What is the Pegan Diet?

In his new book, functional medicine doctor, Mark Hyman, MD says a Pegan diet—which combines principles of Paleo and Vegan diets—is the best way to eat. We will explore his 13 Pillars of the Pegan Diet.

Some say if you live longer, you will spend more time with chronic disease and disability, and in the hospital, increasing the burden on society and our health care system. Not true. A famous Stanford study found that if you kept your ideal weight, exercised, and didn’t smoke, you were likely to live a long, healthy life and die painlessly, quickly, and cheaply.

In fact, simple, daily habits hold the key to unlocking your longevity potential.

Tip number 1: Fix your blood sugar 

Most people don’t realize that insulin resistance and pre-diabetes can lead to heart attacks, strokes, dementia, cancer, impotence and more decades before you get diabetes. Hacking your blood sugar and insulin is the best way to live a long healthy life. Eliminate refined sugar and starches or significantly cut down on them. Depending on the individual, you might be able to cut back significantly. Others with pre-diabetes, excess belly fat, and gut challenges can experiment with removing them for a few months. It might be challenging in the beginning, but once you start to reap the benefits, you won’t want to turn back. This means cutting out muffins, bagels, cereals, pasta, candy, and pastries. Focus on non-starchy plant foods, protein, fats, and small amounts of whole grains and starchy vegetables like sweet potato.

Tip number 2: Prioritize protein 

As we age, we also lose muscle and gain fat, even if we don’t change our weight. Think marbled ribeye vs. filet mignon. Unless you get enough of the high-quality building blocks of muscle, namely protein, you can’t build muscle, especially as you age. Eat 4 to 6 oz of high quality protein with every meal. Some good ones include grass-fed meat, chicken, wild fatty fish, tempeh, non-GMO and organic tofu, and high quality protein powders.

Tip number 3: Build muscle 

As we age, our risk of fractures and falling increase. Loss of muscle is to blame and can lead to lower sex hormones, high insulin, abnormal lipids and more. No matter what age you are, it’s never too late to start. Start lifting weights today. You might need the help of a trainer or a loved one to start.

**And I would add Tip number 4: restrict caloric intake

First, it reduces free radical production– highly reactive molecules that impact cellular structure and function. The second is that calorie restriction increases the resistance of cells to stress. Both of these are important in combating the effects of the normal aging process.

In addition, Dr. Simone’s research in prostate cancer and also in breast cancer suggests that restricting calories has many anti-cancer effects in the body – including, in mice, decreasing the likelihood of metastasis.  It lowers inflammation, changes the gut microbiome, may decrease the side effects of systemic therapy and generally seems to slow down cancer.  In effect, caloric restriction gives cancer a “brown-out,” limiting its energy.  “We’re just beginning to understand the promise and the power of caloric restriction,” says medical oncologist and molecular biologist Jonathan Simons, M.D.  “If there were a drug that could do all these things, we’d prescribe it in a heartbeat.”

Both the paleo and vegan diets have been in the spotlight in recent years for their independent approaches to food and health. Most of us probably think of them as polar opposites, with paleo focusing on meats our ancestors theoretically ate and veganism opting out of animal products altogether. But a relatively new eating plan aims to show that meat-heavy paleo and veggie-centric veganism can coexist in a single diet.

The pegan diet (as in, paleo + vegan), created by celebrity functional medicine doctor Mark Hyman, M.D., purports to offer the best of both worlds. The diet advises filling 75% of your plate with plant-based foods and 25% with lean, sustainably raised meats. According to Dr. Hyman, eating this way can reduce the risk of chronic disease, curb inflammation, and promote general health. Dr. Hyman and I agree in most ways. Below are his guidelines.

1.    Stay away from sugar. That means a diet low in anything that causes a spike in our insulin production — sugar, flour, and refined carbohydrates. Think of sugar in all its various forms as an occasional treat, that is, something we eat occasionally and sparingly. I tell people to think of it as a recreational drug. You use it for fun occasionally, but it is not a dietary staple.

2.    Eat mostly plants. As we learned earlier, more than half your plate should be covered with veggies. The deeper the color, the better. The more variety, the healthier. Stick with mostly nonstarchy veggies. Winter squashes and sweet potatoes are fine in moderation (1⁄2 cup a day). Not a ton of potatoes! French fries don’t count even though they are the No. 1 vegetable in America.

3.    Easy on fruits. This is where there could be a little bit of confusion. Some Paleo champions recommend eating mostly low-sugar fruits like berries, while some vegan advocates recommend all fruit equally. I find that most of my patients feel better when they stick to low-glycemic fruits and enjoy the others as a treat. Stick with berries, kiwis, and watermelon, and watch the grapes, melons, and so on. Think of dried fruit as candy and keep it to a minimum.

