MODULE 3 |
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Whole Food Plant-based Foods Benefits
Shifting of Diets Plant-based substitutes Eating Mindfully Healthy & Delicious Meals Optional Ingredients for Some Recipes Common Misconceptions about WFPB Diets Fibers an the Microbiome Food Preparation Article Review |
GOALS:
OBJECTIVES:
- Appreciate the numerous benefits of Whole Food Plant-based Diet
- Implement efficient strategies on Shifting Diets
- Realize the advantage of Eating Mindfully to address certain chronic conditions such as diabetes and obesity
- Utilize certain ingredients that can be added in cooking WFPB recipes
OBJECTIVES:
- Identify evidence-based benefits of Whole Food Plant-based Diet for improving health outcome
- Describe Protein Flip and Dessert Flip during diet transition
- Describe benefits of Mindful eating for chronic disease
- Identify effects of certain ingredients added in WFPB preparations
- Discuss the common Misconceptions about WFPB Diet
Whole-Food Plant-Based Diet
You already learned about the many types of plant-based diet from Module 1, but a plant-based diet does not necessarily mean whole food diet. The more whole, plant foods and fewer highly processed, calorie dense, and animal-derived foods one eats, the more health benefits one accumulates (e.g., reduced risk of chronic diet-related diseases, increased longevity, etc.) and the less time one needs to spend worrying about such activities as counting calories or restricting portion sizes in order to maintain or lose weight. Plant foods are also filled with fiber and antioxidants.
- Decreases in all-cause mortality
- Weight loss and favorable changes in lipid profile
- Decreased risk, and even reversal, of cardiovascular disease
- Decreased risk of some cancers
- Reduced markers of early stage, biopsy proven, prostate cancer
- Decreased risk of diabetes and improved glycemic control or normalized blood glucose levels for those with diabetes
- Improved migraine symptoms
Numerous other benefits, with new studies coming out regularly. It is important to note that many studies showing benefits of diets high in whole, plant foods are not studying purely WFPB diets. Many (if not most) actually refer to either predominantly WFPB diets, vegetarian diets, vegan diets, pescatarian, or Mediterranean-style diets.
Predominantly WFPB diet: the diet promoted by the ACLM and is a dietary pattern centered on whole, plant foods including vegetables, fruits, whole grains, legumes, nuts, and seeds. Processed foods and animal foods are limited or excluded.
Entirely WFPB diet: a dietary pattern made up entirely of whole, plant foods including vegetables, fruits, whole grains, legumes, nuts, and seeds. It completely excludes meat, poultry, fish, shellfish, dairy, eggs, oil, refined sugars, and refined grains.
Mediterranean-style diet: Is a predominantly (but not entirely) plant-based diet with staples including whole grains, vegetables, fruits, legumes, nuts, seeds, and plant oils, such as olive oil. Fish and seafood are eaten 2-3 times weekly along with small amounts of dairy, eggs, and poultry. Wine in moderation is also included. Red meat, processed meat, refined carbohydrates, and added sugars are generally avoided. (*There are a variety of Mediterranean diets. This description refers to the type of Mediterranean diet most commonly described in clinical trials, which has been the topic of numerous health related studies and dietary guidelines. Actual foods eaten do not need to be those found in the Mediterranean region of the world.)
Entirely WFPB diet: a dietary pattern made up entirely of whole, plant foods including vegetables, fruits, whole grains, legumes, nuts, and seeds. It completely excludes meat, poultry, fish, shellfish, dairy, eggs, oil, refined sugars, and refined grains.
Mediterranean-style diet: Is a predominantly (but not entirely) plant-based diet with staples including whole grains, vegetables, fruits, legumes, nuts, seeds, and plant oils, such as olive oil. Fish and seafood are eaten 2-3 times weekly along with small amounts of dairy, eggs, and poultry. Wine in moderation is also included. Red meat, processed meat, refined carbohydrates, and added sugars are generally avoided. (*There are a variety of Mediterranean diets. This description refers to the type of Mediterranean diet most commonly described in clinical trials, which has been the topic of numerous health related studies and dietary guidelines. Actual foods eaten do not need to be those found in the Mediterranean region of the world.)
Shifting Diets
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Protein Flip
This term was popularized by the Culinary Institute of America, one of the premier culinary schools in the U.S. It is the practice of flipping the plate from meat-centric to plant-centric. Instead of meat making up the center of the plate with vegetables being the smaller portion or an afterthought, vegetables and other plants become the stars while meat portions get reduced to garnishes or sides. This is a great strategy for patients who are not willing to entirely give up meat but could benefit from reducing intake and/or substituting with plant sources of protein. In a typical meal, one might have eaten a large piece of chicken with a small side salad. |
In a Protein Flip, the portions are reversed. In a Protein Flip this meal may become a large salad with added whole grains, legumes, nuts, and seeds to make the salad more filling and increase the protein content while reducing the portion of chicken to 1-2 ounces sliced atop the salad as a garnish.
The Protein Flip can be the gateway to healthier foods. This technique is very useful for those who are uninterested or unwilling to cut unhealthy foods-such as red meat-out of their diets completely. It also adds the familiarity of something they associate with deliciousness and satiety (e.g., meat) to foods previously eschewed from the diet (e.g., vegetables). Finding a way to incorporate these healthier foods into the diet helps one to develop a taste for them, making it more likely they will try other vegetables or choose them as a regular part of their diet.
When making dietary shifts-even if interested in cutting down or cutting out meat and other animal products-cravings for these items can remain intense for quite some time. This makes sense since food is part of culture, memories, and time shared with loved ones. The Protein Flip method of incorporating small amounts of highly craved foods may help some people prevent binging on them after periods of trying to abstain completely. Satisfying a craving can also help some people limit total food consumed because their psychological hunger (a desire to eat for a variety of reasons-such as habit, emotional state, or because something looks or tastes good-separate from physiologic hunger) is quenched. For others, however, controlling portions of these foods is challenging and they may find it easier to completely eliminate them.
