Brain Food

Posted on by Rebecca Dale, MD

For me, trying to move my family to healthy eating is a slog.  A marathon.  A never-ending battle.

In one corner, we have my convictions that they will be physically, intellectually and emotionally healthier if they are given healthy fuel for their growing bodies.

In the other corner we have some really strong opponents.  Taste buds that are motivated by sugar and salt and a food industry that has decades of research on how to make the foods they sell taste best to consumers. Confusing information about nutrition and food guidelines from the government, industry and doctors. Fatigue, stress and hungry kids. (I dare you to have no plan and quickly come up with healthy food options for kids who are melting down. Try offering them a salad instead of granola bars, and see what happens.)

So recently I had my own mini-crisis. I’ve been happily plant-based for two years, but then read a book by a well-known MD and started questioning. Maybe animal products aren’t so bad. Maybe a couple of cage-free, organic, pastured eggs for breakfast every day would be good for me. Maybe bacon, chicken and beef aren’t so bad. It’s fascinating to me how quickly my brain is able to adapt it’s views of what is and is not healthy. However within two weeks of adding back meat and more eggs my acid reflux, constipation and generally feeling poorly was back.

I connected with some other MDs, and asked their opinions re: the theories put forth by Dr. X, and the responses ranged from “that doesn’t sound right to me, there is a lot of research to the contrary” to “This is simple. This particular doctor is motivated by making profits and selling books and supplements.”

How Not To Die.jpgI’ve discovered that what I feed my brain is as important as what I feed my body. And I’ve got some new food for my brain. The book “How Not to Die” by Dr. Michael Greger. I was extremely pleased that in the forward of his book he notes that all of his speaking fees and book profits go to charity. I was more pleased at the solid research he uses to inform his advice. And I’m even more pleased that after a week of returning to a whole-foods, plant-based diet I feel more energetic and my abdominal symptoms are completely relieved.

So, for my kids, I’m back in the ring and ready to fight. This morning I won two out of three matches (kids) with Chocolate* Pancakes.

The * is for the hidden ingredients… whole-grain flour, about 3 cups of spinach, 3 tablespoons of ground chia seeds, two cans of  organic coconut milk.

I’m not a chef, and I’m confident others could improve on my recipe. Especially since I’m not big on measuring, I’m more of a “concept cook”.

Blended Spinach and Cocoa
Chia “eggs”
Chocolate* Pancake Batter

But in case you want to give it a go, here’s the approximate recipe:

  • 1 tub organic spinach, blended in vitamix with 1-2 cups water
  • 3-4 tbsp chia seeds, ground and mixed with about 3/4 cup of water to make a goopy paste (egg substitute)
  • 2-3 cups whole-grain flour (I used wheat)
  • About a cup of baking cocoa
  • About a cup of coconut sugar
  • 2 tbsp baking powder
  • 1 tsp baking soda
  • Two cans organic full fat coconut milk
Blended Spinach and Cocoa
Chia “eggs”
Chocolate* Pancake Batter

Mix everything well to pancake batter consistency. You may need to add more or less water or flour. Cook on a griddle like regular pancakes, although these are slightly more delicate conventional pancakes. Top with strawberries. Or (sigh) jam.  Because to win the war, I’m going to need to compromise on a few battles.

Plants for the Long Haul

Posted on by Rebecca Dale, MD

Screen Shot 2017-10-09 at 11.03.23 PMYesterday was a sunny day in Chicago, and I experienced first-hand the exuberance of Chicago marathon spectators on a 26.2 mile tour of this city.  This was the sixth marathon I’ve run, and even though it wasn’t my fastest, I think it was my best.  For the first time, I completed the course giving it my sustained effort without succumbing to fatigue and walking because I just didn’t have it in me to keep running.  This also happens to be the first marathon I’ve run since evolving to a whole-foods, plant-based (WFPB) diet.

