Notes from PBNHC 2018
Over 3½ day the 2018 Plant-Based Nutrition Healthcare Conference featured 17 talks, a cooking demo, a movie screening and two discussion panels. In its six years it has grown attendance from 220 to about 1000 this year. Most attendees were doctors or other medical professionals. The conference was organized to provide doctors with the latest information on treating patients with a plant-based diet. My notes below capture a small fraction of the scientific information presented. In summary, more is known each year about the causes of disease, and the more we learn, the more we find that the consumption of animal products is linked to disease creation and that the consumption of whole plants is linked to health.
Woven through the discussion of the latest nutrition research results, were triumphant case studies of people sick and on the edge of death, learning about a plant-based diet and curing themselves through dietary change. While these cases are too numerous to still be surprising, they are still nonetheless compelling.
To your long life and health,
John Tanner, PhD
Director, NuSci, The Nutrition Science Foundation
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Links into the notes below:
The Plantrician Luminary Award went to Dr. Hans Diehl
Hospitals changing to cure disease through a plant-based diet: Stoll
What you eat causes inflammation and disease: Kahn
Using calorie density to guide in healthy food choices: Lim
Curing rheumatoid arthritis with a plant-based diet: Aggarwal
Comparing stents and cancer drugs with plant-based eating: Ornish
Improving mental health through nutrition: Aiken
The American diet is bad for bones: Rosenberg
Diet versus drugs for healthy cholesterol levels: Jenkins
Techniques for making white bean soup, tacos, and wild rice salad: Rubin
This must-see movie coming January 2019 - The Game Changers
How industry suppresses inconvenient nutrition research: Campbell
Comparing traditional heart disease treatments with diet: Batiste
Treating multiple sclerosis with a whole food plant-based diet: Stancic
Getting patients off medications as they switch to a plant-based diet: Kelly
Balancing hormones through diet: Loscalzo
Diet for reversing diabetes: Youngberg
Panel: Nutrition to optimize athletic performance: Stoll, Bausch, Loomis, Wilks
Research summary - How Not To Die: Greger
Food requirements for a growing and aging population: Essigs
Building a medical team to cure patients with diet: Misquitta
Questions and answers with a panel of doctors: Stoll, Belardo, Bellatti, Klaper, Marbus
Additional links and next year's conference
The 2018 Luminary Award went to Dr. Hans Diehl, creator of the Coronary Health Improvement Program, later renamed the Complete Health Improvement Program which now has more than 85,000 graduates. Hans says about a plant-based diet “How you choose to eat determines how you die.”
Keynote - Healthcare Organizational Transformation: What’s Working and Why, Scott Stoll, MD
On behalf of the Plantrician Project, Scott announced the “International Journal of Disease Reversal and Prevention” for medical professionals and “Disease Reversal and Prevention Digest” for the general public.
Kim Williams, MD Past President of the American College of Cardiology says, “What is the leading cause of death of physicians? Heart disease. Doctors don’t generally know how to protect themselves and their families, let alone their patients.”
Medical service organizations face challenges including fee-based financial models. A fee-based model encourages billing for sickness care, not for curing diseases. However, we are slowly moving toward value-based reimbursement models. This change will take years but will be transformative. For both organizations and individuals, they first need to know different in order to be different and do different. So greater health begins with learning.
To begin a change, we need to start with instilling a sense of urgency. With determination, people have successfully made significant changes toward plant-based health practices at four hospitals. Midland Health in Midland, TX found that providing a month of plant-based meals resulted in a reduction of readmission by almost 50%.
Eskenazi Health in Indianapolis, IN has a garden on the roof of their 7 story hospital that produces thousands of pounds of food per year to help people through eating healthy food but also learning how to grow and cook with plants.
Lee Health in southwest Florida invested $38,000 in an employee program that resulted in $70,000 savings in medical costs for their employees, almost a 2:1 return on investment. With patients, 4 weeks of plant-based food resulted in 58% reduction in hospital readmission rate.
Geisinger Health in Northern Pennsylvania and New Jersey. Patients saw 2 point reductions in A1c (which corresponds to a 40% reduction in death) and dramatic reduction in annual health costs through providing plant-based meals to patients.
Lifestyle Choices and Inflammation: The Origins of Chronic Disease, Joel Kahn, MD
Naturally lower LDL blood levels, which can be achieved with a plant-based diet, results in lower inflammation and heart disease.
Excessive inflammation leads to heart disease, rheumatoid arthritis, cancer, depression, neurological diseases, autism, and more.
A recent study showed clearly the association between CRP (C-Reactive Protein) which is an indicator of inflammation, and incidence rates of cardiovascular disease. (CRP is produced by the liver in response to inflammation and can be detected through a CRP blood test.)
Another study shows the association of a meat-based diet and inflammation.
A tick bite can result in an allergy to eating meat. People with this allergy have more atherosclerosis.
Ornish study compared plant-based eaters vs people on the AHA diet. After 8 weeks, the plant-based dieter did far better as measured by HS-CRP.
A leading biochemical nutritionist recommends a low protein diet for greater longevity. A study showed that a reduced calorie diet for 5 days lowers fat levels in the body, but not muscle levels.
Studies have shown that clove, ginger, turmeric, and rosemary spices can lower a number of inflammatory markers.
Despite all the press about good fats, studies show that consuming saturated fats results in a surge of inflammation markers for a few hours as well as ongoing lower levels of inflammation.
There are now 9 studies that all confirm that a ketogenic diet (low carb, high protein and fat) results in substantially lower length of life.
