Review of the plant-based nutrition and lifestyle medicine news June 2026

Three important reports, more evidence on plant-rich diets, huge benefits from Food as Medicine initiative and healthy habits improve cancer outcomes.

Three important reports on food, health and climate

This month we see the release of three important report. The 2026 Global Nutrition Report brings together the evidence on food systems, nutrition and the impact on health, climate and the financial bottom line. It describes the global food system as ‘one of the defining challenges of our time’. I could not agree more.

Our current food system is harming people, the planet and the animals. 2.6 billion people can not afford a healthy diet, with most of this burden concentrated in low- and middle-income countries. We remain way off track to meet Sustainable Development Goals 2 (zero hunger) and 3 (good health and well-being). Obesity and diet-related diseases continue to rise whilst undernutrition still persists in some regions. At the same time, climate breakdown and biodiversity loss threatens our food supply. The report terms this a ‘polycrisis’.

We need a whole system approach to transforming food and farming. The report endorses the need to transition to a plant-based food system and provides recommendations for action across all sectors of society from Governments, policymakers, funders, NGO’s and the private sector. It is going to require us all to transform our food system into one that is healthy, nutritious, accessible, affordable and just. You can find more information about individual countries here.

What I did not like about the report was the promotion of animal grazing systems for the regeneration of soil health. There is no evidence that animals are required for this purpose. Under Conservation Agriculture, the food production system recommended by the Eat-Lancet Commission, animals are not required and in fact studies have shown that animal-free farming has significant advantages for meeting our climate and nature goals.

Closer to home, the flagship annual report from the Food Foundation, the Broken Plate 2026, is a stark reminder of the problems facing individuals and communities in the UK.

Some of the headline findings include:

• Healthier food remains nearly twice as expensive per calorie as less healthy food, and the gap is widening
• Households in the lowest income fifth of the population would need to spend 85% on food to afford the government-recommended healthy diet
• The price gap between healthier and less healthy food is increasing and is now the widest it has been in over a decade
• 40% of food and non-alcoholic drink promotions are on foods high in fat, salt or sugar.
• Fruit and vegetables only account for 3% of traditional advertising food and non-alcoholic drink expenditure, compared to at least 29% for unhealthy foods

The consequences are that diet quality in the UK is at an all-time low, diet-related diseases continue to rise, healthy life expectancy is in decline and our food system continues to be a major driver of climate breakdown and biodiversity loss.

In good news, the BDA (British Dietetic Association) have published their long-awaited report on reducing carbon in NHS patient menus. It is the strongest signalling we have had from the UK dietetic profession on the need to transition to a plant-rich food environment, where plant-based meals are prioritised to meet health and climate goals. There remains an undertone of caution, but the overall message signals to the profession must embrace the evidence and lead on transforming the food service in healthcare settings. I hope this will allow us to accelerate our work through the Plants First Healthcare Coalition.

More evidence supporting plant-rich diets

The consensus on diet quality has remained unchanged for decades. Healthy diets are those that emphasise the consumption of fruit, vegetables, whole grains, legumes, nuts and seeds, whilst minimising/avoiding red and processed meat and foods high in saturated fat, salt and sugar. This way of eating can be adapted to all cultural and traditional diet patterns including Mediterranean, Asian, African, flexitarian, plant-based and more.

With this in mind, a new study examines the Optimal Dietary Patterns for Lower Weight Gain and Risk of Obesity Surrounding Menopause. The study included 38, 283 women from the Nurses’ Health Study II (1989-2019) observed over a 12-year period surrounding the menopause. Diet was assessed every 4 years using validated food frequency questionnaires. The data was analysed with reference to a number of different eating patterns, including Mediterranean, plant-based, Planetary Health Diet, low-carb, high in ultraprocessed foods.

The results showed that in general, eating patterns high in fruits, vegetables, whole grains, legumes, nuts and seeds and low in red and processed meats, sodium, potatoes, and French fries supported better weight management. The two dietary patterns that seems to be most effective were the Planetary Health Diet (>87.7% plant-based) and low-insulinaemic diet. suggesting that high insulin levels may precede the onset of weight gain.

As a sidebar, the empirical dietary index for hyperinsulinemia (EDIH) is comprised of eighteen food groups; thirteen are positively associated with C-peptide – a marker of insulin production – (red meat, high energy drinks, cream soups, margarine, chicken, butter, French fries, fish, low energy drinks, tomatoes, eggs, low fat dairy) and five are inversely associated (red wine, coffee, whole fruit, high fat dairy, green leafy vegetables). I know these are an odd collection of foods and drinks, but they are ones that are associated with insulin levels (high or low) in the blood.

Interestingly, we also have a new study showing that diets higher in whole plant-based foods are associated with a lower risk of sepsis. Sepsis, or bloodstream infection, is not usually a condition thought to be related to diet. Yet, in this study of 180, 442 participants from the UK Biobank, adherence to a healthy plant-based diet was associated with a 16% lower risk of developing sepsis. There was a dose effect, with the more healthy plant foods consumed the lower the risk, and the impact was independent of traditional risk factors (age, alcohol and smoking, presence of chronic conditions). On further analysis the benefit came from having a lower body weight, lower levels of inflammation (lower C-reactive protein) and better metabolic health.

Interestingly, very similar results were found using data from the UK Biobank and analysing the impact of the Planetary Health Diet on risk of sepsis. Greater adherence was associated with a lower risk of sepsis, independent of genetic predisposition, and through the modulation of immune-inflammatory proteins.

Readers will already know that plant-rich diets result in a healthier gut microbiome, which in turn has a positive impact on the immune system. This leads to reduced inflammation, improved insulin sensitivity and metabolic health. These impacts are most likely to explain the reduced risk of sepsis.

Vegan versus Med diet for fibromyalgia

The Mediterranean diet (Med diet) has been extensively investigated over the years with benefits found for all aspects of physical and mental health. However, studies have shown that the health impacts are mostly due to the higher intakes of fruit, vegetables, whole grains, beans, olive oil nuts and seeds and not due to the wine or fish, as often suggested.

So, there should be no reason why a healthy plant-exclusive diet (appropriately supplemented with vitamin B12) should not be just as beneficial. Prior studies have supported this notion, including a randomised study comparing a vegan diet to the Med diet where the vegan diet was better for weight loss, improving insulin sensitivity and blood lipids, but not as good for blood pressure reduction. A lacto-ovo vegetarian diet, as tested in the Cardioveg study, may be better than the Med diet for weight loss and lowering cholesterol but not as good for lowering triglycerides. The vegetarian diet was also better for kidney health.

It is good to read this new randomised study of a Med diet versus a vegan diet for women with fibromyalgia, specifically looking at the impact on cardiometabolic health – the FIBROVEG study. The primary outcome was impact on LDL-cholesterol.

It is a very small and short study – only 11 participants in each study arm and following each diet for 6 weeks. Of note, the vegan diet includes plant-based dairy and meat alternatives and vitamin B12 supplementation.

The results showed that the vegan diet resulted in greater reduction in LDL-cholesterol than the Med diet. For secondary outcomes the vegan diet was also better for lowering triglycerides and for improving fibromyalgia-related pain. It’s worth noting that during the vegan period participants reported lower satisfaction and barriers such as perceived lack of willpower and the cost of foods associated with maintaining the dietary pattern.

This study probably doesn’t tell us anything we didn’t know already. We know a plant-exclusive diet tends to have the greatest impact on cholesterol lowering than other healthy diet patterns. Interesting the lipid lowering occurred in the absence of weight loss, demonstrating that this impact was due to dietary components, most likely fibre.

The impact on pain however is useful given the limited treatment options for fibromyalgia. We have started to recognise that diet has an impact on pain and should be considered a modifiable lifestyle factor when supporting people with pain. In fact a new analysis from the UK Biobank shows that diet patterns higher in plant-based foods, such as the healthy plant-based diet index and the Eat-Lancet Planetary Health Diet, is associated with a lower risk of chronic pain, both musculoskeletal and other types of pain.

Food is medicine

A landmark new study published in Nature Medicine provides some of the strongest, real-world evidence to date that food really can be medicine.

Researchers evaluated a large-scale Medicaid program in Massachusetts that provided medically tailored meals to food-insecure adults living with complex chronic diseases, including cardiovascular disease, diabetes, chronic kidney disease, and mental health conditions. The analysis included 1,866 participants receiving meals and 1,372 matched controls across 11 health systems over a 6-month period.

The dietary plan offerings include five Core Diets: Renal, Diabetic, Cardiac, Maternal Health, General Wellness

The Core Diets were then be combined with ten potential Modifiers to meet personal dietary preferences, additional medical needs, or allergies: Mild flavour with fewer spices, soft foods for individuals with dental issues or swallowing challenges, low fibre, pescatarian, no fish, no red meat, low lactose, vegetarian, high calorie and high protein and no nuts.

The results were remarkable:

• 31% fewer hospitalisations among participants receiving medically tailored meals
• 20% fewer emergency department visits
• US$3,433 lower healthcare costs per person during the intervention period
• Healthcare savings offset 98% of the program costs within a 7-month period
• No reduction in primary care visits, suggesting participants remained engaged with routine healthcare while requiring less acute care
• The greatest benefits were seen among those with the highest disease burden
• Cardiovascular disease: healthcare costs reduced by US$10,450 per person
• Chronic kidney disease: healthcare costs reduced by US$12,312 per person
• Healthcare costs fell by nearly US$9,700 per person amongst the most medical complex patients

This reinforces some key concepts. Addressing the root cause of chronic conditions is not only possible but essential.

Healthy lifestyle habits after a cancer diagnosis.

This important new study from the UK Biobank is the first study to investigate associations between adherence to the 2018 WCRF/AICR Cancer Prevention Recommendations, assessed using an abbreviated version of the 2018 WCRF/AICR score, and all‐cause mortality in people with cancer in the United Kingdom.

Using data from more than 28,500 people who developed cancer during follow-up, the researchers examined adherence to five key recommendations relating to maintaining a healthy weight, being physically active, eating a diet rich in fruits, vegetables and fibre, limiting red and processed meat, and limiting alcohol intake.

Individuals who adhered more closely to these recommendations had a significantly lower risk of death from any cause after a cancer diagnosis. For every one-point increase in the adherence score, equivalent to fully meeting one additional recommendation, the risk of death was reduced by around 8%, after accounting for factors such as age, sex, education and smoking status. Those with the highest adherence scores experienced a 16% lower risk of death compared with those with the lowest scores. Importantly, these associations were consistent regardless of smoking status and whether cancer was diagnosed relatively soon after lifestyle assessment or many years later. The reduction in mortality was apparent for early onset cancers, <50 years old, as well as those occurring in people >50 years old.

When the researchers examined individual cancer types, higher adherence scores were associated with significantly better survival among people diagnosed with prostate, breast, lung, oesophageal and liver cancers. The reduction in mortality risk ranged from around 5% to 14% for every additional point on the lifestyle score. There was also a trend towards improved survival in colorectal cancer, although this did not quite reach statistical significance.

Overall adherence to the recommendations was only low to moderate, with particularly poor adherence to recommendations on limiting red and processed meat and alcohol consumption, especially among men. In contrast, adherence to recommendations on fruit and vegetable intake, physical activity and healthy body weight was generally better. These findings suggest clear opportunities for targeted lifestyle support among people living with and beyond cancer.

Although the study could not account for important clinical factors such as cancer stage and treatment, which may also influence survival, the consistency of the findings across multiple analyses strengthens confidence in the results.

Overall, this research provides compelling support for the WCRF/AICR recommendation that people should continue to follow healthy lifestyle guidance after a cancer diagnosis whenever possible. It reinforces a growing body of evidence showing that lifestyle medicine has an important role not only in cancer prevention but also in improving outcomes for those living with cancer.

We have a useful factsheet for people living with and beyond a cancer diagnosis. Listen to the In a Nutshell podcast episode to hear more about this study

Slovenia’s new dietary guideline and the ensuing controversy

Nutrition professionals in Slovenia have been working on their food-based dietary guidelines for the last 4 years (I have been told the work was conducted free of charge). They have brought together the best available evidence on health and sustainability and devised a brilliant three plate model that allows protein sources to be varied based on preference. Three-quarters of the plate remains constant and composed of fruit, vegetables and whole grains. The remaining one quarter for protein can be akin to the Mediterranean diet, a vegetarian diet or fully plant-based. It is very much in line with the Eat Lancet Planetary Health Diet and was endorsed by its lead author Dr Walter Willet.

The global community celebrated this evidence-based guide, which would be a template for other countries yet to align with the Planetary Health Diet. However, rather alarmingly, two weeks after publication, the new Slovenian government have decided to disassociate themselves from this guidance and removed it from the government website. Instead, they have decided to reevaluate the evidence.

Please support Prof Natasa Fidler as she now navigates this situation and help her to call out what can only be the meat and dairy lobby discrediting evidence-based recommendations.

See you back in July.

Please follow my organisation ‘plant-based health professionals UK’ on Instagram @plantbasedhealthprofessionals and facebook. You can support our work by joining as a member or making a donation via the website.

Review of the plant-based nutrition and lifestyle medicine news May 2026

Healthy life expectancy is at an all time low in the UK, yet healthy habits support better liver, cardiovascular and brain health. Plus more food industry shenanigans.

Healthy life expectancy in the UK at an all time low

A sobering start to this month’s review. A new report from The Health Foundation finds that healthy life expectancy – the average number of years a person would expect to live in good health – is at an all time low in the UK. Over the last decade it has fallen by 2 years, making it 60.7 years for males and 60.9 years for females.

Even more alarming is that the gap in healthy life expectancy between the most and least deprived deciles in England is now 19.4 years for males and 20.3 years for females. Healthy life expectancy fell more rapidly for females than for males, raising concerns about the worsening trend of women’s health.

Of 21 high-income countries, the UK is one of only five that saw healthy life expectancy fall between 2011 and 2021, and had the second steepest decline. The UK now ranks 20th with only the United States having a lower healthy life expectancy.

This has not been caused by the COVID-19 pandemic as life expectancy has largely remained stable in the UK and other similar countries have seen healthy life expectancy remain stable or improve. Rather, it is a reflection of lifestyle and socioeconomic factors, which are of course inextricably linked.

The authors conclude ‘the UK’s trajectory is not inevitable, but the result of policy choices and underlying conditions that have left the population, particularly among working-age adults, more vulnerable to ill health.’

This should be a wake up call to ensure the UK can offer citizens a minimum standard of living (i.e. housing, education, jobs) and access to healthy behaviours (diet and nutrition, physical activity and avoiding tobacco and alcohol).

New Lancet Commission on liver health

This second Lancet commission on liver health raises awareness of lifestyle factors that are driving liver disease across Europe. Alcohol and unhealthy diets are the key drivers of liver-related mortality (from cirrhosis and liver cancer) and eliminating these risk factors would almost half the burden of liver disease.

The major dietary factors remain excess consumption of saturated fat (mainly from animal-sourced foods), and added or free sugars, such as fructose or sucrose in foods and sugar sweetened beverages. These dietary factors are usually associated with excess calorie intake and overweight/obesity, which in turn causes liver dysfunction.

