Patients and members of the public are equally dissatisfied. They are put off by healthcare professionals who seem remote and sometimes even disrespectful; thanks to the internet and other readily available sources of information, they are aware of the side effects of commonly prescribed drugs; they are sickened by the conflicts of interest that are pervasive in the diet and health businesses; and they want better outcomes.
While the dissatisfaction is understandable and the search for alternatives is admirable, the problem is that many people tend to latch onto the first option they find that appears to be different. If the first exposure to something new is Forks Over Knives or one of the health professionals in that film, they become enthusiastic about plant-based nutrition. If the first new idea encountered is Functional Medicine, they become enamored with certain forms of diagnostic testing and the prescribing of supplements. If it’s the Paleo diet, a meat-based diet is adopted.
The tendency to latch onto organizations, beliefs, diets, and protocols that are not supported by solid research is based on many factors. The first is that even the worst of the alternative diet and health programs have positive attributes which seem appealing. Many of the diet plans, even if they are not ideal, are better than the Standard American Diet; the approaches seem patient-centered; the focus is on the whole person; and the treatments appear to be more “natural.”
Research shows that healthcare professionals, including doctors, notoriously lack skills for properly evaluating research concerning diagnostic testing, drugs, and procedures. Shannon Brownlee wrote extensively about this in her book Overtreated. One recent example is reflected in a study published in the Annals of Internal Medicine which showed that most doctors surveyed were unable to correctly evaluate the efficacy of cancer screening tests like mammography and PSA testing based on statistical evidence. This inability to interpret data is concerning, and most certainly contributes to bad decision-making when looking at diet and health programs.
Low expectations are another factor. Most patients and practitioners do not know that it is possible to stop and reverse disease, and instead think that the best that can be expected is to mitigate symptoms while diseases progress. On this basis, the idea that symptoms can be addressed with dietary supplements instead of drugs and surgery, for example, becomes an exciting concept for many patients and their doctors.
Both practitioners and patients are driven by the same dissatisfaction with the existing medical system and the American diet. They want and need to find better alternatives. And they both get excited as soon as an alternative presents itself. We can forgive a lay person for latching on to a new idea that seems to offer less potential for harm and more hope for a better outcome. But we should be able to expect better from practitioners; they need better training and also to be held to a higher standard (evidence) when making recommendations to patients.
In the meantime, we must be committed to telling the public that better outcomes are possible – that disease and obesity are food-borne conditions that can be prevented and treated with the right diet and lifestyle changes. The answer to our current healthcare mess is not to try to find alternative diagnostic tests and more natural pills; it is to throw out our existing framework and adopt a new one in which diet and lifestyle are the basis of care.
Wegwarth O, Schwartz LM, Woloshin S, Gaissmaier W, Gigerenzer G. “Do physicians understand cancer screening statistics? A national survey of primary care physicians in the United States.” Ann Intern Med. 2012 Mar 6;156(5):340-9.
]]>The Diet and Lifestyle Intervention Course is offered by The Wellness Forum Institute for Health Studies. The course is designed to teach doctors and other health and fitness professionals how to use diet and lifestyle as a preventive and curative tool and how to develop a profitable practice around this philosophy. In addition to diet, issues like vaccinations, diagnostic testing, joint and back injuries, and mental health are covered.
The faculty includes Dr. T. Colin Campbell, Dr. Caldwell Esselstyn Jr., Dr. Neal Barnard. Dr. John McDougall, Dr. Ralph Moss, Dr. Pam Popper, Dr. Larry Palevsky, Dr. Mark Scholtz, William Lessler, and Dr. Alan Goldhamer. Specific protocols are taught as part of the course.
The course is taught via virtual classroom, or conference call. Prior to each call, participants are instructed to read the texts and are emailed copies of the instructor’s slides. The call is interactive and the participants can ask questions at any time.
The class series is only offered once per year.
For a course catalog or more information you can call The Wellness Forum at 614 841-7700; write to pampopper@msn.com; or visit the school’s website at www.wellnessforuminstitute.org.
]]>I’ve written extensively about the risks associated with mammography and PSA testing, which include missing aggressive cancers that develop between screenings; false positives resulting in extreme distress and even more tests and procedures; and identification of “pseudo-cancers” which you’d probably be better off not knowing about and which usually result in over-treatment that can be harmful.
But screening tests are still aggressively promoted. In my opinion, there are two reasons why. First, screening generates a lot of money and creates a market for medical services. Doctors, hospitals, and other medical facilities bill insurance companies and Medicare for expensive screening tests and the tests produce customers for procedures and treatment, often offered by those same doctors and facilities (and also billed to third-party payers).
The other reason that screening continues to be a standard practice in spite of its lack of efficacy is the emotional outcry any time there is a discussion about limiting or eliminating ineffective tests. Public health officials, legislators, and the general population become almost hysterical, often accusing the government and insurance companies of trying to increase profits and ration care at the expense of public health.
I receive emails from people about this issue frequently. Some of these emails are outwardly hostile; people accuse me of being irresponsible for suggesting that cancer screening for the general public may not be a good idea. But most correspondence is from people who are frightened and concerned. They say things like “If these tests do not work, what am I supposed to do to protect myself? How will I know if I have cancer?” These people are genuinely upset because their belief system about how to protect themselves has been shaken.
I am often asked to recommend an alternative screening test that is reliable. Life would be so much simpler if I could, but there is no such test. Instead, I recommend the only option that really does work to reduce the risk of developing or dying from cancer – dietary excellence™ (a Wellness Forum-style diet). Adopting this diet does not eliminate all risk; it just eliminates the controllable risk. A good comparison is the practice of buckling children into the back seat with seat belts before backing out of the driveway. Doing so does not guarantee that children will not die in a car accident, but it does reduce the risk so significantly that there are few parents or caregivers who do not take the time to make sure that children are secure in the car.
A common frustration shared by people promoting a plant-based diet is that some people are resistant to the idea. I’ve found that this resistance is significantly lowered when people are provided with published evidence showing the futility of their current plan for health care, and also provided with evidence showing the potential for a well-structured plant-based diet to prevent, stop, and even reverse disease. The challenge in communicating this information is that people must be helped to move beyond the emotional state in which they find themselves when confronted with information that threatens their sense of well-being, which is often the case when the discussion about diagnostic testing begins.
