Clicky

It’s time for healthcare professionals to demand a plant-based food system

Shireen Kassam* (left) is a Consultant Haematologist and Lifestyle Medicine Physician. She is founder and director of Plant-based health professionals UK and co-founder of Plant Based Health Online.

Laura Freeman* (right) is a GP and Lifestyle Medicine Physician. She is co-founder and medical director of Plant Based Health Online.

Diet-related diseases are at an all-time high and the latest UN Intergovernmental Panel on Climate Change (IPCC) report on climate change has been called a ‘code red for humanity’.

These two issues are intimately related. Our food system is at the centre of three global crises: health, climate and ecological. We also have a crisis of ethics whereby more than a billion people remain hungry despite the production of enough food to feed two planets. If everyone ate a diet typical of the wealthiest nations, we would need seven planets to feed the world.

Our food system is at the centre of three global crises: health, climate and ecological.

We have a simple solution in plain sight. A healthy plant-based diet would not only improve global health, preventing an estimated 1 in 5 deaths, but would keep the food system within planetary boundaries necessary to avert climate disaster, whilst promoting biodiversity and feeding more people. The Planetary Health Plate created by the Eat-Lancet commission is a predominantly plant-based diet, with more that 85% of energy derived from healthy plant foods, and acknowledges that a 100% plant-based diet is not only nutritionally adequate but has additional benefits for planetary health.

Red and processed red meat production and consumption is particularly harmful for personal and planetary health, with 842,000 deaths associated with excessive red meat consumption globally. The largest analysis to assess the co-benefits of a nutritionally adequate yet sustainable diet, using the Planetary Health Plate as an example, found that the adoption of such a diet could prevent 19–63% of all deaths and up to 10–40% cases of cancer whilst at the same time reducing greenhouse gas emissions up to 50% and land use up to 62%.

More than a billion people remain hungry despite the production of enough food to feed two planets.

The National Food Strategy plan in the UK clearly lays out the problem and makes the connection between our food system and climate and health outcomes. Although the recommendations in our opinion do not go far enough, they are a step in the right direction. These include a 30% reduction in meat consumption, whilst increasing fruits and vegetables and fibre consumption.

These recommendations reflect the fact that animal agriculture accounts for nearly 60% of food system greenhouse gas emissions, with beef and dairy farming contributing the majority.

Animal agriculture is also responsible for deforestation, biodiversity and species loss, land, air and ocean pollution, not to mention the generation of new infectious threats with pandemic potential and contributing to antibiotic resistance. It is a highly inefficient system which also harms people, usually marginalised, migrant groups, who have little choice but to work in slaughterhouses, a workplace that contributes to both mental and physical ill health.

We now have compelling evidence that a plant-based diet can promote pandemic resilience, reducing the severity of SARS-CoV-2 infection. The first clue came from a study from China demonstrating the impact on the health of the gut microbiome, which thrives on a fibre-rich diet, on COVID-19 severity.

Animal agriculture accounts for nearly 60% of food system greenhouse gas emissions.

This has been followed by the publication of two observational studies. A case-control study of healthcare workers with significant exposure to COVID-19 captured demographic, medical, lifestyle and dietary data and correlated these with severity of COVID-19 amongst 568 cases compared to 2316 controls. The results showed that those following a plant-based dietary pattern had a 73% reduction in the risk of moderate or severe COVID-19. This was independent of underlying chronic health conditions. In contrast, participants following a high protein, low carbohydrate diet had a 3-fold higher risk of moderate or severe COVID-19.

We accept that this study has a number of limitations, nonetheless, those participants described as plant-based had significantly higher consumption of legumes, nuts and vegetables and lower consumption of red/processed meat, sugar-sweetened beverages and alcohol compared to participants who did not follow a plant-based diet.

A further paper reporting more robust data from the Zoe COVID symptom study analysed diet quality in more than half a million participants from the US and UK. During the follow-up period, 31,815 COVID-19 cases were documented. Adherence to a healthy plant-based diet was calculated using the healthy plant-based diet index. Those eating a healthy plant-based diet had a 10% reduction in risk of COVID-19 and a 40% reduction in severity of COVID-19. The impact of a plant-based diet was greatest in those from lower socioeconomic groups and independent of underlying chronic health conditions and lifestyle factors.

It is heartening to see that healthcare professionals are strongly advocating for climate health. Greener practice and Doctors for XR (Extinction Rebellion) are doing an incredible job at highlighting the impact of healthcare services on climate change and providing pressure for the implementation of readily available solutions. Similarly, the UK Health Alliance on Climate Change are working at a policy level.

Our food choices matter. Without addressing food production, we cannot meet our climate targets.

However, a more open and bold conversation is still lacking around the true impact of our food choices, and the healthcare community continues to prioritise their own diet preferences ahead of public and planetary health. The recent British Society of Lifestyle Medicine annual conference served red meat at lunch so not to exclude individual diet preferences. Hospitals continue to serve red and processed meat.

