THE SCIENCE OF HEALTHY NUTRITION OR FOOD …...•Paleo, Ketogenic, Mediterranean, DASH •Mistakes...
Transcript of THE SCIENCE OF HEALTHY NUTRITION OR FOOD …...•Paleo, Ketogenic, Mediterranean, DASH •Mistakes...
THE SCIENCE OF HEALTHY NUTRITION OR FOOD
AS MEDICINE
CHARLIE ROSS DO
LIFESTYLE MEDICINE
EMAIL [email protected]
2018
DISCLOSURE STATEMENT
• I have no financial interest from any issue discussed in this session
Testimonials
VACATION…..
LET ME SHARE MY STORY
• I did not want to do this….
AMA RESOLUTION FOR ALL US HOSPITALS….
• AMA Passes Resolution: Hospitals Should Provide Plant-Based Meals and Remove
Cancer-Causing Processed Meats
• WASHINGTON—The American Medical Association’s House of Delegates has adopted
a resolution calling on hospitals to provide plant-based meals and remove processed
meats from menus.
• “RESOLVED, That our American Medical Association hereby call on US hospitals to
improve the health of patients, staff, and visitors by (1) providing a variety of healthful
food, including plant-based meals and meals that are low in fat, sodium, and added
sugars, (2) eliminating processed meats from menus, and (3) providing and promoting
healthful beverages.”
• The resolution was co-sponsored by the Medical Society of the District of Columbia and
the American College of Cardiology.
• June 21, 2017
2015 USDA DIETARY GUIDELINES ADVISORY COMMITTEEAMERICAN DIABETES ASSOCIATION 2018, PROPOSED CANADA FOOD GUIDE 2018, AMERICAN INSTITUTE FOR
CANCER RESEARCH, AND THE DIETARY GUIDELINES OF SWEDEN, BRAZIL, GERMANY, QATAR, NETHERLANDS,
DENMARK, FINLAND, ICELAND, NORWAY, & SWEDEN—ALL RECOMMEND A MORE PLANT-BASED DIET FOR HUMAN
HEALTH AND FOR ENVIRONMENTAL SUSTAINABILITY.
VIDEO LAST 10 YEARS
WHAT IS YOUR GOAL?
LIFESTYLE MEDICINE—THE ROOT CAUSES OF DISEASE
• What we eat
• How we move
• The chemicals we choose
• How we deal with stress
WHO DO YOU TRUST?
• Are you confused?
• One month fish oil capsules are great for your health…months later capsules increase
cancer rates…. And what about supplements? Coconut oil?
• Paleo, Ketogenic, Mediterranean, DASH
• Mistakes have been made in the past
• Mastectomy vs lumpectomy 30 years
• Tomato effect
• Medical journal support
• Follow the money…. DVD “What the Health”
• Nutritionfacts.org Greger
GREGER VIDEOS ON NUTRITIONFACTS.ORG SITE
WHAT DOES THE SCIENCE SHOW?
www.nutritionfacts.org (Greger videos on philosophy and behind the scenes)
www.pcrm.org
ucdintegrativemedicine.com
• What is the problem?
• Why did this happen?
• What is the solution?
• What are the barriers to achieving health?
THE PROBLEM
OBESITY TRENDS* AMONG U.S. ADULTSBRFSS, 1985
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
OBESITY TRENDS* AMONG U.S. ADULTSBRFSS, 1995
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
OBESITY TRENDS* AMONG U.S. ADULTSBRFSS, 2005
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
OBESITY TRENDS* AMONG U.S. ADULTSBRFSS, 2010
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
CHRONIC DISEASES
• Obesity 2/3 of adults are overweight, 1/3 are obese Children (from CDC
2015)—no state had prevalence of obesity less than 20% South (31.2%) Midwest
(30.7%) Northeast (26.4%) West (25.2%)
• Diabetes 1 out of 4 adults over the age of 65 Born after 2000 1 in 3 First
generation where children will live shorter life than parents
• Hypertension
• Cost #1 (#24-40 worldwide)
• 106,000 prescription drug deaths/year
• Of 17 high-income countries studied by the National Institutes of Health in 2013, the
United States was at or near the bottom in infant mortality, heart and lung disease,
sexually transmitted infections, adolescent pregnancies, injuries, homicides, and rates
of disability. Together, such issues place the U.S. at the bottom of the list for life
expectancy. On average, a U.S. male can be expected to live almost four fewer
years than those in the top-ranked country.
• "U.S. Health in International Perspective: Shorter Lives, Poorer Health" (2013)
National Institutes of Health Committee on Population, Board on Population Health
and Public Health Practice
SAD• STANDARD AMERICAN DOCTOR
• STANDARD AMERICAN DIET
• Side effects
WHY?
