B2 中高級 美國腔 1246 分類 收藏
開始影片後,點擊或框選字幕可以立即查詢單字
字庫載入中…
回報字幕錯誤
“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, NutritionFacts.org.
[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.