FOOD AS MEDICINE/ MEDITERRANEAN DIET/ PREVENTION/EVIDENCE BASED INTERVENTION/HEALTH/CULINARY/ EDUCATION MEDICAL SCHOOLS CURRICULUM/INTEGRATIVE MEDICINE/PLANT PROTEIN/ WHOLE GRAINS/BIODIVERSITY/SUSTAINABILITY/PROACTIVE/USDA/GUIDELINES/OBESITY/VEGETARIAN/VEGAN/FATS

1. FOOD AS MEDICINE
THE POWER OF THE MEDITERRANEAN DIET
PRESENTED BY CAHMI IN COLLABORATION WITH THE UAMS
INTEGRATIVE MEDICINE INTEREST GROUP
JANUARY 30TH 2016

2. PERFECT STORM
UNIVERSAL
HEALTH
COVERAGE
RISING
INCIDENCE
OF FOOD
ALLERGIES
OPEN DATA
MICROBIOMEAwareness
of food and
health
GMO
TRANSPARENCY
CLIMATE
CHANGE
CELIAC
DISEASE
FOOD
SAFETY
ISSUES

3. PROACTIVE VS ‘RE’ACTIVE MODEL
FOR HEALTHCARE

4. WHO/WHAT DECIDES OUR DIET??
 SOCIAL CULTURAL AND RELIGIOUS FACTORS
 TASTE AND FLAVOR
 BIG FOOD
 COST
 EMOTIONS
 AVAILABILTY
 USDA: SCHOOL LUNCHES. LONG TERM FACILITIES,
HOSPITALS

5. DUAL ROLE OF THE USDA
PROTECT AGRICULTURAL PRODUCERS
AND
MAKE DIETARY RECOMMENDATIONS
TO THE AMERICAN PUBLIC

6. CAN DIET IMPACT THE TOP TEN
CAUSES OF DEATH?

9. USDA MY PLATE

10. HARVARD EATING PLATE

11. WHAT ABOUT MEAT?

12. WHAT ABOUT MILK?
 No evidence that dairy
protects against
osteoporosis
 Possible link to prostate
and ovarian cancer
 Lactose intolerance

13. AND BEANS?
 HIGH IN FIBER
 CHEAP
 PACKED WITH PROTEIN
 LOWERS RISK FOR COLON CANCER, OSTEOPOROSIS AND BREAST
CANCER
 LOW GLYCEMIC INDEX
 VERSATILE
 TASTY

14. EVIDENCE BASED:
MEDITTERANEAN DIET

15. DIETARY TRIBES
 MEAT AND POTATOES
 MEATLESS MONDAYS
 FLEXITARIANS
 CLIMATARIANS/HUMANITARIANS
 VEGETARIANS
 PALEO
 FAD DIETS: ADKINS/ZONE/BEACH BODY/

17. WHY LESS MEAT?
( 99% OF OUR MEAT COMES FROM FACTORY
FARMS)
 ANTIBIOTIC RESISTANCE
 REDUCE THE CARBON FOOTPRINT
 CRUELTY TO ANIMALS
 HEALTH OF FARM WORKERS
 LESS MEAT= LESS DIABETES AND HEART DISEASE

19. COMMON SENSE GUIDELINES
(BRAZILIAN)
1. Prepare meals from staple and fresh foods.
2. Use oils, fats, sugar and salt in moderation.
3. Limit consumption of ready-to-consume food and drink products.
4. Eat regular meals, paying attention, and in appropriate environments.
5. Eat in company whenever possible.
6. Buy food at places that offer varieties of fresh foods. Avoid those that mainly sell products ready for
consumption.
7. Develop, practice, share and enjoy your skills in food preparation and cooking.
8. Plan your time to give meals and eating proper time and space.
9. When you eat out, choose restaurants that serve freshly made dishes and meals. Avoid fast food
chains.
10. Be critical of the commercial advertisement of food products.

