April 10, 2013

Dr. Phil Tuso: A healthy argument for Greek salad

Another colleague of mine has written a guest post about plant-based diets. He suggests a different approach than Dr. McDougall in last week's post. Both agree, however, that a diet focused on plants rather than meat or dairy can offer major improvements in health, often within a few months. And there is no risk whatsoever in doing so - only benefits. So, if someone is struggling with the medical problems the doctors write about, it may make sense to give a plant-based diet a chance after discussion with your primary care doctor.

-Preston Maring

My name is Phil Tuso and I am a practicing physician for the Southern California Permanente Medical Group. I had the honor to meet Preston Maring in Washington DC several weeks ago at the Partnership for a Healthier America conference.

Next month, The Permanente Journal will publish an article I wrote with a few of my colleagues entitled “Nutritional Update for Physicians: Plant-based Diets.” Plant-based diets have received a lot of criticism because most people think they exclude meat, fish and dairy products. In the article, we propose a different paradigm. We propose that plant-based diets can focus on fruits and vegetables, but also include healthy meats, fish and dairy products based on a person’s risk for cardiovascular disease. Therefore, we propose we get away from using terms like “vegan” or “vegetarian” and focus more on healthy eating.

There is at least moderate-quality evidence from the literature that plant-based diets are associated with significant weight loss and a reduced risk of cardiovascular disease and mortality. These data suggest that plant-based diets may be a practical solution to prevent and treat chronic diseases. Another potential benefit is the possibility of reducing the number of medications a patient takes to treat a chronic condition that may be the result of an unhealthy diet.

A plant-based diet is not an all-or-nothing program, but a way of life that is tailored to each individual. It may be especially beneficial for those with obesity, Type 2 diabetes, high blood pressure, lipid disorders, or cardiovascular disease. Strict forms of plant-based diets with little or no animal products may be needed for individuals with inoperable or severe coronary artery disease. Low sodium, plant-based diets may be prescribed for individuals with high blood pressure or a family history of coronary artery disease or stroke. A patient with obesity and diabetes will benefit from a plant-based diet that includes a moderate amount of fruit and minimal low-fat animal products.

If we are to slow down the obesity epidemic and reduce the complications of chronic disease, we must consider changing our culture’s mind-set from “live to eat” to “eat to live.” The future of health care will involve an evolution toward a paradigm where the prevention and treatment of disease is centered, not on a pill or surgical procedure, but on another serving of broccoli.

I hope you enjoy this recipe for one of my favorite plant-based meals:

Greek Salad Ingredients

• 3 vine ripe tomatoes, cut into chunks

• 1 red onion, thinly sliced

• 1/2 European seedless cucumber, cut into bite-size chunks

• 1 small red bell pepper, seeded and chunked

• 1 small green bell pepper, seeded and chunked

• 1 cubanelle pepper, seeded and chunked

• 1 cup Kalamata black olives

• Several sprigs fresh flat-leaf parsley, about 1/2 cup

• 2 (1/4 pound) slices imported Greek feta

• 1/4 cup (a couple of glugs) extra-virgin olive oil

• 3 tablespoons (3 splashes) red wine vinegar

• 1 teaspoon dried oregano, crushed in palm of your hand

• Coarse salt and black pepper

• Pita bread


Combine vegetables, olives, and parsley in a large bowl. Rest sliced feta on the top of salad. Combine oil, vinegar, and oregano in a small plastic container with a lid. Shake vigorously to combine oil and vinegar and pour over salad and cheese. Season with salt and pepper and let the salad marinate until ready to serve. Serve salad with pita bread blistered and warmed on a hot griddle or grill pan.