dr gregor
Flashback Friday: The Best Diet for Diabetes
"The Best Diet for Diabetes" There are all sorts of different scoring
systems to rate diet quality. My favorite, for its simplicity, is the
dietary phytochemical index: a fancy name for a simple concept. It's just the percentage of your calories
from whole plant foods, so 0 to 100. The average American diet
has a score of 12. Twelve out of a hundred; so, like on a
scale of one to ten, our diet is a one. You can split people up based on how they
score, and show how the higher you score the better your metabolic markers
when it comes to diabetes risk. There appears to be like this stepwise
drop in insulin resistance and insulin-producing beta-cell dysfunction
as you eat more and more plant-based. And that highest group was
only scoring about 30, less than a third of their diet
was whole plant foods, but better than the lowest, which was
down around the standard American diet.
No wonder diets centered around
plants, emphasizing legumes— beans, split peas,
chickpeas and lentils— whole grains, vegetables,
fruits, nuts and seeds, and discouraging most or all animal
products are especially potent in preventing type 2 diabetes, and as a little bonus has been associated
with much lower rates of obesity, hypertension, hyperlipidemia,
cardiovascular mortality, and cancer. And not just preventing type 2 diabetes
but treating it as well. A systematic review and meta-analysis
found that the consumption of vegetarian diets is associated
with improved blood sugar control, but how much improved?
Here's one of the latest trials.
The effect of a strictly plant-based diet
centered around brown rice—it was done in Asia—versus the conventional
diabetic diet on blood sugar control of patients with type 2 diabetes:
a 12-week randomized clinical trial. For the diabetic control diet, they set
up food exchanges and calculated specific calorie and portion controls,
whereas on the plant-based diet people could eat much as they want;
that's one of the benefits.
The emphasis is on food
quality rather than quantity, and they still actually
lost more weight. But even after controlling for
the greater abdominal fat loss in the plant-based group,
they still won out. Of course, it only works
if you actually do it, but those that pretty much stuck
to the healthier diet dropped their A1c levels 0.9%, which is what you
get taking the leading diabetes drug, but of course only
with good side effects. Yeah, but would it work in
an underserved population? The impact of a plant-based diet support
program on mitigating type 2 diabetes in San Bernadino, the poorest
city of its size in California. A randomized controlled trial,
but not of a plant-based diet itself as the title suggests,
but of just an education program telling people about the benefits
of a plant-based diet for diabetes, and then it was up to them. And still got a significant improvement
in blood sugar control.
Here are the numbers. Got a little better
in the control group, but way better in the plant-based
instruction and support group. And more plant-based diets
are not just effective in the prevention and management of
diabetes, but also its complications. Check this out. One of the most devastating complications
of diabetes is kidney failure. This shows the decline in kidney
function in eight diabetics in the one or two years
before switching their diets.
They all showed this steady,
inexorable decline on a fast track to complete
kidney failure and dialysis. But then they switched to a
special supplemented vegan diet, and their kidney decline
was stopped in its tracks. Imagine if they had switched
a year or two earlier! Most diabetics don't actually end up on
dialysis though because they die first. Cardiovascular disease is the major cause
of premature mortality among diabetics; that's why plant-based diets are perfect.
There is a general scientific consensus that the elements of a whole-foods
plant-based diet— legumes, whole grains, fruits,
vegetables, and nuts, with limited or no intake of processed
foods and animal products— are highly beneficial for preventing
and treating type 2 diabetes.
Equally important, plant-based
diets address the bigger picture by simultaneously treating cardiovascular
disease, our #1 killer, along with obesity, high blood
pressure, lowering inflammation, and we can throw cancer
into the mix too, our #2 killer. The bottom line is that the case
for using a plant-based diet to reduce the burden of diabetes
and improve overall health has never been stronger..
Video Transcript – As found on YouTube
The Best Diet for Hypothyroidism and Hyperthyroidism
"The Best Diet for Hypothyroidism
and Hyperthyroidism" There are several autoimmune diseases
that affect the thyroid gland, the most common being Graves' disease
and Hashimoto's thyroiditis. Graves' disease results in hyperthyroidism,
an overactive thyroid gland. Though slaughterhouses are
supposed to remove thyroid glands, should some neck meat slip in,
you can suffer a similar syndrome called hamburger thyrotoxicosis. But that's not from your body making
too much thyroid hormone; that's from your body eating
too much thyroid hormone.
Graves' disease is much more common,
and meat-free diets may be able to help with both, as plant-based diets
may be associated with a low prevalence
of autoimmune disease in general, as observed, for example,
in rural sub-Saharan Africa. Maybe it's because plants
are packed with antioxidants, which are possible protective factors
against autoimmune diseases. Maybe it's because plants are packed
with anti-inflammatory compounds. After all, a whole food plant-based diet
is basically synonymous with an anti-inflammatory diet.
But you
don't know until you put it to the test. It turns out the exclusion of all
animal foods was associated with half the prevalence of hyperthyroidism
compared with omnivorous diets. Lacto-ovo vegetarian and
fish-only diets were associated with intermediate protection, but
a 52% lower odds of hyperthyroidism among those eating strictly
plant-based diets. This apparent protection may be due
to the exclusion of animal foods, the benefits of plant foods, or both. Animal foods, like meat, eggs,
and dairy products, may contain high estrogen concentrations,
for example, which have been linked to
autoimmunity in preclinical studies.
