7 responses to “Recommending a plant-based diet”

  1. At our family practice clinic we have been actively educating our patients about the significant health benefits of a plant based diet for several years. Contrary to some opinions, it is my experience that many people are interested in making diet changes to improve their health and reduce medication burden. We have see some great successes in weight loss, diabetes and hypertension control.

  2. I think we have to be careful to make dietary recommendations to our patients based on poor science. One study of 28 patients that looked at making global changes including regular exercise and a diet change, plus the anecdotal opinion of a cardiologist does not make for good science. We have been following a low fat diet for the last 50 years and it has caused nothing but trouble for North americans. Perhaps the work of Professor Tim Noakes is also of interest to you. The only thing I would agree with it that a diet with a lower glycemic index and regular exercise is going to to of benefit overall but I do not think we have good evidence that plant based protein diets are better or worse for us. Even the latest observational non randomized study of 130,000 does not prove the point.

  3. I would be extremely hesitant to ever recommend a plant-based diet to any patient, in particular to healthy ones. I am well aware of the difficulty in creating studies to evaluate dietary changes but putting emphasis on a single cardiologist’s opinion is, as described above, not good science. Also as mentioned above, the recent observational study found a plant-based diet to be of no benefit to healthy patients (ie without risk factors of an unhealthy lifestyle). Even in unhealthy people, when removing processed red meat from the equation, a plant based diet was only mildly better for those patients and we realize how often observational studies will over estimate risk or benefit.
    Given that the initial article is referring to diabetic patients, I would certainly advocate for dietary changes if the patient is not eating healthy, however, encouraging them to follow a very difficult way of eating that could easily cause them to be deficient in certain nutrients does not seem to be the most ideal way to get them healthier. I encourage these patients to exercise up to 150 min/week and to increase their intake of vegetables, fruits, and whole grains while avoiding lots of red meat and eating chicken/fish instead. I provide them with a handout that has numerous dietary suggestions/tips and encourage them to see a dietitian.

  4. Thank you for writing this great article and for all the resources. (disclaimer-I follow a plant based diet myself and find it to be an easy and very enjoyable way of eating). There is much compelling science showing that a plant based diet is one of the healthiest diets to follow (along with the Mediterranean diet and DASH diet) for well-being, disease prevention and management of chronic diseases. I advise patients to look at any of these diets. In reply to Dr Arduini; a plant-based diet that includes a wide variety of fruits, vegetables, whole grains, nuts and seeds will not make you deficient in nutrients other than Vitamin B12; the resources cited in Dr Hajik’s article will help patients on their way to know what to do to make the dietary changes. (The only reason vegans should take a B12 supplement is because our food is sanitised. B12 is obtained from bacteria in the soil).

  5. Thank you for your article. I always enjoy seeing physicians concentrating more and more on using dietary approaches for chronic disease management. I am sure we all agree that switching from the standard North American diet to a diet rich in whole foods will lead to positive health outcomes for the general population.

    Where I disagree with a vegan/vegetarian approach in managing diabetes is forgetting to focus on the root cause of the disease. Diabetes is primarily a disease of carbohydrate metabolism due to insulin resistance. Suggesting a diet naturally rich in carbohydrates (Wheat, grains and fruit) does not reverse the disease. Eliminating fats from the diet of a diabetic and suggesting ‘healthy carbohydrates’ makes about as much sense on a physiological level as eliminating grains from the diet of a lactose intolerant patient and recommending ‘healthy dairy’.

    In my practice my patients have had great success in treating and reversing diabetes and medication load, positively reversing/improving triglyceride/HDL ratio, maintainable weight loss and better BP control. Our approach involves carbohydrate restriction with higher fat intake (saturated, monounsaturated).

  6. Thank you for your comments,

    Dr. Martin Andreae, please take another look at the literature supporting more healthy carbohydrates and less fat as a dietary measure to improve glucose tolerance and reduce insulin resistance.

    There is physiologic evidence demonstrating that higher dietary fat intake results in insulin resistance and glucose intolerance. Conversely, clinical trial data has demonstrated that individuals with type 2 diabetes consuming a low-fat, plant-based diet have reduced their insulin requirements.

    Hot of the press –
    A Comprehensive Review of the Literature Supporting Recommendations From the Canadian Diabetes Association for the Use of a Plant-Based Diet for Management of Type 2 Diabetes

    http://www.ncbi.nlm.nih.gov/pubmed/27476051

    This article provides an informative review of evidence for plant-based diets as part of diabetes care and explores ways to address some of the barriers patients face in learning about and adopting plant-based diets (PBDs):

    “The current Canadian CPGs recommend PBDs for the management of type 2 diabetes.”

    “Practitioner and patient education is key to improve both clinicians’ confidence in recommending PBDs and patients’ abilities to adopt PBD diets.”

  7. People interested in dietary advice for their patients should also read ‘ Eat Dirt’ by Dr Josh Axe. It makes for interesting reading and he makes a compelling argument for organic foods.
    I realize this is not main stream and the Kaiser Institute has not verified this but age old traditional diets in Ayurveda and Chinese Medicine also gives us a wholistic picture of how to keep healthy.

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