Food as Medicine: Preventing and Treating the Most Common Diseases with Diet

“Food as Medicine: Preventing & Treating the Most Dreaded Diseases with Diet” Good evening For those of you unfamiliar with my work, every year I read through every issue of every English-language nutrition journal in the world so you don't have to

[Laughter, applause] Every year my talks are brand new because every year the science is brand new I then compile the most interesting, the most groundbreaking, the most practical findings to new videos and articles I upload every day, to my nonprofit site, NutritionFactsorg [Applause

] Everything on the website is free There's no ads, no corporate sponsorship It's strictly noncommercial, not selling anything I just put it up as a public service, as a labor of love New videos and articles every day on the latest in evidence-based nutrition

In my 2012 review, I explored the role diet may play in preventing, treating, and reversing our deadliest diseases In 2013, I covered our most common conditions And in 2014, I went through our leading causes of disability This year I'd like to address some of our most dreaded diseases, and cancer tops the list in the latest Gallup poll The #1 cancer killer in the United States of both men and women is lung cancer

But if you look at the rates of lung cancer around the world, they vary by a factor of ten If there was nothing we could do to prevent lung cancer, you'd assume the rates would be about the same everywhere, I mean if it just happened kind of randomly But since there's a huge variation in rates, you assume there's some contributing cause And indeed we now know that smoking is responsible for 90% of lung cancer cases So, if you don't want to die of the #1 cancer killer by just not smoking, we can take 90% of your risk and throw it out the window

Colorectal cancer is our second leading cause of cancer death, and for that there's an even bigger spread around the world So it appears colon cancer doesn't just happen, something makes it happen Well, if our lungs can get filled with carcinogens from smoke, maybe our colons are getting filled with carcinogens from food Why do African Americans get more colon cancer than native Africans? Why that population? Because colon cancer is extremely rare in native African populations, like more than 50 times lower rates than Americans, white or black We used to think it was all the fiber that they were eating, However, the modern African diet is highly processed, low in fiber, yet there's been no dramatic increase in colon cancer rates

And we're not just talking low fiber intake We're talking United States of America low fiber intake, down around half the recommended daily allowance Yet colon disease still remains rare in Africa, still 50 times less colon cancer Maybe it's because they're thinner and exercise more? No, they're not, and no they don't If anything, their physical activity levels may actually be lower than ours

So if they're sedentary like us, eating mostly refined carbs, few plant foods, little fiber — like us, why do they have 50 times less colon cancer? Well, there is one big difference The diets of both African Americans and Caucasian Americans is rich in meat, whereas the native Africans' diet is so low in meat and saturated fat they have cholesterol levels averaging 139, compared to over 200 in the US So yes, they don't eat a lot of fiber anymore, but they continue to minimize meat and animal fat intake, supporting evidence that perhaps the most powerful determinants of colon cancer risk are the levels of meat and animal fat intake So why do Americans get more colon cancer than Africans? Maybe the rarity of colon cancer in Africans is associated with their low animal product consumption But why? Did you ever see that takeoff of the industry slogan, "Beef: It's What's For Dinner" "Beef: It's What's Rotting in Your Colon

" I remember seeing that on a shirt with some friends and I was such the party pooper —no pun intended— explaining that, no, meat is completely digested in the small intestine, and never makes it down into the colon No fun hanging out with biology geeks But it turns out I was wrong! It turns out up to 12 grams a day of protein can escape digestion, and when it does, it reaches the colon, it can be turned into toxic substances like ammonia This degradation of undigested protein in the colon is called putrefaction, so a little meat can actually end up putrefying in our colon The problem is some of the by-products of this putrefication process can be toxic

The same thing happens with other animal proteins If you eat egg whites, for example, some of that can putrefy too So you say, wait a second There's protein in plants, too Ah! The difference is that animal proteins tend to contain more sulfur-containing amino acids like methionine, which is found concentrated in fish and chicken, and then eggs

Less in beef and dairy, but much less in plant foods, which can be turned into hydrogen sulfide in the colon, the rotten egg gas that, beyond it doesn't just smell bad, but it can produce changes in the colon that increase cancer risk Now there is a divergence of opinion as to whether it's the animal fat, cholesterol, or animal protein that's most responsible for the increased cancer risk, but as all three have been shown to have carcinogenic properties, but, I mean, does it really matter since a diet high in one is high in the others But the protein does more than just putrefy, though Animal protein consumption causes an increase in blood levels of a cancer-promoting growth hormone called IGF-1 But remove meat, egg whites, and dairy proteins from our diet, and our bloodstream can suppress cancer cell growth about eight times better

An effect so powerful that Dr Ornish and colleagues appeared able to reverse the progression of prostate cancer without chemo, without surgery, without radiation — just a plant-based diet and other healthy lifestyle changes The link between animal protein and IGF-1 may help explain why those eating low carb diets tend to die sooner, but not just any low carb diets— specifically those based on animal sources, whereas actually vegetable-based low carb diets were associated with a lower risk of death But meat-based low carb diets are high in animal fat as well So how do we know it wasn't the saturated fat and cholesterol that was killing people off and had nothing to do with the animal protein? What we would need is a study that, you know, follows a few thousand people and their protein intakes out for 20 years or so and just see what happens: who gets cancer, who doesn't; who lives longer? But there's never been a study like that

until now [Laughter] 6,000 men and women over age 50, across the US, were followed for 18 years and those under age 65 with high protein intakes had a 75% increase in overall mortality, a 4-fold increase in dying from cancer But not all proteins Specifically animal protein

Which makes sense given the higher IGF-1 levels in those eating excess protein Eating animal protein increases IGF-1 levels, which increases cancer risk The sponsoring university sent out a press release with a memorable opening line: "That chicken wing you're eating could be as deadly as a cigarette—” [Applause] —explaining that eating a diet rich in animal proteins during middle age makes you four times more likely to die of cancer — a mortality risk factor comparable to smoking Look, almost everyone's going to have a cancer cell or pre-cancerous cell

And at some point the question is: does it progress? And that may depend on what we eat See, most malignant tumors are covered in IGF-1 receptors, but if we have less IGF-1, the tumor may not progress And it wasn't just the more deaths from cancer Middle-aged people who eat lots of proteins from animal sources were found to be more susceptible to early death in general Crucially, the same did not apply to plant proteins like beans, and it wasn't the fat; it was the animal protein that appeared to be the culprit

