This is a quick view of a panel talk recently shared with Matt Rusigno RD at the 1st Annual P-POD conference. www.p-pod.org

1. Synergistic Effects of Whole-foods
Plant-based Nutrition and Physical
Exercise, in Helping Reduce the Risks
of Major Chronic Diseases
Stephan Esser MD, USPTA
Matt Ruscigno RD,MPH

2. Goals
• Identify 3 plant food compounds beneficial for
both physical activity recovery and chronic
disease prevention
• Describe the physiological benefits of regular
exercise on behalf of disease prevention
• During counseling of patients, successfully
cite practical, evidence based methods to
increase physical activity and increase use of
plant based meals

3. “Eating alone will not keep a man well; he must
also take exercise. For food and exercise……
work together to produce health.”
Hippocrates
Regimen 400 BC

4. Ancient Awareness
• Early observations
– Hippocrates (460-370 B.C.)
• “if we could give every individual the right amount of
nourishment and exercise, not too little and not too
much, we would have found the safest way to health”
– Cornelius Celsus (ca.10-60)
• “take exercise: for whilst inaction weakens the body,
work strengthens it; the former brings on premature
old age, the latter prolongs youth”

5. CDC Exercise Stats
• > 60% of adults are not regularly active
• 25% are not active at all
• By age 75 1:3 men and 1:2 women engage in NO
physical exercise
http://www.cdc.gov/nccdphp/dnpa/physical/health_professionals/index.htm

7. Exercise

9. Defining Exercise
• Exercise:
–movement of the body resulting in the
enhancement of health and improvement
of function

10. Categories
• Leisure time Exercise: organized sports,
running, gym activities, rehabilitation etc.
• Lifestyle Exercise: activity incorporated into our
daily pattern of life
– eg: parking in the distant portion of the parking lot rather then the first
bumper, taking the stairs instead of the elevator etc.

11. Present Recommendations
• Cardiovascular
– 150 min/wk

12. Present Recommendations
• Resistance Training:
– 2-3 days per week
– All major muscle groups
– 2-4 sets of each exercise
– 48 hours in between sessions

13. Present Recommendations
• Flexibility:
– 2-3 days/week to improve range of motion
• Balance:
– 2-3 days/week

14. The Science

15. Exercise and Physical Health
• Reduces risk of
– Heart Disease ≈ 40%
– Obesity: ≈ 30-100%
– Stroke ≈ 50%
– Type 2 Diabetes ≈ 50%
– Hypertension ≈ 50%
– Disability delayed ≈15 years
– Colon Cancer ≈ 25-40%
– Breast Cancer ≈ 20%-44%
– Osteoporosis ≈ 20+%
• As many as 250,000 deaths per year in the United
States are attributable to a lack of regular
physical activity

16. Physical Health Cont’d
• Improve Balance
• Reduce Fall risk
• Improve Systemic Circulation
• Accelerate Skin Healing
• Bowel Regularity
• Improved Energy/Resilience

17. Exercise and Mental Health
• Regular Exercise:
– Reduces risk of:
• Depression
• Anxiety
• ADD/ADHD
• Alzheimers Dementia
– Improves:
• Mental Clarity, test scores, focus

18. Disuse
• Bedrest:
– BMD, increased bone resorption
– muscle mass and strength
– muscle fiber size
– fatty infiltration of muscle
–Impaired O2 exchange
– Cardiac function, efficiency

19. “A review of biologic changes commonly
attributed to the process of aging
demonstrates the close similarity of
most of these to changes subsequent to
a period of enforced physical
inactivity………………a portion of the
changes that are commonly attributed
to aging are in reality caused by disuse
and, as such, are subject to correction.
There is no drug in current or prospective
use that holds as much promise for
sustained health as a lifetime program of
physical exercise.”(JAMA 1982;248:1203-1208)
Disuse and Aging
Walter Bortz MD

21. Plant Compounds

22. Beet Juice

23. Beet Juice
Applied Physiology July 2010 vol. 109 no. 1135-148

24. Beet Juice
• Webb et al. Acute blood pressure lowering, vasoprotective, and anti-platelet
properties of dietary nitrate via bioconversion to nitrite.
– Healthy Volunteers
– Given 500ml of beet root juice
– 3 hours after consumption
– BP  by (max –10.4/8 mm Hg)
– Dietary nitrate load also prevented endothelial dysfunction induced by an
acute ischemic insult in the human forearm
– Significantly attenuated ex vivo platelet aggregation in response to collagen
and ADP
– “high nitrate content” acts as a source of vasoprotective
nitric oxide via bioactivation
Hypertension.2008; 51: 784–790

25. • Beetroot juice and exercise:
pharmacodynamic and dose-response
relationships
• 10 young adult healthy males
• 70, 140, and 280 ml BR or NO3−-depleted BR as placebo (PL)
• 2.5 hrs after completed cycle exercise tests
• Plasma [NO2−] increased in a dose-dependent manner, with the peak changes
occurring at approximately 2–3 h.
• 70 ml BR did not alter the physiological responses to exercise.
• 140 and 280 ml BR reduced the steady-state oxygen (O2) uptake during
moderate-intensity exercise
• Time-to-task failure was extended by 14% and 12% (both P < 0.05), respectively,
compared with PL.
• Journal of Applied PhysiologyPublished 1 August 2013Vol. 115no. 3, 325-336

26. • Matt Ruscigno RD,MPH