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

This post is part of an on-going review of the recommendations of celebrity doctor Joseph Mercola, D.O. For an overview, see Monday's post.

As I have explained over the last few days, see The Meat and Butter Diet. I believe Dr. Mercola is aggressive beyond reason in recommending meat as a health food.

There is, however, some reasonable evidence in the scientific literature to support the idea that people should include some animal products in their diet. There are primarily three weaknesses of a vegan diet, they are:

• Plant foods do not contain B12 (all vegans should take B12).
• Some people have a need for more taurine, and may not get optimal amounts with a vegan diet. (Some vegans need to take a taurine supplement, or they could get a blood test to assure adequacy).
• Some vegans may not produce ideal levels of DHA fat (from the conversion of short-chain omega-3 fats) found in such foods as flax and walnuts, if they don't eat fish. I advocate that vegans and people who do not eat fish should supplement with DHA or get a blood test to assure adequacy.

Obviously, these three areas of potential deficiency on a vegan diet are easily remedied by taking a few supplements. There are loads of advantages of a vegetarian diet however that also should be considered, but that is not the topic of this article. And clearly a poorly designed vegetarian diet or one that is not supplemented properly with B12, Vitamin D (the sunshine vitamin), can be dangerous for one's health, but that still cannot be used as an argument to justify dietary recommendations with lots of high saturated fat animal products.

Meat in a Vegetable-Based Diet
Ignoring the ethical and environmental benefits to a vegan diet, which undoubtedly are substantial; claiming that a vegan diet-style is healthier and will make one live longer than a diet-style that contains even a small amount of animal products is not an argument that can be made with good scientific integrity.

We have substantial evidence from not only the China Study, but thousands of other studies to conclude that animal products when consumed in even moderate amounts such as 20 ounces a week can contribute to the development of chronic disease and are not health promoting. Many of these studies are referenced in my book Eat To Live and some can be reviewed elsewhere on this blog. However, these studies and the China Study cannot be used to validate the necessity of a strict vegan diet for optimal health as vegan populations were not studied in this enormous project. The lowest ranges of animal products consumed in the China Study were in the range of 1.7 servings per week or about 10 ounces per week.

Below that level of animal product consumption supplementation with B12 become critical for populations. If there were studies with large populations on vegan diets, a J-shaped* curve would likely be experienced, showing that as diets get lower than one serving of animal products per week, later life morbidity and mortality would start to be increased. The reason for this is that strict vegans who don't take supplements will likely develop B12 deficiencies (rural villagers do not take supplements) leading to life shortening events, lessening the reduction in heart attack or cancer deaths achieved by the reduction of animal foods.

Besides B12, there are also nutritional advantages to a small amount of animal products for some individuals, as there are individual differences in the production of non-essential amino acids, and reduction in the absorption and metabolism of essential amino acids that makes the ingestion of additional amino acids beneficial for some individuals, such as those with digestive impairments. For others, the addition of pre-formed DHA from fish or fish oil may be beneficial because the enzymes converting short-chain omega 3 fatty acids (obtained from plant) to these longer chain fats (what is already present in fish) may not be as efficient in some individuals. It also may be possible that some people have heightened needs for DHA, taurine or other protein components as they age and digestion and conversion is decreased. I have counseled thousands of individuals on vegan and near vegan diets over the last 15 years and have found these recurring issues when investigating patients with health problems and health concerns after doing extensive evaluations to discern a cause of their complaints.

A Research-Based Approach
It is too frequent that writers on both sides, the vegan proponents and those advocating inclusion of substantial amounts of animal products as health supporting, have pre-formed biases and try to defend their views, rather than evaluating all the evidence with logic and clarity. Nevertheless, the reality is that for the majority of individuals, allowing under 10 - 12 ounces of animal products per week does not appear to have disease risks as long as the animal products are low in saturated fat and not contaminated with parasites or toxic pollutants. Certainly, I have no desire to promote the consumption of animal products, and I am always willing to modify my recommendations if more science suggests that this guideline is not accurate in any way. However, we have to go with whatever data we have available today, and I suggest that for those who want to include animal products in their diet, we cannot with good science insist that this small amount is cancer or heart disease promoting.