The Protein Flip can be the gateway to healthier foods. This technique is very useful for those who are uninterested or unwilling to cut unhealthy foods-such as red meat-out of their diets completely. It also adds the familiarity of something they associate with deliciousness and satiety (e.g., meat) to foods previously eschewed from the diet (e.g., vegetables). Finding a way to incorporate these healthier foods into the diet helps one to develop a taste for them, making it more likely they will try other vegetables or choose them as a regular part of their diet.
When making dietary shifts-even if interested in cutting down or cutting out meat and other animal products-cravings for these items can remain intense for quite some time. This makes sense since food is part of culture, memories, and time shared with loved ones. The Protein Flip method of incorporating small amounts of highly craved foods may help some people prevent binging on them after periods of trying to abstain completely. Satisfying a craving can also help some people limit total food consumed because their psychological hunger (a desire to eat for a variety of reasons-such as habit, emotional state, or because something looks or tastes good-separate from physiologic hunger) is quenched. For others, however, controlling portions of these foods is challenging and they may find it easier to completely eliminate them.
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Dessert Flip
Trying to reduce the amount of very sweet foods-including artificially sweetened foods-eaten is important for retraining the palette to appreciate the natural sweetness in healthier options, such as fruit. In a typical dessert, one might have a large piece of a decadent sweet garnished with a bit of fruit—think strawberry cheesecake with a sliced strawberry on top. In a Dessert Flip, the portions are reversed. The size of the decadent dessert is reduced to just a bite or two and accompanied by a larger arrangement of fresh fruit. This is generally just as satisfying as the original while increasing the nutrient density and decreasing the calorie density. This is because the most enjoyable bites of any dessert are the first and having a couple bites is generally enough to quench a sweet craving at the end of a meal. |
The Dessert Flip is not the same as a healthy dessert, which is one that is nutritious in its own right. While the Dessert Flip, like the Protein Flip, works well for some to satiate cravings and prevent binging on sugary foods, other individuals may struggle to limit highly palatable foods to a few bites and may prefer to cut added sugars altogether. Work with your patients to find out what works best for them. The overall goal of reducing added sugars in the diet is achieved by both approaches.
Plant-based Replacements
Starting a plant-based diet sounds restricting but it really doesn't have to. In fact, with right the information and patience most dishes can be made plant-based using some simple ingredient swaps and easy steps.
Egg Replacement
There are various ways to replace egg when cooking plant-based recipe. Common replacements include chia and flax seeds, tofu, and aquafaba (also called the "water bean").
Flax and Chia Seeds
Both flax and chia seeds are readily available and can be easily purchased from health food stores or online stores. Flax and chia seeds have similar properties that produces jelly-like texture when mixed with water and serves as egg substitute. To get the equivalent of one egg, add one tablespoon of ground flax or chia seeds to three tablespoons of water. Mix thoroughly and allow to stand for about 15 minutes to thicken.
Egg Replacement
There are various ways to replace egg when cooking plant-based recipe. Common replacements include chia and flax seeds, tofu, and aquafaba (also called the "water bean").
Flax and Chia Seeds
Both flax and chia seeds are readily available and can be easily purchased from health food stores or online stores. Flax and chia seeds have similar properties that produces jelly-like texture when mixed with water and serves as egg substitute. To get the equivalent of one egg, add one tablespoon of ground flax or chia seeds to three tablespoons of water. Mix thoroughly and allow to stand for about 15 minutes to thicken.
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Tofu
To some, it could be surprising to use tofu as egg replacement. But because of the texture and properties of tofu, it can be used as direct replacement for eggs. About 1/4 cup of silken tofu is equivalent to 1 egg. Firm tofu is available in your local market, it can also be used to replace the most famous scrambled egg dish.
To some, it could be surprising to use tofu as egg replacement. But because of the texture and properties of tofu, it can be used as direct replacement for eggs. About 1/4 cup of silken tofu is equivalent to 1 egg. Firm tofu is available in your local market, it can also be used to replace the most famous scrambled egg dish.
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Aquafaba
Aquafaba is a liquid in cooked legumes, such as chickpeas. Since it is already viscous it can be whisked to form a foamy mixture that can also be used to replace egg. It is generally used in pastry recipes such as cake. Use 3 tablespoon of aquafaba to replace 1 egg.
Aquafaba is a liquid in cooked legumes, such as chickpeas. Since it is already viscous it can be whisked to form a foamy mixture that can also be used to replace egg. It is generally used in pastry recipes such as cake. Use 3 tablespoon of aquafaba to replace 1 egg.
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Cheese Replacement
Cheese is an important part many recipes and it is one of the foods that people going plant-based lifestyle miss the most. This doesn't have to be the case and there is always a replacement for the flavors and textures using only plant-based ingredients.
Cashew Cheese
Making cashew-based cheese an be made in different ways that includes cheese sauce and melty cheese.
Making cashew-based cheese an be made in different ways that includes cheese sauce and melty cheese.
Soak 2 cups (300 g) of unsalted cashews in water for 2-3 hours. Rinse and drain. Add the cashews in a food processor (or blender) along with 2 tablespoons each of nutritional yeast, lemon juice, 1/2 teaspoon of garlic powder, and a pinch of salt and pepper. Blend the ingredients until you get a stiff and thick texture. You may also add herbs as desired. This kind of cheese will last for up to 1 week in the fridge. (more cheese recipes in our professional course)
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Parmesan
Making plant-based replacement of grated parmesan cheese is so easy and it can be one of the staple items in your plant-based kitchen.
Making plant-based replacement of grated parmesan cheese is so easy and it can be one of the staple items in your plant-based kitchen.
You only need very few ingredients to make plant-based grated parmesan cheese. 150g unsalted almonds, 2 tablespoons nutritional yeast, 1 teaspoon garlic powder and 1 teaspoon of salt. Simple put all ingredients in the food processor (or blender) and pulse together until the desired texture is reached.
Nutritional yeast
This is used in so many plant-based recipes because of its distinct nutty and cheesy flavor with much lower sodium content compared to regular cheese. You can get them from health food stores although the easiest is through online purchasing. Nutritional yeast can be added directly to pop corn or mixed with other ingredients to make a cheese sauce.
