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The EAT Lancet diet for diabetes & weight loss?

By Matt O'Neill, MSc(Nut&Diet), APD

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Can the EAT Lancet Commission's Planetary Health Diet optimise health and the environment at the same time? Will this higher carbohydrate, plant-based diet take hold at a time when low-carb diets are growing in popularity for weight management?

On 17th January, 2019 the EAT-Lancet Commission launched the Planetary Health Diet.

The aim is to feed a future population of 10 billion people a healthy diet without destroying the planet. It's pitched as a win-win for health and the environment.

The plant-based diet places limitation targets on red meat (just 14 grams per day), poultry (29 grams per day) and fish (28 grams per day).

Targets for carbohydrate-containing foods within the 10,450kJ/2500 Cal/day reference diet include: wholegrains (232 grams per day), potatoes and cassava (50 grams per day), fruit (200 grams per day), legumes (50 grams per day).

Too many carbs?

One nutrition analysis of the reference diet calculated total carbs at 329 grams per day.

Whilst the Planetary Health Diet contains generous quantities of natural, unprocessed foods a question has been raised about the quantity of carbohydrates for metabolically compromised individuals.

-Georgia Ede MD a psychiatrist and nutrition consultant wrote at;

"For those of us with insulin resistance (aka “pre-diabetes”) whose insulin levels tend to run too high, the Commission's high-carbohydrate diet—based on up to 60% of calories from whole grains, in addition to fruits and starchy vegetables—is potentially dangerous."

Adjusting total calories down to a 1250Cal/6000kJ/day weight loss diet would halve the carbohydrate to 165grams/day of carbohydrate.

This contrasts with the CSIRO's Low-Carb Diet designed for individuals with pre-diabetes and type 2 diabetes, which initially recommends just 50 grams per day of carbohydrate, with an optional increase to 70 grams after six weeks.

The daily meal plan from the CSIRO plan allows for 250 grams/day of meat, fish, poultry, eggs or tofu. If you choose to eat animal options only, this is over three times the targets in the Planetary Health Diet.

Health versus the environment

The Planetary Health Diet comes at a time when low-carb diets and ketogenic diets are on a popular rise for weight management and often emphasise animal protein.

In January, the UK NHS approved The Low carb Program app and added it to their NHS Apps library. Charlotte Summers, Chief Operating Officer of Diabetes Digital Media ( - the global diabetes community) pointed out the potential health budget savings;

"In 2018 over 13,000 people in England completed the Low Carb Program, saving the NHS £10.8m. We expect that to increase three-fold with a saving of more than £30m in 12 months."

How will environmental dietary objectives compete with the relatively more pressing challenge of reducing burgeoning healthcare costs?

The full win-win here may be realised for individuals' living in developed countries who embrace a Planetary Health Diet style of eating from a young age and live a physically active lifestyle. They may never experience type 2 diabetes or other diet-related metabolic complications.

However, for the growing number of people who are already metabolically compromised and do not tolerate carbohydrate well, a diet lower in carbohydrate and higher in animal protein could provide superior clinical outcomes and with less tricky dietary design to achieve a higher protein and nutrient intake.

An easier win-win may be to reduce hyper-processed, packaged food and eat a varied, natural diet for your energy needs. Then, on success with this strategy consider further steps to reduce your carbon footprint, which may already include non-diet measures, including reduced motor vehicle usage.

Of course, the challenges in developing countries are different and need to focus on food access and under-nutrition.

A word from our sponsor

To help realise the EAT Lancet Commission's vision; they have formed FReSH an “ambitious global business partnership that brings a consumption lens and systematic approach across the food system to drive industry change.”

More than 30 companies are now part of this project, including; Ferrero, Kellogg's Nestle, Unilever and PepsiCo.

There is no doubt that farmers, food companies, supermarkets and all involved from “farm to fork” need to reassess their impact on the environment and make positive changes.

What is yet to play out is how adopting the Planetary Health Diet will look like in the supermarket. Innovation to bring affordable plant protein to developing countries may also bring more processed foods to developed countries, under the plant-based marketing banner.

Additional questions

The EAT Lancet has a highly commendable vision and one that should trigger the question, “How can I contribute and make a difference with what I eat?”

But there are several questions that are sure to be hotly debated in what could be 2019's biggest food fight.

Will cutting back on animal protein make it harder to achieve a higher protein diet, which may assist in appetite management?

If more people switch to vegetarian and vegan diets, will the diet advice and programs they follow be nutritionally adequate?

Will dietitians, doctors and health professionals openly communicate any bias for or against animal protein? As a dietitian, my client experience, is that animal protein has advantages for weight management but I can work with any requirements. I'm not sponsored by animal protein.

How will consumers make informed and respected decisions about what to eat when consuming advice from social media's polarised and fake facts debate between vegans and carnivores.

Will people have to choose between eating for the environment and eating to manage their waistline?



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