Or the decrease in animal protein
may downregulate IGF-1, which is not just a cancer-
promoting growth hormone, but may play a role in
autoimmune diseases as well. Or it could be the good stuff in
plants that may protect cells, like the polyphenol phytochemicals,
such as flavonoids found in plant foods. Maybe it's the environmental toxins
that build up in the food chain. For example, fish contaminated with
industrial pollutants, like PCBs, are associated with increased
frequency of thyroid disorders. Okay, what about the other autoimmune
thyroid disease, Hashimoto's thyroiditis, which, assuming you're getting
enough iodine, is the primary cause of hypothyroidism, an underactive
thyroid gland. Graves' disease wasn't the only autoimmune disorder
that was rare or virtually unknown among those living in rural sub-Saharan
Africa, eating near-vegan diets.
They also appeared to have less
Hashimoto's. There's evidence that those with Hashimoto's have
compromised antioxidant status, but we don't know if
it's cause or effect. But if you look at the dietary factors
associated with blood levels of autoimmune anti-thyroid antibodies,
animal fats seem to be associated with higher levels, whereas vegetables and other plant
foods are associated with lower levels. So again, anti-inflammatory
diets may be useful. No surprise, as Hashimoto's
is an inflammatory disease. That's what thyroiditis means:
inflammation of the thyroid gland. Another possibility is the reduction
in methionine intake, an amino acid concentrated in animal protein, thought
to be one reason why the consumption of whole plant foods is likely to have
a favorable influence on longevity, through decreasing the risk of cancer,
heart disease, and diabetes. And methionine restriction improves
thyroid function in mice, but it has yet to be put to the test
for Hashimoto's in humans.
If you compare the poop of patients
with Hashimoto's to controls, the condition appears to be
related to a clear reduction in the concentration of Prevotella
species. Prevotella are good fiber-eating bugs known to enhance
anti-inflammatory activities. Decreased Prevotella levels
are also something you see in other autoimmune conditions, such as
multiple sclerosis and type 1 diabetes. How do you get more Prevotella?
Eat more plants. But put a vegetarian on a diet
of meat, eggs, and dairy, and within as few as four days
you can drive down levels. So one would expect those eating plant-
based diets to have less Hashimoto's, but in a previous video I expressed
concern about insufficient iodine intake, which could also lead to hypothyroidism. So, which is it?
Let's find out. Vegan diets tended to be
associated with lower, not higher, risk of hypothyroid disease.
Why the word "tended"? Because the associated protection against
hypothyroidism incidence and prevalence studies did not reach
statistical significance.
It wasn't just because they were slimmer. The lower risk existed even after controlling for body weight, so
they think maybe it's because animal products may induce inflammation. The question I have, though, is: if
someone who already has Hashimoto's, I mean, what happens
if you change their diet? That's exactly what I'll explore next..
Video Transcript – As found on YouTube
Plant-Based Diets for Diabetes
"Plant-Based Diets for Diabetes" I’ve talked about the role meat may
play in increasing the risk of diabetes, and the potential protective
role of healthy plant foods. But plant-based diets
not only appear to guard against getting diabetes
in the first place, they may successfully treat the disease
better than the diabetic diets patients are typically placed on, controlling
weight and cholesterol. Diets based on whole plant foods can
result in significant weight loss without any limits on portion
size or calorie counting, because plant foods tend
to be so calorically dilute. Here's a 100 calories of broccoli,
tomatoes, strawberries, compare that to a 100 calories
of chicken, cheese, or fish.
People just can't seem to eat to enough
to compensate for the calorie deficit so lose weight eating whole plant foods.
And most importantly, it works. Better. A plant-based diet beat out the conventional
American Diabetes Association diet in a head-to-head randomized
controlled clinical trial, without restricting portions,
no calorie or carb counting. A review of all such studies found that
individuals following plant-based diets experience improved reductions in blood
sugars, body weight, and cardiovascular risk, compared with those following
diets that included animal products.
And cardiovascular risk is
what kills diabetics the most. They're more likely to get strokes,
more likely heart failure. In fact, diabetes has been proposed as
a coronary heart disease risk equivalent, meaning diabetic patients without
a history of coronary disease have an equivalent risk to those
non-diabetic individuals with confirmed heart disease. A newer study used a technique to
actually measure insulin sensitivity. Improved on both diets
in the first three months, but then the veg diet pulled ahead.
And look at their LDL cholesterol. That's what we see when people
are put on plant-based diets; cholesterol comes down so much it can
actually reverse the atherosclerosis progression, reverse the
progression of heart disease.
We know about the beneficial
effect of vegetarian diets on controlling weight, blood sugars,
cholesterol, insulin sensitivity, and oxidative stress compared
to conventional diabetic diets, but what about quality
of life, mood? How did people feel after making
such a dramatic change in their diets? In this randomized controlled trial,
study subjects were assigned either to a plant-based diet
group or control group. Vegetables, grains, beans, fruits, and
nuts, with animal products limited to a maximum of one daily
portion of low-fat yogurt, and the control group got
the official diabetes diet. Quality of life improved on both
diets in the first few months, but within six months, the plant-
based group clearly pulled ahead. Same thing with
depression scores. Dropped in both groups
in the first three months, but started to rebound
in the control group. Bottom line, the more plant-based
diet led to a greater improvement in quality of life
and mood. Patients consuming a vegetarian diet
also felt less constrained than those consuming the conventional diet.