I argue that either way of eating (vegan or non-vegan) can be made health-supporting (and should be supplemented appropriately to assure nutritional adequacy) and that debating which is better is not a valuable exercise. Therefore, I advocate a plant-based (vegetable-based) diet that is either vegan or one that is near vegan with a small amount of animal products, and my food pyramid designed for public guidance contains two to three servings of animal products permitted per week, assuming that the total ounces per week is under the 10 - 12 ounces range. Beef and cheese are too high in saturated fat and should not be considered health-supporting foods to be utilized on a regular basis in one's diet. Plus those animal foods rich in fat are much higher in environmental pollutants.

FISH: Not the Easy Answer
Even though some fish in the diet has been shown to be beneficial at reducing heart disease risk, presumably because of those beneficial fish oils, and there are studies that indicate some fish in the diet is longevity promoting.1 I still do not recommend people eat much fish. We do not need to eat fish to get those benefits from fish oil, we can take a supplement for that and there is too much good evidence linking fish consumption with higher rates of breast cancer, plus the pollutants in fish are of a major concern. Whether it is the pollution in fish or the cancer promoting effect from the high level of animal protein, eating fish is linked to a higher rate of breast cancer. When 23,963 women were followed as part of the Diet, Cancer and Health study, what stood out most was the link between fish consumption and breast cancer. The conclusion of the researchers was, "this study showed that higher intake of fish was significantly associated with higher incidence rates of breast cancer."2 Surprisingly, women consuming little or no fish were found to have approximately half the incidence of breast cancer compared to high consumers of fish. This study should not be ignored. It received scant media attention. Frequent fish consumption has also been linked to increased occurrence of thyroid cancer.3

If fish are consumed on a regular basis it should be a maximum of once per week and it should be of the cleanest variety, not those in the highest range of mercury or other pollutant contamination. That limits the choice in most cities in the continental US to ocean perch, shrimp, haddock, scallops, talapia, hake and trout, eliminating swordfish, pike, mackerel, shark, lobster, tilefish, grouper, sea bass, marlin, snapper and halibut as simply too high in mercury and bluefish, herring, clams, crab and oysters as simply too polluted. Most other fish are in-between these two categories.

EGGS, WHITE MEAT FOWL, FAT FREE DAIRY: Guidelines
Therefore, I do not recommend the eating of fish more than a few times a month, and I would much rather people who eat some animal products utilize eggs, (especially those high omega-3 eggs) and white meat fowl, such as turkey, chicken or fat-free dairy.

To conclude, if you want to eat animal products on a regular basis, limit the consumption to one or two servings of two eggs or egg whites, or one serving of eggs and one serving of white meat turkey a week, or one serving of eggs and one serving of low-fat dairy and one serving of white meat or an occasional fish. Do not eat fish for the supposed health benefits of fish. It is not advisable to consume enough fish to get enough omega-3 fats for your heart health. (It is much more reasonable to just take a daily amount of DHA to assure nutritional excellence and adequacy, such as my DHA Purity, which is algae-derived DHA and refrigerated to maintain freshness.)

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This post is part of an on-going review of the recommendations of celebrity doctor Joseph Mercola, D.O. For an overview, check out Monday's post.

As I was going through Dr. Mercola's website, I found that he attacks the Physician's Committee for Responsible Medicine. That group, he claims, "horribly distorted the facts behind the death of Dr. Robert Atkins, one of Dr. Mercola's mentors."

I happen to know something about this, and am compelled to add my thoughts.

It is Dr. Mercola who is distorting the facts. Before Dr. Atkins was hospitalized near the end of his life, he weighed about 200 pounds. Atkins' medical record showed he had atherosclerosis, coronary artery disease, had suffered from a previous heart attack, and had high blood pressure. However, many would have you believe he was merely a healthy guy who died after slipping on a patch of ice.