This is used in so many plant-based recipes because of its distinct nutty and cheesy flavor with much lower sodium content compared to regular cheese. You can get them from health food stores although the easiest is through online purchasing. Nutritional yeast can be added directly to pop corn or mixed with other ingredients to make a cheese sauce.
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Milk Replacement
Milk is a very important ingredient in many different dishes and going plant-based lifestyle doesn't have to be restrictive. There are many types of plant-based milk that can replace the most beloved dairy milk. These milk replacements can be easily purchased from the grocery store but it is always possible to make your own using very few ingredients and simple methods. Soy milk making is included in this course and you will find the video recipe as you advance to next modules.
(other milk recipes are found in our professional course)
Milk is a very important ingredient in many different dishes and going plant-based lifestyle doesn't have to be restrictive. There are many types of plant-based milk that can replace the most beloved dairy milk. These milk replacements can be easily purchased from the grocery store but it is always possible to make your own using very few ingredients and simple methods. Soy milk making is included in this course and you will find the video recipe as you advance to next modules.
(other milk recipes are found in our professional course)
- Soy milk
- Almond milk
- Cashew milk
- Rice milk
- Oat milk
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Healthy and Delicious Meals
This course teaches how to make healthy dishes delicious and craveable. Humans are wired to seek out delicious food healthy or not. The best ways to get people to eat more healthy foods and fewer unhealthy foods are to make the former taste as good (or better!) and be as accessible as the latter.
Recipes
When cooking, there is no award for following a recipe to the letter. Many recipes available on the Internet haven't been tested. If a recipe from a source of unknown reputation fails, you have no idea if it's you, the ingredients, or the recipe. Learn to trust your gut-if you get a feeling that a dish would be better with a tweak or addition, try it. Recipes are included throughout the course since some people like to follow recipes, while others just like to have a general guide on their cooking journey. Recipes also helps you to shop for appropriate amounts and types of ingredients for each session.
Recipes
When cooking, there is no award for following a recipe to the letter. Many recipes available on the Internet haven't been tested. If a recipe from a source of unknown reputation fails, you have no idea if it's you, the ingredients, or the recipe. Learn to trust your gut-if you get a feeling that a dish would be better with a tweak or addition, try it. Recipes are included throughout the course since some people like to follow recipes, while others just like to have a general guide on their cooking journey. Recipes also helps you to shop for appropriate amounts and types of ingredients for each session.
Balancing Flavors & Textures
Good cooking begins with tasting and learning to adjust flavors. Begin to taste foods for sweet, salty, bitter, acidic, and umami (savory) flavors. Note whether a flavor predominates or if flavors are balanced. Think about what you ideally want in terms of flavor from a final dish. Do you want something with an acidic tang, or do you prefer a savory, balanced dish? If the flavors of the dish are not where you want them to be, try to balance them using flavoring ingredients with other aspects of taste. For example, if a food is too acidic or bitter, try adding something sweet. If a dish is bland, try adding a few drops of acid, such as lemon juice, vinegar, or hot sauce, and then salt to taste (if using salt). From a culinary perspective, when salting, the optimal level for flavor (without over salting) is achieved when you can taste the flavor of the food toward the back of your tongue but don't get a dry or parched feeling in your throat after eating it. From a medical perspective, to reduce salt intake, consider adding herbs or spices to savory foods or cinnamon, cloves, nutmeg, or ginger to sweet foods to limit the amount of salt that you need to make the dish delicious. Adding a little acid to a dish prior to salting also heightens flavor and can reduce the amount of salt needed.
Texture is also an important consideration. Crisp and crunchy textures stimulate the appetite; this is why most appetizers have a crisp component. Creamy textures can be comforting, but anyone required to eat a pureed diet for any length of time will tell you how boring and unappetizing meals are when every item has the same texture. The best meals incorporate a variety of textures. Textures can have positive and negative associations for some eaters. If someone is averse to a certain
food, make sure to explore whether the flavor, texture, or both are issues. Oftentimes, someone may be averse to a vegetable cooked in a way that gives it a certain texture, but enjoy it prepared another way.
Good cooking begins with tasting and learning to adjust flavors. Begin to taste foods for sweet, salty, bitter, acidic, and umami (savory) flavors. Note whether a flavor predominates or if flavors are balanced. Think about what you ideally want in terms of flavor from a final dish. Do you want something with an acidic tang, or do you prefer a savory, balanced dish? If the flavors of the dish are not where you want them to be, try to balance them using flavoring ingredients with other aspects of taste. For example, if a food is too acidic or bitter, try adding something sweet. If a dish is bland, try adding a few drops of acid, such as lemon juice, vinegar, or hot sauce, and then salt to taste (if using salt). From a culinary perspective, when salting, the optimal level for flavor (without over salting) is achieved when you can taste the flavor of the food toward the back of your tongue but don't get a dry or parched feeling in your throat after eating it. From a medical perspective, to reduce salt intake, consider adding herbs or spices to savory foods or cinnamon, cloves, nutmeg, or ginger to sweet foods to limit the amount of salt that you need to make the dish delicious. Adding a little acid to a dish prior to salting also heightens flavor and can reduce the amount of salt needed.
Texture is also an important consideration. Crisp and crunchy textures stimulate the appetite; this is why most appetizers have a crisp component. Creamy textures can be comforting, but anyone required to eat a pureed diet for any length of time will tell you how boring and unappetizing meals are when every item has the same texture. The best meals incorporate a variety of textures. Textures can have positive and negative associations for some eaters. If someone is averse to a certain
food, make sure to explore whether the flavor, texture, or both are issues. Oftentimes, someone may be averse to a vegetable cooked in a way that gives it a certain texture, but enjoy it prepared another way.
Healthy Plant-based Snacks
People who adhere to a plant-based diet are not automatically healthy and it is not uncommon to find vegans snacking on unhealthy foods - crisps, chips and many fizzy drinks are considered vegan, for example. Yet, going plant-based generally makes it easier to be healthy, as it opens the door to many nutritious and wholesome foods that one may otherwise not have tried. We have included simple recipes that can be made to enjoy as a quick, low calorie snack. They can also be served as finger food at a party and is likely to be a crowd-pleaser.
