Dr. Joan Sabaté, chair of the Department of Nutrition at Loma Linda University, has been named to a six-member expert panel that will advise the US Department of Agriculture as it creates its next set of national dietary guidelines. Sabaté is the only vegetarian on the panel.
Sabaté graduated from medical school in his hometown of Barcelona, Spain, and worked in a hospital there and for the national health service before giving up his white coat in 1984 and going to Loma Linda on a Fulbright scholarship, where he completed a masters in public health. That wasn’t enough, so he then did a doctorate in public health nutrition.
He was named an American Heart Association Fellow, and while researching with Adventist Health Studies (long-term epidemiologic studies exploring the links between lifestyle, diet, and disease among Seventh-day Adventists), made the discovery that nuts lower the risk of heart disease. That discovery changed his professional life. Sabaté’s research on the vegetarian lifestyle gained widespread recognition, and his naming to the USDA’s advisory panel is a testament to his influence.
Question: How did the invitation to the expert panel advising the USDA come about? What does your research focus on?
Answer: Ever since 1990, I have been doing clinical trials on different nuts and cardiovascular risk factors. My first study focused on walnuts, and I was fortunate enough to get it published in the New England Journal of Medicine in 1993.
Ever since, growers of different nuts and other foods have been coming to us at the Loma Linda School of Public Health and asking us to do studies to find out if their foods have certain health properties.
Most recently, we have been studying avocadoes. We have found that eating avocado for lunch has an effect on the appetite, and one’s subsequent food intake at dinnertime.
About a year ago I received an email inviting me to be part of an expert panel to review scientific evidence on dietary patterns. The USDA and the Department of Health and Human Services issue these guidelines every five years.
The 2010 guidelines included for the first time a chapter on dietary patterns.
Originally the guidelines placed the emphasis on specific nutrients. When the researchers realized this was not practical, they emphasized foods, and created the food pyramid. Now they have realized people eat in a patterned way. However, there is not much scientific evidence about eating patterns.
The 2010 guidelines mentioned the vegetarian and Mediterranean patterns of eating. They decided they needed experts in those areas to advise on the 2015 guidelines.
The USDA said they chose me because I am an expert in vegetarian dietary nutrition. Loma Linda has been the leader in scientific research in this area. Next February we will be hosting the sixth International Congress on Vegetarian Nutrition. [See www.vegetariannutrition.org for information about the conference.] Also, I am the editor of Vegetarian Nutrition, a book written for professionals by a number of contributors, summarizing different aspects of a plant-based diet. This is the only such book on vegetarian nutrition.
Question: How much work will you have to do as a panel member? How often do you meet with other members?
Answer: Our committee first met in September last year. Now we meet via teleconference every two weeks, together with a group of five or six from the USDA.
The role of the committee is to give guidance to the officers of the USDA. I gathered a list of 80 relevant research papers on the vegetarian diet and health and sent those to them. Other members do the same thing. Based on our work, the USDA officers select the papers, and summarize the papers in the literature. We just advise.
Question: What will be included in 2015 guidelines?
Answer: We are still working, and don’t know the results. Even if I did, I am sure I couldn’t tell you! But we don’t make the decisions; we just help gather information on dietary patterns. Our final task will be a report, and hopefully one or two scientific papers on the evidence. But there is no guarantee that whatever we publish in the report will be included. This material will be reviewed, and hopefully will help to create the 2015 guidelines. Creating the federal dietary guidelines is a political process as well as a scientific one.
Question: As the only vegetarian on the panel, do you think your views will come into conflict with those of the other five panel members?
Answer: I don’t think there is any contradiction or any problem among current scientists – they recognize the health aspects of a vegetarian diet. In the scientific literature it is well accepted that the vegetarian diet is healthier than a diet that includes generous amounts of meat and animal products.
The problem is that the vegetarian diet is less studied than, say, the Mediterranean diet. There is a lot of industry behind that diet and its research: the olive oil industry, the dairy industry the wine industry, and the governments of those countries, sponsoring and pushing for it. For the vegetarian diet there is no such situation. It is not that people have doubts, it is just the low number of studies and the way they are published means it is often not considered.
Another problem is that there are so many varieties of vegetarians: vegans, or lacto-ovo-vegetarians, or lacto-vegetarians or ovo-vegetarians. So many variations makes it harder to study the diet as a whole. At our upcoming conference, we will have a symposium on defining the vegetarian diet from a scientific viewpoint.
Question: Can you characterize the importance of the USDA dietary guidelines?
Answer: The guidelines are important because they are policy-making. Any federal program, such as school lunch programs or any other thing the federal government sponsors that relates to nutrition always has to be in accordance with the guidelines.
The second aspect is that the guidelines are widely publicized, and the general public does pay attention to what they say.
Thirdly, the guidelines have an international influence, as a template, or example. For example, when the US adopted the food pyramid, many other countries did the same.
The guidelines are a scientific and political/cultural process. They are first based on the scientific literature, but then maybe modified by culture or whatever.
Question: How influential have Adventist studies been when pointing to the benefits of a meatless diet?
Answer: There was a focus on nuts as part of the daily diet in the USDA’s 2010 guidelines. But the only article mentioned to support the importance of nuts was our paper on evidence of nuts and cardiovascular disease. We have helped to change policy.
Adventist Health Study-2 of some 96,000 Adventists across the US and Canada began in 2002. The study has published some reports showing a reverse correlation between people with vegetarian lifestyles to diabetes and metabolic syndrome. [Editor’s note: See a summary of findings at http://www.llu.edu/public-health/health/lifestyle_disease.page.]
This is one of the articles considered by this review panel. This is an example of the important contribution of the study of the diet and health outcomes of Adventists in this country to change diets in the nation.
Adventist Health Studies has published hundreds of reports, and has been influential in changing attitudes of scientists. Previous studies done in small groups at Loma Linda since the 1950s are the most abundant and sound in favor of the benefits of the vegetarian diet.
More than 50% of the studies on the vegetarian diet and nutrition are coming from the Loma Linda University School of Public Health. Only one other group in England is publishing significant studies, but they are smaller. Our contribution is enormous.
The growing popularity of the vegetarian diet is one thing, but the scientific evidence is another.
Question: Are you a vegetarian?
Answer: I became a vegetarian when I married my wife at 24. I am an exceptional vegetarian – I practice a vegetarian lifestyle, but I eat meat on exceptional occasions.