Plant-Based Diets as the Nutritional Equivalent of Quitting Smoking

The Best Kept Secret in Medicine.jpeg

Despite the most widely accepted and well-established chronic disease practice guidelines uniformly calling for lifestyle change as the first line of therapy, doctors often don't follow these recommendations. As seen in my video, The Best Kept Secret in Medicine, lifestyle interventions are not only safer and cheaper but often more effective in reducing heart disease and failure, hypertension, stroke, cancer, diabetes, and deaths from all causes than nearly any other medical intervention.

"Some useful lessons may come from the war on tobacco," Dr. Neal Barnard wrote in the American Medical Association's ethics journal. When he stopped smoking himself in the 1980s, the lung cancer death rate was peaking in the United States. As the prevalence of smoking dropped, so have lung cancer rates. No longer were doctors telling patients to "[g]ive your throat a vacation" by smoking a fresh cigarette. Doctors realized 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 being bystanders--or even enablers--to leading the fight against smoking." And today, says Dr. Barnard, "Plant-based diets are the nutritional equivalent of quitting smoking."

From an editorial in the journal Alternative Therapies in Health and Medicine: "If we were to gather the world's top nutrition scientists and experts (free from food industry influence), there would be very little debate about the essential properties of good nutrition. Unfortunately, most doctors are nutritionally illiterate. And worse, they don't know how to use the most powerful medicine available to them: food."

Physician advice matters. When doctors told patients to improve their diets by cutting down on meat, dairy, and fried foods, patients were more likely to make dietary changes. It may work even better if doctors practice what they preach. Researchers at Emory University randomized patients to watch one of two videos. In one video, a physician briefly mentioned her personal dietary and exercise practices and visible on her desk were both a bike helmet and an apple. In the other video, she did not discuss her personal healthy practices, and the helmet and apple were missing. In both videos, the doctor advised the patients to cut down on meat, not usually have meat for breakfast, and have no meats for lunch or dinner at least half the time. In the disclosure video, the physician related that she herself had successfully cut down on meat. Perhaps not surprisingly, patients rated that physician to be more believable and motivating. Physicians who walk the walk--literally--and have healthier eating habits not only tend to counsel more about exercise and diet, but have been found to seem more credible or motivating when they do so.

It may also make them better doctors. A randomized controlled intervention to clean up doctors' diets, called the Promoting Health by Self Experience (PHASE) trial, found that healthcare providers' personal lifestyles were correlated directly with their clinical performance. Healthcare providers' improved wellbeing and lifestyle cascaded to the patients and clinics, suggesting an additional strategy to achieve successful health promotion.

Are you ready for the best kept secret in medicine? Given the right conditions, the body can heal itself. For example, treating cardiovascular disease with appropriate dietary changes is good medicine, reducing mortality without any adverse effects. We should keep doing research, certainly, but educating physicians and patients alike about the existing knowledge regarding the power of nutrition as medicine may be the best investment we can make.

Of course, to advise patients about nutrition, physicians first have to educate themselves, as it is unlikely they received formal nutrition education during their medical training:

For more on the power of healthy living, see:

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Sally Plank. This image has been modified.

Original Link

Plant-Based Diets as the Nutritional Equivalent of Quitting Smoking

The Best Kept Secret in Medicine.jpeg

Despite the most widely accepted and well-established chronic disease practice guidelines uniformly calling for lifestyle change as the first line of therapy, doctors often don't follow these recommendations. As seen in my video, The Best Kept Secret in Medicine, lifestyle interventions are not only safer and cheaper but often more effective in reducing heart disease and failure, hypertension, stroke, cancer, diabetes, and deaths from all causes than nearly any other medical intervention.

"Some useful lessons may come from the war on tobacco," Dr. Neal Barnard wrote in the American Medical Association's ethics journal. When he stopped smoking himself in the 1980s, the lung cancer death rate was peaking in the United States. As the prevalence of smoking dropped, so have lung cancer rates. No longer were doctors telling patients to "[g]ive your throat a vacation" by smoking a fresh cigarette. Doctors realized 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 being bystanders--or even enablers--to leading the fight against smoking." And today, says Dr. Barnard, "Plant-based diets are the nutritional equivalent of quitting smoking."

From an editorial in the journal Alternative Therapies in Health and Medicine: "If we were to gather the world's top nutrition scientists and experts (free from food industry influence), there would be very little debate about the essential properties of good nutrition. Unfortunately, most doctors are nutritionally illiterate. And worse, they don't know how to use the most powerful medicine available to them: food."

Physician advice matters. When doctors told patients to improve their diets by cutting down on meat, dairy, and fried foods, patients were more likely to make dietary changes. It may work even better if doctors practice what they preach. Researchers at Emory University randomized patients to watch one of two videos. In one video, a physician briefly mentioned her personal dietary and exercise practices and visible on her desk were both a bike helmet and an apple. In the other video, she did not discuss her personal healthy practices, and the helmet and apple were missing. In both videos, the doctor advised the patients to cut down on meat, not usually have meat for breakfast, and have no meats for lunch or dinner at least half the time. In the disclosure video, the physician related that she herself had successfully cut down on meat. Perhaps not surprisingly, patients rated that physician to be more believable and motivating. Physicians who walk the walk--literally--and have healthier eating habits not only tend to counsel more about exercise and diet, but have been found to seem more credible or motivating when they do so.

