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Prevent and reverse heart disease
- 1. Preventing & Reversing HeartDisease Ashwani K. Garg, MD Board certified family medicine, lifestyle medicine Reversive Medicine Certificate in plant-based nutrition September 8, 2019 Chicago
- 2. Goals • Discuss researchon prevention and reversal of heart disease • Mechanism of heart disease • Discuss nutrition basics of plant-based diet • Phytonutrients and antioxidants • Putting it all together, analyzing diet
- 3. 34 seconds • Weare going to do a prayer/meditation for 34 seconds • When you hear the chime, close your eyes and meditate or pray, or send loving thoughts to your friends, your loved ones, and around the world
- 5. Burden of HeartDisease • Every 34 seconds, 1 American has a coronary event, and approximate every 1 minute 23 seconds, an American will die of one • 1/6 deaths is related to heart disease (379,559 Americans) • 620,200 will have a 1st heart attack • 295,000 will have a recurrent heart attack • 150,000 will have a SILENT heart attack • CVD is the #1 cause of death globally (31% of ALL global death)
- 6. All males 65years and older, and all females 70 years and older, who have been exposed to the traditional western diet have cardiovascular disease and should be treated as such. -Lewis Kuller, M.D. Univ. of Pittsburgh April 2007
- 7. Leading Causes ofDeath in Perspective
- 8. Dean Ornish, EarlyPioneer • Dean Ornish was the 1st to offer documented proof that heart disease could be reversed by lifestyle • Most patients, chest pain disappeared • For 82%, artery clogging reversed • This was REQUIRED READING during my medical school years in the mid 1990s at Northwestern Feinberg Medical School
- 9. What was theOrnish plan? • Intensive lifestyle changes (10% low fat whole foods vegetarian diet, aerobic exercise, stress management training, smoking cessation, group psychosocial support) for 5 years. • 1 year initial study extended to 5 years • Decrease in stenosis in experimental group, increase in control group • 2-1/2 times more events in the control group
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- 13. Dr. Esselstyn study •Diet only intervention: whole grains, lentils/beans, vegetables, fruits, flaxseeds. Low fat / no oil (avoidance of nuts/olive/avocado) • Initially 17 patients, then expanded to 177 (adherent) patients, 44 months • 93% had resolution or improvement of symptoms • 22% had disease reversal on radiology or stress testing • 27 of patients were able to AVOID stent / bypass • Avg. weight loss 18.7 lbs.
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- 19. Heart Disease • NOOTHER diet has been shown to reverse heart disease, not the Mediterranean, not a low carb diet, not the standard diet or the AHA or DASH diet. • Whole food Plant-Based is the only one that has proven to reverse heart disease.
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- 22. Atherosclerosis • Atherosclerosis isthe disease process that leads to heart attack and heart disease • Atherosclerosis starts in young age • PRIMORDIAL prevention begings in infancy and even before, in the womb.