A study based on questionnaires of 68,000 swedish found a substantial decrease in heart disease and increase in longevity for people who ate an anti-inflammatory diet.
Caloric Density: A Simple Yet Powerful Concept, Anthony Lim, MD, JD
Jeff Novick quote: ”Calorie density is the simplest approach to healthful eating and lifelong weight management.”
Many patients as they work toward weight loss, they lose at a good rate but then hit a plateau and often drift back into weight gain. Often it is because they are not focussed on calorie density.
Body mass index (BMI) is calculated from height and weight and indicates whether you are normal, overweight, or obese. You are considered to have healthy weight if your BMI is between 18.5 to 24.9. However, it is recommended to target a BMI of 23.
Calorie density is the amount of energy divided by the unit weight of the food. Foods range from lettuce with a calorie density of 64 calories per pound to oil with 4000 cal/lb.
For the same number of calories, foods with a lower calorie density have a larger volume and thus trigger the stretch receptors of the stomach which tell you you are full and you want to stop eating.
Vegetables 100 cal/lb
Fruits 300
Whole “Unprocessed” Starches 500
Legumes 600
Animal Meat 800
Whole “Processed” Starches 1500
Sugars 1500
Refined, Processed Junk Food 2300
Nuts/Seeds 2800
Oil/Fat 4000
Quote from Matt Lederman: “You can have as much coconut oil as you want as long as you don’t put it in your mouth. Rub it on your skin or hair - just don’t eat it.”
World Cancer Research Fund recommendation: eat less than 600 calories/lb.
These both have 500 calories: a 5 oz bag of gummi bears and a 7 lb watermelon
These both have 800 calories: 1 cup of cashews and 5 medium sized baked potatoes
If you eat the first one in each pair, the high calorie-density one, you can easily eat too much. But if you eat the second one in each pair, the low calorie-density one, you can’t eat too much.
Results from research study entitled “Obesity and cardiovascular risk intervention through the ad libitum feeding of traditional Hawaiian diet” by Terry Shintani and others:
When they fed patients traditional Hawaiian plant-based foods for 21 days, it resulted in an average patient decrease of the following: total calories consumed: 40%, weight: 6%, BMI: 8%, cholesterol: 14%, LDL: 12%, glucose: 24%, blood pressure systolic 9% diastolic 11%.
Common pitfalls within a plant based diet - foods with high calorie density: Meat-like substitutes, plant-based snacks. For example a That’s It fruit bar: 1500 calories per pound, a Zing bar: 2050 cal/lb. (Reminder from above: We should be eating foods with 600 cal/lb or less.)
- Eat freely vegetables fruits, starch vegetables, intact whole grains, legumes.
- Exercise caution with these: bread, bagels, dry cereals, crackers, tortillas, added sugar, dried fruit, nuts, seeds, avocado, hidden salt and oil when eating out and liquid calories.
- Eliminate one or more categories of the cautionary foods from your diet if self-restraint is too difficult or if you are not getting results.
- Sequence your meals, starting with the lowest density foods.
- Aim for a 50/50 plate of veggies/starches.
- “Dilution is the solution through substitution” from Jeff Novick. Replace part of your high calorie-density foods with low calorie-density foods.
Rheumatoid Arthritis, the Microbiome and the Science of Whole-Food, Plant-Based Intervention, Monica Aggarwal, MD
After her third child, she began suffering from severe rheumatoid arthritis. She was diagnosed and was prescribed multiple medications that had bad side effects. Already a vegetarian, she eliminated dairy and other inflammatory foods. Now five years after eating plant-based diet, and four years after off all medications, she no longer suffers from Rheumatoid Arthritis.
What you eat affects your gut flora which causes inflammation which causes illness.
A study compared diet, gut flora and colon cancer rates between Africans vs African Americans. The Africans ate more whole plants, had gut flora that produced more butyrate, and had less colon cancer. They switched diets between the two groups and found significant changes in the gut flora within two weeks, with the good results following whichever group ate the plant-based diet.
A study shows that dietary carnitine (which comes in meat foods) accelerates atherosclerosis by 1.8 times.
Another study shows a reduction of production of endotoxins in people eating plant-based diet.
One example of a disease involving the gut is celiac disease. For those patients, the gluten in wheat that they eat causes leaky gut which allows gut bugs to get through the intestinal wall which then cause inflammation and associated symptoms throughout the body.
Tarahumara Indians eat primarily a plant-based eating and are known for their running ability and low cholesterol. Volunteers were served a traditional Western diet and in a few weeks had significantly higher cholesterol.
A research study (JACC by Satija 2017) shows that a healthy plant-based diet results in significantly less heart disease than an unhealthy plant-based diet.
Cardiologists don’t eat much better than the general population.
There is no time in life appropriate to eat junk food. Autopsies of kids show significant atherosclerosis if they have eaten poorly.
She is driving major changes to her clinic and University of Florida Hospital, including training doctors in plant-based disease prevention.
Scientific Breakthroughs in Prostate Cancer, Telomeres and Plant-Based Nutrition Dean Ornish, MD
Dean Ornish along with Anne Ornish have a book coming out in January titled “Undo It!: How Simple Lifestyle Changes Can Reverse Most Chronic Diseases”
A variety of diseases have a common cause which are lifestyle factors including diet.
A recent Lancet study showed that stent emplacements had the same effect in reducing angina as did a placebo procedure.
The Ornish program has showed that medical costs can be reduced by half in the first year after training patients on lifestyle improvements.
In one study of prostate cancer, they found that lifestyle changes had the same level of reduction of the cancer as did a $100,000 drug.
Another study showed a reduction in blood flow of 50% within a few hours of eating an animal product breakfast of sausage and eggs.
