Words by Dr Malcolm Mackay, Jenny Cameron and Dr Heleen Roex.
From September 22-25, one of the world's leading medical conferences on plant-based nutrition took place in Oakland, California: The Seventh International Plant-Based Nutrition Healthcare Conference (PBNHC).
Several of the Doctors For Nutrition team attended, including Dr Heleen Roex, Dr Juliette Roex, Dr Andrew Davies, Peter Johnston PhD, Dr Malcolm Mackay and Jenny Cameron, as well as international Advisory Council members Dr Scott Stoll (co-founder of the PBNHC) and Dr Neal Barnard.
It was DFN co-founder Dr Heleen Roex’s seventh year of attending the conference. She recommends it unreservedly: “the speakers, the topics, the science, the organisation, and not unimportantly the exceptional whole food plant-based catering covering all meals across the four days.”
It was also Dr Malcolm Mackay's seventh year at the conference. Malcolm says attending this conference every year is invaluable to his medical practice and his role in providing plant-based nutrition education. It’s not just the great information from the conference presenters, it’s also the sharing of ideas and experience with other delegates who are bringing nutrition into healthcare.
“Every year I return from this conference with a renewed passion to work harder and smarter to empower people to transform their health with whole food plant-based nutrition”.
It is a tough job narrowing down the highlights, but here are key takeaways from some of the most outstanding sessions.
The Power of the Plate: The Science of Regeneration and Sustainability – Dr Scott Stoll
Dr Stoll opened the event with a presentation describing how everything is interconnected between humans, animals and plants. Our food choices have a huge impact on health and beyond. We know that moving away from animal agriculture will have a huge benefit for our environment. Restoring soil quality should also be a priority to optimise the nutrition contained in food. Dr Stoll explained how we should aim to achieve the levels of healthy microorganisms and nutrients that once were seen decades ago, before the widespread use of pesticides and herbicides.
Cardiovascular Disease Prevention and Reversal: The Esselstyn Program – Dr Caldwell Esselstyn and Ann Esselstyn
Key take home messages from this energetic pre-conference workshop were that patients need to understand the endothelium (the inner lining of our blood vessels) and nitric oxide (a powerful vasodilator formed from nitrates in certain foods). We should avoid eating anything that damages endothelial health, such as animal based foods and processed foods – including oil. The best foods for protecting and enhancing the endothelium are green leafy vegetables. For patients with heart disease, Dr Essylstyn recommends that eating green leafy vegetables, not drinking these, 6 times per day.
Further core principles of Esselsyn's nutrition are: no animal products; absolutely, definitely no oil; no caffeinated coffee; no sugar; low salt and no avocado or nuts apart from a small quantity of flaxseed meal or chia seeds. The foods to include are grains, legumes, vegetables and fruit. He only recommends restricting fruit when triglycerides are elevated. In Dr Esselstyn's experience if patients adhere perfectly to his diet their heart disease goes into long term remission even if their LDL cholesterol does not reach the 'heart attack proof' target of less than 2.0mmol/L. An antioxidant rich whole food plant-based diet reduces the stickiness of the blood and stabilises plaque so that patients may not need to continue taking aspirin after a year or so on the program.
The Hidden Connections: Tendon Health and Nutrition – Dr Jimmy Conway
When Jimmy suffered a heart attack nearly a decade ago and discovered Esselstyn's Prevent and Reverse Heart Disease book, he turned his life around with a whole food plant-based diet. Not only did he reverse his own heart disease, but he also experienced pain relief from old sporting injuries. This led him to dive deep into the scientific literature to see if there was a link between tendon pain and nutrition. What he found led him to conclude that rotator cuff tears are the equivalent of a heart attack of the shoulder. The same risk factors for heart disease apply to rotator cuff tears. As with heart disease there are multiple mechanisms through which nutrition can damage or enhance tissues. e.g. Advanced Glycation End products (AGEs - from meat and processed foods) are toxic to rotator cuff tendon cells. He talked about the mechanisms of injury and repair and found nitric oxide to be important for tendon healing. Just like Dr Esselstyn recommends for reversing heart disease, nitrate rich foods are important for recovery from injury. Healthy blood vessels means healthy tendons and a healthy heart.
Plant-Based vs. Omnivore For Gut Health: The effect of a low-FODMAP diet on the microbiome when treating SIBO/IBS – Dr Angie Sadeghi
The lecture on gut microbiome and small intestine bacterial overgrowth/irritable bowel syndrome (SIBO/IBS) was of particular interest to DFN Ambassador Dr Malcolm Mackay, as he frequently sees patients with bloating and other gut symptoms. We learnt that fibre is an essential macronutrient for the gut and that high fat diets adversely alter the gut microbiome leading to damage to the gut barrier and inflammation. Fibre and carbohydrates support a community of good gut microbes that produce health supporting short chain fatty acids.
