The New Nutritional Approach to Diabetes, Heart Health, and Brain Health SUSAN LEVIN, MS, RD
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1 The New Nutritional Approach to Diabetes, Heart Health, and Brain Health SUSAN LEVIN, MS, RD Director of Nutrition Education Physicians Committee for Responsible Medicine
2 Dean Ornish, M.D. Lifestyle Heart Trial RCT: Lifestyle intervention vs Usual care Ornish D. Lancet. 1990;336:
3 1. Vegetarian foods Lifestyle Heart Trial Intervention (Vegan except for 1 cup/d non-fat dairy and egg white) 2. Half-hour walk daily 3. Manage stress 4. Avoid tobacco Lifestyle Heart Trial 1-year results Experimental Control Cholesterol 24% 5% LDL 37% 3% Weight 22 lbs 3 lbs Reversal 82% of 42% of participants participants Ornish D. Lancet. 1990;336:
4 Lifestyle Heart Trial 5-year results Ornish D. Lancet. 1990;336: Two rules: 1. No animal products 2. Minimize oils Weight-Control Study Randomized Control Trial No exercise 14-week intervention Barnard ND, et al. The effects of a low-fat, plant-based dietary intervention on body weight, metabolism, and insulin sensitivity. Am J Med. 2005;118:
5 Typical Day s Meals Breakfast Blueberry pancakes or Oatmeal with cinnamon and raisins Half cantaloupe Rye toast with jam Lunch Chunky vegetable chili Garden salad with sesame dressing Snack Banana Dinner Lentil soup with crackers Linguine with artichoke hearts and seared oyster mushrooms Steamed broccoli Results 14 weeks 13 lbs average weight loss Improved insulin sensitivity Maintained weight loss for 2 years Barnard ND, et al. The effects of a low-fat, plant-based dietary intervention on body weight, metabolism, and insulin sensitivity. Am J Med 2005;118: Turner-McGrievy et al. A two-year randomized weight loss trial comparing a vegan diet to a more moderate low-fat diet. Obesity 2007;15:
6 Tufts University 4 Diets 160 participants assigned to 4 diets 1. Low-carb (Atkins) 2. Macronutrient balance (Zone) 3. Caloric restrictions (Weight Watchers) 4. Low-fat vegetarian (Ornish) Dansinger ML, et al. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction. JAMA. 2005;293: Tufts University 4 Diets Weight loss in kilograms 1. Low-carb (Atkins) kg 2. Macronutrient balance (Zone) kg 3. Caloric restrictions (Weight Watchers) kg 4. Low-fat vegetarian (Ornish) kg Dansinger ML, et al. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction. JAMA. 2005;293:43-53.
7 A Plant-Based Diet for Type 2 Diabetes Randomized control trial Low-fat vegan diet or ADA guidelines 22-week study with 1-year follow-up Barnard ND, et al. A low-fat, vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes. Diabetes Care. 2006;29: Barnard ND, et al. A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-week clinical trial. Am J Clin Nutr. 2009;89:1588S-1596S.
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10 Vance Lost 60 pounds Stopped all diabetes medications A1c fell from 9.5 to 5.3 Nancy Lost 40 pounds Stopped all diabetes medications A1c fell from 8.3 to 6.8 Arthritis improved dramatically
11 GEICO Study Ten Sites Mishra S, et al. Eur J Clin Nutr. 2013;67:
12 Mishra S, et al. Eur J Clin Nutr. 2013;67:
13 Diabetes and Alzheimer s Risk 1,017 adults Japan Ohara T. Risk of Alzheimer s disease based on glucose tolerance results 15 years earlier. Neurology. 2011;77:
14 Saturated Fat 4 13 grams 25 grams 3 2 Alzheimer s Risk 1 0 Mild Cognitive Impairment 1,341 adults Average age: 50 Followed 21 years 6 5 APOEε4 4 3 Saturated fat per day Low (<21.6 grams) High (>21.6 grams) 2 Eskelinen MH. Cardiovascular risk factors, Aging, and Dementia (CAIDE) study, Finland. Int J Geriatric Psychiatr. 2008; 23:
15 Trans Fats 5 4 Low: 1.8 grams High: 4.8 grams 3 2 Alzheimer s Risk Cholesterol and Alzheimer's Risk Relative Risk 1 0 < Serum Cholesterol (mg/dl) ,844 participants in the Kaiser Permanente health plan. Solomon A. Dement Geriatr Cogn Disord. 2009;28:75 80.
16 Meat vs. Plant-Based Diets Proportion remaining free of dementia Loma Linda University, 272 participants Giem P. Neuroepidemiology. 1993;12: Case Study 60-year-old man Massera D, et al. A whole-food plant0based diet reversed angina without medications or procedures. Case Rep Cardiol. Published online Feb 10, 2015.
17 Take Home Message Reversal of heart disease Weight loss Improved symptoms related to diabetes Improved brain health Foods that look and taste great!
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