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How To Find A Plant-Based Doctor #Jeff Novick, MS,RD #Esselstyn, MD

How To Find a Plant-Based Doctor

Caldwell Esselstyn, Jr., MD

Jeff Novick, MS, RD

Introduction

Jeff Novick, MS, RD

Over the last few years, I have been honored and privileged to work with and speak to literally 10’s of 1000’s of people who were looking to change to a plant based diet and lifestyle.  As a result of this work, one of the questions that comes up very frequently is how does someone find a plant based doctor to work with.

While there are several ways to respond to this question, one of the greatest responses I ever heard was from Dr Caldwell Esselstyn during our Q & A sessions at an immersion.   After hearing it, I asked him if we could work together on expanding and drafting his response into a formal article.   What follows is our first draft, which we may update and amend over time, but because of the importance of this, we wanted to put it out now.

Here we go…

How To Find a Plant-Based Doctor

Caldwell Esselstyn, Jr., MD

Jeff Novick, MS, RD

People often despair that they lack a local physician with a plant based focus. It is a common concern we hear often. While ideally it would be best if there were a plant based doctor for everyone who wants one,this is rarely the case.

However, do not despair. Working together we can bring you and your current doctor fully up to speed with knowledge about plant based nutrition. Therefore the first thing that will be important for you to do is to get yourself up to speed on the basics of plant-based nutrition.

One way to do this is by visiting one of the residential or immersion programs** run by one of the recommend doctors. Other ways that can also be of value include reading the recommended books**, watching the recommended DVD’s** or taking the E-Cornell plant based nutrition course**. Of course, nothing can take the place of a live interaction with a knowledgeable plant based doctor.

It is important to continue to work with your doctor and let them realize we are not taking away his/her patient; we are merely focusing on a very important dimension of care -the causation of their illness, which local physicians 1. don’t have the time for 2. don’t have the passion for or 3. lack the training or skill set for.

Also, in the beginning, you do not have to get into the specific details of your diet.  Just let them know you have decided to start eating better and going to make some changes (eat a few more fruits, veggies, whole grains and beans and less junk food and fried foods) and see how things go and that you would like them to keep an eye on your numbers. Even ask them if they have any recommendations.

Then, just keeping following the program. This way, working together with your local physician, he/she will be able to reduce 1. blood pressure meds as the patient’s hypertension resolves 2. reduce cholesterol meds as cholesterol lowers 3. reduce diabetic meds as glucose is reduced.

In addition, once you being to have success and your doctor sees these positive changes, he/she may initiate the conversation with you about what you have done and be far more willing to have the conversation from a more open perspective having witnessed the improvements. And, by doing it this way, you will have helped to educate your doctor about the power of plant based, no oil way of living without having any confrontational interactions.

When we approach it this way, the local MD’s will recognize that those of us in lifestyle medicine are working synergistically in the spirit of cooperative endeavor to have their patients have the full benefit of plant based nutrition to halt and reverse their disease.

**Here is the beginning of the recommended resource list in alphabetical order by last name.

(It will be updated over time with live links to the resources.)

