.

How to Reliably Combat Disease

and Achieve Optimal Health
through Nutrition and Lifestyle

Neil Nedley, M.D.

Edited by David DeRose, M.D.

JI1
&

eil Nedley, M.D.

1010 14rh t. W
Ardmore. OK 73401

Copyright 1998 by Neil Nedley, M.D.

AII rights reserved. No pan of chis book may be u 'ed or reproduced,
stored in a retrieval sysrem, or (l'ansmiued in any form or by any means
withour prior wriuen permission hom the publisher (Neil Nedley. M.D.,
1010 14rh Sr. NW, Ardmore, OK 73401).

lSBN 0-9661979-3-3

Caution: dus book does not estabJish a docror-patienr relationship with rhe reader.
Persons who are ill or on medication who wish to significamly change their lifeseyle
should do so under the direction of a physician familiar wirh the effects of Jjfesryle
change on health.

Library ofCongress Card Catalog Number: 97-92826

Publisher's Cataloging-in-Publication
(PrQvidul hy QlIllli~y Books. Ine)

Nedlcy. Neil.
Proofpositive: how 10 reliably combat disease and achieve
optimal heallh through nutrition and lifeslyle / Neil Nedlcy.
-- 1" ed.
p. cm.

Includes bibliographical references.

ISBN: 0-9661979-3-3
1. Health. 2. Self-care. Health.
1. tle.
RA 776.N43 1997

II

3. Health promolion.

613
QB197-41508

Dedication
To my father, A. LLoyd Nedley, Jr. (Eud).
My father is a mechanical engineer and not a heaIth professional by trade. He has spent
most of !lis working life designing automobiles for General Mowrs. lf it were not for the
personallifesryle changes my father made whell I wa growing up, this book would probably have never been wriuen. As a young ba)' I wirnessed lum make dramatic changes in
rhe areas of nmrition and exercise and turn his own failing health imo exceptionally good
health in a marter of mOll(hs. This sparked my interest in health, and by the time my
iruerest haei fully grown into adulthood, I was a ph)'sician and an Internal Mcdicine specialist. Dad, an aurhor of numerous scientil1c engincering papers, volunt.eered ro function
as the "lay editor" of this book. He has put in untold tireless hours in attempting ro make
lhis book UJ)derstanelable [Q the general public and in certain technical portions of the
book his work has been quire perplexing. Ye! he has wilJingly sacrificeel, stating tha! he
ma)' "do more for mank.ind in assisting in this book rhan 1 have done in ali of my engiIIccring years. ' If d)is book assisrs individuals ro change lifesr)'les for the beuer, thlls improving health. my father (ancl l) will be (fui)' gratified.

III

Acknowledgments
My gratitude and thanks to:
David DeRose, M.D., as an instructor in my Internal Medicine residency. who demonstrated rhe impoflance of diet in assisting in healing certain diseases. De. DeRose was
ilie fim person tO show me (rom modern scientific [jterature fhe superioriry of a dier thar
1describe and recommend in ilie book. He was instrumental in bringing abour changes in
my own diet and lifesryle for rhe berrer. It is fitting chat he be t!le editor for this work.
Uchee Pines Instirute, Seale, Alabama, who kindly loaned one of ies students ro assist
in referencing this book. Each chapter is extensively referenced, thanks Iargely ro the work
of Rodney Scale, who delayed the recum [O his home in Australia for over rwo years in
order to see rhe book completed. He spenr countless hours on MedHne (an online service),
obtained many full articIcs, and made maoy caJls ro individual authors of scudies ro cooflrm thac we were quoting the <lmhors correcdy. He is presently worlcing extensively on the
more exhaustive upcoming CD-ROM version.
Charles C1eveland, M.PH., who helped iuitiare che project by "rranslating" videotaped leccures inco book format and assiscing in initial referencing.
Shellie Hammack and ony Clifron who helped with the ftgure !ayouts and design.
Mcrcy Memorial Healili Center, Ardmore, Oklahoma, who not only "pllt up" with
rme periods that 1was absent writing the book, bur provided he1p through the use of their
medical library. Kim McClemore, ilie medical librariaJl, always cheerfully obtained fuU
arricles even ehough they were sometimes difficuJt ro hnd.
Velda Lewis, Ardmore Insticure of Health, who asked me ro give many health leccures
in several different settings aner we moved ro Oklahoma. She always insisred OI) professional-appearing visual aids. In the audience, occasionally, were those who lacer invired me
tO give additionaJ peesentations on a national and international scaJe. Had it not been for
the initiaJ heaJrh Iecmres, the material forthis book would never have been formed.
The board of direcrors of the Ardmore Institute of Healdl, owner and operator of clle
Lifesryle Center of America, who asked me ro be their initial medical director. They conInued to stimulare my thoughrs around nutricion and lifesryle lines. Their subsequem
medical direc[Qt, Dt. Zeno Charles-Marcd,also provided multiple weekends of medical
coverage for my medical practice ro aUow me ro finish the book.
Brian Shockcy, M.D., who has willingly provided muhiple weeks of medical coverage
for my practice ta permit rne (O author this book. This on-en meanr work days in excess of
16 hours so his medical partner could stay home and write withour interruption.
My pariems, who not only "put up" wirh my medical coverage while 1 was wriring the
book, but who were on my mind as I wrote many secroos of the book. Although rheit
names, for the mose part, do not appear in the book. they helped provide some of che
maJly true examples eiced in the book. Furthermore, chis book is written for any parjem ro

rcad, ro learn. and live a he.1lrhier way of1jfe.

My srudenrs :lnd lecwre audiences, who initially demande I rhe book so rhey \-vould
nor need ro rape lecrures aJld phorograph rhe visual aids ofinreresr ro them. The book was
conceived from rheir requests for written material ro rake home wirh rhem.
The late Ellen Wlure, whosc:: wriring conrinue ro srimulate thoughr discovery, and
research in healrh and medicine. Appendix X provides fu[[her acknowledgmenrs in rhis
regard.
My farher and morher, Lloyd and Orvetta Nedley, who provided me wirh as clase ro an
ideal upbringing as possible in rhe rurbulent 60s and 705. and who were m)' fim inslfucrors in hcalrh. The book's "Dedication" provides more derails conceming my farher.
My lovely wife Erica who nor only pariendy awaired the compleron of rhe project.
bur also made sure 1 remained focused during rhe rimes dedicared to the boole
AJso my three sons Joel, AJlen and Nathan, \Vho learned ro respect the rime rhat
Daddy was home bur was busy "working an rhe book.
OI

VI

Contents
AllOUT THE AUTHOR

IX

"

FORE\X/ORD ............... "

"

PREFACE.

"

"

PURPOSE

"

,,"

Xl

Xln

"

XIV

1.

fltrNCIPLES FOR OPTIMAL 'HEALTH ..

2.

GOOD

3.

HEAR'f D1SEASE: CONQUERtNG THE NUMBEn. ONE KILLER

4.

BLOCICED A1uERlES:

5.

THl: TIUlTH ABOUT F'iSli

111

6.

ON1: NATION UNOI':U PRFsSURE ..'

129

7.

THE

NEWS ABO'UT CANCE-R: IT

GafA

CAN

8r

11

PREVENTm!

55

CLEAN THEM Orrrr NATURALLY

91

MUT ANO PROTEIN MYfI't

147

8. SWEET 1IooTH, BiITER HAR.vEsT~ THE SUGAR ANO DIABETES STORY ...... [71

9.

M:U-ATONIN: AGENT FOR

IUsr ANO RE]UVENATrON

193
211

10. ANIMAL DISEASES ANO HuMAN HEAJTH RISK

Il.

MJLK: Fnlr:~D OR

Fo.E?

12. THiE FRONTAL LonE: Tm

13.

,.."

257

CROWN 'OF THE BRAIN

STEMMiJI~G THl: TIDE Of VIOLENCE

14. STRF.SS WTTHOUT

237

DISTRF.SS

, ..

299
325
Vll

15.

A1DS AND

HIV: THE UNTOLD STORY

16.

DYlNG FOR A ClGARE1TE? KICK THE

LlVE

369

17. WANT A DRIN-K?

425

18.

DEALLNG WITH BAD liABlTs AND AnDlcnoNs

455

19.

NUTRITION AND THE ENVIRONMENT

471

20.

BEYOND THE LEADING CAUSES OF

1
APPENDLX II
ApPENDlX

APPENDIX

III

N
APPENDIX V
APPENDIX VI
ApPENDIX

VII
ApPENDIX VIII
ApPENDIX IX
ApPENDIX X

ApPENDIX

VIII

HABn AND

347

"

DEAl1;I

485

525
526
527
529
530
533
534
535
536
537

About the Author

Nel Ned)ey, M.D., is a full-rime practicing physician in Interna) Medicine with ernphasis in Cardiology, Gasuoenrerology, Critical Care, and Preventive Medicine. He did
his undergraduate swdes ac Andrews Universiry in Michigan, majoring in Biochemjsrry.
FIe.graduaced from medical school in 1986 with a Doctor of Medjcine (M.D) degree from
Loma Linda Universit}' in California, ranking in the tap 10 percent of his class.
He completed his residency in Inrernal Medicine ar Keteering Medical Center at Wright
State Universiry in Ohio in 1989, and in the same year he became certiflee! by rhe American Board of [nrernal Medicine. He is a 111e1nber of the American Medical Associarion,
American College ofPhysicians, and Alpha-Omega-Alpha Honor Medical Sociery, as well
as a number of othcr health and med.ical associations. He is llighly skilled in numerous
careliology, gastroenterology. and critical care procedurc.5.
In 1989 he came ro Ardrnore, OklaJlOma, because of the uniquc opportuIliry to practice both acute care Inrernal Medicine wirh an emphasis in critica! care, and Lifestyle anei
Preventive Mcdicine with u)eArdmore Insritute of Hcalth, who operares rhe Lifestyle
Center of America, a Jive-in Prevenrive Medicine facility. Dr. Nedley served as MedicaJ
Direc(Or of rhe Ardmore Institute of Health and irs associated !ifesryle cemer rhrough
1996. He served as Chairman of rhe Medicine Deparrment ar Mercy Memorial HospiraI
and Healrh Cenrer, and President of the Medical Sraff He currendy is a hospital board
member ar Mercy Memorial Healrh Cenrcr, a regional referral medical center for sourhcrn
Oldahoma, and chajrs [he MedicII Education alld Medical Librar}' Commirrees.
Dr. Nedley has lecrured exrensively in rhe United Srates, Canada, Europe. and Russia
on nurrtion, lifesryle. and health. He has held numerous nlltririon seminars, cooking
schools (with his wife. Erica), srress semina.rs, and Stop smoking programs. He has produced a scries of health educarional videos an rhe ropics in rhis book, somc of which have
run on national sarellire relevision. He lives wirh his wife and rbree boys on a 90-acre
ranch in OkI<lhoma and cnjoys readillg, running. tennis, gardening, c1assicaJ rnusic, and
ridjng !lis rraCIOf.
lX

Foreword
This book is the most useful book for health promotion ever wriuen in rhis generarion
and willundoubredly emerge as rhe standard handbook for aU healrh educarors. It provides the faers in a sciemifie and bahnced manner thar shouJd be compeUing for any
rational being ro give reason for improving !lis/her lifesryle.
The book goes beyond the faers and dangers of our lifesryles ro give constructive rechniques in how eo change. It is well known thar rhe faers al1d dangers are noe enough [Q
change mosr people. However, rhis informarion alone ma)' well keep many horn developing soroe of rhese bad habits ta begin wirh as well as srop rhose in rheir rraeks who have
bad habirs, forcing rhem ro reeonsider whar ehey are doing. Bur rhis book conrinually
poinrs ro rhe only real Souree tlur will make change possibJe and urges ali ro avail rhemselves of rhar Power.
The major areas of lifesr)'le rhar need changing in rhe developing world are also addressed in rhe book. The World Healrh Organization~ srates:
"'On currenr projecrions. cardjovascular diseases (and cancer) will emcrge, or be esrablished,
. as subS[.1nria} heahh probJems in vinually every colJnrry in rhe world by [he year 2000." "Their
prevenrion or redllCrioJl is boch a social responsibiJiey and an economic necessiry."
"1 n developcd countries, diseases ee1al.ed ro life-slyle (including diel, alcohol consumption,
smoking, :LIld rhe level of physical activiry) ac.coum for mos[ morbidiry and morraliry."
The WHO sr'l(es rhar a program is needed of "primordi<ll" prevenrion; rhar is. do
somerhing ahour it before rhe epidemie oeeurs. Ir is possible ro reduce rhe coronary hean
disease risk by 90 percenr aod cancer risk by as much as 80 pereenr.
The moral brerkdown of socjety also has resulred in many of our problems, sueh as
AJDS. Srudies have demonstrarcd rhe lack of effeeriveness of the usual sex edueation
cITam whereas the spirirual influence of rwo parenrs in the hOlne has been effective.
Through rhe righr exercise of rhe will, an cnrire change may be made in rhe lifesryle.
This is ehe governing power in rhe nawre of man-rhe pO\ver of deeision, of ehoice.
Everyrhing depends an rhe righr aecion of (he will. Through rhe use of the informarion
ptesenred here in making proper choices. disease cannoc only be prevenred, bur many aJso
will be able ro regain rhe heaJ(h rhar rhey have Iose.

J.A. SCHARFFENBERG, MD
Nutrition Researcher and
Adjunct Prof ofNutrition
Loma Lindo Universit)'

"'\Yfl-IO Ie(h. Report Serit-, 797, 1990, pp. 28, 157, 38, 36.

Xl

Recent research has given us new rools [har help us scay healiliy and live life ro ilie
fullesr. Through aur choice of foods aJld by avoiding che pirfalls of smoking and other
chemical exposures, we have more power for health than we mighc have imagined. Even
seriOliS ilJnesses, such as hearr disease and cancer, are dramacicaJly influenced by rhe food
and lifestyle choices we make each day.
However, an optimal dicr is not the fOmine of skinless chicken breast, yogun, and
salad thar many people imagine it ro be. The powcr of foods goes mllch further. In ch.is
volume, Neil Nedley, M.D., takes [he latcs[ medical research and shows you how ro build
a rrul}' powerful menu for heaJ[h. He also shows how to break free of bad habits and
addiccions [har prevcnr sa many people from really living.
Of. Nedley's medical knowledge enriches readers with new insighrs, and his wa(lmh
a.lld compassion help LIS over any momenrs of reticence we may have as we embark on aur
journey ca health.
NEAL D. BARNARD, M.D.

President, Physicians Committee

for Respo~lSib!e Medicittn

Xl!

Preface
This book addresses the un.iversal problem of personal health and disease, and is wrirten for the generaJ public as well as rhe health professionaJ. le speaks to any person who
wishes ro auaill (or mainrain) good health and freedam from disease by natural means,
minimizing rhe use of prescriprioll drugs, food supplemems, and diet fads. It conrains
specific medica.l advice ro arrain rhese goaJs. The prevemioll of a disease as weB as the
rrearment, if it exisrs rhrough lifesryle measures, are both addressed.
It is designed to be readable and eas)' ro understand, wirh mally color illusuatiolls dlar
claJify the subjecr at hand. Each of the 20 chaprers covers a specific topic, and each "stands
alone," which permi.rs a frec choice to begin ar rhe topic of highest interest ro r.he reader.
The book is based on the latesr facrual, reliable medical principles rhar have been llsed
by Dr. Nedley for r.reaullg his par.ienrs for many years. Counrless sciemific srudies COIlducred arotlnd the world, combined widl rhe latesr medical knowledge of the effecrs of
lifesryle faccors, form the basis for the information and advice given. Many specific diseases and ailments are addressed, in addirioll ro stJess, problems of addicrions, common
myrhs a~olJ( nurririon, food supplements, substance abuse, and other health topics.

XIII

PURPOSE
10 demonstrate che impact al nurrition and ocher lifesryle facrors an ovcrall health.
To show how cenain common (and sometimes unconilll0n) diseases can often be
completely prevemed ar helped by cenain lifesryle changes withour prescriprion drugs
and their accompanying side effeccs.
Ta enhance the readers' satisfacrion and enjoymcm of life by providing IDorivarion
and guidance for adopting rewarding lifestyle changcs thar are in agreemenc with cimeless
biblical principles and chose of modern science.
Ta present scielHific documelHacion of rhe chrust of dus book, raking it our of che
realm of opinion or fad and imo the realm ofsolid, reliable facr.
To provide a rdiable. well documemed saurce book for providing lIseful, IIp-ro-datc
information ca health professionaJs and assisrng them in educacing che public.
Ta make alI of me figures in chis book available in transparency, slide, or compurcr
presemation form ro beaJch educators and others for their use in preselHations ro omer
healrh professionals ar ro the general public rhrough {he soon-to-he-released CD-ROM
verSlon.

XIV

CHAPTER ONE _

PRINCIPLES
FOR OPTIMAL

LT
H

is situat ion was seriolls. 1 SlISpecred Harold had heaT[ disease. As parc ofm}" evalliacion,
1was now preparing bim for a
treadmill rest. While the llllfse and 1 were
hooking Haroid up ro the heaT[ monitor,
he. confided: "Oocror, J really don't rhink it
marter how J check out on the te t raday.
We each have a rime when \Ve are going tO
dic; thar rime is set and [here is nothing we
can do about it."
As 1 thought aboUT his sraremenr 1 reaJjzed how out of rouch Harold was ""ith aur
currenr knowledge of ehe relatiollship becwecl) lifesryle and health. An overwhclming amOllJlt of scienrific researeh eleady
demonsrrares rhat aur dai!y choices afFecr
our likeJihood of living a long ;md healchy
life. 1 decided lO ofFer Harold an extreme
cxample of how lifestyle choices can affect
Jongevicy. "Harold, ir may ar may nor bc
rrue [har God has already planned the besr
rime for you ta clic. Let us for a moment,
rhough, assume Hc did. What rhen would
happen if you committed suicide? Wouldn'r
you be dying sooner rhan the cime Gad
planned for you to dic?"
My point was obviolls. However, each
day mOsc aII of us make decisions tluc ultimarely have a bearing on life and healch.
Wc may nor commit suicide in a single de-

Iiberare acr, bur we may pllr harmfi.t1 sub"rances imo our bodies rhar will premarurely
cause dearh Or decrease our qualit)' of Jite.

Health Depends Largely on Lifestyle

Many erroneollsly believe thar inherred
rrairs (generic facrors) are rhe primary hlCtoL determining cheir quatiry of life and
how long [hey will Jive. For [Il vasr majority of us, aur health is primarily dependenr
on t\VO orher f.1crors: (1) whar we pur i ma
aur bodies, and (2) whar we do with our
bodies. A simple word rhar encapsulates
both of rhese concepts is "Iifesryle." The
good news is rhar even rhough we cannot
change aur genecics, \Ve Uln change our
lifesrylc. Those lifesryle choices can prevent
or foresrall che developmenr of diseases for
which we are genercally predisposcd. Regarding the most common diseases, OI'.
L1mom Murdoch of Lama Linda Universiry School of Medicine has put ic aptly:
"faulry genetics !oads the gun. fife.. ~yie pul/s

the triggcr."
1 have ofren wondered why people take
beteer care of theil' ears rhan their bodies. 1
have yer ta meet a person who said, "God
has a plan as to when my car should 'die.
and 1do nor need ro 'Vorry abour it. 1don'r
need ro check or change the oiI, ar perfol'm
any routine mailllenance. And 1don'r need

PROOF POSITIVE

DEATH IN THE U..S.. (1990)

lofectious disclIses 90,000

1Toxic Agent.s 60,000

1..-_ _.....

*Firearms 35,000
*Sexual Bebavior 30,000
Motor Vebdes 25,000
*lIIicit Drugs 20,000
75

2S

200

100

300

400

500

600

700

* Denotes lijestylefQcto~'
Figure 1

ro worry abollt the rype of gasoLi.ne ruse. n

We recognize the necessiry of proper care
ro get the Jongest life and best performance
aur of our auromobiles. When wiU we realize that proper care also gives our bodies
the Jongesr life and best performaJlce?
What are the root cau e.s of death?
When someone dies with a heart atrack,
srroke, or orher fatal condition, what really

538,000
105,000

Chronic luog djsease

90,000

Accidents

Ii~~~~~~'
I~

84,000

Pneumonia/influcnza
Diabetes

59,000
43,000
31,'000
25,000
241000

1 0 . Kidney failure

Other 398,'000
2,312,000

2S
Figure 2

so

7S

100

200

300

400

500

600

700

eaused rhar f:Hal disease at thar rime in a

person's life? Researchers McGinnis and
Foege recendy analyzed ilie roor causes of
whar Americans die rrom and published
uleir findings in the Journal of rhe American Medical Associarion. The !line leading
causes of dcarh were largely relared ro
lifesryle choices: what wc put iota our bodies and what we do WiUl aur bodies. These
callses arc lisred for rhe year 1990 in Figurc 1.1
AII of rhe facrors widl asterisks are directly impacred by lifestyle. The total of
these facrors is abollr 1.25 miII ion, which is
over half of rhe roral mllnber of deaths in
America each year. We see dur rhe roor
causes of death are largely unhealrhfuJ
lifesryles. As surprisingly high as chis rotal
is, it may greatly underestimare [he roral
number of lifesryle-relarcd dcadls. Many
dearhs due ro infecrious disease.s are caused
by an immune system rhar is weakened by
a poor lifesryJe. Also, rhe researchers listed
onJy rhe deaths rhar could be amibuted ro
kllown lifesryle facrors. As we continue ro
learn more abolit lifesryle and health, we
likely will discover how orher lifesryle
choices could pl'evelH stiH more deaths.
Nonerheless, the figures demonstrare rhat
the nurnhel' of premature dearhs in our
counrry would be dramaricaLly decreased if
Americans wouJd be willing ro replace a11
of rheir harmfullifestyle factors with hclpfulones.
T!le.re would be benefits even beyond
rhe reduction in premarure dettths. Qutllil)'
of lift would improve, as diseases would
strike less frequently at any given age. YOl!
can help ro change rhese statisrics by joining the growing nllmber ofAmericalls who
are focllsing on healthy lifesryle choices ro
arraill t!le highesr qllalily of life a.nd optimallongeviry.

Prevention is the Key

Today, a wealth ofscienrific research has
confirmed that mOSt of the leading causes
of death are prevenrable. The mo.st COJl)mon aHlictions dur cause death in America
are lisred in Figure 2. 2
C. Evereu Koop, M.D., Sc.D, formel'
Surgeon General of the United Srarcs, pro-

PRINCIPLES FOR OPTIMAL HEALTH

duce-d rhe fim Surgeon General's Report an
Nurririon and Healrh in 1988. It \Vas based
on an exhausrive review of the scielHific literarure. He concluded that "dierary excess
and mhalance" colHribured significanrll' ro
cighr of the leading killer diseases in our
country. Excerprs from his rcpon are shown
in Figure 3. 3

Longevity Studies Related to Lifestyle

Just whar are these lifestyle factors thar
will help liS ro live a longer life? Drs. Nedl"a
Belloc and Lester Breslow were among rhe
first researchers ta presell( a convincing answet. In rheir classic smdl' of nearll' 7000
individuals living in Alameda COllnry, California, rhel' found dut there wcre seven
lifestyle factors that influenced how long
people \ived. These facrors are lisred in Figure 4. 4The number of these habits thar all
individual followed made a tremendous
impaCt on cheir longevity. Afret nine years,
the number ofhealthfullifesrylc practiccs a
person followed was directly related ro tlle
likeilllOod ofdying. The results are depierd
n Figure 5. 5 Norice t1m only abour 5 percem of men and women who followed all
seven health habits clied in the nine year
period, compared ta 12.3 to 20 percenr who
followed three habirs or less. .
Anorher way of lookng at rhe mpacr
of lifesryle an longeviry is by consideting
something referred to as "health age." As
an exaJup1e, a 50year.old who embraces
enough healrhfullifesryle facrors may havc
rhe samc health or physiologic age as che
average 35-yearold person. We could say
thar chis individual has a "heaJth age" of35.
On rhe orher hand, anorher 50-year-old
\vho had no regard for a heaJchfullfesryle
ma)' have a much older health age, perhaps
as high as 72. Ll ocher words, a person's
healrh age can be lower OI' higher tl\Jn che
actual chronological age, depending on rhe
numbcr of lifesryle facmrs adopted.
HeaJdl age rabIes have been crcatcd from
rhe AJameda Counry sratisrics. They cover
the chronological age range from 20 years
1:0 70, and are based on the same seven
health habirs lisrecl in Figure 4. One sllch
table is depcred in Figure 6. 6
You c..1n use this figure as a guicle ro get

DIETA Y E CESS
D
CE
CAUSE MUCH DIS ASE AND DEA
1. Diet has a vital inOucncc on bcaltb.
2. Fi'lc of tbc tcn Icading causcs of iIlncss and dealh arc as!ociatcd
\'iith dicl (coronary hcart disCllSC, CjlDccr, slrokc, diabclcs,
and alhHoscierosis).
3. Anotherthrce ha'le been associalcd IVilh cxccssi'lC alcohol intakc
(cirrhosis of Ihe liver, accidenfs, and suicide).
4. These cight conditions accounled for nearly 1.5 million or the 2.1
mimon total deaths in 1987.
5. Dictary exccsscs or imbalanccs also contribuIe to
olhcr problelm such ilS hgh blood prCSSiJrc,
obesity, denl:!1 disel\ses, oslcollorosis, llnd
gastrointesfinal diseases.
6. It s now dear Iiull dicl conlribulcs in substantial
ways 10 the devclopmcot of thesc, discascs and that
modifical'ioD of dkt can contribuie 10 their
prc\'cniioll aud control.

Figure 3

BELLOC & BRESLOW'S SEVEN REALm

FACTO SFO
ONGEVI
]. Slcep 7 to 8 hours
2. No eating between meals
3. Eat brcakfast regularly
4. Maintain proper weight

,;

5. Regular exercise

6. Moderate or

DO lIse

of alcohol

7. No smoking
Figure 4

Age-adj/lsted (le"l" rll1e

Men
No, of bcaltb
h.:lbits practiced

Womco
Porccnt

dc~d

in 9 Yf'ar~

"fi,

of bcahb

habUi li"raC:1i.ud

"crcent dcad
lO 9 ~lt2t'!

5.3

6
5

7.7
8.2

4
6-3

s
0-3

10.8
12.3

Figure 5

PROOF POSITIVE

Far

//leiI alld WOl1lell

Hablts

Rabits

Habits

Hablts

Hablts

0-2

20

+14.3

+7.4

0.5

-1.1

-4.2

-9.4

30

+16.9

+9.1

+3.0

-0.6

-4.7

-1 J.I

40

+19.4

+10.7

+5.4

-0.1

-5.2

-)2.9

50

+22.0

+12.4

+7.9

-Ifl.3

-S.7

-14.7

60

+24.5

+14.0

+10.4

-Ifl.8

-6.2

-)6.4

70

+27.1

15.7

+12.8

+1.3

-6.8

-lIU

Age

Rabits

Figure 6

a feei for your own healrh age. For example,

assume rhar you are an average 40-year-old
Alameda county resident. If you are following only two of the seven Belloc and
Breslow's health habits, yOLlI' health age is
40 plus 19.4, OI' about 59, indicating a dramatic shortening of your Jlfe cxpectancy.
You would havc the saltle life expecrancy as
rhe average individual 19 yar older. Ifyou
conrinue the same lifesryle for 10 mare
yeaIs, when yOll are 50 your healr.h age will
be 50 plus 22, ar 72. Ar age 40. you had a
19-year health handicap, but a( age 50, the
handicap wilJ even be \Vorse by 3 years. In
10 years you wiU age 13 years!
an rhe otber hand, if yOll, ar 40, are
consistenrly following aII seven of Bel10c and
Breslow's health hahirs, your healrh age is
only 27 (40 minus 12.9). Furr.hennore. ar
age 50 youl' hcalth age wiU be onl)' 35. In
10 years you will only age 8 years! The
concepr. of health age iUusrrates how much
our lfesryle can eithet hasten 01' slow rhe
agmg process.

But What About Quality ofLift at

OldAge?
Some individua.!s believe u1at they are
able 10 exrend r.heir live-s, rer rhey fear rhe
resulrs ofliving longer. Tracy, a respirawry
rherapist, recenrly said lO me, "} don'r want
ta live ro be 70 years olel. People rhar age
seem ro have so man)' problems. [rhink I
wanr ro clie before ['m 70."

1 said in response, "Tracy, you 111ay sa}'

rhar now, bur wair until you'l'e. 69. Then
you will want ro live uneil70, and once you
ger to 70 you will likely want ro live ro 71
parricularly if )'OU havc good heahh. I know
mall)' individua.ls in theil' 70's and 80's that
are enjoying a goocl qualiry ofliCe. The socaUed 'golden ycars' are a realiry for them."
More recene research has funher he1ped
ro allswer Tracy's concern. Alrhough rhe
original AJameda Councy reports focused
primarily on the age at deat!? subseqllen(
work has looked ar quali~y of/~fe iSSllCS. For
example, rhe "Alameda sevel( have emerged
a powel'flll ways ro prevem probabl)' (he
mosr Feared complicarion of aging: dimbilit)!. A recene repore demonsrrared rhat those
who followed rhe greatest mtmber of (hese
health habirs expel'enced on.!)' ha!ftiu: risk
of disability as rhose wrh (he pool'est habirs. Those wirh an imermediare nllmber of
heahh habir.s also fared beuel' than rhose
\Vho spurned mosr of Belloc and Breslow's
seven. They expel'ienced ooly rwo rhirds
the risk of disability as the least hea.lr.h-consciolls grollp.7
Let llS look at some of the individuaJ
habits rhar BeHoc and Breslow idenrified
and sec how they have a bearing on life's
quaLry as well as Jongeviry.

Eat Breakfast Regularl)'

Many people reading rhe Alameda
Counry study are surpri cd tO finei "earjng
breakfasr' included in a lisr of seven of (he
most important longeviry facrors. Earing
breakfasr in and of itself increases longeviry. In some of r.he original dara ir W:lS found
rhat meo who ate breakfast and clid nor cat
berween meals had lcss than half the risk of
deaeh of men who skipped breakfasr anei
sl1acked. A more recent analysis of the
AJarneda Counry srudy dara focllsed particularly on individuals in the 60 to 94 year
old range. Those who did nor ear breakfast
regularly had a 50 perce)1( increased risk of
dea(h compared (Q the reguJar breakfast earers. 9 Rern:ukably, in chis group of older
Americans, long life \vas aS dependell[ on
earing a good b(eakfas( as it was on nor slHok
ing and getring regular phy. icaJ exercise.

PRINCIPLES FOR OPTIMAL HEALTH

Despjte rhese facrs (and whar rheir
morhers likely cold rhem), IUosr people give
a variecy of reasons for nor earing break.fasr.
A common reason is rhar they are nor 11lIngry in ilie morning, which is the usual resulr of earing a fuU meaJ in rhe evening. A
JiglHer evening meal will tend ta salve rhe
problem. Berter yet, if you have rhe re olve,
try caring no suppers for a week. By rhe
end of the week you will likel}' be hungry
for a good breakfast. You might also flnd
that }'ou are sleeping more soundly, even
though )'ou may go [O beci hungry for a few
nights uneil yom bod)' adjusts. With a litde
planning, brcakfasts are lIsually easier ro
prep:uc than Jllnch ar supper. Be creative
with )'our use of grains ancl be sun: co have
several servings of fresh Emir.

Eating Breakfast Helps to 7

Prevent Weight Cain
Another reason given for slcipping breakfast is to keep from gaining weighr. Some
rea an rhar becallse the)' were not hungry
in the morning, skipping breakf.,sr would
help them e<lr fewer calories during the c1ay
and wOlllC! thu favor weighr 1055. This is a
myrh. The rrurh is thar eariJlg a good breakfast should be parr of, ny weight loss program.
Years aga Dr. Charles Cllpp proposed
(har weighr gain is rhe result of inappropriare /iming of food intake in relaron (O the
evcning sleep rime. During a medical practice thar spanned a rell1<lrkable seven decade, Cupp insrrucred hllndreds of patienrs
on his novel approach ro weight COntrol.
Overweighr patients were insrrucred tO
change rheir meaJ patrern from a heavy meal
anei snacks in rhe evening ro a heav)' lUoming meaJ a moderare lunch, and a Iiglu supper. They were ro ear rheir lasr meaJ ideaUy
ar noon bur by no means larer rhan 3:00
p.m., and rhe)' were insrrucred nor ro go (O
sleep for at leasr eigh t and a hal f hours aher
[!le lasr inrake offood. Ofsignifica.nce, they
were 1I0t asked ro cha.nge rheir food choices
nor (he amOlllH of calories chey are. 1nrriglled researchers in rhe Depanmenr of
Nurririon ar Ti.Jlane Universicy's 5chool of
Public HeaJtn anaJyzed rhe records of 595

of CUPP's overweight pariems. The resulrs

of rheir srudy are shown in Figure 7 10 This
evidence and numerous orher srudies indicare rhar earing breakfasr regularly should
be parr ofany serious weight reducrion program. Nore rhar some additional bendlrs

All patiellts who fol/owed illstrucliolls 10S1 weigIJt

Those ",ho ate only break.fast a\'craged 10 Ib. weight
loss a month.
Thosc who ate brcak.fast, lunch, a,nd snacks averaged
5 to 6 Ib. a month.
Those who lost from 20 to 30 Ib. showed an
incrcase in hemoglobin levcl.
Blood sugar levels of diabctic paticnts who
lost 30 Ib. or more were normalized.
Hypothyroid patients showed a reductioll in
daily thyroid maintenance requirements.

Figure 7
accrlled from earing breakfasr: improved
blood hemoglobin level, reduced blood
sugar, and improved rhyroid funcrion.
The cypes of foods rypically earen ar
breakfasr ma}' al50 conrribure ro rhe imporranee of rhe morning meal for weighr control. III rhe U.5. eulrure the evening meal
tradirionally features a far-rich fare based an
animal producrs, and breakfasr is ofren eentered arollnd fruirs and grains wirh rheir
assoeiared complex carbohydratcs. This
becomes imponanr when we recognize rhar
weighr gain is ofren related ta gerring roo
many calories from fat rarher (han from
complex carbohydratt$. In rhe researdllab,
animals an a high fat djet gain more weight
than rheir pe r an a low-F.u regimen--evcn
whcn bod) grollpS ear rhe same number of
calories each day.ll

Breakfast and Heart Attacks

Eating breaJJ"ast has been found ro have
yer another benefic. Aduirs may be able ro
reduce their risk of hearr attacks by eating
breakfasr regularl}'. Plarelet$, the body's
blood cJorring cells, become "s(iclcier" in rhe
morning before breakfasr. This increases clle

PROOF POSITIVE

''Wilboul bre.akfasl,
possible heart-allack
risk may be elevalcd
for 2-3 boun afler
wakiog."

Clol-formlng
potential 2

tendency for a blood c10r ro form during

the morning hours. If such a elOt occurs in
a heart blood vessel, a beaT( atrack can reSl1.Ir. As expected from this physiology, most
he;m anacks occur between 7 AM and 12
noon. Earing breakf.1sr can help the plarelets ro become less sticky and thus decrease
the risk of morning heart attacks. The impact of [hese eelarionships is illusrrated in
Figure 8. 12

B~ak~tHe~sOurA1en~1
o

Capa1Jiliry

Breakfast-

Dreakfast-

skippcrs

ealen

Figure 8

ADVA

,AKFAST

AGESOFEAT

more efficient problem solving

improved memory
increased verbal flucncy
improved attention span
better attitudes
better scholastic scores

Sleep) Exercise) and Smoking

Figure 9

MO TALITY S RELATED TO
SLEEP, EXERCISE, AND SMOKING
Nine year follo ...-up for ages 30 1069
J

.MCll

Wom~n

2.2

Monallty
risk Bllo 2

Smours

Figure 10

There are addition:tl benetlts from eating a good breakfast beyond longevicy. In
August of 1995, the Pediarrics Depanment
at rhe University of California ar Davis
hosted a number of psychoJogisrs, neuroscienrisrs, nurririonists, and physiologisrs ro
review the sciemific srudies on breakfasr.
The researchers coneluded rhar rhe "eating
of breakfast is imponanr ro learning,
memory, and physical well-being in both
children and adl1.lts."13 Good breakfast habits are essential for maximum efficiency,
both menraJ and physical, parricularly during rhe late mOfJ1ing hours. Breakfast eaters demonstrate berrer attirudes and improved scholastic performance. A more
complete lisring of rhe benefits enjoyed by
breakfast-eating are listed in Figl.lre 9. 14

The AIameda Councy srudy showed rhat

our lifesryle habits regardingsleep, exercise,
and sllloking impacr rhe risk of dearh. ReSlllrS are presented in Figure 10,15.16 Six ro
nine hours of sleep per night appears tO be
ideal for most people. Ir is actual1y po sible
ro get roo much sleep as well as roo litde.
Those rhat slept significantly more or less
than this experienced a 60 tO 70 percem
increased risk of dying wirhin a nine year
period. For men, roo 111uch Or roo little
sleep carried a risk similar ro not exercising
reglilarly. Within the nine-year period, the
non-exercisers had a 50 percem increased
risk of dying compared ro those who made
a consistent effon ro keep fir. Women wirh
low physical activiry fared even worse. They
had over twice the risk of dying within (hat
nine year period.

PRINCIPLES FOR OPTIMAL HEALTH

Exercise
Ir is never roo Iare ro begin an exercse
program. A separate study found rhat regardJess ofhow our ofshape a person is, r.he
risk of dearh from aH causes could be ceduced by lllerely becoming fir rhrough a
regular exercise progmm. The amount of
benefir is tabulated in Figure II Y
Notice rhat the death care ofphysically
fir men is only one-third ofIhe rare of those
,hat are unfir. For rhose that were uDnt and
then became fir, rhe dearh rare is abolit half
as much as for rhose who are unfit.

ner one's bones, the more likely rhey will

fracruce when subjected ro even minor
trauma. \'V'hen osreoporosis is nor dHeatening life, it is often decreasing irs qllaliry.
The disease can lead ro chronic pain as weti
as ta physical deformity.
These arc just a few examples of the
many dangers of smoking. More complere
informarion on chis subject is found in
Chapcer 16, cnriued "Dying for a Cigarette?
Kick d1C Habit and Live."

Dangers ofSmoking
The AJameda Counry data revealed that
if arnan smoked, he had double rhe risk of
dying wirhin a nine year period compared
{O a man who did nor smoke. If a womall
smoked, she had a 60 percenr increased risk
of dying. Anorher study found rhar meD
who smoked throughour rheir enrire adult
life had an average life expectancy of only
65 years. 18 This is 12 years shorcer (han the
expected 77-year life span for a lifelong nonsmoker. 19
AJrhough length of life is important,
quaLity Of life is also crirical ro ali of us.
Smokecs tend ro have a poorer qllality of
life. For example, peptic ulcer disease is
much more common among smokers.
Awakening ar 2;00 AM wirh burning abdominal pain cerrainly is nor qualiry living.
Evcn if a smoker does nor ger u1cers, o{her
digestive problems may arise relared ro rhe
smoking habir. For example, rohacco decreases rhe rone in [he band of mllscle berween {ile esophagus (swallowing tube) and
rhe sromach. This makes it easier for sromach acid ta flow inca rhe esophagus ,Uld
cause heartburn, anorher common robber
of life's quality.
Cigarette smoking also affecrs orher organ syscems. It contribures ro early skin
wrinkling and osccoporosi (rhinning of rhe
bones). Skin wrinkling is merely an undesicable condirion, bur osreoporosis c.an be
life threarening. Hip fractuces ace alllong
rbe leading c.auses of dearh in older Americans. (More complete infonnarion an osreoporosis is included in Chapter 7, "The
Grear Mea{ and Prorein Mym." The thin-

DeatJr rate per 10,000 lIlalt-years, lIIen ages 20 to 82.

Figure 11

Alcohol Use Shortens Lift

There are many voices roday advocaring moderate alcohol consumprion. This
is nor out of harmony with what the
AJameda Counry srudy in rhe early 1970s
revealed; namely, {hac moderate or no use
of alcohol enhanced longeviry. However,
research in the 25 years following Belloc and
Breslow's landmark publicacion demonstrates thar tolllL avoidllnce ofalcohol is Ule
best option from {ne perspective of disease
prevenrion. This issue is addcessed at lengrh
in Chapter 17, "Wanr a Drink?"

Social Relationships and Mortality

10 rhe surprise of mally skepeics, research aho suggesrs rhar rrusring Gad and
auending church on a reglllar hasis illcrease
longeviry. Having genuine friends, being a
member of a group, and even heing married have benefJcial effects on longeviry.
Most people inruirively lIndersrand that

PROOF POSITlVE

SOCIAL ETWORKS
Nille year follow-up of 7,000 adultI' ill lIorthern California for llges 30 to 49
3

2.9

Mcn

WonM:l1

2
Mortality
rlsk ratio

NOI

nlsrricd

Fe", rricndsl
rrlarivcs

Non cburch
mcmbcr

Non ~roup
mcmbcr

Figure 12

ehese e1emenrs enhance the moral and social quality of life, bm in addirion eheyalso
posieivdy affecr physiclli hellith imei longe-v;ty. When the Alameda COllllty data was
analyzed for ehese social and spirirual faetors, rhe I'esules were impressive. PanicuIarly srriking were ehe rcsuhs for rhose who
are 30 ro 49 years old. These are depicred
in Figme 12. 2oA growing body ofresearch
reseifies ro ehe value ofbdiefin God to one's
social and emOtional health. One such report from Duke Universiry fOllnd rhar individuals wirh strong religious faith reponed
higher levels of happiness ami s;'leisfaceion
in life. They 31so appeared ta handle craumarie evelHS better-wirh less menr31 and
social difflculries. 21 Chaprer 15, "AIDS and
HN- The Unrold Srory," and Chaprer 20,
'Beyond rhe Leading Causes of Death,"
provide addirional informarion on how [-urh
in God enhances healrh.

Conclusion
Many people in America in addirion to
my rreadrnill pariem, Harold, th.ink rhar
because of rheir generics or becallse ofsomt:
celesr.ial c1ock, the day and hour of deat.h
are hxed in srone. This faralisrie arritllde
forces rhem ro conci ude tiut they ca.n do
norhing ta prolong mei r Iives. The cvidence
presemed in rhis chaprcr dispds ali such
myths.
W. C. Willeu of rhe Harvard 5chool of
Public Healrh, Dcpanmenr of Nurrition

stares, "One clcar conc111sion from exisring

epidcmiologic evidence is dur man}' inclividuals in rhe United Srates have sllboprimal diets and that rhe porenrial for disca c
prcvemion by improved nllIrir.ion is subsIamial. "22 Betloc and Breslow summari1.ed
rheil' finelings in rhese words: "These data
are consistent wirh rhe idea... rhar a lifetirne
of good health pracrices produces good
healrh and exrends the period of relarively
good physical healrh sta rus by some 30
years."23
Indeed, Belloc and Breslow's seven
healrh principles are simple, yer rhey are
extremelyeffecuve. Furtherrnoee, rhey have
no adverse long-term side cffecrs and offer
profound bcnehts in the qualiry of life. If
any one of rhese seven healrh principles were
a medicarion ir would be classitled as a
"wonder drug." The originatar and rnanufacrurer would no doubr be rewarded with
fame and fonune. However, as an Inrernal
Medicine specialist, .1 can unequivocally say
thar no meelicarion even comes c10se ta a
single one of rhese healrh principles in irs
power ta improve and mainrain health.
The good ne\vs does nor scop [here. This
book will reveti a hosr of additional healrh
principles rhar careful researchers have discovercd in rhe 25 years following Bdloc and
BresJow's original srudies. These principles
offer additional benefirs for maintaining
health and erearing cerrain disease stares.
Yall will sec dut rhe healrh principles
brought co lighr in rhis book are dependable. They can be relied on with confidence
ro help yOll reaeh and m;linrain your health
goals.
Reaping healrh bendlts by following
sOI.U1d Iifesrrle principles is nor a new concept. Cenruries ago God made a promise
recorded in the Bible ro the newly formed
narion ofIsrael, , If ehou wilr diJigenrly hearken ro ehe vaice of rhe Lord d1Y Gad and
wilt do rhar which is righ[ in his sight, aud
wilr give ear ta his commandmenrs, and
keep aII his srarures, I will pur none of rhese
disease upon (hee, which I have brought
upon r.11C Egypri;ms: for] am [he Lord rhar
healetll [hee. "24
Yes, followng cerran principles thar resuit in good healrh is nOI a new concept.

PRINCIPLES FOR OPTIMAL HEALTH

Bur this very old concepr needs ro be resurrected in aur personallives, across America,
and rhroughotlt rhe world. As Egyprian
diseases could be avoided in ancienr times,
the ren leading causes of death in rhese
modern rimes can largely be avoided by fol-

lowing sound health prJlciples. In rhe chapters {hat foUow you will 1nd the information yOll need (Q successfully guide yOll ro
"do what is right" and thllS experience the
oprimal healrh promised.

References McGinnis JM. Foege W'H. ActlJaI callse,' of de;lth in the United St:l.tes.
JANf.A 1993 ov 10;270(18):2207-2212. F~'{IIl'eiltlLI!)tl'dJ1l1d J1djllSudfom
fiill,micfe. pper rang<-'S uscd for tobacco, ,,\Cohol, and diet/exercise ba "d
on additionJI intormation presellled in rhi, book.
I

Preliminary da!.1 on birlh and deaths-United Slare;, 1995. MMIllR

Morb MOrll11 Wkly Rep 1996 Ocr 25;45(42):914-9 J 9.

The Surgeon Gel/emIs Rtpon OII N/ltritioll alld Ht/1.lth. U.S. Dep!. ofHe:Jdl

~JJd

Human Services (Public HeaJlh Service), 1988.

Belloc NB, Brcslow L. Rdarionship of physical heallh sratu and health

pr:\ctices. P,.,v M"d 1972 Aug; 1(3):409-421.

:; Breslo", L, Enslrom JE. Per. iSlence of heahh hahilS and their rel:uionship w mOrlaliry. Prrv Med 1980 Jul;9(4):469-483.
a ted from AJamcda Counry Sll.ldy data. For a similar table see T:\blc
X, page 79 In: BcHoe NB. Rclationship ofhealth pra liec and morraJiry.
?re-Il Merl1973 Mar;2(1):67-81.

13 Mathews R. Importanee of bl'eakfasr to cognirive performance ami

hcalth. Pm-pfCIive.f in Appli"d Nlltrilioll 1996;3(3):210.
14 Mathews R. lmportance of bl'eakfast ro cognitive perfonnance :H1d
hcalth. Perspectivt' in Applied Nurritioll 1996;3(3):204-212.

1; Wingard DL, Berkm'lI1 LE Monalir)' risk associ:\rcd Wilh sle.cping patterns among adults. Slup 1983;6(2): 102-107.
16 Wingard DL. Berkm:UJ. LE Brand, RJ. A mulriv:uialC analysis ofhca.lthrdalcd praerices: A ninc-year monaliry follo\\'-up of rhl' AI:uneda COllnty
studl'. Am J EpidellJio/1982 Nov; I 16(5):765-775.
17 Blair SN, Kohll-lW 3rd, el a.1. Clta.nges in physica.1 t1tnc_\-~ and all-causc
morraliry. A prospecuve s[Udr ofhcalthy and unhcalrhr men. JAMA 1995
Apr 12;273(14): 1093-1098.
18 Cigarene slOokin<>-:l1uiblitable morta.!iry :U1d rears ofp<>tcl1liallife )ostUnilcd States, 1990. MMWR MOI'h MOI'/J1/ Wkly Rep 1993 Alig
27;42(33):645-649.

Bre;l"w L, BresJow N. Heahh praclices aJld Jisability: some 'vidence

frorn AJameda Counry. T'rNi Med 1993 J:\11;22(1 ):86-95.

l? Lew EA. G~rtlnkel L. Diflercnces in 1110rraliry and Jongeviry by sex,

smoking hca.lth hab.ils and health stalUs. Sacict} ofArtUitries TmmJ1ceionJ,
p. 39. 107-1.30.

Bclloc ND. Rdationship of h""lth prae.tices Jnd monality. !'reI.' Med

1973 Mar;2(1 ):67-81.

a /line-rear folJow-up srud}' of AJamcda COlllUy rc-sidems. Am j Epid(mio/

2u

J3erkmaJl

LE Syme SI..

Social nelM'ol'ks, hosl rcsistancc, aJld mortality:

1979 Feb; I 09(2): 186-204.

Kaplan GA, SttnUll TE, et al. Mortaliry among thc e1dcrJy ill ilie AJameda
Counry Sludy: behavioral and demographic risk faelOrs. Am j Public HCJ1hb
1987 Mar;77(3):307-312.

Soc &b(/II 1991 Mar:32( 1):80-99.

iO Carler JP, Browo J. Dr. Cupp's Simple Approaeh ro Weight Loss.

1IJ1loftIJe LOllisitJIIJ1 SttJlt .MedicJ11 Society 1985; 137(6);35-38.

22 Wilkll Wc. Diet and healrlt: wh:n ,hould

22;264(5158):532--37.

JOii/'-

N,uion;)l R"'c:uch Col.lndl. C:Ilorics. In: Diet I1l1d HeJ1It1J. !mplicfltiollS

Washington, DC: National Academy
Pres., 1989 p. 151.
II

fo,. Rdullg C!JTOllic Disr.ase Risk,

21

Ellison CG. Religious involvemem and ubjcclive welJ-being.

\Ve cat~

f HCllltb

Scit!llu 1994 Apr

Belloc NB, Breslo", 1. ReI:l1ionship of physical hcalth s!alus and hcaJth

pracdces. Prel) Mcd 1972 Aug; 1(3):409-42 J.

lj

24 Exodus 15:26.

The Holy Bibie. ;\urhori7.ed King James version.

RaJoff J. Breakf.1St may reduce momi ng heart atlack risk. Science New!
1991 April 20;139(l6):246-247.

12

PROOF POSITIVE

10

CHAPTERTWO

GOOD
NEWSABOUT
~ANCER:
It Can Be Prevented!

r was one of those appoinrmem tiut

we ali dread. June was back ar Or.
McAJesrer's office. A she sar fidgering in rhe wairing room, che thoughrs
were racing rhrough her mind. "Whar's raking him so long? 1 have ro find outwhar the
biopsy sH:owed. Maybe rhe news is bad and
he doesn't know how ro break it ro me."
5000, however, Juoe's name was calJed,
and she was broughr back ro one ofrhe exam
rooms. Aher what seemed like !loun larer,
Dr. McAlesrer sar facing her in rhe small
eX:lm rooro. He began r!le conversarion:
une.
"1' m sorry, J
" N o sooner were rh ose
three words our of his mourh rhan June
sraned ctying. When she finally regajned
enollgh composure, she managed ta ger a
few words our: "Cancer-isn'r ir?" Or.
McAJesrer sadly oodded his head yes.
"Cancer." The word srrikes fear inca rhe
hearts of most Americans. Often in my years
of pracrice as a physician, 1 have had the
same lIncomforrable rask thar Dr. McAJester
haei. Many rimcs 1 have had ro rell individuals the frighrening news: "Yes, rhe biopsy is back and ir shows whar we aII
feared-you do have cancer."
A diagnosis of cancer is nor aJways a
death senrence. Somermes it can be rrcated
wirh chemorherapy, rad iar ion, surgety. or
other means. Unfortunate1y, far roo ofren

it advances beyond irs inirjaJ srage and the

disease js faraJ. Cancer is currendy rhe nllmber rwo killer in Americ.'l, rrailing onJy hearr
disease. Unless we as a narion make posirive lifesryle changes, soon afrer rhe year
2000 ir could be rhe number ooe cause of
dearh. 1 In America, rhe sr;trisrics indicare
rhar one in every nvo men and one in evety
rhree women wiU ar some time be diagnosed
wirh chis frighrfuj disease. 2 ClIrrenrly one
in every fOLU dearhs in rhis coufltry is from
cancer. 3 AH rold, over 500,000 Americans
die each year from rhis dreaded killer. This
alone is reason enollgh ro fear cancer. However, maoy people fear rhe ravages of cancer
even more rhan dearh irse1f.
Before a person dies from cancer, rhere
ofren are dramatic changes in physical appearance and inrelleccuaJ funcrioning. 511ch
changcs may include significanr weighr and
muscle los$, 10$s of hai r, severe episodes of
pain, memoty loss, near delirium, ,Uld even
profound personaliry changes. This is onJy
a parriallisrjng of rhe devast<lring effecrs of
cancer and irs rrearmcnr. Undollbredly, rhe
disease deserves to be feared for rhese reasons as well.
Unformnarely, mosr people feei rhar ali
[hey can do is hope rhcy never ger cancer.
They do nor realize rhar rhe degree of risk
of an individual ro develop cancer is Iargely

11

PROOF POSITIVE
a marter of personallifesryle decisions. One
evidence of this lack of awareness is the filce
ehat, unJike some orher lifesryle-rdated diseases (such as hean disease), ehe total number of cancer deaths in America have been
sreadily increasing. 4 . S The rate of increase
is shown in Figure 1.

CANCER SON

ERISE

600,000

Cancer
Deatb5

500,000 400,000
300,000
200,000
100,000
O

1930

1940

1950

)960

I~O

1980

1990

2000

Year
Figure 1

12

The rare of rise is dramaeic, doubling in

the last 30 years. Furrhermore, of the estimaeed 560,000 cancer victims who would
die in 1997,6 most ofrhem could have prevenred d\eir illness had ehey paid anemion
to some simple lifesryle facrors.
Akhough rhe number of cancer deaths
conrinues ro rise each year in rJ,e V.S., the
per capitl1 cancer morrality rate has jusr recently searced ro decline. 7 This celebrated
smaH decline was f1rst announced by (he
Nacional Cancer Institute in larc 1996, bUl
a ca refu I retrospective review of che daca
indicared ehat rhe per capiea cancer death
racc peaked in 1991 and has ever so sJowly
declined thereafter.RThe reason for rhis dec1ine~ Nor improved cancer rrearmems, bur
cancer preventioJl irselfemergcs as rhe cause
for rhis good news. 9 AJmough che auchors
of rhis repore readily admit rhar "rhe war
againsr cancer is far from over," they emphacic.llly srare rhar "A narional commirmene ro che prevention of cancer, largely replacing reliance on hopes for un iversal curef,

is now the way co go." This chapter is wrirten on che hopes of putting che reader on
tile cuning edge of rhis new commirmem
ro the prevenrion of cancer and cancer
dearh.

, How Cel/s Become Cancerous

Lec us look ar whar cancer actually is.
Cancer involves rhe producrion of cells in
rhe body. Every minute 10 miJlion cells divide in ollr bodies. Complex internal control mechanisms usual!y eosure rhac every
one of these ceH divisions occurs in a precise way ar just che righr rime. 10 The process called cancer can begin when foreign
subsrances in the externttl environmene
(chemic.'lls, radiarion, virusc.s, etc.) ger inro
the body and somehow perturb these imernal control mechanisms. It can a1so begin
as a result of problems rhar originate with
rhe body's interna! environmenr (hormonal
imbaLulces, immune impairmenr. inherired
mucacions, erc.).ll Regardless of rhe corn
bination offaccors rhat start ilie process, che
resule is ehe same: a single cel! begins ro
mulriply in an unregulated manner. As this
ceH multiplies, ir passes irs characrerisric of
unregu!ared growth co its offspring. A caucerous rissue made up of many unregulared
cells is me result.
One of rhe ways thar environmental
agenrs appear co induce cancer is by inlliccing damage on [he cells' DNA. DNA conrain explicit nstfuceions for aU cell activiues and thus spells ouc exactly how each cell
in our body should function. For example,
rhe DNA [dIs our bodics what color (Q
make our hair and whether we should have
blue eyes or brown eyes. This same DNA
controls the rate of division ofcells. On cerrain criticaJ areas of a cell's DNA chere are
gene.s clut can stimulare che growrh of that
cel! and other genes char can suppress ies
growrh. One way tiUt cancer can occur is
chrough damage ro rhis DNA. II the d,1mage causcs ac(ivarion of areas (hat srimulare
growrh and/or the inaccivarion of areas thar
would keep growth in chcck, the resu1c cau
be unconrrolled growth of thar cel! aod its
offipring. This, as we have noced. signals
the beginning of a C~lI\cerolls growth. 12 We
refer ro that a1tered cdl as a cancer cell ifi[s

GOOD NEWS ABOUT CANCER

generics are ehanged in sLlch a way as [Q aJlow uneolltrollcd multiplication.
If rhe body derecrs abnormal cancerous
cdls at an carly stage, mase cells can be desrroyed before rhey have a chance ro signi(jcandy grow and multiply. In fact, many
sciencists belicve rhar evcry day-in evcry
pcrson-some normal celis are converted
inco cancerous cdls. Usually, rhe pcrson's
immune system desuoys rhese newly a1rered
cdls. Unforrunatdy. howevcr. sometimcs a
new eancerous ceU is nor derected and it
managcs ro divide and growwithot1t check.
These cells can rhen continue ta silencly
grow our of control. UJrimarely they can
fonn a mass ar "wmor." Commonly. cancer ceUs from larger (Umors will get into rhe
blood sueam aod/or Iymph sysrem and
rravel ro other vital organs. AI! of rhesc
changes may oeeur long before the cancer
is even djagnosed. Depending an rhe growrh
rate of the cancer, it may take 10 years or
longer before signs or symproms develop
that wtimate1y prompt rhe medical evaluarlon rhar results in rhe diagnosis ofcancer. 13
In rhis ehapter you will leam how ro
dctecr if you have cancer. and a1so how ta
reduce yur risk of getting it. We begin by
presencing means of detecting cancer.

Early Detection is Crucial

Early derecrion provides rhe besr chance
of rrearing cancer while it is stil! curable.
There arc rwo ways to do this: (1) prompr
recognition of cancer's symproms; and (2)
appropriare use of cancer screening tests.

Recognizing Cancer's Symptoms

Cancer is ofren curable if dcrccred catly
enough. Unforrunately. many pa[ienrs are
nor mindful of r!le importance ofearly dercetion. Time and rme again 1 have been
forcibly impressed wirh this sad real ity. In
addicion to my work in general internal
medici ne, I work in the fidd of gastroenterology. 1 have many paeienrs who come
ro my ofhee complaining of inrermirreo[
bleeding rrolll rhe rectulll for pcrhaps dyear
OI' more before seeing me ar any other physician. Somc pur atI that doctor's visit because of simple procrasrinarion, while orhcrs may have delayed because of ehe fcar of

cancer. Srill others may have dismissed [he

seriousness of this warning sign, thioking it
was due ro a minor condirion like a hemorrhoid. Only after they srart having pain or
orher symproms do rhey tJnally decide tO
have me evaluare rhe bleediog problem. By
rhis time. for many, it is aJready too late.
[n my eval1l3eion 1 use a colono;copea long, f1exible rube that is inserted nto the
rectum and passed up through rhe Iarge intestine, or colon. It has a light ar rhe end
rhat allows me ta direcdy look at the inside
of rhe inrestine. It also comes with special
rools for removing early cancers or non-cancemus polyps wirhout major surgery. As 1
look ehrough the scope J occasionally find
a cancerOlIs mass rhar is already [00 large
for me ro remove. Ar rhar poinr rhere may
be linIe chance of c urc:, but rhe person may
still need major surgery-ar Ie.ast ro avoid a
tOtal bowel blockage. Frequenrly. dearh is
rhe result. since by rhis time. the cancer has
often spread tO vital organs such as rhe Iiver.
T!le message rhar rhis and a rhousand
orher scenarios illustrate is tiut everyone
should pa)' artention ta canccr's warning
signs. It is onIy by heeding dlcse early warnings thar we have the best chance of detecting and treating t!le disease while it is stil!
curable. For years. the American Cancer 50ciery has encouragcd al! Amcricans tO be

SEVE WA ING
S GNALS OF CANCE
1. A change in bowel or bladder habits
2. A sore that does not beai
3. Unusual bleeding OF discharge
4. Thickening or a lump in the !"
breast or elsewhere
~~
5.1ndigestion or difficulty in
CANCER
swaUowing
~
6. Obvi?US change in ,a wart ormole
7. N agglng cough or hoarseness
<_"

'L
Figure 2

13

PROOF POSITIVE
aware ofseven of the mosr imporranr ca.ncer
warning signs. These are [isred in Figure 2. 14
Mosr of these warning signs are self-explanatory. For example, "a change in bowel
habits" can refer ro persistent diarrhea ar
consriparioo as well as ta changes in color
or size of rhe sIOols. "Bleecling" ncludes
such rhings as recral or II nusllal vagi nal
bleeding. "Difflcul[y in swallowing" can

AMERICAN CANCER SOCIETY'S

RECOMMENDED SCREENING TESTS
1. Digital reetal exam (yearly after age 40)
2. Stool sUde test, for microscopic blood (yearly after

age 50)
3. Sigmoidoscopy, preferably flexiblc (every 3 to 5
years after age 50)
4. Pelvic exam aud Pap smear (women: youIIger tita"
18 if sexually active; after 18 yearly for at least
three consecutive years, then frequeucy
determincd in conjunction with personal pbysician)
5. Blood PSA test (meu: yearly after age 50)
6. Selfibreast exam (women: monthly after age 20)
7. Breast physical exam (women: every three years
from 20-40, then annually)
8. Mammograro (women: begin by age 40, then
every other year, yearly after age 50)
Figure 3

14

occur when food secms ro remain in your

esophagus (swallowing rube) before ir goes
down. The imporram message is rhar any
of rhese seven signs indicares a need for a
prompt medical evall1<lrion. Paying ;tuenrion ta your body and recognizing when you
develop somerhing d1ar needs ro be evaluared ma)' provide a window of opporruniry
where cancer can be diagnosed-and
eureel-in irs early stages. Unfortunarely,
even prompr evalliarion of rhese signs does
nor gllaramee rhar we wiU diagnose a cancer at a rrearable stage.
Recently 1 had a patienr rhar came ro
me afrer onl y a single episode of recta I bleeding. When 1 checkeel dle stool microscopicaUy, blood was present. A few da)'s larer 1
diel a eolonoscopy exam anel found a rumor so large rhar r could nor remove ir using rhe scope. Grher lab resrs showed dur

[he cancer hac! ;llready spread ro rhe viral

organs. Yer for every pariem Jike this, l have
others who iniriated prompt evalllation of
reera! bleeeling and rumed our nor ta have
cancer-ar ro have it al an earlier srage so
rhar ir could be safely removed by using rhe
colonoscope.

Yes, prompr evaluarion ofany of cancer's

warning sign is important ancl ShOllld never
be put offfor a convenienr rime. It can save
your life. However, there is an even hener
a1rernarive: raJ{e advanragc of any opporruniry [O derecr GUlCer before any signs or
symproms develop.

Eari)' Detection b)' Screening

Fonunace1y, in oreler to gain an lIpper
hand on cancer, rhere are ways ro derecr
cancer before we have symptoms. The
American Cancer Sociery recommends that
each person lmdergo eerrain rests designed
for chis purpose. These tesrs are generally
referred ro as "cancer screening tesrs." The
goal of rhe e evaluations is to derecr cancer
in irs early stages before symptoms occur.
The cllnem list of screening reconunendations is shown in Figme 3. l5
Further clescription ofsome of these resrs
may be helpful. A sigmoidoscopy exam i.s
performed lIsing a flexible rube ar scope.
The sigmoidoscope s virrllaHy idenrica! ro
the COIOI)OSCOpe wirh one exception: it LS
significanrly shoner. The six foor long
colonoscope can rravel the lengrh of {he
enrire colon. Ir is mos{ often lIsed for diagnosis when rhcre is a known problem such
as intestinal bleeding. On rhe orher hand,
rJ1e rwo tom long sigmoidoscope is more
ideal for screening purposes since it is simpler and less cosdy than the co10noscopy. lr
can visualize the lower one third of rhe colon where hisrorically mos{ colon canccrs
have occurred. Screening for colon cancer
is exrremely important-ir is the second
leading cause ofcancer dearh$ in A.mericland rhe Jeading Cause of cancer dearhs
among rhose who have never smokecl. Flll"rhermore, colon cancer is very prevemable
if ie is diagnosed in a precancerous stare.
A.lmos[ every colon cal1cer begins as a benign lump or finger-like projecrion known
as a polyp.lfdereercd in rhis stage, rhe polyp

GOOD NEWS ABOUT CANCER

C,U1 generaliy be removed witl1 the scape and
ir will never develop imo a cancer.
A pap smear can detect cancer of rhe
cervix (rhe opening of rhe t1terus or womb)
ar an early stage. Cervieal cancer is one of
rhe more common cancers in women. Ir is
also a preventable cancer ifit is detected early
enough by raurine screen ing.
Artention ro cancer's warning signs combined wirh proper lIse ofscreening rests has
alread}, saved literally thousands of lives in
our country. However, me American Cancer Society estimaees mat bereer use of diagnostic testS and more prompr attemion
ta cancer's warning signs could save another
115,000 lives each year. 16 This far exceeds
the nllmber of lives saved throllgh the acrual trearmenr of cancer. li
In spite of the chollsands of lives saved
by early detection of cancer, "early" decection is nor earl)' enollgh in many cases. The
CUlcer idemified by the screen ing test stili
ma}' kill some pacienrs. This sobering reality has left many wondering, "Is there hope
of prevenring cancer from starting in che
first place?" The answer is an lInequivocal
yes. The remainder of chis chapter reveals
che 'sreps' you can take tO prevem cancer
from ever beginning.

Two Primary Lines

OfDefinse Against Cancer
There are ewo basic strategies mat wiU
prevent most cancers from starting; even if
cancer has already begun, rhey may help che
body gain an upper hand. These strategies
are simple:
1. Avoid facrors that [avor cancer developmem.
2. T:tke advantage of facrors [hac help
rhe body ro ward off cancer.
These rwo srraregies are usually effecrive
because ofone or hod1 of the followiug reasons:
1. They help lIS avoid or mnimize contact with cancer-causing substances.
2. They help lIS strengthen aur body's
own mmune system for fighring
cancer.

The remaillder of chis chapter is divided inca rwo sections. The ftrsr section
deals with minimizing contact with cancercausing subsrances. The second deals wim
rhe agenrs that will help aur immune system ta fight c.ancer, and other agenrs that
will reduce our risk of getting cancer.

CANCER PREVENTION:
SECTIONIAvoid Factors
That Favor Cancer
Development
Ler us look ar the factors rhat F.lvor rhe
development of cancer and how we can
avoid rhem. As an exanlple, one (,\cror is
alcohol. We will see rhar rhe use of aleohol
favors the developmenr ofcancer and rherefore shollld be avoided. Furthermore, we
will find rhar avoiding alcohol helps us on
both of ehe froms menrioned. Alcohol a.nd
irs breakdown producrs have cancer-causing potential, and it al50 undermines t!le
immune system. COllsequent1y, a double
benefit will result from avoiding alcohol.
It is clear (har the besr way ro avoid cancer is by prevenring it before it has a chance
ro form in rhe first place; before it can even
be derected by screening resrs; before it has
a chance ro cause any symproms. Most can-

cers cari it/deed be pret/elUed before they ever

form. In 1988, the U. S. Surgeon General's
Report on NlItririon and Health carne off
che press. In irs comprehensive review of
cancer research, it st.ared, "In che course of
rhis research, it has become deal' mat many
cancers have [known] excernal causes and,
in principle, should therefore be preventable."18These findings concurred with oftcted research done a decade earlier by Drs.
Wynder and Gari. Their detailed comparisons of inrernational cancer rares lead rhem
co conci ude tine roughly 80 percenr of cancer was prevenrable by relativeIy simple
lifesryle choices. 19 Anorher decade prior to
Wynder and Gori's published work, Dr.
Higginson conduded that 90 perceLU of
cancerwas due ro "environmenral factors."2o
Thus, rhe Surgeon General's panel endorsed

15

PROOF POSITIVE

16

research on rhe imporcance of lifeseyle w

cancer risk lhal had been prominently advocated since the 1960s.
What c1id they mean by "environmentaI f.1.cwrs?" They are referrillg (Q any factors apan from om imernaJ body processes
and inherited rcn<lencies thar affecr us.
These factors include the air we breathe, the
water we drink, rhe food choices we make,
our exercise habits (or Iack of chem), our
sexual praceices, our social relationships, etc.
So, when the expens tell us tiut 80 ro 90
percenr of cancer is 'envronmental" rhey
are saying tllat the vast majoriey of cancers
can be prevented if we pay arrenrion ro che
rhings we pur intO our bodies, che things
we allow Dur bodies (Q eome into comaer
with, and rhe rhings we do with Dur boclies.
Oespite 30 years of understanding rhe
linkage berween cancer and lifestyle, the
world's populaces for rhe most pan have not
integrated this knowledge intO praetjce. In
1996, Professor Michael Sporn reviewed 25
years ofhiscory since the U.S. ofticially dec1areel "war on cancer." Nthough he cited
area.5 ofsuccess, he also highligheed our very
slow progress in achieving significam cure
rate. for sorne of rhe leading cancers such
as breasr, lung, and prosrate. His remarks
brouglu us righr back to Higginsons insights
when he said: "We need to bolster educarionai efforts ro encourage challges in
Jifesryle, diet, and orher narura! facrors thar
might sllppress rhe process of carcinogenesis [causing cancer] ."21 Althollgh researchetS have been ralking abolit it for yea! , it is
obvious from devated cancer tares tllat we
stiU have nOt learned the lessons. Again, rhe
plea is for each one of us ro leam how aur
own lifesryle affects ollr risk of cancer and
make changes accordingly.
Jusr what are rhese experrs telling us
when it cornes ro Iifeseyle and "environmene" in rhe broadesr sense of the word?
They are communicatng a relarively simple
message d1<1t does not lend itself ro much
media hype. The environmemal concerns
anei the advoc:lred lifestyle changes are
si mple yet profound. They are talbng abOlit
things like sropping smoking, eatng bener,
gerring regular exercise, and losing weighr.
However. when rhe \'<Iall Srreet Journa1 Sllf-

veyed the rype of cancer news thar network

TV, news magaznes, and newspapers were
covering, rney taund rJ1ar cancer researchers feir the merua was misplacing irs emphasis. 22 Srories in rhe secuia.r media were
dominated by concems regarding fooel addirives, pollurion, radiarion, and pesricides.
These issues were much lower on cancer
expens' lists of imponance than our basic
habitual dierary choice .
Ne<1rly rwo clecades before the JoumaJ's
repon, Or. Ernsr Wynder already realized
what rhe problem was. "Individuals renel ro
ignore rheir own responsibiliey and blame
harmful occurrences, including exposure ro
carcinogens (cancer-causing agenrs), on
olltside forces. Therefore the genera! environmemal elemems [things tl1at we cannot
conerol well such as chemical pollurion of
air and water, or food addirives and COI1raminams] recei ve the mo t attention rather
than factors reslllting from personal
)ifesryles."23 M}' foens in chis chapter wiU
be solidly an rhe mosr important c.1ncer
prevenrive facrors-lifeseyle faclors rhar each
one of us can change.

Tobacco is the Number

One Culprit
Tobacco is rhe number one cancer culprit in rhe Urured Srares and in much of
the world. Increased cancer dearh rares accoum for a large share of robacco's bllrden,
and rhis bllrden is sraggering. In the U.S.
alone, approx.imarely 170,000 lives are losr
each year rrom cancer cal! ed by smoking, 4.
25 which is one-third of aII cancer dearhs.
(A conservarive estjmate of 400.000 Americam die [rom ali diseases callsed by smoking each year?' at an annual medical expense of $50 bllion.)27 Worldwidc, the annual dearh roll from smoking has reached a
mincl-boggling 3 million people. 28 This
equates ro one elearh every 10 seconds.
We have massive evidence demonsrraril1g eobacco's power ta callse cancer. Ova
4,000 diffirent chemicals have becn idenrifled in robacco smoke. 2':> A number of rhese
chemic.1.Js has rhe abilit), ro cause cancer aJI
by rhemselve . There are specific carcinogens in robacco thar cause lung cancer, orh-

GOOD NEWS ABOUT CANCER

ers that (duse kidney and bladder cancer,
some mat cause cancer of rhe esophagus,
and oehers (hat eause caneer of the pancreas.
AII rold, a [ong lisr of cancers have been
linked [O exposure ro robacco products.
They are Jisred in Figure 4. 30 . 31 2, 3.34
When you consider ehe veritable wirches'
brew of chemicals in robaceo smoke, it
should corne as no surprise rhar tobacco
causes more human cancers rhan any orher
known environmencal factor.
The porency of these chemicals is furrher artested ro by rhe fact dur it is nor onJy
{he individual who smokes or chews tobacco
who is ar risk. Those who brearhe second
hmul smoke aho increase their cancer risk.
Currenc estimares are thar cach year in the
U,$. 3000 non-smokers die from lung cancer due solely to second hand smoke exposure. 35 ln addirion, fathers who smoke
greater than 10 cigarettes a day ac ehe rime
rhey conceive rheir offsp.ring increase the
6sk ofa childhood malignanc)' in their new
son or daughrer by 31 perceut, Ifthey smoke
grearer ehan 20 cigarettts a day (he increased
risk goes up to 42 pereenc..36Tlus is rhoughc
ro be due ro rhe DNA damage in rhe sperm
caused by smoking.
The ohvious cancer preveneion message
ro each person is: "Avoid aU possible robaeco
exposure." That means we muse stop smoking. That means we have co stop chewing
eobacco. That means we need [O decrea e
even our passive smoking by choosing workplace.s and se[[ings for reereaton that are
smoke-free.
Many Americans htlve heeded rhe tobaceo warnings rhar have been publicized
for years. Approximate1)' 46 miI/ion Arnericans have scopped smoking cigaretresY
Cigare[[e smoking among aduJts aged 18
and over declined from 42 percenc in 1965
ro 25 percenr in 1990. As a result, lung cancer is now finaJly scareing ro decline in
men. 8 However, since 1990, that sready
dedine in smoking has aJarmingly stopped.
The percentage of aur population ehae
smokes has remained unchanged for ehe lase
haJf decade. 9 Of perhaps even grearer concern is the face ehar more high $chool seniors are smoking roday ehan duee years
'\00 .
(o

10

CANCE
Lung
Lip
Mouth (oral cavity)
Throat (pharynx)
Voice box (larynx)
Trachea (wind pipe)
Esophagus
Stomach

DTOTO ACCO
. Liver
Pancreas
Bladder
Kidney
Cervix
Leukemia
Colon
Skin
Penis
Figure 4

II you are currendy struggling with nicotine addiction, do nOt despair. There are 46
million Americans who can eeseify thar ir
really is possible ro quic. Take advantage
roday of some of rhe effeceive strategies for
dealing wirh rhis addicrion as found e1sewhere in rhis book (see Chapter 16, "Oying For A Cigarene? Kick the Habie and
Live," and Chapter 18, "Overcoming Addiccions").

Alcohollncreases Cancer Risk

There is mueh evidenee that alcohol iner ases rhe risk of cancer on many froms, I
presenr some of the scienrific evidence linking alcohol with cancer in Chapeer 17,
"\X'ane a Drink?" Noneeheless, rhis copie is
so vieaJ roda)', tiut ie is wonh more than a
passing referenee in this ehapeer.
From population srudies it is weU estab
lished that drinking alcoholic beverages increases the risk of a varieey of cancers. The
list indudes cancers of rhe mourh, throat,
esophagus, liver, brease, and recrum. 41 ,42
AJehough the cancer association is primarily with heavy alcohol eonsumprion, moderate alcohol ttse may aho raise the risk of
some of these cancers. Breasr cancer is t11e
dassic example wirh the evidence suggesting ehae as Iittle aS three drinks per week increases a woman's risk. 43
Research has given 1I~ a goocl approx.i-

17

PROOF POSITIVE

PERCENT OF FATAL CANCERS

RELATED TO ALCOBOL

Figure 5

mation ofthe percenrage offatal cancers mar

a1cohol contriblltes ro. A parriallistingappears in Figure 5. 44
Compared ro non-drinkers, more rhan
rwo aJcoholic drinks per day doubles the risk
offorming benign rumors of the colon that
can larer become cancerous. 45 . 46 But if a
drinker's diet is low in folic acid and methionine. the risk of colon cancer rriples. 47

Akohol Jncreases Risk

OfBreast Cancer

18

AJcohol can affect hormone levels ehar

may in curn increase cancer risk. The greatest concern is with female hormanes aod
their re!arionship ro breasr cancer, which is
the second leading callse of cancer deadls
among American women (lung cancer is
first). Among nonsmoking women, breast
cancer is the number one cancer killer.
Many people are nor aware thar CI.
woman who drinks onl)' socially (:h~ little as
three drinks per week) significandy increases
her chance of gening breasr cancer. 48 49 Various studies have now shown rhar moderare
drinking may be associated with up ta 50
to 100 percenr elevated risk of breasr C<1ncer compared ro non-drinkers. 50 This increased risk exists wherhcr rhe alcohol comes
from beer, wine, or spirirs. 51 Of interesr (O
rhose who advocare wine ar meals as CI.

"health-eohancing habir," a French study

found an increased risk of breasr cancer in
subjects who consumed alcoholic drinks
wirh rheir meals. The associarion held rrue
for borh beer and wine. 52
Further supporr for rhe alcohol-breast
cancer relatiooship comes from the Nurses'
Heahh Scudy. Thcre, in a four-year study
of nearly 90,000 U.S. nurses aged 34 ro 59,
a significant relationship was found herween
aleohol consumpeion and breast cancer
risk. 5J Those who consumed ooly duee ro
nine drinks per week had a 60 percenr increased risk of breasr cancer. The more the
women drank the greater the iocreased risk.
This sreadily increasing risk of cancer wieh
increasing amounrs of aJcohol consumed is
called a "dose response" cffecI. This type of
relationship stroogly suggests rhar alcoholic
beverage consumption and nor somc other
factor is increasing the risk. For rhe younger
women below 55 ycars of age, rhe consumption of ooe drink per day illcreased their
risk 2.5 times.
Why does aleohol increase hreast cancer risk? AJrhoughall of me answers are nor
yer in, there is evidence [har alcohol increases estrogen levels. 54 . S5 Since rhis fcmale
hormone is known ro increase breast cancer risk, it is suspected chac alcohol's hormonal effecrs may be a damaging facror.
Furthermore, women with the most advanced forms of breast cancer rend ta be
drinkers of a1cohol, indicacing thar alcohol
mayacr primarily as a "tumor promotor or
growth enhancer"5 6 in those rhat are JUSt
beginning ro develop the disease. To date,
over 50 solid sciemific srudies have indicated
thar aleohol plays a definite role in rhe developmem of breast cancer. 57

What Percentage ofCancer Deaths

are Caused by Alcohol?
There are several mechanisms as ro why
aleohol use is associated with cancer: roxic
infiuences, immwle effeccs, dierary relationships. and hormonal associarions. Yet these
broad-ranging mechanisms teU us not.hing
abolit rhe total impact of alcohol on cancer.
Researchers previously rhoughr that only
ahour three percenr of ali U.S. cancer deaths

GOOD NEWS ABOUT CANCER

could be arcribured-even in parc-to alcohol. Sril! rhis figure is ignificant, accOlll1ting for 16 000 ro 19,000 dearhs per
ycar. 'sThe American Cancer Sociery quotes
a figure of 19,000 deaths, defining rhem as
being related ta 'excessive a1cohol use, frequencly in combination with robacco lIse."59
However, as we have seen, newer studies link
even relatively moderate aleohol consllmption-apan from smoking-with rwo major cancers: breast cancer and colon cancer.
Taking into aeeount chis additional evidenee some be1ieve that tOtal avoid,uKe of
alcohol could prevenr some 60,000 deaths
per year, which is 11 percenr of aii cancer
deaths. 60 The facr thar even relarively small
amounrs of a1cohol can increase one's risks
of common cancers leads to the following
conclusion: anyone who wants 10 keep ther
cancer risk as low as possible will romlly
avoid akoholic beverages. Indeed, e1iminating the use ofboth alcohol and robacco wil!
dectease your lifetjme cancer ri k by a signiflcant amounr.

Female Hormones and Cancer Risk

Esrrogens are CUlT .ndy at the crux ofone
of medi_ine's major COlltroversies. Many
health professionals ar encouraging ali poStmenopausal women ro use estrogenic replacement hormoncs. Commonly cited reasons are rhe pllrporred benefits for the hean
and bones. However, few wornen seem to
be full)' aware of the serious side eJjeets of
e.xcess esrrogens. Arnong r!le most sobering
is an increased risk of certain female cancers. For years rhere has been tecognition
that women who, fol1owing menopause.
take esrrogen alo ne (without a progesreronctype drug) experience a dramatical1y increa ed risk of CUlcer of the lining of the
womb. In an exrensive review of aii the research on the subject, Universiry of California ar San Francisco scienrists conclllded
rhar prolonged use of esrrogen after menopause could increase risk of cancer of r!le
womb by over 800 percent. 61 Because of
these well-known increased risks, physicians
have prescribed progesratjonal agenes in
combinarion wirh esrrogcns ro rry ro prevent th is cancer ri k. Although the data rcve..lls that rhe addjrjon of progesterone de-

crea es rile amoune of elevarion in risk, rhe

use ofthe combinarion stiU increases the risk
of womb cancer by 30 percent when compared with wornen who do nor take horJllones. 62 Potential bellefirs and risks of raking estrogen are included in Appendix 1,
enrided "Estfogen: Balancing Benefirs and
Risks".
Cancer of t!le womb is an imponanr
cancer, bur it pales in significance compared
ro breasr cancer-the leading cancer kjller
among nonsmokjng women.lt is of utmOst
importance that we look at the relationship
of hormonal replacement and breasr cancer. Harvard Universiry has produced one
of the mose convincing repons on this subjecr, again from cheir urses' Healrh
Srudy.63 In their data covering 725,000 person-years of follow-up, women using esrrogen (alone) after menopause faced a 32 percene increased risk of breasr cancer. The
popular regimen of combining esuogen
with a progesterone hormone acmaUy increased the risk ro 41 percene Risk rended
ro increase ro 71 percem in women who
were over 60 and had llsed esrrogen for over
five years. 61 These reslIlts are similar ro a
smaller study done in the Seventh-day
Adventisr popu!ation. 65 There researchers
found that women taking hormonal replacement aEter menopallse experienced a 69
percenr illcrease in breasr cancer risk.
One obviollS message of these srudies s
that any women raking estrogen after menopause 'hollld be aware thar he is increasing
her breasr cancer risk. For a more complete
look at the benefits and risks of taking es
u'ogen a.her menopallse, see Chaprer 7, "The
Great Mear and Prorein Myth." Another recent smdy provjdes more evidence of r.he
breast cancer-estrogen reJariollshj( . It found
rhat women who yttl/urtlL(J' have hjgher estrogen levels al50 dramariclJly incre'J. e their
cancer risk. 66 Dr. Paolo Toniolo and associates ar Ne...v York Universit:y 5chool of Medjcine examined esrrogcn blood levels in 130
women wirh posrmenopallsal breast cancer
and 251 women the same age who were
cancer-free. An ullusual aspect of the srudy
was ehac the patienrs' esrrogen levels were
measured on blood thar had been drawn
frozen, and stored several years before their

19

PROOF POSITIVE
cancers were diagnosed. This helped ro ensure rhat estrogen levels were nor influenced
by the cancer irself or by orher recent facrors, including estrogen replacemenr. The
women wrh the highesr naeural estrogen

ANNUAL CANCER MORTALITY RATES OF

JAPANESE IMMIGRANTS PER 100,000
CANCER
TYPE
Colon
Rectum
Prostate
Breast
Womb
Ovary
Lung
Stomach
Esophagus

Japanese
in Japao

78
95
14
335
32
51
237
1331
150

Caucasians

in Hawaii

in Hawaii

371
297
154
1221
407
160
379
397
46

368
204
343
1869
714
274
962
217
75

Figura 6

\evels experienced t\VO ro four rimes the

breast cancer risk.

The American Diet is Conducive

to Cancer
The impact of nurririon on cancer is
phenomenal. Some nutritional factors
elearly fvorcancer development while orhers help to ward off cancer. The dietaty
choces that increase rhe risk of cancer wiU
be dealt wirh in this seClion. Our unhealthfuI dier ranks as one of rhe mosr powerful
faccors increasing aur cancer risk. Estimates
are rhar 35 ro 60 percenr ofali cancer deaths
in our nation ma}' be anributahle ro poor
eating habits. 67 How do we know thar dier
has such powerful effecrs on cancer risk?
Perhaps more imporrantly, what dietary
challges can we make in order ro decrease
cancer risk? Ler us examine rhe scienrific
evidence that answers rhese important questioos.

20

Migration Demonstrates that Poor

Eating Habits lncrease Cancer Risk
A large number of research studies have
found thar lifesryle changes as a result of
migrarion are key facrors relating ro health
and disease. Migranrs generally assume the
risk of rhe indigenous populace in the country la which rhey move. Such sludies show
elearly mat the risk of cancer is gready influenced by diet. In Japan mosr cancer fates
are low (with rhe exception of sromach and
esophagus), bUL whcn people from Japan
emigrare ta Hawaii, death (ares of maoy
rypes of cancer become quite similar ro the
Caucasian Hawaiians. 68 The changes in
morraJity rates of various cancers due ro
migration are listed in Figure 6.
We see thar seven of clIe nine cancers
listed increase dramatically when the Japanese come ta live in Hawaii. For example,
cancer of the colon in Japan is low, wirh
only 78 cases per 100,000 people. After
emigrat ing ro the United States, rheir colon cancer rate rises to 371 cases per
100.000, nearl)' a fiveloM increase in risk.
Notice, coo, thar the new rate is similar la
r.hat of their Caucasian neighbors. Cancer
of clIe rectum is also 10w in the Japanese
who live in ]apan. After living in rhe U.S.'s
ftftietb state, however, recra! cancer strikes
rJ1em three rimes more frequcntly.
Many lifesryle Jactors change when
people emigrate ro rhe U.S. or ro any differem cuiture. The research scientisrs who
srudy these changes and the diseases associated wirh them are called epidemiologists.
Epidemiologisrs believe r.har changes in di
etary habits are one of rhe maio reasoos why
cancer risks change in r1lOse who immigrare. 69
The dietary practices of the Japanese
ll1ldergo a marked transformarion when
the}' move ro Hawaii.7' 71 Unfortunately,
mosc of (he chaoges are for the worse. The
Hawaii emigranrs cat rwice as much far and
subsraotially less carbohydrate than their
peers in ]apan. They car subsranrialiy more
bureer, margarine, and cheese, and slightly
more meaL Their consumprion of rice and
rafu (soybean curd) drops. It is, therefore,
no surprise thar the fars ealen by me Ha-

GOOD NEWS ABOUT CANCER

waiian group are 65 ro 70 percelU saturated
(ooly 40 percent of t11e fats eaten in Japan
are saturated). Among those in Hawaii, 35
percem of the carbohydrares they eat are in
the form ofsugar. This is comrasted by sugaJ
composing onl)' 20 percem of the carbohydrate inrake ofthose in Japan. Furthermore,
rhe changes toward an American diet become more complete over rime. The first
generation immigranrs retain more of rheir
japanese eating habits rhan their secondgeneratoll ofTspring. Compared ta theiI
parenrs, those born in Hawaii ear significaml)' more a.nimal protein, fat, satllrated
fat, and sugar. 72 These dietary changes conrribllte ro [he increased cancer rares ar such
diverse sires as tbe colon, rectum, prosrate,
breast, womb, and ovary. Other srudies confirm rhis conclusion as we will see.
The dietary changes mat rhe Japanese
made are nOt harmful in aII aspects. At leasr
two cancers-stomach and esophagusdecrease in incidence whcn they come ro
Hawaii, and th.is also likely has ro do with
changes in earing habits. Thc imake ofsalry
pick.led vegetables and dried, salred hsh decreascs dramaricall)' among dlose raised in
Ha}vaii. hese kinds offoods are tinked with
increased rares ofboth sromach and esophageal cancer. 73, 74
Similar associations have also been reportcd in srudies of Filipinos migrating ro
Hawaii.7 5 The immigration studies menrioned here provide only a glimpse of che
weahh of research published an this rapic.
They make an e\oquem point that in the
development of cancer, genetics are much
Iess important rhan environmemal condjtions, such as the way we live and eat.
Clearly, there is much more ro cancer rJlan
genetics. Diet plays a proftund
in causing or prevenring cancer.

,.ou

Excessive Dietary Fat lncreases

Cancer Risk
Every American has heard the message:
"Cut the fat." Whether the subject is heart
disease, cancer, or a hosr of other problems,
dietar)' fat often seems ro emerge as the vi\lain. There are good reaSons for fat's bad
replltation. Studies involving the dietar)'

babits of many counrries provide slIbsrantiaJ evidence rhar excess fat in the diet increases the risk for cancer ofthe breast, prostate, skin, colon, rectum, ovaries, and
womb. 76

Breast Cancer lncreases

with Fat Comumption
One of rhe studies involving breast cancer was condllceed in 1970. It shows that
the rate of breast cancer faralities in any
given natiol1 corre!ares weB with bow much
fat its population eats, as illllstrated in Figure 7. 77

MORE DIETARY FATMORE BREAST CANCER DEATHS

FEMALE

25

Deatb
rate per

Canada
U.S.A.

Malta.

Australia
Swede
W. Germany
France
Finland
Polaod
Greece
Hong Kong
Mexico

20

100,000 15

10

20

40

60

80

100

I
120

140

160

Total dietllr)' fat inlake (g1day) 1944-66

Figure 7

Notice that the U.S. ranks among rhe

tOp counrries in both far intake and brease
cancer dearh rate. Canada, Australia, Sweden, and Germany share a similarly llnenviable status. This curve plot delllollserates
thar. those who eat the most animaJ far te ud
ca have the highest brcast cancer risk.i 8
A French stud)' found ehat women who
ate the mose total fac increased their risk
of breast cancer by 60 percenr. Risk was
greater wben the analysis foctlsed on saturated fat earen by post-menopausal
women-chey more tban rripled their risk
of breast cancer. 79
Berween 1964 and 1978, the japanese

2]

PROOF POSITIVE
doubled their fac cOllsumprion. As their far
inrake increased, so did rheir rare of bre.1sr
cancer. RO Unfonun.1rely, as illuscraced by Japan, [he rrend in many nariolls is ro emulare America with irs richer, faner diec. As a
result of living like Americans, rhey are begiJllling ro dic like Americans-from
chronic lifesryle-rclared diseases. Eating a
high far diet during pregnancy may also increase rhe risk ofdcvdoping breasr cancer. RI
A srlld)' based in Arhens, Grecce is .1150
noreworrh)' on rhe subjccr of breasr cancer.
Invesrigarors found-nor unexpecredlydur women rhere who ate marg.1rine expefienced more breasr cancer. Howevcf, rhc
Greek research ream nored rhar ar !casr onc
f.1r aceual1y seemed ta dccrease breasr cancer risk. Women who used more olive oii (a
predominantly monounsamrared far) had
a 25 percenr elecrease in breasr cancer risk. S2
Whar abour dlose who aL-eady have cancer? Does their clierary far consllmprion have
any effecr on rile success rare of their rrearment? Swedi h researchers found evidence
rhar dier does affecr breast (Umor growth

PROSTATE CANCER DEATHS

JAPAN

Prostate Cancer Increases

with Fat Const/mption

22-

Mortllllly18
per
100,000 14

rat~

10
6
AII ages

2._-=*=::::::=:::::::::t=======::===="""?-54

O0_
1950

1955

:.

1960

1965

1970

1975

1980

ycars

old

1985

Y~ar

Figurll 8

22

every one pereenr inerease in rotal calories

from far, ehey increased cheir risk of rrearmenr failure (breasr cancer re-currence) by
13 percene. In orher words. if a woman was
earing a 45 percent fat dier while her peers
were earing a 35 percenr clier, r!lose 10 percentage poinrs difference would translate
inra a 130 percene il1creased risk of her
breasr cancer recurring. The sraristics were
even worse for saturateel fat. For every one
perecnr rise in rhe porrion of toral calories
from saturated fat, risk rase 23 percenr. The
obvioLLs message from rhjs srudy is rhat resrriecing dierary far appears ro have a role in
treatment of mosr rypes of breasr cancer as
\\lell as in prevention.
Dr. Rose and eolleagues from rhe American HeaJth Foundation (AHF) shed furrher
light on ule breast cancer-dicrar}' far Jinkage in a srudy of 30 narions. 84 They also
found unt higher breasr cancer rates OCcurred in narions wirh higher levels of far
consumprion. However, they nored the
srrongesr relationship in posrll1enopausal
women-and they found no relarionship
wr.h lJegetabl.e fars.

rare. S3 The)' seudied 240 predominandy

posonenopausal women wha had been recently diagnosed as having breasr cancer.
Nearly rwo-tllirds of rhe women had hormonall}' responsive tumors. Among these
women, diet made a srriking difference over
rhe course of four years of follow-up. For

The leading faral canccr among nonsmoking men, prostare cancer, is also linked
widl a high far inrake. The pattern is similar ro breasr cancer in dus regard. In rhe
1950s Japan had a very low dearh rarc from
prosrate cancer. Norice tbeie dramatic death
rare inerease from this cancer shown in Figure 8. 85
The remarkable increase in prostate G..1.ncer dearh rate c10sely pa.rallels rhe rise in f.1t
inrake by the Japanese. As we have already
nored, the Japanese doubled rheir fat inrake
berween 1964 and 1978. 86
Similar f1ndings are apparenr when comparing 1950s prostarc cancer rares for me
Japanese living in both Hawaii ancl the
Unired States with rheir Caucasian COllmerparrs. Faral prosrare cancer occurred markedJy less frequendy in me Japanese, as it clid
for breasr cancer, wirh Caucasians having a
four fold increase in risk. 87 Broad internarional comparisons have consisrendy shown

GOOD NEWS ABOUT CANCER

an association between prosrare cancer and
fat inrake. 88.89 As poinred our by Rose and
associates in rhe mose recent of these studies, ilie incl'ease in prosrate cancer risk was
linked anly ro animal fat imakc; rhere was
110 relarionship ro vegetable far consumprion in rhe e cross-culrural comparisons.
Srudies wirhin mher population groups
reveal similar associations bet\'lcen fat inrake and prostate cancer. In one extensive
srud}' based in five U.S. and Canadian
locations, prostate cal1cer risk was analyzed
for duee eehnic groups: blacks, whiees, and
Asian Americans. 90 For aII ethnic groups
cllere was a sraristicaliy significane association betwecn roral far inrake and proseare
cancer. When rhe researchers looked ar specific faes, ehe increased risk was primarily
duc ro saturated fats, which come mainly
from animal produets. Mono-unsatllrared
fars seemed ro have onJy a weak effecr, while
(here was no relarion between polyunsaturared fat consumprion and prosrate cancer
risk.

Skin Cancer Risk Increases

wih Dietary Fat
Even skin cancer risk can be decreased

by foLiowing a low fae clieI. Animal srudies

have shown ehat a high fat diet increases
rhe risk of skjn cancer following sun exposure. 91 . 92 In 1994, Baylor University reseaJchers published data confirming ehese
relarionships in humans. They idcmified 76
parienrs who were willing ro parricipate in
rheir reseaJch. AH had prcviously been diagnosed wirh skin cancer and were generali)' folJowing a rypica1 high fat American
dier. They randomly enrolJed 38 of ehe paJricipanrs in an educational program rhat
helped rhem swiech ro a low-fae clicr where
far consejweed only 20 percent of their toraI calories. Over che coursc of rhe nexr rwo
years, che experimencal group followed the
program weB (rheir ave rage far incake was
21 percem ofcalories). Resulcs are illusrraced
in Figure 9. 9
Their adherence ro rhe diec paid off:
when compared (() rhose on an average fat
incake, rhey developed only ane-third as
many pre-cancerolls skin lesions.

A LOW FAT BIET DECREASES

PRECANCEROUS SION LESIONS
Number ofLesiolls
00 low fat diet
(21 % or less calories from fat)

3
00 average diet
(approx. 39% calories from fat)
~ ,.'-

~7

'~~

,~~~~~~.~,

..:

......

, 10
I

Figure 9

Ofher cancers linked ta a high consumpeion of saturaeed fat include colon cancer
and ovarian cancer.

u S. Fat Consumption is High

We have been looking in SOme deeail ar
problems relating to far imake. The amounc
of fat consumed by America ns over a 37 year
period is shown in Figure 10. 94 . 95
Although f.1r consumpeion has stayed
relarively stable since 1983, Americans are
stiU earing mllch more fac than they did a

U.S. FAT CONSUMPTION TREND

Daily fat conslImptioll per perso"
170

160
GrJlRls

offal

50

1.

140

D.S.A.

130
120

110
100

_ _L

1910

1920

1930

1940 1950
Ycar

1960

1970

1980

1990
Figura 10

23

PROOF POSITIVE
generation ago. Average far consumprion in
the 1980s was abouc 20 percenr higher rhan
thar in rhe 1950s. ar 165 grams per day compared to 140 grams per day. Before 1920,
far consumpeion was even lower, averaging
araund 120 grams per day. % Expressing
rhese exrremes il) tecms of percenrages, rhe
average American had a diet rhar was 32
percenr far in 1910. ThroughoLlr an 80 year

co

_
T

F oods with 10 gram'.\' ofsaturated fat:

2 cups of whole milk
1 double hamburger
213 serving of a Macand cheese
1 cup vaniUa ice cream
2 cups frozen soft serve yogurt
2 cups plain yogurt
2 slices of American processed cheese

Eating Meat lncreases Cancer Risk

In many people's minds. red meac epiromizes foods rhar are high in sarurared fat.
This associarion has nor been losr on some
n rhe mear and livestock industry; they have
been making concerred e/Torrs ro decrease
rhe sarurated far comem of meat products.
Even if they stlcceed, medical research indic.ares thar rhere is more wrong wiril red meac
than its saruraced fat conrenr. Regarding
cancer risks, flesh foods in generaJ-red
mear, pOLlttry, or even fish-have more
srrikes againsr chem rhan merely cheir far
contenc. The same is true ofdairy foods such
as checse, milk, and ice cream. Dairy foods
are nor derived from animal flesh, bllt chey
are animal products, and are listed wirh
otller irems rhar increasc cancer risk.
Ler LIS look ar SOme of the growing concerns wirh mear and animal prodLlcrs in
general from a cancer perspecrive. Several
studies have looked at rhe strong relationship berween eatng mese items and cancer
risk, and some of the theories as ro why such
relationships exist.