So what was the response to this revelation that diets high in meat, eggs and dairy could be as harmful to health as smoking? One nutrition scientist replied that it was wrong and potentially dangerous Not the discovery animal protein might be killing people, but the way they were telling people about it It could damage the effectiveness of important public health messages A smoker might think "why bother quitting smoking if my cheese and ham sandwich is just as bad for me?" [Laughter] You know, that reminds me of a famous Phillip Morris cigarette ad that tried to downplay the risks by saying "you think second-hand smoke is bad, increasing the risk of lung cancer 19%, drinking one to two glasses of milk every day may be three times as bad— 62% increased lung cancer risk

Or doubling the risk frequently cooking with oil, or tripling your risk of heart disease eating nonvegetarian, or multiplying your risk six-fold eating lots of meat and dairy" So, they conclude, let's keep some perspective [Laughter] The risk of lung cancer, the risk of second-hand smoke may be well below the risk reported for other everyday activities So breathe deep, basically

That's like saying, "Oh, don't worry about getting stabbed because getting shot is much worse" How about neither? Two risks don't make a right [Applause] Though you'll note, when Phillip Morris bought Kraft, they stopped throwing dairy under the bus [Brief laughter

] The heme in the ham may also play a role Heme iron is the form of iron found in blood and muscle, and may promote cancer by catalyzing the formation of carcinogenic compounds Cancer has been described as a ferrotoxic disease: a disease, in part, of iron toxicity Iron is a double-edged sword Iron deficiency causes anemia, but excessive iron may increase cancer risk, by acting as a pro-oxidant, generating free radicals that may play a role in a number of dreaded diseases like stroke

But look, only the heme iron, the blood and muscle iron, not the nonheme iron that predominates in plants Same with heart disease – only the heme iron Same with diabetes – only the heme iron And same with cancer In fact, you can actually tell how much meat someone is eating by looking at their tumors

To characterize the mechanisms underlying meat-related lung cancer development, they asked lung cancer patients how much meat they were eating, and examined the gene expression patterns in their tumors, and identified a signature pattern of heme-related gene expression Though they just looked at lung cancer, they expect these meat-related gene expression changes to occur in other cancers as well The safest form of iron then is non-heme iron, found naturally in abundance in whole grains, beans, split peas, chickpeas, and lentils, dried fruits, nuts, and seeds How much money can be made on beans, though? So the food industry came up with blood-based crisp bread made out of rye and cattle and pig blood, one of the most concentrated sources of heme iron, about two thirds more than chicken blood Though if blood-based crackers don't sound appetizing, they do have cow blood cookies or blood filled biscuits

The filling does end up "a dark-colored, chocolate-flavored paste with a very pleasant taste" Dark-colored because spray-dried pigs blood can have a darkening effect on the food product's color But the worry is not the color or the taste It's the heme iron, which because of the potential cancer risk is not considered safe to add to foods for the general population This reminds me of nitrosamines, a class of potent carcinogens found in cigarette smoke

They are considered so toxic that carcinogens of this strength in any other consumer product destined for human consumption would be banned immediately And if that were the case they would have to ban meat One hot dog has as many nitrosamines and nitrosamides as five cigarettes And these carcinogens are also found in fresh, unprocessed meat as well: beef, chicken, pork But practice Meatless Mondays and you could wake up Tuesday morning with nearly all of these carcinogens washed out of your system

So, toxic nitrosamines should be banned immediately, but are still allowed for sale in cigarettes and meat because the carcinogens are found there naturally It would be illegal to add them, but hey, if they're found Right? Just like the heme iron, not safe enough to expose the general population to, but allowed for sale at the deli counter

The irony is that the iron and the protein are what the industry boasts about Those are supposed to be the redeeming qualities of meat: protein and iron, but sourced from animal foods may do more harm than good And that's not to mention all the other stuff, like the saturated fat, industrial pollutants, and hormones, that may play a role in our third leading cancer killer, breast cancer Steroid hormones are unavoidable in food of animal origin, but cow milk may be of particular concern The hormones naturally found in even organic cow's milk may have played a role in the studies that found that a relationship between milk and dairy products with human illnesses, not just like teenagers' acne; but prostate, breast, ovarian and uterine cancers; many chronic diseases plaguing the Western world; as well as male reproductive disorders

From an increased risk of early puberty all the way to endometrial cancer in older women But hormonal levels in food could be particularly dangerous in the case of vulnerable populations, such as young children and pregnant women in which even a small hormonal intake could mean a large change in metabolism Look, dairy milk evolved to put a few hundred pounds onto a calf, but the consequences of a lifetime of human exposure to the growth factors in milk have not been well studied We know milk consumption increases IGF-1, which is linked to cancer, and we're milking cows while they're pregnant, leading to particularly high levels of hormones Although dairy products are an important source of hormones, other products of animal origin must be considered as well

This could explain why women can cut their breast cancer risk more than half by not just being normal weight and limiting alcohol, but also eating mostly foods of plant origin Now to help differentiate the effects of diet from other behaviors like smoking and drinking on overall cancer incidence, Adventists were compared to Baptists Now both discourage alcohol and tobacco, but Adventists go further, encouraging a reduction of meat In general, the Adventists had less cancer than the Baptists, and within Adventist populations, the vegetarians did even better, and those eating the most plant based did the best All edible tissues of animal origin contain estrogen

This may explain why women avoiding all animal products have a twinning rate which is one fifth that of vegetarians and omnivores It appears that vegan women have five times fewer twins presumed to be because they're not exposed to all these hormones in the diet And why is that a good thing? Because twin pregnancies can unfortunately be risky pregnancies, for both mom and the babies, who may be ten times more likely to die at birth To avoid these complications, women attempting conception may want to consider avoiding milk and dairy products And this isn't even talking about the synthetic hormones that are injected, implanted and fed into farm animals

In 1979, an epidemic of breast enlargement was noted in Italian children Poultry or veal was suspected because they were using estrogens to accelerate weight gain So after this episode, Europe banned the use of anabolic growth promoters in agriculture, and banned the importation of American meat ever since, because we continue to inject animals with drugs like Zeranol, sold as Ralgro Magnum You drip Zeranol-containing blood from implanted cattle onto normal breast cells, human breast cells in a Petri dish and you transform them into breast cancer cells within 21 days But people aren’t Petri dishes