It may also make them better doctors. A randomized controlled intervention to clean up doctors' diets, called the Promoting Health by Self Experience (PHASE) trial, found that healthcare providers' personal lifestyles were correlated directly with their clinical performance. Healthcare providers' improved wellbeing and lifestyle cascaded to the patients and clinics, suggesting an additional strategy to achieve successful health promotion.

Are you ready for the best kept secret in medicine? Given the right conditions, the body can heal itself. For example, treating cardiovascular disease with appropriate dietary changes is good medicine, reducing mortality without any adverse effects. We should keep doing research, certainly, but educating physicians and patients alike about the existing knowledge regarding the power of nutrition as medicine may be the best investment we can make.

Of course, to advise patients about nutrition, physicians first have to educate themselves, as it is unlikely they received formal nutrition education during their medical training:

For more on the power of healthy living, see:

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Sally Plank. This image has been modified.

Original Link

Big Sugar Takes on the World Health Organization

Big Sugar Takes on the World Health Organization.jpeg

The World Health Organization (WHO) recommends we reduce our consumption of salt, trans fats, saturated fats, and added sugars. Why? Because consumption of such foods is the cause of at least 14 million deaths every year from chronic diseases.

"Several decades ago, it was heresy to talk about an impending global pandemic of obesity." Today, we're seeing chronic disease rates skyrocket around the world. The Western diet has been exported to the far reaches of the planet, with white flour, sugar, fat, and animal-based foods replacing beans, peas, lentils, other vegetables, and whole grains.

In order to understand the reasons underlying this trend toward greater consumption of animal products, sugar, and oils, and reduced consumption of whole plant foods, we need to begin by understanding the purposeful economic manipulations that have occurred since World War II relating to agricultural policies around the world. For example, since early in the last century, the U.S. government "has supported food production through subsidies and other policies, resulting in large surpluses of food commodities, meat, and calories. In this artificial market, large food producers and corporations-Big Agriculture and Big Food-became very profitable." Their profitability may be part of the problem.

Dr. Margaret Chan, the Director-General of the World Health Organization, gave the opening address at the 8th Global Conference on Health Promotion. One of the biggest challenges facing health promotion worldwide, she said, is that the efforts to prevent our top killers "go against the business interests of powerful economic operators." It is not just Big Tobacco anymore. "Public health must also contend with Big Food, Big Soda, and Big Alcohol. All of these industries fear regulation and protect themselves by using the same tactics...front groups, lobbies, promises of self-regulation, lawsuits, and industry-funded research that confuses the evidence and keeps the public in doubt."

And the World Health Organization should know. In 2003, the organization released a draft report that outlined a global strategy to address issues of diet. Although many of the WHO's recommendations were rather tame, a remarkable series of events was spurred by six words in the report: "limit the intake of 'free' sugars" (added sugar). Within days, the sugar industry, through the Sugar Association, enlisted the support of officials high in the U.S. government and led a vigorous attack on both the report and the World Health Organization itself, culminating in a threat to get Congress to withdraw U.S. funding to the WHO. The WHO, the organization that "deals with AIDS, malnutrition, infectious disease, bioterrorism, and more, threatened because of its stance on sugar." At the same time, the U.S. went to bat for American tobacco companies and led the charge against the World Health Organization's Framework Convention on Tobacco Control.

As discussed in my video, Big Sugar Takes on the World Health Organization, the threat from the sugar industry was described by WHO insiders as worse than any pressure they ever got from the tobacco lobby. As revealed in an internal memo, the U.S. government apparently had a list of demands. These included deletion of all references to the science that WHO experts had compiled on the matter and the removal of all references to fat, oils, sugar, and salt.

The threats failed to make the WHO withdraw their report. Entitled "Diet, Nutrition and the Prevention of Chronic Disease," it "concluded that a diet low in saturated fat, sugar and salt and high in fruit and vegetables was required to tackle the epidemic rise in chronic diseases worldwide." They did end up watering it down, though. Gone was reference to the comprehensive scientific report, and gone was its call for its recommendations to be actually translated into national guidelines.

History has since repeated. At the last high-level United Nations meeting to address chronic diseases, representatives from some Western countries, including the United States, helped block a consensus on action after lobbying from the alcohol, food, tobacco, and drug industries. When asked why Michelle Obama's successful childhood obesity programs in the U.S. should not be modeled around the world, a U.S. official responded that they might harm American exports.

See also: How Much Added Sugar Is Too Much?

If sugar is bad, then what about all the sugar in fruit? See If Fructose Is Bad, What About Fruit? and How Much Fruit Is Too Much?.

