“To eat is a necessity, but to eat intelligently is an art.”

—François de La Rochefoucauld

Black bean and avocado soft corn tacos. Blueberry pancakes. Baked potatoes with mushroom gravy.

Does any of that sound good to you? These are the kinds of delicious, nutritious meals you get to eat on the Whole Foods Diet. If you’ve read this far, we hope you’re thinking seriously about the relationship between your diet and your health, and getting inspired by your own health potential. And you’re probably starting to ask the all-important question: So, what should I eat?

Our intention in this book is not to dictate what you can or cannot eat—those are decisions only you can make for yourself, informed by the science available, based on your goals, your preferences, and your particular circumstances. While having someone else tell you what to put in your mouth may work for a short-term diet program, we don’t believe it’s sustainable as a lifestyle. Besides, human beings are contrary creatures and we tend to rebel against the dictates of others. As Dr. Dean Ornish likes to point out, “as soon as I tell somebody what to do, they want to do the opposite… This goes back to the first dietary intervention, when God said, ‘Don’t eat the apple.’”¹

To change the way you eat for the long haul, you need to decide how dramatic you want the changes to be and then you need to feel empowered to make those changes. What we intend to do is support you in making those decisions—give you knowledge, tools, and confidence to take your health into your own hands. We hope that what you’ve read so far has inspired you to want to do so—not because we told you that you should, but because you recognize the incredible benefits of making the shift. Above all, we want to make it simple for you to do so—to offer commonsense guidelines that can lift the fog of confusion that too often surrounds healthy eating. In the chapters ahead, you’ll find:

• Practical guidance for choosing foods that fit within the Whole Foods Diet

• A list of the Essential Eight food groups that will help optimize the nutritional benefits from your diet

• Insight and guidance to deal with the psychological challenge of changing your habits and evolving your palate

• Helpful tips for dealing with everyday situations

Our recommendations reflect what we conclude is the optimal diet, based on the best science available to us. Do you have to follow these recommendations “perfectly” to see any benefits? We like to look at it this way: every step you take in this direction will directly affect your health, but the more you change, the greater will be the transformation. Do you want to reach and maintain your ideal weight? Get off your medications? Reverse chronic disease? Add years to your life? We think it’s important that you know what’s optimal and to set your goals high. Too many dietary experts take a patronizing attitude—toning down what science shows is optimal in order to make it more acceptable. We believe you should know what the optimal diet is and then make up your own mind about what you want to do with it.

Once again, the optimal human diet for health and longevity is 100% whole foods, 90+% plant-based. Eat lots of fruits, vegetables, whole grains, and legumes, plus some nuts and seeds. Cut out the highly processed foods, especially refined flours, sugars, and oils. And if you choose to eat animal foods, keep them to less than 10% of your calories. We as authors each strive to eat this way, and we’re motivated to do so by how healthy, vital, and nourished we feel every day.

Of course, there are occasional circumstances when it’s just not possible to make the optimal choice, and then we choose the best that is available. And there are times when we choose to enjoy something we would not consider to be the healthiest food—but these are rare exceptions, not the rule. Don’t let perfectionism trip you up. If you listen to people in the plant-based eating movement, you’ll probably hear terms like “plant-perfect” and “plant-pure.” While well intentioned, in our experience such language can be counterproductive, leading people to aim for a perfection that, for them, may be impossible to achieve. That’s not to say there’s anything wrong with striving to be the best you can be, but the downside of trying to be perfect is that any small slip is perceived as failure, leading too easily into a negative spiral of self-blame and doubt. And when we feel bad about ourselves, it’s all too easy to seek comfort in our old habits. We feel we’ve failed anyway, so why even try?

Instead, own your choices and make better ones the next day. Learn from your mistakes and try again—things are often easier the second time around. Challenge yourself to go a little further than you think is possible, then let the results you experience inspire you to go even further.

When it comes to diet, what matters most is the overall pattern. Get the big pieces in place: 100% whole foods, 90+% plant based. Dr. Pam Popper, nutritionist, health educator, and founder of Wellness Forum Health, compares a dietary pattern to a combination lock, with the numbers representing the major elements of the diet. All the numbers need to line up for it to open—it’s not enough to get just some of them right.2 If you shift to a primarily plant-based diet but keep eating large quantities of highly processed foods, you won’t see the benefits. And if you choose to eat whole foods, but continue to get a large percentage of calories from animal products, the same holds.