The choice to eat plants instead of visiting doctors for tests and treatment represents a major shift for many people, and should be a well thought-out decision. The reason to do this is not because I say so. I remind people daily that the reason many people have been over-treated or mistreated by the medical profession is that they have formed the habit of doing what they are told. I am clear that just following my directions instead of someone else’s is not what I mean when I advise people to take control of their health. This is why we provide referenced information for people to read; we want them to make informed decisions and to take ownership of their choices.
Two great books that are helpful resources for learning more about this issue are Should I Get Tested for Cancer? Maybe Not and Here’s Why and Over-Diagnosed. Both are by Gilbert Welch, M.D. and discuss the myth of early detection and the risks associated with testing. They are well-referenced and easy to read.
The medical system is not going to reform itself, and the government is not likely to be a positive influence either. Consumers are going to force reform by collectively increasing the demand for strategies and services that work (like diet) and drying up demand for strategies and services that do not work (diagnostic testing and bypass surgery, for example). I am optimistic that this shift is taking place now and gaining momentum. Interest in health grows daily; dissatisfaction with medical care is at an all-time high; information can be disseminated rapidly, and the science is on our side.
]]>John McDougall, M.D.
A new group, called Health at Every Size, promotes the idea that being overweight is not something to be concerned about and that people should accept themselves as they are. If you’re looking for reassurance that being overweight is ok, this is the group to join.
HAES offers training for practitioners on the group’s website, and the information I saw there is almost hard to believe. Doctors are instructed that healthy eating is defined as choosing a wide variety of foods based on the USDA Food Guide Pyramid. “Healthy unrestrained eating” refers to “the legalization of all foods. No food is "good" or "bad". All foods contain various combinations of calories and nutrients and may be consumed in moderation as part of a healthy diet.”
The benefits of “legalizing” all foods helps “clients to enjoy eating without the intrusion of guilt, fear, or other negative emotions that the client relates to the eating experience.”
And practitioners are instructed to avoid “condemning weight gain” or “praising weight loss.”
The HAES website and its disciples choose to ignore the evidence that being overweight affects health by increasing the risk of not only developing diseases, but dying from them too. Instead, overweight people are told that they should focus on improving their health, which may or may not result in weight loss. In fact the group advises that weight loss should not be used as a measurement of health improvement.
HAES promotes self-acceptance and advocates paying attention to hunger and satiety, and evaluating food choices based on things like moods and ability to concentrate. Instead of structured exercise, people are advised to incorporate activities they find enjoyable into their daily life.
I see and read about ridiculous ideas in health care every day; the people hurt most by these ideas are patients, closely followed by taxpayers and those paying insurance premiums who foot the bill for these wrong-headed concepts. But this takes the cake and is the ultimate in irresponsibility.
For the record, I do not condone ostracizing overweight people or discrimination against the obese. But being overweight or obese is a sign that something is wrong. Health care practitioners are not advised to ignore other signs that health is compromised. We don’t avoid discussions about high cholesterol or tumors because we don’t want to upset patients; we aggressively encourage them to seek treatment because we know that without intervention bad things can happen. Yet many doctors simply do not want to have a frank discussion about weight with overweight patients to help them understand the health risks associated with their weight. Furthermore many continue to insist that there are lots of reasons for being overweight and not everyone can lose weight with diet and exercise. I’m appalled, disgusted, and angry about this. We are not helping people by teaching them to accept their overweight status like helpless victims.
A health-promoting diet that properly addresses blood pressure, cholesterol, sugar levels and other issues results in a 2-3 pound per week loss. We can measure compliance on the diet by measuring the weight loss in almost every instance unless the individual has thyroid or other metabolic disorders. These cases are fortunately the exceptions rather than the rule.
The avoidance of honest talk about obesity is representative of a larger issue, which is the unwillingness to honestly address many aspects of diet, health, and medical care. We will not solve our health care issues in this country until we toughen up and engage in uncomfortable discussions that are invariably going to make someone unhappy or even angry. The agriculture groups are going to be angry if the USDA starts issuing health-promoting guidelines because these will include advice to eat less of or to even to eliminate some foods. The drug companies are going to be upset if we start telling people the truth about the cause of disease and the fact that diet will reverse it; this information will hurt sales of their products. The hospitals will be angry if we have honest discussions about how to reverse heart disease with diet since the leading sources of revenue for hospitals are bypass surgery and angioplasty. And letting overweight people know that their food choices are responsible for their weight and that almost all of them can lose weight with the right diet may make some of them mad because they are uncomfortable dealing with the issue, or because they do not want to take personal responsibility.
For the last 15 years, I’ve made unpopular statements about diet, health, medical care, personal responsibility, conflicts of interest, and other related issues. In response I’ve received my share of hate mail and assaults on my character. But my straight talk has helped a lot of people and the letters thanking me for my honesty have outnumbered the communications from people who wish I’d disappear from the planet.
We can no longer afford to maintain the status quo in the interest of political correctness and our desire to avoid discussions that may be upsetting to individuals or groups. It’s time for everyone in the nutrition and health field to develop some backbone and take a stand on these issues. I’m sure some people will be angry, but some progress will finally be made.
]]>Americans are sicker than they’ve ever been, and if they believe the claims made by food companies, their health issues can be helped by eating fortified crackers, sugar-laden cereals made with whole grains, or drinking certain fruit juices. In response to growing interest in diet and health, food companies have become more aggressive in promoting functional foods as having health-promoting properties. This strategy has paid off - these foods generate tens of billions of dollars of sales annually.
The Federal Trade Commission and the Food and Drug Administration are charged with regulating advertising and health claims for foods, and these agencies spend hundreds of millions of dollars annually policing the activities of food manufacturing companies. Their collective mission is to review research and authorize health claims, and to insure that food companies stay within published guidelines. I’ll assume that the regulators are well intentioned, but their efforts are misdirected and divert attention from the discussion about diet that we should be having.
Americans are sick because they are eating a diet based on animal foods and processed foods. There is no evidence that people can overcome the ill effects of consuming this poor diet by eating fortified/functional foods, taking vitamins, or adding or eliminating one or two foods from the daily fare.
