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About the Author
Dr. Micaela Karlsen serves as Director of the Lifestyle Medicine Economic Research Consortium from the American College of Lifestyle Medicine and the Lifestyle Medicine Institute, as well as co-investigator on the Adhering to Dietary Approaches for Personal Taste (ADAPT) Study from Tufts University. She is also Adjunct Faculty for the University of New England Master’ Programs in Applied Nutrition and Global Public Health. Dr. Karlsen is the author of A Plant-Based Life and a contributor to the New York Times bestseller Forks Over Knives: The Plant-Based Way to Health. She created and maintains PlantBasedResearch.org, an online library of original, peer-reviewed research studies relevant to plant-based nutrition, as well as SustainableDiet.com, a 3-month transition program for supporting successful and permanent transitions to plant-based diets. Her expertise is in dietary patterns, plant-based nutrition and nutritional adequacy, and predictors of successful behavior change. She holds a PhD in Nutritional Epidemiology from the Tufts Friedman School of Nutrition Science and Policy and a Masters degree in Human Nutrition from the Johns Hopkins School of Public Health.
Read an Excerpt
A Plant-Based Life
Your Complete Guide to Great Food, Radiant Health, Boundless Energy, and a Better Body
By Micaela Cook Karlsen
AMACOMCopyright © 2016 Micaela Cook Karlsen
All rights reserved.
FIND YOUR MOTIVATING FORCE
gathering food for the mind
* * *
YOU NAME IT, I pretty much had it," Gary told me, as he leaned back and mused about his old life. "I'd had one bypass surgery and was facing another. I was really heavy — like 70 pounds heavier than now. I felt sluggish all the time and I was on these fiber drinks because I was so constipated. Plus, I was taking pills for my blood pressure and my cholesterol. My doctor said I was prediabetic. I didn't sleep well but I wasn't really ever awake either. I felt like it was the beginning of the end of my life, even though I was supposed to be looking forward to my retirement."
Even with all these symptoms, it wasn't until the birth of Gary's grandson, a stern warning from his doctor, and the realization that he controlled his own health that he developed the impulse to try a plant-based path. Now, he says, his motivation grows stronger every day, as he keeps feeling better and better — especially when he thinks about all the medication he no longer takes. But it took a health crisis and the pressure to stay well for his grandchildren to get him started.
The motivation to change your diet because of a health issue doesn't always wait until you're older. My friend Pulin became a vegetarian at age eight and gave up all animal products at age seventeen. This translated to a tan-colored diet composed largely of peanut butter sandwiches, soymilk, and cereal, and it expanded to include the vegan junk food so readily available in the big cities he lived in as young adult. Pulin didn't regret his decision to go vegan, but the diet he was following pushed his cholesterol to 265 and his triglycerides to 795, even while he avoided animal foods. His doctor warned him that those were the first steps to an eventual heart attack, and he found himself facing taking statins in his early thirties.
Pulin was scared, but he turned his fear into action. After replacing the processed fake meats with whole plants and letting go of the vegan mayonnaise and fatty salad dressings, he found that his new diet was working.
A few weeks after we spoke, I got a text from Pulin that read: "Cholesterol 175, triglycerides 111" I felt so happy for him, knowing he had just set a new course for his life that avoided the slew of problems that Gary had faced. These sorts of results are common when people are motivated to switch to a whole food, plant-based diet, and they are possible for everyone. Provided, that is, that you are motivated, informed, and engaged.
In Step One, we will take a look at what you need to cultivate motivation, examine the health benefits of plant-based diets (which really serves to strengthen your motivation!), and discuss how to stay in touch with that feeling on a daily basis.
THE MOTIVATION EQUATION
Gary's and Pulin's stories emphasize the positive effects that plant-based eating can bring. Reading these stories can deepen your expectation of your own success. Keeping in mind or reminding yourself of the health benefits that can be derived from plant-based eating can also strengthen the value you ascribe to the diet.
