MODULE 5B - Nutrition Science, Assessment and Prescription |
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DIETARY PATTERNS
Numerous other benefits, with new studies coming out regularly. It is important to note that many studies showing benefits of diets high in whole, plant foods are not studying purely WFPB diets. Many (if not most) actually refer to either predominantly WFPB diets, vegetarian diets, vegan diets, pescatarian, or Mediterranean-style diets.
BENEFITS OF WHOLE FOOD PLANT-BASED DIET
Predominantly WFPB diet: the diet promoted by the ACLM and is a dietary pattern centered on whole, plant foods including vegetables, fruits, whole grains, legumes, nuts, and seeds. Processed foods and animal foods are limited or excluded.
Entirely WFPB diet: a dietary pattern made up entirely of whole, plant foods including vegetables, fruits, whole grains, legumes, nuts, and seeds. It completely excludes meat, poultry, fish, shellfish, dairy, eggs, oil, refined sugars, and refined grains.
Vegan diet (otherwise known as a strict vegetarian diet): is one that includes no animal products (i.e., no meat, poultry, seafood, dairy products, or eggs), but could include any plant-based foods. A vegan diet does not necessarily limit unhealthy processed foods if they are free of animal products. However, most following vegan diets eat healthier than the general public, primarily owing to higher intake of plant foods. A purely WFPB diet is a type of low-fat, vegan diet based on whole foods. A predominantly WFPB diet is not a vegan diet if it includes any animal-derived foods.
Vegetarian diet (otherwise known as a lacto-ovo vegetarian diet): is similar to a vegan diet but includes dairy products and eggs. A vegetarian diet does not necessarily limit unhealthy processed foods provided they are free of animal products that would require an animal to be killed to obtain the food (e.g., meat, poultry, seafood, gelatin, etc.). However, most following vegetarian diets eat healthier than the general public, primarily owing to higher intake of plant foods.
Pescatarian diet: similar to either a vegan or vegetarian diet, but with the addition of fish and/or seafood. Pescatarians do
not eat meat or poultry.
Mediterranean-style diet: Is a predominantly (but not entirely) plant-based diet with staples including whole grains, vegetables, fruits, legumes, nuts, seeds, and plant oils, such as olive oil. Fish and seafood are eaten 2-3 times weekly along with small amounts of dairy, eggs, and poultry. Wine in moderation is also included. Red meat, processed meat, refined carbohydrates, and added sugars are generally avoided. (*There are a variety of Mediterranean diets. This description refers to the type of Mediterranean diet most commonly described in clinical trials, which has been the topic of numerous health related studies and dietary guidelines. Actual foods eaten do not need to be those found in the Mediterranean region of the world.)
BENEFITS OF WHOLE FOOD PLANT-BASED DIET
- Decreases in all-cause mortality
- Weight loss and favorable changes in lipid profile
- Decreased risk, and even reversal, of cardiovascular disease
- Decreased risk of some cancers
- Reduced markers of early stage, biopsy proven, prostate cancer
- Decreased risk of diabetes and improved glycemic control or normalized blood glucose levels for those with diabetes
- Improved migraine symptoms
Predominantly WFPB diet: the diet promoted by the ACLM and is a dietary pattern centered on whole, plant foods including vegetables, fruits, whole grains, legumes, nuts, and seeds. Processed foods and animal foods are limited or excluded.
Entirely WFPB diet: a dietary pattern made up entirely of whole, plant foods including vegetables, fruits, whole grains, legumes, nuts, and seeds. It completely excludes meat, poultry, fish, shellfish, dairy, eggs, oil, refined sugars, and refined grains.
Vegan diet (otherwise known as a strict vegetarian diet): is one that includes no animal products (i.e., no meat, poultry, seafood, dairy products, or eggs), but could include any plant-based foods. A vegan diet does not necessarily limit unhealthy processed foods if they are free of animal products. However, most following vegan diets eat healthier than the general public, primarily owing to higher intake of plant foods. A purely WFPB diet is a type of low-fat, vegan diet based on whole foods. A predominantly WFPB diet is not a vegan diet if it includes any animal-derived foods.