The commission makes it clear that unhealthy behaviours are primarily related to the environments we live in rather than a failure of individual will power and thus Government and policy makers need to focus on shaping healthy living environments.

Food insecurity is compounding the problem as more people are relying on cheaper, energy-dense, high-fat, high-sugar, low-nutrient foods, leading to an overall decline in dietary quality.

Check out our factsheet on diet and lifestyle for liver health.

Sleep, nutrition and physical activity important for cardiovascular health

This study investigated the combined impact of three healthy behaviours – sleep, nutrition and physical activity – on cardiovascular health. The researchers analysed data on 53,424 participants in the UK Biobank study. Sleep and physical activity information was collected from a wearable, wrist accelerometry data. Dietary intake was assessed once at baselines using a self-reported questionnaire.

Over the 8.0-year follow-up period, 2034 major adverse cardiovascular events (MACE) occurred, comprising 932 myocardial infarctions, 584 strokes, and 518 heart failure events.

The results showed that 8-9.4 hours of sleep per day, 42-104 minutes of moderate to vigorous physical activity per day and a high diet quality score was associated with a 57% lower risk of a MACE. Even small increments towards ideal healthy habits was beneficial with the combination of an additional 10 min/day of sleep, 5 min/day of physical activity and 3 extra points on the diet quality score (equivalent to an extra one-fourth cup of vegetables) associated with a 10% lower risk of MACE.

The authors conclude ‘These findings highlight the need for integrated multi-behaviour lifestyle prevention trials to evaluate the effectiveness of small, achievable lifestyle changes for MACE prevention.’

Read our article on plant-based diets and cardiovascular disease.

Plant-based diets and risk of dementia

Studies on diet and dementia risk are increasingly demonstrating a consistent theme. Diets rich in whole plant foods and lower in animal-sourced and ultra-processed foods are associated with a reduce risk. This is in part because plant-rich diets reduce the risk of hypertension, obesity, type 2 diabetes, dyslipidaemia, condition which increase the risk of dementia.

This new study aimed to investigate the impact of plant-based dietary patterns on the risk of dementia in ethnically diverse population. Data from the Multiethnic Cohort Study, based in Hawaii and California (primarily Los Angeles County), was analysis and includes African American, Japanese American, Latino, Native Hawaiian, and White participants who completed food frequency questionnaires at baseline (1993-1996; age 45-75 years) and at 10-year follow-up (2003-2008). Dietary data were scored according to overall plant-based diet, healthy plant-based diet and unhealthy plant-based diet index. You can read more about the plant-based diet index here.

The results showed that participants most adherent to an overall plant-based diet and a healthy plant-based diet had a 12% and 7% reduced risk of dementia, respectively. Adherence to an unhealthy plant-based diet was associated with a 6% increased risk.

Researchers were also able to assess the impact of dietary change over time. Participants who changed their diet to a more unhealthy plant-based diet over the follow up period had a 25% increased risk of dementia, whereas participants who improved their diet quality over time had a 11% lower risk.

The findings were overall consistent across age groups, race and ethnicity and APOEℇ4 carrier status.

The researchers explored changes in intake of individuals food groups. A large decrease in 4 of the 7 healthy plant food groups (whole grains, vegetable oils, nuts, and tea/coffee) was associated with a higher risk of dementia by 11%–15%. Of the 4 less healthy plant food groups, only increased consumption of added sugars was associated with a 12% higher risk of dementia. Of the 5 animal food groups, a large decrease in egg consumption was associated with a 12% higher risk of ADRD. Increase in consumption of animal fats and meat were associated with an increased risk of dementia.

Overall, the study supports the findings of other similar studies, that increasing the consumption of healthy plant foods, whilst reducing the consumption of animal-sourced foods and limiting unhealthy plant-based foods is helpful for reducing the risk of dementia. The reasons for these finding are multiple, including the presence of nutrients within plant foods such as fibre, vitamins and minerals that help maintain cardiovascular health, normal blood lipid levels and help prevent diabetes.

The finding on eggs is interesting as other studies have also found that egg consumption is associated with a lower risk of dementia, including this new analysis of the Adventist Health Study-2. But, and there is a big BUT. The results from the Adventist Health Study showed that substituting eggs for nuts/seeds or legumes in the diet was associated with a similarly reduced risk of Alzheimer’s disease.

In my view, there is nothing special about eggs. The nutrients that are thought to support better brain health include, omega-3 fats, vitamin B12, choline and lutein and zeaxanthin-carotenoids. All the nutrients in eggs can be adequately sourced from plants, fortified foods or in the case of vitamin B12, from a supplement. Of note, several nutrients in eggs, such as omega-3 fats and vitamin B12 are fed to chickens. It is no different for humans to obtain these nutrients from their original source without having to eat eggs.

Most populations globally are not consuming sufficient legumes and nuts, even if traditionally their diets have been mostly plant-based, like in India. For this reason it is more difficult to assess the impact of legume and nut consumption on brain health or other aspects of health for that matter. If people are not consuming these foods, observational studies can’t assess the impact on health. What we do know from multiple studies is that substituting animal-sourced foods, including eggs, for legumes and nuts, consistently has a positive impact on health, including a reduced risk of premature mortality.

Brain health is dependent on many other factors. Learn more in our article on diet and lifestyle and brain health.

Limiting ultraprocessed foods and optimising fibre intake.

Two new review articles are worth reading. The first is a consensus on ultraprocessed foods and cardiovascular health from the European Society on Cardiology. Diets high in UPFs are associated with negative health outcomes, including cardiovascular diseases. However, not all UPFs are created equal and the classification itself does not tell you about the nutritional value of the foods.

This consensus statement recommends that in clinical practice, we should support patients to remove or greatly limit processed meat, packages snacks and sugar-sweetened beverages in the diet, whilst prioritising fibre-rich plant-based foods. Any shift towards a more plant-based diet is better for health. Encouraging home cooking, considering meal timings and the context in which meals are eaten – earlier in the day, mindfully and slowly – is also important.

The document does not discuss plant-based meat or dairy alternatives which is a shame as these are increasingly included in country-based dietary guidelines and growing numbers of people are actively reducing the consumption of animal-sourced foods for environmental and ethical reasons.

The second is a review on dietary fibre, which remains one of the most under-consuming nutrients in the modern diet.. Despite decades of evidence linking fibre-rich diets with lower rates of cardiovascular disease, type 2 diabetes, obesity and bowel disorders, fibre intake across industrialised nations remains far below recommended levels. In the UK, only 4% of children and adults meet recommended daily intakes.

The authors explore the difference between intrinsic fibre found naturally within whole plant foods and functional fibre added to processed foods or sold as supplements. While both may have physiological effects, the evidence consistently shows that the greatest health benefits come from consuming minimally processed plant foods such as vegetables, fruits, legumes, nuts and whole grains. These foods contain fibre within an intact plant matrix alongside polyphenols, antioxidants and other protective compounds that work together to support health.

A central theme of the paper is the relationship between fibre and the gut microbiome. Different fibres influence microbial composition and metabolism in highly specific ways, particularly through the production of short-chain fatty acids, compounds known to support gut integrity, immune function and metabolic health. However, not all fibres are equal. The physiological effects depend on their structure, fermentability and viscosity, as well as the food matrix in which they are delivered. This may explain why fibre supplements and fortified foods often produce less consistent and less comprehensive benefits than whole plant foods.

The review also highlights the limitations of highly processed diets and cautions against relying solely on isolated fibre ingredients to solve a population-wide fibre deficit. Targeted fibre fortification and supplementation may help in certain contexts, they cannot replicate the broad clinical benefits seen with diets centred on minimally processed plant foods.

The authors emphasise that improving fibre intake requires more than individual behaviour change. Public policy, food reformulation, labelling initiatives and better access to affordable plant foods will all be necessary to create healthier food environments.

Keto diets and LDL-cholesterol

Although low-carbohydrate, animals-based diets, including the ketogenic diet (KD), remain outwith consensus, some clinicians and high profile influencers continue to recommend this way of eating. In the short-term there may be some benefits, but concerns remain about long-term health outcomes. In part, because diets high in saturated fat and low in fibre lead to elevated LDL-cholesterol (LDL-C) and apolipoprotein B levels and thus a higher risk of atherosclerotic cardiovascular disease (ASCVD).

This new review focuses on KD-induced elevation of LDL-C in people with normal body mass index, exploring potential mechanisms underlying this phenotype, and discusses implications for ASCVD risk and management.

The bottom line is that keto diets can result in large elevations in LDL-C. The authors state ‘there is currently no established evidence that individuals with marked LDL-C elevations on KDs are protected from LDL-mediated atherogenesis’ and they suggest that reintroducing carbohydrates is a useful strategy for reducing LDL-C levels. If a person wants to continue a KD despite the dyslipidaemia, then cholesterol lowering medication may need to be instituted.

The authors conclude ‘The absence of long-term outcome data should not be interpreted as evidence of cardiovascular safety in these patients’.

It seems crazy to me that people want to adopt KDs when fibre-rich, plant-based diets have so many benefits for both short and long-term health.

Animal-based versus plant-based protein for muscle protein synthesis

This new systematic review and meta-analysis of 12 studies found that animal-based proteins confer a small but significant advantage in stimulating muscle protein synthesis (MPS) compared to plant-based proteins. Most animal protein data were derived from milk-based sources, while plant proteins were from a variety of different sources.

However, the interpretation is more nuanced. The observed advantage of animal protein was mostly seen in older adults (>65 years), whereas younger individuals showed comparable MPS responses regardless of protein source. MPS responses were observed for young and older adults regardless of resistance exercise or not.

The authors suggest that this age-related difference may be related to the lower leucine content typically found in plant-based proteins. Leucine is a key regulator of MPS and can be rate limiting if not consumed in sufficient amounts. In older adults, anabolic resistance (blunted MPS response to stimuli such as protein and exercise) means that higher per-meal leucine intake is required to effectively stimulate MPS. This could be mitigated by increasing total protein intake or fortifying plant proteins with additional leucine.

Of note, this meta-analysis assessed acute MPS responses rather than long-term changes in muscle mass but overall the data suggests that both plant and animal-based protein can support muscle synthesis providing daily intake is sufficient (approximately 1.6 g/kg). It should also be noted that most of the participants in the included studies were male and so the generalisability to females is uncertain.

Greenwashing by meat & dairy companies and meat industry research funding

Two different but related papers highlight how environmental claims and climate promises by the meat and dairy companies are best classified as ‘greenwashing’ and how meat industry funding of scientific research more often than not finds in favour of eating meat.

The first paper analysed the environmental commitments and claims of 33 of the world’s largest meat and dairy companies. 1233 environmental claims were identified of which 68% (841) were climate-related. 98% of the claims were categorised as Greenwashing i.e. no clear or achievable plan to reach the target.

The second paper included 500 studies investigating the health impacts of meat consumption. 78 (15.6%) reported industry involvement. Studies linked to the meat industry were 16 times more likely to report positive findings about meat consumption with a significant association between meat industry funding and the study conclusion.

These two studies demonstrate the typical industry playbook allowing ‘business as usual’ to continue. It mirrors the tactics of the tobacco and alcohol industry. Fund the scientists and the research; cast doubt and perpetuate misinformation; pretend to care but continue to promote a product that harms; renege on commitments that would improve health and the environment. This has all been eloquently summarised in a fantastic report by Changing Markets – Big Meat and Dairy’s narratives to derail climate action.

Additional papers of interest

Exposure to plastics is of increasing concern as there are associations with negative health impacts. A new intervention study has shown that limiting consumption of highly processed foods, plastic food packaging and canned goods, and minimising plastic touch points during production – from farm to fork – can reduce urinary excretion of phthalates and bisphenols (chemicals associated with plastic exposure). This provides actionable evidence for individuals who are looking to reduce ingestion of plastic.

We know that many chronic conditions are driven by the same undying mechanisms. This is recognised now by the fact that the combination of heart, kidney and metabolic conditions (diabetes and obesity) is known as cardiovascular-kidney-metabolic syndrome, or CKM syndrome. These same chronic condition are known to increase the risk of cancer. A new large retrospective analysis from Japan that includes almost 1.4 million people finds that people with CKM syndrome have an increased risk of multiple cancer types and the risk increases as the stage of CKM worsens. Thus preventing CKM syndrome should also reduce cancer incidence.

Diet and lifestyle practices are essential for cancer prevention but can also have a positive impact even after a cancer diagnosis. This new short report finds that in a large cohort of cancer survivors in the US, adherence to healthy lifestyle practices has not changed much over time. However, people who received counselling on lifestyle factors were more likely to engage in these positive behaviours. This once again highlights the need for lifestyle medicine to be incorporated into all aspects of primary and secondary healthcare.

Processed meat consumption is associated with a number of health harms according to this new umbrella review that summarises existing systematic reviews and meta-analyses. Eating 50g/d was associated with a 72% higher risk of gastric cancer, 17% higher risk of colorectal cancer, 4% higher risk of prostate cancer, and an 8% higher risk of chronic obstructive pulmonary disease. There is no safe limit of consumption and therefore zero is the optimal amount to include in the diet.

Last but not least, our very own research paper published in BMJ Nutrition, Prevention and Health from the team at Plant-Based Health Professionals UK in collaboration with Dr Dagfinn Aune. Consumption of legumes and soya is associated with a reduction in the risk of hypertension. Read more here.

See you back in June!

Please follow my organisation ‘plant-based health professionals UK’ on Instagram @plantbasedhealthprofessionals and facebook. You can support our work by joining as a member or making a donation via the website.

Why nurses can lead the shift towards a plant-based transition

Gio’s reflection for Nurse Week and International Nurses Day 12th May 2026.

By Giovanna Dicandia

As nurses, advocacy is at the very heart of our profession. We are trusted voices at the bedside, in communities, and increasingly within healthcare leadership and systems change. During International Nurses Week, it feels especially important to recognise the powerful role nurses can play in advocating for a sustainable, inclusive, plant-rich diet within our hospitals.

Nurses are often the healthcare professionals who spend the most time with patients, carers, and families. We see firsthand the impact that food has on health, recovery, dignity, and wellbeing. We also witness the growing burden of diet‑related chronic disease – conditions that are not only affecting individual lives but placing unsustainable pressure on the NHS. Advocating for healthier, plant-rich food in hospitals is not a “nice to have”; it is a clinical, ethical, and environmental imperative.

Hospital food sends a powerful message. When our healthcare institutions serve meals high in processed meat and low in whole-plant foods, it undermines the prevention messages we share with patients every day. Conversely, offering nutritious, culturally inclusive, and appealing plant-rich meals normalises healthy choices, supports recovery, and signals that healthcare is aligning practice with evidence.

Nurses are uniquely positioned to champion this change. Our role includes speaking up both for patients who need meals that respect cultural, religious, ethical, and medical needs, and for populations disproportionately affected by poor diet and environmental harm. A plant rich approach can be inclusive, affordable, and adaptable across cultures, while also supporting planetary health and the NHS’s net ‑zero commitments.

