1) The presentation reviewed the rising rates of chronic lifestyle-related diseases like diabetes, heart disease, and obesity in America and their associated healthcare costs.
2) It discussed how Americans are eating more processed foods, sugar, salt, fat and meat/dairy while exercising less. This has led to increasing rates of metabolic syndrome, diabetes, and cardiovascular disease.
3) The aging of the population combined with these disease trends means that healthcare spending, much of which goes towards treating chronic diseases, has risen to 17.7% of GDP. Interventions targeting lifestyle factors like diet and exercise could help curb costs.
Learn how the personal choices you make every day can radically influence your health and begin to develop a plan for health and wellbeing for decades to come.
A recent presentation on health and healthy living. Learn how you personal choices just may be the most powerful predictors of your personal health. Be empowered and inspired to achieve your best health in 2018.
Diet and Nutrition - Prevention of Chronic DiseasesGreenFacts
As a result of changes in the way we eat and live, some chronic diseases are increasingly affecting both developed and developing countries. Indeed, diet-related chronic diseases - such as obesity, diabetes, cardiovascular disease, cancer, dental disease, and osteoporosis - are the most common cause of death in the world and present a great burden for society.
How can improvements in terms of diet and physical activity help us reduce the risk of these chronic diseases?
Learn how the personal choices you make every day can radically influence your health and begin to develop a plan for health and wellbeing for decades to come.
A recent presentation on health and healthy living. Learn how you personal choices just may be the most powerful predictors of your personal health. Be empowered and inspired to achieve your best health in 2018.
Diet and Nutrition - Prevention of Chronic DiseasesGreenFacts
As a result of changes in the way we eat and live, some chronic diseases are increasingly affecting both developed and developing countries. Indeed, diet-related chronic diseases - such as obesity, diabetes, cardiovascular disease, cancer, dental disease, and osteoporosis - are the most common cause of death in the world and present a great burden for society.
How can improvements in terms of diet and physical activity help us reduce the risk of these chronic diseases?
Nutrition in Cancer Prevention and TreatmentTim Crowe
This presentation will help you to understand the influence that dietary and lifestyle factors play in the prevention and causation of cancer. It outlines the important nutritional considerations for patients undergoing treatment for cancer and reviews procedures to improve patient safety by knowing the risks and benefits of antioxidant supplementation during cancer treatment
About Children’s Cancer Recovery Foundation (CCRF)
Headquartered in Harrisburg, PA with a division in The Woodlands, TX, the Children’s Cancer Recovery Foundation supports children under 18 and their families facing the hardships of cancer. The foundation performs acts of care and kindness through the following programs: Bear-Able Gifts (largest distributor of gifts to children with cancer in the U.S.); Toxic-Free Kids (educates families on the dangers of environmental toxins); New Era Cancer Research Fund (funds research for less toxic, minimally-invasive pediatric-cancer treatments); International Aid (provides medications and supplies to clinics in developing and impoverished countries); Helping Hands Fund (provides emergency financial assistance to families); and Camp Scholarships (allows children in remission to reconnect with activities they love). With a national pediatric-hospital partner network of 215+ locations, the foundation directly helps more than 15,000 children affected by cancer and their families every year. Please visit www.ChildrensCancerRecovery.org.
Did you know that the basic, type II diabetic can eliminate their condition through proper nutrition? Did you know it only takes about 30 days to be diabetes free? Watch and learn.
How to Live Longer and Stay Healthy by Kenneth S. Bannerman, MD, FACC Simone ...Summit Health
Hear from Kenneth S. Bannerman, MD, FACC, Cardiologist and Simone Gampel, RD, CDE, General Surgeon about the importance of lifestyle over diet. Topics will include how much exercise you really need; principles of good nutrition; modifying risk factors to improve health; recognizing the warning signs of a heart attack in men and women, and what to do when someone is having a heart attack. This talk will be interactive and audience participation will be encouraged.
Hosted by with Sophie Tully BSc MSc, 10th October
This presentation addresses the role of cholesterol in CVD and the latest evidence into nutritional strategies to manage and treat high cholesterol and support healthy CVD function. Sophie covers the aetiology of CVD and why cholesterol has long been considered an important marker of CVD health and the emergence of newly identified CVD risk factors which may offer a more effective diagnostic tool. Finally she discusses new opinions on nutritional approaches to keep cholesterol levels healthy and prevent CVD events.