Books

Neal Barnard MD

– Dr. Neal Barnard’s Program for Reversing Diabetes

– Breaking the Food Seduction

– 21 Day Weight-loss Kick start

Colin Campbell

– The China Study

Caldwell Esselstyn

– Prevent & Reverse Heart Disease

Rip Esselstyn

– The Engine 2 Diet

Doug Lisle

– The Pleasure Trap

John McDougall MD

– Dr. McDougall’s Digestive Tune‐Up

– The McDougall Quick & Easy Cookbook

– Dr. McDougall’s Total Health Solution for the 21st Century DVD

– The McDougall Program: Twelve Days to Dynamic Health

– The McDougall Program for Maximum Weight Loss

– The New McDougall Cookbook

– The Starch Solution

DVDs

Neal Barnard MD

– Tackling Diabetes DVD

– Kick Start Your Health DVD

Caldwell Esselstyn

– Prevent & Reverse Heart Disease

Rip Esselstyn

– Forks Over Knives Presents The Engine 2 Kitchen Rescue

Michael Klaper

  1. -Digestion Made Easy

Douglas Lisle

– The Continuum of Evil

– Losing weight without losing your mind

– The Pleasure Trap

John McDougall MD

– Dr. McDougall’s Total Health Solution for the 21st Century DVD

– McDougall Made Easy & Irresistible

– Dr. McDougall’s Money-Saving Medical Advice

– Dr. McDougall’s Common Sense Nutrition

– McDougall Made Irresistible

– Dr. McDougall Disputes Major Medical Treatments

– McDougall Made Easy

– McDougall’s Medicine

Jeff Novick

– Lighten Up

– Calorie Density

– Should I Eat That

– From Oil To Nuts

– Nuts & Health

– Fast Food Vol 1 The Basics

– Fast Food Vol 2 Burgers & Fries

Movies/Documentaries

– Forks Over Knives

– Processed People

Immersions and Programs

– The McDougall 3, 5 & 10 Day Programs

– Dr Esselstyn – 5-hour intensive counseling seminar at the Cleveland Clinic Wellness Institute

– Farms To Forks Weekend Immersions

Online Course

– E Cornel Plant Based Nutrition Course

Additional Material

BOOKS

John Abramson MD

– Overdosed America

Gilbert H. Welch MD

– Should I be tested for Cancer?

– Overdiagnosed: Making People Sick in the Pursuit of Health

– Know Your Chances: Understanding Health Statistics

Nortin Hadler MD

– Worried Sick: A Prescription for Health in an Overtreated America,

Thursday, August 2, 2012

Is Belly Fat the Worst Kind of Fat?

by Emily Milam

While excess belly fat may allow for a more impressive splash when flopping into the pool, it also packs some not so stellar abilities, like leading to higher cholesterol levels and increased risks for cardiovascular disease[1][2]. What’s more, belly fat — also known as visceral fat, abdominal fat, or central adiposity — can lead to type 2 diabetes, a disease that causes blood sugar levels to rise dangerously high[3]. The good news? Some types of midsection weight are less worrisome than others.

Tubby Tummies — Why It Matters

Belly

Photo by Jess Ivy

So why aren’t jelly bellies and thunder thighs equally bad? Of course, excess fat anywhereon the body can contribute to cardiovascular disease and diabetes, but not all fat is created equal: Geography matters[4].

Abdominal fat is stored in two different ways. First, there is subcutaneous fat (the pinchable stuff!), which sits between the skin and the abdominal wall. This fat is more of a holding tank for extra calories, and is less of a health threat since it does not directly surround organs and the blood vessels that keep them healthy[5]Visceral fat, however, sits deeper in the stomach and blankets the abdominal organs[6]. Now, everyone has some amount of visceral fat, but concerns surface when this inner fat exceeds normal levels. In some cases, the fat can invade the organs themselves (a common occurrence in the liver)[7]The organ-swaddling visceral fat negatively affects organ function and integrity by increasing inflammation, clogging blood supplies (which prevents nutrient and oxygen delivery to organs), and eventually causing insulin resistance. Insulin resistance, a pre-cursor to diabetes, is a condition by which the body’s muscle, fat, and liver no longer respond properly to circulating insulin supplies[8]. This means that insulin — a hormone made in the pancreas that tells glucose to enter the body’s cells to fulfill their energy needs — can’t do its job. The result? The body’s cells starve while the excess glucose accumulates in the blood, ultimately damaging organs and vessels throughout the body. What’s more, visceral fat cells also produces hormones that regulate weight and appetite, sometimes leading to further weight gain or increased feelings of hunger[9].

Getting Waisted — The Answer/Debate

They say America is a melting pot, but let’s think of it as a fruit basket. Different body shapes are associated with each gender and type of fat[10]Pear-shaped women have more padding around the butt and thighs (hence, apple bottom jeans — not be confused with apple shape!). These areas harbor mostly subcutaneous fat. Apple-shaped men and women, or those with fat around the middle, have more visceral fat (the dangerous kind). Banana-shaped are relatively thin throughout, or have a more equal distribution of fat. And we can’t forget beer bellies! Beer guzzlers beware — tummies full of Budweiser also count as dangerous visceral fat[11][12].

