Transcript: From Table to Able: Combating Disabling Diseases with Food
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. Every year my talks are brand-new because every year the science is brand-new. I then compile all the most interesting, the most groundbreaking, the most practical findings to create new videos and articles every day, for my nonprofit site, NutritionFacts.org. Everything on the website is free. There's no ads, no corporate sponsorship, It's strictly noncommercial; I'm not selling anything. I just put it up as a public service. It exists because thousands of people donate to support the 501c3 nonprofit charity that keeps it alive. And thanks to your support, in less than 3 years NutritionFacts.org has ramped up to a total of... 25 million pageviews, now with more than a million new hits a month. People are hungry, for evidence-based nutrition. In my 2012 year-in-review, I explored the role a healthy diet may play in preventing, arresting, and reversing our deadliest diseases. In 2013 I covered our most common conditions. This year I thought I'd address some of our leading causes of, disability. We want to live a long life, not a long miserable one. Heart disease, is not only our leading cause of death, but also our leading cause of death, and disability. Dr. Dean Ornish, showed that on his plant-based diet and lifestyle program, cardiac patients, had a 91% reduction in angina attacks (that's the crushing chest pain people with advanced heart disease can get). In contrast, control group patients who were instead told to listen to the advice of their doctors, had a 186% increase, in attacks. This marked reduction in chest pain was sustained 5 years later, a long-term reduction in angina comparable to that of bypass surgery, but without the knife, or the saw, used to cut our chest in half. Forks over knives; soup over saws But this was back in the 90s when Ornish was only studying a few dozen patients at a time. How about a thousand patients on a whole foods plant-based diet. Within 3 months, nearly three quarters of angina patients became angina free. 74% cured without a single scalpel or side-effect. Now Ornish didn't just put people on a plant-based diet. He also advised moderate exercise like walking. So how do we know what role the diet played? Well if you go back to Ornish's first publication, he put cardiac patients on a quasi-vegan diet, with no added exercise-just diet and stress management-and got a 91% reduction in angina attacks in less than a month. And Dr. Esselstyn was able to improve angina using a plant-based diet as the only lifestyle intervention, so we know the diet is the active ingredient. But they weren't the first. There are published case series going back to the 1970s. We've known about this for decades. Angina and the Vegan Diet. like Mr. F.W. here. Chest pain so severe he had to stop every 9 or 10 steps. Started on a vegan diet-and not even a low fat vegan diet-and months later, climbed mountains, no pain.This may be, because vegetarian arteries, dilate four times better, than the arteries of omnivores. Put people on a plant-based diet for a year and their clogged arteries can literally get cleaned out... 20% less atherosclerotic plaque in their arteries at the end of the year than at the beginning. Put people on a low carb diet, though, and their condition worsens. 40 to 50% more artery clogging at the end of the year. Here are some representative heart scans. The yellow and particularly red represent blood flow through the coronary arteries to the heart muscle. This patient went on a plant-based diet and their arteries opened right up increasing the blood flow. This person, however, started out with good flow, but after a year on a low carb diet, their blood flow significantly clogged down.This is not just measuring risk factors, but actual blood flow to people's hearts on plant-based versus low carb diets. No wonder a recent meta-analysis found that low-carb diets were associated with a significantly higher risk of death-all-cause mortality in the long run, meaning those on low carb diets live, on average, significantly shorter lives. There is a new category of anti-angina drugs, but before committing billions of dollars of public and private monies to dishing them out, maybe we should take a more serious look at dietary strategies. To date, these strategies have been marginalized by the ‘drug pusher' mentality of orthodox medical practice; presumably, doctors feel that most patients will be unwilling or unable to make the substantial dietary changes required. While this may be true for many patients, it certainly is not true for all. And, in any case, angina patients deserve to be offered the plant-based diet alternative before being shunted to expensive surgery or to drug therapies that can have a range of side effects and never really get to the root of the problem. In response to this paper, a drug company executive wrote a letter to the medical journal: Although diet and lifestyle modifications should be a part of disease management, he said, many patients may not be able to comply with the substantial dietary changes required to achieve a vegan diet (so of course everyone should go on their fancy new drug), called ranolazine. Costs over $2000 a year to take it but the side effects aren't, horrible, and the drug works. Collectively, the studies show that at the highest dose, ranolazine, sold as Ranexa, may prolong exercise duration as long as 33 and half seconds. It does not look