The Proof with Simon Hill
Eating for Cardiovascular, Metabolic, and Gut Health | Highlights of 2023 (Part 1 )
Podcast summary created with Snipd AI
Quick takeaways
- The quality of fat consumed, rather than total fat intake, is crucial for health.
- Omega-3 fatty acids, particularly DHA, play a significant role in brain health.
- A healthy dietary pattern is key for brain health, including unprocessed foods and limiting ultra-processed foods.
- Changing nutrition beliefs and recommendations can be challenging, even with strong evidence.
- Plant-based diets have been associated with a reduced risk of developing cancer overall and specific types of cancer.
Deep dives
Importance of Dietary Fat Type
The type of fat in the diet is crucial for health. Total fat intake itself is not associated with adverse effects, but the quality of fat matters. Trans fat, found in processed foods, is the most harmful, increasing LDL cholesterol, reducing HDL cholesterol, and promoting inflammation and insulin resistance. On the other hand, polyunsaturated fats, such as those in plant oils, are highly beneficial, reducing LDL cholesterol, inflammation, and insulin resistance. Mono-unsaturated fats from plant oils also show benefit, while those from animal sources do not. The increase in polyunsaturated fats and the switch to healthier fats may have played a significant role in the decline of heart disease.
Omega-3 Fatty Acids and Brain Health
Omega-3 fatty acids, particularly DHA, play a crucial role in brain health. DHA constitutes a significant portion of the brain, and its adequate supply is essential for brain function and development. While the evidence for the cognitive benefits of omega-3 supplementation in midlife is limited, in older adults and pre-dementia patients, higher doses of omega-3 fatty acids have shown positive effects on cognition. A personalized approach, considering factors like ApoE4 status and the individual's ability to convert alpha-linolenic acid (ALA) to DHA, may be necessary. Ensuring optimal levels of DHA, either from dietary sources or supplementation, becomes crucial, especially when fatty fish intake is low.
Understanding Dietary Patterns for Brain Health
A healthy dietary pattern is key for brain health. It should include unprocessed or lightly processed foods, fruits, vegetables, whole grains, legumes, nuts, and seeds, while limiting ultra-processed foods, added sugars, refined carbohydrates, and alcohol. Maintaining cardiovascular health markers like blood pressure, LDL cholesterol, glucose metabolism, vitamin levels (B12 and D), and avoiding high-risk factors like smoking or excessive alcohol intake are also important for brain health. Monitoring and personalizing nutritional recommendations based on an individual's metabolic characteristics, such as omega-3 metabolism efficiency or genetic factors, may further optimize brain health.
Importance of Type of Fat in Health
The type of fat consumed has a significant impact on health. Partial hydrogenation, which has been outlawed in many countries, is detrimental to health. Polyunsaturated fats, like omega-3 and omega-6, are considered beneficial for health. The belief that low-fat diets are optimal for cardiovascular health is slowly changing, as evidence shows the importance of the quality of fat rather than the total fat intake.
Challenges in Changing Nutrition Beliefs
Changing nutrition beliefs and recommendations can be challenging, even in the face of strong evidence. The push for low-fat, high-carbohydrate diets took time to change, despite emerging evidence. One reason for slow changes in beliefs is the difficulty humans have in changing their established beliefs. However, with advancements in research and availability of information, evidence-based changes in dietary guidelines are becoming more accessible to clinicians and the public.
The Role of Lipids in Atherosclerosis
Lipids play a vital role in the development of atherosclerosis, the buildup of fatty plaque in the artery walls. Lipoproteins, such as LDL and HDL, transport lipids in the bloodstream. Elevated levels of LDL cholesterol and low levels of HDL cholesterol are known risk factors for atherosclerosis. The measurement of Apo B, a protein found on LDL particles, is considered more accurate in determining cardiovascular risk than LDL cholesterol levels. Triglycerides and non-HDL cholesterol are also important markers in assessing lipid-related cardiovascular risk.
The importance of glucose metabolism and the role of mitochondria
Glucose metabolism and metabolic health extend beyond the ability to get glucose from circulation into the muscle cell. The focus should also be on how glucose is metabolized within the cell, which is strongly linked to the function and health of mitochondria. If glucose is not metabolized properly within mitochondria, it can lead to metabolic challenges and conditions like hyperglycemia, insulin resistance, and an increase in fat deposits in the muscles. Ultimately, the dysfunction of mitochondria plays a critical role in the connection between cardiovascular disease and type 2 diabetes.
The twin cycle hypothesis and the underlying cause of type 2 diabetes
The twin cycle hypothesis provides a comprehensive explanation for the development of type 2 diabetes. It suggests that excess food intake over time leads to the accumulation of fat in the liver, causing the liver to become resistant to insulin and resulting in excess glucose production. This excess glucose is then turned into fat, leading to a cycle of increased glucose and fat production. Additionally, fat accumulation in the pancreas impairs insulin-producing cells, further contributing to elevated glucose levels. Understanding this single cause and the related metabolic cycles is crucial for addressing and potentially reversing type 2 diabetes through weight loss and the reduction of fat deposits in organs.
