“Let Food Be Your Medicine, Your Medicine Be Your Food” - Hippocrates
@2015 J. Evans
Identify 1 research study which demonstrates
the correlation between plant-based nutrition
and heart disease
Identify one activity you could share with your
organization to encourage nurses to be heart
health
@2015 J. Evans
The speaker does not have any conflict of
interest to disclose
She is not funded by any plant based
organizations, animal right groups or farms
She does not receive any royalty from any of
the resources provided
@2015 J. Evans
If you take medication or have serious health
concerns, please discuss this change in eating with
your heath care provider
A diet change can be very powerful and impact
your medication
@2015 J. Evans
According to the Dictionary, medicine is
a compound or preparation used for the
treatment or prevention of disease, especially a
drug or drugs taken by mouth
@2015 J. Evans
Fever, chills
Headache
Faintness
Itching
Wheezing
Tightness in chest
Vomiting
Red, irritated eyes
@2015 J. Evans
Another study from Mayo Clinic- 70% of Americans took at least one drug
50% of Americans were on 2 medications
20% of Americans took 5 or more meds
Cholesterol lowering medication – 11%
Most common for children - antibiotics, anti-
asthma, vaccines
Women prescribed more then men
@2015 J. Evans
According to the dictionary, food is
A material consisting essentially of
protein, carbohydrate, and fat used in the body
of an organism to sustain growth, repair, and
vital processes and to furnish energy
@2015 J. Evans
Leading killer of death in US
Heart Disease will kill one out of 3 Americans
US contains 5% of global population but 50% of
angioplasties and bypass procedures are
performed in the world
@2015 J. Evans
High cholesterol
High Blood Pressure
Diabetes
Smoking including second hand smoke
Obesity – (20% of children over 5 are obese)
@2015 J. Evans
12.4 million people visit their MD each year for heart disease
3.7 million people go to the hospital each year for heart disease
$3.3 billion is the estimated cost of heart disease
Average hospital stay is 4.6 days
$135 million each year in CVD and stroke research –
AHA
@2015 J. Evans
Heart disease is rare where diets are low in fat and
serum cholesterol levels are below 150mmg/dL
Dr. William Castelli, former director of the
Framingham Heart Study, a 50 year study - no one in
study who maintained a cholesterol level lower than
150mh/dL had a heart attack
Esselstyn, Prevent and Reverse Heart Disease, 2007
@2015 J. Evans
Mississippi Kentucky
Alabama Michigan
Oklahoma Missouri
West Virginia Ohio
Louisiana Washington, DC
Arkansas Tennessee
@2015 J. Evans
Cost - $3 to $600 a month
Most widely prescribed in the US
22% of Americans over 45 take a statin
Crestor is 3rd top selling drug in US
Generate $16.9 Billion in US sales (2102)
@2015 J. Evans
Nausea and vomiting
Stomach pain
Kidney damage
Muscle breakdown - myopathy
Brown or dark colored urine
Memory loss, Forgetfulness, Confusion
Coma and death
Long term effects are unknown
@2015 J. Evans
https://www.drmcdougall.com/health/education/health-science/stars/stars-video/george-goff/
@2015 J. Evans
Research - A way to reverse CAD?
198 patients with cardiac disease
ate diet free of fish, meat, dairy, and added oils
81 percent improved their symptoms and experienced fewer complications
from heart disease
lost an average of 18.7 pounds
22 percent saw a complete reversal of their condition.
Esselstyn CB Jr., Gendy G, Doyle J, Golubic M, Roizen MF. A way to reverse CAD? J Fam
Pract. 2014;63:356-364b.
@2015 J. Evans
44 healthy adults on Paleo diet
Ate lean meat, fish, eggs, nuts, fruit, and vegetables
After ten weeks, LDL (“bad”) cholesterol increased by 12.5 mg/dL and total cholesterol by 10.1 mg/dL.
Triglycerides also increased slightly
The worst outcomes were seen among the subgroup that had been the healthiest before starting the diet.
The “Paleo” diet worsens cholesterol levels, according to a new study in the International Journal of Exercise Science.
