Kelsey Moore, RD* | Melanie Liu^ | Chris Culhane^ | Anthony Marotta, PhD*

*Peqish Health Advisors | ^UBC, Dietetics Program. Student RD

Key Takeaways

• Plant-based diets offer many health benefits, including reducing the risk of chronic diseases, improving gut health, and promoting weight loss.

• Plant-based diets require careful planning to ensure adequate intake of all essential nutrients. Inadequate intake of certain nutrients, such as vitamin B12, iron, calcium, and omega-3 fatty acids, can lead to health problems.

• When consuming ultra-processed plant-based foods, plant-based diets can lack essential nutrients, such as fiber, vitamins, and minerals.

• Ultra-processed plant-based foods can be high in added sugars, unhealthy fats, and sodium, leading to adverse health outcomes such as obesity, type 2 diabetes, and cardiovascular disease.

• Individuals following a plant-based diet should focus on consuming whole, minimally processed plant-based foods to ensure a balanced and nutritious diet. Consultation with a registered dietitian or healthcare provider can help develop a healthy plant-based meal plan.

KEYWORDS

Plant-based diets, Health Benefits and Risks, Managing Lifestyle Change, Risks with Ultra-processed plant-based foods

The Power of Plant-Based Diets: Exploring Health, Environmental, and Economic Benefits

In recent years, the concept of adopting a plant-based diet has gained significant attention, with an increasing number of individuals considering the switch. The allure of a plant-based lifestyle lies in its potential health benefits, ethical considerations, and environmental sustainability. However, before embarking on any dietary changes, it's essential to carefully weigh the benefits and risks to determine if a plant-based diet is the right choice for you.

A plant-based diet primarily focuses on consuming whole, unprocessed foods derived from plants, such as fruits, vegetables, legumes, grains, nuts, and seeds, while minimizing or excluding animal products like meat, dairy, and eggs. Evidence supporting this dietary approach shows that it can lead to numerous health benefits, including reducing the risk of chronic diseases such as heart disease, diabetes, and certain cancers (Tuso et al., 2013).

Beyond a personal health approach, following a plant-based diet aligns with ethical considerations surrounding animal welfare. Additionally, the environmental impact of animal agriculture has raised concerns about climate change, deforestation, and resource depletion.

While a plant-based diet offers numerous potential benefits, it also comes with certain risks and challenges that individuals must consider. To make an informed decision about whether a plant-based diet is suitable for you, it's crucial to examine both the benefits and risks in detail.

This white paper aims to provide an overview of the benefits and risks of a plant-based diet. The article presents evidence-based research from systematic reviews and meta-analyses on plant-based diets' health, environmental, and economic benefits. It also aims to discuss the challenges and opportunities of transitioning to a plant-based diet and provide practical tips for incorporating more plant-based foods into everyday meals.

Scientific Exploration of Plant-Based Diets: Unveiling Health Benefits and Research Trends

This section provides an overview of the literature based upon the scientific community's interest in plant-based diets, the increase in peer-reviewed publications since 2002, and a discussion of systematic literature reviews conducted since 2019.

The interest in plant-based diets stems from their potential to promote health, prevent chronic diseases, and reduce the environmental impact of food production (Tuso et al., 2013). The scientific community's interest in plant-based diets has grown in recent years, as evidenced by the increasing number of studies published on this topic.

Furthermore, systematic literature reviews have been conducted to evaluate the impact of plant-based diets on health outcomes. In a recent systematic review, Satija et al. (2019) found that a plant-based diet was associated with a lower risk of coronary heart disease, type 2 diabetes, and mortality. This is in line with other papers that associated plant-based diets with decreased risk for type 2 diabetes, metabolic syndrome, cardiovascular disease, and mortality (Qian et al., 2018; Quek et al., 2021).

Moreover, a recent systematic review and meta-analysis conducted by Dinu et al. (2017) evaluated the effects of a vegetarian diet on cardiovascular risk factors. The study found that a vegetarian diet was associated with significantly reduced body weight, total cholesterol, LDL cholesterol, blood pressure, and fasting blood glucose levels.

