Unleashing the Power of Plant-Based Diets by Brenda Davis, R.D.

Good morning everyone is it still morning it will be yes I just flew in about midnight last night and I was so glad to make it because I was an hour and a half delayed at my first point and I had a very tight connection so I got my exercise of running one one gate to the other but I’m very happy to be here and very grateful to share this time with you so this morning we’re going to be talking about unleashing the power of plant-based diets oh and by the way I’m from Kelowna British Columbia so this is of the southern part of BC so the other end of the of the continent so let’s start out with just a very brief thank you just a brief outline we’re going to talk a little bit about the link between diet and disease we’ll talk about the advantage of plant-based diets and then we’ll talk about the practical piece seven steps to an optimal disease-fighting diet and I wanted to start out with a little story about my dad my dad I didn’t get my interest in health and nutrition from my dad and I want to tell you this story and I’m going to tell you the rest of the story at the end of the presentation but the story happened over 40 years ago I was in university and I was home for the holidays and I was in the kitchen I can remember it like it was yesterday and as I was preparing supper in the kitchen my dad walked by the kitchen and he was teasing me m’as studying nutrition and I was all into health and he wasn’t and he had two cigarettes hanging out of his mouth and he was he was carrying a big bag of chips a two-liter bottle of coke and a bag of liquorice allsorts and he walked by me really slowly just kind of sauntering by he stuck his belly out as far as it would go and then he turned to me and just had this big grin on his face and I just shook my head in disgust and later on that evening I said to him dad I don’t understand why you’re doing this to yourself and he said to me I would sooner live 50 years doing what I love to do just having that freedom to eat what I want to eat and smoke my cigarettes he said I’d rather live to be 50 doing that then lived to be 75 having to restrict this and restrict that he said you know I could be hit by a truck tomorrow and I said to him I know dad but it doesn’t mean you should go walk out in front of one and the reality is of course this is what we know 70% of all deaths are due to chronic diseases of our own making an estimated 80 to 90% of heart disease 90% of type 2 diabetes and about 40 to 70% of cancers are considered entirely preventable and in 2011 the World Health Organization identified the four big lifestyle culprits as being a sedentary lifestyle alcohol tobacco and an unhealthy diet and they define the unhealthy diet as one that is based on processed foods with added fat sugar and salt and animal products rich in saturated fats it’s low in vegetables fruits legumes whole grains nuts and other high-fiber foods and I want you to notice something about this quote they name two things that are responsible for our high risk of chronic disease number one processed foods with added fat sugar and salt and number two animal products rich in saturated fats they name one category of foods that protects us and that is plant foods and if you look around the world the people at the highest risk are in active populations consuming western-style diets the highest rates globally are North America northern Europe Australia and of course all of the developing countries who are adopting our Western ways unfortunately and at the lowest risk are populations who live simply are physically active and consume unprocessed plant-based diets the lowest rates globally are some parts of rural Asia South America and of course the people of the Blue Zones and for those of you most of you have probably heard about the Blue Zones but the Blue Zones are places in the world where people live the longest healthiest lives what’s really unique about the Blue Zones is when people reach ninety or a hundred years of age they’re actually still productive they’re doing things and that’s what we all want to achieve so there are five blue zones Okinawa Japan and that’s court of the traditional Okinawan Sardinia Italy Loma Linda California which is the seventh-day adventists of Loma Linda Korea Greece and the Nicoya Peninsula of Costa Rica and what’s interesting about the blue zones is that they all every single blue zone on the planet they tend to have features that that are common to all of these blue zones and they are that they all have strong sense of family they tend not to smoke they’re very socially engaged they do constant moderate physical activity they do a lot of walking and hiking and gardening and so forth and where diet is concerned there are two things that are common to all the blue zones one is that they all consume plant diets and the second is that they all consume legumes this man is an Okinawan centenarian he’s a hundred years old this is the goal really to be that vibrant at that age and the evidence for plant-based diets continues to grow so we won one of sort of the I think the most compelling of all of the types of research is when you follow groups groups of people for many years and look at what they’re doing their lifestyles their diets and see who gets what disease and we actually have been following three populations for many years so three cohorts the first being the Adventist Health Study – which is over ninety six thousand seventh-day Adventists from North America this study began in 2002 and is ongoing the second is epic Oxford with over 65,000 individuals from the UK it began in 1993 and is ongoing and the suchi Health Study with over six thousand participants and these are Buddhist some who are meat eaters some who are vegetarians it began in 2007 and is ongoing and I want to just mention one thing that’s important to know about these three cohorts and that is that people in these cohorts diet about half the rate of the general population whether they’re meat eaters or vegetarians they all are health-conscious individuals and so when we compare the meat eaters with the vegetarians we’re comparing people that exercise the same amount smoked the same amount drink the same amount so it’s a very fair comparison we’re controlling for all of these variables so what are the findings I’m just going to touch on some of the interesting findings of these various studies so with cardiovascular disease compared to similar health-conscious non vegetarians or meat eaters in epic Oxford the veg taryn’s and vegans had about 32% less heart disease and in the Adventist Health Study 2 there were 23% there was 23% lower risk of heart disease among lacto-ovo vegetarian men and 42% lower risk of heart disease among vegan men although there were no differences among the women hypertension in the Adventist Health Study 2 compared to similar health-conscious non vegetarians the risk of hypertension was 55% lower among lacto-ovo vegetarians and 75% lower among the vegans and the the results of epic Oxford actually was quite similar in the Adventist Health Study to the rates of diabetes were 38% lower among lacto-ovo vegetarians and 62% lower among vegans in the suchi study diabetes the rates of diabetes were were 51% lower among vegetarian are near vegan men compared to the non vegetarians and 74 to 75 percent lower among the women a non-alcoholic fatty liver disease the SUCI this is a study that that just came out in 2018 compared to similar health-conscious non vegetarians non-alcoholic fatty liver disease was 21% lower among the vegetarians and if you replace soy with meat or fish the risk increased 12 to 13% and if you replaced whole grains with refined grains the risk increased 3 to 12% cancer comparing to the health-conscious