At PBHP UK, we see nurses leading this shift in practical and meaningful ways: influencing ward practices, contributing to menu discussions, supporting colleagues with evidence-based nutrition knowledge, and helping patients feel confident with plant‑rich meals during and after hospital stays. Nurses are also powerful role models – what we advocate for in our professional practice often shapes wider attitudes within teams and institutions.

Most recently we want to celebrate the work of Siew Yin, one of our PBHP UK nurses who led a fantastic plant-powered eating initiative in her local NHS hospital. With the support of a multidisciplinary team, the campaign sparked genuine curiosity and engagement among staff. Over 160 colleagues took part in a quiz, many asking to learn more about plant-based nutrition or to access the webinar playback led by Dr S. Kassam, Founder and Director of PBHP UK. A live “Lunch and Learn” session on plant-powered eating attracted strong attendance, and staff were signposted to practical resources, including culinary medicine training and a 21-day plant-based challenge. The initiative also included the provision of healthy, plant-based snacks, helping to start conversations and normalise plant-rich choices at work. It’s a great example of how nurse leadership, supported by teamwork, can turn education into meaningful cultural change within healthcare.

Siew Yin says: “I was driven to run this campaign so that my colleagues could fully grasp the power of plant-based eating – for their own well-being and for the health of our planet. As an advocate, the real joy came from seeing people benefit from the facts. Knowing that better choices stem from better understanding made the experience deeply fulfilling.”

Advocating for plant-rich food is not about perfection or removing choice. It is about ensuring that the healthiest, most sustainable option is the easy, inclusive option – especially in places dedicated to healing.

This Nurses Week, let us celebrate nurses as compassionate leaders in creating a healthcare system that truly promotes health of people, communities and the planet. Through our voices, our values, and our daily actions, nurses can lead the change we so much need for the benefits of everyone and the planet we inhabit.

Spread the word – we need more nurses on board!

Join PBHP UK as a member – lots of benefits and lots of exciting things to come! To learn more or to get involved, please contact Giovanna, PBHP UK Nurse Lead, at giovanna@pbhp.uk.

As global hypertension rates continue to rise – could soy and legumes be the answer?

The prevalence of hypertension has increased by 115% in over three decades, but new research suggests that higher consumption of these plant-foods could lower this risk.

New findings from a systematic review and meta-analysis published in the BMJ Nutrition, Prevention & Health journal has found a higher daily intake of soy and legumes is linked to a lower risk of developing high blood pressure.

These findings have considerable implications for public health guidance, given the current landscape of hypertension globally. High blood pressure affects an estimated 1.4 billion people worldwide and is a leading risk factor for cardiovascular diseases such as heart attack, stroke, and kidney disease all of which contribute to millions of preventable deaths each year.

Previous studies have shown that consumption of legumes and soy foods is associated with lower risk of overall cardiovascular disease, but specific research examining the relationship between legume and soy consumption relationship and hypertension needed to be systematically quantified.

The research team at Plant-Based Health Professionals UK (PBHP UK), supported by Dr Dagfinn Aune from Imperial College London, searched various medical databases for peer-reviewed research studies on the topic up until June 2025. This resulted in nine research publications representing eleven prospective cohort studies being included in the meta-analysis. Five studies were from the United States, four from Asia, two from Europe. Eight studies included both men and women, two studies included only women, and one study included only men. The number of participants ranged from 1,152 to 88,475 and across the studies the number of cases of hypertension ranged from 144 to 35,375.

The highest vs lowest intake of legumes and soy was associated with a 16% and 18% lower risk of developing high blood pressure, respectively. In the linear dose-response analyses there was a 12% and a 24% lower risk per 100g day of legumes and soy, respectively. 100g of legumes/soy is equivalent to a serving size of approximately 1 cup or 5-6 tablespoons of cooked beans, chickpeas, lentils, soybeans or a palm-size serving of tofu).

There was a clear dose-response relationship between increasing intakes of legumes and lower hypertension risk with a 30% reduction in risk at an intake of ~170 g/day, while for soy there was a 28-29% reduction in risk at 60-80 g/day, with no further reduction in risk at higher intakes.

When using grading criteria from the World Cancer Research Fund to evaluate the likelihood of a causal relationship between legumes and soy and hypertension, the researchers considered the evidence to be ‘supportive of a probable causal relationship between both legume and soy intake and a reduced risk of hypertension’.

There are many reasons why legumes and soy might contribute to lower hypertension risk – including their content of minerals, fibre and bioactive compounds. Legumes and soy are also high in potassium, magnesium dietary fibre all of which are associated with lower rates of hypertension.

Prior research by PBHP UK has shown that consumption of whole grains lowers the  risk of hypertension and Dr Aune has also shown that higher intakes of fruit and vegetables is also beneficial. The team is currently reviewing the available data on nuts and hypertension. All in all, the evidence strongly supports plant-rich diets for reducing the burden of this leading cause of ill health.

We are at a real watershed moment for both ecological and human health. The 2025 EAT-Lancet Commission report underscores, once again, that how we produce and consume food is central to addressing the twin crises of chronic disease and environmental degradation. It reinforces that dietary patterns richer in whole plant foods – such as legumes, whole grains, fruits, vegetables, and nuts – are associated not only with improved health outcomes, but also with reduced pressure on climate systems, biodiversity, and natural resources.

These new findings published in the BMJ point to a clear opportunity: increasing legume and soy consumption could help reshape dietary guidance and strengthen global efforts to address the global burden of hypertension.

So how can we incorporate these new research findings and increase our daily intake of legume and soy foods?

When it comes to breakfast ideas, making a simple tofu scramble (150g serving) or overnight oats with fortified soy yoghurt (150 grams) or 200mls of a soya-based dairy alternative is an easy way of getting more legumes and soy in the morning. For lunch, a coronation chickpea sandwich might be a great way to recreate a popular British classic. For dinner, why not try a traditional chickpea or tofu curry or even lentil lasagna using 1 cup measure of each legume type. And for some snack/dessert ideas, why not make a simple silken tofu chocolate mousse by just blending together 100 grams melted dark chocolate, 340 grams silken tofu and 2 tablespoons maple syrup. Can also add 1 tsp orange extract. Easy, delicious way to add tofu/soy into your diet and great for the whole family.

Don’t forget we have a huge range of educational resources on our website including our hypertension factsheet which you can share with colleagues, friends and family.

One of the researchers of this new meta-analysis, Michael Metoudi, RD, M.Sc, will be speaking at our upcoming Nutrition and Lifestyle Medicine Conference on all things plant-power and hypertension – secure your place now!

Review of the plant-based nutrition and lifestyle medicine news April 2026

This month sees an update to several national guidelines, all emphasising plant-rich diets and exercise, plus lifestyle interventions for Parkinson’s, diet and cancer and fasting for Crohn’s disease.

New lipid guidelines and dietary guidelines to improve cardiovascular health

The new dyslipidaemia guideline from the American College of Cardiology, American Heart Association, and nine other medical associations that replaces the 2018 guide, places renewed emphasis on lifestyle practices as the foundation of cardiovascular disease prevention, while recognising that pharmacotherapy is often required to reach increasingly stringent lipid targets.

A key message is the importance of a life-course approach. Elevated atherogenic lipoproteins over time drive cardiovascular risk, so early intervention, particularly through healthy behaviours, is essential. These include heart-healthy eating, regular physical activity, maintaining a healthy weight, good sleep, stress management, and avoidance of tobacco.

A heart-healthy diet is recommended to reduce cardiovascular events, while dietary supplements are not advised due to limited and inconsistent evidence of benefit. Physical activity is also emphasised, both for modest lipid improvements and broader cardiovascular protection.

The guideline recognises that behaviour change requires support. Referral to dietitians and use of multidisciplinary care are encouraged, particularly in higher-risk individuals such as those with severe hypertriglyceridaemia.

Despite this strong focus on lifestyle practices, drug therapy, especially statins, remains central. Lower LDL-cholesterol targets, particularly in secondary prevention, mean that many patients will require combination therapy alongside lifestyle measures. It also includes lowering the screening and treatment age from 40 to 30.

The American Heart Association (AHA) has also updated its dietary guidance for cardiovascular health and is notably different from the recently released Dietary Guidelines for Americans. The AHA reinforces that overall dietary patterns, rather than individual nutrients, are central to cardiovascular health. Poor diet quality remains a leading contributor to cardiovascular disease, and the guideline emphasises that adopting and sustaining a heart-healthy dietary pattern across the life course is fundamental to prevention.

At its core, the guidance promotes a predominantly plant-based, minimally processed way of eating. This includes a high intake of vegetables and fruits, whole grains, legumes, nuts, and seeds, alongside healthy sources of protein, whilst limiting red and especially processed meat. There is a clear emphasis on replacing saturated fats, found in animal fats and tropical oils, with unsaturated fats from plant oils and whole foods, reflecting strong evidence for improvements in LDL-cholesterol and cardiovascular risk. Healthy protein sources mainly focus on beans and pulses and also include fish.

A major focus is the quality of foods rather than just macronutrient composition. The guideline strongly encourages shifting away from ultraprocessed foods, and towards minimally processed foods that retain their natural structure and nutrient profile. Similarly, it highlights the importance of reducing added sugars, particularly from sugar-sweetened beverages, and lowering sodium intake, both of which have well-established links to cardiovascular risk.

Energy balance is also central, with maintaining a healthy body weight through alignment of diet and physical activity identified as a key determinant of cardiometabolic health. Physical activity is therefore integrated into the dietary framework rather than treated separately.

Importantly, the guidance challenges common misconceptions around supplements and single “superfoods.” Nutritional needs should be met primarily through whole dietary patterns, which provide fibre, micronutrients, and bioactive compounds that work synergistically. In most individuals, a high-quality diet removes the need for supplementation. The exception being a meat-free diet that requires supplementation with vitamin B12 (through fortified foods or supplements).

Alcohol guidance is rightly more cautious than in previous iterations. The statement advises against initiating alcohol consumption for health reasons and recommends limiting intake due to uncertain cardiovascular benefit and clear risks across a range of health outcomes.

A useful article on trending cardiovascular nutritional controversies covers evidence for and against beef tallow, ultraprocessed foods, full-fat dairy, seed oils, medium chain triglyceride (MCT) oils, seafood, and alternative sweeteners. In short, the paper concludes that beef tallow is harmful to health as it raises LDL-cholesterol levels. There is insufficient evidence to choose high-fat over low-fat dairy (remembering that dairy is not required in the diet). Ultraprocessed foods should be limited in the diet, favouring minimally processed, whole foods instead. Seed oils benefit cardiometabolic health and can be part of a heart-healthy diet, but they should not be heated to excessive temperatures or repeatedly heated. MCT oils may have a role in certain rare medical conditions, but the evidence does not support promotion in the general population. It reminds us that coconut oil is not an MCT and is not considered heart healthy. Seafood (or should we say sea animals) are considered a beneficial component of the diet, but there are increasing concerns around environmental contamination of these foods. Articifical sweetners (aspartame, advantame, acesulfame potassium, neotame, saccharin, and sucralose), natural sweeteners (monk fruit extract and stevia) and sugar alcohols (erythritol, mannitol, sorbitol, and xylitol) have an overall negative impact on health, although they may be healthier to consume that sugar-sweetened beverages. The healthiest choices is to stick to consuming water, tea and coffee.

Vegetarian and vegan diets and cancer incidence

This 2026 systematic review and meta-analysis provides a comprehensive assessment of vegetarian and vegan diets in relation to cancer risk, drawing on prospective cohort studies across multiple populations and cancer types.

Overall, vegetarian diets are associated with a modest but consistent reduction in total cancer incidence, with around a 13% lower risk compared to non-vegetarian diets. This reduction extends across several specific cancers, with the strongest associations seen for cancers of the digestive system, particularly stomach and colorectal cancers, as well as pancreatic cancer. There are also smaller but statistically significant reductions in breast cancer, especially postmenopausal breast cancer, alongside bladder cancer, melanoma, and non-Hodgkin lymphoma.

For vegan diets, the evidence base is more limited but broadly consistent in direction. Vegan diets are associated with a larger reduction in total cancer risk, in the range of around 20–25%, and a reduced risk of breast cancer. However, findings for colorectal and prostate cancer are less clear, reflecting the smaller number of studies available.

The authors conclude that the evidence linking vegetarian diets to lower risk of total cancer, colorectal cancer, colon cancer, and breast cancer is “probable,” while for other cancers it is considered suggestive but less certain due to limited data. For vegan diets, the evidence is currently more limited overall.

The paper also explores potential mechanisms. Part of the observed benefit appears to be mediated through lower body weight, as vegetarian and vegan diets are associated with reduced adiposity, an established risk factor for several cancers. However, this explains only part of the effect. Independent dietary factors are likely important, including higher intakes of fibre, whole grains, fruits, and vegetables, and lower consumption of red and processed meat. These dietary differences may influence cancer risk through effects on inflammation, insulin resistance, hormonal pathways, and the gut microbiome.

Overall, the findings support the conclusion that more plant-based dietary patterns, including vegetarian and vegan diets, are associated with a lower risk of several cancers. While further research is needed, particularly in vegan populations and across a wider range of cancers, the evidence adds to the growing case for plant-based diets as a central component of cancer prevention.

Fasting mimicking diet in Crohn’s disease

The fasting-mimicking diet (FMD) is a short, periodic, plant-based dietary intervention designed to reproduce the metabolic effects of prolonged fasting while still providing limited nourishment. Typically followed for five consecutive days each month, it is plant-based, low in calories, protein and sugars, and relatively higher in unsaturated fats. Developed and extensively studied by Dr Valter Longo and colleagues, earlier work has shown that FMD can reduce systemic inflammation, improve metabolic health, and promote cellular repair processes. Preclinical studies have also demonstrated effects on gut microbiota, immune regulation, and intestinal regeneration, providing a strong rationale for testing this approach in inflammatory bowel disease.

This 2026 randomised controlled trial evaluates the effects of FMD in adults with mild-to-moderate Crohn’s disease. Participants were assigned either to continue their usual diet or to undertake three monthly cycles of a 5-day FMD, returning to their habitual diet between cycles. 60-70% of participants were also receiving medications for Crohn’s disease.

The findings are notable. Around 70% of participants in the FMD group achieved a clinical response, compared with approximately 44% in the control group, and nearly two-thirds achieved clinical remission. These improvements were seen early, with benefits emerging after just a single 5-day cycle. Alongside symptomatic improvement, there were reductions in objective markers of inflammation, particularly faecal calprotectin, supporting a genuine anti-inflammatory effect.

The intervention also led to improvements in patient-reported outcomes and quality of life, suggesting that the clinical benefits translated into meaningful day-to-day improvements for patients. Although endoscopic data were limited, early signals pointed towards possible improvements in mucosal healing.

Mechanistically, the study provides insight into how FMD may work. The diet was associated with reductions in pro-inflammatory lipid mediators and downregulation of key inflammatory cytokines, including TNF, IL-1β and IL-18. These findings are consistent with earlier research showing that fasting-like states can suppress inflammatory pathways, enhance autophagy, and promote tissue repair. Additional mechanisms may include beneficial shifts in the gut microbiome and increased production of ketone bodies, which have anti-inflammatory effects.

