|THE FOOD HOURGLASS - About weight loss and longevity
A note for doctors and dieticians
In my book ‘The food hourglass’ I refer to numerous studies. Some of these studies show, for example, that people who eat a handful of walnuts every day lower the risk of a heart attack by 45 percent (1), or that those who drink green tea on a regular basis have 21 percent less chance of suffering a stroke.(2)
I mention such studies because they reveal an important tip of the iceberg: namely that healthy food, like walnuts or green tea really can have a significant effect on our health, especially when this is part of an all-round healthy diet. Despite this, there are some people who don’t believe that nutrition can have a large impact on our health.
Luckily there are actually different kinds of studies that even more convincingly demonstrate the power of healthy nutrition. While the walnut and the green tea studies used questionnaires to assess dietary habits, there are also intervention studies. Here, researchers carry out actual interventions: they deliberately alter the eating habits of their test subjects, and then wait to see what happens.
In this way, researchers from the University of Newcastle succeeded in completely reversing type-2 diabetes in just eight weeks. The patients taking part in this study were put on a (strict) diet, which cut out bread, potatoes, pasta and rice, but did include plenty of vegetables. In eight weeks, their blood sugar levels were normal, the fatty degeneration of the liver was five times less and the pancreas (which produces insulin) was working normally again, and this is all without medication.(3)
Or take heart disease. Previously, it was impossible to claim that the plaque (the ‘chalky’ mass on the artery walls which silts up the blood vessels) could be reduced. Recent research has shown that the silting up of the blood vessels can be reversed, and this can be achieved by diet. Researchers from Harvard University assembled a number of patients who were on the waiting list for a heart operation. By putting these people on a special diet, almost 80 percent of the patients no longer needed an operation. They could be crossed off the operating list. Not only that, but due to this new approach, those people on the diet had 10 times less chance of suffering a heart attack than those patients who were having the normal treatment.(4)
These kinds of studies are important, because they show that ‘chronic’ illnesses can actually be reversed. The important point here is that the ‘diets’ or changes in the nutritional habits have to be sufficiently thorough. The nutritional recommendations offered by the government, hospitals and official bodies often don’t go far enough. You cannot reverse diabetes by simply replacing white bread with the whole-wheat (wholemeal) variety. However, if you include eating less bread, potatoes, rice and pasta for a while in the advice to a diabetes patient, then you can bring about significant improvements.
It’s hardly surprising that doctors are sometimes less than enthusiastic about diets: patients that follow the official government diet recommendations rarely achieve significant improvements (the average reduction of the HbA1c – a measure for the saccharification (‘glycation’) of the red blood cells – is only 0.4 percent for patients who follow an official ‘diabetes diet’). These meagre results can be blamed on the fact that most government recommendations are for various reasons not very effective and could be much healthier.(5)
Many studies have shown this convincingly. Heart patients who followed an unofficial, more Mediterranean-inspired diet (plenty of vegetables, fruit, good quality oils, nuts, ...) had 70 percent less chance of dying during the study than patients who followed the official low-fat diet recommended by the American Heart Association, the organization in the USA which issues all kinds of health guidelines.(6) After 2.5 years, the study was cancelled because it was deemed ‘unethical’ to allow patients to carry on with the official diet recommended by the American Heart Association. Another study in which diabetes patients followed a more vegetarian diet, saw a three-times greater improvement in their blood sugar levels than those who followed the official diet of the American Diabetes Association, the diet recommended for diabetes patients by almost all hospitals.(7)
Even these non-standard diets, which can lead to so many improvements, could be better, as I have tried to show in my book ‘The food hourglass’.
It is these along with many other studies that have encouraged universities such as Harvard, illustrious hospitals such as the Mayo Clinics and countries like Austria to create different nutritional models. The basis of the Austrian food pyramid and that of the Mayo Clinic for example, are no longer based on bread, potatoes, pasta and rice, but on vegetables and fruit.
Almost as a last resort, the proponents of the official nutrition guidelines often claim that the other diets are too difficult for patients to follow, or require major changes. The beauty of it is that patients do actually stick to these diets more readily because they soon see the health benefits and can reduce their medication, and because, ironically enough, these diets are often intrinsically simpler than the official diet guidelines with their long lists of ‘forbidden foods’ or obscure recommendations.
I could cite many other intervention studies, from heavily uncontrolled diabetes patients who, thanks to oatmeal, are able to use 40 percent less insulin (8) to researchers from Oxford University who gave older patients B-vitamins and discovered that the brains of their patients showed 7 times less shrinkage as they grew older.(9) You might call these figures nit-picking and believe that it is better not to tell patients about this kind of thing because they just might live on nothing but oatmeal or swallow pounds of B-vitamins. I really believe that we should tell our patients about these studies, so that they can see how important nutrition is to our health. They have the right to know that good nutrition can prevent or slow down the onset of certain illnesses associated with ageing, and sometimes even reverse the effects.
Dr. Kris Verburgh, MD
1. Nut consumption and risk of coronary heart disease: a review of epidemiologic evidence. Curr. Atheroscler.Rep. 1, 204–9 (1999).
2. Green and black tea consumption and risk of stroke: a meta-analysis. Stroke. 40, 1786–92 (2009).
3. Reversal of type-2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol. Diabetologia 54, 2506–14 (2011).
4. Clinical events in coronary heart disease patients with an ejection fraction of 40 percent or less: 3-year follow-up results. J. Cardiovasc. Nurs. 25, E8–E15
5. Rebuilding the food pyramid. Sci. Am. 288, 64–71 (2003) [note: the classic food pyramid is still used in many countries today. In the USA, the classic food pyramid has recently been replaced with a food plate, which is even less clear and health-promoting than a food pyramid]
6. Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease. Lancet 343, 1454–9 (1994).
7. A low-fat vegan diet improves glycaemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type-2 diabetes. Diabetes Care 29, 1777–83 (2006).
8. Clinical benefit of a short-term dietary oatmeal intervention in patients with type-2 diabetes and severe insulin resistance: a pilot study. Exp. Clin. Endocrinol. Diabetes 116, 132–4 (2008).
9. Preventing Alzheimer’s disease-related gray matter atrophy by B-vitamin treatment. Proc. Natl. Acad. Sci. U.S.A. 110, 9523–8 (2013).