Scott Stoll, M.D. FABPMRCo-Founder Plantrician Project

The earth brought forth vegetation, plants yielding seed after their kind,

and trees bearing fruit with seed in them, after their kind; and God saw that it was good

Genesis 1:12

”Mankind’s final coming of of age, the emancipation of the human consciousness from an immature state of ignorance and error.”

Reductionism replaced wholism

Urbanization

Automation

Exploitation

New transportation-railway system

Refrigeration

Meat and milk could be transported long distances

Farming conglomerates, food corporations

Packaging of food

First canned foods

1870- large canning facilities

Pasteurization

Advent of processed food

Child labor 15 hour days

Marketing of food

1938 Agricultural Adjustment ActFixed prices on dairy, hogs, chickens, wheat, corn, cottonWWII

“WHAT THIS WAR IS ALL ABOUT . . . [is the right to] once more walk into any store in the land and buy anything you want.”“A steak for every frying pan” New York Daily News 1943 “the janitors appetite for a sirloin steak is as profitable as the bankers,” it would democratize the benefits of prosperity’.

Production of animals 1940’sPre-war cattle 68 million post war peak 132 million, today 10 billion animals/chickens Corn silage new food – developed the siloIntroduction of antibiotics that helped stabilize feed lots Automatic milking systems 1948DDT used to kill flies Development of fast foodNew large processing plants

Food preservatives: MSG

10 TNT plants transitioned to fertilizer plants; “Nitrogen fertilizer was a huge factor in the yield increases that began”

Introduction of herbicides and pesticides

Hybrid plants- withstand herbicides

War funding gave 11 pharmaceutical companies funding to develop drugs and they produced ½ of the worlds pharmaceuticals

McGovern committee 1977“Cut down on meat and dairy”

Firestorm led to alteration of language from “reduce” to “choose”

Nutrients became the focus

Except sugar: maximum permissible level is 25% of calories

1982 National Academy of Sciences ReportCodified new official dietary language of ‘nutrients’

Initiated scientific reductionism: cholesterol, fiber, fats, protein, carbohydrates, antioxidants

In Defense of Food, Michael Pollen Penguin Books 2008

Year 1900 2010

Sugar/sweetener 5 lbs/year 141.5 lbs/year

Oils/fat 4 lbs/year 74.1 lbs/year

Cheese 2 lbs/year 30 lbs/year

Meat 140 lbs/year 210 lbs/year

Fruit/Veget. 131 lbs/year homegrown

11 pounds/year homegrown

Calories 2100 2757

Nutrient Density 40-60%

Soft drinks 0 53 Gallons

TV 0 4 hours/day

Sources:USDA,FoodReview:

MajorFoodTrendsaCenturyinReview2000

Whathappened?

1900 2000

Free radical formation

Initiates inflammatory cascade

Processed food, animal products, toxins, stress, etc.

NF-kB

Impacts 400 genes inflammation

Atherosclerosis

Cancer

Diabetes

Arthritis

Alzheimer’s

Colitis, GI disease

Autoimmune disease Aging Asthma/ AllergiesBai SK, Lee SJ, Na HJ, et al .b-Carotene inhibits inflammatory gene expression by suppressing the activation of the redox-sensitive transcriptionfactor, NF-kB(342,343). (2005)

High Quality Low Quality

Fruit: red berries, oranges, grapefruit, plums (red),

Fruit: apple, pear, banana, grape (white), melon

Vegetable: spinach, beet, Swiss chard, pepper (red bell), Brussels sprouts, broccoli, rocket, radicchio, olive (black), mushrooms, broad beans

Vegetable: eggplant, leek, potatoes, zucchini, French beans, carrots, celery, lettuce, cucumber, radish

Image courtesy of Weizmann Institute of Science

Dr. Trygve Tollefsbol University of Alabama-“epigenetic diet”

“Rich in plant based foods, phytochemical rich modify DNA methylation, histone modification, and microRNA expression prevent degenerative diseases such as CVD, cancer, Alzheimer’s, obesity, osteoporosis.”

Li, Yuanyuan, Sabita N. Saldanha, and Trygve O. Tollefsbol. "Impact of epigenetic dietary compounds on transgenerationalprevention of human diseases." The AAPS journal 16.1 (2014): 27-36.Tollefsbol, Trygve O. "Dietary Epigenetics in cancer and aging." Advances in nutrition and cancer. Springer Berlin Heidelberg, 2014. 257-267.

