From Table to Able: Combating Disabling Diseases With Food

September 5, 2019 0 By Jose Scott

“From Table to Able: Combating
Disabling Diseases with Food” In my 2012 review, I explored
the role a healthy diet may play in preventing, treating, and
reversing our deadliest diseases. In 2013, I covered our
most common conditions. This year I’d like to address some
of our leading causes of disability. We want to live a long healthy
life, not a long miserable one. Heart disease is not only
our leading cause of death, but also our leading cause
of death and disability. Dr. Dean Ornish proved with his
plant-based diet and lifestyle program that cardiac patients had a
91% reduction in angina attacks (that’s the crushing chest pain that some
people with advanced heart disease can get). In contrast, control group patients,
who were instead told to listen to the advice of their doctors,
had a 186% increase in attacks. This marked reduction in chest pain
was sustained five years later, a long-term reduction in pain
comparable to that of bypass surgery, but without the knife or the saw
used to cut our chest in half. Forks over knives.
Soup over saws. But this was back in the 90’s
when Ornish was only studying a few dozen patients at a time. How about a 1,000 patients on
a whole food plant-based diet? Within three months, nearly
three-quarters of angina patients became angina free — 74% cured
without a single scalpel or side effect. Now Ornish didn’t just put
people on a plant-based diet. He also advised moderate
exercise like walking. So how do we know what
role that diet played? Well, if you go back to
Ornish’s first publication, he put cardiac patients on a quasi-
vegan diet with no added exercise — just diet and stress management — and got a 91% reduction in
attacks in less than a month. And Dr. Esselstyn was
able to improve angina using a plant-based diet as
the only lifestyle intervention, so we know the diet is
the active ingredient. But, you know, they
weren’t the first. There are case series
going back to the 1970’s. We’ve known about
this for decades. Angina and the Vegan Diet,
like Mr. F.W. here. Chest pain so severe he had
to stop every 9 or 10 steps. Started on a vegan diet —
not even a low fat vegan diet — and months later climbed
mountains, no pain. Now this may be because
vegetarian arteries dilate four times better
than arteries of omnivores. Put people on a plant-
based diet for a year and their clogged arteries
literally get cleaned out — 20% less plaque in their arteries at
the end of the year than at the beginning. Put people on a low carb diet,
a meat heavy Atkins-like diet though, and their condition worsens: 40 to 50% more artery blocking
at the end of the year. Here’s some representative
heart scans. The yellow and particularly
red represents blood flow to the actual heart muscle
through the coronary arteries. This patient went on a plant-based
diet and their arteries opened right up, increasing blood flow. This person, however, started
out with pretty good flow, but after a year on a meat-based diet,
their blood flow significantly clogged down. This isn’t measuring risk factors, but actual blood flow to the heart muscle,
plant-based versus meat-based diets. No wonder a recent meta-analysis
found that low carb diets associated with a significantly
higher risk of death — all-cause mortality in the long run, meaning those on low carb diets live,
on average, significantly shorter lives. Now there is a new category
of anti-angina drugs, but before committing millions,
billions of dollars to dishing them out, maybe we should take a more
serious look at dietary strategies. To date, these strategies
have been marginalized by the “drug pusher” mentality
of orthodox medical practice. Presumably doctors feel most
patients will be unwilling or unable to make the substantial
dietary changes required. Now while this may be true of many
patients, it certainly is not true for all. And, in any case, angina
patients deserve to be offered the plant-based diet alternative before
being shunted to expensive surgery or to drug therapies that can
have a range of side effects and never really get to
the heart of the problem. Now in response
to this paper, a drug company executive wrote
a letter to the medical journal. “Although diet and
lifestyle modifications should be a part of disease
management,” he said, “many patients may not
be able to comply with the substantial dietary changes
required to achieve a vegan diet,” so, of course, everyone
should go on their fancy new drug called ranolazine,
that’s sold as Ranexa. Costs about $2,000 a
year to take it, but the side effects aren’t horrible
and the drug works. Collectively, the studies show
that at the highest dose, the drug may prolong exercise duration
in angina patients as long as 33.5 seconds. It does not look like those choosing the drug
route will be climbing mountains anytime soon. Plant-based diets aren’t just safer
and cheaper but can work better. I’ve talked about COPD
as a leading killer. But what about low back
pain like sciatica? Now low back pain became one of the
biggest problems for public health systems in the Western world just in
the second half of the 20th century. Chronic low back pain affects about
1 in 5, disabling 30 million Americans. It’s an epidemic. Are people just
lifting more heavy stuff? No. Mechanical factors,
such as lifting and carrying, probably do not have a
major role in the disease. Well, then what causes it?
