An Introduction to a Whole-Food, Plant-Based Diet - a presentation by Dr. Lim

good morning everyone my name is Anthony Lim I am a board certified family physician I am also an attorney license to practice in the state of California I work here as TrueNorth as one of three staff MDS including dr. Michael clapper and dr. Peter Sultana I also worked as the medical director of the mcdougal program which is based here in Santa Rosa and last I work part-time in the Department of Family Medicine at Kaiser Permanente in Santa Rosa I see patients there one half day a week and I also teach their plant-based eating class it is a monthly support group and it was started by a cardiologist dr. Sanford Warren and I'm proud to say it is the number one subscribed group in all of Kaiser Santa Rosa we have anywhere between 40 to 60 people come out on a monthly basis my goal today is to give you an introduction to a whole food plant-based diet and specifically what is a whole food plant-based diet why should I adopt this way of eating and how can I get started and before I dive into these questions I wanted to explain why I am so passionate about this entire whole food plant-based movement and why I can stand before you today and say that I truly believe 40 years from now I'm still going to be saying the same message I had a traditional medical training I trained at Boston University School of Medicine from 2006 to 2010 and after that I came out to Santa Rosa and trained at the Santa Rosa family medicine residency from 2010 to 2013 and during those seven years of med school and residency success looked like this for me success looked like having a patient with type 2 diabetes and helping them to bring their blood sugar levels to less than 150 with the aid of medications such as metformin or glipizide or in some cases insulin success looked like having patients with high blood pressure in the 160s over 100 and helping them to reduce their blood pressure to less than 140 over 90 again typically with the aid of medication such as lightson Aprill or hydrochlorothiazide or cloth a low tone or amlodipine success look like having patients with high cholesterol of over 200 and helping them to lower their total cholesterol levels to less than 200 oftentimes with the aid of medications such as lipitor or crest or or simvastatin homeruns in it during my training were when we would help overweight patients lose 5% of their body weight so someone coming in at 300 pounds okay if we could help them lose 15 pounds we would encourage them and say that this couldn't improve your diabetes to improve your blood sugar levels and cholesterol and those were rare but when those happened we celebrated in contrast since of becoming a physician who practices whole food plant-based medicine and helping people to change their overall health simply by what they put at the end of the fork I have witnessed nothing short of complete transformation this is Robert Smith he gave me permission to use his name and his picture and share his story this was in 2014 he weighed 298 pounds his blood pressure was in the 140s over 90s and he was taking multiple medications edea norvasc pristiq albuterol zetia is a cholesterol medication norvasc is a blood very powerful blood pressure lowering medication pristiq is an antidepressant albuterol is for asthma and at his activity level he was sedentary he said you'd have too much pain in his joints such as his knees to walk very far at all these pictures were taken at a wedding that he and his wife attended and he told me that when he looked at these pictures he had reached that point where he said enough is enough I can't continue on this way and he went online and did some research and essentially learned about a whole food plant-based diet and all the evidence in favor of it and he decided to go ahead and try it so this is him today this is him three years later today he is a hundred and seventy three pounds his blood pressure is in the 110 over 70 s and this is off all medication he is no longer on his cholesterol-lowering medication he is no longer on his blood pressure lowering medication he is no longer on his antidepressant so his mood has improved along with his overall health and he no longer uses albuterol I had to catch him this picture is catching him before he was about to go for his morning 5 mile run he went from completely sedentary to first thing he wakes up in the morning going for a 5-mile run I chose Robert specifically because this is not two months this is not four months this is three years later this has changed that is sustainable and long-term and if I had an interview of him and you could hear him you can you can sense that this is a permanent life change for him this is not something this is not a diet that he's going on and then going off he is eating this way for the rest of his life I took care of Robert Smith at true north just a few months ago well let's look at a patient of mine from the mcdougal program this is Josh Meyer he describes himself as a Nebraska meat-eater okay these two pictures of him were taken in at the November 2015 MacDougall employee program and let me explain a little bit about the employee program so dr. mcdougal who is a pioneer in the field of plant-based medicine and a mentor of mine who I'm extremely indebted and grateful to he runs ten day residential programs out of the Flamingo Hotel people come from all around the world and they stay at the Flamingo Hotel for ten days and there they get medical care from dr. mcdougal and myself they hear lectures from 8:00 a.m. to 5:00 p.m. and most importantly they eat the food they eat starch based plant-based meals free of animal products and oil and whole foods for the last over five-six years has been sending employees of theirs from all around the nation to the MacDougall program and the fact that it's been doing it for the last five to six years gives you a sense for how successful that's been well centurylink which is one of the largest telecommunications company in the United States it's an SMP 500 company and they're the third largest telecom company after Verizon and AT&T they decided a couple years ago in 2015 to send their first group of employees to the program and Josh Meyer was one of these people so this was their first program and these two pictures were taken of him at the program okay he's a nebraska meat-eater at this time he weighed over 300 pounds and he had that same moment that robert smith had after halloween of 2015 where he said i can't i can't continue on this way and the opportunity came up to come to the mcdougal program so he came to the mcdougal program and he was still skeptical but he decided to give it 30 days and then at the end of 30 days he decided to give it another 30 days and then at the end of 60 days he decided to give it a year and he sent a email with his story and this is him one year later November of 2016 so this is just four months ago he is no longer in Nebraska meet leader he is a nebraska plant eater and he feels better than he has ever felt before i never once in my entire 7 years of medical school and residency training witnessed a total transformation like this the closest I ever got was seeing patients who after bariatric surgery maybe one year after bariatric surgery lost a considerable amount of weight and came off a lot of medications the sad part of the bariatric surgery story is that I've now seen many patients who are four or five years out from bariatric surgery and have not only put back on the original weight but are heavier okay not to mention the complications that I have seen from many patients who have had bariatric surgery so with that as sort of a segue let's learn about what exactly is a whole food plant-based diet anyone know who this is Michael Pollan Michael Pollan he is an author he's a journalist he's a food activist he wrote this book back in 2008 in defense of food in eaters manifesto and he is most famous for seven words so first eat food eat food that your grandma would recognize so gogurts right gogurts is not a food that your grandmother would recognize you want food in as natural and minimally processed as possible