Because these anabolic growth promoters in meat production are by far the most powerful, potent hormones found in human food, we should really be testing people, especially children, before and after eating meat Until we do that we really don't know what kind of threat they pose, though the fact that Zeranol is as potent as DES should concern us DES is another synthetic estrogen marketed to pregnant women, all pregnant women, until 1971 when it was shown to cause cancer of the vagina in their daughters But it was also used in meat In the absence of effective federal regulation, the meat industry uses hundreds of animal feed additives, with little or no concern about the cancer causing and other toxic effects

Illustratively, after decades of misleading assurances about the safety of DES in the meat supply, we finally banned it some 40 years after it was already shown to cause cancer The meat industry then promptly switched to other potentially carcinogenic additives, such as this Ralgro Magnum When girls started dying of vaginal cancer, DES-treated meat was subsequently banned in Europe However, misleading assurances, including the deliberate suppression of residue data, managed to delay a US ban on DES in the meat supply for another eight years Where are we today? Virtually the entire US population consumes without any warning, labeling, or information, unknown and unpredictable amounts of hormone residues in meat products over a lifetime

If all hormonal and carcinogenic feed additives aren't banned immediately, the least we could do is label them Label the hormone residue levels in all meat products, including dairy and eggs Speaking of eggs, the next on the dreaded list of diseases is heart disease Eggs are the #1 source of choline, which can be converted by gut bacteria into a toxin that increases the risk of stroke, heart attack, and death Eggs are also the #1 source of cholesterol

Why does it matter if we have lots of cholesterol circulating throughout our bloodstream? Cholesterol doesn’t just infiltrate our arteries and help form those inflamed pockets of pus within our arterial walls, but may play an active role in the final fatal plaque rupture Cholesterol crystals may actually pop our plaque If you look at ruptured plaques from autopsies, they're filled with cholesterol crystals protruding from the plaque Cholesterol in the plaque may get so supersaturated that it reaches a point that it crystalizes like rock candy And the growing crystals may then burst the plaque open

Here's a cholesterol crystal shooting out the top of a test tube, and when you look at the tips of the crystals under a microscope, they are sharp jagged needles They placed a thin membrane over the top of the test tube to see if the cholesterol needles would poke through, and indeed, the sharp tips of the cholesterol crystals cut through the membrane So they showed that as cholesterol crystallizes the peak volume then increases rapidly and sharp-tipped crystals can cut through and tear membranes, suggesting that the crystallization of supersaturated cholesterol in atherosclerotic plaques that can induce those final ruptures And indeed, that's what you see on autopsy All patients who died of acute heart attacks had these perforating cholesterol crystals like this, sticking out of their plaques, but no crystals were found perforating the arteries of people with severe atherosclerosis that first died of other non-cardiac causes

This can explain why dramatically lowering cholesterol levels with diet, and drugs if necessary, can reduce the risk of fatal heart attack, by pulling cholesterol out of the artery wall, decreasing the risk of crystalizing these cholesterol needles that can then pop the plaques in our arteries High cholesterol can also cause what's called fatty liver disease, our next global chronic disease epidemic Fatty deposits in our liver can trigger inflammation, and result in liver cancer, failure, and death And again it may be these crystals, cholesterol crystals, triggering the progression of fatty liver into serious hepatitis We're talking dietary cholesterol, the cholesterol people eat in eggs and other animal products

A strong association between cholesterol intake and hospitalization and death from cirrhosis and liver cancer And beyond just the crystals, dietary cholesterol may oxidize and directly cause toxic and carcinogenic effects It was not appreciated until recently that the average cholesterol in the United States, the so-called "normal" levels, were actually abnormal, accelerating the blockages in our arteries and putting a large fraction of the normal population at risk Having a normal cholesterol in a society where it’s normal to drop dead of a heart attack — not necessarily a good thing Normal cholesterol levels may be fatal cholesterol levels

In cholesterol lowering, moderation kills Even if all Americans kept their total cholesterol below the recommended 200, millions would develop coronary artery disease Strong evidence shows we need to keep our total cholesterol under at least 150 to stem the epidemic What kind of evidence? Well, in many cultures, coronary disease is practically unheard of when total serum cholesterol level's under 150 Here in the US, the famous Framingham Heart Study, few under 150 developed heart disease, and none died from it

We cannot continue to have these public and private organizations on the forefront of health leadership recommending to the public a dietary plan that guarantees that millions will perish of the very disease that the guidelines are supposed to prevent The reason given by health authorities to not tell people the truth, for not advocating what the science shows is best, was that it might frustrate the public, who may have difficulty getting their cholesterol levels that low But the public's greatest frustration might come from not being informed of the optimal diet for health [Applause] Heart disease can be reversed with a plant-based diet

The evidence justifies igniting a social movement— let the people lead and eventually the government will follow Some criticize plant-based diets for being extreme You want extreme though? Check out the consequences of our present diet Having a breastbone sawed in half for bypass surgery, or having a stroke that renders one mute or having a breast, prostate, colon, or rectum removed for cancer Now that's extreme

A bean burrito? Easy [Laughter, applause] Instead of just bypassing the problem, literally, you can treat the cause, arrest and reverse heart disease, our #1 killer, with a whole-food, plant-based diet Next on the list is arthritis, such as rheumatoid arthritis, a chronic inflammatory systemic disorder causing progressive destruction of the joints As many as 80% become disabled

Can cut 18 years off one's lifespan There are drugs, but unfortunately they're often associated with severe side effects: blood loss, bone loss, immuno suppression, toxicity to the liver and eyes There's got to be a better way Well, populations that eat more meat do seem to have more rheumatoid arthritis, and there have been some dramatic case reports of rheumatoid arthritis attacks being triggered by the consumption of animal products, starting six to ten hours after ingestion of animal protein and lasting a few days, but they stopped when patients stopped consuming animal products The researchers suggest that immune complexes formed by the body attacking animal proteins may promote autoimmune reactions inside the joints themselves

And indeed, those with rheumatoid arthritis have striking elevations in antibodies to foods like fish, pork, egg whites, dairy proteins, and even some cereals It could also be because of a pro-inflammatory effect of meat fats or free radicals from the iron accumulating in the joints or other mechanisms, but look, case reports and country-by-country analyses can really only raise questions To prove cause-and-effect, you need an interventional study to put it to the test Here we go A 13-month long randomized controlled trial of plant-based diets for rheumatoid arthritis