A growing body of scientific evidence shows that a more comprehensive approach, a whole-foods, plant-based diet, can not only prevent, but can also stop and even reverse common degenerative diseases. My colleagues and I have been successfully teaching people how to change their health outcomes using this diet for many years, and public interest in it is growing. In fact, a new film called Forks Over Knives is being shown in theaters throughout the U.S. today and chronicles the work of two researchers, Dr T. Colin Campbell at Cornell University, and Dr. Caldwell Esselstyn at the Cleveland Clinic, who have proven that this diet successfully addresses the major diseases that plague our society today. The film presents the scientific evidence supporting this claim, includes interviews with doctors and other nutrition experts, and features reality patients who actually reverse their diseases as a result of adopting a plant-based diet.
Many Americans are trying to improve their diets, but the results have generally been disappointing. The reason is that Americans are trying to make minor changes, such as incorporating functional foods, and this approach simply does not work. Dietary change that results in improved health outcomes works just like a combination lock – if it takes four numbers to open the lock and you only dial three, you do not get 75% of the results – you get nothing. You must get all four numbers right, and in the right order, to get results. And so it is with diet. There is a right dietary pattern and a wrong dietary pattern, and there are good and bad foods. Our federal authorities don’t like to talk about this because it means telling Americans to eat more of some foods, less of some foods, and to eliminate some foods. These directives may be detrimental to some food companies and agricultural organizations, but are imperative in order to improve the health of Americans.
I know that some people find it hard to believe that the solution to our expensive and negatively life-altering health problems could be so simple. Americans have been trained to think that effective medical care involves expensive equipment, tests, drugs, and procedures. But mangoes and broccoli are far more powerful than these high-tech tools will ever be for chronic health conditions.
Because we live in a free country, companies should be allowed to manufacture, market, and sell junk foods. We simply must prohibit these companies from making health claims about these foods, regardless of how much they are altered or what is added to them. The federal government, starting with the USDA, should start promoting the diet that has been proven prevent and cure disease – a whole-foods, plant-based diet – regardless of the effect this advice might have on food companies and agricultural groups. We are sacrificing the health of hundreds of millions of people in order to protect the financial interests of a few thousand companies and farming groups. I find this unacceptable and so should you.
]]>This is an important issue and question. I detect from my colleagues almost a sense of futility or resignation; many have determined that people just will not make changes and that even if you can get people to change, compliance is nearly impossible. We have not found this to be the case.
Our experience has been that people will not only change but will remain reasonably compliant if the following criteria are applied:
People must thoroughly understand the futility of the current treatment they are receiving. Many people operate under the misconception that taking drugs and having procedures will prolong their life or address their health issues; this misconception can prevent them from being open to change. Once we show people the actual expected outcomes of the treatments they are receiving (for example, statin drugs and bypass surgery do not reduce the risk of heart attack), they become very open-minded about exploring other options.
People must be presented with scientific evidence about how diet causes conditions like the one(s) they have, and how a program of dietary excellence has been shown to stop or reverse those conditions.
They must be given very specific instructions on how to make the right changes.
They must see results.
These are important components of the programs that are producing positive results with diet – The Wellness Forum, Dr. McDougall, and others.
There are several reasons why it has historically been difficult to market other health care programs. One is that health care professionals tend to think that people are not interested in detailed information about diet and health, or that the information is too complicated for the average person to understand. Our experience is that people are interested and that this information is easily understandable if it is communicated correctly. Many people would like to be in control of their health, and given the right information many will make positive changes. I have been thanked many times for not “talking down” to people about their health; for not watering down the message; and for taking the time to help people understand their health status and how to change it.
Another missing link is that “other” programs do not offer advice that is likely to result in significant changes in health status. In a misguided effort to promote moderation and other tools that ask little of the patient; little, if any, improvement is made in health. Diabetics don’t get excited about reducing medications while their diabetes continues to progress; they get excited about becoming former diabetics. Big changes result in big improvements, and those improvements, which are quickly reversed by reverting back to old habits, provide a motivation to stay on track.
This does not mean that everyone is ready to or going to change; it also does not mean that everyone is 100% compliant. It does mean that many people are willing to make changes and are compliant enough to maintain the improvements they make in their health.
It is time for health care professionals to stop hiding behind the excuses that change is hard and that people are too lazy to help themselves, and realize that one of the reasons they are getting poor results with their patients is that they are not offering the right solutions. Motivating people to participate and stick with ineffective programs that do not positively affect their health in significant ways will continue to be difficult.
]]>The Diet and Lifestyle Intervention Course teaches specific protocols for treating diabetes, cardiovascular disease, GI disorders, autoimmune diseases, and other common conditions, but also provides guidance on how to set up a profitable practice around this philosophy.
Issues like vaccinations, diagnostic testing, joint and back injuries, evaluating cancer treatment, and mental health are also covered.
The faculty includes Dr. T. Colin Campbell, Dr. Caldwell Esselstyn Jr., Dr. Neal Barnard. Dr. John McDougall, Dr. Ralph Moss, Dr. Pam Popper, Dr. Larry Palevsky, Dr. Mark Scholtz, William Lessler, and Dr. Alan Goldhamer. Specific protocols are taught as part of the course.
The great news is that you can live anywhere and participate in this program! It’s taught via virtual classroom, or conference call. Prior to each call, participants are instructed to read the texts and are emailed copies of the instructor’s slides. The call is interactive and the participants can ask questions at any time. The series begins June 1 and lasts for 14 weeks.
For more information or to request a course catalog, you can call The Wellness Forum at 614 841-7700; write to pampopper@msn.com; or visit the school’s website at www.wellnessforuminstitute.org.
]]>There are lots of reasons, a major one being that most of the people that most of us know do not live and eat the way we do. This means we are all faced with constant temptation to do the wrong thing. But there is a greater issue that must be addressed, which is that being successful at anything is an unnatural experience and is generally only achieved by people who are willing to work to overcome their natural tendencies, which are to avoid doing things they do not want to do.