not too much right in the United States we tend to overeat we tend to eat till we're stuffed to the point that we have to loosen our belt buckle and unbutton our pants so you want it you want to eat till you're satiated but not stuffed and then lastly mostly plant okay and what does mostly plants look like well it looks like this the new for food groups in a whole food plant-based diet are whole grains so amaranth buckwheat's barley oats rye tap which is a whole grain from Ethiopia used to make the in Arab red fruits all sizes varieties shaped colors vegetables you're going to have your starchy vegetables and your non starchy vegetables so starchy vegetables would be things like potatoes and sweet potatoes and butternut squash and then your non starchy vegetables will be your leafy greens your kale your spinach tomatoes eggplant cucumber and then last legumes beans peas lentils that's the bulk of a whole food plant-based diet you're deriving the vast majority of your nutrition from these four food groups with maybe a small amount of seeds and nuts no more than one ounce a day then that in essence is what a whole food plant-based diet looks like so if we just look at a few pictures there's a bowl of steel-cut oatmeal right this is my breakfast 85 90 percent of every of all days I tend to use a mashed sweet banana as my sweetener so I don't even add any sugar and then top it with some berries I had I had this this morning as did my my daughter my son and my wife dr. McDougall they I'm in the midst of a the March 2017 program right now and just the other day we had the mcdougal pizza okay and basically it's a whole wheat crust no oil added with top with all sorts of vegetables and no teeth this was my lunch last week I brought two I brought two work barley edamame asparagus bok choy chickpeas pinto beans this is a salad that I had the other day from True North right you see beets and carrots and cucumbers and and bell peppers this was my dinner a few days ago mix of brown and white rice normally mine would be all brown rice but you have to compromise as a father and my five-year-old and nine you will need that little bit for now so I work with them so it's a combination my brown and white rice black beans pinto beans corn some bok choy and some mushrooms this is a sample plate from Kaiser that they put out again some black beans quinoa as your as your grain and as you can see a wide variety of vegetables and dessert it looks like fruit much less on the side of ice cream and cakes and cupcakes and cookies after a while your palate adjustment and proof becomes very sweet and a delectable dessert so the question that I oftentimes get asked is this what's the difference between a whole food plant-based diet and a vegetarian or vegan diet is is this whole food plant-based just a really long-winded fancy way of saying begin or vegetarian and the answer is they are very different and and I thought I would share some pictures to really highlight just how different they can be so if I was vegan right I could theoretically eat this in the course of a day and still call myself vegan I could start off my day with wonder white bread and I can't believe it's not butter and I could have four slices of that lathered with I can't believe it's not butter and that is a vegan breakfast now of course that has almost no fiber so I would probably be starving by 10 a.m. in the morning and so I'm going to reach for my vegan snack and what better vegan snack then Oreos right Oreos are a vegan cookie there's no animal product in it so I could eat 20 Oreos as my mid-morning snack and still call myself vegan now by lunchtime I'm really hungry because I've had about zero grams of fiber and so I'm going to reach for my vegan pizza that I comfort myself by saying that I'm using di'ja vegan cheese so that makes it healthy and french fries and that's my that's my vegan lunch and then for dessert I'm going to reach for my bag of gummy bears okay which is vegan candy and then I'm going to wash it all down with my vegan beverage coke now this is only up till 1 p.m. right and this is what I've consumed during the day and I am vegan there's not a single food up here that is whole food plant-based okay even though french fries that are made of potatoes is no longer a whole food because it's been deeply processed right it's been deep-fried so that is really that really captures to me the difference between a whole food plant-based diet and begin and veganism you can have a vegan diet that is healthy but you can also have a vegan diet that is very unhealthy this is one of the other most common questions I get how will I get adequate protein if I do not eat meat and we don't need to look much further than the animal kingdom let's take the gorilla this is from forks over knives no meat no problem the gorillas can lift up to ten times its body weight the diet of a gorilla is 98% of I'm basically plant plant matter it leads branches roots they have two percent one to two percent maybe that's caterpillars and larvae but they are not meat eaters and no one has ever looked at a gorilla and said that a gorilla suffers from protein deficiency and if we look at other examples within the animal kingdom right the elephant the bison or Buffalo horse you don't look at these animals and say that they are suffering from protein deficiency in fact in my entire medical career I've never seen someone in the United States that suffers from protein deficiency it's just not something that we see this is frank Medrano he is a bodybuilder a calisthenic expert and this is him today and he has all sorts of videos that you can go online and look at of just these insane demonstrations of muscle strength and control and you would not look at Frank Medrano and say that he suffers from protein deficiency this is what he said about his diet I thought I was healthy and strong before but after adopting a plant-based diet I started to feel energetic and I was having quicker recovery after training the bottom line is you will get adequate protein on a whole food plant-based diet the most recent example that I wanted to share is Tom Brady he is a five-time Super Bowl champion now I just learned recently that Tom Brady eats a whole food plant-based diet this is him pictured with his wife Gisele and as he describes what they eat the 80% of their diet comes from those four food groups that we just talked about fruits vegetables whole grains and legumes and here you see Gisele pictured with a bowl of soup with broccoli and potatoes this is a picture of their daughter Vivian slurping down a green green smoothie okay so I think you all have a good intuitive sense for what is a whole food plant-based diet right eat food not too much mostly plants from the four main new fit new food groups fruits vegetables legumes and grains so this raises the question why well why should I go adopt this way of eating the fact is if if America was healthy if we were doing well as a nation then there wouldn't be much need to discuss a plant-based diet it mean that whatever we were doing currently was working but it's not two-thirds so two thirds of the United States is overweight or obese over one-third is obese we spend and despite the fact that we spend over forty billion per year on dieting and diet related products 95% of us regain that weight within one to five years all right so clearly what we're doing in terms of dieting is not working fifty percent of adults in the u.s. either have pre-diabetes or diabetes okay and that has just continued to grow over the years one out of every two fifty-two seconds every 52 seconds an adult in the United States dies from heart disease okay I can't this statistic keeps me up at night I can't get over this whether it's a stroke whether it's a heart attack the total in a year is six hundred and ten thousand in the course of this one-hour presentation 70 adults in the United States will have died from heart disease and when we look at why this is the case we don't have to look very far all right on every street corner we have fast food like McDonald's Taco Bell Burger King Pizza Hut you've checked out of every aisle and you're met with a whole