The Tomato Effect

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.”

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• Esselstyn CB Jr. Resolving the Coronary Artery Disease Epidemic Through Plant-Based Nutrition. Prev Cardiol. 2001 Autumn;4(4):171-177.
• Goodwin JS, Goodwin JM. The tomato effect. Rejection of highly efficacious therapies. JAMA. 1984 May 11;251(18):2387-90.
• Bartholomew M. James Lind's Treatise of the Scurvy (1753). Postgrad Med J. 2002 Nov;78(925):695-6.
• Kong MH, Fonarow GC, Peterson ED, Curtis AB, Hernandez AF, Sanders GD, Thomas KL, Hayes DL, Al-Khatib SM. Systematic review of the incidence of sudden cardiac death in the United States. J Am Coll Cardiol. 2011 Feb 15;57(7):794-801.
• Martin W. The beriberi analogy to myocardial infarction. Med Hypotheses. 1983 Feb;10(2):185-98.
• McCarty MF. Vegan proteins may reduce risk of cancer, obesity, and cardiovascular disease by promoting increased glucagon activity. Med Hypotheses. 1999 Dec;53(6):459-85.

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

• aspirin
• cardiovascular disease
• dietary guidelines
• Dr. Caldwell Esselstyn
• Europe
• exercise
• gout
• heart disease
• industry influence
• lifespan
• longevity
• medical profession
• medications
• mortality
• nutrition myths
• Plant-Based Diets
• processed foods
• rice
• scurvy
• thiamine
• tomatoes
• vitamin B1
• vitamin C