@2015 J. Evans
Fiber decreases the likelihood of dying after a heart attack
4,098 heart attach victims from Nurses Health Study and Health Professionals Study
A high-fiber diet – a 35 percent reduction in death from heart disease
Fiber, especially fiber from grains, decreases systemic inflammation, lowers bad cholesterol, improves insulin sensitivity, and enhances healthy gut flora.
High-fiber foods are also high in vitamins, minerals, antioxidants, and phytochemicals -- all nutrients that are beneficial to health.
Li S, Flint A, Pai JK, et al. Dietary fiber intake and mortality among survivors of myocardial infarction: prospective cohort study. BMJ. 2014;348:2659-2671.
@2015 J. Evans
Research - Processed and unprocessed red meat consumption
and risk of heart failure: a prospective study of men
37,035 men for almost 12 years as part of the Cohort of
Swedish Men study
For each 50 gram serving of processed meat, about the size
of a regular hot dog, heart failure risk increased by 8 percent,
and the chances of dying from heart failure increased by 38
percent.
Kaluza J, Åkesson A, Wolk A. Processed and unprocessed red meat consumption and risk of
heart failure: a prospective study of men. Circ Heart Fail. Published online June 12, 2014.
@2015 J. Evans
Research - Different time trends of caloric and fat intake between statin users and
nonusers among US adults: gluttony in the time of statins?
27,886 adults
For those placed on statins, calorie intake increased 9.6 percent and fat intake
increased 14.4 percent over the course of ten years;
Those who did not take cholesterol-lowering medications had no significant changes in
calorie or fat intake.
The authors conclude that patients have adopted a false sense of security, and dietary
intake needs greater emphasis.
Sugiyama T, Tsugawa Y, Tseng C, Kobayashi Y, Shapiro MF. Different time trends of caloric and fat intake between
statin users and nonusers among US adults: gluttony in the time of statins? JAMA Intern Med. Published online April
24, 2014.
@2015 J. Evans
Researchers observed 664,159 women in the U.K. from the Algorithm
for Comorbidities, Associations, Length of Stay and Mortality (ACALM)
study.
Risk of developing breast cancer was 64 percent higher in women with
high cholesterol. This study builds upon previous research that linked
obesity to breast cancer risk.
Potluri R, Lavu D, Uppal H, Chandran S. Hyperlipididaemia as a risk factor for breast cancer?
Report presented at: Europran Society of Cardiology 2014 Frontiers in cardiovascular
Biology Meeting, July 4, 2014: Barcelona, Spain
@2015 J. Evans
Produced more than 8000 statistically significant
associations between various dietary factors and
disease
Comprised 65 counties, 130 villages and 6500 adult
and their families
Campbell, China Study 2006
@2015 J. Evans
Nutrient China US
Calories 2641 1989
Total fat 14.5 34-38
Dietary fiber 33 12
Total protein 64 91
Animal protein 0.8 10-11
Total iron 34 18
@2015 J. Evans
Campbell, China Study, 2006
In countries where people had low incidence of cardiac
disease, it increased significantly when people transitioned
to a western diet
New England Journal of Medicine – massive doses of
cholesterol-lowering drugs – no change in diet - 3 out of 4
seemed to do very well but 1 out of 4 patients in the study
experienced a new cardiac event or died within 2.5 years of
starting this treatment
@2015 J. Evans
http://nutritionfacts.org/video/cholesterol-
crystals-may-tear-though-our-artery-
lining/?utm_source=rss&utm_medium=rss&ut
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though-our-artery-
lining&utm_source=NutritionFacts.org&utm_c
ampaign=0db56dab8d-
RSS_VIDEO_DAILY&utm_medium=email&utm_
term=0_40f9e497d1-0db56dab8d-23580281
@2015 J. Evans
There is no cholesterol in plant based diets -
cholesterol is only in animal products such as
meat, dairy, eggs, chicken and fish
High in fiber
Optimal protein
Low in fat
Low in processed or minimally processed
food – low in sugar and salt
High in micronutrients – vitamins and
minerals
@2015 J. Evans
