FOOD AS MEDICINE
THE POWER OF THE MEDITERRANEAN DIET
PRESENTED BY CAHMI IN COLLABORATION WITH THE UAMS
INTEGRATIVE MEDICINE INTEREST GROUP
JANUARY 30TH 2016
PERFECT STORM
UNIVERSAL
HEALTH
COVERAGE
RISING
INCIDENCE
OF FOOD
ALLERGIES
OPEN DATA
MICROBIOMEAwareness
of food and
health
GMO
TRANSPARENCY
CLIMATE
CHANGE
CELIAC
DISEASE
FOOD
SAFETY
ISSUES
PROACTIVE VS ‘RE’ACTIVE MODEL
FOR HEALTHCARE
WHO/WHAT DECIDES OUR DIET??
 SOCIAL CULTURAL AND RELIGIOUS FACTORS
 TASTE AND FLAVOR
 BIG FOOD
 COST
 EMOTIONS
 AVAILABILTY
 USDA: SCHOOL LUNCHES. LONG TERM FACILITIES,
HOSPITALS
DUAL ROLE OF THE USDA
PROTECT AGRICULTURAL PRODUCERS
AND
MAKE DIETARY RECOMMENDATIONS
TO THE AMERICAN PUBLIC
CAN DIET IMPACT THE TOP TEN
CAUSES OF DEATH?
USDA MY PLATE
HARVARD EATING PLATE
WHAT ABOUT MEAT?
WHAT ABOUT MILK?
 No evidence that dairy
protects against
osteoporosis
 Possible link to prostate
and ovarian cancer
 Lactose intolerance
AND BEANS?
 HIGH IN FIBER
 CHEAP
 PACKED WITH PROTEIN
 LOWERS RISK FOR COLON CANCER, OSTEOPOROSIS AND BREAST
CANCER
 LOW GLYCEMIC INDEX
 VERSATILE
 TASTY
EVIDENCE BASED:
MEDITTERANEAN DIET
DIETARY TRIBES
 MEAT AND POTATOES
 MEATLESS MONDAYS
 FLEXITARIANS
 CLIMATARIANS/HUMANITARIANS
 VEGETARIANS
 PALEO
 FAD DIETS: ADKINS/ZONE/BEACH BODY/
WHY LESS MEAT?
( 99% OF OUR MEAT COMES FROM FACTORY
FARMS)
 ANTIBIOTIC RESISTANCE
 REDUCE THE CARBON FOOTPRINT
 CRUELTY TO ANIMALS
 HEALTH OF FARM WORKERS
 LESS MEAT= LESS DIABETES AND HEART DISEASE
COMMON SENSE GUIDELINES
(BRAZILIAN)
1. Prepare meals from staple and fresh foods.
2. Use oils, fats, sugar and salt in moderation.
3. Limit consumption of ready-to-consume food and drink products.
4. Eat regular meals, paying attention, and in appropriate environments.
5. Eat in company whenever possible.
6. Buy food at places that offer varieties of fresh foods. Avoid those that mainly sell products ready for
consumption.
7. Develop, practice, share and enjoy your skills in food preparation and cooking.
8. Plan your time to give meals and eating proper time and space.
9. When you eat out, choose restaurants that serve freshly made dishes and meals. Avoid fast food
chains.
10. Be critical of the commercial advertisement of food products.
COMMON MISCONCEPTIONS
 HEALTHY DIET IS EXPENSIVE AND UNAFFORDABLE
 MEAT = PROTEIN
 COOKING IS COMPLICATED AND SHOULD BE LEFT TO
PROFESSIONALS
 HEALTHY FOOD TASTES BLAND
THIS IS WHAT A VEGAN LOOKS LIKE
(DIVERSITY=RESILIENCE)
BIOLOGICAL SYSTEMS ARE SAME
WHAT ARE NUTRIENTS?
MICRONUTRIENTS
Vitamins
Minerals
Water
MACRONUTRIENTS
Carbohydrates
Fats
Proteins
WHOLE FOODS PLANT BASED
(WFPB) DIET
 Encourages plant foods in their WHOLE form.
