Eating a plant-based diet will cut your cardio risk. So why aren’t more doing it?

Dr. Ashok Mittal is so convinced that a vegan diet is good for your health that the cardiologist has switched to a more plant-based regimen himself.

‘The hardest thing for me to give up was milk in my coffee and eggs in the morning,” said Mittal, a cardiologist at Miami Cardiac & Vascular Institute, part of Baptist Health. “It took me a good six months.”

Now, Mittal uses almond or soy milk in his coffee and eats oatmeal, an apple or a banana instead of an egg. Still, there are times, Mittal admits, that he “sometimes cheats.”

“I still eat a little bit of sushi. I’d say I’m 85 percent vegan.”

Mittal understands the challenges patients face when making the effort to alter their diet.

“Food changes are hard to make because they’re ingrained in us,” Mittal said “They’re a habit and it’s hard to change habits unless the drive comes from within. It’s hard but doable.”

Some would argue that adapting a more plant-based diet today is easier than years past when a vegan diet was considered a fringe movement. Thanks to celebrities, athletes, teens — and Instagram — plant-based diets have moved from marginal to mainstream. It’s much easier now to find vegan options in restaurants, whether fast-food joints or fine dining.

In addition, physicians, dietitians and organizations like the American Heart Association are extolling the advantages of a diet redo.

“Whether you’re considering eating less meat or giving it up entirely, the benefits are clear: less risk of disease and improved health and well-being,” according to the American Heart Association’s heart.org website. Advantages include decreasing the risk of heart disease, stroke, obesity, high blood pressure, high cholesterol, Type 2 diabetes and many types of cancer.

Dr. Gervasio Lamas, chief of cardiology at Mount Sinai Medical Center in Miami Beach, pointed to new studies published in the Journal of the American Heart Association that show positive indications for a plant-based diet.

In an August 2019 study, researchers found that “to reduce cardiovascular disease risk people should eat more vegetables, nuts, whole grains, fruits, legumes and fewer animal-based foods. “ The lead researcher, Casey M. Rebholz, said it “ is one of the first studies to examine the proportion of plant-based versus animal-based dietary patterns in the general population.”

Despite all the pros in switching to a plant-based diet, there are still mixed views about whether diet and exercise can limit the use of medications. Experts said a decision depends on the individual patient, risk factors, condition and motivation to stay on a strict diet.

“Having a healthy heart is truly a lifestyle commitment,” Lamas said. “Eating a plant-based diet is likely to reduce your cardio risk. Whether you can do that or not is really based on your willpower and concern about your personal health.”

Lamas noted that some people will give up meat but then eat a lot of starchy foods like white rice, potatoes and pasta — or prepare foods in an unhealthy way.

“You can take all of these healthy things, bread them and fry them and you’re back to zero,” Lamas said.

There are still misconceptions about all the dietary terms being bandied about.

A vegan diet is totally plant-based, focusing on vegetables, fruit, whole grains, legumes, nuts and seeds. It excludes meat, fish, dairy and eggs. Vegans, in general, avoid eating anything that comes from an animal.

Vegetarians also eat a plant-based diet but their menu can include eggs, milk, cheese, butter, yogurt and honey.

Flexitarians primarily eat a plant-based diet but also eat meat or dairy products in moderation.

The focus of any of these diets is to eat the least processed, most natural form of food, dietitians say.

“There really are no cons of a plant-based diet,” said Candace O’Neill, registered dietitian in the Huizenga Executive Health Program at Cleveland Clinic in Weston. “The only way there can be a potential negative outcome is a poorly planned diet or a lack of education about a plant-based diet. There’s a potential for nutritional inadequacies.”

These inadequacies can include a lack of nutrients like Vitamin B-12, which is found in meat, fish, poultry, eggs, milk and milk products. Other potential deficiencies in a plant-based diet include vitamin D, iron, calcium, iron, omega 3 fats and protein, O’Neill said. In some cases, vegans may need to take supplements or look for fortified foods, such as fortified cereals.

Calcium, needed to build and protect your bones, can be found in fortified nut milks or tofu, dark leafy greens and nuts (particularly almonds) and sesame seeds, O’Neill said.

Protein sources include leafy vegetables, peanut butter, quinoa, soy foods and seeds. Legumes, including beans, chickpeas, lentils and green peas, are also good sources of protein, said Dr. Kashmira Bhadha, cardiologist at Memorial Healthcare System in Broward County.

Knowing about certain food combos also helps. To best absorb iron from green leafy vegetables, pair it with Vitamin C, nutritionists say. For instance, add a squeeze of lemon or orange juice or sliced strawberries into a spinach salad. Black pepper helps make the beneficial values of turmeric more “bioavailable.”

“A vegan diet is a tremendous change,” Bhadha said. “A lot of people, myself included, are eating more of a plant-based diet, cutting down on dairy and red meat and other meats but not necessarily giving up on seafood completely.”

If a patient does want to try a plant-based or vegan diet, cardiologists and nutritionists urge them to take it slow.

At the outset, Mittal, the Baptist cardiologist who follows a vegan diet, urges patients and their families to watch two documentaries: “Forks Over Knives,” which discusses how a plant-based diet can prevent, control or reverse disease, and “The Game Changers,” which delves into professional athletes and the rise of plant-based diets and food myths.

“By watching documentaries, they’re hearing from other people,” Mittal said. “I’m not forcing it on them.”

Tips for switching to a plant-based diet

Start with a meatless day, then increase the number of meatless days.

Search for good vegan recipes.

Change it up. Blend, steam, broil, roast or sauté. You can also add extra veggies, fruits and whole grains into soups, salads and snacks.

Plan varied meals to ensure you’re getting all the nutrients you need.

As for greater acceptance of a vegan diet? “If you can change the mindset of what’s a healthy diet to children, then children will change the minds of their parents,” Lamas said. “It has to start with kids, I think.”