Of interest is that one of my patients, who had severe coronary artery disease which he developed on the Atkins diet, who now has reversed his heart condition under my care, was friends with Dr. Atkins and they used the same cardiologist. This successful man had no motive to make up this story. He told me that after Atkins died his cardiologist (who was Dr. Atkins' doctor too) mentioned to him that Atkins had a heart attack, that is why he fell--he did not slip.

Dr. Atkins' wife quickly switched cardiologists to find one who would aid in the cover-up. The only point to be made here is these guys advocating a high meat diet are unfortunately hurting themselves too, not just their followers, but it is a shame that people have to suffer and even die needlessly from the advice of these high-meat advocates.

UPDATE: TheSmokingGun.com has a wealth of information regarding the death of Dr. Atkins, including a leaked copy of his actual death certificate. The autopsy report medical examiner's report shows a 77 year old white male with a medical history of myocardial infarction, congestive heart failure, and hypertension. The hand writing reads of these three conditions. Also check out Snopes.com for more information.

Tomorrow we will examine healthy ways to integrate meat into your diet.

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This post is part of an on-going review of the recommendations of celebrity doctor Joseph Mercola, M.D. D.O. For an overview, see Monday's post.

Keep in mind, I am not arguing that a vegan diet is healthier or will lead to a longer life compared to someone who eats a small amount of animal products, such as a little fish or eggs in their diet. But I am arguing that as the amount of animal products increases in a diet-style forcing natural plant foods off the plate to become a smaller percentage of total caloric intake, the modern diseases that kill over 80 percent of Americans (heart disease, stroke, cancer, diabetes) will occur in greater and greater likelihood in every genetic type. My review of over 60,000 articles in the scientific literature supports the conclusion that animal products if consumed should be held to a maximum of ten percent of total caloric intake, reduced from 40 percent in America today and certainly significantly reduced from 60 percent on the Zone and South Beach diets and 80 percent of total caloric intake on the Atkins type diets, and somewhere in between these level on Dr. Mercola's high protein type diet. Dr. Mercola's recommendation are somewhat similar to the Weston Price Foundation, another group that advocates a diet rich in meats based on distorted science and old scientific views that have been disproven by the preponderance of the evidence. The difference is that the Weston Price Foundation does not use a questionnaire to determine if you are the type that deserves a diet rich in high saturated fat animal products, they just teach that everybody is healthier eating a diet chock full of animal products.

Dr. Mercola and the Weston Price Foundation flood the internet with their saturated fat is good for you message. They produce articles with supposedly scientific references that either quote the same bunch of people (each other), ignore a ton of modern reputable research, or distort what was said in the study, claiming saturated fat is okay and not related to heart disease. They all use the same distorted logic that it is the consumption of trans fats that are responsible for heart attacks, not saturated fats. They didn't inform the reader that the reason trans fats are bad is because they have been processed to saturate their carbon bonds so they behave in the body as saturated fats. Because trans fats are bad or worse, does not make saturated fats good. It is similar to the twisted logic of the Weston Price crowd who present the work of this dentist who traveled around the world showing that populations who did not eat processed foods had good teeth, to argue that because some of these cultures ate lots of animal products that must mean diets rich in animal products are good. Because processed foods, sugar, corn syrup and white flour are bad, does not make a diet high in animal products lifespan promoting. Weston Price used some very short-lived people as examples of good health, just because their teeth looked good. Fortunately, we know more today than we did in the early 1900's. We know which foods contain the full spectrum of nutrients that resist aging and we know that the diseases that afflict modern civilization are not the consequence of aging; they are the consequence of nutritional ignorance. And we also know that saturated fat raises cholesterol and is an important cause of heart disease, but not the only cause. Too bad so much nutritional ignorance is promoted on the internet, in books and in the media, it only leads to more people being confused.

Quoting Dr. Mercola's website:

Some of you might be watching your weight and be rather hesitant to add butter into your diet. Have no fear. About 15% of the fatty acids in butter are of the short and medium chain variety which are NOT stored as fat in the body, but are used by the vital organs for energy.

