Exercise vs Whole Food Plant-Based Diet

Which is more important for your health – exercise or diet? If you listen to the likes of Michelle Obama 1, then it would appear that exercise Trumps diet (pun intended and immediately regretted). This opinion appears to be shared by all those who have an interest in making money out of manufacturing/selling processed and junk food, those who want us to keep popping the pharmaceuticals and paying for mere management of our chronic illnesses rather than cure, and also by those who own gyms or sell home gym equipment and the plague of protein powders. But what do WFPB doctors and scientific research tell us?

WFPB doctors – exercise vs diet

I know that I go on and on about diet, devoting only a relatively small amount of blog space for exercise-related issues. Interestingly, it appears that I share this tendency with Dr Thomas Campbell: “…when I discuss lifestyle with my patients I spend almost all my time talking about food. My new book, The Campbell Plan 2 , contains just about a page on exercise. Am I delinquent? Perhaps I am. We know how crucial exercise is, but what I see more often than not is an overemphasis on exercise. I tend to see people focus their energies on getting to the gym as their primary strategy for weight control while leaving their diet largely the same. Perhaps they are trying to eat less, or just not snack on the junk in the house as often. Overall, this is a poor strategy.” 3 .

On the other hand, you’ll see Dr Michael Greger bounding along on his treadmill when doing his regular YouTube Q&A sessions, and he includes exercise as an integral part of his Daily Dozen 4 : “I advise one daily “serving” of exercise, which can be split up over the day. I recommend ninety minutes of moderate-intensity activity each day, such as brisk (four miles per hour) walking or, forty minutes of vigorous activity (such as jogging or active sports) each day. I explain my reasoning for that in my video, How Much Should You Exercise?” 5

Dr Joel Fuhrman considers 6 that exercise has a lot more value than simply helping us to lose weight by more quickly burning calories: “The calories burned during exercise, unless you’re a professional athlete, make up a very small portion of our total calories burned for the day; what we eat has a much greater influence on our body weight. So why should we bother to exercise? The answer is that burning calories is just one of the many benefits of exercise.

“For example, in the chapter titled “Nutritional Excellence, Not Drugs” in my book, The End of Heart Disease 7 , I discuss how exercise is an important component in attaining excellent health: ‘When you change to a Nutritarian diet-style, cut the salt out of your diet, exercise regularly, and lose weight, you remove inflammation, reduce atherosclerosis, and eliminate the inflammation of the endothelium. In other words, the causes of high blood pressure are eliminated, and the blood vessels begin to heal themselves.’ ”

Many other WFPB doctors extol the virtue of exercise, but they all consider that it must be within the context of a healthy plant-based diet.

Which does the science say is more important – diet or exercise?

In his book How Not To Die 8 , Dr Michael Greger makes it pretty clear that, whilst exercise is important, it’s diet that’s the biggie when it comes to warding off obesity and other chronic diseases:

“The food industries like to blame inactivity as the prime cause of obesity, not the promotion and consumption of their calorie-rich products 9 . On the contrary, however, research suggests that the level of physical activity may have actually increased in the United States over the past few decades 10 . We know that obesity is rising even in areas where people are exercising more 11 . This is likely explained by the fact that eating activity levels are outstripping physical activity levels 12 .

Surveys suggest that most people believe controlling diet and getting enough exercise are equally important for weight control 13 . Researchers who accept grants from the Coca-Cola Company 14 call physical inactivity “the biggest public health problem of the 21st century.” 15Actually, physical inactivity ranks down at number five in terms of risk factors for death in the United States and number six in terms of risk factors for disability 16 . And inactivity barely makes the top ten globally 17 .

“…diet is by far our greatest killer, followed by smoking 16 . Of course, that doesn’t mean you should sit on the couch all day. As we’ve seen in this book, in addition to helping you enjoy a healthy body weight, exercise can also ward off and possibly reverse mild cognitive decline, boost your immune system, prevent and treat high blood pressure, and improve your mood and quality of sleep, among many other benefits.” 18

Which is more effective – exercise or drugs?

A 2013 BMJ review 19 concluded that: “Although limited in quantity, existing randomised trial evidence on exercise interventions suggests that exercise and many drug interventions are often potentially similar in terms of their mortality benefits in the secondary prevention of coronary heart disease, rehabilitation after stroke, treatment of heart failure, and prevention of diabetes.

As pointed out by the PCRM website 20 this review, which analysed more than 305 trials with 339,274 participants, compared drug and exercise interventions and it found that: “…exercise proved similar to medications for heart disease prevention, heart failure treatment, and diabetes prevention. For those who had suffered a stroke, exercise was more effective than drug treatment. In addition, physical activity often provided patients with fewer side effects and injuries. The authors stress that these data provide health care professionals with a safe and effective alternative for their patients.

What are some of the benefits of exercise?

Dr Greger considers that: “…in addition to helping you enjoy a healthy body weight, exercise can also ward off and possibly reverse mild cognitive decline, boost your immune system, prevent and treat high blood pressure, and improve your mood and quality of sleep, among many other benefits.” 18

The science certainly seems to support the importance of physical exercise for preventing/treating a whole range of chronic diseases affecting all parts of the body, including:

  • the heart
    • regular physical activity reduces the risk of coronary heart disease and diabetes by 30-50% 21
    • when you exercise, the heart muscle gets a workout too. Over time, the heart becomes more efficient, allowing the resting heart rate to decrease—beneficial, since a high resting heart rate is a risk factor for cardiac mortality 22 23
    • regular exercise helps to increase production of nitric oxide, a key regulator of blood pressure. In addition to reduced blood pressure, resulting in improved blood flow to skeletal muscle and the heart 24 25
  • the brain
    • physical exercise is a natural mood elevator, and has been shown to be just as effective as (and, naturally, much safer than) anti-depressant drugs 26 27 28 29
    • physical activity has consistent and long links to cognitive abilities and mental alertness 30
    • for older adults, regular walking was shown to decrease the risk of cognitive impairment 31 , and strength training also produces cognitive benefits 32
  • the whole body
    • muscle strength is regarded as the best predictor of bone strength— exercise protects against osteoporosis 33 34 35
    • a decreased risk of colon, breast, and prostate cancers are associated with increased physical exercise, thought to partly due to the effects on the insulin-like growth factor 1 (IGF-1) system 36
    • the body’s antioxidant defences are built and maintained by regular physical exercise 24
    • sleep is enhanced by exercise 37 38
    • exercise protects against chronic inflammation 39

Final thoughts

So, which is most important, then – exercise or diet? I think it’s clear from the above that both are important. However, if I was to recommend one rather than the other, it would be diet every time. There’s some benefit in exercising while still eating the toxic SAD (Standard American Diet) full of excess animal protein, fat and cholesterol, processed junk, salt, sugar and oils; but the benefit would be minimal compared with doing relatively no exercise but simultaneously eating a WFPB diet.

You couldn’t go far wrong if you simply followed Dr Greger’s Daily Dozen – treat exercise as one of the daily components of your optimal diet and lifestyle – the best of both worlds…

