Fortunately, we’ve got the answers. Forks Over Knives spoke with two leading voices on lifestyle medicine in the United States. Scott Stoll, MD, is a practicing physician and co-founder of The Plantrician Project, an organization that aims to educate health care providers about using food as medicine. Susan Benigas is the executive director of the American College of Lifestyle Medicine (ACLM), the largest organization of U.S. health care professionals who are committed to preventing, treating, and reversing disease with the help of lifestyle changes. Let’s take a look at some of the most commonly asked questions about this expanding medical field. 

Skip to the section you’re most interested in:

• What Is Lifestyle Medicine?
• Why Don’t More Doctors Incorporate Nutrition and Lifestyle Strategies Into Patient Treatment Plans?
• How Does a Whole-Food, Plant-Based Diet Fit Into the Lifestyle Medicine Puzzle?
• How Has the Medical Community Responded to the Rise of Lifestyle Medicine?
• What Advantages Do Lifestyle Changes Offer Over Prescription Drugs?
• Who Can Benefit From Lifestyle Medicine?
• What Has Caused the Increased Interest in Lifestyle Medicine Over the Last Several Years?
• How Is Lifestyle Medicine Connected to Environmental Sustainability?

What Is Lifestyle Medicine?

“Lifestyle medicine is an evidence-based approach that integrates lifestyle factors—including a whole-food, plant-based diet as the centerpiece—into patient care,” explained Stoll. “The goal is to prevent, suspend, and reverse diseases that are directly related to lifestyle choices.”

While traditional Western allopathic medicine focuses heavily on disease management, lifestyle medicine ultimately aims to eradicate the root cause of disease. These two styles of medicine—allopathic and lifestyle—ideally work hand-in-hand, and most doctors who practice lifestyle medicine use it as a supplement to their traditional training. 

Benigas breaks down lifestyle medicine into six key pillars: One: a whole-food, plant-predominant diet. Two: regular physical activity. Three: stress management. Four: restorative sleep. Five: the avoidance of risky substances. And six: positive social connections.

While nutrition is typically the largest component of lifestyle medicine, the other five pillars target important areas of life that have been scientifically proven to impact our health. A physician practicing lifestyle medicine may begin by prescribing a change in diet, but if the patient is lacking quality sleep and is constantly stressed out by their job, a more robust treatment plan would be created to address the impact of anxiety and insomnia on that person’s overall well-being.

Why Don’t More Doctors Incorporate Nutrition and Lifestyle Strategies into Patient Treatment Plans?

If this is your first time hearing about lifestyle medicine, you’re not alone. According to Stoll, most medical students receive fewer than 25 hours of nutrition training and only 20 percent of medical schools in the U.S. have a required nutrition course. The stats get even worse when new doctors go into residency: In most cases, there are zero requirements for young physicians to learn about the benefits of nutrition as they take on real-life patients. 

“When we look at the number-one cause of preventable death in the world, it’s diet. Nearly 11 million deaths globally are caused by poor dietary choices every year,” Stoll says. “We have this real cognitive dissonance in Western medicine where everybody recognizes that obesity and lifestyle choices are a problem, but there’s no education to address that. There was an interesting study done where first-year medical students were surveyed about whether they believed nutrition was important for treating patients. At least 75 percent of all the students said that it was. By the end of their second year of medical school, that number was nearly zero. So our education system actually trains out the value of diet and nutrition as medicine.”                                                                                                 

How Does a Whole-Food, Plant-Based Diet Fit into the Lifestyle Medicine Puzzle?

“We’re grateful for modern medicine, and it absolutely has its place in a treatment plan,” said Benigas. “But medications don’t cure the disease, right? They try to help slow the progression or mask symptoms. What the American College of Lifestyle Medicine advocates for is to first attempt to identify and eradicate the root cause of the disease. There may be a need for medications as well, but it’s really about committing to a clinical outcome of health restoration and a de-escalation of medication use so that our patients can live disease-free.”

How Has the Medical Community Responded to the Rise of Lifestyle Medicine? 

As executive director of ACLM, Benigas says she has witnessed enormous growth in this sector of medicine over the past decade. 

“When I joined ACLM in the spring of 2014, it had fewer than 400 members,” she explains. “Flash-forward to 2021, and ACLM is close to breaking the 7,000 mark which represents a near 1,600 percent growth! ACLM is recognized by many as the nation’s fastest growing medical professional association.”

The ever-growing body of evidence that confirms the benefits of a whole-food, plant-based diet spurred the formation of many educational organizations, including Stoll’s Plantrician Project, which is one of the most significant resources for lifefstyle healthcare professionals. 

“We want to provide physicians with the best evidence-based information on utilizing a whole-food, plant-based diet as an intervention for the treatment of lifestyle diseases,” Stoll explains. “The goal of The Plantrician Project is to educate, inspire, inform, and equip health care providers with the information and tools and resources that they need to restore the lost quality of life for their patients. Over the last few years, our annual conferences have grown to about 12,000 healthcare providers from 26 countries.”

What Advantages Do Lifestyle Changes Offer Over Prescription Drugs?