 Whole grains, vegetables, fruits, legumes (beans, peas
and lentils), seeds and nuts.
 Limits animal products (eggs, dairy, fish, meats).
MEDITERRANEAN DIET
 Similar to WFPB diet but allows small amounts of animal
products.
 High in fruits, vegetables, whole grains, legumes, nuts, and
seeds. Fat is not restricted.
 Olive oil as an important fat source.
 Low to moderate consumption of dairy products, fish, eggs and
poultry.
 Red meat is rarely consumed.
 Moderate wine consumption.
CARBOHYDRATE
Whole food examples
 Grains: wheat, corn, rice, rye,
barley, oats, quinoa, bulger,
oatmeal, popcorn
 Root, tuber, starchy vegetables:
beets, carrots, potatoes, sweet
potatoes, corn
 Legumes (beans, peas, and
lentils): navy beans, split peas
 Fruit
Refined food examples
 Grains: White rice, white bread,
grits, couscous, regular pasta,
pretzels
 Other: Coke, candy, cake, cookies
ice cream, chips etc.
WHOLE GRAIN
 The bran is the outside layer where most of
the fiber exists.
 The germ is the inside layer where many
nutrients and essential fatty acids are found.
 The endosperm is the starchy middle layer.
 When grains are milled, you are left with only
the endosperm. In doing this, you take out
the majority of the nutrients.
CARBOHYDRATES
Refined grains
 Little nutritional value
 High glycemic index
 Linked to GI issues
 Linked to weight gain
 Less satiety
Whole Grains
 More nutrition: Unsaturated fatty acids,
fiber, vit E, vit B6, magnesium, zinc,
potassium, calcium, phosphorus, iron
 Lower glycemic index/help regulate
blood sugars
 Promote a healthy GI tract
 Blood pressure and cholesterol
lowering benefits
 Promote satiety
PROTEIN
 “Complete” proteins: animal sources. Contain all essential amino
acids.
 Poultry, pork, chicken, fish, eggs, dairy.
 “Incomplete” proteins: plant sources. Lacking in 1+ essential amino
acids.
 nuts and seeds, legumes (beans/lentils/peas), and even whole
grains.
 Complementary proteins: Most plant foods are not “complete”
proteins. However, eating a wide variety of plant foods will ensure you
get all of the necessary amino acids to fuel your body.
COMLIMENTARY PROTEINS
PLANT BASED VS ANIMAL PROTEIN
 Protein=meat, meat=protein??
 Red and processed meat has been linked to high risker of
CVD, type 2 DM, cancer, and osteoporosis.
 A diet high in vegetable protein has shown CVD benefit.
 A well-balanced, plant-based diet will provide adequate
amounts of essential amino acids and prevent protein
deficiency.
PROTEIN
Plant
 Linked to longevity (lower
incidence of CVD, DM,
cancer)
 Incomplete protein
 Sustainable/Cheap
 Nitrogen fixing
Animal
 Linked to CVD, DM,
cancer
 Complete protein
 Less sustainable
(environmental impact)
 Animal well-fare
FATS
 The problem with fats has more to do with the TYPE of fat you
eat rather than the QUANTITY.
“Best” fats:
Nuts/seeds
Olive oil
Avocado oil
Coconut oil
“Okay” fats:
Organic canola
Butter (grass fed,
organic)
Ghee
Lard
“Bad” fats:
Vegetable oil
Corn oil
Trans fats
Soybean oil
Cottonseed oil
Canola oil
FATS IN THE MEDITERRANEAN DIET
 This is not a low fat diet- may comprise up to 40% of total energy intake.
