Many of the heavyweights in the field were there, and it was a truly amazing experience. While the material was meaty, since the conference offers educational credits for medical professionals, it was accessible to the general public as well, and people had come from all over the country. There was even a delegation from the Brooklyn Borough President's office, as well as from the Mayor's office, in this week when it had just been announced that Brooklyn was launching Meatless Mondays in 15 public schools.
The speakers included the following:
- Opening remarks by Dr. Robert Ostfeld, cardiologist at Montefiore, who was the conference organizer.
- He was followed by Dr. Paul M. Ridker, Director of the Center for Cardiovascular Disease Prevention at the Brigham and Women's Hospital, who spoke on the issue of inflammation in cardiovascular disease. The bottom line is that cholesterol levels and inflammation are equally important in cardiovascular disease (CVD).
- Next came Dr. Neal Barnard (he of PCRM fame), who spoke on the role of nutrition in the prevention and treatment of diabetes. The bottom line is that the ADA approach (low carb), does not work nearly as well as a Whole Foods Plant-Based diet without added sugar, oil or salt, and that this is now fully scientifically proven. It is notable that fruit is healthy for diabetics because the sugar in the context of fruit is not a problem, it's the refined sugar we add to food that is the problem. Carbs are also essential, and sugar in and of itself does not cause diabetes, fat does. So, the avoidance of added oils and fats is critical. Most importantly, once a patient starts on the diet, the changes can happen so fast that medical supervision is critical since otherwise people can become hypoglycemic if their medications are not adjusted in a timely fashion. Not in all cases, but for probably two thirds of diabetics it seems realistically possible to get off of medicine and insulin altogether within weeks or months.
Dr. Barnard's graphical illustrations of the diabetes mechanism were extremely helpful.
Barnard also brought up a fascinating report on Geico, where he was involved in lowering health care costs with a Whole Foods Plant Based diet, for a company that is self-insured for health. This type of development could point the way towards a better solution for our healthcare crisis. Whole Foods operates along similar lines.
- Next was Dr. Kim Williams of Rush University Medical Center in Chicago and former president of the American College of Cardiology, who spoke on "Describing My Evolution Toward Advocating for a Lifestyle Oriented Approach for the Prevention and Treatment of Cardiovascular Disease. A very engaging speech - you can get a little taste here.
- Next up was Dr. Caldwell Esselstyn, Jr. and it is always a delight to hear him state his core position, that heart disease is a toothless paper tiger that does not even exist, not to mention how amazing it is that this has become a multi-billion dollar medical specialty in the Western world, without anybody wondering why large parts of the world do not even have this problem. In short, coronary heart disease is entirely preventable and in most cases (except when it is totally critical) reversible with diet and exercise.
- Finally, Dr. Robert Ostfeld spoke specifically on the challenges of the Bronx, the borough that steadily always comes in at #62 of 62 counties in NY in the Robert Woods Johnson survey of health outcomes for the state. With his customary sense of humor he described the challenges of working in a poor community and focusing on teaching people to make the transition to a WFPB diet on a budget.
- Next, there was a panel discussion, which also included Dr. Michelle McMacken, Assistant Professor of Medicine at NYU School of Medicine and Director of the Adult Weight Management Program at Bellevue Hospital.
Another salient point that came out during the day was the difference between a "vegan" diet, defined in the negative (no animal products), but not observing the whole foods paradigm, which often produces worse health outcomes than a meat-based diet. This confirms again that "vegan" is not a useful category from a nutritional standpoint, for a whole foods plant-based diet, without added Sugar, Oil and Salt is really the issue. Potato chips, Coca Cola and chocolate may make a "vegan" diet, they do not add up to a healthy lifestyle.
Overall, it is increasingly clear that the Whole Foods, Plant-Based nutritional model is slowly becoming main stream and in fact that the adoption is picking up speed as evidenced by the developments in Brooklyn, which now are getting the support from the mayor's office, as well as the adoption in hospitals, such as the Montefiore health system, which includes five hospitals. Both AMA and the American College of Cardiology now recommend that hospitals offer plant-based menu options at every meal.
Throughout the day the food was excellent and a worthwhile demonstration of the variations that are possible within the #WFPB paradigm. The sky is the limit. Literally - as was also emphasized by various speakers - #WFPB is more bulky but you lose weight automatically and end up returning to a homeostatic, healthy weight. Overeating is never a problem because the diet is rich in fiber and nutritionally abundant as long as people eat enough different foods. There is no such thing as a protein deficiency if people eat a reasonably varied plant-based diet, and likewise the notion of supplements is completely moot, with the sole exception of B12. It was not discussed in detail, but there was mention of the fact that supplements from bottles can indeed easily be counter productive - everything is more easily absorbed from food, and the plant based diet will provide abundant nutrients.
Another simple way of looking at the problem is this: your body produces all the cholesterol it really needs, you need no dietary cholesterol ever. Plant-based nutrition has zero cholesterol and all animal-based nutrition has cholesterol, hence you should not eat it.
As to added sugar, oil and salt:
- sugar is harmless in fruit, but adding refined sugar in any form is bad news
- added oil is always bad, it damages the endothelium immediately, preventing your bloodvessels from dilating normally with exercise. You'll get about 10% of your calories from naturally occurring oil if you include small amounts of nuts, avocado or coconut in your diet, but, generally speaking, all plants contain small amounts of oil naturally, so it is easy to go over.
- as to salt, 2,000 micro grams per day is all you need which is easy to meet if you eat all plants, and sometimes you can even add a sprinkle, but generally you want to use herbs and spices for seasoning, not salt. All vegetables and grains contain sodium naturally.
Ostfeld tends to be rather mild and focuses on not letting the perfect get in the way of the merely good: progress is progress. The other side of that coin is that, as reported above, a sloppy and only nominally "vegan" diet is really counter productive, and in practice is often the reason why would-be vegans fail. Esselstyn typically does not allow his patients any wiggle room for that reason, for he knows that once you are on the right track, you will feel so much better, you will not want to get off it. One thing sums up the difference perhaps. Esselstyn recommends 6 fist-sized green leafies per day, typically cooked kale with balsamic vinegar, which taken together is great for nitrous oxide production. Ostfeld, more modestly, ask for four. Personally I find that cooked kale, drizzled with balsamic vinegar is an absolute delight, and I miss it when I don't have it.
In other news, the movie Code Blue is being announced, which is going to be a next chapter in the adoption of the Plant-based nutritional program in clinical practice. It reminds us of the fact that 86% of our healthcare spending is on treating the degenerative chronic diseases, which by and large are the result of bad diet and conversely are preventable and most often reversible with a Whole Foods Plant-Based diet. If we can eliminate 75% of the 86%, we will have largely solved the healthcare crisis. In this conference only heart disease and diabetes were being discussed at length, though the more general application was mentioned. The movie Code Blue is going to add MS to the discussion. The implications are truly staggering.