A Plant-Based Life: Your Complete Guide to Great Food, Radiant Health, Boundless Energy, and a Better Body

By Micaela Karlsen

More people than ever are eating a whole-food, plant-based diet. Studies show that it is better for our bodies and better for the planet, but it isn't always easy.

Whether you're taking your first steps on this path to wellness or recommitting yourself to success, author Micaela Cook Karlsen clearly maps the way. Her program enables you to set your own pace and stay the course--without relying on willpower.

Drawing on personal experience and the latest research, A Plant-Based Life reveals how to:

• Find and sustain your motivation
• Gradually add more whole, plant foods into your diet
• Break old food addictions and establish new habits
• Translate favorite recipes to create delicious, nourishing meals
• Reshape your food environment (at home, at work, and on the go) to make healthy eating a no-brainer
• Cultivate relationships that celebrate and support your new lifestyle

Especially valuable are directions for navigating roadblocks. You'll find strategies for getting family members on board and for allaying friends' concerns about your food choices with evidence-based nutrition information. Take advantage of shopping tips, pantry lists, menu plans, and more than 100 mouth watering recipes, with contributions from plant-based leaders.

If your goal is a healthier, more energized life, make A Plant-Based Life your personal GPS. The journey will be more satisfying than you ever imagined.

• Language: English
• Publisher: Thomas Nelson
• Release date: Jul 22, 2016
• ISBN: 9780814437087

Micaela Karlsen

Dr. Micaela Karlsen serves as Director of the Lifestyle Medicine Economic Research Consortium from the American College of Lifestyle Medicine and the Lifestyle Medicine Institute, as well as co-investigator on the Adhering to Dietary Approaches for Personal Taste (ADAPT) Study from Tufts University. She is also Adjunct Faculty for the University of New England Master’ Programs in Applied Nutrition and Global Public Health. Dr. Karlsen is the author of A Plant-Based Life and a contributor to the New York Times bestseller Forks Over Knives: The Plant-Based Way to Health. She created and maintains PlantBasedResearch.org, an online library of original, peer-reviewed research studies relevant to plant-based nutrition, as well as SustainableDiet.com, a 3-month transition program for supporting successful and permanent transitions to plant-based diets. Her expertise is in dietary patterns, plant-based nutrition and nutritional adequacy, and predictors of successful behavior change. She holds a PhD in Nutritional Epidemiology from the Tufts Friedman School of Nutrition Science and Policy and a Masters degree in Human Nutrition from the Johns Hopkins School of Public Health.

Book preview

FOREWORD

by T. Colin Campbell

Adopting diets mostly or entirely composed of intact, whole plants—vegetables, fruits, grains, legumes, nuts—has been a challenge for decades, if not for centuries, given the natural human tendency to seek more calorie-dense foods. Animal-based diets have long been preferred by most people, becoming firmly entrenched in the cultural fabric of societies able to afford these foods. At the same time, taste preferences have, over time, become fixed to the point that we can now call them addictions. In recent decades, this has been exacerbated by the increased use of refined carbohydrates—especially sugars and refined flours—primarily for the purpose of responding to what we might refer to as snack attacks by creating sweet-tasting convenience foods, which are also loaded with fat and salt.

The scientific evidence in favor of a whole food, plant-based diet has become impressive in recent years, suggesting to many people an urgency in making a dietary change, for a variety of personal and public reasons. However, because of the seeming intransigence of dietary tradition, change can be quite difficult. A Plant-Based Life, by Micaela Karlsen, addresses this challenge with a personal and professional focus that readers will find both useful and compelling.

Among those of us involved in the scientific and clinical development of data on the benefits of whole food, plant-based diets, there is good consensus that we need to find ways to make change possible. It is not a lack of reliable evidence favoring this way of eating but a question of behavior change, as the professionals like to call it. How can people navigate change for themselves and their families and friends? On a societal scale, there are powerful institutions that will resist this change using all the resources under their control and at their command, however reasonable or unreasonable their efforts may be. The answer, it seems to me, is to go directly to the consumer and offer them some ideas that make easier their transition to a better lifestyle. Readers will find such ideas, and more, in this book, making the path to a plant-based life desirable as well as achievable.