Our advice to you is to focus on unlocking your health potential by establishing the overall pattern. Within this pattern there is plenty of room for variation based on preference, health, life circumstances, and so on. On a day-to-day basis, make food choices consciously, knowing that the closer you keep to that optimal diet, the better chance you’ll have for optimal health.

So what are “better” choices? Food does not fall into two simple categories labeled “good” and “bad.” It’s more accurate to think of it as a continuum, with the most health-promoting foods on one end and the most disease-promoting foods on the other. Between those two extremes lie many of the foods that the average person encounters every day. In order to decide which of them you want, let’s return to the two general rules introduced in chapter 1. These two rules can act as your compass for the choices you make every day.

A Whole Foodie…

eats whole foods instead of highly processed foods

and

eats mostly plant foods (90+% of calories).

Follow these two rules and fairly quickly you may notice more energy and vitality. Continue eating this way, and you’ll naturally reach your optimum weight and find that many health complaints resolve themselves. Let’s take a closer look at how each of these rules plays out in specific situations.

Eating Whole Foods Instead of Highly Processed Foods

Processing—it’s a simple word that contains a multitude of problems. It can turn a healthy, nutritious food into one that has little nutritional value left and may even make you sick. Let’s revisit the key distinctions when it comes to the transformation of food.

Unprocessed or Whole Foods

These are “real foods.” These foods are essentially intact, close to the form in which they grew. None of their essential nutritious parts have been removed, and no unhealthy substances (sugar, salt, oil, or chemicals such as artificial flavors, preservatives, or colors) have been added to them. This includes all types of whole fruits and vegetables, whole grains, beans and other legumes, and nuts and seeds, as well as unprocessed animal foods. You’ll often find unprocessed foods in the perimeter aisles of grocery stores, as well as at farmers markets. They usually don’t need much if any packaging, nor do they feature long ingredient lists. They won’t contain preservatives, and many need to be kept in the refrigerator and consumed soon after purchase, unless they’ve been dried, like beans and whole grains, or purchased frozen.

Whole plant foods are always healthy choices. Eat these foods in abundance, embracing the wonderful variety of nature’s bounty—from crunchy green vegetables to hearty, nourishing beans to comforting starchy vegetables to wholesome grains to sweet and vibrant fruits.

The only time we recommend caution in the category of whole plant foods is with calorie-dense varieties like nuts, seeds, olives, avocados, and dried fruits. While these play a part in a healthy diet, they contain a much higher ratio of calories to weight. As we discussed in chapter 2, it can be wise to limit consumption of calorie-dense foods (unless you are someone who needs extra calories, like an endurance athlete) and focus on foods that are rich in nutrients and highly satiating, but lower in calories, especially if you are trying to lose weight.

Minimally Processed Foods

These are a harder category to define, but we use this term to mean that while some processing has occurred, the food is still nutritious and has not been overly adulterated. This includes products that are made from whole foods, like whole grain flours and pastas; whole grain breads and tortillas; certain soy products like tofu and tempeh; nut butters and unsweetened nondairy milks; and so on. Many of these still contain all the parts of the whole food, but it has often been broken down into smaller pieces. Once again, we consider these equivalent to whole foods, following Dr. Michael Greger’s definition: “Nothing bad added, nothing good taken away.” These foods are healthy choices, compared with more heavily processed options, especially when they are used as a vehicle for eating more whole plant foods. Whole grain pasta primavera, bursting with beautiful spring vegetables, is one example; another is whole corn tacos stuffed with beans, grilled veggies, and fresh salsa.

With any processed food, even minimally processed ones, it’s always important to pay attention to what has been taken away and what may have been added. The more fiber that has been removed, the more calorie dense the food is likely to be (see chapter 2). White rice is a bit more calorie dense than brown rice for this reason and has had its nutritional value reduced with the removal of the bran layer and germ along with all that beneficial fiber. However, it’s not a bad choice if you don’t have the option of brown, particularly if it becomes the bed for a big pile of fresh vegetables and beans. In general, when buying packaged foods and breads, we try to choose those with at least one to two grams of fiber per fifty calories—so if you look at a food label and it has one hundred calories per serving, ideally it should have at least two to four grams of fiber per serving.

