Mediterranean Diet

Can Your Diet Cause You To Lose Your Mind?

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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?

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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.

 

 

Is It Too Late To Change Your Diet?

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You Can Improve Your Health At Any Age

Author: Dr. Stephen Chaney

Fast Food ExamplesIf you are like most Americans, your dietary preferences as an adult are based on the foods your family ate while you were growing up.

  • Your favorite foods…
  • Your comfort foods…
  • The foods you always avoid…

…are based on your family heritage, not on your genes. And if you are like most Americans, your diet isn’t healthy.

  • It’s high in fat and cholesterol…
  • It’s high in sugar and refined carbohydrates…
  • It’s high in processed foods…
  • It’s low in whole, unprocessed foods…
  • It’s high in calories, so your waistline keeps growing.

You know your diet isn’t healthy, but you keep coasting along through your 30’s and 40’s until…the unthinkable happens. You are diagnosed with a deadly disease, like heart disease, high blood pressure, or diabetes, and your doctor says that unless you change your diet, you are doomed to a short unhealthy life. You have reached a fork in Food Choicesthe road.

Changing the diet you grew up with, the diet you love, is a daunting task. It’s tempting to think, “Why bother…

  • It’s probably too late to change my diet…
  • The damage has already been done…
  • I can’t reverse it now.”

If this scenario describes you or someone you love, you aren’t alone. There are millions of Americans just like you. You want to know whether changing your diet is worth the trouble. You want to know whether it is too late, or whether you can still change your health for the better.

Most clinical studies don’t answer this question. Most clinical studies do a diet assessment at the beginning of the study and look at health outcomes 20 or 30 years later. If they do more than one diet assessment during the study, the purpose of these assessments is to show that most people stick to the same diet throughout the study.

These studies measure the effect of habitual diets on health outcomes. They tell you that good diets lead to good health outcomes, and bad diets lead to bad health outcomes. But they don’t tell you whether changing your diet from bad to good in your 30’s or 40’s can have a significant effect on your health.

Fortunately, a recent study has answered this question. This study (Y Choi et al, Journal of The American Heart Association, 10e020718, 2021) started with people in their mid-20s. It looked at whether changing their diet from bad to good in their 30s and 40s had any effect on their risk of developing heart disease in their 50s and 60s.

How Was This Study Done?

Clinical StudyThe data for this study were obtained from the CARDIA study (Coronary Artery Risk Development in Young Adults). The study enrolled 4946 young adults (average age = 25, 55% female and 45% male, 50% black and 50% white) and followed them for 32 years (average age of participants at the end of the study = 57).

Diet was assessed by a trained interviewer at year 0, year 7 (average age of participants = 32), and year 20 (average age of participants = 45).

Adherence of the participants to a healthy, plant-centered diet was assessed using an analytical tool called APDQS that divided the foods eaten by the participants into 3 groups based on their known influence on heart disease:

1) Beneficial.

    • These foods included fruit, avocado, beans/legumes, green vegetables, yellow vegetables, tomatoes, other vegetables, nuts and seeds, soy products, whole grains, vegetable oil, fatty fish, lean fish, poultry, moderate alcohol, coffee, tea, and low-fat milk/cheese/yogurt.
    • This is what the investigators considered a plant-centered diet. It encompasses diets ranging from vegan to Mediterranean and DASH.

2) Adverse.

    • These foods included fried potatoes, refined grain desserts, salty snacks, pastries, sweets, high-fat red meats, processed meats, organ meats, fried fish/poultry, sauces, soft drinks, whole fat milk/cheese/yogurt, and butter.
    • This could be considered a typical American diet.

3) Neutral.

    • These foods included potatoes, refined grains, margarine, chocolate, meal replacements, pickled foods, lean meats, shellfish, eggs, soups, and fruit juices.
    • These foods are not the healthiest, but the evidence that they have a negative effect on health disease risk is inconclusive.

The participants were divided into 5 quintiles based on adherence to a plant-centered diet, with quintile 1 having the lowest adherence and quintile 5 having the highest adherence to a plant-centered diet.

The effect of diet on heart disease was measured in two ways:

1) The dietary data from years 0, 7 and 20 were averaged and the effect of average adherence to a plant-centered diet on the risk of developing heart disease by the time the participants were 57 was measured. This is similar to the design of most other studies looking at the effect of diet and heart disease.

