This document summarizes a presentation given to Harvard Medical Students on plant-based nutrition. It discusses the speaker's goals of exploring myths and engaging the science on this topic. It then reviews human anatomy and physiology to argue humans are anatomically herbivorous. It discusses concerns about protein, vitamins/minerals, and presents evidence that a well-planned plant-based diet can support health and reduce risks of chronic diseases like heart disease, diabetes, and cancer. Overall, the presentation makes the case that a plant-based diet can be nutritionally adequate and have health benefits.
Jose María Ordovás-El impacto de las ciencias ómicas en la nutrición, la medi...Fundación Ramón Areces
El 29 de marzo de 2016 celebramos un Simposio Internacional sobre el 'Impacto de las ciencias ómicas en la medicina, nutrición y biotecnología'. Organizado por la Fundación Ramón Areces en colaboración con la Real Academia Nacional de Medicina y BioEuroLatina, abordó cómo un mejor conocimiento del genoma humano está permitiendo notables avances hacia una medicina de precisión.
Predimed study is one of the few truly long term randomized trials with disease and mortality outcomes. It is unique in many ways and will have a strong and lasting impact
Plant-based Eating: Enhancing Health Benefits, Minimizing Nutritional RisksRobin Allen
Learning Objectives
At the end of the session, the participants will be able to:
1. Know there is no single definition of a plant-based diet.
2. Discuss health aspects of vegetarian and vegan diets and quality of evidence supporting health claims.
3. Assess nutritional adequacy/status of vegetarians and/or vegans throughout the life cycle and provide strategies for meeting dietary recommendations for vitamin B12, DHA calcium, and zinc.
Dietary guidelines are accused to be the key reason for obesity and diabetes epidemic. This slide deck shows why they are not. Junk food diet is the key reason.
Background: Vegetarian diets are associated with reduced risk for diseases such as diabetes and cardiovascular disease. We aimed to determine the nutritional adequacy of usual food intake in a cohort of young vegetarians and omnivores who regularly exercise.
Methods: Five vegetarian (aged 21.7±2.0 yrs), three vegan (aged 31.3±7.5 yrs) and eight age and sex matched omnivore participants (aged 21.1±1.9 yrs) volunteered for this project. Participants completed diet diaries to determine usual intake of macronutrients such as protein and fat and micronutrients such as vitamin C and iron.
Results: All participants met or exceeded the recommended dietary intake (RDI) of protein, thiamine, riboflavin, niacin, vitamin B6 phosphorus, and vitamin C. Vegetarians and vegans consumed insufficient quantities of vitamin B12 and vegans consumed less the half the amount that omnivores managed (1.7μg compared to 4.5μg). Folate consumption was adequate amongst vegetarians and vegans (510μg and 696μg respectively) and vitamin C consumption was highest among the vegan group (>400% of the RDI). Zinc intake was lowest among the vegetarians while low iron and copper intakes were reported by omnivores. Calcium consumption was poor overall.
Conclusions: Nutritional inadequacies can arise from consuming omnivore, vegetarian and vegan diets. Over time such inadequacies may result in nutrient deficiencies thus it is important to consume a variety of nutrient rich foods to ensure nutrition requirements are being met
This presentation compares the effects of different animal proteins on cancer, diabetes, heart disease and stroke. Presentation covers fish, dairy, poultry, red meat, processed meat and eggs.
Jose María Ordovás-El impacto de las ciencias ómicas en la nutrición, la medi...Fundación Ramón Areces
El 29 de marzo de 2016 celebramos un Simposio Internacional sobre el 'Impacto de las ciencias ómicas en la medicina, nutrición y biotecnología'. Organizado por la Fundación Ramón Areces en colaboración con la Real Academia Nacional de Medicina y BioEuroLatina, abordó cómo un mejor conocimiento del genoma humano está permitiendo notables avances hacia una medicina de precisión.
Predimed study is one of the few truly long term randomized trials with disease and mortality outcomes. It is unique in many ways and will have a strong and lasting impact
Plant-based Eating: Enhancing Health Benefits, Minimizing Nutritional RisksRobin Allen
Learning Objectives
At the end of the session, the participants will be able to:
1. Know there is no single definition of a plant-based diet.
2. Discuss health aspects of vegetarian and vegan diets and quality of evidence supporting health claims.
3. Assess nutritional adequacy/status of vegetarians and/or vegans throughout the life cycle and provide strategies for meeting dietary recommendations for vitamin B12, DHA calcium, and zinc.