like those choosing the drug route, will be climbing mountains anytime soon. Plant-based diets aren't just safer and cheaper; they worked, better. I've talked about COPD as a leading killer, what about, low back pain, like sciatica.Low back pain, became one of the biggest problems for public health systems, in the western world, during the second half, of the 20th century. Chronic low back pain now affects about 1 in 5, disabling over 30 million Americans-it's an epidemic. Are people just lifting more heavy stuff? no. Mechanical factors, such as lifting and carrying, probably do not have a major role in this disease. Well then what causes it? I've touched on it before, Atherosclerosis can obstruct the arteries that feed the spine and it's this diminished blood flow that can cause back problems. This can be seen on angiography, showing normal spinal arteries on the left and clogged on the right, or on autopsy, where you can see how the openings to the spinal arteries can get squeezed shut by these cholesterol filled plaques on the right. Autopsy, because back pain may predict fatal heart disease, just like clogs in the penile arteries-erectile dysfunction, can precede heart attacks, because it's the same disease-inflamed clogged crippled arteries throughout our body. Now we have MRI imaging, that can show the occlusion of spinal arteries in people with back pain, and the degeneration of the disks-all linked to high cholesterol. Those with narrowed arteries appear about 8 and a half times more likely to suffer from chronic low back pain. This makes sense. The disks in our lower back are the largest avascular tissue in the body, meaning our disks don't have any blood vessels. Thus, their nutrition just kinds of diffuses in from the margins, making them especially vulnerable to deprivation. Using MRIs you can measure the effects of impaired blood flow on that diffusion, and see how this can turn into that. By age 49, 97%, of the disks of those eating the standard American diet show at least grade 2 degradation. Starting, in our teens, our disks are already starting to degenerate... starting, around age 11... As I've talked about, nearly all kids have the beginnings of atherosclerosis by age 10 in this country.And sadly, low back pain is now common in children and adolescents, And it's getting worse. Just like kids now getting adult-onset diabetes, teenagers starting their lives out with a chronic disease. That's why it's never too early to start eating healthier to clean out the arteries in our heart, our spine, and throughout our bodies. To get you back into circulation, you need to get circulation, to your back. Skipping down a few in the interest of time, having a stroke can be severely disabling. Thankfully, high dietary fiber intake, which is to say whole plant foods, may help prevent strokes as well. The belief that dietary fiber intake is protectively associated to some chronic disease was postulated 40 years ago and then enormously fuelled and kept alive by a great body of science since. Today it is therefore generally believed that eating lots of fiber, meaning eating a lot of unprocessed plant foods, helps prevent obesity, diabetes and cardiovascular diseases such as stroke. Strokes are the second most common cause of death worldwide. and a leading cause of disability and so preventing strokes in the first place-what's called primary prevention should, therefore, be a key public health priority. Based on all the best studies to date, different strokes for different folks, depending, evidently, on how much fiber they eat. Notably, increasing fiber just 7 grams a day was associated with a 7% reduction in stroke risk. And 7 grams is easy, like a small serving of whole grain pasta with tomato sauce, and an apple. But if you really don't want a stroke, we should try to get 25 grams a day of soluble fiber , which is found in beans, oats, nuts, and berries, and 47 grams a day of insoluble fiber, found primarily in whole grains. One would have to eat an extraordinarily healthy diet to get a total of 72 grams of fiber a day-huge amounts of plants. Yet these cut-off values could be considered as the minimum recommended daily intake of fiber, to prevent stroke. They admit these minimums are higher than those commonly and arbitrarily proposed as “adequate,” but do we want to be patronized to, as to what authorities think is practical, or do we want them to just tell us what the science says, like they did here? Someone funded by Kellogg's wrote in to complain that in practice such fiber intakes are unachievable, Rather, the message should just be the more, the better, yaknow, just have a bowl of cereal or something, wink-wink. The real Dr. Kellogg, who was actually one of our most famous physicians, credited for being one of the first to sound the alarm about smoking, may have been the first American physician, to have recognized the field of nutrition as a science, would today be rolling in his grave, if he knew what his company had become. Diabetes-our 7th leading cause of, loss-of-life, is also our 8th leading cause, of loss-of-health. Up to 50% of diabetics eventually develop neuropathy, damage to their nerves. It can be very painful, and the pain is frequently resistant to conventional treatments. In fact there is supposedly no effective treatment for diabetic neuropathy. Us doctors are just left with steroids, opiates, and antidepressants, to try to mediate, the suffering.But... 20 years ago, a remarkable study was published on the