array of different types of candy I was shopping at Best Buy the other day or employed electronics right and what am i met by is just a huge row of candy to buy on my way out and I actually took a picture I was at the Sonoma County Fair last summer and I couldn't quite believe my eyes see now we've reached the point where a hamburger between two buns is no longer decadent enough so we need to sandwich it between two Krispy Kreme Doughnuts this says home of the Krispy Kreme burger get it here I had never seen this before right and you know the fact that we've had two Krispy Kreme doughnuts at and quite count as desert because there was a burger in between it so you don't have to go far you just go to the next stand and you can get your dessert of deep-fried Snickers or deep-fried Oreos or marshmallow pops right because an Oreo in a Snickers bar is just not quite enough before dessert we need to deep-fry it to really really bring it home more than 50% of the American diet is ultra processed more than 50% and to be exact it's 58% of the American diet is ultra processed so what exactly does that mean I thought I'd read to you the definition from the study that that performed this in that was published at BMJ so ultra processed our formulations of several interior ingredients which besides salt sugar oils and fats include food substances not used in culinary preparations in particular flavors colors sweeteners emulsifiers and other additives used to imitate sensorial qualities of unprocessed or minimally processed foods and their culinary preparations or to disguise undesirable qualities of the final product more than 50 50 % of what we eat comes from this kind of food I wish I could say that the remainder was healthy plant-based foods but it's not right over 25% of our diet then comes from meat and dairy products such as cheese steaks chicken egg right less than 10% of the American diet actually comes from fruits and vegetables and most of that 10% is going to be things like fruit juice right or or french fries because put in the potato would count as a vegetable this book hungry planet the author and photographer went around the world to different countries and they took a photo of what an average family in each of these countries eats during a week this is the revised family in North Carolina and this is one week's worth of food for them and as you can see this is truly the standard American diet right we've got lots of pizza lots of meat we've got our instant ramen noodles lots of fast food from the Burger King s-see McDonald chips sodas here's our 10% of fruit right you've got some fruit tree here oh and if you look really hard you can see some potatoes and a couple a few bunch of the grapes we've got our Budweiser a diet coke lots of milk it's an ultra processed fast-food heavy and meat dairy American diet and just contrast that with other countries around the world all right not perfect but just compare pictorially the difference so if we looked at Egypt this is the Ahmed family in Egypt and just look at the colors right a lot more vegetables fruits we've got some bananas yes there is some meat yes there are some soft drinks but it's much much less than what you just saw was Revenge I'm only in the United States this is Guatemala again lots of fruits vegetables it got right this is a pop car family in India again same thing you're what you're struck by is a huge amount of fruits and vegetables grains and legumes the average American adult in the US eats over 200 pounds of meat a year and then contrast that with India where the average adult eats 11 pounds of meat per year this is our answer to our problem this is our answer to the two thirds of Americans that are overweight obese to the 50% that are pre-diabetic and diabetic to the patients with heart attacks that are dying every 52 seconds it spills right and if it's not pills it's procedures this is a stent and one of the most common procedures done in the United States is to put a stent in one of the vessels to the heart to open it studies have shown that stents for chronic coronary artery disease does nothing to extend the lifespan so it is purely a band-aid and if not stent then we'll take it a step further and we'll do a coronary artery bypass graft surgery we take a vein from the leg and use it to get around the arterial blockage in the heart all right we'll have to crack open the chest do the surgery and then sew it back together so in this context comes a whole food plant-based diet there is another way and we could spend eight hours 16 hours a whole week talking about the health benefits of a plant-based diet there is literature dating back to the 1920s showing the benefits of a plant-based diet but here's just a few healthier weight improve cholesterol blood pressure blood sugar ultimately equating to less medication prevention and reversal of heart disease and diabetes and I'll have more to say on that in a minute may slow the progression of certain types of cancer such as colon cancer prostate cancer breast cancer and then last improve symptoms from chronic illnesses such as gout rheumatoid arthritis inflammatory bowel disease and multiple sclerosis and I thought I'd give you just a brief case study that was recently published this was a nutrition update for physicians on plant-based diet this came out in the Kaiser Permanente Journal all right and was written by a number of doctors in Southern California and they presented an actual case study of theirs so excuse the acronyms but I'll explain so it's a 63 year old male with high blood pressure hypertension hyperlipidemia so high cholesterol who came in with fatigue nausea and muscle cramps okay this was an actual patient who came to Kaiser Southern California he was on these four medications like Senna Pro 40 milligrams daily hydrochlorothiazide 50 milligrams daily amlodipine which is a blood powerful blood pressure medication five milligrams and torva statin which is a very powerful cholesterol-lowering medication 20 milligrams at the doctor's office he got a random blood glucose level and it came back at 524 and just to give you a sense for how high that is the cutoff for a random blood glucose level for diagnosis of diabetes is 200 okay so this was off the charts this was his new diagnosis of diabetes hemoglobin a1c came back 11.1% hemoglobin a1c is average of your blood sugar for the last two to three months it's if you had another way that we diagnose diabetes the cutoff for diagnosis of diabetes by hemoglobin a1c is six point five percent and here he was at 11.1% so this represents very poorly controlled diabetes and this was his new diagnosis his total cholesterol came back 283 despite the fact that he was on a tour of a statin or lipitor which is one of the most powerful cholesterol-lowering medications his blood pressure was 132 over 66 not bad but again he was on two blood pressure medications hydrochlorothiazide in mice inappro-- right this is what I mentioned earlier that's an example of successful control of blood pressure and then his BMI his body mass index was 25 25 less than 25 is considered the normal weight 25 to 30 is considered overweight and 30 to 35 is obese and 35 and higher is morbidly obese so he's just at that border between normal weight and overweight so what did the doctor do he has a good responsible physician who started him on metformin which is for diabetes he started him on glipizide which is for dighby and he started on NPH which is a form of insulin ten units for his diabetes right in start him on three medications for diabetes why because this patient was very poorly controlled and he wanted to get his blood Sugar's under better control but we also started him on a whole food plant-based diet and advised him to exercise daily so let's fast forward four months okay let's just fast forward four months four months later in terms of blood pressure he was off BM load of heme he was off the hydrochlorothiazide he had decreased his life improved from 40 milligrams all the way down to 5 milligrams and despite that his blood pressure was lower than when he first came in 132 over 66 down to 125 over 60 in terms of his diabetes right