moving from treatment to prevention · neal d. barnard, md . adjunct associate professor of...
TRANSCRIPT
![Page 1: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/1.jpg)
Moving from Treatment to Prevention
Neal D. Barnard, MD Adjunct Associate Professor of Medicine The George Washington University School of
Medicine Physicians Committee for Responsible
Medicine
![Page 2: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/2.jpg)
A Lesson from Japan
![Page 3: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/3.jpg)
![Page 4: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/4.jpg)
Diabetes Prevalence in Japan
In adults over age 40: Prior to 1980: 1-5% Kuzuya T. Prevalence of diabetes mellitus in Japan compiled from
literature. Diab Res Clin Practice. 1994;24 Suppl:S15-S21.
![Page 5: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/5.jpg)
![Page 6: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/6.jpg)
Rising Fat Intake in Japan
Murata M. Am J Clin Nutr 2000;72(suppl):1379S-83S.
Fat (grams/day)
0
10
20
30
40
50
60
1955 1965 1975 1985 1994
![Page 7: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/7.jpg)
Falling Carbohydrate Intake in Japan
Murata M. Am J Clin Nutr 2000;72(suppl):1379S-83S.
Carbohydrate (grams/day)
250
280
310
340
370
400
430
1955 1965 1975 1985 1994
![Page 8: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/8.jpg)
Overweight in Japan
Women
Men
National Health and Nutrition Survey Japan, 2006 http://www0.nih.go.jp/eiken/english/research/pdf/nhns2006_outline.pdf
BMI ≥ 25kg/m2
![Page 9: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/9.jpg)
Diabetes Prevalence in Japan
In adults over age 40: Prior to 1980: 1-5% By 1990: 11-12% Kuzuya T. Prevalence of diabetes mellitus in Japan compiled from
literature. Diab Res Clin Practice. 1994;24 Suppl:S15-S21.
![Page 10: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/10.jpg)
A Lesson from the U.S.
![Page 11: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/11.jpg)
U.S. Per Capita Meat Intake (lb)
1900 1920 1940 1960 1980 2000
20
40
60
80
100
120
140
160
180
200
220
Source:US Department of Agriculture, Economic Research Service,http://www.ers.usda.gov/Data/FoodConsumption/FoodAvailSpreadsheets.htm#mtpcc,accessed August 15, 2009.
1909
2004
123.9 lb
201.5 lb
(Includes red meat, poultry, and fish)
2012181.5 lb
![Page 12: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/12.jpg)
U.S. Per Capita Chicken Intake (lb)
1900 1920 1940 1960 1980 20000
10
20
30
40
50
60
Source:US Department of Agriculture, Economic Research Service,http://www.ers.usda.gov/Data/FoodConsumption/FoodAvailSpreadsheets.htm#mtpcc,accessed August 15, 2009.
1909
2006
10.4 lb
60.9 lb
201256.6 lb
![Page 13: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/13.jpg)
U.S. Per Capita Cheese Consumption (pounds)
1900 1920 1940 1960 1980 20000
10
20
30
40
Source:US Department of Agriculture, Economic Research Service,http://www.ers.usda.gov/data-products/dairy-data.aspx#.Ui9QRT_4LTI, accessedSeptember 10, 2013
19608.3 lb
201233.5 lb
19093.8 lb
![Page 14: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/14.jpg)
![Page 15: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/15.jpg)
Diabetes Prevalence 1994
![Page 16: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/16.jpg)
Diabetes Prevalence 1995
![Page 17: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/17.jpg)
Diabetes Prevalence 1996
![Page 18: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/18.jpg)
Diabetes Prevalence 1997
![Page 19: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/19.jpg)
Diabetes Prevalence 1998
![Page 20: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/20.jpg)
Diabetes Prevalence 1999
![Page 21: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/21.jpg)
Diabetes Prevalence 2000
![Page 22: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/22.jpg)
Diabetes Prevalence 2001
![Page 23: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/23.jpg)
Diabetes Prevalence 2002
![Page 24: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/24.jpg)
Diabetes Prevalence 2003
![Page 25: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/25.jpg)
Diabetes Prevalence 2004
![Page 26: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/26.jpg)
Diabetes Prevalence 2005
![Page 27: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/27.jpg)
Diabetes Prevalence 2006
![Page 28: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/28.jpg)
Diabetes Prevalence 2007
![Page 29: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/29.jpg)
Diabetes Prevalence 2008
![Page 30: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/30.jpg)
Diabetes Prevalence 2009
www.cdc.gov/diabetes
![Page 31: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/31.jpg)
Adventist Health Study – 2 60,903 participants, aged ≥30, enrolled 2002-2006
Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of type 2 diabetes. Diabetes Care 2009;32:791-6.
