Naturalmente delicioso - El brócoli en Polonia, Dra. M. Desmond

Cruciferous vegetables in nutritional medicine

Vegetable/Broccoli consumption in Poland lorem ipsum dolor sit

Trends • Vegetable consumption in Poland has been decreasing in the last years

• Good news – the decrease in consumption of cruciferous vegetables has been smallest out of all vegetable groups

Analiza PMR GUS

Broccoli consumption in real life: busy 30-year old female lawyer

Broccoli consumption in real life: 10 –year old boy, overweight

Broccoli consumption in real life: 34-year old health conscious vegan, female

Breakfast: millet/buckwheat/wholegrain cereal with seeds, seedlets, nuts, grinded poppy, dried fruits Lunch: salad with vinaigrette sauce.

Dinner: millet/ brown rice + steamed vegetables (broccoli, beet, cauliflower/brussels sprouts/zucchini) or legume or raw vegetables (grated carrot and parsley) Dessert: fruit salad Supper: home –made bread sandwiches with home-made jam/honey/spreads (e.g. bean spread)

Drinks: (i.e. coffee, tea, juice, water, alcohol etc.): Tea: green, white, roiboos, fruit, herbal; vegetable juices; water (in the spring and the summer only)

What is nutritional medicine?

The inadequacy of clinical education is a consequence of the failure of health care and medical education to adapt to 2 related transformations in the past 50 years that are central to good health care today.

In the first, chronic disease replaced acute disease as the dominant health problem. Chronic disease is now the principal cause of disability and use of health services and consumes 78% of health expenditures.

In the second, chronic disease dramatically transformed the role of the patient.

Halsted Holman is the Berthold and Belle N. Guggenhime Professor of Medicine, co-chief of the Division of Family and Community Medicine, director of the Stanford Multi-Purpose Arthritis Center, and a CHP/PCOR associate

What is nutritional medicine?

Prof. Walter Willet, head of Nutrition Department, Harvard School of Public Health: for most diseases contributing importantly to mortality in Western populations, epidemiologists have long known that nongenetic factors have high atrributable risks, often at least 80-90%, even when specific etiologic factors are not clear

Causes of death in Poland

Gębska – Kuczerowska, 2009

Current model of medicine

IFM -21st Century Medicine

Current model of medicine

IFM -21st Century Medicine

Medicine of the Future

IFM -21st Century Medicine

Lifestyle Medicine

Lifestyle Medicine

Prevention

Lifestyle Medicine- Prevention

"EPIC" (European Investigation into Cancer), Archives of Internal Medicine; 23,000 osób, 8 years of follow up: • • • •

Not smoking Exercise at 3.5 hrs a week Eating a healthy diet [vegetables, fruit, whole grains, pulses, low meat] Avoiding obesity

• among those adhering : 93% diabetes, 81% heart attacks, 50% strokes i 36% cancers could be prevented

Lifestyle Medicine- Prevention

American Heart Society’: ‚… If these recommendations are followed (i.e. healthy diet and lifestyle), coronary heart disease can be eliminated to a large extent in the population aged <70 years, and by implementing these recommendations at middle-age, there will be lower annual costs for medical care in older age’

Lifestyle Medicine- Prevention

‚… If we could prevent about 40% of cancers by adopting a healthy, plant based diet, being physically active and maintaining a healthy weight’

Therapy

„...there are an infinitive number of insults to a human body but there are only 3 finite responses within the human body”.

• • •

Inflammation Oxidative stress Autoimmune Disease

Dr Mark Houston

„...there are an infinitive number of insults to a human body but there are only 3 finite responses within the human body”.

• • •

Inflammation Oxidative stress Autoimmune Disease

Dr Mark Houston

Inflammation/Oxdative Stress – Diabetes/Obesity •

…obesity is a state of chronic inflammation (increased plasma concentrations of inflammatory markers - CRP, IL-6, and PAI)

•

the plasma concentration of inflammatory mediators, such as TNF-a, IL-6, is increased in the insulin resistant states

•

increase in inflammatory mediators or indices predicts the future development of obesity and diabetes!

Trends Immunol. 2004 Jan;25(1):4-7.

Inflammation/Oxdative Stress â&#x20AC;&#x201C; Diabetes/Obesity

Trends Immunol. 2004 Jan;25(1):4-7.

Inflammation- Hypertension

Hypertension. 2011 Feb;57(2):132-40.

Inflammation- Atherosclerosis

Am J Clin Nutr. 2006 Feb;83(2):456S-460S.

