Today on the NutritionFacts podcast, we look at antibiotic resistance genes, the misleading packaging on dietary supplements, and why health insurers don’t embrace plant-based eating. This episode features audio from Why Don’t Health Insurers Encourage Healthier Eating?, Supplement Regulation and Side Effects: Efforts to Suppress the Truth, and Antibiotic Resistance Genes in the Guts of Vegetarians vs. Meat-Eaters. Visit the video pages for all sources and doctor’s notes related to this podcast.
Have you ever wondered if there’s a natural way to lower your high blood pressure, guard against Alzheimer's, lose weight, and feel better? Well as it turns out there is. Michael Greger, M.D. FACLM, founder of NutritionFacts.org, and author of the instant New York Times bestseller “How Not to Die” celebrates evidence-based nutrition to add years to our life and life to our years.
You may have heard the expression “Knowledge is power.” Well – today – we’re going to give you more power to control your diet and lifestyle – by giving you the facts. Welcome to the NutritionFacts Podcast. I’m your host – Dr. Michael Greger.
It’s time for the NutritionFacts Grab Bag – where we look at the science on a wide variety of topics. Today, we start with a pressing question: Why don’t health insurers embrace plant-based eating?
Many of the diseases that cause a constant drain on health care budgets can be prevented by proper nutrition; so, why aren’t the big payors getting involved? I mean even like a 1 percent decline in excess body fat could alone save tens of billions. You’d think at least the health insurance industry would try to get people to eat healthier to try to pay out less money. Well, one could say the insurance industry actually benefits from high healthcare costs because these rising costs are simply passed on to both individuals and employers in terms of higher premiums, and insurers take a fixed percentage of these premiums as increasing profits. They get a piece of the pie; so, the bigger the pie—the unhealthier everyone is—the bigger their piece. As such, insurers have not done as much as they could to help reduce health care costs because lower costs would hurt their bottom line.
“What if there was a medication that could successfully treat and even reverse heart disease, type 2 diabetes, high blood pressure, and many other chronic conditions without any negative side effects and offered the promise of dramatically reduced health care costs?” Imagine all the advertising there would be to promote it; imagine how much they would charge. A drug that could not just treat but cure diabetes and these other diseases? “Then, what if you were told this medication exists today, is available to everyone in unlimited quantities at a low cost, but the vast majority of the American public has never heard about it.” Do you want a solution to significantly reduce health care costs? The solution is to use food as medical treatment, specifically, foods made from minimally processed plants.
“One of the main barriers is simply the current widespread belief that once someone has a chronic condition, such as heart disease or type 2 diabetes, there is very little that can be done to actually reverse the disease, and the best outcome possible is to maintain the condition so that it just doesn’t get any worse. The fact that a whole food plant-based approach provides a safe, effective, low-cost alternative to not just eliminating symptoms but potentially reversing the underlying condition without drugs or surgery is unknown to a vast majority of Americans. In contrast to the pharmaceutical industry that spends large sums to market new drugs…there are not big profits in promoting a plant-based diet.”
The politics surrounding healthcare is who’s-going-to-pay-for-it, instead of what kind of healthcare is best, and the evidence is overwhelming that a whole food, plant-based diet provides the best opportunity to not only reduce the growth in spending, but actually decrease total health care costs more than any drug, medical procedure, insurance reform, or provider payment model out there.
Thankfully, the word is spreading. A review of the evidence published in Kaiser Permanente’s journal concluded that “[p]hysicians should consider recommending a plant-based diet to all their patients, especially those with high blood pressure, diabetes, cardiovascular disease, or obesity. Kaiser has followed up with user friendly guides (freely available online) for both physicians and patients, explaining the benefits and practical aspects of implementing a plant-based diet.” So hey, why aren’t all insurers sending out such information to all their members? You know how all the drug ads are, like, “Ask your doctor if this drug is right for you.” Well, members could be prompted to ask their physicians about the ability of plant-based diets to reduce or eliminate prescription drug use and reverse disease. Though of course, these materials would also have to list all the side effects. Side effects include: “increased energy, lower blood pressure, improved digestion, all while eating unlimited quantities of satisfying food.” Ask your doctor if plants are right for you.
