The Plant-based PlanLynne Garton BSc (Hons) RD

Consultant Nutritionist and Registered Dietitian

www.alimenta.co.uk

@dietlg

Overview…

What is plant-based eating?

Reviewing the latest science

What’s new?

Current nutritional status of Europe

Nutritional rationale for more plant-based eating

Heart health benefits of plant-based eating

Plant-based eating in practice

Types of Plant-based Eating Patterns

Reviewing the latest science...

Search conducted in Medline

Search terms: “plant-based” all references

“Vegetarian” + health issue, e.g. cholesterol, heart, BP,

bone, weight etc

“Mediterranean Diet” + health issue

Hand search of references, reviews, meta analyses

Total number of references: 1008 references

Primary source of data were human studies

Population studies

Randomised controlled trials

What’s new…

• Nutritional Benefits

• Health Benefits

• Environmental Benefits

Key European Nutritional and Dietary

Recommendations

Nutrient WHO/ FAO* EFSA

Dietary Fat (%e) 15-30 (15-35*) 20-35

Saturated Fat (%e) < 10 Not set, but advised to be as low

as possible within a nutritionally

adequate diet

PUFA’s 6-11%e

*n-6 PUFAs 2.5-9.0 %e

*n-3 PUFAs 0.5-2.0 %e

4%e linoleic acid (AI)

+ 0.5%e (AI) linolenic acid

+ 250mg LC n-3 PUFA

Protein (%e) 10-15 0.83g/kg body weight/d (PRI)

• Men (74.6kg) = 62g/ day

• Women (62kg) = 52g/ day

Fibre (g/ day) > 25 25

Fruit and Vegetables (g/

day)

≥ 400

Nutritional Achievements

Nutrient WHO

Recommendations

Western

European

Men

Western

European

Women

Recommendation

Achieved?

Dietary Fat

(%e)

15-30 34.8 – 36.5 35.1 – 36.9 x

Saturated

Fat (%e)

< 10 13.7 – 14.6 13.7 – 14.7 x

PUFA’s 6-11%e 6.7 – 7.0 6.7

Protein (%e) 10-15 14.7 – 16.3 15.6 – 17.0

Fibre (g/d) > 25 12.8 – 24.4 10.4 – 20.1 x

Elmadfa et al, (2009) Forum Nutr.62;1-405

Selected Nutrient Intakes for Adults as a

Percentage of the Recommended Amounts

0

20

40

60

80

100

120

140

160

180

Fat (%e)

Saturated fat (%e)

PUFA's (%e)

Protein (%e)

Fibre (g/ day)

Perc

enta

ge o

f th

e R

eco

mm

end

ed A

mo

un

t

Elmadfa et al, (2009) Forum Nutr.62;1-405

0

20

40

60

80

100

120

140

160

180

MENWOMEN

Major European Nutritional Challenges…

Reducing Saturated Fat Improving the Fat Quality

Increasing Fibre (Wholegrains, Fruit and Vegetables)

Sources of Saturated Fat in the Diet

Average contribution of major food groups to

saturated fat intake in men from selected countries

participating in the EPIC Study

Average contribution of major food groups to

saturated fat intake in women from selected countries

participating in the EPIC Study

Linseisen et al (2009) Eur J Clin Nutr 63(4);S61-80.

UK (2008/9 – 2011/12)

• 20% of SFA from meat products

• 22% of SFA from dairy

• 5% of SFA from butter

Dutch population (2011)

• 19% of SFA from meat products

• 30% of SFA from dairy

Individual European Countries Meat Consumption

Typically Europeans eat double the recommended

amount of red meat

Westhoek H, et al (2011) PBL Netherlands

Environmental Agency

Meat Consumption in Selected European

Countries

EFSA Concise European Food Consumption Database

Fruit & Vegetable Consumption in EU Countries

* Mean intake

% of popn. consuming

<400g/d

Tennant DR, et al (2014) Br J Nutr. 112(7);1214-25

Wholegrain Intake

Scandinavian countries -

minimum 75 g whole grain per

10 MJ (2,388 kcal) per day

USA – 3+

servings a day

• Average adult intake 20g/day

• 18% of adults ate no wholegrains

• 17% of adults met the US recommendations

Mann, KD, et al (2015) Br J Nutr;1-9

Nutritional Rational for Eating More

Plant-based Foods

Population studies have found plant-based

eating is associated with a better nutritional

intake in line with recommendations

Nutritional benefits not just due to the

absence of animal foods but also the inclusion

of a wide variety of important plant-foods

No need to completely exclude animal foods, but plant foods should be at the core

