Plant-based diets are increasingly recognized as a healthier and viable alternative to the standard American diet (Lynch, Johnston, & Wharton, 2018).  Research repeatedly affirms the value of plant-based diets in preventing or reducing the risk of a variety of common and chronic illnesses (Lynch et al., 2018).

While the popularity of plant-based diets continues to increase, many people remain concerned about a variety of items, such as:

• Where will I get my protein?
• Will I develop nutritional deficiencies?
• What if I am an athlete or I train for fitness goals?
• What about “all those carbs?”
• Are plant-based diets sustainable over time?

This article addresses the above questions along with highlighting just a few of the many health benefits of plant-based diets.

What is a plant-based diet?

Definitions vary in the research, but generally, plant-based diets refer to diets that emphasize plant-foods over animal foods in varying degrees.  Examples of plant-based diets include:

• Vegan diets that exclude all animal products
• Lacto-vegetarian diets (eat plant-based except include dairy products)
• Lacto-ovo-vegetarians (eat plant-based except include dairy and egg products)
• Pescatarian (eat plant-based but include fish to varying frequencies/ amounts)
• Semi-vegetarian (meat is consumed but at levels lower than more traditional western diets)

While potato chips and french fries may be plant-based, a healthy plant-based diet is one that emphasizes fruits, vegetables, whole grains, nuts, legumes, and beans while minimizing refined grains, meat, and sugar-rich beverages (Satija & Hu, 2018).

Plant-based diet benefits

Benefits of vegetarian or vegan plant-based diets as demonstrated in both observational and experimental research trials include (Kahleova et al., 2020; Lynch et al., 2018; Satija & Hu, 2018):

• Reduction in heart disease fatality risk
• Cancer rate reductions particularly for vegan diets
• Reduced risk of diabetes 
• Reduced risk of metabolic syndrome 
• Lower blood sugar averages 
• Lower blood pressure
• Lower triglycerides, LDL cholesterol, and total cholesterol
• Lower C-reactive protein levels (a measure of inflammation)
• Lower uric acid levels
• Reduced visceral body fat
• Lower obesity rates and lower BMI

Researchers note that cardiovascular benefits increase as consumption of whole grains, fruits, vegetables, nuts, and beans increase in the diet (Satija & Hu, 2018)

Some fascinating research highlights include:

Vegan diet proved superior to standard diabetic diets in treating diabetes!  

A 12-week randomized-controlled trial comparing standard diabetic dietary interventions versus a vegan diet centered on brown rice, legumes, and vegetables revealed that while both diets worked, the vegan diet was superior in lowering A1C levels (Lee et al., 2016).  

This mirrors findings by the American Diabetic Association comparing their own diabetic diet versus a vegan diet–with the vegan diet proving superior to the American Diabetes Association diet in lowering A1C levels (Bernard et al., 2006).

Getting to the root cause of insulin resistance:  A vegan diet consisting of 75% carbohydrates, 15% protein, and 10% fat lowered fat levels in the liver, lowered fat levels in muscle tissue, improved insulin sensitivity and promoted weight loss in a 16 week randomized controlled trial (Kahleova et al., 2020).

Whole food plant-based diets are effective for weight loss, lowering cholesterol, and improving quality of life!

• Participants encouraged to adopt a whole-food plant-based diet emphasizing whole grains, beans, legumes, vegetables, and fruits while minimizing or eliminating meat, dairy, and processed foods saw improvements in weight averaging 20lbs in lost weight in 3 months!!
• Participants experienced improvements in cholesterol, quality of life, reductions in medications, and reductions in insulin resistance / A1C levels (Wright, Wilson, Smith, Duncan, & McHugh, 2017).
• Participants continued to lose weight after the study ended, with an average weight loss of 27lbs at 6 months from the start of the original 12-week study period!! (Gregor, 2020).

Protection against severe outcomes from COVID-19 during the pandemic

• As reported in the British Medical Journal, those consuming predominantly plant-based diets were at lower risk for COVID-10 and for severe COVID-19 disease outcomes (Merino et al., 2021).

Nutritional adequacy, fitness applications of plant-based diets

A common concern regarding plant-based diets, particularly among fitness enthusiasts, involves protein quality and amounts of protein available in plant-based diets.  

However, a 12-week randomized-controlled trial comparing whey protein supplementation versus soy protein supplementation found no significant differences in strength or muscle development between participants who exercised (Lynch et al., 2020).  

According to the American College of Sports Medicine concerning plant-based diets:

“Vegetarian, vegan, flexitarian, and nutritarian diets are healthful options for serious athletes.” (Fuhrman & Ferreri, 2010).

