The following article appeared in the Winter 2018 edition of the Health Science Magazine
Question: How should I talk to my doctor about transitioning to a plant-based diet? I’m anticipating some push-back and want to be prepared.
Answer: It's been almost five years since Kaiser Permanente's The Permanente Journal released their nutritional update for physicians. Some highlights that you may want to share with your doctor include:
"Healthy eating may be best achieved with a plant-based diet, which we define as a regimen that encourages whole, plant-based foods and discourages meats, dairy products, and eggs, as well as all refined and processed foods."
"Research shows that plant-based diets are cost-effective, low-risk interventions that may lower body mass index, blood pressure, HbA1c, and cholesterol levels. They may also reduce the number of medications needed to treat chronic diseases and lower ischemic heart disease mortality rates."
"Physicians should consider recommending a plant-based diet to all their patients, especially those with high blood pressure, diabetes, cardiovascular disease, or obesity."
More and more physicians today are entering practice armed with the knowledge that a plant-based diet is a powerful tool for keeping their patients healthy and off unnecessary medications. Until then, we must gently signal to our doctors that we are going on a quest for a healthy diet and would like them to monitor us (even if they just watch from afar). Some doctors may become nervous about changes to a patient's diet because they have never seen or studied the effects. For these doctors, a copy of The Permanente Journal may help them breathe a little easier (Perm J. 2013 Spring; 17(2): 61–66).
Question: Can I lose weight by just exercising more?
Answer: Good question. Let's do the math. A typical strenuous exercise session can burn 500 calories per hour, and to lose a pound of weight, one must burn 3,500 calories. So, to maintain a safe weight loss of about two pounds per week, you would need to exercise two hours more every day in addition to what you're already doing and avoid over-consuming extra calories. And this is only to lose weight, not reverse heart disease, diabetes, chronic inflammation, or other unpleasant effects of an unhealthy diet. Exercising to lose weight is not a recipe for long-term health (however, overall good health includes weight loss until a natural weight is reached). It is a recipe for exhaustion, burnout, frustration, and injury. As they say, "You cannot out-exercise an unhealthy diet." Similarly, you cannot "burn off" disease by working out more often. A more practical strategy includes moderate exercise along with eating a diet rich in fruits, vegetables, and starches and avoiding meat, fish, fowl, eggs, dairy products, oil, salt, sugar, and flour. When foods are consumed in their natural state, with minimal processing, the natural hunger and satiety mechanisms prevent excess weight gain as the body returns to its natural weight.
Question: If I'm following a whole-food, plant-based diet, do I need to track my nutrient intakes?
Answer: Unless you have a specific condition, you do not need to track daily, or even weekly, nutrient consumption. Every single food we eat has carbohydrates, fats, protein, water, fiber, and micronutrients in varying quantities. You need only focus on consuming a variety of whole plant foods when you are hungry and stop eating when you are full. If you are getting enough calories from those foods (meaning you are not becoming underweight), you will meet your nutritional needs. (You can certainly track your nutrition on a daily or weekly basis if you like, but you do not have to.) However, there are two nutrients that you want to be aware of since they are hard to get from a plant-based diet alone: vitamin D and vitamin B12. Vitamin D is naturally produced by the body after adequate sun exposure. But if you suspect a vitamin D deficiency, ask your doctor to check your blood levels to determine if supplementation is appropriate. Vitamin B12 is not reliably accessible in a strict vegan diet. People who eat animal foods usually get adequate B12 since the animals they have consumed have synthesized B12 from ingested bacteria. But since plant-based eaters don't consume animal foods, and since our modern-day food is so thoroughly cleansed of bacteria, they can become B12-deficient. Only strict long-term vegans do not get a reliable amount from their food; therefore, a daily or weekly supplement is recommended. Also, keep in mind that plant-based diets are so powerful that they can decrease the need for certain medications. Talk to your doctor and keep them in the loop with your dietary changes.
Question: On occasion, I get off track with my healthy eating, and getting back "in the saddle" is so difficult. Any suggestions?
Answer: While I was working at TrueNorth Health Center, Dr. Alan Goldhamer would describe the devastating effect of "the Pleasure Trap" to me, noting that the pull of the Pleasure Trap can be so powerful that at times it can render even the most determined people helpless in the face of cravings. It's useful to know that cravings decrease the longer you go without the stimulant. This is why it's so difficult during the first few days and weeks of fully abstaining from junk food. If that sounds familiar and you still struggle, possible options include (1) hiring a plant-based, SOS-free personal chef to help you get through the first few weeks; (2) easing up on yourself and re-starting but with only half of your expectations; or (3) escaping completely and getting away for a short period of time at a health or fasting retreat. The last recommendation allows your body the chance to rebalance and reboot by getting some much-needed rest, giving your taste buds a short break, and meeting other people with similar goals, all without using any willpower. Coming back home after a week of healthy living, education, and social support is an excellent way to start fresh and stay on track.
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