Meat lncreases Risk Of

Lymph Gland Cancer
figure 11

period, that figure has gradually increased

ro 40 percem in 1990,97
Based on evidence dealing wirh issues as
diverse as cancer prevenrion, weighr control, diabetes management, and hearr disease prevention, che expens are suggesting
mat we should try co eat bener than our
forefathers-not ~orse. Most aLlthorities
recommend char Eltshould comprise less
than 30 percellt of aur total calories, and
che far should be from planr and nor animal sources.
What foods arc we eating that sllpply
aJl of rhis fat-particuJarly sacurared fat? The
. sources are. shown JI1
. F'Igure 11 .-qs
n1aJor
Note thac rhese foods are aII animal
products. Planc foods are generally much
lower in sarurated fat. People wha are an a
pure vegetariall dier havc liule difflculty
keeping their saturaced fat intakc at a low
level.

24

Some researchers such as Dr. James R.

Cerhan, assistanr professor at rhe University of Iowa College of Medicine, advise
decreasing both mear and fat in me same
breath: "Cur back on red meat, reduce saturated fat intake, and ear more vegetables."99
His commenrs were based an anorher Gl.1lcer (hat has been (inked ro meat earing, cancer of the Iymph glands. This important
cancer claims over 23,000 lives each year in
America. loo Chiu, Cerhan. and colleagues
studicd over 35,000 Iowa women and discovered rhat chose in che upper chird of red
rneac consumption had nearly double me
risk oflymphoma as those in r.he lower r.hird.
peeifically, eating hamburgers more rhan
four till1es per week more r.han doubled a
woman's risk of non-Hodgkin's Iymphoma.
FLlrthermore, women eould dccrease thcir
Iymphoma risk by 36 percenr by eatjllg rhree
ar more servings of fruit per day.

GOOD NEWS ABOUT CANCER

CoLon Cancer Connection

to aMeat Diet
Colon cancer is a1so srrongly relared (Q
mear earing. A srud)' of over 88,000 nurses
conducted by Harvard Universiry found
rhar rhose who regularly are red mear as a
main dish had a signlficant ulcrease in clle
risk of colon cancer. 101 The more ofcen chey
are it, rhe grearer rhe risk, as shown in Figure 12.
Note rhar eariJlg mear dai!)' caused a 149
pereem increase in risk. Expressed anorher
way, rhe dail)' mear earers had roughly two
tmd one halftimes me risk of ulOse who seldom or never ate red mear. Their dassiflcarion of "red mear" included a variery of
popular beef, pork, and Iamb irems. Exalllpies included roasts, sreaks, ham, mear
lasagnas, sandwiches, stews, casseroles, hamburgers, hor dogs, bacon, sausage. salami,
and other lun.cheon mears. Those \vho are
such red mear irems less frequently but sriU
olten (defined as five ro six times per week)
had an 84 percent increased risk of colon
cancer. Even rhose eating red mear as a main
dish jusr one te four rjmes per month had
39 percert more colon cancer than the lowesr risk group-rhose who never ate red
mear-or are it less than once per momh.
Regarding rhe cancer risk of eating fish
or chicken. ule srudy did not show rhal rhey
lowered cancer risk. They simply ma} not
mise the ris!? as much as orher meal. Ir is
important ta poine Out rhat mose eating rhe
mosr f1sh had relatively more cllses of colon
cancer rhan those eating fish rarely or never.
The data showed a grearcr colon cancer
risk from eating red meat SOUl'ces rhan was
e>:plained by an analysis of sarurared far
alone. This suggesrs (har [here are orher fac
tors in red mcat rhar furrher increase colon
cancer risk.
The findings in rhe Harvard-based
Nurses' Healrh 5rudy are not unique. A
1990 European srudy found similar relationships. When womn who ate mear frequenrly were compareel ro rhose rhar rarely
Of never ate mear, rhey had nearJy double
rhe ri k of colon cancer.'02 An Ausrralian
srudy found an association berween a hosr
of difrerent animal producrs and colon can-

MEAT

C ASES
COLON CANCE
SK
Frequency ofeating
beef, pork, or Iamb

Colon cancer risk,

percent increase

Less than once per month

Once per month to once per
week
Two to four times per week
Five to six times per week
Daily or more

o
39

50

84
149

figure 12

cer U1 women. I03 104 Implicared foods included red mear and liver as weU as seafood
and dairy producrs. In rhis srudy, however,
rhe very worsr food group was eggs, wiu) rhe
heaviest consumers experienci ng .,i.'< times tht,
risk ofcolon cancer. Tbis Australian research
h.ll"rher emphasizes the condusion U):H. regarding mear eating and colon cancer, red
meat definirdy increases risk; chicken and
fish are associated wirh less risk, but are acmally not prorecri,'e. ThllS, Cllrrenr research
makes an e10quem poinr ro leave off alI red
meat-and ir does not provide a sound reason ro car more fish or chicken.
The colon cancer stlldies melltioned
thus far have been do ne on women. Srudies
in men have also linked mear inrake with
colon cancer. IOS , 106 For exaJnple, the same
Harvard research grollp lIsed similar medlodolog}' ro look ar colon cancer cases in rheir
male he.ahh professionals srudy.l07 They discovereel some srrkng dietary relarionships
b}' analyzing aII new cases of colon cancer
among rhe nearly 50,000 men in rhe sllId}'.
Those earing red mear as a main dish five
Of more rmes per week had a 3.5 rimes increilsed risk of colon cancer when compared
to rhose avoiding these foods (eating them
less rhan once per monrh). Remarkably.
despile rhis strong relarjonship, J10 relatioJ1ship emerged with silturated filt in/.ake. This
furrher srrengrhens rhe lkelihood rhar other

25

PROOF POSlTIVE
jctors besidefat contribute ro mear being a
high-risk food. This means rhat changing
animal-raising tcchniques and breeding
pracrices ta produce leaner live rock with
less sarurared far will not decrease many of
the most damaging aspects of these animal
products.

Charcoal-Broiled Meat is
Even More Dangerous
A patent meat-related carcinogen, caUed
benzopyrene, is l'e1ated ta cooking. Benzopyrene is one of 4000 ehemicals found in
cigarette smoke. In srudies using rodenrs
as well as hllmaJl cells in culture, benzopyrene demonstrates carcinogenic activiry
affeeting many tissues, such as me liver,
stomach, colon, intestine, esophagus, lungs,
and breasr. lOS Charcoal-broiled mear prodllces this substance in large quantiries on
the surface of the mear, as illustrated in
Figure 13. 109

A DANGEROUS CARCINOGEN IN
.CHARCOAL-BROILED MEAT
Beozopyrene in 2 Ib. }
charcoal-broiled steak

Benzopyrene in smoke
{ from 600 cigarettes

benzopyrene concenrrarion in rhe charcoalgriJled prodUCr. IIO

Too Much Iron in Meat?

One of the sllrprising discoveries in
modern nurririon is the growing concern
abour rhe large amounr of icon in rneat. A
readily available and abundanr.sollrce ofiron
was once routed as one of meat's bcnefirs.
However, problems wir.h iron in our diets
are now pllrring mear's liberal iron stores in
their uue liglu-as anorher of meat's LiabiLities rarher rhan a benefic A nllmber ofsrudies suggesr [har an iJlCreaSe in rhe srorage of
iron in the body or disrupriol1s in a person's
urilization ofiron increase rhe risk of colon
cancer. J 1 J A recent disserrarion from UCLA
suggesrs rhar tlle risk of colon polyps aud
rhus colon cancer is increased by eirher exeessively LoUl or excessively high levels of
iron. 112 Evidence like rhis furrher srrengthens (he case for a meatless dier rhar emphasizes plam sources of nurririon. Planr foods
provide icon in amOUllrs mar are generally
adequate-bur nor excesslve. A 1996 article
summarized some of the problems wirh exces ive aJuounrs of iron as it relares ta cancer risk: 1 13
1. It favors rhe formarion of compounds
called hydroxyl radicaJs which have
ehe porenrial (O damage DNA.
2. le sllppresses (he acriviry of host defense cells.
3. Ir promotes CaJKer cell mll!riplication.
Dr. E. D. Weinberg, rhe srudy's author
concluded: "P(Ocedllres associared wirh
lowering... iron inrake can assisr in prevention aud managemenr of neoplasric diseases
(cancerJ."

Eating Meat Increases

Breast Cancer Ri:Jk

Figure 13

26

About rwo pounds ofsteak produces an

amounr of benzopyrene on rhe mear surface equivalenr ro rhar fOUJld in 600 cigarettes. Thus, nonsll1okers can be exposed tO
a huge dose of one of cigarerte's powerful
carcinogens by simply earing grilled mears.
Furrhermore, in general, rhe higher rhe fat
comem of rhe mear. rhe grearer wili be the

A oumber of srudies demonstrare a

stfong association between meat eating and
breast cancer risk Some 20 years aga, Dr.
Takeshi Hirayama made a series ofsrarrling
observarions abour breast cancer in Japan
in a 10-year srudy of 140,000 women. Results are swnmarized in Figure 14. 114
Note rhe sharp difference in risk berween

GOOD NEWS ABOUT CANCER

rhe rwo groups. One parricularly illteresring aspecr of rhis research is rhac mear earing did not appear ro be rhe only facror of
imporrance. Ifyou (Ook ocioeconomic srarus our of rhe equarion, rJle risk of heav)'
meat consumers was reduced, but was srill
abolit four rimes rhar of rhe low mear consumers. This "uggesred [har orher dierary
and lifesryle facrors are also involved. Such
associarions are now well recognized.
Socioeconomic ami demographic facrors
are known (O have a role in breasr cancer
risk. Fewer pregnancies, a grearer age ar fir r
pregnancy, and less breast feeding alJ appear
ta increase brcasr cancer risk. 115.116.11/ Furrhermore, each of ehese facrors is likely ro
be more common among women who are
in professional and managerial roles. 1 hese
observaeons lcad ro twO imporranr observarions. Fim, diet--or mear eaeing per seis nor rhe only important factor in breasr
cancer. Many faccors have a cole in this devasraeing cancer, bur diet is one imporranr
modifiable faccor rhat aH shouJd address.
Second, dietary habits appear ro be mosr
importanr for rhose who already have other
risk facrors for brease cancer. Since Americam as avwhole are a high-risk populaeion,
dier would be expecred tO have a greater
impact.
Resules of ehe Japanese srudy are nor
unique. Other srudies have linked mear earin a wirh breasr cancer. One stlch example
is ~rovided by a Norwegian stlldy of over
14,000 women. 118 In rhis research, dlOse
earing meat five or more eimes per week were
compared ro rhose eating mear rwice ar less
weekJy. The heavier consumers had nearly
double rhe breasr cancer risk.

What is the Aetion ofMeat on the

Body Regarding Breast Cancer?
There arc a number of possible explanarions for rhe )inkage berween meat earing
aod breasr cancer ri.sk. These include many
of the f.1crors already presenred, such as isucs involving [ar and 5aeurared far intake
as well as concerns wirh toxins in meat and
hormonal effecrs.

MEAT USE AN BREAST CANCER RISK

Category

Risk

Low socioeconomic
status - eating meat
occasiooally, rarely,
or Ilot at aU

High socioeconomic
status - eating meat
daily

8.5

Figura 14

Toxins in Meat and

Breast Cancer Risk
le is wcll-recognized rhat many toxic oroanic compounds and heavy merals are
:tored in animal risslles. There is mounring
evidence rhat coxins have a role in breast
cancer. 119.. 120.121 .. 122

DDTandDDE
In rhe 1970's the level of the pesricide
DDT. a cornpound known ro be derrimenrai ro human healrh. (including possible
.
1'3)
immllne sysrem sllppresslon
- was anaIyzed in rhe breast milk of morhers. Among
mea-t-eating morhers, 99 percenr had significam levels of DDI: Only eighr percent of
vegetarian morhers were found ro have significanr DDT levels. 124 DDE. a breakdown
producr of D DT, presents some serious concerns in rhe breasr cancer arena. Borh ir and
DDT have been c1assifjed by rhe U.S. Environmema1 Proreerion Agency as "proba bie
human carcinogens."125 Furchermore, researchers ar rhe Narional Insritute of Environmemal Health Sciences have poinred Out
mat rhere is a higher risk ofbrease cancer in
women wirh elevared blood levels of
DDE. 126 Orher international srudies demonstrare whar should be obvious by now: rhe
serong link berween rlle animal products
we eat and human exposure ro pesricides.

27

PROOF POSITIVE
A srudl' from Spain amibured up [Q 85 percene of rheie popularion's exposure ro D DT
and relared substances ro livestock mear and
clairy produers. The Spani. h researchers
made rhis relling observarioo: "These pereentages are in accordance with rhe welldocumented fact rhar [DDT subsrances]
predominanrly accuJllulare in [animal] fat
[causingl animal fatty foods ro become a
major mure of exposure for humans. "127
Ir is imponanr to emphasize the conneetion berween Inear eating and high human roxin levels (as illusrrated by DDT anei
DDE). In researeh cired C<lrlier, vegetarian
morhers had the lowesr levels of D DTeven rhough rhe)' habiruaJly coosumed
fruirs and vegetables. Several pesrieides and
coxins arc srill being employed in our oarion (DDT is now banned). Alrhough u1ey
flnd rheir wa}' inro or onro fruirs and vegerables, the amounr rhat a person ears \vith
ilie planr producr is generally very small
compared to the amOUlH of pesrieides concained in animal f;H.
The reason dur pesticides and ocher roxins aecumulare in :lIlimalrissues is explained
by a process called biomagniflcarion. In rhis
process, animal rissues magnify rhe coocenrrarion of roxins over rhe course of rheir liferime as rhel' ear ocher animals or planrs thar
rhemselve have some level of concaminarion. The average animal ears at leasr ren
rimes its weiglu in food throughom rhe
course ofirs life span, bur cannor eflectively
ger rid of mose fat-soluble roxins and hea"l'
meraJs. Thus, mally of rhese roxins aceumulare in irs t:Ir srorcs. uch poisons are
poorly e1irninated from altimals and humans. As a resuit, over a period of weeks,
mondls, ar years, rhe chemicals thar rhese
animals have earen are compounded manl'fold in rheie fau)' rissues.

"Cleaning Up" Our Wters

28

Although rhere has becn progress in

"e1ean ing up" our warers in rhe V.S., significanr problems still remain. A recenr
California srudy illustrares the serious narute of pesticide conraminarion in tsh and
shelLfish. 1l8 The srate's Mussel Warch program has serialll' monirored shellflsh since
1977 for evidence of pesticidc conramina-

tion. Despire well-publicized resulrs of improved warer eeoJogy, approxirnarell' half of

rhe 47 monitoring stations showed ilO decrease in DDT levels, and fully rhree-quarters showed 110 PCB decrease. The conrinuing duear of PCB exposure is nor limired
ro rhe Unired Stares. Anall'sis of human
breasr milk specimens in Englal1d reveals ilO
decrease in P B levels since rhe Iare 1970s,
anorher indicatioo of cOHrinuing exposure. 129

Meat Eating lncreases

Prostate Cancer Risk
When individuals who consume animal
products begin ro see rhe wealdl of evidence
incriminari/lg such food , some may wonder wherher there is any hope for them.
"Afrer aII," a person may reason, "( have altead)' consumed huge amoums of animal
produCts-will ir make any difference ta
change now?" Research indicares rhar
changing dietary habirs ar any poinr tlocs
make a difference. Because of rhe varietl' of
ways rhar mear and omer animal producrs
affecr us many of our body processes can
be pur back inro a normal relarionship by
moving roward a vegeearian diee. Even ifyou
do nor make a complere change in l'our
habirs, parrial changes can mal<e some differenee.
This has been eloqueody illustrared by
research on prosrare cancer. [n rhe famolls
Advenc:isr Healrh srudl" deaths hom pres{are cancer wne srudied in relarion ro dieL
Ir wa observed rhar rhe more mear, milk
eggs. and cheese a man are, dle greater his
risk of dying of prosrare cancer. There was a
dose-response relarionship such rhar rhe
more of rhese producrs consumed ehe
greater rhe risk of faral prosrar.e cancer.
Those cOJlsuming rhe Iargesr quanrities of
animal producrs had 3.6 rimes the risk of
dl'i ng from prosrare cancer. 1 'o
The benefic of a dier low in mear regarding prosrare cancer risk is nor limired ro
Sevenrh-day Advemisrs. The large Harvardbased Health Pmressionals Follow-Up rudy
has come ro similar conelusions. Among
over 50,000 men srlldied, jr was observed
thar rhose earing red meat flve rimes per

COOD

EWS ABOUT CANCER

week had 2 1/2 times rhe risk of a life-rhrearening form of prostate cancer when compared wirh rhose earing reel mear once a
week or less. 13l

Ovarian Cancer Risk

and Meat Eating
Ovarian cancer also is more frequene
<l1l10ng meat earers. Since it is usualIy detecred ar a very Iare srage, afrer ir has spread
ta orher viral organs, rhis cancer rends ro
be panicularly devasraring. The resllits of
an ovarian cancer study are shown in Figure 15. U2
In a Japanese Stllely, the daily consumption of meat anel/or fish \Vas also significantly associareel wirh an increaseel risk of
ovarian CJnCeL U3 ]n fact, rhi' srari rical
analysis suggested rhar neacly 20 percenr of
aiI ovarian GlJ\cers were relarecl [Q high mear
imake alone. Iralian researchers also looked
for connecrions berween elier anei ovarian
ancer. They came ta similar conc.lllsons.
Women who are mear seven ar more rimcs
per week had a 60 percenr increased ovarian cancer risk when compared ta rhose
wh6 had~ less than four porrions of mear
weekJy. The wou mear seemed ro be pork:
rhose earng ham four ar more times per
week had nearly double rhe amoul1t ofovarian cancer as rhose who are Iess rhar rwo
porrions of ham weekly.134
Mear may increase rhe risk of prosrare
and ovarian cancer rhrollgh similar mechanisms by which it exerrs irs breasr cancerdevating effecrs. Aher ali, each of these cancers is hormonally relared. However, as we
have seen, orher non-hormonally relared
cancers a1so bear a striking relarion ro mear
consllrnprion. Lung cancer, non- Hodgkin's
Iymphoma, colon cancer, and cancers ofrhe
pallcrea',135 Iiver,136 kidney,137 and womb
have been linked ro a more liberal incake
of mear specifically or animal producrs in
general.

Cho!esterol is Linked to Cancer

A high intake of cholesterol, which is
presenr in mear, eggs and dairy ptoducrs.
ha' also been linked ro an increased incidencc of cancer in severa.l sruelies. 13s . lY)

Cancer sires demonsrraring rhis increa$ed

risk include ovary, lung, and laJYi1x.
Whether cholesrerol irself presenrs a problem or wherher it merely indicares a dier
[har is rich in mear and ocher animal proelucrs j nor clear. Further research linking
high blood levcls of cholesterol wirh colon

EATING MEAT, POULTRY, AND FISH

INCREASES OVARIAN CANCER SK
Age-(Idjusted III01tality per 100,000

26.4

18.0
15.9

Meat I to 3
times per
week

Figure 15

cancer and colon polyps has been published. 140 Women wid) rhe highesr cholesrerollevels are more [han three rimes likely
ta develop ovarian cancer as women wirh
low cholesterollcvds. \41
50 [,u in this chapter I have presented
rhe linkage of mear producrs wirll cancer.
When addressing cancer-prevenrive or
cancer-prorecrive factors, it shoulel be recognjzecl rhar mear, in addirion ro conrajning harmful subsrances, is ofccn sadly defient in some of rhese helpful compoundl". A
c1assic example is provided by dicrar)' fiber.
Tr is a f.1Cr rhar mear and animal producrs
generalI)' look baei in rhe cancer risk area
because of whar rhey lack in addirion ro
whar rbey cOn/ain. Even if aU of the reasons
rhar mear and animal producrs consistenrly
emerge in rhe medical lirerarure as having a
clase linkage wirh cancer arc nor complerely
understood. we shollld avoid rJ)cir lIse.
From rhis broad perspective on mear, it

29

PROOF POSITIVE
is imeresring ro nore rhat over 100 years aga,
Ellen White wrote:
"Man)' die ofdiseases wholly due to mear
eating, when che real cause is scarce1y suspecred by themselves or oehers. Some do
noc imrnediately feei its effecrs, bur rhis is
no evidence thar r does nor hurt rhem. It
may be doing irs work surdy upon the s)'srem, yer for rhe rjme being rhe vicrim may
realize norhing of iL" 142
From a spiritual perspecrive, ir is equally
interesring rhat a diet devoid of meat ar
animal producrs is recordcd in rhe Bible as
God's original der for hurnankind. 143

Dairy Produets Linked to Cancer

A number ofsrudies have indiclted thar
rhere are plenry of grounds for concern regarding animal products such as milk, eggs,
and cheese. FataJ cancers ofborh me colon
and ovary have been linked ro egg consumption. 144 Orher research has suggesred rhar
eggs may also increase ova..rian cancer risk.
A Yale Universry srudy found rhar for each
addirional 100 mg of egg cholesrerol a
woman averaged per day, she had a 42 pcrcent increased riskof chis malignancy.l,j5Egg
consumpron is also posirively associatcd
with death from prostate cancer. 146 The
same study showed rhat milk consumption
aJso ncreased prostace cancer risk. The extensive international comparisons macle by
Rose, Boyar and Wynder ideJUified both
meat and milk as srrongly related ro breast
cancer riski milk inrake also showed a strong
relationship ro prosrare and ovarian cancer
in their analysis. 147

Coffee: Another Source of

Dietary Carcinogens?
Coffcc is another COIllIllon source of
carcinogens in rhe American dier. The experrs stiH debate whether cofI-ee presents a
significam cancer risk, but there is no ques(ion thar (rus popular beveragc conrains cancer-causing chemicals. Such chemicals include methylglyoxal,148. 149 catechol, cblorogenic acid, and neochlorogenic acid. 150
The pharmacologists aclulOwledge (hac

30

even caffeine irself "has potem muragenic

effecrs" in laboratory srudies of microbes.
le can also damage the chromosomes ofborh
planrs and animals in lab se((ings. ISI This
facr can suggest that a substance is carcinogenic in humans. However, (he same source
believes rhat a person could not obrain high
enough levels of caffeine with ordinary consumption of medicarions, foocis, and beverages ro increase cancer risk in this LUay.152
This argument fails ro rake imo aCCOllnt
me facr rha( coffee brings eogether a variety
ofcarcinogenic compounds. Caffeine is further superirnposed an other cancer risk factors thar we are aII exposed ro in varying
degrees. In this context, there is concern tha(
bod1 coffee and caffeine may significandy
increase cancer risk in che right setting. 5uch
a conclusion agrees with rhe epidemiologic
lirerarure that shows caffeine and coffee
sOll1etimes increasing risk, 3J\d orher tirnes
having no effec{ on certain cancers. The difference may have tO do wim rhe other carcinogens tIlat individuals in a population
may or may nor be exposed ro.
Dr. Winston Craig in his book, Nurririon for rhe Nineties, seems ro come ro a
similar conclusion, even though he rakes a
somewha{ differenr perspective. 1S3 Craig
sides with research suggesring tlur caffeine
is not a frank carcinogen irself, but is rat11er
a co-carcinogen. This means rhar it can increase rhe likelihood rhat cancer wil! occur
if it is in me presence of other carcinogens.
The cancer sites thar have been linked wirh
coffee include kjdney, breast, colon, pancreas, and ovary. 154 A look at a few of chese
epidemiologic srudies is i1hnninating.
Pancreas cancer has probab!)' received
the most attenrion regarding increased risk
from cofIee. This apparenrly derives in large
pal'( from a highly publicized Harvard study
in rhe early 1980s.)55 Other studie have not
found such a reJationship, bringing LIS back
ro my eartier poim about rhe likely interacrion berween coffee, caffeine, and other risk
factors. Coffee seems ro bear a more srriking relationship ro bladder C<1ncer. The first
smdy rhar drew rny atten{ion co (his was
[he large Advenrisr Hea.lth study. This epidemiological research involved some 24,000
California Sevenrh-day Adventisrs. The re-

GOOD NEWS ABOUT CANCER

sulrs of rJ1C smdy are depicted in Figure 16.'56
Norice rhat those who drank two ar
more cups of coffee per da)' had rwice rhe
risk of dearh from bladder cancer as those
rhar did nor drink coffee at alI. Orhcr research such as rhar condlleted at the Stare
Univcrsiey of New York ar Bllffalo has confil"rned the potemial of coITee drinking ro
double bladder cancer risk.'57 Significandy,
(he BuITalo researchers looked ar C/lSei of
bladder cancer, in contrast 10 rhe SDA inve5tigarors who compared bladder cancer

COFFEE USE AN BLADDER CANCER

Mortality risk ratio for men

Non coffee users = 1

2+ cups/day = 2

dl'aths.
Orhel" studies have a150 shown an increase in bladder cancer wirh coltee usage
or other cafleineated beverages. This has 1e.1.d
some ro speculare dur for bladder cancer,
caffeine irself may be rhe man culprit in
coflee. Faral colon cancer has aJso been
linked ro coffee consumprion. Those consurning two or more cups of coffce per day
increased rJleir risk ofdearh from colon cancer by 70 percetH when compared ro rhose
rhar consumed Jess than one cup a day. The
sUldy a1s0 revealed a dose-response relationshipi rhat is, rhe more coITee consumed the
higher rhe risk. 15

A Reltttive ofCaffeine in Chocolate

In anorher srudy of prostare cancer, mose
""ho averaged 20 mg ar more of rheobromil1e (a caffeine relarive rhar is especially
known ro be found in chocoJate) per day,
doubled [heir risk of prosrare cancer. Those
wirh inrermediare consumption had an inrennediare level of risk.'59 It does nor rake
much chocolare ro provide those 20 mg of
rheobromine. The amount of rheobromine
in some represenratve chocolate products
is Jisred in Figure 17. 160
Cbocolate also conrains the carcinogen
aJpha-merhylbenzyl alcohol. 16 !

Figure 16

rhough somc 750,000 squamous and basaJ

cell skin cancers are diagnosed each year in
rhe Unired Srarcs, only abOlit 2, I 00 faralirics result. 163 The faralities occur mostly in
rhose who failed ro get prompr and complete removal of the cancer.
Melanoma, another type ofskin cancer,
provides a markedly difterem siruarion. This
uSllally darkly pigmenred cancer has a fearsome rendency ro spread and kill rhe victim. Each year only abolit 34,000 cases of
melanoma are diagnosed in our counrry, and

THEOBROMINE CO TENT OF
CHOCOLATE FOODS
Item
Cadbory milk chocolate, 1 ounce

Theobromine content
44 mg

Chocolate sy'ru.p, 2 table.spoobs89 mg

(1 fii oz.)

Sun Exposure and Cancer

SlIlllighr in high doses increases skin
cancer I"isk. AbOlit 95 percenr of skin cancers are of two types: squamous cell and
basal cel 1. 162 Both of the e rypes of cancer
are increased by substantial cumularive liferime exposure to rhe sun. Forrunately, however, these skin cancers are slow growing and
usually remaln confined ro rhe skin. Even

Ohocolate tlavor mix in whole

milk (2 to 3 hea'ping teas'poons in
8 ounces of whole milk)

120 mg

Figure 17

31

PROOF POSfTIVE

su."__~,, . . .

CANCE
TS

Tobacco
Alcohol
Excess Fat
Meat:
Saturated fat
Nitrosamines
Excessive iron
_
ijj
Toxins:
~
Benzopyrene
(from cookiog)
PCB, DDT, DDE

32

Eggs, milk, cheese:

Saturated fat
Toxins
Viruses
Coffee
I Excess SUIl exposure
Asbestos
Wood dost
Excess sugar in the diet
Genitall powder and genital
deodorantsprays

7.200 dic <lnnllal1y from rhis dreadeci skin

cancer. 164 Melanoma is cllrrenrly on a rapid
rise worldwide; in Europe it is increasing
by rhree ro seven percem ever)' year. 165 Regarding this deadliesr of skin cancers, jt appears d1at the imporrant factor is nor so
much the totai am01/.nt of suniight you are
exposed ro, bur wherher ar nor you ger sunburned. Sllrprisingly, rhere is soroe evidence
rhar ourdoor work with chronic sun exposure ma)' actually be prorective (apparently
by increasing resi tance ro sunburn).166
The sunburns sllstained in childhood
seem ro be paniclllarly dangerolls. 167 168
One srlld)' showed rhar an execurive working indoors would be more likely ro devetop
me1anoma than a construction worker who
works outside aII day long. Although rhe
office-baseel executive is more likely to get
sunburned on a weekend excursion ro the
beach, the association with sunhurn and
melanoma appears (Q be more iJ11pOnanr
in childbood than in adulthood. Nonecheless, especially in a fair-skinned adult, avoiding excessive sun cxposure is prudent. This
does nor necessarily mean that fair-skinned
individuals should use more sunscreen. In
both humaJl and animal research rhere is a
worrisome lack of protection-or even increase in melanoma risk with sunscreen lIse.
As expressed by the U .S. Preventive Services

Task Force, "Ir is aho pas 'ible rbat sunscreens may increase skin cancer risk by
encouraging susceprible persons ro prolong
exposurc of greater skin surface areas ro solar rays rhar are not blocked by most currently used sunscreens."169 However, the
research does suagesr thar sunscreens may
help ta prevent squamous cell skin cancers. I70 Unlike melanomas, as already
pointed our, squamoLis cell cancers appear
relared ro substantial cUJnuJarive lifetime
sun exposure.
In Olu" byporherical example, given equal
skin rypes, (he construction worker would
be ar more risk of rhis type of cancer, assuming dut rhe executive avoids getting
sunburned. In one srudy, six or more severe
sunburns in a lifetime more rhan doubled
rhe risk of squamoLls cell carcinoma. 17I In
faer, the number of sunburns better predjcted risk of rhis cancer than a person's
natural complexion.
One other word of caurion: wearing a
T-shirt or polo shirc usually does nor provide full prorecrion from rhe sun's buming
rays. The Universir)' of California ar Berkeley Wellness Lener bas observed rhat such
lypical summer garb does nor block out aII
ultraviolet radiarion. These shins provide a
similar amount of sun blocking rhat a sunSCreen with a sun prorecrion factor of 6 or 7
affords.
Before the rair complexioned among llS
think rhe solLlrion is roral sunlight avoidance, 1 should haslen ro mention that suniigbt in moderate amounts is heaitl~ful. It is
necessary for rhe production of viramin O,
the viramin/hormone thar is involved in
calcium baIance, bone healrh, and perhaps
even cancer prelJention. Research now suggcsrs lhat judicious sun exposure and the
associaled production ofvirarnin O may also
help ro prevent cenain rypes of cancer.

Other Cancer-causing Agents

Other ca.ncer-callsing agems prevalent in
aur sociery include asbestos, which can cause
mesorhelioma, a cancer of rhe lining of the
lllng;l72 wood dust, whch can c:luse sinus
cancer; 173 excess sugar in the diet, which
may callse sma1J bowel cancer; 174 and genital powder and geniral deodoram sprays

GOOD NEWS ABOUT CANCER

which markedly increase rhe risk ofovarian
cancer. 175
A number of carcinogens and canccrcausing agencs havc bcen presemed in rhis
chaprer. For an oprimal cancer-prevemion
lifescyle, rhese can be and should be avoided.
A summary lisr of them is provided in
Figure 18.
The presence of robacco anei alcohol on
rhis lisc of cancer-causing agenrs is probably
nor une:xpected to many. Howcver, the pre eoce of rhe large nwnber of damaging factors in mear and dairy products rhar can
cause cancer, and ilie presence ofcoffee, may
be surprising ro many. As we sem rhis lisr,
we see thar every irem on ir can be avoided
by any individual whose gaal is co accomplish a maximum reducrion in che risk of
acqumng cancer.

we Can Limi! Our Personal

Risk ofGetting Cancer
The informacion presemed in (his seccion examined factors rhar favor cancer developmenc. Such information provides a
basis for each of us ro significanrly reduce
our personal risk of geuing cancer. I wiU
summarize the secrion wirh a guotarion
from Dr. Wynder, a world-renowned cancer prevenrion specialisr. "Wiili (he increasing number of news reporrs regarding hazardous componems, the average cirizen considers himself imll1ersed in an unconrrollable sea of carcinogens. Nrhough sociery
musr and can play an impowlIlt role in rhe
reducrion of those environmenral facrors
thar contribuce ro cancer incidence, we havc
shown rhar an individuaL can significan.tLy
/imit JJi-J own risk by appropriateLy aLtering

his LiftstyU."176

CANCER PREVENTION:
SECTIONII-

Agents That Act to

Reduce the Risk
ofCancer
In many of my original presemacjons an
cancer, 1 emitled chis secrion "lncrease Fac-

tors To Boost Your Immune Sysrem." However, excensive research on rhe subjecc of
cancer revealed chat lifesryle facrors chat prorect us from cancer involve Il\Ore chan cheir
important effeccs on rhe immune sysrem.
There i a variery of ways rhar healthful
choice help us ward offcancer. Even though
this chaprer rakes a broad approach ro cancer prevencive facrors, 1 scill marvel ac how
many of rhese f.1crors exerc rheir proteccjve
influence by screngchening aur immune
systems.
Our bodies are continuously under arcack from a variery of germs, roxins, and
pollutanrs. We brearhe air chat contajns dirr
parcides, smoke, fumes, carbon monoxide,
and chemjcals. We handle garbage in che
normal process of life. We ear food fuI! of
bacreria and drink warer wirh varyillg degree of conraminacion from a hosc of wells
and municipal wacer syscems. Nighr and
day, day aher day, we encoumer coundess
microbiologlc enemies who \VaD( ro dominace liS for cheir own purposes. Simply plIC,
rhere is no way ro go rhrollgh life complerely
avoiding aU rhrcars ro our healrh. And rhere
is no way ro avoid each altd every carcinogen. No mareer how hard we try, we \VilJ on
occasion brearhe in che roxins from someone e1se's cigarene smoke, ar facrory, ar incmeraror.
Because rhese dangers are ali around us,
many people throw up cheir hands and say,
"Forgec it. I will never be able ro avoid every carcinogen, sa why even cry?" This defearlsr 3rriCIJoe ignores r\Vo importanc facrs.
Firse, ir is noc an all-or-none phenomenon
regarding rhe dangers of carcinogens. Exposure ro a few carcinogens is not as harmfui as exposure ro many carcinogens. The
more we avoid carcinogens, rhe greater che
proreccion we will enjo)'- Second, the "why
rry" argument ignores rhe f.'lCC rhac our immllne syscems can help us deal effecrively
wich carcinogens. When we are exposed ro
a moderate level of carcinogens and aur
immune s}'srems are in cip-cap shape, we
can descroy cancer cdls before rhey have a
chance ro mulriply ro any significanr excem-and before rhey have a chance ro
C<"lUse sympcoms or even be derecced an an
x-ray ar a blood rese. This is, indeed, good

33

PROOF POSITIVE
oews concerning tlle immune system.
The inUl1une sysrem has one mission:
ro idemify aod desrroy foreign invaders before signifJcam harm s dane ro our bodies.
Disease-causing organisms sllch as bacreria,
viruses, fungi, aod parasires, are detecred
llpon emry by a healrhy im.nlune sysrem,
and are ragged for eliminarion by hungry
immllne system cdls. Cancer cells should
be similarly detected as aboormal cells,
treated as unwelcome intrllders, and eliminated wirh a srrong immlloe system.
Our singular dllry ro the immune system is to develop a lifesryle that will SllppOft its constant defense work on our behalf. How we live day by day detennioes
whecher our immune system works ar peak
levels ar is inhibired by aur negleet and even
abuse. But is ir possible tO strengrhen our
immune system? Yes, there are a variery of
ways we can provide help ro aur immune
systems. Three of the mosr imporram are
diet, exereise, and srrcss control. Ler us Grst
look ar diet, both from rhe perspeerive of
its immune-enhancing potential and its
abiljry tO help LIS deal wirh cancerous duears
on orher levels.

Vitamin A and Related

Compounds

34

Ir is widely known that vitamin A is required for the mainrenance of normal mucous membranes and for normal vision. 177
However, few realjze rhat, as oDe nutrition
text put ir, "Yiramin A is essemial, either
directly or indirectly, for the proper functioning of most organs of me body."178 Indeed, vitamin A is important for reproductive function in both males and females, and
ir also appears ro be critical for immune
function.
Yitamin A is present in rhe dier as the
fully active form of rhe vitamin (cal led the
preformed vitamin) and as precursor compounds rhar the body can converr into vitamjn A. The mosr familiar precursor is beracaratene. Animal producrs can be rich
sources of preformed vi ramin A, but roxiciry can also occur from roo mllch of the viramin in rhis active state. Bera-caratene, a
planr subsrance, is safer: when viramin A

acriviry is needed, the body can rcadily converr ir into ule active vitamin. Unlikc viranun A irself, bera-carore-ne is virrually never
toxic regardless of the level of intake even il'
ir makes your skin yellow.
Animal products tich in preformed viramin A often have other strikes againsr
them. Some of me tichesr sources, like liver,
whole eggs, and whole milk are also best
avoided because rhey ,u'e loaded wirll cholesreral.
Borh humall epidemiology and animal
reseaIch suggest that viramin A is important for reducing aur risk of cancer. One
c1assic Norwegian study, published in 1975,
reported five years of research on over 8000
men. Dr. Bjelke found thar, for an)' given
level of smoking, low vramin A intake increased lung cancer risk. 179 For rhe (Otal
popularion, which includes smokers and
nonsmokers, mose who had low levels of
vitarnin A inrake had over double me risk
oflung cancer. More impressively, rhose wha
ever smoked had over four times rlle risk of
developing rhe mosr common smoking-reIared lung cancers jf their viramin A inrake
was low.
A more recem Japanese stUdy also fO!1nd
rhat [ow blood leve1s of vitamin A increased
thc risk of lung cancer. Those with serum
viramin A levels in the lowest third had
nearly six-times rhe risk of lung cancer as
rhose wirh levels in rhe upper third. I o Nor
ali lung cancers are developed in smokers.
Up ro 15 pereenr oflung cancers can occur
in those wllo do nor actjvely smoke, but may
be exposed ro varying levels ofsecond-hand
smoke. Those nonsmokcrs wirh a higher
bera C<lfOrene intake from fruirs and vegetables had only 70 percent of ehe risk of
lung cancer as rhose eating less bcra-carotene. 181
A hosr of other beta-carate-ne re!arives
occurs in planrs. These are caUed carorenoids
and can also be convened into vitamin A. 18Some ofrhese carorenoids include beta cryptoxant1un, lutein, and Iycopene. Lycopene
C<'luses rhe red color in strawberries and tomaroes. Foods thac are parricularly rieh in
lycopene have been associared wirh prostare
cancer prevenuon. Harvard's Hea1rh Professionals Follow-llp Srudy found rhat men

GOOD NEWS ABOUT CANCER

who ate tomara sauce as little as once per
week had prosrate cancer risks 23 percent
lower than those who never are ir .183 Those
men earing tomaro-based producrs ren or
more rimcs per week were LIp ro 35 percent
less likely ro develop pmsrate cancer. The
study's lead author, Dr. Edward Giovannucci, believes mat Iycopene may be the key
ingredient rhar causes rhis risk reducron.
Those wiril the lowest Iycopene blood
levels also have a significanrly increased risk
of developing pancrearic cancer. \84 Lycopene, like mOSt of the helpful beta carotene
relativcs, cannor be founel in pills but only
in frllts and vegerables.
To whar do rhe viramin A-related compOllnds owe rheir protecrive qualiries? Fim,
rhey act as anrioxidams. 185ln rhis mie, rhey
helI' rhe body dispose of chemicais callce!
free radicals dut can generically damage
normal cdls and sec ilie stage for cancer.
(Free raelicals are explained in ilie nexr section). Second, viramin A-related compoullds appear tO be <:''l.pable ofstimularing
rhe immune system. Mice given additional
viramin A have an improvemenr in rhe hlnction of their T Iymphocyres, which are a
variery ofwhite blood cells thac destroy <:'1ncer ceUs.186 Third. viramin A compounds
help body tissues to differenriare. that is,
develop in a normal, orderly fashion. Sincc
cancer is charaeterizecl by a Iack ofdifferenriation, some theorize {hat vitamin A may
help ro reverse carly cancerous changes by
helping rhose abnormal tissues ro move into
a more orderly stare of growrh. 187

Free Radicals and Antioxidants

1 have made menrion of free radicals already in rhis chaprer; d\ey are explained
more fuUy in connection wirh dle antioxidanr capaciries of me1awnin in Chapter 9,
"Melatonin: Agent for Rest and Rejuvenalion." However, in order ro undersrand the
importance ofanrioxidant acrion in preventing lung cancer, seme commems abolit free
radicals are in order.
Normally every molecule has elecrrons
rhar are in orbir arollod its nucleus. Those
eleclrons normally come in pairs, and render rhe molecule chemkally stable. How('veI', a free radical is a molecule that has an

unpaired e1ecrron. This leaves it extremely

unstable. lc has a powerful c1rive ro acquire
an electron to pair wirh rhe one ehar lacks a
partner. Often wirhin a fracuon of a second, a frec radi<:'1J wiU grab an e1ecrron from
a neighboring compound. Thar neighbor
who lost an e1ecrron is said ro have been
"oxielized." Furthcrmore, the oxidized COIllpound itself rypieally becomes a free radical. Since it now is missing an e!ecCJon. il'
has a srrong desire ro grab one from one of
ies neighbors-and it usually does so in
short order. The resuir is a chain reaetion,
where oxidation and damage can spread
from one molecule ro rhe next tlntil something stops rhe process. Molecules rhat can
top rhis chain reacrion are called antioxidancs, which restore the unstable molecules
ro a chc:mically srable conditioo.
While on the subject of free radicals. 1
should poim OUl' that radiation is yer anorher well known cause of free radicals. 188
This kind of free radical prodllCtion may
provide Oluch of the explanarion for the
increased cancer risk in acom bomb survivers. There are things we can do ro limit
our exposure ro frec radicals. However, becausc aJlliving creaeures produce them, we

mCB LEVEL CAROTENE

(VITAMIN A) FOODS
Food
Orange Yams, peeled after baking
Carrots, cooked*
Carrots, raw
Pumpkin, cooked
Sweet potato, pcelcd after baking
Sweet red beII peppcrs
Cantaloupc
Mixed vegetlbles, frozen
Spinacb, cooked
Kalc, cookcd
Turnip greens, cooked
Apricots, ",hole
Broccoli, cookcd
Watermclon, slicc hlO in.
Collard greens, cooked
Lertuce

Serving size
I cup
1 cup
1 cup
112 cup

1 med.

1 eacb
balf
1 cup
thcup
'/2 cup
lhcup
3 each

1 cup
1 servillg
Ihcup
Slcavcs

%RDA

436%
383

309
271

249
135

86
78
74
48
40

28
22
18
18
10

.. 8)' cooll:ing canotJ: Ih(' Indigrillblll' nb4;:r mt'mbranci ari' brokl'll down ka\.'in2 mort \.'ifamin,\ ,*\'~i1ablt (f)r .'dHU)rpfion.
RccoOlm~nLlcd [)lIU,' AlIO'ft':.n('1t rQr Vif.,\ 01 CirOlf'nt~. (<null,' 800 RE. lUllIl{' 1000 RF. (1 Rdintll ~llth'Jolikn1 "" 10 rU)

Figure 19

35

PROOF POSITIVE

36

canllor comp1erely avoid rhese high1y reaceivc compollnds. Ir is tor rhis reason rhar 1
encourage individuals ro srrengehen cheir
anuoxidanr defenses in addirion to avoiding tree radicals.
Where can we flnd foods that are rich
in the amioxidanr capacir)' provided by Viramin A-related compollnds? The quanriries of viramin A (as bera-carorene) in cerrain foods are lisrcd in Figure 19. 189
Note dur roor vegerables are specifically
high in bera-carorene. Therc is a whole hosr
of other Viramin A relatives (retinoids) in
planr foods rhae are nor induded in this lisr.
Since high beta-carorene inrake has been
associaecd wieh low rares ofcenain cancers,
many have concluded rhat they can protecr
themselves from rhese cancers by taking viramin A or beea carotene supplements. 50
far, medical research suggests thar these
suppfementJ do not providc ehe bencfits rhar
eating plam foods rich in bera carore.ne delivers. 190 However, tor rhose nor raking
supplemenrs, the higher the blood levels of
beca-carorene, rhe less rhe risk otboth cancer am! heart disease. 191
A Finnish srudy of ne.1r1y 30,000 male
smokers tound rhar raking bera-carotene
pills for lip ro eighr )'ears actually incretued
their risk of lung cancer by 18 percenr. In
Bera-carorene, like many anrioxidants, can
actualJ}/ become a tree radical or paradoxically increase free radical production when
consumed in 1arge amounts by itse.lf. \93
However, when bera carorene is combined
wich adcquate Viramin C, \fitamin E, and
other antioxidanrs such as is found in bera
carorene narucal foods, a porent antioxidanr
dfecr occurs. 194 Some are wonderiog itberacarocene ma}' be more important in che
bloodsrream as an indicator of a plant-rich
dier dut has man}' orher aJltic<lncer factors
going for it. We wiU look at a number of
those compounds larer in rhe chapter.
There is anorher d,Ulger ofbeta-carorene
supplemenrs. In both human and animal
srudies, raking beta-carorcne pills can lead
to ehe dep1etion of viramin E in rhe body.
Mice as well as hllmans have shown 40 percene drops in rheir viramin E levels while
an bera-carotene pills. '95 This is just one
example ofwhar are referred ro as "vitamin-

viramin inreraceions." There are dozens of

such inreractions, where ralci ng one viramin
increases OI' decreases your requiremem for
anorher. The safest pOlley is ro ear a variety
of planr foods rhae are loaded wich a balanced slIpply of vitamin as weU as other
cancer-prorcerive subsranees-some of
which have nor }'er been discovered.

Eat Foods Rich in Vitamin C

Viramin C is anorher cancer-proreerive
food. lrs main effecrs are also likely due to
its role as an amioxidant, similar to viramin
A, rhus decreasing exposure to toxic 'Tree
radicals."
Viramin C a1so rends ro prevem ehe formarion ot carcinogenic nirrosamines rrom
nifrires in rhe dier.
It does more rhan prorecr rhe person
himself from cancer. Recenr research suggesrs ehar viramin C may help ro prorecr
sperm hom generic damage. There is evidence ehar genericaJI}' damaged sperm may
cause inherired diseases such as cancer in
rhe neXl gencrarion. Viramin C provides
prorecrion r1uough ies cole as an anrioltidanr.
Cerrain childhood maJignancies such as leukemia and cancer of the kidney and brain
have theirroors in fhe father's genericaJly
damaged speI'rn. l96 Such sperm abnormaliries may represenr a combinarion of factors
such as cigarerre smolcing l9i (which appears
able ro acwal!y ox.idizc rhe sperm and genetically damage ir), a poor diet (less rhan
250 mg of Viramin C a day)l?S and low
consumprion oforher antioxidams), and expOSIHe ro occuparonal toxins. Thll.s a man's
!ifesryle includillg eafing habirs, trom a few
weeks prior ro conceprjon up fO the rime of
conceprion is vitaliy importam in detcrmining rhe integriry of his oftspring's DNA.
The recornmended dietary imake tor
viramin C as published by rhe Naeional
Ac.ademy ofSciences is 60 mg per day. However, 1 beJievc every American shollld consume ar least 250 mg daily. My reasoning
is not only for [he benefirs ro men in procecring rheir sperm fOf fllwre generarions,
bur also because of rhe important ro!c rhat
viramil) C plays as an aneioxidant. Furrhermore, since viramin C is abundancly supplied in aur foods, obraini ng chis level

GOOD NEWS ABOUT CANCER

ofincake is nor difficulc. ome good sources
of rhis importanr vjramin are !isred in Figure 20. 19

FOO
Food

Eat Foods Rich in Vitamin E

Viramin E appears [O help protecr
against cancer for similar reason that viramin does. Ir is an anrioxidanr and a freeradical scavenger. It also has a role in blocking rhe formation of carcinogenic 111trOsamines and nirrosamide from foods conraining nirrire.100.101. 202
fu an example of rhe power of alltioxidane viramins ro reduce cancer risk. consider rhe following srudy. Rcsearchers obrained a hairless strain
rabbirs thar were
prone ro skin cancer and exposed rhem ro
ultraviolet Iight ro accelerare rhe development of cancer. The resllies are shown in
Figurc 21.
Viramins e and E provided complete
prorecrion againsr skin cancer. The antox.danr acrion of these vitamjns apparenrly
decreased oxidizarion of the rissues where
skin cancer rends to develop.203
The rabbir skin cancer resrs are in agreemenr with a recent human srudy of Lung
Clmcer froln )apan. In chis srudy. ir was found
rhat rhose wirh low blood levels of vitamin
A (beta-carocene) had a six-fold grearer risk
of lung cancer compared ro rhose wirh
higher levels. The same srudy found an even
more ill)pressive prorecrive effect for Viranun E blood levels. Those with levels in the
lowest rhird had nearly 8.5 times rhe risk of
rhose with levels in {he upper rhird. 104
Ir is important to emphasize mar mosr
srudies thac have looked at cancer prorecrion from amioxidanrs like viramins A. C,
and E, have involved individuals who were
generally gerring rheir vitamins from nat71mi fOods, not viramins in a boule. Many
people :lrc undeI' rhe impression [har viramin A, e, and E supplemenrs will provide
adcquare srrengrh to rheu immune systcrn.
lowever, as we have seen, some of rhe research indicares thar vitmnin Jupplements do
Ilot furnisIJ tIJt' proteetion rhar food ources
of thesc viramins providc. Furrhcrmore,
foods conraining rhesc vitamins (fruirs and
vegerablesl conrain a hos! of narurally occurring protecrive subsrances in addition ro

ar

Sweet red bell peppers,

raw
Orange juice, fresb
Brussels sprouts, boiled
PinkJred grapefruit
Strawberries
Kiwifruit
Orange
Sweet green beII
peppers, raw
Broccoli, pieces, raw
Raspberries
Blackberries
Sweet potato, baked
Kale, boiled
Tomato
Cab bage, raw
Baked potato
Banana
My

r~ommendcd daily

mg

Serving size
1 med

141

1 cup
1 cup
1 eacb
1 cup
1 each
1 med
1 IOed

124
98
94
82
75
70
66

1/2 cup

41
31
30
28
27
24
23
16
10

1 cup
1 CU))
1 med
lf2CUP

1 each
1 cup
1 med
1 med

aUowance for vitamin C

j,

250 mg.
Figure 20

DIET CAN PROTECT AGAINST

S
CANCE
RaMii!> e.r:pllsed 10 lI1tral'io/ellig/II for 24 weeks
Regular diel

24% gol skin cancer

Regubr diel wilh extrll .'il. C & E

,
0"1.

gOl

skin cancer
Figure 21

37

PROOF POSITIVE

mGH SOURCES OF V1TAMIN E

Food

Serving size

%RDA

(for male5.)

Wheat germ oii

1 tsp
Sunf10wer oil
1 tbs
Sunf10wer seeds,
1 tbs
oii roasted
Almond butt~1 tbs
Canola oil ........... 1 tbs
Almonds
10 reach
Soybean oU
1 'bs
Margarine, tub
1 tbs
Safflower oil
1 tbs
Olive oiI
1 tbs
Blueberries
1 cup
Mustard greens
'/2 ClIp
Soybeans, grecn,
1/2 cup
boiled
Spinach, cooked
1/2 cup
Wheat germ
1 tbs

83.0
42.4
42.4
31.6
30.3
27.2
23.5
18.2
16.2
15.6
14.5
14.1
12.6
H.7
11.2

Rrrommc:nd~d DJilil~' All6wanc(' for ~'ifa_min E il: 8tllg: a:n:(;Ho('ophero' ~Iui,"al('nts)

(For JU. add onf,.....thi ...d 10 Ih~ aTF. ,a.lut... (".R- I tbl ()( illmontl buller JJaTE=-C.4IlJ)

Figure 22

(based 011 equal weigIJt proportiolls)

Fruits

Veget(bles

l.

1. Garlic

2. Pilum
3. Orange

2. Kale
3. Spinach

4. Red grapes

4. Brussels sprouts

5. Alfalfa sprouts
5. Kiwi fruit
6. Grapefruit, pink 6. Broccoli
7. White grapes

8. Banana
9. Apple
10. Tomato
Figure 23

38

7. Beets
8. Red beII pepper
9. Onion
10. Corn

mese widely-hyped vitamins.

If you are looking for some good namraI sources of viramin E, a lisr offoods ehat
provide healthy doses of this anrioxidaJlt
viramill is shown in Figure 22.10~
One adclitionaJ considcrarion is in 01'der: as beneficia! as an tioKidams [ike vitamins A, C and E are, anrioxidants are noe
aii good. Exce sive amollllts can paradoKically ace as "pro-oxidanrs," compound
which acrually fiwrJ1' the formarion of free
radicals. This is rrue of vi ramin C and viramin E as well as orher anrioxidanrs such as
slIperoKide dismurase and glurarhione. 106
However, when bera carorene, Viramin C.
and Viramin E are presenr in abundanrbur nor superabunclanr-amoullrs (i.c.. in
whole plam foods) rhey aCIually work in
combinatjon ro e1icit a prorecuve anrioxidant effecr. This ef!-ecr is mllch more powerfui rhan just rhe aelditive effeees of these
rhree separate anrioxidants. 207 Funbennore,
suppiernenrs cOllsist aimo r enr.rely of one
parricular rype of vramin E, ealJed alpharocopherol. A recem srlldy has found rhar
anorher rype of viramin E gamma-rocopherol, may be a berrer antioxidam aud rhus
berter ar inhibiring DNA-damaging parrides in rhe bod)'. os Abour 75 percem of
vitamin E consllmed fi'om food is in ehe
gamrna-tocopherol form, whjle sllpplemtnrs comain either nont, or less dl<ln 10
percent gamma-rocopheroJ. The most effect.ive acrion is ro remper )'01.11" emhllsasm for
parronizing your local vitamin supptier and
illsread invesr in more fresh fruirs and vegerables.

Whole Plant Foods AlonePowerfid Antioxidants

Anorher illusrraeion of rhe power of
planr foods ro as isr in can el' pl'evemion
and possibly even to combar l'he effects of
aging v,ras pl'ovidtcl by rhe Unirecl Srares Deparrlllenr ofA.griclIJrure (USDA). They recendy arrempred ro rare foods accol'ding to
rlleir measured natural anrioxidanr pwperrjes, AJrhough rhey used onJy one group of
frec radicals (rhe pe.rQxyls) in rheir resring,
rhe Universiry of California ar Berkeley
championed rhe research an rhe headlines

GOOD NEWS ABOUT CANCER

of rheir March 1997 newslertcr. This research is the firsr rhat I am aware of thar
rated the power ofwllole plalH foods (as opposed ra just rhe SLlm of their viramin A, C,
and E content) ta provide antioxjdanr effeers. The rap ren fruit and vegerable SOLlfces
of aneioxidanrs from this USDA research
are Esteti in Figure 23. 209 . 210
Each of rhese foods has mLlch more anrioxidanc acciviry rhan rhe sum of rhe ~uHi
oxidanr contene of viramins A, C and E.
For example, ooe cup of cooked kale has as
mLlch aneiaxidanr acriviry as abour 800 mg
of Vitamin C ar 1100 IV of Vi ramin E.
However, rhe kaJe oniy conrains abOlit 50
mg ofVitamin C and 13 IV ofVit3.ll1in E.
Whar accouncs for ilie djJference? A whole
hosr of other twtioxidants in rhe kale thar
we ofreu do nor measure. It is well established rhar many frllirs and vegerables have
powerful anrioxidanr effecrs far beyond
what an assessment ofconventional vitamin
conrcnrs wOllld reveal.
These ranlcings should be viewed with
the realizarion rhar only a few dozen foods
were analyzed, wim some food groups nor
being represenred ar aJl-sueh as rhe legumes.

Phytochemicals
The natural chemicals rllaf are fOllnd in
planr foods are caJled phytochemicaLs. In one
sense of rhe word, vitamjns ar any other
consrituenr rhar is found in a planr producr
eould be given dus designarion. However,
rhe rerm js mosr Ohen used for food chemicais thal come ftom vegel/./ril1n sources dur
c.1JlJlOt be obrained from JnJnal prodllcrs.
There are literally rhousands of
phyrochemiC<11s, many of which appear ro
have a role in fighcing cancer. Many of rhese
ehenucals have JUSt recendy begun ro be
appreeiated. No doubt many orher
phycochemials are yer ro be discovered.
Even sa, wharever you find in a food
supplemenr pili represencs yesrerday's science. Regardless ofwhar be omes next year'
honesr selling phyrochemical in rhe healrh
food store, you can be reasonably cercain
rhat rhose wno ear an abundance of planr
foods have already been getting generous
doses of{har compound. On rhe orher hand,

rhase who skimp on fi'lIirs and vegerables

wiU be obliged ro waic for rhe vitamin companies ro firsr be convinced of the
compound's promise and salabiliry, and (hen
figure our how ro ger ir inra a pilI.
Study aher scudy cOllrlnlles ro reveal rhe
ca ncer-prorecri ve benefi tS of differenr
phyrochemicals. OI'. John D. Pouer of
Sea{eJe's Fred Hutchinson Cancer Research
CelHer has poilHed our ciur rhese phyrochemicals usually work in oile of rwo ways:
rhey eir.her function as blocking agenrs or
suppressing agenrs. 11 1 Blocking agen{s work
on the carcinogens-prevelHing them from
affecting rhe body's cells (rhis may occur by
desrroying rheir activicy or orher means).
Suppressing agellts work on rhe body's own
cells, combaring maJignanr changes tlur
ma)' have becll sr,med by carcinogens.
Many of rhe insighrs on che healch benefus of phyrochemicals came direcr1y from
r!le Iaborarory. A list of a few of (he
phyrochemicals (har have been shown ro
prevene ar even rreat cancer in rhe laboracory and rhe foods rhe)' are found in are
lisred in Figure 24. 212 13,214.21 J. 216
One group of foods rhar are loaded wrh
cancer-pror.ective factors are the cruciferous
vegerables. I hese Illcmbers of the Qlbbage
family include bmssels sproucs, cauliflower,

FOODSOURCESOFCANCER-nGHTING
PHYTOCBEMICALS
Phytochemic{ll

Sinigrin
SuJphoraphane
Dithioltbiones
Resveratrol
PEITC.
Limonene
Allyl sulfides
Isot1avones, Saponins
Protease Inhibitors
Ellagic Acid
Caffeic Acid
Pbytic Acid

Foods

Brussels sprouts
Broccoli
Broccoli
Red grapes
Watercress
Citrus fruits
oIl'::'
Garlic, ouions, leeks
Soybeans, legumes
Soybeans, legumes
Grapes
Fruits
Grains

.~

Figura 24

39

PROOF POSITIVE

40

broccoL, bJe, wrnips, kohlrabi, bok chol"

collards and cabbage. One srudy showed
rnar dlOse who ate cabbage ar least once per
week had rwo-rhirds Icss colon cancer rhan
rhose who ate it once per momh ar Iess. lJ7
Indoles are arnong the cancer-protecrive
phyrochemicals in rhesc plams. These compounds work as blocking agenrs b)' increasing colon enzl'mes that can deacrivace carcinogens. ll8
Earing whole frujt dramarically reduces
the risk of cenain cancers. In rhe Advenrisc
Healtb Scudy involving 34,000 subjecrs.
Sevenrh-day Aelvenrisrs thac ear fruic rwice
a da)' decrease dleir risk of developing lung
cancer by a srarrling 74 percem compared
ro rhose rhac ear fmir le..ss rhan twice a week.
Sromach and olher cancers were also dramarically reduced. 219
Over 90 pcrcenr of rJle 34,000 subjecrs
were nonsmokers, which meanr rhar rhel'
were alI ar a low risk ofdeveloping lung cancer ar the outser. However nonsl11okers infrequendy do ger lung cancer. This srudy
shows that rheir risk can be sharply lowered
even more by includ ing an abundance of
fruir in rheir diets.
Soy is anolher food highly tomed for irs
cancer-protective properries. h is a verirable
gold mine of cancer-protecrive phytochemicals. Dr. Mark Messina summal'ized
over 30 difrerenr epidemiologic srudies on
soybcans and cancer in his book, The Simple
Soybean And Yom Health. 220 He poinrs our
rhar the results suggesr rhar those who consume the l'flOSt sOl JOods ha've the least cancer.
These srlldies sugge,st rhar sa)' decreases cancer risk ar mao)' sites including breasr. colon, recrum, lung, and sromach.
A large srudy from the 1erherlands involved over 120,000 men and women. Researchers dlere made a connecr.ion berween
anorher ph)'tOchemicaJ-rich food and cancer prevenrjon, rhe simple onion. The cancer ir prevenred was stOmach cancer. Those
earing rhe most onions (one or more onions every other day) had half rhe stomach
cancer risk of rhose who oevel' are onions. LI
Garlic has been shown ro prorecI againsr
developing cancer; in mice, it is effective in
trertting cancer. The amounr of 50 milligrams of garlic adminisrered in 3 ounce.~ of

drinking warer ro mice wirll bladder cancer

led ro signiftcanr shrinking of the rumors,
while 500 milligrams of garlic nor on]y reduced the cancer size but actually decrcased
rhe morraJiry rare from rhe cancer. 22 AlI of
chis occurred withour side effeers. The rcsearchers believe thar ilie garl.ic ma)' have
srimulared rhe mices immunc s)'stern , helping rhem ta combar rhe cancer.
The message from (hese few selecred ex<lmples is nor thar we sholild ear a soy, cabbage, aod ollion andwich every day. Rarher,
1 recite (hese studies only ro illllsrrate rne
wealth ofsciemif'ic informarion thal is coming out abour many fruirs, grains, and veget'lbles. In facr, some of rhe mosr exciung
research Jooks ar ali mese foods collecrivel)'.
For example, Harvard's Dr. Walrer \X/illetr
has observed rhat (here is abundanr and consisrent scienrific evidence which demonsrrares rhal "high intakes of fruits and vegerables" reduce rhe risks of "mose human
caocers."223 Willetr sees in this evidence support for "rhe concept (hal micronlluienrs
[such as vitamins minerals, and orher
ph)'tochemica]s] ma)' play important. 1'Oles
jn the prevention of human cancers."21.j
lndeed, rhe conslImptiofl of fruirs and vegerables is associared wirh 100",'er rares of cancers ofthe brea.n colon, rectum, IUllg, prostare, urinary bladder sromach. esophagus.
cervix, larynx (voice box) mourh, plurynx
(rhroat), and liver.21~ 126. 2-7
The National Research COllllci! has come
ro imilar conclusions as Or. Wlllerr: "There
is consistent evidence rhar fmit and vegerable
consumprion is prorective againsr severaJ amcer. ... Therefol'e, in considering appropl'lare
preventive measures, consumprion of rhe releva.nt foods (the foods themselves)-nor rhe
putarive prorecrive componenrs of rhose
foods-should be encollraged. "228 In orher
words, the Council is encouraging al!
Americans ro eat foods rhat conrain cancer-prorective compounds rarher rhan seeking supplemenrs rhar featllre thase compounds. Considel'ing rhe overwhelming
evidence as ro rhe imporrance of prorecrive
phytochemicals in fl'1I1rs grains, and vegetables, 1 could not agree more.
Even if Ihe prospecrs of making a dramaric dierary change seern daunring, rake

GOOD NEWS ABOUT CANCER

he.,If(. There are man)' natural food cook
books dur can make rhe rransirion much
casier. These books feature an abundance
of fruirs, grains, and vcgerable$ in a mulrilude of good rasring recipes. Appendix II
Iim several such books.

Fiber Reduces Cancer Risk

Anocher llmrien t class thac some wotlld
include among rhe phytOchemicals is rhar
of fiber. Fiber includes rhe pam of planr
n arerials thar resisr digesrion by rhe nOrmal human inresrina.! sysrem. Just as rhere
are maoy difftrenr cypes ofviram ins, so rhere
are many different types of flber. These
include celluloses, hemicelluloses I ignin,
pectins, gllms, mucilages, and algal polysaccharides. Major food sourees of flber are
fruirs, vegeeables, whole grain cereals, and
legumes. 229 There is virtually no liber in
meat, milk, eggs, cheese, OI' any other animal produce
A fiber-rch diet elearly reduces the risk
of developing colon cancer. Drs. Howe,
Beniro, and colleagues analyzed rne resu!rs
of 13 srudies thar looked ar the influence of
fiber intake on colon cancerYo They found
a t'rong "dose-response relationship when
ehe)' looked ar fiber incake: the more f1ber
earen, rhe lower rbe risk of colon cancer.
SpecificalJy, whel) tlle researchers divided
people inlO five groups based on rheir level
of fiber inrake, those wich rhe lowesr flber
intakes had rhe grearesr risk of colon cancer. Even rhose in rhe next lowesr group of
fiber consumpIion still had 21 percent le"ss
colon cancer when compared ro Ihe pooresr fiber earers. Those n rlle group with
ave rage fjber inrake had 31 percenr less,
those wirh somewhat above average intake
had 37 percenr less, and rhose with rhe besr
iiber inrake had nearly 50 percent less risk
of this major cancer.
The researchers concluded thar if rhe
average U.S. ciri7..en would merely increase
his or heI' fiber il)rake by 70 percenr (rhus
going from a current average of abolit 18
grams per day ro around 30 grams per day),
we would decrease our national rate of colon cancer by 31 percent and would save
some 50,000 cases of colon cancer ,mnu-

ally2"J

Eadier in this chaprer we looked ar dara

from Harvard Universir}"s Healrh Professionals Follow-Up Srudy. ReseaTchers rhere
srudied rhe relarionships of lifCsryle ro rhe
lesiolls rl1at precede colon cancer, known as
colorecral adenomas. Jn addition ro finding links wirh aleohol, the Harva~rd grollp
has documenred relarionship bet\vet:'n these
adenomas and both bigh sacurated fat COJlsumprion and low fiber inrake. Speciflcally,
rhose with high sawrared fat incake had
double rhe risk of these Iesions. Men wirh
r!le poorese fiber inra.!zc had almost duee
rime rhe risk ofcolorecral aclenomas \vhen
compared with those consuming flber liberali)'. When rhe)' ielentifed a group of rnen
earing liberal amounes of sarurared fat and
linIe fibct, rhe)' discoVCiTd rhar the)' experi
enced nearl}' faur rimes the risle of rhose on
a low sarurarcel far, high fi bel' diet. 2 '2
Dietar)' fiber has proteccjve bendlrs regarding other canecrs as well. For example,
a high fI.ber diet has been shown ro decrease
breasr ancer b)' more rhan 50 percenr. 233
Dr. David Rose of rhe American Healrh
FOliildarion believes that the evidence suggestS rhar fiber "ma)' favorably modify the
enhanced breast cancer risk associared wirh
the rypical AJllerican h igh-f:1t, low-IIber
dieL" Hc suggesrs rhar fiber ma)' "iork
through a varier)' of ways ro lower breasr
can er risk, but r!le primal)' effect is probabi)' through affecring eirher rhe acriviry OI"
the metabolism ofestrogen. Associated wirh
plant flbers are planr csrrogens ("fibehlssociared phytoestrogens") that may lower
breasr canccr risk. There is al$o evidence thar
flber can inrerfel"e with rhe intestinal re-absorprion of esrrogen-rhis wOldd aho be
expecred co lower breast cancer risk. 3';

SeLenium
Seleniull1 is a trace mineral found in
whole grains, such as wheat grown in North
and South Dakora in seJenilUn-rich soil. A
diel high in seknium (approximare!y 200
ro 400 micrograms a day) decreases rhe risk
of lung, colon, and prosrare cancer. 235 But
anorher word of camion for supplement
lIsers: too mllch se1erLiwn is toxic and causes
hair anei nailloss, baei brcarh, or other symproms.

41

PROOF POSITIVE

OBESITY INCREASES BREAST

CANCERRISK
Pre-menopause Post-mellopause
Ftisk

~sk

Thin

Overweight

2x

5x

Obese

3x

12x

Figura 25

Maintain Proper Weight

Increased body weighr has been linked
an increased riskof several different rypes
of Cancer. The lisr includes cancers of rhe
breasr, kidney, endomerrium (inner lin ing
of rhe womb), and prosrare. 236 Ler us examine a few of [he man)' srudies [har have
explored chis rebrionship.
A c1assic Japan se study dane by Dr.
Hirayama found rhar rhin women had rhe
lowes[ ra[es of breasr cancer as porrrayed
in Figure 25. 237
In rhis figure, [he "overweighr" caregory
[O

OBESITY AN INCREASED RISK

OF DEAm FROM CANCER
60

% of SO
increased
risk of 40
dealh

S5

Meu
\VOOlen

33

20
10

o
Figure 26

42

was up to about 20 percent more (han (he

upper limit of nOftnal weiglu; obese was an)'
weigln above rhe "overweighr~ range. No[e

rhar obese WOmen had a r.hree-fold increased

risk for rhose who had not )'et gone rhrough
menopause, bur rhe risk climbed ta a rwelvefold level for rhose who were post-menopausal.
Anorher wa)' ta look ar facrors [hat predispose wamen ro breast cancer is ta srudy
rhose who developed more than one breast
cancer rJlar was not spread from rhe initial
cancer. Such seudies are imp0f(~lIn because
chey wauld be expecred ta idenrify a group
of women who have special flCwrs favaring rhe developmenc of breasr cancer. In
1985, other Japanese re earchers idenrified
such a group of over 60 patiems and compared them wir.h individuals who had just a
single breasr c..lncer. 238 A srrong rdarionship
emerged berween weighr and multiple
breast eancers. Those who were overweighr
had (fiple ilie risk ofhaving more rhan one
episade ofbreasr cancer, demonsrraring rhat
rhe overweiglu conditian in some wa)' predisposed rhem ro the developmenr of rhis
maJignancy.
American research has also becn publisheel on rhe breasr cancer-overweight rda[onship. Dr. Kumar anei associates ar rhe
Universiry of South Florida found rhar
weighr gain from puberry ro early adulr.hood
was especially important in increasing breast
cancer risk They found rhar an exrra 10
pounds an a 30-year-old waffiall raised her
risk of breasr cancer by 23 pereenr, while
an exrra 20 pounds raised her risk 52 percenr. 239 Gaining weight aher rhe age of 18
has jusr recently been found ro be an "independenr risk facrar" (apan from aleohot
consumpron) use of hormones, physical
acrivity levels, age of firsr pregnancy, menarche. and menopause) for the devdop
menr of breast cancer. 240
Wamen are nor rhe only ones who experience an increased c.'tncer risk due ro
being overweight. In 1985, Dr. Garfinkel
reponed resulrs from one ofr.he largest srud
ies dur examined the relationship berween
body weighr anei c.1J1Cer risk of750,000 men
anei women. A 12 year follow-up srudy revealed ncreased cancer monaJity for rhose
who were overweighr. The flndings are tabuIared in Figure 26. 241
Nore rhar men who were 40 percenr

GOOD NEWS ABOUT CANCER

overweiglH haei a 33 pereel)( increased risk
of dying from cancer. \'V'omen who were
overweighr by the same percenrage increased
rlleir cancer dearh rares bl' 55 perccnr. In
men, chis relarionship \I,.as sr<]risrically significant for cancer of the colon, rcctum,
and prostare. For women. risk increased nor
onl)' for breasr cancer b\l( also cancer of the
uterus (cervix and endometrium), ovary, and
galJ bladder. 242
How do l'au Imow ifl'ou are overweight?
There are a varier)' of ways ro flnd DUC one
ofthe standard merhods is ro compare yourself ro tables such as rhose publjshed by rhe
Meeropoliran Life Insurance Company.
However, rhose rabIes do Hor work weB for
people rhar have signiFicandy grearer
amollnts of mllscle mass than average. By
such srandards mosr bodl' builders, for example, would be ovenveighr. Therefore,
some feel a more imponanr determinanr is
wherher l'au are "over-far." Me,asuremems
ofbody f.1r can be nude bl' a variety of rnerhods ranging from underwarer weighing
ro slun fald measuremenrs. ewee rnerhods usc an infrared beam or resistance ro a
weak e1ectrical currenr ro estim;lre bodl' fat
percenta'ge.
A simpler and yer very valuable method
for esti maring excess bodl' fat compares rhe
size of r.he waisr ta rhar of the hips.243 You
can do rhis l'ourself. Tal<e a measuring r:1pe
and measure araund l'our hips. then araund
your wa.isr. For women, rlle waisc size should
be 20 percem less than rhe hip size. For example, if the hips measllre 40 inches, rhe
waist ShOllld be 8 inches less, ar 32 inches
(0.2 rimes 40 = 8). If ir ' anl' b-ger rhan
32, you have excessive weighr.
For men. the waisr size should be 10
percem less rhan hip sze. For example, if
rhe hips meaSllre 40 inches, rhe wajst shouJd
be 4 i Dches less (40 rjmes 0.1 = 4), ar 36
inches. H1 lf it is larger, you are overweighr.
Those who are over-far bl' the waist/hip
mcrhod nor on-'y have a grearer risk of cancer bur aJso a greater risk of diabetes, hypertension, and coronary hearr disease.

Watch Out for Excess Protein

A clier low in prorein, parricularly in cerrain amino acids, will also srrengthen the

immune sl'srem agajnsr cancer. More informarion is provided in Chaprer 7 enrirled,

"The Great Mear and Protein Myrh."

Viruses in Animal Products

A pania1 1isring of viruse' known ta
callse human cancers indudes: the Hepatiris B virus, the Epstein-Barr virus, human
T-cell leukema viruses, and HfV, che human immunodeficiency viru ,.245 The human papilloma virus which also causes cancer, is dealt with in Chaprer 15, "AlDS and
H1V-The Untold Scory." In addirion to
viruses, parasites-which are comenon overseas-also find rhemse1ves an rhe Ist ofCo1ncer-causing infectious agenrs. Foryears, rwo
such parasires have been known to cause
cancer: they ale Schistosoma haematolJium
and Chlonorchis sinensis. The former is
Iinked ro bladder cancer, while rhe laner is
a known liver cancer risk factor. -16 Chronic
bacterial infecrions such as Helicobtlcter P)'lori Gtn callse cancer of the stomach and
have been linked ta lymphoma. 147 With a
renewed appreciarion for the dangers ofinfecriolls diseases, man)' arc wondering
wherher mear and orher animal prodllcts
mal' harbor infecrious agenrs mar could increase cancer risk. 1 deal wirh this concern
in Chapter 10, "Animal Diseases and Hllman Health Risk."

Regular Meals with Nothing Between

Meal frequency has been idemified as a
ri k faeror for colon. cancer. A number of
srudies in differenr pans of the world demonstrate thac eating meals more frequenrly
leads ro an increased risk ofcolon cancer. 218 .
219,250 Or. La Vecchia and colleagues in
Milan Italy have published an rhis subjecr,.
Their group faunei rhat rhe risk of borh
colon ancl rectal cancer coulel be nearll'
doubled by ea[ing more frequenrJy, as rabuIared in Figure 27. 251
Four meals per day almosr doubles rhe
risk of colon and reeral cancer compared ro
[wa meals per day. These impressive resuh
discovered by (he Milan researchers could
nor be explajned by a variery of djetary ar
orher lifesryle factors. The resulrs indjcated
thar meaJ frequency was indeed [he factor
thar impanecl increased risk.

43

PROOF POST NE

c
M ea lsper d ay

2 or Jess

3
4 or more

Risk o f R i s k of
Rectal Cancer Colon Cancer
1.0
1.7

1.9

1.0

1.4
1.9

Figure 27

44

The resuhs concur with counsel given

years ago by Etlen White: "It should be
shown (hac to eoat two meaJs is far bener for
rhe hea.lth dun ro ear three. '252 She provided funher c1aloific<ltion: "Most people
enjoy bener health while earing rwo meals
a day (han three; od1ers, under their existing circllmsrances may reqllire somerhing
(O eat at supper time; bllt rllis meal should
be very light..."253
The medical research presemed rhroughour this book is mosr consisrent with such
an eaung sryle. We should eat a bean)' breakfast in rhe morning. his is an appropriate
rime to eat several servings of fruits and
grains, with nuts in moderation. These
foods alOC rich in viGunins, minerals, and fi
ber, wirh no cholestera!. The second meal
can be ar noon ar in the ea.rly afternoon.
This ITlay sound like an impossible ea(ing

sryle for many people-and it may nor be

permitted by your work schedule. However,
if you have the abiliry ro implement such a
program, 1 have found rl1ar mosr indjviduals nor only adjusr ro it, bur actuaJly thrive
on sllch a regimen. Oprimatly, if you do eat
in rhe evening, ir should be a liglu mea.!;
[he heavier rhe evening meal the greater
chance for weight gain, as itlustrared in
Chapter 1, "Principles for Optimal Hea/rh."
A good example ofa lighr supper woulcl be
a meal based on fruit.

E'(ercise-A Friend }Dur

Immune System Needs
Exercise and a healthy immune sysrem
go hand in hand. Can el' mana/ity rates are
signiflcanrly lower in regular exercisers. A
well-publicized swdy of Harvard Alumni
found thar rhose who burned only 500 calories ar less per week in exercise had 35 percem more cancer dearhs rhan rhose expending grearer rhan 2,000 calories per week. 25
Dearhs from aII causes, including hean discase, were increased by over 60 percenr in
rhe poorer exercisers.
Over 17,000 men ages 30 ro 79 were
c1assified according ro ilieir level of physical acrivity on rwo eparale occasions over a
25 year period. Those who \~'ere highly active (expending 2,500 OI' more ca/ories per
week in exercise) had 38 ro 61 percen( Iess
lung cancer (han rhose who were inactive
(ani)' 1,000 calories ar less of exercise per
week).255 Heavier individuals who were
highly active dropped rheir colon cancer risk
by 44 ro 81 percene. Expressed in orher
terms, their inactive peers had lip ro five
rimes the risk of colon cancer. Other srudies have a1so suggested that physical inacriviTJ' increases colon cancer risk. 256. 257
Stiti ocheI' stllrues have linked physical
acriviry to prorecrion from ocheI' cancers.
Researchers a( rhe Cooper Clinic in DaJlas
have found rhat rJlOse who exercse moderately have only abour rhree-quaners of tne
prostate cancer risk experienced by rheir
inactive peerS. The hig/' exerse group tared
by far rhe best; they had 011~Y I1bout 30 percent ofthe risk faced by rhase gerring linie
ar no regular exercise. 25

GOOD NEWS ABOUT CANCER

Exercise's protective effects extend ca
women as well. One recem swdy found rhar
women who exercise an ave rage of faur
hours per week during their childbearing
years decrease rheir risk of breast cancer by
nearly 60 percem. Even rhose \Vho ani)' had
one ro three hours per week of exercise cur
their risk by 30 percenr compared ro nonexercisers.259. 260
Why does exercise reduce cancer ri k?
There are several possible reasons-many
ofthem cenrer around the immune s)'stem.
For example, srrenuous, susrained exercise
srimllJares white blood cdls ro rdease a compound called inrerleukin 1. 261 We colild
expect an)' vigorous exercise ro accoll1plish
this dIecr, whether it is gardening, brisk
walking, or dozens of orher activities. This
is good news because inrerlellkin-l , in and
of icself, is a natural chemoeherapy agent.
Beyond rhis, inrerleukin- I. Stimlliates ehe
release ofinrerleukin-2, which also aids rhe
immune sysrem. These inrerlellkin chemicaIs from our white blood ceIls serve as
modularors of the whole immllne sysrem.
Anou1er wa)' ehar vigorous exercise helps
ule immune sysrem is b)' doubling the blood
plasma ibe.erferon levels. lG2 Inrerferon is a11orher chemorherapy agenr that aCL~ againsr
cerrain cypes of cancer such as hairy-ceUed
leukemia. It also fighrs chronic viral infecriollS such as heparitis B and hepatieis C.
Exercise also increases orJlcr critical irnIllLlne subsrances, the natural killer cells. 263
Natural bileI' cells arc cerrain wh ite blood
cells [har seern ro have a natural instinct ro
deeect abnormal cdls and desuoy [hem.
They stern to be especiaJly imporranr in
defending us from cancet.- 64 Finally, rhe
blood lymphocytes, which are a broad grollp
of whire blood cells that are very prominendy involved in rhe mmune system rself, are increased wirh exercise. 265
Exercise a1so has the abil-iry ro modulare
hormonal mechanisms. This ma)' be imporrant in borh sexes ar aII ages, but has been
parricularly nored in yOllng women who exercise vigorously. It is common kllowledge
rhat rhe hormonal changes from exercise in
rhar group can be so profound rhar mensrrual cycles can cease.
A1rhough no one really knows how

mllch exercise is oprimal regareling cancer

prevention, mosr expens agree rhar one of
tlle mosr imporranr facrors is consistency.
Indeed, exerci e should be a parr ofour daily
rautine if we are really serious abolit cancer
prevenrlon.

SunLight in Moderation
Mose. of {he media's ancmion has becn
on sunlight as a cause of cancer, as well it
is-in excess, a' menrioned earlier in rhe
chaprer. However, sunlight deprivlltioll inaClTSes the risk ofcancer of the breast, colon,
anei prosrare, possibly due ro less circlilating Vit;unin D-3 and irs derivatives. 2GG The
aurhors of rhis discovery conci ude {'rhar
rJ1ere should be no broad condemnation of
moderate sunlight exposure. "267
Sun expOSlire may actuali}' help prevent
colon cancer. Researchers ar rhe Universicy
ofWashingron srudied cancer rares in nine
areas of rhe United Stares. They discovere:d
rhat men from Sourhern srates haei much
less colon cancer than Norrherners. _68 When
cornpared ro New Me:xicans, men in Mich.i.gan, Connecticllt, and Washingron had colon cancer r,lfCS 50 ro 80 percenr higher.
The dTecr also seemed ro hold true for
women, althollgh it was not as marke:d. One
explanation for rhis decrease in colon cancer risk in sOllthem srates is ncreased sunlighr exposure with a resulting increase in
vitamin D leveJs. Vie.amin D appears able
to sllppress rhe growrh of cancerous cells.

Stress and the lmmune System

To optimall)' boosr yOllr immune system, adequare srress conrrol is a must. Srudies show rhat people who are not coping
adequae.ely wirh major stressors in rheir lives
have a mllch greater cha11ce of developing
cancer ar a life-threatening infection. A
number ofscudies have been performed on
people who already have a life-threarening
cancer. Although the specific biologic process of a person's cancer is rhe mosr consistent factor affecr.i.ng survival, social support
(such as given by a loving SpOll e) and a fairh
dimension (such as prayer) ale rwo relatively
consistem characrerisrics among 10ng-rerm
survivals of cancer.-69 Because stress control
is so illlporranr, 1 have wrirten aII emire

45

PROOF POSITIVE

Proper diet

Fruits
Vegetables

Regular mcails with

no snacks

Regular aerobic cxercise

Cereai grains
Nuts
Maintain proper
weight

Sun)jgM lin moderation

Stress control

to dramacical1y reduce our risk of cancet is

in order. And rhey are ali wr1Lin rhe scope
of pracricaliry. They are nor complicared'
rhey can bc implemented inco our lives \Virh
no addirjonal cost. For convenence, a summary lisr of the e1emenrs of a litestyle rhar
wiU vastly reduce our risk of gening cancer
is shown in Figure 28.
As we have seen, antioxidanr.s, seleniunl,
vitamin A, C, and E, and many phyrochemicals have been fotlnd ro have speciaJ
qllaJiries rhar prevelH cancer. Fruirs and vegerables rh:u comain one or more of rhese
subsrances in guod qtl:lnricy are lisced in
Figure 29.

A Personal Cancer-Protective Lifestyle

in a Nutshell
The information in rhis chaprer enables

Figure 28

ro oudine a personal cancer-procecrive

lifeslyle. Such a lifestyle would avoitl carcillogens. In chis chaprer we have seen (hat
liS

CANCER-PROTECTIVE FRUITS
AND VEGETABLES
Fruits
blueberries
straWbcrrieSf
plums
.oranges
grapes
citrus fruits
apricots
orange juice
grapefruit
kiwifruit
raspberries
blackberries
bananas

Ve'letables
kale, spinach
lettuce, collard grecns ~
brussel sprouts, cabbage
beans, peas, lentils
broccoli, caulinower
carrots, beets, I)otatoes
watercress, mustard greens
garlic, onions, leeks
turnip/turnip greens
tomatoes
yams, sweet potlltoes
mixed vegetables
pumpkin
cantaloupe, watermclon
beII peppers

Figure 29

chaprer, "Srress wirhollt Disrress" (Chapter

14). on how adequare srress control fan be
achieved even by rhose under vcry high
Stress.

Summary ofAgents
That Prevent Cancer
46

To close Section II ofthis chaprer, a review of rhe mm}' acrions rhar we can rake

rhe leading and mosr common carcinogen

is robacco. Smokers need ro kick t!Je tobacco
!labil; efforts ShOllld continue ro have a
smoke-free. robacco-free society to eradicate
second hand smoke.
Regarding akohol, the data is ali in. We
need ro stop ltsing aLcohof. lndeed, even
moderare drinking increases cancer, and
when you consider rhar 56 percenr of rhe
American populatiol) drink aJcoholic beverages, this is no small ma((er. When we
rhink abour a1cohol's carcinogenic porentiai and whar it is doing in relation ro illcreasing accidems, homie.ides, and suicides
\Ve need ro choose ro abseain and encourage orhers ro do che same-it is ule only
oprion rhac ma.kes sense.
If we reali)' wam to maximize our personal cancer-procecrion eHort, we must

(hoose the fOods that wiLl UJork fOr our henef;'

and eliminate the foods t!JiU are working
agllin.st Iti, as (he man)' studies cired in rhis
chaprer have shown. We have seen ehar sociecies rhar regularly consume mear, high
fat dajl)' proelucrs, and sacurared fars associated wirh chem, have dle highesr rates of
cancer. Changing our c1icr does noe mea})
cU((ing down an reci meac anei eacing insread more chicken, (lIfkey, or IIsh, which
con.cain many roxins, viruses, anei other

GOOD NEWS ABOUT CANCER

pQ[enrially d;Ulgerolis subsrances. There is
no uet gain from thar approadr ir srill has
many of rhe origina.l haz.1.rds. Only by chang-

ing fi'om the 'Ypical American animal-based

JieI to il plant-bastd diei (such as in China
and many orher counuies in rJle world who
have rhe 10weSl cancer rares) \'.'ill we achieve
rhe resulrs we want. Eating freely offruits,

grains, 1Jegetables, and nuls in mod.eratiol1,

prepared in a variery of ways, offers us the
mOSl healthful dier in the world. It \Vas rhe
fim dier reeorded ill the history of man and
is still the besr rhar we know of roday. Ir nor
only e1iminares a host of cancer-causing
substanccs bur is aJso ideal for mainraining
proper weighr. Ir boosrs rhe immune sysrem by ma1<ing USe of viramins A. C, and E
and other very important proceerive
phyto hemicals and f1ber.
Coupling rhis dier wirh regular aerobic
exercise will boos[ the immune sysrem even
further. Rounding our rhe program wirh
adeqllare slress controL, moderate sunlight,

weight controL, aneideereasing snacks and meal

frequency will maximize rhe preventive porentiaL

Anyrhing wonh doing is worrh doing
righr. AlI of us are indeed capable of changing aur behavior for the good, espeeially
when we Imow whar benefics may resu1t.
The personal srakes are high-it is a life and
dearh marrer-my life, your life, and the
livcs of OUl' ehildren and loved ones. The
message is clear and ir caUs for aerian. The
rime ro act is now.

The Best Kept Secret for Preventing

a Catastrophic Disease
Think of whar would happen if romorrow-afrer ali the billions of dollars spent
on cancer rreatment research-a miracle
cancer pili was finally discovered. And ic's
promise was nor false: ir fllJly cured 90 percent ofaII cancers! No doubr rhe drug would
make headlines. The company that deve!oped ir could pur a huge priee rag an it.
Mter alI, rh.ink of aiI the money it would
S3ve on surgeries, radiarion rherapy, and
chemorherapy hospitalizations. o doubt
it would have irs share of side effects-all
drugs do. But who cares abOllr side effeers

when )'ou have cancer and me cure is just a

pili away!
The drug developer wOllld probably
receive rhe Nobel Prize for rheir work. It
would not be surprising jf (he President of
rhe Unired Srares invited the chief investigarors ro a special reception ar [he White
House. What a cause for rejoicing rhis truly
would be. AU the hoopla, rhe national fame,
and rhe honor bestowed upon the participanrs would be tremendous-as well ir
should.
BUl stop for a minute. There is no sign
that any drug like rJlis is on rhe horizon.
Furthermore, whar is reali)' more important,
prevenrion or cure? We are alI aware of rJle
old saying, "An ounee ofprevention is worth
a pound of cure." But do we really live as
though we believe it? Even if mat imaginary cancer ellre piU reali)' were developed,
t hin k of ali [he problems tha t cancer
cause '-before it is even diagnosed: ali the
medic.ll bills, rime lost from work, and famil)' stress, nor ro menrion rhe pain and suffering caused b)' the disea.se. Even if chere
\'Iere a cllre for every single cancer, prevenrion would sriU be much cheaper and llluch
more desirable and ple.asanr. Bur in an era
when, despire ali rhe billions of dollars that
have already been spenr on hopes of rhat
e1usive wonder cancer drug, and we are stiU
nowhere clase to such a magic cancer
cure,2/0 how mueh more important is the

pre1Jmtion ofcancer?
As hard as ir may be ro beLieve, in a sense,
rhe magic cp.m.:erpillhas bem foul'Id Research
has revealed dur we now have lip ro a 90
percent effeelive "elite" for cancer in the.
form of a comprehensive cancer-preventive
lifestyl.e. Bur rhere have been 110 headlines,
no hoopla. no presidenrial invitatiolls, 110
Nobel prjzes. In fact, hardly anyone even
knows about rhis powerfullifesryle. Illdeed,
(here are many people wha know various
aspecrs of rhe program I have described in
dtis chaprcr. Many are aware of rhe importance of sropping smolcing, OI' exereising,
or earing more fruirs and vegerables. Ver,
regarding rhe whale package mat can give
such amazing resulrs, mosc of rJ1C general
public s rmally unaware. Unfonunately, dlis
includes heaJrh professionals. Alrhough

47

PROOF POSITIVE
mOst ,ue aware of some of the e1emcnrs 1
have discllssed in this chapeer, feware aware
of [he power of the comprehensive lifesryle
approach ro cancer rhat has been preselHed.
This lack ofawareness is even more srriking in light of ehe "age of informaeion" in
which we live. We should be c1early broadcasring [his comprehensive approach tO cancer prevencion an every relevision and radio station; we should presenr ie graphically
and powerfully in every newspaper, magazine, and computer news service. Th.is
Iifestyle should be rhe sllbjecr of a massive
governmeru educationaJ program. lf such
happened ro morrow, and the American
public embraced rhe new way ofliving [hat
was championed, me number rwo hller in
America would soon be relegared to rhe
bottom ofthe 10 lea.ding cau.se~- ofdeatb. The
pain, suffering, productive work losr, family heartac11e, docror and hospieal visits, noe
ro menrion rheir associared eosts, would be
grearly diminished.
But for rhe mose parc, the media, researchers, healch educators, and Presidencs
have been dearhly silenc in promoting a

comprehensive lifeslyle program for cancer

prevention. They, like most of sociery, declare war on cancer b)' focusing energy on
e1usive ueatmencs and narrow preveneive
approaches, when a comprehensive prevenrive lifesryle is riglu al our finger tips. Is it
simply ignoraJlce? Or is it possible dut
many of aur leaders, scientises, and media
spokespcrsollS are not willing ro make bold
lifesryle c11anges themselves (sa long as rhe)'
are feeling well)-and mus wouJd be uncomfonable ill chaJlenging anyone else eo
adopt such a way of Jiving?
Is mere a rcar of back1ash from powerfuI cammereia! interesrs if the optimal cancer prevencive lifeseyle is advocated? (The
message of this chapter wiU nOI likely be
popular wieh the likes of the alcohol, meae
anei dairy industries, etc.) 1 hone-sely do nor
know whae aJl the impedimencs are, bur 1
do know ehat nolV is the eime ro get the word
our abolit rhis IOral lifesryle. Anei now is the
rime for eaeh one of us tO become a living
example of ilie power of such a lifestyle ro
combat America's fearful number lWO killer.

13

Can er Facrs & Figurcs-1997. Alluri.cl1Jl etmce,. 'oeiety, p. 1.

14

American Cancer Sociely, Ine. 1-800-ACS2345.

Cancer Fact5 & Figurcs-1997. American umur ~oely. p. 1.

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Cancer Facts & Figures-1997. A1IIl'ricl111 Ctmcer Soeiery. p. 1.

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(,7

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1981

49

PROOF POSITIVE
(,9

Stcmmermann GN, Mandel ~,1 Mowcr HF. Colon cancer: its precur-

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eketiXJphil~

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CHAPTERTHREE

RT

SE:

Conquering the Number

One Killer
A WorlJwide Problem

ue never worried mllch abolit hean

disease. Sure, her dad had died ar
45 wich a heart acrack, but every
one knew that femaJe hormones
would procect her ftom hean problems ar
leasI umil she wene [hrollgh menopause.
Ovemighr, however, she was jolred back ro
re.aliry. Ar [he age of 40 hec younger sisrer
died wirh her fim hean anack-before she
weor rhrough rhe "cb:Ulge of life." Suddenly, Sue was confroneed wirh whar she
fcared deep inside ali along: she was ar risk
of a heare aaack.
Almosr every American knows someone
who has died of hearr disease. Like Sue,
you may have premawrely lost c10se relarives from rhis dreaded killer. Perhaps you
have had neighbors, friends, or coworkers
snacched away by hearr disease. As a resulr
of chis kilJer's predominance, most ofus have
ac leasr occasionally wondered, "Will 1 be
[he nexc one wirh a heart af(ack~" Such COI1cerns are warranred. Hean disease is rhe
num ber one killer in rhe induscrialized
coumries, as ourlined in Figure 1.1. 2
Contrary ro popular misconceprions,
heart di ease is nor only a disease of men.
In America, hean disease is rhe leading killer
of mcn and women aJike. Despire ali rhar
I\ledical science knows about how ro pre-

vent chis di ease, rhe latese stariscics show

thar over 954,000 people died of diseases
of rhe hcart and blood vessels (cardiovascllIar disease) in rhe Unired Srates alone in
1994, lip from 925,000 in 1992. 3 Every
33 seconds an American dies of cardiovascular disease. Since 1900 the nUlnber one
killer in rhe United Stares has been cardiovascular disease in every yeat bur one (918).
When an airline crashes in rhe U.5. and

Heart disease is tbe biggest killer in the entire world.

In developed nations, the proportion of total dca,ths riscs
to more than 50 percent.
It willlikely overtake
infectious diseases as
the main cause of
death in many
developing nations.
Worldwide, beart attacks and s'rokes account for 25
percent of deaths.
Figure 1

55

PROOF POSITIVE
hllndreds of people die, the news is fiUed
with rhi foP tory for days. In-depth analysis is performed and broadcast regarding the
possible cause of the crash and how it miglu
have been preventcd. Consider dut approximately 2600 dearhs, many of them as
sudden as in an airline crash, OCCllr cach rlay
in the U.5. from cardiovascular diseas'e
alone. This is greater than 10 jumbo jet
crashesper day. Yet, these deaehs do not even
make rhe news broadcasrs except when a
farnous person dies from a hearr attack, and
then if rhe disease j menrioned ar aII, it 1S
only as al) aftenhought, as if it was inevirabie. The llumber one cause of death deserves more ehorough a((emion in America.
SadJy, dearhs only reU parr of rhe s(()ry
of rh.is dreadful disease. Of rhe currenr U .S.
poplllarion of abolit 258 million, more (han
57 miUion people have some form of (his
disC<1se. 4 The annual cost ro America for
diseases of the hearr and blood ve. sels is an
astounding 259.1 billion dollars, which includes not OI1J.y rhe medical and surgical
rreatment, bur also Iose producriviry in the
work force. 5 It you personally happen ro
survive a snoke, u)e average lifetime coSt in
medical bills and lost earnings will be
$103,576. 6 How much bener ro prevcnt:1
stl'oke OI' a hean ;ltrack rhan ro pay for one
and stiU sufler the diminshed qualiry oflife
that is aJmost cenain ro foUow! No wonder

Clyde Yancy, M.D., president of the American Hearr Associarion's Dallas divi ion and
researehing eardiologist al' the Universiry of
Texas SourJHvesrern Medical Ccntcr in Dallas said recenr1y, 'No matter where somcbody is in rheir marurity process, young,
middle-aged, Of old incorporaring a heanhealrhy lifesryle i5 rhe mosr cosr ef1eerive
rh ing (har can be dane righr now." Nor
only is it COSt ef1'ective, but even more important wiU likely be life saving, and cerrainJy will be life-enhancing!
How can rhe number of beaI'( anacks
be reduced? What can a person do ro reduce th risk of a hean atrack? Dt. Ivan
Gyarfas, Chief of tbe World Health
Organization's :udiovaseular Disease Prevenrjon Program, explains that prevenrion
measures could savc a significant number
of people from premature death: "AbOlit
twelve milIion people die [worldwide] evcry year ofhearr problems, but up to hll1fof
them couJ.d be saved if bena prevention
programs were in effeeL"!
Although betta prevenrion programs
could Cut dearhs due ro heart disease (especiaUy coronary hearr djsease) by abollt 50
percen.t. evidence suggests that optirnttL prevemion programs could CUt hean disease
deaths by as much as 90 percent. In shorr,
although hean disease is by far the number
one cause of deau) in America, it does nor
need to be. Nine out of ten hN/r' attacks
I11I1Y

Diogram of OII Atlrerosclel'otic Plaq/le

Ulceralion
Dcgeneraling ce Ils

Fibrou' cap
Smooth ll1uscle cel1s

Artery

\Vall

S6

be p reventabIe!

