Can Diet Protect Your Mind?

Which Diet Is Best?

Author: Dr. Stephen Chaney 

can diet prevent alzheimer'sAlzheimer’s is a scary disease. There is so much to look forward to in our golden years. We want to enjoy the fruits of our years of hard work. We want to enjoy our grandkids and perhaps even our great grandkids. More importantly, we want to be able to pass on our accumulated experiences and wisdom to future generations.

Alzheimer’s and other forms of dementia have the potential to rob us of everything that makes life worth living. What is the use of having a healthy body, family, and fortune if we can’t even recognize the people around us?

Alzheimer’s and other forms of dementia don’t happen overnight. The first symptoms of cognitive decline are things like forgetting names, where you left things, what you did last week. For most people it just keeps getting worse.

Can diet protect your mind? Recent studies have given us a ray of hope. For example, several meta-analyses have shown that adherence to the Mediterranean diet was associated with a 25-48% lower risk of cognitive decline and dementia.

However, there were several limitations to the studies included in these meta-analyses. For example:

  • For most of the studies the diet was assessed only at the beginning of the study. We have no idea whether the participants followed the same diet throughout the study. This means, we cannot answer questions like:
    • What is the effect of long-term adherence to a healthy diet?
    • Can you reduce your risk of cognitive decline if you switch from an unhealthy diet to a healthy diet?
  • These studies focused primarily on the Mediterranean diet. This leaves the question:
    • What about other healthy diets? Is there something unique about the Mediterranean diet, or do other healthy diets also reduce the risk of cognitive decline?

This study (C Yuan et al, American Journal of Clinical Nutrition, 115: 232-243, 2022) was designed to answer those questions.

How Was The Study Done?

clinical studyThe investigators utilized data from The Nurse’s Health Study. They followed 49,493 female nurses for 30 years from 1984 to 2014. The average age of the nurses in 1984 was 48 years, and none of them had symptoms of cognitive decline at the beginning of the study.

The nurse’s diets were analyzed in 1984, 1986, and every 4 years afterwards until 2006. Diets were not analyzed during the last 8 years of the study to eliminate something called “reverse causation”. Simply put, the investigators were trying to eliminate the possibility that participants in the study might change their diet because they were starting to notice symptoms of cognitive decline.

The data from the dietary analyses were used to calculate adherence to 3 different healthy diets:

  • The Mediterranean diet.
  • The DASH diet. The DASH diet was designed to reduce the risk of high blood pressure. But you can think of it as an Americanized version of the Mediterranean diet.
  • The diet recommended by the USDA. Adherence to this diet is evaluated by something called the Alternative Healthy Eating Index or AHEI.

Adherence to each diet was calculated by giving a positive score to foods that were recommended for the diet and a negative score for foods that were not recommended for the diet. For more details, read the article.

In 2012 and 2014 the nurses were asked to fill out questionnaires self-assessing the early stages of cognitive decline. They were asked if they had more trouble than usual:

  • Remembering recent events or remembering a short list of items like a grocery list (measuring memory).
  • Understanding things, following spoken instructions, following a group conversation, or following a plot in a TV program (measuring executive function).
  • Remembering things from one second to the next (measuring attention).
  • Finding ways around familiar streets (measuring visuospatial skills).

The extent of cognitive decline was calculated based on the number of yes answers to these questions.

Can Diet Protect Your Mind?

Vegan FoodsHere is what the investigators found when they analyzed the data:

At the beginning of the study in 1984 there were 49,493 female nurses with an average age of 48. None of them had symptoms of cognitive decline.

  • By 2012-2014 (average age = 76-78) 46.9% of them had cognitive decline and 12.3% of them had severe cognitive decline.

Using the data on dietary intake and the rating systems specific to each of the diets studied, the investigators divided the participants into thirds based on their adherence to each diet. The investigators then used these data to answer two important questions that no previous study had answered:

#1: What is the effect of long-term adherence to a healthy diet? To answer this question the investigators averaged the dietary data obtained every 4 years between 1984 and 2006 to obtain cumulative average scores for adherence to each diet. When the investigators compared participants with the highest adherence to various healthy diets for 30 years to participants with the lowest adherence to those diets, the risk of developing severe cognitive decline was decreased by:

  • 40% for the Mediterranean diet.
  • 32% for the DASH diet.
  • 20% for the USDA-recommended healthy diet (as measured by the AHEI score).

#2: Can you reduce your risk of cognitive decline if you switch from an unhealthy diet to a healthy diet? To answer this question, the investigators looked at participants who started with the lowest adherence to each diet and improved to the highest adherence by the end of the study. This study showed that improving from an unhealthy diet to a healthy diet over 30 years decreased the risk of developing severe cognitive decline by:

  • 20% for the Mediterranean diet.
  • 25% for the DASH diet.

There were a few other significant observations from this study.

  • The inverse association between healthy diets and risk of cognitive decline was greater for nurses who had high blood pressure.
    • This is an important finding because high blood pressure increases the risk of cognitive decline.
  • The inverse association between healthy diets and risk of cognitive decline was also greater for nurses who did not have the APOE-ɛ4 gene.
    • This illustrates the interaction of diet and genetics. The APOE-ɛ4 gene increases the risk of cognitive decline. Healthy diets reduced the risk of cognitive decline in nurse with the APOE-ɛ4 gene but not to the same extent as for nurses without the gene.

This study did not investigate the mechanism by which healthy diets reduced the risk of cognitive decline, but the investigators speculated it might be because these diets:

  • Were anti-inflammatory.
  • Supported the growth of healthy gut bacteria.

The investigators concluded, “Our findings support the beneficial roles of long-term adherence to the [Mediterranean, DASH, and USDA] dietary patterns for maintaining cognition in women…Further, among those with initially relatively low-quality diets, improvement in diet quality was associated with a lower likelihood of developing severe cognitive decline. These findings indicate that improvements in diet quality in midlife and later may have a role in maintenance of cognitive function among women.”

Which Diet Is Best?

Mediterranean Diet FoodsIn a sense this is a trick question. That’s because this study did not put the participants on different diets. It simply analyzed the diets the women were eating in different ways. And while the algorithms they were using were diet-specific, there was tremendous overlap between them. For more specifics on the algorithms used to estimate adherence to each diet, read the article.

That is why the investigators concluded that all three diets they analyzed reduced the risk of cognitive decline rather than highlighting a specific diet. However, based on this and numerous previous studies the evidence is strongest for the Mediterranean and DASH diets.

And I would be remiss if I didn’t also mention the MIND diet. While it was not included in this study, the MIND diet:

  • Was specifically designed to reduce cognitive decline.
  • Can be thought of as a combination of the Mediterranean and DASH diets.
  • Includes data from studies on the mind-benefits of individual foods. For example, it recommends berries rather than all fruits.

The MIND diet has not been as extensively studied as the Mediterranean and DASH diets, but there is some evidence that it may be more effective at reducing cognitive decline than either the Mediterranean or DASH diets alone.

Which Foods Are Best?

AwardThe authors of this study felt it was more important to focus on foods rather than diets. This is a better approach because we eat foods rather than diets. With that in mind they analyzed their data to identify the foods that prevented cognitive decline and the foods increased cognitive decline. This is what they found:

  • Fruits, fruit juices, vegetables, fish, nuts, legumes, low-fat dairy, and omega-3 fatty acids (fish oil) reduced the risk of cognitive decline.
  • Red and processed meats, omega-6 fatty acids (most vegetable oils), and trans fats increased the risk of cognitive decline.

While this study did not specifically look at the effect of processed foods on cognitive decline, diets high in the mind-healthy foods listed above are generally low in sodas, sweets, and highly processed foods.

What Does This Study Mean For You?

Question MarkThe question, “Can diet protect your mind”, is not a new one. Several previous studies have suggested that healthy diets reduce the risk of cognitive decline, but this study breaks new ground. It shows for the first time that:

  • Long-term adherence to a healthy diet can reduce your risk of cognitive decline by up to 40%.
    • This was a 30-year study, so we aren’t talking about “diet” in the traditional sense. We aren’t talking about short-term diets to drop a few pounds. We are talking about a life-long change in the foods we eat.
  • If you currently have a lousy diet, it’s not too late to change. You can reduce your risk of cognitive decline by switching to a healthier diet.
    • This is perhaps the best news to come out of this study.

Based on current evidence, the best diets for protecting against cognitive decline appear to be the Mediterranean, DASH, and MIND diets.

And if you don’t like restrictive diets, my advice is to:

  • Eat more fruits, fruit juices, vegetables, fish, nuts, legumes, low-fat dairy, and omega-3 fatty acids (fish oil).
  • Eat less red and processed meats, omega-6 fatty acids (most vegetable oils), and trans fats.
  • Eat more plant foods and less animal foods.
  • Eat more whole foods and less sodas, sweets, and processed foods.

And, of course, a holistic approach is always best. Other lifestyle factors that help reduce your risk of cognitive decline include:

  • Regular exercise.
  • Weight control.
  • Socialization.
  • Memory training (mental exercises).

The Bottom Line 

Alzheimer’s is a scary disease. What is the use of having a healthy body, family, and fortune if we can’t even recognize the people around us?

A recent study looked at the effect of diet on cognitive decline in women. The study started with middle-aged women (average age = 48) and followed them for 30 years. The investigators then used these data to answer two important questions that no previous study had answered:

#1: What is the effect of long-term adherence to a healthy diet? When the investigators compared participants with the highest adherence to various healthy diets for 30 years to participants with the lowest adherence to those diets, the risk of developing severe cognitive decline was decreased by:

  • 40% for the Mediterranean diet.
  • 32% for the DASH diet.
  • 20% for the USDA recommendations for a healthy diet.

#2: Can you reduce your risk of cognitive decline if you switch from an unhealthy diet to a healthy diet? This study showed that improving from an unhealthy diet to a healthy diet over 30 years decreased the risk of developing severe cognitive decline by:

  • 20% for the Mediterranean diet.
  • 25% for the DASH diet.

The investigators concluded, “Our findings support the beneficial roles of long-term adherence to the [Mediterranean, DASH, and USDA] dietary patterns for maintaining cognition in women…Further, among those with initially relatively low-quality diets, improvement in diet quality was associated with a lower likelihood of developing severe cognitive decline. These findings indicate that improvements in diet quality in midlife and later may have a role in maintenance of cognitive function among women.”

For more details on the study, which diets, and which foods are best for protecting your mind, and what this study means for you, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

Can Diet Add Years To Your Life?

Which Foods Have The Biggest Effect On Longevity? 

Author: Dr. Stephen Chaney

Fountain Of YouthEveryone over 50 is searching for the elusive “Fountain Of Youth”.

  • We want to look younger.
  • We want to feel younger.
  • We want the energy we had in our 20s.
  • We want to be rid of the diseases of aging.

The list goes on!

But how do we do that? Pills and potions abound that claim to reverse the aging process. Most just reverse your wallet.

  • Should we train for marathons or bodybuilding contests?
  • Should we meditate or do yoga to relieve stress?
  • Should we get serious about losing weight?
  • Should we get more sleep?
  • Is there some miracle diet that can slow the aging process?

All the above probably slow the aging process, but the evidence is best for the effect of diet on aging. Several recent meta-analyses have looked at the effect of diet on the risk of premature deaths. In this issue of “Health Tips From the Professor” I review a study (LT Fadnes et al, PLoS Medicine, February 8, 2022) that combines the best of these meta-analyses into a single database and provides a provocative insight into the effect of diet on longevity.

How Was This Study Done?

Clinical StudyThis study combined data from recent meta-analyses looking at the impact of various food groups on the risk of premature deaths with the Global Burden of Disease Study which provides population-level estimates of life years lost due to dietary risk factors.

The authors then developed a new algorithm that allowed them to estimate how different diets affect sex- and age-specific life expectancy.

They divided the population into three different diet categories based on their intake of whole grains, vegetables, fruits, nuts, legumes, fish, eggs, dairy, refined grains, red meat, processed meat, white meat, sugar-sweetened beverages, and added plant oils. The diet categories were:

  • Typical Western Diet (TW). This diet was based on average consumption data from the United States and Europe. This was their baseline.
  • Optimal diet (OD). This diet is similar to a vegan or semi-vegetarian diet. However, it was not a purely vegan diet nor a purely semi-vegetarian diet. Instead, it represented the best diet people in this study were consuming.
  • Feasibility diet (FA). This diet recognizes that few people are willing to make the kind of changes required to attain an optimal diet. It is halfway between the Typical Western Diet and the Optimal Diet.

