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

4 Things To Help Prevent Most Disease

NF-Sep23 4 Simple Things You Can Do to Prevent Most Diseases.jpg

Though I was trained as a general practitioner, my chosen specialty is lifestyle medicine. Most of the reasons we go see our doctors are for diseases that could have been prevented. But lifestyle medicine is not just about preventing chronic disease--it's also about treating it. And not just treating the disease, but treating the causes of disease.

If people just did four simple things--not smoking, exercising a half hour a day, eating a diet that emphasizes whole plant foods, and not becoming obese--they may prevent most cases of diabetes and heart attacks, half of strokes, and a third of cancers. Even modest changes may be more effective in reducing cardiovascular disease, high blood pressure, heart failure, stroke, cancer, diabetes, and all-cause mortality than almost any other medical intervention.

The key difference between conventional medicine and lifestyle medicine is instead of just treating risk factors, we treat the underlying causes of disease, as Drs. Hyman, Ornish, and Roizen describe in their landmark editorial Lifestyle medicine: treating the causes of disease. Doctors typically treat "risk factors" for disease by giving a lifetime's worth of medications to lower high blood pressure, elevated blood sugar, and high cholesterol. But think about it: high blood pressure is just a symptom of diseased and dysfunctional arteries. We can artificially lower blood pressure with drugs, but that's not treating the underlying cause. To treat the underlying cause, we need things like diet and exercise, the "penicillin" of lifestyle medicine (See Lifestyle Medicine: Treating the Causes of Disease).

As Dr. Dean Ornish is fond of saying, disregarding the underlying causes and treating only risk factors is somewhat like mopping up the floor around an over-flowing sink instead of just turning off the faucet, which is why medications usually have to be taken for a lifetime. As Dr. Denis Burkitt described, "if a floor is flooded as a result of a dripping tap, it is of little use to mop up the floor unless the tap is turned off. The water from the tap represents the cost of disease, and the flooded floor represents the diseases filling our hospital beds. Medical students learn far more about methods of floor mopping than about turning off taps, and doctors who are specialists in mops and brushes can earn infinitely more money than those dedicated to shutting off taps." And the drug companies are more than happy to sell rolls of paper towels so patients can buy a new roll every day for the rest of their lives. Paraphrasing poet, Ogden Nash, modern medicine is making great progress, but is headed in the wrong direction.

When the underlying lifestyle causes are addressed, patients often are able to stop taking medication or avoid surgery. We spend billions cracking patients' chests open, but only rarely does it actually prolong anyone's life. Instead of surgery, why not instead wipe out at least 90% of heart disease through prevention? Heart disease accounts for more premature deaths than any other illness and is almost completely preventable simply by changing diet and lifestyle, and the same dietary changes required can prevent or reverse many other chronic diseases as well.

So why don't more doctors do it?

One reason is doctors don't get paid to do it. No one profits from lifestyle medicine, so it is not part of medical education or practice. Presently, physicians lack training and financial incentives, so they continue to do what they know how to do: prescribe medication and perform surgery.

After Dean Ornish proved you could open up arteries and reverse our number one cause of death, heart disease, with just a plant-based diet and other healthy lifestyle changes (see Resuscitating Medicare and Our Number One Killer Can Be Stopped), he thought that his studies would have a meaningful effect on the practice of mainstream cardiology. After all, he had found a cure for our #1 killer! But, he admits, he was mistaken. "Physician reimbursement," he realized, "is a much more powerful determinant of medical practice than research."

Reimbursement over research. Salary over science. Wealth over health. Not a very flattering portrayal of the healing profession. But if doctors won't do it without getting paid, let's get them paid.