PREFACE

AT AGE 17, I made a decision to stop eating meat. My reasons then weren’t anything like my reasons now. There was just a vague feeling that moved me to stop. It could have been related to the fact that some of my friends didn’t eat meat, or it could have been some innate instinct for health, but for whatever reason, I just didn’t want meat anymore. Becoming a vegetarian was gradual over months, but by the time I had turned 18 and was in my senior year of high school, I had stopped eating meat completely and began to think more specifically about my health. I was highly allergic to dust and dust mites, so much so that I was a candidate for weekly allergy shots. The shots helped but, it seemed, only up to a point. I have memories of waking up on the morning of my shots with dry lips and a sore throat from breathing through my mouth all night. I would sit up in bed feeling everything in the world start sliding downwards. My nose ran, the room spun, and it was all I could do to stumble into the shower, where the hot water gave me 15 wonderful minutes of normal breathing. Add skin problems, sleep deprivation due to insomnia, typical concern over my weight, and it’s amazing that I was still a good student.

The diet I ate as a vegetarian in high school involved lots of white bread, skim milk and cereal, cans of green beans for lunch, and orange juice. I organized my choices around an attempt to lose weight by eating a low-fat diet. I did lose weight, but I was always hungry. Constantly looking ahead to my next meal, while at the same time trying to concentrate on calculus or my after-school job, I limped along in a state of deprivation that seemed justified because it allowed me to maintain a healthy weight—or at least a weight at which I didn’t feel self-conscious. Moving into my freshman year of college soon ended my dedication to a low-fat diet as the all-you-can-eat buffets provided more than enough extra calories for me to gain the freshman 15.

During my junior year, one of my best friends, Meghan Murphy, took a popular course at Cornell, NS:200 Vegetarian Nutrition, taught by Dr. T. Colin Campbell, the university’s Professor Emeritus in nutritional biology, and later the coauthor of The China Study (2005), the first and most comprehensive account of the research on plant-based diets and health, as well as author of Whole (2013). Through Meghan, the evidence-based, scientific information about diet and disease began to seep into my thinking. Having already read John Robbins’s Diet for a New America, and eaten a vegetarian diet for several years, it was no big mental leap to cut out dairy and think of myself as a vegan. Physically, my cravings for cheese remained in full force for a few years (in contrast to giving up meat), but intellectually a totally plant-based diet made sense.

By the time I began working for Dr. Campbell’s foundation in my mid-twenties, I’d been eating what I considered a vegan diet for several years, had much improved my allergies and skin, and had settled into something close to my ideal weight—and minus the deprivation. Being so closely involved with information about whole food, plant-based (WFPB) nutrition, I was able to further refine my understanding of what whole food meant. It took me at least another six months to a year to move into a truly whole food, 100 percent plant-based diet, but it’s now been almost a decade of this gradual shift, and I couldn’t be more pleased. Once I started eating a truly whole food, plant-based diet, I felt comfortable in my body for the first time since I was a child. I still have challenges when I’m in certain food environments and I have to strategize around them to make sure that I don’t get pulled back down the addictive rabbit hole of fatty foods. But I am able to maintain my dietary lifestyle successfully because of specific strategies that are discussed in this book, and these strategies can work for everyone.

The people whose stories are shared in A Plant-Based Life, who provide supporting evidence for the research and examples of certain principles we’ll cover, can also serve as inspiration to you. Many who were motivated have struggled. They have overcome their backgrounds, their childhood eating patterns, unsupportive family members or spouses, and challenges with their children, but they have achieved permanence in following a dietary lifestyle that is quite unusual in the current environment, and they have attained good health that they can enjoy for many years. I was one of those people, and it took me years of trial and error to arrive at a peaceful and successful place with my eating and my diet. I’m grateful for what I’ve learned, and now I’d like to help you skip some of that difficulty.