4.     Stay away from pesticides, antibiotics, hormones, and GMO foods. Also, no chemicals, additives, preservatives, dyes, artificial sweeteners, or other junk ingredients. If you don’t have that ingredient in your kitchen for cooking, you shouldn’t eat it. Polysorbate 60, red dye 40, and sodium stearoyl lactylate (also known as Twinkie ingredients)

5.     Eat foods containing healthy fats. I’m talking about omega-3 fatty acids and other good fats like those we find in nuts, seeds, olive oil, and avocados. And yes, we can even eat saturated fat from fish, whole eggs, and grassfed or sustainably raised meat, grassfed butter or ghee, and organic virgin coconut oil or coconut butter.

6.     Stay away from most vegetable, nut, and seed oils, such as canola, sunflower, corn, grapeseed, and especially soybean oil, which now accounts for about 10 percent of our calories. Small amounts of expeller or cold-pressed nut and seed oils like sesame, macadamia, and walnut oils are fine to use as condiments or for flavoring. Avocado oil is great for higher-temperature cooking.

7.     Avoid or limit dairy. Dairy doesn’t work for most people, so I recommend avoiding it, except for the occasional yogurt, kefir, grassfed butter, ghee, and even cheese if it doesn’t cause any problems for you. Try goat or sheep products instead of cow dairy. And always go organic and grassfed.

8.     Think of meat and animal products as condiments or, as I like to call them, “condi-meat” — not a main course. Vegetables should take center stage, and meat should be the side dish. Servings should be 4 to 6 ounces, tops, per meal. I often make three or four vegetable side dishes.

9.     Eat sustainably raised or harvested low-mercury fish. If you are eating fish, you should choose low-mercury and low-toxin varieties such as sardines, herring, anchovies, and wild-caught salmon (all of which have high omega-3 and low mercury levels). And they should be sustainably harvested or farmed. Check out http://www.cleanfish.com/and http://www.foodthebook.com/to learn more about your fish options.

10.                  Avoid gluten. Most gluten comes from “Frankenwheat,” so look for heirloom varieties of wheat like einkorn. Eat wheat only if you are not gluten-sensitive, and, even then, only occasionally. Dr. Alessio Fasano of Harvard, the world’s top gluten expert, has done research showing that gluten damages the gut — even in nongluten-sensitive people who show no symptoms.

11.                  Eat gluten-free whole grains sparingly. They still raise blood sugar and can trigger autoimmunity. All grains can increase your blood sugar. Stick with small portions (1⁄2 cup per meal) of low-glycemic grains like black rice, quinoa, teff, buckwheat, or amaranth. For type 2 diabetics and those with autoimmune disease or digestive disorders, a grain- and bean-free diet may be key to treating and even reversing your illness. Stick to the 10-Day Detox Diet or even a ketogenic diet for diabetes.

12.                  Eat beans only once in a while. Lentils are best. Stay away from big starchy beans. Beans can be a great source of fiber, protein, and minerals. But they cause digestive problems for some, and the lectins and phytates they contain may impair mineral absorption. If you are diabetic, a high-bean diet can trigger spikes in your blood sugar. Again, moderate amounts (up to 1 cup a day) are OK.

13.                  Get tested to personalize your approach. What works for one person may not work for another. This is called bio-individuality and it is why I recommend that everyone eventually work with a functionally trained nutritionist to personalize his or her diet even further with the right tests.

How It Works

Unlike some diets, peganism doesn’t give rules for exactly what to eat for breakfast, lunch, and dinner. Rather, it provides a general outline of dietary advice based on a number of basic principles.

The top tenets of a pegan diet include choosing foods with a low glycemic load; eating lots of fruits, vegetables, nuts, and seeds (about three-quarters of your daily intake), choosing grass-fed or sustainably raised meats when you do eat meat; avoiding chemicals, additives, pesticides, and GMOs; getting plenty of healthy fats like omega-3s and unsaturated fat; and eating organically and locally.

Compliant Foods

• Grass-fed and/or sustainably raised meats
• Fruits and vegetables
• Nuts and seeds
• Eggs
• Fish

Not surprisingly, meat comprises the “paleo” part of going pegan. The diet emphasizes choosing meats like beef, chicken, and lamb—and other, more unusual ones like ostrich or bison—that have been grass-fed, sustainably raised, and locally sourced. However, it’s important to note that meat makes up only a minority of the food you’ll eat on a pegan diet. Hyman instructs pegans to “eat meat as a side dish or condiment.”

Fruits and Vegetables

And now for the vegan side of things! The majority of calories on a Pegan diet come from plant-based foods like fruits and veggies. Unlike Paleo’s rules about which fruits or vegetable cavemen would have eaten, Peganism doesn’t discriminate. All types of produce are allowed on the diet—though Hyman encourages choosing ones with low glycemic load, like berries or watermelon, when possible. 

Nuts and Seeds

Nuts and seeds provide additional fiber, protein, and micronutrients on a Pegan diet. They’re also a source of healthy monounsaturated and omega-3 fats. 

Eggs

Eggs are another suitable protein for pegans. This breakfast food classic helps provide vitamin B12, which may run low in a limited-meat diet.

Fish 

Though fish isn’t the star of a pegan diet, it has its place in this eating plan. Hyman states that low-mercury fish like sardines, herring, and anchovies are acceptable seafood.

