You Are What You Eat

1. You Are What You Eat Charlie Petersen MD

2. Diet/Eating • It’s personal • Everyone “does it” • A powerful factor affecting health -more potent than smoking “Combining healthy diet, regular exercise, and not smoking can eliminate 80% of heart disease and 70% of some cancers.” Walter Willett MD

3. The Top 10 Sources of Calories in the American diet Soft drinks, Pastries and baked goods, Hamburgers, Pizza, White bread and crackers, Alcohol, Milk and cheese, Meat, Poultry, Salty snacks- potato chips and French fries

4. The most important predictor of future health is weight

5. Weight and waistline Weight strongly influences the chances of- • Stroke • Heart disease • Hypertension, high cholesterol, diabetes • Sleep apnea • Breast, uterine, colon, kidney cancers • Arthritis • Esophageal reflux/heartburn

6. “Diet” Don’t think elimination, avoidance, abstinence Think - diet of abundance Abundance of foods proven to nourish and protect us.

7. You are what you eat…. Every molecule of your being is derived from what you chose to eat. Thus we need eat intentionally, mindfully.

8. What do K Rations from WW2 have in common with the Mediterranean Diet? Ancel Keys

9. Seven Countries Study • Prospective, 1950-’60’s • 16 different populations in 7 countries • Country by country food surveys • Tenfold difference between Finland and Crete in heart disease rates. • The more saturated fat in the country’s diet the more heart disease

10. Seven Countries Study • Cretan diet was largely plant based- Basic foods - whole grains, fruits, vegetables, beans, nuts and seeds. Limited amounts – cheese, yogurt, fish. Not daily – red meat, poultry. Olive oil was the main dietary fat source. People drank wine often with meals.

14. Lyon Diet Heart Study • French study began 1988 • 605 men & women after 1st heart attack • AHA prudent diet versus Mediterranean diet, with alpha-linolenic acid enriched margarine. Patients encouraged to eat more fruits/vegetables, whole grains, and fish while less red meat.

15. Lyon Diet Heart Study Findings After 2.5 years the trial was stopped early with 70% reduction in all cause mortality with Mediterranean diet. At 5 years 70% mortality benefit maintained. Despite no change in weight or cholesterol levels. Hmmmmm????

16. Lyon Diet Heart Study

17. Essential Fatty Acids

18. Essential Fatty Acids • Omega-6 Omega-3 • Arachidonic EPA/DHA Acid

19. Essential Fatty Acids Linoleic α – Linolenic Flaxseed Walnuts Canola Soy Inflammatory Anti-inflammatory Vaso-constricting Vaso-dilating Thrombotic Blood thinning

21. Where do Fish get their EPA and DHA ?

22. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet- NEJM 2/2013 • 7447 men & women, ages 55-80 years • No known CAD • Must have either diabetes, or at least 3 risk factors- smoking, hypertension, high LDL cholesterol, low HDL, overweight, and strong family history of CAD.

23. Spanish trial Patients were randomized to either - M diet with olive oil (1 liter/week) - M diet with nuts (30 grams/day) - Low fat diet. Mediterranean diet patients encouraged to increase fruits, vegetables, legumes, fish, poultry, olive oil 4 tbs/day, and wine. Discouraged red meat, soda, baked goods, and fatty dairy

24. Spanish trial • Patients were followed for median 4.8 years • Trial stopped early 30% relative risk reduction in composite of myocardial infarction, stroke, and death from CV causes.

25. Ornish CAD Reversal Lifestyle Trial • Very low fat diet • Moderate exercise • Stress reduction • Group support Outcomes: Chest pain resolution 1 and 5 year angiogram improvement in stenoses

26. What does Cauliflower have to do with Breast Cancer?

27. Indole-3 carbinol • The crucifer family of vegetables cauliflower, broccoli, Brussels sprouts, kale, cabbage, collard/mustard greens, radishes, turnups, rutabaga contain cancer protecting chemicals- - indoles, isothiocyanates, thiocyanates, and nitriles. -Phytochemicals-

28. Indole-3 carbinol • Is a negative, “down-regulator”, of estrogen. • Studies increasingly show that dietary I-3-C prevents the development of estrogen-enhanced cancers including breast, endometrial, and cervical cancers.

29. There are thousands of plant based chemicals which protect both plants and people.

30. Tomatoes, apricots, watermelon, papaya, and pink grapefruit are concentrated sources of lycopene.

31. Phytochemical Lycopene • Evidence is strongest for Lycopene’s protective effect against cancer of the lung, stomach, and prostate. • Perhaps also cancer of cervix, breast, mouth, pancreas, esophagus, and colon. Am. Cancer Society

33. Eat from the Entire Rainbow of plant foods… Fruits, vegetables, legumes, whole grains, nuts, seeds, herbs and spices

34. BUT………..???

35. Protein Quality? All essential amino acids are plant based….

36. Only Plants Give us Fiber Animals have boney skeletons for structure.

37. Only the carbohydrate endosperm remains after refining whole grains…

38. High intake of fruits and vegetables • Replace refined “white nothingness” foods with whole grains

39. Summary * Maintain healthy weight * Replace refined “white nothingness” foods with whole grains * Replace red meat with better protein “packages” of nuts, seeds, beans and fish * Use olive oil as primary fat * Supplement with omega-3 fatty acid (fish oil, walnuts, and/or flaxseed) * Low to moderate alcohol intake

40. Make Sure That You Are Getting Enough Of The Good Stuff…

41. No medicine or surgery has reversed lifestyle induced disease. Only profound lifestyle change has proven successful.

42. True Healthcare • Is discovered at the grocery store and not the pharmacy…….

43. Any moment unaware is lost - Jon Kabat-Zinn Only that day dawns to which we are awake- Henry David Thoreau Eat mindfully, heartfully and enjoy – Charlie Petersen

44. Health and Wellness