People actually felt the conventional diabetic diet was more restrictive
than the plant-based diet.
Disinhibition decreased
with a vegetarian diet, meaning those eating vegetarian
were less likely to binge. And the veg group folks
tended to feel less hungry, all of which helps with
sustainability in the long term, which is, of course, critical
for changing diet. So not only do plant-based diets
appear to work better, but they may be easier to stick to.
And with the improvement in mood, patients may exhibit desired
improvements not only in physical, but also in mental health..
Video Transcript – As found on YouTube
Should Vegetarians Take Creatine to Normalize Homocysteine?
"Should Vegetarians Take Creatine
to Normalize Homocysteine?" Almost universally, research findings
show a poor vitamin B12 status among vegetarians because they're
not taking vitamin B12 supplements like they should. And this results in
an elevation of homocysteine levels that may explain why vegetarians
were recently found to have higher rates of stroke. Of course, plant-based eating is just
one of many ways to get B12 deficient. I mean, even laughing gas can
do it, in as short as two days, thanks to the recreational use
of whipped cream canister gas. That's something new I learned today.
Anyways, if you do eat plant-based, giving vegetarians and vegans
even as little as 50 micrograms once a day of cyanocobalamin, the
recommended, most stable form of vitamin B12 supplement,
and their homocysteine levels start up in the elevated
zone, and within 1 to 2 months their homocysteines normalize right
down into the safe zone under 10.
Or just 2000 micrograms of
cyanocobalamin once a week, and you get the same beautiful
result, but not always. In this study even 500 micrograms
a day, either as a sublingual chewable or swallowable regular B12 supplement, didn't normalize homocysteine
within a month. Now, presumably if they had kept it up, their levels
would have continued to fall like in the other study. But if you're
plant-based and have been taking your B12 and your homocysteine levels
are still too high, meaning above 10, is there anything else you can do? Now, inadequate folate intake
can also increase homocysteine, but folate comes from
the same root as foliage. It's found in leaves, concentrated
in greens, as well as beans. But if you're eating beans and
greens, taking your B12, and your homocysteine level is still
too high, then I'd suggest trying, as an experiment, taking
one gram of creatine a day and getting your homocysteine levels
retested in a month to see if it helped.
Creatine is a compound formed
naturally in the human body that is primarily involved in energy
production in our muscles and brain. It's also naturally formed in the
bodies of many animals we eat. And so when we eat their
muscles, we also can take in some creatine through our diet. We need about two grams a day,
so those who eat meat may get like one gram from their diet, and
their body makes the rest from scratch. There are rare birth defects where
you're born without the ability to make it, in which case you have to get it
from your diet, but otherwise our bodies make as
much as we need to maintain normal
concentrations in our muscles.
When you cut out meat, the
amount of creatine floating around in your bloodstream goes down, but the
amount in your brain remains the same, showing dietary creatine doesn't
influence the levels of brain creatine, because your brain just makes
all the creatine you need. The level in vegetarian muscles is
lower, but that doesn't seem to affect performance, as both vegetarians
and meat-eaters respond to creatine supplementation with similar
increases in muscle power output. And if vegetarian muscle
creatine was insufficient, then presumably they would
have seen an even bigger boost. So basically, all that happens
when you eat meat is that your body just doesn't
have to make as much. What does this all have
to do with homocysteine? Okay, in the process of making creatine,
your body produces homocysteine as a waste product. Now
normally this isn't a problem because your body
has two ways to detoxify it using vitamin B6 or using a
combination of vitamins B12 and folate.
Now B6 is found in both plant and
animal foods; it's rare to be deficient. But B12 is mainly in animal
foods, and so can be too low in those eating plant-based who don't
supplement or eat B12 fortified foods. And folate is concentrated in plant
foods, so can be low in those who don't regularly eat greens or
beans or folic-acid fortified grains, and without that escape valve
homocysteine levels can get too high. If, however, you're eating a healthy
plant-based diet and taking your B12 supplement, your homocysteine levels
should be fine, but what if they're not? One might predict that if you started
taking creatine supplements, the level of homocysteine might go
down since you're not going to have to be making so much of it from scratch,
producing homocysteine as a by-product. But you don't know until you put it
to the test, which we'll cover next..
Video Transcript – As found on YouTube
Friday Favorites: Is Vegan Food Always Healthy?
"Is Vegan Food Always Healthy?" In my video on flexitarians,
I talk about how the benefits of eating a plant-based diet
are not all-or-nothing. Simple advice to increase
the consumption of plant-derived foods with
parallel reductions in the consumption of foods from
animal sources was found to confer a survival advantage,”
a live-longer advantage. They call it a pro-vegetarian eating
pattern, just moving in that direction, as a more gradual, gentle
doable approach. If you’re dealing with a serious
disease, though, like diabetes, avoiding some problem foods
completely may be easier than attempting to moderate their intake. It’s like clinicians would never tell
alcoholics to simply cut down on alcohol. Avoiding alcohol entirely
is a more effective and, ironically, easier for a problem drinker. Paradoxically, asking patients
to make a large change may be more effective than
making a slow transition. Diet studies show that recommending
more significant changes increases the changes that
patients actually accomplish. It may help to replace the common
advice, ‘all things in moderation’ with ‘big changes beget big results.’ Success breeds success.