Educators at the What Kids Can Do organization, a cutting-edge nonprofit based in Providence, Rhode Island, that develops materials to improve educational outcomes for children, use a concept they call the Motivation Equation. This equation links motivation with expectation and value. It's readily applied to adults and nutrition and is as follows:
Motivation = Value × Expectation of Success.
Motivation is the impulse moving you toward a goal, but you can't be motivated without both valuing the results and also expecting that those results are possible for you — and each one of these two elements increases the impact of the other.
Expectation of success creates belief in the potential outcome, and it comes from two sources: your emotions and your intellect. The stories in this book of people who've achieved good health and lasting dietary change will help you relate to dietary success on an emotional level. At the same time, knowing the scientific basis for the health benefits of plant-based diets will frame the nutrition recommendations and make it possible for you to understand how and why you can take charge of your health. Together, these two components work in concert to keep you motivated and charged. If you revisit Figure 1 on page 7, you'll see that not only do you need to be ready for change, you also need several other elements that we'll address here in Step One: motivation, expectation of success, nutrition knowledge, which we'll introduce in this step, and commitment.
We know you're interested and that you have some level of motivation, but you must also value success, and you'll find that even easier after reading about some of the documented health benefits that a plant-based diet can bring.
THE HEALTH BENEFITS OF A PLANT-BASED DIET
The scientific evidence that demonstrates and supports the benefits of a plant-based diet is growing all the time, and the most dramatic aspect is that the effects not only prevent people from getting sick but, for certain serious conditions, the food they eat can also make them well.
Making people well is not something that medication for chronic disease has ever accomplished, and perhaps it never will. This is not for lack of effort on the part of drug developers or doctors, but the medications for chronic disease manage symptoms rather than treat the cause of the illness. Many studies suggest that when you look at the rates of adherence for medication, they are pretty dismal — many patients struggle to take their prescriptions as directed, and quitting altogether is common! And who can blame them? Often, medications have side effects that make them feel worse, not better.
In contrast, many people who switch to a whole food, plant-based diet are highly motivated to continue because suddenly, perhaps for the first time in a long while, they feel good! For heart disease and type 2 diabetes, there are countless examples of individuals who, by changing their diet, have been able to reduce or discontinue their medications under their doctor's supervision. These outcomes are consistent with what has been demonstrated in the peer-reviewed research data on people who eat plant-based diets over the long-term, as well as intervention studies in which participants are assigned to a plant-based eating plan and their results are compared with other diets. This information has begun to permeate the field of medicine, as increasingly more physicians now support plant-based diets as the foundation of medical treatment for a variety of chronic diseases.
The feelings of sustained energy and longer-lasting satiety (feeling full after a meal) are only the beginning of the many benefits of a plant-based diet. While you no doubt have your own reasons for reading this book, in the next few pages we're going to cover some of the demonstrated health benefits for the prevention and/or reversal of four major chronic health problems that people in developed countries currently face: weight issues (which impact many conditions and diseases), type 2 diabetes, cardiovascular disease (heart disease), and cancer. For each, we'll take a look at the typical outcomes for plant-based eaters, delve into some background as to what is going wrong when these conditions develop, and explain how a plant-based diet can remove the source of the problem. This information will not only provide you with a deeper understanding of the positive effects of this diet, but may also serve to inform your conversations with your family, friends, and doctors. The results speak for themselves!
How would you like to eat until you felt full every time you were hungry, maintain a healthy weight, and never have to worry about counting calories? That is what can be gained by eating a plant-based diet. Plant-based eaters, both vegetarians (who eat no meat), and vegans (who eat no animal foods at all), are more likely to be at their normal weight compared to omnivores. They're also more likely to gain less weight over time — the nemesis of many aging adults.
Both overweight children and adults also lose weight more easily eating a plant-based diet than other types of diets, and this is true even without controlling portion size. In an exciting experiment published by researchers at the University of South Carolina, five different diet groups of overweight adults were given guidelines for the kinds of foods to eat, but without any portion control. In other words, they could eat as much as they wanted — they could eat until they were satisfied — and the individuals in the vegan group lost more weight compared to pesco-vegetarians (plant foods plus fish), semi-vegetarians (reduced animal food), and omnivores (plants and animals)!