The first step in treating SIBO is to stop all dairy foods and investigate for the underlying causes such as coeliac disease or hypothyroidism. Low FODMAP diets are a band aid solution and restrict the very foods that support a diverse gut microbiome – these diets were never intended to be long term. Dr Sadeghi recommends first eliminating animal products, alcohol, sugar, refined oil and environmental toxins. She then uses a ‘reverse elimination diet’, adding back a diversity of whole plant foods, starting with those that are least likely to cause symptoms – starchy fruits and vegetables (e.g. bananas, plantains, root vegetables, squash). All food is either cooked or frozen first (freezing breaks up the fibre) even if it is to be blended into a soup or a smoothie. People switching from a standard American diet (SAD) diet can expect rapid improvements but progress can be slow for people who have lost microbial diversity by following restrictive diets for long periods of time.
Overcoming Insulin Resistance: Keys to Restoring Insulin Sensitivity – Cyrus Khambatta PhD
Dr Khabata’s expertise in diabetes comes from his experience as both a patient and a practitioner. After being diagnosed with type 1 diabetes, he went on to earn a PhD in Nutritional Biochemistry, which he now channels into helping thousands of people master their diabetes. His session described the steps in the development of insulin resistance, including the literature documenting the rise of insulin resistance in people living with type 1 diabetes. He explored the mechanisms by which dietary and lifestyle choices impact cellular insulin sensitivity, showing how a low fat whole food plant-based diet and exercise interventions can be used to reduce total insulin requirements and potential long term complications for people with a diagnosis of either type 1 or type 2 diabetes.
In the case of type 2 diabetes, Cyrus explained that a high fat diet is the cause of insulin resistance because fat deposits end up in places where they don’t belong, such as muscle, liver and pancreas cells. The high fat content in these cells lowers their sensitivity to insulin, known as insulin resistance. The cause of the disease is thus high dietary fat, not high blood sugar, which is a presenting symptom. A whole food plant-based diet will also benefit patients with type 1 diabetes in lowering their insulin requirements, although these patients will stay dependent on external administration of insulin, while many type 2 diabetes patients manage to come off their medications entirely. He noted that the effect of insulin resistance on type 1 and 1.5 diabetes is often not appreciated by health professionals when they recommend a high fat diet, explaining how people eating a ketogenic diet can give themselves 'double diabetes', i.e. the autoimmune form plus insulin resistance.
Nutrition, Cognition and Dementia – Drs Ayesha and Dean Sherzai
Husband and wife neurologists Dean and Ayesha Sherzai are co-directors of the Alzheimer’s Prevention Program at Loma Linda University Medical Center, which is situated in one of the Blue Zones of the world. ‘Team Sherzai’ as they are known, talked about dementia, highlighting the factors that increase risk and the healthy lifestyle behaviours that are protective, stating that nutrition is the most important factor in brain health. The process of dementia starts decades before it is diagnosed, and everything we do will move us towards or away from the precipice of dementia. For Alzheimer’s disease, prevention is the new treatment. Doctors For Nutrition are excited to host Team Sherzai at their 2nd International Australasian Nutrition in Healthcare Conference in February 2021.
Nutritional Foundations for Paediatric Populations: Growing Healthier Children – Dr Jackie Busse
Dr Andrew Davies described this session as “the single best plant-based talk I’ve ever heard - Jackie is full of knowledge and enthusiasm.” Paediatrician Dr Busse presented an evidence based case for how children thrive on a plant-based diet. Essentially, children are just small humans when it comes to their nutritional needs. However, they do need about 75% more calories per kilogram of weight for growth and to compensate for higher physical activity levels. This allows for a higher fat content of their diets compared to adults, which can easily be reached by adding in higher fat whole plant foods, such as avocados, nuts, seeds and soy products. One of the most common problems doctors see in children in the general population is constipation, which can be treated by adopting a naturally fibre-rich whole food plant-based diet.
2019 Plantrician Project Luminary Award Ceremony
Dr Neal Barnard MD, was honoured with this year’s prestigious Plantrician Project Luminary Award. Dr Stoll presented the award, describing Dr Barnard’s “invaluable scientific contribution through scholarly research; pioneering work in public policy that continues to shape numerous national initiatives and key legislative decisions; selfless leadership and compassionate service; and the creative development of practical resources that have transformed people around the world.” It was followed by an entertaining conversation between these two pioneering doctors on the topic of “What years of experience shows about the power of plants for human health.”
Doctors For Nutrition highly recommends this outstanding conference to all, whether you are a medical doctor, other healthcare professional, or just interested in the science of healthy nutrition. Visit the PBNHC website for the photo and video gallery, and upcoming announcements about the next conference.
About the authors
Dr Heleen Roex is Doctors For Nutrition's co-founder and Executive Director, Jenny Cameron is our Lead Research Advisor and Dr Malcolm Mackay is our GP Resources Advisor.
Read their full bios here.