The Development ofHeart and Blood

Vessel Disease
Man}' peopJe who have hean disease are
not aware of it. This is because heart disease usually develops silenrly. Before any
d~unage ro the heart occurs, a process called
arherosclerosis (or "hardening ofthe aneries") has been taking place in u)e aneries of
the hearr for many years. The earl}' phase
of atherosclerosis is called a "fatry srreak."8
The process of atherosclerosis is not COI1fined ro rhe heart aneries (known as "coronaryaIteries"). The term "coronary aner)'
discase" refers pecifically ro [he gradual
nanowing of arherosclerosis as it afTeers rhe
hean anerie.s. Large and medium sized ar-

HEART DISEASE
teries throughour tlle body can become narrowed by rhis bllildllp of farry marerial as a
plaque is formed, illllsrrared in Figllre 2.
Norice rhar rhere is more ro rhe process
of atherosclerosis man the buildllp of far.
When far accumlliares an rhe inside of rhe
coronary arreries (or any other acrery), rhe
body reacrs ro prevenr a blood c1or. Ir covers rhose farry deposirs wirh a tollgh. fibrollS
cap, as shown in the figure. This is an impoream response, because if f.rry material
is a1lowed ro carne imo direcr comacr wirh
lhe blood ir c.n stimulare the blood ro c1or.
The fibrous cap prorects againsr rhis deadly
dorring. In fact, this dual process gives arherosderosis ilS name. "Arhero" refer ro rhe
"mushy" or "gruel-like" fatry material ular
builds up inside rh aneries. "Sderosis"
describes me hard fibrous marerial made by
rhe body in response.
Unfoftunately, an atherosderoric plaqlle
can 1IIce.rare, causing a break in tlle prorective cap ;~s shown n dle ftgure. Wheo dus
happens, a combinarion offlbrous and farry
marerial is released ioro rhe blood srream.
A now smaller, eroded farty deposir, calted
an ulcerared plaque (somerimes called "Iesion"), remains attached (O r11e anery wall.
Borh the liberated farry marerial and the
u1cerared plaque irself can acrivare plarelers,
rhe body's doning cells. This often sers il1
mouoll a chain ofevenrs rhar can complere1y
obsrrllct any anery rhar is already significaody narrowed by arherosclerosis.? If rhis
or another process reslIlrs in complere obstrucron of a comnary anery, the hean
muscle rhar was dependent on [he blood
Aow in rhar anery will die. This dearh of
hearr tissue is calted a myocardial infarcrion
(MI), Of heart attack.
Atherosclerosis progresses at differenr
r:Hes in different people. The change over
rime in rhe arreries of a person who at rhe
age of 60 Of 70 wiU sllffer from hean disease is shown in Figure 3.1
Note mar cady atherosderosis is presenr
ar age 20, as shown ar rhe bonom of rhe
figure. This is commo!} in Wesrern narions.
1; f.Kt, it may be presenr arage 10 or 15.
By [he rime a person reaches 20, Farry stfeaks
can be so prominenr rhar rhe}' are elearly
visible when the coronary artery is cur open.

If rhe unhealrhy lifesr}'le continues, by age

30 the plaques progress ro become even
more pronoullced. By age 40, ir is noe unllSUal tO have significanc coronary anery
blockages rhar reduce the diamerer of the
anery by more rhan hali: Even ar rhis point,
rhe eflects of 30 years worrh of aeherosdef()sis will likely srill be "si lent. " Mosr individuals will have 110 sympeoms ar ali, as
nored on rhe figllre by the area labeled "a5ymptomaric."
Ifsymptoms do arist, rhey may be vague
or "arypical," or they may be c1assic "angina
peecoris," which is shown ill the figure as
rhe first symprom in rhe progTession roward
a hean arrack (shown as MI in rhe figure).
Angna pectoris refers ro chesr pail1 an exereion ar severe emorional srress rhar is USllally described as a heaviness, pressure, or
tighrness cenrered in rhe middle ar lefr side
of rhe chest. The pain can rravelup ro rhe
ncck Of jaw or down eirher arm. Occasionally there is also back ar sromach area pain.
A large meal ar cald wearher may also precipitate this paiu. l1 The symprom of pain
is GlllSed by an inslifficient blood slIpply ro
rhe hearr mllsc1e, reterred ro as "c(}ronary
illSufficiency" in the figure.
Currenr1y, approximare1y 6,750,000
people in rhe Unired $rares suffer from angina pecroris. 12 Unfortunare1y. mally have

Coronary
Insuf.6ciency Ischemie
(Angm.a
CardioPectortS)
myopatby

% of Artery Remaining Open

MJ

100
70
40
20

No Symptoms

10

AGE

o o
10

20

Congesti...e Hean Failure /

40

60

70
Figure 3

S7

PROOF POSITlVE
no such symproms umil they have their fim
hean attaek. Even llnder siruarions of significanr exertion, a hean aner)' musr have
at leasr 50 ro 60 percenr of its diameter
blocked before the hean musde suJfers from
lack of blood sllpply, which is the eause of
the pain. 13 Many individuals \Virh nanowing even in rhe 70 pereenr range ar greater
have no recognizable symproms.
As a result of ilie lack ofsympeoms, hearc
disease is often not derected in its earlier
srages. A person may feel grear, be working
full rime, and yet be on the verge of a major
hean anack aJld perhaps even sudden dearh.
Approximately 60 percenr of hearc aeraek
dearhs occur suddenly or ourside of a hospital before treatmenr can be adminisrered. 11
Over half of ali sudden dearhs (almosr (WOrhirds ofsudden deadl cascs in women) oecur in individuals who were nOt previously
diagnosed \Vith coronary artery disease. It
is a sobering realicy for many iliar r-!leir firsr
hean arrack is their ouly heart anack. Sudden death offers no second chances.
Even when people survive a heart anack,
over rwo-rmrds do nof make a complete rtcovery, leaving rhem with some form of disabilicy and a permanencly decreased qualiry of life. ' S Following a heact attack, rhe
hearc is weaker because of losr musde rissue.
This weakness can be signifieanc, particularly if rhe heaer atrack \Vas large. In
such a case, rhe hean may be unable ro adequare!y per[orm even ramine pumping
functions. This s an example of what is
callcd ischemie ctlrdiomyopflt/~y rcferred ro in
Figure 3. The rerm refers (Q a hean muscle
("cardio-myo") disease or parhology
("parhy") thar was caused by lack of blood
supply ("ischemia"). When such a diseased
hean is nor ahle ta keep rhe bod)' funcrions
going, physicians use ilie rerm "congestive
hean faiIure." In rhis situarion, an affected
individual may ger shorc of breath easily,
experience feer or ank1e swelling, or be generally farigued.
Ta prevenc these progressive steps from
leading ta a fatal or crippling hean anack,
it is unwise ro pur offhean evaluarions untiI symptoms develop. A variery of rem io5
availabJe ro diagnose hean disease before a

58

faral evenr, such as an elecrroeardiogram

(EKG) wirh or withollt a stress (rreadmill)
rest. A resting EKG can rcveal evidence of
previous hearr attacks, but ir is a poor cool
for detecti..ng blockages rhar have not yet
resulred in the loss of hean muscle. One
signilcant exceprion is rhe occurrence of
chesr pain. In rhjs siru3rjon, if a hearc problern is causing rhe discomfort, rhe EKG,
when performed while rhe pain is OCCllfriJ)g, wiU ofren idenri/)r a porential coronary
bloekage.
fn a person wirhom syrnproms, an EKG
srress re t is far superior for derccting coronary anery narrowing (ha.1l the plain EKG.
Even a 50 pereenc blockage of a single artery will sornerimes sllow up an a good scress
rest. Unforrunare!y, ho\Vever, even a streso5
test can miss a considerable number of diseased individuals. As many as 35 percellt
of chose \Virh signiflcanr hean vessel blockages will have a normal srreo5s EKG.1G The
number offalsely reassured individuals can
be reduced significan ly by che use of a radioaetive rracer ca1led Thallium or by doing the stress rest in conjuncrion wirh
emocardiography (an ultrasound resr of rhe
hean perforrned imrnediately befare and
after the steess re r). Giving an injeetion of
ThaHium at rhe maximum Ievel of exercion
on r!le srress rest ""iIl identi/)r ali bur abOlIT
eighr percene of individuals wid) hearc arrery blockages and aJI bur abour four percent if the echocardioaram is ur il izedY
Since coronary arter)' disease and c!lesr pain
are so common, as a practicing physici'lJl I
perform one ar more of dlese resrs an a dail)'
basis.
The mose conclusive tesr rhar can be
performed is a dye srudy of the hean and
its blood vessels. Ir is very good for idemifying bJackages thar are likely ro cause problems. Such dye srudies are sometime referred ro as "cardiac carheterizations" or
"coronaryangiograms." Unlike r!le previous tests menrioned, a cal'c!iac catheterizarion is an iJwasive rest (meaning we go inside the body wirh a cathercr). Once a
blockage narrows t!le diameter of the blood
vessel by 40 ro 50 percenr or more such a
dye srudy usuaily idemiiles the problem.

HEART DISEASE

The Different Kinds ofHettrt and

Blood Vessel Disease
As the rerm cardiovascular disease imattacks are nor rhe onl)' mani,
fesration of rhis disease. Strokes are 31so
ofrcn camed b)' athcrosclerosis. Complete
blockage ofa bran anery resuhs in rhe dearh
of any brain rissue that depeoded an rhe
blood flow in that artery. It is r11e deaeh of
brain riSSlle thar is called a srroke. Although
mosI people know tiut srrokes commonly
paralyze half of rlle bod~" fhel' can (ause
alher serious diHiculries. For example, rhe)'
can cause blindness, inabilry 1O speak or
hear, aod severe personal it), or memory
prablems. The actual problcms rhat accur
depeod on whar part of rne brain is damaged.
Arherosclerosis, as we have aJ readl'
nored, rends ro a/Tect aii of the large anei
medium sized bJood vessels throughout the
bodv. Some of rhe more common sires
\Vhe're atherosderosis tends ta accur are depicred in Figurc 4, along wirh rhe resulting
afllicrions.
Most of these affiictions can cause death;
such. dearJls would be classified as cardiovascuJar monality. The bodl"s largest aHery,
rhe aona, is commonl)' affeeeed by atherosderosis. This huge vessel (hal carries blood
direcrJy from the heart and is auached ta it
is especially prone ro problems called "ancurysms." Aonic aneurysms rypcally result
when the lning of ehe aona is weakened by
Jrherosclerosis. Because of the h.igh presSlll'es n this grear anely, rJle weakened wall
can baUoon aur like a bad spot on a rirc. If
rhis balJooned area gels large cnough, the
rissues will be roo thin ro conrain rhe high
prc8sure and the artery will burst. A ruptllfcd
aonic aneurysm is usuaJly a deam senrenee.
Massive internal bleeding oecurs literalJy
wirhin il mareer ofseconds or minures.
Two arreries dut branch off (he aorta in
rhc abdomcn are also prone ro arherosclerade narrowing. These are rhe renaJ aneries, the blood vesseLs thar supply rhe kidneys. rf one of these aneries becomcs significantly narrowed, a person can develop
high blood pres-sure, or-even wo[se~lose
rhe funcrion of that kidney enrirely.
pljcare~, he'lrr

Othet atherosclerosis-re1ated conditions

mally nOt cJ.use deam but will rob me gualiw oflife, allowing the amicted jndividuaJs
r~ live wirh varying degrees of misery. For
example, male impotence, leg pain when
waHcing (called "intennrrelH claudjcation"),
I imping, and gangrcnc can rcsult from atherosclerosis in (he femoraJ arteries in rhe
thigh, shown in the ftgure, Jnd posrerior
ribiaJ arreries in (he lower leg and ankle.
When atherosclerosis affect. he~u-t and brain
aneries, peripheral arreres supplying (he
legs and atms are often also narrowed. Gan-

MON ATl!JlA;iJl'II.~SC
LOCATION

AFFLICTION

Cerebral arteries

Stroke

Carotid
arteries

Hcart attack

Coronary
arteries

Angina pectoris
Ancurysm

Aorta .

Renal Arteries

r,;

Femoral arteries

Intermittent
claudication
Gangrene

l.tJ

Figure 4

grene can result in blood poisoning and

dearh if ampurarion is nor carried Out
promprJy.
Cardiovascular diseases c1aim ehe [ives
ofabolit one om of rwo people il) ollr COUJlrr)'. Bur rJlcre is good news. The major
factor in a.lmosr ali of rhese deaths is atherosclerosis-and arherosclerosis is a condjtion dut medical science has now demonsrrated ro bc preventable, tTeatable, anei
evm reversible. Let us now look ac the compelling evidence tiut will give you t!le keys
to a lifesryle program ro combar atherosderosis. aur focus will be primarily on hean
diseasc prevenrion, bur be aware rhar rhe
preventive factors \Ve iUuminat.e wiU help
addre s arherosclerosis in ali its varicries aod
loca(ions in the bodl"

59

PROOF POSITlVE

-_._-----_._~~~~~-----~.

-"

In Finland, 14,257 men and 14, 786 wOlllen:

lowered thelr cholcsterol' intake
lowered their blood pressure
stopped smoking

Results:

Focusing on ChoLesteroL

55% decreased dea,th rate in men

68% decreased death rat'e in women
Figure 5

DEAT S OM CO ONARY HEA

DISEASE
VS. CHOLESTEROL LEVEL IN MEN
600
500

In:tand.
Australia

HWIglUY

.CHD.400

USA

Deaths
Per

tOMOO 300
.aelgium
Switzerlaod
Itai)'

200

.Franee

100

o
200

225

250

275

Mean scrunl cholesierol (mgldl)

Figure 6

60

ing. high blood pressure, and hjgh choleste ro 1.

Addressing aII rhree can make a consielerable impact, as was illusrrated by a srudy
of some 29,000 Finnish men and wamen
over a 20-year period (1972 ro 1992).
When these individuals lowered rhe cho)esterol in t!leir diets, lowered rheir blood
pressure, <mei sropped [heir tobacco llse, they
recluced theu hearr attack risk by more than
half, as shown in Figure 5. 18

Keys to Preventing Heart Disease

There are some factors [har inf1uence aur
risk of heart disease tbar we can do nothing
about. For example, age and sex cannor be
ch:wged, )'er rhey have a significanr bearing
an cardiovascular risk. The older we are.
rhe grearer aur risk. Similarly, men are ar
higher risk rhan women of [he same ageparricularly in [he years before menopause.
FOfruna[e1y. however. medical research dernonsrrares thar we can ChaJlge a number of
factors dut influence our risk of hean disease. The duee mosr imponanr modifiable
heart disease risk faerors are cigarette smok-

Smoking and high blood pressure are

each related ro so many differenr healrh isstles that rhe}' warrant individual chapters.
We wiU examine lhem more closely iarer in
the book. Cho)esrerol, an rhe alher hand,
is of primar)' irueresr becatlse of irs specific
role in heart disease; eonsequendy, we wiU
fOCllS on it here. However, before leaving
rhe impression mat eholesrerol is only aJl
isstlc as il relares to increasing hearr djsease
risk, J must emphasize rhar eholeslerol is 3n
imporraJH and essenrial natural compound.
This white, waxy f.-H is manufacmred in aur
bodies and is used LO builel cell walls and
make certain hormones. However, roD
much cho[eslero) in the blood srream (callee!
"serum cholesterol") can conrribure ro a[herosclerosis. For this reason, high blood
choleslerollevel as a single factor correlates
wel! with eoronary hearr disease dealh rare.
Ir is recommended rhar aII Americans over
[he age of 20 know wha[ their LOcal blood
cholesterol and HDL are. 19 The higher [he
choleslerol level d1e greater [he death rate,
as demonsrr;)red in Figure 6.
This graph shows lhat [he average serum eholesrerol level in 19 coumries is a
predicror of [he risk of hean disease among
men in those narions. 20 Note dur Finland
tOpS rhe seale, wirh a very high average choleseerol and a very high death rate. The
Unired Srares is also relarively high an both
seales. Ireland and England are higher than
Poland, Yugoslavia. and Japan.

HEART DISEASE

Lowering Cholesterol Protects against

Heart Disease
How ean we ehange rhese high levds of
cholesterol rhal are liJ)ked to hundreds of
thollsands of needless deaths every year? We
gain some insighls iIlto an allswer by s(lJdying the example of ilie Japanese. In rhe figurc, Japan s at the bouom of rlle sca.le for
heart disease aldlOugh rheir smoking rate is
much highcr rhan here in the Unreei Srat~s.
Japan is ranked number 10 in the worIeI in
s'l'loking, wirh 59 perecn( of ]apancsc men
and 14 pereent of Japanese womell smoking. On the olher hand, the Unired St3res
ranks 78rh wirh 28 percenr of American
men and 23 percenl of American womer,
smoking. 21 Why, rhen, is eheir hearr disease rate lower tl1an ours? le appears ro be
due tO their signifieanrly lower average eholesrerollevels. The Japanese staliseics provide one piece of evidence suggesring dur
on a worldwide sC<lle, cheleslerol is the mose
importam risk faCtor for hean disease.
A man wirh a serum ehelestera! over 240
mg/dl (or 6.2 mmol/L) has more [han (hree
rimes rhe risk of dl'ing from a hean attaek
rhan a. maT\. wirh less rhan 200 mg/dJ,22 as
illustrated in Figute 7.
Nore rhar the inerease in risk is mosr
pronoullced when cholesrerol levels climb
over (he 240 mg/dl mark.
We have aJready observed ehar hean discase and atherosclerosis bcgin earl)' in life
il) \'\Iestern nations. Individuals 30 l'ears of
age and younger have comrnonly been
found ro have deposi(s of a(herosc!erorie
fmy srreaks an rl'e nner waUs of their arrerie!;. The size of the wal! area rhar is cavered is grealer in individuals in chis age range
\Virh high blood choJestcrollevels, as shown
in Figure 8. 23
Note that those with a cholesterollevel
of230 have over 50 percenr of (heir blood
vessels' surface area covered with earIy arherosclerorie fatry s(reaks. This amounrs ro
roughly five times ehe amounr of fauy
buildup (han thar of a person wirh a more
ideal cholesrerol level of 11 O. T!le evidence
is elear: high blood cholesterol does damage ro (he ane.ries even in people undtr 30.
Some people misrakeoly J.Ssume rhar heart

200

183

150

Mortality
Risk
100

ss
50

0----200

200-219

220-239

240-259

260+

Cholesterol Levcl

Figure 7
discase is reserved for rhe e1derly, bur 5 percerU of ali hearl attacks occur in people
under rhe age of 40, :Ind 45 percen( of aII
hearr ae.tacks occur in people under (he age
of 65. 2,1

What is the Ideal Cholesterol Lellel?

Somc experts have fOf years asscrred (hat
andeal cholesterol is 100 plus l'om age,ZS
Suppofr for this value cornes from a number

60
50

40

Pcrecut Covcrcd 30
20
iiI
0

_
110

140

170

200

230

Serum Cholestcroi

Figure 8

61

PROOF POSITlVE

CHOLES
OL ABOVE 50 INCREASES
OFDEATHF OM EART DISEASE

SK

18
16

14
Death
Rate
12
per J,OOO
10
Meu
8
6
4

160

140

180

240

220

200

260

280

300

Serum Choleslerol

Figura 9

H GH
CO

C O ES
A
A

J&.4nJAJ

-------

_._"-

--

lOO . -

Male
. Beart
Attack
Victims,
Rate
per
1000

1511!

100

so
Il

75+

74-65

64-55

54.45

44-35

34-25

LESS
THAN
2S

HDL Cholesterol (mg/dl)

lOII

Female
Heart
Attack
Victims,
Rate

J!'/l

>----

per
1000

75+

74-65

64-55

54-45

IIDL Cholesterol (mg/dl)

Figura 10

62

44-35

U:SS

THAN
25

of perspecrives. Two examples may prove

helpflll. Fim, when inrernational comparisons are made, cOllnuies with e)(tremely low
risks of hearr disease (end to have average
cholesrcrollevels rhar run 100 plus (heir age.
Second, extcnsive dara an rhe U.S. popuLa(ion was garhered in rhe course of the Multiple Risk Factor Intervenrion Triaj
(MRFIT). Among rhe more rhan 300,000
men studied. rhe risk of death frorn hearr
disease beg'ln to increase \Vhen total choLesrerol exceeded ) 50 mg/dl, as shcwiI1 in Figure 9. 6.27
A cholesrerol level of I 50 is fU' below
rhe 200 level whieh m,llly people misrakenly think is ideal for rhe U.S. Furrhermore, rhe 150 levelrepresems a value of 100
plu aoe for an average 50 year old-a firring guideline for an age group rhat is ofren
more aware of cheir hean disease risk factors rhan younger individuals.
Much confusion has eorne from che initial repon ofThe National Cholesterol Eduearion Program rhat provided a public
heal(h goal when rhey recommended eholesterol va.lues ro be tess than 200 mg/dJ.28
This level is an excellenr number for public
healrh workers and policy pLlIlners to ser as
a goal for every American, considering fhat
97.2 million Amcricans (52 percent of
adlllrs) have serum cholesrerols in excess of
200 mg/dl. 29 In fact, if cvery U.S. citizen
reduced his ar heI' cholestero! ro {har level,
counrless rhousands oflives wOllld besaved.
However, if you, personally, wanr ta have
rhe lowesr risk of hean disease, you would
be much wiser to adopt as a personal goal
100 plus your age. There is a vast difference bet\'v'een a goal for the popula(ion ar
large and a personal gaal for an optimal
chole rerol.
Allother problern wirh rranslating u)e
panel's original public healrh gaal inro indjvidual reeomrnendarjons was rhe faer (har
rhe guidelines clici not address rhe all-importa.nr subrypes of cholesrerol. (This subjecr was fonunare1y reerined in rhe second
repon issued by rhe National Cholesterol
Education Program Expert Panel.).lO Le( us
e.xamine rhese sllbtypes.

HEART DISEASE

Chalesterol's Subtypes: HDL and LDL

Choleseerol nevec tcavels alone in ouc
arreries and veins. Ir alway rravels in differene carriers ar vehicles. Each rype of vehicIe has a differenr weighe ar dcnsity. Ouc
ro rhis faer, we can put blood cholestcrol in
adevice called an u!cracenrrifllge ancl divide
it imo fmerions according ro the density of
ies vehides. The heaviesr carriers of cholesterol are caUed HOL ar high dcnsiry lipoprotein. Some ligheer weight carriers are
named low densiry lipoprorein (LDL), whilc
a scilllighter vehicle is caUed very low clensit)' lipoprotein (VLOL).
Today we are able ro llse rhese cholesterol fracrions as bener indicarors of hcart
disease risk rhan [Oeat cholesterol levels
alone. For example, HOL acrually proeeces
liS [rom heart disease. The reason for chis is
rhat HOL accually removes cholesecrol from
the areeries. 31 The HDL vehide then carries that choleste.rol ro rhe livcr, whcre ehe
bod)' disposes of the fauy material ehrough
the bile. The benefirs of a high HOL cholesterol levei in both men and women are
illustrared in Figure 10,31 .
The upper part of ehe figllre shows male
heare auack vicrims, anei ehe lower part
shows female hean aerac1<s. Noeice duc in
chis scudy there was nor a single hearr <1[eack among men with H D Ls greater than
75 mg/dl, but when ehe HDL was less than
25 mg/dI, the risk ofa hearc attack was ve!"y
high. Women wirh an HDL cholesrerol
greaeer [han 75 mg/dl ..1lso had low risk of
hean dise.ase. Those wieh HOLs less ehan
35 mg/dl bad a dramatic rise in theiJ coJ'onary hearc disease risk.
LOL (Iow densiry lipopcotcin), an ehe
orher hand, is the so-called ('bad choleseerol"
ehat is linked ro an incretJJed risk of hearc
disease. f[ is probably a cercain rype ofcholesterol wiehin LDL ehae is rhe bad acror,
n..1me1y, ox.idized choJesterol. brer in ehe
chapter we will explore this tox.ic compound
in detail. For now, lce me affirrn che wellknown face ehae ehe level of LDL in ilie
blood s an imporcam determinant of rhe
rate at which cholesterol is dtjJOfited in the
arter)' waLIs.
Now tlue we sec ehe effeces of che cholesterol subrypes HDL and LOL, let llS review

leEP initially recommended that for individuals wjth a

total cholesterol of 200 or less, there is no oeed to test
for the Icvel of choJesterol subtypes HDL aod LDL.

A person with 160 LDL Of 35 HDL would be in the bigh risk

category for a heart attack, but could bave a false seose of
security if he knew onJy his total cholesterollevel.
Amoog individuals with total cholesterol
below 200, 21 % have high LDLs aod
66% have low HDLs.

Figure 11
the practice of using the coral choleseerolleveJ
as an indicator of risk of heart disease. The

problem with simply focusingon the National

CholesteroJ Eeluc;lrion Panel's (NCEP'S) initial 200 mg/dl gllideline for roral cholesterol
is explained in Figure 11.33
Individuals wieh high risk HOL and
LDL levels but with a eoeallevelunder 200
would be misseel if they imply haei a roral
cholesterol reading; iliey woulel receive a par
an rhe back beclUse rhey were below (he
200 cucoff poinr.

AL
Mean Ratio
... - ~--

Total Vegetarians

2.8

Boston marathon
runners (pbysicians)

3.4

Average risk (women)

4.4

A verage risk (men)

5.0

Average CHn victim (male)

5.5 - 6.1

Average

cun victim (female)

4.6 - 6.4
Figure 12

63

PROOF POSITIVE
In shon, ifwe merei)' followeel rhe Educarion Program's original recommene!atiOlls,
we would only pick lip 59 percenr of rhe
. people who are ar high risk of a heart art:1ck. YOIJ can beuer une!ersrand )lOW why
ir is importanr ro look ar rhe total blood far
picrurc with HDL aneI LDL as well as tot:11
cholesrerol. Unfortunarely, ll1:1ny lay people
aneI healrh professionals still seem ro holel
the concept rhar if total cholesterol is under

C".Il'lLJ'JWJ:;.JlJTE O
Cholesterol is found

Fruits, vegetables,

only in animal foods.

grains, and nuts con 'ain

DO

cholesterol

Figure 13

Items (3 Oz.)
Fruils
Grains
Nuts
Vegetablcs
MiiI<. nOD-fat, 1 t
MiiI<. 2% JOW-fllt, It
MiII<. wbole, le

Egg while
Mayonnllise
Ite cream, 1/2 C
Buttcr, 1 Tbs
Egg, (Iargc

DrumSlick & skin

Drumslicl<. DO skin

Figure 14

64

Cltol. (mg) 1tems (3 Oz.)

_CJw/. (mg)

TUDa

O
O

Clams
Crab
Cbieken b,-cast, DO skin
Pork
Beer, sirloin
Chicken breast & skin
Oyster
Sardines
Sbrimp
Beef kidncy
Beef liver
Caviar
Bedbrains

O
4
18

33

o
8

29
31
213

47

60

26
57

64
73

200 rhere is no neeel for concern.

One \Vay oflooking ar borh HDL and
(Oral cholesreral \Vid1 a ing1e value s ro look
ar the rario of rhe rwo. This provides a betrer indicarion of hean disease rsk rhan by
looking ar eirher value alane. You cao appreciare the valuc of rhi rario b)' looking ar
some example.s listeel in Figure 12.
Nore dur vcgerarians have an average
toral cholesrerol to HDL rario rhar is 10\V,
ar 2.8. 34 Veg rarians generali)' have a very
low rsk of hean di case, a f.1C( we will furrher explore Jater in rhis chaprer. Boston
Mararhon runners are aiso ar low risk for
hearr disease; d1eir ratia is 3.4. These desirable low levels can be compared wirh (he
average AmeriGU1 woman who has a rario
of 4.4, or rhe average mall who come in ar
5.0. Although many peaple would feel secure ro be 'average," average is nor reali)'
desirable in a counrry whcrc more peop1c
clie from heart disea e (han any other c~use.
Thi, is emphasized b)' rhe t:1Cr rhar rJ1e average hearr auack vicrim has a total cholesrerol ro HDL ratio rllar is very dose ro average for d1e whole popuJarion. The r)'pical l11an wllo has a hearc anack has a rato
grearer (han 5.5. 3nd rhe average female
coronary hean disease vicrim has a ratio
grearer rhan 4.6. In orher words, if you arc
a woman and your roral cholesterol ro HDL
rario is greater rhan 4.6, or ifyau axe a man
wirh a ratio above 5.5, you are right where
rhe avcrage hearr arrack vicrim is. The mcssagc is thar before a hearc arrack srrike
adapr a bettcr Ijfesryle program. Tly ro ger
yOllr total cholesterollHDL raria inro d1e
ideal range-3.4 or Jess.

76
80

82
84
120

165
329
4JO

500
J697

How to Achieve the Best

Cholesterol Levels
How can we improve aur cholesreral
levels? Specific:'llly, how can we decrease
toral cholesrerol and LDL and at rhe same
rime raisc HDL? The answcr ro rhis question i. exrreme!y important. To fully appreciarc rhe 3l1swers, however, we musr
rnake sure we undersrand where cholesrerol
comes ham.
Ir is of primary imporr:mce rhar we recognize rhat our livers manufacrure more

HEART DISEASE
lhan cnough cholesterol for aII aur body
fllllclons. For Ihis (eason, we do nor need
ro ear an)' cholesterol wharsoever. In orher
words cholesterol is total61 unnecessa'y in the
JJUmllJ1 diel. However, many of us get signiflcanr amOllnl of cholesterol from our
foods. rn faer, rhe average American ears
about 300rng of cholesterol every da)'.35
\'<fhere does alI this chole 'terol come from?
Figure 13 gives us rhe answer in simple
lerms.
Nor.e that aII lhe cholesterol we eat comes
rrom animaJ producrs. It is critica1 d1ar we
ullderstand rhat frujcs, vegerables, grains,
and even nuts comai n no cholcsrcrol. Tf
[he food COll1,es exclusively from planr products, rhen it has no cholescerol in it. On
lhe ocher hand, if the food producr cornes
[rom an animal, ir almost always has cholesrcrol in it. (A few exceprions exisr where
the cholesrerol-coruaining porrion of me
animal product has been removed. Egg
whires wOllld be rhe main example of rhis.)
Funher information regarding dielar)'
sources of cholesterol is rabuialed in Figure 14,36
AII would be wise ro pa)' eareful attenlion'ro tnese examples in the figllre. AJThough most people rnay be aware mat organ meats such as liver and kidney are
among rhe mosI' intense sources of cholesterol as rhe figure shows, many sTill do nor
undersTand the basic prevalence of cholesterol in an.imal foods. They rhink that if
rhey eat chicken, rurkey, OI' fish they are nor
getting cholesterol. On the contrar)', we see
(haT every animal produc( conrains cholesleroI. AJso, Take note rhar chicken cO\1rains
abOlit rlle same amount as pork and beer
This bad news abour "white mear" has nor
received much press. Funhermore. many
kinds of f1sh have a high cholesterol con-

1600

1200

Dletary
Cholesterol
(mg/day) 800

400

20

40

60

80

Change in serum cholcsterol (mgldl)

Figure 15

lf aur inrake is gre.1ter rhan 900 mg, nor

mueh funher increase in serum cholesterol
oecurs. Forrunarely, OUl' bodie have protecrive mechanisms ro keep blood cholesterol from going sky high a~ter consllJlljng
extremely large amounts of cholesterol.
The curve in (he figure also shows mar
we can dramarically drop aur cholesrerol
level by decreasing ehoIes(erol inlake subslanrially below dur 900 mg dail)' level. For
exarnple rhe f1gurc shows mar dropping tbe

Cooking fats 6.0%

Other 8.0%

Tent,

To \Vhat extenr does our jmake of cholesterol affect our blood cholesrerol level?
The more cholesrerol we ear, me higher Dur
blood cholesrcrol lends ro bej as shown in
Figllre 15,37
Noticc rhat as our inrake of cholesrcrol
increases, it is reflecled as an increase in senun cholesterol. An in crease of 75 pointJ
can occur if we consume 900 mg per day.

Milk products

16.0%

Egg yolk 35.:,0%

Figura 16

6S

PROOF POSITIVE

o
L1Blood cbolesterol, mg/dl

= 1.26 (2.L1S - L1P) + 1.5L1[4C]

S = Saturated Fat (% Calories)

P = Polyunsaturated Fat (% Calories)
C = mg Cholesterol (Per 1000 Calories),
fj.

= change in intake

Figure 17
cholesrerol in your diet from 900 mg ro 200
mg daily may lower l'oul" cholesrerol 50 or
60 poinrs. Norice (har you get even more
benefit when you elrop )'our cholesterol below 200. GOillg from an inrake of200 mg
per dal' dOV.rtl ro no cbolesterol in your dier
ma)' drop your blood levels anorher 20
poims. The imporr.an[ message is rhat l'ou
can dramarica1ll' lower your cholesterol by
removing aII cholesrerol (ali animal preduers) from l'our dier.

TypicalSources ofDietary Cholesterol

66

Ame6cans get mOSt of their cholesterol from meat and eggs, as shown in
Figure ] 6. 8
Note rJ\ar 35 percenr of the cholesrerol
conSllmed in Anlerica each da)' comes from
meat, fowl, and fish, and anather 35 percenr comes from eggs. The cooking [1.rs and
oils rhar contain cholesterol are ani_mal in
origin, sllch as buneI', lard, anei orher fat.
Conunercial baked goods rend ro use lard,
which accounrs for eight percenr of the cholesterol consumed per day.
This figure show that we can lower our
cholesterol inrake by 70 percenr just by
e1iminating eggs, red mcar, pou1rry, and 6sh.
Of course we can lower it even funher JUSt
by e1iminaring more of ilie an.imal producrs.
lfwe realll' want ro eliminate ali the cholesrerol in ou r d ier, essen [ia L1y ali animalproducts must go.

Animal Fats Contribution to

Cholesterol Levels
50 hlr we have seen rhar e!ev:ued blood
cholesrerollevels are closely associated wirh
faral hean disease. We have also nored thar
cholesrerol in rbe diet wiU rase blood cholesrerollevels. There are a number of orher
facrors, however, rhar contribure ro elevarcd
cholesrerollevcls. Some ofthese facrors were
c1arified by one of the grear cholesrerol pioncers, Dr. Ancel Keys. In the 1960s, Dr.
Keys demollstl'ared hs abilir}' ro predcr
with asrounding acclIracy rhe average blood
cholesterollevels of population groups. AlJ
he lIsed was il knowledge of rheir habitual
diers in order tO make lus srartling preclicrjons. Unforcunare!y, rhere was tOo much
genetic variabiliry from person ro person ro
do rhis on an individual basis. However.
when looking ar large groups of people, rhe
ave rage generic rendencies rended ro be
similar from one popularion ro rhe neXL
Thus, Kel's could make his cholesrcrol predictions baseel on habirual food choices
alone-withollt deaJing with genetics. He
devised il marhematical formula rhar fir rhe
dara. This equacion is ofren referred to as
the "Keys Equarion" and is illusrrated in
Figu re 17. 39 Those with a marh backgrolmd
will find the equarion illuminacing. Wirh.
out goi ng [h rough rhe ca1cu1arions, OI'. Keys
preves with rhis eqllation thar, apan from
geneucs, aur blood cholesrerol level is derermined by our dier, and essen.[ially only
duee val'iables in the diet: saturated fat (5),
polyunsarumed fat (P), and cholesrerol (C).
Many people do nor lInderstand the difference berween rhe rwo [1.rs. Imagine thar
you are sitting in from of two 1O-galion glass
f1sh ranks. Each rank is filled with fat. One
is filled emirell' wir11 saturareel far, and the
orher wirh polyunsatllrated. Ir would be
easy ro rell rhe difference ben....een the rwo.
The satllrated f.1.t would be solid at room
temperatllre and the polyunsaturated far
woulcl be liquid. Generally, rhe more solid
tJle fat, the more saturated it is. Mosr fars
from animal products are predominately
sarurared, while most planr prodllets are
high in po!yunsaruratcd fats. We willlook
ar specific examples sbortly.

HEART DISEASE
With a basic undersranding of rhe three
rerms uscd in the Keys eqllarion, ler me now
explain whar the equarion rdls LIS. Firsr, it
asserrs thar borh satllrated fat and cholesrerol in rhe dier rend ro raise blood cholesrerollevels. Second, it rnakes rhe poinr (har
sarurared far is mllch more porent ar raising your blood cholesrerol rhan even dierary
d1olesrcrol irself. Third, polyunsatllrared fat
rends ro Jower cholesterol in rhe blood.
However, sarurated far has rwice rhe power
ro raise your eholesrerol as polyunsarurated
far has ro lower it. Expressed anorher way,
ro caneel out rhe eholesrerol-raising effeets
of a given amoulH of saturared fat, yOll
would have ro ear lWiee as much polyunsalUl"ared far. This faer can be u cd tO judge
whether rhe far contenr of a given food will
raise or lawer your blood cholesrerollevel.
Since alI naturally oceurring foods have a
combination of fars in them (both polyunsatufared and satll'dred), you ean divide rhe
3mounr of pol)'llnsalurared fat in the faod
by the arnounr of saturared fat in ir, and
cnd lip wirh whar is called a "{l ro S rario"
(abbreviared "P/S ratia"). rf rhis P/S rario
is greater rhan 2.0, the fat in the food \ViII
rend ta lawer one's blood eholesrerol leve!.
Be aware rhat th is ratio rdls us nothing
about mher factors in rhe foad (Iike cholesterol irself, for cxample) rhar ma)' affect a
person's cholesrerollevel.
Since a high P/S ratia in aur diet will
tend ro lower rhe blood cholesterol. we need
ro be awal"e of the ris ratia of eommon
foocis. This raria is [isred in Fgure 18 for a
variet)' of foods. 40
Nore thar many of rhe animal producrs
such as beef. venison (deer), Iamb, and bacon have extremely low rIs rarios. These
foods, based on rheir far courenc, will rend
ro dramatically raise an individuaJ's serum
dlOlesrero!. Thus, red meats are undesirable nor anly because [hey conrain cholesterol, bur rheir harmfulness is compounded
because rhey conrain 50 much S<1rurated fat,
and so !.irue polyunsaturated far. The same is
rruc ofmilk, burter, and cheese. Chicken aod
rurke)' have lcss sarurarcd fat
red meats,
but their P/S rarios are stilllower rhan rwa
ro one, so rhey, roo. will r;lise eholesrerol
levels. One of rhe greare t mYlhs is rhar

mao

chicken, {Urkey, and fish lower a pcrson's

cholesrerolleveL These foods actuali}' raise
a person's cholesterol, but rhey raise it less
than red meac does. As a resulr, a person's
cholesterol may go down when leaving off
red meat and subsrituring fish and faw!. But
ule drop in cholesterol level occurs because
chicken, rurkey, and fish raise one's cholesrerolleve11ess than red mear, nor because rhey
have a cholesterol-Iowering effecr.
1 have had people came inco m)' office
and tell me, "1 JUSt can'{ understand what is
happening. r have been eating mostly
chicken and rurkey but my cholesterol stiU
has nor carne down that much!" When you
understand the rIs ratio, it tdls where parc
of the problem lies. Furrhermore, as 1 menrioned earlier, chicken and mrkey have as
much cholesterol in r11em as do the red
mears. We will sec /ater thar some of rhe
cholesterol in fowl is undoubtedly oxidized.
Switehing from one kind of meat ro another
is simply not the uleimate solucion for cholesterol COntrol.

Animal
Ave. selected fish
Turkey
Cbicken
Butter
Milk
Checse
Beef, lunch mcats
Bacon, decr, Iamb

PIS rlltio
1.80
0.87
0.76
0.11

0.11
0.09
0.09
0.17 - 0.50

P/allt
Walnut, black
Walnut, English
Rickory nut
Pecao
Almond
Brazii Nut
Filbert
Pistacbio
Cashew
Palm oii
Coconut

PIS ratio
10.33
6.90
3.11
3.08
2.21
1.49
1.30

1.20

0.86
0.20
0.01

Figure 18
The Story is simjlar wirh fish. Some fish
have favorable {lIS ratios (grearer than 2.0),
bur many orhel"s do nor. Furchcl"more, ali
fish eomain cholesrerol. In shon, flsh, like
fowl, if sllbsriwred for red me;:lt, will tend
ro lower eholesterol levels, possibly even
more rhan fowl. However, yOUl' eholesterol

67

PROOF POSITIVE

1.2
).0

1.0

Nonfatal MI

1.0

FataJMI

0.8

Relative
Risk of 06
Heart .
Attack
0.4

0.2

o
Frcquency of Eating Nuts
Figure 19

levels would be Iowa yet ifl'O\! lefr chicken,

rurkey, and fish completc/y out ofyour diet.

Vegetable Fats Effeet on Cholesterol

In conrrasr ro animal faes, vegerable fars
have no cholesrerol ar aiI. There are differeor kinds of vegetable f.us, and aiI bur a few
are highJy polyunsaturared. In figure J 8,
notce that coconut has a P/S ratio of 0.01.
This s a highly saturated far and will tend
ro raise cholesrerol levcls. Although coconur has no cholcsrcro\' irs s;lrurared fat coo-

"With nuts may be combined grains, fruits, and some

roots, to make foods that are healthful and
nourishing. Care should be taken, bowever, not to
use too large a proportion of nuts.
...some nuts are not so wbolesome as otbers.
Almonds are preferable to peanuts, but peanuts in
limitcd quantities, used in connection with grains, are
nourishing and digestible."

Figure 20

68

eent dramarically inerC<lses blood chole terol. On rhe orher end of the specrrum,
walnurs can have a rarher dramaric effen in
lowering an individual's choleseeroL
Mosr nuts, in view of eheir fat conrenr,
are "hean healthy" foods, as shown in rhe
figure. Nurs in general have been stlldied
extensively and have been found nor only
ro lower blood cholesterol levels, bur also
ro proviele a corresponding decrease in rhe
risk of hearr disease, as shown n Figure
19.11. 42
This stllcly on Ilm consumprion was
conducted at Loma Linda Universiry and
has received nrernationaJ arteruioll. The
inirial srudy focused on rhe ;Jmount of nuts
eaten by rhe panicipams in rhe Adveruisr
Health Study. They found rhar {hose con
suming nllts less mall once per week hael
the highesr risk of hearr arrack. 1 hose who
consumed nllts one tO four rimes per week
lowered their risk abollt 25 percent as ShOWI1
in rhe figure. Those who consumed nurs
more rhan five rmes a week Cllt their risk
in haH: The s[lJdy was cOJ1rwlled for other
lifestyle variables so rhar the researchers
could be more certain rhar che nuts were
che onl}' t:lCror involved. Many health professionals were surprised by the findngs of
chis srudy. Previously, healrh professionals
eommonll' t:l1couraged pacients ta avoid
nurs because of rheir high far Gomene. Now
we know that nuts in small ta moderare
amOllntS are parc of a healrhfl.ll elier because
dley supply some fac nurriems mac are beneficial for preveming hearr disease.
Regarding peanurs, dle fae in peanurs has
a specific chemisrrl' and triglyceride srructure (apan from rhe sarurared anel polyunsaturared comem) thar makes rhem surpl'isingly harder an your arrcl'ies rhan ocheI' vegerable fars. 43 Thus, a person who wanrs !O
proteet his arteries would be wise ro choose
ocher nurs such as almonds walnurs, or
pecans in place of peanurs. AJmonds have
another advamage. They are unique among
rhe fim food group in thar rhey conrain far
moreviramio E rhan orher oucs; in t3.ct, they
exceed just abolit aiI omer foods n rhis regard. We will sec larcr rhar vitamin E redllces the risk of hean discase. The realization ofsome of peanur fat's negarive aspects

HEART DISEASE
leaves me impressed widl a sraremenr 1 read
about I1lItS thar was wrinen nearly 100 years
ago in rJle c1assic book on rhe principles of
healrh, 77u Ministry ofHi?t1/ing, wrineo by
Ellen W11re and quored in Figure 20. 44
Why did she wam against excmive nut
consumption? One likely reason is thar a
high fat dier (even jffrom ugood fats") rends
to promore weighr gain. For manl' people.
a Iarge a proporrion of nuLS in their dier may
contribure (Q obesiry. The overweighr conditon iLSeif can raise cholesterol levds and
increase rhe risk of hean disease and orher
healrh problems.

The \!ery Low Fat Theory

The research on nurs has helped tO lal'
to resr a popuJar bur ficririolls approach ro
hean disease prevenrion somerimes called
"(he verl' low fat r11eory." For years, many
have advocared that ro ma.ximalll' reduce rhe
heart aHack rare we musr cur rhe far in large
amouncs, (O abour 10 percenr of caIorie.).
Some people have become f,UllOUS by advocating such a verl' low fat diec. Unfortunarell', very low far diers are oh:en not palatable and are nor necessariJy the arlswer to
reducing heaf( disease risk. lfthe far is coming from monouJlsarurated and polyunsarurarcd sourees, a higher far dier ean aCluaJly
be as good for rhe heart as rhe vcrl' low far
fare. The Commirree an Diet and Healrh
of me National Research Council said this
in so m:tny words when rhel' posed ule gllestion, "Is d1e very low far rheory correcr?"
From a review of ilie currenr [jrerarure, rhey
concluded, "No." Thel' went an ro state,
"L1rake of (Otal fat per se, independenr of
the relarive comem of rlle djfferenr types of
f.my acids, is nor associated wirh high blood
cholesterol and coronarl' hearc disease. "45
We now know rhat we can have a healthful
dier thar incIudes moderare levels of fat if
we are using (he besr types of fat.
After (he 1992 srudl' of nurs and cholesterol, Dr. Sabare rook (he nur research a
srep funher. Insread of using Sevcnrh-day
Advenrists again, who are already an a berter overall dier than mosr Americans, he now
studied inruviduals an an average American dieL One haJf of rhe rora.! group was
placed on an average diee The o(her half

were feel an identical-looking diet W1(h one

major difference. WaJnurs were blended lip
and added to various food tems. Orher
sourees of fat were decreased ro keep rhe
calorie and roral far levels the same in the
rwo groups. The effects an cholesrerolleve1s are shown in Figure 21. 46
Earing walnurs daily hac! some amazing
results. LDL cholesterol, the "bad cholesrerol " dropped by 18 point". This represel1ts a remarkable lowering oChean attack
risk. For each percenrage poinr drop in rhe
bad cholesterol, (here is a rwo ro duee pereenr clrop in rhe hearr arracl< rareY An 18
poinr drop in LDL translate~ inro a 36 ro
54 percenr elrop in hearr eli ease risk. The
benetts of walnurs ma)' nor simply be due
ro rheir excellenr P/S rario. These nurs are
also high in so-caIled omega-3 fatty acids,
which have some special benefirs. Chaprer
5, "Tile 1rurh About Fish," has more informarion on rhis subject.

Other Fat Factors

Although P/S ratios offoods are importanr, rhey do nor necessaril)' provide the final word an wherher a fat is good ar bad.
They do give liS an excellenr idea of where a
food srands in relation ro its fat content.
However, rhings are JHOre complex rhan

The study group ,ale 1% cup (84

grams) of walnuts daily for
4 weeks.
A verage LDL (bad chol.esterol),
was reduced by 18 (mg/dl).

Figura 21

69

PROOF POSITlVE
Keys originaUy elwisioned. Some satLIrated
fats are extremely bad while orhers are not
very difficllir for rhe body to dcal wirh.
Si~ilarly, not al! foods thar ;re high in polyllnsarurarcd fars provide equaJ heart benefic. Margarine is an example ofsuch a food.

Margarine
Margarines were fim thought tO be beneficia] because they had a higher polyunsarurated far con tem than buner. Some tub
margarines hoast a P/S rario grearcr rhan
4.0. Most margarines, however, are !lOt
narural products. Thesc POPUlal' sprcads are
rypicaJly nude rTom vegeeahle oiI, such as
corn oii, which is heated under pressllre ro
paniaIly hydrogenare (saturate) il sa rhar ie
becomes a spreadable, soljd (lt ac room remperature.
The hydrogenation process alrers some
of the fat in rhe vegetable oii by changing
rhe microscopic shape of rhe fat molecules.
Normali)' fatry acids (the building blocks
offar) are found in nature in what is called
rhe cis form, which refers ro rhe molccnles'
rhree dimensional appearancc. The hydrogenarjon process changes somc of rhese
molecules inro the tram form. Ti-arts fany
acids, unlike cheiI' cis counr.erpans, significandy raise rheserum cholesterol and LDL,
even thollgh rhey are poJyullsaturaeed. 48

Womc.n who eat 4 or more teaspoonfuls of margarine a

day have a 66 per."centgreater risk of hear,t disease than
women ",ho have margarine less than once a month.
The trans~fatty ada J.ev,els in margarine s,eem to be the
pro'Mem.
"Vege,table oils should be used in their natural state,"
said the lead researcher.

Figure 22

70

This risc in choJcsrcrol corre1arcs with rhe

cffen of margarine an heart disease risk
measured in an eiglu year Harvard University study. The findings are summarized in
Figure 22.,19
Trans fatiy acids have also been implicated in callsi ng cancer. 50
AJI of ehese facrs suggesr that i( wOllld
be bener ro sprcael a little nut burrer, llcb
as alrnond burrcr (a favorite of mine) an om
breacl (han margarine ar buner. Anothcr
op(ion would be (O I'eplace margarne ou
aur breael with canola (rapeseeel) oii ar 01ive oiI. Ei(her ofIhcse oils could he brushed
on (he breael. In a srudy of margarine llsers
who consen(ec! ro re place margarine an ilicir
bread by rape-secel ar oJive oiI, (here was a
distinct rise in HDL levels anei also a favorable slight decrease in LDL,5I

Fat Substitutes
People are always rrying ro finei ways to
avoid changing (heir eating habirs. Foad
manutlCHlrers are well aware of this element
of human Ila(ure and are reaei)' ro profit
from it. Currendy; food companies are testillg various far subsriwtes. Some have slIggested that rhe Food and Drug Adminisaation (FDA) seems verywUing ro approve
fat substitutes rhat may 1Iitimately provc
harmful. A case in poille is (he FDA-approved fat subs(jrllte called Olesrra. Not
ani)' can Olesua cause diarrhea anei soileel
unelerwear, but evcn more cOncern ing are
studies demons(ra(ing [hac earing Olesera
decreases one's absorption of fat-solllbie vitamins. Thm, less vitamin A, D, E anei K
will be absorbed. Furrhermore, prolonged
use of O[estra appears able ro deplcee the
body's stores of vitamin E. It can also disasrrollsly inreract wiili medjcations such as
COllrnaelin. Other far subsritlltcs are being
stlldied. Nor ooe dtar I am aware of has a
completely safe ([ack record. Fat-fl-ee subsrl(U[.es are not the arlswer for a nul} healthconsciOliS individual who does not wam ro
(rade the rsk of one bealdl pl'Oblem for
a.nother. 52

HEART DISEASE

Beyond Ancel Keys and His Equation

for Blood Cholesterol Levels
For nearly 20 years, convenrional health
educat ion in America clici nor go beyond
Dr. Keys' amazing insights inro the effect
of diet:.1ry cholesterol ancl f.,tS on blood eholesrerollevels. Dietit ans would rightly tall<
about cholesteroJ and saturared filt in the
dier \.vhile negJecting a number of orher
importanr dietary f.,crors. Forrunarely, however, we are now seeing a growing appreeiatiou among healm professionals for orher
dietary facror that can inf1uence beaI( disease risk. Some of the horrcst areas are fiber, oxidized eholesterol, and anrioxidanr
viramins. We will look ;tt each of mese areas in dc(ail.

Fiber's Cholesterol-Lowering Abilities

Fiber in aur food will help lowcr cholesterol. Mosr Americans eat far less rhan the
recommended 25 ro 30 grams per day. Evidence now sugges( tllat a low fat, high fiber, high earbohydrate dicr offcrs a number
ofadV:lntages. Eating at least 30 ta 40 grams
offiber eer day from a \Iariery of planr food,~
ean'low;r your risk of heart disease, cancer,
intestinal disordcrs, and other diseases. 5.3 A
!is( ofdiseases associated with a t)'pica! American low-fiber diet appe:lIs in Figllre 23. 54
Many are sllrprised ro Jeam thar [here
are different rypes of fiber. Yer .111 fibers have
one rhing in com(l)on-r.he)' cannor be digested by d1e normal human inrcsrinaJ s)'stem. One definition for fiber is "jndigesrible carbohyd.rate," ll1eaning thar fiber is nor
absorbed but is rather excrered. Differem
caregories offib rs include celluloses, hell1icelluloses, lignin, pecrins, gUll1S, ll1ucilages,
and algaJ polysaecharides.
A si I11pler c1assificarion of fiber divides
flber types simply inro water solubJe and
insoluble flbers. It is rhe warer-soluble 6bers that are particularly valuabJe for lowering cholestcrol. Fruits, vegetables, nuts,
grains, and legumes, all in (heir natural,
unrefincd stare, are rhe five main food
OrollpS
[hat CQmain rhis cholesrerol-Iower~
ing liber. Examples of such warer-soJuble
liber. are oar bnu1 aJ1d frui( pec(in. These

compounds work by bind.ing ro cholesrerol

and biJe aciels (exereted by t!le liver) in the
small intestine, mus preveming their absorption. Fortunarely, neirher bile nor choles(eroi is absorbeel high in (he intestinal tracr,
bur rather in rJ1e distal ileum (rhe last pan
of the small bowel). This a!lows rhe fiber
plenry of rime ro bind up mese compounds.
lf, however, adequate fiber is lacking, bath
bile and cholesteraJ are reabsorbed imo the
blood stream, raising blood cholesrcrol

Constipation
Appendicitis
. Diverticular disease

Colon polyps

Hiatus heroia

Heart disease

Varicose veins

Strokes

. Hemorrhoids

Diabetes mellitus

Bowel cancer

Gallbladder disease
Figure 23

1.0

Relative
Risk

0.8
0.6

0.4
0.2

o
Figure 24

71

PROOF POSITfVE

A high fiber diet CdlI

lower serum chokterol ,by
J5 pereent

levels. Bile acids are actually made from

cholesterol by the liver. As a reslllt, dle more
bile yOll Iose in (he stool, the more cholesterol the body must urilize ro make new bile
acids thar arc necessary for fat digestiol1.
The medical lireratllrc is replete wirh
examples of fiber's health-giving benefirs.
One stlldy, published in 1992, found rhar
adding 15 grams of fiber per day ro r!le djer
lowered serum cholesterol by 15 percenr. 55
The effec( of fiber in lowering cholesrerol correlates wirh rhe decrease in heaT[
disease risk in people \vho consume high
amounrs of it. Those [hat consume a high
fiber diet have a 65 percem less risk ofhean
disease, as shown in Figurc 24. 56 In another
srudy, seven groups were fed differing

Serl'ing is l Clip or l piece IIl1less intiiul/eri olherwise

Foods

---

Wbole wbeal bread

Bagel, wbole whe.at
Pita bread, wbole wheat

t3

Popcoro (4 c)r->~.JN'f'"il

Fiber (g)
2.1
4.3

6.3
5.2
4.1

Oatmea
,. ~
Spaghetti, wbole wbeat

4.5

Shrcdded wheat, biscuits

Granola

2.2
6.6

Apple" with skin

Orangc, fresh
Blackberries, raw
Pears, canned
Raspberrie

2.8
3.1
7.2

7.1

Foods
Caulinower
Broceoli
~=;:
Pells
"':
Brussels sprouts
Swcet potato, without skin
Lentils
Pinto beans
Navy beans

Eggs
Meal
Milk
Cheese.

Fiber (,g)
4.6
5.2
6.7
7.0
7.7
10.3
12.0
15.4

0.0
0.0
0.0
0.0

1.0

Figure 25

72

amounts of either oatmeal, oar bran, or farina. At (he end of six weeks there were
significam improvemellts in rotal and LOL
cholesterol for rhose daily consllming either
oile ounee offarina, (WO ounces of oar bran,
(2/3 of a CUI' dry), or three Ollnces of
oatmeal (one Clip of dry rolled oats).57 Beeallse some skeprics were stiH nor willing ro
believe that oars can lower cholesterol, a
computer assessmcnr (mera-analysis) of 20
carefully performed oat srudies was comp!ered in 1992. The resulrs demonsrrared
rhar oar prodllcrs in rhe diet signitlcanrly

reduce eholesterol levels. S8 Anorher grain

rhar has been found ro have beneficial effeets on blood cholesrerol levels is buckwheat. 59 A study from mainland China
founel buck:wheat [O lower borh ro rai cholesterol and LOL cholesterol; at t!le salIle
rime it lowered rhe ratio of roral cholesterol
ro HOL.
Animal producrs (meat, milk, eggs, and
cheese) have absolmely no fiber. Many
wonder why, sinee animals often consume
large quancires of fiber. For exarnple, t.!le
cow, a total vegerarian, ears fiber ali da)' long.
You would think that eating [he cow would
furnish plenry of fiber, bur ir does nor. The
reason is thar when a cow ears, it extracrs
anei absorbs many nurrienrs, but the fiber
in its foocl has a differenr fate. Some of this
fiber can acruaHy be digested by the cow
(even though it is indigesrible by humans).
The re.st of rhe fiber passes rhrough c.!le cow's
intestina! traer anei is excretecl onco the pasrure. In eicher case, che cow's meat OI' milk
ineorporates none of the beneficial fiber. ln
effect, when people eat eows or ocher animals, rhey are eatillg llutrienrs second hand.
Unfornmarely, they get no fiber, since the
animal has "refined" rhe food through its
process of digestion. If we wam an abundant supply of 6ber, we will choose to eat
grains, fruirs, vegerables, or nuts dircctly.
Foods that al'e gooel sourccs offiber are lisred
n Figure 25. 60
As we observed earlier, umil very recenrly, mosr cholestcrol education programs
never wenr beyond t!le Keys equarion. They
rold panicipams abolit the imporcance of
cholesterol in rhe dier as well as the dangers
of satllrared fat wim mosr of tne emphasis
being on saturated fat, bur this is where disclIssions endeel. More recently, dle copic of
fiber has found irs way inro lay eelueational
effofts, bur ir ofren cloes nOt ger the full attemion rhat it deserves. Other information
rhar is sadly lacki.ng in mOSI educational efforrs is the topie of protein anei oxidized
cholesrerol.

Animal Protein Raises Cholesterol

The relatonships benveen cholesrerol
and protein have been published in the
medicallirerature for some 20 years, but for

HEART DISEASE
rhe mosr parr have been sadJy ncglectcd. An
exrensive bod)' of research now has est~b
lished rhat serllm cholesterol is extremely
dependelH on ehe eype of prorein conSlill1ed. 6 1. 62. 63 Animal protein alone (even
skim miJk protcin) will increase blood cholesterol levels wh iJc pLant proteins will decrease cholese.eroJ. [n face) man}' peoplc who
are an orherwise hean-healthy diets will be
uuable ro lower cheir choleseerol sufficiently
uJlless rhey cornpleteo' eliminate animalproleln rrom cheir diers. Research has shown
rhar swirching from a 10w sarurated fat, low
cholesterol dict using skim milk prorein ro
a 10w sarurared fat, Iow choJesrerol diet using soy procein as a milk substirute Can drop
cholesrerollevels by as much as 60 ro 80mg/
dt in as linie as three weeks. 1 have seen this
happen in many of my patienrs who have
nied a roral vegerari:m dier (no animal protein). lf a dramatic reducrion does nor occur in such a diee., 1 ehoroughly review what
rhe patiem is actually eating, and often find
thae animal protein has b en unwi((ingly
consumed in rhe form of casein in a milk
subsrirme or a choles[erol-free cgg product
such as Egg Bearers. Once the animal protcin
is completely excluded, rhe expecred dramatic
result usually occurs. More complere informarion on rhe subjecr of prorein sources and
serum cholesrerol is found in Chaprer 7,
"The Gtear Mear :lIld Proeein Myrll."

c
Stored foods that cootain chol1esterol can
combine with oxygeo in the air.
An cstimated 32 oxidation products have been
found in such foods.
Some of these products, even in small amounts,
have a lethal damaging effect on arterial walls.

sclerosis. On rhe orher hand, chickens [har

were given hormones ro raise rheir choleseerol ro similar levels haei virtuali)' no fate)'
bllildllp in [heir arreries. 64 Des. Peng anei
Taylor in Albany, New York carried an fureher experimenrs looking for something in
dierary cholesrerol thar was panicularly
damaging ro blood vessels. Their discovcries are stared in Figure 26. 65 . 66
Some of rhe chemiClls, called 'oxidation
products," were sa toxic rhae dley desrro)'ecl
cells ehar line ehe arreries in less rhan 24

The Problem with Oxidized

Cholesterol
Cholesrcrol exposed ro the atmosphere
for a period of rime rends ro combine wirh
oxygen in rhe air, producing whac is called
"oxidized cholesterol." Oxidizeel cholesrerol
is anorher importanr dieeary factor rhar the
Keys equarion did nor address. In facr, chis
compound may turn out ro be ehe mosr
imporc<lnr dieeary factor dur influences
heart disease risk.
As early as ehe 19405 ir was discovered
rhar nor aII cholesrerol was the same in irs
Iikelihood of C1using arherosclel'Osis. Dr.
Chaikoff :md associares found that chickens rhat were fed large amoull(s of cholesterol developed high blood cholesrerolleve1s and a considerable amounr of athero-

Sources oftlle most IwrmfuJ c1IOJestero/ to mOJlkey lIortlls "re:

~~.,

,0::-. :.,~ ..

1. Custard mixes
2. Pancakes mixes
3. Parmesan Cbeese
4. Lard
Figure 27

73

PROOF POSITTVE
hours. Furthermore, it took on.!)' a smalL
amollnt of these toxic chemicals ro cause
irrel)crsible damage. In Peng and Taylor's
work rhe deadl)' efTeces an blood vessels
oecurred when as linJe as one half of one
pereene of rhe blood cholesterol was oKidiud. 6i Their researeh is panicularly imporranr because deseruerion ofareery-lining
ceUs is oue of d1e main factors rhar begins
or acceJerates rhe buildup of choleseerol .in
aeherosclerosis.

Especially harmful are the custards

and puddings in which millk, eggs,
and sugar are the chief
ingredients. The free use of
mUk and sugar taken
together sbould
be avoided.
Figure 28

Oxidized cholesterol fed to rabbits and

mODkeys produced dramatic vascular
damag,e within 24 hours.
Pure, non-oxidized cholesterol
produced DO vascular
damage.
Figure 29

74

Peng and Taylor al50 made ehemiGll

measuremems of specific fooels ro see how
much oxidized dlOlesterol ehey conrained.
The researchers ehen tested the harmful
cornpounds on blood vessel cdls of monkeys to determine how dangerous d1ey were.
Foods that conrained oxidized cholesterol
products and produced damage ro blood
vessel ceUs are listed in Figure 27. 68
The mose harmful combinacion of cholesterol oxidat.ion products \Vas found in
custare! mi>:. where sugar, milk, and eggs were
combined. The dried mix was apparenrly
exposed to air for a considerable period of
rime due ro irs long shelf life.
Over 100 years ago che dangers of custards and puddings was recognized by
Ellen White. Her warning is quoted in Figure 28. 69
Some have obselved that ce cream is the
most common form of custard in America
roday. Pancake mixes conraining eggs and
dried powdered milk were equally as hannfui as cusrard. The chird mase hannful item
was Parmesan cheese; it tumed out ro be as
damaging as lard.
Funhennore, earing oxidized cholesterol
may raise blood cholesrcrollevels more dUJl
pure eholesterol alone. 70 However, even if
your blood cholesterol level remains normal, animal research demonstrates thar cating oxidized cholesterol can have adverse
consequences, as summarized in Figure 29. 71
The rabbits were fed a moderate amOUlH
of pure, non-oxidized cholesteral for 45 days.
Their blood cholesrcrols stayed in rhe normal range and ehey suffered no damage ro
their blood vessels. Those rabbirs rhar were
given rhe same amount of oxidized cholesrerol also mainrained normal blood cholesrerol values. However, rhey susrained significaJ1t darnag" ro their blood vessels. Research on humans ..1lso supporcs the fact iliat
oxidized cholesrerol in rhe dier can increase
your risk ofheart disease even f your blood
cholesterollevd stay normal. For e:xarnple,
we have known for years that-regardless
of your blood cholesrerol level-rhe more
cholesterol you eat, the greater your risk of
hean disease. Cholestero! in the. diet is ""har
is called an "independent risk factor" for ilie
developmellt of hean disease.7 2

HEART DISEASE
Let me try to make this c1earer Wdl an
example. Assume dur rwin sisrers are identical in every faccor that reiates ro hearr discase. They have identica! blood pressures,
they both have never smoked, they have
idencical genes, etc. Let us a!so assllme rhat
rhe)' have identical blood cholesterollevels.
Buc suppose there is one difference: one of
the sisters ears much more cholesrerol rhan
(he omer. What the research tdls us is thar
the liberal cholesterol eater is much more
likcly ro suffer a he-arc ateack. Simply put,
we know rhat cholesrerol in your diet is
harrnful for more reasons than its tendency
ro mise blood cholesrero!. I believe that a
large amount of this added danger is explajned by the presence of oxidjzed cholesterol. Even rllOugh as of chis dare, detailed
measuremencs of oxidized cholesrerol have
nor been made on every food, it is logical
to assume rl)ar every food that con tai ns cholesterol has some oxidation producrs in il.
The important message is rhar even individuals with normal blood eholesrerols
should be careful to limit cholesterol in their
diets. If )'ou are not an sueh a low chole 'teroJ dier,rhen you are Likely at increased
risk of h'earr altack ar stroke, regardless of
what your cholesterol numbers are.
Atherosclerosis often begins early in life.
The oxidized cholesrerol srudie.s may also
he1p ro explain why some individuals develop arherosclerosis earlier rhan orhers.
One importanr earl)' factor may be rhe rype
of milk mar infants drink. When a baby
cOllsumes hllman breast milk direcu)' [rom
the human nipple, ir does get cholesrerol in
that milk. However, me cholesrerol dur
comes from mom is pure, nor oxjdized like
that presenr in cow's milk-based formulas
dl,H have been extensively processed in the
presence of alr. Peng and Taylor idemifled
toxic oxidized eholesterol prodllcts in powdered infaJ\t milk formula.7 3 One theory is
[har babies that are fed on cow's milk formula are predisposed tO fatey srreaks early
in infancy. However, you should not conclude from this thar rlle best way for adults
ro ger their milk is ro go down ro the bam
and ger ir suaight from rhe eow ro mnmize exposure to aid Thar meehod might
decrease your cOfLSumption ofoxidized cho-

lesterol, but. it wOlJd a1so grearly inerease

your exposure ro a host of infectious disedSes as listeel in Chapter 11, "Milk-Friend
or Foe?"
Our growing understanding ofoxidized
cholesterol has Jead me ro conci ude mat any
program that does not address rhis subject
is neglecting one of (he mosr important f:1.CtOrs in decreasing hean disease risk. 1 tllink
rJlat t11e increased research anention 00 oxdation prodllcrs of cholesterol will illumioare some orher relatiollships. For instance,
ir is very possible that foods with high sugar
comem are more susceptible ro oxidarion. 74
This would help further explain r!le abundant oxidation producrs thar are found in
rhings like Cllsrard and pancakes-foods
wim a souree ofcholesrerol (milk and eggs)
and sugar. It would also explain why dierary sugar has repe~Hedly been linked ro
aeherosclerosis.

Probfems with lro12 and Oxidation

In 1992, Scandinavian researchers surprised many in rhe med.ical commuHiry wim
rhe discovery that higher amounts of iron
stored in the body increased a person's risk
of hean disease. These researchers highlighted al) important fact: in addition to
cholesrerol being oxidized in our food, it
may also become oxidized wichin our bodies. Higher blood icon levels (measured by
a blood compolJnd calJed "ferritin") may
increase the conversion of normal cholesrerol inco dle dangerous oxidized varierywithin our own bodies. In fact, iron is a
well-recognized stimulanr (eatalysr) of oxidarion. Oxidized compounds like oxidized
cholesrerol can then damage rhe lin ing of
blood vessels and prolnotc atlleroselerosis.
Iron a1so promotes higher hemoglobin
levels. Ahhough high hemoglobins were
once rhought to be desirable, roo high a
hemoglobin level can presenr problems.
More hemoglobin means more oxygen in
rhe blood. Oxygen-carrying hemoglobin
can, in rurn, provide fuel for rhe oxidation
thar iron stimulares. Thcrefore excessive
icon ma)' be adversely working in t\vo ways
in OUl' blood: fiJst, it means more oxygen is
presem, and second, ir srimulares rhe oxygen ro combine with cholesterol ro form

75

PROOF POSITIVE
oxidized cholesrerol. A rhird adverse resulr
ofhigher hemoglobin levels is that it makes
rhe blood thicker and more likely ro c10r
and initiare a heart attack.7 5
It is imponallt to undersrand rhar we
do need iron, but excess iron appears ro be a
problem. Forrunarely, a person can maintain sufficiellt iron levels wicllollC having
excess iron by adopring a rotai vegerarian
diee. Research from Harvard Universiry
proves rhese relarionships.7 6 Harvard researchers analyzed rhe dierary habirs of
nearly 45,000 men and rhen kepr in rouch
wirh rhem for four years. They found rhar
rhe men who are rhe largesr amOlln[ of animal sources ofiron (caJled "heme' iron) had
higher rares ofhearc attacks. This relationship could nor be explained by differences
in rhe :unOlllH offar or cholesreroI rhey were
earing. Those same men wirh liberal inrakes of iron from animal sources aJso had
higher serum ferririn levels, meaning rhar
rhey had more iron srored in rheit bodies.

Vitamins Benefit Cho/estero! Levels

An increased
consumption offruits
and vegetabfes high
in Bela Carotene
decreases cardiovascuLar disease dealhs.

76

We have seen char iron appears ro increase rhe likelihood rhac normaJ cholesterol
wiU become oxidlzed in our bodies. However, rhere are a llumber of subsrances in
foods mar appear ro prevenr oxidarion from
raking place inside of u . These subsrances
are called anrioxidams. Three of rhe mose
well-researched compounds in this r gard
are the anrioxidanr viramins E, C, and beracarorene.
Vira-min E inrake has been found ro reduce one's risk of hearr disease. A total of
40,000 men were cacegorized as ro rhe
amounr of their daily vitamin E intake.
Those who consumed 60 IU per day decreased cheir risk of hearr disease by 34 ro
50 percenr, regardless of orher food chey
consumed. 77
How can we ger enollgh viramin E in
aur diee an a daily basis? Since animal producrs are.low in viramin E, rhis leaves us wirh
a choice of taking sllpplelllenrs or making
substanrially more vegerarian food choices.
AldlOugh rllere are no known roxic effecrs,
rhere is also no medical jllsriflcarion for rhe
use oflarge dose.~ ofviramin E supplemenrs
ca prevenr heare disease, panieularly since

ie is widely disrriburcd in common foocls.?

Good sources ofViramin E are whear germ
vegerable oils, legumes, l111rs (particularly
aJmonds), whole grains, and green, leafy
v gerables.i? As we have already nored, rlle
prorecrion againsr hean disease provided by
viramin E is rllOught ro be due ro rhe prevenrion of rhe oxidarion of cholesrerol
wirhin rhe bod)'.

Beta-carotene Foods Benefit

Cho!estero! Levels
A Harvard Universiry srudy found thar
rhe consllmption ofbera-carorene foods reduced card:iac dearhs. Over a period of
nearly f1ve years, some 1300 individllals
participared in chis research. The resulrs
showed dur an jncreased consumprion of
fruirs and vegerables high in bera-carorene
decreased subseqllenr ca rdiovascu.lar diseasc
dca[hs. 80 Inrerestingly, taking ~'upplements
of beta-carorene does noi lower [he ri 'k of
hearr disease. I Thus other anrioxidanr
llll[rienrs in rhe fruirs and vegerabies ma)'
be adding a prorecrive effecr ro the blood
vessels.
Bera-carorene is plenriflll in ca.lTors, tOmaroes, broccoli, strawberries, and rhe leafy
green vegetables such as kaJe, collards, and
musrard greens. It is aJso found in warel'melan, pineapples. and the yeUow rypes of
squash. In the srudy, when rJlese faods were
consllmed, no mattcr whar rhe cholesrcrol
level was in (he pareicipams, rhere was an
independent rda[ion,ship in lowering rhe
hean arrack risk.

Other Dietary Factors Affecting Heart

Disease: Homocysteine
Homocysrcine is one of more rhan 20
different amino acids thar rhe body uses ro
cOllsrrucr proreins and carry Out chemical
processes in che cells. AJrhough genes play
a parc in e1evated levels of homocysreine,
djcr aJso has a signifiGlIlt mie. Researchers
have now found thar individuals wirh high
levels ofhomacysreine in [heir blood rream
are t:\vice as Iikely ca have c10gged arreries. 2.
83. 84 One researcher srared thar because
many Americans have devated homocys-

HEART DISEASE
rcine levels, it "ma)' aCCOlint for a substanrial proportion of va cular disease in the
Unired Srates."8 For every 10 percenr rise
in blood homocysreine levels, hearr disease
risk goes lip roughly 10 percent as well. 86
Alrhough rhis is nor quire as significanr a
risk factor as serum cholesrerol (for every
10 percenr risk in dlOlesterol [here i a 20
ro 30 percelH rise in hean disease risk), homocysreine levels are anorher "independent
risk facror" for dle disease.87 The good
news, as li ual, is rhar a hea.lrhful lifesryle
can hclp salve rhe problem by beneficia II)'
decreasing blood homocysreinc Icvcls.
Coffee drinkers have high blood levels
of rhe subsrance. If rhey smoke it is higher,
:lceording ro a study of 16,000 aellllrs in
Norway.88 The srudy is slImmaJized in Figure 30.
Abmtining from coffee and tobacco wilI
go a long \Vay in freeing a person from rhis
J"isk of hean disease.
Folare anei viramins B6 and B l2 in [he
e1ier ger rid of homoc)' [cine, convening it
ro aI)orher amino acid calle.d merhioninc.
These B vitamins are founel in fonified soy
milks and cenain break.fasr cereals as \-vell
a animal. producrs. Obraining ar teasc 400
mcg/day of folate in fJ"ujts and vegerables
solely may reduce rhe risk of hean arrack
and srroke by lip ro 40 percenr by lowering
hOlllocysreine leve!s,89.9ll while reslllring in
an esrimared 13,000 fewer dearhs per year
from coronary hean disease. \'Vomen (especially rhose who may ger pregnant) should
consume rhis amount of folic acjd each day
fa prevenr fetal malformarions of the cen[raI nervous sys[em. Rich sources offolate91
and B6 92 are listed in Figures 31 anei 32.
Adequare supplies of methionine (an
essemiaJ amino acid) are imponant anei can
be ea ily obrained from a toral vegerarian
dier. However, exeessive amollnts of merhionine may be dange.rous. One of [he
reasons for this is rhar merhionne is also
convened in the bod)' ro homocys[eine. 93
Avoiding foods wim excessive levels of merh.ionine, such as eggs, cheese, beef, fowl.
and fish eems prudent. 94

HOlllocystei/'e in f/te blood is raised by:

Drinking more than Dine eups of eoffee pcr day.
Heavy smoking eombined with
high eoffee eonsumption.
The biggest coffce drinkers had
almost 60% more homocysteine
than abstainers.
Figure 30

Footl/tem

A "'mIII(

FO/Q(e (mcg)

Sirloin sleak, broiled. trilUJIlcd

16

'/2 cup

Parsnips. raw sliee$

44

1 Clip

Pineapple juicc. canl)ed

58

1 Clip

Frcsb oral)gc juicc

II. Clip

75

panish peanu!S, ra\\'

88
105

I Clip

Mustard grecI) ,ra\\'

1 cup

Spinllcb. rll\\'

109

1 cup
1 Clip

Na"y beans
Okra pod~. frozel)

255
269

1 Clip
1 cup

Lcnlils
Black-eyed cowpeas

831
1057

Figure 31

Footl/tem

AmQUlII

86 (IIIg)

1'/2 ounccs

Becfrump roaS!

0.15

1 Clip

ReU peppers, chopped

0.25

1 eaeh

SmaU swc,et potato. bakcd

0.25

'h cup

Enl:lish walnlll

0.28

1 Clip

Brussels sprolllS. frozen

0.45

1 cach

Banana

0.66

1 cup

Garbanzo beansJchickpeas

1.07

1 cup

SlInf10wer secds

1.08

Sesame secds, wholc

1.14

Ricc bran

1.69

1 cup
'/2 cup

""'>.

Figure 32

77

PROOF POSITIVE

E'<ercise Benefits HDL

CholeJterol Levels
When rhe HOL cholesterol is high, it
extracts the bad choles(erol from (he arte(ies and helps protect the arteries from damage. High levels of HOL may even help
reverse coronary arrery disease. How can
we get our HOL leveJs LIp? Exercise has
been shown to rajse HDL.95 The exercise
rhar rases HOL is nor rhe weigJ)[-lifting

s
Exercise

Other Factors That Raise HDL

Cholestero1

Running, jogging, brisk walking,

biking, cross-country skiing,
swimming, cardiac rehabilitation

Drugs
Fibrate drugs, niacin, estrogen, dilantin,
gemfibroziJ, alcohol

Foods
Lecithin, ginseng, garlic, onions, brewer's
yeast, chromium, vitamins C and E

'. Cessation ofsmoking

Chlorinated pesticides
Figure 33

Iltitial

78

4th

1110

8th

1110

Serum cholestcrol

300

320

235

Serum triglyceridc

170

165

120

LDL + VLDL (% of totall)

83%

84%

72%

HDL (% of total)

17%

16%

28%

Figure 34

rype, bur rarher the more active or aerobic

sOrt ehat gees dle hean rare up and requires
rhyrhmic body movemems aod deep breaming. The more aerobic exercise obeained the
grearer rhe rise in HOL.% Because of rhe
role of exercise in raising HDL and dms
lowering ehe risk of arherosclerosis, low
physicttl fitruss should be ehoughr of as an
independent riskfactor for rhe developmenr
of heal"( disease,97 A list of HDL-raising
factOrs is shown in Figure 33. The besr news
is rhar if you are unot now, and yOll get on
a regular excrcise program, research indicares
(hat you can decrease your risk ofheart discase by 50 percenr. 98

Taking any of the drllgs lisred in Figme

33 rhat raise HOL is nor rhe preferred
merhod due to possible side effecrs. 99 . 100
High doses of the B vitamin, niacin, can
boost HDL levels; however, in rhese do es
(he niacin is acring as a drug rather than a
viramin. 101 Consequenrly, ifyou are (aking
high doses of niacin yOll should be under a
docror's care. Careful medical monitoring
for side effects is srrongly recommended.
Particular arrcnrion should be pajd ro rhe
liver as high doses of niacin can be toxic ro
[har organ on occasion.
Esrrogen in women raises HOL. This
ma)' be one of rhe primary reasons why rhe
average woman does nor experience heart
disease unril 10 years larer rhan the average
man. Afrer menopallse, when e rrogen production drops, women quickly carch lip
with men with regard ro hean disease risk.
Thus, 52 percent of ali coronary hean disease deaths occur in women. 102
Alcohol drinking has been assocjared
wirh higher HDL leveIs. However, 1
stfongly discouragc a1cohoI use because of
rhe significanr hidden dangers rhar ir carries. These dangers are covered more COI11plerely in Chaptcr 17, enritled "Wanr a
Orjnk?" Furmermorc, alcohoI may nor raise
yom HOL if you are already on an excellent program. Hartung and colleagues
found dlar moderate alcohol consumpuon
provided no HOL benefir for men ehat were

HEART DISEASE
running regularly.103 In addjrion to aleohol, rhere are orher toxins rhar raise HOL
levels, such as chlorinated pestieides. Again,
[ would obviously nor recommelld such
agems as HOL enhaneers.
There ;He safer ways ro raise HOL.
When individuaJs srop smokillg, cheir HDL
u uaJly rises signjfieantly as a resulr. Weighr
loss can aJso help raise your HOL. 104 Foods
conraining leeirhin, ginseng, garlie, onions,
brewer's yease, (he rrace mineral chromium,
vitamin C, and viramin E ali ean help raise
HOL. An example of a food wirh HOLboosring ef1eccs is garljc. One gaJ"lic smdy
had individuals with coronary heart disease
lIse lip ro four doves of garlie each day for
eighr monrhs. The resulrs are impressive
and are shown in Figure 34. 10S
Ar r.he srare of rhe srudy, HOL levels were
dismaJly low, ar onl)' 17 percent of rhe roral
cholesrerol. They were solidly in rhe danger zone. However, at rhe end of eighr
monrhs rheir absolute levels ofHOLs were
a fult 65 percent higher, at 28 percenr of
rhe rorat. Moreover, garlie not only raised
the desi rabie HOL, ic aJso lowered rotal and
LOL cholesreral as welt as rriglycerides. In
othar words, alt cholesterol values moved
in rhe right direction. The only signifieanr
variable in this study was the consulllptioll
ofgarlie. From many difTerent perspeerives,
garlic is nor only a food enhancer, but is
pare of a healrhful dier.

One step is to Iose weighe. Many people

wirh high triglycerides are overweighr. Getting down ro your ideal weight may bring
yaul' rriglycerides inca ilie ideal range (Iess
than 150mg/dl). Anorher. cep is ro exercise. Exercise, as we have already nored, also
raises HDt. The third item lisred is ro ear
less far. As we have aJready seen, mosr of
the Lpids in our diet are rriglycerides by
narure. In addition, dccreasing your Stress
level and sropping smoking can lower che
rriglycerides.
Many people have high triglyceride levels just because of akohol use. When rhey
become abscainers their uiglyceride levds
come down ro normal. Las tl y, use sugar
sparingly. Sugar raises triglycerides. lf you
wam [Q bl'ing your rriglycerides inco line,
especially avoid refined sugars like whire
sugar, hone)', molasses, and sofr drinks, des~
sens, candjes, etc. rhar mil.ize rhose sweereners. Sweereners in combination wirh cho~
lesreroJ and sarurared [ars as in custards and
iee cream are especially to be avoided.

Genetics and Cholesterol

Somc individuals generically have a tendency roward low blood cholesrerol levels.
However, if rhey follow a poor Iifesryle, ehey
ean stiU have a hearr auack. Other indi-

Triglycerides
"Triglyceride" refers ro a compound that
is rnade up of rhree f:u (rechnicalty, 'farry
acid") ehains. These eompounds are d1e
main transpore form of F.u in rhe bloodsrreaJll. Furrhermore, the far in foods is usually in rhe form of rriglycerides. Elevared
ilJUOllnts of triglycerides are a1so a risk facrar for heare disease.
For years it has been recognized dut the
higher one's rriglycerides, rhe lower his HOL
remis ro be. It is not e1ear wherher rriglycerides depress HDL, bur rhis may be the
case. In any evenr, bringing down a high
triglyceride level will invariably boost HOL.
How do we ger the triglycerides down?
An overview ofsome of rhe key life.sryle recommendarions is shown in Figure 35.

Lose weight
Exercise
Eat less fat
Decrease stress
Stop smoking
Abstain rrom alcohol
Avoid sugar
Figure 35

79

PROOF POSITIVE
viduals have "bad genes rhat predispose
rhem ro high cholesteroJ levels. However,
if cheir overalilifesryle is good rhey can definirei)' posrpone-if nor complerely avoida hearr att3ck. There are people who genetiealJ)' cend ro run high toral cholesterol
levels but may nor be at risk for hean arracks beeause (hey are living a healrh)'
Ijfesryle and have high HOL levels.
The important messageis chis: we need
ro look beyond whar our cholesrerol levels
are, beyond whar our HDL levels are, and
be)'ond whar our trigl)'eerides are. The
nllmber ooe line of defense is to live a
healrhfullifesryle. This includes special atremioo ca a food imal<.e rhat is based largely
on rhe eholesrerol-free, high-fiber plam
foods dlat we have been looking ar in this
chaprer. We have a150 identified other aspeets of a heart disease preventive regimen
including regular e,xercise, not smoking, and
conrrolling blood presslIre. However, rhere
are stiH orher factors in a heart-healdw
lifesryle dur we must address ifwe wam r~
maximize rhe preventive porential of hearr
rusease.

The study iDvolved the use of Cholestyramille, a

moderately priced medication.
Tbe cost va.ried from $36,000 to $1,000,000 per year
of Iife sav,ed.
Cost effectiveness was best with youllger
patieots, smokers, aud hypertensives.

Figure 36

80

Risk Factors Beyond Cholesterol:

''Normal'' Weight
In 1990, rhe U.S. Go"ernmenr revised
women's weigh( guidelines. This appeared
ro suppon rhe idea rhat a modest weiglu
gain in middle age was aceeptable. However a subseqllenr srudy analyzed weight
dara an over I 10 000 female regisrered
nllrses over a 14-year period. The Harvard
researchers found rhar any tveight gain afrer
18 years old incretued rne risk of hean djsea e. Even among those who were wimin
the new guidclines for normal weight, {he
more weight rhey gained, the more they
increased their heaT[ disease risk. There \Vas
abour a 20 percem increase in risk for rhe
smallest weight gain bur nearly four times
the ehance of hean attack for rhe largesr
weighr gainers who were still/.oithin the nor-

mal weight guidelines.

The researeh arricle concluded (hat a
weighr gain aher 18 years of age s a srrong
predictor ofhean djsease.. It expressed eoneerns thar Cllrrenr U.S. weight guidclines
""ere falsely reassuring a large proporrion of
people who are within d1e currem gllidelines bUl have avoidable risk [acrars for hean
disease. Although we have known for years
rhar obesir)' aJone is a risk for hean disease,
rhis study shows thar eveo "nieely fliled our"
people may have a sgniftcarn risk for hearr
disease compared wirh theit rhinner nonsmoking eOllIlterparrs. I06 However, obese
women are free from increased risk if rhey do
not have high blood pressure, e1evared lipds,
or diabetes. OnIy ooe-third of women ~aJI in
rh is caregory.

Use ofDrugs to Reduce

Cholesterol Levels
In rodays America it is popular ra lower
high cholesrerollevels wim drugs. We have
very porenr medicarons dur can ineleed
help lower cholcsteroL bur rhey ali have rhe
potential for adverse side effeet.'>. On the
other hand, many who adopt a healrhful
lifesryle find that (hey can lower their cholestero] levels as much or more rhan rhey
could wirh drugs-and they avoid rhe porenciaJly harmful side effecrs. There are no

HEART DISEASE
adverse side efTecrs when following a jlldicious regula.r exercise program and consuming a dier low in sarurared (.1r, low in cholesrerol, and high jn fiber. There are only
good side effecrs rhar resuh from such a
lifesryle. Examples include a bener energy
Jevel, sounder sleep, more anracrive appearance, and Jess minor iJlnesses.
When physicims prescribe medications,
we musr always weigh the benefits against
the risks. It is rrue rhat a small minoriry of
the popularion, because of genetic defects,
may need medicarion in addirion ro a
healrhfullifesryle (O prcven( ar reverse hean
disease. However, (he vasr majoriry would
nor need such medicarion if rhey developed
a healrhfullifesrylc ro irs fullese potential.
The cost of medicariol1 is anoeher factor ehat for many is a burden, panicularly if
they do not have insurance coverage for such
medici ne. Whcn someone comes (O n1y
office that has high cholesterol and needs
to be followed very c1osely, even when the
benefir of the medication seems ro outweigh
the risks, cost is a seriolls concef\l. A srudy
published in rheJournal ofAmerican Medical A~ociation suggested t.hat a mcdic:!tion's
possible benefit.s should be weighed againsr
irs risks, not only in rhe arca of sidc effects,
but also in the COSt deparement. 107 The
3uthors' cosr estimares are summarized in
Figure 36.
For people wirh high cholesterol and an
additional problem such as high blood pressure or smoking, t.he COSt per yeal" of life
saved is relatively less.
Medicarion is nor reaIly the bes[ answer
ro America's number one kilIer, heart discase. Prescription drllgs have eheir place, but
in ehe overall prevenrion of hearr disease,
rhe besr, mosr inexpensive, and most effective way is stiH a healehy life.style. A heaJrhfuI dier is nor expensive and rhe bendits are
far reaching. Even the drug manllti1Crurers
who wrire the Physician's Desk Reference
of prescripeion drugs always menron rhar
dier is rhe ftrst and cornersrone step of cholesterol-Iowering therapy. Even for those on
medications, a good dict is stiU necessary.
That person wilI ger a grearer cholesterollowering effecr if rhey make lifesryle changes
in addition ro taking a pili.

Lift Stresses Can Cause a

Heart Attack
Stress is yet another factor thar increases
hean anack risk. Deadlines, d.isagreemenrs
with r!le boss, and orher such puIse-raising
situatiollS aH significanrly increase hean
attack risk. A tOral of 129 heart attack survivors were questioned abOlit everyrhing
[hat happened ro (hem in the 26 hours before rJ)e arrack. Serious Stress was experienced by 51 percent. The o/pes of evenrs
rhar they experienced are (isred in Figure
37. 108
In comparison, a large number of people
rhac clid not have a hean anack were asked
aboLlr their stresses. Only 12 percenr of
rhose experienced any seriom stress J) rhe
same rime frame.

Anger Can be Dangerous

Stressful situarions rhat provoke anger
are especiaIly rrying for thase wirh hean
disease. Individuals wirh pre-e:cisting hearr
disease more rhan double rheir risk of myocardia) infarc(ion when they get angry.l09
This increased risk continues for twO hours
afrer the anger episode.
It is clear from these and orher studies
rhar stressful experiences can significamly
raise om hcan ;}uack risk. One reason may

Deadlines, fights with the boss, other pulse-raising

situations
Important meetings, givin~ presentatioDs, being
laid off
Emotionally meaningful il1teractions
with spouses, kids
Deaths in the family
Financial problems -- pay bills,
bounced checks, comil1g into
a financial \VindfaU

Figure 37

81

PROOF POSITTVE
be rhat suess can cause hean aneries ro go
inro spasm. As a resulr, when the body's
c10uing cells, rhe p1ate1ets, rry (Q pass
through that aner)' rhey are resrrained aod
clar more easily.

The Importance ofEmotiona! Support

Srudies have shown rhar emotional support provides a way co buffer srres .
Whedler we recognize it or nor, it is a factor thar is desirable for aII of us. However,
it is especaJly important for rhose wieh he,lf(
disease. Elderly people who have suffered
hearr arracks and have oile or rwo sources
of emotional support are twice as hkely ro
live ar least a year afrer rhe arrack rhan rhose
wirhour sllpport. The author of one srudy
conclllded, "With rhis srudy we have a
much more specific idea dlae (he aspect of
emotional supporr ma)' be the crirical di-

s
Ameri~QII

Qveloge cllOlesterollevels for ",CII und women dec1illed

7% between 1960 -1991. This COllltl redllce CHD hy 12-32%.

110

Total 100
Cholesterol
Level (mg) 190
.80

170

Should Drug. Ee Used to Control

Stl'ess?
N1<my individuals rry ro control (heir
stress by using drllgs. This s no( oprind.
Psychiarric drugs can actually increaJe rhe
risk of a hearr attaek. A study was dane
with women who were taking anti-anxiety
drugs (such as Valiurn Ariv,ln, Libri1l111, and
Xanax) and/or anrdepressaIHs (such as
Elavil, Tofranil, and Pamelor). The study
found that rile drugs mlly greatly increcue the
risk for a hearr arraek. Women using the
drugs had nearl)' ] 7 (imes [he rsk for a heart
attack, and (hase who had at some rime in
meir life used the e drugs werc ar (h ree times
the r1sk. III AII of rhe increased risk may
nor be due simply ro being 011 the medica(ion. Some may weB be due to the s(ress
nnderlying rher problems. Nonerheless, even
beyond the stress f.Kror, ehe rnediemion itself
poses a signi/lcam hearr disease risk.
The imponam message from these lines
of research is thar a hean disease prevemve
lifesryle includes an emphasis an dea.!in o
wirh srress-ideally withouc medicarions.
Ways to achieve oprimum stress control are
preserued in Chaprer 14, "Stress withou!
Disrress."

How Much Difference Can Lifestyle

Years

Figure 38

82

pon GlO be a tremendous help in preventing a second hean Grrack. This is uot somerhing ro be taken lighrly. A second heart
arrack i ofren more dead.!y rhan the f1rst
one.

mension relared ro survival af(cr rhe onser

oflife-threatening artacks. "110 Relatives and
rriends provide a unique Sa uree ofemOliona.!
suppon; however, spiritual facrors also play
a cole. Alrhough you may be living alo ne.
you can have a sense of spiritual supporr
rhat comes from knowing Cod personally.
The imporrance of emotional supporr
also reminds lIS of aur obligations ro our
rriends and neighbors. Tfan individual clase
ro us has a hearr arrack, aur emotional sup-

Make?
Therc is mllch good news in Americ<l
regarding hean disease. Alrhough i( is stil!
the number one killer, hean arrack rares h<lve
decreased. In face, rhe hearr disease dearh
rate dropped some 22 percenr berween 1984
aJld 1994 a.!one. 112 One of [!le main reasons for rhc general improvemenr is rhar
Americans are paying more attention ro
rheir food choices. l13 arion<ll HeaJrh and
NlIrririon Surveys demonstrare thar cholesrerol leve\s in America have bcen c1ecreasing aver rhe ]ast tiu-ee decades, as spelled
aur in Figllre 38.

HEART DISEASE
Norice {har in 1960, an average cholesrerol for a Olan was abour 215 mg/dJ. In
1991, rhar averagc chole terol came down
ro 205mg/dl. In women, rheir average chole (eroi in ) 960 was 222. In 1991, rhar
average value had fallen ro 205, rhe same as
for men.
These rrends are encouraging, bur cholesrerol levels are stiH bigher than rhey
hould be. Hean disease does nor need ro
be the number one !<iller in America. We
bave seen from the variery of srudies reviewed rhus far thar hearr disease is largely
prevenrable. We can be encouraged by rhese
choles{erol deereases over the lasr 30 years
and the decrease in rhe hearr dearh rate rhat
ir conrributed ro. Thousands of lives have
been saved. But rhis should be looked ar .15
only rhe beginning, because fuU)' 42 percent of dearhs in America are sriH due to
diseases of che hean and blood vesseIs. 111
elearly, dramatic changes srill need ro be
made.
How mum can we aeruall)' reduce aur
hean a((ack risk? Information from The
Harvard Healrh Lener helps provide rhe
an wer, which is documenred in Figure
39. IJ

orice {he jmponance of rhese five

lifesryle facrors. By sropping s/lloking aIone,
we can reduce OUl' hearr attack risk by onehalf ar more wirhin five years. Aerobic exercise lowers aur heart attack risk by almosr
as much. By mainraining aur ideal weight,
our risk is 35 ro 55 perccnr lower ifwe were
20 pereenr ar more above rhar ideal weighr.
The greater che decline in the s)'srolic blood
pressure and blood cholesrerol, rhe more rhc
ri k is reduced. A 10 point reduction in
blood pressure would reduce rhe risk 20 ro
30 percenr. A reducrion in cholesterol of
30 pcrcenr (which is quite possible ro do
rhrough diet) reduces the risk of a hearr arlack 60 ta 90 percellt by rhis means aIone.
It is weU known thar among rho e who have
high serum eholesrerol, significantly reducing thar cholesrerol will definirely produce
rhe beneflr in risk reduerion. One recent
tudy showed rhar 3/ll0ng rhose rhar already
have had a hearr aw\ck, but happen ro have
a "Iow" cholesterol of less than 200 mg/dI,
dropping their cholesrerol will htIther lower

Preventive Measure

Risk Reduction

Stop smoking
Reduce blood cholesterol
Exercise regularly
(aerobic)
Maintain ideal weight
Reduce blood pressure

c::> 50 to 75% in 5 years

c::> 2 to 3% with cach 1%
reduction
c::> 45%
c::> 35 ta 55% lower risk 'if overweight b)' 20% or more
c::> 2 to 3% for cach llmm

~
,

reduction in diastolic
pressure

even cheir risk of a subsequenr life-ending

addirional hearr arrack by up ro 45 percenr. 116
Let us look at a compelling srudy dur
helps us ro see d1e impacr of dier a10ne in
decreasing heart disease risk. Maoy honestly wonder, "How much can 1 expecr ro
reduce my hea.rt auack risk by adopring a
uuly ideal dier?"
First, what is rhe ideal dier? By now it
should be clear from rhe medical researeh
thar the ideal dict consists of plenry of fruirs,
vegerables, whole grains, and nucs (rhe lacter in Inoderation). TE we use foods thar
come exclusively from d1ese food group ,
we can make the mosr dramaric changes in
lowering cholesrerol and hean disease rares.
This is the ideal dier 1 recommend ro rny
parienrs wim high cholesterol or orher risk
facrors for hean disease, and is also the besr
diet for my hean disease patienrs. Most of
my patienrs with high cholesrerol will drop
rheir serum cholesterols 60-80 mg/dl an such
a JieI. Now baek ro rhe primary quesrion:
how much can you expecr ro lower your
risk? This seudy looked ar the impact of
duce diers an hearr disea e risk: COtal vegerarian (ilie diet 1 recommend for my high
cholesrerol and hean diseasc patienrs),
lacra-ovo vegerarian, and non-vegerarian.
The popularion that was srudied were Seventh-day Adventist men over 35 years ofage
living in California. The U.S. governmenr

Figure 39

83

PROOF POSITIVE

Males age 35 QI,d over as percelJt ofexpected, in

comparison with genera/population

Total Vegetariaos

Lacto-Ovo Vegetarians
Non-Vegetarians
Figure 40

Zero cholesteroJ
Low saturated fat
High fiber
Zero animal pro1tein
Zero "heme" iron
Rich in antioxidants
Rich in folic acid and B 6
Promotes weight control
More nutrients for the dollar

Figure 41

has spent more than fourreen rnillion dollars tunding research on Seventh-day
Advencists and their lifestyle. 117 Ths tascinaton with Advclltists probably derives
largely from their markedly increased 1.00gevity and decreased disease rares. They
found a signific.ant decrease in hean disease
deaths among vegetarian Advcmists, as
shown in Figure40. 11 >
The rese.uch revealed that abolit half of
the Adventists were nor vegerarialls; nanerheless, th is non-vegctarian grollp had onl)'
56 percellt of rhe average he.arr disease death
rare compared ro the general population.