Once you get into these high zones of animal product intake there is no genetic type that is not going to have their health damaged by such a high consumption of animal products. There is an overwhelming amount of evidence in the scientific literature to support this (about 1500 references alone in my book, Eat To Live), but that is just the tip of the iceberg. Dr. Mercola's comments on the studies linking meat to colon cancer is to protect yourself with high quality grass-fed beef or high quality butter. I remember once a patient told me that they can't get lung cancer because they use high quality tobacco, farmed without pesticides, that's a good one!

People who are fixated to their rigid views, especially addicts will look to rationalize their behavior even if the excuse can't withstand scientific scrutiny. Dr. Mercola has to overlooks all the data that shows that it is not merely the barbequing of meat, processed or commercial meats that are linked to heart attack and cancer it is other important features that are also present in grass-feed beef.

Let's review a few of these scientific studies on colon cancer to illustrate:

Chao A. Thun JT. Connell CJ. Et al. Meat Consumption and Risk of Colorectal Cancer JAMA. 2005;293:172-182.
This study concludes that examining meat consumption over many years prior to the diagnosis of cancer illustrates that prolonged high consumption of red and processed meat increases (more than doubles) the risk of colon cancer. In this study even two to three ounces of red meat or processed meats a day increase risks significantly.

Sesink AL; Termont DS; Kleibeuker JH; Van der Meer R Red meat and colon cancer: dietary haem-induced colonic cytotoxicity and epithelial hyperproliferation are inhibited by calcium.Carcinogenesis. 2001; 22(10):1653-9

Hughes R; Cross AJ; Pollock JR; Bingham S Dose-dependent effect of dietary meat on endogenous colonic N-nitrosation.Carcinogenesis. 2001; 22(1):199-202
These two studies go into the mechanism via which red meat promotes colon cancer. Since red meat contains no fiber, it remains in the gut much longer than fiber-filled foods.They describe the biochemical effects of this slower transit time, including heightened exposure to red meat's nitrogenous metabolites. In other words, red meats' slower transit time in the bowel promotes prolonged exposure to these carcinogenic compounds (naturally occurring N-nitroso compounds) when a larger percentage of the diet is made of animal products rather than plant materials. Another important mechanism reported was the high haem content of red meat, because dietary haem increased cytolytic (cell-killing) activity and colonic epithelial proliferation, thus explaining why red meat is more colon cancer promoting compared to fish or chicken.

Heart disease also occurs not just because of the processing of meats or the fact that beef is grain fed and not grass fed, but because of other intrinsic properties of animal foods, and the fact that we require a significant exposure to a full symphony of natural antioxidants and phytochemicals in unprocessed plant matter that we are not getting as animal products increase and the percentage of vegetation decreases.

Tomorrow, DiseaseProof will feature a look at the real cause of Dr. Atkins' death, while on Friday I will discuss the healthy way to integrate some meat into your diet.

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This post is part of an on-going review of the recommendations of Joseph Mercola, M.D. D.O. For an overview, see yesterday's post.

On his website, Dr. Joseph Mercola advocates people fill in a detailed questionnaire to help him determine which of three types they fall into. (Of course you must buy this questionnaire from him, a few pages of information at a price of 59 dollars before the software can add up your score, determine how much you love your meat and then he can know the right diet for you.)

This supposedly will help you decide what type of diet is best for your health. Instead of using blood type, eye color, shoe size, or date of birth of your first born, Dr. Mercola has determined a better way. His questions have a lot to do with how you feel when you eat meat. He divides the types into three categories. The indented section below is cut and pasted from Dr. Mercola's website.

PROTEIN TYPES do better on a low-carbohydrate, high-protein and relatively high-fat diet. Depending on your Metabolic Typing profile, these ratios are then perfected to help you make wise food choices.

CARBO TYPES normally feel best when the majority of their food is carbohydrate. Yet, there are major differences between classes of carbs such as vegetables and grains. Learning which types of carbs are best for your unique physiology is just one way in which Metabolic Typing excels.