Neurodietetics: The New Science of Lifestyle Intervention for the Mental Health Crisis Richard Aiken, MD, PhD
Ranking diseases by years of life lost, 4 of the top 7 are neurological or psychiatric. Grouped together, they represent the leading cause of lives lost.
Suicide of children ages 10 to 14 years old has doubled (males) or tripled (females) in the last seven years.
Years of life lost to disability, the number one cause is mental disorders.
The brain is very sensitive to damage. It responds with inflammation to vascular damage, infection (pathogens, bacteria, viruses), traumatic brain injury, and neurotoxins. Diet can minimize the inflammation.
Neurogenesis, the ability of the brain to grow new neurons, can help resolve depression, but can take months to grow. The gut-brain axis is also definitely involved, but details are still being worked out.
Challenges to research studies include measuring depression and measuring diet. Neither of these are well defined.
A study entitled “Dietary recommendations for the prevention of depression” included a recommendation to increase consumption of fruits, vegetables, legumes, whole grain cereals, nuts, and seeds.
Another study “A longitudinal analysis of diet quality scores and the risk of incident depression in the SUN project” found that adherence to a pro-vegetarian diet could be effective for the reduction of depression risk.
Some have hypothesized that the so-called “good” fat from fish is important to healthy moods. However, a study “Vegetarian diets are associated with healthy mood states: a cross sectional study in SDA adults” found that despite a low intake of long-chain omega-3 fatty acids, a vegetarian diet does not negatively affect mood.
Another multicenter randomized controlled trial found that many physical and mental traits were improved upon eating a plant-based diet.
You may hear people recommending consuming omega-3 polyunsaturated fatty acids (PUFAs) including ALA from plants or EPA or DHA from fish oil to benefit cardiovascular health. However in the study “Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease” researchers found that increasing omega-3s has little or no affect on death rates. In another study “Interventions to Prevent Age-Related Cognitive Decline, Mild Cognitive Impairment, and Clinical Alzheimer’s-Type Dementia” researchers found no high-strength evidence for the effectiveness of any intervention (including omega-3 supplementation) to delay or prevent cognitive decline.
In the study “Omega-3 fatty acids for the treatment of depression: systematic review and meta-analysis“ researchers found non significant benefit of omega-3 FAs for major depression.
A study of rats suggests that dietary ALA is sufficient for their bodies to make DHA, so DHA is not necessary to be in the diet.
Iodine is essential in the diet of all animals. Plants don’t need it. It is an antioxidant. Lack of iodine is the most commonly preventable cause of retardation. There is an association between hypothyroidism and depressive symptoms. We can get iodine from seaweed and iodized salt.
There is an inverse relationship between dietary magnesium and depression. Suicidal depression appears to be related to magnesium deficiency.
Lithium is good for general mood and prevention of suicidal behavior. Lithium is the only anti-psychotropic medication that doesn't have a suicide warning. A study showed that Texas counties that had higher levels of natural lithium in the water had lower levels of crimes suicides and arrests related to drug addictions.
Iodine, magnesium, and lithium are all elements that have been found to have an affect on mood and mental health. We can get these elements from plant foods including seaweed, drinking water (in some locations), and if necessary, supplements.
The Standard American Diet is Bad for Bones and Joints: Observations in Surgery Thomas D. Rosenberg, MD
Knee replacement allows the review of 10+ layers of tissue, giving a good indication to the surgeon of the health of the patient. Sadly most patients are not healthy.
Not only are bones the largest organ of the body, but also are involved with insulin release, testosterone, and muscle energy uptake. The flat bones produce red blood cells, platelets, lymphocytes, and more.
Sick bones result in osteoporosis, cysts, anemia, deformity, metastatic cancer.
Bone health requires superior nutrition (a plant-based, alkaline diet), vitamin D, avoiding drugs including (PPIs such as Nexium, Prevacid, and Prilosec and NSAIDS such as aspirin, Advil, Motrin and Celebrex) and exercise.
C-reactive protein (CRP: a blood test that indicated body inflammation) should be less than 2.5, but drugs affect the test. For example, statin drugs lower the test result, but don’t reduce inflammation. A plant-based diet promotes lower CRP with reduction in inflammation.
It costs $50,000 for a knee replacement and 20% don’t work well. Some are considered disasters.
Bone problems are not age related. They are diet related.
Osteoporosis and osteoarthritis are lifestyle diseases.
Lipid Research: From Confusion to Clarity David Jenkins OC, MD, FRSC, FRCP, FRCPC, PhD, DSc
Initially the therapeutic diet was low saturated fat, low cholesterol. The result was very modest and that led to a conclusion that diet was ineffective.
Next the recommendation was to add fibers and plant sterols. FDA added a recommendation of nuts and soy protein foods.
The confusion is the incorrect ideas that 1) diet does not work, 2) disease is in your genes and 3) medications work. But research followed that showed that the new recommendation for adding plants resulted in lowered cholesterol and inflammation marker (CRP) similar to statin drugs (but without negative side effects).
Therefore the anti-inflammatory effect of a plant-based diet may have both CVD and cancer benefits. But does a plant-based diet work clinically?
In a study published by Dean Ornish in JAMA in 1998, over a five year period, artery openings decreased in size over time with normal diet, but a plant-based diet the size increased over time.
About 7 million years our ancestors split off from chimps which are largely vegetarian but a little omnivorous and gorillas which are vegetarian. Orangutans and gibbons split off earlier and are vegetarian. Of these species, which we share a large percentage of our DNA, only modern humans eat significant amounts of meat.
