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Six Pillar Review: Plant-based Dietary Quality

Extracted from the American College of Lifestyle Medicine: Benefits of plant-based diets for quality

Nutrition is a key pillar in lifestyle medicine. Per the American College of Lifestyle Medicine, the highest quality dietary pattern that offers optimal nutrition, addresses nutrients of concern, and avoids excess calories and fat is one based on unrefined vegetables, fruits, whole grains and legumes.

Poor diet quality is a problem in Indiana, but is prevalent across the globe, and is a driver of poor health and chronic disease. Diet quality refers how patterns of eating provide energy and essential nutrients to allow for growth, healing, physical activity, and optimal health at all stages of life. Work is being done by researchers to standardize how we measure diet quality - some metrics include maternal and child health (MCH), non-communicable disease (NCD), Mediterranean Diet Score (MDS), Alternate Healthy Eating Index (AHEI), and Healthy Eating Index (HEI), Dietary Approaches to Stop Hypertension (DASH). Differences in metrics are which food products are used: for instance, MCH metrics focus on grains, fruits, vegetables, dairy products, meat and fish. Interestingly, MDS, AHEI, HEI, and DASH had convincing evidence of protective relationships for all-cause mortality, cardiovascular diseases, type 2 diabetes, total cancer, and cancer mortality.

Measures of diet quality result in some undernutrition (not enough calories, under nourished), overnutrition (excess intake of calories, saturated fat and sodium), malnutrition (several factors related to stunting, rapid weight loss, or insufficient growth), and underconsumed or overconsumed nutrients (failure to consume recommended nutrients).

There is some research on children in vegetarian or vegan diets. Some results point to lower risk for obesity, cardiovascular disease and diabetes. However, parents are advised to watch critical nutrients of protein, iron, calcium, vitamin B12, and omega 3 fatty acids.


Coze Health Medical supports and encourages the whole food plant-based diet, but we encourage whole foods above all else. Our certified lifestyle medicine providers help patients to understand the pendulum of healthy eating -- making changes can be difficult. Using the WFPB diet as a goal can mean introducing macronutrients (protein, carbohydrate, and fat) that support health.

Overall, nutrition from plant-based diets is typically of higher quality than omnivorous diets, as assessed by the Alternate Healthy Eating Index (AHEI). A whole food plant-based (WFPB) diet is one made up of predominantly unprocessed fruits, vegetables, whole grains legumes, nuts and seeds, and excludes animal foods, with certain selective supplementation of vitamins B12 and sometimes D. Intentionally planned, WFPB diets provide sufficient nutrient intakes for all stages of life and can be therapeutic for chronic disease and overall health and healing. The plant-based dietary pattern protects against overconsumption of nutrients that lead to obesity and disease, particularly animal protein, saturated fat, trans-fats, cholesterol simple sugars, and sodium.


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