Dr. Roma Patil, Intern, Bangalore Medical College and Research Institute

                       Dr. Geeta Sundar, Consultant Surgeon, Bangalore

About the author

Dr. Anitha Reddy Kankar has been working as a physician for over 25 years in Los Angeles and is a passionate whole food plant based lifestyle advocate.

Dr. Kankar has conducted several health camps in India and is currently working on addiction awareness, access to treatment and promotion of lifestyle medicine, mainly in south India. She has conducted many sessions of Diabetes reversal programs in India and USA. Dr. Kankar was actively involved during the COVID pandemic in providing telehealth services and spearheaded efforts in mobilizing funds for providing medical equipment including pulse oximeters, thermal scanners and PPE in hard hit areas of Andhra Pradesh. Dr. Kankar is passionate about promoting plant based diet and has hiked to Everest Base Camp and climbed Mt. Kilimanjaro while on a plant based diet.

You can follow and reach her on and

1. As a doctor in medical practice since over 2-3 decades in the US, can you tell us more about the trend of how diet induces health? What are the changes that you have noticed across the generations? Are they more adapting to fitness and strict diets?

Of late, I have been seeing a rampant rise in the incidence of heart disease and diabetes in the younger population. Childhood obesity is also on the rise. The media has made us believe that, eating processed food like sugary cereals and drinks are healthy. Most people take to these, as they are convenient as well. Nowadays, people are more aware of what they eat and when I discuss about plant based diet, they do mention that they have someone in the family who is a vegan. But, not all vegan food is healthy andlow fat unprocessed vegan foods (wfpb- whole food plant based) is what’s recommended.

I recently got board certified in Lifestyle Medicine where I learnt the concept of SMART prescription. Just like how we prescribe medications, we give them a customized written action plan which is specific, measurable, attainable, and relevant and time based. The diet plan is introduced gradually to make it more acceptable and achievable. Significant changes in their health can be observed, measurable in terms of their weight loss and blood work.

Same with exercise, we give them a FITT prescription (frequency, intensity, time and type). For example- Walk briskly for 30 minutes daily for 1 month. For someone who is already doing moderate exercise, we add muscle strengthening exercises- 3 times a week for 15 minutes.

With these kinds of prescriptions and due to awareness from social media, many get on board. If they fail, the next visit we give them different goals.

2. What are the basic components of a vegan diet? Why would you recommend it? Is it healthier? What advantages does it offer over a diet with fish, chicken, and meat? Is plant protein better than animal protein? If so, why?

As I mentioned earlier, we have to clearly explain to the patients, to not assume that all vegan food is healthy. We recommend a predominant WFPBNO (whole food-plant based no oil) diet. You can still have some animal foods (around 5-10 %) and get the same benefits. This diet consists of whole or minimally processed grains, millets, legumes (lentils and beans), fruits, vegetables, nuts and seeds. There are many advantages of WFPBNO foods.

Plant protein is better than animal protein because it has,

  • No cholesterol
  • Less saturated fat for the same amount of protein intake
  • Low calorie density (ideal for weight loss)
  • More minerals, vitamins and phytonutrients.
  • High fiber content.

We all know that, low fiber diet is a risk for colorectal cancer. A recent study showed that, high total fiber consumption was associated with a reduced risk of breast cancer. 

For each 5 gm/ day increase in fiber, there’s a 11% decrease in CKD incidence. We can help the patients who are at a risk for CKD by giving this information. I know some nephrologists here who are seeing wonderful results in patients with early CKD. It’s important to note that there’s “ZERO” fiber in animal foods.

It’s important for me to say here that Vitamin B12 is prescribed for everyone who is on WFPBNO foods.

3. Is it possible to have a good control over most of the chronic conditions with a healthy approach to consuming the right food? What is your personal experience with such patients? Have you seen/observed some marvelous transformations? Please mention them.

“Let food be thy medicine and medicine be thy food”. – Hippocrates 400 BC

For diabetes, we know that excess fat accumulation in the muscle cells causes insulin resistance. So just significantly reducing fried foods and animal foods, including milk products like paneer, malai and curd, which have saturated fat, will help reduce blood glucose. Many of my patients including family members have reversed their diabetes. I remember this particular patient with a blood glucose of 700. He refused to get admitted to the hospital and also refused insulin. He then followed all the recommended lifestyle changes including diet, exercise and sleep habits. He’s still doing well at a recent visit, one year after diagnosis, with medications reduced to only metformin and Hgb A1 C in normal range.

