Recall from previous discussions that Wellness is achievement of one’s maximal potential. Part of achieving this goal is the development of a health framework, by which you can begin to see your Wellness potential. Recall also that Nutrition is one of Doctor of Living’s 5 Pillars of Health. This brings us full circle then as we look at the role of nutrition in the achievement of wellness. “Everything in moderation” or “the standard American diet” will not cut it here folks. We need to discuss the science behind what nutrition really does and can do for us. Only then, can we recognize how our nutritional choices are limiting our maximal potential.
Of course, the elephant in the room, is that we all should be consuming a plant-based diet. After all, the elephant is the largest land mammal and elephants are plant-based…Hmmm. I wonder if they get enough protein though? Think that they have any problems with calcium and osteoporosis. Come on folks, if you are still buying into those questions, then you are officially the victim of propaganda. Of course, elephants get enough protein are not drinking milk for bone strength.
What happens when you go plant-based?
People often wonder, what’s the best diet? Of course, there is a laundry list a mile long of different opinions on that topic. If you made it here, chances are that you have hear of a plant-based diet, are interested in starting one, or are still in the discovery phase of learning about diet. Remember that if a diet is a short-term fix, you can’t expect to sustain whatever the diet calls for. We refer to diet in the long-term context, like “as humans we consume a diet rich in fruits and vegetables.”
People often ask me about how we eat. We eat a whole foods plant-based diet. We don’t identify ourselves as Vegan or Vegetarian. We eat a whole foods plant-based, because it’s healthier for our bodies, better for the environment, and because it’s fun. We have reduced the inflammation that plagued us, lost weight, and improved our energy. It’s worked for us and will work for you too! It does take time.
A whole foods plant-based diet is generally a vegan diet, but is different. Vegan diets “contain greater amounts of iron, folate, thiamin, magnesium, potassium, manganese, fiber, beta-carotene, and vitamins B6, C, and E than omnivorous diets.” They may contain lower amounts of zinc, iodine, calcium, selenium, riboflavin, and vitamins B12 and D.
A friend recently said, you are not plant-based you are Vegan. According to the Center for Nutrition Studies a whole food, plant-based diet (WFPB) “doesn’t include any meat, dairy or eggs. It’s not, however, the same as a vegan diet, which is defined only by what it eliminates. A WFPB diet is defined also by what it emphasizes: a large variety of whole foods.” In addition, the term “whole” “describes foods that are minimally process. This includes as many whole grains, fruits, vegetables, and legumes you want. It includes moderation nuts, seeds, avocados, natural sweeteners, and certain soy or wheat products that do not contain added fat.”
Let’s dig into the research.
Rizzo, et al 2013 (AHS-). 71,751 participants compared diet, BMI, lifestyles of non-vegetarians, semi-vegetarians, pesco-vegetarians, vegetarians and vegans. BMI was lowest among vegans. Vegans had lowest incidence of overweight and obesity. Fiber, beta carotene, magnesium, and potassium intakes highest among vegans. Intakes of B12, vit D, vit E calcium and Zinc lowest among vegans, but all were within the recommended range, other than vit D and calcium.
Spencer, et a UK EPIC Oxford 2003. 37,875 participants compared diet, BMI, lifestyles of meat eaters, fish eaters, vegetarians, and vegans. BMI was highest among meat eaters and lowest among vegans, fish eaters, and vegetarians having similar BMIs. Dietary factors most strongly associated with increased BMI were high protein and low fiber.
This study is important. It identifies “high protein” with increased BMI. In plain language, as you eat more protein, you get fatter. Here’s where things get even more interesting. Another study found that high protein intake is linked to increased cancer, diabetes, and overall mortality. High IGF-1 levels increased the relationship between mortality and high protein. In this study, they found that respondents aged 50-65 reporting high intake of protein had a 75% increase in overall mortality and 4-fold increase in cancer death risk during the following 18 years. These associations were either “abolished or attenuated” if the proteins were plant-derived. 
It is the animal derived proteins that seem to be problematic as it relates to cancer.
Alright, so we have established that eating vegan or
vegetarian or at least pesco-vegetarian is good for health in terms of BMI,
weight loss and avoidance of cancer, diabetes and overall mortality. But, what
about all the nutrient deficiencies. I have heard often, “It’s just not
natural.” “It’s not a balanced diet.” Or “I don’t want to have vitamin
A study by Davey, et al UK EPIC 2002 looked at 65,429 participants (2,596 vegans) and questioned, interviewed and compared nutrients between meat eaters, fish eaters, vegetarians and vegans. The study found that vegans had the highest intakes of thiamin, vitamin C, vitamin E, folate, magnesium, iron and fiber. Vegans had the lowest intakes of retinol (preformed Vit A), vitamins B12 and D, calcium, and zinc. Even with those lower intakes, Vegan intakes exceeded recommended intakes for all vitamins except B12 and calcium. Iron intakes were low in premenopausal women in all dietary groups.
This study shows us that Vegans are not vitamin deficient, with a couple of exceptions. Obviously, depending on your preference, you can spin the data and make it look like Vegans are low in certain areas of consumption, but from a “recommended intake” perspective vegans appear to have totally adequate intake.
