How to Adapt the Chinese Diet to Modern Lifestyle Zhaoping Li, M.D., Ph.D. Professor of Medicine David Geffen School of Medicine, UCLA VA Greater Los Angeles Health Care System 如何调整中国饮食适应现代生活方式

2 Traditional Cuisine vegetables fruitsmeat whole grain

Adoption of Western Life Style Setting up the first McDonald's in China in Shenzhen in 1990 Expanding steadily and successfully China is the No 1 growth market for McDonald's » 960 restaurants » Over 60,000 employees

Adoption of Western Life Style Kentucky Fried Chicken has led the way in China Opening its first store in Beijing in 1987 The Colonel has opening another 1,242 Chinese outlets It pulled in $205 million in operating profits from China 2004

5 JUNK DIETS ARE OUT OF BALANCE TOO MANY CALORIES TOO MUCH FAT TOO MUCH SUGAR NOT ENOUGH VITAMINS AND MINERALS NOT ENOUGH NATURAL PLANT NUTRIENTS

6 Nutrient Classification Macronutrients Carbohydrates Fat Protein Micronutrients Vitamins Minerals Phytonutrients

Small ( 1-3/4” to 2-1/2” dia ) 131 calorie 1 cup (154g ) 132 Calorie 1 cup (cooked) 250 Calorie

Calorie450 Calorie

11 High Fructose Corn Syrup Current US annual consumption of HFCS 63 pounds per person

Adulteration of Food Supply Addition of fructose palatability (esp. with decreased fat) browning agent Removal of fiber shelf life freezing Cheap, ample supply

Fructose is Not Glucose Fructose does not suppress ghrelin Acute fructose does not stimulate insulin nor leptin Hepatic fructose metabolism is different Chronic fructose exposure promotes the Metabolic Syndrome Eliot et al. Am J Clin Nutr Nutr, 2002 Bray et al. Am J Clin Nutr Nutr, 2004 Teff et al. J Clin Endocrinol Metab Metab, 2004 Gaby, Alt Med Rev, 2005 Le and TappyTappy, Curr Opin Clin Nutr MetabMetab Care, 2006 Wei et al. J Nutr Biochem Biochem, 2006, Johnson et al. Am J Clin Nutr 2007 Rutledge and Adeli Adeli, Nutr Rev, 2007 Brown et al. Int. J.Obes Obes, 2008

Elliott, S. S et al. Am J Clin Nutr 2002;76: Fructose Metabolism in Liver

Fructose Increases de novo Lipogenesis Hellerstein et al. Ann Rev Nutr 16:523, 1996

Body Weight, Body Fat, and Lean Body Mass During 8 Weeks of Overeating Bray, G. A. et al. JAMA 2012;307:47-55

Fat

18 Increased Saturated Fat

20

Polyunsaturated Fatty Acids Omega-6 (linoleic) Sunflower oil (70%) Corn Oil (55%) Soybean oil (51%) Omega-3 (linolenic) Canola (10%) Walnut oil (10%) Fish (DHA, EPA) Leafy greens Flaxseed

Ratio of ω-6 to ω-3 Paleolithic Man 2:1 Traditional Chinese 1:1 to 2:1 Current American 15:1 to 30:1 WHO recommendation 5:1 to 10:1

Protein Protein is found in meat, fish, milk and cheese. Protein provides the building blocks for most of the body's tissues, nerves, internal organs Proteins are used to make neurotransmitters and are essential to improve immune system

Best Protein Sources

Why is Protein important? Protein helps curb hunger Protein helps build muscle mass Soy protein gives you high quality plant protein without the added calories of animal protein

Weight loss with Higher Protein Shakes

Four Year Body Weight Loss with Meal Replacement Pounds Experimental Period, months Meal Replacement, 1x a day Conventional Diet MR 2x/ day Group A Group B Flechtner-Mors et al. Obesity Research, 8: , 2000

Prevention of Weight Regain Percentage weight regain after body weight loss in the additional-protein group (n=73) vs the control group (n=75). * P<0.01,

Maintenance of Lean Body Mass with Higher Protein Intake Time course changes for the ratio of loss of body fat compared with loss of lean body mass (fat/lean) during weight loss for adult women consuming diets with a carbohydrate (CHO)/protein ratio of 3.5 (CHO Group) or 1.4 (Protein Group). Layman DK et al. J. Nutr. 133: , 2003 fat as % of loss: CHO = 68% PRO = 80%

Maintenance of Lean Body Mass with Higher Protein Intake Treyzon et al Nutr J Aug 27;7:23

Increased Satiety with Higher Protein Intake Perceived satiety for subjects consuming high-protein (HPLF, n = 9) or high- carbohydrate (HCLF, n = 7) low-fat, energy-restricted diets for 6 wk using a 7-point Likert scale.

Batterham et al. Cell Metab

UCLA One Year Weight Loss Studies In DM Patients Eur J Clin Nutr Mar;59(3):411-8.

MR

Eur J Clin Nutr Mar;59(3):411-8.

MR

Safety with Higher Protein Shakes

Bone Mineral Density

43 Traditional Cuisine vegetables whole grain fruits

THE TRADITIONAL ASIAN DIET IS THE HEALTHIEST DIET IN THE WORLD Sweet Home