  1. Let’s Move Campaign – Michelle Obama. []
  2. The Campbell Plan by Thomas Campbell, MD []
  3. Reasons You Should Include Exercise in Your Diet Plan. March 27, 2015. By Thomas Campbell, MD. []
  4. Dr. Greger’s Daily Dozen Checklist. Michael Greger M.D. FACLM September 11th, 2017 Volume 38 []
  5. How Much Should You Exercise? Michael Greger M.D. FACLM April 28th, 2017 Volume 35 []
  6. Exercise Has Surprising Benefits for Your Heart and Brain. May 21, 2016 by Joel Fuhrman, MD []
  7. The End of Heart Disease by Joel Fuhrman []
  8. How Not To Die by Dr Michael Greger []
  9. Freedhoff Y, Hébert PC. Partnerships between health organizations and the food industry risk derailing public health nutrition. CMAJ. 2011;183( 3): 291– 2. []
  10. Westerterp KR, Speakman JR. Physical activity energy expenditure has not declined since the 1980s and matches energy expenditures of wild mammals. Int J Obes (Lond). 2008;32( 8): 1256– 63. []
  11. Dwyer-Lindgren L, Freedman G, Engell RE, et al. Prevalence of physical activity and obesity in US counties, 2001– 2011: a road map for action. Popul Health Metr. 2013;11: 7. []
  12. Laskowski ER. The role of exercise in the treatment of obesity. PMR. 2012;4( 11): 840– 4. []
  13. Matthews J, International Food Information Council Foundation. Food & Health Survey: Consumer Attitudes Toward Food Safety, Nutrition & Health. August 31, 2011. []
  14. Archer E, Hand GA, Blair SN. Correction: Validity of U.S. Nutritional Surveillance: National Health and Nutrition Examination Survey Caloric Energy Intake Data, 1971– 2010. October 11, 2013. []
  15. Blair SN. Physical inactivity: the biggest public health problem of the 21st century. Br J Sports Med. 2009;43( 1): 1– 2. []
  16. Murray CJ, Atkinson C, Bhalla K, et al. The state of US health, 1990– 2010: burden of diseases, injuries, and risk factors. JAMA. 2013;310( 6): 591– 608. [] []
  17. Lim SS, Vos T, Flaxman AD, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990– 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380( 9859): 2224– 60. []
  18. Greger, Michael; Stone, Gene. How Not To Die: Discover the foods scientifically proven to prevent and reverse disease (Air Side Edt) (pp. 392-394). Pan Macmillan. Kindle Edition. [] []
  19. Naci H, Ioannidis JPA. Comparative effectiveness of exercise and drug interventions on mortality outcomes: metaepidemiological study. BMJ. Published online October 1, 2013. []
  20. PCRM: Exercise as Effective as Drugs in Disease Treatment. October 3, 2013. []
  21. Bassuk SS, Manson JE. Epidemiological evidence for the role of physical activity in reducing risk of type 2 diabetes and cardiovascular disease. J Appl Physiol 2005;99:1193-1204. []
  22. Duncker DJ, Bache RJ. Regulation of coronary blood flow during exercise. Physiol Rev 2008;88:1009-1086. []
  23. Verrier RL, Tan A. Heart rate, autonomic markers, and cardiac mortality. Heart Rhythm 2009;6:S68-75. []
  24. Kojda G, Hambrecht R. Molecular mechanisms of vascular adaptations to exercise. Physical activity as an effective antioxidant therapy? Cardiovasc Res 2005;67:187-197. [] []
  25. Brown MD. Exercise and coronary vascular remodelling in the healthy heart. Exp Physiol 2003;88:645-658. []
  26. Medina J: brain rules. . Seattle, WA: Pear Press; 2008.))  ((Hyman M: The UltraMind Solution. New York, NY: Scribner; 2009. []
  27. Gill A, Womack R, Safranek S. Clinical Inquiries: Does exercise alleviate symptoms of depression? J Fam Pract2010;59:530-531. []
  28. Uebelacker LA, Epstein-Lubow G, Gaudiano BA, et al. Hatha yoga for depression: critical review of the evidence for efficacy, plausible mechanisms of action, and directions for future research. J Psychiatr Pract 2010;16:22-33. []
  29. Saeed SA, Antonacci DJ, Bloch RM. Exercise, yoga, and meditation for depressive and anxiety disorders. Am Fam Physician 2010;81:981-986. []
  30. Medina J: brain rules. . Seattle, WA: Pear Press; 2008.  []
  31. Erickson KI, Raji CA, Lopez OL, et al. Physical activity predicts gray matter volume in late adulthood: the Cardiovascular Health Study. Neurology 2010;75:1415-1422. []
  32. Davis JC, Marra CA, Beattie BL, et al. Sustained Cognitive and Economic Benefits of Resistance Training Among Community- Dwelling Senior Women: A 1-Year Follow-up Study of the Brain Power Study. Arch Intern Med2010;170:2036-2038. []
  33. Arq Bras Endocrinol Metabol. 2014 Jul;58(5):514-22. Physical exercise and osteoporosis: effects of different types of exercises on bone and physical function of postmenopausal women. Moreira LD, Oliveira ML, Lirani-Galvão AP, Marin-Mio RV, Santos RN, Lazaretti-Castro M. []
  34. Osteoporos Int. 2014 Aug;25(8):2017-25. doi: 10.1007/s00198-014-2724-3. Epub 2014 May 8. The effect of exercise and education on fear of falling in elderly women with osteoporosis and a history of vertebral fracture: results of a randomized controlled trial. Olsen CF1, Bergland A. []
  35. Osteoporos Int. 2015 Oct;26(10):2491-9. doi: 10.1007/s00198-015-3165-3. Epub 2015 May 12. Exercise and fractures in postmenopausal women. Final results of the controlled Erlangen Fitness and Osteoporosis Prevention Study (EFOPS). Kemmler W, Bebenek M, Kohl M, von Stengel S. []
  36. American Institute for Cancer Research: The Exercise Factor. []
  37. Atkinson G, Davenne D. Relationships between sleep, physical activity and human health. Physiol Behav2007;90:229-235. []
  38. Montgomery P, Dennis J. Physical exercise for sleep problems in adults aged 60+. Cochrane Database Syst Rev2002:CD003404. []
  39. Mathur N, Pedersen BK. Exercise as a mean to control low-grade systemic inflammation. Mediators Inflamm2008;2008:109502. []

Chia Seeds To The Rescue Of Type 2 Diabetics

We previously considered chia seeds (both Salvia hispanica and Salvia and Salvia sclarea) as excellent sources of ALA in a blog on non-fish-based omega-3 fatty acids 1 . But these amazing little seeds just can’t stop giving. They also appear to have significant benefit benefit if you have type 2 diabetes. But you need to look at final thoughts to get the whole picture from ground level.

This was seen in a double-blind randomised controlled trial 2 which looked at whether the humble chia seed (Salvia hispanica L.) could help in the treatment of overweight and obese patients who have type 2 diabetes.

Aim of the study

The researchers considered that Salba-chia 3  (a white variant of the black Salvia hispanica species), an ancient seed, improves management of type 2 diabetes and suppresses appetite. It just happens that they used the white variety, it wouldn’t have mattered if they had used the black variety. In fact, Dr Greger argues 4  that the black variety is even more  beneficial to human health.

The aim of this study was to assess the effect of chia on body weight, visceral obesity and obesity-related risk factors in overweight and obese adults with type 2 diabetes.

Study method

This was a 6-month long double-blind, randomised, controlled trial which used two groups of overweight/obese patients with type 2 diabetes.

Each group had a calorie-restricted diet:

test group received 30 g/1000 kcal/day of chia seeds

control group received 36 g/1000 kcal/day of an oat bran-based alternative

Changes in the following would be measured at the end of the study:

  • body weight
  • waist circumference
  • body composition
  • glycaemic control 5
  • C-reactive protein 6
  • obesity-related satiety hormones 7

Study results

When tested after 6 months, the following results were found:

  • chia group had lost more weight than control group
  • chia group had a greater reduction in waist circumference than control group
  • chia group had a reduction in C-reactive protein compared with control group
  • chia group had increase in plasma adiponectin 8  levels compared with control group

Study conclusions

The results of this study, support the beneficial role of Salba-chia seeds in promoting weight loss and improvements of obesity related risk factors, while maintaining good glycemic control. Supplementation of Salba-chia may be a useful dietary addition to conventional therapy in the management of obesity in diabetes.

Final thoughts

What’s really important in this study, which is not made clear in the above abstract, is that the chia seeds used were not whole. Rather, they were ground chia seeds. This is something that also applies to reached that has been undertaken on flax seeds which have such a tough shell that they largely pass straight through your body with all that potential goodness ending up in the toilet bowl. Some previous research 9  into the efficacy of chia seeds did not manage to get the same positive results simply because the seeds were consumed whole instead of ground. “It ain’t what you do it’s the way that you do it!”

So, if you want the benefits outlined above, I strongly advise that you grind up your chia and flaxseeds before adding them to your morning muesli or any of the other meals during the day where you would (I hope) use lots of these two miracle seeds. And, by the way, avoid sprouting chia seeds, particularly ground chia seeds, since research 10 has shown they are pretty good at growing salmonella as well!

Oh, and one more helpful benefit of chia seeds is that they have been shown 11  to reduce appetite – hence reducing the number of calories that people eat. Just one teaspoon of chia a day (50 Kcal) appeared to be enough to reduce what subjects ate afterwards by as much as 300 Kcal).