To help you understand these diets based on the foods the study participants were eating, here are the comparisons in terms of daily servings:

Food TW Diet FA Diet OD Diet
Whole grains 1.5 servings 4.3 servings 7 servings
Vegetables 3 servings 4 servings 5 servings
Fruits 2.5 servings 3.75 servings 5 servings
Nuts 0 serving* 0.5 serving* 1 serving*
Legumes 0 serving** 0.5 serving** 1 serving**
Fish 0.25 serving 0.5 serving 1 serving
Eggs 1 egg 0.75 egg 0.5 egg
Dairy 1.5 servings 1.25 servings 1 serving
Refined grains 3 servings 2 servings 1 serving
Red meat 1 serving 0.5 serving 0 serving
Processed meat 2 servings 1 serving 0 serving
White meat 0.75 serving 0.6 serving 0 serving
Sugar-sweetened beverages 17 oz 8.5 oz 0 oz
Added plant oils 2 tsp 2 tsp 2 tsp

*1 serving = 1 handful of nuts

**1 serving = 1 cup of beans, lentils, or peas

Using their algorithm, the authors asked what the effect on longevity would be if people changed from a typical western diet to one of the other diets at age 20, 60, or 80 and maintained the new diet for at least 10 years. The 10-year requirement is based on previous studies showing that it takes around 10 years for dietary changes to affect the major killer diseases like heart disease, cancer, or diabetes.

Finally, the authors improved the accuracy of their estimates of the effect of diet on longevity by taking into account the quality of each study included in their analysis. I will discuss the importance of this below.

Can Diet Add Years To Your Life?

The results were impressive.

The authors estimated that if people in the United States were to change from a typical western diet to an “optimal diet” and maintain it for at least 10 years,

…starting at age 20, men would live 13 years longer and women would live 10.7 years longer.

…starting at age 60, men would live 8.8 years longer and women would live 8 years longer.

…starting at age 80, both men and women would live 3.4 years longer.

But what if you weren’t a vegan purist? What if you only made half the changes you would need to make to optimize your diet? The news was still good.

The authors estimated that people in the United States were to change from a typical western diet to a “feasibility diet” and maintain it for at least 10 years,

…starting at age 20, men would live 7.3 years longer and women would live 6.2 years longer.

…starting at age 60, men would live 4.8 years longer and women would live 4.5 years longer.

…starting at age 80, both men and women would live ~2 years longer.

The authors concluded, “A sustained dietary change may give substantial health gains for people of all ages for both optimized and feasible [diet] changes. [These health gains] could translate into an increase in life expectancy of more than 10 years. Gains are predicted to be larger the earlier the dietary changes are initiated in life.”

Which Foods Have The Biggest Effect On Longevity?

The algorithm the authors developed also allowed them to look at which foods have the biggest effect on longevity. The authors estimated when changing from a typical western diet to an optimal diet, the greatest gains in longevity were made by eating:

  • More legumes, whole grains, and nuts, and…
  • Less red and processed meat.

The authors concluded, “An increase in the intake of legumes, whole grains, and nuts, and a reduction in the intake of red meat and processed meats, contributed most to these gains [in longevity].”

However, this conclusion needs to be interpreted with caution. We also need to recognize that an “optimal diet” was defined as the best diet people in this study were eating. In addition, the effect of different foods on longevity depends on:

  • The quality of the individual studies with that food, and…
  • The difference in consumption of that food in going from a western diet to an optimal diet.

For example:

  • Legumes, whole grains, nuts, red & processed meat made the list because the quality of data was high and the difference in consumption between the typical western diet and optimal diet was significant.
  • The quality of data for an effect of fruits and vegetables was also high. For example, one major study concluded that consuming 10 servings a day of fruits and vegetables a day reduces premature death by 31% compared to consumption of less than 1 serving a day. However, the difference in consumption of fruits and vegetables between the western and optimal diets in this study was small, so fruits and vegetables didn’t make the list.
  • Eggs and white meat didn’t make the list because the quality of data was low for those foods. Simply put,  that means that there was a large variation in effect of those foods on longevity between studies.
  • Other foods didn’t make the list because the quality of data was only moderate and/or the difference in intake was small.

So, the best way to interpret this these data is:

  • This study suggests that consuming more legumes, whole grains, and nuts and less red & processed meats has a significant beneficial effect on health and longevity.
  • Consuming more fruits and vegetables is likely to have a significant benefit on health and longevity, but you would need to consume more than people did in this study to achieve these benefits. In the words of the authors, “Fruits and vegetables also have a positive health impact, but, for these food groups, the intake in a typical Western diet is closer to the optimal intake than for the other food groups.”
  • Other foods may impact health and longevity, but the data in this study are not good enough to be confident of an effect.

What Does This Study Mean For You?

This study is the best of many studies showing the benefit of a more plant-based diet on health and longevity. It particularly encouraging because it shows:

  • You can achieve significant benefit by switching to a more plant-based diet late in life. You get the biggest “bang for your buck” if you switch at age 20. But even making the switch at age 60 or 80 was beneficial.
  • You don’t need to be a “vegan purist”. While the biggest benefits were seen for people who came close to achieving a vegan or semi-vegetarian diet, people who only made half those changes saw significant benefits.

As I said above, this is a very strong study. However, the underlying data come from association studies, which can have confounding variables that influence the results.holistic approach

For example, people who eat more plant-based diets tend to weigh less and exercise more. And both of those variables can influence longevity. Each study attempted to statistically correct for those variables, but they still might have a slight influence on the results.

However, I don’t see that as a problem because, in my view, a holistic approach is always best. As illustrated on the right, we should be seeking a lifestyle that includes a healthy diet, weight control, and exercise.

As for supplementation, both the vegan and semi-vegetarian diets tend to leave out whole food groups. Unless you are married to a dietitian, that means your diet is likely to be missing important nutrients.

The Bottom Line

A recent study asked whether changing from the typical western diet to a healthier, more plant-based diet could influence longevity. The results were very encouraging. The study showed that:

  • Changing to a healthier diet could add up to a decade to your lifespan.
  • The improvement in lifespan was greatest for those whose diets approached a vegan or semi-vegetarian diet, but a significant improvement in lifespan was seen for people who made only half those dietary improvements.
  • The improvement in lifespan was greatest for those who switched to a healthier diet in their 20’s, but significant improvements in lifespan were seen for people who didn’t change their diet until their 60’s or 80’s.

In terms of the foods that have the biggest effect on longevity.

  • This study suggests that consuming more legumes, whole grains, and nuts and less red & processed meats has a significant beneficial effect on health and longevity.
  • Consuming more fruits and vegetables is likely to have a significant benefit on health and longevity, but you would need to consume more than people did in this study to achieve those benefits.
  • Other foods may impact health and longevity, but the data in this study are not good enough to be confident of an effect.

The authors concluded, “A sustained dietary change may give substantial health gains for people of all ages for both optimized and feasible [diet] changes. [These health gains] could translate into an increase in life expectancy of more than 10 years. Gains are predicted to be larger the earlier the dietary changes are initiated in life.

An increase in the intake of legumes, whole grains, and nuts, and a reduction in the intake of red meat and processed meats, contributed most to these gains. Fruits and vegetables also have a positive health impact, but, for these food groups, the intake in a typical Western diet is closer to the optimal intake than for the other food groups.”

For more details about this study and what it means for you, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

Does Olive Oil Help You Live Longer?

Which Fat Is Healthiest?

Author: Dr. Stephen Chaney

If you believe the headlines, olive oil is a superfood. It is often described as the star of the Mediterranean diet. It is referred to as the healthiest of dietary fats. Is this true, or is it hype?

Olive oil’s resume is impressive:

  • It is rich in monounsaturated fatty acids, which…
    • Are less susceptible to oxidation than polyunsaturated oils.
    • Make our arteries more flexible, which lowers blood pressure.
    • Lower LDL-cholesterol levels, which reduces the risk of heart disease.
  • Extra-virgin olive oil contains phytonutrients and tocopherols (various forms of vitamin E), which…
    • Have anti-inflammatory properties.
    • Improve insulin sensitivity and blood sugar control.
  • Olive oil consumption is also associated with healthier gut bacteria, but it is not clear whether this is due to olive oil or to the fact that a Mediterranean diet is also richer in fresh fruits, vegetables, and whole grains.

Several recent studies have shown that olive oil consumption is associated with a lower risk of heart disease. However, these studies were conducted in Mediterranean countries where the average intake of olive oil (3 tablespoons/day) is much greater than in the United States (0.3 tablespoons/day).

The current study (M Guasch-Ferré et al, Journal of the American College of Cardiology, 79: 101-112, 2022) was designed to test whether:

  • The amount of olive oil Americans consume decreases the risk of heart disease.
  • Whether olive oil consumption had benefits beyond a reduction in heart disease risk.

How Was This Study Done? 

Clinical StudyThis study combined data from 60,582 women enrolled in the Nurses’ Health Study and 31,801 men enrolled in the Health Professionals Follow-Up Study). The participants:

  • Were free of heart disease and diabetes at the start of the study.
  • Were 56 at the start of the study with an average BMI of 25.6 (Individuals with BMIs in the 25-30 range are considered overweight, so they were at the lowest end of the overweight range).

The Nurses’ Health Study and Health Professional Follow-Up Study are both association studies, meaning they looked at the association between olive oil consumption and health outcomes. They cannot directly prove cause and effect. However, they are very strong association studies because:

  • Every 2 years, participants filled out a questionnaire that updated information on their body weight, smoking status, physical activity, medications, multivitamin use, and physician-diagnosed diseases.
  • Every 4 years, participants filled out a comprehensive food frequency questionnaire.
  • In other words, this study did not just rely on the participant’s lifestyle, dietary intake, and health at the beginning of the study, as so many association studies do. It tracked how each of these variables changed over time.

The participants were followed for an average of 28 years and their average olive oil intake over those 28 years was correlated with all-cause mortality and mortality due to specific diseases.

  • Deaths were identified from state vital statistics, the National Death index, reports by next of kin, or reports by postal authorities.
  • Causes of death were determined by physician review of medical records, medical reports, autopsy reports, or death certificates.

Does Olive Oil Help You Live Longer?

During the 28 years of this study:

  • Olive oil consumption in the United States increased from an average of ~1/3 teaspoon/day to ~1/3 tablespoon/day.
  • Margarine consumption decreased from 12 g/day to ~4 g/day.
  • The consumption of all other fats and oils remained about the same.

As I mentioned above, olive oil consumption was averaged over the life of the study for each individual. When the investigators compared people consuming the highest amount of olive oil (>0.5 tablespoon/day) with people consuming the least olive oil (0 to 1 teaspoon/day):

  • Mortality from all causes was decreased by 35% for the group consuming the most olive oil.

However, the group consuming the most olive oil also was more physically active, had a healthier diet, and consumed more fruits and vegetables than the group who consumed the least olive oil.

  • After correcting for all those factors, mortality from all causes was decreased by 19% for the group consuming the most olive oil.

The authors concluded, “We found that greater consumption of olive oil was associated with lower risk of total…mortality… Our results support current dietary recommendations to increase the intake of olive oil…to improve overall health and longevity.” (I will fill in the blanks in this statement once I have covered other aspects of this study)

The authors also said, “Of note, our study showed that benefits of olive oil can be observed even when consumed in lower amounts than in Mediterranean countries.”

Are There Other Benefits From Olive Oil Consumption?

Mediterranean dietThe study didn’t stop there. The investigators also looked at the effect of olive oil consumption on the major killer diseases in the United States and other developed countries. When they compared the effect of olive oil consumption on cause-specific mortality, they found that the group who consumed the most olive oil reduced their risk of dying from:

  • Cardiovascular disease by 19%.
  • Cancer by 17%
  • Respiratory disease by 18%.
  • Neurodegenerative disease (cognitive decline and Alzheimer’s disease) by 29%.
    • The reduction in neurodegenerative disease was much greater for women (34% decrease) than for men (19% decrease).

With this information I can fill in one of the blanks in the author’s conclusions: “We found that greater consumption of olive oil was associated with lower risk of total and cause-specific mortality… Our results support current dietary recommendations to increase the intake of olive oil…to improve overall health and longevity.”

Which Fats Are Healthiest?

Good Fat vs Bad FatThe sample size was large enough and the dietary information complete enough for the investigators to also estimate the effect of substituting olive oil for other dietary fats and oils.

They found that every ¾ tablespoon of olive oil substituted for an equivalent amount of:

  • Margarine decreased total mortality by 13%.
  • Butter decreased total mortality by 14%.
  • Mayonnaise deceased total mortality by 19%
  • Dairy fat decreased total mortality by 13%.
    • The same beneficial effects of substituting olive oil for other fats were seen for cause-specific mortality (cardiovascular disease, cancer, respiratory disease, and neurodegenerative disease).
    • There was a linear dose-response. This means that substituting twice as much olive oil for other dietary fats doubled the beneficial effects on total and cause-specific mortality.
  • However, substituting olive oil for polyunsaturated vegetable oils had no effect on total and cause-specific mortality.

