The Tomato Effect

The Tomato Effect
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Why does the medical establishment sometimes ignore highly efficacious therapies, such as plant-based diets, for heart disease prevention and treatment?

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

In his landmark article “Resolving the Coronary Artery Disease Epidemic Through Plant-Based Nutrition,” Dr. Caldwell Esselstyn notes how fortunate we are “to possess the knowledge of how to prevent, arrest, and selectively reverse this disease. However,” he goes on to lament, “we are not fortunate in the capacity of our institutions to share this information with the public.” He blames ties to industry and politics resulting in conflicts of interest “within our private and governmental health institutions, compromising the accuracy of their public message. This is in total violation of the moral imperative of the medical profession. Now is the time for us to have the courage for legendary work.” He concludes: “Science…must dictate dietary recommendations.”

After all, “The fact that a low-fat, fiber-rich vegan diet is likely to reduce risk for most types of cancer, ischemic heart disease and its complications, obesity, diabetes, hypertension, osteoporosis, multiple sclerosis, gallstones, renal stones, appendicitis, diverticulitis, hiatal hernia, varicose veins, hemorrhoids, and possibly the chief metabolic complications of pregnancy—disorders which collectively are responsible for the majority of the deaths and hospitalizations in Western society—should be sufficient to recommend it. Those who are only willing to make less striking changes in their lifestyle can be encouraged to reduce their consumption of animal products as much as they can.”

In the process of writing this paper on the comparative endocrinological effect of plant versus animal proteins, the researcher himself was overwhelmed by the balance of evidence and disclosed that “During the course of researching and writing this article, my findings impelled me to become a vegan.”

Why don’t more within the scientific and medical community similarly embrace a plant-based diet? Part of the reason may be the “tomato effect.”

Coined in the Journal of the American Medical Association 27 years ago, the tomato effect describes the rejection of highly efficacious therapies by the medical establishment because they happen to go against the prevailing conventional wisdom.

Imported from the New World, “By [the year] 1560, the tomato was becoming a staple of the continental European diet…[A]t the same time it was actively shunned in North America [for literally centuries]… The reason…is simple: they were poisonous. Everyone knew they were poisonous, at least everyone in North America. It was obvious.”

Evidently, it was not until 1820 when some dude ate a tomato on the steps of some courthouse—and survived, did things finally change. And today, in the United States, tomatoes are a billion-dollar crop.

Examples of this tomato effect—a slavish devotion to orthodoxy—are mentioned in medicine. For example, ignoring the successful use of this plant in the treatment of gout for a thousand years before modern medicine “discovered” it was the drug colchicine. Aspirin was also ignored for almost 3,000 years of successful use as willow tree bark extract.

But I’d like to extend the tomato effect analogy into the field of nutrition. For example, thousands died of scurvy—vitamin C deficiency—for a hundred years after lemon juice was found to cure it, because disease at the time was considered an imbalance of the humors; what role could eating fruit possibly play?

A century later, in the mid-1800s, humanity came up with the brilliant idea to polish rice from brown to white, causing an epidemic of sudden death from heart attack in Asia. Millions died of beriberi, a vitamin B deficiency that affects the heart muscle. Again the cure was discovered—rice bran, or rice bran tea—yet there were decades of death before the medical community finally woke up and actually adopted it.

Today, there is another epidemic of sudden death from heart attack. It, too, is caused by diet, and it, too, has a cure. How long must we wait?

McCarty ends his paper: “I suspect that the simple injunction, ‘Do not eat animal products’ has the potential to do more for world health than all the abstruse wisdom in all of the world’s medical libraries.”

Please consider volunteering to help out on the site.

Images thanks to Lestath and Brinerustle via Wikipedia Commons as well as the University of Virginia.

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

In his landmark article “Resolving the Coronary Artery Disease Epidemic Through Plant-Based Nutrition,” Dr. Caldwell Esselstyn notes how fortunate we are “to possess the knowledge of how to prevent, arrest, and selectively reverse this disease. However,” he goes on to lament, “we are not fortunate in the capacity of our institutions to share this information with the public.” He blames ties to industry and politics resulting in conflicts of interest “within our private and governmental health institutions, compromising the accuracy of their public message. This is in total violation of the moral imperative of the medical profession. Now is the time for us to have the courage for legendary work.” He concludes: “Science…must dictate dietary recommendations.”

After all, “The fact that a low-fat, fiber-rich vegan diet is likely to reduce risk for most types of cancer, ischemic heart disease and its complications, obesity, diabetes, hypertension, osteoporosis, multiple sclerosis, gallstones, renal stones, appendicitis, diverticulitis, hiatal hernia, varicose veins, hemorrhoids, and possibly the chief metabolic complications of pregnancy—disorders which collectively are responsible for the majority of the deaths and hospitalizations in Western society—should be sufficient to recommend it. Those who are only willing to make less striking changes in their lifestyle can be encouraged to reduce their consumption of animal products as much as they can.”

In the process of writing this paper on the comparative endocrinological effect of plant versus animal proteins, the researcher himself was overwhelmed by the balance of evidence and disclosed that “During the course of researching and writing this article, my findings impelled me to become a vegan.”

Why don’t more within the scientific and medical community similarly embrace a plant-based diet? Part of the reason may be the “tomato effect.”

Coined in the Journal of the American Medical Association 27 years ago, the tomato effect describes the rejection of highly efficacious therapies by the medical establishment because they happen to go against the prevailing conventional wisdom.

Imported from the New World, “By [the year] 1560, the tomato was becoming a staple of the continental European diet…[A]t the same time it was actively shunned in North America [for literally centuries]… The reason…is simple: they were poisonous. Everyone knew they were poisonous, at least everyone in North America. It was obvious.”

Evidently, it was not until 1820 when some dude ate a tomato on the steps of some courthouse—and survived, did things finally change. And today, in the United States, tomatoes are a billion-dollar crop.

