"Okay, but what do I eat... how much meat? Is there is difference between choosing chicken or red meat? What do I make for breakfast? How much saturated fat?" All of these questions fired at me in a single breath.
With the holiday season in full swing, I am fielding questions left and right about what we should be eating for optimal health. And while I don't agree that there is a one-size fits all diet for everybody, there are some basic principals to keep in mind.
There is no debate that we should all be eating more plants. But what is optimal and what is practical are two very different questions. If optimal isn't attainable, or if we are stuck with perfectionist thinking (an "all or nothing" approach), or barely struggling to make it by as is, then optimal likely shouldn't be our goal... at least not initially. Yes, there is an optimal for those of us with the means and know-how to do it, but for many of us, a slower transition focusing on one dietary goal at a time is likely the most practical response. That's why I specialize in helping clients succeed in making long-term sustainable changes to improve health outcomes.
So what is an optimal dietary pattern? Based on my own understanding of the current evidence, I agree with the scientists at EAT-Lancet, a commission on food, the planet and human health who seem to think that the answer is a plant-based dietary pattern.
The EAT-lancet committee very clearly outline the Planetary Diet recommendations down to the gram. These amounts are based on a 2500 kcal/day dietary intake (the average daily calorie need for an adult female).
Aim for a minimum of 1 lb of non-starchy vegetables per day, with an eventual goal of 1-2 lbs per day (EAT-Lancet suggests 500-600 grams per day). Sorry, potatoes, peas and corn don’t count (they’re starchy).
Snack on fruit (around 100-300 grams per day). That’s the equivalent to one giant apple or 1-2 cups of berries.
Include 2-3 serving of nuts (50-70 grams per day)
Learn to love legumes (dry beans, lentils and peas). Aim for 75-100 grams (dry weight) per day as the main protein source.
Limit red meat, poultry and fish.
Note that the following are weekly limits:
No more than 98 grams of red meat, 203 grams of poultry or 196 grams of fish to flavor dishes (as a topper, rather than the main dish)
Choose unsaturated plant fats (olive oil for cold dishes. Avocado or grape-seed oil for cooking because these oils have a higher smoke point).
Limit saturated fat intake to no more than 11.8 grams per day.
A tablespoon of butter has 7 grams of saturated fat (4). So that’s, around 1.5 tablespoons of butter if you don’t plan on consuming any other animal-based fats for the day (ie, cheese, milk, yogurt, meat and many processed foods).
Choose whole grains, limiting refined grain intake (flour, sugar and processed foods). Aim for less than 5% of daily calories from added sugar.
How much whole grains and starchy vegetables? Aim for 232 grams of cooked whole grains per day and 50-100 grams of starchy vegetables.
Include dairy if you prefer, aiming for 0 to 500 grams per day.
It’s important to remember that what is optimal in theory versus practical in each of our personal situations will be different. If you have the financial means and the confidence to make a dietary transition, then the EAT-Lancet Planetary Health Diet is the best choice for optimal health, longevity and the environment.
The planetary health diet is flexible by providing guidelines to ranges of different food groups that together constitute an optimal diet for human health and environmental sustainability. It emphasizes a plant-forward diet where whole grains, fruits, vegetables, nuts and legumes comprise a greater proportion of foods consumed. Meat and dairy constitute important parts of the diet but in significantly smaller proportions than whole grains, fruits, vegetables, nuts and legumes. In addition to the targets set within each section, the dietary targets also suggest that the average adult requires 2500 kcal per day. While this amount will vary based on age, gender, activity levels and health profiles, overconsumption is a waste of food with both health and environmental costs.(1)
The commission stresses that this dietary pattern is “not a question of all or nothing” when it comes to animal foods, but rather a gradual transition towards a plant based dietary pattern that is more sustainable for the planet (2). While many patient's commonly think in black or white terms, asking me questions like "is this food good or bad?", the answer lies across the dietary continuum. The further that we move away from the Standard American Diet (SAD) towards a plant-based dietary pattern, the better our health outcomes will be. How far along that spectrum that each of us personally need to move depends on our current state of health and our goals.