The growing interest in plant-based diets has also led to the development of plant-based dietary guidelines. The EAT-Lancet Commission, a group of international experts in health, nutrition, and sustainability, developed a planetary health diet that is primarily plant-based (Willett et al., 2019).

In conclusion, the scientific community's interest in plant-based diets has grown recently, as evidenced by the increase in peer-reviewed publications and systematic literature reviews. The development of plant-based dietary guidelines reflects the increasing recognition of the importance of plant-based diets in promoting health and sustainability.

Plant-based diets have been shown to have numerous health benefits, including reducing the risk of chronic diseases such as coronary heart disease and type 2 diabetes.

Health Benefits of Plant-Based Diets: Weight Management, Blood Pressure, Cardiovascular Health, Glucose Metabolism, and Cardiometabolic Outcomes

Plant-based diets have been shown to have numerous health benefits, including weight status improvement, blood pressure regulation, reduced risk for cardiovascular disease and mortality reduction, glucose metabolism improvement, and treatment of obesity and cardiometabolic health outcomes. In this section, we will provide an overview of several studies that investigate these benefits.

1. Blood Pressure Regulation

A plant-based diet can reduce blood pressure by being low in sodium and high in potassium, fiber, and antioxidants, all of which promote healthy blood pressure levels and overall cardiovascular health. Plant-based diets tend to be rich in potassium, a mineral that plays a crucial role in regulating blood pressure. Potassium helps counteract the effects of sodium and relaxes blood vessel walls, supporting healthy blood pressure levels.

Gibbs et al. (2021) conducted a systematic review and meta-analysis to evaluate plant-based diets' effect on adults' blood pressure. The study analyzed data from 39 randomized controlled trials involving 8,203 participants.  The results showed that plant-based diets, mainly vegetarian and vegan, were associated with significant reductions in systolic and diastolic blood pressure.

These findings suggest that plant-based diets can be an effective intervention for preventing and managing hypertension.

2. Cardiovascular Disease (CVD) and Mortality Reduction

Quek et al. (2021) conducted a systematic review and meta-analysis to investigate the effect of plant-based diets on cardiovascular disease and mortality risk. The study analyzed data from thirteen studies involving 410,085 participants.  

Adherence to a plant-based diet significantly was reported to result in a reduced risk of cardiovascular disease and mortality. These findings support the notion that plant-based diets can have an effective outcome in preventing cardiovascular disease and mortality.

3. Insulin Sensitivity Improvement

Kalheavoa et al. (2010) conducted a randomized, open, parallel study to investigate the effects of plant-based diet and exercise on insulin resistance, visceral fat and oxidative stress markers in subjects with Type 2 diabetes. This study involved 74 patients randomly assigned to a vegetarian calorie restricted diet or a control calorie restricted diet for 24 weeks. 

The results showed that the participants in the plant-based diet group had a significant increase in insulin sensitivity compared to the control diet. Additionally, a reduction in both visceral and subcutaneous fat was greater in the experimental group than in the control group.

These findings indicate that plant-based diets may have a beneficial role in improving insulin resistance and reducing oxidative stress.

Incorporating more whole, plant based foods into your daily routine can have a positive impact on your well-being. It is important to note that the positive impacts of this lifestyle modification are negated when individuals consume plant-based processed foods.

Economic Benefits of Plant-Based Diets: Reducing Healthcare Costs and Fostering Economic Opportunities for Individuals and Communities

Plant-based diets not only offer health and environmental benefits, but they can also provide economic advantages. In this section, we will explore the evidence for the economic benefits of plant-based diets, including their ability to reduce healthcare costs and increase economic opportunities in the food industry. We will also discuss how plant-based diets can benefit individuals, communities, and the economy.

Several systematic reviews and meta-analyses have examined the economic benefits of plant-based diets. Countless studies have shown the impact plant-based diets can have on decreasing the prevalence of non-communicable diseases (Sabate et al., 2014; Tuso et al., 2013; Dinu et al.,2017; Qian et al., 2018; Quek et al., 2021), highlighting the significant potential plant-based eating can have on decreased healthcare costs.

