#95: Dr. Alan Desmond - Top 10 Prescriptions for Better Health
If all health begins in the gut, then the United States needs a major overhaul.
One in three adults under the age of 50 have diverticular disease, colorectal cancer will affect more than one in 20 adults in their lifetimes, non-alcoholic fatty liver disease is off the charts, and millions of others suffer from irritable bowel syndrome and other inflammatory complications in our gut.
These are sobering facts, BUT you can do something about it and, today, with renowned Gastroenterologist Dr. Alan Desmond, we open up the prescription pad and give you real Doctor's orders - The Top 10 Prescriptions for Better Health - from Dr. Desmond's book, "The Plant-Based Diet Revolution: 28 Days to a Happier Gut and a Healthier You."
Unlike most prescriptions that simply treat the problem, these prescriptions get to the root cause and provide long-term solutions. The best part? They don’t involve taking more pills - just beautiful, nutritious, whole plant-based foods, the optimal diet for health and longevity.
Eat a diversity of plants (28:50)
Ditch the junk and ultra-processed food (30:25)
Eat whole grains every day (34:40)
Embrace whole carbohydrates - for fiber, fuel, and nutrients (39:30)
Choose your protein wisely - yes, you will get enough protein (43:23)
Take a B12 supplement (49:20)
Cut out the sweet stuff (50:28)
Remember, milk is for babies (57:46)
Get your sunshine, Vitamin D (1:01:00)
Get help if you need it (1:02:37)
We're so thrilled to have you along for this powerful plant-based diet revolution!
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Dr. Alan Desmond
About Dr. Alan Desmond, MB, BCh, BMedSc, MRCPI, FRCP
Doctor Alan Desmond is a Consultant Gastroenterologist who is dedicated to educating the public on the health benefits of a whole-food plant-based diet. His best-selling book, The Plant-Based Diet Revolution: 28 Days to a Happier Gut and a Healthier You, is available wherever books are sold.
Doctor Alan has made evidence-based dietary advice an essential part of his practice as a doctor specializing in gut health problems. He has presented at numerous international medical conferences on the benefits of this approach to food, alongside other renowned advocates including Dr. Michael Greger, Dr. Michael Klaper, Dietician Brenda Davis, Dr. Kim Williams, and Dr. Neal Barnard. He is an Ambassador for Plant-Based Health Professionals UK, a not-for-profit group that educates members of the public, health professionals, and policy makers on the incredible health benefits of a plant-based diet.
Certified in both Gastroenterology and General Internal Medicine, Doctor Alan completed his medical training in Ireland and Oxford. He has a specialist interest in the role of diet in the prevention and treatment of Crohn’s disease and Ulcerative Colitis. A fellow of the Royal College of Physicians, London, he has published several influential research papers in the field of Inflammatory Bowel Disease and is a dedicated advocate for the gut health benefits, and overall health benefits, of a whole-food plant-based approach to nutrition. He lives in South Devon with his wife and three children.
Full Transcript
Dr. Alan Desmond:
One in three adults under the age of 50 have diverticular disease, which costs the US $2.5 billion a year. Colorectal cancer affects more than one in 20 adults in their lifetime. In the US right now, non-alcoholic fatty liver disease, so the deposition of excess body fat on your liver is now thought to be the most common cause of chronic liver disease and cirrhosis. It's the leading cause of cirrhosis among females requiring liver transplant. It affects up to 100 million people in the US right now. And then you've got less harmful but very bothersome and difficult conditions like irritable bowel syndrome affecting up to 45 million Americans. One in five US adults lives with gastroesophageal reflux disease.
Rip Esselstyn:
Yeah.
Dr. Alan Desmond:
So right now the US needs a gut health overhaul.
Rip Esselstyn:
Season three of the PLANTSTRONG podcast explores those Galileo moments where you seek to understand the real truth around your health and dare to see the world through a different lens. This season, we honor those courageous seekers who are paving the way for you and me. So grab your telescope, point it towards your future, and let's get PLANTSTRONG together.
Rip Esselstyn:
Hey everyone. I hope you're doing off the charts well and you had a healthy, safe, and fun long July 4th holiday weekend. My family and I were up in Wisconsin staying on the shores of this little lake, and we've been going for lots of kayaks and swims, barbecuing lots of PLANTSTRONG foods, and playing a ridiculous amount of board games and slowing everything down. It's just what the doctor ordered.
Rip Esselstyn:
Speaking of what the doctor ordered, today on the PLANTSTRONG Podcast, I am going to be your personal physician's assistant right alongside the amazing Dr. Alan Desmond. He is a gastroenterologist. I know you've heard that term before because we've had two other gastroenterologists on the PLANTSTRONG Podcast. In season one, we had Dr. Robynne Chutkan. And in season two, we had Dr. Will Bulsiewicz, the author of Fiber Fuel.
Rip Esselstyn:
So Alan is a gastroenterologist. He hails from across the pond in the UK, and he's the author of the new book The Plant-Based Diet Revolution. I discovered Alan because my parents had been raving about him for several months, and I think today you're going to see exactly why. His knowledge and expertise of gut health and the microbiome is so vast that we're actually going to break up this conversation into two parts because I want you to digest absolutely everything that he says.
Rip Esselstyn:
From the get-go in our conversation, Alan lays out some super sobering statistics for gut health in the US. Check this out. One in three adults under the age of 50 have diverticular disease. Colorectal cancer will affect more than one in 20 adults in their lifetimes. Non-alcoholic fatty liver disease is off the charts, and 97% of Americans are deficient in fiber.
Rip Esselstyn:
If all health begins in the gut, then I think it's fair to say that the US needs a major overhaul, and that's what we're here to do with Dr. Desmond over the next two weeks. In part one today, we're going to whip out the prescription pad and give you the top 10 prescriptions for better health. But unlike most prescriptions that simply treat the problem, these prescriptions get to the root of the issue and help you solve these problems. And the best part, they don't involve taking more, you guessed it, pills. This is just about beautiful, nutritious, whole, PLANTSTRONG foods. The optimal diet for health and longevity.
Rip Esselstyn:
So with that, my friends, the doctor is in the house, and now it's your turn to spend some quality time with Dr. Alan Desmond.
Rip Esselstyn:
Well, first of all, what is a gastroenterologist?
Dr. Alan Desmond:
Well, can I just say, Rip, it's a pleasure and an honor to spend time with you, man. I've been such admirer of your work, your family's work, and everything you guys do. Everything from your dad's work at the Cleveland Clinic to Engine 2 and everything else. So thank you for letting me spend time with you and hang out with and your audience. I truly appreciate it.
Rip Esselstyn:
Oh yeah. This is going to be a blast. Am I talking to you right now like across the pond? Where are you? Are you in the UK?
Dr. Alan Desmond:
Yeah. I'm from Ireland, Rip. I'm from County Cork from Blarney. I grew up near the Blarney Castle if anyone's heard of the Blarney Castle and the Blarney Stone. So if you kiss the Blarney Stone, you get the gift of the gab. I've kissed it seven times, so let's see how we go.
Dr. Alan Desmond:
But yeah, I live in the UK now. I live in England, southwest England. So I fell in love with the lady who's now my wife, Hannah, an English girl. So I've moved over here like 10 years ago. So I'm speaking to you from across the pond, absolutely.
Rip Esselstyn:
So let's get back to so what exactly is a gastroenterologist?
Dr. Alan Desmond:
Well, a gastroenterologist is a doctor who specializes in diagnosing and treating digestive problems. So if you were looking for me on any day of the week, you would probably find me at the hospital, and if you go into the hospital, you will either find me on the ward doing a ward round with my team, with the other doctors who are on my team, the junior doctors as we call them in the UK, maybe with the dieticians and the nurses. We'll be doing the round. We'll be going to see patients, reviewing the results, and trying to make a plan to help them to get better.
