About Omega-3 and Omega-6: It's the #WFPB Paradigm, stupid...

The correct balance of Omega-3 to Omega-6 is hard to get, nutritionally, except if you are following the #WFPB program. This is just another way of realizing that #WFPB, or also the "plant strong" and "plant perfect" diets, as Rip Esselstyn likes to call them are not "diets" per se, but more variations within a new nutritional paradigm.

The point was driven home to me rather forcefully again the other day, when I ended up facilitating an exchange between T. Colin Campbell and a biochemist friend. The said biochemist is a researcher who knows a lot about different nutrients, and often from first hand research. He is also a great critical thinker. Among other things, he made me aware of the ignominious start of the Harvard nutrition program under Frederick Stare, one of the seriously compromised researchers in the health field, who essentially was a paid promoter for the Standard American Diet, which we now know is making people sick. Nevertheless, on this occasion he was limited by the paradigm he spoke from, i.e. the Standard American Diet, and various diets that are variations on it.

The standard advice to vegans is to get some vegan EPA/DHA supplements, but it turns out that if you eat a reasonably balanced Whole Foods Plant-Based diet, you end up with Omega-3 and 6 in the proper balance almost automatically. Understanding this underscores again the fact that #WFPB is a nutritionally complete paradigm, with almost the sole exception being some B12, and maybe some D3 in winter.

Here it is in the words of Colin Campbell (in private correspondence):

quote
When one consumes a truly whole food plant based diet, without added oil (it is the added oil not the high fat plant foods), the ratio will be around a very healthy 1:1, to 3:1 (omega 6 to omega 3). The problem with people speaking about this ratio out of context is that they are grossly omitting the myriad effects of other dietary component and, worse, the underlying biochemistry. 

unquote

In short, don't mess with success. If you're doing #WFPB, things take care of themselves nutritionally, it is within the SAD and its dietary variants where one is constantly at risk of not getting sufficient intake of one nutrient or another.

The Paradigm Shift

I remember growing up, when my parents became vegetarians, my mother was always concerned about:  but how are you going to get your proteins. And her cooking pattern for two decades largely was potatos, vegetables, and something in the place of meat. That last piece would be the protein source. There was zero knowledge or awareness that vegetables and grains have proteins, let alone enough proteins, but the truth is that spinach is 51% protein, and the lowly potato or brown rice each have about 9% protein. Plus, of course, we know now, since the China Study, that we want to beware against over consuming protein. The ideal range is 5-10% and not the more typical 15-25% which we see in SAD. More importantly, we want our proteins from plant sources, not animal sources.

What really is scary about this paradigm shift, is how long it has remained a secret, or, in the words of T. Colin Campbell:
quote
The research in "The China Study" was handsomely funded by NIH (a very competitive process, 70 grant years of funding), was published in the very best nutrition and cancer journals and I have since presented this material to well over 150 medical schools and their conferences (over 700 total invited presentations since the book was published).
unquote
It is now forty years since Campbell began publishing papers, followed by the first edition of the book in 2005. Still, this information is not well known, although that is rapidly changing.





What is hard to fathom for many is that suddenly maximizing protein intake is no longer a virtue and, if you maximize anything, it is fiber. The other thing that is hard to understand is the no-added oil precept. We hear too much about supposedly healthy oils, that may be healthier compared to the worst, but the body still does not need them. As Dr. Ostfeld from Montefiore Hospital likes to put it, added oils are like inviting Mike Tyson to practice on your veins. For six hours after an oily meal, your veins loose their oompf. Along with that, adding oils the balance of Omega-3 to Omega-6 is upset, and you don't want that.

Sources of Omega-3 fatty acid for vegans

You can find ample articles online that document good sources of Omega-3 and/or how to achieve a balanced Omega-6 to Omega-3 ratio. Most of it is geared to the wrong paradigm for veganism, and not to the #WFPB diet, or plant strong or plant-perfect. Often times articles point to supplements, but if you follow what Colin Campbell says above, you need not worry. Good sources of Omega-3 for vegans are Chia seeds, Flax seeds, and various vegetables. One that is especially good is Verdolaga, a.k.a. Purslane. 

https://worldcrops.org/crops/verdolaga

https://en.wikipedia.org/wiki/Portulaca_oleracea

http://www.gracelinks.org/blog/4236/real-food-right-now-and-how-to-cook-it-purslane

Purslane from Wikipedia

I recently discovered that Verdolaga grows between corn, and it was available at our Parkchester Green  Market, along with some of the sweetest corn I've tasted in years.