• Food--Our food sources have been altered Processing side effects?
• How we move—convenience, transportation, TV/computer screen time
• Chemicals—Smoking, alcohol, others
• Stress in our lives—Is stress increasing in our world?
• Heart attack café video
OUR CHANGING FOODS & LIFESTYLE
1900 2010
Sugar 5 lbs/yr 77-100 lbs/yr
Oils/Fats 4 lbs/yr 74 lbs/yr
Cheese 2 lbs/yr 30 lbs/yr
Fruits/Vegetables 131 lbs/yr 11 lbs/yr
Calories 2100 2757
Nutrient Density Decreased 40-60%
Soft Drinks 0 53 gal/yr
TV 0 4 hours/day
Fiber ? 14 g/day
Sources: USDA, food review:
major food trends a century in
review 2000
Nutrient Composition of plant and animal based foods per 500 cal of energy
Plant Based Foods* Animal Based Foods**
Cholesterol (mg) ------- 137
Fat (g) 4 36
Protein (g) 33 34
Beta-carotene (mcg) 29,919 17
Dietary fiber (g) 31 --------
Vitamin C (mg) 293 4
Folate (mcg) 1168 19
Vitamin E (mg) 11 0.5
Iron (mg) 20 2
Magnesium (mg) 548 51
Calcium (mg) 545 252
*equal parts of tomatoes, spinach
**equal parts of beef, pork,
lima beans, peas, potatoes
chicken, whole milk
SO WHAT IS THE REAL DEFICIENCY IN SAD?
THE SOLUTION….
• 7-8 out of 10 people with chronic illness might not have to suffer from these diseases
should they choose to make different lifestyle choices.
• Heart disease and ED
• Diabetes Mellitus
• Kidney disease
• Obesity
• Cancer
• Autoimmune diseases and chronic pain
• GI issues—constipation, diverticulosis and diverticulitis
Slide credit: Dr. Ellis, Culinary Medicine CME 2014
GREGER VIDEO FINLAND STUDY
• Dietary Guidelines: From Dairies to Berries
GREGER VIDEO
• Thousands of vegans studied
TEXAS TOWN VIDEO
INSANITY-----DOING THE SAME THING OVER AND OVER AGAIN AND EXPECTING DIFFERENT RESULTS.
ALBERT EINSTEIN, (ATTRIBUTED)
IT IS TIME FOR CHANGE…..
FUHRMAN TED TALK
WHY CHANGE WHAT YOU ARE EATING?
• My path Myths
• Esselstyn Prevent and Reverse Heart Disease
• Ornish Prevent and Reverse Heart Disease/Prostate Cancer
• Barnard Reverse Diabetes www.pcrm.org
• Campbell Stop Promoting Cancer
• Greger nutritionfacts.org
DOES IT REALLY MATTER WHAT YOU EAT? WHAT DOES THE SCIENCE SHOW?
• Genes and genetic makeup
• China study—disease incidence diet and genetics
• Campbell Cancer
• Prevent your body from rusting—free radicals and antioxidants
• TMAO story
• Nitric oxide fat arterial walls “moderation kills”
• Advanced glycation end products (AGEs), Heavy metals, free radicals, petrochemicals, Phthalates, Bisphenol-A
(BPA), Potassium Bromate, Sodium phosphate (found in fast foods and processed foods)
• Healthier foods lead to improved mood, better academic performance, and less crime
VIDEO CARNITINE, CHOLINE….AND TMAO
VIDEO NUMBER 1 KILLER
VIDEO PALEOPOO
• Why I am whole food plant based (plant strong, plant perfect)
• For my health
• For the world—air, land, water, fish depletion 90%, fish contamination UN 2010
(slide)
• For the animals---concentration camps (slide)
FOR THE WORLD
• Resources used
Water. 1 lb of beef. 2500-5000 gal water or 3-6 months of showers
Air pollution --methane worse than CO emission...global warming
Ocean pollution. Dead zones from fertilizers
Land use--kick the poor off land to convert to grazing Amazon destruction
• Since 1960 90% of fish stores have been depleted…and the remaining are
polluted
• United Nations 2010
A global shift towards a vegan diet is vital to save the world from hunger, fuel
poverty and the worst impacts of climate change, a UN report said today
ENVIRONMENTAL VIDEOS
• How Much Water for a steak?
• Black Beans vs
• You Cannot be …
FOR THE ANIMALS
• Concentration camps have replaced family farms
• World Peace Diet Will Tuttle
ROSEBURG EXPERIENCE WITH LIFESTYLE MEDICINE
• Free Wednesday Community Nutrition Education Classes
• CHIP (complete health improvement program)—nutrition, exercise, chemicals,
stress management
• What is CHIP?
