Millions of Americans experience food insecurity-induced chronic diseases.¹ Over 90% of Americans consume less than the recommended amounts of fruits, vegetables, whole grains and legumes, and 98% consume more than the recommended amounts of solid fats and added sugars.² A plant-based diet typically includes fruits, vegetables, whole grains, legumes, nuts and seeds, and for some, a small amount of meat, fish, eggs and dairy. By some estimates, moving toward a plant-based diet could reduce global mortality rates by as much as 23%.³

Americans living in underserved communities are less likely to follow a plant-based diet than others, often due to a lack of access to grocery stores, and the abundance of convenience stores in these communities. Food companies spend over $11 billion on television advertisements annually with 80% of food advertising spent on soda, fast food, candy, and unhealthy snacks – much of which is directed toward underserved communities. Poorer diet quality, lack of exercise, and a higher body mass index are correlated with race, ethnicity, level of education and household income.² Healthcare professionals (HCPs) can promote a plant-based diet for underserved clients with simple meal prep guidance using healthy foods that they are typically more accessible.

Food is Medicine: Nutrition Security for Those in Greatest Need
Referring clients to “food is medicine” interventions such as produce prescriptions, portion size training, ingredient selection and cooking instructions can help HCPs address common barriers to healthy eating. Upon incorporating these interventions in practice, HCPs often notice better disease management and fewer hospital admissions. Here are some considerations:

• Discuss healthy foods in medical visits and engage clients in food choice. 
• Offer shelf-stable, healthy foods through a food pantry at the clinic where clients are seen.
• Research low-cost, healthy meal delivery options, some of which may be covered by insurance.
• Consider the timing of food assistance at the end of the period of SNAP benefits so healthy food is available to clients at their greatest time of need.⁴

Food is critical to help manage the obesity epidemic and other chronic diseases. Food insecurity and lack of access to healthy foods is a structural problem that warrants the need of HCPs to take action. Helping clients use more plant-based foods is one way to help reduce the consequences of poor health due to poor nutrition.³

Debunking Myths on Plant-Based Nutrition

Protein

With meat as a mainstay of the typical American diet, some people believe that choosing plant-based foods won’t supply enough protein. In fact, an examination of participants in the EPIC-Oxford study showed similar protein levels and adequate amino acid intake for a 2,000-calorie diet among different dietary patterns:

• Meat-eaters: 17.2% of total calories, 1.28 g protein/kg body weight
• Fish-eaters: 15.5% of total calories, 1.17 g  protein/kg body weight
• Lacto-ovo vegetarians: 14% of toal calories, 1.04 g protein/kg body weight
• Vegans: 13.1% of total calories, 0.99 g protein/kg body weight. 

In the U.S., there is no evidence of inadequate protein intake among those choosing a plant-based style of eating. The only exception is for those who drastically limit calories and avoid legumes, nuts and seeds entirely.⁵

The bottom line: plant-based diets can supply enough protein but especially when properly planned under the guidance of a healthcare professional. 

Affordability
A 2013 systematic review and meta-analysis of 27 studies found that a very healthy diet costs about $1.50 more per person per day when compared to a suboptimal diet. This daily price difference is trivial when compared to the massive healthcare costs associated with a poor diet.⁶ 

• Healthy US-Style – Fruits, vegetables, greens, beans, seafood, and plant proteins with limits on saturated fats, refined grains, sodium and added sugars.
• Healthy Mediterranean-Style Eating (MED) – Vegetables, legumes, fruits, nuts, cereals, fish and unsaturated fats, with limits on meat, poultry, dairy and saturated fats. 

A modest, realistic shift of a 20% increase in US adults following these healthier eating patterns can result in drastically reduced healthcare costs for chronic diseases including cardiovascular disease, cancer and type 2 diabetes for both the Healthy US-Style and the MED patterns, with reduced healthcare costs for Alzheimer’s disease and hip fractures also attributed to the MED pattern. The Healthy US-Style pattern resulted in $31.5 billion in healthcare cost savings, and the MED Pattern showed a cost savings of $16.7 billion.⁷ These diseases disproportionately affect underserved communities and the benefit of making healthy, affordable plant-based foods accessible and providing simple meal instruction can make a big impact on reducing healthcare costs.^1,7

The bottom line: Plant-based foods can be affordable, and the healthcare cost savings are undeniable.

