What Is the Pegan Diet?

In a world as diverse and complex as ours, it should come as no surprise the number of diet plans you can follow for healthy eating are myriad. Diet and culture are intertwined, as are nutrition and health. Within this context, it's not always easy to decide what to put on your plate, especially in light of our ever-changing understanding of how food influences well-being.

Over the years, many smart researchers, doctors and nutritionists have attempted to devise healthier ways of eating. Veganism -- which is a strict form of vegetarianism that prohibits the use of any and all animal products -- is one that has gained followers as much for its purported health benefits as for its environmental message and animal welfare ethics.

Another, more recent entry to the named diet lineup is the paleo diet. This eating pattern is based on the simple concept of eating only what our Paleolithic caveman ancestors ate. That means a hunter-gatherer diet that excludes any processed or cultivated food. In other words, say goodbye to refined sugar, dairy, legumes and grains. Considered a high-protein diet, the paleo diet encourages consumption of meat, fish, poultry, fruits and veggies.

[See: 10 Reasons You May Be Feeling Fatigued.]

Both ways of eating have their pros and cons. Both can support weight loss, slow diabetes and lower cholesterol. Both are marked as much by what they restrict as by what they permit. But they seem to be at opposite ends of the spectrum. Where veganism is strictly plant-based foods, the paleo diet features lots of meat and fat.

What if there were a way to combine the two? After reading dozens of studies about each diet and "reading between the lines" of what's being presented, Dr. Mark Hyman, director of Cleveland Clinic's Center for Functional Medicine, founder of The UltraWellness Center in Lenox, Massachusetts and a prolific author, developed an eating program he calls the pegan diet. "The pegan diet essentially combines what I like about both paleo and vegan diets," he says.

The basic tenets of the diet state that followers should:

-- Eat mostly plants. "More than half your plate should be covered with veggies. The deeper the color, the better. The World Health Organization recommends 5 servings a day. That is the minimum. It should be 15 servings or 7 to 8 cups of veggies and fruit a day," Hyman says. Limit starchy vegetables such as potatoes and squash and opt instead for bright, leafy greens. (One of the main aims of the diet is to keep your blood sugar in check, and that means opting for foods with a low-glycemic index. Low-glycemic foods won't spike your blood sugar the way high-glycemic index foods can.)

-- Go easy on the fruits. "Some paleo champions recommend eating mostly low-sugar fruits like berries, while some vegan advocates recommend all fruit equally. If you are fit and healthy, more fruit is fine. But if you are overweight (like 70% of Americans) then go easy on the fruit. 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," but limit grapes and other types of melons. "Think of dried fruit as candy and keep it to a minimum," Hyman says.

-- Opt for healthy fats. Fat is an important component of diet, but as with most other nutrients, consuming it in its whole food form offers better nutrition. Select "good fats found in whole, unprocessed foods such as nuts, seeds, olive oil, avocados, pasture-raised eggs and small, wild fatty fish such as sardines, mackerel, herring and wild salmon," Hyman says. He also recommends using extra virgin olive oil in uncooked dishes and avocado oil or organic virgin coconut oil in cooking. "And yes, we can even eat animal and saturated fat from fish, eggs and grass-fed or sustainably raised meat, grass-fed butter or ghee (a type of clarified butter often used in Asian cuisine). The evidence now clearly exonerates saturated fat, as long as you don't eat it with refined starch and sugar. That combination is deadly." And limit your use of vegetable, bean and seed oils because they are highly processed and refined, he says.

-- Increase consumption of nuts and seeds. "They have universally been shown to prevent and reverse disease; help with weight loss, diabetes and heart disease; are great sources of minerals, protein, good fats, fiber and more. Almonds, walnuts, pecans, macadamia nuts, pumpkin, hemp, chia and sesame seeds are all great," Hyman says.

-- Use meat as a condiment. Keep your portions of meat small and "not as a main course," Hyman says. "Vegetables should take center stage and meat should be the side dish. Servings should be 4 to 6 ounces, tops, per meal." And if you're feeling adventurous, "insects are also a great new source of high-quality protein being used in shakes, bars and other products." Crickets, which certain companies are grinding into flour to make a high-protein powder, are gaining ground as a sustainable source of protein.

