American College of Lifestyle Medicine Conference (2014)

October 19th -22nd in San Diego

Summary by Rajiv Misquitta, M.D.

Dr. David Katz, MD, MPH

President of the American College of Lifestyle Medicine

 Director, Yale University Prevention Research Center

Diseases are not causes, they are effects of bad lifestyle choices. If current trends continue, 1/3 of the US population will be diabetic in the mid century. That translates to 100 million people. How could the US be solvent with this. If the FDA approved a drug that was acessible to all, stunningly free of side effects and it would prevent 8/10 chronic illnesses who wouldn’t want it. That is the power of lifestyle changes. It can reduce heart disease by 80%, diabetes by 90% and cancer by 60%.

We are adapted to a world where calories are hard to get and physical activity was unavoidable and are now in a world where physical activity is hard to get and calories are unavoidable. We are like polar bears in the Sahara desert with no adaptation to the environment around us. We are victims of our success.
We are faced with a flood of marketing dollars that propel us and our children to poor nutrient food and a flood of technology that reduces our activity.
Much of healthcare is caring for disease and not caring for health. Healthcare does not make health, but health is built by people everyday by the choices they make and the things they do at work, dining table, exercise, love and pray.
What is it we prize – more life in years, not just years in life. The effects of a healthy lifestyle even reverberate to within the double helix of DNA (genes). Dean Ornish’s study showed downregulation in prostate cancer gene expression in men undergoing an intensive lifestyle intervention. The master levers of medical destiny are not robotics and high tech but
feet (activity)
fork (healthy food)
fingers (quitting tobacco).
Quote from Michael Pollen -” Eat food, mostly plants, not too much.”

Dr. T. Colin Campbell, Ph.d

Jacob Gould Schurman Professor Emeritus of Nutritional Biochemistry (Cornell)

Healthcare costs in the US have been rising. We spend the most money but get the least return. We rely heavily on the use of pharmaceuticals to create health. The solution is nutrition. The nutrition field however has performed very poorly in helping the public in the last 100 years. The public is very confused. There is little or no nutrition training in medical schools. Funding for nutrition is almost non-existent. The NIH has 28 institutes and not one is devoted to nutrition. The tiny amount of money (3%) that it does fund is largely spent on testing supplements. It has become a reductionist science. We seem to be focused on singular criteria when it is more complex than that. Vitamin supplements don’t work. A meta-analysis published in the Cochran reports in 2008, which included 67 randomized trials (230,000 subjects) concluded – ” there is no evidence to support antioxidant supplements prevent mortality in healthy people or patients with various diseases. Furthermore vitamin E was shown to increase hemorrhagic strokes by 74%. The latest debacle involves omega-3 fatty acids. In a meta-analysis that involved 89 studies (600,000 subjects) it was found that omega-3 fats don’t work for total mortality, heart disease or cancer. 

Dr. Campbell is the author of hundreds of peer-reviewed journal articles and has a crystal clear focus on the science of nutrition. He was raised on a farm and grew up milking cows but eventually found himself working in the research labs at Cornell on trying to find the perfect protein. He spent 65 years of his life doing research and has been on many expert panels. Early in his career, while working in the Phillipines, he found a link between young children getting liver cancer and high animal protein consumption. He detailed his work in the NY Times best-seller The China Study.
He goes on to say that the two main problems with present day nutrition is (1) protein overconsumption (2) nutrient supplements over emphasized.
We only need 4-5% of protein in our diets to make up for our nitrogen losses. The recommended daily allowance is 7% and we average 17 -20%. We can get all the protein we need by eating a whole food plant based diet. Thanks to the power of marketing, people think that protein is just meat. A direct effect of animal protein is to create free radicals. Also, when we consume more eggs, milk and meat we are displacing the consumption of food that matters. Antioxidants, complex carbs and vitamins are only present in plant food. If we keep doing this for years we are going to have a problem at the end of the day.
He does not subscribe to the view of (diet) moderation as he wishes to honor the scientific literature which support whole foods plant based diets as having a beneficial effect. People may find themselves on different paths towards that goal. If we took the best of all the pharmaceuticals and packed it into one pill it wouldn’t come close to what a whole foods plant based diet can do. Food is not a quick antidote but sustained in a lifestyle, it produces a positive effect. It is about the treatment of disease which is a change in paradigm. Dr. Campbell’s latest book ‘Whole’ continues his cutting-edge thoughts on nutrition.
He also touched on the environmental damage of animal foods.
-50% of global warming is due to raising livestock for food
-70% of water used in California is used to feed livestock raised for food. We are in a drought.
To try to move his agenda forward, he has worked with all divisions of congress – the right, left and middle. He and his son have been working on their latest documentary called ‘Plant Power Nation’ which will be released next year.

Dr. Dean Ornish, M.D.

