Choosing to Eat to Live

Here's a recent discussion from Dr. Fuhrman's Member Center:

Forum Member:
I went to a little health fair at the local Y two weeks ago and the did a non-fasting cholesterol test, blood pressure test and they checked our carotid arteries (very cool to watch blood pumping through veins).

I'm 50 years old and my results are as follows…

Total cholesterol = 188
HDL= 88
TRG= 117
BP= 140/94
Pulse rate= 76

The carotid test showed a BB size white spot of plaque on both sides.

My question is this…

Is that plaque left over from my Fatkins days (went from Atkins right to you) or is it an indication of a build up from me straying into the SAD (Standard American Diet) foods these past fours months after being 80-100% on your plan for a year?

My dad had the carotid operation and died at 74 from heart problems and lots of strokes. (This is why I started your program in the first place.)

I've been having a hard time getting back on your diet 80-100% of the time, it's been more like 60% (fruit in A.M., salad at lunch, but I lose it by dinner).

Please advise.

Dr. Fuhrman:
The plaque is a result of your old diet and maybe from the one you have been on lately too. Moderation really doesn't accomplish much and in most cases the disease still advances, just at a slower rate. I guess you are just going to have to bite the bullet and eat great tasting healthy food and get well.

What is interesting is that my daughter and I are in Ontario, California and just went to an Italian restaurant in Rancho Calabunga or some town that sounds like that. In any case, we were commenting on that we can't get food that we like the taste of in a restaurant because everything is too heavily seasoned with salt or hot spices and it simply does not taste as good as the stuff we make at home. The point is that we like our home-based healthy cooking the best. With time you can learn that you do not lose pleasure to gain excellent health. I believe you gain pleasure. In any case, your health is worth it.

Forum Member:
Thanks that's just what I needed to hear. I have been feeling worse and worse lately (knees hurt, swollen ankles, migraines are back) and I guess I was just too stubborn to admit to myself that the best way to health is your way. I really was feeling so much better when sticking to plan 100%. I guess what I wanted to hear was that the plaque was waning, not waxing. I also wanted to let you know that after I wrote to you I found your VHS tape and sat down and watched it again.

By the way was the non-fasting cholesterol test very accurate or should I ask my doctor for a full test when I go for my next visit?

Dr. Fuhrman:
It may be off about 5 per cent, but it does not matter. Just let it go for now and get yourself in great health.

Research: Canadians Have Less Disease than Americans, Too

First the redcoats, now the red leaves! Last week DiseaseProof looked at a study published in the Journal of the American Medical Association showing the British are healthier than Americans. This week new research indicates our neighbors to the north are healthier too. MSNBC reports:

Americans are 42 percent more likely than Canadians to have diabetes, 32 percent more likely to have high blood pressure, and 12 percent more likely to have arthritis, Harvard Medical School researchers found. That is according to a survey in which American and Canadian adults were asked over the telephone about their health.

This graph from the Associated Press shows additional health disparities found during this study:


The knee-jerk reaction to this study (other than panic) is to point to Canada's national health insurance program as an explanation. Some researchers adhere to the idea, but others dismiss it as anecdotal:

Canada's national health insurance program is at least part of the reason for the differences found in the study, Dr. Steffie Woolhandler, a co-author of the Canadian study said. Universal coverage makes it easier for more Canadians to get disease-preventing health services, she said.

James Smith, a RAND Corp. researcher who co-authored the American-English study, disagreed. His research found that England's national health insurance program did not explain the difference in disease rates, because even Americans with insurance were in worse health.

"To me, that's unlikely," he said of the idea that universal coverage explains international differences.

Research like this is fascinating. But it does little improve your health, no matter where you live. In the meantime do your own research. Check out all the research on a nutrient-rich vegetable-based diet and how it can protect against diseases such as cancer, diabetes, heart disease, etc.

Weight-loss, Grief, and the Gridiron

The Philadelphia Inquirer reports Eagles right guard Shawn Andrews is on a mission this off-season: beat the battle of the bulge. Staff writer Ashley Fox explains Andrews wouldn't let himself to hit the four hundreds despite some terrible news:

After the Eagles' season ended in January, Andrews gained 10 pounds, pushing perilously close to a weight that began with the number four. He made a decision. Enough was enough. He had to stop.

