This entry was posted on Monday, November 4th, 2013 at 5:23 pm and is filed under Jack Norris RD Interviews. You can follow any responses to this entry through the RSS 2.0 feed.
You can skip to the end and leave a response. Pinging is currently not allowed.
Also, I received my order of kala namak today, out of curiosity, not because I was desperately craving eggs which I haven’t had in a year. I actually loath the smell of other people baking/cooking eggs. But o boy how suprisingly good was it suddenly to have that taste of sulfur! I now keep craving it. Not eggs, but just that horribly smelling sulfur taste. Perhaps there is something to those ex-vegans craving eggs for reasons other than nutrition.
I guess I am still an ardent disbeliever that low cholesterol is the issue here with failure to thrive. Did you mention on the show that the brain has its own HMG CoA reductase to synthesize cholesterol, and thus is not dependent on liver synthesis or dietary cholesterol? The probable reason for that is because the brain is 60% lipid and very rich in cholesterol.
Statins do not affect testosterone levels, despite reducing serum cholesterol by 50% or more, but statins are not the same as a very low fat vegan diet. I wonder what Ornish or Esselstyn would recommend in such a patient, since they both abhor fat. I saw a patient on Esselstyn diet who had marked improvement in potency and erections despite a documented history of vasculogenic impotence. And his cholesterol was very, very low. So that just goes to show how good anecdotes are.
Such a person as you’ve mentioned could ease up on his dietary fat restriction or add 1-2 tsp of coconut oil to stimulate liver cholesterol synthesis – just as a personal trial. If there’s no effect, maybe it’s not the diet to blame.
Well, today was the first day I started fully urging people in my practice to pick up a plant-based diet (when you think where I began in my counselling — fully drug-based, then Atkins, then Eco-Atkins, and now vegan — this represents a real sea change). Some impressions:
1) The biggest resistance seems to come with the question, “Well, what will I eat if I stop eating meat?” People also loathe to give up their eggs. I give them dietary recipes and recite by heart, “legumes, nuts, seeds, grains, starchy vegetables, non-starchy vegetables, fruits, etc.” This seems to satisfy their (initial) disbelief. People are under the impression that a veg*n diet consists of lettuce and grass, when nothing could be further than the truth (although we do eat alot of grass!).
2) People have no idea about factory farm conditions. To cite just one example, the pus-filled bilge water that forms up to 30% of the weight of a poultry purchase. Absolutely no idea. I refer them to your book, Jack, or Safran-Foer’s “Eating Animals”. I think if we could get across how disastrous the farm factory system is, in terms of hitting people at their bottom line (not their pocket book, but their health), we could easily persuade many individuals of the virtues of a meat-free diet. Perhaps, since I practice up in Canada, I can find some youtube video of a farm here that purports to be “free range organic” and still shows wretched conditions in either the slaughterhouse or battery cages, etc. Any thoughts?
About 1 in 1000 will have already given up meat before they come to see me. But 999 will not have done so. I won’t be able to tell you my success rates for another year or so at changing the 999/1000 odds to better odds. I would like to investigate other printed counseling materials, or some way to better support my patients in their personal efforts. Considering how slow the adjustment was for me, and all the growing pains, uncertainties over supplements (maybe that’s just me), and difficulties with letting go of certain dietary items (especially dairy), it is going to be remarkably harder for the average senior with established vascular disease in my practice.
Here is an example: 75 year old male with two cardiac arrests, ongoing VT shocks, coronary stents, atrial fibrillation, smoking 6-7 cig/d, CHF, mild renal insufficiency, no diabetes, has carotid stenosis (95-99%), COPD, morbidly obese — eating 5 eggs per week with no meatless days whatsoever. No weight loss in the past year. On multiple medications. Very resistant stage at the ‘stages of change’ model. I laid it all out for him – plant-based vs meat-based – how he could make health improvements in both him and his morbidly obese wife – how it was not too late to reverse his disease status, how bloody remarkable it was that he did not already have type 2 diabetes! My guess is that he will not change his habits.
