The China Study

[TerpDO]

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So I got this book for Christmas and just finished reading it. Did anyone else here have the chance to look at this? As a VERY BRIEF and incomplete summary the author presented lots of evidence as to how many major diseases such as diabetes, cancer, and heart disease can be prevented or combated with a diet of plant-based, whole foods. And that the "Western diet" we eat in the U.S. consisting of high animal protein and dairy is what is contributing to a majority of our population getting these diseases at some stage in our lives.

So I wanted to ask my fellow SDN'ers:

1) Do you think that diet has much influence on our total health? And if so, to what extent?

2) As future D.O.'s we have a duty to encourage prevention of diseases and after reading the book I feel that recommending a healthy diet based on plant-based, whole foods would accomplish that goal well. Would any of you give advice concerning diet to your patients or would you feel that you are not in a position or authority to do that?

Please let me know your thoughts on this matter, if you've read the book that's great (And I do encourage those who haven't to pick it up, it is an easy read for the most part), but if you haven't read it your opinions concerning the relationship between diet and medicine are still welcome. Thanks!

 

[LastDance]

Is the name of the book, "The China Study" ? and by the way, who is the author? Thanks i will read it!!

 

[jkhamlin]

So I got this book for Christmas and just finished reading it. Did anyone else here have the chance to look at this? As a VERY BRIEF and incomplete summary the author presented lots of evidence as to how many major diseases such as diabetes, cancer, and heart disease can be prevented or combated with a diet of plant-based, whole foods. And that the "Western diet" we eat in the U.S. consisting of high animal protein and dairy is what is contributing to a majority of our population getting these diseases at some stage in our lives.

So I wanted to ask my fellow SDN'ers:

1) Do you think that diet has much influence on our total health? And if so, to what extent?

2) As future D.O.'s we have a duty to encourage prevention of diseases and after reading the book I feel that recommending a healthy diet based on plant-based, whole foods would accomplish that goal well. Would any of you give advice concerning diet to your patients or would you feel that you are not in a position or authority to do that?

Please let me know your thoughts on this matter, if you've read the book that's great (And I do encourage those who haven't to pick it up, it is an easy read for the most part), but if you haven't read it your opinions concerning the relationship between diet and medicine are still welcome. Thanks!

Hokey diets such as this one don't even pass the sniff test. We are omnivorous animals. We require an omnivorous diet. Our anatomical and physiological design require it. Period.

Diet is important, but about 99.9% of the diet information out there is false. A "western" diet is no more disease causing than any other diet. In fact, probably less. One disease I can think of that results from certain all plant based diets is kwashiorkor. Another resulting from certain all plant diets is cirrhosis of the liver.

 

[dlazar]

I have not read this book however, I have researched this topic tremendously. I believe DIET is one of the major aspects of good health. I also feel proper nutrition is highly overlooked but the tides are beginning to change. As physicians of the future we have the opportunity to improve both the quality and quantity of patients lives through diet and exercise.

 

[Doctor Bagel]

I read it a while ago. I've got to say I wish it was better edited, but it seemed thorough. Of course, I'm already a vegetarian, so it doesn't take much to convince me. 🙂

About diet -- yeah, I think it's hugely important to a person's health. Whether or not I'd emphasize it to my patients, I don't know. I can see where you just get really discouraged because no one seems to want to listen to diet advice. Also, suggesting that people don't focus their diets around meat seems like a losing proposition a lot of the time, especially in certain parts of the country.

Jkhamlin -- a vegetarian, plant based diet is not a hokey diet. 🙄 In fact, even the conservative ADA has stated that it's safe for all ages levels. Kwashikor doesn't happen in anybody who's meeting their caloric requirements. Also, generations upon generations of people in Asia have eaten diets of either no meat or very little meat. Obviously, it's not as deadly as you're making it out to be.

Here's the link to the ADA's position on vegetarian diets.

http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/advocacy_933_ENU_HTML.htm

 

[TerpDO]

Is the name of the book, "The China Study" ? and by the way, who is the author? Thanks i will read it!!

Yes, that is the name of the book, here it is on amazon.com

http://www.amazon.com/China-Study-C..._bbs_sr_1/002-3115516-5492861?ie=UTF8&s=books

I hope that link works. Yes please do read it and let us know what you think. Thanks!

 

[TerpDO]

Hokey diets such as this one don't even pass the sniff test. We are omnivorous animals. We require an omnivorous diet. Our anatomical and physiological design require it. Period.

Diet is important, but about 99.9% of the diet information out there is false. A "western" diet is no more disease causing than any other diet. In fact, probably less. One disease I can think of that results from certain all plant based diets is kwashiorkor. Another resulting from certain all plant diets is cirrhosis of the liver.

This was exactly the type of skepticism I was looking for from some of my fellow SDN'ers. Thank you. Although I do not agree with your views and even more so after reading the book, I know that many people in our society (including lots of health professionals) do firmly believe that as Americans we should be able to eat lots of meat and dairy and that the more of those products we eat the healithier and stronger we will be. However, from extensive studies that I've read from the book this is not the case. The more animal based products we consume the more likely we are to develop cancer, diabetes, and heart disease (diseases of affluence). Now I am not going to rewrite the book here but I will say that the book is NOT a diet book and should not be compared to an "Atkins" or "South Beach" diet book. I would encourage you to read the book or perhaps even read some of the REVIEWS on AMAZON.COM and see if you still feel the same way. Cheers!

 

[8744]

I have not read this book however, I have researched this topic tremendously. I believe DIET is one of the major aspects of good health. I also feel proper nutrition is highly overlooked but the tides are beginning to change. As physicians of the future we have the opportunity to improve both the quality and quantity of patients lives through diet and exercise.

Well, of course. But you can be perfectly healthy eating steak, baked potatoes, and salad. Or bacon and eggs. Or anything else if it is in a balanced diet combined with exercise.

I think the OP is talking about a fad diet.

 

[dlazar]

Well, of course. But you can be perfectly healthy eating steak, baked potatoes, and salad. Or bacon and eggs. Or anything else if it is in a balanced diet combined with exercise.

I think the OP is talking about a fad diet.