Now I can fill in the remaining blanks in the author’s conclusion: “We found that greater consumption of olive oil was associated with lower risk of total and cause-specific mortality. Replacing other types of fat, such as margarine, butter, mayonnaise, and dairy fat, with olive oil was also associated with a lower risk of mortality. Our results support current dietary recommendations to increase the intake of olive oil and other unsaturated vegetable oils in place of other fats to improve overall health and longevity.”

What Does This Study Mean For Us?

ConfusionAs I said above, this is an association study, and association studies do not prove cause and effect. However:

1) This is a very strong association study because:

    • It is a very large study (92,383 participants).
    • It followed the participants over a long time (28 years).
    • It utilized a very precise dietary analysis.
    • Most importantly, it tracked the participant’s lifestyle, dietary intake, and health at regular intervals throughout the study. Most association studies only measure these variables at the beginning of the study. They have no idea how they change over time.

2) This study is consistent with several previous studies showing that olive oil consumption decreases the risk of dying from heart disease.

3) This study draws on its large population size and precise dietary analysis to strengthen and extend the previous studies. For example:

    • The study showed that increased olive oil consumption also reduced total mortality and mortality due to cancer, respiratory disease, and neurodegenerative disease.
    • The study measured the effect of substituting olive oil for other common dietary fats.
    • The study showed that increased olive oil consumption in the context of the American diet was beneficial.

I should point out that the headlines you have seen about this study may be misleading.

  • While the headlines may have depicted olive oil as a superfood, this study did not find evidence that olive oil was more beneficial than other unsaturated vegetable oils. Again, this is consistent with many previous studies showing that substituting vegetable oils for other dietary fats reduces the risk of multiple diseases.
  • The headlines focused on the benefits of increasing olive oil consumption. However, they neglected the data showing that increasing olive oil (and other vegetable oils) was even more beneficial (35% reduction in total mortality) in the context of a healthy diet – one with increased intake of fruits, vegetables, whole grains, nuts, legumes, and long-chain omega-3s and decreased intake of red & processed meats, sodium, and trans fats.

So, my recommendation is to follow a whole food, primarily plant-based diet and substitute extra-virgin olive oil and cold pressed vegetable oils for some of the animal fats in your diet.

Some vegan enthusiasts recommend a very low-fat whole food plant-based diet. They point to studies showing that such diets can actually reverse atherosclerosis. However:

  • Those studies are very small.
  • The overall diet used in those studies is a very healthy plant-based diet.
  • The studies did not include a control group following the same diet with olive oil or other vegetable oils added to it, so there is no comparison of a healthy vegan diet with and without vegetable oils.

If you have read my book, Slaying the Food Myths, you know that my recommendations encompass a variety of whole food, primarily plant-based diets ranging all the way from very-low fat vegan diets to Mediterranean and DASH diets. Choose the one that best fits your food preferences and the one you will be most able to stick with long term. You will be healthier, and you may live longer.

The Bottom Line

A recent study looked at the effect of olive oil consumption on the risk dying from all causes and from heart disease, cancer, respiratory disease, and neurodegenerative diseases. When the study compared people consuming the highest amount of olive oil (>0.5 tablespoon/day) with people consuming the least olive oil (0 to 1 teaspoon/day):

  • Mortality from all causes was decreased by 19% for the group consuming the most olive oil.

They also found that the group who consumed the most olive oil reduced their risk of dying from:

  • Cardiovascular disease by 19%.
  • Cancer by 17%
  • Respiratory disease by 18%.
  • Neurodegenerative disease (cognitive decline and Alzheimer’s disease) by 29%.

They also found that every ¾ tablespoon of olive oil substituted for an equivalent amount of:

  • Margarine decreased total mortality by 13%.
  • Butter decreased total mortality by 14%.
  • Mayonnaise deceased total mortality by 19%
  • Dairy fat decreased total mortality by 13%.
  • However, substituting olive oil for polyunsaturated vegetable oils had no effect on total and cause-specific mortality.

The authors concluded, “We found that greater consumption of olive oil was associated with lower risk of total and cause-specific mortality. Replacing other types of fat, such as margarine, butter, mayonnaise, and dairy fat, with olive oil was also associated with a lower risk of mortality. Our results support current dietary recommendations to increase the intake of olive oil and other unsaturated vegetable oils in place of other fats to improve overall health and longevity.”

For more details and a summary of what this study means for you, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Which Diets Are Best In 2022?

Which Diet Should You Choose?

Author: Dr. Stephen Chaney

Emoticon-BadMany of you started 2022 with goals of losing weight and/or improving your health. In many cases, that involved choosing a new diet. That was only a month ago, but it probably feels like an eternity.

For many of you the “bloom” has gone off the new diet you started so enthusiastically in January.

  • Perhaps the diet isn’t working as well as advertised…
  • Perhaps the diet is too restrictive. You are finding it hard to stick with…
  • Perhaps you are always hungry or constantly fighting food cravings…
  • Perhaps you are starting to wonder whether there is a better diet than the one you chose in January…
  • Perhaps you are wondering whether the diet you chose is the wrong one for you…

If you are rethinking your diet, you might want to know which diets the experts recommend. Unfortunately, that’s not as easy as it sounds. The diet world has become just as divided as the political world.

Fortunately, you have an impartial resource. Each year US News & World Report invites a panel of experts with different points of view to evaluate popular diets. They then combine the input from all the experts into rankings of the diets in various categories.

If you are still searching for your ideal diet, I will summarize the US News & World Report’s “Best Diets In 2022”. For the full report, click on this link.

How Was This Report Created?

Expert PanelUS News & World Report recruited panel of 27 nationally recognized experts in diet, nutrition, obesity, food psychology, diabetes, and heart disease to review the 40 most popular diets.  The panel is not the same each year. Some experts are rotated off the panel, and others are added. The experts rate each diet in seven categories:

  • How easy it is to follow.
  • Its ability to produce short-term weight loss.
  • Its ability to produce long-term weight loss.
  • its nutritional completeness.
  • Its safety.
  • Its potential for preventing and managing diabetes.

 

  • Its potential for preventing and managing heart disease.

They converted the experts’ ratings to scores 5 (highest) to 1 (lowest). They then used these scores to construct nine sets of Best Diets rankings:

  • Best Diets Overall combines panelists’ ratings in all seven categories. However, all categories were not equally weighted. Short-term and long-term weight loss were combined, with long-term ratings getting twice the weight. Why? A diet’s true test is whether it can be sustained for years. And safety was double counted because no diet should be dangerous.
  • Best Commercial Diets uses the same approach to rank 15 structured diet programs that require a participation fee or promote the use of branded food or nutritional products.
  • Best Weight-Loss Diets was generated by combining short-term and long-term weight-loss ratings, weighting both equally. Some dieters want to drop pounds fast, while others, looking years ahead, are aiming for slow and steady. Equal weighting accepts both goals as worthy.
  • Best Diabetes Diets is based on averaged diabetes ratings.
  • Best Heart-Healthy Diets uses averaged heart-health ratings.
  • Best Diets for Healthy Eating combines nutritional completeness and safety ratings, giving twice the weight to safety. A healthy diet should provide sufficient calories and not fall seriously short on important nutrients or entire food groups.
  • Easiest Diets to Follow represents panelists’ averaged judgments about each diet’s taste appeal, ease of initial adjustment, ability to keep dieters from feeling hungry and imposition of special requirements.
  • Best Plant-Based Diets uses the same approach as Best Diets Overall to rank 12 plans that emphasize minimally processed foods from plants.
  • Best Fast Weight-Loss Diets is based on short-term weight-loss ratings.

Which Diets Are Best In 2022?

Are you ready? If this were an awards program I would be saying “Envelop please” and would open the envelop slowly to build suspense.

However, I am not going to do that. Here are the top 5 and bottom 5 diets in each category (If you would like to see where your favorite diet ranked, click on this link). [Note: I excluded commercial diets from this review.]

Best Diets Overall 

The Top 5: 

#1: Mediterranean Diet. The Mediterranean diet has been ranked #1 for 5 consecutive years.

#2: DASH Diet (This diet was designed to keep blood pressure under control, but you can also think of it as an Americanized version of the Mediterranean diet.)

#3: Flexitarian Diet (A flexible semi-vegetarian diet).

#4: MIND Diet (This diet is a combination of Mediterranean and DASH but is specifically designed to reduce cognitive decline as we age.)

#5: The TLC Diet (This diet was designed by the NIH to promote heart health.)

The Bottom 5: 

#36: Whole 30 Diet (A whole food, restrictive diet, designed for a 30-day jump start to weight loss. It was not designed for long-term use).

#37: Modified Keto Diet (A slightly less restrictive version of the Keto Diet).

#38: Keto Diet (A high protein, high fat, very low carb diet designed to achieve ketosis).

#39: Dukan Diet (High protein, low carb, low fat diet).

#40: GAPS Diet (A diet designed to improve gut health).

Best Weight-Loss Diets

The Top 5: Weight Loss

#1: Flexitarian Diet

#2: Volumetrics Diet (A diet based on the caloric density of foods).

#3: Vegan Diet (A diet that only allows plant foods).

#4: Mayo Clinic Diet (A diet designed to establish lifelong healthy eating habits).

#5: Ornish Diet (A whole food, semi-vegetarian diet designed to promote heart health).

The Bottom 5: 

#36: Fertility Diet (A diet designed to improve fertility, but the experts were skeptical that it would increase your chances of becoming pregnant)

#37: Whole 30 Diet

#38: Alkaline Diet (A diet designed to make your blood more alkaline, but the experts were skeptical about that claim)

#39: AIP Diet (A diet designed for people with autoimmune diseases)

#40: GAPS Diet

Best Diabetes Diets

The Top 5: 

#1: Mediterranean Diet

#2: Flexitarian Diet

#3: Vegan Diet

#4: Mayo Clinic Diet

#5: DASH Diet

The Bottom 5: 

#36: Alkaline Diet

#37: Dukan Diet

#38: GAPS Diet

#39: Sirtfood Diet (a very low calorie, fad diet that emphasizes plant foods rich in sirtuins)

#40: Whole 30 Diet

Best Heart-Healthy Diets 

strong heartThe Top 5: 

#1: Mediterranean Diet

#2: Ornish Diet

#3: DASH Diet

#4: Flexitarian Diet

#5: TLC Diet

#6: Vegan Diet

The Bottom 5: 

#36: Keto Diet

#37: AIP Diet

#38: Whole 30 Diet

#39: Modified Keto Diet

#40: Dukan Diet

Best Diets for Healthy Eating

The Top 5: 

#1: Mediterranean Diet

#2: DASH Diet

#3: Flexitarian Diet

#4: MIND Diet

#5: TLC Diet

The Bottom 5: 

#36: Raw Food Diet

#37: Atkins Diet

#38: Dukan Diet

#39: Modified Keto Diet

#40: Keto Diet 

Easiest Diets to Follow

The Top 5: Easy

#1: Mediterranean Diet

#2: Flexitarian Diet

#3: Fertility Diet

#4: MIND Diet

#5: DASH Diet

The Bottom 5: 

#36: Modified Keto Diet

#37: Keto Diet

#38: Whole 30 Diet

#39: GAPS Diet

#40: Raw Foods Diet 

Best Fast Weight-Loss Diets

The Top 5 (Excluding Commercial Diets): 

#1: Atkins Diet

#2: Biggest Loser Diet

#3: Keto Diet

#4: Raw Food Diet

#5: Vegan Diet

The Bottom 5 

#36: Dr. Weil’s Anti-Inflammatory Diet

#37: The Fertility Diet

#38: AIP Diet

#39: Alkaline Diet

#40: Gaps Diet

Which Diets Are Best For Rapid Weight Loss?

Happy woman on scaleThere are 3 take-home lessons from the rapid weight loss category:

1) If you are looking for rapid weight loss, any whole food restrictive diet will do. The top 5 diets are very different. For example, the keto and vegan diets are polar opposites, yet they both are in the top 5 for rapid weight loss.

  • The Atkins and keto diets are meat heavy, low carb diets. They restrict fruits, some vegetables, grains, and most legumes.
  • The Biggest Loser diet relies on restrictive meal plan and exercise programs.
  • The restrictions of the raw food diet are obvious.
  • The vegan diet is a very low-fat diet that eliminates meat, dairy, eggs, and animal fats.
  • I did not include commercial diets that rated high on this list, but they are all restrictive in one way or another.

2) We should ask what happens when we get tired of restrictive diets and add back some of your favorite foods.