I’ve touched on it before. Atherosclerosis can obstruct
the arteries that feed the spine, and this restriction in blood
flow can cause back problems. This can be seen on angiography, showing normal spinal arteries
on the left, and clogged on the right. Or on autopsy where you can see how
the openings to the spinal arteries can get squeezed shut by these
cholesterol-filled plaques on the right. Autopsy, because back pain can
precede, predict fatal heart disease, just like clogs in the penile
arteries, erectile dysfunction, can precede heart attacks,
because it’s the same disease: inflamed, crippled, clogged
arteries throughout our body. Now we have the MRI
imaging which can show the narrowing of spinal arteries
in peoples back with back pain, and the degeneration of the disks,
all linked to high cholesterol. Those with narrowed
arteries appear about 8.5 times more likely to
suffer from chronic low back pain. This makes sense. You know, the disks
in our low back are the largest avascular
tissue in the body, meaning they have
no blood vessels. So nutrition just kind of has
to diffuse in from the edges, so they’re particularly
vulnerable to deprivation. Using MRI’s you can measure the
effects of this impaired blood flow on the diffusion, and you can
see how this can turn into that. By age 49, 97% of the disks of those
eating a standard American diet show at least stage 2 degradation. Starting in our teens, our disks are
already starting to degenerate by age 11… As I’ve talked about, nearly all kids
eating the standard American diet have the beginnings of
atherosclerosis by age 10. And sadly, low back pain is now common
among children and adolescents, and it’s getting worse. Just like children getting
adult-onset diabetes, teenagers starting out their
life with a chronic disease. That’s why it’s never too early
to start eating healthy. To get you back into circulation,
you need to get circulation to your back. Skipping down a few in the interest of time,
having a stroke can be severely disabling. Thankfully, a high
dietary fiber intake, which is to say whole plant foods,
may help prevent strokes as well. This belief that dietary fiber
intake is protectively associated with some chronic diseases was postulated
40 years ago and since has been enormously fueled and kept alive by a
great body of science since. Today we therefore believe
that eating lots of fiber, eating a lot of whole,
unprocessed plant foods helps prevent obesity, diabetes, and
cardiovascular diseases such as stroke. Stroke is the second leading cause of death
worldwide, a leading cause of disability, and so preventing strokes
in the first place — what’s called primary prevention —
should be a key public health priority. Based on all the best studies to date,
different strokes for different folks, depending, evidently, on how
much fiber they’ve been eating. Notably, increasing fiber just 7 grams
a day may decrease stroke risk 7%. And 7 grams is easy, like
a small, you know, serving of whole grain pasta with
tomato sauce, and an apple. Easy! But if you really don’t
want a stroke, we should all try to get 25
grams a day of soluble fiber, which is found in beans,
oats, nuts, and berries, and 47 grams a day of insoluble fiber,
found primarily in whole grains. One would have to eat an
extraordinarily healthy diet to get 72 grams a day:
huge amounts of plants. Yet these cut-off values
could be considered the minimum recommended daily
intake of fiber to prevent strokes. Now they admit these
minimums are higher than is commonly and arbitrarily
proposed as “adequate,” but do we want to be patronized to,
as to what authorities think is practical, or do we just want to have them
tell us what the science says, as they did here, so we
can make our own minds? Now someone funded by
Kellogg’s wrote in to complain that in practice such fiber
intakes are unachievable. Rather the message
should just be “the more, the better,” you know,
have a bowl of cereal or something. The real Dr. Kellogg, who was actually
one of our most famous physicians, credited for being one of the first
to sound the alarm about smoking, may have been the
first American physician to have recognized the field
of nutrition as a science — would today be rolling in his grave if
he knew what his company has become. Diabetes, our 7th leading
cause of loss of life is also our 8th leading
cause of loss of health. Up to 50% of diabetics eventually develop
neuropathy, damage to the nerves. It can be very painful, and the pain is frequently resistant
to conventional treatments. In fact, supposedly no effective
treatment exists for diabetic neuropathy. Us doctors are just left with steroids,
and opiates, and antidepressants — anything to try to
mediate the suffering. But 20 years ago, a remarkable study
was published on the regression, the reversal of diabetic neuropathy
with a plant-based diet. Twenty-one diabetics suffering with
moderate or worse painful neuropathy for up to 10 years were placed on
a whole food, plant-based diet. Years and years of suffering,
and then complete relief of the pain in 17 out of
the 21 patients within days. Numbness noticeably improved too. And the side effects were all good. They lost 10 pounds. Blood sugars got better;
insulin needs dropped in half. And in five of the patients not only did —
their painful diabetic neuropathy was cured; so apparently,
was their diabetes. Normal blood sugars,
off of all medications. Diabetics for up to 20 years, and then