remember he came in poorly controlled he stops the glipizide he completely came off the insulin and his a1c went from 11.1% down to point three percent his new a1c did not even meet criteria for diagnosis of diabetes in essence in four months he had reversed his diabetes and had come off of insulin and had come off of glipizide all he was left on was metformin and then finally in terms of his cholesterol he dropped it but he did stay on the lipitor but he dropped his cholesterol from 283 down to 138 all right begin to see that the beauty of a plant-based diet is not that it just treats one condition right it's not like a blood pressure medication or diabetes medication that just specifically treats that condition this is the magic pill so to speak that you put on the end of your fork every day that treats all conditions and this is a cartoon that I'll never forget it was early on when I first learned about plant-based medicine dr. Dean Ornish who is another pioneer in in the field he gave a lecture at a plant-based conference in San Diego and he started off with this cartoon and it has stuck with me ever since what this is is a picture of two doctors who are mopping up the floor okay and if you look in the background the sink the the faucet is still on it's just pouring water out what this represents is the state of modern medicine today we are mopping up the floor we're mopping up the floor with glipizide metformin lisinopril hydrochlorothiazide stents cabbage coronary artery bypass graft surgeries and meanwhile we're not addressing the root cause so as we're putting in Krispy Kreme burgers as we're putting in the candy from the checkout aisle the faucet keeps running and so we're literally just playing catch-up okay and what a plant-based diet does is it addresses the root cause finally we are turning off the faucet so that we don't have to keep mopping up the floor I wanted to focus a little bit on coronary artery disease since it is the number one killer of men and women in the United States and globally all right as I mentioned every 52 seconds when US adults died from this this is dr. Caldwell Esselstyn he is a general surgeon he practices at the Cleveland Clinic and he became very disenchanted with the state of modern medicine he felt like we were essentially mopping up the floor just like that cartoon that dr. Dean Ornish presented earlier showed and when he did the research he came to the inescapable conclusion that a whole food plant-based diet was the solution and so what he did is he solicited he went to the cardiology department at the Cleveland Clinic and asked them to send him their most difficult challenging patients with heart disease okay and they sent him 18 patients who in the eight years before he started his study suffered 49 coronary events these patients were very sick in the eight years leading up to the start of his study they suffered a total of 49 coronary event 49 coronary events in 18 patients right that's an average of almost between two to three events and these events included things like increased angina or worsening chest pain angiographic disease progression to a progression of the blockages of their coronary artery bypass surgery infarctions or heart attacks strokes angioplasty that procedure I mentioned earlier order we put a stent in the artery to the heart to open it up or worsening stress test people who were put on treadmills and were evaluated for how much what their exercise capacity was and he put them on a simple study intervention of a diet consisting exclusively of vegetables fruits whole grains legumes and lentils while at the same time excluding all meats dairy and oil and we followed these 18 individuals for 12 years after the study was done and remember right 48 coronary events in the 8 years leading up to it in the 12 years following zero-zero coronary event most people would expect that many of them would have died or certainly that they would have at least the same number of events if not more okay and instead all but one one patient died of an arrhythmia at the five year mark but 12 years later 17 patients still alive with zero coronary events and if we look at actual imaging this was from one of the patients this is the angiography done in November of 1996 what you see here distel LED status for the distal left anterior descending artery is one of the main arteries of the heart you can see it's nice and open and then right here at the end of it it gets very narrow okay in a refeed angiography done three years later this is what it looks like right it has just opened wide up and really what this shows is that you cannot just keep it keep these lesion stable you can actually reverse the heart disease you can reverse the blockages in the arteries of your heart just another image this is a nuclear scam and what you're looking at here is sort of a cross sectional view of the main chamber of the heart the left ventricle and the way to understand this is the red areas represent areas of good blood flow and the sort of yellow greenish darkish areas that represents areas of the heart that are not getting good blood flow okay this image was done just three weeks into the study for one of the patients as you can see look at this nice good blood flow almost surrounding the entire heart well right around the same time dr. Dean Ornish who yet another pioneer and I mentioned earlier the cartoon that he showed he was doing a similar kind of study except that his was a randomized control trial so he took 48 patients okay and he ran to my Taff of them to the American Heart Association diet and these were patients with significant heart disease anywhere from one vessel took to be vessel disease and he randomized the other half of them to low fat based way of eating in addition he did things like stress reduction or mindfulness he did things like having support groups to increase people's sense of connection with each other and incorporated movement as well and what has he measured progress well he looked at the coronary arteries again and looked at the level the amount of blockage okay and here's what we see so the control group the group that was on the American Heart Association diet right getting conventional care by cardiology their level of blockage in their coronary arteries went on average from forty point seven percent and then at the one-year mark to forty two point three percent and then at the five-year mark just continued to get worse fifty one point nine percent and then in contrast here's the intervention group on the low-fat plant-based diet 41.3% they actually started off worse right with a greater degree of blockage than the control group one year later down to thirty eight point five percent and then five years later continued to go down to thirty seven point three percent so again what we see here is not just stabilization but actually actual reversal of heart disease furthermore there was a 91% decrease in the frequency and severity of angina or chest pain attacks in the in via intervention group on the low-fat plant-based diet and in contrast there was a one hundred and sixty five percent increase at the one-year mark in the frequency and severity of angina attacks in the control group on the American Heart Association diet and in conventional cardio cardiology care and so it's for this reason that dr. Kim Williams president of the American College of Cardiology when he looked at the research done by doctors Esselstyn by dr. Ornish and just to top it all off he had a patient who he did a nuclear scan on who came in with three vessel disease and did a scan that basically showed that she had blockages and then six months later when he really essentially the scan showed reversal of her disease and when he asked her how she had accomplished it she had mentioned that she had learned of dr. Dean Ornish and went on the Ornish diet and so with all of that in combination we finally decided to try it on his own and for all his life his LDL or his bad cholesterol had been high I think it was around like 190 180 190 and this was eating a healthy what he believed to be a healthy diet with lots of fish lots of chicken a decent amount