The total energy you use on a daily basis is primarily determined by three factors: your basal metabolism, which reflects the minimum level of energy you need to keep your body alive while at rest — breathing, eating, digesting, keeping your heart and other organs working, maintaining your immune system, and performing countless other jobs; your level of physical activity; and adaptive thermogenesis (how much of the food you eat is converted to heat and released). Of course, it's possible to eat less than the minimum level of energy you need to stay alive; that's called negative energy balance, and it's what happens when you lose weight because you are using energy that your body has previously stored as fat.
WHAT'S GOING WRONG?
You create those fat stores when the energy you take in (in the form of food) is greater than the energy you use. This is called positive energy balance, and it's no secret that this constitutes a major problem for many people. Currently in the United States it's less common to be at a healthy weight than it is to be overweight. Two-thirds of all Americans are overweight and half of those are obese; sadly, almost one-third of children in the United States are overweight, with an additional 16 percent being obese; globally this disturbing trend continues in many other countries.
Beyond the immediate personal discomforts, physical and emotional, that can come with being overweight, excess pounds also put you at greater risk for a host of chronic diseases, especially the three we'll cover next — type 2 diabetes, cardiovascular disease, and cancer. Most adults in the United States continue to gain weight as they age, averaging almost half a pound per year after age 20. If left unchecked, this pattern increases the risk of developing metabolic syndrome (MetS), type 2 diabetes (T2D), heart disease, cancer, sleeping problems, kidney disease, depression, asthma, and osteoarthritis.
Gaining weight is easy in the modern world because the majority of the foods we're consuming are very energy-dense, meaning that when compared to the amount of space they take up in the stomach, they pack a lot of calories. We'll discuss this further in Step Three, but suffice it to say that animal foods like meat, cheese, eggs, and butter; processed foods like soda, cookies, chips, candy, white flour products; and sugary or oily snacks (like the colorful spread of packaged "foods" you might see for sale in a gas station or the middle aisles of a grocery store) make it easier than ever to eat more calories than you need, usually without realizing it. Table 1 shows the energy-density of 100 grams each of a sampling of various foods, and how much exercise a 175-pound person would need to perform to burn them off. This is the source of the disappointing results of research studies that attempt to produce weight loss with physical activity but without changing diet; if you were to choose either changing your diet or exercising more, you would get a much bigger bang for your buck by choosing to eat different foods than by trying to exercise off what you've eaten.
Don't get me wrong — exercise is important and brings a lot of health benefits, like reduced risk of other diseases, but when it comes to achieving a healthy weight, you can't do it without adjusting your diet. It's just too easy to eat larger portions of foods that are more energy dense, even without realizing it, and the delicate balance of homeostasis (the steady-state of dynamic equilibrium) that our bodies work so hard to maintain can be thrown off in a heartbeat. Since one pound of fat contains about 3,500 calories, you need only 10 unburned calories per day to gain a pound over the course of a year. Most adults are eating several hundred calories more than they need, which provides that excess weight, even after the body's automatic adjustments to try to burn the extra energy. Over time, this leads to a steady weight gain in adulthood.
Although not everything we eat comes in 100 gram quantities, Table 1 illustrates how much more exercise is required to burn off energy-dense foods — 884 calories of fat is about seven tablespoons, which sounds like a lot but can easily be worked into a meal if you're not paying attention by choosing fatty foods, sauteing food in oil, buttering your bread, and eating almost any typical dessert.
HOW CAN A PLANT-BASED DIET HELP?
While most adults gain weight as they age, this is not part of healthy aging, and it doesn't have to happen to you! The foods that make up a plant-based diet (whole grains, legumes [peas, beans, and lentils, for example], fruits, vegetables, and limited amounts of nuts and seeds) are dense in vitamins and minerals but contain plenty of fiber (mostly indigestible complex carbohydrates — what many people call "roughage"). Because for the most part we don't digest fiber, it doesn't add any calories to the diet. This is why you can fill up eating whole plant foods and still consume fewer calories.