84

The researchers felt this was due largely to

their being nonsmokers; they aha avoided
alcohol and possibly had a somewhar
health.ier diet ehan rJ1C general poplIIation.
Most of the other Advemsts were lacto-ovovegerarians; fhar is, they lIsed eggs and diary produClS bur no mear ofany kind. Their
hearr disease death (ate was down to 39
pereenr of expecred-apparendy due simply ta eJiminating mear from their diers.
The rotal vegetarians had fhe most asrounding results. Thcy only experienced 14 percent of rJ1e expectec! death rare.
The low risk ofhean disease among rotaI vegerarian Seventh-Day Advemjsrs is not
surprising in lighr of rhe beneftrs of such a
c1ict as ourlilled in rhis chapter. These benefirs are summarized in Figure 41.
As we have seen, any one of these fea(llres alone redllces rhe risk ofhean disease.
When taken in ror;ll, rhey have a great impact in prorecring againsr the number one
killer in the nation. The first two features
on the lisr are probably the mose commonJy
known ro reduce heart disease risk. The
rhird one, high fiber, is cOlTImonly denrifled as protecrjon againse cancer, but we have
seen rhar ir also prorec.rs againsr hearr Jisease. Lesser known are [he benefirs of irem
numbers four throllgh eight in fighring
hearr disease.
The Advenrist Healrh Srudy provides
solid evidence that we can significamly reduce our risk of hearr disease dearh by following a roral vegetarian djet. IJ1 ('lct, (he
research wc havc presenred in rhis chapter
suggests rhar fully nine aur of ten hearr ar
rack dearhs eould be prevenced wirh a proper
lifesryle program. We now know enough
abolit rhe cause ofhean disease to virtually
eliminate chis disease as a major cause of
death in the world. If [he elimination of
hearr disea e was accomplished in rhe U.5.,
rhe American Hean Association srae(::s chat
our average life expecranc)' wOllld increase
by almosr 10 years. 119
In realty, however life ex:pec[ancy wouJd
increase significancly more [han rJle nearly
ten years sllggested br rhe American Hearr
Association. An ideal program ro prevellt
hean disease would also, ro a large extent
prevenr cancer, chronic Obstructive pul mo-

HEART DISEASE
nar)' disease, pneumonia and many orher
Icading causes of dearh. Preveming rhesc
maladies wOllld no doubt exrend OUl life
span aod qualiry of life even furrher.

Heart Attacks Can be Prevented

Denis Diderot, an eighreenth cemury
French philosopher, gave LIS :t proverb rhar
1 believe is applicable roday. srared in Figure 42.
Ir is rime we do somerhiog abour rhis
crisis in America's kirchens. Our cooks can
prepare delicious meals wirhollt using ingredienrs mar damage our healrh. I and my
LuniI)' personaJly follow a [Dtal vegeral"ian
dier and Olake no sacrifices in the deparrmem of taste. My food 1S de1ieious, sarisfying, and varied. Besides, ir impans a sen e
of healrh and viraliry mar an inferior dier
would nor provide.
Ler Ole illusuare olY pOnt wirh I"WO example.s. One favorite in our house is a nondairy (no cholestera!) "iee cream." We make
it by purring frozen bananas and other se
leered ffO'.l.en fwits rllrough a Champion
juieer. Ir comes our smoorh and cold aod
creamy. and sweer (Q the tasre. However, ir
is law in far, high in fiber, and has no animaJ prorein and no cholesterol. Another
example is provided by rofu (soy bean curd),
an incredibly versarile (ood. By lIsng a varicry of seasonings, it makes a rasry subsritute in our home for somc dairy products,
eggs, and even some mear dishes. I could
give hundreels of other examples, but, of
course, rhis is nor a cookbook. The Appendix II listS a few of the mally exeeUe.nt vegeraran cookbooks rhar fearure recipes (har
are cholesrerol-free, low in saturdred far, and
high in fiber. Bceause of my own experienee, 1 firmly believe rhat we can re-educare aur cooks ro prepare Ilew varieries of
foods chat both caste good and hdp ro furrher decre;:tse hearc disease risk.

Does High Tech Treatment ofHeart

Disease Make Lifestyle Changes
Obsolete?
Some people may feei rhar our advaneed
rechnology for treating hearc dsease gives
rhem more liberty ro do as chey please. They

reason rhac rhere s 110 need for a concrolled

lifestyle if rhey live near a srare-of-rhe-;}rr
hospiral. Indeed, "high reeh" has made ti
significanr differellee n dle hearr disease
scene. When a person has a hean anack,
cardjologisrs can open up rhe blocked arreries wirh potent drugs or angioplasry baJ100ns. As a resulr, if rhe tim-rime hean arrack patient livcs ro reach rhe hospiral rhey
have only about a LO percenr risk of dying
from rhe hearr a((ack. Twenty-five years ago
r,he risk was almosr 30 percenr. Judging
from cheir own practces, even cardiologists
scem prcdisposed ro fali inro thinking thar
lifesryle is nor very important. (Sad.!)', hean
specialiscs have 110 berrer blood cholesrerol
levels as a group than do rhe general popula cion). 120
By failing ro emphasize the imponance
of lifestyle, cardiologisrs and oehers seern ro
neglecr rhe important faer ehar heart a((ack
survvors ofren live on wirh a marked decrease in ql<.ttLity o/Lift. Of COlll"se, cardiologisrs are well aware of rhe resulrs of hean
Jrraeks. The main cardiology associarion
in our nation, the American Hean Associa-

"Doctors are always worklng to

preserve our healtl1 and cooks to
destroy it. But the latter are
often tlle more
successful."

Figure 42
don, recently arracked rhe common lay
myrh rhar hean arrack victims who survive
will "recover and be fine." The)' explained
(hat (hose who do survive a bean a((ack have
a risk ofillness and death rwo ro nine times
higher ehan rhe general popularion. 121

85

PROOF POSITIVE
One COIl1mon problem thar xesulrs from
heart aeracks is congestive hearr failure. As
previously srared, rhis is a condirion in
which rhe hearr is weakened by a hean attack (or ocher cause) and can no longer perform aJl rhe work it sbould be c\oing. As a
resuIt, fluid typically backs lip inco rhe lungs,
legs, and feet. Conges[ive hean fajJure hospiralizarions more than doubled from 1979
ro 1992. Tn 1979,377,000 were hosptalized due ro this very borhersome disease.
In 1994,874.000 had ro be admitted ro ule
hospital. Congestive hean failure is now
the mos[ common cause of hospitalization
for people over 65. 122 We e1earl)' need ro
ger ro the root of the problem. It is nor
sllfficiem ro trade an epidemic ofheart disease deaths for an epidemic ofhean disabiIiries. Ooly by prellcnting or rC/lersing arhero e1erosis by lifestyle improvemenrs will
we see an)' grear srrides roward bom decre;~s
ing hean disease dearhs and hean-related
disabi.lities.

Conclusion
The evidence is indeed deal'. We can
dramatcaHy decrease our risk of heat[ disease by following an oprimal Jifesryle. We
need ro make rhese changes sa [hat a known
prevenrable disease no longer leads the list
of America's killers. 1 am aware that you
probably will nor change your lifeseyle to
merely aJrer general statisrics abour rhe lerhal impacr of heart disease in America.
However, 1 am concerned abour individuals, hundreds of thou. ands of who will un-

Refertmces Gyar[\s 1. Chief of rhe World He.ahh Org'Uliz~riorl Cardiovascular Dis

(ase. Prevenlion Program: World Hcalth Day, Apr. 1992.
l

Murray CJ, Lopez AD. Monaliry by cause for eight rcgions of tbe world:
Global Burden of Disease Srudy. umcer 1997 Mal' 3;349(9061): 12691276.

American Hearr ;\ssoci,\tion. Hmrr and Srroke Filet: 1996stllfistirlt/ wppkmmt. 1996 p. 2.
Amcrican Hean A.ssocialion. 1997 HeilTtlllld SI7'Oke StIlIsli,n/ Upthee.
American Heart Associalion, 1997 p. 2.

0\

American HC'.1rl Associalion. 1997 Hearl ilnd Sh'ak,' StaliJliml Updal<'.

American Hean Associaeon, 1997 p. 28.

necessaril)' go ro rheir graves-rhis year

alone-becallse [hey did not take the proper
lifestyle steps in rime. And I know tiUt yOll
are ar leas[ somewhar concerned abollt yourself.
A[ rhe risk ofsounding trire or affeered,
1 musr honesd)' sa)' 1 feei a deep sense of
responsibiliry for ea h one of you wha are
reading rhis chaprer. I waIU ro do ever)'rhing I can ro help prevem me rragedy of
hearr disease from rouching your life. I havc
sem roo man)' [har have been hurt, killed,
and crippled b)' rhis murderer ro be llnimpassioned an the subject. From. eha[ perspective, Je[ me make a dosing request: jf
rhis chapter has convinced you of areas rhar
you need ro change in yOUl' life, do nOt clelay. Now is rhe ver)' besr rime ra improve
your die[ anei other lifest)'le habirs. Do nor
wait for warning signs or a first hean attack
before gerrillg serious abolit lifesryle changes.
By rhen you ma)' have already developed irreversible disease. Worse, yer, hean djsease ma)'
dam your life before you are ever aware dur
you had a hean problem.
For your own sake and rhe sake of your
loved ones, why nor embark on ar Icasr ome
elemems of a new lifesry[e raday? Tf you
stick wirh such change , [ am convinced you
will regard chem as among )'our life's wisesr
invesrments. Afrer aiI, the inves[mem will
pay dividends in providing longer life, disability prevemion, and an enhanced qualiry of tife. Do not procrastinare-starr ro
get more of rhe fuJI benefits of a hean disease prevemive lifestylc roday.

(, Presel1ted b}' Tholllas N. Taylor and others from the Universiry of Iowa
to t!le American !-lean Asso iation 1-25-96. Ba.sed upon tolal lifetime
COSt for a slroke occurriJlg in 1990,
7 G}':lrfus 1. Chicf oftbe World He.l1th Orga.niz.ltion Ca.rdiovasclilar D,i,casc Prcvclllion Program: World !-lealth Da}', Apr. 1992.

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muJ DiSt:il.Je-/" ldi/ion. Philadelphia. PA: Lea and Febiger. 1988 p. 1363
1367.
.B1och A ,Shils ME. Appendix: Table A-43a. In: hi!, ME. Young VR.
edllOrs. Afot/all Nl1tririoJl ill Healrb allti Dise4Sf'-/''' ediJioll. Phil del
phia. PA: .:a and Febiger., 1988 p. 1629.

72

?-4

73 Pcng SK. Taylor CB. Alherogeni(' Effi:cr of Oxidized Choleslerol. Ir\:

9~ Isselbacher

tam I r), hekelle R. Dielary eholesrerol and hum;ln eoronary heart

di case. The epidemiologie cvidenee. IlreIJ Pa/Iiol Lab Mrd 1988
Oel:112(10):1032-1040.

Perkins EG. Visek W), edilors. Dit'"lry Pau /md l-/l'fllrlJ. Champaign. Il.:
American OU Chemisrs' Soeiery. 1983 p. 919-933.
Colaeo CA, Roser B). Arhcros Icro. s and glycaeion. Bio"<S/Jp 1994
Feb: J 6(2): 145-147.

7f

88

KJ. Braunwald E. editors, el al. Alhero clerosi a.nd Othcr

Forms of Arlcriosdcrosi. In J-IllrriJons PrillcipleJ of Illumnl Mrtiicinf/3,h ctlitiofl (CD-ROM).
ew York. IY: MeGRAW-HILL. Inc. Hea.hh
Proles.sion Di\'ision, 1994 p. 1106-1116.

HEART DTSEASE
\X!illiam I'T High-dCllsiry lipoprolcin choleslcrol and orlwr lj k f.'ctors (or coronary he.n discas~ in ft:male runners. N E1lglJ Md 1996 Ma)'

Jacobs S. American Hcan As. ociarion Mecling, 1992.

108

16;334(20): 1298-1303.

109 Mitrleman M, Mlliler J. 1994 Harvard Medical. chool. Rcporred ar

rhe American He;J.rt ,\ssocialion Mccting.

B1air SN. Kohl j-fW 3'", et al. Changes il1 ph)'sical fimc> and aLl-causc
Il\onality. A prospccrive slUd}' ofhcahh)' and unhealth)' Jl1~n. JAi.fA 1995
Apr J 2;273(14): 1093-1098.
97

9~ Blair S ,Kohl HW 3,J, el al. Change.s in ph)' 'ical

fllllcs.. nd a11-causc
monaliry. A prospeaive lUd)' of health)' and llnhcahhy mcn. }AJ\.fA 1995
Apr 12;273(14):1093-1098.
9" Glue.ck CJ. Nonpharmacologic and pharmacologic ahelalion of highdensiry lipoprOlcin choleslerol: IherapelHic approa les ro prevemion of
adlerosclerosis. Am Ht:lm} J985 No,,;110(5):1107-11l5.

A.Ilzalon DA. An:z.,lone FL, Fos PJ. High-d I1siry lipoprolein.cholesterol: delermining h)'gicnic facrors for imervention. ) Gem/' Ellviro" MIr!
1995 Jul;.:37(7):856-861.
100

ilO Berklllan LF. Leo-Summcr' 1.. Horwirz Rl. Emotional suppon and
SurviV'll aher myo ardial infarClion. A prospcclive. popuhltion-based stud}'
of rhe elderl)'- Il"" I"tem Ml't! 1992 Dec 15; 117( 12): I003-1 009.

III Thorogood M. Cowen I~ ct al. Faral myoc:uJial infarcrion and usc of

psyc!Jo{lopic d rugs in )'oullg women. Lmeet .1992 Ocr 31 ;340(8827): 10671068
t12 American Hearr Associariof1. 1997 Heurt iI"d SlI'okc SIlitistim! Updiltl.
American Hearr Associ:Hion. 1997 p. 3.
Il.l Johnsoll CL, Rifkind BM. el al. Dcclillillg serum tolal cholesrerol
levels among US aclu.!r. Thc NationaJ Heahh and NlIlririoll Examinalion
SUI'veys. fA~I1A 1993 Jun 16;269(23):3002-3008.

'OI

1'1 American Hean Associalioll. 1997 Hellrll111d St,.okc StntiJliud Uprln/t'.

Americ<ln Heill'l Associarion. 1997 p. 2.

IO~ Amcric~n Hean Associarion. 1997 Henrt n"d troke tntistiml Updme.
American Hcan Associarion. 1997 p. 3.

acks FM, Pfeffer ~A, ~t ~1. Thc Ef!'ec! of Prava5larin 011 Corollary
EVC11lS after M)'ocardial Infarajon in Pariems IVilh Avcragc Cholcstcrol
LeveJs. N Eng!J Ml'f/1996 Oct 3:335(14):1001-1009.

Glueck CJ. Nonpharmacologic .nd pharmacologic ireration orhighden ity iipoprOlein cholesterol: rhcrapcutic approachcs ro prevemion of
.uhero c1e{osis. Am HFnrr} 1985 Nov; II 0(5): II 07-1115.

10) Harrung GH. Fore)'t JP et al Effea of almhol inrake on high-densiry

lipoprotein cholcsrc(ollevels in nJl1ners "nel inactive ruen. lA.MA 1983
Fcb II ;249(6):747-750.

,0-1

Gibbolls L.\'iI, Mirchell TL. HDL Cholcsrcrol and Exercise.

YoII/'

Pa-

riem & Fil1Jtsf 1995 JlIJ)' 16-AlIgust;9(4):6-13.

10\ Bordia A. Effecr of garlic on blood lipids in palients with corollary
hem disca e. Am} CIi" Nil!" 1981 O t:34( I0):2100-2103.

lOG Willctt Wc. MansoJl JE. CI al. Wcight, wcighl changc, anei coronary
!leal! diseasc in womcn. Risk wid,il1 thc 'normal' wcight rnnge. fAMA
1995 Fcb 8;273(6):461-465.

rer G. Epsrcin AM. Cosr-effccliveness of amiJl)'pcrlip~nliclherapy

in the prevcntion of coronary hcart dis~" c. The case of cho1csryral1line.
}AMA 1987 No 6;258(7):2381-2 87.
l07

11\

The Harvard l-kdth uun, 1992.

116

117 Bcnnett, H. Personal COllllllunicatjon. Aovenust Heahh 5tl1d\'; Lam:!

Linda Universiry 5chool of Public l-Iealrh. Augusr 1996.
.

'18 l'hillips RL, Lcmon FR. er al. Coronary hearr Jjscase monaUry among
Sevcnth-Da)' .Adve11lisr wirh diffcring Jietary habi!s: a prdiminary report,
Am} Clin NII/" 1978 Ocr;31 (10 Suppl):S191-S 198.
119 Amcricm Hean Associaton. 1997 Ham IIml St,.o!u Slil/inurIl Updll//'.
Amccrican Hean Associ.,uion, 1997 p. 2.

IlO

Medirn!Ti'ifJlIJlF, Cardiology secrion, Mar 23. 1995. p. 5.

III American Hean Associ:nion. J997 HClII'/ IlIId S')'oke SliIti.<tiClJ! Update.
AmericlIl Hcart Associarion, 1997 p. 2
lU AJ11ericll1 Hean Assocjarion. 1997 HCIIl'tl1l1d Stroke Srlltistica! Updll/e.
American Heart Associarioll. 1997 p. 1Il.

89

PROOF POSITlVE

90

CHAPTER FOUR

BLOCKED

RTERIES:
Clean Them Out
Naturally

he ~aJdiologisr ~lHered.d1e examinanon room wlth a grlm look on

his face. Aher exchanging a few
formaliries, he came ro rhe main
reason for rhe consulrarion. "Jim, I've reviewed your angiograms again, :llld r.here is
1l0.opriQn. You will need ro have bypass
surgery."
Jim was dearly shaken. "Bur doctor, are
)'OU sure? J nearly died on the operarng
rabIe rhe lasr rime 1 had surgery. Are mere
ilO orher oprions? What abour that balJoon
procedure-or new medications?"
Jim, J really am sorry. J know how
much you drcad ilie rhought ofsurgery. but
rhere is simply no orher oprion."

T
I

Drawbacks ofHeart Surgery

DiaJogues like chis take place thollsands
of rimes each year in America. In spire of
al1 of oul' advancemelHs in rechnology, we
stiU perform some 500,000 hean bypasses
each year. l The darling of hearr specialisrs
roday, however, appears ro be coronary
angioplasty. Fully 404,000 angioplasries are
performed each year in the 0.5. 2 Often
referred (Q as the "balloon procedure" in lay
circles, rhis rechnique opens Lip bJocked
hearr arreries by forcibly opening a sturdy
baUoon inside the c10gged vessel. The balloon flauens our rhe obsrructng farry de-

posirs, and rhus allows more blood ca pass

through the previously narrowed area. If
the cardiologisr believes rhere is a high likelihood of repear elosure of rhe artery, a stainless steel wire O1esh circular wbe, called a
"srem," will be placed where (he angioplasry
was performed ro decrease tlle possibiliry of
short-renn repeated c1ogging.
Many lay people roday have become so
familiar wirh borh bypass surgery and
angioplasty rhar chey mighr rhink thar Jim
is a bit childish to fear slIch weU-honed
rherapies. Ver, expcrrs who recognize ilie
resulrs of these common procedures would
likely share Jim's senrimellts. One of che
grearcsr concerns wieh rhese memods is rhar
rhey do not address the underlying disease
process. Th:l.( disease is arheroselerosis, a
condirion rhar silendy affects blood vessels
throughollt rhe body. The disease causes a
slow but steadily il1creasing blockage of
major arreries. Bypass surgery and
angioplasry do nodLing {Q change rhis
gradual accumularion of farry deposirs
throughollt the body. These high-rech procedures only "buy time" by addressing what
are ofren rhe most life-d1fearening areas of
blockage-the blood vesseIs nourishing d1e
hean. If rhe process of acheroselerosis is nor
addressed, the arreries rhar have been bypassed wiIl again c10g up; rhe vessels mat

91

PROOF POSITlVE

THREE DRAWBACKS OF
HEAR SURGE Y
Provides a temporary fix.
Does not corr,ect tbe
underlying cause.
Permanent side

effect.s can occUJl".

High cost.

Figure 1

92

have been angiopl~~tied OI' steIHed will again

be obsrrucred wirb fatry marerial.
Furrhermore, surgiGlI merhoels are expensive anei fraught with some very real
risks. The ave rage cosr of a hospiralizarion
for coronary anery bypass surgery is
$35,000 to $62.000 (national average of
$44,200) depeneling on the operaring surgeons anei in what hospitaJs rhey perform
rhe surgery,5 AJthough rhe risk of operarive
dearh is 1l0W down ta about tluee percenr
or less in some cenrers,4 most people are
completely unaware of the potentially permanent siele ejJect. rhar can occur from dus
surgery. For insrance, tv"o percenr of bypass parienrs have a stroke anei up ro 57
pereenr suffer some kind of neurological
complicarion, often so subrle that [he
inelividual's family may have simply written it off as 'Dad is just getting older."S. 6. 7
MIU evaluarions have shown thar rhe brain
swells v,;ithin an hour ofbypass sllrgery; rhe
reason may be panly ex.plaineel by microscopic blood c10ts rhat arc COllllllon duting
hean surgery. 8
On (he orher hand, coronary angioplasry
COStS abolit $22,000, elepending on rhe
physiciao who eloes rhe procedure and
where ie is performed. 9 The failure rare of
angioplasties done 00 a single heart blood
vessel in rhe firsr six months is 35 to 45 percene, and for mul(i-vessel angioplasries is 50
ro 60 pereene within the same length of
time. Such F.!.ilures rhen require an omer

angioplast)', stent placement, Of even bypass

surgery.lO
Thus, performing surgery on a person
with hearr disease has three drawbaeks, as
summarized in Figure 1.

Alternatives to Conventional Tretltments for Heart Disease

Fonunaeely, rhere are alternatives ta bypass surgery, angioplasty, and medications.
However, many pariems-and even phy icians-ar nor aware of rhese options. Prevenrive medicine experrs have now proven
(har blockages in hem blood vessel can be
rel)ersedby changing one's lifesryle. Perhaps
what is more important, when li ed properly, lifesryle agenrs such as stress control,
smoking cessation, diet, and exercise have
no harmfuL siele effiCiJ. The only side effects
are desirable ones-coneriburing ro a betrcr
qllaliry of life anei a decreased risk of diseases of many rypes in addirion ta heart elisease.
Those incljviduals with hcan disease who
become aware of rhe faers as outlined in rhis
book are confroneed with a vital quesrion:
"Am J willing ro make the eommon sense
Lifescyle changes necessary ro reverse Ill)' disease?" II' rhe answer is "no" it is likely that
either angioplasry 01' bypass surgery will be
llnavoidable ar sOllle poine.

The Standard Heart Disease Diet

Some hospjeals in variou l'am of rhe
worlel otfer nutririon classes for indviduals
who are trying ro deal wirh hearr disease.
This dicr instrucrion focllses mosuy an rwo
main issues: deereasing saturatcd fat and ro
a lesser exrem decreasing cholesterol in [he
diel. Comprehensive programs also tailor
rhe dictary advice ro help overweight pariems Iose weighr. In 1992 rhe National
lnstitlltes of Healrh's "Expert Panel" spelled
11
Out rhese goaJs wirh specific guidelines.
Their guidelines were similar ro mose enuncated by other presrigioLls inelivieluals OI'
groups such as rhe Surgeon General I
American Hea.rt Associatjon 13 and Naronal
Aeadem)' of Sciences. '4 The guielelines are
somewhar effective, but fali shorr of yielding u1e desired rcsulrs.

BLOCKED ARTERIES
In this ehapter you will see a diel mar is
fu superior ro rhe diets suggested by rhese
in~tirtHions. Howcver, rheir recommcnded
dier is wonh examinjng because of rhe widespread populariry it and similar diers cnjoy.
lr is called rhe Narional Cholesrerol Educarion Program (NCEP).
The NCEP diet reeommends Jimjring
daily cholesterol inrake ra 300 mg per day
in rhe Srep r elier, anei ro 200 mg in rheir
mosr restricrive ar Srep II diee. In both diers, far is ro be kepr ar ar below 30 percenr
of rhe raral calories. Sarurated fu is ro make
up only eighr ra ren percelH n rhe $rep 1
dier, and less than seven percenr in rhe $rep
II diee.
How do rhese levels of cholesrerol inrake compare [O ehar of rhe average American? Approx.imations indicare rhar men consume 270 ro 400 mg per day and women
consume 200 ro 260 rog per day.l;
Therefore, mosr women and many men
are already below rhe NCEP cholesrero!
goals of 200 or 300 - but have we seen a
large decrease in hearr disease? Hardly. We
c.m be glad ehar Americans overall have lowered rheir cholesrerollevels, bur we cannor
be sarisfred ro only begin the race. We wanr
ro win it. A dierary cholesrerol of even 220
mg is srill higher rhan the oprimum ,unOLlIH,
as we shall funher illustrare. In addirion,
Americans also consume significant
amounts of far in rheir dier, including sacurared far, which of irself has a blood cholesrerol-raising effece.

Failures ofThe Standard Heal't

Disease Diet
Let us see whar The National Choie rerol Education Program Dier, by jrself, has
dane for people. In a srudy called rhe Cholesterol Lowecing Atherosderosis Srudy
(CLAS) , individuals with corona!'y arrery
disease were r[eared wirh diet ar diee plus
medicarions. The djer used was one that
rhe researchers apparendy thought was
miC(: no more rhan 250 mg ofdietary cholesterol per day, and less thaD 26 percenr of
calories from far. 16 Norice rhar dle CLAS
dier was actuali)' quite simila.r ro rhe National Cholesterol Edllcation Prograll1's rec-

ommendations and was more fat-restrictive

tha.n the average American diee. Mrer faur
ye.:us on rJ1IS program, rbe panicipanrs' heart
arc ries were re-evaluated by coronary
angiograms. Those on the special diet wirhOUt medicarion had a meager decrease in
dler rotal and LDL (bad) cholesrcrolleve1s. The resulrs of rhe angiography (special xray picrures of rhe bearr aneries) before and

Standard heart disease diet

After 4 years:
6 0/0 decrease in total cholesterol
6 0/0 decrease in LDL cholesterol

Angiography results:
6 0/0 regression
150/0 no cbange
79 % progression

-..

-..
Figure 2

afrer (he four year period, along \Vlrh the choIesrerollevels, are shown in Figure 2.
These are very discouraging reslllrs.
Noriee dur rhe vasr majoriry, almosr four
out of five, had lUorse blockages rhan rbey
did before rhey went an the dieL Only six
perce n t expedenced an im provemen r.
Cleariy, rhese dienry change and rhe resulring six pereent drop in coral cholesterol
and LDL is not mouglJ for (he average person wi[h comnar)' anery disease. The resulrs are nor unique. Similar studies have
been perfoIllled in differenr settings and rhe
resulrs are always similar and equally disappOlnClng.
Another srudy rhar illu trales chis pojD(
was called rhe "Program an the Surgical
Concrot of rhe Hyperlipidemias."l7 1'h1s
srudy examined rhe resulrs of an inresrinal
surgery rhar iruerruprs rhe rec)'cling ofcho(es[erol through rhe digestive rraer. They
demonstrared rhar rhis surgery, caUed a "partial ileal bypass," could reduce cholesrerol
leve\s. This procedure carne on rhe scene
over 20 years aga; now, however we recognize [here are much beuer ways ro deal with

93

PROOF POSITIVE
elevaeed blood fars. Consequently, my inrerese is not in the group that was sllrgically
rreared. It is rarher in anorher group rhat
was smdied ar the same time, tllOse thac
served as (he "conrrols." Ac me beginning
of the program (hey randomly assigned enrollees ro one of rhe t\vo grollps. The controls did noc have rhe imes(in.al. surgery but
were placed on a special diec instead. Spcci fi cally, they were given a diet chat was as
restrictive, if not more restrictive [han rhe
study shown in Figure 2. It conrained 25
percene fat and 200 ro 250 mg of dietary
cholesrerol.
The subjects were ob erved for a perod
of ten years. Those on rhe die( program
low red their total cholesrerol and LDL. In
one year their average LDL choleseerol wene
down slightly, from 178 ro 174. By flve
years on the program mac average was down
even more, ro 167, and by 7 years ir was
159. Even ar 10 years, parricipams stiH
maintained a lower average cholesterollevel
rhan when they started, alrhough the LDL
value had risen back to 167. Despite the
modest improvemene in cholescerol nUIl1bers, blockages in cheir hea.rc arteries became
progressively worse. as shown in I;igure 3.
Norice tllar ehey sceadily became worse
ehroughollt the 10-year perjod. Ar che 10-

After 3 years
41 % had progression

After 7 years
77% had progression

After 5 years
65% had progression

Figure 3

94

After 10 years
85% had progression

year pOilH, fuJ!y 85 percenr showecl disease

progresslOll .
Is it an)' wonder that so Illany bypass
pariem must undergo a repeat surgery 10
years lacer? Although a few individuals improve on a dier like that recommellded by
t.he National Cholestero! Education Program, most do not improve. Sporadic success sCOl'ies are simply not good enough.
Imagine yom disappoinnnenr and frusuacion if you had hearc disease and pt:rfecrJy
Followed your docror's dier instructions for
years only ro find ehat your hean blood vessels became significantly wor e. Your frus{[ation wOllld likely further in crease if you
men learned t.hal almosr everyone e1se who
perfecdy followed me same diec also became
worse. Frustration woulcl become complere
when you learned that rhe dicr had already
been rested and found ro be inadeqllate.
It is obviou.s thllt something better is
needed.

A Proven Diet for Heart

Disease Revemtl
De. Dean Ornish and colleagues conducced a srudy called 'The Lifeseyle Hearr
Trial" in the San Francisco Bay area. 18 Like
the rwo previolls examples, me focus was
noe on bypass surgery or angioplasry. In
chis trial, rhere was a remarkably different
dieralJ' approach: insrcad of allowing 200250 mg of dietary cholesteroI, as did rhe
t\vo previolls srlldies, che Lifesryle Hean
Trial allowed a mere 5 mg of cholesrerol per
day. Insread of 25 ro 26 perceJlt of calories
from fat, this study allowed only a 10 percent far dieL Total calories. howevcr, were
noe restricted. Basically, rhe dier was nearly
total vegecarian (fruirs, vegetables, grain ,
and a small amOlJlH of Illlrs) wirh no animal products excepr egg whites and up ro
one cup pet day of skim milk or non-far
yogurt. (The skim milk Of non-fat yogllrt
comains 5 mg of cholesterol.) The resllirs
of the Lifestyle Hean Tria! are rablliated in
Figure 4. This diet is remarkab!)' bener on
aII counts. Notice rhe very large decre:,l. e
in both (Ota! cholesterol and LDL "bad"
cholescerol. These decreases are much
greater ehan rhose rhar occurred in rhe pre-

BLOCKED ARTERIES
vious (\VO srudies. Especiall)' norewonhy is
(he face tbat these individuals were aJready
on a program ver)' c10se ro chac advocar.ed
by r.he Nacional Cbolesrerol Educacion Program b~(rJre this srud)' began. Before working wirh Or. Ornish and his col1eaglles, ilie
parricipanrs on rhe average were anI)' consull1ing 3] .5 percenr of rheir calories from
far and 213 mg/day of cholesterol.
O)'e srudies of ilie hearr blood vessels,
called caronar)' angiogr<UllS, were ll1ade before (he program scarted and tben 12
mOIl{h later. Special campucerized 3ssessments of these angiograms allowed very precise calcu1acion of whecher na.rrowing had
worsen d, s(3)'ed ehe same, ar improved. Ta
rhe atnazemenc of mall)' physicialls, che
compucer comparisons revea.led thar 82 percent of (he patienrs experienced a reversal
of their arherosclerosis. anI)' 14 percenc
had no change, and jllsr 4 percene worsened.
This is che fim scudy where any significanc
rcgression occurred by lifesryle changes
;llone, and it happened ro 82 percent ofparticipant.' wich i n rhe shon per iod of J2

months.
"Regression" \Vas rhe rerm applied ro the
reversa!s in bloc.kages char occlIrred in becler rJlall 8 in 10 of rhese parricipants. Overali, there \Vas a 2.2 percem diamerer regression ofalliesions, which rranslates to a bJood
Ilow increase of9 percem. Norce char chose
who began rhe srudywim the greatestscenosis OI' bloc.kages, and rhus had che greatesr
need for regression, reaped rhe greatest bentors. Of rhe coronaries rhac were more rhan
SO percent blocked rhere was a 5.3 percenr
iJllprovemem, uans!aring co a 23 percenr
increase n blood flow. This is a significam
amount of regression afccr ani}' one yea.r.
Be.fOre this study was conducted, most physiciam diei not beliel/e regre.iSion bJI lifestyle
c!Jange WI1S possible in an'y length oftimelee alone within twell/e months.
Note rhac a small percentag change in
di:.unecer steJloss provides a much greacer
percenrage increase of blood flow. This is
because che blood Haw rare is malhemaricll1y proportional ta che fouCth power of
the c.hange in diamerer (rhe diamerer change
mulriplied by icself 3 rimes). 10

RESULTS OF 10% FAT AND 5 mg

OF CBOLESTEROL DIET IN THE
LIFESTYLE HEART TRIAL

IArter ODe year:

24% decrease in total cbolcsterol
37% decrease in LDL cholestcrol

Aogtography:
82 % regrcssion
14% DO change
4 % progrcssion

AJllelloDl:
2.2% diameter ovcrall regressioD
of atbcrosclerosis (alllesions)
9% increase in blood fIol"
LetioDl grellter than !4).;' bl~kage:
5.3% regressioD of atberosclerotic
lesioDS greater tbao 50% blockage
23% iocrease in blood fIow
o

Figure .4

DIETCONTE
LIFESTYLE BEA
No animal products except egg
whites aod nonfat dairy
7510 complex carbohydrate
Al (east 15% protein
Lcss than 5 mg of ehulesterol
No caffeine
Calories not restricted
Figure 5

Diet ofSubjects in the Lifestyle

Heart Trial
Even Wilh Il1cdications, not a single
scudy before the Lifesryle Hearr Tria! demonsrrared regression in such a shorr period
of rime. Th.is study not onl)' showed dur
regression is possible in a shorr rime, but ir
can occur witbout the use ofmedications, furnishing an example of\Vhat Ca.tl happen with
che acceprance of a simple Jjfestyle program
mat includes an excellenr diet among ocher

95

PROOF POSITIVE

LIFESTYLE CHANGES
THE
LIFESTYLE HEART TRIAL
Low fat vregetarian diet
Stress management training
Smoking cessation
Moderate exercise
Social and emotional
support
figure 6

rl:JS!

,-

'~'.-.

/~

~.

"Fa,miliar tbings happen and

mankind does not bother aJbout
them. It requires a very unusual
mind to undertake the
aoalysis of the obvious."
figura 7

TREATTNG THE SYMPTOMS

facrors. Ler us rake a c10ser look ar the dier;

it is outlined in Figure 5.

Factors Other Than Diet in the

Lifestyle Heart Trial
A10ng with changes in diet, rhe subjects
made several omer lifeseyle changes. The complete list of changes is shown in Figure 6.
Recently, Ornish's patients completed a
nve year follow-up eva1uarion. Measurement ofhean blood flow continued ro show
signiflcant improvements when compared
ro rheir evaluatjons before the five year program, and when compared wirh rhe COIltrol group who received rhe N CEP-rype dier
and other aspecLS of usual Gue. 20
Alfred Whirehead, a philosopher, Wl'Ote
a stacemenr thar apples ro this problem of
heart disease and rhe srudies chat show ies reversaJ. The staremellr is quored in ,Figure 7.
Or. Ornish's work provides a good e.xample ofwhat an unuslla1 mind can do witb
the obviollS. Hean disease is the nllmber
one killer in Americ.1. Every U.S. physician is very familiar with it, yer it seems mat
mosr of LIS merely rrear the dise~se's symptoms rather rhan rhe roor cause. Lifeseyle is
c1early ule roor cause in the vast majoriry of
cases. Many medical professionals spend
so much rime and efrort mopping up rhe
Ooor that we do not norice dut an overrunning fallcet is the lInderlying GIUSe of
rhe problem, as illustrared in Figure 8.
Now mat t!le obviolls has been demonsrrated, it is time for people wirh hearr disease ro rake notice and begin ro change (heir
lifesryle accordingly-before it is roo late.

Ca.ffeine May Work Against the Heart

96

Note rhar beyond dle near zero cholesterol intake and a very low fat intake, rhe
Lifesryle Hean Ti-ial alJowed no caffeinc.
Why prohibit caffeine, when it is an integral ingredient in some of Americ.1'S f.worire foods and drinks? First, there are concerns that caffeine may have a relatively
small bur signific.1nt effecc in elevating cholesterol ,md blood pressure levels,2l It a150
may raise the blood homocysteine level
which may bring about atherosclerosis. 22
What is more important, Ornish and his

BLOCKED ARTERIES
eolleagues excluded caffeine becallse of irs
abiliry ro /lJorscn siTess in many people. 23
Srress control appears [O be extreme1y important in reversing coronary artery disease.
If you wam ro sray cool, collecred, and
sready, ir will often reqllire a c1ean break wirh
catfeine.

E'Cercise with Elevated Heart Rate

The Lifesryle Hearr Trial also inclllded
a regular exerei e program as oudined in
Figure 9. The goal was to rake a daily walk
rhal is brisk enough ro ralse r.he hearr fate
in beats per minure ro 50 ro 80 percem of
each ;ndividual's m,Lximum heart rate.
The maximum heart rare and the Guger
rare for exercise is calculared aceording ro
age. To illllstrare rhis simple calculation.
derermine your own maximum rarc and
rarger rare a explaioed in Figure 10.
An emry-level srre s test was adminisrered ro each participam before rhe exercise program began. If a person had an abnormal EKG rhat indiated a shonage of
blood supply ro the hearr dming rhe resr.
rhe hearr rate ar rhe moment of rhe shortagc was nored. The targer bear rare for rhar
person's exercise session would be 50 ro 80
percelU of rhar hearc rate. l4

Total Blood Cholesterol Reductions in

the Lifestyle Heart Trial
There were two groups ofsuhjecrs in the
Lifesryle Hean Trial. The results presel\{ed
rhus far are for the grollp callee! rhe "Ex_
perimental Group." The other group was
called rhe "Control Group." The control
group followed a diet similar to [he National
Cholesterol Eduearion Program dier as previously spelled out. A eomparison of rhe
tora1 eholesterol of rhe rwo groups is hown
in Figure II.
This graph vividly illu rrares rhe superiority of rhe vegetarian diet of rhe experimental group over rhe mear-earing dier of
rhe control group. The vegerarian group
had a 56 poinr reducrion in cholesterol, or
24 pereenr. after one year; rhe mear-earing
group haci only a 13 poinr reduction, or six
percenr. This is whar we would expeer for
rhe mear-earing group, in keeping wirh rhe

EXE CI EP OG
LIFESTYLE DE

RE

Walking
3 hours per week,
at least 30 minutes
per session
Heart rate at 50-80%
of maximum heart rate
Figure 9

YOURTARGETHE
CALCULATION O
AE
ICEXE C E
Step 1 Figure your maximum heart rate by
subtracting your age from 220.
Example: ifyou are 40 years old, your
predicted lIul.;'Cimum would be 180 beats
per minute.

Step 2 Multiply that number by 0.5 to give the

lower end of your range and 0.8 for the
upper end. Example: ifyou are 40
years old, tIris wouJd be 90 to 144 beats
per minute.
Figure 10

TOTAL CHOLESTE OL CHANGES

IN THE LIFESTYLE HEART TRIAL
Total ellolesterol

260

245

240

Exp.

220

Cont.

232

200
180

160
140

120
Baseline

One year
Figure 11

97

PROOF POSITlVE
rypical six percenr decrease attained on the
National Cholesterol Edllcarion Program
Oier. Can we be sarsfied wrh so small a
reducrion when we know now rhar a ve.getaran diet like [he Lifesryle Hearr Trial djer
can provide such siglliflcam positive resll1rs?

L L CHOLES
OL CHANGES IN
E LIFESTYLE HEART TRIAL
LDL c/lOleSlerol
180

166

160

Impact ofLow LDL

Exp.

Cont.

157

140
120

95

100
80
Baseline (pre)
Figure 12

One year (post)

SES
ReduCng LDL in heart disease patients with
Ihigh LDL was more effective than conventional
therapy as follows:
Reduced progression
frequency by half
Increased regression
frequency by 200%
Reduced cardiac
occurrences by 750/0
Figure 13

LDL Reduetions in the Lifesty!e

Heart Trial
98

ages the aneries, and produces coronaly arrery disease? Comparison of dle rwo groups
is depicted in Figure 12.
After one year on ehe vegerarian dier and
ocher lifesryle illtervenriolls, rhe LOL of the
experimental group droppcd 37 percen(.
The conrrol group rJ1ar was on a National
Cholesrerol Educarion Program-rype dier
onlyexperienced a drop offive percent. This
certainly helps w e.xplain why d1ere was such
significanr reversal of coronary anery disease in the vegetarian pariems.

What abolit rhe "bad" cholesrerol, rhe

LOL cholesrerol iliat so easily oxidizes. dam-

Numerous srudies have demonsrratcd

thar f rhe LOL cholesrerol s subsralHiaJly
brought dOW{l, reversal of coronary anery
dsease will likely occur. ome high LOL
subjeees with coronaJ)' hean disea e were
rreared by lowering rheir LOL and others
wirh conventional hean disease rherapy.
The resulrs are compared in Figure 13. 25
Abolit one in hve patiems thar has a
hean attack has a rotal cholesrerol below
200. A1rhough (hese pariems willlikely havc
other risk facrors such as smoking or a low
HOL, physcans have convenuonalIy not
paid aerenrion ro rheir rotal or LOL cholesrerol. However, a recent srudy has shown
thar he.arr arrack patienrs mar already have
"desirabie" cholesrerol levels will gain further benefit from a program rhar brings rheir
cholesterol down even furrher. 26

Vegetarian Diet Reduces Cardiac

Occurrences
FlIrrher SllppOrt for rhe dia wirh reduced cholesrerol and roral lifesryle approach is provided by the Sr. Thomas' Atherosclerosis Regresson 5tudy (STARS).27
This British srudy moved closer ro the dic[
program rhat Ornish lIsed and, as expected,
prodllced resllits rlUt were between thosc
achieved on rhe NCEP cliee and [hose Olt
rhe Ljfesryle Heart Trial regimen. The
STARS researchers wenr beyond rhe CEi>
Srcp II dier in a number of ways. They: (1)
added a sgniftcam amount of planr fiber
ro rhe dier (lip ro 6 grams per J 000 calories); (2) furtber decreased cholesrerol inrake amollnring ro only 100 ro 120 mg per

BLOCKED ARTERlES
day for mally of the panicipanes; and (3)
inercased polYllnsaturared f.1t in the eliet. AJI
of ehese changes made ehe diee closet ta a
vegerarian dler than rhe NCEP diet. They
aJso counseled parienrs againsr smoking and
"advised a suirable level of daily exercise."
However. me descriprion of rhese componenes in cheit repare slIggests rhar relatively
liale atten(ion was given to these areas COlllpared ro Ornish's strllcrured foclIs on exercise. When angiograms dane ar the beginning of rhe STARS were compared with
lhose dane an average of abOlit 3 years bter,
the results were as expecred. That is, rhe
results were becween rhase aehieved by
Ornish and those seen wirh rhe NCEP diee.
SpecificaJly, regressionocclIrred in 38 percem, while 15 percent progressecl; about haJf
clici nor show any significanr change.
However. lh is dietary approach decrcased clle number ofcardiac evenrs. When
ehey looked ar rhe toraJ of aU the serokes,
hean attacks, deaths, comnary bypass sllrgeries. and angioplasries. rhey realized they
made a remarkable impace. Whereas ten
percenr of control patierns had one of mese
evems, only mree percenr ofthe dier-rreared
patlents had one.

HDL Did Not Rise In the Lifestyle

Hetlrt Triaj
Whar abollr HOL cholesterol? As we
saw in me previolls chapter, the higher rhe
HOL cholesrerol the berrcr as far as heart
disease is concerned. The HOL valucs for
r.he (wo groups are compared in Figllre 14.
Borh groups had a slight decrease in
HOL, which is so small as ro be scatisticaJly
insignificanr. However, rhe experimenraJ
group stiH experienced reversal of coronary
hearc disease despite rheir low HOL. 1 believe mis makes an important. sr.acemenr: if
you have coronary anery di case, Jowering
your LOL is more important (han raising
your HOt. The control group had a higher
HOL, whidl is considered to be heaJrhy,
but cheir earonary arrery disease sriH gat
worse. which suggesrs again rhat lowering
LOL may be more imporram in regression
of amerosclerosis. However. do not chink
[har me rale of HOL is of 110 imporrance.

HDLC OLESTE
THEL FESTYL
HDL c1wlesterol
60

53

Exp.
Cont.

50

51

40

30

20

o
Baseline (pre)

One year (post)

~
Figure 14

We willlook ar HOL concerns more c10sely

later in the chapler.

Triglycerides IncretlJed in the Lifestyle

Heart Triaf
For average Amerieans, [he higher rheir
rriglyceridcs, the worse ehey fare as far as
coronary anery dlscase is cOllcerned. 2 Ir
was rherefore slIrprising rhat [he inelivieluals who reversed cheir hean disease on [he
Lifesrylc Hean Trial experienced a rise in
rheir rriglycerides, as secn in Figure 15.

T
Triglyceritles

270

256

250

Exp.

Cont.

230
210
190
170
150

Baseline

One year
Figure 15

99

PROOF POSITIVE
The vegetadan group haei a 46-point
increase in rriglycerides. On the other hand,
{he cOlluol group [owercd (heu triglycerides over r.he samc time pcriod by 17 point.s.
This rise in triglycerides is nor rypical for
vcgerarians in orher srudies. Some studies
have idenrified groups of vcgcrarians wirh
lower triglyceride levels ehan average. 29, 30
Whar, tl1cn, was happcning in tl1e Lifesryle
Hcarr Trial? Individua.ls an a jat-restricted
vcgcrarian diet may rcnd ro run a higher
rriglyceride Icvel because d1CY are consuming higher amounts of complex carbohydrares. Carbohydrares made lip fully 70 ro
75 percenr of thc Lifesryle Hearc Trial eliee
However, these carbohydrate-rich foods
usually look like good guys regarding hean
disease risk as wel! as cancer risk. Ir seems
difficult ro comprehend rhar rhey wcre getting "roo much of a good thing."
Alrhough rhe rise in rriglyceridcs did nor
appear ro interfetewith the ovemll success
of rhe Lifesryle Hean Trial ir leaves a nagging question: cOll.ld the teslllts have been
stiH berrer if far consumprion had not been
so rigorously reduced? Could Ornish's severe fat restricrions COme back ro haune the
parricipanrs in rhe long run? The quesrion
is more rhan academic. As we have a[ready
seen, vegerarians who havc not made pains
ro drop their f:l.t intake, do rend ta consume
less fat than average but nowhere near as
litde as Ornish anel his colleagues required.
lnterestingly, in Resnicow's own research,
as well as in nine o[her srudies rhar he anaIyzed, toral vegctarians generally had lower
cholesrerol, lowcr LOL levels, and lower
triglyceride levels-all wirh equally good
HDL levels. 31 This evidence cam sLlspicion
on the exrremel)' low far inrake and rhe corresponding higl~ carbohydrare inrake of the
Ornish dier being the cause of the risc in
rrigJycerides.
Another report documeming vcgerarians' lower [riglyceride levels provides further insighrs. Specifically, vegcrarians who
decrease {heir far consump{ion within more
moderate range5 (down tO 23 percent of
cheir calories) have been found to lower {heir
triglycerides. 3- Other teseareh has shown
that a vegetarian dier that doe. not excessively restricr fat consumprion 01n Jower

100

cholesterol levels, yet nuintain HOL va!

ucs. 33 These srudies cast nlfther sLlspicion
on dle very low-fat diet. The concern is
rhar lowering fat con.sumption w the profound levels of (lte Ornish diet w111 result ill
a tiSf oftrig/ycetides and a dcprcssion o/HDL,
as we have seeI). in. the Lifesryle Hean Tria!.
A laSt bit of information m<ly help ro
put the pcrcent fat issue inta stiU berter COIltext. When Dr. Ornish analyzed his da[:I
ro find rhe mOSI imporcant parc of his diet
in reversing hearr disca e, he found ir \Vas
irs low cholesrcrol COlltcnt rarher than irs
lo\v far conrenr .34 Ir implies thar U1e absence
of animal prodllctS in the dier (which ensures that a dier will have no chokstcrol) s
more imporranr rhan dramatic l'edllCrions
in far contenr. This line of thinking is in
harmony wirh rhe !arest srudies rhar demonstrate the preventive benehtS ofsome high
far, no-cholesrcrol foods like nllrs. Srlldies
an dle beneficia.! effects of nllrs are pre.seIited
in the prcviolls chaprcr.
Stil! furrher support ro this perspective
comes from Sranford University. Researchers there a[so demonsrrated dur lifesryle
changes cOllJd be used ro significanrly impace rhe progression of coronary artery disease. 35 Based on {heit research and orher
published srudies, rhey concluded: "In general, it appears (har bener angiographic ourcomes are achieved wirh greater reduceions
[i n LO L cholcsrerol] beca use stud ies reponing regr ssion of diseae in rlleir rreatmellt
groups 31so produced reduc(ions in LDLof
35 percent 01' more." As we have seen in
rhe previous chapter, a very lo\\' far elicr is
nor necessary ro achieve a reduction of either tOtal ar LDL cholesrerol.
Considering ali of [he evidence regarding the besr level for far in the diet, we Conclude dur five ro ten percem is too low, and
30 percen{ is probably too high. AbOlit 25
percenr fat scems ro be oprimum.

Chest Plfins R~duce Rttpidly With a

Vegetarran Dtet
When an individual experiences frequent chesr pain rypica.l of coronary arrery
dlsease, rhey \ViII ofren undergo a coronary
angiogram. An angiogram derermi nes if rhe
pariem does indeed have signiHc..1.nt coro

BLOCKED ARTER1ES
nary anerl' disease. Ifblockages are present,
the tesr measures exactly where and how
.-evcre rne blocbges are. Partially blocked
arreries reduce blood flow ro hearr muscles,
causing pain in the mllscle.
In several studies preselHed in rhis chapter, rhe parricipants were individuals who
haei heart-related chest pain. or angina, on
a frequenr hasis. lr was rhis pain rhar rr.iggered rhe examination of rlleir coronar)' arreries in rhe fi rsr place. We have seen thar
rhe vegerarian group in rhe Lifesryle Hearr
Trial had significanr improvemenr in their
overall cholesrerol levels and reductions n
lheir areerial blockages. What happened ro
their chesr pa.ins~ When ilie studl' slaned
lhe average rnember of rhe experimenlaJ
group experienced chesr pain approximarely
five limes per week. Chesr pain comparisons of the lifesryle group and rhe onrrol
group in {Ile Lifesryle Hean lrial are shown
in Figure 16.
(hest pains in ilie experimenral group
(vegerarian dier) decreased 91 percelH, [O
less than once per week. On rhe orher hand,
in the control group (mear diet recommended bl' CEP) rhel' worsened hy 165
percenr over rhe course of a year. These resulrs are as expected, and in agreemenr with
the reduced blockages in the hean aneries
of the fim group and increased blockages
in the !aner rhar were shown in Figure 4.
One resulr of this srudy was largely unexpected. The dramatic 91 percem reduclion in chest pain of rhe experimentaJ group
occurred in tiu! first ihree weeks-Iong betore we could reasonably expecl an)' signiflcallt physical reversal of rheir blockages.
Such quick reductions in chest pains were
starrling ro mally in rhe medical communil}'. However, orhers of LIS were well aware
of the dramatic shorr-term changes ('har
could take place wirll lifesryle changes. 1
personally have seen mally patiellrs who.
initially. would merely wa1k across rhe room
and develop crushing anginal chese pain.
After twa ar three weeks an a vegerarian diet
and exercise program. maol' of rhose same
parienrs would be waJkingfive mi/es il dl1)1without chest pain and using less hearr rnedicalion rhan before. The rcsults are ofren so
amazing rhar you wOllld have ro sec it firsc

hand (O flllll' appreciare the dramaric improvement.

High Blood Cholesterol Preverzts Blood

Vessel Relaxation
Alrhough some people think of blood
vessels as wbes or pipes dur pass rhrough
OUl' badies, such a characrerization is misleading. Actuali)', healehl' arreries are muscular organs rhat have rhe abiliry ro control
how much blood f10ws rhrollgh them bl'
changing thei r diamerer. Thel' can relax and

A IIgill a freqllency/week
.Exp.~

7
6

Cont.

6.24

5.10

4
3
2

1
O
Baseline (pre)

Ooe year (post)

Figure 16

allow more blood ro pass rhrough, ar rhel'

can consrricc and permir less blood f1ow.
Blood v ssel re1axarion is eXlremel)' imporranr ror rhe work of rJle hean. Relaxarion
of tlle caronary arreries a110ws grearer blood
/low ro rhe hean muscle. Relaxarion of
blood vessels elsewhere reduces th hearr's
workJoad bl' decreasing che resisrance thac
rhe hearr pumps againsr.
1f reducrions in rhe amoulH ofblockage
could not explain rheir improvemenr in
chesr pain, what could? The reasons for rhis
impressive reduclion in angina on rhe vegerarian dier are only recenrly becoming elear.
The answer probably relares-ar le~lSt in
pan-ro how a vegerarian dier can help relax blood vessels.

101

PROOF POSITIVE

A
Foodltem

Amollnt

Arg (g)

American cheese
Egg ~
Nonfat skim milk
Beef sirloiD steak
Firm tofu
English walnuts
Brazii nuts
Almonds
Black walnuts
Baby Uma beans
Red kidney beans
Garbanzo beans/
Chickpeas
Lentils
Soybeans
Roasted pUlmpkin
kernels

1 piece
loz.
1 c.
loz.
1J2 c.
112 c.
112 c.
1/2 c.
112 c.

0.2
0.2
0.3
0.5
1.3
1.3
1.5
1.6

1 c.

2.4

..".

Figure 17

102

2.3

1 c.~.., 2.6
1 c.
3.6
1 c.
1 c.
1/2 c.

4.2
5.3
6.2

The Role ofNitric Oxide in Preventing Chest Pain

A chemical in rhe blood called nirric
oJLide i essential ro the abiliry ofblood vessels ta relax. Nor ro be confused wieh ninous oxide ("[aughlng gas"), ninie oxide is
a critical relaxing factor dur is made by rhe
endoehelial ceUs lining our blood vcssels.
However, when cholesterol Icvels rise, rhe
blood vessels do nor relax sufficiently in response ro )linic oxide. Changes in blood
cholesterol levels can make a significant differcnce in the amounr of reiaxaeion in a
shorr period of rime. Recentiy, researchers
caused pacients' cholesrerollevels ro rise by
stopping their cholesterol-Iowering drugs.
Wirhin [Wo weeks there was a signific.1llr
drop in responsiveness ta the effects of nirric oxide. reducing relaxation. 36

Why wou[d high cho[esterol levels inrerfere wirh rhe effects of nirric oxjde? Recent lab work provides one reason for this
associarion. Researchers have now documenced ehat high blood cholesterol [evels
cause the destruction of nirric oxideY The
endorhelial cdls try ro compensate for this
[OS5 by making more nitric oxide. 38 Ho\\'ever, due ro rhe rapid destfllction of nit.rie
oxide, ehose cells generally run Out ofL-arginine, a crucial raw material thar is essenrial
for making ninic oxide. A recent study
demonstraeed ehat a significant cholesrerol
drop will improve suess EKG test scores
(showing improved blood flow to the hean)
in four weeks. 39 In harmony wirh rhese relationships, scienrists have found mat giving addieional L-arginine helps resrore normal anery relaxation even if someone has
high cholesterol levels. 4o L-arginine JUSt
happens ro be found in abundance in a vegetarian djet, but is sparse in mcat and dairy
products. Tabularion of the arginine content of foods is shown in Figure 17.
Note that meat and dairy proclucrs fali
far shon ofargininc in comp:uison ro beans,
nurs, and seeds, which have 3 ro 35 times
as much.
Consequcnrly; me rapid angina improvemenc in the Ufesryle Hean Trial may be due
ro ac leasr twO separare effecrs. First, reduced choleseerol levels may help ro resrore
normal blood vessel re1axation mechanisms.
Second, an increase in dietary arginine provided by me vegetarian diet will furmef-help
to relax areeries from dle outscr, likely even
before blood cholesrerollevels have d ropped
sign ificanr1y.

Reduction ofRed Blood Cell ''Stickiness" Reduces Chest Pain

There is a third cxplanation for the rather
d.ramatic shorr-rerrn angina reducrion occurring wirh cholestcrol-lowering diets. A
reduction in rhe rendency for red blood cells
ro srick rogerher, or blood "fluidity," was
observed in a slUdy by German researchers.
This is anorher study of (he impact of
lifesryle changes an hearr disease progression. Dr. Gerhard Schuler and his associaees made some of the mose detaiJed mea-

BLOCKED ARTERIES
suremelHs of any of ilie stlldies regarding
rhe regression of areery blockages. 41 Using
regulat physica1 exereise and a diet ehat averaged 26 pereent f.u and 135 mg of cho1eseero!, (beeeer than ehe bese "narional eholesterol education diet") rhey helped 30 percent of 56 smdy parricipants :main regression. Only four percent of a second group
achieved regression withollt the lifeslyle
changes.
Of interese ro the angina quesrion, ehe
researchers measured ehe ecndcncy for red
blood cells co stick together (caUee! ehe
"eryrluocyte aggregation rate"). Stickier red
blood cells eend ro c1ump and interfere \Virh
optimal blood flow ro the hean lllusc!e,
which can increase angina. Even an thjs
Iess-than-optimaJ lifesryle program, dle red
blood cells' tendency ro stick togerher decreased by a highly sigll.i.ficam percentage.
This evidence thus provides anodlcr reason
why we would expect angina to decrease on
a bcerer lifeseyle program. One only wonders how profound the changes would havc
bem if a zero choleseerol, roral vegeearian
dier had been adopted.
A summary of rhe three possible reasons
for rapid angina reductions mat occur wirh
cholesterol-lowering diers is shown in Figure 18.

Afler a Heart Attack - Change YOur

Diet to Reduce Death Risk
Orher research has prodllced hndings
(hat are relevam in showing the power of
dier in reversing coronary anery disease. A
1992 repon did nor measllre regression but
examined an imponallt issue: subseqllem
hearr probJems in hean anack survivors. 42
Parienrs in the experimental group were
given a specific intervention dier that moved
[hem strongly in the direction of vegerarianism. Meat and eggs were not allowed.
Their descriprion of the dietary protocol
sOllnds essenrially vegetarian, being described as "conraning fruits, vegerables, cereals, and nllts," although some flsh was
apparendyallowed. Among rhe (over 400)
hearr attack vicdms in rhe study. those an
rlle inrcrvencion dict experienced a dramatic
decrease Ul total cardj~lC events. Wirhin just

six weeks, rhe near-vegetarians showed a significanr 35 perccnr decrease in toral cardiac
OCCllrrences rJlar included fatal and non-fatal heart attacks as well as sudden cardiac
deaeh.
The repon suggesrs that diet changes are
superior to 17ledication for someone who has
had a recent hean anack. which is asronishing ro rhe medical communiry. One of
the most widely tOuted groups of medic."lrions in rhis regard :lre bera blockers and
ACE inhbitors. They demonstrate onJy
half of the effecriveness of the vegetarian
diet, \Vith an average redllcrion in toral
morrality of onJy abour 20 percent. 43 . 44

REASO
O
ANGINA
DUCT
LlFESTYLEC
1. Relaxation of blood vessels caused by
reduced serum cholesterol increases
the amount and effectiveness of nitric
oxide in the blood.
2. Further relaxation of arteries due to an
increase in arginine in vegetables occurs
before blood cholesterollevels have lowered.
3. Reduction in red blood ceH stickiness,
increasing blood flow to the heart muscle.
Figure 18

Drawbacks ofDrug Medications fOr

High Cholesterol or Triglycerides
There are numerolls medicarions now
<wailable to assist in lowering LOL cholesterol and in some cases lowering criglycer'des or raising HOL cholesterol. One of
the mOSI popular grollps of drugs is knawn
as the "statins" and include prescription
medications such as 20cor, Pravachol,
Mevacor, and Lescol. These medicarions
can significantly lawer LOL cholesterol
while slighrly raising HOL choleseerol but
onl}' when L1sed in conjllncton with a good
low cholesrerol, low saturated fat dieL

103

PROOF POSITIVE
Srarins can infreqllenrly callse severe liver
inf1ammarion and desulicrion as well as
dearh of volunrary muscles of me body.
Anorher popular agenr used ro lower
borh cholesrerol and rriglycerides is a very
high dosage of the B vitamin, niacin. When
used in rhe high doses necessary ro achieve
significanr1y Jower cholesterol and rriglycericles. niacin should be considered a drug
because it can illfreqllently callse life-rhrearening side effects. These side effecrs include
destrucrion of the [iver and internal bleeding from severe inf1ammation of the stomach; omer cOl11l11on annoying side dfects
are hot flashes and flushing of the skin.
1 prefer ro reserve rhese meelications for
rhe approximarely 1 in 400 people wirh a
heredirary disorder that callses rhe Jiver ro
greatly overproduce cho[esrerol or rriglycerides. 1 also use them in heart patienrs who
have failed ro achieve rhe desired serum lev-

4.5
Risk of

cardiovascula'r 3
mortality
2

I
O
umbcr of fitness tcsts passcd

Figure 19

104

e1s of cholesrerol wirh elier alone and who

are willing ro pa}' ilie high cam. The costS
conssr of medications (a year's supply of a
popular cholcsrerol-Iowering drug costs
$1308),45 frequent doctor visits, and lab
work necessary ro monitor for and possibly
prevenr serious side effecrs. The good news
is rhar t!le majority of people wirh high cholesterol can bring i[ elown ro an ideal level

with an ideal eliet and lifesryle program rhat

includes regular exercise IVithout the llse of
drug meelicarions.

Beyond Diet-Physical Fitness

In chis chapter we have se n rhar an excellent lifesryle is essemial for anyone ehat
wishes ro reverse coronar)' areer)' dise.ase.
More than dur, it is the basis fOf preventing
hearr disease from occllrring in rhe fim
place. This lifesryle must include a cliet rhar
has negligible amounts ofclierary cholesterol
,uld is low in sarurared far. Besides being
on a good diet, one neeels ro have a regubr
program of moderate exercise.
The imporrance of regular exercise in
prevenring and reversing hearr elisease needs
ro be emphasized. Regular exercise alone
has been shown ro help the hean in many
srudies. I wiU cite JUSt one. A 19-year srudy
of abour 10,000 men addressed the impact
of regular aerobic exercise on the risk of
deam duc ro card iovascu Iar disease. 16 They
were categoriz.ed neo three groups as determinecl by each pareicipant raking (wO I1t
ness rests 011 a treadmjll at an ave rage offive
years aparr. ThllS, physical fimcss was assessed for each parricip,lnt at [he start and
again afrer five years. Those who enjoyed
sustained physical fitness (passed bod} tesrs)
comprised the firsr grollp. Those who had
shorr-lived fitne.ss (p,L~sed only one of rhe
rwo tests) made up rhe second grollp. The
rhird group consisted of r!lose who were
llnfit (failed both teSIs). The reslllrs are
shown in Figure 19.
Note thar rhase wha were physically fir
and maintained their fitness had the lowest
risk. The risk \Vas rwice as mllch for rhose
who faileel ta mainrain a lasting fimess program, and was over four rimes as much for
ilie non-exercisers. Another significant resuIt is rhar in addition ro [he benefir for rhe
hearr, those ehat mainr;lined their firness also
had rhe LOUJest risk ofdeath fi"om nIL cal/ses.
It is sobering ro recognize ehar non-exercisers increase rheir risk of dearh from
hean disease by abotlt rhe same amOUIH as
smokers. In other worcls, from the srandpoinr of hearr disease, you probably have
Jiule right ro pat yoursclf on the back for
nor smoking lInless you exercise regularly.

BLOCKED ARTERIES
Exercise is eleady a major paH of any program ro prevent or reverse heart disease.

Healthier Lifestyle-Better Sense of

Well-being
The Lifesryle Hean Trial also looked at
(he "before and after" results of how well
panicipams fared as far as their general sense
ofwell-being was concemed. Each participant was asked ro fiU out a questionnaire
before and after the study regarding his or
her psychological diseresses. They were
asked ro rare theit degree of anxiery, depression, illSomnia, and rheir inabiliry to experience pleasure (anhedonia). These four
distresses were totaled ro yidd a distress ndex level for each participanr. The average
levels are shown in Figure 20.
It carne as a surprise to many that aFrer
one yeaI it was rhe vegcrarian grollp rhat
nor only felr better ph)'sicaJly, but memally
as well. The)' had a decrease in depression
and anxiery. fewer problems wth srress, and
improved irnerpersonal reiarionshipsY
Many mistakenly believe rhat their overali enjoymem of life wiJl deteriorare if they
change ro a he.a1thy liJestyle, especially if
they become vegerarians. What will 1 rell
my friends when 1 go out to eat? Will 1
have to sacrifice attending cerrain social
evellts becallse of my new diet? What about
my relatives coming home for the holidays?
Will my taste buds suffer? Will my hllnger
be satisfied? Despite ali of rhese new "problems," the vegetarian group enjoyed Lift more,
and even had a better social lift than before.

CHANGES PSYCHOLOGICAL
STRESSI THE
L STYLE HEART TRIAL
Alfxiety, depressiolf, ilfsomllia, & alfhedolfia index

,30

Exp.
Cont.

27.2

25

24.1

20

15
10
5

Baseline (pre)

One year (post)

Figura 20

blood vessel improved over four percenr on

the average. 48 Those (hat were moderarely
adherem ro rhe program experienced a 2.5
percenr regression ofcoronary arrery disease.
Those rhat were the leasc adherent had minimal improvemenr, measuring less than one
percenr.
The issue of adhel'ence makes three
poinrs. Firsr. the closer one gers ro ilie optimal lifestyle, the bener. Obviously, rhe
closer we follow a vegerarian diet, a regular

ADVERSEEFFECTSOF"CHEATlNG"
IN THE LIFESTYLE HEART TRIAL
Angiographic results
6

Sticking with the Program

Did it make a difference how elosely dle
participanrs stuck ro the program in (he
Lifesryle Heart Trial? Were there an)' <ldverse affeets from "chearing"? This quesrion was looked at very carefully in rhe ini
tial report rhar fcarure<! 12 momhs of follow-up. The allswer was a resoundingyes.
as illusrrated in Figure 21.
These resulrs are not surprising. Within
the vegetarian grollp, rhose rhar were the
mosr adherenr ro [he program had ilie greatest amollnt of regression; that is, [hey xperieneed rhe mose reversa!. Each diseased

5
%

regrc5son 4
ofblood
vessel
blockage 3

o
Most adbcrcQce

Medium adberence Leul adberence

Figura 21

105

PROOF POSfTlVE
exercise program, and stress conrrol measures-rhe bener off our arreries are going
ta be. The second point is that le ser degrees of adherence can srill produce some
benefic, alchough the resulrs are not as dramarie. The third i rhat ilie lifesryle changes
in the Lifesryle Hea.rr Trial were of grearer
benefit ilian the data shows beeause ofweak
adherence ro che program by some participanrs.

Doctors' Recommerzddtions-Who
Follows Them?
lf you have heart disease. there is much
you C<1n do with simple lifesryle changes.
But mosr people [aii ta grasI' ilie full 1'0renrial of lifesryle changes upon ilieir overali health. Many wim hean disease do not
do l.nuch more than see their doctor and
take medications. An American Hearr Associarion srudy was made to determine how
many individuals who have been diagnosed

VICE
About Jh of heart disease patients follow
their physicians' advice in dealing with:
high cholesterol
high blood pressure
lack of exercise
smoking

Figure 22

106

wirh hearr disease complied with rhe correcrive measures prescribed by rheir physicians. The astaunding results are shown in
Figure 22Y)
We see rhat abOlit {Wo-th.irds of hean
disease parients neglecr ta make rhe basic
changes in habits prescribed by mosr doc-

rors (Iower salt, less red meat intake, daily

waJking, no tobaeco. etc.). Thi is a surprisingly Iarge nurnber, since the disease will
take the life of80 percent of tho e patiel1rs.
lf rhey are unwilling ro make ule simple
changes in lifesryle, how can we expeet [hem
ro make major ehanges such as oudined in
dlis chapter? Ase these changes more restrictive than most people cOlild tolerate;

ls Lifestyle Change for Everyone?

It is one ch i ng {Q prcseIH overwhelming
evidenee thar a veoerariall dier is of signifi.
cam advamage in reverslllg heart disease, bUl
is ir a clier that rhe average person C<1n rollow for life? It may seem resrricrive ar fim
becallse most of LIS grew lip earing whalever we liked-an abundance of meat, milk
eggs, checse., ice cream srore-boughr cOJ]venience foocls, erc.-you name ir, we are
it. But loolc how sick many have become
on dur lifesryle. Americans, instead ofbeing an example of fir r c1ass hcaleh, are
among che world's Inosr obese, and conrinue
ro have high rares ofhean disease.We have
ilie largesr and most advancecl hospital in
rhe world-and \ve need rhem for people
who are on the rich, rehl1ed, cholesceroI, farbden elice.
lf yOLl begin to make [he change ro a
vegetarian elier, you wiJl be surprised rhal
what may stan offlooking lilce a "sacrifice"
eloes nor have ro end rhar way. This book i
ded.icared nor only (Q inform yOll of a berreI' way ro live, bur ro also encourage you ro
make ch,Ulges and expericnce rhe benefir,.
They say "Rome wasn'( builr in a day," bUl
when ir comes ro OUl' earing habits, we real'
dle "building" process. Perhaps ir would
be more accurate ro say we mosr fear the
"remodeling" process, rhe c1eaning out of
freeurs and clIpboards of foods thar arc
dangerous ta OUl' hcalth. But 011 rhe posirive side, joining a vegerariaJl ar narural
foods cookiJlg clas can help you get a jumpsrarr imo a new worle! ofbrand new dishes
and foods rhar are borh healchful and rrul)'
sacisfying. lf you do nor havc a cooking
class available in yom arca, obtain several
vegerarian cookbooks and set aside some
qualiry rime ro experimenr. A list of good
vegerarian cookbooks is provided in

BLOCKED ARTERJES
Appendix II. Sriek wirh ir, and soon you
will be surprised by how quiekly you have a
wi le varier)' of new recipes that you ean look
f01WaJd ro-and in addition, you wiU Iikely
feei rnuch ben r in a number ofways, borh
ph}'sieally and menrally.

The Vegetarian Bandwagon Rolls

Vegerarianism is beginning ro sweep the
counrry. Millions ofAmericans have raken
srep roward a more healrhful lifesryle in
var}'ing degrees. Many have gone aJl rhe
wa}' 10 dle rotal vegerarian dier and rhe orher
aspeers of a healrhful lifesr)'Je. Vegerarian
rcstauranrs and healrh food srores are proliferating. Ali major airlines now offer roral
vegerarian meals an reqllesL The Ilumber
of brands of non-dair)' foocls such as miJk
and cheese made from wholesome grains is
multiplying. Medical insuranee companies
are bcginning (Q cover costs of vegerarian
lifesryle inStIllet10n and eOllnseling for heare
patient,'. Communiry vegerarian cooking
schools are increasing in populariry. Vegelarian periodicals and eookbooks are being published in increasing numbers. The

vegetarian bandwllgon is rol/ing and this is

mus.

one you wiLL 110t W/lnt to

tvledieal insuranee companies are recognizing rhar the vegetarian approaeh is mllch
more cosr-effective tllan rhe alternative of
surgery. MueuaJ of Omaha's expe.nses per
hearc parient is cur by over half by covering
rhe cosr of lifestyle insrruerion for hean
patients. They repon rhar rheir healrh care
subscribers with chesr pains rhar are 0.11 the
program have a 65 percenr decrease in rhe
l1umber e.xperienei ng chesr pain. For rhe
remainder who riU have ir the frequel\cy
and ,everir)' de-crease < often dramaricall)'."
They ;llso repon a signiflcant drop in blood
cholesterol widl no medicarion; !lean seans
sho\\' {hat many pariems experience cessa{ion Of rcversal ofhean disease progression,
and exereise toleranee measured on a ueadmiII "improved 22 percenr." This program
is reducing Mlltual's bealth care COSIS while
producing bener health ofirs subscribers ar
the same time.

"Lifestyle Center/'
Some may feei that ilie)' would like formal insrruerion ro help rhem in making rhe
rransirion ro rlle idealliIestyle. There are
instirutions known as "Lifesryle Cemers"
thar are dediaued ro perform.ing sucll a service. These cenrers accommodare guesrs
wirh various aspeers and severiry of hean
disease and other ailmenrs who sray for a
number ofdays or weeks. Eaeh guesr i pur
on a dail)' exercise raurine railored ro ilie
individual's need, fed a vegetarian diel, given
insrruction in nurririon and orher aspecrs
of healrhfulliving, and raughr how ro prepare healrhful and rasry dishes ro maintatn
rhe dier aner rerurning home. A lisr of
names and locations ofsueh cen rers is found
in the Appendix III.

"It's a very paternalistic attitude

to say, 'We know you won 't even do
it because it's too bard.'" "The
program is not for everyone, but
there is a larger percentage of people
interested in foUowing a
program like this tban
many doctors might
believe."
Figure 23

Health Professionab'-Get the Facts

Out-Let the Patimt Decide
Or. Omish is convineed ehar we should
get the faet.s out ta everyone as ta how to
prevenr hearr disease, and inform [hose who
already have it how to reverse iL His staeemenr is quored in Figure 23. 50
Is lifestyle dlange for everyone? Yes, for
everyone wbo has a deep desire for a full
and happy Iife rhac is stronger [han rhe desire for shon-eerrn rasre blid graei ficat ion.
The taste buds wiU adjuse in a few weeks

107

PROOF POSITIVE
and will then respond wit.h grea tel' gratitlcaeion rhan eveI before.
Gone by the wayside is (he obsolete CllSrom of healeb professionals who "compassionately withhold" (he oprimal life ryle
counsel-so as noI' [Q "blll'den" patienrs.
Such an approach is nor uue compassion.
Today's health professionals need ro more
fuUy presenr aII of rhe beneflcial lifesryle
options, regardless of how difficult they
think r may be for a pacient (Q implement.
Health professionaJs have no right tO withhold any informa(ion that could lead a parient ro atrain the highest level ofhealth thar
is possible for rhar person. Mv messaoe
1'0
b
the he.1l(h professional is "Transmit the potential benefirs of a healchy lifeseyle c1eaxly.
Then IeI' each patiem decide for himself"
By analogy, if (here was an ideal bul' expensive medicarion available ro ueaI a condition, most physiciallS, including myself,
would inform [he parient of the ideal drug,
and advise the pariem of rhe expense. le
would (hen be up ro the patient ro decide
wherher to take rJle drug.
j

"Good" Diet "Better" Diet "Best" Diet

Cholesterol (mg)
Fat (% of calories)
P/S Ratio of fat
Animal' protein
Vegetable protein
Carbohydrate
Caffein.e (mg/day)
Fibet (grams)
Figure 24

<200
<30%
>1.5: 1
7.5%
7.5%
55%
<100
>20

III

<100
<28%
>2:1/0 rr
3%
12%
58%
<50
>30

Zero
<25%
>3:1
Zero
15%
60%
Zero
>40

Thl'ee Diet Choices-Good, Better,

and Best
We conci ude this chapter by looking al
the approach 1 use when discussing lifeseylc
d1a.nges with my hean patients. 1 call it the
'Cood, Better, Besr Approach." Firsr, thc
"be.~e" approach is the lifesryle program tim
has bcen clearlv shown ro be (he mosI'
heal(hful: a wral' vegetarian diet-the ideal
dic(-in addirion ro smoking cessa(ion, caf
[eine avoidance, regular ex.ercise, emotjonal
supporr, and stress COntrol.
There will be some people ehat for one
reason OI' anorher feel (har iliey cannor~or
choose noI' to--gee on ehe best program.
For chem we can offer the "bcrrer" approach.
The better approaeh would be somewhcre
beeween the j ational Chole.secrol Education Program Diet and tlle best appraach.
For rhose who eleeI' not ro follO'oN eieher
approach, there is the "good approach,"
which is ro follow the National Choleseerol
Educaeion Program ar a similar diet. The
conr.enr of these (h ree diets is shown in Figure 24.
The patients are informed of the level
ofexpececd resulrs from following each opeion. Those who only sllcceed in meeting
[he "good" dier, which is rhe NCEP's srrictesr reeommendaeions: 200 mg cholesrerol
incake per da)', :lnd 30 percent OI' less calories of coral fat (with noe more ehan sevcu
percenc sarura(ed fat), willlikely experiencc
progrt!ssion of hean disease racher ehan regrcssion, especially if iliey are nor on chranie
choleseerol-lowering medication. However,
if (heir previous diet was Tl111ch worse rhan
rhis, (hey may slow ehe ratc of progression.
But the odds are good (hat rhe futuce evenma.lly holds sl1l'gery 01' angioplasry, if noe a
heal'( anack. Whcn one nceds ro jump
across a chasm, a half jllmp just does noI'
do the job.
The goot! news is that throllgh proper
lifeseyle change.s withour use of medications
01' other sophisricared teehnologies such as
angioplastics OI' bypass surgeries, you can
noI' only pret-'m! heare disease. Vim can reIJtrs(!

108

it.

BLOCKED ARTERI ES
Ornish 1). an l'ou prcvenr-and rever.e-CAD? I'atiml Care. 1991
15;25:25-4 J.

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I?

American Hean A5socialion. 1997 H"llrt Ill1(j Suoke SI.olistiea! UPc/IIIt'.

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OC[

American Hean Associarion. 1997 Hl'llrt Ilnd 5trokc Statistica! Upc/atr.

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11 National Chole.lcrol EduC<ltion Program Expcrl P"nel. Second Reporr

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taclOr reduClion on coronary 31heroscJerosis aJid clinical Gtrdiac cveJ1ts in
mcn aJld w(Jmcn wirh coronary aerery di case. TheSlaJlford Coron:>ry Risk
lmervetllion Proiect (SCRIP). CirCl/IIl/iOIl 1994 Mar;89(3):975-990.
3S

Srroe ES. Koomans HA. er al. VasculaI funclion in the fore3rm of

hypercholcslcrolaemic parienls offand on lipid-lo\Vcri.ng mcdic:uion. lAnce:
1995 Alig 19;346(8973):467-4 I.

3{:

,1 Harrisoll DG, Ohara Y.

Physiologic con eqllcl\ces of increased vasc.ular

oxidam Slresses in hypcrhole.srerolcmia and arherosderosis: impliCJtions
for impaired vasomotion. Am j Canlio/1995 Feb 23;75(6):758-81 B.

133.

109

PROOF POSITIVE
Minor RLJr, Myers PR, el al. Diel-induced alherosclerosis iJ1CfeaSCS !he
release of nilrogen oxides from rabbit aona. } Clin Inzleu 1990
Dec:86(6):2109-2116.

I,~ Cody RJ. Cornparing angiolcnsin-converting eJ1zyme inhibitor rrial remiu; in pariellls Wilh aCUle myocardial infarclion. Archives oflntema/Medicine 1994 Seprcmbcr 26. 154(J 8): 2029-2036

9 Andrews Te. Rab)' K et al. Effec! of cholcslerol reduCI ion on myocMdial ischemja in pa!ielllS Wilh coron"r}' discase. Circulalion 1997 Jan
21 ;95(2):324-328.

4; WabJII/l"l PIHJrl7/PC)' "ell1i!pricc. Ardlllore, OklahOIJl;l oblained Fcbruary

9, 1997 for Zocor (20 mg daily).

J"

Slroes ES. Koom:ms HA, el al. Vascular hmction in dle [orearm of

bypercholcslcrolaemic parjcllcs offand on lipid-lowering medicllion. LIII/cel
1995 Aug 19:346(8973):467-471.
40

Schuler G, Hambrechr R. el al. Regular physic11 exercise and low-fal

dieL EfTecls 011 progression of coronar)' anery ruscase, Cireu/ot/oll 1992
Jul;86(1):I-11.
41

Singh RE, !U.<rogi SS. e! al. An Indian experimeUl wid} nUlrilional

mOduJalion in aCUle myocardial infarclion. Am j Cordiol 1992 Apr
1:69(9):879-985.
4Z

YusufS, PelO R, el al. Bela blockadc during and af!el myocardial inh.rcrion: an ovcrview of lhe ralldomized rrials. Prog Dl1y!iO"l/OSe Dis 1985 MarApr;27(5):335-371.
'J

110

Bhir SN, Kohl HW 3'~, er al. Ch:Ulges in ph)'sical firness and aii-caus,'
mort;lJir)', A prospecrive lUd)' ofhc.aJrhy and ul\healrhy Ine". }AMA 1995
Apr 12;273(4): I093-1 098.

46

Ornish. D., BroWl\, S. ., cr :lI. 1990. Call LifcsryJe Challges Reverse

Coronary Hean Disease?The Lifesr}'1c HcarrTrial. umal Jul21 ;336(8708)
:129-133.

47

< Ornish D. Browll SE, el al. Ca.n IiI" ryle changes reverse corOlur}' hean
disc~se? Tlle Litcsryle Hearr'frial. LiI1lCCf. 1990 Jul21 ;336(8708): 129-133,

se

Smith
Jr, B1air S ,el"!. Prcvenring hcarr allack and dealh in pariems Wilh coronar)' disease. Cirrull/lio71 1995 Jul I:92( 1):2-4.

<'1

;0

Ornish D. Fim AJlIlIIo! COllft1'C71ct ()l1lhe Eiimilltltioll ofCoro71t11)' A1'11'1)'

Disl'osf, 7iICf07J, Ari.2IJ7m. Ol'lobn, 1991.

CHAPTER FIVE

THE

TRUTHABOUT

ISH
D

r. Richardson was seartled. What

could possibly have gone wrong?
After years of Sllccess in controlling her cholesterol wirh diet,
Jane's choleseerol was now again an ehe rise.
In lace, in roughly ehree months her LDL
Jevel had soared 50 poinrs. Like any good
doctor, Richardson cried ro find ehe explanation for ehis perplexing rise. Nothing
major seemed ta have changed. Jane's
weight was not a problem; in fact, she had
Iose ftve pOllnds since her last visit. Furthermore, there was no change in the glands
Of oeher organs that can affect cholesrerol
Jcvels, such as the rhyroid or liver. Fi nalIy,
an fllfther queseioning, the source of che
problem surfaced. Jane !lad heard about the
hearr benefits of fish and had added a liberal amOllllt offish ro her nearly-vegetarian
diet. Dr. Richardson discovered it was rhis
addition of fish that had boosted her choleseerollevels. I
If sllch a scenario sounds perplexing to
you, I am sure it did ro many of the physicians who read that actual case history il)
1987. le was inc111ded in a special physician newsletter ehar was paft of a cholesrerol education program co-sponsored by
Columbia Universiry aod ehe American
Heart Associaeion. AJ.though we were noe
raId rhe doctoc's or patienr's acrual name,

the accounr was there in print-a woman

who had moved from a vegetarian-sryle diet
ro a fish-based dier and had experienced a
marked rise in her cholesrerollevels. What
could be ehe explanarioJl fOf chis delctcrious effecr from a [ood we have heard so
IDllCh good about?
For weB over a decade ehe media has
championed fish consllmption. They have
tollted ics abil it)' ro lower cholesterol and
decrease heart disease risk. In 1985, three
high profile studies carne Out on the same
day in the prestigiolls New EnglaJld Journal of Medjcine. In one of (hose reportS,
rcsearchers studicd 20 years worch of coronary hean disease deaths among men in
HoBand. They found [hat ehose who consumed loz. of fish daily reduced cheir eisk
of heart dearh by 50 perccnr. 2 A second
repon dcscribed rhe effecrs of fish oiI on
the lowering of cholesrerol and rriglyceridcs. 3 The rhird srudy dealr wirh fish oil's
effect on whiee blood cell function. 4 As a
resulr of these and ocher stlldies, rnany
Americans switched from red m~u ro fish,
hoping ro improve cheir fat imake, lower
cheir cholesterol levels, and dccrease cheir
risk of heaT{ disease. In rnany cases, the
strategy seems to have worked. A switch
from heavy red meat usc to heavy fish consumption does (end ro lower cholesrerol

1I 1

PROOF POSITIVE
levels and bring wirh it health beneflrs ro
rhe hean. Howevel', medical research aIso
contains ample UJf1-rnings abour rhe use of
hsh and fish oiI.
Before we look ar some of rhe porenrial
drawbacks of fi, h consumprion, (er us look
at rhe advanrages of earing flsh compared
ro orhel' animal products. fu already stated,
many have lowered rheir blood cholesterol
levels by abandoning cheir "sreak and bacon" ways n favor of a tlsh-rich fare. The
physiology of fish helping ro lower chole.srerol is sound. Compared ro mher aJ1ima.l
prodllCtS, hsh has a generally more [worable P/S ratia. You wiJl recall from Chaprer
3, "Heart Disease-Conquering rhe Leading KilJer," rhat a high P/S ratio meaos
hjgher in polyul1s:lturared tu. An increase
in this rype of fat wilJ lower cholesrerol. Fish
aJso bas less sarurared far. Sarurared fat is
high in sLlch proelllces as meat, whole milk,
eggs, cheese. and coconut and palrn oils.

UO

1J5

90

Cholclerol,
rog
60

30

O
3.502.

IS g

IS g

15 g

J5 g

Figura 1

Two Sides to the Fish Story

Wirh aII of these things seeming ta faUle Llse of tlsh, how do we explain the
perplexing illusrr:.uion at the opening of ehis
chapter? The aurhors of Jane's srory k.new
the explanation and stated ir elearly:
"... compared \"'irh a dier rhar is essenrially
vegerarian, rhe consumption offish wiJJ increase dieta1Y cholesterol and often rhe inrake
VOI

112

of sarurateel farry acid as weU. The net resuIt may be, as in this parienr, a rise in LDL
levels."s Olhe.r more recent stuelies have
contlrmed rhar fish oiJ consllmption wiU
very Jjkely illcrease the LDL cholesterol in
mosr people. 6 .7 As e.xplained in Chaprer 3
on heal"( disease, LDL is the "bad" cholesrerol rhar can produce clogged arrcric,
t1uoughour rhe body.
Ler us look ar rhe rwo poinrs madc in
dus disringuished publicarion and see why
fish presenrs a problem. Firsr, fish is an
animal produce, and ie therefore contains
cholesterol. In faer, rhere is nor much difference berween tlle cholesrerol conrel)( of
fish and orher ;:Inimal producrs such as
chicken, turke)', ar even pork and beef.
These cholesteraJ Jevels aJe also rabulared
in Figure 14 in Chaprcr 3 on hearr djsease.
The facr rhar f1sh conrains cholesrerol
purs it in a complerely elifferenr c1ass than
aII planr produces. You will recall rhar aII
plaur sources of nutririon have absolutely
zero cholesrerol. A comparison of rhe cholesterol con tem of various fish and .fish oils
is found in Figure 1. 8
orice rhar rhe cholesrerol levels are
srared for rhe amounr of 15 grams of fish
oiI, which is a standarei supplemenrarion
dosage for cardiovasclilar disease. 9 We see
mat rhese amoums ofcholesrerol in fish oii
are eqllal ro ar grearer than ehe cholesrerol
in a generous serving of T bone srcak, as
shown in the bar on the lefr side of Figure
1. It is ilO woneler thar fish oii can raise the
serum choleseerol. The American Hean
Associarion is known for being soft on dielary guidelines; neverrheless, cven eheir
mosr liberal diet for heaI( disease sriH forbids more rhan 300 mg of choleseerol per
da)'. SlIpplemenra.l use of flsh oii GlJ1 go a
long wa)' ro exce ding even rhis recommendarion.
The second poinr raised by rhe aurhors
of Jane's srory has lO do wirh rhe iSSlle of
sarurared far. Compared ta ot!Jermeats, flsh
has a favorabJe polyllnsatllrared ro saturatcd
far rario (P/S ratio). However, ir does nor
have as favorable a rario as mosr plam-derivedfrati. Again, wh.ile i( is true rhar rhose
who have been earing red mear can bring rheir
cholesreroJ down somewhar b)' s\Virching 10

THE TRUTH ABOUT FISH

a hsh-based dier, a vcgerarian dict is much
more dTecrlve. The poim is mar fish raises
blood cholesrerol levels less rhan red mear
ar even poultry. Compared ro planr proclucrs, however, fis/' mises cholesrerollevels.
Although many la} people have been
drawn ro flsh because of ir adveni ed cholesrerol- [owering effecrs, ir is imeresring ro
rcvisir rhe Holland smdy rhar hclped ro srir
up so ll1uch inrereSL 10 When rhe aurhors
published rheir dara showing a 50 percenr
dmp in hean disease deaths, rhey incllldcd
an irnporram facr t.har has been o[ren overlooked: rhe fish earers and heavy red mear
earer had virtual!;, identica! cholesterol levels. The facr rhar flsh may Ilor lower cholesterol bcgs a quesrion: whar is rhere abour
hsh rhar mighr reduce hearr disease risk even
rhough choleslerollevels may nor be alrered?
The answer may [ie wirh anorher compound, ealled omega-3 fars.

Omega-3 Fatty Ads Reduce Heart

Disease Risk
Cerrain fish are rieh sources ofamega-3
fan)' acids. 511Ch flsh include sah110n sardines, mckerel, and some orher fany fish. II
The omega-3 fars in rhese hsh are long-chain
pO[Yllnsamrared farry acids which include
eicosapemacnoic acid (EPA), a far wirh some
unique hearc advamages. For e-xample EPA
helps ro decrease rhe srlckiness of plarelers.
lhe body's c10ering cdls. ll This is imporranr: anyrhing lhal helps ro prevem platelers c1umpi ng cogether decreases rheir rendcncy ro plug up blood vessels. This in rurn
ean help ro decrease ehe ri k of a blood elOt
forming in a hean blood vessel aud causing
a hearr arrac1<.
Omega-3 far can aJso help ro mildl)' decrease blood peessure. 13 Many experience
an aClual decrease in rhe serum rrigl)'cerides from consuffi.ng rhis dass of far .14 For
mese re.lsons and omers, l s likely ehar rhe e
omega-3 fars al leasr have some rendency
ta decrease rhe rate of al.herosderosis. 1;
Bc)'ond tJ)ese reasans, animal lnodels suggesll.har ifa hearr arl.ack does occur, omega3 fany acids may decrea e rhe amOllnr of
muscular damage occllrring horn lhe artack. 16 These unique fars 31so appear ro

decrease rhe likelihood of blood vessels

blocking up again afrer angioplasry ("rhe
baJloon procedure" used ro open up blocked
hearr arreries), 17 ;:md can a[so decrease lhe
rare of c10gged bypass grafrs following bypass surgcry.18 A ummary of rhese omega3 benefirs is sho\vn in Figure 2.

OMEGA-3 FATS FIGHT

HEART DISEASE
They help to decrease stick.iness of platelets, tbe
blood's c10tting cells.
They tend to decrease blood pressure.
They tend to decrease serum
triglycerides.
If a heart attack does occur, they may
decrease muscular damage resulting
from the attack.
Tbey appear to decrease the Iikelihood
of blood vessels block.ing up again after
angioplasty or bypass surgery.
COllsidering (he evidence, should we eal.
flsh to help decrease hearr disease risk? A
furrJ)er look ar orher popularion studies may
help ro provide rJ)e answcr. We have alread}' looked ar the DUICb srudy thar demonsrrared a 50 percenr decrcase in coronary
aner)' discase dearh. among dajJy fish earers. 19 Wh.ile a 50 perccl1t reducrian is signiflcanr, a ll1uch grearer re,ducrion occurs
among total vegetarians. A sludy ofSevenrhday Advenrisr men on a toral vegerarian diet
showed [har cheie risk was lowered bv 86
perceI1t. ,,0 The resulrs in borh srudie~ are
noe unexpecred: rhose on a poor diee may
benefir from adding fi h in place of other
more harmful foods. Adding hsh may lower
rheir hearr disease ri k; ir mighr even Jower
[heir cholesrero[ levels. However, t.hey cannor get lhe magnilLlde of benefit rhar ehe
optimal dier provides. As we have seen in
[he rwo previous chaplers, 111311Y lines of
evidence demonserare rhar lhe oprimal dier
for hearr disease preveneion is (he (Oral vegerarian diee.

Figure 2

113

PROOF POSITfVE
Anomer popularion stlldy is of parricuIar noee. This published repore from
Harvard Universiey represents probably che
mose sIarisrically powerful research ever condueted ro examine che fish-hearr relarionship. Where che Ducch srudy looked ac only
852 men, Ihe Harvard researchers srudied a
phenomenal44,895 male healrh professionals. 21 The researchers' findings were asronishing: men who ace fish several cimes a week
were jusc as likely ro have hean disease as
rhose who are ie only once a moneh. If anything, there was a suggestion ehae [he men
who consumed six or more servillgs of fish
per week had a somewhac grealer risk of
coronary hearc disease ehan those who con-

DISORDERS THAT MAY BENEFIT

FROM OMEGA-3 FATTY ACIDS
rheumatoid atthritis

depression

primary Raynaudl's
disease
psoriasis

over-aggressiveoess

GI ul'cers
uJcerative colitis
Croho 's disease

possible prevention
of breast aod
colon carcooma
possible prevention of
chronic obstructive
puLmonary disease

Figure 3

The better the diet, the less

benefit rkrived from adding fish. On an excellent
diet, fish wilL increase
rather than decrease heart
disrase risk.

114

sllmed one serving per month ar less. The

explanaeion mOSI likely has ro do with whac
foods other than fish were inclllded in the
dieL The beuer ehe dice, (he less benefir
derived from adding fish. On an exeellem
dier, fish will lncrease racher rhan decrease
hearc disease risk.

Smoking Negates Benefits of

a Highjish Diet
Inrake of omega-3 farey acids in a highftsh dier by ehose who smoke does nor pfOrect against coronary dearh. In (acr, it might
have ehe opposite effect. A six year srudy

spearheaded by Dr. Pirjo Pieeinen of Helsinki, Finland, involved 22,000 middle-age

srnoking men for c<udiovascular disease risk
and intake of fauy acids. Those who had
t!le highest inrake (eating more fish) had a
30 percenc incrett.ccd risk of dying of COfOnary disease compaced ro mose who had rhe
lowese imake. 22
In summary, regacding ehe hean. rhere
is srrong evidence ehar fish only worsens an
excellenr diee and thar in smokers a high
fish dier is also deerimenra1. However, could
there be orher benefirs beyond hearc disease
from earing hsh and eheir accompanying
omega-3 faley acids? Should we eal ar least
some f1sh co reap ehose benefits? Let us look
ac furcher information on omega-3.

