The Plant-based Plan - alpro Foundation · The Plant-based Plan Lynne Garton BSc (Hons) RD...
Transcript of The Plant-based Plan - alpro Foundation · The Plant-based Plan Lynne Garton BSc (Hons) RD...
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
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ge o
f th
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eco
mm
end
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mo
un
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Elmadfa et al, (2009) Forum Nutr.62;1-405
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20
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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