INTRODUCTION

THE SECRET’S OUT, AND everyone’s trying it. Eating a whole food, lant-based diet not only can prevent and reverse chronic disease, t’s delicious, beautiful, environmentally sustainable, compassionate—it’s the prescription you’ve always wanted, the one that actually makes you feel better than you ever thought you could with only positive side-effects.

Once it’s a habit, plant-based eating can be easy, not to mention tasty. But reformatting your patterns and old way of interacting with food takes skill and strategy; like any habit, sustaining it requires some ongoing maintenance. It’s not something that happens to you; you have to choose to make it happen. Our busy schedules, long commutes, and the sheer volume of food choices we have make the modern food environment a relentless challenge to healthy eating. A Plant-Based Life is a resource to help you understand, navigate, and conquer these challenges at your own pace so you can enjoy a life of dietary ease and health. It will also help you stay connected to other people while you’re on this journey.

You may have picked up this book because you’re just beginning your journey of eating plant-based food. You may have picked it up because you’ve been eating some version of a whole food, plant-based diet for some time and you’ve hit a roadblock or a plateau.

You may not actually want to eat a vegetarian, vegan, or largely plant-based diet but are just looking for strategies to help you incorporate more vegetables and fruits into your life.

If any of those things are true, you are in the right place.

Even for motivated eaters who may care deeply about their health, our environment, or the suffering of animals, it can be difficult to stick with your intentions about what you want to put in your mouth. You may have streaks of great success interrupted by periods of falling off the wagon. You may feel satisfied with your overall diet but wish to ferret out those few habits that prevent you from losing the final five pounds so many other plant-based eaters seem to lose so easily.

You may be facing a serious illness, confronted by the reality that changing your diet is essential—but you have no idea where to begin.

You may have read other books on nutrition or factory farming that provided motivation to give it a try, but you’re dubious about whether or not you can stick with it.

This book is written to be an effective and compassionate how-to manual for anyone who wants to know more about what a whole food plant-based diet is, how to transform his or her own diet, and how to ensure success in sticking with it.

It’s hard to explain to someone who’s never tried it just how good you can feel eating whole, plant foods. Personally, I think that feeling good is one of the reasons it’s so much easier to stick with it than other behaviors we feel we should do for our health. People who eat some version of a plant-based diet already will be familiar with the improved energy and clarity of mind, but it doesn’t stop there. You may want to lose weight and achieve a healthy weight without counting calories, and you can. Plant-based diets have also been demonstrated to reverse (that’s right—reverse, not just prevent) type 2 diabetes¹ and heart disease,² stop the progression of MS,³ and reduce the risk for cancer.⁴ These are the major causes of preventable death and disability in the Western world!

But this isn’t just about physical health. You may want to eat in alignment with your values, and you can. You may want to create a sustainable future for our planet, and you can. The power of plant-based eating is that you can make a real and appreciable difference in your own life, which at the same time makes a difference in our world.

Most people embarking on a whole food, plant-based diet for the first time will have questions and concerns about plant-based nutrition. We will cover these questions and concerns carefully, tackling these topics from an evidence-based perspective.

Evidence-based thinking means allowing the available scientific research to direct your conclusions, with your mind open to changing your position if the evidence supports it. Evidence may include personal experiences and case studies, but it should be founded on population-based or intervention research studies that track the response of groups to different conditions. It is the most objective and trustworthy way of gathering food for the mind.

Here are some of the questions and concerns that people often express:

■ Will I get enough protein without eating animal foods?

■ Don’t carbs make you fat?

■ What about B12?

■ What about vitamin D?

■ Don’t I need to take fish oil supplements for omega-3s?

■ What is gluten-free all about?

■ I ate a vegetarian diet in the past and I was so tired. I’m not sure if it’s good for me.

■ I think my body needs meat, or needs dairy.

■ What about raw food? Is a raw diet healthier?

■ How do I know what to believe about nutrition? There’s a new diet every week.