20. COMMON MISCONCEPTIONS
 HEALTHY DIET IS EXPENSIVE AND UNAFFORDABLE
 MEAT = PROTEIN
 COOKING IS COMPLICATED AND SHOULD BE LEFT TO
PROFESSIONALS
 HEALTHY FOOD TASTES BLAND

21. THIS IS WHAT A VEGAN LOOKS LIKE

22. (DIVERSITY=RESILIENCE)
BIOLOGICAL SYSTEMS ARE SAME

23. WHAT ARE NUTRIENTS?
MICRONUTRIENTS
Vitamins
Minerals
Water
MACRONUTRIENTS
Carbohydrates
Fats
Proteins

24. WHOLE FOODS PLANT BASED
(WFPB) DIET
 Encourages plant foods in their WHOLE form.
 Whole grains, vegetables, fruits, legumes (beans, peas
and lentils), seeds and nuts.
 Limits animal products (eggs, dairy, fish, meats).

25. MEDITERRANEAN DIET
 Similar to WFPB diet but allows small amounts of animal
products.
 High in fruits, vegetables, whole grains, legumes, nuts, and
seeds. Fat is not restricted.
 Olive oil as an important fat source.
 Low to moderate consumption of dairy products, fish, eggs and
poultry.
 Red meat is rarely consumed.
 Moderate wine consumption.

27. CARBOHYDRATE
Whole food examples
 Grains: wheat, corn, rice, rye,
barley, oats, quinoa, bulger,
oatmeal, popcorn
 Root, tuber, starchy vegetables:
beets, carrots, potatoes, sweet
potatoes, corn
 Legumes (beans, peas, and
lentils): navy beans, split peas
 Fruit
Refined food examples
 Grains: White rice, white bread,
grits, couscous, regular pasta,
pretzels
 Other: Coke, candy, cake, cookies
ice cream, chips etc.

28. WHOLE GRAIN
 The bran is the outside layer where most of
the fiber exists.
 The germ is the inside layer where many
nutrients and essential fatty acids are found.
 The endosperm is the starchy middle layer.
 When grains are milled, you are left with only
the endosperm. In doing this, you take out
the majority of the nutrients.

29. CARBOHYDRATES
Refined grains
 Little nutritional value
 High glycemic index
 Linked to GI issues
 Linked to weight gain
 Less satiety
Whole Grains
 More nutrition: Unsaturated fatty acids,
fiber, vit E, vit B6, magnesium, zinc,
potassium, calcium, phosphorus, iron
 Lower glycemic index/help regulate
blood sugars
 Promote a healthy GI tract
 Blood pressure and cholesterol
lowering benefits
 Promote satiety

30. PROTEIN
 “Complete” proteins: animal sources. Contain all essential amino
acids.
 Poultry, pork, chicken, fish, eggs, dairy.
 “Incomplete” proteins: plant sources. Lacking in 1+ essential amino
acids.
 nuts and seeds, legumes (beans/lentils/peas), and even whole
grains.
 Complementary proteins: Most plant foods are not “complete”
proteins. However, eating a wide variety of plant foods will ensure you
get all of the necessary amino acids to fuel your body.

31. COMLIMENTARY PROTEINS

32. PLANT BASED VS ANIMAL PROTEIN
 Protein=meat, meat=protein??
 Red and processed meat has been linked to high risker of
CVD, type 2 DM, cancer, and osteoporosis.
 A diet high in vegetable protein has shown CVD benefit.
 A well-balanced, plant-based diet will provide adequate
amounts of essential amino acids and prevent protein
deficiency.

33. PROTEIN
Plant
 Linked to longevity (lower
incidence of CVD, DM,
cancer)
 Incomplete protein
 Sustainable/Cheap
 Nitrogen fixing
Animal
 Linked to CVD, DM,
cancer
 Complete protein
 Less sustainable
(environmental impact)
 Animal well-fare

34. FATS
 The problem with fats has more to do with the TYPE of fat you
eat rather than the QUANTITY.
“Best” fats:
Nuts/seeds
Olive oil
Avocado oil
Coconut oil
“Okay” fats:
Organic canola
Butter (grass fed,
organic)
Ghee
Lard
“Bad” fats:
Vegetable oil
Corn oil
Trans fats
Soybean oil
Cottonseed oil
Canola oil

35. FATS IN THE MEDITERRANEAN DIET
 This is not a low fat diet- may comprise up to 40% of total energy intake.
 The Mediterranean diet emphasizes the consumption of two types of fat:
 Omega-3 PUFA (flax seed, chia seed, walnuts, fatty fish)
 Monounsaturated fatty acids (olive oil, flaxseed oil, macadamia nuts, olives,
avocado, peanut butter)
 Balanced ratio of omega 6:omega 3 fatty acids (1-2:1)
 Low in saturated fat
 Avoids unhealthy fats (trans fats, highly processed vegetable oils)