For more on the corrupting political and economic influences in nutrition, see videos such as:

And because of that, check out a couple of my introductory videos: Why You Should Care about Nutrition and Taking Personal Responsibility for Your Health.

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Sally Plank. This image has been modified.

Original Link

Big Sugar Takes on the World Health Organization

Big Sugar Takes on the World Health Organization.jpeg

The World Health Organization (WHO) recommends we reduce our consumption of salt, trans fats, saturated fats, and added sugars. Why? Because consumption of such foods is the cause of at least 14 million deaths every year from chronic diseases.

"Several decades ago, it was heresy to talk about an impending global pandemic of obesity." Today, we're seeing chronic disease rates skyrocket around the world. The Western diet has been exported to the far reaches of the planet, with white flour, sugar, fat, and animal-based foods replacing beans, peas, lentils, other vegetables, and whole grains.

In order to understand the reasons underlying this trend toward greater consumption of animal products, sugar, and oils, and reduced consumption of whole plant foods, we need to begin by understanding the purposeful economic manipulations that have occurred since World War II relating to agricultural policies around the world. For example, since early in the last century, the U.S. government "has supported food production through subsidies and other policies, resulting in large surpluses of food commodities, meat, and calories. In this artificial market, large food producers and corporations-Big Agriculture and Big Food-became very profitable." Their profitability may be part of the problem.

Dr. Margaret Chan, the Director-General of the World Health Organization, gave the opening address at the 8th Global Conference on Health Promotion. One of the biggest challenges facing health promotion worldwide, she said, is that the efforts to prevent our top killers "go against the business interests of powerful economic operators." It is not just Big Tobacco anymore. "Public health must also contend with Big Food, Big Soda, and Big Alcohol. All of these industries fear regulation and protect themselves by using the same tactics...front groups, lobbies, promises of self-regulation, lawsuits, and industry-funded research that confuses the evidence and keeps the public in doubt."

And the World Health Organization should know. In 2003, the organization released a draft report that outlined a global strategy to address issues of diet. Although many of the WHO's recommendations were rather tame, a remarkable series of events was spurred by six words in the report: "limit the intake of 'free' sugars" (added sugar). Within days, the sugar industry, through the Sugar Association, enlisted the support of officials high in the U.S. government and led a vigorous attack on both the report and the World Health Organization itself, culminating in a threat to get Congress to withdraw U.S. funding to the WHO. The WHO, the organization that "deals with AIDS, malnutrition, infectious disease, bioterrorism, and more, threatened because of its stance on sugar." At the same time, the U.S. went to bat for American tobacco companies and led the charge against the World Health Organization's Framework Convention on Tobacco Control.

As discussed in my video, Big Sugar Takes on the World Health Organization, the threat from the sugar industry was described by WHO insiders as worse than any pressure they ever got from the tobacco lobby. As revealed in an internal memo, the U.S. government apparently had a list of demands. These included deletion of all references to the science that WHO experts had compiled on the matter and the removal of all references to fat, oils, sugar, and salt.

The threats failed to make the WHO withdraw their report. Entitled "Diet, Nutrition and the Prevention of Chronic Disease," it "concluded that a diet low in saturated fat, sugar and salt and high in fruit and vegetables was required to tackle the epidemic rise in chronic diseases worldwide." They did end up watering it down, though. Gone was reference to the comprehensive scientific report, and gone was its call for its recommendations to be actually translated into national guidelines.

History has since repeated. At the last high-level United Nations meeting to address chronic diseases, representatives from some Western countries, including the United States, helped block a consensus on action after lobbying from the alcohol, food, tobacco, and drug industries. When asked why Michelle Obama's successful childhood obesity programs in the U.S. should not be modeled around the world, a U.S. official responded that they might harm American exports.

See also: How Much Added Sugar Is Too Much?

If sugar is bad, then what about all the sugar in fruit? See If Fructose Is Bad, What About Fruit? and How Much Fruit Is Too Much?.

For more on the corrupting political and economic influences in nutrition, see videos such as:

And because of that, check out a couple of my introductory videos: Why You Should Care about Nutrition and Taking Personal Responsibility for Your Health.

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Sally Plank. This image has been modified.

Original Link

How Much Nutrition Education Do Doctors Get?

How Much Nutrition Education Do Doctors Get?.jpeg

In the United States, most deaths are preventable and related to nutrition. Given that the number-one cause of death and the number-one cause of disability in this country is diet, surely nutrition is the number-one subject taught in medical school, right? Sadly, that is not the case.

As shown in my video, Physician's May Be Missing Their Most Important Tool, a group of prominent physicians wrote in 2014 that "nutrition receives little attention in medical practice" and "the reason stems, in large part, from the severe deficiency of nutrition education at all levels of medical training." They note this is particularly shocking since it has been proven that a whole foods, plant-based diet low in animal products and refined carbohydrates can reverse coronary heart disease--our number-one killer--and provide potent protection against other leading causes fof death such as cancer and type 2 diabetes.

