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The Solution to the Omnivore’s Dilemma

The Solution to the Omnivore’s Dilemma. According to Christopher Gardner PhD – Nutrition Science Associate Professor of Medicine Stanford University.

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The Solution to the Omnivore’s Dilemma

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  1. The Solution to the Omnivore’s Dilemma According to Christopher Gardner PhD – Nutrition Science Associate Professor of Medicine Stanford University

  2. “The human animal is adapted to, and apparently can thrive on, an extraordinary range of different diets, but the Western diet, however you define it, does not seem to be one of them”.

  3. TARAHUMARA DIET Extremely high carbohydrate 90% Corn and Beans Remainder almost entirely other vegetables(e.g., squash, chilies) ~2 eggs/week Meat seldom eaten ULTRAMARATHONERS Run equivalent of marathon or more every day

  4. NATIVE ALASKAN DIET Extremely low carbohydrate hunter/gatherer Whales, walruses, caribou, seals, polar bears, muskoxen, birds Vegetation:Grasses, tubers, roots, stems, berries, and seaweed

  5. MAASAI DIET (traditional) Breakfast:Milk (fresh, raw, whole, warm) Lunch:Maize porridge (Ugali) with wild cooked greens/weeds Occasional fruit found while herding Dinner:Same as lunch, with different greens, or just milk or just meat Mushrooms during rainy season Blood every ~2 months (fresh, raw, warm) Fats boiled from cows/sheep/goats

  6. Australian Aboriginal Diet Patterns Hunter-Gatherer Lifestyle Western Lifestyle Energy Density Nutrient density Animal protein Plant protein Complex carbs Simple carbs Fiber Animal fat Vegetable fat Low High High Low-Mod Moderate Low High Low Low High Low Moderate Low Low High Low High Low O’Dea, Phil. Trans. R. Soc. Lond. B. 1991; 334: 233-41

  7. We “just” want to know how/what to eat to prevent disease and promote health

  8. Gee Professor Gardner, how do vegetarians get enough protein? Vegetarian Nobel Laureates and Scientists Albert Einstein Leonardo Da Vinci Thomas Edison Benjamin Franklin Linus Pauling Steve Jobs

  9. Hey there Dr. Gardner… do you want to know how low I go in carbohydrate and fat?

  10. How much omega-3? Fish vs. Flax? EPA vs. DHA? Foods vs. Supplements? Omega-6:Omega-3 ratio? Mercury poisoning? I’M REALLY CONFUSED!

  11. I wonder if I should take Vitamin D and Calcium supplements? And if so, how much? What would Professor Gardner say?

  12. Surely Professor Gardner, no matter what else in nutrition is confusing, FOODS are always the best sources of nutrients (vs. supplements)!!?? Charles Darwin Naturalist

  13. Surely a vegetarian diet is superior to all other choices, wouldn’t you agree Dr. Gardner?

  14. How could we not know... …the answers to such basic questions about our diet and our health?

  15. Consider the following perspectives

  16. Nutrition from a NUTRIENT perspective

  17. Genistein (an isoflavone) Indole 3 carbinol (anti-carcinogen?) Allicin (a sulfur containing molecule) Linoleic acid (a monounsaturated fat)

  18. Nutrition from a FOOD perspective

  19. Broccoli (Cruciferous vegetable) A source of I3C Edamame (green soy beans) A source of the isoflavone genistein Olive Oil A source of monounsaturated fat Garlic A source of allicin

  20. Nutrition from a CULTURAL perspective

  21. THE Traditional VegetarianDiet A good source of broccoli THE Traditional Asian Diet A good source of soy foods THE Traditional Latin American Diet A good source of garlic THE Traditional Mediterranean Diet A good source of olive oil

  22. Switch Perspectives

  23. Science from anACUTE DEFICIENCY DISEASEperspective

  24. Scurvy From a Vitamin C deficiency

  25. Collagen Synthesis Interaction of protein, vitamin and mineral • Collagen – to be functional, proline and lysine must be hydroxylated after being strung together into protein (post-translational hydroxylation) • An enzyme is required for the post-translational hydroxylation • The enzyme is a “metallo-enzyme” that requires IRON, in its reduced atomic state, to be functional • Vitamin C keeps iron “reduced” (Fe2+) • This is the metabolic link • between Vitamin C and SCURVY

  26. Iron Deficiency Anemia Normal Red Blood Cells Iron Deficiency Anemia Small pale cells

  27. Normal red blood cells Stop dividing when [Hb] > 20% Final [Hb] = 34% Cell divides

  28. Normal red blood cells Stop dividing when [Hb] > 20% Final [Hb] = 34% Cell divides Micro-cytic anemia Iron Deficiency

  29. In Iodine deficiency, the thyroid gland enlarges--a condition known as simple goiter(US fortifies salt with iodine)

  30. OH OH OH OH OH I I OH I I I I I I I I I I I I I Thyroid hormone Thyroglobulin I I Mono-iodinated tyrosine Di-iodinated tyrosine Over 99% of thyroid hormone is bound to proteins, and inactive. The amount of “free” (i.e., unbound) T4 and T3, AND the T4 / T3 ratio determines metabolic rate. T3 is the more active of the two. T4 T3 Deiodinase I Tri-iodo- thyronine Thyroxine

