Disease Proof : Disease Proof : Health & Nutrition News & Commentary : Dr. Joel Fuhrman

Reuters London reports that new studies conclude a quantitative relationship between consumption of fruits and vegetables and reducing risk of stroke. Professor Graham MacGregor of St George's medical school at the University of London commented on the studies:

For the first time we have shown a quantitative relationship between fruit and vegetable consumption and stroke.

It has been known that fruit and vegetables seem to reduce stroke but it wasn't known how much they did it by.

It is a very important finding because it really shows that the quantity of fruit and vegetables you should be eating is more than five a day.

In this excerpt from his book Eat to Live Dr. Fuhrman talks about healthfully getting stroke preventing monounsaturated fats and essential fats from plants:

There is no longer any question about the importance of fruits and vegetables in our diet. The greater quantity and assortment of fruits and vegetables consumed, the lower the incidence of heart attacks, strokes, and cancer.1

The best fats are monounsaturated fats and essential fats (omega-3 and omega-6) present in whole, natural plant foods, including avocados, olives, and raw nuts and seeds. Studies continue to show that consumption of raw nuts protect against both heart attack and stroke, without the risks of increasing heart disease and cancer, as is the case with the high consumption of animal-origin fats.2 When the fats you consume are from whole food, rather than oil, you gain nature's protective package: a balance of vitamins, minerals, fibers, and phytonutrients.

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The buildup of plaque in arteries is a leading killer in America. And it is widely believed that there is little to nothing that can be done to reduce the plaque once it is there.

In his book Eat to Live, Dr. Fuhrman explains that research and first-hand experience show heart disease is reversible:

Two things are necessary to predictably reverse heart disease: one is to become thin and superbly nourished, and the other is to get your LDL below 100. Reversal of heart disease then occurs.

In studies, patients eating certain kinds of diets have demonstrated modest reduction in plaque (more on that below). Dr. Fuhrman has found that with the aggressive diet he advocates, greater reductions in plaque are common. "My patients demonstrate much more dramatic cholesterol lowering since the advised dietary program is based on nutrient density," he explains, "and reversals from 20 to 40 percent per year are typical in my experience. I even have a patient who reversed his carotid blockage from 80 percent to undetectable in one year on carotid ultrasound."

Dr. Fuhrman's book Cholesterol Protecion for Life covers a lot of this in depth. An updated and expanded version of that book will be out soon, and here is an excerpt:

Studies preformed by Dean Ornish and other investigators have documented the effects of a low-fat vegetarian (vegan) diet on patients with heart disease and found reversal of the condition occurred in the majority of patients. The reversal was modest, but nevertheless, no study previously showed diet could be so effective at preventing and reversing heart disease.

Caldwell Esselstyn, Jr., M.D. of the Cleveland Clinic put together a program utilizing a vegetarian plant-based diet with the addition of cholesterol-lowering medication in 18 patients who had severe angiographically demonstrated coronary artery disease. All of these high-risk patients with advanced heart disease were noted to have no coronary events during the following 12 years, and on repeat angiogram, 70% were found to have regression of their disease and none had progression.1 When you consider these 18 patients had experienced 50 coronary events during the 8 years before this study, you have to agree on the effectiveness of combining plant-based nutrition with cholesterol lowering.

Dr. Esselstyn tracked these patients for 17 years, which is the longest ongoing research project of this kind, and not one of these people, who years ago had severe heart disease, has had any further cardiac complaints or heart attacks.

Dr. Esselstyn also tracked the long-term results in six of his patients that did not want to adhere to the diet and returned to the standard care of their cardiologists. They experienced 13 new cardiac events during the first 12 years.

Although Ornish and Esseltyn studied vegetarian diets, Dr. Fuhrman has found that when reversing heart disease is the goal, eliminating meat is hardly the only important step. The diet Dr. Fuhrman recommends in Cholesterol Protection for Life is more specific, and more aggressively heart-healthy. (In addition, Dr. Fuhrman's book advocates natural supplements--including delta tocotrienol, plant sterols, policosanol, and pomegranate extracts that can be helpful. On DrFuhrman.com you can read all about the supplements he recommends, complete with 16 references to articles in respected journals.)

High nutrient density makes a measurable difference. From an article on DrFuhrman.com:

Dr. Fuhrman's Eat To Live approach is the only dietary plan that has ever been shown in medical studies to lower cholesterol more effectively than cholesterol lowering medications. Other dietary programs, such as the Atkins diet plan, have been relatively ineffective at lowering cholesterol. Though the low-fat vegetarian diet did lower LDL cholesterol 16%, it raised triglycerides 18.7% and the LDL/HDL ratio remained unchanged, reflecting minimal overall improvement. The Eat To Live approach differed in that the LDL cholesterol was more significantly lowered without unfavorable impact on HDL or triglycerides, reflecting sizable improvement in cardiac risk factors.