I think the book is saying the exact opposite. Diets that are high in Fat and animal protein are causing problems hence the western diet. Thus a balanced diet combined with exercise does not create perfect health. For instance, Heart Disease is still the #1 killer in the USA. Thus, the american diet of steak and potatoes should be studied.

I am not saying that everyone should be a vegetarian b/c animal protein is very important. However, I am advocating for regulations that provide individuals a healthy option. Prevention and health promotion can be effective strategies of improving the health of others.

 

[czanetti]

Hokey diets such as this one don't even pass the sniff test. We are omnivorous animals. We require an omnivorous diet. Our anatomical and physiological design require it. Period.

Diet is important, but about 99.9% of the diet information out there is false. A "western" diet is no more disease causing than any other diet. In fact, probably less. One disease I can think of that results from certain all plant based diets is kwashiorkor. Another resulting from certain all plant diets is cirrhosis of the liver.

Diet is an important aspect of health and prevention. The description of hokey diets doesn’t really grasp the effects on our well being. I think that a general diet plan would be helpful but it isn’t an all encompassing solution. Each individual would need specific alterations for more efficient healthy consumption. Western diet is horrible. Our nutrition is a large component in establishing well being, but it is not the only one. I truly believe that nutrition should be a fundamental aspect of trying to maintain a healthy lifestyle and should have a higher weight of value when we try to concern ourselves about prevention.

 

[Doctor Bagel]

Well, of course. But you can be perfectly healthy eating steak, baked potatoes, and salad. Or bacon and eggs. Or anything else if it is in a balanced diet combined with exercise.

I think the OP is talking about a fad diet.

I don't think something a fad diet if it's been around for thousands of years. The author of the book studied the traditional Chinese diet and detailed its health benefits. Atkins -- now that's a fad diet. A diet that the Chinese have been following until recently is not so much a fad diet.

 

[dlazar]

Diet is an important aspect of health and prevention. The description of hokey diets doesn’t really grasp the effects on our well being. I think that a general diet plan would be helpful but it isn’t an all encompassing solution. Each individual would need specific alterations for more efficient healthy consumption. Western diet is horrible. Our nutrition is a large component in establishing well being, but it is not the only one. I truly believe that nutrition should be a fundamental aspect of trying to maintain a healthy lifestyle and should have a higher weight of value when we try to concern ourselves about prevention.

I like your thinking and I agree with you 100%. Now only if we could make it feasible for everyone.

 

[jkhamlin]

I read it a while ago. I've got to say I wish it was better edited, but it seemed thorough. Of course, I'm already a vegetarian, so it doesn't take much to convince me. 🙂

About diet -- yeah, I think it's hugely important to a person's health. Whether or not I'd emphasize it to my patients, I don't know. I can see where you just get really discouraged because no one seems to want to listen to diet advice. Also, suggesting that people don't focus their diets around meat seems like a losing proposition a lot of the time, especially in certain parts of the country.

Jkhamlin -- a vegetarian, plant based diet is not a hokey diet. 🙄 In fact, even the conservative ADA has stated that it's safe for all ages levels. Kwashikor doesn't happen in anybody who's meeting their caloric requirements. Also, generations upon generations of people in Asia have eaten diets of either no meat or very little meat. Obviously, it's not as deadly as you're making it out to be.

Here's the link to the ADA's position on vegetarian diets.

http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/advocacy_933_ENU_HTML.htm

The ADA? You're kidding right? The ADA doesn't take much interest in science. They base their decisions on fashion magazine science played out in the public media. Also, the ADA is hardly "conservative" in ANY sense of the word. 🙄

Vegetarian diets ARE hokey. The human animal is an omnivorous animal. Humans have to eat meat. Vegetarian diets are incomplete nutrition. It is definitely NOT safe for all ages. There have been cases where people had their children taken away because of malnutrition and neglect due to parents putting them on vegetarian diets. These hokey diets are EXTREMELY dangerous to young children. 🙄

 

[jkhamlin]

Diet is an important aspect of health and prevention. The description of hokey diets doesn’t really grasp the effects on our well being. I think that a general diet plan would be helpful but it isn’t an all encompassing solution. Each individual would need specific alterations for more efficient healthy consumption. Western diet is horrible. Our nutrition is a large component in establishing well being, but it is not the only one. I truly believe that nutrition should be a fundamental aspect of trying to maintain a healthy lifestyle and should have a higher weight of value when we try to concern ourselves about prevention.

If by "western diet" you mean all the people loading up on cake and ice cream, and having very little variety in their diet, while at the same time the most excercise they get is when the batteries on their remote die, then I agree.

If by "western diet" you mean a well rounded diet that includes a variety of foods taken from many different cultures that includes normal portions of meat and vegetables coupled with regular exercise, then I cannot disagree more.

 

[group_theory]

However, from extensive studies that I've read from the book this is not the case. The more animal based products we consume the more likely we are to develop cancer, diabetes, and heart disease (diseases of affluence).

NEVER trust a review of "extensive studies" by a single person or group ... you have to look at them with a critical eye because studies can be bad, can be biased, or can be reviewed with a biased perspective. 10 bad studies does not make a good argument. That's why in med school and residency, they have journal clubs that will teach you to view articles with a critical eye, to dissect the hidden meanings, to agree or disagree with the conclusions, etc. Even articles that review multiple articles (meta-analysis or Cochrane) attempt to dissect each articles and give limitations of the articles they are reviewing)

Anyway, now to the meat of your post

What exactly is a Chinese Diet? Is it what people eat in Beijing? Or Hong Kong? or Shanghai? or perhaps Harbin? or Lanzhou? Or perhaps more rural in nature, like near the Mongolia, Tibet, or perhaps the Western region?

(hint: do people in Florida eat the same thing as those in Texas, West Virginia, Kentucky, Maine, Wisconsin, California, and Alaska?)

Also, I agree ... diet does have a major influence on people's health. With proper diet and excercise, we can cut down the rate of DM2, CAD, early onset of OA, and probably even HTN and cardiomyopathy. Now whether it leads to increase risk of cancer? That's a little bit more difficult to tease out.

