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EAT-Lancet Commission Outlines a Healthy, Sustainable Diet

Diet is intimately linked both to human and environmental health. In this article, a commission of distinguished scientists from different fields set out to examine the components of a healthy diet and the link between diet and environmental health. Through an extensive review of literature, the researchers found that an ideal diet that meets basic nutritional needs and can be sustainably produced is mostly plant-based. Specifically, this diet is based around about 11 ounces vegetables, 9 ounces of dairy foods (a little over a cup of milk) 8 ounces of whole grains (about 8 servings, such as a slice of bread or a ½ cup cooked grains), 7 ounces of fruit, 3 ounces of legumes, 2 ounces of nuts, and an optional 2 ounces of other animal foods (like eggs, poultry, or meat) per day. The authors suggest that a global shift towards these dietary principles can prevent approximately 11 million deaths per year, and can sustainably produce enough food for the growing population without further damage to the environment.
Lancet.  2019 Feb 2;393(10170):447-492. doi: 10.1016/S0140-6736(18)31788-4. (Willett W et al)

Plant-Based Korean Diet with Brown Rice Can Improve Blood Pressure and Blood Sugar in Hospitalized Patients

Many people are surprised at how effective lifestyle changes can be when it comes to managing chronic disease. In this study, 160 hospital patients in South Korea with high blood pressure changed their diet to eat a plant-based (vegan) diet based on brown rice at each meal, with lots of kimchi and pickled vegetables, fermented soy foods, and lots of other vegetables (both raw and cooked). They averaged about 1,700 calories per day and did not eat any refined grains or any noodles or breads, relying on brown rice as the staple. Their sodium intake was quite high, at 7,382mg per day. However, after about 2 weeks, 86% of the patients were able to stop taking their blood pressure and diabetes medications, and their reduced blood pressure levels remained stable even after stopping the medications. Similarly, HBA1C reduced from 7.6 to 7.2, indicating better blood sugar management. More research is needed to see if similar approaches might be effective in other populations.
Journal of Ethnic Foods. 2018 Nov 1. DOI: https://doi.org/10.1016/j.jef.2018.09.002 (Jung SJ et al.)

Shifting to Healthy Vegetarian Diets Could Lower Earth's Water Footprint by 35-55%

Scientists are beginning to discover that eating choices that are best for people also happen to be best for the planet. Researchers from the European Commission’s Directorate for Sustainable Resources analyzed national food surveys, water footprint databases, and other datasets across the UK, France, and Germany to determine how the water footprint changes when people shift their diet. They found that shifting from the current eating pattern to a healthy eating pattern (that contains meat) cut reduce the water footprint by 11-35%, and that even larger reductions could be made by shifting to a healthy pescatarian (vegetarian with fish) diet (33-35% reduction) or a healthy vegetarian diet (35-55% reduction).
Nature Sustainability. 2018 Sept 1. doi: 10.1038/s41893-018-0133-x. (Vanham D et al.)

Healthy Diets (Like Mediterranean, Vegetarian) May Improve Gut Microbiome

Scientists are increasingly interested in researching the gut microbiome, the community of bacteria of our digestive tract, as studies suggest that the types of microbes we produce and carry around may impact our risk for chronic disease. In this review, researchers analyzed the existing research on diet and the gut microbiome, focusing on vegetarian diets and Mediterranean diets. Both epidemiological studies and randomized clinical trials demonstrate that healthy Mediterranean and vegetarian diets are linked with various beneficial changes to the gut microbiome (such as increased short chain fatty acid production, increases in Prevotella, and decreases in trimethylamine). They suggest that these healthy diets may lower risk of chronic disease by impacting our gut microbiome, but that more research is needed to identify the exact mechanism.
Journal of Nutrition. 2018 Sep 1;148(9):1402-1407. doi: 10.1093/jn/nxy141. (Tindall AM et al.)

Protein from Nuts and Seeds Linked with Less Death from Heart Disease than Protein from Meat

Protein is important for our muscles, enzymes, and numerous essential body processes, but not all protein is created equal. To see how different protein sources relate to heart disease deaths, researchers carefully analyzed the diets of 81,337 men and women. Those getting more protein from nuts and seeds were significantly less likely to die from heart disease than those not getting as much protein from nuts and seeds. On the other hand, those getting more protein from animal sources had a higher risk of dying from heart disease. The relationship between heart disease death and these foods was so strong, even after controlling for other diet and lifestyle factors, that the researchers concluded that the link “could not be ascribed to other associated nutrients considered to be important for cardiovascular health.”
International Journal of Epidemiology. 2018 Apr 2. [Epub ahead of print] (Tharrey M et al.)