People who adhere to a plant-based diet are not automatically healthy and it is not uncommon to find vegans snacking on unhealthy foods - crisps, chips and many fizzy drinks are considered vegan, for example. Yet, going plant-based generally makes it easier to be healthy, as it opens the door to many nutritious and wholesome foods that one may otherwise not have tried. We have included simple recipes that can be made to enjoy as a quick, low calorie snack. They can also be served as finger food at a party and is likely to be a crowd-pleaser.
Ingredients Added to WFPB Diet
Throughout the recipes and lessons, you may note the occasional use of small amounts of optional sugar, salt, and oil. These items are used solely to bring out, and balance, the flavors of otherwise whole and plant-based foods. They are not used as main ingredients or in large amounts, so the whole of the curriculum is still reflective of a predominantly WFPB diet. The vast majority of the added sugars, oil, and salt in people's diets comes from processed and prepared foods.
Transitioning to cooking as much of your own food as possible is the best way to reduce these items in the diet. Even if you add a pinch of salt or sugar to a dish to balance flavors, you will be eating a tiny fraction of what you would have eaten had you chosen to order off the menu at a nearby restaurant. In most instances, alternatives or modifications of cooking methods are given to limit or eliminate these items. Therefore, if you wish to strictly eliminate any use of these items, you should also feel free to do so and omit from recipes.
Transitioning to cooking as much of your own food as possible is the best way to reduce these items in the diet. Even if you add a pinch of salt or sugar to a dish to balance flavors, you will be eating a tiny fraction of what you would have eaten had you chosen to order off the menu at a nearby restaurant. In most instances, alternatives or modifications of cooking methods are given to limit or eliminate these items. Therefore, if you wish to strictly eliminate any use of these items, you should also feel free to do so and omit from recipes.
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Sugar
In most foods that are high in added sugars, the purposes of the sugars are to preserve, make hyperpalatable, and add flavor to foods otherwise stripped of naturally complex flavors through ultra-processing. Sugars are not used for these purposes in this curriculum. Sugars used in this curriculum serve the culinary function of balancing flavors, as sugars occur naturally to varying degrees in most foods, particularly by ripeness and season. Think of eating a store-bought, under ripe tomato and recall its slightly sour taste. Contrast that with a sun-ripened tomato from the garden, dripping with juicy sweetness at each bite. There are much more naturally occurring sugars in the latter than the former. |
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In a recipe calling for tomatoes, you can imagine that the end result of dishes made with these two types of tomatoes will taste differently from one another.
A pinch of sugar, for example, can help balance the sourness of under ripe tomatoes in a dish so that the result tastes similarly sweet as the dish with the ripe tomato. When adding very small amounts of sugar to food it matters little to health which type (e.g., white, brown, raw, honey, date paste, etc.) you use as most have similar physiological effects. However, in larger quantities, sweeteners have different cooking properties from one another and therefore cannot be used interchangeably without altering other parts of the recipe. Details of how to convert between different types of sweeteners in recipes using large amounts of added sugars are beyond the scope of this curriculum. For those who wish to use minimally refined or wholly natural sugars, you may want to opt for dates, date paste, honey, or maple syrup. Nearly all recipes in the curriculum that call for sweeteners give these options. To make date paste, simply remove the pits from dates and puree in a food processor with just enough boiling water to allow the dates to transform into a smooth paste. You can store extra date paste in the freezer. The high sugar content makes the mixture scoopable when frozen, so you can take out a little to use here and there as needed.
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Oil
Throughout the curriculum, oil is optional and limited and its use. For recipes containing optional oil, instructions are given on how to modify cooking methods to achieve the best results if oil is omitted. For those whose main dietary goal is prevention of chronic disease, there is good evidence for a Mediterranean-style diet promoting health; this type of diet includes liquid plant oils. For those aiming to reverse cardiovascular disease or early stage prostate cancer, there is more support for an oil-free (or nearly oil-free) WFPB diet. The reason that oil is limited or excluded from a predominantly WFPB diet is because it is not a whole food. |
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Oil is pressed or extracted from whole foods (such as olives, avocados, nuts, and seeds) to remove beneficial components, including fiber, water, and micronutrients. The resulting oil is calorie-dense and nutrient-poor compared with the original whole food from which it was derived. While this curriculum focuses on a predominantly WFPB diet, optional oil is included in recipes and lessons because people have a spectrum of health goals, come from different food cultures, and may be at various stages of change with regard to their diet. In cooking, oil facilitates browning and crisping of foods, which imbues complex flavor characteristics. It prevents sticking and allows one to cook vegetables quickly over high heat in ways that maintain their bright colors and crisp textures. For many, it is part of making food irresistibly delicious and can be a gateway ingredient to facilitate getting more vegetables, whole grains, and legumes onto the plates of those who have been reluctant to eat them in the past.
For a medical professional taking a Culinary Medicine course, it may be useful to learn to cook both with and without oil so that you can tailor motivational interviewing around dietary behavior changes to a given patient's needs and preferences.
For a medical professional taking a Culinary Medicine course, it may be useful to learn to cook both with and without oil so that you can tailor motivational interviewing around dietary behavior changes to a given patient's needs and preferences.
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Salt
Salt, which contains sodium, is not specifically restricted in a WFPB diet, but the literature shows that too much sodium in-take can be detrimental to the health of those sensitive to it. Evidence-based diets focused on lowering sodium and saturated fat, and increasing plant foods, such as the Dietary Approaches to Stop Hypertension (DASH) diet, have been shown to reduce blood pressure, heart attacks, and strokes. More than 70% of the sodium people get in their diets is from processed and prepared foods, while only about 5% comes from salt added while cooking, and another 5% from salting at the table. |
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From a culinary perspective, salt is included in the curriculum because it helps transfer the flavors in foods to your tastebuds. If one were to make all of their food at home with whole foods and salt to taste, they would likely consume only a small fraction of the sodium eaten by someone who consumes many processed and prepared foods. That said, most dishes in this course do utilize a variety of ingredients (e.g., spices, herbs, acidic ingredients) and cooking techniques that will provide flavor in order to reduce the reliance on salt to enhance flavor. If you want to avoid all added salt, make sure to increase the other flavoring ingredients in the dish and/or consider adding a squeeze of lemon or some additional herbs and spices to bolster flavor. There are many salt-free dried herb, spice, and vegetable blends available commercially for this purpose.