Dr. Alan Desmond:
If I'm not in the ward, I'll be in my clinic seeing patients at the out-patient department. And other than that, I'll be down in the endoscopy unit doing diagnostic and therapeutic procedures, like gastroscope and colonoscopy and looking inside people's digestive tracts with a slim tube, a camera scoping as we say to look up close and personal at the living organ that I focus on treating, the digestive tract, which is one of the unique things about being a gastroenterologist is that we've got this incredible technology that allows us to... We take your story, we do the lab work and everything, but ultimately we get to look inside, Rip, which is incredible. So we get to look at the living organ and watch it moving and functioning. And we can often make a diagnosis just by the appearances of your internal organs, which makes gastroenterology pretty unique.
Rip Esselstyn:
How many different digestive tracts would you say you've looked at?
Dr. Alan Desmond:
Thousands. Literally thousands. Yeah, must now be in the high thousands. I've been putting tubes inside people's bodies to look at their digestive tracts for at least 14 to 15 years. So I've seen a lot. It's fascinating because people generally look pretty much the same on the inside. Whatever your race, color, size, age, the insides look pretty consistently the same more or less in most people, which also surprises people to hear. But it's a fascinating aspect. One of the reasons that I got really interested in gastroenterology was that ability to actually look at the organ that you're trying to fix and form an opinion of the disease process by looking at it.
Dr. Alan Desmond:
But you know gut health is so important. It's crucial. If you don't have good digestive health, you're not going to enjoy your day. What do we do? We get up in the morning. We think about breakfast. We finish our breakfast. We're packing our lunch to take to the office or we're thinking about what we're going to have for lunch. We might call our wife or partner on the way home and what do we say? "Hey, this is what I'm doing for dinner tonight." Or, "What should we do for dinner tonight?" It's so crucial. We use dinner to mark occasions and birthdays and weddings and everything. So food is absolutely crucial and the enjoyment of food is absolutely crucial.
Dr. Alan Desmond:
So if you've got poor digestive health, you're in trouble. But it goes beyond that. I mean, I often say to people when they are surprised to hear that I care so much about digestive health in terms of overall health, but it shouldn't surprise us at all. Fifth century BC, let's go way back. Let's go way back. So let's go way back. Hippocratis, the father of modern medicine, two and half thousand years ago. He taught his disciples that all disease begins in the gut. So when he was teaching his disciples how to take a history and how to cure people, he would put a great emphasis on digestive health and an incredibly great emphasis on food.
Dr. Alan Desmond:
We know now in 2021 we know that hidden in that ancient wisdom was an awful lot of truth because not only does food matter so much in terms of digestive and overall health. Not only is that true, but also in many ways health does begin in the gut. And a good digestive health is crucial. And this is why I'm so glad to be speaking to you today, and I'm so glad that the book is available in the US right now because, Rip, if all health begins in the gut and as this conversation goes on, I'm going to convince you and your listeners that it really does. If all health begins in the gut, the US is in trouble, my friend.
Dr. Alan Desmond:
One in three adults under the age of 50 have diverticular disease, which costs the US $2.5 billion a year. Colorectal cancer affects more than one in 20 adults in their lifetime. In the US right now, non-alcoholic fatty liver disease, so the deposition of excess body fat on your liver is now thought to be the most common cause of chronic liver disease and cirrhosis. It's the leading cause of cirrhosis among females requiring liver transplant. It affects up to 100 million people in the US right now. And then you've got less harmful but very bothersome and difficult conditions like irritable bowel syndrome affecting up to 45 million Americans. One in five US adults lives with gastroesophageal reflux disease.
Rip Esselstyn:
Yeah.
Dr. Alan Desmond:
So right now the US needs a gut health overhaul.
Rip Esselstyn:
Well said. So the title of your new book is called The Plant-Based Diet Revolution. Why that name? I love it, but why that name?
Dr. Alan Desmond:
Well, there's two aspects to it. Okay, there's three aspects to it. There's two definite, then one that I haven't really mentioned to anybody but I'm going to mention it to you and your listeners.
Dr. Alan Desmond:
Number one, diet. In the first few pages of the book, I give the definition from the Collins English Dictionary diet. The food that an animal or person eats every day. I want to reclaim that word, Rip. That word diet has been stolen and repurposed by a multi-billion dollar weight loss industry. A multi-billion dollar industry that doesn't work, is not interested in making people healthier, is interested in quick fixes that you can sell and make a whole ton of money from over and over again. Diet. I want to bring that word back to its original meaning, the food that we eat every day.
Dr. Alan Desmond:
In fact, the original derivation of the word diet had nothing to do with food at all. It referred to your daily habits. So I want to reclaim the word diet, number one.
Dr. Alan Desmond:
Number two, it is a revolution. This revolution is already on. Even before COVID, more and more people were realizing and becoming better informed on the benefits of building your place from the foods that have been benefiting human health from generations, fruits, vegetables, legumes, nuts, seeds, leafy greens. People have already switched onto this. They've been hearing about the benefits of a plant-based approach to food from their doctors, from celebrities, from athletes. This revolution is already on. I just want more people to join. I want more people to educate themselves and fill in that huge knowledge gap that generally exists in high income countries about the role food has in defining our health. So I want them to get onboard.
Dr. Alan Desmond:
I want to tell you the third secret reason that I haven't told anybody.
Rip Esselstyn:
Yes, yes.
Dr. Alan Desmond:
Okay. It's a tribute to Dr. Atkins.
Rip Esselstyn:
Okay.
Dr. Alan Desmond:
Dr. Atkins, The New Diet Revolution. With all due respect to the gentleman, did more harm in the world of food than anybody ever did before. I remember reading that book when I was a medical student and a young doctor and thinking, "What the heck? Nobody is going to do this," and then everybody did it. Taking that high meat, high fat, low carb approach did so much damage.
Dr. Alan Desmond:
So in 2021, I thought, "You know what, maybe it's time for another diet revolution, a more evidence-based diet revolution." And I hope this doesn't get me sued by the Atkins Corporation, but in a way it was kind of a slight reference to that previous Diet Revolution because we need a new one.
Rip Esselstyn:
Absolutely. That's awesome. I love that. So you also talk about in the early part of your book how when it comes to being healthy, what you eat absolutely really matters. And you referenced The Lancet and a recent study they did called The EAT-Lancet. What was the outcome of that? This is probably one of the most prestigious medical journals on the planet.
Dr. Alan Desmond:
This was a big moment for me actually as a gastroenterologist who'd been advising as patients to move towards an unprocessed, plant predominant or completely plant-based diet for years because I've been reading the research for a long time, and whatever condition I was looking at in digestive health, it would say the same thing. Unprocessed and eat plants.
Dr. Alan Desmond:
So in 2019, The Lancet Medical Journal published this huge review of the evidence. In fact, it was the report of the EAT-Lancet Commission because The Lancet being one of our most prestigious medical journals tries to answer really important questions. The really important question that they were answering with this commission was what should I eat? What should we eat for optimal health? The same question that every single patient asks their gastroenterologist. What should I eat?
Dr. Alan Desmond:
But they were trying to come up with a blueprint to feed everybody in the world, including the 820 million people in the world who don't get enough calories and are living with food poverty. Including the 3.5 billion people in the world who have an excess of calories and too much of the bad stuff, and they're suffering from all those chronic diseases that fill up our hospitals in countries like the US, the UK, and Ireland. They wanted this blueprint to tell us how should we aim to feed ourselves globally in a sustainable and healthy way to make humans the healthiest possible versions of themselves. And having reviewed decades of evidence, their handpicked panel of globally recognized experts from institutions like Harvard, University of Oxford, University of London, et cetera.