1. Reduced Healthcare Costs

Plant-based diets have been associated with a lower risk of chronic diseases, which can lead to reduced healthcare costs. For instance, a study published in 2019 found that a vegetarian diet was associated with a 24-29% decreased risk of heart disease (Satija et al., 2019). Similarly, a study published in 2018 found that a plant-based diet could reduce the risk of type 2 diabetes and metabolic syndrome by up to 50% (Qian et al., 2018).

2. Increased Economic Opportunities in the Food Industry

Plant-based diets can also provide economic opportunities in the food industry. The demand for plant-based foods has increased recently, leading to new market opportunities for producers and entrepreneurs. The growing popularity of plant-based diets has increased investment in the plant-based food industry, with companies developing innovative plant-based products to meet consumer demand. In addition, plant-based diets can benefit local communities by promoting sustainable agriculture and supporting local food systems (Sabate et al., 2014).

3. Benefits to Individuals, Communities, and the Economy

Plant-based diets can benefit individuals, communities, and the economy by reducing healthcare costs and promoting economic opportunities in the food industry.

In addition, plant-based diets can help to address global food security issues. By reducing the demand for animal products, plant-based diets can free up resources for producing plant-based foods, which can help feed a growing global population (Springmann et al., 2018).

Overall, the economic benefits of plant-based diets are supported by systematic reviews and meta-analyses. By reducing healthcare costs and promoting economic opportunities in the food industry, plant-based diets can benefit individuals, communities, and the global economy. Plant-based diets can also help address food security issues, making them viable and sustainable.

Plant-based diets hold the key to transforming healthcare by reducing costs and improving individual well-being. Embracing plant-based eating empowers individuals with the ability to enhance their health while contributing to a sustainable and thriving future.

Transitioning to a Plant-Based Diet: Current Challenges, Opportunities, and the Role of Individuals and Communities

While there are many benefits of plant-based diets, several challenges must be addressed to transition to a plant-based diet successfully. This section will discuss the challenges and opportunities of transitioning to a plant-based diet, including cultural and social factors, access to affordable and nutritious plant-based foods, and the need for education and awareness-raising. We will also explain how plant-based foods can be integrated into different diets and lifestyles and how individuals and communities can support and promote plant-based foods.

1. Cultural and Social Factors

Cultural and social factors are one of the primary challenges of transitioning to a plant-based diet. Food plays a crucial role in social and cultural activities, and many traditional diets include animal products as a significant component. Moreover, meat consumption has been associated with social status and masculinity in many cultures, making it challenging to shift toward plant-based diets (Ruby, 2012).

In addition, the need for plant-based food options in specific regions and communities can also pose a challenge. Many traditional diets in areas such as Africa and Asia include animal products. Access to plant-based foods can be limited due to the high cost or lack of availability.

Promoting the cultural and social significance of plant-based foods is essential to overcome these challenges. Governments and organizations can work together to provide education and awareness-raising campaigns highlighting the benefits of plant-based diets and encouraging the consumption of plant-based foods. Furthermore, local communities can promote producing and consuming locally sourced plant-based foods, supporting small farmers and businesses.

2. Access to Affordable and Nutritious Plant-Based Foods

Another challenge of transitioning to a plant-based diet is access to affordable and nutritious foods. Plant-based foods may be more expensive or harder to find in some areas than animal products. Some plant-based foods may also lack essential nutrients typically found in animal products, such as vitamin B12 and iron (Neufingerl & Ans, 2021).

To overcome this challenge, governments and organizations can work to increase the availability of affordable and nutritious plant-based foods. For example, subsidies and incentives can be provided to farmers who produce plant-based foods, and more plant-based options can be added to school and hospital menus. Additionally, individuals can create balanced plant-based diets that include a variety of vegetables, fruits, whole grains, nuts, and seeds, which help to ensure that essential nutrients are obtained.

