Disease Proof

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Dr. Fuhrman talks about the powerful phytochemicals and nutrients in bean burgers with the host of the local cable television show Patriot Panache. Check it out:

Bean Burgers

½ cup sunflower seeds
2 cups red or pink canned beans (unsalted)
½ cup minced onion
½ tsp. chili powder
2 tbsp. ketchup
1 tbsp. wheat germ or oatmeal

Chop the sunflower seeds in a food processor or hand chopper and mash the beans with a potato masher or food processor and mix. Mix in the remaining ingredients and form patties. Bake at 350 degrees for 20-25 minutes. Remove from the oven and let cool until you can pick up each patty and compress it firmly in your hands to reform the burger. Then cook for another 15 minutes on each side.

The famed naturalist's Harvest for Hope website includes links to many healthy living resources, including DiseaseProof. Thanks, Jane.

The 100th roundup of the blogosphere's medical news is up now at The Examining Room of Doctor Charles.

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.)

Forbes magazine recently included Pop'ems in its list of the Healthiest Candies. Dr. Fuhrman was quoted in the article as well. Check out Slashfood.com for more discussion on the list.

For more information on Pop'ems click here.

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.

Over the weekend, we perused the dozens and dozens of reviews of Dr. Fuhrman's book Eat to Live on Amazon.com. Most of the reviews are amazing, positive, and full of encouraging tales.

A handful are simply based on certain misperceptions. Just in case some of those misperceptions are widely held, or in case any of you have encountered these same misperceptions, we thought it might be worth addressing some of them briefly on DiseaseProof.

What does Eat to Live have to offer athletes who need a lot of calories?
Dr. Fuhrman explains:

The dietary recommendations in Eat to Live are not intended for weightlifters, athletes and thin people. The book is specifically designed for people who have had trouble losing weight on other diets. It is designed for the overweight. For athletes, as I explain in the book, I recommend much more nuts and seeds, and a diet mugh higher in fat. Also, keep in mind that bulking up is dangerous to one's longevity and power lifters and football linebackers often eat in a way that radically shortens their lives. If you were a weightlifter, for instance, you might improve your chances of muscle growth with more animal products then I recommend, certainly. But the point of Eat to Live is that this much animal products is not conducive to longevity. But if size is your only goal, go for it.

What about the idea that Eat to Live is a one-size fits all prescription?
Dr. Fuhrman explains that some individuals, athletic or non-athletic, may have to adapt Eat to Live to their particular needs:

Clearly Eat to Live is a diet book for overweight people, it gives the guidelines for the healthiest way for people eat. I do recognize that some people do better with a little bit of animal products in their diet too, but these people are not common and I am clear to advise that the public should only use a small amount of animal products or you will invariably hurt yourself.

There are a million books claiming they can fix weight problems. Why believe this one?
Many misperceptions about Eat to Live dissolve when people learn about the studies and anecdotes that show overwhelmingly that people who follow the recommendations in Eat to Live enjoy excellent results. Dr. Fuhrman:

Eat to Live has been shown to be the most effective diet-style to lower cholesterol, and lose weight in scientific studies because it simply is the healthiest way to eat and it explains that low-nutrient eating leads to toxic hunger and overeating. Most people choose to eat to live because they do not want to be on a diet, counting calories and eating thimble-sized portions of food. They eat with abundance and feel secure they are protected against heart disease, stroke, dementia and other disease of nutritional ignorance in our society.

You can listen online as Dr. Fuhrman discusses recent news about the FDA investigating deaths that may have been related to ADHD drugs. He will be a guest a little after 8pm ET (5pm Pacific) on Thursday, February 9--in about two hours from this writing.

Click here for more of Dr. Fuhrman's thoughts and anecdotes about treating ADHD with diet.

UPDATE: Gardiner Harris of The New York Times explains the new concerns about the effect some prescription stimulants may have on heart disease.

The votes came after F.D.A. medical officers described reports of 25 sudden deaths among people taking stimulants — the deaths were mostly children — and a preliminary analysis of millions of health records that suggested stimulants might increase the risks of strokes and serious arrhythmias in children and adults. The reports of sudden deaths never exceeded one in a million for any stimulant drug, although the F.D.A. usually receives reports of only a fraction of drug problems.

The preliminary analysis suggested that the stimulants might increase heart risks more than twofold. Such an increase may not be significant in children, whose heart risks are low, but could cause concern in adults, panel members said.

One of the drugs, Ritalin, has been marketed since 1955, and dozens of studies have shown it to be safe and effective. But no studies have been of sufficient duration or included enough participants to evaluate stimulants' long-term effects on the heart.

But the drugs' soaring popularity and increasing use in adults, panel members said, mean that the F.D.A. should study them more closely and warn patients and doctors about the potential risks to the heart.

Arthur A. Levin, director of the Center for Medical Consumers in New York City and a member of the panel, said that patients assumed that stimulants were safe, but that that confidence was misplaced.

"For us to sit around and talk about it, and for us to not make a very strong warning about the uncertainty of these drugs and their possible risks, would be unethical," Mr. Levin said.

Dr. Fuhrman and DiseaseProof have been popping up around the blogosphere lately. Here are some of sightings:

• First he encouraged Myke's Weblog to eat his veggies.
• After that he dropped in to Diabetes Mine with some information on the New York City's diabetes epidemic.
• Then he took a moment to Monitor Reflections about a recent Wall Street Journal article.
• Finally Dr. Fuhrman ended up in the February 7th Grand Rounds hosted by Science & Politics.