Gout patients have shown the most satisfactory results. Their pain reduces quickly and they don’t have relapses. Contrary to what we were taught, plant based protein is not avoided in gout. Patient starts on a WFPBNO and only animal protein is avoided.

Just eliminating dairy products and including more whole foods than before have helped my patients with Asthma and Eczema.

4. What is wholesome nutrition? How does it make up for all the minor and macronutrients that we need on a daily basis?

Wholesome nutrition is simple to obtain, minimally processed and has a shorter cooking time. Even though India has the highest vegetarian population, we still have the highest number of deaths due to diabetes, surpassing China. We must be doing something wrong. Oil is the main culprit. We have to avoid using oil in our cooking. Frying in oil also increases AGEs (Advanced Glycation End Products) which contributes to inflammation and increased oxidant stress, which is linked to many chronic diseases including diabetes, cardiovascular disease and cancers.

American College of Lifestyle Medicine has suggested a simple WFPB PLATE. Half your plate should consist of fruits, vegetables and leafy greens. One quarter of the plate will be plant protein, which includes legumes ( peas, lentils and beans), tofu (soy paneer), nuts( almonds, walnuts) and seeds ( sunflower, pumpkin,chia and flax seeds). The other quater should consist of whole grains like brown rice, millets, whole oats, whole grain rotis/ bread/ idli. Take note all carbs here are whole, minimally processed to keep all the fiber. The carbs which need to be avoided are processed carbs like white rice, maida, suji, white sugar etc. Choice of drink is just water. You can use dates and date syrup to sweeten the desserts. The fat part of the macronutrients is from nuts, seeds, peanuts, avocado and small amounts from the legumes.

All the minerals and vitamins with the exception of Vit B12 are available and sufficient if one is having a balanced meal as mentioned above. Vit B12 supplementation is very important and the recommended dose is 2500mcg/ weekly. This shouldn’t be the only reason for someone to eat animal products as we see the same incidence of Vit B12 deficiency in people consuming meat.

Vit D and DHA/EPA are the only other supplements we may recommend if needed.

Dr. Greger’s daily dozen available online is another quick list which is easy for patients to follow.

5. How would you handle a difficult patient with multiple co-morbidities, obesity who isn’t motivated for a holistic well-being with proper diet and exercise?

There are four other pillars of Lifestyle Medicine which are equally or even more important than diet and exercise. Other than a predominant wfpbno eating and physical activity we focus on restorative sleep, stress management, avoidance of risky substances and positive social connections.

Poor sleep increases glucose levels and blood pressure, increases hunger and is linked with obesity. I advise these patients to focus on getting 7-9 hours of sleep every day. If they have sleep apnea, we refer them to specialists to get it treated. We counsel the night shift workers to get the required restorative sleep every day or change their schedule for a few months.

Positive social connections is another important pillar. During the COVID-19 pandemic, we saw how isolation negatively impacted physical and mental health. We encourage them to engage in a hobby or join classes of their liking.

If they are smokers or alcoholics, I offer treatment. In the beginning, harm reduction is the primary goal, not complete abstinence.

We give small positive prescriptions like eating 2 fruits and walking 15 minutes after dinner everyday. These are achievable and the patient is motivated to do better on his own, as he observes noticeable changes.

6. How common are autoimmune diseases in your practice? What is the most efficient diet that you recommend to such patients? 

Some of the autoimmune diseases that I treat are, Rheumatoid Arthritis and Psoriasis. Eliminating dairy products, oil free cooking, consuming high amount of greens in salads and green smoothies with fresh flax seed powder or chia seeds for a month, gives quick relief from their symptoms. CRP levels start falling within a month and the required dosage of their medication also comes down.

In Lifestyle Medicine, we do not stop any of their medications. We or the specialists, reduce the dosage according to the improvement seen.

7. In a world where Google happens to be the “quickest” doctor and patients come with an already accepted diet advice from Dr. Google, or they pop vitamin and other supplements OTC, what would be your advice to them? What are side-effects of the online diet advices and these supplements in the long run.

Lifestyle Medicine is “evidence- based” medicine to prevent, treat and reverse non-communicable chronic diseases.

