Joel Kahn is an interventional cardiologist, professor at Wayne State University in Detroit who actively advocates plant based eating to prevent and treat heart disease. He has his own restaurant for patients and the public where only healthy whole plant foods are served. Kahn’s presentation consisted of a review of scientific studies supporting the importance of this diet in heart disease. They included:
Ridler’s work on hsCRP (heart sensitive C reactive protein)– CRP is the basis of a blood test measuring inflammation; hs is the fraction of CRP which best reflects the form of inflammation which effects the heart and blood vessels. Chronic inflammation is critical in the progression of dangerous atherosclerotic plaques, the kind that lead to heart attacks. hsCRP is increased greatly with obesity, mainly proportional to visceral fat, the cause of a pot belly. A meat based diet and elevated blood sugar are also associated with elevated hsCRP.
A recent study from NYU which compared a WFPB diet with the recommended American Heart Association diet showing much lower hsCRP with WFPB plus better patient compliance- it’s a tastier, more satiating diet.
Valter Longo’s research on longevity conclusions- a low calorie “Mediterranean” diet with very little meat and processed carbs, especially sugars prolongs life. Cancer promoting IGF-1 levels are very low on this diet with improvement in diabetes, multiple sclerosis and response to cancer chemotherapy.
Saturated fats and vegetable oils damage bowel lining with resultant “leaky gut” and subsequent chronic inflammation.
A long term high animal protein ketotic diet has been examined in nine published studies all of which showed much higher mortality. This is one of the worst, perhaps the worst, diets ever studied.

Monica Aggarwal is a cardiologist at the University of Florida medical center who developed rheumatoid arthritis five years ago. At the time she was in her 30’s, had just had three children in rapid succession, was working hard, sleeping little and stressed. An aggressive drug regime improved her arthritis but she was still very sick from all her medications. Although she was a lifelong vegetarian she realized lifestyle including diet was playing a role in her disease. She started yoga, got more sleep and gave up dairy which allowed her to wean her drugs. Now she is again an active cardiologist and does triathlons.

Western lifestyle has lead to an explosion of heart disease, cancer, Alzheimer’s and auto-immune conditions like rheumatoid arthritis. A genetic predisposition to disease is triggered by lifestyle choices. Diet affects the gut microbiome with resultant bowel wall damage and the development of “leaky gut.” Toxic bowel contents reach the bloodstream, cause chronic inflammation and disease is triggered, the variety depending on genetic predisposition.

Aggarwal is changing the paradigm at the University of Florida: all cardiac patients get a plant based menu; the staff cafeteria offers many healthy whole plant foods; medical students, residents and fellows all receive training in nutrition science and the importance of lifestyle in chronic disease.

Aggarwal’s rheumatoid factor, a marker for her disease, remains very high but she has been symptom free off all medications for four years.

Anthony Lim practices lifestyle medicine in Santa Rosa where he works at Kaiser, TrueNorth and the McDougall program. He observed that many patients become discouraged when they lose weight but plateau at a level above optimal. They may become frustrated and return to old eating habits since weight loss was their primary reason for diet change.

Lim suggests that allowing unlimited eating of healthy foods may fail for weight loss if caloric density is not considered since dilatation of the stomach plays a major role in satiation. Stretch receptors around the stomach signal satiety. Eating enough food to fill the stomach but limiting calories is best done by eating mainly low calorie dense foods.

He measures food groups by average calories per pound. His numbers:

                      Vegetables- 100
                       Fruit-  200
                       Whole unprocessed starches like potatoes, oatmeal-  520
                       Pasta or Legumes-  600
                       Meat- 800
                       Processed starches (even whole grain bread and whole grain cold cereals)-  1500
                       Sugars and Dried fruit-1500
                       Junk food (chips, cookies)-  2300
                       Seeds and Nuts- 2800 (very healthy but limit to 1 ounce/day if trying to lose weight)
                       Oils and Fats- 4000

His cut off for unlimited quantities is all foods at 600 or less.

Lim suggests limiting or avoiding healthy snack bars, meat substitutes and starting the meal with low calorie dense foods. His ideal dinner plate is half veggies and half legumes and healthy starches.