After a few days or weeks of
major dietary changes, patients are more likely
to see improvements in weight and blood sugar levels— improvements that
reinforce the dietary changes. Furthermore, they may enjoy other health
benefits of plant-based eating. that may give them further motivation. Those who choose to eat plant-based
for their health say it’s mostly for general wellness and disease
prevention, or to improve their energy levels or immune function. They felt it gave them a sense
of control over their health, helps you feel better emotionally,
improves your overall health, and makes you feel better.
Most felt it was very important for
maintaining their health and well-being. For the minority that used it
for a specific health problem, it was mostly for high cholesterol
or weight loss, followed by high blood pressure
and diabetes, with most reporting they felt it helped a great deal. But others choose plant-based diets
for other reasons like animal welfare or global warming, and it looks
like they’re more likely to be eating things like vegan doughnuts,
sugary and fatty foods, compared to those eating
plant-based because of religious or health reasons. I mean the veganist vegan could bake
a cake using soda instead of eggs, with frosting, covered in marshmallow
fluff and chocolate syrup, topped with Oreos, with a side of Doritos
dipped in, vegan bacon grease.
But fruit for dessert… in the form of
Pop Tarts and Krispy Kreme pies. This, is a vegan meal. Yes, plant-based diets have
been recommended to reduce the risk of type 2 diabetes. However, not all plant foods
are necessarily beneficial. Like in that pro-vegetarian scoring
system you got points for eating potato chips and French fries,
just because they were technically plant-based, but Harvard researchers
wanted to examine the association of not only an overall plant-based diet,
but both healthy and unhealthy versions. So, they created the same kind
of pro-vegetarian scoring system weighted towards any sort
of plant-based foods, and against animal foods and then also
created a healthful plant-based diet index, where at least some whole
plant foods took precedence and Coca-Cola was no longer
considered a plant. Then lastly, they created an
unhealthful plant-based diet index by assigning positive scores
to processed plant-based junk, and negative scoring healthier
foods and animal foods.
And then they found that a more
plant-based diet in general was good for reducing diabetes risk, but eating
especially healthy plant-based foods did better, nearly cutting risk in half, while those eating more
unhealthy plant foods did worse. Now, but is that because they
were also eating more animal foods? People often eat burgers with their fries; so, they separated out the
effects of healthy plant foods, less healthy plant foods,
and animal foods.
And healthy plant foods were
protectively associated, animal foods were
detrimentally associated, and less healthy plant foods were more
neutral when it came to diabetes risk. Here’s what the graph looks like:
higher diabetes risk with more and more animal foods, no protection
whatsoever with junky plant foods, and lower and lower diabetes risk
associated with more and more healthy whole plant foods in the diet. So, they conclude that yes, plant-
based diets are associated with substantially lower risk of
developing type 2 diabetes, but it may not be enough to just
lower the intake of animal foods, but also less healthy plant foods as well..
Video Transcript – As found on YouTube
The First Studies on Vegetarian Athletes
"The First Studies on Vegetarian Athletes" In 1896, the aptly named
James Parsley evidently led a successful vegetarian
cycling club to victory, their competitors evidently having
to "eat crow with their beef." Evidently some Belgian
put it to the test in 1904, with those eating more plant-based
supposedly lifting some weight like 80 percent more times, but I couldn't find the
primary source in English. This I could find though: a famous
series of experiments at Yale, published more than a century ago, on the
influence of flesh-eating on endurance. Forty-nine people were compared:
regular athletes (mostly Yale students), vegetarian athletes, and then
just sedentary vegetarians. "The experiment furnished a severe test
of the claims of those flesh-abstainers." Much to the researchers' surprise,
the results seemed to vindicate the vegetarians, suggesting that
not eating meat leads to far greater endurance compared to those accustomed
to the ordinary American diet.
Check it out: the first endurance test was
how many minutes straight you could hold out your arms horizontally:
flesh-eaters versus flesh abstainers. The regular Yale athletes were
able to keep their hands out for about 10 minutes on average. It's harder than it sounds;
give it a try… OK, but those eating vegetarian
did like five times better. The meat-eater maximum was only
half that of the vegetarian average. Only two meat eaters
even hit 15 minutes, whereas more than two-thirds
of the meat-avoiders did. None of the regular diet
folks hit a half hour, whereas nearly half of
the healthier eaters did, including nine that exceeded an
hour, four that exceeded two hours, and one guy going for
more than three hours. How many deep knee
bends can you do? One athlete could do more
than 1,000—averaging 383— but they got creamed even
by the sedentary plant-eaters.
That's the crazy thing; even
the sedentary abstainers surpassed the exercising flesh-eaters. The sedentary abstainers were, in most cases, physicians
who sat on their butts all day. I want a doctor that that can do
a thousand deep knee bends! And then in terms of recovery, all those
deep knee bends left everyone sore, but more so among those eating meat. Among the vegetarians, of two that
did like 2,000 knee bends, one went straight off to the track to run and
another went on to their nursing duties. On the other hand, among the
meat-eaters one guy reached 254, went down once more and couldn't
get back up, had to be carried away, and was incapacitated for days; another
impaired for weeks after fainting.