Common Misconceptions on WFPB Diet
Where do you get your____________. This question needs no explanation for anyone who has followed WFPB, vegetarian, or vegan diets at any point in their lives. Growing up in a society in which we're taught to drink milk to build strong bones, and a big hunk of meat is generally the center of the dinner plate, well-meaning family members and friends worry about the health of those that forego these items. However, the literature clearly shows well-planned vegan and vegetarian diets provide all necessary nutrients. According to the Academy of Nutrition and Dietetics, "vegetarian, including total vegetarian or vegan, diets are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases."
The American Association of Pediatrics has also published a detailed manuscript regarding vegan diets in infants, children, and adolescents with details on how to make sure all necessary nutrients are included in sufficient amounts. A balanced, calorically appropriate diet based on a variety of whole foods including vegetables, fruits, legumes, whole grains, nuts, and seeds is also generally sufficient in macronutrients and micronutrients. In fact, it is easier to be sufficient in most of the nutrients of concern when following a WFPB diet than most typical diets. Notable exceptions are Vitamins B12 and D which are common deficiencies among those eating nearly any type of diet. Selected details follow about nutrition questions likely to arise in courses or conversations promoting WFPB diets.
Where do you get your Calcium?
Calcium is a key mineral involved in human health and is best known for its role in promoting bone health. The daily recommended dietary allowance (RDA) for calcium from the Food and Nutrition Board at the Institute of Medicine of the National Academies ranges from 1,000 mg to 1,300 mg, depending on age, for those aged four years and older. For many, calcium is thought to be synonymous with dairy, and to eschew dairy is to be deficient in calcium intake-not true! Taking a moment to think about milk intake, it makes sense that adults would not need dairy. Mammals, including humans, wean well before adulthood.
Calcium is a key mineral involved in human health and is best known for its role in promoting bone health. The daily recommended dietary allowance (RDA) for calcium from the Food and Nutrition Board at the Institute of Medicine of the National Academies ranges from 1,000 mg to 1,300 mg, depending on age, for those aged four years and older. For many, calcium is thought to be synonymous with dairy, and to eschew dairy is to be deficient in calcium intake-not true! Taking a moment to think about milk intake, it makes sense that adults would not need dairy. Mammals, including humans, wean well before adulthood.
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Therefore, it would be poor design for humans to need lactation products from another mammal (such as dairy milk from cows) to survive, particularly in their adult years. There are plenty of other sources of calcium beyond dairy products in the diet. Plant foods that are good sources of calcium include tofu, tempeh, dark green vegetables, beans, almonds and fortified plant-based milks. See the Amounts of Calcium in Dairy and Non-dairy Foods handout for more details. Many people, regardless of dairy consumption, need additional calcium for medical reasons, this can be eaten in the forms of naturally calcium-rich foods and fortified foods, or taken as supplemental calcium. Calcium is incorporated into dairy products in a variety of ways including (1) from the plants that cows eat, (2) calcium supplementation of cow feed, (3) or calcium fortification. Humans can either eat plants or take supplements just as well as cattle. Bonus: avoiding intake of dairy and beef helps to limit greenhouse gases, deforestation, and other negative environmental impacts.
Where do you get your protein?
From nearly all foods that we eat, is the answer. Contrary to popular belief, meat does not have a monopoly on protein. Those eating a calorie-sufficient, balanced, plant-based diet will get plenty of protein. Evidence-based food guidelines, such as Canada's Dietary Guidelines, published January 2019, support moving toward more plant-based diets. Similar to the Canadian Food Guide, The ACLM WFPB Plate highlights WFPB protein options. Note that the U.S. Dietary Guidelines for Americans are influenced by a variety of industry lobbyists and are not wholly evidence based.
From nearly all foods that we eat, is the answer. Contrary to popular belief, meat does not have a monopoly on protein. Those eating a calorie-sufficient, balanced, plant-based diet will get plenty of protein. Evidence-based food guidelines, such as Canada's Dietary Guidelines, published January 2019, support moving toward more plant-based diets. Similar to the Canadian Food Guide, The ACLM WFPB Plate highlights WFPB protein options. Note that the U.S. Dietary Guidelines for Americans are influenced by a variety of industry lobbyists and are not wholly evidence based.
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Those not eating plant-based diets generally consume far more protein than is necessary. People in the United States consume more total and animal-based protein per capita than any other country in the world. Although protein is an essential macronutrient, consuming excess protein does not lead to bigger muscles, better health, or improved weight-loss outcomes.
Excess calories from protein or any other macronutrient will be stored as fat. The overconsumption of animal-protein in particular may be deleterious for the environment as well as one's health. Aim to make plant-based sources of protein a bigger part of the diet. Legumes, beans, tofu, and tempeh are all good plant-based sources of protein. Whole grains and vegetables contain some protein as well. For example, 100 Calories of broccoli contains 8 grams of protein. Recall that in an entirely WFPB diet, plant-based proteins are 100% of proteins consumed. In a predominantly WFPB diet, if including animal
sources of protein, it is still advisable from a health perspective to limit portion sizes and avoid red and processed meats. Of note, poultry and eggs also have the smallest environmental footprint of all animal sources of protein, whereas beef and dairy have the largest.
Excess calories from protein or any other macronutrient will be stored as fat. The overconsumption of animal-protein in particular may be deleterious for the environment as well as one's health. Aim to make plant-based sources of protein a bigger part of the diet. Legumes, beans, tofu, and tempeh are all good plant-based sources of protein. Whole grains and vegetables contain some protein as well. For example, 100 Calories of broccoli contains 8 grams of protein. Recall that in an entirely WFPB diet, plant-based proteins are 100% of proteins consumed. In a predominantly WFPB diet, if including animal
sources of protein, it is still advisable from a health perspective to limit portion sizes and avoid red and processed meats. Of note, poultry and eggs also have the smallest environmental footprint of all animal sources of protein, whereas beef and dairy have the largest.