I became vegetarian two years ago, felt an improvement in well-being, and then reverted to a more conventional American diet last winter.  In February I finished my fifth marathon.  I just edited my word-choice there, changing “ran” to finished.  This marathon, physically speaking, was my worst.  I didn’t train because of chronic injuries and frankly just feeling blah.  So I ran about half of it, and walked the other half.  Shortly after that, I made the transition to a whole-foods, plant-based diet.

So yesterday, in Chicago, I had trained.  My chronic injury was still an issue, but it felt reasonably good.  My stomach felt good, the weather was clear, and the energy from the other 39,999 runners was infectious.  I was cautiously optimistic that I might be able to run the whole thing, despite the inevitable deviations I had made from my training schedule.

In the first miles I remembered the classic marathon advice not to start out too quickly.  I ran comfortably but steady and found the first five miles passed easily.  At 10 miles, my injury — plantar fasciitis — started acting up a bit, but my legs still felt strong. And that’s when I realized that my body felt better in this marathon than it had in the past three.  Although fatigued, I was buoyed by the impression that my body was working more effectively because I was fueling it better.  Success in any endeavor is due to a complex mixture of circumstances.  But one important factor in my personal success yesterday has been the change in my diet.

Friends who find out I’m WFPB/vegan frequently voice concerns about the importance of protein and meat in their diet.

  • “My body just really loves a good steak.”
  • “I could never do that, because I know I don’t feel good when I don’t get enough protein.”
  • “I tend to be anemic, so I have to eat red meat.  When I get really tired, I know that’s what I need.”

I don’t presume to tell these friends what food choices they should make any more than I would tell them who to have a relationship with or what career they should pursue.  However, in my reading – which is admittedly biased thus far towards authors who endorse a whole-foods, plant-based diet – suggests to me that these ideas are rooted in some of our cultural associations between meat and strength, and not necessarily in rigorous scientific study.

My original inspiration to pursue a WFPB diet actually came from an athlete:  Scott Jurek.  In his book “Eat and Run” he details the relationship in his own life between WFPB eating and his extremely successful career as an endurance athlete.  He has had many running achievements, including winning the Western States 100 mile endurance run seven times.  A second athlete who spurred me on my journey was Rich Roll, who’s book “Finding Ultra” details his transformation from fatigue, depression, excess weight and poor health to a transformation that began with what he calls “plant-powered” eating.  In his case, the changes in his diet came first.  He felt so much better with these diet changes that he then took up running, and eventually evolved into a world-class ultra-endurance athlete.  Let me spell out for you what ultra-endurance means.  One of his feats is competing in the Ultraman World Championships.  Powered only by plant-based nutrition, he completed the three-day event consisting of a 6.2 mile ocean swim followed by a 90 mile cross country race on the first day.  The second day is a 170 mile cycling race.  The final day is 52 miles of running.  These types of distances sound super-human to me.  But I find Rich Roll inspiring in part because his changes started when he was out-of-breath simply climbing up the stairs in his own home.  He cites plants, rather than steaks, as the key to his success.  Running happens to be my preferred sport, but what about other sports?  A quick web search will yield names of athletes from mixed marital arts cage fighting to power lifting to figure skating who have succeeded and choose a plant-based diet for fuel.

So what about my assertion above, that the idea that meat and lots of protein are required for strength and energy is not based on rigorous scientific study?  Stay tuned for the next post.

Chick-in-Salad

When I was in college, I created this meal I called “cheesy egg pancakes.”  It was sort of half-omelette, half-pancake with a few slices of cheese melted on top.  The reason this became a favorite for me was simple:  I could whip it up without a recipe, with ingredients that were easily on hand, and it was quick and filling when I was hungry.

I think most people have at least 2-3 “memory meals.”  Quick dishes they can whip up without cracking open a cookbook or thinking carefully and shopping for unusual ingredients.  With new recipes, I always find that I need to expend some amount of mental effort to monitor and follow new directions.  Did I add enough flour?  Wait, how long am I supposed to saute this ingredient?  But those memory meals — grilled cheese, macaroni and cheese, a bowl of cereal, spaghetti with meat sauce — these ones become staples in our diets because of how little effort it takes to whip them together.