So, how has medical education been affected by this knowledge? Medical students are still getting less than 20 hours of nutrition education over 4 years, and even most of that has limited clinical relevance. Thirty years ago, only 37 percent of medical schools had a single course in nutrition. According to the most recent national survey, that number has since dropped to 27 percent. And it gets even worse after students graduate.

According to the official list of all the requirements for those specializing in cardiology, Fellows must perform at least 50 stress tests, participate in at least 100 catheterizations, and so on. But nowhere in the 34-page list of requirements is there any mention of nutrition. Maybe they leave that to the primary care physicians? No. In the official 35-page list of requirements for internal medicine doctors, once again, nutrition doesn't get even a single mention.

There are no requirements for nutrition before medical school either. Instead, aspiring doctors need to take courses like calculus, organic chemistry, and physics. Most of these common pre-med requirements are irrelevant to the practice of medicine and are primarily used to "weed out" students. Shouldn't we be weeding out based on skills a physician actually uses? An important paper published in the Archives of Internal Medicine states: "The pernicious and myopic nature of this process of selection becomes evident when one realizes that those qualities that may lead to success in a premedical organic chemistry course...[like] a brutal competitiveness, an unquestioning, meticulous memorization, are not necessarily the same qualities that are present in a competent clinician."

How about requiring a course in nutrition instead of calculus, or ethics instead of physics?

Despite the neglect of nutrition in medical education, physicians are considered by the public to be among the most trusted sources for information related to nutrition. But if doctors don't know what they're talking about, they could actually be contributing to diet-related disease. If we're going to stop the prevailing trend of chronic illness in the United States, physicians need to become part of the solution.

There's still a lot to learn about the optimal diet, but we don't need a single additional study to take nutrition education seriously right now. It's health care's low-hanging fruit. While we've had the necessary knowledge for some time, what we've been lacking is the will to put that knowledge into practice. If we emphasized the powerful role of nutrition, we could dramatically reduce suffering and needless death.

Take, for example, the "Million Hearts" initiative. More than 2 million Americans have a heart attack or stroke each year. In 2011, U.S. federal, state, and local government agencies launched the Million Hearts initiative to prevent 1 million of the 10 million heart attacks and strokes that will occur in the next 5 years. "But why stop at a million?" a doctor asked in the American Journal of Cardiology. Already, we possess all the information needed to eradicate atherosclerotic disease, which is our number-one killer while being virtually nonexistent in populations who consume plant-based diets. Some of the world's most renowned cardiovascular pathologists have stated we just need to get our cholesterol low enough in order to not only prevent--but also reverse--the disease in more than 80% of patients. We can open up arteries without drugs and surgery, and stabilize or improve blood flow in 99% of those who choose to eat healthily and clean up their bad habits. We can essentially eliminate our risk of having a heart attack even in the most advanced cases of heart disease.

Despite this, medical students aren't even taught these concepts while they're in school. Instead, the focus is on cutting people open, which frequently provides only symptomatic relief because we're not treating the actual cause of the disease. Fixing medical education is the solution to this travesty. Knowledge of nutrition can help doctors eradicate the world's leading killer.

I've previously addressed how Doctors Tend to Know Less Than They Think About Nutrition, which is no surprise given most medical schools in the United States fail to provide even a bare minimum of nutrition training (see Medical School Nutrition Education), with mainstream medical associations even actively lobbying against additional nutrition training.

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Sally Plank

Original Link

How Much Nutrition Education Do Doctors Get?

How Much Nutrition Education Do Doctors Get?.jpeg

In the United States, most deaths are preventable and related to nutrition. Given that the number-one cause of death and the number-one cause of disability in this country is diet, surely nutrition is the number-one subject taught in medical school, right? Sadly, that is not the case.

As shown in my video, Physician's May Be Missing Their Most Important Tool, a group of prominent physicians wrote in 2014 that "nutrition receives little attention in medical practice" and "the reason stems, in large part, from the severe deficiency of nutrition education at all levels of medical training." They note this is particularly shocking since it has been proven that a whole foods, plant-based diet low in animal products and refined carbohydrates can reverse coronary heart disease--our number-one killer--and provide potent protection against other leading causes fof death such as cancer and type 2 diabetes.

So, how has medical education been affected by this knowledge? Medical students are still getting less than 20 hours of nutrition education over 4 years, and even most of that has limited clinical relevance. Thirty years ago, only 37 percent of medical schools had a single course in nutrition. According to the most recent national survey, that number has since dropped to 27 percent. And it gets even worse after students graduate.

According to the official list of all the requirements for those specializing in cardiology, Fellows must perform at least 50 stress tests, participate in at least 100 catheterizations, and so on. But nowhere in the 34-page list of requirements is there any mention of nutrition. Maybe they leave that to the primary care physicians? No. In the official 35-page list of requirements for internal medicine doctors, once again, nutrition doesn't get even a single mention.