Patients put on a vegan diet for three and a half months and then switched to an egg-free vegetarian diet for the remainder Compared to the control group that didn't change their diet, the plant-based group's significant improvement in morning stiffness within the first month, cutting the number of hours they suffered from joint stiffness in half A drop in pain A drop in disability They reported subjectively just feeling better, significant improvement in their grip strength, fewer tender joints, fewer tenderness per joint, and less swelling

They also had dramatic drops in inflammatory markers in the blood, sed rate, C-reactive protein and white count Highly significant and clinically relevant findings What about osteoarthritis? The most frequent cause of physical disability among older adults, affecting about 20 million Americans, Affecting maybe 20% of Americans in coming decades, becoming more and more widespread among younger people You know, osteoarthritis is characterized by loss of cartilage within the joint Now we used to think it was just kind of wear and tear, but is now generally accepted, it's as an active joint disease with an inflammatory component

So if the loss of cartilage is caused by inflammation, maybe if we put people on an anti-inflammatory diet, it could help, like with rheumatoid arthritis Using optimal nutrition and exercise as a "first-line" intervention could well be the best medical practice So where's the best science on what optimal nutrition might look like? The China study is a prime example, showing the serious health consequences — [Applause] the serious health consequences of high consumption of pro-inflammatory foods: meat, dairy, fat, and junk, and low consumption of anti-inflammatory plant foods: whole grains, vegetables, fruits, and beans, split peas, chickpeas, lentils The unnatural Western diet contributes to this low-grade systemic inflammation, oxidative stress, tissue damage, irritation, placing the immune system in this kind of overactive state, which can be kind of a common denominator for these conditions like arthritis

Next on the list is stroke and high blood pressure, which go together because high blood pressure is the #1 risk factor for stroke The PREDIMED study found that a Mediterranean diet with nuts could cut stroke risk nearly in half, though they were still having strokes Half as many strokes, but it was still a stroke-promoting diet and heart attack promoting as well So that's what Dr Ornish noted when he wrote in: no significant reduction in the rates of heart attack, death from cardiovascular disease, death from any cause, just that stroke benefit

But hey, I mean that's something A Mediterranean diet is certainly better than what most people are consuming But even better may be a diet surrounding whole plant foods, shown to actually reverse heart disease, not contribute to it That may be true, the authors of the study reported, but the major problem with Ornish's diet is, nah, it just doesn't taste good so hardly anyone sticks to it But it's not true

Ornish got extraordinary adherence in his studies with no difference in any of the acceptability measures, same enjoyment compared to their regular diet They even had success in barbeque country, rural North Carolina See, stricter diets may meet greater acceptance among patients than more modest diets because they may work better Greater adherence means greater disease reversal But you don't have to be facing certain death

Even those young and healthy, no health problems had no problem sticking to a plant-based diet In fact, it worked a little too well This is a crossover study where they asked people to eat plant-based for a few months and then go back to their original diet to note the contrast, but people felt so good eating healthy some of them refused to go back to their regular diet, which kind of – it actually messes up the study [Applause] So they were, you know, losing weight with no calorie counting or portion control

They had more energy, their periods got better, better digestion, better sleep And many were like, no way, we're not going back But if doctors just presume people aren't going to eat this way – a self-fulfilling prophecy Just like smoking doctors are less likely to tell their patients to stop smoking, and couch potato docs are less likely to counsel exercise or things like fruits and vegetables, we need to role-model healthy behavior This greatly enhances our credibility and effectiveness

Gone are the days of traditional authority when the fat physician, dropping cigarette ash down his gravy-stained vest, could credibly prescribe a change in behavior One reason why plant-based diets can save so many millions is because the #1 killer risk factor for death in the world is high blood pressure, laying to waste nine million people every year, and in the United States killing off more than a thousand a day 400,000 Americans dead every year High blood pressure affects nearly 78 million Americans That's one in three of us, and as we age our pressures creep higher and higher, such that by age 60 it strikes more than half

If it affects most of us when we get older, maybe it's less a disease and more just kind of a natural, inevitable consequence of aging? No We've known for nearly a century that high blood pressure need not occur Researchers measured the blood pressure of a thousand people in rural Kenya who ate a diet centered around whole plant foods Whole grains, beans, vegetables, fruit, dark green leafy vegetables Now up until age 40, the blood pressures of rural Africans – about the same as Europeans and Americans, 120s over 80s, but as Westerners age, their pressures creep up such that by the age 60 the average person is hypertensive, exceeding 140 over 90

What about those eating plant-based? Their pressures improved with age Not only did they not develop hypertension, their blood pressures actually got better Now this whole 140 over 90 thing is arbitrary Just like studies show that the lower the cholesterol the better — really no safe level above about 150 — blood pressure studies also support this kind of "lower the better" approach to blood pressure reduction Even people starting out with blood pressures under 120 over 80 appear to benefit from blood pressure reduction

So the ideal blood pressure, the no-benefit- from-reducing-it-further blood pressure is actually 110 over 70 But is it even possible to get blood pressures down to 110 over 70? It's not just possible, it's normal for those eating healthy enough diets Over two years at a rural Kenyan hospital, 1,800 patients were admitted How many cases of high blood pressure did they find? Zero Wow, so they must have had low rates of heart disease

No, they had no rates of heart disease Not low risk No risk Not a single case of arteriosclerosis, our #1 killer, was found Rural China too, about 110 over 70 their entire lives

Now look, Africa and China – vastly different diets but what they share the common theme that they're plant-based day-to-day, with meat only eaten kind of on special occasions Now why do we think it's the plant-based nature of their diet that was so protective? Because in the Western world, as the American Heart Association has pointed out, the only folks really getting down that low are the strict vegetarians, coming in at about 110 over 65 So does the American Heart Association recommend a strict vegetarian diet? No, they recommend the DASH diet The DASH diet has been described as a lacto-vegetarian diet, but it's not It emphasizes fruits and vegetables and low-fat dairy, but just a reduction in meat