meat-eaters epic Oxford showed 11 percent lower risk among lacto-ovo vegetarians and 19 percent lower risk among vegans in the Adventist Health Study – an 8 percent lower risk among lacto-ovo vegetarians and a 16 percent lower risk among vegans in suci cancer compared again to the similar health-conscious non vegetarians the risk of breast cancer was 58% lower among the near vegan participants and daily soy isoflavone intake was associated with a 63% lower risk so remember that we’re going to come back to soy a little bit later cataracts epoch Oxford showed a 30 percent lower risk among lacto-ovo vegetarians and a 40 percent lower risk among vegans a diverticular disease epoch Oxford again showed a 27 percent lower risk among lacto-ovo vegetarians and a 72 percent lower risk among vegans kidney disease in the Adventist Health Study 252 percent less kidney disease among the vegetarians and vegans and in epic Oxford compared to those with a high median take more than three and a half ounces a day the vegetarians and vegans combined had 31 percent fewer kidney stones so these are pretty compelling numbers and what we can deduct from all of that is is plant-based diets are highly protective against chronic disease but not only are they highly protective against chronic disease they provide a very safe and powerful treatment option in many cases reversing chronic diseases so if we look at treatment outcomes well for cardiovascular disease they are as far as I know the only diets that have ever been shown to prove reversal of heart disease diabetes plant-based diets improve insulin resistance insulin sensitivity they improve our our blood lipids and in many cases we do see reversal of diabetes as well and for cancer plant-based diets have been shown to favorably alter genetic expression reduce cancer cell growth decrease DNA damage and so improving or reducing risk for cancer and of course the side effects with treatment using plant-based diets are all worth having you tend to increase your life expectancy you lose weight you improve your lipids you improve fasting glucose you improve expression of genes you reduce your risk of other chronic diseases whereas with medications and surgeries the side effects are not always so positive so why the vegetarian Advantage what is it that gives plant-based diets an advantage over omnivorous diets and and the reason is simple plant-based diets work because they address the root causes of the diseases so how do they do this well they do this by reducing our risk of overconsumption but also by essentially disabling the drivers of chronic disease inflammation oxidative stress lipo toxicity and dysbiosis and so we’re going to look at each one of those very briefly first inflammation chronic low-grade inflammation is associated with pretty much every chronic disease you can think of it increases our risk of cardiovascular disease by weakening fibrous caps increasing risk of rupture increasing plaque formation they do all inflammation does all kinds of things that increases risk of cardiovascular disease for diabetes inflammation interferes with insulin signaling so insulin can’t do its job essentially and that increases insulin resistance and for cancer it increases a tumor growth it triggers the loss of proteins involved with DNA repair so it’s bad news all around so we want to reduce this low-grade inflammation and if we look at the levels of inflammation in people eating plant-based diets versus those eating animal centered diets we see a huge difference there was a systematic review and analysis done in 2017 that showed vegetarian diets had a favorable effect on a marker of inflammation called HS CRP which is C reactive protein if a person had been vegetarian at least two years of eight studies six found lower levels and vegetarians one found no difference and one actually found a slightly higher levels we have only two studies that I know of on vegans and the first is from Brazil they showed vegans had about half the levels of CRP that omnivores do and the second was a study from the United States showing about the same except people eating a Western diet had levels of 2.61 milligrams per liter compared to vegans at about 0.5 and vegans were about 0.5 in both of these studies which is highly protective against chronic disease oxidative stress is another one of the drivers of chronic disease and it induces damage to proteins to DNA to cell membranes and it increases the development of progression and complications that are associated with chronic diseases and we have multiple studies showing that vegetarians including vegans have more favourable antioxidant status because they eat more antioxidants it’s really that simple and they eat fewer Pro oxidants and we’ll talk about those a little bit later lipo toxicity this is something that a lot of people have never even heard of but what lipo toxicity is is the accumulation of fat in places where fat shouldn’t accumulate okay so for example where do we store most of our fact in our adipose tissue right we have this special tissue that has an unlimited capacity to store fat when we we get over when our bodies get overwhelmed trying to store fat we sometimes start to store it in places it shouldn’t be like our liver our heart or pancreas and when these organs don’t store fat they don’t function very well and that is lipo toxicity we also store it in our muscle tissue as well and this causes cell damage and cell death it causes inflammation it causes mitochondrial dysfunction it causes insulin resistance it causes elevated triglycerides and elevated blood glucose and so what causes lipo toxicity well overconsumption leading to overweight and obesity are the biggest drivers of lipo toxicity but diets that are high in fat high in saturated fat high in trans fatty acids also increase lipo toxicity also diets high in refined carbohydrates particularly sugars with fructose being more problematic than other sugars but fructose is a bit of a story and of itself because of course fruit has a lot of natural fructose but our bodies can handle the amount of fructose in fruit fruit comes packaged with fiber and phytochemicals on all of these wonderful protective components and the amount of fructose that comes in our system is slow enough for the enzymes are in in our intestines to be able to convert it to glucose and to lactate into other things before it enters the body it’s when we’re drinking the stuff down in sodas that we we our bodies our intestinal tract gets overwhelmed and we get more fructose leaking into this into the bloodstream and it gets shuttled to the liver very rapidly and the liver gets overwhelmed and it gets turned into lipids quite quickly in that case to be stored and it’s more glycol toxic than glucose now there’s a plant-based advantage here again vegans have the lowest rates of overweight and obesity of all dietary categories that the lowest intake of saturated fat and they have lower levels of something called intra Myo cellular lip and intra my Oh cellular lipids are a marker of lipo toxicity and finally dysbiosis dysbiosis is really just when sort of bad gut bacteria start to overrun the good gut bacteria so you have an imbalance and and you end up with an unhealthy gut microbiota and the integrity of the gut microbiota is really important because when it’s out of whack you get a decrease in your supply of essential nutrients you get reduced immune function increased inflammation and oxidative stress and an elevated risk of obesity and chronic disease there is an advantage again for people eating plant-based there was a study out of Brazil in 2017 that found vegans had the most favorable microbiota of any dietary category followed by lacto-ovo vegetarians and the author conclusions was exposure to