  • If you lose weight on a vegan diet and add back some of your favorite foods, you might end up with a semi-vegetarian diet. This is a healthy diet that can help you maintain your weight loss.
  • If you lose weight on the Atkins or keto diets and add back some of your favorite foods, you end up with the typical American diet – one that is high in both fat and carbs. This is not a recipe for long-term success.

3) Don’t pay too much attention to the bottom 5 diets. None of them were designed with weight loss in mind.

Which Diet Should You Choose?

Food ChoicesWith rapid weight loss out of the way, let’s get back to the question, “Which Diet Should You Choose?” My recommendations are:

1) Choose a diet that fits your needs. That is one of the things I like best about the US News & World Report ratings. The diets are categorized. If your main concern is diabetes, choose one of the top diets in that category. If your main concern is heart health… You get the point.

2) Choose diets that are healthy and associated with long term weight loss. If that is your goal, you will notice that primarily plant-based diets top these lists. Meat-based, low carb diets like Atkins and keto are near the bottom of the lists.

3) Choose diets that are easy to follow. The less-restrictive primarily plant-based diets top this list – diets like Mediterranean, DASH, MIND, and flexitarian.

4) Choose diets that fit your lifestyle and dietary preferences. For example, if you don’t like fish and olive oil, you will probably do much better with the DASH or flexitarian diet than with the Mediterranean diet.

5) In case you were wondering, intermittent fasting ranked 26-30 and the Paleo diet ranked 26-33 on most of the list – not the worst diets, but a long way from the best. If you have a favorite diet I didn’t mention, check the US News website to find where it is ranked.

6) Finally, focus on what you have to gain, rather than on foods you have to give up.

  • On the minus side, none of the diets include sodas, junk foods, and highly processed foods. These foods should go on your “No-No” list. Sweets should be occasional treats and only as part of a healthy meal. Meat, especially red meat, should become a garnish rather than a main course.
  • On the plus side, primarily plant-based diets offer a cornucopia of delicious plant foods you probably didn’t even know existed. Plus, for any of the top-rated plant-based diets, there are websites and books full of mouth-watering recipes. Be adventurous.

The Bottom Line 

For many of you the “bloom” has gone off the new diet you started so enthusiastically in January. If you are rethinking your diet, you might want to know which diets the experts recommend. Unfortunately, that’s not as easy as it sounds. The diet world has become just as divided as the political world.

Fortunately, you have an impartial resource. Each year US News & World Report invites a panel of experts with different points of view to evaluate popular diets. They then combine the input from all the experts into rankings of the diets in various categories. In the article above I summarize the US News & World Report’s “Best Diets In 2022”.

There are probably two questions at the top of your list.

#1: Which diets are best for rapid weight loss? Here are some general principles:

  • If you are looking for rapid weight loss, any whole food restrictive diet will do.
  • We should ask what happens when we get tired of restrictive diets and add back some of our favorite foods.
  • Long term weight loss is possible if you transition to a healthy diet after you have lost the weight.

#2: Which diet should you choose? Here the principles are:

  • Choose a diet that fits your needs.
  • Choose diets that are healthy and associated with long term weight loss.
  • Choose diets that are easy to follow.
  • Choose diets that fit your lifestyle and dietary preferences.
  • Finally, focus on what you have to gain, rather than on foods you have to give up.

For more details on the diet that is best for you, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

Can Your Diet Cause You To Lose Your Mind?

What Is A Mind-Healthy Lifestyle? 

Author: Dr. Stephen Chaney

Cognitive-DeclineMost of us look forward to our golden years – that mystical time when we will be free from the workday pressures and have more time to spend with friends and family doing the things we love.

But cognitive decline can cast a dark cloud over those expectations.

  • By the age of 65, 11% of adults suffer from some degree of cognitive impairment.
  • And by the age of 80 the percentage of adults suffering from cognitive impairment has increased to 26-30%, depending on which study you cite.

The results of cognitive decline can be devastating.

  • First you start to lose the cherished memories of a lifetime.
  • Then comes confusion and an inability to perform basic tasks and participate in your favorite activities.
  • Eventually you may reach a stage where you no longer recognize the ones you love.

In short, cognitive decline can rob you of everything that makes you you.

The causes of cognitive decline are complex, but recent studies have pointed to the role of chronic inflammation in cognitive decline. If that is true, it is a good news – bad news situation.

  • The bad news is:
    • Some increase in chronic inflammation appears to be an inevitable consequence of aging.
    • Chronic inflammation can be caused by certain diseases that are beyond our control.
    • Chronic inflammation can be triggered by viral or bacterial infections.
  • The good news is that chronic inflammation is also controlled by your diet and lifestyle. For example, as I said above, chronic inflammation is often triggered by a viral infection, but whether the inflammation is mild or severe is strongly influenced by diet and lifestyle.

In this issue of “Health Tips From the Professor” I share a study (S Charisis et al, Neurology, In Press, November 10, 2021) showing that diets high in inflammatory foods increase the risk of dementia. Then, I answer 3 important questions.

  • Can your diet cause you to lose your mind?
  • What is a mind-healthy diet?
  • What is a mind-healthy lifestyle?

How Was This Study Done?

Clinical StudyThe data for this study were taken from the first three years of the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD), a study designed to look at the effect of diet on dementia and other neuropsychiatric conditions in the Greek population.

There were 1059 participants (40% male, average age = 75 at the beginning of the study) in this study. At the beginning of the study the participants completed a food frequency questionnaire administered by a trained dietitian. The foods were broken down into individual nutrients using the USDA Food Composition tables adapted for foods in the Greek diet.

The diet of each participant was then rated on a 15-point scale ranging from pro-inflammatory to anti-inflammatory based on something called the Diet Inflammation Index (DII).

Simply put, the DII is a validated assessment tool based on the effect of food nutrients on 6 inflammatory biomarkers found in the blood (IL-1β, IL-4, IL-6, IL-10, TNF-α, and CRP). Nutrients that decrease these markers are considered anti-inflammatory. Nutrients that increase these inflammatory biomarkers are considered pro-inflammatory.

For example, anti-inflammatory nutrients include:

  • Carotenoids and flavonoids (found in fruits and vegetables).
  • Omega-3 polyunsaturated fatty acids (found in cold-water fish, walnuts, flaxseeds, and chia seeds).
  • Monounsaturated fatty acids (found in olive, avocado, and peanut oils).
  • Fiber (found in minimally processed plant foods).
  • Antioxidants, most B vitamins, and vitamin D.
  • Magnesium and zinc.
  • Garlic, onions, most herbs & spices.

Pro-inflammatory nutrients include:

  • Refined carbohydrates.
  • Cholesterol.
  • Total fat.
  • Saturated fats.
  • Trans fats.

The participants were followed for 3 years, and all new diagnoses of dementia were recorded. The diagnoses were confirmed by a panel of neurologists and neuropsychologists.

Can Your Diet Cause You To Lose Your Mind?

Forgetful Old ManAs described above, the diet of each participant in the study was rated on a 15-point DII (Diet Inflammatory Index) scale ranging from pro-inflammatory to anti-inflammatory. The association of the DII score of the participant’s diets with the onset of dementia was evaluated in two ways.

  • Each one-point increase from an anti-inflammatory diet to a pro-inflammatory diet was associated with a 21% increase in the risk for dementia.
  • In other words, even small changes in your diet can have a significant impact on your risk of developing dementia.

The investigators then divided the participants into three equal-sized groups based on the DII score of their diets.

  • The group with the highest DII scores were 3 times more likely to develop dementia than the group with the lowest DII scores.
  • In other words, a major change in your diet can have a major effect on your risk of developing dementia.

The authors concluded, “In the present study, higher DII scores (indicating greater pro-inflammatory diet potential) were associated with an increased risk for incident dementia [newly diagnosed dementia]. These findings may avail the development of primary dementia strategies through tailored and precise dietary interventions.”

What Is A Mind-Healthy Diet?

Vegan FoodsThis and other studies show that an anti-inflammatory diet is good for the mind. It helps protect us from cognitive decline and dementia. But what does an anti-inflammatory diet look like?

One hint comes from analyzing the diets of participants in this study:

  • Those with the lowest DII scores (most-anti-inflammatory diets) consumed 20 servings of fruit, 19 servings of vegetables, 4 servings of beans or other legumes, and 11 servings of coffee or tea each week. That’s almost 3 servings of fruit and 3 servings of vegetables every day!
  • Those with the highest DII scores (most pro-inflammatory diets) consumed only half as many fruits, vegetables, and legumes.
  • In short, a diet rich in fruits, vegetables, and legumes is a good start.

I have described anti-inflammatory diets in more detail in a previous issue of “Health Tips From the Professor.” Let me summarize that article briefly.

Anti-inflammatory foods include:

  • Colorful fruits and vegetables.
  • Whole grains.
  • Beans and other legumes.
  • Nuts, olive oil, avocados, and other sources of monounsaturated fats.
  • Fatty fish and other sources of omega-3 fatty acids.
  • Herbs and spices.

Pro-inflammatory foods include:

  • Refined carbohydrates, sodas, and sugary foods.
  • Foods high in saturated fats including fatty and processed meats, butter, and high fat dairy products.
  • Foods high in trans fats.
  • French fries, fried chicken, and other fried foods.
  • Foods you are allergic or sensitive food. For example, gluten containing foods are pro-inflammatory only if you are sensitive to gluten.

If your goal is to reduce chronic inflammation and keep your mind sharp as a tack as you age, you should eat more anti-inflammatory foods and less pro-inflammatory foods.

Of course, we don’t just eat random foods, we follow dietary patterns. It should be apparent from what I have Mediterranean Diet Foodscovered above that whole food, primarily plant-based diets are anti-inflammatory. This is true for diets ranging from vegan through semi-vegetarian, to the Mediterranean, DASH, and MIND diets.

All these diets are anti-inflammatory and likely protect the brain from cognitive decline. However, the best evidence for brain protection is for the Mediterranean, DASH, and MIND diets.

  • The Mediterranean and DASH diets have been shown to prevent cognitive decline in multiple studies.
  • The MIND diet is a combination the Mediterranean and DASH diets that was specifically designed to prevent cognitive decline. It has been shown to cut the risk of developing Alzheimer’s disease in half.

What Is A Mind-Healthy Lifestyle?

Diet is just one aspect of a holistic approach for reducing cognitive decline as we age. Other important factors include:

  • Reduce excess body weight.
  • Exercise regularly.
  • Get adequate sleep.
  • Reduce and/or manage stress.
  • Eliminate smoking and reduce alcohol consumption.
  • Socialize with friends and family who support you. Numerous studies have shown that a strong support network reduces dementia risk in the elderly.
  • Keep your brain active. Work crossword puzzles. Learn new things. An active brain is forced to lay down new neural pathways.

The Bottom Line 

Recent studies have suggested that chronic inflammation increases the risk of cognitive decline and dementia as we age. Some causes of chronic inflammation are beyond our control, but others, such as diet, we can control.

Recently, a precise scoring system called the Diet Inflammatory Index (DII) has been developed. This scoring system allows studies to look at the correlation between the inflammatory potential of the diet and cognitive decline.

A recent study enrolled 1,000 participants with an average age of 75 in a 3-year study to determine the impact of diet on cognitive decline. The association of the DII score of the participant’s diets with the onset of dementia was evaluated in two ways.

  • Each one-point increase from an anti-inflammatory diet to a pro-inflammatory diet was associated with a 21% increase in the risk for dementia.
  • In other words, even small changes in your diet can have a significant impact on your risk of developing dementia.

The investigators then divided the participants into three equal-sized groups based on the DII score of their diets.

  • The group with the highest DII scores were 3 times more likely to develop dementia than the group with the lowest DII scores.
  • In other words, a major change in your diet can have a major effect on your risk of developing dementia.

The authors concluded, “In the present study, higher DII scores (indicating greater pro-inflammatory diet potential) were associated with an increased risk for incident dementia [newly diagnosed dementia]. These findings may avail the development of primary dementia strategies through tailored and precise dietary interventions.”

For more details and a description of mind-healthy diets and a mind-healthy lifestyle read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Which Diet Is Best?

Tips For Loosing Weight And Keeping It Off

Author: Dr. Stephen Chaney

Diet season starts in just a few days! Like millions of Americans, you will probably be setting a goal to eat healthier, lose weight, or both. But which diet is best? Vegan, Paleo, Keto, 360, Intermittent Fasting, low-carb, low fat – the list is endless.

And then there are the commercial diets: Meal replacements, low calorie processed foods, prepared meals delivered to your door – just to name a few of the categories.

You can choose to count calories, focus on portion sizes, or keep a food journal.