Why not vegetarian? I mean, we've known for decades food of animal origin was highly significantly associated with blood pressure In fact, you can take vegetarians, pay them enough to eat meat and you can see their blood pressures go right up So when the DASH diet was created, were they just not aware of this landmark research, done by Harvard's Frank Sacks? No, they were aware The Chair of the Design Committee that came up with the DASH diet was Frank Sacks See, the DASH diet was explicitly designed with the #1 goal of capturing the blood pressure lowering benefits of a vegetarian diet, yet contain enough animal products to make it palatable to the general public

In fact, Sacks found that the more dairy vegetarians ate, the higher their blood pressures went, but you have to make the diet acceptable A recent meta-analysis found that vegetarian diets were good, but strictly plant-based diets may be better Vegetarian diets in general confer protection against cardiovascular diseases, some cancers and death, but completely plant-based diets seem to offer additional protection for obesity, hypertension, type 2 diabetes, and heart disease mortality Based on a study of 89,000 Californians, those eating meat-free diets appeared to cut their risk of high blood pressure in half, but those eating meat-free, egg-free, and dairy-free diets cut their risk 75% Now if, however, you're still — you're eating a whole food, plant-based diet, and you're still not hitting 110 over 70, there are a few plants recently found that may offer additional protection

A randomized placebo-controlled study found that a cup of hibiscus tea with each meal significantly lowers blood pressure In fact, tested head-to-head against a leading blood-pressure drug, called captopril, two cups of hibiscus tea every morning was as effective as the drug Another randomized placebo-controlled trial found that a few tablespoons a day of ground flaxseeds a day induced one of the most potent antihypertensive effects ever achieved in a dietary intervention, two to three times more powerful than instituting an endurance exercise program, though there's no reason you can't do both [Clears throat, while audience chuckles] Red wine may help, but only if the alcohol has been taken out

Sorry [Laughter] Raw vegetables or cooked? And the answer is both, though raw may actually work better Kiwifruit didn't seem to work at all, even though the study was actually published by a kiwifruit company Maybe they should have taken direction from the California Raisin Marketing Board, which came out with this study showing that raisins can reduce blood pressure, but only, apparently, compared to fudge cookies, Cheez-Its, and Chips Ahoy! [Laughter

] They know like the big pharma trick of choosing the right control group Next on the dreaded list is diabetes and vision loss, which go together since diabetes is the leading cause of preventable middle-aged blindness Even with intensive diabetes treatment, at least three insulin injections a day or these implantable insulin pumps, the best we can offer is usually just a slowing down of the progression of your disease We can slow down your blindness with modern medicine But a half century ago, Kempner at Duke proved you could reverse it with an ultra-strict plant-based diet, mostly rice and fruit

44 consecutive patients with diabetic retinopathy In 30% of the cases, their eyes improved, from like this to that That's not supposed to happen Diabetic retinopathy was considered a sign of irreversible damage What does this mean in real life? Unable to even read headlines to normal vision

How do we treat diabetic retinopathy these days? With steroids and other drugs injected straight into the eyeball And if that doesn't work, there's always pan-retinal laser photocoagulation, in which laser burns are placed over nearly the entire retina Surgeons literally burn out the back of your eyeball Now why would they do that? Well, one theory is that you kill off most of the retina, the little remaining piece you have will get more of the blood flow Now when I see this, along with Kempner's work, I can't help but feeling like history has been reversed

Like, "yeah, can you believe 50 years ago, we had that barbaric burn-out-your-socket surgery, but now, thankfully we know that through dietary interventions alone, we can sometimes reverse the blindness?" But instead of learning, medicine seems to have forgotten The most efficient way to avoid diabetic complications is to simply eliminate the diabetes in the first place This is often feasible with a healthy enough diet A plant-based diet beat out the conventional American Diabetes Association diet in a head-to-head randomized controlled clinical trial, without restricting portions, no calorie or carb counting A review of all such studies found that those following plant-based diets experienced better improvements compared with those diets that include animal products, but this is nothing new

The successful treatment of type 2 diabetes with a plant-based diet was demonstrated back in the 1930's, showing that a diet centered around vegetables, fruits, whole grains and beans — more effective in controlling diabetes than any other diet Randomized controlled trial: after 5 years, no big change in the control group, but the plant-based group, insulin needs were cut in half, and a quarter ended up off of insulin altogether Now this was a low-calorie diet though So maybe their diabetes just got better because they lost weight To tease that out, what we would need is a study where they switch people to a healthy diet, but force them to eat so much food that they’d actually maintain their weight

Then we could see if a plant-based diet had benefits independent of all the weight loss We'd have to wait another 44 years, but here it is Subjects were weighed every day, and if they started losing weight they were made to eat more food In fact, so much food some of the participants had trouble eating it all, but they eventually adapted, so no significant alterations in body weight despite restricting meat, dairy, eggs, and junk OK

So with zero weight loss, did a plant-based diets still help? Here's the before and after insulin requirements of the 20 people they put on the diet So the number of units of insulin they had to inject themselves before and after going plant-based Overall insulin requirements were cut about 60%, and half were able to get off insulin altogether, despite no change in weight Now how many years did this take? Was it five years like the other study? No, 16 days [Applause

] So we're talking diabetics who've had diabetes for as long as 20 years Injecting as much as 20 units of insulin a day, and then as few as 13 days later, they're off insulin altogether, thanks to less than two weeks of a plant-based diet Diabetes for 20 years then off all insulin in less than two weeks Here's patient 15 32 units of insulin on the control diet, and then 18 days later on none

Lower blood sugars on 32 units less insulin That's the power of plants And as a bonus, their cholesterol dropped like a rock, too, in 16 days to under 150 You know, just like moderate changes in diet usually result in only modest reductions in cholesterol, asking patients with diabetes to make moderate changes achieves equally moderate results, which is one possible reason they end up on drugs, injections, or both Everything in moderation is a truer statement than people realize

Moderate changes in diet can leave one with moderate blindness, moderate kidney failure, and moderate amputations— maybe just a few toes Moderation in all things is not necessarily a good thing The more we as physicians ask from our patients, the more we are likely to get The old adage "shoot for the moon" seems to apply It may be more effective than limiting patients to small steps that may sound more manageable, but not sufficient to actually stop the disease

