2015 10 05 dc sr resource grp body and brain

Foods for Protecting Body and Mind

Neal D. Barnard, MD Physicians Committee for Responsible Medicine

Adjunct Associate Professor of MedicineThe George Washington University School of Medicine

Number and Percentage of U.S. Population with Diagnosed Diabetes, 1958–2010

CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at http://www.cdc.gov/diabetes/statistics

A Lesson from Japan

Diabetes Prevalence in Japan

In adults over age 40:

Prior to 1980: 1-5%

Kuzuya T. Prevalence of diabetes mellitus in Japan compiled from literature. Diab Res Clin Practice. 1994;24 Suppl:S15-S21.

Rising Fat Intake in Japan

Murata M. Am J Clin Nutr 2000;72(suppl):1379S-83S.

Fat (grams/day)

0

10

20

30

40

50

60

1955 1965 1975 1985 1994

Falling Carbohydrate Intake in Japan

Murata M. Am J Clin Nutr 2000;72(suppl):1379S-83S.

Carbohydrate (grams/day)

250

280

310

340

370

400

430

1955 1965 1975 1985 1994

Diabetes Prevalence in Japan

In adults over age 40:

Prior to 1980: 1-5%

By 1990: 11-12%

Kuzuya T. Prevalence of diabetes mellitus in Japan compiled from literature. Diab Res Clin Practice. 1994;24 Suppl:S15-S21.

A Lesson from the U.S.

U.S. Per Capita Meat Intake (lb)

1900 1920 1940 1960 1980 2000

20

40

60

80

100

120

140

160

180

200

220

Source:US Department of Agriculture, Economic Research Service,http://www.ers.usda.gov/Data/FoodConsumption/FoodAvailSpreadsheets.htm#mtpcc,accessed August 15, 2009.

1909

2004

123.9 lb

201.5 lb

(Includes red meat, poultry, and fish)

2012181.5 lb

U.S. Per Capita Chicken Intake (lb)

1900 1920 1940 1960 1980 20000

10

20

30

40

50

60

Source:US Department of Agriculture, Economic Research Service,http://www.ers.usda.gov/Data/FoodConsumption/FoodAvailSpreadsheets.htm#mtpcc,accessed August 15, 2009.

1909

2006

10.4 lb

60.9 lb

201256.6 lb

U.S. Per Capita Cheese Consumption (pounds)

1900 1920 1940 1960 1980 20000

10

20

30

40

Source:US Department of Agriculture, Economic Research Service,http://www.ers.usda.gov/data-products/dairy-data.aspx#.Ui9QRT_4LTI, accessedSeptember 10, 2013

19608.3 lb

201233.5 lb

19093.8 lb

Diabetes Prevalence 1994

Diabetes Prevalence 1995

Diabetes Prevalence 1996

Diabetes Prevalence 1997

Diabetes Prevalence 1998

Diabetes Prevalence 1999

Diabetes Prevalence 2000

Diabetes Prevalence 2001

Diabetes Prevalence 2002

Diabetes Prevalence 2003

Diabetes Prevalence 2004

Diabetes Prevalence 2005

Diabetes Prevalence 2006

Diabetes Prevalence 2007

Diabetes Prevalence 2008

Diabetes Prevalence 2009

www.cdc.gov/diabetes

0 - 6.56.6 - 8.08.1 - 9.49.5 - 11.1> 11.2

Adventist Health Study – 2 60,903 participants, aged ≥30, enrolled 2002-2006

Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of type 2 diabetes. Diabetes Care 2009;32:791-6.

Weight-Control Study

2 rules:

1. No animal products

2. Minimize oils

No exercise

14-week study

Typical Day’s MealsBreakfastBlueberry pancakes or Oatmeal with cinnamon and raisinsHalf cantaloupe Rye toast with jam

LunchChunky vegetable chiliGarden salad with sesame dressing

SnackBanana

DinnerLentil soup with crackers Linguine with artichoke hearts and seared oyster mushrooms Steamed broccoli

Results at 14 Weeks

13 lb average weight loss

2-inch drop in waist measurement

Increased insulin sensitivity

Plant-Based Diet for Type 2 Diabetes

Plant-based diet vs conventional diet

22-week study, 1-year follow-up

n = 99

Barnard ND, et al. Diabetes Care 2006;29:1777-1783.Barnard ND, et al. Am J Clin Nutr 2009;89(suppl):1588S-96S.

Funding: NIDDK; Diabetes Action Research and Education Foundation

Hemoglobin A1c at Baseline and at 11 and 22 Weeks

Week 0 Week 11 Week 226.5

7.0

7.5

8.0

8.5

VeganADA

Individuals with no medication changes, n = 24 vegan, 33 ADA

P = 0.01

8.07

7.88

7.42

7.18

7.50

6.84

A1c (%)

Vance

Lost 60 pounds

Stopped diabetes medications.