 The Mediterranean diet emphasizes the consumption of two types of fat:
 Omega-3 PUFA (flax seed, chia seed, walnuts, fatty fish)
 Monounsaturated fatty acids (olive oil, flaxseed oil, macadamia nuts, olives,
avocado, peanut butter)
 Balanced ratio of omega 6:omega 3 fatty acids (1-2:1)
 Low in saturated fat
 Avoids unhealthy fats (trans fats, highly processed vegetable oils)
BENEFITS OF
WFPB/MEDITERRANEAN DIET
 Cardiovascular Disease
 Lifestyle Heart Trial, Ornish D et al. JAMA, 1998 (6)
 Lyon Diet heart study. D et al. JAMA, 1990 (7)
 PREDIMED trial, Ramon et al. New England Journal of Medicine, 2013. (8)
 Obesity
 Berkow SE et al. Vegetarian diets and weight status. Nutrition Review, 2006. (8)
 Farmer B et al, A vegetarian dietary pattern as a nutrient-dense approach to weight management.
J Am Diet Assoc, 2011. (9)
 Rosell M et al, Weight gain over 6 years in 21,966 meat-eating, fish-eating, vegetarian and vegan
men and women. International Journal of Obesity, 2006. (10)
 Tonstad S et al. Type of vegetarian diet, body weight, and prevalence of type 2 diabetes.
Diabetes Care, 2009. (11)
 Diabetes
 Snowdon DA, et al. Does a vegetarian diet reduce the occurrence of diabetes? Am J Public
Health, 1985. (12)
 Vang A, et al. Meats, processed meats, obesity, weight gain and occurrence of diabetes among
adults: findings from Adventist Health Studies. Ann Nutr Metab, 2008. (13)
 Tonstad S et al. Type of vegetarian diet, body weight, and prevalence of type 2 diabetes.
Diabetes Care, 2009. (11)
PREDIMED trial - New England Journal
of Medicine
VEGETARIAN/VEGAN DIETS VS
MEDITERRANEAN Diet
 Although vegetarian diets are associated with lower risk of several
chronic diseases, different types of vegetarians may not experience
the same effects on health. The key is to focus on eating a healthy
diet, not simply a vegan or vegetarian diet.
COMMON HEALTH CONCERNS OF A
PLANT BASED DIET
Protein
Iron
Calcium
Vitamin D
Vitamin B12
IRON
 Plant based iron sources include: kidney beans, black beans,
soybeans, spinach, raisins, cashews, oatmeal, cabbage, and
tomato juice.
 Heme (animal sources) vs. Non-heme (plant sources)
 Non-heme iron absorption is increased by consuming foods
that contain vitamin C along foods that contain iron.
 Iron-deficiency anemia is rare in individuals who follow a plant-
based diet.
CALCIUM
 Plant-based sources: fortified non-dairy milks, dairy leafy
greens (turnip greens bok choy, broccoli, kale), bean
sprouts, nuts and seeds, whole grains, fruit, blackstrap
molasses.
 Intake can be adequate with a well-rounded, balance
plant-based diet.
VITAMIN D
 There are only a few good food sources of Vitamin D-
including fatty fish, egg yolks, and fortified rice or
almond milk.
 Most people should consider a supplement if sunlight
exposure is limited.
VITAMIN B12
 Vitamin B12 is found in animal foods but synthesized by
bacteria.
 Those who do not eat animal products of any kind must
supplement their diet with vitamin B12 via supplement,
or plenty of fortified foods (such as breakfast cereals,
nutritional yeast or plant milks).
CONCLUSION
 ALL OF THIS BEING SAID, DIET IS DIFFERENT FOR
EVERYONE.
 There are a lot of diets out there, but no one can deny that
eating more plants is a good thing for both you and the larger
picture.
 It does not have to be difficult to eat plant based!
WHY COOK?
 Build community
 Acquire life changing skills
 Greater control over your family’s health
 Connect with the large picture
 It’s magical!
OUR RECOMMENDATIONS
 Eliminate all sweetened beverages
 Avoid snacking
 Learn how to cook
FUTURE TOPICS
 FERMENTATION AND PROBIOTICS
 UMAMI
 GOURMET COOKING FOR SPECIFIC DISEASE STATES
 SUSTAINABILTY AND LOCAL SOURCING
 GLUTEN FREE
 FODMAPS DIET FOR IBS
 COOKING FOR PEOPLE WITH FOOD ALLERGIES
 KITCHEN PHARMACY

Food as medicine (meenakshi budhraja)

  • 1.
