Sunday, October 7, 2018

The 2nd Annual Montefiore Preventive Cardiology Conference.

It was a memorable event and I won't even attempt to produce a full account here by touching on some of the highlights.

I think this was a historical conference, all the greats from the world of the Whole Foods, Plant-Based nutrition were there, creating a very comprehensive view of the field in a single day, with very up to date information.

  • Robert Ostfeld, MD, MSc, FACC
  • Neal D. Barnard, MD
  • Valentin Fuster, MD, PhD
  • Kim A. Williams, MD, MACC, FAHA, MASNC, FESC
  • W. H. Wilson Tang, MD, FACC, FAHA, FHFSA
  • Caldwell B. Esselstyn, Jr., MD, FACS, FACC, FALM
  • T. Colin Campbell, PhD.
  • Michelle McMacken, MD
  • Joel Kahn, MD, FACC
  • Lauren Graf, MS, RD, CDE
Plus some new players, young doctors just starting and interns, from whom we are sure to hear more in the future. One of them is in the process of launching a new plant-based clinic at Yale. They presented some explosive reports.

T. Colin Campbell for Nobel Prize

What made this conference unique was the presence of T. Colin Campbell, for one way or another, and ex-post facto in some cases, the nutritional science behind the Whole Foods, Plant-Based (#WFPB) paradigm is the anchor for the only realistic healthcare reform in this country and in the world.

T. Colin Campbell
I can only say this: I feel so very grateful to have completed the Plant-based certificate at the institute for nutrition studies, and this was my first opportunity to meet Dr. Campbell in person. All I could do was thank him from the bottom of my heart, since I know that without the nutritional science to back it up, all of these plant-based doctors would just be fighting their lonely battles. Campbell's work is the connective tissue from that point of view. This is the reason that one doctor created a petition to nominate Dr. Campbell for a Nobel Prize. Please sign the petition

Brooklyn Borough President Eric Adams: "Food is crack."

Here in the Bronx, we are blessed with a few politicians who have their own personal stories to tell about the significance of #WFPB nutrition, such as senator Luis Sepulveda and Council man Fernando Cabrera. However, even in the Bronx' #not62 campaign, #WFPB has not played much of a role yet. In Brooklyn it is different, for Brooklyn Borough President Eric Adams is truly a man on a mission and being very effective at it.
Eric's own story is remarkable, having been predictably (as he now recognizes), but 'unexpectedly' (denial is NOT a rive in Egypt!) diagnosed with diabetes, and told he would have to be on insulin and several medications, instead, he googled "reversing diabetes," and made an appointment do see Dr. Esselstyn in Cleveland and on the plane he read Dr. Greger's book How not to die. Having been told he might lose his eyesight altogether, he instead completely recovered it in three weeks without medications, and in three months he was no longer a diabetic. Earlier this year, his 80-year old mother decided that she wanted some of what Eric had, and in a few months she was off of insulin and medications.
Eric is in the unique position to really do something about this new found wisdom and he has not skipped a beat. His events at Borough Hall are not to be missed.
In an impassioned speech, Eric Adams called our industrialized food out because of what it does, adulterated as it is to create the cravings that brings customers back again and again, he stated what is exactly the point: "Food is crack." This is even more painfully true in the African American community where "soul food," made a virtue out of necessity, and is the cause why "Southern food," with it's reliance on meat, grease and sugar and other refined carbs is an extremely unhealthy diet.
Finally, he acknowledged Dr. Michelle McMacken, who will be heading up the new plant-based program at Bellevue Hospital

Dr. Kim Williams: Reducing risk of heart disease by 50% for blacks

Dr. Kim Williams in audience, Dr. Neal Barnard on stage

When Dr. Kim Williams spoke later in the day, he raised the same issue by pointing out that changing from a "Southern diet" (and as Dr. Williams pointed out this is code for a black diet), to a Whole Foods, Plant-Based diet reduces risk of heart disease by 50%. The romance with soul food, which is understandable, because it did make a virtue out of necessity and symbolized the resilience of black culture under atrocious conditions has become the new slavery. Thus the Whole Foods, Plant-Based diet symbolizes a new freedom. The beauty is that this time around, we have a combination of clinical experience from all the doctors in this field, backed by the nutritional science of Dr. T. Colin Campbell. The growing recognition of this new lifestyle is decisively the most hopeful thing that is happening in the healthcare field, in America and world-wide. Here is an interview with Dr. Williams:


At the end, Dr. Williams was also on the panel, and an important question came up from a Bangladeshi man, who is a nurse at Elmhurst Hospital in Queens, but came to the Bronx to become a patient of Dr. Robert Ostfeld, because he could not find a plant-based cardiologist at the time when he had his first heart-attack at age 36. In Dr. Williams' answer we learned that the American College of Cardiology recently visited Bangladesh, where the average age of heart attack patients is 43, apparently in part because genetically blood vessels are narrower in that population than is typically the case with Westerners, so that blockages develop earlier. In short, the Bangladeshi population should be extremely interested in the opportunity to drastically improve their quality of life and life-expectancy by switching to a Whole Foods, Plant-Based diet. It is also well known that diabetes is explosive in the South East Asian population, with white rice, animal protein and cooking oil being a leading causes. In the Western world in particular, food is the leading cause of death, but some populations are just genetically more prone to this form of suffering. Fortunately, it is reversible and the Southeast Asian cuisine offers a very good starting point for brown rice, lentils and chick peas as well as many of the traditional vegetables and spices can create endless variations of healthy food with very little effort.

