Synergistic Effects of Whole-foods Plant-based Nutrition and Physical

Exercise, in Helping Reduce the Risks of Major Chronic Diseases

Stephan Esser MD, USPTAMatt Ruscigno RD,MPH

Goals

• Identify 3 plant food compounds beneficial for both physical activity recovery and chronic disease prevention

• Describe the physiological benefits of regular exercise on behalf of disease prevention

• During counseling of patients, successfully cite practical, evidence based methods to increase physical activity and increase use of plant based meals

“Eating alone will not keep a man well; he must also take exercise. For food and exercise……

work together to produce health.”Hippocrates

Regimen 400 BC

Ancient Awareness

• Early observations – Hippocrates (460-370 B.C.)• “if we could give every individual the right amount of

nourishment and exercise, not too little and not too much, we would have found the safest way to health”

– Cornelius Celsus (ca.10-60)• “take exercise: for whilst inaction weakens the body,

work strengthens it; the former brings on premature old age, the latter prolongs youth”

CDC Exercise Stats

• 60% of adults are not regularly active

• 25% are not active at all

• By age 75 1:3 men and 1:2 women engage in NO physical exercise

http://www.cdc.gov/nccdphp/dnpa/physical/health_professionals/index.htm

Exercise

Defining Exercise

• Exercise:–movement of the body resulting in the

enhancement of health and improvement of function

Categories

• Leisure time Exercise: organized sports, running, gym activities, rehabilitation etc.

• Lifestyle Exercise: activity incorporated into our daily pattern of life – eg: parking in the distant portion of the parking lot rather then the first

bumper, taking the stairs instead of the elevator etc.

Present Recommendations

• Cardiovascular – 150 min/wk

Present Recommendations

• Resistance Training:

– 2-3 days per week

– All major muscle groups

– 2-4 sets of each exercise

– 48 hours in between sessions

Present Recommendations

• Flexibility:– 2-3 days/week to improve range of motion

• Balance:– 2-3 days/week

The Science

Exercise and Physical Health• Reduces risk of – Heart Disease ≈ 40%– Obesity: ≈ 30-100%– Stroke ≈ 50%– Type 2 Diabetes ≈ 50%– Hypertension ≈ 50%– Disability delayed ≈15 years– Colon Cancer ≈ 25-40%– Breast Cancer ≈ 20%-44%– Osteoporosis ≈ 20+%

• As many as 250,000 deaths per year in the United States are attributable to a lack of regular physical activity

Physical Health Cont’d

• Improve Balance• Reduce Fall risk• Improve Systemic Circulation• Accelerate Skin Healing• Bowel Regularity• Improved Energy/Resilience

Exercise and Mental Health

• Regular Exercise:– Reduces risk of:• Depression• Anxiety• ADD/ADHD• Alzheimers Dementia

– Improves:• Mental Clarity, test scores, focus

Disuse

• Bedrest:

– BMD, increased bone resorption– muscle mass and strength– muscle fiber size– fatty infiltration of muscle–Impaired O2 exchange– Cardiac function, efficiency

“A review of biologic changes commonly

attributed to the process of aging demonstrates the close similarity of

most of these to changes subsequent to a period of enforced physical

inactivity………………a portion of the changes that are commonly attributed to aging are in reality caused by disuse and, as such, are subject to correction.

There is no drug in current or prospective use that holds as much promise for

sustained health as a lifetime program of physical exercise.”(JAMA 1982;248:1203-1208)

Walter Bortz MD

Disuse and Aging

Plant Compounds

Beet Juice

Beet Juice

Applied Physiology July 2010 vol. 109 no. 1135-148

Beet Juice• Webb et al. Acute blood pressure lowering, vasoprotective, and anti-

platelet properties of dietary nitrate via bioconversion to nitrite.– Healthy Volunteers– Given 500ml of beet root juice– 3 hours after consumption– BP by (max –10.4/8 mm Hg)

– Dietary nitrate load also prevented endothelial dysfunction induced by an acute ischemic insult in the human forearm

– Significantly attenuated ex vivo platelet aggregation in response to collagen and ADP

– “high nitrate content” acts as a source of vasoprotective nitric oxide via bioactivation

Hypertension.2008; 51: 784–790

• Beetroot juice and exercise: pharmacodynamic and dose-response relationships

• 10 young adult healthy males• 70, 140, and 280 ml BR or NO3−-depleted BR as placebo (PL)• 2.5 hrs after completed cycle exercise tests• Plasma [NO2−] increased in a dose-dependent manner, with the peak changes

occurring at approximately 2–3 h. • 70 ml BR did not alter the physiological responses to exercise. • 140 and 280 ml BR reduced the steady-state oxygen (O2) uptake during

moderate-intensity exercise • Time-to-task failure was extended by 14% and 12% (both P < 0.05), respectively,

compared with PL.

• Journal of Applied PhysiologyPublished 1 August 2013Vol. 115no. 3, 325-336

• Matt Ruscigno RD,MPH