Summary of Talk with References

Below is a summary of a talk given January 25th 2017 with links to references in PubMed (which will also tell you if the article is available to download for free):

Why Food is the Best Medicine – Dr S Ganguli

Dr Ganguli’s website:  www.foodasprevention.com (overview here)

DVD – ‘Forks Over Knives’ (in library, Netflix, iTunes & at www.forksoverknives.com)

Evidence-based book: How Not To Die by Dr Greger (on Amazon.ca)

Evidence based, referenced videos at nutritionfacts.org

Abbreviations

W = women; M = men, NNT = number needed to treat, RR = relative risk, *= extra information

1. Epidemiologic Studies
   1. A prospective cohort study followed 78,865 women for 34 years and 44,354 men for 27 years to estimate the impact of lifestyle factors on premature mortality.  They came up with 5 low-risk lifestyle factors (never smoking, BMI of 18.5 to 24.9 kg/m2, >= 30 min/day of moderate to vigorous physical activity, moderate alcohol intake, and a high quality diet quality score).  Findings were as follows:
      1. Hazard ratio for mortality in adults with 5 vs 0 low-risk factors were 0.26 (P<0.05) for all cause mortality, 0.35 for cancer mortality (P<0.05), and 0.18 for cardiovascular disease mortality (P<0.05).
      2. Population-attributable risk of nonadherence to 5 risk factors was 60.7% (P<0.05) for all-cause mortality, 51.7% for cancer mortality (P<0.05), and 71.7% for CV disease mortality.
      3. For those who adopted all 5 low-risk lifestyle factors, the projected life expectancy at age 50 years was 14.0 years longer for women (93.1 vs 79.0 years) and 12.2 years longer for men (87.6 vs 75.5 years).
   2. Over 36 year, a lifestyle intervention in Finland resulted in the following mortality  decreases: All cause 62%, cardiovascular 79%, all cancer 65%
   3. High meat consumption (top 20% vs bottom 20%) is associated with increases in the following: Total mortality 24% (W) 37% (M), NIDDM 30% (W) 44% (M), cardiovascular mortality 45% (W), 35% (M), cancer mortality 17% (W), 24% (M).  Substituting just 1 portion meat per day with legumes, whole grains, poultry, or NUTS decreases total mortality by 10-20%.
   4. High animal protein consumption (top 20% vs bottom 20%) is associated with a 49% increase in NIDDM (plant protein associated with 9% decrease in NIDDM)*
   5. Meta-analyses have shown that vegetarians have significantly lower cancer incidence (10% omnivores vs 5% for vegans) & CAD mortality.(RR=0.71)
2. Obesity
   1. In a meta-analysis of 239 prospective studies of over 10 million participant with median followup  for 13.7 years in comparison to mortality for BMI of 20.25 kg/m2:
      1. Increased mortality with increased BMI (HR 1.07 for BMI of 25.0-27.5 [P<0.05], HR 1.20 for BMI 27.5-30.0 [P<0.05], HR 1.45 for BMI 30.0-35.0 [P<0.05], HR 1.94 for BMI 35.0-40.0 [P<0.05], HR 2.76 for BMI 40.0-60.0 [P<0.05].
      2. Per 5 kg/m2 of BMI over 25.0, the HR of mortality was 1.39 in Europe and east Asia, 1.29 in North America
      3. The HR per 5 kg/m2 of BMI over 25.0 was greater for younger people (HR 1.52 at 35-49 yrs) than older (1.21 for 70-89 yrs). and greater in men than women (HR 1.51 vs 1.30 P<0.0001).
3. NIDDM
   1. While a 4 year RCT of a CONVENTIONAL diet & exercise was positive to prevent diabetes, at 15 yrs followup 52% still became diabetic.
      1. After an average follow-up of 2.8 years the incidence of diabetes was 11.0, 7.8,and 4.8 cases per 100 person-years in the placebo, metformin and lifestyle groups respectively.
      2. In comparison with placebo, the rate of diabetes was decreased by 58% by lifestyle [P<0.05], and 31% by metformin [P<0.05].
      3. The NNT to prevent one case of diabetes during a period of 3 years was 6.9 persons in the lifestyle intervention and 13.9 people in the metformin group.
   2. Meta-analysis shows that a low glycemic index diet decreases HbA1c by 0.50 (P<0.05)
   3. Vegan diet better than American diabetes association diet in a 74 week RCT & meta-analysis (HbA1c 0.4 lower with vegan) & better total cholesterol & LDL
4. RCTs of Mediterranean diet (plus nuts or olive oil)
   1. Positive to prevent NIDDM positive (NNT = 13)
   2. Positive in primary (NNT 100) and secondary prevention (NNT 3.6)  of cardiac events
5. RCTs of ground flax seeds (2 Tbsp/day) show
   1. Decrease blood pressure (systolic by 15 mmHg; diastolic 7 mmHg)
   2. Slow the proliferation rate of breast cancer & prostate cancer.
6. Cancer
   1. Countless case-control & cohort studies show lower cancer rates with fruits and vegetables
   2.  RCT of lifestyle change in prostate cancer associated with lower PSA.
   3. In vitro study of 34 vegetables vs 8 cancer cell lines showed > 50% inhibition of all cell lines by cruciferous vegetables (KALE, brussels, broccoli, cabbage) & allium (GARLIC, leek, onion)

For those who would like to go further, see CME opportunities under item #6 on my Health Workers page (here)