Vegetarian diet (otherwise known as a lacto-ovo vegetarian diet): is similar to a vegan diet but includes dairy products and eggs. A vegetarian diet does not necessarily limit unhealthy processed foods provided they are free of animal products that would require an animal to be killed to obtain the food (e.g., meat, poultry, seafood, gelatin, etc.). However, most following vegetarian diets eat healthier than the general public, primarily owing to higher intake of plant foods.
Pescatarian diet: similar to either a vegan or vegetarian diet, but with the addition of fish and/or seafood. Pescatarians do
not eat meat or poultry.
Mediterranean-style diet: Is a predominantly (but not entirely) plant-based diet with staples including whole grains, vegetables, fruits, legumes, nuts, seeds, and plant oils, such as olive oil. Fish and seafood are eaten 2-3 times weekly along with small amounts of dairy, eggs, and poultry. Wine in moderation is also included. Red meat, processed meat, refined carbohydrates, and added sugars are generally avoided. (*There are a variety of Mediterranean diets. This description refers to the type of Mediterranean diet most commonly described in clinical trials, which has been the topic of numerous health related studies and dietary guidelines. Actual foods eaten do not need to be those found in the Mediterranean region of the world.)
ARTICLE REVIEW
Ultraprocessed food
Western Diet microbiome and metabolic syndrome
Dietary fiber hypothesis
The BROAD Study
Ultraprocessed food
Western Diet microbiome and metabolic syndrome
Dietary fiber hypothesis
The BROAD Study
the science of culinary nutrition
It is essential for readers to be aware of the credibility of information we deal. Articles coming out in social media and a multitude of publications may not equally be reliable. It’s also necessary to understand that research studies coming in many forms are not exempted from influences coming from many unnamed factors. Below are the common types of studies used in establishing nutritional science.
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Nutrition prescription is one of the Core Lifestyle Medicine Competencies. Dr. Dennis Burkitt emphasized on the major dietary changes that followed the industrial revolution causing the major increase of chronic disease incidence and prevalence whenever there is reduction in starch foods and fiber intake, and a great increase in consumption of animal fats, salt, and sugar.
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One study published in the International Journal of Epidemiology revealed the strong correlation of serum cholesterol, diet, and coronary heart disease. People in this specific part of the world are not in any way exposed to Western diet and it’s surprising that heart disease, the number one killer among Americans are almost non-existent in the African population of Uganda. The staple foods, green plantain and sweet potatoes, are steamed in banana leaves: cassava, yams, and millet are also staple commodities in particular of the non-Baganda groups, while pumpkins, tomatoes, and green leafy vegetables are taken by all. The adequacy of protein in the diet depends almost entirely on the extent to which pulses, ground nuts, and cereals are used.
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Dr. Caldwell Esselstyn also noted that coronary artery disease is virtually absent in cultures that eat plant-based diets, such as the Tarahumara Indians of northern Mexico, and Papua highlanders of New Guinea, and the inhabitants of rural China and central Africa. Hundreds of thousands of rural Chinese live for years without a single documented myocardial infarction.
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The editor-in-chief of the American Journal of Cardiology Dr. William Roberts is convinced that the disease has single cause, namely cholesterol, and that the other so-called atherosclerotic risk factors are only contributory at most. In other words, if the serum total cholesterol is 90 to 140mg/dL, there is no evidence that cigarette smoking, systemic hypertension, diabetes milletus, inactivity, or ebesity produces atherosclerotic plaques. Hypercholesterolemia is the only direct atherosclerotic risk factor; the others are indirect. Dr. Roberts also implied that the goal for all populations – not just those with heart attacks or strokes, diabetes mellitus or non-coronary atherosclerotic events – must be LDL cholesterol <100 mg/dL and ideally <70mg/dL. If such goal was created, the great scourge of the Western world would be eliminated. In fact, it was published in the Journal of Lipid Research that the average blood cholesterol level in the United States (and other countries using Western medicine guidelines), the so-called normal level (up to 200mg/dL), was actually abnormal. It was accelerating atherogenesis and putting a large fraction of the so-called normal population at a higher risk for coronary heart disease.