A good primary care doctor (whether DO or MD) will work on diet to prevent such diseases. But just like a doctor telling a smoker to quit, most people will ignore the advice. Why? Humans are a creature of habit, and to tell someone to radically change their daily activity or diet will be difficult to accomplish. You can tell them about diabetes, heart disease, etc. but unless you are telling them that they have it, they'll ignore it. A few will actually change, but the vast majority will continue ignoring the advice until it's too late and you have to start them on oral hypoglycemics, or statins, or anti-HTNs.

You can try to give health eating recommendations to teenagers (good luck with that), or even pre-teens. The trouble is kids don't usually decide what to prepare for their meals ... and convincing the entire family to change is very tough.

Throw in an urban environment (maybe inner city) and you just complicated things a lot more ... fast food is cheaper than healthy food. A big bag of deep-fried chips is cheaper than a bag of fresh apples. It is easier to go order pizza than to cook something fresh. If you are dealing with single parents taking care of multiple kids, it's easier to order take-out than to cook something fresh after a 8-12 hr job (or a double-job).

Or if you're in Texas or North Carolina ... good luck telling a native Texan (or North Carolinan) to stop eating meat.

These are the difficulties towards healthy eating. People are a creature of habit. They want to change, they want to be healthy, but they are not willing to change anything to be healthy ... hence why diet pills, fad diets (promising quick results), diet plans offering cake and sweets as part of the diet, are so popular and part of a multi-billion dollar industry.

 

[jkhamlin]

NEVER trust a review of "extensive studies" by a single person or group ... you have to look at them with a critical eye because studies can be bad, can be biased, or can be reviewed with a biased perspective. 10 bad studies does not make a good argument. That's why in med school and residency, they have journal clubs that will teach you to view articles with a critical eye, to dissect the hidden meanings, to agree or disagree with the conclusions, etc. Even articles that review multiple articles (meta-analysis or Cochrane) attempt to dissect each articles and give limitations of the articles they are reviewing)

 

[indynshrty]

I read the China Study awhile back, and I have to agree with group_theory - the research method used is highly unreliable. What kind of assumption can you make based upon a small group of people overviewed?

But just to clear this up, I was born and raised a vegetarian. Yes, I don't eat meat, and that include fish, turkey and chicken. So, yes, essentially a person can be a vegetarian, healthy, and NOT be hokey. A vegetarian can also be very unhealthy, because they are not eating the right foods (such as eating potato chips all day long, hey, they're not really meat, right?).
It comes down to getting the proper nutrients, staying away from bad fats, and getting plenty of exercise.

I will step off my soap-box now. 🙂

 

[czanetti]

If by "western diet" you mean all the people loading up on cake and ice cream, and having very little variety in their diet, while at the same time the most excercise they get is when the batteries on their remote die, then I agree.

What do you think???? come on. I would probably go with the one that includes the majority of people. Because the majority is what we concern ourselves about when we are in a democratic western culture. This is a very important feature that needs to have a higher priority in medicine today. Just because it would be difficult to implement doesn't mean it wouldn't be feasible. I guarantee that 20 years ago people like you said the same thing regarding smoking cigarettes but yet every year the number decreases. A change in lifestyle isn't easy but it is the most important aspect of living healthy. It is the foundation for prevention, I think you would agree that it would be a little bit more difficult explaining to a patients family that a particular disease had a high percentage chance of being prevented if there family member changed there lifestyle a few years ago as oppose to waiting until a point where medicien could potentially be useless. The point of all this is that we would like to decrease instances like this. In all reality you can't stop everyone from being complacent, but you can directly attack ignorance and reality of the situation by having medicine concentrate on the only medical measure that can make a true lasting effect on an entire population.

One where the patient starts taking more responsibility for there actions when concerning there health, it's a common human fallacy to not realize the impact that our seemingly fleeting daily activity over time can have a cumbersome effect on our health. It's not an excuse if we realize that this is what is going on its our job as future physicians to realize the severity of the problem and attack it head on. It would be difficult to tailor a diet for each individual but everyone has a primary care doctor, which could act as a tool for its mass implication.

 

[jkhamlin]

What do you think???? come on. I would probably go with the one that includes the majority of people. Because the majority is what we concern ourselves about when we are in a democratic western culture. This is a very important feature that needs to have a higher priority in medicine today. Just because it would be difficult to implement doesn’t mean it wouldn’t be feasible. I guarantee that 20 years ago people like you said the same thing regarding smoking cigarettes but yet every year the number decreases. A change in lifestyle isn’t easy but it is the most important aspect of living healthy. It is the foundation for prevention, I think you would agree that it would be a little bit more difficult explaining to a patients family that a particular disease had a high percentage chance of being prevented if there family member changed there lifestyle a few years ago as oppose to waiting until a point where medicien could potentially be useless. The point of all this is that we would like to decrease instances like this. In all reality you can’t stop everyone from being complacent, but you can directly attack ignorance and reality of the situation by having medicine concentrate on the only medical measure that can make a true lasting effect on an entire population.

Not sure what you meant by this, but I can assure you that I am one of the first people to stand behind any effort to increase people's awareness that cigarettes are bad for you, as well as a diet that is low on variety, and habits that don't include regular exercise. People like me weren't saying that about cigarettes. People VERY DIFFERENT from me were saying that.

That said, I don't stand behind unscientific value judgements on types of food. For example, calling fat "bad" is not factually correct, nor is it useful. Also, I don't stand behind attempts to quantify a diet. It is just not possible, nor is it useful. There is too much human variation. That is why there are so many different takes out there on what a "good" diet is; no one can successfully quantify it. It is better to encourage people to exercise regularly, and to get variety without overeating. Our bodies are designed to sort it all out quite well if we do those two things. Trust me, once you get into the habit of exercising regularly, it is very difficult to overeat.

