Shireen: Podcasting from Dallas, Texas. I am Shireen, and this is a Yumlish podcast. Yumlish is working to empower you to take charge of your health through diet and exercise and reduce the risk of chronic conditions like type 2 diabetes and heart disease. We hope to share a unique perspective and a culturally relevant approach to managing these chronic conditions with you each week.

Shireen: In this episode we are speaking to Dr. Celine Heskey, who talks to us about plant-based diet. And also making the transition from an animal-based diet to plant-based diet and how a plant-based diet can be useful for someone to prevent or even delay chronic disease. Stay tuned.

 Dr. Heskey is an assistant professor of nutrition in the School of Public Health at Loma Linda University. Her recent and current research activities revolve around the effects of various nutrients and foods on body composition and cardiometabolic health. Welcome Dr. Heskey.

Such a pleasure having you on Dr. Heskey. I want to dive right in and want to understand a little bit more about how would you describe the impact of nutrition in your own life?

Dr. Heskey: I would say definitely early on my perspective was more along the lines of science and just trying to understand the role of nutrients and foods in terms of health inside of our bodies.

I was just really interested in the science of it. But over time my perspective has broadened and somewhat shifted. So, I’m definitely interested in disease management and prevention when it comes to foods. And nutrients and also those non nutrients compounds in foods like phytochemical.

I realized that there’s a lot we don’t know that we still need to explore and investigate. And I’ve also realized that our overall eating patterns are probably what’s most important rather than just looking at individual foods. And I also realized that empathy, is really important when providing education and counseling to other people, and also considering social determinants of health, which is really important in public health.

So, understanding that individual choice is not the only thing that drives behavior and trying to reduce judgment when considering individual choices. And as I continue to get older, there are always these occasions when you’re thinking about the choices that you’re making as an individual in terms of your diet and the outcomes related to that.

Shireen: Thank you for sharing that. Dr. Heskey you did a study back in 2019. If avocados can help control weight and compared the intake of avocados to the odds of becoming overweight between avocado consumers and non-consumers. Why did you and your group choose avocado as the super food to examine in the study?

Dr. Heskey: So, among the nutrition faculty that I work with, there is an interest of looking at whole plant foods and their effects on human health. Especially some plant foods that we are not really sure about especially because of the fat content. So historically they’ve looked at nuts, a lot of different types of nuts. Also fruits and avocado to see if those particular foods can reduce risk factors related to heart disease and diabetes, and also if they could improve cognitive function.

That’s just a summary of some of the recent research. So, we chose to look at avocados because they have a similar nutrient profile as nuts, and there’s already quite a bit of evidence that indicates that nuts are really good for health. And then looking at the avocado itself, it’s a nutrient dense whole food that has healthy type of fat in it is also rich in fiber and there’s evidence that avocados can improve satiety.

So, that could help to reduce hunger and calorie intake. So, we came up with a hypothesis that noting some of the things about avocado, maybe they could favorably impact weight. So, we know that avocados contain monounsaturated fatty acids both soluble and insoluble dietary fiber minerals, like, potassium, and magnesium.

Also contains vitamin C and it contains various phytochemicals, including phytosterols, and polyphenols, which are known to have favorable impacts on disease reduction, disease risk reduction. And there’s a fairly unique compound that’s only in a few foods called mannoheptulose, which is believed to have an impact on calorie intake and the gut hormones related to appetite, and that particular substance is found in avocados.

So overall people who incorporate avocados into their diet are more likely to have a better diet quality. So, their overall dietary pattern is more healthy and they tend to consume higher amounts of the nutrients that are found in avocados. So those are basically the reasons we considered in terms of looking at this food.

Shireen: You mentioned just a minute ago, dietary fibers. Can you explain the benefits of dietary fibers? And then particularly in avocados.

Dr. Heskey: Yeah, so fiber rich foods are important for the gut microbes in our large intestines. And in terms of the science, we’re just starting to really understand more about the link between gut health and various chronic disease risk factors Also, overweight and obesity and brain health.

So, we do know that there are benefits, but there’s still a lot more to learn and in addition to being sort of food for the gut microbiomes. Another benefit of fiber related back to why we looked at the avocado is that fiber is one of the components of avocados that increase satiety. So thereby decreasing hunger, which might help with weight management.

And then because avocados are a really good source of healthy fat, fat in and of itself also helps to increase satiety. And then when we look at the different types of fiber that are in avocados, Soluble fiber is fermented by the microbes and the intestines, which then causes the formation of short chain fatty acids, which are known to be one of the ways that soluble fiber helps to decrease the LDL or bad cholesterol in our bodies.

