“Let Food Be Your Medicine, Your Medicine Be Your Food” - Hippocrates

@2015 J. Evans

Identify 1 research study which demonstrates

the correlation between plant-based nutrition

and heart disease

Identify one activity you could share with your

organization to encourage nurses to be heart

health

@2015 J. Evans

The speaker does not have any conflict of

interest to disclose

She is not funded by any plant based

organizations, animal right groups or farms

She does not receive any royalty from any of

the resources provided

@2015 J. Evans

If you take medication or have serious health

concerns, please discuss this change in eating with

your heath care provider

A diet change can be very powerful and impact

your medication

@2015 J. Evans

According to the Dictionary, medicine is

a compound or preparation used for the

treatment or prevention of disease, especially a

drug or drugs taken by mouth

@2015 J. Evans

Fever, chills

Headache

Faintness

Itching

Wheezing

Tightness in chest

Vomiting

Red, irritated eyes

@2015 J. Evans

Another study from Mayo Clinic- 70% of Americans took at least one drug

50% of Americans were on 2 medications

20% of Americans took 5 or more meds

Cholesterol lowering medication – 11%

Most common for children - antibiotics, anti-

asthma, vaccines

Women prescribed more then men

@2015 J. Evans

According to the dictionary, food is

A material consisting essentially of

protein, carbohydrate, and fat used in the body

of an organism to sustain growth, repair, and

vital processes and to furnish energy

@2015 J. Evans

Leading killer of death in US

Heart Disease will kill one out of 3 Americans

US contains 5% of global population but 50% of

angioplasties and bypass procedures are

performed in the world

@2015 J. Evans

High cholesterol

High Blood Pressure

Diabetes

Smoking including second hand smoke

Obesity – (20% of children over 5 are obese)

@2015 J. Evans

12.4 million people visit their MD each year for heart disease

3.7 million people go to the hospital each year for heart disease

$3.3 billion is the estimated cost of heart disease

Average hospital stay is 4.6 days

$135 million each year in CVD and stroke research –

AHA

@2015 J. Evans

Heart disease is rare where diets are low in fat and

serum cholesterol levels are below 150mmg/dL

Dr. William Castelli, former director of the

Framingham Heart Study, a 50 year study - no one in

study who maintained a cholesterol level lower than

150mh/dL had a heart attack

Esselstyn, Prevent and Reverse Heart Disease, 2007

@2015 J. Evans

Mississippi Kentucky

Alabama Michigan

Oklahoma Missouri

West Virginia Ohio

Louisiana Washington, DC

Arkansas Tennessee

@2015 J. Evans

Cost - $3 to $600 a month

Most widely prescribed in the US

22% of Americans over 45 take a statin

Crestor is 3rd top selling drug in US

Generate $16.9 Billion in US sales (2102)

@2015 J. Evans

Nausea and vomiting

Stomach pain

Kidney damage

Muscle breakdown - myopathy

Brown or dark colored urine

Memory loss, Forgetfulness, Confusion

Coma and death

Long term effects are unknown

@2015 J. Evans

https://www.drmcdougall.com/health/education/health-science/stars/stars-video/george-goff/

@2015 J. Evans

Research - A way to reverse CAD?

198 patients with cardiac disease

ate diet free of fish, meat, dairy, and added oils

81 percent improved their symptoms and experienced fewer complications

from heart disease

lost an average of 18.7 pounds

22 percent saw a complete reversal of their condition.

Esselstyn CB Jr., Gendy G, Doyle J, Golubic M, Roizen MF. A way to reverse CAD? J Fam

Pract. 2014;63:356-364b.

@2015 J. Evans

44 healthy adults on Paleo diet

Ate lean meat, fish, eggs, nuts, fruit, and vegetables

After ten weeks, LDL (“bad”) cholesterol increased by 12.5 mg/dL and total cholesterol by 10.1 mg/dL.

Triglycerides also increased slightly

The worst outcomes were seen among the subgroup that had been the healthiest before starting the diet.

The “Paleo” diet worsens cholesterol levels, according to a new study in the International Journal of Exercise Science.

