Introduction to the Nutrition Spectrum Reversal Program

Our Goals For This Session

• Discuss the typical American diet and its impact on heart disease risk

• Provide an overview of a low-fat, plant based eating style and its health benefits

• Describe the nutrition guidelines and the rationale• Introduce the Reversal Food Guide Pyramid • Describe the process of adjusting to the Nutrition

Spectrum Reversal Program

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What Is the Typical American Diet?

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FAT38%

CARB45%

PROTEIN17%

Fat and Animal Protein Sources In the Typical American Diet

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The Average American Consumes…

• 15 cows

• 12 hogs

• 900 chickens

• 12 sheep

• 1,000 pounds of other assorted animals– Klaper, Michael MD. A Diet For All Reasons,

1992

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The Results

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Even Man’s Best Friend…• “FDA OKs Pfizer Drug For Obese Dogs” Fri Jan 5,

1:59 PM– “The Food and Drug Administration said Friday it

approved a Pfizer drug to help manage the weight of obese dogs. Pfizer will market Slentrol, a liquid formula, to the estimated 5 percent of U.S. dogs that are 20 percent over their ideal weight. In a statement issued Friday the FDA says the drug's "mechanism for producing weight loss is not completely understood," but seems to cause less fat absorption. Overweight pets are more likely to develop heart disease, diabetes and joint problems, according to the government agency. According to Slentrol's labeling, a veterinarian must monitor the monthly weight change of a dog on the drug and adjust the dosage accordingly.” (Cited from Associated Press)

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What We Eat Impacts Our Health

• Coronary artery disease

• Stroke

• Certain cancers

• Diabetes

• Hypertension

• Overweight and obesity

• Osteoporosis

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Nutrition and the Formation of Atherosclerotic Plaque

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The Goals of the Dr. Dean Ornish Program For Reversing Heart Disease

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An Integrated Approach to Reversing Heart Disease

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Plant Versus Animal-Based Nutritional Programs• Studies world-wide have shown that populations

eating a plant-based, low fat diet have…– Less risk of heart disease– Lower death rates from ischemic heart disease– Less hypertension– Less risk of type 2 diabetes– Fewer intestinal disorders– Less incidence of certain cancers– Less risk for osteoporosis, kidney stones, and

gallstones

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Factors that Reduce Risk for Heart Disease

• Reduced saturated fat and cholesterol intake• Higher fiber and antioxidant intake• Lower heme iron intake and lower iron stores• Lower blood pressure• Decreased tendency to form unwanted blood clots• Reduced blood viscosity• Higher folate intake

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FAT10%

PROTEIN15%

CARB75%

What is the Nutrition Spectrum - Reversal Program?

• Whole Grains• Vegetables• Fruits• Legumes and Beans• Soy• Fat-free Dairy/Egg Whites

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It is a plant-based, whole-foods eating style that emphasizes…

• Caffeine• Sodium• Alcohol• Soy• Nutrition Supplements

Nutrition Spectrum Reversal Program Guidelines for Reversing Heart Disease

• Fat• Cholesterol• Animal products• Calories• Refined Carbohydrates

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10% of TOTAL CALORIES from FAT

• Nutritional programs that include 20-30% of calories from fat, like the American Heart Association Diet, have been associated with heart disease progression.

• NO REVERSAL OCCURS.

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Achieve 10% FAT by:

• Eliminating:– Meat, Poultry, Fish, etc.– Avocados, Olives– Nuts, Seeds– Added Oils/Fats

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ELIMINATE

Hidden Fat and Saturated Fat in Animal Based Products

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0

10

20

30

40

50

60

70

80

90

100

CHEESE BEEF EGG MILK PORK SALMON VEAL CHICKEN SHRIMP

% o

f To

tal C

alo

ries

fro

m F

at

TOTAL

SATURATED

Hidden Fat and Saturated Fat In Oils and Added Fats

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0102030405060708090

100

% T

ota

l Cal

ori

es F

rom

Fat

SATURATED TOTAL

Hidden Fat and Saturated Fat In Nuts, Seeds, Avocados

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0102030405060708090

100

P ecans P eanuts Hazelnuts Walnuts Avocados Almonds Sunflowerseeds

Cashews

% T

ota

l Cal

ori

es F

rom

Fat

SATURATED TOTAL

Choose Plant-Based Whole Foods

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0

20

40

60

80

100

Brown

Rice

Beans

, Blac

k

Veget

ables

Pasta

Barley

Kidney

Bea

ns

Lent

ils

Peas,

Spli

t

Crack

ed W

heat

Frui

t

% C

alo

ries

Fro

m F

at

TOTALSATURATED

0-10 mg Cholesterol per Day

• Dietary cholesterol is related to the increased risk of heart disease. – This risk is separate from the risk of dietary fat.

