Eat your fruits and vegetables.
Hasn't that been a constant refrain over the years from public health authorities? Certainly, I have. The benefits of eating fruits and vegetables have been widely touted, and seemingly with good reason. A diet high in fruits and vegetables, it is said, reduces the risk of cardiovascular disease and cancer. In the case of the latter, it as claimed that potential decreases in the risks of some cancers could be as high as 50% a day. As a result, the National Cancer Institute developed the 5-A-Day program, whose goal was to increase people's consumption of fruits and vegetables to five or more servings a day. Indeed, on the NCI website, this effort is described thusly:
In 1981, Doll and Peto concluded that about 35 percent of all cancer deaths were related to nutrition, with a plausible range of 10 to 70 percent.26 This conclusion was driven largely by data on dietary behaviors that might increase risk. Evidence for the role of plant foods in cancer risk coalesced in the late 1980s and early 1990s, based on summaries of the epidemiologic literature specific to the relationship between vegetables and fruit and cancer.
The evidence supporting the role of vegetables and fruit in cancer prevention provided a foundation for several documents that were the basis of national nutrition policy in the 1980s and 1990s. In 1982, the National Research Council (NRC) published the seminal document, Diet, Nutrition and Cancer, which summarized the research literature on the relationship between various chronic diseases and dietary patterns.36 Other Federal documents followed such as Healthy People 2000, the first Surgeon General's Report on Nutrition, Dietary Guidelines for Americans, and the Food Guide Pyramid.
There's no doubt that diet is critically important to health, but does it have that dramatic an effect on cancer, with a possible effect size potentially as large as 70%? Answering that question has been difficult and has been very dependent on the methodology of the studies used to address the question. Studies have been conflicting regarding the existence and magnitude of benefit of a diet rich in fruit and vegetables when it comes to preventing cancer. Enter the EPIC Study (European Prospective Investigation into Cancer and Nutrition), whose results were just published in the Journal of the National Cancer Institute (JNCI) this week and have made the news all over the world, with some news stories having titles like Fruit and vegetables have little effect on cancer risk, study finds. Is it true? Should you stop worrying about eating five portions a day of fruits and vegetables. (Given how bad I am at trying to be healthy, I never came close to that on an average day, anyway.)
Let's looks at the study itself and its proposed answer to this question. One thing the authors note is that most prior studies concentrated on one or a few types of cancer, which can skew the results because there may be small subsets of cancers that are highly sensitive to diet while the bulk of cancer is not. Positive results lead to further studies, and these cancers for which an effect of diet was found then come to be seen as surrogates for all cancer, falsely inflating the magnitude of any effect on cancer. Surprisingly, not nearly as much research has been performed to look at the relationship between a fruit and vegetable-rich diet and overall cancer risk describing the state of the literature thusly:
The association between fruit and vegetable intake and overall cancer risk, rather than risk of specific cancers, has been less frequently studied. A total of six prospective studies that included more than 10 000 individuals have reported results on cancer incidence (5-9) or mortality (10). Of the six studies, one showed that mortality was lower in both men and women when higher amounts of green and yellow vegetables and fruits were consumed (10); three studies reported a lower incidence of cancer in women on high intake of fruits and vegetables (5,6,8); and the remaining two showed no association between cancer risk and fruit or vegetable intake. A few possible explanations for inconsistent results in the above-mentioned studies could be recall, selection bias in case- control studies, and inadequate exposure contrast and exposure misclassification in cohort studies (4).
The authors also correctly point out that most of the previous evidence linking high fruit and vegetable intake to decreased cancer risk come from retrospective case control studies rather than from prospective studies. Anyone who knows anything about epidemiology (or has just read this blog) knows that retrospective studies are inherently prone to more confounding factors that can produce false positives than prospective studies. That's not to say prospective studies aren't prone to such problems, only that they are less so.
Enter the EPIC study. This study encompasses over 500,000 men and women aged 25 to 70 in several European countries who were recruited between 1992 and 2000. Their dietary intake was assessed by country-specific questionnaires, and then study subject outcomes were assessed, including cancer incidence and mortality. It is the largest study of its type. In addition, it included a wide variety of subjects from various nationalities spread across Europe and consuming varied diets, making it well-suited to look at the question of what effect diet has on overall cancer risk and the risk of dying from cancer.
The results of the study were of the "good news, bad news" variety. The good news is that there was an inverse correlation between fruit and vegetable intake and cancer risk. Importantly, there was a dose-response effect, meaning that the more fruit and vegetables people ate, the lower their risk of cancer. The bad news is that the effect observed was much lower than much of hte hype. Among people who ate more than 2.5 portions a day (an additional 200 g per day) had a 3% lower risk of cancer than those who ate less than that, while those who consumed 5 portions a day had a 9% decreased risk of cancer. Eating more than 8 portions a day was associated with an 11% decreased risk of cancer. As any good epidemiological study would do, the authors corrected for lifestyle issues and other cancer risk factors, such as hormone replacement therapy, smoking, alcohol intake, physical activity, etc. By any epidemiological measure, this is a modest effect. a 3% decrease, for instance, is not very large. Even an 11% increase, while more respectable, is still not that large and requires eating a lot of fruit and vegetables, far more than most people would be able to manage.
Why are the results of this study so much more modest than previous results? As I mentioned before, most of the old studies were case control studies, in which "cases" (people with cancer) were compared to age-, sex-, and race-matched controls. Subjects were asked to recall their dietary habits, and recall bias is a very real problem in such studies. Since then, larger cohort studies, of which the EPIC study is the largest thus far, have tended to produce less dramatic results, as is expected when more rigorous studies are done to followup results from les rigorous studies. Another reason that the results of this study are less dramatic is that it looked at nearly all cancers, rather than just a few. If diet has a much more dramatic effect on a few cancers, looking at all cancer incidence will dilute out the effects, given that cancer is not just one disease but many. Indeed, EPIC results have been published for several cancers, with some cancers being affected by diet (head and neck, esophagus, and colorectal cancer, for example) and others not (breast cancer, prostate cancer, and ovarian cancer, for example). For cancers for which no correlatoin was found, the total number of cancer cases have been too small to be definitive, and there may not have been enough years of followup to rule out a protective effect that isn't evident until later. In any case, these results are intriguing not just for their insight into how we can reduce our risk of various cancers but for limning biological differences between cancers.
So we shouldn't bother eating our fruits and vegetables anymore, right?
