When people come to my office, they often feel like they "need" to eat in a vegan/vegetarian/plant-based (v/v/pb) style to be healthy. One thing that we talk about is the scientific substantiation for many different healthy eating styles, some that include (lean) animal proteins, and some that do not.
The first thing is to go along with someone's belief system, and also what is the most realistic for them and their family. There is not just one “best” dietary approach for all, but I think we can pull from the different approaches to create something that will work for them.
If someone feels better being vegan or vegetarian or chooses to do so for religious or ethical purposes, of course they should do this. But if they are looking for the health benefits of eating a plant-based diet, that may be easier as the food rules are not as strict; the emphasis is just on fitting more plants into your day.
The Approach
I have a lot of patients who start to do one or two meatless meals per week, while others who are cutting out red meat transition over to primarily fish and some organic chicken. Some who were having primarily deli meat at lunch may start to have more nut butters, salads with beans, or veggie burgers. I usually feel that a gradual transition is better for anything we do.
However, just like some people do "dry January," I have had some patients do a vegan month here and there. I think it's more effective for the long term to create a healthy balance that you can live with.
Potential Health Risks
Even after making the switch, there are some potential health risks to a v/v/pb lifestyle. Making sure you are meeting your nutrient needs is important, so make sure that there are healthy sources of protein in your day. French fries and pasta are vegetarian, so just because someone is a vegetarian certainly doesn't automatically mean they are eating in a healthy and balanced way.
Make sure there are enough protein sources, such as beans, tofu, legumes, soy products, nuts and seeds, and eggs/dairy products or plant-based alternatives.
Some people may use a plant-based protein shake to help meet protein needs, such as a pea protein or chick pea protein.
In addition, some of the plant-based options, like the Beyond Burgers and Impossible Burgers, are high in saturated fat, which can have a negative impact on cholesterol and heart health. There are veggie burgers available that are made from just vegetables and beans, sometimes quinoa, and I think those are a better choice. The saturated fat will be very low and the fiber will be high. Read the entire label and make sure you are not just exchanging one source of saturated fat for another.
Also, your doctor may have recommended that you limit soy; in certain situations, that may be the case if a woman has had an estrogren-positive cancer. If that’s the case, look for a veggie burger that is made from real veggies and beans rather than one that has soy protein as the first ingredient. This is an area that’s unique to the individual, who can work with a dietitian who specializes in oncology for clear guidance.
Guaranteed Weight Loss? Not So Fast
Sometimes a v/v/pb diet is actually higher in calories; if someone finds they are eating more pasta and grains, they may end up with a much higher carbohydrate intake. If you’re meatless but having pancakes for breakfast, pasta for lunch, pretzels as snacks and pizza for dinner, you’re not going to experience a reduction in weight. You should still be taking a look at the calories that you are taking in, and put more of an emphasis on vegetables/plants – just as the term “plant-based” indicates!
In conclusion, I would never discourage someone from going plant-based or vegetarian if that is what they choose. But over the years we have learned that there are many different options that can lead to healthy weight management and improvements in labs (such as cholesterol and blood sugar) and improvements in blood pressure. The changes do not necessarily need to be extreme, but they do need to be sustainable.
But nobody in their right mind would say to eat less plants – so at least go for that part of it!
Elizabeth DeRobertis is a Registered Dietitian with the Scarsdale Medical Group. To make an appointment, call 914-723-8100.