Food Over Medicine (6 page)

Another cause of inflammation is obesity itself. We used to think that adipose cells and tissues were just sort of benign and didn’t do much; now we know that these cells are busy all day long pumping out substances like hormones and inflammatory cytokines. So the fat cells of overweight people are pumping out inflammatory chemicals all day long, leading to generalized inflammation. That’s why it’s so important to address the weight issue. Even a person eating a plant-based or vegan diet can be maintaining extra weight and is therefore still at high risk for lots of health issues.

GM:
How does CRP rank as a marker of heart disease compared with cholesterol and homocysteine?

PP:
They’re all good markers and they all should be low numbers. Cholesterol should be under 150 mg/dl, CRP should be 1.5 mg/L or lower, and homocysteine under 6 micro mol/L. So you want low numbers all the way around. But here’s the big problem: we’ve gotten to the place now where we focus on those numbers and don’t necessarily care how we get there. People go to the doctor and they’re diagnosed with high biomarkers. The doctor puts them on drugs to bring those numbers down without actually changing the health status of the individual. And what’s the result? A new phenomenon in this country, as Dr. McDougall points out: people dying of sudden heart attacks with great blood work.

GM:
The classic good news, bad news kind of thing.

PP:
It’s sad but true. Instead of curing the individual, we’re curing his biomarkers. Here’s an example to illustrate how terrible our system is. Tim Russert, NBC News’ political guru, died a few years ago. He had a great job, great insurance, and money. He went to the best doctors and had all the right tests done. He was diagnosed early, which is supposed to be a good thing, right? He was treated for all his problems: he took a drug for blood pressure, statin drugs, a drug to treat his pre-diabetic condition, and a daily aspirin. And he still died at fifty-eight of a heart attack because none of those drugs addressed what was wrong with him: the amount of unstable plaques throughout his arteries from the animal food and fat that he was eating. He trusted his doctors and they offered what Western medicine traditionally offers, which did him no good at all.

On the other hand, you get the critics of the Western pharmaceutical approach, the advocates of a more holistic approach to pharmacology, who say that Russert shouldn’t have been taking those drugs. Instead, they say he should have been taking high-dose cinnamon for his diabetes, hawthorn berry for his blood pressure, and high-dose niacin or red rice yeast extract for his cholesterol. And you know what? He’d still be a dead guy with great blood work because none of those things address what killed him. So, we’ve gotten very carried away with biomarkers. While we need to look at them, we also need to recognize that all methods to bring them down aren’t equal. The only thing that brings those numbers down in a way that matters is diet. The other things change your blood work, but don’t change your health outcome.

GM:
I remember when Tim Russert died; all his colleagues talked about what a great guy he was and how they loved going to the ball game with him and having hot dogs together. Of course, they didn’t seem aware of the irony that it was those very hot dogs that helped cause his death.

PP:
Right, and unfortunately, he just dropped dead. Other people survive a heart attack and end up going to the average dietician or cardiologist, who tell them to eat fish and lean meats and poultry. Their cholesterol keeps going up, so the doctors say, “Well, you know, it’s a genetic issue.” The doctors put them on a pharmaceutical drug because that’s really all they know to do.

If people really understood, in clear terms, what food did to them, they’d have a whole different attitude about it. I know when people come to my lectures, they leave with a whole different attitude. They don’t all change overnight, but they leave with a different attitude about the whole thing.

GM:
What’s their attitude about giving up the animal foods that they grew up eating and have been encouraged to eat all their lives?

PP:
Well, first of all, at The Wellness Forum, we don’t ask people to give up animal foods entirely. The Wellness Forum is not an explicitly or exclusively vegan program.

GM:
Okay. Why not?

PP:
Because I’ve yet to see the evidence that people who eat a low-fat, starch-centered, plant-based diet, while including up to three servings a week of animal foods, have worse health outcomes than people on a similar, but purely vegan, diet. There just is no such evidence. I believe, and my experience with The Wellness Forum confirms my belief, that we will help more people convert to a healthy diet if we espouse a more moderate message, if we don’t scare people away by insisting that they abstain from animal foods entirely.