SHARE Webinar: Optimal Nutrition for Cancer Survivorsbkling
SHARE hosted a webinar featuring this presentation on May 8, 2013. Jessica Iannotta, Chief Clinical Officer at Meals to Heal, reviewed the current guidelines for nutrition and cancer survivorship, including highlights of cancer-fighting foods that can help to decrease risk of recurrence. She provided helpful strategies on how to implement these recommendations into your current diet and lifestyle. questions related to nutrition and cancer.
The information in this presentation is not intended to be a substitute for professional medical advice, diagnosis or treatment.
MedicYatra provides the safe & best Weight loss treatment and procedure at its affiliate & trusted hospitals & clinics in various metro cities of India, like Mumbai, Delhi, Bangalore, Chennai, Pune etc.Our Associate Board certified doctors are extensively trained and vastly experienced and have performed hundreds of such cases at our state of the art JCI accredited hospitals & Clinics. Our aim is to provide you the best of the services at the most affordable costs. Don't forget to say hi at info@medicyatra.com
This presentation discusses why weight loss is not just about calories. Hormones, Environment, Stress are just a few reasons weight management is so challenging
Nutrition in Cancer Prevention and TreatmentTim Crowe
This presentation will help you to understand the influence that dietary and lifestyle factors play in the prevention and causation of cancer. It outlines the important nutritional considerations for patients undergoing treatment for cancer and reviews procedures to improve patient safety by knowing the risks and benefits of antioxidant supplementation during cancer treatment
About Children’s Cancer Recovery Foundation (CCRF)
Headquartered in Harrisburg, PA with a division in The Woodlands, TX, the Children’s Cancer Recovery Foundation supports children under 18 and their families facing the hardships of cancer. The foundation performs acts of care and kindness through the following programs: Bear-Able Gifts (largest distributor of gifts to children with cancer in the U.S.); Toxic-Free Kids (educates families on the dangers of environmental toxins); New Era Cancer Research Fund (funds research for less toxic, minimally-invasive pediatric-cancer treatments); International Aid (provides medications and supplies to clinics in developing and impoverished countries); Helping Hands Fund (provides emergency financial assistance to families); and Camp Scholarships (allows children in remission to reconnect with activities they love). With a national pediatric-hospital partner network of 215+ locations, the foundation directly helps more than 15,000 children affected by cancer and their families every year. Please visit www.ChildrensCancerRecovery.org.
Did you know that the basic, type II diabetic can eliminate their condition through proper nutrition? Did you know it only takes about 30 days to be diabetes free? Watch and learn.
How to Live Longer and Stay Healthy by Kenneth S. Bannerman, MD, FACC Simone ...Summit Health
Hear from Kenneth S. Bannerman, MD, FACC, Cardiologist and Simone Gampel, RD, CDE, General Surgeon about the importance of lifestyle over diet. Topics will include how much exercise you really need; principles of good nutrition; modifying risk factors to improve health; recognizing the warning signs of a heart attack in men and women, and what to do when someone is having a heart attack. This talk will be interactive and audience participation will be encouraged.
Hosted by with Sophie Tully BSc MSc, 10th October
This presentation addresses the role of cholesterol in CVD and the latest evidence into nutritional strategies to manage and treat high cholesterol and support healthy CVD function. Sophie covers the aetiology of CVD and why cholesterol has long been considered an important marker of CVD health and the emergence of newly identified CVD risk factors which may offer a more effective diagnostic tool. Finally she discusses new opinions on nutritional approaches to keep cholesterol levels healthy and prevent CVD events.
SHARE Webinar: Optimal Nutrition for Cancer Survivorsbkling
SHARE hosted a webinar featuring this presentation on May 8, 2013. Jessica Iannotta, Chief Clinical Officer at Meals to Heal, reviewed the current guidelines for nutrition and cancer survivorship, including highlights of cancer-fighting foods that can help to decrease risk of recurrence. She provided helpful strategies on how to implement these recommendations into your current diet and lifestyle. questions related to nutrition and cancer.
The information in this presentation is not intended to be a substitute for professional medical advice, diagnosis or treatment.
MedicYatra provides the safe & best Weight loss treatment and procedure at its affiliate & trusted hospitals & clinics in various metro cities of India, like Mumbai, Delhi, Bangalore, Chennai, Pune etc.Our Associate Board certified doctors are extensively trained and vastly experienced and have performed hundreds of such cases at our state of the art JCI accredited hospitals & Clinics. Our aim is to provide you the best of the services at the most affordable costs. Don't forget to say hi at info@medicyatra.com
This presentation discusses why weight loss is not just about calories. Hormones, Environment, Stress are just a few reasons weight management is so challenging
20161222 recull desembre nadal a l escolaPere Vergés
Pastorets
•El passat 15 i 16 de desembre els nois i noies de cinquè, de les classes Nausica i Vilamar, van fer la representació de l’obra Els Pastorets, de Josep Maria Folch i Torres.
