What is the Flexitarian Diet?

Written by Dr. Steve Chaney on . Posted in Flexitarian Diet

Is The Flexitarian Diet Good For You And Good For The Planet?

Author: Dr. Stephen Chaney

 

flexitarian diet breaking newsIf you follow U.S News & World Reports, you may have noticed that the Flexitarian Diet was ranked #3, just slightly behind the Mediterranean and DASH diets. You may be scratching your head and wondering: “What is the Flexitarian Diet?” There are so many popular diets these days that it is hard to keep track. It is confusing. To paraphrase the old baseball quote: “You can’t tell the diets without a scorecard.”

Let me provide you with that scorecard. I will describe the Flexitarian Diet and answer two important questions:

  • Is the Flexitarian Diet good for you?
  • Is the Flexitarian Diet good for the planet?

 

What Is The Flexitarian Diet?

flexitarian diet to lose weightThe term “flexitarian” was coined 10 years ago by dietitian Dawn Jackson Blatner in her book, “The Flexitarian Diet: The Mostly Vegetarian Way To Lose Weight, Be Healthier, Prevent Disease and Add Years To Your Life.” Flexitarian is simply a contraction of the phrase “flexible vegetarian.”

Blatner’s premise was two-fold:

  • A vegan diet is very healthy. It is also very restrictive and hard for most people to follow.
  • Allowing small amounts of meat and other animal products in a primarily vegetarian diet would preserve most of the health benefits of a vegan diet. It would also be more flexible and easier to follow.

The Flexitarian Diet has no strict rules or calorie limits. It has no prohibited foods or food groups. It is neither low-carb nor low-fat. It focuses more on what to eat than on what not to eat. It is just based on a few general principles:

  • Eat mostly fruits, vegetables, legumes, and whole grains. In other words, it is a primarily plant-based diet.
  • Focus on protein from plants rather than from animals.
  • Be flexible and incorporate small amounts of meat and animal products in your diet. Flexibility reigns here. The diet recognizes that some people do better with more meat and animal products than others.
  • Eat the least processed, most natural form of foods.
  • Limit added sugars and sweets.

If you have read my book, “Slaying The Food Myths,” you know that this is essentially a semi-vegetarian diet. It is also very similar to the Mediterranean and DASH diets.

 

Is the Flexitarian Diet Good For You?

 

flexitarian diet good for youAs you may have guessed from the title of her book, Dawn Jackson Blatner claimed her diet would help you lose weight, get healthier, reduce your risk of diseases, and add years to your life. You might ask: “Is there any basis for her claims?”

The answer is “Yes,” but the evidence does not come from studies of the Flexitarian Diet. The evidence is based on similarities between the Flexitarian Diet and the semi-vegetarian diet, the Mediterranean diet, and the DASH diet.

I have covered the health benefits of these diets in detail in my book, “Slaying The Food Myths.” In summary, compared to people following the typical American diet or meat-based low-carb diets, people following these 3 diets:

  • Tend to weigh less.
  • Have a lower risk of diabetes and heart disease.
  • Have a lower risk of some forms of cancer.
  • Have lower blood pressure.
  • Have less inflammation.

In addition, a paper has recently been published entitled, “Flexitarian Diets and Health: A review of the Evidence-Based Literature” (EJ Derbyshire, Frontiers In Nutrition, 3: 1-7, 2017). The title is a bit misleading in that the review did not include any studies on Flexitarian Diets (There have been none). Instead, the study reviewed 25 studies of semi-vegetarian diets published between 2000 and 2016 and relied on the fact that the Flexitarian Diet and semi-vegetarian diets are virtually identical.

The study concluded that semi-vegetarian (Flexitarian) diets:

  • Resulted in weight loss.
  • Improved metabolic markers (cholesterol, triglycerides, blood sugar levels).
  • Lowered blood pressure.
  • Reduced the risk of type-2 diabetes.
  • May play a role in the management of Inflammatory bowel disease, such as Crohn’s disease.

In short, there is no direct evidence that the Flexitarian Diet is healthy. However, its similarity to semi-vegetarian, Mediterranean, and DASH diets makes it highly likely that the Flexitarian Diet is very good for you.

 

Is The Flexitarian Diet Good For The Planet?

 

flexitarian diet good for planetThe short answer is “Yes.” More importantly, it is critical for the health of our planet that we adopt a more plant-based diet. Our current diet is not environmentally sustainable.