Mehmet C. Oz, M.D. will cohost a new show with Michael Roizenon, M.D. on the Discovery Health Channel called "You: The Owner's Manual." The one-hour special, which premieres 8 p.m. Wednesday (EST/PST), is based on their best-selling book of the same name.

Dr. Oz also wrote the foreword to Dr. Fuhrman's book Eat to Live. Here's some of what he said:

Dr. Fuhrman is doctor as teacher; he makes applying nutritional science to our own lives easy to learn, compelling, practical, and fun. His own common sense and his scientifically supported solutions to many diet-induced ailments will enable readers to achieve unexpected degrees of wellness quickly and easily. He reminds us that not all fats or carbohydrates are good or bad and that animal products catalyze many detrimental effects to our health. He pushes us to avoid processed foods and to seek rick nutrients and phytochemicals available in fresh foods. Finally, he offers a meal plan that is tasty and easy to follow. However, make no mistake, the information you will find in Eat to Live will challenge you; the scientific evidence he cites will make it harder for you to ignore the long-term impact of the typical American diet. Indeed, it is a wake-up call for all of us to make significant changes in your lives. Now is the time put this information into action to bring optimal health to all Americans. Go for it.

The National Health Test is a one-hour television event, hosted by Bryant Gumbel. The program focuses on: How healthy are you? How healthy is America? How do we measure up to other countries? And what's at stake?

Recently Dr. Fuhrman was interviewed for the show. He is joined by experts such as Surgeon General Richard H. Carmona, Editor of Men's Health David Zinczenko, Julian Whitaker M.D., Senator John Kerry, etc. Celebrities such as Jean Smart, Marilu Henner, Bruce Jenner, and Dwight Freeney are also on hand to offer their own personal health tips and encouragement.

It's playing on different days across the country. Check for show times in your area.

• The studies have been out for months, and Dr. Fuhrman has talking and writing about it for years, but today the Washington Post is catching up to the idea that body mass index is an inferior tool for predicting disease. Here are some better ways.
• The Chicago Tribune story (more about that here) about mercury in fish is making more waves: now the FDA says they will look into canned tuna.
• Dr. Fuhrman has discussed his aversion to harsh chemical household cleaners and pesticides. Organic Authority has some ideas about other things to use.
• Try to avoid sugar, you start being amazed at the many different ways people are constantly promoting it. Now, for instance, there's a dinosaur-era mammal named for the Cadbury company.
• Paul McCartney's wife, Heather Mills McCartney, is tremendously inspirational--and she loves Eat to Live! On her website, there is a link to DrFuhrman.com.
• Something to shoot for: according to a study, plenty of people report that they are in excellent health well into their senior years.

Remember Jane Goodall? She is the naturalist who became famous for her work with chimpanzees. She has written tons of books. The newest one is on a topic that's very relevant to this blog: how the food we eat affects our health.

Jane Goodall's book Harvest for Hope discusses Dr. Fuhrman and his approach to eating. Dr. Fuhrman says he has never met her, and was pleasantly surprised to find that he was mentioned in a book.

DiseaseProof reader Frederick Conroy emailed the following review (which I have edited slightly for length):

Library Journal is a respected resource that helps librarians decide which books to buy without having to read them all. Elaine M. Bergman, of the State University of New York at Albany recently reviewed Dr. Fuhrman's new book, Disease-Proof Your Child, and this is what she has to say:

In his latest book (after Eat To Live), physician Fuhrman does not make a terribly radical point: kids need to eat a lot of fruits and vegetables to ward off disease. However, he also alleges that a child's diet before the age of ten may have a dramatic effect on the occurrence of diseases much later in life, such as heart disease, diabetes, and cancer. In addition, he maintains that "superior nutrition"-a healthy mix of "good" fats; ample fruits, vegetables, and beans; and whole foods-can ameliorate eczema, ADHD, allergies, ear infections, and other ailments. If children's food options are all healthy ones, he assures readers that kids will eat what they need; they will not starve if there are no chicken nuggets. Although Fuhrman is emphatic about fruits and vegetables, he does not go so far as to advocate eschewing all animal products. Rather, he provides the advantages and disadvantages to vegan, vegetarian, and omnivorous diets, explaining how to choose the best foods within each model. He also bucks some of the traditional child nutrition experts, who previously advocated dairy products and carbohydrate-rich diets. Including many suggestions, tips, patient stories, and even some recipes, this nutrition guide is good for public libraries with an extensive consumer health section.

Dr. Fuhrman was quoted in an Associated Press article that ran in all sorts of newspapers last week. His message was simple: getting kids to eat healthy food begins with empowering children.

"The child has to be a part of the decision-making process. They have to feel empowered," said Dr. Joel Fuhrman, an author of family fitness books who helped the Wandlings get on track.

Instead, experts say adults often inflict more harm than good by setting rules that only provoke rebellion. Some parents become so restrictive that they forbid even small treats like birthday cake. Others deeply humiliate their children, making a fuss in public over what their kids are eating.

Another common pitfall is isolating a child with a special diet while the rest of the family indulges freely, Fuhrman said. That only creates a forbidden fruit syndrome that can make the child yearn for foods that are off-limits.

The website The World Around You has reviewed Dr. Fuhrman's new book Disease-Proof Your Child. Here's what an anonymous reviewer had to say:

This book does not disappoint in any way.He gives his own personal experiences in a commensense practical way that anyone can understand. Everything he states is well documented with footnotes to other studies,this makes his points less controversial. I strongly recommend this book to any parent.