Wrong. Although the effect size cancer risk reduction due to consuming lots of vegetables and fruits is modest at best, as pointed out in an accompanying editorial by Walter Willett amusingly entitled Fruits, Vegetables, and Cancer Prevention: Turmoil in the Produce Section, there is evolving evidence suggesting that high fruit and vegetable intake has a profound effect on cardiovascular health:
Even if we assume that the weak association seen in the EPIC cohort represents a true protective effect of fruits and vegetables, the question would still remain whether an effect of this magnitude should lead to clinical interventions or public health actions. Conveniently, although the evidence for benefits of fruits and vegetables against cancer was waning, data supporting benefits for cardiovascular disease were accumulating (10,11). For example, in the same population of men and women that showed no association between fruits and vegetables and total cancer, incidence of coronary heart disease or stroke was 30% lower for those consuming five or more servings per day compared with those eating less than 1.5 servings per day (12). Data from a large randomized trial showing that increasing intake of fruits and vegetables reduces blood pressure (13), a major determinant of cardiovascular disease, make the case for causality compelling, although benefits through additional pathways are also possible. Thus, recommendations and actions to increase intake of fruits and vegetables have a sound basis.
So, even though fruits and vegetables may not have much of an effect on your overall risk of cancer, they can have a significant effect on the risk of specific cancers, as well as a profound effect on cardiovascular risk. That their benefits when it comes to cancer risk reduction have arguably been oversold is unfortunate, but the heart benefits are reason enough to see what a better diet can do. Unfortunately, there's one thing that fruit and vegetables can't do, and that's to taste like meat.
Boffetta, P., Couto, E., Wichmann, J., Ferrari, P., Trichopoulos, D., Bueno-de-Mesquita, H., van Duijnhoven, F., Buchner, F., Key, T., Boeing, H., Nothlings, U., Linseisen, J., Gonzalez, C., Overvad, K., Nielsen, M., Tjonneland, A., Olsen, A., Clavel-Chapelon, F., Boutron-Ruault, M., Morois, S., Lagiou, P., Naska, A., Benetou, V., Kaaks, R., Rohrmann, S., Panico, S., Sieri, S., Vineis, P., Palli, D., van Gils, C., Peeters, P., Lund, E., Brustad, M., Engeset, D., Huerta, J., Rodriguez, L., Sanchez, M., Dorronsoro, M., Barricarte, A., Hallmans, G., Johansson, I., Manjer, J., Sonestedt, E., Allen, N., Bingham, S., Khaw, K., Slimani, N., Jenab, M., Mouw, T., Norat, T., Riboli, E., & Trichopoulou, A. (2010). Fruit and Vegetable Intake and Overall Cancer Risk in the European Prospective Investigation Into Cancer and Nutrition (EPIC) JNCI Journal of the National Cancer Institute DOI: 10.1093/jnci/djq072
Willett, W. (2010). Fruits, Vegetables, and Cancer Prevention: Turmoil in the Produce Section JNCI Journal of the National Cancer Institute DOI: 10.1093/jnci/djq098
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I also suspect it has an impact on immune health because most of the other things we eat in the modern diet (processed cereal grains, dairy, sugar) instead of fruits and veggies have a pro-inflammatory effect.
Thank you, Orac! I saw an article about this study and was confused; I appreciate you laying it out so clearly.
Not to tell you what or what not to write, but I'd really like to see more articles like this one from you, Orac. This is good stuff; very informative and well researched. Thanks for the article.
Awesome. Thanks Orac. A great tip for those that are interested in more easily incorporating larger quantities of fruits and vegetables into their diets, is to try juicing and also green smoothies. They taste great, are easy to drink and are loaded with nutrients.
I have one of each every day and it helps me to meet my daily intake of fuits and veges. I highly recommend it.
Just thought I would share with you all.
Yeh i remember seeing the BBC news reports on this study, and they completely focused on the 3% figure, and basically ignored the rest of the study.
They also mis-represented that 3% figure by saying that was the reduction in cancer risk for eating your 5 a day, where the report clearly says those who consume 5 a day had a 9% reduction in risk.
The reduction in heart disease was not mentioned once in the bulletins.
What are you doing promoting eating fruits and veggies? Only naturopaths and the like do that! Western medicine allopaths only focus on drugs that keep us sick!!!one!!!eleventy!
Actually, watch for this study to be picked up by (my guess) Adams as "proof that 'western medicine' doesn't consider diet."
Cool, a subject I am well versed in. :)
Regarding juicing; the green smoothies are probably a great way to get servings of veggies, one needs to be careful not to add too much sugar. But juicing is not the best way to get your "five a day". Juicing removes the fiber and concentrates the natural sugars, which is only slightly different from drinking sweetened beverages. Some juice is okay, but definitely not good for more then perhaps one of your daily servings.
The information I have seen on this study didn't control for starchy vegetables. Whether or not many of the servings are white potatoes, corn or other veggies that (at least in western countries) we eat far too much of (I am not saying these are bad, just that they are overly consumed), rather than the colorful ones that we need more of.
But I was glad they controlled for cooking method. This was also something I immediately thought of when I saw the news reports on this study.
I guess the moral is that the foods we eat are very important, but they cannot be counted on for preventing/curing what ails us. There is far too much that goes into the health of our bodies as we age. Just try to live as healthfully as you can, but still get regular medical check-ups and recommended tests to find the bad stuff as early as possible.
There's a person over at Bad Astronomy posting under the name "Food Magick" making claims that if people ate healthy, they wouldn't need to get vaccinated. I've been trying to get a journal citation out of FM, but all they keep doing is referring to eating healthy web sites.
There is still a big problemm with this study, the diet was self-selected. There is no way to tell if the effect was due to diet, or if people who were healthier ate more fruits and vegetables because that is what healthy people self-select to eat.
The study would need to eliminate food choice. Until you do that, you don't know if eating "healthy foods" is a cause, or an effect of being healthy.
I always wondered if the positive effect of 5 a day is due to the positive content of the veggies or due to not eating the stuff the veggies replace. There are probably few people who do 5 a day combined with two supersized BigMac meals, or maybe have all their 5 helpings in form of screwdrivers.