It may be inferred without reasonable
doubt, concluded the once skeptical Yale researcher, that the meat-eating
group of athletes was very far inferior in endurance to the vegetarians,
even the sedentary ones. What could account for
this remarkable difference? Some claimed that flesh foods contained
some kind of "fatigue poisons," but one German researcher who detailed
his own experiments with athletes offered a more prosaic answer.
In his book on what looks like physiological studies of
uber-driving vegetarians— I told you I only know English— he conjectured that the apparent
vegetarian superiority was just due to their tremendous determination
to prove their point and spread their propaganda,
so they just make a greater effort in any contest than do
their meat-eating rivals.
The Yale researchers were worried
about this, and so special pains were taken to stimulate the flesh-eaters
to the utmost, appealing to their college pride. Don't let those lousy
vegetarians beat the "Yale spirit." The experiments made it
into The New York Times. Yale's flesh-eating athletes—
sounds like a zombie movie— beaten in severe endurance tests.
Yale professor believes that he has shown definitely the inferiority
in strength and endurance tests of meat eaters compared to
those who do not eat meat.
Some of Yale's most successful
athletes took part in the strength tests, and Professor Fisher declares they
were obliged to admit their inferiority. How has the truth of this result
been so long obscured? One reason, Professor Fisher
suggested, is that vegetarians are their own worst enemy.
In their fanaticism, they jump from the premise that meat eating
is wrong—often based on scripture or some kind of dogma—and jump
from that to meat-eating is unhealthy. That's not how science works
and such logical leaps get them dismissed as zealots and prevent
any genuine scientific investigation. Lots of science, even back then,
was pointing a distinct trend towards more plant-based eating,
and yet the word vegetarian— even 110 years ago—had
such a bad, preachy rap that many were loath to concede
the science in its favor. The proper scientific attitude is to study
the question of meat-eating in precisely the same manner as one would
study the question of anything else.
Video Transcript – As found on YouTube
Vegetarians and Stroke Risk Factors—Vegan Junk Food?
"Vegetarians and Stroke Risk Factors
—Vegan Junk Food?" Plant-based diets are
associated with a lower risk of cardiovascular disease, mortality, and
dying from all causes put together. This study of a diverse sample
of 12,000 Americans found that “progressively increasing
the intake of plant foods by reducing the intake of
animal foods may be associated with benefits on cardiovascular
health and mortality…”, but when it comes to plant-based diets
for cardiovascular disease prevention, all plant foods are not created equal. Were the vegetarians in the
British study that found the higher stroke risk just
eating a lot of vegan junk food? Any diet devoid of certain
animal food sources can be claimed to be a
vegetarian or vegan diet; so, it’s important to see
what they’re actually eating. One of the first things I look
at when I’m trying to see how serious a population is
about healthy eating is look at something undeniably, uncontroversially
bad: soda, liquid candy. Anyone drinking straight
sugar water obviously doesn’t have health top of mind. In the big study of plant-based
eaters in America, where people tend to cut down
on meat for health reasons far more than ethics… flexitarians
drink fewer sugary beverages than regular meat-eaters, as do
pescatarians, vegetarians, and vegans.
In the UK study, though, where the
increased stroke risk was found, where folks are more likely to go
veg or vegan for ethical reasons, the pescatarians are drinking less soda, but the vegetarians and
vegans are drinking more. I’m not saying that’s
why they had more strokes; it just might give us an idea of
how healthy the people were eating. In the UK study, the vegetarians and
vegan men and women were eating about the same amount of
desserts, cookies, and chocolate, and about the same total sugar.
In the U.S. study, the average
non-vegetarian is nearly obese, even the vegetarians
are a little overweight, and the vegans were the
only ideal weight group. In this analysis of the UK study, though,
everyone was about the same weight— in fact the meat-eaters
were skinnier than the vegans. The EPIC-Oxford study seems to
have attracted a particularly health conscious group of meat-eaters weighing substantially less
than the general population. Let’s look at some particular
stroke-related nutrients. Dietary fiber appears beneficial
for the prevention of cardiovascular disease
including stroke, and it appears the more the better. Based on studies of nearly a half
a million men and women there doesn’t seem to be any
upper threshold of benefit; so, the more, the better. More than
25 grams of soluble fiber, 47 grams of insoluble dietary
fiber and you can really start seeing a significant drop
in associated stroke risk. So, one could consider these
as the minimal recommendable daily intakes to prevent
stroke at a population level. That’s what you see in people
eating diets centered around minimally processed plant foods.
Dean Ornish got up around there with his whole food plant-based diet.
Maybe not as much as
we were designed to eat, based on the analyses of fossilized feces, but that’s the kind of neighborhood
where we might expect significantly lower stroke risk. How much were the
UK vegetarians getting? 22.1. Now, in the UK they measure
fiber a little differently; so, that may actually
be closer to 30 grams, but not the optimal level
for stroke prevention. So little fiber that the vegetarians
and vegans only beat out the meat-eaters by about 1
or 2 bowel movements a week, suggesting they were eating
lots of processed foods.