animal foods may favor an intestinal environment which could trigger systemic inflammation and insulin resistance and in Italy another study in 2017 found lacto-ovo vegetarians had the most favorable microbiota followed by the vegans and both plant-based diets reduced genotoxicity which is that that they were less toxic to our genes so and then the most effective dietary patterns are really simply patterns that minimize pathogenic or harmful components and maximize protective components and so when you think about that you think about all the things in foods that are protective automatically we think of things like fiber and phytochemicals and plant enzymes and antioxidants and anti-inflammatory compounds and plant sterols and sterols and stanols and pre and probiotics and macronutrients from healthy sources and micronutrients from healthy sources and when you look at this list the thing that kind of just stands out is that first of all fiber where does it come from fiber comes from plants and only plants fight ok phytochemicals plants and only plants antioxidants mostly plants anti-inflammatory compounds mostly plants and then the plant sterols and stanols are only plants and and pre and probiotics aren’t really mostly plants prebiotics are certainly only plants probiotics can be in in in any fermented food but you get the picture the things that protect us most are the things that are concentrated in plant foods and we’re going to talk I think it’s tomorrow about low carb diets and one of the big concerns I have about low carb diets is they’re removing so many of the foods that are so intensely protective to human health they’re minimizing fiber in the diet not maximizing it there’s no way you can construct a diet that is you know super low in carbohydrates which is the predominant macronutrient of plants and and get optimal longevity and and disease risk reduction it’s impossible if you look at the pathogenic factors in foods trans fatty acids excessive saturated fat refined carbohydrates excessive sodium neu5gc chemical contaminants products of high-temperature cooking Pro oxidants TMAO if you look at these things will trans where where did they come from remember that what the World Health Organization said two categories of foods processed foods and animal products rich in saturated fats he looked down this list trans fatty acids processed foods excessive saturated fat mainly animal products refined carbohydrates processed foods sodium processed foods neu5gc is a pro-inflammatory molecule in meat especially red meat meat chemical contaminants tend to move up the food chain products of high-temperature cooking while whatever we’re cooking at very high temperatures we’ll talk about those a little bit later Pro oxidants things like heme iron animal products TMAO is trimethylamine and oxide which is formed from carnitine in meat so it goes into the you know into the digestive tract and the bacteria there will convert it into tea ma and then it goes to the liver and it gets converted to tmao and this stuff is highly atherogenic it increases plaque formation it increases the risk of kidney disease and so on not a good thing vegans don’t even have the bacteria and they’re got to make tea ma so we don’t produce this stuff at all it’s just another protection and then endotoxins endotoxins are are sort of the the outer membrane of gram-negative bacteria the harmful bacteria and and you can when your bad gut bacteria breaks down it can produce endotoxins that can leak into the bloodstream increasing inflammation but you can also eat it in things like hamburger there’s a lot of these dead bacteria in those products and so now if you look at the the actual what we actually eat in the United States 39% of the calories come from added fats oils and sugars 30% comes from animal foods 22 percent comes from grains 90 plus percent of which are refined so refined white start to white sugar products 9% come from vegetables fruits and legumes probably half of which are orange juice and ketchup so you know we’ve got a problem so it’s not rocket science why people are getting these chronic diseases most of what we eat is a threat to health so this is a problem fortunately we have a choice and when people make the right choice miracles happen it’s just incredible how powerful when you think about when a die it is is is lifestyle induced the only thing that will ever dramatically change that is extreme lifestyle changes you know every single cell of the human body is a product of what we put in our mouths it would make no sense to think that it doesn’t impact us it has to and so I’m you know when I first started working in the Marshall Islands I was absolutely awestruck by the rate at which this change happens we had people that that you know were barely able to walk across a room when we first saw them that had painful legs for twenty years and within a week it was gone it was just shocking so so I wanted to share a story with you because this is I’ve shared this story before but it really is my favorite story about dramatic change and it’s my favorite story because of the way it happened this is andreas and he received a very rare cancer diagnosis when he was about 36 years old he made a huge shift from being a food and wine aficionado to a whole food plant-based diet devotee and his cancer went into remission now ondrea’s when I say he was a funa food and wine aficionado I mean that it’s it’s an understatement really he his favorite pastime was eating in the best restaurants buying the biggest steak and the most expensive bottle of wine on the menu I remember him telling me that he and his wife flew to Paris for the weekend to eat in one of the ten best restaurants in the world and they paid three thousand dollars for their meal so he really was food was very important to him so you can imagine going from that to eating a hundred percent whole food plant-based no oil no sugar no nothing processed at all this was a big change for ondrea’s but what I love about this story is his whole foodie family his parents his brothers brothers family they all said ondrea’s whatever diet you’re doing we’re doing with you because we always want to be able to eat as a family and we want to support you so they were all willing to give up all of these foods they love to support andreas and and it was unbelievable what happened to the whole family and I’m not going to tell you what happened to the whole family I’m just going to tell you what happened to his father Carlos say Carlos had type 2 diabetes he was diagnosed with it in 93 he had just had a serious heart attack the year before his son was diagnosed with cancer he had hypertension he had high cholesterol he had peripheral artery disease he was in early stage renal failure and he had recurring doubt he had cataracts and and the doctor said he would need surgery within a year or so his prognosis he was told by his doctors that all of his diseases were progressive and irreversible and that he could expect to live about two years he was being treated with 17 pills a day and 30 to 40 units of insulin after less than one year on a whole food plant-based diet Carlos was taking zero insulin and zero pills here it’s it’s really quite quite amazing considering his doctors told him he’d be dead in a couple of years so his fasting glucose went down to eighty to eighty seven milligrams per deciliter his a1c was five point one blood pressure 115 over 70 they couldn’t get it to that on two medications his arteries opened up without any surgery they did a PET scan I’ll show you one of his reports he his peripheral artery disease disappeared his kidney function normalized went right back to he didn’t have one single further recurrence of goat after becoming plant-based his cataracts stopped