Dr. Alan Desmond:
Whole food plant-based. They came back, looked at all the evidence, and described the planetary health plate. They said that a planetary health plate should consist of half fruits and vegetables, 25% whole grains, and the remainder should be made up of protein rich plants, such as legumes, small amounts of healthy plant derived oils, and optionally small amounts of animals products. But the lengthy report was very clear that the animal products should be regarded as optional.
Dr. Alan Desmond:
If you are eating an animal product, you're probably going to be better off not eating that animal product if you have the option. If you're lucky enough to live in a country and have the means that you have an option, then it's always safer and healthier to choose the plants. If you do choose to consume animal products, the amounts that they describe as safe to consume are incredibly low. Just one ounce of chicken or fish per day, like half an egg, seven grams of red meat a day. Although in their report, they said the safest amount of red meat to consume is probably zero, especially if it was replaced with healthy plant-based sources of protein. They were very, very clear on all this.
Dr. Alan Desmond:
So this came out in February 2019, and they estimated that if they could wave a magic wand then, Rip, and get the whole planet eating like this, that it would prevent almost 12 million preventable deaths globally per year plus hundreds of millions of fewer cardiac stents, bypasses, courses of chemotherapy for preventable cancers, prescriptions for statins, blood pressure meds, admissions to hospital, perforated diverticular disease, emergency laparotomies. I mean, really it's so important. The food that we consume is incredibly powerful.
Dr. Alan Desmond:
Of course, it's not just The EAT-Lancet Report who talked about this. The British Dietetic Association, the American Academy of Nutrition and Dietetics, the World Cancer Society, the World Health Organization were all singing from the same hymn sheet right now.
Dr. Alan Desmond:
Did you see, Rip, in August of last year the letter that the American Medical Association wrote to the USDA?
Rip Esselstyn:
I did not.
Dr. Alan Desmond:
Okay. So in the middle of a pandemic, the American Medical Association, one of the world's oldest, most respected professional organizations for doctors in the US, writes a letter to the US Department of Agriculture who are responsible for the commissioning and writing of the dietary guidelines for Americans. We can talk about how screwed up that is in a minute.
Dr. Alan Desmond:
So the AMA writes a letter to the USDA who are finalizing the new dietary guidelines for Americans latest revision, the 2020 revision. And in that letter, they very clearly laid out their argument, their request to the USDA to stop putting dairy and meat in the guidelines as mandatory food groups. And they said the reasons that they said they shouldn't be in there is because they're not necessary. They're not required for all diets, and they are drivers of disease, including cardiovascular disease, heart disease, prostate cancer, and other cancers, including many conditions that disproportionately effect Americans from ethnic minorities.
Dr. Alan Desmond:
So that's the American Medical Association saying that you don't need to have meat and dairy in your diet to be healthy, and you'd probably be healthier without it. So The EAT-Lancet, the AMA, and all of these all GUST professional societies around the world are on the same page. So this is the revolution I'm talking about.
Dr. Alan Desmond:
I was reading an analysis this week that said that this year and last year are the first two years since the 1960s that meat consumption and meat production has been down globally. So I'm hoping that two years ago the standard western diet peeked out, Rip, and that it's now going to be in decline. In the next few years we'll tell, I guess.
Rip Esselstyn:
Yeah. Well, that would certainly be fabulous as this is a trend, a downward trend that just keeps going exponentially. And with all these organizations, basically like you said, singing from the same hymn sheet, I think it's just a matter of is it going to be two years, five years, 10 years before animal products and animal byproducts... I'm not going to say become eradicated, but instead of having 7% of the population here in the States for example be vegetarian or vegan, we're going to crossover that 20, 30, 40, 50% of us.
Dr. Alan Desmond:
It's more important than ever right now. I mean, I know as we start this conversation, you said it's going to be fun. It is going to be fun. Food is fun. Delicious food is fun. My book is like really upbeat. It's a very positive book. It's essentially a cookbook, right?
Rip Esselstyn:
Yeah.
Dr. Alan Desmond:
But let's just get serious for a second. This trend that I just described has got to continue. We are right now in the US and the UK, we are lucky enough to be just to feel like we are coming out of this pandemic. But this pandemic is still raging globally. Okay? Last August, around the time the AMA were writing to the USDA asking them to take meat and dairy out the dietary guidelines, the United Nations, Rip, issued a report called Breaking the Chain of Transmission: How To Prevent The Next Zoonotic Pandemic. We're in the middle of coronavirus, and they issue a report and guidelines and recommendations for governments around the world to take action now to prevent this from happening again.
Dr. Alan Desmond:
The number one thing that they said that we can each do as individuals, as countries, as nations, the number one thing we can do, each one of us can do to reduce the risk of another pandemic is to eliminate or dramatically reduce the amount of meat that we put on our plate each day because the dietary habits that now require 100 kilos of meat for every adult American every year or 83 kilos of meat for every British adult every year necessitate and absolutely require that we keep tens of billions of animals in incredibly unnatural, cramped, unhygienic conditions in close proximity to each other and the humans who are involved in handling and processing them into food.
Dr. Alan Desmond:
So animals and their diseases have never been closer. So the UN is very clear. If we want to reduce the risk of a future pandemic, we need to really radically overhaul our diet and start eating like The EAT-Lancet Report. It suggested two years before this pandemic.
Dr. Alan Desmond:
Now a very smart person, a very wise man once said we don't change, Rip. Humans don't change their habits until they experience pain. It's only through realizing the suffering that our daily habits impose on us that we recognize the need for positive change and improve our habits.
Dr. Alan Desmond:
So right now as we sit here having this conversation, globally we've lost 3.5 million loved ones. Hundreds of millions more people have been infected with this virus, and they didn't die but we're only beginning to understand the long term health effects it has on them. We've been through 18 months where our elderly relatives in care facilities were devastated and the people who survived in elderly care facilities were then condemned to a year of solitary confinement, unable to see their family and friends. Our kids couldn't go to school. They had to learn how to wear masks and socially distance from everybody.
Dr. Alan Desmond:
So here's the question, have we suffered enough to recognize that we need to change? If it doesn't happen now, Rip, I don't think it's ever going to happen.
Rip Esselstyn:
Well, it's got to happen.
Dr. Alan Desmond:
It's got to happen. I mean, I haven't been a doctor for that long really. I view myself still as on the learning curve. I became a consultant 10 years ago. This isn't the first time I treated patients in hospitals who were dying from a zoonotic pandemic. This time it came from a meat market on the other side of the world. 10 years ago I was treating patients with Swine Flu who were dying from disease that came from pig farms in the southern US.
Dr. Alan Desmond:
Anyway, that's the serious message that I wanted to give to your listeners today. I'm sorry to get all serious, but it's been on my mind lately, man. Things have got to change.
Rip Esselstyn:
No, no. I mean, yeah. As a physician, this pandemic has affected you in ways I think a little bit harder than it has affected a lot of other people. But there's the thing is that I don't think mainstream media has done an appropriate job connecting the dots so that Tom, Bill, and Mary understand that this is a zoonotic disease. I bet you that 80% of, maybe 75% of Americans don't know what a zoonotic disease is. They're not making the connection. But if they had that knowledge and understood that the pain that we're experiencing right now is coming in large part because of our insatiable consumption of all these animal products, I think you're right. I think we would then have the massive collective change in the habits.