Telomere length (shortening) is correlated with aging, cardiovascular disease, anxiety disorder, oxidative stress, elevated BMI

Dr. Ornish demonstrated increased telomere length and activity of telomerase in plant based/lifestyle group vs. control

30% increase in telomerase

Ornish, Dean, et al. "Effect of comprehensive lifestyle changes on telomerase activity and telomere length in men with biopsy-proven low-risk prostate cancer: 5-year follow-up of a descriptive pilot study." The lancet oncology 14.11 (2013): 1112-1120.Cassidy, Aedín, et al. "Associations between diet, lifestyle factors, and telomere length in women." The American journal of clinical nutrition(2010): ajcn-28947.

Epigenetic – effect of environmental influence upon susceptible genetic areas

Ornish-lifestyle altered positively > 500 gene switches; on 48 off 453

Generational effect--- Agouti mice

Plant based food stabilizes epigenome

Gasser, Susan M., and En Li, eds. Epigenetics and disease. Vol. 67. Springer, 2011.Junien, Claudine. "Impact of diets and nutrients/drugs on early epigenetic programming." Journal of inherited metabolic disease 29.2-3 (2006): 359-365.Pasman, W. J., et al. "Nutrigenomics approach elucidates health-promoting effects of high vegetable intake in lean and obese men." Genes & nutrition (2013): 1-15.Nutrigenomics and antioxidantsNasséra Chalabi, Dominique J Bernard-Gallon, Marie-Paule Vasson, and Yves-Jean BignonPersonalized Medicine, January 2008, Vol. 5, No. 1 , Pages 25-36

NHANES 2017 Consumption of nuts and seeds accounts for meaningful decreases in biologic aging and cell senescence. Telomeres lengthened with nut intake

Powerhouse of the cellMaintain glutathione levelsRegulates cellular activity and protects DNA

Plant based diet improves efficiency and number of mitochondria—Biogenesis

Phytochemicals in broccoli protect mesenchymal stem cells from oxidative injuries, mobilize—dietary amounts

Inhibits formation of cross-linking agents, AGE’s

Enhances DNA repair

Assist in cellular detoxification

Phytochemicals act as cell signaling, bind to nuclear receptors

Enzymatic affect- mushrooms inhibit aromatase

Fontana L, et al. Long-term effects of calorie or protein restriction on serum IGF-1 and IGFBP-3 concentration in humans. Aging Cell 2008; 7(5):681-687. Grube BJ,Eng ET,Kao YC,Kwon A,Chen S. White button mushroom phytochemicals inhibit aromatase activity and breast cancer cell proliferation. J Nutr 2001; 131: 3288–93.

William W. Li, Vincent W. Li, Michelle Hutnik, Albert S. ChiouTumor Angiogenesis as a Target for Dietary Cancer Prevention

Kale Blackberries Sea cucumber

Bok Choy Blueberries Pomegranate

Broccoli Strawberries Olives

Cauliflower Cranberries Maitake mushrooms

Brussels sprouts Cherries Onion

Asparagus Red grapes Garlic

Parsley Oranges Tumeric

Artichokes Lemons Ginger

Soy beans Grapefruit Cocoa

Tomatoes Apple Ginseng

Pumpkin Pineapple Green Tea

Source:Angiogenesis Foundation

Microbiomefiber prebiotics feed beneficial bacteria shape populations

assist in healing leaky gut

Reduce inflammation-TMAO

Increase production of neurotransmitters-serotonin

Improve blood sugars

Reduce colon cancer risk

J Oncol. 2012; 2012: 879623. Published online 2011 September 29.Bendich, Adrianne. "β-Carotene and the immune response." Proceedings of the nutrition society 50.02 (1991): 263-274.Crozier, Alan, Mike N. Clifford, and Hiroshi Ashihara, eds. Plant secondary metabolites: occurrence, structure and role in the human diet. John Wiley & Sons, 2008.

Protects against oxidized LDL

Down regulates inflammatory pathways

Increases NO

Reduces smooth muscle proliferation

Reduces cardiovascular disease risk

CV-normalize blood pressure prevent/suspend/reverse atherosclerotic plaque

GI—eliminates constipation, diverticulosis, resolves reflux, IBS/IBD, gastroparesis, prevents colon cancer

Nervous System: Improving ADD, MS, Neurotransmitter stability, improves mood, prevention dementia

MSK-improves bone density, maintenance of muscle, stem cell mobilization, cartilage health

Liver, kidney- normalize BP, repairs liver cells/resolves NAFLD, normalizes fatty acid metabolism, improves renal function

1 year: 91% regression of angina vs. control 165% increase

Artery regression 82% vs progression in control group

Reperfusion in 3 weeks

Greater improvement in 5 years vs 1 year

Medicare approved program

Ornish, Dean, et al. "Intensive lifestyle changes for reversal of coronary heart disease." Jama 280.23 (1998): 2001-2007.