With minimally processed foods, it’s always important to read the ingredients closely. Too much added salt, oil, or sugar can turn a simple plant-based food into a health risk. Don’t be fooled by health claims on the packaging. A whole grain, vegan, gluten-free doughnut is still a doughnut, and contains plenty of sugar and oil. Always look for products with the fewest added ingredients.

For example, if you buy almond milk, choose the unsweetened version without added oil or salt, or if you feel ambitious, you can make it at home (see technique, here). When you choose bread, make sure it’s 100% whole grain. For condiments, sauces, or spreads, pay attention to added sugar, oil, or salt per calorie. If it has a list of ten or twenty ingredients, and half the terms are in science-speak, you can be fairly certain it’s not a real food.

Many people might consider freshly squeezed fruit and vegetable juices minimally processed plant foods—after all, they’ve only gone through a juicer. However, the transformation those fruits and vegetables have undergone is significant. While they retain many of their nutrients, they have lost all of their essential fiber, along with some nutrients bound to that fiber. Therefore, they deliver a concentrated dose of sugars without the natural fiber that helps you metabolize them. As Dr. Garth Davis writes, “It turns out fruits and vegetables are perfectly packaged. The sugars in fruit are designed to work almost like a time-release pill, due to their relationship and binding with the fiber. When you juice, you uncouple this perfect package by removing the fiber.” He adds that in this light, the idea of a prolonged juice fast for detoxification makes little sense, given that “fiber is the most detoxifying substance we can consume. It literally scrubs your insides. You can’t detox without fiber.”3 Rather than drink a juice, consider blending fruits and vegetables into a smoothie (see here for our favorite smoothie recipes), or, better still, eat them whole.

Highly Processed or Ultraprocessed Foods

These foods have been significantly altered from their original form, often to the point that they bear no resemblance to something that grew out of the ground or on a tree. Stripped of fiber and other essential parts and often packed with added salt, fat, sugar, and chemicals, they become calorie rich and nutrient poor. This category includes all refined grains and products made from them, such as white flour, white pasta, cookies, and so on. Oils and margarines also fall into this category (see here), as do candy, sweets, and anything that’s been deep-fried, such as tortilla chips and French fries.

These foods tend to have long ingredient lists full of unrecognizable terms, and they often make all kinds of health claims on the packaging. “Added Calcium!” “Heart Healthy!” “Fiber Rich!” You’ve probably seen such claims on breakfast cereals, bags of chips, granola bars, and many other products. Michael Pollan points out, that in contrast, the food that is unquestionably good for you—fresh fruits and vegetables—often doesn’t have the political clout or the advertising dollars to tout its benefits. “Don’t take the silence of the yams as a sign that they have nothing valuable to say about health,”⁴ he cautions.

Here’s a reminder of three essentials you need to understand about processing:

Processing removes or breaks down fiber. When fiber is broken down or removed, many important benefits of fiber are lost. (see here).

Processing concentrates calories. Because fiber has been removed or broken down and water has been removed, processed foods pack more calories into less bulk, meaning that to feel satisfied, you’re likely to eat more calories than your body needs.

Processing adds unhealthy substances. Too often, as food is processed, it gets loaded with oils, sugars, salt, and chemicals, increasing its calorie count and other health risks without any nutritional benefit.

Whatever the packaging claims, most highly processed foods have little or no nutritional benefit; in fact, they often have adverse effects on health. They do not have any place in an optimal human diet.

The chart on here shows what happens to some common foods as they move through the spectrum of processing—starting out as wholesome, nutrient-rich foods and ending up as calorie-dense, nutrient-poor shadows of themselves. The Whole Foods Diet focuses on the left-hand side of this spectrum.

Eating Mostly Plant Foods (90+% of Calories)

While the distinction between whole and processed foods is a continuum, the distinction between plant foods and animal foods is a clear line. If it grew out of the ground, on a tree, or on a vine, it’s a plant. If it had a face, or a mother, or came from something that had a face or a mother, it’s an animal food.

Some people, for ethical reasons, may choose not to eat any animal products, or only to eat dairy products and eggs. Putting aside the ethical issues for now, from a health perspective, our recommendation is that plants should make up at least 90% of your overall calorie intake.