2) The effect of an improvement in adherence to a plant-centered diet between ages of 32 and 45 on the risk of developing heart disease by age 57 was also measured. This is what makes this study unique. Basically, the investigators were asking if you could eat a bad diet for 30 years or more and still reduce your risk of heart disease by switching to a good diet by the age of 45. That is the question that millions of American are asking themselves right now.

Is It Too Late To Change Your Diet?

Heart Healthy DietAs I described above this study asked two distinct questions:

1) What effect does your habitual diet have on your risk of developing heart disease?

For this portion of the study, the investigators averaged the dietary data collected in years 0, 7, and 20 of the study and ranked the participants diet from 1 to 5 based on their adherence to a plant-centered diet. When they compared the group with best adherence (group 5) with the group with worst adherence (group 1):

    • Adherence to a plant-centered diet reduced their risk of developing heart disease by 48%.
    • This is consistent with previous studies looking at the beneficial effects of plant-centered diets on heart disease.

2) What effect does changing your diet from bad to good when you are in your 30s or 40s have on your risk of developing heart disease? 

For this portion of the study, the investigators compared the dietary data collected at years 7 and 20 (corresponding to average ages 32 and 45 for the participants) and ranked the participants from 1 to 5 based on improved adherence to a plant-centered diet. When they compared the group with best improvement in adherence (group 5) with the group with worst improvement in adherence (group 1):

    • Improved adherence to a plant-centered diet reduced the risk of developing heart disease by 39%.
    • This answers the questions I posed at the beginning of this article. In short, it is never too late to change your diet for the better.

The authors concluded, “In summary, our study shows that long-term consumption of a nutritionally rich plant-centered diet is associated with a lower risk of heart disease. Furthermore, increased [adherence to a] plant-centered diet in young adulthood is associated with a lower subsequent risk of heart disease throughout middle age, independent of the earlier diet quality” [In short, they are saying that changing to a more plant-centered diet in your 30s and 40s reduces your risk of heart disease.]

You Can Improve Your Health At Any Age

I titled this section, “You Can Improve Your Health At Any Age” for a reason. I wanted to make the point that it is never too late to change your diet, and your health, for the better.

Yes, I realize that the study I described above only shows:

  • The effect of changing to a more plant-centered diet in your 30s and 40s.
  • The benefit of changing to a more plant-centered diet on heart disease outcomes.

However, we have ample evidence that changing to a more plant-based diet at any age is likely to reduce the risk of many diseases. For example:

  • There are multiple reports in the literature of people in their 60s and 70s who had a health scare, changed to a more plant-centered diet, and dramatically improved their health.

While neither type of study can be considered definitive by itself, together they suggest it is never too late to change your diet for the better.

But what changes should you make? As I said above, anything from Vegan to Mediterranean or DASH fits the definition of a plant-centered diet (something I have previously referred to as a primarily plant-based diet).

You could choose the plant-centered diet that best fits your preferences and lifestyle and read books or go online to find details and recipes that will help you transition to that diet…or you could simply:

  • Eat more fruit, avocado, beans/legumes, green vegetables, yellow vegetables, tomatoes, other vegetables, nuts and seeds, soy products, whole grains, vegetable oil, fatty fish, lean fish, poultry, moderate alcohol, coffee, tea, and low-fat milk/cheese/yogurt.
  • Eat less fried potatoes, refined grain desserts, salty snacks, pastries, sweets, high-fat red meats, processed meats, organ meats, fried fish/poultry, sauces, soft drinks, whole fat milk/cheese/yogurt, and butter.
  • Eat these foods in moderation: potatoes, refined grains, margarine, chocolate, meal replacements, pickled foods, lean meats, shellfish, eggs, soups, and fruit juices.

The Bottom Line

If you are like most Americans, you know your diet is unhealthy. But it is the diet you grew up with. It’s the diet you love. So, you keep eating it anyway.

Then you have a wake-up call. You find yourself in your doctor’s office, and your doctor is advising you to change your diet. But giving up the diet you love is difficult, and you wonder if it is worth it. Can you really improve your health significantly by changing your diet now, or is it too late? Has the damage already been done?

Fortunately, a recent study has answered these questions. This study started with people in their mid-20s. And it looked at whether changing their diet from bad to good in their 30s and 40s had any effect on their health in their 50s and 60s. This is what the study found.

  • Improved adherence to a plant-centered diet in their 30s and 40s reduced their risk of developing heart disease in their 50s and 60s by 39%.

While this study was very specific in terms of age and disease, I have discussed in the article above why changing to a more plant-based diet at any age is likely to reduce your risk of multiple diseases. In short, it is never too late to change your diet, and your health, for the better.