Average daily intake of selected nutrients in the

AHS-2 study

Rizzo NS, et al (2013) J Acad Nutr & Diets 113(12); 1610

Food & Nutrient Intakes According to Pro-

Vegetarian Eating Patterns+ve weighting given to

• Fruit

• Vegetables

• Nuts

• Cereals

• Legumes

• Olive oil

• Potatoes

-ve weighting given to

• Added animal fats

• Eggs

• Fish

• Dairy products

• Meats or meat

products

TOTAL SCORE 12 -60

Martinez-Gonzales, et al (2014) Am J Clin Nutr, 100(S1);320S

Daily Intake of Selected Food Groups of Low

Meat and Regular Male Meat Consumers

Gilsing AM, et al (2013) Nutr J 12;156

Plant-based Eating and Cardiovascular

Health…

Type of Study Measurement Outcome

Observational CVD risk 15 – 20%

Clinical studies LDL-C -7% to -15% compared to baseline

BP

Portfolio studies LDL-C -20% to -35%

(long term study -13%)

SBP

DBP

-4.2mmHg

-2.3mmHg

(long term study)

The Sum of the Whole Is Greater than it’s Parts…

Lower

energy

density

Rich in

phytonutrients

Low

Fat

High

Fibre

Low

Saturated

Fat

Plant

Protein Low

GIGood source of unsaturated fats

Rich in

potassium

The Sum of the Whole is Greater than it’s Parts…

High

Fibre

Low

Saturated

Fat

Low GI

Good source of unsaturated fats

Lower energy

density

Plant

Protein

Rich in

phytonutrients

Low

Fat

PLANT-BASED

BENEFITSPlant

Stanols/

Sterols

Rich in

potassium

International Dietary Support

Consumer’s Readiness to Eat a Plant-

Based Diet…

Lea EJ, et al (2006) Eur J Clin Nutr: 60(3):342-51

58%

14%

28%

MORE

• F & V

• Nuts & seeds

• Wholemeal bread

• Cooked cereals

LESS

• Meat (white & red)

• Dairy

• White bread

Higher Barrier Scores

- Information barriers

- Family & personal Barriers

- Convenience Barriers

- Health barriers

Higher Benefit Scores

- Well-being benefits

- Weight and health benefits

- Convenience and financial

benefits

58%14%

28%

STEP 1: Define Plant-based Eating…

• FRUITS AND VEGETABLES

• WHOLEGRAINS

• PULSES – INCLUDING SOYA

• NUTS AND SEEDS

More than just Fruits and Vegetables…

STEP 1: Principles of Plant-based Eating

Eat more plants foods, e.g. fruits, vegetables,

wholegrains, legumes, nuts and seeds

Eat a variety of foods – have a colourful plate

Waste less food

Moderate your animal food consumption – enjoy

other sources of proteins such as peas, beans and

nuts

Buy foods that meet a credible standard

Eat fewer highly processed foods and foods high in

fat, salt and sugar

LiveWell for Life…

Step 2: Discuss Benefits

Well-being

Weight & Health

Ethical

Convenience &

Financial

Lea E.J, et al. (2006) Eur J Clin Nutr 6(3):342-51

Step 2: Overcome Barriers…

Cost

Nutritional

Adequacy/ Health

Information

Practical skills

Lea E.J, et al. (2006) Eur J Clin Nutr 6(3):342-51

STEP 2: Nutrition & Health Barriers…

Macdiarmid JI, et al (2012) Am J Clin Nutr;96:632–9 : Scarborough P (2012) EJCN66,710–715 : Livewell Report (2011)

http://assets.wwf.org.uk/downloads/livewell_report_corrected.pdf : Livewell for LIFE http://livewellforlife.eu/wp-

content/uploads/2013/02/A-balance-of-healthy-and-sustainable-food-choices.pdf :Friel, et al (2009) Lancet;374:2016–25 :

Aston LM, et al (2012); BMJ Open;2:e001072 : J Acad Nutr Diet. (2015);115 (5):801-10

Appropriately planned

plant-based diets are

healthy, nutritionally

adequate and provide

environmental benefits

STEP 2: Cost Barriers…

Healthy plant-based diets are not necessarily more expensive

Meat/ animal protein tends to be the most expensive part of the

meal

Plant Sources (cost/ 100g) Animal Sources (cost/

100g)

