Whole Foods, Plant-Based Diet

Relationship to Disease Prevention and Progression

Friday, March 10, 2017

Tracy L. Bonoffski, MS, RD, LDN, CSSD, CEP
 Background
Education
• Cornell University (BS Nutrition)
• Wake Forest University (MS Exercise Science)

Certifications
• Registered/Licensed Dietitian
• Certified Clinical Exercise Physiologist
• Certified in Adult Weight Management
• Certified Sports Dietitian

Professional
• Cardiac Rehabilitation (CMC-NE)
• NASCAR
• UNC Charlotte Kinesiology Department
– Joined as full-time faculty 2007
– Teach nutrition and exercise physiology courses
– Internship Coordinator
Cornell University
Belk Gymnasium
Subtitle or section title,
Arial 30 pt, bold
• Number or bullet list,
Arial 28 pt
– Sub points are 26 pt.
– Can align images/graphics
to the left or right of text
 Objectives

 What does the research show?

 What does a plant-based diet look like?
 What are some of the benefits?
 Where can you find additional plant-based resources?
 How does a plant based diet compare to other diets?
 What is a Whole Foods, Plant Based Diet?
(PB Diet)
It's a diet based on fruits,
vegetables, tubers, whole grains,
and legumes

No animal products and highly

refined foods

No bleached flour, refined sugar,

and oil
 Historical timeline
• 1550 BC
– Egyptians
• 300-400 AC
– Roman Gladiators
• Middle Ages
– Da Vinci, Van Gogh
• 1785
 Historical timeline
• 1904
– Chittenden
• 1907
– NY Times
• Middle Ages
– Da Vinci, Van Gogh
• 1939
– Kempner
 Historical timeline
• 1948 “Vegetarians have the
– Framingham Heart Study best diet. They have the
lowest rates of coronary
• 1949 disease of any group in
the country … they have
– MS Study a fraction of our heart
attack rate, and they
• 1960 to Present have only 40 percent of
our cancer rate.”
– Adventist Studies
– Dr. William Castelli –
• 1965 Director Framingham
Heart Study
– India study
– Hegstead Equation
Lancet Study
Data from Adventist Studies
 Historical timeline
• 1971
– Diet for a Small Planet
• 1975
– North Karelia, Finland
• 1976
– Nathan Pritikin
• 1977
– McGovern Report
“In Africa, treating people who live largely off
the land on vegetables they grow, I hardly ever
saw cases of many of the most common diseases
in the United States and England, including
coronary heart disease, adult-onset diabetes,
varicose veins, obesity, diverticulitis,
appendicitis, gallstones, dental cavities,
hemorrhoids, hiatus hernias, and constipation.
In 20 years of surgery in Africa, I had to
remove exactly one gallstone.”

– Dr. Denis Burkitt

 Historical timeline
• 1982
– Dr. Colin Campbell
• 1985
– Neal Barnard
– Physicians Committee for Responsible Medicine (PCRM)
– Dr. Caldwell Esselstyn
– Dr. Pritikin’s Heart
• 1986
– Dr McDougall
 Historical timeline
• 1990’s
– Food Libel Laws
• 1990
– Dr. Dean Ornish
– China Study
• 1997
– Harvard Nurses Study
• 2000
– Dr. Fleming
 Historical timeline
• 2006
– The China Study
• 2009
– Mediterranean Diet Review
• 2011
– My Plate
• 2014
– International Plant Based Health Conference
– Barnard Medical Center
– Maine Residency Program
PB DIETS in the MEDIA
 Research
• Rising health care costs
• Chronic diseases on the rise
• Cost effective interventions
• Research shows PB diets:
• Cost effective
• Decrease BMI
• Decrease HgA1c
• Decrease cholesterol
• Decrease cancer risk
 Cardiovascular Disease
• Lancet (1990)
• 82% of patients reversed heart disease

• Angiology (2000)
• Negative effect of a high protein diet on coronary artery blood flow.

• British Journal of Nutrition (2012)

• Negative effect of a low-carbohydrate, high-protein, high-fat diet on
small peripheral artery reactivity in patients with increased cardiovascular risk

• ISRN Nutrition (2013 )

• Adverse effects on CVD from a high protein diet (meat)

• Journal of Family Practice (2014)

• Strict vegan intake reversed and halted heart disease

• Review of 27+ studies

• PB diet decreased LDL by 15% on average
 Obesity
• Obesity Society (2013)
• Greater weight loss on plant-based diet vs. other dietary
modifications
• Journal of Nutr and Food Sciences (2016)
• Meat availability correlated with obesity as strongly as
sugar availability
• PubMed (2016)
• Vegetarian diet reduced obesity, hypertension and
inflammation
• Journal of Pediatrics (2014)
• Plant based diets likely result in same benefits as children
• American Journal of Clinical Nutrition (2016)
• Decreased BMI, BP, LDL and insulin resistance in children
Whole Food, PB Diet
 Debunking Health Concerns

