Plant-Strong KIDS

Check out this latest article from the Physician’s Committee for Responsible Medicine:


Vegetarian Diets for Children: Right from the Start

Eating habits are set in early childhood. Choosing a vegetarian diet can give your child—and your whole family—the opportunity to learn to enjoy a variety of wonderful, nutritious foods.

Children raised on fruits, vegetables, whole grains, and legumes grow up to be slimmer and healthier and even live longer than their meat-eating friends. It is much easier to build a nutritious diet from plant foods than from animal products, which contain saturated fat, cholesterol, and other substances that growing children can do without. As for essential nutrients, plant foods are the preferred source because they provide sufficient energy and protein packaged with other health-promoting nutrients such as fiber, antioxidant vitamins, minerals, and phytochemicals.

Complete Nutrition for Children

Vegetarian diets provide excellent nutrition for all stages of childhood, from birth through adolescence. Of course, an infant’s nutritional needs are best met by his or her mother’s breast milk. It’s nature’s way of boosting the baby’s immunity as well as his or her psychological well-being.

Doctors recommend introducing solid foods in the middle of the first year of life. The best weaning foods are soft plant foods such as ground, cooked cereals, mashed fruits, and well-cooked vegetables. Given a chance, toddlers and young children usually enjoy a wide variety fruits, vegetables, grains, and legumes—even more so if they are involved in the preparation. School-aged children are often curious about where their food comes from and delight in learning how to cook, visiting farmers’ markets, and gardening. Adolescents raised on a vegetarian diet often find they have an easy time maintaining a healthy weight and have fewer problems with acne, allergies, and gastrointestinal problems than their meat-eating peers.

Some studies suggest that the growth of vegetarian children is more gradual than that of non-vegetarians—in other words, vegetarian children grow a bit more slowly at first, but they catch up later on. Final heights and weights for vegetarian children are comparable to those of meat-eating children. Interestingly, breast-fed babies also grow more slowly than bottle-fed babies. Somewhat less rapid growth during the early years is thought to decrease disease risk later in life.

On the other hand, diets rich in animal protein, found in meat, eggs, and dairy products, appear to reduce the age of puberty, as shown in a 2000 study from the Harvard School of Public Health, which found that girls who consumed higher levels of animal protein compared to vegetable protein between 3 and 8 years of age went through menarche earlier. Nature may well have designed the human body to grow up more gradually, to reach puberty later, and to last longer than most people raised on omnivorous diets experience.

In a 1980 study in Boston, researchers measured the IQs of vegetarian children. Some of the children were following a macrobiotic diet, a few were Seventh-day Adventists (many of whom follow a plant-based diet), and the rest were from families that had simply decided to go vegetarian. On intelligence testing, the kids were considerably above average, with a mean IQ of 116. Now, the diet may have had nothing to do with their intelligence. Rather, these vegetarian families were better educated than the average meat-eating family, and it is probably the parental education, rather than a dietary effect, that was reflected in their children’s measured intelligence. However, this study should reassure vegetarian parents who wonder whether animal products contain something necessary for brain development. Clearly, they do not.

Perhaps the most important consideration for feeding children is this: Lifelong dietary habits are established at a young age. Children who acquire a taste for chicken nuggets, roast beef, and French fries today are the cancer patients, heart patients, and diabetes patients of tomorrow. Children who are raised on whole grains, vegetables, fruits, and legumes will have a lower risk of heart disease, stroke, diabetes, cancer, and many obesity-related illnesses compared to their counterparts raised on the average American diet. Because of this, they will also tend to live years longer.

Nutrient Needs

The complex carbohydrates found in whole grains, beans, and vegetables provide the ideal energy to fuel a child’s busy life. Cultivating a taste for brown rice, whole wheat breads and pastas, rolled oats, and corn, as well as the less common grains barley, quinoa, millet, and others, will boost the fiber and nutrient content of a child’s diet. In addition, steering children away from sweets, sugary drinks, highly processed baked products, and overly sweet cereals will help them avoid overeating and gaining unwanted weight.

Naturally, children need protein to grow, but they do not need high-protein, animal-based foods. Many people are unaware that a varied menu of grains, beans, vegetables, and fruits supplies plenty of protein. The “protein deficiencies” that our parents worried about in impoverished countries were the result of starvation or diets restricted to very few food items. Protein deficiency is extremely unlikely on a diet drawn from a variety of plant foods.