Fiber provides bulk as well as slows the emptying of your stomach. This helps you feel full longer, causing you to want to eat less. Fiber also makes it physically impossible to overeat, because the added bulk activates the "stretch receptors" in the stomach. These receptors signal the brain that you've had enough. Animal foods contain no fiber (meat and dairy), and processed foods have either had fiber removed (white flour) or had energy added in the form of fat and sugar without an increase in fiber (French fries). So a meal of a cheeseburger, white bun, and fries packs a lot of calories but it doesn't fill you the way a meal of brown rice, vegetables, and beans does, even though the plant meal has a lot less energy! Most people starting to eat a whole food, plant-based diet for the first time find that excess weight just slides away, even without increasing their level of exercise. This is not only true for people who are already plant-based, but also for those who step it up a notch and take out the added fat as well.
Type 2 Diabetes and Cardiovascular Disease
A plant-based diet is the only treatment that has been shown to reverse our top culprits of disability and mortality. More plant food consumption predicts lower blood pressure, improved blood lipids, lower risk of developing type 2 diabetes, and a lower risk of death from cardiovascular disease (CVD). But it doesn't stop there. Physicians who prescribe plant-based diets as treatment get results unmatched by medication. A word of warning here: It's very important to talk to your doctor before changing your diet if you are taking any medication, especially if it is a medicine that lowers your blood pressure or controls your blood sugar. Dr. Neal Barnard, from the Physicians Committee for Responsible Medicine, in collaboration with George Washington University School of Medicine, has conducted studies of type 2 diabetics and found that medication changes are frequently required after switching to a low-fat, vegan diet. The effect of totally plant-based eating is so rapid that your blood sugar can drop to dangerously low levels if you are taking medication at the same time.
Excerpted from A Plant-Based Life by Micaela Cook Karlsen. Copyright © 2016 Micaela Cook Karlsen. Excerpted by permission of AMACOM.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Table of Contents
Foreword T. Colin Campbell xv
How to Use This Book 5
Part 1 Five Steps to Great Food and Radiant Health: making a plant-based diet easy and sustainable 19
Step 1 Find Your Motivating Force: gathering food for the mind 21
The Motivation Equation 22
The Health Benefits of a Plant-Based Diet 23
Constant Contact Keeps Motivation Alive 35
Your Path Going Forward 38
Step 2 Add Plant-Based Foods to Your Diet: welcoming new friends 41
What Is Plant-Based Eating? 42
Planning Plant-Based Meals 48
Shopping Makes Cooking Possible 50
Preparing Plant-Based Meals 56
Involving Your Children in Cooking Healthy Foods 67
Eating Out and Traveling 70
Your Path Going Forward 71
Step 3 Choose Health Over Habit: letting go of the foods that no longer serve you 75
What Your Body Is Telling You… and How You Can Choose to Respond 76
The Addictive Allure of Hyperpalatable Foods 78
Reading Labels to Avoid Added Fat, Sugar, and Salt 82
Defining a "Natural" Diet 85
Foods to Include, Avoid, or Eliminate in Your Diet 88
Un-Training Your Palate 92
Creating Habits of Health 94
Deciding What to Do with the Food You No Longer Want to Eat 97
The Bottom Line 98
Your Path Going Forward 99