At a time when public institutions and civil society organisations are removing meat from menus, we need to do better. Our food choices matter. Without addressing food production, we cannot meet our climate targets. Healthcare professionals should be leading by example and supporting patients to make healthier choices that will improve their quality of life and those of future generations.

 

*DOI: Shireen Kassam is Founder of Plant-Based Health Professionals UK and co-founder of Plant Based Health Online. Dr Laura Freeman is co-founder of Plant Based Health Online.

 

Featured image by Drahomir Postby-Mach on Unsplash     

 

59 Comments

  1. Thank you for writing such an important and timely article. We have a simple solution for improving both personal and planetary health.

  2. This is everything I try to explain almost daily to patients, family, friends, anyone who will listen. It is the most important advice healthcare professionals can be giving, for all the reasons outlined above.

  3. Very well said. The evidence for plant based diets for health and the planet is clear, and both issues are urgent. GPs are in a privileged position to get this message over to patients, and to call for community plant based cooking classes. Hackney is lucky enough to have Made In Hackney, but every area needs something similar

  4. Thank you for writing this. It is way past time now that health care professionals were educating themselves about nutrition and its central role in health. I hope that the climate crisis might tip those who are firmly entrenched in their outdated views into seeking the facts, which are undeniable.

  5. Such a well written and timely article. We can utilise plant based approaches not only to improve patient health now, but also the chances of a livable future for future generations to come. The RCGP Green impact scheme also reflects this. Thank you so much for giving this hugely important issue time and space. The time is now.

  6. Really well written article. The most important challenge facing us today is the climate crisis, and a plant based diet is a double winner- vital to the fight against climate change, and the optimum diet to reduce the burden of chronic disease and improve the lives of our patients. Something every GP should be advicating for .

  7. Thank you for such an excellent & much needed article article. Health professionals need to lead the way. The evidence is overwhelming & such a diet connects everything – health, compassion & the planet

  8. Man thanks for writing this important piece. It is time that we as healthcare professionals start advocating for our patients to eat a more plant-based diet.

  9. Such a timely article. I’d like to add that mental health has also been proven to respond positively to a naturally anti-inflammatory, plant based diet.
    Doctors and associated health professionals don’t have to wait for guidance from above, the evidence is clear and it would seem ethical to communicate this understanding to patients at every opportunity.
    I hope the MSM take the opportunity of COP26 to get this winning message across to the general public.

  10. Great article! Thank you so much. The recent UK government budget announced for the NHS didn’t mention prevention (and healthy diets and active lifestyles) at all! Millions of pounds and thousands of lives could be saved if medical professionals focused more on plant-based nutrition…

  11. Thank you, and to the point! We need to start understanding, and widely educating about the concept of ONE health, it’s synergies, and cascaded benefits. Regenerative agriculture and plant-based food systems tick these boxes.

  12. Thank you so much for this brilliant and thought-provoking piece: “Healthcare professionals should be leading by example and supporting patients to make healthier choices that will improve their quality of life and those of future generations.” Beautifully articulated.

  13. Such an important article. And so timely given the urgent need to shift our approach to diet-both for our planet, and the health of ourselves, our loved ones and our patients. What a wonderfully clear, evidence-based article.

  14. Thank you for this amazing and important article. The world needs to hear this message, a plant based food system is the answer to so many problems. Thank you for everything that yhou are doing, you are giving me and my family so much hope. 💚Carla

  15. The future of the planet as well as humans are already at stake, I don’t understand why this has not been implemented beforehand! Absolute yes from me 👏👏👏

  16. Thank you for an excellent and timely article. The health professionals and the general public need to know this. Well done Shireen and Laura!

  17. The very fact that I have stayed committed to a plant based diet for 5+ years is a testament to the convincing evidence for the benefits to us both personally and for our planet. Without these real truths I know I could not stay committed. Thank you for working to make this information more and more well known for the good of our loved ones, our planet, ourselves.

  18. A timely article. We can help our patients so much more effectively with a plant based dietary change than we can in any other way. At the same time we help the environment. What a lovely win/win. Great to see this published.

  19. Thanks Drs. Kassam and Freeman for your elegant analysis and much needed call for action. You are speaking truth to power and the time for action is now. Future generations may be aghast at the healthcare system condoning and promoting unhealthy foods, in the same way that it is shocking to us that doctors and nurses were once paid participants in advertisements for cigarettes. Your recent example of the British Society of Lifestyle Medicine annual conference serving red meat at lunch is telling of the abject failure of many of our current organizations, even those that cloak themselves in the lifestyle medicine banner, to adhere to the first principle of medical ethics – primum non nocere or first, do no harm. Lest this be seen as a trivial matter, let me draw an analogy – it would be akin to the same conference having a smoking lounge for attendees and serving cigars. We need to truly care for the health of our patients, our communities, and our planet. The disease care model needs to be replaced by a genuine health care model. Let’s show we care about health by caring about health! Thank you for your important paper.

