Welcome to Swmdda's Corner, a space used to discuss current topics and happenings with the dietetics community
By Anja Grommons, MA, RDN
In practice, patients will frequently paint a picture of their idea of a healthful diet, which is often contradictory, restrictive, and interwoven with the misinformation of diet culture. Their food beliefs are at times distorted, and their intakes are unbalanced with a maldistribution of macronutrients. Think back to the 1970s and ‘80s when the low-fat trend emerged and took the food companies and consumers by storm. Fast forward to now: fat is “back,” protein is on a pedestal, and carbohydrates are the enemy. Food confusion is a common topic seen in practice and it appears that much of the population is affected (1). With the help of the media and its convincing misinformation, people are often looking for a quick fix or answer to their rather complex nutrition problems or questions. While we’ve been bombarded with sub-par research that promotes the current diet trends, the truth is, a healthful diet consists of balance. But what is balance?
The Institute of Medicine (IOM) created the Acceptable Macronutrient Distribution Ranges (AMDR), which recommends consumption of 45 to 65 percent of calories from carbohydrates, 10 to 35 percent from protein, and 20 to 35 percent from fat. Additional recommendations include limiting saturated fat and added sugar while aiming for foods rich in dietary fiber. With “balance” defined, how does the Standard American Diet (SAD) measure up?
For one, when comparing what we are eating to what we should be eating, our fiber intake is certainly not meeting the mark. In fact, fewer than 3% of Americans meet the minimum fiber recommendations (2). Dietary fiber is an indigestible form of carbohydrate that can help with weight control and gastrointestinal health. High fiber foods include fruits, vegetables, whole grains, and legumes, which the SAD is lacking (3).
If Americans aren’t eating enough fiber, what is making it to the table? Interestingly enough, total carbohydrate intakes are within the recommendations of the AMDR, but they likely stem from low-fiber, highly processed sources. Similarly, Americans are meeting their protein and fat needs, but due to the consumption of animal-based sources, especially cheese (3), saturated fat intake exceeds its mark (4). It’s not exactly the public’s fault; nutrition can be a confusing topic to navigate. Just thumb through a health and fitness magazine; see any ads for fruits and vegetables? Didn’t think so. Instead you will find advertisements promoting foods already over-consumed, like dairy and animal-based products. In knowing where the SAD is falling short and what is being overconsumed, what exactly should Americans be focusing on? Glad you asked. Research has indicated that a vegetarian eating plan most closely resembles that of the dietary recommendations (5). What better way to remedy the fiber deficit while promoting adequate protein and reduced saturated fat intake than by shifting the focus to a plant-based diet?
A diet rich in fruits, vegetables, whole grains, and legumes provides the aforementioned redistribution of macronutrients and can provide a plethora of antioxidants, phytonutrients, vitamins, and minerals, all necessary for growth and development. A plant-based diet has shown to be effective in the prevention and treatment of type 2 diabetes (6), overweight (7), coronary artery disease (8), and cancer (9), some of the most devastating and expensive chronic conditions in the U.S. A plant-based diet also packs a strong benefit for the environment and provides a more compassionate lifestyle benefiting all living beings. It may provide an improved relationship and understanding with food as well. Many testimonials exist on the latter (10), which of course are subjective and therefore a limitation of research, but nonetheless a potential valuable benefit of a plant-based diet.
If you are interested in adapting to a plant-based diet, you should understand that there is no one-size-fits-all approach. A great transition may include focusing on plant-based alternatives to some of your favorite recipes or products, such as bean-based taco fillings instead of the beef-based variety, or a pulsed chickpea salad rather than egg salad in sandwiches or lettuce cups. A plant-based diet should still be modeled after the recommendations of the Dietary Guidelines and the MyPlate method may be employed to minimize the guess work of meal planning. In fact, vegan registered dietitians Ginny Messina (11) and Julieanna Hever (12) have created vegan adaptations of the standard plate.
If recipes are your thing, check out some of my favorite vegan recipe resources, including Minimalist Baker (13), Forks Over Knives (14), and Bosh (15). As with all dietary changes, small steps are key, and evidence-based guidelines, along with tasty recipe resources, are imperative for navigating the transition. So, what will be your first step?
Anja is a registered dietitian providing nutrition education in the Patient-Centered Medical Home setting. Captivated by the benefits of plant-based nutrition, she has researched and personally followed a plant-based, vegan lifestyle for many years. After finishing graduate school, Anja completed the T. Colin Campbell Plant Based Nutrition Certification through eCornell and has continued to build upon that knowledge base to write personally and professionally on the benefits of plant-based living.