off all their drugs in a matter of weeks. And their triglycerides and
cholesterol improved, too. High blood pressures got better. In fact, gone in half
the hypertensives — an 80% drop overall
in the need for high blood pressure
medications within three weeks. Now we’ve known plant-based diets
can reverse, cure Type 2 diabetes and hypertension,
but this was new. Years of painful suffering, and then
complete relief of pain in 80% within days. Now this was a live-in program, where
patients were actually given meals. You know, what happened
when they were sent home and kind of had to go
back to the real world? Well, the 17 folks were followed
for years, and in all except one, the relief of painful neuropathy
continued or improved even further. How’d they get that kind of compliance
with a strict plant-based diet? Because it works! One of the most painful and frustrating
conditions to treat in all of medicine, and three-quarters cured in a couple
days with a natural, nontoxic — in fact, beneficial — treatment:
a diet composed of whole plant foods. Should have been front-
page headline news. So how could nerve damage
be reversed so suddenly? Well, it didn’t appear to be
the improvement in blood sugars because it took about 10 days for
the diet to control the diabetes, whereas the pain was
gone in as few as four. There are several mechanisms
by which a total vegetarian diet can alleviate the problem of diabetic
neuropathy as well as diabetes itself. Now their most interesting speculation is
they thought it could be the trans fats naturally found in meat and dairy that
could be causing an inflammatory response. They found a significant percentage
of the fat under the skin of those who eat meat or even
just dairy and eggs was trans fats. Trans fats stuck inside their
body, under their skin, whereas those who had been
on a strictly plant-based diet, whole food plant-based diet, had no
detectable trans fats within their bodies. The researchers stuck needles in the
buttocks of people eating different diets, and nine months or more on
a strict plant-based diet appeared to remove all trans fat from
their bodies, or at least their butts. But their pain didn’t take 9 months to
get better; more like 9 days, right? So more likely the amazing reversal was
due to an improvement in blood flow. Nerve biopsies taken from diabetics
with severe progressive neuropathy have shown to have arterial
disease within the nerve. There are blood vessels within our
nerves that can get clogged up, too, depriving the nerves of oxygen,
presumably leading them to cry out in pain. Within months, though,
improvements in blood “rheology,” meaning the ease at which blood
flows, on a plant-based diet may play a prominent role in
the reversal of diabetic neuropathy. Plant-based diets may also lower the level
of IGF-1 within the eyeballs of diabetics and decrease the risk of retinopathy —
diabetic vision loss — as well. But what about treating retinopathy? Kempner at Duke
used a plant-based diet composed mostly of rice and fruit
to document for the first time the reversal of diabetic neuropathy
in a quarter of his patients, something never even
thought possible. For example, 60-year-old diabetic
woman, already blind in one eye, can only see contours of large objects
with the other — effectively blind. Five years later on the diet, instead
of it getting worse, it got better. She could then make out faces, see signs,
start to read large newspaper print — in addition to being off all
insulin, normal blood sugars, and 100 point drop
in her cholesterol. The most effective way to
avoid diabetic complications is to eliminate the diabetes
in the first place. And this is often feasible
for those Type 2 diabetics who can make an abiding commitment to
daily exercise and a healthy enough diet. Type 2 diabetes can be
reversed, can be cured, eliminated with diet, and so
can some of its complications. Since the initial report of neuropathy
reversal was published 20 years ago, it’s been replicated
by other researchers. So why didn’t we learn
about this in medical school? The neglect of this important work
by the broader medical community is little short
of unconscionable. Alzheimer’s disease perhaps
best captures the difference between life span and health span. Who cares if you live to be 100, if in the final years you don’t
recognize yourself in the mirror? In 1901, Augusta was taken
to an insane asylum by her husband. She was described as a delusional,
forgetful, disoriented woman, who tragically could not carry out
her homemaking duties any more. She was seen by a Dr. Alzheimer and was to become the case
that made his a household name. On autopsy, he described
the plaques and tangles that would go on to
characterize the disease. But lost in the excitement
of discovering a new condition, a clue may have been overlooked. He described arterial sclerotic changes —
hardening of the arteries — within her brain. And we typically think of artery
clogging in the heart, right? But as we saw with the
spine and the nerves, atherosclerosis involves virtually
the entire human organism, our whole vascular tree from top
to bottom, including our brain. One of the most poignant examples of
the systemic nature of clogged arteries is the link between coronary artery
disease, degenerative brain disease, and Alzheimer’s, dementia. Just as a heart attack or brain attack—
stroke— can be significantly prevented, one can think of Alzheimer’s