The vegetarians were only
eating about a half serving more of fruits and vegetables,
thought to reduce stroke risk in part because of
their potassium content, yet the UK vegetarians at
higher stroke risk were evidently eating so few greens and beans they
couldn’t even match the meat-eaters, not even reaching the
recommended minimum daily potassium intake of 4700 mg a day. And what about sodium? The vast
majority of the available evidence indicates that elevated salt intake is
associated with higher stroke risk. There’s like a straight-line
increase in the risk of dying from a stroke
the more salt you eat. Even just lowering sodium intake
by a tiny fraction every year could prevent tens of
thousands of fatal strokes. Reducing sodium intake to prevent stroke:
time for action, not hesitation, but the UK vegetarians and
vegans appeared to be hesitating, as did the other dietary groups.
All groups exceeded the advised less than 2400 mg daily sodium intake—
and that doesn’t even account for salt added at the table, and
the American Heart Association recommends under just 1500 a day;
so, they were all eating lots of processed foods.
So, no wonder
the vegetarian blood pressures were only 1 or 2 points lower;
high blood pressure is perhaps the single most important modifiable
risk factor for stroke. What evidence do I have that if the
vegetarians and vegans ate better their stroke risk would go down?
Well, in rural Africa where they were able to nail the fiber intake that
our bodies were designed to get by eating so many whole healthy plant
foods— fruits, vegetables, grains, greens and beans, their protein
almost entirely from plant sources, not only was heart disease, our
#1 killer, almost non-existent, so apparently, was stroke, surging
up from out of nowhere with the introduction of salt
and refined foods to their diet. Stroke also appears to be
virtually absent in Kitava, a quasi-vegan island culture
near Australia where diet was very low in salt and
very rich in potassium, because it was a vegetable-based diet.
They ate fish a few times a week, but the other 95% or so
of their diet was lots of vegetables, fruits, corn, and beans,
and they had an apparent absence of stroke, even despite their
ridiculous rates of smoking.
After all, we evolved eating
as little as less than an 8th of a teaspoon a day of salt
and our daily potassium consumption is thought to have been
as high as like 10,000 mg. We went from an unsalted, whole-food
diet to salty processed foods depleted of potassium
whether we eat meat or not. Caldwell Esselstyn at the
Cleveland Clinic tried putting about 200 patients with established
cardiovascular disease on a whole food plant-based diet. Of the 177 that stuck with the diet
only one went on to have a stroke in the subsequent few years
compared to a hundred-fold greater rate of adverse events—
including multiple strokes and deaths in those that
strayed from the diet.
“This is not vegetarianism,”
Esselstyn explains. Vegetarians can eat a lot
of less-than-ideal foods. This new paradigm is exclusively whole
food, plant-based nutrition. Now this entire train of thought,
that the reason typical vegetarians don’t have better stroke statistics
is because they’re not eating particularly stellar diets, may
explain why they don’t have significantly lower strokes rates,
but that still doesn’t explain why they might have higher stroke rates.
Even if they’re eating similarly
crappy, salty, processed diets at least they’re not eating meat,
which we know increases stroke risk; so, there must be something
about vegetarian diets that so increases stroke risk that
it offsets their inherent advantages? We’ll continue our hunt, next..
Video Transcript – As found on YouTube
How to Cultivate a Healthy Gut Microbiome with Food
Check out this new video
on the microbiome. And if you want more, just go to
NutritionFacts.Org/Topics/Microbiome for all my videos on good gut health. "How to Cultivate a Healthy
Gut Microbiome with Food" When we eat meat,
dairy, eggs, seafood, our gut flora can take certain
components in them (carnitine and choline)
and produce something that ends up as a toxic
compound called TMAO, which may set us up for a
heart attack, stroke, and death.
So, give people two eggs,
and you get a spike of TMAO in your bloodstream
within hours of consumption. Because gut bacteria play a critical
role in this process, though, if you then give them a week
of antibiotics to wipe out their gut flora and refeed them
two more eggs, nothing happens. No TMAO in their bloodstream
because they have no egg-eating
bacteria to make it. But give it a month for their gut
bacteria to start to grow back, and the eggs start to cause
TMAO production once again. The same thing with meat. Give people the equivalent
of an 11-ounce steak, and TMAO levels shoot
up in the blood.
But feed them the same amount
after a week of antibiotics and nothing happens. So to run into problems, you need both the meat and
the meat-eating bugs. That's why you can
feed a vegan a sirloin, and they don't produce
TMAO within their body. They just don't have the
meat-eating bugs in their gut. Okay, now this should all be
old news for those who've been following the science. The
reason for this video is to show that this phenomenon happens
the other way around, too. When we eat whole plant
foods, like fruits, vegetables, whole grains, and beans,
along with nuts and seeds, our gut flora can take
certain components in them (fiber and resistant starch) and
produce short-chain fatty acids which can set us up for the
prevention of human diseases.
