Tabula Rasa HealthCare Tabula Rasa Healthcare | A Family of … · 2019-09-23 · Dr. Dean Ornish,...

Medication Risk Identification and Mitigation

Copyright © 2019 Tabula Rasa HealthCare, Inc., All Rights Reserved. May not be used without permission. | NASDAQ – TRHC.Copyright © 2019, Tabula Rasa HealthCare, Inc., all rights reserved. These materials are confidential and proprietary information of Tabula Rasa HealthCare, Inc. and may not be reproduced in whole or in part without the written consent of Tabula Rasa HealthCare, Inc. | NASDAQ – TRHC.

The Whole-Food Plant-Based Diet—What Every Practitioner Should know

Prepared for the CareVention HealthCare Clinical Advisory Panel Meeting9/20/19Lake Nona, Florida

Orsula V. Knowlton, PharmD, MBAGraduate of e-Cornell Certificate Course on Plant-Based Nutrition, August, 2019


Copyright © 2019 Tabula Rasa HealthCare, Inc., All Rights Reserved. May not be used without permission. | NASDAQ – TRHC.

+Explain the potential root cause of diet as it relates to cancer, cardiovascular disease, diabetes and obesity

+Identify the conflicts that exist in the U.S. as it relates to dietary recommendations

+Through case studies, describe the potential role for the prescribing of a whole-food plant-based diet in PACE

+List the food content of a whole-food plant-based diet

Goals and Objectives



+I have no conflicts related to this presentation (the Whole Food Plant Based Diet can result disease reversal and fewer medications).

Fundamental #1—Do the right thing always.

Confl ict of Interest



+Most people consider various therapies (i.e., medication, surgery, PT, OT, etc…) as treatment for chronic disease. Yet, little time is spent on getting to the root cause for the disease. Thus, therapies are PALLIATIVE not CURATIVE.

+An example of this is that a house is on fire, and dousing it with fuel (animal fat and protein) instead of putting it out with a change in diet, the root cause (i.e., Whole food Plant Based Diet (WFPBD)).

+A WFPBD can minimize therapies, and health care related expenses, if adopted as a lifestyle.

+A WFPBD and prevent and even REVERSE these chronic disease, e.g., heart disease and diabetes.

Chronic Disease in the US



+According to the American College of Cardiology (Feb 19th, 2019)

+Cardiovascular disease is the leading cause of death in the US, since 1920.

- Every 40 seconds, an American will have an MI, with an average age of 65 years old for men and 72 for women.

- Risks: obesity, smoking, LDL >130, hypertension, diabetes, chronic kidney disease, lack of exercise.

+According to the American Cancer Society

- Cost of Cancer Treatment $80 Billion in 2015, and 1700 people per day die of cancer.

Economic Impact of Heart Disease and Cancer

“By 2035, nearly half of the US population will have some form of Cardiovascular disease.” -American Heart Association

From AHA 2017 Report: Cardiovascular Disease: A costly burden for American | Projections through 2035.

Cardiovascular Disease

Current 2035

Direct cost $318 B $749 B

Indirect cost $237 B $368 B

Total Cost $555 B $1.1 Trillion



Let ’s look at Obesity In Countries with low rates of CV Disease



What about Fat? + Humans, unlike cats, get atherosclerosis from

eating animal fat.

+ Nitric Oxide production is a key benefit of WFPBD.

Pinterest



Evidence—The China Study and Others

Animal protein promotes the growth of cancer.

+ T. Colin Campbell, PhD

+ Multiple, peer-reviewed animal studies, researchers discovered that the growth of cancer cells can be turned on and off by raising and lowering doses of casein, the main protein found in cow’s milk.

+ Conclusion: Animal protein is a carcinogen.

Heart Disease can be Reversed with WFBPD

• Caldwell B. Esselstyn, Jr., MD, The Cleveland Clinic, treated 18 patients with established coronary disease using a whole food, plant-based diet.

• Disease progression stopped of the WFPBD intervention group

• 70 percent of the patients saw an opening of their clogged arteries.

Dr. Dean Ornish, Harvard Medical School, completed a similar study with consistent results.

Conclusion: Heart disease can be reversed.

Eat plants for health.

• People who ate the most animal-based foods had the

most chronic disease.

• People who ate the most plant-based foods were the

healthiest.

Plant-Based or not, put as many plants on your plate

as possible at every meal.



W h a t i s a W h o l e Fo o d P l a n t B a s e d D i e t ( a n d w hy i s t h e U S D e p t o f A g r i c u l t u re p ro v i d i n g n u t r i t i o n g u i d e l i n e s o ve r t h e N I H ) ?