And another way that soluble fiber helps in that way is. It helps to increase the amount of cholesterol that is excreted from the body. And in terms of reducing the risk of cancer there is the thought that soluble fiber may help to prevent colon cancer cells from going. And then the insoluble fiber, they help to keep our bottles regular, which is also important for colon health.

Shireen: Okay. You know talking about avocado a little bit more now. Avocados are among the foods that are considered to be good sources of what you mentioned MUFAs, right? Can you elaborate on what exactly that is and why are monounsaturated fatty acids beneficial for us?

Dr. Heskey: So those are a type of fat that that’s derive from plants, sources, plant foods. And so some of the rich sources of MUFAs, in addition to avocados, include things like olive oil, canola oil, and peanut oil. When the MUFA is used in place of something like butter, which happens to be high in saturated fat, which is another type of fat replacing the butter with the MUFA can help to lower LDL cholesterol.

It can help to lower triglycerides. It can also improve endothelial function, which will then help with blood pressure control. And the MUFAs can also help to reduce inflammation which is important also in reducing the risk for various chronic diseases. So, all of those different impacts of the MUFA can then help to reduce the risk of diabetes and cardiovascular disease.

Shireen: We know that the prevalence of obesity can lead to cardiovascular disease, type two diabetes. How can diets rich in MUFAs be used to help combat the risk of these diseases?

Dr. Heskey: So, LDL cholesterol is one of the significant risk factors for heart disease. So, if you’re eating a diet that’s rich in MUFA and that helps to reduce the LDL cholesterol, that’s going to help to also reduce your risk of heart disease.

And one of the things about diabetes is that it’s a direct risk factor for heart disease also. So, any sort of choices that you can make that could decrease your risk of diabetes or help with the management of diabetes will decrease the risk of heart disease. I mentioned inflammation. and inflammation is sort of the key to a lot of different chronic diseases.

So, if we’re able to reduce inflammation, that will help to reduce Insulin resistance, which is a risk factor for diabetes. And inflammation also is one of the key factors in atherosclerosis, which is part of what causes people to have heart attacks and strokes and so on. So, if we’re able to reduce inflammation with foods, stutter rich in monounsaturated fatty acids, then ultimately, that can help to reduce the risk of heart diseases.

Shireen: Can you discuss some of the key findings from this study with our listeners? So, you looked at these certain types of fats, but what did you derive at the end of this?

Dr. Heskey: Yeah, so to give a bit of context this was an observational study, so we compared avocado consumers to non-consumers based on their reports at typical intake of avocados. And this study was done in a group of 70 Adventists who reside in the US and Canada. And many of them actually choose to follow a vegan of vegetarian diet for health reasons. So many of those people in that cohort are a bit health conscious.

So, what we found is that consumers tended to have a lower BMI than non-consumers. And non-consumers were more likely to become overweight or obese over time than non-consumers. But what was interesting is that among individuals who are 60 years of age and older, consumers were less likely to lose weight over time. Which initially you might be like, huh, that’s the opposite effect of what we would think we would find.

However, it’s possibly a good thing because when older adults lose weight, they often lose muscle instead of fat. Which could be an indicator of increased risk for malnutrition and poor diet quality. So, what we are thinking is that those people who have better diet quality who probably incorporate avocado into their diet.

As they get older, they’re less likely to suffer that weight loss that might not be good. And then lastly to summarize the key findings, we did see that vegans and vegetarians tended to be more likely to consume avocado than non-vegetarians.

Shireen: Speaking of vegetarian, you also focus a lot on plant-based diets, and I know that’s different. But you focus a lot on plant-based diets where you examine the effects of plant foods in chronic disease prevention. What are the different types of plant-based diets?

Dr. Heskey: Yeah, so that’s a bit of an interesting question because there isn’t any consensus, I think, among experts about what a definition is for plant based.

And there’s actually a pretty wide spectrum of diets that are considered to be plant-based by some individuals. So, I’ll give you an example that is sometimes surprising, but a Mediterranean diet is sometimes called a plant-based diet because the focus is more on plant foods and reducing the amount of meat that is in the diet.

And another thing I wanted to also clarify before I go into some definitions is that quality and content within a diet is really important when you’re defining what a plant-based diet is. So, to give you kind of an example there are some individuals who are on diets where they don’t eat any animal products, but the choices that they’re making are not necessarily healthy.

