WHAT IS A WHOLE FOOD, PLANT- BASED DIET?

Whether you think of it as a diet or a nutritional lifestyle, the descriptive term whole food, plant-based is cropping up everywhere, from food product labels and menu-listings to book titles and celebrity testimonials. Where did this term come from? What does it mean exactly? What are the health benefits of this lifestyle?

In the 1980s, Dr. T. Colin Campbell, author of the best-selling book, The China Study,1 assigned the term whole food, plant-based diet to a diet consisting of foods that were low in fat and high in fiber, with an emphasis on vegetables, fruits, and whole grains.2 Since then, what comprises a whole food, plant-based diet has come to mean different things to different people, ranging from eating mostly plants but still including a limited amount of meat and/or dairy to only consuming foods from plant sources, with minimal processing (animal- based and processed foods are avoided entirely). And when other plant-based lifestyle terms like veganism and vegetarianism are thrown in the mix, things get a little more complex.

VEGETARIANISM VS. VEGANISM VS. WHOLE FOOD, PLANT-BASED DIET

By definition, a vegetarian’s diet consists wholly of vegetables, fruits, grains, and nuts; no meat is consumed. However, some vegetarians include eggs (ovo-vegetarian), fish (pescatarian), and/or dairy (lacto- vegetarian) foods in their diet.3 A vegan, on the other hand, does not eat animals or any type of food derived from animals (e.g., eggs, dairy, honey). In addition, some individuals who choose a vegan lifestyle avoid using products made from animals (e.g., leather, fur, silk, wool, cosmetics, soaps).4 People who adhere to vegetarian or vegan diets choose to do so for a variety of personal reasons—whether for health, environment, ethics, or religion (or a combination of these). But, while both vegetarianism and veganism are considered plant-based diets, neither are necessarily whole food, plant-based.

A whole food, plant-based diet comprises only plant-based foods in their whole or minimally processed form (e.g. potatoes, rice, oats, fruits, legumes, vegetables, nuts, and seeds). Excluded from this list are highly processed foods, such as plant-based oils and sugars, and any type of animal- sourced foods, including meat, dairy, and eggs. Like other lifestyle choices, choosing a whole food, plant-based lifestyle might be motivated by any number of health, environmental, ethical, or religious reasons, and the reasons can vary widely from individual to individual. What distinguishes a vegan diet from a whole food, plant- based diet is that a vegan diet may include processed foods, as long as they do not contain animal products. For example, potato chips, candy, French fries, and many meat substitutes (which typically contain high levels of fats, salt, sugars, preservatives, and food additives) can all be part of a vegan diet. A whole-food, plant-based diet, on the other hand, includes only whole or minimally processed plant-based foods. This is an important distinction when considering the health benefits of vegetarian, vegan, and whole food, plant-based diets.

THE HEALTH BENEFITS OF A WHOLE FOOD, PLANT-BASED DIET

The health benefits of a whole food, plant-based diet have been well documented in scientific literature, particularly regarding its ability to reduce risk factors associated with diseases caused by modifiable lifestyle behaviors (e.g., diet, physical activity). These diseases include heart disease, certain types of cancer, Type 2 diabetes, and certain types of autoimmune diseases, and affect tens of millions of Americans. For example, The China Study,1 the largest human population nutrition study ever conducted, found 8,000 statistically significant relationships between lifestyle, diet, and disease. The study’s investigators observed the following:

1. Consumption of animal protein was associated with growth of cancer.

2. A plant-based diet was associated with reversal of heart disease.

3. People who ate the most animal- based foods got the most chronic disease.

4. People who ate the most plant- based foods were the healthiest.

5. In addition to heart disease and cancer, a plant-based diet was associated with reduced risk for diabetes, obesity, autoimmune diseases, and bone, kidney, eye and brain diseases.

Results from other large studies, such as the Adventist Health Study of Loma Linda5 and the Framingham Heart Study,6 support the observations seen in the China Study, indicating that a whole food, plant-based diet can prevent and even reverse some lifestyle-related diseases.