as a “mind attack.” Mind attack, like heart attacks
and strokes, need to be prevented by controlling vascular risk factors
like high blood pressure and cholesterol, controlling chronic blood hypoperfusion,
the lack of adequate blood flow to the brain in the years before
the onset of Alzheimer’s. We now we have a
substantial body of evidence strongly associating atherosclerotic
vascular disease with Alzheimer’s. Autopsy studies, for example, have shown
that individuals with Alzheimer’s — significantly more atherosclerotic
narrowing of arteries within their brain. This is what our cerebral
arteries should look like: open, clean, allowing blood to flow. This is what atherosclerosis
in our brain arteries looks like. Clogged with fat and cholesterol, closing off the artery, restricting
blood flow within our brain. Which kind of arteries
do you want in your brain? This reduction in blood flow
can starve the brain of oxygen, causing these silent little mini-
strokes, brain atrophy — shrinkage. The cumulative effects appear to play a
pivotal role in the development of Alzheimer’s. But what about the role
of metals in Alzheimer’s? Well, the metals appear to just
aggravate the detrimental effects of the high intake of saturated
fat and cholesterol. What about the so-called
Alzheimer’s gene, ApoE4? Diet trumps genes. The highest frequency of Alzheimer’s
gene in the world is Nigeria, but they also have some of
the lowest Alzheimer’s rates. To understand why, one has to
understand the role of ApoE. What does the gene do? The Alzheimer’s gene makes the principal
cholesterol carrier in the brain, but if your cholesterol
is low enough, because your diet is low
enough in animal fat, if you center your diet around
grains and vegetables, then changes in cholesterol can
lead to changes in gene expression. Just because we’ve been dealt
some bad genetic cards doesn’t mean we can’t
reshuffle the deck with diet. According to the latest guidelines
for the prevention of Alzheimer’s, the two most important things
we can do is cut down our consumption of
meat, dairy, and junk, and replace them with vegetables,
beans, fruits, and whole grains. That’s the best science we have on
the prevention of Alzheimer’s disease. Wait, grains protective of the brain? I had the distinction
this year of serving on a panel with Grain Brain
author, Dr. Perlmutter, who sold lots of books claiming
carbs are destroying our brain, but what does the science show? Take Japan, for example, where the prevalence of dementia
has shot up over the last few decades. And the blame for this increase in
Alzheimer’s: increases in animal products. Traditional diets weighted towards vegetable
products like grains, away from animal products, but since 1960, the diet in Japan has changed
from a more traditional rice-based diet to one with a preponderance of meat. So less grain equaled more Alzheimer’s. The dietary factor most
strongly associated with the Alzheimer’s was the
consumption of animal fat. So the link between diet and
dementia can be characterized less as grain brain
and more as meat head. A similar analysis in China
arrived at the same conclusion. On the basis of these findings, the rates of Alzheimer’s disease and
dementia will continue to increase unless dietary patterns change to those
with less reliance on animal products. This is consistent with data
showing those who eat vegetarian are 2 to 3 times less likely
to develop dementia. And the longer one eats meat-free,
the lower one’s risk falls. In fact, where are the lowest rates
of Alzheimer’s in the world? Rural India. It may be no coincidence that the country
with the lowest rates of Alzheimer’s has among the lowest rates
of meat consumption. About 40% eat meat-free and egg-free diets
that are high grain, high bean, high carb diets. Population studies
have found a protective, strongly protective role of grains
in relation to Alzheimer’s disease, and including gluten-containing
grains, not just rice. The science shows the exact opposite of
what one might read in the popular press. In other words,
don’t pass on the grain. Pass the grain
to spare the brain. The link between arterial blockage
and Alzheimer’s is good news because atherosclerosis
can be prevented and treated, so maybe Alzheimer’s can be
prevented and treated as well. Well, let’s put it to the test. If you follow people who are just
starting to lose their mental faculties, the cognition of those with the
least artery-clogging in their brain remains pretty stable
over the years. But those with more
cholesterol buildup got worse, and those with the most
blockage rapidly declined. And the same with
the ability to carry out activities of daily living
like dressing oneself. And arterial disease doubled
the progression to Alzheimer’s. In summary, an inefficient
blood supply to the brain can have very grave
consequences on brain function. But does treatment of
vascular risk factors, like high blood pressure, high
cholesterol, make a difference? We didn’t know until now. 300 patients with Alzheimer’s, and those
with their vascular risk factors treated showed significantly less decline,
slowed progression of their disease. It is often said that, “The goal of medicine
is to provide patients with hope, and when there is no hope,
to offer understanding.” Well, for the first time in
the history of this disorder, we have the chance to provide
Alzheimer patients with hope. Let me close with cancer, a leading
