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Forks Over Knives

Getting consumers to think about what they eat

A few months ago I received a copy of "Forks Over Knives,"1 a documentary that is both a review and a set of recommendations about vegan diets. Some consumers and clinicians label this way of eating a "traditional" diet, and makers of the documentary have named it "The FOK Diet." I watched the film with my 10-year-old son, who declared at its conclusion that he was going to become vegetarian. "No buts, Mom!"

The film was of interest to me for many reasons. Over the past few years, several medical colleagues have refocused their nutrition recommendations to urge full vegan diets - but they use the term "traditional" rather than "vegan." In my own practice as an NP and dietitian, I counsel many college students, women, athletes and patients with eating disorders. Close to 40% of them refer to themselves as some type of vegetarian. I was intrigued by how this film would affect the average consumer of healthcare. If my son could make a decision to become vegetarian as a result of seeing it, what would its impact be in the larger world?

The Broader Picture

Soon after viewing this documentary and considering it as a potential topic for this column, I received the Summer 2011 edition of Weight Management Matters, a publication for members of the Weight Management Dietetics Practice Group of the American Dietetic Association. The issue contained a brief review of Forks Over Knives, which stated that the documentary advocated a whole-food, plant-based diet to reverse disease and prevent obesity while promoting animal welfare and limiting environmental destruction.2

Forks Over Knives incorporates findings of the China Study, which analyzed the types of food consumed and the average disease rates in various regions of China. The China Study was conducted almost a decade ago by physician T. Colin Campbell, who argues that food is medicine and that a whole-food, plant-based diet can cure almost anything when used as the primary approach to treating chronic disease.3 His research showed that the more plant products and less animal products eaten in a particular region, the lower the rates of most chronic diseases.

The China Study compared population groups rather than individuals. In Forks Over Knives, individual patients work with their personal healthcare providers to achieve weight loss and enhanced health, and this work includes transitioning to a whole-food, plant-based diet (the FOK diet). The process is an in-depth lifestyle choice that requires much time and thought, but if patients receive appropriate support, as in the film, they can succeed.

Although the FOK diet may work for some people who are committed to a vegan lifestyle, dietitians point out that other people, such as severely obese patients with a myriad of medical problems, may not experience long-term benefits from it. The main reason is that they are unlikely to be able to stick to such a rigid way of eating. Many overweight people can find a way of eating that may work for 3 to 12 months, but for the long term the small changes in nutrition and exercise that become habit are the strategies that keep weight off.

Evidence-Based Practice

The Journal of the American Dietetic Association recently published a study that examined vegetarian dietary patterns as a method for weight loss.4 The researchers analyzed data from the National Health and Nutrition Examination Survey and found that patients who were nondieting vegetarians (ovo-lactovegetarian) consumed a more nutrient dense diet that also was lower in calories (by an average of 363 per day) than that ingested by nonvegetarians who were not dieting.

The researchers documented higher intakes of fiber, vitamins A, C and E, thiamin, riboflavin, folate, calcium, magnesium, iron and potassium in the ovo-lactovegetarian groups.4 This reflects the reliance of ovo-lactovegetarians on milk and dairy for protein sources. People who follow a vegan diet do not consume dairy products, and they need to be particularly careful to avoid shortfalls in zinc, B12, calcium and vitamin D. A commentary published in the same issue of the Journal of the American Dietetic Association stated that the benefits of a plant-based diet can be valuable beyond weight loss, whether or not a completely vegetarian pattern is adopted.5

Best Practices for Patients

Vegan diets are higher on the complexity scale than simply "eating more plant foods."4,5 However, today's wider availability of vegan foods makes it much easier to be a vegan than it was a few decades ago.4,5

The FOK diet is essentially a vegan diet. It is a major commitment in lifestyle, habits, meal preparation and food label reading. For weight loss and weight management, vegan diets can be helpful, but carbohydrate intake should be hindered to produce weight loss. Many overweight patients may do better adopting some but not all vegan principles, or by following other types of vegetarian diets. Working with a registered dietitian can help new followers of vegan and vegetarian diets stay committed and stay healthy.

Any diet trend should be carefully considered as a lifestyle decision for the long term, not as a short-term cure for chronic disease or excess weight. The habits a person can adopt for life - such as increasing fruit, vegetable and whole grains while decreasing high-fat protein and dairy - are sustainable for a lifetime. The latter may be a more appropriate choice for people who are considering veganism but haven't yet made this dramatic transition.

When my son asked to become a vegetarian after viewing Forks Over Knives, I bought vegetable burgers for him to try. I also grilled low-fat ground beef burgers, so that he had a choice. Although he resumed eating animal protein, he incorporated more fruits and vegetables throughout the day. Maybe the film is a tool to increase children's consumption of fruits and vegetables and encourage consumers to think about what and how they are eating in relation to their everyday health and longevity. No matter your opinion on veganism, the producers of Forks Over Knives have succeeded in getting viewers to rethink how they eat.

Robyn Kievit is a family nurse practitioner, a registered dietitian and a certified specialist in sports dietetics. She operates a private nutrition practice in Boston and is on staff at Emerson College. E-mail your nutrition and weight loss questions to or visit her website at On Facebook and Twitter, search for nutritionmentor.



1.      Forks Over Knives website. Accessed Aug. 10, 2011.

2.      Andrews RD. Weight films. (editorial) Weight Management Matters. 2011;9(1):15.

3.      Campbell TC. The China Study. Dallas, Texas: BenBella Books; 2004.

4.      Farmer B, et al. A vegetarian dietary pattern as a nutrient-dense approach to weight management: an analysis of the National Health and Nutrition Examination Survey 1999-2004. J Am Diet Assoc. 2011;111(6):819-827.

5.      Thedford K, Raj S. A vegetarian diet for weight management. J Am Diet Assoc. 2011;111(6): 816-818.




Nutrition Now Archives

Wonderful to here Bev. :) Congrats...

Its just a whole new learning, like how your learned to get to the diet your at now. I simply do not think it is extreme or rigid at all. You can eat as much as you want with the diet. At the age of 42 I have become vegan for health, animal cruelty and the environmental reasons. I have never felt better in my life. I get complete satisfaction from knowing I am contributing to the good and well-being of all, as well as eating beautiful tasty foods.

It's great that your son was inspired to become vegan. It is tough in this day and age, especially at school where lunches are highly processed and full of meat and dairy most of the time. I just wonder if we never began eating this way, it would be so normal. I actually am the point where I feel it's quite strange that anyone would eat meat and drink milk of another animal. I did for many years, although very sparingly, and am so glad to have woken up and had the veil lifted. I was ready for it, grabbed hold of it and will never let it go. I wish with all my heart that others would grab hold too. It's holistic eating from the inside out.

Taste the rainbow...


julie westSeptember 19, 2011
rancho cucamonga, CA

I adopted the plant-based diet at age 80 after seeing FOK. After a year I find I have more energy, no medical problems requiring medications, and am amazed that I don't miss meat and cheese. Beans are delicious!

Bev ,  retiredSeptember 01, 2011


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