Making the case for vegetarian diets! Joan Sabaté, MD, DrPH!
Vegetarian diets are ffffffffffffffff of eating.
The roots of vegetarian diets can be traced back to the beginnings of recorded history.
The book of Genesis! Pronounces that the seeds of plants and the fruits of trees are the nourishment of human kind.
Gautama Buddha! The eating of meat extinguishes the seed of great compassion.
Plato! The Republic asserted that the ideal city was a vegetarian city because it was more rational to choose a diet less harmful to the environment and to the spirit.
Vegetarian diets are not a modern invention or fad from a recent book.
A vegetarian diet is defined by the exclusion of flesh foods.
How are the dietary patterns defined?! Meat! Non-vegetarian! Pesco! Lacto-ovo! Vegan! Poultry/Fish! Dairy/Eggs!
" Most studies of vegetarians " come from either the: " North-American Seventh-day Adventists Cohorts (AHS-1 & 2)! or" the EPIC-Oxford study in the UK.!
Health effects of vegetarian diets!
CVD risk factors!
Vegetarians weigh less! 200 180 Female 5 6 tall! Male 5 10 tall! Weight (lbs)! 160 140 120 100 0! Vegan Lacto-ovo Adventist Health Study
Vegetarians have lower BMI! Meat-eaters! Fish eaters! Vegetarians! Vegans! EPIC-Oxford Study
Vegetarians have lower risk of diabetes! 8% 7.5%! % Reporting Type 2 Diabetes! 6% 4% 2% 2.1%! 3.2%! 4.7%! 0% Vegan Lacto- ovo Pesco- veg Non- veg Adventist Health Study
Vegetarians compared to! non-vegetarians have:! 2 5 points lower BMI 25% - 50% lower risk of hypertension 25% to 50% lower risk of diabetes 50% lower risk of metabolic syndrome
IHD mortality of vegetarians! 1 Adjusted Hazard Ratio (HR)! 0.9 0.8 0.7 0.6 1! 0.81! 0.88! 0.71! 0.5 Meat eater Vegetarian Veg Women Veg Men Adventist Health Study
Vegetarians have a slightly lower risk of overall-cancers! 1 Adjusted Hazard Ratio (HR)! 0.9 0.8 0.7 0.6 1! 0.92! 0.98! 0.88! 0.93! 0.5 Non- vegetarian Vegetarian Pesco- V Lacto- V Vegan A Vegetarian diet seems to reduce the risk of some cancer sites (colorectal, prostate, GI tract) while it has no effect on other cancers.
All-Cause mortality for vegetarians! 1 Adjusted Hazard Ratio (HR)! 0.9 0.8 0.7 0.6 1! 0.88! 0.93! 0.82! 0.5 Meat eater Vegetarian Veg Women Veg Men Adventist Health Study
Longevity" In general, vegetarians live 2 3 years longer than non-vegetarians.
What do vegetarians eat?!
Relative food intake of vegetarians compared to non-vegetarians! fruit vegetables avocados potatoes grains legumes soy foods & meat analogues nuts & seeds meat dairy products eggs added fats sweets snack foods beverages drinking water Adventist Health Study Vegan vs. Nonveg Lacto vs. Nonveg Pesco vs. Nonveg 0.00 0.50 1.00 1.50 2.00 2.50 3.00 * Means, adjusted for age, sex & race and standardized to 2000kcal)!