growing and the doctor said he didn’t need surgery anymore and seven seven years later Carlos is still medication still free of all of these diseases and the medications he was on for them and so here’s his coronary artery disease reports 2005 he had very severe coronary artery disease with a with an inferior wall in fact he had kipo Kinesis he had in ejection fraction of about 50% this is all you know Greek to many people but it’s just very severe coronary artery disease in 2017 this is 12 years later no evidence of abnormal cardiac activity no evidence for reversible perfusion defects no evidence of ischemia normal chamber size normal ejection fraction it’s really quite amazing and and you know before I even go into this I want to tell you that he went back to his doctor and he said why didn’t you tell me that all I had to do was change my diet and I could cure myself and his doctor looked at him and he said I didn’t tell you because I didn’t know he said I do now he said to be honest with you if somebody would have told me this was possible I would have laughed at them he said but I’ve seen it with my own eyes now and I know it’s possible so not everyone is willing to make the kind of changes that Carlos made but I believe that everyone has a right to know that lifestyle changes are a safe and highly effective treatment option at the very least when the physician lays the options out on the table it should be among them and people have a right to choose so I want to talk now a little bit about all of the practical aspects of creating a diet that work powerfully for you in protecting you and in helping to reverse chronic diseases so one thing that I want to say before I start is some plant-based diets are more helpful than others just because you’re on a plant-based diet doesn’t mean it’s a healthy plant-based diet chips are from potatoes you know these things are a hundred percent vegan snacks so we need to recognize that there that are is a raid there are many ranges as a matter of fact in 2017 Harvard put out a study looking at they had a healthy plant-based diet index and an unhealthy plant based diet index and they found that if you ate a healthy plant-based diet it really reduced your risk of disease quite dramatically but if you ate an unhealthy plant-based diet not so much so there’s a big difference so we’re going to talk about seven steps to an optimal disease-fighting diet step number one make whole plant foods the foundation of the diet get your carbohydrates from beans and vegetables and all of these whole grains whole plant foods get your fat from nuts and seeds and avocados whole plant foods so what do we want I would say at least 10 servings of colorful wonderful variety of vegetables and fruits every day we want at least two servings of legumes a day we want you don’t absolutely have to have grains for most people you could have starchy vegetables as a carbohydrate source instead but at least three servings a day for most people is what you would aim for we’re going to talk more about all of these things as we go nuts and seeds one or two servings a day as a minimum to provide you with the essential fatty acids you need and then you want to sprinkle it all with generous amounts of herbs and spices for many reasons which we’ll talk about as we go through so step 2 is to select your carbohydrates with care I think this is the biggest mistake people switching over to a plant-based diet make they switch from eating meat and potatoes to eating pasta and bagels and they it’s refined carbohydrates and the studies that show that saturated fat has been vindicated don’t really show saturated fat have has been vindicated all they actually show is if you replace saturated fat with refined carbohydrates you do not risk reduce your risk of heart disease one is almost as bad as the other that’s all they really show so we need to select our carbohydrates with care carbohydrates are not the enemy contrary to popular opinion people are the low-carbohydrate ketogenic carbohydrates from Whole Foods are consistently protective to human health the average carbohydrate intakes and Blue Zones are are in the about 62% of calories okay so they’re not the enemy the food’s most strongly associated with disease risk reduction which are whole plant foods get most of their calories from carbohydrates with the one exception of nuts and seeds look at this fruits over 90 percent 92 percent of their calories are carbohydrates starchy vegetables about 90 percent grains about 75 legumes about 70 non starchy vegetables about 58 so most flat foods are 60 to 90 percent of their calories from carbohydrates so carbohydrates are just not the problem not since these the exception at about 12% of calories from carbohydrates so if carbohydrates are not the problem then why so much negative press about carbohydrates because most of the carbohydrates people eat do not come in the form of fruits and vegetables and whole grains they’re coming in the form of refined carbohydrates and these are bad news so what are refined carbohydrates well refined carbohydrates are high carbohydrate foods that have been stripped of their nutrients by food processing tact techniques so we’re talking about simple refined carbohydrates like all of the sugars and sodas and candies and all of these things and the complex refined carbohydrates like white flour products and white rice products both types of refined carbohydrates increase disease risks they increase inflammation and they increase our risk of overeating and obesity of non-alcoholic fatty liver disease of insulin resistance of high triglycerides and heart disease but most of the carbohydrates as I mentioned that people eat are refined probably at least 80 to 90 percent and I want to talk a little bit about grains and a little bit about sugars so what is a safe level of added sugars well the American Heart Association says not more than nine teaspoons for men and not more than six for women the Dietary Guidelines for Americans say not more than 10 percent of calories or about 12 teaspoons a day the World Health Organization says not more than 10 percent of calories but if we made it not more than 5 percent of calories we would have much greater health benefits so you might think to yourself 6 teaspoons 9 teaspoons 12 teaspoons that’s a lot of sugar but in fact how much is in food well we get 12 teaspoons or more from a 12 ounce soda how many people drink a 12 ounce soda these days you go to the movie theater and it’s a 24 or 36 ounce soda one large flavored coffee one cup of fruit flavored yogurt can give you nine to 12 teaspoons of sugar one cinnamon bun 12 teaspoons of sugar even things we don’t associate so much with sugar like barbecue sauce or or tomato some spaghetti sauce or energy bars or instant oatmeal can have three four to six teaspoons of sugar in a serving the numbers add up very very quickly so one of the things I do myself is I don’t have any added sugar I just don’t buy things without add sugar and I also when I prepare foods at home if I want something sweet I’ll use dates or dried pears or something like that that’s a whole food to provide the sweetness in that food sugars not poison but it doesn’t it’s not a nutrient-dense food it doesn’t come with any fiber any of the protective components we talked about so it’s always better if you can get it from Whole Foods so if we look at the sources of added sugar in the u.s. diet 47% of the sugars come from sweet beverages and by the way on average people are consuming about 19 teaspoons a day so that’s average in the United States and and so just cutting out sweet beverages would cut that intake in half so I want to talk a little bit about the grains as well because most of the grains people eat are refined and if you take a