You are not alone if you are asking, “Where will I get my protein?” People believe this single nutrient is so important and difficult to get that we must actively pursue foods that contain high amounts of it, even when those foods, such as meat and dairy, in so many ways, compromise our health. We have been led to believe that primarily animal-based foods contain sufficient protein and, furthermore, that we need to eat those foods to avoid becoming protein-deficient. The reality is that protein deficiency is almost exclusively seen in people suffering from a calorie deficiency. In these cases, there will be an overall nutrient deficiency, not just protein deficiency, and when this happens the concern should be getting more calories and all nutrients—not just more protein. When you eat a diet based on fruit, vegetables, tubers, whole grains, and legumes about 10% of your total calorie intake will be from protein. We list this percentage only to demonstrate how the diet contains a sufficient amount of this nutrient­—not as any kind of target. In fact, you should not worry about how much protein you’re getting any more than you should worry about the perfect number of breaths you should take in a day. And, if you’re worried that 10% isn’t adequate, note that there’s evidence that consuming too much protein is harmful—especially when it comes from animal sources.

READ MORE

Vegetarians and Vegans Eat Enough Protein?

Many believe that it’s important to get enough calcium from certain foods, especially milk and other dairy products, which they perceive to be excellent “sources” of it. It’s easy to interpret this message—that constant vigilance is necessary to make sure we’re getting our calcium—as an implicit warning that we might not otherwise get enough. Just as with protein it is not difficult to get enough calcium—you just need to eat whole, plant-based foods. Calcium, like iron, magnesium, and copper, is a mineral. It is found in the soil, where it is absorbed into the roots of plants. Animals get their calcium by consuming the mineral-abundant plants and metabolizing that calcium into their bodies. Surprised? That’s because we’ve been so conditioned to think that calcium comes primarily from milk and dairy products that few of us realize it actually comes from the earth and is abundant in all whole foods. For strong bones and calcium, how much of the nutrient you get isn’t as important as where you get it—and how you lose it. There are two major contributing factors to the leaching of calcium from bones, which leads to their weakening and may increase the risk for osteoporosis: First, consuming a highly acidic diet. Our bodies are alkaline. It is vital that the acidity level of your diet is not so high that your bones must leach calcium to keep your body’s alkaline levels balanced. The levels of acidic compounds are lower in plant foods so they won’t draw the calcium from your bones the way animal foods will. Eating a whole-food, plant-based diet gives your body the acid/alkaline balance it needs for optimal bone health. Second, consuming a high-sodium diet. The diet we recommend is naturally low-sodium, as it relies very little on processed foods, which tend to be very high in salt. Once a certain threshold for calcium has been met—which you will do eating a whole-food, plant-based diet—the formula for strong bones relies on two other factors entirely: First, that you get sufficient vitamin D from exposure to the sun. Vitamin D is a key factor in calcium absorption, and the sun is the best way for us to meet our requirement. The key is getting sufficient sun exposure on our bare skin without getting burned. (The vitamin D in milk is added to it; we do not recommend getting vitamin D from milk or other fortified foods in which the vitamin does not naturally occur.) Second, that you practice strength training and impact exercise. When you lift weights or do resistance exercises you not only build muscle, you stress your bones—this makes them stronger. Walking, jogging, and running are examples of impact exercises that will also help with bone strength. As with protein, many organizations will suggest that you need to consume a specific amount of calcium per day for strong bones. We do not make any such recommendations because we know that good bone health has nothing to do with hitting an arbitrary number for calcium intake. Furthermore, we fervently believe that when people are instructed to achieve these subjective targets, it creates a skewed notion of what is good nutrition and leads people to make poor food choices—as is the case with dairy.