Dietary guidelines are accused to be the key reason for obesity and diabetes epidemic. This slide deck shows why they are not. Junk food diet is the key reason.
Background: Vegetarian diets are associated with reduced risk for diseases such as diabetes and cardiovascular disease. We aimed to determine the nutritional adequacy of usual food intake in a cohort of young vegetarians and omnivores who regularly exercise.
Methods: Five vegetarian (aged 21.7±2.0 yrs), three vegan (aged 31.3±7.5 yrs) and eight age and sex matched omnivore participants (aged 21.1±1.9 yrs) volunteered for this project. Participants completed diet diaries to determine usual intake of macronutrients such as protein and fat and micronutrients such as vitamin C and iron.
Results: All participants met or exceeded the recommended dietary intake (RDI) of protein, thiamine, riboflavin, niacin, vitamin B6 phosphorus, and vitamin C. Vegetarians and vegans consumed insufficient quantities of vitamin B12 and vegans consumed less the half the amount that omnivores managed (1.7μg compared to 4.5μg). Folate consumption was adequate amongst vegetarians and vegans (510μg and 696μg respectively) and vitamin C consumption was highest among the vegan group (>400% of the RDI). Zinc intake was lowest among the vegetarians while low iron and copper intakes were reported by omnivores. Calcium consumption was poor overall.
Conclusions: Nutritional inadequacies can arise from consuming omnivore, vegetarian and vegan diets. Over time such inadequacies may result in nutrient deficiencies thus it is important to consume a variety of nutrient rich foods to ensure nutrition requirements are being met
This presentation compares the effects of different animal proteins on cancer, diabetes, heart disease and stroke. Presentation covers fish, dairy, poultry, red meat, processed meat and eggs.
Harnessing the Power of Nutrition to Complement Brain Tumor CareJeanne M Wallace PhD
Presentation by Jeanne M. Wallace, PhD, CNC, at the 1st Annual Brains Matter conference (Sept 2012 in Seattle), sponsored by the Chris Elliott Foundation. Learn how nutrition can play a powerful role to influence the terrain (environment) surrounding cancer cells. Discover foods that can "talk" to your genes, suppressing oncogenes and turning on tumor suppressor genes. Explore simple diet and lifestyle changes you can make to nourish your wellness when facing a brain tumor diagnosis.
Fat intake US has remained rather stable during the past decades despite many claims. I present here the case based on USDA and NHANES data.
Claiming that fat intake has decreased in US is as silly as advising a dieter: “If you want to follow a low-fat diet just keep your fat intake at the current level and simply increase the consumption of carbs. Then you are on low-fat diet and you will reap all the benefits of the diet”
Considering the mechanisms behind cancer cachexia-anorexia can inform wiser n...Jeanne M Wallace PhD
Unwanted weight loss and lack of interest in food drives many cancer patients to conventional canned nutrition formulas like Ensure, but these may actually foster the oncogenic process. This article outlines the underlying physiology of cachexia and compares various feeding formulas including holistic nutrition options.
This slide deck summarizes the studies on edible fats and inflammation in humans. Saturated fat seems to mildly pro-inflammatory, omega-6 fats neutral among healthy individuals and omega-3 fats mildly anti-inflammatory. Margarine outperforms butter in terms of inflammation.
Join Doc Andrew to see the research that supports plant based diet recommendations. Address common misconceptions. Ask questions @DenverWWAD or join current discussions at #PlantBased, #PlantBasedRx, or #CulinaryRx.
Also, enjoy bonus learning with these topic-related, 2-minute podcasts by Dr. Andrew:
"The Plant Based Diet and How to Get Started"
https://soundcloud.com/denverwwad/healthcast-23
"Eat Your Way to the Finish Line"
https://soundcloud.com/denverwwad/healthcast-4
Andrew Freeman, MD, FACC, FACP is a cardiologist and Assistant Professor of Medicine at National Jewish Health, Denver, Colorado. He is part of the leadership of both the local and national American College of Cardiology.
Dr. Freeman founded the Denver chapter of the Walk with a Doc program and is the leader of Walk with a Doc-Colorado.