Thank you, Jack. I will do a more detailed search soon (my patients all tell me they have backed off red meat and only eat chicken, just like the rest of the general non-vegan population, thereby intensifying needless animal suffering).
Back to clinic this week with more vegan counselling. I got resistance today from an older couple who said that “Going vegetarian is just one opinion”, and had all sorts of arguments against it, which I tried to counter. There are some folks who just won’t ever go vegan.
Then I saw a gentleman who has been vegan on the Ornish plan for three years and has recently slid back onto some no-fat dairy and salmon — we discussed that this was not the best way to approach optimal health, and he is readily willing to eliminate these animal products.
A few people seemed to be a bit in a state of ‘shock and awe’ when I told them that a plant-based diet was the best approach for their health — no one had ever told them this before! I am telling people more and more to just ‘jump in’. Heh, the water’s warm here and we have handouts. Make sure you take your B12 and your vitamin D. The whole shebang could be the solution to your hypertension, dyslipidemia and diabetes – in fact, it probably is. “Where do you get your protein?” “Where do you get your calcium?” These questions are readily answerable – people just don’t have the imagination (just as once I didn’t have).
The perspective I am taking is that I feel obligated now to inform patients that a vegan diet is most likely the healthiest possible diet they could ever consume, especially if it’s ‘whole foods-based’. There are so many people out there who are overconsuming chicken and dairy, not to mention other dietary toxins (if you’ll agree dairy is a toxin — controversial, I admit), that I am bound to rub up against some pretty firm, fixed beliefs. Look around in society – you see meat advertised everywhere – it’s in the popular culture, it’s in song lyrics, it’s in our English idioms. It’s a bit like brainwashing – maybe one can make an analogy to 1930’s Germany. Everyone – except a lucky few – are steeped in it from birth. Change minds one person at a time – just like Eleanor Roosevelt said.
I know that, and actually I learned that from your veganhealth.org website. I eschew dairy purely for ethical reasons, although much has been made of its propensity to harm health (which I don’t entirely agree with; for example, I peer-reviewed a paper from Asia – large observational cohort with long-term follow-up specifically focused on dairy intake – suggesting strong benefit for cancer and cardiovascular mortality and morbidity with higher dairy intake; the reduction in stroke was particularly striking).
I didn’t really clarify – the reason I asked him to stop eating low-fat dairy was that it still contains some cholesterol and his plaque was surprisingly progressing on his vegan diet (whereas before it was reversing). The two animal products he was consuming were fish and dairy. Even zero fat dairy has a small amount of cholesterol (10-15 mg per 3/4 cup serving, if memory serves me). It is probably trivial in the greater scheme of things but I want to eliminate any confounders because I can’t find anything else in this person to treat (he is incredibly fit, exercising daily with weights and aerobic, he consumes an otherwise vegan diet, he takes a statin, he doesn’t smoke, and yet he has both CAD and carotid plaque). He does not overeat carbs – his glucose tolerance is outstanding. His cholesterol is actually incredibly low, but we have fasting levels, not postprandial. He is going to cut out fish and dairy, sleep more and try to de-stress better. I should have pointed out the whole context when I mentioned ‘Ornish’.
Dave, as far as I can see the article is not yet out. I am reluctant to mention the name of the journal because I was one of the peer reviewers (probably the most critical of them) and this would be breaching the confidentiality of the peer review process at this journal (maybe I’ve already said too much).
But do the results I mentioned above really surprise you? Unless one is looking only at cherry-picked data, there is a large body of evidence suggesting that dairy intake is at least somewhat protective against metabolic syndrome and type 2 diabetes, as well as colorectal cancer, stroke and coronary disease. Isn’t that why in all the general public nutrition recommendations “low fat dairy” is so repeatedly and broadly recommended? I realize there is a competing hypothesis – that dairy is harmful, in part due to the cancer-increasing effects of casein/animal protein and IGF-1 production.
I just checked the journal website and have not found that the article has yet been published online.