Rather than fixating on animal- or plant-based diets, Christopher Gardner, PhD, suggests that people should eliminate the "crappy carbs" in this interview with Akshay B. Jain, MD.
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Akshay B. Jain, MD: Hello. Thanks for joining us. I'm Akshay Jain, an endocrinologist in Vancouver, British Columbia. Joining us is Dr Christopher Gardner, a nutritional scientist at Stanford. He is the author of many publications, including the widely cited SWAP-MEAT study. He was also a presenter at the American Diabetes Association conference in San Diego in 2023.

We'll be talking about his work and the presentation that he did classifying different kinds of diets as well as the pluses and minuses of a plant-based diet vs an animal-based diet. Welcome, Dr Gardner.

Christopher Gardner, PhD: Glad to be here.

Jain: Let's get right into this. There's obviously been a large amount of talk, both in the lay media and in the scientific literature, on plant-based diets vs animal-based diets. When it comes to an individual living with diabetes, does one diet make more sense than the other?

Gardner: I think this is one of those false dichotomies. It's really not all one or all the other. Two of my favorite sayings are "with what" and "instead of what." You may be thinking, I'm really going to go for animal-based. I know it's low-carb. I have diabetes. I know animal foods have few carbs in them.

That's true. But think of some of the more and the less healthy animal foods. Yogurt is a great choice for an animal food. Fish is a great choice for an animal food with omega-3s. Chicken McNuggets, not so much.

Then, you switch to the plant side and say, "I've heard all these people talking about a whole-food, plant-based diet. That sounds great. I'm thinking broccoli and chickpeas."

I know there's somebody out there saying, "I just had a Coke. Isn't that plant-based? I just had a pastry. Isn't that full of plants?" It doesn't really take much to think about this, but it's not as dichotomous as animal vs plant.

Jain: There is, obviously, a good understanding regarding what actually constitutes the diet. Initially, people were saying that animal-based diets are really bad from a cardiovascular perspective. But now, some studies are suggesting that it may not be true. What's your take on that?

Gardner: Again, if you think "with what" or "instead of what," microbiome is a super-hot topic. That's really fiber and fermented food, which are only plants. Saturated fat, despite all the controversy, raises your blood cholesterol. It's more prevalent in animal foods than in plant foods.

Are there any great nutrients in animal foods? Sure. There's calcium in dairy products for osteoporosis. There's iron. Actually, people can get too much iron, which can be a pro-oxidant in levels that are too high.

The American Heart Disease, in particular, which I'm very involved with, came out with new guidelines in 2021. It was very plant-focused. The top of the list was vegetables, fruits, whole grains, and protein. When it came to protein, it was mostly from lentils, beans, and grains.

Jain: That's good to know. Let's talk about protein. We often hear about how somebody on a plant-based diet only can never have all the essential amino acids and the amount of protein that one needs. Whether it's for general everyday individuals or even more so for athletes or bodybuilders, you cannot get enough good-quality protein from a plant-based diet.

Is there any truth to that? If not, what would you suggest for everyday individuals on a plant-based diet?

Gardner: This one drives me nuts. Please stop obsessing about protein. This isn't a very scientific answer, but go watch the documentary Game Changers, which is all about vegan athletes. There are some pretty hokey things in that film that are very unscientific.

Let's go back to basics, since we only have a couple of minutes together. It is a myth that plants don't have all the amino acids, including all nine essential amino acids. I have several YouTube rants about this if anybody wants to search "Gardner Stanford protein." All plant foods have all nine essential amino acids and all 20 amino acids.

There is a modest difference. Grains tend to be a little low in lysine, and beans tend to be a little low in methionine. Part of this has to do with how much of a difference is a little low. If you go to protein requirements that were written up in 2005 by the Institute of Medicine, you'll see that the estimated average requirement for adults is 0.66 g/kg of body weight.

If we recommended the estimated average requirement for everyone, and everyone got it, by definition, half the population would be deficient. We have recommended daily allowances.

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