LDL Cholesterol Lowering Results

Method	% Decrease in LDL Cholesterol
American Heart Association Standard Low-Fat Advice	6%
High Protein Atkins' Type	No significant change
Low-Fat Vegetarian	16%
High Olive Oil Mediterranean	No significant change
Cholesterol Lowering Medication Statins	26%
Eat to Live - Fuhrman Type, Lower Cholesterol without Drugs	33%

For those desiring more than mediocrity, for true protection against heart disease and premature death, there is a clear-cut answer—Eat To Live. The most effective—and safest—way to lower your LDL cholesterol level is through this approach that could save your life.2

In a meeting the other day, Dr. Fuhrman said something that I found amazing: to his knowledge, no one in his care, following his recommended diet, has ever had a heart attack. (Of course, he has no way of knowing about the people who have left his care.) 15 years of practicing medicine. How many doctors can say that?

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Jeff Minerd of MedPageToday writes about a study from the Jan. 17 issue of the Canadian Medical Association Journal that examined diabetic drugs Daibinese (chlorpropamine) and Orinase (tulbutomide).

Patients were placed into three groups. There were 120 who received a first-generation sulfonylurea, either Daibinese (chlorpropamine) or Orinase. A second group included 4,138 who received Diabeta (glyburide), and the third group included 1,537 who received the non-sulfonylurea drug metformin, which improves insulin sensitivity.

Each of these groups was further divided into a high-dose or low-dose group, with the median daily dose serving as the dividing line.

Participants were followed until death or termination of Saskatchewan Health coverage. Average follow up was about five years. The main outcomes were all-cause mortality and death from an acute ischemic event.

There were 1,503 deaths during the study period, of which 372 (about 25%) were attributable to an acute ischemic event. First-generation sulfonylurea users had the highest mortality (67.6 deaths per 1,000 person-years), compared with Diabeta users (61.4 deaths per 1,000 person-years) and metformin users (39.6 deaths per 1,000 person-years).

Compared with the low-dose patients, a greater risk of death was found in the high-dose patients receiving first-generation sulfonylureas (adjusted hazard ratio=2.1; 95% confidence interval=1.0-4.7) and Diabeta (HR=1.3; 95% CI= 1.2-1.4), but not metformin (HR=0.8; 95% CI=0.7-1.1).

The study also found an increased risk of death from ischemic event in the high-dose patients receiving first-generation sulfonylureas, though it was not statistically significant (HR=1.21; 95% CI=0.10-3.75). A significant association was found for Diabeta (HR=1.37; 95% CI=1.25-1.50). A slight and non-significant association was found for metformin (HR=1.10; 95% CI=0.75-1.30).

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The next issue of the Journal of the American College of Cardiology will include research comparing 25 members of the Calorie Restriction Society (aged 41 to 64)--who consume 1,400 to 2,000 nutrient-rich calories per day--with the same number of people who eat a typical Western diet of 2,000 to 3,000 calories per day.

They found that those on the restricted diet had significantly healthier hearts. Jim Salter describes it this way in an Associated Press article about the study:

"This is the first study to demonstrate that long-term calorie restriction with optimal nutrition has cardiac-specific effects that (delay or reverse) age-associated declines in heart function," said Luigi Fontana, lead author and assistant professor of medicine at Washington University in St. Louis.

The study will be published Tuesday in the Journal of the American College of Cardiology.

Fontana said simply consuming less food is not the answer. Members of the study group eat food resembling a traditional Mediterranean diet, focusing on vegetables, olive oil, beans, whole grains, fish and fruit. They avoid refined and processed foods, soft drinks, desserts, white bread and other sources of "empty" calories.

For the general public, the researchers recommend a moderate reduction in calories, combined with moderate, regular exercise.

Research on mice and rats indicated that life span can be stretched by about 30 percent with stringent and consistent caloric restriction. That research also suggested that restricting calories can help prevent cancer.

Heart attacks and strokes cause about 40 percent of deaths in Western countries, researchers said. Cancer causes another 30 percent. Fontana said those deaths are attributable to "secondary aging" from high cholesterol, diabetes, high blood pressure and other often-preventable conditions.

While it has long been known that a healthy diet and exercise can reduce risks, the study suggests that caloric restriction combined with optimal nutrition can do even more.

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The following is an excerpt from the upcoming, newly revised version of Dr. Fuhrman's book Cholesterol Protection for Life.

Is a vegetarian diet healthier than a diet that contains a small amount of animal products?

We do not know for sure. The preponderance of evidence suggests that either a near-vegetarian diet or a vegetarian diet is the best, especially for patients with heart disease. In the massive China-Oxford-Cornell Project, reduction in heart disease and cancer rates continued to be observed as participants reduced their animal-food consumption all the way down to 1.7 small servings per week. Under this level, there is not enough data available.

Some smaller studies suggest that a small amount of fish added to a vegetarian diet adds benefit, which is the result of the documented benefits from the increased DHA-fat from fish. This benefit can be achieved and heart reversal maximized on a strict vegetarian diet by including flaxseeds and nuts that contain omega-3 such as walnuts and the addition of a DHA supplement. Whether you are a strict vegetarian or not, your diet still must be plant-predominant to achieve protection against both heart disease and cancer.