Dietary Research

Vegetarian vs American Diabetes Association (ADA) diet

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

MedicationsWeightInsulin Sensitivity

ADA

Vegetarian

Adiponectin, Leptin, Vitamin C, SOD, Glutathione vs no change in ADA group

Meta-analyses with positive outcomes

44% of patients with type 2 diabetes could stop their insulin within four weeks.

74% of patients with type 2 diabetes on oral drugs were able to leave the center drug-free within 4 weeks.

Improved beta cell function

Reduces fat in the cells

Diabetes Care 6:268, 1983JAppl Physiol 98:3, 2005

(874 pts, meta-analysis

Kahleova, Hana, et al. "A plant-based dietary intervention improves beta-cell function and insulin resistance in overweight adults: A 16-week randomized clinical trial." Nutrients 10.2 (2018): 189.

Reduced pain of diabetic peripheral neuropathy

20 week trial: significant reduction pain scores (8.2) and improved quality of life scores Nutrition & Diabetes volume 5, page e158 (2015)

25 day inpatient intervention:17/21 or 81% reported a significant improvement in symptoms including numbness in just 4-16 days2 weeks Insulin requirement decreased in 50% of patients

14th day fasting blood glucose decreased 35%

4 year follow-up 71% maintained on the diet, 16/17 reported no return of symptoms

Crane, Milton G., and Clyde Sample. "Regression of diabetic neuropathy with total vegetarian (vegan) diet. Journal of Nutritional and Environmental

Medicine 4.4 (1994): 431-439.

Improved daily health, reduced presenteeism

Fewer sick days, improved general well being

Cost savings, reduced copay, deductible, lost wages, lost time and quality of life

Optimal weight

Improved pain, mobility

Improved mood stability, natural MAO inhibitors, serotonin production

Improved relationships--health influence, resolves of food addiction

Systematic Review of 86 observational studies and 10 cohort trials

“significant reduced levels of body mass index, total cholesterol, LDL-cholesterol, and glucose levels in vegetarians and vegans versus omnivores.”

“significant protective effect of a plant based dietmortality from ischemic heart disease (−25%) and incidence from total cancer (−8%). Vegan diet conferred a significant reduced risk (−15%) of incidence from total cancer.”

“We should be investing in people and processes, not hospitals.”

Dr. David Feinberg, CEO

Identified patients with T2DM (A1c >8 ) and who self identified with food insecurityFood insecurity: 14% pop, 23% children Claims data revealed $8000-$12000 per month expenses

37 patients for 12 months

Pre A1c 9.6%, Post 7.5%

corresponds to 40% decrease in risk of death and serious consequences

Mean healthcare costs decreased by 80%

From $240,000/member/year to $48,000/member/year

“Our Findings showed that the increased intake of certain

foods and not enough of others was associated with nearly

half of all deaths in the US due to heart disease, stroke,

and diabetes.”

Renata Micha, PhD, RD Lead Author, Jama Study 2017

Micha, Renata, et al. "Association between dietary factors and mortality from heart disease, stroke, and type 2 diabetes in the United States." Jama 317.9 (2017): 912-924.

Lappe, Frances Moore. Diet for a Small Planet. 1982, page 69.

UN: Losing 1% topsoil annually last 40 years with 60 harvests remaining

Regenerative agriculture-Rebuild soil via cover crop, soil-biome, carbon sequestration

Care and concern for animals elimination of CAFO’s

June 2018 Largest study to date

Included 38,700 farms 119 countries

40 food products that represent 90% of what we eat

“Agriculture is a sector that spans all the multitude of environmental problems” Dr. Joesph

Poore- Lead researcher Oxford

Sequester more than 80% of CO2 emissions with a switch to organic, regenerative agricultureReversal of the greenhouse effect“Farming like life on earth matters”.

van Dooren, Corné, et al. "Exploring dietary guidelines based on ecological and nutritional values: a comparison of six dietary patterns." Food Policy 44 (2014): 36-46.

Healthcare Reimbursement, volume/ procedure based

Education and acceptance

Competition over cooperation and unity

Philosophy

Medical education

GovernmentSubsidies

Agri/Food corporations

Lobby groups

Healthcare allocation

General PublicMindset/belief and value system

Cultural education and media

Awareness

Dietary misconceptions/confusion

Access

Cost

Education

Skills

Time

PBN is the only consistent, expeditious, cost effective, sustainable solution

Google search “whole food plant based diet” 5,220,000

Google Scholar; since 2015 37,200

Hundreds of books on Amazon

Multiple conferences

Health systems- Lee and Midland

Documentaries

Uber test