Now when I say “moderate,” I’m not repeating the shibboleth that everything in moderation is okay, like cheeseburgers and ice cream sundaes; I’m saying that it’s not a dealbreaker to have two or three small servings—three to five ounces—per week of wild-caught salmon or organically raised beef. There’s no wiggle room on the diet; when we say two or three servings, that doesn’t mean four or five or six, and dairy is absolutely out. And it’s important that, if you choose to include two or three portions of animal foods per week, that they be from organically raised animals or wild-caught fish, which in almost all cases is going to mean that you’re going to have to prepare these meals at home.

Let’s not forget that we have this phenomenon of the unhealthy vegan. There are a lot of people who’ve renounced animal foods for ethical reasons. I respect their decision; that’s an admirable reason to give up animal foods. I have no quarrel with their reasoning, but many of these people are no healthier than their meat-eating counterparts. They’re living on veggie cheeses, fake meats, olive oil, margarine, potato chips, and French fries. You’ll be much better off from a health standpoint if you eat according to The Wellness Forum program, even if you choose to include two or three portions of organically raised meat per week, than if you eat a fat-laden, nutrient-poor vegan diet.

GM:
I’ll accept that yours may well be the most effective approach to getting people to convert to a healthy diet; I just won’t go so far as to actually endorse eating any animal foods, since I believe that the optimal intake of such foods is zero.

People make their dietary decisions based on lots of factors, including convenience, taste, and habit. And to the extent that for any or all of these reasons, people decide to continue to consume some animal products in accordance with The Wellness Forum guidelines, I have no issue with that. But for those who are making their dietary decisions strictly based on health concerns, here’s what I would say: there is no direct scientific evidence that small amounts of flesh foods in the diet will have a detrimental effect on your health or your longevity. Indeed, some of the longest-lived populations, like the Okinawans, eat fish. But since we know that all flesh foods, including fish, have no fiber, are high in fat and cholesterol, are high in sulfuric animal protein, contain no antioxidants, and have no carbohydrate for the fueling of our cells, we might want to deduce that if you consume a little of it, to the extent that it affects your health at all, it might be in a negative way. At least, that’s my reasoning.

PP:
Glen, you’ve made a personal choice. What you’re saying is, “It’s better for me to have no animal foods at all.” I’ve made the same choice. I just don’t want to say that’s the only choice available, or that one has to make that choice in order to achieve and maintain optimal health.

GM:
Do you come across people who say, “I can try this Wellness Forum diet, but only because I can still have my chicken or fish a couple of times a week”? And then a year or two later they go vegan?

PP:
Yes, lots of them. We call them the accidental vegans. We can almost tell in advance who they’re going to be. It’s an interesting thing; it’s the people who are most likely to draw the line in the sand and say, “I don’t want to be a vegan!” We tell them that we’re not asking them to be vegan. And then they make that decision on their own later on and announce it proudly. I’m an accidental vegan myself, by the way.

GM:
Are you?

PP:
Yeah. When I first converted to this diet, I still allowed myself to have fish a couple of times a month. I did that for a while and then more or less forgot about the fish. One day I woke up and said, “Huh, I don’t think I’ve had fish for six or seven months.” And then I thought, “Well, apparently I don’t miss it, so I don’t think I’m going to have it anymore.”

GM:
Let’s stipulate that people are drawn to the vegan diet not just for reasons of health but also out of concern for the treatment of animals and for the environment. Half of the United States right now is suffering a severe drought; the grazing of animals contributes to drought by reducing vegetation, from which water transpires.
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Animal agriculture has been determined by a United Nations report to be the world’s leading source of greenhouse gases,
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and it’s a leading cause of water pollution; in countless ways, it’s creating an environmental nightmare. But I think we can also agree that the animal agriculture industry would worry more about 30 or 40 or 50 percent of the population scaling back to just a couple of servings of meat per week than it would worry about 1 or 2 or 3 percent of the population going strictly vegan.