Whole grains – 5 or more servings a day – pasta, rice, corn, tortillas, whole grain bread – ½ cup cooked, 1 cup dry, 1 slice bread, ½ pita or tortilla
Vegetables – 4 or more servings a day – especially dark green, dark yellow and orange, sweet potatoes, -½ cup cooked, 1 cup raw
@2015 J. Evans
Fruit – 3 or more servings a day – citrus, melon,
strawberries – whole fruit better than juice due to
fiber – ½ cup chopped or 1 piece
Legumes – 2 or more servings a day – beans, peas,
lentils, tofu, soymilk, chickpeas – ½ cup cooked,
3 oz tofu, 1 cup nondairy milk
@2015 J. Evans
Animal foods – all beef, chicken, pork, lamb,
fish
Dairy – milk, eggs, yogurt, cheese, ice cream
Fats
Sugar
Salt
@2015 J. Evans
Employees concerned about their health in
general
Employees wanted to lose weight
Concerned about weekly cost of another
weight loss program previously offered on
site
Wanted to encourage employees to be
healthier to reduce insurance plan costs
@2015 J. Evans
21 day plant based weight loss program
Provided
◦ menus
◦ recipes
◦ grocery lists
◦ Cooking demonstrations
@2015 J. Evans
Additional support added
A buddy system
Weekly support meetings
Lab work to demonstrate results
@2015 J. Evans
Cold cereal – with soymilk or rice milk with
peaches, berries or another fruit
Whole grain toast with jam and fruit
Oatmeal with non-dairy milk with cinnamon
and raisins
Blueberry buckwheat pancakes and meat-free
bacon
@2015 J. Evans
Cinnamon Raisin Oatmeal
Blueberry Pancakes
Hot Whole Wheat with Dates
Breakfast Scrambler
Fantastic Fruit Smoothie
Whole-Grain Bagel with Jam
Swiss Style Muesli
Slow Cooker Whole-Grain Porridge
@2015 J. Evans
Almond milk
Soy milk – regular, vanilla, chocolate
Coconut milk
Rice milk
@2015 J. Evans
Veggie burger with whole grain bun and salad
Bean burrito, fruit
Soy yogurt, fruit, vegetable soup, whole
wheat bread
Hummus wrap with whole wheat pita,
shredded carrots, cucumber, tomato
@2015 J. Evans
Black bean chili with cornbread, salad, greens
Whole grain pasta marinara with mixed
vegetables, salad
Fajitas with peppers, onions, tomatoes,
beans, broccoli
Beans and rice with salsa, corn, salad
@2015 J. Evans
Chunky Vegetable Chili
Chuck wagon Stew
Portobello Mushroom Steaks
Oven-Barbecued Tofu Steaks
Roadhouse Hash
Sweet & Sour Tempeh
Southern Beans & Greens
Mandarin Stir-Fry
Stuffed Vegetable Rolls
Zucchini & Herb Calzones
Chili Bean Macaroni
@2015 J. Evans
On the average, participants dropped 24 points in total
cholesterol with 8 participants dropping 31 points or
more including 3 who dropped 59, 49 and 42 points
respectively in 21 days
@2015 J. Evans
Lost weight 86.4%
Have more energy 72.7%
Sleep better 54.5%
Think more clearly 36.4 %
Breathe easier 31.8%
Fewer or no mood swings 31.8%
@2015 J. Evans
Cheese 48%
Fish 48%
Other dairy – ice cream, yogurt, chocolate 40%
Chicken 28%
Milk 12%
Beef 12%
Pork 8%
@2015 J. Evans
Essential for healthy blood and nerves
Found in bacteria from animals which they
get from the soil
Sources – fortified foods – soymilk and cereal
Or take a supplement – daily or weekly
@2015 J. Evans
Do not acknowledge there is a problem
Acknowledge there is a problem but not ready to change
Getting Ready To Change
Changing the Behavior
Maintaining the change
Relapse – returning to old behavior or abandoning new behavior
@2015 J. Evans
We recommended plant-based nutrition
Advocated for a nutritionally healthy work
environment
@2015 J. Evans
63% - Hospitals, State, Local and Private 7.5% - Nursing and Residential Care Facilities 5% - Office of Physicians 4.6% – Outpatient Care Centers 4% - Home Health Care Services
Other – Government, Schools, Employment Services
US Department of Health and Human Services, The US Nursing Workforce: Trends in Supply and Education, April 2013
@2015 J. Evans
Can improve the health of their food systems
Can improve the health of their patients,
staff, and visitors
Can invest in the well-being of communities
and the environment
Can educate and model for the public -
healthy eating habits and significance of
fresh, nutritious foods.