Step 4 Make Your Food Environment Match Your Biology: creating the context that guarantees success 103
More Challenges to Eating a Healthy Diet 103
Identifying Your Diet and Eating Choices 111
The Dominant Motivations in Your Eating Decisions 118
Reshaping Your Food Environment 120
Your Path Going Forward 123
Step 5 Cultivate Connection For the Long Haul: making your diet socially sustainable 127
The Benefits of Social Support for Your Dietary Choices 128
Creating a New Normal 133
Your Path Going Forward 141
Part 2 Ongoing Success: keeping up the momentum 145
Recipes For Everyone 147
Everyday Oats 151
Morning Glorious 152
Breakfast-and-Beyond Smoothie 153
Apple-Lemon Breakfast 154
Almond-Cinnamon Granola 155
Green Colada 156
Savory Tofu Scramble 157
Sweet Potato Hash 159
The Best Waffle You'll Ever Have 160
Breakfast Sunshine Salad 161
Breakfast Rice Pudding 162
Florentine Frittata 163
Speedy Spinach-Artichoke Dip with Snack Stick Buffet 167
Teatime Cornmeal Muffins 168
Oatmeal Bars 169
Carrot Cake Smoothie 170
Unlimited Baked Corn Chips 171
Pumpkin-Oatmeal-Raisin-Carrot Cookies (aka PORCCs) 172
Fresh Fruit Snacks 173
Oyster Mushroom Ceviche and Bitter Orange-Lime Sauce 177
Cape Cod Delights 178
Tasty Corn Cakes 179
Summer Rolls with Red Chili-Pineapple Dipping Sauce 180
Cowboy Caviar 182
Jacked-Up Fruity Appetizers 183
Almond-Crusted Tempeh Fingers 184
Collard Wraps 185
Pesto-Stuffed Mushrooms 186
Sweet Blintzes 187
Corn Chowder 191
Simple Split Pea Comfort Soup 192
Classic Borscht 193
Dr. Lederman's Black Bean Soup 194
Potato-Leek Soup 195
Gingery Carrot Soup 196
Lemon-Rice-Kale Soup 197
Farmshare Miso Soup 198
Romantic Vegetable Stew 199
The Best Bean Chili 201
Italian Vegetable Lentil Soup 203
Salads and Sides
Blackberry Mango Tango 207
Colorful Yams and Greens 208
Potato Salad with Pine Nuts, Olives, and Dill 209
Summer Strawberry Salad 210
Tu-no Salad 211
Zesty Three-Bean Salad 212
Basket of Jewels with Walnut Sauce 213
Colorful Crudités 215
Salade Niçoise 216
Skinny Red Smashed Potatoes 217
Flexible Fennel Salad 218
Arame, Red Onion, and Pine Nuts 219
Guacamole Salad 220
Sauces, Spreads, and Dressings
Mushroom Gravy 223
Homemade Ketchup 224
Quick Sun-Dried Tomato Marinara 225
Cashew Cream 226
Del's Basic Mayonnaise 227
Favorite Sandwich Spread 228
Walnut-Mushroom Pâté 229
Surefire Pesto 230
Use-Me-All-The-Time Hummus 231
Raspberry Vinaigrette Dressing 232
Peanut-Lime Dressing 233
Classic Italian Dressing 234
Sweet Mustard Dressing 235
Thousand Island Dressing 236
Emergency Mini Burritos 239
Curried Chickpea Salad Sandwich 240
Rescue Quinoa 241
Fresh Fruit Tart 242
Sprouty Squash Delight 243
Five Ways to Sushi 244
The Esselstyns' Stacked High Black Beans and Rice 249
Interstellar Lasagna 250
Mac and Cheeze Casserole 252
Portobello Steaks 253
Leftover Cobbler 254
Tofu Quiche with Millet Crust 256
Best Basic Southwestern Burgers 258
Cauliflower au Cratin 259
Carrot-Rice Casserole 260
Super Easy Pizza 261
Pesto Kasha Varnishkes 262
Ginger Roasted Vegetables and Tempe 264
West African-Inspired Sweet Potatoes and Kale 265
Hearty Lentil Loaf 267
Chilled Peanut Noodles 268
Rich and Creamy Chocolate Mousse 271
Carrot Cake 272
Strawberry Shortcakes 274
Coconut Dream Whipped Cream 276
Pioneer Gingerbread 277
Mom and Me's Apple Thing 278
Sweet Ending Baked Pears 279
Two-Layer Vanilla-Vanilla Birthday Cake 280
Banana Ice Cream 282
Buckwheat Crepes with Chocolate 284
Apple Crisp with Almond Whip 286
Plum Carpaccio with Vanilla-Agave Syrup and Ginger Cream 288
Ongoing Support Resources 291
Recipe Contributors 303