COMMENTARY

A Personal Journey to a Plant-Based Diet

Michelle L. O'Donoghue, MD, MPH

Disclosures

May 17, 2017

Hello. This is Dr Michelle Donoghue, reporting for Medscape. What if I told you that there was a potential treatment for heart disease that might not only stop atherosclerosis in its tracks but also even potentially reverse its course? Why is it that when I say the solution might be in our diets, many of you might just groan and roll your eyes? The truth is that human nature is quite fascinating. Many of us are looking for a quick fix. If there is a pill that can take care of a problem, then that might seem easier at the outset than having to take a hard look at diet and lifestyle.

If we believe in the power of a tiny pill, one can only imagine how much our diets are really shaping our bodies and our health. As you know, most of our patients are constantly complaining about having to take too many medications and are looking for ways to cut down. There have also been several studies that have shown that compliance rates, even in the days early after an acute coronary syndrome, are really quite low with most medications-in fact, shockingly so.[1]

My own journey led me to a plant-based diet about 10 years ago when I faced my own health crisis.

Why might there be so much reluctance to embrace dietary change as an important treatment strategy if not a core part of our treatment strategies? In part, it stems from a fair amount of confusion about what constitutes the optimal diet. This is true, among not only the public but also for us as clinicians. Frequently we are seeing studies that are touting the value of the single food group; one day it's about chocolate and the next day it's about olive oil, again with the idea that a single food might be the answer. I think we all know that the reality is that we would all need to embrace a more inclusive dietary approach.

My own journey led me to a plant-based diet about 10 years ago when I faced my own health crisis and was diagnosed with MS. At the time, I was not really ready to embrace any dietary changes, although I had read about the potential impact of diet on different types of autoimmune conditions. It was along that personal journey that I began to spend more time looking at different diets and lifestyles, and I began to really appreciate how much impact our diets have on our health and the fact that most western diseases are probably a direct consequence of the food we eat.

There are not the same types of corporate sponsors for diet and lifestyle changes as we have for many pharmaceutical compounds.

In my own personal journey, I have not been eating either meat or dairy for nearly 10 years now. I have really come to believe that a plant-based diet is probably the healthiest path forward both for heart disease as well as for most western diseases. I know that many of you out there might object to that particular recommendation and say that an X, Y, Z diet is much better.

The important part of what I am trying to discuss is just the fact that we do not really spend much time as clinicians really thinking about the impact of diet or lifestyle. We say it in passing to our patients, but we do not really give it much thought beyond that. How they could be welcomed if we could have more studies or clinical trials that are really committed to advancing this field forward. Of course, it's challenging, because there are not the same types of corporate sponsors for diet and lifestyle changes as we have for many pharmaceutical compounds. It's also much harder to get patients to participate in these types of randomized designs in order to have a rigorous level of evidence.

Nonetheless, there has been a lot of growing evidence from the work of such pioneers as Dean Ornish, Caldwell Esselstyn, and T. Colin Campbell that has repeatedly demonstrated the impact that diet can have on our health.[2,3,4] I just wanted to leave you with those thoughts for today and get your feedback as well. I know that there are many cardiologists out there who have been recommending plant-based diets for their patients. That is something that I have been doing as well. There are challenges. Once we think about trying to tackle diet during any outpatient or inpatient visits, that is an additional time commitment to think through rather than just telling patients to take a daily pill.

What diet do you recommend for your patients? If you do, what steps do you take to try to help your patients with those decisions? As always, I welcome your input, and I will be looking forward to hearing your comments. Signing off for Medscape, this is Dr Michelle O'Donoghue.

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