Simple recipe, based on the one listed on Gracelinks above: 

Potato salad with Purslane

• essentially follow their (Gracelinks') steps, except:
• If you can't get fresh dill, use dried, and reconstitute it with some lime juice and lemon juice. That will do the job very quickly.
• if you do the above, you barely need and dressing for this salad other than the lime/lemon juice. But if you need more dressing, obviously you make it oil-free. 
• That's really all, and itś finger-licking good. 

For the Potato salad, I used the leaves, with the stems I made a sauce, with onions, garlic pimentos, some turmeric, and a cup of vegetable bouillon and a bit of arrowroot to thicken it. Et voilà, that made a great sauce over a plate of long beans over rice.

You can also add the leaves to salad, and the next project will be to cook a split pea soup with the remainder of the purslane. 
 

And Another Brilliant #WFPB Supper at Packsun

It was a quiet affair, just Fr. David (St. Helena's) and myself with the owner of the restaurant (Khokon), plus one other Bangladeshi visitor who wanted to sample what we were having.

Muhammed (Khokon) Rahman

Cucumber Salad

Super simple, but effective:

• Cucumber, diced
• Cilantro
• Peppers
• Salt & Pepper
• Chilis
• Lemon juice

Okra in Lentil Sauce and Eggplant over GABA Brown Basmati Rice

Two dishes, first a lentil sauce:

Lentil Sauce with Okra

• Onions
• Garlic 
• Turmeric
• Chilis
• Lentils
• Okra(added last, so as not to overcook it)

 Along with this a Eggplant sauté (yes, oil-free - sautéed in water)

Eggplant Sautée with Peppers and Onions

• Eggplant
• Peppers
• Onion
• Garlic
• Cilantro

It all really ends up being incredibly simple once you have a sense for the condiments. 
You set up every vegetable dish with onions (some thinly sliced chilis if you want), and then add garlic when the onions get soft. As needed, you can add some water or vegetable broth, but some veggies will produce enough water by themselves when you cook them.
Besides knowing the right level of spiciness (the chilis), what matters is to know where the condiments add the most flavor and where they don't fit at all. Cilantro, turmeric etc. are strong flavors, so you need to know what you are doing.

To Khokon it all comes natural. He is the philosopher in the kitchen.

Plantstock 2017 - The #WFPB Mecca in Upstate NY

After changing to a #WFPB (Whole Foods Plant-Based) lifestyle 2.5 years ago, I have recently begun to read much more and seek other sources of information, because I realized that there is a profound change in the works in my own life, but also in the world.

Caldwell, Rip, and Anne Esselstyn at Plantstock 2017

Attending Plantstock 2017 seemed like the thing to do, and boy am I glad I did. The roster of speakers was quite impressive, and covered a wide area of expertise and life experience. Below I'll just recap the stories as best as I can, to bring out the points that seem the most relevant for now. The bottom line is, as I've shared in previous posts, #WFPB is not a diet, but a new nutritional paradigm that is very much based on a solid body of research, starting with The China Study, which was just re-issued in an updated 2017 edition. The theoretical foundation of the China Study, combined with the clinical work of Dr. Caldwell Esselstyn and many others, plus a cascade of newer research have create a broad-based new approach to health, nutrition and medicine, which is actually closer to the Hippocratic ideal than most of modern medicine manages to be. Hippocrates is thought to have said "Let food be thy medicine and medicine be thy food," regardless if he did say it or not, he also formulated the principle of "do no harm," which is in the Hippocratic oath that doctors take, and apparently promptly forget. In the US, with the most expensive (and unaffordable!) healthcare system in the world, iatrogenic illness continues to be a leading cause of death, if not THE leading cause of death.

The biggest thing about the #WFPB lifestyle is that you can no longer get around it after hearing numerous doctors say that the greatest improvement in health outcomes is the simple dietary change to #WFPB, which far surpasses any medications in its effectiveness (which is not to say medications have a role to play, sometimes). At Plantstock, we heard a mixture of research reports and clinical experience, both personal testimonials of lay people, and experience from doctors. The enthusiasm knew no bounds, for these are life-changing experiences, and people can't shut up about them!