Inauguració del pessebre
•El passat 14 i 15 de desembre van tenir lloc els actes d’Inauguració del Pessebre de Cicle Inicial i de Cicle Mitjà i Superior.
La Festa del Tió
•El passat dimarts, 20 de desembre, vam celebrar la Festa del Tió a l’Escola amb els nens i nenes de 1r i de 2n de Primària.
Concert de Nadal
•L’última setmana de desembre van tenir lloc a l’Escola els Concerts de Nadal. Dilluns, els nens i nenes de 3r i 4t de Primària van demostrar les seves habilitats musicals tot delectant el públic amb un repertori ben variat que va donar el toc d’inici a les festes de Nadal.
Lifestyle Medicine: The Power of Personal Choices, North American Vegetarian...EsserHealth
Learn about the leading chronic diseases in America and how Lifestyle Medicine can radically shift the burden of disease in your life and western society at large.
All too often we hear nutrition myths. They confuse many people and result in personal choices that compromise health and increase the risk of disease. In this powerpoint, Dr Esser reviews some foundational and a few specific myths and presents compelling science to set the record straight. Enjoy and remember to keep on asking questions and learning how you can achieve your best health in 2018.
This powerpoint covers the following subtopics:
What is obesity?
Pathogenesis
Burden
Epidemiology of obesity
Assessment of obesity
Consequences of obesity
Prevention and Control
Overweight And Obesity : Proven Health Risks, We All Should KnowSanjiv Haribhakti
Overweight and obesity are defined as abnormal or excessive fat accumulation in the body that presents a risk to health. Obesity will have a negative effect on health, leading to reduced life expectancy and/or increased health problems. According to WHO, Obesity is one of the most serious public health problems of the 21st century. For more info visit :- http://gisurgery.info/player_presentation.php?id=133
Title: Navigating Obesity: Understanding, Impact, Solutions
In this presentation, we unravel obesity's complexity, exploring its subcategories and the significance of Body Mass Index. Key facts underscore its global urgency. We dissect causes, from genetics to sedentary lifestyles, and outline health risks like cardiovascular issues and diabetes. We address the challenge of "double burden of malnutrition." Solutions include balanced diets, activity, stress management, and professional guidance. Real-life success stories inspire, and a Q&A session fosters engagement. Our aim: empower individuals to grasp obesity's nuances, mitigate its impacts, and embrace healthier living.
Learn why heart disease is a major issue and what you can do to prevent and reverse the number one killer of American's today. Review extensive science and studies demonstrating the effect of nutrient dense foods, exercise and mental health on heart health. Establish your own personal heart health program today.
The Intersection of Orthopedics and Lifestyle MedicineEsserHealth
What you eat, drink and how you move can radically influence the health and happiness of your joints! Learn how to make powerful science based decisions about your personal health and keep your joints healthy and pain free.
Autoimmune Disease: Understanding the Inflammation WithinEsserHealth
AutoImmune Disease can seem scary, overwhelming and complicated. In this powerpoint we break down the science into applicable nuggets for your life. Enjoy it live on facebooklive as well at esserhealth
The Intersection of Sports and Spine Medicine and Plant Based Nutrition EsserHealth
Whether it is pain, performance or recovery, plant based nutrition has a great deal to offer orthopedic patients. Enjoy reviewing this presentation and learning.
The mind is powerful. Emotions are perhaps the most powerful influence of our personal choices every day. As you transition to a more healthy tomorrow, be sure you evaluate your personal thoughts, emotions and feelings on a daily basis. These thoughts and feelings might just be the key to your long term success.
Learn the basics of Diabetes Prevention, reversal and Management. The Science is clear, follow the five key behavior changes to live a diabetes-free life.
Back to the Swing of Things: Golf InjuryEsserHealth
Golf Injury is a real risk of participation, Dr Esser teaches other medical providers about some common golf injuries and both management and prevention in this presentation.
Many of us know we should eat more of those healthy foods but find it hard to stick with our "healthy" goals. Why is that and what can you do to make maintaining healthy habits easier.
