Diet and Exercise Flashcards
Okinawa Diet
HIghetst proportions of cenetarians 34/100,000 vs 5-10/ 100,000 Americans
Ornish studies - Multicenter Lifestyle Intervention Project
440 pts with Coronary artery disesase participated in lifestyle change;
- Diet: low fat ≤ 10%, whole foods, plant-based
- Exercise: moderate exercise ≥ 3 hours/week
-Stress management: ≥ 1 hour/week
Group support sessions 2X/week
Baseline, 3-month, and 12-month F/U
Significant improvements Medical ↓ plasma lipids ↓ blood pressure ↓ body weight ↑ exercise capacity Psychosocial, ↑ quality of life
Ornish Studies - Multisite Cardiac Lifestyle Intervention Program
Multisite Cardiac Lifestyle Intervention Program: Demonstrated similar results to multicenter – Significant decrease in coronary risk factors
Esselstyn Study
5-year F/U –> 18 patients were compliant
Mean cholesterol 237 mg/dL decreased to→ 137 mg/dL
Coronary events: None in first 5 years & 49 coronary events in 8 years < study
- 6 patients left study ≤ first 18 months –> Coronary events: 13
11 patients underwent angiography –>No additional stenosis
8 of 11 had disease regression
@12-year F/U—> 17 patients remaining & Mean cholesterol 145 mg/dL
Esselstyn’s Study/ DIET : 1985 - 2000
24 patients (1 ♀, 23 ♂) with severe coronary artery disease
began plant-based diet with < 10% fat
- No oils, fish, meat
- No dairy except: Skim milk, Non-fat cheese, Non-fat yogurt
- Maintained cholesterol < 150 mg/dL with Diet & Cholesterol-lowering medication
Ornish Diet: The reversal diet
The Reversal Diet 10% fat (mostly polyunsaturated or monounsaturated) 70-75% carbohydrate 15-20% protein 5 mg. cholesterol daily
Typical american diet
Typical American Diet: 35-50% fat (mostly saturated) 25-35% carbohydrate 25% protein 400-500 mg. cholesterol daily
“In cholesterol lowering, moderation kills”: Caldwell B. Esselstyn, Jr., MD
“The high-fat American diet is responsible for an epidemic of coronary artery disease. A plant-based diet with less than 10% fat will prevent coronary disease from developing, halt the progress of existing disease, and even reverse the disease in many patients. Given proper support and education, motivated patients with a history of coronary disease can follow this diet and prevent future cardiac events.”
High-fat diet (55-65%), low-carbs, & high-protein causes
---> ketosis Atkins’ diet Carbohydrate Addict’s Diet Protein Power Life Without Bread
Moderate-fat diet (20-30%), balanced nutrient reduction, modrate-to-high carbs, moderate protein
USDA Food Guide Pyramid DASH diet Weight Watchers Jenny Craig Zone Diet South Beach Diet Mediterranean Diet
Low-fat diet (11-19%) and Very-low-fat (VLF) (< 10%), high carbs, moderate protein → primarily plant-based
Ornish Diet
Eat More, Weigh Less
Pritikin Diet
& esselton’s diet
Diet differences - Chinese vs. American
America: 15-16% Calories from protein, 80% animal-based China: 9-10% calories from protein, 10% animal-based
Vitamin C
Aids in making collagen for connective tissues
Aids in wound healing
Protects against free-radical damage
Doesn’t decrease frequency of colds, but can decrease the duration and severity
Reduces risk of many GI cancers
Vitamin D
Hormone manufactured by sun exposure of skin
Winter-time supplementation reduces bone loss and improves bone density
Sunscreen users can be Vit D deficient
Evidence that it reduces risk in several cancers
Vitamin E
Excellent free-radical scavenger
May reduce risk of: heart disease & prostate cancer
Can interfere with blood thinners
Folate (folic acid)
Prevents neural tube defects during pregnancy
Reduces homocysteine levels
Lowers risk of heart disease
Calcium
Supplementation can help improve bone health
Decreased bone fractures in high-risk groups
Free radicals
unpaired electrons
Denature bio-molecules: Proteins, Lipids, Nucleic acids
Results in tissue injury
Oxidative stress
Exogenous sources: Diet, Environmental pollution, Cigarette smoke, Exhaust fumes
Endogenous sources: Mitochondrial respiration & Activation of phagocytes
Antioxidants
Natural or synthetic compounds that are oxidized very readily, therefore preventing other compounds from being oxidized.
Enzymes: Superoxide dismutase, Catalases, Peroxidases
Vitamins: Beta-carotene, Vitamin E, Vitamin C, Vitamin A
Antioxidant diet
Low-calorie diets lowers production of cell-damaging free radicals.
Antioxidant-rich foods : Legumes (beans), Vegetables, Whole grains, Fruits
It follows that plant-based foods and diets are richest in antioxidants.
Popular Diets
Very-low-fat: Ornish, Pritiken, Okinawa
Moderate-to-Low-carbohyrate: Atkins, Carbohydrate Addict’s, Zone, South Beach, Low-calorie, Weight Watchers,
Jenny Craig
The Five A’s
Assess obesity risk
Ask about readiness to lose weight
Advise in choosing and designing a program
Assist in facilitating the right intervention
Arrange for follow-up
Body mass index (BMI)
= weight (kg) / height (m2)
< 18.5 underweight 18.5 – 24.9 normal ≥ 25 overweight ≥ 30 obesity (class 1) ≥ 35 obesity (class 2) ≥ 40 extreme obesity (class 3)