regression, the reversal of diabetic neuropathy with a plant-based diet. Twenty-one diabetics suffering with moderate or worse painful neuropathy for up to 10 years were placed on a whole food, plant-based diet. Years and years of suffering and then, complete relief of the pain in 17 out of the 21 patients, within days.... Numbness noticeably improved too. And the side-effects were all good. They lost 10 pounds, blood sugars got better-insulin needs dropped in half, and in five of the patients not, only was their painful neuropathy cured, so was, apparently, their diabetes. Normal blood sugars off of all medications. Diabetics for up to 20 years and then off all drugs in a matter of weeks. And their triglycerides and cholesterol improved too. High blood pressures got better. In fact gone in about half the hypertensives-an 80% drop overall in the need for high blood pressure medications within 3 weeks. But we've known that plant-based diets can reverse diabetes and hypertension, but this was new. Years of painful suffering, and then complete relief of the pain in 80%, within days.Now this was a live-in program, where patients meals were provided. What happened after they were sent home and went back to the real world? The 17 folks were followed for years, and in all except one, the relief from the painful neuropathy continued, or improved even further. How'd they get that kind of compliance with a strict plant-based diet? Because, it works... One of the most painful and frustrating-conditions-to-treat in all of medicine, and three quarters cured in a couple days with a natural, nontoxic-in fact beneficial-treatment, a diet composed of whole plant foods. Should have been front-page headline news... How could nerve damage be reversed so suddenly? It didn't appear to be the improvement in blood sugar control, since it took about 10 days for the diet to control the diabetes, whereas the pain was gone in as few as four. There are several mechanisms by which the total vegetarian diet works to alleviate the problem of diabetic neuropathy as well as the diabetic condition itself. Their most interesting speculation was that it could be the trans fats naturally found in meat and dairy that could be causing an inflammatory response. They found a significant percentage of the fat under the skin of those who eat meat or even just dairy and eggs was trans fats. Trans fats inside their bodies, under their skin, whereas those who had been on a strictly whole food plant-based diet had no detectable trans fat in their tissues. The researchers stuck needles in the buttocks of people eating different diets, and nine months or more on a strict plant-based diet appeared to remove all the trans fat from their bodies, or at least their butts. But their pain didn't take 9 months to get better; it got better in more like 9 days. More likely, the amazing reversal was due to an improvement in blood flow. Nerve biopsies in diabetics with severe progressive neuropathy have shown arterial disease within the nerve. There are blood vessels within our nerves that can get clogged up too, depriving the nerves of oxygen, presumably leading them to cry out in pain. Within days, though, improvements in blood “rheology,” meaning the ease at which blood flows on a plant-based diet may play a prominent role in the reversal of diabetic neuropathy... Plant-based diets may also lower the level of IGF-1 inside the eyeballs of diabetics and decrease the risk of retinopathy-diabetic vision loss-as well. But what about treating retinopathy?Kempner at Duke used a plant-based diet of mostly rice and fruit, to document for the first time the reversal of diabetic retinopathy in a quarter of his patients, something never even thought possible. For example, 60 year old diabetic woman already blind in one eye and can only see contours of large objects with the other, effectively blind. Five years later on the diet, instead of it getting worst, she got better. She could then make out faces, see signs, large newspaper print. (in addition to being off insulin, with normal blood sugars and 100 point drop in her cholesterol). The most efficient way to avoid diabetic complications is to eliminate, the diabetes in the first place, and this is often feasible for those type 2 patients who make an abiding commitment to daily exercise and a healthy enough diet. Type 2 diabetes can be eliminated, reversed-cured with diet, and so, evidently, can some of its complications Since the initial report of neuropathy reversal, the results have been replicated by other researchers. Why didn't we learn about this in medical school? The neglect, of this important work by the broader medical community is little short of unconscionable...... Alzheimer's disease perhaps best captures the difference between lifespan and healthspan. Who cares if you live to be 100 if, in the last years of your life, you don't recognize yourself in the mirror. In 1901, Auguste was taken to an insane asylum by her husband. She was described as a delusional, forgetful, disoriented woman who, tragically, could not carry out her homemaking duties. She was seen by a Dr., Alzheimer, and was to become the case that made his a household name. On autopsy, he described the plaques and tangles in her brain that would go on to characterize the condition, But lost in the excitement of discovering a new disease, a clue may have been overlooked. He described atherosclerotic changes-hardening of the arteries-within her brain.We typically think of artery