Monthly Archives: September 2013

THE 5/2 MEDITERRANEAN EATING PLAN

LIFETIME WEIGHT CONTROL IS POSSIBLE

One year ago Michael Mosley, MD, published his book The Fast Diet  with the 5/2 concept of intermittent fasting. Benefits of calorie restriction have been known for many years. There are many variations on this theme.

True fasting – eating nothing – can trigger a reduction in the body’s metabolic rate. This slowdown stimulates efficient calorie storage and weight gain when eating resumes. Known as a starvation response, it is part of our genetic makeup.

Ancestors who survived long droughts and periods of starvation carried the surviving genes of longer life.  With these favorable genes came the body’s natural ability to pack on weight easily during good times in preparation for periods when food was scarce. In the past, this was life-saving. Today, those same genes carry some of the responsibility for obesity, but not all.

 With food easily available and daily exercise reduced, one-third of our society has become obese. People are eating more calories than they need. The excess calories are stored in tissues as fat. Over time, the natural process of fat storage as energy reserve produced the obesity epidemic.

With the dramatic increase in obesity in the US and around the world in developed countries, we see an upsurge in related diseases. With excess weight, there is an associated increase in heart disease, Type 2 diabetes, sleep apnea, arthritic joints, high blood pressure and strokes. Many forms of cancer are also associated with obesity.

 Overweight people try many gimmick diets to lose weight and fail. If the dietary recommendations are non-sustainable over a lifetime, the excess weight returns. Learning and practicing healthy eating is the key to success.

 I am proposing  a variation on Dr. Mosleys concept. A 5/2 eating plan combined with the Mediterranean cuisine. Even if you are busy and eating in restaurants daily, this is effective, easy and can be followed over a lifetime.   I will explain more below.

First, a little background and recommended reading: The China Study, a book published in 2005, and the Mediterranean and plant-based food choices.

The China Study

A twenty year study began in 1983 with T. Colin Campbell, an American biochemist and nutritional expert at Cornell University and his physician son Thomas M. Campbell, in association with the Chinese Academy of Preventive Medicine, Cornell University and the University of Oxford. Using dietary surveys and blood work, these men examined the effect of diet on 48 forms of cancer and chronic disease on 6,500 people in 65 counties in China.

 Many complex analyses were made on the data, but in the final judgment, consuming animal-based protein increased blood cholesterol, heart disease, diabetes, autoimmune diseases and many forms of cancer. These diseases common in Western countries were extremely low in the Chinese population. This led to their recommendation of the vegan (animal product-free) plant-based diet.

Following President Bill Clinton’s diagnosis of coronary artery disease and bypass surgery, Clinton began eating vegan. His health improved. He lost weight and became a supporter. Sanjay Gupta, MD, CNNs chief medical correspondent is an advocate of plant based eating. Long time advocate of whole food eating and minimal animal product consumption, Dean Ornish, MD, combined this eating pattern with exercise and yoga. His patients with advanced heart disease showed evidence of reduction in arterial blockages.

 In 1970, a University of Minnesota physiologist, Dr. Ancel Keys published a report on cardiovascular disease related to diet. The initial research involved 12,000 men in Finland, Greece, Italy, Japan, Holland the United States and Yugoslavia. The highest incidence of heart disease was found in the US and Finland. These two countries also had the highest intake of saturated fat and cholesterol. Mediterranean and Japanese inhabitants with low saturated fat intake had very low incidence of heart disease and lived longer.

The Mediterranean diet, as it was later named, consists primarily of fresh fruits, vegetables, nuts, olive oil and olives, wine, whole grains, fish, limiting red and fatty meat.

 Mediterranean and Plant-based Cuisine Combined with a 5/2 Eating Plan

The Greek island of Crete had 57% fewer cardiac deaths than Finland. Their intake was also the highest in olives and olive oil, monounsaturated fats. Vegetarian or plant-based eating typically kabob vegavoids meat, but may include eggs, cheese and milk products. Omit meat and all animal products, and you are vegan.


This is the weekly menu for the 5/2 Mediterranean Plan for Weight Control and Lifelong Healthful Eating:

         5 days of a healthful eating following Mediterranean or plant-based food consumption and avoiding all fried foods

         2 non-consecutive days of eating 500-600 calories/day, such as Monday and Thursday

(Note: A low calorie intake like this done on consecutive days is more likely to induce the starvation response and reduce your metabolic rate. It is important to separate the days and add exercise to counteract this effect.)

         One hour of exercise each day, such as walking

 Utilizing the information above, you have the tools for eating healthy. If you are overweight, following the 5/2 calorie reduction plan is healthful. If you are taking medications for heart, blood pressure or Type 2 diabetes, discuss the 5/2 plan with your physician before using this. (This is not a plan for Type 1 diabetics or women who are pregnant.)

Weight Control Math

To review: One pound = 3500 calories. If your normal intake is 2500 calories/day and you eat 500 calories two days/week, your calorie reduction each week could be 4,000 calories or more than one pound in weight loss. This is approximately 4-5 pounds per month and 48-60 pounds in a year. In addition, if you choose lower calorie foods, (more vegetables, less fat and sugar), you may lose more. Most people find this plan easy to follow for long periods.

