It’s good for our health, it saves money and reduces emissions, but is a plant-based diet something that the NHS could adopt? Dr Shireen Kassam investigates...
The first tenet of a healthcare professional or institution is ‘first, do no harm’. Since becoming vegan almost 10 years ago, for me, as a practicing doctor in the NHS, this means ‘do no harm to people, planet and animals’.
This is known by the international healthcare community as ‘One Health’, defined as ‘a collaborative, multisectoral, and transdisciplinary approach with the goal of achieving optimal health outcomes recognising the interconnection between people, animals, plants, and their shared environment’.
Can the NHS go vegan?
Veganism is a social justice movement that centres animals at its core and aims to eliminate the use and commodification of animals in everyday life. Realistically, the NHS is not going to become vegan, certainly not immediately.
Sadly, all treatments we use for our patients, that is medicines and medical devices, have involved the use of animals during their development. It’s shocking to learn that globally, almost 200 million animals are used for scientific purposes every year.
Our reliance on animals in science needs to end, especially since more than 90 per cent of studies conducted in animals fail to lead to effective treatments for humans. There are instead a vast number of validated non-animal models that can be used in medical research.
The NHS needs to support its researchers and scientists to transition away from animals in research and to become skilled in using non-animal models. This could happen quickly with the right investment in education and training.
Could the NHS support patients and staff to adopt a vegan diet?
Here the answer is a resounding yes, with so many good reasons to support such a decision. A healthy plant-based diet or vegan diet is one of the best choices we can make for our health, with significant benefits for reducing rates of overweight and obesity, cardiovascular disease, type 2 diabetes and certain cancers.
80 per cent of conditions dealt with by the NHS are entirely preventable if we were all to adopt a healthy plant-based diet, alongside other healthy habits. As we live through the Covid-19 pandemic, we shouldn’t need reminding of the risk of future pandemics, which predominantly arise from the way we interact with and farm animals.
Of course, many things would have to be put in place to support such a transition, including making healthy plant-based foods accessible and affordable for all. However, this is not an insurmountable proposition.
Luckily for the NHS, Plant-Based Health Professionals UK (PBHP UK) have been working hard to make sure that, should this decision be taken, everything needed is already in place for a seamless transition.
80 per cent of conditions dealt with by the NHS are entirely preventable if we were all to adopt a healthy plant-based diet, alongside other healthy habits. Image credit: kitzcorner via Getty Images
Education and training on plant-based diets
Medical education tends to focus on treating chronic conditions once they have arisen rather than emphasising a preventative approach. This is mirrored in how funds are spent within the NHS, with only 5 per cent of the roughly £200 billion budget spent on prevention and the rest on treatment.
Given that unhealthy diets are the leading risk factor for chronic conditions and early death, you would have thought that nutrition education would be prioritised in undergraduate healthcare education. Yet most doctors feel ill prepared to address diet and nutrition with their patients and on the whole avoid the topic or provide very generic information.
On a positive note, the UK now has a nutrition curriculum for medical students. Although vegan or plant-based diets are not emphasised as such, this opens the way for incorporation of nutrition education into clinical teaching.
PBHP UK is now teaching student selected modules in three medical schools with our course ‘Cooking for the Climate’, run by GP Dr Hayley Tait. This culinary medicine course teaches the knowledge and practical application of plant-based nutrition.
I teach an accredited course on plant-based nutrition at the University of Winchester for health professionals in clinical practice. This has been hugely popular and in its fourth year of running.
PBHP UK, along with international collaborators, have just published a textbook called Plant-Based Nutrition in Clinical Practice. The hope is that this book and its teaching is incorporated into undergraduate and postgraduate healthcare programmes.
PBHP UK is now teaching the knowledge and practical application of plant-based nutrition in three medical schools. Image credit: Vladimir Vladimirov via Getty Images
Plant-based hospital menus
We have a long way to go to transform both staff and patient meals in hospitals, where processed red meat, a known cancer-causing food, is still served. In my workplace, popular meals include the ‘all-day cooked breakfast’ and ‘sausage and mash’ and caterers are reluctant to remove these best-selling items.
There is also resistance from staff who expect their favourite meals on the menu and, during a trial of ‘Meatless Mondays’ in the staff canteen, sales dropped by 50 per cent. Clearly more education is needed to change hearts and minds.
On the other hand, when patients are made aware of the health risks of certain foods, such as processed red meat, they are supportive or neutral regarding removing these items and incorporating more health promoting foods.
There is precedent. Hayat Hospital in Lebanon is the first plant-based hospital in the World. In addition, the American Medical Association has endorsed a resolution that plant-based meals should be provided in hospitals.
A Lebanese hospital has become the first in the world to make its menu 100% vegan, while the American Medical Association has also endorsed a resolution to provide plant-based meals in hospitals. Image credit: Svitlana Hulko via Getty Images
The NHS was the first healthcare system in the world to declare a climate emergency and have committed to achieving net-zero emissions by 2045. It’s widely recognised by the medical community that the climate crisis is in fact a health crisis.
With over a million employees and 140 million meals served to hospital patients each year, switching to a plant-based menu could have a huge impact on the carbon footprint of the NHS.
The food system is responsible for more than a third of greenhouse gas emissions, most of it from animal agriculture. Without addressing food, the UK will not be able to meet is climate and nature commitments.
Just eliminating beef and dairy would reduce food-related emissions by half. £633 million is spent on in-patient food provision, yet studies have shown that a vegan diet would actually cost a third less in the UK.
Improving quality of life and reducing NHS reliance with vegan food
Plant-based diets have been shown over and over to reduce the risk of chronic health conditions. Studies continue to show that vegans have lower rates of heart diseases, type 2 diabetes and certain cancers. With 42 per cent of adults living with a chronic condition and most of us spending our last decade in ill health, supporting people to adopt a plant-based diet seems a simple solution.
Studies show that healthy plant foods increase healthy life-expectancy1, that vegetarians spend 15 per cent less on healthcare2 and vegans use 58 per cent less prescribed medications, compared with omnivores3.
Is the future of healthcare vegan?
I hope so. All healthcare organisations, including the NHS, need to formally embrace the ‘One Health’ approach and consider human and non-human animals and planetary health in its practices.
Without addressing the way we use and treat animals, be it for research, treatments or food, we cannot truly achieve optimal health for our patients.
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Featured image credit: pamspix via Getty Images
- Fadnes LT, Økland JM, Haaland ØA, Johansson KA (2022) Correction: Estimating impact of food choices on life expectancy: A modeling study. PLOS Medicine 19(3): e1003962. https://doi.org/10.1371/journal.pmed.1003962
- Lin CL, W JH, Chang CC, Chiu THT, Lin MN. Vegetarian diets and medical expenditure in Taiwan — a matched cohort study. Nutrients. 2019;11:2688. https://doi.org/10.3390/nu11112688
- Dos Santos H, Gaio J, Durisic A, Beeson WL, Alabadi A. The Polypharma Study: Association Between Diet and Amount of Prescription Drugs Among Seniors. American Journal of Lifestyle Medicine. 2021;0(0). doi:10.1177/15598276211048812