• The body makes all the cholesterol it requires. • Food sources of cholesterol are in excess of what

the body needs.

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Achieve 0-10 mg Cholesterol Per Day by: • Eliminating:

– Meat (all types)– Poultry (all types)– Fish (all types)– Animal products except for egg whites and fat-

free dairy foods (0 to 2 servings/day)

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Hidden Sources of Cholesterol In Food

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0

50

100

150

200

250

Eg

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mg

)

Cholesterol Content of Dairy Foods

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0

5

10

15

20

25

30

35

Che

ese,

Fat

Fre

e

Che

ese,

Low

Fat

Che

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Reg

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Milk

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Low

Fat Yog

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Reg

ular

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mg

)

Eliminate Animal Products

• Animal products: – Contain fat, saturated fat and cholesterol in high

concentrations– Contain animal protein and iron, which

create an environment that increases heart disease risk– Reduce the consumption of other food components that

protect against heart disease

• EXCEPTION: Non-fat dairy and egg whites are allowed with limits

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ELIMINATE

Protein Sources

• Choose:– Egg whites as a source of protein– Fat-free dairy products (0 to 2 servings/day) for

protein, calcium, riboflavin and vitamin B12– Plant-based sources for adequate protein

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Eat Abundantly

• Calories are not restricted unless overweight or not losing weight (if desired).

• The Nutrition Spectrum – Reversal Program:– Is rich in fiber and naturally low in calories per bite– Increases satiety value with fewer calories– Self-regulates calories without calorie counting– Helps to gradually reach and maintain an healthy body

weight– Promotes eating with awareness and portion control

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An Integrated Approach• Regular exercise burns calories and reduces stress.

• Stress management increases awareness of when you are hungry, how much you eat, and why you eat.

• Group support improves social connections and communication skills.

• Improved nutrition eliminates high-fat, calorie-dense foods.

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Limit Refined Carbohydrates• Angel food cake

• Fat-free frozen yogurt

• Fat-free sweets

• Table sugar

• Jelly

• Fat-free pudding

• Limit to 0 to 2 servings per day

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LIMIT

Why limit refined carbohydrates?

• Absorbed quickly into the bloodstream, and causes swings in blood sugar levels (i.e. highs and lows)

• Source of empty calories (i.e. weight gain)• Can elevate triglycerides• Many contain hydrogenated or partially

hydrogenated fats

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LIMIT

Replace Refined Carbohydrates with Complex or “Preferred” Carbohydrates

Instead of: Choose:

White Rice Brown Rice

White Bread 100% Whole Wheat Bread

White Pasta Whole Wheat Pasta

Refined Cereals Whole Grain Cereals

White Flour Whole Wheat Flour

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Moderate Sodium Intake

• Follow your doctor’s recommendation if you are medically restricted.

• Only about 1/4 of the population is sensitive to sodium. – Individuals who are not sodium-sensitive can have

moderate quantities of sodium.

• Salt can add flavor to very low-fat vegetarian dishes, improving taste and making adherence to the eating style easier.

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Sources Of Sodium

Added at the

Table

33%

Naturally Occurring in Foods

34%

Processed Foods

33%

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If Sodium Is Restricted

• Use fresh herbs and spices instead of salt.• Choose sodium-free spices.• Use reduced-sodium soy sauces, vegetable broths

and condiments.• Ask for foods to be prepared without added salt.• Use fresh lemon juice, other citrus,

flavored vinegars, hot sauce and wine in cooking to enhance flavor.

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LIMIT

Caffeine-Free Living

• Eliminate caffeinated and decaffeinated coffee, colas, chocolate and cocoa products, regular and decaffeinated teas as well as over-the-counter medications containing caffeine.

• Choose grain-based coffee, herbal tea and naturally caffeine-free diet and regular soft drinks.

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ELIMINATE

Caffeine’s Effect on the Body • Increases stress hormone levels (epinephrine,

norepinephrine and cortisol)• Interferes with stress management• Increases blood pressure• Increases frequency and severity of irregular heart

beats• Increases stomach acid• Acts as a laxative• Promotes nervousness, restlessness, • May contribute to a shorter “fuse”

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Caffeine Content of Common Beverages

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0

40

80

120

160C

offe

e, P

erc

.

