Dr Josh Cullimore – The health benefits of a whole-food plant based diet

Dr Josh Cullimore – The health benefits of a whole-food plant based diet



GP Josh Cullimore – The health benefits of a whole-food plant based diet

Recorded at Brighton Vegfest on 23rd March 2019

Filmed by Fizzeek Media

[Music] okay thank you very much serene and thanks everyone for coming as Shireen said I'm my name's Josh Cullimore I'm a GP in Brighton and I'm I'm vegan I've been vegan for ten years and vegetarian for six years before that yeah and I'm here to tell you about the the benefits of a whole food plant-based diet so to start with I'm just going to tell you tell you about two patients I saw last year that's not him and that's not me maybe in a few years but he came to see me because he was really fed up with all of the tablets he was taking for his diabetes high blood pressure and high cholesterol they were giving him lots of side effects such as diarrhea tiredness rashes coughs and he'd been on them a couple of years and he'd really just had enough so I said okay let's let's talk about your lifestyle a bit he assured me he had an excellent diet which which people always do I find but then went on to say that he eats lots of protein lots of eggs and sausages and chicken and that he does lots of exercise and by that he meant he does some walking but it never really got him out of breath so I said you know I would prefer to produce the medication and you know and gradually improve his lifestyle but he was really adamant he just wanted to come come off it all together so I said okay go away and read this I don't know if anyone's read it yeah it's a really fantastic book explaining the benefits of a Whole Foods plant-based diet and how to do it so he went away he he committed to doing it he was going to go to the gym three times a week as well I was a little bit skeptical but he came back three months later and actually he the first thing I saw was how much better he looked he was he was beaming he clearly lost some weight and when we actually looked at his figures his blood pressure on medication was actually a little bit high and then three months later it come down to 119 over 71 and then his cholesterol should be under five and it was it was just about okay with the statin off the statin and with a whole food plant-based diet and some exercise it come to 3.5 and then his hba1c which is your measure of your diabetic glucose control should be under 48 his despite the metformin was was at 57 off the metformin he had plummeted to 26 he basically cured reversed his his type 2 diabetes just purely with a plant-based diet so so that was us afterwards we were both very very happy about this his wife was was over the moon as well she'd gone vegan was really enjoying cooking new meals they were convincing all their friends to go vegan so he was basically doing my job for me and interestingly he had said that he'd started to read about the animal cruelty aspect of the animal agriculture industry as well which he persisted until that point and he was quite shocked so yet so just a bit about me how did I get to this point actually I've always been an animal lover that this was me in the late eighties early nineties which you can tell by the slightly interesting haircut and that's my cat woody and I even at that time I really did question why do I treat her like a member of the family and yet we eat other animals but I I found that I didn't know any vegetarians and I was really embarrassed to say I wanted to go vegetarian didn't even understand that veganism was a thing so I secretly went vegetarian I was scraping the meat off the plate into into the bin when my mum wasn't looking but she was looking and she caught me and she accusingly asked me if I'd gone vegetarian and I denied it immediately because I didn't want to be strange but the the signs were always there because anyone from but the similar age and the 80s would recognize count ocular he was a vegan vampire duck who ate nothing but broccoli sandwiches and he was my my favorite it was my favorite TV show so the signs were there but it was only later when I went to university to med medical school that I really started to think about this again and it was doing medical ethics lectures actually that you know we came across this idea of non-maleficence or do no harm it's one of the fundamental pillars of medical ethics and I started to see the connection with this term himsa a Sanskrit word from some Eastern philosophies which is basically the same thing do no harm but for all sentient beings and I just was struggling to see why I was being educated to become compassionate professionally but then in my personal life three times a day I was continuing to contribute to great suffering if anyone's read this book you'll you know how great it is that it's a history of humankind and the author has said that animals are the main victims of history and the treatment of domesticated animals in industrial farms is perhaps the worst crime in history which I would agree with so this is when I had my Lisa Simpson style vegetarian awakening when I was 21 and then when I actually read about and saw what