Here is our story.

As a plant-based cardiologist at Montefiore Health System, I have had the privilege of seeing patients transform before my eyes; I’ve witnessed them evolve from illness toward health, from despair toward hope, mostly by changing what is at the end of their fork. The initial seed of change, however, may not immediately take root. Plant-based diets are uncommon in the community where I work, namely, the Bronx, New York. In fact, the Bronx is one of the least healthy inner cities in America, in part due to its limited access to healthier foods; however, Montefiore is working to change that.

When I mention a plant-based diet to some of my patients, they quite literally look at me like I am from Mars. They have never heard of such a thing, and the climb sometimes can be very steep. I have had patients chose not to pursue a plant-based diet for years, then something clicks and they suddenly decide to adopt it and come to their next visit twenty pounds lighter. That is always a great feeling, and these patients become some of the strongest advocates for plant-based nutrition.

These transformations take place in our outpatient clinic. However, sometimes we meet patients for the first time when they are admitted to the hospital. Many times this encounter occurs following a heart attack, an episode of heart failure, or some other urgent cardiac issue. These hospitalizations are great opportunities to teach people about ways by which they can become healthier. So, breaking from the usual mold, we decided to bring plant-based nutrition and education into the hospital.

We wanted to reinforce physician discussions with in-patients about plant-based vegan meals and offer in-patients the opportunity to watch Forks Over Knives in real-time, in the hospital. This combination is a win, win, win: the medical team highlights the importance of plant-based nutrition, the patient then tastes it, and the film powerfully reinforces the message.

So we did just that. After a successful collaboration with Montefiore’s Department of Food and Nutrition Services, we created plant-based vegan meals for in-patients that can now be ordered in five of our hospital locations. Simultaneously, Montefiore’s Department of Patient Education worked closely with the incredible team at Forks Over Knives, and now the Forks Over Knives film is available to play in those same five hospitals, in front of roughly 2,300 patient beds!

To my knowledge, Montefiore is the only hospital in the world to offer this combination of resources for patients. I hope many more will join in soon.

Now, when I visit my in-patients, I know that I have my plant-based posse with me. I discuss the diet with the patient (and perhaps their family), we order the patient plant-based meals (we call them “Heart Healthy Vegan” in our system), and I ask them all to watch the film (I even offer to turn it on before leaving the room!).

A strong seed has been planted, and the feedback has been great. In fact, we’ve even had patients watch the film before being seen by a physician, and then call the nurses’ station to ask if they could eat the “Forks Over Knives” way.

This great collaboration has made Mars seem a little less far away. Thank you, Forks Over Knives!

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Today we are learning more about the molecular pathways underlying aging and how the foods we eat can affect these pathways to slow down or speed up the clock. We do have an anti-aging secret, one that can keep us young inside and out, and it’s the best-kept one to date.

Telomeres, a Key Part of the Aging Process

Telomeres may be one key to the aging process. Telomeres protect our DNA by acting as buffers at the ends of chromosomes. They have been compared to the plastic caps on shoelaces that keep the lace from fraying. Telomeres function as shoelace caps do, but they protect genes instead of shoelaces. The average cell divides between 50 and 70 times before cell death. Each time the cell divides, the telomeres on the end of the chromosome get shorter. Studies have shown that people with long telomeres live longer and healthier lives than people with short telomeres.

Telomerase Keeps the Chromosomes from “Fraying”

The telomerase enzyme rebuilds telomeres and keeps DNA from fraying. In 2009, scientist Elizabeth Blackburn was awarded the Nobel Prize for her discovery of telomerase, found in the roots of bristlecone pines but also in humans. (The oldest living organism on Earth is a 5,000-year-old bristlecone pine tree in the White Mountains of California. Bristlecone pines not only live long but also age well.)

How Can We Increase Telomerase and Protect Telomeres?

Many studies have connected plant foods to longer telomeres and higher telomerase activity. In a study published in the European Journal of Nutrition, data from 3,660 U.S. adults looked at diets rich in carotenoids and telomere length. The study found that a carotenoid-rich diet was linked to longer telomeres. Carotenoids are the organic pigments responsible for the bright colors of many fruits and vegetables.

In 2008, Dr. Dean Ornish teamed up with Blackburn and found that just three months of eating a plant-based diet significantly boosted telomerase activity. In a 2013 follow-up study published in The Lancet Oncology, Ornish noted that telomere length had actually increased in the plant-based diet group. While the group eating plant foods also exercised and lost weight, other studies have shown that even more vigorous exercise and similar amounts of weight loss have not affected telomere length. And in a 2013 review, fiber (found exclusively in plant foods) was associated with longer telomeres. Plant foods are filled with antioxidants that can fight the oxidative stress responsible for telomere shrinking, preventing and even reversing cellular aging.

Enzyme TOR, an Anti-aging Mechanism

Another antiaging mechanism involves the enzyme TOR, which stands for “target of rapamycin.” Rapamycin was discovered in the 1970s in Easter Island in the southeast Pacific Ocean. It suppresses the immune system and is given to transplant patients to prevent the body from rejecting the new organs, but it also inhibits TOR, an engine of aging and age-related diseases. When TOR is activated, cells grow and divide; but when it’s turned down, cells go into conservation mode and clean up and recycle old proteins. TOR-driven aging is likened to an engine on a race car going at 100 mph without brakes. When we are young, the engine runs at full speed, pummeling through the roads and soaking up fuel as we grow into adults. It’s then time to slow down, yet our “cars” continue at 100 mph.

