CONCLUSION VA Beach Diets Study ➢ Healthy diet and lifestyle are critical for preventing hypertension. ➢ In our study, all diets were associated with statistically significant reductions An Investigation of Plant-Based, Mediterranean, in blood pressure for all participants ➢ The Vegan diet proved to be the most effective at reducing LDL and total Paleolithic, and Dash Diets Study cholesterol ➢ No significant improvements in glycemic control were seen for any diet group Sophie Talreja1, Alex Talreja2, Hyeon Choi, MD3, Deepak Talreja, MD3 1. Princess Anne International Baccalaureate (Virginia Beach, VA) DISCUSSION 2. Ocean Lakes Academy (Virginia Beach, VA) 3. Sentara Healthcare (Virginia Beach, VA) ➢ Some limitations of this study included a) not incorporating a randomized study design and therefore allowing patients to select their research group, and b) approximately 40% of patients were lost to follow-up thus reducing the BACKGROUND Which diet do you think power of our 6-month findings. ➢ To improve this study, we could have a control group with which to compare Cardiovascular disease (CVD) is the leading cause of death in the U.S. and results, include more male participants in each group as well as people of all costs the U.S. billions of dollars per year in healthcare services is the healthiest? ages in the four groups. The leading risk factors for CVD include high blood pressure, high ➢ I would propose a follow study in teenagers to address community health cholesterol, diabetes, high dietary saturated fat, physical inactivity, obesity. amongst a younger generation. Prevention and/or control of CVD can thus be achieved by modifying aspects ➢ Vegan (Whole Food Plant Based) of one’s lifestyle such as diet Given that the Hampton Roads area is the 36th-largest metropolitan area in ➢ Paleolithic (Ketogenic) FIGURE 1: THE FOUR DIETS the U.S. and its CVD mortality rate is comparable to national data, it is an ideal place to conduct a CVD study ➢ Mediterranean METHODS Nondiabetic adults (ages 35-85) from the Hampton Roads area with one or ➢ DASH more risk factors for CVD were invited to serve as participants and then chose 1 of the 4 diets (n=280): ➢ WFPB (Vegan): 58 ➢ DASH: 65 ➢ Paleolithic: 77 ➢ Mediterranean: 80 Study Objective: Vegan (WFPB) Diet Paleolithic Diet Mediterranean Diet DASH Diet They received education on their selected diet and then began the 60-day • Focus on the consumption of • Low carbohydrate and high • A modern nutritional plan (Dietary Approaches to Stop The purpose of this study was plant foods such as fruits, protein diet similar to a hunter- inspired by the traditional Hypertension) vegetables, legumes, grains, gatherer diet of our ancestors dietary patterns of southern intervention in which they kept a daily food log and met weekly with a • A nutritional plan promoted by nuts and seeds • Primarily grass-fed lean meats, Italy, Greece, and Spain the U.S.-based National Heart, multi-disciplinary study team where they reviewed the diet and their recent to evaluate the impact of four • Allows breads, rice and pasta seafood, vegetables; and • High consumption of fruits, Lung and Blood Institute to (preferably whole grain) secondarily, fruits, seeds, eggs, vegetables, olive oil, legumes, prevent and control eating habits common diet programs: a • No meat or animal products are and nuts and whole grains; as well as hypertension allowed (excludes milk, butter, • Avoid: Processed foods, sugar, moderate consumption of fish, Their weight, blood pressure (BP), blood sugar, hemoglobin A1C, C- • The diet is rich in fruits, dairy); Nothing with “a mother soft drinks, grains, most