happens on dairy farms and and with with eggs as well I realized it was just as cool if not more so so I I couldn't put it off any longer and I had to come out as a vegan my I remember my mum being very disappointed she thought it was very extreme but things have changed a lot in 10 years and unfortunately she's she's now gone vegan herself in the last six months and she's another great case study she's lost lots of weight her blood pressures gone down and she feels amazing and she wishes she'd done it sooner as we all do when we when we finally get there and then so yeah just you had to tie it back to to the medicine so I was becoming increasingly disillusioned with the medical system really in that the NHS is great at treating acute problems that my first job was on a cardiology unit patients would have their lifesaver e life-saving bypass grafts their angioplasty x' but then straight afterwards they're they're given sausage and chips for lunch there's you know there's no education there's no trying to prevent these things happening in the future so at that point I decided to look more the root causes of illness our diets are so bad now that actually that a bad diet is worse than drugs alcohol and tobacco combined so I went to Imperial College and did a master's in public health and I was really really shocked actually how many of the problems facing the world are due to animal agriculture so for example bird flu and swine flu are all due to animals being kept in unhygenic cramped conditions and then you've got bacteria like e-coli compliment Ella actually you know these these bacteria are fatal they do kill people every year and then partly to compensate for that and to make the animals grow faster they're they're pumped full of antibiotics and in fact half the world's antibiotics are used in animal agriculture as growth promoters so the GPS get bashed for prescribing antibiotics unnecessarily but actually this is a massive issue and then obviously the environmental impacts are huge it's estimated that a vegan diet uses only a third of the energy land and water that an omnivorous diets uses and in terms of climate change this is a the vegan Nobel Prize nominee Greta Thornburg you started the climate strike movement it's great that she's finally getting that back on the agenda because we were told last year by the UN that we've got less than 12 years to stop climate change and giving up meat and dairy and eggs is actually one of the biggest things we can do to stop that and then a collaboration between an organizer could eat and lock the lancet the biggest medical journal journal in the world did this big study called the planetary health diet which was showing that a predominantly plant-based diet it would actually save the world from climate change and or the other environmental stresses we face and be the best thing for our health so there's some examples there of what they suggest to eat and you'll struggle to find any animal products there this is the suggested plate so half the plate is fruit and vegetables then a large section of whole grains then plant protein unsaturated plant oils and then only very small amounts of optional added sugars dairy foods and animal source protein unfortunately the majority of the world is not eating like this there were some places in the world that do eat like this these are the blue zones and they're actually the areas in the world that had the longest life expectancy and the things that they have in common are summarized in this Venn diagram and you can see the things they all have in common include a plant-based diet and legumes legumes are have such a powerful effect that they're they're given their own category and all all of the other dietary components are are plant-based so an example of one of those areas are a quinoa in Japan this is what they eat sixty sixty seven percent is sweet potatoes the dreaded carbs that people get so worried about nowadays and then rice legumes vegetables only two percent fish meat and poultry and this is an example of the macronutrient ratios that they eat in the in the Blue Zones it's 65 percent carbs and this is just worth pointing out that there's such an obsession now with low carb dieting high protein you know the keto diet Atkins paleo but there was this big study done in The Lancet last year which so that a low carb diet actually shortens your life expectancy quite considerably unless you do it in a vegan way so-called eco app canoe so actually plant proteins and fats are good for you so just looking at the advice from the British Dietetic Association because sometimes people are still concerned that a vegan diet isn't actually nutritionally adequate but they are very very reassuring they've said that plant-based diets which are rich in beans nuts seeds fruit and vegetables whole grains such as oats and rice and cereal based foods such as breads and pasta can provide all the nutrients needed for good health this includes essential fats protein vitamins minerals and plenty of fiber too not only that well-balanced plant-based diets that are also low in saturated fat can help you manage your weight and may reduce your risk of type 2 