Heart disease.

Heart disease is the leading cause of death in the United States (US), with 836,000 related deaths each year; this translates into 2,300 deaths per day or one related death every 38 seconds in the US from heart disease.7 It is imperative that we develop prevention and reversal treatments that are effective and long lasting. Not only has a plant-based diet been shown to reduce the risk for heart disease but it has been shown to reverse the disease in some patients. Patients with advanced heart disease and those who had suffered heart attacks who adopted a plant-based dietary lifestyle were still alive 10 and 20 years later, respectively, with no further cardiac incidents.8–12

Cancer.

Cancer is the second leading cause of death in the US (500,000 related deaths per year). Research has shown that people who consumed a plant-based diet reduced cancer risk factors, increased survivability, and decreased recurrence of nearly all cancers, including breast, colon, pancreatic, and prostate.13–20

Diabetes.

The incidence of Type 2 diabetes has increased over the past 20 years. At least 37 million people in the US (representing 10% of the population) are believed to have diabetes, and 25 percent (1 in 4) of American adults 65 years of age or older have diabetes.21 Studies have shown that people with Type 2 diabetes who switched to a whole food, plant-based diet were able to control their blood sugar three times more effectively than those who did not consume a plant- based diet. Additionally, the plant- based diet groups exhibited accelerated weight loss, controlled cholesterol, decreased blood pressure, and reduced or complete elimination of diabetes medications, and, in many patients, a reversal in their disease, compared to the non-plant-based diet groups. 22–27

Autoimmune diseases.

The number of people reported to be suffering from some form of autoimmune disease in the US ranges from 23 to 50 million. 28,29 an autoimmune disease is caused by an immune reaction to antibodies that are produced against one’s own tissues.30 Common autoimmune diseases include lupus, rheumatoid arthritis, multiple sclerosis, inflammatory bowel disease, and psoriasis. A plant-based diet has been shown to improve inflammation and reduce pain symptoms in people with autoimmune diseases, such as rheumatoid arthritis and lupus.23–25

GET STARTED ON YOUR HEALTH- CHANGING JOURNEY

Overall, the health benefits from eating more fruits, vegetables, and whole grains cannot be disputed. No matter what nutritional lifestyle you choose, remember: it is progress, not perfection, that keeps us on the road to better health. I adopted a plant- based lifestyle over nine years ago, and I have experienced life-changing health benefits. It has not always been easy, but I have found that I am most successful when I surround myself with others (online and in person) who have a similar nutritional lifestyle. Educating yourself with science-based information; preparing easy, healthy, and nutritious recipes; planning and prepping your meals in advance; and building a supportive social network, can ease your transition into a whole food, plant-based lifestyle and get you started on a health-changing journey that may enhance the quality of your life.

REFERENCES

1. Campbell TC, Campbell TM. The China Study: The Most Comprehensive Study of Nutrition Ever Conducted and the Startling Implications for Diet, Weight Loss and Long-term Health. Dallas, TX: Benbella Books; 2006.

2. Campbell TC. History of the term whole food plant based. 29 Nov 2016. Center for Nutrition Studies site. https:// nutritionstudies.org/ history-of-the-term-whole-food-plant-based/. Accessed June 2019.

3. Vegetarian definition. Merriam Webster Dictionary. https://merriam.webster.com/ dictionary/vegetarian/. Accessed June 2019.

4. Vegetarian Resource Group site. Vegetarianism in a nutshell. https://www.vrg.org/nutshell/ nutshell.htm. Accessed June 2019.

5. Loma Linda University School of Public Health site. Adventist Health Study-2: Early findings. https://publichealth.llu.edu/adventist-health- studies/findings. Accessed June 2019.

6. Framingham Heart Study site. https://www. framinghamheartstudy.org. Accessed June 2019.

7. Heart disease and stroke statistics 2018 at-a- glance. American Heart Association site. 31 Jan 2018. https://heart.org/-/media/data-import/ downloadables/heart-disease-and-stroke- statistics-2018—at-a-glance-ucm_498848.pdf Accessed June 2019.