Examples of this tomato effect—a slavish devotion to orthodoxy—are mentioned in medicine. For example, ignoring the successful use of this plant in the treatment of gout for a thousand years before modern medicine “discovered” it was the drug colchicine. Aspirin was also ignored for almost 3,000 years of successful use as willow tree bark extract.

But I’d like to extend the tomato effect analogy into the field of nutrition. For example, thousands died of scurvy—vitamin C deficiency—for a hundred years after lemon juice was found to cure it, because disease at the time was considered an imbalance of the humors; what role could eating fruit possibly play?

A century later, in the mid-1800s, humanity came up with the brilliant idea to polish rice from brown to white, causing an epidemic of sudden death from heart attack in Asia. Millions died of beriberi, a vitamin B deficiency that affects the heart muscle. Again the cure was discovered—rice bran, or rice bran tea—yet there were decades of death before the medical community finally woke up and actually adopted it.

Today, there is another epidemic of sudden death from heart attack. It, too, is caused by diet, and it, too, has a cure. How long must we wait?

McCarty ends his paper: “I suspect that the simple injunction, ‘Do not eat animal products’ has the potential to do more for world health than all the abstruse wisdom in all of the world’s medical libraries.”

Please consider volunteering to help out on the site.

Images thanks to Lestath and Brinerustle via Wikipedia Commons as well as the University of Virginia.

79 responses to “The Tomato Effect

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    1. Hello! I was wondering…. I need to get my diabetes under control again. If I switch to plant base diet will this help my diabetes and help lower my triglycerides? A1C is 7.1 and fasting glucose is 147.. I started out with 11.2 A1C two years ago and and I dropped to a 6.4 then recently went up to 7.1due to not eating right. I LOVE vegetables so I believe this would be something I can do.




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      1. Deb Garrett: Following is a really great book I have read more than once. The book is based on solid, published research and is consistent with the information Dr. Greger has shared with us regarding diabetes. Dr. Barnard has done studies on diabetics where he only changed the diet. Dr. Barnard got published in peer reviewed, respected medical journals and was able to prove that his diet is 3 times more effective than the ADA diet. Both in research and on this website, people have reported being able to reverse their insulin sensitivity following the diet. What’s more, note that Dr. Barnard is not the only researcher who has proven that the diet works.
        .
        The book is called “Dr. Neal Barnard’s Program for Reversing Diabetes: The Scientifically Proven System for Reversing Diabetes without Drugs”. https://www.amazon.com/Neal-Barnards-Program-Reversing-Diabetes/dp/1594868107/ref=sr_1_1_twi_pap_1?s=books&ie=UTF8&qid=1480632167&sr=1-1&keywords=barnard+diabetes The diet can be labeled as a low fat, whole food plant based (WFPB) diet. The beauty of this diet is that you not only get the benefits of treating the type 2 diabetes, but you also get the benefits of maximizing your chances for long term health. As evidence for that statement, I’ll note that this is same diet which is great for preventing or reversing the top 15 killers of Amercians (http://nutritionfacts.org/video/how-not-to-die ). It is also mirroring the eating patterns of the longest lived and healthiest populations on the planet. The traditional Okinawans are an example of this: http://nutritionfacts.org/video/the-okinawa-diet-living-to-100/.
        .
        Here is the practical side: Dr. Barnard’s book contains both sample meal plans and recipes at the back. So, you will get a lot of support. You will not be on your own to try to figure out what to do. I imagine that once you start, you will want more ideas. Dr. McDougall’s recipe books should all be in line with this diet. You might try The Starch Solution for starters. The Happy Herbivore series of cookbooks is very popular and tasty and at a glance, the recipes all look to me to be in line with the diet. Once you have a sense of what kinds of dishes fit in a low fat WPFB diet, you can really branch out for recipe sources, tweaking recipes as needed. One of my favorite cookbooks for recipes is: Vegan On the Cheap. I just have to tweak a few of the recipes sometimes. (That’s easy to do once you learn some tricks.)
        .
        Would you like more hand holding than cookbooks offer? Dr. Barnard heads a group called the Physcian’s Committee for Resposible Medicine (PCRM). PCRM offers a free 21 Day Kickstart on-line program. The 21 Day Kickstart is recommended by Dr. Greger in his book How Not To Die. The 21 Day Kickstart is super great for beginners because they hold your hand for 21 days – including grocery lists, meal plans, recipes, cooking videos, inspirational e-mails, and a forum moderated by an RD where you can ask all sorts of questions. If you are interested, click the green button on the following page to register: http://www.pcrm.org/kickstartHome
        .
        One thing to keep in mind is that some people can go “cold turkey” and change their diet in a day and be very successful. There are some good benefits to this route. However, other people need to transition over time, both to let their bodies and their minds adjust to the healthier diet. I have heard PCRM’s director, Dr. Barnard, say that initially, people are not ready to make a change. There needs to be some planning and finding out what foods you like. Maybe try some new dishes mixed in with your regular ones until you are feeling confident/not overwhelmed about making a change. Here is a page from PCRM that talks about how to make a plan (if you don’t want to do either of the above ideas or you want to combine all of these ideas): http://www.pcrm.org/health/diets/vsk/vegetarian-starter-kit-three-step
        I don’t know which approach is best for someone who wants to transition from a ketogenic diet to a low fat WFPB diet. You might think about both approaches and work with a knowledgeable doctor or registered dietician???
        .
        A ***CAUTION*** FOR PEOPLE ON DIABETES (and/or high blood pressure) DRUGS: I am repeating what I have seen other doctors caution for: Eating a healthy diet can sometimes result in rapid healing. In those cases, it may be necessary to work with a doctor who understands this so that you can be quickly and safely weaned off your meds. (Yes, people make the transition by themselves and are fine. It’s just safer to work with a doctor. I wanted to be clear about this.)