36. BENEFITS OF
WFPB/MEDITERRANEAN DIET
 Cardiovascular Disease
 Lifestyle Heart Trial, Ornish D et al. JAMA, 1998 (6)
 Lyon Diet heart study. D et al. JAMA, 1990 (7)
 PREDIMED trial, Ramon et al. New England Journal of Medicine, 2013. (8)
 Obesity
 Berkow SE et al. Vegetarian diets and weight status. Nutrition Review, 2006. (8)
 Farmer B et al, A vegetarian dietary pattern as a nutrient-dense approach to weight management.
J Am Diet Assoc, 2011. (9)
 Rosell M et al, Weight gain over 6 years in 21,966 meat-eating, fish-eating, vegetarian and vegan
men and women. International Journal of Obesity, 2006. (10)
 Tonstad S et al. Type of vegetarian diet, body weight, and prevalence of type 2 diabetes.
Diabetes Care, 2009. (11)
 Diabetes
 Snowdon DA, et al. Does a vegetarian diet reduce the occurrence of diabetes? Am J Public
Health, 1985. (12)
 Vang A, et al. Meats, processed meats, obesity, weight gain and occurrence of diabetes among
adults: findings from Adventist Health Studies. Ann Nutr Metab, 2008. (13)
 Tonstad S et al. Type of vegetarian diet, body weight, and prevalence of type 2 diabetes.
Diabetes Care, 2009. (11)

37. PREDIMED trial - New England Journal
of Medicine

38. VEGETARIAN/VEGAN DIETS VS
MEDITERRANEAN Diet
 Although vegetarian diets are associated with lower risk of several
chronic diseases, different types of vegetarians may not experience
the same effects on health. The key is to focus on eating a healthy
diet, not simply a vegan or vegetarian diet.

39. COMMON HEALTH CONCERNS OF A
PLANT BASED DIET
Protein
Iron
Calcium
Vitamin D
Vitamin B12

40. IRON
 Plant based iron sources include: kidney beans, black beans,
soybeans, spinach, raisins, cashews, oatmeal, cabbage, and
tomato juice.
 Heme (animal sources) vs. Non-heme (plant sources)
 Non-heme iron absorption is increased by consuming foods
that contain vitamin C along foods that contain iron.
 Iron-deficiency anemia is rare in individuals who follow a plant-
based diet.

41. CALCIUM
 Plant-based sources: fortified non-dairy milks, dairy leafy
greens (turnip greens bok choy, broccoli, kale), bean
sprouts, nuts and seeds, whole grains, fruit, blackstrap
molasses.
 Intake can be adequate with a well-rounded, balance
plant-based diet.

42. VITAMIN D
 There are only a few good food sources of Vitamin D-
including fatty fish, egg yolks, and fortified rice or
almond milk.
 Most people should consider a supplement if sunlight
exposure is limited.

43. VITAMIN B12
 Vitamin B12 is found in animal foods but synthesized by
bacteria.
 Those who do not eat animal products of any kind must
supplement their diet with vitamin B12 via supplement,
or plenty of fortified foods (such as breakfast cereals,
nutritional yeast or plant milks).

44. CONCLUSION
 ALL OF THIS BEING SAID, DIET IS DIFFERENT FOR
EVERYONE.
 There are a lot of diets out there, but no one can deny that
eating more plants is a good thing for both you and the larger
picture.
 It does not have to be difficult to eat plant based!

45. WHY COOK?
 Build community
 Acquire life changing skills
 Greater control over your family’s health
 Connect with the large picture
 It’s magical!

46. OUR RECOMMENDATIONS
 Eliminate all sweetened beverages
 Avoid snacking
 Learn how to cook

48. FUTURE TOPICS
 FERMENTATION AND PROBIOTICS
 UMAMI
 GOURMET COOKING FOR SPECIFIC DISEASE STATES
 SUSTAINABILTY AND LOCAL SOURCING
 GLUTEN FREE
 FODMAPS DIET FOR IBS
 COOKING FOR PEOPLE WITH FOOD ALLERGIES
 KITCHEN PHARMACY