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Health and environmental benefits of a plant-based diet Dr Shireen Kassam Founder and Directorthf Plant-Based Health Professionals UK 10 March 2025 Promoting sustainable health and nutrition About me/disclosures • Haematologist and Certified Lifestyle Medicine Physician • Founder & director of Plant-Based Health Professionals UK • Sustainability lead for pathology practice - RCPath • Education on plant-based diets and cancer at University of Winchester • Author/Vegan since 2013Why are we talking about food? HEALTH CRISIS CLIMATE BIODIVERSITY ANTIBIOTIC PANDEMIC BREAKDOWN LOSS RESISTANCE RISK AIR SOCIAL POLLUTION JUSTICE Diet-related ill health • Unhealthy diets are responsible for a quarter of deaths globally • 31% of premature deaths in Europe • All forms of malnutrition, hunger to obesity, are rising https://ffcc.co.uk/publications/the-false-economy-of-big-food https://globalnutritionreport.org Why are diets unhealthy? Dietary risk Causes of death High in sodium Cardiovascular disease Low in whole grains Cancer Low in fruits Type 2 diabetes Low in nuts and seeds Low in vegetables GBD 2017 Diet Collaborators (2019) Lancet. Published Online April 3, 2019 http://dx.doi.org/10.1016/S0140-6736(19)30041-8 https://www.lancetcountdown.org/2023-report/ Why are diets unhealthy? Dietary risk Causes of death High in sodium Cardiovascular disease Low in whole grains Cancer Leading to 12 million premature Low in fruits Type 2 diabetes deaths globally every year Low in nuts and seeds Low in vegetables GBD 2017 Diet Collaborators (2019) Lancet. Published Online April 3, 2019 http://dx.doi.org/10.1016/S0140-6736(19)30041-8 https://www.lancetcountdown.org/2023-report/ Life expectancy vs healthy life expectancy • Increases in lifestyle expectancy in the UK have stalled • in 11.3 yearsifespan and healthspan • Impact greater in lower SE groups JAMA Network Open. 2024;7(12):e2450241. doi:10.1001/jamanetworkopen.2024.50241 (Reprinted) https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(25)00009-X/fulltextHealthy diet patterns Mediterranean Dietary Approaches to Stop Hypertension MIND Nordic Traditional Asian/African Vegetarian/Vegan Whole food plant-based *MIND =Mediterranean-DASH Intervention for Neurodegenerative Delay Defining a Healthy Diet: Evidence for The Role of Contemporary Dietary Patterns in Health and Disease. Nutrients. 2020 Jan 27;12(2):334. doi: 10.3390/nu12020334.Foods that promote health Impact of our food system on planetary health • >30% of all GHG emissions • Animal agriculture >50% of these emissions • Animal ag is the leading cause of biodiversity loss • In the UK, the food system accounts for a 1/5 of GHG emissions – but that rises to around 30% if we factor in emissions from all the food we import • Red meat and dairy production >70% of farming emissions https://s41874.pcdn.co/wp-content/uploads/UK-Lancet-Countdown-policy-brief-2023-v1-1.pdf https://www.nationalfoodstrategy.orgLand use in the UK • 70% devoted to agriculture • >80% to raise animals for food • Half again used overseas • Farm animals consume 5x more food than the entire human population • Produces only 32% of calories ØLand is our greatest opportunity to restore nature, store carbon https://www.nationalfoodstrategy.orgLand use in the UK • 70% devoted to agriculture • >80% to raiseWe could release 75% of farmland if we • Half again used overseas • Farm animals consume 5x more foodplant-based diet than the entire human population • Produces only 32% of calories ØLand is our greatest opportunity to restore nature, store carbon https://www.nationalfoodstrategy.org Methane • 60% from human activities • Short lived gas, but 28 x warming potential of carbon • 32% from farming animals • Manure and enteric fermentation • Methane emission alone will prevent us from limiting global warming • Urgent action needed https://www.greenpeace.org/aotearoa/publication/report-turning-down-the-heat/mate-change-heres-how-reduce-them Global food system emissions could preclude achieving the 1.5° and 2°C climate change targets ‘Even if fossil fuel emissions were eliminated immediately, emissions from the global food system alone would make it impossible to limit warming to 1.5°C and difficult even to realise the 2°C target’. Global food system emissions could preclude achieving the 1.5° and 2°C climate change targets. Science. 