When David Swartz first started seeing William Duffy, MD, three years ago, he was in his seventh year fighting type 2 diabetes, high blood pressure, high cholesterol levels, excessive weight, and a host of other health concerns.
“I grew up in a house in Philadelphia where food was very important,” said Swartz. “I learned to eat all kinds of interesting things as a young kid – hoagies, pizza, cheesesteaks, Chinese food, Indian food, and whatever – I just loved food. So, when Duffy suggested I try to embrace a plant-based lifestyle, I was pretty skeptical and not very interested.”
Swartz wasn’t enthusiastic about changing his nutrition, but after about a year and a half of Duffy’s voice in his ear, living with decreasing energy levels, and worsening medical conditions – despite compliance with standard medical therapy – he knew he had to face his fears and make the change.
“It’s such a fleeting experience, you crave pizza, eat it, and in minutes, it’s gone,” Swartz said. “It’s great for the moment you’re eating it, but it’s gone in minutes. Then I’m miserable and tired, and I have headaches, and all the things that come with being diabetic and eating certain foods.”
Swartz gradually began to embrace more plant-based foods while eating out at restaurants.
“I would hear Dr. Duffy’s voice in my head, and I’d say, ‘OK, I’ll have a falafel instead of a chicken kabob sandwich,’” said Swartz. “I thought, that’s not that bad.”
Changing eating habits is not always easy, yet polls show that over the past few years, more consumers like Swartz are going vegetarian or vegan. Some choose this path citing environmental benefits, animal welfare, food cost savings, or religious beliefs, but health and nutrition was the factor of focus at last month’s “Food as Medicine Philadelphia” symposium at Pennsylvania Hospital.
The symposium sold out 150 seats in less than two weeks. This strong interest locally in whole foods and plant-based nutrition mirrors a broader national shift in food choices; for example, delivery service Grubhub reported a 19 percent increase in vegan takeout orders in 2017, and food industry giant Tyson Foods Inc. announced in December 2017 that they had increased their investment in partnerships with vegan meat company Beyond Meat, and other start-ups that develop meat substitutes.
What may have started as a celebrity fad with pop star powerhouses like Ariana Grande and Beyonce jumping on board, is now becoming mainstream, with documentaries like “What the Health” and “Forks Over Knives,” shining a brighter spotlight on the potential benefits and encouraging more people to embrace plant-based and vegan diets.
“Living a plant-based lifestyle can be challenging at first, but the health benefits make it an easy decision,” said Duffy, an internist at Penn Medicine Valley Forge who moderated the symposium, which featured presentations and panel discussions by experts on how whole food, plant-based nutrition can help prevent and manage chronic disease, assist those looking to maintain a healthy weight, and improve a broad range of health problems from cardiovascular health to boosting energy levels.
In the keynote address, T. Colin Campbell, PhD, co-author of the China Study and professor emeritus of Nutritional Biochemistry at Cornell University, discussed why nutrition deserves a bigger voice in medicine. Campbell argued for more research funding for nutrition studies, more nutrition-focused training in medical schools, and other measures to give nutrition more respect in modern medicine.
Swartz is a case and point for nutrition’s role in medicine. By making small changes in what he was ordering at restaurants, Swartz saw his numbers start to steadily improve. Next, he cut out all cow products (including dairy) in his diet. Then he decided to eat whole food, plant-based items for breakfast and lunch, and limit meat intake to dinner.
“There was this fear that I’m not going to be full, but it worked,” said Swartz. “I went to see Dr. Duffy, he said my numbers are looking great, and now things are rolling.”
Duffy encouraged Swartz to embrace a full whole food, plant-based diet, which Swartz said was “easy, it was nothing – I just rolled right into it.”
Beyond health measured in numbers, Swartz says his overall outlook on life has improved; he had more energy, he’s happier, his personal relationships have improved. Today, he is committed to the new path and has no plans to resume his old habits.
While encouraging some of his patients to consider dietary changes, Duffy was undergoing a similar change himself. After resolving his chronic reflux by quitting his 5-6 diet soda per day habit, Duffy started paying more attention to his nutrition. Soon after, his first son was born and subsequently diagnosed with a milk allergy. Duffy first went dairy-free in solidarity with his son. The new diet also combatted acid reflux that he still experienced on and off.
Feeling much better, Duffy started looking for other ways to be more conscious about his own nutrition. The next light bulb went on while on a trip to Ireland, during which he was surprised by the amount of red meat available at every meal. Steak and burgers were the next thing to go.
When he returned to the States, Duffy read more and more. Two years later, he was entirely plant-based and was convinced of the benefits. In 2013, he connected with the American College of Lifestyle Medicine.
“They are all proponents of lifestyle as a treatment, they use this as therapy – and I had finally found my tribe,” Duffy said. “This is an organization that actively and regularly encourages their patients to eat better. The more whole food plant-based nutrition, the better your health will be – it all came into renewed focus for me.”
About two years ago, Duffy decided he wanted to reach more than just a few patients here and there. He met with dieticians, clinicians, entrepreneurs and others in Philadelphia about expanding the reach. The result was what eventually became the “Food as Medicine Philadelphia” symposium.
Duffy favors increasing the amount of nutrition education that medical students, residents, and interns receive. Board exams need to test for nutrition, Duffy argues, as there is otherwise little incentive for medical schools to teach it due to the already expansive amount of knowledge taught to medical trainees.
Next year, Duffy and his team are hoping to have a two-day symposium, the first day offering continuing medical education credits for medical providers, and the second day for the lay public. Until then, Duffy will continue to encourage his patients to live healthier lives. He makes it clear that he doesn’t tell his patients they need to become entirely plant-based overnight, or even ever.
“One small change can lead to another small change, which can eventually lead to big change,” he said. “No one has a perfect diet. This is not about being perfect – it’s about being as healthy as you can and want to be.”