The myth that plant proteins must be combined at every meal to be of any use to the body was popularized in the early 70’s by the book Diet for a Small Planet by Frances Moore Lappé. The author has since been retracting the statement frequently. “In combating the myth that meat is the only way to get high-quality protein, I reinforced another myth,” she said. Unfortunately, the protein combining myth has taken root in the public and even among a few doctors.
“It is the position of the Academy of Nutrition and Dietetics [formerly the American Dietetic Association] that vegetarian diets can provide health benefits in the prevention and treatment of certain health conditions, including atherosclerosis, type 2 diabetes, hypertension, and obesity. Well-designed vegetarian diets, that may include fortified foods or supplements, meet current nutrient recommendations and are appropriate for all stages of the life cycle, including pregnancy, lactation, infancy, childhood, and adolescence. Vegetarians must use special care to ensure adequate intake of vitamin B-12.
A recent European study confirmed the superiority of plant-based or vegan diets. This study used several different indexing systems to rate the healthfulness of a wide spectrum of diets, from vegan to vegetarian, semivegetarian, pesco-vegetarian and omnivorous and concluded that, “the use of indexing systems, estimating the overall diet quality based on different aspects of healthful dietary models indicated consistently the vegan diet as the most healthy one.” The study goes on to say that, “the vegan diet received the highest index values and the omnivorous the lowest. Typical aspects of a vegan diet (high fruit and vegetable intake, low sodium intake, and low intake of saturated fat) contributed substantially to the total score, independent of the indexing system used.”[i]
With diet being the leading health risk factor in the United States[i], one would think that it would occupy a central position in medical education, continuing education and practice. But unfortunately that’s not currently the case. It turns out that, as a group, our nation’s physicians are not adequately trained in nutrition to provide the care their patients need.
A recent study published in the JAMA demonstrates that the top health risk factor faced by American patients is an unhealthy diet[i]. The leading risk factors related to DALYs (Disease Adjusted Life years), YLLs (years of life lost due to premature mortality) and YLDs (years lived with disability) were dietary risks.
This study puts unhealthy diet front and center as the greatest health risk faced by most patients in the US. While still important, infectious diseases are no longer the cause of most morbidity and mortality. Now instead lifestyle has come to the fore. Lifestyle choices, especially dietary choices, are either the main etiologic, or a significant exacerbating, factor behind common chronic diseases such as coronary artery disease, hypercholesterolemia, essential hypertension, metabolic syndrome, type II diabetes and some cancers such as prostate and colon cancer.
[i] Christopher J. L. Murray and the US Burden of Disease Collaborators. “The State of US Health, 1990-2010 Burden of Diseases, Injuries, and Risk Factors.” JAMA. 2013;310(6):591-606
Vegetarian nutritional medicine is a branch of lifestyle medicine. It utilizes a diet composed of vegetables, whole grains, fruits, legumes and nuts as both a prophylaxis against, and a treatment for, a wide varieties of diseases, including most of the common chronic diseases in the United States and other industrialized nations. Its safety and efficacy has been borne out by both research and clinical experience.
Vegetarian nutritional medicine represents an addition to pharmacotherapy and surgery, not a replacement for them, thus widening the tools available to the physician.