I keep attempting to simplify the definition of the #WFPB concept, and I think you could say it this way:

• Maximize fiber, not protein, this automatically leads you to plant-based nutrition, and away from animal protein, which has been shown to be a carcinogenic in the high dosages that are common under the Standard American diet (SAD).
• Use Whole Foods as much as possible, and avoid added oils, or sugar, and limit salt. Small amounts of oil or sugar as it naturally occurs in vegetables, fruit (e.g. avocado) and nuts.
• Get a healthy level of exercise.

The point is, we over-consume protein, and we don't get enough fiber. #WFPB fixes that in one fell swoop, and people can eliminate all supplements except B12, and most medications, as 75% of health care spending is on treatments for chronic, degenerative diseases, which respond well to the #WFPB diet, and in many cases, patients are getting off of all or most of their medications within the first year, and sometimes immediately. Instead of worrying about drug interactions and side effects, you should worry about your next cup of spinach.

One clarification about terminology is in order. The term vegan is not meaningful in the sense that it is more a marketing concept than a well-defined nutritional practice. "Vegan" includes people who are motivated by animal welfare, environmental concerns, weight loss, or nutritional wholeness. Famous are the stories of malnourished vegans, who merely eliminate animal proteins, and mabye even honey, but do not follow #WFPB, and therefore tend to lack complete nutrition. If you go vegan and continue to eat donuts, you will fail. The Whole Foods Plant-Based paradigm is defined in all its glory in the books The China Study, and Whole by T. Colin Cambpell, Ph.D. which include an account of the foundational research. Within #WFPB there is the "Plant Strong" plan which Rip Esselstyn promotes, which is for otherwise healthy people who want to get healthier. For severe heart patients, the original Esselstyn diet, as defined by Caldwell Esselstyn is sometimes referred to as the "Plant Perfect" diet in which you avoid not only added oil, but also fruits such as avocado and coconuts which have a lot of oil, as well as most nuts. Other vegetables still contain whatever little bit of oil the body really needs.


Here is a recap of the accounts that stood out for me most, in no particular order:

• Dr. Saray Stancic of Ramsey, NJ. Dr. Stancic is a Lifestyle Medicine Physician, focused on #WFPB, and the way she arrived at her new practice was because she was once diagnosed with MS, and ended up dependent on twelve medications she could not tolerate, and then she discovered #WFPB and within one year she was off of all medications, and decided to change her specialty to Lifestyle Medicine. She is also involved with a new documentary we will soon hear more about Code Blue.
• Eric L. Adams, Brooklyn Borough President, his was a story of a personal experience, followed by public action. He was at one point diagnosed with life-threatening diabetes, but refused medication, and consulted Dr. Caldwell Esselstyn instead. Inside of three months, his A1C had gone from the high teens to 5.7, and his cardiologist asked him for Dr. Esselstyn's phone number, as he was about to go in for surgery to get stents, but was clearly interested in an alternative. Since then, Brooklyn has committed $13 million for #WFPB education in schools, and has funded the building of a greenhouse in a housing project. Eric's speech was remarkable in that he explicitly raised the spiritual dimension of the process. There is such a thing as wanting to be well!
• Of course there were Rip Esselstyn, the organizer, his father, Dr. Caldwell Esselstyn, his wife Anne Crile-Esselstyn, and their daughter (Rip's sister) Jane Esselstyn.
  Rip's presentation about his new book, The Engine 2 Seven-Day Rescue Diet: Eat Plants, Lose Weight, Save Your Health was dynamic and inspiring. The program is a mini course in #WFPB, in which you can make the switch quickly and completely in one week, or use it to get yourself back on track whenever you feel you need new inspiration and simple dishes you can prepare quickly.
  Caldwell Esselstyn was of course inspiring, and you always learn a new nuance about his path to the discovery of #WFPB, which was all about stopping to treat symptoms and starting to treat the cause, since his working experience showed him how heart patients were never really healed, but continued to deteriorate, and he wanted to make a change.
  Jane Esselstyn, RN was an inspiration by explaining in graphic terms how the major mechanisms work, based on her experience as a sex-educator in the schools. Her presentation was unforgettable, because it made complicated stuff, such as the mechanisms of diabetes, simple to understand. Her explanation of why ED is merely an early manifestation of CVD (Cardiovascular Disease) simply because the arteries to the penis are smaller and more easily compromised by a diet full of animal protein.
  The mother and daughter combo was priceless in the way they explained the simple principles of the diet, along the lines of the KISS principle, such as oats for breakfast, a big salad for lunch, and more variation for dinner. One of the most practical suggestions was how to eat simple cooked kale (5 mins) with some balsamic vinegar. At the conference they served it with delicious infused balsamic vinegars from Bema and Pas.
  In short the Esselstyn family is really involved in all aspects of the #WFPB revolution, and they are an inspiration for us all.
• Then there was Dr. Neal Barnard, of the Physicians Committee for Responsible Medicine, speaking about his new book, The Cheese Trap, which was super informative and motivating, because once you understand just how bad cheese is and why it is addictive, that is enough to get rid of it for good. He also revealed himself as a rock musician with his group CarbonWorks. There seems to be no limit to this man's range.
• There was Milan Ross, whose introduction to #WFPB hailed from his joining Whole Foods in 2012. He was sent to a #WFPB immersion program by Whole Foods, and it changed the direction of his life. He lost 200 lbs, and became free of medications, including for high blood pressure and cholesterol. He now has his own line of vegan food products. his upcoming book is titled The Change. That says it all.
• There was Dr. Melanie Joy speaking on the unconscious paradigm of carnism, the eating of animal protein, which would help anyone to understand why veganism can be threatening, because it upsets the apple-cart.
• John Mackey, the CEO of Whole Foods was interviewed by Rip Esselstyn about his new book, The Whole Foods Diet, and also shared some of his experiences in building Whole Foods, including their innovative approach to health care, in which they offer their employees a #WFPB immersion program if they need it, and are self-insured for medical costs. Of course the new acquisition by Amazon came up, and his own decision process, in which he ascertained that it would enhance and not diminish the Whole Foods company culture. Based on what I know about Amazon, they could learn from Whole Foods.
• Dr. Irminne Van Dyken, MD is a general and trauma surgeon in Hawaii. With her husband she created the Out of the Doldrums youtube channel. She spoke about the effects of #WFPB on intestinal fauna, and the most amazing thing is to learn just how fast change takes place.
• Then there was James Wilks, Mixed Martial Arts champion and budding film maker. His story was amazing. For him it began when he had a knee injury and became interested in nutritional approaches to aid his recovery. He devoured scientific articles, and stumbled across some archaeological research showing that the gladiators in Rome ate a primarily plant-based diet. He experienced powerful help in his recovery from #WFPB. We will certainly hear more about him. He is not one so shut up about it!
• Tim Kaufman, a former trial lawyer from Atlanta, now living in Costa Rica, shared an amazing story about personal recovery, from a time when he weighed 430 lbs and in December 2016 was at death's door with an enlarged heart. Up to the day of the conference he lost 137 lbs in eight months, and he promises to be there next year and weigh 190 lbs. Rest assured this man will not shut up. Check out his blog, Fat man rants. In his moment of recognition of his predicament as a completely self-inflicted wound, he realized that he had spent his professional life as a trial lawyer trying to catch people in a lie, but he had been living a lie himself.
• Josh Lajaunie a self-professed "coon-ass" from Louisina swamp land, who extricated himself from a family tradition of meat eating and chronic illness, and embraced a plant based lifestyle as he became a running champion who was recently featured on the cover of Runner's World Magazine. An almost incredible story, his entire immediate family is now on #WFPB and collectively lost 1008 lbs since they started, the point being as always that #WFPB is rich in fiber so you can eat however much you like and you will automatically return to a homeostatic, optimal weight.
• Adam Sud's story was a searing account of obesity and a cascade of illness ending in drug addiction, which was finally reversed with a #WFPB diet, and he is now a health coach for Whole Foods. Mind blowing stuff.
• Dr. Avram Cooperman is a specialist on Pancreatic Cancer, associated with Mount Sinai hospital in NY, and he is working on a book. His talk focused specifically on the impact of #WFPB on cancer prevention, and was very, very powerful and informative. He is clearly in command of his subject. I cannot wait for his book.
• Susan Benigas runs the American College of Lifestyle Medicine, and her talk was very informative. You now have a way to find medical professionals who understand #WFPB, which makes all the difference in the world, since most doctors are woefully uneducated in nutrition. She also runs the Plantrician project.
• Alexis Fox presented jointly with Susan Benigas, she runs a company called Lighter, which enables on-line buying for #WFPB meal plans.She also made mention of the environmental degradation of animal husbandry which was part of her path to taking an interest in these issues. The truth remains that going vegan is the largest single thing anyone can do to stop environmental degradation and climate change.
• Dr. Elizabeth Winings spoke of the relationship between autism and nutrition, and once again this was a completely surprising discovery that diet can make a lot of difference. 
• And perhaps the greatest surprise of the show was Saudi Prince Khaled bin Alwaleed, who follows a #WFPB diet himself and as an investor is actively involved in areas related to meat alternatives, as well as renewable energy and energy efficiency. He is another person we are bound to hear more about. Abolishing the livestock industry is just one of his personal goals.