3. Education and Awareness-Raising

Another critical aspect of transitioning to a plant-based diet is education and awareness-raising. Many people need to be made aware of the benefits of plant-based diets or need more knowledge to create balanced plant-based meals. Moreover, misinformation and myths about plant-based diets can be widespread, making it challenging to promote the benefits of plant-based foods.

To address these challenges, education and awareness-raising campaigns can be developed to promote the benefits of plant-based diets and provide individuals with the knowledge and skills necessary to create balanced meals. Nutrition education can be provided in schools and hospitals, and organizations can work to dispel myths and misinformation about plant-based diets.

4. Plant-Based Foods: Adapting to Diverse Diets and Lifestyles

Plant-based foods can be integrated into different diets and lifestyles, making them accessible to many individuals. For instance, plant-based diets can include vegetarian and vegan diets and flexitarian and reducetarian diets, which allow for occasional or moderate consumption of animal products (Ruby, 2012).

Furthermore, plant-based foods can be integrated into different cuisines and culinary traditions. For example, in many cuisines, beans, lentils, and other legumes are a staple source of protein. In South Asian cuisine, lentils and legumes are commonly used to make dal, a thick soup-like dish typically served with rice or bread. In Middle Eastern cuisine, hummus, made from chickpeas, is a famous dip or spread that can be enjoyed with pita bread or vegetables.

In addition, plant-based foods can be incorporated into minimally processed and convenience foods, making them more accessible to individuals with busy lifestyles. For example, plant-based burgers and sausages are now widely available in grocery stores and fast-food chains, providing consumers with a meat-free alternative that is easy to prepare and can be used in various dishes. There has also been a recent push from consumers to eat a more mindful plant-based regimen, avoiding labels such as vegetarian or vegan, but opting for meat consumption occasionally or only at social occasions (Ruby, 2012).

5. Support and Promotion of Plant-Based Foods

Individuals and communities can be essential in supporting and promoting plant-based foods. One way to keep plant-based diets is to advocate for policies and initiatives that promote access to affordable and nutritious plant-based foods. This can include initiatives to support local farmers and businesses that produce plant-based foods and programs that provide education and resources on plant-based diets and cooking.

In addition, individuals can make a difference by incorporating more plant-based foods into their diets and encouraging their friends and family to do the same. This can include hosting plant-based meals and potlucks, sharing recipes and cooking tips, and promoting the benefits of plant-based diets on social media and other platforms.

Finally, raising awareness about the environmental and health benefits of plant-based diets is essential. This can include educational campaigns, community events, and media coverage highlighting the benefits of plant-based diets and the challenges of the current food system. By raising awareness and promoting plant-based foods, individuals and communities can help to create a more sustainable, equitable, and healthy food system for all.

Transitioning to a plant-based diet comes with challenges like cultural factors and access to affordable, nutritious options. However, by addressing these obstacles, individuals can contribute to a more sustainable food system and support positive change in their communities.

Considerations and Challenges of Plant-Based Diets

While plant-based diets have several health benefits, there are also potential drawbacks. This section will discuss some of these drawbacks and their implications.

1. Nutrient Deficiencies and Imbalances

One of the main concerns associated with plant-based diets is the risk of nutrient deficiencies and imbalances. A plant-based diet may not provide sufficient nutrients for optimal health, such as vitamin B12, iron, calcium, and omega-3 fatty acids (Craig, 2009). 

Inadequate intake of these nutrients can lead to various health problems, including anemia, impaired cognitive function, and bone loss (Mangels, Messina, & Messina, 2011). Therefore, it is essential for individuals following a plant-based diet to consume various nutrient-dense plant foods and consider taking supplements if necessary.

2. Achieving Adequate Protein Intake

One concern often perpetuated in the media is that plant-based diets provide inadequate protein compared to meat-rich diets.

Studies have shown that plant-based eating can meet most individual’s protein needs (Hertzler et al., 2020; Sabate et al., 2016; Langyan et al., 2021; Mariotti & Gardner, 2019). The notion that plant-based proteins having incomplete or insufficient levels of essential amino acids has become less supported in recent years (Langyan et al., 2021). Plant-based proteins such as soy, peas, and quinoa have very comparable amounts of essential amino acids to animal proteins (Hertzler et al., 2020).

