Interrupting the Family Barbecue: In Search of the Planetary Health Diet

A display meat case with food made out of crochet, by Madame Tricot. Photograph by Jim Ross.

More than a few friends have fled from family barbecues to the emergency room, believing they were having heart attacks, only to be told their problem was gallbladder. I assumed I was immune. Not quite.

This past summer, far from home, I couldn’t sleep. As soon as I laid down, my gut—the right upper quadrant, beneath the rib cage—felt under attack. My wife, Ginger, and I were in the French Midi-Pyrenees visiting friends who adored big meaty and cheesy lunches, to which we had succumbed. After three sleepless nights, we texted our kids. Our ER nurse daughter said, “Your mother had her gallbladder out. Now it’s your turn.” Our health-researcher son disagreed, “There’s nothing wrong that improving your hydration and food choices can’t cure.”

After we left our friends to continue traveling, we gained more control over food choices, increased our physical activity, and improved our hydration. The result was that the nighttime attacks eased up. Still, if I laughed, coughed, or sneezed, I doubled over in pain. Turning over in bed at night, I experienced similar pain. The big meals dominated by fatty foods were the culprit.

Before heading home, we visited a museum in Zurich, Switzerland, that happened to feature a temporary exhibit on food choices. To reach the exhibit, we had to pass “the future of food” table where a young woman invited us to sample mealworms, locusts, and crickets. Ginger declined without reservation. I said, “I’ll consider it.”

“You’re joking, right?” asked Ginger.

I said, “Not at all. Outside North America and Europe, many people depend on insects as a protein source.”

“Not in our world,” she said.

“You’re mostly right,” I answered. “But you and I know people who add cricket powder when they bake bread. And you can buy cricket protein powders and energy bars on Amazon.”

“So would you like to try some crickets?” the young woman invited.

“Yes, I’d love to, if you can give me some water to wash them down,” I said.

“I’m sorry, I can only offer you a piece of chocolate,” she apologized. “No water is allowed inside the museum.”

With regrets, I declined.

The crickets struck a cultural and spiritual lightning rod. We sped through the exhibit as if on fire. The central message was that the prevailing Swiss agricultural system, centered around grazing animals for meat and dairy, contributes significantly to greenhouse gas emissions and thus is incompatible with earthcare. The imperative is to cut back on pasture and grazing and to find peace with alternative sources of protein, even crickets. We left alarmed and engaged but also amused by the prominent display of a complete meat market fashioned from yarn entirely using crochet.

80 percent of the planet’s agricultural land is used for grazing and animal feed production while meat delivers only 18 percent of our calories. Why not eliminate the intermediary?

When we got home, we started rethinking food choices. Ginger and I both shop, but historically she’s done most of the cooking. Unless we arrived upon a new model for meal planning and preparation, if she wanted pork chops, that’s likely what we’d eat.

As we were sorting this out, a UK friend shared an article from The Guardian on calls for Europe to halve its meat and dairy production by 2050. It’s partly a matter of efficiency because 80 percent of the planet’s agricultural land is used for grazing and animal feed production while meat delivers only 18 percent of our calories. Why not eliminate the intermediary? The bigger issue is that industrial animal farming is a major source of greenhouse gas emissions, dumps phosphorus and nitrogen runoff into water supplies, pollutes the air with ammonia and fine particulate matter, and contributes to antibiotic resistance. The article said that adjustments facing the meat and dairy industries will require policymakers, farmers, and consumers to make “deeply uncomfortable choices.” Change can be facilitated by imposing penalties for violations and offering incentives to transition to a sustainable agricultural system. Consumers can promote the transition by consuming meat and dairy less frequently and in smaller portions.

After seeing the gastroenterologist, I began radically changing my diet. Armed with the HIDA scan, I cut out meat totally. I also made a get-to-know-you appointment with the surgeon two weeks out.

I chose to make an appointment with a gastroenterologist about my tender gut. His response was “Looks like a duck, sounds like a duck.” He gave me referrals for an abdominal ultrasound (mostly to check for gallstones), blood work (to rule out kidney damage), a nuclear HIDA scan (to evaluate gallbladder function), and an office visit with a surgeon. The scan showed normal shape and size with no stones. Blood work was normal. The HIDA scan, however, said my gallbladder had a 13 percent ejection fraction. By way of comparison, 99 percent of people have an ejection fraction of at least 38 percent. If my heart had a 13 percent ejection fraction, I’d be on the heart replacement list. There’s no gallbladder list because it isn’t a vital organ. I took the results as definitive and was convinced it had to come out.

After seeing the gastroenterologist, I began radically changing my diet. Armed with the HIDA scan, I cut out meat totally. I also made a get-to-know-you appointment with the surgeon two weeks out.