In April, weeks into a diet that was showing results, Andrews went to a park near his Arkansas home with a childhood buddy named Willie. The two had ridden the bus together to third grade, had pigged out in home economics class, had played hoops. Like Andrews, Willie was a big man, but unlike Andrews, he had stopped working out years ago.

That day, Andrews and Willie sat at the park watching the cars go by, talking about their lives and winking at girls. Afterward, Andrews went to Subway, ordering a chicken teriyaki sandwich on whole wheat bread, Sun chips, and a bottle of water. Two hours later, he got the call. Willie was dead, apparently of a heart attack brought on by high blood pressure. He was 23.

Diet and Disease Prevention

A new study shows the British are healthier than Americans despite U.S. health care spending per person that is more than double what Britain spends.

The study, published in the Journal of the American Medical Association concludes:

The US population in late middle age is less healthy than the equivalent British population for diabetes, hypertension, heart disease, myocardial infarction, stroke, lung disease, and cancer. Within each country, there exists a pronounced negative socioeconomic status (SES) gradient with self-reported disease so that health disparities are largest at the bottom of the education or income variants of the SES hierarchy. This conclusion is generally robust to control for a standard set of behavioral risk factors, including smoking, overweight, obesity, and alcohol drinking, which explain very little of these health differences. These differences between countries or across SES groups within each country are not due to biases in self-reported disease because biological markers of disease exhibit exactly the same patterns. To illustrate, among those aged 55 to 64 years, diabetes prevalence is twice as high in the United States and only one fifth of this difference can be explained by a common set of risk factors. Similarly, among middle-aged adults, mean levels of C-reactive protein are 20% higher in the United States compared with England and mean high-density lipoprotein cholesterol levels are 14% lower. These differences are not solely driven by the bottom of the SES distribution. In many diseases, the top of the SES distribution is less healthy in the United States as well.

Based on self-reported illnesses and biological markers of disease, US residents are much less healthy than their English counterparts and these differences exist at all points of the SES distribution.

No one is sure why the two similar cultures have such different results. Gina Kolata of The New York Times takes a crack at it.

The question of which country is healthier, Dr. Nortin M. Hadler, professor of medicine at the University of North Carolina and others say, turns out to be a perfect illustration of an issue that has plagued American medicine: the more health problems you look for, the more you find. And Americans, medical researchers say, are avid about looking.

The British, doctors say, are different.

"The U.K. has a tradition of independent and perhaps more skeptical primary-care practitioners who are probably slower to label and diagnose people and more reluctant to follow guidelines than their U.S. counterparts," says Dr. Iona Heath, a general practitioner in London. "I have heard it argued that the U.S. believes more in the perfectibility of humanity and the role of science than the Europeans."

Some people call it disease-mongering, says Dr. Lisa Schwartz of Dartmouth Medical School. She once calculated that if everyone had the recommended tests for blood cholesterol, blood sugar, body mass index and diabetes, 75 percent of adults in the United States would be labeled as diseased. And new diseases arise by the minute, she says, her favorite example being "restless legs."

Maybe it's overanalysis. Maybe it's stress. Maybe it's something else. We can all guess why it might be that Americans are "sicker" than Brits even though we spend more money on healthcare. (Your thoughts?)

But one thing is certain: the killer diseases in America today, afflictions like type-II diabetes, cancer, and heart disease, need not ruin your health no matter where you live. On DiseaseProof we have trotted out study after study showing that we could make a huge dent in those diseases by abandoning the standard American diet (SAD) in favor a diet based on vegetables, fruit, legumes, nuts, and seeds.

This post summarizes many of the benefits of a healthy diet in preventing disease. Here is a collection of some of the most important research behind Dr. Fuhrman's work. The role diet can play in precenting cancer is discussed in detail here and here. Dr. Fuhrman says you need not settle for diabetes and that there is a counter attack for heart disease.

The result? Let's not wait around until researchers unravel the mystery of what makes English people seem to be healthier. Instead, let's do what has already been shown to be effective preventing and reversing the chronic diseases that are killing so many of us, starting with a plant-based, nutrient-dense diet that is effective in both Americans and the British.

Heart Disease Quiz

From Dr. Fuhrman's book Eat to Live:

Heart disease is the number one killer in the United States, accounting for more than 40 percent of all deaths. Each year approximately 1.5 million Americans suffer a heart attack or myocardial infarction (MI); nearly 500,000 of them die as result.1 Most of these deaths occur soon after the onset of symptoms and well before victims are admitted to a hospital.