The only thing better than reversing diabetes is to not get it in the first place You know that study that purported to show that diets high in meat, eggs, and dairy could be as harmful to health as smoking supposedly suggested that people under 65 who eat a lots of animal protein are four times as likely to die from cancer or diabetes But if you look at the actual study you'll see that's not true Those eating a lot of animal protein didn’t have just four times more risk of dying from diabetes, they had 73 times higher risk of dying from diabetes As one eats more and more plant-based, there appears to be a stepwise drop in the rates of diabetes down to a 78% lower prevalence among those eating strictly plant-based

Protection building incrementally as one moved from eating meat daily to less than daily, to just fish, to no meat, to no eggs and dairy either A similar pattern was found for the leading cause of vision loss among the elderly, cataracts This suggests that it's not all or nothing Any steps we can make towards eating healthier may accrue benefits But why? Why is total meat consumption associated with higher risk of diabetes, especially processed meat, particularly poultry? Well, there's a whole list of potential suspects, culprits in meat

Yes, it may be the animal protein, but maybe it's the animal fat Maybe it's the cholesterol, maybe it's the iron leading to free radical formation which can cause inflammation Advanced glycation end products are another problem They promote oxidative stress and inflammation, and food analyses show the highest levels of these so-called glycotoxins are found in meat Here are the 15 most contaminated foods found with glycotoxin contamination: Chicken, pork, pork, chicken, chicken, beef, chicken, chicken, beef, chicken, turkey, chicken, fish, beef, and

McNuggets — I don't know if you can actually call that chicken Though other foods from animal sources can also harbor these pro-oxidant chemicals Now in this study, they fed diabetics foods packed with glycotoxins: chicken, fish, eggs, and their inflammatory markers shot up, like tumor necrosis factor, C-reactive protein

Thus in diabetes, these dietary AGEs can promote inflammatory mediators, leading to tissue injury The good news is that restricting these kinds of foods may suppress the inflammatory effects These glycotoxins may be kind of the missing link between increased consumption of animal fat and meat and the subsequent development of type 2 diabetes in the first place As well as Alzheimer's disease, the final disease on our dreaded list Dietary AGE's appear to be important risk factors for Alzheimer's disease as well

If you measure the urine levels of glycotoxins flowing through the bodies of older adults, those with the highest levels went on to suffer the greatest cognitive decline over the subsequent nine years, as well as the greatest brain shrinkage – it's called cerebral atrophy, all helping to explain why those that eat the most meat may have triple the risk of getting dementia compared to long-time vegetarians The bottom line is that the same diet that may help prevent the other dreaded diseases— cancer, heart attacks, arthritis, stroke, high blood pressure, diabetes, vision loss may also help prevent brain loss and Alzheimer's as well You know, one disease that's not on the list is ALS, or Lou Gehrig's disease, which strikes healthy, middle-aged people seemingly at random, and holds little hope for treatment and survival Although mental capability stays intact, ALS paralyzes people You know, most patients die within three years when they can no longer breathe or swallow

At any given time, 30,000 Americans are fighting for their lives We each have about a 1 in 400 chance of getting this disease in our lifetime And it appears to be on the rise around the world What causes it? Well, there's a neurotoxin produced by blue-green algae in our rivers, lakes, and oceans that ends up in seafood, which is currently a strong contender as the cause of, or at least a major contributor, to ALS and maybe Alzheimer's and Parkinson's as well Researchers in Miami found this BMAA neurotoxin in the brains of Floridians that died of sporadic Alzheimer's and ALS, significant levels in 49 out of the 50 samples from Alzheimer's and ALS patients

The same thing was found up in the Pacific Northwest and in the brains of those dying from Parkinson's disease You can also apparently pick up more of this neurotoxin in the hair of live ALS patients compared to controls So is this neurotoxin present in Florida seafood? Yes, in both freshwater fish and shellfish – oysters and bass, etc, and out into the bay And not just in Florida

On up the Eastern seaboard, out in the Midwest So this could explain ALS clusters around lakes in New Hampshire, or fish in Wisconsin, or blue crabs from the Chesapeake around where I live, or seafood eaters in France, or in Finland's Lakeland district, or around the Baltic Sea, building up particularly in fish, mussels, and oysters There is a general consensus that these harmful algal blooms are increasing worldwide thanks in part to industrialized agriculture, which may increase the exposure to this neurotoxin, leading to a possible increased risk of these horrible neurodegenerative diseases With substantial and ever growing evidence that this neurotoxin does play a role in the onset and progression of neurodegenerative diseases, the most important question is "what mode of activity does BMAA exert?" No, it's not The most important question is how do we reduce our exposure? We know that the presence of this neurotoxin in aquatic food chains could be a significant human health hazard, so until more is known, it may be prudent to reduce our risk by limiting exposure to BMAA in the human diet

Now there are neurotoxins in the dairy supply, too, which may explain the link between milk consumption and Parkinson's High levels of organochlorine pesticide residues are found in milk and in the brains of Parkinson's patients, and other pollutants like tetrahydroisoquiniline, which is actually what scientists use to try to induce the disease in primates found in the milk supply, particularly cheese So maybe the dairy industry should do these toxin screenings of milk Good luck with that You could always just not drink the stuff, but then what about your bones? That's a marketing ploy

If you look at the science, milk does not appear to protect against hip fracture risk whether drinking during the adult years, or drinking during one's teen years If anything, milk consumption was associated with a borderline increase in fracture risk in men This suggests a partial explanation for the long-standing enigma that hip fracture rates are highest in populations with the greatest milk consumption This enigma irked a Swedish research team, puzzled because studies again and again had shown a tendency of a higher risk of fracture with a higher milk consumption Well, there is a rare birth defect called galactosemia, where babies are born without the enzymes needed to detoxify the galactose in milk, so they end up with high levels of galactose in their blood stream, which causes bone loss

So maybe, the researchers figured, even in normal people that can detoxify the stuff, maybe it's not so good for the bones to be consuming all that galactose all day And galactose doesn’t just hurt the bones That's what scientists use to cause premature aging in lab animals They slip them a little galactose, shorten their lifespan, oxidative stress, inflammation, and brain degeneration, just like one to two glasses of milk's worth of galactose a day Look, we're not rats, though, but given the high amount of galactose in milk, recommendations to increase milk intake for prevention of fractures could be a conceivable contradiction