• Who benefits
• Testimonials
• UHA flexible funds and OHP participants
• CHI Mercy lab support for CHIP
UC VEG VIDEO OF ROSEBURG CLASS SUCCESS
SO WHAT CAN YOU DO?
• 21 day Kick Start www.pcrm.org
• Nutritionfacts.org “Uprooting the Leading Causes of Death”
• The Mayo Clinic Guide to Stress Free Living by Amit Sood MD
Change Your Lifestyle…..!
BARRIERS TO ACHIEVING HEALTH
PLANK CHALLENGE BUSTING MYTHS
MYTHS
Protein
Milk does a body good
Genes
Animal products are needed for good health
It costs more to eat healthy
Calcium supplements are good
• FACTS
• 8-10% RDA
• Highest rates of osteoporosis in countries with highest cow
milk intake
• China Study—turn genes on and off with food
• Vegans live 14-15 years longer than meat eaters (Finland
study)
• $4-8/day to eat healthy
• Increased risk of heart attack and stroke
RIP ESSELSTYN TED TALK
CHANGING BEHAVIOR
• Habits are difficult to change…but can be accomplished
• Education
• Modeling others
• Group support (CHIP and the Roseburg experience)
• Barriers to Change
• Cultural Influences
• We are bombarded with messages (food pornography)
• Family and Friend Ridicule
• Eating out is not easy
CHANGING THE WAY THAT MEDICINE IS PRACTICED
• Physician role--from pill pusher to personal coach
• Practitioner role model—”Walking the talk”
• “Walking office visits”
• Embrace Lifestyle Medicine as medicine—treat the root of the problem instead of the
symptoms
• 30 day challenge to all participants—give it a try and you might find your life changed
and the joy back in your practice….. as I have!
WHOLE FOOD PLANT BASED……..
• It is not enough to just eat vegan….junk foods do not promote health. Read
labels, avoid processed foods, stick with whole foods or very minimally
processed.
LOOKING FOR HEALTH?…….
•Eat mostly unprocessed plants
•Eat little to no animal foods
QUESTIONS?
DO YOU NEED TO DRINK COW’S MILK?
Osteoporosis
Hormones (IGF-1) and early menarche
Resistant Antibiotics
Lactase deficiency
Constipation and other GI problems
Allergy to cow’s milk
Stealing another specie’s milk (Whitewash by Keon)
WHAT ABOUT SUPPLEMENTS?
• Helpful or harmful?
• Vit B12
• Vit D
EATING VEGAN ON $4 PER DAY
• Getting enough protein
• Getting enough fiber
• Getting enough Omega 3
• Getting enough energy
• The path to health…….
PROTEIN
• Is there enough protein in plants?
• 8-10% when eating a variety of plants
• RDA (recommended daily allowance) 8% protein in diet
• Too much protein has been shown to be cancer promoting
CARBOHYDRATES
• Energy source for body
• Glycemic index
• Simple sugars (bad carb) taste sweet
• Monosaccharides (glucose, fructose, galactose) and disaccharides (sucrose, lactose, maltose)
• Absorbed rapidly—so insulin spike(leading to resistance and ultimately diabetes)
• Complex carbohydrates (good carb) taste starchy
• Found in most all plants in varying degrees.
• Absorbed less rapidly---so less insulin spike
FATS
• % in diet (Strive for 10% in whole food plant based diets) 30-50% not uncommon in USA
• 9 calories/gm…less than a thimble
• “Good fat”
• Monounsaturated (olives, nuts, seeds)
• Polyunsaturated
• Omega 3 (flax, English walnuts)
• Omega 6
• “Bad fat”
• Saturated—solid at room temperature (meat, butter, cheese, coconut)
• Trans—partially hydrogenated oils (deep fried fast food, commercially prepared bakery goods)
FIBER
• How much fiber? Currently >10-14 grams or so. Recommended 35-60gm/day
• Only plants have fiber—plants use fiber as their skeleton
• There is no fiber in animal products—animals use bones as their skeleton
• Types of fiber include (insoluble/cellulose/lignans/hemicellulose/pectins/gums/mucilages/soluble)
• Let’s talk about gas….(CHIP--war between bacteria)
• 10% decrease in colon cancer for each 10 gm fiber intake…. Low fiber leads to diverticulosis
(2/3 of adults by age 85 will develop)
• Burkett—large stools lead to small hospital, small stools lead to large hospitals
ANCIENT WISDOM
HOW TO TRANSITION????
• Food pictures folder
• What to Buy Folder