For more details about this study and how to change your diet for the better, 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.

A Diet To Die For

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Which Diet Is Best? 

Author: Dr. Stephen Chaney

Heart AttackMany clinical studies focus on the benefits or risks associated with individual components of our diet. For example, we have been told:

  • Saturated and trans fats are bad for us and monounsaturated and omega-3 fats are good for us.
  • Sugar and refined carbohydrates are bad for us, but complex carbohydrates are good for us.

However, we don’t eat saturated fats or sugars in isolation. They are part of a diet with many other foods. Do other foods in our diet affect the risks we associate with saturated fat or sugar? We don’t know.

Simply put, we don’t eat foods, we eat diets. We don’t eat saturated fats, we eat diets. It would be more helpful for the average person if research focused on which diets are good and bad for us instead of which foods are good and bad for us.

One recent study (JM Shikany et al, Journal of the American Heart Association, 10:e019158, 2021) did just that. It evaluated the effect of 6 different dietary patterns on the risk of sudden cardiac death (dropping dead from a stroke or heart attack).

  • It turns out that one of the diets significantly increases your risk of sudden cardiac death. I call that one, “A diet to die for”.
  • Another diet significantly decreases your risk of sudden cardiac death. I call that one, “A diet to live for”.
  • The other diets had no significant effect on the risk of sudden cardiac death.

You are probably wondering, “What were the diets?”; “Which diet is best?”; and “Which diet is worst?” I cover that below, but first we should look at how the study was designed.

How Was The Study Designed?

Clinical StudyThe study involved 21,069 participants in the REGARDS (Reasons for Geographical and Racial Differences in Stroke) clinical trial who were followed for an average of 10 years. This clinical trial enrolled:

  • 30% of its participants from what is called the “the stroke belt” (North Carolina, South Carolina, Georgia, Tennessee, Alabama, Mississippi, Arkansas, and Louisiana).
  • 20% of its participants from what is called “the stroke buckle” (the coastal plain of North Carolina, South Carolina, and Georgia).
  • 50% of its participants from elsewhere in the continental United States.

At the beginning of the study, participants were given a medical exam and filled out an extensive questionnaire on diet.

Based on the diet analysis, the participants were ranked for adherence to six dietary patterns.

#1: The Convenience Pattern. This dietary pattern relied heavily on pre-packaged or restaurant meals, pasta dishes, pizza, Mexican food, and Chinese food.

#2: The Plant-Based Pattern. This dietary pattern relied heavily on vegetables, fruits, fruit juice, cereal, beans, fish, poultry, and yogurt.

#3: The Sweets Pattern. This dietary pattern relied heavily on added sugars, desserts, chocolate, candy, and sweetened breakfast foods.

#4: The Southern Pattern. This dietary pattern relied heavily on added fats, fried food, eggs and egg dishes, organ meats, processed meats, and sugar-sweetened beverages.

#5: The Alcohol and Salad Pattern. This dietary pattern relied heavily on beer, wine, liquor, green leafy vegetables, tomatoes, and salad dressing.

#6: The Mediterranean Pattern. Adherence to the Mediterranean dietary pattern was based on the well-established Mediterranean Diet Score.

  • Points are added for beneficial foods (vegetables, fruits, legumes, whole grain cereals, nuts, and fish).
  • Points are subtracted for detrimental foods (meat and dairy).
  • Points are added for a high ratio of monounsaturated fats to saturated fats (think diets rich in olive oil).
  • One point is added for moderate alcohol consumption, Zero or excess alcohol consumption is assigned 0 points.

The study looked at the correlation of these dietary patterns with the incidence of sudden cardiac death during the 10-year study.

A Diet To Die For

deadThe results were striking.

  • The Southern Diet increased the 10-year risk of sudden cardiac death 2.2-fold. Basically, it doubled the risk.
    • In people with no previous history of heart disease at the beginning of the 10-year study, the Southern Diet increased the risk of sudden cardiac death by 2.3-fold.
    • In people with a previous history of heart disease at the beginning of the 10-year study, the Southern Diet increased the risk of sudden cardiac death by 2-fold.
  • The Mediterranean Diet decreased the 10-year risk of sudden cardiac death 41%.
    • In people with no previous history of heart disease at the beginning of the 10-year study, the Mediterranean Diet decreased the risk of sudden cardiac death by 51%. Basically, it cut the risk in half.
    • In people with a previous history of heart disease at the beginning of the 10-year study, the Mediterranean Diet decreased the risk of sudden cardiac death by 23%, but that decrease was not statistically significant.
  • None of the other diets had a significant effect on the 10-year risk of sudden cardiac death.