 

[czanetti]

NEVER trust a review of "extensive studies" by a single person or group ... you have to look at them with a critical eye because studies can be bad, can be biased, or can be reviewed with a biased perspective. 10 bad studies does not make a good argument. That's why in med school and residency, they have journal clubs that will teach you to view articles with a critical eye, to dissect the hidden meanings, to agree or disagree with the conclusions, etc. Even articles that review multiple articles (meta-analysis or Cochrane) attempt to dissect each articles and give limitations of the articles they are reviewing)

Anyway, now to the meat of your post

What exactly is a Chinese Diet? Is it what people eat in Beijing? Or Hong Kong? or Shanghai? or perhaps Harbin? or Lanzhou? Or perhaps more rural in nature, like near the Mongolia, Tibet, or perhaps the Western region?

(hint: do people in Florida eat the same thing as those in Texas, West Virginia, Kentucky, Maine, Wisconsin, California, and Alaska?)

Also, I agree ... diet does have a major influence on people's health. With proper diet and excercise, we can cut down the rate of DM2, CAD, early onset of OA, and probably even HTN and cardiomyopathy. Now whether it leads to increase risk of cancer? That's a little bit more difficult to tease out.

A good primary care doctor (whether DO or MD) will work on diet to prevent such diseases. But just like a doctor telling a smoker to quit, most people will ignore the advice. Why? Humans are a creature of habit, and to tell someone to radically change their daily activity or diet will be difficult to accomplish. You can tell them about diabetes, heart disease, etc. but unless you are telling them that they have it, they'll ignore it. A few will actually change, but the vast majority will continue ignoring the advice until it's too late and you have to start them on oral hypoglycemics, or statins, or anti-HTNs.

You can try to give health eating recommendations to teenagers (good luck with that), or even pre-teens. The trouble is kids don't usually decide what to prepare for their meals ... and convincing the entire family to change is very tough.

Throw in an urban environment (maybe inner city) and you just complicated things a lot more ... fast food is cheaper than healthy food. A big bag of deep-fried chips is cheaper than a bag of fresh apples. It is easier to go order pizza than to cook something fresh. If you are dealing with single parents taking care of multiple kids, it's easier to order take-out than to cook something fresh after a 8-12 hr job (or a double-job).

Or if you're in Texas or North Carolina ... good luck telling a native Texan (or North Carolinan) to stop eating meat.

These are the difficulties towards healthy eating. People are a creature of habit. They want to change, they want to be healthy, but they are not willing to change anything to be healthy ... hence why diet pills, fad diets (promising quick results), diet plans offering cake and sweets as part of the diet, are so popular and part of a multi-billion dollar industry.

http://www.cdc.gov/tobacco/research_data/adults_prev/prevali.htm

Here is a little info on the amount of people and the decrease in smoking over the years. I work for the New York state smokers quit line and believe me I know how difficult this aspect of change can be. I also am starting a smoking prevention program at my college. Regardless the fact of the matter is that the numbers show the decrease in smokers. So people aren’t ignoring doctors all together, it just takes time for it to take effect.

You mentioned how fast food and less healthy food is much cheaper and convenient. This is true one possible solution for this is something called a Sin Tax
http://www.cdc.gov/tobacco/research_data/adults_prev/prevali.htm

It’s a step in the right direction but there needs to be more done on this subject. Once again just because it will take time and isn’t as instantaneously gratifying as giving some a surgery, medication or other seemingly quick fixes for the problem doesn’t mean we should ignore it and drop it because of difficulty level. It’s a fact that prevention needs to take a higher priority in medicine. Nutritional values should be a starting ground.

Creatures of habit we may be but we are also creatures of change. The paradox of the human species is what causes drastic paradigm changes. It is what has gotten us this far.

 

[It'sElectric]

However, from extensive studies that I've read from the book this is not the case. The more animal based products we consume the more likely we are to develop cancer, diabetes, and heart disease (diseases of affluence). Now I am not going to rewrite the book here but I will say that the book is NOT a diet book.

Don't you think it's a little misguided to put so much stock into one book's perspective??

I've personally never read the book, but I can assure you that I would never place so much value in a singular piece of "evidence".

 

[czanetti]

Not sure what you meant by this, but I can assure you that I am one of the first people to stand behind any effort to increase people's awareness that cigarettes are bad for you, as well as a diet that is low on variety, and habits that don't include regular exercise. People like me weren't saying that about cigarettes. People VERY DIFFERENT from me were saying that.

That said, I don't stand behind unscientific value judgements on types of food. For example, calling fat "bad" is not factually correct, nor is it useful. Also, I don't stand behind attempts to quantify a diet. It is just not possible, nor is it useful. There is too much human variation. That is why there are so many different takes out there on what a "good" diet is; no one can successfully quantify it. It is better to encourage people to exercise regularly, and to get variety without overeating. Our bodies are designed to sort it all out quite well if we do those two things. Trust me, once you get into the habit of exercising regularly, it is very difficult to overeat.

I don't know how can you say that it wouldn't be possible to set up a nutritional plan for an individual when they have a primary care doctor that could do just that. Each person has a variation I agree and fully appreciate the complexity of the situation, but have you ever seen a nutritionist? Do you know how long it takes to get a simple plan set up. Athletes have this done on a regular basis. It will take effort to adjust the current system for such changes but its possible. I think the biggest problem that we should be concerned about would be the price of healthy food compared to fast food. Sin tax is one possible way there needs to be more.

 

[czanetti]

dbl pst

 

[czanetti]

Don't you think it's a little misguided to put so much stock into one book's perspective??

I've personally never read the book, but I can assure you that I would never place so much value in a singular piece of "evidence".

You know most books have more than one source that they obtain there information from. I highly doubt that the book has one set of researchers doing all the studies.

Regardless the idea of putting more of a priority on nutrition is the most important aspect of the conversation. There are many studies to back up the effect of diet.

 

[It'sElectric]

You know most books have more than one source that they obtain there information from. I highly doubt that the book has one set of researchers doing all the studies.

I completely agree with you, since I never made this statement. The research doesn't have to come from one person or even group for it to become heavily biased. As anyone that has done research should know, 2 different individuals can draw entirely different conclusions from different sources of information.

The people that wrote this book compiled and interpreted the research as they saw fit. I'm sure they did an excellent job of making a compelling argument, but all of that does not equate to them being right.