diabetes cardiovascular disease and some cancers and this is this is a huge statement because these are the issues which are are crippling our NHS they are these chronic diseases of lifestyle are what we are dying from now in terms of weight in the next 15 years three out of four of us are going to be overweight or obese type-2 diabetes by 2050 one in three of us will have type-2 diabetes cardiovascular disease is our number one killer and cancers I'm sure you all know now one in two of us will get cancer so just to look at this in a bit more detail this is the Adventist Health Study one of the biggest cohort studies in the world and it shows that on the Left you've got your body mass index by category of diet and there's a very clear gradient that the more Pro that the more animal products you eat the the higher your weight in fact the the vegan group are the only ones with a normal BMI and with type 2 diabetes is a very similar trend only 2.9 percent of vegans have type 2 diabetes versus 7.6 percent of a non-vegetarian diet and people often say to me well how about fish and eggs and white meat this is very clear that if you eat those you you have you're more likely to be obese and have type-2 diabetes and in fact again another big study in the BMJ last year a systematic review that showed that a vegan diet is the best for controlling and reversing type 2 diabetes there were two kinds of cardiologists vegans and those who haven't read the data that's dr. Kim Williams he is a cardiologist who has read the data so he is vegan he was the president of the American College of Cardiology and he can make that statement because the evidence you know is so clear that there's at least a 32% reduced rate of dying from heart disease in people who don't eat meat and it's estimated that 40,000 lives would be saved in this country alone if everyone did that this is quite a striking picture it's an angiogram which was done by Caldwell Esselstyn a physician in the States which shows on the left this is the main coronary artery is is quite blocked up there you can see with at the roamer sort of fatty like cholesterol deposits in the artery and then 32 months later after having been put on a plant-based diet you can see how much that artery has opened up so this is quite revolutionary I was always taught that once your arteries were furred up that was it but actually we have the evidence now that you can actually reverse heart disease just by changing your diet and then eggs there's been controversy on and off over the years about whether they actually contribute to heart disease and again there was another study last week confirming yes actually it does increase your your heart risk about 8% risk of death per half an egg a day they are they awful of cholesterol and then and fried food is obviously particularly bad so fried chicken and fried fish increase your risk of death also and this is just to show graphic the difference in cholesterol rates in between vegans and the average diet and this this line here 150 it's estimated that if if everyone had their cholesterol under that line 90% of heart attacks would be eradicated and you can see the average there for the vegan diet is 146 and that's the total cholesterol for your bad cholesterol the LDL cholesterol there's there's an even even bigger difference there and it also worth pointing out that there have been these so-called cholesterol deniers over the years who are trying to say that actually saturated fat and cholesterol don't lead to heart disease in fact there's absolutely no evidence for that all of the major health bodies say this is an incredibly dangerous thing to be encouraging people to eat saturated fat and cholesterol the head of public health England British Heart Foundation Heart UK you know that all adamant that cholesterol does cause heart disease that's why we keep giving statins because the evidence is so clear and there is a suggestion actually that cholesterol deniers should be seen in the same way as climate change deniers it's it's a small fringe group that are trying to make themselves out to the media like there's a debate when there there really isn't one this is looking at blood pressure again the more animal products you eat the the higher your risk of high blood pressure you've got vegans have got under half the risk and it's all very well looking at graphs but I find that I believe things when I see it with my own eyes and this is a small moment for me to brag this was was my blood pressure doing quite a stressful day at work 89 over 59 which has actually probably the lowest blood pressure I've ever seen so I was I was quite proud about that it's working and clearly and again lots of studies showing diets high in meat eggs and dairy could be as harmful to health as smoking in fact um four times more likely to die from from cancer or diabetes if you eat lots of animal products and the biggest cancer organization in the world the world Cancer Research Fund recognizes that and that's why they recommend a diet which is what they have in the Blue Zones it's a whole food plant-based diet yeah they recommend a diet rich in whole grains vegetables fruits and beans