Other Omega-3 Benefits

Tlle advantages of a dier high in omega3 do noe Stop wim the heare. The various
known non-cardiac benefiIs of following a
dier high in omega-3 fatIy acids are \isred
in Figure 3. 23
Omega-3 farey acids are of benefir to
[hose with rheumaroid archriris and other
infhmm.arory anhriric condirions. 24 . 25.26.
27 Rheumaroid archrili is a crippling eype
of arrhrieis. Often Ihe hands and orher
joilHs become seriously deformed. In addi(ion, ir rends eo affect the whole body and
nor juse ehe joinrs. It can affecr blood vessels, ehe spleen, heare, lungs, and skin. 28
Funhermore, rhis disease can be notoriously
difficuh ro treae. Often ehe drllgs employed
have serious side cffecrs. Thus, when rhe
news earne ouc thar a dierary change could
help chis devaseaeing disease, rhousands of
sufTerers 110 doube rejoiced.
The omega-3 fars are also help/td in psoriasis. 29 . 30 Psoriasis is a skin condirion rhar
can range from mild irehiness and scaI ing
ro distlguring and painful rashes ehae ma)'
ooze and bIeed. Omega-3 fars along wirh
orher polyunsacuraeed fars can also help wirh
[he healing of skin and sromach 1I1cers. 31
These fars can prevem the mulciplicarion
of or even kiU Helicobacterpylori, bacreria
[har are weli known to cause seomach and
duodenal ulcers. 1'his provides furrher good
news for armrieis pariems; many of mem
suffer from sromach ulcers duc ro common

THE TRUTH ABOUT FISH

arr1lfiris medicarions, especialJy if chey harbor the harmfuJ bacteria in their stomach
linings. The omega-3 fars may also have a
role in cancer prevenrion. The risk ofbom
colon cancer and breasr cancer seems ro
decrea e when rhese fars are inc1uded in the
clieL 32,3 ,34
One of my special interesrs is in gasrrointesrnal diseases. One problem rhar 1
crear in my office on a daily basis is a disease caUed u1cerarve coliris. Ulcerative coliris is an auroimmune disease wherein rhe
body atracks rhe colon, causing ulcers, in~ammarion, fevers, bJeeding, diarrhea, and
abdominal pain. It tenels ro relapse frequently; that is, it will subside for awhile
and then fiare lip agaiJl. A four-monrh long
stlldy included 23 patienrs wieh chronic
acrive ulcerarive colitis. 35 About onc-half
of rJle parienrs were given duee grams daily
of eicosapemaenoic acid (EPA), an omega3 fatty acid. The omer group received lookalike pills rhar had no medicinal cffeces
(called a placebo). Afeer four monchs, rJle
rwo groups were switched ro the opposite
trearmenL The results of ehe scudy are summarized in Figure 4.
Norice chac only rhree Out of ten who
took rhe placebo had remission, and aII duce
lacer relapsed. The stOry was rernarkably
differenr for rJlOse raking ornega-3: 10 aur
of 13 experienced a remission of their discase. Even rhough sJighdy morc rhan 50
percenr of chose wirh a remission later relapsed some remained disease-free.
Unfortunate!y, cow's milk anei many infam formulas lack cerrain ol11ega-3 fars rhar
are necessary for o~){imaJ brain and eye developmen(. Human breasr milk, however,
has abllndanr omega-3 fars and may be one
reason why infanrs raised on hllman milk
do berter on inreliigence tescs rhan rheir
formuJa-drinking counrerparrs. 36 . 37. 38 An
omega-3 farry acid deficicncy can also cause
depression or even over-aggressiveness in
adlllrs. 39
Wirh ali the wealth ofinformation demonstraring ilie bcnefirs of omega-3 fars, it
ll1ighr seern thar we should ar leasr pur a
[itde /lsh on our din ner plates. Bur before
final recommendarions are issued regareling
our personal eating habirs, we need ro ex-

plore more flllly ilie "down side" of fish consumptlon.

Fish and Fish Oif's Bad Side

Fish oii capsules anei other fish oiI
sllpplemenrs may nor olter che benefies of
flsh oii in its fresh, naruraJ stare. Alrhough
rhe fresh omega-3 polYlll1sarurated acids
tend ro help plarelers anei decrease heart
disease risk. oxidized omega-3 fatry aciels
may do rhe opposice. 40 While on the shelf,
natural fish oil can become oxidized,4f and
therefore very damaging ro arreries due ro
the oxielizeel cholesrerol. Furthermore, EPA
(the omega-3 fatty acid present in flSh)
re:adily ox.idizes ro form peroxides, which
are powerflli (ree radicals. For anyone who

EPA (AN OMEGA-3 FATfY ACID)

THERAPY IS EFFECTIVE
FOR ULCERATIVE COLITIS
Dose = 3 g/day
First Test

EPA Placebo
otal subjects

13

10

No. Improved

10

No. Uncbanged

No. Worsened

Figure .4

is concerned aboLIt avoiding free radicals,

giving up fish wOllld be a logical fim srep.
Fish oiI supplemencs may nor offer me hearr
and blood vessel benefits consumers aoricipare. The Nllerition Commirree of the
American He:trt Association has recenr.ly
gone on record staring, "fish oiI capsules
cannor be recommended at this rime ... tO
prevenr disease of rhe coronary aneries. "42
There are several important potenrial
problems wirh eacing fish aud fish oiI. These
problems have nor been well publicized.
They are ljsted in Figure 5.

115

PROOF POSITIVE

PROBLEMS WITB FISH AN

FISHOIL
Can worsen blood sugar levels in diabetics.
Large amounts can dangerously prolong the
blood clotting time.
Fish oii is expensive.
Large amounts cause vitam'in overloading Olr
vitamin deficiency.
Can lead to an increase in body weigbt.
Sea food is a large reservoir for infeetious
diseases.
Toxins acquired from contaminated waters
concentrate in the fatty tissues of fish.
Figure 5

116

The irems in Figure 5 deserve funher

commenr:
1. Fish oiI can raise blood sugar in adulronser diaberics. A Universiry of California
smdy found rhar chese so-called Type II diaberics experienced a nearly 20 percem rise
in their f.1.Sting blood sugar levels after raking fish oiI for a mere four weeks. 43 The
reason for the diaberic worsening appears
ro be EPA; rhis omega-3 fac may reduce insu1in produccion in diabecics.
2. A dier very high in fish or fish oii can
dangerollsly increase rhe blood clorring
rime. 44 Eskimos, alrhough rhey have [ess
heart disease. have more hemorrhagic
(bleeding) srrokes ehan Americans do.'oS
Apparenrly, rheir fish-rich dier causes such
an impairmem of plateler fllnccion thar rhey
bleed more easily.
3. Fisb oii is expensive, especially in capsuIes. Researchers used [5 capsules of fish
oii daily for six momhs in arder ta decrease
re-acclImularion of arherosderosis folJowin.g angioplasty.46 Remit prices are about
$9.00 for 100 capsules. This rranslares imo
over $245 for rhe six month course of
rherapy. Continuing on rhe regimen wouJd
cosr around $500 per year.
4. Large amounrs of fish oiI used as 3
supplemem may upscc your viramin baIanceY Or. Jack Yetiv has poimed out rhar

high doses of fish oiI may cause ve,.y high

levels of Vitamins A and O-so hjgh thar
rhey could be toxic. BOth of rhese vir3mins
are fac-soluble nurrenr rhar are necessary
for life and healrh in appropriate amoums.
However, either can cause poisoning-and
in some cases-death, iflevels buiJd up roo
high n the bJood. On rhe ocher hand, a
diet rich in fish oiI can cause Viramin E r!e-

ficiency.48

5. The large amOllnrs of fish oii rhar

have been lIsed in many studies can Iead ta
a signiflcanr increase in body weiglu. These
prepararions are exuemely high in far and
calories. 49 Yeriv estimaced a person could
gain up ro 24 pounds in a year ifhe rook as
mllch fish oii eacb day as some srudies wcre
llsing. so
6. Seafood is a reservoir for infectioU5
diseases. There are abolit 113,000 reporred
cases offood poisoning from comaminared
seafood each year in rhe U.S.51 This is clearl}'
an underestimare, since many iJlCidents are
nor reported. Seafood concribures ro ;t disproporrionaeely high amounr of food poisoning otltbreaks. Staristics suggese rhar
reporr.ed outbreaks (episodes of food-relared
iJIness where more rhan (\Vo people are affccted by a commons source) 1nighr be as
much as 15 ar more rimes likely ro occur
wirh seafood than with beef, poultry, or
pork. 52 Raw shellfish in particular (such as
oysters. clams, and mussels) have a dismal
record. Abotlt 20 miII ion Americ.1ns ear raw
shellfish, which account for more rhan 90
percenr ofseafood poisoning cases. S3 When
raw sheUfish s earen, rhe whole living crearure is consumed complete wieh irs gasrroinresrinal uact. Thac would be equivalent to plllcking a [ive chjcken and eating il
whole, guts and alI. Whar's more, shellfish
feed by filtering (\VO ro rhree gallons of water an hour. That means rhe)' ral<e in wharever is floaring by-not only plankron and
orller food, but viruses, bacreria, mercur)',
and who knows whar else~
Unfoftunace1y, sheUfish are commollly
harvesred from coasral w<trers [har have becn
conraminared with human sewage. Infecrion wirh salmonella, campylobacter, t11e
Norwalk virus Vibrio vulniflcus (which
alone kilis 10 ro 15 people each year), and

THE TRUTH ABOUT FlSH

orher infecriolls diseases can reslIir. Even
well-cooked shellfish can infrequendy cause
serious or life-rluearening illness. Two such
maladies include paralytic shelJfish poisoning and neurocoxic shellfish poisoning. 54
hellfish are nor the only seafood ehar
presene causes for concern. For example,
over 400 different species of reef fish carry
rhe risk of rransmitting ciguarera poisoning, which is rhe most common fin fish
poisoning in rhe Unired Srares. 55 Some
8000 Americans a year are made il! by rhe
ciguarera roxin. Altecred fish, such as red
snapper, amberjack, barraclIda, and grouper, look and Tasre normal but C<ln produce
a disease thar causes digestive symptoms
such as nausea, abdominal cramps, and diarrhea. Later a "pins and needles" sensation occurs around and inside the mourh
and in rhe hands aud feet. Vierims often
experience "remperatllre reversals" where
hor rhings feel cold and more likely, cold
rhings feei hot. While the effects of
ciguarera usually last aboUf twO weeks, as
mal\Y a 20 percem of aH victims will srill
have some symptoms at six momhs and five
percenr ar rwo years. 56 Nerve and vision
invoJvemenr, heart and joinr problems, and
somerimes even dearh can occur. 57
Scombroid poisoning is less common
and less serious rhan cigU:Hera. SYll1ptoms
include a rillglillg and burning sensation
around the mourh as well as diarrhea,
ccamping, and an ieching rash. Most cases
in the U.S. occur from mahimahi or fresh
luna. 58 Sushi, raw fish Japanese-sryle, a1so
presenrs unique risks. Roundworms, flarworms, tapeworms and flukes can aII be
rransmirred by rhese sea food items. 59
What about rJ1C~ redllcrion in warer pollurion~ Has it now made it safe ro ear fish?
Do not be misJed by impressions thar warer pollution is f:1sr becoming a rhing of rhe
past. AJehough regularory bodies may be
keeping a closer eye on roxins released by
indusrries, rhere are even more imporram
non-industrial concerns regarding infecrious
disease agems. For example, in some locations l:lrge numbers of sepric tanks have
been consrrucred in unsllirable soi! near
\Varer sources. The resuiring overElow has
been known ro callse such severe pollurion

rhar shell fish beds have been officially

c1osed. 60 Other sources of microbi;ll water
comamination include animal wastes from
agriculture and municipal wastewarer discharged by publidy owned trearmem facilities. 61
7. Perhaps mosr imponandy, fish concentrare roxins in rheir fatry ti sues. These
roxins include pesricides, chlorinated hydrocarbons, diox.in chlordane, and mercury. As
of 1996, 47 srates had fish consllmption
advisories thar wam againsr eating cenain
species. They cover 1,740 rivers and lakes
(including alI of the Creat Lakes) and large
chunks of coastal areas. 62 The mosr COl11mon reason for consumprion advisories is
mereury. which can callse brain and nerve
damage, especiaJly ro feruses and young
children. Large fish fike fresh tuna, swordfish, and shark have rhe highesr levels of
mercury.63 Despire rhe popular belief rbar
fruits and vegerables have rhe greatesr risk
of pesticide contam.inarion, rhe FDA's resC<1rch reveals rhat domestic fish producrs
conrain significamly more pesticide residues
ehan domesric fruits, grains, or vegerables. 64
Bluefish, along wirh lake reout and orher
freshwarer fish caughr in inland lakes, are
most likely ro be conraminated wieh carcinogens like dioxin or PCBs (poJychlorinated biphenyls).6"

Contaminated Fish from Contaminated W0ters

Pesricides are an extremely important
issue. Worldwide, there are more than 900
differenr active pe,sricides in some 40,000
difTcrem chemical formularions. 66 In the
U.S., abolit 600 pesricide ingrediems are
used, accouming for some 800 million to 1
billion pOllncls per yearY Huff and
Hascman reviewed some 200 radene studies; they concluded rJ)iH "rhere is considerable evidence that exposure ro cerrain pesricides may prcsem real carcinogenic hazards ro hunlalls. "68
How do fish become exposed t() pesticides? fu previously memioned, one big
cause is agricultural runoff. When a farmer
sprays !lis fields, a ponion of rhe chemicaJs
will be washed ofT into neighboring creeks

117

PROOF POSITIVE
and srreams, and ulcimarely imo eivers and
oceans. Sewage overflows, falllry sepric sysrems, boarjng wastes, and poisonous eunoff Erom city streets have a1so coJ1tribllced
ro the poUurion of warers. These watees are
sometime-s considered so dangerous rhar
signs like (he one shown in Figllre 6 are
erecred ar some swimming beaches.

Figure (,

NUMBEROFREPORTEDF~H

KILLS CA SED BY POLLUTIO

"""RGpctlOO
Q

IIQ
-

Figure 7

118

11-30

31-70

:>70

rf swimming in the warer is haz:lrdolls

for humans, it i~ ironic that peaple Stil! go
fishing n these areas. The sign are nOt "calJing wolf." IlInesses sucit as gasrroenreriris,
dysentery, hepariris, and orhers can result
from swimming in conraminared wareI.
The risk of spending rime in the warers
an aur globe is highlighred bya disrurbing
tTend among fish. Fish have more cancer
now rJlan 50 years ago. 69 A Canadian biologisr, Ron Sonsregard, has examined borrom-dwelling fish in the Grear Lakes aIld
rhe rivers rhar feed rhem. In every fish spccies he has found [Umors-ofren maIignanr
ones. 70 For example, 30 percene of rhe buliheads in Lake Ete had liver cancer. The
Ph.D. nurririonisr and amhor, Dr. Winsron
Craig, in commenting an these findings,
added duee more sobering facrs: (1) the
Grear b.kes sruarion is not unique: problems wirh cancerous ftsh have [Umed up
from Pugct Sound ro rhe Culfof CaJifornia
and from the Hudson River ro rhe F10rida
Keys; (2) National Cancer lnsrittlte dara
show an increased death rarc from cancer
among people living in areas wherc fish have
exceptionally large amounrs of tlImors; (3)
tne toxic nature ofwhat s found in some of
our watcrways is astOnishiIlg: whe-n seelimenrs [rom the bottom of L1ke Erie were
painred an cl1e skin of mice, rJ1e mice developed skin cancers. 71 A1though Craig's
insights may not necessaril)' prove human
risk, clIey surdy raise serious concerns abour
the hllman healrh hazards from rhe "epidemie" of cancers in fish.
Rarher large amounrs of fish die in
droves every year throughour our counrry
simply due ro pollurion itse1f. The Environmemal Protection Agenc)' (EPA) of the
D.S. governmenr has arrempred ro rraee rhe
amount offish kills duc ro pollmon as well
as orher causes. Figure 7 reports rJ1e nuOlber of fish kills proven ro be due ro pollution by state in 1993. 2 Each fish kjllllSllally represents lireralIy thou 'ands of fish.
The EPA admjts tiut rhese figllres
grearIy ullderesrimare rhe aCtual number of
fish kills, since 15 stJtes did nor repon oe
keep track of cheir fish kiJls. Also, man}'
addirional fish kiJls oceur bur cannor be
definireiy proven ro be duc ta pollution.

THE TRUTH ABOUT FISH

Pesricides were rJ1e mo 1 freqllenrly identifiee! wxc pol/mam callsing hsh kills, followed by oiI and gasoline prodllcrs, chlorine, ammonia heavy mecals, and orher
toxic subsrance5.1 3 Unforrunarely, many
fish rhar are ill and suffering from rhese
pollulanrs bur have nor yel died are c<lllghr
by flsherman, taken to marker, and COJ1sumed by humans rhar rhink rhe)' ale ea(ing healthy food.

No Mandatory Inspectiol1 ofFish

OI'. Craig has poilHed our another serious concern wirh fish safee}'. There is no
governmem mandatar)' inspection program
for fish ar fish producrs ar rhis wriring.
Craig srares (har only "bom 1O percem of
flSh undergo any rype of inspecrion, and rhis
is through a voluntary program.74 Obviously, there is need for a well-ordcred inspection sysrem for fish rhar has just noe
laken place. If we could find I~on-fish
sources of rhe beneficial omega-3 fats,
wouldn'[ it be more sensible, from aU rhar
\Ve bave learned, ro JUSl ser fish aside? Such
Coods would not provide a porential reservoir for cancer, infecrjolls diseases, ~U1d oeher
ailmenrs. Foods of rhis kind do exisr, as we
shall sec later.

Mildly-polluted wtlter Produces

Super-polluled Fish
\'{firh cancer being ehe greatesr concern
regarding exposure ro pesricides and orher
ro>ns, we musr recognize which roxins pose
the grearese risk during long [enn exposure.
Poisolls thar present rhe greatest long-renn
rhrears ro hllmans have rwo narural characterisrics: a tendency toward "bioaccumubrion" and a rendency wwarel "biomagniflcation." 80rh of these processes cause
fish from mildly poLiuceel warers ro have
lalge concenrrations of rox.ins in f1sh tissues.
Bioaccumularion is rhe process by which
IOxins gradually build lip in cenan organs
of hllmans 01' ocheI' rargec organisms.
Biomagniflcation refers ro a process where
poisons become progressively more concentrared as rhey move lip rhe food chain,75
A c1assic example of biomagnification
was discovered in Cle<lr Lake, California,

abOli! 90 miles norrh of San Francisco.76

The Iake had been sprayed several rimes with
an insecticide called 000 ta control rhe
insece popularion. (000, a less pOleIH
cousin of ebe infamolls ODT, is eechnicaIly
referreel ro as a halogenared hydrocarbon,)

BIOMAGNIFICATION OF DDD
INSECTICIDE

ill

parts per million (ppm) in Clear Lake, CA

Figure 8

The re5l1lrs of spraying rhis insecticide are

shown in Figure 8.
Norice ehat the lake warer revealed bardv
derectable levels of rhis pescicide. at .02 PPI~
(2 drops of 000 in every 100 million drops
oflake water). Biomagnificarion. however,
callsed a dramatic increase in rhe lisslle leve1s of organisms thar lived in rhe lake. The
concenmHion ofDOO in rhe phytoplankcon in the lake measured 5 ppm, which is
500 rimes rhe concenrrarion in the Jake
warer. furthermore, in progressing up rhe
food chain, rhe conccnrration ofDOO approached 2500 pplll-a whopping 125.000
rimes rhe warer concenrrarion.
Such examples of biomagnificarion are
not rhe exceprion; rlley are lhe rule. The
EPA has gone an record ebat: "Aquatic organisms may bioaccllmulare environmental contaminanrs tO more rhan 1,000,000
rimes rhe concenrrarions dereeted in the
warer. .. "7 Evidence is mounrng rhar rhere
may be a relationship berween IOxns a.nd
chronic hllman diseases sllch as cancer

119

PROOF POSITIVE

120

and hean disease rhar altecr rhe developed

narions in epidemic proportions. An example is provided by rhe halogenared hydrocarbons, which is one cIass of compounds, as we have seen, known ro be
biomagnified through rhe food chain.
They also bioaccumulare in humans.
Elevared levels of these compounds have
been found in d)e rissue of breasr cancer
parienrs. 78 The researchers who idemified
rhis breast cancer 1inkage conduded:
"These resulrs, alrhough preliminar)', suggesr a role for environmenrally-derived suspecr carcinogens in the genesis [origin] of
mammary [breast] carcinoma." But the
problems do not srop wirh cancer. One
invesrigaror, in rus review of rhe lirerature,
found a "correIarion berween DDT plus
ODE [rwo orher halogenared hydrocarbons] in the blood and subjecrs who reported hyperrensiol), arreriosderosis, and
diabetes during subsequem years ..." 79
Fish present some of rhe grearesr concerns
from
rhe standpoinr of
biomagnificarion and bioaccumularion.
They have nor only bee)) found ro be conraminared wirh PCBs and various heavy
merals such as mercllry, bur also wirh perroleum hydrocarbons and the halogenared
organic compollnds. 80 . Rl In a prominem
medical rexrbook an environmenral medical issues, Dr. Kennerh Rosenman ofMichigan Srate Ulliversry srared: "The major
ongoing source of PCB exposure for rhe
general popularion is rhe consumprion of
6sh."82 Along with concerns about causing
cancer, rhere is preliminary evidence linking borh PCBs and dioxins with e1evated
blood cholesreral and uiglycerides. 83 Orher
data indicate rhar PCBs may affect male
sperm cou nts and fertil i()'. 84
Research suggesting rhar d)ese contaminams can harm the developing ferus has
increased rhe srake.s in rhe PCB issue even
furrher. Dt. Theo Colborn has poinred our
that ilie research lirerarute suggests that PCB
presem in the womb can "affect rhe developing nervous sysrem of rhe embryo, ferus,
and newborn."85 RecentIy, the New England Journal of Medicine grabbed headlines when Drs. Joseph and Sandra Jacobsen
further quanrified the developmemal risks

of PCB e.xposure. 8G Even ar 11 rears of age,

children wirh higher exposures to PCBs brftre birth showed impaired inrellecrual development. AJrhough rhe children were nor
rerarded, dwse with the highesr PCB exposures were rhree rimes more like1y ro have
low IQs and f\vice as likely to be at least
rwo years dela)'ed in rheir readij)g comprehension.
Accllmulation of toxic merals in fish has
become of particular concern recenti)' in
light of the problems wirh acid rain. Acid
rain Ieads ro acidified waters. This chemically-a1rered warer can then leach a1uminum, manganese, lead, zinc, cadmiuln, aaci
mercury our of bonom sedimenrs or soil
ineo the warer. Once rhese toxic merals are
liberared, rhe)' find rheir wa)' imo the food
chain and rend ro bioaccumulare in fish rissues. Even i Il seenie Maine, women ofehiJdbearing age and children under eighr are
being urged not to ear fish from any pond
or lake in Maine. Orhers are advised ro resrricr rheir consumprion ro no more than
six large fish ar 22 small ones annllaHy, aU
due ro rile mercur)' comene of the fish. 87
Mercury ingestion in high levels ean harm
the deve10pmenr ofhuman fetuses and children, and callse nervous sysrem disorders
and kidl)ey damage in children and adults.
Michigan is rhe only orher srare ta issue
such a sratewide warning. However, aceording ro Martha Kearing, an EPA sraff scienrist, the U .S. national average of orher lakes
and srreams are jusr as hazardous as Maine's.
The Boswn-based Clean Water Aetian
grollp has even gone on record stating that
90 percenr of freshwater fish callghr in New
England warers have conraminarion levels
of mercur)', lead, PCBs, or dioxin rhat are
ullsafe when consumed more thar once a
week. Alrhough the group had collecred
significanrly less data an salrwarer fish and
thus could not make such a sweeping srJremenr, rhey did warn rhar rhe salf'.'Iater fish
rested had high levels ofPCB and mercur)'.
Probably the most widely publicized case
of hsh-l'e1ared heavy metal poisoning had
nothing ro do wirh acid rain. It involved
the tragic human methyl mercury poisoning thar resulted from eating fish from
Japan's Minamata Bay. Japanese facrory dis-

THE TRUTH ABOUT FISH

charges of merhylmercury into rhe bay Iaid
rhe foundacion for rhe problem. The
biomagni/lcation rhat occurred through rhe
food chain exposed humans who are ilie fish
ro dangerous organic mercury levels. 88

Health Problems/rom
Contaminated Fish
Perhaps rhe grearesr dangers from fish
are rhose faced by Illirsing infams. One
srudy found rhar those who consllmed conraminared Grear Lakes fish experienced reproductive complicarions. These incLllded
alrerarions in birrh size, gesraronal age,
changes in neonaral health sratus, an.d effeers rhar persisred inro early infancy.8? As
a resulr of rhese risks, some have sllggested
tim infanrs should .nor be breasr-fed becallse
of rhe cancer risk. A1rhollgh rhis may secm
ro make sense in aur roxin-conraminared
world, a berrer alternarive may be avoiding
rhe major sourees of (hose roxins. Orher
researeh suggesrs rhar the borrle-feeding
srraregy may back.fire. There is evidence rhar
breasr feeding in alld ofirself tkcreases breasr
cancer risk. A 1994 srudy found (har daughrers who 'were breasr fed by (heir motl1ers
had 2S percenr less breasr cancer. 90
For convenience, a SllJnmary of previously menrioned conraminarion compounds fOllnd in fish is shown in Figure 9.
Possible links ro cancer from conraminared fish are slImmarized in Figllre 10.
PCB con ramil-lar ion of fish has been weU
docllmenred. The evidence of the delereriDUS efTecrs of PCB on rIIe human reproducrive sysrem is sunuuarized in Figllre Il.

Fish Farmingfor Safer Fish?

In fairness ro the fishing indllsrry, it
shouJd be menrioned rhat aquaculrure (fishfarming) may circumvenr some of rhe concerns regarding roxins. Such fish are grown
in conrrolled bodies of warer (har are isoIared from open srreams. Ifauenrion is paid
(O warer qualiry in (hese commercial fish
fanns, some of rhe problems assoeiated with
pollution can be avoided.
However, if financial inreresrs continue
ro prevail, lax warer qualiry standards may
also render these fish po(entially dangerous.

FISH CONTAMINATION
COMPOUNDS
Fish from mildly polluted water concentrate
toxins up to more than 1,000,000 times more
than detected in water.
Toxins in their fatty tissues include
pesticides, chlorinated hydrocarbons,
mercury, and dioxin.
. . Fish can also be contaminatcd with peRs,
various heavy mctals, petroleum
hydrocarbons, halogenated
organic compounds, and Icad.
Figure 9

EVIDENCE LINKING FISH CONTAMINAnON

TOCANCER
Elevated levels of pcsticide compounds bave been
found in tbe tissue of breast cancer patients.
ational Cancer Institute data ShOlV an increased
death rate from cancer among people Iiving in
areas wbere fisb have exceptionally Jarge
amounts of tumors.
Fish have more cancer now
than 50 years ago. Example:
30 percent of the bullheads
in Lake Erie were found
wth Iiver cancer.
Figure 10

pes AND THE REPRODUCTIVE SYSTEM

The major ongoing source of PCR exposure for
the general population is the consumption
of fish.
peR may affect male sperm counts and fertility.
PCB-contaminated fish eaten by pregnant
mothers are Iioked to alterations in
birth size, gestational age, and
changes in neonatal heaith status.
Children at tI years of age with hgher
exposures to peR before birth show impared
intellectual development.
Figure 11

121

PROOF POSITIVE
Of. Mchael Jacobson of rhe Cenrer for Science in rhe Public lnreresr indicarcs rhar
farm-raised hsh are nor free from concern.?1
Based on rus research, he has highlighted
several issues: (J) food coloring has iliegaHy
been added ro feed ro make farmed ush look
more arrractve ro consumers; (2) anribiories are romine1y used in the ush farming
indLJsrry; (3) pesticides have also been applied by aqua-cu1rurisrs; (4) fann-raised fish
may have lower omega-3 levels due ro differences in their feed.

PLANT FOODS CONTAINING OMEGA-3

(LINOLENIC ACID)
Amollnt

Food Item
Fla.xseedlLinseed oiI
Walouts, Englisb
Canola oU
Walnuts, black
Wbeat germ oii
SoybclIn oU (Crisco/Wesson)
Green soybeans
Spin8ch, canned
......
AlmoDds
California avocado
Turnips
Samower oii
Swcct pot,atocs
Banana
Medium apple w/pccl
Roasted potato, medium size
Cucumber slices w/pecl
Whole wbeat bread

1 Tbs.
cup
1 Tbs.
1/4 cup
1 Tbs.
1 Tbs.
1 cup
1 cup
1/4 cup
1/2 cup
1 cup
J Tbs.
1 piece
1 each
1 cach
J each
10 picces
1 piece

1/4

Omega-3(mg)
7526
1703
1094
1034
938
927
637
353
136
99
74
55
38
38
25
17
12
Il

----~-----

Figure 12

Get the Omega-3 Benefits Without the

Risks ofEating Fish

122

There is a way ro have rhe benefirs of

rhe omega-3 fatry acids without having to
ear fish, fish oii, or expensive capsules. There
is a way ro bypass rhe cholesterol and toxins rhar come w,irh rhe animal-derived
omcga-3. The way is so simple, bur it is
nor gening rhe publieiry it deserves. We
can obrain rhe benefits of omega-3 fatry
acids /Tom a planr far caUed linolenic acid.

The human body can acrually make rhe

well-srudied eicosapenraenoic acid (EPA)
from linolenie acid. Linolenic acid is itself
an omega-3 farry acid and is an essential
componenr of rhe human dier.
Linolenic acid is differenr from linoleic
acid. The cririeal difference is in the letrer
"n" rhar is rhree lerrers from the end. StIldenrs of biochemistry may remember che
difference berween rhese very difFerem fats
by noting rhar rhe one with rhe "n" rhrec
lerrers from rhe end is an "n-3" t1r (another
redmical nallle for an omega-3 far). an
rhe orher hand, rhe far wirhour rhar crirical
"n" is linoleic acid, called omega-6 fatry acid,
and is round in corn oii and safflower oiI.
Mally comOlon planr foods are rich in
linolenic acid. Some of rhem are lisred in
Figure 12. 92
Nore rhar rhe highesr source oflino!enic
acid is flaxseed oii (a1so c;ll1ed linseed oii).
Onc rablespoon has over 7500 mg of linolenic acid. One-quaner cup ofEnglish walnurs conrains 1700 mg of rhe omega-3 linolenie acid. One tablespoon of soybean
oii has more rhan 900 mg. Even one cup of
canned spinach comaios abolit 350 mg. We
do nor normally rhink ofspinach as having
much far, bur it is an excellent source of
omega-3. Today's generarion of morhers can
now rell rhei( children ro ear rheir healrhful
spinach wirh added force. Even common
foods we ear every day, Wee a banana, an
apple, bre-ad, or poraroes, aII make rlleir
conrriburion ro our linolenic acid imake.
As we can now bener undersrand the
benefirs of omega-3 fatt)' acids, we can also
appreciare rhar it can make a difference
where we ger rhem. When adopring a balanced dier of plaJH foods, we reap the benefits of omega-3 wirhour rhe roxins, pesticides, aod cancer risk inherenr in rodav's
fish. Besides enjoying ilie foods lisred abo~'e,
if you are in need of eoncentrated amOUl1TS
of omega-3 fan}' acids, rry grinding equal
proponions of flaxseed and walnuts. We
caII it "flax-nm burrer." It has a te..xture similar tO peanllt butter and is quire tasry. Patienrs suffering from significanr coronary
arrery disease, rheumaroid anhritis, psoriasis, or hyperrriglyceridemia may benefir
from rhe higher doses of omega-3 rhar flax-

THE TRUTH ABOUT FISH

nut blltter Cln provide.
It is import:tm ro poinr out [hat mosr
stlldies tegarding the benefits of omega-3
f.my acids have focused on rhe oile farry acid
Ibar has been considered in this chapterEPA. Many researchers seem to ignore rhar
EPA is not an essential farry acid. We have
already identified why it is not essential: our
bodies manufacrure EPA from rhe linolenic
acid char is found abunclantly in rhe planr
foods listed above. The sreps by which EPA,
eicosapenraen.oic acid, is derived from linolenic acid are omlined in Appendix IV.
Studies clearly show that whcn a person
increases his consumprion of plam sources
of alpha-linolenic acid, blood levels ofEPA
a1so significanrly increase as expected. 93
Anorher study demonsrrarjng conversion of
a1pha-linolenic acid imo EPA in humans
prornpred an inreresring observauon. This
seudy shows mar linolenic acid may have
llnique benefirs in irself in addirion ro rhe
benefits ir provides in being converted ro
EPA.9 4 Thus, ic may be berrer to ear foocls
conr.aining linolenic acid rarhcr than rhose
wirh EPA. In this way, rhe body can use
however much ir needs for conversion ta
EPA while reserving the excess for orher
beneficial llses. Thjs would also avoid rhe
dangers of an excess of EPA in the bloodSlream, whkh Cln trigger a stroke due ta
hemorrhaging.
One study of a diet enriched in alphalinolenic acid has already suggesred rhar rhis
fal has a role in preveming hearr disease. 9S
A cousin of alpha-Iinolenic acid, known as
gamma-linolenic acid. appears effecrive in
dealing with arthritic conditions.%

Vegetables and Pesticides

Regarding conlaminarion wilh pesricides, man)' American consumers are mostl)'
concerned abOlit conraminared fruit.s and
vegerables. le is truc thar acute roxicities
rrom pesricides have been rraced ro conramioared plant producrs. A 1991 repon reviewed some of the classic examplesY7 In a
1962 episode in Turkey 333 died and as
many as 3000 were poisoned due ro consllmprion of seed grains treated wirh
hexachlorobenzene. In 1968. severe poisonings and dearhs were documented when

individuals are bakery producrs that had

been contaminated wim paratbion. Man)'
also died in a 1972 Irag incidem when rhey
ingested grains treared with an organomercuriaJ fungicide. More recendy in 1987,
fifreen Peruvians died and 260 became il!
when rhey are bread made from aldrin-contaminated flour.
Acute roxiciries like rhese, although serious and frightening, are relatively easy ro
prevenr in developed nations. Because of
ule acute narure of Ihese tox:icities, rhey have
been well srudied. Legislarion bas been enacted thal guarcls consumers againsr exposures ro roxin levels bigh enough ro Cluse
acute hllman healrh risks.
Long rerm or chronic effecrs, however,
are not as easy ro prevenr. wherher the contaminarion is (rom vegerables or fish. The
reasons for this include: (1) it may take
lllaJly years for long-term effecrs ro become
apparent; (2) even when the effea occurs,
it may be difficulr ta pinpoinr the toxin
causing rhe effecr; (3) even if an association
is made, ir is difficult ro derermine how
much exposure is required to produce [he
effect.
Chronic effecrs, particularly cancer rislc,
tend ro take cemer slage regarding Americam' concerns for pesricides. As 1 talk with
(he average person 011 the street abOlit pesticides, it seems tbat the greatest concern is
cancer. Usually, rhe food groups they fear
ro be rhe mOSt comarninared are frllirs and
vegetables rather rhan animal producrs.
However, the f..1Cts tell a different srory.
When you look ar fmit and vegerable
cOllsllmprion, rhe more of rhese plam foods
we eal, rhe smaller our risk of Gl11Cer. This
fact was highlighted by one of America's
foremost nutririon researchers, Of. Gladys
Block of rhe Universiry ofCalifornia ar Berkeley. Dr. Block and her colleaglles reviewed
170 stlldies rhar ser our ro derermine if fruir
and vegetable consumprion affected cancer
risk. 98 Results showed rhar 132 of rhose
srudies showed a dear Cflnt:er-protective benefit rrom rhese planr foods. Only 4 studies
our of 170 suggested a sratistically signiflcam increased risk of cancer. The other 34
studies were indeterminate.
Let lIS consider a simple law that applies

123

PROOF POSTTIVE
w statisrical srudies. Jf there is a true relationship between nvo things, and you do
nearly 200 srudies, you would expecr rhe
vast majority of them ta disc/ase rhat re1ationship. BecaLlse of rhe narure of statisries, however, you wouid expect SOll1e scuc\ies ro be indererrninate, and a few srudiesjuSt by chance-will suggesr a relarlonship
in rhe opposire direction of rl'uth. Such is
rhe case wirh Block's analysis. In summary,
fruirs and vegetables emerge solidly as cancer-pwrective foocis.
Perhaps rhe most imponant point of
Block's repon s that she was not looking
exclusively ar vegetables grown organically.
These nearly 200 srudies simply looked
ar rhe foods rhat the average person is accustomeel ta eating. Likely, most of rhe
fruits and vegetables lud been spraycd with
pesticides anei grown wirh fenilizers. le is
deal' rhat, far from plltring us ar cancer I'isk,
fruirs aud vegetab1es-even if grown wirh
fenilizers and pe ,ticide -help us prewnt

cancer.

Jnspiration lnsights
Because I quore inspired sources rourinely ancl believe in rhe accuracy of the
Bible, I am ot1en asked Biblica! quesrions
about fish. A common query is: if fish is
nor an ideal food, why elid Jesus eat it? (ln
faet, dus is ilie only animal product the Bible
explicitly records being eaten by Jesus),
First, the fish that Christ consumeel in His
day were lIneloubtedly much healrhier than
the marine life available ro llS currently,
IndusrriaJly pollured \-"arers as we have today did not exisr in the rime of Christ and
chemica.! pesticides were unknown. Second,
alrhough the Bible presents Jesus as aur example, it does so from the perspecrive of
His characrer-not from r.I1e minute derails
of His life. JUSt as "being like Jeslls' doe.s
not mean moving ro Palestine ro live, oeirher does it imply thar we will ear fish as He
clici. However, Gad did record in the Scriprures His original intenrion for rhe e1ict of
mankind: a total IJegetarian diet. 99
Mear and fish are not included in this

124

original diet, but c1ean mear wirhollt rlle

fat were not (Otally prohibited in Chrisr's
day. Christ's ex:unple. in t":lcr, does show
(har Goel cliel nor rigidly enforce His original diet, bur m:lele aJlowances for rime and
circull1srances. However, rhe book of Genesis also indicares rhar rhose \Vho consumed
:l vegetarian eliet lived substantially longer
than (heir offspring who began ro incorporate mear into rheil' dieL This can be een
by comparing rhe long life span of the generarions that lived before "Noah's" flood
with a s(eady decline for (hose who followed
iL 100 Chapter 7 on protein, Figure 27,
documems rhis life span decline. Of note.
ilie Bible records (har ir was aher rlle fload
that God gave bumankind permjssion ro ea[
animal f1esh. 101

Conclusion
As a physician I find deep satisfacrion
in helping sick f01ks regain their health and
"igor. But there is somerhing eqllally and
perhaps even more sa(isfying and rhat is
helping indivieluals understand bow to prevenI illness. ham aII rhe research we now
have an rhe causes ofhe<lrt disease, rhe conclllsion is e1ear: hean disease is largely prcvenrable. Meelications have theit place, bur
regarding the prevenrion of hean disease,
rlle very best srrategy is a commonsense vegetariall elier using a variery of fruits, grains,
nurs, seeels, and vegetables. Adei to rhis dicr
a consistent exercise program a program for
srress managemenr, and the other pracric.al
lifesryle recommendations in rhi and rl1C
chaprcrs ro carne. Such a cOlnbination will
give you the Hnesr program for prevenring
hearr disease ar addressing a problem that
has alread}' begun.
Remember: anythil'g worrhwhile i.n life
takes time. Many people have given (heir
ali ro make a fortune, bur in rhe process have
lost what is mosr deal' and priceless: rheir
hea.lth. My wish for you can be besr. expressed from rhe Bible, 'Beloveel, l wish
above aII things thar thou maresc prosper
and be in health, even a thy saul
prospereth. '102

THE TRUTH ABOUT FISH

Refere1lCl's ) Diagno ti Dilemmas: 1'00 Much of a Good n,ing. Choleslerol ,md
CoronalJ' Hean Disease... Rcducing the Risk. 1987; 1(5); 13-14.
~ Krol11hour O, 805';chieler

EB. de Le-lcnlle Coulander C. The invers('

reblion betweco fish cOIIsurnplion and 20-rear morraliry from coron'lry
hean disea . N tilgl} Ivled 1985 Mal' 9:312(19): 1205-! 209.

1 Phillipsoll BE. Rothrock DW, et al. ReduClion of plasma lipicls. lipoprotcins. and apoprolcin. bl' diclarl' fi h oils in pariellts wirh
h)'jlewigl)'ceridcmia. N Eng!} Med 1985 Ma)' 9;312(19):1210-1216.
I Lee TH, Hoovn RL. el al.
Effecr of dietary ct<richmelll Wilh
deo,apcmacnoic and daco ahC1G1Clloic acid. on in vino neurrophil and
monocyle leukOlriene general ion and lIeurrophil fUIlClion. N EJJg!} Merl
1985 Ma)' 9;312(9); 1217-1224.

~ Di:\gnosdc Dilemmas: 100 much of a good rhing. Choleslerol and

coronary hean dise:\Se... Reducing U1C risk. 1987; 1(5); 13-14. (Nore: Nt1mes

d!llllged ro prorea IlIIOJJ)'mity).

\I;/jlt TJ, Lofgren JU" et al. Fi h oii supplemcl1t:l.Iion docs nor lower
p!: ma. cholesterol in men \Vith hl'percholcsrerolel11 ia. Resulrs of a raIIdomizoo. pbc.ebo-cormollecl cros over slud\'. AnJJ ltl/l'rn Met/1989 Dec
J: 111(11);900-905.
.
Slrlukawa M. Abbcy M, er al. EfTecr.s offi.sh oii farr)' acids 011 low densit)'
lipoplOlein size. oxjJjzabjlit)'. and uptake b)' m:tcrophagt'S. } I.ipid RfS
1995 MaI;36(3):473-484.

The foood Processor for Windows: Nutrilioll Analllsis & Fimes. Sofn,.,arc
!computer program]. ESHA Rcsearch. Salem, Or;gon.
,/ Bair:Hi (, Rol' L, Mel'er F. Double-blind, randomized. cOlllrollcd tri:u of
lish oiI supplemcms in prcvcnriOll of recurrellce of slenosis afler coronary
angioplasry. CimdtUion 1992 Mar:85(3):950-956
KromhoUI D. 130sschieler ER. de Lc""lenne Coulander C. Tbe inverse
rdarion bctwc'Cn lish caJlSumplioll and 20-l'ear lllorraliry from coron.ry
hean disease. N E1Jg!) Med 1985 Mal' 9;312(19):1205-1209.

.onnor \XfE. Davidson M. er al. Alternative approaches ro lower'ng

chole rcrol. Patimi Cirre 1995 Nov 15. p. 110-133,
11

J: I..caf A. Weber Pc. Cardiovascular dTects of n-3 fanl' acids. N /:.ngLJ

Mrrl1988

~v"'r

3;318(9);549-557.

11 Lorcnz R, Spellgler l), CI al. P!are!er funClion, lhromboxane formarion

and blood pre urc comrol during supp!cmenratioll of rhe Wesrcrn diet
"ilh cod livn oiI. CirrultUi()ll 1983 Mar;67(3):504- 511.

14 Margolis S. Dobs AS. NUlrilion:u managemelll of plasma lipid disorders. } Am Co!1 N"tI 1989;8 SuppIO:33S-4 5 .
1< I..<.-ai A. Wcba Pc. Cardiovascular eAecrs of ,,-3 fim)' ac.ids. N EJlg!}
Mt'lt 1988 M.1f 3;318(9):549-557.
1(, Culp 13R. L1nds WEM, er al
Tbe efieCI of dielat')' supplemelllalion of
lI:h oii on experimental m)'ocardial infarction. I'ro>foglol1dil1s 1980
Oce;20(6): I 021- J 031.

11 Dehmcr GJ. Popma.JJ. et al. R..dUClion in rile rare of earl)' reslenosis

afier coronar)' angioplasl)' bl' a cliet suppIemenred wilh n-3 falry acids. N
EI/gil Mrd 1988 Septembc'r 22:319(12);733-740.

l8 Et;rsland J, Arncsen H. el al, EfieCI of dieraI)' sllpp!cmelllalion witil n3 f,nr)' a ids on coronar)' "ner)' byp"ss grnfl parenC)'. Am} Dmlio! 1996
J~n 1: 77( J ):3 J-36.
lry Krolllhour O, Bosschieter EB. de Lezennc COlllander C. The inverse
rel~tion benveen fish consumption and 20-year monaliry from coronary
he:lI'l dise:lSe. N EnglJ Ml'd 1985 Ma)' 9;312(19):1205-1209.
Phillip R. Lemon F. Kuzma J. Coronar)' hean disease monaliry among
Scventh-D~)'Advenrists wilh differing diet.1I'j' habit.~. Am} Clill NIII" 1978
Ocd 1(10 Suppl):SI91-S 198.
.'D

Il Aschel'io A, Rimm EB, CI al. Dielary illl;tke of marine 11-3 fanv acids,
fish intake, and the risk of coronary dise:l e alllong men. N EllglJ M<'fi
1995 Apr 13;332( 15),977-982.
Pielinen P. Ascherio A. el:U. Inr:lke of farl)' a ids and risk of coronar)'
hean disease in a cahor! of Finnis" mCIl. The Alpha-Tocopherol, BeraCHOtelle C. ncer Prevention Srlld)'. Am} Epidemio! 1997 Mal'
15; 145(1 0):876-887.
.

11

, RJ)~um'lIoid An!lltri!is: Shapiro JA. Koepsc.1I TO, el al. Diet and rhculIlalOid anhrili. in womcn: a possible proreclil'e effect of fish c.onSllmpdon . .Epidnniology 1996 May:7(3):256-263.
Rt~)'Jlt1l/d's Dismsc: DiGiacomo RA. Kremer JM, Sha" OM. foi.h-oil diCla')' upplementation in p.ti.enr.s wilh Illynaud's phenomenoll: a doubleblind, cOlllrolled. prospective slUd)'. IIm) Med 1989 Feb:86(2):158-164.

Psoriasis: Grimlllinger F. Ma)'ser P. el al. A dOllble-bllud, r:lOdomizeJ. placCbo-colllrolled lrial of n-3 farrl' acid based lipici inru.sion in aCUle, C;(lended gllrtale psoriasis. Rapid improvcrncrH ofclinica! manifesrations and
chanc.s in nellrropilillellkolriene profile. C/in InlJesrig 1993 f\llg;71 (8):634643.
CI Ulcer!: Thompson L. Cockayne A, Spiller Re. lll.hibitory cffece of pol)'linsat urawd fali)' acid un the growlh of Hei icobacler p)dori: a possible
cxplanalioo of Ihe cffect of diet on peptic ulcerarion. CU! 1994
ov;35(11): 1557-l561.
U!((rariv~ Coliiis: Slenson \'lE COr! D, el' al. Dietar)' supplemcnralion
with fish oiI in uIccrativc coli ris. A1I7J IlIfl'I'J1 Med 1992 ApI' 15;116(8):609614.

Bellu~l.i A, Brignola ,el al. Effecl of 311 emeric-c.oalcd

li.sb-oiJ preparation on rdapses in Crohn's disease N Ellg!} Med 1996 Jun
) 3;334(24): 1557-1560.

Crolms Disease:

Depre iOIl & OfJCr-Aggn:Hivl?ws: Hibbeln JR, SaIem N Jr. Oielar)' pol)'unsarurarcd farry acids and deprcssion: when chol~ lerol does nOI s:lli f)'.
Am J CLin Nll,' 1995 Ju\;62( 1): J -9.
Bmm Callar: Rose DE COJlJIOII)' JM. Effecls of dietar)' omega-3 falry
:tcid on hU1l1an bre:.t.<t cancer glOwtb and mClaStaSe in nude m;ce. } NI1II
Callcer ImI 1993 Nov 3:85(21): 1743-.1 747.
CO!OIl QmuI~ Narisawa T: Fubllra Y, CI al. olon cancer prevelllion wirh
a sma.ll amount of dielar)' periUa oiJ h.igh in alpha-linolcnic acid in :In
animal model. Gmec! 1994 ApI' 15;73(8):2069-2075.

COPD: Shah;lf E, [:0150111 AR. et al. DiCla')' n-3 pol)'u.n a(mared fau)'
. cid and smoking-relarcd chronic ob uuclive pulmonar)' disc-ase. t\therosclerosi Risk in Comrnunities SI ud)' InvesrigalOrs. N En !} Mtd 1994 JuI
28:331 (4):228-233.
~. Geusen< P. Wollters C, el' al. Lollg-rerm c/TecI of omega-3 fatl)' acid
supplemenralion in ae[ive rhcumaloid arrhrilis. A 12-momb, doub1e.-blind,
comrolled slud)'. Arlhrilis Rltelltll 1994 JUll;37(6):824-829.

2, Espersen GT. Grunnct N, et al.

Decrea.sed ilJlcrlellkin-1 bela level in

plasma from rhcull1alOid anhritis p:llients afler dietarl' supp!emenlaljon
witb 0-3 poJyunsaluutcd f:ur' acids. Clill RJlt'fItttt1toL 1992 Sep; II (3):393395.
I6 Nakamur.l N. Hama'l-.'lki T. el al. The efrect of oral adminislution of
eico apenlacnoi amI docosahexaelloic :tcids on acute inOammalion aml
f:lHy acid colltposiriol~ in rats. ) Nllir Sci VitomilloL (Tokyo) 1994
Apr;40(2); 161-170.

DiGiacomo RA, Kremer JM, Shah OM, Fish-oil dietar)' suppiemellration in patiems \Vith Raynaud's pb,~nomcnol1: a double-blind. comrolled.
prospect;ve stud)'. Am} Mcd 1989 l'eb;86(2): 158-164.

27

1J) )3:111 EV. Koopman WJ.

Rheul1aloid Anhrilis. In: Kcll)' \'V'N. DeVita
VT J r.. edilOrs. el al. ,'xr Book of Inrerna! )\1,or.iieine-2"J cditiotl.
Philide1phia, PA: J.B. Lippneoll Compan)'. 1992 p. 914-919.

125

PROOF POSITIVE

r.

J9 Grimminger F, Ma}'ser
el .11. A doubleblind, randomized, placeboconuolled lrial of n-3 farrl' acid ba cd lipid infllsion in aCUle, eXlended
gurrare psoriasis. Rapid improveJllCIll ofdinical manifesmons and chan<>es
in neulrophilleukolriene prolllc. CIi" IJlvmig 1993 Aug:71 (8):634-643.

Fr.lti C. Bcvilacqua L, Apostolico V Associalion of e[felinare and ftsh

oii in psoriasis [herapy. Inhibirion of hypenriglyccridcmia resulting from
rcrinoid lherapy afrer ftsh oil upplemcnrarioll. Actl/ Dfrm Vtrlt'reo/ Stlppl
(StOckh) 1994; 1860: 151- J 53.

30

Thompson L, C.-ockayne A, SpiJkr RC Inhibirory efreC[ of polyuman'ra[Cd farry acids on rhe grewth of Hdicobacter p)'lori: a possible e.xplanalion ofrheefrectofdiet on peplic u!ccralion. G"t 19941 0\';35(11):15571561.

31

Rose OP. Connolly JM. EAecls of dierary omega-3 faul' acids on human breasl cancer growth and mWtstasc in nude mice, j Nt1t1 Gmca /wt
1993 Nov 3;85(21): 1743-1747.

31

33 Narisawa T. FlIkaura Y, el al. Colon "''Ulcer prcvcnrion witil a small

amounc of dielaty periUa oii high in alph'l-linolenicacid in an animal model.
GilllUY 1994 Apr 15;73(8):2069-2075.

Lindncr MA. A ftsh oii diel inhibils colon canCer in mice_ Nun' Grnccr
/991;15(1):1-11.

SI Food and Dmg A<!minimalioo (EQA) data accortiing ro' Schardr D.

Sdl1ltidr S. Fishing for Safe Seafood. Nutritioll Action HraltlJ Lmer 1996
No,,;23(9): 1.3-5,

;J MiJJer

RW. Get Hooked on Seafood Safery. !-DA COlIstmuy. Junc 1991

p.7-11.
;3 Food and Om!; Adminimaljon (EDAl dala according 10: Sdwdt D,
Schmidr . Fishiog for Safe SeafooJ. N1ItritioJl AClioll Hel/lrh Lrr-tel' 1996
Nov;23(9): 1,3-5.

>4 Miller

RW. GCl Hooked on Sea/ood S~fcty. FDA Cowumer. Junc

1991. p. 7-11.
~ L,1Sr JM. WaHace R13. editor. food poi.\oning. [II:

Mrl.l'cy-Rose1/rlll-LiU/
Public HMltb El/Iti PTI:llt'l1Iitle Medi";/le. Norwalk. Cl": Applcron & L"ngc.

19921'.193-201.
16

Lange WR. Ciguatcra fish poisoni ng. Am FEtm Physirl/l 1994 Sep

1;50(3):579-584
~7 Lasr JM, W:1.lIaec RE, edilOrs. Food poisoning. [o: Mf1XC)~RosmElu-Lrut

Public /-Irairll /Ind PrCt/emili" Metlicinc,

orwalk. CT: Applelon & Lange,

1992 p. 193-201.

J4

Stenson WF, Con O, el al. Oielary supplcmcl1tarion wiril tsh oiI in

lIiceralive colilis. Ann Inrcrn Med J992 Apr 15:116(8):609-614.

.1;

Uauy-Oagach, R, Mena P. J ulrilional rolc of omega-3 Eury acids during (he perinalal pcciod. C/in Perinlllo/1995 Mar:22(I): 157-175.

36

American Acaderny of Pcdiarrics. The usc of whale c.ows milk in inf:lllcy. Pedil1tric; 1992JlIl\;89(6):1105-1109.
37

LUC.1S A, Model' R, et al Brc:m milk ;Ind wbse.quellr imelligenec qlloUCIll in ehiJdren born prClcnn. Lan,..., 1992 Feb 1;339(8788) :261-264-

38

I-libbeln JR. Salem N JL DiCla!}' poll'unsalurarcd Ellry acid, and de

p=ion: when choleSlcrol docs not 5-1risfy. Am j C/in Nun' 1995 JuJ;62( 1): 1-9.

39

Giani E, Masi 1, Galli C. l-lealcd far, viramin E ane! vascular eicosanoids.

Lipids 1985 Jul;20(7):439- 448.

1,0

Piehe LA, Draper HH. Cole 1'0. Malolldialdchyde excrelion by subjccls consum ing cod liver oii v. a concCf1lratc of 11-3 farry acids. Lipitfs
J 988 Apr;23(4):370-37 1.)

41

42

Stone NJ- Fish cOllSumplion, flsh oii, lipiJs, and coronary he:m discase.
ov 1;94(9):2337-2340.

Cimdlltiolt 1996

Glauber H, WaJlace P, el al. Adverse merabolic <"!TecI of omega-3 falt}'

acids in non-insulin-dependclll diabet mellilu. AnII iltUrtI Mrd 1988
Mal'; I 08(5):663-668.
3

.. Rogers S, James KS, cI al. EfTecls of a tsh oii supplcm"'nl Oll enUll
lipids, blood prc.~urc, blceding lime. ha<"JIlo talic and rheologiGll v:lriables.
A double blind tandomized colltrolkd Ui:1J in heallh)' voluJHccrs. AthertJiderOiis 1987 Feb;63(2-3): 137-143.
41

Middallgh lE Cal'diovascular Jealhs among Alaskan

ati,'c, 1980-86.

Am j Puh/ic Hcrr/th 1990 Mar;80(3):282-285.

Bairali.l, Roy L_. Me)'cr F. Double-blind. r~ndomized, coTllroHed triat of
fish oiI supp!emcllls i Il preveTll ion of recllrrence of srcn05is aticr coronary
angioplasry. Cin:ulAtioli 1992 Mar;S5(3):950-956.
6

17 Ycriv JZ. Clinic:ll appliellions of t,h oil5.

JAMA 1988 AlIg 5;260(5):665-

670.
.. Yeliv JZ. C1nical appliearions offish oil . jAlvJA 1988 Aug 5;260(5):665670.
~9 Thc Food f'roc<:ssor for Windows:
ulriljon Analysis & Fitness Soflware [computer program). ESHA Rcscarru. Salem.Oregon.
50 YctivJZ. C1inical applic:uiollS of fish oik
670,

126

JAMA 1988 Aug 5;260(5):665-

;8 Lee Wedig of Narional Fisherics Instilllte as quored by: Schaldl O.

SchmiJI S, Fishing foI' Safe St,afood. Ntltyirioll /IctiOft Ht'rr/th Lcuer J996
Nov:23(9): 1,3-5. -

Miller RW. GCt Hooked on Seafood Safery, FDA COIISuma. Junc

1991. p. 7-[ \.

10

60 P:lncorbo oc. Barnlurt HM. Microbial palhogcns and ndcators in

estuarinc envil'OnmelH a_ud shellfish. jOt/ml11 ofEnvirOllmmfl1L Helflt1J 1992
Ma(chlApril ;54(5):57 -63.
61 Pancorbo O ,Barnhan HM. Microbial pathogcns and indicators in
csluariJ1C environmel\ls and shellft h. jounflfL ofEnvirvl1/11l'lIlrlf Hmlth 1992
March/April;54i5l:57-G3.
61

Schardl D, Seh miclt S. Fi h illg for Safe Seafood. Nurritiol1 AaitJn Hel1/tI)

Lma 1996 Nov;23(9): 1,3-5.

63

Schardl O, Schmidt S. Fishing for Safe Se:tfood. Nt/rririo7lActioJ] Ht:i1Lth

L<'tur 1996 Nov;23(9): I ,3- 5.

6.{

Food and Drug Aclmillisllalion Pesticide Prog(anl. Residue MonilDring

J 992, jOl/ml1l ofthr Associlttioll ofOjjicial Amilytical Chemisrs. Volumc 76:

Seplemb<T/OClObcr 1993.
GI

Sch'lrdt O, Sch midl S. Fish ing for Safe Scafood. Ntltyition Acriorl Hel/ltb

Lmn- 1996 Nov;23(9):1,3-5_

W'axman M F. Whcn pest control gers
Hl'I1/rh alul Si1Jery. Ma}' )993:81-87.

66

OUl

of

COIll rol.

SdVlcidcr K. New pesticid, plan pUlS safetl' ftrsl.

143: 49,461 (Septclllber, 21,1993), p. A19.

67

Occt/plltioll111

TI),. N(IV York Tinm

HulrJ', Hasernan J-K. Ncws Forum. Rjsk assessmenl of pesticides.

ExposUl'e ro certain pcsticides ma}' pose real careinogcnic risk. ClJl'llliarLl1Iul
Engilll'l'YiJlg Ncw! 1991 ;69( 1):33-36.
MorcU V. Fi.lhing for uouble, A canCl'r cpidemie in ftsh i.s warning us:
You ma)' be nCxl. [nti Wildlife 1984 Jul/Aug; 14(4):40-43.

69

More-II V Fishillg for nouble. A ca.ncer epidemic in ftsh is warning lL\:

You mal' b nexl. bul WildliF 1984 Jul/Aug; 14(4):40-43.

70

71 Craig W). Fishing for l-i-ouble. 111: Nurrjrioll For The N;'tefiu. E~u
C1aire. MI: Golden HarvCSI Books. 1992 p. 76-84.

7! EnvironmeOlal Prorcction Ag<"llcy (EPA) , Nalion.J W:1ter Qualil)" 111\'<'IIlDr)'. 1994 Rep0rl ro Congre- S. Pg. 141,

Envirollmelllal Prorcclion Agcnc)' (EPA).

venlOry. 1994 Repari to Congress. Pg. 143

7J

alional Walcr Qualit)' In

Craig WJ. Fishing for TrOllble. In: NlI/Tition For 7he NinericJ. Eall C1airc
MI: Goldcn Harvcsr Books. 1992 p. 76-84.

74

THE TRUTH ABOUT FlSH

7}

Nadalavllkarcn A. Pesr, and PC5ricide5. ln: Mall and ElivirOllllli'IJt, A

Henlth Pl"f"spcClivl', TlJirr/ EE/ilioll. Prospecl f-Ieighls. IL: \'iZweland Press.

1990.
76

N:l<J,.kavubren A. Pest.> and Pesticides. In; AI",) ""d Enviromnmt, A

Hta"h Pcnpmive, TlJird Edirion. Prospect Hcighrs. IL: Wavdand Prcss,

1990.
U.S. EPA. omcc ofScience and Technolog,v. Office ofWarer. Guid:lace for assessing ehel1lic:u eontaminanl dJI~ for mc in fish advisories.
Volume 1: Fish Sampling andAnl1lysis-&condEdirion. Seplembcr 1995.
: EPA 823-R-9S-007; p. 1-1.

17

n Fa! k F J r, Ricci A. J r,

al. Pest icides and poly h!orinated biphenyl

residues in buman breasl lipids a.nd their l'c1alion tO breasl cancer. Arch
t.lwiroll Hl'IIlth 1992 Mar-Apr;47(2): 143-146.
CI

sa.

19bedioh
EilcCLS of agriculllmlJ peslicides on humans, anim:us and
higher plJllts in developing cOllnrries. Arch blViron Hetrlth 1991 Juli\ug;46(4):218-224.
79

'o

Nicoh. RM, Branchf10wcr R. Pieree D. Chernical COlltalllinJlllS in

bOl10rnllsh. JOIITfla! ofEn/Jir01l1ne11lIJ/ Hm!th 1987:49(6):342-347.

Hovinga ME, Sowers M. HU1l1phrey HE. Environmenral exposure and

lifeslylc predi "tors oflead. cadmiurn. PCB. 3nd DDT le"e1s in Grear Lakes
ftsh calces. J]rc!J Environ HMlt!J 1993 Mar-Apr;48(2):98-1 04.

SI

. R()~ent11an KD. Dioxin, po!y,.!JIoriI1lJled biphm)'Lf, fwd dibmzofim1lls il}

EIII}ronmem"!
Oallpl1rionl1/Ml't/icine-Z'" ediiion (editor: \X . Rom).
B()SIOII MA: Linie Brown and Co. 1992 p. 927-933.

,,,,ti

Dioxin. po/ychlori1111ud biphm)'ls, IlrId dibmwfimJll( in

Elwironl)Jl'IItJlll1nd Ocmpt1riowtl M,.dicine-2"" rJition (editor: W Rom).

'.1 Rosenman KD.

Boston

~{A:

Little Brown and Co.. 1992 p. 927-933.

-.( Colbom T AnimallHea.hh Connection. In: l'roceedings oflhe VS tiwiroml/mllll Proreci;on Agemys NtltioJllt! Tt'chnil'tl! \17orks/JOp "PCBs i,1 flsh
lIJJUe." Septcmbcr 1993. EPAl823-R-93-003: p. 2-27 ro 2-30.
, Colboftl T. AnimaJ/I-\calrh COllncclion. In: Proce,.dings ofrbr VS EnvirOllmmlll! Prorection Agmrys Nn/ionn! llc!Jnicn! Work.shop ''PCBs in Fis!,
Timll'." Septernber 1993. EPAl823-R-93-003; p. 2-27 to 2-30.
Jacobson JL Jacobson SW. lnlellcclual irnpairment in children e.xposed
poJychlorinalcd biphenyl in utero. N Engi J Med 1996 Sepl
12;335(11):783-789.

Rosenman KD. C/JI'Il}i"t! C()11l1lmiruui()n EpiJodes in E1JviromnC1lttr! tJml

OXl/pa/io1JtllMtttirinl!-2"d rdition (editor: W Rom). Boston. MA: Linie
Brown and Co., 1992 p. 935-940.
i<8

S9 Swain \'q.R. EfieCIS of org;mochlorine chemic.ls on the reproductive

olltcome of humans who cOllSumed conlaminared Greal L'lkes l1sh: an
epiJerniologic considerarion. J Toxico/EllIfiron Hen/tiI 1991 Aug:33(4):587639.
90 Freudenheim JL lliar hali JR, CI al. Exposure ro breasr milk ln lnL1ncy
and rhe risk of breasl cancer. Epidemiology 1994 May;S(3):324-331.

~l Jacobson MF, Lefferts

LY, G~rland A\Yf. Fish .. nd shellfish. In: Strfi'food:

Efi/ing llJisd)' il/ a risky //Jor/d. Ven-ice. California: Living Planer Press, 1991

p.118-130
~l The Food Processor for Windows: Nutrilion Analvsis & Firness Soft-

ware [computer program]. ESHA Researeh. Salem,Oregon.

MeSI I-l), Beia J cr al. The influence of lin eed oiI diel on falry acid
panern in phospholipids and mrombox:lJlc formation in plalclers n mall.
X/in V70rlmuc/'r 1983 Feb 15;61(4):187-191.

Cunnane SC. Chen Z-Y. el al. Alpha-linolenic acid i1l humans: direcI
f1ulcrion colc or dictary precursor? Nutrition 1991 Nov-Dec:7(G):437-439.

94

de Lorgeril M, Renaud S, ee al. Mediterranea.n alpha-lino1enic acid-rich

diet in secondar}' prevcnrio!l of coronary bearr disease. umcer 1994 Jun
11;343(8911): 1454-1459.

95

LJ, Boyce G. Zuricr RI3. TrealmelH of rhcumaroiJ arthril-is

\Virh gamrnali!lolcnic acid. Ann Intern Med 1993 Nov 1; 119(9):867-873.

% Levemhal

7 19bedioh 50. Effecls ofagricultura.1 pt'Slicide.s on humans, animals. and

higher pbnrs in devcloping collntries. Arc/' Environ Hcalt!J 1991 JulAug;46(4):218-224.

Block G, Panerson R, Subar A. Fruit vegclablcs, and cancer prevenlion: a review of the epidemiological evidence. NulT CrlTlcer J992; 18(1): 129.
98

99
100

11

Gene~is 5:1-22, 11:10-32.

Tbe Holy Bibk. AUlhorized King James

version.

16

10

Gencsi 1:29. Tht Holy Eib!". Authoriud King ):uncs "<:rsion.

101

Genesis 9:3. 17Je Ho~y Eib!r. Authorized KingJamcs version.

102

3 Jolul 1:2.

Tiu Hol;' Siblt. Authori7.Cd King James version.

Mail1e issucs mcrcury warning reponcd Junc 29. 1994.

127

PROOF POSITIVE

128

CHAPTER SIX _ _

ONE
NATION UNDER
~SSU

(
I

aU seemed 50 hard (O believe. Jolul

had been [he picture of healrh. Now,
a( 62 years old, he had gone from eEO
of a Fortune 500 compa.ny to a nursing home residem. It had been six months
since hjs devastatng suoke and rhe docrors
heJd linIe hope of any significam recovery.
Whar John had anen referred ro as "just a
lirde high blood pressure" now took on new
significance. Hs physicians said [hat rhe
srroke was undoubtedly due ro his poorly
cOlllrolled blood pressure.
Although John did not die from the ravages of high blood pressure, his situation
iUustra(es why the condi(ion is oft:en referred
(O as "(he silent kiIler."
High blood pressure (a1so called hypertension in rhe medical lileratlJre) often does irs damage wi(hout warning. Indeed, the disease has lifelong and life-shorrening implicuions. In
lhis chapter we wiIl explain whar high blood
pressure is, what causes ir, whar damage jt
does, and how Il can be colltrolled without
medication.

Measurement ofBiood Pressure

Each time the heart beats, i[ sends a
blood pressure pulse down [he arm. The
force of this pulse generates rhe sysrolic
blood pressurc. The systolic measuremenr
s the "top llumber" of the blood pressure

reading. After each heart beat, rJle hearr

rests for a fraction of a second. The pressure in the blood vessel during rrus resring
phase drops, and is called the "diastolic pressure." It is measured by the "bonom number" of the blood pressure reading.
Blood pressure is relatively simple ro
determine. You can measure it yourselfwith
a device called a sphygmomanome{er
("sphyg" for short, pronounced "sfig"). The
sphyg is made up of a heavy dury baJloon
ar aiI' chamber thar lies inside a band ofdo{h
called the "cuff." The cuff is wrapped
amund the upper arm and the baHoon is
filled wirh air. The increasing pressure in
(he balloon eompresses the artery un tii
blood flow to rhe lower arm is eompletely
shur off You then graduaJly decrease the
cuff pressure. During rhis time you are listening over {he anery with a stcrhoscope
and warching a scale that records (he
amOUJlt of pressure in the balloon. As you
decrease {he cuffpressure ro the sysrolic pressure level, you will begin ro hear the pulsil1g sound of tlle heart beac. This indicates
the rerum ofblood flow in {he artery. The
number an (he measurement gauge at that
installt is recorded as the sysrolic blood pressure. As you continue ro slowly reduce the
pressure in {he cufT, {he plllsing sound conullues ulltil it suddenly cannor be heard.

129

PROOF POS1TrvE

How High is High?

Blood pressure is measured in millimeters (mm) of mercury. This dares back ro

..;.~.;;;;,;;;;..;;;;;;...;,;;;;;....;.,;;..---------------

High blood pressure

(greater risk
of disease)

above 140 or abovc 90

90

-----

Blood pressure
that iocreases the
risk of disease
Optimal blood
pressure

130 to 139 or 8S lo 89
(high-normal)
130

8S

120

80

120 to 129 or 80 to 84
(normal)

below 120 and below 80

Numbers opply 10 /IIJulrs who are noI laking Jmgs 10 Jower Illeir
blood pressure.
.lIyour sysloJic and Jias(o/ic pressures loJI inlo differenl calcgories
_J'!}.l!..r ~i1k depends on Ihe higher calegory.

Figure 1

The pressure at which chese soullds disappear is recorded as rhe diasrolic pressure.

Some Causes OfHigh Blood Pressure

Arteries are muscular organs [har can
borh contracr aud expand. Excessive contraerion or sti ffen ing ofthe artery walls raises
blood pressure. Hormones can also raise
blood pressure. Some organs such as rhe
kidneys and adrenal glands are espeially
important ro ilie hormonal regulation ofour
pressure. However, the major cause ofhigh
blood prcssure is a lcss rhan optimallifesryle.
Most people have some rendency ro high
blood prcssurc; wherher chey develop the
problem anei how soon rhey do, is large!)' a
function of rheir everyday decisions.
Ofcourse, there are rJ10se unusual people
who seem to be generically immllne ta bypercension. You may know of someone who
does everyrhing wrong-but stiH has a normal blood pressure reading. Even if rhac
person is a close relarive, do not assume mat
you can bear [he odds. There appears ro be
many genetic factors thac have eidler a direct OI' indirect bearing on blood presslIre.
lr is unlikely tlur your generic makeup is
idenrical ro any relative in aII of those respects.

130

me days when aII sphygmomanometcrs

used a column of mercur}' to record rhe
pressure. The medical world eoday divides
blood pressure readings imo faur levels of
. k as s hown In
. p''Jgure I .'1 1
ns
Norice dur rhe safest blood pressure
range i characterized by an average sysrolic
pressme of 120 mm of mercury ar lower,
and an average diasrolic presSllre of80 mrn
ar lower, ac rest. Every person should srrve
ro get his ar her resri ng blood pressure inro
chis "120/80 mm or less" range. Highrr
pressu re , carry increased risks of disease and
premature deach. J However, rhe most carefuJ research suggests ehat lowering ehe diastolic blood pressure below 80 furrJ1er lowers one's risk of heart arrack ,mei seroke. In
fact, there is Ha ehreshold ar which fllfther
lowering of diastolic blood pres ure (DBP)
does not give further lowering of risk ofborh
he:lrt disease and stroke. 4 For example, a
DEP of 70 is benel" rhan 80. A diastolic
reading of 60 is bener stiH.
Control of blood pressure begin with
knowing whar your blood pressure is. Do
not aSSllme dut just because you feei fine
you are free of a blood pressure peoblem.
I-ligh blood pressure is indeed G11lcd "rhe
silent killer." It has this name because serious disabiliry or dearh is ofte.n rhe ver)' fim
sympCOm of hypertension. Many people
wiJl never reaJize rhat their blood pre,~sure
is high unless [hey ger it checked bya docror, go ro il screcning program, ar get a blood
pressure instrument and check il rhell1selves.
In faer, it is common for people ro feeI tine
with blood pressures of 200/ 100 or e.vcn
higher. Indeed, you may feel grear \vhile
being uuwiningly on [he verge of a disasrer
such as a sudden scroke or heart arrack, or
gradual kidney damage wich resulring renal
failure down the road.

Prevalence ofHigh Btood Pressure

As man" as 50 mllion Americans h;wc
eJevared bl~od pressure. 5 This is ddined in
Figure 1 as a systolic blood pressure of 140
mrn or more and/or a dia8rolic prcssure of
90 mm or more. Despice improvemenrs in

ONE NATION UNDER PRESSURE

awareness and treatmenr, as maoy as 35
percent ofAmericans wirh dcvared pressures
still are nor even a\v;u'e r.har r.hey have a probIem. 6 Even among rhose rhar knO\'". rhey
have a blood pressure problem and are an
medication, onll' about half of them reaUy
appear tO have rheir pressure undeI' conrroI.7
Even iJl'ou recendy had yom blood presstire checked and do nOt have high blood
pressure now, do nor assllme dur yOll never
wil!. As il person ages, blood pressure tcnds
ro rise. In [he U.S. the average person's systalie pressure rises by 15 poinrs between me
ages of 25 and 55. About 60 percenr of
Amerjcans aged 65 ro 74 have high blood
pre sure. 8

Dangers OfHigh Blood Pressure

c
Stroke

Aneurysm

Congestive heart
faHu.re

Kidney disease
Disease of the retina

Hcart attack
""""';.Jf,K\W

Atherosclerosis
("hardening of
the arteries")

Blood vessel rupture

Weakened memory
and mental ability

What damage can high blood pressure

Figure 2

do ro your body? There are many diseases

assoejated with bigh blood pressure. The
major ones are shown in Figure 2. 9 10
Stroke, the fi est maladl', is caused bl'
hypcrrension through at least rwo differenr
lllecharlisms. Firsr., bigh blood pressure predisposes individuals ro arherosc1erosis (often ca/Ied "hardening of the atteries"). In
,his process, large and medium sized arteries u1roughout me body become narrowed
bya buildup of f~my materia!. Arherosclerosis commonly strikes the vessels in [he
head and ncck that carry blood tO the brain.
Evidence testifies mar high blood pressure
Gln darnage the cdls rhar line these blood
vessels. This damage appears ro be one of
[he ways rhat me process of atherosderosis
is initiated or perperuJred. \ I
The bodl' does nor sir idly by as its vessels accumulatc far. It responds by covering the fatr.y deposits wirh a rough fibrous
cap. This is an important response. Iffatry
material comes inw direct contact with
blood it can stimulate rhe blood tO dot. The
/lbrous cap helps ro ensure thar such an
cvent will not OCCUf. It is acruaJly tlus du;u
process whjch gives atherosclerosis it.s name.
"Amero" refers ta the "mush}/' or "gruellke" fatr.y material and "sclerosis," meaning "hard," designates the bod)"s fihrous
walling off of this materia!.
Unfortunarell', areas of <lrhcrosclcrosis,
called plaques, can uleerate. When t.his hap-

pens, the fibrous cap is lost OI' damaged. A

combination of flbrous aod farty material
is relcascd into the blood seream. A now
smaJler, eroded fauy deposit is left on the
ancry wall; this is called an ulcerated plaque.
If a plaque in a blood vessel sllpplying the
brain breah down in this way, the resuII
can be a "mini srroke" or TIA (rransiem ischemc attack). These episodes are very
similar ro srrokes, but chel' resolve completdy. Full recovery occurs withill nunutes to hours.
Worse l'et, however, ulcerated plaqlles
Gtn activate platdets, (he c10rting cells of
thc body. This often sers in motion a chain
of evclHs thar can complctely obsrruct an)'
aftcry that is alrcady narrowed by arhcrosclerosis. If complde obstruction occurs in
all artety supplying blood to paft of the
brain, rhe brain risslle [har \Vas dependent
on dur anery will die. This deam of brain
tissue is caJled a stroke.
A second \vay that high blood pressure
causes sHokes is by causng more severe
damage ta brain blood vessels. In this scenaria, cumularive damage ro the artery is
so severe that [he vessel ruprures and bleeds.
These so-called hcmorrhagic srrokes :lfe
particularll' dangerous. The bleeding ofren
continues for sOlIle rime. Since the brain is
encased in a rigid shcll c-aJlcd Ihc skull, iI
has no place ta go when an acculllularon

131

PROOF POSITIVE
of blood comperes wirh it for roOO1. Thc
more blood rhar accumulares. rhe more [!le
pressure rises inside rhe brain. If rhe bleeding does nor stop, pan of r!le brain can actuaUy be pushed down duough rhe small
opening for the spinal cord. Thisis calJed
"herniarion of rhe brain" and generally
causes elead, rapidJy.

J\C
5

Relative
Risk

o
110-119
Optimal

120-129

130-139

140 or more

Norm31

lIij:IJ-Normal

Hjgh

SystoLic Blood Pressure

Figure 3

6-22 times

greatcr

10
Risk 8
of
kidlley 6

failure

4
2

120/80

130/85to

140/90

140/90 to
159/99

Blood p"ressure
Figure 4

132

ovcr 159/99

Hozo Much Stroke Risk Does High

Blood Pressure Cause?
Studies have shown rhar the risk of developing arherosclerosis (mainly ischemie
hean elisease anei cerebrovascuJar elisease) is
five rimes grearer for rhose whose blood
presslIre is 160/95 than rhose wirh normal
blood pressure. Il Blood pressure's effecr in
increasing rhe rsk ofhean ;}rtack and stroke
is illllsrra red in Fi gll re 3. 13
As we have alread)' nored, rsk begins ro
rise ar rhe 120 ro 129 level even though rhis
range s frequendy called "normal." Risk
rises even more Sh<Hply ar highcr pressure
levels. StilI ro minimize l'isk, blood pressure should be below 120 systOlic. In orher
words, do not be satisf1ed when someone
tells you dUH yOLlr blood pressure is ('normaL' Make sure thar il is below rhar 120
Ievel. This suicter guideune means mall)'
Americans musr get more serious aboLIt their
Iifestyle. Nearly haJf of aur male popularion
has a sysrolic pressure of 130 or greater. 14

Kidney Failure Caused by High Blood

Pressure
Kidney f'lilure is anorher disease callsed
by high blood pressure, and rhe higher the
pressure rhe grearcr rhe risk. In facr, in rhe
Unired Stares hgh blood pressure is the second leading c<luse of kidney failure. (The
first is diaberes). Kidney failure and its relarionship ro high blood pressure were smdied in mOfe ulan 300,000 men over a 16
year pel'iod. 1S The resulrs are shown in Figure 4.
The srudy also showed dIar. a ver}' mild
increase iIl blood pressure ro 127 systolic
increased rhe risk of kidney failul'e larer in
Iife by 50 percenr. How does high blood
pressure harm the kidneys? It acrually deStroys nephrons, dlOse riny microscopic fii
rcring cells rhar make rhe kidney function.
By gl'adually desrroying one nephron afrer
anorhel', r!te kidney's abiliry 10 c1ea.nse rhe
blood becomes progressively compromised.
\Y./e lIse tlle rerm kidney (01' renaJ) fuilure
when this purif'lcarion funcdon becomes sa
impaired that roxin levels build lip in rhe
body. With early kidl1ey failure there ma)'

ONE NATION UNDER PRESSURE

bc no symproms. As rhe disease progresses,
a pcrson reods [O dcvelop nausea and fatigue. Ultimare!y. when kidney funcrion
bccomcs markedly impai red, dearh occu rs-unlcss dramatic steps are raken. Such
steps mar include dialysis ar kidney trans
planr. Wrhour dialysis machi nes many
pcople would die soooer from rhe consequences ofrheir high blood pressure. However, even wirh diaJysis, many experience a
shon exrension oftife accompanied by a signiHc.'mr decrease in their quality oflife. For
this reason, some people have even chosen
10 die rarher rhan ro begin ar continue with
dialysis.

High Blood Pressure and Decreased

Mental Ability
Numerous scudies have documenred
rh;H high blood pressure rhar is nor con
rrolled by lifesryle frequently causes gradual
menral decline. One recenrly published
srudy showed rhar for every 10 mm of mercllry increase in systolic blood pressure ar
midlife, rhere was a 9 percent increased risk
of poor inrellectual ability 25 years later. 16

egor}'. This figure confirms rhar a desirable

sysrolic blood pressure is less rhan 120.
Since rhere are benettts ro having sy.srolic blood pressures of 120 or lower, why
do physicians rend ro avoid prescribing
meclicarions thar help parienrs drop rheir
blood pressures from, sa)', 138 systoLic ta
118 sysrolic? The reason js rhar ali high
blood pressure drugs have side efficts. When
prcssurcs are only mildly e1evtcd above rhe
ideal; the risk of rak.ing a drug is generaJly
greater than the benefit of funher lowering
rhe blood pressure.
;-\1so, when deal1ng wirh rhe lower enel
of rhe spectrum ofclear cut high blood pressure, rhere is nO consensuS on rhe benefirs
of long r.erm drug rrearmen[" One recent
srudy dealr with "mild hypertensives," rhose
wir.h sysroLic blood pressures in the 140 ro
1S9 range ami diastOlic~ in the 90 ro 99
range. Tbe researchers observed: "concerns
have been raiseel regarding rhe appropriareness of long term drug rberapy for mild
hyperrensives and rhere is interesr in ilie
possibiliry of trearing rhese parienrs wirh
nonpharmaco'logic therapy .... "18 Thus,
rhere are growing misconceprions-even in

Quality OfLift Reduced by High

Blood Pressure
The roll that high blood pressure ralees
an rhe kidneys reminds us rhar high blood
pressure does more than lull. Ir robs uS of
qualiry of life. "Morbidiry level" is a measure of rhe illnesses thar cause suffering and
decracr frorn life's qualiry. A study relaring
morbidity level ro blood pressure is shown
in Figure 5. 17
This figure demonsrraecs how rapidly
m.orbidiry increases once a person's blood
pressure creeps over duc 120 level. It ma)'
nor be surprising ro sec rhar rhose wirh a
ystolic blood pressure greare r rhan 160 have
tour ril1le~~ the risk ofmorbidry as rhose wirh
a systolic blood pressure of Icss rhan 120.
The risk doubles evcn when you move frorn
less than 120 inco rhe 120 ro 139 range.
When one exceeds 140 sysrolic, rhe risk of
morbidiry is even greater. Over the 160
level, rhe risk dramarically rises and srays
abolit the same in rhe grearer rhan 180 car-

Morbidity
ratio

100

120

120-139 140-159 160-179

180+

Systolie blood pressure

Figure 5
the medic~11 communiry-abollt rhe wisdom of lIsing drug rherapy ro trear "nlild"
high blood pressure. More are looking ro
rhe non-drug or lifesryle approaches.

1.33

PROOF POSITIVE
Funher cOll1plicaeing dle picture are ehe
subrle side effeets of high blood pressure
drugs on qualir)' oflife. 111 one study, phyicians and patienes cOllsistenrly felt d1<lt
qllality of life had improved or scayed the
same while on high blood pressure drllgs.
However, the c10sest l'e1atives of the medication-ereatecl patienes had a differel)( perspective: 99 percel)( of ehem were aware of
imponant changes in eheir loved ones. Specifically ehey reponed such pl'oblems as
memory loss (33 percenr) irrjtabilir)' (45
percent), depression (46 percene), and dccreased sexual interest (64 percellt). 19

E./fie! ofLowering Blood Pressure on

Cardiovascular Disease
There is direct evidence dlat jf you reduce blood pressure, you decrease ehe risk
of cardiovasClllar disease. This is illustrated
in Figure 6. 20

RE UCED BLOOD
VREREDUCED CARDIOVASCULA DISEASE
For the general population, a 3mm decrease
in systolic blond pressure would yield:
11 percent fewer strokes
7 percent fewer coronary events
5 percent fewer deaths

Figure 6

134

We see ehat a relativd)' small reduction

in blood pressure has a significanr impact
on disease of the hean imei blood vessels. Jr
is as[Ounding [O consider the implications
if aU Americans with high blood pressure
wOlUel lower rheir blood pressures by juSt 3
mm. Ae least 27,500 lves would be saved
each year, noe ro mcmion ehe Olany more

people whose lives would noe be markedJy

worseneel as a resule of living through a
srroke Of hean auack. These facts, combined with rhe ocher inforrnation (har \Ve
have examined 50 far, sbollld motivate us
ro do everything we can in OUl' own lives ta
prevent ar cOITece high blood pressure.

How Can
Pressure?

we Lower Dur Blood

aur approach ro blood pressure control

depends on the rype of hypertension chae a
perSOll has. There are ('\\'O main rypes of
high blood pressure:
Secondary hypertension is callsed by
orher diseases. There are many examples of
dlis. For insrance diseased adrenal glands,
the small hormolle-producing gJands 10cated JUSt above che kidneys, can produce
excess hormones cilat c<luse high blood pressure. Overproelucrion of hormones by e!le
gland in the neck, caIJed the thyroid, can
cause high blood pressure.
We have al ready Jearned that high blood
preS5ure can damage rhe kidneys. an che
ocher hand, kidnc)' disease (from problems
other ehan hyperrension) can actuaJll' cause
high blood pressure in and of itself There
are sr.ill omer callses ofsecondat)' high blood
pressure. For rhest reasons, 311yone who has
high blood pressure should be checked bya
physician; ie may nor be rhe "garden variery" high blood pressure chat grandma had,
bur secondaty hypertension.
For chose wirh secondary hypertension,
treaement is lIsually srraighrforward. We
search for rhe lInelerlying disease that is cauS'ing ehe high blood pressure aod then treat
thac disease. ClIring the d.isease solves the
blooel presslll'C problem. Unfortunate1y, ereatroent is nor thar easl' for mosr hl'perrensives.
Ninery percenr ofchose with high blood pressure have primary hypertension. 21
Whar can we offer in eerms of rreaeJ1}ent
when their condition is (aused by a lessrhan-desirable lifesryle along wirh an in.herited sllscepeibiliry? Whae sreps shouJd thel'
r.ake ro bring (heir blood pressure down ro
normal? A common allswer would be eo
rake medicarion prescribed bya doctor. Noe
l11al1)' years ago, rJlis seemed to be che only

ONE

ATION UNDER PRESSURE

answer. We now know that this is usuallv

not the best answer. There are several re;sons for thk
1. Every drug has muJdple potential side
effects-including cffecrs an quaJiry
oflife thar ofeen go unnoriced by rhe
medicaeion user. 22
2. High blood pressurc, cven if controlled by medicine (and nor
Jifesryle), causes a slow deecrioration
of brain maner whidl wealeells rhe
parienr's ability and inrelligence. 23
Unconrrolled high blood pressure
causes rhe same problem.
3. Less than halfof rhose who take drugs
lower rheir presSUre below 140/90. 24
4. The cost of drugs.
5. Lowering blood pressure with medication is not equivalent to lowering
blood pressure natllrally.
People takjng antihypereensive drugs
have higher rates ofhean disease than people
who have identicaJ blood pressures wiehour
drugs. 25
It is obvious rhar rhe preferred method
of conuolling blood pressure is ro adopt
lifesryle changes ro bring ehe blood pressure
down in a natural way. Since lifesryle caused
rhe high blood pressure in the fim place,
why nor lower it with lifesryle changes? Is
it possible ro reduce blood pressure with
lifesryle changes? The good news is thar
medical srudies demonstrate that rhis approach does indeed work. Moreover, 1 have
scen ie rourinely work in my practice.
A logical quesrion is, "How much of a
reduction in blood pressure can 1expect ifI
am willing ro make lifesryle changes?" Thc
answer depends on how much change you
are willing (Q embrace. Approximatdy 80
percem of hypenensives wiU be able ro reduce meiI blood pressure co a sah levdwithollt medjcation-if chey accept ali the
changes oudined in this chapccr. The remain ing 20 percen t will also be able to lower
their pressure to a safe level by combining
rhose lifcscyle changes with some am,ount
of drug cherapy. What \cind of challges in
lifCSlyle will result in lowering blood pressure? We will cire rhree srudies ta answer
lhis important question.

Specific Lifestyle Changes for Lowering Blood Pressure

The Nationallnscituce of Heahh sponsored a swdy thar demonsrrared rhe power
oflifesryle changes co lower blood pressure.
Over 900 subjects (men and womeu, black
and whice) wich mild hypertension were
enrolled in a Iifesryle change program. SpecificalJy, program parricipams initially had
diasrolic blood pressures in the 85-99 range
(average 90.5). Sysrolic blood pressures averaged 140.4. 26 Some of (he subjecrs were
pur on a lifesryle change regimen, while rhe
remaitting ones were ueared wim a single
blood pressure medicarion. The reductions
in blood pressure for (he group rreaced wirh
lifesryle challge alone are shown in Figure 7.
As impressive as rhis daca is, lifescyle
changes of a greacer magniwde than thase
in rhis srudy can yield even more impressive reduccions in pressur ".We will explore
thar evidence later.
Anorher stlJdy derermined rhe efreC[ of
just twO lifestyle factors on blood pressure. 17
le involved over 30,000 men, ages 40 to 75,
who were categorized as (O rhe amounr of
fiber they are and rheir degree of obesiry.
The tesulrs shown in Figure 8 illustrare ehat
obesiry was rhe largest sillgle factor affeering

LIFESTYLE eBA GES CAN

~AI'UCE BLOOD PRESSURE
Four simultaneous lifestyle changes reduced
blood pressure:

Weight loss
Low salt diet
Alcohol reduction
Increased pbysicall activity
Afler one year:
Average reductian in systolic pressure = 10.6 mm.
Average reduction in diastolic pressurc = 8.1 mm.
Figure 7

135

PROOF POSITIVE
bleod pressure.
Obesiry appears ro be one of the most
importanr high blood pressure facrors in
America. ln rlle famolls Frarningh,un smc!y,
fuUy 70 percent ofhyperrension in /nen and
61 percent in women was direerly anribured to inereased body fa(,28
A thirel study involved 73 men anei
women with high blood pressure who atteoded a rhree week live-in program ar
Weimar Institute in California. Their aver-

CU BLOOD PRESSURE RISK

AFFECTED BY BIE A
OBESITY
Thin men eating
ltigh liber
Men eatulg
low fiber

Obese men

Rjsk of high blood pressure

Figure 8

LARGE BLOOD PRESSURE REDucno S

WITH LIFESTYLE CHANGES
Lifestyle challges:
Abstinence from alcohol,
tobacco, coffee
Total vegetarian diet
Aerobic exercise
Length oftest -- 3 weeks
Average blood rpressure a,t the start
150/81
129/78
Average blood Ipressure at the end
Percent off of blood pressure medicine
= 80%
after three weeks
Figure 9

136

age age was 65. They adopred a series of

lifest)'le changes during dtis supervised program anei reapeel large redllCtions in blood
pressure. The resu1rs are shown in Figllre 9. 2 '1
These blood pressure redlletions arc
greater rhan tlle reducrions in the fim study'
rhe reason is thar more lifesryle facwrs were
changed. Over 90 percent of the partieipants were on ar leasr one medication 10
control their blood pressure when they enrolled in rhe program. Thar figure dropped
to 20 pereenr afrer rhree weeks; even rhose
remaining on medjcine were able ro significantly reduce rheir dosage.
The averagc efrecr oflifesryle changes in
this study is grearer rh3n indicared in Figure 9. Two sers of changes were nude sil1111ltaneously: ehanges in lifesryle al\d reducrions in blood pressure medjcine. However. redllcing the medicine would oormally
produce an average increase in blood pressure, bur the eXl1.ct opposite occurred. Why?
Because rhe lifestyle changes had such a
powerful effecr rhat rhey more than offser
rhe blood pre Sllre increase rhar would be
callsed by r.he reducrion in medici ne.
Anorher inreresring resulr is tlur over
half of rhe cimp in blood pressure occurred
in tlle fim week. Blood pressure levels rcspond quicldy ro I ifesryle changes.
The above studies ,ue in harmony wirh
maoy orhers. Collecrively they firmly demonstrate rhat lifestyle change is a porenr defense againsr high blood pressure bringing
quick and positive reslllts. Fatalisrs [ah
nore: rhe my[h thar yaur genes enrirely dicrare yOllr blood pressure level has bem com
plerely discredjred.
So far, we have seen rhe efrecrs ofseveral
lifesrylc facror in combinarion. Are rhere
an)' swdies thar show rhe effect of a single
lifesryle factor on blood pressure? The an
swer is yes. The rcmainder of the chaprer
looks ar research on individual lifestyle factors.

Dietary Factors That Reduce Blood

Pressure
The firsr lifesryle f:1CtOf \Ve wilJ fOCllS on
is diet. Whar 1 advocare is called dietary
rherapy, a self-irnposed rrearmenr. Dierary

ONE NATION UNDER PRESSURE

rherapy obvously involves what you put
inra yOllT body in rhe form of food. There
are mally foods in the average dier rhar affecr blood p ressu re. Some are helpful and
some ~ue harmful. If you want (O lower your
blood pre.ssure, you will need ro know which
foods (O cat more of and which ones ro
avoid.
Oiet, however, is not reaJJy a single facror. \'{fe ear many differenr foods, each of
which are made up of combinations of nurririona[ componenrs. We willlook ar each
of severaJ eomponents rhat affecr blood presSUIe.

S,tlt-A Major Culprit

Sah is rhc first componem of r!le diet
rhar we wanr ro explore. because [here is
Illuch evidence rhat it significanrly raises
blood pressLlre. Thc relarionship berween
salt in rhe diet and blood pressure is lisred
in Figure 10. 30
Ir is no exaggerarion ro say rhar salr is a
major culprir in causing high blood presSUTe. For hyperrensivc patients, r!le greater
rhc reducrion in dietary salr, rhe greater the
rcduction in blood prcssure. One hasic
caLlse of hyperrension appears ro be an inability of the kidney [O eliminare an increased sah load. To excrete rhis excess salt,
rhe body makes adjusrments rhat boost the
blood pressure, which then enables (he kidne}' ro eliminare rhe salr. J1
Salt consisrs of twO elemenrs-sodium
and cWoride; it is 40 percent sodium. It is
founei in a majoriry of foods in the supermarker, and the amount per serving is lisred
(as sodium) on the concainer or package by
law. Surprisingly, research suggest$ thac c
is actuall)' the comhinarion of sodium with
chloride thar does the damage. 32 In animaJ
srudies on high blood pressure, neither excess sodium alone nor excess chloride alone
causes high blooel pressure. 33 However, rhe
labei ing of sodium cOlltenr usually provides
rhe necessary informacion: sodium and chloride rypically are found in rougWy equal
JlTlounrs in foods. Thus by [imiring rhe
sodium intake, we generaJly limit (he chloride inrake as well.
A srudy involved 20 high blood pressure paliencs who were taking no medica-

SALT RAISES BLOOD PRESSURE

1. Societies that ingest Httle or
hypertension.

00

salt have

00

2. When diets very low in salt, such as the rice

aud ,frut diet, are given to hypertensive patients,
blood pressure often Calls toward normal.
3. Chaoging to a cliet that is on'ly maderatdy
low in salt produces only smal)
reductions in blood pressure.
4. Salt-induced hypertension bas been Iproduced in
both mao and experimental aoimals.
Figure 10

tion, bur reduced their previollsly high sodiurn intake ro less rhan 3000 mg a day.34
The resulring reducton in average blood
pressure is ourlined in Figure 11.
This i, a dl'amatic demonstration of the
effect ofchanging juSt one item in tlle elietsalt. The average reducrion was 19 mm systoljc pressure and 14 mm dia rolie aftcr one
yeaT. We wOllld expect furrher blood presstire reducrion if rhe salt imake was further
reduced.
I have tre:ued many people in my practice

1. 20 patients with average blood pressures of

161/101 rom reduced their salt inta1kc for
one year.

2. After one year, tbeir average systolic pressure

was lowered by 19 points and diastolic was
lowered by 14 points.
3. Blood pressure of 16 of the 20
patients was well controlled by
simply restricting their salt intake.
Figure 11

137

PROOF POSITIVE

WHICH FOODS ARE

HIGHER IN SODIUM?
or

Corn flak!?s, 1 c.

Peaouh, 1/4 c.

or

Tomato soup, 1 can

Sauerkraul,l/1 c.

or

EggMcMuffin

CorD

chip~,

1 c.

or

Inst.anl mashed pOlatoes, 1 c.

Ham, cured, :) oz-

or

Rlce, Chinese stylc. I c.

Freuch Frles, 1 servo

or

Ice cream, soft serve,

Bou11loD, [Il c.

or

Oill pick1c, 1 large

or

Peas canned, III c.

POlato cbips,

Peas, froz!?n

1/2

!mall bag

c.

Bacon. 2 slices
8ultermilk, 1 c.

or

Oallish pastry, I piece

or

Cottage cheese, I c.

c.

Figure 12

SODIUM CONTENT COMPARISON

OF FOODS

mgsodium

mg sodium

Corn chip!, I c.

163

Corn flakes. 1 e-

217

Pellnuls,l/4 c.

155

Tomato soup, 1 can

932

420

Egg Mcmuffin

821

1611

Inslaut mashed polaloes. 1 c.

491

Sauerkuut,J/l

C.

Polato chips, 1 small bag

Ham, cured, 3 OZ.

10110

Rice, Chiuese style, I c.

2700
220

Frencb {ric!, I servo

123

Ice cream, sofl sen'e,l c.

Bouillon, J/2 c.

647

Dill pick1e, I large

833

70

Peas callned, lh c.

340

Pe.as, frozen

112 C.

Bacou, 2 slices

290

Danlsb pastry, 1 piece

371

ButtermiJk, I c.

257

Cottage cheese, 1 C.

