Eating plant-based for health isn’t an all-or-nothing deal

On Nutrition

When you hear the term “plant-based,” what comes to mind? It’s not all salads and new-and-novel plant-based meats, said Dr. Michelle McMacken, executive director of nutrition and lifestyle medicine at NYC Health + Hospitals in New York, speaking at the annual meeting of the Academy of Nutrition and Dietetics in Orlando, Florida, earlier this month. “A plant-based eating pattern can be wonderfully diverse, nutritious and, most importantly, delicious. And it aligns with so many cultural traditions.”

McMacken pointed out that there are many types of plant-based eating patterns. Vegetarian eating patterns exclude meat, poultry and seafood, while vegan eating patterns exclude all foods of animal origin — but both of these could include refined grains, added sugar and other highly processed foods. That’s why she encourages what she calls a “healthful plant-based” eating pattern.

“You’re focusing on a variety of whole fruits and vegetables, you’re shifting your sources of protein to more plant sources such as legumes, tofu, tempeh and so forth,” she said. “You’re shifting your fats to plant-based fats including avocados, nuts, seeds and unsaturated plant oils, as opposed to some of the tropical oils like coconut and palm. And finally, for your grains you’re focusing on whole grains.”

McMacken said this way of eating is aligned with most medical nutrition guidelines for prevention and treatment of chronic disease, including cardiovascular disease, cancer and diabetes. In particular, vegetarian diets have been consistently associated with lower risk of heart disease.

What if you are not a vegetarian, but you eat a lot of plants? The Atherosclerosis Risk in Communities study, which followed 12,168 omnivores — people who eat both plant- and animal-based foods — for more than 25 years, found that those that were eating the most plants had the lowest risk (16% lower) of developing heart disease, a 32% lower risk of dying of cardiovascular disease and a 25% lower risk of dying from any cause. “These are not vegans or vegetarians necessarily,” McMacken said. “These are folks who would call themselves omnivores but are eating mostly plants. And that’s extremely beneficial.”

Researchers from the very large, long-running Nurses’ Health Study and Health Professionals Follow-Up Study — also omnivorous populations — went even further, looking at the degree to which participants were following a healthful or an unhealthful plant-based diet. (Because it’s possible to eat plant-based and eat a lot of french fries and soda.) The healthful plant-based eating pattern was linked to a 25% risk reduction in coronary heart disease, while eating an unhealthful plant-based pattern was linked to 32% higher risk of CHD.

McMacken said when someone eats more foods linked to cardiovascular health — whole grains, vegetables, fruit, legumes and other sources of plant protein, nuts, seeds and other sources of unsaturated fats — this crowds out foods linked to higher risk of cardiovascular disease, including processed meats, red meat, added sugar and processed/refined grains. Multiple research studies have found that replacing 3% of daily calories — 60 calories in a 2,000-calorie diet — with plant protein instead of animal protein was linked to reduced risk of death from cardiovascular disease. Those who swapped out processed red meat for a plant-based protein saw the biggest risk reduction — 34%. “It pays to diversify,” she said.

Because healthful plant-based eating patterns contain a wealth of beneficial elements including fiber, heart-healthy fats, antioxidants, potassium and other nutrients, even being semi-vegetarian can decrease LDL cholesterol by 10%-15%. The Dietary Approaches to Stop Hypertension eating plan by design has the blood pressure-lowering benefits of a vegetarian diet, yet contains enough animal products to make it palatable to nonvegetarians. “A plant-predominant [plan] can be very effective for lowering blood pressure,” McMacken said.

Chickpea and farro soup

This recipe qualifies as “plant-predominant,” but to make it fully vegetarian, use vegetable broth instead of chicken broth. To make it vegan, also skip the Parmesan cheese. I order black chickpeas from Rancho Gordo, but you can use all “regular” chickpeas.

Ingredients for the soup

• 1 cup dried chickpeas
• 1 cup dried black chickpeas
• 3 tablespoons extra-virgin olive oil
• 1 medium yellow onion, chopped
• 1 medium-to-large carrot, peeled and chopped
• 2 stalks celery, chopped
• 2 medium garlic cloves, chopped
• 1 pinch chili flakes
• 6 cups chicken or vegetable broth
• 1 14 1/2-ounce can diced tomatoes
• 1/2 cup French green (Le Puy) lentils
• 2 sage leaves
• 1 bay leaf
• 1 rosemary sprig
• 1 thyme sprig
• 3 teaspoons salt, divided, plus more to taste
• 1 cup uncooked farro
• 3 handfuls dark leafy greens (spinach, kale, etc.) chopped

Ingredients for the optional garnish

• Freshly ground black pepper
• Chopped Italian parsley
• Grated Parmesan cheese
• Drizzle of olive oil

Steps

1. Soak chickpeas for at least 6 hours, then drain. Rinse lentils and check for any debris.
2. In a Dutch oven or soup pot, heat olive oil over medium heat. Add onion, carrot and celery and cook, stirring occasionally, until they begin to soften, about 5 minutes. Add chopped garlic and chili flakes and cook, stirring, for about 1 minute.
3. Add broth, tomatoes, drained chickpeas, lentils, herbs and 2 teaspoons of the salt. Bring to boil, turn the heat to low, cover and simmer until the chickpeas are tender but not mushy, at least 1 hour. Remove herbs. Carefully remove the soup in batches and partially puree in a blender before adding back to the pot or — much easier — dip an immersion blender into the pot and blend until the texture is to your liking. Taste, adding more salt if needed.
4. While beans are cooking, cook farro in a separate pot according to package directions (if no directions, cook via the “pasta method” by cooking in ample water, about 6 to 8 cups) with 1 teaspoon of the salt, then drain off excess water.
5. After pureeing the soup, add cooked farro and simmer together for 10-15 minutes, adding the chopped greens in the last few minutes so they can cook just until wilted.
6. Serve, garnished with freshly ground black pepper, chopped parsley, grated Parmesan cheese and/or a drizzle of olive oil, as desired.