Food Over Medicine (24 page)

It’s often one of the reasons why people won’t seek care from somebody else or get a second opinion; they just think they’re stuck with it. I see this when people come to dinners here at The Wellness Forum. They’ll come as a guest with somebody else; they really don’t know much about what we do and they’re just flabbergasted to find out. They’ll raise their hands and say, “I have high cholesterol and I’ve done the diet thing; I’ve tried everything and I just can’t get my numbers down. I’ve been taking statin drugs and my doctor says that’s just the way it’s going to be. Now you’re telling me that you can get rid of that problem?” When I estimate a 95 percent chance that proper diet will rid them of that problem, they almost cannot believe it. It’s breathtaking to them.

It’s very important that people understand the difference between having a gene and genetic expression, and the effect that your behavior has on the expression of certain genes, including those that predispose you to developing diseases. We have lots of evidence.

First, we have migration studies that have shown that when people move from one area to another and start eating the typical diet of their new home, they soon have the same disease risk of the area to which they moved.
⁴
For example, Japanese women in the United States are significantly more likely to develop breast cancer than Japanese women living in Japan and other Asian countries.
⁵
One of the reasons is that the traditional Japanese diet is lower in fat, particularly saturated animal fat, than the typical Western diet. In the 1940s, breast cancer was relatively rare in Japan; at that time, the Japanese diet was comprised of less than 10 percent of calories from fat.
⁶
But within a short time after moving to the United States, Japanese women have the same risk of breast cancer as American women.

Their genetic makeup does not change as they fly across the ocean to their new homes; the main cause is the increase in consumption of fat, particularly fat in animal foods. Their behavior changes when they get here—that’s the cause of their health deterioration. One of the first such studies was published in the
Journal of the National Cancer Institute
in 1968; it demonstrated that when people migrate from one area to another and adopt the typical diet in their new home, they acquire the disease risk of the area to which they migrated.
⁷

There are some interesting population comparisons that have been done. One of them involves the Pima Indians, who are essentially divided into two groups: one leads a mostly Westernized lifestyle in Arizona, consuming a diet high in animal protein and fat; the other eats a more traditional Indian diet in Mexico: a grain and starch-based diet, with potatoes, corn, rice, beans, and locally grown vegetables and fruit—a diet with more than fifty grams of fiber per day. So they have the same ethnicity, essentially the same genetic makeup, and are close geographically, yet we find a huge difference in the diabetes rates between one group and the other. Naturally, the far worse outcomes are with the Western diet and lifestyle habits.

GM:
How big is the difference?

PP:
Diabetes rates are about 38 percent in the Arizona Pima and 6.9 percent in the Mexican Pima, according to the 2006 study published in
Diabetes Care.
⁸
That’s a big difference for people who are essentially ethnically identical.

We have to educate people quite a bit to get this point across. I’ll tell you an area where it affects public policy. This way of thinking is going to take a long time to shift, but controversy arises when insurance companies and other companies seek to reward people for improving their health and losing weight. There are always those who object that companies are discriminating when they reward people for improving their health, since they see people as helpless victims of their genetic history. If we assume that people have no control over their own health, it seems unfair to reward those who lose weight. How then do we compensate the people that can’t possibly lose weight because everybody in their family’s overweight? Well, this is the defeatist prevailing wisdom out there. We need to tell employers that for the very tiny percentage of employees who actually can’t change their health status, then we agree—they shouldn’t be penalized. But for the rest of the group who can do something about it, they should be rewarded for doing it and penalized if they don’t. That’s an area where this misconception about genetic predisposition really influences what can be done in the public arena.

GM:
Let’s move on to supplements, since a lot of studies are designed to demonstrate whether or not they provide a benefit.

PP:
What we find is that the weight of the evidence shows over and over again that supplements fail to prevent, stop, or reverse any disease. Sometimes they’re even harmful. The advocates of the supplements are not usually the conventional doctors, but rather complementary and alternative and integrative practitioners, who I refer to as “holistic pharmacists.” They are gaining more traction every day because of dissatisfaction with the traditional medical community. That dissatisfaction is widespread, and I firmly understand its roots. But the holistic pharmacists say to treat your health problems with health supplements instead of drugs because they’re natural and don’t have the same toxic side effects.

The reality remains that treating symptoms instead of the underlying cause is a bad idea. You could argue that some of the supplements are less toxic than the drugs, but they still don’t solve the problem. You’ve just got a different method of symptom control. Second, it’s premised on the same defeatism toward diet that conventional medicine offers: people won’t eat the right diet, so we have to give them supplements. I totally disagree with that whole line of thinking. And if you look at the studies, they clearly show that you cannot make up for your dietary indiscretions by popping a couple of vitamin pills in the morning. Much of the public has bought into the attitude toward supplements that they’re harmless. Even if they don’t help you, they believe, supplements aren’t toxic; the worst-case scenario is that you end up with expensive urine. I still hear a lot of comments like that.

In fact, there was a huge study reported in the
British Medical Journal
in 2006 that looked at tens of thousands of participants and addressed the issue of whether or not omega-3 supplementation actually helps. That’s a hot issue right now. Lots of doctors are promoting the idea that omega-3 deficiency has to be made up for with supplements. The study demonstrated that supplementation resulted in no benefits, found no reduced risk of total mortality or cardiovascular events in participants, and couldn’t rule out an increased risk of cancer.
⁹
That’s a powerful study that supports my premise: you can’t make up for your dietary indiscretions with supplements.