![Page 32: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/32.jpg)
Adventist Health Study – 2
Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of type 2 diabetes. Diabetes Care 2009;32:791-6.
![Page 33: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/33.jpg)
Weight-Control Study
2 rules:
1. No animal products
2. Minimize oils
No exercise
14-week study
![Page 34: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/34.jpg)
Typical Day’s Meals Breakfast Blueberry pancakes or Oatmeal with cinnamon and raisins Half cantaloupe Rye toast with jam Lunch Chunky vegetable chili Garden salad with sesame dressing Snack Banana Dinner Lentil soup with crackers Linguine with artichoke hearts and seared oyster mushrooms Steamed broccoli
![Page 35: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/35.jpg)
Results at 14 Weeks
13 lb average weight loss
2-inch drop in waist measurement
Increased insulin sensitivity
![Page 36: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/36.jpg)
Weight at 1 and 2 Years
Turner-McGrievy GM. Obesity 2007;15:2276-81.
![Page 37: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/37.jpg)
Neal D. Barnard, M.D. Joshua Cohen, M.D. David J.A. Jenkins, M.D., Ph.D. Gabrielle Turner-McGrievy, M.S., R.D. Lise Gloede, R.D., C.D.E. Stanley Talpers, M.D. Paul J. Poppen, Ph.D. Amber Green, R.D. Brent Jaster, M.D. Kim Seidl, M.S., R.D Susan Levin, R.D. Earnest Noble, M.D. Terry Ritchie, Ph.D. Robyn Webb, M.S.
George Washington University George Washington University University of Toronto University of North Carolina Private practice, Arlington, VA George Washington University George Washington University PCRM PCRM PCRM PCRM University of California, Los Angeles University of California, Los Angeles Robyn Webb Associates
Plant-Based Dietary Intervention in Type 2 Diabetes
Funding: National Institute of Diabetes and Digestive and Kidney Diseases, NIH Diabetes Action Research and Education Foundation
![Page 38: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/38.jpg)
Plant-Based Diet for Type 2 Diabetes
Intervention: Vegan, low-fat, low-GI
Control: ADA guidelines (2003) 22-week study, 1-year follow-up n = 99 Barnard ND, et al. Diabetes Care 2006;29:1777-1783. Barnard ND, et al. Am J Clin Nutr 2009;89(suppl):1588S-96S.
![Page 39: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/39.jpg)
Hemoglobin A1c at Baseline and at 11 and 22 Weeks
Week 0 Week 11 Week 226.5
7.0
7.5
8.0
8.5
VeganADA
Individuals with no medication changes, n = 24 vegan, 33 ADA
P = 0.01
8.07
7.88
7.42
7.18
7.50
6.84
A1c (%)
![Page 40: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/40.jpg)
Hemoglobin A1c, All Participants(n = 49 vegan, 50 ADA)
0 11 22 35 48 61 746.5
7.0
7.5
8.0
8.5
VeganADA
Data shown are last values before any change to hypoglycemicmedications carried forward. For between-group comparison of changesfrom baseline to final values, P = 0.03.