Where do you get your OMEGA-3 fatty acids! What about Omega-6 fatty acids?
Omega-3 and Omega-6 fatty acids are essential fatty acids, meaning the body cannot make them endogenously and they must be consumed from food sources or supplements. Consumption of Omega-3 rich foods is associated with a variety of improved health outcomes. The health effects of consuming plant sources of Omega-3 fatty acids have not been studied as extensively as other sources, however evidence suggests comparable benefits. Like calcium to dairy, Omega-3 fatty acids are thought to be synonymous with fish, since fish is a common source of Omega-3 intake in many diets. However, just as cows don't make calcium, fish do not make Omega-3 fatty acids. Instead, fish concentrate the Omega-3's they ingest from algae and other green, aqueous plants (or the smaller fish they ate that were eating these greens). Humans can get Omega-3's from algal sources as well, but this often isn't palatable in the quantities required. Instead, opt for walnuts, chia seeds, hemp seeds, ground flaxseeds or take an algal-based Omega-3 supplement if choosing to follow an entirely WFPB diet. For those following a predominantly WFPB diet who choose to incorporate some fish, opt for sustainable and low-mercury, low-contaminant options as mercury and contaminants may counteract some of the benefits of the Omega-3's in fish.
Omega-3 and Omega-6 fatty acids are essential fatty acids, meaning the body cannot make them endogenously and they must be consumed from food sources or supplements. Consumption of Omega-3 rich foods is associated with a variety of improved health outcomes. The health effects of consuming plant sources of Omega-3 fatty acids have not been studied as extensively as other sources, however evidence suggests comparable benefits. Like calcium to dairy, Omega-3 fatty acids are thought to be synonymous with fish, since fish is a common source of Omega-3 intake in many diets. However, just as cows don't make calcium, fish do not make Omega-3 fatty acids. Instead, fish concentrate the Omega-3's they ingest from algae and other green, aqueous plants (or the smaller fish they ate that were eating these greens). Humans can get Omega-3's from algal sources as well, but this often isn't palatable in the quantities required. Instead, opt for walnuts, chia seeds, hemp seeds, ground flaxseeds or take an algal-based Omega-3 supplement if choosing to follow an entirely WFPB diet. For those following a predominantly WFPB diet who choose to incorporate some fish, opt for sustainable and low-mercury, low-contaminant options as mercury and contaminants may counteract some of the benefits of the Omega-3's in fish.
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Omega-6 fatty acids are found in plant oils and are therefore abundant in processed and fast foods. Omega-6 fatty acids are commonly found in such whole foods as nuts and seeds, and in smaller amounts in olives and avocados. There is some controversy about the role omega-6 fatty acids play in health. Farvid and colleagues published a systematic review and meta-analysis of prospective cohort studies comparing Omega-6 intake with risk of coronary heart disease that is worth reviewing if time permits.
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Where do you get your Vitamin B12?
Vitamin B12 rich foods include meat, poultry, fish, seafood, dairy products, eggs, and fortified foods, such as breakfast cereals and most plant-based milks. Much like the Omega-3 fatty acids found in fish, Vitamin B12 is not made by animals, but is concentrated in their tissues. Vitamin B12 is only made by bacteria and archaea; it is found in foods only through the interactions of these bacteria and archaea with animals and plants. Those following a WFPB diet can get vitamin B12 from fortified foods (e.g., most plant-based milks and cereals), nutritional yeast, or nori; otherwise, supplementation is needed. However, most people with Vitamin B12 deficiency are deficient due to non-dietary factors affecting absorption such as autoimmune diseases, gastrointestinal diseases or surgeries, certain infections, certain drugs, and other causes. Anyone with a medical or dietary cause of Vitamin B12 deficiency needs supplementation.
Vitamin B12 rich foods include meat, poultry, fish, seafood, dairy products, eggs, and fortified foods, such as breakfast cereals and most plant-based milks. Much like the Omega-3 fatty acids found in fish, Vitamin B12 is not made by animals, but is concentrated in their tissues. Vitamin B12 is only made by bacteria and archaea; it is found in foods only through the interactions of these bacteria and archaea with animals and plants. Those following a WFPB diet can get vitamin B12 from fortified foods (e.g., most plant-based milks and cereals), nutritional yeast, or nori; otherwise, supplementation is needed. However, most people with Vitamin B12 deficiency are deficient due to non-dietary factors affecting absorption such as autoimmune diseases, gastrointestinal diseases or surgeries, certain infections, certain drugs, and other causes. Anyone with a medical or dietary cause of Vitamin B12 deficiency needs supplementation.
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Where do you get your Vitamin D?
Vitamin D deficiency is highly prevalent and has little to do with diet as most Vitamin D (which is actually a hormone and not a vitamin) is made in our skin through a reaction with the sun. For those living more than 37 degrees latitude north or south of the equator, Vitamin D is only made via sun-exposed skin between late spring and early fall, not in the cooler months. For reference, the 37th north parallel runs through the middle of the United States, Mediterranean Sea, Middle East, and Japan; the 37th south parallel runs through southern Chile and Australia. Most people who don't make enough Vitamin D need supplementation since few people get enough from diet alone, regardless of the type of diet they eat. In addition to location, the following also increase the risk of vitamin D deficiency: obesity, cancer, darker skin pigmentation, pregnancy, institutionalization, and anyone with limited sun exposure. Dietary sources of vitamin D include fortified foods (dairy and plant-based milks), oily fish and seafood, egg yolks, mushrooms, animal fat, and liver. For those eating entirely WFPB diets, the main dietary sources of Vitamin D are mushrooms and fortified foods, such as plant-based milks.
