Flexitarian is a relatively recent term used to describe a diet that emphasizes vegetarian foods but is flexible enough to permit occasionally eating meat, poultry or fish. It can serve as a gradual transition from a meat-based diet to one that is mostly vegetarian, ideally with only two meals per week including animal-based foods. The diet was popularized by a 2008 book, The Flexitarian Diet, by dietician Dawn Jackson Blatner.

How Healthy Is A Flexitarian Diet?

Consuming plant-based foods and limiting those from animals can yield many of the health benefits of a vegetarian diet, including a lower risk of heart disease and hypertension. While the health benefits of the flexitarian diet itself haven’t been researched, a study from the Harvard T.H. Chan School of Public Health published in 2016 found that even moderate changes in the direction of a plant-based diet can help prevent type 2 diabetes. The researchers reported that a healthy version of a plant-based diet was linked with a 34 percent lower risk of diabetes, while a less healthy version, which included such foods as refined grains, potatoes and sugar-sweetened beverages, was associated with a 16 percent increased risk of the disease.

In addition, results from a study that tracked and analyzed the eating habits of 451,256 Europeans from 10 countries for 13 years demonstrated that those whose diet contained about 70 percent plant-based foods had a 20 percent lower risk of dying from cardiovascular disease compared to those whose diet consisted of less than 45 percent of plant-based foods.

How Popular Is It?

According to findings from a 2018 Gallup poll, an increasing percentage of U.S. consumers seem to be eating more plant-based foods, although they’re not prepared to completely stop eating meat, chicken and fish. Reportedly, sales of plant-based food totaled $3.1 billion in 2017, an increase of 8.1 percent over 2016. These changes appear to reflect growing interest in the flexitarian way of eating. The Flexitarian diet is one of several popular diets reviewed on DrWeil.com.

General Principles Of A Flexitarian Diet

Apart from the health benefits of a predominantly vegetarian diet, reducing consumption of protein foods from animals by 18 percent could lead to a tenfold reduction in household greenhouse gas emissions. In this way, the flexitarian diet dovetails with efforts to slow climate change. A study from the UK’s University of Oxford found that while meat and dairy provide only 18 percent of calories and 37 percent of protein, raising the animals that serve these industries produces 60 percent of agriculture’s greenhouse gas emissions. To study the environmental impact of food production the investigators surveyed nearly 40,000 farms in 119 countries, and researched 40 different foods that represent 90 percent of what we eat. They looked at the impact of these foods “from farm to fork” on land use, climate change emissions, fresh water use, and both water and air pollution.

What Can You Eat?

The flexitarian diet emphasizes fruits, vegetables, legumes and whole grains. Sources of protein include soybeans and whole soy foods like tofu and tempeh, and other legumes, as well as some meat, poultry or fish. The diet excludes processed foods, sugar-sweetened beverages, added sugar and sweets.

How Many Calories On A Flexitarian Diet?

Since this is not a weight-loss diet (although you’ll probably drop a few pounds if you follow it), but an eating plan, calories aren’t limited. However, if you follow the five-week meal plan that introduces you to the diet, you will likely consume about 300 calories at breakfast, 400 at lunch and 500 at dinner, plus about 150 for each snack. You can increase or decrease those counts depending on your height, weight, and the amount of physical activity you are accustomed to getting.

What Do Doctor’s Say?

A study published in 2016 summarized the medical evidence supporting the health benefits associated with flexitarian diets, including weight loss, improved metabolic health and lowered risk of diabetes. The lead British researcher noted that most flexitarians seem to be women and saw “a clear need to communicate the potential health benefits of these diets to males.” In general, doctors are aware that a plant-based diet is healthier than the typical Western diet and that vegetarians and vegans have significantly lower body mass index (BMI) and lower levels of total cholesterol, LDL cholesterol and blood glucose. Studies have also shown that people eating plant-based diets have a 25 percent reduced risk of incidence of ischemic heart disease and death due to this condition as well as a 15 percent lower risk of cancer.

Dr. Weil’s Take On The Flexitarian Diet:

Dr. Weil has said that in some respects, the flexitarian approach is not very different from his Anti-Inflammatory Diet, which emphasizes vegetables, fruits, whole grains, beans and other legumes, and healthy fats. The Anti-Inflammatory Diet also encourages you to eat fish and seafood two to six times a week but restricts other sources of animal protein, except for high-quality cheeses and yogurt and some eggs.

Dr. Weil has said that even with the occasional indulgence of a steak, becoming a flexitarian or a part-time vegetarian is better for your health than following the mainstream American diet. If you decide on the flexitarian approach, he suggests limiting your servings to three ounces when you do eat meat. He also recommends eating grass-finished beef free of antibiotics and hormones. When eating fish, choose wild Alaska salmon (especially sockeye) herring, sardines and black cod (sablefish), all of which are rich in omega 3 fats.