limit consumption of fast foods limit consumption of red and processed meat and sugar and sweetened drinks so if it is as bad as smoking why don't we treat it in that way why have we not got warnings on meat why are we not putting a tax on meat and again there was a big study showing that that would save that hundreds of thousands of lives if we did that and the answer is it's that the industries are very powerful and with cigarette smoking we had the the data for decades to tell us that it was killing people how harmful smoking was and nothing was done because because of their propaganda basically so I'm confident we will we will get to to this point but how long you know that that's that's the question and then on a similar note you may have seen these adverts from Oatley which I really like they actually got sued in Sweden for these adverts by the dairy industry but actually you can't you can't argue if the fact that milk is designed cow's milk is designed for cows they produce it for their young it contains a compound called igf-1 insulin-like growth factor which causes rapid cell proliferation and that is to turn a tiny calf into a giant cow but if you have that compounded in humans human adult's the naturally rapid cell proliferation has been clearly linked to cancer igf-1 is clearly linked to cancer particularly hormone sensitive cancers like prostate cancer and this study shows yes the vegan diet can reduce your risk of prostate cancer by 35 percent so you may all be feeling quite smug now if you're vegan but now is the time to point out there is a difference between a whole food plant-based diet and a junk food vegan and in fact and you really need to try and minimize processed foods as much as possible because that the reason a plant-based diet has such a powerful effect is it's an anti-inflammatory diet those chronic diseases I've been talking about are all promoted by inflammation and through vegetables whole grains nuts they reduce that whereas fried food sugar refined grains thought they they promote inflammation and that they all need to diabetes heart disease they're toxic to the good bacteria in your bowels there's lots of evidence now showing ultra-processed food is linked to cancer and also mental health junk food definitely raises the risk of depression there's some evidence now that depression is actually an inflammatory process in the brain so avoid refined grains so that's white bread white pasta rice all the fibers been taking out taken out there's very little nutritional value and it will give you a big spike in your blood glucose and insulin try and limit sort to less than six grams a day and you need to be careful with sort of vegan burgers because often they have a lot of sort added to them Toofer key apparently at the worst fruit juice I think a lot of people are aware now that fruit juice is not actually a health food you've taken out all the good fiber so you're just left with a very high calorie drink which has as much sugar as coca-cola try and avoid sweeteners if you can as well there's evidence that sweeteners increase the risk of stroke and diabetes and and dementia so try and avoid so what should you be eating I really recommend this app the daily dozen by Michael Greger again it's free and it's basically a checklist of all the things that you should be trying to incorporate into your diet every day so first of all beans like the Blue Zone diet said actually they have such a powerful effect and in and it's one of the foods that have been highlighted to try and stop climate change we need to be eating five times as many beans as the a bonnet as we do at the moment they're full of fiber they're full of protein soy yo is a complete protein just worth pointing out now that there's a lot of worry about soya particularly on men because they have phytoestrogens but actually there's no evidence at all that it causes feminizing effects in men that is a complete myth and there are lots of health benefits to soil as well if they're so good what is the main reason that people don't eat beans I hear a lot that it gives people gas and that's because you if you're not used to eating them you don't have the right bacteria to digest them it that will come eventually and so I usually recommend people build up their being consumption gradually but if you do it very suddenly and you have lots of gas I recommend these digestive enzymes are really effective of reducing that issue berries they're some of the foods with the highest amount of antioxidants you should be eating you know at least a cup of these day by Deeley if you're worried about the air miles and out of season and all the plastic it's a good idea to get a giant bag in the freezer and add it to smoothies fruit three portions a day you'll notice that the recommendations are much higher than the five a day that we we hear about the five a day was picked just because it seems more achievable for most people it's not that it's actually the the optimum thing for your health cruciferous vegetables so kale cauliflower bottom sprouts again very high in antioxidants you do get more of the positive effects if you eat it war if that isn't your cup of