In a study, researchers attempted to construct a simian diet and subjects had to eat over 10 lbs of food per day. Difficult to do. Result: subjects were always very full, they had no obesity, 8 hours of eating yields lots of time to socialize with others, and they had 2 lbs of bowel movements per day. In two weeks, this diet resulted in 35% reduction in LDL.
For years there have been many studies showing the relationship between consuming red meat and death. It has taken longer to conclude similar risks for other meats and dairy products.
Now there is international clarity. Netherlands recommends no more than 2 servings of meat per week, China reduced its recommendation for all meat consumption by 50%, Belgium recommends making foods derived from plants the basis of every meal and limiting intake of animal products.
Culinary Wellness, Foundational Cooking Techniques for Taking Control of Health Ken Rubin of Rouxbe cooking school
Dry saute technique. Heat the pan until drops of water scoot around as little balls. Cook onion first, then garlic, then add liquids.
White bean soup. Make mirepoix - cut up onions, put them in a hot soup pan. Cut carrots and add to the soup pan. Cut celery and add to pan. Add garlic last or it will burn. Then add vegetable soup stock. After a number of minutes, add kale and thyme.
Used for multiple dishes: Add onions to an already hot fry pan. Add garlic. Add a little bit of stock and let it quickly boil off while stirring.
Tacos: Simmer black lentils for 40 minutes in vegetable stock. Add smoked paprika, cumin, and vegetable stock to some of the onion and garlic mix (above).
Combine rice wine vinegar, sliced red onions, and lime juice. Let it sit to marinate. Sear pineapple in a hot non-stick pan.
Dry saute mushrooms. Don’t crowd them in the pan. Add a bit of vegetable stock and let it quickly boil off. Cut the seared pineapple. Cut some slices of tomato and avocado.
Assemble tacos by placing mushroom mix on a warmed corn tortilla, top with cream sauce and slices of tomato. On another tortilla place lentils, pineapple, red onions, and cilantro.
Sunomono wild rice salad: Start with wild rice cooked with vegetable stock. Add, sesame seeds, finely chopped scallions, rice wine vinegar, mirin (Japanese rice wine), stir. Stir in quartered, sliced cucumbers.
Cashew Cream Sauce: Sweat onions in a dry hot pan. Don’t let them color. Add soaked cashews, garlic, and nutritional yeast. Blend in blender. Add lime zest. Add spinach and lime juice, a little bit of soup stock, and a little rice wine vinegar. (Without the spinach it can be fermented at room temperature for three days to taste like sour cream.) Blend. You can thicken it up with cooking if desired.
No Oil Roasting technique: Cube sweet potatoes and coat them with spices. Roast in a 375 degree oven for 15 minutes.
The finished version of The Game Changers movie was screened for the first time. This movie is due out in January 2019. Executive Producers include Pamela Anderson and James Cameron. This documentary chronicles the achievements of extreme athletes on a plant-based diet including runners, weightlifters, fighters, and football players. The movie is awesome. I believe this movie will have a major impact not only for top athletes but for young people of all kinds. The documentary movie from released in 2011, Forks Over Knives had a huge impact, primarily on older people suffering from diseases. Many young people ignored it. I think that the movie The Game Changers will have a similar impact for young people that Forks Over Knives had for older people. Come January, please encourage everyone you care about to see this film.
Nutritional Research, Reductionism and PBN, A Recipe for Confusion T. Colin Campbell, PhD
Colin Campbell was one of the authors of a 1982 a scientific panel that published a report on the relationship between diet and cancer. It recommended eating more vegetables, fruits, whole grains, reducing total dietary fat from 35% to 30%, and supplements were not advocated. One chapter was written questioning protein, but that chapter was deleted before it was published. Industry responded by denouncing the report. Prior to the report, Campbell had been voted to become the president of the American Institute of Nutrition. After the report, the vote was reversed. Then the Institute tried to get Campbell expelled. In 1985 he was accused of financial fraud. Approval was reversed for NIH funding of $7M for follow up research in China.
Historical documents show that starting from the 1700s, some medical researchers began to understand the relationship between animal foods and cancer and that cancer was a problem with the whole body and local surgery wouldn’t be an effective solution. By the mid 1800s, surgeons began to control the dialog and promoting surgery for dealing with cancer. In 1882 they began treating breast cancer with radical mastectomy, removing not only the tumor but the entire breast and the muscles surrounding it. And then doctors began also promoting lead for chemotherapy.
Well known doctor and researcher Frederick Hoffmann published a book in 1937 that included “most authorities agreed that excessive nutrition if not the chief cause of cancer is at least a contributory factor of the first importance.” Even though he founded the American Cancer Society, he was thrown out after publishing this book.
Another researcher was kicked out of the American Association of Cancer Research for stating nutrition was related to cancer.
There has been a century long discussion on the cause and treatment of cancer: theories local vs. whole body
Big institutions control the conversations. If you want funding from them, you better adhere to their way of thinking.
A 1991 study on dietary animal protein and early cancer found that with 5% of protein consumption that cancer doesn’t grow. But with 20% of calories as protein, diet turns on cancer growth, even if consumption is increased to 20% a long time after the carcinogen exposure ended.
Studies have found correlations between animal protein and breast cancer deaths, breast cancer incidence, colon cancer incidence, renal cancer incidence, prostate cancer mortality.
Research has shown that a whole food plant based diet prevents or cures dozens of major diseases.
A study of beta carotene among smokers found that if delivered in food, it substantially decreased incidence of lung cancer, but if delivered by supplement, it increased incidence of lung cancer. The whole food is important.