USDA Guidelines Compared to the WFPBD (‘Whole’ refers to minimally processed)

No counting calories, or carbs.

https://i.pinimg.com/originals/df/64/e3/df64e35e219c375da0e57f69dfe9853f.jpg

https://www.choosemyplate.gov/

https://i.pinimg.com/originals/df/64/e3/df64e35e219c375da0e57f69dfe9853f.jpg

https://www.choosemyplate.gov/



WFPBD—Guidel ines A l i festyle change

+ WFPB diet– No meat, poultry, fish, dairy, or eggs.

+ Not the same as a vegan diet, defined only by what it eliminates.

+ Includes:

- whole grains, fruits, vegetables, and legumes.

- Moderation: nuts, seeds, avocados, natural sweeteners, and certain soy or wheat products that don’t contain added fat (e.g., tofu).

+ Not included: Heavily processed foods, avoiding

- Highly refined grain products (e.g., white rice, white flour)

- Foods containing added sugars or artificial sweeteners (e.g., confectioners sugar, high fructose corn syrup), and foods containing added fat, including olive oil).

https://www.google.com/search?q=cns+food+guide&tbm=isch&source=iu&ictx=1&fir=UNOqofmYCQkL4M%253A%252CsZSjUmb_Lo5btM%252C_&vet=1&usg=AI4_-kQaEkFsZoUGMt7n910QRyGWNnjxSQ&sa=X&ved=2ahUKEwjrjqKkxdrkAhVMm-AKHQ_uAf4Q9QEwA3oECAcQBg#imgrc=UNOqofmYCQkL4M:&vet=1

https://www.google.com/search?q=cns+food+guide&tbm=isch&source=iu&ictx=1&fir=UNOqofmYCQkL4M%253A%252CsZSjUmb_Lo5btM%252C_&vet=1&usg=AI4_-kQaEkFsZoUGMt7n910QRyGWNnjxSQ&sa=X&ved=2ahUKEwjrjqKkxdrkAhVMm-AKHQ_uAf4Q9QEwA3oECAcQBg#imgrc=UNOqofmYCQkL4M:&vet=1



“From where do you get your protein?”

+ We have been conditioned to think that protein is the #1 most important nutrient. Why is that?

+ Protein--every cell, tissue and organ constantly broken down and replaced. Our bodies will use protein from all sources.

+ Most animals that we eat, eat plants for their protein. Eating plants takes out the ‘middle man’ to get our protein.

Protein in Food

Digested into Amino Acids

Protein replacement in our bodies



What are the driv ing factors against the widespread adoption of WFPBD

+ Our own experiences, conditions and cultural beliefs

+ American Food Politics

E.g., Dairy--laden with sugar, fat, and salt Why

is dairy still promoted in the American

diet?

Government Checkoff programs• Developed and organized by the US government• Responsible for collecting funds from • certain sectors of agri-business• Funds used for research and advertisement on

behalf of those businesses• food groups (dairy, beef, etc.).

https://www.google.com/search?biw=1920&bih=969&tbm=isch&sa=1&ei=MDqCXZOwFdCJggeegaSQBA&q=got+milk+ad+beef+it%27s+what%27s+for+dinner%2C+incredible+egg+pork+the+other+white+meat&oq=got+milk+ad+beef+it%27s+what%27s+for+dinner%2C+incredible+egg+pork+the+other+white+meat&gs_l=img.3...3341.13472..13634...2.0..2.187.4510.68j2......0....1..gws-wiz-img.......0j0i8i30j0i24.nLMc9N6x1o4&ved=0ahUKEwiTiJHjxdrkAhXQhOAKHZ4ACUIQ4dUDCAc&uact=5#imgrc=pZXuHVx_z5LZZM:

https://www.google.com/search?biw=1920&bih=969&tbm=isch&sa=1&ei=MDqCXZOwFdCJggeegaSQBA&q=got+milk+ad+beef+it%27s+what%27s+for+dinner%2C+incredible+egg+pork+the+other+white+meat&oq=got+milk+ad+beef+it%27s+what%27s+for+dinner%2C+incredible+egg+pork+the+other+white+meat&gs_l=img.3...3341.13472..13634...2.0..2.187.4510.68j2......0....1..gws-wiz-img.......0j0i8i30j0i24.nLMc9N6x1o4&ved=0ahUKEwiTiJHjxdrkAhXQhOAKHZ4ACUIQ4dUDCAc&uact=5#imgrc=pZXuHVx_z5LZZM:



Want to Learn More?

Two books we have for you during this meeting on the topic:

Certificate in Plant-Based Nutrition (3 credits)

“A good diet is the most powerful weapon we have against disease and sickness.” T Colin Campbell, PhD

Documentary Movies to Watch: 1. Forks over Knives2. What the Health3. PlantNation4. The Game Changer



Thank you.

Enjoy the plant-based lunch.

Tabula Rasa HealthCare Tabula Rasa Healthcare | A Family of … · 2019-09-23 · Dr. Dean Ornish,...

Documents

Transcript of Tabula Rasa HealthCare Tabula Rasa Healthcare | A Family of … · 2019-09-23 · Dr. Dean Ornish,...