cause of death and disability. How many years of life are lost
to potentially preventable cancers? Every year more than 5 million expected
years of life in the United States are lost to those three
disabling cancers alone: lung cancer, colorectal
cancer, and breast cancer. Therefore, identifying and
improving strategies for prevention of cancer
remains a priority, especially since no more
than 2% of all human cancer is attributable to
purely genetic factors. So 2% may be in our genes, but the
rest may involve external factors, particularly our diet. You know, our skin is
about 20 square feet. Our lungs, if you actually
flatten them out, it’s like about a 1,000
square feet of surface area. But our intestines — 3,000 feet if you include
all the little folds, 3,000 square feet. So what we eat is our primary interface
with the outside world, right, with our external environment. The most comprehensive study, summary of
evidence on diet and cancer ever compiled, recommends we eat foods of plant
origin to help prevent cancer. This means centering our diet
around whole plant foods. Not just whole grains and beans
every day, but every meal. And when it came to foods
that increase cancer risk, they were similarly straightforward, unlike some other dietary changes that
kind of wimp out and just advise people to “moderate” their intake of bad
foods, like “eat less candy.” The cancer guidelines didn’t mince words
when it came to the worst of the worst. For example, don’t just
minimize soda intake. Avoid it. Don’t just cut back on bacon and hot dogs
and ham and sausage and lunch meat. Avoid processed meats, period, because
data do not show any level of intake that can be confidently shown
not to be associated with risk. Even small amounts
may be risky. Processed meat cannot only be thought of
as a powerful multi-organ carcinogen, but may increase the risk
of heart disease and diabetes. Red meat was bad, but
processed meat was worse, and that included white meat
like chicken, turkey slices. So with more heart disease,
cancer, and diabetes, no surprise: processed meat consumption is associated with
increased risk of death, even at small amounts. In Europe, they calculated that
reduction of processed meat consumption to less than half a hot dog’s worth a day
would prevent more than 3% of all deaths. This was the second
largest prospective study on diet and cancer ever,
a study of 400,000 people. Well, the largest ever, 600,000, was done
right here in the US, the AARP study. They found the preventable
fraction to be even higher, suggesting that 20% of heart disease
deaths among women, for example, could be averted if the highest
consumers cut down to less than like a quarter strip of
bacon’s worth a day, right? That’s a lot of death. So what does the meat industry
think about all this? In the journal, Meat Science,
the industry acknowledged that the cancer prevention guidelines
now urge people to avoid processed meat, a statement that represents “a clear and
present danger” to the meat industry. Processed meat, they say,
is a social necessity. How could anyone live
without bologna? The challenge for the meat industry
is to find a way to maintain the consumption of these products,
while somehow not damaging public health. Well, they’ve considered
removing the nitrites for decades because of the long-known
toxic effects. The industry adds them
to keep the meat pink. There are, evidently, other
coloring additives available. Nevertheless, it’s going to be
hard for the industry to change. You have to balance all that cancer with
the positive effects of these substances as preservatives and desirable flavor
and red-color developing ingredients. No one wants
green eggs and ham. It’s like salt reduction
in meat products. They’d like to, but one of the biggest
barriers to salt replacement within the meat industry is cost, as salt is one of the cheapest
food ingredients available. Now there are a number of
taste enhancers you can inject into the meat to help compensate
for the salt reduction, but some of the compounds
leave a bitter after-taste, so they can also inject a
patented bitter-blocking chemical that can prevent taste nerve
stimulation at the same time, the first of what may become
a stream of products that are produced due to the convergence
of food technology and biotech. Or they could always start adding
non-meat materials to the meat. You could add fiber or
resistant starch from beans that have protective
effects against cancer. After all, in the United States
dietary fiber is under consumed. This is meat science saying,
saying, oh, under consumed fiber, indicating that fiber fortification of
meat products could have health benefits, failing to note, of course, that
their products are one of the reasons why America’s so
deficient in the first place. The industry is all in favor
of causing less cancer, but obviously such optimization
has to achieve a healthier product without affecting
the hedonic aspects. It’s important to realize that
nutritional and technological quality in the meat industry
are inversely related. An improvement in one leads
to a deterioration of the other, so you’ve got to
balance it out, right? They know that the consumption
of lard is not the best thing, heart disease being
our #1 killer. However, those downsides are in sharp
contrast to lard’s technological qualities, which makes saturated fats indispensable
in the manufacture of meat products, otherwise you just don’t get
