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Food For Life with Dr. Mona Sigal – North Shore Magazine

9/1/14

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Of the hundreds of clients that Mona Sigal, MD, has treated at her Peabody practice, Nourish Health With Food For Life (NHWF- FL), one of the toughest was her husband, Julien Vaisman.

mona-sigal-articleDr. Sigal was transitioning from emergency room medicine to healing through healthy lifestyle practices while her husband, also a physician, was on medication to control his high blood pressure and cholesterol. Although he was a highly trained physician, he still had not made the connection of food and lifestyle to health.

“Eating is such a primal pleasure and primal need; the intellect has almost nothing to do with it,” Dr. Sigal says. She then boldly asked her husband if he would let her treat him. Eventually, as Dr. Sigal recalls, “he saw the light.” Within three months of a plant-based diet, he was off all his prescription medicines and felt like a different person.

Since Dr. Vaisman’s conversion to his wife’s regimen, “he’s become militant about it,” Dr. Sigal says. While her husband occasionally dines on fish, the couple otherwise maintains a plant-based diet with minimally processed ingredients—a diet that some would label vegan, though she is not fond of the word.

While practicing in traditional emergency rooms, Dr. Sigal had seen plenty of evidence of the effects of poor diet and inadequate exercise, especially relating to chronic illnesses such as type 2 diabetes, cardiovascular disease, and some types of cancer. “I harbored great passion,” she says of her years working in community hospital settings, “but I quickly became sobered and frustrated at not being able to change people’s lives. I was always putting out fires.” Too often, she says, she was seeing the same patients returning. “All these patients had gone home to the same diets and lifestyles they had [before],” Dr. Sigal recalls. “In the end, nothing had changed.”

mona-sigal-cookingSince she opened NHWFFL, Dr. Sigal has seen clearly that eating well and managing stress “are proven to be more effec- tive than most prescribed medications.” Finally, she adds, a plant-based diet and more conscious lifestyle practices are now more commonly accepted by many leading primary care physicians, includ- ing the mainstream Physicians Committee for Responsible Medicine.

Born in Romania, Dr. Sigal, 53, fled the Communist regime, moving to Germanywith her parents when she was a child. She later lived in Israel and then moved to the United States. Dr. Vaisman was her childhood sweetheart; the couple divorced and, after five years apart, remarried. Ahead of the curve, she studied the role of diet and lifestyle in chronic illness on her own. Even today, she says, “there is no real education on connections be- tween diet and lifestyle and disease.”

A team of professionals assists her at NHWFFL, including a mind/body coach, certified dietician/nutritionist, and yoga instructor. She and her staff see clients both individually and in group courses like “Breath as a Meditation Tool” and “Kickstart Your Health,” a cooking class.

Dr. Sigal knows that life is complex and busy, and that “people want quick fixes and miracles.” But, she notes, diet and lifestyle are the cornerstone. “A plant-based, whole foods diet is the best health insurance you can have.” nourishhealthforlife.com



This article appears in the September 2014 issue of Northshore Magazine

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Photo By MICHAEL BASU
Written By MARY GRAUERHOLZ

Big Cheese Meltdown – Dr. Sigal’s Testimony Before USDA

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thebig-cheese

Every five years the federal government publishes “Dietary Guidelines for Americans,” a series of recommendations on what we should eat. It’s a controversial list heavily influenced by industry lobbyists, leading to recommendations based on economics, not science. This is why Americans have grown so frustrated about “whether eggs are good or bad this week” – different reports, with different agendas, gain attention and often promote the opposite advice.

On January 14, 2014, Dr. Mona Sigal had the opportunity to present in front of the committee working on the 2015 guidelines. Her speech, which you can read below, excoriates the USDA for providing money to Domino’s to market their pizzas and use more cheese.

Commonly referred to as the “cheese pushing scandal,” the NY Times published a detailed journalistic investigation of the issue. There was justifiable outrage. Directly against their own recommendations, the organization mandated with safeguarding Americans’ health, had funded marketing that promoted not just eating cheese but also increasing daily intake of saturated fats. So much for the anti-obesity efforts of the same agency.