grain of wheat and you turn it into white flour you’re losing two of the three parts of the week you’re losing the bran and the germ what you’re left with is endosperm and in that process you lose 80 to 90 percent of the fiber 70 to 80 percent of the vitamins and minerals and 95 percent of the protective phytochemicals and then of course who eats a bowl of white flour nobody nobody eats a bowl of white flour what do we do with the flour before we eat it well we add fat we add sugar we add salt we add additives like flavors and colors and then we eat the white flour and therein lies the problem not only how we removed almost everything of value to human health in making the white flour but we add a bunch of things that are cheap and unhealthy to the white flour before we eat it and that is the issue so you know in order to to metabolize calories from carbohydrates and protein and fat we need certain nutrients in our diet and when we strip them out of our diet it makes it very difficult on the body to deal with these things so and and whole grains I think that’s the other thing that people believe it’s grains are bad refined grains are not so great but whole grains are just fine thank you very much and as a matter of fact we have a study from 2016 which is a meta-analysis of 45 studies showing that people that eat three servings of whole grains per day reduce the risk of diabetes by 51% of cardiovascular disease by 22% respiratory diseases 22% stroke 18% and all cause mortality by 17% and total cancer by 15% so whole grains are our healthy foods but all whole grains are not created equal a granola bar does not equal a bowl of oatmeal and a box of Kemet flakes does not equal a camo berry salad okay so there’s a one of the things that I found when I first started working with diabetes is is people we’re living on whole wheat bread and whole wheat pasta and all of these whole wheat flour products and and so I started thinking to myself I need to provide them with a tool that will help them to understand that there are differences between the level of processing of whole grains so for example at the top of so here’s my hierarchy at the top of the whole-grain Archy are intact whole grains grains as they’re picked off the plant nothing added nothing taken away so things like barley chemic berries quinoa red or black or brown rice and then next on the hierarchy would be cut whole grains like steel cut oats or bulgur then would be rolled whole grains like rolled oats rolled barley roll dry then shredded whole grains like shredded wheat then ground whole grains like whole wheat flour products then flaked whole grains like flaked cereals and then puffed whole grains at the bottom of the barrel ok so why are we going down on this list in the way we do well as you increase the surface area of that original grain you increase the rate at which it will be absorbed into the bloodstream and so it has a higher glycemic index and a higher impact on blood sugar and inflammation as you go down this list you lose nutrients so when you eat that green intact as with nothing added nothing taken away it takes your body a long time to digest it but also everything that was intended for you to have was there but as you process you lose nutrients so two things nutrient losses an increase in rate of absorption of that food so if you’re trying to fight disease you might want to say I’m only gonna eat intact grains or intact grains and and cut grains and I’m going to stop there but definitely you want to minimize puffed and flaked you you may want to if you’re trying to reverse disease say no flour products for a time and and see how that works for you because I’ve found it makes a huge difference for people so carbohydrate common-sense will get your carbohydrates from vegetables fruits legumes and whole grains avoid ADD sugars especially in beverages and minimize all refined carbohydrates whether there start twos or sugars step number three is to pick plant protein instead of meat and just a quick comparison here for you in the green are the things we talked about that are protective like fiber and phytochemicals and antioxidants and prebiotics and plant sterols and stanols and in the red below all the things that are not so protective fat and cholesterol and heme iron which is a pro-oxidant and neu5gc and chemical contaminants and endotoxins and if you compare beans and lentils with meat and poultry what you see is the the things that we want they’re the things that are protective to human health are either high or very high in the beans and lentils and are either 0 or low in the meat and poultry and most of them are zero and then if you look at the things that we’re trying to reduce in our diet they’re either low or zero or very low in beans and lentils whereas they are mostly moderate or high or very high in in the meat and poultry when we look at legumes and mortality well there was a actually there are two studies from 2017 that have analyzed the link between legumes and mortality and the the latest report showed a 7% risk reduction in the highest versus the lowest consumer groups and I think we didn’t see a bigger difference because a lot of people that eat beans being eat beans and pork or beans with with meat so it’s hard to separate the beans from the meat but there was another study looking at people of 70 years of age and older and they reported a 7 to 8% risk reduction in mortality for every two-thirds of an ounce of legumes eaten that’s unbelievable two thirds of an ounce it’s like a tablespoon and a half or two tablespoons at the most so quite a remarkable risk reduction with legumes and remember they’re staples in all the blue zones every single blue zone consumes legumes so this is where I want to come to the question of soy because soy is such a big question in in you know not just within vegetarian groups but in in in general people often say don’t eat soy it’s dangerous so what do we know about soy well first of all to me the acid test is to look at the blue zones these are the longest lived healthiest people on the planet and the blue zones soy is a staple in two out of the five blue zones in Loma Linda California in Okinawa Japan and in Okinawa the diet looks like this seven servings plus of vegetables generous servings of purple fleshed sweet potatoes smaller amounts of rice and grains a tiny bit of fish about a half an ounce a day that’s their animal product in their diet and two servings of soy a day so if the healthiest longest lived people and actually the amounts in Loma Linda would be about the same around the two servings a day if the healthiest longest live people on the planet who have more centenarians than anyone else include soy as part of their diet it’s probably not poisonous or they probably wouldn’t be the longest lived people on the planet so what what is the science of soy well soy may protect against prostate cancer breast cancer as we saw in the sushi a study cardiovascular disease and kidney disease and bone loss as well and it may also help with a menopause symptoms relief and male pattern baldness and a little bit on the prevention of wrinkles as well so however that having been said I would say if you’re consuming so you don’t have to it’s definitely not an essential food you want to always opt for organic soy non GMO at least but preferably organic and you want to stick with less processed choices most often like edamame tofu tempeh miso natto fortified soy milk are all reasonable choices that have been made with organic soybeans and you want to limit your intake of more highly processed choices like veggie meats and soy cheeses and if you’re eating veggie meats make sure they’re organic because sometimes the protein is extracted using hexane which is a neurotoxin so just to be on