When Sapana Shah, MD, opted for a plant-based diet seven years ago, she didn’t expect her decision to touch the lives of her patients at NYC Health + Hospitals/Bellevue, an essential hospital and association member in New York City.
But her research gave her valuable tools to share with patients with chronic conditions.
“I came across this body of literature that hadn’t been taught to us in medical school about the benefits of actually eating a whole foods, plant-based diet,” she says.
Studies show plant-based diets can help people prevent and manage chronic conditions. A 2015 meta-analysis published in the Journal of the American Heart Association found that people who adopted a vegetarian diet lowered cholesterol levels, which can reduce the risk of heart disease.
Shah began sharing this research with her patients, including one who struggled to manage his diabetes.
“We were going up on the insulin, and he really wasn’t happy about that,” Shah remembers.
But just three months after shifting to a plant-based diet, the patient was able to stop taking insulin and blood pressure medication, and he had his best test results in nearly five years.
“He felt this incredible energy, which was so rewarding,” Shah says. “That’s when I realized how powerful it was. Until that point, I had just been giving patients very general [dietary] information, but I realized that by being more specific about the foods, I could actually help patients make these significant changes.”
Shah brings that practical advice to more than 300 New York patients participating in Bellevue’s Plant-based Lifestyle Medicine Program. Launched in January, the pilot pairs patients who have cardiometabolic risk factors — Type 2 diabetes, prediabetes, high blood pressure, high cholesterol, excess weight, or heart disease — with dietitians and lifestyle coaches to encourage their transition to a plant-based diet.
What, exactly, is a plant-based diet? Shah, along with three other physicians who specialize in lifestyle medicine, promote a diet rich in fruits, vegetables, legumes, beans, lentils, chickpeas, and whole grains. They encourage patients to avoid animal products, refined grains, added oils, and sugars, which contribute to chronic conditions. Physicians work with patients to create custom diet plans; while some patients are ready to make the transition to a completely plant-based diet, others prefer to shift their diet one meal at a time.
“We’re going to try to meet them where they’re at and then work with them from there,” Shah says.
Clinicians and lifestyle coaches are trained chefs and help patients plan meals that fit with their cultural preferences and financial needs. Besides diet, the program targets other elements of lifestyle medicine, including stress management, exercise, and smoking cessation.
Between bimonthly dietitian visits, patients meet with lifestyle coaches who use motivational interviewing to help them identify and set goals. While some patients have weight loss goals, others seek to stop taking medication for their conditions. Patients will meet with a physician every two months to review clinical outcomes — blood pressure, blood sugar, and weight loss — and assess the need for medication.
After the pilot period ends in October, the health system will decide whether to continue the program. While Medicaid and Medicare cover the program, and uninsured patients pay on a sliding scale, reimbursement for privately insured patients has been challenging to navigate, Shah said. The program had a 500-person waiting list in February.
Despite the challenges, Shah is excited about the opportunity to share practical dietary tools with a broader audience. The program “just gave a whole spark to my medical career,” she says.