Up until three and a half years ago, I practiced medicine like most other primary care physicians. My day was filled with refilling prescriptions for high blood pressure, high cholesterol and type 2 diabetes. In fact, I was overweight, had high cholesterol and sleep apnea. Then I saw “Forks Over Knives” and “the rest is history” as they say. After adopting a whole-food plant-based diet (WFPBD), I have lost 60 plus pounds, dramatically lowered my cholesterol, cured my sleep apnea and am currently training for my first Ironman triathlon! I now try and teach my patients that the most powerful medication available is not the pill they take for their chronic disease, but the food they put in their mouths.

But despite the overwhelming evidence of the health benefits of a WFPBD, many patients remain challenged to fully embrace the WFPBD lifestyle due to some common fears and misconceptions. These include:

The protein myth: This is probably the biggest misconception. Dr. Campbell has written extensively on this subject. I try to explain to patients that almost all of the protein consumed from animals comes from plants (Cows are vegan and you don’t see any protein deficient elephants!) and that the overconsumption of proteins, especially animal derived proteins, can have adverse health consequences.

Equating WFPBD with a vegan diet: I see many “junk-food” vegans (potato chips and soda are vegan!) who think they are eating healthy because they don’t consume animal products. In fact processed sugars, processed grains and processed vegetable oils (which are all vegan) pose just as great, if not more, of a health risk than animal products.

Nutritional reductionism: Probably my biggest pet peeve. Because nutritional reductionism is taught in med schools, taught too dieticians and pervades public policy (ie food labels), we have stopped talking about food. It has led to the proliferation of “low-carbs” diets and “100-calorie snack-packs”, because we presume all carbs and calories are the same. From a biochemistry and thermodynamic standpoint this is true; but from a physiologic standpoint it is absolutely not. A 75-80% “carb” WFPBD is infinitely healthier than any “low-carb” diet.

No one else in my family will give up meat and dairy: This can be a big challenge which I faced with my teenage children. What I found was that as they overcame their misconceptions about eating “rabbit-food” all of time and began to enjoy the tasty, nutritious, filling plant-based meals I cooked at home, they didn’t complain so much.

I don’t know how to shop, cook, stock my pantry, etc.: Fortunately there are an increasing number of excellent books, cookbooks and websites to help people adopt a WFPBD, such as those from “Forks Over Knives”, T. Colin Campbell, PhD & Thomas M. Campbell, MD, Neal Barnard, MD, Caldwell Esselstyn, MD and Lindsay Nixon, “The Happy Herbivore” to name a few. You also may be able to find local resources that offer cooking classes or seminars. For example, there are several plant-based cooks (including myself) who offer WFPBD cooking classes at a local cooking school.

I don’t have time: This is one of the biggest barriers for many people. The key to overcoming this is PLANNING. There are many quick and easy meals that can be prepared in a short period of time, but if you don’t have kale and quinoa in the kitchen, it makes things much more difficult. We oftentimes cook a lot of food on Sundays and portion it out or freeze it for the rest of the week. We also plan our meals ahead of time and go to the grocery once or twice a week, instead of constantly having to run to the store because you forgot the beets. In season, we often let what’s available in our garden or at the local farmer’s market dictate the menu.

Even after these fears and misconceptions are overcome and addressed, many patients face two other major challenges:

Operating in a paradigm of moderation: This is how we currently think about our diet; “It’s okay to eat ice cream every now and then, just not too often.” For most of us, this has not been a successful strategy for two reasons. First, and most important, we forget that eating is a learned behavior. Our food preferences, triggers to start eating and triggers to stop eating are all learned and once we learn them, our subconscious brain takes over making the choice for us (bread on the table at the restaurant, donuts in the break room at work). To reap all of the benefits of a WFPBD, we really need to be all-in. Probably the most important lesson I learned was the simple fact that if ice cream wasn’t good for my cholesterol, and I didn’t want to take medication or put myself at risk for a heart attack or stroke, I needed to stop eating ice cream.

Changing behaviors: Trying to undo decades of attitudes toward food, bad eating habits, etc. is VERY difficult. I like to equate it to pushing a snow ball over the top of a mountain. If you can just get it to the top, you don’t have to push anymore. The hard part is getting it to the top and if you don’t have a good reason to push, you probably won’t be successful. I think we have done a poor job as health care professionals helping people find a reason to push. We usually frame the reason in a very clinical way; “If you don’t change you will have a heart attack or stroke. However, most patients already know eating donuts isn’t healthy, yet they still do it. I think one of the main reasons is the event horizon of the risk; the heart attack, stroke or cancer won’t happen until some unseen time in the future, and I’m not sick yet, so I will address that tomorrow, because I’m really busy today. A different way to frame the reason to change is to list all of the things you wouldn’t be able to do if you had a heart attack or stroke, things like being around for my kids, grandkids, wife, etc.

So remember the most powerful medication is the food you put in your mouth!