Short-chain fatty acids like butyrate
can help seal up a leaky gut, fight inflammation, prevent weight
gain, improve insulin sensitivity, accelerate weight loss,
and fight cancer. But these benefits
rely on two things: eating fiber and having
fiber-feeding bugs, just like the detrimental effects
from TMAO required not only eggs, dairy, or meat, but also the eggs, dairy,
or meat-munching bugs. Check this out. If you give people whole
intact grains — in this case barley kernels,
also known as barley groats — three servings a day, like I recommend in
my Daily Dozen app, within just three days of eating
that extra 30+ grams of fiber and resistant starch, their gut bugs were so happy
and produced so many short-chain fatty acids that people's
insulin levels improved by 25%, which means their bodies
needed to produce less insulin to take care of the same amount
of white bread, while still dampening the blood sugar spike.
But this was on average.
Some people responded to all that
extra fiber with beautiful dips in blood sugar and insulin responses,
but in others, the same amount of fiber and resistant
starch didn't work at all. Why? Because you don't just
need fiber, but fiber-feeding bugs like Prevotella.
How do you get more Prevotella so you can take full advantage
of the health benefits of plants? Eat more plants. Prevotella
abundance is associated with long-term fiber intake.
If you look at rural African children eating 97%
whole food, plant-based diets, their Prevotella is off the charts
compared to kids eating standard Western diets,
and this is reflected in the amount of short-chain
fatty acids they are churning out in their poop. In the industrialized world,
it's those habitually eating vegetarian and vegan that
promotes the enrichment of fiber-eating bacteria
in the gut. Here's the relative Prevotella
abundance between those who eat meat,
no meat, or all plants. This may help explain the
worse inflammatory profile in omnivores
than in vegetarians. Based on the findings relative
to bacteria abundance, the researchers suggest
that exposure to animal foods may favor an intestinal
environment which could trigger systemic inflammation and
insulin resistance-dependent metabolic disorders
such as type 2 diabetes.
And it's the reduced levels
of inflammation that may be the key factor linking a
plant-based gut microbiota with protective health benefits. Yeah, but can't meat-eaters
eat lots of plants, too? Omnivores have constraints
on diet-dependent gut microbiome metabolite
production. In other words, it's the flip side of the
vegan eating a steak. They can eat all the fiber
they want but may be lacking in fiber-munching machinery.
At low levels of fiber intake, the more you eat, the more
of the beneficial short-chain fatty acids are made. But at a certain point,
your available fiber-feeders are maxed out, and there's
only so much you can benefit. But those habitually eating
a plant-based diet have been cultivating the growth
of these fiber-feeders, and the sky's the limit,
unless, of course, you're eating vegan junk. But a whole food, plant-based diet
should be effective in promoting a diverse ecosystem of
beneficial bacteria to support both our gut microbiome
and our overall health..
Video Transcript – As found on YouTube
The Gladiator Diet How Vegetarian Athletes Stack Up
"The Gladiator Diet –
How Vegetarian Athletes Stack Up" Recently, the remains of
dozens of Roman gladiators were discovered in a mass grave. The clue to their identities
were the rather distinct types of mortal injuries they found, like being speared in
the head with a trident. Using just their skeletons
they were able to reconstruct the death blows, show just
how buff they really were, and even try to reconstruct
their diet of barley and beans. You can look at carbon isotopes and
see what kinds of plants they ate; nitrogen isotopes reflect any
intake of animal protein.
You can also look at the
Sulphur in their bones and the amount of strontium,
leading commentators to submit that the best athletes
in ancient Rome ate largely plant-based diets. Then there were the legionnaires,
the Roman army troopers, famed for their abilities, also
eating a similar kind of diet, suggesting “the best fighters
in the ancient world were essentially vegetarian.” So, if the so-called
perfect fighting machines, the great sports heroes of the day,
were eating mostly grains and beans, should that tell us anything
about sports nutrition and the preferred diets
of elite athletes? Well, most of the Greeks and
Romans were basically vegetarian, centering their diets around
grains, fruit, vegetables and beans, so maybe the gladiators’ diets
weren’t that remarkable.
Plato, for example, pushed
plants, preferring plant foods for their health and efficiency. So yes, the Roman gladiators
were known as the ‘‘barley men,’’ but is that because barley
gives you strength and stamina, or was that just the basic food
that people ate at the time, not necessarily for performance,
but because it was just so cheap? Well, if you look at the modern
Spartans, the Tarahumara Indians, the ones that run races where
they kick a ball for oh, 75 miles just for the fun of it,
running all day, all night, and all day, maybe 150 miles
if they’re feeling in the mood. What do you get if you win? A special popularity with the ladies
(although how much of a reward that would actually prove to be
for a man who had been running for two days straight is questionable; though, maybe their endurance
extends to other dimensions). “Probably not since the
days of the ancient Spartans has a people achieved such a high
state of extreme physical conditioning.” And what did they eat? The same kind of 75 to
80 percent starch diet based on beans, corn, and squash.