READ MORE

Getting Clarity About Calcium

Some fats are necessary in our diet. Consuming oil, fish, and highly processed foods as a means to get these, however, is unnecessary, and even harmful. Every whole plant food has fat, and there’s no evidence that we need any more fat than what occurs naturally in a low-fat, whole-food, plant-based diet. Just as is the case with protein and calcium, we should not target specific foods to get enough of a particular kind of fat. Omega-3 and omega-6 fatty acids appear to be involved in a variety of important bodily functions, including cell membrane stabilization, nervous system function, immune system function, and blood clotting, as well as impacting triglyceride levels, blood pressure, inflammation, cancer, and heart disease. Although they are both essential (meaning you need to consume them), you have probably heard a lot more often that you need to seek out omega-3. This is not because it is more essential than omega-6. Instead, it is because, in general, these two essential fatty acids should be consumed in a healthy ratio to each other. Studies are not clear exactly what that ratio should be, but we do know that the Standard American Diet is significantly skewed in such a way that we get an excess of omega-6. This excess consumption of omega-6 impairs the absorption of omega-3.1 The answer, however, is not simply that you need to eat more omega-3 fats. The answer is to eliminate or minimize processed and animal-based foods and instead eat a whole-food, plant-based diet, which we know in most cases restores a healthy omega-6 to omega-3 balance and, more important, leads to positive health outcomes. And isn’t that what we care about most? If 1 to 3 percent of your calories come from the essential fats, you’ll be in great shape. Adequate omega-3 intake specifically is 1.1 g for adult women and 1.6 g for adult men.2 That’s 1⁄4 to 1⁄3 teaspoon per day. If you meet all your caloric needs with a low-fat, whole-foods diet full of fruits, vegetables, whole grains, and legumes, you will easily consume enough essential fatty acids and those fatty acids will be in good balance to each other. Note that while walnuts and flax- and chia seeds are whole plant foods with higher concentrations of essential fatty acids, there’s no evidence that you actually need to eat these foods to get the proper amount of any kind of fat. Most whole plant foods have small amounts of essential fats. Over the course of a day full of these foods you will achieve the needed amounts—which aren’t that much to begin with. In fact, it is significantly more important to worry about not consuming excess fat than it is to worry about consuming sufficient omega-3.1Philip C. Calder, “N-3 Polyunsaturated Fatty Acids, Inflammation, and Inflammatory Diseases,” American Journal of Clinical Nutrition 83 (June 2006): 1505S–19S.2Jennifer J. Otten, Jennifer Pitzi Hellwig, and Linda D. Meyers, eds., DRI: Dietary Reference Intakes: The Essential Guide to Nutrient Requirements (Washington, DC: National Academies Press, c. 2006).

The guiding principle of the WFPB diet is a focus on whole (or minimally processed) plant-based foods. Oil is not a health food and not essential to a healthy diet. For people with heart disease or major risk factors such as hypertension, high LDL cholesterol, diabetes, or obesity, avoiding or minimizing added oil is beneficial. For others, research suggests a small amount of extra-virgin olive oil or other vegetable oil is unlikely to be harmful. That being said, oils remain the world’s most calorie-dense foods, so replacing them with whole foods is always a win.

READ MORE

How to Order a Healthy Plant-Based Meal from Any Restaurant Menu

The relationship between whole food and the human body is very intricate and has come about as a result of millions of years of evolution. There are countless nutrients and substances in food that lead to thousands of metabolic reactions when they are consumed. As T. Colin Campbell, PhD, describes it, when it comes to nutrition, the whole is greater than the sum of the individual parts. The nutrients in whole food work together much like a symphony; extract and consume those nutrients apart from the whole, and all bets are off as to their effects. The complex, harmonious relationship between our bodies and the whole food we eat might explain why the hardworking supplement industry has not been able to produce beneficial products, despite decades of effort and billions of dollars. Consequently, we do not recommend our patients take supplements—with the notable and important exception of vitamin B12— unless a specific deficiency arises that cannot be corrected with whole, plant-based foods. Putting aside the bluster of consumer marketing, the research on multivitamin supplements is consistent: They do not demonstrate benefit and may cause harm.1 A review of twenty-four randomized controlled trials showed “no consistent evidence that the included [vitamin and mineral] supplements affected CVD [cardiovascular disease], cancer, or all-cause mortality in healthy individuals.”2 Single-vitamin supplements have shown similar negative results. In fact, the harm caused by some of them is dramatic. For example, vitamin A, beta-carotene, and vitamin E—while all healthy when consumed in food—have been shown to significantly increase death when consumed as supplements.3The problems with supplements shouldn’t come as a surprise. The fact that we need a particular nutrient doesn’t mean we need a megadose of it, nor should we consume it in isolation from all the other nutrients and substances it’s designed to work with. It may run counter to what we’ve been taught, but when we think about nutrition, we should think about getting the right amount of nutrients; this means obtaining neither too little nor too much of them—and being sure they are packaged in the right proportions. We should not think for a moment that we are “playing it safe” by taking supplements; the only true way to play it safe is to not take those supplements—and to look instead to whole, plant-based foods for the nutrition we need.1Jaakko Mursu, Kim Robien, Lisa J. Harnack, Kyong Park, and David R. Jacobs, “Dietary Supplements and Mortality Rate in Older Women. The Iowa Women’s Health Study,” Archives of Internal Medicine 171 (October 10, 2011): 1625–33.2Stephen P. Fortmann, Brittany U. Burda, Caitlyn A. Senger, Jennifer S. Lin, and Evelyn P. Whitlock, “Vitamin and Mineral Supplements in the Primary Prevention of Cardiovascular Disease and Cancer: An Updated Systematic Evidence Review for the U.S. Preventive Services Task Force,” Annals of Internal Medicine 159 (December 17, 2013): 824–34.3Goran Bjelakovic, Dimitrinka Nikolova, Lise Lotte Gluud, Rosa G. Simonetti, and Christian Gluud, “Mortality in Randomized Trials of Antioxidant Supplements for Primary and Secondary Prevention: Systematic Review and Meta-Analysis,” Journal of the American Medical Association 297 (February 28, 2007): 842–57.