the same lard consistency. See, the pig fat doesn’t
get hard enough, and as a result a fatty smear
upon cutting or slicing can be observed on the cutting
surface of the knife. So, look, you’ve got to get
your priorities straight, right? Although the evidence for the relationship
between colorectal cancer (at least!) and processed meats intake
cannot be denied, the meat industry suggests
further research. For example, compare the risks of
eating meat to other risky practices: alcohol, inactivity,
obesity, smoking. Compared to lung cancer and smoking,
maybe meat wouldn’t look so bad. But don’t worry. Consumers probably
won’t even hear about the latest cancer
prevention guidelines. Consumers today are
overloaded with information. Thus the industry can hope that the
dissemination of the update on meat and cancer drowns out in this
information cloud. And even if the consumers do see it, the
industry doesn’t think they’ll much care. For many consumers in the Western world,
the role of healthfulness, although important, is not close to taste satisfaction in
shaping their final choices of meat products. It is hence questionable whether
the revised recommendations, based on the carcinogenic
effects of meat consumption, will yield substantial
changes in consumer behavior. You know, doctors and nutrition professionals
feed into this patronizing attitude that people just don’t care enough
about their own health to change. This paper, from a leading
nutrition journal, scoffed at the idea that people
would ever switch to a “prudent diet,” reducing their intakes of animal protein and
fat, no matter how much cancer was prevented. The chances of reducing consumption
to avoid colon cancer? Virtually nil. Consider heart disease. We know that we can prevent
and treat heart disease with the same kind of diet,
but the public won’t do it. “The diet,” they say, “would lose
too much of its palatability.” In other words, the great palatability of
ham largely outweighs other considerations, although health and well being are increasingly
important factors in consumer decisions. This 1998 industry article feared
that unless meat eating becomes compatible with eating
that is healthy and wholesome, it could be consigned to a minor role
in the diet during the coming decade. Their prediction
didn’t quite pan out. Here’s meat consumption per
person over the last 30 years. Rising, rising. Now, 1998 was when the Meat
Science article was published, worrying about the next
decade of meat consumption, which continued to
rise even further, but then did kind of, kind of sort of
flatten out, before it fell off a cliff: per capita meat consumption
down about 10%. Millions of Americans are reducing
their consumption of meat. So don’t tell me that people aren’t
willing to change their diets. Yet we continue to get
diluted dietary guidelines because authorities
are asking themselves: what dietary changes could
be acceptable to the public, rather than just telling us
what the science says and letting us make up our own
minds as to whether, you know, pig fat smearing on knives should
trump our families’ health. What we eat doesn’t just affect
cancer risk in the colon. Why do constipated women appear
to be at higher risk for breast cancer, whereas women who have three or
more bowel movements a day — super poopers I call them. Sounds like an ABBA song, doesn’t it? — appear to cut their risk
of breast cancer in half? This could be because constipation
means a greater contact time between your waste
and the intestinal wall, which may increase the formation
and absorption of fecal mutagens — these compounds that can cause
DNA mutations and cancer — into the circulation
and then into the breast. We know that breasts actively take
up chemicals from the bloodstream, so researchers are concerned that
substances originating in the colon might enter the bloodstream
and reach the breast, specifically bile acids,
which are formed as a way of getting
rid of excess cholesterol. Our liver dumps bile acids
into the intestines for disposal, assuming our intestines
will be packed with fiber to trap it and flush
it out of the body, but if we haven’t been eating
whole plant foods all day, it can get reabsorbed back into the
body and then build up in the breast. Carcinogenic bile acids are found
concentrated in the breast at up to a 100 times the level
found in the bloodstream — they just concentrate it,
pull it out of the system. By radioactively tagging bile
acids, they were able to show that intestinal bile acids
rapidly gain access to the breast, where they can exert an estrogen-like
cancer-promoting effect on breast tumor cells. This could explain why we see
50% higher bile acid levels in the bloodstream of newly
diagnosed breast cancer victims. So how can we facilitate the removal
of bile acids from our body? Well, we can speed up the
so-called oroanal transit time, the speed at which food
goes from mouth to toilet, because slowed colon transit can lead
to increased absorption of bile acids. But we can speed things up
by eating lots of fiber. A diet packed with plants greatly
increases bile acid excretion. Fiber can bind up and remove toxic
elements like lead and mercury as well as cholesterol
and bile acids. But plants can even bind bile
acids independent of fiber. Vegan diets had significantly more bile acid,
bind up significantly more bile acid than lacto-ovo or nonvegetarian diets,