Often, when people hear that I follow a plant-based diet, they comment how hard it sounds to follow this new and strange way of eating.  However, I think success is linked to practice, and one key is to develop a few easy meals you can make without much effort.  When you’re hungry, you don’t want to spend 30 minutes exploring a half-dozen websites, you want to just open your fridge, pull out a few things, and happily munch away in less than 10 minutes.

With this in mind, I’ll share my new favorite easy-to-make-it-from-memory staple:  Chick-in-Salad.  The Chick is for chick-peas, and the process it pretty simple and adaptable to your tastes.  That’s what I love about this recipe:  once you’ve made it a few times, you can easily recreate it from memory, and adapt it to both what you have on hand and your personal tastes.  The recipe I have listed below is adapted from Angela Liddon’s blog “Oh She Glows.”  Here is a link to the original recipe.  Her original recipe is delicious, but what I really love about this — now that I have made it a few times — is how easy it is to make and adapt without a lot of thinking.  That’s why my version has so many optional ingredients — they are all for flavor for your personal taste.  Start with the basics:  chick peas and vegenaise, and it’s unconsciously easy to go from hungry to chick-in-salad sandwich in about 10 minutes.  Yum!

Some readers may be wondering if this is really any healthier than chicken salad.  It’s a valid question, and the short answer is YES.  Chick-in-salad has more fiber, less calories, and no cholesterol.

Let’s look at the two basic ingredients that make up the bulk of the recipe

Vegenaise vs. Mayonaise:  1 tablespoon of Vegenaise has 45 calories, 3.5 grams of mono-unsaturated fats and 0.5 grams of saturated fats, and no cholesterol.  Compare this with one tablespoon of mayonaise:  94 calories, 1.6 grams of saturated fat, 2.3 grams monounsaturated fat, 6 grams of polyunsaturated fat, 0.026 grams of trans fatty acids and 6 grams of cholesterol.  Overall, the mayonnaise packs in a lot more calories, and a lot more unhealthy fats.  Vegenaise is still primarily a fat, though, and should be eaten sparingly. 

Chick Peas vs. Chicken:  1 15-oz can of chick peas (about 1.75 cups) contains 130 calories, 5 grams of fiber, 7 grams of protein, 1 gram of fat (no saturated or trans fat), and 21 grams of carbohydrates.  It also provides a fair amount of folate, along with magnesium, phosophorous, zinc, iron and calcium.  About 1.75 cups of roasted, skinless chicken breast contains 404 calories, 76 grams of protein, 2.5 grams saturated fat, 3 grams monounsaturated fat, 1.9 grams polyunsaturated fat and 208 mg of cholesterol.  I was surprised to find that chicken also contains some calcium, magnesium, iron and phosphorous although the chick peas were a much better source of these minerals.

Print Recipe
 Chick-in-Salad
Learn to substitute chick-peas for your favorite chicken or tuna salad recipe.
Servings
Ingredients
Servings
Ingredients
Instructions
  1. Drain and rinse chick peas. Dump entire can into food processor and process until the mixture is even crumbles.
  2. Transfer chick peas to a medium mixing bowl, add additional ingredients and stir to mix well. That's it.
Recipe Notes

If you'd like to try with cashew cream, rather than vegan mayonnaise, here's a link to a good basic cashew cream recipe from Meg van der Kruik at her blog "this Mess is Ours."  Cashew cream is great to have on hand and works in a variety of different recipes, but takes some advanced planning to soak the cashews.

I make this when I'm hungry for a quick and filling sandwich, and keep the extra in little glass jars in the fridge.  I've never had it stick around longer than a few days because it is so delicious and easy to use on top of spinach, in sandwiches, scooped up with crackers ... but it should keep for 4-5 days in the refrigerator.

