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Which Diet Works Even Better the Longer You Do It?

AHA Publisher — Wed, 24 Aug 2022 07:00:32 +0000

Michael Greger M.D. FACLM via Nutrition Facts – The most well-published community-based lifestyle intervention in the medical literature is also one of the most effective. CHIP, the Complete Health Improvement Program—now known as Pivio, may be “the most well-published community-based lifestyle interventions in the [medical] literature.” It is also one of the most effective, with clinical changes “approaching those outcomes achieved in [live-in] residential lifestyle programs.” As I discuss in my video The Weight Loss Program That Got Better with Time, CHIP encourages people to transition toward a more whole food, plant-based diet, and the “average reductions in blood pressure were greater than those reported with the DASH [Dietary Approaches to Stop Hypertension] study and comparable with the results” of blood pressure-lowering drug trials. If we’re going to reverse the worldwide chronic disease epidemic, though, we’ve got to scale this up. To make CHIP more accessible to a wider audience, each of Hans Diehl’s live presentations was videotaped. Then, a “trained and certified” volunteer facilitator got people in a room to watch the videos and helped foster discussion. When it comes to safe, simple, side effect–free solutions, such as a healthier diet and lifestyle, you don’t need to wait for a doctor to show up and give a lecture. Sounds great, but does it work? Those individuals who were the worst of the worst and participated in the program, finishing all the videos, had a 20-point drop in blood pressure, a 40-point drop in bad LDL cholesterol, and more than a 500-point drop in triglycerides, as you can see below and at 1:08 in my video. Of those who came in with diabetic-level fasting blood sugars, about one in three left with nondiabetic-level fasting blood sugars. Remember, all of this was achieved simply by empowering people with knowledge. Just encouraging people “to move toward a whole-food, plant-based diet” led to these remarkable benefits. What was the effectiveness of this volunteer-delivered lifestyle modification program on 5,000 participants? The same kind of significant reductions in weight, blood pressure, cholesterol, triglycerides, and blood sugars were found. Most studies giving “dietary advice to free-living subjects can be expected to reduce blood total cholesterol by only 3-6%…[but a] sustained reduction in blood total cholesterol concentration of 1% is associated with a 2-3% reduction in the incidence of heart disease.” So, on a population scale, even small differences matter. Put thousands of people through just one month of CHIP, however, and you get an 11 percent drop on average and up to a nearly 20 percent drop among those who need it most, as you can see below and at 2:12 in my video. Do the participants maintain their healthy habits, though? Doctors can’t even get most people to take a single pill once a day. How effective can a volunteer-led video series be at getting people to maintain a change of eating habits? Researchers looked at the CHIP data to find out. How were participants doing 18 months after completing the program? Most were able to maintain their reductions of meat, dairy, and eggs, though some of the junk food had started to slip back in. Their fruit and veggie consumption dipped, though not back to baseline. Ready for the huge shocker? Even though the participants had been told explicitly to eat as much as they wanted without any calorie- or carb-counting and without any portion control, just by being informed about the benefits of centering their diets more on whole plant foods, by the end of the six-week program, they were eating, on average, about 339 fewer calories a day without even trying. Instead of eating less food, they were just eating healthier food. But that was right at the end of the six-week program when they were all jazzed up. Where were they 18 months later? Anyone familiar with weight-loss studies knows how it works: You can excite anyone in the short term to lose weight using practically any kind of diet, but then after six months or a year, they tend to gain it all back—or even more. The CHIP participants were eating about 300 fewer calories a day during the program, but 18 months later, they were eating about 400 fewer calories. What kind of diet can work even better the longer you do it? A whole food, plant-based diet. “Many weight loss programs restrict energy [calorie] intake by limiting portion sizes, which often results in hunger and dissatisfaction with the eating regime, thus contributing to low compliance and weight regain,” but the satiety-promoting all-you-care-to-eat plant-based, whole-food dietary approach may be the secret weapon of sustainable weight loss. Key Takeaways The Complete Health Improvement Program (CHIP) encourages transitioning to a more whole food, plant-based diet and may not only be the most well-published community-based lifestyle intervention in the medical literature, but also one of the most effective. Its clinical changes may be on par with outcomes achieved in live-in lifestyle programs, and the average drop in blood pressure achieved with CHIP exceeded reports by the Dietary Approaches to Stop Hypertension (DASH) study and was comparable to results from trials with blood pressure–lowering drugs. To make CHIP more widely accessible, each live presentation delivered by Hans Diehl, the developer of the program, was videotaped so volunteer facilitators, each trained and certified, could screen the lectures and foster discussion among participants. Participants who completed the facilitated video program had a 20-point drop in blood pressure, a 40-point drop in bad LDL cholesterol, and more than a 500-point drop in triglycerides. Most of those who started CHIP with diabetic-level fasting blood sugars left with nondiabetic levels. Typically, studies giving dietary advice to participants not in a live-in setting may get cholesterol reductions of 3 to 6 percent, and sustained reduction of 1 percent is associated with a 2 to 3 percent drop in heart disease incidence. Just one month of CHIP achieved an 11 percent drop on average and up to a nearly 20 percent drop among those participants most in need of intervention. Eighteen months after completing the volunteer-led video series, most CHIP participants maintained their reductions of animal products, though some began eating more junk food and less fruits and vegetables (though not back to baseline quantities). Importantly, they were eating about 400 fewer calories a day than before they started CHIP. (At the end of the six-week video program, they were down only 300 daily calories.) Unlike many weight-loss programs that count calories and limit portion sizes, an all-you-care-to-eat plant-based, whole food dietary approach appears to be more sustainable. To read the original article click here.