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It was also found out that almost 75% of heart attack patients fell within recommended targets for LDL cholesterol demonstrating that the current guidelines may not be low enough to cut heart attack risk. Accumulating data from multiple lines of evidence consistently demonstrate that the physiologically normal LDL level and the thresholds for atherosclerosis development and coronary heart disease events are approximately 50 to 70 mg/dL.
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THE BLUE ZONE
Centenarians are rare because the average life expectancies all over the world are below 100. But there are certain areas in the world where unusual concentrations of people who live into their nineties and beyond are commonly dwelling with the general population. |
The well-known Longitudinal Study of Aging Danish Twins, a research on genetics and longevity suggested that genetics account only for 20% to 30% of life span, with the rest due to environmental and lifestyle factors.4 With this findings, Dan Buettner, a journalist set out a remarkable work of finding the longest-lived people on earth and called them the “Blue Zone.” They are distributed across the globe with diverse history, genetics, cultures, traditions and environments. But they have many things in common which includes eating a whole foods diet with an average of 90% calories coming from plant-based sources and active lifestyle. In 2004, Dan Buettner teamed up with National Geographic and the world’s best longevity researchers began their exploration and were able to identify 5 Blue Zones.
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The first Blue Zone identified by Buettner was Sardinia, Italy. There have always been centenarians in Sardinia, but in the most mountainous inland region called Barbagia with nearly 58,000 population, a cluster of villages in the island is linked to exceptional longevity. This is due to geographic isolation, and the undiluted genes of the residents. But even more importantly, Sardinians of this area are culturally isolated, and very traditional.
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They have kept their healthy lifestyle throughout generations; they still hunt, fish and harvest the food they eat. Sardians are farmers and shepherds and they live in a clean environment. They remain close with friends and family throughout their lives.
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Ikaria, Greece is another Blue Zone, a relatively remote island with only a little more than eight thousand inhabitants. It’s in the Aegean Island that is found to be one of the world’s lowest rates of middle age mortality and the lowest rates of dementia. Ikarians exercised mindlessly. They eat a variation of the Mediterranean diet, with lots of fruits and vegetables, whole grains, beans, potatoes and olive oil.
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They enjoy drinking antioxidant rich herbal teas coming from wild rosemary, sage and oregano that also act as a diuretic that maintains blood pressure. People in Ikaria doesn’t mind time and lives with relaxed lifestyle.
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Okinawa, Japan is another Blue Zone with a unique outlook in life. They’re capable of letting difficult early years remain in the past while they enjoying today’s simple pleasures. Okinawans has one of the highest ratios of centenarians, about 6.5 in 10,000 live to be 100 lower rates of disease than Americans in every given category.
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Their staple food is composed of vegetables, sweet potatoes (67%) with high nutrients and low in calories. The Okinawan diet is rich in foods made with soy, like tofu and miso soup. They also have medicinal herbs including ginger and turmeric in their regular food consumption.
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Another Blue Zone is Costa Rica’s hilly Nicoya region, the mestizos (people combined European and American Indian descent) reach the age of ninety at two and one-half times the rate of northern Americans and have much less cancer, heart disease, and diabetes.6 The Caribbean nation is economically secure and has excellent health care and Nicoyans have also stayed relatively free of the diseases of affluence that afflict Costa Rica’s city-dwelling populations.
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Nicoyan centenarians frequently visit with neighbors, and they tend to live with families and children or grandchildren who provide support, as well as a sense of purpose. One unique tradition of Nicoyans is eating light dinner early in the evening. For most of their lives, Nicoyan centenarians ate their staple diet composed of squash, corn, and beans.
And the last Blue Zone we will discuss is a unique religious group that are called the healthiest people in the world, the Seventh Day Adventists in Loma Linda California. Unlike the four identified Blue zones, this religious group is not in an isolated place in the United States. Loma Linda is in Southwestern San Bernardino County.
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HEALTHIEST PEOPLE IN THE WORLD In the 1970’s and ‘80s the first Adventist study was conducted in Loma Linda California with more than thirty-four thousand people who were followed for fourteen long years. It is uncommon in epidemiological studies that researchers can survey a group of people with very similar lifestyles and practices. |
And most importantly many distinct dietary subgroups, enabling them to more effectively isolate the impact of diet on health. The Seventh-day Adventist is a religious group established in the mid-ninteenth century.
