FOOD AS MEDICINETHE POWER OF THE MEDITERRANEAN DIET

PRESENTED BY CAHMI IN COLLABORATION WITH THE UAMS INTEGRATIVE MEDICINE INTEREST GROUP

JANUARY 30TH 2016

PERFECT STORM

UNIVERSAL HEALTH

COVERAGERISING

INCIDENCE OF FOOD

ALLERGIES

OPEN DATA

MICROBIOMEAwareness of food

and health

GMO

TRANSPARENCYCLIMATE CHANGE

CELIAC DISEASE

FOOD SAFETY ISSUES

PROACTIVE VS ‘RE’ACTIVE MODELFOR HEALTHCARE

WHO/WHAT DECIDES OUR DIET??

SOCIAL CULTURAL AND RELIGIOUS FACTORSTASTE AND FLAVORBIG FOODCOSTEMOTIONSAVAILABILTYUSDA: SCHOOL LUNCHES. LONG TERM FACILITIES, HOSPITALS

DUAL ROLE OF THE USDAPROTECT AGRICULTURAL PRODUCERS

AND

MAKE DIETARY RECOMMENDATIONS TO THE AMERICAN PUBLIC

CAN DIET IMPACT THE TOP TEN CAUSES OF DEATH?

USDA MY PLATE

HARVARD EATING PLATE

WHAT ABOUT MEAT?

WHAT ABOUT MILK?

No evidence that dairy protects against osteoporosis

Possible link to prostate and ovarian cancer

Lactose intolerance

AND BEANS?HIGH IN FIBERCHEAPPACKED WITH PROTEINLOWERS RISK FOR COLON CANCER, OSTEOPOROSIS AND BREAST

CANCERLOW GLYCEMIC INDEXVERSATILETASTY

EVIDENCE BASED: MEDITTERANEAN

DIET

DIETARY TRIBESMEAT AND POTATOESMEATLESS MONDAYSFLEXITARIANSCLIMATARIANS/HUMANITARIANSVEGETARIANSPALEOFAD DIETS: ADKINS/ZONE/BEACH BODY/

WHY LESS MEAT?( 99% OF OUR MEAT COMES FROM FACTORY

FARMS)ANTIBIOTIC RESISTANCEREDUCE THE CARBON FOOTPRINTCRUELTY TO ANIMALSHEALTH OF FARM WORKERS LESS MEAT= LESS DIABETES AND HEART DISEASE

COMMON SENSE GUIDELINES(BRAZILIAN)

1. Prepare meals from staple and fresh foods.

2. Use oils, fats, sugar and salt in moderation.

3. Limit consumption of ready-to-consume food and drink products.

4. Eat regular meals, paying attention, and in appropriate environments.

5. Eat in company whenever possible.

6. Buy food at places that offer varieties of fresh foods. Avoid those that mainly sell products ready for consumption.

7. Develop, practice, share and enjoy your skills in food preparation and cooking.

8. Plan your time to give meals and eating proper time and space.

9. When you eat out, choose restaurants that serve freshly made dishes and meals. Avoid fast food chains.

10. Be critical of the commercial advertisement of food products.

COMMON MISCONCEPTIONSHEALTHY DIET IS EXPENSIVE AND UNAFFORDABLE

MEAT = PROTEIN

COOKING IS COMPLICATED AND SHOULD BE LEFT TO PROFESSIONALS

HEALTHY FOOD TASTES BLAND

THIS IS WHAT A VEGAN LOOKS LIKE

(DIVERSITY=RESILIENCE)BIOLOGICAL SYSTEMS ARE SAME

WHAT ARE NUTRIENTS?MICRONUTRIENTSVitaminsMineralsWater

MACRONUTRIENTSCarbohydrates Fats Proteins

WHOLE FOODS PLANT BASED (WFPB) DIET

Encourages plant foods in their WHOLE form.Whole grains, vegetables, fruits, legumes

(beans, peas and lentils), seeds and nuts. Limits animal products (eggs, dairy, fish, meats).

MEDITERRANEAN DIETSimilar to WFPB diet but allows small amounts of animal

products. High in fruits, vegetables, whole grains, legumes, nuts, and

seeds. Fat is not restricted. Olive oil as an important fat source. Low to moderate consumption of dairy products, fish, eggs

and poultry.Red meat is rarely consumed. Moderate wine consumption.

CARBOHYDRATEWhole food examples

Grains: wheat, corn, rice, rye, barley, oats, quinoa, bulger, oatmeal, popcorn

Root, tuber, starchy vegetables: beets, carrots, potatoes, sweet potatoes, corn

Legumes (beans, peas, and lentils): navy beans, split peas

Fruit

Refined food examples Grains: White rice, white bread,

grits, couscous, regular pasta, pretzels

Other: Coke, candy, cake, cookies ice cream, chips etc.

WHOLE GRAINThe bran is the outside layer where most

of the fiber exists. The germ is the inside layer where many

nutrients and essential fatty acids are found.

The endosperm is the starchy middle layer.

When grains are milled, you are left with only the endosperm. In doing this, you take out the majority of the nutrients.

CARBOHYDRATESRefined grains

Little nutritional valueHigh glycemic indexLinked to GI issues Linked to weight gainLess satiety

Whole Grains More nutrition: Unsaturated fatty

acids, fiber, vit E, vit B6, magnesium, zinc, potassium, calcium, phosphorus, iron

Lower glycemic index/help regulate blood sugars

Promote a healthy GI tract Blood pressure and cholesterol

lowering benefits Promote satiety

PROTEIN“Complete” proteins: animal sources. Contain all essential

amino acids.Poultry, pork, chicken, fish, eggs, dairy.