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  1. Thanks for another excellent video, Dr. Greger!
    I agree that the tomato effect – or dogmas, in general – are at the core of why less than 5% of people in North America have embraced vegetarianism, despite enormous scientific support for plant-based diets. One example of non sequitur reasoning that I’m sure you will recognize, goes something like:

    1) we have been eating meat for eons as proven by the anthropological record;

    2) therefore, we have evolved to eat meat and require it.

    Hmm…maybe if the discredited theory of Lamarck had been proven true, but #2 does not follow automatically according to the well supported model of Darwinian evolution.

    Yet meat proponents as sophisticated as Michael Pollan will suggest that following the current science of nutrition, pejoratively referred to as nutritionism (http://en.wikipedia.org/wiki/Nutritionism), will lead people astray. Instead they suggest that we should use common sense intuition to eat according to the pattern of our ancestors.

    I feel that even rather rational people, with limited time to explore the literature, would buy into flawed arguments, like the above, and ultimately avoid vegetarianism.




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    1. It is certainly an educational challenge to make major changes in the way people view the foods they eat. In my reading of Michael Pollan, I was understanding his mantra of “Eat food, mostly plants, and not too much,” is certainly advocating for a plant based diet as the primary food source. Although he may eat meat, his writings, seem to clearly decry the traditional western diet and the “food industry”.

      As he says in his “Food Rules”, Eat foods from plants, not food made in plants.




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      1. I feel that ‘Mostly plants’ does not say much since most people of the world, including those from developed nations, already get most of their calories from plant sources. The food balance tables (http://faostat.fao.org/site/368/default.aspx#ancor) provide ample support for this.

        In his ‘Six rules for eating wisely’ (http://michaelpollan.com/articles-archive/six-rules-for-eating-wisely/), I think Pollan sums up his attitude when he writes: “The more I learn about the science of nutrition, the less certain I am that we’ve learned anything important about food that our ancestors didn’t know.”

        Concerns about the sincerity of Pollan’s support for vegetarianism have been well-covered elsewhere, including: (http://www.theatlantic.com/magazine/archive/2007/09/hard-to-swallow/6123/4/)




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        1. I would agree that the majority of the world has historically obtained the majority of calories from plant sources. The problems facing us here in the USA are we have really made a shift in the last century and it has been detrimental to our health.

          Pollan’s statement about nutrition is one I took as a critique of our reductionist approach, basically we have been taught to look at eating nutrients rather than whole food. Although being concerned about nutrients we need or don’t need can be helpful, most of the research seems to show eating whole foods is most beneficial.

          I am not too concerned about Pollan’s personal philosophy and whether he eats meat or not. I find his writing stimulated my own thought about what I eat – so his writings have been beneficial to me!

          concerned about Pollan’s sincerity




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          1. Nicely said! … I agree with you that Pollan makes an excellent point about the nutritional value of whole foods, which is well-supported by current research. If he is inspiring others to think more critically about the food they eat, then he is making a valuable contribution.

            Thank you.




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          2. I started down my healthier path by just adding 3 pieces of fruit a day to my diet. Then I started reading and adding more veggies, then less sugar, then less meat and so on. Pollen’s writings have helped me along with Furman, McDougle and Gregers. It’s good to not forget that we all start in different places and most people can not go from the Standard American Diet to a vegan diet in one swoop…




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          3. I’m amazed by how much some vegetarians love Michael Pollan!

            If you doubt that Pollan is a meat-proponent, come talk to me after you watch the The Oprah Winfrey Show: Oprah and 378 Staffers Go Vegan: The One-Week Challenge (Feb 1st, 2011) where Pollan goes head to head with the veganist Kathy Freston and even remarks in his backstage appearance that “meat is a perfectly nutritious enjoyable food…its not like you’re hurting yourself eating meat”.

            Pollan’s scientific errors and anti-vegetarianism have been well documented on Adam Merberg’s blog ‘Say what, Michael Pollan’.

            Most amazing of all is why anyone would take dietary advice from an english major who has no scientific credentials!




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        2. It’s obvious our ancestors knew what to eat. They weren’t influenced by mass media. They grew it or foraged it. They didn’t pick it up at the grocery. IF, and that’s a big “IF”…if grocery stores only sold what was grown a few hundreds of years ago, the masses (in the USA) would know even today what our ancestors knew. Imagine Thomas Jefferson or Ben Franklin going to and American super market. They couldn’t find the food. They’d read the ingredients on the package and think we’ve all gone mad. Maybe we have!




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    2. Most Americans don’t know who Pollard is. They DO know who Dr.Oz, Rachael Ray, Rush Limbaugh, and a plethora of other media spokesperson’s are who mislead the masses. The masses hear their message daily. They don’t hear evidence based nutritional news (science) with few exceptions. American’s are conditioned to expect recipes for serving bacon with burgers and greens drowned in oil and Greek Yogurt. They snicker at any attempt to change the status quo. They are afraid to confront their doctors; instead they meekly take all the prescriptions to hide disease symptoms. In short, Americans are indoctrinated by the hidden food police, big business, who powerfully, through lobbyists and threats of economic downturn, sway politicians to not only support, but promote meat and dairy consumption. Had Pollard never been born the same epidemic of nutritional ignorance would exist today. Vegan proponents tape up one debate after the another to refute the latest meat and dairy diet nonsense. Meanwhile, it’s business as usual. The masses don’t have a lobbyists. We debate the science when the war is a political one. Unfortunately, polite doctors are armed with evidence based science while politicians are obliged to listen to their backers, big business. We are so entrenched in the meat and dairy consumerism-based economy we won’t risk change. Instead of independent men growing their own food, as a nation, we rely on the food police to not only tell us what’s right to eat but they sell it to us too. Billions of dollars worth. Polite doctors armed with evidence are no match for shrewd marketers who already have consumers convinced it is the evidence based doctors who are the food police. American’s therefore resist influence by facts. They instead die taking their pills.
      Americans, “meat and dairy” eaters, believe they must have meat and dairy to be healthy. They believe eating vegan means living on salads and cooked vegetables. They can’t imagine how anyone can endure that. They don’t have a clue it’s easy to fill up on starches and never bee hungry, even eating a small amount of calories. They don’t believe it because the message is seldom said. When media does say something like, Research proves that adults drinking three glasses of milk daily have significantly more hip fractures than those who only drink one. One, or more reporters scoff at the news saying THEY believe otherwise. Clearly this country lacks ethical journalism, responsive government, and honest business owners. By default, American men allows others in government and business to make health decisions for their families. It’s metrosexual to the extreme. Instead of a father saying, I’ve come to realize milk and meat are harmful to my children”, he instead, says, “Who wants KFC tonight and who wants McDonalds?” The problem will get worse before it gets better because Americans are so much more connected by media and not by family. Our government will change policy distribute the truth when we are too unhealthy to compete in the word and can’t afford medical treatments. Until then it’s a David and goliath war and most don’t even know David is in the fight.