Call it karma or poetic justice, but following Mona,
the next presenter was announced: Jill Nicholls, representing the National Dairy Council.

The audience burst into laughter.

Dr. Mona Sigal’s Speech:
“My name is Mona Sigal, and I am Board certified emergency Physician. I have been in medicine for almost 30 years. In 2012 the USDA celebrated its 150th anniversary, after being founded by President Lincoln in1862. In his final annual message to Congress in 1864, President Lincoln called the USDA “The People’s Department”.

Is the USDA really The People’s Department?

In 2009, Domino’s Pizza’s domestic sales slumped. It then teamed up with a company named Dairy Management, which proceeded to devise and pay for a $12 million marketing campaign featuring pizzas with 40% more cheese. The campaign was a soaring success.

Dairy Management is a marketing creation of the USDA. It has an annual budget approaching $140 million dollars, financed by the dairy industry and the Agriculture Department. Dairy Management spent millions on research to support a 4-year national advertising campaign promoting the notion that people could lose weight by consuming more dairy products, even though other independent researchers found no such weight loss benefits.

Americans are now eating an average of 35 lbs. of cheese a year, nearly triple the 1970 rate – and probably more, because someone must be eating my share.

Cheese has become the largest source of saturated fat in the American diet.

Dairy lobbying groups have billions of dollars at their disposal and are being aided and abetted by the USDA, convincing the population and nutrition professionals for years that dairy is an essential part of a healthy diet and the only reliable source of dietary calcium.

But the fact is that dairy is the highest dietary source of:

  • Saturated fat.

And a significant source of:

  • Naturally occurring hormones which are detrimental to human health.
  • A source of infective agents, which are not destroyed by pasteurization.
  • Bacteria.
  • Blood and pus cells, whose numbers are defined by the so called somatic cell count, regulated courtesy of the USDA.

Dairy consumption has been linked to:

  • Certain cancers like prostate and testicular cancer in men and possibly ovarian and breast cancer in women.
  • Increased incidence of childhood diabetes Type 1.

So why is the USDA in bed with the dairy lobbying groups?

Because it’s their job.

What are we going to do in order to protect the public?

One possibility might be to move dietary guidance into a more independent federal agency like the NIH or CDC. Another way might be to recognize the ways in which corporate lobbyists corrupt our food system and do something about election campaign laws. One thing is for sure: We must have change. Now.

I left my work back home. I paid my own way to Washington, in order to stand before you today to make my voice heard. Why? Because I owe it to the patients I swore to take care of and protect.

Thank you.”

*Read the full NY Times article about the “cheese pushing scandal

Low on Carbs, Low on Fats and LOW on Truth

Another research article hit the media this week, rewarding those who love to hear good news about their bad habits.

The Annals of Internal Medicine published a paper titled: “Effects of low-carb and low-fat diets.”  In it, the authors conclude, “the low carb diet was more effective for weight loss and cardiovascular risk factor reduction than the low fat diet. Restricting carbohydrate may be an option for persons seeking to lose weight and reduce cardiovascular risk.”

The media  – social and otherwise – celebrated: See? We always knew it. Those evil carbs. Fat is good. Pass on the grass-fed butter.

While I am waiting to read what Drs. Barnard, Greger and McDougall have to say about this paper, I will give you my interpretation of the data. It is very important that we understand what the message is here, since too much misleading and downright false information is being poured over the public.

Who is going to argue with the honorable Annals?  By the way: I should mention, that the authors did not receive any funds from industry. Their grant was from the NIH.

I am not going to write a detailed critique about the study methods; overall they are sound. Although the cohort is small, the participants were properly randomized to either the low fat or the low carb intervention group; this is a good epidemiological technique when designing an interventional study, where a question is being asked and the outcome is unknown. Here the question was: are low carb diets, which are so popular for weight loss, improving cardiovascular risk profiles or not?