Why? It’s how we evolved. In the wild, most living organisms don’t live long enough to age and thus have no use for breaks. In 1600s London, 75 percent of people died before they reached age 26. We evolved mechanisms to make sure our bodies run at full speed so that reproduction happens before death. But problems arise when the car continues at full speed. TOR is involved in cancer, heart disease, diabetes, Alzheimer’s, and other diseases.

How Can We Slow Down TOR, the Engine of Aging?

Changing our diet may be the best way to slow TOR down. Rapamycin can inhibit TOR, but it comes with side effects since it suppresses the immune system, making people vulnerable to infections. Caloric restriction also inhibits TOR, but eating too few calories can leave you feeling weak and hungry and is difficult to sustain. Is there a better way? Yes. Increasing your intake of plant foods can help. Eating less animal protein has been shown to hamper TOR activity, mimicking the effects of caloric restriction without the side effects. A 2012 paper found that the amino acid leucine, mostly found in animal foods, has the greatest effect on TOR signaling compared to other proteins. On the other hand, fruits and vegetables have phytochemicals that function as natural TOR inhibitors. The cancer-protective effect of plant-based diets is thought to be in part due to TOR down-regulation.

Aging is complex. Aside from telomere dysfunction and TOR signaling, other molecular pathways as well as genetics can play a role. But the food you eat makes a big difference in the length and quality of your life by affecting some of these pathways. We’re also learning that food can change the expression of genes involved in aging. Luigi Fontana, director of the longevity research program at Washington University in St. Louis, said that about 25 percent of your risk of death is due to genetics. Of the remaining 75 percent, diet is likely the most important factor.

People in the “Blue Zones,” or the longest-lived populations in the modern world, are less likely to succumb to age-related diseases. They eat plant-centered diets. In Okinawa, Japan, one of the Blue Zones, plates carry indigenous vegetables like purple sweet potatoes and bitter cucumbers along with other fruits, vegetables, grains and legumes.

Medical, cosmetic, and technological advances have allowed people today to look younger and live longer, but most people are not living better. To that end, plant foods are the best answer yet.

The post Telomeres, the Key to Longevity, Show Food May Be the Best Anti-Aging Treatment appeared first on Forks Over Knives.

I first heard about the health benefits of a plant-based diet nearly 20 years ago when I arrived at Thompson Hospital in Canandaigua, NY, fresh out of a family medicine residency program. The head of radiology at the hospital was Dr. Ted Barnett, who was and still is a passionate advocate for healthy vegan diets. While reviewing an X-ray with him in his office one day, he regaled me with the wonders of veganism. I thought to myself that if eating this way really made such a huge difference to health, then surely I would have learned about it in medical school or residency. Since I hadn’t, I chalked Ted up as an animal rights nut job and ignored the whole thing for many years.

The Turning Point in My Own Life and Career

Then I watched the documentary Forks Over Knives in 2013 and wondered if maybe Ted had been right all along. Either the doctors in the film promoting a whole-food, plant-based diet were all quacks, or my training as a physician had left out the most important thing I needed to know! I spent the next three months researching plant-based diets and performing a “study of one” by personally adopting a whole food, plant-based diet.

My drastically improved health and my reading of the available data convinced me, beyond any shadow of a doubt, that a WFPB diet was better than any pill I’d ever prescribed. I was thrilled to have this incredible tool but more than a little angry that I hadn’t learned about this in my training. I paid a lot of money for that education, and couldn’t believe this lifesaving information was left out of the curriculum. My feelings of anger were rapidly followed by a feeling of horror as I realized that I had been practicing medicine all wrong for many years. I had been pushing pills and procedures instead of broccoli and beans. It felt like a punch to the stomach. Despite wanting nothing more than to help my patients get well, I had enabled many of them to stay sick.

Thinking back to my training, I can remember diet being briefly discussed, but it was usually in reference to diseases like kwashiorkor (a protein wasting disease from starvation) or scurvy (from inadequate vitamin C consumption). While I have yet to see either of these diseases, I see heart disease, diabetes, autoimmune disease, and cancer multiple times a day. I also remember hearing a little about the ADA diet for diabetics, but I was told that I didn’t need to know much since it was the dietitian’s job to discuss that with patients. Most doctors receive the same paltry dietary education that I did.

Physicians will often advise patients to follow the dietary guidelines put out by the USDA, which turns out to advocate much more for farmers and their profits than it does for human health. The dairy and meat industries are powerful influences on the guidelines while the kale lobby is, well, nonexistent. In addition, doctors are barraged by the same media as the general public, with its confusing frenzy of changing diet theories which are mostly put out to sell a book or a product. It is highly likely, therefore, that you (even if you are just starting your investigation of a whole food, plant-based diet) know more about the role of diet on health than your physician.

Why You Should Hug Your Doctor

While this is completely unacceptable, please don’t be too hard on your doctor. Very few doctors are in it for the money or status; most work long hours under difficult conditions because they really want to help people. They are doing their best with the education that they have received. So the next time you see your doctor, consider dropping off a copy of Forks Over Knives (along with a compassionate hug)! At some point your doctor is going to have to face the fact, just like I did, that much of the medical misery he’s spent his life patching up could have been prevented if he had told his patients how important a whole-food, plant-based diet is for health. And it will not be a good day for him.

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