of fruits and vegetables and he decided to go 100% for a period of time well just a few months later when he reject his cholesterol his LDL level was less than 100 okay they dropped almost a hundred points just in a matter of months and so what he had believed prior was that it was just his genetics and that was as much as he could do and then within a few months it changed so he is now since gone completely 100% plant-based and I love this quote of his wouldn't it be a lot of a goal of the American College of Cardiology to put ourselves out of business like President Bill Clinton he learned up the research of doctors Ornish and Esselstyn and as you remember during his presidency he was famous for the standard American diet that he very much enjoyed right and as a result 2004 he had a quadruple bypass surgery and just six years later when he was walking around New York he experienced chest pain and was rushed to the hospital and had two stents placed and so he reached that moment where he said enough is enough I can't continue and keep keep doing it this way this is him now mm 15 2012 just a couple years ago right he's over 20 pounds lighter he adopted a whole food plant-based diet and here he is showing off his lunch to to the reporters and he had this quote I wanted to live to be a grandfather so I decided to pick the diet that I thought would maximize my chances of long-term survival so we don't have time to talk in depth about diabetes but I did want to mention one study that does one of my favorite studies diabetic neuropathy okay diabetic neuropathy is one of those chronic conditions that is very difficult to alleviate we have all sorts of medication gabapentin lyrica and you know what none of them truly work maybe they decrease your pain by 10% or 20% never do you ever see a patient coming in with diabetic neuropathy where you give them a medication and it goes away well back in the 90s dr. crane he did a study on 21 patients with significant diabetic neuropathy that was extremely painful and essentially what he did is he put him in a 25 day residential program all right and during that program they ate a plant-based diet that was low in fat less than 10% of the calories were from fat and moderate walking exercise program at the end of 25 days 17 of the 21 patients with significant diabetic neuropathy had 100% complete relief of the neuropathy without the aid of medications and that's just talking about their neuropathy that most of them were able to come off many of the medications for diabetes including insulin all of them lost weight cholesterol went down blood pressures went down and what's even more interesting about this study is that they followed up with these same patients three to four years later and with the exception of one of them 100% of them had the same degree of relief from their neuropathy essentially it was a thing of the past and it just shows you that as you stay on this right it is sustainable and the results are sustainable as well this is one of my favorite books the Blue Zones lessons we're living longer from the people who've lived the longest written by Dan Buettner a journalist for National Geographic and what Dan Buettner did is he went around the world and looked for places that have the highest percentage of centenarians or people who live past 100 and not just people who live past 100 but people who are thriving and living full lives into their old age and he identified five Blue Zones Loma Linda California Nicole in Costa Rica Sardinia Italy Acharya Greece and Okinawa Japan and he did over 250 interviews of these centenarians and essentially asked what is it looked at their daily patterns what they ate how they moved who they spent time with and at the end of it all he distilled principles nine power principles that he learned from the centenarians of what tied all these places together and at the very top of the list was a plant-based diet okay so when we get away from the studies and look for what's actually going on in the real world we see that this is a diet that civilizations around the world across time are thriving on so this is dr. Ellsworth Wareham he is one example of the centenarians from the brews owned he lives in Loma Linda California he's a cardiothoracic surgeon I believe today he's 104 years old and he made the decision to go whole food plant-based about 30 40 years ago when he was doing surgeries and realizing that all the blockages that he was seeing in the arteries these were all in people eating the standard American diet and he noticed that he would never find these in people eating a whole food plant-based diet and so to this day that is what he follows he finally stopped assisting with surgeries at the age of 95 but there's an interview of him with dr. Sanjay Gupta on TNN just describing helpful and rich his life is and as I mentioned he's 103 or 104 today so this quote from that study I mentioned or that paper I mentioned earlier that's put on the Kaiser Permanente Journal I think really captures it the future of health care will involve an evolution toward a paradigm where the prevention and treatment of disease is centered not on a pill or surgical procedure but on another serving of fruits and vegetables so we've talked about what a plant-based diet is right we've talked about why we should adopt a whole food plant-based diet looking at coronary artery disease looking at diabetes and diabetic nephropathy looking at people from around the world who are living well past 200 and thriving on a plant-based diet this raises the question how do I get started alright how do I get started on this one big thing is to keep learning okay you there this is really just the tip of the iceberg this is meant as an introduction it's meant to titillate your curiosity but there is so much material out there the starch solution written by my mentor dr. John McDougall is a great book for learning more and seeing the benefits of starches and beans and potatoes and legumes and introducing those into your diet this is a good movie fat sick and nearly fat sick and nearly dead forks over knives is one of the movies that we recommend that all people if they haven't watched should definitely watch it's an outstanding documentary on a whole food plant-based diet really highlights the research of dr. Caldwell Esselstyn and dr. T Colin Campbell who is the author of the China Study as we mentioned dr. Esselstyn this book of his prevent and reverse heart disease really discusses the research behind that landmark study of his that showed reversal of heart disease in the patients that he worked with and then you can start attending conferences so the International plant-based nutrition health care conference is is outstanding conference I've been to it twice and you basically get experts from all around the world discussing the many benefits of eating this way but as you are learning we got to actually start implementing right and really the first thing you have to do there is you've got you've got to clear out your kitchen you just got to get a big garbage bag and put all the foods that are not plant-based that are going to be tempting you day in day out if you're surrounding yourself with them so the chips they're cookies the meat the egg the dairy okay you want to put it and get in a bag and get it out of the house and then the flip side of that is you need to stop your kitchen you need to stop your kitchen with plant-based foods that make it easy for you on a moment's notice to put together a meal here you see legumes and being then pasta and lentils you're going to want to stock it with fruits and vegetables critical to success is planning in advance right we leave it we live in a culture where we our work days are extremely busy and the fact is if you are prepared in advance you've taken the time to you know on Sunday plan what your meals are going to be for the week and take the time to go grocery shopping and prep and cook you're far more likely to be able to eat this way and be successful then if you just take it on a day-by-day basis and then finally you've got to do it you've just got to jump in and you can do all the planning you