Walk with a Doc-Denver is a free health improvement and community empowerment initiative. Local doctors and a team of healthcare professionals--all volunteers--host Saturday walks that include expert talks, health screenings, refreshments, and motivational giveaways. For more info visit: Denver.WalkWithADoc.org
Lyon Diet Heart Study is still considered as the ultimate evidence for the health benefits of Mediterranean diet. Unfortunately its' results have never been re-produced since then. However, PREDIMED trial may change this situation.
The recovery and re-evaluation of the old data on Sydney Diet Heart Study uncovers unexpected outcomes. However, interpret with care because things have changed since 1970s.
Evidence-based guidelines for the nutritional management of adult oncology pa...milfamln
Webinar Objectives
1. The participant will be able to discuss the validity of malnutrition screening and nutrition assessment tools and their utilization in clinical oncology settings
2. The participant will be able to better utilize the Nutrition Care Process to provide appropriate and high-quality nutrition care to oncology patients
3. The participant will be able to describe the evidencebased relationships between nutritional status and morbidity and mortality outcomes in oncology
Death and Disease Rates of Vegetarians and Vegans – Summary of Prospective Co...Jussi Riekki
My notes on "Death and Disease Rates of Vegetarians and Vegans – Summary of Prospective Cohorts, 1960–2014." Parts of this slidedeck were adapted from the work put out by Jack Norris at http://jacknorrisrd.com/
Harnessing the Power of Nutrition to Complement Brain Tumor CareJeanne M Wallace PhD
Presentation by Jeanne M. Wallace, PhD, CNC, at the 1st Annual Brains Matter conference (Sept 2012 in Seattle), sponsored by the Chris Elliott Foundation. Learn how nutrition can play a powerful role to influence the terrain (environment) surrounding cancer cells. Discover foods that can "talk" to your genes, suppressing oncogenes and turning on tumor suppressor genes. Explore simple diet and lifestyle changes you can make to nourish your wellness when facing a brain tumor diagnosis.
Fat intake US has remained rather stable during the past decades despite many claims. I present here the case based on USDA and NHANES data.
Claiming that fat intake has decreased in US is as silly as advising a dieter: “If you want to follow a low-fat diet just keep your fat intake at the current level and simply increase the consumption of carbs. Then you are on low-fat diet and you will reap all the benefits of the diet”
Considering the mechanisms behind cancer cachexia-anorexia can inform wiser n...Jeanne M Wallace PhD
Unwanted weight loss and lack of interest in food drives many cancer patients to conventional canned nutrition formulas like Ensure, but these may actually foster the oncogenic process. This article outlines the underlying physiology of cachexia and compares various feeding formulas including holistic nutrition options.
This slide deck summarizes the studies on edible fats and inflammation in humans. Saturated fat seems to mildly pro-inflammatory, omega-6 fats neutral among healthy individuals and omega-3 fats mildly anti-inflammatory. Margarine outperforms butter in terms of inflammation.
Join Doc Andrew to see the research that supports plant based diet recommendations. Address common misconceptions. Ask questions @DenverWWAD or join current discussions at #PlantBased, #PlantBasedRx, or #CulinaryRx.
Also, enjoy bonus learning with these topic-related, 2-minute podcasts by Dr. Andrew:
"The Plant Based Diet and How to Get Started"
https://soundcloud.com/denverwwad/healthcast-23
"Eat Your Way to the Finish Line"
https://soundcloud.com/denverwwad/healthcast-4
Andrew Freeman, MD, FACC, FACP is a cardiologist and Assistant Professor of Medicine at National Jewish Health, Denver, Colorado. He is part of the leadership of both the local and national American College of Cardiology.
Dr. Freeman founded the Denver chapter of the Walk with a Doc program and is the leader of Walk with a Doc-Colorado.
Walk with a Doc-Denver is a free health improvement and community empowerment initiative. Local doctors and a team of healthcare professionals--all volunteers--host Saturday walks that include expert talks, health screenings, refreshments, and motivational giveaways. For more info visit: Denver.WalkWithADoc.org
Lyon Diet Heart Study is still considered as the ultimate evidence for the health benefits of Mediterranean diet. Unfortunately its' results have never been re-produced since then. However, PREDIMED trial may change this situation.
The recovery and re-evaluation of the old data on Sydney Diet Heart Study uncovers unexpected outcomes. However, interpret with care because things have changed since 1970s.