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    3. The most important reason for people’s eating habit is HABIT. People DO NOT USE REASON to choose what to eat! If they
      did they would choose Whole Plant Foods without added oil…BECAUSE THERE IS AMPLE EVIDENCE FOR WFPB,
      People do not look at objective evidence to determine what to eat but instead look for people to give them a reason to stick
      with their current eating style.




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  2. On one hand, you have people like the doctor in this video who educated himself and then felt compelled to go vegan.

    On the other hand, you have people like my morbidly obese, diabetic co-worker who takes pride in never eating vegetables, who can’t stand to go a day without a burger or two, and who would rather die than change her eating. I lent her Dr. Bernard’s book on Reversing Diabetes. She read it just far enough. She said she returned it to me before getting to the end because she knew that she would never make that change. She didn’t deny the science. She didn’t say everything is going well for her on her current path. She only said that she isn’t willing to eat healthily.

    Even my parents, who have listened to a lot of nutritional information and don’t really doubt it’s validity, are not willing to do much change.

    So, on one hand, we do need the medical community to wake up. On the other hand, I suspect that there are a large number of people who won’t change no matter what the medical community says. It may not be too late to help the kids. But I suspect that it is way too late to help most adults. Us adults outside the medical community all have our own tomato affect going on.




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        1. Well, I think it was not health issue, it was higher taxes, higher price for cigs, 2nd hand smoke issues causing no smoking at desk, etc.




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    1. “They” changed from an agrarian society to a money incentive, mass marketing society over generations. As long as big business can profit from dumping unhealthy food substitutes on Americans and Government condones it, why change? The masses simply don’t know any better. Eighty percent of the population are dependent on an authoritarian figure to make decisions for them. Advertisers do so gladly.




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      1. Govt not only condones it, govt is a major advocate, not the peoples’ advocate. FDA, etc. is “owned” by big pharma, etc. Well, maybe not “owned”, but certainly $ are involved.




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    2. JJ, my mom died from body cancer, originating from lung cancer, my dad from heart disease. Both were heavy, heavy smokers for years. After my dad’s last heart attack (they couldn’t even do bypass because he didn’t have enough vein left in his leg and no heart muscle to attach it to anyway) and STILL neither would stop smoking. Mom was young, 64, my dad, patched up twice with bypasses, survived a bit longer. Not a good life. So, it’s not only the food…




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    1. Dr.Greger hasn’t done a specific video on gout. Gout is associated with higher blood uric acid levels. Increased consumption of meat, poultry and fish result in higher or uric acid. People getting most of their protein from plants have lower uric acid levels. I have had patients markedly decrease the number of gouty attacks or eliminate them altogether by going a a whole plant food based diet. Low fat dairy has been shown in men to decrease uric acid but you can’t recommend dairy because of its association with other diseases plus all the other non health arguments unnecessary suffering and environmental concerns. Go to browse all topics and click on Dairy for a number of excellent videos on the effects of dairy.




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    2. I’ve been on a low fat vegan diet for 14-months – many health improvements including the elmination of gout-like symptoms. Went from a frequent sufferer to worry free in about a month!




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    1. Oh that’s a great example! Everyone should know about Ignaz Phillip Semmelweis. Quoting from the Proceedings of the Royal Society of Medicine: “Many men have been endowed with clear intellects and hearts full of love for their fellow men, with the enthusiasm of humanity, and they have been enabled to achieve some signal service for the human race in their day and generation; but in the whole history of medicine there is only one Semmelweis in the magnitude of his services to Mankind, and in the depths of his sufferings from contemporary jealous stupidity and ingratitude.”

      Let me set the scene:

      The year was 1846. The place, Viennese General Hospital, the largest of its kind in the world. Semmelweis gets a job as obstetrical assistant. He notices that three times as many women are dying at the hands of the medical students than at the hands of the midwifery students from puerperal fever, commonly known at the time as, “the black death of the childbed.” Semmelweis describes: “In the medical school division the mortality from puerperal fever was so terrifying that this division became notorious….There were heart rendering scenes when [pregnant] patients knelt down, wringing their hands, to beg for a transfer [to the midwifery division]….”

      Why the discrepancy? The food and ventilation was the same in both divisions. If anything, surgical skill was better in the medical school and overcrowding less. The idea at the time was that the excess mortality was due to the emotional strain of being examined by male students, since the midwives were all female. So the elders of the Medical School met in council and proceeded to exclude the foreign students from the hospital on the ground that they were, “rougher in their examination than the Viennese.” Death rates didn’t change.

      Before Lister, before Pasteur, Semmelweis made the connection between the autopsies the medical students were doing and the, “examining finger which introduces the cadaveric particles.” In May 1847 he required every medical student to wash his hands with a chlorine solution before making an examination and the death rate plummeted. For the first time in the history of the Vienna Hospital, the mortality rate at the medical school fell below that of the school of midwives.