tea try and chop it up as much as you can forty minutes before you eat it before you cook it rather because actually that that means you get more of that positive antioxidants affect green veg you should have a cup a day just a word of caution if you take anticoagulants like warfarin you should discuss that with your with your nurse because it can affect the levels but everyone else as much green veg as you can another cup of other veg particularly mushrooms and garlic and onions are very good for you if you're less interested in health and vanity is more of an issue then go for green veg and orange or yellow veg as evidence that decreases wrinkles it's recommended to have a tablespoon of flaxseed every day that's partly because of the fiber but also the Amiga threes and I've got some other examples here of foods that are high in omega-3 so walnuts chia seeds are very good also soya and rapeseed just to point out on the on the right here are some algae capsules and they are the type of Amiga 3 that the body uses directly for the brain and the heart dr. blind you with too much science but just to clear this up because often you hear doctors saying that the the Amiga 3s from fish are better for you than from plant products and this is just to explain that so the Ala is where most is the type of Amiga 3 that is in most plant foods so the the 3 on the left here the the algae capsules are the only ones the only plant source of EPA and DHA and that is the type of omega-3 you get in fish as well and fish habit because they eat the algae so you you can just eat the ala foods and then your body will convert it but it's sometimes not the most efficient process you have to eat quite a lot of those foods and so if you want to be really careful you're you're getting enough epa and DHA and then i recommend taking one of these these are algae supplements of epa and DHA and if you're doing that that you're getting all the benefits of fish without all the toxins and mercury that come along with fish whole grains again massively important because people are so worried about carbs that there's been a big drop in whole grain consumption and at least 90% of people aren't eating enough fiber so whole-grain bread is good for you up to three pieces a day oats very anti-inflammatory other other grains like brown rice quinoa millet couscous yeah you should be eating three portions a day and just yet to point out that again this big study shows that a high-fiber diet has a much lower risk of chronic disease and death the vegans here will probably know this reaction you probably get asked this a lot by people who are very confused about where a vegan can get their protein I suggest asking them where they get their fiber because that will probably throw them but it's really not an issue and in fact plant so animal protein there's a lot of evidence that it's actually really bad for you it raises your risk of early death you don't need anywhere near as much protein as as people generally eat we eat over twice as much protein in the West that we should be eating you need about point eight grams of protein per kilogram of body weight a day so for the average man that's about 56 grams and for a woman that's about 46 grams and there were lots of lots and lots of sources of plant protein nuts beans grains green leafy vegetables and if you're doing bodybuilding you're trying to build muscle then you do need to eat more about one point five to one point eight grams per kilogram but for everyone else it is really very easy and tied to that idea is the the idea that that vegans are we can have no energy so I've created this slide which is quite hard because there are so many plant-based athletes now it's hard to know who to choose so this these are sort of you know highly professional first-rate athlete you've got Fiona Oaks the marathon runner Lewis Hamilton Formula One driver that the tennis players Venus Williams Novak Djokovic you've got the world's strongest man in the top right Patrick Babu Mian you've got the boxer David hey Anthony mu Lally the rugby player for Leeds Rhinos jermain defoe don't know the football team he's a footballer you've got rich role with an ultra runner and Nimai Delgado the the body builder so just some examples if anybody ever asks you that you can just show them this slide the thing I hear most often is that people are concerns about women who are having periods and their iron consumption and they and women tell me oh my doctor told me I'm anemic so I need to start eating steaks again which is very frustrating and that is tied to the fact that you know doctors get very little training in nutrition I'm teaching at the medical school here and until a few years ago they only had one hour of teaching and nutrition in the five-year program that's now gone up to eight hours which is better but still obviously not good enough so yeah I just want to put this to rest there's absolutely no reason to treat animal products for iron in fact the iron in animal products is heme iron and there's a lot of evidence that it's about compounds that is partly responsible for the increased rates of cancer diabetes and heart disease in people who