Every single one of those heart attacks is a terrible tragedy, as it could have been avoided. So many people die needlessly because of wrong, weak, and practically worthless information from the government, physicians, dietitians, and even health authorities like the American Heart Association. Conventional guidelines are simply insufficient to offer real protection for those wanting to protect themselves from heart disease.

If you are an American over the age of forty, your chance of having atherosclerosis (hardening) of your blood vessels is over 95 percent. You may think, "Heart disease won't happen to me!" But I have news for you: it has already happened, and you chance of dying from a heart attack because of your atherosclerosis is about 50 percent. You exercise program and your Americanized low-fat diet won't help you much, either. You need to do more.

Quick Quiz: Heart Disease

1. Percentage of children between the ages of four and eleven who already have signs of heart disease?2

A. None
B. 10 percent
C. 40 percent
D. More than 75 percent

2. Percentage of female heart attack victims who never knew they had heart disease and then die as a result of their first heart attack?3

A. None
B. 10 percent
C. 25 percent
D. More than 75 percent

3. Percentage of heart disease patients who undergo angioplasty and then have their treated arteries clog right back up again within six months?4

A. None
B. 10 percent
C. 30 percent
D. None of the above

Keep reading for the answers.

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Fish Fat Affects Heart's Electrical Function

HealthDay News is reporting Omega-3 fats might heighten the risk of potentially dangerous heart condition in some people. New research claims individuals who consume fish more than five times a week are 61 percent more likely to develop atrial fibrillation. Randy Dotinga reports:

In recent years, many doctors have urged patients to eat oily fish—such as mackerel, herring, albacore tuna and salmon—or take fish oil supplements. Both contain omega-3 fatty acids, which have been linked to better recovery from heart disease and a lower risk in older people of atrial fibrillation, in which the heart's electrical system malfunctions, and the muscle fails to beat in an orderly fashion.

But it's not entirely clear that omega-3 fats are good for the general population without heart disease. And some research has suggested they may actually boost the risk of atrial fibrillation in certain people, such as those younger than 60.

In the new study, researchers analyzed data from nearly 17,700 U.S. male doctors who took part in the Physicians' Health Study. The men answered questions about their fish consumption in 1983 and were asked in 1998 if they had developed atrial fibrillation.

After adjusting the data to account for factors like existing heart disease, the researchers found that men who ate fish more than five times a week were 61 percent more likely to develop atrial fibrillation, compared to those who ate fish once a month. In total, about 7 percent of all the men in the study said they developed the condition, which is somewhat common among the elderly but rarer among younger people.

First mercury contamination and now this! Fish is certainly earning an unsavory reputation. If you're alarmed by this research, remember Dr. Fuhrman's recommendation: Only eat lean fish like flounder, sole, or tilapia no more than once or twice a week.

Now, incase you think you're not getting enough Omega-3, consider another recommendation from Dr. Fuhrman's book Eat to Live:

Have a tablespoon of ground flaxseed everyday. This will give you those hard-to-find omega-3 fats that protect against diabetes, heart disease, and cancer.1 The body can manufacturer EPA and DHA from these omega-3 fats for those of us who do not consume fish. An additional source of omega-3 fat might be a few walnuts or soybeans. Edamame, those frozen green soybeans in the freezer of most health-food stores, taste great and are a rich source of omega-3 fat. A nutritional supplement containing DHA fat is also a good idea, especially for those who are poor DHA converters (which can be determined via a blood test). Vegetable-derived (from microalgae) DHA fat can be found in most health-food stores.

Dr. Fuhrman points out that his DHA Purity is not only a high grade, vegetable-derived DHA supplement (it's made from algae) but it is the only DHA available in America that is kept refrigerated for freshness since the day of manufacturing. Children and adults like the taste, too.

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Refined Foods Raise Your Cholesterol

Adapted from Dr. Fuhrman's book Cholesterol Protection For Life:

Once you start eating larger amounts and bigger portions of fruits and vegetables, you will naturally not have as much room for other food like processed or refined food (fake, man-made foods). These foods are lowest in nutrients and will sabotage your long term health. Processed foods are implicated in the scientific literature in the causation of obesity, diabetes, heart disease and cancer.

