eCornell Plant Based Nutrition Certification
My name is Jaimela Dulaney. My nickname, Jami, is after a local general practitioner in the small rural town I grew up on the Pennsylvania-West Virginia border. Growing up, my parents and grandparents had vegetable gardens but also ate family raised pork and beef. We ate the Standard American Diet.
Diabetes and heart disease was very prevalent in my family and my mother’s parents died in their late forties and early fifties. Riding in the back seat taking my grandmother to the hospital late at night and sitting in waiting rooms played a big role in my going to medical school.
Cardiology made sense to me. By controlling risk factors for heart disease I could help people to avoid the fate of my young grandparents. I never thought that hypertension or diabetes could be reversed, only managed.
As far as my own genetic risk, I sought to stay in shape and eat what I thought was a healthy diet. The reality I believed was that if I exercised enough and controlled my portions I could delay the onset of those conditions. So I switched from golfing to running and started running marathons. I framed my finisher shirts and displayed them in my office to motivate my patients to exercise. Even though I was normal body weight, I still took statins for borderline high cholesterol.
My initial plan was to increase my exercise and eat a whole foods plant based diet with a focus on decreasing lipids and preventing diabetes. While my lipids remained adequate, my insulin resistance symptoms started to increase despite being at a very normal BMI. The macronutrients associated with a plant based diet was 80 % carbohydrates, 10% fat, and 10% protein. The carbohydrates were vegetables, fruits, whole grains, and limited nuts and seeds. The focus of a plant based diet is to maximize lipid lowering through a high carbohydrate low fat diet. However, the expense of chronic high carbohydrate intake resulted in more insulin and eventually insulin resistance for me and many of my patients.
After 15 years of a practice focused on an unprocessed plant based diet. we began to see complications. The first was a strikingly low level of the long chain omega 3 fatty acid, DHA in our plant based patients. DHA is a large component of the brain, the eye and the myelin sheath of the nerves. The second was an increase in insulin levels and HgA1C in normal weight individuals chronically exposed to high carbohydrate loads. This is secondary to nonalcoholic fatty liver disease and the accumulation of fat in the pancreas. The third was lower abdominal bloating associated with a markedly high fiber intake with a high carbohydrate diet in the aging patient population.
It is well accepted that diabetes, metabolic syndrome, and insulin resistance are major risks for cardiovascular disease and have been reported to be a 10 fold greater risk than the now debated LDL.
A high saturated fat diet along with adequate protein and a low carbohydrate intake has been associated with improved insulin resistance, increased HDL and lower triglycerides thereby decreasing cardiovascular risk. It has also been associated with improved satiety and better weight loss over time. We believe this gives us another tool in the tool box to help patients struggling with weight, and metabolic syndrome.
The goals of our practice are the same. Foremost, improve health span as long as possible through nutrition and movement. We will continue to provide an intimate practice experience aimed at the care of each individual as a part of our practice family. We respect the unique needs of the individual and feel even better equipped to meet their nutritional needs and health care goals.