You may also be concerned about any of the numerous roadblocks you will encounter in making healthy choices and you’re not alone in this. We’re going to address each of these concerns and lead you through the steps you can take to overcome the obstacles. You may relate to some of the following:

■ I know eating a whole food, plant-based diet is a good thing. How do I stay motivated?

■ What am I actually eating for breakfast, lunch, and dinner? How do I do this diet?

■ What ingredients do I buy? What do I cook?

■ How can I get my family on board?

■ What do I feed my kids?

■ I feel insecure when friends and family question me about what I’m doing. I’m not sure what to say, and I start to doubt my decision.

■ I can’t say no; temptation gets me every time and I eat food I don’t want to be eating.

■ I get so hungry when I’m out of the house that I end up buying unhealthy, prepared food.

■ I’m addicted to fat, sugar, and salt.

■ Every time I get close to breaking the addictions, I give in to cravings and I’m back to square one.

■ There are reasons other than hunger that I turn to eating (emotional eating or overeating).

■ No one in my immediate circle is supportive of my diet.

■ I live in a place where healthy food is hard to find or actually get to, or where it’s very expensive.

■ I’m too busy to cook.

■ I won’t be able to go to normal restaurants with my friends now that I eat this way.

■ I feel intimidated thinking about giving up so many foods I love.

I have heard these beliefs from people many times. These are the places where people get stuck, but there is a path through each one of them and the reward far outweighs the challenge. Even if you have tried eating a plant-based diet in the past and struggled or met with only mixed success, you definitely can succeed—if you commit to success and use the strategies we’ll discuss here. You have an incredible opportunity to change your life. Change is initially uncomfortable, but so, so worth it. You’ll be repaid many times over in long-term ease and comfort in your body.

HOW TO USE THIS BOOK

JANET HAS ALWAYS BEEN an inspiration to me around cooking. I love food! she has declared. Some of my favorite lasagna experiences are thanks to Janet; she makes an ever-varying recipe, sometimes using zucchini for the noodles, sometimes rice pasta, and sometimes just layering various vegetables and herbs in a delicious approximation of lasagna that I have only wondered how to replicate. I’ve settled for being grateful to have such a talented friend.

Janet has such a right relationship—to use her words—with eating that I am often caught up in a poetic appreciation of her cooking. I belong to a local farm, and last night I picked up some chard, she once told me. This chard, it’s grown in a hoop house—it’s just the sweetest, tenderest, most delectable chard you can imagine. The closer it is to the point of picking, the more exciting it is, the more nourishing and comforting it is.

I don’t actually love chard, but I love Janet, and hearing her thoughts about it made me love the chard in that moment, too.

Of my many friends who eat a whole food, plant-based diet, Janet’s delight in it is inspiring, especially when you consider her background. As a child, her family food environment revolved around Sunday dinners of exquisite torture. The weekly ritual, aptly named Prison Dinner by her parents, efficiently precluded any possibility of undiscovered misdeeds going unpunished, as all the children were fed special food the parents had reserved in the back of the refrigerator to grow moldy, thus systematically penalizing all uncaught misbehavior. After decades of healing, experimenting, learning, testing, getting help, and trying various eating patterns, Janet’s diet is worlds away from what she ate as a child, as it is from the steak and hamburger she ate regularly in her twenties, and food is now a source of joy and inspiration. Today, those childhood horrors no longer seem to affect her except in shaping her tolerance of other people’s food choices. She has health and vitality, alignment with her personal values, and a lot of friends who love to eat her cooking.

How is Janet able to do it, and how can you do it as well? Wavering commitment to a dietary goal is something many of us have shared at one point or another in our lives. The inspiration to eat a healthier diet might have come from a health crisis, influence or pressure from friends and family, innate curiosity, desire for greater fulfillment, or as an expression of your principles. Whatever the source of your urge, there are two certainties. First, you have to start somewhere, with some kind of motivation to make an improvement. And second, it’s going to take more than your initial burst of enthusiasm to keep it going. Making permanent lifestyle change requires experimentation, adjustments, and continual recommitment. This is how you integrate new information and make it your own.