And, if you really want to live dangerously, you can try the latest diet pills that claim to curb your appetite and rev up your metabolism.

The advertisements for all these diets sound so convincing. They give you scientific-sounding mumbo-jumbo to explain why they work. Then they talk about clinical studies they say prove their diet works.

If you are like most Americans, you have already tried several of these diets. They worked for a while, but the pounds came back – and brought their friends with them.

But, as the saying goes, “Hope springs eternal in the human breast. Surely some diet you haven’t tried yet will work for you.

There are such diets. But they will require effort. They will require a change of mindset. There is no magic wand that will chase the extra pounds away forever.

If you are searching for the perfect diet to start the new year, let me be your guide. Here are:

  • 4 tips on what to avoid and…
  • 6 tips on what to look for…

…when you are choosing the best diet for you.

What Should You Avoid When Choosing The Best Diet?

AvoidEndorsements.

Endorsements by your favorite athlete or public person are paid for. They don’t necessarily represent their opinion. Nor do they assure you that they follow that diet or use that diet supplement.

Endorsements by Dr. Strangelove and his buddies can be equally misleading. They usually tell you that the medical establishment has been lying to you, and they have discovered the “secret” to permanent weight loss and the “Fountain of Youth”.

Recommendations of the medical and scientific communities usually represent a consensus statement by the top experts in their field. I would choose their advice over Dr. Strangelove’s opinion any day.

2) Testimonials

Most of the testimonials you see online or in print are either paid for or are fake.

Testimonials by your friends can be equally misleading. We are all different. What works for your friend or your trainer may not work for you.

For example, some of us do better on low-carb diets, and others do better on low fat diets.

[Note: Some DNA testing companies claim they can sequence your DNA and tell you which diet is best. However, as I reported in a recent article in “Health Tips From The Professor”, independent studies show that DNA testing is of no use in predicting whether low-carb or low-fat diets are better for you.]

3) Diets Based on “Magic” Or “Forbidden” Foods or Food Groups.

I have often said we have 5 food groups for a reason. Each food group provides a unique blend of nutrients and phytonutrients. And each plant food group provides a unique blend of fibers that support the growth of different types of friendly gut bacteria.

The bottom line is that each of us does better with some foods than others, but there are no “magic” or “forbidden” foods that apply to everyone.

4) “Magic” Diets.

MagicI have written perhaps the first diet book, “Slaying The Food Myths”, that doesn’t feature a “magic” diet that is going to make the pounds melt away and allow you to live to 100. Instead, I recommend a variety of healthy diets and suggest you choose the one that fits you best.

However, I understand the allure of “magic” diets. Dr. Strangelove claims the diet will be effortless. He gives you some scientific-sounding mumbo-jumbo to convince you the diet is scientifically sound. Then he cites some clinical studies showing the diet will cause you to lose weight and will improve your health parameters (things like cholesterol, triglycerides, blood sugar, and blood pressure). It sounds so convincing.

Before you fall for Dr. Strangelove’s latest “magic” diet, let me share two things that may blow your mind:

    • The studies are all short-term (usually 3 months or less).
    • When you rely on short-term studies, the very low-fat Vegan diet and very low-carb Keto diet give you virtually identical weight loss and improvement in health parameters!

Those two diets are as different as any two diets could be. That means we can forget all the scientific-sounding mumbo-jumbo as to why each of those diets work. Instead, we should ask what these two diets have in common.

The answer is simple:

#1: The clinical studies are comparing “magic” diets to the typical American diet. Anything is better than the typical American diet! It is high in sugar, refined carbohydrates, saturated fat, and highly processed foods. No wonder the “magic” diets look so good.

#2: The diets are whole food diets. Anytime you eliminate sodas, fast foods, and highly processed foods, you will lose weight.

#3: The diets eliminate one or more food groups. Whenever you eliminate some of your favorite foods from your diet, you tend to lose weight without thinking about it. I call this the cream cheese and bagel phenomenon.

    • If you are following a low-fat diet, it sounds great to say you can eat all the bagels you want. But without cream cheese to go with the bagels, you tend to eat fewer bagels.
    • If you are following a low-carb diet, it sounds great to say you can eat as much cream cheese as you want, but without bagels to go with your cream cheese, you tend to eat less cream cheese.

#4: Because they eliminate many of your favorite foods, “magic” diets make you focus on what you eat. Whenever you focus on what you eat, you tend to lose weight. That is why food journals and calorie counters are effective.

#5: Finally, whenever you lose weight, your health parameters (cholesterol, triglycerides, blood sugar, and blood pressure) improve.

What Should You Look For In Choosing The Best Diet?

Skeptic1) Choose whole food diets. Avoid sodas, fast foods, and highly processed foods.

2) Choose primarily plant-based diets. These can range from Vegan through semi-vegetarian, Mediterranean, DASH, and Nordic. All are healthy diets. I have discussed the evidence for this recommendation in my book “Slaying The Food Myths”. Here is a brief summary.

When we look at long term (10-20 year) studies:

    • Vegetarians weigh less and are healthier than people consuming the typical American diet.
    • People consuming semi-vegetarian, Mediterranean, and DASH diets are healthier than people consuming the typical American diet.

If you look at low-carb diets:

    • People consuming plant-based low-carb diets weigh less and are healthier than people consuming the typical American diet.
    • People consuming meat-based low-carb diets are just as fat and unhealthy as people consuming the typical American diet.
    • The Atkins low-carb diet has been around for more than 50 years, and there is no evidence it is healthy long-term.

3) Choose diets that include a variety of foods from all 5 food groups. I have discussed the rationale for that recommendation above.

4) Choose diets that consider meat as a garnish, not a main course.

5) Choose diets that feature healthy carbs and healthy fats rather than low-carb or low-fat diets.

6) Think lifestyle, not diet. If you choose a restrictive diet so you can achieve quick weight loss, you will probably be just as fat and unhealthy next December 31st as you are this year. Instead, choose diets that teach healthy eating and lifestyle changes that you can make a permanent part of your life.

Tips For Losing Weight And Keeping It Off

You know the brutal truth. Around 95% of dieters regain everything they lost and then some within a few years. You have probably gone through one or more cycles of weight loss and regain yourself – something called “yo-yo dieting”. You may even be asking yourself if it is worth bothering to try to lose weight this year.

Rather focusing on the negative statistics of weight loss, let’s look at the good news. There are people who lose the weight and keep it off. What do they do?

There is an organization called the National Weight Control Registry that has enrolled more than 10,000 people who have lost weight and kept it off. The people in this group lost weight on almost every diet imaginable. However, here is the important statistic: On average people in this group have lost 66 pounds and kept it off for 5 years.

The National Weight Control Registry has kept track of what they have done to keep the weight off. Here is what they do that you may not be doing:

  1. They consume a reduced calorie, low fat diet.

2) They get lots of exercise (around 1 hour/day).

3) They have internalized their eating patterns. In short, this is no longer a diet. It has become a permanent part of their lifestyle. This is the way they eat without even thinking about it.

4) They monitor their weight regularly. When they gain a few pounds, they modify their diet until they are back at their target weight.

5) They eat breakfast on a regular basis.

6) They watch less than 10 hours of TV/week.

7) They are consistent (no planned cheat days).

Which Diet Is Best?

Now it is time to get back to the question you are asking right now, “Which diet is best?” I have covered a lot of ground in this article. Let me summarize it for you.

If you are thinking about popular diets:

  • Primarily plant-based diets ranging from Vegan to Mediterranean and Dash are associated with a healthier weight and better health long term.
    • If want to lose weight quickly, you may want to start with the more restrictive plant-based diets, like Vegan, Ornish, Pritikin or semi-vegetarian.
    • If you do better with a low-carb diet, my recommendation is the low-carb version of the Mediterranean diet.
    • If your primary goal is rapid weight loss, you could also start with one of the healthier of the restrictive low-carb diets, like the Paleo or the 360 diet. I do not recommend the Keto diet.
  • No matter what diet you start with, plan to transition to the primarily plant-based diet that best fits your lifestyle and food preferences. This is the diet you will want to stick with to maintain your weight loss and achieve better health long term.
  • Plan on permanent lifestyle change rather than a short-term diet. Otherwise, you are just wasting your time.
  • Eat whole foods. Big Food keeps up with America’s favorite diets and is only too happy to sell you highly processed foods that match your favorite diet. Avoid those like the plague.

If you are thinking about commercial diets featuring meal replacement products:

  • Look for meal replacement products that:
    • Do not contain artificial sweeteners, flavors, or preservatives.
    • Use non-GMO protein. A non-GMO certification for the other ingredients is not necessary. For a more detailed explanation of when non-GMO certification is important and when it is unnecessary, see my article) in “Health Tips From the Professor”.
    • Have stringent quality controls in place to assure purity. “Organic” and/or “non-GMO” on the label do not assure purity.
  • Look for programs that can provide clinical studies showing their diet plan is effective for weight loss and for keeping the weight off. Many programs have short-term clinical studies showing they are effective for weight loss, but very few have longer-term studies showing the weight stays off.
  • Finally, look for programs that teach permanent lifestyle change. This should include guidance on exercise and healthy eating.

I do not recommend most commercial diets that feature prepared low-calorie foods “shipped right to your door” as a major part of their program. The foods are highly processed. Plus, they include all your favorite unhealthy foods as part of the program. Even if they include lifestyle change as part of their program, they are undermining their message with the foods they are providing you.

I would be remiss if I didn’t mention that Weight Watchers is highly recommended by most experts in the field. Weight Watchers emphasizes journaling and counting calories, which is a plus because it makes you focus on what you are eating. They also have a good lifestyle program and support that can help you transition to permanent lifestyle change if you are willing to put in the effort. However, I don’t recommend their prepared low-calorie foods. They are no better than foods provided by the other commercial diet programs.

The Bottom Line 

Weight loss season is upon us. If you plan to lose weight and/or adopt a healthier diet in the coming year, you are probably asking, “Which Diet Is Best?” In this issue of “Health Tips From The Professor” I give you:

  • 4 tips on what to avoid when selecting the diet that is best for you.
  • 6 tips on how to choose the best diet.
  • 5 tips on what to look for when selecting a diet featuring meal replacement products.
  • 7 tips on how to keep the weight off.

Then I put all this information together to help you choose the best diet, the best meal replacement product, and/or the best commercial diet program.

For more details read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 

 

How Diet And Gut Bacteria Affect Our Health

Why Is Your Microbiome Important? 

Author: Dr. Stephen Chaney

Vegan FoodsWe have known for years that primarily plant-based diets are healthy. As I have shared in my book, “Slaying The Food Myths”, people who consume primarily plant-based diets have lower risk of heart disease, diabetes, and some cancers and live longer than people who consume the typical American diet.

But why is that?

  • Is it the nutrients, phytonutrients, and fiber plant foods provide?
  • Is it because plant foods are lower in saturated fats and are good sources of healthier monounsaturated and polyunsaturated fats?
  • Or is it because plant foods have a low caloric density, which makes it easier to maintain a healthy weight?

The answer, of course, is that all the above are important. But is there something else? Is there a “missing link” we don’t talk about much? Many experts think our microbiome (our gut bacteria) is that missing link.

You have heard the saying, “We are what we eat”. You might be scratching your head and saying, “I could eat cabbages all day long, but I am never going to become a cabbage.” It seems like a crazy saying.

But for our microbiome that saying is true. What we call fiber, our gut bacteria call food. Consequently, microbiomevegetarians and meat eaters have very different populations of gut bacteria in their microbiome. The question, of course, is whether these differences influence our health. This central question has spurred multiple research studies on our microbiome in recent years.

Two central themes have emerged from these studies:

  • There are certain populations of gut bacteria that are associated with healthy outcomes (lower risk of obesity, diabetes, heart disease, and some cancers). We can think of these as “good bacteria”.
    • There are certain populations of gut bacteria that are associated with unhealthy outcomes (increased risk of obesity, diabetes, heart disease, and some cancers). We can think of these as “bad bacteria”.
  • People consuming primarily plant-based diets tend to have more of the “good bacteria” and less of the “bad bacteria” in their gut microbiome.

However, most of these studies have been small and have looked at individual foods rather than the effect of the overall diet.

The study (KK Koponen et al, American Journal Of Clinical Nutrition, 2021; doi.org/10.1093/ajcn/nqab077 I will describe today was designed to overcome those limitations.

Metabolism 101: What Are Short Chain Fatty Acids And Why Are They Important?

professor owlTo fully understand the findings of this study, you need to understand what short chain fatty acids are and why they are important. Simply put, short chain fatty acids are the end products of fiber digestion by some species of gut bacteria in our intestines. The major short chain fatty acids in our intestines are acetate (2 carbons), propionate (3 carbons), and butyrate (4 carbons).