If the term calorie reminds you of many failed attempts at “calorie-counting” diets, let us clarify that with a whole foods, plant-based diet you don’t need to obsess over calories. If the majority of meals come from a variety of whole plant foods, you’ll naturally satisfy your nutritional needs and appetite without overeating (see chapter 2). However, when it comes to animal foods, we think it’s worth taking a calorie-focused approach, simply because most of us are accustomed to overeating these foods. You may need to do a little calorie calculation at first until you get used to the appropriate portions.

Based on a two-thousand-calorie-per-day diet, the box on here shows some examples how that 10% or less might look. You may need to adjust for your particular caloric needs—you can easily find tools online to calculate your daily average (we like the website Cronometer.com, which offers many other helpful free tools as well). You might take a “condiment” approach, in which you use animal foods not as the centerpiece of your meal but as a topping or enhancement, as is common in traditional Asian cooking.

Alternately, if you love to enjoy a larger serving of your favorite animal foods, think of them as occasional treats once or twice a week at most, or save them for celebratory occasions, as many of the world’s longest-lived cultures do. This strategy means you’ll eat your maximum of 10% animal foods in one or two meals for the entire week.

If you choose to eat animal foods, be aware how the animals are raised. Modern industrial factory farming has made animal foods widely available and affordable, but at significant cost—both to the well-being of animals and to your health. From a health perspective, common practices that are cause for concern include treating livestock with antibiotics and growth hormones, and feeding them corn and other products that are far removed from their natural diet. While people in all the Blue Zones ate small amounts of animal foods, none of them ate modern factory-farmed versions. We recommend, if you choose to eat animal foods, that you follow these guidelines:

• Choose grass-fed, organic, antibiotic-free meat and dairy products, and pasture-raised chickens and eggs.

• Choose wild-caught fish and seafood where possible, and avoid those more likely to contain toxins such as mercury—Species to avoid tend to be those that are longer lived and higher up on the food chain, including tuna, swordfish, and king mackerel.

• Avoid processed meats. The World Health Organization recently categorized processed meats as a Group 1 carcinogen, alongside cigarettes and asbestos.5 If you decide to eat meat, choose unprocessed forms and stay away from hot dogs, salami, bologna, bacon, ham, and the like.

Food Choice FAQs

We hope you’re starting to feel confident about making important distinctions that will make all the difference for your health and well-being. But you probably still have questions. Let’s try to answer a few of them.

Once a day you could add just one of these foods to your salad or stir-fry, or include it as a side dish. That would put you at your ≤10% daily limit on animal foods. If you’re aiming for closer to 5%, do this every other day.

Grilled salmon (four ounces)

Grilled chicken breast (four ounces)

Broiled steak (four ounces)

Shrimp (six ounces)

Goat cheese (two ounces)

Note that with all these examples, we recommend choosing cooking methods that don’t involve added oil—which immediately adds extra calories you don’t need, along with other health risks. (See here for more tips on cooking without oil.)

Where Will I Get My Protein?

Human beings need protein to survive and thrive. Protein has become associated in the American mind with energy, vitality, and strength—like an all-purpose wonder nutrient. Feeling a bit low? Getting a bit skinny? Looking a bit pale? You must not be getting enough protein. And many people fear that if you eat a plant-based diet, you definitely will lack this critical macronutrient. “Where do you get your protein?” is the common refrain, since most people associate protein almost entirely with animal foods, and are convinced we need a lot of it. Both of these assumptions are unfounded.

First, plants contain protein. After all, how do you think the elephants and giraffes live off of them? Beans and other legumes, whole grains, seeds, nuts, and even green vegetables are all wonderful sources of protein. And not only do plants contain protein, they may be a healthier source of it. Using data from the Nurses’ Health Study, researchers at Harvard School of Public Health analyzed the diets of more than 130,000 people, and found that greater consumption of protein from animal sources, especially red and processed meats, increased risk of mortality. Alternatively, the researchers found that greater consumption of plant-based protein was associated with a longer life.6 Perhaps this is because most meat, which is a common source of protein, is also a significant source of extra calories, fat, and other problematic nutrients—especially when consumed in the amounts common in American diets today. The healthiest diets we know of that include meat do so only in limited amounts.