My simple point is that everyone on this planet has some sort of bias/agenda, and it would be misguided to place all of your faith into one source of information. Unfortunately, people do it everyday.

 

[It'sElectric]

You know most books have more than one source that they obtain there information from. I highly doubt that the book has one set of researchers doing all the studies.

Regardless the idea of putting more of a priority on nutrition is the most important aspect of the conversation. There are many studies to back up the effect of diet.

I whole-heartedly agree that nutrition is an integral part of any person's lifestyle. The fact of the matter remains that Americans (Westerners, whatever) do not follow healthy diets and exercise routines. We're not all dying because we eat meat and dairy. We're all dying because we don't exercise, we eat fried foods and fast food, and we have an overall disinterest in our health. The United States is a constantly "on the go" society, and we're paying for it.

If you can rectify these very obvious problems, then I'm certain that there would be an overall decline in many of the diseases that plague our society today.

 

[czanetti]

I completely agree with you, since I never made this statement. The research doesn't have to come from one person or even group for it to become heavily biased. As anyone that has done research should know, 2 different individuals can draw entirely different conclusions from differents sources of research.

The people that wrote this book compiled and interpreted the research as they saw fit. I'm sure they did an excellent job of making a compelling argument, but all of that does not equate to them being right.

My simple point is that you everyone on this planet has some sort of bias/agenda, and it would be misguided to place all of your faith into one source of information. Unfortunately, people do it everyday.

I completly agree with you there, there is a lot of biased in are current healthcare system too. I am just pushing for more concentration on prevention, and nutrition would be a great way to start. The healthcare system has a biased too and doesn't appreciate prevention as much as it should.

 

[It'sElectric]

I completly agree with you there, there is a lot of biased in are current healthcare system too. I am just pushing for more concentration on prevention, and nutrition would be a great way to start. The healthcare system has a biased too and doesn't appreciate prevention as much as it should.

Agreed.

 

[MossPoh]

So I got this book for Christmas and just finished reading it. Did anyone else here have the chance to look at this? As a VERY BRIEF and incomplete summary the author presented lots of evidence as to how many major diseases such as diabetes, cancer, and heart disease can be prevented or combated with a diet of plant-based, whole foods. And that the "Western diet" we eat in the U.S. consisting of high animal protein and dairy is what is contributing to a majority of our population getting these diseases at some stage in our lives.

So I wanted to ask my fellow SDN'ers:

1) Do you think that diet has much influence on our total health? And if so, to what extent?

2) As future D.O.'s we have a duty to encourage prevention of diseases and after reading the book I feel that recommending a healthy diet based on plant-based, whole foods would accomplish that goal well. Would any of you give advice concerning diet to your patients or would you feel that you are not in a position or authority to do that?

Please let me know your thoughts on this matter, if you've read the book that's great (And I do encourage those who haven't to pick it up, it is an easy read for the most part), but if you haven't read it your opinions concerning the relationship between diet and medicine are still welcome. Thanks!

Diet does have an impact on total health.....it has been shown that crappy diets can lead to an increased risk of cancer (correlation is probably a better term), along with all of the other standards. Also pickled foods and smoked foods have a correlation to cancer....which is suspected to be the reason why the Scandinavians countries have such a higher risk of cancer than even the united states.

 

[Doctor Bagel]

Vegetarian diets ARE hokey. The human animal is an omnivorous animal. Humans have to eat meat. Vegetarian diets are incomplete nutrition. It is definitely NOT safe for all ages. There have been cases where people had their children taken away because of malnutrition and neglect due to parents putting them on vegetarian diets. These hokey diets are EXTREMELY dangerous to young children. 🙄

Okay, show me your data to prove that. You can just say it, but what credibility do you have? Sorry, but I'll trust the ADA before I trust some random premed on a message board. 🙄

 

[NonTradMed]

I agree that a diet high in animal fat, meat and dairy products is bad, and that is it s a well rounded diet which consists mostly of healthy carbs, vegetables and some meats that are probably most healthy. Any country with a diet that consists of a variety of foods, and lots of fresh fruits and vegetables is probably healthier than any diet that consists of lots of fatty, fried foods and animal products.

I will add that where my parents are from in Sichuan, China, people there really do have a overall healthier diet than the average American. The main reason (my parents say) is that there are literally a several dozen types of vegetables available and people there load up on vegetables as a result. Meat was traditionally eaten a few times a week at most. And people eat a lot of fish and chicken if it's availabe rather than pork or beef. Also, tofu is huge, a main staple that replaces meat sometimes.

The end result are people with slimmer build and shorter stature (perhaps contributing for the Sichuanese' sensitivity to height) but also overall lower rates of heart disease and other 'affluent' illnesses.

 

[toothless rufus]

The healthcare system has a biased too and doesn't appreciate prevention as much as it should.

Why would they? Since from a business sense by preventing a disease you are preventing income. Especially nice expensive chronic ones.

 

[NonTradMed]

Why would they? Since from a business sense by preventing a disease you are preventing income. Especially nice expensive chronic ones.

I spoke with my parents about this, and they said that's one reason why their company (a BigPharm) shutdown parts of its infectious disease research unit and is focusing on things like AIDS, diabetes etc. They said that drug companies would prefer drug treatments for people with the disease rather than cures or vaccinations because treatments lasts a lifetime while cures and vaccinations is a one shot thing. I guess that's a harsh way to look it but it does make sound economic sense.

 

[czanetti]

Here is another idea try to explain to a business run healthcare system that we will give you great results but you won’t be able to see it for about 20 years oh and it’s also going to take much longer than that to make it more efficient and reach as many people as we can. Plus it is going to involve a multifaceted approach with primary care physicians, FDA, massive grant funding for information distribution and you probably won’t make any money off of it because it involves informing the people and having them take more responsibility for there well being. As oppose to spoon feeding them biased information when it comes to pharmaceutical commercials, having junk food, fast food be much cheaper for them than nutritional foods and other great aspects of our system that are currently flawed. It doesn’t make any sense humanely why they wouldn’t put more pressure on our healthcare system to concentrate on prevention more heavily. But it makes perfect business sense why they wouldn’t. It is like comparing it to global warming. Humanly we need to do something about it we have had the information that shows great evidence for it for a long time. When regarding a business perspective it’s a nightmare. When you mix business with human life it will slow the process down every time. It took until this year for Bush to recognize the severity http://www.washingtonpost.com/wp-dyn/content/article/2007/01/04/AR2007010401264.html

Hopefully it won’t take much longer for our healthcare system to recognize its own global warning ie. Prevention, problem.

