Incremental, plant-based dietary changes can improve glycemic control, weight, and lipid outcomes while complementing cardiometabolic pharmacotherapy in routine pharmacy practice.
In an interview with Pharmacy Times, Hana Kahleova, MD, PhD, MBA, director of clinical research at the Physicians Committee for Responsible Medicine, discussed practical strategies pharmacists can use to integrate plant-based dietary guidance into routine care for patients with obesity, diabetes, and dyslipidemia. Kahleova emphasized that meaningful cardiometabolic improvements can be achieved through low-fat, plant-based eating patterns without calorie counting or carbohydrate restriction, making this approach especially accessible for patients who struggle with glycemic control or weight management. She noted that pharmacists do not need to promote complete dietary overhauls; instead, identifying plant-based foods patients already consume and encouraging small, incremental substitutions can foster sustainable change.
Kahleova also addressed common patient barriers, including concerns about taste, cost, convenience, and family acceptance, and highlighted the importance of framing plant-based eating as familiar, flexible, and achievable. Importantly, she stressed that dietary counseling should complement—not replace—pharmacotherapy, reinforcing that medications manage symptoms whereas diet targets underlying disease mechanisms such as insulin resistance and excess saturated fat intake.
This is part 2 of a Q&A series with Kahleova. You can read the insights from
Pharmacy Times: Pharmacists often see patients who struggle with glycemic control or obesity. How might you recommend integrating plant-based diet guidance into routine pharmacy practice without overwhelming patients?
Hana Kahleova, MD, PhD, MBA: Our clinical research studies show that a low-fat vegan diet can help improve glycemic control and lead to significant weight loss, without requiring calorie counting or carbohydrate restriction. Participants are encouraged to eat freely from plant foods while avoiding animal products and limiting added fats. In routine pharmacy practice, the goal does not need to be full dietary transformation. Pharmacists can start by helping patients recognize plant-based meals they already eat—such as oatmeal, toast with jam, bean burritos, vegetable soups, pasta with marinara sauce, or rice and beans.2
Building from what patients are already doing well makes change feel achievable. Pharmacists can then suggest 1 or 2 simple substitutions per week, such as replacing meat in a favorite recipe or choosing a plant-based option when dining out. Small, consistent changes are often more sustainable than complete overhauls.
Pharmacy Times: What are common barriers patients face when trying to adopt more plant-based eating patterns, and what practical strategies can pharmacists offer to help overcome these obstacles?
Kahleova: Common barriers include concerns about taste, cost, convenience, and family acceptance. Many patients worry that plant-based eating will require unfamiliar foods or extensive cooking. Pharmacists can reassure patients that plant-based eating does not have to be complicated. Familiar foods—such as pasta, sandwiches, cereals, soups, and stir-fries—can easily be made plant-based. Encouraging patients to involve family members in meal planning and to explore restaurants with plant-based options can also improve adherence.
Community support can be helpful as well. Patients may benefit from local or online plant-based groups, cooking classes, or educational resources that provide recipes and practical guidance.
Pharmacy Times: For patients already on glucose-lowering or lipid-lowering medications, how can pharmacists frame discussions about diet so that dietary changes complement pharmacotherapy and improve outcomes?
Kahleova: Dietary change should be presented as a complement—not a replacement—for medical therapy. Our clinical research shows that adopting a low-fat, plant-based diet can significantly improve cholesterol levels, glycemic control, and body weight, sometimes allowing medication doses to be reduced under physician supervision. Pharmacists can explain that medications treat the symptoms of cardiometabolic disease, while diet addresses many of the underlying causes—such as excess saturated fat intake, hepatic fat accumulation, and insulin resistance.
For pharmacists, this distinction is empowering—it allows for practical, patient-centered counseling that prioritizes achievable dietary improvements rather than rigid food rules. - Hana Kahleova, MD, PhD, MBA
By reinforcing that dietary improvements may enhance medication effectiveness and potentially reduce long-term medication burden, pharmacists can motivate patients while emphasizing the importance of ongoing monitoring and collaboration with their health care team.
Pharmacy Times: Is there anything else that you would like to add?
Kahleova: One important message from our review is that public discussions around ultraprocessed foods should not overlook food sources. The evidence consistently shows that ultraprocessed animal foods—especially processed meats and sweetened beverages—are the primary drivers of cardiometabolic harm, while many plant-based ultraprocessed foods are associated with neutral or beneficial outcomes.
For pharmacists, this distinction is empowering. It allows for practical, patient-centered counseling that prioritizes achievable dietary improvements rather than rigid food rules—supporting better long-term adherence and better cardiometabolic health.