The Ties that Bind: Depression and DisabilityEsserHealth
The Disability status of an individual and their risk of concomitant mental health needs is linked. If you or a loved one are considering going out on " disability" be sure you have the tools to deal with depression and the like. Reach out, find support and be proactive.
Tennis Injuries can keep athletes off the court and unable to achieve their personal on court goals. Learn how to reduce the risk of these injuries and to enhance function.
Conservative Management of Knee osteoarthritisEsserHealth
Osteoarthritis is a major burden on personal health and international health care expenditures. Learn the basics of osteoarthritis and conservative management options for the physician.
What you eat is powerful "medicine." The foods, you choose to eat or to skip can radically influence your risk of disease. Learn what you can do and why it matters to your breast cancer risk in this presentation.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
1. A presentation at NAVS
Summerfest 06/28/12
Stephan Esser MD
www.esserhealth.com
2. Dollars and Salad: The Economics of
Personal Choice
Stephan Esser MD
www.esserhealth.com
3.
4. Goals
• Plant Seeds
• Stimulate Dialogue
• Harvest Ideas
• Identify a Problem
• Evaluate the Evidence
• Unravel a Solution
5. Goals
• Review the state of lifestyle-related disease in
America
• Understand the widening and graying of
America
• Unravel the related epidemic of chronic
disease
• Review the cost associated with management
• Review the literature and identify life and cost
benefits of plant-based nutrition
6. Foundational Questions
• What are the most common chronic diseases?
• How many people have them?
• How much do they add to care costs?
• Where is the most money spent?
• Can plant-based nutrition improve health and
save money?
8. “A global response to a
global problem: the epidemic
of overnutrition.” WHO
It is estimated that by 2020 2/3 rds of the global burden
of disease will be attributable to chronic non-
communicable diseases, most of them strongly
associated with diet. The nutrition transition towards
refined foods, foods of animal origin, and increased
fats plays a major role in the current global
epidemics of obesity, diabetes and cardiovascular
diseases, among other non-communicable conditions.
Sedentary lifestyles and the use of tobacco are also significant
risk factors. …….. A concerted multi-sectoral approach,
involving the use of policy, education and trade mechanisms,
is necessary to address these matters.
24. Perspective
• We eat more
– Sugar, Salt, Fat, Meat, Dairy
– 1970-2006:
• ↑ 24.5 % C/day ≈
617K/day
• We get less then ideal Physical Activity
– 18.8% of adults achieved CDC reccs on
Exercise
– 10% of adults >65 y/o
26. “A global response to a
global problem: the epidemic
of overnutrition.” WHO
It is estimated that by 2020 2/3 rds of the global burden
Diabetes diseases, most of Disease
Heart
of disease will be attributable to chronic non-
communicable them strongly
associated with diet. The nutrition transition towards
refined foods, foods of animal origin, and increased
High Blood Pressure
fats plays a major role in the current global
epidemics of obesity, diabetes and cardiovascular
diseases, among other non-communicable conditions.
Sedentary lifestyles and the use of tobacco are also significant
High Cholesterol
risk factors. …….. A concerted multi-sectoral approach,
involving the use of policy, education and trade mechanisms,
is necessary to address these matters.
39. What we Know
• Americans are:
– Increasing in Width
– Increasing in Age
• The Result
– Increasing Metabolic Syndrome
– Increasing Diabetes
– Increased Prevalence of “Heart Disease”
– Increased Medication Use
– Increased use of the Health Care System
50. What we know
• Rising Tide:
– Obesity
– Lifestyle Related Disease
– Population > 65 y/o
• Healthcare Spending
– All time High
– Primarily on Chronic Disease
51. “A global response to a
global problem: the epidemic
of overnutrition.” WHO
It is estimated that by 2020 2/3 rds of the global burden of
disease will be attributable to chronic noncommunicable
……if…….Lifestyle is the
diseases, most of them strongly associated with diet.
Problem
The nutrition transition towards refined foods, foods of
animal origin, and increased fats plays a major role in the
current global epidemics of obesity, diabetes and
cardiovascular diseases, among other noncommunicable
conditions. Sedentary lifestyles and the use of
What is risk factors. …….. A concerted
tobacco are also significant
the answer……..?
multi-sectoral approach, involving the use of policy, education
and trade mechanisms, is necessary to address these matters.