For example, someone living with Pre-diabetes or Type 2 Diabetes Mellitus will need to make significantly larger shifts in the dietary pattern to reverse their chronic illness than a person of good health looking to improve biomarkers and reduce cardiovascular risk.
How can the EAT-Lancet dietary pattern improve our health?
We know that the foods that we chose on a day-to-day basis significantly impact our risk of developing diabetes, cancer and heart disease (heart attacks, hypertension, hyperlipidemia, heart failure, stroke, peripheral vascular disease, etc). Even swapping out 2 servings per day of meat for a plant-based mimic can improve health outcomes (3). The commission estimates that this transition could lead to a global prevention of “11 million premature adult deaths by 2050” (2). Recommendations from the American Cancer Society (ACS) and the American Heart Association (AHA) certainly support this estimate (5)(6). The most recent recommendations by the AHA even went as far as to advocate choosing “mostly protein from plants (legumes and nuts)” in their 2021 Dietary Guidelines to Improve Cardiovascular Health (6). That's why Lifestyle Medicine Maine recommends a gradual transition towards a Plant Based Dietary Pattern for most patients.
Good food can be a powerful driver of change: The EAT-Lancet Commission outlines a planetary health diet, which is flexible and recommends intake levels of various food groups that can be adapted to local geography, culinary traditions and personal preferences.(2)
Now, what to cook for dinner?
Check out the EAT-Lancet Cook Club, featuring ethnically diverse recipes.
Looking for guidance in making this dietary transition for you or a loved one?
Jessica Krol, FNP, DipACLM is a Lifestyle Medicine Professional (board certified through the American College of Lifestyle Medicine) with advanced training on plant based dietary patterns as a therapeutic tool to improve health outcomes, and in some cases, reverse chronic illness. As the sole provider at Lifestyle Medicine Maine, Jessica Krol understands that change isn't easy. While many of us know what we should be doing, most of us aren't sure where to start or how to effectively implement these changes in a way that is sustainable. Lasting change is dependent on systems, not will power. If you're looking to get started, then sign up for a FREE initial consult to see if Jessica Krol, FNP, DipACLM can help you achieve your health goals.
References
1. The Planetary Health Diet. The EAT-Lancet Commission on Food, Planet and Health. (accessed 11/2023). https://eatforum.org/eat-lancet-commission/the-planetary-health-diet-and-you/
2. EAT-Lancet Commission Brief for Healthcare Professionals. The EAT-Lancet Commission on Food, Planet and Health. (accessed 11/2023). https://eatforum.org/lancet-commission/healthcare-professionals/
3. A randomized crossover trial on the effect of plant-based compared with animal-based meat on trimethylamine-N-oxide and cardiovascular disease risk factors in generally healthy adults: Study With Appetizing Plantfood—Meat Eating Alternative Trial (SWAP-MEAT). Crimarco et al. American Journal of Clinical Nutrition (2020). https://www.cambridge.org/core/services/aop-cambridge-core/content/view/23427D15EB176F218136927600BB7869/S2048679022000842a.pdf/assessing-the-effects-of-alternative-plant-based-meats-v-animal-meats-on-biomarkers-of-inflammation-a-secondary-analysis-of-the-swap-meat-randomized-crossover-trial.pdf
4. Butter, stick, unsalted. FoodData Central, USDA database. (2020). https://fdc.nal.usda.gov/fdc-app.html#/food-details/789828/nutrients%20%0D5
5. American Cancer Society Guideline for Diet and Physical Activity for Cancer Prevention. Rock et al. Cancer Journal for Clinicians (2020). https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/caac.21591
6. 2021 Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement from the American Heart Association. Lichtenstein et al. Journal Circulation. (2021). https://www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000001031
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