Doctors can’t be reimbursed for nutrition training of patients, but nutrition is the most important aspect of health.
Traditional medical practice assumes each disease has one cause, one mechanism, one drug treatment (foreign chemical with side effects). Despite its critical importance, nutrition is not a medical specialty and has no dedicated Institute of Nutrition at NIH.
Our bodies have natural killer (NK) cells which attack cancer cells in our bodies. Consuming animal protein diminishes the capability of NK cells.
The science of nutrition is infinitely complex. The implementation is simple: avoid animal-based protein and consume whole plant foods.
We can save 80% of our health care costs if everyone ate a whole food plant based diet.
Developing a New Algorithm that Includes Whole-Food, Plant-Based intervention in the Treatment of Cardiovascular Disease Columbus Batiste, MD, FACC, FSCAI
More people die in America from heart disease in one year than all the wars of the last century.
64% of all women who die of heart disease have no prior symptoms.
Cardiovascular disease (CVD) costs the U.S. over $500 billion per year.
When the endothelium (inside wall of the arteries) is damaged, 20 different diseases result.
Most heart attacks happen with stenosis of less than 50%. These cannot be detected and so the myocardial infarction (MI) (heart attack) cannot be predicted.
Research shows that common heart medications don’t work. Beta blockers don’t increase survival. Statin therapies increase the risk of diabetes and other diseases. Percutaneous coronary intervention (PCI or stents) and CABG (bypass surgeries) fail to demonstrate superiority to other medical therapies. In the BARI 2D and COURAGE trials, PCI did not reduce the risk of death, myocardial infarction or other major cardiovascular events.
A study published in the Archives of Internal Medicine in 2012 concluded that stents don’t help. The ORBITA trial found that the exercise time that a patient could perform was the same after a stent emplacement as for a placebo procedure.
PCI reduces angina but doesn’t decrease the risk of long term death due to heart disease.
Delaying stents or bypass surgery is not associated with worse outcomes.
Effects of intensive lifestyle changes: decreased inflammation, artery walls less damaged.
One meal can affect the blood composition, the artery function and the heart function.
Multiple studies show a plant based diet reduces blood pressure, cholesterol, glucose, and weight.
Dr. Batiste began instituting changes to his practice, adding nutrition education for patients. One
patient had angina so bad he couldn't walk 100 feet without stopping to rest twice. The doctor recommended a plant based diet. Patient reported that in two weeks, his pain went away, in 6 weeks he was golfing and in two years his only complaint was plantar fasciitis because of all his activities.
Emerging Research Concepts for the Treatment of Multiple Sclerosis: Microbiome and Whole-Food solutions Saray Stancic, MD
She started in infectious diseases, but changed to lifestyle medicine. As a young doctor she was diagnosed with multiple sclerosis (MS). She began a large number of medications which had major negative side effects. She was prescribed a number of other drugs to combat the side effects of the first set of drugs. She happened upon a study linking blueberries to MS patients feeling better so she began researching the literature on the relationship between diet and MS. The 1952 Roy Swank study found a low fat diet showed a significant improvement with MS patients. Another Canadian 1998 study found consumption of animal fat associated with an increase in MS and consumption of vegetable protein and dietary fiber associated with a decrease in MS.
Studies show that coronary heart disease (CHD) is correlated with MS, not a surprise because the same animal foods consumption is correlated with both.
With studies in hand, she talked with her doctor who told her that MS wasn’t affected by diet, but by genes. However, studies with identical twins show that MS is not solely determined by genes.
She decided to discontinue medications and adopted a WFPB diet. Gradually her condition improved, eventually was able to leave the cane behind. Her brother suggested she run a marathon. She began to run. It didn’t go well at first. Eventually she did run and finish a marathon.
Only 1 in 4 medical schools provide the minimum of nutrition classes, which are minimal.
Documentary movie coming in Jan 2019 called Code Blue.
In 1960s, the surgeon general issued a report about the dangers of smoking. But it wasn’t until 1998 until hospitals banned smoking. This was the tipping point for making smoking uncool.
The hope is that we can start a major change in health through spreading a plant-based diet.
Medication Management for Patients Eating a Plant-Based Diet John Kelly, MD, MPH
Every cell has the complete code for all types of tissues in our body. Fortunately, the vast majority of the genes in every cell are turned off. Epigenetics is the study of the mechanisms for turning on and off genes within a cell. This is called gene expression. Our diet is the strongest determinant of epigenetics. So what you put in your mouth switches your genes off and on. Genetic studies of DNA sequence without epigenome cannot make sense of genetic risk.
A study by Dean Ornish published in PNAS in 2008 looked at gene expression of 30 men with prostate cancer at baseline and after eating a low-fat plant based diet for 90 days. The study found that in that time period, 450 plus genes turned down or off and 50 genes turned up or on.
Medication generally work by inhibiting natural body functions. Food generally works by enabling or empowering normal physiologic mechanisms.
Physicians should recommend a plant-based diet to all their patients, especially those with high blood pressure, diabetes, cardiovascular disease, and other food-related diseases.
Plant foods support and aid normal physiologic function to promote health including improved cognitive function and healthier biome. Plant diet is superior to medicine.