One of the best lectures on this topic I have ever heard was given by Earl Nightingale, in which he talks about the difference between successful and unsuccessful people. According to Nightingale (and I agree with him) the difference between successful and unsuccessful people is that successful people have formed the habit of doing things that unsuccessful people are unwilling to do. Successful people are motivated by desirable results, while unsuccessful people are motivated by pleasing methods. As it pertains to our issue, the person who succeeds in making permanent life changes with diet and exercise is motivated by achieving goals – regaining health, maintaining health, staying fit, etc., and is willing to do things that he/she does not want to do in order to achieve those goals.
What are the things that people do not want to do? Exercise when you don’t feel like it, avoid the cheese tray at a reception, order a baked potato when everyone else is eating cheese quesadillas, and throw away Halloween candy after eating only two pieces. In other words, the things that are contrary to everyone’s tendencies. Successful people do them any way in order to achieve their goals.
So, if you are one of those people who usually gives in to your desire to avoid discomfort and seek momentary pleasure instead, how can you change your ways? You have to work on yourself beyond just learning the basics of plant-based nutrition. This means self-examination, reading articles and books on self-improvement, disciplining yourself to make commitments and keep them, seeking mentors, and hanging around with people who reinforce your good habits while minimizing the time you spend with people who don’t.
This is one of the reasons why The Wellness Forum schedules so many activities in addition to our basic Wellness 101 course. We know that there is more to health than just a plant-based diet (how to choose a doctor, evaluating health information, the value of diagnostic tests, etc.) and we also know that most people need reinforcement and support in order to maintain their good habits. Just as doctors and lawyers need continuing education in order to practice for life, people who want to be healthy for life need continuing education too.
If you are not currently connected to The Wellness Forum or a group like The Wellness Forum, it may be time to form such a connection. Reinforcement of what you know is always valuable, there is always more to learn, and regular communication with people who are all heading in the same direction is important.
It’s commitment time. Are you ready to be lean, healthy and fit? If you are, ignore your tendency to delete this newsletter after reading it and go on about your day, and do something proactive instead. Call us or call someone else, but begin today creating your own success story by gathering the resources needed to consistently do the things you’d rather not do.
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One strategy described in the book that has been proven to help people to do better is using what is called an "action trigger." For example, you might say to yourself, "Tomorrow I am going to go straight from the office to the gym and work out before I go home." You've tied a specific healthy behavior (working out) to a specific situational trigger (leaving the office).
The book cites the research of Peter Gollwitzer, a New York University psychologist. In one study, Gollwitzer gave college students the opportunity to earn extra credit by writing a paper about how they spent Christmas Eve and turning it in on December 25. Only 33% of the students completed the assignment and turned it in on time. But some of the students were asked to set action triggers in advance - they decided when they were going to write the report and where they were going to do it. 75% of those students completed the assignment.
The authors state that "action triggers can have a profound power to motivate people to do the things they know they need to do." The reason, according to Gollwitzer, is that action triggers eliminate the need for conscious deliberation by making people "pre-decide" what they are going to do, and that they "protect goals from tempting distractions, bad habits, or competing goals."
Here's a great way to start the year: write down all of the things you know you are supposed to be doing but are not doing. This list does not have to be limited to only diet and lifestyle-related activities (although focusing on those would make me the happiest!). See if you can tie all of them to an action trigger and create an environment in which you start to succeed at making changes instead of constantly beating yourself up for not getting certain things done. A hidden benefit of engaging in this exercise is that it will help you to be more organized since you'll be planning your schedule carefully to include everything you need to get done.
An extra step I personally recommend is to think through the situations in you are likely to eat things you are not supposed to eat (I'm assuming you have sanitized your house and office and that restaurants and events are where the temptations are greatest). Take time to visualize yourself in these settings before you get there and pre-determine how you are going to avoid eating six dinner rolls, having appetizers with cheese, or other foods you know you should avoid. See yourself, lean and strong, eating a baked potato and salad, and think about how great it is to be in control of food instead of letting food control you! Just a little time spent thinking before you attend an event can help you to avoid just reacting to what is placed in front of you. You can use this strategy to plan what you'll do while travelling and other situations in which you want to maintain your good habits.
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By now everyone is familiar with Bill Clinton's story. We know his diet was less than optimal and he had bypass surgery several years ago. He was reported as being really diligent about his diet and lifestyle habits, and followed closely the directions given to him by his expert doctors. In spite of this, the vessels used for the bypass clogged up (they do almost half the time) and he had a stent implanted. Subsequent to this, he very publicly adopted a plant-based diet, and stated in one of his interviews it was because he realized that the bypass did not work.
Clinton was influenced by The China Study and the work of Dr. Caldwell Esselstyn, who has an incredible track record in helping patients with coronary artery disease. Some of his patients were terminal when they began their relationship with him, and he was able to stop and even reverse their disease with diet. Not only was he able to accomplish this with the original group of 18 compliant patients, but he was also able to repeat this success with close to 250 additional patients during the last several years. He is currently following up and gathering data on these additional patients, and the results so far show that 88% are still compliant on the diet. Of the 119 compliant patients he has interviewed, there has been no progression of coronary artery disease in any of them. This is the information patients with coronary artery disease should be getting every day - that they can quickly and effectively resolve their health issues by just changing what they put in their mouth.
But unfortunately, Americans are getting a different message. This is what Mr. Clinton's cardiologist and other well-known "experts" have said about his condition and coronary artery disease in general:
Dr. Allan Schwartz, chief of cardiology at New York Presbyterian Hospital said in an interview with Campbell Brown on CNN:
"This was not a result of either his lifestyle or his diet which have been excellent."
"His cholesterol numbers have, and other risk factors that we follow, have all been excellent. This is part of the natural history, just as illnesses have natural history, treatments have natural histories. And this particular type of bypass graft has about a 10 to 20 percent failure rate at five to six years."
"I think this is like high blood pressure... this is a chronic condition. We don't have a cure for this condition (emphasis mine), however we have excellent treatments that involve lifestyle modification, medications, and occasionally when necessary, procedures."
Dr. Sanjay Gupta, a regular commentator on CBB chimed in with these comments on the same program:
"Well, you know, I think it's safe to say that. When someone has heart disease, they really are always going to be thinking about heart disease...The doctors are going to have to figure out how to prevent that from happening again in the future. It may mean more aggressive medications."