That assessment is based on four factors; Greenhouse Gas Emissions, Land Use, Water Use, and Population Growth. Here are some fast facts to ponder:

  • Food production currently is responsible for:
    • 40% of global land, and land conversion for food products is the single most important driver of biodiversity loss.
    • Up to 30% of global greenhouse emissions.
    • 70% of freshwater use.
  • The population is expected to increase by 2.5 billion people between now and 2050. That raises two important issues:
    • How are we going to feed those people?
    • How are we going to do it in a sustainable manner?
  • Ruminant animals (cattle and sheep, for example) are the worst offenders when it comes to greenhouse gas emissions. That’s because they not only breathe out CO2, but they also release methane into the atmosphere from fermentation of the food they eat in their rumens. Methane is a potent greenhouse gas, and it persists in the atmosphere 25 times longer than CO2. The single most important thing we can do as individuals to reduce greenhouse gas emissions is to eat less beef and lamb.

Two major studies have published recently that have evaluated the effect of food production on our planet.

The first study (L Aleksandrowicz et al, PLOS One, 11(11): e0165797, 2016) reviewed 63 studies that looked at the effect of dietary patterns on greenhouse gas emissions, land use, and water use. It concluded that moving from our current diet to a more plant-based diet would:

  • Reduce greenhouse gas emissions and land use for food production by 70-80%.
  • Reduce water use for food production by 50%.

The degree to which all these parameters could be reduced was generally proportional to the extent to which animal foods were replaced with plant foods (vegan > semi-vegetarian > Mediterranean).

The second study (W. Willet et al, The Lancet, 393, issue 10170, 447-492, 2019) was the report of the EAT-Lancet Commission on Healthy Diets from Sustainable Food Systems. This Commission convened 30 of the top experts from across the globe to prepare a science-based evaluation of the effect of diet on both health and sustainable food production through the year 2050. The Commission reviewed 356 published studies in preparing their report.

Based on an exhaustive evaluation of the literature on healthy diets and sustainable food production, the Commission recommended something they called the “Planetary Health Diet.” This science-based diet ended up being very close to the Flexitarian (semi-vegetarian) diet.

  • It starts with a vegetarian diet. Vegetables, fruits, beans, nuts, soy foods, and whole grains are the foundation of the diet.
  • It allows the option of adding one serving of dairy a day (It turns out that cows produce much less greenhouse emissions per serving of dairy than per serving of beef. That’s because cows take several years to mature before they can be converted to meat, and they are emitting greenhouse gases the entire time).
  • It allows the option of adding one 3 oz serving of fish or poultry or one egg per day.
  • It allows the option of swapping seafood, poultry, or egg for a 3 oz serving of red meat no more than once a week. If you want a 12 oz steak, that would be no more than once a month.

In other words, it is a less flexible version of the Flexitarian diet. You could also consider it a restrictive version of the Mediterranean or DASH diets.

The Commission concluded:

  • “A diet that includes more plant-based foods and fewer animal source foods is healthy, sustainable, and good for both people and planet.”
  • “Shifting from unhealthy diets to the ‘planetary health diet’ can prevent 11 million premature adult deaths per year and drive the transition toward a sustainable global food system by 2050 that ensures healthy food for all within planetary boundaries.”

 

The Bottom Line

 

The Flexitarian Diet has been in the news lately. You might be asking 3 questions:

  • What is the Flexitarian Diet?
  • Is it good for me?
  • Is it good for the planet?

Here are the answers:

#1: The Flexitarian Diet is a contraction of the phrase “flexible vegetarian.” It is a vegetarian diet that allows small amounts of meat, dairy, and/or eggs. It is virtually identical to what has been called a semi-vegetarian diet for years and is very similar to the Mediterranean and DASH diets.

#2: There is no direct evidence that the Flexitarian diet is healthy. However, its close similarity to the semi-vegetarian, Mediterranean, and DASH diets makes it highly probable that the Flexitarian Diet is a healthy diet. It is likely to be good for you.

#3: When greenhouse gas emissions, land & water use, and population growth are all taken into account, experts have concluded that the only sustainable diet is a semi-vegetarian diet in which meat, dairy, and eggs are severely restricted (details in the article above). You can think of it as a less flexible version of the Flexitarian diet or a very restrictive form of the Mediterranean or DASH diets.

According to these experts, controlling carbon emissions from fossil fuels is not enough. We also must change what we eat if we wish to avoid catastrophic global warming.

For more details read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Latest Article

Are Pregnant Women and Children Dangerously Deficient in Omega-3s?