Did you know that there is little guarantee that a dietary supplement will actually contain what is advertised on the packaging? Here’s the story.
In a video I did a few years ago, I talked about how press releases about the latest science coming out of even top medical centers were filled with overstatements and omissions. Medical journal press releases suffered from similar problems, and press releases from the drug companies themselves were no different, filled with hype and exaggeration. What about press releases issued by the supplements industry? Not even the companies that published the studies, but like trade organizations for the multi-billion dollar dietary supplement industry.
Researchers found that 100 percent of supplements industry press releases contained “spin,” meaning strategies to hype or denigrate findings to distort the results of clinical studies. And here’s the crazy part: industry press releases advocated supplement use in response to >90 percent of even the studies that reported no benefit or harm. Here are the harm studies. A study comes out showing a supplement is actually bad for you, and the vast majority of independent institutions, like the National Institutes of Health or mainstream media stories, are like “don’t take it.” Duh. But the industry trade organizations are like, “Harm? Go for it! Buy an extra bottle.”
It is, therefore, likely that the propagation of the ‘spin’-enriched industry press releases contributes to the ongoing, and even burgeoning, enthusiasm for use of supplements in the face of accumulating evidence of most of their ineffectiveness and, in some cases, harm. In some cases, people are paying to make themselves sick. Sadly, the science may not even matter to many supplement users. Most dietary supplement users said that they would be minimally influenced by independent, taxpayer-funded studies contradicting the efficacy claims of supplement manufacturers. Only a minority of users said they would stop taking a supplement if public health authorities stated that it was just a waste of money.
The iconic image of the snake oil salesman was actually a real dude: Clark “the Rattlesnake King” Stanley, in 1916. Turns out that Stanley’s snake oil, in fact, contained no snake oil at all, but rather just like spicy mothballs and turpentine, prosecuted under the newly enacted Pure Food and Drug Act, and ultimately fined a lofty sum of 20 bucks. And a century later, here we are with snake oil coming out our ears, a vast number of supplements marketed and sold without routine oversight. Now, the supplement industry bristles at such talk, saying that the supplement industry is regulated to protect consumers. And it’s true there are definitely laws on the books, but the ability of regulators to successfully carry out this mission is hampered by the sheer number of products.
The FDA estimates that there are more than 85,000 dietary supplement products currently available in the U.S. alone. So, there’s the sheer number, the underreporting of adverse side effects, the difficulty of successfully prosecuting cases against offenders, and the ease with which suppliers can rebrand products removed from the shelves have led to a largely unregulated environment. In the real world, there is little guarantee that a supplement will even contain what is advertised on the packaging and not contain unlisted ingredients, potentially leading to significant harms, resulting in an estimated 23,000 ER visits every year. Now, of course, prescription drugs don’t just sicken but kill many more, making them perhaps the third leading cause of death, wiping out more than 100,000 Americans. But still, the less death and disability, the better.
Dietary supplements are often adulterated with undeclared pharmaceuticals, which could represent an enormous risk to consumers, most often found in erectile dysfunction, weight loss, diabetes, and high blood pressure supplements. But wait a second, what about supplement manufacturers who say they have independent, 3rd party certification of purity? There is a practice called dry labbing, a dirty little secret of the supplements industry, where quality assurance labs just rubber stamp fake documents. And if you think that’s outrageous, check out the story of BMPEA.
A researcher at Harvard published a paper replicating prior research from the FDA detecting a designer amphetamine-like stimulant, β-methylphenylethylamine in various U.S. supplements sold in the United States. In response, one of the offenders, Hi-Tech Pharmaceuticals, manufacturers of weight loss supplements like Black Widow and Yellow Scorpion, sued the Harvard researcher for libel, slander, and product disparagement, originally to the tune of $200 million in damages.
