A New Approach to Food and

Health Neal Barnard, MDPresident, Physicians Committee for Responsible Medicine

Adjunct Associate Professor of MedicineGeorge Washington University School of Medicine

A Lesson from Japan

Diabetes Prevalence in Japan

In adults over age 40:

Prior to 1980: 1-5%

Kuzuya T. Prevalence of diabetes mellitus in Japan compiled from literature. Diab Res Clin Practice. 1994;24 Suppl:S15-S21.

Rising Fat Intake in Japan

Murata M. Am J Clin Nutr 2000;72(suppl):1379S-83S.

Fat (grams/day)

0

10

20

30

40

50

60

1955 1965 1975 1985 1994

Falling Carbohydrate Intake in Japan

Murata M. Am J Clin Nutr 2000;72(suppl):1379S-83S.

Carbohydrate (grams/day)

250

280

310

340

370

400

430

1955 1965 1975 1985 1994

Overweight and Obesity in JapanOverweight and Obesity in Japan

Yoshiike N. Obes Rev 2002;3:183-90. Yoshiike N. Asia Pac J Clin Nutr 2002;11(Suppl 8):S727-31.

BMI 25-29.9

BMI ≥ 30

%

%%

%% %

%

Prevalence in MenPrevalence in Men

Diabetes Prevalence in Japan

In adults over age 40:

Prior to 1980: 1-5%

By 1990: 11-12%

Kuzuya T. Prevalence of diabetes mellitus in Japan compiled from literature. Diab Res Clin Practice. 1994;24 Suppl:S15-S21.

A Lesson from the U.S.

U.S. Per Capita Meat Intake (lb)

1900 1920 1940 1960 1980 2000

20

40

60

80

100

120

140

160

180

200

220

Source:US Department of Agriculture, Economic Research Service,http://www.ers.usda.gov/Data/FoodConsumption/FoodAvailSpreadsheets.htm#mtpcc,accessed August 15, 2009.

1909

2004

123.9 lb

201.5 lb

(Includes red meat, poultry, and fish)

2010188.8 lb

U.S. Per Capita Chicken Intake (lb)

1900 1920 1940 1960 1980 20000

10

20

30

40

50

60

Source:US Department of Agriculture, Economic Research Service,http://www.ers.usda.gov/Data/FoodConsumption/FoodAvailSpreadsheets.htm#mtpcc,accessed August 15, 2009.

1909

2006

10.4 lb

60.9 lb

201058.0 lb

Diabetes Prevalence 1994

Diabetes Prevalence 1995

Diabetes Prevalence 1996

Diabetes Prevalence 1997

Diabetes Prevalence 1998

Diabetes Prevalence 1999

Diabetes Prevalence 2000

Diabetes Prevalence 2001

Diabetes Prevalence 2002

Diabetes Prevalence 2003

Diabetes Prevalence 2004

Diabetes Prevalence 2005

Diabetes Prevalence 2006

Diabetes Prevalence 2007

Diabetes Prevalence 2008

Adventist Health Study – 2 60,903 participants, aged ≥30, enrolled 2002-2006

Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of type 2 diabetes. Diabetes Care 2009;32:791-6.

European Prospective Investigation into Cancer and Nutrition (EPIC)

N = 37,875; aged 20 – 97; enrolled 1993 - 1999

Spencer EA, et al. Diet and body mass index in 38,000 EPIC-Oxford meat-eaters, fish-eaters, vegetarians, and vegans. Int J Obesity 2003;27:728-34.

Weight-Control Study

64 women Moderately to severely overweightPost-menopausal

Weight-Control Study

Low-fat vegan diet

No exercise

14-week study

Typical Day’s MealsBreakfastBlueberry pancakes or Oatmeal with cinnamon and raisinsHalf cantaloupe Rye toast with jam

LunchChunky vegetable chiliGarden salad with sesame dressing

SnackBanana

DinnerLentil soup with crackers Linguine with artichoke hearts and seared oyster mushrooms Steamed broccoli

Weight-Control Study

Low-fat vegan diet

No exercise

14-week study

Weight-Control Study

Low-fat vegan diet

No exercise

14-week study

→

13 lb average weight loss in 14 weeks

Sustained weight loss for 2 years

How Does It Work?

Fiber Tricks the Brain

Fiber tells the brain you’re full.

Getting the After-Meal “Burn”

Fat in cells slows your after-meal calorie burn.

Getting fat out of cells boosts your after-meal calorie burn.

Body Weight

P-value < 0.0001

Am J Health Promotion, In press

Waist Circumference

Am J Health Promotion, In pressP-value < 0.001

PCRM 2009 USDA 2011

Complete Nutrition

Protein

Calcium

Vitamin B12

Beginning a Healthful Diet

Step 1. Check out the possibilities

Breakfast

Lunch

Dinner

Snack

Foods to Try

Healthy Breakfasts

• Cinnamon Raisin Oatmeal• Blueberry Pancakes

• Hot Whole Wheat with Dates• Breakfast Scrambler

• Fantastic Fruit Smoothie• Whole-Grain Bagel with Jam

• Swiss Style Muesli• Slow Cooker Whole-Grain Porridge

• Orange-Pineapple Crush

Lunches and Dinners• Chunky Vegetable Chili

•Chuckwagon Stew • Seitan & Mushroom Stroganoff • Portobello Mushroom Steaks • Oven-Barbecued Tofu Steaks

• Roadhouse Hash • Sweet & Sour Tempeh

• Southern Beans & Greens • Seitan Cassoulet • Mandarin Stir-Fry

• Stuffed Vegetable Rolls • Zucchini & Herb Calzones

• Chili Bean Macaroni

Italian Cuisine

Mexican Cuisine

Chinese Cuisine

Fast-Food Options

Veggie delight

Bean burrito, hold the cheese

Beginning a Healthful Diet

Step 1. Check out the possibilities Step 2. Do a 3-week test drive Optional: Use transition foods

Resourceswww.pcrm.org

PCRM.org

PCRM.org

http://pcrm.org/kickstartHome/

PCRM.org