• Protein deficiency
• Soy
• Iron
• Vitamin B12
• Calcium and Vitamin D
• Fatty acids
• Too many carbs
 Performance driven-measurable outcomes

• The percentage of physicians who have:

– completed a course on nutrition

• The percentage of our hospitals, cafeterias, and

physicians’ meeting facilities that serve PB meals

• The percentage of patients on a physician panel who are obese and

who have completed a course on weight management and nutrition
that emphasizes a PB diet.

• The percentage of patients in a physician panel with high blood

pressure, diabetes, high cholesterol, or cardiovascular disease who
completed a course on nutrition that emphasizes a PB diet.
 Take away points

 Use terms like PB or Whole Food vs. Vegan

 Reduction of number of medications
 Decreased risk of cancer
 Decreased BMI, BP and blood lipid levels
 Patients with chronic health need be
monitored closely
 Further research needed to make PB diets
the new norm
 Want to learn more?
 Yum Universe
 PCRM.org
 Forks over Knives
 The China Study
 McDougall Plan
 Engine2 Diet
 Cleveland Clinic
 Plantbasedresearch.org
 UC Davis Integrative Medicine
 Vegetarian Dietitian Practice Group
 The Plantrician Project
 Dean Ornish
 The Vegan RD
 No Meat Athlete
 References
Ornish D, Brown SE, Scherwitz LW, et al. Can lifestyle changes reverse coronary heart
disease? The Lifestyle Heart Trial. Lancet. 1990 Jul 21;336(8708):129–33. DOI:
http://dx.doi.org/10.1016/0140-6736(90)91656-U. [PubMed]

Berkow SE, Barnard N. Vegetarian diets and weight status. Nutr Rev. 2006
Apr;64(4):175–88. DOI: http://dx.doi.org/10.1111/j.1753-4887.2006.tb00200.x.
[PubMed]
Sabaté J, Wien M. Vegetarian diets and childhood obesity prevention. Am J Clin Nutr.
2010 May;91(5):1525S–1529S. DOI: http://dx.doi.org/10.3945/ajcn.2010.28701F.
[PubMed]

Vang A, Singh PN, Lee JW, Haddad EH, Brinegar CH. Meats, processed meats, obesity, weight
gain and occurrence of diabetes among adults: findings from Adventist Health Studies. Ann
Nutr Metab. 2008;52(2):96–104. DOI: http://dx.doi.org/10.1159/000121365. [PubMed]

Appleby P, Roddam A, Allen N, Key T. Comparative fracture risk in vegetarians and non-
vegetarians in EPIC-Oxford. Eur J Clin Nutr. 2007 Dec;61(12):1400–6. DOI:
http://dx.doi.org/10.1038/sj.ejcn.1602659. [PubMed]
 References
Campbell TC, Campbell TM., II . The China study: the most comprehensive study of
nutrition ever conducted and the startling implications for diet, weight loss and long-
term health. Dallas, TX: BenBella Books; 2006. May 11,

Yan L, Spitznagel EL. Soy consumption and prostate cancer risk in men: a revisit of a
meta-analysis. Am J Clin Nutr. 2009 Apr;89(4):1155–63. DOI:
http://dx.doi.org/10.3945/ajcn.2008.27029. [PubMed]
Koh WP, Wu AH, Wang R, et al. Gender-specific associations between soy and risk of
hip fracture in the Singapore Chinese Health Study. Am J Epidemiol. 2009 Oct
1;170(7):901–9. DOI: http://dx.doi.org/10.1093/aje/kwp220. [PMC free article]
[PubMed]http://dx.doi.org/10.3945/ajcn.2010.28701F. [PubMed]

Pipe EA, Gobert CP, Capes SE, Darlington GA, Lampe JW, Duncan AM. Soy protein reduces
serum LDL cholesterol and the LDL cholesterol: HDL cholesterol and apolipoprotein B:
apolipoprotein A-I ratios in adults with type 2 diabetes. J Nutr. 2009 Sep;139(9):1700–6.
DOI: http://dx.doi.org/10.3945/jn.109.109595. [PubMed]
Lea EJ, Crawford D, Worsley A. Public views of the benefits and barriers to the consumption
plant-based diet. Eur J Clin Nutr. 2006 Jul;60(7):828–37. DOI:
http://dx.doi.org/10.1038/sj.ejcn.1602387. [PubMed]