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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
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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Barnard Medical Center
5100 Wisconsin Avenue, Washington, DC Opening January 2016