The quick answer: The modern diet was invented in America and like an ancient plague is now spreading around the world. The cure could also come from America. Here are four docs who effectively preach the gospel of good diet and health.
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Hero Docs
Nearly 20 years ago, David Halberstam wrote a bestseller about the Vietnam War titled The Best and the Brightest. Vietnam, despite the valor of those who fought and died, was a horrible mistake, the book concluded. Worse, the string of bad decisions that put us in that unwinnable war, were made by the best and brightest people our society could muster.
Halberstam meticulously demonstrated that really smart people, despite their best efforts, could fail the public they serve. His phrase, “best and brightest,” seems an apt introduction to the topic of this post: doctors. I like doctors; taken together, I think they’re the best and brightest of our society. But like the soldiers of Vietnam, they also fight an unwinnable war—the war against chronic disease, which is a product of our modern lifestyle. They write prescriptions for pills, but the problem is what we eat. It doesn’t have to be that way.
A handful of these doctors, like Halberstam, have seen a better way, and have spoken openly. They’re pioneers, in my view. Rather than “going along, to get along,” they have gone against the grain, and called for radical change. They not only practice medicine, they do research, and become public advocates. Their message: Prevention is better than treatment; simple lifestyle changes are superior to expensive drugs and high-tech procedures. Like others who take unpopular stands, they’ve faced derision and censure from the powers that be. Here are four practicing physicians with their own bestsellers:
Cardiology
Heart disease is too profitable to cure. A cynical statement, don’t you think? The docs who perform the bypass operations, or slip stents into your coronary arteries, make a lot of money. Likewise for the drug and medical device companies. Hospitals have invested billions in coronary care wards, surgical suites, and cath labs; for some, coronary treatments provide half their income. When the big bucks flow, such an enterprise, like a run-away train, takes on a life of its own and isn’t easily stopped—even if there’s a better answer.
But a handful of doctors have dared to speak up. They’ve pointed out that these pricey procedures are just treating symptoms and aren’t really extending life. And they have gone to the root of the problem and argued for making lifestyle changes, big changes. In their mission, a few have become well known:
Dr. Dean Ornish: A Texas kid who graduates summa cum laude from the University of Texas, then attends Baylor College of Medicine, isn’t likely to leave the Lone Star state. But Ornish did; he served his internship and residency at prestigious Mass General, and then crossed the country to practice and teach cardiology in San Francisco. Some call it Bagdad by the Bay, justifiably, but it was also just up the 101 highway from Silicon Valley, ground zero for the digital revolution. This was during the ‘80s and change was in the wind, especially along the 101.
The rising star in cardiology was CABG, coronary artery bypass graft surgery, a procedure that sawed open your chest and replaced occluded heart arteries with veins cut from your leg, or arm. Surgeons who did CABG procedures were the rock stars of the hospitals. But a new paradigm was coming—less invasive procedures. Just down the 101 from Dr. Ornish, a medical device start-up named ACS, for Advanced Cardiology Systems, was using balloon catheters, and then stents, to prop open those diseased coronary arteries.
But Ornish had a zero invasive procedure in mind: cure heart disease by removing what caused it—the modern lifestyle. He organized a study that treated 28 heart disease patients with diet (low-fat, plant-based whole foods), smoking cessation, stress management (including yoga and meditation—this was San Francisco, after all), and exercise. (You may, ahem, note the similarity between Ornish’s program and the lifestyle advocated in this blog.) For comparison, a control group of 20 patients received the conventional treatment, mainly drugs.
The result was dramatic: After one year the test group’s progression of coronary blockage was stopped, and for 82% of the patients reversed. In the control group the progression of artery blockage continued unabated. The results were reported in a top medical journal, Lancet. Did the world adopt the Ornish program? No, revolutions don’t happen that easily, especially when it involves the dismantling of lucrative enterprises.
Ornish appealed to the public, with the 1990 book Dr. Dean Ornish’s Program for Reversing Heart Disease. The application of lifestyle change to other diseases followed, and a 2008 book, The Spectrum: A Scientifically Proven Program to Feel Better, Live Longer, Lose Weight, and Gain Health. Ornish also founded the nonprofit Preventive Medicine Research Institute, and worked with Nobel laureate Elizabeth Blackburn, PhD, to show that lifestyle changes can lengthen telomeres, the ends of chromosomes that control how long we live. Ornish is a hero, but there are others.
Dr. Caldwell Esselstyn, Jr: This is a guy who walked the fitness talk—he won an Olympic gold medal in 1956 in 8-oared rowing. As a surgeon at the prestigious Cleveland Clinic, and chair of their Breast Cancer Task Force, he grew dissatisfied with the treatment of cancer and heart disease—treating symptoms with pills and procedures seemed like surrender; it wasn’t the same as curing the disease, or protecting future victims.
Esselstyn started an experiment with 22 patients suffering from severe coronary artery disease. The treatment included a low-fat vegan diet (just 10% of calories from fat), use of cholesterol-lowering drugs, and group therapy sessions with Dr. Esselstyn and his wife.
Of the 22, 11 were still following the program after five years, and examination showed that the progression of blockage had been stopped, and in some cases reversed. More important: none had suffered heart attacks. Esselstyn published a bestseller, Prevent and Reverse Heart Disease, and collaborated with Dr. T. Colin Campbell in the recent movie, “Forks over Knifes.”
Nutrition: There’s a growing awareness of the importance of diet and lifestyle in disease prevention, but as a nation we have just begun to actually change the way we eat and live. The pendulum is poised to swing, however, and two doctors are active advocates of dietary change:
Dr. Neal D. Barnard is a major spokesman for the idea that a healthy diet can prevent and treat disease. If you’re reading this blog you likely agree, but Barnard goes one step beyond the diet presented in this blog (a home-cooked diet of fruits, vegetables, legumes, nuts, whole grains, and sparing meat). He advocates zero meat, or a vegan diet, though he comes from a family of ranchers. Barnard is also a leading opponent of the Atkins diet, which basically replaces carbs with meat.
In 1985 Barnard founded the Physicians Committee for Responsible Medicine (PCRM), to promote the benefit of plant-based diets, oppose harmful medical practices, and the use of animals in medical research. In 1991 he organized the Cancer Project to inform the public about the role of a plant-based diet in cancer prevention and survival. Earlier this year PCRM actually sued the US government for pushing food guidelines that lacked scientific evidence (specifically, the recommendation for meat and dairy, as well as the confusing food pyramid). Some of Barnard’s books:
Dr. Joel Fuhrman is a former world-class figure skater, family physician, nutrition researcher, and author. Reflecting his work as a diet-focused family physician, he addresses a variety of medical conditions:
Please comment: Who has influenced you to eat better? What made you ready to change?