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A New Approach to
Food and Health
Neal Barnard, MD
President, Physicians Committee for
Responsible Medicine
Adjunct Associate Professor of Medicine
George Washington University School of
Medicine
A Lesson from Japan
Diabetes Prevalence in Japan
In adults over age 40:
Prior to 1980:

1-5%

Kuzuya T. Prevalence of diabetes mellitus in Japan compiled from
literature. Diab Res Clin Practice. 1994;24 Suppl:S15-S21.
Rising Fat Intake in Japan
Fat (grams/day)
60
50
40
30
20
10
0

1955

1965

Murata M. Am J Clin Nutr 2000;72(suppl):1379S-83S.

1975

1985

1994
Falling Carbohydrate Intake in Japan
Carbohydrate (grams/day)
430
400
370
340
310
280
250

1955

1965

Murata M. Am J Clin Nutr 2000;72(suppl):1379S-83S.

1975

1985

1994
Overweight and Obesity in Japan
Prevalence in Men
%
%

%

%

BMI 25-29.9
BMI ≥ 30

%

%

Yoshiike N. Obes Rev 2002;3:183-90.
Yoshiike N. Asia Pac J Clin Nutr 2002;11(Suppl 8):S727-31.

%
Diabetes Prevalence in Japan
In adults over age 40:
Prior to 1980:
By 1990:

1-5%
11-12%

Kuzuya T. Prevalence of diabetes mellitus in Japan compiled from
literature. Diab Res Clin Practice. 1994;24 Suppl:S15-S21.
A Lesson from the U.S.
U.S. Per Capita Meat Intake (lb)
2004
201.5 lb

220
200

2010
188.8 lb

180
160
140

1909
123.9 lb

120
100
80

(Includes red meat, poultry, and fish)

60
40
20
1900

1920

1940

1960

1980

2000

Source:US Department of Agriculture, Economic Research Service,
http://www.ers.usda.gov/Data/FoodConsumption/FoodAvailSpreadsheets.htm#mtpcc,
accessed August 15, 2009.
U.S. Per Capita Chicken Intake (lb)
2006
60.9 lb

60

2010
58.0 lb

50
40
30

1909
10.4 lb

20
10
0
1900

1920

1940

1960

1980

2000

Source:US Department of Agriculture, Economic Research Service,
http://www.ers.usda.gov/Data/FoodConsumption/FoodAvailSpreadsheets.htm#mtpcc,
accessed August 15, 2009.
Diabetes Prevalence 1994
Diabetes Prevalence 1995
Diabetes Prevalence 1996
Diabetes Prevalence 1997
Diabetes Prevalence 1998
Diabetes Prevalence 1999
Diabetes Prevalence 2000
Diabetes Prevalence 2001
Diabetes Prevalence 2002
Diabetes Prevalence 2003
Diabetes Prevalence 2004
Diabetes Prevalence 2005
Diabetes Prevalence 2006
Diabetes Prevalence 2007
Diabetes Prevalence 2008
Adventist Health Study – 2
60,903 participants, aged ≥30, enrolled 2002-2006

Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of type 2
diabetes. Diabetes Care 2009;32:791-6.
European Prospective Investigation
into Cancer and Nutrition (EPIC)
N = 37,875; aged 20 – 97; enrolled 1993 - 1999

Spencer EA, et al. Diet and body mass index in 38,000 EPIC-Oxford meat-eaters,
fish-eaters, vegetarians, and vegans. Int J Obesity 2003;27:728-34.
Weight-Control Study
64 women
Moderately to severely overweight
Post-menopausal
Weight-Control Study
Low-fat vegan diet
No exercise
14-week study
Typical Day’s Meals
Breakfast
Blueberry pancakes
or Oatmeal with cinnamon and raisins
Half cantaloupe
Rye toast with jam
Lunch
Chunky vegetable chili
Garden salad with sesame dressing
Snack
Banana
Dinner
Lentil soup with crackers
Linguine with artichoke hearts and seared oyster mushrooms
Steamed broccoli
Weight-Control Study
Low-fat vegan diet
No exercise
14-week study
Weight-Control Study
Low-fat vegan diet
No exercise
14-week study

→

13 lb average weight loss in 14 weeks
Sustained weight loss for 2 years
How Does It Work?
Fiber Tricks the Brain
Fiber tells the brain you’re full.
Getting the After-Meal “Burn”
Fat in cells slows your after-meal
calorie burn.
Getting fat out of cells boosts
your after-meal calorie burn.
Body Weight

P-value < 0.0001

Am J Health Promotion, In pre
Waist Circumference

P-value < 0.001

Am J Health Promotion, In pre
PCRM 2009

USDA 2011
Complete Nutrition
Protein
Calcium
Vitamin B12
Beginning a Healthful Diet
Step 1. Check out the possibilities
Foods to Try
Breakfast
Lunch
Dinner
Snack
Healthy Breakfasts
• 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
• Orange-Pineapple Crush
Lunches and Dinners
• Chunky Vegetable Chili
•Chuckwagon Stew
• Seitan & Mushroom Stroganoff
• Portobello Mushroom Steaks
• Oven-Barbecued Tofu Steaks
• Roadhouse Hash
• Sweet & Sour Tempeh
• Southern Beans & Greens
• Seitan Cassoulet
• Mandarin Stir-Fry
• Stuffed Vegetable Rolls
• Zucchini & Herb Calzones
• Chili Bean Macaroni
Italian Cuisine
Mexican Cuisine
Chinese Cuisine
Fast-Food Options

Veggie delight

Bean burrito, hold the cheese
Beginning a Healthful Diet
Step 1. Check out the possibilities
Step 2. Do a 3-week test drive
Optional: Use transition foods
Resources
www.pcrm.org
PCRM.org
PCRM.org
PCRM.org

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Kickstart Your Health

Notas del editor

  1. Age-Adjusted Prevalence of Diagnosed Diabetes per 100 Adult Population, by State, United States
  2. We saw no change in body weight in control group participants, but an average of 11 pound weight loss in participants in the vegan group. 16 control-group participants began the optional program initiated at their site. These participants attended an average of 46% of meetings and lost a mean of 9 lb. Attendance was significantly correlated with weight loss (r = -0.61, P = 0.01). Of participants who attended &gt;50% of meetings (n = 8), mean weight loss was 13 lbs.
  3. As you would expect, waist circumference also decreased in the vegan group – about two inches smaller (or X cm).