“Incomplete” proteins: plant sources. Lacking in 1+ essential amino acids. nuts and seeds, legumes (beans/lentils/peas), and even whole

grains.

Complementary proteins: Most plant foods are not “complete” proteins. However, eating a wide variety of plant foods will ensure you get all of the necessary amino acids to fuel your body.

COMLIMENTARY PROTEINS

PLANT BASED VS ANIMAL PROTEINProtein=meat, meat=protein??Red and processed meat has been linked to high risker

of CVD, type 2 DM, cancer, and osteoporosis. A diet high in vegetable protein has shown CVD

benefit. A well-balanced, plant-based diet will provide adequate

amounts of essential amino acids and prevent protein deficiency.

PROTEIN Plant

Linked to longevity (lower incidence of CVD, DM, cancer)

Incomplete proteinSustainable/CheapNitrogen fixing

AnimalLinked to CVD, DM,

cancer Complete proteinLess sustainable

(environmental impact)Animal well-fare

FATSThe problem with fats has more to do with the TYPE of

fat you eat rather than the QUANTITY.

“Best” fats:Nuts/seedsOlive oilAvocado oilCoconut oil

“Okay” fats:Organic canolaButter (grass fed, organic)GheeLard

“Bad” fats:Vegetable oilCorn oilTrans fatsSoybean oilCottonseed oilCanola oil

FATS IN THE MEDITERRANEAN DIETThis is not a low fat diet- may comprise up to 40% of total energy

intake. The Mediterranean diet emphasizes the consumption of two types

of fat: Omega-3 PUFA (flax seed, chia seed, walnuts, fatty fish) Monounsaturated fatty acids (olive oil, flaxseed oil, macadamia

nuts, olives, avocado, peanut butter)Balanced ratio of omega 6:omega 3 fatty acids (1-2:1)Low in saturated fat Avoids unhealthy fats (trans fats, highly processed vegetable oils)

BENEFITS OF WFPB/MEDITERRANEAN DIET

Cardiovascular Disease Lifestyle Heart Trial, Ornish D et al. JAMA, 1998 (6) Lyon Diet heart study. D et al. JAMA, 1990 (7) PREDIMED trial, Ramon et al. New England Journal of Medicine, 2013. (8)

Obesity Berkow SE et al. Vegetarian diets and weight status. Nutrition Review, 2006. (8) Farmer B et al, A vegetarian dietary pattern as a nutrient-dense approach to weight

management. J Am Diet Assoc, 2011. (9) Rosell M et al, Weight gain over 6 years in 21,966 meat-eating, fish-eating, vegetarian and

vegan men and women. International Journal of Obesity, 2006. (10) Tonstad S et al. Type of vegetarian diet, body weight, and prevalence of type 2 diabetes.

Diabetes Care, 2009. (11) Diabetes

Snowdon DA, et al. Does a vegetarian diet reduce the occurrence of diabetes? Am J Public Health, 1985. (12)

Vang A, et al. Meats, processed meats, obesity, weight gain and occurrence of diabetes among adults: findings from Adventist Health Studies. Ann Nutr Metab, 2008. (13)

Tonstad S et al. Type of vegetarian diet, body weight, and prevalence of type 2 diabetes. Diabetes Care, 2009. (11)

PREDIMED trial - New England Journal of Medicine

VEGETARIAN/VEGAN DIETS VS MEDITERRANEAN Diet

Although vegetarian diets are associated with lower risk of several chronic diseases, different types of vegetarians may not experience the same effects on health. The key is to focus on eating a healthy diet, not simply a vegan or vegetarian diet.

COMMON HEALTH CONCERNS OF A PLANT BASED DIET

Protein IronCalciumVitamin DVitamin B12

IRONPlant based iron sources include: kidney beans, black

beans, soybeans, spinach, raisins, cashews, oatmeal, cabbage, and tomato juice.

Heme (animal sources) vs. Non-heme (plant sources)Non-heme iron absorption is increased by consuming

foods that contain vitamin C along foods that contain iron.

Iron-deficiency anemia is rare in individuals who follow a plant-based diet.

CALCIUMPlant-based sources: fortified non-dairy milks,

dairy leafy greens (turnip greens bok choy, broccoli, kale), bean sprouts, nuts and seeds, whole grains, fruit, blackstrap molasses.

Intake can be adequate with a well-rounded, balance plant-based diet.

VITAMIN DThere are only a few good food sources of

Vitamin D- including fatty fish, egg yolks, and fortified rice or almond milk.

Most people should consider a supplement if sunlight exposure is limited.

VITAMIN B12Vitamin B12 is found in animal foods but

synthesized by bacteria. Those who do not eat animal products of any

kind must supplement their diet with vitamin B12 via supplement, or plenty of fortified foods (such as breakfast cereals, nutritional yeast or plant milks).

CONCLUSIONALL OF THIS BEING SAID, DIET IS DIFFERENT FOR

EVERYONE. There are a lot of diets out there, but no one can deny

that eating more plants is a good thing for both you and the larger picture.

It does not have to be difficult to eat plant based!

WHY COOK?Build community Acquire life changing skills Greater control over your family’s healthConnect with the large pictureIt’s magical!

OUR RECOMMENDATIONSEliminate all sweetened beverages

Avoid snacking

Learn how to cook

FUTURE TOPICSFERMENTATION AND PROBIOTICSUMAMIGOURMET COOKING FOR SPECIFIC DISEASE STATESSUSTAINABILTY AND LOCAL SOURCINGGLUTEN FREEFODMAPS DIET FOR IBSCOOKING FOR PEOPLE WITH FOOD ALLERGIESKITCHEN PHARMACY