There is always resistance to change.  We are, unfortunately, creatures of habit.  So when the subject of whole food plant based eating comes up, some people tend to dismiss it as out of hand and undoable.  “I could never do that” is a common refrain.  We also see resistance to adding in more activity and exercise into our daily routine.  While it’s true that people who have severe cases of chronic disease really need to be 100% compliant to reverse their disease,  what about people who have early cases of disease or are trying to prevent illness? What about people who just want to lose weight? Just like medication, there is a dose to take But what is the dose of healthy plant based eating in order to achieve positive results?

Let’s digress for a moment about the harm that all or nothing (perfectionist) thinking can cause. The idea of distorted thoughts was first documented by psychologist Dr. Albert Ellis in his rational emotive behavior therapy and was subsequently refined by Dr. Aron Beck with his 10 categories of distorted thinking. This is known today as cognitive behavioral Psychology (CBT).  Dr. Beck’s number one distorted thought is all or nothing thinking.  All-or-nothing thinking refers to thinking in extremes. You are either a success or a failure. Your performance was totally good or totally bad. If you are not perfect, it’s a disaster. In this way of thinking , there is no consideration for anything in between; what some people might refer to as shades of gray.  In the end, you will have a negative outlook toward yourself and others.  But how does this apply to our nutrition and lifestyle in general?

I have been helping people with fitness, nutrition and weight loss for over 25 years.  As I stated, there are some individuals who really need to strive for 100% compliance on a diet to reverse disease.  For instance, people who do Dr. Caldwell Esselstyn’s program for reversing heart disease are usually at an advanced state of coronary artery disease and there is really no wiggle room on the diet if they want to succeed.  Yes, there is a lot of variety within their diet, but they have to stay within the program guidelines.  And they are successful!  This is not all or nothing thinking.  It is simply what has to be done in order to lengthen their life and bring and enjoy quality of life.  And itt works!  But what about people with mild disease?

When examining the many epidemiological studies that we have on lifestyle and disease, it is pretty clear that we need not be 100% plant based in order to be healthy and reverse mild disease and certainly to prevent disease.   Most large population studies show that for the majority of people, if you are 80-90% whole food plant based, you will do well.  This, of course includes not eating vegan junk food.  Look at the blue zones—those 5 places in the world where people live to be 100 years old and maintain very good quality of life throughout their years. We see that they do include very small amount of meat, fish and in one of those places, even a little bit of dairy.  However, unlike the standard American diet, the size of animal protein portions are very small and are more of a condiment or side dish to the meal. They are not consumed daily and they are never the main course.

Back to our all or nothing approach.  I have seen people try to be perfect in their nutrition program and go off.   If they tend to be perfectionists, they can easily go from eating a diet full of fruits, vegetables, whole grains, legumes, lentils and nuts to one of donuts, pizza, hamburgers, and French fries (chips) and chocolate bars.  They couldn’t go all the way so they went in reverse. This is why I try to be careful with what I require from my clients when they are given their food programs.  Yes, if you want success, then you have to make changes.  And many times those changes are difficult because they are new.  So, unless a person has severe disease, (we do have people like that in The Wellness Clinic), I try to leave them a few things that make the diets plant predominant and healthy, but not 100% plant based. Sometimes, it is trial and error process. Many times with need to adjust and make a few more changes as our sessions progress.  But for most people, plant predominance, and especially with a lot of variety, will do the trick.  And, it is extremely sustainable which unlike diets that almost always fail, will bring long-term compliance. 

Personally, I eat a very small piece of chicken at our Friday night meal and a very small piece of fish at our Shabbat day meal.  The rest of my week is free of meat, poultry, fish, eggs and dairy. On holidays, there is a small piece of red meat.  And on this regimen, I was able to greatly improve all markers on my blood tests significantly. I would say over the course of any year, I am 95% whole food plant based with very low oil and very low salt and sugar. Ultra processed foods are probably not even 1% of my diet and considering they make of 63% of the standard American diet, that also makes a huge difference.

As Dr. David Katz points out often, we don’t have a study of 100% whole food plant based eating versus 80%.  He points out that although it makes sense that it would be more effective in both prevention and reversal of disease, we can’t really prove it.  What we do know it that for some people, if we make it impossible, it ends up being counterproductive.  I would say that the typical client that I see is starting his program in 75%-85% plant based range.  What surprises me is how many of them, on their own, take it further when they start feeling so much better.

For me, approach is very individualized.  Do we do this in stages or just put it out there?  This is a point of debate amongst the plant based doctors and dieticians.  There seems to be validity in each approach.  But the approach has to take into consideration the state of their health and not just their personality.  As Dr. B.J. Fogg, behavioral researcher at Stanford University has shown, we certainly need to create ability in order to get compliance.  It is more important than motivation. It is important to set up an environment that makes it easy.  In either approach, one can’t go back to the diet mentality.  It’s not okay to say “it’s just this time” or “it’s just a little bit”.  It’s okay to build in non-plant based food in specific small amounts at specific times, but not more than the prescribed amount.  I can tell you that based on clinical experience, it is essential to approach it in that manner and not allow the client to slip back into diet mode.

I do find it bothersome that with all the fantastic research we have amassed that more people aren’t turning in the direction of a healthy, plant-predominate diet.  No, we can’t water it down so much that it is ineffective.  But physicians and patients alike must put that which is the most effective for healing—whole food plant based eating—at least on par with, if not ahead of the less effective for chronic disease--pharmaceuticals.  In the United States and in New Zealand, drug companies are allowed to advertise on television (a bad idea).  This bring patients into the doctor’s office asking for specific drugs.  And a survey showed that the majority of the time, the doctor writes the prescription.  Let’s try something else.  “Doctor—I saw a lot of research about using whole food plant based eating to reverse my (fill in the illness)”  Maybe, if enough people start doing that, we can see an even bigger change in approach than what we’ve seen so far.  But we are making a lot of progress.  I just attended a very interesting webinar with Dr. David Katz with the The Health Sciences Academy.  The subject was about the future of public health nutrition.  I want to share an interesting fact that Dr. Katz pointed out toward the end of the interview. In its early days, about 20 years ago, the Amercian College of Lifestyle Medicine had 400 physicians as members.  Here we are 20 years later and there are now 10,000 doctors as members and growing all the time.  There is hope that the opening quote in this article from Thomas Edison will really happen. Instead of having a society where more people are sick than well, which is what we have now, we will have most of society well and thriving.  We will to  “add hours to her days, days to her years, and years to her life.”

Alan Freishtat is a HEALTH and WELLNESS COACH and PERSONAL TRAINER with 23 years of professional experience. He is a graduate of the eCornell University Certificate course on Plant Based Nutrition for preventing and reversing illness. Alan is director of The Wellness Clinic.  He can be reached at 02-651-8502 or 050-555-7175, or by email at alan@alanfitness.com www.alanfitness.com US Line: 516-568-5027