Very young children may need a slightly higher fat intake than adults do. Healthier fat sources include soybean products, avocados, and nut butters. Soy “hot dogs,” peanut butter and jelly sandwiches, seasoned veggie burgers, and avocado chunks in salads, for example, are very well accepted. However, the need for fat in the diet should not be taken too far. American children often have fatty streaks in the arteries—the beginnings of heart disease—before they finish high school. In contrast, Japanese children traditionally grew up on diets much lower in fat and subsequently had fewer problems with diabetes, heart disease, obesity, and other chronic diseases.

Parents will want to make sure their child’s diet includes a regular source of vitamin B12, which is needed for healthy blood and nerve function. Deficiencies are rare, but when they happen, they can be a bit hard to detect. Vitamin B12 is plentiful in many commercial cereals, fortified soy and rice milks, and nutritional yeast. Check the labels for the words cyanocobalamin or B12. Children who do not eat these supplemented products should take a B12 supplement of 3 or more micrograms per day. Common children’s vitamins contain more than enough B12. Spirulina and seaweed are not reliable sources of vitamin B12.

The body also requires vitamin D, which children and parents are happy to know can be obtained by simply playing outdoors in the sun. Fifteen to twenty minutes of daily sunlight on the hands and face is enough sun exposure for the body’s skin cells to produce the necessary vitamin D. Children in latitudes with diminished sunlight may need the vitamin D found in multivitamin supplements or fortified non-dairy milks.

For calcium, beans, dried figs, sweet potatoes, and green vegetables, including collards, kale, broccoli, mustard greens, and Swiss chard, are excellent sources. Fortified soymilk and rice milk and calcium-fortified juices provide a great deal of calcium as well. In addition, eating lots of fruits and vegetables, excluding animal proteins, and limiting salt intake all help the body retain calcium.

Growing children also need iron found in a variety of beans and green, leafy vegetables. The vitamin C in vegetables and fruits enhances iron absorption, especially when eaten together with an iron-rich food. One example is an iron-rich bean burrito eaten with vitamin C-rich tomato salsa. Few people are aware that cow’s milk is very low in iron and can induce a mild, chronic blood loss in the digestive tract, which can reduce iron and cause an increased risk of anemia.


Again, the best food for newborns is breast milk. When breast-feeding is not possible, commercial soy formulas are nutritionally adequate. There is no need for infants to be raised on cow’s milk formulas. In addition to containing colic-inducing proteins that bother many children, cow’s milk is a common cause of allergies. Unfortunately, immune responses to milk proteins are implicated in insulin-dependent diabetes and even in Sudden Infant Death Syndrome. Soy formulas are commonly used in all hospital nurseries, although they can occasionally be allergenic as well. Soymilk sold in grocery stores for adults is not the same as soy baby formula, however, and is not adequate for infants.

Infants do not need any nourishment other than breast milk or soy formula for the first half year of life, and they should continue to receive breast milk or formula at least throughout their first 12 months. Breast-fed infants also need about two hours a week of sun exposure to make vitamin D—a great motivator for Mom to get back into a walking routine. Some infants, especially those who are dark-skinned or who live in cloudy climates, may not make adequate amounts of vitamin D. In these cases, vitamin D supplements may be necessary.

At about 5 to 6 months of age, or when baby’s weight has doubled, other foods can be added to the diet. Pediatricians often recommend starting with an iron-fortified cereal because, at about 4 to 6 months, infants’ iron stores, which are naturally high at birth, begin to decrease. Add one simple new food at a time, at one- to two-week intervals.

The following guidelines provide a flexible plan for adding foods to your baby’s diet:

5 to 6 Months

  • Introduce iron-fortified infant cereal. Try rice cereal first, mixed with a little breast milk or soy formula, since it is the least likely to cause allergies. Then, offer oat or barley cereals. Most pediatricians recommend holding off on introducing wheat until the child is at least 8 months old, as it tends to be more allergenic.

6 to 8 Months

  • Introduce vegetables. Potatoes, green beans, carrots, and peas are all good choices. They should be thoroughly cooked and mashed.
  • Introduce fruits. Try mashed bananas, avocados, or strained peaches, or applesauce.
  • Introduce breads. By 8 months of age, most babies can eat crackers, bread, and dry cereal.
  • Introduce protein-rich foods. Also by about 8 months, infants can begin to eat higher protein foods like tofu or beans that are well cooked and mashed.