      Knighted, no doubt, for the discovery of the century? Hardly. Historians believe his doctrine was unpalatable to colleagues since it implied that the obstetricians were the cause of death. He shared this knowledge with his superiors. From the Proceedings: “The suggestion was unheard of! Indeed, it was sheer impertinence to suggest that the Accoucheur to the Imperial household should carry contagion upon his hands.” Semmelweis was summarily dismissed.

      So he lectured, he wrote papers; he continued to be ridiculed. Doctors regarded antisepsis as a poor joke. His successor in Vienna publicly stated that the doctrine was, “discredited and universally rejected.” Semmelweis wrote a book, The Cause, Nature, and Prevention of Puerperal Fever, expecting it to save thousands of lives, but it was ignored.

      So he turned from academics to polemics. He started to publish open letters to midwifery professors. “Your teaching… is based on the dead bodies of… women slaughtered through ignorance. If… you continue to teach your students and midwives that puerperal fever is an ordinary epidemic disease, I proclaim you before God and the world to be an assassin….”

      By the summer of 1865 he had taken to the streets of Budapest thrusting circulars into the hands of startled pedestrians. “The peril of childbed fever menaces your life! Beware of doctors for they will kill you…. Unless everything that touches you is washed with soap and water and then chlorine solution, you will die and your child with you!”

      Semmelweis, at the age of 47, the father of three young children was committed to an insane asylum in Vienna. He attempted to escape, but was forcibly restrained by several guards, secured in a straight jacket, and confined in a darkened cell. The asylum guards beat him severely.

      Quoting from the Bulletin of the History of Medicine, “He was not in the asylum for long. Thirteen days after admission he was dead.” From the autopsy report: “It is obvious that these horrible injuries were… the consequences of brutal beating, tying down, trampling underfoot.”




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      1. This story is very telling. It shows how far people will go to keep their blinders on when the truth threatens their self-image or their entrenched way of life no matter how unfounded.




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  3. Dr. Greger, your website is a treasure; thank you.

    On a personal note: I have IBS, and am following Dr. Barnard’s advice on conducting an Elimination Diet to identify potential triggers. Tomatoes, it turns out, really are poison for me. In fact, many foods that have much to recommend them cause problems for me……wheat, oats, onions, tomatoes, squash…… Sometimes I get excited about something you discuss on a video, but evenutally find that I have to avoid it, if I want to feel good.
    Again, thanks for the information you provide; it’s wonderful.




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  4. It really is frustrating to have the weight of culture against you. Having been vegetarian for 23 years and vegan for 14 years, I’m an “extremist”. That I’d 3 major chronic health problems by the age of 15 which have probably been kept to some extent in check by diet, several years BEFORE going veggie doesn’t stop the comments that I’d feel better if I ate some meat.

    And worst of all is the argument that, “There’s no point to life if you don’t enjoy it while you can”; pointing out that it’s easier to enjoy life when you don’t have major health problems doesn’t cut it.

    As a young person, I tried angry outright argument when provoked; then I turned to refusing to discuss it; then I went through a phase of being cheerily fact-based and then changing the subject. Now I’m mentally noting the videos and articles on this site most likely to get emailed next time a member of the family and social circle complains about their asthma/gout/rheumatoid arthritis/type 2 diabetes/high cholesterol/high blood pressure, or asserts that soya products will make them infertile/less manly/gay/die from breast cancer. There’s something about a good-humoured short graphical representation by an MD specialising in clinical nutrition that packs more of a punch than “extreme” claims by someone you know. You’ve made my life a lot easier.  And how much do I love your video on cocoa solids as a treatment for chronic fatigue? – there are no words!




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  5. I recently turned vegan.  I have lost 15 pounds in 4 months.  I feel so much better since I stopped consuming meat and dairy.  I have asthma and am a smoker but since not eating dairy I can breath much better.




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  6. I would really appreciate seeing more videos on gout.  There is a ton of conflicting information (or misinformation) about diet and gout: eat soy/don’t eat soy; avoid wheat bread/eat whole-grain bread; eat tomatoes/don’t eat tomatoes; eat lots of cherries, etc.  I’d love to get the real scoop on whether and how diet can prevent gout and whether diet can impact gout attacks when they occur.

    Many thanks for responding to my requests in the past!




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  7. Dearest docta’ G!

    I and many others would love a LINK to McCarty’s vital report that concludes:

    “I suspect that the simple injunction, ‘Do not eat animal products’ has the potential to do more for world health than all of the abstruse wisdom in all of the world’s medical libraries.”

    So sorry if I missed it, as you source your facts almost as thouroughly as another favorite writer/healer/thinker truth-teller…Noam Chomsky [ http://www.chomsky.info

    Please re-post or post a link to McCarty’s paper, if you would, or simply its title, so we might be able to hunt it down.

    Thank you Noblest of Physicians!
    I am 2 months into being primarilly vegen, and truly love it.
    THANKS for your wisdom, joyful guidance and subtle encouragement!

    Life! Dave in harrisburg, PA




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    1. If you look under the video ‘window’, you will see headings: Topics, Supplementary Info, Sources cited, etc. Click on Sources cited and the list will unfold (or drop down). McCarty is the last one, linked to an online source.
      Perhaps you’ve already found it, but I thought it might be helpful to note this for others who overlook those headings.




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  8. Thanks, Dr Greger. You, Dr McDougall, and Dr Esselstyn are responsible for my going vegan. You converted me to a vegetarian first. That lasted a day. The very next day, I went vegan!

    It’s been five weeks, and I have never been hungry, never craved animal products, and I’ve lost 5 pounds! (without exercise).




