Why Do People Eating Whole Food Plant Based Diets Do So Much Better by Brenda Davis, R.D.

Introduction

why the vegetarian advantage why do people eating plant-based do so much better and the the the simple answer is whole food plant-based diets work because they address the root cause of disease it’s really that simple so how do they work

Inflammation

well they essentially disable the drivers of chronic disease and there are several and i’ll on and we’re going to talk about four inflammation oxidative stress lipotoxicity and dysbiosis and inflammation is what we know is is i mean most people know inflammation when they get a cut and it turns red and puffy but we can get this sort of chronic low-grade inflammation in throughout the body and it’s a risk factor for almost every chronic disease you can think of including the big ones cardiovascular disease diabetes and cancer what what inflammation does is it promotes the growth of plaque weakening fibrous caps which you’ll hear about from dr esselstyn a lot and it basically increasing the risk of rupture of these fibrous plaques it interferes with insulin signaling and it increases insulin resistance it promotes tumor growth and can trigger the loss of proteins involved in dna repair so what causes chronic inflammation well overweight and abdominal obesity especially when the fat is carried in and around the vital organs this is what we call visceral fat as compared to subcutaneous fat which is at the surface of the skin uh processed western style diets chronic chronically elevated blood sugar causes inflammation extreme exercise lack of sleep smoking alcohol pollution and stress are all things that can increase inflammation so is there a plant-based advantage well we had a systematic review and meta-analysis in 2017 that showed that vegetarian diets had a favorable impact on crp levels a measure of inflammation in people that had been vegetarian for at least two years and what they found was of eight studies six found significantly lower levels of crp and vegetarians one found very little difference and one actually reported higher levels in the vegetarians we only have two studies on vegans that i’m aware of and one was done in 2017 in brazil with 268 participants the crp levels in vegans were 0.5 milligrams per liter lacto-ovo vegetarians they were 0.8 milligrams per liter omnivores 1.1 milligrams per liter the second study was done in the united states in 2007 only 63 participants but interestingly the the crp levels of vegans were almost the same as what was reported from the from the brazil research group and this was 0.52 milligrams per liter they were compared to endurance athletes their crps were 0.75 milligrams per liter and they were both compared to people eating a western style diet and their crps were 2.61 milligrams per liter so a lot higher than the omnivores in brazil a worse diet i would expect

oxidative stress oxidative stress what we know is it induces damage to proteins dna cell membranes and it increases the development progression and complications associated with chronic disease so what causes oxidative stress well it’s very similar to what causes inflammation but an in one of the main things is an insufficient supply of antioxidants from whole plant foods overeating highly processed foods chemical contaminants products of high temperature cooking alcohol tobacco stress and air pollution and basically and radiation so basically what we’re looking at is is all of those things um are sort of pro-oxidants if you will and so there’s an imbalance between the antioxidants and the pro-oxidants and and for those of you that aren’t really don’t really understand this whole antioxidant thing oxidative stress is about free radicals in your body that are trying to steal electrons from other molecules because they’re missing an electron but when they do that they turn whatever they stole the electron from into a free radical and it starts this chain reaction of destruction in your body now what if what what an antioxidant does is it comes along and says excuse me free radical would you like an electron and the free radical says why thank you yes but so it donates an electron but it doesn’t turn into a free radical so it remains stable that’s what an antioxidant is so that that’s very helpful and we need more antioxidants and fewer pro-oxidants so is there a plant-based advantage in terms of oxidative stress well i you know do your search on pubmed and the list of studies is really extensive i’ve got a few written down here but the studies completely consistently demonstrate vegetarians including vegans have more favorable antioxidant status because they eat more fruits and vegetables and other antioxidant rich foods and and that’s you know that’s the bottom line