 

[dlazar]

I spoke with my parents about this, and they said that's one reason why their company (a BigPharm) shutdown parts of its infectious disease research unit and is focusing on things like AIDS, diabetes etc. They said that drug companies would prefer drug treatments for people with the disease rather than cures or vaccinations because treatments lasts a lifetime while cures and vaccinations is a one shot thing. I guess that's a harsh way to look it but it does make sound economic sense.

Harsh are you kidding me? Chronic diseases can be reduced easier through prevention. There are no cures for heart disease (Take this pill and it will open your arteries). Diet and Exercise are the real cures. But how do you explain to individuals that fast food is not a good source of nutirion when there are no alternative options that are fast and inexpensive. Eating healthy is expensive and limited.

 

[It'sElectric]

Eating healthy is expensive and limited.

People always say this, but I genuinely disagree. Hear me out for one second. If you were to go all out and literally try to lead a diet that is perfectly balanced and full of only the healthiest foods, then yeah, there would be a significant difference in price between that diet and one based solely on fast foods.

Nevertheless, it is not impossible to develop a diet that is rich in nutrition and variety, easy to do, and not so expensive that you won't be able to pay rent. Fact of the matter is, people are lazy. They're too lazy to fit the time into exercise and they're far too lazy to take the time and effort to develop a reasonable diet - one that isn't based on the McDonald's Food Pyramid.

I definitely do NOT eat perfectly. I struggle with incorporating vegetables into my diet on a regular basis, but it is possible to eat reasonably healthy with very little time to do it. I have no desire to follow the "perfect diet" becasue, like most people, I like certain foods that I am unwilling to completely give up. You only live once, so it would be a shame to not enjoy the occasional pleasure now and again.

 

[czanetti]

you can eat what you want but in moderation. It is possible to create a nutritional plan that is convienient. Its just a matter of doing it through the health care facilities and coming up with a innovative program.

 

[dr.kicia]

yes diet is VERY important for health.
i think the problem of Americans with obesity, health etc. doesn't lie in the consumption of too much protein or what not but in the quality of the food here:
-food processing (which is crazy, it's enough to read some food labels and then it gets really scary...for instance in many European countries, like Poland GMO is not even allowed and most ppl eat home grown food with very little additives, collorants and preservatives...one thing that always suprizes Poles is American bread's abbility to stay fresh for weeks and it's "plasticity" ).
-the amounts of food, portions and all that king size stuff is what a regular person in Europe would eat over the period of two days or something close to it.
-the fact that most people drive even to their mailbox doesn't help either.😛

I do not belive in any crazy diets etc. but i do belive that processed food is bad for you.

 

[Doctor Bagel]

I do not belive in any crazy diets etc. but i do belive that processed food is bad for you.

But the plant based diet advocated by the book isn't a crazy diet. And unlike jkhamlin's protestations to the contrary, vegetarianism isn't "hokey."

 

[Beau Geste]

These are the trends that I observe related to "western diet" and illness:

1. laziness: not many people exercise.

2. processed foods: originally meant to up the shelf life and decrease productivity costs, but strip foods of nutrients.

3. Really good public transportation/vehicle ownership. Although public transport isn't a bad thing, many people really don't have to walk very far if they don't have to, to take care of daily living.

4. Limited education on health and exercise in the school. As much as the government likes to make itself look good with the food pyramid and "healthy school lunches", the school districts where I live don't emphasize health very well. And my husband's best friend is a health teacher for a jr. high.

Trends I do see related to "eastern diet":

1. Limited public transportation: lots of walking

2. Less access to refined foods, although this is changing with fast-food, and obesity rates are increasing there too.

3. More home-cooked meals? It seems like this is the case, but I haven't seen as much reported on this as the other stuff.

There are so many other cultures that incorporate tons of omnivorous content, such as Italy, Greece, Middle East countries, Spain, France. They all eat oils, red meat, drink alcohol (except maybe for religious reasons) and so on, but moderation is key, and it's how the food is processed. They eat more whole foods, and fresh foods. America is bound by ocean, but not many have fish as a staple. And so on with other healthy foods. And these countries all get more exercise than Americans.

If I could only change one thing about American diet - more exercise.

 

[jkhamlin]

http://www.cdc.gov/tobacco/research_data/adults_prev/prevali.htm

Here is a little info on the amount of people and the decrease in smoking over the years. I work for the New York state smokers quit line and believe me I know how difficult this aspect of change can be. I also am starting a smoking prevention program at my college. Regardless the fact of the matter is that the numbers show the decrease in smokers. So people aren’t ignoring doctors all together, it just takes time for it to take effect.

You mentioned how fast food and less healthy food is much cheaper and convenient. This is true one possible solution for this is something called a Sin Tax
http://www.cdc.gov/tobacco/research_data/adults_prev/prevali.htm

It’s a step in the right direction but there needs to be more done on this subject. Once again just because it will take time and isn’t as instantaneously gratifying as giving some a surgery, medication or other seemingly quick fixes for the problem doesn’t mean we should ignore it and drop it because of difficulty level. It’s a fact that prevention needs to take a higher priority in medicine. Nutritional values should be a starting ground.

Creatures of habit we may be but we are also creatures of change. The paradox of the human species is what causes drastic paradigm changes. It is what has gotten us this far.

I served on my hospital's Tobacco Free Task Force to help make the transition to a totally tobacco free campus last year to comply with new state licensing requirements. Unfortunately smokers still bitch about their "rights," and continue to smoke on campus. Our senior VP has finally had security start cracking down on these people. They just don't stop. The worst thing is the employees who work in clean areas and have to wear the clean scrubs from the hospital. They go outside, wander around the parking lot and smoke, and then return to the clean areas without changing.