-- Eat only whole grains. Skip the whole grain flours. "Stick with small portions (½ to 1 cup per meal) of low-glycemic grains like black rice, quinoa, teff, buckwheat or amaranth," Hyman says. Even though these grains can be a source of protein, "it takes 3 cups of quinoa to equal 4 ounces of chicken," in terms of protein content.

-- Eat beans. But stay away from big, starchy beans and opt for lentils. "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 can impair mineral absorption. Pressure cooking is the best way to get the most out of your beans with the least risks," Hyman says.

-- Stay away from sugar. Avoid anything that spikes insulin production and elevates blood sugar -- granulated sugar, corn syrup, refined starches and carbohydrates. "Think of sugar in all its various forms as an occasional treat. Remember, your body can't tell the difference between a bagel and a bowl of sugar once it gets below your neck. I tell people to think of sugar as a recreational drug. You use it for fun once in a while, but it's not a dietary staple."

-- Limit dairy. Hyman says that the dairy production process is hard on the environment and the animals that produce it, plus, "dairy has been linked to cancer, osteoporosis, autoimmune diseases, allergic disorders, digestive problems and more. I recommend avoiding it, except for the occasional grass-fed dairy from yogurt, kefir, grass-fed butter, ghee and even cheese if it doesn't cause any (digestive or allergy) problems for you."

-- Remove chemicals and preservatives. "Stay away from pesticides, herbicides, antibiotics, hormones and ideally GMO foods," Hyman says. "Also no chemical additives, preservatives, dyes, artificial sweeteners or other junk ingredients." The safety of genetically modified organisms is a controversial subject, but Hyman says he believes it's "an uncontrolled experiment on humans," and he recommends skipping them.

-- Choose sustainably raised, grown or harvested foods. This tenet is aimed more at helping the planet's health than your own. "Sustainably sourced animal proteins means looking for meat and eggs that are grass-fed, organic and pasture raised," says Lori Zanini, a registered dietitian and a certified diabetes educator based in Los Angeles. "Additionally, the pegan diet recommends choosing fish that is low in mercury, like wild salmon."

[See: 6 Ways to Train Your Brain for Healthy Eating.]

What Are the Benefits of the Pegan Diet?

Zanini says adopting the pegan diet may help you to "reduce inflammation and the many diseases that are linked to it, improving heart health, and lowering the risk of developing many chronic diseases." Chronic inflammation has been associated with everything from autoimmune diseases, such as psoriasis, to diabetes, heart disease, vascular disease, Alzheimer's and cancer.

Cathy Leman, a registered dietitian nutritionist and founder of Dam. Mad. About Breast Cancer, a nutritional consulting firm aimed at helping breast cancer patients and survivors, describes the pegan diet as "a mashup of paleo and vegan diets. Blending the paleo view that processed foods, legumes, grains and dairy are harmful to our health with veganism, this diet emphasizes that followers ideally eat fresh, local, organic and sustainably raised foods."

As she sees it there are some benefits to the pegan diet. "Compared to the standard American diet, eating a pegan diet is certainly an improvement in nutritional quality. Compared to a vegan diet, the inclusion of fish and red meat may be appealing to someone intrigued with a predominantly plant-based diet, yet reluctant to avoid animal products completely. Pegan diet is on par with paleo diet in that they both discourage dairy, grains and legumes and encourage a health-positive, wondrous amount of produce."

What Are the Challenges Associated With the Pegan Diet?

All diets have challenges associated with them, not least of which is the difficulty many people face in simply making the changes to their lifelong eating habits. "Adapting to new eating habits and having to give up foods that many of us are used to consuming" is one challenge of the pegan diet, Zanini says. "The diet is restrictive in that it eliminates the entire dairy food group, many grains and all sources of added sugars, including processed foods. This can be difficult when deciding what to eat and when participating in social gatherings." But, she says, it's not impossible and over time, you're likely to adapt.