54. Motorola
• Cost ≈ $6 mil/yr on wellness and work/life programs
• Offerings: Health Screenings, Education, gym access
etc
• Cost-effectiveness:
– $1 invested in wellness benefits, $3.93 saved
– 2.4% increase in annual health care costs for
participating employees vs 18% increase for non-
participants
– $6.5 million annual savings in medical expenses for
lifestyle-related diagnoses (e.g., obesity,
hypertension, stress) compared with non-participants
55. Northeast Utilities
• 17% healthcare costs = LR
• WellAware program: financial incentives for participation, employees
and spouses eligible, a health risk assessment, secondary coronary
artery disease management program, phone contact and Internet site
allows access at work and home, and a toll free hotline for materials
and questions.
• 1st 2 years: 1.6 return on investment, including a $1,400,000 reduction
in lifestyle and behavioral claims and flat per capita costs for health
care.
• Participants demonstrated: 31% decrease in smoking, a 29% decrease
in lack of exercise, a 16% decrease in mental health risk, a 11%
decrease in cholesterol risk, an 10% improvement in eating habits, and
a 5% decrease in stress.
56. Common Ground
• Health Assessments
• Risk Stratification
• “High Touch”
• High Tech and Low Tech
• Family/Spouse Participation
• Incentivization
57. How does “Plant-Based Nutrition” fit in to cost
savings and our “not-so-fabulous 4”?
58.
59. Dietary habits and mortality in 11 000 vegetarians
and health conscious people: results of a 17 year
follow up
BMJ 1996; 313 : 775 (Published 28 September 1996)
Results: 2064 (19%) subjects smoked, 4627 (43%) were
vegetarian, 6699 (62%) ate wholemeal bread daily, 2948
(27%) ate bran cereals daily, 4091 (38%) ate nuts or dried fruit
daily, 8304 (77%) ate fresh fruit daily, and 4105 (38%) ate raw
salad daily. After a mean of 16.8 years follow up there were
1343 deaths before age 80. Overall the cohort had a
mortality about half that of the general population.
Within the cohort, daily consumption of fresh fruit was
associated with significantly reduced mortality from
ischaemic heart disease (rate ratio adjusted for smoking 0.76
(95% confidence interval 0.60 to 0.97)), cerebrovascular
disease (0.68 (0.47 to 0.98)), and for all causes combined
(0.79 (0.70 to 0.90)).
60. Vegetarian diets: what do we know of their
effects on common chronic diseases?
Am J Clin Nutr May 2009 vol. 89 no. 5 1607S-1612S
There is convincing evidence that vegetarians
have lower rates of coronary heart disease,
largely explained by low LDL cholesterol,
probable lower rates of hypertension and
diabetes mellitus, and lower prevalence of
obesity. Overall, their cancer rates appear to
be moderately lower than others living in the
same communities, and life expectancy
appears to be greater.
62. BLOOD-PRESSURE-LOWERING EFFECT OF A
VEGETARIAN DIET: CONTROLLED TRIAL IN
NORMOTENSIVE SUBJECTS
The Lancet, Volume 321, Issue 8314, Pages 5-10I.Rouse
59 healthy, omnivorous subjects aged 25-63 years were randomly allocated to a
control group, which ate an omnivorous diet for 14 weeks, or to one of two
experimental groups, whose members ate an omnivorous diet for the first 2
weeks and a lacto-ovo-vegetarian diet for one of two 6-week experimental
periods. Mean systolic and diastolic blood pressures did not change in the
control group but fell significantly in both experimental groups
during the vegetarian diet and rose significantly in the
experimental group which reverted to the omnivorous diet.
Adjustment of the blood-pressure changes for age, obesity, heart rate, weight
change, and blood pressure before dietary change indicated a diet-related fall
of some 5-6 mm Hg systolic and 2-3 mm Hg diastolic. Although the
nutrient(s) causing these blood-pressure changes are unknown, the effects
were apparently not mediated by changes in sodium or potassium intake
63. • BLOOD PRESSURE IN VEGETARIANS
– Am. J. Epidemiol. (1974) 100 (5): 390-398.
• Vegetarian diet in mild hypertension: a
randomised controlled trial.
– 58 subjects aged 30-64 with mild untreated hypertension were allocated either to a
control group eating a typical omnivorous diet or to one of two groups eating an
ovolactovegetarian diet for one of two six week periods.
A fall in systolic blood
pressure of the order of 5 mm Hg occurred during the vegetarian
diet periods, with a corresponding rise on resuming a meat diet.
64. Cholesterol
• The Effect of Vegetarian Diets on Plasma
Lipid and Platelet Levels Arch Intern Med. 1986;146(6):1193-1197
65. Rapid reduction of serum cholesterol and
blood pressure by a twelve-day, very low fat,
strictly vegetarian diet.