From a practical perspective, the appeal of FMD lies in its feasibility. Unlike many dietary interventions that require continuous restriction, FMD involves only five days of dietary change per month, allowing individuals to maintain their usual eating pattern for the remainder of the time. Adherence in the study was relatively high, and the intervention was generally well tolerated, with mild symptoms such as fatigue and headache being the most common side effects.

There are, however, important limitations. The study was relatively small and open-label, and most participants had mild disease, which may limit generalisability. The benefits also appeared to diminish after a washout period, suggesting that ongoing cycles may be needed to sustain the effect.

Overall, this trial adds to a growing body of evidence that dietary interventions can have clinically meaningful effects in inflammatory conditions.

Updated guidelines on resistance training for adults

This 2026 American College of Sports Medicine position stand makes a compelling case that resistance training should be considered a fundamental component of health for all adults, not just those interested in fitness or performance. Drawing on a large body of evidence (130 systematic reviews and data from more than 30,000 people), it shows that resistance training improves muscle strength, muscle mass, power, endurance, balance, and overall physical function. These changes translate into meaningful real-world benefits, including improved ability to perform daily activities, maintain independence with ageing, and reduce the risk of falls. Beyond musculoskeletal health, resistance training is also associated with reduced mortality and lower risk of cardiovascular disease, cancer, and type 2 diabetes, alongside benefits for mental health and sleep.

A key message is that resistance training does not need to be complex to be effective. Many different approaches can deliver similar benefits, and the most important factor is consistency over time. The guideline emphasises that programmes should be tailored to the individual to support adherence, taking into account preferences, confidence, and practical barriers. This represents a shift away from rigid, highly structured prescriptions towards a more flexible and inclusive approach.

For most adults, a practical starting point is to engage in resistance training at least twice per week, targeting all major muscle groups. Exercises can be performed using free weights, machines, resistance bands, or body weight, making the approach accessible in a range of settings, including at home. A small number of sets per exercise is sufficient to begin with, and intensity can be progressed gradually as confidence and strength improve. For those aiming to build strength, using relatively heavier loads and focusing on controlled movements through a full range of motion is effective. For improving muscle mass, increasing overall training volume over time is important, while for enhancing power and functional performance, incorporating faster, more dynamic movements with moderate loads can be beneficial.

Importantly, the guideline challenges several common misconceptions. Training to exhaustion is not necessary to achieve results, and no single type of equipment or programme is superior for all individuals. Complex programming strategies offer little additional benefit for most people compared with simpler approaches. Resistance training is also considered safe for healthy adults across the lifespan when introduced progressively, countering the perception that it is inherently risky or only suitable for younger individuals.

Read this short summary, including advice from the lead author.

Physical activity for public health in the 21st century

This 2026 Nature Medicine paper reframes physical activity as a central pillar of public health while challenging the persistent assumption that it is simply a matter of individual choice. It highlights that despite overwhelming evidence of benefit, global levels of physical activity have not meaningfully improved, with a substantial proportion of adults still failing to meet recommended levels. The authors argue that this stagnation reflects not a lack of awareness, but deeper structural and societal barriers.

A key contribution of the paper is its focus on inequality. Patterns of physical activity vary markedly across countries, genders, and socioeconomic groups, with the greatest disparities seen between wealthier men in high-income settings and poorer women in low-income settings. These differences are not incidental; they reflect unequal access to safe environments, time, cultural acceptance, and financial resources. In this context, physical activity is better understood as something shaped by opportunity rather than simply motivation.

The paper also broadens the scope of why physical activity matters. While traditionally emphasised for cardiovascular and metabolic health, it is shown to have wide-ranging effects across physical and mental health, including immune function, mental wellbeing, and cancer outcomes. This reinforces its role as a foundational determinant of overall health, rather than a niche behavioural factor.

One of the most important insights is the distinction between different domains of physical activity, particularly between leisure-time activity and work- or place-based activity. Leisure-time activity, such as walking, cycling, sport, or exercise, is typically performed by choice, in safer environments, and at intensities and durations that are more consistently associated with health benefits. In contrast, work-related or necessity-based activity, such as manual labour, domestic work, or physically demanding jobs, is often repetitive, prolonged, and performed under conditions of low autonomy, limited recovery, and sometimes physical risk. The paper highlights that these forms of activity do not confer the same health benefits and may, in some cases, be associated with adverse outcomes, a phenomenon sometimes referred to as the “physical activity paradox.”

This distinction has important implications. Public health messaging that treats all movement as equivalent risks obscuring the lived realities of those whose physical activity is driven by necessity rather than choice. For individuals in physically demanding occupations, the issue is not insufficient activity but rather the quality, context, and physiological burden of that activity. Conversely, those with sedentary occupations may have the time and resources to engage in beneficial leisure-time activity, reinforcing health inequalities.

In response, the authors propose a shift towards a systems-based model of “physical activity for health and wellbeing.” This approach recognises that activity patterns are shaped by the environments in which people live and work. Factors such as urban design, transport systems, workplace structures, safety, and social norms all influence whether individuals are able to engage in health-promoting activity.

The practical implication is that improving population health will require more than advising individuals to exercise. It will depend on creating conditions that make beneficial forms of physical activity accessible, safe, and integrated into daily life. This includes designing cities that support walking and cycling, ensuring equitable access to green space, addressing gender and socioeconomic barriers, and rethinking workplace environments to reduce harmful physical demands while enabling healthier movement patterns.

A case for lifestyle interventions in Parkinson’s Disease

Parkinson’s disease is a progressive neurodegenerative disorder characterised by motor symptoms such as tremor, rigidity, and slowed movement, alongside a wide range of non-motor features including cognitive impairment, sleep disturbance, depression, and autonomic dysfunction. While traditionally managed with pharmacological therapies, there is growing recognition that lifestyle factors play a central role in influencing symptoms, quality of life, and potentially disease progression.

This paper presents a comprehensive review of a “wellness prescription” for Parkinson’s disease, advocating a shift from a reactive, medicalised model of care to a proactive, patient-centred approach grounded in lifestyle medicine. It adopts a biopsychosocial framework, placing the individual at the centre and emphasising that everyday behaviours, particularly exercise, diet, sleep, mental health, and social engagement, are integral to outcomes.

Among lifestyle interventions, physical activity has the strongest evidence base. Regular exercise improves core motor symptoms such as mobility, balance, strength, and gait, and also benefits non-motor symptoms including sleep, pain, cognition, anxiety, and depression. There is emerging evidence that it may influence disease progression. Current guidance supports early and sustained engagement in a combination of aerobic, resistance, balance, and flexibility training. Importantly, enjoyment and adherence are key, with activities such as dance, tai chi, and group exercise offering both physical and psychosocial benefits.

Diet is increasingly recognised as an important modifiable factor in both the risk and progression of Parkinson’s disease. Nutritional challenges are common, with a substantial proportion of individuals at risk of malnutrition due to motor difficulties, gastrointestinal dysfunction, reduced appetite, and interactions with medications such as levodopa. Beyond these practical considerations, dietary patterns appear to influence disease biology. Mediterranean-style and plant-rich diets, high in fruits, vegetables, whole grains, legumes, nuts, seeds, and olive oil, are associated with a lower risk of developing Parkinson’s disease, a later age of onset, slower progression, and reduced mortality. Diet may also exert effects through the gut microbiome, with higher-quality diets linked to increased production of anti-inflammatory metabolites. Although randomised trial data remain limited, current evidence supports a predominantly plant-based, Mediterranean-style dietary pattern as the most beneficial approach.

Other aspects of lifestyle are also critical. Sleep disturbance is common and contributes to poorer cognitive and mental health outcomes, with interventions such as sleep hygiene, light exposure, and behavioural therapies offering benefit. Mental health is central to overall wellbeing, with proactive strategies, including exercise, mindfulness, and social engagement, helping to reduce depression and anxiety, which are highly prevalent in Parkinson’s disease. Mind–body approaches such as yoga, meditation, and tai chi show evidence of improving both motor and non-motor symptoms, as well as reducing stress and inflammation.

The paper also highlights the importance of social connection and a sense of purpose. Social isolation is common and associated with worse outcomes, while engagement in meaningful activities and supportive communities can improve quality of life and potentially influence disease trajectory. Broader aspects of wellbeing, including sexual health, general medical care, and self-management skills, are also emphasised as essential components of a holistic approach.

Overall, the review argues that lifestyle interventions should be considered core to the management of Parkinson’s disease rather than optional adjuncts. It calls for a fundamental shift towards integrating exercise, diet, and other lifestyle strategies into routine care from diagnosis, empowering individuals to take an active role in their health and supporting a more holistic approach to living well with Parkinson’s disease.

Half the calories from crops lost in feeding farm animals

The global food system is a major driver of climate change, biodiversity loss, and water use, yet it fails to deliver equitable nutrition. As highlighted in UK government food security reports, rising food insecurity alongside diet-related disease reflects systemic inefficiency rather than a lack of production. This paper examines how effectively global croplands are used to produce food for human consumption.

The central finding is that only around half of the calories grown on croplands are ultimately available to feed people. While global crop production increased significantly between 2010 and 2020, much of this growth was diverted towards feeding farm animals and non-food uses such as biofuels, rather than direct human consumption. As a result, gains in food availability have lagged behind increases in production.

A major source of inefficiency is the conversion of crops into animal products, particularly beef. Large quantities of feed are required to produce relatively small amounts of meat, meaning most of the original calories are lost from the food system. The greatest loss of calories (39.7%) is through production of beef, which only provides 9% of animal-sourced calories (excluding fish).

The scale of this loss is substantial. Croplands produce enough calories to feed far more people than the current global population, yet nearly half of this potential is lost through inefficient use. Shifting towards more plant-based diets or even replacing beef could significantly increase the number of people that could be fed.

Overall, the paper argues that the challenge is not producing more food, but using what we already produce more effectively. We have the ability to ensure every person on this planet has sufficient calories and nutrients to live healthy lives, we just need to ensure there is equitable distribution of food.

Plant-based alternatives to animals foods to improve planetary health

This new paper, Novel Plant and fungi-based Alternatives Support Nutritional Adequacy of Diets and Reduce Their Environmental Impacts, provides important evidence that plant-based meat and dairy alternatives can play a practical and effective role in supporting a shift away from animal-sourced foods, without compromising overall diet quality.

Using a realistic UK “basic basket” that reflects how people actually eat, the authors modelled small, achievable changes, replacing processed meats, milk, or yogurt with plant-based alternatives, and assessed the impact on nutrition, environmental outcomes, and cost.

A key finding is that targeted substitutions with plant-based alternatives can maintain nutritional adequacy across the whole diet. Despite concerns about these foods being ultra-processed, most products assessed were classified as “healthy” using nutrient profiling models, and overall diets continued to meet recommended nutrient intakes in most scenarios . In some cases, nutritional quality even improved, with increases in fibre and reductions in energy intake and saturated fat, particularly when replacing processed meats. While certain micronutrients such as iodine or vitamin B12 may be lower in some products, these differences had minimal impact when considered within the context of the whole diet.

The environmental benefits were consistent and meaningful. Across all substitution scenarios, greenhouse gas emissions, land use, and water use decreased, even with relatively small dietary changes . This reinforces the idea that shifting away from animal products, even partially, can contribute significantly to climate and sustainability goals.

Importantly, the study highlights that plant-based alternatives offer a realistic pathway for change. Unlike whole food plant-based diets, these products are designed to mimic the taste, texture, and convenience of meat and dairy, helping to overcome common behavioural barriers such as familiarity, cooking skills, and social norms. The modelling approach, focusing on single, incremental substitutions, reflects how people actually change their diets, rather than assuming complete dietary overhauls.

Cost remains a key limitation. While plant-based dairy alternatives were often comparable or cheaper, plant-based meat alternatives were consistently more expensive, which may limit accessibility and uptake, particularly among lower-income groups. The authors emphasise that without policy action to improve affordability, the full public health and environmental potential of these foods may not be realised.

Overall, this study makes a strong case that plant-based meat and dairy alternatives can serve as a useful and pragmatic bridge in dietary transition. When carefully selected, they enable reductions in animal food consumption while maintaining nutritional adequacy and delivering environmental benefits, supporting a gradual and achievable move towards more sustainable, plant-forward diets.

Read this article for more information about plant-based meat alternatives.

Updated food-based dietary guidelines from the Netherlands

The new Dutch dietary guidelines are bold, taking both health and planetary sustainability into consideration.

The core of the “Wheel of Five” remains unchanged but there has been an update to quantities of various food groups. The recommendations include:

• Eating Plenty of vegetables, fruit, legumes, and whole grains
• Limiting intake of salt, saturated fat, and sugar
• Increasing legumes intake to 250g per week
• Reducing meat consumption from a maximum of. 500g to 300g/week (with ≤100g red meat). This is less red meat than recommended in the Eat-Lancet Planetary Health Diet.
• Halving cheese intake from 40g to 20g per day
• Whilst still including dairy, encouraging alternating with fortified plant-based alternatives.

These guidelines demonstrate real leadership from the Dutch Government, helping to put scientific evidence into action. We hope the UK Government follow suit.

See you back in May.

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Plants First Healthcare Coalition launch statement

Serving Up Change

A new coalition launches to support the healthcare sector to pioneer the best in sustainable, delicious plant-rich meals.

We are excited to announce the launch of a groundbreaking new coalition, supporting and empowering healthcare organisations to adopt delicious, nutritious and sustainable plant-rich food cultures.

The Plants First Healthcare Coalition (PFHC) is formed of five founding members: Greener By Default, MyNutriWeb, ProVeg UK, Plant-Based Health Professionals UK, and Real Zero. Together, we bring a wealth of experience to support the healthcare sector in increasing plant-based meal provision, benefi ting people and the planet, and maintaining choice.

A culmination of several years of working in partnership, the founding organisations have come together to share their expertise as a single coherent offering, including business case development, culinary and service staff training, recipe development, sector engagement, choice architecture, behavioural nudges, healthcare professional training and food culture change. We have a successful track record of implementing food change in healthcare settings, schools and other institutions.

The coalition has already delivered a milestone invitation-only event, bringing together sector leaders to champion, spotlight and share existing excellence in the sustainable diet space. This work will continue with the aim of building a shared roadmap for achieving a world class plant-rich food offering in UK health services.

Pilot programmes are currently taking place in 10 NHS hospital trusts with more to start over the coming months.

Philip Shelley, NHSE National Lead For Net Zero Food says:
“If we are to drive positive change across healthcare, then partnership working will be at the core of any success. The Plants First Healthcare Coalition has worked tirelessly to drive a collated approach to plant-rich menus across our NHS sites. This has included educational events, workshops and supplier engagement. If we are to have a purposeful and long standing change of direction, then support for choice and healthier outcomes should be prioritised.”