Hyman counters that the diet isn't actually as restrictive as you might think at first review of the rules. "The reason this diet is sustainable is because it allows room for pleasure foods. I think that's a good fit for everyone. The pegan diet is not about perfectionism. It's about eating in a way that serves your body, and also allowing yourself to enjoy dessert every now and then or a glass of wine. These shouldn't be staples in your day-to-day life, but there are occasions that call for 'celebratory' foods." Moderation is the key he says. "Do the best you can 90% of the time."

Nevertheless, because the pegan diet emphasizes using whole, fresh foods, it may well mean more time in the kitchen. "This way of eating will encourage individuals to make much of their own food while avoiding processed food, and this can be challenging from a time management point of view," Zanini says. It may also cost more than what you're currently eating, Leman adds. "I'm all for quality nutrition and including lots of fruits and vegetables. I'm also a fan of eating nuts, seeds and healthy fats. The challenge with this diet is long-term adherence and budget concerns. The elimination of several beneficial food groups, restrictive do's/don'ts and higher cost of local, sustainable produce and animal products could be a roadblock for some."

Who Is the Pegan Diet Best Suited For?

"The pegan diet actually takes what's best from both the paleo and vegan diets and combines it into an inclusive way of eating that is a good fit for everyone, regardless of their dietary restrictions," Hyman says. But he cautions that it's "not a quick fix or something you follow for 10 or 30 days and then quit." It's intended to be a lifestyle.

"Because the diet is intended to be a sustainable, long-term approach to eating, it could benefit just about anyone who is looking to improve their health. Of course, individuals with chronic conditions or eating disorders should check with their health care team first," Zanini says.

Dr. Adil Akhtar is associate professor in the department of medical oncology and hematology at Oakland University-William Beaumont School of Medicine. Also director of Inpatient Clinical Operations at Karmanos-McLaren Oakland Cancer Center in Michigan, and chief of the division of palliative and end of life care for Michigan Health Professionals in Michigan, Akhtar says that the pegan diet can be a good, middle-of-the-road option for many people, and it may be helpful for those dealing with a cancer diagnosis or those who want to reduce their risk of developing cancer or its recurrence. "The pegan diet has taken good things from the vegan diet and attached it to some of the good things from the paleo diet. Both of them emphasize eating whole, natural foods, and avoiding eating anything processed or anything artificial. If you look at the pegan diet, it's about 75% vegan. The only difference is the source of protein in the vegan diet. Vegans get protein from beans and legumes. On the pegan diet, you're allowed to tap into grass-fed, healthy animal meat," he says.

This combination "actually looks quite close to the Mediterranean diet," which is similar to the nutritional guidelines issued by the American Cancer Society. Akhtar says he recommends that his patients should be looking to follow these guidelines. He recommends following a balanced, sensible diet that's rich in vegetables and fruits, limits excess sugar, alcohol and processed foods. "I tell my patients that you can use any diet," as long as it's balanced. "I don't support going to the internet and finding claims that if you use a specific herb or very high dose of antioxidants, that will cure your cancer."

And Leman cautions that the pegan diet might not be the right fit for every person. "Anyone struggling with disordered eating patterns or a full-blown eating disorder should definitely steer clear. The pegan diet isn't scientifically proven to be an optimal diet -- it's a made-up eating plan -- yet with a few tweaks, it could have wider appeal and potentially be beneficial for overall health. Adjusting the diet to be more inclusive of legumes, grains, conventional produce and dairy, as well as education on how to adopt as a lifestyle versus a 'diet' would go far in encouraging more people to give it a try," she says.

Pegan Recipes

"The pegan diet is all about the quality of your food and making sure that you're eating nutritionally dense food," Hyman says. The following recipes may help you do just that.

Taco Salad

From Hyman's "The Eat Fat, Get Thin Cookbook"

Serves: 4

Ready in: 40 minutes

Ingredients:

-- 1 tablespoon coconut oil

-- 1 pound grass-fed ground beef

-- 2 teaspoons ground cumin

-- 1 teaspoon ground coriander

-- 1/4 teaspoon chipotle powder

-- 1 teaspoon dried oregano

-- 1 teaspoon sea salt

-- 1 avocado, pitted, peeled, and cut into large chunks

-- 2 tablespoons extra-virgin olive oil

-- 1/4 cup fresh cilantro leaves

-- 1 garlic clove

-- juice from 1 lime

-- 1/4 teaspoon cayenne pepper

-- 7 to 8 cups mesclun

-- 2 cups shredded red cabbage

-- 2 carrots, scrubbed and shredded

-- 1 large tomato, cut into large chunks

Step 1: In a large skillet, warm the coconut oil over medium-high heat until simmering. Add the beef and cook, stirring frequently and breaking it into pieces with a wooden spoon, for 2 minutes. Add the cumin, coriander, chipotle powder, oregano, and 1/2 teaspoon of the salt and continue to cook, stirring occasionally, until the beef is cooked through, about 4 minutes.