clogging in the heart, but as we saw with the spine and the nerves, atherosclerosis involves virtually the entire human organism. Our whole vascular tree. Including our brain. One of the most poignant examples of the systemic nature of clogged arteries is the link between coronary artery disease, degenerative brain disease, and dementia Just as a heart attack or brain attack-stroke-can be significantly prevented, one can think of Alzheimer's dementia as a ‘‘mind attack." Mind attack, like heart attacks or strokes, needs to be prevented by controlling vascular risk factors like high blood pressure and cholesterol, controlling chronic brain hypoperfusion, the lack of adequate blood flow to the brain over the years before the onset of Alzheimer's disease. We now we have a substantial body of evidence that strongly associates atherosclerotic vascular disease with Alzheimer's. Autopsy studies, for example, have shown that individuals with Alzheimer's have significantly more atherosclerotic narrowing of the arteries within their brain This is what our cerebral arteries should look like: open, clean, allowing blood to flow. This is what atherosclerosis in our brain arteries looks like. Clogged with fat and cholesterol, closing off the artery, restricting blood flow to our brain... Which kind of arteries, do you want, in your brain?... This reduction of blood flow can starve the brain of oxygen, cause silent little mini-strokes, brain atrophy--shrinkage, the cumulative effects of which appear to play a pivotal role in accelerating and augmenting the development and evolution of Alzheimer's. But what about the role of metals in Alzheimer's? The metals appear to just aggravate the detrimental effects of a high intake of cholesterol and saturated fat.What about the so-called Alzheimer's gene, ApoE4? Diet trumps genes. The highest frequency of the Alzheimer's gene in the world is in Nigeria, but they also have some of the lowest Alzheimer's rates. To understand why, one has to understand the role of ApoE. What does the gene do?The Alzheimer's gene makes the principal cholesterol carrier in the brain, but if your cholesterol is low enough, because your diet is low enough in animal fat. If you center your diet around grains and vegetables... then changes in cholesterol may lead to changes in Alzheimer's gene expression. Just because we may have been dealt some bad genetic cards, doesn't mean we can't reshuffle the deck, with diet. According to the latest guidelines for the prevention of Alzheimer's... the two most important things we can do, is cut down our consumption of meat, dairy, and junk and replace them with: vegetables, beans, fruits and whole grains. Wait, grains protective of the brain? I had the distinction this year of serving on a panel with Grain Brain author Dr. Perlmutter, who sold lots of books claiming carbs are destroying our brain, but what does the science show? Take Japan, for example, where the prevalence of dementia has shot up over the last few decades. Mechanisms to explain increases in Alzheimers include increases in animal products. Traditional diets generally are weighted toward vegetable products such as grains and away from animal products, but since 1960, the diet in Japan has changed from a more traditional rice-based diet to one with a preponderance of meat. So less grain, more Alzheimer's The dietary factor most strongly associated with the rise in Alzheimer's disease in Japan was the increased consumption of animal fat. So it may be less grain-brain and more meathead. A similar analysis in China arrived at the same conclusion. On the basis of these findings, the rate of Alzheimer's disease and dementia will continue to rise unless dietary patterns change to those with less reliance on animal products. This is consistent with data showing those who eat vegetarian appear 2 to 3 times less likely to become demented, And the longer one eats meat-free, the lower the associated risk of dementia.In fact, where are the lowest rates of Alzheimer's in the world? Rural India. It may be no coincidence that the country with the lowest rates of Alzheimers, has among the lowest rates of meat consumption, with 40% of Indians eating meat-free and egg-free diets, that are high grain, high bean, high carb diets. Population studies have found grains to be strongly protective, in relation to Alzheimer's disease. The science shows the exact opposite of what one may read in the popular press. In other words, don't pass on the grain pass the grain, to spare the brain. The link between arterial blockage and Alzheimer's is good news because atherosclerosis can be prevented and reversed, suggesting that strategies proven to delay the progression of atherosclerosis may be useful for preventing or treating Alzheimer's as well.So let's put it to the test. If you follow people just starting to lose their faculties, the cognition of those with the least artery-clogging in their heads remains pretty stable over the years. But those with more cholesterol buildup got worse, and those with the most blockage, rapidly declined. And the same with the ability to carry out one's activities of daily living, like dressing yourself. And arterial disease doubled the progression to Alzheimer's... In summary, an inefficient blood supply to the brain has very grave consequences on brain function. But does treatment of vascular risk factors like high blood pressure and high cholesterol make a difference? We didn't know, until now. 300 patients with Alzheimers, and