April 3, 2013

Dr. Craig McDougall: Bringing public health into the kitchen

This week is National Public Health Week, so it's appropriate to highlight the importance of a healthy diet. Just like you, I read all kinds of conflicting advice online, in newspapers, and hear about the benefits of different diets on the radio. There is a consistent theme. As Michael Pollan said, "Eat food. Not Too Much. Mostly Plants."

I've decided to invite expert colleagues to submit guest posts to my blog so you, the readers, and I can learn from the discussion. Read on.

- Preston Maring

My name is Craig McDougall, MD, and I am a new physician, an Internist, at Kaiser Permanente in Beaverton, OR.

Like most doctors, I went into medicine to help people. Unfortunately, the tools I was given to treat chronic disease fell short of my expectations. I learned how to start medications and refer patients for complex procedures, but nowhere in my 7 years of training did I learn how to truly improve someone’s health. Most of what I had learned, I now realize, was simply an attempt to relieve the signs and symptoms of diseases caused by poor lifestyle choices. As a result of this ‘more is better’ approach, 2.7 trillion dollars are spent per year on healthcare in the US, and still we have some of the worst healthcare outcomes among developed countries.

Fortunately, I have learned that, 70 to 80 percent of the problems that I see as a primary care doctor can be prevented, improved, or cured with a healthy diet.

I learned how to truly help people from working with my father, John McDougall, MD, at his medical practice in Santa Rosa, CA. He, and others, have taught me the amazing power of diet therapy. I learned that when people eat a starch-centered diet, avoiding animal products, added oils, and other refined foods, most chronic health problems simply disappear. Other terms used to describe a starch-centered diet are low-fat vegan, pure vegetarian or a plant-based diet. Labeling this a starch-centered diet, places focus on where people should obtain the bulk of their calories. A few examples of starchy foods include rice, corn, potatoes, sweet potatoes, grains and beans. Starchy foods are loaded with fiber, energy, vitamins, minerals, and plenty of protein, while being very low in fat and contain essentially no cholesterol.

Worldwide, populations who live on starch-centered diets avoid obesity and many of our common diseases, including type-2 diabetes, heart disease, hypertension, stroke and common cancers (breast, prostate, and colon); these are among the leading causes of death in the US. Examples of thriving populations who have lived on starch-centered diets include Japanese, Chinese, and other Asians eating sweet potatoes, buckwheat, and/or rice, Incas in South America eating potatoes, Mayans and Aztecs in Central America eating corn, and Egyptians in the Middle East eating wheat.

In addition to the benefits of disease prevention and treatment, diet-therapy is without harm and is low-cost which would benefit our healthcare system and our nation. If a healthy America is truly our goal, then diet should be at the center of our healthcare discussion, the building blocks of medical education, and the focus of patient care.

Below are some of my favorite links to website information about plant-based diets and recipes--All are available for free.

www.drmcdougall.com: My father, John McDougall, MD’s website. Here, under quick links, you can find a section called ‘free program.’ This is a step-by-step approach to lifestyle change. Also you can find access to his free newsletter that focuses on many heath related topics and there is an archive of over 1000 plant-based recipes.

www.nutritionfacts.org: Michael Greger’s MD website provides a collection of daily short videos focusing on nutrition.

www.plantpositive.com: a collection of videos focused on debunking the myth of Paleo, or Atkins style diets.

www.forksoverknives.com: Official website for the documentary of the same name.

www.pcrm.org: Website for Physician’s Committee of Responsible Medicine. President is Neal Barnard, MD. His personal website is www.nealbarnard.org

www.heartattackproof.com: Caldwell B. Esselstyn, MD, website for his program to prevent and reverse heart disease.

www.ornishspectrum.com: Dean Ornish, MD program. Here you can find information about his program and what type of research he is conducting using a plant based diet.

One of my favorite vegan recipes, that is a regular in my home, is from my parents’ August 2009 newsletter:

Monk Bowl

Preparation Time: 15-30 minutes
Cooking Time: 45 minutes
Servings: 4

1 ½ cups uncooked brown rice
4 cups water
6-8 cups assorted chopped vegetables (see hints below)
1-2 cups sautéed tofu cubes (optional)
1 ½ cups cooked beans of your choice (optional)
Sauce of your choice (see below)

Place the rice and water into a saucepan and bring to a boil. Reduce heat, cover and simmer for about 45 minutes until tender. (Or you can cook rice in a rice cooker)

Steam the vegetables just until tender. Remove from heat and place in a bowl.

To serve, place a scoop or two of the rice in a medium bowl (or on a plate). Layer some of the vegetables over the rice, followed by the tofu and beans, if you wish.

Top it all off with a couple tablespoons of sauce of your choice.

Hints: This can be made with any variety of brown rice. Or use instant brown rice or frozen brown rice to save some time. Chop the vegetables into similar sized pieces so they steam in about the same length of time. Try broccoli, carrots, snow peas, snap peas, broccolini, asparagus, bok choy and kale. Top this with a couple of tablespoons of sauce or your favorite oil-free salad dressing

Peanut-Hoisin Sauce

This is a higher-fat choice because of the peanut butter.

Preparation Time: 10 minutes
Servings: makes 1 cup

½ cup natural chunky peanut butter
½ cup water
2 tablespoons hoisin sauce
1 tablespoon soy sauce
½ tablespoon agave nectar
2 teaspoons chili garlic sauce
2 teaspoons tomato paste
1 teaspoon lime juice
½ teaspoon grated fresh ginger
Dash sesame oil

Place all ingredients in a food processor and process briefly until well combined but not smooth. Pour into a covered container and refrigerate until ready to use. May be heated before serving, if desired.

Asian-Ginger Sauce

Preparation Time: 5 minutes
Cooking Time: 5 minutes
Servings: makes 1 ½ cups

¾ cup water
½ cup low sodium soy sauce
¼ cup rice vinegar
1 tablespoon mirin
1 tablespoon agave nectar
1 teaspoon crushed garlic
1 teaspoon grated fresh ginger
½ teaspoon crushed red pepper
2 tablespoons cornstarch

Combine all ingredients in a saucepan and whisk until smooth. Bring to a boil while stirring and cook and stir until thickened. Serve warm over grains and vegetables.

Baked Tofu

Preparation Time: 5 minutes
Marinating Time: 10 minutes
Baking Time: 25-30 minutes

20 ounces extra firm tofu
¼ cup soy sauce
1/8 cup rice vinegar
1 teaspoon agave nectar
Dash sesame oil (optional)

Drain tofu and slice into ¼ inch pieces. Place in a large flat baking dish. Combine the remaining ingredients and pour over the tofu slices. Allow to marinate for at least 10 minutes and up to 1 hour. (Or place in the refrigerator and marinate overnight.)

Preheat oven to 375 degrees.

Remove from marinade and place on a non-stick baking sheet. Bake for 25-30 minutes, turning once halfway through the baking time. It should be brown and crispy on the outside. Remove from oven and cool. Slice into strips or cubes for use in recipes calling for baked tofu.

Hints: This tastes much better (and is less expensive and healthier) than the baked tofu found in packages in many markets and natural food stores. Other seasonings may be added as desired, such as garlic, ginger, balsamic vinegar, or rosemary, to change the flavor of the tofu. It’s also delicious just marinated in plain soy sauce. The marinade may be saved in a covered jar in the refrigerator a couple of weeks for later use. The tofu may also be cubed before baking with slightly crispier results.