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rip

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oft D

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ea

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tura

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affe

ine

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7 U

P

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ine

(m

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Withdrawing from Caffeine

• Gradually…– Take 1-2 weeks to go caffeine free– Switch to lower caffeine sources– Reduce intake 1/2 to 1 cup at a time– Have caffeine-free substitutes available

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Green Tea: An Exception to the Caffeine-Free Rule • Contains powerful antioxidants that may reduce

the risk of chronic disease• Choose fresh brewed regular or naturally

decaffeinated green tea.• Limit to no more than 2 cups/day.• Individuals with arrhythmias, elevated stress

and/or taking certain medications should avoid green tea.

• Coumadin and other blood thinning medications may need adjustment.

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Alcohol In Small Amounts (But Not Encouraged)

• If consumed at all, limit alcohol to 1 serving/day.• One serving equals:

– 1.5 ounces liquor – 4 ounces wine– 12 ounces beer

• Speak with your doctor about alcohol and possible adverse interactions with medications or medical conditions.

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LIMIT

The Pros and Cons

• Beneficial effects:– Moderate amounts may increase HDL cholesterol

• Negative effects:– Direct toxic effect on heart muscle and other organs– Source of “empty” calories– Decreases the body’s ability to burn fat by about 1/3– Inhibits willpower and adherence to the diet– Associated with increased rates of breast cancer and

liver disease– Associated with increased accidental deaths

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One Full-Fat Soy Product Per Day

• Source of essential fatty acids (omega-3)• Isoflavones (plant chemicals unique to soybeans)

have antioxidant properties, which may protect LDL from oxidation.

• Soy isoflavones have favorable effects on blood vessel function.

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LIMIT

What is a Full-Fat Soy Product?• Greater than 3 grams of fat/serving• Naturally occurring fat derived from the soybean• No added fat/oil • Examples include:

– Soymilk (1 cup; >3 grams of fat)– Tofu (1/2 cup)– Dry roasted soy nuts (1/4 cup)

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Vitamin and Mineral Supplementation• Added insurance• Source of omega-3 fatty acids

– Reduce risk of sudden cardiac death, prevent certain types of arrhythmias, decrease platelet stickiness/blood clots, decrease triglycerides

• Source of antioxidants – Help to prevent oxidation of LDL cholesterol, the form of

cholesterol that is most likely to deposit in the arteries

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Required Supplements

• MULTIVITAMIN 100% Daily Value with Minerals – With B12 (24 mcg/day or 2.4 mg)– Without Iron (Unless female of childbearing age)

• OMEGA-3 FATTY ACID SOURCE (Fish Oil Capsules) – Approximately 600 mg EPA and 400 mg DHA per day

for both women and men (Dosage typically found in 2 to 4 grams of fish oil capsules per day)

– Choose cholesterol-free fish oil supplements.

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Optional Supplements

• FOLIC ACID 400-1000 mcg/day • VITAMIN E no more than 100 IU/day

– If taking a cholesterol-lowering statin medication, check with prescribing MD.

• VITAMIN C 1-3 grams/day• SELENIUM 100-200 mcg/day

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Food Sources First

• Vitamin E– Unrefined cereal grains, wheat germ, spinach,

green peas and corn

• Vitamin C– Fruits and vegetables especially: peppers,

sweet green and red peppers and hot red and green chili peppers, citrus fruits and juices, Brussels sprouts, cauliflower, cabbage, kale, collards, mustard greens, broccoli, spinach and strawberries

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Food Sources First• Selenium

– Plant foods are the major sources of selenium in most countries; amount depends on soil.

– Primarily found in grains and vegetables.

• Folic Acid– Dark green leafy vegetables (spinach, kale,

mustard greens, escarole, arugula, beet greens, bok choy, dandelion greens, radicchio, Swiss chard), oranges, lentils, pinto beans, garbanzo beans, asparagus, orange

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Nutrition Spectrum – Reversal Program: Summary

• 0% of total calories from fat

• 0-10 mg cholesterol

• No animal protein

• Eat abundantly

• Limit refined carbohydrates

• Sodium in moderation

• Caffeine-free living

• Alcohol in moderation

• 1 full-fat soy product per day

• Nutrition supplements

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• Short-term– Gas/bloating– Cramping/constipation – Headaches

• Long-term– Fewer ups and downs– Desire to eat more frequently – Sustained energy throughout the day– Weight loss

Adjusting Well to a New Way of Eating

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• Empowerment and pride

• “Road less traveled”

• Anger

• Fear

• Guilt

• Inspiration

• Excitement

Adjusting Well to New Feelings

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Upcoming Nutrition Discussions

• Identifying Ornish friendly foods• Grocery store tour • Evaluating the Nutrition Spectrum Reversal

Program• Cooking demonstrations• An integrated approach to weight management• Shopping and meal planning• Eating out, traveling, socializing• Advanced nutrition: calcium, phytochemicals and

functional foods

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Questions

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