- 23. Thrombosis • Thrombosis isa complicated phenomenon that leads to sudden heart attack and stroke • Thrombosis involves inflammation, nitric oxide deficiency, elasticity, and inflammation
- 26. EPC • Endothelial progenitorcells were shown to be INCREASED by Okinawan vegetables Atherosclerosis. 2009; 204(2):544-8 (ISSN: 1879-1484)
- 28. TMAO: a newmarker of vascular disease
- 29. The old nutritionparadigm (reductionism) Food is thought of in terms of its components Macronutrients (fat, protein, carb) Micronutrients (vitamin A, B, C, D…) Fiber Leads to: macro confusion supplements poor health outcomes (rearranging the deck chairs on a sinking ship)
- 32. The NEW paradigm(wholism) • Defines nutrition as the synergistic and wholistic effects of FOODS on health • Nutrients interact with other nutrients and don’t work in isolation • Effect of the whole food is greater than any of its components. • A fruit is not “sugar” • Brown rice is not a “carb” • An avocado is not “fat”
- 33. These foods donot have labels
- 34. Nutrition… (according to Campbell) •The biologically “wholistic” process by which elements of food and water are used by the body to optimize health • The highly integrated reactions and events of countless food chemicals working together, as in a symphony
- 35. Whole food plant-baseddiet "One of the most fortunate findings from the mountain of nutritional research I’ve encountered is that good food and good health is simple. The biology of the relationship of food and health is exceptionally complex, but the message is still simple. The recommendations coming from the published literature are so simple that I can state them in one sentence: eat a whole foods, plant-based diet, while minimizing the consumption of refined foods, added salt and added fats.” - T. Colin Campbell, PhD
- 36. Factors Affecting Nutrient Variation AndMore… nutritionstudies.org
- 37. Nutrient Composition Plant andAnimal-Based Foods (Per 500 Calories of Energy) 1. USDA Nutrient Database for Standard Reference. http://ndb.nal.usda.gov/ndb/. 2. Holden JM, Eldridge AL, Beecher GR, et al. “Carotenoid content of U.S. foods: an update of the database.” J. Food Comp. Anal. 12 (1999): 169–196. 3. The exact food listings in the database were: Ground Beef, 80% lean meat/20% fat, raw; Pork,fresh, ground, raw; Chicken, broilers or fryers, meat and skin, raw; Milk, dry, whole; Spinach,raw; Tomatoes, red, ripe, raw, year-round average; Lima Beans, large, mature seeds, raw; Peas,green, raw; Potatoes, russet *B12 is from soil bacteria and is variable; can be obtained from supplements or supplemented foods
- 38. Where do youget your protein?
- 39. Protein requirements A balancedplant-based diet with adequate calories will always contain enough protein. For a 150 lb. person, minimum is about 1/3 of the weight or 50 gm. 50 gm = 200 calories worth Even a “low protein” diet of 10% will give enough if 2000 kCal/day
- 40. Animal protein isdirty fuel • Elevated cholesterol, heart disease • Inflammation and autoimmune disease • Asthma, skin conditions and allergy • Acidity promotes osteoporosis • Kidney Disease • Gout • Growth hormones/cell division (cancer) • Hormonal effects • Alzheimer’s disease, kidney stones…
- 41. Plant proteins arethe best fuel for the body • Nutrient-dense • Anti-inflammatory, anti-oxidative stress • Increased energy • Optimized athletic performance • Reduction and treatment of cancer • Prevention AND reversal of heart disease
- 42. Phytochemicals • Phytochemicals arecompounds only in plants that promote health • There is no daily reference intake for phytochemicals • New research shows they may very well be essential to life, and for prevention of cardiovascular diseases and cancer • ONLY about 1/5 of Americans meet the minimum intake
- 43. Flavonoids • Pigments infoods found in pigmented foods such as leafy greens, citrus, tea, berries, and chocolate • Over 5000 natural occurring flavonoids have been isolated • Antioxidant, anti-inflammatory, anticancer, antiplatelet, antibacterial
- 44. Carotenoids • Alpha/beta carotene,lutein, lycopene, zeaxanthin • Found in Carrots, fruits, vegetables, tomatoes • Reduce muscle fatigue, neutralize free radicals, reduce risk of prostate cancer • Regulate cell growth, modulate gene expression • Carotenoids also regulate body fat and modulate obesity
- 45. Nonstarchy polysaccharides • fucoidan,beta glucan • Mushrooms, barley, oats, brown seaweed, wheat bran • Apoptosis of cancer cells, brain development, antithrombotic, blood pressure, reduced risk of breast/colon cancer, improved cholesterol and reduced CVD
- 46. Lignans • Outer coatof seeds, woody parts of plants, provide building blocks • 100 times higher in flax than other foods • Lowering of blood pressure • Hormone regulation (phytoestrogen) • Protective against heart disease and breast cancer
- 47. Glucosinolates • Sulfur containingcompounds found in brassica (cruciferous vegetables) • Indole-3-carbinol (I3C) formed from metabolism • Denatured by high heat (boiling) and activated by chewing • Antibiotics will inactivate the absorption • Anti-cancer, anti-CVD, immune regulation
- 48. Isoflavones (soy) • Isoflavones(genistein and dadzein) act as agonist/antagonist for estrogen receptor • Isoflavones were thought to be harmful based on ANIMAL studies • HUMAN research supports benefit of soy foods • Lower type 2 diabetes risk • Lower menopause symptoms • Lower breast and gynecologic cancers • Lower prostate cancer
- 49. Omega-3 fatty acids •ALA is an essential fatty acid, converted to DHA/EPA • Omega-6 found in oils will “compete” with the conversion and interfere • DHA can be obtained in algae form (for example Vegetology) • Turmeric can increase absorption of DHA • Role in heart health, brain health, anti-inflammatory
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- 52. Legumes, nuts, seeds,grains
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- 54. Every day, wemake a choice what to eat and on living beings’ lives. It’s up to us to choose.