Children and Teens
Children have high calorie and nutrient needs, but their stomachs are small. Offer your child frequent snacks, and include some less “bulky” foods like refined grains and fruit juices. Do limit juices, however, since children may fill up on them, preferring their sweetness to other foods.

Teenagers often have high energy needs and busy schedules. Keeping delicious, healthy snack choices on hand and guiding teens to make lower-fat selections when eating out will help to steer them away from dining pitfalls that often cause weight gain and health problems for adolescents. Caloric needs vary from child to child. The following guidelines are general ones.

Food Groups

Whole Grains

  • Whole grains include breads, hot and cold cereals, pasta, cooked grains (such as rice and barley), and crackers.
  • One serving equals 1/2 cup of pasta, grains, or cooked cereal, 3/4 to 1 cup of ready-to-eat cereal, 1/2 bun or bagel, or 1 slice of bread.


  • Dark green vegetables” include broccoli, kale, spinach, collard greens, turnip greens, mustard greens, beet greens, bok choy, and Swiss chard.
  • Other vegetables” refers to all other vegetables, fresh or frozen, raw or cooked.
  • One serving of vegetables equals 1/2 cup cooked or 1 cup raw (unless an amount is specified).

Legumes, Nuts, Seeds, and Non-Dairy Milks

  • Legumes include any cooked bean such as pinto, kidney, lentils, split peas, black-eyed peas, navy beans, and chickpeas, as well as soy products, such as tofu, veggie burgers, soy “hot dogs” or sandwich slices, and tempeh.
  • One serving of legumes equals 1/2 cup of beans, tofu, or other item (unless an amount is specified).
  • Non-dairy milks include breast milk and soy formula for infants and toddlers, and rice-, soy-, and other vegetable-based milks for children at least 1 year of age. Choose fortified soymilk, such as Westsoy Plus, Enriched VitaSoy, or Edensoy, whenever possible, or use other fortified vegetable-based milks.
  • One serving of non-dairy milk equals 1 cup.
  • Nuts include whole or chopped nuts, nut butters, whole seeds, and seed butters.
  • One to two servings of nuts may be included in a healthy diet, but they are optional. One serving of nuts or nut butters equals 1 tablespoon.


  • Fruits include all fruits, fresh or frozen, raw or cooked, and fruit juices.
  • One serving equals 1/2 cup cooked fruit, 1/2 cup fruit juice, 1/4 cup dried fruit, or 1 piece of fruit (unless an amount is specified.)

Daily Meal Planning for Children and Teens

1- to 4-Year-Olds
Whole Grains, Breads, Cereals: 4 servings
Vegetables: 2-4 tablespoons dark green vegetables , 1/4 to 1/2 cup other vegetables
Legumes, Nuts, Seeds, Non-Dairy Milks: 1/4 to 1/2 cup legumes, 3 servings breast milk, soy formula, soymilk, or other non-dairy milk
Fruits: 3/4 to 1 1/2 cups

5- to 6-Year-Olds
Whole Grains, Breads, Cereals: 6 servings
Vegetables: 1/4 cup dark green vegetables , 1/4 to 1/2 cup other vegetables
Legumes, Nuts, Seeds, Non-Dairy Milks: 1/2 to 1 cup legumes , 3 servings soymilk or other non-dairy milk
Fruits: 1 to 2 cups

7- to 12-Year-Olds
Whole Grains, Breads, Cereals: 7 servings
Vegetables: 1 serving dark green vegetables , 3 servings other vegetables
Legumes, Nuts, Seeds, Non-Dairy Milks:2 servings legumes , 3 servings soymilk or other non-dairy milk
Fruits: 3 servings

13- to 19-Year-Olds
Whole Grains, Breads, Cereals: 10 servings
Vegetables: 1-2 servings dark green vegetables , 3 servings other vegetables
Legumes, Nuts, Seeds, Non-Dairy Milks: 3 servings legumes , 2-3 servings soymilk or other non-dairy milk
Fruits: 4 servings
Be sure to include a source of vitamin B12, such as any typical children’s multivitamin or vitamin-fortified cereals or soymilk.