2020 Nov 6;370(6517):705- 708. doi: 10.1126/science.aba7357. weanimalmedia.org Meeting our climate and nature targets Measured as CO 2e per person per day https://www.wwf.org.uk/eating-for-net-zero What we eat really matters GHG emissions of various diets kg of CO2equivalents per year https://awellfedworld.org/wp-content/uploads/Climate-Food-Guide-2024-single-pages.pdf Local is not the answer • <10% of emissions are from transportation • For beef, it is 1% • 80% from land use change and farm stage emissions • Most plant-based foods are shipped • The UK only grows 17% of fruit and 55% of vegetables • We don’t have sufficient supply for 5 a day https://www.bbc.co.uk/news/science-environment-69009207What is a healthy and sustainable diet? >85% plant-based Per week Ø1 portion of red meat (98g) Ø2 portions poultry (200g)) Ø2 portions of fish (196g) Ø3 eggs ØEstimated to save 11 million premature deaths per year 10.1016/S0140-6736(18)31788-4 EAT-Lancet Commission on healthy diets from sustainable food systems. Lancet. 2019 Feb 2;393(10170):447-492. doi:Vegan diets are nutritionally adequate https://www.bda.uk.com/resource/british-dietetic-association-confirms-well-planned-vegan- diets-can-support-healthy-living-in-people-of-all-ages.html Benefits of a plant-based diet • Low in energy yet high in nutrients • Supports a healthy body weight • Low in saturated fat • improves blood lipids • High in fibre • Helps satiety • improves gut health • improves insulin sensitivity • High in phytonutrients • Lowers inflammation • Low in sugar • Can support health across all ages and stages of lifeThe Blue Zones • Ikaria, Greece • Loma Linda, California • Nicoya peninsula, Costa Rica • Okinawa, Japan • Sardinia, ItalyProspective cohort studies on vegan health Adventist Health Study-2 (AHS-2) • >96,000 SDAs from North America; began in 2002 – ongoing EPIC-Oxford • >65,000 participants from the UK; began in 1993 - ongoing ≈1/3 are lacto-ovo vegetarian or vegan Health outcomes of vegans Odds ratio of type 2 diabetes Tonstad S, et al. Diabetes Care. 2009;32:791–796. Public Health Nutr. 2012 Oct; 15(10): 1909–1916. Eur J Clin Nutr. 2014 Feb;68(2):178-83. doi: 10.1038/ejcn.2013.248. Epub 2013 Dec 18 Tonstad S. Nutr Metab Cardiovasc Dis. 2013;23(4):292-9. Health outcomes of vegans Tonstad S, et al. Diabetes Care. 2009;32:791–796. Public Health Nutr. 2012 Oct; 15(10): 1909–1916. Eur J Clin Nutr. 2014 Feb;68(2):178-83. doi: 10.1038/ejcn.2013.248. Epub 2013 Dec 18 Tonstad S. Nutr Metab Cardiovasc Dis. 2013;23(4):292-9. Health outcomes of vegans 25% reduction in heart disease risk Tonstad S, et al. Diabetes Care. 2009;32:791–796. Public Health Nutr. 2012 Oct; 15(10): 1909–1916. Eur J Clin Nutr. 2014 Feb;68(2):178-83. doi: 10.1038/ejcn.2013.248. Epub 2013 Dec 18 Tonstad S. Nutr Metab Cardiovasc Dis. 2013;23(4):292-9.UK Biobank study 472,377 participants followed for 11.4 yrs • Regular meat-eaters (n = 247,571) • Low meat-eaters (n = 205,385) • Fish-eaters (n = 10,696), • Vegetarians (n = 8685, including 466 vegans) Vegetarians 14% ê cancer Vegetarian women 18% ê breast cancer Vegetarian men 31% ê prostate cancer BMC Med 20, 73 (2022). https://doi.org/10.1186/s12916-022-02256-w 6002 participants in Taiwan • 4625 certified Tzu Chi volunteers and 1377 non–Tzu Chi volunteers The T zu Chi 1/3 vegetarian/vegan Health Study Vegetarians have better health • ê Body weight • ê Diabetes • ê Fatty liver • ê gallstone • ê Stroke • êMedical expenditure Cohorts,AdvancesinNutrition,Volume 10,Issue Supplement_4,November2019,PagesS284– S295,https://doi.org/10.1093/advances/nmy109 Cost savings • Improved health • Less diabetes and CVD • Environmental benefits • Lower household costs • Implementing meat-free defaults in public catering could save the NHS £74M a year The global and regional costs of healthy and sustainable dietary patterns: a modelling study, The Lancet Planetary Health, Volume 5, Issue 11, 2021 https://www.ohe.org/insight/could-plant-based-diets-transform-health-care-spending/n-windfall-for-the-nhs-new-research-reveals-how-the-uk-could-unlock-savings/Plant-based diets align with NHS priorities 1 2 3 4 5 6 Health crisis Cto net zero approachth Financial Indiversitynd Social justice Hospitals can lead by example Ø >50% of eligible patients stick with the plant-based meal Ø >90% satisfaction rates Ø Emissions from food have fallen by 36% Ø 59 cents saved per meal https://dnyuz.com/2023/08/31/how-new-yorks-public-hospitals-cut-carbon-emissions-more-vegetables/National campaign Conclusion • The medical profession can help to move the needle by embracing radical change when possible — especially within our own ranks — and incremental change when necessary to promote harm reduction. We owe it to the profession, to our patients, and to the planet we share’ Plant-Based Nutrition, The American Journal of Cardiology, Volume 188, 2023,e weanimalsmedia.org https://doi.org/10.1016/j.amjcard.2022.10.006 Next steps Ø Work with Greener by Default and their UK dietitian, for free https://plantsfirsthealthcare.com/wp- Medicine.pdfads/2024/11/GBD-UK-Version-Food-As-https://tinyurl.com/foodinhealthcarepbhp.uk/21-day 36Podcast 8-week online course For health professionals 5-6 hours of study/week 30 CPD/CME hours ACLM maintenance of certification https://www.winchester.ac.uk/study/further-study-options/cpd/plant-based-nutrition/Order worldwide from wherever you buy your books