Dr. Alan Desmond:
I've seen some encouraging data though, Rip. Even before the pandemic, I saw data like 42% of Australians were actively reducing their meat intake for health reasons. I think The EAT-Lancet Report a couple years ago did kind of twinge into the mainstream a little bit. Look, I'm not a fan of junk food, but we live in a world now where places like Burger King and McDonald's are serving vegan meals. So that wasn't happening a few years ago. I'm not saying that a vegan Big Mac or whatever is like a health choice. But it just shows that this thing has permeated the mainstream. It's no longer a fad, right? It's becoming human behavior. It's becoming entrenched.
Rip Esselstyn:
Plant-based is on. This is the PLANTSTRONG era. It is here. It is now-
Dr. Alan Desmond:
The PLANTSTRONG era. Absolutely.
Rip Esselstyn:
Oh yeah. It is not going anywhere. So let's take a break from that. I want to ask you as a doctor, you have a little section in your book called Doctor's Orders and The Top 10 Prescriptions for Better Health. So if you don't mind, I'd like to toss it out there to you each one of them, and then you can kind of riff on each one. Does that sound good?
Dr. Alan Desmond:
Yeah, that sounds like fun. Yeah, absolutely.
Rip Esselstyn:
Yeah, and then after we do that, I want to talk about... Let's go back and talk about the gut.
Dr. Alan Desmond:
Yup, let's do it.
Rip Esselstyn:
What our listeners can do to really sure up their gut health, their immune systems, and all that. So let's start with number one on your list is eat a diversity of plants. Why?
Dr. Alan Desmond:
Well, the key to a healthy plant-based diet is variety. So if we learn to prepare and cook a wide range of vegetables, fruit, whole grains and legumes every day, like a really essential part of our journey towards a healthy whole food plant-based diet. Right now in the world our food system depends on a very narrow variety of plants. I think corn, wheat, and rice account for like 50% of all calories consumed in the world. There are 250,000 different plants that are fit for human consumption. Now I'm not saying we need to eat 250,000 different plants, Rip, but variety is really important. Because when you build in that variety, you're maximizing your intake of a wide range of plant derived nutrients and oxidants, complex carbohydrates, different mixes of amino acids, and the beneficial fats that are naturally occurring in fruits and vegetables and legumes.
Dr. Alan Desmond:
Of course, we can talk a bit about it later too. The diversity concept is also really key to unlocking a healthy gut microbiome. Let's come back to the microbiome later because that's going to blow people's minds.
Rip Esselstyn:
Well, I want to come back to that, and I want to come back to short chain fatty acids and how important that is because I love for our listeners to really grasp that and understand that. So number two is doctor's prescription top 10 is ditch the junk.
Dr. Alan Desmond:
Yeah, ditch the junk, man. Ultra processed food, junk food, also known as junk. So the food industry since 1950s has been shooting out mass produced cakes and pastries and chips and crisps and soft drinks and candy bars and chicken nuggets and meatballs and all these foods that are cheap to make, pumped full of artificial chemicals to make them taste like food and stay shelf stable. In most cases, by consuming them, but in all cases I would think, you are missing out on all those benefits of whole foods while you're increasing your intake of added sugar, unhealthy fats, and salt, sodium.
Dr. Alan Desmond:
Then we add to that the artificial flavors and sweeteners and emulsifiers that we know are bad news for our health and bad news for our gut health. For me, when I look the evidence, I see that our current junk food obsession, which means it's 60% of calories consumed in the US come from ultra processed food. For one in five people in the UK that get 80% of the calories from this stuff, this stuff poses a real and present danger to our health and also has negative effects on the gut microbiome. I'm going to mention it again because it runs like a thread through the book.
Rip Esselstyn:
You said real and present danger. It sounds like a Tom Clancy novel.
Rip Esselstyn:
We'll return with Dr. Desmond in a sec, but holy moly, guys and gals, you really showed up last week when we announced our 10th anniversary Plant-Stock event was open for registration. And I want to thank those who jumped in so quickly to this event that's scheduled for September 8th through the 12th. If you'd like to join in, I want you to know it's not too late for our special 10th anniversary pricing, and this is because we want everyone, and I mean everyone, to have access to this educational summit. This year's event is going to be online streaming once again from the Esselstyn family farm in upstate New York. This is an excellent primer for anyone that's interested in learning the science and the practical application of a plant-based lifestyle.
Rip Esselstyn:
So gather up your friends and family and invite them to join us as we stream talks and cooking demos from the farm. Again, September 8th through the 12th. To see all the speakers and the special content, go to plantstrong.com/plantstock today.
Rip Esselstyn:
Also, I have another great email that I want to share with all of you. This one is from John [Hovaneck 00:33:31] and he writes, "Dear Esselstyn Family, I wanted to take a moment and thank you for helping me turn my life around. I have lost over 50 pounds in about nine weeks. I just had my annual checkup with lab work, and both my doctor and I were amazed. I'm now off my high blood pressure meds, no more statins, no more stomach pills for indigestion, and now the hard part of keeping it up. I came across a YouTube video of Dr. Esselstyn where he said if half of this is true, how could you not try it? Attest from our lab results that are living proof this incredible nine week journey works. On behalf of myself, John C. [Hovaneck 00:34:18] and my wife and daughter, thank you."
Rip Esselstyn:
Well, thank you, John. And look what you did. You are a prime example of what's possible when you get in the driver's seat for your health and you harness the power of plants.
Rip Esselstyn:
For anyone listening, we have a full array of resources to help you with the hard parts. Simply visit plantstrong.com or join our free online community at community.plantstrong.com.
Rip Esselstyn:
Now let's get back to Dr. Alan Desmond.
Rip Esselstyn:
All right. Prescription number three is eat whole grains every day. Why?
Dr. Alan Desmond:
It's so important. This is one of the questions that I ask every patient. In the book, I talk about the three questions I ask every patient that comes to my clinic, and this is one of them. How many servings of whole grains do you eat every day? And sadly a lot of the time, Rip, I end up explaining to people what I mean by whole grain because it's not really something that's been on their radar, which is a pity because eating whole grains every day substantially increases your chances of a healthier gut and a longer and healthier life.
Dr. Alan Desmond:
There was a review... This is one of the most awesome reviews ever in terms of what one food can do to your health. So there's a big systematic review a couple years ago looking at the effect that regular whole grain consumption has on your health, and they concluded, and I might be quoting slightly wrong here. But they quoted whole grain intake is associated with reduced risk of dying of heart disease, cancer, mortality from all causes, respiratory disease, infectious disease, diabetes, all causes of death non-cardiovascular and non-cancer. Basically if you eat whole grains every day, you are going to a live longer life statistically.
Dr. Alan Desmond:
It's not just about whole grain bread or high fiber breakfast cereals. Though those are great things to eat. I would like people to think about the diversity point here as well. Barley, brown rice, millet, oats, freekeh, buckwheat, popcorn, it's a whole grain. Breakfast is a great time of day to get your whole grains in, so porridge or Rip's big bowl or something. Great way to start the day. Get those whole grains in early.
Rip Esselstyn:
So you're liking intact whole grains.
Dr. Alan Desmond:
Yes. Yeah, absolutely. So intact whole grains. I mean, when we process whole grains, when we puff them, it tends to increase their surface area. So although they may still technically be a whole grain, they kind of behave a little bit more like a processed sugar when we consume them. So I'm talking about brown rice and millet and freekeh and those sorts of things. I'm talking about on the plate still looking like a whole grain.
Rip Esselstyn:
Yeah. Little round circles, little round balls for the most part.
Dr. Alan Desmond:
Yeah, exactly. Yeah.
Rip Esselstyn:
Yeah. Let me ask you this regarding that point, whole grains, because there seems to be, especially in the keto, paleo camp a lot of noise right now around why whole grains or grains are bad. They're inflammatory. There's gluten. There's lectins. How would you address that?
