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

New York Times reporter Gina Kolata's work has come up again and again on DiseaseProof.

We just happened across a feature on The New York Times website that has video of Kolata discussing some of her recent work.

Her "Health Minute" video piece about the relationship between diet and cancer is shocking. Here are some quotes:

• "You might have assumed that what you eat makes a big difference in whether you get cancer... "
• "Many scientists say that there is still a reason to eat a healthy diet, but cancer prevention is probably not one of them. If there are effects, they are likely to be small, and swamped by other factors."

The basis of her story is the Women's Health Initiative study that was wholly flawed. "Look closely and you will see that the researchers compared a typical, disease-causing American diet, with one that was just marginally better, but still terribly unhealthy," says Dr. Fuhrman.

He likens it to studying those who smoke 50 cigarettes a day, and comparing them to those who some 60 cigarettes a day. If you find little difference in their cancer rates, does that mean cigarettes don't affect cancer?

What's more, the study merely assessed the efficacy of "low-fat foods" which is not the most important designation in determining cancer-fighting potential. Some high-fat foods like nuts, seeds and avocados contain heart disease and cancer fighting compounds, points out Dr. Furhman, who adds that "eating more low-fat foods such as egg whites, chicken, and pasta does not expose us to the disease-fighting compounds in berries, seeds, nuts, cruciferous vegetables, tomatoes and carrots."

If you haven't read it yet, please do check out the still relevant longer response to Gina Kolata's original article--complete with references to medical studies etc.

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Business travelers are prone to bad eating habits and physical inactivity. This coupled with rising healthcare costs is inspiring company-run wellness programs designed to target the needs of the road warrior. Christopher Elliott of The New York Times reports on the actions of the Parksite Group:

The new programs do more than educate frequent travelers about the dangers of a sedentary lifestyle punctuated by deep-fried meals. They use online journals, Web-based support groups and other technologies to keep employees healthy while they are on the road.

It is too early to gauge the effectiveness of these programs, but there are some notable early successes. In 2004, for example, Parksite's health care premiums soared by 23 percent. But last year, after its wellness program began to take hold, its costs did not change even as other employee expenses were rising. The wellness program is run by the ComPsyche Corporation of Chicago.

Programs like this are encouraging, but experts insist changing behaviors requires more:

"In order to change your behavior, you need more than just one workshop," said Mindy Paulet, director of the work-life programs at Purdue University, who administers a wellness course developed by Human Kinetics, which is based in Champaign, Ill. "A workshop can't change your behavior. It can't change a sedentary or inactive employee. That takes time."

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The media is saturated with reports trying to explain why Americans are so overweight. A new one examines the food industry's role in the obesity epidemic. J.M. Hirsch of the Associated Press reports:

"We don't think the food industry has done anything particularly wrong in this regard," says Robert Earl of the Food Products Association, a lobbying group that prefers to indict sedentary lifestyles and poor choices.

Companies have tried to help people make better choices, he says, offering healthier products and more nutrition data. But people can't be forced to make the right choice and consumer disinterest doomed many of those products.

True, people can't be forced to make healthy decisions, but has the food industry contributed to consumers' poor judgment? Yale obesity expert Dr. David Katz explains:

Despite his criticism of the industry's practices, Yale's Katz acknowledges companies are in a difficult position. Ultimately, they sell food, and staying in business means selling the foods people want. Public health is secondary.

But what if those companies engineered their foods to make you eat more of them? Though he acknowledges that evidence is scarce, Katz believes companies do just that, much the way tobacco companies were accused of tinkering with nicotine.

Research shows that people eat more when faced with a variety of foods, or even a variety of flavors within a single food. For example, you are less likely to overeat plain baked potatoes than those drenched in butter, salt, sour cream and chives.

It's tempting to point fingers and the play the blame game, but remember your weight and overall health is your responsibility. Ellen Van Gelder, an obese woman from Concord, N.H., sums it up best:

"I would love to blame somebody else. The reality is it's each person's responsibility," says Van Gelder, who has battled her weight her entire life. "You put the food on your plate. You choose whether to eat it."

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Earlier this month U.S. Surgeon General Richard Carmona stated that America's obesity epidemic may pose a bigger threat than terrorism.

It's more than a little ridiculous how practically everything in Washington is likened to some form of terrorism these days. But there's no point in pretending the obesity epidemic isn't on a massive and deadly march straight through the heart of America.

Dr. Fuhrman reacts to the Surgeon General:

We graduate from high school, college, even graduate and professional schools and we never gain the most knowledge we need to be in control of our health destiny. We live in a society that believes that we protect our health with access to medical care and drugs; it doesn't work.