For starters: let’s establish what a low carb diet is: the popular ones are Atkins, South Beach, Paleo and Zone, and several variations thereof.

As far as low-fat is concerned: the authors used the currently prevailing (and failing) definition propagated by the American Heart Association of 30% of fat calories from the daily calorie intake. There is a very large body of research evidence, that 30% fat does not constitute a healthy diet: All the studies done which showed reversal of coronary artery disease and type 2 diabetes allowed for 10-15% fat calories from total calorie intake. In other words: no diet containing 30% of fat prevented or reversed anything ever.

Participants assigned to the low-carbohydrate group were instructed to eat no more than 40g of carbs a day.

Participants assigned to the low-fat diet were instructed to eat no more than 30% of total calories from fat.

Participants were also instructed to have the “recommended dietary fiber intake of 25g/day.”

All participants were instructed in the different kinds of fats and educated about the need to avoid saturated and trans fats as much as possible, and to get as much monounsaturated fats as possible.

And that, folks, is ALL we know about the dietary content of the diets that the participants followed. Now, considering that the FOOD eaten was THE MOST IMPORTANT part of this study, don’t you think that it would have been ABSOLUTELY key to provide more detailed information about what the participants actually ate? Instead, the researchers are leaving this up to the readers’ imaginations. And that is a big problem: the main readers of this journal are physicians, and their imagination as far as nutrition goes is limited to non existent. As for the lay readers like “health journalists”: they read what they want to read. See above.

Where it gets really interesting in this paper, is on page 313: Table 2 titled “Daily dietary composition in the low-fat ad low-carbohydrate diet groups over the course of the study” gives an overview of the nutritional components of the diets.

Presumably the data listed on the left under “Baseline” represents the dietary values of the participants at the outset of the trial. Usually, this is done by having participants complete food frequency questionnaires, which are then evaluated by dietitians, and the appropriate calculations are made does this. The numbers in parenthesis (..) represent deviations from the average number. For example, in the low-fat group, the average calorie intake was 2034 calories a day, which could vary by about 702 calories either below or above (1332 – 2736 calories a day).

Once the two groups (low-fat and low-carb) received their instructions and education, their diets were analyzed again at 3, 6 and 12 months respectively. Again: most likely this was done by having people fill out questionnaires about their diets.

For starters: both groups had their calories cut by about 500 calories and this is really the definition of a weight loss caloric intake. But over time, caloric intake crept up in both groups, since cutting calories in general is not that easy.

Looking at the macronutrient make up (fat, protein and carbs) of the diets in both groups, the low-fat group consumed a diet consisting of 53% carbs, 19% protein and 27.5% fat.

The low-carb group consumed 29% carbs, 25.6% protein and 42.7 % fat on average. Hmm. What does that remind you of? Can you guess? Yep. Eco-Atkins, people.

“Instead of the steaks and bacon found in the original Atkins diet, dieters [in the study] were given prepared foods that consisted mostly of healthy fats, soy foods, beans, nuts, seeds, no-starch gluten products, fruits, and vegetables. Some 31% of the calories in the diet came from plant proteins, 43% from vegetable oils, and 26% from carbs.

Protein came primarily from gluten, soy beverages; tofu; soy burgers; veggie products such as bacon, breakfast links, and deli slices; nuts; vegetables; and cereals. The diet emphasized viscous vegetables like okra and eggplant, along with other low-starch vegetables.

The diet included “good fats” from canola oil, olive oil, avocado, and nuts. The dieters got carbs from fruits, vegetables, and cereals, with a limited amount of oats and barley. But they ate no starchy foods like enriched white bread, rice, potatoes, or baked goods.” http://www.atkins.com/Science/Articles—Library/Cardiovascular-Health/-The-“Eco-Atkins”-Diet.aspx

The excerpt taken from the Atkins website does not refer to the study I am critiquing here. But if you look at the macronutrient break down you HAVE to start laughing. Eco-Atkins has gone VEGAN!!!!