    FOOD AS MEDICINE THEPOWER OF THE MEDITERRANEAN DIET PRESENTED BY CAHMI IN COLLABORATION WITH THE UAMS INTEGRATIVE MEDICINE INTEREST GROUP JANUARY 30TH 2016
  • 2.
    PERFECT STORM UNIVERSAL HEALTH COVERAGE RISING INCIDENCE OF FOOD ALLERGIES OPENDATA MICROBIOMEAwareness of food and health GMO TRANSPARENCY CLIMATE CHANGE CELIAC DISEASE FOOD SAFETY ISSUES
  • 3.
    PROACTIVE VS ‘RE’ACTIVEMODEL FOR HEALTHCARE
  • 4.
    WHO/WHAT DECIDES OURDIET??  SOCIAL CULTURAL AND RELIGIOUS FACTORS  TASTE AND FLAVOR  BIG FOOD  COST  EMOTIONS  AVAILABILTY  USDA: SCHOOL LUNCHES. LONG TERM FACILITIES, HOSPITALS
  • 5.
    DUAL ROLE OFTHE USDA PROTECT AGRICULTURAL PRODUCERS AND MAKE DIETARY RECOMMENDATIONS TO THE AMERICAN PUBLIC
  • 6.
    CAN DIET IMPACTTHE TOP TEN CAUSES OF DEATH?
  • 9.
  • 10.
  • 11.
  • 12.
    WHAT ABOUT MILK? No evidence that dairy protects against osteoporosis  Possible link to prostate and ovarian cancer  Lactose intolerance
  • 13.
    AND BEANS?  HIGHIN FIBER  CHEAP  PACKED WITH PROTEIN  LOWERS RISK FOR COLON CANCER, OSTEOPOROSIS AND BREAST CANCER  LOW GLYCEMIC INDEX  VERSATILE  TASTY
  • 14.
  • 15.
    DIETARY TRIBES  MEATAND POTATOES  MEATLESS MONDAYS  FLEXITARIANS  CLIMATARIANS/HUMANITARIANS  VEGETARIANS  PALEO  FAD DIETS: ADKINS/ZONE/BEACH BODY/
  • 17.
    WHY LESS MEAT? (99% OF OUR MEAT COMES FROM FACTORY FARMS)  ANTIBIOTIC RESISTANCE  REDUCE THE CARBON FOOTPRINT  CRUELTY TO ANIMALS  HEALTH OF FARM WORKERS  LESS MEAT= LESS DIABETES AND HEART DISEASE
  • 19.
    COMMON SENSE GUIDELINES (BRAZILIAN) 1.Prepare meals from staple and fresh foods. 2. Use oils, fats, sugar and salt in moderation. 3. Limit consumption of ready-to-consume food and drink products. 4. Eat regular meals, paying attention, and in appropriate environments. 5. Eat in company whenever possible. 6. Buy food at places that offer varieties of fresh foods. Avoid those that mainly sell products ready for consumption. 7. Develop, practice, share and enjoy your skills in food preparation and cooking. 8. Plan your time to give meals and eating proper time and space. 9. When you eat out, choose restaurants that serve freshly made dishes and meals. Avoid fast food chains. 10. Be critical of the commercial advertisement of food products.
  • 20.
    COMMON MISCONCEPTIONS  HEALTHYDIET IS EXPENSIVE AND UNAFFORDABLE  MEAT = PROTEIN  COOKING IS COMPLICATED AND SHOULD BE LEFT TO PROFESSIONALS  HEALTHY FOOD TASTES BLAND
  • 21.
    THIS IS WHATA VEGAN LOOKS LIKE
  • 22.
  • 23.
  • 24.
    WHOLE FOODS PLANTBASED (WFPB) DIET  Encourages plant foods in their WHOLE form.  Whole grains, vegetables, fruits, legumes (beans, peas and lentils), seeds and nuts.  Limits animal products (eggs, dairy, fish, meats).
  • 25.