We can win the war on cancer and heart disease, not with more money put into medical interventions and drugs, but by unleashing the big artillery found in our kitchens; berries, green vegetables, beans and seeds to name a few. The science is important and motivating because we are eating ourselves into a tremendous amount of needless and tragic diseases in this country and our cancer rates have increased unrelentingly each year for the last seventy years. But aside from all the convincing scientific data, it is just as important to show people how they can deal with their picky eaters, get their family to like the healthful foods at the family table and make healthy eating great tasting and fun. My experience has been that after gaining the knowledge, people can transition their family over to a disease-preventive lifestyle and enjoy the change.

Here's a tool to consider: Dr. Fuhrman's free podcast will help parents succeed in introducing healthy foods to your children.

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BBC news reports that a ferryboat accident in Baltimore, which killed five, was caused in part by the fact that Americans weigh so much more, on average, than they used to. The water taxi was built using 1940s weight guidelines, which assumed the weight of an average rider was 140 pounds. Just a few decades later, the average is closer to 170. In the end the boat was carrying 700 pounds more than its maximum limit, making it too low in the water to operate safely in bad weather.

A simple solution has been proposed: markings on the hull could show how low a boat is in the water.

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In Eat to Live Dr. Fuhrman warns against eating regular quantities of animal products, refined grains, and oils, urging you instead to get most of your calories from vegetables, fruits, legumes, seeds, and raw nuts:

Vegetable and fruits protect all types of cancers if consumed in large enough quantities. Hundreds of scientific studies document this. The most prevalent cancers in our country are mostly plant-food-deficiency disease. Raw vegetables have the most powerful anti-cancer properties of all foods.

Research shows that those who avoid meat and diary have lower rates heart disease, cancer, high blood pressure, diabetes, and obesity.1

Studies have confirmed that individuals consuming a vegetarian diet (one based on plant matter and not dairy or refined grains) live longer than non-vegetarians and almost never get heart attacks.

With this in mind, consider this recent weight loss study from the European Prospective Investigation into Cancer and Nutrition. The eating habits of 22,000 people, meat eaters and vegetarians, were tracked over five years. In the end results found that all participants gained a few pounds, but individuals who adopted a vegetarian or vegan diet gained the least. Reuters reports:

"The weight gain was less in the vegans than in the meat-eaters and somewhere in between in the other groups," said Tim Key, of Britain's Cancer Research UK charity and the University of Oxford, who conducted the study.

"The lowest weight gain was in people who changed their diet to eat fewer animal products," he told Reuters.

In addition to stressing the importance of physical activity for sustained health, the study also comments on the link between diet and cancer:

[The study] also showed that diet is second only to tobacco, as a leading cause of cancer, and, along with alcohol, is responsible for nearly a third of cancer cases in developed countries.

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In Eat to Live Dr. Fuhrman calls obesity "the number one health problem in the United States."

If the current trend continues by the year 2030 all adults in the United States will be obese. The National Institutes of Health estimate that obesity is associated with a twofold increase in mortality, costing society more than $100 billion per year.1

Dr. Fuhrman's approach was shown in a study to reduce LDL cholesterol 33%, making it the only nutritional approach shown to be more effective than statins.

Now there's news of a milder nutritional intervention that has been getting some milder--but promising results. A study published this month in the American Journal of Clinical Nutrition found that eating nutrient rich foods like tofu and oatmeal help lower cholesterol. Beth Duff-Brown of the Associated Press reports:

Jenkins, Canadian research chair in metabolism and nutrition at Toronto, and Dr. Cyril Kendall, also of the University of Toronto, studied 55 middle-aged men and women who had high cholesterol and were at risk for heart disease.

The participants were already on a heart-healthy diet. They were then prescribed a diet that included more specific foods, such as raw almonds, tofu and other soy foods, viscous fibers such as oatmeal, barley, okra and eggplant, and plant sterol-enriched margarine.

After a year, the group who stuck faithfully to the new eating plan lowered their cholesterol by an average of 29 percent. Jenkins said the rate was comparable to results from participants who had taken a statin drug for one month before starting the diet, as well as general studies of patients on such drugs.

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Ahh, The New York Times. I love it for having a lot of great reporting. I hate it for having some wacky judgment from time to time.

Last month The New York Times published a massive, convincing, yet horribly misguided article on the futility of low fat diets. Lots of people took it as permission slip to gorge themselves on burgers, fries, ribs, and chocolate shakes. Dr. Fuhrman offered a comprehensive rebuttal at the time.

His main point was that the study in question proved little, as neither group studied ate a low-fat or healthy diet. (He said it was like studying one group that smoked 50 cigarettes and comparing it to a group that smokes 60 cigarettes a day. If you find they both get sick at about the same rate, does that really prove cutting down smoking doesn't help your health?)

