by Dr. Bhiku Jethalal

Despite advice from dietitians, two-thirds of all deaths in the West are due to heart disease and cancer, both linked to our 20th century lifestyles.

Many people ask about vitamins as a defense. Reports about anti-oxidant vitamins, particularly beta carotene and vitamin E, have been confusing.

Before we can understand the role of these vitamins, we need to understand the concept of free radicals - potential factors in many illnesses. Free radicals are unstable molecules, with one of their many pairs of electrons missing an electron. This free radical goes on a "search and destroy" mission, stealing an electron from a healthy molecule.

Unfortunately, our air, water, soil and much of our food is full of chemicals that can cause health problems ranging from asthma to cancer. The good news, however, is that a natural chemical removal system is built into our basic biochemistry. It is powerful enough to eliminate thousands of different chemicals. It just needs to be turned on.

by Sally Grande 

Many vegetarians have been led to believe that consuming an unlimited quantity of high carbohydrate foods is perfectly healthy. Some people eat what they like and remain slim and vigorous after decades of unchanged eating habits while others wonder why, as vegetarians, they seem to experience weight gain and fatigue.

Barry Sears, author of the best seller, Enter The Zone, (Regan Books, 1995) thinks he knows. At first glance, vegetarians might think that the Zone diet is a reincarnation of other high-protein, non-vegetarian diets (Scarsdale and Atkins) which were popular in the 1970s. While Sears stresses protein (the book's title refers to the high protein zone), he is not anti-vegetarian but readers of his book may be influenced to cut carbohydrates and gorge on high protein foods.

I came across Sears' book and echoed the same sentiments that appeared in the January 1997 issue of Vegetarian Times, where Karen Cope Straus, Food Editor, offers a positive summary to vegetarian readers who might be contemplating Sears' pro-protein stance. Sears, like other protein-diet advocates, blames obesity on carbohydrate intake, which he claims causes insulin resistance.

Carbohydrates come in different shapes and sizes but all are starches. Some starches are simple, like the potato, but as a simple starch, it transforms directly into sugar in the blood stream and can cause problems for diabetics just like candy would. In a diet full of breads, pastas, potatoes and rice, there is actually a lot of sugar flooding into the bloostream contributing to a condition called "insulin resistance". According to Sears, when a high-carbohydrate meal or sugary beverage (alcohol included) is consumed, an exaggerated insulin response occurs that prevents the proper processing of the glucose so that it remains in the bloodstream and the insulin levels remain low. This condition causes the body to store more fat and prevents the release of previously stored fat. The glucose remains in the liver instead of feeding the brain. People who have this insulin response to high-carbohydrate meals are said to be predisposed to obesity and other serious health risks.

Sears claims that 25% of the population is not insulin resistant and can tolerate high levels of carbohydrates with no weight gain and no adverse health effects. He claims that another 25% is resistant, as in the case of those with diabetes. The remaining 50% fall somewhere between the two extremes. Heredity determines the level of insulin resistance in each person. Sears claims that the key to an optimal metabolism is more judicious use of carbohydrates. However, most low carbohydrate diets are also low calorie diets and it is no surprise that people lose weight when they reduce their calorie intake.

Particularly annoying for vegetarian readers is Sears' attack on the work of vegetarian physicians, particularly Dean Ornish. Sears recounts that patients on the Ornish heart disease reversal program experience a dramatic drop in cholesterol levels within weeks of being vegetarian but their triglyceride levels jump up and that sounds ominous, says Sears. What Sears doesn't add, according to vegetarian physician Mark Fromberg in British Columbia, is that these tryglicerides drop after a short time as well. Toronto Vegetarian Association has its share of members following the Ornish program and they can testify to its longterm benefits. While Sears' assumptions may be faulty, he does pose a valid question: Is there an optimal balance of low-carbohydrate/high protein foods versus low-protein/high carbohydrate foods in the diet? 