Animal protein foods! unprocessed red meat processed red meat unprocessed poultry processed poultry pork fahy fish Vegan vs. Nonveg Lacto vs. Nonveg Pesco vs. Nonveg other fish regular milk products reduced milk products cheese eggs Adventist Health Study 0.00 0.20 0.40 0.60 0.80 1.00 1.20 1.40 Rela1ve mean quan1ty eaten compared to non vegetarians (adjusted for age, sex & race and standardized to 2000kcal)
Plant protein foods! legumes meat analogues soybeans & tofu soymilks peanuts Vegan vs. Nonveg Lacto vs. Nonveg Pesco vs. Nonveg peanut buher tree nuts mixed nuts seeds Adventist Health Study 0.00 1.00 2.00 3.00 4.00 5.00 6.00 Rela1ve mean quan1ty eaten compared to non vegetarians (adjusted for age, sex & race and standardized to 2000kcal)
Fruits and vegetables! avocados tomatoes leafy greens cruciferous vegetables onions other vegetables Vegan vs. Nonveg Lacto vs. Nonveg Pesco vs. Nonveg citrus berries other fruits dried fruits Adventist Health Study 0.00 0.50 1.00 1.50 2.00 2.50 3.00 Rela1ve mean quan1ty eaten compared to non vegetarians (adjusted for age, sex & race and standardized to 2000kcal)
Starchy foods! whole grains refined grains mixed grains Vegan vs. Nonveg Lacto vs. Nonveg Pesco vs. Nonveg sweet potatoes white potatoes fried potatoes Adventist Health Study 0.00 0.20 0.40 0.60 0.80 1.00 1.20 1.40 1.60 1.80 2.00 Rela1ve mean quan1ty eaten compared to non vegetarians (adjusted for age, sex & race and standardized to 2000kcal)
Fats, Sweets & Snacks! solid fat liquid fat salad dressing Vegan vs. Nonveg Lacto vs. Nonveg Pesco vs. Nonveg buher dairy dessert other dessert Adventist Health Study 0.00 0.20 0.40 0.60 0.80 1.00 1.20 1.40 Rela1ve mean quan1ty eaten compared to non vegetarians (adjusted for age, sex & race and standardized to 2000kcal)
A healthy vegetarian diet includes:! More plant foods Less dairy and eggs Less refined foods Less beverages And more water
Sustainability of Vegetarian diets!
" " " " Not all foods are produced equally! " The production of Plant foods " is more sustainable because:" they require fewer natural resources " are less taxing on the environment " compared to production of animal foods.
Green house Gas emissions in the production of different foods! Post- producmon emissions ProducMon emissions
Relative environmental impacts of protein production from plants vs. animal sources! Relative Environmental Impact! 20 18 16 14 12 10 8 6 4 2 0 Beans Almonds Eggs Chicken Beef Land Water Fuel FerMlizer PesMcide Animal waste *Beans as the reference value Sabate et al., 2014
The production of foods within a vegetarian diet requires less resources! Water Energy PesMcide FerMlizer Moderate Meat diet Vegetarian diet 0 10 20 30 40 50 60 70 80 90 100 Adventist Health Study Marlow et al., 2015
The production of all foods within vegetarian diets emits less GHGe! Vegans Vegetarians Fish- eaters Low meat- eaters (<50 g/day) Medium meat- eaters (50 99 g/day) High meat- eaters ( 100 g/day) kg CO 2 e/2000 kcals! 0 1 2 3 4 5 6 7 8 EPIC-Oxford Study! Scarborough et al., 2014.!
The production of foods within a vegetarian diet emits less GHGe! Vegetarian 68%! 15%! 13%! 29% decr Low Meat 59%! 6%! 17%! 14%! 22% decrease! Moderate Meat 40%! 20%! 19%! 17%! kg CO 2 e/d! 0 0.5 1 1.5 2 2.5 3 Plant Foods Meat Dairy/Eggs Beverages Adventist Health *Adjusted Study to 2000 kcal! Soret et al., 2014
The adoption of vegetarian diets at the global level has the potential to, all at once, optimize the food supply, improve human health, increase environmental sustainability, and advance social justice outcomes.! Sabate and Soret 2014
Making the case for vegetarian diets! Simple easy to understand and practice. Adaptable many cultures and cuisines. Healthy - lower risk for chronic disease. Sustainable requires less natural resources. It is not all or nothing