Should We Be Teaching a Public Health Diet?

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by Jay Maddock, PhD, FAAHB

The Dean’s Perspective focuses on issues pertinent to the relationship between academic public health and the practice community.

public health diet

Jay E. Maddock, PhD, FAAHB

Schools of Public Health have educated the public and their students about the importance of healthy eating for decades. Poor diet, along with physical inactivity, is one of the largest contributors to premature morbidity and mortality in the developed world. As public health professionals, we typically think in terms of populations, but in the area of diet, our work tends to be focused on individuals rather than populations.

What would a public health diet include? First of all, it would have to promote human health. Next it would need to be sustainable and have a low carbon footprint. Third, it should have a minimal impact on the environment. Finally, it should not promote antibiotic resistance. 

So what diets promote human health? This is an area with a lot of differing opinions. In full disclosure, I am not a nutritionist and am not giving individual nutrition advice. There does seem to be consensus that a plant-based diet rich in fruits and vegetables promotes health. Last year, the International Agency for Research on Cancer classified processed meat as a carcinogen and red meat as a probable carcinogen. There also appears to be general consensus that consumption for ultra-processed foods and sugar should be minimal. These recommendations are similar to both the DASH Diet and the Mediterranean Diet, which have research backing up their claims for improved health.

Moving from individual diets to the public health concerns, the Eat-Lancet commission has released new recommendations called the “Planetary Health Diet.” This commission, led by Dr. Walter Willett, epidemiologist and nutritionist at the Harvard T.H. Chan School of Public Health, recommends a very limited amount of meat and dairy, some fish and poultry, and lots of fruits, vegetables, nuts, beans, and starchy vegetables. The researchers estimate that if everyone in the world adopted this diet, it would save about 11 million lives annually while being sustainable for a population of 10 billion.

One aspect of a public health diet that I have not addressed yet is food borne illness.  With large factory farms, national outbreaks appear to be a growing common. A variety of steps can be taken to reduce the likelihood of food borne illness, including cooking meat thoroughly and avoiding cross contamination, washing fresh produce, and avoiding under-cooked foods. The CDC has a good list of ways you can reduce your likelihood of contracting a food borne illness.

In meeting all of the stated goals for a healthy, sustainable diet, the evidence points towards a mostly plant-based diet. A Gallup Poll conducted last summer found that only 5% of Americans are vegetarian and 3% are vegan. People below 50 are a bit more likely to be vegetarian at around 7-8%. While this has been stable over the past 20 years that Gallup has been collecting this data, sales of plant-based foods increased by 8% in 2017, and plant-based alternatives to dairy account for almost 40% of dairy beverage sales. The message does seem to be slowly sinking in. A Flexitarian diet focused on plant-based foods but allowing occasional consumption of meat and dairy appears to be one that is acceptable to more Americans and can also have a greater impact if it leads to widespread adoption. Personally, I started thinking about these issues in earnest last summer. I decided to try to stop eating meat for a month. Six months later, I am still going strong and don’t miss meat at all. I do allow myself 1-2 servings of seafood a week, consistent with the Monterrey Bay Aquarium’s Seafood Watch for sustainable seafood items. I feel better and have been surprised with the variety of new foods that I am eating. By removing pork, beef, and poultry from my diet, I have discovered a lot of other foods that taste great and are highly nutritional. This is a great time to explore how your diet affects not only your health but the health of the planet. Meatless Monday has simple tips and recipes for starting on a one-day-a-week change. Try it. I think you’ll find it healthy, delicious, and rewarding. 

Jay E. Maddock, PhD, FAAHB, is the Dean of the School of Public Health at Texas A&M University. He is internationally recognized for his research in social ecological approaches to increasing physical activity. He has served as principal investigator on over $18 million in extramural funding and authored over 100 scientific articles. [Full Bio]

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