Posted August 13, 2019 by Dr. Steve Chaney

What Is The Omega-3 Status Of The American Population?

Author: Dr. Stephen Chaney

 

pregnant women omega 3 deficient fishIt is no secret that the American population is deficient in omega-3s. Numerous studies have documented that fact. There are many reasons for Americans’ low intake of omega-3s:

  • The high price of omega-3-rich fish.
  • Concerns about sustainability, heavy metal contamination, and/or PCB contamination of omega-3 rich fish.
  • Misleading headlines claiming that omega-3 supplements are worthless and may even do you harm.

Of course, the questions you are asking are probably?

  • How deficient are we?
  • Does it matter?

The latest study (M Thompson et al, Nutrients, 2019, 11: 177, doi: 10.3390/nu11010177) goes a long way towards answering those important questions.

How Was The Study Done?

scientific studyThis study used data on 45,347 Americans who participated in NHANES surveys between 2003 and 2014. (NHANES or National Health and Nutrition Examination Surveys is a program run by the CDC that is designed to assess the health and nutritional status of adults and children living in the United States).

EPA and DHA intake from foods was based on the average of two 24-hour dietary recall interviews. Trained dietary interviewers collected detailed information on all foods and beverages consumed during the past 24 hours.

To assess EPA and DHA intake from supplements study participants were asked what supplements they had taken in the past 30 days, how many days out of 30 they had taken it, and the amount that was taken on those days.

 

What Is The Omega-3 Status Of The American Population?

 

omega 3 statusThe results of the NHANES surveys were shocking.

In terms of total EPA+DHA intake:

  • EPA+DHA intake across all age groups was lower than recommended.
  • Toddlers (ages 1-5), children (ages 6-11), and adolescents (ages 12-19) had lower EPA+DHA intakes than adults (ages 20-55) and seniors (ages > 55).
  • Women had lower EPA+DHA intakes than men.
  • Pregnant women and women of childbearing age did not differ in their EPA+DHA.
  • Pregnant women consumed less fish than women of childbearing age (perhaps because of concerns about heavy metal contamination).
  • Pregnant women consumed more omega-3 supplements.

In terms of EPA+DHA from supplements:

  • Less than 1% of the American population reported using omega-3 supplements.
  • The one exception was pregnant women. 7.3% of pregnant women reported taking an omega-3 supplement.
  • People taking omega-3 supplements had significantly higher EPA+DHA intake than people not taking omega-3 supplements.
  • This was also true for pregnant women. Those taking omega-3 supplements had higher EPA+DHA intake.

Of course, like any clinical study, it has strengths and weaknesses.

The biggest weakness of this study is that omega-3 intake is based on the participants recall of what they ate. The strengths of the study are its size (45,347 participants) and the fact that its estimate of omega-3 intake is consistent with several smaller studies.

 

Are Americans Deficient In Omega-3s?

 

pregnant women omega 3 deficient questionsNow we are ready to answer the questions I posed at the beginning of this article. Let’s start with the first one: “How deficient are we?”

You would think the answer to that question would be easy. It is not. This study provides a precise estimate of American’s omega-3 intake. The problem is there is no consensus as to how much omega-3s we need. There is no RDA for omega-3s.

There are, in fact, three sets of guidelines for how much omega-3s we need, and they disagree.

  • The World Health Organization (WHO) recommendations for EPA+DHA intake range from 100-150 mg/day at ages 2-4 years to 200-500 mg/day for adults.
  • The US National Institute of Medicine (IOM) recommendations for EPA+DHA intake range from 70 mg/day for ages 1-3 to 110 mg/day for adult females and 160 mg/day for adult males.
  • As if that weren’t confusing enough, an international group of experts recently convened for a “Workshop on the Essentiality of and Recommended Dietary Intakes for Omega-6 and Omega-3 Fatty Acids” (Workshop). This group recommended an EPA+DHA intake of 440 mg/day for adults and 520 mg/day for pregnant and lactating women.

Using these recommendations as guidelines, this study reported that:

  • EPA+DHA intake for children 1-5 years old was ~25% of the WHO recommendations and ~40% of IOM recommendations.
  • EPA+DHA intake for children 6-11 years old was ~27% of WHO recommendations and ~40% of IOM recommendations.
  • EPA+DHA intake for adolescents 12-19 years old was ~50% of IOM recommendations (The WHO did not have a separate category for adolescents.
  • EPA+DHA intake for adults 20-55 years old was ~30% of WHO recommendations, and ~65% of IOM recommendations.
  • EPA+DHA intake for seniors >55 years old was 38% of WHO recommendations and 82% of IOM recommendations.
  • EPA+DHA intake for pregnant women was ~20% of Workshop recommendations (The WHO and IOM did not have a separate category for pregnant women).