What Causes Lipotoxicity

uh this is something called lipotoxicity this is another major driver of chronic disease and it’s one that many people have never heard of but it’s one that you need to know about because it is hugely hugely important so most of us or all of us i should say have this way of storing excess calories and it’s called our adipose tissue we put anything that is consumed in excess of what our body needs gets stored as fat in adipose tissue but when our body gets overwhelmed with trying to shuttle the stuff to the adipose tissue just so much is coming in what can happen is we can actually store lipids in tissues that are not meant to be lipid storehouses so we start to store lipids in the liver in the heart in the pancreas in the muscle tissue now we do store some lipids in the muscle tissue and intra as intramyocellular lipids and and those are needed they’re little important little organelles but they get sort of overrun with intramyocellular lipids that are not functioning well when we’re eating too too much of this stuff so this is lipotoxicity is very important it can cause cell death or cell damage it can even as little as one percent of lipids in your pancreas can destroy beta cells so this is really important it can cause tissue inflammation it can cause mitochondrial dysfunction insulin resistance and especially when your liver when you end up with this sort of non-alcoholic fatty liver disease you’re storing these lipids in the in the liver um your liver makes your whole body insulin resistant when that happens so even 30 percent at a level 30 reduction in liver fat can reverse insulin resistance it’s really quite phenomenal this is important um just important knowledge to have it can cause elevated triglycerides it can cause elevated blood glucose so lipotoxicity is is something that we just need to be aware of what causes it over consumption leading to overweight and obesity diets that are high in fat especially saturated fat and trans fatty acids and diets that are high in refined carbohydrates particularly sugars and fructose being more even more damaging than glucose and and so one thing to understand is as soon as i say fructose people think fruit but one thing to understand is that the liver has a capacity to be able to deal with the fructose in fruit efficiently it’s when you take fructose concentrate it and pour it into your sodas and and into your processed foods and start eating it that way that the liver becomes overwhelmed it can’t deal with that much fructose because fructose isn’t like glucose where your whole body can deal with it the liver has to deal with it and so it gets overwhelmed very very very quickly so plant-based advantage here well vegans actually have the lowest rates of overweight and obesity of all dietary patterns they have lower level levels of lipids in the muscle the intramyocellular lipids which are marker of lipotoxicity when compared to matched omnivores and they have the lowest intakes by far of saturated fat so they’re at an advantage and finally

What Causes Dysbiosis

dysbiosis dysbiosis compromises the integrity of the gut barrier with numerous adverse health consequences we get a decreased supply of essential nutrients reduced immune function increased inflammation and oxidative stress and elevated risk of obesity and chronic disease so what causes dysbiosis well unhealthy western style diets for sure antibiotics medication stress and poor dental hygiene can all be contributors to dysbiosis is there a plant-based advantage well that and there are many studies that have looked at microflora in people eating different dietary patterns so we’re just going to look at a couple of studies from 2017 the most recent studies the first study was that brazil study where they actually looked at microflora as as well as as other indicators of health like crp the vegans had the most favorable microbiota followed by the lacto-ovo vegetarians and in this study the authors actually concluded that exposure to animal foods may favor an intestinal environment which could trigger systemic inflammation and insulin resistance in the second study this was a study from italy a smaller study only 29 participants with just very small numbers 10 vegans 12 lactova vegetarians and seven non-vegetarians but in this study the lacto-ovo vegetarians and the vegans had the most favorable microbiota but the people who were lacto-ovo vegetarian had actually had the um the most favorable of all which is interesting and it may be because they were consuming a lot of yogurt i’m not i’m not sure but both had reduced genotoxicity as well so the bottom line is the most effective dietary patterns are dietary patterns that minimize pathogenic dietary components and maximize protective dietary components

