peaches, pineapple, bananas, etc.
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.
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.
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 talk about Lifestyle Medicine, feel free to contact me using the contact form below.
American College of Lifestyle Medicine. 2018. “Position Statement for Treatment and Potential Reversal of Disease.” PR Web, September 25, 2018. https://www.prweb.com/releases/american_college_of_lifestyle_medicine_announces_dietary_lifestyle_position_statement_for_treatment_and_potential_reversal_of_disease/prweb15786205.htm.
Flower, Meridee. 2020. “Why Adopt the Whole Food Plant Based Diet?” Atticus Health. October 27, 2020. https://atticushealth.com.au/why-adopt-the-whole-food-plant-based-diet-talking-with-dr-meridee-flower/.
Kubala, Jillian. 2018. “Whole-Foods, Plant-Based Diet: A Detailed Beginner’s Guide.” Healthline. June 12, 2018. https://www.healthline.com/nutrition/plant-based-diet-guide.
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. https://www.health.harvard.edu/blog/what-is-a-plant-based-diet-and-why-should-you-try-it-2018092614760.