There are the key facts about short chain fatty acids you should know:

  1. They are formed by anaerobic fermentation of dietary fiber by our gut bacteria. However:
    • Not all gut bacteria can produce short chain fatty acids.
    • The amount and type(s) of dietary fiber determine whether the gut bacteria that can produce short chain fatty acids are present.

2) Acetate is readily absorbed into the bloodstream and is utilized for fat production and other biosynthetic pathways.

3) Short chain fatty acids, especially butyrate, are the primary energy source for cells lining the colon. Because of this, they have several important health benefits.

    • They support the immune cells that line our intestine. This helps strengthen our immune system.
    • They help maintain the integrity of the intestinal wall. This helps protect against leaky gut syndrome.
    • They reduce inflammation. This reduces the risk of inflammatory bowel diseases like ulcerative colitis and Crohn’s disease.
    • They reduce the risk of colon cancer.

4) In addition, small amounts of propionate and butyrate can be absorbed into the bloodstream. Butyrate is of particular interest because it has the potential to regulate gene expression.

    • There is some evidence that short chain fatty acid production in the intestine is correlated with reduced risk of inflammatory diseases, obesity, type 2 diabetes, and heart disease, but these studies remain controversial.

How Was This Study Done?

Clinical StudyThis study made use of data from the FINRISK Study. This study was conducted by the Finnish Institute of Health and Welfare every 5 years between 1972 and 2012 to assess risk factors for noncommunicable diseases, health behavior, and their changes in adult Finns.

This study included 4930 individuals from the 2002 FINRISK assessment. The characteristics of the group were:

  • 53% female, 47% male.
  • Average age = 48.
  • Average BMI = 26.9 (slightly overweight).

Upon entry into the study, the participants were asked to fill out a food frequency questionnaire.

  • The data from this questionnaire were used to calculate a Healthy Food Choices (HFC) score based on the Nordic Nutrition Dietary Guidelines for a healthy diet.
    • The HFC score ranged from 9-745 and was based on the consumption of fiber-rich breads; vegetables (including beans and lentils); fruits; berries; fresh, non- sweetened berry and fruit juices; fish; poultry; low-fat cheeses; salad dressings and oils; nuts; and seeds.
    • In the words of the authors, “A high HFC score effectively acts as an indicator of a healthy omnivorous Nordic diet rich in plants, fiber, and polyunsaturated fatty acids.”
  • The data were also used to calculate a total dietary fiber score.

The participants were also asked to provide a stool sample. DNA was extracted from the stool sample and sequenced to determine the number and types of bacteria in their gut microbiome. These data were analyzed for:

  • Bacterial diversity (greater bacterial diversity is associated with better health outcomes).
  • Species of gut bacteria known to be associated with better health outcomes.
  • Species of bacteria known to produce short chain fatty acids.

How Diet And Gut Bacteria Affect Our Health

MicrobiomeMicrobiome research is complex. But here is a description of the results in simple terms.

Both the Healthy Food Choice (HFC) and fiber scores correlated positively with:

  • Bacterial diversity (greater bacterial diversity is associated with better health outcomes).
  • Species of gut bacteria known to be associated with better health outcomes.
  • Species of bacteria known to produce short chain fatty acids that are associated with better health outcomes.

Simply put, a healthy, primarily plant-based Nordic diet produces the kind of gut microbiome that is associated with better health outcomes.

When the authors analyzed the contribution of individual components of the diet to a healthy microbiome:

  • Vegetables; berries; fruits; fiber-rich breads; salad dressings and oils; low-fat cheeses; poultry; fresh, unsweetened juices; and fish were all positively associated with a healthy microbiome.
    • Each of these foods supported the growth of different gut bacteria that contributed to the healthy microbiome.
    • Simply put, none of these foods was sufficient by itself. It was a healthy diet with all these foods that resulted in a healthy microbiome.
  • Nuts and seeds did not affect the microbiome. This may have been because there was too little of them in the diet to have a significant effect.
  • Red and processed meats were negatively associated with a healthy microbiome.

The authors concluded, “Our results from a large, population-based survey confirm and extend the findings of other, smaller-scale studies that plant- and fiber-rich dietary choices are associated with a more diverse and compositionally distinct microbiome with a greater potential to produce short chain fatty acids.”

The authors also said, “The associated between red and processed meat products and the gut microbiome cannot be ignored either…[Our data] indicate that increased usage of red and processed meat is associated with the microbiome composition in an opposite manner to that of a healthy diet.”

Why Is Your Microbiome Important?

happy gut bacteriaThe most important message from this and previous studies is that your gut microbiome is the “missing link” between a healthy diet and a healthy body.

Simply put,    healthy diet →→→healthy microbiome→→→healthy body

However, I also need to acknowledge microbiome research is in its infancy. That is because our microbiome is very complex:

  • We have around 38 trillion microorganisms (give or take a few trillion) in our intestine. That means we have slightly more microorganisms than we do cells in our body.
  • Each of us have more than 1,000 different species of bacteria in our intestine.
  • Collectively, these bacteria have around 750,000 genes. That is 30 times more than the number of genes in our DNA.
  • Finally, we all have different species of bacteria in our intestines. We are all unique.

The only simplifying principle is that these bacteria exist in communities that generally group together. Unraveling the complexities and identifying the communities of bacteria in our intestines requires high throughput DNA sequencing and supercomputers to analyze the data.

Studies like this one can identify the associations between diet and distinct communities of bacteria. They can even identify which foods in the diet support the growth of these bacterial communities. Other studies can identify the association between distinct communities of bacteria and healthy outcomes.

The strength of this study is that it identifies the kind of diet and the kinds of food that support the communities of bacteria associated with healthy outcomes. However, these are just associations. They don’t tell us why these associations occur. Specifically:

  • We don’t know why certain diets are associated with different communities of gut bacteria. However, we do know several things.
    • High fiber diets are a major driving force in creating a healthy gut microbiome. This is because what we call fiber, our gut bacteria call food.High Fiber Foods
    • The diet should contain a variety of high fiber foods. This is because different kinds of fiber support the growth of different kinds of gut bacteria, and the diversity of our gut microbiome is associated with healthy outcomes. As I have said before, “We have 5 food groups for a reason”.
    • However, the type of fat and the type of protein in the diet also influence the type of bacteria that thrive in our intestines. We know less about why that is.
  • We also don’t know why certain communities of gut bacteria are associated with healthy outcomes.
    • The exception is communities of bacteria that produce short chain fatty acids. We do have a good idea why short chain fatty acids are associated with gut health.

However, the fact we don’t know why these associations occur, doesn’t detract from the strength of these associations.

  • The associations between a healthy, primarily plant-based diet and a healthy microbiome are not based on this study alone. The same associations have been seen in multiple studies.
  • The associations between a healthy microbiome and better health outcomes have also been seen in multiple studies.

The evidence for these associations is too strong to ignore.

What Does This Study Mean For You?

Questioning WomanThis study shows that a healthy Nordic diet is associated with a healthy microbiome. “But what is a healthy Nordic diet?”, you might ask. Simply put, it is a whole food, omnivorous, primarily plant-based diet with Scandinavian food preferences.

And, if pickled herring, potato pancakes, and meatballs aren’t your favorite foods, never fear. You have lots of other options:

  • The Mediterranean diet is essentially the same diet with Mediterranean food preferences.
  • The DASH diet is essentially the same diet with American food preferences.
  • You can start with a semi-vegetarian diet and tailor it to your food preferences. Of course, some common sense is required here. You will need to primarily include whole, unprocessed food preferences in your diet.

Let me close with some simple advice I have shared before:

  • We are what we eat. Our microbiome (gut bacteria) reflects what we eat.
  • What we call fiber, our gut bacteria call food. A primarily plant-based diet is best because our friendly gut bacteria thrive on the fiber it provides.
  • We have 5 food groups for a reason. Each plant food group provides different kinds of fiber and feeds different families of friendly gut bacteria. We eliminate plant food groups at our peril.
  • We should think of red meat as a condiment, not a main course. Plants contain antidotes to many of the harmful ingredients in red meat. Two to three ounces of steak as part of a green salad or stir fry is much healthier than an 8-ounce steak and fries.

The Bottom Line

Most previous studies on the effect of diet on our microbiome have been small and have looked at individual foods rather than the effect of the overall diet. In this week’s “Health Tips From the Professor” I report on a large, well-designed study that examined the effect of a healthy Nordic diet on our microbiome.

In case you were wondering, the investigators defined a healthy Nordic diet as a whole food diet that:

  • Includes lots of fruits, vegetables, and whole grains and is, therefore, high in fiber.
  • Uses fish, poultry, and low-fat cheeses as its primary protein source.
  • Minimizes red and processed meats.
  • Has more polyunsaturated oils than saturated fats.
  • Reflects Scandinavian food preferences.

This study found that a healthy Nordic diet correlated positively with:

  • Bacterial diversity (greater bacterial diversity is associated with better health outcomes).
  • Species of gut bacteria known to be associated with better health outcomes.
  • Species of bacteria known to produce short chain fatty acids that are associated with better gut health outcomes.

Simply put, a healthy, primarily plant-based Nordic diet produces the kind of gut microbiome that is associated with better health outcomes. To put this into perspective, a healthy Nordic diet is similar to a healthy Mediterranean diet or a healthy DASH diet except that the Mediterranean diet reflects Mediterranean food preferences, and the Dash diet reflects American food preferences.

The most important message from this and previous studies is that your gut microbiome is the “missing link” between a healthy diet and a healthy body.

Simply put,    healthy diet →→→healthy microbiome→→→healthy body

I summed up the article with some simple advice I have shared before:

  • We are what we eat. Our microbiome (gut bacteria) reflects what we eat.
  • What we call fiber, our gut bacteria call food. A primarily plant-based diet is best because our friendly gut bacteria thrive on the fiber it provides.
  • We have 5 food groups for a reason. Each plant food group provides different kinds of fiber and feeds different families of friendly gut bacteria. We eliminate plant food groups at our peril.
  • We should think of red meat as a condiment, not a main course. Plants contain antidotes to many of the harmful ingredients in red meat. Two to three ounces of steak as part of a green salad or stir fry is much healthier than an 8-ounce steak and fries.

For more details about this study and what it means for you, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

 

Which Diet Is Best For Your Heart?

Why Are Dietary Studies So Confusing? 

Author: Dr. Stephen Chaney

heart diseaseYou are concerned about your heart.

  • Perhaps it is because of genetics. Everyone on one side of your family tree had their first heart attack in their mid-forties.
  • Perhaps it is because your doctor has warned you that your heart is a ticking time bomb. Unless you make some drastic changes, you will die of a heart attack in the near future.
  • Perhaps you already have some symptoms of heart disease, and you are scared.

You want to make some changes. You want to protect your heart. What should you do?

The short answer is that a holistic approach is best, and I will share the American Heart Association recommendations below. But let’s start by asking what you should eat. There are two important questions:

#1: Which diet is best for your heart?

  • A whole food vegan diet, the Mediterranean diet, and the DASH diet are all strong contenders for the best heart healthy diet.
  • But there are many other diets that claim to be heart healthy. Some enthusiasts even claim the Paleo and keto diets are heart healthy.
  • The problem is that few studies have compared these diets against each other. That makes it difficult to settle the question of which diet is best for your heart.

#2: Which protein source is best for your heart – plant protein, fish, poultry, or red meat?

  • Plant and fish protein are both strong contenders for the most heart healthy protein.
  • Poultry has the reputation of being more heart healthy than red meat. But this has become controversial. Some recent studies suggest poultry is no better than red meat in terms of heart health.

Fortunately, a recent study (F Petermann-Rocha et al, European Heart Journal, 42: 1136-1143, 2021) has made this comparison. It compared vegetarians, fish eaters, poultry eaters, and red meat eaters for the risk of developing heart disease.

How Was This Study Done?

Clinical StudyThis study made use of data from the UK Biobank program. The UK Biobank program recruited over 500,000 participants (ages 37-73) from England, Wales, and Scotland between 2006 and 2010 and followed them for an average of 8.5 years.

At entry into the program, each participant filled out a touchscreen questionnaire, had physical measurements taken, and provided biological samples.

Dietary intake was assessed based on the touchscreen questionnaire and the average of 5 24-hour dietary recalls. The participants were divided into four groups based on this dietary analysis:

  • Vegetarians (All participants in the study consumed cheese and eggs, so this group would more accurately be described as lacto-ovo-vegetarians).
  • Fish eaters.
  • Poultry eaters.
  • Red meat eaters.