Affordable and Accessible Plant-Based Nutrition in Action
Healthcare professionals should be mindful to not focus on foods that may be inaccessible for some clients such as fresh produce, especially expensive organic products, and instead, embrace less expensive, yet nutritious alternatives such as canned and frozen foods. It’s also less expensive to use shelf-stable items which can reduce the expense of wasted food. Here are some tips:

• Nutritious foods can be found in many locations. Discuss accessible grocery shopping options such as Walmart and dollar stores.
• Connect clients with a registered dietitian to provide further nutrition guidance, when needed.
• It’s unlikely that clients are willing to start cooking complex recipes after choosing convenience items such as ramen or fast food. Offer simple, throw-together recipes to ensure use of healthier food options.¹
• Consider offering food through a pantry at medical visits to help clients maintain access to healthy foods.  Here is a list of affordable staples to recommend:
  • Oatmeal
  • Peanut butter
  • Whole grain or legume-based pasta
  • Dried or canned beans or legumes, no-salt-added 
  • Canned vegetables, no-salt-added
  • Canned fruit, packed in juice or water or applesauce with no added sugar
  • Whole grain rice and quinoa
  • Shelf-stable plant-based milk 
  • Whole wheat bread and wraps
  • Dried fruit with no added sugar or fat
  • Freeze-dried vegetables, available online, can be eaten as is or added to soups and stews
  • Dried herbs and spices

Orgain – Making Strides to Increase Accessibility in Underserved Communities
Orgain’s mission is to help more people live vibrant lives through the power of clean nutrition. Partnering with Los Angeles Food Policy Council (LAFPC) since 2021, Orgain will rally our supporters to help people in underserved neighborhoods in the greater Los Angeles area gain access to better nutrition. As part of the relationship, Orgain will support the organization’s Healthy Neighborhood Market Network, a program empowering small business owners in low-income neighborhoods to bring good food to their communities.  

By working with storeowners to champion healthy food access, the Healthy Neighborhood Market Network supports community vitality and economic development.  Storeowners receive training, guidance and upgrades to their stores, transforming them into beacons of healthy, affordable food. As a result, communities have more options for living a healthy life.

In partnership with LAFPC, Orgain has worked to transform Village Mart & Deli into a convenient and healthy food retail option for residents. The partnership will bring to life the first-ever Farm Stand in El Sereno for residents in April 2022. Learn more about LAFPC here: https://www.goodfoodla.org/healthyneighborhoodmarketnetwork

1. Long CR, Rowland B, Steelman SC, McElfish PA. Outcomes of disease prevention and management interventions in food pantries and food banks: a scoping review. BMJ Open. 2019 Aug 21;9(8):e029236. doi: 10.1136/bmjopen-2019-029236. PMID: 31439606; PMCID: PMC6707699.
2. Ramesh G, Belardo D, Gulati M, Ostfeld RJ, Michos ED. Agricultural policy and societal factors influence patients’ ability to follow a healthy diet. Am J Prev Cardiol. 2021;8:100285. Published 2021 Nov 2. doi:10.1016/j.ajpc.2021.100285
3. Selvik HA, Fullilove RE. From Global Thinking to Local Action: The Planetary Diet as Chronic Disease Prevention. Public Health Rep. 2020;135(4):424-427. doi:10.1177/0033354920935070
4. Downer S, Berkowitz SA, Harlan TS, Olstad DL, Mozaffarian D. Food is medicine: actions to integrate food and nutrition into healthcare. BMJ. 2020;369:m2482. Published 2020 Jun 29. doi:10.1136/bmj.m2482
5. Mariotti F, Gardner CD. Dietary Protein and Amino Acids in Vegetarian Diets-A Review. Nutrients. 2019;11(11):2661. Published 2019 Nov 4. doi:10.3390/nu11112661
6. Rao M, Afshin A, Singh G, Mozaffarian D. Do healthier foods and diet patterns cost more than less healthy options? A systematic review and meta-analysis. BMJ Open. 2013;3(12):e004277. Published 2013 Dec 5. doi:10.1136/bmjopen-2013-004277
7. Scrafford CG, Bi X, Multani JK, Murphy MM, Schmier JK, Barraj LM. Health Economic Evaluation Modeling Shows Potential Health Care Cost Savings with Increased Conformance with Healthy Dietary Patterns among Adults in the United States. J Acad Nutr Diet. 2019 Apr;119(4):599-616. doi: 10.1016/j.jand.2018.10.002. Epub 2018 Dec 24. PMID: 30591404.