scott stoll, m.d. fabpmr co-founder plantrician project · co-founder plantrician project. the...
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Scott Stoll, M.D. FABPMRCo-Founder Plantrician Project
The earth brought forth vegetation, plants yielding seed after their kind,
and trees bearing fruit with seed in them, after their kind; and God saw that it was good
Genesis 1:12
”Mankind’s final coming of of age, the emancipation of the human consciousness from an immature state of ignorance and error.”
Reductionism replaced wholism
Urbanization
Automation
Exploitation
New transportation-railway system
Refrigeration
Meat and milk could be transported long distances
Farming conglomerates, food corporations
Packaging of food
First canned foods
1870- large canning facilities
Pasteurization
Advent of processed food
Child labor 15 hour days
Marketing of food
1938 Agricultural Adjustment ActFixed prices on dairy, hogs, chickens, wheat, corn, cottonWWII
“WHAT THIS WAR IS ALL ABOUT . . . [is the right to] once more walk into any store in the land and buy anything you want.”“A steak for every frying pan” New York Daily News 1943 “the janitors appetite for a sirloin steak is as profitable as the bankers,” it would democratize the benefits of prosperity’.
Production of animals 1940’sPre-war cattle 68 million post war peak 132 million, today 10 billion animals/chickens Corn silage new food – developed the siloIntroduction of antibiotics that helped stabilize feed lots Automatic milking systems 1948DDT used to kill flies Development of fast foodNew large processing plants
Food preservatives: MSG
10 TNT plants transitioned to fertilizer plants; “Nitrogen fertilizer was a huge factor in the yield increases that began”
Introduction of herbicides and pesticides
Hybrid plants- withstand herbicides
War funding gave 11 pharmaceutical companies funding to develop drugs and they produced ½ of the worlds pharmaceuticals
McGovern committee 1977“Cut down on meat and dairy”
Firestorm led to alteration of language from “reduce” to “choose”
Nutrients became the focus
Except sugar: maximum permissible level is 25% of calories
1982 National Academy of Sciences ReportCodified new official dietary language of ‘nutrients’
Initiated scientific reductionism: cholesterol, fiber, fats, protein, carbohydrates, antioxidants
In Defense of Food, Michael Pollen Penguin Books 2008
Year 1900 2010
Sugar/sweetener 5 lbs/year 141.5 lbs/year
Oils/fat 4 lbs/year 74.1 lbs/year
Cheese 2 lbs/year 30 lbs/year
Meat 140 lbs/year 210 lbs/year
Fruit/Veget. 131 lbs/year homegrown
11 pounds/year homegrown
Calories 2100 2757
Nutrient Density 40-60%
Soft drinks 0 53 Gallons
TV 0 4 hours/day
Sources:USDA,FoodReview:
MajorFoodTrendsaCenturyinReview2000
Whathappened?
1900 2000
Free radical formation
Initiates inflammatory cascade
Processed food, animal products, toxins, stress, etc.
NF-kB
Impacts 400 genes inflammation
Atherosclerosis
Cancer
Diabetes
Arthritis
Alzheimer’s
Colitis, GI disease
Autoimmune disease Aging Asthma/ AllergiesBai SK, Lee SJ, Na HJ, et al .b-Carotene inhibits inflammatory gene expression by suppressing the activation of the redox-sensitive transcriptionfactor, NF-kB(342,343). (2005)
High Quality Low Quality
Fruit: red berries, oranges, grapefruit, plums (red),
Fruit: apple, pear, banana, grape (white), melon
Vegetable: spinach, beet, Swiss chard, pepper (red bell), Brussels sprouts, broccoli, rocket, radicchio, olive (black), mushrooms, broad beans
Vegetable: eggplant, leek, potatoes, zucchini, French beans, carrots, celery, lettuce, cucumber, radish
Image courtesy of Weizmann Institute of Science
Dr. Trygve Tollefsbol University of Alabama-“epigenetic diet”
“Rich in plant based foods, phytochemical rich modify DNA methylation, histone modification, and microRNA expression prevent degenerative diseases such as CVD, cancer, Alzheimer’s, obesity, osteoporosis.”
Li, Yuanyuan, Sabita N. Saldanha, and Trygve O. Tollefsbol. "Impact of epigenetic dietary compounds on transgenerationalprevention of human diseases." The AAPS journal 16.1 (2014): 27-36.Tollefsbol, Trygve O. "Dietary Epigenetics in cancer and aging." Advances in nutrition and cancer. Springer Berlin Heidelberg, 2014. 257-267.