Certainly, more than a few small servings per week of animal foods (even if low in saturated fat) starts to increase cholesterol significantly and, in population studies, we observe an increasing incidence of heart attacks in susceptible individuals.

Most of my heart patients choose to follow a strict vegetarian diet. They do not want to chance putting even a little bit of gasoline on the fire. By taking a supplement of DHA fat, and utilizing a vegetarian diet, we see a dramatic end to their chest pains (angina), increased exercise tolerance, and most often, a reversal of their heart problems forever.

It is important to note that a vegetarian or vegan diet is deficient in meeting the nutrient needs of most individuals for vitamin B12; supplementation is essential. Some unique individuals with a genetic need for higher amounts of non-essential amino acids may feel healthier with a very small amount of animal products added to their diet, but this increased requirement that is rarely observed can also be met with a nutritional supplement that supplies the required need, such as extra carnitine and taurine.

It is also important to make sure Vitamin D intake is adequate in those not getting sufficient sunshine to meet their Vitamin D needs. Deficiency of Vitamin D is epidemic in America and this deficiency does not merely contribute to the development of osteoporosis, but to cancer and heart disease as well.

The supplementation plan in this book complements a healthy vegan diet to assure nutritional completeness and to maximize results. This recommended diet plan is rich in calcium and iron from green vegetables, contains adequate protein, and is otherwise extremely nutrient dense.

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I know you were told that if your blood pressure is below 140/90, it is normal. Unfortunately, this is not true, either. It is average - not normal. This number is used because it is the midpoint of adult Americans older than sixty. The risk for strokes and heart attacks starts climbing at 115/70.

In societies where we do not see high rates of heart disease and strokes, we don't see blood pressure increase with age. In rural China the healthy elderly had the same low blood pressure readings as they did when they were kids. Almost all Americans have blood pressure that is unhealthfully high. At a minimum, we should consider blood pressure higher than 125/80 abnormal.

Numerous scientific investigations have shown that the following interventions have some degree of effectiveness in lowering blood pressure.1

• Weight loss
• Sodium restriction
• Increased potassium intake
• Increased calcium and magnesium intake
• Alcohol restriction
• Caffeine restriction
• Increased fiber intake
• Increased consumption of fruits and vegetables
• Increased physical activity or exercise

Studies have shown controlling sodium intake and weight loss to be effective in reducing blood pressure, even in the elderly.2 How can you implement these interventions into your lifestyle? It's simple. Eat many more fruits, vegetables, and legumes; eat less of everything else; and engage in a moderate amount of exercise. High blood pressure is relatively simple to control.

I encourage my patients to do what it takes to normalize their blood pressure so they do not require medication. Prescribing medications for high blood pressure has the effect of a permission slip. Medication has a minimal effect in reducing heart attack occurrence in patients with high blood pressure because it does not remove the underlying problem (atherosclerosis), it just treats the symptom. Patients given medication now falsely believe they are protected, and they continue to follow the same disease-causing lifestyle that caused the problem to begin with, until the inevitable occurs -- their first heart attack or stroke. Maybe, if high blood pressure medications were never invented, doctors would have been forced to teach healthful living and nutritional disease causation to their patients. It is possible that many more lives could have been saved.

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Expanding waistlines prompted Europe's health chief to issue a public invitation for suggestions to help tackle obesity, especially among children.

A European Commission survey acknowledges this bulging problem:

Obesity levels are increasing at an alarming rate, with up to 27% of men and 38% of women now considered to be obese in some parts of the European Union (EU). The number of overweight children is also growing rapidly, currently rising by 400,000 a year. Obesity is a risk factor for many serious illnesses including heart disease, type-2 diabetes, hypertension, stroke, and certain types of cancer. Poor nutrition and insufficient exercise are among the leading causes of avoidable death in Europe, and obesity related illnesses are estimated to account for as much as 7% of total healthcare costs in the EU.

Reuters reports that the problem of tackling obesity widens in Mediterranean or southern Europe:

The problem is worst in southern countries, as traditionally healthy Mediterranean diets give way to processed foods rich in fat, sugar and salt--although Poland and Britain have also seen steep rises in child obesity in recent years.

Spain, Portugal and Italy report obesity levels above 30 percent in children aged between 7 and 11, the Commission says.

Dr. Fuhrman's book Eat to Live offers insight on the devolution of the Mediterranean Diet:

In the 1950s people living in the Mediterranean, especially on the island of Crete, were lean and virtually free of heart disease. Yet over 40 percent of their caloric intake come from fat, primarily olive oil. If we look at the diet they consumed back then, we note that Cretans ate mostly fruits, vegetables, beans and some fish. Saturated fat was less than 6 percent of their total fat intake. True, they ate lots of olive oil, but the rest of their diet was exceptionally healthy. They also worked hard in the fields, walking about nine miles a day, often pushing a plow or working other manual farm equipment.

Today the people of Crete are fat, just like us. They're still eating alot of olive oil, but their consumption of fruits, vegetables, and beans is down. Meat, cheese, and fish are their new staples, and their physical activity level has plummeted. Today, heart disease has skyrocketed and more than half the population of both adults and children in Crete is overweight.1

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