To be effective and long-lasting, the manner of eating must be sustainable. It must become a way of life something you can do for the rest of your life. If you have a lot of weight to lose, this would be a life-changing method of controlling your eating and reducing weight. Once you reach your ideal weight, omit the 2 light calorie days and continue eating a Mediterranean or plant-based cuisine daily.

 Animal and human studies examining the effects of fasting, show a heart benefit, along with reduced blood pressure and lower cholesterol levels. Intermittent fasting also decreases diabetes development in lab animals. Eating fewer calories two days a week is not true fasting but produces health benefits.

Because Dr. Mosleys unique concept of marked calorie reduction for two out of five days lacked scientific evidence to support the process in reduction of heart disease and diabetes in humans, I was hesitant to include it in my evidence-based book, Your Heart. However, as I was writing that portion of the book a very exciting scientific review in the British Journal of Diabetes and Vascular Disease was published!

 An Aston University team in the UK, led by Dr. James E.P. Brown evaluated various approaches to intermittent fasting, looking for any evidence of advantage for its use in treating Type 2 diabetes. In their review, they found intermittent fasting was just as effective, possibly even more effective, than daily calorie restriction and calorie counting. Other favorable findings: even markedly low calorie days (not true fasting) can reduce inflammation, reduce both glucose and lipids, and reduce blood pressure.

 In Your Heart Prevent and Reverse Heart Disease, there is a significant amount of information on the Mediterranean cuisine and plant-based eating and more information on the 5/2 eating plan with sample menus.

With the right knowledge and actions, the number one cause of death in women and men is preventable. If you already have heart disease, vascular disease or Type 2 diabetes you can take control and improve your health.

 Let me know how it works for you.

Betty Kuffel, MD

Advertisements

TAKE ACTION TO AVOID TYPE 2 DIABETES

Person's Hands Pricking Their Finger with a Glaucometer

Type 2 Diabetes Increases Heart Attack Risk

Would you jump out of the way of a rolling car if you knew the inevitable impact might kill you? Type 2 diabetes is like a rolling car.

 If you have Type 2 diabetes, elevated blood sugars and accumulating intra-abdominal fat have already released your ‘brakes’ setting you in motion for a health crisis.

The bad news is: Type 2 diabetes often leads to coronary heart disease, the leading cause of death in both women and men.

 The good news is: Type 2 diabetes and coronary artery disease are preventable. And —you have the ability to stop the progression of both diseases by eating healthy and making good lifestyle choices.

 If you’ve been told you have pre-diabetes or “borderline” blood sugar elevations, it is time to take control to stop cholesterol plaques from forming inside the large vessels on the surface of the heart. The build up of cholesterol gradually slows, and then stops blood flow causing a heart attack. Other arteries around the body are also affected. Blood flow in the neck and arteries feeding kidneys, eyes and limbs also become diseased.

A study presented this month at the American Heart Association High Blood Pressure Research Scientific Sessions reported important findings: Women of all ages, from 19 to 84, showed Type 2 diabetes was a major contributor to arterial plaque buildup regardless of age, family history, smoking or having high blood pressure.

 If borderline blood glucose levels are present, Type 2 diabetes can be prevented with weight control, exercise and the addition of the medication, Metformin. Men and women with Type 2 diabetes who keep their weight in check, eat healthy, exercise and take glucose-lowering medication also reduce their risks for heart disease, kidney damage and visual loss.

 Obesity is a major contributing factor to developing diabetes. Because so many people are overweight, the incidence of Type 2 diabetes has increased. Screening females for cholesterol plaques at younger ages is now recommended so the disease can be identified and aggressively treated. This may also pertain to men with Type 2 diabetes, although this particular study only included women.

Scale measuring tape jpeg Stop your run-away car. Take control. If weight is a problem for you, read my next blog on a new approach to lifetime weight management.

Betty Kuffel, MD

OPTIMISM AFTER A HEART ATTACK

Living LongerA couple senior asian talking and exercising at a park

In health and disease, taking a positive approach is important, especially in heart disease. A recent medical article published in Circulation: Cardiovascular Quality and Outcomes, reported information gathered on mental outlook and mood in people following a heart attack. The people who lived longer and exercised more were those with positive attitudes.

 When the heart arteries narrow silently over years, the person may not realize they have a progressive disease. Suddenly a heart attack strikes and the disease makes itself known. At that point, when the shock and realization a life-changing event has occurred, it affects people differently. Disbelief and depression are part of the process.

 Most hospitals have cardiac rehabilitation programs and it is within these programs that many individuals develop the attitudes and confidence to take control of their health and do everything they can to live healthier and longer.

Four keys to improved health following a heart attack are:

  • Stop all tobacco use.
  • Eat a healthy diet such as plant-based or Mediterranean with minimal fat.
  • Control lipid abnormalities – the LDL goal is 70mg/dl in most. – This is the range that can show reversal of the size of cholesterol plaques within arteries and improve blood flow.
  • Exercise daily under the guidance of your physician.

In the Circulation study done in Denmark, the patients with the most positive outlook exercised more and had a 42% lower chance of dying during the five year follow-up period than those with a poor outlook and negative mood.  However, they found even those with less optimism lived longer if they exercised.