Dr. Valentin Fuster speaks of starting early


Some of the Bangladeshi doctors I've gotten to know, were familiar with Dr. Valentin Fuster from the cardiology textbook he wrote, which they apparently used in medical school in Bangladesh. Dr. Fuster presented a very information-laden speech on the need to start early, in particular by teaching children. He has been a medical adviser to Sesame Street to do exactly that.

Treating the disease at the end state is expensive, not to mention unaffordable, and more than "prevention," starting with adults with bad habits already formed, he argues for starting with children. It was very compelling.

Dr. Ostfeld, common sense in underserved communities

With his usual, delightful and very gentle sense of humor, Dr. Ostfeld presented some of his experiences and solutions in serving a very under-served community in the Bronx and making affordable solutions work, including his practice of funneling all of his patients with their significant others into a half-day workshop on Whole Foods, Plant-Based cooking.

He mentioned some of the many sources which are available for inspiration to live a plant-based lifestyle on a budget, including some links on Forks over Knives which discuss plant-based living on a budget:
(In general you can find more by searching for "budget" on Forks over Knives.)

Particularly important is his clinical experience of how he gets patients motivated to comply, but the all important first step is to simply demonstrate that the improvements to be had from the plant-based diet out perform any drugs, such as statins.

Dr. Ostfeld's support system
He builds it up from a 30-minute first visit, which is largely fact finding and an initial plan, to a second follow-up visit and an invitation to his plant-based workshop. He is truly a leader in this emerging field. The PBNSG.org website he mentioned is another important resource.

Through the looking glass with Dr. Wilson Tang

In a fascinating presentation, Dr. Wilson Tang took us into the latest finds in the rapidly advancing field of understanding the gut biota with the primary bad boy being TMAO. Specifically, the fact that TMAO is a flagrant demonstration of oxidative stress in the body and comes from animal nutrition is interesting, and should point people quickly to diet as a cause for heart disease. Planteaters simply do not have the problem of this major villain lurking in their gut. See here some info from the Cleveland Clinic.
This type of information has us looking at causation, and at the same time puts us on a track to fixing it, for maybe, just maybe, if we ate something different, the outcome could be different... what would that be? Oh wait... Whole Foods, Plant-Based nutrition of course.

To hell and back with Essy, or... Dr. Esselstyn for you

Actually the discussion with Dr. Wilson Tang showed us the road to hell, and Dr. Esselstyn first showed us what heart disease looks like up close and what healing looks like. He took us through his experiences, including all the supporting evidence for #WFPB in general, and with particular attention to how eating a hand full of green leafy vegetables with balsamic vinegar, paves the way back, because it creates the nitric oxide which heals the endothelium and keeps our arteries limber. The deeper point is, as always, that 'vegans´ only know what you don't eat, and #WFPB is about knowing what you should eat and why. Once you have a firm understanding of that, it should be a lot easier to comply. Dr. Esselstyn's discussion of how a fatty meal prevents the normal expansion of the arteries, which is supposed to occur with strenuous effort, for four to six hours after that meal... by which time we eat again, is priceless and should also be powerful motivation for beginners. Understanding why you should do ABC or D, is the most important thing to get people to do it.

Notes on Keto-diets

The ketogenic diet is sort of an urban myth that refuses to die. There's always a new huckster promoting it. Throughout the day it came up both directly and indirectly. The information on TMAO in the gut of meat eaters alone should make it clear why this type of a diet comes with increased risk and mortality in the long run. Heart disease, diabetes, and cancer have all been associated with meat consumption. In short, there is nothing scientific about it. Dr. Joel Kahn had a recent article on How to Evaluate Nutrition Science (And Why Cranky Old Men on Twitter are Not the Source) which is yet another refutation of this particular craze.

Conclusion

This conference took place at a time when more and more people realize that we cannot continue with a healthcare system that consumes 20% of our Gross National Product and two times what the next most expensive country pays, but produces health outcomes that are somewhere in the range of 25th to 50th in the world, depending on which analysis you follow. Since 37 of the top 40 leading causes of death, mostly the typical, chronic diseases of affluence that are thought to be incurable, respond well to a Whole Foods, Plant-Based diet and many are preventable or even reversible with such a diet, it is becoming increasingly imperative we make the change, even if it takes a generation. We cannot afford not to.

The question period at the end was exhaustive - every last question was answered. Again, I left out a lot of detail here, in order to present sort of a bird's eye view of this whole affair, which we are blessed to have in the Bronx, if we ever hope to get serious about #not62.

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