Listening to your body and monitoring the effects of dietary change are part of a healthful lifestyle

Although The Zone is not a weight-loss program, it may help explain why some vegetarians can eat liberally in all the food groups and remain slim, while other vegetarians who eat only low-fat foods seem to fight the battle of the bulge constantly. Certainly the factors contributing to a balanced metabolism are complex, exercise being one of the principle components. Anyone who starts to substitute more fresh fruits and vegetables for high-fat foods, will lose weight and reduce their risk of contracting a diet-related disease. However, for certain people, after 10 or 20 years on a diet which encourages regular intake of pasta, rice and other carbohydrates, their bodies may benefit from a different approach. Perhaps a shift to more concentrated vegetarian protein foods (tempeh, TVP and tofu) and higher doses of low-carbohydrate vegetables such as broccoli or cabbage (and almost anything green) is enough to make a difference?

We should remember that plant sugars, like cellulose, pectin, fructose and gums, are beneficial because they encourage the growth of good bacteria in the gut and provide a sticky surface on which cholesterol and other toxins are carried out of the body.

The hard part for vegetarians trying the Zone diet is eliminating most beans, nuts and nut butters, bread, bagels, muffins, potatoes and rice, limiting some fruits such as bananas, some juices and even some vegetables such as carrots. The Zone can be more easily adapted to lacto-ovo vegetarians who can use fat- and cholesterol-reduced dairy products in addition to tofu and TVP.

Sears also recommends dropping caffeine and limiting alcohol since both have dramatic consequences for insulin levels. That's about all he would have in common with John McDougall MD, a vegetarian advocate of rice and other complex carbohydrates as staples.

The emphasis on low carbohydrate foods also aligns with the recent research into ancient diets, which likely consisted of very few cooked or baked foods, little in the way of complex grains and no processed foods. Before the domestication of animals and horticulture, it is very likely that the human diet consisted of large quantities of low-carbohydrate plant materials such as leafy greens, root vegetables, some seeds, berries and small amounts of high protein items such as nuts, the occasional egg, insects or the results of a rare and risky hunt. In this scenario there is little room for excess protein but lots of room for exercise, sunlight and fresh air.

Looking back and looking forward, there are no easy answers. One thing is for sure though, increasing the quantity of green, leafy vegetables in the diet almost always has positive consequences. Listening to your body and monitoring the effects of a dietary change, especially going vegetarian, is part of maintaining a healthful lifestyle. Toronto Vegetarian Association is here to help everyone do just that!

From the March/April 1997 isssue of Lifelines

Dr. Attwood's four stage plan for adopting a low-fat healthy vegetarian diet works for kids and adults

According to Charles R. Attwood, MD, F.A.A.P., we can immunize our children against leading killers: heart disease, stroke, adult diabetes, hypertension, obesity, constipation and some 50 percent of all cancers.

Dr. Attwood is author of Dr. Attwood's Low Fat Prescription for Kids: A Pediatrician's Program of Preventive Nutrition (out of print), a book endorsed by medical and nutritional experts – including Benjamin Spock, Dean Ornish, T. Colin Campbell, Frank A. Oski, Neal D. Barnard and Suzanna Havala. In the book he states that it is as essential for children to eat a low-fat diet as it is for their parents. Dr. Attwood, who has one of the largest private pediatric practices in the US, based in Crowley, Louisiana, draws on his more than 30 years of experience in preventive nutrition and on numerous studies from around the world, which he cites in his book.

No bones about it, vegetarians can maintain healthy calcium stores on a dairy-free diet. Eating a calcium-rich, vegan diet just takes a little knowledge about calcium requirements, an understanding of calcium absorption, avoidance of calcium thieves and a bit of menu planning.

Iron is the most abundant mineral found in blood. The human body contains from 3.5 to 4.5 gm of iron, 2/3 of which is present in hemoglobin. The remainder is stored in the liver, spleen and bone marrow.

by Stephen Leckie

Over 1,000 people turned up for a special $100 a plate fund-raising dinner in honour of Dr. Dean Ornish held at The Westin Harbour Castle Hotel on May 27, 1995. The audience which included many health professionals was as far from new age as you can get, yet they were there to hear the man credited with proving scientifically that heart disease can be reversed by using a low fat vegetarian diet, stress reduction techniques, moderate exercise and no smoking. Ornish's books include Reversing Heart Disease and Eat More, Weigh Less. 