Step 2: Meanwhile, combine the avocado, olive oil, cilantro, garlic, lime juice, cayenne, the remaining 1/2 teaspoon salt, and 1/4 cup filtered water in a blender and blend on high speed until smooth, about 45 seconds. Transfer the dressing to a small serving bowl.

Step 3: In a large bowl, combine the mesclun, cabbage, carrots, and tomato and toss to combine. Divide the vegetables among four plates and top with the beef mixture. Serve, passing the dressing on the side.

Nutritional analysis per serving: calories: 500; fat: 31 g; saturated fat: 11 g; cholesterol: 70 mg; fiber: 17 g; protein: 28 g; carbohydrates: 37 g; sodium: 713 mg

[See: 7 Reasons to Choose a Plant-Based Diet.]

Blueberry-Walnut Pancakes

Recipe from Hyman's blog

Serves: 2-3

Ready in: 20 minutes

Ingredients:

-- 3 large omega-3 eggs

-- 3/4 cup almond milk

-- 1/2 tablespoon freshly squeezed lemon juice

-- 1 teaspoon vanilla extract

-- 1/2 cup coconut flour

-- 1/2 teaspoon baking powder

-- 1/2 teaspoon baking soda

-- pinch of sea salt

-- 1/4 cup roughly chopped walnuts

-- coconut oil, for greasing the skillet (about 1/4 cup)

-- 1 pint fresh blueberries

-- 1/2 cup arrowroot

-- 1 teaspoon cinnamon

Step 1: In a large bowl, whisk the eggs and then add the almond milk, lemon juice, and vanilla. Whisk until well blended. In a separate bowl, mix together the coconut flour, cinnamon, baking powder, baking soda, salt, and arrowroot. Add the dry ingredients to the wet mixture, 1/4 cup at a time, while continuously whisking. Once combined, gently fold in the walnuts.

Step 2: Grease a large skillet and place over medium heat. Once the skillet is hot, use a ladle to pour 3-inch pancakes onto the skillet. Cook until bubbles appear, then flip. The pancake should cook on each side for about 2-3 minutes. Repeat with rest of the batter. Add a tablespoon or more of coconut oil to the hot griddle, as needed.

Step 3: Make a blueberry sauce by simmering the blueberries in a small saucepan with 2 tablespoons of water for 10 minutes before serving.

Step 4: To serve, place 3 pancakes on a plate and top each stack with the blueberry sauce.

Nutritional analysis per serving: calories: 423; total fat: 19 g; protein: 12 g; fiber: 14 g; sugar: 14 g; sodium: 416 mg

Baked Sweet Potato With Almond Butter Drizzle

Recipe by Leman

Bake several sweet potatoes at once. Store them in the fridge to quickly pull together this nourishing option for breakfast, a snack, side dish or mini-meal.

-- 2-3 medium sweet potatoes

-- olive oil

-- 1/2 cup almond butter

-- 2-3 tablespoons hot water

-- 1/2 teaspoon vanilla

-- 1 1/2 teaspoons cinnamon

-- chopped walnuts (optional)

Step 1: Preheat oven to 375 degrees F.

Step 2: Slice potatoes lengthwise. Drizzle cut side with a bit of olive oil. Place potatoes cut side down on a parchment paper-lined baking sheet.

Step 3: Bake for 30-35 minutes. Check for doneness by pressing top of potato. They'll yield to gentle pressure when done.

Step 4: Mix almond butter with 2 tablespoons hot water (add more water for thinner consistency), vanilla and cinnamon.

Step 5: Drizzle over warm sweet potato, top with walnuts if desired.