the safe side choosing the organic products now if we look at red meat and mortality we see quite a different picture okay compared to legumes I looked at all of the most recent meta analyses and we can see for processed red meat the risk of mortality is increased by 15 to 44 percent for red meat unprocessed red meat about 5 to 14 percent and for total red meat between 17 and 29 percent this is consistent evidence these are the largest meta analyses we have looking at red meat and mortality if we compare animal protein versus plant protein while the Harvard health professional studies followed people for about 30 years and found that if we replace just 3 percent of the meat of the calories from animal protein with plant protein we will reduce our risk of death significantly by 34 percent if we replace the processed meat with plants by 19 percent if we replace eggs with plants by 12% with unprocessed red meat by 8 with dairy and about 6 for fish and poultry there was another study looking at high protein and mortality with over 6,000 people they found people that eat more than 20% of their calories from protein had a 74% increase in mortality of 433 percent increase in cancer deaths and a 393 percent increase in diabetes risk and that association was abolished or greatly attenuated if the protein came from plants so those numbers were for people getting their protein from animal products step four is to replace harmful fats with healthful fats and so when we talk about fat we want to focus light with carbohydrates or like with protein we want to focus on quality we want to make whole plant foods the primary sources of our fat high-fat plant foods are rich in all of the goodies that we were talking but the fiber and antioxidants and sterols and stanols and phytochemicals whereas concentrated fats and oils have a lot of calories with few nutrients okay so again it’s like sugar they’re not poisoned but they’re processed foods you’ve extracted them from the food and you’ve left the fiber and the good stuff behind just like you do with sugar and so just to give you an example this is sunflower seeds versus sunflower oil so you can see the oil so we’re using a hundred and twenty calories worth of oil which is one tablespoon and a hundred and twenty calories worth of seeds which is two thirds of an ounce okay so we’re comparing equal calories from both fat you get about 14 grams of fat in a tablespoon of the oil and about 11 from a tablespoon of the seeds but look at the other macronutrients no protein no carbohydrate in the oil you get about four grams of protein from the seeds look at the minerals zero zero zero zero zero in the oil and you get you know reasonable amounts from the seeds and it’s the same with vitamins now vitamin E is the only exception oils often contain vitamin E but there’s more in the seeds and then I didn’t have room to list all of the other vitamins but there’s zero zero zero zero zero for the oil and they’re fairly high for the seeds you can see fallen folic acid as an example so very very important to be getting your calories from Whole Foods as opposed to highly processed foods we want to cut back on saturated fat the American Heart Association in the American College of Cardiology in their guidelines for heart disease risk reduction recommend no more than five to six percent of calories from saturated fat which is about what most vegans get so five to six percent of calories is about 16 grams on a 2,000 calorie diet if you look at the amount in animal products two slices of meat lovers Pizza 22 18 and a double cheeseburger 16 in a soft taco with beef and cheese nine and an ounce of cheese aid in a cup of whole milk that adds up to 16 pretty quickly when you’re eating these kinds of foods whereas in plant foods it’s much lower amounts with the exception of coconut products but you can see avocado nuts and seeds tofu olives are very very low you would have to eat a lot of them to get 16 grams of saturated fat and then finally we want to minimize our exposure to damaged fats so these are high highly oxidized fats they produce aldehydes and acetylenes and all of these things that are toxic so we want to avoid fried and highly processed foods we want to avoid or minimize oils and cooking and if you do use oils in your cooking you don’t want to let the oil smoke because more of these compounds are formed and you want to store high-fat foods carefully so nuts and seeds are protected by a hard shell when that hard shell is removed the fats become subject to oxidation especially if there’s if they’re unsaturated like walnuts and so when whenever i buy nuts and seeds they go in the freezer immediately the freezer or the refrigerator to help protect the the fats then you want to ensure sufficient omega-3 fatty acid so for most people who don’t eat fish two to four grams a day would be a good amount to aim for so how do we get that will an ounce of walnuts a tablespoon of ground flaxseed a tablespoon of of chia seeds or two probably about three tablespoons of hemp seeds or about twenty to forty cups of greens so you can see greens could contribute if you’re eating a lot of them but you would have to eat like a horse or a cow to get twenty to forty cups a day so it’s a lot so you need to have some seeds or some nuts in the mix at least it’s very helpful so what about EPA and DHA these long-chain omega-3s from fish actually fish don’t make epa and DHA they’re made by micro algae and the micro algae is in plants in the ocean and they get into fish because at some point along the food chain the small fish ate the zooplankton which ate the phytoplankton which ate the mic microalgae so that’s how they get into fish and so now people culture the micro algae no raping of the oceans just culture the micro algae and you can purchase it in supplement form and it’s not a bad idea to take it if you do probably two to three hundred milligrams a day is recommended some people may need more to get their omega-3s up to where they need to be a step five is to maximize the protective components in the diet the fiber the phytochemicals and antioxidants the pre and probiotics we’ll just go through these really quickly fiber how much is recommended well thirty eight grams a day for men twenty-five for women how much do we actually get well most people about fifteen to seventeen grams a day vegans thirty-five to forty four women and forty-five to sixty for men anybody has her to get well I’m telling you here but how much people ate in Paleolithic times seventy to a hundred and fifty plus grams a day that was what people got back then and so what is optimal well probably optimal is at least 40 grams a day to you know 40 to 80 grams a day somewhere in there and certainly vegans are at an advantage because all plant foods contain fiber all whole plant foods so how much well you get 10 to 20 grams in a cup of beans or lentils you get lentils are about 16 Navy beans are about 19 just for example avocados about 13.5 in one avvocato that’s amazing to me it would have never thought they were a really rich source and that’s not including the skin by the way you don’t have to eat that and grains about five to ten and a cot berries about three to eight and then fruits and vegetables and nuts and seeds other than berries would be in the two to five range per serving and of course only plant foods contain fiber the low fiber foods are the refined carbohydrate foods fast foods highly processed foods and the known fiber foods are meat poultry fish dairy and of course oils and sugars so we want at least 12 to 20 grams of fiber per meal from a variety of whole plant sources phytochemicals and antioxidants we just need to be maximizing these in our diets because they afford powerful protection against disease phytochemicals these