Health care should prioritize plant-centered diets
A Health Care Without Harm position statement
Americans on average eat three times more meat per capita than the rest of the world and health care bears the burden of the human health impacts of high meat consumption and the secondary degradation of air, water, and soil generated by the meat production system.
Diets that embrace plant-based proteins are trending. One in four consumers are eating less meat. While only 6 percent of U.S. consumers are vegan and 7 percent are vegetarian, a growing number are considered “flexitarian,” choosing to consume meat at a reduced rate. Health professionals and hospitals can take advantage of this trend to advance public and environmental health and influence consumer choices by educating and guiding individuals toward the most affordable, transparent, and scientifically-sound plant-based diet emphasizing whole foods from local and sustainable producers. However, interest in meat alternative products is gaining momentum faster than whole plant-based proteins.
Northwestern Memorial Hospital's red dahl, a plant-based meal
and winner of the Health Care Culinary Contest (Northwestern Memorial Hospital).
Definition: Meat alternative products
“Meat alternative products” also known as “meat analogs” are food products that mimic the taste, texture, and appearance of meat such as plant-based meat crumbles, bacon, burgers, hot dogs, etc. This excludes tofu, tempeh, and seitan, which are traditional foods in many cultures, are usually minimally processed, and have associated health benefits when produced in a customary manner. However it is important to note that highly-processed varieties of tofu, tempeh and seitan do exist. For those options, be sure to read the label for added sodium or other ingredients (see definition “processed”).
Meat alternative products are viewed by many as a strategy to reduce meat in an omnivorous diet. Twenty-six percent of consumers reporting using meat alternative products to reduce their meat intake. Millennials in particular are increasingly interested in vegan offerings, however, the interest in meat alternatives extends to general consumers with one-third of consumers purchasing plant-based meats in addition to traditional meat products.
Unfortunately, not all meat alternatives are equally healthy and consumers must decipher opaque ingredient labels when making their choices.
Veggie burger (Dano/Flickr)
Meat alternatives and other food products that have been “highly processed” include added salt, sugar, fat, dyes, or other ingredients associated with increasing shelf life or palatability. “Minimally processed foods,” on the other hand, maintain quality attributes similar to those of fresh products. Minimal processing may include manual alterations such as chopping, washing, peeling and natural fermentation. A whole-food diet centers on “whole” or “minimally processed” foods.
Meat alternative options
Meat protein alternative products have been introduced into the market with increasing popularity. However, the majority of these products contain sodium, fillers, unrecognizable ingredients, and other undesirable additives prompting reflection as to their position as a healthy alternative to meat. This summary of the predominant protein ingredients that compose these products distills available science and research to inform decisions about the products’ potential as healthy meat alternatives.
- Soy protein isolate
- Textured vegetable protein
- Isolated pea protein
- Plant heme/Leghemoglobin
- Whey protein
- Insect protein
- Lab-grown meat
Many assume that consuming healthy, local and sustainably produced foods is only accessible for those with middle to high incomes. However, meat is one of the most expensive items in a diet. Growth in meat consumption is directly tied to the economic growth of developing countries. Decreasing the use of meat and processed foods while increasing protein-rich whole grains or legumes is a proven cost-effective strategy. On the contrary, processed meat protein alternative products are subject to the pricing of any one ingredient as well as discretionary pricing by large corporations who brand and market the product.
A readily accessible alternative is for individuals in countries with high levels of meat consumption to focus energies on culinary and menu strategies that reduce meat and increase the use of naturally cost-effective, whole-food, plant-based proteins.
Some hospitals have invested in hiring professional chefs to upgrade their menus resulting in improved patient experience and satisfaction scores. In addition to direct food cost savings, one study noted that a global shift to more plant-based diets by 2050 would save trillions of dollars in health care costs.
The presence of health disparities among different racial or ethnic groups is notable, especially as those populations assimilate to American culture, according to the National Institutes of Health. As a result there is a new interest within health care facilities to provide culturally-prefered foods to improve consumption of healthy meals. Research is emerging to indicate that the provision of culturally preferred foods may also improve health outcomes.
Because processed meat alternative products are not associated with the traditional diet of any culture, offering them is contrary to this goal. An alternative strategy would be to direct culinary creativity to traditional staple proteins that offer optimal human and environmental benefits such as the use of beans, peas, and lentils which are a popular, naturally high-protein food in Middle Eastern, Greek, European, and South American cultures.
Baked falafel (A Healthier Michigan/Flickr)
Confusion from ingredient lists, packaging claims, and nutritional guidance is a primary driver of poor eating habits according to health professionals. A reliance on processed meat alternative products will perpetuate this confusion due to the use of new ingredients and need to decipher labels.
The main reason consumers report using meat alternative products is the perception that they are healthy. This poses possible health concerns as many of these products contain added sodium and other additives. The interest of some meat alternative manufacturers to keep ingredients and formulations proprietary further exacerbates the issue.
This lack of transparency presents an obstacle for consumers concerned about potential allergens, other health concerns, and the environmental impacts of their food. Meat alternative products should undergo the same rigorous review of health and life cycle impacts as the meat they are intended to replace. This should be transparent. Only then can consumers make an informed choice.
A better alternative
It is paramount to reduce meat consumption, particularly conventional meat from industrial operations. Health care facilities and other purchasers should note that meat alternative products detract from the valuable opportunity to support new markets for community farmers to diversify production to meet demand for whole legumes or other high protein plant foods, which offer optimal nutritional benefit and restore farmland and natural resources for future food production.
Due to their significant purchasing power and trusted role as authorities on health and wellness, hospitals are able to not only increase access to healthier, more sustainably produced food for patients, staff, and the community but also support transforming the food system toward greater health and sustainability through local sourcing of goods and services and strategic investments.
Through investment in culinary professionals, strategic marketing, taste testings, and consumer education, health care facilities can drive greater acceptance of plant centered menus — a teaching tool for good health.
Hospitals have the opportunity to model menus that center around whole food plant proteins to respond to cultural needs, support sustainable farming, and encourage a clear path to a healthy diet.
- Meat protein alternatives: Protein bars, powders, veggie burgers, and imitation meat products have different health and environmental considerations. This summary distills available research to inform decisions about these products’ potential as healthy meat alternatives.
- Redefining Protein Purchasing Considerations: This guide offers procurement recommendations for health care purchasers based on values of sustainability, nutrition, social, and animal welfare concerns.
- Ingredient Guide: While framed as a guide for school food, the analysis and guidance from School Food Focus applies to any individual or institution aiming to avoid negative impacts of processed food products.
- Good Food on a Tight Budget: This guide from the Environmental Working Group can be used in culinary and nutrition education by health professionals as well as offer guidance to hospital purchases as to the top 100 foods that rank best on food prices, nutrients, environmental pollutants and artificial ingredients.