Achieving adequate protein intake may be more difficult for vegans, as vegetarians have a greater variety of high protein sources such as eggs and dairy (Langyan et al., 2021). Achieving adequate protein from plant-based sources may also be more challenging for some populations such as those with nut or legume allergies, soy intolerances, and young children who have greater protein needs (Hertzler et al., 2020; Mariotti & Gardner, 2019). Whether all elderly individuals have higher protein needs or not requires more investigation, but Mariotti and Gardner (2019) suggest the frail elderly certainly require higher protein intake.

3. Need for Careful Planning to Ensure Proper Nutrition

A plant-based diet requires careful planning to ensure adequate intake of all essential nutrients. In addition to protein, plant-based diets may be low in other nutrients such as vitamin D and zinc (Craig, 2009).

Careful planning can help ensure that individuals following a plant-based diet consume various nutrient-dense plant foods and meet their nutritional needs.

This may include consuming fortified foods, taking supplements, and consulting a registered dietitian or healthcare provider to develop a balanced and nutritious meal plan.

While a plant-based diet can be a healthy choice for many individuals, it is important to note that restrictive eating patterns, including veganism or other plant-based diets, may increase the risk of developing disordered eating behaviors, particularly if taken to extremes or accompanied by rigid rules and restrictions. Some individuals may use a plant-based diet as a means of control or avoidance of certain food groups, leading to orthorexia or other disordered eating patterns. It is crucial to approach any dietary change, including adopting a plant-based diet, with a balanced and flexible mindset and to seek professional guidance if concerns about disordered eating arise.

Plant-based diets offer numerous health benefits, but they also come with potential drawbacks. Nutrient deficiencies and imbalances can arise, making careful planning and consideration of supplements necessary. Additionally, ensuring adequate protein intake and avoiding disordered eating behaviors require thoughtful management and professional guidance when adopting a plant-based diet.

The Pitfalls of Ultra-Processed Plant-based Foods

While a plant-based diet can offer many health benefits, it is essential to note that not all plant-based foods are created equal.

Recently, there has been a growing trend towards plant-based ultra-processed foods, which are highly processed foods made from plant-based ingredients.

These foods can be high in added sugars, unhealthy fats, and sodium, lacking essential nutrients (Monteiro et al., 2019). This section will discuss some of the negative aspects of plant-based ultra-processed foods.

1. High in Added Sugars

Plant-based ultra-processed foods often contain high amounts of added sugars, contributing to weight gain, type 2 diabetes, and other health problems (Malik et al., 2010). For example, many plant-based alternatives, such as almond and soy milk, contain added sugars to improve their taste (Silva et al., 2020). Plant-based meat alternatives, such as veggie burgers and sausages, often contain added sugars to enhance their texture and flavor.

2. High in Unhealthy Fats

Plant-based ultra-processed foods can also be high in unhealthy fats, such as saturated and trans fats. These fats can increase the risk of heart disease, stroke, and other health problems (Mozaffarian et al., 2016). For example, some plant-based meat alternatives, such as vegan cheese and faux bacon, can be high in saturated fats and sodium.

3. Low in Important Nutrients

Plant-based ultra-processed foods can also lack essential nutrients like fiber, vitamins, and minerals. This is because many of the nutrients in plant-based foods are lost during processing (Monteiro et al., 2019). For example, some plant-based milk alternatives may be low in calcium and vitamin D, essential for bone health (Silva et al., 2020).

4. Linked to Chronic Disease

A diet high in plant-based ultra-processed foods has been linked to an increased risk of chronic diseases such as obesity, type 2 diabetes, and cardiovascular disease (Monteiro et al., 2019). These adverse health effects are likely due to these foods' high amounts of added sugars, unhealthy fats, and sodium as well as additives that are commonly found in this category of foods.

Consuming a diet high in these foods has been linked to adverse health outcomes such as obesity, type 2 diabetes, and cardiovascular disease. Therefore, it is essential for individuals following a plant-based diet to choose whole, minimally processed plant-based foods whenever possible.