And two tablespoons of chia seeds a day (ideally ground):


References

  1. Non-Fish Sources of Omega-3 []
  2. Nutr Metab Cardiovasc Dis. 2017 Feb;27(2):138-146. doi: 10.1016/j.numecd.2016.11.124. Epub 2016 Dec 9. Salba-chia (Salvia hispanica L.) in the treatment of overweight and obese patients with type 2 diabetes: A double-blind randomized controlled trial. Vuksan V1, Jenkins AL2, Brissette C3, Choleva L3, Jovanovski E3, Gibbs AL4, Bazinet RP5, Au-Yeung F3, Zurbau A3, Ho HV3, Duvnjak L6, Sievenpiper JL7, Josse RG8, Hanna A []
  3. Livestrong.com: Comparison of Chia & Salba []
  4. Video: Do Chia Seeds Help with Belly Fat? Michael Greger M.D. FACLM June 29th, 2018 Volume 42 []
  5. Medical Dictionary: Definition of glycaemic control []
  6. Mayo Clinic: C-reactive protein test []
  7. Medical News Today: Obesity: Lack of ‘satiety hormones’ plays a role []
  8. Adiponectin regulates glucose levels and fatty acid breakdown: Wikipedia []
  9. Nieman DC, Cayea EJ, Austin MD, Henson DA, Mcanulty SR, Jin F. Chia seed does not promote weight loss or alter disease risk factors in overweight adults. Nutr Res. 2009;29(6):414-8. []
  10. Harvey RR, Heiman marshall KE, Burnworth L, et al. International outbreak of multiple Salmonella serotype infections linked to sprouted chia seed powder – USA and Canada, 2013-2014. Epidemiol Infect. 2017;145(8):1535-1544. []
  11. Ayaz A, Akyol A, Inan-eroglu E, Kabasakal cetin A, Samur G, Akbiyik F. Chia seed () added yogurt reduces short-term food intake and increases satiety: randomised controlled trial. Nutr Res Pract. 2017;11(5):412-418. []

Vegans Most Concerned About Healthy Eating? Think Again…

A recent BBC article 1  considered why veganism was on the rise. You might be interested in knowing the differences between reasons given for wanting to avoid eating meat by two groups: firstly, people who are already vegans and, secondly, people who are considering cutting out meat but who are not currently vegan.

I have maintained for some time that there is a big difference between being vegan (or vegetarian, for that matter) and being a person who eats a WFPBD (wholefood plant-based, diet). The following results of a 2018 survey by Lightspeed/Mintel of 1,040 UK adults 2 , covered in the above-mentioned BBC article, seems to support this.

The following is the chart I am talking about.

Why vegans are not as healthy as you’d think

You will see that the following is the order of importance of going meat-free to vegans:

  1. Animal welfare
  2. The environment
  3. Health
  4. Taste
  5. Concern about antibiotics
  6. Weight management

Whilst the following is the order of importance of going meat-free to non-vegans who are thinking about the switch to veganism:

  1. Health
  2. Weight management
  3. Animal welfare/the environment
  4. Concern about antibiotics
  5. Taste

You’ll see that vegans are most concerned about animal welfare and the environment, with health in third position and other health concerns (antibiotics and weight management) below taste.

On the other hand, those who are not vegans, but are who are thinking about it, put health first, weight management second, and the other health concern (antibiotics) above taste.

Why vegan restaurants are not so healthy

Visit most vegan restaurants and you will find food and food preparation methods that a WFPB advocate would not even touch – food fried in oil, white bread/pasta/rice, salads drowned in olive oil, salt added to most recipes, sugar-laden desserts.

Why I am not vegan

This is one of the main reasons that I will not call myself a vegan. From the vegans I know, the vegan recipe websites and books I read, and the vegan restaurants I’ve visited, their diet is not optimally healthy and, in many cases, is actually not that much better than those stuffing the chicken and chips down their throats on a regular basis.

The BBC article is, however, interesting in that it further suggests there is a wave of interest sweeping the general public towards more concern about the impact of diet on their health – something that seems so very, very obvious whenever you stop and think that we are literally what we eat – never mind the factual evidence that scientific research has shown for many decades, and conventional wisdom has known for centuries.

The following chart 3 shows that meat-free foods are on the rise:

And looking at the following popularity chart 4 (where 100 is the highest level of popularity and zero is the lowest), you will see that in 2008 searches for “veganism” had a popularity score of only 17  in 2018 it has increased to 88:

I’m glad that I didn’t go vegan before I went WFPBased.  Whilst I am cognisant (and supportive) of the animal welfare and environmental issues associated with veganism 5 , I consider that human health comes first.

Why human health comes before animal welfare & environmental concerns

I believe this because of a very practical reason: once you start to eat a WFPB diet, you are already doing the best thing you can possibly do in order to solve all the other issues itemised above in the chart of reasons for not eating meat 2 – animal welfare, the environment, concern about antibiotics, weight management and, I guess arguably to a large extent, taste.

Taste is a sticky one

Opting for a WFPB diet (especially if it’s the optimal no-SOS (no added salt, oil or sugar) diet) will not necessarily give you those amazing tastes you might have grown up with – bacon butties with white bread, butter and tomato ketchup, sticky barbecued chicken, Cornish dairy ice-cream, etc – but losing these is only something that we who have been brought up on them are likely to miss. A generation brought up on the healthiest diet on the planet (no-SOS WFPB)  would not miss what they never ate.

Taste is like any other addiction

Addictive tastes of food are no different from addictions to anything else – tobacco, alcohol, drugs, gambling. If you’ve never had the addiction, you never miss it. And, once you have “kicked the habit”, the benefits are always greater than the deficits, in spite of the parrot on your shoulder telling you that you’re missing out! Ask any ex-smoker whether they really felt better when they were having to inhale their 20 or 30 a day. Ask any ex-alcoholic if they were really happier when they couldn’t get through more than a couple of hours without having to plan where the next fix was coming from.

Final thoughts

If the only reason you continue eating animal products is because of taste, then I can tell you that a no-SOS WFPB diet is really tasty and satisfying. Of course, you won’t believe it, but neither would a lot of vegans if they thought they had to give up their olive oil, fake ice-cream, fake sausages/burgers or white pasta.

Do I miss some of the foods I was raised on? Yes, occasionally. But I also occasionally miss the relaxation you get from taking that first drag of a cigarette or slug of whisky when you feel stressed.

The justification for missing something that a person knows was not good for them is that they would now know they were doing the right thing to stay healthy and live a long and productive life. If that’s not good enough justification for change, then I suspect a person won’t change.


 

References

  1. Veganism: Why is it on the up? By Lora Jones. Business Reporter, BBC News. 18 June 2018. []
  2. ETHICAL LIFESTYLES – UK – JUNE 2018 [] []
  3. Mintel: MEAT-FREE FOODS – UK – MAY 2017 []
  4. Google Popularity Search results []
  5. Definition of Veganism: The Vegan Society []

Dr Kim Williams – Life’s Simple Seven

Dr Kim A Williams1, the first ever vegan president of the American College of Cardiology, gives2 his version of the American Heart Association’s simple rules for having a healthy heart, called “Life’s Simple Seven”. If we are really concerned about living long and healthy lives – both for ourselves and for our loved ones – why would anyone not use these as an essential lifestyle foundation?

1. Everyone should be on a plant-based diet.

The AHA don’t say “plant-based”, instead they talk about a “heart-healthy diet”:

“Eat Better – A healthy diet is one of your best weapons for fighting cardiovascular disease. When you eat a heart-healthy diet, you improve your chances for feeling good and staying healthy – for life!” 3

There’s a clear reason why Dr Williams modifies the AHA’s definition of what is “heart-healthy” when you look at the list of foods the AHA recommend as foods we should eat4:

” Eat an overall healthy dietary pattern that emphasizes:

This is not the place to go into the research showing the harmful effects of four of the items in the above list – dairy, poultry, fish and oils), so we’ll move on and just be thankful that the ex-president of the American College of Cardiology is up-to-date with –  and prepared to be honest about – the findings relating to plant-based vs meat-based diets in nutritional research literature.

2. Everyone should be at their ideal body weight.

  • If you’re overweight, you need to address it.
  • If you’re obese, you really need to deal with it now.
  • If you’re morbidly obese, you’re going to have to make some dramatic changes that are behavioural and not easy – but they have to be done.

3. Everyone should know their blood sugar and make sure it’s normal.

The health services of an ever-growing number of countries are increasingly under threat of being swamped by cases of diabetes. In addition to this, there is a worrying change in the CVD mortality figures.

For 40+ years, in the U.S., these figures have been dropping because of the pharmaceutical and surgical advances (stents, by-pass surgeries, etc) made in prolonging the lives of heart disease patients  – admittedly they still have restricted lives and are not being cured, unlike some of heart disease patients treated with WFPB lifestyle changes by the likes of Dr C B Esselstyn and Dr Dean Ornish.