While the percentage deficiency varied according to the EPA+DHA guidelines used, it is clear from these results that Americans of all age groups are not getting enough omega-3s from their diet.

The authors concluded: “We found omega-3 intakes across all age groups was lower than recommended amounts.”

 

Are Pregnant Women and Young Children Dangerously Deficient In Omega-3s?

 

danger symbolWhile the authors concluded that all age groups were deficient in omega-3s, they were particularly concerned about the omega-3 deficiencies in pregnant women and young children.

The authors said: “Taken together, these findings demonstrate that low omega-3 fatty acid intake is consistent among the US population and could increase the risk for adverse health outcomes, particularly in vulnerable populations (e.g., young children and pregnant women).”

In part, the focus on young children and pregnant women was based on their very low omega-3 intake. With intakes at 20-27% of recommended levels, I would consider these groups to be dangerously deficient in omega-3s.

pregnant women omega 3 deficient pregnancyHowever, the focus on young children and pregnant women was also based on the seriousness of the adverse health outcomes associated with low omega-3 intake in these population groups. This answers the second question I posed at the beginning of this article: “Does it matter?”

According to the authors low intake of EPA and DHA during pregnancy and early childhood is associated with maternal depression, pre-term births, low birth-weight babies, increased risk of allergies and asthma, problems with learning and cognition, and other neurocognitive outcomes.

None of these associations between low omega-3 intake and adverse health outcomes have been proven beyond a shadow of a doubt, but the evidence is strong enough that we should be alarmed by the very low omega-3 intake in pregnant women and young children.

There is, however, a simple solution. The authors of this study concluded: “Individuals taking EPA/DHA containing supplements had significantly elevated intake compared to individuals not taking omega-3 fatty acid-containing supplements or not reporting any supplement use.”

omega 3 supplementsThey went on to say: “As supplement use is associated with increased omega-3 intake, supplementation could be an important source of EPA/DHA, particularly for pregnant women given their lower fish consumption compared to non-pregnant women of childbearing age.”

I agree. Given the low omega-3 intake in these population group and current guidelines for omega-3 intake. I recommend:

  • Pregnant & lactating women (and women of childbearing age who might become pregnant) take an omega-3 supplement providing around 520 mg of EPA+DHA/day.
  • Young children (ages 1-5) take an omega-3 supplement providing around 100 mg of DHA/day.

Of course, this study also confirmed that Americans of all age groups are not getting enough omega-3s from their diet, and low omega-3 intake may increase the risk of heart disease. Furthermore, recent studies have shown that high purity omega-3 supplements may reduce heart disease risk.

You will find my recommendations for omega-3 supplementation for adults in a previous issue of “Health Tips From the Professor.”

 

The Bottom Line

 

The largest study to date (45,347 participants) measured omega-3 intake for Americans of all ages and compared that to current recommendations for omega-3 intake.

The authors of the study concluded:

  • “We found omega-3 intakes across all age groups was lower than recommended amounts.”
  • “Low omega-3 fatty acid intake … could increase the risk for adverse health outcomes, particularly in vulnerable populations (e.g., young children and pregnant women.”

In part, the focus on young children and pregnant women was based on their very low omega-3 intake. With intakes at 20-27% of recommended levels, I would consider these groups to be dangerously deficient in omega-3s.

However, the focus on young children and pregnant women was also based on the seriousness of the adverse health outcomes associated with low omega-3 intake in these population groups.

  • According to the authors low intake of EPA and DHA during pregnancy and early childhood is associated with maternal depression, pre-term births, low birth-weight babies, increased risk of allergies and asthma, problems with learning and cognition, and other neurocognitive outcomes.

There is, however, a simple solution. The authors of this study also concluded:

  • “Individuals taking EPA/DHA containing supplements had significantly elevated intake compared to individuals not taking omega-3 fatty acid-containing supplements or not reporting any supplement use.”
  • “As supplement use is associated with increased omega-3 intake, supplementation could be an important source of EPA/DHA, particularly for pregnant women given their lower fish consumption compared to non-pregnant women of childbearing age.”

For more details on the study and my recommendations for omega-3 supplementation, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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