PP:
If half of the country ate animal food only a couple of times a week, and only organic animal food, the factory farms would be gone. You’d have some humane, small operations out there, but factory farming would not be remotely sustainable with such reduced demand. And if we could encourage millions of Americans to eat this way, the improvement in their health will encourage millions more, and a tipping point would be reached. And from that pool of enlightened people, there’s no telling how many accidental vegans might be created.

GM:
And we do know for a fact that when people eat this way, others are inspired to join the fold because the effects are dramatic.

PP:
Absolutely. People who have gone through The Wellness Forum program have improved the quality of their lives enormously, extended their lives, and brought new life into the world against the odds.

GM:
Against the odds?

PP:
Many of the members of The Wellness Forum have been women who were unable to conceive until they got on our program. We’ve had about a hundred babies delivered to women who hadn’t been able to conceive or who had had one or more miscarriages until they found us.

GM:
That’s something I didn’t know. This diet can help a woman conceive?

PP:
Absolutely. I say that for two reasons: a lot of anecdotal evidence that I’ve seen here at The Wellness Forum, and clinical studies that demonstrate that the proper diet can help a woman conceive.
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GM:
And bring more plant eaters into the world?

PP:
I certainly hope so.

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GM:
Pam, here’s my nearly all-inclusive list of the various causes of diseases: diet and lifestyle, the environment, genes, stress, psychological factors, and pathogens. Let’s review the many maladies plaguing our population and examine the cause for each. Let’s start with heart disease.

PP:
Definitely diet and lifestyle.

GM:
Does genetics play any role?

PP:
With very few people. I can say the same with regard to any condition that we would label chronic and degenerative. You have genetic predisposition, but those genes are switched on by diet and lifestyle choices. You’re going to have, in any practice setting, 2 to 3 percent of the population whose cholesterol levels, no matter how much they clean up their diet and lifestyle, won’t get down to ideal levels. Or perhaps they’re salt-sensitive and an adjustment in salt intake is needed to get their blood pressure down, and sometimes even that doesn’t work. We see a very tiny percentage of people who honestly have been dealt a bad hand. But the good news is that you can say to the new person coming in that the chances are outrageously high that your body is going to respond positively to this diet and lifestyle that we’re going to show you and that it’s well worth doing.

GM:
I’m someone with heart disease and hypercholesterolemia rampant in my family, and yet I lowered my cholesterol levels when I finally got the diet exactly right.

PP:
Yeah, most people have had it drilled into them that it’s familial; I tell them that there’s no question that you have genetic predisposition. As I think I’ve mentioned to you, women in my family have rheumatoid arthritis and they’re fat. I’m positive that it would not take me, at my age, but a year or two to eat my way into rheumatoid arthritis and obesity, if I choose to do so. But I’m not going to switch on those bad genes with my diet.

GM:
How about strokes?

PP:
Definitely diet and lifestyle. There are times when there is a structural abnormality that will cause somebody to develop a blood clot. That’s fairly rare; again, it’s diet and lifestyle that’s going to cause your risk of stroke to go up. Stroke is an outcome of atherosclerosis, just like heart disease.

GM:
High blood pressure?

PP:
Diet and lifestyle most of the time. The causes are similar to heart disease and stroke.

GM:
Cancer?

PP:
Diet and lifestyle, above all. Two lifestyle factors are significant: obviously, cigarettes profoundly increase the risk of many cancers, not just lung cancer, and alcohol increases the risk of many cancers, not just liver cancer. There’s a role that stress plays, but it may not be what people think. I don’t think stress causes cancer, just as I don’t think it causes heart disease. I think that stress often causes people to become even less diligent about taking care of themselves; that’s its role in disease-promotion. As your stress levels increase, you may exercise less, eat more junk food, or turn to alcohol, and that’s how you end up with cancer.

GM:
What about the environmental factor for cancer?