Over the next ~8.5 years, each group was compared with respect to the following heart health parameters:

  • Risk of developing cardiovascular disease (all diseases of the circulatory system).
  • Risk of developing ischemic heart disease (lack of sufficient blood flow to the heart. The most common symptom of ischemic heart disease is angina).
  • Risk of having a myocardial infarction (commonly referred to as a heart attack).
  • Risk of having a stroke.
  • Risk of developing heart failure.

Which Diet Is Best For Your Heart?

The study compared vegetarians, fish eaters, and poultry eaters with red meat eaters with respect to each of the heart disease parameters listed above. The results were:

  • When fish eaters were compared with meat eaters, they had:
    • 7% lower risk of cardiovascular diseases of all types.
    • 21% lower risk of ischemic heart disease (angina).
    • 30% lower risk of myocardial infarction (heart attack).
    • 21% lower risk of stroke.
    • 22% lower risk of heart failure.
  • When vegetarians were compared with meat eaters, they had:
    • 9% lower risk of cardiovascular diseases of all types.
    • Lower, but statistically non-significant, risk of other heart disease parameters.
  • When poultry eaters were compared with meat eaters there were no significant differences in heart disease outcomes.

The authors concluded, “Eating fish rather than meat or poultry was associated with a lower risk of adverse cardiovascular outcomes…supporting its role as a healthy diet that should be encouraged. Vegetarianism was only associated with a lower risk of cardiovascular disease incidence.”

Why Are Dietary Studies So Confusing?

confusionSo, you are probably thinking, “Are diets with fish protein really more heart healthy than diets with plant protein?”

Fish have a lot going for them. They are an excellent source of heart healthy omega-3 fats. And, when substituted for red meat protein, they decrease intake of saturated fats.”

But plant protein has a lot going for it as well. Numerous studies have shown that vegetarian diets are more heart healthy than the typical American diet. And only plant-based diets have been shown to reverse atherosclerosis.

So, why are dietary studies so confusing? The problem is that diets are complex. They have many moving parts. When we focus on one aspect of a diet, we are ignoring the rest of the diet. The food we have focused on may be healthy. But if it is paired with unhealthy foods, the overall diet can still be unhealthy.

The current study is a perfect example of that principle:

  • The participants represented a cross section of the British population. All the “diets” were high in sugar, sugary drinks, saturated fat, and processed meals bought from the supermarket. None of them were optimal.
  • In addition to consuming cheese and eggs, “vegetarians” consumed more crisps, slices of pizza, and smoothie drinks than meat-eaters. [In case you were wondering, the English refer to small thin salty snacks like potato chips as crisps. They reserve the term chips for what we call French Fries.]
  • “Vegetarians” also consumed a lot of highly processed vegetarian alternatives designed to taste like other meat products.
  • On the other hand, fish eaters consumed more fruits and vegetables than meat-eaters. It wasn’t just the fish that made this diet more heart healthy.

In other words, the “vegetarian diet” in this study was not nearly as healthy as the whole food vegetarian diets that have previously been shown to be heart healthy. And the “fish-eaters diet” was healthier than the “meat-eaters diet” because of both the fish and the extra fruits and vegetables these people were consuming.

In the words of the authors, “…As a group, vegetarians consumed more unhealthy foods, such as crisps, than meat eaters. Therefore, vegetarians should not be considered a homogeneous group, and avoidance of meat will not be sufficient to reduce health risk if the overall diet is not healthy.”

My summary:

  • Whole food plant-based diets (the true definition of vegetarianism) are very heart healthy. [Note: The diet in this study was lacto-ovo-vegetarian rather than a true vegetarian diet. However, recent studies have suggested that addition of small amounts of dairy and eggs to a vegetarian diet may make them more heart healthy rather than less heart healthy.]
  • Primarily plant-based diets with fish as the main protein source (otherwise known as pescatarian diets) are also very heart healthy.
  • If you want a healthy heart, choose the one that best fits your preferences and your lifestyle.

A Holistic Approach: The American Heart Association Recommendations

Doctor With Patient

  • If you smoke, stop.
  • Choose good nutrition.
    • Choose a diet that emphasizes vegetables, fruits, whole grains, low-fat dairy products, poultry, fish, legumes, non-tropical vegetable oils, and nuts.
    • Choose a diet that limits sweets, sugar-sweetened beverages, and red meats.
    • Reduce high blood cholesterol and triglycerides.
    • Reduce your intake of saturated fat, trans fat and cholesterol.
  • Lower High Blood Pressure.
  • Be physically active every day.
    • Aim for at least 150 minutes per week of moderate-intensity physical activity per week.
  • Aim for a healthy weight.
  • Manage diabetes.
  • Reduce stress.
  • Limit alcohol.
  • Have a regular physical checkup.

The Bottom Line

A recent study in the United Kingdom compared vegetarians, fish eaters, poultry eaters, and red meat eaters for the risk of developing heart disease and the risk of dying from heart disease. The results were:

  • When fish eaters were compared with meat eaters, they had:
    • 7% lower risk of cardiovascular diseases of all types.
    • 21% lower risk of ischemic heart disease (angina).
    • 30% lower risk of myocardial infarction (heart attack).
    • 21% lower risk of stroke.
    • 22% lower risk of heart failure.
  • When vegetarians were compared with meat eaters, they had:
    • 9% lower risk of cardiovascular diseases of all types.
    • Lower, but statistically non-significant, risk of other heart disease parameters.
  • When poultry eaters were compared with meat eaters there were no significant differences in heart disease outcomes.

The authors concluded, “Eating fish rather than meat or poultry was associated with a lower risk of adverse cardiovascular outcomes…supporting its role as a healthy diet that should be encouraged. Vegetarianism was only associated with a lower risk of cardiovascular disease incidence.”

However, the “vegetarian diet” in this study was not nearly as healthy as the whole food vegetarian diets that have previously been shown to be heart healthy. And the “fish-eaters diet” was healthier than the “meat-eaters diet” because of both the fish and the extra fruits and vegetables this group of people were consuming.

In the words of the authors, “…As a group, vegetarians consumed more unhealthy foods, such as crisps [potato chips], than meat eaters. Therefore, vegetarians should not be considered a homogeneous group, and avoidance of meat will not be sufficient to reduce health risk if the overall diet is not healthy.”

My summary:

  • Whole food plant-based diets (the true definition of vegetarianism) are very heart healthy.
  • Primarily plant-based diets with fish as the main protein source (otherwise known as pescatarian diets) are also very heart healthy.
  • If you want a healthy heart, choose the one that best fits your preferences and your lifestyle.

For more details about this study, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

If You Want To Be Green, You Have To Eat Green

What Is The Planetary Diet?

 Author: Dr. Stephen Chaney

Earth DayEarth Day was last Thursday. You have recommitted to saving the planet. You plan to recycle, conserve energy, and turn in your gas guzzler for an energy efficient car. But what about your diet? Is your diet destroying the planet?

This is not a new question, but a recent commission of international scientists has conducted a comprehensive study into our diet and its effect on our health and our environment. Their report (W. Willet et al, The Lancet, 393, issue 10170, 447-492, 2019) serves as a dire warning of what will happen if we don’t change our ways. I touched on this report briefly in a previous issue of “Health Tips From The Professor”, but this topic is important enough that it deserves an issue all its own.

The commission carefully evaluated diet and food production methods and asked three questions:

  • Are they good for us?
  • Are they good for the planet?
  • Are they sustainable? Will they be able to meet the needs of the projected population of 10 billion people in 2050 without degrading our environment.

The commission described the typical American diet as a “lose-lose-lose diet”. It is bad for our health. It is bad for the planet. And it is not sustainable.

In its place they carefully designed their version of a primarily plant-based diet they called a “win-win-win diet”. It is good for our health. It is good for the planet. And, it is sustainable.

In their publication they refer to their diet as the “universal healthy reference diet” (What else would you expect from a committee?). However, it has become popularly known as the “Planetary Diet”.

I have spoken before about the importance of a primarily plant-based diet for our health. In that context it is a personal choice. It is optional.

However, this report is a wake-up call. It puts a primarily plant-based diet in an entirely different context. It is essential for the survival of our planet. It is no longer optional.

If you care about our environment…If you care about saving our planet, there is no other choice.

How Was The Study Done?

The study (W. Willet et al, The Lancet, 393, issue 10170, 447-492, 2019) was the report of the EAT-Lancet Commission on Healthy Diets from Sustainable Food Systems. This Commission convened 30 of the top experts from across the globe to prepare a science-based evaluation of the effect of diet on both health and sustainable food production through the year 2050. The Commission included world class experts on healthy diets, agricultural methods, climate change, and earth sciences. The Commission reviewed 356 published studies in preparing their report.

If You Want To Be Green, You Need To Eat Green

Factory FarmWhen they looked at the effect of food production on the environment, the Commission concluded:

  • “Strong evidence indicates that food production is among the largest drivers of global environmental change.” Specifically, the commission reported:
    • Agriculture occupies 40% of global land (58% of that is for pasture use).
    • Food production is responsible for 30% of global greenhouse gas emissions and 70% of freshwater use.
    • Conversion of natural ecosystems to croplands and pastures is the largest factor causing species to be threatened with extinction. Specifically, 80% of extinction threats to mammals and bird species are due to agricultural practices.
    • Overuse and misuse of nitrogen and phosphorous in fertilizers causes eutrophication. In case you are wondering, eutrophication is defined as the process by which a body of water becomes enriched in dissolved nutrients (such as phosphates from commercial fertilizer) that stimulate the growth of algae and other aquatic plant life, usually resulting in the depletion of dissolved oxygen. This creates dead zones in lakes and coastal regions where fish and other marine organisms cannot survive.
    • About 60% of world fish stocks are fully fished and more than 30% are overfished. Because of this, catch by global marine fisheries has been declining since 1996.
  • “Reaching the Paris Agreement of limiting global warming…is not possible by only decarbonizing the global energy systems. Transformation to healthy diets from sustainable food systems is essential to achieving the Paris Agreement.”
  • The world’s population is expected to increase to 10 billion by 2050. The current system of food production is unsustainable.

Food ChoicesWhen they looked at the effect of the foods we eat on the environment, the Commission concluded:

  • Beef and lamb are the biggest contributors to greenhouse gas emissions and land use.
    • The concern about land use is obvious because of the large amount of pasture land required to raise cattle and sheep.
    • The concern about greenhouse gas emissions is because cattle and sheep are ruminants. They not only breathe out CO2, but they also release methane into the atmosphere from fermentation in their rumens of the food they eat. Methane is a potent greenhouse gas, and it persists in the atmosphere 25 times longer than CO2. The single most important thing we can do as individuals to reduce greenhouse gas emissions is to eat less beef and lamb. [Note: grass fed cattle produce more greenhouse gas emissions than cattle raised on corn because they require 3 years to bring to market rather than 2 years.]
  • In terms of energy use beef, lamb, pork, chicken, dairy and eggs all require much more energy to produce than any of the plant foods.
  • In terms of eutrophication of our lakes and oceans, beef, lamb, and pork, all cause much more eutrophication than any plant food. Dairy and eggs cause more eutrophication than any plant food except fruits.
  • In contrast, plant crops reduce greenhouse gas emissions by removing CO2 from the atmosphere.

What Is The Planetary Diet?

Planetary DietIn the words of the Commission: “[The Planetary Diet] largely consists of vegetables, fruits, whole grains, legumes, nuts, and unsaturated oils. It includes a low to moderate amount of seafood, poultry, and eggs. It includes no or a very low amount of red meat, processed meat, sugar, refined grains, and starchy vegetables.”

When described in that fashion it sounds very much like other healthy diets such as semi-vegetarian, Mediterranean, DASH, and Flexitarian. However, what truly distinguishes it from the other diets is the restrictions placed on the non-plant portion of the diet to make it both environmentally friendly and sustainable. Here is a more detailed description of the diet:

  • It starts with a vegetarian diet. Vegetables, fruits, beans, nuts, soy foods, and whole grains are the foundation of the diet.
  • It allows the option of adding one serving of dairy a day (It turns out that cows produce much less greenhouse emissions per serving of dairy than per serving of beef. That’s because cows take several years to mature before they can be converted to meat, and they are emitting greenhouse gases the entire time).
  • It allows the option of adding one 3 oz serving of fish or poultry or one egg per day.
  • It allows the option of swapping seafood, poultry, or egg for a 3 oz serving of red meat no more than once a week. If you want a 12 oz steak, that would be no more than once a month.

This is obviously very different from the way most Americans currently eat. According to the Commission:

  • “This would require greater than 50% reduction in consumption of unhealthy foods, such as red meat and sugar, and greater than 100% increase in the consumption of healthy foods, such as nuts, fruits, vegetables, and legumes”.
  • “In addition to the benefits for the environment, “dietary changes from current diets to healthy diets are likely to substantially benefit human health, averting about 10.8-11.6 million deaths per year globally.”