even at the same fiber intake, which could explain why it appears
that individuals eating vegetarian might excrete less mutagenic, less mutation-causing
feces in the first place. Now you’ll notice that the same type
of diet used to help lower cancer risk is the same type of diet used to
help lower Alzheimer’s risk, right, and diabetes, and diabetic complications,
and high blood pressure, and stroke, and back pain, and
heart disease, right? A diet centered around
whole plant foods — the type of diet eaten by
populations that are largely free of our deadliest and
most disabling diseases. Heart disease was so rare among those
eating these traditional plant-based diets, there were papers
published like this: A Case of Coronary Heart
Disease in an African. After 26 years of medical practice
they finally recorded their first case of coronary heart disease
among a population of 15 million — a judge, who had started consuming
a partially Westernized diet. Now some thought it was the
preponderance of plant foods that was protecting
these populations; others thought it was the
avoidance of animal foods. But either way, we couldn’t prove it was
the diet until it was put to the test. Pritikin, Ornish, Esselstyn and others
took people with heart disease and put them on the
kind of plant-based diet followed by populations that had no —
that didn’t suffer from heart disease, hoping it would stop the disease process,
keep it from progressing further. But instead something
miraculous happened. Their disease started
to reverse, to get better. As soon as they stopped eating
an artery-clogging diet, their bodies were able to start
dissolving away some of that plaque, even in some cases of severe triple
vessel disease, arteries opening up without drugs, without surgery, suggesting
their bodies wanted to heal all along, but were just never
given the chance. This is Esselstyn’s new study,
published four days ago. This increase in blood flow
to the heart muscle on the left happened within just
three weeks of eating healthy. Let me share with you the
best kept secret in medicine. The best kept secret
in medicine is that under the right conditions
the body can heal itself. You know, if you whack your shin
really hard on a coffee table, it can get all red,
hot, swollen, painful, but it’ll heal naturally if you just stand
back and let your body work its magic. But what if you kept whacking your poor shin
against that coffee table in the same place over and over, 3 times a day:
breakfast, lunch, and dinner. It would never heal. You’d go to your doctor and
you’d be like, “Oh, my shin hurts.” And the doctor would
be like, “No problem,” whip out their pad and write
you a prescription for painkillers. You’re still whacking your shin 3 times
a day and it still hurts like heck, but, ah, feels so much
better with the pain pills. Thank heavens
for modern medicine. It’s like when people take
nitroglycerine for chest pain: tremendous relief, but doesn’t do
anything to treat the underlying cause. Our body wants to come
back to health, if we let it. But if we keep re-injuring it
3 times a day, we may never heal. It’s like smoking. One of the most amazing things
I learned in medical school was that within 10 years of stopping
smoking, your lung cancer risk approaches that of
a lifelong nonsmoker. Isn’t that amazing? Your lungs can like
get rid of all that tar, and eventually it’s almost as if
you never started smoking at all. Our body wants to be healthy. And every morning of our smoking life
that healing process started, until bam! Our first cigarette, reinjuring
our lungs with every puff, just like we can reinjure
our arteries with every bite, when all we had to do all
along — the miracle cure — is just stop re-damaging ourselves
and get out of the way and let our bodies natural healing
processes bring us back towards health. There is only one diet
that’s ever been proven to reverse heart disease in the majority
of patients: a plant-based diet. Anytime anyone tries to
sell you on some new diet, ask them one — do me a favor,
one simple question: “Has your diet been proven
to reverse heart disease?” You know, the #1 most likely reason
you and everyone you love will die? “Does it reverse heart disease?” If it doesn’t, why would
you even consider it? And if that’s all a plant-based diet
could do — reverse our #1 killer — well then shouldn’t that be the
default diet until proven otherwise? And the fact that it can also be
effective in preventing, treating, reversing other leading killers, like
diabetes and high blood pressure, would seem to make the case for
plant-based eating overwhelming. So why don’t more
doctors prescribe it? Available time is a reason
frequently cited by physicians, but if you probe
a little deeper, yes, they complain about
not having enough time to give their patients
dietary advice, but the number one reason was
their perception that patients fear of being deprived of all
the junk that they’re eating. Can you imagine a doctor saying, “Yeah, I’d like to tell my patients to stop
smoking, but I know how much they love it.” Dr. Neal Barnard wrote
a compelling editorial in the American Medical
Association’s Journal of Ethics. When he stopped
smoking in the 80’s, the lung cancer death rate
was peaking in the US, but has since dropped with
dropping smoking rates. No longer were doctors
telling patients to give their throat a vacation
by smoking a fresh cigarette. Doctors realized that they were more effective