One of the most outlandish, woo-drenched statements I've *ever* encountered(and I've encountered many) involves the relationship between diet and cancer:(paraphrase)"Now we all *know* that eating vegetables reduces incidence of cancer by '20%'**, so imagine if you eat 5 different kinds of vegetables,that means you'll eliminate cancer by 100%!"(the Gary Null Show) Now Adams *has* made similar statements, but he didn't *do the math*.Both sell the idea of food(and/or supplements)-as- preventive-medicine which of course, leads to the wholesale worship of sprouts and solemn recital of protective *phyto-chemicals*(which can also be extracted and marketed as *nutra-ceuticals*, i.e. supplements).**(Where'd he get the 20% figure? I guess the same place he got "vaccines-cause-autism")
You're just in the pocket of Big Veggie, you Carrot Shill! You're trying to suppress the fact that eating meat unevenly roasted over an open flame and foraging for roots and berries is the TRUE way to guarantee long life. It's what our ancestors did, and none of them ever died!
Does ketchup count as a serving of vegetable?
""Now we all *know* that eating vegetables reduces incidence of cancer by '20%'**, so imagine if you eat 5 different kinds of vegetables,that means you'll eliminate cancer by 100%!"(the Gary Null Show)"
So exactly how much is a "serving" or "portion" anyway? I frequently hear I'm supposed to have x servings of this or that, but have no idea how much that actually is. Does it vary by food type? Does it vary by food?
@ JohnV:Yes.He *actually* said that,succinctly illustrating the level of discourse abounding in Woo-world.
Yes, it depends on the type of food. A serving of fruit is typically a single medium-sized apple (or an equivalent volume thereof). Cooked vegetables are about half a cup (125 mL), and shredded vegetables like cabbage or lettuce are double that. Meat is around the size of the palm of your hand.
t as claimed that potential decreases in the risks of some cancers could be as high as 50% a day.
What the heck is that supposed to mean?
eat 6 kinds and 20% of cancers will go into remission.
We don't need no stinking oncologists, we need to be training a generation of greengrocers to replace them.
The size of the palm of your hand may be what some say but MY serving of meat is about the size of a dinner plate, medium rare please.
"Does ketchup count as a serving of vegetable?"
Legally, yes. Technically, no. Thank you, Zombie Reagan.
Seriously, are you eating 4 oz ketchup at a time?
"Even an 11% increase, while more respectable, is still not that large and requires eating a lot of fruit and vegetables, far more than most people would be able to manage."
uh, why can't most people "manage" this? have they had their "free will" obliterated by Big Meat? too "addicted"? too emotionally attached to their "comfort foods" from childhood? too "inconvenient"? too stupid? what? how about a little respect for the human race. or at least how about a little less rationalization and fewer lame excuses.
i believe humans are capable of "managing" whatever they please/choose. certainly changing lifelong "habits" might be a somewhat difficult and in some ways painful task, but if a human wants to do that, and is motivated by their own or others interest, i'm pretty sure they can pull it off.
i believe we have choices. if we don't make the choices that we believe would be better for us, that is our responsibility. there is no mysterious force out there (that i'm aware of) making us eat whatever we choose to eat. i believe it is demeaning, not to mention false, that humans cannot "manage" to eat whatever they might chose as an optimal diet.
are there any results in this study for the vegan and/or raw food diet choices? these diet choices would presumably have an even higher intake of fruit and vegetable servings than that which resulted in the 11% risk reduction.
Since the USDA considers potatoes to be a vegetable I wonder if french fries were included as vegetable in the study.
Iceberg lettuce consumption could mute the results because it's quite popular yet not very nutritious.
Finally I would think variety would be important. After all if you ate 5 apples you'd get what the apples had to offer but you'd lack other key nutrients
Thanks for the information. It sounds so vague and when you think of it as 5 servings of one thing, impossible to achieve. Five apples a day? You must be mad! However, when you think of it as a variety and a variety of quantities it seems much more realistic. I'll have to start keeping track.
@Michael J Behrent -
Same here, except "Very rare, cold in the center, please" instead of "Medium Rare" for me. I think having portions that large may be part of why the suggested portions per day seems so unachievable.
Interesting, particularly since I eat a rather absurd amount of fruits and veggies each day, and scare my wife into doing the same by saying "CANCER!!!" in a spooky voice. There is also some hand-waving involved, it's all very scientific.
I wonder, and perhaps Orac can answer this: would the increased longevity from the cardioprotective effects in many ways produce an increase in cancer? Was this controlled for? I'm sure its a trivial epidemiological question but not all of us are sentient, science-crunching computers with years of sophisticated algorithm-generating inputs.
On the other hand, reducing my fiber intake would certainly cut down the number of visits I make to the bathroom...
Man, eating fruits and veggies is *expensive* though. Difficult on a rice-ramen-and-peanut-butter budget.
For all nay-sayers about eating lots of fruits and vegetables - it is doable. I have a couple tricks:
1) Tasty fruits and vegetables. I eat a lot of organic food, not because it lacks pesticides, but because a lack of pesticides forces the plant to increase the quanitity of chemical defences it produces - and while they may kill aphids, they taste delicious to us. Whenever possible, it is food that has a short picking-to-purchase timeline.
2) Limiting the amount of cash and alternatives available. I only bring fresh, healthy food to work with me, so I have to either go out and buy something else (which would be more of a barrier if I wasn't also pretty lazy) or eat what I've got. Of course, I sometimes go hog-wild at home with garbage, but at least I'm getting adequate fiber and micronutrients every day.
3) Eating all day. It's tough to cram in upwards of several pounds of fiber into your gullet during a lunch hour. I'm lucky my job lets me basically chew while working. Also, I try to eat the veggies while doing something else so I don't notice how much cruciferous vegetables suck.
4) Education. Really, really terrify yourself with horrible cancer stories (also works to prevent the consumption of CAM nonsense).
5) Indulge. When I do eat a steak (or pork, cheese, chocolate, whatever), it's expensive, aged meat that's cooked the way I like it.
6) Start small, work up. I first started eating this way by chopping up a couple carrots every day. Then I added brocolli. A couple months later, it was peppers, then peas. Now I've added cauliflower, radishes and beets. I've also expanded the volume from perhaps a sandwich baggie to a gigantic container. I don't think anyone could just pick it up and go, but over time it is doable.
Of course, I'm hugely lucky because I have an income and lifestyle that affords me these luxuries. So if you're not a wealthy member of the upper-middle class in an affluent Western country, all this may be worthless to you (but then again, you may come from a culture with delicious unprocessed food anyway. Mmmmm, hummus...)
i believe humans are capable of "managing" whatever they please/choose.
Really? It would please me to be able to float weightless in a 1G field. I think I'll choose to do that now...oops, it doesn't seem to have worked. Do I need pixie dust to make my choice work, perhaps?