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  9. I agree with “The Tomato Effect” theory. Beyond that, many today lack time to research and prepare healthy vegan meals. People who don’t cook grab whatever is easy (or cheap) and those who do cook have not had enough experience preparing truly appetizing and satiating vegan meals. It is much faster for them to throw a roast in the crockpot with dry soup mix than to look up a recipe that requires a few spices and fresh ingredients they are not used to buying and do not have in their home.
    Finally, one has to be motivated to change. The “We’re all going to die from something” attitude is still strong for many.




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  10. I’d love to find a family physician who practices Lifestyle Medicine. Are there any resources for finding someone like this? I would love to find a dr. who “gets” why I eat a plant-based diet. Dr. Greger, I promise if you come to Akron, Ohio to set up practice, I will find you a ton of patients!!




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    1. Hi Annette, I live in Akron too and have wished for the same thing too. My doc is ok but he has no interest or appreciation for my diet choices, even though I got off by blood pressure medicine by changing my diet,




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  11. Dr. Greger, could we re-name this the Coconut Oil Effect? I couldn’t even argue with a friend who fed gobs of it to her 80-year-old husband, a brilliant music composer and choir director who had Alzheimer’s. “It’s good for you. The doctor told me it could help his Alzheimer’s.”
    I suppose she didn’t kill him, but she must still think she helped him, rather than hastening his death along.




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    1. tess: I recommend taking a look at the book, “Power Foods For the Brain, An Effective 3-step plant to protect your mind and strengthen your memory” by Neal Barnard, MD. Dr. Barnard includes a lot of research in regards to diet and dementia.




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  12. Is there anything that can done for tinnitus! I developed it after a heart attack! I take a lot of medications! Is there any particular med that contribute to this!




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    1. Sam, I too developed tinnitus shortly after adopting a vegan diet. I wonder whether this was coincidental or a true correlation. I have taken a tetracycline prescription for 23 years for rosacea which confounds ny experience because one side-effect of tetracycline can be tinnitus (but it did not appear until I went vegan).




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      1. Could be the effect of cleansing. Look up Herrings Law of Cure. We go back through in reverse order the symptoms we had
        when we treat the cause rather than the effect. Let food be our medicine.




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  13. OMG! YOU’R GOD!… haha excuse my enthusiasm, but you nailed how to express the roots of the problematics in today’s health and how still lots of people in health provision services still can’t look beyond they’re old teachings and look at evidence.




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  14. I have stage 3 Polycystic Kidney Disease in both kidneys, my liver etc. I am familiar with the Tanner rat studies research results. Has anyone followed this up with humans yet please? Can you tell me what level of potassium citrate I should be taking daily? Any other advice y are able to give me will be appreciated. (My doc told me to avoid stress. This is not really very helpful advice!)




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    1. Helen: I don’t have an answer to your question. But I wanted to comment on: “My doc told me to avoid stress. …” Goodness, one sure way to create stress is to give that advice, right? Argh.

      I hope you get some help!




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  15. I enjoyed reading Dr. Esselstyn’s book Prevent and Reverse Heart Disease and How Not to Die by Dr. Greger. I found the info quite informative in both books, and I tried going without meat (organic chicken, turkey, and wild caught salmon), yet with all of the plant-based food that I ate, I still felt very hungry/uncomfortable. I also lost weight just eating only plant-based foods that made me look like a stick insect, and I am thin to begin with. I somehow feel that eliminating meat might be very helpful, but I cannot presently tolerate the feeling of being hungry after eating only a plant-based diet. Any suggestions on how to get through this small dilemma?




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    1. jhk: Other people have reported similar problems here on NutrtionFacts. And I have a personal friend who had the same problem. I’m not an expert, but experience seems to indicate that the problem stems from not getting enough calories. You are eating so many whole plant food which are bulky/low calorie density (something good for many of us to focus on) that you are just not getting enough food. That’s likely why you can’t maintain your weight and are feeling hungry.

      The solution is to eat foods that are more calorie dense, but still are healthy. In other words, don’t add in salmon or oreos, but instead focus on making sure you get enough nuts, tempeh, tofu, beans and dried fruits. You can get a lot more calories from say prunes than from plumbs because plumbs take up so much less space in your tummy. You might also enjoy some avocado. Even cooked veggies are pretty low calorie density, but also are generally more calorie dense compared to their raw counter parts. Meaning you can eat a whole lot more calorie-wise of say cooked spinach compared to raw spinach. When you get enough calories, you should not be hungry nor lose any more weight.

      In my opinion, a healthy diet does not include being constantly hungry. I hope this helps. Give it a try and let us know.




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      1. Thanks Thea for the insights. I will try cooking many of the greens and see what happens. I tried eating 1/2 cup servings of organic canned beans with breakfast, lunch, and dinner as advised by Dr. Gregor in his book How Not to Die, and that’s seems to take the edge off of my hunger. I am excited though with the new vegan diet proposed by Dr. Esselstyn because of the many health benefits of eliminating meat, dairy, eggs, and oils. It’s an exciting journey.

        If you know anything about Dr. Esselstyn’s diet, do you know anything about whether eating trace amount of oil contained in vitamin supplements will make any large difference in the efficacy of Dr. Esselstyn’s heart-healthy regime? (I also have this question posted below the video on Mediterranean Diet from Dr. Gregor.)

        Best,
        jhk




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        1. jhk: I have read Dr. Esselstyn’s book (multiple times) and listened to several of his talks. My interpretation of Dr. Esselstyn’s work is that: The question on whether small amount of oil can be a problem would depend on how advanced your heart disease is. Those people who do not have advanced heart disease can probably tolerate more fat. You will note that the back the book has a recipe that includes nuts, though Dr. Esselstyn would not recommend that recipe for someone who has advanced heart disease. Whole plant foods high in fat are a different ‘ball game’ compared to eating processed oils, but I think the example is helpful in this discussion.

