Tag Archive for: plant-based diet

Building a Healthy Microbiome

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After last week’s Memos on the importance of a healthy microbiome and immune health, let’s review how to have a healthy microbiome to protect your brain and boost your immune system.

First, eat a mostly plant-based diet: some raw, some cooked, some fermented. The raw will give you probiotics and fiber. The cooked, especially whole grains and beans, will give you fiber. The fermented such as sauerkraut and yogurt will give you even more probiotics.

Second, fast once in a while. I covered this in Memos from June, so you can re-read the Memos on fasting and microbiome health.

Third, reduce your refined carbohydrate and sugar intake. Simply put, they provide the bad microbes with the food they need to overtake the good bacteria. Good bacteria need fiber from foods or supplements, so make sure you’re getting 25–30 grams per day.

My knee replacement surgery is scheduled in six days, so I’ve been working on preparing my body to defend against staph infections. I’ll talk about that in Saturday’s Memo.

What are you prepared to do today?

        Dr. Chet

The Bottom Line on “What the Health”

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“What the hell is going on around here?” That’s one of my favorite sideline videos of Vince Lombardi as he’s talking to his players, and that’s the way I felt after watching this movie. As I said, I’m going to cover one of the studies that was cited several times, but there’s a whole lot more science that warrants explanation; it’s available for Members and Insiders as a Straight Talk on Health audio. Now to the study.
 

“A Vegan Diet Is Better Than ADA Diet”

One of the films experts may be recognizable to some readers: Dr. Neal Barnard, president of the Physicians Committee for Responsible Medicine. He’s a leading proponent of a vegan diet. He led a research group that conducted a study to compare a vegan diet with a diet based on the American Diabetes Association diet guidelines (2). In the film, there were several references to the study that claimed it was more effective than the ADA diet—in fact, twice as powerful at controlling or reversing diabetes as the ADA diet, which included meat and dairy.

Researchers gave both groups dietary guidelines to follow for each diet as well as training with a registered dietician; 49 subjects began in the vegan group while 50 began in the ADA group. The study went 22 weeks and then continued through 74 weeks with the subjects tested periodically. I don’t know the significance of the 22 weeks; those results were not included in the paper.

Here are the results that didn’t quite make the movie:

  • There were no differences in the decrease in blood sugar; both diets reduced fasting blood sugar a similar amount.
  • Fewer than half the people in both groups completed the study.
  • The subjects in both groups claimed to reduce their caloric intake over 400 calories per day. However, weight loss was just ten pounds in the vegan groups and seven pounds in the ADA group. Really? In 74 weeks? Those results are simply not possible unless the subjects did not accurately report what they ate.
  • Finally, this study didn’t show that a vegan diet was twice as beneficial as the ADA diet; it showed that they were both ineffective at achieving reasonable goals for weight loss and a reduction in HbA1c over an extended period of time. While it was statistically significant, a reduction from 8.1% to 7.7% in over a year is not much improvement. Yes, it was better than the ADA diet in which the HbA1c stayed the same, but I wouldn’t start touting the benefits for diabetics just yet.

 

What the Movie Did Right

The only expert who comes through this movie unscathed is Dr. Caldwell Essylstein, the physician from the Cleveland Clinic who has demonstrated in a large clinical trial that severe CVD can be reversed using a low-fat vegan diet. I’m a fan of his work and education program. He was in only a couple of scenes and did not corrupt science in anything he said.

No so for many others in the movie. I just don’t understand why these medical and healthcare professionals would say the things they said. I have more to say, and it’s in the Straight Talk on Health audio for Members and Insiders.

What the movie got right was to provide the research that the experts cited in the movie. It was done scene by scene and makes it easy for anyone to check where the experts got their research facts. Unfortunately, that didn’t stop the research from being misinterpreted by people who know better.
 

The Bottom Line

“What the Health” is a mess of a documentary. It’s not an objective examination of what constitutes a healthy diet; it’s a critique of the food industry and health organizations that get funding from that industry. The problem is that it’s not done very well and never quite gets around to proving what it claims. Maybe they’ll do better next time.

I know a vegan diet is a very healthy way to eat if you do it right. We must move to a more plant-based diet if we’re going to be healthy, and it’s better for the planet as well. While I don’t think it’s the only healthy diet, it’s certainly great if you take the time to learn how to follow it correctly. The problem is that the plants we count on for nutrients may continue to have fewer of them. That’s the topic for next weeks Memos.