It’s important to recognize that lifestyle medicine is designed to complement traditional allopathic approaches, not replace them. Think of lifestyle medicine as the first line of defense against the progression of a disease, while medication, surgery, and other treatments are used when a disease resists lifestyle changes. Because lifestyle interventions are largely free of side effects, lifestyle doctors can use them to prevent unnecessary complications for their patients that can arise with more aggressive treatments.

After several decades as a practicing physician, Stoll has worked with countless patients who were able to discontinue their medications or cancel surgeries because a healthy diet had resolved their symptoms. 

“I treated a young woman in her early 30s who struggled with infertility, hyperthyroidism, general fatigue, depression, and pain throughout her entire body,” he says. “When she arrived at my office she said, ‘I don’t know how I’m gonna get up and keep going to support my family.’ I helped her get set up with a whole-food, plant-based diet, and even after a week she was starting to have some energy, mental clarity, and some of the constant pain had dissipated. A year later all of her disease conditions had fully resolved and she required no further medication.”

Who Can Benefit From Lifestyle Medicine?

Long story short—everyone. While many assume that a change in diet is only necessary for people battling heart disease, diabetes, or other chronic illnesses, approaching your health from the perspective of lifestyle medicine can drastically reduce the likelihood of developing severe diseases later in life. 

“Over 60 percent of all American adults now have at least one chronic condition, and sadly over 40 percent of children have two or more chronic conditions,” Benigas says. “When we look at people who apply to join our armed forces, 70 percent of applicants can’t pass the physical examination. So this isn’t just an issue that’s related to our elder population or to those already struggling with a life-threatening disease. It’s something that desperately needs to be addressed for all ages, because chronic illness is something that can impact us from our mother’s womb all the way through the aging process.”

What Has Caused the Increased Interest in Lifestyle Medicine Over the Last Several Years? 

“I think there are several factors at play,” Benigas says. “One, our medical professionals are awakening to the fact that the ‘diagnose and manage’ approach to health care is unsustainable, nor is it in the best interest of their patients. Two, there is so much research that overwhelmingly supports the efficacy of evidence-based therapeutic lifestyle intervention to treat, reverse, and prevent chronic disease and autoimmune conditions. And third, lifestyle medicine reignites the passion many of our physicians cited as the reason they first went into medicine. When you’re truly educating and equipping your patients with knowledge that will help them reach the end goal of health restoration, it really brings back that joy of being a healer.”

How Is Lifestyle Medicine Connected to Environmental Sustainability?

It’s clear that lifestyle medicine can radically benefit our personal health—but what about the health of the planet? It turns out that what’s good for our bodies is also good for the environment. In 2018 the largest study ever done on the environmental impact of food supply was published in Science magazine. It looked primarily at the use of farmland in more than 100 countries and found that 80 percent of our active farmland is used to produce animal-based foods, despite those products supplying only 18 percent of our total calorie intake. Additionally, those farmlands were responsible for more than 50 percent of greenhouse gas emissions. 

“I think it’s important to have a mindset shift from being an owner of the land to being a steward of the land,” Stoll says. “A steward looks at optimizing the current circumstances so we can regenerate and renew resources for future generations. The world’s leading scientists are now recognizing that without a transition to a whole-food, plant-based plate, we will never be able to stabilize climate change. What’s exciting is that just as a change in diet can regenerate a human body in a relatively short period of time, it can do the same with the Earth.”

If you’re curious to learn more about lifestyle medicine, the American College of Lifestyle Medicine has a wealth of resources on their website that are created for both physicians and patients to explore. The Plantrician Project also features educational literature, book recommendations, event information, and a service that helps you locate a plant-based doctor near you. 

The post What Is Lifestyle Medicine? appeared first on Forks Over Knives.

But it’s important to understand that having a higher proportion of essential amino acids, as animal protein does, is actually damaging (not advantageous) for our health. We outline seven ways that animal protein damages your health.

1. Animal Protein and Fiber (or total lack thereof)

Unlike plant protein, which comes packaged with fiber, antioxidants, and phytonutrients, animal protein comes with exactly none of the foregoing. To this point, meat, eggs, poultry, dairy, fish and other animal foods have absolutely no fiber whatsoever.

Many people, in their effort to “get enough” protein, tend to eat large amounts of animal foods, which displaces plant foods that have these important nutrients. Fiber deficiencies, in particular, are far more common than not.

For example, The Institute of Medicine recommends that men consume 38 grams of fiber, but the average adult only eats about 15 grams per day—less than half the recommended amount. In fact, according to the USDA, almost all Americans (~95%) do not get an adequate amount of dietary fiber.^38,39

High fiber intake is associated with decreased cancer risk, specifically colon and breast cancers, as well as lower risk of ulcerative colitis, Crohn’s disease, constipation and diverticulitis. It may also reduce the risk of stroke, high cholesterol, and heart disease.^40,41

2. Animal Protein and IGF-1 (increased cancer risk)

When we ingest proteins that have a higher proportion of the essential amino acids (which is a characteristic of animal protein), it results in our bodies producing higher levels of the hormone insulin-like growth factor-1 (IGF-1).^2-8

This hormone stimulates cell division and growth in both healthy and cancer cells and, for this reason, having higher circulating levels of IGF-1 has been consistently associated with increased cancer risk, proliferation, and malignancy.^2-8

3. Animal Protein and TMAO

Consuming animal protein also results in us having higher circulating levels of trimethylamine N-oxide (TMAO).