J Am Coll Nutr. 1995 Oct;14(5):491-6.
During this short time period, cardiac risk factors
improved: there was an average reduction of total
serum cholesterol of 11% (p < 0.001), of blood
pressure of 6% (p < 0.001) and a weight loss of 2.5 kg
for men and 1 kg for women.
66.
67. Dean Ornish MD
“Can Lifestyle Changes Reverse Coronary Heart Disease?”Lancet 1990
Regression of Atherosclerotic plaques
$30,000 per patient in the first year
“Intensive Lifestyle Changes for Reversal of Coronary Heart Disease”
JAMA 1998
5 yr f/u showed continued atherosclerotic regression and ½ the rate of
cardiac events
“Angina Pectoris and Atherosclerotic Risk Factors in the Multisite Cardiac
Lifestyle Intervention Program” AM J Card 2008
Reduced total health-care costs in those with
By 12 weeks 74% were angina free
coronary heart disease by 50 percent after only
one year
“The effectiveness and efficacy of an intensive cardiac rehabilitation program
in 24 sites” Am J Health Promotion 2010
Significant reductions in BMI/SBP/DBP/A1C/Tchol/LDL/Trig
68. Dean Ornish MD
• High Mark BCBS : 2 years f/u post 1 year
intervention
• MI’s: 87 % in Ornish group, 48% for the
control group.
• Angioplasty: 84% in OG
• Bypass Surgery: 80% in OG
• Catheterizations: 64% in OG
70. Diabetes
• Does a vegetarian diet reduce the occurrence of
diabetes? American Journal of Public Health, Vol. 75, Issue 5 507-512
– 25,698 adult White Seventh-day Adventists identified in 1960 followed for 21 years
– vegetarians had a substantially lower risk than non-vegetarians of diabetes as an
underlying or contributing cause of death
• Fruit and Vegetable Consumption and Diabetes
Mellitus Incidence among U.S. Adults Preventive Medicine Vol 32 Iss
1 January 2001. Pages 33-39
– Appr. 10, 000 participants, highest fruit and vegetable consumption = lowest risk of
T2D
• Dietary Patterns and the Incidence of Type 2
Diabetes Am. J. Epidemiol. (2005) 161 (3): 219-227.
– 4,000 Finnish men and women, followed 23 years
– Highest consumption of fruits/vegetables in prudent diet resulted in decreased risk
71. A Low-Fat Vegan Diet Improves Glycemic Control
and Cardiovascular Risk Factors in a Randomized
Clinical Trial in Individuals With Type 2 Diabetes
Diabetes Care August 2006 vol. 29 no. 8 1777-1783
– 100 people randomized vegan vs ADA diet 22 weeks
– 43% VG 26% ADA reduced diabetes medications.
– HbA1c (A1C) 0.96 points VG 0.56 points in the ADA group
– Excluding those who changed medications, A1C fell 1.23
points in the vegan group compared with 0.38 points in the
ADA group
– Body weight 6.5 kg VG and 3.1 kg ADA
– LDL cholesterol 21.2% in the vegan group and 10.7% in the
ADA group (P = 0.02).
– urinary albumin reductions 15.9 mg/24h VG than in the ADA
group 10.9 mg/24 h
72. A low-fat vegan diet and a conventional diabetes
diet in the treatment of type 2 diabetes: a
randomized, controlled, 74-wk clinical trial
Clin Nutr May 2009 vol. 89 no. 5 1588S-1596S
Weight loss was significant within each diet group but not significantly different between groups
(−4.4 kg in the vegan group and −3.0 kg in the conventional diet group, P = 0.25) and related
significantly to Hb A1c changes (r = 0.50, P = 0.001). Hb A1c changes from baseline to 74 wk
or last available values were −0.34 and −0.14 for vegan and conventional diets, respectively
(P = 0.43). Hb A1c changes from baseline to last available value or last value before any
medication adjustment were −0.40 and 0.01 for vegan and conventional diets,
respectively (P = 0.03). In analyses before alterations in lipid-lowering medications, total
cholesterol decreased by 20.4 and 6.8 mg/dL in the vegan and conventional diet
groups, respectively (P = 0.01); LDL cholesterol decreased by 13.5 and 3.4
mg/dL in the vegan and conventional groups, respectively (P = 0.03).Conclusions: Both diets
were associated with sustained reductions in weight and plasma lipid concentrations. In an
analysis controlling for medication changes, a low-fat vegan diet appeared to improve
glycemia and plasma lipids more than did conventional diabetes diet recommendations.
