Last updated on Jul 7th, 2020 at 02:36 pm

This year, the EAT–Lancet Commission released the first universal healthy reference diet. We asked nutritional expert Patrick Holford for his opinion on it

Based on scientific research, the EAT–Lancet Commission’s universal healthy reference diet is designed not only to be good for human health but for the planet too.

In a nutshell, could you outline the healthy reference diet’s guidelines for consumption?

The Lancet Commission’s recommendations are almost exactly the same as my low GL diet.

Half of what’s on your plate should be vegetables and fruit.

One quarter should be protein-based foods but a lot more from vegetarian sources such as beans, lentils, nuts and seeds and eggs. Red meat, they say, should be once a week. They recommend a small serving of chicken and/or fish a day, about that which would fit into the palm of your hand. So, it’s not really a vegetarian diet – more a ‘fishichickitarian’ diet.

Subscribe to our Free Daily All4Women Newsletter to enter

The Lancet Commission suggests that eating this way would improve general health and reduce premature human deaths worldwide. What health problems do you think this diet could address and how?

We already have almost a billion people malnourished in the world, and our population is growing and expected to hit 10 billion by 2050. We have to increase food production and switch away from grazing animals to growing vegetables. Almost half the world is already pretty much vegetarian.

In countries like South Africa and the UK, where we eat too much meat, not enough fish and vegetable proteins, and not enough vegetables and fruit, a shift in this direction means less diabetes, heart disease, cancer, dementia and obesity. These are all diseases of so-called civilisation. We have been digging our own graves with a knife and fork.

What impact would eating less meat have on the planet?

If the Earth were an apple, cut in quarters, three quarters is ocean, and the skin of the remaining quarter is land.  Half that land is unfarmable. We live on the remaining eighth. But three-quarters of this eighth either has buildings on it or has too poor topsoil to farm. So, we get all our food from 1/32nd of the earth’s surface.

When you plough with tractors it turns over the soil and destroys the topsoil which is needed to capture carbon. We need more good quality soil, which means better farming practices, to capture carbon. Grazing animals on unfarmable land makes sense, like sheep in the hills, makes sense, as does small-scale farming where, for example, pigs turn over the soil and fertilise it, making it then able to capture more carbon. But using good quality land to graze cattle produces way less protein than you’d get, for example, if you grew beans. 

I think the one factor, not taken into account fully in the Lancet report, is our need for seafood. It is the lack of seafood that is driving a big increase in mental illness – Patrick Holford

Does this mean that a vegan diet is better for our health and the environment? 

Yes and no. We do need seafood, both fish and the nutrients that you find in both seafood and seaweed. We have way more farmable sea and coasts than land. The Japanese and Chinese are already doing marine agriculture on a much larger scale. In Canada, they are making omega-3 fats from algae. To be a healthy vegan you really have to supplement omega-3 from seaweed and also supplement B12, which is only in animal produce.

I think the one factor, not taken into account fully in the Lancet report, is our need for seafood. It is the lack of seafood that is driving a big increase in mental illness. Also, IQ has dropped seven per cent in the last generation. Seafood gives you both omega-3 and B12, as well as zinc, selenium and iodine. The trouble is there’s not enough fish to go around if we were all eating fish three times a week, which is what I recommend from a health point of view. So, protecting our oceans from pollution and using coasts for fish farming and seaweed agriculture is going to be vital to save humanity’s mental health from declining.

Patrick Holford’s guide to essential nutrients for women

A recent study by the WHO says that we need more fibre in our diets to reduce disease. What foods do we need to start incorporating into our diets to ensure we are getting a sufficient fibre intake?

If you eat a wholefood diet it is not hard to get enough fibre. This includes wholegrains, beans, nuts and seeds. There’s fibre in vegetables but much of this breaks down with cooking, so raw veg is better.

The best fibre of all is in oats and chia seeds. This is called soluble fibre, which absorbs water. Hence you can make porridge with oats but not wheat. [The fibre helps the slow-release of] the sugars in food which stabilises your blood sugar and [moves] food more quickly through you, which means less putrefaction [of animal produce]. We call these low glycemic load, or low GL foods.

The high-meat, low-carb ketogenic diet seems to have taken off worldwide. Does this not contradict the principles of the healthy reference diet and the findings of the World Health Organisation? Why/why not?

There are problems with a high-meat, ketogenic diet, certainly as a global principle. It’s neither sustainable nor I think the best baseline diet. Both processed and red meat are convincingly associated with increased colorectal cancer. This is partly due to carcinogens in cooked, burnt meat and partly due to, effectively, constipation – a high meat diet tends to lead to slower elimination. If you eat no grains and beans, it’s very hard to get enough fibre to keep things moving through.

But you can do a ketogenic diet more based on oily fish like mackerel, salmon and sardines and fatty foods like avocados, high-fat nuts and low carb beans, eating meat rarely. This is what I advocate for reversing diseases like diabetes, and then eating a low GL diet once recovered.

There’s also the danger from a high-meat diet of getting too much protein, which taxes the kidneys. We need some, but not too much protein. The healthiest high-fat, keto diets have less protein overall, and less from meat and dairy than, for example, the original Atkins or Banting diet.

Where can people find more information on your low GL lifestyle?

Have a look at both my websites,, which has some good low GL recipes, and also the GL section on There is a general convergence on what a healthy diet actually is, so, in this respect, we are making progress. Changing farming practices and eating habits across the world is more challenging, but essential if we and the planet are to survive.

While All4Women endeavours to ensure health articles are based on scientific research, health articles should not be considered as a replacement for professional medical advice. Should you have concerns related to this content, it is advised that you discuss them with your personal healthcare provider.