those with their vascular risk factors treated showed significantly less decline, slowed progression of their disease. It is said that “The goal of medicine is to provide patients with hope, and when there is no hope to offer understanding.” Well for the first time in the history of this disorder, we have the chance to provide Alzheimer patients with hope.Let me close with, cancer, a leading cause of death and disability. How many years of life, are lost to potentially preventable cancers? Every year more than 5 million expected years of life, are lost in the United States, to those three disabling cancers alone, lung cancer, colorectal cancer, and breast cancer. Therefore, identifying and improving strategies for prevention of cancer remains a priority, especially since not more than 2% of all human cancer is attributable to purely genetic factors. 2% may be in our genes, but the rest involve external factors, particularly our diet. Our skin is about 20 square feet. Our lungs, flattened out, about a thousand square feet, but our intestines? Three thousand square feet of surface area counting all the little folds. What we eat, is our primary interface with out invironment. The most comprehensive summary of evidence, on diet and cancer ever compiled, recommends we eat mostly foods of plant origin to help prevent cancer. This means centering our diet around whole plant foods, Not just whole grains and beans every day, but every meal... And when it came to foods that may increase cancer risk they were similarly straightforward. Unlike some other dietary guidelines that wimp out and just advise people to “moderate” their intake of bad foods, like: eat less candy. The cancer guidelines didn't mince words when it came to the worst of the worst. For example, don't just minimize soda intake, avoid it. Don't just cut back on bacon, ham, hot dogs, sausage and lunch meat, avoid processed meats, period, because data do not show any level of intake that can confidently be shown not to be associated with risk. Even small amounts are risky. Processed meat... cannot only be thought of as a powerful multi-organ carcinogen, but may increase the risk of heart disease and diabetes. Red meat was bad, but processed meat was worst, and that included white meat, like chicken, and turkey slices. So with more heart disease, cancer, and diabetes it's no surprise processed meat consumption has been associated with increased risk of death, even at small amounts. In Europe, they calculated that reduction of processed meat consumption to less than half-a-hot-dog-a-day's worth would prevent more than 3% of all deaths. This is the kind of stuff we feed our kids. This was the second largest prospective study ever done on diet and cancer, a study of more than 400,000 people. The largest ever-600,000, was done here in the US, the AARP study. They found the preventable fraction to be much higher, suggesting, for example, that 20% of heart disease deaths among women could be averted if the highest consumers cut down to like less than a quarter-strip-of-bacon's-worth a day-that's how bad the stuff is. That is a lot of death. So what does the industry think about that? In the journal Meat Science, the industry acknowledged that the cancer prevention guidelines now urge people to avoid processed meat, a statement that represents “a clear and present danger”... for the meat industry. Processed meat, they say, is a social necessity. How could anyone live without bologna? The challenge for the meat industry is to find a way to maintain the consumption of these products while somehow not damaging public health. They've considered removing the nitrites for decades because of the long known toxic effects (The industry adds them to keep the meat pink). There are, evidently, other coloring additives available. Nevertheless, it's going to be hard to get the industry to change-you have to balance all the cancer with the positive effects of these substances as preservatives, and desirable flavour and red colour developing ingredients. No one wants, green eggs and ham. It's like salt reduction in meat products. They'd like to, but one of the biggest barriers to salt replacement within the meat industry is cost, as salt is one of the cheapest food ingredients available. Now there a number of taste enhancers they can inject into the meat that can help compensate for the salt reduction, but some of the compounds leave a bitter after-taste so, they can also inject a patented bitter-blocking chemical that can prevent taste nerve stimulation at the same time, the first of what may become a stream of products that are produced due to the convergence of food technology and biotech.Or they could always try adding nonmeat materials, to the meat. You could add fiber, or starch from beans that have protective effects against cancer. After all, in the United States dietary fiber is under-consumed by most adults, indicating that fiber fortification in meat products could have health benefits.... Failing to note, of course, that their products are one of the reasons the American diet is so deficient in fiber in the first place. The industry is all in favor of causing less cancer but, obviously any such optimization has to achieve a healthier product without affecting the hedonic aspects. It is important to realize that nutritional and technological quality in the meat industry are inversely related. An improvement in one will lead to deterioration of the other. So you have to balance it out. They