Whether the observed differences provide clinical benefit for the macro- or microvascular
complications of diabetes remains to be established.
73. Toward Improved Management of NIDDM: A
Randomized, Controlled, Pilot Intervention
Using a Low-fat, Vegetarian Diet
Preventive Medicine, Volume 29, Number 2, August 1999 , pp. 87-91(5)
28% mean reduction in fasting serum glucose of the
experimental group, from 10.7 to 7.75 mmol/L (195
to 141 mg/dl), was significantly greater than the 12%
decrease, from 9.86 to 8.64 mmol/L (179 to 157 mg/
dl), for the control group (P < 0.05). The mean weight
loss was 7.2 kg in the experimental group, compared
to 3.8 kg for the control group (P < 0.005).
77. Precedent
• Pritikin et al. Effects of a high-complex-carbohydrate, low-fat, low-
cholesterol diet on levels of serum lipids and estradiol AJM 1985
– 26 day inpatient stay 15-20% in TC
• Pritikin et al Long-Term Use of a High-Complex-Carbohydrate,
High-Fiber, Low-Fat Diet and Exercise in the Treatment of NIDDM
Patients Diabetes Care 1983
– 26 day inpatient stay, 77% off Oral Hypoglycemics, 25% in TC
• Effect of Short-Term Pritikin Diet Therapy on the Metabolic
Syndrome Journal of Cardio-Metabolic Disease 2006
– 12-15 day stays, BMI 3%, SBP, SG, LDL 10-15%
– 37% no longer met criteria for Metabolic Syndrome
78. 30-day lifestyle modification program delivered by
volunteers in a community setting.
-5,070 participants (January 2006 to October 2009)
-Outcomes: Reduction in body mass ( 3.2%), systolic and
diastolic blood pressure ( 4.9% and 5.3%, respectively), total
cholesterol ( 11.0%), low-density lipoprotein
cholesterol( 13.0%), triglycerides ( 7.7%), and fasting plasma
glucose ( 6.1%) p<0/001.
2011 Elsevier Inc. All rights reserved. Am J Cardiol 2011
79. CHIP
Intervention:
28 video classes conducted
in worksite, medical and
community settings
Subjects: 763 middle-aged
adults, ages 30–79 years
Follow-Up: Four to 8 weeks
after baseline
80. What we know
• What are the most common chronic diseases?
• How many people have them?
• How much do they add to care costs?
• Where is the most money spent?
81. What we know
• Plant-Based Nutrition can prevent, reverse or
improve management of the “not-so fabulous
4”
• Plant-Based Nutrition appears likely to be able
to reduce health care spending at all levels
86. Thank You!
Stephan Esser MD
www.esserhealth.com
87. References
• http://aspe.hhs.gov/health/prevention
• Prevention of Type 2 Diabetes Mellitus by Changes of Lifestyle Among Subjects with Impaired Glucose Tolerance. N Engl J Med
2001;344:1343-50.
• Knowler, WC. Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin. NEJM 2002 Feb
7;346(6):393-403
• Herman et al. The Cost-Effectiveness of Lifestyle Modification or Metformin in Preventing Type 2 Diabetes in Adults with Impaired
Glucose Tolerance. Ann Intern Med. 2005 Mar 1;142(5):323-32.
• Crandall. J et al. The influence of age on the effects of lifestyle Modification and Metforming in Prevention of Diabetes. J Gerontol A
Biol Sci Med Sci. 2006 Oct;61(10):1075-81.
• Chopra M et al Bull World Health Organ. 2002;80(12):952-8. Epub 2003 Jan 23.
• www.cdc.gov/.../mmwrhtml/ figures/m846qsf.gif
• www.cdc.gov/nccdphp/publications/factsheets/Prevention/pdf/obesity.pdf
• Fox, Caroline. Et al. Trends in the Incidence of Type 2 Diabetes Mellitus: Circulation 2006:113;2914-2918.
• http://meps.ahrq.gov/mepsweb/
• http://www.heart.org/idc/groups/heart-public/@wcm/@sop/@smd/documents/downloadable/ucm_319587.pdf
• http://care.diabetesjournals.org/content/early/2010/09/30/dc10-0879.full.pdf+html
• http://www.ncbi.nlm.nih.gov/books/NBK91989/
• http://meps.ahrq.gov/mepsweb/data_files/publications/cb11/cb11.shtml
• http://www.cdc.gov/nchs/data/series/sr_13/sr13_169.pdfh
• ttp://www.cdc.gov/nchs/data/nhds/2average/2009ave2_firstlist.pdfRankin, Am J Cardiol. 2012 Jan 1;109(1):82-6. Aldana et al., A
video-based Lifestyle Intervention and changes in coronary risk. Health Education Research. 2008; 23:115-124.