TMAO is a substance that injures the lining of our vessels, creates inflammation, and facilitates the formation of cholesterol plaques in our blood vessels. And that, of course, is highly problematic for cardiovascular health.^9,10

TMAO is created by complex interactions involving our gut flora and the nutrients in the food we eat. And when we eat animal foods, it alters our gut flora in such a way that facilitates the creation of TMAO.^9,10

So, consuming animal foods result in higher TMAO levels, which is damaging to our vessels. Even without all of the other problematic aspects of animal foods, this one issue involving TMAO is, according to the recent president of the American College of Cardiology Dr. Kim A. Williams, sufficient by itself for people to vigorously avoid animal foods.¹¹

4. Animal Protein and Phosphorus

Animal protein contains high levels of phosphorus. And when we consume high amounts of phosphorus, one of the ways our bodies normalize the level of phosphorus is with a hormone called fibroblast growth factor 23 (FGF23).

FGF23 has been found to be harmful to our blood vessels. It can also lead to hypertrophy of the cardiac ventricle (abnormal enlargement of our cardiac muscle) and is associated with heart attacks, sudden death, and heart failure.^12,13 So eating animal protein with its high concentration of phosphorus can result in increased levels of this hormone in our bodies, which in turn is highly problematic for our health.

5. Animal Protein, Heme Iron, and Free Radicals

Iron is the most abundant metal in the human body. We can consume it in two forms: (a) heme iron, found widely in animal foods like meat, poultry, and fish; and (b) non-heme iron found widely in plant foods.

One of the problems with heme iron is that it can convert less reactive oxidants into highly reactive free radicals.¹⁴ And free radicals can damage different cell structures like proteins, membranes, and DNA.^14,15

Heme iron can also catalyze the formation of N-nitroso compounds in our bodies, which are potent carcinogens. So, not surprisingly, high intake of heme iron has been associated with many kinds of gastrointestinal cancers as well as other pathologies.¹⁵

It is true that heme iron has higher absorption rates and bioavailability than non-heme iron. However, iron itself can cause oxidative stress and DNA damage, so with iron generally, it’s not always a situation where “more is better.”¹⁵

While we definitely need iron, the absorption and bioavailability of iron from a well-rounded plant-based diet is generally adequate, and we can avoid the problems associated with heme iron and other negative health attributes of animal foods.^16,17

6. Higher Sulfur-Containing Amino Acids and Bone Health Problems

Animal proteins also have, in general, higher concentrations of sulfur-containing amino acids, which can induce a subtle state of acidosis when metabolized.¹⁸ One of the mechanisms our bodies use to compensate for this acidosis is leaching calcium from our bones to help neutralize the increased acidity. Over time, this can have a detrimental effect on bone health.^19-24

This is thought to be one of the reasons why some studies have found that populations with higher dairy consumption, as well as higher consumption of animal protein in general, also have a higher incidence of bone fractures.^18-30

7. Animal Protein and Cholesterol

Most animal foods contain saturated fat and cholesterol (this is true for even so-called “lean” meats like chicken, turkey, and salmon, regardless of how they are cooked or prepared—even if boiled, baked, or steamed).

As humans, we do not need to consume any cholesterol, since our bodies synthesize all the cholesterol we need for our physiologic functions.

Eating cholesterol despite this fact is problematic for our health, as it increases our risk of developing heart disease—currently the No. 1 cause of death for both men and women in the United States.^31-37

Atherosclerosis, or plaques of cholesterol that accumulate in the lining of our vessels, is exquisitely less common on a plant-based vegan diet devoid of animal products. And some studies have found that eating this way can even reverse atherosclerosis.^32-37

The Real “High Quality” Foods

Given all the issues, the “high quality” aspect of animal protein might be more appropriately described as “high risk” instead.

And there’s no need to obsess about getting enough protein either. If you are eating a sensible variety of plant foods (e.g., vegetables, fruits, legumes, grains, roots, nuts, and seeds), and you are eating enough calories (i.e., you feel satisfied), there is no need to worry about protein adequacy.

The amino acids we need are structurally identical regardless of the source. However, as discussed above, there are serious health implications depending on whether the amino acids are packaged within animal or plant foods. Dr. Walter Willett, the chair of Harvard’s Department of Nutrition, said it well:

“To the metabolic systems engaged in protein production and repair, it is immaterial whether amino acids come from animal or plant protein. However, protein is not consumed in isolation. Instead, it is packaged with a host of other nutrients.”⁴²

He therefore recommends that you “pick the best protein packages by emphasizing plant sources of protein rather than animal sources.”⁴²

In the end, plant foods are the real “high quality” foods that we should be eating for optimal health.

_Sources:

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