Sources:
E.J. Derbyshire, “Flexitarian Diets and Health: A Review of the Evidence Based Literature,” Frontiers in Nutrition, January 6, 2017, doi: 10.3389/fnut.2016.00055.eCollection 2016

Ambika Satija et al, “Plant-Based Dietary Patterns and Incidence of Type 2 Diabetes in US Men and Women: Results from Three Prospective Cohort Studies,” PLoS, June 14, 2016, doi.org/10.1371/journal.pmed.1002039

The post A Flexitarian Diet appeared first on DrWeil.com.

FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharide and polyols. These compounds are all types of carbohydrates that can be difficult to digest. Fermentation of them in the gastrointestinal tract can result in bloating, discomfort, and other symptoms.

This is not a weight-loss diet. It was designed for people with irritable bowel syndrome (IBS) and is sometimes recommended for treatment of inflammatory bowel disease. IBS symptoms can include any combination of constipation, diarrhea, gas, bloating, abdominal pain or discomfort, fatigue, and headaches.

FODMAPs include wheat, rye, onions and legumes; lactose (found in soft cheese, yogurt and milk), fructose (as in high-fructose corn syrup), honey and certain fruits, including apples and pears. Artificial sweeteners, such as sorbitol, are also regarded as FODMAPs, and the diet limits fiber. Entirely eliminating these foods allows you to more easily identify which ones bring on your IBS symptoms when you add small amounts back in. The FODMAPs responsible vary from person to person and frequently change over time. The Low FODMAP diet is one of several popular diets reviewed on DrWeil.com.

How Healthy Is The Low FODMAP Diet?

Researchers at Australia’s Monash University developed this diet in 2005. Once all foods containing FODMAPs have been eliminated, they are reintroduced one by one in small amounts to see which ones bring on symptoms. After the troublesome FODMAPs are identified, a new diet that excludes them can be designed by a trained dietician. This process can take from two to six weeks. Because you must work with a dietician, costs will range from $150 to as much as $350 per hour depending on where you live, but the expense may be fully covered by your health insurance plan.

What Can You Eat On The Low FODMAP Diet?

Although the diet initially requires eliminating many foods, you can continue to consume several others: meat, poultry, fish, and eggs, as well as wheat-free grains and flours. You also can eat bananas, berries, oranges and melon, as well as such vegetables as kale, cucumbers and sweet potatoes. Certain dairy foods, including lactose-free products, hard cheeses and mozzarella are also permitted. An app available from Monash University provides recipes and information on FODMAP products from major food brands. It also allows you to check unfamiliar foods to see if they contain FODMAPs.

How Many Calories On A Low FODMAP Diet?

You don’t have to count calories on this diet. Many people shed a few pounds during the elimination phase, but dieticians generally advise against trying to lose weight at that time, or when you’re adding back foods. Afterwards, if you want to lose weight, you can work with your dietician to come up with an eating plan that will help you reduce your caloric intake without triggering symptoms.

What Do Doctors Say?

If you have IBS, your doctor may recommend the FODMAP diet to identify the foods that are causing your symptoms. The diet has been scientifically evaluated and is in widespread use as a treatment for IBS. According to researchers at Monash University, following the low-FODMAP diet results in relief of symptoms in three out of four patients with the disorder. They maintain that the positive effects are long lasting.

Dr. Weil’s Take On The Low FODMAP Diet:

If you have IBS, you may be able to help ease your symptoms by identifying and eliminating any foods that appear to set them off. I also recommend avoiding caffeine (including decaffeinated beverages), tobacco and other stimulants that can irritate the bowels and worsen diarrhea. Avoiding dairy products can also help. Although the FODMAP diet incidentally reduces fiber for those sensitive to certain compounds in fiber foods, others may see benefit from increasing intake of fiber – eating fruits, whole grains and cooked vegetables, sprinkling a tablespoon of freshly ground flaxseed on cereals, soups or salads, and using a psyllium-based fiber supplement if you can’t sufficiently increase your consumption of fiber-rich foods. These are changes you can make on your own. While there is evidence that a low-FODMAP diet can have a positive impact on IBS symptoms, it has not yet been shown whether it works better than other less restrictive diets for IBS.

Sources:
Peter R. Gibson and S.J. Shepherd, “Evidence-based dietary management of functional gastrointestinal symptoms; The FODMAP approach“. Journal of Gastroenterology and Hepatology, February 2010, doi:10.1111/j.1440-1746.2009.06159.x.

Peter R. Gibson, “History of the low FODMAP diet,” Journal of Gastroenterology and Hepatology, March 2017, doi.10.1111/jgh.13685

The post A Low FODMAP Diet appeared first on DrWeil.com.

The vegan diet eliminates all foods of animal origin – including eggs, dairy products and honey, as well as meat, fish and poultry. People choose to eat this way to improve their health, or for environmental or ethical reasons – often a principal concern about the killing of animals for food.