Foods to Eat Freely

Vegetables, fruits, intact whole grains and whole grain pasta, beans and other legumes, starchy vegetables

Foods to Eat in Moderation*

Whole grain breads, tortillas, crackers, dry cereals, tofu, tempeh, soy and nut milks, nuts, seeds, avocados, olives, dried fruit

Meat (unprocessed), fish, eggs, and dairy products (keep animal foods to 10% or less of your caloric intake)

Foods to Avoid

Refined flours, sugar, oils, baked goods, sweets, junk food, soda

Lunch meats, bacon, sausages, hot dogs, salami

Second, Americans tend to vastly overestimate the amount of protein needed. We drink protein shakes, eat protein bars, go on high-protein diets, and choose breakfast cereals that advertise protein content. Yet, as a nation, we are far from protein deficient. Most people who worry about not getting enough protein—and who always look for more—are not aware of how much they already get nor how much they need for optimum health. Government recommendations are forty-six grams of protein per day for the average woman and fifty-six grams of protein per day for the average man,⁷ but the average American woman aged twenty to forty-nine gets more than seventy, and the average man age twenty to forty-nine gets well over one hundred.⁸ We may in fact get too much protein, which is not necessarily a good thing. Excess protein can stress systems and make kidneys and liver work too hard, among other things.

It’s virtually impossible to be protein deficient if you eat enough whole food calories. Yes, that’s right. If you eat enough whole foods (even just plant foods), you don’t need to worry about protein. So the concern about getting enough protein on a plant-based diet is unfounded. Yet, as Dr. Garth Davis writes, “Despite decades of evidence… the presupposition that protein is good and more is better is still firmly implanted in our mind.”9 Davis, whose 2015 book Proteinaholic dismantles that presupposition beyond any reasonable doubt, likens the American attitude to this nutrient to an addiction. “Our obsessive and mindless overconsumption of protein fits the pattern of addiction, and its health consequences—for individuals and society as a whole—are no less serious in the long term.”¹⁰

We promise you that a whole foods, plant-based diet will not be protein deficient. Plant sources of protein are perfectly adequate. Forget the common myth that while meat is a complete source of protein, rice and beans need to be combined to deliver all the essential amino acids. It doesn’t work like that. Rice or beans, like almost any other whole plant food, are complete in and of themselves. (Check for yourself on any nutrition calculator¹¹).Eating lots of whole plant foods not only provides enough protein, it also protects from getting too much, which should be your bigger concern.

Why Are Oils Off-Limits?

The Whole Foods Diet recommends staying away from all refined, extracted oils. That includes canola oil, olive oil, sunflower oil, corn oil, coconut oil, and anything you find beside them on the shelf. For many Americans, that may come as a surprise. Of all the highly processed foods that we tend to eat daily, vegetable oils are not on most people’s list of concerns. We use them for cooking, we douse our salads in them, and these days some people even blend them into their coffee. Many consider certain oils—olive oil and coconut oil in particular—to be health foods, even superfoods. However, there are several problems with oils, starting with them being largely devoid of any nutritional value beyond fat.

Oils are nutrient poor. Olives, corn, coconuts, and sunflower seeds all contain nutrients, in their whole food forms. Olive oil, corn oil, coconut oil, and sunflower oil have been extracted in such a way that removes these beneficial nutrients, along with fiber, leaving only empty calories. As you can see from the chart below, extra virgin olive oil and coconut oil barely contain more nutrients than sugar, yet deliver more than double the calories.

Per 100 calories: Amount

Extra Virgin Olive Oil: 2.5 teaspoons

Coconut Oil: 2.5 teaspoons

Sugar: 6.2 teaspoons

Per 100 calories: Saturated Fat (% calories)

Extra Virgin Olive Oil: 1.6 grams (14%)

Coconut Oil: 9.2 grams (83%)

Sugar: 0

Per 100 calories: Fiber

Extra Virgin Olive Oil: 0

Coconut Oil: 0

Sugar: 0

Per 100 calories: Omega-3 fatty acids

Extra Virgin Olive Oil: 0.1 grams

Coconut Oil: 0

Sugar: 0

Per 100 calories: Omega-6 fatty acids

Extra Virgin Olive Oil: 1.1 grams

Coconut Oil: 0.2 grams

Sugar: 0

Per 100 calories: Omega-6 to omega-3 ratio (goal is 2:1-4:1)

Extra Virgin Olive Oil: 11:1

Coconut Oil: Unable to calculate because no omega-3 fatty acids

Sugar: 0

Per 100 calories: Vitamins

Extra Virgin Olive Oil: Small amount of vitamin E and vitamin K

Coconut Oil: 0% RDA

Sugar: 0% RDA

Per 100 calories: Minerals

Extra Virgin Olive Oil: Trace amount of iron

Coconut Oil: 0% RDA

Sugar: 0% RDA

Per 100 calories: Protein

Extra Virgin Olive Oil: 0

Coconut Oil: 0

Sugar: 0

Per 100 calories: Calorie Density

Extra Virgin Olive Oil: 4,000 calories per pound

Coconut Oil: 3,900 calories per pound

Sugar: 1,750 calories per pound

Thanks to Jeff Novick, MS, RD, for permission to adapt this chart from his work.