The ultra low fat approach

A low fat vegetarian diet is probably the most important aspect of Ornish's program and is certainly the most scientifically proven. According to Ornish, vegetarian foods have several health promoting advantages - they contain no cholesterol, are low in saturated fats, high in fibre (which animal foods lack), and are high in antioxidants such as beta carotene which naturally protects against cancer and cholesterol build up. Meats are high in oxidants (such as iron) which he said turns cholesterol into a more dangerous form.

Most people in Canada eat a diet containing 40% fat. The major health associations and government bodies recommend eating only 30% fat. Ornish found that 10% fat was the optimum amount for reversing heart disease. Control patients in his studies that were put on 30% fat diets got "worse, albeit more slowly, over time".

He made it clear that it is important to give people the freedom to reach their own conclusions. "People want to be in control". Ornish never tells patients that they must adopt a vegetarian diet. Instead he gives them the facts and tells them to only change if they want to.

Why diets don't work

According to Ornish, virtually all weight loss programs are based on deprivation of total calories, and studies have shown that 97% of followers gain all the weight they lost within five years. The typical response to these studies has been one of nihilism – "why bother dieting, be fat and happy." Yet no one is denying that obesity is a major health problem in North America, one that can lead to severe illness and premature death. Ornish brought out his second book, Eat More, Weigh Less to demonstrate that losing weight can be both permanent and enjoyable. The book is half information and half gourmet recipes.

Ornish encourages his patients to eat as much low-fat vegetarian food as they want and has found that most lose all their excess weight. One word of caution, simple carbohydrates such as sugar, alcohol and to a certain extent white flour can lead to swings in insulin production and increased weight gain. Ornish stressed the importance of eating complex carbohydrates (eg. whole grains).

Soul searching

Although more difficult to pin down scientifically, Ornish put a lot of emphasis on stress reduction through finding inner peace and social connections. He reminded us of social networks that were commonplace only a few decades ago – such as being part of an extended family, being at the same job for over 10 years, knowing your neighbours, being part of a church, temple or club. These radical shifts in society have lead to severe loneliness and alienation. People don't care about living longer, they just want to get through the day and they use alcohol, cigarettes, fatty food and overwork to fill the void. He underlined the seriousness of this with a study that found that people who are socially isolated (i.e.. who have no close friends) are four times more likely of die from all causes.

Ornish spoke of the importance of intimacy for healing, "everyone can benefit from being touched and held." Meditation, yoga, and Tai Chi were recommended as ways to find inner peace and concentration. Ornish also mentioned the joy of making simple ordinary tasks an exercise of awareness and conscious movement - a dance of life.

“Everyone can benefit from being touched and held."

The most common criticism of Ornish's approach has been the radical change in lifestyle required. He responds to this by pointing out that most people aren't afraid to make major lifestyle changes. "Look at the consequences of the decision to have children", he said. In the case of the reversing heart disease program, major change leads to a major improvement in health, energy and spirit. Ornish has found that once properly informed, people will overcome lifelong bad habits and make major changes gladly. "At the very least", he said, "heart disease patients should be told of powerful possibilities of this approach instead of just assuming that they will be unable and unwilling to eat less than 30% fat diets." 

Ornish says the big benefit for following the program is the 'here and now' feeling of having more energy and clarity. He became vegetarian himself at age 19 for this very reason. According to Ornish, the idea of living longer doesn't actually appeal to most people because no one spends much time thinking about their own death, or their current day-to-day existence is so hard that the thought of living several more years is far from being a motivating factor for change.

Overall, the evening was pure magic. I don't know if it was Dean Ornish himself, a doctor with impeccable medical and scientific backing, recommending a vegetarian diet and spiritual healing, or if it was partaking in what was likely the largest gourmet vegetarian meal ever served in Toronto, or seeing conservative medical professionals swinging their arms in the air and shaking their hips to the aerobic demonstration during the break, but I had the distinct feeling that a revolution was brewing – a paradigm shift of epic proportions.