Vitamin D deficiency is highly prevalent and has little to do with diet as most Vitamin D (which is actually a hormone and not a vitamin) is made in our skin through a reaction with the sun. For those living more than 37 degrees latitude north or south of the equator, Vitamin D is only made via sun-exposed skin between late spring and early fall, not in the cooler months. For reference, the 37th north parallel runs through the middle of the United States, Mediterranean Sea, Middle East, and Japan; the 37th south parallel runs through southern Chile and Australia. Most people who don't make enough Vitamin D need supplementation since few people get enough from diet alone, regardless of the type of diet they eat. In addition to location, the following also increase the risk of vitamin D deficiency: obesity, cancer, darker skin pigmentation, pregnancy, institutionalization, and anyone with limited sun exposure. Dietary sources of vitamin D include fortified foods (dairy and plant-based milks), oily fish and seafood, egg yolks, mushrooms, animal fat, and liver. For those eating entirely WFPB diets, the main dietary sources of Vitamin D are mushrooms and fortified foods, such as plant-based milks.
Where do you get your Iron?
Iron deficiency is prevalent throughout the world and affects women and children much more commonly than men. The global prevalence of iron deficiency among women is 25 percent. The main causes of deficiency are low dietary intake, reduced absorption, and blood loss. In developed countries, blood loss is the predominant cause, whereas dietary intake plays a larger role in developing countries. Iron is perhaps one of the most interesting minerals in the diet as numerous factors affect our absorption and homeostasis.
Iron deficiency is prevalent throughout the world and affects women and children much more commonly than men. The global prevalence of iron deficiency among women is 25 percent. The main causes of deficiency are low dietary intake, reduced absorption, and blood loss. In developed countries, blood loss is the predominant cause, whereas dietary intake plays a larger role in developing countries. Iron is perhaps one of the most interesting minerals in the diet as numerous factors affect our absorption and homeostasis.
There are two types of dietary iron-heme and non-heme iron. Heme iron is present solely in animal foods as it comes from hemoglobin and myoglobin. Non-heme iron is present in both plant and animal foods. Heme iron is more readily absorbed than non-heme iron and this absorption is not subject to as many checks and balances as non-heme iron. Depending on iron balance, this can be a good or bad thing. Additionally, the literature has shown association of heme iron intake with increased risk of coronary heart disease, breast cancer, esophageal cancer, and stomach cancer. Non-heme iron absorption depends on the current iron balance in the body and is affected by inhibitors (e.g., phytates, polyphenols, calcium, proteins) and enhancers (e.g., ascorbic acid, muscle tissue, non-digestible carbohydrates) of absorption.
Ascorbic acid (aka. Vitamin C) is the best enhancer of iron absorption for those eating plant-based diets. Deficiencies of riboflavin and Vitamin A, chronic inflammation, and obesity can also lead to iron deficiency through a variety of mechanisms. For those getting the majority of their iron intake from plant-based, non-heme sources, the following are some tips to help you consume and absorb more iron:
- Eat plant-based foods containing iron such as beans, tofu, dried fruits, greens, oatmeal, quinoa, amaranth, olives, mushrooms, unpeeled potatoes, nuts (cashews, pine nuts, macadamias) and seeds (pumpkin, sesame, hemp seed,flaxseed), dark chocolate, and fortified grain products like breads and cereals.
- Eat foods with ascorbic acid (aka. Vitamin C) with iron-containing foods to increase absorption. Vitamin C rich foods include citrus, pomegranate, tomatoes, cantaloupe, kiwi, broccoli, cauliflower, peppers, papaya, berries, lychee, pineapple, mango, green leafy veggies, and guava. Vitamin C degrades quickly with cooking and storage, so make sure to eat these foods fresh or shortly after cooking to get the most Vitamin C.
- Eat a variety of dark greens rather than relying on just one type. Don't rely solely on spinach for iron. While spinach contains many healthful nutrients, the oxalates in spinach interfere with absorption of iron. The techniques included in this section can help with iron absorption from spinach to some degree; however, it is better to opt for other dark, leafy greens if specifically looking for good sources of absorbable, non-heme iron. Cook in cast iron using acidic and/or ascorbic acid rich ingredients.
- Avoid coffee, tea, and wine with meals as polyphenols and tannins interfere with iron absorption.
- Avoid calcium supplements (or calcium-rich foods) one hour before and 2 hours after iron supplements or iron-rich foods to prevent the calcium and iron blocking the absorption of each other. For infants, beans and lentils are an ideal first food (beginning at age 6 months and beyond) because they are rich in iron.
Where do you get your Fiber, Folate, Potassium, Magnesium, and Vitamins A, C, and E?
OK, so maybe no one will ask you where you are getting these nutrients-but maybe they should. The SAD and other unhealthy diets that lead to overweight, obesity, and other chronic diseases are generally low in these nutrients and high in
saturated fat, cholesterol, sodium, added sugars, and ultra-processed foods. Eating a balanced, predominantly WFPB diet means that you will not need to worry about getting enough of these nutrients often lacking in less healthy diets.
OK, so maybe no one will ask you where you are getting these nutrients-but maybe they should. The SAD and other unhealthy diets that lead to overweight, obesity, and other chronic diseases are generally low in these nutrients and high in
saturated fat, cholesterol, sodium, added sugars, and ultra-processed foods. Eating a balanced, predominantly WFPB diet means that you will not need to worry about getting enough of these nutrients often lacking in less healthy diets.
Fiber and the Microbiome
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This indigestible part of plants helps control blood sugar, lowers blood cholesterol, keeps the gastrointestinal system healthy, encourages a health-supportive mix of gut bacteria, and aids with weight loss by staving off hunger. All whole plant foods contain fiber; it provides their shape and structure. Animal flesh foods, dairy products, sugar, and oil provide none.
Multiple studies have demonstrated an inverse relationship between fiber intake and diabetes risk - the more fiber you eat, the lower your risk. Once recent meta analysis of seventeen studies, including almost five hundred thousand participants and over nineteen thousand incident cases of type 2 diabetes, reported a 6 percent decrease in diabetes risk for every 2 grams of fiber consumed. |
Fiber is what gives plants their structure, and its not present in any animal foods. Acting as natures broom, fiber keeps food moving smoothly and efficiently through the intestinal tract. While fiber is a type of carbohydrate, it can't be broken down into digestible sugar molecules like most other carbohydrates. Although it passes through the intestinal tract relatively intact, it has a significant and positive impact. It is well known that fiber prevents constipation, but it can also help lower blood cholesterol and blood pressure, reducing the risk of heart disease and aid in irritable bowel syndrome. Fiber can improve blood sugar control and insulin sensitivity, reducing the risk of diabetes, and it can diminish the risk of diverticular disease and some cancers, especially colorectal cancer.