Dr. Clyde Yancy, President of the American Heart Association and cardiologist at Baylor Medical Center in Dallas, was quoted in a Wall Street Journal article on the topic:
Dr. Yancy said the former president's experience makes it clear that coronary-artery disease is a progressive process. "We like to think of it as an event, but it is a disease," he said. "There aren't any cures. We have to have constant surveillance."
Remember that these are well-respected "experts" who are regularly featured on television, radio, and in newspaper and magazine articles, and they have been effective (with the help of their peers, drug companies, national health organizations and others) in convincing people that once you have coronary artery disease, you'll take drugs, have surgeries, the disease will get worse, and then you will need more drugs and surgeries.
I like Dr. Esselstyn's comments better: "Coronary artery disease need not exist and if it does, it need not progress."
Dr. Esselstyn's has written an amazing article titled "Is the Present Therapy for Coronary Artery Disease the Radical Mastectomy of the Twenty-First Century?" which can be accessed through the link below. Share it with your skeptical friends; it addresses the shortcomings of the medical profession in dealing appropriately with coronary artery disease.
http://www.heartattackproof.com/Esselstyn_Caldwell_Article.pdf
References:
http://archives.cnn.com/TRANSCRIPTS/1002/11/ec.01.html
transcript from the Campbell Brown Show
http://online.wsj.com/article/SB10001424052748704337004575059882438150018.html
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For example, I recently spoke with a woman who told me that she had to take drugs for high blood pressure and high cholesterol because these conditions "run in her family" and "changing her diet didn't work." Under her doctor's direction, she had tried to eat more chicken and fish, avoid fried foods, and eat less fat, and doing these things did not result in her blood pressure or cholesterol going down. She was both skeptical and shocked when I told her that eating chicken and fish actually caused her coronary artery disease to progress. She then ordered a cheeseburger and fried onion rings, because she believed, based on her experience, that her condition could not be controlled by diet, and her doctor had told her that the medications would offer her protection, neither of which is true.
Diet does work, but you have to adopt the right diet. And research shows that the right diet is the dietary excellence program we recommend at The Wellness Forum. Making a few or even many changes to your diet, but not adopting the whole plan, will not produce results (we define results as preventing, stopping the progression of, or reversing disease).
I talk to people regularly about their attempts to eat better. Their food journals show that they have tried to do the right things - they don't eat fast food, they avoid fried foods, they have stopped drinking soft drinks, and they don't eat dessert. But they are dehydrated, they eat fish 3-4 times per week, they eat too much fat and too much processed food, and while claiming to be vegetarian, they include dairy products in their diet. Many are confused because their weight and health problems have not resolved or they've gotten worse, or new conditions have developed, all while they have been trying to use diet to improve their health. The tools they are using are not wrong, the problem is that they are not enough. Getting 75% of the diet right does not result in 75% health improvement. It takes 100% to get the job done.
Dietary change is like a combination lock. A lock that requires three numbers to open it will not open if you only use two of the numbers, even if they are two of the right numbers and they are in the right sequence. Without the third number, the lock simply will not open. Add the third number and he lock opens right away.
And so it is with diet. If you've been frustrated by attempts to change your health outcomes with diet, try adopting the whole dietary excellence program we recommend. The last few changes you make will be like the third number needed to open the lock - your weight and health will improve very quickly after you make them.
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This is HUGE.
Regardless of what you think of Clinton's politics, he has enormous reach and influence and will definitely help to further our cause, which is to educate the entire world about the power of nutrition to resolve our most expensive and debilitating health issues.
But it is important to consider how long it took for Clinton to listen. Dr. McDougall has sent him numerous letters over the years pleading with him not to have bypass surgery, angioplasty, and to change his diet instead. Dr. Esselstyn sent Clinton a copy of his book several years ago through a trusted mutual friend. Nothing happened. Clinton had bypass surgery, angioplasty, and his disease progressed. People frequently told me how disappointed they were about this and many took it as confirmation that it's hard to convince people to use diet instead of drugs and surgeries, and that we were fighting a losing battle. Part of the frustration people expressed was, I am sure, a result of difficulties in convincing some of their family members and friends to change their dietary habits too.
But President Clinton eventually did get the message. He is eating a plant-based diet. Another "win" for the plant-based crowd has been achieved, and if Clinton is compliant on the diet, reporting his results will probably have a positive influence on reforming the healthcare system. Things may not be changing as fast as we sometimes would like for them to, and it is true that sometimes the people we care most about won't respond to us. But progress is being made all the time, and we should never give up. This is a time to be more optimistic than ever, and to put more, not less, energy into spreading the word about the power of the right diet to positively influence health.
According to author Malcolm Gladwell, "The Tipping Point is that magic moment when an idea, trend or social behavior crosses a threshold, tips and spreads like wildfire."
I think we have reached the "magic moment." Let's not let it pass, but instead use the momentum our movement is experiencing to help create a healthier America now.
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On Thursday, July 8 a joint committee of the United States Department of Agriculture and Health and Human Services heard presentations from many individuals about the report from the Dietary Guidelines Committee concerning new dietary recommendations for Americans. I was one of the people who made a presentation to the committee and submitted written comments too. I am often asked if I think that this effort pays off, or if the influence of industry and agricultural groups is so strong and the process is so corrupted that it is a waste of time to try.
In my opinion, we must continue to try; remaining silent implies consent. And I do think that in small ways we have already made a difference (the report does recommend that Americans eat more plant food) and we can continue to do so if we make a commitment to speak out. Showing up is important; it notifies both the government and our opponents that we are watching and monitoring what they are doing.
Here is the written and referenced report I submitted in addition to my public comments to the committee.
The Wellness Forum
July 3, 2010
The Honorable Kathleen Sebelius
Secretary of Health and Human Services
200 Independence Avenue, SW
Washington, D.C. 20201
The Honorable Thomas J. Vilsack
Secretary of Agriculture
1500 Independence Avenue, SW
Whitten Bldg, Room 200A
Washington, D.C. 20250
Dear Secretaries Sebelius and Vilsack:
Thank you very much for the opportunity to comment on the report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010. I appreciate the time and effort that has been invested in this very important project.
