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The Evidence Supporting a Plant-Based Diet for Optimal Health

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The Evidence Supporting a Plant-Based Diet for Optimal Health The evidence supporting a plant-based diet for optimal health and prevention of chronic disease Authors: Dr Sue Kenneally, Doug Bristor, Dr Gemma Newman, Dr Alan Desmond, Dr Mahesh Shah, Dr Luke Vano, Dr Miriam Martinez-Biarge, Lucy Russell, Marta Lewandowska, Dr Shireen Kassam. Plant-based health professionals, UK (pbhp.uk) Updated April 2020 DEFINITION: A whole food plant-based diet (WFPB) is one consisting of fruits, vegetables, whole grains, legumes, nuts, seeds, with few or no animal products. Well-planned plant-based diets can support healthy living at every age and life-stage. Include a wide variety of healthy whole foods to ensure your diet is balanced and sustainable. The British Dietetic Association (BDA) INTRODUCTION: Poor diet is now the number one cause of death and disability in the UK, resulting in a rising burden of obesity, cardiovascular disease, diabetes and cancer (1). A WFPB diet has been shown to reduce the risk of these diseases, improving health and longevity (2). BENEFITS OF A WFPB DIET PATTERN Obesity and Compared to omnivores, more likely to have normal BMI and a hypertension lower BP. WFPB diet low in salt, can be as effective as NOTABLE NUTRIENTS (11) medication in lowering BP (3,4). Fibre Abundant in a WFPB diet, promoting a healthy gut ↓ ↓ Cardiovascular 30% ↓ in CVD mortality (5). WFPB can arrest and reverse microbiome, improving satiety, cholesterol, cancer. disease (CVD) atherosclerosis (6). Vitamin B12 Not made by plants or animals but microorganisms. Cancer 15% ↓ in cancer incidence and may improve survival after a Deficiency is an issue for all dietary patterns. cancer diagnosis (24,7). Mechanisms include lowering IGF1, Supplementation is required on a WFPB diet (tablet or avoidance of haem iron and ↓ generation of carcinogens. The fortified foods). WCRF recommends a diet consisting of predominantly plant Calcium & Calcium is easily obtained from plant sources, including foods (7). A WFPB diet may reverse early stages of cancer (8). vitamin D greens, beans, fortified foods. No negative effect on bone Type 2 diabetes 60% ↓ risk compared to omnivores (3). In those with diabetes, a health if dairy is avoided. Vitamin D is mainly made by the WFPB diet improves glycaemic control better than standard action of the sun on skin. A supplement is recommended approaches and can even reverse the disease and improve end for all during the winter months. organ damage (9). Omega-3 Plant sources include algae, walnuts, flax seeds, hemp Non-alcoholic 21% ↓ risk plant-based diets. NAFL is strongly associated with fatty acids seeds, chia seeds and soya beans. This avoids the fatty liver obesity, insulin resistance, diabetes and CVD, (22). pollutants in fish, such as mercury, dioxins, PCBs. Dementia Shares the same risk factors as CVD, which are improved or Iron Iron stores may be lower but will not be associated with avoided with a WFPB diet. Healthy lifestyles could prevent a deficiency. The avoidance of haem iron is beneficial given third of cases (21). its role in cancer, diabetes and CVD. Improved Those eating predominantly plants, live longer and healthier (10). Iodine, zinc Iodised salt and seaweed provide iodine, which is needed longevity WFPB diet ↑ telomere length, which protects DNA (19). & selenium in moderation. Phytates in grains and beans can reduce zinc absorption, however, soaking, fermenting and Emotional & WFPB promotes a healthy gut microbiome. These friendly sprouting can increase absorption. Good sources of zinc mental bacteria produce unique chemicals (SCFA) that act in the brain are tempeh and miso, nuts and seeds. Selenium is found in well-being and provide a sense of well-being (17, 23). grains, seeds and nuts. Just two brazil nuts will provide Improves Phytochemicals and antioxidants reduces inflammation and your daily requirement. fitness promotes faster recovery times and pre-training fitness (20). The average diet of a UK adult aged 19-64 yrs Data from the National Diet and Nutrition Survey (NDNS) rolling programme 2018 CAUTION ON DIETS HIGH IN ANIMAL-DERIVED FOODS, Average percentage and quantity Average food consumption of a UK adult of daily energy by macronutrients aged 19-64 yrs (1866 kcal/d) trans-fats ⬤ Starches 38% INCLUDING LOW CARB HIGH FAT AND KETOGENIC DIETS 1g ⬤ unsaturated starches & Fruits & Veg 8% ⬤ fat 45g bound sugar Dairy 9% ⬤ Meats & beans 23% Processed and red meat cause 20% of colorectal cancer and increase the risk of 165g ⬤ Fats, Oils & Spreads 3% 35% pancreatic, lung, oesophageal and nasopharyngeal and stomach cancers (7). ⬤ Drinks & Alcohol 8% 48% ⬤ saturated Snacks & other 12% Carnitine and choline in meat and eggs are converted into TMAO, which is fat 26g Items (not to scale) 17% fibre = 85 kcals implicated in the pathogenesis of atherosclerosis (13). 9g protein free sugars 78g 52g src: NDNS 2018 (combined) Increases insulin resistance, dyslipidaemia and inflammation (14). References 12. Seidelmann SB, et all. Lancet Pub Health 2018 S2468-2667(18)30135-X Restricts whole-grains, which have been associated with reduced risk of 13. Wilson Tang, WH. N Engl J Med 2013;368:1575-84 1. GBD 2017 Diet Collab.Lancet. 2019 S0140-6736(19)30041-8 14. Rosenbaum M. et al Obesity 2019 10.1002/oby.22468 diabetes, CVD and cancer (7, 14). 2. Bodai B.I. et al. Perm J 2018 10.7812/TPP/17-025 15. Manzel, A et al. Curr Allergy Asthma Rep. 2014 Jan;14(1):404 3. Tonstad S, et al.Diabetes Care. 2009;32(5):791-6 16. Losasso, C. et al. Int Journ Antimicro Agents 2018 1 2018.07.023 4. Yokoyama Y, et al. JAMA Intern Med. 2014;174(4):577-87 Increase risk of inflammatory bowel disease and autoimmune diseases (15). 17. Doré J et al. Curr Opin Biotechnol. 2015 Apr;32:195-199 5. Satija, A. et al.. J Am Coll Cardiol. 2017; 10.1016/j.jacc.2017.05.047 18. gov.uk 2016 Eatwell Guide: colour PDF 6. Kim H. et al Am Heart Assoc. 2019 10.1161/JAHA.119.012865 19. Ornish D, et al. Lancet Oncology 2013 S1470-2045(13)70366-8 7. wcrf.org/dietandcancer/exposures/wholegrains-veg-fruit Promotes antibiotic-resistant infection (16). 20. Barnard N. et al Nutrients 2019 10.3390/nu11010130 8. Ornish D, et al. J Urol. 2005;174(3):1065-9 21. Livingston, G et al. Lancet 2017; 390:2673-734 9. Barnard, N et al. Am J Clin Nutr. 2009; 89(5): 1588S–1596S 22. Mazidi, M. and Kengne, A. Clin Nutr, 2018 10.1016/j.clnu.2018.08.010 Decreases life expectancy (12). 10. Li Y, et al. Circulation. 2018;138:345-355 23. Agarwal, U et al. Am J Health Promot 2015 29[4]:245–254 11. Melina V, et al. J Acad Nutr Diet. 2016;116(12):1970-80 24. Dinu, M. et al. C Rev Food Sci Nutr. 2017 0408398.2016.1138447.
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