are plant chemicals and antioxidants literally put a lid on inflammation and oxidative stress so we need them in our diet and one of the things I should mention here is is that if you take antioxidants or phytochemicals and you packaged them in a pill form they don’t do the same thing as they do when they come from food and as a matter of fact their intake in that form could backfire as it has in some studies do you remember in 1980s they found people with high levels of beta carotene had low levels of lung cancer so they did several studies giving beta-carotene to people with with who are at risk for lung cancer smokers and what they found is the people who took the beta-carotene ended up with more cancer less and so you’d go why how could that be well it could be because when you eat carotenoids from foods you’re eating 50 or 60 different kinds of carotenoids not just one and it may be that a variety of those carotenoids are needed to our need it in order to work synergistically to provide the protection and when you load your body up with just beta-carotene maybe you actually prevent the absorption of some of those others because your body thinks it’s got enough carotenoids so we don’t know for sure but it’s always better to be getting those those you know protective antioxidants and phytochemicals from Whole Foods and we know these compounds can help to reduce our risk of disease so how do we maximize intake well to start with we want to think variety so instead of always having the same grain or instead of always having the same nut or seed or the same vegetable mix it up because each one provides something a little different and so the whole works it’s not just fruits and vegetables that provide these antioxidants and phytochemicals it’s all of the plant foods we want to think color so the richest sources are often the most colorful so instead of white onions choose purple onions instead of you know brown rice choose black or red rice instead of you know white beans choose red or purple beans or whatever and you you get the idea but generally even with lettuces you want deeper green rather than lighter green you always want to go for color when you can so if you’re buying quinoa you can buy the red or black it just gives more antioxidants and and certainly you it doesn’t mean you can’t eat the you know the bay you sure the white colored grains they’re fine too but just mix it up so you have a variety of colors in your repertoire so and with vegetables and fruits you want to eat the whole rainbow I would say at least three green to orange yellow red pink one purple blue and one white beige every day and and so when you make a salad one of the the little goals you can have for yourself is to see if you can reflect the whole rainbow in your salad and even try to include things that have unusual colors like watermelon radishes that are this unique fuchsia pink you know try to get that mix of all sorts of different colors increase your intake of raw foods and the reason we talked about plant enzymes but some plant enzymes help you to convert the phytochemicals and foods into their active forms what we call bioactive metabolites and so for example there’s my rose amazing cruciferous vegetables that helps to convert glucosinolates into isothiocyanates and isothiocyanates like are things like sulphur phaeton for example our potent inducers of Phase two enzyme systems that help to convert inactive actually help to convert toxic compounds into water-soluble compounds so you can get excrete them from the body so very very important function if you cook your broccoli you kill the my Rosen aides and you get less conversion okay so having some of these these cruciferous vegetables raw is helpful and it’s the same with the Allium vegetable there’s a enzyme called Alan ace that helps to convert Alan to allison which again is the active form so having some raw in a salad dressing or or even chopping it and letting it sit for 10 or 15 minutes before you throw it in your soup you’ll get more of the conversion happening and then you want to add sprouts I saw some wonderful sprouts over here and just unbelievably amazing foods because what happens when you sprout of food is you’re sending a message to the seed that it’s time to let the phytochemical army explode because the phytochemicals are what hell what what protects the plant and so when that little seed has to protect the plant it’s gotta multiply its army of protection so in some cases like in in broccoli sprouts the sulforaphane content is fifty two to a hundred times higher than it is in mature broccoli in a lot of grains it’s you know it increases a hundred two hundred three hundred four hundred five hundred percent when you sprout not only that but when you’re telling a seed to grow you do a couple things you reduce anti nutrients and you release the stored forms of nutrients so that the plant has the nutrients it needs to grow so it’s wonderful transformation in this plant when you sprout more phytochemicals less anti-nutrients so it’s all good and then you want to pile on the herbs and spices and this is something that we need to think more about it I think herbs and spices should be a food group in of themselves and and certainly we think about the the colorful herbs and spices the Reds and the the golden colors like in tumeric and these are some of the most potent anti-inflammatory compounds known to mankind they’re just incredible incredibly powerful and we need to use them in in your breakfast you can add you know cloves and nutmeg and cinnamon and all of these kinds or you can do a savory breakfast and include you know a wide variety but at every meal think about adding herbs and spices and then we’ve got plant-based probiotics and prebiotics probiotics are the microorganisms and food that take up residence in our gut and help to support a healthy gut flora and and if the you know if if our gut flora is healthy we reduce inflammation of course and prebiotics are the food for that flora so that’s what they would you to keep themselves healthy and so there are a number of things we can do to shift our gut flora from unhealthy to healthy we can eat a plant-based diet rich in in prebiotics so prebiotics where are they well beans are a wonderful source Jerusalem artichokes bananas onions and you know all of the plant foods are sources of these indigestible fibers that feed our gut bacteria we want to eat food based probiotics such as yogurts like almond yogurt or coconut yogurt or any of these kinds of fermented foods fermented vegetables sauerkraut tempeh me so all of these probiotic rich foods we want to minimize our intake of refined carbohydrates processed foods meat fried foods that can damage our gut microbiota take probiotics if you’re taking antibiotics and minimize alcohol which are quite is is quite harmful to your gut microbiome step six is to minimize dietary contaminants and here we’re talking about agro chemicals environmental contaminants the products of high-temperature cooking and food additives and I’m going to go through this very very quickly but agro chemicals we’re talking about pesticides that that are concentrated in conventional produce and other conventionally grown foods and all the veterinary drugs the hormones and antibiotics and antimicrobial agents which are mainly in meat poultry and fish and dairy products the solution is simple eat organic if you can as much as possible and you can look at the environmental working groups Dirty Dozen and clean 15 they raid about 50 different fruits and vegetables and the 12 with the highest pesticide content are called the Dirty Dozen and the 15 with the lowest pesticide content are called the clean 15 and they updated every single year and the environmental contaminants things like