Weeks
7.65
7.948.057.93
P = 0.03
A1c (%)
![Page 41: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/41.jpg)
Body Weight(n = 49 vegan, 50 ADA)
(Missing values returned to baseline)
Week 0 Week 11 Week 22 Week 7485
90
95
100
105
Vegan
ADA
93.3
96.797.0
99.3
P=0.36
(-3.7 from baseline)
(-2.6 from baseline)Weight (kg)
![Page 42: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/42.jpg)
Low Density LipoproteinBaseline to 74 Weeks or Last Value before Medication Change
(n = 49 vegan, 49 ADA)
Week 0 Week 7480
90
100
110
120
130
VeganADA
P = .001
104
91
118114
-13%
LDL (mg/dl)
-3%
![Page 43: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/43.jpg)
Glucose Insulin
Intramyocellular lipid
Inside the Cell
●
● ● ● ● ● ●
●
![Page 44: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/44.jpg)
Three Keys:
1. Vegan 2. Low in fats and oils 3. Low-glycemic index
![Page 45: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/45.jpg)
![Page 46: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/46.jpg)
PCRM 2009 USDA 2011
![Page 47: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/47.jpg)
Fat Content (Percentage of Calories from Fat)
• Leanest beef 29%
• Skinless chicken breast 23%
• Sea trout 32%
• White tuna 16%
• Broccoli 8%
• Beans 4%
• Rice 1–5%
• Sweet Potato 1%
![Page 48: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/48.jpg)
Body Weight
P-value < 0.0001
Am J Health Promotion, In pre
![Page 49: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/49.jpg)
Waist Circumference
Am J Health Promotion, In press P-value < 0.001
![Page 50: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/50.jpg)
Study Sites vegan
control
Buffalo, NY
Woodbury, NY
Chevy Chase, MD
Virginia Beach, VA San Diego, CA Tucson, AZ Macon, GA Dallas, TX Lakeland, FL
Fredericksburg, VA
![Page 51: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/51.jpg)
Body Weight (pounds)
190
195
200
205
210
Week 0 Week 18
Control
Intervention
![Page 52: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/52.jpg)
Hemoglobin A1c
6.0
6.5
7.0
7.5
8.0
Week 0 Week 18
Control
Intervention
![Page 53: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/53.jpg)
Beginning a Healthful Diet
Step 1. Check out the possibilities
![Page 54: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/54.jpg)
Breakfast Lunch Dinner Snack
Foods to Try
![Page 55: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/55.jpg)
Healthy Breakfasts
• Cinnamon Raisin Oatmeal • Blueberry Pancakes
• Bran Flakes with Almond Milk • Hot Whole Wheat with Dates
• Breakfast Scrambler • Fantastic Fruit Smoothie
• Whole-Grain Bagel with Jam • Swiss Style Muesli
• Slow Cooker Whole-Grain Porridge • Orange-Pineapple Crush
![Page 56: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/56.jpg)
Lunches and Dinners • Veggie Pizza
• Chunky Vegetable Chili • Bean Burrito
• Seitan & Mushroom Stroganoff • Portobello Mushroom Steaks • Oven-Barbecued Tofu Steaks
• Roadhouse Hash • Sweet & Sour Tempeh
• Southern Beans & Greens • Seitan Cassoulet • Mandarin Stir-Fry
• Stuffed Vegetable Rolls • Zucchini & Herb Calzones
![Page 57: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/57.jpg)
Italian Cuisine
![Page 58: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/58.jpg)
Mexican Cuisine
![Page 59: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/59.jpg)
Chinese Cuisine
![Page 60: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/60.jpg)
Japanese Cuisine
![Page 61: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/61.jpg)
Fast-Food Options
Veggie sub
Bean burrito, hold the cheese
![Page 62: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/62.jpg)
Beginning a Healthful Diet
Step 1. Check out the possibilities
Step 2. Do a 3-week test drive
Optional: Use transition foods
![Page 63: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/63.jpg)
![Page 64: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/64.jpg)
![Page 65: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/65.jpg)
PCRM.org
![Page 67: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/67.jpg)
Washington, DC July 31-August 1, 2015 www.pcrm.org George Washington University School of Medicine Physicians Committee for Responsible Medicine
International Conference on Nutrition and Cardiovascular Disease
![Page 68: Moving from Treatment to Prevention · Neal D. Barnard, MD . Adjunct Associate Professor of Medicine . ... Tonstad S, et al. Type of vegetarian diet, body weight and prevalence of](https://reader034.vdocuments.net/reader034/viewer/2022042709/5f51cc8933ac6c57f4786eb8/html5/thumbnails/68.jpg)
Thank you!
Neal D. Barnard, MD Adjunct Associate Professor of Medicine The George Washington University School of
Medicine Physicians Committee for Responsible
Medicine pcrm.org