The counsels of Seventh-day Adventists are largely inspired by the biblical verse Genesis 1:29: “And God said, Behold, I have given you every herb bearing seed, which is upon the face of all the earth, and every tree, in which is the fruit of a tree yielding seed; to you it shall be for meat.” In other words, eat real food, eat plants. They also have comprehensive guide and counsels written in many books emphasizing healthy lifestyle as part of their doctrine and beliefs.
The counsels of Seventh-day Adventists are largely inspired by the biblical verse Genesis 1:29: “And God said, Behold, I have given you every herb bearing seed, which is upon the face of all the earth, and every tree, in which is the fruit of a tree yielding seed; to you it shall be for meat.” In other words, eat real food, eat plants. They also have comprehensive guide and counsels written in many books emphasizing healthy lifestyle as part of their doctrine and beliefs.
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The Seventh-day Adventist church view health as central to their faith and that made them one of the most interesting groups to study, from the perspective of diet. They have such a similar overall lifestyle. Active members of the church are not smokers or alcohol consumers, they have a strong religious faith and community, and they exercise regularly. |
The Adventists’ staple diet was largely composed of fruits and vegetables, nuts, legumes, and soy foods. Although other Seventh-day Adventists are consuming animal products, they still avoid certain types of foods they considered unclean based on a Biblical and health perspective. Specific members also follow different vegetarian pattern including vegan (no animal products) to lacto-ovo vegetarian (vegetarian with dairy and eggs), to peco-vegetarian (vegetarian with fish).
In 2002 a second major Adventist study was started, led by Dr. Gary Fraser and a team of researchers from Loma Linda University, which included ninety-six thousands participants from across the United States and Canada. The results from that study showed that Adventist meat-eaters had the biggest waistlines, and had a higher death rate than their vegetarian Adventist counterparts. They also tended to have worse overall dietary habits including greater consumption of highly processed foods such as sugar, soda, and refined grains. This raises the question of whether it was the animal foods or the processed food or both that led to shorter lives in this cohort. Although we cannot tease that out with this study, what we can tell is that the lacto-ovo vegetarians, the pesco-vegetarians, and the vegans all had significantly lower mortality rates compared to the meat-eaters.
It’s worth noting that even those Adventists classified as meat-eaters were much less so than most Americans. The meat eating Adventists’ diet (in terms of daily intake in grams) was largely composed of fruits and vegetables, nuts, legumes, and soy foods. And the overall better life expectancy of the community reflects that fact.
The Adventists are one of the most interesting groups to study, from the perspective of diet, because they have such a similar overall lifestyle. It is rare in epidemiological studies that researchers can observe a group of people with very similar lifestyles but so many distinct dietary subgroups, enabling them to more effectively isolate the impact of diet on health.
When it comes to America’s leading cause of death – heart disease and cancer – the vegetarian Adventist again fare well. They have the lowest rate of heart disease in the nation.15 In men, the risk of fatal heart disease was “significantly related to beef intake.”16 The risk of colon cancer was increased by 88% in Adventists who ate meat over their vegetarian counterparts. Diabetes, our rapidly growing national epidemic, is rare among the Adventists. Indeed, they boast the nation’s lowest rates of the disease. Switching to plant-based nutrition involves a radical remaking of what’s on the plate and in the pantry. It means changing a lifetime of habits, learning new skills, and developing new tastes. Some people do best with a slow, step-by-step transition, while others choose to go all in, all at once.
In 2002 a second major Adventist study was started, led by Dr. Gary Fraser and a team of researchers from Loma Linda University, which included ninety-six thousands participants from across the United States and Canada. The results from that study showed that Adventist meat-eaters had the biggest waistlines, and had a higher death rate than their vegetarian Adventist counterparts. They also tended to have worse overall dietary habits including greater consumption of highly processed foods such as sugar, soda, and refined grains. This raises the question of whether it was the animal foods or the processed food or both that led to shorter lives in this cohort. Although we cannot tease that out with this study, what we can tell is that the lacto-ovo vegetarians, the pesco-vegetarians, and the vegans all had significantly lower mortality rates compared to the meat-eaters.