Sarcasm aside, there are a number of reasons ranging from habit to economics to time why people don't eat as many fruits and vegetables as they should or might like to. Cut the victim blaming out already.
Of course, some of us like to grow our own with edible landscaping (lots of enthusiasts means lots of Google hits, like http://www.eatyouryard.com/, I started with plant pots in my apartment window growing tiny tomatoes).
As far as buying fruits and veg on a budget, there are ways. Buy food in season, and that has not been shipped from across the globe. Buy the whole carrots, not the cut up snack carrots. Basically the less processed stuff is usually cheaper.
If you find a deal, learn how to save it for later. Fresh basil can be made into pesto which can be frozen. An over abundance of apples can be made into applesauce, or just cut up and frozen (same with berries, and I make blueberry muffins with applesauce substituting for part of the egg).
Frozen vegies are good to have around. Modern agriculture makes the trip from field to frozen fairly quick, so that quality is pretty good. Though for a college student, do not buy Costco sized bags because they will get freezer burn. Frozen veg can be tossed into ramen noodles, I will also toss bits left over from salad (onion, tomato, pepper, celery and cucumber) into the bowl before pouring the ramen soup in. While in college I would throw spinach into the spaghetti sauce (which was made from cans of tomato sauce, not pre-made jars of sauce).
Learn how to cook, and that includes how to make greens tasty. Collard, mustard, beet and other greens taste good if you put a wee bit of olive in a pan, saute a piece of garlic and then add the greens to wilt (with no more water!). Cruciferous vegetables that are cooked or prepared well do not "suck." They actually mix quite well with apple and pear.
What are also vegies are legumes like dried beans and lentils. These are inexpensive and lentils can be made into soup, dip (dal) or salad bits fairly quickly.
well, bust my raw-food bubble. :-) I love eating fruits and vegetables, but I'm honestly relieved to know that the numbers don't change THAT much... because when I was really, really into raw foods recipes (they ARE delicious, and also aesthetically appealing) I was also scared into thinking by various advocate/fanatics of "the raw food lifestyle" that a grilled cheese sandwich was the door straight to the cancer ward. I'm relieved to know this isn't a concern. Once again, always happy to change my views when it's supported by facts. Thanks!
"Willpower" is shorthand for "this is something difficult that most people won't do for very long." After all, we don't talk about needing willpower to sleep, or talk to the people we love.
There's habit, there's economics, there's time, and there's the simple fact that it takes more than an abstract invocation of "willpower" to get people to spend significant time, here and now, on things they dislike or find pointless by telling them that they'll benefit 30, or even 3, years from now.
That goes double for people who have been told to use "willpower" for things and "failed" in the past, or succeeded in doing what they were trying but didn't get the desired results. They changed their diets, but didn't get, or stay, thin or muscular. Or they got thin but what they really wanted was to get married, or for their parents to stop criticizing their looks, and those things didn't change. And maybe, a while later, they were told that the advice they were given, and used willpower to follow, was mistaken. So now they've learned that "willpower" is a way to do something unpleasant, get nothing, and eventually be told "Ha, you did the wrong thing! Carbs are not the answer! Now try this!"
Yes, there's a lot to be said for changing one's habits: but it's not an ethical issue. I'm not more ethical if I make a habit of eating a piece of fruit every morning, or less ethical if I don't exercise on a schedule. I could use the same change-your-habit techniques to start giving x amount of time or money to a political party: and no matter what party I chose, some people would consider that choice to be wrong.
Who says it has to be at once?
If I am putting ketchup on everything, it adds up.
(how big is one of those ketchup packets? 1/2 oz? I can do 4 of them with an order of curly fries from Arbys)
Ketchup is to sweet. For all my veggies, I'm sticking to:
RagÃº Pasta Sauce: Full Serving of Vegetables in One Serving
There's a full serving of vegetables in every Original Manwich*
Sid, there are ways to fix both pasta sauce and Sloppy Joes that included vegetables. I am not a fan of buying jarred stuff that can be made quite easily. I would suggest that you would be healthier and save money if you learned how to cook both sauces (they are both very easy).
I found that finely chopped carrots and celery work in both types of sauces as substitute some of the meat and to add nutrients. A small food processor is useful for the task.
The trick with the Sloppy Joes is to allow time for the tomato sauce to cook down and thicken. If time is an issue, spend one day making the sauces to warm up quickly later.
Raw food exclusivists need to read this and this. We've been cooking for hundreds of thousands of years at least, well before we evolved into Homo sapiens sapiens. If cooking was bad for us, it would have killed our ancestors off a quarter of a million years ago.
Moderation in all things. And moderation does not mean all of one thing or all of another.
I'm not much of a cook, really at all. That said, and I realize I'm straying out of my area of expertise here, I was under the impression that pasta sauce was made from tomatoes and that tomatoes are in the fruits+vegetables category.
Please tell me that I'm not wrong on this :p
I'm sure not going to claim that it's "healthy", but I've started mixing homemade harissa paste with a little tiny bit of mayo and using that where I might otherwise use ketchup (i.e., on a burger), and it's awesome (and not sweet).
More seriously, even with "willpower", and perhaps even with money, I don't think it's that easy to work as many servings of fruits and vegetables into one's daily diet as is recommended. At the very least, it's hard to track. The Canada Food Guide that was linked above says that a woman my age should be eating 7-8 servings of fruits and vegetables every day. For lunch today, I probably got 2 servings, maybe a bit more (carrot sticks and a tomato that was split between my sandwich and the chunks that I ate out of hand). I'll have an apple for a snack, so that's 3 servings. Dinner tonight is going to be soft tacos with black beans, shredded cabbage, and peppers; I don't think that I'm going to be eating 2 1/2 to 3 1/2 cups of dinner at all, let alone just that amount of vegetables.
I don't eat throughout the day because I'm not hungry throughout the day, although if I need a snack I do try to make sure it's fruit or vegetables. I eat a mostly vegetarian diet and I consciously try to make sure that I don't eat grains at the expense of vegetables, much as I love rice and bread, but I'm still not sure that I'm meeting the food guide recommendations. And I'm not even beginning to address the problems of accessibility or knowledge.