dairy dairy products, and wine whole-food, plant based vegetables, whole grains, and reactive protein, lipids, and lipoprotein particles were assessed during an or face” products, legumes, artificial consumption low-fat dairy foods; and also • Dairy alternatives such as sweeteners, vegetable oils, • Generally minimize includes meat, fish, poultry, initial health screen and again after the 60-day intervention [WFPB] or Vegan diet, a soymilk, coconut milk, and margarine and trans fats consumption of red meat and nuts, and beans almond milk are allowed • Popularized by Walter associated meat products Group results were shared with participants from all dietary groups at a • Sugar-sweetened foods and • Popularized by Dean Ornish, Voegtlin and Loren Cordain • Recommended by the American Mediterranean diet, a beverages, red meat, processed town hall meeting and they were encouraged to continue with their Forks Over Knives, Heart Association (AHA) and foods and added fats are Gamechangers American Diabetes Association generally avoided in this diet respective with another follow-up health screen at 6-months. Paleolithic diet and the DASH (ADA) diet on participants’ RESULTS AFTER 60-DAYS modifiable CVD risk factors; TABLE 1: BASELINE DEMOGRAPHICS TABLE 2: 60-DAY COMPARISON

➢ After 60 days on their respective diets, subjects lost an average of 9 lbs. including weight, body mass Variable DASH (n=65) Paleo (n=76) Med (n=80) Veg (n=58) P-value (4.7% body weight, total 2,576 lbs.) with subjects on the Vegan and Paleo Weight (lbs) -7.7 ± 6.5*2 -13.4 ± 7.8 -4.4 ± 12.7*1 -12.3 ± 6.2 < 0.001 index (BMI), systolic blood BMI (kg/m2) -1.3 ± 1.2*3 -2.2 ±1.4 -1 ± 1*4 -2.1 ± 1.1 < 0.001 diets losing the most weight (~6.5%) SBP mmHg -10.7 ± 20 -11.6 ± 16.3 -13.5 ± 19.1 -15 ± 16.8 0.581 DBP mmHg -7.9 ± 15.5 -5.1 ± 10.8 -5.3 ± 9.3 -8.4 ± 10.2 0.231 ➢ Overall, participants on the Vegan diet had the most improvement in pressure, diastolic blood MAP mmHg -8.3 ± 20.4 -7.3 ± 11 -12.3 ± 20.9 -13.2 ± 18.4 0.165 Triglycerides, (mg/dL) -19 ± 64.5 -23.2 ± 46.3*6 2.2 ± 33.4 10.2 ± 49.4*5 <0.001 LDL (14% decrease), triglycerides (18% decrease) and total Total cholesterol (mg/dL) -12.1 ± 46 -7.4 ± 25.8 -6.4 ± 28.3 -29.2 ± 24.6*7 <0.001 pressure, and advanced lipid HDL-C (mg/dL), 0.6 ± 17 -1.3 ± 7.2 0.9 ± 7.3 -8.1 ± 9*8 <0.001 cholesterol (13% decrease) compared to all other diets (Table 2). LDL-C (mg/dL) -6.8 ± 33.3 -2 ± 21.9 -3.8 ± 23.9 -17.9 ± 19*9 0.002 parameters. Fasting blood sugar (mg/dL) 3.1 ± 18 1.7 ± 9.5 4.4 ± 7.8 4.6 ± 9.6 0.426 ➢ For HDL, the Mediterranean diet produced the greatest improvement HgA1C -0.01 ± 0.8 0.15 ± 0.2 0.09 ± 0.3 0.03 ± 0.2 0.179 LP-IR -6.3 ± 16.8 -7.5 ± 12.7 -2.8 ± 10.4 -0.4 ± 13.1*10 0.009

(5% increase) followed by the DASH diet (3% increase). HDL CRP -1 ± 9.7 -0.3 ± 3.2 0.2 ± 3.7 -0.7 ± 3.4 0.601 *p <0.01. 1) M vs P and V; 2) D vs P and V; 3) M vs P and V; 4) D vs P and V; 5) V vs P and D; 6) M vs P and D; decreased in the Vegan diet (10% decrease). 7) V vs P, M and D; 8) V vs P, M and D; 9) V vs P, M and D; 10) V vs P ➢ The total cholesterol improved most in the Vegan group (p=<0.0001) and triglycerides improved only in the Paleo group (p=0.005) ➢ Significant decreases in systolic and diastolic blood pressure DISCLOSURE INFORMATION (p=<0.0002) were seen in all diets. Sophie Talreja, Alex Talreja, Hyeon Choi, MD: No Disclosures ➢ Diabetic measures (HbA1c, Glucose and LP-IR) and inflammatory Deepak Talreja, MD: Speaker’s Bureau for Abbott, Astra-Zeneca, BI, Merck, Sanofi, St markers (CRP) failed to improve after 60 days for any diet group. Jude, GSK; and Research Grants: NMT Abbott, AGA