He's not alone in his criticism on the underlying study, which is called the Women's Health Initiative. In today's New York Times Jane E. Brody uses a nearly identical rationale to explain why she's still eating right and exercising:

As I read them, the findings of the Women's Health Initiative on bone disease border on meaningless.

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The global obesity epidemic is getting plenty of attention, and rightly so.

In Dr. Fuhrman's book Eat to Live he address the state of obesity and weight loss and many of the health complications of being overweight:

Obesity is not just a cosmetic issue—extra weight leads to an earlier death, as many studies confirm.1 Overweight individuals are more likely to die from causes, including heart disease and cancer. Two thirds of those with problems also have hypertension, diabetes, heart disease, or another obesity-related condition.2 It is a major cause of early mortality in the United States.3 Since dieting almost never works and the health risk of obesity are so life threatening, more and more people are desperately turning to drugs and surgical procedures to lose weight.

Health Complications of Obesity

Increase overall premature mortality	Lipid disorders
Adult onset diabetes	Obstructive sleep apnea
Hypertension	Gallstones
Degenerative arthritis	Fatty infiltration of liver
Coronary artery disease	Restrictive lung disease
Cancer	Gastrointestinal diseases

(Rather than losing weight with a temporary diet, Dr. Fuhrman advocates permanently shifting the focus of eating to the healthiest and most nutritious foods.)

Recent news is full of new angles and thoughts on obesity. Reuters reports one such study links obesity to migraines:

As BMI increased, so did the frequency of migraine attacks. The [research] team notes that 4.4 percent of the normal weight group had 10 to 15 headache days per month. This increased to 5.8 percent in the overweight group, 13.6 percent in the obese group and 20.7 percent in the morbidly obese group.

The percentage of subjects who reported severe migraines also increased with BMI group, from 53 percent in subjects of normal weight to 57 percent in the overweight group, 59 percent in the obese group and 65 percent in the morbidly obese group.

According to Reuters another study claims that many parents can't admit their children are overweight:

Many parents do not identify their child as "overweight," but will select a sketch of a heavier model when asked to choose one representative of their child, new study findings show.

"Comparisons between images and sketches showed that parents' visual perceptions of their children more clearly reflect their child's physical appearance than words they might use to classify the child's weight," study author Dr. Helen J. Binns, of Northwestern University in Chicago.

The AFP is reporting that Sweden will begin screening four-year-olds for obesity:

In addition to registering Swedish four-year-olds' height and weight development, pediatricians will be asked to survey their BMI, which measures the relative percentages of fat and muscle mass in the body by dividing weight in kilos by height in meters and which is considered the best index for obesity.

"In most children, weight problems won't surface until later, but by checking four-year-olds we hope to find people who are especially at risk, who are genetically predisposed to become overweight," Carl-Erik Flodmark, head physician at the child obesity center in Skaane in southern Sweden.

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Melanie Warner of The New York Times reports that for the first time in twenty years the number of cases of soda sold in the United States declined. This is great news for those who believe that soft drinks cause obesity. According to research, people's demand for variety and healthier choices is attributed to the drop off:

In a research report yesterday, William Pecoriello, a beverage analyst at Morgan Stanley, said he expected the soda category to continue to decline at a 1 percent clip over the next few years. His research shows that 64 percent of the growth in bottled water is a result of people switching from soda to what nutritionists say is the healthiest beverage anyone can drink.

Even diet sodas, once a booming category, have slacked off. Diet Pepsi's case volume was down by 1.9 percent in 2005 and Diet Coke's was virtually unchanged, up only 0.1 percent, according to Beverage Digest.

Mr. Pecoriello attributed this to changing attitudes about diet soda. "According to our research, consumers say they don't like the taste, are worried about artificial sweeteners and," he wrote, do not view diet soft drinks "as 'healthy.'"

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Yesterday, Dr. Fuhrman discussed recent research about soft drinks and obesity. Today in The New York Times, Eric Nagourney has more on recent research into the soda/obesity connection:

Writing in Pediatrics, researchers reported on what happened when they asked a group of teenagers to stop drinking sweetened beverages for 25 weeks — and had nonsweetened drinks delivered to the teenagers' homes to encourage them to stick to their commitment.

The researchers, led by Cara B. Ebbeling of Children's Hospital Boston, found that the teenagers' consumption of the high-calorie drinks went down by about 80 percent during the study and that the teenagers who had been the most overweight had significant reductions in their body mass indexes at the end of the 25 weeks.

The researchers acknowledge that there is little proof that drinks sweetened with sugar or corn syrup play a major role in obesity compared with other foods. But the study says that as the obesity rate among young people has gone up, so has their consumption of the drinks, which are heavily advertised.