While calculating body mass index (BMI) is a helpful tool to assess the overall health of an individual’s weight, determining a waist-to-hip ratio with a measuring tape is a better method to pinpoint belly fat[13]Calculate waist-to-hip ratio by dividing the waist’s circumference at its narrowest point (use the belly button as a guide) by the hips’ circumference at their widest points (near the top of the bony protrusions). Ratios of 0.8 and below are healthy, and those above 0.8 suggest an increased risk for heart disease and diabetes. Some studies have found waist circumference to be a better determinant and to better express the amount of belly fat present[14]. Measure waist circumference at the spot right above the hip bones right afer breathing out. Risk for developing obesity-related health problems (like cardiovascular disease) increases in women with waists larger than 35 inches and in men with a circumference large than 40 inches.

Ready to battle the bulge? Thankfully, visceral fat typically surrenders to diet and exercise. Trim the fat with the four pillars of a healthy middle: exercise, diet, sleep, and stress management. While core exercises such as the plank and crunches will firm up abs, they won’t blast the belly fat that lies underneath. Instead, try moderate or vigorous intensity aerobic activity — recent research suggests that sprinting is the best way to lose the love handles[15][16][17]. Complement aerobics with diets low in saturated fat, cholesterol, and carbohydrates (beer lovers, beware), and considerprotein-rich meals and low-fat snacks[18]. And don’t forget to manage life stressors and catch plenty of Zzzs — increased cortisol levels (the stress hormone) and lack of sleep are both tied to abdominal weight gain[19][20].

The Takeaway

Belly (aka visceral) fat can be more harmful than other types in terms of leading to bigger health issues. The good news? It also surrenders more easily to improved fitness and diet than other types!

This article was read and approved by Greatist experts Sherry Pagoto and Lisa Moskovitz

What do you think about the debate between BMI or waist circumference being the better determinant of health risks? Join the conversation in the comments section below! 