Evidence-based guidelines for the nutritional management of adult oncology pa...milfamln
Webinar Objectives
1. The participant will be able to discuss the validity of malnutrition screening and nutrition assessment tools and their utilization in clinical oncology settings
2. The participant will be able to better utilize the Nutrition Care Process to provide appropriate and high-quality nutrition care to oncology patients
3. The participant will be able to describe the evidencebased relationships between nutritional status and morbidity and mortality outcomes in oncology
Death and Disease Rates of Vegetarians and Vegans – Summary of Prospective Co...Jussi Riekki
My notes on "Death and Disease Rates of Vegetarians and Vegans – Summary of Prospective Cohorts, 1960–2014." Parts of this slidedeck were adapted from the work put out by Jack Norris at http://jacknorrisrd.com/
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.
Dr. Eric Berg - USDA Dietary Guidelines: Why aren't they telling us to eat li...John Blue
USDA Dietary Guidelines: Why aren't they telling us to eat like pigs? - Dr. Eric Berg, North Dakota State University, from the 2018 Iowa Pork Congress, January 24 - 25, 2018, Des Moines, IA, USA.
More presentations at http://www.swinecast.com/2018-iowa-pork-congress
There are a lot of "myths" about plant based nutrition. In this light hearted review of some of the most common myths learn more how plant based nutrition can improve your health.
Professor André Marette of the Physiology and Endocrinology Department at the Laval University in Canada explains the impact on health markers: “Is yogurt associated with reduced cardio-metabolic risk factors in children?“. During this talk, he evaluated the role of yogurt as a nutrient-dense snack and its influence in reducing the risk of developing diabetes and obesity.
Recomendaciones para luchar contra el cambio climático mediante la alimentación
1. Comer poca carne
2. Reducir el sobre consumo de energía (disminuir las tasas de obesidad)
Phytonutrients and Cardiovascular Disease webinar slidesmilfamln
What are phytonutrients/phytochemicals? How are they beneficial? How does inflammation play a role in the progression heart disease? We all know diet has a significant impact on the development of cardiovascular disease. This webinar will explore plant food components, bioactive phytonutrients, with health benefits and their effect on prevention of cardiovascular disease.
Learning objectives:
1. The participant will be able to explain the state of the art of the science behind the effect of bioactive compounds in plant foods related to cardiovascular disease.
2. The participant will be able to discuss the potential of fruit and vegetable flavonoids on heart health implications and their capacity to protect against chronic diseases.
3. The participant will be able to identify the sources of bioactive compounds in the diet and educate clients/patients in selecting foods to reduce their risk of cardiovascular disease.
Approved for 1.0 CPEU for Registered Dietitians
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.
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.
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.
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.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
4. Goals
• What are we meant for?
• Why it’s Important?
• Review Basic Definitions
• Explore some Myths
• Engage the Science
• Recommendations for self/family/friends
5.
6.
7.
8.
9.
10.
11. What are we meant for?
• Evolution or Creation
• Anatomy
• Physiology
12. Anatomy
• Grinding/Reciprocating Molar Teeth
• Absence of Claws
• Opposable Thumbs
• Vision: color vs B&W
• Colonic Shape:
– Convoluted vs Smooth
• Long Intestines
– 12 times the length of our torsos (about 30 feet).
– 3 times the length of its torso.
13. Physiology
• Absence of Uricase
– Present in vertebrates
• Weak Stomach Acid
– 3-4
– 1-2
• Vitamin Requirements
– Vit. C
14. Why it Matters
• Eating
– Universal
– Uniquely Modifiable
• Opportunity for Influence
– Modifiable risk factor
• 20-30% Cancer Risk WHO
• Obesity, CAD, HTN, HLD, Stroke, T2D Etc.