But between 2014 and 2015, this downward trend came to an end. Some5 predict:

“The number of people with heart failure is expected to rise by 46 percent by 2030.” 

The rise could be partly due to the increase in obesity and diabetes, but also as a natural dropping of the curve as the average 10-year life expectancy increase of medical interventions in CVD catches up with those treated a decade or so ago.

For those who are diabetic, or at risk of becoming diabetic, losing weight is something that should be an immediate priority.

The obesity and diabetic epidemic is real.”

And transitioning to a WFPB diet is probably the healthiest and most sustainable way of doing this.

4. Everyone should know what their blood pressure is and it should be controlled.

It’s shocking how few people are even aware of what their blood pressure is. And of those who do know, only a relatively small proportion are doing anything to control it. Surely almost everyone should be able to justify either the small cost of purchasing a wrist or arm blood pressure monitor (also called a sphygmomanometer) or the short journey to the doctor’s surgery for a test.

5. Everyone needs to be getting some physical exercise every day.

Even aiming for a daily minimum of 30 minutes exercise would make a tremendous difference – whether it’s on a cross-trainer, walking briskly or playing a round of golf. Mixing the types of exercise is ideal, so that both aerobic and load-bearing exercises are involved.

Regardless of your age or level of fitness, there are exercises6 that will suit you and allow you to grow stronger and feel so much more alive.

6. Everyone should should know what their cholesterol is and that it is at a normal level.

If you have to normalise your cholesterol with medication, then do it. Ideally, of course, it’s best to achieve it by eating a WFPB diet, since then the only cholesterol you will have in your body is what your body (liver, intestines etc) is making for you. And an added benefit is that you then don’t have to pay for possibly expensive medications.

There’s so much invaluable advice7 – that can be found online about which foods lower cholesterol and how important it is to reduce, or better still, eliminate dietary cholesterol completely from your diet. Remember that dietary cholesterol only comes from animal foods, and because almost all animal foods come naturally pre-packed with corresponding amounts of saturated fat, this increases the damage that the cholesterol can do to your body.

7. Nobody should smoke.

Although the rate of tobacco smoking has reduced in the Western World, it’s still a major cause of a variety of diseases that are almost completely avoidable if you don’t smoke.

*********************

If you follow these 7 simple rules…

…there will be a dramatic change in your lifestyle, functional capacity and the influence you will have on your friends and family.

If we ignore these rules, it’s not just the future of our own health that’s at risk. The solvency of our national health service and the economic future of our country will also be casualties – victims of the unfortunate lifestyle and dietary choices made by its well-intentioned citizens.

 


References

  1. 1st Vegan President of the American College of Cardiology []
  2. Dr. Kim Williams And Jeremy Glogower Get Real About Going Plant-Based, Seven Rules We Can All Live By And More… []
  3. My Life Check – Life’s Simple 7. American Heart Association. []
  4. The American Heart Association: Diet and Lifestyle Recommendations. []
  5. CBS News: U.S. heart failure rates on the rise. []
  6. Physical Exercises for Beginners and Seniors []
  7. Cholesterol Advice from Dr Greger []

The Three Mechanisms of Satiation

 

 

The condition of feeling full after eating (or satiation) conforms to a law as real as Newtons’ Laws of Motion, according to Drs. Doug Lisle and Alan Goldhamer in their book The Pleasure Trap. They call it the Law of Satiation.

[su_box title=”THE LAW OF SATIATION” style=”glass” box_color=”#ede8f8″ title_color=”#07114e”]”In a natural setting of caloric abundance, animals will consume the correct amount of food needed for optimal function.”[/su_box]

They explain that in the natural, animal world, there is a balance between caloric intake and activity level; wild animals simply do not become overweight.

Today in the western world, however, foods are overly processed and packed with extraordinarily high calorie content – very different from how nature intended.

It is very sad to see millions of people busily counting calories while all along there’s a beautifully evolved innate machinery inside our bodies that can handle this automatically for us.

So, contrary to almost everything you hear in the popular media, the answer lies not in how much we eat, but in what we eat.

The three mechanisms of satiation

  • Stretch sensation
  • Nutrient sensation
  • The “Yowel” circuits

The gastrointestinal system automatically assists us in helping us to feel just how much we have consumed. It does this with stretch receptors and nutrient receptors. The former sends signals to the brain to indicate the stomach volume is full, while the latter senses the caloric density of what we’ve consumed.

 

The Yowel circuits

The “Yowel” circuits can be explained by the acronym You’re Over-Weight, Eat Less! This isn’t a scientific term but simply another mechanism related to feeding behaviour – a psychological feedback mechanism that allows us to monitor our weight and food consumption, reflect on it and, hopefully, make appropriate behavioural adjustments – i.e. eating less if we are noticing that we’re getting a bit podgy.

The question is: if there’s this so-called “Yowel” circuit then why is anyone overweight?

 

“The excess fat reduction mechanisms were never intended to do battle with the degree of dietary indulgence caused by modern processed foods. We are no longer dealing with mildly elevated caloric intakes, but rather with a problem of massively excessive calories and excess body fat.” (The Pleasure Trap, p. 72).

 

When our ancestors over-indulged during the rare occasions when they would come across a plentiful natural food supply, the “Yowel” circuits would soon discourage overeating. Becoming aware of physiological changes as a result of indulgence in extra calories would cause a natural return to appropriate levels of consumption. Clearly, evolution would have favoured the thin and mobile, rather than the obese caveman or woman when the group had to escape from predators. And in any event, the period of excessive consumption would rarely have lasted for long in a natural pre-industrial environment.

The conscious regulation of food intake is simply not necessary when eating a diet consisting of whole natural foods – satiety is controlled unconsciously by our inherent natural mechanisms.

The trick, therefore, within the toxic dietary environment in which we now find ourselves, is to eat foods designed by nature – which naturally balances caloric intake with caloric expenditure – for a lifetime.

Artificial concentration of foods

So what happened? Why are so many of us burdened with being overweight?

The artificial concentration of calories fools the Yowel mechanism with too much fat and refined carbohydrates, which comes from:

  • high-fat animal products,
  • oils,
  • sugar,
  • other refined carbohydrates,
  • as well as plant foods with damaged fibre.

It works like this: the stomach does not become as full with highly processed, fatty animal foods as it does when eating a balanced, high fibre plant diet. So the brain is not informed by the stomach’s stretch receptors that sufficient bulk (calorie-load) has been consumed. Also, the artificial nature of the highly concentrated and processed food fragments that comprise much of the modern diet do not register clearly enough with the biochemical sensors in order to trigger a sense of satiation.

Satiation Confusion

Without a sensation of satiation, we continue eating – day after day, year after year in the same way. When, in time, we notice that we are putting on excess weight, and maybe feeling increasingly ill after heavy consumption, we become confused. Our eyes are telling us one thing – You’re Over-Weight, Eat Less! but our stomach keeps telling us another You’re Still Hungry! Thus, the body has become chronically fooled by the abnormal modern diet.

The fear that results from seeing ourselves becoming increasingly obese has surely played a part in the flood of expensive and quite useless diet-related products – low-fat, low-carb, low-sugar, gluten-free, etc, as we try to wrestle back control of our diets.

And from all the evidence, veganism and vegetarianism are incapable of offering a reliable solution, either, if they are merely replacing processed animal foods with processed plant foods, full of sugar, salt and oil.

If you have any lingering doubts that this whole process depends on whether you are eating a WFPB or SAD (Standard American Diet) diet, just ask yourself which of the following similarly calorific choices is most likely to satisfy your hunger?

  • A medium-sized chocolate chip muffin,
  • 4 apples,
  • 15 carrots,
  • 1250 grams of raw salad,
  • 4 corn on the cob,
  • 4 sweet potatoes,
  • 600 grams of ripe cherries.

Quick Quiz - The Three Mechanisms of Satiation

(All answers are contained in the article.)

1.

Where is leptin produced in the body? 

2.

Ghrelin ........... appetite.

3.

Leptin resistance cannot happen if there is plenty of leptin in the bloodstream. True/False?


References:

Lisle, DJ, Goldhamer DC. The Pleasure Trap: Mastering the Hidden Force that Undermines Health & Happiness. Summertown, TN: Book Publishing Company. 2006.

Satiation and Satiety—“Stop” Signals – (http://aibolita.com/dietetics/28780-satiation-and-satiety-stop-signals.html)

Which Diets Work for Weight-Loss?