Acute Dietary Exposure and the Gut Microbiome
While the core bacterial taxa are resilient to most temporary outside influences, the gut microbial community as a whole displays a high inter-individual day-to-day variability. Gut microbes are extensively and regularly purged and have the ability to double in number within one hour. Within 24-48 hours of a dietary intervention rapid changes are thought to be made to the microbial composition on a species and family level. Although the gut microbiota is not exposed to the light and dark cycle associated with the circadian rhythm, its composition and function are thought to still be affected by this cyclical ebb and flow. In humans, at least 10% of Operational Taxonomic Units (OTUs) oscillate due to the circadian rhythm. The microbiota fluctuates based on nutrient availability and the level of host-derived auto-antibodies and peptides, both of which are associated with circadian rhythm oscillations. Likewise, disrupted sleep patterns, often common in shift workers, has been found to alter the gut microbiota, increase dietary intake and promote an inflammatory response that can incite metabolic stress.
While the core bacterial taxa are resilient to most temporary outside influences, the gut microbial community as a whole displays a high inter-individual day-to-day variability. Gut microbes are extensively and regularly purged and have the ability to double in number within one hour. Within 24-48 hours of a dietary intervention rapid changes are thought to be made to the microbial composition on a species and family level. Although the gut microbiota is not exposed to the light and dark cycle associated with the circadian rhythm, its composition and function are thought to still be affected by this cyclical ebb and flow. In humans, at least 10% of Operational Taxonomic Units (OTUs) oscillate due to the circadian rhythm. The microbiota fluctuates based on nutrient availability and the level of host-derived auto-antibodies and peptides, both of which are associated with circadian rhythm oscillations. Likewise, disrupted sleep patterns, often common in shift workers, has been found to alter the gut microbiota, increase dietary intake and promote an inflammatory response that can incite metabolic stress.
Leaky Gut
Elevated levels of interleukin 6, a pro-inflammatory peptide cytokine, and plasma levels of lipopolysaccharide (LPS) endotoxin, a marker of gram-negative bacterial translocation, were found to be elevated in a subpopulation of IBS-D patients with small intestinal permeability, analogous to that observed in celiac disease. It is hypothesized that psychological stress can exacerbate the inflammatory condition by allowing translocation of harmful bacterial products across the intestinal epithelium. Known as “leaky gut”, a compromised epithelial barrier allows toxins and antigens in the GI lumen to enter the bloodstream. One A healthy gut flora is important in maintaining the intestinal barrier. By increasing the expression of tight cell junction proteins, beneficial probiotics such as Lactobacillus and Bifidobacterium can limit the development of autoimmune diseases in genetically susceptible individuals and fatty liver disease in obese individuals. In alcoholic liver disease, alcohol consumption causes gut permeability by reducing the expression of REG3, a bactericidal protein normally responsible for restricting the mucosal colonization of luminal bacteria.
Elevated levels of interleukin 6, a pro-inflammatory peptide cytokine, and plasma levels of lipopolysaccharide (LPS) endotoxin, a marker of gram-negative bacterial translocation, were found to be elevated in a subpopulation of IBS-D patients with small intestinal permeability, analogous to that observed in celiac disease. It is hypothesized that psychological stress can exacerbate the inflammatory condition by allowing translocation of harmful bacterial products across the intestinal epithelium. Known as “leaky gut”, a compromised epithelial barrier allows toxins and antigens in the GI lumen to enter the bloodstream. One A healthy gut flora is important in maintaining the intestinal barrier. By increasing the expression of tight cell junction proteins, beneficial probiotics such as Lactobacillus and Bifidobacterium can limit the development of autoimmune diseases in genetically susceptible individuals and fatty liver disease in obese individuals. In alcoholic liver disease, alcohol consumption causes gut permeability by reducing the expression of REG3, a bactericidal protein normally responsible for restricting the mucosal colonization of luminal bacteria.
Recipes
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Task
You may access all the recipes listed above. Choose one recipe in each category and create 1 set of meal course that you can recommend to patients/clients or your family member. All recipes have instructions that you may also use as guide. Document your activity by taking photos of each recipe, starting from Mise en place up to the final presentation with brief description of your planned meal.
Please organize your documentation in a single file and send us the completed task using PDF format. Please go back to Module 2 and review the tutorial for food photography. You may also use other resources you have which you think is helpful for you to comply with the task.
Please organize your documentation in a single file and send us the completed task using PDF format. Please go back to Module 2 and review the tutorial for food photography. You may also use other resources you have which you think is helpful for you to comply with the task.
Daily Reflection
The violation of physical law, with its consequent suffering and premature death, has so long prevailed that these results are regarded as the appointed lot of humanity; but God did not create the race in such a feeble condition. This state of thins is not the work of Providence, but of man. it has been brought about by wrong habits, - by violating the laws that God has made to govern man's existence. A continual transgression of nature's laws is a continual transgression of the law of God. Had men always been obedient to the law of the ten commandments, carrying out in their lives the principles of those precepts, the curse of disease now flooding the world would not exist.
"Know ye not that your body is the temple of the Holy Ghost which is in you, which ye have of God, and ye are not your own? for ye are bought with a price; therefore glorify God in your body and in your spirit, which are God's." When men take any course which needlessly expends their vitality or beclouds their intellect, they sin against God; they do not glorify Him in their body and spirit, which are His.
Counsels on Diet and Foods 118
"Know ye not that your body is the temple of the Holy Ghost which is in you, which ye have of God, and ye are not your own? for ye are bought with a price; therefore glorify God in your body and in your spirit, which are God's." When men take any course which needlessly expends their vitality or beclouds their intellect, they sin against God; they do not glorify Him in their body and spirit, which are His.
Counsels on Diet and Foods 118