Telomere length (shortening) is correlated with aging, cardiovascular disease, anxiety disorder, oxidative stress, elevated BMI
Dr. Ornish demonstrated increased telomere length and activity of telomerase in plant based/lifestyle group vs. control
30% increase in telomerase
Ornish, Dean, et al. "Effect of comprehensive lifestyle changes on telomerase activity and telomere length in men with biopsy-proven low-risk prostate cancer: 5-year follow-up of a descriptive pilot study." The lancet oncology 14.11 (2013): 1112-1120.Cassidy, Aedín, et al. "Associations between diet, lifestyle factors, and telomere length in women." The American journal of clinical nutrition(2010): ajcn-28947.
Epigenetic – effect of environmental influence upon susceptible genetic areas
Ornish-lifestyle altered positively > 500 gene switches; on 48 off 453
Generational effect--- Agouti mice
Plant based food stabilizes epigenome
Gasser, Susan M., and En Li, eds. Epigenetics and disease. Vol. 67. Springer, 2011.Junien, Claudine. "Impact of diets and nutrients/drugs on early epigenetic programming." Journal of inherited metabolic disease 29.2-3 (2006): 359-365.Pasman, W. J., et al. "Nutrigenomics approach elucidates health-promoting effects of high vegetable intake in lean and obese men." Genes & nutrition (2013): 1-15.Nutrigenomics and antioxidantsNasséra Chalabi, Dominique J Bernard-Gallon, Marie-Paule Vasson, and Yves-Jean BignonPersonalized Medicine, January 2008, Vol. 5, No. 1 , Pages 25-36
NHANES 2017 Consumption of nuts and seeds accounts for meaningful decreases in biologic aging and cell senescence. Telomeres lengthened with nut intake
Powerhouse of the cellMaintain glutathione levelsRegulates cellular activity and protects DNA
Plant based diet improves efficiency and number of mitochondria—Biogenesis
Phytochemicals in broccoli protect mesenchymal stem cells from oxidative injuries, mobilize—dietary amounts
Inhibits formation of cross-linking agents, AGE’s
Enhances DNA repair
Assist in cellular detoxification
Phytochemicals act as cell signaling, bind to nuclear receptors
Enzymatic affect- mushrooms inhibit aromatase
Fontana L, et al. Long-term effects of calorie or protein restriction on serum IGF-1 and IGFBP-3 concentration in humans. Aging Cell 2008; 7(5):681-687. Grube BJ,Eng ET,Kao YC,Kwon A,Chen S. White button mushroom phytochemicals inhibit aromatase activity and breast cancer cell proliferation. J Nutr 2001; 131: 3288–93.
William W. Li, Vincent W. Li, Michelle Hutnik, Albert S. ChiouTumor Angiogenesis as a Target for Dietary Cancer Prevention
Kale Blackberries Sea cucumber
Bok Choy Blueberries Pomegranate
Broccoli Strawberries Olives
Cauliflower Cranberries Maitake mushrooms
Brussels sprouts Cherries Onion
Asparagus Red grapes Garlic
Parsley Oranges Tumeric
Artichokes Lemons Ginger
Soy beans Grapefruit Cocoa
Tomatoes Apple Ginseng
Pumpkin Pineapple Green Tea
Source:Angiogenesis Foundation
Microbiomefiber prebiotics feed beneficial bacteria shape populations
assist in healing leaky gut
Reduce inflammation-TMAO
Increase production of neurotransmitters-serotonin
Improve blood sugars
Reduce colon cancer risk
J Oncol. 2012; 2012: 879623. Published online 2011 September 29.Bendich, Adrianne. "β-Carotene and the immune response." Proceedings of the nutrition society 50.02 (1991): 263-274.Crozier, Alan, Mike N. Clifford, and Hiroshi Ashihara, eds. Plant secondary metabolites: occurrence, structure and role in the human diet. John Wiley & Sons, 2008.
Protects against oxidized LDL
Down regulates inflammatory pathways
Increases NO
Reduces smooth muscle proliferation
Reduces cardiovascular disease risk
CV-normalize blood pressure prevent/suspend/reverse atherosclerotic plaque
GI—eliminates constipation, diverticulosis, resolves reflux, IBS/IBD, gastroparesis, prevents colon cancer
Nervous System: Improving ADD, MS, Neurotransmitter stability, improves mood, prevention dementia
MSK-improves bone density, maintenance of muscle, stem cell mobilization, cartilage health
Liver, kidney- normalize BP, repairs liver cells/resolves NAFLD, normalizes fatty acid metabolism, improves renal function
1 year: 91% regression of angina vs. control 165% increase
Artery regression 82% vs progression in control group
Reperfusion in 3 weeks
Greater improvement in 5 years vs 1 year
Medicare approved program
Ornish, Dean, et al. "Intensive lifestyle changes for reversal of coronary heart disease." Jama 280.23 (1998): 2001-2007.