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Can Food Choices Help Prevent Cataracts?

Posted on by Rebecca Dale, MD

Friends, this is a pretty long post.  But here’s the speed version:

Eating a vegetarian or vegan diet, especially with a high dietary intake of fruits, vegetables and leafy greens, is correlated with a lower incidence of cataracts.

Want to understand the details?  Read on …

Continue reading Can Food Choices Help Prevent Cataracts?

Humpty Dumpty had a Great Fall

Posted on by Rebecca Dale, MD

In the past two months since I’ve had the opportunity to fully embrace a whole-foods plant based diet, I’ve loved getting questions from friends and coworkers.  Yesterday, a woman who fits both categories looked up with a curious expression and asked

“So, you don’t eat any eggs?”

“Nope.”

“But how?  I don’t think I could live without eggs.”

Let me introduce you to two new staples in our pantry:  flax eggs and chia eggs.

chia egg
Chia seed eggs have a fun viscosity too them … they gel up and bind together.

The concept is pretty simple, and if you google it you’ll find several blogs that have recipes and instructions.  But it’s not difficult.  Simply mix one tablespoon of either flax meal or ground chia seeds with 2.5-3 tbsp of water.  Stir it a bit.  Let it sit for a few minutes.  And voila!  You have a plant-based “egg”.

You can substitute this for eggs in most recipes for baked goods.  (reality check:  you cannot make a reasonable souffle or an omelet out of these.  There are recipes for plant-based versions of these foods, but the flax or chia egg really shines in recipes like pancakes, muffins, bread, or cookies in which the egg is in more of a supporting rather than a starring role.)

Right now, eggs are enjoying a bit of a resurgence in popularity after many years of a bad reputation due to high cholesterol.  Eggs have also gone hipster.  Do you want Omega-3?  Pasture-raised?  Organic?  Cage-free?  Brown?  White?  Non-GMO?  All-natural?  My friends, there are a lot of folks marketing the improved nutritional content and health benefits of the humble egg.  But let’s compare the nutritional profiles of one large chicken egg vs. these easy and cheap plant-based eggs (nutrition information source:  www.nutrition.gov).

Chicken Egg (1 large)Flax EggChia Egg
Ingredients1 egg1 tbsp flax meal
2-3 tbsp water		1 tbsp ground chia seed
2-3 tbsp water
$$$ cost per one egg
$0.19 - $0.58$0.04$0.25
Total Calories72
3550
% calories from fat59%58%
57%
% calories from protein35%17%14%
% calories from carbohydrate
6%25%29%
Fiber01.5g3.5g
Protein6.28g1.50g
1.69g
Fat4.75g2.25g
3.14g
Cholesterol186g
0.000.00
saturated fatty acids1.563g0.00g
0.340g
mono-unsaturated fatty acids1.829g
0.500g0.236g
polyunsaturated fatty acids
0.956g1.50g2.414g

So what can we learn from our comparison?

  • Flax eggs are significantly cheaper than chicken eggs.  Chia eggs were about the same cost or cheaper (depending on how hipster you like your eggs).  $0.19/chicken egg was the price for regular ol’ white eggs – not cage-free, organic, high Omega-3 or other.
  • There is no cholesterol in plant-based eggs, because there is no cholesterol in plants.  Our bodies have the ability to make all of the cholesterol we need, so there is no need to ingest it.
  • Animal eggs are much higher in protein than either flax or chia eggs.  Currently it is in vogue to add (unecessary) protein to foods and snacks, but in actuality it is exceedingly rare (essentially only if you are not eating enough calories overall) to be protein deficient in the United States.  If this statement seems controversial or incorrect to you, I’d heartily recommend the book “Proteinaholic” by Garth Davis, MD, which is an extremely well-researched, logical and scientific perspective on the role of protein in our diets.
  • Plant-based eggs both contain fiber, which (as opposed to protein) is significantly lacking in the standard American diet.
  • Chicken eggs and plant-based eggs all had close to 60% of their calories from fat.  But all fats are not equal, and do not have the same effects in our bodies.  I’d like to highlight the following statements from Nutrition.gov.