want but at the end of the day you've got to do it ideally with a partner and partner studies have shown that when you do it together in a group you're your chances of success are far more likely than if you try and do it alone now along the way there's going to be times when you falter right or you go off the plan and the key here is really to be resilient so as Vince Lombardi said it's not whether you get knocked down it's whether you get up and you know if you end up eating something that is part of the standard American diet one day then as as dr. Ornish would say and the next day you eat healthier ok and you don't just continue to eat in an unhealthy manner when I think of resilience I think of Jason's hair Ramos these were two patients I took care of recently here at true north as jason says my current diet at the time this was in 2014 consisted of mainly sheet cakes ice cream pizza chicken wings and hamburgers and they're husband and wife they had together tried many different diets over the years right but they never gave up they never gave up they kept with it they kept determined and they knew that there was a better way and eventually they learned about a whole food plant-based diet so they've been on it I believe since 2014-2015 and this is them today again just another complete transformation and I took care of them for over four weeks here at true north if you could have seen the size of their plates and in terms of the amount of food that they consumed you would be shocked and that's the beauty of this way of eating I have never once ever told a patient that they need to calories this is not a is not a caloric restriction or portion control kind of way of eating if you put the right foods into your body you basically eat as much as you want until you're satiated okay and despite eating as much as you want this is the result it into two to three years right they have essentially gone from a morbidly obese category to a normal weight so to recap we are not doing well as a nation in terms of health medications procedures and surgeries are not the answer this is really simply mopping up the floor and in order to turn off the faucet we must adopt a whole food plant-based diet is primarily on whole or minimally processed fruits vegetables grains and legumes the whole food plant-based diet has the potential to not just prevent okay but actually reverse that's the beauty that reverse chronic illnesses such as heart disease and diabetes in terms of next steps continued learning is critical and adopting a whole food plant-based lifestyle ourselves and trying it out Hippocrates the father of modern medicine right over 2,000 years ago really had it right and somehow along the way we got derailed and failed to listen to his wisdom let food be thy medicine and medicine be thy food now I want to end with one final personal note so a lot of times patients will say to me you know it's it's even for you to say you've probably eaten this way your whole life you know you probably grew up eating whole food plant-based and you don't know what it's like coming from the standard American diet and trying to eat this way and that's when I laugh and say oh phone if only you knew all the way up through the end of fifth grade I was the most overweight kid in my grade I remember it like it was yesterday the being in gym and PE and waiting until everyone in the locker room had finished changing before I changed because I didn't want them to see me without my shirt on I remember just absolutely being petrified of getting an invitation to a party and it being twin party right and and the times I did go there swim party I would jump in with my shirt on and my friends would say why are you jumping with your shirt on and I would say because I'm cold right and I didn't get this way by accident right I very much enjoyed and partook in the standard American diet so I remember being back in Singapore when my parents grew up one summer and my mission was to go to every restaurant that had banana splits and basically get one at each meal and compare and decide which one was the best and so you know eventually I might diet improved slightly but I will say that along the way I have had missteps so you know in the 80s there is a whole fat-free craze and under in the fat-free paradigm you could eat as much food as you want as long as it was fat-free so you know the factory Entenmann's pies and the fat-free Entenmann's cookies Twizzlers gummy bears gross and orange juice I would consume massive amounts of these thinking that that's healthy because it was zero fat and then I'm embarrassed to say it but during residency I went through the paleo phase okay where you could eat as much meat as you want as long as you're avoiding carbs and so I'm really proud I was really proud at the time but I knew about in and out and they're off menu item is a protein style burger right it's their burger patties wrapped in lettuce instead of buns to avoid the carbohydrates and I remember once going to in and out and I got not one but two double patty protein style burgers alright and yeah so I went through the Paleo diet for a couple of years and it's only in the last few years that I finally seen the light so to speak and entered what I truly believe is the final phase of my nutrition history a whole food plant-based lifestyle and so I wanted to end with a demo that I think sort of highlights this okay now this was a this was a demonstration that I saw many years ago from a motivational speaker men Darren Hardy and he was talking about this in reference to the pernicious influence of the news and television and I've adapted this demonstration that he's done because it really struck me and sort of modified it to what I believe adopting a whole food plant-based diet represents okay so imagine this cup was me in my childhood right and eating corn dogs in Orange Julius and Wendy's Frosty's croissants corned beef hash from Price Club watching television essentially just right filled with the standard American diet and then even later moving to the fat-free phase and the Paleo okay and then I just want to show what I believe the power of the whole food plant-based diet has is capable of all right it won't happen immediately but day by day as you put fruits of various colors variety sizes vegetables starchy non starchy legumes beans peas lentils whole grains amaranth buckwheat barley you are just cleansing from the inside out people who have diabetes are reversing their diabetes people who have high blood pressure are not just lowering their blood pressure with medications but they're actually able to lower their blood pressure and come off their medications and you're actually able to reverse whatever damage that you've done and accumulated over the years and then at the end what you're left with is a pure cream glass of water thank you very much all right any questions yes I [Music] I mean I do believe there's a difference you know certainly organic vegetables that are free of pesticides and you know GMOs I think that is the healthier option but what we want to you know what what I want to emphasize is that we don't want that to stand in the way of someone adopting a whole food plant-based way of eating so better to if they can't afford it to get conventional vegetables then to let that be a barrier to them adopting this way now on the other hand if it is within your budget I can't think of a better thing to spend your money on than what you're putting inside your body so if it's within your budget to afford organic and I do think that's better for certain ones you do for other ones the cooking actually brings out the nutrients so for example where Tomatoes when you cook them it actually increases the lycopene which is a powerful antioxidant content of the tomatoes and so what we say is generally try to get a balance you know I don't I don't eat exclusively raw and I don't need exclusively cooked you saw just now the pictures of what I ate right one was a huge salad that was raw cucumbers and beets and bell peppers and then on the next one you saw a cooked bok choy with cooked mushrooms so I think you just want to have a balance of