- 55. Is eating “plantsonly” healthy? Statement by the Academy of Nutrition and Dietetics: It is the position of the Academy of Nutrition and Dietetics that appropriately planned vegetarian, including vegan, diets are healthful, nutritionally adequate, and may provide health benefits for the prevention and treatment of certain diseases. These diets are appropriate for all stages of the life cycle, including pregnancy, lactation, infancy, childhood, adolescence, older adulthood, and for athletes. Plant-based diets are more environmentally sustainable than diets rich in animal products because they use fewer natural resources and are associated with much less environmental damage. Vegetarians and vegans are at reduced risk of certain health conditions, including ischemic heart disease, type 2 diabetes, hypertension, certain types of cancer, and obesity… Vegans need reliable sources of vitamin B-12 https://jandonline.org/article/S2212-2672(16)31192-3/abstract
- 56. Putting it alltogether (credit Julieanna Hever)
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- 59. Mindful Eating “Savor, MindfulEating, Mindful Life” • Lilian Cheung, Editorial Director, HSPH Nutrition Source (written with Thich Nhat Hanh) • (1) Honor the food (sometimes we forget where the food comes from) • (2) Engage ALL your senses (taste, sight, aroma, texture, beauty of the food) • (3) Be mindful of portion sizes (don’t take too much – modest amount) • (4) CHEW your food – enzymes digest food, taste is more powerful
- 60. Savor - continued •(5) Eat slowly and mindfully – enjoy and taste food thoroughly • (6) Don’t skip meals – you will overeat in this way • (7) Eat a PLANT-based diet (when I say PLANT-based, I really mean plants only) (eating meat increases risk of cancer and other diseases) • https://www.youtube.com/watch?v=Emd9q6_o6Z0
- 61. Other lifestyle factors adaptedfrom Dr. David Katz • Feet (150-300 minutes of exercise weekly, with 2 days of resistance) • Forks (plant-based diet) • Fingers (avoid alcohol / tobacco) • Sleep (7 to 8 hours per night of good quality sleep) • Stress (mindfulness, regular practice of prayer/meditation, fellowship) • Love (Love for one’s significant other, the Earth, the Animals, cultivation of universal love)
- 62. Example analysis (plant-based) Cronometer.COM (1)breakfast smoothie, soy milk, spinach, banana, pineapple, kiwi, hemp (2) lunch chickpeas, broccoli, bulgur (3) apple/PB snack (4) dinner bean/veg/kale curry with swt potato, tahini + 4 brazil nuts (5) 10 almonds for a snack w/soymilk
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- 69. Resources • NutritionCME.ORG (pcrm) •CancerProject.Org • PCRM Nutrition Guide for clinicians • ForksOverKnives.Com • NutritionFacts.Org • FullPlateLiving.Org • InternationalVegan.Org
- 75. Albert Einstein: “Nothing willbenefit human health and increase the chances for survival of life on Earth as much as the evolution to a vegetarian diet.