I take a daily multi-vitamin to ensure adequate consumption of all vitamins. Almost any multi-vitamin you choose will have adequate B12 and calcium. Certainly, a multi-vitamin is a much better option than obesity, increased cancer risk, diabetes, and increasing overall death rate!
Diet and Heart Disease
One of the main reasons that we care so much about diet is that it seems our diet is associated with long-term health and chronic diseases. In 2008, 63% of global deaths were due to cardiovascular disease, diabetes, cancers, and lung cancers. According to the 2010 WHO Global Status Report on Non-Communicable Diseases, the four primary causes of the epidemic are an unhealthy diet, physical inactivity, tobacco use, and alcohol consumption.
Remember the Doctor of Living model, you can’t achieve wellness (your maximal potential), unless you have a healthy framework. It’s very hard to do that, when you are sick with a preventable, chronic disease. How can you look in the mirror and ask what’s my maximal potential today, when you are bogged down by debilitating chronic disease? Having said that there are diseases that become irreversible. At that point, sadly, your maximal potential has shifted. You must then remember the serenity prayer, “to accept the things we cannot change.” Our new maximal potential still likely calls for lifestyle modification to improve our framework for developing wellness. So, if we concede that avoiding disease is important to our framework for wellness, then we must adopt a diet that avoids disease…
Fortunately, we have some amazing studies on diet and disease. Let’s start with heart disease the leading killer in the United States. The Adventist Health Study 2, includes 96,000 participants, 28% who were vegetarian and 8% vegan. It found that for vegan men, there was a 55% risk reduction in ischemic heart disease and 42% risk reduction in cardiovascular disease compared to non-vegetarians.
In Europe, they are conducting a study called the European Prospective Investigation into Cancer and Nutrition (EPIC). There are approximately 520,000 participants from 10 countries. The UK’s EPIC-Oxford is one of 23 Epic Centers and has 65,500 people enrolled with 29% vegetarian and 4 % vegan.
In the EPIC-Oxford study, they found a 32% lower risk of ischemic heart disease in vegetarians compared with meat eaters.
Ischemic heart disease isn’t just one and done either. Many
times, people have repeat disease. Stents can be placed and meds given, but
often the patients have a heart attack prior to knowing about their disease.
Sadly, many will go on to develop infarcted or dead heart, which predisposes
them to heart failure.
Recently, there has been a lot of discussion about cholesterol and whether dietary factors play a role in cholesterol. There have been 24 studies of vegan, lacto-ovo vegetarian, and nonvegetarian populations from 1978-2007.5 The total blood cholesterol level of vegans were shown to be lower than those of any other group, averaging 150 mg/dl, compared with 187 mg/dl for lacto-ovo vegetarians, 193 mg/dl for the nonvegetarians.
According to Dr. William Castelli, the former director of the Framingham Heart Study, “In the first fifty years of Framingham, only 5 subjects with a cholesterol level less than 150 mg/dl developed coronary artery disease.” Cholesterol does matter. It may be more complex than we previously thought, but it does matter.
The other major risk for heart disease is high blood pressure. The AHS-2 study found that the incidence of high blood pressure was 75% lower for vegans compared to nonvegetarians. In 2012, similar findings were released again from the AHS-2 finding a 63% reduction in the risk of developing hypertension compared with nonvegetarians.
What about obesity? This likely goes without saying, but vegans are thinner than meat eaters. Since 1990, more than 20 studies have reported that vegans are leaner than people in other dietary groups and have a lower BMI and lower percentage of body fat.
- Whole foods plant-based diet will reduce the risk of heart disease substantially.
- WFPB diet will reduce the risk of high cholesterol.
- WFPB diet will reduce the risk of high blood pressure.
Diet and Cancer
Evidence suggests that diet accounts for 30-35% of all cancers.5 For certain cancers, it is much higher. For prostate and colorectal cancer, it’s 75% and 70% respectively are linked to diet.5 That’s really high. For breast, endometrial, gallbladder and pancreatic it’s 50%.5
We will get into more on diet and cancer in the next magazine article.
 “What is a whole food, plant-based diet?” Center for Nutrition Studies. August 8th, 2018. https://nutritionstudies.org/what-is-a-whole-food-plant-based-diet/. Accessed March 5th, 2019.
 “Low Protein Intake is Associated with a Major Reduction in IGF-1, Cancer, and Overall Mortality in the 65 and Younger but Not Older Population.” Levine, et al. March 4, 2014. DOI: https://doi.org/10/1016/j.cmet.2014.02.006.
 WHO. Global status report on communicable diseases 2010. WHO Press, Geneva Switzerland. 2011.
 Orlich, et al. Vegetarian dietary patterns and mortality in Adventist Health Study 2. JAMA Internal Medicine. 2013; 173 (13):1230-8.
 “Becoming Vegan.” Brenda Davis et al. pg 36-37.
 Castelli, et al. Making Practical Sense of clinical trial data in decreasing cardiovascular risk. Am J Cardiol. 2001; 88 (4a):16F-20F.