There are many things in the report upon which we are in agreement. I fully support the advice to consume more fruits, vegetables, whole grains and legumes. I also agree that it is important to develop guidelines that take into consideration the fact that most Americans are overweight, that the incidence of many degenerative diseases is going up, and that the health of our children must become a priority.
It is with these objectives in mind that I offer the following suggestions:
The guidelines should stress the superiority of a plant-based diet.
Although the report recommends eating more fruits, vegetables, whole grains, and legumes, it falls short of advising Americans of the superiority of a plant-based diet. The recommendations should clearly state that a well-structured plant-based diet is superior to other diets for weight loss, and for preventing, stopping the progression of, and even reversing degenerative diseases.
Nutrient needs are easily met on a plant-based diet, and studies have confirmed that this diet can be used as a primary treatment tool, even for very sick people with conditions like coronary artery disease, diabetes, and multiple sclerosis.
Calorie counting and portion control are ineffective tools for weight management.
It is true that most Americans are eating too many calories, and that in order to lose weight, calorie consumption must be reduced. The report advises Americans to "know their energy needs in order to avoid weight gain." However, calorie counting and portion control are not effective methods for reducing calorie intake. I am well-trained health care professional and I can only guess at my own calorie needs, and they fluctuate daily.
Even if people try to measure their calorie intake, the level of accuracy needed in order to succeed is almost impossible to achieve. For example, if it takes 2000 calories per day for a person to maintain her current weight, she would consume 3,650,000 calories in a five-year period of time. Consuming 5% too many calories would result in weight gain of over 52 pounds, or obesity; consuming 5% too few calories would result in losing 52 pounds. If an individual starts at normal weight, the weight loss could be fatal.
Fortunately, humans have built-in mechanisms for figuring out exactly how much to eat without calorie or nutrient counting. These are stretch receptors in the stomach that detect when the stomach is filled with food, and nutrient receptors that detect the nutrient density of the foods consumed. The key to satiety is eating fiber-rich foods that fill the stomach from a volume standpoint, and that have enough calorie density to satisfy the nutrient receptors. Beans, rice and vegetables both fill the stomach, and with 400-500 calories, satisfy the nutrient receptors. These mechanisms do not work, however, when eating rich, calorie-dense foods. Eating chicken and cheese until satiety is achieved requires the consumption of over 3000 calories.
Consuming a well-structured plant-based diet resolves this issue because the fiber content of the diet is self limiting. A bowl of black bean soup and a salad have about 14 grams of fiber; a person cannot consume four servings of this meal.
Portion control is also ineffective. Research has shown that refined, calorie-dense and processed foods are addictive; they have the same effect on the dopamine receptors in the brain as drugs like heroin or cocaine. Asking anyone, particularly a child, to control their intake of these foods using willpower is a recipe for failure.
The report advises moderation as a tool for managing food intake. The problem with moderation is that it is too subjective and vague, and most often people practice moderation by eating and drinking numerous unhealthy foods and beverages daily in moderation; the totality of these poor choices, all consumed in moderation, comprises a significant percentage of their intake.
My company has a high success rate in helping people to convert to health-promoting diets and maintaining their new eating habits. One of the reasons is that our directions are very specific. There are good and bad foods, and our clients can eat as much of the foods on the "allowed" list as they want without calorie counting and portion control. The plan is easy to follow. I suggest that such specific and easy-to-follow directives should be recommended to the general public.
The guidelines need to discourage the consumption of junk foods.
The guidelines allow for daily consumption of junk foods, with encouragement to consume healthier versions of those junk foods. Whole grain muffins are still muffins, and should not be eaten instead of vegetables and rice. Treats should be reserved for special occasions, like birthday parties and Valentine's Day. When people simply substitute health food store versions of the junk they eat daily, their grocery bill goes up and their health problems do not resolve.
Americans are suffering from diseases of excess, not deficiency.
There seems to be a great deal of concern in the report about nutrient deficiencies in the American diet. However, people who are overweight or who have degenerative diseases are suffering from excess, not deficiency. They are eating too much fat, too much protein, and too many calories. A well-structured plant-based diet provides all of the nutrients needed for optimal daily function, while resolving issues of excess.
Americans should not be encouraged to eat more dairy foods.
The report advises Americans to consume low-fat and fat-free dairy products as a source of "nutrient-dense carbohydrate" and for building bone health.
Studies show that as the consumption of dairy products increases in various countries, the incidence of fractures increases too. Americans consume more dairy products per capita than people in most other countries, yet many studies show that this increased dairy consumption leads to increased fracture risk and calcium excretion.
The report says that when dietary calcium intake is too low, the body draws calcium from the bones. Calcium is actually released from the bones to neutralize the acidity that results from consuming too much animal protein (which includes dairy products), fat, and processed foods. This is not a result of inadequate calcium intake, but the body's response to metabolic acidosis. Researchers from Yale University looked at data from 34 studies in 16 countries, published in 29 peer-reviewed journals and concluded that consuming animal protein increased calcium excretion and fracture risk.
The consumption of cow's milk is linked to an increased risk of juvenile diabetes. In fact, studies have shown that the risk for a child consuming cow's milk of developing type 1 diabetes is higher than the risk of a smoker developing lung cancer.
Cow's milk is also linked to chronic infections, constipation, multiple sclerosis, and prostate cancer. The protein in milk is the causative link. Consuming low-fat and fat-free cow's milk is even more risky for health since the protein is then more concentrated. The science is quite clear that all cow's milk products are best avoided, but low-fat or no-fat products are worse than full-fat milk products.
Americans should not be encouraged to consume more seafood.
Americans should be encouraged to consume a plant-based diet with an allowance for very small amounts of animal foods (10% or less of calories), since animal protein has been proven to be a powerful cancer promoter. Animal foods should be optional, since there is no evidence that consuming them is necessary for health. Seafood can be included in a well-structured, plant-based diet, as long as total consumption of animal foods remains very low. But seafood is high in protein and fat, and has been misrepresented as a healthier choice when it is not. Eating more seafood is associated with an increased risk of prostate cancer in Japanese men, and the mercury content of most seafood is also a concern, not just for pregnant women but for the general population.