know that consumption of lard is not the best thing in the world, heart disease being our #1 killer, however those downsides are in sharp contrast to lard's technological qualities which makes saturated fats indispensable in the manufacture of meat products. Otherwise you just don't get, the same lard consistency. The pig's fat doesn't get hard enough, and as a result a fatty smear upon cutting or slicing can be observed on the cutting surface of the knife-so you have to have your priorities straight. Although the evidence for the relationship between colorectal cancer risk (at least!) and processed meats intake cannot be denied, the meat industry suggests further research. For example, compare the risk of consuming meat to other risky practices-alcohol, inactivity, obesity, and smoking. Compared to lung cancer and smoking, maybe meat wouldn't look so bad. But don't worry, consumers probably won't even ever hear about the latest cancer prevention guidelines. Consumers today are overloaded with information. Thus the industry can hope that the dissemination of the update on meat and cancer drowns in this information cloud. And even if consumers do see it, the industry doesn't think they'll much care. For many consumers in the Western world, the role of healthfulness, although important, is not close to taste satisfaction in shaping their final choice of meat products. It is hence questionable that the revised recommendations based on the carcinogenic effects of meat consumption will yield substantial changes in consumer behavior. Doctors and nutrition professionals feed into this patronizing attitude that people don't care enough about their health to change. This paper, from a leading nutrition journal, scoffed at the idea that people would ever switch to a “prudent diet,” reducing their intakes of animal protein and fat no matter how much cancer was prevented. The chances of reducing consumption to avoid colon cancer? Virtually nil. Consider heart disease. We know that we can prevent and treat heart disease with the same kind of diet, but the public just won't do it. “The diet,” they say, “would lose too much of its palatability.” In other words, the great palatability of ham largely outweighs other considerations, although health and wellbeing are increasingly important factors in consumer decisions. This 1998 industry article feared that unless meat eating becomes compatible with eating that is healthy and wholesome it could be consigned to a minor role in the diet during the next decade. Their prediction didn't quite pan out. Here's meat consumption per person over about the last 30 years. Rising, rising. 1998 was when the Meat science article was published, worrying about the next decade of meat consumption, which rose even further, but then did seem to kind of flatten out, before it fell off a cliff. Per capita meat consumption down about 10% in recent years. Millions of Americans are cutting down on meat. So don't tell me people aren't willing to change their diets. Yet we continue to get diluted dietary guidelines, because authorities are asking themselves: what dietary changes could be acceptable to the public, rather than just telling us what the science says and letting us make up our own minds as to whether... pig fat smearing on knives should trump our families' health. What we eat doesn't just affect cancer risk in the colon. Why do constipated women appear to be at higher risk for breast cancer, whereas women who have 3 or more bowel movements a day. Superpoopers I call them. (sounds like an ABBA song)-appeared to cut their risk of breast cancer in half. This could be because constipation, means a greater contact time between our waste and our intestinal wall, which may increase the formation and absorption of fecal mutagens-compounds that can cause DNA mutations and cancer-into the circulation, and then into the breast. We know that breasts actively take up chemical substances from the bloodstream, so researchers became concerned that substances originating in the colon might enter the bloodstream and reach the breast. Specifically bile acids, which are formed as a way of getting rid of excess cholesterol. Our liver dumps bile acids into the intestine for disposal, assuming our intestines will be packed with fiber to trap it and flush it out of the body, but if we haven't been eating whole plant foods all day long, bile acids can be reabsorbed back into the body, and build up in the breast. Carcinogenic bile acids are found concentrated in the breast at up to a hundred times the level found in the bloodstream-they just suck it up. By radioactively tagging bile acids they were able to show that intestinal bile acids rapidly gain access to the breast, where they can exert an estrogen-like cancer-promoting effect on breast tumor cells. This would explain why we see 50% higher bile acid levels in newly diagnosed breast cancer victims. So how can we facilitate the removal of bile acids from our body? Well we can speed up the so-called oroanal transit time, the speed at which food goes from mouth to toilet, because slowed colon transit can increases bile acid absorption. But we can speed things up by eating lots of fiber. A diet packed with plants greatly increased bile acid excretion. Fiber can bind up and remove toxic elements like lead and mercury, as well as cholesterol and bile acids. But plants can even bind bile acids independent of fiber. Vegan diets, bind significantly more bile acid than lacto-ovo, or nonvegetarian