So Dr. Ornish went to Washington. He argued that if we train and pay for doctors to learn how to help patients address the real causes of disease with lifestyle medicine and not just treat disease risk factors we could save trillions of dollars. And that's considering only heart disease, diabetes, prostate and breast cancer. The Take Back Your Health Act was introduced in the U.S. Senate to induce doctors to learn and practice lifestyle medicine, not only because it works better, but because they will be paid to do it. Sadly, the bill died, just like millions of Americans will continue to do with reversible chronic diseases.

By treating the root causes of diseases with plants not pills, we can also avoid the adverse side effects of prescription drugs that kill more than 100,000 Americans every year, effectively making doctors a leading cause of death in the United States. See One in a Thousand: Ending the Heart Disease Epidemic and my live presentation Uprooting the Leading Causes of Death.

-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 More Than an Apple a Day and From Table to Able.

Image Credit: Punchyy / Flickr

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Eat Beans to Live Longer

NF-Sep11 Eat Beans to Live Longer.jpg

Beans, beans, they're good for your heart; the more you eat, the...longer you live? Legumes may be the most important predictor of survival in older people from around the globe. Researchers from institutions different institutions looked at five different cohorts in Japan, Sweden, Greece, and Australia. Of all the food factors they looked at, only one was associated with a longer lifespan across the board: legume intake. Whether it was the Japanese eating their soy, the Swedes eating their brown beans and peas, or those in the Mediterranean eating lentils, chickpeas, and white beans, legume intake was associated with an increased lifespan. In fact, it was the only result that was plausible, consistent, and statistically significant from the data across all the populations combined. We're talking an 8% reduction in risk of death for every 20 gram increase in daily legume intake. That's just two tablespoons worth! So if a can of beans is 250 grams, and we get 8% lower mortality for every 20 grams, if we eat a can a day can we live forever?

If, however, one wants to decrease their lifespan, studies suggest eating a bean-free diet may increase our risk of death.

Having arrived at the one dietary fountain of youth, why aren't people clamoring for beans? Fear of flatulence. So is that the choice we're left with: Breaking wind or breaking down? Passing gas or passing on? Turns out that people's concerns about excessive flatulence from eating beans may be exaggerated.

A recent study, profiled in my video Increased Lifespan from Beans, involved adding a half-cup of beans every day to people's diets for months to see what would happen. The vast majority of people experienced no symptoms at all. However, a few percent did report increased flatulence, so some individuals may be affected. But most aren't. Even among those that were affected, 70% or more of the participants felt that flatulence dissipated--no pun intended--by the second or third week of bean consumption. So we've just got to stick with it.

And a small percentage reported increased flatulence on the control diet without any beans. People have preconceived notions about beans such that just the expectation of flatulence from eating beans may influence their perceptions of having gas. Researchers didn't actually measure farts in this study, they just asked participants how much gas they had. We know from previous studies that if someone eats a product that's labeled to have something that may cause intestinal distress, it causes more intestinal distress--whether it actually contains that ingredient or not!

So people thinking beans are going to cause gas may just be more likely to notice the gas they normally have. Either way it tends to go away. After a few weeks of daily bean consumption, people perceive that flatulence occurrence returns to normal levels.

In another study, researchers added more than a half a cup of kidney beans to people's daily diets, and the research subjects reported that the discomfort they initially felt within the first day or two quickly disappeared. We've just got to stick with it.

The bottom line is that an increasing body of research supports the benefits of a plant-based diet, and legumes specifically, in the reduction of chronic disease risks. In some people, increased bean consumption may result in more flatulence initially, but it will decrease over time if we just keep it up. Doctors should recommend a bean-filled, plant-based diet to their patients, as the nutritional attributes of beans far outweigh the potential for transitory discomfort. The long-term health benefits of bean consumption are great.

Eating beans in the long term may make our term on earth even longer.

I've previously covered intestinal gas in one of my more amusing blog posts, Beans and Gas: Clearing the Air.

More on the benefits of beans in:

-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 Uprooting the Leading Causes of Death, More Than an Apple a Day, and From Table to Able.

Image Credit: Tony Alter / Flickr

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