PP:
The environment is often responsible for cancer initiation, but not usually promotion; it’s diet that promotes the cancer. There
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some types of cancer, however, that are purely environmental. For example, I had a good friend die of lung cancer who never smoked. However, he owned a plastics factory. He used to spend a lot of time on the factory floor, of course, and this was at a time when environmental regulations were a lot more lax. That’s probably what caused his lung cancer. That would be a case of an environmental cause, but it’s an atypical case. And you also have to consider the degree of exposure. My friend’s exposure was massive and daily, as opposed to our exposure to chemical carcinogens and air pollution, which is not as massive as people might believe. I think that that’s a minor factor for most people.

There is an area where environment and diet overlap concerning carcinogens—pesticides and toxins in our food. The most important thing to know about toxins is that they are concentrated in the fatty tissues of animals and become more concentrated as you move up the food chain. Fish have levels of heavy metals, pesticides, and other toxins that are often off the charts. As a general rule, you’ll find far less pesticide exposure in plant foods and you can wash some of it off, or avoid it altogether if you eat plants grown organically. But even the Environmental Working Group, one of the most active in trying to change farming practices, states on its website that the benefits of eating fruits and vegetables far outweigh any exposure to pesticides in those foods.

GM:
Type 1 and type 2 diabetes?

PP:
Type 2 diabetes is definitely brought on by diet and lifestyle. For type 1 diabetes, there are a number of causes, but a major one is dairy products through the mechanism known as molecular mimicry.
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Some other causes can be viruses and infections, and genetics is definitely a factor as well. In other words, we know that not all children who consume cow’s milk develop juvenile diabetes, so there has to be some genetic predisposition that actually causes that to happen. Of course, we don’t know which kids are genetically susceptible, so when we feed almost every child in the country cow’s milk, some of them will get juvenile diabetes. The better option would be to never give cow’s milk to infants and toddlers.

GM:
So I take it you’re an advocate for breast-feeding.

PP:
I am. Dr. John McDougall says that if he were surgeon general, he would make formula available only by prescription. I’m not sure I’d go that far, but I do think we need to educate all moms-to-be that infants do best with breast milk, and there are many negative consequences of formula feeding, including compromised immunity and increased risk for many diseases, such as asthma
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and Crohn’s disease.
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GM:
If somebody has the genetic predisposition to type 1 and he never consumes dairy, might the gene still express itself?

PP:
It could, if exposed to the right virus or some types of infection.

GM:
What do we know about the cause of Alzheimer’s?

PP:
Alzheimer’s is a cardiovascular disease, very much related to diet and lifestyle.
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GM:
Now that’s not generally accepted wisdom, is it?

PP:
No, it’s not. I think the general wisdom about the etiology of most diseases comes down to genes, bad luck, and we don’t know.

GM:
Most mainstream doctors would concede that diet and lifestyle play a major role in heart disease, but they wouldn’t say that about Alzheimer’s.

PP:
True. But their own medical journals, if they would take the time to read them, have shown that taking statin drugs can improve symptoms in early-stage Alzheimer’s patients.
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That tells me that there’s a connection. The other thing is that the brain is the biggest user of glucose, oxygen, and water, so it only makes sense that if you narrow blood vessels to the brain, you’re going to impair its supply of those essential substances.

GM:
What about the fact that with Alzheimer’s, there’s an amyloid plaque that forms that resembles the plaque found in people who have Creutzfeldt-Jakob disease (CJD), the human form of mad cow disease?

PP:
Yes, and there’s a theory, which Howard Lyman has talked about, that some people being diagnosed with Alzheimer’s actually have CJD.
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Alzheimer’s is rarely present in plant-eating populations; it’s a disease of the Western diet. It’s a vascular disease that is most prevalent in the populations, like ours, that eat the most meat.
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GM:
What’s the cause of osteoporosis?

PP:
Well, first of all, osteoporosis is a mythical disease much of the time.

GM:
It’s mythical?