  20. Excellent article. Doctors need to stress the importance of a whole food plant based diet. I have been vegan for 35 years (and more recently switched to whole food plant based) and during that time have only been to the doctors twice and have taken no medications at all, not even an aspirin). What a saving to the struggling NHS.

  21. Great article. As healthcare professionals we have duty of care for our patients. Thank you for highlighting this important issues which has been ignored. NHS staff need support via up to date nutrition education in order to take action now.

  22. This is such an important message and one which needs to be spread widely, to everyone and not just to health professionals. Whilst we all have an individual responsibility for our health, what is so often lacking is a reliable, commonsense and evidence-based guide as to what represents a healthy and sustainable diet. The content of this article is just that.

  23. Thank you! More doctors need to vocalize these very important issues AND walk the talk, lead by example, inspire change in their hospitals…we have to work bottom up while we wait impatiently for more significant changes from the top! You guys are awesome!

  24. This is so important- just as the smoking doctors were so recalcitrant to act on the overwhelming evidence that smoking is detrimental to health in the 50s and 60s, so now the medical profession is dragging its heels in the light of mounting excellent evidence that a plant based whole food diet is best for health, the planet and the animals.

  25. All the arguments so clearly laid out- this needs to be widely and urgently disseminated within and beyond the health community. Signposting to a wholefood plant-based diet is the most important health intervention we can make as both HCPs, and members of families and communities we care about. Thank you.

  26. Such an excellent and important article. Thank you. Our health is intimately connected with the health of the planet on which we all depend. We need a more holistic understanding of health and health care professionals should be leading the way. Our food system is a key driver of so many of the multiple interconnected health, ecological and social justice crises we are facing. We need an urgent shift to a sustainable and just plant-based food system if we are to have any hope of addressing them.

  27. Great article as always! ,Wouldn’t it be wonderful if the findings of the EAT-Lancet study were to be used to shape diet policy and serve food based on the Planetary Health Diet, starting with all tax funded institutions, parliament, the military, schools, hospitals, local councils, prisons etc. Serving red meat at Lifestyle Medicine conferences and climate conferences is just plain pathetic!

    • Such an important article, thank you. In our time of crisis to hear of medical organizations and COP serving red meat is ludicrous! Wholeheartedly agree with this powerful and informative article.

  28. Every doctor, every medical student, every health professional and health organisation should read this article. We can heal patients and the planet with the same diet while fulfilling what we set out do when we decided to work in health. Great article. Dr Nitu Bajekal Consultant Gynaecologist

  29. Thank you for this timely article!!! We need more doctors to join in and halt this global health crisis of we are in. Most chronic diseases can be easily reversed with simple lifestyle changes you have mentioned. Excellent article.

  30. Brilliant article all health care professionals should read clearly explaining that the diet that is harming us is harming our planet and expands health inequalities. Health care professionals are in a privileged position, can lead by example and as advocates for our patients should demand policy change. The problem is this is still not known by many Health care professionals- red meat at COP26 and BSLM is an example as is still advising full fat dairy for healthy bones and frailty on orthopaedic and geriatric wards, red meat for anaemia, prescribing drugs for diet related disease.
    Just as the world’s population behaviour changed overnight in an attempt to lessen the covid pandemic, we can change dietary habits to enjoy delicious, healthy, sustainable food. Win win for health of all animals and our planet , super quick fix, it has it all. This message needs to be heard and question who is putting the brakes on? (I’m an NHS GP, prev ortho and rehab medicine)

  31. This is such an important and timely issue on a global scale. We need everyone to sit up and listen and take this issue seriously for the sake of our planet and future generations. Well written article indeed.

  32. Such an important article. This should be mandatory reading for not just all health professionals, but everyone! The answers they’re trying to “find” from conferences like COP26 are already known and in plain sight. I really hope this message is received and acted upon urgently.

  33. Thankyou Shireen and Laura for summarising the essential message that a whole food plant based diet is the best diet for human and planetary health. It is such a simple message and one which cannot be spoken and promoted enough.

  34. Thanks so much for laying the evidence out so clearly for the benefits of a plant based diet. We feel healthier and happier since adopting this. It is a win-win for the environment, people and healthcare systems. A further step to encourage is getting people to grow some food even if it is on a pot on a window sill. Connection with nature has another level of benefits.

  35. Thank you for this informative article. I so wish we could improve the food in hospitals (where I work) from being something provided to fill people up, to something that enhances their health. But how much greater would be the improvement if primary care were able to effectively promote the effects of diet on health, and the huge difference a plant based diet can make.

  36. Thank you for this great article. I am waiting for the political will of our leaders and a broad education of societies.

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Previous Story

Validate yourself from within

Next Story

Goal-oriented case presentation for GP trainee education

Latest from Opinion