The Basic Care & Feeding of Homo Sapiens: Are We TRULY Clueless? David L. Katz, MD, MPH, FACPM, FACP, FACLM Director, Prevention Research Center Yale University / Griffin Hospital Immediate Past-President, American College of Lifestyle Medicine Founder, The True Health Initiative
UMN Minneapolis, MN 6-1-17 The Blind Men and the Elephant -John Godfrey Saxe
On the menu
Elephant Bits The Dark Wood Archimedes Lever(s) A Fork in the Road Choices The Big Spoon Voices A Fork in the Road, Revisited
Elephant Bounds Death, in the dark wood McGinnis JM, Foege WH. Actual causes of death in the United States. JAMA. 1993;270:2207-12
Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. JAMA. 2004;291:1238-45 The People in Potsdam
Ford ES, Bergmann MM, Krger J, Schienkiewitz A, Weikert C, Boeing H. Healthy living is the best revenge: findings from the European Prospective Investigation Into Cancer and Nutrition-Potsdam study. Arch Intern Med. 2009 Aug 10;169(15):1355-62 Or the UK:
Kvaavik E, Batty GD, Ursin G, Huxley R, Gale CR. Influence of individual and combined health behaviors on total and cause-specific mortality in men and women: the United Kingdom health and lifestyle survey. Arch Intern Med. 2010;170:711-8 Or the US
McCullough ML, Patel AV, Kushi LH, Patel R, Willett WC, Doyle C, Thun MJ, Gapstur SM. Following cancer prevention guidelines reduces risk of cancer, cardiovascular disease, and all-cause mortality. Cancer Epidemiol Biomarkers Prev. 2011;20:1089-97 Fresher still? The beat goes on Akesson A, Larsson SC, Discacciati A, Wolk A. Low-Risk Diet
and Lifestyle Habits in the Primary Prevention of Myocardial Infarction in Men: A Population-Based Prospective Cohort Study. J Am Coll Cardiol. 2014 Sep 30;64(13):1299-306 Aleksandrova K, et al. Combined impact of healthy lifestyle
factors on colorectal cancer: a large European cohort study. BMC Med. 2014 Oct 10;12(1):168. [Epub ahead of print] Chomistek AK, Chiuve SE, Eliassen AH, Mukamal KJ, Willett WC, Rimm EB. Healthy lifestyle in the primordial prevention of cardiovascular disease among young women. J Am Coll Cardiol. 2015 Jan 6;65(1):43-51
rePercussions to our pith and marrow; the case for nurturing nature: Ornish D, Magbanua MJ, Weidner G, Weinberg V, Kemp C, Green C, Mattie MD,
Marlin R, Simko J, Shinohara K, Haqq CM, Carroll PR. Changes in prostate gene expression in men undergoing an intensive nutrition and lifestyle intervention. Proc Natl Acad Sci U S A. 2008 Jun 17;105(24):8369-74
Hietaniemi M, Jokela M, Rantala M, Ukkola O, Vuoristo JT, Ilves M, Rys J, Kesniemi Y. The effect of a short-term hypocaloric diet on liver gene expression and metabolic risk factors in obese women. Nutr Metab Cardiovasc Dis. 2009 Mar;19(3):177-83 Freedland SJ, Aronson WJ. Dietary intervention strategies to modulate prostate cancer risk and prognosis. Curr Opin Urol. 2009 May;19(3):263-7 Ujvari U, Hulchiy M, Calaby A, Nybacka , Bystrm B, Hirschberg AL. Lifestyle intervention upregulates gene and protein levels of molecules involved in insulin signaling in the endometrium of overweight/obese women with polycystic ovary syndrome. Hum Reprod. 2014 Jul;29(7):1526-35 Ornish D, Lin J, Chan JM, Epel E, Kemp C, Weidner
G, Marlin R, Frenda SJ, Magbanua MJ, Daubenmier J, Estay I, Hills NK, Chainani-Wu N, Carroll PR, Blackburn EH. Effect of comprehensive lifestyle changes on telomerase activity and telomere length in men with biopsy-proven low-risk prostate cancer: 5-year follow-up of a descriptive pilot study. Lancet Oncol. 2013 Oct;14(11):1112-20
The epigenetic power of lifestyle Khera AV, Emdin CA, Drake I, Natarajan P, Bick AG, Cook NR, Chasman DI, Baber U, Mehran R, Rader DJ, Fuster V, Boerwinkle E, Melander O, Orho-Melander M, Ridker PM, Kathiresan S. Genetic Risk, Adherence to a Healthy Lifestyle, and Coronary
Disease. N Engl J Med. 2016 Dec 15;375(24):2349-2358 The Master Levers of Destiny Feet Forks
Fingers But. Lost in translation
Knowledge, alas, isnt power Katz DL. Life and death, knowledge and power:
why knowing what matters isnt what's the matter. Arch Intern Med. 2009 Aug 10;169(15):1362-3 The Problem- When clear where there is(Can We Say What Diet Is "Best"? David L. Katz; Huffington Post, 9/7/11: http://www.huffingtonpost.com/david-katz-md/bestdiets_b_950672.html) -it may still seem
you cant get there from here: & the other problem: Is it clear where there
is? Health Diet/Nutrition Low-Carb Diet Beats Low-Fat for Weight Loss Fingers Forks... Feet
Mandy Oaklander @mandyoaklander Sept. 1, 2014 W T F ?!? to about Birds (Katz?) eye view
Katz DL et al. Can we say what diet is best for health? Annu Rev Public Health. 2014 Mar 18; 35:83-103 Science Compared Every Diet, and the Winner Is Real Food
Researchers asked if one diet could be crowned best in terms of health outcomes. If diet is a set of rigid principles, the answer is a decisive no. In terms of broader guidelines, it's a decisive yes. James Hamblin Mar 24 2014, 1:14 PM ET
Katz DL et al. Nutrition in Clinical Practice, 3rd Edition. Wolters Kluwer/Lippincott Williams & Wilkins. September, 2014 Other eyes, on the same prize - D. Dietary and Policy Priorities for Mozaffarian
Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review. Circulation. 2016 Jan 12;133(2):187-225 Mann J et al. Low carbohydrate diets: going against the grain. Lancet. 2014 Oct 25:384;1479-80
Ley SH, Hamdy O, Mohan V, Hu FB. Prevention and management of type 2 diabetes: dietary components and nutritional strategies. Lancet. 2014 Jun 7;383:19992007 Katz DL, Hu F. Knowing what to eat, refusing to
swallow it. Huffington Post. 7/2/14 Low GL Low fat vegan DPP Low Carb
Paleo Mediterranean DASH Eat food, not too much, mostly plants. -Michael Pollan Much
thebedrock same, in And the of 572 common pages ground Scientific Report of the 2015
Dietary Guidelines Advisory Committee http://www.health.gov/dietaryguidelines/2015scientific-report/ http://oldwayspt.org/programs/oldways-common-ground/oldways-common-groundconsensus Leaving only pseudocontroversies
Journal of the American College of Cardiology Volume 69, Issue 9, March 2017> DOI: 10.1016/j.jacc.2016.10.086 PDF Article Trending Cardiovascular Nutrition Controversies
Andrew M. Freeman, Pamela B. Morris, Neal Barnard, Caldwell B. Esselstyn, Emilio Ros, Arthur Agatston, Stephen Devries, James OKeefe, Michael Miller, Dean Ornish, Kim Williams, Penny Kris-Etherton And the very key components wed
expect Micha R, Pealvo JL, Cudhea F, Imamura F, Rehm CD, Mozaffarian D. Association Between Dietary Factors and Mortality From Heart Disease, Stroke, and Type 2 Diabetes in the United States. JAMA. 2017 Mar 7;317(9):912-924
1) eat less highly processed foods, and especially less processed
meat 2) eat less fast food 3) drink less soda 4) eat more nuts and seeds 5) eat more vegetables 6) eat more fruits 7) eat fish and seafood in the place of other meats Reaffirmed
Schwingshackl L, Schwedhelm C, Hoffmann G, Lampousi AM, Knppel S, Iqbal K, Bechthold A, Schlesinger S, Boeing H. Food groups and risk of allcause mortality: a systematic review and meta-analysis of prospective studies. Am J Clin Nutr. 2017 Apr 26. pii: ajcn153148. doi:
10.3945/ajcn.117.153148. [Epub ahead of print] Yet, we wind up here Less pepperoni, more_____? Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Metaanalysis of prospective cohort studies evaluating
the association of saturated fat with cardiovascular disease. Am J Clin Nutr. 2010 Mar;91(3):535-46 Chowdhury R, Warnakula S, Kunutsor S, Crowe F, Ward HA, Johnson L, Franco OH, Butterworth AS, Forouhi NG, Thompson SG, Khaw KT, Mozaffarian D, Danesh J, DiAngelantonio E. Association of dietary, circulating,
and supplement fatty acids with coronary risk: a systematic review and meta-analysis. Ann Intern Med. 2014 Mar 18;160(6):398-406 Li Y, Hruby A, Bernstein AM, Ley SH, Wang DD, Chiuve SE, Sampson L, Rexrode KM, Rimm EB, Willett WC, Hu FB. Saturated Fats Compared With Unsaturated Fats and Sources of
Carbohydrates in Relation to Risk of Coronary Heart Disease: A Prospective Cohort Study. J Am Coll Cardiol. 2015 Oct 6;66(14):1538-48 And, by the way Dietary Guidelines1980!