Yes, marinara sauces are tomato based. There are also very evil pasta sauces that involve just butter, cream and cheese. Yummy, but very evil. (Alfredo sauce is butter melted in a pan, optionally with some garlic and parsley, followed with cream that is reduced slightly, then a bunch of freshly grated Parmesan cheese that is melted, go over noodles --- that is it, really no reason to buy it packaged)
Also, an Italian ragu sauce is meat based. An example:
Pasta sauce can be a great source of fruits and veggies, though note that they are cooked; you should get some fresh veggies too. (Good for the digestion, and the teeth too, actually. Plus, more fiber means you'll feel full quicker.)
I just wish I could find ways to get fruits and veggies into my eldest. She has entered a Picky Phase. She used to adore green vegetables, but now the only one she likes is asparagus. Steamed. No sauce.
Sid: potatoes are indeed vegetables, and surprisingly nutritious. You'll get good nutrition from French Fries. Unfortunately it also comes with a whole bunch of vegetable oil, so there's that. ;-) My favorite way of eating potatoes is to clean them, cut them into chunks, boil them (skins and all), drain, add a little butter, cream, and minced garlic, and then mash. Very yummy.
One of my favorite grocery-store discoveries was the fact that you can buy minced garlic in a can. Very awesome. I mean yeah, you can mince your own garlic, but then your hands reek of garlic. :-D It's great stuff, though. Garlic paste, too. I put garlic paste on my steaks. Minced garlic goes in my beef stroganoff, mashed potatoes, the filling for chicken kiev, and of course, my absolute favorite, ratatouille. That's another great way to eat veggies, though I haven't yet persuaded my children of that. My mom served that a lot when i was a kid. It's a great side dish, and very yummy. Also very flexible; you can put in pretty much whatever veggies you like.
A better motto is "variety in all things" rather than moderation. While some foods have an abundance of some nutrients (protein in meats, B vitamins in leafy greens, vitamin A in yellow veggies), each has its deficiencies as well. Eating the same kinds of foods all the time can result in vitamin deficiency over time. The best way to avoid this is to keep a varied diet, eating lots of different kinds of foods.
@JohnV Pasta sauce is indeed made of vegetables, but it shouldn't be considered a substitute for veggies. A lot of the good stuff in vegetables (fibre, vitamins) get lost the more you boil/process them. It's easy to toss a handful of olives or cherry tomatoes on a pasta dish, which will give you all the good stuff, plus make you look that much more culinary.
Chris: butter + cream + cheese = Alfredo, and the cheese had really better be Reggiano. ;-) It is not evil at all, but is in fact one of the finest sauces ever invented! Also one of the hardest to screw up, so I highly recommend it if you want to impress guests. Heat the cream and butter until the butter is melted. Turn off the heat. Add grated cheese. Stir until mixed. (The cheese will melt partially.) Adjust proportions of each ingredient to taste; roughly equal is pretty typical, but it's not very critical.
I once had a cook serve me "alfredo" which was really a roux. That was quite a surprise when it hit my tongue. Bleah.
Been there, done that.
I started putting spinach in my spaghetti sauces in college because I did not want to wash both a salad bowl and a plate (trying to get the meal in one pot). I extended that to picky eater kids. I now also put a layer of greens in the lasagna.
I also make a scalloped potatoes, but while the Betty Crocker cookbook said to start the white sauce by sauteing some onion, I extended that to include finely chopped carrots and celery (oh, and dried basil). Occasionally I will toss in some other left over veggies like beans and bell pepper. Kids ate it.
Fortunately, the kids have changed and are eating more fruits and vegetables voluntarily. Even salads! I still make the elaborate scalloped potatoes, because it is tasty.
My daughter has started to make smoothies that involve filling the target glass with frozen strawberries (measuring). Tossing them into a food processor, and chopping them. Then that is followed up by a bit of milk, with some added powdered milk and whirled, sometimes with and sometimes without a bit of sugar. This is something that was in our over twenty year old What To Eat When You're Expecting book as a way to boost calcium intake.
Yep, Calli, I have made that sauce several times. The one cheese to not use is the stuff that comes in a can!
My mother-in-law once took a pizza recipe I gave her and did that. AAARGH!
I sometimes dress up the sauce with bits of ham and peas.
Oh, and it is evil because I love it, and it is very high calorie!
I had a question: I was always under the impression that the main cancer that fruits and veggies were supposed to help prevent was Colon cancer - that the high fiber was supposed to be the reason for that. Anyone know if that's true. Well I guess I could do a search on some studies on that.
I'll reiterate the point about economics while I'm at it. As someone with non-too-much money I do find it expensive to buy as much greens as I'd like to. I mean, yeah I could go buy some iceberg lettuce, but I doubt that helps all that much (unless it's solely the fiber that's helping). I'm lucky though, even though I rent, I have an actual house (shared) with a nice yard, that I've converted into a garden (Gardens not Lawns! is a saying we have here). I got a very good harvest of winter veggies (the BEST butter lettuce) and now have my spring/summer crop planted.
@29 Diane wrote:
"i believe humans are capable of "managing" whatever they please/choose. [quoting my post @23]
Really? It would please me to be able to float weightless in a 1G field. I think I'll choose to do that now...oops, it doesn't seem to have worked. Do I need pixie dust to make my choice work, perhaps?"
sorry, i apologize for not including the phrase "within the bounds of demonstrable reality". please consider that phrase to be implicitly a part of all my sentences. but, your sarcasm aside, clearly orac originally seemed to assume a priori that most people cannot "manage" to eat as many servings of fruits and vegetables as might optimize their health, even if they wanted to. obviously, there is no question of "management" of diet if you aren't attempting to adhere to certain criteria in your food choices.
"Sarcasm aside, there are a number of reasons ranging from habit to economics to time why people don't eat as many fruits and vegetables as they should or might like to. Cut the victim blaming out already."
so now people who don't eat as many fruits and vegetables as they might like are "victims"? i'm shocked. my point was exactly that people aren't victims, nor are they incapable of managing their diet however they'd like... they have choice (with the possible exception for financial reasons, but i find that one hard to believe... unless someone really is living on the ramen diet...). "habit"? yeah, i'm guessing a substantial percentage of people are eating basically what their parents fed them in childhood. have a lot of people shed that habit and eat substantially or almost completely differently now? obviously yes. "time"? how much time is involved in preparing a piece of fruit? i don't believe there is any more time involved eating one choice or the other. there are packaged and prepared foods from the fruit and veggie and grains categories that take exactly same amount of time to prepare (possibly zero time other than opening the package) as any other choice.
there is no "victim". people ARE capable of managing any dietary choices they prefer. stop asserting that humans are hapless creatures without true choice and decision making capabilities. within the bounds of demonstrable reality, of course.