15. Definitions
• Carnivore:
– flesh-eating mammals that include dogs, foxes,
bears, raccoons, and cats
• Omnivore:
– One consuming both plant and animal matter
16. Definitions
• Vegetarian:
– No flesh-foods
– Pescatarians: fish
– Ovo-Lactotarians: dairy and eggs
• Vegan
– No “animal” products
– Nothing with a “face or a mother”
20. Nutrition Concerns and Health Effects of
Vegetarian Diets
Volume 109, Issue 7, Pages 1266-1282 (July 2009
Nutr Clin Pract December 7, 2010 vol. 25 no. 6 613-620
It is the position of the American Dietetic Association that appropriately
planned vegetarian diets, including total vegetarian or vegan diets,
are healthful, nutritionally adequate, and may provide health
benefits in the prevention and treatment of certain diseases. Well-
planned vegetarian diets are appropriate for individuals during all
stages of the life cycle, including pregnancy, lactation, infancy,
childhood, and adolescence, and for athletes. A vegetarian diet is defined as one that
does not include meat (including fowl) or seafood, or products containing those foods. This article reviews the current data
related to key nutrients for vegetarians including protein, n-3 fatty acids, iron, zinc, iodine, calcium, and vitamins D and
B-12. A vegetarian diet can meet current recommendations for all of these nutrients. In some cases, supplements or
fortified foods can provide useful amounts of important nutrients. An evidence-based review showed that vegetarian diets
can be nutritionally adequate in pregnancy and result in positive maternal and infant health outcomes. The results of an
evidence-based review showed that a vegetarian diet is associated with a lower risk of death from ischemic heart disease.
Vegetarians also appear to have lower low-density lipoprotein cholesterol levels, lower blood pressure, and lower rates of
hypertension and type 2 diabetes than nonvegetarians. Furthermore, vegetarians tend to have a lower body mass index
and lower overall cancer rates. Features of a vegetarian diet that may reduce risk of chronic disease include lower intakes
of saturated fat and cholesterol and higher intakes of fruits, vegetables, whole grains, nuts, soy products, fiber, and
phytochemicals. The variability of dietary practices among vegetarians makes individual assessment of dietary adequacy
essential. In addition to assessing dietary adequacy, food and nutrition professionals can also play key roles in educating
vegetarians about sources of specific nutrients, food purchase and preparation, and dietary modifications to meet their
needs.
21. Content and bioavailability of trace
elements in vegetarian diets
Am J Clin Nutr May 1994 vol. 59 no. 5 1223S-1232S
Despite the apparent lower bioavailability of
zinc, copper, manganese, and selenium in
vegetarian diets because of the high contents
of phytic acid and/or dietary fiber and the low
content of flesh foods in the diet, the trace
element status of most adult vegetarians
appears to be adequate.
22. B12
• Water soluble
• Stored in liver: enterohepatic re-circulation
• Function: -DNA synthesis
– Red cell production
– Myelin synthesis
– Immune function
– Psychiatric health
• Blood Levels
– MMA
23. B12
• VITAMIN B12 DEFICIENCY AS A WORLDWIDE PROBLEM
Nutrition: Annual Review of Nutrition Vol. 24: 299-326
• Vitamin B12 (cobalamin) deficiency in elderly patients
CMAJ • August 3, 2004; 171 (3). doi:10.1503/cmaj.1031155. (20%)
• Vitamin B12 Deficiency Due to a Strictly Vegetarian Diet in
Adolescence
CLIN PEDIATR December 1987 vol. 26 no. 12 662-663
• Reversible Subacute Combined Degeneration of the Spinal
Cord in a 14-Year-Old Due to a Strict Vegan Diet
CLIN PEDIATR July 1, 2001 40: 413-415
24. B12 Deficiency
• Strict Vegan:
– 3-10 yrs to exhaust body stores
• Other Causes:
• Bacterial overgrowth in part of the small intestine
• Malabsorption
• Inflammatory bowel disease
• Fish tapeworm infection
• Post-Surgical short gut syndrome
• Drugs such as antacids and metformin
• Lack of intrinsic factor
• Decreased stomach acidity
• Consider repletion at
– 1000-2000mcg/ day
25. Vitamin D
• ADEK
• Vitamin or Neuro-hormone?
• Functions:
– Osseous balance
– Mood
– Cardiovascular Health
– Pain
– Anti-oxidation
– Immune function
–?
28. Omega 3
• ALA/ EPA / DHA
• Function
– Inflammation
– Cardiovascular Health
– Mood
– Neuro-development
29.
30. Protein
• Adequate
• Clinically relevant deficiency is extremely rare
• WHO 5%, 10-15% of total calories
• May benefit from
– Elderly/Adolescent
– Pregnancy/Lactating
– Athletes
31. General Health
Is there any evidence that
Plant-based nutrition
alters morbidity or mortality?
32.
33.
34. 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)).
35. 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.