Practical Principles
- Hold all medication subject to overdosing with plant diet and lifestyle change when starting a WFPD including antiglycemic medications and beta blockers
- Consider holding or decreasing medication interfering with improved fitness (statins, beta blockers)
- Monitor blood pressure twice a day and glucose 5 times a day
- Use maximum lifestyle change as tolerated by the individual patient
Disease specific Medication Management
- Type 2 diabetes: fasting, steamed leafy greens and high-water veggies to control glucose
- Type 1 diabetes: usually has insulin resistance as well. Use Type 2 techniques in addition to insulin
- High cholesterol: get a fasting lipid profile, hold statins and add exercise to build fitness, may resume statins as needed after intensive phase
- Hypertension: trial of sodium-free potassium salt substitute, exercise, stress management, relaxation techniques hold beta blockers, monitor BP daily and adjust accordingly
Usually after 15 days on a plant-based diet, cholesterol drops 15-20%, sugar drops 20-30%, blood pressure drops 15-20%, CRP 30 to 50%, depression drops 69%, quality of life increases 76%.
Nutritional Endocrinology: Achieving Balance and Optimizing Function Through Targeted Dietary Strategies Dr. Ritamarie Loscalzo, MS, DC, CCN, DACBN
This doctor at one time had major headaches and brain fog. She thought she had an ulcer, but didn’t. She tried fasting which helped temporarily. Then she found a book on fasting that suggested a plant-based diet after fasting. It changed her life, leading to long term health.
Western medicine is awesome for trauma care, but is terrible for chronic diseases.
When the food is correct, medicine is of no need; when the food is incorrect, medicine is of no use.
Testing postprandial (after a meal) blood sugar can surge too high resulting in too high insulin levels which stiffens the artery walls which contributes to long-term cardiovascular disease.
The endocrine system is the one body system that can make or break the health of the entire body. This doctor founded the Nutritional Endocrine Institute.
Hormones control many systems throughout the body, and hormones are controlled in large part by foods, but also herbs and supplements, stress, environment, digestion, sleep, exercise and other hormones.
Foods that disrupt hormones: packing materials, oils and butter, coffee, alcohol, beef, chicken, fish, (for some people gluten), pesticides
Foods that support hormones: cruciferous vegetables, colored vegetables, organic foods, GMO free foods, and a balance of water and macronutrients (carbohydrates, fats, proteins):
We need an Omega 3 and 6 balance. Plant-based sources of omega-3 include flax, chia, hemp, walnuts, purslane, and algae.
Hormone balancing foods: mushrooms, seeds, turmeric, black cumin oil and seed, (use for thyroid repairs and Hashimotos), fermented foods, leafy greens and sprouts, brassicas, ginger, kelp, coconut, walnuts, and blueberries.
Hormone imbalances need to be addressed in this order: digestive, blood sugar, adrenal, thyroid, and sex hormones.
Insulin Resistance: Understanding the Role of Diet in Treating and Reversing Type 2 Diabetes Wes Youngberg, DrPH, MPH, CNS, FACLM
Doctors need to learn how to aggressively reduce their patients medications to be effective with transitioning them to a plant-based diet.
James Anderson published studies starting in the 1970’s that type 2 diabetes could be reversed by diet. But there are still many medical experts and establishments that claim that type 2 diabetes is not reversible.
Experts Dean Ornish, Joel Fuhrman, and John McDougall say type 2 diabetes is completely reversible.
Still the establishment doesn’t get it. For example, in Diabetes Care Volume 37: Incidence of Remission in Adults with Type 2 Diabetes. “Remission can occur, but is rare.” Don’t you believe it.
You have to be the chairman of the board of your own health. Your family can’t do it, your doctors can’t do it. You have to do it.
Studies show that taking diabetes medications decrease life span.
Diabetes progresses faster than traditional tests would indicate. 60% of the insulin producing cells are non-functional by the time you are diagnosed with prediabetes. To help people understand their risk better, categories have been defined lower than prediabetes. Optimal fasting blood sugar is in the range 70-84, and optimal HgA1C is in the range 4.7-4.9.
In addition to eating a plant based diet, it is recommended to walk 30 minutes after a meal. For diabetic patients, it often lowers blood sugar by 90 points or more.
Patients should check their blood sugar after meals before changing anything. Then after making a change, if they have a large number, but smaller than before, it will seem good, not bad.
Someone with diabetes or other serious illnesses should eat only intact whole grains, not processed grains (e.g. brown rice, not white rice).
On a plant-based diet, some patients show increased insulin production - that is, their pancreas function increased.
Panel Discussion: How Plant-Based Nutrition Optimizes the Physiology of World Class Athletes Scott Stoll, MD, Dotsie Bausch, James Loomis, Jr., MD, MBA, James Wilks
Question: Did a plant-based diet allow faster recovery? Wilks: Not only did he personally recover quicker, but 35 athletes that he interviewed for his upcoming movie said that they saw that they recovered faster. Bausch: Yes. She was able to recover faster than her Olympic team mates. Loomis: Exercise generates oxidative stress. The antioxidants in plant foods allows a faster recovery from a greater stress. Also, the recovery is more full so that the micro tears don’t accumulate so the chances of a major injury such as hamstring pull happen less often. Exercise promotes capillary growth. A plant based diet enhances that effect. Stoll: Muscle and tendon injuries heal faster in the bobsled athletes that he works with as a team physician.
Question: What is the motivation for players adopting a plant-based diet? Wilks: It's a mix of concern for animals or the planet, but most are primarily concerned with maximizing their performance. One boxing champion didn’t want to give an interview for the movie on his eating a plant-based diet because he didn’t want to give up his edge over competitors. Unfortunately some highly paid NFL players have a clause in their contract that they can’t give up meat. Loomis: Players act on bro-science. That is, they do what their fellow athletes do, even if there is no solid science behind it. They tend to follow the practices of the athletes that are their role models. Wilks: The film is trying to counter the idea that to be a man you have to eat a lot of meat. The strongest animals on this planet (e.g. gorillas, elephants) don’t eat meat. Bausch: Trainers are trying their best but are deluged with misleading “science” from industry. Loomis: Nutritional reductionism is as big a problem with trainers as with the general public. They concern themselves with the relative performance of different isolated protein supplements instead of considering food as a whole. Wilks: You have to showcase role models for young men. Science information about diet sometimes backfires. Loomis: We are evolved to exercise, recover, and repeat.