http://www.vox.com/2016/5/18/11704458/ american-diet-changes The Extraordinary Science of Addictive Junk Food - By MICHAEL MOSSFEB. 20, 2013 We are constitutional omnivores, and so
we have CHOICES - We have choices for fat - Wang DD, Li Y, Chiuve SE, Stampfer MJ, Manson JE, Rimm EB, Willett WC,
Hu FB. Association of Specific Dietary Fats With Total and CauseSpecific Mortality. JAMA Intern Med. 2016 Aug 1;176(8):1134-45 Mediterranean diets EPIC hits:Trichopoulou A, Bamia C, Trichopoulos D. Anatomy of health effects of Mediterranean diet: Greek EPIC prospective cohort
study. BMJ. 2009 Jun 23;338:b2337. doi: 10.1136/bmj.b2337 high consumption of vegetables, fruits and nuts, olive oil, and legumes moderate consumption of ethanol
low consumption of meat and meat products Minimal contributions were found for cereals and dairy products (heterogeneity) fish and seafood (low consumption)
We have choices for protein - Song M, Fung TT, Hu FB, Willett WC, Longo VD, Chan AT, Giovannucci EL. Association of Animal and Plant Protein Intake With All-Cause and
Cause-Specific Mortality. JAMA Intern Med. 2016 Aug 1. doi: 10.1001/jamainternmed.2016.4182. [Epub ahead of print] Substitution of Protein Sources (1 sv/day) and Risk of CHD in NHS, 1980-2006 (3162 cases) 9.202
(Bernstein et al. 2010) We have choices for water preservation Your Contribution to the California Drought
By LARRY BUCHANAN, JOSH KELLER, and HAEYOUN PARK Photos and video by TONY CENICOLA and DAVE FRANK May 21, 2015
We have choices for the climate Meat is a complex health issue but a simple climate one: the world needs to eat less of it July 5, 2015 4.18pm EDT
We have choices for biodiversity Machovina B, Feeley KJ, Ripple WJ. Biodiversity conservation: The key is reducing meat consumption. Sci Total Environ. 2015 Dec
1;536:419-31 We have choices for the economy
From public to planetary health: a manifesto http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736%2814%2960409-8.pdf Springmann M, Godfray HC, Rayner M, Scarborough P. Analysis and valuation of the health and climate change cobenefits of dietary change. Proc Natl Acad Sci U S A. 2016 Mar 21. pii: 201523119. [Epub ahead of
print] We have choices, and yet Blanck HM, Gillespie C, Kimmons JE, Seymour JD, Serdula MK. Trends in
fruit and vegetable consumption among U.S. men and women, 1994-2005. Prev Chronic Dis. 2008 Apr;5(2):A35. Epub 2008 Mar 15 Kimmons J, Gillespie C, Seymour J, Serdula M, Blanck HM. Fruit and vegetablei ntake among adolescents and adults in the United States: percentage meeting individualized recommendations. Medscape J Med. 2009;11(1):26. Epub 2009 Jan 26
Katz DL. Plant foods in the American diet? As we sow... Medscape J Med.2009;11(1):25. Epub 2009 Jan 26 EVEN when clear where there is(Can We Say What Diet Is "Best"? David L. Katz; Huffington Post, 9/7/11: http://www.huffingtonpost.com/david-katz-md/bestdiets_b_950672.html) -it may seem
you cant get there from here: The big spoon is culture.
Katz DL. Is obesity cultural? US News & World Report, Eat + Run Blog; 10/4/12; http://health.usnews.com/health-news/blog s/eat-run/2012/10/04/is-obesity-cultural From - Lifestyle Medicine
is CULTURAL Medicine To the Amazon Amazon men in their 80s have the arteries of Americans in their 50s
Lancet study shows diet low on processed carbs, sugar, cholesterol, while active living boosts heart health By Amina Zafar, CBC News Posted: Mar 17, 2017 12:24 PM ET Last Updated: Mar 19, 2017 10:20 AM ET
Coronary atherosclerosis in indigenous South American Tsimane: a cross-sectional cohort study. Lancet; Published: 17 March 2017 The Finnish Town That Went on a Diet - http://www.theatlantic.com/health/archive/ 2015/04/finlands-radical-heart-healthtransformation/389766/ Jousilahti P, Laatikainen T, Peltonen M, Borodulin K, Mnnist S, Jula A, Salomaa V, Harald K,
Puska P, Vartiainen E. Primary prevention and risk factor reduction in coronary heart disease mortality among working aged men and women in eastern Finland over 40 years: population Be part of the global movement! Join us at Thank you! It's not what we don't
know about diet that David most L. Katz, MD, MPH, FACPM, FACP, FACLM threatens our Director, Yale Prevention Research Center Founder, True Health
Initiative health; it's the 130 Division St. wild constant, Derby, CT 06418 (203) 732-1265 misrepresentations
of [email protected] what we do know. www.davidkatzmd.com
