Table Of ContentVegetarian and Plant-Based
Diets in Health and Disease
Prevention
Edited by
François Mariotti
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List of Contributors
Carlo Agostoni Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico,
Milan, Italy; University of Milan, Milan, Italy
Sutapa Agrawal Public Health Foundation of India, Gurgaon, India
Ute Alexy University of Bonn, Bonn, Germany
C. Alix Timko University of Pennsylvania, Philadelphia, PA, United States;
Children’s Hospital of Philadelphia, Philadelphia, PA, United States
Benjamin Alles Sorbonne Paris Cité Epidemiology and Statistics Research Center
(CRESS), Nutritional Epidemiology Research Team (EREN), Inserm U1153, Inra U1125,
Conservatoire National des Arts et Métiers (CNAM), Paris 5, 7, 13 Universities,
Bobigny, France
Rossella Attini University of Torino, Torino, Italy
Yun-Jung Bae Shinhan University, Uijeongbu, Korea
Neal D. Barnard Physicians Committee for Responsible Medicine, Washington,
DC, United States; George Washington University School of Medicine and Health
Sciences, Washington, DC, United States
Nawel Bemrah Risk Assessment Unit – French Agency for Food, Environmental
and Occupational Health & Safety (ANSES), Maisons-Alfort, France
Silvia Bettocchi Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico,
Milan, Italy; Università Cattolica del Sacro Cuore, Milan, Italy
Marie-Christine Boutron-Ruault Institut Gustave Roussy, Villejuif, France;
University Paris-Saclay, Villejuif, France
Patricia Burns Instituto de Lactología Industrial (CONICET-UNL), Facultad de
Ingeniería Química, Universidad Nacional del Litoral, Santa Fe, Argentina
Gianfranca Cabiddu Brotzu Hospital, Cagliari, Italy
xxv
xxvi List of Contributors
Irene Capizzi University of Torino, Torino, Italy
Peter Clarys Vrije Universiteit Brussel, Brussels, Belgium; Erasmus University
College, Brussels, Belgium
David A. Cleveland University of California, Santa Barbara, CA, United States
Peter Clifton University of South Australia, Adelaide, SA, Australia; School of
Health Sciences Flinders University, Adelaide, SA, Australia
Emilie Combet University of Glasgow, Glasgow, United Kingdom
Pieter C. Dagnelie Maastricht University, Maastricht, The Netherlands
Luc Dauchet CHRU Lille University Medical Center, Lille, France; Lille University,
Lille, France
Valentina De Cosmi Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico,
Milan, Italy; University of Milan, Milan, Italy
Peter Deriemaeker Vrije Universiteit Brussel, Brussels, Belgium; Erasmus University
College, Brussels, Belgium
Anthony Fardet INRA, UMR 1019, UNH, CRNH Auvergne, Clermont-Ferrand,
France; Clermont Université, Université d’Auvergne, Clermont-Ferrand, France
Massimo Filippi San Raffaele Scientific Institute and Vita-Salute San Raffaele
University, Milan, Italy
Ségolène Fleury Risk Assessment Unit – French Agency for Food, Environmental
and Occupational Health & Safety (ANSES), Maisons-Alfort, France
Meika Foster University of Otago, Dunedin, New Zealand
Quentin Gee University of California, Santa Barbara, CA, United States
Marian Glick-Bauer City University of New York, New York, NY, United States
Daiva Gorczyca Wroclaw Medical University, Wroclaw, Poland
Marcel Hebbelinck Vrije Universiteit Brussel, Brussels, Belgium
List of Contributors xxvii
Sydney Heiss University at Albany, State University of New York, Albany, NY,
United States
Wolfgang Herrmann Saarland University Hospital, Homburg, Germany
Sarah R. Hoffman UNC Gillings School of Global Public Health, Chapel Hill, NC,
United States
Julia M. Hormes University at Albany, State University of New York, Albany, NY,
United States
Motoyasu Iikura National Center for Global Health and Medicine, Tokyo, Japan
Piia Jallinoja University of Helsinki, Helsinki, Finland
Nicole Janz University Clinic Bochum, Bochum, Germany
Carol S. Johnston Arizona State University, Phoenix, AZ, United States
Jae G. Jung Dongguk University Ilsan Hospital, Goyang, Korea; Incheon Sarang
Hospital, Incheon, Korea
Sarah Jung Loma Linda University, Loma Linda, CA, United States
Hana Kahleova Institute for Clinical and Experimental Medicine, Prague,
Czech Republic
Hyoun W. Kang Dongguk University Ilsan Hospital, Goyang, Korea
David L. Katz Griffin Hospital, Derby, CT, United States
Sarah H. Kehoe MRC Lifecourse Epidemiology Unit, Southampton, United Kingdom