Inflammation- Cancer

in: "Oxidative Stress and Chronic Degenerative Diseases - A Role for Antioxidants", book edited by JosĂŠ A. Morales-GonzĂĄlez, ISBN 978-953-51-1123-8,

Inflammation- Autoimmune Disease- Intestinal permeability

Scientific American August 2009

Scientific American August 2009

Nutrition intervention in disease coronary heart disease;atherosclerosis, diabetes type 2, hypertension

Plant based

different conditions (i.e. autoimmune)

Elimination Diet Paleo type diet hypertension

autoimmune disease, diabetes type 2, hyeprtension, metabolic syndrome

DASH diet

Nutrition intervention in disease

Plant based

Elimination Diet Broccoli and other cruciferous vegetables must comrpise 50|% of daily vegetable intake

Paleo type diet

DASH diet

Nutrition intervention – example of a protocol – Paleo type diet 2000kcal

Nutrition intervention – example of a protocol – Ornish type diet 1850 kcal

Case histories

December 2010!

Coronarography â&#x20AC;&#x201C; after 32 months with no statins (decision of the physician) on a low â&#x20AC;&#x201C; fat plant based diet (Esselstyn, 2007)

A single-photon emission computerized tomography (SPECT) â&#x20AC;&#x201C; before (top part) and after 3 weeks of a low â&#x20AC;&#x201C;fat plan based diet (Esselstyn, 2007)

Ryszard S., male â&#x20AC;&#x201C; 64 years, after a heart attack, the Ornish diet: intensive nutrition programme

Before:

After 6 months:

Fasting glucose: 108 mg/dl

Fasting glucose: 90 mg/dl

Tadeusz W., male â&#x20AC;&#x201C; 66 years, hypertension, DASH diet November 2011

February 2012

Anna B.â&#x20AC;&#x201C; 32 years, insulin resistant, morbidly obese, plant based intervention May 2011

May 2011

body weight: 113 kg

body weight: 109 kg

BMI: 45.3

BMI: 43.66

Total cholesterol: 245

Total cholesterol: 175

LDL - 170

LDL - 109

TG: 162

TG: 163

Fasting glucose: 99

Fasting glucose: 97.5 (now 87.5)

Fasting insulin: 18.6

CRP - 10 Blood pressure: 143/102

Fasting insulin: 11 CRP â&#x20AC;&#x201C; 1.82 Blood pressure: 131/72

Marta M.- 29 yrs old, ankylosing spondylitis

I have had problems with my joints, back and my gut all my life.

January 2011 â&#x20AC;&#x201C; My first hospitalization. I've felt pain in my knee joints, my arm and feet joints were swollen. Positive ANAs, I was diagnosed with Raynaud's phenomenon, NSAIDs. HLA-B27, chlamydia antibodies, pneumonia, chlamydia trochomatis, salmonella, yersinia; GUT SYMPTOMS: diarrhea with mucus and blood, flatulence, antibiotics, Sulfasalazine.

January 2012 â&#x20AC;&#x201C; I was diagnosed with Ankylosing spondylitis, inflammation of knees and arm joints.

Marta M.- 29 yrs old, ankylosing spondylitis

Every morning my back was so stiff, that it was hard for me to even get up. Every morning I had to spend about 1,5h to warm up. I often needed the help of my husband. Alternating cold and hot showers were really helpful.

Because of leucopenia my physician advised me to throw aside the Sulfasalazine.

The treatment was using non-steroidal anti-inflammatory drugs â&#x20AC;&#x201C; Celebrex and then Naproxen 2x500 mg.

That time I had problems with my menstruation. Despite of young age I became disabled and obsolete in the society. It was hard to accept.

Marta M.- 29 yrs old, ankylosing spondylitis

In April 2012 I heard about nutritional medicine and the therapy used by Mrs MaĹ&#x201A;gorzata Desmond. I saw a movie presenting some stories of her patients. One of them was a lady who suffered from the same disease as I did. I decided to try it out.

When I started the diet, I often had migraines, I was chronically tired, had no energy, rapid mood swings and irregular menstruation.

The goal of Mrs. Desmond therapy was the elimination of potential nutritional antigens, which could be the cause of immunoreactivity (plant-based, gluten-free and fish) After 4 weeks on this diet I did blood tests:

Marta M.- 29 yrs old, ankylosing spondylitis

Marta M.- 29 yrs old, ankylosing spondylitis

I've started to feel the effects of the diet after 3 or 4 months. There was no pain anymore and my gut problems faded away. The stiffness I felt every morning eased off and I could start to exercise without fearing that my knees would start to ache .

My life was full of hope and finally I was able to enjoy every second of it.

Now I don't take any anti-inflammatory drugs. I don't feel any pain and I am really grateful for showing me a way to live without swallowing a handful of drugs each day.

I want to add, that I am 4 months pregnant â&#x20AC;&#x201C; I believe that thanks to the diet I regulated my menstrual cycle.

Aneta G., female- 46, ankylosing spondylitis, diabetes, metabolic syndrome, abnormal liver enzymes, Paleolithic diet March 2014 Fasting glucoseâ&#x20AC;&#x201C; 121 mg/dl

Aneta G., female- 46, ankylosing spondylitis, diabetes, metabolic syndrome, abnormal liver enzymes, Paleolithic diet April 2014

Less morning stiffnes in the back!