37. 90
77.3
80 70.8
65.4 64.6
Percent of Population
70
60 53.2 54.1
50 38.8 38.4
40
30 24.4
16.2
20 12.2
6.6
10
0
20-34 35-44 45-54 55-64 65-74 75+
Men Women
Prevalence of high blood pressure in Adults age 20 and older, by age and sex
(NHANES: 2003-2006). Source: NCHS and NHLBI.
38. 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
39. • 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.
40. Cholesterol
• The Effect of Vegetarian Diets on Plasma
Lipid and Platelet Levels Arch Intern Med. 1986;146(6):1193-1197
41. 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.
47. 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 en and women, followed 23 years
– Highest consumption of fruits/vegetables in prudent diet resulted in decreased risk
48. 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
49. 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.
50. 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).
51.
52. The calorically restricted low-fat nutrient-dense diet in Biosphere
2 significantly lowers blood glucose, total leukocyte count,
cholesterol, and blood pressure in humans
PNAS December 1, 1992 vol. 89 no. 23 11533-11537
• Biosphere 2 is a 3.15-acre space containing an ecosystem that is energetically open (sunlight,
electric power, and heat) but materially closed, with air, water, and organic material being
recycled. Since September 1991, eight subjects (four women and four men) have been sealed
inside, living on food crops grown within. Their diet, low in calories (average, 1780 kcal/day; 1
kcal = 4.184 kJ), low in fat (10% of calories), and nutrient-dense, conforms to that
which in numerous animal experiments has promoted health, retarded aging, and extended
maximum life span. We report here medical data on the eight subjects, comparing preclosure data
with data through 6 months of closure. Significant changes included: (i) weight, 74 to 62 kg
(men) and 61 to 54 kg (women); (ii) mean systolic/diastolic blood pressure
(eight subjects), 109/74 to 89/58 mmHg (1 mmHg = 133 Pa); (iii) total serum
cholesterol, from 191 +/- 11 to 123 +/- 9 mg/dl (mean +/- SD; 36% mean
reduction), and high density lipoprotein, from 62 +/- 8 to 38 +/- 5 (risk ratio
unchanged); (iv) triglyceride, 139 to 96 mg/dl (men) and 78 to 114 mg/dl (women); (v)
fasting glucose, 92 to 74 mg/dl; (vi) leukocyte count, 6.7 to 4.7 x 10(9) cells per
liter. We conclude that drastic reductions in cholesterol and blood pressure may be
instituted in normal individuals in Western countries by application of a carefully
chosen diet and that a low-calorie nutrient-dense regime shows physiologic features in
humans similar to those in other animal species.
53.
54. Vegetarian diet: panacea for modern
lifestyle diseases?
QJM (1999) 92 (9): 531-544.doi: 10.1093/qjmed/92.9.531
There are few adverse effects, mainly
increased intestinal gas production
and a small risk of vitamin B12
deficiency.
55. Other Reasons
• Food and Agriculture Organization of the United Nations
– Livestock use 30% of the Earth’s Land Surface
– Produce 18% of greenhouse gases
• 70+ % of antibiotics used in US are for livestock
• 80+% of all wheat, corn, rye and oats for livestock
• Cruelty/Abuse etc
• Loss of Ocean Species/Pollution of waterways
– http://www.fao.org/newsroom/en/news/2006/1000448/index.html
– http://www.nytimes.com/2009/07/14/health/policy/14fda.html
56. Take Homes
• Plant Based Diets:
– Are Safe when adequately planned
– Minimal, readily addressed ‘risk’
– Have Therapeutic Benefit
• Obesity
• Heart Disease
78% Health Care Expenditures are consumed by
• High Blood Pressure of chronic disease
the management
• High Cholesterol Holman, H. JAMA 2004 Sep 1; 292:1057-1059
• Type 2 Diabetes
57. Points to Consider
• Repletion in “at Risk” Populations
– B12
– Vitamin D
• Supplementation
– Consider Omega 3’s
58. Knowledge = Responsibility
• Do it!
• Have fun with it!
• Celebrate Colors, Flavors!
• Achieve your best health!
• Share it and Inspire Others!
Most commonly performed voluntary physiologic act…if it can influence our health for good or ill then we want to know how and where
Water soluble vitamin stored in the liver as unique among vitamins in that it contains a metal ion, cobalt. Deficiency---pernicious anemia……absence if intrinsic factor 0.1% lost per day ?