at counseling patients to quit smoking if they no longer had tobacco
stains on their own fingers. In other words, doctors went
from bystanders, or even enablers, to leading the fight
against smoking. And today, he says,
plant-based diets are the nutritional equivalent
of quitting smoking. This is not vegetarianism. Vegetarians often consume
all sorts of junk. Vegans, too, for
that matter, right? This new paradigm is exclusively
plant-based nutrition, whole plant foods. Why exclusively? Well, as reported in the
Cornell-Oxford-China Study, there does not appear to be a threshold
beyond which further benefits did not accrue with increasing proportions
of plant foods in the diet. It appears the more plant-based foods
and less animal-based foods, the better. It took five decades after the initial
studies linking tobacco and cancer for effective public health
policies to be put into place, with enormous cost
to human health. Must we wait another 50 years to respond
to the epidemics of dietary diseases? They do have money
on their sides. The chemical, tobacco, and food
industries have the luxury to share similar tactics with the drug companies
because they have the resources to do so. In contrast, powerful and cheap health-
promoting activities, like eating healthy, are too cheap, can’t be
patented, aren’t profitable. And they throw
that money around. The American Dietetic
Association, for example, promotes a series of
Nutrition Fact Sheets. Who writes them? Industry sources pay $20,000
per fact sheet to the ADA and explicitly take part
in writing the documents. So you can learn about eggs
from the egg industry, the benefits of chewing gum
from the Wrigley Science Institute. I didn’t know Wrigley’s
had a science institute. In 2008, the ADA announced that the Coca-Cola Company
had become an official partner to give them prominent access to
key influencers and decision makers and share the Coca-Cola
Company’s research findings. For example: Did you know
there are no harmful effects of different Coca-Cola
beverages on rat testicles? Was that even a concern? Thou doth protest
too much, methinks. When the American Academy of
Family Physicians was called out on their proud new corporate
relationship with Coke to support patient education
on healthy eating, an executive vice-president of
the Academy tried to quell the protest by explaining that the alliance
was not without precedent. They had relationships with Pepsi
and McDonald’s for some time, reminiscent of similar types
of relationships in the past. This didn’t seem placate the
critics, so the exec assured them that the American Dietetic Association
has made a policy statement that “There are no good or bad foods,” a position
that the food industry has then exploited. You know, in the early years, the tobacco
industry sounded a similar theme: smoking per se wasn’t bad,
just “excess” smoking. Sound familiar? Everything in moderation. Is this what family docs and
dietitians have been reduced to, to justify unholy
financial alliances they deny that there are
actually unhealthy foods? Thankfully there is
a corporate sector that actually benefits from healthy
people: the insurance industry. Last year a Nutritional
Update for Physicians was published in the official
journal of Kaiser Permanente, the largest managed care
organization in the country, covering about 9 million people,
about 15,000 physicians, who were told that healthy eating may be
best achieved with a plant-based diet, defined as a regimen that
encourages whole, plant-based foods and discourages meats, dairy, and eggs
as well as all refined and processed junk. And too often physicians ignore the
potential benefits of good nutrition and quickly prescribe medications, instead of giving their patients
a chance to correct their disease through healthy eating
and active living. Physicians should therefore
consider recommending a plant-based diet
to all their patients, especially those with high blood pressure,
diabetes, cardiovascular disease, and obesity. The major downside is that
it may work a little too well. If people are on medications for blood
pressure or blood sugar, right, they could actually
drop too low, so physicians may need to adjust
medications or eliminate them altogether. The side effects, ironically,
may be not having to take drugs. Despite the strong body of evidence
favoring plant-based diets, many physicians are not stressing
the importance of plant-based diets as a first-line treatment
for chronic diseases. That’s a bit of an understatement. Now this could be because of
a lack of physician awareness — or a lack of patient
education material. So Kaiser sought
to change that. Want to lose weight,
feel better? Improve, stabilize, or even
reverse chronic disease? Get off some of
your medications? If you answered yes to
any of these questions, then a plant-based eating
plan may be right for you. Side-effects may include lower cholesterol,
blood pressure, and blood sugar, reversal or prevention of our #1 killer,
a longer life, healthier weight, lower risk of cancer, diabetes,
even slow the progression of cancer, improve inflammatory conditions
like rheumatoid arthritis. They offer tips to get started,
meal plan ideas, and, I’m honored to say,
a good taste in websites. The paper ends with a familiar
refrain: further research is needed. In this case, though,
further research is needed to find ways to make plant-based
diets the new normal. Thank you.