Sample Menus

Ages 1 to 4 years
Breakfast: Oatmeal with applesauce, calcium-fortified orange juice
Lunch: Hummus (chickpea and sesame seed butter spread) on crackers, banana, soymilk, carrot sticks
Dinner: Corn, mashed sweet potatoes, steamed kale, soymilk
Snacks: Peach, Cheerios, soymilk

Ages 4 to 6 years
Breakfast: Whole grain cereal with banana and soymilk, orange wedges
Lunch: Tofu-Egg Salad Sandwich, apple juice, carrot sticks, Oatmeal Cookie
Dinner: Baked beans with soy “hot dog” pieces, baked potato, spinach, soymilk, fruit salad
Snacks: Trail mix, graham crackers, soymilk

Ages 7 to 12 years
Breakfast: Strawberry-Banana Smoothie, toast with almond butter, calcium-fortified orange juice
Lunch: Hearty Chili Mac, green salad, bread
Dinner: Steamed broccoli with nutritional yeast, steamed carrots, Oven Friesapple crisp, soymilk
Snacks: Popcorn, figs, soy “ice cream”

Ages 13 to 19 years
Breakfast: Bagel with apple butter, banana, calcium-fortified orange juice
Lunch: Bean burrito with lettuce, tomato, and guacamole, rice, baked tortilla chips and salsa
Dinner: Braised broccoli, carrots, yellow squash, and mushrooms, Peanut Butter Spaghetti, cucumber salad, soymilk
Snacks: Hummus and baby carrots, fruit smoothie, Luna or Clif Bar


Strawberry-Banana Smoothie
Hearty Chili Mac
Bean Burrito
Oatmeal Cookies
Tofu-Egg Salad Sandwich
Apple Crisp
Peanut Butter Spaghetti
Oven Fries

More Information on Healthy Eating for Children — look for Healthy Eating for Life for Children by PCRM’s expert panel of doctors and nutritionists in bookstores — order your free copy of Parents’ Guide to Building Better Bones — get information on how to improve food offerings in public and private schools

Coming Soon…Healthy Food Instead of Drugs

Coming soon to a doctor’s office near you: Prescriptions for vegetables


(Highwaystarz-Photography/Getty Images/iStockphoto)
By Cara Rosenbloom August 4
Eating well can help prevent chronic conditions including heart disease, diabetes and obesity. So why aren’t more doctors prescribing broccoli and flaxseed?Despite the wealth of research linking nutritious diets to disease prevention, the importance of food receives little attention in most physicians’ practices. But a shift is slowly happening, doctors say. More are recognizing the link between food and health and are advancing their nutrition knowledge to provide better patient care.

Nutrition education in medical school

The National Academies of Science recommend a minimum of 25 hours of nutrition education for medical students, but a 2015 study showed that 71 percent of medical schools failed to meet that goal. Despite this lack of formal nutrition education, doctors remain a trusted source of nutrition information for patients. But just 14 percent of physicians say they feel adequately trained in nutrition counseling.

“Food touches our patients in so many conditions — diabetes, celiac disease, food allergies, high blood pressure — we need more education about food and nutrition so we can be better physicians,” says Timothy Harlan, a practicing internist and associate dean for clinical services at Tulane University School of Medicine.

Harlan is part of the groundswell toward educating physicians about nutrition. He’s also executive director of Tulane’s Goldring Center for Culinary Medicine, the first dedicated teaching kitchen implemented at a medical school. Yes, you read that right: It’s an actual kitchen where medical students learn to cook and provide nutrition advice to patients.

 “We translate courses like anatomy, physiology and biochemistry into practical conversations about food that doctors will have with patients in exam rooms. We teach doctors about food so they can teach the community,” Harlan says.

The inclusion of nutrition education in medical schools is a growing trend. The Goldring Center has already licensed its culinary nutrition program to 25 other medical schools and six residency programs, and Harlan says he talks to a few medical schools or residency programs every week about what Tulane is doing.

There’s even a bill before Congress to try to enforce nutrition education for physicians. The Enrich Act hopes to use grants to encourage the development and expansion of nutrition and physical activity curriculums.

After medical school

For doctors who missed the culinary curriculum in medical school, there are now opportunities for nutrition-based residencies, fellowships, conferences and online continuing medical education (CME) courses.