Although incorporating more plant-based foods into your diet offers numerous health benefits, it is crucial to recognize that not all plant-based foods are equal. The rise in popularity of plant-based ultra-processed foods, laden with added sugars, unhealthy fats, and lacking essential nutrients, poses potential risks to health. Opting for whole, minimally processed plant-based options is essential to mitigate the negative aspects associated with these highly processed food choices.

Plant-based Eating and the Environment

Another key benefit to plant-based eating is its impact on the environment. Several studies have shown emphasis on plant-based eating has significant positive impacts on climate change, greenhouse gas emissions, water and land use, and overall global sustainability (Springmann et al., 2018; Sabate et al., 2019; Sabate et al., 2014).

One study found that the production of 1 kg of kidney beans required approximately eighteen times less land, ten times less water, nine times less fuel, twelve times less fertilizer and ten times less pesticide in comparison to producing 1 kg of protein from beef.

Shifting the paradigm away from red meat and towards plant-based proteins can also greatly aid in feeding a growing global population (Springmann et al., 2018).

Conclusion 

In conclusion, this white paper highlights the benefits of consuming plant-based foods. According to research conducted by Tuso et al. (2013), plant-based diets can improve overall health and reduce the risk of chronic diseases such as heart disease, diabetes, and cancer. In addition, plant-based foods have a lower environmental impact than animal-based foods, which can help combat climate change (Sabaté et al., 2016). Finally, promoting plant-based foods can have positive economic effects by supporting local agriculture and reducing healthcare costs.

Therefore, individuals, communities, and policymakers must support and promote plant-based foods. We can improve our health, protect the environment, and boost the economy by changing our diets and food systems.

We encourage everyone to consider incorporating more whole plant-rich foods that are minimally processed into their diet and support local producers of plant-based foods. Doing so can create a more sustainable and healthier food system for ourselves and future generations.

References

Beydoun MA, Gary TL, Caballero BH, Lawrence RS, Cheskin LJ, Wang Y. Ethnic differences in dairy and related nutrient consumption among US adults and their association with obesity, central obesity, and the metabolic syndrome. Am J Clin Nutr. 2008 Jun;87(6):1914-25. doi: 10.1093/ajcn/87.6.1914. PMID: 18541585; PMCID: PMC2585752.

Craig WJ. Health effects of vegan diets. Am J Clin Nutr. 2009 May;89(5):1627S-1633S. doi: 10.3945/ajcn.2009.26736N. Epub 2009 Mar 11. PMID: 19279075.

Dinu M, Abbate R, Gensini GF, Casini A, Sofi F. Vegetarian, vegan diets and multiple health outcomes: A systematic review with meta-analysis of observational studies. Crit Rev Food Sci Nutr. 2017 Nov 22;57(17):3640-3649. doi: 10.1080/10408398.2016.1138447. PMID: 26853923.

Gibbs J, Gaskin E, Ji C, Miller MA, Cappuccio FP. The effect of plant-based dietary patterns on blood pressure: a systematic review and meta-analysis of controlled intervention trials. J Hypertens. 2021 Jan;39(1):23-37. doi: 10.1097/HJH.0000000000002604. PMID: 33275398.

Hertzler SR, Lieblein-Boff JC, Weiler M, Allgeier C. Plant Proteins: Assessing Their Nutritional Quality and Effects on Health and Physical Function. Nutrients. 2020 Nov 30;12(12):3704. doi: 10.3390/nu12123704. PMID: 33266120; PMCID: PMC7760812.

Langyan S, Yadava P, Khan FN, Dar ZA, Singh R, Kumar A. Sustaining Protein Nutrition Through Plant-Based Foods. Front Nutr. 2022 Jan 18;8:772573. doi: 10.3389/fnut.2021.772573. PMID: 35118103; PMCID: PMC8804093.

