Lifestyle medicine: Finding the right 'dose' to combat chronic disease

Two years ago, the biggest success story here at The Wellness Clinic was a client named Jeffery. Our weekly Zoom sessions literally changed his life. Let’s review the status of Jeffery’s health before we met. He had every problem you can imagine in terms of chronic disease.

He had obesity class 3, high blood pressure, type 2 diabetes, high cholesterol, and anxiety. This is what we call metabolic syndrome. Then, he got started on his program. At first, it was slow going. But Jeffery was determined and persistent. He knew that if he didn’t tackle his health issues head-on, his future quality of life wasn’t going to be great. 

He had the advantage of an extremely supportive wife. As time went on and we fine-tuned his program, the progress became better and better. And every time he was able to reduce another medication, his weight began to drop more steadily and in slightly larger amounts. 

After about half a year of work, he ceased taking five different medications. Now, without all of these medicines, he no longer had a blood pressure problem, he was no longer a type 2 diabetic, his cholesterol was in a great place, and his anxiety was very much under control. 

He had lost 30 kg. (66 lb.), and he felt like a brand new person with a new life. It is now two years later, and all in all, compared to what once was, Jeffery is in a good place. But he was back in contact with me this past week. 

The reasons were some slight weight gain and an uptick in cholesterol. I asked him to track his food for a week, and then we met. There were some big lessons to learn from what we discovered.

What’s the dose?

When one gets sick with a common illness, say a throat infection or bacterial bronchitis, we go to the doctor. After examination and perhaps a test, he verifies the infection and prescribes antibiotics. 

He picks the appropriate choice and explains the dose to you – how much to take and how many times per day. This is actually one of the tricky parts of prescribing medication. Too little, and the drug is ineffective. Too much, and the side effects can be pronounced and even damaging.

Several years ago, a lady with very high cholesterol came to see me. I helped her overhaul her diet, and in five weeks, her cholesterol dropped 110 points. Remarkable. Her physician and another doctor I showed the results to couldn’t believe it. 

In contrast, let’s take a look at yours truly. When I switched my diet, my cholesterol also dropped – but it took a year and a half to achieve a similar drop. It was only when I shifted to a 99.5% whole food, plant-based, low-salt, low-sugar, and no-oil diet, that I saw an even bigger and more dramatic lowering of cholesterol. 

This means that for this lady, an 85% whole food, plant-based, and cutting-out-junk-food-diet, brought a very quick and pronounced result. For me, on a similar regimen, it took 18 months, and only with 99% compliance did I see as radical a drop as she experienced. There is certainly dose dependency in lifestyle, and it can be very individual. 

What happened to Jeffery

After looking very carefully at Jeffery’s eating habits, I found that he had made some very small changes in the wrong direction that put his health in reverse. I had recommended that he eat a maximum of three to four small portions of animal protein each week. 

By anyone’s definition, that is a very plant-predominant way of eating. He doesn’t eat junk food. But what happened was that those small portions became larger portions, still 3-4 times a week, but sometimes, his portions were almost double my recommended serving size. 

That means he was now eating more in the range of 6-7 portions weekly. Over a long period of time, it makes a big, big difference. This is the difference that resulted in the rise in cholesterol and the creeping weight gain. 

The other poor habit that had snuck back into his life was eating solid food late at night. That may not have affected his cholesterol, but it definitely contributed to his weight gain. 

Jeffery is back on course now, and this should bring his cholesterol and weight back to a good place. But how do we know how much is enough in dietary change to bring results? What is the dose?

Here is what we know. Someone who eats a plant-predominant diet, meaning roughly 85% or more of the food they consume is made up of unprocessed plants, doesn’t smoke, stays active or exercises, and keeps their weight in the normal range, will decrease the chance of chronic disease by about 80%. 

They will live longer. This is a great statistic based on a lot of reliable epidemiology. But different people have different needs and goals. What helps one person may not be enough for the other. Jeffery got a little too liberal on the consumption of animal protein and it cost him. 

So here is my rule, that I try to apply to my clients. If you are a person who wants to prevent disease or simply halt the progress of early-stage disease, then 85% compliance, along with the elimination of ultra-processed food will usually do the trick. 

However, if you already have a more advanced disease, the closer you are to being 100% compliant on a whole food plant-based diet, along with exercise, good sleep, and no smoking or any other substance abuse, the more likely you are to get amazing results. 

The dose is important – very important. It’s always beneficial to add positive health behaviors. But in order to defeat disease, make sure your lifestyle medicine prescription is the right fit for you so that you will be able to “add hours to your days, days to your years, and years to your lives.”