If you’d like to learn how we can support sustainable food culture change in your healthcare setting – get in touch at info@plantsfirsthealthcare.com

NEW WEBSITE COMING SOON

Coalition partners:

Plant-Based Healthcare Professionals UK, Shireen Kassam
“PBHP UK is delighted to join forces with other sector leaders in bringing the very best in sustainable, plant-rich meals to healthcare settings in the UK. Our combined expertise and experience as coalition members make us the ideal collective to champion a shift towards healthy and sustainable diets. We look forward to collaborating with and supporting healthcare catering leaders, professionals and suppliers on the journey to build a positive, world-class plant-rich food culture.”

Greener By Default, Heidi Fritz
“Greener by Default is thrilled to take our work with UK hospitals to the next level alongside our dynamic coalition partners, with whom we share a deep commitment to building greener, healthier, and more inclusive healthcare settings and a belief that, together, we can amplify our impact far beyond what any of us could achieve alone.”

ProVeg UK, Sophia Millar
“ProVeg are delighted to bring our expertise in transforming large-scale public food systems to the healthcare space, joining forces with a wealth of food industry and healthcare experts to drive plant-rich innovation. With people and the planet at the heart of what we do, together we’re pioneering a systemic shift to embed healthy, sustainable nutrition at the core of healthcare provision.”

Real Zero, Adrian Byrne
“Delivering plant-rich food in the healthcare setting is a high-impact intervention that benefi ts people and planetary health and delivers incredible value for money for the public purse. We are hugely excited to be working alongside our ground-breaking coalition partners to deliver world-class, evidence-based, sustainable food solutions across the NHS. As a coalition, we have a shared vision that rightly places food and food services at the heart of patient care and believe that together, we can scale the pace and impact of our work beyond what we would achieve individually.”

MyNutriWeb, Tanya Haffner
“Delivering a delicious plant-rich food culture in healthcare, is one of the most powerful and lowest cost interventions that we can be implementing to improve patient outcomes, cut environmental impact and reduce healthcare costs – all within existing food and nutrition standards and maintaining full patient choice. The triple wins for people, planet, and the NHS budget, make it an essential high impact game changing healthcare strategy for the benefi t of all. MyNutriWeb is privileged to be collaborating with progressive stakeholders and change makers in the NHS including food service dietitians and the Plants First Healthcare Coalition to help make this vision a lasting reality.”

Review of the plant-based nutrition and lifestyle medicine news March 2026

Cancer and brain health are the main themes of this month’s review. Plus a reminder that genetics are not our destiny and that diets can be healthy AND sustainable.

Healthy lifestyles can improve heart health even when high genetic

Heart disease remains the top killer of men and women globally, yet 90% of cases could be prevented if we addressed modifiable risk factors.

This new study investigated the combined impact of diet and lifestyle on the risk of coronary heart disease. While we know that both genetics and lifestyle influence cardiovascular risk, fewer studies have looked at how these factors interact, particularly in the context of plant-based dietary patterns.

Researchers analysed data from 7,764 participants in the long-running Rotterdam Study, following them prospectively for several decades to track the development of coronary heart disease. The investigators applyed a validated lifestyle score that incorporated a healthy plant-based diet in combination with non-smoking, adequate physical activity and moderate sleep duration, alongside polygenetic risk score.

The results showed that higher adherence to this healthy plant-based lifestyle was associated with a significantly lower risk of developing coronary heart disease. For every increase in the score reflecting healthier behaviours, the risk of coronary heart disease fell. Participants with the highest adherence to the healthy plant-based lifestyle had a 22% lower risk of developing coronary heart disease compared with those with the poorest adherence.

Importantly, adherence to a healthy plant-based lifestyle benefited all genetic risk groups. However, participants with a high genetic risk benefited the most with a 44% reduction in risk compared to participants with a low or intermediate genetic risk who showed a 20% reduction in risk. Once again, these data confirm that genes are not our destiny.

The accompanying editorial highlights an important point. Lifestyle behaviours rarely occur in isolation. People who follow a healthier diet are also more likely to be physically active, avoid smoking and maintain good sleep patterns. Looking at these behaviours together therefore provides a more realistic picture of how lifestyle influences cardiovascular health.

Taken together, these findings reinforce a powerful public health message. A diet rich in whole plant foods, combined with other healthy lifestyle habits, can substantially reduce the risk of coronary heart disease. Even for individuals with an unfavourable genetic profile, lifestyle choices remain a powerful tool for protecting long-term health. This is of particular importance for South Asian. New data from the MASALA study in the US show that South Asians have a significantly higher risk of heart disease and type 2 diabetes, which also occur much earlier in life, compared to all other ethnicities. Thus, tailored and earlier prevention strategies are required with intensive risk factor management.

Do vegan diets increase the risk of colorectal cancer?

One of the largest studies of its kind on diet and cancer saw a hugh amount of media attention. The analysis brings together data from nine different studies, 3 different continents and includes 1,645,555 meat eaters; 57,016 poultry eaters; 42,910 pescatarians; 63,147 vegetarians; and 8,849 vegans. Participants were followed for a median of 16 years.

Although the results support prior literature and shows that vegetarian diets lower the risk of five different cancer type, there are also some surprising results.

Vegetarians in this cohort had a reduced risk of pancreatic, breast, prostate, and kidney cancers, and multiple myeloma. This lower risk was explained, in part, by lower body weight. However, they also had a higher risk of squamous cell oesophageal cancer, which is not easily explained, but could be due to lower intakes of B vitamins. Prior studies have identified B vitamins to be important for preventing oesophageal cancer

For those following a vegan diet, there were just too few numbers of each cancer type to draw firm conclusions. However a surprising finding was that vegans had an increased risk of colorectal cancer.

As the authors themselves point out, this should be interpreted with caution since the results for vegans were based on just 93 cases across all the studies with some studies having fewer than 10 cases. When the first 4 years of follow-up were excluded, the higher risk of colorectal cancer was no longer significant. This suggests that some people already had the early stages of cancer present prior to entry into the study as there is a long lead time prior to cancers becoming clinically apparent. In addition, as pointed out in this excellent video by Mic the Vegan, the models reported adjusted for body mass index (BMI). If you accept that a lower BMI is a result of the vegan diet rather than a confounder then this association with colorectal cancer disappears. In addition, when BMI was not adjusted for, vegans also had a lower risk of prostate and breast cancers.

However, it is worth noting that a very plausible reason for the higher risk of colorectal cancer in vegans is the low calcium intakes across most of the cohorts analysed. Adequate calcium intake has long been known to protect against colorectal cancer.

The lower calcium intake in vegans is likely a reflection of the fact that these studies were from the 1990’s and 2000’s when fortified vegan products were not widely available. Modern day analysis of vegans shows that calcium intakes are now adequate.

Another points to note are that this study did not report on total cancer risk, only site specific risk. Prior analyses, including from the EPIC-Oxford study and Adventist Health Study-2, have clearly shown a reduced risk of total cancer in both vegetarian and vegans, with a greater reduction in vegans. In addition, omnivores in the current analysis had relatively low intakes of meat compared to current typical Western diets. The study did not consider diet quality and vegans were identified based on what they do not eat (animal-sourced foods), rather than what they were eating – which of course is not always healthy.

The take home message remains unchanged. Diets high in fruit, vegetables, whole grains, beans, nuts and seeds are best for cancer prevention. Vegan diets need to be appropriately supplemented with vitamin B12 and certain nutrients need extra focus such as calcium, vitamin D, iodine, selenium and zinc.

Physical activity in cancer survivors

This study examines the impact of physical activity in cancer survival. While there is strong evidence that regular exercise reduces the risk of developing cancer, there has been less research on whether physical activity improves survival after a diagnosis, particularly for cancers other than breast, prostate and colorectal cancer.

Researchers analysed data from six large cohort studies involving more than 17,000 cancer survivors diagnosed with bladder, endometrial, kidney, lung, oral, ovarian or rectal cancer. Participants were followed for an average of almost 11 years after diagnosis, allowing the researchers to examine how levels of leisure-time physical activity related to the risk of dying from cancer.

The findings were striking. Even small amounts of moderate to vigorous physical activity after a cancer diagnosis were associated with a lower risk of cancer mortality for bladder, endometrial and lung cancer. Higher levels of activity, double or triple the recommended amount, were associated with reductions in mortality for oral cancers.

Perhaps the most encouraging finding was that becoming active after diagnosis appeared to be beneficial even for people who had previously been inactive. Lung and rectal cancer survivors who met physical activity guidelines after diagnosis had a lower risk of cancer mortality regardless of their activity levels before diagnosis. This reinforces an important message for patients: it is never too late to start moving.

As with most observational studies, the findings cannot prove cause and effect. People who are able to be physically active may already be healthier than those who are not. However, the results remained broadly consistent even after accounting for factors such as smoking, cancer stage and treatment.

Overall, this research strengthens the case for physical activity as an important component of cancer survivorship care. Alongside good nutrition and other lifestyle measures, regular movement may play a meaningful role in improving long-term outcomes for people living with and beyond cancer.

An opportunity for breast cancer prevention

A major new analysis from the Global Burden of Disease Study provides a stark reminder of the growing global impact of breast cancer and the urgent need to prioritise prevention. The study analysed trends from 1990 to 2023 across 204 countries and territories, making it one of the most comprehensive assessments of breast cancer worldwide.

Breast cancer remains the most commonly diagnosed cancer among women globally and a leading cause of cancer death. Although survival has improved in many high-income countries due to earlier detection and better treatment, the overall number of cases continues to rise as populations grow and age.

What is often overlooked is the extent to which breast cancer is preventable. The study estimates that around 28% of the global burden of breast cancer is attributable to modifiable risk factors. The largest contributors include dietary risks, tobacco exposure, high blood glucose, excess body weight, alcohol consumption and low levels of physical activity.

Looking ahead, the projections are concerning. By 2050, the number of new breast cancer cases each year is expected to increase to around 3.5 million globally, with deaths rising substantially as well. Much of this increase will occur in low- and middle-income countries where access to screening, diagnosis and treatment remains limited.

These findings highlight an uncomfortable truth. While advances in treatment are improving survival, far less attention is given to preventing cancer in the first place. Policies that support healthier diets, increased physical activity and reduced alcohol consumption could prevent a significant proportion of cases.

Diet and brain health

Interest in how diet influences brain health continues to grow, and several new papers this month add to the evidence that what we eat may play an important role in the risk of cognitive decline and dementia.

A systematic review and dose–response meta-analysis examined the relationship between plant-based dietary patterns and the risk of cognitive impairment and dementia across seven prospective studies involving more than 220,000 participants. The overall findings suggested that people who followed plant-based diets more closely tended to have a lower risk of cognitive impairment and dementia. However, the most important message from this analysis was that diet quality matters. Healthy plant-based diets rich in vegetables, fruits, whole grains, legumes and nuts were associated with a lower risk, while plant-based diets high in refined grains, sugary foods and ultra-processed products were associated with a higher risk. In other words, simply eating “more plant foods” does not guarantee protection if those foods are heavily processed.

A second study combined analyses from large prospective cohorts in the United States and the United Kingdom with a broader meta-analysis of cohort studies examining plant-based diets and dementia risk. Once again, the results highlighted the importance of diet quality. Participants with the highest adherence to healthy plant-based diets had a substantially lower risk of developing dementia, while those with diets characterised by less healthy plant foods had a higher risk. Foods most strongly associated with lower dementia risk included vegetables, legumes, nuts and beverages such as tea and coffee. In the pooled analysis, those most closely following a healthy plant-based dietary pattern had around a 21% lower risk of dementia compared with those with the lowest adherence, while unhealthy plant-based diets were associated with a 24% higher risk.

A third paper offered a more cautionary perspective. Using data from cohorts in China, Europe and the United States, researchers reported that more restrictive vegetarian diets in older adults, particularly vegan diets, were associated with a higher risk of cognitive impairment, while pescatarian diets appeared to be associated with lower risk. The authors suggested that nutritional inadequacy could partly explain these findings, particularly with respect to nutrients such as vitamin B12, vitamin D, iron and long-chain omega-3 fats. Importantly, however, the study did not directly measure nutrient status and did not distinguish clearly between healthy and unhealthy plant-based dietary patterns, meaning the findings need to be interpreted carefully.

Taken together, these studies reinforce a key point that is often lost in discussions about plant-based diets. The question is not simply whether a diet is vegetarian, vegan or plant-based in name, but whether it is a high-quality dietary pattern centred on minimally processed plant foods. The strongest evidence continues to suggest that diets rich in vegetables, fruits, legumes, whole grains, nuts and other whole plant foods are associated with better cardiometabolic health and, increasingly, with better brain health as well. At the same time, the more cautionary findings remind us that plant-based diets need to be well planned, particularly in older adults, to ensure adequate intake of key nutrients such as vitamin B12.

Parkinson’s disease and dairy – is there a link?

A new systematic review and meta-analysis has examined whether dairy consumption is associated with the risk of Parkinson’s disease. Parkinson’s disease is a progressive neurodegenerative condition affecting almost 12 million people worldwide, and the number is expected to more than double by 2050. Identifying modifiable lifestyle factors that influence risk is therefore an important public health priority.

This review analysed nine observational studies from the United States, Europe and Asia, including more than 630,000 participants and over 4,000 cases of Parkinson’s disease. The researchers found that people with the highest intake of dairy had a 21% higher risk of developing Parkinson’s disease compared with those consuming the least dairy. When milk alone was examined, the association remained significant, with a 13% higher risk among those with higher milk consumption. Interestingly, the relationship appeared stronger in men than in women.

Not all dairy products were associated with risk. The analysis did not find a significant link between Parkinson’s disease and fermented dairy products such as yoghurt, or with cheese, butter or ice cream. This suggests that the type of dairy consumed may be important, with the strongest signal seen for plain milk.

The reasons for this association are not yet fully understood, but several explanations have been proposed. One possibility relates to the gut–brain axis. Changes in the gut microbiome may influence the misfolding and spread of alpha-synuclein, a protein that accumulates in the brains of people with Parkinson’s disease. Another theory is that milk may lower levels of uric acid in the blood. Uric acid acts as a natural antioxidant, and lower levels have been linked to greater vulnerability to neurodegeneration. Environmental contaminants such as pesticide residues in dairy products have also been suggested as a possible contributor.

It is important to interpret these findings cautiously. The evidence comes from observational studies, which means the research can identify associations but cannot prove cause and effect. Dietary intake was also typically measured only once and relied on self-reported food questionnaires, which can introduce error. Nevertheless, the consistency of the findings across multiple large studies means the potential link between milk intake and Parkinson’s disease warrants further investigation. It is worth noting that prior studies using Mendelian randomisation and the lactase gene variant to predict for intakes of dairy have found that higher intakes are associated with an increased risk of Parkinson’s disease. This suggests that a causal relationship is indeed possible.

Taken together, this research adds to a growing body of evidence suggesting that dietary patterns may influence the risk of neurodegenerative disease. While more research is needed to clarify mechanisms and causality, it highlights the importance of considering diet as part of a broader strategy to reduce the burden of chronic disease.

When it comes to dairy, we know it is not required in the diet, 75% of the worlds population is lactose intolerant (the natural state in humans), dairy may increase the risk of prostate cancer and of course its production is terrible for the environment and the animals. If we apply the precautionary principle we should be moving away from consuming dairy, especially when we have healthier alternatives in the form of plant drinks.