    MEDITERRANEAN DIET  Similarto WFPB diet but allows small amounts of animal products.  High in fruits, vegetables, whole grains, legumes, nuts, and seeds. Fat is not restricted.  Olive oil as an important fat source.  Low to moderate consumption of dairy products, fish, eggs and poultry.  Red meat is rarely consumed.  Moderate wine consumption.
  • 27.
    CARBOHYDRATE Whole food examples Grains: wheat, corn, rice, rye, barley, oats, quinoa, bulger, oatmeal, popcorn  Root, tuber, starchy vegetables: beets, carrots, potatoes, sweet potatoes, corn  Legumes (beans, peas, and lentils): navy beans, split peas  Fruit Refined food examples  Grains: White rice, white bread, grits, couscous, regular pasta, pretzels  Other: Coke, candy, cake, cookies ice cream, chips etc.
  • 28.
    WHOLE GRAIN  Thebran is the outside layer where most of the fiber exists.  The germ is the inside layer where many nutrients and essential fatty acids are found.  The endosperm is the starchy middle layer.  When grains are milled, you are left with only the endosperm. In doing this, you take out the majority of the nutrients.
  • 29.
    CARBOHYDRATES Refined grains  Littlenutritional value  High glycemic index  Linked to GI issues  Linked to weight gain  Less satiety Whole Grains  More nutrition: Unsaturated fatty acids, fiber, vit E, vit B6, magnesium, zinc, potassium, calcium, phosphorus, iron  Lower glycemic index/help regulate blood sugars  Promote a healthy GI tract  Blood pressure and cholesterol lowering benefits  Promote satiety
  • 30.
    PROTEIN  “Complete” proteins:animal sources. Contain all essential amino acids.  Poultry, pork, chicken, fish, eggs, dairy.  “Incomplete” proteins: plant sources. Lacking in 1+ essential amino acids.  nuts and seeds, legumes (beans/lentils/peas), and even whole grains.  Complementary proteins: Most plant foods are not “complete” proteins. However, eating a wide variety of plant foods will ensure you get all of the necessary amino acids to fuel your body.
  • 31.
  • 32.
    PLANT BASED VSANIMAL PROTEIN  Protein=meat, meat=protein??  Red and processed meat has been linked to high risker of CVD, type 2 DM, cancer, and osteoporosis.  A diet high in vegetable protein has shown CVD benefit.  A well-balanced, plant-based diet will provide adequate amounts of essential amino acids and prevent protein deficiency.
  • 33.
    PROTEIN Plant  Linked tolongevity (lower incidence of CVD, DM, cancer)  Incomplete protein  Sustainable/Cheap  Nitrogen fixing Animal  Linked to CVD, DM, cancer  Complete protein  Less sustainable (environmental impact)  Animal well-fare
  • 34.
    FATS  The problemwith fats has more to do with the TYPE of fat you eat rather than the QUANTITY. “Best” fats: Nuts/seeds Olive oil Avocado oil Coconut oil “Okay” fats: Organic canola Butter (grass fed, organic) Ghee Lard “Bad” fats: Vegetable oil Corn oil Trans fats Soybean oil Cottonseed oil Canola oil
  • 35.
    FATS IN THEMEDITERRANEAN DIET  This is not a low fat diet- may comprise up to 40% of total energy intake.  The Mediterranean diet emphasizes the consumption of two types of fat:  Omega-3 PUFA (flax seed, chia seed, walnuts, fatty fish)  Monounsaturated fatty acids (olive oil, flaxseed oil, macadamia nuts, olives, avocado, peanut butter)  Balanced ratio of omega 6:omega 3 fatty acids (1-2:1)  Low in saturated fat  Avoids unhealthy fats (trans fats, highly processed vegetable oils)
  • 36.