There are no requirements for nutrition before medical school either. Instead, aspiring doctors need to take courses like calculus, organic chemistry, and physics. Most of these common pre-med requirements are irrelevant to the practice of medicine and are primarily used to "weed out" students. Shouldn't we be weeding out based on skills a physician actually uses? An important paper published in the Archives of Internal Medicine states: "The pernicious and myopic nature of this process of selection becomes evident when one realizes that those qualities that may lead to success in a premedical organic chemistry course...[like] a brutal competitiveness, an unquestioning, meticulous memorization, are not necessarily the same qualities that are present in a competent clinician."

How about requiring a course in nutrition instead of calculus, or ethics instead of physics?

Despite the neglect of nutrition in medical education, physicians are considered by the public to be among the most trusted sources for information related to nutrition. But if doctors don't know what they're talking about, they could actually be contributing to diet-related disease. If we're going to stop the prevailing trend of chronic illness in the United States, physicians need to become part of the solution.

There's still a lot to learn about the optimal diet, but we don't need a single additional study to take nutrition education seriously right now. It's health care's low-hanging fruit. While we've had the necessary knowledge for some time, what we've been lacking is the will to put that knowledge into practice. If we emphasized the powerful role of nutrition, we could dramatically reduce suffering and needless death.

Take, for example, the "Million Hearts" initiative. More than 2 million Americans have a heart attack or stroke each year. In 2011, U.S. federal, state, and local government agencies launched the Million Hearts initiative to prevent 1 million of the 10 million heart attacks and strokes that will occur in the next 5 years. "But why stop at a million?" a doctor asked in the American Journal of Cardiology. Already, we possess all the information needed to eradicate atherosclerotic disease, which is our number-one killer while being virtually nonexistent in populations who consume plant-based diets. Some of the world's most renowned cardiovascular pathologists have stated we just need to get our cholesterol low enough in order to not only prevent--but also reverse--the disease in more than 80% of patients. We can open up arteries without drugs and surgery, and stabilize or improve blood flow in 99% of those who choose to eat healthily and clean up their bad habits. We can essentially eliminate our risk of having a heart attack even in the most advanced cases of heart disease.

Despite this, medical students aren't even taught these concepts while they're in school. Instead, the focus is on cutting people open, which frequently provides only symptomatic relief because we're not treating the actual cause of the disease. Fixing medical education is the solution to this travesty. Knowledge of nutrition can help doctors eradicate the world's leading killer.

I've previously addressed how Doctors Tend to Know Less Than They Think About Nutrition, which is no surprise given most medical schools in the United States fail to provide even a bare minimum of nutrition training (see Medical School Nutrition Education), with mainstream medical associations even actively lobbying against additional nutrition training.

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Sally Plank

Original Link

Can Oatmeal Reverse Heart Disease?

Can Oatmeal Reverse Heart Disease?.jpeg

Fiber continues to be singled out as a nutrient of public health concern. We're getting only about half the minimum recommended intake on average. There is a fiber gap in America. Less than 3 percent meet the recommended minimum. This means that less than 3 percent of all Americans eat enough whole plant foods, the only place fiber is found in abundance. If even half of the adult population ate 3 more grams a day--a quarter cup of beans or a bowl of oatmeal--we could potentially save billions in medical costs. And that's just for constipation! The consumption of plant foods, of fiber-containing foods, may reduce the risk for diabetes, heart disease, stroke, cancer, and obesity as well.

The first to make this link between fiber intake and killer disease was probably Dr. Hugh Trowell. He spent 30 years practicing medicine in Africa and suspected it was the Africans high consumption of corn, millet, sweet potatoes, greens, and beans that protected them from chronic disease. This twisted into the so-called "fiber hypothesis," but Trowell didn't think it was the fiber itself, but the high-fiber foods themselves that were protective. There are hundreds of different substances in whole plant foods besides fiber that may have beneficial effects. For example, the fiber in oatmeal can lower our blood cholesterol levels so that less gets stuck in our arteries, but there also are anti-inflammatory and antioxidant phytonutrients in oats that can prevent atherosclerotic build-up and then help maintain arterial function (see Can Oatmeal Reverse Heart Disease?).

Visionaries like Trowell were not entrapped by the reductionist "simple-minded" focus on dietary fiber and insisted that the whole plant foods should receive the emphasis. Fiber intake was just a marker for plant food intake. Those with the highest fiber intake and the lowest cholesterol were those whose who ate exclusively plant-based diets.

Risk factors like cholesterol are one thing, but can these individual foods actually affect the progression of heart disease, the #1 killer of Americans? We didn't know until 2005. Hundreds of older women were subjected to coronary angiograms, where we inject dye into the coronary arteries of the heart to see how wide open they are. Each participant got an angiogram at the beginning of the study and one a few years later, all while researchers analyzed their diets. The arteries of women eating less than a serving of whole grains a day significantly narrowed, whereas the arteries of women who ate just a single serving or more also significantly narrowed, but they narrowed less. These were all women with heart disease eating the standard American diet, so their arteries were progressively clogging shut. But there was significantly less clogging in the women eating more whole grains, significantly less progression of their atherosclerosis. A similar slowing of their disease might be expected from taking cholesterol-lowering statin drugs. But do we want to just slow the rate at which we die from heart disease, or do we want to not die from heart disease at all?

