Eating for Health: The Whole Food Plant Based Diet

Investing in our Health and in our Planet
February 23, 2016
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Dr Esselstyn: Prevent and Reverse Heart Disease
July 25, 2016

Eating for Health: The Whole Food Plant Based Diet


The state of health of the human race is a cause for great concern. The epidemic of obesity and diabetes is just a part of it. The suffering caused by preventable disease is huge, and much of it is down to the food that we eat. Despite many technical advances, things are getting worse. A former US Surgeon General stated not long ago that “because of the increasing rates of obesity, unhealthy eating habits and physical inactivity, we may see the first generation that will be less healthy and have a shorter life span than their parents”. This is a disaster.

It is true that there are mind-boggling and almost miraculous technical advances in medicine and surgery, which can be life-saving. But I say this as a conventionally trained and practicing physician: we must absolutely understand that medicine and health are not the same thing.

Where should we turn to find out how to promote overall health? What should we focus on? I would like to start by looking at the leading causes of death.

In the US, as representative of the affluent, developed world, heart disease leads the way, and combined with stroke and diabetes, accounts for about a third of all deaths. Cancers, including lung cancer, account for a further one fifth. In 2015, the World Health Organization tells us that three quarters of deaths worldwide are now attributable to hypertensive (high blood pressure induced) heart disease, ischaemic heart disease and strokes. Clearly, diseases of the heart and blood vessels are major killers today, all over the world.

Let’s jump back several decades to a large epidemiological study called “The China Study”. This study showed the association of patterns of eating with patterns of disease. At the time of the data collection (1970’s and 80’s) the Chinese population was eating a mainly plant-based diet containing adequate total protein. Their diet had about 10% of daily calories coming from protein, but of that, only 6 grams of animal protein per day which amounted to about 1% of their total calories was consumed. Six grams of animal protein is the amount of protein in one egg or about 20 grams of meat. US populations were eating a diet containing 55 grams of animal protein per day, amounting to 12% of total daily caloric intake, about the amount of protein contained in 9 eggs, or 200 grams of meat. At the same time, US average cholesterol level was 225, while the Chinese average cholesterol level in the study was 127. At the same time, the US population suffered heart disease at a rate 17 times (1700%) that of the Chinese population.


Foods that are good for you… Broccoli, apples and beans

Previous large studies, such as the “Seven Countries Study”, had demonstrated the link between saturated fat intake, blood cholesterol and heart disease. Animal foods all contain saturated fat. To the extent that you remove animal foods from the diet, you remove most saturated fat from the diet as well. Indeed, at the time of the China Study, the average American got 35% of daily calories from fat, while the Chinese diet derived only 15% of calories from fat.

Could we say then, eat like the Chinese and we will get rid of our number one killer? Well, this was an observational study which can show a link but not cause and effect. However, interventional studies by two American researchers, Dr Ornish and Dr Esselstyn, have demonstrated that with a very low fat vegan diet, it is possible to reverse coronary artery disease, in other words, to reduce cholesterol plaque and inflammation in the arteries of the heart, improve blood flow, reduce angina symptoms and restore healthy function to a degree never seen before. Dr Ornish has advised former US President Bill Clinton who, as a result, became a vegan following his cardiac surgery.



Foods that are bad for you … white sugar, white bread and sausages

We should not think that such diets are only for the sick. Autopsies of US soldiers who were killed in the Korean and Vietnam wars showed the beginnings of cholesterol plaque in their 20-year-old arteries. Nowadays these signs are found even in young children who have eaten the typical American diet which is so rich in animal products and processed foods and low in fruit and vegetables.

Dr Neal Barnard, founding president of the Physicians Committee for Responsible Medicine, has been conducting research on diet and diabetes since the 1980’s. Using a vegan diet with no added oil, and avoiding processed foods such as sugar and white bread, resulted in improving the participants’ blood glucose three times more effectively than the standard diabetes diet.

Dr Joel Fuhrman, a pioneering family physician, treats his patients with a similar diet which he calls “nutritarian”, or “nutrient dense, plant rich”. His version of the diet emphasizes raw and cooked vegetables, legumes, fruits, grains and a few nuts, and eliminates refined oils, sugars and excess salt. Eight ounces of animal products per week are allowed, about an ounce or 30 grams per day. Dr Fuhrman recently published an article describing a series of patients in his practice who suffered from overweight, high blood pressure and cholesterol, and who experienced across the board at least 80% improvement over a two to three year period when adhering to the diet.

Other published clinicians include Dr John McDougall, who has been using a plant-based whole foods diet for decades to reverse hypertension, diabetes and autoimmune disease (such as rheumatoid arthritis and lupus). Dr McDougall’s version uses more grains and fewer nuts and seeds, but essentially relies on whole unprocessed foods from the plant kingdom.

Dr Roy Swank was a neurologist who treated multiple sclerosis patients with a very low fat diet containing a minimum of animal products, which was essentially another variation on the theme of the plant-based whole food diet. Of Dr Swank’s patients who followed this regime, 95% were free of disability at the end of 35 years.

The famous DASH diet (Dietary Approaches to Stop Hypertension) restricts fat to 25% of calories and emphasizes increasing vegetables and fruits, and reducing salt in the diet, and is as effective as single drug therapy for high blood pressure.

One could go on. The evidence is mounting that a whole food plant-based diet promotes health and has the power to reverse heart disease, stabilize and improve diabetes, prevent disability in MS and more. This diet appears in slightly different versions but here are the basics on which most of the clinicians mentioned above would agree.

  • Eat raw and cooked vegetables, legumes, fruits, grains, and depending on individual factors, nuts and avocados in small amounts, or not at all.
  • Avoid completely or minimize animal products, including (and especially!) dairy.
  • Avoid the used of processed foods. This includes white flour products and sugar, but also refined oils.
  • If you are vegan, check vitamin B 12 levels and supplement if necessary.

As a physician, I strongly encourage this style of eating, which can be varied to suit individual needs.

The Whole Foods Plant-Based diet is not a gimmick or a trade name. It does not require or encourage expensive supplements. It is kind to the body, kind to animals and kind to the environment which suffers heavy pollution and use of resources in the production of animal foods.

A warning to people who wish to adopt this style of eating: if you take medications for diabetes or hypertension, the dietary changes involved are likely to result in lower blood pressure and lower blood sugar, and your medicines may need to be reduced or eliminated. Please do not try to do this yourself, but rather consult with a qualified doctor during the transition period to make sure it goes smoothly and safely.

I hope this article will have stimulated your interest and lead you to try some healthy changes, or at least to read further. I will leave you with best wishes for the best of health, and with two quotes.

“If everyone were to adopt a whole-food plant based diet, I really believe we could cut health care costs by 70 to 80 per cent”. (T Colin Campbell PhD, author of The China Study)

“Eat food, not too much, mostly plants” (Michael Pollan, author of The Omnivore’s Dilemma)

Dr Miriam Maisel is a GP practicing in Tel Aviv and Scotland. She emphasizes the use of nutrition for health promotion. In addition, she gives talks on nutrition and health.