Dr. Alan Desmond:
Well, I think a lot of the people who rail against whole grains spend a lot of time looking at potential mechanisms, but they don't look at what's going on in the real world. When we look at the population data, we see that whole grain consumption alongside bean consumption is one of the key markers of a healthy diet. As I said a moment ago, huge meta analysis published a couple years ago found that people who eat whole grains regularly have longer, healthier lives and are substantially reduced risk of numerous cancers and diseases, including colorectal cancer.
Dr. Alan Desmond:
So if they were so bad for us, then how come they're making us so healthy? It doesn't make any sense, right?
Rip Esselstyn:
Well, it really doesn't. But in your profession, as a gastroenterologist, you probably see people that truly have a gluten intolerance.
Dr. Alan Desmond:
Oh sure, sure. I mean, there's some people who need to avoid gluten containing whole grains, and that would be mostly wheat containing whole grains. So glutens technically are family of proteins that are found in certain plants. There is a gluten in wheat called gliadin. Some people develop an immune reaction to gliadin and other glutens. So they do need to avoid eating whole grain wheat or any wheat containing product, which we sometimes just call a gluten containing product.
Rip Esselstyn:
I have a quick little acronym for one. Typically it's BROW. It's barley, it's rye, it's contaminated oats, and then it's of course wheat.
Dr. Alan Desmond:
Yes. Exactly. Exactly. But I want them to embrace other whole grains. So my clinic when we have someone who has a diagnosis of celiac disease, they work with the dieticians to make sure that they're getting those naturally gluten free whole grains as part of their daily intake because it's going to really benefit them. I would rather they weren't eating the kind of expensive processed gluten free products. I'd rather they were just eating a naturally gluten free diet in the ideal world.
Rip Esselstyn:
Right. Right. Okay. Let's move on from whole grains to why we want to embrace carbohydrates.
Dr. Alan Desmond:
Whole, man. Whole carbohydrates. It's a little bit of an overlap with whole grains here. But I thought this was worth putting in the book because of all this carb phobia. Being PLANTSTRONG, joining the plant-based diet revolution does not involve avoiding carbohydrates. In fact, it's the opposite. By eating plenty of whole carbohydrates, you're giving your body the fiber, the fuel, and the nutrients it needs. In fact, if you deprive yourself of these whole carbohydrates, whole grains, whole fruits, whole vegetables, you are cutting out some of the most beneficial foods known to nutritional science. Oats, rice, whole grains, bananas, strawberries, apples, potatoes. These are incredibly beneficial foods.
Dr. Alan Desmond:
Of course, through my practice and also through some of the online courses that I run with my friend Stephen David Flynn who you were speaking with recently, The Happy Pear Boys. I mean, one of the most common mistakes that I've seen, I'm sure you've seen this too, is people who have read about the health benefits of a whole food plant-based diet, and then they embark on their own plant-based journey. But they try to combine it with low carbohydrate because they still believe the hype that low carbohydrate is going to be healthier. It's just not. They end up feeling hungry and lethargic because they're depriving themselves of all of these benefits.
Dr. Alan Desmond:
So in the meal plans in my book, you get about 60 to 70% of your calories from whole carbohydrates, which the science tells us that by making these healthy carbohydrates the main state of your daily diet, you're just going to make you healthier.
Rip Esselstyn:
Yeah. Well, as human beings, that's what we run off of, right? We run off carbs.
Dr. Alan Desmond:
Absolutely. There's so much research we could talk about in this, but it's like a paper published this this week some research findings. They just found a neanderthal burial ground somewhere. I was reading this in the newspaper yesterday. So they examined their enamel of their teeth, and they were starchivores. They were predominantly eating starch. That's why they thrived. Our brains can only run on starch really in the normal day to day. There's cells in our kidneys that need glucose. Our red blood cells need glucose. They can't run on anything else.
Dr. Alan Desmond:
So yeah, I agree. When we look at the healthiest, most long lived populations in the world, like the Okinawans, the traditional Okinawans, 70% of their calories coming from carbohydrates, whole carbohydrates. This whole carb phobia's got to end.
Rip Esselstyn:
Yeah. But I will say that unfortunately people don't know, most people don't know the difference between a whole carbohydrate and a processed carbohydrate, or they need to be educated and understand that fruits and vegetables and whole grains and beans and potatoes... Potatoes not your enemy. It's typically what you're putting on your potato.
Dr. Alan Desmond:
That's it, man. Whole carbohydrates don't make you fat. Lean protein doesn't make you skinny. Fat and skinny shouldn't be your goal anyway. It should just be able being a really healthy person. Yeah, there's so much diet confusion out there, and that's part of my mission on social media, in my public advocacy, and now embodied in the book. It's very cut through all this confusion. Make it really simple for people.
Rip Esselstyn:
Super simple. Super simple. So prescription number five is choose your protein wisely. So can you really get all the protein you need from plants? Where are you going with this particular prescriptions?
Dr. Alan Desmond:
Well, with this prescriptions, it's twofold. Number one, yes, people who eat an unprocessed plant-based diet will get enough protein. The average adult requires about 40 or 50 grams of protein per day. So for example, research in Canada back in 2014 looked at dietary intakes in tens of thousands of non-vegetarians and about 6,000 strict vegetarians or vegans, and what they found was that the strict vegetarians were consuming about 70 grams of protein per day. So they were exceeding their daily protein needs. In fact, the top 5% were consuming 100 grams of protein per day.
Rip Esselstyn:
Wow.
Dr. Alan Desmond:
But these weren't like guys in the gym slamming protein shakes. These were just people eating food. That's the key because all plants contain protein, and not only do all plants contain protein, all plants contain all 20 amino acids that your body needs to build the protein that makes up 15% of your human body. So this whole concept that plants don't contain enough protein is not scientifically based. The whole concept that vegans and vegetarians need to be super careful to include whole protein foods like soy and quinoa... I mean, those are great foods, don't get be wrong, but it's not evidence based. It's just not scientifically accurate.
Dr. Alan Desmond:
I mean, the American Medical Association admitted as much I think about 18 or 19 years ago when they issued their dietary guidelines to avoid heart disease, and they talked about the benefits of vegetarian dietary patterns. But they mentioned the whole protein myth, and I believe it was Dr. John McDougall wrote them and said, "Hey, that's not true. What you said there isn't true." They wrote back, and the letter was published in Nutrients, and they said, "Oh yes, you're right actually. If you eat five servings of whole grains and five servings of fruit and veg every day, you'll get all the amino acids you need." But somehow that myth persists.
Dr. Alan Desmond:
I hear doctors and dieticians repeat that myth all the time. I was recently asked to contribute an article that was published in Irish National Newspaper, and it was about protein and vegetarianism and veganism. And I put in that statement that despite that the oft repeated myth that vegans need to eat complete proteins is just a myth and not based on evidence. But they didn't publish it in the article because they didn't believe me.
Rip Esselstyn:
Now it is crazy how this myth persists. We got to do everything we can to slay it.
Dr. Alan Desmond:
If it persisted, why did The EAT-Lancet Report tell us that animal products are optional? Why is the UN calling for us to reduce or eliminate meat from our diet to prevent the pandemic? Why do the official dietary guidelines for newly diagnosed patients with type two diabetes in the UK tell us to prescribe a plant-based diet?
Rip Esselstyn:
Well, good points. Let me ask you this, how many patients have you seen that have come into you that are protein deficient?
Dr. Alan Desmond:
If somebody is capable of consuming enough calories, so they're a generally healthy person, never.
Rip Esselstyn:
Right. Right.