MIXED TYPES require a combination of foods somewhere between the carbo and protein type groups. This is actually the most challenging type to have and requires a great deal of fine-tuning while "listening" to your own body with the help of Metabolic Typing.

Changing your dietary habits is indeed a good thing, but avoiding meat and animal protein just isn't the healthiest choice for most people, based on their body's unique metabolic type. Each type benefits from varying ratios of macronutrients (fats, proteins and carbohydrates) to feel great and avoid chronic degenerative diseases, like those associated with obesity.

Dr. Mercola says avoiding meat is not a good idea for most people because their metabolic type indicates that red meat is needed and good for them. He also explains that the Atkins diet is good, because of its critical recognition of the glycemic index of food, but it is not as good as Dr. Mercola's because he (Dr. Mercola) takes into account the metabolic typing of the individual thus adjusts the diet for that person's particular need.

Dr. Mercola's viewpoints on nutrition and health would fail nutrition 101; too much science contradicts him. He may not be as dangerous as Atkins, but he is a very poor choice to be offering nutritional information to the masses because his advice is not just an unscientific gimmick, it can promote an earlier death or a life-ending cardiac event, especially in his high-protein type.

Dr. Mercola does make some good points as do most nutritional gurus, but the problem is the overall advice that may not be lifespan-favorable because of his faulty logic and misinterpretation of the data.

Vegetarian vs. Meat-Eating is Misleading. High Nutrition vs. Low Nutrition is What Counts.
Dr. Mercola correctly points out that most vegetarians may not have excellent health because of their overdependence on grains. I agree. Not that my agreement determines truth, but clearly the literature is abundant with evidence that demonstrate that the foods with the best correlation with longer life and resistance against later life diseases are vegetables, beans, raw seeds, fruit and raw nuts; not grains. Eliminating animal products and continuing the consumption of processed grain foods is not a longevity diet. The bottom line here is most vegetarians are unhealthy for the same reason most non-vegetarians are unhealthy, and that is they eat too much processed foods. Whole grains are not nutrient-rich food and may form a minor part of the diet, but when consumed as baked, fried, toasted and shot out of canons, they are low-nutrient junk foods that are powerfully disease-promoting.

Also there is no disagreement here that some people are not going to get all their nutritional needs met on a vegan diet and will need to add supplements to make the diet complete or add a small amount of animal products. Rather, the most critical disagreements involve two issues. The first issue is that if you add the (large) amount of animal products Dr. Mercola allows or recommends (including red meat and butter) especially the large amounts recommended in his protein-type, you will be powerfully promoting heart disease and cancer.

A Diet Safe for No One.
The scientific literature is clear; there is no genetic type that has immunity from such a disease-causing, high saturated fat diet-style. All Americans, not just some, develop atherosclerosis on a diet so rich in animal products. Over ninety percent of Americans eventually develop atherosclerosis and hypertension from the low intake of unprocessed vegetables, fruits, beans, nuts and seeds. Our high intake of animal products AND processed foods and our low intake of unrefined plant food is the dietary pattern undeniably associated with these avoidable illnesses and a premature death from heart attacks or stroke.

And the second issue is that his metabolic typing questionnaire is not an accurate way to determine a person's nutritional needs. When he advises his "protein type" to eat a diet where most calories are supplied by animal products, he is appealing to that person's food preferences and addiction and not only deviating from scientific integrity here, but promoting dietary suicide to his uneducated entourage to make a buck. His opinion is without scientific foundation in both these areas, and unquestionably can lead people to a shorter lifespan.

Dr. Mercola's position on saturated fat (high in cheese, butter and red meat) runs counter to thousands of medical research studies showing that saturated fat is the food factor most promoting high cholesterol levels and heart disease. Though Dr. Mercola (like Atkins) denies the saturated fat--> high cholesterol--> heart disease link. Dr. Mercola's topsy-turvy advice actually promotes the consumption of high saturated fat foods and makes ridiculous health claims for coconut oil (ninety percent saturated fat) including weight loss, detoxification, viral killing, heart disease reversing and other unsubstantiated silliness'. Good health comes from nutritional excellence, not from a jar of oil. See the comments of this post for more of my thoughts on coconut oil.