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From Adequate Nutrition to Optimum Nutrition

The AHA! Team — Wed, 21 Aug 2019 07:00:00 +0000

Michael Greger M.D. FACLM via Nutrition Facts – We need to shift from the concept of merely getting adequate nutrition to getting optimal nutrition. That is, we shouldn’t just aim to avoid scurvy, but we should promote health and minimize our risk of developing degenerative diseases. Research in human nutrition over the past four decades has led to many discoveries as well as a comprehensive understanding of the exact mechanisms behind how food nutrients affect our bodies. As I discuss in my video Reductionism and the Deficiency Mentality, however, the “prevalence of epidemics of diet-related chronic diseases, especially obesity, type 2 diabetes, osteoporosis, cardiovascular diseases, and cancers, dramatically increases worldwide each year.” Why hasn’t all this intricate knowledge translated into improvements in public health? Perhaps it has to do with our entire philosophy of nutrition called reductionism, where everything is broken down into its constituent parts; food is reduced to a collection of single compounds with supposed single effects. “The reductionist approach has traditionally been and continues today as the dominant approach in nutrition research.” For example, did you know that mechanistically, there’s a chemical in ginger root that down-regulates phorbol myristate acetate-induced phosphorylation of ERK1/2 and JNK MAP kinases? That’s actually pretty cool, but not while millions of people continue to die of diet-related disease. We already know that three quarters of chronic disease riskâ€“â€“diabetes, heart attacks, stroke, and cancerâ€”can be eliminated if everyone followed four simple practices: not smoking, not being obese, getting a half hour of exercise a day, and eating a healthier diet, defined as more fruits, veggies, and whole grains, and less meat. Think what that could mean in terms of the human costs. We already know enough to save millions of lives. So, shouldn’t our efforts be spent implementing these changes before another dollar is spent on research such as figuring out whether there is some grape skin extract that can lower cholesterol in zebra fish or even trying to find out whether there are whole foods that can do the same? Why spend taxpayer dollars clogging the arteries of striped minnows by feeding them a high cholesterol diet to see whether hawthorn leaves and flowers have the potential to help? Even if they did and even if it worked in people, too, wouldn’t it be better to simply not clog our arteries in the first place? This dramatic drop in risk and increase in healthy life years through preventive nutrition need not involve superfoods or herbal extracts or fancy nutritional supplementsâ€”just healthier eating. When Hippocrates supposedly said, “Let food be your medicine and medicine be your food,” he “did not mean that foods are drugs, but rather, that the best way to remain in good health is to maintain a healthy diet.” (Note: Hippocrates probably never actually said thatâ€”but it’s a great sentiment anyways!) The historical attitude of the field of nutrition, however, may be best summed up by the phrase, “Eat what you want after you eat what you should.” In other words, eat whatever you want as long as you get your vitamins and minerals. This mindset is epitomized by breakfast cereals, which often provide double-digit vitamins and minerals. But the road to health is not paved with Coke plus vitamins and minerals. This reductionistic attitude “is good for the food industry but not actually good for human health.” Why not? Well, if food is good only for a few nutrients, then you can get away with selling vitamin-fortified Twinkies. We need to shift from the concept of merely getting adequate nutrition to getting optimal nutrition. That is, we shouldn’t just aim to avoid scurvy, but we should promote health and minimize our risk of developing degenerative diseases. Bringing things down to their molecular components works for drug development, for example, discovering all the vitamins and curing deficiency diseases. In the field of nutrition, “[h]owever, the reductionist approach is beginning to reach its limits.” We discovered all the vitamins more than a half-century ago. When is the last time you heard of someone coming down with scurvy, pellagra, or kwashiorkor, the classic deficiency syndromes? What about the diseases of dietary excess: heart disease, diabetes, obesity, and hypertension? Ever heard of anyone with any of those? Of course we have. Yet we continue to have this deficiency mindset when it comes to nutrition. When someone tries to reduce their consumption of meat, why is “where are you going to get your protein?” the first question they get asked, rather than “if you start eating like that, where are you going to get your heart disease?” The same deficiency mindset led to the emergence of a multibillion-dollar supplement industry. What about a daily multivitamin just “as ‘insurance’ against nutrient deficiency?” Better insurance would be just to eat healthy food. This article has been modified. To read the original article click here. For more articles by Dr. Greger click here.

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