And so, when you consider that even though they’re not eating meat, it doesn’t mean that their diet is automatically healthy. And in the last few years there’s actually been research that shows that people who have more of a healthy plant-based diet that’s rich in whole grains, fruits, vegetables, nuts, legumes, vegetable oils, they have a lower risk of heart disease, for instance, than individuals who are on a “plant-based diet.”

And I put quotes around that on a plant-based diet, but it tends to be more like they’re eating a lot of junk food, French fries, sweets, and desserts, soda, fruit juice. Rather than some of those more healthy whole food options.

So, the key there is whole food and good diet quality and choices in terms of what a really good plant-based diet is. So, in terms of that spectrum of different types of plant-based diets we have vegan diets, which can be plant-based, so the focus can be on whole foods. But these individuals who follow this diet do not eat any dairy, eggs, or meat fish or any animal products.

And then vegetarians may include eggs and or milk into their diet. So, they have some of the animal products, but not flesh food. And then interestingly enough, there is a category called pesco-vegetarian. And these are individuals who don’t eat red meat or poultry, but they might include fish into their diet, and sometimes they may also have eggs and dairy.

And then flexitarians or semi vegetarians are people who don’t eat meat that frequently, so they might have it a couple times a week. And the portions that they’re having are probably a lot smaller than the average person.

Shireen: That then takes me to understanding the difference between plant-based diet and how they’re healthier when compared to an animal based.

Dr. Heskey: Yeah. So, if someone is following a healthy plant-based diet, it is possible that their diet’s quality can be better than an individual following an animal-based diet for a number of different reasons. So, what we’ve found in some research studies is that among vegans and vegetarians following a healthy diet, they tend to eat more fruits and vegetables than individuals who are eating meat.

And those are rich sources of variant nutrients and phytochemicals and fiber that we know are important for things like blood pressure control and so on. And they also tend to eat more whole grains which are also rich in fiber. So, they tend to eat more things like brown rice whole grain bread rather than white rice and white bread.

And then going back to the whole conversation about gut microbes when animal foods are consumed as we are digesting them and the byproducts of the digestion reaches the large intestines, the microbes also feed on that stuff. And what we found is that when the microbes feed on the byproducts of animal protein digestion it causes it the liver to produce a substance called TMAO, which is a risk factor for heart disease.

So that’s one of the things that helps us to understand why there’s a difference there. Additionally, individuals who follow these plant-based diets tend to get their protein from plant-based sources like legumes, soy, tough food, things like that which are known to have health benefits. And their fat choices tend to be unsaturated fat choices.

So, the MUFAs that we talked about, and also the PUFAs, which is another type of unsaturated fat. And they tend to have lower intake of saturated fat, which means that they’re less likely to have elevated bad cholesterol, LDL cholesterol. And when it comes to looking at their overall intake of all of these foods like grains, legumes, not seeds, plant oils and so on, those are actually good sources of plant steriles, which is a class of phytochemicals that are known to lower bad cholesterol. And the healthy plant-based diets can also reduce inflammation and oxidation within the body, which are known to help to reduce the risk of heart disease, diabetes, and cancer.

Shireen: So, then that takes us to the question of how does eating plant-based diets really help prevent potentially even reverse chronic conditions and then like heart disease and then can plant-based diets actually help us live longer?

Dr. Heskey: Yeah. So, in terms of heart disease, there is some research that shows that very restrictive plant-based diets, and these are diets where they didn’t have any animal products, no oils whatsoever, no avocado, unfortunately, no nuts, no soda, and other sugar sweetened beverages. Those diets can have been shown to reverse heart disease.

So, the issue there is some people may not be able to follow them for a long time and which is fine. There’s still benefits to the plant-based diets that we have described so far. But usually, they’re on them temporarily to kind of reverse the heart disease and then hopefully they continue to make good choices after that.

And then in terms of diabetes, that’s a hot topic, so we don’t have evidence that plant-based diets can cause the remission of type two diabetes. However, there is some anecdotal information that suggests that people who follow whole food plant-based diet are able to get their A1C down. They’re able to lose a lot of weight, which improves insulin resistance.

And so, they may not have to be on medication at least for a certain amount of time because their blood glucose is well controlled. But we definitely need some randomized controlled trials to really answer that question. And then in terms of living longer here in Loma Linda, California, it’s actually the only original blue Zone in the United States.