A randomised study looked at how effective five different diets were for weight-loss: vegan, vegetarian, pesco-vegetarian, semi-vegetarian and omnivorous diet. Do what did the study reveal?

Method

Sixty three subjects followed the diets for six months.

These were people who were interested in weight loss, and a lot of them had tried everything before – from cabbage soup diets to fasting.

Results

The vegan group lost 7.5% of their body weight

The vegetarian group lost 6.3% of their body weight

The pesco-vegetarian, semi-vegetarian, and omnivorous groups had all lost about 3.2% of their body weight

Inflammatory index

The researchers involved in this study were also interested in looking at how to quantify the inflammatory potential of the diets. And so they developed a dietary inflammatory index based on large epidemiological studies that measured both diet and other measures of inflammation – things like C-reactive protein and Interleukin 6. They were thus able to quantify different components of the diet.

What did they find?

At the two-month mark, the vegan group, pesco-vegetarian group, and the vegetarian group all had significant decreases in their inflammatory potentials. So their diets became less inflammatory over the course of that two-month time period.

In terms of macronutrients, it looks like it’s the carbohydrates profile in heavy plant-based diets that improves anti-inflammatory responses, while high protein/fat and low-carb diets seem to do the opposite.

But what percentage of carbs?

The figures we are talking about are in the area of 70% of calories coming from carbohydrates, around 20% fat and 10% protein. The low carb diets, of course, had much higher amount of fats, saturated fats and protein.

Was getting enough protein a problem for vegan/vegetarians?

Not at all. Both groups still had ample protein (around 10% of calories). This is the upper end of healthy calories from protein, according to Professor T Colin Campbell.

Fibre and glycaemic index

As soon as you tell someone that they’re going to be eating a higher carbohydrate diet, they get a little scared. They’ve been told that carbohydrates make you fat. So, two of the things that they focused on in this research were fibre intake and glycaemic index.

But even though each group endeavoured to stick to these requirements, it was only the vegan group that came anywhere close to meeting recommended fibre intake (UK – 30 grams/day, US – 25 grams).

Saturated fat

US dietary guidelines state that saturated fat should really not be above 7% (around 15 grams) of daily calorie intake, if you are at risk for disease. The UK dietary guidelines state almost twice this for men (30 grams) and around 20 grams for women. And if you thought the vegan group would easily manage to stay below this, think again. While the vegan group were indeed the only group that met saturated fat recommendations, their intake was on the borderline of eating too much saturated fat.

What were the participants’ diets like before the study?

Their diets were “pretty dismal” in terms of the percentage of macronutrients.

They were eating about 40% of their calories from fat, with 13-14% of that being saturated fat.

Protein was about 16-17%.

Carbohydrates were only about 40%.

Vegans and processed foods

The lead author of this research, Dr Brie Turner-McGrievy, considers many people transitioning to plant-based diets tend to put heavier reliance on more processed foods. And she acknowledges that if a person has eaten a hamburger for lunch every day, getting them to switch to a veggie burger is a sensible transition before they then progress to whole foods.

Beans are the next stage

She suggests that the next stage in transitioning to a plant-based diet is to focus on beans. That’s where one really starts to see a difference, when the protein sources are also always high in fibre. The fibre intake recommendations can then be satisfied very easily and in most cases well-exceeded.

Were there any other concerns with the vegan diet?

Quite the opposite.

Antioxidant intake was increased, as were vitamins C and E.

Levels of vitamin B-12 and calcium – the usual ones that people think will suffer on a vegan diet – were not significantly different from those of the other four groups. In fact, at two months the vegan participants were consuming about 2.7 micrograms of B-12. And this was without considering the fact that all groups were on supplemental B-12.

So they did not see a lot of differences in those nutrients that the media tend to scaremonger about.

Two areas where vegans experienced a much greater increase were in vitamin B9 (folic acid) and potassium intake.

Getting the right balance between sodium and potassium intake is one area of real concern for many people on standard diets. It is addressed easily by consuming sufficient leafy greens and other good potassium sources – things that the vegans were consuming in larger quantities than the other four groups.

Dr Turner-McGrievy pointed out that the improvements seen on the vegan diet would be even greater on a whole food plant-based diet.

Comment

The above study only went so far as to look at vegan diets – and there is never a guarantee with vegan diets that they will be significantly healthier than other diets, especially if they consist of processed foods that contain added oils, salt and sugar.

Compared with the other four groups, the vegan group showed improvements in the following: sustained weight-loss, increased dietary intake of vitamins (C, E and folic acid), minerals (particularly potassium) and increased fibre.

But all the evidence suggests that these and other factors improve even more with a WFPBD (whole food plant-based diet).

For those who have not yet transitioned to a WFPBD, there are some wonderful surprises in store if and when they do so. And, unlike other diets, WFPB nutrition is a sustainable and rewarding way of eating that can last for the rest of one’s life.

Much of our future health really is in our own hands …

 


References

Moore WJ, McGrievy ME, Turner-McGrievy GM. Dietary adherence and acceptability of five different diets, including vegan and vegetarian diets, for weight loss: The New DIETs study. Eating Behaviors. 2015 Dec; 19:33-38.

Turner-McGrievy GM, Davidson CR, Billings DL. Dietary intake, eating behaviours, and quality of life in women with Polycystic Ovary Syndrome who are trying to conceive. Hum Fert. 2015 Mar; 18(1):16-21.

Turner-McGrievy GM, Davidson CR, Wingard EE, Wilcox S, Frongillo EA. Comparative effectiveness of plant-based diets for weight loss: A randomized controlled trial of five different diets. Nutr. 2015 Feb; 31(2): 350-358.

Turner-McGrievy GM, Wirth MD, Shivappa N, Wingard EE, Fayad R, Wilcox S, Frongillo EA, Hébert J. Randomization to plant-based dietary approaches leads to larger short-term improvements in Dietary Inflammatory Index scores and macronutrient intake compared to diets that contain meat. Nutr Res. 2015 Feb; 35(2):97-106.

Turner-McGrievy GM, Davidson CR, Wingard EE, Billings DL. Low glycemic index vegan or low calorie weight loss diets for women with Polycystic Ovary Syndrome: A Randomized Controlled Feasibility Study. Nutr Res. 2014 June; 34(6):552-8.

Turner-McGrievy GM, Davidson CR, Wilcox S. Does the type of weight loss diet affect who participates in a behavioral weight loss intervention? A comparison of participants for a plant-based diet versus a standard diet trial. Appetite. 2014 Feb;73:156-62.

Turner-McGrievy GM, Jenkins DJ, Barnard ND, Cohen J, Gloede L, Green AA. Decreases in dietary glycemic index are related to weight loss among individuals following therapeutic diets for type 2 diabetes. J Nutr. 2011 Aug; 141(8):1469-74. 46.

Turner-McGrievy GM, Barnard ND, Scialli AR. A 2-Year Randomized Weight Loss Trial Comparing a Vegan Diet to a More Moderate Low-Fat Diet. Obesity. 2007; 15: 2276-81.

Dr. Campbell’s recommendations for Dietary Guidelines. May 4, 2015. By T. Colin Campbell, PhD (https://nutritionstudies.org/2015-dietary-guidelines-commentary/)

Dr Turner-McGrievy’s CV – (http://www.sc.edu/study/colleges_schools/public_health/documents/cvs/cv_turner-mcgrievy.pdf)

Physical Exercises for Beginners & Seniors

Time for Exercise

Even if you are on the healthiest diet, exercise is still really important. Here are some suggestions if you are considering starting some regular exercise and want to start flexing those muscles.

There are basically three areas that we will look at:

  1. Stretching exercises
  2. Aerobic exercises
  3. Strength training/load-bearing exercises

1. Stretching exercises

This helps to maintain the range and flexibility that your joints require. A knock-on benefit is that stretching reduces the risk of muscle soreness and injury. You might consider joining a yoga or Pilates class which will help you to increase your stability and core body strength. But you can do all the stretching you need at home. It’s a good idea to make this type of exercise a part of your daily routine.

The following three stretching videos are a good starting point. I would suggest that you build up to all the stretches shown, maybe aiming to be able to do all the stretching exercises by the end of 7 days. Just play the videos, follow their instructions and let them give you the encouragement to continue.

This is a simple introduction to Pilates:

And this is a basic introduction to yoga:

Have a try at the above and see how you get on with the different methods. Some people are happier with one form of stretching than another.

2. Aerobic exercises

You could, of course, just join a local gym and take guidance from an instructor. However, if this is not for you at this stage, maybe consider regular walking, cycling or swimming as a starting point.