It’s worth noting that even those Adventists classified as meat-eaters were much less so than most Americans. The meat eating Adventists’ diet (in terms of daily intake in grams) was largely composed of fruits and vegetables, nuts, legumes, and soy foods. And the overall better life expectancy of the community reflects that fact.
The Adventists are one of the most interesting groups to study, from the perspective of diet, because they have such a similar overall lifestyle. It is rare in epidemiological studies that researchers can observe a group of people with very similar lifestyles but so many distinct dietary subgroups, enabling them to more effectively isolate the impact of diet on health.
When it comes to America’s leading cause of death – heart disease and cancer – the vegetarian Adventist again fare well. They have the lowest rate of heart disease in the nation.15 In men, the risk of fatal heart disease was “significantly related to beef intake.”16 The risk of colon cancer was increased by 88% in Adventists who ate meat over their vegetarian counterparts. Diabetes, our rapidly growing national epidemic, is rare among the Adventists. Indeed, they boast the nation’s lowest rates of the disease. Switching to plant-based nutrition involves a radical remaking of what’s on the plate and in the pantry. It means changing a lifetime of habits, learning new skills, and developing new tastes. Some people do best with a slow, step-by-step transition, while others choose to go all in, all at once.
CLINICAL PIONEERS OF PLANT-BASED NUTRITION
In the late 1950s, a young man named Nathan Pritikin had been diagnosed with heart disease at just forty-two years of age. Through a long experimentation with diet, he eventually reversed his disease. In 1975, he opened up a “longevity center” in California to share his regimen, which was essentially whole foods, primarily plant-based diet, along with exercise every day. Pritikin’s patients got better – a lot better! Risk factors for heart disease improved across the board, cholesterol went down, and arterial function and blood flow improved, along with a host of other health transformations. Pritikin’s works attracted a great deal of attention in his day, but without medical credentials or controlled trials, he was never fully accepted by the establishment. Since his death, more than 100 studies in peer-reviewed journals have validated the program’s effectiveness. Meanwhile, however, the task of scientifically demonstrating that diet and lifestyle change could reverse heart disease was being taken up by an independent-minded young physician from the Lone Star State.
In the late 1950s, a young man named Nathan Pritikin had been diagnosed with heart disease at just forty-two years of age. Through a long experimentation with diet, he eventually reversed his disease. In 1975, he opened up a “longevity center” in California to share his regimen, which was essentially whole foods, primarily plant-based diet, along with exercise every day. Pritikin’s patients got better – a lot better! Risk factors for heart disease improved across the board, cholesterol went down, and arterial function and blood flow improved, along with a host of other health transformations. Pritikin’s works attracted a great deal of attention in his day, but without medical credentials or controlled trials, he was never fully accepted by the establishment. Since his death, more than 100 studies in peer-reviewed journals have validated the program’s effectiveness. Meanwhile, however, the task of scientifically demonstrating that diet and lifestyle change could reverse heart disease was being taken up by an independent-minded young physician from the Lone Star State.
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Dean Ornish, MD had been curious about how diet and lifestyle – a whole foods, plant-based diet, moderate exercise, meditation and social support – might impact heart disease since his medical school days. In 1980 he began with a new study – a randomized controlled trial of forty-eight patients.
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After only twenty-four months, the patients who made comprehensive lifestyle changes showed improvement (reversal) in their heart disease, whereas those in the randomized control group got worse. This, the first randomized controlled trial showing that lifestyle changes alone could reverse heart disease was published in the Journal of the American Medical Association. In 1984, he launched the Lifestyle Heart Trial.
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In Cleveland clinic, Dr. Caldwell Essenstyn was also developing a study. He had encountered some resistance from the establishment. Most senior cardiologists at the Cleveland Clinic, he writes, “did not believe there was a connection between diet and coronary disease. Nevertheless, in 1985, the Department of Cardiology agreed to participate in his first proposed study.
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It would refer patients to him – primarily those for whom bypass surgery or angioplasty had failed, and several who had been told there was nothing more that could be done for them. Esselstyn’s hypothesis was that plant-based nutrition could reduce their cholesterol levels below 150 mg/dL (closer to the level seen in those traditional cultures that had no heart disease) and in so doing, slow or halt the disease process. By 1988 a cohort of twenty-four people with severe, progressive coronary artery disease was eating a very low-fat, plant-based diet under his supervision.