    “When eaten in place of saturated fat, monounsaturated and polyunsaturated fats can lower the levels of total cholesterol and low-density lipoprotein (LDL or “bad”) cholesterol in the blood — which, in turn, can reduce the risk of developing cardiovascular disease. Cardiovascular disease is the leading cause of death in both men and women in the U.S.  The Dietary Guidelines for Americans recommends consuming less than 10% of your calories per day from saturated fat by replacing saturated fat with monounsaturated and polyunsaturated fats.”

    (I selected this source, in part, because it is advice vetted by the FDA and not endorsing a specific eating pattern.  The recommendation to replace saturated fats with mono- and polyunsaturated fats is a generic and non controversial recommendation that is not specific to those endorsing a whole-foods, plant-based diet).

So let’s go back to the idea of the hipster eggs.  In essence, these are products designed to increase the nutritional value of the egg, balancing out against its negatives (like saturated fat and cholesterol).  But wouldn’t it be easier to simply eliminate those negatives?  The wording from the FDA — again, because it is Federal the language must satisfy a wide diversity of opinions — is not “to balance out saturated fats, eat more mono- and polyunsaturated fats”.   They are clear about using the word replace.  Avoid saturated fat, eat more mono- and polyunsaturated fats.     Rather than balancing out a slice of pound cake with an omega-3 supplement capsule, I’ll continue to make baked goods for my family that skip the cholesterol and saturated fat, but none of the flavor.

If you’re intrigued by this idea and haven’t tried making flax or chia eggs previously, let me encourage you to dive in!  Take your favorite recipe and replace one or two of the eggs with a flax or chia egg, and see how the recipe is altered.  Be brave and experiment – it’s just cooking, not defusing a bomb.  I tried to make one of our traditional family favorites — dutch babies — with plant-based eggs.  Total fail.  But with every fail I learn a little something, and cooking techniques that seemed odd or difficult at first are quickly becoming second nature.

Here’s to you and your health!

 

Makeover: “Camping” Oatmeal

Posted on by Rebecca Dale, MD

My husband grew up calling oatmeal that was pre-flavored in little packets “camping oatmeal.”  I’m not sure if it was a special treat that they only got to eat when camping, or if it was just convenience for camping.

My kids love camping oatmeal.  They especially love the little packets that have dinosaur eggs in them.   Have you tried this flavor?  On the Quaker website, it notes “Dinosaurs may be extinct, but warm up Quaker® Dinosaur Eggs® and fun dinosaur shaped pieces appear right before your eyes! It’s a morning adventure filled with the sweet flavor of brown sugar and 100% whole grain Quaker® oats.”  In the oatmeal are little white “eggs” that dissolve and have small crunchy-sugary-brightly colored dinosaurs within.  Spoiler alert:  dissolving sugar eggs with colorful crunchy dinosaurs do not occur in nature. However, for this “makeover” I wanted to compare apples to apples.  Literally.  Quaker Instant Apple Cinnamon Oatmeal to my homemade versions.

The idea of pre-flavored oatmeal at home isn’t a new one.  Searching for the phrase “make oatmeal packets at home” turns up a variety of  ideas and recipes to try.  The goal of my makeover was to see if I could meet these standards:

  1. move the kids towards whole foods and away from processed foods
  2. lower cost than commercial options
  3. convenient and easy

So let’s see how I did.

