Ms Morgen Smith. Dr Bruce Duncan. Dr Nicholas Wright
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1 Dr Nicholas Wright General Practitioner Dr Bruce Duncan Public Health Physician Tairawhiti Gisborne Ms Morgen Smith Kinesiologist 14:00-14:55 WS #28: Sustainable Weight Loss and the Plant Based Diet 15:05-16:00 WS #38: Sustainable Weight Loss and the Plant Based Diet (Repeated)
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3 Sustainable weight loss and the plant based diet
4 Presentation 1. Bruce - Lifestyle approaches: population health perspectives 2. Nick BROAD Study results 3. Morgen Smith talking to patients
5 Lifestyle approaches: Population health perspectives Dr Bruce Duncan, Public Health Physician and Medical Officer of Health, Tairawhiti
6 Weight-related Metabolic Cancer Obesity
7 Obesity Weight-related Metabolic Cancer Diabetes Common More people die from diabetes than from war Morbidity Dominates health care system
8 Obesity Diabetes
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10 Current approach Demand driven Targets Treatment, not resolution or cure Try not to get worse too quickly Lifestyle advice
11 Diabetes: some NNTs Drugs: Statins 122 ACE 42 Metformin 14 Surgery: Bariatric surgery 6 Lifestyle: Exercise NNT 4-8 Diet 3-10 BROAD study 2-5
12 Obesity Individual vs population benefits 10% reduction in BMI = benefits at population level Helps with Hypertension Diabetes Lifestyle Population and individual benefits
13 Statins, 5 y Lives saved No MI No stroke Heart disease 1 in 83 1 in 39 1 in 125 No heart disease 0 1 in 60 1 in 268 Harms: 1 in 50 develop diabetes 1 in 10 muscle damage
14 No prevented: Deaths Strokes Heart attacks Tight glucose control: 5 y Helped: 1 in prevent amputation Kidney failure Microvascular disease Harmed: 1 in 6 from severe hypoglycemia req admission
15 Research: BMJ 2015 Prediabetes: Slow progress by lifestyle OR metformin. Metformin only benefits high risk patients; NNT 5.6. Lifestyle works in all, NNT: 20 for low risk 3.5 for high risk Metformin: 20% stop
16 Pick the winners No young children Partner participates Turns up at assessment Planting the seed Preparing people to be winners (future)
17 Take home messages? Current approach target driven Treatment vs Cure All NNT research favours lifestyle approach Lifestyle will work for the winners
18 BROAD study results Dr Nicholas Wright, MB ChB, MRNZCGP, MACLM
19 WFPB Diet Why do research? Learned about plant-based diet
20 Plant based diet for heart disease
21 WFPB Diet Why do research? Learned about plant-based diet Want to see this put into action No one else doing it! Get stuck in to a research project
22 Who Nick Wright Luke Wilson Morgen Smith Bruce Duncan Patrick McHugh Lots of people helped!
23 12-Week Intervention
24 Programme itself RCT Funding thanks EIT provided chefs Eat as much as you like No exercise
25 WFPB Diet
26 What CAN you eat?
27 WFPB Diet
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47 What are we doing now?
48 The Principles of Energy Density Morgen Smith B.Sc. Spec. Hons, CSCS
49 Jeff Novick - Dietician
50 Percent Energy from Fat Oats Find grams of fat Multiply by 37 Find total energy Divide fat by total energy Multiply by 100 Percentage should be 20% % 1633 = = % Tasty Cheese
51 Exceptions to plant foods Nuts and seeds 60-80% energy from fat Avocado 75% Coconut 80% Margarines 100% Oil 100%
52 1000 kj of different foods Vegetables Meats Cheeses Fats
53 Adding oil to foods 1.5 heads broccoli steamed with no oil 858 kj Total 81 kj from fat 608 grams 1.5 heads broccoli cooked in 1 tbsp of olive oil 1358 kj Total 581 kj from fat 622 grams
54 Iceberg lettuce Tomatoes Kale (cooked) Broccoli Carrots Plum Kale (raw) Apple Kiwifruit Cherries Grapes Boiled potatoes Baked potatoes Brown rice Lentils Pasta, whole wheat Snapper White rice Avocado Tuna Veal (pan) Chicken (roast) Dried prune Big Mac Beef patties (pan) Honey Pork Luncheon Sugar Cheddar cheese KFC Oreos Cashew nuts Almonds Butter Olive oil
55 Iceberg lettuce Tomatoes Kale (cooked) Broccoli Carrots Plum Kale (raw) Apple Kiwifruit Cherries Grapes Boiled potatoes Baked potatoes Brown rice Lentils Pasta, whole wheat Snapper White rice Avocado Tuna Veal (pan) Chicken (roast) Dried prune Big Mac Beef patties (pan) Honey Pork Luncheon Sugar Cheddar cheese KFC Oreos Cashew nuts Almonds Butter Olive oil Vegetables Starches Meats Cheese Fat / Oil
56 Iceberg lettuce Tomatoes Kale (cooked) Broccoli Carrots Plum Kale (raw) Apple Kiwifruit Cherries Grapes Boiled potatoes Baked potatoes Brown rice Lentils Pasta, whole wheat Snapper White rice Avocado Tuna Veal (pan) Chicken (roast) Dried prune Big Mac Beef patties (pan) Honey Pork Luncheon Sugar Cheddar cheese KFC Oreos Cashew nuts Almonds Butter Olive oil LOTS - Healthy fibre - NONE Vegetables Starches Meats Cheese Fat / Oil
57 Iceberg lettuce Tomatoes Kale (cooked) Broccoli Carrots Plum Kale (raw) Apple Kiwifruit Cherries Grapes Boiled potatoes Baked potatoes Brown rice Lentils Pasta, whole wheat Snapper White rice Avocado Tuna Veal (pan) Chicken (roast) Dried prune Big Mac Beef patties (pan) Honey Pork Luncheon Sugar Cheddar cheese KFC Oreos Cashew nuts Almonds Butter Olive oil Weight LOSS Weight GAIN Vegetables Starches Meats Cheese Fat / Oil
58 Nutrient Requirements Exceeded RDIs for Protein Calcium Iron Fibre Every area except B-12 (supplemented)
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60 Take home Eat as much as you like of whole foods plantbased diet with no oil Nutritionally complete diet Evidence-based regression of disease
61 Sources WHO Cochrane collaboration NNT.com Public Health England NZ Parliament Sussman JB, Kent DM, Nelson JP, Hayward RA. Improving diabetes prevention with benefit based tailored treatment: risk based reanalysis of Diabetes Prevention Program. BMJ Feb 19;350:h454. Ministry of Health. Understanding excess body weight: New Zealand Health Survey. Wellington, NZ; 2015.
62 Put your name on the list! handout
63 Contacts Bruce Nick Morgen Conflicts: Bruce None Nick and Morgen plantbasedvideos.com
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