@2015 J. Evans

Fiber decreases the likelihood of dying after a heart attack

4,098 heart attach victims from Nurses Health Study and Health Professionals Study

A high-fiber diet – a 35 percent reduction in death from heart disease

Fiber, especially fiber from grains, decreases systemic inflammation, lowers bad cholesterol, improves insulin sensitivity, and enhances healthy gut flora.

High-fiber foods are also high in vitamins, minerals, antioxidants, and phytochemicals -- all nutrients that are beneficial to health.

Li S, Flint A, Pai JK, et al. Dietary fiber intake and mortality among survivors of myocardial infarction: prospective cohort study. BMJ. 2014;348:2659-2671.

@2015 J. Evans

Research - Processed and unprocessed red meat consumption

and risk of heart failure: a prospective study of men

37,035 men for almost 12 years as part of the Cohort of

Swedish Men study

For each 50 gram serving of processed meat, about the size

of a regular hot dog, heart failure risk increased by 8 percent,

and the chances of dying from heart failure increased by 38

percent.

Kaluza J, Åkesson A, Wolk A. Processed and unprocessed red meat consumption and risk of

heart failure: a prospective study of men. Circ Heart Fail. Published online June 12, 2014.

@2015 J. Evans

Research - Different time trends of caloric and fat intake between statin users and

nonusers among US adults: gluttony in the time of statins?

27,886 adults

For those placed on statins, calorie intake increased 9.6 percent and fat intake

increased 14.4 percent over the course of ten years;

Those who did not take cholesterol-lowering medications had no significant changes in

calorie or fat intake.

The authors conclude that patients have adopted a false sense of security, and dietary

intake needs greater emphasis.

Sugiyama T, Tsugawa Y, Tseng C, Kobayashi Y, Shapiro MF. Different time trends of caloric and fat intake between

statin users and nonusers among US adults: gluttony in the time of statins? JAMA Intern Med. Published online April

24, 2014.

@2015 J. Evans

Researchers observed 664,159 women in the U.K. from the Algorithm

for Comorbidities, Associations, Length of Stay and Mortality (ACALM)

study.

Risk of developing breast cancer was 64 percent higher in women with

high cholesterol. This study builds upon previous research that linked

obesity to breast cancer risk.

Potluri R, Lavu D, Uppal H, Chandran S. Hyperlipididaemia as a risk factor for breast cancer?

Report presented at: Europran Society of Cardiology 2014 Frontiers in cardiovascular

Biology Meeting, July 4, 2014: Barcelona, Spain

@2015 J. Evans

Produced more than 8000 statistically significant

associations between various dietary factors and

disease

Comprised 65 counties, 130 villages and 6500 adult

and their families

Campbell, China Study 2006

@2015 J. Evans

Nutrient China US

Calories 2641 1989

Total fat 14.5 34-38

Dietary fiber 33 12

Total protein 64 91

Animal protein 0.8 10-11

Total iron 34 18

@2015 J. Evans

Campbell, China Study, 2006

In countries where people had low incidence of cardiac

disease, it increased significantly when people transitioned

to a western diet

New England Journal of Medicine – massive doses of

cholesterol-lowering drugs – no change in diet - 3 out of 4

seemed to do very well but 1 out of 4 patients in the study

experienced a new cardiac event or died within 2.5 years of

starting this treatment

@2015 J. Evans

http://nutritionfacts.org/video/cholesterol-

crystals-may-tear-though-our-artery-

lining/?utm_source=rss&utm_medium=rss&ut

m_campaign=cholesterol-crystals-may-tear-

though-our-artery-

lining&utm_source=NutritionFacts.org&utm_c

ampaign=0db56dab8d-

RSS_VIDEO_DAILY&utm_medium=email&utm_

term=0_40f9e497d1-0db56dab8d-23580281

@2015 J. Evans

There is no cholesterol in plant based diets -

cholesterol is only in animal products such as

meat, dairy, eggs, chicken and fish

High in fiber

Optimal protein

Low in fat

Low in processed or minimally processed

food – low in sugar and salt

High in micronutrients – vitamins and

minerals

@2015 J. Evans

Whole grains – 5 or more servings a day – pasta, rice, corn, tortillas, whole grain bread – ½ cup cooked, 1 cup dry, 1 slice bread, ½ pita or tortilla