Another good money-saving tip is to rob old ladies at the Farmer's Market. As long as you wear tight jeans and "ironic" eyeglasses, nobody will be able to identify you afterward.
@jj - the explanation I got about the fibre/colon thing was that fibre helps sweep out your bowels, preventing semi-digested food from accumulating in your large intestine. Accumulated solids can apparently cause problems that are precursors for cancer. It's not that I didn't pay attention in nutrition class, but it was mostly confined to the girl who sat in front of me.
Like we have been saying for quite some time now, most cancers are immune function related. Cancer is the result of an illness, not the illness itself. Therefore when you treat the symptom, you fail to cure the disease. That's why chemo seems to do nothing but hide cancer in another organ only to return with a vengeance.
Treat the illness, ot the result of the illness and a cure can happen. The immune system dysfunction is the cause of most cancers.
I think we may now know what is causing most of the gayism in America now:
Now we can cure it.
Off topic troll is off topic. And delusional.
Some vegetable-cooking tips from an Aussie
* Any kind of leafy green vegetable will taste good with a bit of grated ginger. Heat a bit of oil in a large pan, toss in about a tablespoon (15 - 20g) of grated ginger, sizzle until you can smell it, then add your veges and cook, stirring, until they wilt.
* A good combination I've found: leeks and bacon. Chop your bacon rashers fine, cook them until the fat is starting to become transparent, and then add in your sliced leek. Cook until the leek becomes transparent. This can be a good basis for adding things like finely sliced cabbage or capsicum as well.
* Don't rule out things like soups and stews as a way of getting your fruit and veges. It's coming into soup season here in Australia (or in other words, the seasons are beginning their drift around to winter) and a good hearty minestrone contains lots of vegetables (onions, beans, cabbage, tomatoes, carrots, spuds etc). Also, as mentioned upthread in comment 30, the pulses (lentils, dried beans, dried peas etc) also count as vegetables, as are a lot of the less common grains. So a good beef and barley "stockpot" style soup (I make mine with onions, carrots, celery, a bit of turnip, and maybe some potato if I'm feeling lavish, as well as a good solid helping of pearl barley) is about two serves of vegetables in and of itself.
* Another tip for cooking green leafy veges - use sesame oil for the cooking. You don't have to use much - even a couple of drops mixed in with a relatively bland oil will be enough to convey the flavour.
* Even doing little things, like chucking in an extra onion in things like spaghetti sauce, is a way of increasing your vegetable load.
* There are no strict rules which say you must eat your vegetables plain (and to be honest, just the thought of plain steamed veges makes my tastebuds recoil in horror). If you want cauliflower with cheese sauce, go for it (it tastes even better if you add a teaspoon of seeded mustard, in my opinion), or if you want to sprinkle parmesan or grated cheddar onto your veges, feel free. If you're trying to avoid fats, try lemon pepper as a seasoning, or grated ginger, or even a pinch of paprika. It's food, and despite the ongoing efforts of the diet industry to persuade us otherwise, eating tasty food is not a mortal sin in any religion. Neither is eating bland, unappetising food a particular virtue.
My tips above are based on the Australian guidelines, which makes 1 serve of vegetables approximately 75g, and a serve of fruit 150g.
Over here in Australia, it's cheaper to buy fruit and vegetables than it is to buy meat, and there's fresh fruit and veges readily available at every single supermarket in town (even the inner-city ones). So often if people are saying they're running low on money, one of the things which is recommended here to save dollars is cutting meat protein and substituting in vegetables and fruit instead.
A couple of Australian sites:
For a brief change of sunject, this guy is right on target. The evil tyrant Goerge Soros screwed America over and he should be inestigated and possibly arrested.
Well, if it isn't my stalker Chris. Keep following me, I'm sure you love to sniff where I have been. Do you work for that evil tyrant George Soros? He is the second most evil man on the planet.
As far as I know, the evidence for a protective effect of fibre on colon cancer is still inconclusive.
There is some laboratory and epidemiological evidence suggesting that certain chemicals in cruciferous vegetables like broccoli may have anticancer effects. So that could partly explain the potential inverse correlation between vegetables and colon cancer, if it isn't due to confounding.
You said there were no veggies that taste like meat. What about portobello mushrooms? Ooh, tasty.
Calli, I just had a major event in the expanding diet of my teenage daughter. Yesterday while chopping veggies for dinner (a Chinese-like walnut chicken with lots of lightly sauteed veggies), I slowly cooked two thinly sliced sweet onions. Which I then put some soup stock and cooked some more, as a modified French Onion Soup, which I put in the fridge.
This afternoon I started to warm it up, my daughter asked me what it was because she was hungry (I'm going to a meeting this evening so it is leftovers for everyone else). I told her it was French Onion Soup, and it would be done in fifteen minutes. She wanted to try it.
So I put the soup into two bowls, crumbled sourdough toast on it, covered that with Swiss cheese and some parmesan cheese and put them under the broiler. I gave her a bowl, and she announced it as good! Woo hoo!
Doctor Stupid, if you look you will see I have been posting on this thread long before you showed up.
I'm so glad that you did this post because I wasn't sure what to make of it. I easily eat my ration of veggies and fruits each day and I love them! Lots of berries and I try to eat all the colors every day--red bell peppers, purple cabbage, lacinto kale with golden beets, brussels sprouts with a little parmesean, a small apple, half an orange, small banana, some canteloupe (in season)--why would you disparagingly compare veggies to meat? Meat eaters always do this and I really wish I knew why. It's as if someone who doesn't eat meat is to be pitied. I'm really sick of it and very sorry to see you indulge in it. You eat meat--fine, but why assume everyone thinks that meat tastes better than vegetables? Peraonally, I think the small of burning flesh is rather disgusting, but I rarely mention it, yet meat eaters without fail, make snide comments about veggies and other healthy foods at every opportunity.
Also, thanks for whoever above mentioned the "meatiness" of mushrooms--especially portobellos. It is meat that ruins the taste of perfectly good veggies in my book.
Five servings is two and a half cups and this shouldn't be too challenging for anyone even if they eat meat as well. Why make it sound impossible? I had a colonoscopy a few years ago and the doc said I had the cleanest colon he'd ever seen in 30 years. A weird claim to fame, I admit, but it has to be all that fiber!