Oils are among the most calorie-dense foods on the planet. A single tablespoon of oil contains 120 calories. Because oils contain no fiber, they deliver concentrated energy but no bulk, driving up calorie count without filling the stomach or meeting a nutrient need. Oils, in other words, make it exceedingly easy to overeat—as if we needed any more help. Let’s say you were to sit down to dinner, starting with a salad, followed by a whole grain pasta dish with some broccoli on the side. If you choose an oil-free salad dressing (see formula, here), serve the pasta in oil-free Marinara Sauce (see recipe, here), and steam the broccoli, you have a delicious and satisfying meal that may deliver three or four hundred calories. However, if you drench your salad in an oil-based dressing, pour some olive oil on your pasta, and sauté the broccoli, you could be looking at seven or eight hundred calories—more than a cheeseburger and fries! Set the oil aside, and you’ll make staying in shape much easier.

You may have heard that the polyunsaturated fats in oils are better than other types of fats. The reality is that many vegetable oils tend to be high in omega-6 fatty acids, and Americans in general get far too many of those already, especially relative to omega-3 fatty acids (what we really need more of). An extreme imbalance in the ratio between these two (typical American diets can be as high as 15:1) has been implicated in a host of health ills, including cancer, autoimmune and inflammatory diseases, and other chronic conditions.12 Decreasing vegetable oil can be a quick and virtuous route to improving that critical health ratio (experts suggest in the range of 2:1 to 4:1 is optimal).

Another concern with extracted, polyunsaturated plant oils is that they are susceptible to oxidation, which is implicated in tissue damage, aging, and other health complications.¹³ They have also been implicated in cardiovascular disease risks, actually making the plaques in the blood vessels worse.¹⁴

In general, we don’t feel there are good and bad oils; rather, they range from bad to worse. Extracting all the fat from a whole food and putting it in a bottle to consume as oil is no healthier than taking all the carbohydrate from a whole food and putting it in a bag to consume as sugar. For all these reasons, we recommend for optimum health to avoid all oils. This means being aware of foods that have added oils in the ingredient list, steering clear of fried and sautéed foods, and learning to love oil-free salads. See here for an easy way to make oil-free salad dressing and see here for tips on how to cook easily and efficiently without oil. If you want richer flavors associated with oils and fats (in spreads, sauces, dressings, and so on), use whole foods like nuts and seeds, olives, or avocados as whole or blended ingredients (see recipe for Oil-Free Herb Pesto on here).

What Sweeteners Should I Choose?

We do not recommend using any extracted or concentrated sweeteners, whether in the form of white table sugar, high-fructose corn syrup, or any of the so-called “natural” sweeteners like maple syrup, honey, agave nectar, and so on. If you’re trying to eat a whole foods, plant-based diet, we recommend sticking to fruit to satisfy your sweet tooth. If you want to experiment with whole food desserts, dates make a good sweetener (see recipe for Sweet Potato Chocolate Mousse on here).

Can I Use Salt?

There is nothing health promoting about added sodium other than when it helps get whole plant foods into your body. That being the case, we recommend using as little added sodium as necessary. When you use it, aim to add it to your plate rather than cook with it in a recipe; you’ll get a better bang for your buck because you can taste more and use less. Over time you will find that you need less salt as you stay mindful of it in your diet and your taste buds evolve.

Can I Drink Alcohol?