Works Cited

  1. Visceral fat positively correlates with cholesterol synthesis in dyslipidaemic patients. Lupattelli, G., Pirro, M., Mannarino, M. et al. Internal Medicine, Angiology and Atherosclerosis, Department of Clinical and Experimental Medicine, University of Perugia, Italy. European Journal of Clinical Investigation, 2012 Feb;42(2):164-70. []
  2. Cardiovascular disease under the influence of excess visceral fat. Despres, J. Québec Heart Institute, Québec, QC, Canada. Critical Pathways in Cardiology, 2007 Jun;6(2):51-9. []
  3. Insulin resistance and body fat distribution. Yamashita, S., Nakamura, T., Shimomura, I., et al. Second Department of Internal Medicine, Osaka University Medical School, Japan. Diabetes Care, 1996 Mar;19(3):287-91. []
  4. Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study. Fox, C., Massaro, J., Hoffman, U., et al. National Heart, Lung and Blood Institute’s Framingham Heart Study, Framingham, Mass, USA. Circulation,  2007 Jul 3;116(1):39-48. []
  5. Beneficial effects of subcutaneous fat transplantation on metabolism. Tran, T., Yamamoto, Y., Gesta, S. et al. Joslin Diabetes Center and Harvard Medical School, Boston, MA. Cell Metabolism, 2008 May;7(5):410-20. []
  6. Metabolic obesity: the paradox between visceral and subcutaneous fat. Hamdy, O., Porramatikul, S., Al-Ozairi, E. Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA. Current Diabetes Review, 2006 Nov;2(4):367-73. []
  7. Obesity, Visceral Fat, and NAFLD: Querying the Role of Adipokines in the Progression of Nonalcoholic Fatty Liver Disease. Mirza, M. SpR Surgery, Ninewells Hospital, Dundee, UK. ISRN Gastroenterology, 2011;2011:592404. []
  8. Brown fat lipoatrophy and increased visceral adiposity through a concerted adipocytokines overexpression induces vascular insulin resistance and dysfunction. Gomez-Hernandez, A., Otero, Y., de las Heras, N., et al. Biochemistry and Molecular Biology Department, School of Pharmacy, Complutense University of Madrid, Madrid, Spain. Endocrinology, 2012 Mar;153(3):1242-55. []
  9. Adipose tissue as an endocrine organ. Galic, S., Oakhill, J., and Steinberg, G. St. Vincent’s Institute of Medical Research and Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia. Molecular and Cellular Endocrinology, 2010 Mar 25;316(2):129-39. []
  10. A weight shape index for assessing risk of disease in 44,820 women. Rimm, A., Hartz, A., and Fischer, M. Department of Medicine, Medical College of Wisconsin, Milwaukee. Journal of Clinical Epidemiology, 1988;41(5):459-65. []
  11. The association of lifetime alcohol use with measures of abdominal and general adiposity in a large-scale European cohort. Bergmann, M., Schutze, M., Steffen, A., et al. Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany. European Journal of Clinical Nutrition, 2011 Oct;65(10):1079-87. []
  12. Relationship of abdominal obesity with alcohol consumption at population scale. Scroder, H., Morales-Molina, J., Bermejo, S., et al. Lipids and Cardiovascular Epidemiology Research Unit, Institut Municipal d’Investigació Mèdica, Barcelona, Spain. European Journal of Nutrition, 2007 Oct;46(7):369-76. []
  13. Body mass index, waist circumference and waist:hip ratio as predictors of cardiovascular risk–a review of the literature. Huxley, R., Mendis, S., Zhelezyakov, E., et al. Renal and Metabolic Division, The George Institute for International Health, The University of Sydney, Sydney, Australia. European Journal of Clinical Nutrition, 2010 Jan;64(1):16-22. []
  14. Waist circumference in children and adolescents correlate with metabolic syndrome and fat deposits in young adults. Spolidoro, JV, Pitrez Filho, ML, Vargas LT, et al. Medical School of the Pontifficia Universidade Catolica do RS, Moinhos de Vento Hospital, Porto Alegre, Brazil. Clinical Nutrition, 2012 Jul 28. []
  15. A systematic review and meta-analysis of the effect of aerobic vs. resistance exercise training on visceral fat. Ismail, I., Keating, S., Baker, M., et al. Discipline of Exercise and Sport Science, University of Sydney, Sydney, New South Wales, Australia. Obesity Reviews, 2012 Jan;13(1):68-91. []
  16. Effects of aerobic vs. resistance training on visceral and liver fat stores, liver enzymes, and insulin resistance by HOMA in overweight adults from STRRIDE AT/RT. Slentz, C., Bateman, L., Willis, L., et al. Div. of Cardiology, Dept. of Medicine, Duke Univ. Medical Center, Durham, NC, USA. American Journal of Physiology: Endocrinology and Metabolism, 2011 Nov;301(5):E1033-9. []
  17. The effect of high-intensity intermittent exercise on body composition of overweight young males. Heydari, M., Freund, J., Boutcher, S.H. School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, Australia. Journal of Obesity, 2012;2012:480467. []
  18. Relationship between bread consumption, body weight, and abdominal fat distribution: evidence from epidemiological studies. Bautista-Castano, I. and Serra-Marjem, L. Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain. Nutrition Reviews, 2012 Apr;70(4):218-33. []
  19. Stress-induced cortisol response and fat distribution in women. Moyer, A., Rodin, J., Grilo, C., et al. Department of Psychology, Yale University, New Haven, CT, USA. Obesity Research, 1994 May;2(3):255-62. []
  20. Obesity and metabolic syndrome: Association with chronodisruption, sleep deprivation, and melatonin suppression. Reiter, R., Tan, D., Korkmaz, A., et al. Department of Cellular and Structural Biology, UT Health Science Center , San Antonio, Texas USA. Annals of Medicine, 2011 Jun 13. []

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