Patients do come with articles from a quick google search, but when we break down the information in scientific data, they are usually surprised by the discrepency in the results.  One of the popular diets among the young adults that we come across every day is Keto Diet. They may see a quick weight reduction in the beginning but a recent meta-analysis on Keto Diet has shown increased mortality.

The other frequently debated topic is about the olive oil and fish in the Mediterranean diet. If one eats a small amount of fish with olive oil sprinkled on a large salad with whole grains, there is a known benefit. But if people just fry fish in olive oil and not eat any of the whole grains and vegetables, there’s no benefit.

Most of the supplements do not have a regulated dosage and most of the times, patient do not get the sufficient amount. We show them how to get them with plant based foods at a cheaper cost. Some supplements can cause liver or kidney damage. Most supplements are not needed if one is eating a balanced wfpbno plate or following Dr. Michael Greger’s Daily Dozen. Supplements should be taken only when prescribed and monitored.

8. We see a lot of people hitting the gym these days and consuming protein powders as pre/post workout meals. Are they healthy? Can a person on WFPB diet consume these?

For most people who are doing basic exercises and are on a balanced wfpb diet, there is no need for any protein powder. Beans and lentils have high protein in addition to the vital fiber we need for good health.

If an athlete is preparing for a sport and is burning more calories, they can take plant-based protein powders after calculating the required amount. The elderly can be prescribed with plant based protein powder if needed, as most are not getting the required amount. Protein requirement for an adult is 0.8g/ kg/ day. It can go as high as 2 mg/kg/ day depending on age, disease and fitness goals.

High protein diets are associated with altering kidney function and calcium imbalance. This affects the bones and increases the risk of cancer. An increased intake of eggs and chicken in gym goers, is associated with worsening of coronary artery disease. In addition, they have found heavy metals like arsenic and lead in protein powders.

Most people who are taking protein powders are avoiding carbs. It’s a good time to educate them about the difference between unhealthy processed carbs vs healthy whole carbs (whole grains, fruits and vegetables) which are rich in fiber. Plant based diets also help in faster muscle recovery, so that one can be ready for the next day’s work out. I would recommend everyone, especially athletes to watch the movie “Game changers” and see how top athletes are shifting to plant based diets for higher performance.

9. Meatless meats are becoming famous. Are they a good alternative for non-vegetarians?

Most meatless meats are good, but what matters is, how you cook it. If one is cooking them with oil, then there’s no benefit. These are great especially for someone who is in transition from a non-vegetarian to becoming plant based. You can also use mushroom and jackfruit in meatless recipes, substitute tofu for paneer and use soy milk instead of regular milk.

10. What would be your recommendation to young budding physicians entering this world of medicine – on how to maintain their health and the stress, what diets to follow, and what kind of lifestyle measures to have a smooth transition into their personal and professional life?

I’m so glad you asked this question. As medical professionals we are the last ones to think about our own health. Many of us are burnt out due to long working hours, skipping of meals, less physical activity and unhealthy sleep patterns.

The one lifestyle change that I would recommend is stress reduction. Stress causes cortisol release, which boosts our appetite, which in turn results in increased calorie consumption. Chronic stress reduces immune response and also decreases the length of telomeres.

Some of the ways in which we can deal with stress on a daily basis are:

  • Breathing exercises (you can do a simple boxed breathing)
  • Focus on one thing at a time. Do not multitask
  • Spend time outdoors every day for 30 minutes.
  • Have a gratitude journal
  • Meditate for 10 minutes everyday
  • Try to get 7-9 hours of restorative sleep every day.

To learn more about lifestyle medicine you can refer to books by, Dr. Dean Ornish, Dr. Michael Greger (, Dr. Neal Barnard (, Dr. Esselstyn and Dr. Brooke Goldner.

I would recommend you all to become a member of Indian Society of Lifestyle Medicine ( They conduct frequent educational lectures for clinical and non-clinical graduates, who can later on get board certified in Lifestyle Medicine. This will not only help in holistic patient care, but will also help you to take care of your own heath and that of your family.

Climbed Kilimanjaro on a whole-food plant-based diet
JAMA. 2019;322(16):1542. 10.1001/jama.2019.16074
Source: ACLM ( American College of Lifestyle Medicine)

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