You may have read recent headlines claiming a glass of wine is better for you than an hour at the gym, tequila is good for your bones, and alcohol can protect against diabetes. While much is made of studies showing possible benefits of alcoholic drinks, wine in particular, we’ve yet to see convincing evidence that they should be considered a health food. And we all know the dangers of alcohol—its addictive properties and the role it plays in too many accidents. Plus, there is increasing evidence for a link between alcohol consumption and certain cancers.15

However, we also recognize that alcohol has been a part of human culture for millennia, and it plays a key role in bringing people together in convivial settings, as is demonstrated in almost all the Blue Zones (see chapter 4). Whatever choices you make around alcohol, keep in mind that it is also high in calories, and may deter efforts at weight loss.

Is It Important to Choose Organic?

The most important dietary change you can make is to eat more fruits and vegetables. A 90+% plant-based diet is going to be significantly healthier than a Standard American Diet even if you are not always able to eat certified organic produce. However, if you have the option, choosing organic has the added benefit of keeping chemical pesticides out of your food chain. We certainly think this is a wise choice, but it’s much less important than the choice to eat more fruits and vegetables. One study estimated that if just half the US population increased fruit and vegetable consumption, approximately 20,000 cancer cases per year could be prevented, while only up to ten cancer cases per year could be caused by the added pesticide consumption.¹⁶

Where Will I Get My Calcium?

Many Americans have grown up associating calcium exclusively with dairy products, milk in particular. If you’re concerned that reducing your animal food intake will lead to calcium deficiency, don’t worry. In fact, the body actually absorbs calcium from many plant foods, like kale and broccoli, for instance, more easily than from milk. Even nuts, seeds, and legumes are significant plant sources of calcium that may not be commonly considered.17

What Supplements Do I Need?

If you choose to eat a mostly plant-based diet, we encourage you to do so skillfully, with appropriate supplementation. We know that a vegan diet with no supplementation whatsoever may result in lower levels of certain nutrients (compared to nonvegans). For those vegans or near-vegans committed to a healthy whole foods diet, these concerns are largely mitigated, but not entirely erased. So what, if any, supplements should you take?

B12? Yes

The one nutrient that is indisputably lacking in a vegan or mostly plant-based diet is vitamin B12.¹⁸ We believe that B12 supplementation should be nonnegotiable for pure vegans,¹⁹ and is also likely to be beneficial for those eating 10% or less of their calories from animal foods.²⁰

Zinc, Iodine, Iron, Calcium? No

Many of the nutrients that raise deficiency concerns for vegans can be adequately attained from whole plant foods.²¹ This applies to commonly raised questions around nutrients like zinc, iodine, iron, and calcium. In general, supplementation should not be necessary for a skillful Whole Foodie eating a healthy whole foods, plant-based diet.²² Indeed, most plant foods are rich in a diversity of nutrients, and in general there is little reason to be concerned about inadequate levels. But if you would like to bump up your overall intake of these nutrients, here are some plant foods that are extra rich in these four minerals:

Zinc—Most beans (e.g., adzuki, garbanzo, white), seeds (e.g., pumpkin, sesame, squash), and whole grains (e.g., whole wheat, oats, quinoa), dried mushrooms

Iodine—Sea vegetables (e.g., dulse, kelp)

Calcium—Most leafy green vegetables (e.g., collards, broccoli, arugula) and beans (e.g., adzuki, garbanzo, white)

Iron—Most leafy greens (e.g., collards, broccoli, arugula), legumes (e.g., adzuki, garbanzo, white), and whole grains (e.g., whole wheat, oats, quinoa)

DHA? It’s Complicated

Unfortunately, the science supporting supplementation on largely plant-based diets is by no means settled. Many people, including highly reputable doctors and nutritionists, have different perspectives and recommendations vary. This is especially true when it comes to whether to recommend supplementation of EPA/DHA, or long-chain omega-3 fatty acids. The concern is that plant-based diets tend to be lower in these essential fats. The richest natural source of preformed EPA/DHA is fish, especially oily fishes such as wild-caught salmon, mackerel, and tuna, so if you eat a diet that is less than 100% plant based, you can get preformed EPA/DHA by including wild-caught fish or seafood in some meals. However, because of the contamination of many fish with mercury, dioxin, PCBs, and other pollutants, eating too much fish comes with its own risks 23 (and these concerns appear to apply to fish oil supplements as well).²⁴ Therefore, it is advisable to add other foods containing omega-3s to your diet. Many whole plant foods contain omega-3 fatty acids, and some plant foods are particularly rich in them, including flaxseeds, chia seeds, hemp seeds, walnuts, leafy greens, and soybeans. However, the omega-3 fatty acids in these foods come in a “short-chain” form called ALA, which the body must convert into “long-chain” EPA/DHA. So the question arises: Is it worth supplementing EPA/DHA in order to optimize EPA/DHA levels and long-term health? The authors of this book have come to different conclusions. We will present them separately.