Malik VS, Popkin BM, Bray GA, Després JP, Hu FB. Sugar-sweetened beverages, obesity, type 2 diabetes mellitus, and cardiovascular disease risk. Circulation. 2010 Mar 23;121(11):1356-64. doi: 10.1161/CIRCULATIONAHA.109.876185. PMID: 20308626; PMCID: PMC2862465.

Mangels, A. R., Messina, V., & Messina, M. (2011). The Dietitian’s Guide to Vegetarian Diets: Issues and Applications (3rd ed.). Jones & Bartlett Publishers.

Mariotti F, Gardner CD. Dietary Protein and Amino Acids in Vegetarian Diets-A Review. Nutrients. 2019 Nov 4;11(11):2661. doi: 10.3390/nu11112661. PMID: 31690027; PMCID: PMC6893534.

Monteiro CA, Cannon G, Moubarac JC, Levy RB, Louzada MLC, Jaime PC. The UN Decade of Nutrition, the NOVA food classification and the trouble with ultra-processing. Public Health Nutr. 2018 Jan;21(1):5-17. doi: 10.1017/S1368980017000234. Epub 2017 Mar 21. PMID: 28322183; PMCID: PMC10261019.

Neufingerl N, Eilander A. Nutrient Intake and Status in Adults Consuming Plant-Based Diets Compared to Meat-Eaters: A Systematic Review. Nutrients. 2021 Dec 23;14(1):29. doi: 10.3390/nu14010029. PMID: 35010904; PMCID: PMC8746448.

Satija A, Bhupathiraju SN, Spiegelman D, Chiuve SE, Manson JE, Willett W, Rexrode KM, Rimm EB, Hu FB. Healthful and Unhealthful Plant-Based Diets and the Risk of Coronary Heart Disease in U.S. Adults. J Am Coll Cardiol. 2017 Jul 25;70(4):411-422. doi: 10.1016/j.jacc.2017.05.047. PMID: 28728684; PMCID: PMC5555375.

Springmann M, Clark M, Mason-D'Croz D, Wiebe K, Bodirsky BL, Lassaletta L, de Vries W, Vermeulen SJ, Herrero M, Carlson KM, Jonell M, Troell M, DeClerck F, Gordon LJ, Zurayk R, Scarborough P, Rayner M, Loken B, Fanzo J, Godfray HCJ, Tilman D, Rockström J, Willett W. Options for keeping the food system within environmental limits. Nature. 2018 Oct;562(7728):519-525. doi: 10.1038/s41586-018-0594-0. Epub 2018 Oct 10. PMID: 30305731..

Stevenson, N. (2020). Plant-based protein market growth outstrips overall food sales. Food Dive. Retrieved from https://www.fooddive.com/news/plant-based-protein-market-growth-outstrips-overall-food-sales/582020/

Tuso PJ, Ismail MH, Ha BP, Bartolotto C. Nutritional update for physicians: plant-based diets. Perm J. 2013 Spring;17(2):61-6. doi: 10.7812/TPP/12-085. PMID: 23704846; PMCID: PMC3662288.

Willett W, Rockström J, Loken B, Springmann M, Lang T, Vermeulen S, Garnett T, Tilman D, DeClerck F, Wood A, Jonell M, Clark M, Gordon LJ, Fanzo J, Hawkes C, Zurayk R, Rivera JA, De Vries W, Majele Sibanda L, Afshin A, Chaudhary A, Herrero M, Agustina R, Branca F, Lartey A, Fan S, Crona B, Fox E, Bignet V, Troell M, Lindahl T, Singh S, Cornell SE, Srinath Reddy K, Narain S, Nishtar S, Murray CJL. Food in the Anthropocene: the EAT-Lancet Commission on healthy diets from sustainable food systems. Lancet. 2019 Feb 2;393(10170):447-492. doi: 10.1016/S0140-6736(18)31788-4. Epub 2019 Jan 16. Erratum in: Lancet. 2019 Feb 9;393(10171):530. Erratum in: Lancet. 2019 Jun 29;393(10191):2590. Erratum in: Lancet. 2020 Feb 1;395(10221):338. Erratum in: Lancet. 2020 Oct 3;396(10256):e56. PMID: 30660336.