The report also expresses concern about EPA and DHA levels, and cites this concern as a reason for recommending seafood consumption. There are only two essential fatty acids, Omega-3 and -6. The body synthesizes other fatty acids from those essential fats. It is true that people consuming a poor diet have more difficulty with this process. But adding more high-protein and high-fat foods, such as seafood, compounds the problems of obesity and increases the risk of disease. Adopting a plant based diet resolves the issue for all but those with certain metabolic disorders by returning the body to health and proper function, including the ability to synthesize EPA and DHA.
The report encourages Americans to consult "local seafood advisories" when making decisions about eating fish. I am a well-trained nutrition professional and I am unaware of any such advisories at either of my residences, one of which is in a resort where commercial fishing is a major industry. I think this advice sets up another barrier to improving both the diet and health of Americans.
Fat recommendations are too high, and oils should be eliminated from the diet.
While everyone supports reducing the consumption of saturated fat, replacing that fat with polyunsaturated and monounsaturated fat will not improve health. Oils are not health-promoting; they are fattening. One tablespoon of any type of oil contains 130 calories and 14 grams of fat. A normal weight, physically active person can gain 36 pounds in just one year by adding an oil-based salad dressing to the diet just once per day.
3 Tablespoons of olive oil once per day = 3600 extra calories every 10 days; this results in weight gain of 3 pounds per month or 36 pounds in a year!
Research has shown that oils are cancer promoting, and that polyunsaturated and monounsaturated oils are associated with increased risk of cardiovascular disease since they contribute to the development of atherosclerotic plaques just as much as saturated fat. Using the brachial artery tourniquet test, researchers have shown that consuming oils restricts blood flow due to damage to the endothelial tissue and reduced nitric oxide production.
The Longeril study of the Mediterranean diet is often cited as supporting a diet that includes monounsaturated fat, specifically olive oil. It is true that this study showed that those consuming a Mediterranean-style diet had lower rates of cardiovascular disease than those consuming the Standard American Diet. However, by the end of the study, 25% of those eating the Mediterranean diet had experienced an adverse cardiovascular event or died. This diet may have been better than the American diet, but was far from ideal.
The promotion of the health benefits of olive oil started in the 1950's when researcher Ansel Keys discovered that men living on the island of Crete had very low rates of heart disease and cancer and seemed to have longer life spans. He conducted a 15-year study in which heart disease and cancer rates were examined in Greece (Crete and Corfu), Finland, Japan, Italy, the Netherlands, the United States, and Yugoslavia. The study showed that in Crete and Japan, the rates of heart disease were lower than in the other five countries.
It was true that residents of Crete consumed olive oil - about three tablespoons per day. But they also practiced many other healthy habits - they consumed lots of fruits, vegetables and whole grains, and their physical activity levels were very high - the equivalent of nine miles of walking per day (most residents were engaged in some form of agriculture at that time). Their health status certainly could not be attributed to the consumption of olive oil alone, and one could argue that the other healthy habits practiced by these people helped to overcome what we now know are the detrimental effects of regularly consuming oils of any type. In my opinion, the conclusion that olive oil was responsible for the health status of these people is an error of attribution; a practice that is becoming more common in interpreting studies of nutrition and health.
One relatively recent study of people living on the island of Crete determined that patients with heart disease consumed more monounsaturated fat daily than patients without heart disease. The more olive oil consumed, the more heart disease they developed.
The report expresses concern about consuming enough Omega-3 fats. This concern has developed, I believe, from the excess consumption of Omega-6 fatty acids in recent years. This has resulted from increased consumption of land animals like eggs and pork, and consumption of processed foods which often contain polyunsaturated oils. The better option is to reduce consumption of these foods, rather than to increase the consumption of more high-fat foods, such as seafood.
Americans need to eat less fat, not more. Healthier populations, such as the rural Chinese, live on a diet that is significantly lower in fat, about 14.5%of calories , while Americans are consuming considerably more.
Protein needs are quite small and easily met with a plant-based diet.
For well over a century, myths about the importance of consuming more protein have prevailed, even though protein needs have been established at about 2.5% of calories for adults. We can all agree that human breast milk is the best food for infants, and fuels very rapid growth, yet it is comprised of only 6% protein. It is impossible to structure a diet with enough calories that does not include enough protein.
Myths have also been perpetuated about the superiority of animal protein over plant proteins. While it is true that most plant foods (quinoa and soy being exceptions) do not contain all of the essential amino acids, it is also true that a well-structured plant-based diet does provides all of them. The protein content of plants compares well with the protein content of animal foods:
Black Beans 26%
Oatmeal 14.5%
Asparagus 51%
Spinach 57%
Broccoli 42%
Cheddar Cheese 25%
Hamburger 37%
Skim milk 37%
Egg 34%
The myth of needing to consume all of the essential amino acids through complementary protein combining was proven to be incorrect. Many health care professionals continue to erroneously advise people that they need to consume complementary proteins in order to practice vegetarianism safely. References to this issue should be taken out of the report.
There is no need to vary dietary recommendations for different ethnic and racial groups.
Research has shown that a plant-based diet prevents, stops the progression of, and even reverses disease in all populations. A well-structured plant-based diet will successfully address obesity in both children and the general population, hypertension in African Americans, diabetes in native Americans and Hispanics, and most other conditions currently affecting the general population and all ethnic and racial groups.
Additional barriers to change and proposed solutions.
The report lists several barriers to change, to which I add the following:
People are not being given accurate information about the consequences of their poor eating behaviors or the improvements they can expect to experience when they convert to a well-structured plant-based diet. We must give Americans accurate information so they can make informed choices.
Americans are encouraged to make changes in their diet that do not result in weight loss or improved health. Examples are substituting oils for saturated fat, lean meat for fattier meats, and eating fruit juice-sweetened cookies made from whole grains. When these changes do not result in improvement (and they generally do not), people then erroneously conclude that diet doesn't work for losing weight and improving health. This is not true; they have just not been taught how to structure a diet that affects their weight and health positively.
It is time to tell Americans the truth about the diet they need to adopt in order to lose weight and improve their health, and let them decide whether or not they want to make the necessary changes.