Nevertheless, filling out a questionnaire that tells you whether you digest meat better or worse or feel better after you eat it, or whether you like dark meat better than light meat is like asking a smoker if they feel better after they smoke to determine whether smoking is healthy or not. In fact, the more you crave something and the worse you feel when you stop consuming it is a good sign that you are addicted to it and it is harming you, not helping. For example, most people with hypoglycemic symptoms feel better when they eat a mostly animal-based diet, yet these same people get completely well once they are off the high-protein diet they have been using to lessen their symptoms. and their body is no longer nitrogen toxic. In other words, they no longer feel ill when their withdrawal symptoms have been allowed to come to completion, and they are off the high nitrogen diet.

For many of you that are familiar with my voice on these issues you will know that I advocate a diet rich in nutrients, especially antioxidants and phytochemicals and the large percentage of everybody's diet must be from unrefined plant foods no matter what your genetic type is. I teach there is not one perfect ratio of fat, carbohydrate and protein that are right, there is a broad range of acceptable intakes here, based on body weight, exercise habits and legitimate medical tests. However, Americans generally eat too much carbohydrate, too much protein and too much fat. We need to eat a diet lower in all three sources of calories and much, much richer in nutrients. In order to do this you must understand the nutrient density of all foods and eat more foods higher on the nutrient density ladder, and less low nutrient foods and this is what my book Eat To Live is about.

Furthermore, of course there are genetic differences, and adjusting nutritional advice to fit individual needs is accurately done with blood work, and other accepted medical tests. For example a heightened intake of Vitamin D or B12 or taurine might be indicated for someone who tests deficient in these substances, and some people might require a higher amount of long-chain omega-3 fats because of lower genetically-mediated conversion, indicating an individual with a more fish-dependent genetics. Nevertheless, these issues are best addressed with blood work (facts) not with some flakey secretive questionnaire that is sold for a high price on a website. Those individuals who may need extra long-chain fatty acids or additional protein should achieve this without a diet rich in red meat and saturated fat.

Luckily nutritional science has advanced to the point where we can chose a diet-style that enables us to dramatically lower our cholesterol, maintain a normal blood pressure into later years and not have heart disease or strokes. I continually inform people of the risks in following bad nutritional advice.

Over the next few days, we will investigate:

• How proponents of a diet rich in meat and butter are skewing the debate and encouraging heart disease.
• A look at the cause of Dr. Atkins' death.
• The safe way to integrate some meat into your diet.

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Dr. Joseph Mercola is a prolific writer with a large following. Much of his advice is well-founded and worth reading.

Lately, however, I have been asked by readers of DiseaseProof to assess some of his more outlandish claims: for instance, that coconut oil has miraculous properties, that "metabolic type" (as determined by a $59 online survey) determines dietary requirements, that special butter and grass-fed beef are wonderful health foods.

By looking at these things in detail, I have found that in some cases Dr. Mercola is not practicing good science.

That does not mean everything he advocates is wrong or that his diet is not better than the much worse diet that most Americans eat. However his judgment and nutritional advice is not scientifically based and demonstrates poor judgment and bias.

For instance, there has never been a study showing that any blood type or "metabolic type" is protected from the dangerous effects (primarily heart disease and cancer) of a diet rich in red meat and butter. His advice appeals to the majority of Americans who are addicted to meat and want to justify their dangerously high consumption of saturated fat (butter, cheese and meat) with rationalizations that lack adequate scientific support. Prudent people must recognize that red meat and butter (even if consumed raw from grass-fed cows) must be avoided or consumed in very minimal quantities by all types of people to assure protection against premature aging and the leading causes of death.

I have already addressed his claims about coconut oil, in the comments of a previous post.

Over the next few days, we will investigate:

• Why the metabolic type test is a misleading waste of time and money.
• How proponents of a diet rich in meat and butter are skewing the debate and encouraging heart disease.
• A look at the cause of Dr. Atkins' death.
• The safe way to integrate some meat into your diet.

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