Camping Oatmeal: Store vs. Home

Quaker Instant Oatmeal: Apples and CinnamonDocsKitchen Version: Apples and CinnamonDocsKitchen Version: PB2 and Chocolate ChipDocsKitchen Version: "Mom's Oatmeal"
IngredientsWHOLE GRAIN ROLLED OATS
SUGAR
DEHYDRATED APPLES (TREATED WITH SODIUM SULFITE TO PROMOTE COLOR RETENTION)
NATURAL AND ARTIFICIAL FLAVOR
SALT
CINNAMON
CALCIUM CARBONATE
CITRIC ACID
GUAR GUM
MALIC ACID
NIACINAMIDE*
REDUCED IRON
VITAMIN A PALMITATE
PYRIDOXINE HYDROCHLORIDE*
RIBOFLAVIN*
THIAMIN MONONITRATE*
FOLIC ACID*
CARAMEL COLOR		1 cup Quaker Old Fashioned Oats
1 tsp cinnamon
2 tbsp (~6 gm) freeze dried apples
2 tbsp brown sugar		1 cup Quaker Old Fashioned Oats
2 tbsp PB2 powdered peanut butter
2 tbsp semi-sweet chocolate chips*		1 cup Quaker Old Fashioned Oats
1 tsp cinnamon
2 tbsp (~6 gm) freeze dried apples
1 tbsp brown sugar
1 tbsp whole chia seeds
1 tbsp flax meal
2 tbsp raisins
Sugars 36g (3 packets)32g
(2g oats)
(5g apples)
(25g brown sugar)		19g
(2g oats)
(1g PB2)
(16g chocolate chips)		35.5g
(2g oats)
(5g apples)
(12.5g brown sugar)
(14g raisins)
Fiber12g (3 packets)9.25g
(8g oats)
(1.25g apples)		10g
(4g oats)
(2g PB2)		21.25g
(8g oats)
(1.25g apples)
(10g chia)
(2g flax)
(2g raisins)
Protein12g (3 packets)10g15g
(10g oats)
(5g PB2)		13.5g
10g (oats)
2g (chia)
1.5g (flax)
$$$$0.75
(box of 10=$2.50)		$1.40
($0.18 oats)
($0.12 cinnamon)
($1.06 apples)
($0.04 brown sugar)		$0.74
($0.18 oats)
($0.41 PB2)
($0.15 choc chips)		$1.78
($0.18 oats)
($0.12 cinnamon)
($1.06 apples)
($0.02 brown sugar)
($0.25 chia seeds)
($0.04 flax meal)
($0.11 raisins)

All of this comparison was REALLY time consuming, but also very informative.  Here’s my takeaway points:

  • I compared 3 packets of instant oatmeal to the large-portioned mixes I made, because this reflects what my kiddos (esp. the oldest) actually eat.  I’d always thought that I must be spending a ton of $$ since they went through it so quickly, but it turns out that freeze dried apples are really expensive.  If this was a staple in your home, it would make sense to look for deals on this ingredient.  Or alternatively, do what I usually do … cut up about 1/2 of an actual apple and toss it on top to cook along with your oatmeal.  I usually slice up the rest of the apple and put it out on the table for kiddos to much some whole fruit along with whatever else they are having.
  • Oats have a fair amount of protein.  I created the PB2 and chocolate chip flavor in part to make it fun for the kids (what kid is going to turn down chocolate chips for breakfast?) and in part to add some protein.  Turns out the oats are a pretty good protein source all on their own.  They absolutely love this flavor, though, so I’m looking forward to experimenting with cacao nibs instead of chocolate chips.
  • Chia seeds and Flax meal really are good additional whole food ingredients to add.  And guess what?  All of the oatmeal packs I made have been eaten up by kiddos, and they ate up the “mom’s” packets too, with no complaints about flax and chia or funny textures.
  • When we talk about the evils of “added sugars” in our foods, it applies to how we cook at home, too.  I thought I was being only moderately generous with the amount of brown sugar (for kid appeal), but it really was a lot of added sugar.  I’ll be ratcheting that down with the next batch (but slowly, since I’m sneaky and I don’t want them to notice).
  • Having pre-made oatmeal packets was super convenient.  The kids gobbled them down in a few days, and it was lovely to just toss the ingredients in a bowl, add water and microwave them.  Sure, it’s not hard to pull out brown sugar and raisins and cinnamon and slice an apple each morning … but it was definitely easier to have all of those steps done ahead of time. 
  • The Quaker instant oatmeal packets had a variety of funny sounding ingredients, but many of these were added vitamins.  The benefit of supplemental vitamins in our foods may be questionable.  I would vastly prefer my family obtain their vitamins through eating a variety of fruits, vegetables, whole grains and legumes rather than supplements.  I have no axe to grind with that friendly looking Quaker oatmeal guy, though.  The oats I used for my packets were the Quaker 100% whole grain old fashioned variety, and I love the ingredient list for these:  Whole Grain Rolled Oats.  That’s it.

