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are many other ACLM member handouts that provide evidence-based 3. American College of Lifestyle Medicine (n.d.b.). Food as med-
lifestyle measures. icine jumpstart. https://lifestylemedicine.org/wp-content/
Forks-Over-Knives is a website to support healthy dietary chang- uploads/2024/01/ACLM-Food-As-Medicine-Jumpstart-8.5x11.pdf
es. There are also several Netflix documentaries we recommend to 4. Bansal, S, Connolly, M, & Harder, T. (2022). Impact of a whole-
patients: Forks-Over-Knives, Blue Zones, You Are What You Eat and foods, plant-based nutrition intervention on patients living
The Game Changers. with chronic disease in an underserved community. American
The University of Texas Health San Antonio School of Nursing Journal of Lifestyle Medicine, 16(3), 382-389. https://doi.
has an innovative, data-driven program to help transition patients to org/10.1177/15598276211018159
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a WFPB diet. The Green Wellness Program: Plants-2-Plate is a six- 5. Christianson-Silva, P, Benavides, H & Meireles, C. (2023). Using
month, interprofessional lifestyle modification program using shared shared medical appointments in your practice, The Journal for
medical appointments (SMAs) with a registered nurse, family nurse Nurse Practitioners, 19 (8), 1-3. https://doi.org/10.1016/j.nur-
practitioner and registered dietitian. Patients can self-refer or clini- pra.2023.104709
cians can refer patients through the same website intake form. Patients 6. Esselstyn, CB. (2001). Resolving the coronary artery dis-
complete an institutionally approved SMA confidentiality agreement. ease epidemic through plant-based nutrition. Preventative
Whole Food, Plant-Based Eating Pattern: A comprehensive provider medical appointment is completed with Cardiology, 4(4). 171-177. https://doi.org/10.1111/j.1520-
037x.2001.00538.x
fasting labs at zero, three and six months. Patients meet individually
A Starting Point for Clinicians with the registered dietitian twice. Education during the 14 SMAs 7. Lu, I. (2021). Busting nutrition myths: How plant-based diets
(one hour each) is focused on the ACLM six pillars of wellness (whole
are healthy for children & families. https://nutritionstudies.org/
foods/plant-based diet, physical activity, restorative sleep, social con- busting-nutrition-myths-how-plant-based-diets-are-healthy-for-
By Heidi L. Benavides, MSN, RN, CMSRN, DNPc, Christiane Meireles, PhD, RDN, LD, nections, stress reduction and avoidance of risky substances), chronic children-families/
and Paula Christianson-Silva, DNP, FNP-BC, ANP-BC illnesses and a cooking class by a registered dietitian/chef. Education, 8. Ornish D, Scherwitz, LW, Billings, JH, et al. (1998) Inten-
social support and goal setting are essential aspects of the program. sive lifestyle changes for reversal of coronary heart dis-
Our results have shown improved health outcomes including weight ease. JAMA,280(23). 2001-2007. https://doi.org/10.1001/
Whole Food, Plant-Based (WFPB) eating pattern is an evi- Transitioning to a Whole Food, Plant-Based Diet reduction, decreased inflammatory markers, improved FibroScans and jama.280.23.2001
dence-based modality to prevent, treat and, in some cases, Transitioning to a WFPB diet can be simple with the right tools liver function tests, reduced hemoglobin A1Cs, improved energy and 9. Shah, R, Davis, B, & Katz, DL. (2020). Nourish: The definitive
A reverse chronic disease. 4, 6, 8, 10 In 2017, there were over 11 mil- and depends on the patient’s stage of change. Patients may be in the decreased blood pressure. Self-reported pre- and post-program health plant-based nutrition guide for families—with tips & recipes for
lion worldwide deaths due to dietary risk factors that contributed to car- precontemplation stage, while others are already in the maintenance and nutrition surveys are completed. bringing health, joy & connection to your dinner table.