both does that help okay sir vegan purple-black days or year in effort to reduce or reverse type 2 diabetes at the end of that year we get a blood vessels when I was now 5-1 I progress that is there any weight for this large style to cause the pancreas to come back or so the unfortunately type 1 diabetes right basically means your pancreas is not producing adequate levels of insulin and there's no reports of any sort of intervention that can reverse that what probably happened in your case is that there's this blend of type between type 1 and type 2 diabetes called what we call type one and-a-half diabetes where you may be producing some insulin okay but just not adequate to cover your needs and you never really know whether someone with type 2 diabetes where they're going to end up until they get down to what their true ideal weight should be and then if they're at their true ideal weight and they're eating whole food plant-based and they still need insulin that probably means they have a degree of insulin insufficiency and they're going to need a little bit of insulin for the rest of their life but what we oftentimes have is people who come in diagnosed with type 1 diabetes that over the years have also become very overweight so not only do they have insulin insufficiency but they also have insulin resistance on board and we have been able to see these patients come come off a significant amount of their insulin let's say they were taking a hundred units per day and they just assumed while I'm type 1 that's what I'm going to be taking the rest of my life when they lose 4050 pounds they end up needing you know 10 15 units just to cover their basic needs in a given day generally for my type 1 type dedications I don't want them to count calories but what I do want them to do is generally get in a very regular eating pattern that they just know for breakfast I'm going to eat a bowl of oatmeal that this size and for lunch I'm having my salad with my legumes and so you basically know what you need to your general day-to-day and and then you don't have to very much beyond that unless you have there's some extenuating circumstance and you ate differently but in general once you have a set eating plan and you figure out what your needs are you're able to stick with it it is definitely a little more complicated than say for type 2 diabetic but I don't believe as a type 1 guy that you need to count calories okay my mission is not that the world becomes a 100 percent whole food plant-based you know that 100% vegan my my mission in hope is that we move the needle dramatically not just a bit but dramatically across the world across the United States across the world in the right direction similar to the blue zones right in the Korea Peninsula and Costa Rica Okinawa Japan you know Acharya in Greece Loma Linda California none of these places were exclusively 100% plant-based but you look at one of their meals just that way you saw hungry planet you look at their week's worth of menu I'm it's clearly 8090 percent unprocessed fruits vegetables legumes and grains and so you know if if in your case that's something you're not yet ready to give up or decrease but you've decreased your meat consumption you decrease your dairy consumption you've cut back on the amount of oil you you use you've greatly increase your fruit and vegetable and legroom and whole grain intake then I bought the last thing I would want is for you to focus on where you're feeling or not needing and then there's going to be a time where you're going to say okay I think I feel ready to tackle this all right and then yet your neighbor after watching Forks Over knives may have just said like I'm done that's it that's the last egg that's the last bite of fish that's the last bit of olive oil I ever use and that is right for that person okay the one caveat is there are certain people with certain health conditions where their health history I think makes it a little more imperative for them to make a more drastic change sooner rather than later so if I have a patient come to me a seventy year old with diabetes on sixty units of insulin with a history of two heart attacks on multiple medications and complaining of chest pain I'm not going to say I think an incremental approach is is okay I've benefitted that you need to make changes you need to make big changes and you need to make them now and I'm going to put a harder harder sell so I you know I have different approaches for different folks does that help now the healthcare is back on the political table big time and hopefully somebody can correct me if I'm wrong but I haven't read about any serious discussion of putting health what's really causing the explosion of cost and the health care system that this is it's completely i hawai yeah yeah kit kits comment is very that is a whole nother lecture and it is something I feel it just incenses me right but just to give you a few examples so coca-cola right they created a non-profit found non-profit organization called the global energy balance network all right and it basically came out in the news and the New York Times last year that the global energy balance network was sort of an umbrella with the goal of putting out research showing that our diabetes and obesity epidemic is not from the sugary drink and the coke sensor it's from lack of exercise and so it's brilliant if you think about it right because there's some truth in it right we don't exercise we don't move enough we don't have enough PE of physical education in our schools our children are are not moving their bodies enough and as adults we're certainly not right we're watching too much television so there is some truth but to suggest that that is the primary cause of our diabetes and obesity epidemic and not the cheese pizzas the coca-cola the Pepsi the candy and the aisles the Krispy Kreme burgers is is wrong right and then and just this last year in 2016 documents came out showing that the sugar industry back in the 60s paid researchers at Harvard to put out research showing that the coronary artery disease epidemic was due to fact okay and not from processed sugar and all the added sugar again brilliant strategy right is fat absolutely one of the contributors to the coronary artery disease epidemic yet but to suggest that the sugar has nothing to do with it is wrong and thus the flourishing and boom during the eighties of the whole fat-free craze right and people kind of getting in their mindset I can eat as many Entenmann's pies as I want because the problem is the fat not the sugar alright and so industry has a huge incentive the meat industry the dairy industry the processed food industry they have a huge incentive to not share this information with the rest of the world and what I love about this movement and one of the reasons I'm so passionate about it is that at the end of this presentation I don't have a supplement or a product to sell to you I'm not getting a kickback from the broccoli industry and the cauliflower industry right these are not the wealthy so the people that you see advocating for this movement are doing it because they truly believe it's the truth right they're not they don't have a product to sell these have such great questions I feel like you guys were given cards haha that's Oh Kaiser I want to share a little story that to me gets me very excited so you saw earlier I talked about that international plant based nutrition conference right that is in its fourth or fifth year running now the very first year that they did it for people from Kaiser came okay Kaiser is the largest managed care organization in the United States with over 10 million members four people came the second year the year that I first came okay which was back in 2014 they had over 40 people come to that conference so a tenfold increase all right the very next year 2015 I attended again they had almost a hundred people come and I remember there were so many of us that they actually reserved a room for us all to meet each other and have dinner and at my table I'll never forget it was a round table and there was a general surgeon there was a nephrologist which is a kidney