While the research on vegan and vegetarian athletes is limited, the American College of Sports Medicine notes that findings in the available literature demonstrate equal or at times superior athletic performance when comparing plant-based athletes to omnivore athletes (Fuhrman & Ferrari, 2010).  

Concerns also center on general nutritional adequacy.  However, as noted by the Academy of Nutrition and Dietetics:

“It is the position of the Academy of Nutrition and Dietetics that appropriately planned vegetarian, including vegan, diets are healthful, nutritionally adequate, and may provide health benefits for the prevention and treatment of certain diseases. These diets are appropriate for all stages of the life cycle, including pregnancy, lactation, infancy, childhood, adolescence, older adulthood, and for athletes” (Melina, Craig, & Levin, 2016).

Common concerns about deficiencies on plant-based diets tend to center on protein, iron, zinc, omega-3 fatty acids, iodine, vitamin D, vitamin B12.  However, the Academy position notes that plant-based diets are UNLIKELY to be deficient in the following:

• Protein: needs are met or exceeded on plant-based diets when caloric intake is sufficient
• Omega-3 fatty acids: these needs can be met from plant-based sources such as flaxseed, or vegan algae supplements
• Iron status: as measured by hemoglobin values and other labs is similar between vegetarians and non-vegetarians
• Zinc:  western vegans do not exhibit zinc deficiencies

Areas where plant-based diets may be deficient without supplementation

• Iodine deficiency is possible when following a plant-based diet.  Dairy products are a major source of iodine due to processes involved in milk production.  150 mcg daily is suggested for those concerned about iodine deficiency.
• Calcium is often associated with dairy products.  Vegans need to consume foods rich in calcium such as kale, bok choy, white beans, almonds, tahini, figs, oranges, calcium set tofu, fortified plant-milks, and may consider low-dose supplements.
• Vitamin D deficiency is common in those following omnivore and plant-based diets due to lower levels of sun exposure.  Experts recommend anywhere between 1,000 and 2,000 IU of vitamin D for those who do not get regular sun exposure.
• Vitamin B12: supplementation is a MUST for persons following a plant-based diet.   Recommendations are for 500 to 1,000 μg cyanocobalamin several times per week.

The American Dietetic Association and British Dietetic Association (among others) likewise recognizes the dietary sufficiency of carefully planned vegetarian and vegan diets (British Dietetic Association, 2022; Craig, Mangels, & American Dietetic Association, 2009).

Finally, the American College of Lifestyle Medicine, a board-certification program for physicians and other healthcare providers, fully endorses plant-based diets including vegan diets (American College of Lifestyle Medicine, 2022).   

How Lancaster Wellness can help!

At Lancaster Wellness, we have plant-based meal-plans that we can fine-tune to match your caloric needs and weight goals.  These meal plans contain recipes and can support you as you transition from a traditional western omnivore diet to a more plant-based diet.

With the following plant-based meal plans, we are able to support your health and nutrition goals using:

• Mediterranean diet meal plans
• Flexitarian diet meal plans
• Vegetarian diet meal plans 
• Vegan diet meal plans 

If your goal is weight management and weight loss, we can help you with out comprehensive weight loss program en

• Coaching with weekly check-in’s and high accessibility throughout the week
• Meal plans customized to suit your needs and goals
• Fitness programming customized according to your abilities and fitness levels
• Medical management including FDA-approved medications, hormone assessments when appropriate, and oversight by a physician-led medical team
• A focus on LONG-TERM interventions that enhance both short-term and long-term success
• A track record of successfully weaning many clients off of weight loss medications after achieving their final goals
• Clients frequently lose 20-40 lbs in the first 3 months of care (10-15% or more of their bodyweight in just 3 months!) and many go on to hit their ultimate goals of 50, 60, 70…100+ lbs off with Lancaster Wellness
• Proven track record of weaning clients off the medications for those who desire to use lifestyle measures to manage their weight long term
• Maintenance program for those that need / desire ongoing support after hitting their goals

Reach out today to learn more about how we can help you optimize your health and nutrition!!!  Live well!