The night before my appointment, I asked friends via Facebook whether they had experience with gallbladder surgery. Two dozen people said yes. Some described harrowing experiences that brought them to the point where they’d do anything for relief. A few said they suffered pancreatitis because they waited too long. One was taken by ambulance from a family barbecue to a hospital emergency room because she mistook her gallbladder pain for a heart attack. The consensus was act now or delay at your peril.

A few offered cautions. One reported that his wife and daughter had the surgery and suffered extended ill consequences, including chronic diarrhea. Another said her doctor recommended a healing, vegetable-rich “green soup.” Following that regimen, she remained nearly symptom-free. Someone else suggested herbal remedies. A high school classmate who worked in health care claimed that gallbladder surgery was the least necessary of surgeries.

Ginger went with me to the appointment with the surgeon. With my new diet of fruits, vegetables, legumes, nuts, and whole grains, my belly’s tender spot had calmed. I could risk sneezing, laughing, coughing, or turning over in bed. I told the surgeon about my onset four months ago and the effects of dietary changes in ameliorating symptoms. His response was the following:

  1. If you have gallstones, I could almost guarantee your surgery would give you relief, but you don’t. The odds surgery would grant relief to someone like you are only 60 percent.
  2. Don’t get carried away because your HIDA scan was so low. It’s an unreliable test. Even if your true ejection fraction is only 13 percent, people live with that without surgery.
  3. You’ve already gotten more relief by modifying your food choices than many get after surgery. Many patients never get the relief you’ve already experienced.
  4. I think gallbladder dysfunction is a real thing. I think it is.

When we got home, I posted on Facebook that, with the surgeon’s blessing, I plan to continue with a vegetarian diet to see whether the gallbladder stays quiet. The person who recommended the green soup said, “I told you so.” Several others insisted, “Do it now.”

The surgeon reinforced the notion my problem was largely caused by a meat-dominated, fatty diet. His “I think it’s a real thing,” sounded almost Willy Wonka-esque. It implied he was willing to ask: “Is it a real thing?”

Although our daughter had correctly diagnosed a gallbladder problem, her rush to surgery seemed too aggressive. And our son’s claim that behavioral change—better hydration and food choices—could alleviate my problem was more consistent with my leanings.

I told Ginger, “Everything I’ve been reading says that, for our personal health, and to care for Mother Earth, we need to cut back on meat and dairy. Maybe this was a blessing in disguise. I hope we can do this together.”

She answered, “We’ve come close to cutting out meat before. We need to learn more about food choices, how to get the right nutrients. We need to plan more meals together.”

Our son reminded us that three years ago when he and I attended a rally sponsored by the interdenominational Moral Action on Climate, we met a contingent from Quaker Earthcare Witness. “It was clear,” he said, “political actions promoting care for the earth manifest our moral commitments and spring from spiritual roots.”

At first, I cooked for me; Ginger cooked for herself. It took time to plan and attention to improvise together. After a while, we were cooking for each other and, occasionally, together. What emerged, though, was that while I was a vegetarian, she was really a flexitarian, meaning she sought most of her nutrition from plant-based sources, but now and then she craved meat. When Thanksgiving rolled around, our son and his wife served the traditional turkey dinner. The turkey and I didn’t as much as glance at each other. We all enjoyed the quinoa salad (my contribution), and two starchy and four non-starchy vegetables. The pièce de rèsistance was butternut squash sections crowned with cranberries and drenched with chèvre.

with the earth’s population expected to push ten billion by 2050, only a transformation in food production, transport, consumption, and waste reduction can hope to avert disaster.

As we began to coordinate a vegetarian (for me) and flexitarian (for her) diet, two important developments occurred, one local and the other global. Locally, Ginger had a checkup with her doctor, who said, “If being a vegetarian works for your husband and his gallbladder, that’s his decision. However, your body needs certain nutrients. I believe you can only get them from natural sources. And some of them you can only get by eating meat. So, you need to eat meat even if he doesn’t.” I told Ginger, “There’s room for conversation.”

The global development was the January 2019 release of the “planetary health diet” in Food in the Anthropocene, The EAT-Lancet Commission on Healthy Diets from Sustainable Food Systems. Presented as a springboard for transformation of food systems globally, it offers science-based targets (reference ranges) for different food groups that together constitute an optimal diet for human health and for sustainable food production within planetary boundaries. It presumes that with the earth’s population expected to push ten billion by 2050, only a transformation in food production, transport, consumption, and waste reduction can hope to avert disaster. Such transformation also would help alleviate current suffering from insufficient food, diet-related obesity, and diet-related noncommunicable diseases such as cancer, diabetes, gallbladder dysfunction, and heart disease.