From a dietary standpoint, Ornish’s and Esselstyn’s studies were very similar. However, unlike Esselstyn, who instructed patients to continue their medications, Ornish did not use cholesterol-lowering medications in his study. Moreover, he stipulated other lifestyle changes in addition to the nutritional component, including relaxation techniques, moderate exercise, smoking cessation, and participation in a support group – interventions he believes are also critical to the success of the program. His study included forty-eight patients who were randomized into two groups: twenty-eight of patients made the recommended diet and lifestyle changes, while the other twenty served as a control group, following standard medical treatment and dietary advice from the American Heart Association.
Ornish’s work was the first to be made public. In 1990 he published the one-year results. Most of the experimental group reported a complete or nearly complete disappearance of chest pains. But patients not only felt better, they were better. When measurements were taken of their narrowed arteries using angiograms, 82% showed an increased diameter (reversal). Only one patient who had poor adherence showed significant progression (worsening).
In 2006, Esselstyn launched a second, larger study, this time following 198 patients who adopted his plant-based nutritional program. In 2014 he published the results: of those who complied with the diet, 93% experienced improvement in angina symptoms. And only one patient experienced a major cardiovascular event due to recurrent disease (a stroke) – demonstrating that his diet was protective for 99.4% of patients who followed it. In comparison, among the twenty-one participants who did not adhere to the program, thirteen experienced further cardiac events, including two deaths.
Ornish’s and Esselstyn’s studies represent a dramatic medical breakthrough. Until that point the best that drugs and surgical treatments could do was manage heart disease. They ended up doing something few even believed was possible: they showed that heart disease is reversible. And they did it with lifestyle interventions that had no negative side effects. Simply by stopping eating foods that were clogging up their arteries and instead eating healthy plant-based diet, their patients began to heal – at any age. Their remarkable turnarounds show that it’s never too late when it comes to heart disease.
From a dietary standpoint, Ornish’s and Esselstyn’s studies were very similar. However, unlike Esselstyn, who instructed patients to continue their medications, Ornish did not use cholesterol-lowering medications in his study. Moreover, he stipulated other lifestyle changes in addition to the nutritional component, including relaxation techniques, moderate exercise, smoking cessation, and participation in a support group – interventions he believes are also critical to the success of the program. His study included forty-eight patients who were randomized into two groups: twenty-eight of patients made the recommended diet and lifestyle changes, while the other twenty served as a control group, following standard medical treatment and dietary advice from the American Heart Association.
Ornish’s work was the first to be made public. In 1990 he published the one-year results. Most of the experimental group reported a complete or nearly complete disappearance of chest pains. But patients not only felt better, they were better. When measurements were taken of their narrowed arteries using angiograms, 82% showed an increased diameter (reversal). Only one patient who had poor adherence showed significant progression (worsening).
In 2006, Esselstyn launched a second, larger study, this time following 198 patients who adopted his plant-based nutritional program. In 2014 he published the results: of those who complied with the diet, 93% experienced improvement in angina symptoms. And only one patient experienced a major cardiovascular event due to recurrent disease (a stroke) – demonstrating that his diet was protective for 99.4% of patients who followed it. In comparison, among the twenty-one participants who did not adhere to the program, thirteen experienced further cardiac events, including two deaths.
Ornish’s and Esselstyn’s studies represent a dramatic medical breakthrough. Until that point the best that drugs and surgical treatments could do was manage heart disease. They ended up doing something few even believed was possible: they showed that heart disease is reversible. And they did it with lifestyle interventions that had no negative side effects. Simply by stopping eating foods that were clogging up their arteries and instead eating healthy plant-based diet, their patients began to heal – at any age. Their remarkable turnarounds show that it’s never too late when it comes to heart disease.