Mathilde Kersting University Clinic Bochum, Bochum, Germany
Timothy J. Key University of Oxford, Oxford, Oxfordshire, United Kingdom
Ghattu V. Krishnaveni CSI Holdsworth Memorial Hospital, Mysore, India
Kalyanaraman Kumaran CSI Holdsworth Memorial Hospital, Mysore, India;
MRC Lifecourse Epidemiology Unit, Southampton, United Kingdom
xxviii List of Contributors
Filomena Leone University of Torino, Torino, Italy
Valentina Loi Brotzu Hospital, Cagliari, Italy
Kelsey M. Mangano University of Massachusetts Lowell, Lowell, MA,
United States
Jim Mann University of Otago, Dunedin, New Zealand
François Mariotti UMR Physiologie de la Nutrition et du Comportement
Alimentaire, AgroParisTech, INRA, Université Paris-Saclay, Paris, France
Stefania Maxia Brotzu Hospital, Cagliari, Italy
Alessandra Mazzocchi Fondazione IRCCS Cà Granda Ospedale Maggiore
Policlinico, Milan, Italy; University of Milan, Milan, Italy
Sylvie Mesrine Institut Gustave Roussy, Villejuif, France; University Paris-Saclay,
Villejuif, France
Yoshihiro Miyamoto National Cerebral and Cardiovascular Center, Osaka, Japan
Diego Moretti ETH Zürich, Zürich, Switzerland
Preetam Nath S.C.B. Medical College, Cuttack, India
Kunihiro Nishimura National Cerebral and Cardiovascular Center, Osaka, Japan
Mari Niva University of Helsinki, Helsinki, Finland
Alexandre Nougadère Risk Assessment Unit – French Agency for Food,
Environmental and Occupational Health & Safety (ANSES), Maisons-Alfort, France
Derek Obersby University of West London, London, United Kingdom
Michael J. Orlich Loma Linda University, Loma Linda, CA, United States
Terezie Pelikanova Institute for Clinical and Experimental Medicine, Prague,
Czech Republic
Giorgina B. Piccoli University of Torino, Torino, Italy; Le Mans Hospital,
Le Mans, France
List of Contributors xxix
Fabrice Pierre Université de Toulouse III, Toulouse, France
Jorge Reinheimer Instituto de Lactología Industrial (CONICET-UNL), Facultad de
Ingeniería Química, Universidad Nacional del Litoral, Santa Fe, Argentina
Gianna C. Riccitelli San Raffaele Scientific Institute and Vita-Salute San Raffaele
University, Milan, Italy
Gilles Rivière Risk Assessment Unit – French Agency for Food, Environmental and
Occupational Health & Safety (ANSES), Maisons-Alfort, France
Maria A. Rocca San Raffaele Scientific Institute and Vita-Salute San Raffaele
University, Milan, Italy
Hank Rothgerber Bellarmine University, Louisville, KY, United States
Samir Samman University of Otago, Dunedin, New Zealand; University of
Sydney, Sydney, NSW, Australia
Thomas A.B. Sanders King’s College London, United Kingdom
Silvia Scaglioni Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico,
Milan, Italy
Lutz Schomburg Charité - Universitätsmedizin Berlin, Berlin, Germany
Gina Siapco Loma Linda University, Loma Linda, CA, United States
Shivaram Prasad Singh S.C.B. Medical College, Cuttack, India
Frank Thies University of Aberdeen, Aberdeen, United Kingdom
Tullia Todros University of Torino, Torino, Italy
Serena Tonstad Oslo University Hospital, Oslo, Norway; Loma Linda University,
Loma Linda, CA, United States
Mathilde Touvier Sorbonne Paris Cité Epidemiology and Statistics Research
Center (CRESS), Nutritional Epidemiology Research Team (EREN), Inserm U1153,
Inra U1125, Conservatoire National des Arts et Métiers (CNAM), Paris 5, 7, 13
Universities, Bobigny, France
Amalia Tsiami University of West London, London, United Kingdom
xxx List of Contributors
Katherine L. Tucker University of Massachusetts Lowell, Lowell, MA,
United States
Laura Vacchi San Raffaele Scientific Institute and Vita-Salute San Raffaele
University, Milan, Italy
Annukka Vainio Natural Resources Institute Finland, Helsinki, Finland
Marine van Berleere CHRU Lille University Medical Center, Lille, France
Gabriel Vinderola Instituto de Lactología Industrial (CONICET-UNL), Facultad de
Ingeniería Química, Universidad Nacional del Litoral, Santa Fe, Argentina
Stephen Walsh Vrije Universiteit Brussel, Brussels, Belgium
Michelle Wien California State Polytechnic University, Pomona, Pomona, CA,
United States
P. Winnie Gerbens-Leenes University of Groningen, Groningen, The Netherlands
Ming-Chin Yeh City University of New York, New York, NY, United States
Yoko Yokoyama Keio University, Kanagawa, Japan
Foreword
All life must feed. For most creatures, this exigency of survival is simple, if not always easy.
