Of Mothers and Malhotra: There Are Many Ways to Eat Poorly

My sincere sympathies go to the family of Dr. Anisha Malhotra, recently deceased at the young age of 68. Condolences go to her son Aseem Malhotra, MD, who shares with me advanced training in interventional cardiology. Both Aseem and I have branched off to employ the media as a platform to focus on nutrition and lifestyle as a preventive strategy rather than procedural and pharmaceutical heart care. We share the goals of preventing coronary heart disease, obesity, and type 2 diabetes and both of us call for healthier hospital food.

The dietary approach that the two of us advocate differs however, and we have had an opportunity to debate these differences at a health symposium. I have also highlighted significant issues and differences that exist in our approaches in a review I wrote of his book on diet and lifestyle.

Recently, Aseem chose to profile his mother’s death in the British mediaand blamed her vegetarian diet for part of her poor health. Although he paid a kind tribute to his mother, seen holding his book on nutrition and lifestyle in her hands, the majority of his article was a rant against vegetarian and vegan diet patterns unrelated to his mother. He concluded the article saying:

“Sadly, her devout religious faith to avoid consuming animal products, combined with a high starch, high sugar diet, was ultimately to the detriment of her health. I very much hope that her premature and painful death was not in vain and we can learn that much of these ills are preventable”.

Although one wonders why his mother’s diet over the years did not evolve to one with minimally processed foods, the fact that a poorly chosen vegetarian diet can be unhealthy is not new. For example, health outcomes over 25 years were compared from a large database at the Harvard School of Public Health. Diet histories were compared for subjects eating a healthy plant-based diet pattern concentrated on whole grains, fruits and vegetables, nuts, legumes, teas, coffee, and vegetable oils versus an unhealthy pattern high in juices, sweetened beverages, grains, sweets, fried potatoes. During the study 8,631 subjects developed coronary heart disease (CHD). Overall, eating a plant-based diet lowered the risk of CHD by about 8 percent. This relationship was much stronger for those following the healthy plant diet pattern with a 25 percent reduction in their risk of coronary heart disease. Of importance, the subjects eating the unhealthy plant food pattern, perhaps like Aseem’s mother, actually increased their risk of CHD by as much as 30 percent.

A healthy vegetarian or vegan diet is a whole-food plant-based diet (WFPB) and not a junk food diet packed with processed foods. Indeed, a WFPB diet has been proven to halt and reverse coronary heart disease.

In reality, how much confusion is there over the optimal dietary patterns for preventing disease and enjoying health? Not much at all as was highlighted in a recent conversation between David Katz, MD, founder of the True Health Initiative and author of The Truth About Food with Dan Buettner of the Blue Zones. As Dr. Katz commented, “there’s more than one way to eat badly and the American culture seems committed to trying them all”. Sadly, it appears that this is true of the Indian culture as well and prior nutrition studies have documented this.

Dr Katz goes on to summarize the body of nutrition science as leading to 3 truths all can agree upon:

TRUTH #1: There is no confusion among experts.

TRUTH #2: A diet high in plant foods (beans, vegetables, nuts, fruit, whole grains) and low in processed foods is best for health and longevity.

TRUTH #3: Over 80 percent of chronic disease and premature death could be prevented by following this healthy dietary pattern, getting regular physical activity, and not smoking.

Although this is certainly not a battle of mothers, I must comment that my own mum has passed her 86th birthday and enjoys exceptional health. Whether it is a round of golf, a pilates class, walking the treadmill, or attending political science lectures, she has been fortunate to have avoided chronic diseases and enjoys remarkable vitality. In part, her adoption of the Pritkin lifestyle and diet decades ago after visiting the Longevity Center has supported her life-long health. Her cooking is superb and features whole foods that are minimally processed and consist of fruits, vegetables, whole grains, and legumes. The meat loaf is long gone, and the lentil loaf and other tasty plant offerings are enjoyed by all.

I join Dr. Aseem Malhotra in the unified call to educate the public loudly and clearly that we are too eat a large amount of foods from plants, not made in plants. Reducing or eliminating added salt, oils and sugars is an accepted recommendation. A properly designed vegetarian or vegan diet, of whole foods supplemented with B12 and perhaps a few other nutrients like algae omega-3 (now available in a single and inexpensive daily vitamin) is a path to avoiding chronic diseases. That is the lesson that will honor the memory of Dr. Anish Malhotra and celebrate the vitality of my mum.