VEGAN DOESN’T NECESSARILY MEAN HEALTHY
It’s important to understand that one can adopt a vegan or vegetarian diet (perhaps for ethical reasons) and still end up eating very unhealthy foods. Merely avoiding animal foods is not the answer to good health. Studies have shown that vegetarians have a decreased risk of cancer, less obesity, and depending on the study you look at, possibly greater longevity as well.21 We would suggest that those studies track not just decreased consumption of unhealthy animal products, but also an increase in healthy plant-based foods in the diet – greater consumption of fruits and vegetables, whole grains, and beans and other legumes, with all their corresponding healthy nutrients and micronutrients.
In the very large European Prospective Investigation into Cancer and Nutrition (or EPIC) study, four combined lifestyle behaviors were associated with an extra fourteen years of longevity – not smoking, only moderate consumption of alcohol, physical activity, and the consumption of at least five servings of fruits and vegetables everyday.
Becoming a vegetarian should never be considered a ticker to health all by itself. Doughnuts, French fries, and banana splits are all vegetarian, and not one of them is going to make a top-ten health food list any time soon. A whole foods, plant-based diet stays away from refined grains, highly processed carbohydrates and sugars, and oils. In fact, there have even been studies, like the aforementioned EPIC study, that did not find a significant difference in the life expectancy between meat-eaters and vegetarians. But here’s a key to interpreting that data: the vegetarians in the EPIC study were eating only half the fiber of the Adventist vegetarians in Loma Linda. That means they were eating far fewer whole plant foods! The Loma Linda vegetarians were eating many more whole foods and plants, and all the healthy fiber and nutrients that they are packed in. The results speak for themselves – an ordinary population, genetically diverse, with extraordinary health outcomes. As Garth Davis, MD, puts it, “If everyone ate like a Seventh-day Adventist, everyone would have the health of a Seventh-day Adventist.”
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One person who certainly appears to have the health of a Seventh-day Adventist – or of the rural Chinese he studied – is T. Colin Campbell. Today, in his eighties and still robust and active, he runs a nutritional center, teaches at Cornell, and lectures around the world on the benefits of the whole foods, plant-based diet.
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CULINARY MEDICINE
It’s not an ordinary cooking class, it’s culinary medicine. This is all about practical nutrition education, cooking skills and healthy behaviors, both for patients and for the students themselves. Culinary medicine is an evidence-based practice of blending cooking and the science of medicine. We’re not only just looking to support the health of patients, but equally much the support of the wellness of our health care providers.
We’re talking about what we eat, how we prepare it, what do we put in it, why do we have such food preferences, and how do we deal with those unhealthy cravings and develop our taste buds to enjoy healthy foods instead. We help people to learn the direct link of food consumption and health basing on the evidences out there showing the impact of nutrition on overall health outcome.
We see this practice as totally groundbreaking. Many health care providers have no idea on how to work that science of nutrition and actually use it in a way that translate healthy eating behaviors to their patients. And it’s also least likely that physicians would recommend an optimal diet when they are not practicing it themselves. Studies show that health care providers who are eating healthy themselves would talk to their patients about diet and nutrition because they are a better example for them.
Students learn the nutritional science, we also teach them practical skills on food preparation using fresh produce and plant-based ingredients and we work on increasing their level of confidence. When these three are combined, we can make sure that culinary medicine can be translated in their home kitchen. And this can benefit not only the students enrolled in our course but their family as well.
Once people understand the science behind diet related diseases and realize how easy it is to prepare healthy meals from scratch, they would most likely stick to the new lifestyle and eventually develop sustainability and improve health outcome.
In Culinary Medicine, we give huge emphasis on behavior change which can be particularly challenging for both the patients and the health care providers because we know very well that it’s hard to make changes in our own lives. It is a progressive journey that needs empathy and support.
Our objective is to enhance nutritional literacy to both the health care providers, food industry professionals and patients through engaging innovative online learning opportunities.
We’re talking about what we eat, how we prepare it, what do we put in it, why do we have such food preferences, and how do we deal with those unhealthy cravings and develop our taste buds to enjoy healthy foods instead. We help people to learn the direct link of food consumption and health basing on the evidences out there showing the impact of nutrition on overall health outcome.