Question: Did you have to eat more and specific foods on a plant diet to meet the caloric needs of an extreme athlete? Bausch: It is not really a problem to get 8,000 calories per day. She likes to eat. During heavy training, she made shakes because she got tired of chewing all her calories. Wilks: There can be gastro intestinal discomfort if people switch instantaneously. Some work through that but others move to it gradually. Loomis: Use a food log to prove to athletes that they won’t be protein deficient.
Question: What about supplements? Wilks: Many pro athletes are reducing or eliminating supplements after switching to a plant-based diet, but some still take things like creatine, despite long term kidney problems. Some still take protein powders, some don’t. Bausch: A benefit of eating plant-based eating is that it is so new that you have to examine where you are getting your nutrients. When you do, you realize you don’t need supplements. So Bausch only takes a little B12, and no other supplements. Wilkes: People think that they can take supplements just in case they need them and that there are no down sides to taking them. They are so wrong, as many supplements cause harm. Loomis: Many supplements aren’t what they say they are and may have contaminants including ones that can get an athlete to fail their drug tests. Creatine can produce perhaps a 10% increase of strength, but it is so dangerous that it should be taken only during the off season and under doctor supervision. Often athletes take a collection of supplements each of which may be harmless by themselves, but together cause problems. For many reasons, Loomis is not in favor of supplements.
Question: What about carb loading? Bausch: Before a 100 mile race she would begin eating more carbs 24 hours ahead of the race. Due to pre-race nerves, she had to be careful about what to eat ahead of the race. A couple of hours before and between events she would eat some glycogen. Loomis: A plant-based diet is already 80% complex carbs, so you are already carbo loading. You need to be careful with the high glycemic index supplements because they hit quickly, but can lead to sugar crash quickly.
Question: Do you need to eat only a 100% whole plant foods? Wilks: That would be best, but converting to highly processed meat-based alternatives shows a big benefit over eating meat.
Question: What about supplements just before a workout? Loomis: Be careful with caffeine and ephedra based stimulants. They can lead to sudden death.
Question: In Wilks movie, Game Changers, was the part about erection decreases after eating a meat-based meal scientific? Wilks: In the movie it was a small demonstration with three participants, but they had much larger group of people with the same results and larger studies are being done.
Question: Do plant based foods supply sufficiently complete proteins? Wilks: (Really long and very technical response which can be summarized as) Yes.
How Not To Die: Scientific Strategies for Maximum Disease Prevention Michael Greger, MD
Dr. Greger upcoming book, “How Not to Diet”, will be released in December 2019.
His grandma had multiple bypasses and was sent home to die. Instead she went to Pritikin, changed her diet and lived another 31 years.
Dr. Gregor reads all the English language medical journals and summarizes important results on his web site www.nutritionfacts.com.
By age 10, American children have fatty streaks in their arteries. It gets worse every year. So for the majority of Americans, it's not about preventing heart disease, it’s about reversing the heart disease they already have.
The body will heal itself if we don’t keep injuring our arteries three times a day.
One drug for treating angina results in lengthening exercise times by 33 seconds. People fixing their angina by eating plants often are soon able to climb mountains.
Since the 1930s, doctors have helped patients reverse type 2 diabetes by switching to a plant-based diet. Research shows in some patients who were diabetics for 20 years and on insulin shots, diabetes was reversed in 16 days.
In this country 75% of people over 60 years old have high blood pressure. Other societies with primarily plant-based eaters find that blood pressure goes down slightly with age.
Interventional studies show blood pressure lowers within a few days of adopting a plant-based diet, even after dropping their blood pressure lowering medications.
A major study stated that most deaths in America could be prevented by nutrition.
The consensus that smoking caused lung cancer required 7000 studies showing the connection. The tobacco industry slowed that general realization through advertising. At this point there is a large amount of science showing the connection between eating animal products and heart disease, diabetes, cancer and more, but like smoking, we are slow in recognizing it.
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Announcement: There is a new conference in Australia for nutrition in healthcare: doctorsfornutrition.org
The Future of Food: Research Insights Into the Culture and Language of Food and Health Richard Essigs
From a business perspective, we consider trends, forces, and responses.
By 2050 worldwide there will be a 34% growth in population. The worldwide growth will represent an increase in people equal in size to 7 times the current U.S. population. 4.8 billion people will be middle class by 2030. Cities will gain 1.1 billion in population. By 2030, 68% of the population will live in cities. By then there will be 43 megacities with population over 10 million. This population growth translates into a 60% increase in demand for food globally by 2050, which will require 19% more water. By 2050, the U.S. population over 65 will increase by 69%. 11% of the U.S. population age 18-64 lives with at least one disability. 35% of the people over 65 years old has at least one disability.
Age dependency is a metric that captures how many older people have to be supported by working people. The age dependency is defined as how many people aged 65 or older divided by the number of working people (ages 18-64). Now the metric is 21%. By 2050 the metric is predicted to be 36%. Each worker will have a significantly higher burden. Healthcare expenditures as a percentage of GDP are predicted to increase 20% by 2025.
Paradigm shifts will happen including consumers knowing more about their food and its effects on their bodies. In the future, consumers will maximize health with minimal effort.
