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Introduction by: Kathleen Eckler, RDKellogg’s US Nutrition Marketing GroupSuggested CDR Learning Codes: 2000, 2020, 2070, 2090, 4000, 4030, 4040, 4110, 5460, 6010, 8090; Level 2Learning Objectives: List and discuss five primary statistical trends relating to plant-based eating. Identify five ways in which the Western diet negatively impacts human health and the environment. Discuss commonalities among the USDA’s MyPlate program, the Academy’s position on vegetarian diets, theHarvard Healthy Eating Plate, and the traditional vegetarian food pyramid. Inventory eight specific health benefits that research has shown to be associated with plant-based diets. List four nutrients that may be deficient in plant-based diets and discuss strategies for achieving adequateintakes of these nutrients. Develop strategies to assist clients in adopting and adhering to plant-based eating practices.The planners and presenter of this continuing education activity certify that no aspect of their current personal orprofessional circumstance place them in the position of having a conflict of interest with this presentation/course. 2013 Today’s Dietitian

2Plant-Powered Eating for Optimal HealthA Webinar by Sharon Palmer, RDPlant-based diets have been associated with a variety of health benefits includinghealthy weight, optimal health and longevity. RDs can help vegans, vegetarians, andomnivores understand the benefits of adopting whole-foods, plant-based eatingstrategies. This webinar provides current research relating to plant-based diets, defineswhat a plant-based diet really is, and develops strategies for implementing plant-basedeating with clients. 2013 Today’s Dietitian

3Eat food.Not too much.Mostly plants.Michael PollanIn Defense of Food 2013 Today’s Dietitian

4Plant-based Eating Growing in PopularityPopular booksVeganista, China Study,The Engine 2 DietCelebrities promotingplant-based dietAlicia Silverstone, BillClinton, Ellen DeGeneres,and more!Plant-Based Bloggers& WebsitesHerbivoracious, Oh MyVeggies, SavvyVegetarian, and more! 2013 Today’s Dietitian

5The Vegetarian Resource Group PollNationwide cross section of 1,010 adults (aged 18 and over)Between 2 to 8%of the U.S.population isvegetarian—about 5-12million adults.16% ofrespondentsreported thatthey eatvegetarian meals(no meat, fish,seafood, orpoultry) morethan half of thetime.17% stated thatthey eat manyvegetarianmeals, but lessthan half thetime.Thus, 1/3 of theU.S. populationis eatingvegetarian mealsa significantamount of thetime—inaddition to thenumber ofvegetarians. 2013 Today’s Dietitian

6Meatless Monday is Growing Organizations, hospitals,schools, universities,restaurants, and more goingmeatless on Mondays. Stars lining up to support themovement, from Oprah toJames Cameron. Key influencers, includingMichael Pollan, supportingthe movement. Even Mario Batali announcedthat he will embraceMeatless Monday in all of his14 restaurants across thecountry. Associated with Johns Hopkins’ BloombergSchool of Public Health 2013 Today’s Dietitian

7Flexitarian: Top Trend for 2012“More consumers in 2012 will become‘Flexitarians,’ those that consciously reducetheir meat intake for health reasons but stilloccasionally enjoy animal protein. One of thebest evidences of this trend is the growingpopularity and social media following of thenonprofit Meatless Monday initiative,developed in association with John Hopkins’Bloomberg School of Public Health.”The Wall Street Journal’sMarket Watch 2013 Today’s Dietitian

8Definition of Plant-based DietsVeganNo animal foodsLacto-Ovo VegetarianDefinition ofa plant-baseddiet is onethat focuseson plantsNo animal flesh, but allows fordairy and eggsPescatarianNo animal flesh, except for fishand seafoodSemi-Vegetarian or “Flexitarian”Small amounts of animal foods 2013 Today’s Dietitian

9Indigenous, Traditional DietsCommon Features: Local whole grain Local legumes Seasonal cultivatedand foraged fruits andvegetables Seeds and nuts Minimally processed Low use of animalfoods 2013 Today’s Dietitian

MediterraneanDiet Pyramid 2013 Today’s Dietitian10

11What We DidWhat We FoundEWG partnered withCleanMetrics, anenvironmental analysisfirm, to assess thegreenhouse gasemissions associatedwith 20 types of meat,fish, dairy andvegetable proteins, aswell as these foods’effects on health.All meat is not createdequal. Lamb, beef,pork and cheesegenerate the mostgreenhouse gases.They also tend to behigh in fat and havethe worstenvironmentalimpacts.Copyright Environmental Working Group, www.ewg.org. Reprinted with permission.