What are you prepared to do today?

Dr. Chet

 

References:
1. What the Health. Directed by K. Andersen and K. Kune. 2017.
2. Am J Clin Nutr 2009;89(suppl):1588S–96S

 

“What the Health”: False Sugar Claims

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“Sugar doesn’t cause diabetes!” So says just about every expert in the film “What the Health.” Of all the misstatements in the film, this one is the worst and most dangerous. It isn’t because the statement is false; it’s because of the way it’s presented. Expert after expert looks into the camera and says that excess sugar intake does not cause type 2 diabetes. On top of that, the explanations that they give to justify their position are misleading.

One expert said that sugar will be stored as glycogen in the liver and the muscles and the rest used for energy. That’s correct. Another talked about the Duke University Diet which included rice, sugar, and some fruit and fruit juices; one physician used it to help many people who were too sick for other treatments. All the experts filmed agreed that neither sugar nor carbohydrate caused type 2 diabetes. It just couldn’t.

They are stopping short of telling the truth or intentionally misleading the audience. Sugar doesn’t cause type 2 diabetes if the person does not overeat. The statement about glycogen? True, as I said, but when a person overeats carbohydrates, the liver stores as much glycogen as it can and then converts the rest to fat.

Excess carbohydrates lead to insulin resistance and eventually, type 2 diabetes. The Duke University Diet? That was from the 1940s. It was an ultra low-fat diet with no salt, and was used to treat the sickest patients but only under the care of a physician.

The section on sugar and diabetes was by far the worst. It intentionally misleads people to think that overeating is fine as long as it’s carbohydrates. But there was one study that was cited over and over that’s even worse in my opinion. I’ll cover that on Saturday.

What are you prepared to do today?

Dr. Chet

 

Reference: What the Health. Directed by K. Andersen and K. Kune. 2017.

 

“What the Health”: Half a Star

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“What the Health” claims to be “the health film that health organizations don’t want you to see.” My opinion: it’s a movie that isn’t worth the time it takes to see it, and I’d rate it at half a star. The movie is directed by Kip Anderson, the narrator and star of the movie, and Keeghan Kune; it’s supposed to be about Andersen’s journey to health. It’s more like a movie to nowhere due to a lack of skill in directing and research.

The obvious thing a movie is supposed to do is to tell a story; this one doesn’t. We don’t really get to understand why Andersen begins his quest. He wasn’t sick. He wasn’t overweight. He was already exercising. Why did he want to begin this journey? What we see are his questions about a healthy diet and the answers he gets from experts that explain why a vegan diet is the only healthy diet.

Those health organizations he’s talking about are the American Diabetes Association, the American Cancer Society, and just about every other national health association. He reviews their websites, sees that they recommend diets that are other than vegan, and thus he deems them unhealthy. Then he tries to interview dietary experts from the organization about why the organizations advocate these unhealthy diets. Alas, no one wanted to talk with him. The theme of the movie is that every organization takes money from meat, dairy, and refined food producers; therefore the organizations are corrupt because they don’t advocate a vegan diet.

The direction and writing are poor, but the real problem is the science that the film’s experts try to sell us. I’ll cover two primary issues in the next two Memos, but I don’t have the space to give a complete evaluation of all the claims made in this film. If you want to know more, I’m recording a Straight Talk on Health for Members and Insiders that will be posted later this week.

What are you prepared to do today?

Dr. Chet

 

Reference: What the Health. Directed by K. Andersen and K. Kune. 2017.

 

The Ignorant Vegan

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Before you write me an indignant email, remember this: the definition of ignorant is lacking awareness or uneducated. While being a vegan is a great way to eat, it can also be done poorly and thus can create health issues over time if vegans haven’t bothered to educate themselves. The issue is the foods people choose to include in their vegan diet.

Start with white: pasta, rice, bread, potatoes. Those are all vegan choices and can be prepared with some excellent recipes. The problem is the same as it would be for anyone, vegan or not: too many starches lead to an exaggerated insulin response. Calories still count: those extra calories can be converted to fat and actually increase cholesterol levels. You don’t get to overeat just because you’re vegan.

 

Nutrient Deficiencies

The problem doesn’t end there. Focusing on starches can limit the amino acids necessary to make complete proteins, at least in enough quantities to keep the body healthy. Isoleucine, leucine, and lysine are all deficient in those white starchy foods. The white foods have to be balanced with legumes which have high amounts of those amino acids.