The Benefits of Plant-Based Diets in Cancer Prevention
Plant-based diets have been associated with a reduced risk of developing cancer overall, as well as specific types of cancer, according to large population studies from the USA, UK, and France. This is primarily attributed to the increased fiber content of plant-based diets, which can reduce intestinal transit time and increase butyrate levels in the stool, providing anti-cancer and anti-inflammatory properties. Additionally, plant-based diets have been found to affect diabetes and cardiovascular disease, indirectly improving cancer treatment outcomes. Therefore, it is recommended that individuals aim to obtain 80-90% of their calories from unprocessed plant foods to support overall health and potentially reduce cancer risk.
The Role of Nutrition in Cancer Treatment
During cancer treatment, there is an increased need for calories and protein to support the body's recovery and tolerance to treatments, particularly chemotherapy. Adequate nutrition, mainly focused on obtaining sufficient calories and protein, is crucial to prevent muscle loss, improve quality of life, and optimize treatment outcomes. While plant-based diets are preferred for their potential anti-cancer effects, the priority during treatment is to meet calorie and protein requirements, regardless of the diet followed. However, long-term restriction of fiber consumption or extreme diets like a ketogenic diet may not be beneficial, as they can lead to suboptimal nutrition and potential negative impacts on the microbiome and overall health.
Episode #294. Hit the ground running in 2024 by pressing play on this must-listen episode. Hear the most valuable insights from 19 guests of The Proof, all packed into one episode that brings you the best of each one. 2023 was absolutely loaded with expert advice from some of the best researchers and practitioners in the world, and this episode combines many of them to bring you a powerful tool to have in your arsenal.
This episode will take you on a curated journey through 2023’s most important moments, including the must-knows about nutrition, fats, cardiovascular health, metabolic health, cancer and nutrition, and gut health.
You’ll hear from: Dr Alan Flanagan, Dr Ayesha Sherzai, Dr Christopher Gardner, Dr Dena Sherzai, Dr Gil Carvalho, Dr Inigo San Millan, Dr Joel Fuhrman, Dr Krystle Zuniga, Dr Matthew Nagra, Dr Mohammed Alo, Dr Neil Iyengar, Dr Philip Calder, Dr Roy Taylor, Dr Stephan Guyenet, Dr Suzanne Devkota, Dr Thomas Dayspring, Dr Urvi Shah, Dr Walter Willet, and Dr Will Bulsiewicz.
We discuss:
- Intro (00:00)
- The dangers of misinformation (01:30)
- Which Foods Should You Eat to Stay Healthy? (05:17)
- Does the Quality of Foods Matter? (07:38)
- The Impact of the Average American Diet on Health (09:28)
- Do We Have Sufficient Evidence on How Nutrition Impacts Our Health? (12:04)
- How different diets measure up to health guidelines (15:11)
- Practical insights for doctors and patients (23:08)
- Saturated fat misunderstandings: Is saturated fat bad? (25:32)
- Understanding Essential Fats: Why are They Vital? (30:18)
- Low Conversion Rates: From ALA to EPA & DHA Explained (34:29)
- The Importance of Monitoring Omega 6 Intake (39:52)
- Keeping the brain healthy with omega 3 fatty acids (43:45)
- Biochemical Analysis in Three Cohort Observations of Walter Willet's Studies (56:54)
- Are Low-Fat Diets Good for Cardiovascular Health? (01:02:12)
- Polyunsaturated Fats and Cardiovascular Disease (01:04:14)
- Benefits of Switching from Saturated Fat to Unsaturated Fats (01:09:51)
- Which popular diets are truly heart-healthy? (01:10:23)
- Atherosclerosis and the role of lipids (01:18:22)
- The tests helpful in predicting cardiovascular disease risk (01:31:24)
- Cardiac Imaging: Understanding Imaging Tests (01:43:34)
- Can we take drugs that raise HDL to lower cardiovascular disease risk? (01:52:17)
- Metabolic Health, Mitochondria, and Nutrition (02:00:37)
- Twin cycle hypothesis (02:07:17)
- Linking Non-Alcoholic Fatty Liver Disease with Type 2 Diabetes (02:18:56)
- How Weight Reduction Can Be Revolutionary in Reversing Diabetes (02:31:36)
- Main drivers of type 2 diabetes (02:38:56)
- The role of nutrition in cancer treatment (02:45:56)
- Plant-based diet vs ketogenic diet (02:50:12)
- Can food act as medicine? (02:55:54)\
- Nutrition priorities during cancer treatment (03:05:36)
- Dietary patterns and FODMAP intolerance (03:08:33)
- Effects of antibiotics to gut the microbiome (03:16:41)
- Analysing Kevin Hall's Research: Plant-Based Diet vs. Alternative Diets (03:23:37)
- Outro (03:33:38)
To connect with this episode’s featured guests, head to the full show notes. Make sure to keep an eye out for part two of this series.
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