          Now, here’s the piece that balances the above information: Earlier on in the book (and explained even better in his talks), Dr. Esselstyn talks about how one of his early patients “back slided” compared to the other patients. That patient started eating packaged foods that contained very small amounts of oil (so small that the manufacturer was allowed to say it had zero fat on the nutrition label). And that’s the *one* patient who had another heart attack. The moral being that trivial amounts of oil might truly be harmful to some people in some circumstances.

          Some of the questions you might ask yourself are: If one pill has a trivial amount of oil, how much oil am I getting with all the pills I am taking? And do I really need these supplements??? My instinct tells me that the oil is probably the least of the concerns for the supplements you are taking. But I have no way of knowing your particular situation.

          I agree, it is an exciting journey! And good for you for adding those beans to your meals. That should do the trick and it did for you. Thanks so much for letting me know. I wish you all the best.




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          1. Wow! Powerful facts that will help. I thankfully do NOT have heart disease or so I think. My cholesterol is 151 with my LDL being 70; however, for the past year I have been on the Paleo Diet kick eating tremendous amounts of olive and coconut oils totaling about 5 tablespoons per day and 1-2 cups (yes, cups) of pecans, brazil nuts, and almonds. Of course being on the Paleo Diet, I also ate 4-5 ounces of organic chicken/turkey and/or wild caught fish with every meal. So who knows what my arteries look like despite the good lipid profile numbers of cholesterol and LDL. That’s why I am eager to do Dr. Esselystn’s regime correctly. The vitamins that I take that have a little oil in them to hold the pill together are Vitamin E, Coenzyme Q10, two prostate formulas, and a multi-vitamin. The question is whether anyone actually needs Vitamin E and CoQ10 doing the Esselstyn diet.

            So, it seems that since I don’t have any confirmed heart disease now, that I could still probably do the trace amounts of oil in the supplements and still get benefits of preventing heart disease using the Esselstyn method. Does that sound reasonable or am I still missing something? (One of the videos on Dr. Esselstyn’s website shows CNN host Wolf Bliztzer interviewing Doctors Esselstyn and Ornish. It seems that these fine gentlemen differ on whether to take fish oil supplements on the Esselstyn regime with Ornish saying it is okay to take.)




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            1. Joel: In my opinion, your thinking regarding the oil in the supplements sounds quite reasonable. Let me offer a bit more food for thought though.

              One of the benefits of listening to multiple, proven experts such as Esselstyn and Ornish is that you can see where they overlap and thus can feel pretty confident in that information. And where they don’t overlap, you can take that as less settled information and apply your own intuition based on your particular situation–exactly as you are doing in regards to fish oil. When it comes to fish oil, however, allow me to propose a third alternative as recommended by Dr. Greger. But first, note that fish oil has a lot of known problems and very little known benefits:
              http://nutritionfacts.org/video/omega-3s-prostate-cancer-and-atrial-fibrillation/
              http://nutritionfacts.org/video/is-fish-oil-just-snake-oil/
              http://nutritionfacts.org/video/is-distilled-fish-oil-toxin-free/

              The question is whether fish oil’s benefits out weigh the risks. But remember that fish do not make omega 3s. Fish get the omega 3s from eating sea plants. You can skip the contaminated, dangerous middle man (fish) and take an algae-based omega 3 instead if you feel that taking such a supplement is beneficial.
              http://nutritionfacts.org/topics/fish-oil/




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              1. Thank you Thea for your thought-provoking, focused, and clear responses. I’ve made up my mind and will eliminate all oils except for those still present in the very few supplements that I am taking given that I have no diagnosed heart disease. I presume from your comments that taking the algae-based Omega 3 DHA will support my continued use of ground flaxseeds (which I do myself and immediately put them into a freshly-made vegetable juice) to support my need for long-chain omega 3’s. Is that right?
                Thank you for your generous responses!




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                1. Yes! Algae-based omega 3 supplements go hand-in-hand with continued use of ground flaxseeds. And given the many, many benefits of ground flaxseeds, it’s great that you are getting those in your diet.
                  http://nutritionfacts.org/?s=flax
                  It sounds to me like your diet is becoming extremely healthy. May you live long and healthy!




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            2. Part 2: If I haven’t lost your interest, I have a few more thoughts for you regarding the other supplements you mentioned. While seeing the need for a few supplements for very well researched and defined reasons, I understand that in general NutrtionFacts has shown supplements to either be neutral or harmful to health.
              http://nutritionfacts.org/topics/supplements/ (page just updated!)

              That isn’t to say that your supplements would be harmful to you or not. I don’t know. But I can say that Dr. Greger makes note in his new book that under the right conditions, our own bodies can make CoQ10. (Hopefully there will be a free video on that soon.) And Dr. Greger has addressed prostate cancern and prostate health in numerous videos (plus a whole chapter on it in the new book).
              http://nutritionfacts.org/?s=prostate
              http://nutritionfacts.org/topics/prostate-health/
              I don’t know what pills you are taking for the prostate, but I’m thinking that the above information would be quite compelling and *might* make you re-think the need for any pills. (I don’t know your situation, so please don’t think I’m encouraging you one way or the other. I’m just trying to help you make an informed decision.)

              Having been a bit negative about supplements, I would be remiss if I did not mention that you definitely want to take a B12 supplement. That’s one thing that every single expert I know of agrees on. You can see Dr. Greger’s recommendations regarding B12 (and vitamin D and others) here:
              http://nutritionfacts.org/2011/09/12/dr-gregers-2011-optimum-nutrition-recommendations/
              These are old recommendations from 2011. The new book, How Not To Die, may tweak some of that information, but I think the main recommendations remain the same.