diets, for example, even at the same fiber intake... which could explain why it appears that individuals eating vegetarian might excrete less mutagenic, less mutation-causing feces in the first place. You'll notice, that the same type of diet used to help lower cancer risk, is the same type of diet used to help prevent Alzheimers, and diabetes, diabetic complications, and high blood pressure, and stroke, and back pain, and heart disease, a diet centered around whole plant foods -the type of diet eaten by populations that were largely free of many of our deadliest and debilitating diseases.Heart disease was so rare among those eating these traditional plant-based diets, there were papers published like this. A Case of Coronary Heart Disease in an African. After 26 years of medical practice they finally recorded their first case of coronary heart disease among a population of 15 million-a judge, who had started consuming, a partially Westernized diet... Some, thought it was the preponderance of whole plant foods, that protected these populations; others thought it was the avoidance of animal foods. Either way, they couldn't prove it was the diet, until it was put to the test. Pritikin, Ornish, Esselstyn, and others took people with heart disease and put them on the kind of plant-based diet followed by thesepopulations that didn't suffer from heart disease, hoping it would stop the disease process, keep it from progressing further, but instead, something miraculous happened. Their disease started to reverse, to get better. As soon as they stopped eating an artery-clogging diet, their bodies were able to start dissolving some of the plaque away, even in some cases of severe triple vessel heart disease, arteries opened up without drugs, without surgery, suggesting their bodies wanted to heal all along, but were just never given the chance. This is Esselstyn's new study, published four days ago. This increase in blood flow to the heart muscle on the left happened within just 3 weeks of eating healthy... Let me share with you the best kept secret in medicine... The best kept secret in medicine is that, given the right conditions, the body heals itself. If you... whack your shin really hard on a coffee table, it can get all red hot swollen painful but will heal naturally if we just stand back and let our body work its magic. But what if we kept whacking it in the same place three times a day (breakfast, lunch, and dinner). It'd never heal. You'd go to your doctor and say my shin hurts. And the doctor would be like no problem, whip out their pad and write you a prescription for, painkillers. You're still whacking your shin three times a day and it still hurts like heck, but feels so much better with the pain pills. Thank heavens for modern medicine. It's like when people take nitroglycerine for chest pain, tremendous relief, but you're not doing anything to treat the underlying cause. Our body wants, to come back to health, if we let it. But if we keep re-injuring it three times a day we may never heal. It's like smoking. One of the most amazing things I learned in medical school was that within 10 years of stopping smoking, our lung cancer risk approaches that of a lifelong nonsmoker. Isn't that amazing? Our lungs can clear out all that tar, and eventually, it's almost like we never started smoking at all. Our body wants to be healthy. And every morning of our smoking life that healing process started until... bam, our first cigarette, reinjuring our lungs with every puff, just like we can reinjure our arteries with every bite, when all we had to do all along-the miracle cure, is just stop re-damaging ourselves and just get out of the way and let our bodies natural healing process bring us back towards health. There is only one diet that's ever been proven to reverse heart disease in the majority of patients, a plant-based diet. Anytime anyone tries to sell you on some new diet, ask them one simple question: “Has it been proven to reverse heart disease (yaknow, the most likely reason you and everyone you love will die?)” If not, why would you even consider it? If that's all a plant-based diet could do-reverse our #1 killer, then shouldn't that be the default diet until proven otherwise? And the fact that it can also be effective in preventing, treating, and arresting other leading killers, such as diabetes and high blood pressure would seem to make the case for plant-based eating overwhelming. So why don't doctors prescribe it? Available time is a reason frequently cited by physicians, but if you probe a little deeper... yes they complain about not having enough time to give their patients dietary advice... but the number one reason, was their perception that patients fear being deprived of all the junk they're eating. Can you imagine a doctor saying, yeah I'd like to tell my patients to stop smoking, but I know how much they love it. Dr. Neal Barnard wrote a compelling editorial, in the American Medical Association's Journal of Ethics. When he stopped smoking in the 80's, the lung cancer death rate was peaking in the U.S., but has since dropped, with dropping smoking rates. No longer were doctors telling patients to give their throat a vacation, by smoking a fresh cigarette. Doctors realized they were more effective at counseling patients to quit smoking if they no longer had tobacco stains on their own fingers. In other words, doctors went from being bystanders-or even enablers-to leading the fight against smoking. And today, he