12Copyright Environmental Working Group, www.ewg.org. Reprinted with permission.

13Copyright Environmental Working Group, www.ewg.org. Reprinted with permission.

14Best Choices LentilsTomatoes2% MilkBeansTofuBroccoliWorst Choices SalmonPorkCheeseBeefLambCopyright Environmental Working Group, www.ewg.org. Reprinted with permission.

15Barilla Double Pyramid 2013 Today’s Dietitian

16Optimal Health:Key Motivator for Plant-based Eating“Vegetarian-style eating patternshave been associated with improvedhealth outcomes, including lowerlevels of obesity, a reduced risk ofcardiovascular disease, lower bloodpressure, and lower total mortality.”Dietary Guidelines, 2010 2013 Today’s Dietitian

17Academy’s Position on Vegetarian Diets“Well-planned vegetarian diets are completelyhealthful and nutritionally adequate for peoplethroughout all stages of life and that they have a numberof health advantages, including lower blood cholesterollevels, lower risk of heart disease, lower blood pressurelevels, and lower risk of hypertension and type 2 diabetes.In addition, vegetarians tend to have a lower body weightand lower overall cancer rates, lower intakes of saturatedfat and cholesterol, and higher levels of dietary fiber,magnesium, potassium, vitamins C and E, folate,carotenoids, flavonoids, and other phytochemicals.”Academy of Nutrition and Dietetics 2013 Today’s Dietitian

18Whole, Minimally Processed Plant Foods High in “good” stuff:fiber, vitamins, minerals,healthy fats,phytochemicals, lowglycemic carbs. Low in “bad” stuff:saturated fat, dietarycholesterol, sodium, toxins(nitroso compounds,heterocyclic amines,polycyclic aromatichydrocarbons, glycationend products formed incooking, curing, processingmeats). 2013 Today’s Dietitian

19MyPlate3/4 PlateFilled withPlantFoods 2013 Today’s Dietitian

20 2013 Today’s Dietitian

21Meat Lover Society On average, Americansconsume 8 oz of meat perday – 45% more than theUSDA recommends. Three times the globalaverage of meat. Favorite meat is beef (58%);not eating much fish (5 ozper week—as much as weeat turkey). 2013 Today’s Dietitian

22Typical Restaurant Burger1,149 calories21 grams of saturated fat175 mg cholesterol2,571 mg sodium79 total carbohydrates8 grams of fiber63 grams of proteinTypical Restaurant Steak1,390 calories36 grams of saturated fat 2013 Today’s Dietitian

23Red/Processed Meat Health Risks Harvard meta-analysis: high processed meat 42% higher risk of CHD. (Circulation, 2010) Health Professionals Follow-up Study:100 g/d red meat 19% higher risk type 2diabetes; 50 g/d processed meat 51%increased risk. (AJCN, 2011) NIH-AARP Diet and Health Study: highesttertile for consumption of red meat higherrisk colorectum, esophagus, lung, livercancer; highest tertile for consumption ofprocessed meat higher risk colorectal,lung cancer; both cancer mortality.(AJCN, 2011) 2013 Today’s Dietitian

24Health Benefits for Plant-Based DietLongevityWeigh LessLower Oxidative Stress & InflammationReduced Risk of Heart DiseaseReduced Risk of Type 2 DiabetesLower Risk of CancerHealthy Gut/Immune SystemBrain Protection 2013 Today’s Dietitian

25Longevity EPIC study (cohort with520,000 people in tenEuropean countries),more closely adheredto plant-based diet,longer lifespan (PublicHealth Nutrition, 2007) Diets that includemore whole plantfoods are linked withlonger life span (AJCN,2009) 2013 Today’s Dietitian