850

Figure 13

SODIU

INTAKELI ITS

Average American diet

4000 mglday

Those witb normali blood

pressure

2400 mg/day

Tbose with high blood prcssure

2000 mg/day

Those with ihigh blood pressure

and congestive beart failure
or liver disease

1000 mg/day

Minimum necessary level

Figure 14

138

250 mg/day

Ulat say, "1 :l.In already on a low salc dier,"

and eher firmly believe it because rhey do
not add salr ar the meal rabIe. Since rhe salr
shaker sic5 unused on rhe rabie (01' is removed complerely), :lnd they do nor use a
huge amount in cooking, rhey are confident
rhac ehey are on a low salc dier.
Ar this poin.r, 1 ask my high blood pressure parients ro go duough a liale quiz rhar
you mighr like ro rake regarding rhe sah
comem of some COJlllllon foods. Do you
know whar foods are high in sodium con(em and what foods are low? The foods in
Figure 12 arc shown in pairs for compari50n. 35
1 ask rhe reader ro make choices before
reading fu rrher. Which has more sodium,
a cup of corn chips ar a cup of corn flakes?
How about 1/4 cup of peanurs ar a call of
comaro soup? Or a bag ofpoearo chips vcrsus a cup ofinstant mashed poratoes? When
you finish scanning rhe list, look ac Figmc
13 which Iim rhe same foods along wirh
(he amoullts of sodium.
Notice (har rhe foods wirh the highesr
sodiuJn conccnr are on t!le righr. You may
be surprised ro see thar a cup of tomaro soup
colltains six rimes as much sodium as 1/4
cup of peanurs. Sauerkraur is nor considered ro be a low sodium food, bur Egg
McMuffin is rwice as high. Cured ham is a
high sodium food, but Chinese style rice
has almosc duee rimes as much. Frozen peas
have ver)' low sodium, but canned peas are
ftve times as high because sale is added in
(he processing.
The purpose of (his litr!c exercise is ro
encourage you ro rcad labels when you shop
for groceries. lf you (fuse ro guess work,
you wiLllikely often be wrong. We alI need
ro be aware thar rhere is a high amounr of
hidden sodium in cerrain foods.
What is (he maximum safe inrake of
sodium? le depends an your circumstance,
as shown in Figure 14Y;
Notice rhar (he average American consumes 4000 mg per day, which is 16 times
che minimum necessary levcl 01'250 mg. It
is colllOlonly believed rhat onIy rhose wha
have hypertension, hearr disease, or liver
disease shollld limi[ eheir sodium intake, but
rhar is nor rhe case. A recent srudy showed

ONE NATION UNDER PRESSURE

rhat rhe higher the sodium intake the higher
rhe risk ofhaving a hean arrack, whemer or
not rhe person had hypenensiol).37 The
lowering of sodium ro (he recommended
levels could reduce the monaliry rate of
srroke by 39 percenr and hearr arrack by 30
percenr accordiog ro a panel ofblood pressure expens recenrly convened by the Columbia School of Public Healrh in New
York.
In addirion, a low sodium dier reduces
rhe risk of som.e cancers, osteoporosis, and
kidney srones as listed in Figure 15.38
For example, earing more rhan 3 reaspoons (6.6 grams) of salt per day ar eating
pickJed vegetables more rhan rwice a monrh
significantly increases rhe risk of .'colllach
cancer. 39 .40 In addirion, a recent large inrernational study showed rhat if you have normal blood pressure you wiU reduce yOU( risk
of ever developing hyperrension if you are
already 00 a low sodium diet.~1
If your dier is such thar rhe daily incake
of sodium roeals up ro less than ehe ma.ximum safe amount, you may use some sale
rrom rhe shaker. How mucb an you use?
Actually very linIe. One reaspoon of sah
comajns roughly 2300 mg of sodium 42
(compared tO a limir of2400 mg for a persoo witb normal blood pressure). Therefore. even if ehesodium camel\( ofyour food
is lower man rhe maximum for your condition, you could use very linie additional salt
from tbe shaker in cooking or ac rhe eable
and stiH be sa fe.
Ir is obvious ehar these limits can bc
uHwittinglyexceeded. In our office we provide descripeions of diees coneaining Ofle
gram of sodium per da)' rhar can be easily
followed. They are inclllded for yom use
in Appendix V, entirled, "One Gram $0diurn Diet". Sodillm conrenr of some addirional foods is provided in Figure 16 3 as
addJtionaI help in controlling yom sodiulll
inrake.
Notice rhar soy sauce is bigh in sodium,
and dill pickJe are even higher. Pickles in
general are very high. Sauerkraur ha rhe
highesr amounr ofsodium on the charr. You
wil! find v<lriaeions according ro rhe brand,
but aII sauerkraur is high. On the other
hand, salad dressings are llsual1y low in so-

W~..,.

DUCE

Hypertension and its complications

Myocardial infarction
Complications of congestive heart failure,
cirrhosis of the liver, and kidney failure
Stomach and nasopharyngeal cancer
Osteoporosis
Kidney stones
Figure 15

dium when lISed sparingly. Hor dogs and

bologna are high, in the same range as dairy
produces. Canned SOllpS and canned spaghetti sauce rend ro be very high ,u1d shoulel
be lIseel sp:tringly if ar ali. Some soups may
be higher or lower than those seaeed. The
poinr is that labels should be read before
you buy. Approximate1y 80 percent of our
salt intake comes from proc ssed foods. 44

Food Item
So~'

Amount

Sauee
Diil PickJes
Olives, Mission
Catsup
Mustard
Thousaod Island Drcssing
French Dressiog
~
Italian Dres.sing
~
Blue Cbeese Dressing ....
Mayonnaise
Bologn.a
Bacon
Canned Ham
Hot Dogs
Corned Beef
Sausagc Link
Saucrkraut ~
Prctzels
Canned Soup:
Cream of Mushroom
Vegelarian Vegefable
Bouillon
Spaghetti Sauce
Cbeddar Cheese
Cottage Cheese
Buttermilk
Tomato Juicc

1 Tbs.
1 largI'

10 med.
I Tbs.
I tsp.
1 Tbs.
1 Tbs.
1 Tbs.
1 Tbs.
1 Tbs.
1 slice

2 sllce~
107..

I
107..

I
1 cup
10 tbin
I cup
I cup
1 cup

II: cup
loz.
1 cup
1 cup
607..

1039

838
782
992
198
SIS
319

364
Figure 16

139

PROOF POSITIVE
What abouc resrauram food? There is
much hidden sodium in food served byearing establishmems. Resrauranrs compcrc
wirh each orher, and because Americans
demand it, saIt-flavored food appears ro be
esscnrial w remaining comperirive. Some
resrauralHS, however, specialize in offering
oprional low salr meals ro arrracr healrh
minded cuswmers. Prepared foods, whecher
chey are found in rhe supermarker ar rhe
restauram, are often dangeroLlsly high in
sodillm. The only prorcccion we have is ro
read tlJe labels (ar ger specific nurricional
informa(ion, in d)e case of resr.allranrs) so
we can be aware of where hidden sodium
eXlSts.
Some people become discouraged ac chis
poinr and wonder if rhere are any eommon
faods rhar are very low in sodium. The answer is a resoundingyes. Figure 17, rhe final chan on sodium comene, lists food
grollps [har are extremely low in sodium. 45
The.se foods have 50 Linie sodium chat
you can eat as mueh of them as you like
wirhouc being concerned abour exceeding
che daily limir. Unsalced lllltS are safe [Q
eac; rhe added salt found in some processed
nUC5 makes rhem high in sodium. Thus,
we see rhar rhere are many foods ehar can
be freely earen wi(hout concern abOllt cheir
sodillm conrene. Fruits provide a dOllble
benefit in rhar rhey are a1so high in potas-

Food

Ave. Sodium Content

per Serving, mg

Fresb fruit

Grains & cereals

Nuts (unsalted)

Vegetables
Shredded wheat (loz.)
Figure 17

140

15

sium, which tends ta reduce blood pressure

even further. This is panially wh}' a natLlral
diet high in fruics. vegerables, .'Ind grains is
rhe answer ro the blood pressure problem.
Any food rhar is low in soelium can be
nude high, of eOllrse. b)' holding rhe sah
shaker over it. Any person wid) hjgh blood
pressure sholild keep cbe salt shaker where
it belongs-resring on ehe cable, or berrer
yer, hielelen .in rhe cupboard. Of eourse, if
rhe prepared foods in )'our elicr concain less
sodium rhan rhe chart previoLlsll' shown,
)'ou mal' add a linie sale aeeording (Q rhe
formula previously given. rn our house we
kee.p ehe sah shaker in tlle cupboarcl, reserved for guesrs, even mough no one in
OLlr famil)' has a blood pressure problem.
A eornrnon reaerion ro the idea of reducjng salt in rhe diee is, "1 eannor ear food
wirhollt [he Ievel of salr thar r am accustomed to. There wiU be no tasee ro [he [ood..
I am hooked on salc." YOtl m;ly be surprised.
as ro rhe ehanges ehar can occur in your [asre
buds wirh a Litrle efron and parienee.
My grandfather Ned1ey was told by his
ph)'sician ehar he shouJd reduce his sah incake because of hjgh blood pressure. He
was ;1 heavy salr shaker lIser, anei said rhat i(
was impossiblc for him ro CUt down. He
arglled rhar wirholll his cllscomary use of
salt his fooel haei no taste, and r.har he ma}'
as weU ear salt and dic, because life was nor
wonh )iving ifhe could not enjo)' his food.
AfLer he haei a slighr stroke, he immediarely
changed his stanee-he took (.!le sah OUt of
his elice. My gcandmother sropped cooking with salt, avoided prepareel fooels COl)taining salt, and removed rhe salt shaker
hom che table. Grandpa complained bicrerll' thar the taste of food had elisappeared.
with che salt. Afrer a few weeks, howcver,
his complaining faded away. One day
Granelma miseakenly pur a litrle sale in his
mashed pocacoes. He tOok one bite. pllshed
rhem away, and said, "1 can't ear it. AJI 1
call taste is alt." His salt addicrjon was
gone. The faod aelelitive rhat he OJ1ce was
addieted to he J10W loathed. Masr of Illy'
patiems that have undergone a similar experience with a cenajn food (Iaathing whar
was once enjoyed) start rhat ir mal' rake lip
ro faur months afrer {he decided dietary

ONE NAT10N U DER PRESSURE

change is strietly adhered ro before this advanrageous change in taste oecurs.
\'\Ihar about salr subsrjrures? The earll'
versions had an llnpleasam biuer, merallic
raste rhat few couJd toJerare. Cardia Sah is
one brand name rhat correcrs rhe flavor
problem. It conrains rorassllm, magnesium, and only half the sodium of regular
rabie salt. Prdiminary srudies of 40 men
and women sbow dur replacing regular
rabIe. salr wirh Cardia Salr lowered blood
pressure an average of 13 mm diastolic pressure and 8 mm sysrolic pressure in six
monrhs. Otber studies bave shown similar
resul ($. 46
Salt subsrrures bave rhree drawbacks.
The main one is rhar the)' onl)' conecr parr
of (he sodium problem-rbe amount of
sodium adeled wirh rhe sah shaker. Processed foods sucb as soups, dairy producrs,
and omers lisred in rhe preceding charts will
remain as bigh sources ofsodium in rhe dieL
Tbe second drawback s thar some people
with renal fajlure ar on cerrain blood pressure medicine (such as C~lporen and orher
ACE inhibirors) will dangerollsll' elevare
rheir serum porassillm by consumjng salr
subs(imtes and risk sudden cardiac deatb.
The thirel drawback is rhat they increase the
desire for the "real rhing," and the vicrory
(har ml' grandfarher obtained becomes duSlve.

Monosodium Glutamate Not a

Problem
What ahout anorher source of sodium.
monosodium gllltamaee~ This chemical has
been labeled as a hidelen subsrance ehar is
unclermining aur health. It is commonll'
found in food served in Chinese resraurams,
and is an addieive presene ill some foods thar
we buy in d1C supermarker. Ir has been
blamed for c.'l.llsing sweating anei mall)' orher
biLane symptoms in some people.
Be aware of an important and basic facr
regarding monosodilll1l glutamate
(MSG)-ir is not a substance that is foreign ro rhe bod)'- It is a comhination of
rwo narural subsrances: odillm anei
glutamic acid. Gluramic acid is one of 20
amino acids naturally presenr in the bod)',
and is necessary for normal body funcrions.

As a resulr of the many complaints

again t MSG, it has been the subjecr of
manl' srudies, with surprising results. The
srudies have ali been consisrent in proving
rhar MSG s nOt a problem. The resulrs of
one of rhe stlldies are shown in Figure 18. 47
lf there is a "Chjnese Restauram 5)'0drome," it does not appear to be re1ated ta
monosodium glllramate. le may be re1ated
ro some(hing else thac is in the food. Since
sodillm apan from chloride is not as harmfuI as sadium chloride wirh respeCt to blood
pressure, MSG would nor be expecred to
raise one's pressure. In fact, studies show
thar blood pressure is actually lowered somewhat by consuming MSG.48

71 subjects we,re randomly ~ed MSG or a pllacebo

in their food for five days.
Result -15 % of those consumblg
MSG had symptoms.
- 14% of those conslJmIng
a placebo haEI
symptoms.

Figure 18

What abollr se-a alr? Is ir Iess damaging

ehan "regular" salt? No, it has the same sodiurn and ehe Sal11e chloride. Sea sale will
tend ta misc your blood pressure jllsf as
much as regular sale. Granred, d1ere mal'
be some trace amounrs of addirional nutrienrs in sea salt thar could be helpful ro other
body fUllctons; noncrheless, it wiU do as
mllch dalllage tO your blood prcssure as
regular sale.

141

PROOF POSITlVE

Losing Weight
For individuals who are overweight, iniriaring a weight los5 program can ignificantly lower tlle blood pressure. The blood
pressure will usually dmp as much as a low
salt diet will dmp ir,49 The hyperecnsive
parienr does nor neeel ca rcach optjmuln
weight for a drop in blood pressure ro oecur. Jusr iniriating a weight 105s program
and shedding about 5 pounds will bring rhe
blood pressure down substaruiaJly in mose
ca es. In order for the cHeer to be mainrained, however, rhe individual needs to sra)'
011 ehe weighr loss program umil ideal
weight s achieved. A simple four-step plan
is prescribed for mosr of my overweight
pariell[s ro achieve rheir desired weiglu.
1.
o SIlacks. Drink onl)' warer bef\veen meals.
2. Ear a good breaki'lSf :lJld a moderate
lunch. Eliminate the evening mea!.
If somerhing "must" be eaten in the
cvening, whole fruir is ali rhat is allowable.
3. Eliminate OI' ar teast greatly reduce
refined sug;u and free fars or fatty
foods in the e1iee, wbile emphasizilw
foods high in fi bel'.
4. Dail)' moderate eJ<ercise for approximately 45 minures a da)'-

Foods Hig!? in Catcium are Beneficial

weight loss.

Foods wirh a high calcium conrent can

also significanrly lower blood pressure. Over
6000 men and women wilh high blood
pressure were dassifled as ro ther calcium
inrake. The resuh was rhar each gram of
calcium consumed per day seems ro lower
rhe risk ofhigh blood pressure by about 12
percent. Professor Jamcs Dwyer, who reporteei on rhe research ar rhe American
Hean Associaeion annual meering in November 1992, warns against raking Iarge
amounts of calcium supplemems, however.
"Inslead," he saiel, "people shou1d ger ca1cium rhrough rheir diers ... green leat}> vegerable.. are good sources of calcium."

CafJeine and Alcohol

Oatmeal Helps

Studies show [har caffeine affecrs blood

pressure. One cup of coffee per day (OI' rhe
equvalenr in cola drinks) may raise rhe diastolic and systolic blood pressure ftve to
six points. 50 It follows that e1iminating
caffeinared drinks has dle potential ro lower
blood pressure by rhe same amounr, Caffeine nor only rajses resring blood pressure,
bur if consumed before Of during exercise,
ir can raise blood pressure anei hearr rare
collsiderably above rhe levels achieved during exercise alone. 51 This could turn a
healthy activiry into an unhealrhy one by
increasing [he risk of il sign.ificam ardiovascular evenr during exercise.
Whar is the effecr of alcohol on blood

A common bremlsr food, oarmeal, has

been founel ta reduce blood pressure. In
one s[lldy, 850 people were caregorized for
the amounr of oatmeal they cOllsumed.
One-bowl-per-day users had lower blood
pressure and lower cholesterol..53 The effeer was independent of age, weighr, and
inrake of sodiurn, potassium, and alcohol.
The conc1usion is rhat people who are
trying ro control their blood pressure narurall)' may ger an unexpecred benefir hom
eaeing a bowl of oatmeal each day. Thus
oatmeal offers a double beneflr for our
hearrs. Most of us have known for some
rime rhar oaemeal helps ro lower blood cholesterol levels bccause ic is rich in warer-

Virtually aII of my patients thar srick

ta chis simple program achieve lasting

142

pressure? Many people are unaware rhat

alcohol raises blood pressure. Jusr an mmce
ar two per day is ali rhat is necessary ro cause
signiflcam hyperrension. 52 This is one of
the reasons why cven moderare users of alcohol have a signiflcanrly increased risk of
suoke. 1 have had some people come imo
my office, follow our low sodiU1l1 eliet, ger
on an exerci e program, anei do aH tlle right
rhings. They have come back and said,
"Dac, rny blood pressure is srillup." Ofren
when 1 raise rhe alcohol qucstion, they silently leave. However, if they are bold
enough ro rake my advice, cheiI' blood presslIfe is usuaJJy undeI' control when rhey rerurn. Eliminacing alcohol is a necessary pan
of reelucing blood pressure rhe narural \Vay.

ONE NATJON UNDER PRESSURE

soluble liber. The informacion an blood
pressure provides an addirional cndorsemcm
for rhis versatile grain.

Smoking Increases Blood Pressure

Smolcing is anorher lifesryle factor that
raises blood pressure. S4 After smokil1g just
one cigarerre, borh systolic and diasrolic
blood pressures can remain e1evated for as
long as 30 minure .55 In fact, blood pressure C4n rise by 10 rom of mercury. AIrhough a single cigarerre does not seem to
eause a iasrjng increase in blood pressure,
many smokers have enough eigarenes in e.he
day rhar [hey are conrinually raising r.heir
pressure. Dr. Norman Kaplan, oue of rhe
world's forem05t aurhorities on high blood
pressure, poims aur e.har a (ypieal pack-perday smoker is e1evaring his blood pressure
for most of [he day.5 6

Life's Stresses and Blood Pressure

Along wich dietary factors, life's stresses
ean raise blood pressureY' 58 Stress does not
seern ta afTecr rhe diascolic blood pressure
much, but tends ro act more on the sysc.olic
blood pressure, the rap number. Stress is a
broad subjecri in facr, 1 have devored an
en[ire chapeer ta ir. To rOllch on rhe subjecr here, I will poim out [hat rhe exrernal
pressures thac confram us (called srressors)
are very differem from aur imernal reacrions
(Q chose srressors. Wirh inadequare coping
mechanisms, stressors cake a toU on our
physical and mental well being. Boch aspecrs are addressed jn Chapcer 14, "$eress
Wi[houe. Disrress."

Exercise
Aerobic exercise--exercise rhar calls inro
play [he hearc and lungs- igniflcanr!y lowers blood pressure in hyperrensive pauenc.s.
In one srudy, eighreen sedenrary indjvidual, wirb high blood pressllre eompleted a
16 \Veek exercise progr,un. During che program, [hey rode an exercise bicycle rl1Tee
days a week for abolit 45 minures per day.
They exercised ar a moderare inrensicy (60
ro 80 percenc of their predicred maximum
hean race). N[er e.he four monrh program,
(he average sysrolic blood pressure fell 7 nun
;:1I1c1 che average diascolic pressure. 5 mm.

The exercise program also helped to prevent cheir blood pressure from rising as high
during exercise. Their average systolic blood
pressure when exerdsing was 19 mm lower
anei diasrolic 10 rnrn lower than before che
program. 59

Low Blood Pressure

Many people with low blood pressllre,
around 90/50, ask jf ir is tOO low. The answer is no, noc if the)' are feeling well. In
fact, che lower che blood pressure the less
rhe risk of the many diseases and complications mencioned ac the beginning of the
chapter, as long as che individual is feeling
weU. However, if the individual fee1s
"washeel OUt," lightheaded, or generalI)' ilI,
or if the blood pressllre drops signi.ficandy
when sranding up (normally r:he blood pressure is consranc. or rises slighdy lIpOO seanding), then the blood pressure ma) be toO low.
lf your blood pressure drops more man 10
points diasc.olically when you quickJy go
from a lying down posirion ro scanding lip,
you have significant postural hypotension.
This condition is srrongly associated wirh
tlle chronic facigue syndrome. Finding rhe
reason for rhe postural hypotension and
rreae.ing ic wiU ofcen help rlle chronie fatigue syndrome. 60

Su:mmary
In this chaprer an hyperrensiof), we have
looked ar a number of key f:las. Some of
che mose im.porc.anc poincs are lisred below:
1. High blood pressure is dangerous c.o
your healch; it is rhe cause of mally
debilitatillg and facal diseases.
2. An opcimal blood pressure will noe.
exceed 120/80 ac rest.
3. The majority of those with high
blood pressure can bring ie. under control by nacural means, rhar is, by
lifeseyle changes.
4. Making changes in lifesryle is che besc
and safesc approach c.o reducing blood
pressure, as opposed ro raking drugs.
lf you wane ro use lifeseyle ro lower your
blood pressure, you will wanr ro make che
foJlowing c.hanges:

143

PROO F POSITIVE
1. Ear plenry of fruits, vegetables, grains,
aod unsalted nllts il) moelerarion, anei
orher low sodium foods.
2. Avoid fooels such as dill pickJes, cured
ham, Chinese riee, bouillon, anei
orher high sodium foods. Read rhe
labei:;.
3. Avoid low fiber foods such as mear
aJ1d d:'liry produets.
4. Eliminare eoffee, eola drilJks> and alcohal from rhe diee.
5. Stop smoking.
6. Keep the sah shaker ar fese
7. Bring your weighr down ro the recommended level for your height and
build.
8. Aelopr an aerobic exercise ratiune,
such as brisk waJking.
9. Learn ro cope wirh srreS$.
Wirb rhe above changes in lifesryle, you
have a very good chance of reducing your
blood pre sure ro a normal level and keep-

ing ir rhere wrhour rhe need for medicanon.

Take rhe rime now ro make sure your
blood pressure s in rhe ideal range. Il' r is
nor, do nor pur off rhose simple lifesryle
changes. None of LIS like ta change aur
lifesryle at fmr, bur an)' one can develop
new enjoymclHs for new ways of living.
Be)'onel thar, [he lifesryle changes we have
eliscllssed are smalt compared ro rhe Ijfes[yle
change yOll may have ro make as a '[roke
ar hearr arrack vcrim. And rhe cliet dur a
kdney filure pariem is an is much more
difficuh ro adjust ro [han a pure vegeraria.n
djer. Jt also lacks rhe rich variety of the vegcrarian die[ ancl is much less sarisfYing.
Yes, you may be one of rhe ltlcky ones
who, [ike tn)' grandfather, received a "wake
up call" before it was coo late ro change.
But yotl may nor be sa fortunare. The nursing homes and cemeteries of our nation are
filled with many people who JUSt had "a litde
hgh blood pres .lIre. "

Refermces -

PA.: JP. Lippcou COlllpanr. 19n p. 2%-237.

Klag, M]. Whelton. PK, el al. Blood I'reswre and End- rage' Renal Disca e in tv1en. N E"gl} Md 19% Jan 4;334( 1): 13-18.

Lallner LJ, Masaki K, el al. The association berween midlifc blood

I'ressllrc levels and latc-life cognilive: funcrion. The HOllOlulu-Asia AgiJlg
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~ Tbe fifth repon of lhe JOm Narion:u Commiltce on Derenion, Evalualion. and Trealmenr of High Blood Pressure UNC V). Arc/' 11/1cI"'1 Metl
1993 Jan 25; 1')3(_): 154-183.

The fifth report of lhe Joilll arion,,1 Com'uirrcc on DClection, Ev"lualion. and Trc31mem of l-ligh 13I00d Prcssure UN V). Arci} !lItern j'-"etl
1993 ]an 25; 153(2): 154-183.

10

II Hancock WE. Coronary Arter)' Discase: Epidemiology And Prcve"rion. 1991. In 5ciwrijic J1mericf1ll Mcdilll' (eD ROM), 1995.

12 Isselbacher KJ, Braullwald E, edilOrs, el al. Atherosclerosis and Other

Form,S of Aneriosclewsi. In: Hnl"risolls Principl,] o/ll11tTTUll Medicille13'" rdirion (CD-ROM). New York, Y: McGRAW-HILL. Ine. Heahh
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M"cMahon S. Pero R. er al. BlooJ pressure. troke. 3nd COrOl\3ry heaT(

diSea5e. Parc 1. Prolonged difl"rcnces in blood pressure: prospe tive ob-ervational slUdic correcrcd for I.hC regres ion diJution bi:u. L/lnci't 19(JO
Mar 31 :335(8692):765- 774.

u arion,,1 l-ligh B100d P~essurc EduCllion Prog~am Working Group repon 011 pri.mr)' prcvenlion of hyperrension. Al"Cb Intem Mt'd 1993 Jan
25: 1')3(2): 186-208.

The fiflh rcpOM of the Joint National COml1li(ICC on Dereclion. Ev:uua(ion. aod Trealmenr of High Blood PrCSSUIC U C V). Ardl !l1ll'nJ Med
1993 Jan 25; 153(2): 154-183.

14 K:lplan
M. l-I)/pcrtemion in the Population at Lugc. In: Cliniml
H)'Pl:rtelIJiolJ-6'/' tdirioll. Balrlmore. MD: Williams .1nd Wilkins. 1994 p.
).22.

G The

lS

fifrl, report of rhe Joil1l National Commillee on Delccdon, Evalua(ion, and TrCalltlem of High Blaod Prcssure (1 C V). Arcb !mnn Mt'd
1993 Jan 25; 153(2): 154183.

The Jihb repon of tlle Joinr National ComJ)~ilree on Dcrecrion, Ev:tluation, and Treatmenr of l-ligh Blood Pressure (JNC V). A,.d; !fJ/cm Mcd
1993 Jan 25; 153(2): 154-183.

, Kapl:tn NM. Hypcrlcnsion in lhe Popuiarion al LaIge. In: ClinicfJ!

HYPI"'ll'lIJion-6'" I'tli/ion. Baltimorc. MD: Williams and Wilkin;, 1994 p.
J-22.
Weinbcrger MH. Syslemic hypcrtension. In: Kdle)' \Yl , DcVila VT
]r.. cdiwrs. el al. Textbook o/!mt'mnl Mtdine-Z'" ediliol1. Philadelphia.
?

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Klag, MJ. Whc!ron. PK, cr al. Blood Prcssure. and End-.tage Renal
Diseasc in Mcn. N EnglJ M{!d 1996 ]an 4;3340): 13-18.

It, Launer LJ. Masaki K. e' al. The assoc.iatioll berwcen midlifc blood
pressure levels and laIc-Iii" cognilive fi.lllc,ion. The Honolulll-Asia .Aging
Study. jAMJlI995 Dee 20;274(23):1846-1851.

McGee D. UJC Fmming/'nm 5t11dy: An Epidemiologiml111vesrigrl/ioll of

Dis(f1se. SeClion 28. U.. DepanlllCI1l Health Educarioll
and Welr.~lC, DHEW Publication No. 79-618. 1973.
)7

Crlrdiollf1Smlflr

Elrner PJ. Grimltl R Jr, et al. Lifesrylc inrervenrion: resulis of lhe Trea'fllelll of Mild HypCrtCIlSioll StlJd)' (TOMHS). Puv Mcd 1995
Jll.I:24(4) :378-388.
I

ONE NATION UNDER PRESSURE

l'

Jachuck SJ ' Brierle}' H . el al. The dkcr of hyporcnsive drugs on rhe

qllalily oflifc. J R Coli Gen ['ma 1982 Feb;32(235): 103- 105.

1 ElliOI P, Slamler]. er al. Il1Iersalr r('vi irecl: furrhl'r anal}"es 01'24 houl
odiulll excretion anO blood prcssLlfe within ,<ne! across populations. Intersah
Cooper.uive Research Grollp. Bl\1j 1996lvb)' l8:312(7041): 1249-1253.

10 1995 St11ll711l'1II Fro/ll tbc Nfllionn/ Higb 8/001/ ['rr .fIUr' EdltrlltiolJ Pr()'gmm Coordimlling ommit/el'. Belhesela, MD: Nalional High Blood Pressure Educarion Program.

vr.

21 Weinberger MH. Systcmic Hypencnsion. In Kellcy \'V'N. DcVila

editors, et al. Trxtbookoflll1{'mnl Ml'liiciTl1\ Phih,delphia, pi\: J.r. LipI'
Co.. 1992 p. 238.

0((

Jachuck SJ , Bricrley H . er al. The efrecr of hypolensivc drug: on rhe

qllalicy of li!c. J R L'ol16m Pma 1982 Fcb32(2:~5): 103-105.
l

van Swieten Jc, Gc)'skcs GG, er al. Hypencnsion in lhe elderll' is

as OCial(d wirh w!lire mauer lesion and cognilive decline. AmI Nt'1Irol
1991 Dcc;30(6):825-830.
2.\

Thc fiflh repon of the Joim National Commincc on DClecrion, Evahlalion, and Trearmem of High Blood Pressure ONC V). Arr/' Intern Med
1993 Jan 25: J53(2): J 54-183.
l4

Hl'penension in rhe Population al Largt. In: C/iuir(r/

HyperumioIJ-G" rE/iiion. Baltimorc, M D: Williams :uld Wilkins, ) 994 p.
1-22.

25 Kaplan N}"t.

Elmer PJ. Grimm R Jr. et al. Life lyle imervemion: restlhs of tlw Tre;lrmenr of Mild Hypertension Study (TOMHS). ['rtl) Mu/ 1995
Jul;24(4):378-388.
26

Ascherio A. Rimlll Efi. er.L A prospeclivc sludl' of nuuitiol13.1 faCtor>

ami h}'penen ion among US mCl1. Cirr:ulillion 1992 Nov;86(5): 1475-1484.

!'!

Kanncl WB, Garrison RJ. Dannenberg AL Secular blood pressurc lfl'l1ds

in Jlorl11otensivc persons: rhe F,,,mingham Study. Am Hrtll'/ J 1993
Apr; 125(4): 1154-1158.

28

Cran" MG. Diehl H. el al. Eflecr of I.ife.,ryle Modification on H}'pcrtCllsion. SulJlninctifor publirllrioJl 1996.

29

The Food I'rocessor for Windows: Nutrition Anal)'sis & Fjmcss SoftWaIe !computer programl. ESHA Rescarch. Salem.Oregorl.

44 StllUnWJII !'imI} file NII/ionlll High Blood Prl'JfUl'l! EI/IIl'rl/ioli Progrll1ll Coonlinl1ting Commimt'. Bcthesda. MD: National High Blood Prcssure Eou-

cation Progrnm. 1995.

The Food Processor for Windows: NUllition }\mlysis & fimcss Soft
ware [computer programl. ESHA Rcscarch. S, Icm, On.:gon.

45

Neurel J. Replacing regubr salt ",itI. a reducee! odilltn ah conl:lining

porassium and magnesium mal' ofTa a l1on-pharrnac: 1 approach !O 10\\lcIiJ1g blood pressure. Cirl'llill/ion 1996;94(8 sllpp):341.

-lG

Tarasoff L, Kelly MF. Monosodiun, I~gllt(:lm:lte: a oouble-blind stlJdr

and review. Food Clmn 1'oxico/1993 Dec:31 (12): I O19-1 035.

47

4~ Corr"ea I:M, Saavedra JM. Chemic11 lesion of (he cir Lunvelllricuiar

organs witll monosodium gluramale reduces rhe blood pressure ofsp0nlaneollsll' hypertensive bur not olone kidney-one clip h)'pcrtCl1sve rat_,. BrtlZ
J Med Biol Rtf 1992;2S(5):515-519.

Etrects of weight Joss and sodiulll reduction intervention on blood pressurc and hypenension incidence in ovcrweighr rcople wirh high-normal
blood pressur~. The Trials ofHypenension Prt'vt'ntion, pll, e J1. Thc Tri"I,
of Hrpcnension Prevent ion ollaboralive Research Group. Anb II/lem
Mtd 1997 Mar 24;157(6):657-667.

'o Sung BH. \X1hilsen TL, et al Prolonged incrtase in blood pres urt by a
singl~ ora.! close of caffeine in milclly hypC'rtcnsiw men. Am J Hypenm.t
1994 Aug;7(8):755-758.
SlIng BI-I Lovallo \':(iR. CI al. Cafte.ine e1evales blood pressure reSpollse
eX('Icise in mild hypemalsivc men. Am j Hypt'rrens 1995 Dec;8(l2 Pr
1):1184-1188.

51

Freis ED. The role ofsa.!r in hypcnension. Blood Pm.s J 992 Dce: 1(4):1 96200.

10

Freis ED. The role ofsalr in hl'pcnension. Blood Prm 1992 Dce: 1(4): 196200.

51

30

31

31

Kaplan NM. Primary Hrperrension: Parhogene. is. In: C1iJliotl/~vp<'Y

IClISion-61. t:dition. Bairimore, MD: William; ano Wilkins. 1994 p. 55.

;; Kaplan NM. Primary Hypenension: Parhogcnesis. In: Clinirnlliypertewion-(Jh edilioll. Balrimore, MD: Willia.ms and Wilkins, 1994 p. 55.
H MacGregor GA, Marl"'1.ndu ND, Ct al. DOllblc-blind .nldl' of three
sodium imake ano long-rerm efrecrs of sodium reslricrion in e seruial h}'pertcnsion. Ll11lce/ 1989 Nov 25;2(8674U244-1247.

The I'ood Proa'Ssor for Windows: NlIlriliolJ Anal)' is & Fimes., Softwart [computer program]. ESHA Re.s<arch. S"lem,Oregon.

35

The Food Proccssor for Windows: Nurrilion Analysis & Filncss Soft-

ware [compurer progrmnJ. ESHA ReSC:llch. Salem.Orcgon.

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5 Hc J, Khg MJ, CI al. O:ltS and buckwhe:1I inra.kes anei cardiovascular

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Slcight I~ Smoking :Ind hl'penension.

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C/in Exp H,yperlt'm 1993

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5i;

From thc Nl1/ioml1 Higb Blood PreHuri' EtluCrllion Progmm Coordinn/ingummillee. Berhesda. MD: Nalional High Blood

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Adaplcd trom:

Stdtl7/1t'1IJ

Prcssure Eduattion Program, 1995.

AJderman M H. Madllavan . er al. Low minary sodiulll is associalcd
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HypmtJlJion 1995 J1In:25(6): J 144-1152.

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38 Anronios TE MacGregor GA. Sah imake: potential dclelerioLls e!Tens

exdlle!ing bJoou prc:-s ure. J Hum Hypertt:ll.f 1995 JlIn;9(6):511- -1-.

Ch'lI1g.Cbude J. Raedsch R. et al. Prcvalence of Helicobacrer pl'lori

infeclion and gastritis amOllg l'oung adu.hs iJ1 China. /:.;tr J Cllnrf}' !'reu
1')')5 Fcb:4(I):73-79.

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Naz:lrio CM. S.kJo M, el al. Salt amI gastri Q1I1cer: a case-conrrol

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iO

SI ud}'

57 Boone JL. Strcss ami h}'peftcn ion. Prim Cuc 1991

649.

ep;18(3):623-

;~ Yo,hiuehi K. NOll1ura S, CI:l1. Hemod)'n:unic and cndocrine responsi\'eness 10 mental arilhmcli task and mirror drawing test in patiems with
es enri:.! hypcncnsion. Am J Hypel'ltll.f 1997 M. r; 10(3):243-249.

Kokkinos PF. Naray,n P, el al. EHens of regul;u e.~er ise on blood

pressurc and lefl ventricular hrpenropby in African-Americ:ln men wid,
severe hyperrclIsion. IV Eug! j ivled 1995 No\' 30:333(22): 1462-1467.
59

BOll-Hol.aigah 1. Ro",e PC, el al. The relalionship betw.,en nellralll'

mediatd hl'pOlension and Ihe chroni fatigue synd(ome. JAMA 1995 Sep
27;274(12):961-967.

GO

145

PROOF POSITfVE

146

CHAPTER SEVEN

THEGREAT
MEATAND

ROTEIN
MYTH

Ob'S behaviorwas highly unllsual.

However, he did nOt feel he had
any choice in rhe marter. Each
day he came ro rhe college cafeteriawirh a container ofhigh prorein food.
One day it was peanucs, rhe nexr day roasred
soybeans. the nex( day sllnflower seeds OI
walnuts. Rob wOllld ear r!lese high protein
foods Iiberally. His morivation: he had recenrty become a vegetarian and was worried thar he wouJd nor get enough protein
on his new dieI.
A year or sa iarer when Rob took a good
college nurririon class, he was astonished.
He leamed that he was gerring (Wo ar rhree
rimes rhe amollnc of protein he needed in
his diet. Worse (han rhat, he djscovered rhat
c:lting (00 much protein posed health risks.
But rhen rhere was even worse news: when
Rob analyzed his djet. he was hard pressed
ro {jnd a way [Q lower his prorein in(ake
sufficiendy ro be ,u an oprimallevel. Even
on a vegerarian dier, he was having a hard
rime avoiding his incalce of too muc); protn.'
Rob's rruc srory need never have happened ifhe had bcen aware of research rhar
was done ar Harvard and Lama Linda Universiries in the 1950s and 60s. There. researchers Drs. Hardinge and Stare had discovered mar individuals on a [Ota) vegetar-

ian diet ger sufficient amouncs of al) the

proper rypes ofprorcins needed by rhe human body.l
However, long before Hardinge and
Stare arrived on rhe scene, other eminent
sciencisrs were quescioning rhe long-held
dogma of the imporrance oflarge amounrs
of prorein in rhe die(. The renowned nurritional researcher, Dt. T. Colin Campbell,
recendy described SOme of our cultural biases toward high prorein diers aud mearbased meals. 2 Dr. Campbell, Professor of
Nuuieional Biochemistry ar Cornell Universiry. srands in a unique position to evaluare this subject. He is rhe director of rhe
massive Cornell-Oxford-China Diec aI,d
Healrh Project, and bas seen rhe healch advantages of a lower protein diet such as is
common in Mainland China. In rhe July
1996 issue of his New Cemury Nurrition
healrh leuer. Campbell shared the experience and research of rhe famous Yale Universiry Professor, Russell Chirrenden. 3
Chinenden was among the firsr in clIe modern era ro challenge che nurrirional dogma
chac had persisced for centuries. He had
heard rhe standard line chac rhe high prorein animal-based foods promored screngrh
and energy along with mental and physical
fitness. BlI( he wondered, was this realJy
rhe case? In ilie carly 1900s Chirrenden

147

PROOF POSfTIVE
conducred at least rhree sllIdies rhat examined rhe qucsrion ofwherher mear and high
proren were reali)' necessary for oprimal
performance. The capsronc of his research
was a srudl' of well-rrained arhleres. Ar ilie
beginni ng of his stlIcll', these athletes were
aII on a rypicalmeat dier. Chinenden haei
rhem {hen swirch ta a planr-based dicr for
hve momhs. Ar rhe end of rhe swdy period when rheir fimess levels were rcanaIyzed. the atllJeres had improl)ed a- .()'iking
35 percent. As Campbell commenred, "only
ilie dierary change could have accounred for
rhese remarkable resulrs."4
Whar Chinenden suggesred years ago is
now bei ng re-ccha ci by hundreds of vaices.
Earing animal flesh and animal prorein is
nor necessary in order ro obrain oprimal
prorein intake for proelucrivit)' and performance. So where did this grear meat aod
prorein myth come from?

History OfMan's Knowledge ofProtein

148

Prorein was discovered as a nutrienr class

in 1838. 5 By then, ir was also recognized
rhar proteins were associateel with ali forms
ofLife from rhe simplesr single-ceUed organisms ro man. No wonder rhere has been
such fascination with prorein-anyrhing
rhat is necessary for aII forms of life is rruly
awe inspiring. In f;lCr, Webster suggests thar
rhe verl' word "prorein" is derived from rhe
Greek roor "prows" which means "hrsc"6
Our appreciation for protein has grown over
rhe years; we now know rhat ir is viral for
such diverse roles as musc1e function, hormone synrhesis, and the producrion of enzymes.7 Furthermore, aur need for protein
is increased during our growth years, during rhe repair of rissues (afrer an injllry ar
surgery, for example), anei during musclebuilding exercise. 8
Thus rhere is no myth regarding rhe
importance of protein in aur diet. However> rhe confusion about rh so-called superioriry of a-nimal protein sOllfces emerges
when we look a linie closer ar the natllre of
proteins. Proreins are complex molecules
that are nude up of molecular builcling
blocks called "amino aciels." There are 20
amina aciels rhat the human body uses w
build the proreins it needs for life and

healrh. 9 In adulr humans eight of these

amina acids are called essentiaJ, because rhey
must come from the dier. The names of
rhese amina acids are isoleucine, leucine,
lysine, methionine, phen}'laJanine, ducanine. tryprophan. and vaii ne. 10 The remaining 12 amino acids CUl be made by the human body. If we compare a protein molecule ro a train, the amino ;\cids are like (!le
individual cars of rhe train. Just as a nain
cannot be built out of al! box cars or ali cabooses, so rhe body needs amina acicls in
rhe right proporrions w constfLlCt funcrioual
prorein molecules. At rhis point animal
protein bias begins ro creep in. It is obvious rhar animals are physiologically more
like humans rhan planrs are. Therefore, it
shouJd come as no surprise rhat n comparing meat rrom a singLe animal species (Iike
beeD widl food from a single plam species
(like oatmeal), the mixture of amina acids
in ilie animal product will reml ro be closer
ro the proporrions n which humans ueeel
rhem. Because of chis. manl' have incorr ctll' reasoned rhat a eliet based on animal
protein sources like mear is superior ro a
eliet based on plam products in providing
adequate amounts of rhe cssenrial amina
aciels in the right proportions.

Plant \!ersus Animal Sources of

Protein
This brings LIS back ro rhe basic quesrion: do animal sOllrces of nutrition provide berrer "quality" protein rhan planr
sources? If you look ar the cliet as a whole,
the answer is no. This is exactly wh:lt
Hardinge and Stare faund in their dassic
research in rhe 1960s. Il They lookeel ar the
complere diets of duee groups: meat-eatng
Americans, pure vegerarians (rhose who exclllded alI animal producrs from (heir dier),
and lacro-ovo vegerarians (rhose \Vho exduded aII animaJ proelucrs excepr for dairy
products anei eggs). The researchers measured the actual amotlnt of each amino acid
consumed by each of rhese groupsj7mn their
whole diets. They then compared rhar inrake wirh the ideal balance of amino acids
needed by man according ro twO standarels:
(1) rhe srandarel determineel bl' Dr. Rose in

THE GREAT MEAT ANO PROTEIN MYTH

rhe 19405 and 505 and sriU llsed by rhe
World Healrh Organization ro rhis day, and
(2) hllman breasr miLk. The only food specifically designed ro mCCl aII ilie amino acid
needs of a human is human breast milk.
Amazingly, rhe best qllaljty prorein among
rhe rhree complete dier was rhe pure vegerarian diet. The mix of amina acids in rhe
total vegetarian dier mosr closely resembled
rhe mix in Rose's recommendarions antL in
human breasr milk, as illustrared in Figure 1.
The message from this classic research
is simple. lfyou look ar a single food, 31\imal prodllcrs have r!le upper hand in providing prorcin qllaJiry. However, when yOll
look ar rhe emire dier, rhen the pure vegerarian dicr cmerges as superior in prorein
quaJity. The non-vegetarian diet departs
from bom srandards alrnosr ("\vice as far as
rhe pure vegerarian diet.

Comparisons ofProtein in MiLk of

Different Species
The protein conrenr of milk is an indicarion of rhe protein requirement of a newborn. wherher rhar new-born is human or
animal. Ler us exallline rhe differences in
amounr of prorcin in milk in the differenr
mammaJian species. The)' are tablliated in
Figure 2. 12
This comparison demonsuates that humans actuali)' need less protein rhan rhe
ani maJs an the lise. Notice that the relative
growrh rare is grearer in rhose rhat have
greater alllOlllltS of protein in t!le rnilk, as
wOllld be expecred, because of the grearer
protei n requirement to bllild body rissue.
lf a human con umed a rat's milk [rom
birth, would rhat baby be able ro dOllble irs
birrh weight in days insread of monms? The
answer is obviously no, since the rare of
growth is !argely genetically determined.
The excess protein wOllld not be utiJjzed
and, as we williarer see. cOllld actually harm
rhe developing child.

Is the "CompLementary" Theory VaLid?

Ar rhis poiO[ Oll,1e may cOllnrer: "what
Hardinge and Srare did was unfair-yoll
musr ear a perfecr balance ofamino acids ar

TOTAL VEGETARIAN DIET PROVIDES

THE BEST PROTEIN QUALITY
Typeofdiet

Percent variallce /1'0111

Rose's standard

pure- egetariaD

280/.

DOD-vegetariaD

48%
Percellt variallce /1'0111
''''mall hreast lIIi1k

pure-vegetarlaD

13~

DOD-v~etariaD

22%

Figure 1

PROTEIN COMPARISONS OF
MILK IN DIFFERENT SPECIES
\
\~

Mean values for

Jlrotein content,
mg/liter

Time required
to double birtb
weight (days)

Ruman

1.2

120

2.4
3.3

60
47

4.1

19
8

H~-rs~

Cow
Goat
Dog
. -,... ..Cat
Rat
~

-.-.

7.1
9.5
11.8

4.5
Figure 2

a given meal ro uriJize rhem properly." This

argument is based on an old theory thar argued yOll mllst "complement" plant proreins
at a given meal ro get the proper protein
balance. Tbis would require an impractical
rask of weighing each serving rhar makes
IIp a meal, calculating the amino acid content of each, and rhen adding them lip.
Elaborate charts were drawn up thar listed
whar foods vegetarians needed ro combine
at a given meal ro get rhe same "quality"
prorein that a mear-eater was gerting. This

149

PROOf POSITIVE
dogma went by rhe wayside long ago. Historically, rhe American Dicreric Association
(ehe professionaJ associaeion for dietirians
in the Unieed Srates) has nor been known
for adVOc.1ting a vegerarian diee However,
in 1988, ehey came out solidly in sllpporr
of vegerarian diers. They stated: "It is the
position of dle American Dieectic Association rhat vegctarian diets are health/i.Ii and
nurrirjonaJly adeqllare when appropriately
planned."13 They addressed rhe issue of
complementing proteins in rheir paper.
. it is not necessary that complememarion
of amino acid proflles bc.precise and at exacrly dle same mc.al, as the recently popular
'combined proteins rheory' suggested." The
reaJiry is rhac a vegerarian dier rhat conrajns
fruits, graillS, nurs, and vegerables is fully
adequate in protein.

EIGHT ESSENTIAL AMINO ACID CONTENT

OFCOMMON PLANT FOODS

.Isol.

Swcel
Potato

Baked
Potato

BroWD
Ricc

Tomatocs Pumpkin

Leue.

Whole
Wbe.al
Flonr

Lys.

Melh.*

16
14

Phen.*

12

'"EIO

Thre.
- Trp.

~8

li
4

--i Val.

~---

~MertllOnlnl

Corn

Rolled
Dat

White
Btlns

Asparagus Broccoli RECOM-

..

Cysl1n.

M'ENDED '~:.:..~nl"+

Figure 3

Whether you are a roraJ vcgerarian or

mear earer, you should "appropriately plan"
your diet beyond the llartOw scope of alnino
acids. Other nurrienrs need ro be included
in the planning.
o one withour some
rhought inro his regular earing praccices can
simpJy expect to be gening a nurritionally
balanced diet-regardJess ofwhether or nor
meae is induded in me fa re. There is no
evidence that vegeearians musr be more
knowledgeable man meat eaters in order to
be an a healrhful dier. In face, (he cvidence

150

Jeans solidly in the opposire direcrion. lf

you know llorhing about nutrit ion, you wU
likely be heahhier by leaving meat out of
your dier rather (han including it. The information in rhis chapter establishes (hat
you can ger aU the essenrial amino acids evcn
wth what may look like a very "lInbalanced"
vegerar:ian dict, as we will sec.

Can Plant Proteins Furnish Ali ofthe

Essential Amino Acids?
Let liS rake some examples of the lIJtimate in "unbalanced" vegetarian c1iersnamely, single planr foods-and see how
they measure up ro the amina acid requiremenrs. We have aJready made reference ro
Dr. Rose's work in derermining amino acid
requiremenes in hllmans. A number of
other researchers have each offered rheir own
version ofamino acid requiremems nor only
for adult men, but aJso for adult women,
and for infants and children. 14 MlILHO and
Crim have pllbtished a comparison ofRose's
requiremenrs wirh rbose of rwo orher experrs. 15 For rhe sake of assessing how planr
produers fare in rheir protein conrem I have
chosen to compare rhem ro the highesl
(most stricr) adulr daily requiremem for
each of rhe essenrial amino acids as compilecl by MUlHO and Crim. 16 Since we arc
looking at the wildly hypotherical example
of a person earing only a single food aJI day
Jong, rhe comparisons must be based on a
sufflcient (Ocal dajly caJoric imake. 1 have
chosen tO use a level of2,500 caJorcs, which
is the basis of tlle Percem Dajly Values (as
seen on rJ1e food labei) for many Americ.1n
men anei active women. J chose e1even foods
commonly eaten by non-vegetarians and
vegetarians alike. The quanriry of each of
the eighr essenrial amino acids for these
e1even foods is tabulaeed in Figure 3.
The essentiaJ amino acid color codes are
shown on the extreme right of (he f1gure.
The recommended daily amollnts of rhese
amino acids are represenred by the clllster
of shorr bars on the lower righe. The contem of dle amino acids in each of 11 plant
foods is represemed by ehe raHer bars in rhe
main body of rhe figure. Note rhar these
bars are much eaHer for aJl 11 foods (han

THE GREAT MEAT ANO PROTEIN MITH

ehe bars represeming rhe recommended
amolllltS, signifying mar planc foods supply much more proeein than is needed. This
is rrue for every amino acid of everyfood. In
facr, if you chose virrually tmy vegerable or
whole grain you would find mat rhey have
more rhan adequare quanrities of ali eight
essential amino acids. The recommended
daily quantieies are the srriceesr requirements
ofMunco and Crim, (highcr recommended
qualHities rhan others recommend) which
are similar ro rhose of rhe World HeaIrh
Organ izario o.
Thus, rhere is no shorrage qf proreio
here. Any ooe ofrhem alone fumishes more
rban sufficient amounrs ofeach ofehe cighe
essenrial amino acids. It follows [hat a diet
eonsisting o/a variny o/plan! foods wilf have
a greater content ofali essential amino acids

rhan is needed..
Norce thar rhere is no fruit on this list.
Frwr concains a lower amount of pcoreill,
aod some varieries may nor comajn an adequare amounr of each individual essential
amino acid when earen alone. There may
be omer planr foods thar are similar ro fmir.
However, when you rh..nk abolit ir, mllch
of rhe world's popularion for centuries has
survived primarily on plant proreins. They
havc been ablc ro do rhjs simply because
vcgcrable protein provides alI ehe amino
acids needed for good heaJch.
Once when I was lecruring on ehe subjece of prorein, a woman raised her hand
and said, "Por rhe firsr rime 1 undersrand
why our family survived the Grear Depression." 1asked whar she meant. She replied,
"Our family was very poor ar the rime of
rhe Grear Depression. My parents had
many chjJdren and rhe only thing we had
availablc ro ear during rhase years were potaroes. Thllt WI1S ali. 1 never could undersrand how ali of us not only survived on
such a diet, bur also grew up healthy. Now
1undersrand how we did so wdl." She went
an ro say, "However, afrer rhe Depression,
I was so rired of potatoes that 1 did nor have
another one for 15 years." It may have been
a monotonous dier, bur it was nurritionally
sound in ali rhe essential amino acids.
1 do not recommend rhar yotl eat only
one vegeeable ehroughour rhe day and nom-

ing else. Such a cliet would lack a balance

of vitamins, minerals, aud phyrochemicals,
even though the protein intake would be
adequate. Such a balance does come easily,
however, by eating a variety of vegetables,
grains, nuts, and fruits.
We see dut we do nor need a college
degree in nmrirjon ro get "qualicy pcorein"
an a vegetarian dier. Remember, Drs.
Hardinge and Stare found mat even pure
vegerarians living in ilie 1960s wirhout aII
rhe benenrs of knowledge mar we have today were doing jusr fine regarding their intake of essential amino acids. The daea on
amino acid contene of foods helps llS ro
appreciare why this was the case.
Perhaps one of rhe bese summary sratements on this whole topic is provjded by a
respecred nutrition scienrisr, DI. Mark
Messina. Dr. Messina holds a Ph.D. in
Nutririon Science from Michigan State
University and has worked in the National
Cancer Insrirute's DieI and Cancer Branch.
Afrer speaking in derai) about the balance
of amino acids in plam producrs, he made
t he following sum mary srarement:
" ... when people ear several servings of
graillS, beans, and vegerables rhroughour the
day, and get enough calories, ir is virrually
impossible to be deficiem in protein."17

Can W'e Get Too Much Protein?

Mosr Americans are weU aware ehar ie is
possible ro gee too rnuch fa! in rheir diet.
They also know rhar eating too much sugllr
can be harmful. However, mauy do nor
realize thar rhere is much evidence ehat
shows ehe serious consequ.ences from earing

too much protein.

Osteoporosis and Protein

Osreoporosis-a condition thar refers ro
a loss ofbone densicy or mass-has become
a household word in America. Among the
mOSI feared complicarions of this bone-rh..nning process are hip fractures. Fracrures of
ehe backbones (vertebrae) and wrisrs are also
commonly related to osreoporosis. One in
rhree women over 50 years of age worldwide have oseeoporosis. 18 A1iliough rhe disease hies white women aftcr menopallse the
most, it affecrs ali races and both sexcs.

151

PROOF POSITIVE
Some 70 percenr of aII fracrures rh:u
occur in Ameri ans over 45 have been reIared ro osteoporosis.l 9 Furrhennore, the
srarisrics indicare rhar over h,tIf of alI posrmenopausal women will suffer a fracrure
due ro osreoporosis ar sorne rime in rheil"
lives. 20 AbOlit 1.3 miLlion osreoporosis-I"eIared rracwres occur each year in me Unired
Statcs. The annllal medic.,] costs for 05reoporosis fracwres among adults ages 65
and lip wtaled 13.8 bilLion dolJars in 1995. 21
These fracrures can signiflcandy decrease rhe
quaJity oflife, and can also ser rhe srage for
premature death as a result ofcomplicarions
like pneumonia. For example, in rhe year
f(>l\owing a hip fracrure, risk of death increases 15 ro 20 percenr. 22

IDGH PROTEIN DIET ROBS

BODY OF CALCIUM
Ate 48 gms.
protein/day

Ate 95 gms.
protein/day

Ate 142 gros.

protein/day

20
~Gajn

=
-;

-20

'Cj

-40

U Loss

-60

-70

Figure 4

A growing bod)' of research evidence

indicares rhat e;<cessive prorein in {he die.tespeciaLly animal protein-increases rhe risk
of osreoporosis. Srudy afrer srudy indicares
rhat earing mear can cause a IOJS ofcalcium
from me body. Research done ar rhe Universiry ofWisconsin illusrrared panicularly
weIl rhe hannfuJ effeers of excess prorein. 13
Healrh)' young adult men were given
carefully eonrrolled diers for nearly four
monrhs. During this eIHire rime rh.ey were
consuming 1400 mg of calcillm daily-an
aJnollnr abolit as high as anyone is recoJnmending wday. and signifiGUltiy above rhe
152

U.5. recommended daily aJlowance (RDA)

of 1000 mg per day for women. During
rhe srud)', rhe invesrigawrs also conrrolled
rhe subjecrs' protein int/lkes ar two levels,
namely, 48g per day anei 141 g per da)'.
These two levels of prorein are below and
above rhe currenr average inrake in rhe U.S.
of 105 g per day, according ro rhe btesr St3risrics from the U.5. Deparrment of Agriculture. 24 The amollnr of calcium gain Of
loss in each subject was measured ar {he twa
levels.
Resulrs showed dl,l[ when on rhe 1lJW
protein diet. rhe yOllng men g/1ined 10 mg
of calcium ro rheir body srores each clay. On
rhe high protein dier rhe very same men lost
an average of84 mg each day. The amhors
concluded, "The calcillm loss of 84 rng
dail)'. which oecurred when rhe high prarein dier was fed, was substantial and ifconrinued ()ver a period of rime woulcl resuir in
eonsiderable loss of body calcillm."
A follow-up stlldy was conducred by
Linkswilcr and associares in 1981. 25 The
srudy was similar ro rhe srudy cired abovc,
excepr rhar ir added a rhird level of protein
intake of95 grams per day, which was close
ro rhe average D.S. intake ar rhar rime
(99 g). They divided their sllbjecrs into
duee groups, each wirh a differenr level of
prorein inrake. AlI three grollps were consllming 1400 mg of calcium per day in rheir
diers, which is identical ro rhe previous
srudy. The researchers looked ar caJcium
gain or loss of each grollp by measuring rhe
amollnr of calcium excrered in each
parricipam's uril1e and srool. The results of
rhis srudy are shown in Figure 4.
Notice that rhe grollp eating 142 grams
of prorein per day actllally losr 70 mg of
caJcium daily. Where clid mar calcillm come
from? It carne from rheir bone reserves.
This is an obvioLls conclLlsion since 99 percent of rJ1e caJcilltn in our bodje.s is in our
bones. The high prorein inrake group was
losing calciu-m el}e~y doy silnply because of
rheir high proteil1 cOrJSumption. The excessive prorein was leeching calcium from rheir
bones even though theywere gerring plem)'
of calci li m in their diel.
he group rhar con umed rhe amounr
of prorein close ro rhe dail)' U.5. ave rage

THE GREAT MEAT ANO PROTEIN MYTH

a150 lost calcium. Their 105s was Iess. as expected, because rhey consumed less protein.
The group on che so-called low prorein dier
was rhe only graup dlat had a ner calcium
gain. The gain of 20 mg per day would
help maintain thicker and stronger bones.
It is one thing ro look at data from a
llurrieion lab, buc ie is even more compelling tO see evidence of chese same relationships in people '""ho are living normallives
da~' in and dayour. Internaeional comparisons ofoseeoporosis lead ro some of rhe same
conclusions. The esteemed researcher. Dr.
D.M. Hegsred, has poinred out thar osreoporosis is lugher in coumries th;H consume higher amounts of caLcium. l6 He
looked ar {he average calcium inrake and
number of hip fracrures in 16 coumrie.s.
The resulrs are tabulated in Figure 5.
The councries are listed in ascending
oreler ofcalcium intake. Noeice char in general, those wieh {he higher imakes of calcium tend to have the highest rates of osreoporosis. 27 The first seven countries.
which consume an average ca1cium below
900 mg per day, have less than 100 hip fracrures per 100,000 people. Seven of t.he nine
other countries, a11 ofwhich consume more
than 900 mg, have 100 or more hip fracwres per 100,000.
An exceHem case in poinr is provided
by the Alaskan Eskimos. By direct measuremem ofbone densiry. twO orher Universicy
of Wiscoosin researchers Richard Mazess
anei Warren Marher found thar Eskimos
over the age of 40 had 10 ro 15 percem more
bone 1055 tban white Americans in dle sam.e
age range. These losses were true of borh
sexes. 28 lnreresringly, when these rescarchcrs reviewed the medicallirerature on Eskimos' detary iIHake, they found (hat they
consumed a high LeveL 0/2500 mg ofcaLcium ddiLy.29 Where did t.hey get 50 much
calcium? Apparently they were eating large
quanti ties of fish, inci uding rhe bones.
However. (hey a1so had a high protein intake, in che range of 250 to 400 grams per
day, probably becausc of rheir high consumption offish, walrus, and whale. 30 The
aurhors concluded: "The most obvious f:.lClOr in rhe ... higher rate ofbone loss in middlc;lged Eskimos would be r.heir mear diee:'3]

These stlldies anei orhers like rhem indic<1te thar osteoporosis, contrar)' ro popular opiniol1, is nor reLued ro a Lack of caLum in the Jiei. The bigger problem seems
ro be excessive calciurn losses as a result of
conmming 100 much protein. \Y/e would nor
expecr the American dair)' industr)' ro advenise rhis. Afrer aU rhey have worked for
years ro convince liS rhar drink.ing more milk
and eating more cheese and yogure wou1d
heJp us prevcm osreoporosis. The fact is
chis: if your diet is high in pwrein, you can
car ali (he calcium tha( the dairy association has ro offer and you are stiH likely incre.asing yom risk of rhinning your bones
and pcrhaps facing a hip fracrure latcr in

Eskimos comuming over

2000 m-g ofcaLcium dai!),
have the highest raW ofosteoporosis in the world

RELATIONSHIP BETWEEN CALCIUM

INTAKE AN HIP FRACTURE RATE
Hip-fractllre Rate
(per 100,000 people)
Nonuy

200

S'w('dtn

I7S
[){'nm.r.....

150

Unifrd Stah'5

125

. . .

nited KinKdom

100

......1

75
lIoo~

50

Koog

25

N,... Z..land

Pnlaud

HolI.nd

1~I.nd

\'UItOJlll~ia

o
O

N'ew Goinea

200

400

600

800

1000

1200

1400

CalciwlI llllake
(nrgldaJ' approx.)

Figure 5

life. E'lCcess protein Leads to il decrease ofcalcitim storn even when (aLrium intake is Lib-

emL.

Why Does Meat in the Diet CaUJe

Bone Loss?
What is ir about meat eating and dicrs
high in proeein (har causes bone los5 and an
increase in oseeoporosis risk? Onc explanarion is t.hat meat rcnds ro be rich in amino
acids rhat contaln sllifur, such as merhionine. When consllmed in excess, dlese amina
acids Icad ro a buildup ofsul fur ions. Some

153

PROOF POSITIVE

Vrea is produced in the

metabolism ofprotein and
in excess acts IlS a di uretic

believe that th.is inerease il\ sulfate alone may

eause [he kidlleyS to excrete more calcium
in the urule. 32 Others provide a more complicated explanation for [he relationship.
They argue mat the excess sulfur makes the
blood more acidic. The body [hen uses bone
eonstiruents ta neutralize this acid load, rhlls
causing a loss ofbone tissue. Increased ealcillm in the mille then provides a teHtaJe
sign of this bone loss.33
Another explanation is stiH more complicated. It hinges an a well-known physi-

L FESTYLE FACTORS
AND IP FRACTURE RISK
Variable
Factors SignificantIYJ!1cr~asin Risk

---Rl!l#ve Risk

Current use of anticonvulsive drugs

Current smoking
History of maternal hip fracture
Resting pulse rate> 80 beats/min.
Current use of long-acting benzodiazepines
Current caffeine intake'
(equal to 11/2 cups per day)

2.8
2.1
2.0
1.8
1.6

1.3

Factors Not Affecting Risk

Current estrogen use
Daily calcium intake

1.0
0.9

Factors Significantl Decreasing Risk

Walking for exercise
On feet more than 4 hrs per day

0.7
0.6

Figure 6

154

ologie fact: essential amina acids are needed

in faidy precise amollnts. When intake of
these essential amino acids exceeds the
body's needs, liver emymes are tumed an
[Q break down rJlese amino acids. Some of
the c1assic experimems in this regard vere
done by Elwyn. 34 He fed dogs excessive
amounts of mcat and traced [he path rrave1ed by rhe amino acids. The protein was
broken down in the sromach and inrestine
aod [hen rhe amino acids were raken up inra
the blood vessels surrounding the intestine.
From rhere, they were carried ro [he liver.
At this point, beeause of the exeessive
amounts, a large portion of the amina acids was immediately broken down when

rhey passed through rhe liver. Over half of

them were converred ro a breakdown produet ealled urea, whiJe anly 23 percenr of the
amina acids passed from the liver inco [he
general circulation where they could be used
by other body tissues.
What happens ro rhis excessive urea~ [t
acrs as a diuretic. 35 A diuretic causes e1imination of water, bur in the process it elinlinates not only water, but a1so lIseful mincrak A similar effect occurs when ;~ person
rakes dillretic mediatiolls. That individual
often must take potassium becallse cerrain
diuretics can eliminate potassiuJn a10ng with
water. Excess urea eallses calcium loss \Virh
rhe water loss.
AlI of rhese mechanisms may be panial
explanacions. Whatever the case, it is well
established dur a meat and h igh protein fare
incrCdses the risk of osreoporosis.
This line of evidence may prove very
disconcerring ta mally readers. What are
we ro do wirh rhe revered mineral, calcium?
One of rhe most comprehetlsive srudie" on
osteopowsis helps ro put [he mie ofcakiulll
in perspective. This srudy was nor restricred
ro the lone effect of Gllcium intake, bUl
looked ar man)' additional lifestyle facrors
in relation to hip fractures. Faur major [esearch cenrers worked rogether to analyzc
the risk of hip fracrure ll nearly 10,000
white women over 65. 36 The)' found [har a
low calcium imake-even below 400 mg
per day - did nor cause hip fractures in chis
exrensive srud)'. This result agrees with t!le
smdy shown previously in Figllre 5. Beyond calcium, chey [ollnd many orller factors thar were damaging. They are listed in
Fgure 6.
Notice thar mose whose mothers had
had hip fracmres experienced double rhe risk
afhip fracrure. Those wha did not exercse
regularly were at higher risk. Caffeine consumprion equivalenr to ]1/2 cups of coffce
per day was aha dearly assoeared wirh an
increased risk, as was taking anri-anxiery
(benzodiazepines) 01' anri-seizure medications. Numerous addirional smdies have
shown rhat the higher rhe animal protein
inrake, the lower rhe densiry of rhe bod)"s
bones and rhe greater the risk for hip fracrure.37 Interesringly, higher consumptjon

THE CREAT MEAT AND PROTEIN MYTH

of vegerable prorein does nor appear ro be
relared ro osteoporosis or bone fracrures. 38
AlrJlOugh cakium intake and hip fracrures
are unrelated in many studies, some swdies
have shown that an increase in caJciuffi intake. can prevenr osreoporosis, parricularly
when rhe CaJCiUffi consumption is adequate
and the prorein inrake is relativel)' low before rhe age of30.3~) Omer known risk tac[Ors rhar addirional studies have identfied
for osteoporosis include inadequare sl.lnlighr
(ar low Vitamin D levels), alcohol consumprion, caffeine consumption, and lack of
regular physical exercise. 40 Many srudies
have shown rhar thin posr-menopausal
women who are nor taking eserogen supplemenes are also ar risk. 11
A diet plenriful in cakiuffi comained in
plant foods is srill recommended. Calciuffi
is not only essential for strong bones; it is
beneficia] in orher important body functiOM. For ex.ample, it may help to prevem
high blood pressure. Tr :uso appears ro "assisr ehe heare in beaeing wieh greater viraJiry.42
A number of foods rhat have goodly
amounrs of calcium are listed in Figure 7. 43
Sa)' beans and greens are a good natural
source of calcium. Some green leafY vegerables-like coLlards and Jamb's-quarrershave even more calcium per serving rhan
soybeans. Greens also have propenies rhar
help prevent cancer. rnd ed, we C<1n obrain
adequare C<1kium from planr sources. Fllrrhermore, rhese foods are lower in prorein
and merefore should noe extracr calcium
from our bones. If we avoid an excess levei
of prorein inrake and ear a good \Iariery of
plam foods, our body ca1cium swres wiU
likely be more rhan adequare.
Tables like rhar above fail ta reveal one
orhcr important fact abOli( cakium ba.lance.
Namel)', it is nor on.!)' rhe quantity of calcium in a given food that is important, but
how well that cakiulll .is absorbecl. And calcium absorption is dependent ro some degree on the composirion of the whoLe diel,
nor merely an [he nurririonaJ characterislies of a given calcium-rich food.

CALCIUM IN COMMON FOODS

~FOodltem

Amount Calc (mg)

Oatmeal
le.
Lentils
le.
Quinoa grain
le.
Rutabagas
le.
Dandelion greens
le.
le.
Mustard greens . - .
Baked beans
.., le.
2 Tbs.
Sesame seeds (dried)
Blaekstrap eane molasses 1 Tbs.
Kale
te.
Turnilp greens
lc.
Filberts/Hazelnuts (dried) le.
Green s o y b e a n s l c.
Figs (dried)
10
Whole milk
te.
Amaranth grain
lc.
Nonfat sitim milk
lc.
CoUard greens
lc.
Carob flour
.1 c.
Lambsquarters
lc.

19
38
102
115

147
152
154
176
176
179
249
254
261
269
290
298
301
357 ~
358
464

~-----------------F-ig-U-re--j~

Absorption ofCalcium from Plant

Foods vs. Milk
Although milk has a high calcium contem, 60 to 80 percmt of it is nof absorbed
through rhe human intestine. 44 Of. C.M.
Weaver and associares ar Purdue Universiry
have observed rhar, in general, hllmans ab
sorb a.r much or more ofrhe calcium in plam
products rhan rhe)' do from mi.fk:l5 46 (The
main exceprions are planr foods rhat conrain high concentrations ofcompounds thar
bJock calciull1 absorption. Examples include spinach with irs oxa.lic acid and wheat
bran cerea] wirh irs liberal amounrs of phyric
acid). Since r is now recognized thar calcium can be assimilated as well or better
from vegetarian sOllfces rhan from milk, we
musr simply become aware of the rich

155

PROO F POSITrvE
sources ofcalcium in the vegerarian diet and
ehoose ro regularly consume these items.
One possible reason for the very favorable absorption ofcalciull1 from plam producrs like green leafY vegetables is uleir low
phosphorus comem. Dark green leaf vegetables can have rhree ro Ave rimes as much
calcium as phosphorus. By way of COIllparison, (he rypical U.S. dier is reversed: i(
has more rhan twiee as much phosphorus
as calciulll. And diets with a phosphorusro-ealeiull1 ratio over two have been linked

CALCIUM / PHOSPHORVS RATIO

OF SELECTED FOODS
Food Item:

Calcium ('!!1:) PllOspllOrliS (mg)

Diel Pepsi (12 /1. oz.)

O
Lcan T-bone steak (3 07_)
6
Cund bam (3.5 Ol.)
8
Atlantic salmon (3 Ol.)
14
Polaloes (3 oz.)
4
Calush (3.5 oz.)
39
T.ofu, raw (lh c.) ~ 258
Skim milk (1 c.)~- \
301
Whole milk (1 c.)
290
Scsame seeds (1 Tbs.)
88
Human miJk (1 c.)
79
SpiDacb (1/2 c.)
277
Mustard greens (1 c.)
1S2
Turnip grccns (1/2 c.)
194
Kale (1 c.)
179
[,amhsquarlers (1 c.)
464
Collards (1 c.)
357

CIP Ratio

41
198

279
237

239.

<0.1
< 0.1
< 0.1
< 0.1

43

0.1

234

0.2

248
228

57
34
91

36

P"!'!"'"I"'~
n.lr\.L..-

0.3
1.2
t.3
1.6

2.4
3.0
4.2

44 :"""-=:=...0_ 4.4
4.9
36
81
5.7
7.8
46

Figure 8

WHERE DO WE GET OUR PHOSPHORUS?

to inereased bone Joss in animalsY High

levels of dietar)' phosphorus lead ro inereased losses of calcium in rhe Stool. It is
recolnmended rhat ar Ie..ast as mueh caleium
as phosphorus is consumed in rhe dict if
you want ro oprimize calcium absorption. 48
The balance of calcium and phosphorus in
a variery of foods is 'hown in Figure 8. 49
There is a problem with looking ar rarios: they can be misleading. For example,
some may conclude thar carfish is equaJ ro
poraroes because rheir rarios are equaJ. Nor
so-rhe rario ll1ul the cotaJ phosphorus arc
imporranr. To keep your phosphorus load
down, you wOllld favor the poraro, which
bas onJ}' rvvo-ehirds as much as G.1.dish; and
neilher of them eomribure much in the way
of calcium.
Thus, in addition ro looking at calciumto-phosphorus ratios, we need tO consider
ehe phosphorus cOnteOf itself in common
food groups. The average American dier
has been eva1u<lred regarding (he percelHage of phosphorus in each of eighr major
food groups thar provide aur total phosphorus intake. Two food groups stand aur Wilh
a high phosphorus conrem and rhey account
for rhe major percenrage ofour total imake.
The percenrage in each of the eight groups
is shown in Figure 9.
Note rhac two groups, meat and dair)'
products, aecounr for 60 pereenr of aur
phosphorus imake. To lower ehe inrake, the
besr srrategy would be ro lirnit ar stop our
consumprion of foods in these two food
groups.50

Catcium in the Urine Causes

Kidney Stones

Grain products
19%

Figure 9

156

legUll1CS.
Eggs

4%

Iluts &

soy 5%

1#~

We havc seen tiut losing calcium in the

uril1e increases rhe risk of osteoporosis. It
also presenes ocher problems. One of these
is an increased risk of kidney stones. A
Harvard stud)' of abour 45,000 heaJth professionals found rhat rhere was a 33 percenr
increase in kidlley srones in (hase eaeing the
largesc amounrs of animal protein. The resulrs suggested that inrakes of more tllan
61 grams of prorein daily inereases kidney
srone risk. Anotller result suggests rhar a
50 percene decreased risk is produced by

THE CREAT MEAf AND PROTEIN MYfH

eating high potassium foods from frllirs and
vegerables. S' As expected, me researchers
also found dut drinking plenry of water
decreased kidney Stone risk.
Another scudy done in Brirain reache<\
similar conclusions; namely. rhar a high
animal protein diet increased calcium in the
urine and rhe risk of caJcium srone formarion.)2 rf you have already had a kidney
srone. you are mucll more likely ro form a
recurrem kidney stone if you have a dic[
high in animal prorein. It is obvious lhar
rlle besr way ro reduce rhe risk of kidney
seones is simply ro ear an abllndance ofplant
foods rhar are naturally lower in prorcin.

Cancer is Linked to Eating Ey:cess

Animal Protein
Cancer is anorher problem linked to
excess animaJ prorein. International comparisons suggest that coumries where more
animal prorein is eaten have more Iymphoma,S3 a deadly cancer of rhe lymph
glands. Some rypes are parricularly devasraring becausc rhey strike younger adulrs.
ForruoareJy. modern advances have rendered many Iymphomas rrearable with chemorherapy and/or radiarion. Nonetheless,
lymphoma sriJl c1aims over 23.000 lives per
year in rhe Unired Srates. The link berween
animal prorein consumprion and Jymphoma appears solid. An even stronger relarionship is fouod wirh one parricular rype
of animal protein; namely, bovine (cow)
prorein. The New York rese.archer, Allan
Cunningham, found rhar r11e suongest internarional relationship exists between dairy
and beef protein and Iymph gland cancer.
This re1arjonship is iIJusrrared in Fig1.lre 10.
Nore rhac the U.S. has [he unenviable
distincrion. of sraoding in the rop tier of
counrries regarding the inrake of dairy aod
beef procein and Iymphoma risk.
Grher popllla.tion srudies have found an
association berween animal protein consumprion and increased incidence of cancers mher than lymphoma. 54 Armstrong
and Doll found mat increased animal protein consumption increased rhe risk ofcancers of the breasr, colon, prostace, kidney,
and womb (endomerrium).5S With a.U of

rhese associations, the quesrion could be

asked wherher i[ is animal protein that is so
bad, or wherher rhe bigger problem is lack
of certain nurrienrs fOllnd abwldalltly in a
planr-based dier. ActuaIIy, there is some
truth in borh assllmprions. Animal protein
irself does increase cancer risk when compared to vegerable protein. In addition,
nutrielHs inund in many planr products
appear ro prelJent cancer. Thus, rhose who
consume large amounrs of animal protein
are likdy shortchanging rhemselves regarding an adequare inrake of healrhful plan[
products.
The soybean provides an example ofhow
difficulr it may be ro confirm the reason(s)
planr protein may help decrease cancer. Dr.

AN MAL PROTEIN AND

LYMPH GLAND CANCER
5.0
USA New uRlind
Denmark
Italy

Switzerlaod
F"m laod
Norway
Unlted Kingdom
Netherlands
Belgium
Swed en

Yugoslavia

2.0
JlIpan

France

10
20
30
40
50
Per capita bovine protein consumption (g/day)
Figure 10

Mark Messina, a noted soy bean researcher,

has listed a number ofsoy proten products
rhar have a cancer-fighting role. These include soy protein isolare, soy flour, and textured vegerable protein. 56 Furrhermore,
human popularion studies suggesr that soy
has a role in preventing a variety of cancers
incllJding colon. rectum, prosrate, sromach,
lung, and breasr. 57 Messina explains ehar
the primar)' reasoo for the anricancer beneflts of rhese producrs probably resides
largely in their liberal supply ofanriox:idants,

157

PROOF POSITIVE
which are chemicals ular can block cancer
formarion. Thus, rhe example of soy illusrrares rhat it may be difficulr ro reU how
much benefir comes from rhe plalH protein
irself (and rhus avoidance ofanimal prorcin)
and ha\'{ much arises from other compound.s faund in liberal amoulHs in proreinrich planc foods. The evidence is char plam
producrs often have a hosr of Cll1cer-prorecrive properries rhar may be of even more
benefir rhan thcir superior rype of prorein.
Chapte.r 2 on cancer addresses {!.lese properries more fully.
Specific cancer research, however, identifies animal protein i{self as a cancer-promot ing factor. Researdlers ar Cornell University in ew York have provided striking
evidence of a relarionship berween animal
prorein intake and liver cancer. In humans,
tWO of rlle main causes of liver cancer are
generic changes caused by che hepariris B
virus sS aJld exposure ro a carcinogen called
aflatoxin B 1. 59 (Ailaroxins are a graup of
chemica1s produced by certaln molds rhar
are capable ofcontaminaring ordinar)' foodsrufTs, such as moIdy peanurs.) The Cornell
group has now shown rhar in anima1s these
twO patent causes of liver cancer can be
rhwarred b)' following a dier with reduced
animal prorein. When Illice are given a.flaroxin or have Heparitis B-related generic
changes ro increase rhe cancer risk, a lowcred animal protein dier can elramarically
reduce rheir liver cancer risk.
One recent srudy involved rwo groups
of m.ice prone ro liver cancer mac had Hepatiris B-altereel genetics. Dr. Cheng and colleagues fed one gratiI' of rhese mice a srand:ud 22 percenc milk procein (casein) diec.
They feei rhe ocher group a dier wirh casein
reeluced by abouc 75 I'ercenc. The difference in cancer developmenr was suibngly
proportional (Q the casein in rhe diec. 60
Whereas 64 percenr of rhe mice an rhe srandard eliet contracred liver cancer, onI)' 16
percenc of chose on rhe low animal prorein
dier did (a reduc(ion of75 percenc).
Similar results have been found in rheir
tab with aflaroxill rarher rhan Hepatitis Baltercd genetics. Increasing the procei n COIl(em ro the same 20 percem range by usi tlg
soy ar orher planr proteins insread of miile

158

I'rotejl) did nor increase che cancer risk. T!lis

makes a $rIo11g case tJlat ir is the animal prorein itself, not protei Il in general, rhac is the
problem.
These cancer-promoring effects of a
higher animal protein-based e1ier also appear ro occur in hUll1ans. For example, afla(oxin exposure in China does not seem ro
increase liver cancer risk becausc of their low
prorein dier. 61
Why eloes a high animal procein diet
increase cancer risk? Oile explanarion may
be rhac animal proteins lead to increased
levels of cerrain growrh hormones thar
srimulare cancer growth. One such growrh
factor is called insulin-like growth factor II
(lGF2). T!lis facror is needed for rhe normal growth of the human embryo, and
cencls ro decrease as we get older. 62 . 63 Howevcr, IGF2 is often found in high amOUlHS
in tlImors. 64 . 65 Some researdletS belicvc
rhar rhis growrh f:Kcor helps ro give the cancer cells a growth. advamage. Of particular
importance, fGF2 levels were over four
rimes higher in mice with the hepatitis B
generic chaJlges that were given fhe 22 percent casein diet compared to those with rhe
same genetic changes for mice thar were an
rhe 6 percent casein diet. 66
There lllay be orher rea ons for the Sllperiority of plant protein regarding cancer.
Immune sysrem effects may a1so be pan of
rhe explanation. Although rhe reseacch is
far from conclu ive, we are srarting ro learn
abollt some iJlteresting relariollships berwecn diet and a grollp of cells called natural killer cells.
Nanual kiUer cells are a special type of
whire blood cell. These ceUs have rhe ability ro destroy foreign cells such as cancer
cells. 67 There is now sorue evidence demonsrrating that the consulllptioll of larger
amollnts of proteill, especaJly from animal
sources, can decrease rhe number of narurai killer cells. The higher pwrein illrake
may al50 adversely affecr rwo orher rypes of
whire blood ceUs; rhe T helper cdls and the
T cytoroxic cells. For example, oile scudy
determined dlar resrriction of rwo amino
acids, phenylalanine and ryrosine, could
mprove [he immune sysrems of healrhy
human voluntcers. 68 For 28 da)'s, rhe elice

THE GREAT MEAT ANO PROTEIN MYTH

of rhe panicipams was changed ro restrin
the rwo amina acids, aher which rheir diers
were swirched back ro rhe eypical American
dieI with higher amoul1ts of tbe amina acids. The effecrs of {hese dier changes are
rraced in Figure Il.
Notice rhar the nacural killer cells
doubled. from 3 ro 6. Two orher importalH cancer-prevenring ceUs, the T helper
ceUs and rhe T eytoroxic cells, also increased.
In rhe last 2 weeks of rhe srudy rhe individuals were given back their eypical American lJleac diet rhar is naturally high in phenylalanine and eyrosine. As a resulr, their
healthy high immune cell levels dropped,
excepc for the T-killer cells, which had a
more delayed drop.
Whar kinds of foods have t!le amino
acids phenylalanine and ryrosine? A lisr of
such foods is shown in Figure 12. 69
Notice that various meats have a high
cantene of rhese amina acids, a10ng wirh
lentils. Fruits are among rhe besr foads for
avoiding eyrosine and phe.nylalanine. Fasring, of course, would reduce the intake of
{he amina acids to zero. Ir i5 inreresring in
liglu of rhesc observations ro {ake nore of
{he advice writtcn by E1len Whire as quoted
in Figure 13. 70
There is IlOW evidence rhat resericting
cerrain essential amino acids such as phenylalanine and eyrosioe may help co creac
certain deadly cancers that have already
sprcad ar merasrasized. Several srudies were
done in mice rhat had rhe deadly skin cancer, called melanoma, which had already
sprcad ro the liver and IWlg. However, when
[he mice were placed an a diet 10w in rhese
[WO amina acids, the tumors stopped growing. Me:u1\vhilc., the mice an rhe "normal"
dier died quickly from rapid melanoma [Umor growth.
This research raises some serious concerns. Many would consider rhe amounr
of amino acid resericrion in these srudies as
extreme. Even an a eypical vegerarian dier,
such lowcring would call for specific vegetarian food resrricrions. Thus, one queseion rhar emerges is: can a1rering even a vege[arian die( in cenain ways (such as a very
low phenylalanine dic[) acrually assisr metastatic cancer human pariem' longeviry? The

IMMUNE SYSTEM BENEFITS FROM

REDUCING THE INTAKE OF
TWO AMINO ACIDS
40
35

30
Cell 25
Count

20

18
_11

15

iiiiii_--==:;~~~:: 9

10
.
5 3.O

Natur I killers
Day 28

Day O

IypicD/

Diet 10'" in ]; Dmino acid.\'

Day 42
American diel

Figure 11

PHENYLALANINE AND TYROSINE

CONTENT OF FOODS
Food Item:
Plant

'*

Plren (mg)

Applesauce (Ill c.)

Mediulll Apple (2 uch)
Cabbage (1 c.)
CoUard Grccns (1 c.. )
Muslard Greeos (J c.)
Dried Figs (10 ellch)
Lentils(l c.)

6
14
48

61
90
,138
881

Tyro (mg)
4
II

.26
47
180
247
477'

/lI,imal
Egg (1 each)
Whole milk (1 c.)
Crab (3 oz.)
Tuna (3 oz.)
BeefSirloin Sleak (3 OI.)
Chicken Breasl (1 eacb)

S:'

332
388
799
970

255
388
632

1012

836
868

1147

960

Figure 12

BENEFITS OF FASTING
"10 many e-ases of sickness, lhe very best remedy i5 for
the patient 10 fast for a meal OI' two, that the overworked
organs of digestion may have an opportunity to rest. A
fruit diel for a few days has often brought great reliefto
brain workers. Many times a sbort period of entire
abstinence from food, followed by simple, moderate
eating, bas led to recovery through
nature's own recuperati ve effort. An
abstemious [self-restraining] diet
for a month or two would convince
many sufferers that the path of selfdenial is the path ta bealth."
Figure 13

159

PROOF POSITIVE

LOW
OTEIN DIET ARRESTS
EY FAILURE
DIABETICS
100
Kidney
filtering
ability
ml/min.

80
60

50

40

20

Diei
challged

One year
after diet
change

_ Normal American _ _ Ouc )'car of low

diet
protein diet
Figura 14

LOW P OTEIN DIET INCREASES

BLOOD P OTEl IN DIABETICS
5

Serum
Albumin
(iodicates

blood
protein)

3
2

One year
after diet
change

Dict
changed

o
One Year
Figure 15

answer ro rhis quesrion has nor yer bcen

found.

A High Protein Diet Deteriorates

Kidney Function

160

We have known for years rhar diseases

like high blood pressure and djabcres can
destroy the kidney's microscopic ftltering
units called nephrons. For examplc, among
diabecics, kidney disease is one of rhe leading causes of death and medical disabiliry.

One OUl of duee diaberics who are dependenr an insulin evcmually develop kidney
failure requiring cither dialysis or uansplanrarion.?l More rhar 20 million Americans
suffer diseases of rhe kidney and urinary
rracr and more than 90,000 dic cach year.
A high protein imake can progressively destroy kidney nephrons, which weakens the
kidney filtering abiJilY. Such damaged kidneys normali}' continue ro dereriorate. AlthOligh tightly conrrolling [he blood sugars
and blood pressures of diaberics can help.
rhe disease will srill progress and worsen
wirh rime.
A dassic study was done on chronjc kidne)' failure parients who had already Iose signjficam kidney funceion.l- These paeienrs
had protein in the urine, which is rhe resllir
of weakened kidney flltering. Normal kidneyl> do not produce urine thar colltains
protein. Doctors had measured their kidney filtering ability. In normal individllals
ehis value is around 125 milliliters per
minute (ml/min). However, rhese kidneyimpaired individllals had values rhar averaged only 50 ml/min.. which mea1lS tiut
their kidney fi.lIlcrion had already deteriorared by more t.han 50 perCel)L
The researchers placed these patiems 011
a low protein diet of 40 grams per dar Thc
purpose of rhe srudy was ro derermine it"
kidney dererioration could be arresred by
redllcing prorein in the dieL The resulrs
are shown in Figure 14.
Note rhat one year laeer, rheir kidney
funcrion remaned Slable, srill with a fileering ability of 50 mI per minute. This landmark seudy demonstrated whar sOlUe had
rhollghr was unrhinkable; namely, rhat signit-lcant diaberjc kidney disease could actually be held ar bay. But the nexe questioll
was, will ehe reduce ion in dietll1y?rottin
cause a.n undesirable reducrion in proteil1 in
the Mooel? Blood albumin measuremenrs,
which are an indicator of the level of protein in rhe blood, were done ae rhe beginning and end of rhe rese The resulrs are
shown in Figllre 15.
Note [.har tllOse in the study saw rheir
blood protein leveJs rise significantly, even
though they were an a low prorein elieL This
was rrul)' surprising: man)' docrors had

THE CREAT MEAT ANO PROTEIN MYTH

raughr for years thar diaberics wha were losing prorein in rheir urine musr eat a higher
prorein eliel. A high prorein eliet was
dlOughr neeessary tO make up for mine protein losses. This sruely c1early clemonsrrared
dtar a IOUJcrprotein diel was realI>, what was
called for.
Haw is ir possible rhar rhe levels of prorein in the blooel inereased while the prorein inr~tke was lowereel? he answer is
found by looking Olt the measurem(~ntS of
protein lost in rhe urine ar the begiillling
anei enel of rhe test. Thcse measuremenrs
are shown in Figure 16.
AfteI" a year on rhe low protein elicr, rhe
parienrs' urinary prorein losses elropped signiflcandy. The effeer of rhe lower prorcin
intal,e was more rhan o.ffser by the sharp
reduction in protein IOHCS rhrough [he urine,
resulring in an actuaJ increase in protein in
the blood.
Blooel pressures aJso seerned ro benefi r
from rhe low prorein elier since both rhe
sysrolic anei diastolic came elown slighdy.
Although conrrolling a kielney failure
pariem's blood pressure can help prevenr the
worsening ofrhe disease, rhe aurhors' clcafly
St:lre rhar rhe milel reeluction in blooel pre sure could nor, by irself~ have dramatieally
prevenred the worsening of the elisease seen
in this srudy. Thus, rhe prorein resrricrion
irselfwas the imponanr element in prevenring worsening kidney funcrjon.
To summarize this srudy, rhe resulrs of a
low prorein clicr in pariems with signifieanr
kidney f1ltering clamage proeluced four posirive eftecrs: arrcsred kidney failure, increaseel
blood protein, sharply reducecl mine protein, anei lowered blood pressure. This study
and numerous adelicionaJ subsequenr sruelies
add kidnev failure ro [!le lise of diseases tiut
are besr tr~ateel by protein resrrcron.73. 74

Weight L055 Inhibited by Milk Protein

A Stuely indieares rhar ir is more difficulr for an individual to Iose weighr if rhe
diel conrains a high amollnt of milk prorein. OI'. Cheng anei his associares ac Cornell
have found rhar mice feei a elice higher in
milk prorein (casein) gain more weighr man
mice feei a elier coneaining less casein. To

3000
Urioe 2400
proteio,
mg/d
1800

2000

1200
600

One year
after diet
cbange

Diet changed

100

o
Ooe Year

Figure 16
gain e!le same amoum of weighr, rhe mice
had ro ear 25 percenr mor of a dier conr,lining 6 pereem casein than wirh one containing 22 pereenr easein.7 5 Cheng auributed this elifference ro che fact rhar rhe body
generares more he-ar {thus consumjng more
ealories} when it is funerioning on a elier
thar is lower in animal profein, ehus maJ(ing it easier ro Iose weighr on rhe same
amoum of food. le is important ro nore
[hat wirh the lower <1mount of casei Il, the

SWITCHING TO VEGETABLE ROTE

LOWERS CHOLESTEROL
20

o
Cholesterol
change, -20
mg/dl
-40
-60

-80
Crosso\'cr poinr

-100
-120 L -

_.+-

--L

3 wecks

3 weeks

figure 17

16]

PROOF POSITIVE
dicr was sciH fOllnd ro be consisccnc wich
good growth and long term healrh.