doctor there was an internist there was a pulmonologist or genomic intensive care unit position and there was two or three other specialties represented so what you saw is multi specialty interest in what we're talking about here and not to mention multidisciplinary there is nutritionists there are registered dietitians social workers nurses and physicians and this last year I heard that there was over a hundred people so we've gone from four in a matter of few years to over a hundred in terms of what they're doing to disseminate while we're publishing a lot now in the journals since that article came out in the nutritional update for physicians two or three more articles have come out in Kaiser Permanente on a plant-based diet I am right in the midst of launching Kaiser Santa Rosa's first 21-day plant chow inge for medical staff so nurses medical assistants doctors we bought to Melanie Larson who's the nutritionist and I reco lead the plant-based group and so we've been sort of heading this up and on the kick off event we bought four enough for fifty forty people which would be a big turnout for something like this right this is in the middle of a busy work day we had over a hundred people come there's your standing room only and as of today we have over 250 people signed up for this 21-day challenge now this is 250 staff right so physicians medical these are people on the front lines who are caring for the ten million members at Kaiser imagine if they change the way they think and come to believe that this is truly the best medicine and the impact that they're going to have on the tens of hundreds of thousands of patients that they see year after year so we've got the plant-based challenge that's been rolled out across centers we've got the conferences and the increase in attendance and then last we have a email group and once a month we have webinars where doctors and medical staff are learning about what what sort of initiatives are going on in other centers across Kaiser whether it's Georgia whether it's Southern California and so we're all sort of connected that way and I believe there's over two or three four hundred people on that email listserv so what I what I sort of sense is an explosion about to happen you know that that book by Malcolm Gladwell the tipping point like I'm an optimist alright but I'm also realist but I truly believe that we're kind of at a tipping point where once enough momentum develops and they tell their friends and then their friends tell their friend that it's just going to you know you can't you can't contain the truth and I believe Kaiser is going to be a part of it and it's one of the reasons that I'm honored and feel privileged to be able to be a part of that and that's one of reasons that continue to work at Kaiser so you know I very much see my three different roles as a staff position at true north as medical director of the MacDougall program and as a part type of position at Kaiser I really feel that they're in different worlds that they all intersect and this energy is is amazing what are you planning confusion see what he's saying and met Google food characters right and what yeah I thought a lot about that you know it's kind of fine dr. Fuhrman's the reason I'm here in a way because I had never heard the word whole food plant-based until I saw dr. Fuhrman come on PBS in the summer of 2014 seven years of med school and residency training I had never heard those four words whole food plant-based diet and when he mentioned them and he may be totally outrageous claims about what a whole food plant-based diet could do to not just prevent the reverse chronic illness come on but it hits elated my curiosity enough that I read his book eat to live and then once I read his book on my whoa I really I wasn't aware that there was all this research behind it and then I watched Forks Over knives and then around 2:00 a.m. that night I watched fat sick and nearly dead and my 4:00 a.m. I was a convert as I hallelujah I've seen the light you know and you know I described what was really just a flame at that time really has just it's an all-out bonfire I mean I am so fired up about this I can't even I came to contain my excitement but so he was the reason that I'm here I first learned about it through his sting on PBS and then our medical director of the MacDougall program right and so there is I the first thing I say is there's far more similar about the two of them than there is different and so we could spend a long time focusing on the little differences here and there but at the end of the day they are both were all part of the same team and we're all promoting a way of eating that's predominantly based on those four food groups now that said what dr. MacDougall's main emphasis is if he does not want people to be afraid starches this whole low-carb movement this paleo movement that I'm guilty that I had subscribed to you for a period of time has really pulled the you know of pulled a hoax over us I mean and we're using people that are afraid of potatoes and afraid of whole grains now carbs can be evil right I mean if you have processed carbs in the form of wonder white bread and hot tamales and things like that these ultra processed carbs or cereal breakfast use like tricks and you know honey honey bunches I mean that is not healthy carbs but when we're talking about the grains that have sustained civilizations over time you know dr. McKee would like to talk about the Roman gladiators and they were called the barley barley men because their diet consisted primarily of barley or the Okinawan diet right which is 90 to 95 percent taro or a sweet potato the to suggest that those are unhealthy for you and are going to make you fat and sick is really doing a disservice and so he doesn't want us to be afraid of starches and he believes and I believe that you need those starches to truly feel satiated okay at the same time you know I mean you just look pictorially at what I showed you these fruits and vegetables of all different colors and sizes each of them brings different antioxidant benefits in the same I mean the lycopene from tomatoes right in that beautiful beautiful red color or the beta carotene in the carrots and the and sweet potato you want those as well and so I must I'm a huge advocate of people incorporating fruits and vegetables of all varieties into their diet and so you know I like you know Jeff Novick another pioneer in the field and someone who I dearly value his friendship and and and the fact that he's been such a good mentor to me you know his play if you look at his plate we went out to dinner the other night it was like clockwork he had his starch it was like about a third of his plate he had his legumes so it beans peas lentils I was about a third of his plate and then he had vegetables you know he had leafy greens and and starchy vegetables that was another third of his plate and there was a balance between all of them and I think that's the main point that I would want to come to agree to communicate to people yeah we'll take out one last two and then we'll call it this actually sorry no I think baking is a great way because usually we can bake that and not usual I mean we have Katie Mae and Kathy Fisher do a lot of demonstrations and a lot of their demos or chef AJ a lot of their demonstrations involve baking the things the kind of method that you want to avoid are you know deep-frying or sauteing and heavy amounts of oil or even barbecuing and grilling where you can get that charred effect which is has its carries its own carcinogen those are the ones you want a boy but steaming boiling baking all things that don't involve oil are great and healthy ways and you just want to avoid overdoing it and then you want to incorporate some raw as well you know combination of raw and cooked is the way to go last one you know I don't think you love me but you make such a big impact when you're lecturing and you come across very humane I do give a damn I really do thank you very much [Applause] you

Channel: Alan Goldhamer

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Length: 76min 34sec (4594 seconds)

Published: Tue Jul 11 2017