Non-Compliant Foods:

• Dairy products
• Grains
• Beans
• Sweets

Put away the pizza and ice cream—you won’t be eating dairy on a pegan diet. Hyman believes cow’s milk contributes to obesity, heart disease, diabetes, and cancer. 

Grains

In line with the paleo philosophy, peganism shuns almost all grains, so wheat, oats, barley, bulgur, and many others won’t appear on a pegan plate. The theory goes that grains increase blood sugar and can cause inflammation. Limited consumption of certain low-glycemic grains is occasionally acceptable on the diet, such as a half-cup of quinoa or black rice.

Beans 

You don’t have to swear off beans entirely on a pegan diet, but Hyman urges caution with them, saying that their starch content can raise blood sugar. Up to one cup of beans (or, preferably, lentils) is permitted per day.

Sweets 

Like many other “clean eating” diets, the pegan diet keeps sweets to a minimum as an occasional treat.

Resources and Tips

You won’t be required to master any particular type of cooking technique or purchase any specific products while on a pegan diet. In fact, because the plan is still relatively new, resources on how to follow it aren’t as widely available as many other trendy eating plans.

However, as interest in the diet has risen, more and more pegan cookbooks (and even a handful of food products, such as pegan protein bars) have hit the market. Your best bet for finding resources on adhering to the pegan diet is probably the internet, where blog posts and websites offer recipes that follow the whole foods, three-quarter-plants, and one-quarter meat rules.

Modifications

Clearly, since meat and vegetables make up the majority of the pegan diet, these foods are non-negotiable if you decide to go pegan. However, you may have to make personal decisions about how much you’re willing to pay for non-GMO, chemical-free produce and grass-fed meats.

Since the pegan diet limits or excludes dairy, beans, and grains, you may also need to be extra mindful about getting enough of certain nutrients these foods provide.

If you remove dairy, like yogurt from your diet, for example, you might have to up your intake of fermented foods like kimchi to get gut-boosting probiotics or add sardines, eggs, and lots of green leafy vegetables such as broccoli to supplement for some of the calcium and vitamin D you get from milk. In some instances where you cannot meet your vitamin needs, you may benefit from supplementing. If you are unsure, consult with your doctor or a registered dietitian.

Pros

• Full of fruits and vegetables
• Low glycemic index
• Focus on sustainability
• Less restrictive than other diets

Cons

• Conflicting evidence on nutrition
• Difficult in social situations
• Potential nutrient deficiencies
• Cost

Pros

Full of Fruits and Vegetables

It’s common knowledge that a healthy diet contains plenty of fruits and vegetables—and studies show the majority of Americans are still woefully deficient in this department. A pegan diet will certainly fill any gaps in your five-a-day target, providing much-needed fiber and micronutrients.

Low Glycemic Index

The glycemic index is a system that measures how individual foods raise blood glucose. The pegan diet encourages users to get educated about which foods help stabilize this pattern since a yo-yo of ups and downs in blood sugar can have harmful effects. This can be positive, especially for those with diabetes, pre-diabetes, and other insulin-related conditions.

Focus on Sustainability

The paleo diet often receives criticism for its negative environmental impact. If everyone ate meat at every meal, the planet would face disastrous results of land degradation, air pollution, and water overuse. Peganism mitigates this impact by encouraging the purchase of sustainably raised meat—and scaling back consumption in general.

Less Restrictive Than Other Diets

Let’s face it: It’s tough to commit 100% to paleo or veganism. Because of its middle ground between the two, the pegan diet offers more balance and flexibility. Vegans and paleo eaters may find this a welcome reprieve.

Cons

Conflicting Evidence on Nutrition

Hyman points to a number of studies that back his belief that the food groups of dairy and grains are harmful, contributing to heart disease, obesity, cancer, and diabetes. But in the larger world of nutrition experts, there is no consensus that this is true. In fact, dairy and grains have proven benefits for health.

Though dairy sometimes gets bad press for saturated fat content that could lead to heart disease, a large-scale study from 2016 revealed that dairy fat was not associated with the risk of cardiovascular disease. Plus, cow’s milk contains significant amounts of calcium, protein, potassium, and vitamin D—nutrients that are all necessary for general health.

Beans and grains provide plenty of benefits, too. A landmark study from 2016 confirmed that eating whole grains lowers the risk of heart disease, cancer, and all-cause mortality. Beans are widely accepted as a healthy food because of their fiber, protein, and phytochemical content.

Difficult in Social Situations

Though a pegan diet may be less restrictive than full paleo or veganism, it still comes with major provisos about what you can and cannot eat. If you opt out of eating dairy, grains, and legumes, you may find yourself unable to enjoy many foods offered at social or family gatherings. It may also require you to get creative to prevent boredom or burnout.

Potential Nutrient Deficiencies 

There’s always a risk when going without major groups of food, of becoming deficient in certain key nutrients. Depending on exactly how you follow a pegan diet, it’s possible you might not take in enough vitamin B12, iron, or calcium.

Cost   A pegan diet doesn’t require you to purchase any particular costly products, but following it to the letter by buying high-end meats and farmer’s market veggies could add up.