So they decided to put it to the test, looking at milk intake and mortality as well as fracture risk to test the theory A 100,000 men and women followed for up to 20 years, and milk drinking women had higher rates of death, more heart disease, significantly more cancer for each daily glass of milk Three glasses a day was associated with nearly twice the risk of death And they had significantly more bone and hip fractures, too More milk, more fractures

Milk-drinking men also had higher rates of death, but for some reason you never see any of this in any of the milk ads OK, so where does this leave us? What are the common threads? If you look at four of the major dietary quality scoring systems, which have all been associated with extending lifespan, less heart disease, less cancer, they all share only four things in common What are those four things? More fruit, more vegetables, more whole grains, more nuts and beans They're all built on a common core of diets rich in plant foods Whereas opposite food patterns – Western diet – higher risks

So we need to optimize the food environment to support whole grains, vegetables, fruit, and plant-based sources of protein Taking the diet quality indexes to the logical conclusion, the most plant-based diet comes out the most healthy diet But again, it doesn't have to be all or nothing We now have evidence that simple advice to increase the consumption of plant foods, and decrease the consumption of animal foods, actually has a survival advantage And, boy, do we need it

In terms of life expectancy, the US is down around 27th of the 34 leading free-market democracies People in Slovenia live a year longer than citizens of the United States Why? Most deaths in the United States are preventable and related to nutrition According to the most rigorous analysis of risk factors to date ever published, the number one cause of death in the United States, and the number one cause of disability is our diet, bumping tobacco smoking to number two Smoking now only kills about a half million Americans a year, whereas diet now kills hundreds of thousands more

Let me end with a thought experiment Imagine yourself a smoker in the 1950's The average per capita cigarette consumption was about 4,000 cigarettes a year Think about that The average American smoked a half a pack a day

The media was telling you to smoke and famous athletes agreed Even Santa Claus cared enough about your health to want you to smoke I mean, you want to keep fit, and stay slender, so you make sure to smoke and eat hot dogs to stay trim, and eat lots of sugar to stay slim and trim — less fattening than that apple I mean, sheesh, come on [Laughter

] Though apples do connote goodness and freshness, reads one internal tobacco industry memo, which brings up many possibilities for youth-oriented cigarettes Shameless! In addition to staying fit and slender and soothing your throat, for digestion's sake, you smoke I mean no curative power is claimed for Phillip Morris, but an ounce of prevention is worth a pound of cure So better safe than sorry Better smoke

Like eating, smoking was a family affair Gee, Mommy, you sure enjoy your Marlboro You're darn tootin' Just one question, Mom Can you afford not to enjoy – smoke Marlboros? Your kids were giving you cigarettes in the 50's

Even your dog was giving you cigarettes Blow in her face, and she'll follow you anywhere After all, they're so round Oh, no woman ever says no to Winchester They're so round, so fully packed! [Laughter] After all, John Wayne smoked them— until he got lung cancer and died Even the Paleo folks were smoking, and so were the doctors Yes— No, look, this is not to say there wasn’t controversy within the medical profession

Yes, some doctors smoked Camels, but other physicians preferred Luckies, so there actually was disagreement Eminent doctors, on high and impartial medical authority, call for Phillip Morris Even the specialists could not agree which cigarette was better for your throat; so best to stick to the science, right? And more scientists smoke this brand actually This should not be rocket science, but even the rocket scientists had their own brand, for the man who thinks for himself What was the government saying? Smoke Luckies

I mean who wouldn't want to give their throat a vacation Not a single case of throat irritation How could your nose and throat be adversely affected, when cigarettes are just as pure as the water you drink? Look, and if you do get irritated, no problem Your doctor can write you a prescription for cigarettes This is from the Journal of the American Medical Association

After all "don't smoke" is advice hard for patients to swallow Reminds me of a recent survey of doctors that found the #1 reason doctors don't prescribe heart-healthy diets today was their perception that patients fear being deprived of all the junk they're eating After all, Phillip Morris reminded us, we want to keep our patients happy To make a radical change in habit would do harm You're a doctor; you don't harm your patients

The tobacco industry gave these medical journals big money to run ads like these Not a problem, though Phillip Morris claims come from completely reliable sources Based on studies by recognized authorities published in leading medical journals Even kindly offering to send free packs of cigarettes to doctors so they can test them out themselves

So see you at the next AMA convention in the smoker's lounge What did the American Medical Association have to say for itself? Well, like most other medical journals they accepted tobacco ads They have yet to see an autopsy, the official editorial board said, with a single lesion with a Marlboro label on it So when mainstream medicine is saying smoking, on balance, may be beneficial for you, when the American Medical Association is saying that, Then where could you turn back then if you just wanted the facts? What's the new data advanced by science? She was too tired for fun, and then she smoked a Camel [Laughter

] Babe Ruth spoke of proof positive medical science, that is when he still could speak, before he died of throat cancer Now some of the science did leak out, causing a dip from about 11 cigarettes a day per person down to about 10, but those that got scared could always choose the cigarette that takes the fear out of smoking, or even better, choose the cigarette that gives you the greatest health protection Now if by some miracle, there was a SmokingFactsorg website back then that could deliver the science directly, by-passing commercially corruptible institutional filters, you would have become aware of studies like this An Adventist study in California in 1958 that showed that nonsmokers may have at least 90% less lung cancer

But this wasn't the first When famed surgeon Michael DeBakey was asked why his studies published back in the 30's linking smoking and lung cancer were ignored, he had to remind people what it was like back then We were a smoking society It was in the movies Medical meetings were one big haze of smoke

It's like the debates over cigarettes and lung cancer in Congress taking place in smoke filled rooms Makes me wonder what they serve at the Dietary Guidelines Committee breakfast buffets to this day A famous statistician by the name of Ronald Fisher railed against what he called propaganda to convince the public that cigarette smoking was dangerous He made invaluable contributions to the field, but his analysis of lung cancer and smoking was flawed by an unwillingness to examine the entire body of data available Now his smoke screen may have been because he was a paid consultant to the tobacco industry, all right, but also because he, himself, was a smoker

Part of his resistance to the association may have been because of his own fondness for smoking, which makes me wonder about the some of the favorite foods that nutrition researchers may have of this day It always strikes me as ironic that when vegetarian researchers come out forward and list their diet as a potential conflict of interest, whereas not once in the 70,000 articles on meat in the medical literature have I ever seen a researcher disclose their nonvegetarian habits, because it's normal Just like smoking was normal So back to our thought experiment If you're a smoker in the 50's in the know, what do you do? With access to the science you realize that the best available balance of evidence suggests that your smoking habit is not good for you

