Doctor’s Orders - Plant-based myth-busting 

Dr Heleen Haitjema, co-founder and Board Chair of Doctors For Nutrition, takes down some persistently pesky myths around whole food plant-based eating.

Our health-promotion charity – Doctors For Nutrition – is regularly approached by people who are considering making a change towards whole food plant-based (WFPB) nutrition; often with reservations about if it is right for them. Many of these reservations are not based on facts.

With so much nutrition (mis)information at our fingertips, it is understandable that what we should eat for optimal health becomes confusing.

Below we bust five of the most common plant-based myths so you can be better informed and make more nutritious, sustainable choices.

Myth One: Where Do You Get Your Protein?

Protein is an important nutrient that helps build, maintain, and repair our body tissue. All foods, including fruits and vegetables, contain protein, while certain plant-based foods, like whole grains, beans, nuts, lentils, and quinoa pack an extra protein punch.

Protein from a variety of plant foods, eaten during the course of a day, supplies enough of all essential amino acids (the ones we need to get from our food) when we are consuming enough calories. 

The once-popular recommendation of combining protein sources to achieve a complete essential amino acid profile in each meal is no longer considered necessary. 

Protein deficiency is virtually non-existent in most developed countries. In fact, most of us easily meet (and surpass) the Recommended Daily Intake. The deficiency we should be focused on isn’t protein… it is vegetable consumption, with many of us falling short of the five-plus-a-day recommended nutritional guidelines.

Myth Two: Shouldn’t I be Minimising ‘Carbs’?

Carbohydrates are one of the three major nutrient groups that provide energy (referred to as macronutrients). They are important in the diet and form part of a healthy eating pattern. Not all carbs are created equal. It isn’t the amount of carbohydrates, it is the type that needs to be considered. 

The healthiest sources of carbohydrates are unprocessed or minimally processed whole grains, vegetables, fruits, and legumes (such as lentils, chickpeas, and other beans). These foods provide energy, dietary fibre, vitamins, minerals, and a host of  phytonutrients (beneficial compounds found in plants).

Refined carbohydrates such as white bread and sugary snacks should be kept to a minimum and ideally excluded altogether, while fibre-rich complex carbohydrates should be the body’s main fuel source, and provide the majority of the calories in a healthy diet. 

Low carbohydrate diets, including the currently popular ketogenic diet, are often promoted for their weight loss potential and even as a diabetes management approach. However, research demonstrates frequent unwanted effects in individuals following these diets, including:

• LDL-cholesterol elevation and increased inflammatory markers 
• Harmful effects on the gut microbiome due to fibre deficiency 
• Reduced life expectancy

A WFPB diet is a proven long-term approach for staying healthy for as long as possible, the solution does not lie in excluding nutrient-rich, fibre-filled whole plant foods. 

Myth Three: I Don’t Want to Go on Another Diet

Although it’s often referred to as the “WFPB diet”, this way of eating is not like other diets that require a restrictive mindset. Remember, the goal of a WFPB eating pattern is not weight loss, but health improvement. It may often result in weight loss, but this is a by-product, not the purpose. 

There is no need to monitor dietary intake if you are solely consuming whole grains, legumes, fruits, vegetables and small quantities of nuts and seeds. In fact, this is actively discouraged.

The focus is on what’s included rather than what’s excluded. When you load up on the good stuff, there won’t be any room for processed or animal-derived products. A WFPB way of eating is all about feeling good within ourselves and having a relationship with food that respects our bodies and prioritises our health and wellbeing.

Fad diets fail — this is not a diet, but rather a lifestyle shift that can happen at your own pace.

Myth Four: Doesn’t Soy Contain Oestrogen and Cause Hormonal Issues?

Firstly, plant-based eating does not necessitate eating a lot of, or even any, soy products. Although if you do enjoy minimally processed soy products you might be wondering if it could be harmful.

Soy contains a high amount of isoflavones, a type of plant oestrogen (phytoestrogen). These are plant substances that have a very similar structure to oestrogen from the body and can bind to oestrogen receptors, but soy oestrogens are weaker which results in lowering the possible negative effects of our own more potent oestrogens. While this may sound concerning, the science is clear: There are numerous health benefits related to phytoestrogen consumption for both men and women, and no convincing evidence that isoflavones affect male or female hormones, thyroid function, or fertility.

Soy has been shown to reduce the risk of breast, prostate, colon cancers, and cardiovascular disease and improve bone mineral density. Isoflavones are converted to equol by gut bacteria, and higher production of equol has been associated with lower frequency of hot flushes. 

‘Second generation‘ highly processed soy foods like tofu sausages and supplements should be avoided.

Myth Five: I Tried a Plant-based Diet, it Didn’t Agree With Me, I Was so Bloated

When starting to eat more WFPB, some people can experience digestive upsets. This doesn’t mean it isn’t for you. The time it takes to adjust to a new way of eating is very individual. 

Changing from omnivorous eating to fully plant-based will increase your fibre intake over one-and-a-half times — making this change too quickly can be one cause of digestive upsets. Fibre is essential for staving off gut-related disease, but most people who follow the standard Western diet don’t manage to consume the minimum recommended amount. In contrast, the average plant-based eating pattern easily meets or exceeds our fibre requirements. 

Rapid changes to what we eat can mean rapid changes to the ratios of bacteria in our colon. The types of dietary fibre found in plant-based foods, such as grains, legumes, fruits, vegetables, and small amounts of nuts, selectively stimulate the growth of bacteria known to be health promoting. When first switching to a plant-based diet, people may notice an increase in gas and/or bloating. For almost everyone these symptoms are temporary and will ease over time, eventually disappearing completely. 

It may be helpful to start out slowly, introducing a wider variety and larger quantities of certain foods over time, particularly if you’ve had issues with gut symptoms in the past. If the gas or bloating is causing discomfort, it may be also helpful to include less fibrous grains, such as white rice, for a few days while the bacteria catch up to the new dietary pattern.