Clinical Professor of Medicine at the University of California in San Francisco

Dr. Ornish is the president and founder of the nonprofit Preventive Medicine Research Institute in Sausalito, California as well as Clinical Professor of Medicine at the University of California, San Francisco.
Dr. Ornish goes on to say that your body has the remarkable ability to heal itself, if you give it a chance to do so. He further described his research studies which were published in peer-reviewed journals and showed that lifestyle changes can reverse heart disease. The four components of his lifestyle program are (1) nutrition (plant based without oil, nuts or avocado) (2) Stress management (3) moderate exercise (4) psychosocial support. 99% of patients in the lifestyle intervention group in his study showed improvement or no change in their PET scans after 5 years. With a plant-based diet alone there was a 40% reduction in ldl without cholesterol lowering drugs. It wasn’t how old or how sick his patients were but the more they adhered to lifestyle changes the better they got.
He showed a video clip from an upcoming documentary “escape fire.” In it one of his patients gave testimony that at the age of 55 he was diagnosed with severe heart disease and there was nothing more that his doctors could for him do when he turned to the Ornish program. Fast forward 25 years later, at the age of 80, he is slim and enjoys an active lifestyle. He has actually outlived his cardiologist.
Can lifestyle changes reverse prostate cancer? He described a study where 93 patients with biopsy proven prostate cancer were randomized to a usual care and a lifestyle arm. He found that the more people changed their lifestyles, the lower their psa levels. He also found that tumor growth was decreased by up to 70% in the lifestyle group. The more people changed their lifestyles the more it decreased tumor activity. This is the only randomized trial that shows that lifestyle changes can slow and reverse prostate cancer. He also looked at gene expression and found that lifestyle changes can turn off oncogenes (cancer genes) for colon, breast and prostate cancer in just 3 months.
Can lifestyle changes reverse aging? Telomeres are similar to caps at the end of our chromosomes that control cell aging. They help protect chromosomes and become shorter as we age. If they get too short we become susceptible to illness like cancer and heart disease. Studies have shown that chronic stress can shorten telomeres and accelerate aging. However with lifestyle changes Dr. Ornish has shown telomere increase of 30% in just 3 months. In fact the more patients adhered to his lifestyle changes the longer the telomeres got. We can actually reverse cellular aging. Our genes are not our fate. He stated the more you change, the better you feel, and the more you improve at any age
More than half of Americans will be diabetic or pre diabetic by 2020. Can lifestyle changes prevent type 2 diabetes? A study in the New England Journal in 2002 showed that lifestyle changes are better than drugs (metformin) in preventing diabetes. In fact in the Navigator study, although blood sugar was controlled by medicines it did not prevent complications of cardiovascular disease. The New England Journal went on to say “the prevention of diabetes remains a critical health priority, but for now we should steer away from these 2 drugs, and use effective lifestyle interventions and in selected persons metformin to combat the epidemic.”
Type 2 diabetes is not a deficiency of insulin but actually an increase in insulin as the body is not able to use it effectively. However, a whole foods plant based diet makes the body more sensitive to insulin.
He went on to say that when you eat healthier, manage stress, exercise, and love more… your brain gets more blood flow and oxygen and you grow new brain neurons. Your brain actually gets bigger. In a study in National Neuroscience in 2007, walking for three hours per week for three months caused so many neurons to grow that it actually increased the size of people’s brains.
Diet also impacts cognition. In an article in Neurology in 2006, it was found that in those aged 65 or older, the risk of cognitive decline was 38% lower in those eating high vs low amounts of vegetables. Interestingly enough, another study concluded that in those 65 -94 years old, consuming saturated fats and trans fats more than doubled the risk of developing Alzheimer’s disease.
What about diets that are high in animal protein? A study in the Journal ‘Cell metabolism’ that was published in 2014 concluded that a diet high in animal protein had a 75% increased risk in total mortality, a 400% increase in cancer risk, and a 500% increase risk in diabetes.
He also spoke on how our food choices profoundly affect the energy crisis, the Global warming crises and the health crises.
Energy crises: 20% of fossil fuel that we burn in this country goes to produce processed foods. It also take 10 times more energy to produce animal based protein than plant based protein. Sadly, one out of five people in the San Francisco bay area go hungry every night. Could these resources be turned into feeding them?
Global warming crises: Livestock produces more global warming than all forms of transportation combined. It is responsible for at least 18% of the world’s total greenhouse gas emissions (may be as high as 50%). In contrast, the entire global transportation system accounts for only 13% of greenhouse gas emissions. In fact you may do more damage to the environment by driving a prius and eating meat than by driving a hummer and being vegan.
In terms of the health crises, 75% of the $2.8 trillion in healthcare costs are due to chronic disease. More people are dying today of chronic disease than AIDS, TB and malaria combined. Most of these chronic diseases can often be prevented or even reversed by changing diet and lifestyle.
Finally, he advocates a compassionate way to effect change in oneself. If a change is meaningful it is sustainable.

Dr. Michael Greger, M.D.

Author and internationally recognized speaker on important public health issues.

Lifestyle measures play a big role in managing diseases. Lets compare a medication to a lifestyle initiative. The average absolute reduction of a recurrent cardiac event prevented by a statin on someone who has had a heart attack averages 3.1%. On the other hand, Dr. Essylstyns’s research has shown a 99% reduction in events on patients also adherent to intensive lifestyle measures which involve a plant based-diet. Who would not want these benefits.

Alzheimer’s disease is the 6th leading cause of death. There is a substantial body of evidence that links atherosclerotic disease with Alzheimer’s disease. Nigeria has the highest frequency of Alzheimer’s genes in the world but also the lowest incidence of Alzheimer’s disease. Seemingly a paradox. If your cholesterol is low enough, the changes in cholesterol lead to changes in Alzheimer’s gene expression. Just because we have been dealt a bad deck doesn’t mean we can’t shuffle them. The prevalence of dementia has also shot up in Japan. Their diet has changed to include more meat and less grain and vegetables.
It is never too late to start eating a healthy diet to improve the circulation in our heart and brain. It is time to stop blaming our genes and focus on the 80% under the individual’s control. That is the real solution to the health care crisis

Vegan Athlete

One of the participants at the conference was bodybuilder Nick Delgado.  He has been vegan for 35 years and provided his perspective of a vegan athlete.  I attached the video below.