“The few hours of nutrition that are taught in medical school are often nutritional biochemistry, which has nothing to do with food. Those scientific teachings can’t help doctors answer practical patient questions, like ‘Which fat is best — butter, margarine or oil?’ ” says Victoria Maizes, executive director of the University of Arizona Center for Integrative Medicine, which offers nutrition courses both in medical school and as post-graduate education.

The center’s most popular CME course focuses on the “anti-inflammatory diet,” Maizes says. Culinary-minded physicians can also attend the center’s Nutrition & Health Conference, a combination of lectures and tastings that focus on everything from gluten-free diets to sustainable food systems.

“When a doctor learns about a healthy lifestyle, they are more successful at motivating their patients to be healthier, too,” Maizes says.

What about dietitians?

Seventy percent of Americans say registered dietitians are their most trusted source for nutrition information. So why do doctors need to know more about nutrition?

“We’re not trying to turn physicians into dietitians,” Harlan says. “But many people don’t get to see a dietitian as easily as a doctor. So the physician should have some basic nutrition knowledge.”

He and others in the field have said that when doctors learn more about nutrition, they are better at integrating dietitians into the health-care team and are more likely to refer patients to a dietitian as readily as they would to a cardiologist or endocrinologist. It creates a more effective medical plan, they say, where patients are taught about using food as prevention or treatment before turning to medications or surgical intervention.

Robert Graham,co-founder of Fare Wellness in New York, is one of a small but growing number of doctors who have embraced the concept of a “farmacy.” He provides patients with nutritional prescriptions — such as “fruits and vegetables 5-9x/day” — that they can take to the farmers market or grocery store.

“People are looking for a prescription from their doctor, so why not make it have some impact?” Graham says. “My prescription depends on their condition, but the aim is to get people towards a whole-food, plant-based diet, because the more plants you eat, the longer you live.”

Graham says patients are more likely to fill a prescription than to follow spoken advice. And his success rate? “One-third of my patients contemplate the advice; one-third take action and make steady dietary changes; the final third want deeper details and are referred to a dietitian for nutrition counseling.”

With better eating habits, Graham says, his patients see measurable changes in their health, such as lower blood pressure and reduced cholesterol. He wrote in an email: “Doctors need to take off the lab coats and put on chef jackets; put down prescription pads and pick up recipe books; slow down and learn how to cook so that we can prescribe cooking and eating real food to our patients.”

Registered dietitian Cara Rosenbloom is president of Words to Eat By, a nutrition communications company specializing in writing, nutrition education and recipe development. She is the co-author of “Nourish: Whole Food Recipes featuring Seeds, Nuts and Beans.”

High Blood Pressure?

Any illness that can be treated by diet alone should be treated by no other means.

Drugs for High Blood Pressure Don’t Compare to the Rice Diet

During his career at Duke, Dr. Walter Kempner treated more than 18,000 patients with his rice diet. The diet was originally designed as a treatment for kidney failure and out-of-control high blood pressure at a time when these diagnoses were essentially a death sentence. Patients who would have died in all other hospitals had a reasonable chance for survival if they came under Kempner’s care.

Kempner was criticized for his lack of controls, meaning that when patients came to him he didn’t randomly allocate half to his rice treatment and put the other half on conventional therapy. Kempner argued that the patients each acted as their own controls. For example, one patient, after the medical profession threw everything they had at him, still had blood pressure as high as 220 over 160. A normal blood pressure is considered to be around 120 over 80—which is where Kempner’s rice diet took him. Had the patient not been given the rice diet, his pressures might have been even lower, though: zero over zero, because he’d likely be dead. The “control group” in Kempner’s day had a survival expectancy estimated at six months. To randomize patients to conventional care would be to randomize them to their deaths.

Beginning in the late 1950s, drugs became available that effectively reduced blood pressure and hypertension, leading to a decreased demand for the rice diet. What conclusions can we draw from this all-but-forgotten therapy for hypertension? Not only was it the first effective therapy for high blood pressure, it may be equal to or more effective than our current multi-drug treatments.

This causes one to speculate on the current practice of placing patients on one drug, then another, and perhaps a third until the blood pressure is controlled, with lip-service advocacy of a moderate reduction in dietary sodium, fat, and protein intake. At the same time, the impressive effectiveness of the rice-fruit diet, which is able to quickly stop the leakage from our arteries, lower increased intracranial pressure, reduce heart size, reverse the ECG changes, reverse heart failure, reduce weight, and markedly improve diabetes, is ignored.