Dr. Alan Desmond:
Sadly because I work in the hospital, I meet people at the extremes of human health. So if you have a very advanced disease process whereby you're not consuming enough calories or you're not able to consume enough calories, that's when protein deficiency becomes a problem. But how many patients do I see at my clinic every year who have fiber deficiency or folate deficiency, magnesium deficiency, potassium deficiency? These nutrients that are more abundant on a whole food plant-based diet. Of course, I see patients like that every day of the week.
Rip Esselstyn:
Yeah. Well, what's interesting, the other day I looked up to see how many people worldwide died from lightening each year roughly. And guess what the answer was.
Dr. Alan Desmond:
Oh, I don't know. 20. I don't know.
Rip Esselstyn:
Seven.
Dr. Alan Desmond:
Seven. Oh my goodness.
Rip Esselstyn:
Worldwide.
Dr. Alan Desmond:
Wow.
Rip Esselstyn:
It's like so your chances of protein deficiency are less than getting hit by lightening for the most part. So kind of help-
Dr. Alan Desmond:
If you are eating fruits and vegetables and legumes and nuts and seeds and eating food like you eat and your family consume and like I consume and the recipes in your book, the recipes in my book, if you're eating like the healthiest people in the world, you will not become protein deficient. It's impossible. I mean, we talked about The EAT-Lancet report earlier, Rip, and I talked about 39 experts handpicked from all GUST institutes like Harvard and University of Oxford. They reviewed all this evidence, and they published this huge analysis. There's charts and graphs. There's a glossy PDF. There's an action plan for governments.
Dr. Alan Desmond:
When I talked to patients in the UK or maybe in the US and I show them this plan, they go, "Really? That's how we should be eat to be healthy. That seems crazy to me." But if you go to a really healthy country and if you go to a population of people like the Seventh Day Adventists or if you go to the Nicoya Peninsula or whatever or one of these blue zones or if you go to rural Africa where nobody gets colon cancer or diverticular disease or heart disease, and if you say, "Look, 38 experts, two years of..." They'd say, "Why did you waste your time? That's how we eat. Go away, annoying person." It's like, "I can't believe you spent all this time writing this report. Why didn't you just come to my house for dinner?"
Rip Esselstyn:
Yeah. So take a B12 supplement, kind of basic there, right?
Dr. Alan Desmond:
Crucial, man. Absolutely crucial. B12 deficiency's common in adults in the US over the age of 50, vegan or vegetarian or omnivore. We've seen data now out or Europe showing among health conscious young people, vegans are less likely to be B12 deficient. Why? Because they're smart, they're tuned in, and they're taking their B12.
Rip Esselstyn:
Yeah. What do you recommend? How many micrograms a week?
Dr. Alan Desmond:
Well, for years I've been recommending that people just take cyancobalamin 25 micrograms per day, which is a perfectly reasonable dose for 95% of people. And I have very, very rarely seen a patient develop B12 deficiency at that dose because those patients have the advantage that they're coming to see me and getting their levels checked. So if you're just taking a sup and you're never going to get your levels checked just for whatever reason, then dose of 250 mcg once a day give you that little bit of extra insurance. But generally my practice I think 25 mcg of cyancobalamin seems to do the trick.
Rip Esselstyn:
Yeah, perfect. Prescription number eight, remember, milk is for babies.
Dr. Alan Desmond:
Oh yeah. Well, we skipped seven, which I think is-
Rip Esselstyn:
Oh no.
Dr. Alan Desmond:
It's cut out the sweet stuff.
Rip Esselstyn:
Yes, it is. We need to talk about that for a sec, yes, please.
Dr. Alan Desmond:
So our primitive monkey brains enjoy sugar. There's no getting away from it. But there's no getting away from the fact either that purified sugar is just not a healthy choice. Dietary guidelines all over the world tell us that purified sugar should be less than 5% of your total energy intake. But right now adults eat twice as much of that, getting like 50 to 60 grams or 12 to 15 teaspoons of added sugar per day.
Dr. Alan Desmond:
So it's empty calories. It can pro inflammatory effects, and basically it also causes difficulties with insulin shifts. It's just an unnatural way to consume food. So look, I'm not saying you can never have a sweet or a pastry, but just try and go for something a little bit healthier. In my book, we've got tons of really nice high fiber sweet treats, like carrot cake balls and little flapjacks or a bowl of fruit with a soy yogurt and tahini dip. These things are delicious, and they are far more satisfying. They're packed with fiber and all the good stuff. So yeah, cut out the sweet stuff, people.
Rip Esselstyn:
Yeah. I suppose that all that refined sugars also contributing to the non-alcoholic fatty liver disease.
Dr. Alan Desmond:
Yes. You're absolutely right. Yes. So refined sugar and animal products are the two major drivers of that. Now we use a little bit of maple syrup in the book on some of the desserts, but it's like a really small amount. I'm confident that with time people will realize that it's actually the taste of the fruit and the ingredients and the cacao and the nuts or whatever else, that's what they enjoy. It's that unprocessed taste of healthy plants put together in a really tasty way. That's what your body's craving.
Rip Esselstyn:
Yeah, absolutely. I want you to address before we move on to the remember that milk is for babies prescription number eight is there's a whole segment of the population that's either keto or paleo that is truly afraid right now of having a piece of fruit. I was talking to a woman just the other day who hadn't had a piece of fruit in eight months. I just find this to be absolutely egregious on a number of different levels, and was wondering if you could speak to your opinion on fruit and if it's harmful or beneficial.
Dr. Alan Desmond:
Well, in terms of the diseases that put us in the hospital and deprive us of years of healthy life, then fruits incredibly beneficial. Fruit consumption reduces risk of obesity, significantly reduces risk of developing type two diabetes and also significantly reduces risk of developing colorectal cancer. So these are healthy foods. Fruits are super healthy. They're super good for us.
Dr. Alan Desmond:
In contrast, there's so much science we could talk about here. I'm just going to give you two quick ones. So just a couple of months ago here in the UK, the Oxford BioBank, incredibly respected team of researchers who have been tracking data on half a million UK adults for a decade. There's only 44 million adults in the UK, Rip. So that's a significant chunk of the population spread all the way throughout the country. They just published a paper a few weeks ago where they looked at the top 25 reasons for being admitted to hospital among these 500,000 people followed for almost a decade, and they correlated that with their diet and lifestyle, families through smoking, exercise, body weight, et cetera. But also their consumption of red meat, processed meat, and poultry.
Dr. Alan Desmond:
So the top 25 reasons to be hospitalized are exactly what you'd expect, heart disease, stroke, pneumonia, diverticular disease, perforated haptic ulcer, the things that people end up in hospital with. Type two diabetes, et cetera. In 24 out of 25 conditions, which are the main things that are going to land you in a hospital in your life, meat consumption either had zero benefit or increased your risk. In 24 out of 25, meat did not make you healthier. It either didn't help you at all or it made you more likely to be hospitalized. So why would you adopt a diet that is only made up of those foods? It's insane.
Dr. Alan Desmond:
I'm sure you can lose weight. You can get thinner. You can consume per calories, but last year Kevin Hall and his team in the US admitted groups of volunteers to a metabolic ward. They put them on a whole food plant-based diet for two weeks. They put them on a very low carb, high fat keto diet for two weeks, and they measured everything. Incredible paper. Kevin Hall. Look it up.
Dr. Alan Desmond:
What did they find? Everybody lost some weight. So everybody, if they were doing this at home, they would've stood on the scales ad go, "Yeah, it's working. I'm losing weight. The book I bought was right." But what they saw was that among the low fat, whole food plant-based diet group, when they were doing that, they were losing body fat, which is beneficial. In the keto group, they were losing water and muscle. Who wants to lose muscle in middle age? You don't want to be losing muscle. And also when they were eating the keto, the low carb, high fat diet, they consumed far more calories each day because you were allowed to eat as much food as you wanted on this study. So they consumed far more calories. They lost weight but not fat, as I said. Their insulin resistance increased. Their inflammatory markers increased, and their LDL cholesterol, their bad cholesterol jumped. Their LDL cholesterol jumped by probably more than your total cholesterol is.