What Else Did The Commission Recommend?

In addition to changes in our diets, the Commission also recommended several changes in the way food is produced. Here are a few of them.

  • Reduce greenhouse gas emissions from the fuel used to transport food to market.
  • Reduce food losses and waste by at least 50%.
  • Make radical improvements in the efficiency of fertilizer and water use. In terms of fertilizer, the change would be two-fold:
    • In developed countries, reduce fertilizer use and put in place systems to capture runoff and recycle the phosphorous.
    • In third world countries, make fertilizer more available so that crop yields can be increased, something the Commission refer to as eliminating the “yield gap” between third world and developed countries.
  • Stop the expansion of new agricultural land use into natural ecosystems and put in place policies aimed at restoring and re-foresting degraded land.
  • Manage the world’s oceans effectively to ensure that fish stocks are used responsibly and global aquaculture (fish farm) production is expanded sustainability.

What we can do: While most of these are government level policies, we can contribute to the first three by reducing personal food waste and purchasing organic produce locally whenever possible.

What Does This Mean For You?

confusionIf you are a vegan, you are probably asking why the Commission did not recommend a completely plant-based diet. The answer is that a vegan diet is perfect for the health of our planet. However, the Commission wanted to make a diet that was as consumer-friendly as possible and still meet their goals of a healthy, environmentally friendly, and sustainable diet.

If you are eating a typical American diet or one of the fad diets that encourage meat consumption, you are probably wondering how you can ever make such drastic changes to your diet. The answer is “one step at a time”. If you have read the Forward to my books “Slaying The Food Myths” or “Slaying the Supplement Myths”, you know that my wife and I did not change our diet overnight. Our diet evolved to something very close to the Planetary Diet over a period of years.

The Commission also purposely designed the Planetary Diet so that you “never have to say never” to your favorite foods. Three ounces of red meat a week does not sound like much, but it allows you a juicy steak once a month.

Sometimes you just need to develop a new mindset. As I shared in my books, my father prided himself on grilling the perfect steak. I love steaks, but I decided to set a few parameters. I don’t waste my red meat calories on anything besides filet mignon at a fine restaurant. It must be a special occasion, and someone else must be buying. That limits it to 2-3 times a year. I still get to enjoy good steak, and I stay well within the parameters of the Planetary diet.

Develop your strategy for enjoying some of your favorite foods within the parameters of the Planetary Diet and have fun with it.

The Bottom Line

is your diet destroying the planet? This is not a new question, but a recent commission of international scientists has conducted a comprehensive study into our diet and its effect on our health and our environment. Their report serves as a dire warning of what will happen to us and our planet if we don’t change our ways.

The Commission carefully evaluated diet and food production methods and asked three questions:

  • Are they good for us?
  • Are they good for the planet?
  • Are they sustainable? Will they be able to meet the needs of the projected population of 10 billion people in 2050 without degrading our environment.

The Commission described the typical American diet as a “lose-lose-lose diet”. It is bad for our health. It is bad for the planet. And it is not sustainable.

In its place they carefully designed their version of a primarily plant-based diet they called a “win-win-win diet”. It is good for our health. It is good for the planet. And, it is sustainable.

In their publication they refer to their diet as the “universal healthy reference diet” (What else would you expect from a committee?). However, it has become popularly known as the “Planetary Diet”.

The Planetary Diet is similar to other healthy diets such as semi-vegetarian, Mediterranean, DASH, and Flexitarian. However, what truly distinguishes it from the other diets is the restrictions placed on the non-plant portion of the diet to make it both environmentally friendly and sustainable (for details, read the article above).

I have spoken before about the importance of a primarily plant-based diet for our health. In that context it is a personal choice. It is optional.

However, this report is a wake-up call. It puts a primarily plant-based diet in an entirely different context. It is essential for the survival of our planet. It is no longer optional.

If you care about global warming…If you care about saving our planet, there is no other choice.

For more details read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 

Will Plant Proteins Help You Live Longer?

Is A Vegan Diet Healthiest?

Author: Dr. Stephen Chaney

Fountain Of YouthUnless you are Rip Van Winkle and have been asleep for the past 40 years, you have probably heard that whole food, primarily plant-based diets are good for you.

  • They help you control your weight.
  • They reduce inflammation.
  • They reduce your risk of diabetes and heart disease.
  • They even reduce your risk of some cancers.

But do they help you live longer? If we take that question literally, the answer appears to be no. There is no “Fountain Of Youth”. There are no diets that extend our lives significantly.

However, what if you could reduce your risk of premature death? It would be tragic to have your life cut short by a heart attack or some other major disease. What if you could prevent that?

And what if you could live healthier longer? It would be equally tragic to spend your golden years debilitated by chronic diseases like heart disease, diabetes, or dementia. What if you could delay these diseases and live healthier longer?

The study I discuss this week (Y Sun, Journal of the American Heart Association, 10:e015553, 2021) looks at the effect of different dietary protein sources on premature death.

This study, like many others, suggests that primarily plant-based diets are healthier than meat-based diets. But what does this mean for you? Should you go completely meatless? Is a vegan diet healthier than other plant-based diets? I discuss what we know and what we do not know about the vegan diet compared to other plant-based diets.

How Was This Study Done?

Clinical StudyThe data for this study were drawn from the Women’s Health Initiative (WHI). The Women’s Health Initiative was designed to help identify strategies for preventing heart disease and other diseases in postmenopausal women. It enrolled 161,000 postmenopausal women from 40 sites across the US between 1993 and 1998 and followed them through 2017.

This study excluded women who had heart disease or cancer when they entered the WHI study and women who had incomplete data on either their diet or their use of postmenopausal hormone therapy. They were left with 102,521 women, age 50-79 at time of entry, who were followed for 18 years.

Each woman filed out an extensive dietary survey at the beginning of the study. There were 25,976 deaths during the study. The cause of death was determined by reviewing death certificates, medical records, autopsy reports or by linkage to the National Death Index.

The investigators asked whether women who ate more plant proteins were healthier than those who ate primarily meat protein. To answer this question, they correlated protein sources in the diet with all-cause mortality and deaths from various diseases.

The greatest difficulty with this type of study is that people who eat more plant protein tend to have a healthier diet and a healthier lifestyle. That makes it hard to separate out the benefits of eating plant proteins from benefits associated with other aspects of their diet and lifestyle. So, the authors corrected their data for every factor known to influence the risk of heart disease, diabetes, dementia, and premature death.

Specifically, the data were statistically corrected for age, race/ethnicity, socioeconomic status, hormone use, lifestyle (smoking status, physical activity, and alcohol intake), baseline health status (diabetes and/or high blood cholesterol), family history of heart attack/stroke, dietary factors (calorie intake, dietary fiber intake, whole grain consumption, fruit and vegetable consumption, sugar-sweetened beverage consumption, glycemic load (effect of foods in the diet on blood sugar), and percentage of saturated fats, polyunsaturated fats, monounsaturated fats, and trans fats), and weight (BMI).

In short, the authors corrected for every other factor that could influence disease risk and/or premature death. By doing so, they were able to focus on the effect of protein sources on disease risk and/or premature death.

Will Plant Proteins Help You Live Longer?

Plant ProteinsThe investigators divided the study participants into quintiles with respect the kind and amount of protein they consumed.

  • For animal protein, the intake ranged from 4 ounces/day in the lowest quintile to 9 ounces a day in the highest quintile (For comparison, 3 ounces is roughly equivalent to the size of a deck of cards).
  • For plant protein, the intake ranged from 2 ounces/day in the lowest quintile to 3.5 ounces/day in the highest quintile.
  • When you combine plant and animal protein in these women’s diet, plant protein ranged from 18% of total protein intake in the lowest quintile to 48% of total protein intake in the highest quintile.

When women who had the highest intake for plant protein were compared with women who had the lowest intake of plant protein, the women with the highest plant protein intake had:

  • 12% lower risk of premature death from heart disease.
  • 21% lower risk of premature death from dementia.
  • 9% lower risk of premature death from all causes.

There was an inverse relationship between the amount of plant protein in the diet and premature death. Specifically, every 3 ounces of animal protein that was replaced with 3 ounces of plant protein resulted in:

  • 22% lower risk of premature death from heart disease.
  • 19% lower risk of premature death from dementia.
  • 14% lower risk of premature death from all causes.

The Effect Of Individual Animal Proteins On Mortality

Fatty SteakThe authors also looked at the effect of various animal proteins on premature death. For example:

Red Meat: Women with the highest consumption of red meat had:

  • 14% higher risk of premature death from heart disease.
  • 20% higher risk of premature death from dementia.
  • 10% higher risk of premature death from all causes.

Eggs: Women with the highest consumption of eggs had:

  • 24% higher risk of premature death from heart disease.
  • 14% lower risk of premature death from dementia.
  • 14% higher risk of premature death from all causes.

Dairy: Women with the highest consumption of dairy had:

  • 11% higher risk of premature death from heart disease.

The authors concluded, “In this large prospective cohort study, we found that higher plant protein intake and substitution of animal protein with plant protein were associated with lower risk of all-cause mortality, cardiovascular mortality, and dementia mortality…Our findings support the need for consideration of protein sources, in addition to the amount of protein intake, in future dietary guidelines.”

Is A Vegan Diet Healthiest?

Vegetarian DietYears ago, as my brother-in-law was coming out of anesthesia at the end of quadruple bypass surgery, the first question he asked was, “Does this mean I need to eat tofu?” Obviously, nothing terrified him more than the thought of eating tofu the rest of his life. In the same vein, some of you are probably asking, “Does this mean I need to go vegan?”

The good news is that none of the women in this study were consuming a vegan diet. They were consuming a typical American diet with varying amounts of plant and animal protein. The group with the highest plant protein consumption were still getting 52% of their protein from animal sources.

This study shows that even people consuming a typical American diet can become healthier by simply swapping out some of the animal protein in their diet with plant protein.

However, you are probably thinking, “Plant protein is good for us, and a vegan diet is 100% plant protein. Does that mean a vegan diet is healthier than other plant-based diets?

The answer is………”Maybe”

If the linear relationship between plant protein consumption and risk of premature death could be extrapolated all the way to 100% plant protein, the answer would be obvious. Vegan diets would be healthier than other plant-based diets. But that extrapolation is an assumption. It might not be true.

For example, some recent studies suggest that completely eliminating meat, eggs, and dairy from your diet may slightly increase your risk of heart disease and stroke:

  • One recent study found that adding 1.4 ounces of fish/day to a primarily vegetarian diet decreases the risk of stroke by 20%.
  • Another study reported that adding one egg/day to a primarily vegetarian diet decreases the risk of heart disease by 12% and stroke by 10-26%.

These studies need to be confirmed, but they do suggest we need to be cautious about assuming that vegan diets are healthier than other primarily plant-based diets. This is why, when I recommend primarily plant-based diets, I include everything from vegan through semi-vegetarian, Mediterranean, and DASH.

They are all healthy diets. My advice is to choose the one that best fits your lifestyle and food preferences. And focus on whole foods, not processed foods.

The Bottom Line 

A recent study asked whether women who ate more plant proteins were healthier than those who ate primarily meat protein. To answer this question, the investigators correlated protein sources in the diet with all-cause mortality and deaths from various diseases.

When women who had the highest intake for plant protein were compared with women who had the lowest intake of plant protein, the women with the highest plant protein intake had:

  • 12% lower risk of premature death from heart disease.
  • 21% lower risk of premature death from dementia.
  • 9% lower risk of premature death from all causes.

There was an inverse relationship between the amount of plant protein in the diet and premature death. Specifically, every 3 ounces of animal protein that was replaced with 3 ounces of plant protein resulted in:

  • 22% lower risk of premature death from heart disease.
  • 19% lower risk of premature death from dementia.
  • 14% lower risk of premature death from all causes.

[Note: A 3-ounce serving is roughly equivalent to a deck of cards.]

The authors concluded, “In this large prospective cohort study, we found that higher plant protein intake and substitution of animal protein with plant protein were associated with lower risk of all-cause mortality, cardiovascular mortality, and dementia mortality…Our findings support the need for consideration of protein sources, in addition to the amount of protein intake, in future dietary guidelines.”

Years ago, as my brother-in-law was coming out of anesthesia at the end of quadruple bypass surgery, the first question he asked was, “Does this mean I need to eat tofu?” Obviously, nothing terrified him more than the thought of eating tofu the rest of his life. In the same vein, some of you are probably asking, “Does this mean I need to go vegan?”

I discuss the answer to that question in the article above.

For more details and a discussion about the vegan diet versus other primarily plant-based diets read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

Health Tips From The Professor