With all of this in mind, here’s what I’d recommend as my “ideal” oatmeal:

  • 1 cup oats
  • 1 tsp cinnamon
  • 1 tbsp flax meal
  • 1 tbsp chia seeds
  • 2-4 tbsp raisins or other dried fruit (without added sugars)
  • limit any additional brown sugar or other sweeteners to 1-2 tsp

Have a comment or an idea?  Share it!

 

 

 

Who’s Right, Anyway?

Posted on by Rebecca Dale, MD

Next week, I’m joining a group of women for an informal pot-luck/cooking club.  The idea is pretty straightforward.  Pick a theme each month and bring a dish to share.  The reality isn’t so straightforward.

Julia is gluten free.  Marly is on an anti-inflammatory diet.  I’m whole-foods-plant-based, a.k.a. vegan.  Sarah is low-carb, but does eat some gluten.  Pauline is Paleo.  Melissa is starting Whole30 next week.

What the what?  When did food get so complicated?  Humans have been eating as long as there have been humans.  It’s a luxury to have the option to be so selective about what we eat.  In the past two months that I’ve been WFPB, I can say absolutely that I have noticed positive changes in my health, my energy level and my weight.  But I’m equally sure that within shouting distance of our home I can find a dozen fierce advocates for a smorgasbord of different diet plans.  Each of these individuals has their own success story, and each of them have made choices based on what seems logical and feels right to them.

So what to do?  Is there one right answer?  I’m a neophyte to the nutrition literature, but I was impressed this week by an article that my hubby passed along to me.

“Association of Changes in Diet Quality with Total and Cause-Specific Mortality” by Mercedes Soto-Prieto Ph.D. at al, published in the New England Journal of Medicine this past week.  The crux of the article was to look at the effect of “diet quality” on a very large pool of research subjects — more than 73,000 — on their overall risk of death.  There are a few things I like about this study.

First, they looked at overall risk of death, not intermediate endpoints like serum cholesterol or bone density.  Many studies use these intermediate endpoints — like cholesterol — because they’ve been associated with a higher risk of, for example, a heart attack.  Things can get muddy with secondary endpoints, because they don’t have a 100% correlation with the things we truly care about.  But dying, well that’s an endpoint that pretty much everyone can agree is important.

Second, they focus on dietary patterns, rather than single nutrients.  The foods we put in our mouths each day are incredibly complex.  How our bodies process these foods, and how these foods interact with each other as we digest them adds infinite layers of complexity.  Add in the variation between different people’s food choices, and the complexity becomes immeasurable.  It’s not realistic to, say, have study group A eat nothing but oatmeal three times daily for fifteen years, and study group B eat nothing but eggs.  To find relationships between our health and what we eat, we’re going to have to look at patterns that arise from complex systems.  But I appreciate that rather than trying to focus on single nutrients or food classes, the authors of the study tackled the whole messy complexity of dietary choices.  In fact, they used three different measures of dietary quality:  the Alternate Healthy Eating Index, the Alternate Mediterranean Diet Index and DASH (Dietary Approaches to Stop Hypertension) diet score.  I would have loved to see a measure that included subjects who followed a WFPB diet, but I can appreciate their rationale of using measures that could be applied to a large number of subjects.

