"Do Flexitarians Live Longer?"
What accounts for the benefits of a Mediterranean-style diet?
An anatomy of health effects was published and the single most important component
was the high consumption of plant foods.
In contrast, fish and seafood consumption, the only animal foods
promoted in the Mediterranean diet did not seem to help.
In fact, if you look at four of the major dietary quality scoring systems,
which have all been associated with extending lifespan,
lowering heart disease and cancer mortality,
They all share only four things in common:
more fruit, more vegetables, more whole grains, and more nuts and beans.
They are all built on a common core of a diet rich in plant foods,
whereas opposite food patterns, rich in animal foods, poor in plant-based foods
(in other words, the Western diet), are associated with higher risks.
So we need to optimize the food environment
to support whole grains, vegetables, fruit, and plant-based proteins.
That’s one of the things all the so-called Blue Zones have in common,
the longest living populations, not only social support and engagement, daily exercise,
but nutritionally they all center their diet around plant foods,
reserving meat mostly for special occasions.
And the population with perhaps the longest life-expectancy in the world,
doesn’t eat any meat at all, the California Adventist vegetarians.
So if the primary benefits of the Mediterranean diet
are due to all the whole plant foods,
what if you went back to the famous PREDIMED study
and created a pro-vegetarian scoring system?
We know vegetarians live longer,
but because a pure vegetarian diet might not easily be embraced by many individuals,
maybe it would be easier to swallow if we just tell people
more plant-based foods, less animal-based foods.
But would just moving along the spectrum towards more plants
actually enable people to live longer?
They thought of this food pattern as a “gentle approach” to vegetarianism,
figuring that if it improved survival it would be an easily understandable message
for health promotion - more plant foods, less animal foods.
So you get points for eating fruit, vegetables, nuts, grains, beans, olive oil, and potatoes,
but get docked points for any animal fats, eggs, fish, dairy,
or any type of meat or meat products.
Of course, that means you get a higher score
the more potato chips and French fries you eat.
That’s why I prefer the term whole food plant-based diet
since it’s defined by what you eat, not by what you don’t eat.
When I was teaching up at Cornell I'd have “vegan” students
apparently living off of French fries and beer;
Vegan does not necessarily mean health-promoting.
But did it work?
Regardless of healthy vs. unhealthy,
if you give points to people for any kind of plant food, processed or not,
and detract points for any kind of animal product consumption,
do people with higher scores live longer? Yes.
The maximum pro-vegetarian score is 60,
but even just scoring 40 or more was associated with a 40% drop in mortality.
In fact, there were so few deaths in the highest category of adherence
to the pro-vegetarian diet, they had to merge the 2 upper categories for their analysis.
This is evidence that simple advice to increase the consumption
of plant-derived foods with reductions in the consumption of foods
from animal sources confers a survival advantage.
A live-a-longer-live advantage.
This modest change is realistic, affordable, and achievable
because a sizable proportion of their population was already eating that way.
So one can get significant survival benefit without a radical shift
to the exclusive consumption of plant foods,
a more gradual and gentle approach more easily translatable into public policy.
For example, a 41% drop in mortality rates in the United States
would mean saving the lives of hundreds of thousands of Americans every year.