Vitamin B12 is important for the development and protection of nerve cells and red blood cells and helps in the production of DNA. Insufficient B12 can lead to many health issues, including weakness, fatigue, difficulty concentrating, increased irritability, gastrointestinal distress, anemia, and nervous system dysfunction. B12 is the one nutrient that cannot be obtained sufficiently from today’s plant-based diet. This is not because we need to eat animal products to obtain it. In fact, animal products themselves don’t always contain enough B12.1 The reason for this is that neither plants nor animals naturally synthesize B12. It is made from bacteria. Animals consume dirt, which is full of bacteria, through the unwashed plants and non-chlorinated water they consume. B12 accumulates in the animals’ tissues, which becomes a source of the vitamin for humans when we eat the animal. We humans, on the other hand, rarely eat anything unwashed. In our quest to be clean, we remove the dirt that contains B12-producing bacteria from our foods. This sanitary approach certainly has its benefits, as it has decreased our exposure to parasites and other pathogens. As a result, we believe that when you eat a whole-food, plant-based diet, taking a B12 supplement is the best way to ensure adequate amounts of the nutrient. There is enough research about supplementing B12 that, when taken appropriately, we trust it is beneficial.1Marijke van Dusseldorp, Jorn Schneede, Helga Refsum, et al., “Risk of Persistent Cobalamin Deficiency in Adolescents Fed a Macrobiotic Diet in Early Life,” American Journal of Clinical Nutrition 69 (April 1999): 664–71.

While some people prefer to eat only organic, fresh food, this is not absolutely necessary from a health perspective. Most modern diseases that afflict people are not the result of the difference between organic and conventional produce, fresh and frozen broccoli, or canned and dried beans. Whether our diets lead to health or sickness is determined mainly by the significant difference between whole, plant-based foods on the one side and animal-based and highly processed foods on the other. We should not let our need for convenient, affordable food—including shortcuts, such as canned and frozen as well as less expensive conventional produce—deter us from consuming the whole, plant-based foods that will stave off disease.

The nutrient makeup of animal foods (for example, high in fat and cholesterol; low in fiber and antioxidants) is the main reason why consuming these foods will increase your chances of getting chronic diseases like heart disease and type 2 diabetes. This nutrient profile exists whether animal foods are organic or not, or whether they are grass-fed or not. Replacing animal foods with whole plant-based foods is a significant change that will greatly improve your chances of achieving good health, whereas the change between organic and conventional animal foods is relatively small and therefore unlikely to make much of a difference.

We are always surprised by how many people continue to think that fish is beneficial and important to include in the diet, even long after they become convinced that mammals are not health foods. Much of this perception stems from periodic reports that some study or another has found that fish is “heart healthy” or “good for our brains.” In our review of these studies, time and again we find data is misinterpreted and faulty conclusions are drawn from otherwise reasonable research. Unfortunately, such misinterpretations have occurred so frequently that a false narrative has developed. The practice of misinterpreting data is not unusual. The frequently referenced studies of Okinawan and Mediterranean populations have followed this pattern. The benefits of a diet high in fruits, vegetables, and whole grains frequently get credited to small amounts of fish in the diet (just like they are often credited to olive oil and wine). In the case of the famous Okinawan Centenarian Study, for example, only 1% of calories of the calories consumed by the residents came from fish; the vast majority of the diet—69%—came from sweet potatoes!1 Yet the perception from this very study is that Okinawans are healthy from a fish-heavy diet. What is happening here? We have meaningful long-term studies presented by the researchers with care, which are then pored over by individuals or organizations who cherry-pick data, often to reinforce a specific agenda. The big picture is ignored in favor of subjective claims and reporting, and the public receives false takeaway messages like “Eat more fish!” As our friend and teacher Dr. John McDougall likes to say, “A muscle is a muscle, whether it comes from a chicken, cow, or fish.” In other words, the nutrient profile of all animal products—i.e., high in fat, acid, and cholesterol, and low in fiber and carbohydrates—is as true for fish as it is for beef and other meats. In fact, although fish is often marketed as a wise, “heart-healthy” food choice, it has as much cholesterol as beef, chicken, and pork. And when we look at studies of populations and what they eat, we should examine the entire big picture. In doing so, we see the message is consistent: “Eat more plants!”