If you’re ready to take time out of your busy schedule to improve your diet, it’s worthwhile to get a heads up on how to maximize your return on investment in reading this book. We’ll begin by discussing the book’s structure and approach, what to expect, and how to get the most out of it, all to the purpose of making it easy and possible for you to successfully sustain plant-based eating as a lifestyle. We’ll then move on to a self-assessment that will help you to determine which approach to a plant-based diet is best for you, and a discussion of SMART goals and accountability that will help you create a support structure for your new habits. Let’s start with the big picture. This book is organized in two parts. Part 1 leads you through a program of five steps to transition you to radiant health, renewed energy, and a better body. Each step addresses a different aspect of dietary behavior change and guides you in taking concrete next actions toward a plant-based diet. These next actions lead to three suggested paths for change at the close of each step: a gradual change, called Easing In; a more moderate pace, called Rev It Up; and a 100 percent transition path, called Total Transformation. You will have the choice to move at the pace that feels right to you.

Following the five steps of change, Part 2 offers the Recipe and Resources sections of the book—essential cooking and how-to information and additional opportunities for connection and engagement to help you stay plugged into a plant-based lifestyle. There are 100 delicious, plant-based recipes from my heroes, mentors, and friends, as well as reading lists, recommended programs and conferences, social media sites, and more. These resources will help you stay connected, keep going, and make plant-based eating a lifetime habit.

The five steps of this program—finding your motivating force, adding plant-based food to your diet, choosing health over habit, making your food environment match your biology, and making your diet socially sustainable—are founded on some of the key elements that research has identified as being important in transitioning your diet and maintaining it afterwards (see Figure 1). The more of these elements you possess, the more likely you are to succeed.

All of the elements in the figure enhance each other and act in concert. We’ll cover the why, the what, and the how of each of these in depth in the five steps ahead, but let’s begin with an overview of where you’ll find guidance on each of these elements in the book.

Figure 1: YOUR PATH TO CHANGE

Figure 1: YOUR PATH TO CHANGE

You need an expectation of success, which means the more belief you have in your ability to control your diet,¹ and the more you know that the outcome is possible for you, the more likely you are to succeed.² And success definitely is possible! Stories like Janet’s, and the others that follow, will keep reminding you of the attainability of a plant-based lifestyle. The conceptual model outlining how to successfully transition to and maintain a plant-based diet is presented in Figure 1 so you can start thinking about the big picture of your life and how well it supports your dietary goals. The journey begins with a readiness in you for change and a motivation to eat a plant-based diet.³ As discussed in Step One, that motivation may come from a variety of sources, and it’s well worth your time to enhance those impulses, crystallize your vision, and make a point to stay engaged with your reasons for eating this way.

You then need both knowledge of nutrition so that you can evaluate dietary options and make decisions based on credible information and cooking skills so that you can actually prepare the food. These will enable you to add in more and more whole, plant-based foods, which we’ll discuss in Step Two.

The greater your commitment, especially at the beginning, the more you’ll be able to choose healthy food to satisfy your hunger. This will allow you to reset your taste preferences and break free of cravings.⁴ Step Three will show you how to let go of the processed and animal-based foods and successfully withdraw from food addictions.

Finally, for lasting and sustainable change, you need a supportive physical environment⁵ and plenty of social support.⁶ Step Four will guide you on a thorough examination of your home, work, travel, and other environments and provide strategies for making each place supportive of your dietary intentions so that you don’t have to stop and think about what you’ll be eating and you won’t have to rely on your willpower.

Step Five will help you create a socially supportive environment by maintaining healthy and nurturing relationships with friends and family, cultivating new friendships with people who share a plant-based diet, and building a like-minded community. The social environment is often a make-or-break point for many people in maintaining a plant-based lifestyle in the long-term.