Concerns about follow-up research.
The committee has determined several areas in which more research is needed. However, I have concerns about study design for this research. Many of the studies cited to support the recommendations in the report show that certain foods or nutrients have short-term positive effects on biomarkers. But this is often meaningless in terms of long-term health outcomes. For example, The Atkins diet results in short-term weight loss, but is detrimental to health in the long-term.
It is very important to evaluate the long-term ramifications of dietary patterns. Several doctors, like Dr. Caldwell Esselstyn and the late Dr. Roy Swank, have conducted long-term research with their patients; Dr. Esselstyn followed his original patient group for 12 years and Dr. Swank followed his original patient group for 34 years. They proved that low-fat plant-based diets improved health in the short-term and long-term, even keeping even patients who were deemed terminal by their physicians alive for many years.
Another concern is the need to address the totality of dietary patterns rather than individual foods and nutrients. Scientists have been trying to identify "magic bullet" foods and nutrients for a very long time, but those of us who are having success in changing the health status of our patients through diet are doing so with a comprehensive approach. Most of our patients have been trying minor modifications for a long time before they arrive in our offices, with little or no success.
Still another important issue is the way in which studies are structured that compare outcomes of subjects eating a vegetarian diet vs. those who eat a more meat-based diet. It is true that many of these studies in the past have shown few differences in health outcomes. The reason is that so many vegetarians are following the very advice contemplated in these proposed guidelines - they are eating low-fat dairy products, whole grain muffins, and consuming oils instead of saturated fat. Generally their health gets worse instead of better, and their risk factors do not change. The spectacular results reported by many of us who are using plant-based nutrition as an intervention tool in our practices is based on using a well-structured plant-based diet, an important distinction.
Suggestions for implementation.
The report suggests that the USDA and HHS should convene committees to design plans for implementation. While it is important to include a cross section of stakeholders and others in this process, it is also important to include those who have a successful track record in convincing people to adopt a health-promoting diet, teaching them how to do so, and helping them to maintain such a diet. I am willing to work on this issue and share the expertise that we have acquired during the last 14 years while working with tens of thousands of people all over the world in improving their health with diet.
I hope to have an opportunity to be of further service in helping to improve the diet and health of Americans.
Respectfully submitted,
Pamela A. Popper, Ph.D., N.D.
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The Journal of the National Cancer Institute published an article online in which researchers reported that eating more servings of fruits and vegetables daily did not significantly reduce the risk of cancer.
Researchers obtained data on 478,478 men and women in ten European countries and then followed them for an average of 8.7 years. They assessed the association between cancer risk and fruit and vegetable consumption. The researchers concluded that "high intake of vegetables, and fruits and vegetables combined, was associated with a small reduction in overall cancer risk."
I'm not surprised at these results, and I actually agree with the findings of the researchers. The problem is not that the conclusions are incorrect; the problem is that the interpretation and reporting of the results are very misleading.
The term "high intake" as applied to the fruit and vegetable consumption of the study participants might lead one to believe that the participants were eating a plant-based diet. But this was not the case.
Scientific American included this comment in its online article covering the study: "The researchers concluded that if the results of the analysis can be broadly applied, upping daily fruit and vegetable consumption by about 150 grams (equivalent to about one cup of cherry tomatoes or 1.5 medium bananas), from most dietary levels, could prevent about 2.5% of cancers in most populations." This is true; an extra serving of vegetables or fruit daily is not enough to improve anyone's health outcomes.
This study's structure and conclusions are indicative of a major problem plaguing research studies that attempt to establish a relationship between diet and health. Scientists tend to structure studies that evaluate the effects of individual nutrients or foods, or small variations in less-than-optimal diets on health, instead of looking at the totality of the diet. This is a very important limiting factor.
Those of us who are recommending a well-structured plant-based diet as a means for preventing, stopping the progression of, and even reversing disease, are achieving spectacular results by teaching people to make sweeping changes in their diets, not by adding or restricting one food, or by making small changes in their eating patterns. These changes include the elimination of dairy products; reducing or eliminating the consumption of all other animal foods (the upper limit being 10% of calories); reducing fat and eliminating oils; and eating a diet comprised of high-fiber, nutrient-dense, whole plant foods. Studies have shown that such a diet is not only protective, but can actually stop the progression of and even reverse disease.,,
In this case, the researchers were attempting to isolate the protective effects of what turned out to be very small differences in the amounts of fruits and vegetables consumed on cancer incidence. Although they did factor in consumption of alcohol and smoking, they did not take into consideration other very important dietary factors. Animal protein has been proven to be a powerful cancer promoter. Dietary fat, including monounsaturated and polyunsaturated fat, is also a significant factor in cancer risk. And the consumption of dairy products has been linked to several forms of cancer, particularly prostate cancer. But these factors were not considered.
The dietary habits in this study were self-reported, and researchers acknowledge limitations in self-reported information. Without intentionally trying to mislead, subjects will often misrepresent their eating patterns. People often do not remember what they ate, and are sometimes hesitant to report consumption of desserts, large portions, second helpings, and other habits that they think are unhealthy. They will also tend to over-estimate consumption of foods like fruits, vegetables and whole grains.
The unfortunate result of studies of this type is that they confuse people, perpetuating the idea that diseases like cancer are largely unpreventable and that their diets do not really matter. This turns people into helpless victims rather than empowering them to take control of their health.
A well-structured plant-based diet is effective in reducing the risk of common degenerative diseases, and has been proven to be a powerful tool in helping sick people to regain their health. Much research has already been conducted and published proving this relationship, and medical journals and the media need to report this information to the general public.
Boffeta, P, Couto, E, Wichman J, et al. "Fruit and Vegetables Intake and Overall Cancer Risk in the European Prospective Investigation into Cancer and Nutrition." JNCI published online April 6 2010; doi:10.1093/jnci/djq072
Esselstyn, CB. Ellis SG, Mendendorp SV et al. "A strategy to arrest and reverse coronary artery disease: a 5-year longitudinal study of a single physician's practice." J Family Practice 41 (1995):560-568
Swank RL. "Effect of low saturated fat diet in early and late cases of multiple sclerosis." Mancer 336 (1990):91-103
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