26Weigh Less EPIC study, BMI of fish eaters,vegetarians, and particularlyvegans is lower than meateaters. (International Journalof Obesity, 2003) For example, a 55 year oldmale or female vegan weighs30 pounds less thannonvegetarian of similarheight. Consume more fiber, lowglycemic carbs. (DiabetesCare, 2009) 2013 Today’s Dietitian

27Lower Oxidative Stress & Inflammation Studies show that a diet rich inwhole plant foods, such asfruits, vegetables, whole grains,nuts, tea, coffee, red wine inmoderation and olive oil,decreases levels of oxidativestress and inflammation, whichare associated with thedevelopment of chronic disease.(Nutrition, 2004 and JACC, 2006) In the Adventist Health Study II,a vegetarian diet was linked tolower CRP levels, a marker ofinflammation. (Ethn Dis, 2011) 2013 Today’s Dietitian

28Reduced Risk of Heart Disease Several studies show heartbenefits, possibly due tolower inflammation, oxidativestress, blood pressure, LDLlevels. (AJCN, 2009) Analysis of five studiesincluding 76,000 subjectsfound rates of ischemic heartdisease 34% lower invegetarians thannonvegetarians. (AJCN, 1999) 2013 Today’s Dietitian

29Lower Risk of Type 2 DiabetesHarvard review of threecohorts and updated metaanalysis (total of more than442,000 subjects)Red meatlinked with higher risk of type2 diabetes, but when oneserving swapped for nutsevery day, decreased risk by21%, substituting wholegrains reduced risk by 23%.(AJCN, 2011) 2013 Today’s Dietitian

30Lower Risk of Cancer Vegetarians 12% lower overall rateof cancer (British Journal of Cancer,2009). Plant foods linked with protectionagainst mouth, pharynx, esophagus,stomach, lung, pancreas, andprostate cancer; in particular, highfiber plant foods may protect indigestive cancers. (AICR) Study linked plant-based diet to20% lower breast cancer risk.(American Journal of Epidemiology,2011) 2013 Today’s Dietitian

31Healthy Gut/Immune System Increasing evidence fiberrich, plant-based dietpromotes healthy gutmicrobiota, linked toimmune support anddigestive health. EPIC study found lowerrate of hospital admissionsand risk of death fromdiverticular disease amongvegetarians. (BMJ, 2011) 2013 Today’s Dietitian

32Brain Protection Chronic inflammationand oxidative stress leadto development ofAlzheimer’s. High adherence toMediterranean, plantbased diet linked with48% lower risk ofAlzheimer’s disease.(Archives Neurology,2009) 2013 Today’s Dietitian

33Challenges for Plant-Based Eating Misperceptions, such as gettingadequate protein and calciumintake. More food preparation required. Lack of cooking skills regardingbeans, whole grains, tofu. Unfamiliarity with new foods,such as tofu, tempeh, seitan. 2013 Today’s Dietitian

34Developing a Plant-based Eating StyleInclude more whole plant foods, such as plant proteins:Legumes (beans, lentils, and peas)Whole Soy Foods (tofu, tempeh, soy milk)Nuts and Nut Butters (almonds, walnuts, hazelnuts, pecans,pistachios, macadamias, Brazil nuts, peanuts)Seeds and Seed Butters (sunflower, sesame, hemp, chia,pumpkin)Whole grains (quinoa, wheat berries, oats, brown rice) can begood protein source (up to 11 g protein per cup, i.e. Kamut)Vegetables, such as peas, spinach, broccoli (can contain up to 6g protein per cup) 2013 Today’s Dietitian

35The VegetarianFood Pyramid

36Adequate ProteinChoose adequate servings at each meal, depending on needs.Plant proteins, such aslegumes, nuts andseeds, have excellent“protein package”—packed with fiber,micronutrients,phytochemicals andcontain up to 9 gprotein per serving.Whole grains such aswheat can have up to 6 gprotein per ½ cup.Vegetables such asbroccoli can contain 3 gper ½ cup. 2013 Today’s Dietitian