European diets and sustainability

A new paper examined how closely European diets align with the planetary health diet, a framework designed to support both human health and environmental sustainability. The researchers analysed dietary data from nine European countries, comparing current eating patterns with the dietary targets proposed by the EAT–Lancet Commission.

The study included 16,083 adults with sample sizes ranging from 519 in the UK to 3703 in Portugal. Across all countries studied, the findings showed a clear gap between current diets and what would be considered both healthy and environmentally sustainable. In general, people consumed far more red and processed meat, dairy and added sugars than recommended, while intake of whole grains, legumes, nuts, fruits and vegetables fell well below suggested levels. These patterns were consistent across much of Europe, highlighting how deeply entrenched animal-based and ultra-processed food consumption remains in modern diets.

More specific quantification of food groups showed average intakes of 189.6 ± 24.6 g/d for vegetables and 177.1 ± 47.7 g/d for fruits, followed by 66.2 ± 13.6 g/d for tubers, 31.5 ± 19.5 g/d for whole grains, 27.5 ± 12.8 g/d for legumes, 5.2 ± 3.2 g/d for nuts, and 14.0 ± 7.4 g/d for unsaturated oils. For animal-based foods, mean intakes were 263.8 ± 85.6 g/d for dairy, 82.5 ± 10.5 g/d for total red meat (40.4 g/d from beef and lamb and 42.0 g/d from pork), 49.9 ± 17.8 g/d for poultry, 22.8 ± 7.0 g/d for eggs, 38.6 ± 17.4 g/d for fish and seafood, and 28.2 ± 9.3 g/d for saturated fats. The mean intake of added sugars was 54.6 ± 9.5 g/d.

The UK data reflected this broader pattern and showed some of the lowest scores for adherence to the planetary health diet. Compared with the planetary health diet targets, UK diets were characterised by excessive intake of red and processed meat, poultry, eggs, sugar and saturated fat and insufficient consumption of plant foods such as legumes, nuts and whole grains. Fruit and vegetable intake also remained below optimal levels.

The overall message from the study is clear: achieving diets that are both healthy and environmentally sustainable will require substantial shifts in food consumption across Europe. This requires joined up policy and regulation across farming, healthcare, retail and public sector catering. We are still hopefully that the National Food Strategy for the UK, likely due for publication in the summer, will address these key issues. Read our collaborative Ten Point Plan recommendations for the National Food Strategy team.

Micronutrient adequacy of plant-based meat alternatives

Concerns are often raised about the nutritional adequacy of plant-based diets, particularly with respect to micronutrients such as iron, zinc, vitamin B12 and iodine. At the same time, plant-based meat alternatives have attracted criticism because they are often classified as ultra-processed foods. Critics argue that replacing animal products with these alternatives could worsen diet quality or increase the risk of nutrient deficiencies. A new randomised controlled trial helps address some of these concerns by directly comparing micronutrient intake and status in people consuming plant-based meat alternatives with those eating animal-based meats.

In this eight-week trial, 89 adults were randomly assigned to consume either plant-based meat analogues or animal-based meat as their primary protein source while otherwise maintaining their usual diet. Researchers assessed both dietary intake and blood markers of micronutrient status before and after the intervention. Overall, the study found that replacing animal meat with plant-based meat alternatives did not lead to clinically meaningful declines in micronutrient status. Key nutrients often highlighted as potential concerns in plant-based diets, including iron and zinc, remained within normal ranges, and there were no significant differences between the groups at the end of the study. Some nutrients, including dietary fibre, were higher in the plant-based meat group, reflecting the plant ingredients used in these products.

A remaining concern about plant-based meat alternatives is the higher sodium content. Of course, when people eat meat they tend to add salt when cooking for added flavour, so the differences may not be as wide as expected. Interestingly, the SWAP-Meat study comparing beef with Beyond meat products did not find a detrimental effect on blood pressure from the potential higher sodium intake, at least in the short term.

While the current study was relatively short and cannot address long-term health effects, it provides useful evidence that plant-based meat alternatives, if used as part of a varied diet, may offer a practical way for people to reduce their intake of animal products without increasing the risk of nutrient deficiencies. Read our article on plant-based meat alternatives.

See you back in April!

Please follow my organisation ‘plant-based health professionals UK’ on Instagram @plantbasedhealthprofessionals and facebook. You can support our work by joining as a member or making a donation via the website.

Review of the plant-based nutrition and lifestyle medicine news February 2026

This month I write mainly on nutrition, including the new ACLM and WHO position statements on healthy diets, foods that flare IBD, brain effects of coffee and tea and a HUGE study on vegan children.

American College of Lifestyle Medicine Updated Dietary Position

This way of eating can of course be adapted to different traditional and cultural ways of eating and the ACLM have an enormous amount of resources to support people to adopt healthier eating habits. This includes their complimentary culinary medicine programme.

These guidelines align closely with the Eat-Lancet Planetary Health Diet, relaunched in October 2025. Not only is this way of eating good for our health it will help to support our global food system remain within planetary boundaries. This is also a of key importance to those practicing lifestyle medicine, as there are no healthy people on an unhealthy planet. Lifestyle medicine approaches have the potential to reduce the burden of chronic ill health on healthcare services and hence support greater sustainability.

Updated WHO healthy diet factsheet

It goes on to say ‘In other contexts, consumption of animal source foods is still important to favour nutrient intakes, particularly in children and pregnant/lactating women.’ I do not believe this to be factually accurate given that fully plant-based diets can be adopted at all life stages without a detriment to health (cf the study below discussed on vegan children).

The WHO does acknowledge that healthy diets can vary in macronutrient percentage with carbohydrates ranging from 45-75% of energy intake and in some situations increasing protein intake above 15% of energy. A recent study highlights once again how diet quality matters more than macronutrient intakes, with reduced cardiovascular and all-cause mortality in people obtaining protein and fats from plant-based sources, regardless of the whether the diet is low-carb or low-fat.

Vegan infants grow just fine

A very timely, large and reassuring retrospective study assessing the growth of infants based on the family dietary pattern. Of the 1,198 818 children included, 1.2% (914 790) were raised in vegetarian families and 0.3% (3338) in vegan families. Infants born at 32 weeks or later were included and growth reported in the first 60 days and at 24 months.

The results showed that infants born to vegan mothers had a slightly higher incidence of low birth weight but lower incidence of high birth weight. On average, infants in vegan households were less than 0.5 cm shorter and approximately 100g lighter at birth compared with their counterparts from omnivorous households. These are not clinically meaningful differences. In the first 60 days, there was a slightly higher risk of vegan infants being underweight but no difference in risk of stunting. By 2 years of age, there were no statistically significant differences in growth between the different diet groups. Interestingly, women in the vegan and vegetarian breastfed for a longer duration than omnivorous women. Of note, the study did not provide information on dietary composition of the women during pregnancy.

Overall, these results are very reassuring and suggest that a vegan diet can support healthy growth in infants. The authors suggest that there should be adequate counselling available for parents during pregnancy and infancy to ensure diets are well-planned and I would suggest this important regardless of the chosen diet pattern.

Dietary factors and flares in inflammatory bowel disease

The PRognostic effect of Environmental factors in Crohn’s and Colitis (PREdiCCt) prospective cohort study is the largest to follow patients with inflammatory bowel disease (IBD) to investigate environmental, dietary and lifestyle factors associated with flares of the disease.

This report from the study cohort included 2629 participants from 47 UK centres. Dietary information was collected at baseline and participants followed for a median of 4.7 years. The results showed that higher meat intake, both red and white, in people with ulcerative colitis (UC) was associated with a 95% increase in risk of flares, independent of demographic, clinical and biochemical factors. This association was not present in people with Crohn’s disease. No consistent associations were seen for ultraprocessed foods, fibre or polyunsaturated fatty acid intake.

Interestingly, this is not the first study to suggest such an association. Results of the IBD Partner study also showed an increased risk of flares in people with UC, but not Crohn’s, with higher intakes of red meat. The lack of association for people with Crohn’s disease is interesting to note and may reflect the differences in disease pathogenesis. Other aspects of the diet may be more important. For example, a randomised study from King’s College London has shown that reducing/eliminating emulsifiers in the diet is also beneficial in the treatment of Crohn’s disease.

Nonetheless, accumulating evidence suggest that not only are low and meat-free diets, when composed of healthy plant-based foods, associated with a lower risk of IBD but may also be associated with better outcomes for people living with IBD.

Intermittent fasting for adults with overweight or obesity

There are different ways to achieve weight loss but all require a sustained reduction in calorie intake. Intermittent fasting (IF) has gained popularity for both weight loss and purported additional benefits for reducing inflammation and supporting insulin sensitivity.

This updated Cochrane analysis brings together 22 studies, including 1995 participants. The studies were randomised controlled trials (RCTs) and cluster‐RCTs that compared IF (including time‐restricted feeding, periodic fasting, alternate‐day fasting, and modified alternate‐day fasting) with regular dietary advice, no intervention or waiting list in men and women with overweight or obesity, with or without associated comorbid conditions. The minimum duration of the intervention was four weeks, and the minimum duration of follow‐up was six months.

Overall, the results suggest that IF has no clinically meaningful impact on weight loss compared to no intervention, waiting list or usual dietary advice. This does not mean of course that at an individual level a person won’t experience benefits, but within the context of clinical trials, taking all the currently available data, there do not appear to be any specific advantages for IF in achieving weight loss.

It’s useful to remember that lifestyle medicine approaches play an important role in supporting a healthy body weight. However, to achieve clinically meaningful and sustained weight loss, intensive lifestyle interventions are usually needed. Diet and lifestyle interventions in general achieve around 5% reduction in body weight, which is often not sustained in the long-term. This review highlights the role of lifestyle medicine in the era of highly effective anti-obesity treatment (medication and surgery).

National Cancer Plan for England

This month we saw the publication of the new cancer plan for England. It is bold and ambitious. At first look I did not hold out much hope. I was expecting it to focus on pharmaceutical and technological solutions for our poor cancer outcomes. However, I was pleasantly surprised to find a clear focus on cancer prevention. The report suggests that 30% of cancers are preventable although it’s worth noting that global data suggest that figure is closer to 45% if behavioural and metabolic risk factors are considered. Nonetheless, a focus on prevention is hugely welcome.

In an opinion piece in the BMJ, Adam and colleagues argue that cancer should be recognised and managed as a chronic disease within primary care systems, rather than remaining largely confined to specialist follow-up. Although cancer remains a leading cause of death, improvements in treatment mean that millions of people are now living for years or decades after diagnosis. In the UK alone, 3.5 million people are cancer survivors, a figure projected to rise substantially, with one in four adults over 65 expected to have had a cancer diagnosis by 2040.

Despite this growing population, survivorship care remains fragmented and inconsistently delivered. Cancer survivors frequently experience persistent physical symptoms such as pain, fatigue, neuropathy, and late cardiovascular effects, alongside psychological distress, fear of recurrence, financial toxicity, and the practical burden of coordinating complex care. Many report a sense of “abandonment” when discharged from oncology services, and primary care involvement is often reactive rather than structured. The authors suggest that cancer meets established definitions of chronic disease, sharing long duration, ongoing management needs, and common behavioural and environmental risk factors with other long-term conditions.

Since up to two thirds of people with cancer have at least one other chronic condition, and around half live with multimorbidity, integrating cancer into existing chronic disease reviews in primary care is both logical and potentially beneficial. Core elements of survivorship care, including medication review, symptom monitoring, prevention and health promotion, cardiovascular risk assessment, screening for recurrence or new cancers, and coordinated care, closely align with established chronic disease management frameworks. However, significant barriers remain, including limited primary care capacity, lack of dedicated funding, inadequate communication between oncology and general practice, insufficient GP training in survivorship care, and the enduring cultural perception of cancer as an acute or exceptional illness rather than a chronic condition. The authors call for pragmatic trials with economic evaluation, improved digital systems, standardised treatment summaries, risk stratification, and stronger collaboration between primary care, oncology, and third sector organisations. High quality integrated care for people living with and beyond cancer could improve outcomes and quality of life, but will require strategic policy commitment and investment to become routine practice.

Impact of coffee and tea consumption on brain health

This is good news for those of you who enjoy drinking tea and coffee. There is accumulating evidence that these drinks can be part of a healthy diet, assuming they are not consumed with loads of sugar or cream!

This study specifically examined the impact of caffeinated and decaffeinated coffee and tea on brain health. The study included 131, 821 participants from the Nurses’ Health Study and the Health Professionals Follow-up Study, followed for up to 43 years. The results showed that higher caffeinated coffee intake was significantly associated with lower dementia risk (18% reduction) and lower prevalence of subjective cognitive decline (15% reduction). Higher intake of tea showed similar associations with these cognitive outcomes, whereas decaffeinated coffee intake was not associated with lower dementia risk or better cognitive performance. The benefits were observed with intake of approximately 2 to 3 cups per day of caffeinated coffee or 1 to 2 cups per day of tea, with additional intakes not showing further benefits. These impact were independent of genetic risk for dementia and other major risk factors. The results also suggest that caffeine is the reason for the protective effect, given that decaffeinated coffee did not show benefits.

This is not the first study to show a benefit of coffee consumption with a prior umbrella review of meta-analyses finding a 10% reduction in people who drink coffee.

Global biodiversity loss and ecosystem collapse

There has been a lot of talk about this much delayed report from the UK Government. The state of the planet and its continued destruction is now a direct threat to national security and prosperity. Unless action is taken, it is likely that we in the UK will not be able to maintain food security.

Taken directly from the report ‘The UK does not have enough land to feed its population and rear livestock: a wholesale change in consumer diets would be required. It would also require greater investment in the agri-food sector so that it is capable of innovating in sustainable food production.’ Yet we know if health and agricultural policies were aligned such that our land was used to produce food that promotes health (all the healthy plant foods), our farmers were supported to transition to producing horticultural products and land was managed appropriately i.e. stopped being used graze animals and grow crops to feed animals, we could certainly be self reliant in food production. In fact a transition to a plant-based food system would not only feed the entire population but at the same time release a land mass the size of Scotland that could be returned to nature to recover our biodiversity and also to sequester carbon.

Yet, in the UK, misinformation from the meat and dairy industry remains pervasive. A new report about dairy, from Agricultural and Horticultural Development Board (AHDB) tries to persuade us that dairy is not only important for health but sustainable for our planet. This could not be further from the truth and we have shared an article countering some of the claims made and including a call to action.

The Eat-Lancet planetary health diet provides a global framework by which the food system and diets can feed a global population of 10 billion equitably whilst also keeping within planetary boundaries. It feels like now or never. Read our article on food systems and planetary health.

See you back in March!

Please follow my organisation ‘plant-based health professionals UK’ on Instagram @plantbasedhealthprofessionals and facebook. You can support our work by joining as a member or making a donation via the website.

Review of the plant-based nutrition and lifestyle medicine news January 2026

The new year always brings renewed focus on healthy habits. This month I provide a reminder of how healthy habits can support better health for all life stages.