References

American College of Lifestyle Medicine. (2022). Food as medicine. Retrieved from https://www.lifestylemedicine.org/foodasmed

Barnard, N. D., Cohen, J., Jenkins, D. J., Turner-McGrievy, G., Gloede, L., Jaster, B., Seidl, K., Green, A. A., & Talpers, S. (2006). A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes. Diabetes care, 29(8), 1777–1783. https://doi.org/10.2337/dc06-0606

British Dietetic Association. (2022). British Dietetic Association Confirms well-planned vegan diets can support healthy living in people of all ages. Retrieved from https://www.bda.uk.com/resource/british-dietetic-association-confirms-well-planned-vegan-diets-can-support-healthy-living-in-people-of-all-ages.html

Craig, W. J., Mangels, A. R., & American Dietetic Association (2009). Position of the American Dietetic Association: vegetarian diets. Journal of the American Dietetic Association, 109(7), 1266–1282. https://doi.org/10.1016/j.jada.2009.05.027

Fuhrman, J., & Ferreri, D. M. (2010). Fueling the vegetarian (vegan) athlete. Current sports medicine reports, 9(4), 233–241. https://doi.org/10.1249/JSR.0b013e3181e93a6f

Greger M. (2020). A Whole Food Plant-Based Diet Is Effective for Weight Loss: The Evidence. American journal of lifestyle medicine, 14(5), 500–510. https://doi.org/10.1177/1559827620912400

Kahleova, H., Petersen, K. F., Shulman, G. I., Alwarith, J., Rembert, E., Tura, A., Hill, M., Holubkov, R., & Barnard, N. D. (2020). Effect of a Low-Fat Vegan Diet on Body Weight, Insulin Sensitivity, Postprandial Metabolism, and Intramyocellular and Hepatocellular Lipid Levels in Overweight Adults: A Randomized Clinical Trial. JAMA network open, 3(11), e2025454. https://doi.org/10.1001/jamanetworkopen.2020.25454

Lee, Y. M., Kim, S. A., Lee, I. K., Kim, J. G., Park, K. G., Jeong, J. Y., Jeon, J. H., Shin, J. Y., & Lee, D. H. (2016). Effect of a Brown Rice Based Vegan Diet and Conventional Diabetic Diet on Glycemic Control of Patients with Type 2 Diabetes: A 12-Week Randomized Clinical Trial. PloS one, 11(6), e0155918. https://doi.org/10.1371/journal.pone.0155918

Lynch, H. M., Buman, M. P., Dickinson, J. M., Ransdell, L. B., Johnston, C. S., & Wharton, C. M. (2020). No Significant Differences in Muscle Growth and Strength Development When Consuming Soy and Whey Protein Supplements Matched for Leucine Following a 12 Week Resistance Training Program in Men and Women: A Randomized Trial. International journal of environmental research and public health, 17(11), 3871. https://doi.org/10.3390/ijerph17113871

Lynch, H., Johnston, C., & Wharton, C. (2018). Plant-Based Diets: Considerations for Environmental Impact, Protein Quality, and Exercise Performance. Nutrients, 10(12), 1841. https://doi.org/10.3390/nu10121841

Melina, V., Craig, W., & Levin, S. (2016). Position of the Academy of Nutrition and Dietetics: Vegetarian Diets. Journal of the Academy of Nutrition and Dietetics, 116(12), 1970–1980. https://doi.org/10.1016/j.jand.2016.09.025

Merino, J., Joshi, A. D., Nguyen, L. H., Leeming, E. R., Mazidi, M., Drew, D. A., Gibson, R., Graham, M. S., Lo, C. H., Capdevila, J., Murray, B., Hu, C., Selvachandran, S., Hammers, A., Bhupathiraju, S. N., Sharma, S. V., Sudre, C., Astley, C. M., Chavarro, J. E., Kwon, S., … Chan, A. T. (2021). Diet quality and risk and severity of COVID-19: a prospective cohort study. Gut, 70(11), 2096–2104. https://doi.org/10.1136/gutjnl-2021-325353

Oikonomidou, A. C., Dardavesis, T. I., Williams, J., Wickramasinghe, K., Breda, J., & Chourdakis, M. (2021). Intake and adequacy of the vegan diet. A systematic review of the evidence. Clinical nutrition (Edinburgh, Scotland), 40(5), 3503–3521. https://doi.org/10.1016/j.clnu.2020.11.035

Satija, A., & Hu, F. B. (2018). Plant-based diets and cardiovascular health. Trends in cardiovascular medicine, 28(7), 437–441. https://doi.org/10.1016/j.tcm.2018.02.004

Wright, N., Wilson, L., Smith, M., Duncan, B., & McHugh, P. (2017). The BROAD study: A randomised controlled trial using a whole food plant-based diet in the community for obesity, ischaemic heart disease or diabetes. Nutrition & diabetes, 7(3), e256. https://doi.org/10.1038/nutd.2017.3