• Ali et al. How Effective Were Lifestyle Interventions In Real-World Settings That Were Modeled On The Diabetes Prevention Program?
Health Aff January 2012 vol. 31 no. 1 67-75
• Verhaeghe et al Effectiveness and cost-effectiveness of lifestyle interventions on physical activity and eating habits in persons with
severe mental disorders : a systematic review Int Jrnl of Beh Nutr and PA 2011
•
•
-- Bull World Health Organ. 2002;80(12):952-8. Epub 2003 Jan 23. Chopra M et al
Approx. 1,300,000 new cases per year www.cdc.gov/.../mmwrhtml/ figures/m846qsf.gif www.ncbi.nlm.nih.gov/ bookshelf/picrender.fcgi.. http://www.ctahr.hawaii.edu/CS/blogs/sustainable_agriculture/cdc_logo(2).jpg
Modifiable behavioral risk factors are leading causes of mortality in the United States. (JAMA, 2000 Mokdad et al. CDC) www.cdc.gov/cancer/ breast/statistics/ http://www.cdc.gov/cancer/Prostate/publications/decisionguide/
http://www.gallup.com/poll/147317/chronic-illness-rates-swell-middle-age-taper-off.aspx These findings are based on 24 months of Gallup-Healthways Well-Being Index daily tracking data from 2009 through 2010, encompassing surveys with more than 650,000 U.S. adults, aged 18 and older. The resulting sample sizes for every age from 18 through 90 -- ranging from roughly 1,500 to 18,000 cases -- allow for age-specific analysis of the data.
-- Bull World Health Organ. 2002;80(12):952-8. Epub 2003 Jan 23. Chopra M et al
In 2005-2008 11% of adults 20 years of age or older had diabetes. In 2005-2008 the percentage of adults with dm increased with age from 4% of persons 20-44 to 27% of adults 65 years of age or older http://meps.ahrq.gov/mepsweb/ Medical Expenditure Panel survey
http://www.heart.org/idc/groups/heart-public/@wcm/@sop/@smd/documents/downloadable/ucm_319587.pdf The prevalence of hypertension (defined as high blood pressure or taking antihypertensive medication) increases with age. In 2005–2008, 33%–34% of men and women 45–54 years of age had hypertension, compared with 67% of men and 80% of women 75 years of age and over (Table 67).
http://care.diabetesjournals.org/content/early/2010/09/30/dc10-0879.full.pdf+html 2010 --AHA 2004 --States if you have 2 of characteristics =‘s 2 times risk of death from coronary heart dz, if you have 4 of these =‘s you have 3.5 times the risk? http://www.reuters.com/article/2010/10/15/us-metabolic-syndrome-idUSTRE69E5FL20101015
http://sas-origin.onstreammedia.com/origin/gallupinc/GallupSpaces/Production/Cms/POLL/yxirhsg6pe-ttjvtlo_uuq.gif These findings are based on 24 months of Gallup-Healthways Well-Being Index daily tracking data from 2009 through 2010, encompassing surveys with more than 650,000 U.S. adults, aged 18 and older. The resulting sample sizes for every age from 18 through 90 -- ranging from roughly 1,500 to 18,000 cases -- allow for age-specific analysis of the data.
-- Bull World Health Organ. 2002;80(12):952-8. Epub 2003 Jan 23. Chopra M et al
http://diabetescure101.com/graphics/couch-potato.jpg http://www.firsttracksmarketing.com/wp-content/uploads/2011/06/hospital460.jpg http://0.tqn.com/d/fengshui/1/0/w/9/-/-/fruit-basket-cynthia-berridge.jpg If A + B increase the risk of C then will fixing A or preventing B reduce the risk or expense of C
http://aspe.hhs.gov/health/prevention/
--Fraser et al. Archives of IM: 2001:161;1645-1652
http://www.ornishspectrum.com/
http://www.pmri.org/publications/newsweek/Yes_Prevention_is_Cheaper_than_Treatment_Dean_Ornish.pdf http://www.ncbi.nlm.nih.gov/pubmed/9860380?ordinalpos=33&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum Attrition rate of 10-12.7 %