From 2000 to 2015, the top 2 causes of death globally increased significantly. Diabetes mellitus was not in the top 10 causes of global death in the year 2000. Then, it ranked 6th in 2015.
Eighty percent of heart disease, stroke, and diabetes (top causes of global death) can be prevented when risk factors are reduced, according to WHO. The risk factors that are largely contributing to these deaths are MODIFIABLE because they are lifestyle and dietary-related. Changing to healthier lifestyle habits and consumption of whole plant-based foods will remove all of these modifiable risk factors, significantly reducing your risk of premature death.
Infusing Lifestyle Medicine Into a Part Time Practice - Simplified
Incorporating Lifestyle Medicine in a conventional outpatient practice can be challenging, even more so in a part time practice. Compared to a typical Lifestyle Medicine team practice where there is a health coach, dietician, behavioral specialist, and trained support staff, the provider in a standard practice is left with nothing but himself to assimilate all these roles at a very limited amount of time. The goal of this one year experimental study is to determine if its possible to offer Lifestyle Medicine with particular emphasis on whole food plant based diet in a conventional office set up and still yield remarkable results.
Twenty-one patients were convinced during random clinic visits to try a whole food plant based diet. All of them had at least one of the following health problems: obesity, uncontrolled diabetes, hypertension, and dyslipidemia. Each of the participants were scheduled initially for a one-on-one 40 min visit for an-in depth disease and nutrition education. They were given a printed summary about whole food plant based diet, including food substitutes and where they are locally available. They were also urged to read books and watch documentaries such as Forks over Knives, What the Health, etc. Each of them were followed every 2 weeks in the clinic. Discussions during subsequent visits were very flexible depending on the area where the patient seemed to be needing more help on. It varies from cooking coaching (in terms of time management and meal planning), stress reduction, understanding nutrition labels, motivational interviewing, active listening, cognitive-behavioral therapy and medication adjustment.
Out of the twenty one patients who embraced dietary change, 10 patients adapted the diet completely. The data presented in this article will only be based from these 10 patients who are considered as participants. The changes observed in every participant varies from 3- 10 month period since they adapted whole food plant based diet. Five out of the ten participants have diabetes and all of them achieved A1c <6.5 after no more than 5 months. Three of them came off insulin regimen in less than 6 weeks. The largest amount of insulin discontinued was 84 units. One of the diabetic patients attained complete reversal of diabetes (A1c of 5.5 without medication), while the rest stayed on low dose Metformin. All of the participants have hypertension. Average drop in systolic blood pressure was 15 mmHg. One third of them had to either discontinue medications, or cut the doses of antihypertensive medications in half. All of the participants were also obese. Average weight loss and BMI reduction were 29 pounds and 6, respectively. Largest amount of weight loss was 58 pounds.
It is noteworthy to mention that in this study, one participant who experienced the most dramatically improved quality of life was a 58 years old gentleman with history of severe coronary artery disease with two heart bypass surgery, two cardiac stent, chronic angina, uncontrolled diabetes, stroke, depression, severe neuropathy, morbid obesity, and obstructive sleep apnea. Five days into whole food plant based diet, his insulin regimen (total of 84 u /day) was discontinued and his neuropathy went away even without Gabapentin. Multiple cardiac medications such as IMDUR, Ranolazine, Nitroglycerin patch, Nitroglycerin tablet, Lisinopril and Metoprolol were stopped too. He lost 58 pounds. Patient is now regularly going to the gym for yoga/taichi, weight lifting and cardio exercise five days a week. His calculated medication cost savings is $28,369 per year.
The impact of Lifestyle Medicine to patients is undoubtedly beyond measure. It can be integrated into any type of clinical practice as long as the provider is engage and passionate to support willing patients by all means. Besides, empowering patients at the right time for the right reason is what I think largely determines the longevity of the patient’s positive behavioral change.