You could also consider buying a cross-trainer, exercise bike or running/walking machine. These are excellent ways of being in control of your daily aerobic exercise (not weather-dependant and you don’t need to get dressed up to go out). Increase duration and effort gradually so that your larger muscles can build up and your joints can strengthen without suffering soreness or strain.

Lots of people buy these exercise machines, never use them and end up selling them cheaply on 2nd-hand websites. Maybe that’s where you are best off finding one. You don’t want to be spending lots of money on new machines if you are still unsure that you are going to use them regularly.

Aerobic exercise will benefit your cardiovascular system. Aim to start with 15-20 mins per session, 3 or 4 days a week. Whether walking, cycling, swimming or using running/walking machines, exercise bikes or cross-trainers, ensure that you are able to pass the “talk test” – that is, exercising at a pace which also allows you to have enough spare breath to carry on a conversation.

Once 20 mins seems easy, start to increase exercise time and intensity until you can exercise comfortably for 40 mins without stopping.

3. Strength training

Again, you may wish to simply join your local gym and take advice from an instructor. Alternatively, as with aerobic exercise, you can start by doing all you need in the comfort of your own home.

You will need to purchase a set of dumbbell weights.

Some people prefer this type because they want to be able to vary the weight without having too many dumbbells around the place:

While other people prefer this type, because they are nicer to handle and don’t need to be adjusted in order to vary the weight:

 

Whichever type you get, I would start with no heavier than feels really comfortable for you to lift 8 times at your current strength level. It’s surprising how quickly you will improve as you practice and you’ll be able to lift heavier weights in time as your muscles and joints strengthen. Aim to gradually increase from 8 to 12 repetitions and do your initial weight-bearing exercises every other day for the first week or so, concentrating on different muscle groups each session.

Using dumbbells (or hand weights as they are also called) will improve your strength and posture, as well as maintain your bone strength and density, reduce the risk of lower back injuries and help your body tone up.

The following videos are a good starting point for the beginner:

And for the more adventurous:

All movement matters!

So, even if you’re too busy for your regular workout, find ways of keeping active.

Look for other ways to be in motion:

  • walk up and down stairs instead of taking the lift or escalator
  • walk or cycle instead of using the car whenever possible
  • find a sport or outside activity you enjoy
  • consider teaming up with a friend or a group of friends to exercise with you or share an activity
  • offer to walk dogs – either your friend’s or those at a local dog rescue centre

Remember, research indicates that all those extra steps you take during the day will add up to big health benefits, not just physical but also mental and emotional.


References

Health benefits of physical activity: the evidence – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1402378/

Exercise for Mental Health – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470658/

Health matters: getting every adult active every day – https://www.gov.uk/government/publications/health-matters-getting-every-adult-active-every-day/health-matters-getting-every-adult-active-every-day

A Little Exercise Might Lengthen Life – https://www.nih.gov/news-events/nih-research-matters/little-exercise-might-lengthen-life

Exercise for brain health, study suggests – https://www.ed.ac.uk/news/all-news/exercise-231012

Exercise: 7 benefits of regular physical activity – https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/exercise/art-20048389

 

 

 

 

 

Olive Oil Injures Endothelial Cells

I know it’s not popular amongst advocates of the so-called Mediterranean diet, but there is a fact about olive oil that has been established in peer-reviewed literature for some time now: Olive oil is NOT as good for you as you might have thought.

So why is it that those eating the Mediterranean diet have had such a reputation for longevity and good health? The answer lies in what other foods are eaten and, equally importantly, which other foods are not eaten (processed junk food).

The traditional Mediterranean diet is fading away as the Western diet – also known as the Standard American Diet (SAD) – spreads its influence across the continent.

But before the golden arches threatened to overshadow the Acropolis, the traditional Mediterranean diet was largely plant-based, consisting of vegetables, fruits, nuts, beans, whole grains, pasta, olive oil, wine, and very small amounts of fish, eggs, dairy, and meats. And while heart disease mortality was lower when compared to the UK and USA, for instance, the benefits seem to have been conferred primarily by a high percentage of plant content, the regular consumption of nuts and an avoidance of sugary/fatty desserts, with fruit being the common after-dinner treat.

And, while compared to the modern Western diet, the Mediterranean diet has been shown to be better at cutting heart attack risk, it has not demonstrated the health-promoting power of a purely whole food plant-based diet – whether the latter is with or without SOS (added sugar, oil and salt). As you will know by now, the WFPB diet is the only known diet that has been clinically proven to reverse heart disease.

A major problem with the Mediterranean diet is that it includes three elements that are associated with inflammation and its many harmful consequences in the body:

  • refined grains (pasta and breads),
  • animal products, and
  • olive oil,

and it is the olive oil that concerns us here.

A  publication in the Nutrition, Metabolism & Cardiovascular Diseases journal pretty much sums up its findings in the title of the study:

“Olive, soybean and palm oils intake have a similar acute detrimental effect over the endothelial function in healthy young subjects.”

Objective 

Their objective was to evaluate the acute effect of the ingestion of large amounts of olive, soybean and palm oils, fresh and at two different deep-fry levels, on the glucose and lipid profiles and endothelial function.

Method

Subjects were randomly given a potato soup meal containing one of three different vegetable oils (olive, soybean and palm). Flow-mediated vasodilation (FMD) was performed and blood samples taken to establish the lipid profiles and plasma glucose levels.

Results

All types of oil tested (including olive oil) resulted in a similar acute endothelial impairment.

Conclusions of the Study

“No difference was found in the acute adverse effect of the ingestion of different vegetable oils on the endothelial function. All the vegetable oils, fresh and deep-fried, produced an increase in the triglyceride plasma levels in healthy subjects.”

What are Endothelial Cells and Why are they so Important?

The endothelial cell layer is a one-cell thick layer within the inner surface of our blood vessels. These cells are of vital importance for vascular health and their damage is what leads to the development of CVD (cardiovascular disease).

When you eat the typical Western diet you develop intracellular adhesion molecules – causing blood to flow like Velcro. This results in the LDL particles in the bloodstream burrowing into the subendothelial compartment. The so-called “bad” LDL cholesterol gets oxidised by free radicals in our diet into small hard dense LDL molecules, so our body sends out messengers called chemokines that recruit white blood cells (monocytes) to sort them out.

These monocytes follow the LDL into the subendothelial compartment in order to scavenge for the LDL particles. Once inside the subendothelial compartment, these monocytes are referred to as macrophages as they try to mop up and clear away all the LDL particles.

The macrophages get bigger and bigger as they absorb the LDL particles and they then change their name again and become known as foam cells.

These foam cells are the really dangerous particles because they release some unpleasant enzymes called metalloproteinases which then gradually erode the plaque on the endothelial cell.

The cap over the plaque is very thin and once it ruptures, the plaque content then oozes out and causes a plaque clot.

The plaque clot then grows and spreads out over the inner diameter (lumen) of the blood vessel and this results in something you really don’t want to happen: the downstream heart muscle loses its blood supply.

The result is that the heart muscle dies. This whole nasty process is thought to account for around 90% of all heart attacks.

 

 

Is it Too Late for Sufferers of Heart Disease?

Fortunately, it is not too late, even if plaques have formed. The cap over the plaque can be strengthened and, if it is sufficiently strong, you become “heart attack proof” as Dr Esselstyn says, but only if you change to a whole food plant based diet.

How is Nitric Oxide Involved?

Initially it was called EDRF, but had its name changed because it was then discovered that EDRF was in fact a gas – nitric oxide (chemical symbol NO), discovered by Furchgott et al in 1998, for which they received the Nobel Prize.

The Functions of NO

  • It prevents intracellular contents from getting sticky – makes the blood flow like Teflon instead of Velcro.
  • NO is the strongest vasodilator in the body. When you run for a bus or climb the stairs, it’s the NO produced by your endothelial cells that dilates the blood vessels and allows you to increase activity level without passing out.
  • It prevents the vessel walls from getting stiff, thickened or inflamed – hence preventing hypertension.
  • Sufficient NO will prevent blockages or plaques building up on the surface of the endothelium.
  • NO will prevent the artery wall from “migrating” into the plaque.
  • NO can destroy the foam cells (referred to by Dr Esselstyn as “Darth Vaders”).

What is the Flow-Mediated Dilation Test?

If you take an ultrasound probe, place it over the brachial artery at the elbow, you can get a readout of the diameter of the artery.

You then put a blood pressure cuff on the upper arm, inflate it above systolic blood pressure and leave it there for 5 mins.