A strictly plant-based diet has been shown to reverse the progression of heart disease, opening up arteries back up. Yes, whole grains, like drugs, can help counter the artery-clogging effects of the rest of the diet. Having oatmeal with bacon and eggs is better than just eating bacon and eggs, but why not stop eating an artery-clogging diet altogether?

Oatmeal offers a lot more than fiber, though. See Oatmeal Lotion for Chemotherapy-Induced Rash and Can Oatmeal Help Fatty Liver Disease?

Trowell's work had a big influence on Dr. Denis Burkitt. See Dr. Burkitt's F-Word Diet.

This reminds me of other interventions like hibiscus tea for high blood pressure (Hibiscus Tea vs. Plant-Based Diets for Hypertension) or amla for diabetes (Amla Versus Diabetes). Better to reverse the disease completely.

And for an overview of how whole plant foods affect disease risks, be sure to check out the videos on our new Introduction page!

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Rachel Hathaway / Flickr. This image has been modified.

Original Link

Can Oatmeal Reverse Heart Disease?

Can Oatmeal Reverse Heart Disease?.jpeg

Fiber continues to be singled out as a nutrient of public health concern. We're getting only about half the minimum recommended intake on average. There is a fiber gap in America. Less than 3 percent meet the recommended minimum. This means that less than 3 percent of all Americans eat enough whole plant foods, the only place fiber is found in abundance. If even half of the adult population ate 3 more grams a day--a quarter cup of beans or a bowl of oatmeal--we could potentially save billions in medical costs. And that's just for constipation! The consumption of plant foods, of fiber-containing foods, may reduce the risk for diabetes, heart disease, stroke, cancer, and obesity as well.

The first to make this link between fiber intake and killer disease was probably Dr. Hugh Trowell. He spent 30 years practicing medicine in Africa and suspected it was the Africans high consumption of corn, millet, sweet potatoes, greens, and beans that protected them from chronic disease. This twisted into the so-called "fiber hypothesis," but Trowell didn't think it was the fiber itself, but the high-fiber foods themselves that were protective. There are hundreds of different substances in whole plant foods besides fiber that may have beneficial effects. For example, the fiber in oatmeal can lower our blood cholesterol levels so that less gets stuck in our arteries, but there also are anti-inflammatory and antioxidant phytonutrients in oats that can prevent atherosclerotic build-up and then help maintain arterial function (see Can Oatmeal Reverse Heart Disease?).

Visionaries like Trowell were not entrapped by the reductionist "simple-minded" focus on dietary fiber and insisted that the whole plant foods should receive the emphasis. Fiber intake was just a marker for plant food intake. Those with the highest fiber intake and the lowest cholesterol were those whose who ate exclusively plant-based diets.

Risk factors like cholesterol are one thing, but can these individual foods actually affect the progression of heart disease, the #1 killer of Americans? We didn't know until 2005. Hundreds of older women were subjected to coronary angiograms, where we inject dye into the coronary arteries of the heart to see how wide open they are. Each participant got an angiogram at the beginning of the study and one a few years later, all while researchers analyzed their diets. The arteries of women eating less than a serving of whole grains a day significantly narrowed, whereas the arteries of women who ate just a single serving or more also significantly narrowed, but they narrowed less. These were all women with heart disease eating the standard American diet, so their arteries were progressively clogging shut. But there was significantly less clogging in the women eating more whole grains, significantly less progression of their atherosclerosis. A similar slowing of their disease might be expected from taking cholesterol-lowering statin drugs. But do we want to just slow the rate at which we die from heart disease, or do we want to not die from heart disease at all?

A strictly plant-based diet has been shown to reverse the progression of heart disease, opening up arteries back up. Yes, whole grains, like drugs, can help counter the artery-clogging effects of the rest of the diet. Having oatmeal with bacon and eggs is better than just eating bacon and eggs, but why not stop eating an artery-clogging diet altogether?

Oatmeal offers a lot more than fiber, though. See Oatmeal Lotion for Chemotherapy-Induced Rash and Can Oatmeal Help Fatty Liver Disease?

Trowell's work had a big influence on Dr. Denis Burkitt. See Dr. Burkitt's F-Word Diet.

This reminds me of other interventions like hibiscus tea for high blood pressure (Hibiscus Tea vs. Plant-Based Diets for Hypertension) or amla for diabetes (Amla Versus Diabetes). Better to reverse the disease completely.

And for an overview of how whole plant foods affect disease risks, be sure to check out the videos on our new Introduction page!

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Rachel Hathaway / Flickr. This image has been modified.

Original Link

What Happened to the Rice Diet?