Both Mediterranean and Vegetarian Diets Effective for Weight Loss

From Mediterranean to vegetarian, many of the world’s healthiest diets actually have more similarities than differences, so it’s not surprising to find that both these diets can be an effective path to weight loss. In this study, researchers randomly assigned 118 overweight adults who normally eat meat to either a lower calorie Mediterranean diet or a lower calorie vegetarian diet for 3 months. After a two-week assessment, the participants then switched to the other diet for 3 months. Participants lost about 4 pounds during each diet, and both diets were also effective at decreasing body fat. The only significant difference between the diets was that the vegetarian was slightly more effective in lowering bad (LDL) cholesterol, while the Mediterranean diet was slightly more effective in lowering triglycerides (a type of fat in the blood).
Circulation. 2018 Feb 26. (Sofi F et al.) [Epub ahead of print]

Plant-Based Mediterranean Diet Just as Effective as Drugs at Treating Silent Reflux

Laryngopharyngeal reflux, also known as “silent reflux,” a condition resulting in stomach acid entering the esophagus, is most commonly treated with medication (proton pump inhibitors), but such medications are increasingly tied to long-term side effects. To determine whether a wholly dietary approach can be as effective, researchers studied 85 patients with silent reflux who used medication and 99 patients who were treated with alkaline water (water that’s slightly less acidic than tap water), a plant-based, Mediterranean-style diet, and standard reflux dietary precautions (no coffee, chocolate, soda, greasy/fried fatty foods, or alcohol). There was no significant difference in Reflux Symptom Index, a scoring chart used to assess response to treatment, between the two treatments, indicating that the dietary approach may be just as effective as medicine.
JAMA Otolaryngology – Head & Neck Surgery. 2017 Sep 7. (Zalvan CH et al.) [Epub ahead of print.]

Plant Based Diets Linked with Lower Cholesterol

Research continues to support the benefits of plant based diets, which feature wholesome foods like fruits, vegetables, whole grains and legumes. To get a better picture of the long-term effects, researchers analyzed 49 studies (19 clinical trials, 30 observational). Consistent with other reviews, they found that following a vegetarian diet is linked with lower cholesterol (29.2 mg/dL lower total cholesterol, 22.9 mg/dL lower LDL “bad” cholesterol, and 3.6 mg/dL lower HDL “good” cholesterol) compared with meat containing diets, but the lower levels of fat in the blood (triglycerides) were not statistically significant.
Nutrition Reviews. 2017 August 21. (Yoko Yokoyama et al.) [Epub]

Healthy Plant-Based Diets Linked with Lower Risk of Coronary Heart Disease

Wholesome plant foods are the foundation of a healthy diet, but not all “vegetarian” foods are equally nutritious. To see how different variations of plant-based diets relate to the risk of developing coronary heart disease (when plaque builds and hardens in the heart’s major blood vessels and decreases blood flow), researchers analyzed data detailing what more than 200,000 people ate over 20 years and separated people into three versions of plant based diets: overall plant-based diet (includes all plant foods and some animal foods), healthful plant-based diet (includes healthy plant foods like whole grains, fruits, and vegetables), and unhealthful plant-based diet (includes sugar-sweetened drinks and refined grains). Not surprisingly, they found that the second choice – eating fewer animal foods and more healthy plant foods – was linked with a lower risk of developing coronary heart disease, while eating more animal foods and more unhealthy plant foods was linked with an increased chance of developing coronary heart disease.
Journal of the American College of Cardiology. 2017 July; 70(4):411-422. (Satija et al.)

Vegetable Protein Linked with Lower Risk of Early Menopause

Early menopause is linked with health risks, like heart disease, so strategies to prolong fertile years in women are an important area of research. In a study of 85 women, women with the highest plant protein intake had a 16% lower risk of early menopause (defined as menopause before age 45) compared to women with the lowest intake in the group. Plant foods with protein include beans, peas, nuts, seeds, lentils, whole grains and soy foods. Overall animal protein intake was unrelated to risk of early menopause, but red meat intake was associated with a 12% higher risk of early menopause. Additionally, one serving per day of pasta, dark bread, or cold cereal was also associated with lower risk of early menopause, at 36%, 7%, and 18%, respectively.
American Journal of Epidemiology. 2017 June 24. [Epub ahead of print] (Boutot ME et al.)

Lose Weight (and Fat) with a Vegetarian Diet

Vegetarians tend to weigh less than omnivores, but researchers wonder whether their body fat distribution might be different as well. To test this relationship, researchers randomly assigned 74 adults with type 2 diabetes to either a vegetarian or non-vegetarian diet for 6 months. Both diets were restricted by 500 calories per day, and the second half of the study included aerobic exercise for both groups. The vegetarian diet was almost twice as effective at weight loss (13.7 pounds lost) as the conventional calorie-restricted diet (pounds lost). The vegetarian diet also reduced subfascial fat (a type of internal fat related to poor blood sugar control) by 0.82 cm squared, but the conventional weight-loss diet did not.
Journal of the American College of Nutrition. 2017 June 10;1-6. (Kahleova H et al.)

Plant-Based Diet Can Reduce Obesity Risk by 43%

Nearly every healthy diet around the world is centered on a foundation of colorful produce. To see how eating more plant foods relates to obesity risk, scientists analyzed the diets of 16,000 healthy (non-obese) adults in Spain. Those eating the most plant-based diets (high in fruits, vegetables, grains, nuts, olive oil, and pulses, and low in meat, dairy, seafood, and other animal products) had a 43% lower risk  of becoming obese throughout the 10-year study than those with the most animal-based diets, even after controlling for age, physical activity, and other demographic factors. (Note that findings presented at meetings are typically viewed as preliminary until they’ve been published in a peer-reviewed journal.)
Presented at the European Congress on Obesity. Porto, Portugal. May 18, 2017. (Sanz J et al.)

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