The year kicked off with the highly anticipated release of the Dietary Guidelines for Americans (DGA). These were always going to be controversial since it was known that the recommendations of the Dietary Guidelines Advisory Committee had been thrown out and replaced by a rather non-transparent process. I have written a separate in-depth review. Needless to say, ideology and industry influence has replaced evidence-based recommendations.

At the same time, the US New and World Report has published their annual analysis of the best diets for various health conditions, as recommended by a panel of experts. In contrast to the DGAs, all recommended diets have a focus on nutrient-dense, fibre-rich plant-based foods.

Going forwards, it is going to be difficult to assess the impact of dietary guidelines on health outcomes with so many people using GLP1 agonists for weight loss and their potential positive impacts for other chronic conditions. However, diet and lifestyle support will remain fundamental for the success of these therapies as demonstrated by the next two papers.

Nutritional and lifestyle supportive care recommendations for management of obesity with GLP-1 – based therapies

This expert consensus statement addresses a rapidly evolving area of obesity care: how best to support people using GLP-1–based therapies such as liraglutide, semaglutide and tirzepatide with appropriate nutrition and lifestyle interventions. Recognising that these drugs can produce substantial weight loss but are frequently accompanied by gastrointestinal side effects, nutritional inadequacy and high discontinuation rates, the authors convened an international, multidisciplinary panel to develop practical recommendations using a modified Delphi process.

Drawing on a broad scoping review of the literature published since the introduction of semaglutide for weight management, alongside established obesity and nutrition guidelines and extensive clinical experience, the panel agreed on 52 consensus statements covering the full patient journey. These span preparation before starting therapy, management during the active weight-loss phase, longer-term weight maintenance, and strategies to mitigate harm if treatment is discontinued. Central to the guidance is the recognition that GLP-1–based therapies should not be viewed as stand-alone solutions, but as part of a comprehensive, individualised approach that prioritises nutritional adequacy, physical activity, preservation of lean body mass and long-term behavioural support.

The statement emphasises that people living with obesity are often at baseline risk of micronutrient deficiencies due to poor diet quality, and that the profound appetite suppression induced by GLP-1 therapies may exacerbate these risks. Ensuring adequate protein intake, sufficient dietary fibre, hydration and micronutrient sufficiency is therefore presented as fundamental, not optional. The authors stress the importance of regular monitoring to avoid excessive or overly rapid weight loss, which may compromise muscle mass, bone health and overall nutritional status, particularly in older adults or those with sarcopenic obesity.

Physical activity is positioned as a critical co-therapy, with a strong consensus around combining aerobic exercise with resistance training to support cardiometabolic health and mitigate loss of lean mass during weight loss. The guidance also provides pragmatic advice on managing common gastrointestinal side effects through dose adjustment, meal timing, food choices and hydration, reinforcing that these symptoms are usually transient and manageable without undermining weight-loss efficacy.

Importantly, the paper highlights the reality that many people discontinue GLP-1–based therapies within a year, often due to cost or access rather than clinical choice. In this context, the authors underscore the high risk of weight regain after cessation and the need for structured nutritional and lifestyle support to reduce rebound weight gain. Throughout, there is a consistent call for care that is non-judgemental, stigma-free and grounded in shared decision-making, ideally involving registered dietitians and multidisciplinary teams.

Overall, this consensus statement does not claim to be underpinned by a strong body of direct trial evidence, and the authors are transparent about this limitation. Instead, it offers a thoughtful, clinically grounded framework to help healthcare professionals integrate nutrition and lifestyle medicine into the use of powerful new pharmacological tools, while clearly signalling the urgent need for better evidence on optimal dietary patterns, long-term nutritional consequences and strategies to sustain health gains beyond medication use.

Weight regain after cessation of medication for weight management

This systematic review and meta-analysis pooled data from 37 studies involving more than 9,000 adults treated with weight-management medications, including modern incretin-based therapies such as semaglutide and tirzepatide, as well as older pharmacological agents. The authors sought to quantify what happens to body weight after these medications are stopped, a question of growing importance as incretin therapies become widely used for obesity treatment.

The central finding is that weight loss achieved during active pharmacotherapy is typically followed by substantial weight regain once medication is discontinued. On average, people regained weight at a rate of approximately 0.4 kg per month after stopping treatment, and modelling from the combined studies projected that most individuals returned to their pre-treatment weight within about 1.7 years of cessation. The pattern was similar for both newer GLP-1 receptor agonists and older weight-loss drugs, although the absolute amount of weight regained tended to reflect the amount lost during therapy.

Importantly, the analysis also found that cardiometabolic markers such as blood glucose and blood pressure tended to revert toward baseline alongside body weight, with projected return to pre-treatment levels within about 1.4 years after stopping medication. This suggests that the physiological benefits accrued during drug use are not sustained in the absence of ongoing treatment or concurrent lifestyle support.

When compared with traditional behavioural weight-management programmes involving diet and physical activity, the rate of weight regain after stopping pharmacotherapy was almost four times faster, even though behavioural programmes typically produce smaller initial weight losses. This highlights that the phenomenon of weight regain is not unique to drugs, it reflects the fundamental biology of energy balance, but that medications do not intrinsically alter the body’s homeostatic responses in a lasting way once they are withdrawn.

The authors and subsequent commentators emphasise that these findings do not undermine the value of weight-loss medications for appropriate patients, but they do caution against viewing them as a standalone long-term solution. Instead, the data underscore the chronic, relapsing nature of obesity and the need for integrated, ongoing strategies, including attention to nutrition, physical activity, behavioural support and metabolic adaptation, to support durable health outcomes beyond the period of pharmacotherapy.

Which foods support a healthy body weight?

This comprehensive umbrella review synthesises the highest level of available evidence on how different food groups relate to the risk of developing overweight and obesity, drawing together data from 13 systematic reviews and meta-analyses, most of them based on large prospective cohort studies.

By focusing on food groups rather than individual nutrients, the authors provide a clear and policy-relevant picture of which foods are consistently associated with long-term weight gain and which appear protective.

Across the evidence base, foods most consistently associated with a lower risk of overweight and obesity are whole grains, legumes, nuts and fruits. Higher intakes of these foods were associated with reduced risk both in high-versus-low comparisons and, for several groups, in dose-response analyses. Whole grains and fruits in particular showed a largely linear relationship, with progressively higher intakes associated with lower risk across the observed range. Legumes, although supported by fewer studies, also showed a protective association, aligning with their role as fibre-rich, low-energy-density staple foods. Nut consumption was associated with lower risk of overweight and obesity despite their energy density, with the strongest associations seen at moderate intakes, suggesting that satiety effects and displacement of less healthy foods may be more important than calorie content alone.

Vegetables showed a more nuanced relationship. While many individual studies suggested benefit, the pooled results did not reach statistical significance in all analyses, and non-linear dose-response curves suggested that moderate intakes were associated with the lowest risk. This likely reflects methodological limitations, including measurement error and limited variability in vegetable intake within many populations, rather than an absence of biological effect.

In contrast, foods most clearly associated with weight gain and higher risk of overweight and obesity were sugar-sweetened beverages and red meat. Sugar-sweetened beverages showed one of the most consistent and robust associations in the review, with higher consumption linked to increased risk in both high-versus-low and per-serving analyses. This strengthens the causal inference that liquid sugars contribute to excess energy intake and weight gain. Red meat consumption was also associated with increased risk, particularly in high-versus-low comparisons, likely reflecting its energy density, saturated fat content and the broader dietary patterns in which it is typically consumed.

Refined grains and processed meats showed trends towards increased risk, but the associations were weaker and in some cases did not reach statistical significance, partly due to higher heterogeneity and lower quality of the underlying evidence. Total dairy intake was not consistently associated with either weight gain or protection, with mixed findings depending on dose and product type, highlighting the limitations of grouping diverse foods under a single category.

Taken together, the findings reinforce a pattern that is now familiar across nutrition research: diets built around minimally processed plant foods are associated with better weight outcomes over time, while diets characterised by sugary drinks and higher intakes of red and processed meats are associated with weight gain. Importantly, these associations emerge from long-term observational data rather than short-term weight-loss trials, providing support to their relevance for prevention. In the context of current debates about obesity management, including the rapid uptake of pharmacological therapies, this review serves as a reminder that food patterns remain central to population weight trajectories, and that the foods associated with healthier body weight are, by and large, the same foods associated with lower risk of chronic disease and lower environmental impact.

Minimal and optimal lifestyle habits for improving all-cause mortality

This large prospective analysis from the UK Biobank offers a timely and important reminder that health behaviours do not operate in isolation, and that it is their interaction which matters most. Drawing on wearable-derived data for sleep and physical activity alongside a diet quality score derived from dietary questionnaires, researchers examined how combined variations in sleep, physical activity and nutrition relate to all-cause mortality over a median follow-up of just over eight years. What distinguishes this study is not simply its scale, but its explicit attempt to quantify the minimum combined changes across these behaviours associated with meaningful reductions in mortality risk, rather than focusing only on ideal or often unrealistic targets.

The findings are striking in their practicality. While optimal combinations of moderate sleep duration, higher levels of moderate-to-vigorous physical activity and better diet quality were associated with substantially lower mortality risk, the most clinically relevant message lies elsewhere. Very small, concurrent improvements across all three behaviours were associated with measurable benefits. An additional fifteen minutes of sleep per day, 1.6 minutes more of moderate-to-vigorous physical activity, and a modest improvement in diet quality ( 1/3 cup of cooked vegetables and 1.5 servings of fruit extra per day) were together associated with a 10% reduction in all-cause mortality. None of these changes, when considered in isolation, achieved the same effect. Diet quality in particular showed limited association with mortality unless accompanied by more favourable sleep and activity patterns, reinforcing the idea that nutrition cannot be meaningfully disentangled from the wider context of daily living.

Larger combined shifts were associated with progressively greater reductions in mortality risk. A pattern characterised by roughly an extra hour of sleep per day, around 12 minutes more physical activity, and more substantial improvements in diet quality was associated with a 50% lower risk of death during follow-up. At the upper end of the spectrum, the most favourable combination of sleep, physical activity and diet quality in this study was associated with a 64% per cent lower mortality risk compared with the least favourable pattern.

On a similar theme, it seems even small amounts of physical activity alone can reduce mortality. A large analysis published in the Lancet has shown that even a 5 minute increase in moderate to vigorous physical activity per day could reduce the risk of death by up to 10%, whilst reducing sedentary time by 30 minutes a day would provide additional benefits. Of course, more is better, and this new analysis in the BMJ shows that higher levels of physicial activity are associated with larger reductions in mortality with a greater variety of activities having independent additional benefits to just the total amount of activity.

Lifestyle interventions in pregnancy on gestational diabetes

This study shifts the focus earlier in the life course and into a period where prevention has implications not just for one individual, but for two generations. In this large individual participant data and network meta-analysis, the authors examined the effects of lifestyle interventions during pregnancy on the risk of gestational diabetes, drawing together data from multiple randomised trials to compare different approaches more robustly than has previously been possible.

What emerges clearly is that lifestyle interventions in pregnancy can reduce the risk of gestational diabetes, but that not all interventions are equally effective, and timing matters. Physical activity interventions appeared to be the most effective single intervention and so were interventions delivered in a group format.

The dietary components of effective interventions tended to emphasise overall diet quality rather than rigid macronutrient targets, aligning with broader evidence that dietary patterns matter more than individual nutrients. Prior studies have shown that plant-based dietary patterns are associated with a lower risk of gestational diabetes.

From a lifestyle medicine perspective, the findings reinforce the idea that pregnancy represents a window of opportunity for meaningful, supported behaviour change, but also a moment of vulnerability. Interventions that were supportive, structured and integrated into routine antenatal care were more likely to succeed than those that relied on individual motivation or compliance. The study also highlights a recurring challenge: while lifestyle interventions can reduce gestational diabetes risk, their implementation remains uneven, and access is often poorest for those who would benefit most.

The wider implications extend well beyond pregnancy itself. Gestational diabetes is a strong predictor of future type 2 diabetes and cardiometabolic disease for the mother, and of metabolic risk for the child. Reducing its incidence through achievable, non-stigmatising lifestyle interventions therefore represents a form of intergenerational prevention. Taken together with the broader lifestyle literature, this analysis strengthens the case for embedding nutrition and lifestyle medicine into standard antenatal care, not as an optional add-on, but as a core component of preventive health across the life course.

Dietary interventions and gut microbiota

This systematic review brings much-needed clarity to an area that has generated enormous interest but is often discussed in overly simplistic terms. Drawing together evidence from 80 controlled clinical trials, the authors examined how different dietary patterns influence the gut microbiota, allowing for a direct comparison between plant-based diets (including vegetarian and vegan) and a range of other commonly studied dietary interventions.

Across the body of evidence, plant-based dietary patterns consistently emerged as the most favourable for gut microbial diversity and function. Diets characterised by higher intakes of whole plant foods were associated with increased microbial richness, higher abundance of butyrate and anti-inflammatory bacteria. These changes are widely regarded as markers of a healthier gut ecosystem and are mechanistically linked to improved metabolic, immune and inflammatory outcomes. Additionally, a plant-based diet was associated with reduced triglycerides, total cholesterol, LDL cholesterol, and both fasting and postprandial glucose levels, along with reduced HbA1c levels indicative of improved blood glucose control.

Western-style, high fat and ketogenic diets stood out for their contrasting effects. Although some trials reported short-term changes in specific microbial taxa, these patterns were frequently accompanied by reductions in overall diversity and marked decreases in fibre-associated bacteria and short-chain fatty acid production. In addition, they showed adverse impacts on blood lipids, markers of inflammation and glucose regulation.

From a clinical and public health perspective, these findings strengthen the biological plausibility underpinning plant-based nutrition recommendations. They also help explain why plant-predominant dietary patterns are repeatedly associated with lower risk of cardiometabolic disease, certain cancers and all-cause mortality. The microbiome emerges not as a separate or fashionable add-on, but as a central mediator linking what we eat to long-term health. For lifestyle medicine, this reinforces a familiar but still under-appreciated message: diets built around a wide variety of whole plant foods support not only human physiology, but also the complex microbial ecosystems on which our health depends.

Lifestyle interventions for major depressive disorders – a consensus statement

This expert consensus statement from the American College of Lifestyle Medicine represents one of the most comprehensive attempts to date to formally integrate lifestyle medicine into the prevention and management of major depressive disorder. Using a rigorous modified Delphi process, a multidisciplinary panel of experts reviewed the existing evidence base and reached consensus on 71 statements covering assessment, diagnosis, and the six core pillars of lifestyle medicine: nutrition, physical activity, sleep, stress management, social connectedness, and avoidance of harmful substances.

At its core, the statement challenges the continued marginalisation of lifestyle interventions in mental health care. While acknowledging that pharmacological and psychological therapies remain important, the panel reached strong consensus that lifestyle interventions are foundational to the management of major depressive disorder, rather than optional adjuncts. Physical activity emerged as the intervention with the most robust and consistent evidence, with consensus that it can be used as a primary therapy for adults with mild depression and as an effective adjunct for moderate to severe disease. Notably, the strength of evidence for physical activity compares favourably with antidepressant medication, with substantially lower numbers needed to treat to achieve clinical benefit.