A1c fell from 9.5 to 5.3

Nancy

Lost 40 pounds

Stopped all diabetes medications.

A1c fell from 8.3 to 6.8.

Arthritis improved dramatically.

Glucose Insulin

Intramyocellular lipid

Inside the Cell

●

●●●●● ●

●

There were a few missteps along the way…

Body Weight

P-value < 0.0001

Am J Health Promotion, In press

Hillary and Bruce

Tackling Alzheimer’s Disease

2010 2020 2030 2040 20500

5

10

15Alzheimer's Prevalence in the U.S.

(mill

ions

)

Hebert LE. Arch Neurol. 2003;60:1119-1122

Memory ProblemsLapses

Mild cognitive impairment

• Learning, remembering • Reasoning• Visual-spatial ability• Language • Personality

Alzheimer’s disease =

APOE epsilon-4 Allele

From one parent: 3x risk

From both parents: 10 - 15x risk

Chicago Health and Aging Project

Saturated Fat

13 grams 25 grams

Alzheimer’s Risk

Add Up the Saturated Fat

2 large eggs 3.2 g 1 slice bacon 1.0 g Chicken thigh, skinless 4.7 g Whole milk (1 cup) 4.6 g DiGiorno Pizza for One 12.0 g

Total 25.5 g

Cardiovascular risk factors, Aging, and Dementia (CAIDE) study, FinlandEskelinen MH. Int J Geriatric Psychiatr. 2008; 23: 741–747.

1,341 adultsAverage age: 50Followed 21 years

Mild Cognitive ImpairmentSaturated fat per day

Low (<21.6 grams)

High (>21.6 grams)

Cardiovascular risk factors, Aging, and Dementia (CAIDE) study, FinlandEskelinen MH. Int J Geriatric Psychiatr. 2008; 23: 741–747.

1,341 adultsAverage age: 50Followed 21 years

Mild Cognitive Impairment APOEε4

Low(<21.6 grams)

High (>21.6 grams)

Saturated fat per day

Trans FatsLow:

1.8 gramsHigh:

4.8 grams

Alzheimer’s Risk

Cholesterol and Alzheimer's Risk

<198

198-2

20

221-2

4824

9+0

1

2

Serum Cholesterol (mg/dL)

Rel

ativ

e R

isk

9,844 participants in the Kaiser Permanente health plan.Solomon A. Dement Geriatr Cogn Disord. 2009;28:75–80.

Concord Grape Juice Mild cognitive impairmentAverage age: 781 pint daily

0 1 2 330

35

40Learning

(California Verbal Learning Test)

Grape Juice

Months

Placebo

33.2

38.6

33.2

35.2

University of Cincinnati Krikorian R. Br J Nutr. 2010;103:730-4.

0 1 2 34

5

6

7

8 Recall(California Verbal Learning Test)

Grape Juice

Months

Placebo

5.4

7.2

5.0

6.0

Blueberry Juice Mild cognitive impairmentAverage age: 761 pint daily

0 1 2 3

5

10

15Learning

(Verbal Paired Associate Learning Test)

Blueberry Juice

Months

University of Cincinnati Krikorian R. J Agric Food Chem. 2010;58:3996-4000.

0 1 2 35

6

7

8

9

10 Recall(California Verbal Learning Test)

Months

Blueberry Juice

Physical Activity

University of Illinois, 120 adultsBrisk walk, 3 times per week

Reversed brain shrinkage Improved memory

Erickson KI. Proc Natl Acad Sci USA. 2011;108:3017-22.

Dr. Barnard’s Exercise Tips

1. Arrive at airport as late as possible. 2. Carry massively heavy luggage. 3. Run for the plane.

Beginning Aerobic Exercise

Begin with 10-minute brisk walk.

Increase 5 minutes per week, up to 40 minutes.

The Bilingual Advantage

Languages protect your brain.

Delays cognitive decline by ~5 years.

Craik FI. Neurology. 2010;75:1726-9.

