Diet and nutrition have a major impact on overall health, including our ability to maintain healthy muscle tissue and recover well. Evidence suggests that a plant-based diet––one that emphasizes whole foods and that is free of animal products––is a powerful way to achieve optimal health. Physical therapists can offer dietary guidance to their patients as a complement to their traditional interventions. This post discusses the relationship between nutrition and physical therapy, as well as the benefits of a plant-based diet.
The Role of Nutrition in Physical Therapy
The goal of every physical therapist is to help people gain mobility and function at their highest potential. To that end, some in the PT profession believe that it’s the role of PTs to guide their clients in making healthy lifestyle choices, including nutritional ones. “My career, of course, is focused on the benefit and practice of exercise and overcoming movement impairment,” notes Rachel S. Worman, PT, DPT, MPT. “But movement is not optimal without optimal nutrition.” Dr. Worman makes a strong case for the involvement of nutrition in physical therapy and for physical therapy degree programs to include nutrition coursework.
Research suggests that most chronic illnesses result from poor nutrition and physical inactivity. ((Balazs I. Bodai et al., “Lifestyle Medicine: A Brief Review of Its Dramatic Impact on Health and Survival,” The Permanente Journal, Sept. 20, 2017: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5638636/)) PTs can offer dietary guidance as a way to manage and treat conditions that are caused in part by poor diets. For example, obesity is a contributing factor in causing osteoarthritis of the knee. ((Rachel S. Worman, “Lifestyle Medicine: The Role of the Physical Therapist,” The Permanente Journal, Dec. 30, 2019: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7015533/)) When physical therapists treat patients using a more holistic approach that includes diet, this can have a positive impact on exercise, as certain foods fuel energy for activity.
Physical therapists ought to consider the role diet plays in certain patient health conditions. For example, consuming nitrate-rich juices and vegetables can improve blood flow to the muscles and the brain. Antioxidant-rich foods can decrease the risk of cardiovascular disease. By contrast, just one high-fat meal can increase blood pressure and insulin resistance. (( Chetan P. Phadke, “Why Should Physical Therapists Care about Their Patients’ Diet?” Physiotherapy Canada, Spring 2017: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5435402/))
In light of scientific evidence demonstrating the impact of diet on reducing disease symptoms such as pain, joint stiffness, swelling, and tenderness, dietary solutions are appealing for patients and clinicians alike. Good nutrition is also relatively affordable and accessible compared with other healthcare interventions. (( Stewart Rose and Amanda Strombom, “Rheumatoid Arthritis: Prevention and Treatment with a Plant-Based Diet,” Orthopedics and Rheumatology, Oct. 5, 2018: https://pbdmedicine.org/rheumatoid-arthritis-plant-based-diets-can-help/))
What Is a Plant-Based Diet?
A plant-based diet is one that is free of animal products (meat, fish, dairy, and eggs) and that is composed predominantly of whole foods such as fruits, vegetables, legumes, nuts, and seeds. Overall, a plant-based diet maximizes the consumption of nutrient-dense plant foods while minimizing or eliminating animal-based, refined, and processed foods. As always, you should consult a physician prior to beginning any diet, nutrition, or fitness plan.
It’s worth noting that a plant-based diet is not synonymous with a vegan diet. A vegan diet, which people usually adopt for ethical reasons, seeks only to exclude animal products and does not necessarily minimize the intake of processed foods, such as refined grains and sugar.
4 Benefits of a Plant-Based Diet
Poor diet is a major challenge facing the United States and many other countries. ((The US Burden of Disease Collaborators, “The State of US Health, 1990–2016: Burden of Diseases, Injuries, and Risk Factors Among US States,” JAMA Network, April 10, 2018: https://jamanetwork.com/journals/jama/fullarticle/2678018)) A 2017 study found that a diet consisting of excessive unhealthy foods, and not enough healthful foods, is associated with one in five deaths worldwide. This study ranked the United States 43rd out of 195 countries in the number of diet-related deaths.
Below, we share the key health benefits associated with plant-based diets, including improved athletic performance and mobility as well as reduced risk of disease.
1. Boosts Athletic Performance
Plant-based diets can improve athletic performance thanks to their positive physiological effects, which include: (( Neal D. Barnard et al., “Plant-Based Diets for Cardiovascular Safety and Performance in Endurance Sports,” Nutrients, Jan. 10, 2019: https://www.mdpi.com/2072-6643/11/1/130/htm))
- Leaner body mass. Reducing excess body fat helps to boost endurance and increase aerobic capacity.
- Ease of glycogen storage. Plant-based diets are typically high in complex carbohydrates, which can help the storage of glycogen and modulate its depletion.
- Improved tissue oxygenation. Given that plant-based foods are typically low in saturated fat and do not contain cholesterol, a plant-based diet can lead to better tissue oxygenation and blood flow.
- Reduced oxidative stress. Thanks to higher intakes of antioxidants, such as vitamin C, vitamin E, and beta carotene, plant-based diets may promote increased antioxidant activity, which can decrease muscle fatigue and improve recovery.
- Reduced inflammation: Plant-based diets may have anti-inflammatory benefits stemming from their antioxidant content and absence of inflammatory food products, such as sugars and fats.