Another potential issue can be iron. Because vegans do not eat seafood or meat, they can become iron deficient over time—and I’m talking six months or more. Yes, green vegetables such as spinach and kale do have iron, but a person has to be diligent in knowing the sources so they get those vegetables every day or at least several times per weak. In addition, soy products, sometimes a staple of a vegan diet, can interfere with iron absorption.

Last is vitamin B12. It’s sparse in plant-based products so unless you eat brewer’s yeast or the English staple marmite, vegans must take a B12 supplement.

 

Learning to Be a Vegan

Being a vegan is a healthy approach to improving your health but you have to be informed. It takes work for a while, until it becomes second nature. The one thing you can’t afford to be is an ignorant vegan. It can be dangerous to your health—the last thing you want.

Next week, I’m going to review the movie “What the Health” so make sure you see it this weekend. We’re going to answer the one question posed by the movie: does the science show that a vegan diet is the only path to optimal health?

What are you prepared to do today?

Dr. Chet

 

What Do Vegans Eat?

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The simplest way to describe a vegan diet is that it includes everything—except any food that comes from animals. If it comes from a plant, you can eat it. That includes all vegetables, all fruits, all grains, all legumes, and all nuts.

Peanut butter and jelly? Yes, if the bread is vegan. Baked sweet potato with brown sugar? Yep. A glass of wine or beer? Absolutely. Vegan pasta with marinara sauce? Ditto, but don’t add the Parmesan. I could go on and on, but you can see that it’s more than just salads and raw vegetables. And yes, you should eat plenty of those as well.

What should you eliminate? Meat from any animal; fish is also off limits. Fat from any animal. Anything cooked in or containing animal fats. Those biscuits you love? They’re made with lard, which comes from beef. The butter that goes on those biscuits? Nope, it comes from milk. Your favorite cake? No, it’s made with eggs. How about Jell-O; certainly Jell-O has to be okay! Not that either. It contains gelatin which comes from an animal. You can still eat those deep-fried foods as long as the oil is all vegetable.

The animal sourcing can extend to supplements as well. Gelcaps and capsules are made from animal or fish gelatin, although there are good vegan choices today. But don’t skip the supplements; they’re important because one nutrient that’s not easily accessible from plants is vitamin B12.

Just as there are vegan supplements, there are vegan versions of almost any food you can think of: eggs, milk, cheese, bread, burgers, even steak. I don’t know how good they taste, but they exist.

Seems pretty straightforward, doesn’t it? I’ll tell you how people can get it wrong on Saturday. Don’t forget to catch the documentary “What the Health” so you can follow along my review of the movie next week.

What are you prepared to do today?

Dr. Chet

 

All Signs Lead to Vegetables

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In the past couple of weeks, I’ve had many questions about vegan diets. Coincidentally Paula recommended a couple of HuffPost articles on rising CO2 levels and the effect on crops. Then someone asked me what I thought about the movie “What the Health” available on Netflix or online; it’s purported to be a documentary on the food industry and why a vegan diet is the best. When this confluence of events happens—when the universe gives me this many signs—it’s time to write about it.

I’ve spent the better part of two weeks researching the background on the movie and the articles. This was not easy reading, but I wanted to provide the most recent information so you can make an informed decision. Coming Memos are going to be related to issues surrounding vegan and vegetarian diets that were covered in the movie and the articles.

To get things started, I recommend that you watch the movie. When I review the movie next week, I want you to watch what they said and then what the research says. You can watch it on Netflix; if you don’t subscribe to Netflix, you can take advantage of their free trial, which is what we did. If you don’t like those options, you can watch it on your computer, tablet, or phone. That will cost you $9.99 but you can stream it any time. www.whatthehealthfilm.com.

On Thursday, we look at exactly what a vegan diet is. Reminder for Insiders: conference call is tonight!

What are you prepared to do today?

Dr. Chet

 

The Bottom Line on Veggies and Carbs

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Go ahead and finish your oatmeal and drink your protein-kale smoothie—you do need those veggies. Meanwhile I’ll put the PURE study in perspective.

This is a large study that looks at the economics of food as well as the health benefits. In a separate publication, the analysis of the data focused on the cost of fruit and vegetable intake as a percentage of monthly income. They specifically collected data from low-, middle-, and high-income communities from 18 different countries. Researchers actually went to grocery markets in those countries to collect the cost data. As you might expect, the lower the income, the higher the percentage of monthly revenue spent on vegetables and fruits.

