Sick Care or Health Care

Could it be that we could solve most of our health problems just by changing our diets? What a radical idea. Not really. 

According to Dr. Roberts, the long-time-editor in chief of the American Journal of Cardiology, “Some extremely common conditions in the Western world are relatively uncommon in purely or predominantly plant-eating societies.  These include: 1) severe atherosclerosis, 2) systemic hypertension, 3) stroke, 4) obesity, 5) diabetes, 6) some common cancers (colon, breast, prostate, etc), 7) constipation, cholecystitis, gallstones, appendicitis, diverticulosis, hemorrhoids, inguinal hernia, varicose veins, 8) renal stones, 9) osteoporosis and osteoarthritis, 10) salmonellellosis and trichniosis, and 11) cataracts and macular degeneration.” That’s quite a list.

Unfortunately, in spite of acknowledging that plant-based diets can help to prevent or even reverse coronary disease (as well as other conditions), Dr. Roberts is not unlike many mainstream physicians in that he promotes widespread use of lipid lowering drugs. Why? In his words “...serum cholesterol must be lowered to that of the average pure vegetarian. Because relatively few persons are willing to abide by the vegetarian lifestyle, lipid-lowering drugs are required in most...” 

While I do credit Dr. Roberts for pointing out that diet is the single biggest causal factor of arterial disease (“Atherosclerosis is infrequently hereditary in origin. Most of us get atherosclerosis because we consume too much fat, cholesterol, and calories”), I would argue that most people don’t change their diets because they are not given that option. Rather, patients are wrongly led to believe that there is not much they can do (i.e. genetics is to blame) and that drugs are the only recourse.

The Adventist Health Study is an ongoing study which follows the eating habits and health outcomes of thousands of Adventists. This group makes for a perfect opportunity to study dietary habits without many of the other confounding factors found in the general population. Adventists don’t smoke, are encouraged to exercise and to limit caffeine and alcohol intake. They have strong social ties, attend church regularly and are generally well educated. While they are encouraged to be vegetarian (about 50% are), many still consume meat, albeit in limited quantities (i.e. they don’t eat pork or certain types of meat). Thus, if there was ever a group of ‘healthy’ meat eaters, this is where you would find it.

One study published on this group compared the use of health services between vegetarians and ‘healthy’ non-vegetarians.

How did they stack up?

When it came to various conditions, vegetarians had significantly lower rates of: heart disease, stroke, allergies, high blood pressure, diabetes, diverticulosis, rheumatoid arthritis, asthma, and rheumatism. When it came to medication and health care use, vegetarians used less medication (by a lot), had fewer surgeries, and spent fewer nights in the hospital.

A subsequent study on this group compared BMI and rates of diabetes. They found that BMI was highest in the meat eaters, slightly lower in the semi-vegetarians, slightly lower again in the lacto-ovo and pesco-vegetarians and lowest in the vegans. In fact, the only group who had average BMIs in the ideal range (<25) were the vegans (23.6), although the lacto-ovo vegetarians were close (25.7). Diabetes rates were also less by more than half in the vegans. This could, of course, be partly explained by the lower BMI scores. However, diabetes rates were still lower in the vegans AFTER adjusting for BMI. Thus, in the obese vegans, the risk of diabetes was still lower than in the obese meat eaters.

Meat eating has been strongly linked to weight gain and diabetes in a number of other studies. In the EPIC-Oxford study they also found that as meat and dairy consumption went down, so did BMI, in a dose dependent manner. The factors most strongly associated with increasing BMI were high animal protein and low fiber intakes.

Another EPIC study found that animal protein consumption increased risk for diabetes. The authors noted that it was the animal protein that was problematic not plant protein.

And finally, in a different EPIC study, thousands (actually a few hundred thousand) meat eaters and plant eaters were followed for 5 years. Those most likely to gain weight were the meat eaters. Of interest was that this was after adjusting for calories. The authors calculated that, after adjusting for energy intake, an increase in meat intake of 250g/d would lead to 2kg higher weight gain after 5 years. Thus, for the SAME number of calories, eating meat resulted in greater weight gain. There are a number of mechanisms which may explain why, which i discuss in my Eating to Lose Weight presentation.

In conclusion, it is important to remember the adage that plants are nutrient producers and animals are nutrient consumers. There are more nutrients and antioxidants in nutrient poor iceberg lettuce than there are in equivalent amounts of salmon, chicken, eggs and dairy. Plant foods, on average have about 64x more antioxidants than animal foods.

In an editorial published in the American Journal of Cardiology, Dr. Dean Ornish comments that there are >100,000 disease preventing phyto-nutrients in plant foods. He goes on to say that his research group found that eating a plant-based diet “caused beneficial changes in gene expression in >500 genes in only 3 months, up-regulating disease-preventing genes and down regulating oncogenes that promote breast cancer and prostate cancer and also down regulating genes that promote inflammation and oxidative stress which often contribute to the cause and progression of coronary arterial disease.”

He goes on to say, “We also found that these lifestyle changes increased telomerase the enzyme that lengthens telomeres, the ends of our chromosomes that affect longevity. Even drugs have not been shown to do this."

Eliminating meat and animal derived foods from our diet and eating nutrient rich whole-plant foods will help one avoid, and even reverse, many of the chronic diseases and maladies which plague us today. Eating more nutrient rich plant foods should be our first line of defense and medications and medical procedures should be “alternative medicine”.

Let food be thy medicine and medicine thy food!