eat meat and dairy and eggs so you don't actually want team iron here are some examples of where you can get plant-based iron luckily it's off it's a lot of the same sources as where you get protein so nuts green leafy vegetables pulses it's absorbed less well than animal iron so you do need to eat more of it and but there are things you can do to increase that absorption such as having foods that are high in vitamin C that helps you absorb iron up to 5 volt and not having tea or coffee with your meals as well because tea and coffee binds to the iron and stalks you're absorbing it another concern people have sometimes is that they're happy to be vegan themselves but they worry about their children and there have been you know a couple of high-profile cases of people of vegans having malnourished children actually if you do some reading there's absolutely no reason that that would happen in fact childhood obesity is such a massive issue we need children to be eating more fruit and veg you're doing a you know the best thing for them to give them a healthy vegan diet and in fact again the British Dietetic Association has said that vegetarian and vegan diets are suitable for every stage of life as long as they are well planned and then the equivalent in America has said that vegan diets are appropriate for all stages of the lifecycle including pregnancy lactation infancy childhood adolescence old adulthood and for athletes so yeah if you do have young children I do recommend obviously doing some reading this is a really good guide from the the first steps nutrition trust really comprehensive if you read that they'll be absolutely fine and then another concern is about calcium and having weak bones and fractures so the evidence again is clear if you're eating at least 500 grams or so milligrams of calcium a day then there was no increased risk of fractures in vegans so the recommended daily allowance to 700 milligrams but as long as you're getting 500 milligrams you'll be fine green leafy vegetables and almonds are particularly good sources whole food sources if you're not eating enough of those then I do recommend having fortified foods like plum milks be careful with the organic ones because they don't have added vitamins and minerals but the non-organic ones have as much calcium as cow milk and is worth bearing in mind that they haven't eaten darien in most of Asia for thousands of years and they haven't had increased fracture rates so something to be aware of but not alarmed about so in terms of you know people ask me should I be taking a supplement and I would say yes b-12 you need to be really careful about you can have b-12 in fortified foods and if you go for that approach you just need to be really careful that you're getting at least three micrograms a day in two separate meals if you're doing that consistently then that's fine but if you want to be you know careful then I would just recommend taking a supplement ten micrograms a day or two thousand micrograms a week iodine is something which is difficult to get on a vegan diet you can get it from kelp but there are unreliable amounts and if that's not something you like eating then I would recommend taking a supplement with 150 micrograms a day and just be careful like the Holland and Babbitt vegan supplement it doesn't have iodine so just make it a point to check that when you're buying your supplement and vitamin D I recommend that absolutely everyone in this country takes a vitamin D in the winter where we're all deficient I recommend using this app if you're new to this and you're you're changing the diet you basically just scan or input everything you've eaten in a day and it totals up all of your macro and micronutrients so you can easily see if there are any areas you need to address so that's quite useful the British Dietetic Association has a really good page all about plant-based diets so I recommend looking at that it's quite a brief summary if you want to look into this in more detail this is a really good book by a vegan diet ition in the States he has a website as well called vegan health org and then of course plant-based health professionals run by serene kasam here we've got a fantastic website lots of resources and we've got a conference coming up next month in Warrington and that's open to the public so you're very very welcome to come to that and then there's this veg med International plant-based conference we've got some big speakers like Michael Greger who else'd Neil Barnard coming to that I think it's nearly sold out so do sign up if you're interested I've got an Instagram page vegan dr. Josh so you're very welcome to follow me on that as well so just to say to finalize really actually some people find the idea of changing their diet is is more terrifying than dying but that often is the choice is the way we are leading our lives it's our lifestyles that is making us sick so we have that choice if we want to be Homer Simpson or or Lisa Simpson for your health for the environment for animals go vegan thank you [Applause]

#Josh #Cullimore #health #benefits #wholefood #plant #based #diet

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