A Team Based Approach to Lifestyle Intervention Rajiv Misquitta, MD, FACP
Kaiser is the largest medical organization in the world with over 10,000 doctors. Dr. Misquitta is at Kaiser Sacramento. At age 40, he had a heart attack and got a stent. After recovery, he adopted an American Heart Association diet. After a few months, he developed further heart problems and had bypass surgery. Afterwards he discovered a plant-based diet. In addition to adopting it for himself, he is now trying to figure out how to get more patients to adopt it.
Getting people to change their behaviors can be challenging. It can take many months to years. Studies have found that only 5 to 10% of weight loss programs maintain for a year. Studies show that some plant-based programs have much higher success rates.
Kaiser Sacramento designed a program to implement this change. It involves not only patient education, but also follow up for a year. Cost avoidance is a business justification for paying for the program. It started with one disease and patient group and after years of success expanded it to more diseases and patient groups. They have an engagement rate of 85% at the end of the program and 50% after a year.
They found that the weight loss of patients supported by spouse or friend was much higher than those without.
They found it more effective to video grocery store visits and play them back than to take patients in a group to the store.
At six months, their patients averaged 16 lb weight loss, 2” waist circumference reduction, and A1C reduction of 0.6 points.
Panel Discussion: Everyday Ideas for Your Practice Scott Stoll, MD, Danielle Belardo, MD, Andy Bellatti, MS, RD, Michael Klaper, MD, Laurie Marbas, MD, MBA
How to deal with a suffering IBS patient whose doctor tells them not to eat vegetables? Klaper: Respectfully tell them they are not getting good advice. Others: Start with grains, cooked vegetables, smoothies. Point out that their advice isn’t doing well so far. Klaper: Don’t believe Dr. Gundry who is telling people not to eat beans because of leptins. Leptins are cooked out. Beans are very healthy.
What about obese, ethnic, and poor patients? All: Don’t shame patients. Instead focus on other metrics. There are plant-based stars of all ethnicities. Refer patients to one they will identify with. A plant based diet can be affordable. Beans and rice are inexpensive.
Can a plant-based diet cure bladder cancer? Examples have been seen of bladder cancer reversal. It might not happen in all cases, but certainly the patient should immediately remove the cause of their cancer which was the animal products.
Should we keep plant-based patients on medications? Klaper: As people lose weight, the fat goes into the arteries so temporarily their LDL will go up. This doesn’t indicate the person is less healthy. Marbas: If a patient no longer has diabetes, the doctor must go to great lengths to remove the diabetes diagnosis from someone who has cured themselves.
What about when people change to a plant-based diet have their HDL go down? Is this a problem? Klaper: HDL has been considered the garbage truck that transports garbage to the liver. With a plant-based diet, you have less garbage in your arteries so lower HDL is fine.
What about a high-fat plant-based ketosis diet? Klaper: A short spell of ketosis every once in a while could be OK, but it is stressful diet. Don’t do it on a continual basis. Marbas: If you want to temporarily put your body into ketosis, do a short term water fast. You will get ketosis without the harm of fatty foods.
Do renal failure patients need animal products to avoid too high of potassium in plant foods? Klaper: No. Find low potassium foods.
Can vegans have weak bones? Bellatti: Eat plant foods with vitamin K, manganese, and other nutrients necessary for strong bones. You can’t get these from dairy. Klaper: Weak bones are not a disease of nutrition; it is a disease of lack of exercise. For small, older, women, consider buying a weighted vest. Marbas: Exercise should be ones that stress bones such as jogging. Cycling may not have the same benefit.
What about Atkins diets? Belatti: There are many unhealthy diets that lead to weight loss. A plant food diet lowers weight while improving health and associated markers.
What single study is most compelling? Belardo: JACC july 2017 plant based diet
What about coffees and teas? These were served at the conference. Belardo: For a small number of patients it can produce arrhythmias.
Do pharmacists have a role? Klaper: Yes. Pharmacist Dustin Rudolph wrote the book The Empty Medicine Cabinet to help pharmacists explain to patients how to avoid medications by adopting a plant-based diet.
What about people who shouldn’t lose weight? Belatti: Liquid calories. Klaper: Smoothies, soups, even blended salads.
What about gestational diabetes? Klaper: Have the pregnant ladies get rid of the animal products and oils. Make sure they have plenty of starches. They and the babies will do fine.
Why do we need B12 supplement now, while we didn’t in the past? Klaper: We used to get it from bacteria in the earth and water. Now with greater sanitation, we don’t get it. So on a whole food diet, take a B12 supplement. Belatti: Don’t take B12 from chlorella, as it is a B12 analog and actually blocks uptake of real B12.
The conference was organized by The Plantrician Project (https://plantricianproject.org) to spread knowledge to the medical community of reversing chronic disease through improved diet. The first one, five years ago, had 220 attendees, mostly medical professionals. The conference has grown every year with this year having over 1,000 attendees. The Plantrician Project announced their new Pediatric Plant-Based Nutrition Quick Start Guide that contains facts and recommendations for children’s nutrition. This guide joins their earlier Plant-Based Nutrition Quick Start Guide. These guides can be found here: https://plantricianproject.org/quickstartguide
For those interested in accessing research papers, you can find more than 700, sorted by topic, here: https://plantbasedresearch.org/
Next year this conference will be held in Oakland, CA on Sept. 22 - 25. Doctors, mark your calendars. Patients, encourage your doctor to attend. Keep checking back with their web site: www.pbnhc.com
Clinton Now Eats Healthy
Renee Cures Herself
Eric Reverses His Heart Disease
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