Then we have The Cochrane Collaboration. I like studies done by Cochrane because, again, it’s one of the more independent groups out there. They do meta-analyses of previously published studies. It’s hard to find people and groups that aren’t corrupted by industry influence in some form or another. This is a huge study: sixty-seven randomized trials, with close to a quarter of a million participants. And the researchers concluded as follows:

And people are just flabbergasted at this kind of stuff. You mean vitamin C and vitamin E might have medicinal properties, and I should be careful about taking them? Well, yes, a quarter of a million people in sixty-seven randomized, controlled trials is a pretty good sample. I don’t think we can fault them for not having a large enough cohort here.

Then there’s the Folate After Coronary Intervention Trial,
¹¹
a study published in the
New England Journal of Medicine
in 2004. This study took patients who already had stents implanted and randomized them into two groups: one got folic acid; the other received a placebo. After six months, the results were clear: those getting the folic acid had their arteries clogging again faster than the others. The big take-home point here is that supplements should be treated like medicine. In that regard, they can be useful for specific and targeted purposes. But if you’re self-medicating by buying this stuff over the Internet, through your neighbor in a multilevel marketing business, or at a health food store, and you’re thinking that the worst-case scenario is ending up with expensive urine, you’re wrong. People really need to rethink the money they spend on supplements and the potential damage to their health the supplements can cause.

GM:
When you talk about expensive urine, I’ve often wondered how much of these supplements are just excreted?

PP:
Well, a lot of it is excreted. But excreting substances not needed by the body can cause health issues, ranging from kidney stress to increasing risk of disease. The Folate After Intervention Trial showed that patients taking folic acid after angioplasty were developing arterial thickening faster than patients taking a placebo. The study was ended early as a result.

And there really is no such thing as a “natural” vitamin. In whole foods, nutrients are all bundled up in packages with coenzymes, conutrients, and that sort of thing. We purify these nutrients and take them in pill form, but the first thing the body starts doing is drawing cofactors out of the cell’s tissues to try to create a complex that looks familiar. We’ve seen people develop what I call compensatory deficiencies. A person will take highly purified isolated nutrients and in the body’s attempts to find something to do with these nutrients, it will actually deplete stores of other nutrients.

GM:
So you’re saying the body doesn’t really know what to do with a dose of isolated vitamin E or isolated ascorbic acid?

PP:
Right. The other problem you encounter is flooding the receptors. For example, there are about six hundred different carotenoids in foods. So you take in a massive dose of beta-carotene, for example, and that’s one out of the six hundred. Well, you only have one carotenoid receptor in every cell, so you overwhelm the cells with this massive amount of beta-carotene you’re taking in every day. Then you start eating actual food and your body can’t use the other carotenoids you’re taking in from the foods that you’re eating.

GM:
How about someone who takes the attitude, “Well, I’ll pop a multivitamin once a day or once a week just in case I’m missing some nutrients somewhere that I don’t know about.” Still a bad idea?

PP:
Well, the first thing I would do is laugh because nobody comes to The Wellness Forum with deficiency conditions. What, I wonder, do you think you’re missing? And to my colleagues whom I meet at “alternative conferences,” who tell me that they supplement their patients, I ask, “Why? When’s the last time you had somebody in your office with scurvy? How many people in our line of work are treating beriberi these days?” All the people who are coming to us with health problems have diseases of excess. We’re way too worried about deficiency in a place where deficiency is just not an issue. The second thing I ask people is, “Do you own stock in a vitamin company that you buy this stuff from?” I can’t think of any other reason to take it. In other words, we don’t have any evidence showing that this helps people in any way in the long term, so unless you own stock in the company and it’s your way of supporting its efforts, I don’t know why you’d want to waste your money.

GM:
The one exception you make is with vitamin B
₁₂
, right?

PP:
Yes, but it’s very misunderstood because most people assume that as soon as you adopt a plant-based or vegan diet, B
₁₂
deficiency is an imminent risk. We see B
₁₂
deficiencies, and I do here, much more in meat eaters than we do in plant eaters. And the reason is, while they’re taking in a lot of B
₁₂
in the animal foods that they’re eating, they are notorious for having gastrointestinal problems, which range from simple constipation to serious inflammatory bowel diseases. A lot of times these people are deficient in intrinsic factor, which is a protein manufactured in the stomach that helps with the absorption and use of B
₁₂
. So you can be taking in plenty of B
₁₂
and not using it well at all. Having said that, most people who eat a plant-based or vegan diet are eating some fortified foods. We’re consuming plant milks that are fortified with B
₁₂
, for example, and B
₁₂
requirements are really low. It’s not very likely for somebody to develop a deficiency. The people most at risk are the rare individuals who eat no animal foods and no fortified foods. They
can
develop a B
₁₂
deficiency; supplements are probably a good idea for people like that.

Before I wrote my last book, I did some research looking for toxic effects of B
₁₂
and I couldn’t find any. I don’t discourage people who take a B
₁₂
supplement the way I discourage taking other supplements because you’re not going to hurt yourself with it. So I’m fine with people saying that supplemental B
₁₂
is an insurance policy and they feel better for taking it.

GM:
If the body doesn’t know what to do with a massive dose of ascorbic acid or vitamin E, does it know how to process a sudden massive dose of B
₁₂
? Does the same problem present itself?