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diovascular disease, type 2 diabetes, cancer and other causes. More than stage. Understanding and reinforcing the patient’s motivation for 10. Tuso, PJ, Ismail, MH, Ha, BP, & Bartolotto C. (2013). Nutri-
50 percent of the dietary-related deaths were due to high sodium intake change may help support the patient’s dietary transition. Patients may Clinician’s Role in Educating WFPB Eating Pattern tional update for physicians: plant-based diets. Permanente Jour-
(3 million deaths) and a low intake of whole grain (3 million deaths), want to gradually transition to a WFPB diet by starting with a “Meat- WFPB education should be part of every medical visit. The use nal,17(2), 61-66. https://doi.org/10.7812/TPP12-085
fruits (2 million), vegetables and nuts/seeds. The leading cause of dietary less Monday” or trying one WFPB meal per week, while others may of SMAs can improve delivery of care, increase clinician and patient 11. Wellness 360 Clinic (n.d.). Green Wellness Program: Plants-2-
deaths in young adults ages 25-50 was from low fiber, while older adults want to transition immediately to a 100 percent plant-based eating satisfaction, and increase productivity and revenue.5 Clinicians can Plate. https://wellness360.uthealthsa.org/green-wellness-pro-
aged 70 years and over was due to high sodium diets. pattern. Some patients may never want to stop eating meat and, in obtain continuing education hours to improve knowledge of a WFPB gram-plants-2-plate/
this case, clinicians will want to encourage an increase in whole, plant- eating pattern. Patients can be referred to other healthcare disciplines
What is a Whole Food, Plant-Based Diet? based foods and water consumption while also decreasing animal who specialize in a WFBP eating pattern and other lifestyle measures Heidi Benavides is a registered nurse and currently an Associate Pro-
A WFPB diet includes nutrient dense foods with an abundance products and processed foods. to improve health outcomes. Health professions education should fessor/Clinical at UT Health San Antonio. She is passionate about
of antioxidants and fiber, which are minimally processed. WFPB emphasize evidence-based, WFPB concepts within undergraduate and plant-based nutrition and lifestyle medicine as a means to prevent,
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foods include whole grains, nuts, seeds, legumes, vegetables and fruits. Getting Patients’ Buy-In graduate programs. manage and reverse chronic illness. Heidi spearheaded and co-founded the
Animal products (dairy, animal meat or fish) and processed foods are Clinicians may find challenges in obtaining patient buy-in for any Green Wellness Program: Plants-2-Plate utilizing shared medical appoint-
excluded. There are many myths about WFPB diets, but the evidence lifestyle modifications because behavior change can be difficult. Clini- Conclusion ments with an interdisciplinary methodology and serves as program director.
supports a WFPB approach (or eating pattern) for children, adoles- cians can use motivational interviewing techniques, perhaps leading the A Whole Food, Plant-Based dietary eating pattern is an evi-
cents, adults and pregnant individuals. There are many types of ver- conversation by asking the patient if they would like more information dence-based modality that should be at the forefront of a patient’s Christiane Meireles, PhD, RD, LD, is a registered dietitian and clin-
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satile plant-based protein sources (soy, beans, lentils, peanuts, whole about treating their disease with lifestyle changes, which may reduce treatment plan. Eating a variety of plant-based, whole foods have ical associate professor at the School of Nursing at UT Health San
grains, and nuts and seeds). Plants are good sources of calcium, their overall costs and medication dosing (or possibly stopping medica- been shown to be safe for most individuals. Clinicians can improve Antonio with over 35 years of experience in clinical, community and
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including kale, broccoli, tofu, spinach and bok choy. tion[s] completely). Many patients will be open to learning more. their patient health outcomes through innovative WFPB education research settings. As a clinical dietitian, her work is predominantly on primary
Patients should be taught about the marketing trap of processed plant- approaches and play an important role in WFPB disease prevention, care focusing on chronic diseases, mainly diabetes, chronic kidney disease and
based foods, which can be high in sodium and fat. The packaging can Clinician Education and Patient Resources management and possibly disease remission. obesity. As a researcher, nutrition in kidney disease, women’s health and, more
make the product look healthy and often is misunderstood by the patient. Clinician Education recently, plant-based diets are the center of her studies. Christiane Meireles is
Clinicians may not feel competent in WFPB education. The Amer- co-founder of the Green Wellness Program: Plants-2-Plate.
Reasons an Individual May Eat a Whole Food, Plant-Based Diet ican College of Lifestyle Medicine (ACLM) is a professional organi- References:
Individuals engage in a WFPB eating pattern for many reasons. Some zation dedicated to the six pillars of wellness (including WFPB diets). 1. Ashfin, A, Sur, PJ, Kairsten, FA, et al. (2019). Health effects of Paula Christianson-Silva, DNP, FNP-BC, ANP-BC, DipACLM, is a
may have health issues and want to try a dietary modality to treat Several education modalities exist to include webinars, conferences, dietary risks in 195 countries, 1990-2017: A systematic analysis clinical professor and family nurse practitioner at UT Health San Anto-
or potentially cure their disease, while others may want to prevent interest groups and diplomate certification. for the Global Burden of Disease study 2017. Lancet,393. 1958- nio with expertise in interprofessional care models, lifestyle medicine and
disease. WFPB diets are known to help with climate change. Addi- Patient Education 1972. https://doi.org/10.1016/S0140-6736(19)30004-8 NP education. She has been a primary care NP and educator since 1989. At UT
tionally, others may want to protect animals from a difficult life and a The ACLM has a 43-page Food as Medicine Jumpstart Guide, 2. American College of Lifestyle Medicine (n.d.a.). Home page. Health, Dr. Christianson-Silva has been active in DNP Program curriculum devel-
painful death. which educates about WFPB diet meal planning.3 Additionally, there https://lifestylemedicine.org/ opment and is co-founder of the Green Wellness Program: Plants-2-Plate.

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