8. Ornish D, Brown SE, Scherwitz LW, et al. Can lifestyle changes reverse coronary heart disease: The lifestyle heart. The Lancet. 1990;336(8708)129–133.

9. Ornish D, Scherwitz L, Billings JH, et al. Intensive lifestyle changes for reversal of coronary heart disease. JAMA. 1998280(23):2001–7.

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11. Tuso P, Stoll SR, Li WW. A plant-based diet, atherogenesis and coronary artery disease prevention. Perm J. 2015;19(1)62–67.

12. Threapleton DE, Greenwood DC et al. Dietary fibre intake and risk of cardiovascular disease: Systematic review and meta-analysis. BMJ. 2013;347:f6879.

13. Key, TJ, PN Appleby, Spencer, EA et al. Cancer incidence in British vegetarians Br J Cancer. 2009; 101(1): 192–197.

14. Thompson, CA Habermann TM, Wang AH, et al. Antioxidant intake from fruits, vegetables and other sources and risk of non-Hodgkin’s lymphoma: the Iowa Women’s Health Study. Int J Cancer. 2010: 126(4):992–1003.

15. Han X, Zheng T, Foss F, et al. Vegetable and fruit intake and survival from non-Hodgkin’s lymphoma in Connecticut women. Leuk Lymphoma. 2010 (51(6): 1047–1054.

16. Bosetti C, Bravi F, Turati F, et al. Nutrient-based dietary patterns and pancreatic cancer risk. Ann Epidemiol. 2013. 23(3):124–128.

17. Mills PK, Beeson WL, Abbey DE, et al. Dietary habits and past medical history as related to fatal pancreatic cancer risk among Adventists. Cancer. 1988. 61(12): 2578–2585.

18. Aune D, Chan DS, Lau R, et al. Dietary fibre, whole grains, and risk of colorectal cancer: systematic review and dose-response meta-analysis of prospective studies. BMJ. 2011; 343-d6617.

1. Aune D, Chan DS, Greenwood DC, et al. Dietary fiber and breast cancer risk: a systematic review and meta-analysis of prospective studies. Ann Oncol. 2012. 23(6):

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• Ornish D, Weidner G, Fair WR. Intensive lifestyle changes may affect the progression of prostate cancer. J Urol. 2005;174(3):1065–1069.

• National diabetes statistics report. 6 Mar 2018. United States Centers for Disease Control and Prevention site. https://www.cdc.gov/diabetes/data/statistics-report/index.html. Accessed 25 Sep 2019.

• Barnard ND, Cohen J, Jenkins DJ, et al. 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. 2006;29:1777–1783.

• Satija A, Bhupathiraju SN, Rimm EB, et al. Plant-based dietary patterns and incidence of type 2 diabetes in US men & women: results from three prospective cohort studies. PLOS Med. 14 Jun 2016. Epub. Doi:10.1371/journal.pmed.1002039.

• Yao B, Fang H, Xu W et al. Dietary fiber intake and risk of type 2 diabetes: a dose-response analysis of prospective studies. Eur J Epidemiol. 2014; 29(2):79–88.

• Chowdhury BR. Diabetes reversal by plant-based diet. J Metabolic Synd. 2017;6(4):232.

• Utami DB, Findyartini A. Plant-based diet for HbA1c reduction in type 2 diabetes mellitus: an evidence-based case report. Acta Med Indones. 2018;50(3):260–267.

• Ramirez M. How I reversed my diabetes and stopped all medications with a plant-based diet. 29 Apr 2015. https://www.forksoverknives.com/how-i-reversed- my-diabetes-and-stopped-all-medications-with-a-plant-based-diet/#gs.jz6byb3. Accessed June 2019.

• WebMD site. What are autoimmune disorders? 14 Aug 2018. https://www.webmd. com/a-to-z-guides/autoimmune-diseases. Accessed 25 Sep 2019.
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