@2015 J. Evans
Foods filled with saturated fat and cholesterol
Rents based on how much food they sell so
ask hospitals to help promote and market
them
Most common – Chick-Fil-A, McDonalds,
Wendy’s, Dairy Queen
PCRM, Good Medicine, Winter, 2015
@2015 J. Evans
Take a course on plant based nutrition – McDougall
or Ecornell both online
Organize a group of colleagues that are interested
in transitioning to plant based nutrition
Talk with leadership on how they can support good
food choices and the health of nurses
@2015 J. Evans
See movies - Forks Over Knives, Cowspiracy
Read as much as you can –
China Study by T. Colin Campbell PhD and
Thomas Campbell, MD
Prevent and Reverse Heart Disease –
Dr. Caldwell Esselstyne
Starch Solution - Dr John McDougall
21day Kickstart – Dr Barnard
@2015 J. Evans
Register for free Kickstart online program at
pcrm.org – starts the beginning of each month
for 21 days
McDougall Starch Solution – free 10 day program
dr.mcdougall.com
Plan one meal a day that is plant based – don’t
skip any meals – increase it a meal every week
Select one day a week that is plant based and
each week increase it by 1 day
@2015 J. Evans
Have healthy food at meetings and
conferences
Meatless Mondays and other days of week
Collaborate with other health care providers
in the organization
Have educational meetings on regular basis –
include potluck meals
@2015 J. Evans
Decrease Sugar
Decrease sodium in processed foods
Decrease fat – less than 3 grams in
processed food
Decrease oil
@2015 J. Evans
Identify vegetarian meals you already eat
and like
Think of recipes you can change
Get cookbooks from library
Keep a food diary for a week and identify
the meals that may be challenging
@2015 J. Evans
Healthy Lunch Bunch – weekly or monthly
Bring in speakers or videos – “chocolate and cocaine
what they have in common”
Bring in caterers
Organize your own 21 day Kickstart group
Movies – Forks Over Knives
Pot luck luncheons – share recipes
Select restaurants and have fun with their menus
Have one plant based food option at each meeting
@2015 J. Evans
Go to Happy Cow website for restaurant
suggestions
Know ahead of time which restaurants have the
best plant based foods so you know where to
recommend if asked
Review the restaurant menu BEFORE you go there
if possible so you know what to order
Select foods from various groups
@2015 J. Evans
Today
Tomorrow
This month
This year
In your home
In your work
In your community
@2015 J. Evans
www.drmcdougall.com – free monthly newsletter, 5 and 10 day residential weight loss programs, current research, travel programs to Costa Rica and Hawaii, Starch Based Solution Certificate Program
www.pcrm.org – free monthly Kickstart programs,
multiple languages, newsletters, current research http://nutritionfacts.org Dr. Michael Gregor, has updated research http://www.happycow.net - list of vegan/vegetarian
restaurants throughout the US
@2015 J. Evans
The China Study, Campbell, T. Colin with Thomas M. Campbell II.
Prevent and Reverse Heart Disease - Dr. Caldwell Esselstyne
The Starch Solution, Dr. John McDougall
The Reverse Diabetes Diet: Control Your Blood Sugar and
Minimize Your Medication Within Weeks - Dr. Neal Barnard
Cancer Survivors Guide - Dr. Neal Barnard
21 Day Weight Loss Kickstart – Dr. Neal Barnard
@2015 J. Evans
Identify 1 research study which demonstrates
the correlation between plant-based nutrition
and heart disease
Identify one activity you could share with your
organization to encourage nurses to be heart
healthy
@2015 J. Evans
Joanne Evans MEd, RN, PMHCNS-BC
Executive Director
Healthy Nurses…..Healthy Communities LLC
@2015 J. Evans