says, plant-based diets, are the nutritional equivalent, of quitting smoking. This is not, vegetarianism. Vegetarians often consume all sorts of junk. Vegans too, for that matter. This new paradigm is exclusively plant-based nutrition. Whole plant foods. Why exclusively? Well, as reported in the Cornell-Oxford-China Study, there does not appear to be a threshold beyond which further benefits did not accrue with increasing proportions of plant foods in the diet. It appears the more plant-based foods and the fewer animal-based foods, the better. It took five decades after the initial studies linking tobacco and cancer for effective public health policies to be put into place, with enormous cost to human health. Must we wait another 50 years to respond to the epidemics of dietary disease? They do have money on their side. The chemical, tobacco and food industries have the luxury to share similar tactics with the drug companies, because they have the resources to do so. By contrast, powerful and cheap health promoting activities (like eating healthy) are too cheap, can't be patented, aren't profitable. And they throw that money around. The American Dietetic Association, for example, promotes a series of Nutrition Fact Sheets. Who writes them? Industry sources pay $20,000 per fact sheet to the ADA and explicitly take part in writing the documents. So you can learn about Eggs from the egg industry, the benefits of chewing gum from the Wrigley Science Institute. I didn't know Wrigley's had a science institute. In 2008, the ADA announced that the Coca-Cola Company had become an official partner to give them prominent access to key influencers and decision makers and share the Coca-Cola Company's research findings. For example: Did you know there are no harmful effects of different Coca-cola beverages on rat testicles? Was that even a concern? Thou doth protest too much, methinks. When the American Academy of Family Physicians was called out on their proud new corporate relationship with Coke to support patient education on healthy eating, an executive vice-president of the Academy tried to quell protest by explaining that this alliance was not without precedent. They had relationships with Pepsi and McDonald's for some time. Reminiscent, of similar types of relationships... in the past... This didn't seem placate the critics, so the exec assured them that the American Dietetic Association has made a policy statement that “There are no good or bad foods.” A position that the food industry has then exploited. In its early years, the tobacco industry sounded a similar theme: smoking per se was not bad, only “excess” smoking. Sound familiar? Everything, in moderation. Is this what family docs and dieticians have been reduced to? To justify unholy financial alliances they deny that there are actually unhealthy foods. Thankfully there is a corporate sector that actually benefits from keeping people healthy, the insurance industry. Last year a Nutritional Update for Physicians was published in the official journal of Kaiser Permanente, the largest managed care organization in the country, covering about 9 million people with about 15,000 physicians-who were told, that healthy eating may be best achieved with a plant-based diet, defined as a regimen that encourages whole, plant-based foods and discourages meats, dairy, and eggs as well as all refined and processed junk. Too often, physicians ignore the potential benefits of good nutrition and quickly prescribe medications instead of giving patients a chance to correct their disease through healthy eating and active living. Physicians should therefore consider recommending a plant-based diet to all their patients, especially those with high blood pressure, diabetes, cardiovascular disease, or obesity. The major downside is that it may work a little too well. If people are on medications their blood pressure or blood sugar could actually drop too low, so physicians may need to adjust medications or eliminate them altogether. The side-effects, ironically, may be: not-having-to-take-drugs. Despite the strong body of evidence favoring plant-based diets, many physicians are not stressing the importance of plant- based diets as a first-line treatment for chronic illnesses. (That's an understatement) This could be because of a lack of physician awareness-or, a lack of patient education resources. So Kaiser sought to change that.Want to lose weight, feel better, improve, stabilize, or even reverse chronic disease, get off some of your medications? If you answered yes to any of these questions then a plant-based eating plan may be right for you. Side-effects may include... lower cholesterol, blood pressure, and blood sugar, reversal or prevention of our #1 killer, a longer life, healthier weight, lower risk of cancer, diabetes-may even slow the progression of cancer, and improve inflammatory conditions like rheumatoid arthritis. They offer tips, to get started... meal plan ideas... and, I'm honored to say... a good taste in websites. The paper ends with a familiar refrain, further research is needed. In this case, though, further research is needed, to find ways to make plant-based diets the new normal. Thank you. I have both of my last two annual reviews on DVD, all proceeds to charity, and all of my work is available free, on NutritionFacts.org. Thanks againFor all the individual transcripts, see the daily videos in which each subject is covered. Browse through all the topics at http://nutritionfacts.org/topics/.