In the words of the authors, “We identified a trend towards an inverse association of the Mediterranean diet score and a positive association of adherence to the Southern dietary pattern with risk of sudden cardiac death.” [That is a fancy way of saying the Mediterranean diet decreased the risk of sudden cardiac death, and the Southern dietary pattern increased the risk of sudden cardiac death.]

Which Diet Is Best?

AwardThe Mediterranean Diet Is Best: In this analysis of the effects of 6 different dietary patterns on the risk of sudden cardiac death, it is obvious that the Mediterranean diet is best. It cut the risk of sudden cardiac death in half.

This should come as no surprise:

  • I have reported on a previous study showing that the Mediterranean diet decreases the risk of heart disease by 47%.
  • In the Woman’s Health Study the Mediterranean diet decreased the risk of sudden cardiac death by 36%.
  • In the Nurses’ Health Study there was an inverse association between the Mediterranean Diet Score and sudden cardiac death.

The Southern Dietary Pattern Was Worst. It doubled the risk of sudden cardiac death. As someone who grew up in the South, this comes as no surprise to me. Let me count the ways:

  • It starts with a breakfast of fried eggs, grits with “red-eye gravy” (a mixture of ham drippings and coffee), ham or sausage, and biscuits made with lots of lard and sugar.
  • When I was growing up, a snack might be an RC cola and moon pies (look that one up).
  • Dinner might be fried chicken and hushpuppies or fried fish and hushpuppies.
  • Instead of picnics we have pig pickins (which is pretty much what it sounds like).
  • And we boil our vegetables with fatback (pig fat) and sugar.

I could go on, but you get the picture. Don’t get me wrong, I have fond memories of the foods I ate while growing up in the South. I just don’t eat them much anymore.

Why Didn’t The Plant-Based Dietary Pattern Score Better? One of the surprises from this study was that the Plant-Based Dietary Pattern didn’t score better. After all, numerous studies have shown that mostly plant-based diets reduce the risk of heart disease. Why did it strike out in this study?Vegan Foods

My feeling is that the study did not adequately describe a true Plant-Based Dietary Pattern. As I described above, participants following the Plant-Based Dietary Pattern were identified as having above average consumption of vegetables, fruits, fruit juice, cereal, beans, fish, poultry, and yogurt compared to others in this study. I have two concerns with this classification.

  • As described, this is a semi-vegetarian diet, while the best results for reducing heart disease risk are seen with strict vegetarian and lacto-ovo-vegetarian diets.
  • However, my biggest concern is that we don’t know what other foods they were consuming. Were they also consuming convenience foods? Were they consuming sweets? We don’t know.

That is very different from the two dietary patterns that stood out in this study.

  • 50% of the participants in this study came the Southeastern region of the United States. So, when the study identified participants as following a Southern Dietary Pattern based on a few southern foods, it is likely that those participants ate many other southern foods as well.

If 50% of the participants in the study had come from the Loma Linda area of California where vegetarianism is much more common, the study might have done a better job of identifying participants consuming a plant-based diet.

  • While participants consuming the Mediterranean diet were more scattered geographically, the Mediterranean Diet Score used to identify people consuming a Mediterranean diet is much more detailed and has been validated in numerous previous studies.

In short, the Southern and Mediterranean Dietary Patterns may have stood out in this study because they provided a more precise distinction between those consuming a Southern or Mediterranean diet and those following other dietary patterns. If the Plant-Based Dietary Pattern had been more precisely described, it might have shown a statistically significant benefit as well.

The Bottom Line

Many clinical studies focus on the benefits or risks associated with individual components of our diet.

However, we don’t eat foods, we eat diets. It would be more helpful for the average person if research focused on which diets are good and bad for us instead of which foods are good and bad for us.

One recent study did just that. It evaluated the effect of 6 different dietary patterns on the risk of sudden cardiac death (dropping dead from a stroke or heart attack).

  • It turns out that the Southern diet doubles your risk of sudden cardiac death. I call that one, “A diet to die for”.
  • In contrast, the Mediterranean diet cuts your risk of sudden cardiac death in half. I call that one, “A diet to live for”.
  • The other diets had no significant effect on the risk of sudden cardiac death.

For more details on the study, why the Southern diet is so bad for us, and why the Mediterranean diet is so good for us, 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