Dietary Research
Vegetarian vs American Diabetes Association (ADA) diet
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
MedicationsWeightInsulin Sensitivity
ADA
Vegetarian
Adiponectin, Leptin, Vitamin C, SOD, Glutathione vs no change in ADA group
Meta-analyses with positive outcomes
44% of patients with type 2 diabetes could stop their insulin within four weeks.
74% of patients with type 2 diabetes on oral drugs were able to leave the center drug-free within 4 weeks.
Improved beta cell function
Reduces fat in the cells
Diabetes Care 6:268, 1983JAppl Physiol 98:3, 2005
(874 pts, meta-analysis
Kahleova, Hana, et al. "A plant-based dietary intervention improves beta-cell function and insulin resistance in overweight adults: A 16-week randomized clinical trial." Nutrients 10.2 (2018): 189.
Reduced pain of diabetic peripheral neuropathy
20 week trial: significant reduction pain scores (8.2) and improved quality of life scores Nutrition & Diabetes volume 5, page e158 (2015)
25 day inpatient intervention:17/21 or 81% reported a significant improvement in symptoms including numbness in just 4-16 days2 weeks Insulin requirement decreased in 50% of patients
14th day fasting blood glucose decreased 35%
4 year follow-up 71% maintained on the diet, 16/17 reported no return of symptoms
Crane, Milton G., and Clyde Sample. "Regression of diabetic neuropathy with total vegetarian (vegan) diet. Journal of Nutritional and Environmental
Medicine 4.4 (1994): 431-439.
Improved daily health, reduced presenteeism
Fewer sick days, improved general well being
Cost savings, reduced copay, deductible, lost wages, lost time and quality of life
Optimal weight
Improved pain, mobility
Improved mood stability, natural MAO inhibitors, serotonin production
Improved relationships--health influence, resolves of food addiction
Systematic Review of 86 observational studies and 10 cohort trials
“significant reduced levels of body mass index, total cholesterol, LDL-cholesterol, and glucose levels in vegetarians and vegans versus omnivores.”
“significant protective effect of a plant based dietmortality from ischemic heart disease (−25%) and incidence from total cancer (−8%). Vegan diet conferred a significant reduced risk (−15%) of incidence from total cancer.”
“We should be investing in people and processes, not hospitals.”
Dr. David Feinberg, CEO
Identified patients with T2DM (A1c >8 ) and who self identified with food insecurityFood insecurity: 14% pop, 23% children Claims data revealed $8000-$12000 per month expenses
37 patients for 12 months
Pre A1c 9.6%, Post 7.5%
corresponds to 40% decrease in risk of death and serious consequences
Mean healthcare costs decreased by 80%
From $240,000/member/year to $48,000/member/year
“Our Findings showed that the increased intake of certain
foods and not enough of others was associated with nearly
half of all deaths in the US due to heart disease, stroke,
and diabetes.”
Renata Micha, PhD, RD Lead Author, Jama Study 2017
Micha, Renata, et al. "Association between dietary factors and mortality from heart disease, stroke, and type 2 diabetes in the United States." Jama 317.9 (2017): 912-924.
Lappe, Frances Moore. Diet for a Small Planet. 1982, page 69.
UN: Losing 1% topsoil annually last 40 years with 60 harvests remaining
Regenerative agriculture-Rebuild soil via cover crop, soil-biome, carbon sequestration
Care and concern for animals elimination of CAFO’s
June 2018 Largest study to date
Included 38,700 farms 119 countries
40 food products that represent 90% of what we eat
“Agriculture is a sector that spans all the multitude of environmental problems” Dr. Joesph
Poore- Lead researcher Oxford
Sequester more than 80% of CO2 emissions with a switch to organic, regenerative agricultureReversal of the greenhouse effect“Farming like life on earth matters”.
van Dooren, Corné, et al. "Exploring dietary guidelines based on ecological and nutritional values: a comparison of six dietary patterns." Food Policy 44 (2014): 36-46.
Healthcare Reimbursement, volume/ procedure based
Education and acceptance
Competition over cooperation and unity
Philosophy
Medical education
GovernmentSubsidies
Agri/Food corporations
Lobby groups
Healthcare allocation
General PublicMindset/belief and value system
Cultural education and media
Awareness
Dietary misconceptions/confusion
Access
Cost
Education
Skills
Time
PBN is the only consistent, expeditious, cost effective, sustainable solution
Google search “whole food plant based diet” 5,220,000
Google Scholar; since 2015 37,200
Hundreds of books on Amazon
Multiple conferences
Health systems- Lee and Midland
Documentaries
Uber test