When we think of climate change, we often picture melting ice caps, rising sea levels, or massive forest fires. However, this emergency rears its ugly head in clinical settings as well — by worsening cardiovascular and respiratory illnesses, accelerating infectious disease spread, exacerbating food insecurity, and more. The climate crisis is a pressing health issue, and leading medical bodies like the American Medical Association and World Health Organization agree.
Although the federal government continues to slash climate-protective policy, physicians have sprung into action. From reforming physician education to enhance the environmental health curriculum to making healthcare facilities more sustainable, the medical community has stepped up to the plate. But as the crisis intensifies, we must consider additional means to continue making a difference. Thankfully, one particularly impactful tool sits right on our patients’ dinner plates.
How Does Food Fuel Climate Change?
Dietary guidance has long been an essential part of the physician toolkit, and this guidance can be updated to help both our patients and the planet. Animal agriculture is responsible for an estimated 14.5% of global greenhouse gas emissions, and is also a driving force in deforestation, biodiversity loss, water overuse, hunger, and disease.
Conversely, switching to plant-based agriculture is associated with significant reductions in environmental harm, particularly emissions. To help us stay below the 2° C warming threshold that triggers catastrophic consequences, a major shift in global market demand toward plant-based rather than animal agriculture is necessary — a reality supported by expert bodies like the Intergovernmental Panel on Climate Change (IPCC).
By integrating plant-based diets into patient counseling, doctors can play a central role in propelling this shift.
Plant-Based, Vegan, Vegetarian — What’s the Difference?
In climate-focused dietary discussions, plant-based, vegan, and vegetarian are often used interchangeably. As long-time vegans ourselves, we recognize that veganism extends beyond food — it involves avoiding all animal-derived products as much as reasonably possible. This includes clothing, cosmetics, consumer goods, and more.
Conversely, plant-based typically refers only to diets that entirely or mostly exclude animal products. In this piece, we use vegan and plant-based to describe diets that avoid all animal-derived foods. Although vegetarian diets — which include dairy and eggs — also reduce emissions, vegan diets offer significantly greater environmental benefits. For instance, the IPCC estimates that a global shift to vegetarian diets would reduce greenhouse gas emissions by roughly 6 billion metric tons annually, while a shift to vegan diets could reduce emissions by about 8 billion metric tons; that’s nearly 2 billion metric tons — or 33% — more.
Ensuring the Patient Comes First
Some clinicians may worry about letting societal issues impact medical advice. This is entirely reasonable — patient care must always take precedence over sustainability. Fortunately, recommending a balanced, plant-based diet can prioritize both patient and planetary health.
The Academy of Nutrition and Dietetics’ official position is that vegan diets are safe, healthy, and nutritionally adequate for all stages of life, with further findings of health benefits such as reduced risk of cardiovascular disease and type 2 diabetes. Numerous other professional health organizations agree.
Moreover, recommending a plant-based or vegan diet to a patient is just that — a recommendation. Physicians should acknowledge that some animal-based products, while less sustainable, can still be part of a healthy lifestyle. They should also be mindful of cultural differences in diet, which may impact preferences, and can be acknowledged in an appropriate manner. Even if patients aren’t ready to go completely plant-based, encouraging incremental shifts — such as participating in “meatless Mondays” or opting for oat milk over dairy milk — can carry significant environmental benefits.
Where We’re Falling Short
Others may point out that current clinical guidelines already satisfy our ask. The United States Preventive Services Task Force, American Heart Association, American Academy of Family Physicians, and U.S. Dietary Guidelines all promote increased consumption of fruits and vegetables. In clinical practice, most physicians do the same. Although this is a positive step, simply increasing plant-based food intake does not necessarily reduce the consumption of animal-based products.
In fact, many of these same guidelines encourage the inclusion of lean meats and poultry, low-fat dairy, and fish. Unfortunately, no matter how healthy the option, animal-derived foods harm the environment significantly more than plant-based foods. As patients grow more climate-conscious and seek to make values-informed choices, they need the full picture.
One Pew Research Center study demonstrated that even those not concerned about urgently addressing climate change expressed support for efforts to improve environmental quality, including air and water quality. Trusted physicians can serve as a valuable resource to help these patients understand which foods are not only most healthy, but also most eco-friendly.
The existing guidelines also fail to help patients navigate the real-life shift toward plant-based eating. Many patients lack exposure, often believing such diets are restrictive, bland, or even expensive — when this is usually not true. Others are unsure about how to get nutrients like protein without animal products. Therefore, counseling them to increase fruit and vegetable intake — whether directly tying these recommendations to sustainability or not — is unlikely to inspire change without more specific guidance. Educating doctors with simple strategies, meal ideas, and answers to common questions about nutrition and cost can lead to a more lasting impact.
Translating Guidance Into Conversation
So, what might this look like in practice? The first step can take place while asking patients about their eating habits at their annual check-up. At this point in the visit, it is already standard practice to promote increased consumption of plant-based foods for health reasons. Physicians can then easily introduce the environmental benefits — “Eating more fruits and vegetables is also a great way to reduce your carbon footprint,” or “Reducing animal product consumption also helps protect the environment.” Depending on the patient’s response, providers can take it one step further — “Have you considered going plant-based or vegan?”
If a patient is interested, you’ve already made significant progress. But change is difficult, especially when it comes to food. Doctors should frame this change not as a restriction, but an addition. You’re not cutting out meat, you’re adding beans and lentils. You’re not giving up flavor, you’re discovering new spices and herbs. You’re not losing nutrients, you’re gaining fiber and plant proteins.
Start small. One meal. One swap. Ask patients what plant-based version of a favorite dish they might try. Such motivational interviewing can empower patients without overwhelming them. Following the visit, take-home pamphlets or curated online resources can reinforce the conversation and support gradual dietary changes at home — without the pressure of overhauling an entire diet during a brief clinical encounter.
If clinicians aim to protect their patients, they need to consider protecting our planet. Stepping beyond traditional clinical care offers fresh opportunities to make a difference, and few choices carry as much impact as changing what we and our patients eat. By prescribing what patients put on their plates, we’re also prescribing a means to save our planet.
Akhil Mahant is a third-year medical student at the University of Rochester School of Medicine & Dentistry in Rochester, New York. Jacob Zevitz is a third-year medical student at the University of Kansas School of Medicine in Wichita.