    BENEFITS OF WFPB/MEDITERRANEAN DIET Cardiovascular Disease  Lifestyle Heart Trial, Ornish D et al. JAMA, 1998 (6)  Lyon Diet heart study. D et al. JAMA, 1990 (7)  PREDIMED trial, Ramon et al. New England Journal of Medicine, 2013. (8)  Obesity  Berkow SE et al. Vegetarian diets and weight status. Nutrition Review, 2006. (8)  Farmer B et al, A vegetarian dietary pattern as a nutrient-dense approach to weight management. J Am Diet Assoc, 2011. (9)  Rosell M et al, Weight gain over 6 years in 21,966 meat-eating, fish-eating, vegetarian and vegan men and women. International Journal of Obesity, 2006. (10)  Tonstad S et al. Type of vegetarian diet, body weight, and prevalence of type 2 diabetes. Diabetes Care, 2009. (11)  Diabetes  Snowdon DA, et al. Does a vegetarian diet reduce the occurrence of diabetes? Am J Public Health, 1985. (12)  Vang A, et al. Meats, processed meats, obesity, weight gain and occurrence of diabetes among adults: findings from Adventist Health Studies. Ann Nutr Metab, 2008. (13)  Tonstad S et al. Type of vegetarian diet, body weight, and prevalence of type 2 diabetes. Diabetes Care, 2009. (11)
  • 37.
    PREDIMED trial -New England Journal of Medicine
  • 38.
    VEGETARIAN/VEGAN DIETS VS MEDITERRANEANDiet  Although vegetarian diets are associated with lower risk of several chronic diseases, different types of vegetarians may not experience the same effects on health. The key is to focus on eating a healthy diet, not simply a vegan or vegetarian diet.
  • 39.
    COMMON HEALTH CONCERNSOF A PLANT BASED DIET Protein Iron Calcium Vitamin D Vitamin B12
  • 40.
    IRON  Plant basediron sources include: kidney beans, black beans, soybeans, spinach, raisins, cashews, oatmeal, cabbage, and tomato juice.  Heme (animal sources) vs. Non-heme (plant sources)  Non-heme iron absorption is increased by consuming foods that contain vitamin C along foods that contain iron.  Iron-deficiency anemia is rare in individuals who follow a plant- based diet.
  • 41.
    CALCIUM  Plant-based sources:fortified non-dairy milks, dairy leafy greens (turnip greens bok choy, broccoli, kale), bean sprouts, nuts and seeds, whole grains, fruit, blackstrap molasses.  Intake can be adequate with a well-rounded, balance plant-based diet.
  • 42.
    VITAMIN D  Thereare only a few good food sources of Vitamin D- including fatty fish, egg yolks, and fortified rice or almond milk.  Most people should consider a supplement if sunlight exposure is limited.
  • 43.
    VITAMIN B12  VitaminB12 is found in animal foods but synthesized by bacteria.  Those who do not eat animal products of any kind must supplement their diet with vitamin B12 via supplement, or plenty of fortified foods (such as breakfast cereals, nutritional yeast or plant milks).
  • 44.
    CONCLUSION  ALL OFTHIS BEING SAID, DIET IS DIFFERENT FOR EVERYONE.  There are a lot of diets out there, but no one can deny that eating more plants is a good thing for both you and the larger picture.  It does not have to be difficult to eat plant based!
  • 45.
    WHY COOK?  Buildcommunity  Acquire life changing skills  Greater control over your family’s health  Connect with the large picture  It’s magical!
  • 46.
    OUR RECOMMENDATIONS  Eliminateall sweetened beverages  Avoid snacking  Learn how to cook
  • 48.
    FUTURE TOPICS  FERMENTATIONAND PROBIOTICS  UMAMI  GOURMET COOKING FOR SPECIFIC DISEASE STATES  SUSTAINABILTY AND LOCAL SOURCING  GLUTEN FREE  FODMAPS DIET FOR IBS  COOKING FOR PEOPLE WITH FOOD ALLERGIES  KITCHEN PHARMACY

Editor's Notes

  • #26 This dietary pattern is based on food patterns typical of many regions in Greece and southern Italy in the early 1960s.” (2)
  • #37 ***move everything below 5 down 2*** Hypertension (high blood pressure) Gastrointestinal disease Colon and breast cancer
  • #39 Mediterranean