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According to the Associated Press recent studies predict that by 2010 nearly half of the children in North and South America will be overweight. If present trends continue about 38 percent of all children will be fat. Many experts are alarmed:

"We have truly a global epidemic which appears to be affecting most countries in the world," said Dr. Philip James, chairman of the International Obesity Task Force and author of an editorial in the journal warning of the trend.

The percentages of overweight children also are expected to increase significantly in the Middle East and Southeast Asia. Mexico, Chile, Brazil and Egypt have rates comparable to fully industrialized nations, James said.

He estimated that, for example, one in five children in China will be overweight by 2010.

"They're being bombarded like they are in the West to eat all the wrong foods. The Western world's food industries without even realizing it have precipitated an epidemic with enormous health consequences," he said.

For more information on the childhood obesity epidemic read the following posts: Warning Labels from the Surgeon General on Soda?, Childhood Obesity: Growing In The Wrong Direction, Stopping Childhood Obesity--Thinking Outside the Box, and New York Nixes Full-Fat Milk in Schools.

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Marilynn Marchione of the Associated Press reports that new studies by two groups of researchers claim that consumption of sugar-sweetened drinks actually causes obesity. While it is widely agreed that soda contributes to weight gain, labeling soda as a standalone cause is a new idea that's ruffling some feathers. Epidemiologist Dr. Michael Thun says:

"Caloric imbalance causes obesity, so in the sense that any one part of the diet is contributing excess calories, it's contributing causally to the obesity," Thun said. "It doesn't mean that something is the only cause. It means that in the absence of that factor there would be less of that condition."

Does it merit a warning on soda cans?

"I think it would be a good candidate for a warning," Thun said. "It's something that should be seriously considered."

In Dr. Fuhrman's book Disease Proof Your Child he discusses soft drinks and rising obesity rates:

Obesity rates have risen in tandem with soda consumption in the United States, and in the last twenty years the consumption of soft drinks by teenagers had doubled.1 Twelve to nineteen-year-old boys consume thirty-four teaspoons of sugar a day in their diet, and about half of that comes from soft drinks. Children start drinking soft drinks at a very young age, and advertisements and promotions by the soft drink manufacturers are aggressively marketed to the young.

Source: Data from the National Soft Drink Association, Beverage World, published by the Center for Science in the Public Interest (www.cspinet.org)

Soft drinks and processed foods are full of high-fructose corn syrup (HFCS). HFCS is not only fattening, but this inexpensive and ultra-concentrated sugar has no resemblance to real food made by nature. It is another experiment thrust upon our unsuspecting children with unknown dangerous consequences. Besides sugar, corn syrup, and chemicals, these drinks often contain caffeine, an addictive stimulant. Children crave more and more as they get older. By adolescence most children have become soft-drink addicts. It is no surprise that six out of the seven most popular soft drinks contain caffeine. Contrast this high level of sugary "liquid candy" with the meager intake of fresh produce by children and teenagers, and it is no surprise that we have an obesity epidemic beyond all expectations.

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DiseaseProof isn't the only online information source for healthy eating and living. Recently Dr. Fuhrman came across InformedEating.org an organization that advocates a diet based on whole, unprocessed, organically grown plant foods; very similar to Dr. Fuhrman's position. Their current newsletter has lots of articles worth reading:

• Kraft and Philip Morris Scientists Caught Comparing Notes
• Economics of Fast Food: It's the Burgers Stupid
• Industrialized Food Linked to Mental Illness
• Kellogg and Nick Sued Over Food Marketing
• Update on Connecticut's School Food Battle
• Florida Students Protest Candy Sale
• Suing the Pants Off SpongeBob

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Steven Reinberg of the HealthDay News reports that a new study may show a link between obesity and sensitivity to pain. One third of the individuals observed are obese and exhibited a lower tolerance for pain. This finding didn't surprise many researchers:

"For subjective indicators of pain, obese people indicated similar levels of pain to non-obese people," said study author Charles Emery, a professor of psychology at Ohio State University. "But when we looked at objective indicators, we found that the obese group had a lower threshold for pain."

Emery believes that obese people may have more experience with pain because of their weight. "They may be used to some degree of pain," he said.

But obese people appear to experience greater pain than non-obese people, Emery added. "It is important to look at both objective indicators of pain, as well as subjective indicators," he said. "We need to keep in mind that the subjective rating may not be reflective of physiological processes that are going on."

One expert found the study results compatible with what is known about how people experience pain.

"These results do not surprise me at all," said Dr. Doris K. Cope, director of the Pain Medicine Division at the University of Pittsburgh.

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