Plant-based diet

While cardiovascular mortality rates the past decades have gone down, cardiovascular diseases (CVD) has remained the leading causer of death in the United States. Several clinical studies have shown that there is a strong association between dietary patterns and the incidence of CVD, and that people eating predominantly plant-based foods have lower rates of heart disease compared to those on animal-based foods. This does not even include the beneficial anti-cancer effect of plant-based foods and the higher risk for cancer of meat-eaters.

What is a plant-based diet?

The definition varies as there are different forms: 1. Vegetables, fruits, cereal, yogurt, beans, fish, and poultry; 2. Elimination of refined sugars, white flour, and animal oils; 3. Minimal animal products; 4. Seafood, with and without, dairy; 5. Eggs and dairy; 6. No animal products at all (vegan), just ‘plants.’ But the common among them is absence of red meat. The major concern and rationale here is that red meat consumption is linked to cardiovascular diseases and cancer. Those diets, some with multivitamin supplements, have been proven safe and healthy, practiced for centuries in Asia and rural Europe.

Is eating minimal red meat safe?

While eating red meat only once a week is obviously not a plant-based diet, it could be safe among some people, depending on their genetic make-up, metabolism, and lifestyle, especially those who do regimented exercise daily.  Since science still does not know who among us (based on our genes) could safely smoke, eat red meat ad libitum, drink alcohol daily, or not exercise at all, and still not get sick; the prudent health strategy is to minimize or eliminate red meat and high carbohydrate diets, and concentrate on proteins. This might sound against what we learned in the kindergarten and beyond, but clinical evidence today shows the adverse effects of eating carbohydrates (rice, bread, sweets, etc.) and saturated fats (red meats), especially processed meats. All soft drinks are toxic to our body, especially to children. Someday, science would be able to categorize us humans, based on our genetic composition as to who could eat, drink, or use what, and “are immune to their bad (unhealthy) effects, and who would develop major diseases (cardiovascular, metabolic, Alzheimer’s, or cancer) doing the same. That future would be most welcome.

What are the clinical evidences?

“Randomized controlled trials and epidemiological studies indicate that plant-based diets, particularly vegan diets, are associated with significant improvement in CVD events, lowering risk factors such as diabetes and hypertension and decreasing symptomatic and scintigraphic myocardial ischemia and coronary artery disease, as published recently in the Journal American College of Cardiology.

Any other studies supporting plant-based diet?

The data above are supported by many recent landmark reports, including Song et al.’s large prospective cohort study of U.S. Nurses and other health professionals, which shows “higher intake of animal protein (including processed red meat, unprocessed red meat, dairy, poultry, and eggs) was positively associated with mortality, whereas the inverse was true for high intake of plant protein. In another recent meta-analysis, Kwok et al. found similar results with vegetarians experiencing a 29 percent lower risk of coronary heart disease (CHD) mortality relative to nonvegetarians. These findings suggest the importance of protein source and support recommendations to increase plant protein intake, which in turn calls for education of physicians, patients, and the public about the largely unrecognized protein content of plants (e.g., peanuts and beef having the same protein content, 26 g per 100 g).”

What are some actual clinical proofs?

Here are some actual reports from the medical literature that are mind-opening and truly convincing:

“The 16-week randomized controlled trial showed that participants who ate a diet of vegetables, grains, legumes, and fruits significantly improved their overall metabolic condition, say Hana Kahleova, MD, PhD, of the Physicians Committee for Responsible Medicine in Washington, DC, and colleagues. “Our study suggests the potential of a low-fat plant-based diet in diabetes prevention, addressing both core pathophysiologic mechanisms — insulin resistance and diminished beta-cell function — at the same time. The prevalence of diabetes is 46 percent to 74 percent lower in people who eat a plant-based diet compared with meat lovers in the general population.

“Diets rich in plant- vs animal-based monounsaturated fatty acids show significantly lower rates of total and cardiovascular disease (CVD) mortality, particularly when the plant-based fatty acids replace other notoriously unhealthy fats, including saturated or trans fats, as well as refined carbohydrates.

“In the study of more than 63,000 women in the Nurses’ Health Study and nearly 30,000 men in the Health Professionals Follow-Up, an average of 22 years of follow-up showed that a higher intake of monounsaturated fatty acids from plants was associated with a 16 percent lower risk for death from any cause. A higher intake of monounsaturated fatty acids from animals was meanwhile associated with a 21 percent higher risk for death from any cause.

“In overweight adults with no history of diabetes, a low-fat, plant-based vegan diet can reduce visceral fat and significantly improve both pancreatic beta-cell function and insulin resistance, potentially decreasing the risk of type 2 diabetes, according to researchers.”

What is the societal cost-benefit from this diet?

The benefit to society in general of a healthier diet implemented by the people at large is a massive reduction of disease and healthcare-related expenditures, such as for medical consultation, medications, hospitalization, rehabilitation, especially for high blood pressure, diabetes, Alzheimer’s, chronic kidney diseases, stroke, heart failure, and heart attack, which is the case currently almost 60 percent of Medicare beneficiaries. Example: if plant-based diet is adopted, the incidence of hypertension would be reduced to 25 percent of the present rate and save about 30 percent (billions of dollars) of the Medicare budget and reduced sick calls and man power deficit in the work force, besides avoidance of personal and family health problems.

So, what is the healthy strategy?

Turning off the faucet of unhealthy foods that are poison to our body to prevent diseases and maximize longevity makes more sense than mopping up the floor later of major illnesses and premature deaths.

A rational and practical approach is to eat mostly plant foods and push ourselves away from the dining table less than full, as our mothers and grandmothers (with wisdom and foresight, before the informational age of the internet and the world wide web) have been telling us for centuries.

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Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA, a 501(c)(3) humanitarian foundation in the United States. Email: [email protected]

Dr. Philip S. Chua

Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA, a 501(c)(3) humanitarian foundation in the United States.

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