Dr. Alan Desmond:
So on every measure that matters in terms of long health and healthy life, the keto folks do badly. Then you pair that interventional data with what happens in the real world, and you see studies like published out of Harvard a couple of years ago where they followed a group of adults for a quarter of a century, and they found that people who eat a low carb dietary pattern favoring things like lamb and beef and pork and chicken were far more likely to die during the 25 years of the study. They estimated that the average 50 year old doing a low carb diet with lamb and beef and pork and chicken would take four or five years off their life expectancy.
Rip Esselstyn:
So number eight, remember that milk is for babies.
Dr. Alan Desmond:
Okay, milk is for babies. I mean, when I say this to patients in my clinic, "Milk is for babies," is one of the things that I enjoy saying to my patients because lactose intolerance is incredibly common. I see a lot of patients at my clinic with a lot of bloating and abdominal distension and digestive discomfort, constipation. And when I take a brief dietary history from them, if they're consuming a lot of milk and dairy, I actively encourage them as their first dietary change to take a break from dairy and to maybe... I told them what dairy means to them, and it might be about going to oat milk or having black coffee instead of milky coffee.
Dr. Alan Desmond:
They say, "Are you sure this is okay?" I roll it out, Rip. I say, "Remember, milk is for babies. It's not for grown ups." Most people have this little moment where they go, "Oh yeah, you're right actually. Milk is for babies. I'm not sure why I drink so much of it." Often for my patients that will be the first dietary change that they make that results in a significant improvement in their digestive health because three quarters of adults lack the enzyme required to digest dairy foods. When they consume them, they get bloating and abdominal symptoms. Then we know that when it comes to calcium, for example, we know that it's healthier to get your calcium from plant-based sources like broccoli and tofu, nuts and beans. Those are healthier foods.
Dr. Alan Desmond:
So I have gotten no hesitation whatsoever reminding my patients that milk is for babies.
Rip Esselstyn:
Yeah. Do you have a preference when it comes to plant-based milks that you offer your patients?
Dr. Alan Desmond:
When I'm speaking to my patients, Rip, I basically just tell them to go to the supermarket and shop around because I want them to find one they like the taste of. For me, any plant milk that my patient will use to replace dairy milk in their diet is a good option for them. Personally, I like an unfortified oat milk, an unsweetened unfortified oat milk. It just suites my taste. I'll have my evening cup of tea problem.
Rip Esselstyn:
What brand? Is that an Oatly?
Dr. Alan Desmond:
Yeah. We use Oatly here in my house, and sometimes we make our own. Sometimes we make our own. We just whip it up. It's really simple. There's gizmos you can get to make oat milk, but it's also super simple to make with just water and oats basically in a strainer. But yeah, my preference is for oat, but look at whatever non-dairy milk you choose is going to be a healthier option than dairy milk.
Rip Esselstyn:
I love the oats. The oats are just naturally... They're very sweet. They're about 18% fat, 18% protein. I just love oats. I could be a horse. I really could.
Dr. Alan Desmond:
Yeah. Well, I love oats too, and I think for me, I drink black coffee in the daytime. But in the evening, I like to have a nice cup of tea with a little bit of oat milk. So it does me fine.
Rip Esselstyn:
Yeah. All right. Let's move on to number nine, and that is don't forget your sunshine vitamin.
Dr. Alan Desmond:
Vitamin D. This isn't a vegan thing or a vegetarian thing. Whether you're completely plant-based, flexitarian or omnivore, you are at risk of vitamin D deficiency because of our modern lifestyles. We spent time indoors. We're not out in the sunshine. We need 20 to 40 minutes of bright sunshine on our skin every day to make sufficient vitamin D. And if we're not getting enough vitamin D, the science tells us we've got an increased risk of fracture, cognitive impairment, poor dental health, reduced muscle mass, falls, cancer, poor outcomes, inflammatory bowel disease, heart disease, high blood pressure.
Dr. Alan Desmond:
Vitamin D is a really important vitamin. It's a hormone in fact that we need in our bodies. So I work at the hospital, and I live in the UK. So even if it's sunny, it's not that sunny. And if it is sunny, I'm probably at the hospital anyway. So in the UK, the Scientific Advisory Committee on Nutrition recommends that everybody should supplement with vitamin D during the winter months or year round if you work indoors. So I usually recommend people to take about 800 to 1000 international units, which is 20 to 25 mics of vitamin D each day.
Rip Esselstyn:
Mm-hmm (affirmative). I can't get over the way you say vitamin. Vitamin.
Dr. Alan Desmond:
Vitamin.
Rip Esselstyn:
That's very UK.
Dr. Alan Desmond:
It is. It is. Yup. That's how we say in Ireland as well actually, vitamin.
Rip Esselstyn:
So last one is get help if you need it. What do you mean by this?
Dr. Alan Desmond:
Oh, it's so important. I mean, the whole purpose of the book, The Plant-Based Diet Revolution, and the PLANTSTRONG movement of course is to learn exactly why a plant-based diet can substantially reduce your risk of illness and can help to treat and reverse so many chronic diseases. I see this played out in my clinic all the time. It's super healthy thing to do.
Dr. Alan Desmond:
But if you're having problems, even if you are super healthy person, you got it all dialed in. If you're having digestive problems or unexplained symptoms, just go and see your doctor. Just have a conversation with your doctor. Even if they know nothing about nutrition, Rip, they'll be able to examine your tummy, do the basic lab work, maybe refer you to see a gastroenterologist like me just to get things checked out. Because low risk is not no risk. So just be mindful. Your doctor's always on your team basically. If you've got health concerns, go and chat to your doc.
Rip Esselstyn:
Good. Love those top 10. That's fantastic. Let me ask you this, in your book, you wanted to thank all of your patients for starting you on this journey but also for inspiring you. Was it your patients that gave you that Galileo moment?
Dr. Alan Desmond:
100%.
Rip Esselstyn:
Because not all doctors have this kind of passion towards this. So something happened along either medical school or internship or residency or somewhere.
Dr. Alan Desmond:
Yeah. I graduated med school 2001, and in 2004 I was on my first gastro rotation. So I was the most junior medical doctor on a team of doctors and nurses and dieticians taking care of in-patients with severe gastrointestinal problems. And I remember this one young man, he's about 19 years old who was hospitalized with Crohn's disease, inflammatory bowel disease. So this is a condition whereby sections of your bowel become red and sore and inflamed and disease. It can cause abdominal pain, diarrhea, anemia, weight loss, and inability to eat. It's a medical condition that's very strongly related to the standard western diet and lifestyle. But I didn't know that then.
Dr. Alan Desmond:
So three days in to this young man's treatment, he's on powerful immune suppressive drugs and steroids to tap down the inflammation in his gut. And we're doing the ward run. We come to see this young man at the bedside, and he's feeling better. The treatment is working. And he turns to us, the medical team, and to my boss, the attending, and says, "What about food? Is there anything I should eat? Anything I should avoid?" And my boss at that time turned to the patient and said, "It doesn't matter. You need calories right now. Eat whatever you like." His mom who was at the bedside said, "Really?" And my boss said, "Really. Does he like McDonald's? Why don't you bring him in a McDonald's?"
Dr. Alan Desmond:
That was the thinking at the time, Rip, that calories are just calories and it didn't matter for your digestive health with-
Rip Esselstyn:
Is this year 1901 or 2001?
