 How do you rate the quality of people's diets? Well, what could be more nutrient-dense than a vegetarian diet? Indeed, if you compare the quality of vegetarian diets compared to non-vegetarian diets, the more plant-based diets do tend to win out, and the higher diet quality in vegetarian diets may in fact help explain better improvements in health outcomes. However, vegetarians appear to have higher refined grain intake, eating more foods like white rice and white bread that have been stripped of much of their nutrition. So just because you're eating a vegetarian diet doesn't mean you're necessarily eating optimally healthy. Those familiar with the science know the primary health importance of eating whole-plant foods, so how about a scoring system that just adds up how many cups of fruit, vegetables, whole grains, and beans, split peas, chickpeas, and lentils, and how many ounces of nuts and seeds per 1,000 calories, with or without counting white potatoes? Well, just looking at the total intake of whole-plant foods doesn't mean you're not also stuffing donuts into your face. So you can imagine proportional intake measures based on calories or weight to determine the proportion of your diet that's whole-plant foods. In that case, you'd get docked points if you eat things like animal-derived foods, meat, dairy, or eggs, or added sugars and fats. My favorite proportional intake measure is McCarty's Phytochemical Index, which I've profiled previously. I love it because it's sheer simplicity defined as the percent of dietary calories derived from foods rich in phytochemicals. So it's a score from 0 to 100, the percentage of your calories that are derived from foods rich in phytochemicals, which are biologically active substances naturally found in plants that may be contributing to many of the health benefits obtained from eating whole-plant foods. I mean, you know, monitoring phytochemical intake in the clinical setting could have great utility in assisting people with optimizing their dietary intake for optimal health and disease prevention. However, the quantification of phytochemicals in foods or tissue samples is impractical, expensive, laborious. But hey, this concept of a phytochemical index score could be an alternative, simple method of monitoring phytochemical intake. Theoretically, a whole-food plant-based or vegan diet that excluded refined grains, white potatoes, hard liquors, and added sugars and oils could achieve a perfect score of 100, whereas sadly, the most current American diets might be lucky to hit 20. Let's see what's going on. In 1998, our shopping baskets were filled with about 20% whole-plant foods, and more recently, that has actually shrunk. Wouldn't it be interesting if researchers used this index to try to correlate it with health outcomes? That's exactly what they did. Look, we know that studies have demonstrated vegetarian diets have a protective association with weight and body mass index. Five dozen studies have shown that vegetarians had significantly lower weight in BMI compared with non-vegetarians. And even more studies show that high-intensive fruits, vegetables, whole grains, and beans may be protective regardless of meat consumption. So researchers wanted to use an index that gave points for whole-plant foods. They used a phytochemical index and tracked people's weight over the next few years, which again, I profiled my video, Calculate Your Healthy Eating Score on a scale of 0 to 100, simply reflecting what percentage of your diet is whole-plant foods. And even though the healthiest eating tier only averaged a score of about 40, which meant the bulk of their diet was still made up of processed foods and animal products, just making whole-plant foods a substantial portion of the diet may prevent weight gain and decrease body fat. So it's not all or nothing, any steps we can make to increase our whole-plant food intake may be beneficial. A couple more studies have been performed since, and they all point in the same direction, about a third of the odds of abdominal obesity at higher healthy plant intake, and significantly lower odds of high triglycerides. So the index may be a useful dietary target for weight loss, where there's less focus on calorie intake and more on increasing intake of these high-nutrient lower calorie foods over time. The latest study published 2020 suggests the same is true for childhood obesity. Even at the same weight, the same amount of belly fat, those eating plant-based have higher insulin sensitivity, meaning the insulin they make works better in their body, perhaps thanks to the compounds in plants that alleviate inflammation and quench free radicals. And indeed, things seem to improve as people eat more and more plants. No wonder, researchers found 91% lower odds of prediabetes for people getting more than half their calories from healthy plant foods. Significantly lower odds of metabolic syndrome and high blood pressure, only about half the odds of being diagnosed with hypertension over a three-year period among those eating more plants. Even mental health was impacted, about 80% less depression, two-thirds less anxiety, 70% less psychological distress. What about the dietary phytochemical index in benign breast diseases, such as fibrocystic diseases, ductal ectasia, fatty necrosis, and all sorts of benign tumors? The same thing was found, 70% lower odds of those diseases. Okay, but what about breast cancer? A higher intake of healthy plant foods was indeed associated with a lower risk of breast cancer, even after controlling for a long list of other factors, and not just by a little bit, eating twice the proportion of plants compared to the standard American diet was linked to more than 90% lower odds of breast cancer.