Hopefully, the above is helpful. One thing is for sure. #WFPB is emerging as a paradigm shift that is now being propelled by such powerful stories of personal change that it cannot help to take the world by storm. To some, this just looks like a ripple, but as an economist, I know that change happens at the margin, and the growth of this movement is furthermore unstoppable for the simple reason of its solid foundation of unassailable scientific evidence, and growing support from the organizations that include the AMA, and ACC (American College of Cardiologists), various politicians and others from all walks of life.

I mentioned above how Eric Adams was the only speaker to explicitly address the spiritual dimension of the process, but I would emphasize that in all of the personal testimonials there was a strong element of a personal crisis and a catharsis in learning about and adapting #WFPB from what were in many cases near death situations. I will be writing more about this.

The #WFPB Nutritional Paradigm

#WFPB, the Whole Foods, Plant-Based diet as developed on the basis of The China Study, and the clinical work of cardiologist Caldwell Esselstyn, Jr is a completely new paradigm of nutrition and health. The best known introduction these days is the documentary Forks over Knives.

Veganism is usually defined in the negative, as in: no animal protein, and some vegans do not even eat honey, because it is animal based. Motivations for veganism are sometimes environmental, or based on concerns over animal welfare, and sometimes vaguely based on health concerns. Yet, if you look around in restaurants and on food labels, "vegan" is a meaningless term, because it lacks any positive assertive nutritional concept behind it.
Perhaps the most famous proponent of veganism is Israeli activist Gary Yourovsky:

Gary Yourofsky at City College of NY

The #WFPB Paradigm

#WFPB (the Whole Foods Plant-Based diet) on the other hand is a completely new paradigm for nutrition and health. The fundamental tenets could be defined as follows:

• Focus on the quality, not the quantity of protein intake.
• Healthy protein sources are plant-based, unhealthy protein sources are animal based, be it meat, fish, fowl or dairy.
• By substituting plant-based proteins for animal proteins, you also lower your overall calories from protein to a healthy 5-15% and increase your fiber intake, which is often unhealthy under an omnivore diet.
• Use whole foods, and do not use added oils or sugar.
• "Dieting" does not exist in #WFPB, because whole foods, plant-based nutrition speeds up the metabolism and people automatically achieve a homeostatic, healthy weight.
• Nutritional supplements are meaningless for #WFPB is Nutritionally complete: the only possible exceptions are some moderate supplementation of B12 and maybe vitamin D.

The fundamental research for the #WFPB lifestyle is The China Study, which was just published in a new, updated 2017 edition, by T. Colin Campbell, Ph.D. and his son Tom Campbell, MD. The clinical work that matches up to the China Study came primarily from Caldwell Esselstyn, Jr., M.D., a cardiologist from the Cleveland Clinic in Ohio, which was first published in his book, Prevent and Reverse Heart Disease. many other doctors work in the same vein. Here in the Bronx, we have Robert Ostfeld, M.D. a cardiologist at Montefiore Hospital, who runs the Montefiore Cardiac Wellness program.

T. Colin Campbell, Ph.D. on #WFPB

Nutritionally complete: the Omega-3, B12,D-vitamin

The key concept is that for all practical purposes #WFPB is nutritionally complete, if you eat a reasonably balanced range of plant-based foods.