We tried to pass a tobacco tax twice in the last few years here in Missouri. It didn't pass either time, although it did come close. People came up with every possible canard they could come up with to oppose it. I was about the only person in my department in the hospital who was for it. Unfortunately, my state has one of the lowest taxes on tobacco, but in my state, smokers cost on society is one of the highest.

However, I wouldn't support a tax on any food item that doesn't have unquestionable proof of causing harm to society. Alcohol is about the only one I would currently support. In addition to the fact that it is a dangerous hard drug, it has the added detriment that 10% of alcohol consumed is converted to fat whereas less than 3% of all other calories consumed are converted to fat.

 

[jkhamlin]

I don't know how can you say that it wouldn’t be possible to set up a nutritional plan for an individual when they have a primary care doctor that could do just that. Each person has a variation I agree and fully appreciate the complexity of the situation, but have you ever seen a nutritionist? Do you know how long it takes to get a simple plan set up. Athletes have this done on a regular basis. It will take effort to adjust the current system for such changes but its possible. I think the biggest problem that we should be concerned about would be the price of healthy food compared to fast food. Sin tax is one possible way there needs to be more.

I am an athlete and I stay far away from nutritionists. They are full of pseudoscience fashion magazine rhetoric. Everything they say conflicts with the physiology, anatomy, biochemistry, and cell biology that I have learned as a biologist.

 

[czanetti]

I am an athlete and I stay far away from nutritionists. They are full of pseudoscience fashion magazine rhetoric. Everything they say conflicts with the physiology, anatomy, biochemistry, and cell biology that I have learned as a biologist.

I am an athlete too. I am also not in the dark at all about research, the scientific method, biology, biochemistry and physiology, kinda been doing research involving all of the above for the past 5 years. I have a degree in biomedicine, psychology. So the background is there.

http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=16624970

I'll start with the most recent I found within 2 seconds if you are suggesting that diet, nutritional factors don't have anything to do with science your wrong. Nutritionists would be a suggestion because they refer to scientific articles. Such as the one above.

Here is one on heart disease.
http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=16311219

You know nutritionists probably don't look at these articles at all considering they deal directly with there profession.

Come on think.

 

[Doctor Bagel]

I am an athlete and I stay far away from nutritionists. They are full of pseudoscience fashion magazine rhetoric. Everything they say conflicts with the physiology, anatomy, biochemistry, and cell biology that I have learned as a biologist.

yeah, but apparently you can't back up or cite anything you've learned as a "biologist" to support your assertions in this thread. so you're brilliant. nutritionists are stupid, and you've got nothing to back it up. and yes, you know so much more than vegetarians with better credentials than you, or am i mistaken and are you a tenured science prof at cornell? 🙄

 

[czanetti]

Now regarding Tobacco and the great state of Missouri

http://agebb.missouri.edu/mass/farmfact/crops/crop.htm

Here is how much Tobacco crops our worth to the state
$5.49 million

I found an interesting article regarding the tax hike.
http://archive.columbiatribune.com/2006/oct/20061023busi009.asp

This confirms my point before that our current healthcare system is not putting high enough of a priority on prevention. Comments like this “Opponents say the tax has nothing to do with preventing smoking and everything to do with funding universal health care at an expense to taxpayers of $1.7 billion.”
Do not make any sense when the average smoker spends 5$ a pack on a pack of cigarettes when it takes 5cents to produce the pack, create an addiction and slowly kill the individual along with anyone in the vicinity of the smoker through second hand smoke. This absurd argument has no foundation when you regard the scientific rigor (the sheer amount of scientifically based evidence that shows how smoking will kill you and others)
The FDA and our healthcare system needs to step up its provisions for prevention period. Votes like this that involve and ignorant, addicted, and economically liable public is bound to have a blind bias to the true health and well being of its people.
Nutrition is a way to start just like developing better smoking prevention programs.

 

[TerpDO]

wow, I've created a monster here with this thread, here are some replys and comments to the earlier posts so far:

Harsh are you kidding me? Chronic diseases can be reduced easier through prevention. There are no cures for heart disease (Take this pill and it will open your arteries). Diet and Exercise are the real cures. But how do you explain to individuals that fast food is not a good source of nutirion when there are no alternative options that are fast and inexpensive. Eating healthy is expensive and limited.

you are right on that prevention may be the best way to reduce chronic diseases but I feel that you are dead wrong that eating healthy is expensive and limited. Though I currently eat a varied diet (pizza and burgers 3-4 times a week, cereal every morning, sandwiches for lunch) I know that there are tons of vegetarian and healthy dishes that I do not even know about because I've never looked into it, I highly doubt that a vegetarian diet would be limiting if I were to adopt it and did some research into what is out there. And in terms of money compare the cost of a pound of black or red beans to a pound of chicken breast or lean beef. Which is more expensive do you think?

I agree that a diet high in animal fat, meat and dairy products is bad, and that is it s a well rounded diet which consists mostly of healthy carbs, vegetables and some meats that are probably most healthy. Any country with a diet that consists of a variety of foods, and lots of fresh fruits and vegetables is probably healthier than any diet that consists of lots of fatty, fried foods and animal products.

I agree with this and the comment about processed foods almost 100%. You can argue that a diet rich in animal-products can be healthy (I've read a report on Eskimos and how they are so healthy even though they eat tons of fats and meat) but all their foods are unprocessed. They also are more likely to have jobs that involve hard labor and not ones where they sit around all day so just adopting their diet without their lifestyle probably would not work in the U.S. In addition, I would bet that the vast majority of people who are concerned about their own health would choose a diet without meat and dairy products over a diet without fruits and vegetables. Deep down you know that eating lots of meat, especially the overly processed types in the U.S. is detrimental to our health.

Don't you think it's a little misguided to put so much stock into one book's perspective??
I've personally never read the book, but I can assure you that I would never place so much value in a singular piece of "evidence".