              Again, I hope this helps. :-)




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              1. Amazing info Thea! I just finishing watching 5 videos on the topics you mentioned. The more I listen to Dr. Gregor, the more positively astounded by the usefulness and strength of his discourses. In just a few days, I feel like I am FINALLY on the right path to good health. For example, after using about 35 different prostate supplements over the past ten years with no results, I have again come to the conclusion, that for me to keep doing the same thing over and over and expecting a different result IS lunacy (a paraphrased statement from Albert Einstein). So the information that you and Dr. Greger are providing is like a spring of clarity related to health. I especially liked a video on the topic of the best vegetables to prevent cancer; that video was extraordinarily helpful. (I am going to find a way to mask the smell of garlic and onions because, according to the video, those vegetables are the kings of prevention.)

                The supplements that I am taking are too long to list all of them. The ones that had the oils in them to bind the main ingredients were, as mentioned before, Coenzyme Q10, Vitamin E, Vitamin K2, and the prostate formulas. The prostate formulas contain pumpkin seed extract, another one includes Graminex Flower Pollen, and the last one includes the standard array of prostate ingredients such as saw palmetto, beta sitosterols, stinging nettle, pygeum extract,boron, and lycopene. None of them worked in the past, but I tried them again because I hadn’t heard of Dr. Greger when I decided to use them, and I had no other option at hand other than to use a prescription med called Hytrin. My other supplements include digestive enzymes, proteolytic enzymes in between meals, Beta 1-3 Glucan, probiotics, spirulina, chlorella, vitamin D3, curcumin extract, iodine, betaine HCL (for acid reflux), baking soda (for acid reflux), an antioxidant, berberine, Meeker Red Raspberry powder, chromium plus my multi-vitamin. But after reading your posts, I feel inspired to cut down on my supplements, but I need the confidence to let go of them knowing that the plant-based nutritional plan will indeed take care of dietary needs. I have indeed ordered a spray bottle of B12 and wish-listed the Omega 3 from algae. I am really excited about using the garlic and onions and the cruciferous vegetables, and have been grinding whole flax seeds and eating them 2-3 times a day in my juiced drinks. I feel better already just thinking about it, and as I learn more about the value of plant-based nutrition, I will probably find a way to reduce the number of supplements which my family says is “ridiculous.”

                Thank you for your patient determination to help. I wish you a Happy New Year.
                jhk




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                1. Joel: That’s so cool. I can feel your excitement in your post and totally understand it since I remember the same excitement when I first discovered NutritionFacts. The information here is very empowering.

                  Because the information is so exciting, I do have to often enough remind myself that it is easier to prevent a problem than to reverse one. And that Dr. Greger’s videos are mostly talking about how to reduce risks of getting a disease or increase the chances of reversing a disease. But managing risk is not the same thing as a magic bullet with guarantees. But the good news is that it is unlikely to hurt trying a healthy diet. The side effects are usually all good. And as an analogy: if I got lung cancer, I wouldn’t say, “Darn, I could have smoked.” I would know that I had done everything I could to prevent it. That’s all any of us can do. And diet works the same way.

                  I do encourage you to look through the daily videos as they interest you. FYI: New videos are posted every Monday, Wednesday and Friday. New blog posts are posted every Tuesday and Thursday. For many of us, checking in with NutritionFacts each morning is the best way to start the day.

                  Once a year, Dr. Greger does his annual summary review talk. These talks are not as detailed or cover all the topics as the daily videos, but they are very entertaining and a great way to get an overview. These talks are about 1 hour long, and well worth every minute. If you are interested, the summary videos can be found at the bottom of the first page. Here is the first one, though note that they are all good:
                  http://nutritionfacts.org/video/uprooting-the-leading-causes-of-death/




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  16. I began a plant based diet after I was diagnosed with Lupus and other autoimmune diseases. I make sure my children have a large variety of vegetables and fruits and both of them enjoy almond milk as much as if not more than cows milk. It is refreshing to see an upturn in recent months of local farmer’s markets selling their organic locally grown produce, and more people buying it! I hope this trend of people taking more responsibility for their own health as well as their family’s will continue. With autoimmune diseases on the rise we simply cannot keep ignoring the link between what we are feeding our bodies and our declining health.




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    1. Hi pdinges, I found it interesting that every time they named a nutrient that “might be lacking” in a vegan diet they then went on to name a whole list of plant based foods that contain that nutrient. So clearly if one is actually eating a healthy vegan diet they wouldn’t be lacking in any of the needed nutrients. As for how you could respond, you might write a letter/email to the station pointing out what I just pointed out, and recommending that next time instead of emphasizing what they say may be “lacking in a vegan diet” that they simply portray an appropriate example of a whole foods plant based diet and emphasize the many benefits such as more than adequate fiber, and the phytonutrient content that is lacking in the standard western diet but is so important in prevention of the most prevalent chronic diseases that kill the majority of today’s population.




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  17. Can’t thank you enough for being such a pioneer in exposing the truth! I’m sure you have gotten a lot of backlash from it!

    There are distinct categories of people fighting to keep the truth in the dark:

    -Those in the animal agriculture industry which is highly infiltrated in government and one of the biggest, multibillion dollar industries in the world. This includes both large scale as well as small, “family” “farmers.”

    -Those who are so threatened by the truth because it challenges something they’re desperate to hold onto (addiction to meat/dairy/eggs/etc., their sense of comfort or convenience, tradition, lack of responsibility, their entire belief system and perhaps how they’ve taught their children, etc.) that they will look facts, logic, reason, common sense and so on, in the face and deny it and even get angry at it. I’ve seen otherwise intelligent people refuse to read or acknowledge some of the best scientific literature and instead turn to a “10 reasons why you need to eat animals” type of blog.

    -Those that truly love murdering animals and anyone who knows or has dealt with “hunters” or watched a “hunting” video knows exactly what I’m talking about.

    -The “hunting” industry and all those that bank in on it such as the gun industry and even politics.

    -Big Pharma–I mean what would they do if people stopped needing their drugs to get out of bed each morning?

    Then of course, these things being such big money, no doubt there are a tremendous amount of investors who have a lot to lose as the truth is revealed.




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