How Healthy Is The Vegan Diet?

Depending upon their food choices, vegans may not get all the micronutrients they need, particularly iron, zinc and calcium. Cereals, grains, legumes, dates, prunes, and raisins are good sources of iron, while legumes, nuts, spinach and leavened breads provide zinc. Sesame seeds, collards, broccoli, sea vegetables and tofu coagulated with calcium are the best vegan sources of calcium, as is calcium-fortified orange juice and soymilk.

A number of studies comparing the vegan and other diets have shown that people tend to lose more weight on a vegan diet.

For example, in one study published in 2007, 60 overweight, postmenopausal women followed either a vegan diet or a diet low in fat and dietary cholesterol for a year. When the year ended, those who were on the vegan diet had lost 10.8 pounds compared to only 3.9 for those on the low-fat diet. After two years, the vegans weighed 6.8 pounds less than they had at the outset compared to 1.8 pounds less among women in the other group. Similar differences are found when the vegan diet is compared to other weight-loss plans.

How Popular Is It?

Reportedly, the number of vegans in the United States increased by 600 percent between 2014 and 2017. By 2017 a total of 5.5 percent of U.S. residents were believed to be following a vegan diet. The Vegan Society in the UK reported a 350 percent increase in vegans during the past decade. Worldwide, sales of foods labeled vegan increased by nearly eight percent in 2017. The Vegan diet is one of several popular diets reviewed on DrWeil.com.

General Principles The Vegan Diet

A central principle of veganism is that all animals have a right to life. According to the Vegan Society, roughly 60 billion land animals and more than a trillion marine animals are used and killed annually for human food. The objections of many vegans to animal cruelty and exploitation go beyond the killing of animals for food. They avoid clothing made from animal skin or fur as well as products (including cosmetics) that are tested on animals. Since medications are frequently tested on animals, this can become a problem for vegans who need them.

The environmental concerns of veganism stem from the harmful impact of using land and water to raise animals for food as well as that of transporting them from “farm to fork.” In a study published in June 2018, researchers at the UK’s University of Oxford concluded that adopting a vegan diet could be “the single biggest way” to reduce your personal environmental impact on the planet. The team reported that by eliminating meat and dairy products individuals in the UK could reduce their carbon footprint from food by up to 73 percent, and if everyone followed a vegan diet, worldwide farmland use could be reduced by 75 percent. This would lead to a significant drop in greenhouse gas emissions and free up wild land lost to agriculture, which the study identified as one of the primary causes OF mass wildlife extinction. The investigators also reported that production of meat and dairy products is responsible for 60 percent of greenhouse gas emissions but provides only 18 percent of calories and 37 percent of protein levels worldwide.

What Can You Eat?

The vegan diet includes fruits, vegetables, grains, nuts, seeds and legumes. It is low in cholesterol and saturated fat but can be high in healthy fats from plants. Many popular foods are vegan; think of guacamole, vegetarian baked beans, hummus, pasta, popcorn, lentil soup, veggie burgers, and frozen fruit desserts.

How Many Calories On A Typical Vegan Diet

No matter how much they eat, vegans tend to consume fewer calories than do people whose diets contains meat and other animal products. For this reason, they generally have a lower body mass index and weigh less than non-vegan counterparts.

What Doctors Say

Because nutrition is not a major component of medical education, your doctor may not be familiar with the vegan diet or its health benefits. Others may have concerns, as does Dr. Weil, (see below) that it does not provide adequate amounts of particular micronutrients.

Dr. Weil’s Take On The Vegan Diet:

Dr. Weil is cautious about vegan diets in general, especially for children. While he says that vegetarian diets can be very healthy, he views the vegan diet as more problematic. Even so, he notes that many Westerners forced to eat this way probably would lose weight, have better serum lipid profiles and lower risks of chronic disease as a result of consuming less fat, less saturated fat, less animal protein and more fruits and vegetables. He cautions, however, that without adequate supplementation the diet presents a risk of a vitamin B12 deficiency, and an increased risk of omega-3 fatty acid deficiency. There is also an increased risk of iron and calcium deficiency unless foods rich in usable forms of these are emphasized or supplementation is provided. While Dr. Weil strongly recommends reducing the percentage of animal foods in your diet, he does not see vegan cuisine becoming widely accepted in our society.

Sources:
Julieanna Hever, “Plant Based Diets: A Physician’s Guide,” The Permanente Journal, July 6, 2016, doi:  [10.7812/TPP/15-082]

Joseph Poore et al, “Reducing food’s environmental impacts through producers and consumers.” Science, June 1, 2018, DOI: 10.1126/science.aaq0216

The Vegetarian Resource Group, “Veganism in a Nutshell,” vrg.org/nutshell/vegan.htm

The post A Vegan Diet appeared first on DrWeil.com.