Direction: Read the given passage carefully to answer the following questions. Each question will have five alternatives as its answer. Choose the correct option as your answer.

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A recent article turned the spotlight on dietary habits — is it better to turn to fully plant-based foods and avoid meat? The article relied on several existing studies but stopped short of _______ either way and concluded with a note of _______ that more research is needed before deciding to move away from animal-based foods. Some Indian dieticians agree with the findings, however, pointing out the benefits of going vegetarian. An article in the recent edition of BMC Medicine analyses the evidence that substituting animal-based with plant-based foods does lower risk of cardiovascular diseases, and type 2 diabetes besides mortality. The article ‘Substitution of animal-based with plant-based foods on cardiometabolic health and all-cause mortality: a systematic review and meta-analysis of prospective studies’studied 37 publications based on 24 cohorts and its seven authors did their own calculations such as the summary hazard ratios, and confidence intervals using random-effects meta-analyses. They also assessed the certainty of evidence (CoE) using the GRADE approach. GRADE stands for (Grading of Recommendations, Assessment, Development, and Evaluations). It is a framework to develop and present summaries of evidence and provide a systematic approach for clinical practice recommendations, according to the BMJ Best Practice website. The authors said they used standardised portions for substituted foods which increased the comparability of the results. However, there were limitations as only a few studies were available for some meta-analyses. More studies are needed, the authors acknowledged.  

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The article also acknowledged constraints about dairy products. First, “no study is available regarding meat and dairy replacement products, which have rapidly increased in popularity in recent years”. Secondly, since dairy products were mostly treated as one group in the study of published research they accessed, the authors said more research is needed on the substitution of subtypes of dairy products with plant-based foods. Bhuvaneshwari Shankar, dietician and nutritionist at Apollo Hospital, agreed with the findings of the study saying there is greater awareness about the impact on health due to intake of processed and red meat. “It increases the cholesterol and uric acid levels and invariably preparations end up taking up more fats, especially saturated fats. Changing to a plant-based diet is good but one needs to consider the amount of B12 required for the body. Totally avoiding animal food may not be necessary for everybody. Low-fat milk, a glass-and-half, may be needed for calcium and B 12 in a day,” she said. She suggests that a vegetarian diet is better than a totally plant-based diet. “One can always prefer lean meat, egg whites more than egg yolks if required, but making a diet plan with a qualified dietician is a better idea than reading an article and making a diet plan,” she pointed out.  

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Meenakshi Bajaj, a dietician at the Tamil Nadu Government Multi Superspecialty Hospital and coordinator at the Academy of Clinical Nutrition at the Madras Medical College, also agreed with the findings. “Plant-based foods with fibre, protein, healthy fats and phytonutrients can improve gut health whereas animal-based foods cause gut dysbiosis. Animal-based foods are devoid of fibre and red meat is especially a source of saturated fat,” according to her. Animal-based foods also alter the composition of the gut microbiota as compared to animal-based foods, she said. Plant-based diets have been known to reduce the risk of diabetes, lower LDL cholesterol and non-HDL cholesterol, improve weight loss, reduce the progression of kidney disease and risk of stroke, and different types of cancer, especially colon cancer and breast cancer besides improving blood pressure, irritable bowel syndrome and irritable bowel disease. Since plant-based foods contain antioxidant and anti-inflammatory properties they are better. The worst culprit is processed meat, whether smoked, canned, fermented or preserved as they include added sodium and preservatives. Chemicals such as nitrates, and nitrosamines, could cause gastrointestinal cancers as against unprocessed red meat, she said. “In short, plant-based foods improve glycaemic control (blood glucose) and insulin sensitivity, reduce the risk of colon cancer and improve cardiovascular health,” Ms. Bajaj said.