And, they had the cholesterol
levels to prove it, total cholesterol levels down at an
essentially heart attack proof 136. And it’s not just some
special genetics they have— you feed them enough egg yolks and
their cholesterol creeps right up. Modern day Olympian runners
eat the same stuff. What are they eating over there in Kenya? A 99 percent vegetarian diet centered
mostly around various starches. But as in all these cases, is
their remarkable physical prowess because of their diets, or
in spite of their diets? Or have nothing to do with their diets? You don’t know…until
you put it to the test. In spite of well-documented health
benefits of more plant-based diets, less is known regarding the effects
of these diets on athletic performance. So, they compared elite vegetarian
and omnivore endurance athletes for aerobic fitness and strength. So, comparing oxygen
utilization on the treadmill, and quad strength with leg extensions. And the vegetarians beat out
their omnivore counterparts for cardiorespiratory fitness,
but their strength didn’t differ. Suggesting, in the very least,
that vegetarian diets don’t compromise athletic performance. But this was a cross-sectional study. Maybe the veg athletes were just
fitter because they trained harder? Like in the National Runners' Health Study looking at thousands of runners:
vegetarian runners were recorded running significantly
more on a weekly basis; so, maybe that explains
their superior fitness.
Though, maybe their superior fitness
explains their greater distances. Other cross-sectional studies
have found no differences in physical fitness between
vegetarian and non-vegetarian athletes, or even worse performance, as in this
study of vegetarian athletes in India. Of course, there could be socioeconomic
or other confounding factors. That’s why we need interventional
studies to put different diets to the test and then compare
physical performance, which we’ll explore next..
Video Transcript – As found on YouTube
The Best Diet for Weight Loss and Disease Prevention
"The Best Diet for Weight Loss
and Disease Prevention" Why are vegetarian diets so effective
in preventing and treating diabetes? Maybe it's because of the weight loss.
Those eating more plant based tend to be significantly slimmer,
and not just based on like looking at a cross-section of the population,
but you can do interventional trials and put it to the test: a randomized,
controlled community-based trial of a whole food plant-based diet. The key difference between plant-based
nutrition and other approaches to weight loss is that participants
were informed to eat the whole food plant-based diet ad libitum,
meaning eat as much as you want, no calorie counting,
no portion control. Just eat. It's about improving
the quality of food rather than restricting
the quantity of food. And then in this study, they
had people just focus on diet rather than increasing exercise,
just because they wanted to isolate out the effects of eating
healthier. So, what happened? No restrictions on portions, eat
all the healthy foods you want. Here's where they started out: on
average obese at nearly 210 pounds; the average height was about 5'5". Three months in they were
down about 18 pounds; 6 months in, more
like 26 pounds down.
But you know how these
weight loss trials go. I mean, this wasn't
an institutional study where they locked people up and
fed them; no meals were provided. They just informed people about
the benefits of plant-based eating and encouraged them to do it in
their own lives, their own families, and their own homes and communities.
And so, yeah, typically what you see in these so-called "free-living"
studies is weight loss at six months, but then by a year the weight
creeps back or even worse. But in this study, they were able to
maintain that weight loss all year. And of course, their cholesterol got
better too, but their claim to fame is that they achieved greater weight loss
at 6 and 12 months than any other trial that does not limit calorie intake
or mandate regular exercise.
That's worth repeating. A whole
food plant-based diet achieved the greatest weight loss ever
recorded at 6 and 12 months compared to any other such intervention
published in the medical literature. Now obviously with very
low-calorie starvation diets you can drop people
down to any weight. However, these medically supervised
liquid diets are obviously just short-term fixes, associated
with high costs, high attrition rates, and a high probability of
regaining most of the weight, whereas the whole point of
whole food plant-based nutrition is to maximize long-term
health and longevity. I mean, even if, for example, low
carb diets were as effective, the point of weight loss is not
to fit into a skinnier casket. Studies on the effects of
low-carbohydrate diets have shown higher rates
of all-cause mortality— meaning a shorter lifespan—
decreased artery function, worsening of coronary artery disease,
and increased rates of constipation, headaches, bad breath, muscle
cramps, general weakness and rash. And yet, still not as effective
as the diet that actually has all the good side effects, like decreasing risk of diabetes,
beyond just the weight loss. Yes, the lower risk of type 2
diabetes among vegetarians may be explained in part
by improved weight status.
However, the lower risk also may
be explained by higher amounts of ingested dietary fiber and
plant protein, the absence of meat- and egg-derived
protein and heme iron, and lower intake
of saturated fat. Most studies report the lowest risk
of type 2 diabetes among those who adhere to strictly
plant-based diets. This may be explained by the fact
that vegans, in contrast to vegetarians, do not eat eggs, which appear to
be linked to higher diabetes risk. Maybe it's eating lower on the food
chain, so you avoid the highest levels of persistent organic pollutants like
dioxins, PCBs, DDT in animal products, which have been implicated
as a diabetes risk factor. Maybe it has to do with the gut
microbiome. With all that fiber, no surprise that there'd be
less disease-causing bugs and more protective gut flora,
which can lead to less inflammation throughout the body, that may be the
key feature linking the heathier gut with beneficial health effects— including the metabolic dysfunction
you can see in type 2 diabetes. And it's that multiplicity
of benefits that can help with compliance and family buy-in.
Whereas a household that includes people who do not have diabetes
may be unlikely to enthusiastically follow a "diabetic diet,"
a healthy diet is not disease-specific and can improve
other chronic conditions too.
So while the diabetic patient
will likely see improvement in their blood sugar control, a
spouse suffering from constipation or high blood pressure may
also see improvements, as may overweight children if you make
healthy eating a family affair..
Video Transcript – As found on YouTube