Nutrition and gut health feature prominently, reflecting a growing recognition of the diet–brain–microbiome axis. The panel reached consensus that whole-food, plant-predominant dietary patterns, including Mediterranean-style eating, are associated with lower risk of depression and improved outcomes in people with established disease. Diets high in fibre, polyphenols and minimally processed plant foods were consistently viewed as beneficial, while dietary patterns high in ultra-processed foods, saturated fat, refined carbohydrates and salt were associated with increased risk of major depressive disorder. Importantly, the statement explicitly notes insufficient evidence to support ketogenic or very low-carbohydrate diets for depression management, while highlighting well-documented adverse cardiovascular and metabolic effects associated with these patterns.

Sleep was identified as another critical pillar, with strong consensus that sleep quality, quantity and regularity directly influence depressive symptoms and long-term mental health outcomes. The panel emphasised the importance of assessing sleep routinely in people with depression, including screening for obstructive sleep apnoea, which is highly prevalent in this population. Cognitive behavioural therapy for insomnia, delivered either in person or digitally, was endorsed as an effective intervention that can improve both sleep and depressive symptoms.

The consensus statement also places considerable emphasis on stress, social connection and the wider environment. Loneliness, lack of social connectedness and chronic unregulated stress were all identified as significant risk factors for the development and persistence of depression. Social interventions, including peer support, group activities and community engagement, were viewed as effective components of care, while the panel clearly distinguished meaningful social connection from passive social media use, which does not confer the same mental health benefits. Substance use, including alcohol and cannabis, was consistently associated with higher prevalence of depression, anxiety and suicidal ideation, reinforcing the need to address these factors as part of comprehensive care.

Across all domains, the statement highlights that effective lifestyle intervention depends not only on what is recommended, but on how it is implemented. There was strong agreement that assessment of baseline lifestyle habits should be routine, that care should be trauma-informed and equity-focused, and that sustained behaviour change is more likely when interventions are integrated into daily life, supported by social networks and delivered through coordinated, multidisciplinary care. The authors are careful to position this work as a consensus statement rather than a formal clinical guideline, reflecting ongoing gaps in the evidence, but the message is nonetheless clear: lifestyle medicine offers powerful, evidence-based tools for improving mental health outcomes that remain underused in clinical practice.

There’s no such thing as climate-friendly beef

Food system transformation is urgently needed to meet our global nature and climate targets. Yet the meat and dairy industry continue to suggest that changes in farming practices can reduce the environmental harms associated with the production of animal-sourced foods.

This new analysis from the World Resources Institute makes it clear that claims of “low-emissions” or “net-zero” beef are, at present, more marketing than reality. When greenhouse gas emissions are counted across the full lifecycle, including methane from cows, feed production, land use change and deforestation, even the best available production methods reduce beef’s climate impact by only modest amounts. Even with improved practices, beef continues to emit far more greenhouse gases per unit of protein than most plant-based foods, and labels that tout sustainability often rely on questionable offsets rather than transparent, verifiable reductions in emissions. In practical terms, the only scalable way to reduce the climate burden associated with beef is through lower consumption and a shift toward more plant-predominant dietary patterns that are both healthier for people and markedly lower in carbon emissions.

See you back in February!

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Hopes dashed as new US dietary guidelines veer off course

By Isabelle Sadler and Shireen Kassam

The newly published Dietary Guidelines for Americans has dampened the start to the year. These guidelines tend to have a global influence and, although well known to be heavily influenced by the food industry, they have always broadly followed the scientific consensus on nutrition and health. More importantly, the work of the Dietary Guidelines Advisory Committee (DGAC), who volunteer thousands of hours over the preceding two year period to publicly review the evidence and formulate recommendations, provides the global community with an incredibly useful report.

The Scientific Report of the 2025 Dietary Guidelines Advisory Committee did not disappoint and left us hopeful that plant-rich dietary patterns would be at the forefront of the update. Their recommendations included prioritising plant sources of protein, encouraging people to eat less red and processed meat and recommended legumes to be placed within the protein section (where they should have always been!)

Then came the Trump administration and Robert F.Kennedy Jr appointed as the Secretary of Human Health and Services and sadly nutrition guidance has veered off course ever since. One reason cited for dismissing the recommendations of the then DGAC was because of the emphasis on health equity. Since when is this a bad; to consider all people, including different ethnicities and indigenous people? The Eat Lancet Commission has now centred justice at it’s core.

Sidebar: The guidance is accompanied by a 90 page scientific report and a 418 page Appendix. But we have to confess to not having read these documents fully. We just could not face it. When we saw that Ty Beal, PhD, a well known prominent of meat and dairy consumption had reviewed the evidence on vegan diets and written that ‘Most plant sources of protein do not contain all essential amino acids in high enough quantities to meet requirements without being combined with complementary plant proteins or animal-source foods.’ Big eye roll! In addition, processed meats and processed meat alternatives have been considered together as if they represent one entity. Neither are considered to cause health harms. How can that be when processed meat is classified as a group 1 carcinogen by the WHO?

For us, a healthy diet should be nutritious and healthy, sustainable for the producer, society and the planet, affordable and accessible, culturally adaptable and in our view kind and compassionate to all beings. The latest iteration is far removed from meeting these basic objectives.

The good aspects (or less bad!)

We certainly agree with one key recommendation, which is to focus on ‘real food’ and ‘whole nutrient-dense foods’, whilst limiting or avoiding added sugars and refined grains. This includes an emphasis on consuming fruits and vegetables, shown at the top of the flipped pyramid. This contrasts with the typical American diet where more than 50% of energy comes from ultra-processed foods and is therefore lacking in fibre and other health-promoting nutrients found in whole plant foods.

But from there on the guidelines moves away from the scientific consensus.

The bad (and a lot of it!)

The flipped pyramid

The US dietary guidelines have not used a pyramid shape since 2011. Instead, like many countries, it had moved to a picture of a plate (MyPlate), which provides a better depiction of the proportions of certain food groups to consume regularly/daily opposed to providing a hierarchy whereby one might assume eating foods at the top were sufficient.

A misplaced focus on protein whilst failing to emphasise fibre

We don’t have a major issue with the recommendation to consume 1.2 to 1.6g/protein per day rather than the usual global reference of 0.8g/kg, as there is some debate on this topic. However, most Americans are already meeting and exceeding this level of protein intake and thus emphasising it further risks citizens wrongly focusing on this nutrient. The further concern is the emphasis on animal sources of protein such as red meat, dairy and eggs rather than plant sources. Just the sheer size of the images depicting red meat, chicken, whole milk and egg (seemingly a fried egg!) gives the impression that these are preferred sources of protein. This is at a time when Americans are one of the highest consumers of meat globally, with an average daily intake of almost 400g per day. High meat diets, especially if high in red meat, are associated with a higher risk of chronic conditions and premature mortality, in part because it displaces other potentially healthier foods.

The nutrient that should have been emphasised first and foremost is fibre, since it is lacking in the diets of most Americans. Only 5% of Americans currently meet fibre recommendations, with the average intake only half of what is considered necessary for good health. Found only in plant foods, fibre consumption promotes both physical and mental health and wellbeing and is associated with a significant reduction in rates of chronic conditions.

As pointed out by Prof Christopher Gardner, one of the original 2025 Dietary Guidelines Advisory Committee members, the portions of fruit and vegetables have been changed from cups to servings (1 serving = half a cup), which means that less is being recommended compared to prior versions.

Where have the beans and nuts gone?

We can’t see beans depicted in the pyramid (can you?) and nuts are shown in ridiculously small proportions. These two foods are the healthiest sources of protein, and also serve as a source of fibre and numerous vitamins and minerals.

Without reviewing all the evidence again, beans, lentils, soya foods, nuts and seeds are a cornerstone of every evidence-based dietary recommendation, associated with lower risks of chronic conditions and reduced risk of premature mortality. In the UK, we have an amazing campaign to double the consumption of beans by 2028 for just these reasons. Additionally, a 30g portion of nuts per day is also standard global advice given the association with better health outcomes.

Confusing and conflicting advice

Whilst the guidance to limit saturated fat consumption to less than 10% of energy intake is welcome, if citizens follow the advice to consume more meat, dairy and eggs, there is no way this can be achieved. All the foods that are being emphasised in the guideline are also high in saturated fat content.

The advice to cook with butter and beef tallow also adds further saturated fat to the diet. Although olive oil is also included, other plant-based oils, high in essential polyunsaturated fats are excluded. This is not a surprise as RFK is well known for spreading misinformation about seed oils but his views do not reflect the scientific consensus.

It is unclear why there is an emphasis on whole dairy specifically without consideration of alternative sources of nutrients found within dairy foods. Not only is it higher in saturated fat, it is unsuitable for people with lactose intolerance, especially prevalent in non-White populations. In the UK, the Scientific Advisory Committee on Nutrition has clearly stated that milk from a cow is not necessary in the diet of children or adults. Health Canada removed dairy as a food group in their industry-free 2019 dietary guideline. This was based on the fact that dairy is not necessary in the diet, represents a more inclusive recommendation and because its production is terrible for the planet. So why do US officials consider dairy essential?

The guidance rightly emphasises the need to limit salt in the diet but then goes on to suggest flavouring foods with added salt!

The importance of the health of the gut microbiome is rightly acknowledged, but again, an emphasis on consuming the foods that promote gut health i.e. plants, is lacking.

Lack of nuance around processed foods

The guideline reads as if all food processing is bad. This is incorrect. It is well known that not all processed foods are created equal and that the degree of processing does not necessarily reflect its nutritional profile or impacts on health. The health harms associated with ultraprocessed foods consumption are almost exclusively due to the consumption of processed meats, sugar-sweetened beverages and foods high in salt, sugar and saturated fat. Certain processed foods, such as whole grain breads and cereals, fortified plant milks and certain meat alternatives, have not been shown to negatively impact health and can even be beneficial.

A nod to low-carb diets

The guidance endorses a low-carbohydrate dietary pattern. This may not be an issue in and of itself, since a range of macronutrient ratios can make up a healthy diet pattern.

However, people do not shop for macros, they shop for food. The guidance infers that animal-sourced foods should be consumed in favour of carbohydrate-rich foods (i.e. plant-based foods). This way of eating is known to increase the risk of chronic conditions such as cardiovascular disease, type 2 diabetes, cancer and premature mortality.

Woeful guidance on vegetarian and vegan diets

Although great to see the inclusion of vegetarian and vegan diets, the guidance is insufficient to support the adoption of a healthy plant-based diet. Overly cautious, it assumes that vegetarians and vegans will merely remove dairy and eggs and then by default be deficient in a range of nutrients. Plant-based eaters don’t just remove foods, they replace and add in plant-based foods that on the whole can provide all the nutrients we need, bar vitamin B12 and vitamin D (when exposure to sunshine is limited). Since when do vegans have to worry about potassium consumption! One of the major benefits of a plant-based diet is the high potassium intake which is associated with a lower risk of high blood pressure.

Luckily, we had updated guidance in 2025 on vegetarian and vegan diets from the Academy of Nutrition and Dietetics, which confirms that these plant-based diets can meet nutritional requirements and can be associated with improved health outcomes.

Failure to provide exact limits on alcohol consumption

Although the guidelines do state limiting alcohol consumption, quantities have been removed from the previous set upper limits in favour of this vague guidance, for no clear reason (apart from industry influence…). Less alcohol means different things to different people. The scientific consensus has moved on from the past medical position that low intakes of alcohol can be healthy. Instead, current consensus is that there is no safe amount of alcohol to consume and zero is the optimal amount.

Failure to consider planetary health

Most recently, updated country-based dietary guidelines have considered the impact of the food system on planetary health and guidance has been tailored to ensure that the dietary recommendation can also support environmental health. Afterall, there are no healthy people on an unhealthy planet and the climate crisis is considered the greatest threat to human health. Without food system transformation, it is not possible to meet global climate and nature targets.

This does not seem to have been considered important in this new guideline. We know that the production of animal-sourced foods, especially red meat and dairy, have the most damaging effect on all indicators of planetary health and hence the scientific consensus, as outlined in the 2025 update of the Eat Lancet Planetary Health Diet, is the need for an urgent global transition to a plant-based food system and dietary pattern.

Clear influence of the meat and dairy industry

The usual transparent and open guideline development was thrown out for a closed door approach whereby the advisory committee for this new guideline was only revealed on the day of release. There is no doubt that the meat and dairy industry have had an oversized influence. At least seven of the nine subject matter experts involved have strong relationships with the meat and dairy industry, including links to the Global Dairy Platform, National Cattlemen’s Beef Association, National Pork Board, and the California Dairy Research Foundation.

They have certainly failed on this stated aim ‘“The American public deserves dietary guidance grounded in the best available science—free from ideological bias, institutional conflicts, or predetermined conclusions.”

Failure to consider the welfare of farm animals

The misguided emphasis on eating animals will encourage people to consume more animals, most of whom (99% in the US) are being raised in industrial farming operations. These ‘factory farms’ are hideous places where animals and the people who work in them suffer immeasurable harm. Since we know all animals are sentient, feel pain, have individual personalities, form loving bonds and want to live, surely, we should be aiming to minimise the harm we cause to our animal kin?

Knowing that a 100% plant-based diet can meet our nutritional needs at all stages and ages of life whilst also having the lowest impact on the environment, this should be the default approach wherever possible.

Our concern for long-term health

The major concern we have as a community of healthcare professionals is that these dietary recommendations will lead to worse long-term health outcomes. Meat and dairy heavy diets will lead to increased consumption of saturated fat, higher blood cholesterol levels, and higher blood pressure, all of which increase the risk of cardiovascular diseases. High meat diets increase the risk of overweight and obesity and also increase the risk of type 2 diabetes. Meat-based diets are associated with higher rates of cancer.

This seems to be a dangerous population experiment.

The silver-lining

It may be a blessing that most citizens do not follow their country-based dietary guidelines. People who focus on eating fibre-rich whole foods are not suddenly going to stop. Eating more plants has been popularised through widespread coverage of the health benefits of eating 30 different plant types per week, the latest trend of fibremaxxing and mainstream interest in improving gut health.

We hope that US citizens will take notice of the critiques being published by highly regarded, qualified and trusted health professionals and researchers. We are also pleased our friends at PCRM have launched a federal legal challenge.

Recommended reading

Dr David Katz

Part 1: on the deficiencies in THESE dietary guidelines

Part 2: on the historical deficiencies in the dietary guidelines process

Stanford medicine

Dr Kevin Klatt

The Center for Biological Diversity and the Center for Science in the Public Interest in the US have released a healthy re-write of the new US dietary guidelines, based on the evidence. View them here:

Uncompromised Dietary Guidelines for Americans. Available at: cspi.org/sites/default/files/2026-01/20260107_CSPI_uncompromisedDGA_report_4_FINAL.pdf

A Model for Healthy and Sustainable Dietary Guidelines for Americans. Available at: biologicaldiversity.org/programs/population_and_sustainability/pdfs/2025-sustainable-dga.pdf

Recommended watching:

I was Wrong about RFK Jr´s New Dietary Guidelines – Nutrition Made Simple