Vegetables – 4 or more servings a day – especially dark green, dark yellow and orange, sweet potatoes, -½ cup cooked, 1 cup raw

@2015 J. Evans

Fruit – 3 or more servings a day – citrus, melon,

strawberries – whole fruit better than juice due to

fiber – ½ cup chopped or 1 piece

Legumes – 2 or more servings a day – beans, peas,

lentils, tofu, soymilk, chickpeas – ½ cup cooked,

3 oz tofu, 1 cup nondairy milk

@2015 J. Evans

Animal foods – all beef, chicken, pork, lamb,

fish

Dairy – milk, eggs, yogurt, cheese, ice cream

Fats

Sugar

Salt

@2015 J. Evans

Employees concerned about their health in

general

Employees wanted to lose weight

Concerned about weekly cost of another

weight loss program previously offered on

site

Wanted to encourage employees to be

healthier to reduce insurance plan costs

@2015 J. Evans

21 day plant based weight loss program

Provided

◦ menus

◦ recipes

◦ grocery lists

◦ Cooking demonstrations

@2015 J. Evans

Additional support added

A buddy system

Weekly support meetings

Lab work to demonstrate results

@2015 J. Evans

Cold cereal – with soymilk or rice milk with

peaches, berries or another fruit

Whole grain toast with jam and fruit

Oatmeal with non-dairy milk with cinnamon

and raisins

Blueberry buckwheat pancakes and meat-free

bacon

@2015 J. Evans

Cinnamon Raisin Oatmeal

Blueberry Pancakes

Hot Whole Wheat with Dates

Breakfast Scrambler

Fantastic Fruit Smoothie

Whole-Grain Bagel with Jam

Swiss Style Muesli

Slow Cooker Whole-Grain Porridge

@2015 J. Evans

Almond milk

Soy milk – regular, vanilla, chocolate

Coconut milk

Rice milk

@2015 J. Evans

Veggie burger with whole grain bun and salad

Bean burrito, fruit

Soy yogurt, fruit, vegetable soup, whole

wheat bread

Hummus wrap with whole wheat pita,

shredded carrots, cucumber, tomato

@2015 J. Evans

Black bean chili with cornbread, salad, greens

Whole grain pasta marinara with mixed

vegetables, salad

Fajitas with peppers, onions, tomatoes,

beans, broccoli

Beans and rice with salsa, corn, salad

@2015 J. Evans

Chunky Vegetable Chili

Chuck wagon Stew

Portobello Mushroom Steaks

Oven-Barbecued Tofu Steaks

Roadhouse Hash

Sweet & Sour Tempeh

Southern Beans & Greens

Mandarin Stir-Fry

Stuffed Vegetable Rolls

Zucchini & Herb Calzones

Chili Bean Macaroni

@2015 J. Evans

On the average, participants dropped 24 points in total

cholesterol with 8 participants dropping 31 points or

more including 3 who dropped 59, 49 and 42 points

respectively in 21 days

@2015 J. Evans

Lost weight 86.4%

Have more energy 72.7%

Sleep better 54.5%

Think more clearly 36.4 %

Breathe easier 31.8%

Fewer or no mood swings 31.8%

@2015 J. Evans

Cheese 48%

Fish 48%

Other dairy – ice cream, yogurt, chocolate 40%

Chicken 28%

Milk 12%

Beef 12%

Pork 8%

@2015 J. Evans

Essential for healthy blood and nerves

Found in bacteria from animals which they

get from the soil

Sources – fortified foods – soymilk and cereal

Or take a supplement – daily or weekly

@2015 J. Evans

Do not acknowledge there is a problem

Acknowledge there is a problem but not ready to change

Getting Ready To Change

Changing the Behavior

Maintaining the change

Relapse – returning to old behavior or abandoning new behavior

@2015 J. Evans

We recommended plant-based nutrition

Advocated for a nutritionally healthy work

environment

@2015 J. Evans

63% - Hospitals, State, Local and Private 7.5% - Nursing and Residential Care Facilities 5% - Office of Physicians 4.6% – Outpatient Care Centers 4% - Home Health Care Services

Other – Government, Schools, Employment Services

US Department of Health and Human Services, The US Nursing Workforce: Trends in Supply and Education, April 2013

@2015 J. Evans

Can improve the health of their food systems

Can improve the health of their patients,

staff, and visitors

Can invest in the well-being of communities

and the environment

Can educate and model for the public -

healthy eating habits and significance of

fresh, nutritious foods.