PP:
To the extent that it actually exists, it’s principally a diet and lifestyle disease, or it’s drug-induced. For example, taking steroids can cause osteoporosis. Another thing that happens is people with celiac disease and gastrointestinal disorders often have osteoporosis because they are not absorbing nutrients from foods, including calcium and other nutrients, needed to build bones. But the vast majority of the time, the diagnosis of osteoporosis is fictitious.

GM:
Well, could you explain that? We have millions of Americans believing they have osteoporosis and taking drugs for it. Have they imagined it? What’s going on?

PP:
No, they haven’t imagined it; their doctors have helped them arrive at this conclusion. Years and years ago, osteoporosis would be diagnosed if somebody would have a fracture or broken bone for no apparent reason; maybe they wouldn’t even know they had a fracture—they would just experience pain. Some type of X-ray or imaging would show that the cause of the pain was a fracture. Without the evidence of any impact or memory of falling down or anything else, they would consider a diagnosis of osteoporosis. They used to put you on this scanning device that was very expensive and very large. They would do a whole-body scan that would show porous bones in the skeleton and would give you a firm diagnosis. You actually saw bones that would be porous and poorly formed.

This changed after Merck developed a terrible drug called Fosamax to treat osteoporosis. It doesn’t really work and has been linked to all kinds of side effects, including fractures to the thighbone
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—the very sort of thing you’d think it would help prevent—and osteonecrosis (bone death) of the jaw.
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But in the beginning, the problem was that there weren’t enough people being diagnosed with osteoporosis. So Merck hired a marketing expert to change that. A conference was convened in Rome in 1992, sponsored by drug companies, during which medical experts, if you want to call them that, got together and redefined the diagnostic criteria for osteoporosis. It would henceforth be the loss of bone mineral density that would be the diagnostic criteria.
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The problem with that is that all people lose bone mineral density as they age, particularly women. Women have very strong skeletons because they need strong bones for childbearing; when we’re past our childbearing years, we lose bone density. I’m not planning on carrying any more children, so my bones don’t have to be as strong as they were when I was twenty-eight. Merck succeeded in developing diagnostic criteria that would eventually include everybody. In a process called disease-mongering, the definition of a disease is expanded so that more and more people will qualify and get treatment. The other thing that happened at this meeting was that they picked an arbitrary amount of bone mineral density loss that was not based on any science. The question came up: What about people on the other side of the arbitrary line who aren’t yet qualified for osteoporosis but are getting close? So they made up the mythical disease called osteopenia. Merck, being the ever-accommodating company, actually developed a lower dose of Fosamax to treat those people who had the mythical condition that was considered a precursor to the even worse mythical condition.

GM:
So osteopenia is simply less loss of bone mineral density than osteoporosis?

PP:
Yes. Osteopenia is a stepping-stone. You’re told, once you’re diagnosed with this mythical disease, that if you don’t do something about it, you’re going to progress to the next level of mythical disease.

GM:
So there are no symptoms? Osteopenia is merely a way station, like purgatory?

PP:
Except that I think there’s probably more scientific proof of purgatory.

GM:
But don’t we live in a nation of elderly people falling down and fracturing themselves? Is that just natural or is something wrong?

PP:
Well, first of all, let me make what sounds like an obvious, asinine statement: the number-one cause of fractures is falling. But why do people fall? They fall because they’re frail, on drugs, or have poor balance and coordination. People who haven’t exercised become frail. My mother hasn’t exercised since 1956, so it’s not surprising that she’s terribly frail. Of course, we’re further frightened by the idea that once these falls happen and bones are broken, these people often become bedridden and then die; we’re told it’s the hip fracture that killed them. Well, it isn’t the fracture that killed them; it’s the poor health and the drugs they were taking that caused the fall in the first place. They’re fracturing bones because of the trajectory of the fall in many instances. I’m not saying that nobody has osteoporosis; we see people in here who have it, but I’m saying the vast majority of people who think they have it, don’t. These Dexa scans to determine bone density are very unreliable.
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Many, many health agencies in other countries have said that there’s no relationship between bone mineral density and fracture risk and that the Dexa scan tells us nothing.