This week Deb and I attended the 6th annual Plant-Based Nutrition Conference in San Diego. We had also attended this conference a few years ago in San Diego but they rotate locations (next June NYC; next September San Francisco.) Attendees are mostly health care professionals learning about effects of diet on health with an emphasis on the evidence that whole food plant based eating is the key to preventing and treating most chronic diseases. This conference was a sell out with over 1000 attendees from all over the world. Our only complaint was the huge size with the personal touches being lost. Business is booming for healthy eating!

We’ve now been to dozens of conferences which look at nutrition effects on medical issues and are always delighted to meet the other attendees: some patients, some devotees of a vegan lifestyle for a variety of reasons, and medical professionals seeking to improve what they can offer patients. Deb and I agree the best part of these conferences is talking to those searching for the truth about food’s impact on health (and the planet.) This week was no exception. Our first meal was shared with a woman from Hungary who was attending a plantrician conference for the second time. She works for a health care company and is exploring what information is available to clinicians using diet in their practice. Other attendees we met included a family of dentists from Beverly Hills who encourage patients to use diet for health; a senior psychiatrist from Johns Hopkins who eats plant based himself and considers it an important part of medical care; a dermatologist from San Diego who uses plant based dietary therapy to treat some patients with great success in acne and psoriasis; a primary care physician from St. Thomas, Virgin Islands whose practice emphasizes whole food plant based diet; several nurse practitioners and physician assistants who incorporate information and advice about healthy diet in their daily work.

Subsequent posts will review specific meeting content.

Recently I discovered that I have celiac disease, an auto-immune disorder provoked by wheat gluten and similar grain proteins. Wheat, rye and barley are not tolerated by celiacs and must be avoided for life. Some are exquisitely sensitive and a trace will provoke strong symptoms; others can tolerate very small quantities of these proteins but the intolerance is never outgrown. Unfortunately many processed foods contain traces of gluten. For example some, but not all, soy sauces use wheat. Obviously this makes eating in Asian restaurants and any other place not careful with food cross- contamination a potential problem. Some bread crumbs dropped on a “gluten free” dish may be all it takes to provoke severe diarrhea and further bowel damage.

Cells lining bowel are harmed because of the body turning on itself (auto-immunity.) This can lead to chronic diarrhea, bloating, weight loss, fatigue, an unusual skin rash and malnutrition due to essential nutrients not being well absorbed. Anemia, various vitamin deficiencies and osteoporosis are all common sequelae and may be associated with depression.

Several genes have been identified as important in the development of celiac disease but many people with those genes don’t develop the disease. Ireland has one of highest rates of celiac disease in the world but exact numbers are not known. In the United States the incidence is estimated at little less than 1%, with most cases undiagnosed. Celiac disease may first present at any age from infancy on, and other auto-immune diseases like type 1 diabetes and thyroiditis are not uncommon. Diagnosis is by a combination of family and medical history, blood antibody tests and small bowel biopsy. A confirmed diagnosis requires strict lifelong gluten abstinence even if symptoms are mild since progression with possible severe outcomes like cancer and lymphoma can occur.

https://en.wikipedia.org/wiki/Coeliac_disease (British spelling of celiac)

More and more interest and research on health effects of eating timing has popped up in the scientific literature recently. A previous blog discussed the value of intermittent fasting, concluding that longevity and freedom from chronic disease were greatly improved by periods of fasting which can be as simple as not eating for a consecutive 12 to 16 hours daily.

The brain has a master clock which governs sleeping and waking dependent on exposure to bright light. Every other organ has a similar clock: the pancreas produces less insulin at night; the human gut and its microbiome also have a rhythm with the genes of the gut itself and its bacteria switching on and off at the same time.

People who interfere with this normal circadian rhythm by staying up too late have increases in weight, blood pressure and blood sugar. Night shift workers typically have poorer health.

More extreme periods of daily fasting have surprisingly powerful effects. Prediabetic men who are limited to only eating in a six hour window each day have improvement in blood pressure, less hunger, and less insulin secretion compared to those allowed to eat over a 12 hour window. If laboratory animals are given a poor quality diet with around the clock food access they get fat and sick. The same diet and food quantity limited to an eight hour window does not cause obesity or disease.