Today many people follow a plant-based diet as a choice, which is similar to what Kempner was often able to transition people to. After their high blood pressure was cured by the rice diet, patients were often able to gradually transition to a less strenuous dietary regime without adding medications and with no return of the elevated blood pressure.

If the Kempner sequence of a strictest of strict plant-based diets to a saner plant-based type diet offers the quickest and best approach to effective therapy, why isn’t it still in greater use? The powerful role of the pharmaceutical industry in steering medical care away from dietary treatment to medications should be noted. Who profits from dietary treatment? Who provides the support for investigation and the funds for clinical trials? There is more to overcome than just the patient’s reluctance to change their diet.

What Kempner wrote to a patient in 1954 is as true then as it is now 60 years later:

“[D]rugs can be very useful if properly employed and used in conjunction with intensive dietary treatment. However, the real difficulty is that Hypertensive Vascular Disease with all its possible complications—heart disease, kidney disease, stroke, blindness—is still treated very casually, a striking contrast to the attitude toward cancer. Since patients, physicians, and the chemical industry prefer the taking, prescribing, and selling of drugs to a treatment inconvenient to patient and physician and of no benefit to the pharmaceutical industry, the mortality figures for these diseases are still rather appalling.”

Despite hundreds of drugs on the market now, high blood pressure remains the #1 cause of death and disability in the world, killing off nine million people a year. A whole food, plant-based diet treats the underlying cause. As Dr. Kempner explained to a patient, “If you should find a heap of manure on your living room floor, I do not recommend that you go buy some Air-Wick [an air freshener] and perfume. I recommend that you get a bucket and shovel and a strong scrubbing brush. Then, when your living room floor is clean again, why, you may certainly apply some Air-Wick if you wish.”

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of DeathMore Than an Apple a DayFrom Table to Able: Combating Disabling Diseases with Food, and Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet.

Stanford Medical Professor Recommends We Eat Less Meat… Here’s Why!

5 Questions: Randall Stafford advocates a plant-based diet

In a letter to JAMA, the preventive-medicine expert addresses the failure of the newest USDA Dietary Guidelines to articulate the health and climate benefits of a low-meat diet.

JUL 122016

Nuts and lentils

Plant-based sources of protein, like lentils and nuts, are alternatives to meat.

Eating meat is bad for our health and bad for our planet, according to Randall Stafford, MD, PhD, professor of medicine at the Stanford Prevention Research Center.

Studies show that vegetarians and vegans have lower rates of heart disease and cancer, and that nearly 15 percent of all planet-warming greenhouse gases comes from raising cattle, pigs, poultry and other animals. The upshot is that the estimated greenhouse gas emissions of a vegetarian diet are half those of a meat-based diet. To improve public health and combat climate change, China recently released national dietary guidelines whose goal is to cut national meat consumption in half by 2030.

Yet, here in the United States, where we eat 80 percent more meat than do people in China, guidelines recently released by the federal Department of Agriculture don’t recommend that we eat less meat. For good sources of protein, the new guidelines list meat, eggs and dairy first, with no suggestion that nuts, seeds and legumes could be a better choice.

Disappointed by this aspect of the USDA Dietary Guidelines for Americans 2015-2020, Stafford wrote a letter to the editor of JAMA that was published July 12. “The health benefits of specific components of plants have been documented, as have the harms associated with constituents largely unique to meat,” he wrote. “Vegetarian diets have been associated with a reduction in cardiovascular disease mortality by as much as 29 percent and cancer incidence by 18 percent.”

In a recent interview, writer Jennie Dusheck discussed the letter with Stafford, director of the SPRC’s Program on Prevention Outcomes and Practices.

Randall Stafford

Randall Stafford

Q: What initially prompted you to write your letter?

Stafford: These guidelines have been long-awaited and there are many aspects that are improvements, but I was very disappointed by the way the guidelines dealt with recommendations about the consumption of meat.

People who consume meat generally have worse health outcomes, particularly in terms of heart disease, stroke and cancer. On the flip side, clinical trials show that people who eat mostly plants have better health outcomes. And the evidence goes further than just suggesting an association — it shows that plant-based diets directly cause better health.

The USDA guidelines clearly state that saturated fats should be reduced. We know most of the saturated fat in our diets comes from animal sources, and yet the guidelines don’t take that next logical step and tell consumers to eat less meat. I am bothered by the lack of an explicit message around meat.

