HEQ speaks to Dr Sean Owens from Plant-Based Doctors Ireland about why a plant-based diet and nutrition should be considered a key component in medical education and practice to reduce the burden of chronic disease.
From safeguarding our health to reducing our impact on the planet, more and more of us are choosing to adopt a plant-based diet. In the UK alone, it is estimated that a quarter of the population no longer consume meat, or eat much less, with key drivers including increased commercial investment in plant-based products and awareness of the environmental, animal and health implications associated with the meat and dairy industries. Sales of alternative, non-dairy milks have also garnered a market worth an estimated £400m per year.
Reducing our intake of animal products and highly processed foods, and incorporating more whole foods into our diet, has been shown to dramatically reduce the risk of developing non-communicable diseases such as cancer, cardiovascular disease, and type two diabetes. With this in mind, a growing body of healthcare professionals are advocating the benefits of plant-based nutrition as a preventative measure to reduce the growing burden of chronic disease.
HEQ spoke to Dr Sean Owens who is a GP and co-founder of Plant-Based Doctors Ireland, an organisation dedicated to sharing knowledge about the benefits of a plant-based diet. Their aim is that by sharing evidence-based resources and growing their network, fellow healthcare professionals will feel more equipped to discuss plant-based nutrition with their patients and empower them to make more informed choices about how food can impact their health.
How did Plant-Based Doctors Ireland c20ome to be founded? What are your key goals?
Since Plant-Based Doctors Ireland was founded about four years ago, our group has grown from about five or six people to 30 healthcare professionals, all of whom are from different medical disciplines and backgrounds including neurology, obstetrics, and general practice. Many of us have looked at the literature related to diet and health, as well as diet and disease, and agree that this is a topic which is not really covered as part of medical education and thus does not typically feature within our consultations. As an organisation, we aim to be a source of education for healthcare professionals who want to learn more about the benefits of plant-based nutrition and work with policymakers and industry to highlight the health benefits that a whole foods diet can have. So far, we have organised two plant-based nutrition conferences in Ireland, and these were very well attended by GPs and other healthcare professionals, they are a great way of bridging the gap.
Plant-Based Doctors Ireland is really one of a kind in terms of doctors and other healthcare professionals speaking about this issue. We are a fairly small organisation but on our side is an overwhelming evidence base for the sustainability point of view and from a health point of view. We know that we need to reduce climate-damaging carbon emissions and plant-based diets have the lowest carbon footprint and the least upstream and downstream waste. It is also a diet with negligible antibiotic footprint and antimicrobial resistance, as we know, is a challenge in its own right. There is nothing really controversial about a plant-based diet, we are just a group of people advocating for it.
What inspired you to look at the power of food as medicine?
Some people adopt a plant-based diet for ethical reasons, a personal health issue, or because of a family illness for instance. I have been looking at evidence-based medicine for a while and I think one key problem we see quite often is overdiagnosis. There is a misconception that we live in a fictional world of limitless resources and negligible waste and of course, we know that with the plastics in the ocean and the detrimental carbon emissions that is simply not true. There is an upstream and a downstream effect to everything.
What we are saying as an organisation is not controversial. As GPs, we should be talking about lifestyle with our patients but at present, we are not really equipped with the tools to support them, nor can we point them in the direction of useful tools. We are also hugely limited by time constraints. Additionally, there is a poor food environment where making healthy choices is difficult or not necessarily glamorous. In my mind, this is an unmet need.
What effect does our diet have on both our gut health and overall wellbeing? Can you give me an overview of the various functions that are influenced by gut microbiome?
There was an Irish physician called Denis Burkitt from Fermanagh who is known most famously for Burkitt’s lymphoma, but also for his bestselling book Don’t Forget Fibre in your Diet, which advocated the importance of fibre in the diet for reducing the risk of chronic disease. After training as a doctor in Edinburgh he went to work in Uganda and noticed that, due to the dietary variations, diseases that were common in the west were rarely presented by his patients in Africa.
These days we have the Human Microbiome Project in America which is a leading institution for all things relating to the microbiome. To sum up, their overarching motto is that the number one predictor of a healthy gut is the diversity of plants. We should be aiming to have a variety of 30 different plants per week. We know that a healthy gut drives dementia prevention, cancer prevention and is really important for our mental wellbeing.
In terms of immune function, two papers of interest have been printed, one in BMJ Nutrition where 3000 frontline healthcare workers were asked to monitor their diets; those who ate more plants not only reported fewer COVID cases, but if they had contracted COVID, they had much milder symptoms compared to those who ate fewer plant-based meals. A similar paper was collated by Tim Spector and his colleagues whereby half a million people self-reported their diet and COVID status and those who ate more plants had a better immune system and if they had contracted COVID, their symptoms were much milder. Incorporating a variety of whole foods into your diet is a nice intervention for a healthier lifestyle.
Prescribing a plant-based diet can seem quite novel and conventionally GPs may not necessarily recommend or look at changes in nutrition or lifestyle, what are the key challenges facing the wider adoption of plant-based diets or a more holistic-based approach to health by medical professionals?
Firstly, I would challenge that, and this is something I hear quite frequently, that prescribing a plant-based diet is novel or alternative, but it is really not. Suggesting people eat more plants is probably one of the least controversial things you can say within medicine alongside drinking less alcohol and not smoking. The number one cause of death in Ireland is cardiovascular disease which includes strokes and heart attacks. According to the European Society of Cardiology (ESC), the primary prevention of heart disease, alongside stress management, stopping smoking and drinking less alcohol, is diet. They recently updated their guidelines and advised people eat more plants and less animal products. Furthermore, according to the global burden of diseases survey, diet is the number one driver of chronic disease and mortality worldwide, both under nutrition and over nutrition.
In the west, of course, it is a paradox, where we eat too much but do not consume enough nutrients. Less than 10% of our diet should contain saturated fats which are only really found in animal products and processed foods. The key thing here is that all the level evidence in this is level one or grade A, and what people maybe do not realise, outside of healthcare, is that sometimes we make decisions based on weak evidence, and there is a range of reasons for that. So, when we have such a strong signal for prevention of our number one cause of death then we should absolutely be bringing it into consultations. So, it is not really novel. It is just not the status quo.
From a carbon-policy level, our diets must align with this, especially now as the situation is becoming more serious. However, the agri-food lobby is incredibly powerful, and we might be lucky to get a meeting with a minister once a year. In Ireland, they are writing the 2030 agri-food strategy and our cultural research agency is heavily funded by the dairy industry so there are huge conflicts there.
There is a plethora of information available, sometimes contradictory. For people looking to improve their health, how can they make an informed decision about how to eat a balanced plant-based diet?
In veracity polls, doctors and nurses are cited as some of the most trusted professions so it is really beneficial to glean information from them. If you have an appointment with your doctor, nurse, or dietician these can be teachable moments and a great opportunity to ask questions.
At Plant-Based Doctors Ireland, a key aim is to discuss curriculum and inform GPs about the evidence so they can take this message on and start discussing plant-based diets within their consultations. We do not expect everyone to become plant-based, that would not be realistic, but if we can increase the amount and variety of plants in peoples’ diet, this could make a vast improvement to patients’ overall health, as well as reduce waiting times and pressure on hospitals.
Dr Sean Owens
Plant Based Doctors Ireland
This article is from issue 20 of Health Europa Quarterly. Click here to get your free subscription today.