What stands out is that the planetary health diet’s targets are premised on more than optimizing personal health. The dietary shifts required globally to achieve these targets correspond with what the diet’s developers say must occur to keep food production systems within a safe operating space with respect to climate, biodiversity loss, nitrogen and phosphorus loss to the environment, land system change, and freshwater use. Thus, as diets like this gain support, they may stimulate changes in human consciousness and bring people together to attentively address the deep spiritual crises manifested in the degradation of the earth’s boundaries. Based on this intention, they may appropriately be considered earthcare diets.

It gave me pause that the full scientific report and detailed justification for the planetary health diet was published by The Lancet, an international medical journal. Its attempts to nudge the planet toward plant-based sources are consonant with my own leadings. Much of the scientific rationale, including charts showing the relative contributions of different food types to degradation of the earth’s systems, is beyond my expertise to evaluate, but intuitively it makes sense. Ginger and I are trying to digest the diet’s intent and see what speaks to us.

The diet is symbolically represented by half a plate of fruits, vegetables, and nuts, with the other half consisting primarily of whole grains; plant proteins (beans, lentils); unsaturated plant oils; and as options, modest amounts of meat and dairy, with some added sugars and starchy vegetables. It is flexitarian—rather than force-feeding a narrowly prescribed diet—because it seeks to include those who consume meat and dairy as partners in the effort to bring global food production, transport, production, and waste reduction within earth’s boundaries. Given that, the diet’s scientific ranges for different food groups allow for individual decisions and adaptation to dietary needs, personal choices, and cultural traditions in tailoring meals to optimize personal health while reducing risks of environmental degradation.

The lead U.S. researcher for the international team developing the diet, Walter Willett, states, “A diet rich in plant-based foods and with fewer animal source foods confers both improved health and environmental benefits.” Because plant-based foods have lower environmental footprints, they have smaller impacts on greenhouse gas emissions, land use, and biodiversity loss. Globally, the diet would double the world’s consumption of plant-based foods while cutting back consumption of red meat and added sugars by over half. Reaching the target of a half-ounce of red meat daily—the equivalent of one quarter-pound burger weekly—would require that people in South Asia double their current consumption levels, while those in the wealthier countries of North America and Europe would need to reduce theirs by over 90 percent by 2050. Reaching targets for fruits, vegetables, nuts, and legumes will require more than doubling production globally by 2050. Overall, the gaps between targets and current consumption levels by food group vary widely across the world’s regions.

Another important aspect of the diet is reducing the amount of food we waste globally. It is beyond my ability to evaluate the scientific evidence about the effects of different levels of food waste reduction on our ability to live within the earth’s boundaries. Yet, it resonates strongly with the Quaker values of living simply in harmony with nature.

Ginger and I are experimenting with vegetarian recipes that come with the diet. We can both claim we’re on the planetary healthy diet, even though I’m vegetarian and she sometimes eats meat.

I believe the planetary health diet—reminiscent of Diet for a Small Planet—responds to the eco-spiritual crisis consuming the planet and discouraging many of us.

In the interest of establishing a sustainable relationship with earth and unity with nature, I recommend reading the planetary diet’s summary report or the “brief for everyone” and then meditating on, sharing, and talking about it. I’ve already sent copies of the diet’s “brief for health care professionals” to my doctor and to Ginger’s to begin conversations. Ginger and I are experimenting with vegetarian recipes that come with the diet. We can both claim we’re on the planetary healthy diet, even though I’m vegetarian and she sometimes eats meat.

The urgency of transforming systems for food production to work in unity with nature is reinforced by the 2018 uptick of 3.4 percent in U.S. greenhouse emissions. A personal interest is the way we act as custodians of our planet’s scarce freshwater supplies. Knowing this, Ginger yesterday asked, “Do you know it takes 2,000 gallons of water to produce one pound of beef?”

“No,” I said. “That’s powerful.”

“Guess how many gallons it takes to produce one pound of crickets?” she asked.

“A hundred?” I answered.

“No, just one.”

“Are you saying you want me to order you some cricket protein bars?” I joked.

“No,” she said, “but I can see why eating crickets might be good for the planet.”

Jim Ross

After retiring in early 2015, Jim Ross jumped back into creative pursuits. He’s since published 75 pieces of nonfiction, several poems, and 200 photos in 80 journals in North America, Europe, and Asia. Jim and his wife—parents of two health professionals, grandparents of four toddlers—attend Sandy Spring (Md.) Meeting.

2 thoughts on “Interrupting the Family Barbecue: In Search of the Planetary Health Diet

  1. Jim has always been ahead of the curve, detailed and fully researched. His conclusions and the facts he marshals are virtually unassailable, but like Ginger, I reserve the right to be flexible and for me that means dairy!

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