What Happened to the Rice Diet?.jpeg

During his career at Duke, Dr. Walter Kempner treated more than 18,000 patients with his rice diet. The diet was originally designed as a treatment for kidney failure and out-of-control high blood pressure at a time when these diagnoses were essentially a death sentence. Patients who would have died in all other hospitals had a reasonable chance for survival if they came under Kempner's care.

The results were so dramatic that many experienced physicians suspected him of falsifying data, because he was essentially reversing terminal diseases with rice and fruit, diseases understood to be incurable by the best of modern medicine at the time. Intensive investigations into his clinic vindicated his work, however, which other researchers were then able to replicate and validate.

Kempner was criticized for his lack of controls, meaning that when patients came to him he didn't randomly allocate half to his rice treatment and put the other half on conventional therapy. Kempner argued that the patients each acted as their own controls. For example, one patient, after the medical profession threw everything they had at him, still had blood pressure as high as 220 over 160. A normal blood pressure is considered to be around 120 over 80--which is where Kempner's rice diet took him. Had the patient not been given the rice diet, his pressures might have been even lower, though: zero over zero, because he'd likely be dead. The "control group" in Kempner's day had a survival expectancy estimated at 6 months. To randomize patients to conventional care would be to randomize them to their deaths.

We can also compare those who stuck to the diet to those who didn't. In one study, of those who started the rice diet but then stopped it within a year, 80% died. For those who made it a year but then gave up the diet, instead of an 80% chance of dying, they had about a 50% chance, a flip of the coin. Of those that stuck with the program, 90% lived to tell the tale.

Beginning in the late 1950's, drugs became available that effectively reduced blood pressure and hypertension, leading to a decreased demand for the rice diet. What conclusions can we draw from this all-but-forgotten therapy for hypertension? Not only was it the first effective therapy for high blood pressure, it may be equal to or more effective than our current multi-drug treatments. See Drugs & the Demise of the Rice Diet.

This causes one to speculate on the current practice of placing patients on one drug, then another, and perhaps a third until the blood pressure is controlled, with lip-service advocacy of a moderate reduction in dietary sodium, fat, and protein intake. At the same time, the impressive effectiveness of the rice-fruit diet, which is able to quickly stop the leakage from our arteries, lower increased intracranial pressure, reduce heart size, reverse the ECG changes, reverse heart failure, reduce weight, and markedly improve diabetes, is ignored.

Should we return to the Kempner protocol of starting with the most effective therapy, saving drugs for patients who fail to respond or who are unable or unwilling to restrict their diet? Today many people follow a plant-based diet as a choice, which is similar to what Kempner was often able to transition people to. After their high blood pressure was cured by the rice diet, patients were often able to gradually transition to a less strenuous dietary regime without adding medications and with no return of the elevated blood pressure.

If the Kempner sequence of a strictest of strict plant-based diets to a saner plant-based type diet offers the quickest and best approach to effective therapy, why isn't it still in greater use? The powerful role of the pharmaceutical industry in steering medical care away from dietary treatment to medications should be noted. Who profits from dietary treatment? Who provides the support for investigation and the funds for clinical trials? There is more to overcome than just the patient's reluctance to change their diet.

What Kempner wrote to a patient in 1954 is as true now as it was 60 years ago:

"[D]rugs can be very useful if properly employed and used in conjunction with intensive dietary treatment. However, the real difficulty is that Hypertensive Vascular Disease with all its possible complications--heart disease, kidney disease, stroke, blindness--is still treated very casually, a striking contrast to the attitude toward cancer. Since patients, physicians, and the chemical industry prefer the taking, prescribing, and selling of drugs to a treatment inconvenient to patient and physician and of no benefit to the pharmaceutical industry, the mortality figures for these diseases are still rather appalling."

Despite hundreds of drugs on the market now, high blood pressure remains the #1 cause of death and disability in the world, killing off 9 million people a year. A whole food plant-based diet treats the underlying cause. As Dr. Kempner explained to a patient, "If you should find a heap of manure on your living room floor, I do not recommend that you go buy some Air-Wick [an air freshener] and perfume. I recommend that you get a bucket and shovel and a strong scrubbing brush. Then, when your living room floor is clean again, why, you may certainly apply some Air-Wick if you wish."

As the great physician Maimonides said about 800 years ago, any illness that can be treated by diet alone should be treated by no other means.

For background on this amazing story, see Kempner Rice Diet: Whipping Us Into Shape. He would be proud that there is a whole medical specialty now: Lifestyle Medicine: Treating the Causes of Disease.

This reminds me of the role statin cholesterol-lowering drugs have played in seducing people into the magic bullet approach, but as with all magic it appears to mostly be misdirection:

Check out a couple of my recent overview videos for more on this topic: How Not to Die from Heart Disease and Taking Personal Responsibility for Your Health.

In this day and age, What Diet Should Physician's Recommend?

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Sally Plank / Flickr. Image has been modified.

Original Link

What Happened to the Rice Diet?