So, do you change your smoking habits or do you wait? If you wait until your physician tells you – between puffs – to quit, you may have cancer by then If you wait until the powers that be officially recognize it, like the Surgeon General did in the subsequent decade, you could be dead by then It took 25 years for the Surgeon General's report to come out It took more than 7,000 studies and the death of countless smokers before the first Surgeon General report against smoking was finally released in the 1960's You'd think maybe after the first maybe 6,000 studies they would have maybe given people a little heads up or something? A powerful industry

One wonders how many people are currently suffering needlessly from dietary diseases? Maybe we should have stopped smoking after the 700th study like this With so much money and personal habit at stake, there always going to be dissenters But given the seriousness of the diseases and the sum total of evidence we shouldn't wait to put preventive measures in place As a smoker in the 50's, on one hand you had all of society, the government, the medical profession itself telling you to smoke And on the other hand, the science — if you were lucky to know about studies like this

Now fast forward 55 years There's a new Adventist study out of California warning America about the risks of something else they may be putting into their mouth And it's not just that one study According to the latest review, the total sum of evidence suggests that mortality from all causes put together, many of our dreaded diseases: ischemic heart disease, cerebrovascular diseases like stroke significantly lower in those eating meat-free diets, in addition to less cancer and diabetes

So, instead of someone going along with America's smoking habits in the 50's, imagine you or someone you know going along with America's eating habits today What do you do? With access to the science you realize that best available balance of evidence suggests that your eating habits are probably not good for you If you wait until your physician, between bites, tells you to change your diet, it could be too late In fact, even after the Surgeon’s General report the medical community still dragged their feet The AMA actually went on record withholding support from the Surgeon General's report

They didn't endorse it Could it have been because they had just received $10 million from the tobacco industry? Hmm OK, so look

We know why the AMA may have been sucking up to the tobacco industry, but why weren't individual doctors speaking out? Well, there were a few gallant souls ahead of their time, just as there are today, standing up against industries killing millions, but why not more? Maybe it’s because the majority of physicians themselves smoked cigarettes, just like the majority of physicians today eat foods that contribute to our epidemic of dietary disease What was the AMA’s rallying cry back then? Everything in moderation Sound familiar? Extensive scientific studies prove smoking in moderation: OK Today, the food industry uses the same tobacco industry tactics: supplying misinformation, twisting the science The same scientists-for-hire paid to downplay the risks of second hand smoke and chemicals are the same hired by the National Confectioners Association to downplay the risks of candy, and the same hired by the meat industry to downplay the risks of meat

Consumption of animal products and processed foods cause at least 14 million deaths around the world every year 14 million deaths 14 million people dead every year This is not a failure of individual will power, says the Director-General of the World Health Organization This is a failure of political will to take on big business, which is a formidable opposition

Few governments are willing to prioritize health over big business As we learned from the experience with the tobacco industry, a powerful corporation can sell the public just about anything If there's one thing we've learned from the tobacco experience, wrote one district judge, it’s how powerful profits can be a motivator, even at the cost of millions of lives and unspeakable suffering It may have taken 25 years for the Surgeon General's report to come out, Still longer for mainstream medicine to get on board, but now there are no longer ads encouraging people to inhale to their heart's content Now there are ads from the CDC fighting back

Food-wise, there was meat for health defense, or nourishing bacon, or doctor's prescribe meat, or soda for that matter "Thank heavens Trix are habit forming!" Now, just like there were those in the 30’s, 40’s, and 50’s on the vanguard trying to saves lives, today there are those turning ads about what you can do with pork butt to what the pork can do to your butt The Physician’s Committee for Responsible Medicine’s “Meat is the new tobacco” campaign As Dr Barnard tried to get across in an editorial published in the American Medical Association's Journal of Ethics, plant-based diets can now be considered the nutritional equivalent of quitting smoking

How many more people have to die, though— [Applause] How many more people have to die before the CDC encourages people not to wait until open-heart surgery to start eating healthy as well How long’s that going to take though? Just like we don't have to wait until our doctors quit smoking to quit ourselves, we don't have to wait until our doctor takes a nutrition class or cleans up their own diet before changing our own eating habits Look, it's not your doctor's fault, writes a group of prominent physicians There is a severe deficiency of nutrition education at all levels of medical training

We just never taught it We know a whole food plant-based diet has been proven to reverse our #1 killer, protect against type 2 diabetes and cancer So how has this knowledge affected medical education? It hasn't Despite the neglect of nutrition in medical education, the public considers physicians to be trusted sources, but if doctors don't know what they're talking about they could actually be contributing to diet-related diseases To stem the surging tide of chronic illness, physicians need to become part of the solution

But we don't have to wait for that to happen No longer do patients have to be so patient Doctors no longer hold a professional monopoly on health information There's been a democratization of knowledge, and so until the system changes, we have to take responsibility for our own health and for our family's health We can't wait for society to catch up to the science, because it's a matter of life and death

In 2015, Dr Kim Williams became President of the American College of Cardiology He was asked why he follows his own advice to eat a plant-based diet? He said, [applause] — "I don't mind dying," Dr Williams replied "I just don't want it to be my fault

" Thank you [Extended applause] If you missed last year's talk, I have it on DVD And the year before that and the year before that — you should have come to Summerfest — as well as 25 other DVDs All proceeds from the sale of my books, DVDs, and speaking engagements all goes to charity

Speaking of which, mark your calendars December 8th of this year, new book is coming out: How Not to Die [Applause] December 8th Very excited about it

Not only a compilation of my work, but all the science and thousands of citations, but also a practical guide I go through my kind of daily dozen checklist of all the things I try to include in my own diet: how many greens to eat, how many beans we should eat, how much exercise, how much sleep I've been working on it for over a year Can't wait for everyone read it And in the meanwhile, all my work is available free at NutritionFacts

org Thanks again [Woman comes to the podium to speak] We are so fortunate to have Dr Greger with us I don't think there's anyone else on the planet that could do what you do

Thank you so much And we are honored for you to debut this with us every year Thank you so much [Applause] See everyone over at the LLC

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