It has a high concentration of individuals who live beyond 100 years of age. And some of the key factors include following a whole food plant-based diet and participating in a community of faith. So, there is evidence that scientific evidence actually that individuals who follow a healthy plant-based diet do live longer.

Shireen: Well, can’t argue with that. I mean the healthiest sort of the blue zone, the original blue zone part of the country. It seems like the benefits of plant-based diet are just quite astounding. And it also seems that there’s a healthy option here for a lot of people, especially those struggling certain chronic conditions. However, are there any nutritional deficiencies that you can point to that are associated with a plant-based diet?

Dr. Heskey: Yeah. There’s certain reasons why individuals could run into the risk for nutrient deficiencies. For one, there’s certain people who have certain health issues that increases their need for certain nutrients or makes them more susceptible to nutrient deficiencies, so it just makes it harder for them to plan a plant-based diet and follow it. And then there’s some individuals who switch to a vegan or vegetarian diet without adequate knowledge or planning. And so, they think that, oh, I just removed meat from my diet, so it’s perfectly fine. Without considering, maybe they might be missing certain things. So, I’ll just briefly talk about a few examples.

So, for instance, there’s some food nutrients that are found mainly in animal foods like vitamin D and very long chain omega-3 fatty acids like DHA. And so, targeting the foods that have those nutrients, like 45 foods would be key or in some cases supplements might be appropriate. There are certain nutrients that do not have a reliable plant-based source.

So fortified foods and supplements are absolutely necessary. And vitamin B12, which is a sort of big problem nutrient for many vegans is an example of that type of nutrient. And then there’s certain nutrients that are in plant foods, but the way that you cook that food can affect how much of the nutrient can be absorbed from the food.

So, an example would be calcium from green leafy vegetables. You may need to soak the vegetables and cook them, boil them in order to increase the bioavailability of the nutrient. And then there’s certain nutrients that have higher requirements for vegans and vegetarians due to the body not being able to absorb as efficiently from the plant foods.

So iron is an example of that. And then with iron, adequate amounts of vitamin C is also really important. And some sources of iron include fortified cereals, legumes, tough food, fortified foods, and so on. And then there during periods of growth and development, like during pregnancy, childhood, and also for elderly individual, they may have unique needs because their needs are increased for their growth or to support aging.

And so those individuals might need to be really careful about making sure that they’re getting enough of those nutrients that are essential at those points in time. So, for instance, with elderly individual, Their protein needs tend to be higher. Also, their calcium needs tend to be higher, and that’s important for bone health and also muscle health.

Shireen: Perfect. And with that Dr. Heskey, we are toward the end of the episode, although I feel like we could have talked a little bit more about plant based and then animal based and all of that. But with that, I would love for our listeners to know how they can connect with you. Just learn more about your work.

Dr. Heskey: Yeah, so I’m on LinkedIn. I’m not big on social media. Besides LinkedIn, I also have a faculty page at Loma Linda University where my research and so on is updated.

Shireen: Perfect. And with that, thank you so much Dr. Heskey for joining us on this episode. It was very insightful to hear about all those different things, the components of a plant-based diet and I didn’t know all these benefits of avocado, but certainly something I’m going to remember going forward to our listeners who are here with us today.

Follow us on social media. Head over to our Facebook, our Instagram, find this podcast post and answer this simple and quick question. Help us understand how you have perhaps transitioned from an animal-based diet to a plant-based diet. Share some of the advantages that you’ve personally experienced since you’ve met the switch.

So, if you have made that switch over to a plant-based diet, Been a plant-based consumer for a while. Tell us how it has impacted your life and what are some advantages that you’ve seen in your health and improvements that you’ve seen in your health better yet through making this switch to a plant-based diet.

So we’ll find you on social media, on Facebook, and on Instagram at this podcast post on our social media. And once again, Dr. Heskey, thank you so very much for your time.

Dr. Heskey: Thank you.

Shireen: Thank you for listening to the Yumlish Podcast. Make sure to follow us on social media at Yumlish_ on Instagram and Twitter and @Yumlish on Facebook and LinkedIn for tips about managing your diabetes and other chronic conditions, and to chat and connect with us about your journey and perspective.

You can also visit our website, Yumlish.com for more recipes, advice, and to get involved with all of the exciting opportunities Yumlish has to offer. If you like this week’s show, make sure to subscribe so you can hear more from us every time we post. Thank you again, and we’ll see you next time. Remember, your health always comes first. Stay well.

Connect with Dr. Celine Heskey

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Dr. Heskey’s Research on Avocado