I’m not a vegetarian. I should get that out of the way first. Nearly no meal makes me as happy as seafood or poultry. So for me to advocate for a vegetarian diet would be hypocritical.
Still, we often hear that extremes in diet are needed to stay healthy: Our country’s potential first husband woke up in 2010 with chest pain and famously became a vegan to try to stop his heart disease from getting any worse. Last year, Beyonce went on a 22-day “plant-based” diet to lose weight. Eating plants has become an epicurean fad — take a stroll through Boston and Cambridge’s neighborhoods and you’ll see specialized eateries blossoming, like Harvard Square’s new VO2 Vegan Cafe, the Fenway’s vegan ice cream pop-up FoMu, and the Seaport’s upcoming vegan restaurant By CHLOE.
But most Americans don’t yet have the taste for a mainly vegetarian diet or the time and money to follow celebrity trends. So for decades, as many as 80 percent of us have been eating the unhealthy Western diet centered on red and processed meats, refined sugars, and saturated fats. Vegetarians make up only 3 to 5 percent of the US population, with perhaps 10 percent favoring a “vegetarian-inclined” plate.
The Western diet unfortunately keeps Americans at high risk for diseases we might otherwise prevent. A national study recruiting almost 100,000 people strongly suggests that plant-based diets can cut the risk of heart disease by a third and decrease by half the risk of type 2 diabetes, high blood pressure, and metabolic syndrome. The risk of colon cancer drops 20 percent. Imagine if we had a pill that accomplished all of those effects — it would be heralded as a medical miracle. Yet even knowing these facts, most Americans still aren’t eating well.
There are failures on multiple levels. Physicians tend to get little training in dietary counseling, with only a third of us giving solid nutritional advice. Most struggle to fit such a complex conversation into a 20-minute patient visit.
Federal groups, like medical schools, have done a halfhearted job of public education. Last year, the Dietary Guidelines Advisory Committee prepared a report for the USDA and the Department of Health and Human Services that included a recommendation to reduce “red and processed meats.” Unsurprisingly, the meat industry didn’t agree. When the USDA released its guidelines early this year, gone was any mention of eating less red meat.
That means reform must start with us. Entire cities have begun experimenting — last month, the new mayor of Turin, Italy, unveiled a five-year plan to convert her city into a vegetarian utopia. But we need not go that far. In the past couple of years, new urban gardens have sprung up in places like Dorchester and Mattapan, with programs that expose residents to growing and eating plants, a behavior known to improve how we eat. Buying fresh produce can be difficult for those with limited incomes, but it’s essential, since heart disease, diabetes, and obesity strike lower-income families especially hard. We need to strengthen food programs and education through community-tailored approaches.
The new Boston Bounty Bucks program from the Office of Food Initiatives, run by Tosha Baker, seeks to make farmers’ markets an affordable place to buy groceries for SNAP (Supplemental Nutrition Assistance Program) eligible residents. “You can go to a farmers’ market that accepts Bounty Bucks, and if you spend ten dollars of your own money, we’ll match it with an additional ten,” Baker says.
The Boston Public Health Commission has started a campaign of ads to get residents to any of the 25 farmers’ markets in the area selling locally grown fresh fruits and vegetables.
Meanwhile, public school lunches need continued attention. After the Institute of Medicine found that children ate shockingly few fruits and vegetables in schools, federal legislation was enacted in 2010 to revamp the nutritional standards. Yet, high costs have led some Boston-area schools to cut out greener options. That might save money in the short term, but we are only shifting the costs to children as they grow up.
You can start to change at home, too, and you don’t even have to throw out everything in your fridge. If you don’t eat many plant-based foods, try filling half your plate with greens. Consistency is more important than brief “veggie cleanses.” Try to eat less meat, especially fatty beef and pork. There are ingredients in red meat that can act on their own to cause heart disease, so eating lean red meat is only a partial improvement. “The worst choices,” says Michael F. Jacobson, president of the Center for Science in the Public Interest, “are processed meats like ham and hot dogs, which have been associated strongly with a higher risk of colorectal cancer.”
But diets that include fish, for instance, may reduce the risk of dying from heart disease by more than a third. Talk to your health-conscious friends: The more people you know who have enviable eating habits, the more likely you are to transform your own.
The best chance for reforming the Western diet begins with teaching the next generation. Take your kids to the farmers’ market or, if you have space, plant a little garden or just a put a pot of basil on the windowsill. Interest them in cooking. Go to their schools and find out how you can help ensure access to nutritious meals through groups like the Healthy Food for Boston Schools Action Network.
Most of the leading causes of death in this country are highly preventable. We don’t need special supplements or Beyonce diets or jars of vitamins or vegan retreats. Begin simply: Put more plants on your plate. Cut out most meat. Try to grow a little garden. Then show another person how you’ve changed things.
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Dr. Sushrut Jangi is a gastroenterology fellow and instructor in medicine at Brigham and Women’s Hospital. Send comments to firstname.lastname@example.org.