Is a Plant Based Diet Better for my Heart?
Much information is available on the topic of diet, and many people with an agenda try to promote their own fad diet. Sometimes the agenda is to sell you a meal plan online (Paleo, Keto, Atkins, SouthBeach, Nutrisystem, WeightWatchers) and other times it is to sell you on a cookbook or a guidebook. This makes it increasingly difficult to know who you can trust, and whether the information is valid. They may talk about macronutrients and micronutrients, calorie counting, carb loading and other trendy buzz words. Less than reputable sources will simply make up claims and pass them off as fact, and the average consumer has no way to know if it is legitimate.
The basic principles of healthy nutrition have not changed significantly over the last four decades. We know that we need to eat in moderation, provide our body proteins, fats, and carbohydrates, and make moderate but permanent changes in portion sizes if we are trying to lose weight. This discussion is not for those who are seeking to compete in bodybuilding, and is not for those who must contend with medical conditions that require medical monitoring of dietary intake to achieve certain goals (protein loss from renal disease, gluten allergy, marasmus or kwashiorkor, anorexia nervosa, bulimia, and others). This discussion is for those with a complete gastrointestinal tract seeking to modify their nutritional intake to lead healthier lives.
The term “plant based diet” is a broad description, under which are several different diets. Adopting a plant based diet does not necessarily require to you follow a strictly vegetarian diet. It simply means that a larger portion of your proteins come from beans, and that you include more nuts, seeds, legumes and fruits/vegetables into your diet. Millions in India are lifelong vegetarians, receiving their proteins from lentils, chick peas, kidney beans and peanuts. Thus, by avoiding the red meats that contain higher quantities of cholesterol and saturated fats, you are making a major improvement in your health.
Examples of plant based diets include the Mediterranean Diet, a Semi-vegetarian diet, a Pescaterian diet, Lacto-ovo vegetarian, and a Vegan diet. Let’s spend some time to understand each one.
1. A Semi-vegetarian diet is simply reduction of meat consumption, treating meat as a garnish rather than as the main course (think of a few strips of grilled chicken on a salad). This is a broad category, and a good choice for a carnivore who wishes to transition to a healthier diet, but can’t see themselves giving up meat entirely.
2. A Pescatarian diet permits consumption of fish and seafood, but not meat and poultry. Since fish contain a more favorable quantity of omega 3 fats compared to omega 6 fats, this diet helps to reduce oxidative stress in the bloodstream, which, in theory, reduces inflammation that is a component in both heart disease, and in several forms of cancer like colon cancer.
3. Lacto-ovo vegetarian diet followers can consume dairy products and eggs, but no meat, poultry or seafood. In developing countries like India, Vietnam, Malaysia, and Nepal, meat is expensive, and refrigeration is not available in every household. By necessity, those living in the villages in these countries developed a reliance on beans, nuts, lentils, peas and legumes to replace the proteins that are provided by meat.
4. A Vegan diet includes no animal products. Therefore, milk, cheese, eggs, cream, butter and meat are not part of this diet. Vegans need to be sure to include a B12 supplement. (ref: https://www.health.harvard.edu/blog/what-is-a-plant-based-diet-and-why-should-you-try-it-2018092614760)
Over the past 17 years of practice, I have promoted the Mediterranean diet for my patients, following the results of the Lyon Heart Study (ref: Circulation, 2001;103:1823-1825).The Mediterranean diet consists of, at its foundation, plant based foods. (In rural Alabama, that was a tough sell, for people who like red meat, fried food, vegetables cooked in lard and with bacon. The Mediterranean diet calls for whole grain bread and cereal, infrequent red meat consumption (increased proportion of fish and chicken), use of olive and canola oil sparingly, increasing fruit and vegetable consumption, nuts, seeds, legumes, and decreasing dairy foods (cheese, sour cream, whole milk). Those who have been studied after adopting this diet were found to have lower risk of Alzheimers, Parkinson’s and lower LDL cholesterol, the major type of cholesterol implicated in heart attacks. (Ref https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet/art-20047801)
After you have had a discussion with your doctor about your cholesterol, your weight, your blood sugar, and your nutrition labs, you can make an informed decision about which plant based diet is right for you. I never encourage anyone to make a drastic change in dietary habits that have been ingrained for decades. Choose one change at a time – cutting out sugary soft drinks, reducing your bread and potato consumption, avoiding fried foods, avoiding junk food snacks, or eliminating dessert. Once you have stuck to that one change for 3-4 weeks it will become your new habit, and you are ready to make another change. Once you have eliminated the truly harmful dietary habits, you are ready to start implementing some of the components of a plant based diet.
Reduce your meat consumption. A meal does not have to contain a meat. A bowl of black beans and rice is very tasty, without the saturated fats of red meat. Lentil soup is tasty and nutritious. Chick peas can be added to a salad for a tasty protein boost.
Add oatmeal to your morning routine. Or quinoa. Adding whole grain fibers reduces your lifetime risk of developing colon cancer. Add a tablespoon of honey if you like. Chop up some strawberries, slice some bananas, or drop in some blueberries for a natural sweetener.
Use canola or olive oil sparingly. PAM cooking spray is made with canola oil. This is preferred to peanut oil, coconut oil, or corn oil. Canola and olive oil provide a better ratio of omega 3 fats compared to omega 6 fats. Omega 3 fats are anti-inflammatory. As mankind has progressed from hunter/gatherers to a society of convenience, we have shifted to a diet that provides us too much omega 6 fats, and not enough omega 3 fats. A plant based diet will help correct this transition in the wrong direction, which will help protect you from heart disease.
Choose to eat more vegetables. Use vegetables as snacks – carrot sticks, celery, broccoli with hummus or guacamole for dipping can be a nutritious and tasty alternative to potato chips and cookies. Grilled brussel sprouts and grilled edamame make excellent side dishes for a healthy meal, without missing out on flavor.
Add greens to your diet – kale, spinach, collards. Steam them to preserve nutrients, and avoid cooking the greens with lard, bacon grease or pieces of bacon. People with strokes, TIAs or atrial fibrillation who take warfarin to maintain anticoagulation should not consume green vegetables, since they contain Vitamin K. Vitamin K is the antidote to warfarin. In this subset of people who need to thin their blood, a diet with green leafy vegetables can counteract the important role played by warfarin.
In summary, I encourage moderation. I encourage avoidance of acidic foods if you are prone to gastric reflux, and avoidance of breads and potatoes if you are at risk for developing diabetes. Much research is focusing on the addictive properties of “sugar” and other carbohydrates. It appears that sugar is one of the most addictive legal chemical substances on earth! If you are considering a diet, make sure you have a candid discussion with your physician, rule out conditions that will force your hand in food choices, and make small steps to eliminate the bad habits. Once you have a clean slate, you are ready to dip your feet into the pool of plant based diets, and discover that you may not miss the meat as much as you thought you would.