DFN Health in Nutrition Conference 2023

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Plant-based physicians and health professionals from across the globe gathered in Melbourne last month for an intense, two-day conference covering the wide-ranging benefits of whole food eating.

Organised by registered charity Doctors For Nutrition, the conference featured a venerable line-up of recognised international guests and a strong contingent of local practitioners from Australia and New Zealand.

As an organisation, Doctors for Nutrition focuses on medical and health professionals. However, as a lay observer, I was surprised at how much of the information presented would be easily understood by the general public. After the event, Dr Martyn Williamson of Alexandra remarked that this was a "great conference with some useful presentations from experts", so it was also reassuring to know that medical professionals found something to chew on too.

This conference contained a massive amount of worthwhile information, and comments made by Dr Williamson at the event provide a useful access point to drill into its detail. Firstly though, let's consider the theme that drew everyone together.

This was billed as the Nutrition in Healthcare Conference. Its title implies practicality. At the same time, it raises obvious questions like, what do we mean by nutrition in healthcare? How do we make it happen if it isn't already there? The title is almost an oxymoron because you'd think nutrition would be a normal part of healthcare, wouldn't you?

A challenging discussion

Well, therein lies a significant and often quite challenging discussion. Strict whole food plant-based eating means life without all animal products, fish, sugar, oil, salt, highly refined products, dairy and alcohol. It's an awkward message for doctors to communicate and for patients to comprehend, especially in the space of a 15-minute consultation. Often, the easy answer for both sides is a pill.

A casual observer at such a conference might be forgiven for thinking there is another message to be 'sold' or told here, but on that point, Dr Williamson is very clear.

"I don't sell anything to anybody, and I've given up telling people what to do. It's probably the most ineffective way of helping someone make a change," he explained in a discussion panel on the final afternoon.

The GP panel drew together the most critical elements of the conference and opened up that burning question - how do you actually explain it to your patients? Dr Williamson continues: www.doctorsfornutrition.org/nihc

"I don't sell, and I don't tell. Nor do I persuade, because if you do help someone change through persuading them, you kind of force them into actions that they wouldn't normally have done. I inspire."

The following article covers a small segment of the Doctors For Nutrition Conference held in Melbourne, Australia, February 17-19, 2023. If you are interested in developing a deeper knowledge of plant-based nutrition, we recommend checking out the conference videos, which can be accessed at the web address below until June 30, 2023.

Panel chairperson Dr Luke Wilson: "Suppose then, you have a patient whom you know would benefit substantially from dietary change – how do you suggest we go about conveying this to them?"

Dr Williamson answered it by referring to the experience of conference MC Clint Paddison, who recovered from severe Rheumatoid Arthritis using a plant-based diet.

"Let's say Clint comes in to see us. We know he has had this diagnosis; we want to enquire, we want to connect. I might say to Clint, tell me what impact it's had on you of being given this diagnosis of Rheumatoid Arthritis. I might give him a little prompt by saying, I guess it came as a shock; I guess you have a sense of loss of physical activity and other losses in life.

"He will either nod and agree if I've got that right, but I don't have to get it right; I just have to show him that I'm thinking about what it might be like. Then he'll share his story of loss and what it means to him, the impact and probably most important, it's affecting his ability to have a family. If you really hit the marker, then it might bring a tear to their eye, and it might bring a tear to your eye too.

"Once you've heard that, then you'll know what's important to that person, so I might then say to him, Clint, my role here is to give you the best possible chance with the best course you could possibly have with this diagnosis, so that, maybe you could turn this around through things that you can do - I'm wanting to empower you to make a difference to your health.

"If I've expressed that correctly, then 99 times out of 100, you are going to get someone who is really interested in what you have to say because you've given them hope and you are talking about empowering them. Then what I would say is the first step to make is probably dealing with your nutrition. I've come across something called whole food plant-based nutrition; it's about… and I might explain a little bit and say, if you're interested, watch a documentary called Forks Over Knives, and it'll tell you a lot more. If you are interested and you think it is something you want to give a try, then come back and see me. That conversation probably takes less than five minutes - that's all I do."

Immediately following the panel discussion came a presentation from Dr Malcolm Mackay MD, Dr Peter Johnston (dietitian) and Jenny Cameron that focused on the outcomes of WFPB intensive programmes. Dr Johnston said there were four elements to their review process. These involved:

1. Understanding the strengths of group programmes in nutrition education.

2. Exploring strategies to help people with behaviour change.

3. Appreciating the barriers to making healthy lifestyle changes and

4. Understanding the dose-response nature of dietary intervention.

Jenny, who is deeply involved in the nutrition side of their seven-day WFPB emersion retreats, said their approach strongly relied on the work of Doctors Doug Lisle and Alan Goldhamer as outlined in their book, The Pleasure Trap.

Pleasure, pain, and energy

"We explain to people; it's not your fault if you've struggled with food, with weight management for a long time. We were programmed to think pleasure, avoid pain and conserve energy. And this happens in an environment of an abundance of food so much richer than our natural history," she said.

"We look at the biological and social barriers to making change and give them strategies to overcome these barriers, including bringing in someone to give a session on mental health and selfcare."

She said their programme recognised that people "can't live in a bubble," so they also deal in strategies that enable participants to deal with temptation. Living with the change became easier when it became part of a person's identity.

Conference heavy hitters included US Doctors Dean and Ayesha Sherzai, who attended personally, along with Doctors Caldwell Esselstyn and Michael Greger, who beamed in via Zoom and Doctors Alan Desmond and Gemma Newman from the UK, who also attended in person.