This is a good point, and my quote earlier that "However, from extensive studies that I've read from the book" was meant to say that the point I am about to make is solely from reading the book and reacting to it so soon after reading it. In other words, I have not done much personal research from other sources at this point but would definitely do so before giving any diet advice to my patients as a doctor. Hopefully by then the data will be more clear, like the effects of smoking today. But just to make a point, from reading what the author as written I do believe that the research he talks about is EXTENSIVE and involved great populations of people, not just a small population as stated earlier. And while not every point is explained in details, there are major trends between diet and disease rates that are pointed out that are very compelling.

My simple point is that everyone on this planet has some sort of bias/agenda, and it would be misguided to place all of your faith into one source of information. Unfortunately, people do it everyday.

+

Why would they? Since from a business sense by preventing a disease you are preventing income. Especially nice expensive chronic ones.

Now these are also very good points. But I want to ask you, as a future physician are you going to graduate medical school with the intentions of making the most money you can off of your practice or are you going to try to support and maintain the health of your patients in the manner you best know how? In one way you are going to try to educate your patients about diet, lifestyle and its relationship to prevention and in the other you are going to advocate surgery, prescription drugs, and specialists. For those who are simply blowing off the information about diet as another fad, it can be a choice with significant consquences both personally and for the patients they encounter.


Lastly,

However, I wouldn't support a tax on any food item that doesn't have unquestionable proof of causing harm to society. Alcohol is about the only one I would currently support. In addition to the fact that it is a dangerous hard drug, it has the added detriment that 10% of alcohol consumed is converted to fat whereas less than 3% of all other calories consumed are converted to fat.

I wanted to ask, would you support a tax on fried chicken? McDonald's fries? TGI Friday's Jack Daniels steak and shrimp platter? McDonald's fries are made with trans-fats which are just now considered pure-poison to the body. In fact, it is now recommended that butter (with it's saturated fat) be used over margarine which contains some trans-fat. NYC is banning trans-fats in restaurant use. Now why would they do that if it didn't have "unquestionable proof of causing harm to society?" And as for the the Friday's platter, it probably contains 3-4 servings on one plate which is far more than any person needs to eat in one sitting. Overeating certainly is causing harm to society wouldn't you say??

 

[koshka]

I am an athlete and I stay far away from nutritionists. They are full of pseudoscience fashion magazine rhetoric. Everything they say conflicts with the physiology, anatomy, biochemistry, and cell biology that I have learned as a biologist.

INTRODUCTION: As shown in the first part of this article, consuming high amounts of fruits, vegetables, whole grains and nuts can lower the risk for several chronic diseases. However, the relevance of animal foods consumed within a vegetarian diet is less well-known. MATERIALS AND METHODS: We followed a nutritive and a metabolic-epidemiological approach to obtain dietary recommendations. A MEDLINE-research was performed for all animal food groups relevant with a vegetarian diet (key words: "eggs", "milk", "dietary pattern" "vegetarian diet", "cancer", "cardiovascular disease", "diabetes mellitus", "osteoporosis", "vitamin D", "vitamin B(12)", "iron", "iodine"). All relevant food groups were characterized regarding their nutrient content and rated with respect to the available metabolic-epidemiological evidence. RESULTS: Based on the evidence criteria of the WHO/FAO, colorectal cancer risk reduction by a high intake of milk and milk products is assessed as probable, while a higher risk of prostate and ovarial carcinomas is also probable. The evidence of a risk-increasing effect of eggs relating to cardiovascular disease, colorectal cancer and breast cancer is assessed as probable. As the data of prospective cohort studies suggest, a prudent diet pattern characterized high in fruits, vegetables, whole grains and nuts is associated with a lower risk of coronary heart disease and diabetes mellitus type 2. In contrast, there is no overall association between prudent diet pattern and risk of breast cancer or colorectal cancer. The critical key nutrients for vegetarians are vitamin D and B12, iodine and iron. CONCLUSION: For the first time evidence based dietary recommendations were provided for persons on a vegetarian diet in the D-A-CH-region.

Of course, you already know there are thousand of peer reviewed literature on vegetarian diets. What Exactly are you basing your opinion on? I noticed from your previous posts that you seem to outright slam everything that doesn't agree with your opinion...at least admit that there are other credible ideas out there

 

[jkhamlin]

Of course, you already know there are thousand of peer reviewed literature on vegetarian diets. What Exactly are you basing your opinion on? I noticed from your previous posts that you seem to outright slam everything that doesn't agree with your opinion...at least admit that there are other credible ideas out there

It is based on what I posted before. The basic biological fact is that humans require an omnivorous diet. It is the way our bodies were designed and you cannot change that. Period. There are nutrient requirements that just cannot possibly be met by a vegetarian diet, especially for children, or those engaging in regular exercise programs. I'm not even talking cancer and all that other stuff, just common basic nutritional requirements, which is the only really important part of a diet.

 

[jkhamlin]

Come on think.

I do think. That's the problem. Too many people don't. You guys have similar biology education as I do. Look at the things nutritionists say, and then think about the biological facts that you learned. They are in direct conflict with each other. They can't both be right.

 

[koshka]

It is based on what I posted before. The basic biological fact is that humans require an omnivorous diet. It is the way our bodies were designed and you cannot change that. Period. There are nutrient requirements that just cannot possibly be met by a vegetarian diet, especially for children, or those engaging in regular exercise programs. I'm not even talking cancer and all that other stuff, just common basic nutritional requirements, which is the only really important part of a diet.

That is not a basic biological fact. That is simply your clearly uneducated opinion. But choose to believe what you wish, I don't particularly care now that I expressed my opinion. Your line of argument is based on simply stating "no you are wrong!"

: Forum Nutr. 2005;(57):147-56. Links
Vegetarian diets: what are the advantages?Leitzmann C.
Numerous studies have demonstrated that the observed deficiencies are usually due to poor meal planning. Well-balanced vegetarian diets are appropriate for all stages of the life cycle, including children, adolescents, pregnant and lactating women, the elderly and competitive athletes. In most cases, vegetarian diets are beneficial in the prevention and treatment of certain diseases, such as cardiovascular disease, hypertension, diabetes, cancer, osteoporosis, renal disease and dementia, as well as diverticular disease, gallstones and rheumatoid arthritis. The reasons for choosing a vegetarian diet often go beyond health and well-being and include among others economical, ecological and social concerns.