Dietary Components

when we look at the research and look at what components in the diet are actually associated with reduced risk of disease there’s certain components that come up over and over again and they are fiber phytochemicals a plant enzymes which are responsible for converting some of these phytochemicals into their bioactive metabolites or their active forms antioxidants anti-inflammatory compounds plant sterols and stenos pre and probiotics and then the micro and macronutrients that come mainly from whole plant foods those are i mean macro and micronutrients come from all foods but the healthiest are from whole plant foods so if we look at this list what i really want you to notice is is if you if you know if you look at um every single item here and think about where these dietary components actually come from well first fiber where does fiber come from it comes from plants only plants phytochemicals well phyto means plants it’s chemicals in plants antioxidants predominantly plants anti-inflammatory compounds predominantly plants plant sterols and stenos of course plants pre probiotics you can get from a variety of things but it’s it’s the prebiotics are only plants the probiotics are anything with with the bacteria you know fermented foods um so so the bottom line is and the world health organization said this uh you know in 2011 they actually said it in 1999 even but plant foods are where the protective components are concentrated and if you look at the pathogenic factors in food that you know you see trans fatty acids and excessive saturated fat and refined carbohydrates and excessive sodium new 5 gc which is a pro-inflammatory molecule chemical contaminants all the products of high-temperature cooking pro-oxidants and and tmao and you look at all of these things and think well where do these things come from well they come from the two categories of foods that the world health organization pointed out in 2011 processed foods with added fat sugar and salt and animal products trans fatty acids processed foods saturated fat mainly animal products refined carbohydrates processed foods excessive sodium processed foods new 5gc is the pro-inflammatory molecule in meat chemical contaminants you know we’re looking at things that largely move up the food chain and um and products of of high temperature cooking so a lot of them are are concentrated animal products but in other things as well pro oxidants like heme iron animal products tmao animal products tmao is trimethylamine and oxide and it it comes from carnitine and choline we mainly get by eating meat and our bacteria in our colons change the t change the choline or carnitine into tma and it gets shuttled to the liver and it gets changed into tmao and it’s very atherogenic and it can increase the risk of kidney disease and so on so again two categories of foods that are most most pathogenic and so when you look at what people are actually consuming you know 39 percent of our calories are coming from added fashion added fats oils and sugars 30 30 from animal products 22 from grains 90 or 95 of which are refined so refined carbohydrates nine percent from vegetables fruits and legumes and probably half of that is orange juice and ketchup you know so you look at that and you say ah i understand why most of the people in this country are overweight or obese and dying of chronic you know diet-induced diseases look at what we’re eating most of what we eat is a threat to

Case Study

health that’s the bottom line fortunately uh we have a choice so i want i just want to introduce you to the vallejo family and this this family uh this is andreas and and just just to give you a little case study uh he was diagnosed with cancer in um about i guess six years ago now he was 36 years of age it was cancer of the salivary gland and he decided to adopt a plant-based diet after doing a ton of research to give himself the best chance of survival and i think that and he is in remission by the way but the most exciting part of this story is what happened to the rest of his family because when he announced his his vegan diet his plant-based diet the whole family said whatever diet you’re going on we’re going on with you we we just want to stand with you in in this journey and and this was really quite remarkable because this this family was a a foodie family their favorite pastime was going to the best restaurant in town and ordering the biggest steak in the 500 bottle of wine so this was this was their favorite you know it was it was the thing they did so this was huge but the story i want to tell you is what happened to carlos because carlos was diagnosed with type 2 diabetes in 1993 he had just had a serious heart attack he had hypertension high cholesterol peripheral artery disease early stage renal failure recurring gout and he was being treated on 17 pills a day and 40 units of insulin he asked his doctor how long he could expect to live and his doctor said probably two years if you’re lucky and he was told that every one of these diseases was progressive and irreversible there was nothing he could do to change the course of these diseases but when he went on a whole food plant-based diet after less than a year carlos was taking zero insulin and zero pills his fasting glucose was absolutely normal a1c normal blood pressure 115 over 70 his arteries opened up without surgery he had no peripheral artery disease normal his kidney function went back to normal he had not one single further recurrence of gout and five years later six years later now maybe his numbers have been maintained without any of the medications he was on his heart disease reports he had very severe coronary artery disease his ejection fraction was 50 percent or reduced and that was 2005 in 2017 no evidence of abnormal cardiac activity whatsoever and he had a normal ejection fraction of 61 this is you know 12 years later it’s really quite astonishing but this is what is possible not everyone is willing to make the necessary lifestyle changes but everyone has a right to know that lifestyle changes are a safe and highly effective treatment option that to me is the bottom line we know enough we know enough to protect people by developing policies that make healthy choices the easy choices for people we know enough to make lifestyle medicine the first line therapy for individuals with lifestyle lifestyle-induced chronic diseases