Dean Sherzai is a behavioural neurologist/neuroscientist. In company with his wife Ayesha, a vascular neurologist and research scientist, they pack a powerful punch on the subject of brain health. The Sherzai's dove directly into their specialist field with a presentation titled Preventing Cognitive Decline.

Dr Dean explained that the totality of the human brain had the capacity to expand well into our 80s, 90s and beyond, "but what happens in most of our lives in the west is that cognitive decline starts earlier than you think.

"Actually, just a few years ago, we used to say it starts in your 20s, but the reality is, with the foods we eat, with the stressors and the tension, it actually starts earlier. They've documented kids at 12 years of age who have white matter disease."

Both are particularly concerned about an oncoming dementia epidemic, particularly in the United States, where someone is diagnosed with some form of the disease every 64 seconds.

Dr Ayesha said, with Alzheimer's, a major turning point occurred at the 2019 plenary session of the Alzheimer's Association where, for the first time, it was all about lifestyle.

"The news came out that lifestyle factors were the best and the only bet now for reducing dementia risk. This was after failure after failure of not finding a medication or a disease-modifying agent for these devastating diseases." The answer was contained in a multiple of studies, she said.

Dr Greger focused on evidence-based weight loss and singled out the New Zealand based Broad Study for attention. He noted the key difference between this trial and other approaches was that participants were informed to eat a WFPB diet "ad libitum" and to focus efforts on diet rather than increasing exercise. The study was especially noteworthy, he said, because people lost a substantial amount of weight and kept it off after a year.

Lifestyle medicine practitioners and environmental advocates worldwide agree that dietary change would have a significantly positive impact on the future of our planet.

Perhaps then, the most fitting way to conclude here is with reference to the address delivered by Dr Peter Johnston on a subject that has become mission-critical in Australia and now, finally, in New Zealand.

By his own admission, the content of Dr Johnston's thirtyminute dissertation on Food Systems and the Environment was "grim".

"We’re in really big trouble," he said. "We can’t just rely on ending fossil fuel use. Even if we could do that tomorrow, it won’t be enough – we have to change our food system dramatically. We’re hitting multiple boundaries, and it’s quite frightening when you unpack it. Avoiding meat and dairy is the single biggest way you can reduce your impact on the planet."

Nuovo Minestrone

A new version of an Italian classic, plant-based, high protein, and gluten free. Buon Appetito! by Innes Hope

Thissoup is different every time - with no set recipe. The classic version contains wheat pasta, and sometimes parmesan rind, lard, and/or meat broth. Our version uses lentil pasta, which is high in protein and gluten free. Our secret ingredient? The protein-rich, surprisingly palatable cooking water from the lentil pasta!

Ingredients

You decide the quantity according to how much soup you want and how thick or thin you like it. Choose from each of the following x5 groups of essentials.

1. The base: ‘Soffritto’ – chopped carrot, celery & onion (I use spring onion or leek greens). Leftover pulse-pasta cooking water, water or vege stock.

2. Pantry & ‘hard’ vegetables, preferably in season. Favourites are kumera, pumpkin, green beans, peas, and zucchini in season. Tomatoes are key, so canned toms are fine in winter. Frozen veges can be included and leftovers like chopped potato or kumera.

3. Fresh, leafy greens in season. Cavolo nero (Italian kale) is superb. Silver beet and spinach are good too, but any fresh greens are fine.

4. Legumes – cooked beans or canned. Lightcoloured beans stand out against this colourful soup, especially butter beans and cannellini beans. Borlotti beans are popular, and any beans, or chickpeas, are fine to use.

5. Pulse Pasta – lentil pasta is great (it sometimes retains some colour when cooked with tomatoes), but any high protein gluten free pasta will suffice.

Optional ingredients – salt and a few herbs, fresh if possible. Bay leaf, rosemary, or oregano work well. Cracked black pepper to sprinkle on top.

Method

1. If you’ve no leftover pulse-pasta cooking water, pre-cook the lentil pasta for about half the recommended time, drain the liquid into a jug or pot, and put the pasta in a bowl so it almost reaches the top. Cover with a plate or foil.

2. Finely chop the soffritto vegetables and sauté them in a large pot.

3. Chop the pantry vegetables, add them, plus the herbs, to the soffritto. Pour in enough pasta water to cover the veges, and simmer for 30 mins so the veges ‘melt’ into a creamy texture. Stir occasionally. Add more liquid if needed.

4. Finely chop the leafy greens and stir them into the soup. Add the half-cooked pasta and cook for 3-4 mins. Stir in the beans and cook for another 3-4 mins. If you’re using dry pasta, cook the soup for the length of time recommended on the packet. Serve hot with fresh wholegrain bread and grind some black pepper on top.

Tips

Use any seasonal vegetable you enjoy, for example, corn, eggplant, parsnip, yams, broccoli, broad beans. Rice can be used instead of pasta (allow more cooking time).

Leftover pulse pasta cooking water adds nourishment to many other dishes too, so make sure you save it each time you cook pulse pasta!

Minestrone, minus pasta, can be made in advance – (it tastes even better when it has been rested). Before serving, bring it to the boil then add and cook the pasta.

For an instant version, used canned tomatoes and beans, and leftover pasta and vegetables. It won’t be as wonderful, but it’s a good backstop for exhausted cooks!

Leftover soup can be stored in the fridge or frozen.

If you’re home-cooking the beans, think a day ahead and soak them overnight. For best results and maximum nutrition, cook them in a pressure cooker.