Omega-3

A lot is often made of the difficulty to get a favorable Omega-3 to Omega-6 balance in vegan nutriton, this is a fallacy. Here are some of the sources of Omega-3 for vegans:
flaxseed, chia seed, hemp seed, mustard seed, seaweed, beans, winter squash to broccoli, cauliflower, and brussels sprouts, leafy greens, cabbage, berries, wild rice, various herbs and spices, mangoes, honeydew melon.

B12 vitamin

The only vitamin vegans generally need to supplement is B12. and that's all.

D vitamin

Supplementation of D vitamin is another issue, but that is more generic to the whole population, not just vegans. Here is a great article on vegan sources of vitamin D (note that vitamin D3 is the easiest to absorb form), and if you do not get enough sun, you may need a little vitamin D supplementation.

Beware of vegan marketing hype

Nutritional advice for vegans is usually useless if you follow #WFPB, for if your intake is reasonably varied. There are great vegan sources of iron, from raisins, to prunes, olives, avocado and dried apricots, to asparagus, endives, peas, acorn squash, dandelion greens, Kale, turnip greens, to lentils, chick peas, quinoa, wheat germ, brown rice, and sprouted beans or seeds, and lastly morel mushrooms, brewer's yeast, spirulina, and blackstrap molasses.

But by and large the whole notion that supplements are useful are part of the SAD legacy. In the context of the SAD paradigm, supplements may seem helpful, but this type of research is really silly and misleading, because it focuses on how single nutrients (or medications) improve health outcomes, without questioning the overall train wreck that is the Standard American Diet. Under #WFPB the notion of dietary supplements is silly. The body can generally not absorb them very well, so other than expensive urine, the benefits are limited. It is absurd to ask for small improvements amidst a perfectly preventable disaster. 

The health care angle

As a nation, we are spending 75% of our healthcare dollars on treating degenerative illnesses that can generally be reversed with better nutrition, specifically #WFPB. We spend more on healthcare than any other nation, but without results, for our health statistics remain bad. Here is a brilliant presentation by T. Colin Campbell that sums it all up.

These days the Physicians Committee for Responsible Medicine (PCRM) practically has become the standard bearer for the role of nutrition in medicine. And things are picking up speed at a remarkable rate. Here is some of the latest:

• They just finished up hosting the Fifth-Annual International Conference on Nutrition in Medicine, and one of the fruits of it was an impressive YouTube video about 700 doctors advocating for Prevention over Pills - a ringing endorsement of the #WFPB lifestyle.
• They reported on a recent article by Russel Simmons on refocusing the SNAP program on healthy foods, because the poor have such bad health outcomes already. It is truly criminal to use a government program to provide people more junk food that makes them ill.
• Dr. Neal Barnard's latest book, The Cheese Trap, makes the brilliant case of the correlation of our obesity crisis with the growing cheese consumption, and why cheese is literally addictive (there is a weak opioid in milk that becomes concentrated in cheese). The book also sheds light on government complicity with the dairy industry.
• PCRM came out petitioning the USDA to modify the MyPlate nutritional recommendation and to ditch dairy, and swap animal protein for legumes.
• The American College of Cardiology urges hospitals to add plant-based meals and eliminate processed meats.
• The AMA passed a resolution: Hospitals should provide plant-based meals and remove cancer-causing processed meats.
• The AMA calls for healthier foods in the SNAP program.

This list is evidence of the impressive progress PCRM is making, and they are only just getting started. They truly stand on the shoulders of giants, for it is the work of T. Colin Campbell and his associates in The China Study which is the foundation of all the further research in this area. There is also an excellent documentary on the health issue, What the Health.

Eat your heart out, dieters

The upshot is that the #WFPB lifestyle is actually easier and cheaper than the alternative - meat is surprisingly expensive. Going to a #WFPB will cost you some money in the change over. You may want some different kitchen appliances, and your pantry needs restocking, but you can do that gradually over time, though some folks need to do it all at once, lest they fool themselves and hang on to old, bad habits, such as added oils or sugar.
But since plant-based nutrition speeds up your metabolism, there is no dieting under this concept. Eat to your heart's content, as long as it is reasonably varied, and your body will automatically return to a homeostatic, optimal weight, without even having to think about it.
In short, indulge, you are eating your way to health, as long as you stay within the #WFPB paradigm.