Disease prevention

In 2013 Kaiser Permanente endorsed a plant based diet in a report titled “Nutritional Update for Physicians: Plant Based Diets.” In the introduction the authors made this chilling observation:

In the HBO documentary The Weight of the Nation, it was noted that if you “go with the flow” in the US, you will eventually become obese. In 2011, [it was] reported that in some areas of the country, the rate of obesity is 39% and is increasing at a rate of 5% per year. Risks of obesity, diabetes, hypertension, and cardiovascular disease, along with their ensuing complications (eg, behavioral health and quality-of-life problems) often go hand-in-hand and are strongly linked to lifestyle, especially dietary choices. Of all the diets recommended over the last few decades to turn the tide of these chronic illnesses, the best but perhaps least common may be those that are plant based.

Indeed, obesity, diabetes, hypertension, and cardiovascular disease are leading to the early death of millions of Americans and contributing to the rise in health care costs. Much of the problem stems from our diet. This section will focus on the benefits that a plant based diet offers as endorsed by Kaiser.

One note is that the Kaiser Nutritional Update suggested a “plant based diet” should be focused on what it includes, not what it excludes. The definition is: whole-foods, plant-based, low-fat: Encourages plant foods in their whole form, especially vegetables, fruits, legumes, and seeds and nut. For maximal health benefits this diet limits animal products. I recommend you explore the report in full, as there are many peer reviewed clinical trials that indicate that the fewer animal products we eat, the better we are in preventing disease. Below are a few examples.

High blood pressure. Hypertension is a leading risk factor for stroke, heart disease, kidney disease and shortened life expectancy. The condition affects one in three U.S. adults, according to the CDC. In February 2014 the Journal of Internal Medicine reported on a study from scientists in Japan and the United States, in which 39 high-quality, previously conducted hypertension studies from 18 countries, (with a total of more than 21,000 participants) were analysed. The researchers found that people who avoid meat had consistently lower and healthier blood pressure levels.

The full analysis, led by Dr. Yoko Yokoyama of the National Cerebral and Cardiovascular Center in Osaka, Japan, found that meat eaters with hypertension could gain the most by switching to a diet with greater emphasis on fresh vegetables, beans and whole grains. For some study participants, plant-based diets lowered blood pressure better than did prescription hypertension medicine — and without the medication’s side effects.

Diabetes. The Physicians report on a plant based diet referenced above cited a number of studies showingthat those following a vegetarian diet have a lower risk of developing diabetes than nonvegetarians, stating that a “low-fat, plant-based diet with no or little meat may help prevent and treat diabetes, possibly by improving insulin sensitivity and decreasing insulin resistance.” Many studies show an increased risk of type 2 diabetes especially from red meat. For example, researchers as the Harvard School of Public Health found:

The HSPH investigators, led by professor of epidemiology Frank Hu and research fellow An Pan, analyzed data from three longitudinal studies of male and female healthcare professionals who were followed for 14 to 28 years. After adjusting for other risk factors, the researchers found that a daily serving of red meat no larger than a deck of cards increased the risk of adult-onset diabetes by 19 percent. Processed red meat proved much worse: a daily serving half that size—one hot dog, or two slices of bacon, for example—was associated with a 51 percent increase in risk. (The average 10-year risk of getting diabetes for U.S. adults is around 10 percent.)

American Diabetes Association still recommends a diet that avoids “unhealthy fats” but does not emphasize the avoidance of meat and dairy. But a 2006 randomized clinical trial comparing a low-fat vegan diet with a diet based on the American Diabetes Association guidelines showed that “people on the low-fat vegan diet reduced their HbA1C levels by 1.23 points, compared with 0.38 points for the people on the American Diabetes Association diet. In addition, 43% of people on the low-fat vegan diet were able to reduce their medication, compared with 26% of those on the American Diabetes Association diet.”

Cardiovascular disease. According to the CDC, about 610,000 American die of heart disease every year, and high blood pressure and high cholesterol–both associated with a diet high in saturated fats–are major risk factors. The link between a diet high in animal products and heart disease is widely accepted from many studies, and some are trying to find out why, such as a recent study from the  Cleveland Clinic linking it to gut bacteria. Just as important are the studies that show a plant based diet can reverse heart disease. A study published in the Journal of Family Medicine and led by Dr. Caldwell B. Esselstyn, Jr., author of the book Prevent and reverse Heart Disease, included 198 people with documented cardiovascular disease. 177 of themwere able to stick to the diet for an average of almost four years. During that time, only one person had an event (a stroke) that was deemed a recurrence of the disease. In contrast, 13 of the 21 people who didn’t stick to the diet experienced a cardiovascular event. A study from the Harvard School of Public Health also indicated “that a high consumption of plant-based foods such as fruit and vegetables, nuts, and whole grains is associated with a significantly lower risk of coronary artery disease and stroke.”

Obesity. The Kaiser Nutritional Update for Physicians cites a variety of published reports regarding obesity. Summaries of each are as follows:

  • in overweight people, a vegetarian or vegan diet was highly effective for weight loss, independent of exercise, averaging 1 pound per week. Furthermore, the diet caused more calories to be burned after meals “in contrast to nonvegan diets which may cause fewer calories to be burned because food is being stored as fat.”
  • a vegetarian or vegan diet was effective for weight management, and vegetarians or vegans consumed more nutrients than those whose diets included meat.
  • data collected in the 1999–2004  National Health and Nutrition Examination Survey showed a positive association between meat consumption and obesity.
  • a five year study reported a significant difference in age-adjusted BMI, with meat eaters having the highest BMI and vegans the lowest.
  • plant-based diets are low in energy density and high in complex carbohydrate, fiber, and water, which may increase satiety and resting energy expenditure.
  • compared with nonvegetarians, vegetarian children are leaner, and their BMI difference becomes greater during adolescence. Studies of obesity, food groups and dietary patterns indicate that a plant-based diet seems to be a sensible approach for the prevention of obesity in children.

The Obesity Society posted a study that showed weight loss on a plant based diet without the need for calorie restrictions. A 2105 study showed that just increasing fiber brought weight loss without any other changes. This could be good news for those of us who have tried counting calories and fat with little results.

If you are experiencing health challenges related to diet, US News and World Report ranked various plant based diets based on their ability to deliver weight loss, provide good nutrition and safety, and be relatively easy to follow. And Kaiser put out a booklet with helpful information on how to eat a plant based diet that is a little more compact than this website!

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