The above description of what the Eco-Atkins food plan consists of is all about plant based, minimally processed whole foods – with the exception of the veggie bacon and sausage, but we shall forgive them that one. No mention of dairy, meat, fish or eggs. Yippee!! Take that, Paleo people. The original Atkins camp must be crying.

What makes it “low-carb”? The omission of WHITE bread and BAKED GOODS, i.e. crackers, cookies, cakes, and other processed floury snacks. DUH!

The usual witch-hunt on rice and potatoes is laughable. BROWN – and even white – rice as well as potatoes that have not been drowned in oil and smothered in cheese are HEALTHY carbs, because their starches are complex and unrefined. PERIOD. But that’s for another blog.

And this, folks, is where the un-truths out there fester and multiply: when you throw CARBS into one big vat without differentiating, you commit nutritional crime.

All of us agree that PROCESSED carbs are the villains, whether you come from the Eco-Atkins, the Paleo or the WFPB (whole-foods, plant based) corner.

So, it would have been of immense value if the researchers had actually shared the ACTUAL food contents of the various diets eaten.

If the so called low-fat group (at 30% fat from calories) ate their 53% of carb calories from breads, cookies and baked goods, it’s no wonder that their triglycerides went up, their weight loss was less than stellar. Low-fat has gotten us over the years into great trouble: all those processed foods like cookies, cakes and snacks that are “low-fat” are nothing but gigantic processed carb traps, which contributed to making us fat and sick.

Let’s make it VERY clear: if indeed the so – called low carb group in the study ate a diet similar to Eco-Atkins, they were essentially instructed to eat a plant based, whole foods diet, which surely they had not eaten before, and thus, OF COURSE, they showed significant improvement in weight and several other parameters like blood pressure, plasma insulin and glucose levels as well as cholesterol, triglyceride and other lipid numbers. DUH again.

While their fat intake at about 43% is surely high, switching these people to plant fats instead of animal fats, and ELIMINATING cholesterol from their diets hat tremendously beneficial effects, despite the high overall fat content.

So, what is the conclusion from this study? Not what people who heard about it on TV want to hear:

  1. Eating high fat diets is still bad for you. But if you are going to replace all your animal based foods with plant-based foods, even a high(er) fat diet is still better for you than what you are eating right now. Nope, butter and dairy fat is still not health food. Nor are fish, chicken or beef.
  2. Getting your protein from plants instead of animals is what your body was designed for and what is going to reverse disease or prevent it altogether.
  3. As long as you are eating PLANT based, you are going to thrive, even if you play around with the percentages of protein, carbs and fats. In the “low-carb” category it means, that you are going to eat relatively small amounts of corn and peas, and lots and lots of greens and low carb veggies like tomatoes, cukes, carrots, peppers, broccoli, cauliflower etc. More power to YOU.
  4. What I absolutely don’t understand in this study: if people ate an eco-Atkins style diet in the low carb group, how on earth did they get so little fiber?

In conclusion: a low-fat PLANT based, minimally processed, whole foods diet will achieve all of the health benefits touted in the “low-carb” group and then some. It also happens to be the diet that provides the best protection from cancers, autoimmune diseases and many, many other chronic conditions – not to mention the BEST weight loss ever, which is also sustainable long term.

Reference:

Bazzano L.A. et al: Effects of low-carbohydrate and low-fat diets. A randomized trial. Ann Intern Med. 2014;161:309-318

 

I Hate It – But It Loves Me Back

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Let me be frank: I hate exercise. Always have and always will.
In case you now find yourself disappointed in me – please keep reading.
I believe I’m a much better role model than all those “perfect exercisers,”
who don their squeaky-clean sneakers 24/7/365 and are out there rain or shine, with a big satisfied grin on their faces. It’s easy for THEM.

Not for me.

I hate exercise. I loathe it… but I LOVE the way I feel afterward.
And, no, there exists no pill that can give me that same feeling.
Unless you want to get high the illegal way. But, I don’t suggest it.