Mental Activity Reduces Alzheimer’s Risk

• Intellectual activities

• Documentaries, newspapers

• Crosswords, anagrams

WELLILL

P R E S B Y T E R I A N S

SN AI RET YB S ER P

Online Cognitive Training

Lumosity.comFamiliar Faces

Online Cognitive Training

Lumosity.comWord Bubbles

PCRM 2009 USDA 2011

Beginning a Healthful Diet

Step 1. Check out the possibilities

Breakfast

Lunch

Dinner

Snack

Foods to Try

Healthy Breakfasts

• Cinnamon Raisin Oatmeal• Blueberry Pancakes

• Bran Flakes with Almond Milk• Veggie sausage, veggie bacon

• Breakfast Scrambler• Fantastic Fruit Smoothie

• Whole-Grain Bagel with Jam• Swiss Style Muesli

• Slow Cooker Whole-Grain Porridge• Orange-Pineapple Crush

Lunches and Dinners• Veggie Pizza

• Chunky Vegetable Chili • Bean Burrito

• Veggie burgers, veggie hot dogs• Mandarin Stir-Fry

• Portobello Mushroom Steaks • Oven-Barbecued Tofu Steaks

• Sweet & Sour Tempeh • Southern Beans & Greens

• Seitan Cassoulet •Stuffed Vegetable Rolls

• Zucchini & Herb Calzones

Italian Cuisine

Mexican Cuisine

Chinese Cuisine

Japanese Cuisine

Fast-Food Options

Veggie delight

Bean burrito, hold the cheese

Beginning a Healthful Diet

Step 1. Check out the possibilities

Step 2. Do a 3-week test drive

Optional: Use transition foods

PCRM.org

PCRM.org

PCRM.org

U.S. Per Capita Meat Intake (pounds)

1980 2000160

180

200

Source:US Department of Agriculture, Economic Research Service,http://www.ers.usda.gov/Data/FoodConsumption/FoodAvailSpreadsheets.htm#mtpcc.

1967170.2 lb

2004201.5 lb

(Includes red meat, poultry, and fish)

U.S. Per Capita Meat Intake (pounds)

1980 2000160

180

200

Source:US Department of Agriculture, Economic Research Service,http://www.ers.usda.gov/Data/FoodConsumption/FoodAvailSpreadsheets.htm#mtpcc.

1967170.2 lb

2005

(Includes red meat, poultry, and fish)

U.S. Per Capita Meat Intake (pounds)

1980 2000160

180

200

Source:US Department of Agriculture, Economic Research Service,http://www.ers.usda.gov/Data/FoodConsumption/FoodAvailSpreadsheets.htm#mtpcc.

1967170.2 lb

2006

(Includes red meat, poultry, and fish)

U.S. Per Capita Meat Intake (pounds)

1980 2000160

180

200

Source:US Department of Agriculture, Economic Research Service,http://www.ers.usda.gov/Data/FoodConsumption/FoodAvailSpreadsheets.htm#mtpcc.

1967170.2 lb

2007

(Includes red meat, poultry, and fish)

U.S. Per Capita Meat Intake (pounds)

1980 2000160

180

200

Source:US Department of Agriculture, Economic Research Service,http://www.ers.usda.gov/Data/FoodConsumption/FoodAvailSpreadsheets.htm#mtpcc.

1967170.2 lb

2008

(Includes red meat, poultry, and fish)

2007

U.S. Per Capita Meat Intake (pounds)

1980 2000160

180

200

Source:US Department of Agriculture, Economic Research Service,http://www.ers.usda.gov/Data/FoodConsumption/FoodAvailSpreadsheets.htm#mtpcc.

1967170.2 lb

2009

(Includes red meat, poultry, and fish)

2007

2008

U.S. Per Capita Meat Intake (pounds)

1980 2000160

180

200

Source:US Department of Agriculture, Economic Research Service,http://www.ers.usda.gov/Data/FoodConsumption/FoodAvailSpreadsheets.htm#mtpcc.

1967170.2 lb

2010

(Includes red meat, poultry, and fish)

2007

2008

2009

U.S. Per Capita Meat Intake (pounds)

1980 2000160

180

200

Source:US Department of Agriculture, Economic Research Service,http://www.ers.usda.gov/Data/FoodConsumption/FoodAvailSpreadsheets.htm#mtpcc.

1967170.2 lb

(Includes red meat, poultry, and fish)

2011

2007

2008

20092010

U.S. Per Capita Meat Intake (pounds)

1980 2000160

180

200

Source:US Department of Agriculture, Economic Research Service,http://www.ers.usda.gov/Data/FoodConsumption/FoodAvailSpreadsheets.htm#mtpcc.

1967170.2 lb

(Includes red meat, poultry, and fish)

2012

2007

2008

20092010

2011

U.S. Per Capita Meat Intake (pounds)

1980 2000160

180

200

Source:US Department of Agriculture, Economic Research Service,http://www.ers.usda.gov/Data/FoodConsumption/FoodAvailSpreadsheets.htm#mtpcc.

1967170.2 lb

(Includes red meat, poultry, and fish)

2004 201.5 lb

2012181.5 lb

- - - - - - - - - - - - - - - - - - - - - - -

-20 lb 1983

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