We see this practice as totally groundbreaking. Many health care providers have no idea on how to work that science of nutrition and actually use it in a way that translate healthy eating behaviors to their patients. And it’s also least likely that physicians would recommend an optimal diet when they are not practicing it themselves. Studies show that health care providers who are eating healthy themselves would talk to their patients about diet and nutrition because they are a better example for them.
Students learn the nutritional science, we also teach them practical skills on food preparation using fresh produce and plant-based ingredients and we work on increasing their level of confidence. When these three are combined, we can make sure that culinary medicine can be translated in their home kitchen. And this can benefit not only the students enrolled in our course but their family as well.
Once people understand the science behind diet related diseases and realize how easy it is to prepare healthy meals from scratch, they would most likely stick to the new lifestyle and eventually develop sustainability and improve health outcome.
In Culinary Medicine, we give huge emphasis on behavior change which can be particularly challenging for both the patients and the health care providers because we know very well that it’s hard to make changes in our own lives. It is a progressive journey that needs empathy and support.
Our objective is to enhance nutritional literacy to both the health care providers, food industry professionals and patients through engaging innovative online learning opportunities.
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prevalence and cost burden of chronic disease
In 2015, noncommunicable diseases (NCDs) accounted for 68% of all deaths in the Philippines (WHO, 2017a). The figures from 2015 show that every third Filipino (29%) can die before the age of 70 years from one of the four main NCDs (cardiovascular diseases, diabetes, chronic respiratory disease and cancer) (WHO, 2017a). This highlights a pressing need to make progress specifically on Sustainable Development Goals target 3.4, which aims to reduce premature mortality from NCDs by one third by 2030. NCDs also have development impacts on other Sustainable Development Goals, including: Sustainable Development Goals 1 (poverty), 2 (malnutrition), 4 (education for sustainable lifestyles), 5 (gender equality), 6 (access to clean water), 7 (access to clean air), 8 (safe working environment), 10 (reduce inequalities), 11 (access to safe, green public places) and 12 (sustainable consumption and production). How NCDs affect human health is clear, but this is only one part of the story.
NCDs also result in high economic costs, far exceeding direct health-care costs. NCDs reduce productivity at the macroeconomic level by interrupting full participation in the labour force and subsequently affecting individuals, their caregivers and the public sector. When individuals die prematurely, the labour output they would have produced in their remaining working years is lost. In addition, individuals who suffer from a disease are more likely to miss days of work (absenteeism) or to work at a reduced capacity while at work (presenteeism1 ). In low- and middle-income countries, between 2011 and 2030 NCDs are estimated to cause more than US$ 21 trillion in lost economic output, with nearly one third of that figure attributable to cardiovascular diseases alone (Bloom et al., 2011).
For individuals and governments, high financial burden of disease implies significant opportunity cost,2 including decreased investment in education, transport projects or other forms of human or physical capital that can produce long-term returns. High human and economic costs highlight the need to reduce the burden of NCDs in the Philippines. WHO recognizes that the risk of NCDs can be reduced by modifying four types of behaviour (tobacco use, harmful use of alcohol, an unhealthy diet and physical inactivity) and metabolic risk factors such as high blood pressure and cholesterol (WHO, 2013).
NCDs also result in high economic costs, far exceeding direct health-care costs. NCDs reduce productivity at the macroeconomic level by interrupting full participation in the labour force and subsequently affecting individuals, their caregivers and the public sector. When individuals die prematurely, the labour output they would have produced in their remaining working years is lost. In addition, individuals who suffer from a disease are more likely to miss days of work (absenteeism) or to work at a reduced capacity while at work (presenteeism1 ). In low- and middle-income countries, between 2011 and 2030 NCDs are estimated to cause more than US$ 21 trillion in lost economic output, with nearly one third of that figure attributable to cardiovascular diseases alone (Bloom et al., 2011).
For individuals and governments, high financial burden of disease implies significant opportunity cost,2 including decreased investment in education, transport projects or other forms of human or physical capital that can produce long-term returns. High human and economic costs highlight the need to reduce the burden of NCDs in the Philippines. WHO recognizes that the risk of NCDs can be reduced by modifying four types of behaviour (tobacco use, harmful use of alcohol, an unhealthy diet and physical inactivity) and metabolic risk factors such as high blood pressure and cholesterol (WHO, 2013).
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