I believe that was a device known as a "joke." That is something to be expected on a blog called "Respectful Insolence."
why would you disparagingly compare veggies to meat? Meat eaters always do this and I really wish I knew why.
Most people don't disparage veggies to meat. They disparage veggies without meat. Why? Because we are biologically designed to like the protein/fat combo that is meat.
Eating meat isn't an aberration, it's natural. So people tend to see those who stray from the norm as somewhat to be pitied.
Same goes for a whole bunch of other behaviours that run contrary to our biological imperatives: Self-mutilation; Anorexia; Celibacy, the list goes on.
Personally I try to eat only small servings of meat. 80 grams (3 ounces) is plenty for a meal, and not every meal need meat by a long shot. But I find pure vegetarianism odd. And the idea that it is more spiritual/ethical quite peculiar. Your mileage may vary, but I bet you have canines in your mouth, just like me.
Now I feel an urge to snack on some raw veggies. Behold the subliminal power of the Orac.
I just wanted to correct one point here. While most veggies lose nutrients when cooked, cooked tomatoes are actually more nutritious then raw. I know I am being picky here, but I just wanted to clarify.
Just keep in mind that for some veggies cooking increases certain nutrients. So it is probably a good idea to make sure one is eating a variety, cooked and uncooked (but never over-cooked).
Another good point; remember that many nutrients are fat soluble, so it is a good idea to incorporate a little fat with your veggies (i.e. olive or canola oil).
Interesting how different people can read the same information and come to different conclusions. A 9-11% reduction in cancer across the board sounds hugely significant to me. Yes, some have overblown the benefits, but in what subject do they not? Thanks for this analysis btw!
Now what's the deal with anti-oxidants?
It's complicated. See:
There are probably few people who do 5 a day combined with two supersized BigMac meals, or maybe have all their 5 helpings in form of screwdrivers.
It is important to note that wine is basically concentrated grapes. Consequently a glass of wine surely counts as about 3 servings of fruit a day. Now, how many hops are there in a pint of beer? I figure that should account for 2 vege servings. And there's your five a day, easy! :)
I agree that there is nothing you can do to plants to make them taste like steak. I'm low-carbing now, so I don't cook vegetarian esoterica for sport anymore. But I can tell you that I cooked a casserole for my Jewish grandmother that had her picking it apart bite by bite to see where I hid the chicken. Finally she concluded I must have ground it up and included it in the sauce. Nope... basically just spices, no chickens were harmed in the making of, and all that. I can do it with beef flavor, too, and she also likes my cabbage soup that she thinks I make with beef broth.
Were the fruits and vegetables consumed by the participants in the study of the healthy or healthful variety... or both? ;-)
To bring the discussion back to the study: I don't think it's valid for these reasons. Were the vegetables microwaved in plastic, as is common these days? Did the subjects use tin cans, containing BP-A and probably depleted vegetables? Did the subjects drink diet coke? etc etc. I could go on, but the issue is so complex that to trot out numbers like 3% is meaningless, unless these environmental factors are also controlled. These type of studies are implicitly based on "old school" thinking, in which it is assumed we live in a clean environment and eat pure foods. Even today, to my knowledge, there is no definitive answer to why women in certain metropolitan areas have a higher incidence of breast cancer. And supposedly the Chinese have lower cancer rates. True, they eat more vegetables, but don't consume meat or milk nearly as much. Just some thoughts. The world is a mysterious place, no?
Hello friends -
@Orac - Very nicely done.
@ 14RR - hehe
@ everyone - It isn't that difficult to get 5 a day, and 9 a day is pretty achievable, but you have to feel like changing the way you live, not just the way you eat. You can't go out to eat as much, and you are going to learn how to cook. Your budget towards food will go up, but you'll likely lose weight. I've been 'veganesque' for about two years now, I really feel better than I used to (?), but if I eat a bunch of meat, I definitely feel poor for a day or two. (?)
@ Kristen -
I'm struggling a bit with this argument.
I'm betting that your mouthfull of four canines would be asking for some help the first time you tried to eat a raw steak without the help of a knife and fork. Our tools and mastery of fire are very helpful, but I'm not sure we've had the time to evolve into a state where we can state that we are biologically designed to like meat. Do you have any references I could look up regarding this?
Do we have good evidence for another primate species that gets a significant source of their food from animal sources. (?) The B12 argument is a strange one; does anyone know how other primates gather their b12 considering their negligible (or non existent) meat consumption?
Good post, Orac. Thanks again.
I know chimps are meat-eaters - I remember an article describing a tribe of chimpanzees occasionnally hunting and eating baby baboons from a nearby tribe. Although chimps are mostly eating insects like termites. A quick google search could confirm this, by example:
According to this site, meat represents only 5% of their food intake. Not much, but I would not dismiss it as negligible. Especially if you are talking about uncommon nutrients.
Also, bear in mind that we are not exactly a chimpanzee or a gorilla who just fall down the tree. They are close species, but not our species. Similarly, panda and bears are very close species, and yet their diets are very different.
Now, I'm not saying what we need 1 pound of meat every day. I'm sure a properly selected diet could be without meat. But, not being a nutrionist expert myself, I would not know where to start. And I don't trust much any of the "seen on TV" experts.
@pD: To your knife and fork comment, it's important to remember that genus Homo has had access to knives (of varying quality) for at least 2.3 million years, starting with H. habilis. We see evidence even in modern (anthropologically-speaking) times of stone and bone tool using cultures having no difficulty eating raw red meat (Inuit seal hunts spring to mind).
There is ample archaeological evidence of H. habilis gaining a significant portion of their dietary intake from animal sources. I'd consider 2.3 million years sufficient time to develop an evolutionary predilection for meat protein and fat sources. To say nothing of the evidence for chimpanzees supplementing their diets with animal food sources (5-10% of diet are frequently cited figures) and the recently emerging evidence pointing to the possibility of some degree of the same in gorillas and bonobos (http://www.ncbi.nlm.nih.gov/pubmed/20195539). Either these branches of the primate family independently began to seek at least some amount of animal-sourced food or it was already present in a common ancestor.
Meat eating has been with us for a long time.
Hi Seb30 -
This page has more on chimpanzee hunting:
It is pretty neat, and describes a large seasonality in predatory patterns, up to 40% of the hunts took place in two months. I've been shooting for about a 5% caloric input from animal sources, funny enough.
I also found a bit that indicated there were questions as to if increased b12 ingestion played a part in advanced cognitive abilities in our species.
You are right to struggle with that argument.