Dr. Matthew Lederman and Dr. Alona Pulde: Do those with a plant-based diet benefit from supplementing with preformed EPA/DHA? The answer to this question has yet to be clearly determined. The lower level of DHA in vegan populations has not been conclusively linked to disease or deficiency (unlike with B12, where a link is well established). Moreover, you might be interested to know that a large study of more than fourteen thousand people found that those who didn’t eat fish seemed to convert enough ALA to EPA/DHA, bringing them to levels close to those of fish eaters.25 Still, there is preliminary evidence that some potential benefits to brain health may be associated with supplementation.²⁶ As a result, some experts believe that it is advisable to supplement EPA/DHA routinely, while others, ourselves included, feel that the current evidence is not robust enough to support recommending supplementation preventatively to the average person.

Our recommendation here is that you look to your diet, your personal history, and your risk-to-benefit profile to make that decision. Some people simply have no significant family history and feel well, and as such may choose to wait for better evidence to come out before routinely supplementing. On the other hand, if you have a strong family history of brain-related disorders, you may be more inclined to measure your omega-3 index²⁷ and, if it is low,²⁸ consider supplementation. If you choose to supplement, we recommend an algae-based EPA/DHA supplement free of the environmental contaminants found in fish oil supplements.²⁹ No matter what supplementation path you choose, you should continue to consume whole plant foods rich in omega-3 fatty acids and take steps that will optimize your ability to convert short- to long-chain forms (e.g., minimize alcohol³⁰ and minimize added oils and other sources of omega-6 fatty acids,³¹ which the average person consumes in excess).

John Mackey: I have come to a different conclusion from my colleagues about EPA/DHA supplementation. We need omega-3 essential fatty acids in every cell of our bodies, but EPA/DHA is particularly critical to the development and healthy maintenance of the most important organ in our body—the brain. A large part of the structure of the brain is, in fact, made up of EPA/DHA. The concerns around inadequate levels and brain function are to be taken seriously. Studies have clearly shown that low EPA/DHA levels are associated with slightly lower overall brain volume.32 While our brain does naturally lose some size as we age, there is evidence that EPA/DHA levels that consistently fall below certain thresholds may exacerbate that natural process. Studies also show that many vegans (and not just vegans but many Americans in general) fall below generally accepted EPA/DHA thresholds. It may eventually prove to be true that a whole foods, plant-based eater will naturally end up converting all the EPA/DHA needed for healthy brain function, and that this is more an issue for less healthy vegan diets and those on Standard American Diets. However, the results of a randomized controlled trial published in 2013 suggest that EPA/DHA supplementation can improve cognitive function and brain health, at least in older adults.³³ So while Matt and Alona are correct in saying that the evidence for long-term deficiency in plant-based diets is not yet conclusive, I feel that prudence, in this instance, falls on the side of action. There is little downside to supplementation, and it may prove beneficial to long-term health and cognitive well-being. In addition to consciously consuming plant foods rich in omega-3s, I support EPA/DHA supplementation and personally take 250 milligrams a day derived from algae (perfectly acceptable for vegans and vegetarians).

CHAPTER 9

So, What Should I Eat?

Navigating Everyday Food Choices

Eating Whole Foods Instead of Highly Processed Foods

Unprocessed or Whole Foods

Minimally Processed Foods

Tips for Reading Food Labels

Highly Processed or Ultraprocessed Foods

The Perils of Processing

Eating Mostly Plant Foods (90+% of Calories)

The Continuum of Processing

WHOLE FOODIE HERO

Food Choice FAQs

Animal Foods as Condiments

WHOLE FOODIE HERO

Where Will I Get My Protein?

The Whole Foods Diet at a Glance

Why Are Oils Off-Limits?

What Sweeteners Should I Choose?

Can I Use Salt?

Can I Drink Alcohol?

Is It Important to Choose Organic?

Where Will I Get My Calcium?

What Supplements Do I Need?

B12? Yes

Zinc, Iodine, Iron, Calcium? No

DHA? It’s Complicated

MY WHOLE FOODIE STORY