In the US, vegetarians face the same challenges as the rest of the population when it comes to a lack of cooking skills, time and energy to create healthy meals, said registered dietitian nutritionist and plant-based foods guru Sharon Palmer. Which means that unless you make a special effort to learn how to make chickpea curries, tofu stir fries and ancient grain salads, you can end up living on pizza (minus the pepperoni), pasta with creamy sauces, cakes, desserts, soda and ice cream.
Packaged food companies, meanwhile, wax lyrical about the ‘plant-based’ trend, but often focus their efforts on adding plant-based protein powders to snacks and beverages, rather than displacing animal foods in the center of the plate, she said.
Pizza and ice cream?
While the phrase ‘plant-based diet’ may conjure up images of fruits and veggies, whole grains, nuts and legumes, it can also mean a diet loaded with refined carbs, Frank Hu, MD, PhD, Professor of Medicine at Harvard Medical School told researchers, nutritionists and food companies at the three-day event, held at Loma Linda University in California.
“Not all plant-based diets are created equal… and if you eat an unhealthy plant-based diet, you can be at even higher risk of heart disease and diabetes [than someone eating a well-balanced diet featuring meat and dairy].”
Gary Fraser, MBChB, PhD, Professor of Medicine at Loma Linda University, added: “There are big differences in mortality risk between vegetarians…”
India: ‘We’re heading in the wrong direction when it comes to diet, including among vegetarians’
In India, for example, epidemiological data reveals a “mixed bag” when it comes to healthy eating patterns among the nation’s 300-400 million vegetarians, said Preet K Dhillon, PhD, MPH, BA, with some vegetarians eating more sugar, more dairy, more desserts, more juice and less fruit than their omnivorous counterparts, although vegetarians overall had consistently better health outcomes.
As consumers in the US and Europe seek to cut down on meat, meanwhile, Indians are steadily increasing their intakes, which doubled between 2003 and 2013, she said, although meat eaters in India on average still consume significantly less meat than consumers in the US and Germany for example.
“We’re seeing higher intakes of meat, chicken, eggs, milk, ghee, cream, oilseed crops, wheat and sugar, and less sorghum, millet, pulses…. And rates of ischemic heart disease are increasing… It looks as if we’re heading in the wrong direction when it comes to diet, including among vegetarians.
“People are replacing indigenous eating patterns with processed foods and western diets and we need to change this quickly and come up with lifestyle and dietary interventions that are culturally appropriate.”
We need a better definition of what a healthy vegetarian diet looks like
Vegetarian ‘junk food’ diets notwithstanding, vegetarians - who typically have lower blood pressure and lower LDL cholesterol - also typically have a lower BMI, lower fasting blood glucose (resulting in a lower incidence of type 2 diabetes) and a lower risk of developing certain cancers (notably colorectal cancer), kidney stones, gout, and even cataracts, said successive speakers at the event, which is held every five years.
Precisely why remains the subject of intense debate, with some speakers suggesting that vegetarians’ lower calorie intake - and lower BMI - is the critical factor from which the other health benefits all stem; but others claiming that higher levels of fiber and health-promoting phytochemicals, coupled with lower levels of saturated fat may be responsible.
Other argued that vegetarians might simply be better educated, more health-conscious, more disciplined or less likely to smoke and drink, although researchers typically account for these confounding factors when analyzing their data.
But regardless of the reason, the epidemiological evidence that people on plant-based diets have a reduced risk of chronic disease is pretty compelling, said Dr Fraser.
The challenge when trying to describe vegetarianism as a dietary pattern, is that there are so many different variations on the vegetarian diet, from vegans (who eat no animal products), lacto vegetarians (who eat dairy), lacto-ovo vegetarians (who eat dairy and eggs) to pesco vegetarians (who eat fish, but not meat), before you even get to the difference between a vegetarian in the UK or the US versus a vegetarian in India or parts of Africa, he added.
“We need a better definition of what a healthy vegetarian diet looks like.”