To the rest:
As you can tell by my name, I'm an anthropologist. I have posted the gist of this before (here and elsewhere), but let me take another stab at this idea that prehistoric people ate meat all the time.
The proper term for prehistoric food patterns is gatherer-hunter, not the other way round as you usually see. Very early humans probably scavenged for any meat they ate. Later on the men (at least) hunted but success was probably limited and the bulk of the diet was gathered by women in the form of roots, nuts, and berries all the way to the development of agriculture 10 - 12,000 years ago.
Cutting tools have been around since australopithecus and had many uses. They are not usually called "knives" unless the purpose is known. Blade is more common. Chopping tools are the earliest and were probably used for cracking things open (like nuts and including bones for marrow). It depends on which human ancestor you are talking about.
We are omnivores, as are some chimpanzees, but the meat eating is not common for chimps and was not the bulk of the hominid or human diet. Gorillas seem to be strict plant eaters. Not sure about orangs--will look it up.
Whatever we ate in prehistoric times, we are adaptable and can choose our diet within the parameters of adequate nutrition. Since I don't care to hunt (or scavenge), or know anyone who does, I choose not to eat meat (with occasional exceptions). I keep chickens and eat eggs. If you like meat, it's because you learned to (culture) and you can learn to like other foods as well if you want to. Do as you like, but stop justifying it with human evolution unless you are qualified in the field; otherwise you sound as empty as any altie practitioner playing doctor to me.
I certainly haven't covered every aspect of this here, just tried to point out a few common misperceptions of human prehistory.
Ketchup is a fruit, not a vegetable. ;-)
RE: Cheese sauces. I had a batch of Welsh Rarebit (Basically Pale Ale and Cheddar!) curdle on me, and I was so traumatized that I did not try again for years. Then I found the trick is to dust the cheese with flour so it does not clot. It would probably work with Alfredo sauce as well.
From last Saturday's Wait, Wait... Don't Tell Me!:
@ Chris, #74
Not necessarily. Even people in good health often need pharmaceuticals to get their numbers to acceptable ranges. Early onset heart disease runs in my family and I am the first woman in my family to live past 52. In spite of lifelong exercise and good diet all my adult life, I had a stent at age 49 and even though my weight is now normal, I take small doses of blood pressure meds and a statin. When my weight was higher I took much higher doses. I was edging toward diabetes prior to weight loss as well, but my glucose is now normal with no meds.
This is only one example. There are many conditions requiring pharmaceutical intervention and I don't think any of us (Mike Adams and his ilk excepted) would want to live without antibiotics being available. I don't think Type I diabetics would want the pharmaceutical industry to "collapse". Just because "lifestyle" drugs dominate TV ads, doesn't mean they represent the bulk of drugs--just the ones that make the companies a lot of money. Men who can't "function" will pay anything to get viagra--fine with me if it provides money for research.
Fun to read, and its always useful to hear about the results of a major new prospective study (which after all seem to be the best tool we have for assessing things of this sort)--- but it simply confirms what we already knew. Diet is very important for cardiovascular health. As is fitness etc. Cancer is a much harder problem, which you can affect but less.
I wish someone would answer Cervantes's (#19) question. I just don't grok the 6th sentence of this otherwise brilliant post. I agree with Tracy, surely a glass of wine = a couple of veg units.
Anthro,two recipes for you (the first one is a soup I have been making for myself lately, the important thing is to saute the paprika in oil to bring out its flavor, also since I reduce it to one serving I only use one clove of garlic, and one egg):
Sopa de Ajo (Soup with Garlic)
Vegetarian soup with beer and poached eggs
The last one I just watched on my DVR (I am catching up). It looks good. Personally I find it fun and interesting to poach the egg in the soup itself.
You must share your secrets! I have spent thirty years trying to reduce spousal unit's consumption of meat. As noted before one thing I have done is to use ground up veggies to replace hamburger.
I know I have managed to get the Meat and Potatoes Dutch/Canadian to actually eat tofu, but only when he was very hungry. I need to know how to make him think there is meat in casseroles and beef in soup! Please share your secrets!
Further information about him and his heritage: I have actually spent a week at his grandparents in the Netherlands. They did not have an oven, and they really did start meals by melting half a kilo of butter in a pan. That is where I actually ate a steak braised in butter. It was very pale, but very good. Ah! The power of butter!
Except I am not Dutch. Dear hubby has very low cholesterol numbers despite his fondness of butter, sausage and things braised in fat. I am not so lucky. Stupid genetics.
PS: I also come from a family that has issues with digesting milk. I actually have no issues, but my sister, daughter and mother-in-law are all lactose intolerant.
This is not my comment, I don't even agree with this statement.
I really don't struggle with that argument. I have a background in nutrition. That comment was Mark P it was falsely attributed to me. A number of different diets can be health and unhealthy-just depends on the planning.
Thank you for the very interesting comment.
Someone above asked how animals who don't eat meat get B12. They eat dirty veggies from the ground and get it from the soil. We eat clean produce, hence the need for supplementation. But you can find vegan B12 supplements (made from algae I believe) from "natural food" stores.
Interesting, and certainly at odds with a lot of what I have read. Any online reading?
Chimpanzees certainly are active hunters, that is pretty clearly established from observation, and gathering sufficient wild plants for humans to sustain themselves seems pretty far fetched to me; note that many current plants that we eat are the product of centuries of selection for bulk and calorie content.
Look at it this way: Most plant eaters don't pick the insects off first..
Aren't relative risks below 200% considered statistically insignificant, as in, can be attributed to chance? A difference of 3, 9, 11, or even 20% means that it was a null study.
The press makes a big deal about these numbers, but, in truth, they tell us that we need to keep looking for answers because eat-your-fruits-and-veggies isn't proven yet.
Another big chunk of missing information here: Overall mortality. Do the veggie-eaters live longer than those who don't, or do they just get to have different entries in the "cause" part of their death certificates?
So, diet is not a factor in prostate cancer? I have a family history of prostate cancer and I am struggling with this issue.
You might have heard of Mike Milken's diet. He was given 12 to 18 months to live and converted to a plant and soy based diet. Almost 17 years later he is still doing well.
I would point to Dr. Ornish's study as well. But, I see that he has already been sufficiently vilified on this blog.
A healthy diet typically includes fruits and vegetables. For that matter, avoid the consumption of red meat is deemed as a positive change in a diet. No one ever endorse a pure meat diet. Just my two cents...