So why am I the better role model for you?

Because I exercise, despite the fact that I don’t like it.

Do you wash your hands after relieving yourself in the bathroom? I hope you do, since hand washing revolutionized medicine and public health, when it was finally linked to the transmission of some of the deadliest infections.

Do you brush and floss your teeth at least once a day? I hope you do, since oral hygiene goes WAY beyond healthy teeth and gums, and is tightly linked to heart, brain and general organ health. It is, I promise…

That’s how exercise/physical activity is. It simply reduces mortality. The research is unequivocal and earth shattering. Sure, there’s no such thing (yet) as immortality, but we all want to be around for as long as humanly possible, right? Right!

In an era when the majority of exercise is obtained by running fingers over keyboards and pressing one’s foot on the gas pedal, physical activity – its presence, or lack thereof – has been irrevocably identified and linked to disease prevention and reversal.

And we don’t need much of it.

150 minutes a week. 30 minutes five times a week. That’s what studies have shown to make a DRAMATIC and MAJOR impact on your overall physical (and heck, mental) health.

I am not talking athletics here. You don’t need to find yourself training to be an Olympian (unless you really like a challenge)… I prefer the term physical activity rather than exercise, since the latter may intimidate some who have not broken out in a sweat in a long time.

Sure, there are some clear criteria leading to the definition – but even housework that is intense enough to fulfill those criteria can count toward exercise.

Let me put things in perspective for you: You cannot exercise your way out of a crappy diet. Can’t be done. The research is sobering in that area. You cannot reverse or prevent disease with exercise alone without changing your diet for the better. In fact, the landmark studies on type 2 diabetes and heart disease reversal used a plant based, whole food, minimally processed, no added oils diet alone, just so the researchers could eliminate the “interference” from the exercise component, and make sure that all the benefits were indeed coming from the dietary changes.

BUT: exercise adds synergistic benefits to dietary changes that make the equation “1+1=3” more like “1+1=20.”

If you want to watch a great video on the benefits of physical activity, I highly recommend
23 ½ hours”. The content included therein saves me from listing them all here, and it’s short and entertaining.

The most important thing is to find the RIGHT physical activity for YOU. In lifestyle medicine, the only prescription my client-patient ever receives is the EXERCISE PRESCRIPTION. Because if it isn’t made to measure for YOU – you won’t do it. I know, I won’t.

So, how come I exercise despite the fact that I hate it? And, why (for a very long period of time in the past) didn’t I exercise regularly, despite ALL THE KNOWLEDGE I had? (That last part sounds familiar, right?)

The answer is this: I had to find my own way to exercise that turned it into a life activity that I actually enjoy, and therefore do not even regard as “exercise.”

In my case, it was fulfilling my long held dream of owning two large dogs. I love dogs, but my work schedule in the past would not permit me to do their needs justice. When I was finally ready to take on the responsibility of dog parenting, my life changed in the most dramatically possible way. How? Well, if you have two large dogs, you need to get out there! Every day! And as far as my dogs are concerned: the colder the better! ARGH! What no gym and no number of research studies could achieve, the dogs did. I’m out there, and these guys love to walk for miles! Win-Win.

But there’s more to it. I like goals, accountability, and data. And I’m very competitive. What really helps me in my daily efforts toward a healthy lifestyle is a little device I wear that measures steps taken, floors climbed, calories burned, and miles walked. I am not telling you the device name, because I do not want to advertise for it. This is not something that is right for everyone. For some a simple pedometer will do, or a workout buddy. My point is: GET TO KNOW YOURSELF. Don’t let others tell you what to do. Ask yourself, ‘what do I like? What would it take for ME to get more active, and do better?’

If you can’t explore this alone, ask me. I’d love to help you find the answers, and achieve the best YOU, you can possibly be.

To make an appointment with Dr. Sigal, email info@nourishhealthforlife.com or call 978-744-5804.