Vegetable versus Anima! Protein for

Heart Disetlse
In controlling blood cholesterol, rhere
are a nllmber of srudies ehar now show rhe
advantages ofplant or vegerable protein over
animal protein. One classic six-week studl'
was conducred by Or. Sirtori, who puc two
grollps of patients with high blood cholesterol levels on diets ehat, on thc surface,
appcared equalll' good. 76 Borh wcre low in
cholestcrol and saturaccd fac, but high in
fiber, which sholild help (Q control blood
cholcsterol. There was, however, one significam difference: onc dicc was based on
skim milk procein, while [he oehcr diee was
based on sol' protein. The cffccts of [hese
two diets on e!le blood cholesrerollcvels are
shown in Figure 17.
We see rhat during the firsr duce weeks,
rhe milk protein grollp lowcred rheir blood
cholesterol by 20 points. The soy-based
group did significanrll' berrer, however, wirh
a 60-point drop in cholestcrol. Afrer [hree
wceks, [he two groups were rhen reversed
([his s called a "cross-over study"). Those
who had been on rhe skim milk-based dier
changed ro the soy-based menu and cxperienced a furmer and much sharper choles-

VEGETABLE PROTEIN PROMOTES LOWER

CHOLESTEROL IN RABBITS
200

~~~~~~~~-

---------175

rerol reduction of80 points in rhe Ilcxt duce

wecks. Those who wcre srarted on ilie vcgerable protcin (sol') die[ now swilched to
rhe skim milk-based regimen. They saw
cheir cltolestcrol risc neaely 40 mg/dl.
Sirtori's research is not alone n demonscraring rhe imponance of eating vegerable
protein inscead of animal procein ro lower
che risk ofcoronary hearr disease. Researchers ar the Universiry of Kencucky used advanced statisticaJ computer methods ro anaIl'ze 38 separate stlldies in rhe medical lircrature that have looked ac rhe use of so)'
protein ro lower cholesrerol. Their :lnaJysis
showed rJlat when compared to animal pro[cin, soy protcin signiflcantly decreascs
blood levels of toral cholesrcrol, LOL cholesrerol (rhe "bad" cholesrerol), and rriglycerides. 77

Why the Type ofProtein Matters for

Atherosclerosis
Animal foods are generaHy high in rhe
amino acid lysine and low in argininc.
Conversely, the average ptanr or vcgerable
food is much higher in arginine than Iysine.
The proporlioJls of rhese two viral amino
acds appear ro play a role in how our body
responds hormonaHy (O a meal. Proteins
rhar are low in arginine like rhose found in
animal producrs have been observed tO rai e
human cholesrerol levels, apparenrly
chrough scimularing inslllin producrion.78

Anima! Proteins Increase

eho/estero! Levels
Two renowned cholesrerol researchers,

K.K. Carroll and M.W Huff, have do ne

150

Average
cbolesterol,
mgldl 100

50

o
Figure 18

162

r----f-

Rabbits 00 plaotbased proteio

Rabbits 00 aoimalbased prote.io

cxtensive rese-arch on how differenr planr

and animal proteins affccr cholesrerollevels. In eheir research, rhey lJsed a "laboratorl' chow" diet thac was low in fat and had
absolutely 120 choLesteroL. The onll' item that
was varied from ooe subjcct ro the next was
rhe source of procein in cite chow, which
was from bodl animal and plant sources.
The animal protein was isolated from the
animal product aud added [O rhe chow, such
[hat rhe chow remained free of cholesrcrol.
r imagine alI the fare was indisringuislt-

THE CREAT MEAT AND PROTEIN MYTH

able and looked nondescripr-probably
similar ro dog food. No one could reasonably expecr humans ro accepr such a dier
for the fuI! four weeks of rhe srudy. The
researchers (Umed ro rhe New ZeaJand
whire laborarory rabbit an animal rhar has
dier and cholesreroJ re/arionships rhat are
similar ro humans. Each of I I specific arumal proteins and 10 specific planc protcins
were evaluared on 21 groups of five ro six
rabbits in each group for rhe emire four
week period.
The drecr on rhe blood cholcsrerollevels of rhese 100-plus rabbirs was remarkable, given rhar the diers had no cholesrcrol
and differed only in ther source ofpcorein.19
Figure 18 conrrasrs rhe average cholesrerol
Jevel for rabbirs on planr-derived proreins
wirh rhe cholesrerol Ievel of rhose on proreins from animal sources.
Note rhar on rhe planc prorein-based
chow their average blood cholesterol was
low, averaging 67 poims; however, on rhe
animal protein-based menu rheir cholesrerol
valllCS raJl markedJy higher ar 175. Remember, however, in rheir research rhere wcre
21 groups of rabbirs, wirh each group earing a protein from a differenr source. Figurc 19 delineares how blood cholesrerol values were affecred by differenr rypes of planc
prorein sou(ccs.
The average cholesrerollevel for rabbirs
earing animal protein (J 75) is shown for
compaflson.
Figure 20 provide a similar breakdown
for [hose an animal protein-based diers, wirh
ilie ave rage of rhe animals on rhe plant prorein diets shown for reference.
Note rhar rhe rabbits on animal proreins
had a range of cholesrerol leve/s of 101 tO
270, whereas the range of [hose an planc
proreins was 43 ro 96. The ranges did nor
overlap. C1early, subsrituring planc proeein
for animal prorein in the diee, regardLess of
which specific plant or animal loura is used,
would reduce elle risk of ali disease.s relaeed
ro high blood cholesterol.

Other Advantages o/Plant Protein

Orher advafleages of earing planc prorein are just now surfacing in nucrieional
resea.rch srudies. A recent seudy of women

TEN PLANT P OTEINS CAUSE

LOW CHOLESTEROL IN RABBITS
Ave. Animal Protein 175
Rapeseed Flour . . . . . . 96
Wheat Gluten

80

Peanut Protein

78

Dat Protein

76

Coltonseed Protein

75

Sesame Protein

63

Soy Protein holate

58
51

Sunflon'er Proteill
Pea Protein

46

Faba Bean Protein

43

50

100

150

200

250

300

Blood Cholesterol Level, mg/dl

Figure 19

TEN ANIMAL PROTEINS CAUSE

IDGH CHOLESTE OL IN RABBITS
Egg Yoke Proteill
Skim Milk Protein
Turkey Protein

lIiiiiiiiiiii~iii-ii-iiii i 270

.-----1111!1-.

215
225

Casei II

~-.

203

Whole Egg Prolein

Fish Protein
Beef Protei.D
Chicken Protein
Pork Protein
Raw Egg White

Ave. Plant Protein

._I!III_.

107

...

~.

101

~~67~
o

50

100

150

200

250

300

Blood Cholesterol Levcl, mg/dl

Figure 20

suffering from severe hor flashes was conducred. These uncomfortable episodes of
intense heae sensarion freqllcntly accompany rlle dropping esrrogen levels in menopausal women. le was demonseraeed iliar
eating 20 grams ofsoy proeein a day (eqllivalene ro a half-cup or 4.5 ounces of rofu) significancly rcdueed the severi'y of thei,. hot
flashes. 80 Thc stlldy's (ead researcher, Or.
Gregory Burke from Wake Foresr Universiry
and ehe Bowman Gray School of Medicine
in Nord) Carolina, believes the improvemem

163

PROOF POSITIVE

AMERICAN VS. CHINESE

BASIC FOUR DIET PLANS
American Basic Four
Milk
Meat
FruilS and Vegetables
Cereai GraillS

Chincsc Basic Four

Green Leafy Vegetables

.,

Soybean Products
Sweet Potatoes
Cereals

Figure 21

is due ro plaot estrogens in rhe so)' protein

which "may have the same beneficia! dTects
of e~rrogen, but may not have some of tlte
downside." These plam esrrogens do nor
seern ta increase che risk of uterine cancer
like cheiI' human and piU form counrerparrs.
Ali ohhe women eating the soy protein aho
experienced a beneficial "side efTect" of tl

significant drop in tlle totltl tind LDL dJOlesterol (l0 and Il percenr respeGive1y) wirh
no drop in their good HDL cholesterol during ilie six week sttldy.

CHINESE BASIC FOUR

PROTEIN CONTENT
BasicFour

Recommended daily
amollnt (g)

Profein
supplied (g)

Green leafy vegetables

500

Soybean producls

60
400

18

400

40

Sweet potatoes
Cereals
~

8
Total

Figure 22

164

71 grams

Protein in Growth and Development

The average age of menarche, rhe age
rhar gir1s begin ro have mensrruaJ periods,
seems ro be connecred wirh rhe amotlllt or
rype of protein thar is conStlmed in ch.ild
hood. For illsrance. severaJ years aga when
rhe Japanese were consuming a very low
me:lr and animal producr dier, rhe average
age of menarche wasl . 81 This cOlllpares
wirh the average age of menaI'che in rhe U.S.
ofless rhan 12.8 years ofage. 82. 83 Many
experrs believe rhar an early age of menarche
is a significanr risk facrar for the later developmeru of breasr and uterine cancer84
and may hdp expbjn why American women
have ovcr faur rimes the I'isk ofbreast cancer compared [O japanese women. 8 The
only srudy 1know of dur has compared ule
growrh of vegeearian ehildren with meatconsum ing children in the same geograph ic
arca showed rhar rhe meat-earing children
were slighcly raller than che vegerarians unt.il age ten. However, when both groups had
reached rhe age of 18. the vegerarians had
caughr up wirh and rhen smpassed (heir
meat eatng counrerparrs. being ar lea 'r an
inch raJler as aduJts. 86

USDA Basic Four Food Groups For

Proper Nutrition
The U. S. Departrnenr of AgricuJrure
published dierary recommendarions for
good lluuirion that srood for 40 years. They
divided rhe foods imo faur food groups
caUed rhe "Basic Four. " As a rhird grader, J
learned whac r "must eat" every day ta have
good healrh based an these food groups.
Contrary ro rhe USDA recommendatiolls,
che Chinese Medical Association recoOlmends four food groups rhat are in sharp
contrast. The Chinese approach ro nurririon is especiaJly imerestjng because China
has a very low illcidence of cancer, heart
djsease, diaberes, and many of the odler
degenerative diseases common in Western
socieries. The American and Chinese "basic faur" djets are compared in Figure 2).
Nore thar rhe Chinese ear rhree vegerable
caregories plus cereaJ grains. Animal producrs are conspicuous by cheir absence. In
clle U.S. basic faur lisr, rwo of the faur irems

THE CREAT MEAT AND PROTEIN MYTH

are animal products, while fruirs aod vegetables are dowoplayed by combin.ing r11em
.
.
11HO one [[em.
As we have seen in this chaprer, a vegerarian-based diet like the Chinese dier can
easily provide aH rhe prorein oeeded wirhout the use of animal products. lf we look
at rhe daily amoum of each food caregory
in rlle Chioese basic four recommenda(ions
we see fhat rhe protein comem is ample.
These daily amountS, along WirIl rIle prorein comem, are tabu Iared in Figure 22.
The 7I-gram total prorein exceeds r1le
U.S. recommended daily aJlowance of 56
grams.

us. Government Switches to Lower

Protein Recommendatioll
Why clid rhe American faur food groups
differ sa much from (hose of rhe Chinese?
The USDA recommendarions were nor
based on health 50 much as an American
cultural eating habits. It was nor umil very
recently that our governmellt undenook the
fask of producng new recommendarions
rhar shifted emphasis from nutrient deficiencies ro chronic diseases. Their new recommendarions reduced meat and diary consumptJon.
As expecred, rhe daicy and mear industries were disrurbed abolit rhis change and
pressured the governmem so heavily rhar rhe
new food gujde was wirhdrawn for monrhs
while the speciaJ interesr batcle raged. In
rile end, the mear and dairy indusrries succeeded in having rile wording changed from
"decrcase consumprion of meat" ro "have
rwo or three (daily) servings [of meat]."87
Excepr for rh is unforrunare alreratiol1, rhe
new (ood guide, which is in rhe form of a
pyramid, is an improvemenr over clle older
four-food groups. The chan is reprodllced
for Y0l! in Figure 23.
The foods shown ar rhe base of the pyeamid are ro be earen witil rhe great st fi'equency. This is based on healrh reasons,
not cultural reasons. Grains are abundant
in natural fooru. Mosr Western cOllnrries
have adopre<:! rhe pracrice of refining man)'
of rheir grains. However, we need ro car
Ulholl' f?:'tlin foods ro receive the maximum

beneflrs of fiber, viramins, and minerals.

Frurs and vegerables are rhe nexr carcgory.
Today rhere are numerous stlldies, O1any of
which arc: presenred in Ihis book, rhar clearl)'
indicat.e the procective benetlts of rhese
faods. Those who ear rhe mosr frllirs and
vegerables have the leasr amounr of cancer
and hearr disease. Unfonunarely, rhe average American has failed ro follow rhese pracrical recommendarions. L'uesr sllrveys indicate rhat mosr Americans ear an average

USDA FOOD GUIDE PYRAMID

Fats, oils, and sweets
Use sparingly

DairL

Meat, nuts, eggs

2-3 Svgs.

2-3 Svgs.

Fruit
2-4 Svgs.

Grains
6-11 Svgs.

Figura 23
of onl)' 3.4 servings of fruirs and vegcrables
per day, far from the 5 ro 9 rhe pyran:tid
recommends. 88
Meat.s, l1UtS, and eggs are now dassified
rogcther in the prorein group. However,
\Ve have seen (hat vegerable proreins (including legllmes) are by far rhe safest [orms of
prorein to consume. Dairy is also represen red probably because ofdai ry association
pressure. Bur soy milk, which 1S a substiture for cows milk, is now commonly available, and is cholcsreroI-free :lod low in far;
rhere are many flavors and varieries (Q
choose from. Ac the rop of rhe pyramid,
fars, ous, and sweers are lisred. We agree
",;irh rhe message of llsing [hese sparingJy.
In facr, rhe 1e.ss rhe benCf.
What would be the re.sulr if Americans
followed rhe full recommendations of the
bonom half of rhe food guide pyramid by

165

PROOF POSITIVE

GRAMS OF PROTEIN CONTENT

PER 100 CALORIES
Plant Source
Apple
Banana
Orangc
Baked potato
Brown riee
Corn, frozen
Whole wheat
Cabbage
Chickpeas
Pinto bea ilS

~ro.t~.in(g) Animal SOllrce

0.5
I
2

2
2
4

Pl'otein(g)
5

Whole miJk
American cheese

al

I'ork/ham

6
8
10

Nonfat skim milk

10

Whole egg

Beefrump

II

Pink salmon, calloed

14

5
6

Chicken breast

15

Tuna, canned

22

Figure 24

ommenda[ions? It wOllld drop dramarically

lO a sa fer level, becallse animal prodllCls
would have a smaller parc in our dier. Ta
consume a given amOllllt of calories each
day by using a large amoum ofanimal foods.
a person would have a high inlake of pro[ein. This is simply because the nllmber of
grams of protein in anjmal foods is high in
relaljon lO fhe calories they comain. Conversely, consuming ehe same number of
calories by eating a Iarge amOllnt of planr
foods wOllld result in a lower prolein inlake, becallse plant foods comain less grams
of prolein for a given number of calories.
A comparison of planr and animal foods in
lhis regard is tablliared iJ1 Figure 24. 89
We see rhar plam sOllrces of food are
generally mllch 10we1' in prolein for a given
calorie comene than animal SOllfces.
For those rcaelers who desire to know
the percent of calories from protein in [he
foocls listeel, mllltiply the vaJues by four.

Basic Four Diet Based on lnformation

/rom this Chapter
If we were ro COnSr.Illct aur own recommended food groups baseel on the informa(ion shared in d1S chaprer, we could serve
lhe callse of health well WiUl a simple four
fooel grollp plan. This basic faur plan is
shown in Figure 25.
[fwe were ro subssr wholly on lhese faur
food groups, we could prevent a whole host
of diseases, improve both our quafity arid
quantity oflife, anei make a hllge difference
n [he hcalrh of lhe emire Wesrern \Vorld.

lnspired lnsights

Figure 25

166

earing Il servings of grains, 5 servings of

vegelables, 4 servings of fruit, and 3 servings of lllHS each day? Obviollsly, there
would not b much room left for the undesirable items listed at lhe rop pOliion of dle
pyramid. And that is precisely rhe point.
Whar wOllld happen ro rhe level of pro[ein imake if we followed [he pyramid rec-

If you believe in the Bible as Ido, you

will bc fascinated as you read lhe seclions
in the book of Genesi [har have a bearing
on elier anei longevicy. [n the days of our
earliese ancestofs, the eliel \Vas wholl)' vegcrarian, no dOllbr including a wide variecy
of fruirs, vegetables, grains, and I1U[s.90 In
Genesis, chaprer njne, lhe elier changed
ralher dramarically. Meal and animal produers were aeldeel. Forrunatdy, the Bible also
records rhe life span of inelivieluals represeming ten generatjons before meat earing
anei ule nexr len generarions after mear was

THE CREAT MEAT AND PROTEIN MYrH

ilHroduced. A human longeviry Cl1rve plot
ofBible charaeters is shown in Figure 26.
We see thar rhose living in the first ten
generations on a vegetarian diet lived an
average of about 900 years. After meat and
animal produces carne inro the diet, a life
span of 600 years is recorded, ehen several
ar abom 450 years. The steady decline conrinued uncil reaching ehe "ehree score and
ren" (70) level stated in Psalms.
The essence of ehis biblical account was
reiterated in the 1800s by Ellen White.
Over 100 years ago, White wrate: "the liability to take disease is increased ten-fold
by meat eating."91 In the 1800s vegetarianism had noe gained (he populariey thac it
has roday. Toclay, however, we know with
eereainty th;u meat eating does increase rhe
risk of a nost of degeneracive diseases.

Conclusion
Te is high timewesee aside tlte greac mear
and proeein myth. Preoccupation wim meat
and ies proeein raeher chan improving
healrh, has comributed (Q mally degeneracive diseases such as hearr disease, cancer,

LIFESPAN mSTO YOFMAN

Longevlly,
~'cars

900

'JU 'Il !NS 910 ii.

. ,'"

(Genesis 5 and 11)

9,.

800
700

.lOO

100

1001-iJlH'flHI!l

F100d

1000 B.C.

Figure 26
osteoporosis, kidney failure, and kidney
seones. Plant sources of nutrieion are generally modese in protein and reasonable in fat
coocentj furchermore, ehey never contajn
any cltolesterol. Wirh our growiJlg underst:lnding of protein physiology, a planrbased diee has emerged as the optimal way
to ear for chose interested in maximizing
longevity and the quality ofliving.

PhiJade.lpnia, PA: Lea and Fehiger, 1988 p. 29.

RefermcesJ

Am Din Assoc 1966 Jan;48(I):25-28.

11 J-1ardillge MG, Cmok> H, Stare FJ. Nurririona1 seud.ies of vegerarians. )

Am Diel Assoc 1966 Jan;48( 1):25-28.

Campbcll TC Mliscling Out rhe meat myrh. New Ci:mury Nutrilioll

1996 Jul;2U):1-2.

12 BeJl G. lb:lbook ofl'byrio!ogy and Bioclmnistry--4iJ' l,dilion. Baltimore.

MD: WilLiallls aud Wilkins. 1959 p. 167-170.

) Campbell Te. Musclillg OUl lhe. mear Ill)'lh. New Century N/IIrition
1996 JlIl;2(7): 1-2.

I PositiOIl of t!le American Dieleric Associatioll: vcgctari,\11 diet.~-rechlli

cal suPPOrt paper. J Am Din Assoc 1988 Mar;88(3):3S2-3S5.

, Campbdl Te. Musding Olll rhe meal m)'lh. New Cmmry Nlllririoll
1996 Jul;2(7): 1-2.
l

I~ Munro H , Crim Me. The proteins and :lIniIlO acids. In: Shils ME,
Young VR, eclilOrs. !viodem Nur,.ilion il! fI,'a!lb and Diseau-7lh ttiilio1/.
Philadelphia, I>A: tea and Febiger, 1988 p. 30.

15 Munro J-11 , Crim Me. The proteins :\I\d amino acid. In: Shils ME,
Young VR, edilOrs. Modem Nttt,.iliol! ill Hcallh and Distt1se-7Ih edilioJl.
l'biladelphia, PA: Lea and Febiger, 1988 p. 30.

1 Hardinge MG, Crooks H, St:uc FJ. NlIrritional sllldies of vegerarians.

2

Munro HN, Crim MC The proleins and :unino acids. In: Shils ME.
Young VR, edilOr8. Modern N/II,.itioll in Hen"b ami DiSftut--1llJ edilion.
Ph.iladelphia. PA: Lea and Febiger. 1988 p. l.

P,.ouil1: Mish EC Ed.ilor in Chief. Merrif1JIl-V?l'b5ters Collegillfc Dicrio-

11II1J-1fY' cdilion. Springl1e1d, MA: Merci, m-Wcbster, Iocorporated. 1994.

p.938.
Munro H . Crim MC The proteins and amino acids. In: Shj)s ME,
Young VR, edirors. Modem Nurrition in Health Imd DisclIse-7th rdilioll.
Ph;ladclphi,\. PA Lea and Febiger, 1')88 p. 1.

Torun B. Scrimshaw NS, Young VR. Effcct of isornctric c.xerci.es ou

bod}' pOlassillm :1.nd dierary protein requiren1elll of )'oung mell . .Am J
CIi" Nllir 1977 Dcc;30(12):1983-1993.
Munro J-lN, Crim MC The pcolcins and amino acids. In: Shils ME,
YOllllg VR,. cdilOrs. !vIodan Nutrilioll in Heo!Jh and DiullSr-7lb Niitiorl.
Philadelphia, PA: Lea Jud Febiger, 1')88 p. 1-2.

.0 MlInro HN. Crim MC The protc.ill, and amil\o acids. III: Sltils ME,
YOllng VR, edilors. Modern Nutrition in Hellllll mul Disellsr-lllJ etlition.

16 The Food Proccssor for Windows: Nurrition Analysi, & Fitness Soft
\Vare [computer program]. ESHA Rese,\rch. Salem, Oregon.

17 Messina M, Mcssina V. SClcheU KD. Thl' Simp!l' Soybean And

Hl"l!tJJ. GJrden Ciry Park, NY: Aver)' Puhlishjng Group, 1994 p. 24.

y,,,,,.

18 World Health Organization (WHO). The World flcaltb Reporl 1995:

B,.idgillg ilu Gllpl. Geneva, Swi=rbnd: World HcaJlh Organz.uion, 1995.
19 US Preventive Services 1ask Force. Scrcening for Posullellopausal Osleoporo.;s. In: G11ide la CiiniclI! Pre/JtnJivc SfTlli(fs. Baltimore. MD: Willi,uns and Wilkim, 1996 p. 509-516.

US Preventive Serviccs 1,. k Force. Screeni ng for POSI menopausal Osreoporo.is. In: Guide 10 Ci;',i,," Prrvmlillr Srrvias. Baltimore, MD: \X'i1liams and WiJJns, 1996 p. 509516.
20

167

PROOF POSITIVE
II Cel1lcrs (or Diseasc Comrol and PtCVelllon (CDC).
Incidence and
COStS to Medicare of fractures among Meditare beneficiaries aged 365
years-Unitcd States, July 1991-Jul1c 1992 .MMWR 1996 OCI
18;45(41 ):877-883.

US Prn-clltjve ServiC~"5 Task Forcc. Screcning lor Postmcnopausal Osrcoporosis. In: C/litie /0 C/iniml P""IOlliveS,""viaf. Ballimorc. MD: \Xlilliam and Wilki ns. 1996 p. 509-5 I 6.

45

Johnson NE, Alcallt,tra E ,Linkswiler H. EfTeCl of level of prolein

inrake 011 urinary and !cca.l caJciul\1 and calcium rClenrion of yOllng adulr
males. ) NIItr 1970 Dcc;100(l2):1425-1430.

Unilcd States Deparullem ofAgriculnllc Agriculmr:J Research Service.

N/ltriml Commt ofrlJe U.S. Food StlPPOI 1909-1990. Home Economic
Rcst.":lrch Reporl No. 52. Sepeember 1994 p.53.

14

2; Linkswiler HM, Zemd MB. ee al. Prorcin-induced h)'peecakiuria.

hd

Proc 1981 Jul:40(9):2429-2433.

26
Hegstcd OM. Ca!cillm and osreoporosis.
Nov: 1/6(11):2316-2319.

} N"l/' 1986

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Nestle M, Food lobbics, the food pyrarnid. and U,S. nUlritioll poli }'.

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Gellcsis 1:29,3: 17. The Hol)' Bib/~. Authorized King Jamcs vcrsion.

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Herald Publishing Assoeiation, 1938 p. 386.

Sa.nchez A. HlIbbard RW. er al. Testing a mL'chanism of control in

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73

169

PROOF POSITIVE

170

CHAPTER EIGHT _

BITTER

VES:

The Sugar
and Diabetes Story

he called the Lifescyle Cencer of

America desperately for help.
Thirty years of diaheces had caken a
cremendous roll an her healeh. The
high blood sugars hd done their work silenrly for years, but now the biner harvesr
was undelliably obvious. Jenoy had kidney
failure and resulting fluid accumularion. Of
more concern to her, however, was rhac she
was going blind. Her vision had been gecring progressively worse, and dle docrors had
given her no hope. Wirh those discouraging prospcctS ahead she became excired as
she heard about a lifescyle approach toward
reversing the effects of diabeces.
The Lifescyle Cemcr ofAmerica, a place
in Oklahoma thac provides a three week
rherapy live-in program, is nor unique in
offering a program to reverse the ravages of
diaberes. J have been giving my patienrs
similar information for years and have seen
some of rhe same dramatic resulrs thar the
live-in centers achieve: people decreasiog or
gening ofTinsulin and oral medications with
a lifesryle approach ro chis killer disease.
Sadly, however, there are many people like
Jenoy who come to me wirh advanced diaberes. In many of dl.Ose cases we are not
able [Q "cum back rhe clock" and resrore
rheir vision or their kidney function. Yes,
we may be able ro provide some help in

rhose areas, but onen the severe damage rhat

has already been done is beyond the point
of complere reversal.
Whar is tragic is rllac ic ofcen rakes irreversible complications before people really
ger serious abOLit doing ali they can ro control their diabcres. By rhen it is roo late ro
accomplish aH we could have if rhey had
goncn seriolls years earlier. The cases of a
thollsand Jennys eloquently proclaim: diaberes needs to be prompcly recognized and
treated. MaJly newly diagnosed diabericsas well as those srruggling wirh the disease
for longer periods of rime-----ea.n control rheir
diaberes wirhollf drugs by following an exceHem lifescyle. Do nor wait umil a heafr
auack, ar ampuracion, or blindness serves
as a wakc lip cali. Thc wake up c~1I should
be mar first "borderline blood sugar"-the
slighresI slIggestion of diabcrcs.
In rhis chapter we will look ar important information about diagnosing and dealing wirh diabetes. Even if you do not have
diabetes, you wiJl want ro give special acrenrion ro the closing secrions of rhis chaprer; rhere 1 focLiS on ilie dangers of earing
sugar even for rhose who have no problem
wich diaberes. You will learn abolit rhe effecrs ofsugar on the immune syscem, its rale
in weghr gain, and omer fascinating areas.
Also in dus chaprer I comrast sugar wirh its

171

PROOF POSITIVE

DIABETES IN AMERICA
-THEFACTS Approximately 16,000,000 Americans are diabetic
(50% are unaware).
About 625,000 new cases are diagnosed per year.
Over 6% of tbose 45 - 64 years old and as many
as 20% of those over 65 have diabetes.
Total costs may be as high
as 90 to 130 billion
dollars per year.
Figure 1

AFFLICTIONS OF DIABETES
Life expectancy is sbortened by 5 to 10 years or more
It contributes to 160,000 deaths eacb year
Two to twelve times the risk for heart disease
Two to four times the risk of stroke
Number one cause of blind ness in adults
with 12,000 to 24,000 new cases annually
A factor in half of aII foot and leg amputations
Over 60,000 amputations yearly in diabetics
In any given year, over 50,000 diabetics are either
on dialysis, or have had a kidney transplant (due
to diabetic nepbropathy)
Cause of peripheral neuropathy
Increased risk of breast and uterine cancers
Figure 2

two carbobydrare cousins: complex carbohydrares and fiber. We willlook ar some of

rhe exciting bcnehrs of these more healrhfui carbohydrares.

What Exactly is Diabetes?

172

Diaberes mellirus or "sugar diabetes" is

a condition where an abnormal response ro
insulin and/or inadequare insulin producrion causes high blood sugar levels. This is

lIsual1y deflned by a fasting b100d sugar of

greater rhan 125 on two occasions,) or a
positive glucose rolerance rest (rhe individual drinks a specified amOunt of glucose,
usually 75 grams and rheir blood sugars are
evaluated over a rwo hour period). Over
rime, these high blood sugar levels and rhe
orher metabolic chal1ges thar go aJong with
diabetes are exrremely taxing on rhe body.
Consequemly, diaberes dramatically increases one's risk of dearh and disability.
Current staristics are sobering. In
America [here arc now duee rimes as many
diabeties as there were .in 1958. 2 Estimates
are that some 16 million Americans now
have this condirion, up from Il million as
recenr as 1983. DepeJ1ding on rheir type
of diabetes and orher characrerisrics, rhey
run aJlywhere from 2 ro J 2 times rhe risk of
death when compared ro theil' non-diabetic
peers. 3 Diabetes increases the risk of hean
disease and other diseases l'e1ated ro amerosclerosis such as srroke ar rhe loss of an arm
01' leg from blood vessel blockage. Diaberes also dramaric.1l1y iocreases one's chance
of infeetions, kidney failure, and an eye disease called retinopad1Y, which can resuh in
blindness. The number of people in the
U.S. rhat are affiictcd bv diaberes is shown
in Figure 1. 4
'
The rnyriad ofaffiiccion . rhat result from
diabetes is lisred in Figure 2. ),6.7.8.9
Although hearr disease is the leading
cause ofdearh among diabetics, 10 somerimes
rhe debjliraring efTecrs ofblndness and kidney disease are more frightetting. Wirhin
onIy seven yeaJ's of diagnosis, as man)' as 50
percenr of children with daberes have developed diaberic retiJlopathy, a disease of the
e)'es rhar can result in blind ness. 1I Diabeties Jleed ro ger checked by eye docrors regularly. Diabetic eye disease is prevenrable,
nor only thl'Ough Iifesryle, bur also byearl)'
rreatmenr. Furthermore, diaberics run a
significanc risk ofdeveloping kidney disease.
In any given yeal' some 55,000 Americans
are suffering wth what is caJled "end-srage
renal disease" due ro their diaberes. 1. 13
These ndividuals have such poor kidney
funcrion rhar they al'e alive only by vrrue
ofa transplant or regular dialysis treaunenrs.
End-srage renal disease arnong diabetics is

SWEET TOOTH, BlTTER HARVEST

increasing dramaricaUy in the Unired Stares.
Whereas 5.000 new cases were being diagnosed per year in rhe early 1980s, a decade
!ater the ftgure had jumped co 18,000 new
cases per year. 14 In f.'Ier. over 35 percenr of
aII patients with elld-stage kidney disease
are diabetic. 15 Diabetic women arc also
more prone co develop breast and uterine
cancer. 16
No doi Iar amount can eclipse the thousands of personal tragedies duc ro diaberic
complications.
everrheless, in a llarion
where health care costs are skyrocketing, the
flnancial impact ofdiabete5 is rruly relevant.
The direct and indirect cost ro sociery for
diabetes is esrimared ro be berween 90 and
130 billion dollars per year in America
alone. 17

Al! Diabetics Are Not the Same

Diaberics are ofren divided inro four
c.1regories. Of rhese four caregories, rhere
are actually rwo main types of diabetes: inslllin-dependem diabetes mellirus (IDDM).
often refened ro as Type 1, and non-insulin-dependent diabetes me1lirus (NIDDM).
otl:en designated Type ll.18 A1though some
diabetcs purisrs will rake pains ro usc the
terms IDDM and NIDDM, in rhis chapter I will use rhe rerms Type I and Type II.
A r!lird rype ofdiabetes OCCllrs in pregnancy
and is called gestational diaberes mellirus.
Tbe fourrb cacegory of diabeces takes in a
hosr of rarer callses of rhe disorder such as
those duc ro hormonal abnormalities ar
ocher medical condirions.
Typc 1 diaberes is rhe most severe form
of rhe disease. It rypiC.111y occurs in childhood (bur can develop at any age) and for
rhis reason was previously caJJed "juveniJe
diabetes." The most common c.1use of Type
I eliabetes is destrucrion of che insuJin-making cells in the pancreas by the person's own
immune sysrem. This is referred ro as "auroimmllne destrucrion." The specific facrors rhar rrigger this auroimmune process
have proved e1usive. AJtbough some cases
have been linked ro viruse.s or chemical roxins, much is sriH unknown abollr the beginnings of rhe Type 1 diabetes process. 19
There does seem ro be a generic suscepribiliry ro the disease, plus an envllonmental

factor thar rriggers the disease process. Sorne

of rhe most imeresring recent research links
some cases ofType 1 diabete.s ro an abnormal immune reaction ro milk procein. We
now know dl;1t children who are breasr feci
[ar a shoner rime or who are sr.<lrted on cow's
milk earlier have an increased risk for rbis rype
of diabercs. 20 In fact, the drinking of cow's
milk may be the rrigger dut iniriares rhe
disease in over half of aII Type I diabetics. 21
Regardless of rhe cause of rheir Type I
diabetes, ,tffected individuals Iose their abiliry ro make adequate amOllnrs ofinslllin and
are lefc with an absolute life-and-death need
for inslliin shors. Wirhout those shor$, rhey
go iota a conditian called diaberic keroacidosis, which is faral ifnor promptly ncared.
Bec.111se of their absolure need for illSulin.
individuals wirll Type 1 diabetes are lIsually
diagnosed early in the disease process. Typically rhey have symproms like excessive uri
nation (polyuria), excessive rhirsr (polydipsia), excessive hllnger. al1d excessive earing
(polyphagia). They ohen are also bothered
by farigue anei weight loss.
Why does ehe T}'Pe 1 diabetic develop
these symproms? The answer is best arrived
ar rhrough a brief revie\.... ofsome of ilie main
facrs about blood sugar and how it is conrrollcd. The main fuel for our bodies is a
simple sugar called glucose. There is a poreorial problem, however, wirh rhis fuel
source. It can on.!y get inro each cell of the
body if inslllin is presenr. Some have compared insulin ro a key ehat opens "rhe doors"
in body cells so rhar rhe vital fuel, glucose,
can get inro rhe ceL!. However. il tllere is an
nsufficient amOl1m of insulin (as in Type I
diaberes) or if rhe locks on che doors are
"gulluned up" sa thar the insulin key has
difficulty opening rhem (as Glt1 occur wirh
(he insulin resistance ofType rr diabetes),
then blood sugar levels can rise. When
blood sugar leve\s rise sllfficienrly. rhe ability ofthe kidney ro comain rhe sugar is overwhelmed, and sugar comes our in rhe uri ne.
The sugar takes water with it, thus leading
ro rhe excessive urinaeion so familiar in uncolltrolled diabetes. The loss of water reSlJts in anorher diabetes symprom: increased
rhirsr. Ar rhe same rime, sugar is not moving into the body's celIs adequately. In a

PROOF POSITfVE

174

sense, che body's cells are srarving for energy. This can cause fatigue, weight los5,
and excessive hunger.
Forrunately, only abolit 5 ro 10 percenr
of diaberics in America fali under rhe 'fype
1 diabetes category.22 The remainder are
Type II diabetics. These individuals eirher
have a problcm called "insulin resistance"
or a less severe underproducrion of insulin
than rhose with the Type 1 varicry. In actualiry, mosr fully developed Type II diabcrics
have boch of these problems. 23 There appear ro be many differenr causes ofType II
diabercs; rnost seern lO have a generic basis.
The majoriry of individuals wirh chis rype
of diaberes have a family member that had
also been diagnosed with rhe disease. For
cxample, many NativeAmericans have rllis
genetic rendency; howevcr, it appears rhey
did nor have diabetes umil rhey adopred a
Western dier wirh an overabundance of
sugar and far. Simply pur, ir usually t;\kes a
combination of MO facrors (O develop adult
onset diabetes. One is genetics, and rhe
orher is a poor dier-like rhar consumed
by rhe average American.
Many individuaIs wirh Type II diaberes
generate plenry of insulin but their body is
resisranr ro ir. This cond it ion of illsulin
resistance can be addressed by lifestyle
changes. By maintaining an exceiient diet,
achieving an ideal weight, and embarking
on an exercise program, many Type Il diabetics can control their blood sugars with
rhese lifesryle changcs alone. Some may
need diet changes plus a pili ta help control
cheir blood sugar.
Because of the more subrle narure of
Type Il diabetes compared ro Type 1, it often goes undiagnosed. A person with Type
II diabetes may not have any of the classic
diabetes signs like excessive urinat ion, cxcessive thirst, excessive hunger. farigue, or
weight loss. Ar any poinr in rime, it is estimared thar fully 50 percenc ofType Il diabetics have not yer been diagnosed. 24 Of
course, unrecogrlized diabetes still does irs
damage steadily and slenrly. Abolit 20 percenr of newly diagnosed Type II diaberics
already had damage to rheir eyes (retinopathy).25 Sometimes an unsuspecring person
will be told rhey have diabetes when a rou-

tine blood screen ing reveaIs Iligh blood

sugar. If the blood sugar is above 125 after
an overnighr fast, it indicates diaberes. 1ndividuaIs caJ) have diabetes, however, wirh
fasring blood sugars below rhar leveI. If a
doctor suspecrs diabetes in a person with a
relarively low fasting sugar, further testing
can be dane. The oral glucose tolerance test
checks for diabetes by measuring a person's
blood sugar response tO a sugary beverage.
Pregnanr women routinely have such a test
ro make sure chey are not diabetic. Some
doccors recommend that orhers in the general popularion should have a glucose (01erance test. Depending on rhe physician,
some will recommend the test for those wirh
significanc obesity and/or genetics. Others
advise the g1ucose colerance test in anyone
with fasting sugars higher than a certain
level. Sorne will check ali those Wir11 fasting sugars over 105; some very conservative
docrors will advise the test ro ali their patiems who have fasting sugars consisrenrly
over 95, since th.is usually indicates dur at
least the individual has rhe gene for Type II
diabetes. A glycosylated hemoglobin level
(discussed later in rhe chapter) may be able
ro substirute for che glucose rolerance test
in derecring diabetics wirh fasring blood
sugars less man 125. 26
AJrhough Type fI diabetes can be picked
up by suell blood tem for e1evated sugar,
mauy Americans do nor seek out health
professionals for sucb preventive services.
They wait umil rhey are sick. This is unforrunare. As a resule, many Type II diaberics only become aware of their disease
when r11ey experience potenrially irrevcrsible problems like eye ar kidney disease,
nerve problcms, or a heart attack.
Regarding gesrationaI diabercs, two to
five percenr of ali pregnanr American
women are affecredY This rranslares into
abour 200,000 children being born ro
mothers with gestational diabetes each
year. 28 , 29 Th.is is signific<lnt, because rhose
children experience an increased risk of
healrh disorders such as birth rrauma.lower
blood sugars ar birth (neonaraJ hypoglycemia), and even premature death in infancy
(peri natal morraIiry).30 The message is clear:
ifyou are a diabecic who becomes pregnant.

SWEET TOOTH, BITTER HARVEST

or if you develop gestational diabetes, you
should have yom blood sugar monitored
closely. Your diet and lifestyle need ta be
well regulated. Furrhermore, any woman
who develops gestationa1 diabetes has a genetic rendency for diabetes. She is at high
risk ro develop fuB blown diabetes later in
life. 31 Pracricin&..healthy habits rhroughout her life span mus becomes critica1.

Control/ing Diabetes: Can the Ravages ofDiabetes be Prevented?

Recently, a landmark Diabetes Control
and ComplicadonsTriaI (DCCT) was completed. Thjs six-year study looked at 1441
Type 1 juvenile diabetics. Those diabetics
who strove ro keep their blood sugars as clase
to normal as possible (using insulin and
lifesryle ch:mges) had 76 pereenc less chanee
of developing diabetie retinopathy, a serious eye diseaseY They also experienced 54
percent fewer cases of significant kidney
disease and 60 percenr fewer cases of nerve
problems involving the hands and/or feet
(peripheral neuropathy).33 The participancs
also significandy lowered ther blood ehoIesrerollevels, suggesting rhat right control
could decrease heart disease risk by up ta
35 perccnr. 34 These improvemencs are summarized in Figure 3.
Diabetics in this smdy who keep their
sugars as c10se co normal as possible are said
ro be praericing "intensive therapy" or "tight
control." Trus begs a question: in the rese.arch JUSt referred ro, exaerly how intensive was "jncensive" (or how tight was "tight
COnt ro]")? The DCCT had very clear blood
sugar goals. Fasting blood sugars in the
morning as weU as blood sugars before each
meal were ro be between 70 to 120. Aftermeal levels were to sray below 180. Furthermore, a middJe-of-rhe-night sugar at 3
AM was ro stay above 65. To find out how
weB the participants were adhering to rhese
goals, an addirional blood rest called
glycosylated hemoglobi.ll was taken regularly. This test measures rhe amount ofsugar
that becomes attached to a person's red
blood eells. The amount of attached sugar
in turn is directly related ro the average
amouor of sugar in the blood throughout

the life span of the red blood ceUs. SiJlce

red blood cells rypicaHy live for 90 ta 100
days, the glycosylated hemoglobin value
gives an approximation as to the average
blood sugar level over a three-month period.
In tbe DCCT smdy, levels were aboUI 6.05
percem. This compares favorably with a
value of 7.5 percenr, which is considered
the upper limit of normal in a non-diabetic
population. 35
How does intensive therapy differ from
the standard or conventional way of treating diabetes~ First, intensive therapy always
refers ro r.reatment using insu.lin. Second,

RESULTS OF BLOOD SUGAR

CONTROL FOR TYPE 1 DIABETICS
760/0 reduction in diabetic retinopathy
54 % reduction in significant kidney disease

,o%

Ireduction in peripheral neuropathy

350/0 decrease in cardiovascular risk

Figure 3

with intensive therapy there are no flxed

doses of insu.lin. For example, a diabctic
on this rype of program does not take a fl.Xed
amount of insulin every morning. The
amount of insulin is adjusted according ro
the level of blood sugar at ehe time tlte insulin is given. This differs from the old way
of giving insulin (hat is stiH called a "conventional fixed dose program. "36 That approach assumed rhat insulin requirements
would be the same each day. In fact, we
now know t.hat insu.lin needs can vary tremendously from day ro day. This knowledge ofcbanging insulin needs provides the
rationale for intensive eherapy.
Intensive insulin therapy attempts [Q
artificially simulare how aur bodies' insulin-

175

PROOF POSITIVE

L76

producing organ, the pancreas, works: rbe

pancreas consrantly secrere.~ insulin inra {he
blood so thar mere is always some insulin
presenr. This is whar is called the basa.! insuJin Ievel. The pancreas aho secretes exua
insllJjn in response ro rhe food we earY To
reproduce rhis effea of basaJ insuJill some
diabeties \viJluse a 10ng-acring insulin shor,
while orhers willuse an insulin pllmp (har
works continllollsly ro deliver rhis basal nsulin level. To reproduce rhe food-relared
insulin surge, wherher on shots or on rhe
pump, addirional regular inslllin or a new
shon-acring insulin (Humalog) is given. If
the shor method is used, ar leasr rhree shots
per elay are given on rhe intensive insuun
program. To evaluare rhe body's needs for
insulin, frequenr blood sugar monitoring is
necessary. Blond is obtained for this purpose by prick.ing d1e f1nger wirh a smaJl
needle-like insrrumenr caUed a lancer. Then
this blood is anaJyzed by a home sugarmoniroring device. The diaberic who is on
an intensve schedule lIsua.!l)' pricks his or
her finger a minimum of four times and an
ideal of seven rimes per day: before each
mea.! and ar bedrime, plus ideallyan hour
afrer each meaP8
Alrhough tighr conrrol makes a profoune! difference for rhe Type 1 diaberic, it
is a much more cumbersome and expensive
process in the shorr run. Many have felt
thar rhe DCCT resulrs could be extended
ro apply (Q Type II diabe:rics; rhis inrerprerarian is nor based 011 any facrs obrained
from dlar seudy.
In my opinion, we should noe be roo
qllick ro try ro rigorously control dle blood
sllgars of a Type II diaberic wrh an inrensive insulin program. In addition ro the
time, expense, aod discomforr involved in
finger pricks and mllhjple injeetions, rhere
are even lllore pressing coneerns. Before we
look ac those concerns, some words of exphHlation are in order. Although Type 11
diabetics are called "non-iJlslIlin dependent," remember, this simply means that
rhey do not have a life or deadl need for
insulin shots. Man)' docrors nonerheless put
these individuals on insulin to bener conuol rheir bloodsllgars. In faCt, rhe National
lnscirutes of Health indicate thar 50 per-

cent ofknown Type II diabeucs in America

are eirher using insulin alone OI' insulin in
combination with oral medjcarions. 39 This
grearly confuses many in lay cirdes. They
erroneoLlsly think rhar jusr because someone is on insLllin, the)' are a Type I diaberic.
More ofren rhan nor, a diabetic who is on
illslliin has the Type II variery. Afeer aU,
esrimares are char rhere al'e over 3.5 miII ion
inslILin-usng Type II diaberies in aur narion. This compares wirh only 800,000
ype I diabeues in rotaJ:1O Now rhar we have
paused ro recognize rhat many Type II diaberics L1se insulin, we need ro look ar one of
rhe most worrisome problems wirh rhis
practice. It is whar I caB "rhe vicious cycle
of insulin use." The cyele begins with a 50bering face: usjng nsuJin aggressively srimulares weighr gain. In the DCCT, rhe average participanr 01.1 rhe inrensive program
weghed 10 pounds more rhan the control
subjects after 5 years.'lI This is ('speciali,.
ominolls for rhe Type II diaberic. Type I
diaberies are oftel) rhinner and more resistanc ro weiglu gain relative ro the Type Ils.
However, some rend ro gain weighr afree rhe
onser. of rhe disease. Type Ils ofren have
overweight problems ar. rhe onser of diabefes, and experience further weight gain as
the disease progresses.
In my medical experience when 1 am
asked ro see a Type II diabcric who has been
placed on insulin ro rry ro improve blood
sugar control, T generalIy expect rhem ro
have gained a signiflcanr amollnt of weghr.
Thjs inrroduces rhe nexr part of that vicious
cycle. Weight gain conrribures ro the Type
II diabetic's resisrance ro the effects of insulin; t1ms, as weighr increases so do nsulin
necds. The cycle comes full circle when
insulin dosages are furmer increased, only
to srimulare funller weiglu gajn. The significance of this dilemma has been appreciared by the Narional lnsrirures of Healrh.
Because of rhe tendency of intensive inslllin therapy ro promote weighr gain, rhcy
have srared, "Intensive rreatmem may not
be appropriate for dlaberies who are 'overweighr,"42 which includes mosr Type II diabetcs.
The tighr control of diaberes with insulin also introduces orher problems. The

SWEET TOOTH, BITfER HARVEST

DCCT srudy parricipants ran a much
higher risk of low blood sugar (hypoglycemic) reactions rhan those who were nor
pracricing imensive eherapy. Alrhough hypoglycemia is usually no more ehan a physically uncomforcable inconvenience, severe
re~1.ctioJls can actually be life threarening.
At chis poim, someone may poun out:
yes, rhere are problems wich insulin therapy
for the Type II diabetic, but is ic possible
for these individuals ro keep cheir blood
sugars in an ideaJ range by using oral medication-wthollr ali the ftnger sccks and
insulin? It is true rhac early in the COUfse of
ilie disease it is often possible for a Type II
diaberjc ro use medicarion ro oprimaJly control their sugars. However, over rime, ilie
oral medicatioJls ofcen become insufficiem
ro keep blood sllgars in c.he righr control
range demanded by imensive rreaemen.L
Even if blood sllgars can be cOlurolled
with pills by mouth, this does nor prove rhe
wisdom of using rhem. Although 1 do lIse
oral medicarions in some of m)' diabetc
patiems, rhe practice is parr of one of the
longest sranding controversies in medici ne.
The main drugs that continue ro be used
for blood sugar comrol belong ro a class
called the slilfonylureas. Common drugs
in this family include DiaBet,;t, Micronase,
Glucocrol, Glynase, Amaryl and Diabinese.
Today, if you look up any of rhese drugs in
the Physician's Desk Reference, you will (ind
a warning in bold prim encided "Specia]
warning on increased risk of cardiovascular
mortaliry."43 Thac warning goes on ro explain the findings of a study published back
in 1970 by whar. was called the Universiry
Group Diabetes Program (UGDP). Researehers found chat diaberics who rook
tolburamide, an oral pili used in ehe seudy,
had more than dOlJble the risk ofdying from
heart disease as iliose who treaced their diaberes with diee aJone. Today, some urge thar
the drugs in this family are vastly differenr
now than the tolbllramide of the 1960s.
However, ilie FDA still requires [hac even
ilie newest drugs in rhis class carry a bold
prillr warning ehae reads, "A1though only
one drug in rhe slllfonylurea c1ass (rolburamide) was included in chis [UGDP] sClldy,
ie is prudent from a safery standpoint ro

consider thar dus warning may also apply

ro orher oral hypoglycemic drugs in this
class, in view of rheir c10se similaricies in
mode of acrion and chemical srrucUlre."
Some of the newer medications for diabetes such as Precose, Glucophage, and
Rezulin are not in rhe same c1ass and have
differing mechanisms of aerion. Thus they
may be less likely ta increase tlle risk ofheart
disease, although [hey have not been on the
markec long enough ro make afirm derermination in this regard.
My concllJsion, based an published
medical research and my personal experience, is that careful blood sugaf conrrol is
important in Type II diaberics. However,
rhe use of inslilin and ora.! agents in rhese
individuals carries che potential ro do more
harm ehan good. Thus, {he mose important quesrion iJl my mind always is: how
can I help myType II diabetic patients concroi their sugars withour drllgs? Slich an
approach scands co reduce the eomplicacions
of high blood sligars whiLe decreasing the
risk of problellls from rrearmenr.

Non-Drug Approach Brings

Startling Results
Man)' seem to think rhat using a nondrug approach would increase the risk of
diabetic complicarions and decrease the likelihood ofanaining optimal blood sugar control. Ironically [he evidence suggesrs ehar
rhe opposite is tfue: an optimaJ Lifesryle program seems ro help maJly diabetics more
than an)' drugs available. One recene example of rhe power of a comprehensive
lifesryle program comes [rom Weimar [nsecuee in California. Researchers there scudied the benefits of a live-in 25 day comprehensive lifesryle program on Type II diabetic
parienrs. A frequent complicarion of diabeces is peripheral neuroparhy, a conditon
rhat often manifesrs tse1fas burning ar aching sensations in the feer and legs and may
aJso involve rhe hands and arms. The pain
is ofcen described as excruciating and sharp.
The disease can larer progress ro Ilumbness,
as heat, cold, and pain can no longer be felr
in rhe affecred areas. Although medicariolls
may somerimes help che condjrion, they

177

PROOF POSITlVE
ofren make no significant impact. Thc
smdr's lead researcher was Dr. Milron CTane
(an cndocrinologisr who speciahzes in reversing [he effecrs of diabetes throllgh
lifestyle changes). He showed mat a mearless diet, free from ali animal prodllcts and
high in llnrefined (Oral vegetarian foods, will
bring complere relief ro painflll neUfOpathy in over 80 percent of diaberics with rhis
condition in juSt 4 to 16 days.14 Other clemenrs of rhe program. included: regular exercise, hydrorherapy rreatmenrs, cooking
c1asses, grollp lectures, exclusion of a variety of beverages (coffee, rea, and alcohol)
exclllsion of tobacco, and for rhose who
desired ir, religiolls cOllnseling. Previously,
diabetic neuropathy was thought (Q be inCllrable. This srudy shows rhat rhe condition can actually be reversed cluollgh a C0111prehensive lifesrylc program thar includes
diet and exercise. Blood sugars and cholesrerol a1so dramatically improved on this dieL
The benefits of complere relief of djaberic
painful neuropathy conrinued according ro
a ot)e ro four year follow-up programY
Keeping blood sugars as clase ro normal
as possible 1S one of rhe keys {Q kjdney health
in the diabetic. A comprehensive lifestyle
approach will gready assisr this process.

EXE CISE
RISK
OFDIABETES
Decrease risk ofdeveloping diabetes by 50% in those
with high risk defined by:
High blood pressure
Family history
Relative risk of
Obesity
developiog diabetes

1.00

0.75

0.50
500
Figure 4

178

Kcal of Exerclse per week

3500

Furrhermore, a11 optirnal d.iet, \Vbich is torai vegerarian, generaHy has much less protein in it rhan t-he srandard American farc.
Such a lower protein diet rends ta put less
srress on th kidneys, again providing a boon
ro kidney heaJrh 46 (see Chaprer 7, "The
Creat Meat and Procein Myth," for more
information). Not only can a cornprehensive lifcsryle program help accomplish these
goals, but such a broad-based lifesryle approach will a1so likely diminish ocher risk
facrors rbar could in rime furrher warsen
kid.ney function.
Examples of some of rhe ot-her facwrs
dlat can worsen diabetic kidney problems
include high blood pressure, cigareue smoking, and e1evared blood fars (LDL chobrerol and rriglycerides),47 One little-recognized factor that also seems ro increase rhe
risk of kidney problems in diaberics is the
use ofTylenol OI' other brands of aceraminophen. Srudies show rhar using as lirde as
rwo pills oncC' a week doubled the risk of
severe kidney disease in diaberic parienrs. 48
Controlling diaberes pain with an approach
Like mar used at Weimar would be expected
ro result in a decrease OI' e1iminarion of rhe
need ofsuch drugs among afTected diabetics.

Exercise - First Element Needed in a

Comprehensive Diabetes Lifestyle
Program
Exercise pl.ays a powerjiti rol.e in lowering
blood sugar levels. Evidence suggests rhar
musdes in morion reduce resisrancc ro insulin; dut is, insuljn sCllsitiv1ty 1S improved
by regular physical exercise. 49 More simply
put, exercise-in a sense-works like nsulin in a diabetic: it helps sugar go out of the
blood and imo the musde tissue. In fact,
the prestigiolls Joslin's Diabetes Medical
textbook lldicates rhat lack of exercise is "a
key factor" in the development of insulin
resistance as people ger 0lder. 50 Since diaberics need insulin on a daily basis (eirher
their own body's insulin or injccted insulin) sa do diabeties need daiLy exercise ro
optimally control their blood sugars and
tlleir disease.
Exercise not onJy helps diabeties control rheir blood sugars, it aJso help non-

SWEET TOOTH, BITTER HARVEST

diaberics decrease [heir risk of ever developing diaberes in rhe fim place. Oile srudy
showed rhar cxercisc dramaricaLly decreased
rhe risk ofdeveloping diabetes among rhose
who were ar high risk for the diseaseY As
rhe amounc of energy expended in exercise
increased frorn 500 calories per week [Q
3500 caJories per week, rhe risk of devdoping diabctes dropped by 48 percenr. In
other words, regular exercise nearly cuc the
risk ofdeveloping diabetcs in h,tlf, as shown
in Figure 4. Interesringly, those who were
ar che highest risk of developing c1iabetes
benefited rhe mOSt from regular exercise.
Individuals c1assified as high risk in rhis
srudy induded those who were overweight,
had a Family hi rory of c1iabetes, or haei high
blood prcssure. The bonom line is thar'exercise is important for eVeJ)'one. However. ir is
especially cririca1 for the diabetic and for
rhose at high risk of developing cbe disease.

Proper Diet-Second Eltment in a

Comprehensive Diabetes Lifestyle
Program
Umil recenrly, diabctics wcre rold rhat
n order ro control rheir blood sugars they
had ta e1imi mue most of rhe carbohydratcs
from their diet. They were cold co avoid
sugar, bur rhe message did nor srop rhere.
Planr food.s-narurally rich in complex caIbohydrate.s-werc also an the "hir lisr. ' The
resulr leh diaberics gravitarllg ro a heavy
mear dier. S2 The medical communiry did
nor realize ar rhar rime whar we have already
nored; namely, a high protein diet promotes
kidney destrt/etion. \'V'ith hea")' mear consumprion also carne increased ingesrioll of
cholesterol and saturated fat. Galloping
<}rherosderosis men foJlowed dose behind.
"Missing the forest for the tred' was cerrainly truc in rhis case. The trees were rhe
high blood sugars, rhe forest was the whole
pariem. Yes, earing a low carbohydrare (rugh
mear) diet can control the blood sugars, but
rhe number one cause of dearh atnong eii.\betics is heart and blood vcssel disease. In
faer, the American Hearr Associarion has
gone on record rhar fully 80 percellt of diabetics die of some form of hearr ar blood
vessel disease. S:l The roor cause ofhearr and

blood vessel disease is arherosclerosi . This

process is, of course, accelerared by meat
wirh its high content ofdlolesterol anei saturared fu. Ironically, rhen, by rrearing his ar
her blood sugar wirh a high mear dicr) a
diaberic may likely rrade the coneml of
blood sugar for an early dearh from he~m
disease. Since ir is rhe complicarions and
afflictions of diaberes rhat need ta be particularly avoided (nor jmt rhe control of
blood sugars) rhe dier needs ro be tailored
ro avoid 01' creat rhese complicarions as well
as control rhe blood sugar.
Obesiry is often oue of the main dererminanrs of insulin rcsisrance (the primary
cause ofType Il diabercs). Thus ir is imperative for an obese diabetic ro Iose weighr
if conrrol of the disease is ro be obrained by
lifesryle changes alone. Mear is a1so dens~
in calories and makes weighr 10ss more djfficulr. On the orher hand, whole fruits
vegerables, and grains (without fany roppings) are l11uch les$ dense in calories, rhus
faciliraring an exccUeor weighr loss program.

Meat and Death from Diabetes

Norwi(hsranding rne faer thar mear Gll1
help control blood sllgars n diaberjcs, a large
Southern California srudy dane among Seventh-day Advenrisrs showed rhar rhose rhar

MEAT & DEAm FROM

DIABETES
Risk ratio in Seventh-day Adventist men

UseofMeat

RiskRatio

Less than 1 day per week

1.0

6 or more days p'er wee'k

3.S,x
Figure 5

179

PROOF POSITfVE

GOODSOURCESOFSOLUBLE
AND INSOLUBLE FIDER
Foods high in solubLe alld insolublefiber
Amount
II1 cacll
1 cup
1 cup
1 cup
1 cup
I cup
I cup

Food Item

Soluble Fiber (g)

Dried figs
Garbanzo bCllns/cblckpea
Large lima bcaos
Soybeans-dJ'Y
Red kidncy bean~"
Corn grils
~..
Carob Oour
...

Insoluble Fiber (g)

7.5
8.6

9.9
15.4
24.9
18.0
22.4
2.5
10.9

8.9
12.6
12.7
15.4
30.1

F oods high in insoluble fiher

Amount
lh cup
I Clip
1 Clip
1 cup
1 cUJ!)
leul)
1 Clip

Food Item

Insoluble Fibcr (g)

Wheal br:1Il
Oricd c.oconul
Pislachio nuis
Blackc)'cd cowl'cas
Almonds
LClltiJs
....
Corn bran
~

11.6
12.3
13.4
15.4
18.3
22.1
62.6

~.......~'""'!!i;;:::;r,

Figure 6

are mear six or more rimes per week were ar

3.8 ames grearer risk of dying from diaberes rhan rhose who are mear less (han once
per week, as illustrared in Figure 5. 54 Other
research indicares an addirional benefit ro
diaberics whe avoid meat and animaJ produce.. These anmal-derived irems have no
fiber in them wharsoever. And fiber is
emergjng as a critical ingredienr in the con-

DIABETIC BENEFITS OF A ffiGHCARBOBYDRATE, ffiGH-FIBER BIET

Reduees levels of serum cholesterol and triglycerides
Reduces blood pressure in those with hypertension
Promotes discontinuation of insulin therapy for
1I0n-insulin dependent diabetics
Reduces r,isk of death from beart disease
lmp1roves gastrointestinal fUDetion

Reduces body wdgJht in the obese

Reduces risk of kidney damage
Reduccs insu1n requilfements
Improves glycemic control
Figure 7

180

trol of blood sugar. In fact, some are suggesring rhar an abundant supply of fibee is
one of the main reaSOllS dur a vegerarian
dier bcnefits diabetics.

Fiber Facts
Fiber is a (errn (hat refers ro plant consriruenrs rhat are resisranr ro human digestive enzyrnes. 55 AJmost aII of rhe diHe;enr
r)'pes of fiber are acruaJly indigesrible carbohydrares (rhe only cxceprion is a fiber
called lignin).56 Some of the other fiber
rypes include cdlulose, hemice1ll1lose, prerins, and gums. 57 Fiber is generally c1assifled as either solllbie (disselves in warer) or
insoluble. As we will sec shortly, rhese two
types of f1bers have different benefirs. One
of the bonuses of eating a balanced diet of
naruraJ planr foods is thar we rend ro ger
liberal amounrs ofborh rhe soluble and insolllbie flbers.
There are man)' foods rich in fiber. A
high content of insoluble fiber is found in
wheat (especially the bran) and bananas.
Foods s(rong n soIuble flber include m05r
fruirs, vegerables, legumes (fresh or dried),
oars, brown rice, and barley. Mosr foods
rhat are strong n soluble fiber are also srrong
in insoluble fiber. Examples of foods high
in fiber are shown in Figure 6. 58

Fibel; Jnsufin, and Blood Sugar

Rcsearch makes evident rhar foods (har
are high in fiber lead ro a slower rise in blood
sugar, and as a reslllr, reqllire less insulin ro
handle (he meaJ.S9 Fiber, especially soluble
fiber like rhe pecrins and gurns, slows rhe
emptying of food from the stomach60 and
helps ro slow rhe absorption of simple sugars in the small intesrine. 61 This should be
conrrasted wirh high far meals thar can resuit in high blood glucose levels for up ro 5
hours after [he mea!. 62
Addition of these rypes of fibers ro tlle
diet has been demonsrrated ro improve diabetes COntrol. 63 Indeed, eatjng a low far.
high fiber, vegetarian dier keeps blood sugars low even wben frurs are eaten. Dr. James
Anderson and colleagues at rhe Universit)'
ofKenrucky found rhar by lIsing a high carbohydrare and high fiber diet, rJle need for
inslliin was grearly reduced. Blood sugar

SWEET TOOTH, BITTER HARVEST

control was better and fasring Jevels of cholesterol and (figlycerides feLl. These and
od1er benefl(s ofilie high carbohydrare, high
fiber diet are listed in Figllre 7.64.65.66
Many nlltririon experrs recommend
that aur diers should contain benveen 20
and 35 grams of fiber per day when i[ comes
ta issues I.ike cancer prevention. 67 1owever,
even higher amoums offiber seem oprimaJ
for diaberes conrrol. Stlldies thar demonstrare consisrenr deereases in insulin requiremelHs by improving fasung and post-meaJ
blood sugar levels have lISeel berween 25 and
35 grams of fiber for every 1000 calories
ea[en. 68 This ean easily bring daily fiber
consumption inro rhe range of 50 ro 100
grams per day.
Consumption of solllbie fiber a1so appears ro be imporram in non-diabetics. As
we have already nored, wherher or not a
person has diaberes, rhese fibers prevellt (he
rapid rise in blood sugar, with a resulting
lower peak level. Therefore, insulin reqlliremenrs are aCll1ally deereased when rhese fibers are added ro rhe diet. 69 ll,-is is no smaJi
111atrer. As imporranr as inslliin is in COI1trolling aur blood sugar, ongoing reseaJch
demonstrates rhar higher blood inSlllin levels increase the speed at which the blockagcs of arherosderosis devdop.70. l ThllS,
we ShOllld help our bodies by placing fewer
demands for high insulin OlltpUr. One wa)'
we can do rhis is by e<uing less sugar and
choosing more fiber-rich foods.
One group of Ilon-diabeties rhat may
especiall)' benefir from the in 1Ilin-sparing
effeers of a high~fiber vegetarian diet consisrs of rhose wirh high blood pressure. Individllals wirh elevared blood pressurc (sa
calied "essential hyperrension"), even if d1ey
are not overweighr and nor diaberic, rend
ro have tissues rhar are less sensitve ro iJ1SUlin. n The bod)' responds ro this lack of tissuc senstiviry by making more nsu/in ro
ger rhe job dane. Therefore, ifhypenensives
adopr a bener diet, their blood vesse/ waUs
wiU be exposed to a reduced amounr ofinsulin.

srances and carcinogens found in our food

supply. Fiber helps prevent colon cancer,
and may help against several orher cancers
as well.7 3 A e1ier rich in fiber helps in healing peptic ulcer disease?4 Fiber is effeetve
in curing al1d preveluing chronic constipa[ion. It can also be effecrive in curing
ehronic diarrhea.
We have come a long way since fiber
gained worldwide attention in 1970. It was
then tlur Dr. Denis Burkirr, a renowned
Brirish physieian, published a repon rhar
ver)' effeerively sounded the aJarm. He ob-

DISEASES ASSOCIATED WIm

A LOW FIBER DIET
Diabetes mellitus

Hemorrhoids

Const1ipation

Bowel cancer

Appendicitis

Bowel polyps

Varicose veins

Heart disease

Hiatus herna

Strokes

Divcrticular disease

Gallbladder disease
Figure 8

served thar in counrries where diers include

large :lmOUlHS of fiber, rhere were few cases
of rhe many degenerative diseases common
in rhe Wesrern world roday. These diseases
are lisred in Figure 8. 75
Remember, fiber is found on1y in piant
foods such as fruirs, vegetables, grains, anei
nurs. Fiber is nor presell( in an] ani.mal
produc[s. There is no Aber in meat, milk,
eggs, ar cheese. Yes, a eow eats plel1ty of
fiber and is a vegetarian by namte, bur ir
rerains n-o fiber in its jleJh or its milk.

Other Benefits ftom Fiber

Fiber from plant foods helps dilure,
bind, inacrivJte, and remove toxic sub-

181

PROOF POSITIVE

More on Proper Diet:Meal Timing

on an Optimal Lifestyle Program
Most people do nor rea.lize dMr rheir glucase lOlerance decreases as the da)'
progresses. This means rhar tDward evening,
your body's abilif)' ro hand1e sugar decreases.
In a srudy ofsubjecrs with Type II diabcrcs,
absolure blood sugar leveLs were 10 ro 15
percenr higher when eati~1g six rimcs a da}'
(rhree meals and rhree snacks) compared to
just duee meals a day.76 Years ago, before
veI')' precise insulin rypes were avaiJable, a
snack at bedrime was recommended for djabetics because the insulin Ievels peaked in
the middle of the sleep period. The bedtime snack helped prevenr hypoglycemia.
ar low blood sugar. Today, wirh r.he rypes
of insulin available, this is not only unnecessary, but counrerproducrive. aur hcaviesr me."11 shouJd be in the morning, emphasizing frurs and grains. This prcpares liS
for the most active paft of rhe day. A subsrantial meal for lunch, including several
servings ofvegerables, is also imponanr. As
rhe day progresses, our abiliry ro hand le
blood sugar decreases, so a lighrer mcal in
the evening (ideali)', for obese Type II djaberics, no evening meal) wirh no reflned
sugar is the besr rule ta foHow. Asking your
doctor ro cailor yOllf insulin injecrions so
rhar dus progran; can be followed can produce gre~lt beneflrs.

1s Sugar OKfor the Diabetic?

Many docrors who uear diabetes seem
ro have grown more lenienr about sugar
consumpeion. Therefore, it is not llncommon for diaberic patients ro w,tlk away wirh
rhe idea rhat earing sugar "in moderation"
is OK.
This seemed ro be the attmde ofLois, a
75 year old Type II eliaheric. Alrhough she
was raking abour 50 llnits ofinsulin per day
she saw no problem wirh an occasional ice
cream. There was a major wrinkle, however; Lois hael whar I would caJ) an addictive relationship wirh ice cream. She could
nor control her consumprion of rhat high
fat, high sugar "treat." When she adopted
a healthful program, she left OUt heI' ice
cream and made orher heahhful changes in

182

her lifesryle. Consequenrly, she losr weighe

:lnd saw her insulin needs drop by ovel' 60
pacent in less than three weeks. Parc of Lois'
uccess was due ro tlle face that she flnally
faced rhe realization thar high sugar foods
were a real problem for her and her diaberes.

What Other Problems Does Sugar

Present?
It is imporranr eo recognize rhar wllen
eaten aparr [rom flber, simple sugars are asociateel wieh demal cavities, obesiry, high
rriolvcerides,
malnutrition, and decreased
t> ,
resistance ro disease. This is true whether
(he simple sugar is in rhe form of wluee
sugar, brown sugar, honey, molasses, corn
syrllp, maple syrup, milk, or [ruit juice.
Furthermore, rhere is concern thar higher
amOUlHS of sugar in the blood can combine
wirh LOL cholestcrol ro produce a compound rhar is damaging tO che lining of
blood vessel walls, rhus srimlliaeing aeherosderosis. This "glycared LDL" (LOL cornbineel with sugar) ma)' become oxidized
LOL rhar increases rhe risk ofhearr diseaseF
See Chapter 3, "Hearr Disease-Conqucring rhe Leading Killer," for informarion on
the problems wirh oxjdized cholesrerol.
Retlned sugar has effects rhar also impacr our qualiry of life. A high s'}gar diel
and rhe consllming of fruir juices and sodas
inerease the severit)' of premenseruaJ syndrome symproms in college girls.7 8 Sugar
also may decrease cognitive or inreUecruaJ
funetion, especially in children. 79 Soroe
hypothesize mat rhe reason for chis mental
dererioration is a result of fhe body overreacrlng ro refmed sugar consumption. A load
of sugar srimulaees rhe pancreas ta release
excessive amouJlts ofinsulin, which ln turn
leads in a few hours ro a blooel sugar rhae is
lower than normal. 80 Therefore, children
ma)' ger poor grades on thei r reSIS alehough
they are weU prepared. Eating natura! but
nOt rdlned, ugar, such as is found in apples,
oranges, pears, etc., should be encouraged
because these foods are packed wirh nutrienrs, including fiber, along \Virh rhe lInreflned sugar. Ar the risk ofbeing redundant,
let me reirerate: flber slows rhe rare ofslmple

SWEET TOOTH, BITTER HARVEST

sugar absorption, allowiog utilizaeion of ilie
EFFECT8 OF FOOD PROCESSING
energy from rhe food we ear ac a steadier
ON BLOOD GLUCOSE LEVELS
rare.
One classic srudy examined rlle effects
mgldl
of earing apples in one of ehree differenr
physical forms: as whole apples, as
90
applesauce, or as apple juice. Even though
rhe same number of calories was consumed
85
from each prepararion, eaeing the apples
~
kepe blood sugars sreadier rhan drinking
~
> 80
apple juice or llsing applesauce alone. The
~
change of blood sugar levels rhrough a pe~
~ 75 .~
riod cime after earing apples in rhe rhree
(,j
forms is shown in Figure 9. 81
'&l 70
Nore rhar ilie blood sugar levels peaked
~
for aU eheee ar the same level 30 minutes
65
afler eating. Then aII levels decreased as
~
sharplyas ehey rose, but each ro a different
~
60
low poinr. The level for rhe apple juice consumer feU the lowese, ro 50. The level for
55
Apple Juice
(he apple sauce earer went down ro 61, while
rhe whole apple eater had a high 66 level as
50
-I
his lowesr point. The raw applc eater's level
srayed constant ar (he high level for che re'-'--'--.L-l-.L---'--'-_LI J __LJ-L
maining rwo hours, while {he level for (he
30
60
90
120 150 180
ocher rwo stayed ar lower values. AJehough
Minutes
after
meal
rhis scudy was do ne in non-diabeeics, rhe
blood sugar peaks arc more pronouncedFigure 9
(higher) in diaberics consum ing rhe juicc
Sugar and the Jmmune System
or sauce in comparison wirh rhe whole
Researchers performed a series of srudapple. ehus indica,ing thar the natural whole
ies
ehar
examined how sugar consumprion
apple will produce a steadier blood glucose
weakens
(he abiLiry of white blood cdls ro
tim rhe body can more easily handle. This
seudy demonsrrares that eating food in iu
naturalstate is ehe safesc and-ultima(elyehe mase satisfying way ro enjoy sugar.

More on Sugar and Diabetes

Anoeher concern wirh sugar for rJle diabetic is rhar sugar itself provides plenty of
calories, bue very liede in rhe way of rrace
minerals and orher nutrienrs. There are
growing concerns rhar cenain minerals may
help wich diaberes conrrol. Two examples
are zinc and vanadillm. 82 Ocher minerals
and viramins suggesced [Q have an important role in diaberes include magnesium,
manganese, chromillm, potassium, and pyridoxine (vitamin B().83 The more you fiII
lip on sugar, ilie less capaciry you will generally have for che nurrienc-rich foods like
fruits, grains, and vegerables.

SUGAR WEAKENS WHITE

BLOOD CELLS' ABILITY
TO DESTROY BACTERIA

Teaspoons ofsugar

No. bacteria destroyed

14.0

10.0

12

5.5

18

2.0

24

1.0
Figure 10

183

PROOF POSITIVE

EIGHT CA CERS LINKED TO

SUGAR CO SUMPTION

Colon cancer
Rectal cancer
Breast cancer
Ovarilan cancer
Uterine cancer
Prostate cancer
Kidney cancer
Cancers of the nervous system

Figure 11

184

desnoy bacreria. The srudies showed tlur

rhe capacicy for whire blood cells ro desrroy
bacreria is weakened as sugar consumprion
rises. Rcsu!rs of rhe whire blood cell smdy
are rabuJared in Figure 10. 84
Note rhat if a person consumed no sugar
for 12 hours, each whire blood cell could
dcsuoy an avcrage of fourrecn baneria. If
rhar samc individual are r11c cquivalenr of
six reaspoons of sugar (such as found in a
half-cup of pudding or a mere (\vO ounces
ofcand y85), each whire blood eell cOllld only
eliminate tcn bacteria-a 25 percenr decrease in killing power. Progressive dereriorarion in the white cells' baereria fighting capaciries beyond 25 percenr occurred
when J 2 r.easpoons and rhen 18 reaspoons
were ingesred. When 24 re<lspoons ofsugar
were conslImed (rhe amount in a medillm
piece of cheesecake or a rnilk shak(86 ), rhe
whire blood cdls were so compromised thar
they could onll' destroy an average of O1U
bacterium each. Thar represenrs a 92 percent reducrion. This effecc s silnilar ro whar
happens in a diabetic who !las uIlcontrolled
high blood sllgars. This provides one explanarioll why diabetics frequendy ger foor
infecrions and orher rypes of infecrions.
Keeping a heaIthy immune sysrem is simply a personaj choice rhat each one of us s
frec to make.
The above smdy provides furrher insight

inco why rhe immune sysrcm is weakened

when blood sugar levels rise in diaberics.
The researchers funher demonstrated dut
sugar's impairing efTeers on whire blood cclls
are not shon-lived. The impainneIlt lasred
a full five hours in normal subjecrs. S7 This
means thar during rhar five-hour period rhe
whire blood cdls coule! nor perform optimally.When you considet how ofren
rhroughom the day some people consume
sugar, ir becomes apparent rhar their whire
cells are nor funcrioning very effecrively for
many hours of each da)'. These researchers
also discovered an illteresting sidelighr: a 36
hom fast seemed ro signincandy il1creast' rhe
abilit}' of the whire blooe! eells ro kill off
bacreria. When you are sick anei nor hungry, it may rhus be ro your advanrage !O
avoid earing. or ac least ro car very sparingly
for a dal' OI' nvo.
One orher sobering linkage involves
sugar and cancer. 88 A nllmber of different
cancers have been sfarisrically linked ro sugar
consumprion in scienrific seudies. A listing
of rhese cancers is shown in Figme 11.
There are a number of rheories why mese
linkages exisr; however, a fiiII explanarion
for them is nor l'ec clear. However, rhe dara
rhar is available provides 'ln. addirional reason ro chink seriousll' abour being aware of
l'our imake of sugar, and making adjusIlllenrs as indicartd.
In lighr of ali rhis research ir is imeresring ro nore che caurions of Ellen Whire.
Over a hundred l'ears ago she wrore:
" ... sugar, when largely useel, is more injurious rhan mear."89 Predacing Whire bl' man)'
cemuries, the Holy Scriptures aJso recorded
reservarons abolit simple sugars. Alrhough
honey was melltjoned, the principle seems
ro apply wirh equal force ro any simple
sugar: "It is nor good ro eat much hOlley.'
Proverbs 25:27.
Americans are beginJling (O beed rhe
\varnings regarding meat, bur somehow we
have failed ta make ir clear rhar sugar ar rhe
levels con umed bl' rh average American
lnay be, in some respecrs, even more harmfuI rhan consllming mear. The emerging
dara on sugar suggesrs [har we should nor
rake Lghtly che counsel of modern day scienrisrs tlur coneur wirh rhe reservarions

SWEETTOOTH, BITTER HARVEST

voiced by dle Scriprures and Ellen White
about the dangers of excessive sugar intake.
Sugar. indeed, eems ro be a probJem for
mosr Americans, whether diabetie ar noc.

ls Sugar Comumption Really a

Probtem for Me?
lf you are Jike most Americans, you are
e:uing large amounts ofsugar withour even
realizing ic. The average U.S. eitizen eats
over 147 pounds of sugar each year. 90 Thi
rrans!ates Ulto a whopping 46 tetlSpoons per
day. The trends are even more disturbing.
Americans IOday are eating nenrly 70 percent more sugar than their grandparenrs did
in 1909. 91 Despite aII the emphasis an
healrhier Jiving and healrhier eating, since
1970 rhe average American yearly ugar
consumprion has cominued tO increase by
25 pounds. 91 One reason for this is rhar
even whiJe we may speak more abolit health,
Americans are consllrning more candy and
soft drinks per person roday than ever before. 93
These foocis seern to be replacing rhe
heaJrhful cereaI grains. While rhe average
U.S. eitizen in 1909 are 300 pounds of Aour
and cereai products, caday we average only
199 pounds annually.94 Ali cald, 38 percent of the rotaJ carbohydrates in the AJnerican diet now come from rehned sugars. This
compares to 40 percent of aur total carbohydrares coming from grain. 95 Therc is
callse for serious concern in view of the
problems associated with sa much sugar in
the diec.
Virtually no one ears 46 rcaspoons per
day from rhe sugar bowl. How is it possible, then, ca consume this much sugar?
Mos[ of rhe sugar in our dier is "hidden."
lrs presenee in [he foods we ear often goe
unnoriced. Some of rhese hidden sources
are hsted in Figure 12. 96
Notice that one of the main sources of
hidden sugar is soft drinks or sada pop. Soft
drinks were unknown umil modern times.
However, in 1994 rhe average American
consumed 52.2 gallons of soft drinks, with
40 gaHom of it in rhe form of regular (nondtet) beverages. 97 This amounrs ro the
equivalent of 427 rwelve ounce cans per

year, or more rhan one per day for every

mall, woman, and child. Since a rypica1
non-diet soft drink packs 150 calories,98
each year the average American consumes
over 64,000 calories of sugar from soft
drinks alone. This is no small rl1auer when
you recognize rhar i[ rakes only 3,500 excess calories in aur diet ro gaiu one pound.
What nutritional qualities do soft drinks
comain? Very little. They are the souree of
a liberal amount of simple carbohydrates
rhat must be classitied as (empty calories."
In faer, rhey aptly illustrate whar an empt)'
calorie food is: ir eolltains many calories but
is largely devoid of vieamins and minerals.
Whar, then, makes soda pop so popular? It
is rasry and cheap well advertised. and available almost everywhere. Furrhermore,
many soft drinks are eaffeinated, making
(hem part of an adJictive process.

HIDDEN SUGARS IN FOODS

(TEASPOONS)
Malted milk

12

02

42

Soft drinks

12 02

10-12

Canned fruit
(Iight syrup)

1 serving

Chocolate cake C!Q!!) t

(402

slice)

8
8

Chocolate candy

10I

Fruit pie

1 sUce

Ice cream

1 scoop

Donut, glazed

1 each

Jam,jeUy

1 Tbs

3
Figure 12

Complex Carbohydrates: A Better

Choice than Sugar
The rnain sources of food energy originare Eram d1ree catcgories of Illltriencs:
carbohydrate, fat, and protein. The body can
most casily eonvert G.'l.fbohydrate inro energy

185

PROOF POSITIVE
for our everyday acrivities. Sweer. empty
calorie foods give rhe blood sugar a quick
boost, bur this rise is not sU5tained. To rhe
conrrary, we have learned thar the boost may
he followed by a sharp drop in blood sugar.
We would do well to make carbohydrates
the largesc percemage of our diet, bur nor
the empry calorie ones. Gur energy should
come from quaIiry carbohydrates (called
"complex" carbohydrates) like natural fruits.
grains. and vegerables. We have already
looked in derail ar many of the ben.efirs of
foods with rhese kinds of carbohydraresone of rhe mosr important being thar rhey
tend ro be packed with liberal amounrs of
fiber along wirh orher nurrienrs.
The conc1usion is rhar for diabetics and
non-diaberics alike, complex carbohydrates
should make up the major part of a healrhfuI dier. Most Americans consume 10 to
15 percent of meir ca10ries from prorein.
(eight percenr would be more hcalthful).
and planr sources of protein are the best.
An ideal amount of fat consumption is approximately 25 percem of calories with an
emphasis an the unsamrated and omega-3
[ars. One recent study from Australia has
shown that a diet high in monounsaturated
far (such as is found in olive oii) using 38
percenr total fat and 21 percent monollnsaturated fat can adequately control blood
sugars in diabetics withour adversely affect-

FOODS BlGH IN
MONo-UNSATURATED FAT
Foodltem
Macadamia
Almonds
Pecans
Hazetnut oU
Olive oiI
Avocado
Pumpkin kernels
Sesame lleeds
Olives
Figure 13

186

Amount

Fat(g)

--------

19.5

.U.O
11.4
10.6
10.0
9.7
7.4

6.8

3.8

ing the cholesterol and trglycerides. as long

as the roca 1 calorie inrake remains controlled. 99 Figure 13lists foods rhac are high
in monounsatllrated fat. 1oo
Carbohydrates should makc up the bulk
of rhe diet at approximate1y 55 to 70 percent. They provide rhe most efficient aud
readily available source of energy for our
bodies. The brain and nervous system r1ssues use carhohydrares almost exclusively for
energy. Carbohydrates will act ro detoxify
harmful substances that are manufaccured
by Of raken ioto Dur bodies. Complex carbohydrates are abundant in vegeeables as
well as in whole grains such as rice, wbole
grain pasta, and potaroes.
Adier rich in complex carbohydrates and
fiber is also [he best way to address the problem of obesiry. which, as previously mentioned, is ooe of the major reasons for the
insensitiviry ro nsulin ehar characterizes
diabetes. In fact, the Joslin Diabetes
Center's textbook srates: "the mosr COOlmon and important cause of insulin resistance is obesity."lOl That may be why, as
important as exercise is in an overweiglu
individual, weight /{lSS seems ro be even mOTe
important, at least in prevenring heart disease, improving HDLcholesterol (the good
cholesterol), and in reducing blood pressure
and blood sugars. 102 There is. however. an
old myth in America mat says [hat if you
eat starchy foods you will gain weight. The
fact is. starchy foods in moderate amounts
should be paft of a weight ioss diee. The
extra fars and c.-uories rhat we add to the
starchy foods make them fattening.
For example. it would take 60 potatoes
ro equal the amount offat in one tablespoon
of butter. One medium sized potaro has
onIy 145 calories and a mere trace of fat,
2/10 of a gram. If we add JUSt one tablespoon of buner. rhat one potato jumps up
ro 247 calories wirh 12 grams offat. I03
&ting a liberal supply of complex carbohydrate and fiber-rich fruits, whole
grains. and vegetables will go a long way to
provide benefirs beyond improving blood
sugars. As we have seen, these foods have a
desirable short-term effecr in decreasi.ng insulin needs. But they aIso have long-term
benefits. in ehar rhey form che optimal diet

SWEET TOOTH, BITTER HARVEST

for weight loss. When combined wirh reguIar exercise and oprind meaJ riming (people
Iose more weight if rhey ear lightly-or nor
at aH-in rhe evening), such a diet can help
rhe overweight diabetic tO shed a significam
number of pounds. As the weighr comes
down, sa do the insulin needs.

ArtificialSweeteners
What about artificial $wcctcncrs? Today many believe anificial sweeceners are a
good alternarive ta sugar in everyrhing from
soft drinks ca cakes and candies because rhey
conl<lin fewer caJories. NmraSweet, for example, is the brand name of a synrhelic
amino acid called aspaname. In small
anlounrs it can mimic che tasce of sugar.
Do rhe low calorie soft drinks really
work? Currenr research says "110." In f.1.cr,
lhose who drink the lllosr diec drinks have
che mosr problems widl c1leir weight. And
ir seems ro be more rh:U1 juSt a situation
where heavier people are choosing lower
calorie irems. One srudy of over 75,000
women ages 50 ro 69 found rhat users of
arrificial sweeteners were sign ificanc.ly more
Jikely than non-users tO gain weight over
cime. 104 In anorher swdy, 30 volunreers
drank faur dier sodas daily for rwo weeks.
Surprisingly, rhese diet soda users are more
food and gained more weighr rJlan when
Ihey were free ro drink regular sugar-sweetened sofr drinks. Researcher Michael
TordofT reporrcd [har artificial sweeteners
increase the appetite. "We found rhar Imnger increases aher drink.ing just a liter of
asparrame sweercned soda," he said. 'o ) Simply pUI, arcificial sweeceners jusc seem tO
ncrellSe the desire for the real sUJeeteners. This
is a problem ofobvious significance. In our
councry, an average of over 20 pounds of
arciflciaI sweeteners are consumed per person per year, 106 bur despire rhis increase in
consumplion of arciflcial sweereners, actuaI
.
.
.
sugar consumpnon connoues ro riSC.

A Betier Alternative
Research scudies as well as my personal
experience as a physician make an eloquenr
poinc: if we adopt new and betTer ways of
eacing and living-and srick wich chemwe will likdy devewp an enjoymem for (har

new lifestyle-. In other words, inscead of

concinuing ro car foods that are characrerizcd by excessive sweerness, regardless of
wherher rhe sweet raste comes [rom sugar
ar from arcificial sweeteners, why not ler
your raste. develop for foods rhar are naturalIy sweec.? Try ro fUld more enjoymellt in
a crisp apple, a ripe banana, ar perhaps even
a home grown carcor ar a garden-fresh
squash. Our rasce buds are rrainable.
AJrhough I can rhink of many examples
among my parienrs of"rrainable tasre buds,"
[here is one example from someone who is
nor my pariem dlat is especially "close (O
home"-my f.1ther. When 1 was growing
up in Michigan, my father, although not a
diaberc, was suffering from a number of
minor healrh problems. As a mechanical
engineer, he was nor acquainred wirh medical or healrh subjecrs. He happened across
a book caJJed "Sugar Blues" and bec.'1mc
convinced [har his overweighr condirion and
healrh problems were rel:ued ro his high
sugar inrake. He had always been an avid
milkshake drinker, and an ardem consumer
of Reese's peanut bUlter cups and chocolate
covered cherries, among mher sugary foods.
One evening he inrriglled the family by
announcing he had decided la give up refined sugar emirely. My morher, however,
conrinued ro cook for our family [he way
she always did. When ir carne time for rhe
dessen, my father would leave and go work
in rhe garden. When he carne bome from
work and choeolate-chip cook.ies were baking he wOllld go ourside and do some chore
ta avoid rhe aroma and accompanying
temprarioll. We aII quierly wondercd how
long he could COntiIlue with his decisioIl.
After abour four monrhs, Jlly farher
carne home and anorher sweet dessere was
baking, buc rhe appeal and desire were no
Jonger present. In fact, he described rhe
odor as a "sickening sweet." He now enjoyed apple pies made withouc sugar (my
morher finally broke down and would make
him desserrs wirh no refined sugar) as much
as he had enjoycd his former dessercs. My
unele, who would frequendy visit liS from
lexas, commenred on how ir was worrh {he
ctip just ro sec how "Bud" obviously relished
and delighred in plain simple. foods. My

187

PROOF POSITIVE
f.uher's weighr came down and bjs healrh
probJems disappeared, but his enjoyrnellt
for food and life, ifanyrhing. improved. As
a youllg boy, this obvious "before and after" difference thar 1 had observed in my
own farher launched my interese in lifestyle
and heald). Althollgh ir reqllired disciplined
sacrificc for a few monrhs, the resulrs demonstraee rhat tasre bllds Crin be rrained for
the bener.

Putting It AII Together: Principles of

Diabetic Nutrition
Mall)' of my diabetic patiems requese
that l give rhem a very specific menu thar
will help conrrol rheir diabetes. However,
for mose diabetics, menlls are nOt as imporram as knowing (and practicing) the dietary
principles of diabetic control. This is especially truc for rhe non-illSulin dependent
lype II diabetic. The principles are really
very basic-we have 100ked at aH of them
in this chapter. The more natural fruirs,
vegerables, and whole grajns the bener (Ilms
aJe also good in moderation). The less mear
and dairy prodllcts rhe bener. The less refined sugar ehe bcner. The more fiber rhe
bener. Eat a good breaHm and linie ifany
supper. If you are overweighr ir is of lltmosr imponance dur you reduce your
weight ro yOUI" ideal weighe (thus, rhe less
far in the dier the bener) and follow an earing sryle ehar allows you to attajn and mainrain rhis reasonable weight. Aerobic exercise, ar leasr 30 mjnures in durarion, should
be parc of the daily diabetic ramine.
1 am happy ro provide my patieors wich
de1icious recipes incorporaring rhe balanced
low far, low sugar, high fiber vcgcrarian diee
rhat is besr for diaberes. l avoid giving them
a menll, however. Once rhey understand
rhe principles, 1 le( rhem thoughtfully plan

188

rheir own meals. l would give the same

advice tO each rcader. Do nor feel bound ro
some restrictive way of eaeing. Take rhe
principles ro hean. Experiment with ditTerenc options. You will be surprised ar how
enjoyable a hcalrhy lifestylc c~n really be.

The Surprising Truth-Even for NonDiabetics.

Some people find ir hard to believe this
simple rrurh: rhe diabetic Iifesryle 1 have
been describing is also the best lifesryle for
Ilon-diaberics. Whether you are concerned
about preventing diabetes or merely trying
to oprinuze your healrh, rhis program will
also pay you rich dividends. And you will
not have ro sacrifice pleasl1rc eirher.
Almosr every day at rhe Lifestyle Center
of America in Oklahoma you will find diabetics enrolled n OUl' live-in prograrns for
the purpose of reversing rheil' djsease process. YOl! will also find some oehers-individuaJs fram the surrollnding communities
who come ro cnjo}' a meal in our dining
mom. They are ofren earing rhe very Same
fare mar the diabetic across (he room is en)oymg.
Ofren our fear ofcbange is large1y driven
by ignorance. Pick up a good cookbook or
find a fTiend who can make some tasty mearless entrees, and embal'k roday on a more
vegetarian-type ofearing program. A lisr of
cookbooks (har specialize in healrhfi.ll menus
can be found in Appendix Il. You wiU find
what our neighbors around rhe Lifestyle
Cenrer of America havc found: food can
tasee good, your life can have enjoymenr,
and you can sriH be on rhe finesr dier and
lifesryle ro reverse, control" or prevent diaberes, in additjon ro reducing )'our risk of
mally ocher diseases.

SWEET TOOTH, BITTER HARVEST

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JQ

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SI Habcr GB, Heatoll k"W, cr.1.1. Deplctioll and disrllplion of diclary

fibre. E/TcclS on saricly, plasma-glucosc. and serum-insulin. Ltrnur 1977
OCI 1;2(8040):679-682.

Sprieesma JE, Schlliremaker GE. Diabcles C.111 be prevemed by reducing insulin produclion. Mrd Hyporbcm 1994 Jan: 42(1): 15-23.

52

SJ Jovallovic-T'crcesoll L, Pelcrson CM. Vilamill aJld mineral dcliciellcies

which may predisposc 10 glucose illlOlerilnce of prcgnaJlcy. ) Am (,0/1 Nlllr
1996 Feb: 15( 1): J 4-20.

Kijak E, Foust G, Slcinman RR Rdatiollship ofbJood sugar level aud

leukocytic phagoC}'lOsis. SOU!lJer11 Califo,."ill DenrnlAssoc 1964;32(9):349351.
Penningron JA. Supplemellrary T.1bles: Sugars. III: Bou)(J Il11d ClJIlrcl/s
Food \/tI/rw of Por/iollS Commolll)' Used. Fifimll" Edilion. PhilaJelphia.

PA: JB Lippincon ComparI)'. 1989 p. 269-277.

PenninglOn JA. Supplcmenrary Tables: Sugars. In: &wes I1l1d C"Ulrbs
Food \/nluu of I'oreiom CommoJlIy Un/' Fifiamb Edirion. Philadclphia,

86

PA; JB Lippinoolt Company, 1989 p. 269-277.

Sanchez A. Reesec J L. el al. Role of ugars in human neuerophilic pllagocylosis. Am) Clill Nlltr 1973 Nov;26(11): 1180-1184.

87

Armsrrong B, DoU R. Environmemal factors aod cancer incidence and

mor"llity in diflercOl cOlllllries. wirh pecial reference 10 djerary praceic~.
/111) GlIIm 1975 Apr 15; 15(4):617-631.

HR

9 Whirc EG. ChriSt.ian Temperance. In: Timimolliesftr riu ClmrclJ, Volume 2. Nampa. ID: Pacific Press Publishing Associalion, 1868-1871, p.

.FO.
Pumam JJ. AJlshouse lE. Food Comumplion, Prim. IlI1d Expmdil1lm.
1996. Seatistic.,1 Bu1Jerin No. 928 US Dep;lfllllem of Agrieuhure, p. 20.

'}(l

PlIlnam JJ. AUsholise JE. Fond C01lSumpriolJ, ?rius, and Expmdil1lrt'i.

1996. Slalislical Bullcein No. 928, U Departmenl of Agriculture. p. 21.

9l

PUlllam JJ. Allshouse JE. Food C01lSllmprioll, ?rius. tind Expmtlil1lm.

1996. Swislical Bullelin No. 928. US Depanmenr of Agriclliture, p. 28.

9)

Purnam jJ, Allshouse JE. Food Conmmprion. Prim, Imd E'1>mtlillires.

1996. Statistical Bullelin No. 928, US Deparlmelll of Agriculmrc, p. 27.

94

('urnam jJ, AJlshouse JE. Food COIIJumplion, Prices. tind E...pmdil1lrt'!.

1996. Slalistical Bulletin No. 928, US Deparrmenl of Agriculrure, p. 21.

9~

96 The Food l'rocC&Sor for Windows: Nuerition Analysis & Firness SOflware !complJler program]. ESHA Rescarch. Salem, Oregon.

Purnam JJ. AlJsbonsc JE. Food COIlSllmprion, Prices. IUJd E'<fmdirurr.I.

1996. Starislical Bullelin No. 928. US Deparrmem ofAgriculrure, p. 2829.

97

PenninglOn JA. Carbonated Beverages. In: Bowei and Churel/s Food

VJ!llw ofPorriol1.J C-ommon!y Umf, Fifrmub EdirioJl. l'hiladelphia, PA: JB

98

Lippincou Company. 1989 p. 5-7..

C1mpbell LV, MarmOl PE, el al. The high-rnonounsatllraeed fat diet 1\
a pr:lcrica.1 alrernarive for NIDDM. Diabcw Cnre 1994 Mar; 17(3);177182.
99

100 The Food Proccssor for Windows:

urrilion Analysis & Firlltss Soflware [compuler program). ESHA Rewarch. Salem,Oregon.

ec

101 WeiJ"
u>:Ih)' JL. Palhogenesis of Non-insulin-dependenr Oypc II)
dabeecs mdlitus. In: K.lhn CR. Weir
el al, eJilors. )oslin's Diabms
Mrllirus.-/31h tdir.ion. Malvern. PA: Lea & Febiger 1994 p. 85-86.

ec.

10! Katzel LI. Bleecker ER.. ee al. Effects of weight loss vs aerobic cxercise
lr.lining on risk lactors for coronary disease jn health)'. ohese. middle-aged
and older men. A rallJomizecd concrolled trial. )AMA 1995 Dec
27;274(24): 191 5-1921.
10) The Food Processoc for Wmdows: NUlrilion Anal}'sis & Fimess Softw:uc [compUler program]. ESHA Research. Salem.Ocegon.
l(}.i Slellman SD, Garfinkd L. Pauerns of anificial sweeeener use and weighl
chaJlgc in an American C'Ulcec Sociel}' prospcclive sllldy. Appt-riu 1988: 11
Suppl 10:85-9 \.

IO} Tordofl'MG, AJleva.A.M. Eflcct of drinkiog soda swcclcned wirh asparlamc or high-fTuClose corn syrup OII foo<1 imake and body weight. Am)
CIi" Nlllr 1990 Jun;5 1(6):963-969.

106 Jacobson M, Liebmall B, el al, edilors. NlJr,.i'ioll Ac/iou Hmlrh Lnur.

Washington. DC: Cenrer for Scicnce in the Public Imeresl (CSPI), June
1995 p. 9. (800) 237-4874.

Purnam JJ, AJlshousc JE. FoolL Comumpeioll, Pri(('s. nlld ExpendilllreJ.

1996. Slalislical Bullclin No. 928. US Deparemem of Agricllirllre, p. 28.

91

191

PROOF POSITIVE

192

-----------

"1

CHAPTER NINE

E rONIN:
Agentfor Rest and
Rejuvenation

li was quier in rhe Jones household.

Suddenly there was.a srirring in ilie

bedroom. Richard rubs his eyes
and looks over ar rhe c1ock: "Oh,
no June, we've overslept. It's 7:30. Get our
of bed. Wake ilie kids. We've aU got ro
go." Suddenlyall is pandemonium in rhe
Jones household.
Whar made ehe d.i.fference in those few
moments? An awareness of rime and its
pressure. We ali generally recognize that we
are living in a time~pressured environmenr,
regardless of whether or nor we overslept
rhis morning. Ir afren seems rhar there are
just not enough hours in the day. We tind
ourselves longing for more energy [Q accornplish ali rhar we want or need ta do. Somerimes ir may seem rhat we are wresrling wid1
rwin enemies: frusrration and fatigue.
Farigue is a major problem worldwide.
Srudies from ehe U .S. and abroad suggest
thal in Wesrern narions millions of people
have signiftcanr problems with fatigue. In
rhe Unired Srates, farigue is one of ilie 10
masr common reasons for visiting a physician. l Making rhings worse, a significam
porrion of those rroubled by farigue C<lJ1I\Or
fali asleep when they go to bed. Recent U .S.
dala indicares thar some 3.3 miII ion patienrs
each year visie their doctors for insomnia
alone. 2 Older individuals have been rhollght

ro be at greaeest risk for rhis problem. As

many as 34 percenr of Amerieans over 65
have problems wirll nsomnia. 3
A recent srudy found that sleep problems are cornmon even in YOllllg aduJes aged
17 ro 30. Researehers surveyed abour 3000
individuals regarding problems wieh sleep,
such as: difficulry faHing asleep, waking up
frequendy. "disrupted sleep," napping dUIing ehe day, nighrmares, and waking up roo
early or wakillg tip rired. Only 36 perceJl(
responded rhar they were free of ali of these
indicators. 4
In Western nations, insomnia and related concems have even been documenred
in preschool children. For example, a German srudy found that 12 perceot of four ro
five year old children had difficulries falling
asleep. 5 The research is clear. For a variery
of reasons lireral1y millions of people
iliroughotlt the world are legirimarely erying our: "Why am 1 so eired? And whar
can I do abOlit it?"
Onro rhis srage srepped a ntlrrironal
suppLemenr named melatonin. In 1993,
newspapers rhroughour the U.S. carried
wo.rd of researeh from rhe Massachuserrs
Institute ofTeehnology. Seientisrs ehere had
demonsrrated rhar small amounts of melaro Il i Il aered as a na tu raL sleep aid. (,
Melaronin's populariry grew in 1994 when

193

PROOF POSITIVE
the Iay press reporred ehac ic could decrease
jet Iag? I ncerest in the compound grew
further as leading periodicals continued ro
fan che fire.
an Augusc 7, 1995,
NEW$WEEK fearured melatonin. 8 Since
rhen, ehe compolllld has concinued to receive rave reviews and has demonstr;aed ics
abiliry co generate saJes of millions of dollars for bookstores and heahh food establishmelHs. When one of the. world's leading melatonin researchers, Dr. Russel ].
Reitec, wtote a book in 1995 on rhe subject, he gave one scriking indicacion of
melawnin's popularity. He observed that
24 difTcrent U.S. companies were rhen marketing the hormone. Furthermore, a steady
scream of new companies was joining the
markecing ranks an a monrhly basis. 9
Melaronin is nor a foreign substance ro
the body, but a narural hormone produced
in rhe body and found in cenain foods.
Even thollgh meJatonin sllpplemen(s have
been a commercial success, chere is another
particularly exciting line of research regaJding this hormone. Namely, we are learning
(hac we ean boost me!awnin produccion in
our own bodies in natural ways, wichollt
having to resort to costly supplemencs. 1
will address this research lacer in the chapter and make practical suggestiolls on how
ta boost your own body\ producrion of this
compound.

SLEEP AND JET LAG EFFECTS

OF MELATONIN SUPPLEMENTS
Helps insomnia
Espccially in the efderly
Decreases time to fali asleep by 14 minutes
Improves sleep efficieocy but oot total sleep time

Lessens jet fag

When tsken the day of the flight and conthmed for 5 da)"s

Adverse effects unkn.own

Figure 1

194

The research daims for me1atonin now

go far beyond its abiliry ro enhance sleep
and relicve jet lag. However, before looking ar. the oeher far-reaching effecrs of chis
natural compound, we need. ta look more
closely at cite areas of research ehat fim lIshered me1atonin into rhe limelighr.

Enhancing Sieep
Israeli researchers led by D. Garfinkel
looked ae melatonin's effeces an a dozen individuals whose average age was 76. 10
For rhree weeks, half of rhe grollp was
given 2 mg per day of conrrolled-release
melatonin and rhe othcr group was given a
placebo. Afcer a one week break (called a
"wash our period"), the srudy was repearcd
with the other half of ehe subjects getting
the active melatonin, while ehe remainder
goc t11e placebo. The reslllcs demonstrared
an increase in "sleep efficiency" while on
meiatonn. Sleep efficiency measures [he
totaJ time asleep as a percenrage of the rime
in bed. 11 Ic improved [rom 75 pereent,
wimollt melatonin sllpplementation, to 83
percenc while an the me1atonin. This and
ocher srudies I2 13 have also shown evidence
ehac melatonin helps decrease ehe time it
cakes ro fali asleep (19 verSlIS 33 miJllHeS in
rhe Israeli data). Garfinkel and his colleagues conclllded that mdaronin helped ro
improve the efficiency of sleep alr.hough it
did not improve tOtal sleep rime; this means
that a person will spend a shorrer r.ime in
bed to get a given amount of slcep.

Coping with Jet Lag

Me1atonin has been documenced ta help
wich one of rhe major aggravations of modern travel, namely, jet lag. A number of
sllldies, lIsing a varety of doses and regimens, have looked at chis effecr.. 14 . 15 One
repore concluded tluc the mose effeceive
regimen involved takjng melaconin 01\ che
day of che flight and conrinuing ir for five
days thereafter. 16
A summary of chese benefics of melaronin is shown in Figure 1.

Aging, Healing, and General Repair

Perhaps nor.hing has eaptured rhe huOlan imaginarion as much as the quesc for a

MELATONIN
founrain ofyouth. Some [Oday are sllggesring rhar medical research may have provided
ar (easr a parrial candida re for a "yourh reswrer" in melaronin. These senrimenrs
grow our of rhe recognirion thar meJaronin
may ease rhe daily wear and tear rhar our