Dr. Alan Desmond:
2004.
Rip Esselstyn:
Oh.
Dr. Alan Desmond:
About 2004, yeah. So relatively recently, right? But it didn't make sense to the patient or his mother. At that time, I'm the most junior guy on the team. I'm not going to put my hand up and say, "Really? Is that true?" But as I went through my career and I decided I wanted to be a gastroenterologist, I noticed that every single patient would ask the same question. When they're faced with, whether it's diverticular disease, pre-cancerous colon polyps, colorectal cancer, Crohn's disease, ulcerative colitis, non-alcoholic fatty liver disease, patients who have GI problems ask their GI doctor, "What about food?" We all know intuitively that the food we eat has got a lot to do with our gut health and our overall health.
Dr. Alan Desmond:
So as I went through my training, I would look at those papers too. They're in the mainstream medical journals alongside the articles about medication and surgery and colonoscopy. The answer to that question is in the same medical journals. By the time I became a consultant gastroenterologist in 2012 and now my name is on the patient's chart and it's my responsibility to help them to get the best possible outcome, when my patients started asking me, "What about food, doc," because they all do, I didn't tell them that it didn't matter. I started telling my patients that it really did matter, and I started asking them about fruits, vegetables, and whole grains and pointed them towards dietary guidelines and resources that could help them to move towards a more whole food plant-based diet.
Dr. Alan Desmond:
The real Galileo moment for me, Rip, I'm glad to say happened at my clinic all the time. Can I give you an example? Can I give you a story from my clinic just a couple of weeks ago?
Rip Esselstyn:
Please.
Dr. Alan Desmond:
Young woman with ulcerative colitis. So this is a form of inflammatory bowel disease. Her large bowel is very inflamed. I met her. She'd had this condition for about a year. She was in her first pregnancy, and the condition was raging. She couldn't eat. She was having-
Rip Esselstyn:
Can you actually see this? When you put a tube in-
Dr. Alan Desmond:
Yup, that's exactly it. Exactly. So she's rushing to the bathroom 12 times a day. She can't eat. She's got abdominal pain. She's anemic. She's pregnant. She's early in her first pregnancy, and she's worried about how this is going to go.
Rip Esselstyn:
Sure.
Dr. Alan Desmond:
Of course, right? Not only that, Rip, she's developed gestational diabetes. So insulin resistance magnified by pregnancy. So she's having to inject herself with insulin and check her blood sugars four times a day, which she's never had to do before.
Dr. Alan Desmond:
So I hadn't been involved in her care previously, but she came to see me at a couple of emergency clinics. And we're getting on in her pregnancy now. She's on medication. She's on steroids. She's not getting much better, and we're looking at giving her an immune suppressant drug. We tried to avoid using these in pregnancy, but when people are really poorly and really unwell, we will say yes. Best thing to do is to treat the inflammation. Let's do it.
Dr. Alan Desmond:
So she asks me, "What about food? Is there anything that I can eat or avoid?" And we talked about food, and I talked to her about plant-based. I point her towards some resources, including I think the Canadian Health Eating Guidelines, which are essentially whole food plant-based. We agree a two week break. We're not going to start the immune suppressants. Come back and see me in two weeks. Go and see what happens with the food thing. See you in two weeks.
Dr. Alan Desmond:
She comes back two weeks later, and I remember she tells me that she was so happy that she could cry. Her bowel habit was more normal than it had been for years. And her blood sugar control was better. Now she had got out of the room, and she was one of these patients who just went for it. She got some cookbooks and she changed to a whole food plant-based diet from a standard western diet overnight. That's a Galileo moment when you are able to put away the prescription pad for a couple of days and talk to your patient about food.
Dr. Alan Desmond:
So she got through the rest of her pregnancy without having to escalate her drugs, without having to take the potent immuno suppressants. And then a good sign, she kind of slipped off my radar for a little while. She didn't need to see me anymore. But I met her about three weeks ago at the clinic. She came back to see me at the clinic. It's a routine thing. I said, "Look, I haven't seen you for a year. That's got to be a good thing. How are you?" She's like, "Oh, I'm fantastic. I haven't had any symptoms from my colitis since I made the change." And we can measure the level of gut inflammation present but in a stool test called a fecal calprotectin. So her fecal calprotectin is normal and level and has been since she changed her diet. She's on very little medication at all.
Dr. Alan Desmond:
Better than that, when I met her a couple weeks ago, she's in the final stages of her second pregnancy. She hasn't had any flares of her colitis in the second pregnancy and because she had gestational diabetes in her first pregnancy, she was at a high risk of having it again. So she would have to check her blood sugars every day and go to the clinic once a week at the start of this second pregnancy. And after a few weeks, they told her she didn't have to come anymore because she didn't get gestational diabetes in her second pregnancy. So that's a Galileo moment.
Dr. Alan Desmond:
For practitioners like me, for doctors like me, and the other doctors you've spoken to and the other doctors you know like your dad, it's moments like that at clinic which become pretty routine, that's why we become so passionate about this. That's why we talk to people and stand on stages and do Zoom meetings and write books and do interviews because we need to get this info out there, not just to the public and to patients, but also to our fellow health professions and policymakers.
Rip Esselstyn:
Well, as a physician and the job you signed up for, it's to get your patients better. So this is obviously the best medicine going, right? I mean, how-
Dr. Alan Desmond:
Yup.
Rip Esselstyn:
How gratifying for you.
Dr. Alan Desmond:
Incredible. Because when we want to get our patients healthier, we don't leave any toolboxes in the box. Medications, incredible. Surgery, incredible. Colonoscopy, incredible. Vaccinations, incredible. But let's not forget about the number one driver of disease and disability in the western world, food. Food, food, food. Every doctor should be talking to their patient about food.
Rip Esselstyn:
Yup. And the number one driver of what can cure us, food, food, food.
Rip Esselstyn:
Isn't Alan just great? It's not often that you can sit with a doctor who is able to explain the why behind all of their tips, and I think you'll agree that he has done his research on all of the major studies that are out there. And one of the most exciting things to me is that professional societies around the world are finally starting to get on the same page with this revolution, the plant-based revolution, and I am just so happy that you are able to be a part of this massive paradigm shift that's happening before our eyes.
Rip Esselstyn:
Next week, we'll be back with part two of Dr. Desmond's interview. We're going to dig into the nitty gritty and learn how and why health really does start in the gut. We'll do a deeper dive on the microbiome, and we'll talk bugs, short chain fatty acids, and even the gut brain connection. Yes, as incredible as it seems, what you eat can affect your moods. Fascinating stuff.
Rip Esselstyn:
So until next week, go fill up those 10 prescriptions and we'll see you back here for a followup visit next week.
Rip Esselstyn:
Thank you for listening to the PLANTSTRONG podcast. You can support the show by taking a quick minute to follow us wherever you listen to your favorite podcasts. Leaving us a positive review and sharing the show with your network is another great way to help us reach as many people as possible with the exciting news about plants. Thank you in advance for your support. It means everything.
Rip Esselstyn:
Have you had your own Galileo moment that you'd like to share? What happened when you stepped into the arena and shed the beliefs that you thought to be true? I'd love to hear about it. Visit plantstrongpodcast.com to submit your story and to learn more about today's guests and sponsors.
Rip Esselstyn:
The PLANTSTRONG podcast team includes Carrie Barrett, Laurie Kortowich, Ami Mackey, Patrick Gavin, and Wade Clark. This season is dedicated to all of those courageous true seekers, who weren't afraid to look through the lens with clear vision and hold firm to a higher truth. Most notably, my parents, Dr. Caldwell B. Esselstyn Jr. and Ann Crile Esselstyn. Thanks for listening.
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