Hello, Everybody! The sun is starting to shine more, the frosts are abating, and now seems like the perfect time to live a healthy lifestyle. We’re keeping things simple with this newsletter. We want to share with you a few simple things every month: an interesting study, a recipe we’ve made and liked, a place to go, and an activity to try. We’d love to hear your suggestions and questions. Study Let’s start with a classic, seminal paper. Intensive lifestyle changes for reversal of coronary heart disease, Ornish, et al. JAMA. 1998. This is the landmark, yet still widely unknown, analysis of the Lifestyle Heart Trial. 48 adult humans who all had heart disease were randomized into two groups. 20 people got the usual care (what a typical board-certified physician would have their patients do, plus education on healthy eating and exercise). Then, 28 people took part in a lifestyle intervention program that included a focus on a low fat (<10% fat) mostly plant-based diet (nonfat dairy and egg whites were allowed), exercise, smoking cessation, and stress mitigation with group support. By the time the end point of 5 years came around, only 35 patients were still enrolled, mainly because they initially signed up for a 1 year experiment and didn’t want to extend it to 5 years - additionally, they’d have to get an extra heart catheterization. Also, important to note is that the intervention group did not take lipid lowering drugs, while the control group did - except for a few. Limitations: The randomization was not perfect. This team randomized who would be invited to participate in the study. However, more people invited to be in the experimental group signed up than the control group. Not only that, but more women ended up in the control group - there were none in the experimental group. This means the intervention group had more men and was heavier. It also had people with more chest pain (angina) and a higher number of them had already had heart attacks (MIs) Also, although it wasn’t statistically significant, there were more unemployed people in the control group. Additionally, there isn’t a declaration of the number of smokers in each group - this is my biggest critique on the study. Looking at the balance of data from other studies, I don’t think this made the difference here, but we can’t say without that data. Overall, though, you might interpret this to mean the deck was stacked against the intervention group. However, on the other hand, it’s possible that because the interventional group was worse, they were more motivated to change their lives.
Findings At five years, the experimental group showed a mean relative reduction in stenoses of 7.9% (41.3 to 37.3 absolute % stenosis) while the control group showed a mean relative increase in stenoses of 27.7% (40.7 to 51.9 absolute % stenosis). This might not seem like a lot, but if you’ve ever used a straw then you know small changes in diameter make a big difference in flow. Try using different sized straws to drink something - do you notice a difference? Your heart does too. Check out this cool video for a demonstration https://www.youtube.com/watch?v=wn6eRMIOJ1k My takeaway: Changing your lifestyle can reverse your disease. Addressing multiple factors helps. Place to Go Blendon Woods Natural Play Area. This is a go to spot for my family. There are two classic playgrounds for kids nearby with swings and slides and such, but the natural play area is so much better. It’s actually just a bunch of fun stuff made from ropes and stumps to play on. There is nothing saying it’s just for kids, so this adult goes on all the “rides”.
Thing to Do Rope Swings at Blendon Woods Natural Play Area. Go past the rope walls, past the tree trunk see saw, past the zip line swing (yes they have a zip line! But it’s more for the kids), and you’ll find yourself walking to the top of a hill. There will be three trees, each with a long, thick, rope hanging down. They seem to have difficulty levels with each one being a different height off the ground. Whether you were born for the flying trapeze, or just want to avoid falling -- it’s a lot of fun! As you can see from the picture, we even got Zak to try it out.
Recipe Black Bean Burgers Based on the recipe by: Dr. Michael Greger & Robin Robertson from The How Not to Die Cookbook https://nutritionfacts.org/recipe/black-bean-burger/
1 cup old-fashioned rolled oats
1/2 cup walnut pieces
1 1/4 inch piece fresh turmeric (or ¼ teaspoon ground) grated
1/2 cup red onion chopped
1/3 cup mushrooms chopped
1/3 cup sundried tomato
1 1/2 cup cooked or 1 15-ounce BPA-free can or Tetra Pak salt-free black beans rinsed and drained
2 tablespoons tahini or almond butter
1 tablespoon ground flaxseeds
1 tablespoon nutritional yeast
1 tablespoon fresh parsley chopped
2 teaspoons white miso paste
1 teaspoon onion powder
1/2 teaspoon garlic powder
1/2 teaspoon smoked paprika
1 teaspoon partially dried basil
Preheat the oven to 375ºF.
Pulse the oats, walnuts, and turmeric in a food processor until they are finely ground. Add the onion, mushrooms, beans, tahini, and flaxseeds and pulse until well combined. Add the remaining ingredients and pulse to mix well.
Pinch some of the mixture between your thumb and index finger to test whether it holds together. If the mixture is too wet, add more oats. If the mixture is too dry, add a little water, 1 tablespoon at a time. Transfer the mixture to a work surface and divide into four equal portions. Shape each into a patty about ½-inch thick and transfer to a plate. Refrigerate for 30 minutes.
Line a baking sheet with a silicone mat or parchment paper and arrange the burgers on it. Bake until hot and lightly browned, turning once, about 25 minutes. Serve hot, as desired.
That’s it for this newsletter. I hope you enjoyed it. Let us know your suggestions at firstname.lastname@example.org
Also, if you are ready to start reclaiming your health. Now is a great time. Schedule an appointment with us- try a FREE Consult.
The future depends on what you do today. Take care out there, Sagar Doshi, MD FAAEM Dipl ACLM