So shall we cut to the chase?  Participants who had the greatest improvement in diet quality in the 12-year period of the study had an 8-17% decrease in risk of death.  “Common food groups in each score that contributed most to improvements were whole grains, vegetables, fruits and fish or n-3 fatty acids.”  From the data, the authors extrapolate that “an increase in consumption of nuts and legumes from no servings per day to 1 serving per day and a reduction in consumption of red and processed meats from 1.5 servings per day to little consumption will result in an improvement of 20% in the [alternate healthy eating index] score,” which could reduce your risk of death by nearly 20% in the subsequent 12 years.

The take-home points from this study:

  • Eat more vegetables and fruits.
  • Choose whole grains rather than processed grains
  • Increase your consumption of nuts and legumes and decrease your consumption of red and processed meats.

It’s just one study, and it’s not enough to answer which of my friends at the potluck really has the best diet plan.  But it’s enough for me to continue to enjoy my WFBP diet with gusto, and happily bring a dish with vegetables, whole grains and legumes to share, wishing each of these women great health.

 

The Root of Doc’s Kitchen

Posted on by Rebecca Dale, MD

In 2016 I woke up. I was tired, stressed out and unhappy with my health and energy level.  The previous ten years of a busy but sedentary life were taking their toll.  As a medical doctor, I assumed I had the tools to change my life.  Begin exercising.  Eat a more healthful diet.  Get eight hours of sleep.  This was step one.  I began running (again) and embraced a vegetarian diet and cut out desserts.

That first year had it’s ups and downs.  I lost 35 pounds and completed two marathons.  But inevitably, I ran out of will power and a chronic injury flared up which sidelined my running.  My diet fell apart and my weight crept back up by 15 pounds.

For inspiration, I listened to two books “Eat and Run” by Scott Jurek, and “Finding Ultra” by Rich Roll.  Both of these extreme endurance athletes embraced a vegan diet and wrote passionately about how their diet has fueled their success as endurance athletes.  Intriguing, but … my family eats meat and dairy.  I love cheese, and yogurt, and ice cream.  It’s just a little too extreme.  And then I remembered another book, The China Study by T. Colin Campbell.  I will be eternally thankful to a good friend who recommended this book to me, three years before I actually listened to it.  As I listened, I was aghast at the information presented.  As an ophthalmologist, I was well aware of the links between a poor diet and eye diseases.  Little did I know that when I smilingly earned my medical degree from the University of Minnesota in 2000, my understanding of nutrition and disease was frankly fairly rudimentary.  Dr. Campbell presents a synopsis of decades of research that are a compelling case that all of us should be on a whole foods plant based diet.  Not just to control obesity, but as an effective treatment for diabetes, heart disease, cancer prevention and much more.

I am now three weeks into a whole foods, plant-based diet.  My energy level is back up, I am running better than ever, and along with the help of my physical therapist my chronic injury is under control.

This is a long introduction to what Doc’s Kitchen is all about.  But here’s the deal.  I want to invite you along on a journey, and there are going to be some challenges.

  • My supportive husband is also wonderfully skeptical.  Is a whole foods, plant-based (WFPB) diet really the cure for what ails our patients?
  • My three children are like many kids:  picky eaters.  Most nights it is easier to put chicken nuggets or corn dogs on the table then try for the 300th time to get them to eat something healthier.
  • Just like everyone else, we are a busy family.  It just isn’t likely that I’m going to grow my own organic vegetables in the back yard and then spend 90 minutes preparing a meal from scratch.

So I’m inviting you into our kitchen.  Pull up a chair and let’s chat about what’s for dinner tonight, how I’m doing with getting moving the kids towards a WFPB diet, and consider available research.

Disclaimer:  I am not a nutrition specialist, and the information I present on this blog is not intended to substitute for medical advice.  What I am is an informed friend, who would like to help you benefit from what I am learning on this journey.