What Happened to the Rice Diet?.jpeg

During his career at Duke, Dr. Walter Kempner treated more than 18,000 patients with his rice diet. The diet was originally designed as a treatment for kidney failure and out-of-control high blood pressure at a time when these diagnoses were essentially a death sentence. Patients who would have died in all other hospitals had a reasonable chance for survival if they came under Kempner's care.

The results were so dramatic that many experienced physicians suspected him of falsifying data, because he was essentially reversing terminal diseases with rice and fruit, diseases understood to be incurable by the best of modern medicine at the time. Intensive investigations into his clinic vindicated his work, however, which other researchers were then able to replicate and validate.

Kempner was criticized for his lack of controls, meaning that when patients came to him he didn't randomly allocate half to his rice treatment and put the other half on conventional therapy. Kempner argued that the patients each acted as their own controls. For example, one patient, after the medical profession threw everything they had at him, still had blood pressure as high as 220 over 160. A normal blood pressure is considered to be around 120 over 80--which is where Kempner's rice diet took him. Had the patient not been given the rice diet, his pressures might have been even lower, though: zero over zero, because he'd likely be dead. The "control group" in Kempner's day had a survival expectancy estimated at 6 months. To randomize patients to conventional care would be to randomize them to their deaths.

We can also compare those who stuck to the diet to those who didn't. In one study, of those who started the rice diet but then stopped it within a year, 80% died. For those who made it a year but then gave up the diet, instead of an 80% chance of dying, they had about a 50% chance, a flip of the coin. Of those that stuck with the program, 90% lived to tell the tale.

Beginning in the late 1950's, drugs became available that effectively reduced blood pressure and hypertension, leading to a decreased demand for the rice diet. What conclusions can we draw from this all-but-forgotten therapy for hypertension? Not only was it the first effective therapy for high blood pressure, it may be equal to or more effective than our current multi-drug treatments. See Drugs & the Demise of the Rice Diet.

This causes one to speculate on the current practice of placing patients on one drug, then another, and perhaps a third until the blood pressure is controlled, with lip-service advocacy of a moderate reduction in dietary sodium, fat, and protein intake. At the same time, the impressive effectiveness of the rice-fruit diet, which is able to quickly stop the leakage from our arteries, lower increased intracranial pressure, reduce heart size, reverse the ECG changes, reverse heart failure, reduce weight, and markedly improve diabetes, is ignored.

Should we return to the Kempner protocol of starting with the most effective therapy, saving drugs for patients who fail to respond or who are unable or unwilling to restrict their diet? Today many people follow a plant-based diet as a choice, which is similar to what Kempner was often able to transition people to. After their high blood pressure was cured by the rice diet, patients were often able to gradually transition to a less strenuous dietary regime without adding medications and with no return of the elevated blood pressure.

If the Kempner sequence of a strictest of strict plant-based diets to a saner plant-based type diet offers the quickest and best approach to effective therapy, why isn't it still in greater use? The powerful role of the pharmaceutical industry in steering medical care away from dietary treatment to medications should be noted. Who profits from dietary treatment? Who provides the support for investigation and the funds for clinical trials? There is more to overcome than just the patient's reluctance to change their diet.

What Kempner wrote to a patient in 1954 is as true now as it was 60 years ago:

"[D]rugs can be very useful if properly employed and used in conjunction with intensive dietary treatment. However, the real difficulty is that Hypertensive Vascular Disease with all its possible complications--heart disease, kidney disease, stroke, blindness--is still treated very casually, a striking contrast to the attitude toward cancer. Since patients, physicians, and the chemical industry prefer the taking, prescribing, and selling of drugs to a treatment inconvenient to patient and physician and of no benefit to the pharmaceutical industry, the mortality figures for these diseases are still rather appalling."

Despite hundreds of drugs on the market now, high blood pressure remains the #1 cause of death and disability in the world, killing off 9 million people a year. A whole food plant-based diet treats the underlying cause. As Dr. Kempner explained to a patient, "If you should find a heap of manure on your living room floor, I do not recommend that you go buy some Air-Wick [an air freshener] and perfume. I recommend that you get a bucket and shovel and a strong scrubbing brush. Then, when your living room floor is clean again, why, you may certainly apply some Air-Wick if you wish."

As the great physician Maimonides said about 800 years ago, any illness that can be treated by diet alone should be treated by no other means.

For background on this amazing story, see Kempner Rice Diet: Whipping Us Into Shape. He would be proud that there is a whole medical specialty now: Lifestyle Medicine: Treating the Causes of Disease.

This reminds me of the role statin cholesterol-lowering drugs have played in seducing people into the magic bullet approach, but as with all magic it appears to mostly be misdirection:

Check out a couple of my recent overview videos for more on this topic: How Not to Die from Heart Disease and Taking Personal Responsibility for Your Health.

In this day and age, What Diet Should Physician's Recommend?

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Sally Plank / Flickr. Image has been modified.

Original Link