Sometimes, food is merely elusive. Sometimes, it runs away. Sometimes, it fights back.
Plants, rooted in the bedrock of biology on this planet, feed on sunlight itself. Herbivores
feed on such plants. Carnivores, in their turn, feed on those plant-fed herbivores.
Only for omnivores are the routine difficulties of acquiring adequate sustenance com-
pounded by the complex dilemma of choice. Uniquely, omnivores have choices to make, and
we humans are constitutional omnivores. We have been omnivores since before ever our spe-
cies became “sapiens,” let alone “sapiens” twice over. Our Homo erectus forebears were omni-
vores, too.
When we look over that expanse, the sweep of human history, the view of diet grows fairly
dim very fast. Just consider how challenging it is to remember exactly what we ate yesterday,
and we can readily forgive fairly wide error bars around breakfast in the Paleolithic. Still,
there is a quite a bit we do know with confidence about the diet to which we are natively
adapted. There was a great diversity of plant foods in it. Animals were wild and, in turn,
nourished by their native diets and lean due to their native exertions. Water was the principal
relief of thirst. Excesses of saturated fat, added sugar, or refined starch were nowhere to be
found.
Where the paleoanthropologists debate, they debate the salience of meat in our native diet.
Some now contend we were, as long labeled, hunter-gatherers; others contend we were more
correctly gatherer-hunters. Perhaps, clans of us were both in different places at different times.
Omnivores are opportunists.
The relative preponderance of plants, however, is a matter of relative consensus. Across the
range of dietary patterns debated, plants predominate by volume when not by calories, and by
both at the other extreme. The reasons were almost certainly the obvious: plants do not flee,
and they tend not to fight back (although there are exceptions, as those who have ever picked
a prickly pear know). Gathering is generally less perilous than hunting with primitive weapons,
and more reliably productive.
However, we allow for debates about the Stone Age, as modern diets emphasizing animal
products and processed foods are a marked departure from our adaptations.
All on its own, adaptation would make a case for a return to diets enriched with a variety of
minimally processed plant foods, but we have no need to rely on only that. As laid out in the
many and diverse chapters of this book, there is an enormous aggregation of modern evidence
favoring plant-predominant diets for human health. The basis for plant-based diets in argu-
ments addressing environmental impact and ethics may be stronger still, though they are the
lesser emphasis here.
Across a vast expanse of studies, methods, populations, and outcomes, an emphasis on
vegetables and fruits is perhaps the most consistent feature of diets associated with favor-
able health outcomes. This book enumerates the many particulars underlying that simple
and robust assertion, addressing in turn the what, why, and how of vegetarianism and related
dietary variants. The coverage is comprehensive, the evidence is presented clearly and abun-
dantly, and the editing is methodical. The result is a source all but encyclopedic.
xxxi
xxxii FOrEWOrd
However strong and diverse the arguments for plant-based eating, they do not alter the
omnivorous nature and legacy of Homo sapiens. We are, natively, omnivorous; and omnivores
have choices.
This expansive, richly referenced, and meticulously edited text is dedicated to the proposi-
tion that those choices be well and fully informed.
-Fin,
David L. Katz, MD, MPH
director, Yale University Prevention research Center
Griffin Hospital, derby, CT, United States
Founder, The True Health Initiative
Author (forthcoming): The Truth About Food (HarperOne, 2018)