During this time, there is zero blood flow to the forearm and hand (a weird sensation to say the least).

You then release the cuff and once again measure the new diameter of the brachial artery.

In a normal artery it should immediately increase by 30%.

Enter Dr Robert Vogel…

Dr Vogel did a brilliant study by taking a number of healthy young people to McDonald’s and splitting them into two groups.

He gave one group cornflakes and measured their dilation response. It was normal.

He gave the other group hash browns and sausages. Their brachial arteries could not dilate normally – even after two hours. The endothelial cells’ ability to make nitric oxide was so damaged that they could not dilate the artery. They were tested on an off into the evening, by which time they started to recover full function as the evening progressed.

A One-Off or Chronic Problem?

It is not a good idea to repeat this test, but people do – millions of them, day in day out, week in week out, for years and decades. The next day it’s egg and bacon or cappuccino and brioche for breakfast, ham and cheese sandwich or chicken salad for lunch, take-away Chinese for dinner. What was an acute reaction becomes a regular, chronic health threat.

This is why, in the 21st century, by the time our children are leaving school, they already have the foundation for cardiovascular disease.

Best Advice

If you really want to protect yourself as much as possible against these cardiovascular events, do all you can to optimise the health of your endothelial cells.

To do this, start by always avoiding the following:

  • Oils – no matter whether it’s olive oil, corn oil, soybean oil, safflower oil, sunflower oil, canola oil, palm oil, oil in a crisp/chip, oil in a cracker, oil in bread, oil in a salad dressing.
  • Anything with a face or that had a mother – no matter whether it’s fish or fowl, beef or pork, turkey or chicken, cream or milk, cheese or butter, yogurt or ice cream.
  • Anything with added sugar – no matter whether it’s organic muscovado sugar, molasses, honey, juices* (orange, apple etc), maple syrup or agave syrup.

All of these injure endothelial cells to some extent; and you don’t need a history of cardiovascular disease to already have it developed within your body – in one study, 57% of men who experienced sudden cardiac death had zero history of coronary heart disease.

* Eating an apple or an orange is not the same thing as drinking fruit juices. The fructose is bound with the fibre. But when you make orange juice or apple juice, the sugar is free, goes into your gut and is immediately absorbed, injuring your liver, promoting protein glycation, and injuring those precious and delicate endothelial cells.

I know it is difficult to consider such dramatic changes, but remember that we live in a nutritionally toxic environment in the 21st century, where the all-pervasive “normal” diet is something that has never existed on Earth before. Nowadays, a person who insists on eating a truly healthy diet will feel and probably be treated like an alien from a distant galaxy.


Quick Quiz - Olive Oil Injures Endothelial Cells

(All answers are contained in the article.)

1. What items were identified as being a problem in the Mediterranean diet?
2. What are some of the functions of NO (nitric oxide) in our blood vessels?
3. Where are endothelial cells found?
4. When macrophages digest small LDL particles, what do they become?

 


References:

Rueda-Clausen CF, Silva FA, Lindarte MA, Villa-Roel C, Gomez E, Gutierrez R, Cure-Cure C, López-Jaramillo P. Nutr Metab Cardiovasc Dis. 2007 Jan;17(1):50-7. Epub 2006 Mar 20. Olive, soybean and palm oils intake have a similar acute detrimental effect over the endothelial function in healthy young subjects.

Esselstyn C. Prevent Card. 2001; 4: 171–177. Resolving the coronary artery disease epidemic through plant-based nutrition. 

Esselstyn C, Ellis S, Medendorp S, Crowe T. J Fam Pract. 1995; 41(6):560–568. A strategy to arrest and reverse coronary artery disease: a 5-year longitudinal study of a single physician’s practice. 

Go A, Mozaffarian D, Roger V, Benjamin E, et al. Circulation 2013; 127: 6–245. doi: 10.1161. Heart disease and stroke statistics—2013 update: a report from the American Heart Association. 

van Dam RM, Willett WC. Nutr, Metab Cardiov Dis. 2007; 17(1): 50–57.  Unmet potential for cardiovascular disease prevention in the United States. 

Ryan A. Harris, Steven K. Nishiyama, D. Walter Wray, and Russell S. Richardson. Hypertension. 2010 May; 55(5): 1075–1085. Published online 2010 Mar 29. doi: 10.1161/HYPERTENSIONAHA.110.150821. Ultrasound Assessment of Flow-Mediated Dilation: A Tutorial.

Vogel RA, Corretti MC, Plotnick GD. Am J Cardiol. 1997 Feb 1;79(3):350-4. Effect of a single high-fat meal on endothelial function in healthy subjects.

Kannel WB, Doyle JT, McNamara PM, Quickenton P, Gordon T. Circulation. 1975;51:606–13. Precursors of sudden coronary death: Factors related to the incidence of sudden death. 

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The Lowdown on Low Fat vs Low Carb

Researchers at Stanford University School of Medicine just published results from a 12-month study which aimed to identify which diet was the best – Low-carb or Low-fat. And the winner is…

Well, first, let’s see what were the basic questions (hypotheses) that the leader researcher, Professor Christopher Gardner  and his team were aiming to answer whether either of the following factors would dictate your success at losing weight:
  1. Genotype (that which predicts other factors such as your eye colour), or
  2. Baseline insulin secretion level (how much insulin your body produces to process glucose).

And the winner was?

Neither.

No evidence was found for the existence of a genotype or a baseline insulin level that would clearly favour your chances of losing weight.

Both diets resulted in an overall weight loss:

  • An average 13 pounds / 5.8 kg weight loss within the 609 study subjects
  • Wide variability – some gained as much as 20 pounds/9 kg while others lost as much as 60 pounds / 27 kg.

More detail about the methodology used can be found here.

Conclusions from the Research

Professor Gardner says “We have all heard stories of a friend who went on one diet – it worked great – and then another friend tried the same diet, and it didn’t work at all. It is because we are all very different, and we are just starting to understand the reasons for this diversity. Maybe we should not be asking what is the best diet, but what is the best diet for whom?”
His takeaway lesson from this study was that we should eat:
  • less sugar,
  • less refined flour,
  • more wholefoods (e.g. “wheatberry salad or grass-fed beef “), and
  • as many vegetables as possible.
Future projects are likely to focus on questions related to:
  • the microbiome (the billions of bacteria in our guts),
  • epigenetics (looking at gene expression rather than potential changes to the genetic code itself)

He goes on to say “I’m hoping that we can come up with signatures of sorts…I feel like we owe it to Americans to be smarter than to just say ‘eat less.’ I still think there is an opportunity to discover some personalisation to it.”

In his own words:

What Others Say

In the Telegraph article that discussed this research, they drew the conclusion that “the research showed the key to losing weight was simply eating less.”

Tam Fry, from the National Obesity Forum, a UK campaign group, said: “The best diet in town is not a fad but much less of what you actually fancy – and stick to it.”

Some Thoughts

The findings of the research do not surprise me at all. And I applaud some of the conclusions that Professor Gardner draws – cutting down on (refined) sugars/flours, eating more (plant) wholefoods and vegetables – but there are some issues that require clarification.