Q: What would you say to people who think that eating meat is essential to health and a more natural part of a “paleo” diet?

Stafford: The first way to answer that is to think about protein requirements. The average amount of protein people consume in the United States is far more than we need. A plant-based diet can provide all the protein anyone needs — 40 or 50 grams. Two cups of lentils, two cups of yogurt or a single 4-ounce steak would cover a whole day’s protein requirement. People are generally misinformed about the amount of protein they need, some believing they need four or five times as much protein as they actually do.

Second, the only real deficit in a vegetarian or a vegan diet is a lack of vitamin B12. That’s something that all people who are eating a predominantly plant-based diet should be aware of. The recommended daily requirement for B12 is 2.4 micrograms and even that tiny amount is higher than most people need because it accounts for those people who absorb B12 poorly. On a vegan diet, you could get that much B12 from a vitamin supplement or a tablespoon of nutritional yeast or a serving of fortified tofu. Even if you eat meat, you would need only about 1.5 ounces of beef per day or two forkfuls of fish.

The idea of eating unprocessed or minimally processed foods has value — which the paleo diet emphasizes — particularly when it comes to plants. But some anthropologists think the actual meat consumption of our ancestors was quite low, which would undermine the story that justifies lots of meat in the paleo diet. But regardless of what our ancestors ate, we now live in a very different food environment and we need to be very careful about how we interact with that environment.

Q: From a global environmental perspective, would it be better if people ate mostly plants?

Stafford: Yes, for a couple of reasons. One is that the process of producing meat generates more greenhouse gases per calorie than does growing plants of the same nutritional value. In essence, we can eat the corn and soy we grow or we can feed these plants to livestock and then eat the livestock. For a lot of reasons, it’s energetically much more efficient to eat the plants ourselves.

Food production also relies on other scarce environmental resources. Water is the big one, as is arable land. Both the water and land required for a calorie from meat is far greater than the amount required for plant-based foods.

Q: Do you think there’s support for your point of view generally?

Stafford: I think there is general agreement among scientists interested in nutrition that a plant-based diet provides better outcomes and that this evidence should be more explicitly reflected in the guidelines. What’s so striking about the new guidelines is that they are based on that same information, the same data. Clearly, the recommendation that we reduce our intake of saturated fat comes from that same pool of evidence. But the guidelines don’t say which foods contribute to our consumption of saturated fats. Instead, they leave it up to the consumer to figure out that saturated fats mostly come from animals. Essentially, they’re only telling part of the story, and leaving out the most practical advice.

Q: What do you think it would take for the USDA to change their guidelines?

Stafford: I think it requires a reframing of how we think about dietary guidelines. Dietary guidelines are often focused on the idea that we break foods down into particular components — micronutrients and macronutrients — and that we can define a healthy diet in terms of the proportions of these different categories of nutrients.

But the fact is people eat food; they don’t eat protein or saturated fats or carbohydrates alone. So in some sense the very process of creating guidelines that are based on these categories of nutrients misses the fact that people eat foods, not these categories.

It’s not enough to just tell people what nutrients they should be consuming. I think it really has to come down to telling people what types of foods they should eat less of and what types of food they should be eating more of.

I think the guidelines have moved in the right direction. For instance, the guidelines have moved away from a recommendation to reduce total fat intake and are now focused solely on saturated fat, for which there’s more evidence of harm. And the guidelines’ emphasis on fibrous vegetables and whole grains are more forthright.

But the whole regulatory and guideline process really needs to become more practical and actionable by consumers. It would be much more direct to simply tell consumers to eat less meat. And that would be the most effective way to reduce the consumption of saturated fats.

Despite the tendency of consumers to be attracted to fad diets, I think Americans are more ready than ever to hear a simple recommendation to eat less meat. The dietary evidence is stronger today than it’s ever been. And I think consumers are also uncomfortable with both the environmental impact of their diets and the issues surrounding the ethical treatment of animals. The time is right for the USDA to be more direct in their recommendations, even if it means making a recommendation that is contrary to the interests of some entrenched food manufacturers.

I certainly think more pressure from scientists to have the USDA state the obvious consequences of the data would help. I also think it’s important that consumers complain to the USDA that the guidance is not nearly as clear as it could have been.