I think that explains part of the reason the second study on vegetable intake and mortality said there was no additional benefit beyond three or four servings per day: if people can’t afford more, it’s wrong to teach them that more is better if it might not be. But that doesn’t justify the headlines because the message that Americans hear is “I don’t have to eat those darn vegetables!”

Yes, you do. Here are the issues with each of the studies.

 

Do Carbs Kill?

In the first study on carbohydrate intake and mortality, researchers used a simple percentage of caloric intake in their analysis. Basically we have a math problem: if someone in a poor country eats 80% of their diet as carbohydrates from root vegetables but they only get 1,000 calories per day that’s a completely different situation from a person who eats 3,000 calories per day but 50% of their calories are from refined carbohydrates and sugars.

As I’ve said many times, while we should eat fewer refined carbohydrates, carbohydrates are not inherently bad; it is the overconsumption that’s the problem. If researchers didn’t analyze the total caloric intake from carbohydrates, protein, and fats, we don’t have the complete answer. The PURE study used a food frequency questionnaire. I’ll leave it at that because I rant too much about the FFQs.

Finally, the researchers simply jumped the gun by recommending that health education should now focus on increasing fat intake while reducing carbohydrates. All types of vegetables and fruits are carbohydrates. Because researchers did not parse out different sources of carbohydrates in their analysis, their recommendations are meaningless.

 

Don’t Bother with More Veggies?

PURE is an observational study; it cannot determine cause and effect. Also it can tell you a lot about a large group of people but nothing about an individual.

The lead researcher actually provided the perspective on vegetables and fruit during an interview: if the research shows that the benefit of eating more plant-based food is a 20% reduction in mortality, and the mortality rate of the population is just 1%, that means the reduction goes from 10 out of 1,000 to 8 out of 1,000. It’s virtually meaningless to an individual.

The researchers hesitated to tell people with very low incomes to spend more on additional servings of plant-based food if there was not a meaningful benefit. But for most of you, the cost of fruit and vegetables is not a hardship, so buy ’em and eat ’em.

 

The Bottom Line

These will not be the last headlines we hear from the PURE study because the data continues to be analyzed. One issue for me is that there’s no data from the U.S. included so the ability to generalize to the U.S. population is very limited. We lead the world in obesity and overweight and our food consumption patterns are different even from other Westernized countries.

One thing remains clear to me: we should all eat more vegetables and fruit and reduce refined carbohydrates. The recommendation never changes: eat less, eat better, move more.

What are you prepared to do today?

Dr. Chet

Reminder to Insiders: The next Insider Conference Call will be Tuesday at 9 p.m. Not an Insider? Join now to participate in this call and get your questions answered.

 

References:
1. DOI: http://dx.doi.org/10.1016/S0140-6736(17)32252-3.
2. DOI: http://dx.doi.org/10.1016/S2213-8587(17)30283-8.

 

PURE Headline 2: Don’t Bother with More Veggies?

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Using the same data base of subjects in the PURE Study, researchers examined the vegetable, fruit, and legume intake on total mortality, mortality, and major cardiac events such as heart attacks.

The most important finding was that higher vegetable, fruit, and legume intake was associated with a reduced risk of mortality and morbidity. Simply put, the more plant-based the diet, the better off you are from an overall health perspective.

But that’s not what the headline messages said. They focused on the part of the study that said there appeared to be no additional benefits if subjects ate more than a few servings of vegetables, fruits, and legumes. That seems to fly in the face of the “more is better” results that previous research has shown.

Have all the prior studies been wrong? Have you been eating kale for no good reason? No, and I’ll explain why the headlines are wrong on Saturday.

What are you prepared to do today?

Dr. Chet

 

Reference: DOI: http://dx.doi.org/10.1016/S0140-6736(17)32253-5.

 

How to Reverse Heart Disease

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In this final message of the week on reversing heart disease, I’m going to tell you why I think the program was successful, a couple of problems that I have with it, and the bottom line.
 
The Training
The key to this program in my opinion was education. The program began with a five-hour seminar with limited participation: no more than 12 participants. Here’s what they did in the training:

  • Explained the relationship between diet and heart disease in other cultures throughout the world.
  • Showed the damage to arteries in very young . . .

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