Significant health improvements, especially in weight and blood sugar, are seen if most calories are consumed early rather than late in the day.

A recent book, The Circadian Code, by Dr. Satchin Panda of the Salk Institute reviews his and others’ research on eating patterns.

Recent books examine the history and problems of two major foods.

Milk! by Mark Kurlansky is filled with arcane information that only a quiz show addict or dairy farmer could love. One of his topics is the difference between various mammalian milks. Human milk is very different than that of other species; it is the only really good food for infants. Children who are breast-fed are typically 2 to 3 inches taller, more confident and emotionally healthy, much less allergic. Their IQ is 15 to 20 points higher. In spite of this, our government recently attempted to block a United Nations plan encouraging breast-feeding world-wide. Our food manufacturers make big profits from infant formulas.

James Walton’s Sugar- The World Corrupted From Slavery to Obesity is an historical, environmental and health triple header. Shortly after early European settlement in the Western hemisphere sugar production became the major business and drove most of the need for slaves. Sugar plantations created enormous wealth in Europe and the Americas, dominating policy decisions on slavery, trading and international relations. In the 21st century large amounts of land are wasted to produce high fructose corn syrup, cane and beet sugars for immense quantities of an addicting, unhealthy food used in most highly processed foods and beverages. It’s a dismal story, again reflecting public policy benefitting business and harming citizens.

Medical research on psychedelic drugs was encouraging in the 1950’s and 60’s until Timothy Leary, a Harvard professor, and a few of his colleagues began encouraging young people to trip on LSD and drop out of mainstream culture. This direct attack on the establishment and government was particularly threatening because of increasing resistance to the Vietnam war. The quick reaction was outlawing of LSD by the federal government in 1968 with President Nixon later calling Leary “the most dangerous man in America.” In subsequent years other psychedelic drugs (PD) were also banned, effectively ending promising research.

The excellent scientific journalist, Michael Pollan, has written a new book describing the history of psychedelics, current research, extensive underground therapeutic illegal usage and his personal experiences with guided trips supervised by experienced underground practitioners. Pollan contributed an article in the NY Times Magazine (May 15, 2018) describing some of the material in this book. One reviewer concluded that LSD is non-addictive and “less harmful to the human body than diet Dr. Pepper.”

MRI studies show that brain changes in experienced meditators are the same as those found in people taking a PD. Other research projects have documented:
67% of smokers have continued to quit smoking one year after a treatment with a PD; this is far better than any other treatment program
80% of dying people experience real peace in their last months leading some oncologists to demand access to these drugs
severely depressed patients are often cured or much better following PD therapy after all other current treatment methods have failed
many alcoholics are able to easily quit and maintain sobriety

Pollan emphasizes that his excellent personal experience and the results in various conditions are only possible under the guidance of an experienced therapist.

Michael Pollan: HOW TO CHANGE YOUR MIND; What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression and Transcendence

Many lives are filled with stress from relationships, work, political or environmental issues. Most reading material and media sources are a stream of bad happenings which re-enforce this stress.
The website The Daily Good offers a different message. After registration they send a daily email which briefly describes the work or writing of someone who is improving our society or helping others in some way. A link is provided for in depth information.
After a few seconds scanning that day’s story my day is started on an upbeat. Occasionally I’ll check out the link or find something I want to pursue, but usually it’s just a reminder that many clever people doing good things are as much part of our world as the more publicized politicians and criminals, the two of which are sometimes indistinguishable.

               https://www.dailygood.org

Recent changes in marijuana laws in several states have allowed analysis of effects on the general population which Michael Greger has reviewed in a recent NutritionFacts posting (6/22/18).

Medical cannabis provides pain relief to patients dying of cancer as effectively as moderate codeine. It may allow pain to be tolerable while awake and communicating whereas morphine is more effective for pain but does not allow this awareness.

After medical cannabis is legalized in a state opioid deaths drop 25%. There are also large decreases in sales of alcohol and drugs for depression, anxiety, pain, sleeping and migraines. Is it any surprise that major supporters of marijuana prohibition include big pharma, the beer and private prison industries?