You may be wondering, "Do I need all of these elements? or Is this worth doing if I’m starting with nothing?" Don’t worry. First of all, it’s not overwhelming when we break it down piece by piece and develop each element one at a time. Second, you can succeed despite lacking most of these elements. But our purpose is for you to have the easiest experience possible, and the more elements you cultivate and grow, the easier it will be. There’s plenty of time for you to move at your own pace. Unless you have a life-threatening condition, there is no rush. If you do have a serious medical reason for eating differently, you may need to make a dramatic change quickly; if so, be sure to communicate with your doctor about changing your diet.

This book’s comprehensive approach to shifting your diet allows you to examine each part of your life and to determine how it either helps or hinders your intentions regarding what you eat. Researchers now pinpoint a whole slew of factors, collectively termed the built environment, as the underlying framework enabling our poor diets. The built environment refers to any part of the world we interact with that is created by people—land use and transportation, buildings, food supply, etc.— anything that humans bring into existence. A major component of the built environment is the availability of food—what is sold and where it’s sold; the elements of convenience; price; and how access to it changes depending on income, race, region, and other factors.⁷

Some researchers actually attribute the major part of our problems with obesity to the built environment,⁸ a perspective that has emerged in recent years as a counterpoint to the traditional view that held individuals accountable for their weight problems even though many of the factors that enable and promote overweight are caused by circumstances almost entirely outside of a person’s personal control.⁹ These circumstances, which include advertising; access to fast food and processed food in supermarkets; situational cues like specific social contexts, larger portion sizes, modeling from other people or public figures; and a host of other triggers, have an ability to influence food purchasing and consumption in ways people are not even aware of.¹⁰ Collectively, these factors automatically steer us toward diets heavily based on calorie-rich animal foods that almost all contain added fat, sugar, and salt. We’ll talk about this more in Step Three, but artificially created foods like these stimulate addictive pathways in the brain, and achieving a healthy diet isn’t as simple as eating in moderation.¹¹

Countering this stacked deck requires you to make a personal decision to live differently and to create a new environment that supports your goals. Though many of the circumstances that enable and promote this condition are due to factors almost entirely outside of our personal control, as a culture we tend to hold individuals personally accountable for their diet choices. This causes most of us a lot of frustration when we try to change what we eat and it’s not really working. It’s almost as if we need to take more than full responsibility for our diets if we want to make a real change, because the larger environment steers you largely in one direction—constantly eating animal-based and rich, energy-dense foods with added sugar, fat, and salt.

Unfortunately, the impulse to change is not always enough on its own. Janet has developed the habits and created the support structure she needs to maintain consistent success in what she eats, and as a result she’s having a completely different experience in her body, her mind, and her life from most people her age—one without fear of a heart attack, without guilt about eating too much or losing self-control at a buffet, without allergies, and without the frustration of not sticking with her intentions. This doesn’t happen without design. She and the other people whose stories are shared in the pages ahead are successful for specific reasons.

Wherever you start, and whatever your goals may be, you can use the five steps once or over and over again to arrive at your next level of healthy eating. Sometimes change occurs quickly, but in my own experience and through observing other people who have made a plant-based transition, lasting change arrives only when the new behavior becomes a habit, often after several rounds of readjustment and recommitment. Although I have met many people who went plant-based immediately and absolutely, I’ve met many more (and been one of them myself) who had to take a very active role in the transition for a fairly long period of time before the new behaviors became habitual.

Studying habits and their role in eating behavior is still kind of a fresh idea in research. So far, we know that intentions, the active components of decision making, can be crucial at the beginning of a new behavior, but the more we develop habits, the less our intentions actually matter.¹² This is particularly relevant to eating behavior, because the more automaticity (not thinking about what we’re doing) we exhibit when choosing what to eat, the less we have to use our willpower, and the more likely we will be to have the energy to make healthy choices.¹³ We’ll get into this in more detail in Step Four, but avoiding the use of willpower as much as possible is vital to making a plant-based diet easy to sustain.

Habits are also triggered