  1. When weight loss is the only factor considered, other issues related to the overall health-promoting aspects of nutrition are marginalised. There appears to be no stated justification for Professor Gardner’s jump from talking about the results of the research (genotype and insulin secretion levels) to then recommending specific nutritional elements (less sugar, more wholefoods etc). If he is going to make these statements (especially if he includes “grass-fed beef” in the list of healthy wholefoods), then it would be useful to see some justification for such statements – and, as we would suspect, any justification would not come from a study that simply focuses on weight-loss without also measuring other health factors (cholesterol, triglycerides, mineral/vitamin balance, etc).
  2. Professor Gardner’s statement “It is because we are all very different, and we are just starting to understand the reasons for this diversity. Maybe we should not be asking what is the best diet, but what is the best diet for whom?” is somewhat misleading. It suggests that there is no evidence from large population studies (such as the largest of them all, The China Study) that optimal health appears to depend on diet, to a large extent, irrespective of the individual genetic variations within the members of that population. Indeed, the Stanford University research itself dismisses the primacy of genetics or “insulin secretion levels” as markers for future weight gain, let alone the uncharted, and more vital area, of overall health gain.
  3. There appears to be a misunderstanding in the media about what conclusions can be drawn from the study. Professor Gardner says “I feel like we owe it to Americans to be smarter than to just say ‘eat less.’ The Telegraph, on the other hand, states that “the research showed the key to losing weight was simply eating less.” No wonder the public get confused. And to add more confusion, Tam Fry (National Obesity Forum) states “The best diet in town is not a fad but much less of what you actually fancy – and stick to it.” Again, the implicit assumption here is that all foods are equal, all diets that do not include “moderation in all things” are fad diets, and, again, the mistaken implication that the research is suggesting we should simply eat less calories.
  4. Professor Gardner’s comment “Maybe we should not be asking what is the best diet, but what is the best diet for whom?” is, for me, a frankly shocking indication that he may not have looked at the wealth of research demonstrating that there is one diet that has been proven to be optimal for human health – a whole food plant-based diet, with minimal or no animal protein. I suspect that if his research subjects had been rural Chinese, Papua Highlanders, Central Africans or Tarahumara Indians from northern Mexico, then he would not have even bothered to do this research study since more or less everyone within those communities would already have been at their optimal body weight, largely regardless of genome or insulin secretion level.
  5. When such research projects are taken up by the media and then the public, they are thrown back, once again, on the mistaken belief that nutrition is simply a matter of the quantity and not quality of the calories being “eaten”. People do not eat calories. They eat food. And our bodies are made out of the food we eat.
  6. Yet again, this research focuses in a reductionist manner on genetic and individual biochemical responses in order to establish something so vitally important to our populations’ health and well-being. It still makes me recall Nero fiddling while Rome burned…

In my experience and that of my clients, even increasing the amount of calories consumed after making the transition to a WFPBD (whole food plant-based diet) from a standard diet (whether it be a meat-based, vegetarian or vegan diet), can cause excess fat to drop off the body. Just as a vitamin C supplement does not cause the same bodily responses as compared to the vitamin C derived from eating an apple, the calories “consumed” from eating animal foods (whether processed or unprocessed) have a very different effect on the body than those derived from eating plant foods (whether organic whole plants or even less-healthy processed plant-foods). And the added bonus from eating a wide variety of organic whole plants represents yet another step in the direction of optimal health from eating those less-healthy processed plant foods.

There is yet to be mainstream coverage and acceptance of the only diet proven to reverse heart disease and other chronic diseases. In the meantime, looking after your own diet can have a greater effect on your health, encourage other people’s appetite for dietary change, avoid further damage to other species, and help protect the environmental welfare of our land, sea and air.

 

Quick Quiz - Lowdown on Low Fat vs Low Carb

(All answers are contained in the article.)

1. True or False: Reductionist research looks at the small details rather than taking a wider perspective?
2. Which particular diet is recommended by the researchers as being best for losing weight?
3. Which of the following are recommended by the researchers?


References

Gardner CD, Trepanowski JF, Del Gobbo LC, Hauser ME, Rigdon J, Ioannidis JPA, Desai M, King AC. AMA. 2018 Feb 20;319(7):667-679. doi: 10.1001/jama.2018.0245. Effect of Low-Fat vs Low-Carbohydrate Diet on 12-Month Weight Loss in Overweight Adults and the Association With Genotype Pattern or Insulin Secretion: The DIETFITS Randomized Clinical Trial.

 

Diet Madness or Genuine Health Concern?

There are so many diets out there – drinking dirty bathwater, swallowing tapeworms and inserting yogurt enemas – each claiming its own miracle cure for weight worries and disease distress. But does this display a genuine concern for one’s health?

Most people try and fail at some kind of New Year’s resolution, and most of these are connected to ways in which we want to improve our health – generally diet or exercise. Wreckage of our best intentions are visible in a garage or spare bedroom full of dumbbells, overpriced running trainers, and cross-training machines.

Quick fix diets abound:

This concern about weight and diet is nothing new:

  • In 1087, William the Conqueror was already morbidly obese and decided to fight his own battle of the bulge with an alcohol-only diet. Big Bill took to his bed and refused everything but liquids until he had shed the pounds. Ironically, this didn’t really do him any health favours as later that year, when he’d lost enough weight to get back on his horse, he was thrown from his trusty steed, ruptured his gut, and died in agony. He was still so large, his body had to be wedged into the stone coffin.
  • In 1760, Dr Flemyng’s soap diet recommended eating soap to shed the pounds. Flemyng reasoned that as soap removed fats and oils from clothes it could also wash away excess fat from inside the body. His patients were told to eat soap made from alkaline salt, oil and fat dissolved in quicklime and water. When soap diet devotees complained that they were just as fat as they were when they started the diet (though hopefully somewhat cleaner), he insisted they must be eating the wrong soap or in the wrong amount.
  • In the 18th century, the Bath water diet attracted thousands to spa towns in order to ‘take the waters’. And this was not just bathing in the mineral-rich baths, it also involved quaffing back gallons of unfiltered water that hundreds of other people have sweated and stewed themselves in each day.
  • In 1810, the Vinegar Diet of British surgeon William Wadd (1776-1829) was published in his ‘Cursory Remarks on Corpulence’. Drinking large quantities of vinegar would supposedly dissolve fat. The poet Lord Byron (1788-1824) was an advocate of this particular diet plan as he was morbidly fixated with his weight and had yoyo dieted all his life. Records show in 1806 he weighed 13st 12lb (88kg), but by 1811 Byron weighed under 9st (57kg). In order to purge his body and melt away fat, not only would Byron drink vinegar each day, but he restricted solid foods to potatoes – soaked in vinegar. And the vinegar diet still does the rounds of the “out there” diets to this day.
  • In 1863, the first low-carbohydrate diet book ‘Letter on Corpulence, Addressed to the Public’ was written by William Banting. Meat for breakfast, lunch and dinner. The original Banting diet forbade complex carbohydrates, beer, starchy fruit and veg and dairy, but lean protein, eggs, and the odd sherry with a claret chaser were fine.
  • At the start of the the 20th century, John Harvey Kellogg (1852-1943), of cornflake fame, manufactured plain cereals to suppress sexual urges. The so-called “masturbation diet” not only promised to improve health, aid digestion and regulate weight, but it would also stop you masturbating. Kellogg (and many other doctors) argued that masturbation caused ‘cancer of the womb, urinary diseases, nocturnal emissions, impotence, epilepsy, insanity, and mental and physical debility’. He reasoned that spicy, ‘exciting’ food, overly stimulated the senses, therefore the plainer your diet the less inclined you would be to give yourself a treat. Yoghurt enemas were also encouraged by Kellogg, who actually invented a machine to administer such enemas to his patients. The latter dietary innovation never really caught on the way cornflakes did.
  • In the late 19th century, Horace Fletcher was a great proponent of the mastication diet where you were required to chew each mouthful of food 100 times. The theory was that the food would become liquefied, which meant the chewer wouldn’t overeat and the mush would be easier to digest. Fletcher claimed his method of eating produced stools “with no stench, no evidence of putrid bacterial decomposition, only with the odour of warm earth or a hot biscuit”. Apparently, Fletcher carried around a sample of his own faeces to back up this claim should anyone challenge him on this point. He became known as ‘the Great Masticator’, although I imagine there were variations of this nickname.
  • In the 1920’s, ‘obesity soaps’ were produced by companies in London. This more recent version of s soap diet ony promised that internal fat would dissolve if people washed with i. Luckily, eating it was not necessary this time round.

And there are many, many more diets throughout history which have tried to help with a seemingly insatiable public appetite for weight-reduction and improved health through dietary interventions – smoking yourself to thinness, taking vast quantities of speed, dosing up on sugar, using radium, eating nothing but cabbage, fish, milk or eggs – even taking arsenic to shed those extra pounds.

We can all laugh at historical diets, but there are few signs in the 21st century of a slowing-down in similar attempts to achieve optimal weight and health (with minimal effort). The internet is awash with dodgy diet pills and pseudo-scientific weight loss advice (tried the zodiac diet lately?).

It appears that if a media-reported “scientific study” told us that by drinking a bottle of grimy, slightly hairy bathwater we would definitely lose weight, some people would actually try it – you know they would! I mean, Beyoncé once advised us to eat nothing other than maple syrup and Reese Witherspoon advocated eating a diet consisting solely of baby food.

This obsession with diet can be viewed as an indication of a fundamental human desire to be healthy.

I can get annoyed at how so many companies and individuals make profits out of peddling diets that will eventually fail; but it makes me sad that the only thing people need to do in order to achieve optimal health and ideal body weight is to eat what all the healthiest human populations have always eaten – a diet largely or completely consisting of whole plant foods.

Sometimes the most obvious solution can be the most difficult to swallow…