  31. Science from aCHRONIC DISEASEperspective

  32. Ten Leading Causes of Death--United States, All Ages % Change 1979-1997 Heart Disease Cancers Strokes Chronic obstr. lung disease Motor vehicle accidents Diabetes mellitus Pneumonia & influenza Suicide Homicide+ Chronic liver disease and cirrhosis 50 100 150 0 Deaths per 100,000 population

  33. Typical “Scientific” approach to diet complexity Sum total of consumable foods (diets) Health related factors Diseases 1 risk factor 1 food item 1 disease 1 nutrient or phyto-chemical Reductionist / Isolationist approach Example: Stanol ester and blood cholesterol Cholesterol and heart disease

  34. Science from aCHRONIC DISEASE RISK FACTORperspective

  35. Design Randomized Clinical Trial Low-Fat Diet Randomized n=125 Low-Fat, Plant-Based Diet Day 0 14 28 Blood Samples Meals Provided “Free Choice Meal”

  36. Low-Fat Plus (n=59) Low-Fat (n=61) 5 4-week change (mg/dL) 0 - 5 - 10 - 15 - 20 Total-cholesterol (p=0.01) LDL-cholesterol (p=0.02) HDL-cholesterol (p=0.1) Tri-glycerides (p=0.9) Mean +/- SEM Gardner et al. Ann Int Med 2005;142:725-33

  37. Garlic Study Design Daily Sandwiches WITH or WITHOUT garlic Enrolled n=227 for 2-week run-in Randomized 192 (n=47-49/group) Daily Tablets 2-week run-in Placebo WITH Fresh Garlic Garlicin Without Garlicin (garlic powder) n=227 Kyolic Without Kyolic (aged garlic extract) Placebo Without Placebo Months 0 2 4 6 Lipids

  38. 160 140 120 Raw Garlic 100 Garlicin Kyolic Placebo 0 LDL-cholesterol mg/dL 0 1 2 3 4 5 6 Gardner et al Arch Int Med 2007;167:346-53 Months

  39. Acute Deficiency Disease Chronic Disease Risk Factors Chronic Disease Nutrients Foods Culture

  40. Study Design The tools of Nutrition Science

  41. Ecological Studies

  42. 1200 1000 800 600 400 200 0 0 0 5 10 15 20 25 30 CHD Rate in 40 Countries Finland r=0.78 Death rate/100,000 (men, age 55-64) Coronary Heart Disease France Cholesterol Saturated Fat Index per 1000 Kcal/day Artaud-Wild et al. Circ. 1993;88:2771-9

  43. CHD Mortality in Seventh Day Adventist vs. Non-SDA men 10 Non-SDA 8 Seventh Day Adventists 6 CHD Mortality per 1000/year 4 2 0 45 55 65 Phillips et al., Am J Epi 1980;112:296 Age (years)

  44. Case-Control Studies Cross-sectional

  45. 40 Cases (n=597) 35 Controls (n=966) 30 25 20 15 10 5 0 ≤12 13 - 42 43 - 54 ≥55 Frequency of Tofu Intake (per year) Tofu and Risk of Breast Cancer in Asian-Americans Chinese-, Japanese- and Filipino-American women in Los Angeles, San Francisco/Oakland, Oahu % Wu et al., Canc Epid BioMark Prev, 1996:5:901-906

  46. Tofu and Risk of Breast Cancer in Asian-Americans Chinese-, Japanese- and Filipino-American women in Los Angeles, San Francisco/Oakland, Oahu 1.2 Odds Ratio 1.0 0.97 R e f e r e n c e G r o u p 0.8 0.84 0.6 0.67 0.4 0.2 0 ≤12 13 - 42 43 - 54 ≥55 Frequency of Tofu Intake (per year) Wu et al., Canc Epid BioMark Prev, 1996:5:901-906

  47. Tofu and Risk of Breast Cancer in Asian-Americans Chinese-, Japanese- and Filipino-American women in Los Angeles, San Francisco/Oakland, Oahu Relative to those consuming tofu <12 times/year, breast cancer rates were 33% lower among those consuming tofu at least 55 times/year 1.2 Odds Ratio 1.0 0.97 R e f e r e n c e G r o u p 0.8 0.84 0.6 0.67 0.4 0.2 0 ≤12 13 - 42 43 - 54 ≥55 Frequency of Tofu Intake (per year) Wu et al., Canc Epid BioMark Prev, 1996:5:901-906

  48. Prospective / Longitudinal Cohort Studies Note: The majority of newspaper headlines linking diet to health come from cohort studies

  49. 1.5 6.0 8.5 13.0 22.5 Iowa Women’s Health Study: ~35,000 Postmenopausal Women Relative Risk of Heart Disease after 9-years of follow-up 1.0 P for trend = 0.02 0.8 Relative Risk (CVDRF & Diet adjusted) 0.6 0.4 0.2 0 Whole Grain Intake: Median servings/week Jacobs, Am J Clin Nutr, 1998;68:248-57

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