Tofu £0.38 Chicken breast fillet £0.60

Soya mince £0.33 Lean mince £0.60

Unsalted mixed nuts £0.85 Beef steak £1.50

Lentils (canned) £0.14 Eggs £0.30 (2 eggs)

Baked beans £0.10 Mature cheddar £1.00

Source: www.mysupermarket.co.uk – Tesco. Accessed Nov. 2015

STEP 2: Cost Barriers…

UKLivewell Plate

£28.40/wk

(£32.12/wk)

FRANCELivewell Plate

€4.36/d

(€4.90/d)

SPAINLivewell Plate

€3.479/d

(€3.479/d)

SWEDENLivewell Plate

44.07 SEK/d

(44.64 SEK/d)

www.livewellforlife.eu

STEP 3: Provide Practical Information…

• Re-shaping the plate

• Simple swaps

• Meal make-overs

• Meat free days

Re-shaping the Plate…

Emphasis is on plant-

based foods

Visualise the plate

Serve plant foods first

Plan meals around plant

foods and consider meat

as an accompaniment

Simple Swaps…

FOOD GROUPS PLANT-BASED ALTERNATIVES

Dairy products e.g. milk, yoghurts,

milkshakes, etc.

Fortified plant-based alternatives to dairy e.g. soya alternative to milk; soya

alternatives to yoghurts.

Fortified almond milk, coconut drink, hazelnut drink

Snacks such as crisps, sweets,

chocolates and biscuits

Fresh or dried fruit; fruit smoothie; soya shakes; soya nuts; other unsalted

nuts; seeds; whole-grain cereal bars; rice cakes; pitta/ vegetable sticks/

oatcakes with hummus or salsa; plain popcorn; wholegrain crackers with nut

butter; wholemeal scones and currant buns; malt loaf; soya desserts

White bread, pasta and rice Wholemeal bread, wholegrain pasta and brown rice

Refined breakfast cereals Wholegrain cereals

Butter Margarines made from vegetable oils

Lard Vegetable oils such as olive oil, rapeseed oil, sunflower oil

Creamy meat based pasta sauce Tomato and vegetable based pasta sauce

Mince, burgers, sausages, etc Meat analogs such as soya mince, Quorn, veggie burgers and sausages

Meat/ chicken-based curries or

Chinese dishes

Vegetable curries, dhal, edamame/ tofu stir fries and noodle dishes

Desserts/ Puddings Soya alternatives to yoghurts; soya desserts; fruit crumble (topping made

with wholemeal flour and oats) served with soya custard; stewed fruit topped

with soya cream alternative; meringues with berries and soya alternative to

cream; fresh fruit; fruit sorbet

Meal Make Overs…BREAKFASTS

Instead of granola and Greek yoghurt try sugar free muesli with soya alternative to

yoghurt and mixed berries

Wholegrain cereal, topped with fruit (fresh or dried) and served with a plant based

alternative to milk or yoghurt

MAIN MEALS

Use more beans, lentils and vegetables, and cut down on meat in dishes

Try vegetable and bean salads that include pasta, rice, noodles, couscous or potatoes

Add extra grains to stews or soups e.g. Bulghur/ cracked wheat or pearl barley

Pile a shop bought cheese and tomato pizza with extra vegetables and serve with a side

salad

LIGHT MEALS

Chunky bean and vegetable soup served with a wholegrain roll

Wholemeal toast topped with scrambled eggs, baked beans or sardines in tomato sauce

Wholegrain starchy foods, such as bread, rolls, bagels, pittas, wraps and chapattis

filled with a protein food based on plants e.g. hummus, falafel, beans, bean pate or

nut butter

2. Meat Free Days…

In Summary…

International dietary recommendations emphasise plant foods to promote good

health

Diets in many Western European countries are higher in total fat and saturated fat

and lower in fibre than is recommended

Plant-based eating places the emphasis on plant foods (whole-grains, legumes –

including soya, fruit, vegetables, nuts and seeds)

Plant-based eating patterns tend to be low in total fat and saturated fat, include a

good level of unsaturated fats, and are high in fibre

Plant foods also provide a wide range of nutrients that are thought to contribute to

positive health and well-being

Plant-based eating has been associated with healthy hearts, body weights and blood

sugar levels

The wide variety of plant foods available provides a number of options for designing

a delicious healthy plant-based eating plan

Appropriately planned plant-based eating patterns are both healthy and can meet

the nutritional requirements throughout the lifecycle

Thank you for your

attention

AcknowledgementsThe endeavour, help and support of my

co-author Janice Harland is gratefully

acknowledged as is the support of the

Alpro Foundation