heavy metals and persistent organic pollutants like PCBs DDT and dioxins the most concentrated sources of environmental contaminants are fish meat and dairy products the solutions here eat lower on the food chain and of course eat plants the products of high temperature cooking we’re talking about things like heterocyclic amines which are cancer-causing chemicals that are formed when we cook meat poultry or fish at high temperatures they don’t form in plants because plants don’t contain any of the the creatine or creatinine you need to make heterocyclic amines then there’s polycyclic aromatic hydrocarbons or PAHs these are known mutagens they’re linked with all sorts of cancers they’re present in grilled and charred foods they come from the incomplete burning of carbon so they’re in all foods meat or plant forms and can form at 350 degrees Fahrenheit or higher cooking in order to reduce them you just don’t want to blacken your foods acrylamide is a compound that’s formed in starchy foods especially potato products that are cooked at with dry heat or with oil at high temperatures and you can see the most content acrylamide again is a is a potential carcinogen the the most concentrated sources are sweet potato chips and regular potato chips and we see it in things like rye crisp bread and french fries and coffee coffee’s not really fair here because we’re looking at a hundred gram servings and you don’t you eat five grams of coffee or something so it’s a little bit unfair they’re ready to eat cereals and and so on a little bit they’re not much and then advanced glycation end-products which are strongly associated with diabetes risk and advanced glycation end-products they impair immune function they accelerate aging and the increased risk of just about every disease you can think of and this the most concentrated source and these are really advanced glycation end-products are really just the final and irreversible products of the maori action which is that Browning reaction in food but bacon broiled and boiled frankfurters fried meat poultry fish even butter but even grilled or fried tofu and and other foods can have some advanced glycation end-products the solutions here again eat more raw food use moist cooking methods like steaming and and stewing and boiling and you know like a soup these will produce fewer products of oxidation be very savvy with dry heat a saute with water broth or wine use the lowest temperatures possible and again avoid blackening your food and harmful food additives like preservatives and artificial colors and flavors and all of those things you want to minimize your intake but the most common additive is salt and 70 to 80 percent of salt comes from processed foods even what we think of as healthy processed foods and if you look at this list it’s you can see I don’t know what it didn’t come up by one at the time but basically you can get you know three to five hundred milligrams in one veggie burger you need to to look at this though a one ounce of corn flakes are Raisin Bran has over 300 milligrams of sodium more than you’d get a few ate an ounce of potato chips and an ounce of peanuts combined now this is really shocking to people because why peanuts taste salty salted peanuts potato chips taste salty corn flakes or Raisin Bran don’t and so you go why how could that be that it’s higher it’s because when you put salt on the surface of a food it tastes really salty but when you put it through a batter you don’t it’s not the pronounced flavor anymore and so that’s why it’s important to read labels more the most healthful food have healthful foods of all have no label they have one ingredient broccoli blueberries those are the foods but what you want to look for when you read labels is labels with a short ingredient list and ingredients you actually understand that are that you recognize as food you want to minimize your use of labels and the last step step 7 get lean if you can eat whole unprocessed or minimally processed foods as grown steer clear of processed foods with added fat sugar and salt eat until you’re 80% full Harry hatch eboo choose less calorically dense foods oil is super calorically dense sugar is super calorically dense and and whole plant foods have a much lower a caloric density so what does that mean it means you can eat a lot and not get so many calories and feel satisfied drink water not sugar and increase your physical activity aim for about 60 minutes a day if you can make sure all of your nutrient needs are met and so this is of the food guide that was in our books that we developed and it essentially if you follow the guide it’s pretty much foolproof so just winding up the take-home message here is simple every time you eat or drink you either feed disease or you fight disease you want every when you’re fighting disease you want every calorie that crosses your lips to be fighting disease you can choose to fight disease with the most powerful medicine on the planet whole plant foods organic preferably and I want to end by telling you the rest of the story about my dad about two years after the incident that I told you about at the beginning of the lecture my dad had a stroke and it wasn’t a super serious stroke but he was taken to the hospital and he at his when he was taken to the hospital they found out his blood glucose was over 500 milligrams per deciliter his blood pressure was over 120 it was over 220 over 120 so his blood pressure was through the roof he was diabetic he had had a heart attack he didn’t know about and his blood vessels were completely destroyed and his doctor said to him if you stop smoking you if you don’t stop smoking you might live three months if you do you might live three years my dad wasn’t even fifty years of age yet and I can remember sitting on my dad’s hospital bed with him and we were both crying and he said to me I don’t want to die I want to see my grandchildren grow up and I want to dance with my sweetheart at our 50th wedding anniversary and you know I thought it was so sad that my dad had to get hit over the head with a hammer before he realized that without health there is no freedom he wanted to be free to do what he wanted to do but when your health gets snatched away your freedom gets snatched away right along with it my dad ended up living almost 30 years instead of free three he made big he didn’t make the changes Carlos made I wish he would have because he’d still be alive had he done that but instead of bacon and eggs he ate oatmeal for breakfast he did some things that he could do and we had him with us just so he could see his grandchildren graduate and he could dent at his 50th wedding anniversary and he died eight years ago and there’s not a day that goes by that I don’t miss him terribly and I wish he could see his great-grandchildren my grandchildren but I I just want to leave you with the thought that there’s nothing more important than your health because without it you can’t do what you love to do and you know people say but I just don’t want to eat that way it’s hard and I might not like it you know what I can tell you one thing I can guarantee is that as you change the more you change the more your health will change and as you change your palate changes and those foods you thought were so yummy become disgusting they don’t even taste like food anymore and the foods that you thought we’re disgusting tastes wonderful you actually become addicted to greens oh it’s a whole different world and I’ll tell you you do not enjoy your food any less when you start eating healthfully if anything I think you enjoy it more because you can appreciate the real taste of real food and so with that I will stop and and I know everybody’s probably pretty anxious to taste the food that’s coming thank you so much.