@2015 J. Evans

Foods filled with saturated fat and cholesterol

Rents based on how much food they sell so

ask hospitals to help promote and market

them

Most common – Chick-Fil-A, McDonalds,

Wendy’s, Dairy Queen

PCRM, Good Medicine, Winter, 2015

@2015 J. Evans

Take a course on plant based nutrition – McDougall

or Ecornell both online

Organize a group of colleagues that are interested

in transitioning to plant based nutrition

Talk with leadership on how they can support good

food choices and the health of nurses

@2015 J. Evans

See movies - Forks Over Knives, Cowspiracy

Read as much as you can –

China Study by T. Colin Campbell PhD and

Thomas Campbell, MD

Prevent and Reverse Heart Disease –

Dr. Caldwell Esselstyne

Starch Solution - Dr John McDougall

21day Kickstart – Dr Barnard

@2015 J. Evans

Register for free Kickstart online program at

pcrm.org – starts the beginning of each month

for 21 days

McDougall Starch Solution – free 10 day program

dr.mcdougall.com

Plan one meal a day that is plant based – don’t

skip any meals – increase it a meal every week

Select one day a week that is plant based and

each week increase it by 1 day

@2015 J. Evans

Have healthy food at meetings and

conferences

Meatless Mondays and other days of week

Collaborate with other health care providers

in the organization

Have educational meetings on regular basis –

include potluck meals

@2015 J. Evans

Decrease Sugar

Decrease sodium in processed foods

Decrease fat – less than 3 grams in

processed food

Decrease oil

@2015 J. Evans

Identify vegetarian meals you already eat

and like

Think of recipes you can change

Get cookbooks from library

Keep a food diary for a week and identify

the meals that may be challenging

@2015 J. Evans

Healthy Lunch Bunch – weekly or monthly

Bring in speakers or videos – “chocolate and cocaine

what they have in common”

Bring in caterers

Organize your own 21 day Kickstart group

Movies – Forks Over Knives

Pot luck luncheons – share recipes

Select restaurants and have fun with their menus

Have one plant based food option at each meeting

@2015 J. Evans

Go to Happy Cow website for restaurant

suggestions

Know ahead of time which restaurants have the

best plant based foods so you know where to

recommend if asked

Review the restaurant menu BEFORE you go there

if possible so you know what to order

Select foods from various groups

@2015 J. Evans

Today

Tomorrow

This month

This year

In your home

In your work

In your community

@2015 J. Evans

www.drmcdougall.com – free monthly newsletter, 5 and 10 day residential weight loss programs, current research, travel programs to Costa Rica and Hawaii, Starch Based Solution Certificate Program

www.pcrm.org – free monthly Kickstart programs,

multiple languages, newsletters, current research http://nutritionfacts.org Dr. Michael Gregor, has updated research http://www.happycow.net - list of vegan/vegetarian

restaurants throughout the US

@2015 J. Evans

The China Study, Campbell, T. Colin with Thomas M. Campbell II.

Prevent and Reverse Heart Disease - Dr. Caldwell Esselstyne

The Starch Solution, Dr. John McDougall

The Reverse Diabetes Diet: Control Your Blood Sugar and

Minimize Your Medication Within Weeks - Dr. Neal Barnard

Cancer Survivors Guide - Dr. Neal Barnard

21 Day Weight Loss Kickstart – Dr. Neal Barnard

@2015 J. Evans

Identify 1 research study which demonstrates

the correlation between plant-based nutrition

and heart disease

Identify one activity you could share with your

organization to encourage nurses to be heart

healthy

@2015 J. Evans

Joanne Evans MEd, RN, PMHCNS-BC

Executive Director

Healthy Nurses…..Healthy Communities LLC

joanneevans@verizon.net

@2015 J. Evans