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!

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