These physiological effects can help athletes and non-athletes alike improve their exercise performance and overall health.
2. Reduces Risk of Disease
Author Michael Greger, M.D., notes in his Evidence-Based Eating Guide, “Many people assume that our manner of death is preprogrammed into our genes. High blood pressure by fifty-five, heart attacks at sixty, maybe even cancer at seventy, and so on…. But for most of the leading causes of death, the science shows that our genes often account for only 10–20% of the risk at most.”
Lifestyle changes, such as switching to a diet higher in whole plant foods, may lower your risk of developing illnesses such as diabetes, heart disease, and certain types of cancers. ((Physicians Committee for Responsible Medicine, “Plant-Based Diets: The Power of a Plant-Based Diet for Good Health,” https://www.pcrm.org/good-nutrition/plant-based-diets)) Plant-based diets have been shown to help reduce body mass, blood pressure, hemoglobin A1c, and cholesterol levels. Patients who are on medications for chronic conditions may be able to reduce their medication intake by adopting a plant-based diet. (( Phillip J. Tuso, et al., “Nutritional Update for Physicians: Plant-Based Diets,” The Permanente Journal, Spring 2013: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3662288/))
Nutrition is a non-invasive, non-pharmacological way to alleviate pain. Physical therapists can use nutritional guidance to help patients prevent and overcome diseases, particularly those that cause chronic pain. ((Joe Tatta, “Can Physical Therapists Give Nutritional Advice?” Integrative Pain Science Institute: https://www.integrativepainscienceinstitute.com/can-pts-give-nutrition-advice-what-the-law-says-about-physical-therapists-providing-nutrition/)) While providing guidance on nutrition is part of the professional scope of practice for PTs, each state has its own rules for what PTs can and cannot do, so it’s important to review individual state practices before providing expert diet advice.
3. Fosters Brain Health
Studies show that plant-based diets can improve mental health, including depression, anxiety, stress, and mood disturbances. (( NutritionFacts.org, “Mental Health”: https://nutritionfacts.org/topics/mental-health/)) Additionally, plant-based diets aim to reduce the amount of sugar and refined carbs which are linked to depressive symptoms.
Since mental health issues can greatly interfere with patients’ physical health, including their interest in exercise, clinicians can help them to maintain or improve mental health through good nutrition. This can, in turn, improve physical outcomes and expedite recovery from injury.
4. Improves Gut Health
An imbalance of the gut microbiota has been linked conditions such as obesity, atherosclerosis, Type 2 diabetes, cancer, and autism spectrum disorder, as well as to various gastrointestinal conditions such as: (( Aleksandra Tomova et al., “The Effects of Vegetarian and Vegan Diets on Gut Microbiota,” Frontiers in Nutrition, April 17, 2019: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6478664/))
- Reflux
- Peptic ulcers
- Irritable bowel syndrome
- Non-alcoholic fatty liver disease
- Inflammatory bowel disease
Gastrointestinal conditions can interfere with patients’ ability to remain active and meet their physical therapy goals. A plant-based diet may be an effective way to promote a diverse and stable ecosystem of beneficial microbes that support overall health. In particular, high-fiber intake encourages the growth of species that ferment fiber into metabolites as short-chain fatty acids (SCFAs), which can lead to improved immunity against pathogens and regulation of
critical intestinal functions. Further, polyphenols, which are abundant in plant foods, can have anti-pathogenic and anti-inflammatory effects and can offer cardiovascular protection.
Helpful Resources
- NutritionFacts.org: a nonprofit organization and science-based public service providing free updates on the latest nutrition research in short videos and articles
- Physicians Committee for Responsible Medicine: a nonprofit organization dedicated to saving and improving lives through plant-based diets
- The T. Colin Campbell Center for Nutrition Studies (CNS): a nonprofit organization with a mission of increasing awareness of the impact food has on our health, communities, and planet
For more information on the benefits of plant-based diets, check out the visual below.
By offering nutrition recommendations, physical therapists can further aid patients in reducing pain levels, regaining or improving freedom of motion, and living life to their fullest potential.
The largest PT school in the United States,* the University of St. Augustine for Health Sciences (USAHS) offers a hands-on Doctor of Physical Therapy (DPT) degree. Join a collaborative cohort of peers who learn under the mentorship of expert faculty-practitioners. Practice with mock and real patients in our state-of-the-art simulation centers and learn anatomy with our high-tech tools. Prepare for clinical practice with a wide range of patients, as well as for advanced roles in research, practice leadership, and policymaking. Residential (online coursework + in-person labs on weekdays) and Flex (online coursework + in-person labs on weekends) formats are available.
*Based on total DPT degrees conferred, as reported by the Integrated Postsecondary Education Data System (IPEDS). Data is captured by IPEDS through interrelated surveys conducted annually by the U.S. Department of Education’s National Center for Education Statistics (NCES). https://nces.ed.gov/ipeds/
Additional Sources
Voice of America. (2019, April 4). One in five deaths linked to unhealthy diet. Voice of America – Learning English. https://learningenglish.voanews.com/a/one-in-five-deaths-linked-to-unhealthy-diet/4863743.html
Plant Based Food Association, “Consumer Insights”: https://plantbasedfoods.org/marketplace/consumer-insights/