When you take the whole wheat berry and process it into white flour to make white bread or pasta, more than 90% of the fiber and vitamin E, as well as more than 75% of the minerals, are lost. Your body breaks down the carbohydrate into simple sugars and the physiologic response is not much different than if you had consumed cotton candy. White pasta, white rice and white bread are just like sugar; because their fiber has been removed, these nutrient deficient foods are absorbed too rapidly. This, in turn, will raise glucose, triglyceride, and insulin levels in your blood. Refined grains are undesirable and will sabotage your weight-loss and cholesterol-lowering efforts.

All refined sweets are low in nutrients and fiber and are rapidly absorbed. These refined sweets include sugar, honey, corn syrup, molasses and corn sweeteners. They all contain insignificant amounts of nutrients (per calorie) and no fiber. More and more studies offer evidence that the consumption of these sweets and white-flour products are a significant cause of obesity, diabetes, heart disease, and even cancer.1

Getting thinner is extremely important to maximally lower your cholesterol and protect yourself from heart disease and cancer. As you get closer to your ideal weight, your weight loss will gradually slow down and then stop. Your body is a very intelligent "machine" and when you eat correctly, it will achieve its ideal weight.

In addition, if you consume a diet that contains 90-100% nutrient-dense food, you can practically disease-proof your body. Superior nutrition has such a powerful effect on the body's ability to defend itself against illness that it can force genetics to take a secondary role; therefore, our genetic weaknesses can remain at bay.

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Salt: Potentially More Dangerous For Vegans and Vegetarians

Adapted from Dr. Fuhrman's book Disease Proof Your Child:

Although a low-saturated-fat vegan diet may markedly reduce risk for coronary heart disease, diabetes, and many common cancers, the real Achilles' heel of the low-fat vegan diet is the increased risk of hemorrhagic (vessel rupture leading to bleeding) stroke at a late age. Apparently the atherosclerotic (plaque-building) process that creates a local intravascular embolism (traveling clot) may be protecting the fragile blood vessels in the brain from rupture under years of stress from high blood pressure. Admittedly, hemorrhagic stroke causes a very small percentage of deaths in modern countries. It still is worth nothing that if strict vegetarians are to have the potential to maximize their lifespan, it is even more important for them to avoid a high salt intake because salt intake increases blood pressure. Almost all of the soy-based meat analogues and many other health food store (vegan) products are exceptionally high in sodium.

A number of studies both in Japan (where the high-salt had made stroke a leading cause of death) and in the West have illustrated that fewer animal products and a low serum cholesterol were associated with increased risk of hemorrhagic stroke.1 Keep in mind, stoke mortality is significantly higher in Japan and exceptionally high in certain areas of China where salt intake is high, in spite of low-fat diets. It is also well established that Third World countries that do no salt their food are virtually immune to hypertension, the age-related rise in blood pressure we see in 90 percent of Americans, and they are immune to the incidence of strokes.

The high salt ? high blood pressure ? stroke causation chain may be more likely a late-life event in a vegetarian successfully maintaining excellent heart health. So avoiding excess sodium may be even more important for a vegetarian than for an omnivore. Of course, excess sodium increases both heart attack and stroke death in all diet styles, but in a vegan, the high-salt diet is even more likely to rear its ugly head as a cause of late-life morbidity and mortality, especially since they will often live longer and not have a heart attack first.

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Heart Attack Counterattack

From Dr. Fuhrman's book Eat to Live:

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. If one expects to diminish atherosclerotic plaque over time and stabilize the plaque so the chance of having a heart attack significantly decreases, I insist that he or she must strive to achieve the following parameters of normalcy:

  • The patient must achieve a normal weight or become thin (less than one inch of abdominal fat in women, and less than three-quarters of an inch in men), or be in the process of steadily losing weight toward this goal.
  • The patient must achieve normal cholesterol. My definition of normal is an LDL cholesterol below 100 (most authorities are now using this benchmark). Drugs are rarely needed to attain this level when an aggressive nutritional approach is taken.
  • The patient's diet must be nutrient-dense. Animal products and detrimental fats must be avoided to prevent the after-meal fat surge.1 Refined carbohydrates should also be avoided to prevent the after-meal glucose surges and to control triglycerides. Homocysteine levels should be normalized, by supplementation with appropriate nutrients if necessary.
  • Blood pressure must return to within the normal range, below 130/85, or be slowly improving and moving toward this minimal goal. The normalization of blood pressure as medications are gradually discontinued represents reversal of atherosclerosis and is an important criterion to predict cardiac safety. The person who has removed his cardiac risk no longer requires blood pressure medication to maintain normal blood pressure readings. The vessels have become more elastic through nutritional intervention.
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