This was all documented in a piece by STAT, which is an excellent source of medical journalism that I recommend. The head of Hi-Tech openly admitted that he was “hoping that we were able to silence this guy,” and while ultimately unsuccessful in court, Hi-Tech’s lawsuit effectively sent a warning to other researchers. In fact, Hi-Tech’s CEO is attributed as saying, he “hope[s] that the long and costly legal battle will scare away other academics from investigating the supplement industry.”
Finally, today – we discover that those who are eating plant-based diets have a reduced load of antibiotic resistance genes in their gut.
There are nearly a million salmonella and campylobacter infections in children 10 and younger each year in the United States. Some of these infections are severe, causing meningitis and death, and requiring treatment with antibiotics. The problem is that there’s an increasing problem of antibiotic resistance among these bugs that threatens our ability to treat them. Part of the problem is that the same lifesaving miracle drug antibiotics are being squandered for use in food animals for things like growth promotion in such unhygienic, crowded conditions, which increases the likelihood that pathogens like salmonella or campylobacter will become resistant.
There’s another problem. The resistance determinants, the genes that encode antibiotic resistance, may be transmitted from food animals to humans through the food supply. See, most resistant bacteria have mobile genetic elements, like these little circles of DNA called plasmids, that carry the resistance genes that they can then pass on to other bacteria, including those in our own gut.
Food animals are, therefore, a reservoir of antibiotic resistance genes, and a potential vector for transmission of antibiotic resistance genes to the human intestinal microbiota. In this study, transfer of an antibiotic resistance plasmid from an E. coli originating from a chicken raised for meat to human gut bugs was assessed by using a model that mimics the human intestines. And, it happened within two hours. This spread of antibiotic resistance genes presents an alarming scenario, a growing concern that antibiotic-resistant bacteria present on food can transfer their resistance genes to the inherent gut microbiota of the consumer. But you don’t know, until you put it to the test. Assessing antibiotic resistance gene loads in vegan vs. vegetarian vs. omnivore gut bacteria.
You’d think the results might be obvious, but antibiotic resistance genes are spread due to manure application on agricultural ﬁelds of fruits and vegetables. Yes, massive antibiotic use in animal farming is considered as the greatest contributor to the presence of antibiotic-resistant bacteria (ARB) in food of animal origin: meats, eggs, and dairy. Nevertheless, sewage from treated animals may impact on vegetables grown on fertilized ﬁelds, but it was largely unknown whether, and to what extent, antibiotic-resistant bacteria are being transferred to vegetables, and then to the human gut, until now. Researchers looked for antibiotic-resistant genes (ARGs) against sulfa drugs like bactrim, tetracyclines, penicillins and cephalosporins, and streptomycin-type antibiotics. And…both omnivores and vegetarians showed a signiﬁcantly higher antibiotic-resistant gene load in their guts as compared with vegans.
There wasn’t a significant difference between omnivores and vegetarians, but significantly lower loads in vegans compared to omnivores, and vegans compared to vegetarians––the ﬁrst evidence that a vegan lifestyle is associated with a reduced load of human gut antibiotic-resistant genes, but not the last. Fewer tetracycline resistance genes in vegan guts and more vancomycin resistance genes in the guts of those who eat meat. No surprise, since they found a correlation between tetracycline resistance genes and the intake of eggs, milk, and cheese (I like how there are so many types of milk these days they have to specify “milk from animal source”), and a higher incidence of vancomycin resistance genes was found in consumers of eggs, poultry, fish, and seafood. And vancomycin is one of our antibiotics of last resort, used to treat serious life-threatening strep and staph infections like MRSA.
Despite the links to dairy and eggs, just cutting out meat has indeed been shown to offer an advantage in some studies, as bacteria obtained from meat-eater poop samples showed resistance to a greater number of antibiotics, and carried more tested antibiotic resistance genes compared to the vegan or vegetarian poop.
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To see any graphs, charts, graphics, images, or studies mentioned here, please go to the Nutrition Facts podcast landing page. There you’ll find all the detailed information you need – plus links to all of the sources we cite for each of these topics.
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