bodies susrain. Consequenrly, ir has been
dubbed rhe "fix and rejllvenare" nighttime
hormone. J7 These healing and genera.! repair effecrs of me1aronin may actUally help
ro delay some of rhe changes rhar we normally 3mibure [O aging.
There are omer lines of evidence rhar
suggest rhar melatonin ma)' help [O slow rhe
aging process. Ir is weJl known rhar hllman
melaronin levds fali rhrollghollt life, as depicted in Figurc 2. 18
Nighuime levds reach a peak in children berween one and five years of age and
decrease sreadily throllghout puberry. By
rhe end of puberty, peak mdaronin levels
have decreased 75 percenr. 19 Levels conrinue ro FaJI sreadily rhroughour adult life.

Melatonin Jncreases the Longevity

ofAnimals
Melaronin levels aJso decrease in animals
as {hey get older. Giving melaronin ca animals increases rheir longeviry.2o Could rhis
life span enhancemenr be due ro some rype
of a.mi-aging effecr exerted by melaronin?
Ifso, how specifically would rhar efl-ecr come
abour? A variery oflines of research suggesr
thar melaronin's ami-aging efl-ecrs in animals
(as well as in humans, perhaps) may hinge
largely on irs role as a free radical scavenger.

What Are Free RadicaLs?

AJI matter is made up of molecules. A
free radical is an unusuaJ moleeuJe-it is
"llnbalanced." Every molecule consiscs ofa
nucleus of protons and neurrons which is
surrounded by electrons. These e1ecrrons
travel in orbit around che nuc1eus-something like rhe ean:h traveling around rhe sun.
In living organisms, such e1ecrrons are usually found in pairs. However, some molecules have elecrrons mar are nor in pairs,
calJed "unpaired e1ectJons." These molecules are caJJed "free radicals."
The unmared e!eccrons in free radicaJs

have grear signiflcance. They have a powerful drive co acqllire a parener. Ofren
wirhin a fraerion of a second, a free radjcal
will "ste.11" an e!eccron from a neighboring

FALL IN MELATONIN LEVELS

THROUGH LIFE
120
:::;.

100

80

60

Q.
--"

'i:
o
Ci

Oi
~

40
20

10

20

30

40

50

60

70

80

Age (years)
Figure 2

compound. Thar neighborwho IOSt an e!ecrron is said ro have been 'oxidized." Furrhermore, rhe oxielizeel compollnel irself
rypically becomes a free radical. Since ir
now is missing an elecrron, ic has a srrong
desire co steal one from one of its neighbors-and ir usually does so in shon oreler.
The result is a chail; reaction, where oxidarion and damage can spreael f(Om one molecule co rhe nexr umil somerhing StopS rhe
process. A10lecules thaf can stop fhis chain
reaetion are ca/led amioxid.ants.
Free radicaJs are nor ali bad. In faer,
given rhe proper rime and place, chey are
esselHiaJ ro heaJth. For example, one of rhe
ways the body destroys poisons is rhrough
a syscem wltich uses oxidarion reactions and
free radicals. 21 Free radicals are also essencial for cIte effeccive destrucrion ofgerms by
rhe body's whire blood cells. 22
On che ocher hand, free radicals can be
extremely dangerolls when presem ourside
of rhe body's appropriate desrruccve pwcesses. They have been found ro have a role
in ar leasc 50 diseases.H Of particular relevance, rhey have been observeel ro darnage
DNA and are experimentally linked ro can-

195

PROOF POSITIVE

196

cer. Cancer-e\using substances like cigareue

smoke perform some of rheir diny work by
acring as free radicaJs.
Small amOlllUS of free radicals are aho
creared as byproducts of rhe normal process ofliving. Tbe powerhouses of OUl' body
cells, called mirochondria, can acrually
"leak" a lirrJe bir. Rarher than leaking raxic
chelllicals, rhey leak some of rheir elecrrons.
These e1ecrrons can be taken up by oxygen.
The resulrs are free radic.lls know as superoxides. 24 Superoxides also elUer rhe body
through rhe lungs, becausc a smaJl pereenrage of the oxygen we breathe is acruall)' superoxide.
Frec radica!s are al50 created in the process of the body when fighring infecrions.
Ahhough rhese reactive molecules are necessary ro fighr off germs, an excessive number of rhem (or their presenee in rhe wrong
places) can be damaging ra healrhy bod)'
tissues. Severa! sugars, including the normal blood sugar glllcose, can combine wirh
body proteins ta produce free radicals.
Some believe rhar high levels ofblood sugar
in diabetics cause diabetic complicarions in
part due ro rhe crearion of excessive levels
of frec radicals. 25 Radiarion is yer anorher
well-known cause of frec radicals. 26 Free
radical produc(ioll by rhis roure may peovide much of the explanarion for (!le increased cancer risk in rhe arom-bomb survivors in Hiroshima and Nagasaki. Free
radicals and (he oxidarion rhar rhey cause
are also being linked ro hean disease. Oxidi-zed cholesrerol is being implicared as a
major culpril in causing heart disease.
Chapter 3 on hearr disease has more information on this imporram relationshjp.
Tbere are, of course, things we can do
ta limit aur exposure ro frec radicals. However becallse ali living crearures produce
(hem, we eU1nor completely avoid rhese
highly reacrive compounds. It is for rhis
reason [hat mosr experrs are encolleagillg
individuals ro srrengrhen rheir anrioxidanr
defenses besides avoiding free radicals.
These encouragemenrs have helped fuel a
fascination with antoxidam supplemenrs
such as Vitamin C, Vitamin E, and betacarotene. r hardly need to menrion [har
Americans have largdy raken [hese recom-

mendarions ro heart. Amioxidanr supplemenrs appear to be OI} the besr seller lisr of
virtuali)' every health food srore in [he land.
Despite cheiI' popular appeal, anrioxidanrs are not aII good. Excessive all10UllIS
ofanrioxidanrs can paradoxic.t.lly act as "prooxidanrs," compounds (hat acwaHy fiLVor
(he formarion of free radicals. This is (rue
ofViramin C and Vitamin E as welJ as olher
anrioxidants such as superoxide dismlltaSe
and glmarhioneY

Melatonin's Rofe as an Antioxidant

The mosr toxic of r!le oxygen-free radicaIs is a compound called rhe hydrox:yl radiCelJ.28 Forrunarely, melatonin is an effecrive
anrioxidanr in dealing wirh dus radical. It
is even more powerful than the widely
taured narural anrioxidan( called glurarhione. In one laboratory model, melaranin emerged as a five-fold more po[ent
amioxidant than glutarhione. 29 Melaronin
is superior ro Viramin E in handling [!le
toxic peroxyl radical. Overall, the lireratllre
indicates tiut me1aronin peotects againsr free
radical damage from cecrain carcinogens,
herbicides and radiarion. 30 11I11srrarions of
cerrain free radicals are found in Appendix
VI. Melaronin's role as an antioxidanr is
also illllsrrared in rhe Appendix VII.

Preventing or Helping to Fight Cancerom Tumors

We have a.lready seen how meiaroniJl as
an anrioxidanr can exert a powerflll effecr
in helping ro prevenr cancers duough this
means. However, this hormone appears ro
have stiH other alHi-cancer propenies. Research has demonsrrared rhar mdaronin can
slow [he groweh of breast cancer cells. 31
Some of mese additional benefits in rhe arca
of cancer prevenrion and rrearmenc may
resulr from rhe immunosrimularillg properries of melaronin.

Immune Enhancement
OI'. Georges Maesrconi and colleagues
from SwirLcrland have perfonned some fascinaring research rhar looked at rhe cririca!
role rhar melatonin performs in the immune
sysrem. One of [heir groundbreaking ex-

MELATONIN
perimenrs involved two groups of micc.
BOlh were deliberarely infecred wirh a dangerous virus and rhen subjecred ta a srressfuI sm<llion. 1 he onl)' difference was rhar
ooe grollp was also injeC[ed with melatonin. The reslIlrs were srarding. Ar rhe end
of rhirty days, 92 percent of rhe mice rhar
had nor received melatanin had died. Of
those rhar received melawnin, only 16 percent had died. There was a srriking fivefOld diffirence in mortality.32
Furrher research has illuminatcd some
of rhe ways in which melaeonin exerts ils
immune-enhanci ng effecrs. In anorher
srudy by Maesrroni's group, rhey demonsrrared ehar melatonin can srimulare cenain
whirc blood cells called helper T cells eo
make imJ1UlIle-srimlllaring compollnds. 33
Some of these compounds have rhe ability
ro help regulare a key imrnune sysrem gland,
rhe rhymus. They also help in dealing \Virh
rhe e1fecrs ofsuess. In ShOH, rhese res~rch
ers had idenrified how rhe brain, ehe imll111ne sysrem, and the endocrine sysrem aII
nteracred wirh each orherwhen exposed to
suess. They rheorized ruat chis newly appreciaeed inrerrelarionship had a role in
helping the immune syseem ro recover afcer
being we~lkened by high levels ofsrress hormones or excessive demands.

Helps to Cope with Stress and Maintain a Positwe Outlook

TheworkofGeorges Maeseroni and bis
Swiss collaborarors provides evidence rhar
melaronin has a role in decreasing the impace of stress on rhe immune sysrem. 34
Melaronin a1so appears to have significanr
effeclS upon orhcr ways our minds and bodies relate ro srress. Wheeher ic is stress or
or11e[ fac[Qrs rhat rcnd ro pulllls ioro a negative frame of mind, rbere s evidence dut
melaronin may play a role n maintaining a
posirive mood and ourlook.
The research in rhc mood-e1evarng ef..
fecrs of melaconin is important ro note.
There are severallines of evidence ehar melaromn may contribuee (O one's scnse ofwell
being:
(1) Some of rhe mosr popular dl1.1gs [O
crear depression, such as Prozac, Zoloti:, and
Paxil, increase Ievels of seroronin, a com-

pound used by rhe pineal gland to make

melaronin.
(2) An auropsy series of suicide vicrims
found significantly less melalOJ1in in d1cir
brains than in rhe brains of orhers who died
at rhe same age and rhe same rme of day.3)

It May Help to Lowel' Cholesterol and

Blood Pressure
There is evidence rhar meJaronn may
helI' ro lower cholesrerollevds. This cholesccrol-Iowering property has been idemified in both animal and human models.
Hong Kong rescarchers srmlliated raes ro
develop high blood cholesterol leve!s by
feeding r11cm a cholesrerol-rich diet. These
rars wich high cholesterollevels were rhen
given melaronin. The rars dropped rheir
toral cholesterol levels as weLi as the combined vall1e for rhe rwo "bad" cholesrerols
(VLDLand LOL).36 The authors measured
an jncrease in bile. acids in rhe stools of rhe
rars following rhe me!atonin adminisrration.
This indicarcd chat rhe rars' livers were converting rheir blood choleseerol into bile and
chen eliminaring it in the stOol.
The same srudy also looked at rars with
high cholesterol levels caused by underacrive thyroid producrion. These rars, when
given melatonin, demonsrrared a rise in rhe
prorecrive HDL levels. The authors concluded ehar rhe rwo srudies indjcued that
melaronin could stimulare natural cholesrerol clearance mechanisms by encouraging
cholesrerol ro be tlIrned inro bile and by
increasing procecrive HOL levels in rhe rat.
Besides rhe animal (esrs rhat show rhar
melaronin can enhance cholesrerol removal,
rhere is evidence [rom human cissue studies
thac melaronin can a1so decrease rhe amOUlH
of cholesrcrol thar human cells make. German researchers demonstrated rhar melaronin callsed human cells ro decrease cheir
level of cholesterol producrion.J7 The level
of decrease was impressive-measuring
nearly 40 percent.
Anorher imporranr facror in hearr disease and stroke s high blood pressure. Animal research sllggesrs rhar me!aronin may
also he.lp ro lower blood pressure. 38 In animal models, melaronin manifcsrs rhe abiliry

197

PROOF POSITrVE

PROBABLE EFFECTS OF MELATONIN

Protects against free radical damage from

certain carcinogens, berbicides, and radiation
Prevents or helps figh,t tumors
Delays .some effects of aging
Immune enhancer
Assists in coping with stress
Increases the ability to experience pleasure
Lowers cholesterol, blood pressure, and risk
of heart rhythm problems
Lowers risk of osteoporosis

Figura 3

ro counrer sympatheric nervous sysrem activity. This decrease, in turn, has been
demollsrrated ro lower blood pressure as well
as heart rate. 39

CONTROL OF MELATONIN IN
ENGLAND, CANADA, AN THE U.S.
England and Canada ban sale
Considered a drug, must be obtained from physician
for specific medical condition

U.S.--Dietary Supplement

~_, D
t
i
~

Due to a 1994 Act passed by Congress, FDA cannot review

dietary supplements for effectiveness or safety.
Manufacturers are not required to present evidence of purily
or even to demonstrate that any melatonin is presenl in
Ihc prodUCI.
_
Bottles in the U.S. do not identify the mallufacturer
"proprietary info."
Some melatonin products are made from bovine pineal glands.
Recent analysis fouod Ibat 4 of 6 melatonin products
contaned unspecified impurities.
Figure .4

Stimulatjon of whar is called the symparheric nervolls system rends ro increase

blood pressure and risk of hearr rhyrhm
problems. Hliman stLIdies sllggesr thar
melaronin protccts againsr rhese efTecrs by
roning down rhe syrnpatheric system. 40

198

Partial Solution for Osteoporosis?

Dr. Reuven Sandyk of Albert Einstein
CoHege of Medicine in New York recendy
made a case for a pivoral role of mdatonin
in osreoporosis prevention. 4 ! The honnoJle
appears ro play a number of roles in this
regard. Melatonin appears ro be necessary
for oprimal calcium metabolism and helps
ro lower the levels of a calcium-robbing
hormone called corrisol. Melaronin also
affecrs a group ofchemicals caJled prosraglandins (PGs). One particular prostaglandin, PGE 2, appears ro cause the 105S ofbonc
mass. Melaronin blocks prosraglandin synrhesis, rhus decreasillg levels of a compound
rhar is desrrucrive ro bone health. 42
The manifold benefirs of melaronin be}'ond sleep enhancemem and jer lag relief
are summarized in Figure 3.

Melatonin: Is AII the News

Really Good?
Wirh ali of rhis going for it, what could
ger in the way of melaronin cominuing ro
be a sweeping international success? One
[actor i nterfering with melaronin's drive ro
be [he world's most popular supplemem is
governmenraJ acrions. England and Canada
h,llldie melatonin differendy man the U.S.,
as shown in Figure 4.
Notice rhat in England and Canada the
compollnd can only legally be obrained by
prescriprion. 43 In me United States, melaton in is considered a dietar}' supplement.
The Jaw forbids [he FDA from reviewing
compounds markered as dictary supplemems for effecriveness or safery.44 This lack
ofmoniroring or accollmabiliry raises somc
concerns.

Questiom- OfPurity
One of the foremost concerns is the purity of the compollnds marketed as mdatonin. In rhe U.S., supplemenr manufactUfers are nor required ro presem cvidence of
puriry ro any regulatary body, nor even idenrify the manufacturcr of [he melaronin.
Disrributors apparently consider d1is "proprierary informarion."4s Concerns as to
chese pracrices are warramed. aur of six
products analyzed, four were found ro con-

MELATONIN
rain impuriries rhar, ar leasr iniriaJly, could
nOi be idencified chemically.46 In view of a
previous c.'\se of L-rryprophan, rhis is an
ominous scenario. Many wiU recall how Lrryptoph:tn. a compound srruc[lJrally related to mehuonin, was linked ro over 40
deatbs and some 2000 crippling illnesses
duc to impuriries in ilS manufactureY
According ro their own labeling, some
mclaconin producrs have been obtained
from animal sources including cattle pineal
glands:1R This iS5ue has raken on new significance wirh rhe recelU realization thar
neurologic diseases in animals, such as mad
cow disease, ma)' be nansmissible ro humans. Chaprer 10, "Animal Oiseases and
Human Healrh Risks," deals wirh rhis and
mher diseases in animals.
In addition, as ro quesrions regarding
melatonin cOlUaminaeion, there is anoeher
signitlcanr concern. ManufKrurers do nor
have ro demonstrare ro anyone chat any
melaronin is even presenc in cheir products.
This, of course, raises questions aboul the
effecriveness of che supplement.

Danger ofLong Term E.ffects Are

Unknown
Even iI we could be assured tiut ali melatonin supplemenrs were 100 percenc pure
and concained jusc as much of the com
potlnd as they promised, there are still severai lingering doubes. Despite rhe initial
suggestions of melatonin's safery, whar are
the potelUiallong-rerm problems wirh taking large amounrs ofa sllpplement wirh such
br-reaching effeces? Even Dr. Reiter, one
of mdatonin's biggcsr proponents, was constrained co admit as recently as 1995 ehat
mOSt melaronin studies had involved only
small numbers of people and rhar we do not
yet know who ShOllld not be raking melaronin supplemenrs. 49 In fact, doses raken far
above normal physiologic levels of many
supplemenrs over a period of time often
cause more problems rhan rhey address. 50
An ironic n....ist to one of meJaronin's
earliest claims tO fame is worth noting at
chis poinr. Jet lag actually worsened in a
group who were assigned ro begin raking
the supplement several days before travel

rather rhan wairing umil che day of thei]"

flighr. The implicarion of this finding is
rhar rakiJ1g melatonm on a regular basis may
prevenr some of rhe bendicial effecrs of rhe
compollnd when lleeded. 51

Sexual and Reproductive EfJects of

Melatonin: a Possible Two-edged
Sword
In the arca of sexual effecrs, melaronin
has not proven ro be of benefir. le cOlild
turn our ro be a two-edged sword. Wirhin
normal physiologic limics, higher blood leve1s of melatonin may bencfit sexual healrh.
Howevcr, in abnormally high amounrs,
there may be undesirable side effecrs.
Lay reporrs hypc melaronin as a sexual
performance en.hancer, but there is no scienrific evidence ro back up such a claim ar
rhis wrieng. Even De. Reiter, who seems
quick ro interprer rhe medicalliterarure on
melatonin in a positive liglu, is erue to his
colors as a reputable scienrific researcher and
admies that 'there is no convincing proof"
that "melaronin wiU improve one's sex
life ... "52 On balance, Reieer does poinr out
(hat some of the anri-aging effecrs of melaronin may help preserve sexual function ro
an older age. However, dlis would be expecred. If me hormone is really helping
preserve a more general stare of yourhfulness, we would expece dlar benefits would
accrue ro ali sysrems including the sexual
and reproductive sysrelns.
Some reproductive benchrs of melaronin have bcen found. A South Afric.'\n study
found rhat men wieh higher amounrs of
melatonin in their blood had higher
amounrs ofie in their seminal fluid. These
individua.ls had berrer sperOl moriliry, a
qualiry associared wirh illlproved fertiliry.53
On the contrary, ehere is other evidence
rhar sllggesrs rhar melaronin may interftre
with sexual and reproduccive functions.
High melatonin levels prevenr animals from
going t1uough puberry.51 This action is
called an "antigonadorropic efTecL "55 A case
hisrory of a man in his mid-20's who had
never gone rhorough puberty iIIustrared this
effecr. He was evaluared because ofhis delay in sexual rnaturatiol} and was found ro

199

PROOF POSITlVE
have melatonin levels rhar were five rimes
higher rhan normal. He finally wenr
rhrough puberry afIer his mdaronin levels
came down ro a normal range. 56
Excessively high melaronin levels are also
associared wirh inferriliry in humans. A recent srudy of female athleres found rhar
those who had losr rheir mensrrual periods
had melaronin levels rwice as high as arh[eres who were srill mensrruaringY Of
course, this begs rhe chicken-or-the-egg
quesrion. As we williarer see, rhe higher
melatonin levels may be a resulr of rhe exercise. In turn, it is possible that rhe resulting
highcr mdatonin levels chen depressed rhe
female reproducrive fllnctions. 5S Thus, abnormally Jligh melaronin levels (such as
rhose obrained by taking a slIpplemem or
doing very rigorous arhleric rraining) may
work againsr ~l person's reproducrive imerescs.

CAUTIONS AND UNKN'OWNS

OF MELATONIN SUPPLEMENTS
Purity
Labei accuracy regarding quantity
Potentiallon.g term adverse effects
Possible undesirable side effects of high
doses, such as reduced fertility
Possible dangerous interaction
with prescription drugs
Figure 5

Melatonin Jnteracts with Prescription

Drugs

200

]n our earlier ex.planauon of rhe funcrion of oxidarion reacrjons and free radicaJs,
ir was meJltioIled rhar rhey can desrroy poisons or unwanred foreign marerial. Since
melaronin is a free radical scavenger, ir wiU
decrease che body's free radical [oad and

could disasrrously affecr individuals an prescription drugs. The reasoll for chis is rhar
mosr ofwhar we rerm "drug rherapy" roday
involves chemicaJs rhar che body rreats as
poisons. Oxidarion reacrions and free radicaIs help ro eliminare several of mese drugs
from the systern. The concern is thar by
decreasing rhis acrion, rhe blood leve1s of
certain drugs will rise, resulting in potentially disastrous effeccs. For example,
Mevacor (1ovastarin), the popular cholesterol-Iowering drug, and Coumadin (warfarin), a common antj-dorring drug, boch
rely on frec radicals and oxjdation using rhe
famous cyrochrome P450 sysrem in che
liver. Lowering rhis funcrion has been
ShOWll ro cause severe muscle pain and actual muscle desrruction duc ro an excessive
buildup of lovasratin in rlle blood. Worse
srill are rhe resulrs wirh warfarin. When rhis
function decreases, excessive levels of thc
drug can build up. In turn, chis can predispose ta serious OI' faral bleeding episodes duc
ro excessive "blood chinning." Mulcirudcs
of conUllon drugs rely on this sysrem some
of which include: the antibiotic eryrhromycin; the blood pressure pili nifedipine
(Procardja); quinidine (a hearr rhyrhm stabilizer); rhe anrifungal drug keroconazole
( izoral); <lnd fhe aHergy piU terfenadine
(Seldane).59
A summal'y ofrhe caurions and the UIlknowlls of Melarollin is shown in Figure 5.

Where Do ~ Go From Here?

Is rhere any way ro safely make use of
chis wonder suppJemem in Ijght of ilie possibiliries of its undesirable dTectS, rhe banning ofover-the-counrer saJes in some COllllrries, <lnd medical experts raising still mher
concerns about side effecrs? Fortunare1y,
rhere is. As previously sr<lred, melaronin is
a natural hormone fhar is made by every
normal human being. We can learn Straregies ro increase the amounr of melaronin
char OUl' bodies make. This will guaranree
us improved supplies of pure, unadulreraced
melaronin in safe quanrjries.

MELATONIN

How to Jncrease Our Melatonin

Levels
If a plam foreman desires ro improve
production on a11 assembly line, the likelihood of success will be increased if he is
rhoroughly acquainted with every aspect of
rhe production process. Similarly, if we
wanr ro optimize our melatonin levels, we
must understand how the body makes chis
vita! hormone.
Melatonin production occurs in the piueal gland, a tiny organ that is located in
ilie exact center of [he brain. 60 Its location
is shown in Figure 6.
This gland is only about the size of a
kernel ofcorn and has the shape of a miniature pinecone. Its appearance explains the
roors of its name: the Latin pinea/is is derived from pinea which means pinecone. 61
As a testament ro its importance, the pinea!
gland is rhe fim gland to form during human fetal development. It is dearly discinguishable a mere chree weeks after conception. 62
It is important to note [har the pineal
gland is more than just a melatonin factory.
At leasr four important compounds are seereted by chis riny gland,63. 64 as listed in
Figure 7.
There are several steps in the chemical
production ofmelaronin. They are oudined
in Figure 8.
For {hose acquainted with biochemistry,
a biochemica1 flow chart of (he biosynehesis of melatonin is induded in Appendix
VIU.

Regulation ofMelatonin Production

In spice of whac may seem Iike a very
seraigheforward chemical process, rhe body
carefully regulaces melatonin produeeion. 65
The process is largely conrrolled by the lightdark cycle. Optimal melatonin production
only occurs ac night and is dependent on a
dark environment. Nighttime levels genera1ly peak around 2 A.M. ro 3 A.M., as depicred in Figure 9.
In ehose wee hours of the night, melaronin levels are five co cen cimes higber chan
during the day.66 Light-dark signals are
fed through che opcical nerves co a control

PINEAL ANATOMY
Pneal gland

Figure 6

PINEAL GLAND SECRETIONS

-Epithalamin
Protein thought to iDerease learDiDg eapacity and slow dOWD aging

-Serotonin
Elevates mood and has innuence on sleep and pain

Arginine Vasotocin
Potcnt protein capahle of rapidly induciDg deep sleep

-Melatonin
The "fIX and rejunnate" night-time hormoDe

Figure 7

STEPS IN THE PRODUCTION

OF MELATONIN
1. The pineal gland draws tryptophan, an amino
acid, from the blood.

2. Tryptophan is converted to serotonin in the gland.

3. Serotonin is converted to melatonin.
4. An enzyme called NAT must be present for the
final step. Without sufficient amounts ofNAT,
melatonin production suffers.
Figure 8

201

PROOF POSITIVE

MELATONIN LEVEL VARIATIONS

THROUGHOUT THE DAY
80

r------------

70

M..Jalon'n 60
(pglml)

50
40
30
20E----10

2:00PM

Darkn....

2:00 AM

7:00 AM

TilllC of D.~

Figure 9

FACTORS INVOLVED IN THE

PRODUCTION OF MELATONIN
The body does not store melatonin. A daily
production is needed.
Light/dark signals from the retina travel
through the optical nerve to the brain where
they combine with sgnals rrom our "body
clock," teUing the gland to start and stop
melatooin production.
Melatooin can also be produced directly by
tbe retina itself under conditions of darkness,
with DO involvement of the pneal gland.

NATURAL LIGHT IS REST

FOR MELATONIN PRODUCTION
4.5
J.S
3.0

Z.5
1.0
1.5

0.5

o.t

IOAJlI

Figure 11

202

Boosting Melatonin ...Naturally

How can we now apply the undersranding of [he chemisrry and regularion of mel.aronln in such a way as ro increase [he producrion of rhis viral hormone by OUI own
bodies? The remainder of rhe chap[er will
provide answers ro rhis qllesrjon.

Get Exposure to Bright Light

early in the Day

Figure 10

Mdaronin
(-&!Iiltr)

cemer in the brain where our "body dock"

is located. This dock, in turn, rdls the pineal gland nor ro produce melaronin when
rhe daylighr signal is rransmined from the
eyes. When rhe dark signal from rhe eyes is
received by rhe comrol cemer, ir rriggers rhe
gland ro produce melaronin, which is fed
imo rhe bloodsrream. 67
Animal resrs indicare rhar melaronin can
aho be produced direcrly by the rerina.
Under conditions of darkness, rhis rissue on
rhe back of the eye can aer alone in producing mdaronin. 68
Melaronjn is nor stored in rhe pneal
gland; ir leaves rhe gland rhrough simple
difTusion. 69 Its half-life is shon during rhe
inirial few milllHes, followed by a second
longer phase. 70 As a resuJr we carmot rcly
on yesrerday's meJatonin for roday. We nced
a liberal supply of mehronin each cvening.
Some of the factors involved in rhe
body's producrion of meiaronjJl are shown
in FiguIe 10.

2PM

'PM

IOM.1

lPM

'AM

IOAM

Oile of rhe fim and highly respecred

srudies probing the daylighr/melaronill COIlnecrion was published in 1988. Researchers in Filliand found rhar rars who were exposed ro Datural daylight had signific.nrly
higher evening melaronin levels rhan anorher group of rars who had an equal
amounr ofexposure to artificiallighr. 71 The
difference in melaronin levels of rhe rwa
groups is shown in figure Il.
Ourdoor ljght is incredibly more imense
[han the arriftciaJ variery. Ollrdoor lighr can
reach 3000 lux on a bright sunny day.72 A
brighr indoor environmenr may provide
only 400 lux, less thao ) 5 perecHt of daylight brighmess. 73 This medical research
verifies the counsel given by EJlen Whirc a

MELATONIN
cenrury ago, quoted in Figure )2. 74
There is an interesting observation regarding a special need for more sunlight as
we get older. Consider rhese rhree facrs:
Melaeonin appears to slow rhe aging
process.
The older \Ve get, rhe less me1aeonin
ourpur we have.
NatllraJ lighr exposure in dayrime
increascs melatonin ourpur ar nighr.
We conclude chat

ta

SU LIGHT - ATURE'S
WONDERFUL HEALING AGENT

slow rhe aging pro-

cess, we can boosr Our melaronin ourpur by

being exposed ro more sun.lighr which helps
ro off.ser r!le narurai weakening of melaro!lin producrion. Ellen White undersrood
this need for rhe e1derly ro ger more sunlight, according to he.. srarcmenr shown in
Figure )3.7 5
Brighr Jight, such as sunlighr. also m.ay
increase seroronin producrion in the dayrime which can in turn prevenr dcpression
and farigue.7 6

Figure 12

OLDER PEOPLE NEED

MORE SU LIGHT

Avoid Light Exposure al Night

Years ago rhere was recogoirion rhat
evening iighr suppressed meiaeonin production in humans.7 7 Ir is important ro avoid
lighr exposurc ar nighr while maximizing ir
during (he daytimc hours. Wc know (har
low inrensiry Jighr (50 lux) is not a probJem bur levels of500 lux and above ar nighr
significalldy suppress melaronin release.
Considering rhis lnformauoll, ir is prudent
ro minimize lighr exposure ar nighr, and
where Jighr is necessary in the nighr rime
hours (e.g., waking up ro use ehe baehroom),
llse a lighr as dim as possibJe.
rn Wesrern narions, rhe habit ofsraying
up Iare ar nighr is generally associared wirh
significanr amounrs of lighr exposure during rhose hours. From rhe srandpoinr of
mc!aronin producrion, ir would be beerer
ro go ro bed early ro take advanrage of rhe
nighrrime darkness and rhen risc eatly. The
health advamage of going to bed early was
poinred our a cenrury ago by EHen White,
quoeed in Figure 14.

"Vigor dcclines as years advancc, 1caving

lcss vitality with which to resist
unhc~dthful influcnccs: henn' the grcatcr
necessity for the aged to han plenty of
sunlight and frcsh. pure air."

Figure 13

SLEEP IS BEITER BEFORE MIDNIGHT

"Sleep is worth far more before than

after midnight. Two hours' good sleep
before twe)ve o'clock is worth more
than four hours after twe)ve o'clock...."

Exercise Boosts Melatonin

An carly srudy by Carr and colleagues
looked ar seven healrhy women. They

Figure 14

203

PROOF POSITlVE

FOODS BIGR IN MELATONIN

(pico-gran/S/gram offiMa)
Barley
Banana

demonsuated rhar one ham of exercise on

a srarionary bicyde could double or [riple
ll1e1aton.in levels.?8 0rher studies have also
demonsrrared (hat physical exercise can
boos[ melatOnin levels.?9

Eat Foods Rich in Melatonin

TomalOcs

Melaeon..n is presenr in many foods.

Earing foods rich in natural melaronin 80 eall
raise melaton,in levels in rhe blaodsrream.
Foods rich in me!aronin are listed in Figure

Gingcr

Rice
Corn

15. 8 1.82

Oats

Eat Foods High In Tryptophan

Figure 15

FOODS meH IN TRYPTOPBAN

(mglIOO grams)
WhoJemiJk
BllIcke)'cd Cowpeas
I
Blac.k Wall)uts

AJOlonds
5easame secds
Clutell f10ur
Roasled pumpkin !eeds
Toru
t 00

200

300

400

SOO

600

700

Figure 16

FOODS RIGH IN VITAMIN B6

(mgl100 grams)
Lima beans

As we have observed, trypcophan is necessary for rhe pineal gland fO make borh
serotonin and melatonin. Thus we would
rhink (har rrypcophan is an important compound ro ingest in abundance if "ve wane ro
opeimize our melatonin levels. 83 Animal
research has demollsrrared il1deed rhar increased amounrs ofL-rryptophan can cause
a fourfold rise in blood melaronin levels.
Surprisingly, animals rhar had no pineal
glands showed rhis SJme remarkable risc.
This provides evidence of rhe imestine's
ahiliry ro make melacon,il1 from rryprophan.
This is good news, since aging animaIs' pineal glands rend to Iose rhe abiliry ro make
melatonin [rom thc build.ing blocks of tryprophan and seroronin due to decreases in
the enzyme, NAT, which was previously
mentioned in the producrion of melaronin.
Rich sources of (ryptophan are listed in Figure 16. 84
In medical school, 1 was told thac mjlk
is a rich source of tryptophan, but as you
can see, many planr foods are much richer
in rhis imponam amino acid.

Lentils
English WalDul
BanaDa

Vitamin B6 May Increase Melatonin

Levels

t.56
0.51

5esaoll.' seeds

..."

Sunllower seeds

UI

....

Artichoke hearls
Sweet beII peppers

2.21
0,5

Figure 17

204

1.0

1.5

2.0

In animal studies, viramin B6 appears ta

be necessary for the production of secownin from tryprophan. 85 Seroronin, you wiU
rceal!, is a compollnd rhar che pineal uses
ro make melaronin. Ifhumans also require
B6 for serotonin production, rhen boosring
intake of this viramin will help ro raise mclaronin levels. Rich sources of vitamin B6
are lisred in Figure 17. 86

MELATONIN
There is evidence that calcium is an imporcam molecule for the pineal ro produce
melaronin. One srudy showed that animals
that were given a dier deficie.nc in caleium
developed shrunken pinea! glands. 87 Furrher supporr ofcalcium's imporrance is seen
in rhe delererious resulrs of calcium channd-blocking drugs on me!aronin levels. In
animal srudies, rhese common drugs for
heart and high blood pressure problems
decrease melaronin levels. 88 . 89 Foods high
in cakium are listed in Chapter 7, "The
Grear Mear and Protein Myth."

Food Restriction and Fasting Boosts

Melatonin Production
Resericted food intake in experimental
animals has been found ro produce a more
youthful melatonin cycle and prolong life
spall.?O There may be a number of reasons
for rhese advamageous ettecrs. Animal tesrs
show rhar there is actually a preservation of
pineal function on a chronieaJly sparran
dier. In one srudy, consranr food resrriction decreased the faH in me1aronin and lev~
els of rhe enzymc NAT that usuaJly occurs
wim aging.'l By t!le end ofrhe srudy, rhe
rars who were allowoo ro eat as much as rhey
wanted had levels of mclaronin and NAT
that were only half rhose of ehe sparsely fed
rars. Both groups of rats, however, showed
e1evared levels of seroronin in rheir pineal
glands. The implication of this researeh is
thae older :mimaJs Iose rheir abiliry ro effectively makc melatonin due ro falling levels
ofNAT, which is the crirical enzyme needed
tO converr serotonin inro me!aronin. A
sparse dier rends tO preserve some of the loss
of NAT funcrion that occurs wirh. aging.
Noe only is food restriction beneficiaJ
but fasting irself secms ro hdp preserve pineal funcrion. Dr. GeraJd Huerher of the
Psychiatric University in Goningen Germany has looked eomprehensively ar rhis
issue. 92 Fasring actuaJJy lowers pineaJ produce ion of melaronin, but increases melatonin in the dayrime ro levels usually seen
only ar nighr. 93 The soJurion ro chis paradox hinges on the &ct thar Hueeher and
others have recognized ehat fasting raises
producrion of melaronin outJide of the pi-

neaJ gland. The key place where this happens is in speeialized intestinal cells caLled
rhe enterochromalfUl cells. His theory is
mat fasting preserves the pineaJ by aJlowing ir not ro work so hard, and letring rhe
intestinal sysrem take over some of rhe
pineal's work of produclng mdatonin.
His meory is compelling, yet, most wonder how food restriction would he1p rhe
intestine make more melaronin. Huerher
postulares rhat this is due to a relative increase in the amounr of tryprophan in rhe
inrestine during fasting. You will recall rhat
tryprophan is the key amino acid (or protein buiJding block) rhar is used by the body
ro manufacture melaronin. Mally people
think rhar most of rhe protein our bocly digesrs comes from rhe foods we eat. Hawever, in normal siruations, rwo-thirds of rhe
prorein digesred by the intestine comes from
rhe body jrself. For example, intestinal cells
have a very shorr Ijfe span, and as they die,
they rhemselves are digesred wirhin the intesrine. Significant amounrs of protein-rich

HABITS THAT INCREASE

MELATONIN PRODUCTION
Increase exposurc to naturalligbt and minhnizc
exposure to artificiallight.
Slcep in complete darkness.
Eat foods rich in melatonin,
tryptopban, and vitamin 8 6.
Avoid a calcium deficiency.
Restrict food intake in general.
Practice fasting, especially in evening hours.
Figure 18
mucus are also digested each day. The fact
is rhar rhese rissues are rich il} tryptophan
eompared ro ehe rypicaJ foods we eat rhat
are relatively poor sources ofrhis amino acid.
The resulr is that the fasring srare provides
rhese special intestinaJ cells wim easier access ta tryptophan from which rhey can
make melaronin and relieve (he pneaJ of
some of its work.
We have seen severaJ dierary practices and
orher actjons ehar can increase our body's
production of melatonin in a naturaJ way.

205

PROOf POSITlVE

LIFESTYLE FACTORS THAT

REDUCE THE MELATONIN PEAK
Stress
Caffeine
Cuts me!latonin production
in halI for 6 hours

Alcohol
Up to 41 percent reductioD

Tobacco
Figure 19

These practices are summarized in Figure

18.
Some llabits wiU result in a lowering of
melaronin production. They are listed in
Figure 19.
Research suggests (hat stress and poor
coping skills reduce melaronin production. 94 Thus, finding adeqll:l.te coping
mechanisms for conrrolli ng seress as described in Chapter 14, "Stress Wirhom Disrress," is essenrial in narurally oprimizing
melaronin levels.
Caffeine should be avoided; it srimulares
the body's stress hormone system (the sympathetic nervous system) and tends ro
weaken mebronin proclllerion. It can cut
melatonin production for six hours. 95 In-

DRUGSANDSUPPLEMENTS
mAT REDUCE MELATONIN
Non-steroidal anti-inflamma1tory drugs
Beta & Calcium Channel Blockers
Anti-anxiety drugs & sleep aids
Vitamin B IZ (3 mg a day)
Anti-depressants
Figure 20

206

somnia or disturbed sleep is usually the resuit.

Prohably rhe mose common drug llsed
in ,mempring tO deal with stressful simarions worldwide is aleohol. Alcohol, however, can not be endorsed as a drug tO improve a. rressed person's melaronin supplies.
Alcohol depresses melatonin levels. 96 As
lirele as two mixed drinks raken araund 7
PM have been demonstrated ro depress
melaronin production even five or more
hours later. Producrion of melaronin was
down as Illuch as 41 percenr at 12 midnight.
Tobacco appears ro be another mehuonin depressor. Research indiGltes (har smokers have lower evening melaronin levels than
flon-sll1okers. 97 This may he.lp ro exptain a
well-kJlown side effecr of smoking: sleep
quali(y generally suffers.

Melatonin Production Reduced by

Certain Drug MedicatioflS
Symparheric nervous stimulation is essentiaJ for melatonn production. It can be
impaired by a number of drug medications
even ifthe essenrial condirion of night rime
darkness is provided.9~
Certa11l medcarions reduce me!a(onin
levels. The major tranquilizers haloperidol
anei chlorpromazine block (he fmal srep in
ilie conversion ofseroronin tO melatonin. 99
Beta-blockers like propranolol anei orhers
have been demonsrrared ro markedlv decrease melaronin levels. 1oo They blo~k the
key chemicaJ messenger stimulaton of dle
pineal a( nighr.
Orher drugs Gln depress melatonin leve1s. Sleep aids including the benzodiazepnes are problems in (his regard. 101 Psyc!liarric drugs including rhose d,at work by
increasing seroeonin levels can compromise
melatonin production. I02
Nonsteroidal anri-ini1ammatory drugs
are commonly used [O tr~H aehes, pains, and
inf1ammarion. They have found their way
inco headache preparations. mcdic.;uions for
premenstrual syndrome. 3nd even ccld anei
fiu combinariolls. As litrJe as 400 mg of
t!le commonly used ibuprofen has been
dcmonstrated ro reduce pineal producton
of meiaronin. 'OJ The long-acring sus(ained

MELATONIN
release form of indomerhacin when taken
in a dose of75 mg ac 6 PM was observed ro
complerdy prevem rhe rise in melaronin
rhat oecurs at nighc. 104
Even excessive imake of Bl2 can imerfere wich melaronin productjon. One study
doeumenced depressed melaronin in connection with B12 imakes 00 mg per day.105
Drugs and supplements rhar reduce
melaronin outpur are listed in Figure 20.

Certain Trauma Reduces Melatonin

What public health professionals once
caJled "accidents" are now ealled "uninrenrionaI injuries." The reason for the change
in termi nology is mar these oM:en life-threatening or erippling mishaps are often preventable-they are nor just a bad twist of
fate. Quadriplegie patients rypically havc
an interrupcion in the nerve conneerions
beeween the group of cells that release the
chemical messengers (superior cervical ganglion) aod me pineal. They have been observed ro have no day/oight variation in
urinary melatonin levels in spite of secreting larger amOllnts of melaronin which actually peak in me day time. The fact is that
the quadriplegic has diminished periods of
toeal sleep and redueed pereencages of the
deep rescarative stages of sleep (teehnieally
called stage 3 and stage 4 sleep).

ShouLd we Avoid Electromagnetic

FieLds?
There are probably few areas that are as
comroversial as electromagnetic fields. The
area is emotioflally charged because of rhe
technological world we live in and [he signifJcant exposure that most of us have ro
such sources. Dr. Reiter makes a case for
minimizing EMF exposure, citing some
preliminary research mat suggests soroe
sources of EMF may lower melatonin (evels. 106 The argumems are noe impressive
enough to cause me ca move inro a cave in

the woods (Reiter is not suggesring such a

dramatic approach), bur it is hard ta argue
with the wisdom of try1ng to avoid EMF as
much as possible. Fot example, sitting a bit
farther from your compurer monitor, trading in your eleceric blanket for some old
fashioned wool blankets and comforters (ar
use it only as a pre-warmer), or keeping as
much disrance as possible between you and
other home electrical devices may be prudent.

Summing Vp
Melatol1.n is a compound with incredible promise. We are just beginning, however, ta learn about ies side effects. The use
oflarge amounrs of melaronin supplemems
may in some cases pose significant harm.
The mosr prudent approach seems ro emphasize natural lifesryle approaches chat
boose levels of this remarkable hormone. To
some rhis may sound too simple. le may
even sound strangely reminiscenr of those
things our mothers and grandmoehers emphasized: a healthful diet, regular physical
exercise, regularity in sleeping, avoiding late
night acuvities, sunshine, etc. Despite the
simpliciry of these measures, medical research is demonsuating rheir effecuveness.
However, there are some things ehat even
mom and gralldma did not recognize: the
importance offoods high in trypcophan and
melatonin, and the dangers of drugs once
thought innocenr.
Our growing understallding of melatonin may, indeed, change (he way we attempt
to answer that oft-posed queseion, "Why am
1 50 tired?" When we srruggle with personal fatigue issues, we may find ourselves
running down a mental checklist of factors
(hac affect me1atonin levels. Such an approach is calculated ro help the majority of
people safely boost (heir energy leve1s, minimize farigue, and experience a whole host
of other benefits.

207

PROOF POSITfVE
RefernlUS -

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9S

Ekman AC. LeppaJUOlO J. et al. Ethanol inhibits mdatonin secretion in

healthy volumeers in a dose-<lependent randomi2.cd doublc blind crOS5over sludy. J Clin Endocrinol Mnab 1993 Sep;77(3);78ll-783.
96

97 Toweou Y. Fl."Vre---Moncange M. et al. Agc- and sex-associated modifieation of plasma mclaronin ooncenrrations in man. Rdalionship to pachol-

210

IO~ Surrall K. Smieh JA. el al. Etfccc of ibuprofcn and indomelhacin an

human plasma melatonin. J PIJIITm PIJarlIIco11987 Oct;39( I0):840-843.
106 Honma K. Kohsaka M. CI al. Ellccts ofvita.min BI2 on plasma meblonin rhyrhm in humans: increased light sensiliviry phase-advances
circadian dock? Experientil1 1992 Aug 15;48(8):716-720.

me

107 Reiter RJ. Robinson J. The Elusivc enemy-EJccrromagnccic fidds.

In: Mc1alollill: YoUT Body's Natural Wonder Drug. New York, NY: Banwl!
Books, 1995 p. 169-180.

CHAPTERTEN

ANIMAL

IS

SES

ANDHUMAN
HEALTH RISK
n Wednesday, M:~rch 20, 1996,
"Mad Cow Disease" grabbed
headlines worldwide. The shock
waves were generated by a group
ofprestigious Brirish scienrists who rcve~ed
that ilie (araI caule disease was likely being
rransmtted ro humans. 1 The news broughr
the Brirish mear indusrry to a virrual srandstill. English folk avoided rhe mear markecs. The European Union and a casGlde
of orher countries banned Br;rish beef.
When rhe dust had senled, beefimportS had
been banned by 23 nations.
Since 1986, auropsies of Bririsb canle
dying wirh mad cow disease reveaJed a nervous system infecrion (hat are tiny holes in
rhe brain. When viewed under a microscope, rhe brain acrually looked like a
sponge. This sponge-like appearance gave
rise ro rhe disease's scienrwc name: Bovine
Spongiform Encephalopaehy Ot "BSE."
This cumbersome nalJJe could lirerally be
translated: cows' (bovine) sponge-like
(spongiform) brain disease (encephalopaehy).
The lay (erm, "mad cow disease," in addition ro being much casier ro pronounce
and remember, also conveys rhe fact thar
iJlfeceed cows often develop menta! deeerioration and behavioral abnoemaliees.
"Formerly" docile animals become irritable,

nerVOlls, or aggressive. They often Iose

weight, and develop severe coordination
problems before dying within rwo weeks to
six monilis. 2 The J1umber of caede affected
is staggcring, as st3ecd in Figure ). 3
Beside being a terriblc rragedy for ilie
carrle populatioll, BSE has powerful emotional appeal for other reasons. It is one of
a group of faral brain diseases that clln be
transmitted from one Living Cl'eature to an-

C~ESOF~COWD~E~E

Over 168,000 bead of cattle were infected

between 1986 and 1997.
About 120 new
cases, per week are
being found in
Britain at
this writing.

Figure 1

211

PROOF POSITlVE

ANIMALS AFFLICTED WIm

DISEASES RESEMBLING BSE

Cattle
Mink
Oomestic Cat
Ostrich

Sheep'
Muie Oeer
Cbeetah
Monl{cy

Pig
Puma

--

Mice
Goats
Elk
Ocelot
Gemsbok
Arabian Oryx

Nyala
Greater Kudu
Eland
Scimnar Horned Oryx

Figure 2
other. These diseascs are eechnically C<ll1ed
"rransmissible spongiform encephalopaehics." Mally British consumers had apparendy comfoned themselves for years with ilie
thought [har it was unlikely for BSE to spread
from cows ro humans. However, evcn before
M;uch, 1996, {here were serious concerns
about human risk, because transmissible cncephalopaehies were known ro affect many
other animals besides cattle. Mice, sheep,
goars, mOllkeys, pigs, mink, and orher cactle

DESTRUCTWE POWER
OFPRIONS
Prions are infectious substances found iUr
animal products used for animal feed.
They cause several types of transmissible
spoog;iform cncephalopathy diseases in
humans and anima,ls.
These diseases are fatal, with
Figure 3
212

DO

known cure.

have ali eome down wirh a spongiform encepbalopathy when givcn mear from calde
rhar were known ro have [he disease.
Roughly 20 animal speeics have been documenred to corne down wirh diseases resembling BSE. They are lisred in Figure 2:l
Furrhermorc, caule rhemselvc' likely
conrracted rhe disease from a differenc species. The epidemie in Brirish cows has been
rraeed ro a similar sheep spongiform eneephaloparhy ealled scrapie. 5 This sheep
disease gers its name from rhe facr rhar afflicred sheep can become menrally deranged
and are Imown ro lirerally scrape the wool
off rbeil' own bide.
Before concerns abollr mad cow disease
surfaced, r was eommon for British eanle
ro receivc protein supplemenrs in the form
of mear and bone meal rrom orher animals
such as sheep.6 Evidence suggesrs rhar the
practice of feeding mese reproeessed sheep
careasses (which included their brains) ro
canle allowed rhe cow populatiol) ta acquire
BSE. Before ehe full cxrenr of the problem
was rccognized, disease tr:Ulsmission was
furrher amplified when rhe carcasscs ofBSEinfecred cows were also used in the process
of making animal feed. 7 ,8 Thus, healehy
cows were nor only fed infectcd tissues of
sheep but also of other cows.

Prions: Frightening Carriers of

Disease
One might think thar processed meat and
bone meal from sheep ar cows could noI' carry
any kind of serious infecrion. Aher aU, carcasses are boiled as pan of rhe process of"renderi.ng" rhat ultimarely convcrrs the dead animals i.nro teed for living creatmes. It is rruc
ehar the high temperatures rypical in rhat rendering process would be sufficienr ro kill mosI'
disease-bearing orgarusms. However, rhe type
ofinfectious agent that is responsible for BSE
is very wlUsuaJ. Unlike mosr illncsses that are
caused b}' bacteria or viruses, BSE is caused
by something called a prion (pronouoced
"pree-on"). The destfuctive powers of prions
arc outlined in Figure 3.
Prions are very resilienr proteins that are
particularly worrisome because they are resistant ro mOSI forms of disinfecrion, They

ANIMAL OISEASES ANO HUMAN HEALTH RISK

reraill their intecrivic)' cven afeer normal stcrilzarion procedures uch as rhose using heat
and ioniziJ1g radiarion. In facr, prions are
nor even desrroyed by remperarures well
above the boiljng point. In a laborarory rest
of rhc scrapie prion, some infictivity stilL re1110ined after a [ull hour of exposure ro dry
heat at 68(fJ F (36(fJ Cj.9 Prions are also
impervious ro freezing and drying. 10 Much
of the re.1Son for rheir hardiness is no doubr
rehted ro cheir unusual eomposirion. Prions
have no generic material and consise enrirely
of prorein. l' They arc composed of a complex combinarion of thousands of amina
acids. Since some srerilizarion processeslike ionizing radiarion-work by desrroying an organism's generic marerial, prions
can nOt be harmed by rhese measures.

CEUUlACTEBlSl1CS
OFPBlO S

Prions are unlike bacteria or viruses.

They consist of protein only.
They attack only the nervous system.
The immune system does not attack them.
Their infectious power is not destroyed by
sterilizing Ouids, freezing, drying, or high
temperatures of sterilization.
The shape of the prioD protein is slightly different
from a normal proteio.
They produce a chain reaction ,that causes normal
proteins to change shape.

How Do Prions Cause Disease?

One of the most perplexing quesrion
abollt prions is how an agenr with no generic material can cause disease. The renowned prion researcher, De. Stanley
Prusiner has come up wirh a likely explanarion based on his years of research. In an
excellenr artide in Scientific American,
Prusiner explained rhe current undersranding of how prions do their dirry work. 12
Research suggesrs dur these prion proreins
are similar in srcucture to proreins rhat occur naturally in the brains of humans and
animals. The prions differ from rhose similar normal proteins, however, in slight differences in rheir three dimensional shape. 13
The subcle differences allow these proreins
ro combine into abnormaJ aggregares rhar
are responsible for rhe brain changes produced bya malady calJed Creutzfe1dr-Jakob
disease (C]D) and mher re1ared diseases. 14
Furrhermore, when abnormal prion proreins come imo conracr wirh normal brain
proteins, rhey can influence the normal proreins ta rake an rhe prion prorein's rhree
dimensional shape. This change in shape
appears ro ser up a chain reacrion in which
(he changed proreins larer influence lleighboring proleins ro do the same. The resulr
is a progressively devastaring and ulrimarel)'
faral disease th.ar has no known rrearment.
The characrerisrics of prions are SUIl1marized in Figure 4.

Figure 4

HUm4ns Can Get Transmissible

Encephalopathies
It is nor only animals (har contracr rhe
prion-induced transmissible spongiform
encephaloparhies. Humans caJ1 also get
rhree such diseases, as listed in Figllfe 5. 15
These rarely diagnosed diseases can be
rhoughr ofas rypes offasr-acting AJzheimer's
disease. CJD. (he most common. of rhe
three, rypica.lly oecurs in late middle age and
gelleraJly callses dearh wirhin six monchs of
diagnosis.1 6 The SOUfce of mosr cases of
CJD has nor been derermined.

PBlO -INDUCED DISEASES

FOUND IN HUMANS
Creutzfeldt-Jakob disease - found in Europe
and U.S. (most common prion discase)
Gerstmann-Straussler syndrome (or GerstmannStraussler-Sheinker syndrome)
Koru - found

New Guinea
Figure 5

213

PROOF POSITlVE

Transmitted From One Human

to Another
Prion-relarcd disea es have been founel
ro be uansmissible from one human ro an-

other. This was discovered from srudies of

a formerly cannibaJisric popuJarion in New
Guinea who honoreel their dead by using
ritual cannibalisric rites. Chilelren rypically
are the brains ofd1cir deceased parenrs c1uring these rituals. Mall}' of rhem contracred
a discase similar ro CJD called "kuru"
(which, in rheir narive ronglle, means shivering OI' rrembling).17 The elisease somctimes rook lip ro 30 years ro develop. Young

BRITONS DIED OF
CREUTZFELDT-JAKOB DISEASE
10 youog Britaios died of variant CJD.
Average age at death was 28.
The disease Iiogered for up to 23 months.
Several British dairy farmers have also
died ofCJD.
..........

Figure 6
children who engaged in rhese cannibalistic pracrices seemed ro develop rhe illness
sooner rhan rheir older siblings or peers who
also cOJlsumed infecred brains. 18
Orher examples of human-tO-human
tral1smission of these devasraring illnesses
exist. Before synrheric human growrh hormone was available, indivieluals who were
deflcicnr in d)is important compound often received ir from piruirary gland removed from hllman cadavers. There are
repom of CJD being transmirred by rhis
proce s. Orher body producrs from human
cadavers have also been linked ro CJD transmi. sion. These include eye (cornea!) risslle
and dura marer (a narural brain covering

214

lIsed during some brain surgeries}.19 Medical devices have transmiued CJD. induding conraminared e1ecrrodes rhar are llsed
to measure brain waves in a special EEG
resr. 20
Oue fascinaring scudy emphasized rhe
tenaciry of rhese disease-bearing prions,2l
Elecrrodes were used to probe rhe brain of
a dememed pariem who rurned om ro have
CJD. The disease was inadverrenrly transmined ro rwo orher pariellts when rhe same
e1ecrrodes were used on rhem. Following
rheir lasr lIse in humans, over rwo }'ears
passed. During thar rime rhe dectrodes were
c1eaned rhree times anei rcpearedly sterilized
wirh ethanol and formaldehyde vapor. N:
rer rhis long interval, the elecrrodes were
reimplanred in a chimpallzee's brain.
Within 18 mOllths rhe chimp haei come
down with CJD. The aurhors concluded:
'This finding serves ro re-emphasize rhe
potemjal danger posed by reuse of instrumcnts colltaminated wirh rhe agenrs of
spollgiform encephalopathies, even aher
scrupulous atremprs to c1ean them."

Ten 10ung Infected Britons Awakened

Public Health Officials

It was Creunfeldt-Jakob srarjstics rhar
really gor the medical communiry's arrentiou in Mareh 1996. By thar rime 10 young
Brirons and several farmers had become vietims of dus devastaril1g iUness, as described
in Figure 6.
Tbe fact that the disease affecred a group
of inelividuals whose average age at death
was less rhall 28 (and who were ali younger
rhan 42 when diagnosed)22 was exuemel)'
unllsllal. As we have alreacly pointed out,
CJD is (ypicaUy a disease of older adllhs.
Fllrthermore, aII 1Oof these indjvidllals had
similar symproms-but rhose symproms
were differem from rhose mar usually accompanied CJD. For example, insread of
callsing dead1 wiwn 6 momhs, dus apparent CJD varianr lingered for lip ro 23
months. The brain wave parrerns of rhe
diseased individuals differed from rhe usual
CJD parient, as did rhe rype of memal impairment rhey suffered as rhe disease progressed. 23

ANIMAL OISEASES ANO HUMAN HEALTH RISK

These lInusual disease fearures prompred
a grollp of leading Brirish scientises ro raise
rhe concern thar a new variant ofCJD had
emerged. They fdr rhe mose likely source
ofchis varianr WI1S BSE,24 meaning rhat rhis
form ofCJD was uansmlued from rhe meat
of cows infecred with BSE. Flirther rhickening rhe plot was the occurrence of a worrisome c1usrer ofCJD-infecred Brirish dairy
farmers. Four sllch farmers had died with
CJD in rhe pasr rhree years. Srarisricians
said rhar such a c1usrer wOllld be very unlikely ro oceur simply by chance. 25 According ro rhe microbiologist De. Jeffrey AImond, a researcher and spokesman (ar rhe
Conference on Emerging Infecrions ar
Harvard Ulliversiey) for rhe British
govern.ment's BSE advisory commirree, as
ofJlIne 1997 rhere had been 19 confmned
cases of rhis new CJD causing death, one of
whid1 oceurred eaeh in Franee and ltaly.

CJD Cases in the u.s.

There are CJO cases in our country
among yOllng adults,26 but ar chis wriring
ehey are not rhoughr ro be directly relared
ro mad cow disease. However, rhe sympeoms are nor unlike rhe British form ofCJD.
le is always fatal, and is especiaJly hearr
wrenching when family members watch
such a young vicrim die. The symproms
are listed in Figure 7.2'- 28
The disease eypically begins wirh mild
symproms rhar advance wirhin a few weeks.
The disease can rhen progress ro the point
where rhe parient can no longer funcrion
alone.

PROGRESSION OF SYMPTOMS
OF CJD IN U.S. CASES
Mild early symptoms, such as changes in
ea-ting and sleeping habits
Difficulties in concentrating, slowness
of thinking, and memory loss
Bebavlioral changes, vision loss,
incoordination, incontinence
Muscle spasms and rigidity, and seirzures
Inability to eat, dress oneself, and use toilet
facilities, folJowed by death
Figure 7

heaJrhy looking carele rhar were incllbating

BSE ar rhe rime of rheir slaughrer for beef
purposes.

Mad Cow Disease Not Confined to

Britain
.
Unforrunare!y, the problem does Jlor
appear (Q be eonhned ro Brirain. Ir has been
fOllod in several orher cOllnrries, as shown
in Figure 8. 30 . 31
Over rhe pasr rhree years, CJD showed
up in farm workers in Franee and Iraly. Five

COUNTRIES WHERE PRIO

INFECTED HUMANS AN
CATfLE HAVE BEEN FOUND
Domestic Prioninfected Coule

Almost Two MilNon Infected Cattle

Eaten by the }far 2001

Prion-infected
HllnrOllS

As rragic as (he Brirish deaths were, there

was an even larger concern. Were we jusr
glimpsing rhe beginning of a massive new
epidemie? Will scores more eome down
wirh CJ D because of BSE? These answers
are nor yet known. However, rhe amounr
of human exposure is sraggering. Drs.
Dealler and Kenr have scared rhat by 2001)
a conservative estimare of rhe number of
infecred carle earen by humans will be 1.8
million. 29 This huge nllmber represenrs

Eogland
Britain
._------=(relaod
France
France
Italy
Portugal
Switzerland
Germany
Italy

lnrporled Prioninfected CaJtie

(/ronr EngJond)

Denmark
Canada
Falkland Islands
Omao

Figure 8

215

PROOF POSITIVE
cases were reporced in France and three in
h.aly.32 A]though the United Stares Oepartment of Agriculture has not found BSE in
U.S. catde, (here are questions as [O wherher
it may be present in our country. We wiU
turn our attencion [O rhis issue larer in rhe
chaprer.

Difficulties in Containing the Disease

216

To comain r!le disease, some have suggested rh;a we simply round up and slaughter ali animals infecred with prioos. This
may sound like a way ro prevent human
exposure. Unfortunately, i( is nor a viable
option. There is currently no practical way
[O determine whether a cow or mher animal has a prion infecrion umil it enters the
final stages of the disease. A long incubation
period is typical; animals have the infection
but have not yet shown any symptoms.
Most infectious illnesses-wherher rhey
are in humans or animals-have short incubation periods that range from a few days
to a few weeks. Such diseases include
measles, the common cald, and mosr intestinal infections. There are orher human
diseases, however, wirh long incubarion periods; one example is AlOS. As maoy as
ten or more years can elapse berween the
time of infecrion wim HfV and the development of AIDS. Oiseases wim long incubarion periods are especially worrisome because a person or animal can have the disease and transmit the infecrious agent wirhout ever showing any evidence ofhaving tlle
illness. This has heen one of the worrisome
features of AlOS. Thousands of healthyJooking HIV-infected individuals have
passed the disease to others before they ever
developed signs or symptoms of AlDS.
This same concern surfaces with BSE.
Among catlle, the incubation period for this
illness (time berween infeccion with the disease-bearing agent and actual developmenc
of symproms) raoges from rwo ro eight
years. 33 When humans come down with a
spongiform encephalopathy, they may never
have eaten meat from a cow ehat WtlS known
to have BSE. However, it is collceivable that
rhey are meat from BSE-infecred eatrle mat
were in rhe incubacion period and had not
yet manijested the disetJse. We have aJready

roade reference ro me incredible amounr of

human exposure ro BSE. A minimum of
nearly rwo million infected cows will have
been consumed by the end of this deeade:l4

No Laboratory Test For Prion Diseases

Further difficulty in diagnosing BSE in
asympromatie catrle comes from the fact
thar, unlike human HIV infeetion, there is
no blood test for asymptomatic cows with
the BSE prion. Jnfected animals' immune
systems do not appear ro mount any respoose against prions. It is for chis reason
thar we cannot detecr prion infect ion by
measuring anribody levels as we do with
HIV or hepatitis. Prions also C.1I1not be
growo in the lahoratory because they are
not, in the strictest sense, living organismsthey are merely proteins. In fact, until Scptember of 1996, there was 110 rcadily available Jaboratory test that could identify BSE
in a live animal. Now rhere is a test requiring a spinal tap (a long needle is inserted
berween the bone in rhe back ro the spinal
fluid) that can detect the priOiI protein itself and may be up ro 95 percent accurate. 35
The technical names for the special tests that
100kspecificaIly for me abnormal prion protcins are immunohisrochemistry a.nd
immunoblotting. 36 The test can be falsely
positive in people who have had a stroke or
encephalitis.
Unforrunately, me test cannot detect the
presence of prions in the spinal fluid umil
they have multiplied enough to cau-se symptoms ro appear. 37 Thus, rhe test cannor give
a forewarning of the presence of the disease,
but can ooly verify its presence when symptoms begill ro be apparent. Furthermore,
special post mortem microscopic brain srudies are generally needed to make the diagnosis with more cenaiory, but even they may
miss the detection of the disease. It is especially important to note mat a cow may have
BSE even if rhe telltale spongiform brain
changes are not found on alltopsy. The reason for this is that microscopic studies of
animal brains at the time of theie death may
miss some of the disease's ballmarks. 38 Thus,
the actual prevalence of the disease may be
grossly underestimated both in catt1e and

ANIMAL DISEASES ANO HUMAN HEALTH RISK

in humans. A summary of rhe difficulties
iJ1 detecting or conraining prion diseases is
shown in Figure 9.

How Many Humans Have Prionre!ated !llnesses?

Orher rhan handfuls of cases in Europe
and rhe relatively few individuals diagnosed
with CJD worldwide, are rhere orher cases
wirh prion-relared conditions? Is ir possible
th;u orher individuaJs wirh demenria may
have prion-induced illnesses? There are
concerns in some qU:lners that some cases
of"AJzheimer's" may actually be spongiform
encephaloparhy. Researchers ar rhe University ofPirrsburgh srudied pariems thar were
rhoughr ro have died from AJzheimer's Disease. On c10ser exami narion rhey found rhar
some of rhem had actuaJly died from rhe
prion-relared Creurzfeldr-Jakob disease..w
Whar was imeresring abour rhis repon is
rhar rhese individuals had a slower progression ofdisease rhan rhe typical CJD pariem.
Such slow progression is reminiscent ofone
of the diflerences in rhe varianr CJD duc
has been diagnosed in Brirain.
NeuroparhologisLS wirh rhe A1zheimer's
Disease Research Consorrium occasionaJly
do an auropsy of a parient who has c1earcU! CJD bur whose paperwork sllggesred
only Ahheimer's.40 Despice carefuJly searching rhe medicallirerarure, I have nor come
across any sysremaric srudy of rhe number
of CJD parienrs misclassified as having
AJzheimer's Disease. The experience of a
couple
of
demenria
research
neuropathologists left me wirh a reasonable
guess thar anywhere becween 1 in 50 ro 1
in 200 parienrs who are c1inically diagnosed
with Alzheimer's reaJly have unequivocal
auropsy evidence of CJD. This may not
sound like a very large percenrage. However, when you consider the rotal number
with AJzheimer's, this srnaJl percenrage of
cases accoums for a significanr number of
people. Cunenrly, some four million
Americans have AJzheimer's disease. 41 According ro a Harvard medical repon, rhe
estimares are rhar by 2050 rhe number will
be over 10 millionY If even one in 100
diagnosed Ahheimer's parienrs had CJD,

DIFFICULTIES IN DETECTING
PRION DISEASES
Some may have a long incubation period.
An after-the-fact autopsy may reveal the

spongy appearance of the brain, but not

in aU cases; the disease is sometimes present
with no sponginess.
If therc is

DO sponginess, a test to detect the

abnormal p'rion proteins in the brain is
passible in an autopsy or in an examination
of spiDal fluid.

Figure 9
rhis wouJd rranslate into 40,000 cases CLLrrendy and 100,000 by rhe middle of rhe
nexr century.
So far, we have only been raJlcing abour
dear-cur auropsy cases of CJD. There are
concerns thar not aH prion-relared conditions can be easily diagnosed even if an auropsy is done. For example, a recenr medicaJ repon observed rhar in some cases, rhe
disrincrion berween AJzheimer's and CJO
is "gray."43 Anorber eepon conunented 011
rhe brain changes in a 32-year-old man who
died with a demenria. The aurbors concluded: "This pacient had features ofboth
Creurzfeldr-Jakob disease and Alzheimer's
disease, providing additional sllppon forthe
e.xisrence of an overlap berween rhese disorders. "44
The human prion-relared disease called
Gersrmann-Straussler syndrome provides
addirional human evidence that these rransmissible encephaloparhies may strike and
nor leave rheir c1assic foorprinrs. An indjvidual who was demonstrated ro have this
prion-rdated condition did not show ilie
sponge-like brain changes under the microscope. 45 The researchers concluded rhat
spongiform encephalopathy in humans
"cannor always be excluded on neuroparhologic grounds in an individual dying of a
demenring condirion, and rhe truc prevalence of rhese diseases is likely ro be underesrimared." In other words, among people

217

PRoa F POSITIVE

PARALLELS BETWEEN
PRIO -RELATED DISEASES
AND ALZHEIMER'S
Both are diseases of the brain.
The symptoms are similar.
They are always fatal.
There is

DO

blood test that can detect tbem.

They caD usually be detected in an autopsy.

Figure 10

wirh demenrias (condirions like Ahheimer's

where rhere is severe loss of mental faculcies), we are probably missing Ce1ses of prionre1ated diseases because nor alI such cases
show the expecred microscopic changes.
Perhaps an even more srarding reporr
found spongiform changes in d1e brains of
50 OUT of 66 parjents with Alzheimer's disease. Smid1 and colleagues said that rhesc
changes were "virrually indisringuishable
hisrologically [meaning, under rhe microscope] from the spongiform change characreristic of Creutzfeldt-Jakob disease
(C]D)."46 Alrhough the aurhors rhollghr it

MILK FROM BSE-INFECTED

CAITLEISBANNED
The Uoited Kingdom banned the sale of milk
from BSE-infected cattle in 1988.
The milk was to be destroyed in addition to
the cow that produced it.

Figure 1 T

218

unlikely thar rhey were seeing evidence of

CJD ar anorher prion-relared condition,
they did ar leasr raise thar possibiliry. From
my perspecdve, rheir work rajses coocerns
rhat subrypes of Alzheimer's may exisr. A
vital quesrion is: could some of rhese subrypes be relared at leasr in parr ro prion exposure? The impliCe1tions of such a possibiliry are far-reaching. The paralle1s berween
prion-relared dise'ases and Alzheimer's are
recorded in Figure 10.
The sobering message from rhis colleerive body of research is: we need ro seriously
question our assumption that CJD is a rare
disease. If just a small percemage of individuals who are diagnosed with Alzheimer's
rruly havc CJD (in cirhcr rypicaJ or arypieal
forms), rhe numbers wirh rhis prion-re1ared
disease would be sraggering.

What Animal Products are Pree

ofPrions?
Many consumers have bccomc aware of
ar least some of these compellirlg starjstics
regarding prion-relared diseases. This has
naturally prompted quesrions as ro which
animal producrs presenr risk r.o bumans.
Mosr of rhe foclIs of late has been on beef,
which is warranred. Alrhough organ rissue
carries rhe grearesr risk. animal stlldjes do
suggest duc meat (from animal muscle
alone) can rransmit prioll-re1ared diseasesY
This is not surprising since musc1e is imerlaced wirh Iyrnph and nervous rissue-rwo
tissucs known ro be infecred wirh BSE. 48
However, we cannor exclude rhe possibility
that milk may also cauy disease-inclucing
prions. Many may reeall how some ye.'lrs
ago assurances were given thar a moriter
cOllld nor pass HfV ro her child by nursing. 49 Of course, we now Imow rhat HIV
Ce'lI1 be rransmitted in breast milk. 50
Granred, prion diseases are vasrly djfferent from HTV The risk (rom milk does
appear to be much smaller than from earing beef or Ce1rrle organ risslles. Nonerheless, a British BSE expert has poinred our
rhar ar leasr one human case suggesrs passage of prions in milk. A Japanese woman
dying ofCJD was fOllnd ro have rhe infecrious agent in her colosrrum (rhe rype of

ANIMAL OISEASES ANO HUMAN HEALTH RISK

breast milk made in rhe inirial clays folJowing delivery).51 Milk h.as becn undeI' suspicion in est.ablished medical cirdes. It was
one
rhe producrs targere.d when rhe
Unired Kingdom was beginning to recognize rhe magnitude of the mad eow problem. The aerion raken againsr milk by the
British government is explained in Figure
11. 52
Borh h.umans and animals were banned
from coosuming an infected cow's miile
Un forrunare!y, as we have already nored,
animals are infecred wirh the BSE prionlong
before rhey manifesr any symproms. When
infected symptom-free cows are milked,
rheir milk is mixed in collection ranks wirh
milk from healrhy cows. lf rhe prion is
presenc in milk, it coulel theoretic.aUy COlltaminate rhe whole eollecrion rank. Pasreurizarion ednnor desrroy prions, so rJ1at
process provides no consolaton. Although
ar rhis rime ir cannor be stJtcd for ce-ftain
thar milk can uansmit a prion-relared discase, many are wondering: is it worrh raking rhe chance?
Earing rhe flesh of animals orher rhan
cows ar drinking rheir milk may nor be safe
eirher. These mher animals may also be
infecred with prion-related diseases. As aJready menrioned, some 20 animal spccies,
induding sheep and goars, can become iofected wirh rhe rraosmissible spongiform
encephaloparhies.
Suspicions are also raised concern ing
products made from animal glands. Health
food scores onen fearure a variery ofsupplemenrs thar include glandular exrracts. These
agents appear ro have a higher risk of prion
conraminarion and thus 1 think ir is prudent tO avoid them.

or

Is There Risk OfMad Cow Diuase in

the u.s. or Other Non-European
Countries?
Even in rhe V.S., a country rhar officially srates that rhere is no evidence ofBSE,
rhere have beel) reports rIrat are less rhan
comfoning. One piea of evidence comes
from Americ.an cases oiTransmissible Mink
Encephaloparhy. Fvc ourbreaks ofrhis disease affeccing rhousands of mink have been

documented in rhe U.S. The disease bears

a srrikjng similariry ro borh BSE and CJD.
causing rapid demenria and dearh with
spongiform braio changes.
Three of these five outbreaks occllrred
in large mink filf111S [har had a pracrice of
feedjng rheir mink "downer" ar "non-ambularory" carde. These synonymous rerms
rerer ro cows rhar die in the fidd or faU down
and are unable ro risc and srand up wirhollt
supporr. Oeemed unfir for human consumption, such cows have been lIsed as a
food SOUtee for mink alld mher livestock.
(Of note, diseased carde may have been food
sources for che mink in rhe orher two outbreaks as well).' In oile ollrbreak, rhe only
animal prorein rhar had been consumed by
rhe mink had come from a U.S. downer cow
and aJmosr rhe emire mink herel died rrom
a spongiform encephaloparJly.54
Or. Mark Robinson and colleagues ar
Washington Stare Universiry have demonsrrated rhar mink can ger a spongiform encephaloparhy by earing BSE-infeceed cartle
eissue. ss The original research repon describes rhe eransmission as occurring wirh
"relative ease" even b)' rhe oral roure. In
comrasr ro rhis, ir has nor beeo possible ro
infecr mink by feeding (hem scrapie-infecred sheep riSSllC. One chjlhng possibiliry is rhar U.S. cows are harboring rhe BSE
prion and rhar rhe mink haei rhen conrracted
the disease rrom rhis source.

Government Search for Prion Diseases

Has Narrow FocUJ
How could BSE exist in carde in view
of aU of d1e U.S. Deparrmenr of Agriculture (USDA) reassurances ro rJle contrary?
Some are suggesring rhar the USOA is being far roo naJfOW in irs foclls. Currenr BSE
surveilJance in the D.S. largely focuses on
recognizing rhe Brrish form of BSE. To
rhis end, rhe U.S. governmenr has arrempred tO provide rhorough education ro
vererinary pracririoners, diagnostic labs, and
vetcrinary colleges. The USDA has disrribmed videorapes of British c.anle wi(h "mad
cow" disease and microscopic slides showing BSE infecrion as ir appears in England.
They have even senr specialisrs ro Great

219

PROOF POSITIVE

220

Brirain ro get fim hand experience in disease recognirionY; The USDA admits ro
whar may have been an oversighr up ro rhis
poil1l: as mosr BSE surveillance in rhe U.S.
is bascd on che presumption rhat clinica.!
signs and neuroparhology would be rhe
same as rhac seen in Great Britain.
There is growing evidence rhat t!le
USDA surveillance methods may be misguided. The research suggests that BSE may
cause other rypes ofillness bcsides rhe "mael
cow" syndrome afllicting Brirish cows.
Some of chis research comes from USOA
researchers themselves. Or. Cuuip anei colleagues made some remarkable observations
when they infected American canle wirh
scrapie from American sheep. They were
able ro transmit the disease by injeeting a
suspension of scrapie-infected sheep brain
tissue into rhe brains of ca.lves. The ca.lves
clid develop BSE but it was very differenr
from that seen in England. The animals
did not show the t)'pica! "mad cow" signs
dur cactle elisplay in Brirain. There was no
aggressiveness, increased excitabiliry, or accenruation ofsensory reaccions that are rypical in the British varianr. Furrhermore,
when dle brains of dle affccted carde were
srudied microscopically, they did nor show
the lIsual spongiform changes. The diagnosis could be made with certainry only by
virrue of special tesrs that demonsrrated
prions jn their brains. The authors conc1uded thar "undiagnosed scrapie could contribure to the 'downer-cow' syndrome and
could be responsible for some ollrbreaks of
transmissible mink encepha.lopathy... "57
There is other indirect evidence that suppom rhe possibiliry rhat BSE has infected
American cattle but looks different from che
British varianr. Smdies in other animal species have now demollsrrared tllar differem
strains of prions do exist. For examplc, a
British researcher found rhat when he injected rhe prions from an infected group of
goats illto mice, those mice developed an
encephaJopathy (brain disease) characrerized
by drowsiness. The prions from a difTerenr
group of infected goats a1so causcd brain
disease wheu injeered inco mice; however,
insread ofbecoming lerhargic, the diseased
mice turned hyperactive!58 The message was

cIear: there were apparently ar least rwo cliffereIU strail1s of prion-related illness in goats.
Alrhough rhe disease looked the same in ilie
goats, when it was transmitted ro another
species (in this case the mice) they wOllld
develop one of rwo very differenr diseases.
SlIch research has mised an important
question. If a prion disease in goats could
give rise to djffercm-appearing diseases in
mice, cOllld sheep scrapie resulr in more
than one type of co,... disease? As we have
atready seen, rhe answer seems ro be yes.
One strain or rype of BSE may sllrface in
rhe U.S. as a cause of "downer cow" discase. Another BSE strain is preseJl( as mad
cow disease in England.

Prion Diseases Have Long Incubation

Periods
There is one other very importanr aspect thar needs ro be reemphasized. T!lesc
transmissible spongiform eneephalopathies
have extremely long incubarion periods. As
already mentioned regarding hllmallS, there
is evidenee thar kllrll can take up ro 30 years
ro manifest itself. Thjs is likely ro be rhe
same with CJO. As we have seen with BSE,
it may rake lip ro six Of eight years Of more
before infected cows show signs of rhe disease. Again, dle impon;t1lt implicat.ion is
rhat ulOusancls of animals and humans may
now be infected bur may nor develop symproms for many years. However. an infeered
cow can theorerically trammit the illness
whether or not it bas yet developed symproma(ic disease. The widely plIbliczcd ban
on feeding dcad animal parts ro Brirish catde
has nor sropped rhe epidemie, although it
has appeared 10 slow it down. When the
statisrics were reviewed in a 1997 repore,
31,903 British canle that had developed
BSE were born after {he ban was implememed. 59 The important message is thar
yollng COWS may be infected and may be
able to transmit disease to humans.

"CalfMilk Replacers" Fed to Calves

Contain Animal Products
Furthermore, if BSE is indeed preselH
in eounrries like the U.S., agricultural pro-

ANIMAL OISEASES ANO HUMAN HEALTH RlSK

cesses have likely disseminared rhe disease
quirc wiclely. Up umil April 1996 in rhe
Unired Srares, as much as 15 percem ofprorein in caHle feecl was from rendered (animal) sOlirces. 6O Oile surprising place ehar
remnallt materials have been used is in the
feed for calves. On many f.1rms calves receive "calf milk replacers," a cype of artificial milk. This praccice allows the morher's
miJk ro be sold on rhe marker taeher than
fed to het calr. Up through the beginning
of 1996, if you had read an ingredienc list
on rhese calf milk replacers, you would have
found such irems as "animal plasma" and
"animal protein producrs" thar may include
"mear and bone meal."61 These milk replacers may rJ111S expose calves ro rhe infected blood constiruenrs ar other body
pam of diseased catrle.
Even with the knowledge that BSE likely
resliited from rhe practice of feeding rendered meae ro British cartle, rhe United
StJres had for years appeared unwilling ro
make any laws forbidding such practices in
our narlon. However, in [he wake of aII the
ITlad cow furor, rhe FDA has finally pur
fonh a ban on feeding ruminant animals
any paft of rhe carcasses ofother ruminants
(ruminant ;mimals include canle, sheep, and
goars). This became effecrive August 4,
1997.62 However, blood producrs, milk,
milk products, and gelatin from ruminants
and protein solely from pig or horse sources
wiU srill be allowed ro be included in feeds
in the U.S. An FDA advisory committee
has asked rhe FDA to also exclude gelatin
for feed, saying rhar rhere is not enough dara
ro prove rhat gelatin is sare, parricularly gelatin that comes from Europe. As of rhis wriring, rlle FDA has not yet decided on the
gelatin issue. Ir was nor until 1996 rhar
Creat Brirain banned the feeding of allanimals or animal parrs ro orher animals.
Some have suggesred rhar rhe U.S.
government's delay in imp!ementing a ban
an rendered animal tissues illustrares a very
real conflict of interesr in rhe depawnenr's
organization. Like rheir Brirish counrerparrs. the USDA serves rwo roles: ta safeguard rhe narion's food supply and ar rhe
same rime prorecr the iruerests of the agricultural communiry by promoring the sale

of animal producrs. It is readi!y apparenr

thac rhese dual goals can often conflict.

Other Pri01I Diseases

Although our focus in discussing prion
diseases is rhe possibiliry ofCJD, other less
frighrening diseases are beginning ta emerge
as possibly resulting from prions transmitreel ro humans from animals. One such
disease is a disease rhat significanrly decreases tl1e quality of life, calleel Pager's discase. Pager's disease of tl1C bone disrupts
rhe process ofbone formarion, causing chem
ro weaken, d1kken, and become deformed.
Bones usually affected include the pelvis,
collarbone, skull, spine, and long bones of
rhe leg. Chronic pain in the bones may resuit. Overall. the disease suikes lip ro duee
percenc of rhe U.S. populacion over age 40,
bur the race increases with age. Recent evidence points to a possible different peion as
rhe cause of this disease, again being transmitted from animals. Risk factors for develOpi'1g ehe disease include eating brain or
other organ meats (2 rimes grearer risk) ,
earing meat uaceable to sick livestock (2.7
times greater risk), and hanelling carde
through farming or carele breeding (2 times
greacer risk).63 Regular contact wieh dogs

EATING MEAT SHOULD

BEAVOIDED
" ... there is now an
overwhelmiog scientific
and medical case for
avoiding the consumption of meat aRd meat
products despite the
government's atteRlpts to
persuade os otherwise."
Dr. Richard Lacey,
prominent microbiologist
and BSE researcher.
Figure 12

221

PROOF POSlTlVE
or cars may aJso increase rhe risk in cereain
geographic areas.

What Should W~ Do?

The ConSlImers' A~sociation, an independenr British '\vatchdoggrollp," has been
quored as saying rhar rhe onl)' way ro avoid
BSE risk would be ro stop ea(ing beef aJrogerhee. This concurs wi(h ilie recommendarion of rhe esreemed BSE researcher and
Professor of Microbiology ar Leeds University, Oe. Richard Lacey. His simple answer
64
[O rhe problem is stJred in Figure 12.
Many peoplc in Grear Breain have (aken
his advice ro hean. Ar rhis wriring, 47 percent of homes do not purchase beef in rhe
Unired KingdoJU. 6>
Orhers are saying even more. Some are
suggesting due (!le eime has come ro recognize rhar disease in animaJs has become so
rampam worldwide rhar we aII need ro seriousl)' consider becoming vege(arians. They
poinr our rhar BSE is jusr onc of many faeal
diseases Iinked ro animaJs. LireraUy hllndrcds of dearhs have been documented in
rhe U.S. alone from a hastof animal-relared
infecrions. Some of the mose signiflcant

from rhe Wesrern World's rwo leading killers, cancer and heart disease, rises wirh increasu\g consllmprion of animal producrs.

W'orse Than AIDS?

Wirh conservarive esrimates ofsome rwo
million BSE-infecred Glttle being eaten,
there is rhe porential for a large-scale worldwide epidemie tim could rival AIOS regarding {he number ofpeople touched. We reaUy wiU nor know umil abour rhe ye.1r 2000
if rhe epidemic [har occllrred in cows will
tOllch on a similar scale (in rhe thollsands)
in humans. 66 However, CJO appears from
many perspecrives ro be even worse rhan
AIOS. With HIV we can diagnose lhe infection ar a very early stare. Ar ehat poinr,
pharmacologic or other rherapies can be
institutcd ro rry ro prevenr the progression
of rhe infecron ro AlOS. Even when AIDS
strikes, treaunenr oprions are available. In
rJ1C case of CJO, however, rhere is no abiliry for early detection and no treaunenrs ar
any srage of the disease. Ir is a frighrening
disease (har generaHy suikes quick1y, causes
symproms and incapacirarion often far
worse than AlOS, and progresses inexorably (Q cause death.

OTHER DISEASE-CAUSING AGENTS ls It Aiready Too Late?

have been e;ating beef and using
IN MEAT ANO MEAT PRODUCTS otherIf you
animal products for years is it already
Salmon elia
Listeria
Campylohacter
Yersinia
Figure 13

222

callsative agems may nor yer be household

words; however, mosr will recognize ar leasr
Ol\e of rhem, as lisred in Figure 13.
Adding [O aII of rhe foregoing, we cannor forget rhal rhe risk ofd)'ng premarurely

roD Iare? The answer is clearly no. Ir is probable rhar many peoplc have nor yer becn
expo ed ro rJ1e prions that causc (he rransmissible encephalopadues. These individllals could mainrain rheir low risk of cver
colning dowll wirh prion-relared diseases by
compleeely avoiding animal prodUClS.
Some may not feei [har (hey are rcady
tO adopr a vegetarian dier. Orhers feel rhere
is no reason ro do so bccause the)' have likely
been exposed by rhis rime ro r!le infecrious
ptions. Even for mese individuals rhere is
good news. In rhe case of rhe transmissible
spongiform ellcephaJopathics, rhe evidence
suggesrs [har rhe total amOlll1C of prion exposure affecrs rhe incubarion period of [he
disease. 67 Specifically, in animal resrs, rhe
more prions rhe crearure is exposed to, rhe
sooner it wiU rend ro develop the disease.
Of course, 110 such srudy could erJlically be

ANIMAL DISEASES ANO HUMAN HEALTH RISK

done in hurnans. (An answer is also not
likely from observarionaJ srudies because we
have no way ro measure or even esrimate
how much BSE-infecred meat any given
person has earen in his or her lifetime.)
However, in harmony wirh rhe exisling
animal research, ir is expected rhat rhere will
be variarions from one person ro anorher in
cite delay rime between earing prion-infecred
marerial and cOluracting me disease. Perhaps someone who cars large amounr of
foods conrainillg prions will develop rhe
disease in 10 years ar less, while someone
with modera re, yet sgnific;mdy less exposure may develop rhe condieion in 15 ro 20
years. Another wirh stiH smaJler exposure
may nor mme down wirh rhe iJlness for 30
years or more.
Thus, even if tI person is doomed ro
come down with a condition like CJD because of previous exposure ro prions, ir may
be possible ro de1ay tile ooser of the disease
signifteamJy.GR And do nor forger: a diee
rhat moves away from animal producrs can
dramatically provide an added rew,lrd by
helping ro decrease your risk of ocher diseases [ike heart disease, diabetes, and cancer.
The epidemic of BSE n rhe Uniled
Kingdom has eaused tlS 10 focus an four
ssues rhar are more expansive rhan the discase irse1f. They are lisred in Figure 14.
There is evidence that governmenrs
worldwide have failed to vigorously address
Ihe concerns of animal diseases and rheir
impacr on human health. Why wair uneil
the next epidemie strikes c10ser ro home
when rhe warni ng signals are aJready sOllnding~ Why should mousands more die premarurely from demenring diseases? Why
not begin making changes today thar will
decrease your risk of mese diseases?

Beyond Mad Cow Disease

It was in 1996 thar mad caw disease captured world headJines. However, in rharsame
veac, Olher cliseases [in.ked with aoimaJs were
~Iaiming thousanm ofJmman /ives even rhough
rhey clid nor garner from page caverage.
Few Americans are aware of rhe hosr of
porenrial1y faral diseases rhar are caused by
germs Ihar lie no furrher away rhan rhe 10-

cal grocery srore, or even ilieir own refrigeraror. Some of rhese bacreria and viruses
cause illnesses rhar are well understooel by
public healrh professionals as posing a rhrear
ro hurnan healm. The links benveen orher
germs and hllman risks are more specularive. However, almosr ali of rhese diseases
are largely linked ro animal prodllcrs.
Infeerous illnesses have again beeome a
bigh prioriry in me public health arena. Of

ISSUES RAISED BY THE

BSE EPIDEMIe
Feeding practices in agriculture
Food safety
Speed at which government respoods to
new epidemics
GoverDiment competence and commitment
lIIIIIIIIIII...
to human safety
.

Figure 14

particular concern are growing thre<lts ro our

food safery. A recent editorial in d1e New
England Journal ofMedicine pur it rhis way,
"The microbiologie hazards of foad present
an issue of increasing concern. "69 In vlew
of rhis, we need 10 derermine iE dietary
choices could minimize our personal risk
from mese distressing and sometimes lelhal
infecrious diseases.
Despite the high level of saniration in
rhe Unired Srates, our fooel is responsible
for virrually thousancls ofinfecciolls disease
cases each year. Roughly 60,000 cases of
food-related illness are reported annually ro
Ihe enters for Disease ConrroJ.7 These
60.000 reported cases considerably underesrimare Ihe true number ofcases. Current
esrimares are a sraggering 80 miII ion cases
each year of intestinal illness due to COJltaminated foods in rhe U.S. alone.?!

223

PROOF POSITfVE

Lowly E. Coli
E. Coli is onc of thc mosr common bacreria known ro man. AU of us have lirerally
millions of rhese germs living in our incesrines. Unforrunarely, some rypes ofE. Coli
can be dangerolls and evenlife rhrearening.
Two such dangerous variecies are rechnicaHy
referred ro serorypes 0157:H7 and
0104:H21. Borh of rhcse c.1n causc severe
intestinal sympwms includ ing bloody di-

DANGEROUS E. COLI
BACTERIA DISEASES
Several E. Coli types are known, including
serotypes 0157:H7 and 0104:H21.
They cause severe bloody diarrhea.
They cause Hemolytic Uremie Syndrome
in children (kidney failure and destruction
of red blood celIs), which can tead to deatb.
The bacteria can be found in beef, milk (raw
and pasteurized), sausage, apple cider,
and venison.
Figura 15

DISEASE-CAUSING
E. COLI IN U.S.A.
TOTAL NUMBER OF REPORTED CASES IN 1995 - 2,296

"I~O.

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Figure 16

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De

arrhea. Worse yer, chey can cause a life

threareningdisease in children known as che
hemolyric uremie syndrome (HUS). HUS
is rhe most common cause of acute kidncy
failure in children,72 Irs name is derived
rrom rhe fact rhar rhis disease causes destruccion of red blood cells (hemolysis) aod, commonly, kidney failure. The laner problem
causes a buiJdup of wasres in rhe blood
(known as uremia). It can be severe enough
to lead ro dearh. Survivors may develop
chrollic kidney problcms wirh a nced for
dialysis and/or uansplant.7 3 In late 1992
and early 1993, dangerous E. Coli serotypes
caused over 600 infections and claimed 4
lives in rlle well-plIblicized cvems associared
with fast food hambllrgers in wesrern
America.74 7S Over 2000 infections are reported ro the Centers for Disease Control
with many more esrimarcd cases occurring
rhar arc nor reponed, wirh approximarely
20 dying each year.7 6 Some estimate thar
as many as 20,000 people each year ger sick
from E. Coli wirh lip ro one-rhird reqlliring hospitalizarion .
Beef, however, is nor lhe only food rhat
can harbor this seriolls infectious agent.
Human disease from E. Coli varieties has
been traced to raw milk as well as ro cornmercially pasreurized milk. In lhe Iauer situarion, disease-causing E. Coli, which is
found in large aJl10UIHS in some carrle
wastes, can apparently conraminate milk
I1fter pasreurizarion. 77 Other sources of nfeclion have included sausage,78 roast beef,
and apple cider, since some appJes rhat go
into apple cider are taken from {he ground
where canle roam aud are conraminared
with canle manure.7 9 Meat harvesred from
wild game such as deer can a1so harbor rhe
infectious agent. 80 One percent of all cartle
harbors rhe diseased E. Coli. 81 Because of
processing pracricc-s, mear from many animals may comprise one hamburger, thus
maJcing ground beefand hambu rgers responsible for more human ourbreaks ofthe disease
t1laO any orher single source.82 A summary of
E. Coli diseases is shown in Figure 15.
In 1995. evcry state in America repaned
olltbreaks of disease causing E. Coli. Figure 16 porrrays the numberofcases reported
ro the COC for each state. 83

ANIMAL OISEASES ANO HUMAN HEALTH RlSK

These numbers greatly underestimare
che actual numbers of disease in each stare
since only about 50 percem of laboratories
even cest bloody diarrhea for diseased E.
Coli. 81 The COC has now formally recommended that alliaboratories tesr bloody
diarrhea at least for E. Coli 0157:H7. 8s

Listeriosis
Listeria monoeycogenes is a bacteria that
can also cause life-threarening disease. The
sympeoms of the disease are similar ro rhe
flu. Although we are making progress in
decreasing the number of Listeria cases, it
sriH causes hundreds of needless deaths each
year in ilie United States alone. A 1995
repore in rhe }ournal ofthe American Medical Association indicated ehat about 1100
Americans each year are aftlicted with Lisreria infection. About 250 of these die of
che disease. 86 An earlier Cemer for Oisease
Control evaluation of this germ showed a
similarly sobering death rate. 8 ? In boeh reporrs, over 20 percem of those who developed infeelion ulcimately died from it. Although Lisceria poses particular tisk for
pregnant women and newboms, only onerhird of ilie recenc cases occurred in such
categories. Ocher individuals ac high risk
for chis infectioh are the elderly and chose
with weakened immune syscems from condicions like cancer, diabetes, Of AIOS.
Food categories associared with me highest risk are soft cheeses and undercooked
chicken. 88 Other items idemified as carrying risk were foods from store deli councers
and "non-reheated hot dogs." The link of
Listeria cases with hot dogs and chicken is
srated in. Figure 17. 89

Campylobacter
Campylobacter is thc leading eause of
bacrerial food poisooing in the U.S., a1rhough it does not rend tO make the headlines. Each year over ewo million Americans are nfecced with this organism and
develop symptoms such as abdominal pain.
fever, nausea, and vomiting. In up to 20
percenc of cases, ilie disease can be prolonged alld severe. Each year as many as
200 dearhs in our councry are traced to
Campylobacter. 9o Campylobaccer infecrion

can also cause Guillain-Barre syndrome, a

serious and potemially life-rhreatening discase. 9I Guillain-Barre is a rype of rapid paralysis that usually bcgins in rhe legs aod
travels up the body. Ir can affect tbe muscles
ofbreaming, and can chus cause respiratory
deam. 92 Cases ofGuillain-Barre can be triggered by omer causes beside Campylobacter.
However. Campylobacter tends to cause a
worse paralytic disease that is usually associated with severe disabiliry even if the person recovers from the acute illness. 93
Whcn assessing foods for Campylobacrer risk, chickcns head thc list. More
than halfofhuman cases is uaccd to chicken
consumption. As recencly as 1990, a Universiry of Wisconsin study of over 2000
egg-Iaying hens from tnree different flocks
found thac ali bur eighr birds were infected
with rhis potentiallydangerous germ. 94 AI
though the organism is usually JUSt harbored
in the birds' imestioes, this is still a problem since most modern chicken are not
killcd the way grandmother used ro do it
(chopping irs hcad off), but are now killed
by auromared machi nes while the chickeus
go by 00 conveyer belts. The bodies of rhe
chicken can be opeoed by the sharp knives
in the kiUiog process and rhe gur contents
are men spilled inta the meat irself. Other

LISTERIA BACTERIA IN HOT

DOGS AND CBICKEN
20% of Listeria cases are linked to
uncooked hot dogs and undercooked
chicken.
The V.S. Department of Agricul1tore
tested t 9 brands of hot dogs and
found that 200/0 tested positive
for Listeria.

figure 17

225

PROOF POSITIVE
foods involved in Campy-Iobaeter disease
ourbreaks include beer, cake icing.. raw milk,
anei eggs. 9 )

Salmonella

226

Among baereria causing signifieam diarrheal illnesses in rhe United Srares, Salmonella is second only ta Campylobactcr,
causing an estimated rwo miHion illnesses
annually.9G There are over 2000 different
varieries of SalmoneHa (referred ro as serorypes).
One of the mosr common serotypes of
SalmoneHa is callcd Salmonella enteriridis.
Each year this serotype causes mally Outbreaks where many people are infected from
a common source. An annual average of
55 such ourbreaks is reportedro the Centers
for Disease Control-a figure thar undoubtedly uoderesrimates significamly tile Illlmber ofoccurrences. A recem well-publicized
outbreak indjeated thac only three our of
every 1000 cases are ever reporteei to public
healrh aurhoriries. 97
Most vicrims develop an uncomplicated
intesrinal infecr.ion with diarrhea, fever, and
chills, but over 10 percenr of pariems require hospir.alizacion. Roughly chree Out of
every 100 who are hospiralized dje. 98 Severe ar life-chreatening complicarions from
infeccion with the Salmonella family of
germs include: infection around the brain
(meningiris), blood infeetions (sepsis), and
chronic anhriris, wirh death resulting in
some cases. 99 Again, inf.1.l1ts, rhe e1derly, and
rhose wirh immune sysrem problems run
rhe highesr risk for severe ilisease.
Salmonella appears ro freely cause largescale ourbreaks. Oile of the most strilcing
single source ourbreaks callsed ne:.lfly
200,000 human infeetiolls. The whole epidemie was traced back ro pasreurized milk
produced ar a single dairy plant. 10o Anorher
large outbreak r.har srruek over 200,000 individuals was traced ca infeeted commercial iee cream. 101 The latter case highlighred
rhe power of relacively few Salmonella organisms ro cause seriolls disease. In spir.e of
the thousands of people infeeted, public
health researchers found rhar even rhe most
contaminared ice cream specimens had onl)'
six Salmone1la baeteria per half"cllp serving

of ice cream. 102 The porential of sllch few

nurnbers ofbacreria ro cause serious disease
highlighrs ilie danger ofthese organisms and
illustrares how difftculr it can be ro ensure
rheir complete eradicarion from even a
single food. Other food icems thar have
caused outbreaks of Salmonella infecrion
include home made iee cream, ehocolare,
eggs, and producrs nude from eggs.
The e,gg situarion !las disturbed mally
consumers, because perfecdy normal appearing grade A eggs can be infeeced. Even
when the eggshells are completely intacr and
disinfected, SaLnonella can stiU be residing
inside. The reason for the SalmoneUa-inside-rhe-shell is thac t!le bacreria can silendy
infect the egg-Iaying organs of apparendy
healrhy hens. Since the shell is formed after the rest of ilie egg, rhe eggs eUl become
SaJmoneHa-infected before the shell even
exists. 103
Even in rhe highesc risk region of r.he
country-che U.S. Norrheasr-oJlly abOlit
one in 10,000 eggs are infected with Salmonella. For rhis reason some consumers
have fclr rhat rhe risk from eggs is small. In
ilie days ofthe family chicken f.1.rm rhat mal'
have been true. However, in roday's world
of mass food producrion, risks are multiplied. The Cenrer for Disease Control has
poiJlted Out that many dishes ruade in res..
taurams and commercial esrabJishmenrs llse
"pooled eggs." In orher words, the conrents
of ofcen hundreds of eggs are put togerher
co make a huge barch of food. The CDC
makes tlle following observarion: "If 500
eggs are pooled, one barch in 20 will be
comaminated and everyone who ears eggs
from that batch is ar risk."J04
Another disr.urbing outbreak of Salmonella occurred recendy in rhe western paft
of rhe COllJltry. Ar least 90 individuals becarne ill from eating cOllraminated beef
jerky. Jerky rhus joined a lisr that now incllldes sausage and salami as important disease-bearing agents. The reason this is so
disrurbing i5 that such animal product5 are
(ypicaJly cOllsidered "ready co eaL" The
average consumer sees no need to cook or
sterilize these items. 10S Chocolate also pose'
a concern since most of ilie rime it is not
heated prior to eating. A summarl' of the

ANIMAL OISEASES ANO HUMAN HEALTH RISK

characteristics of Salmonella diseases is
shown in Figure 18.

Yersinia Enterocolitica Infection

Yersinia has me unusuaI distinetion of
being a common cause of unnecessary surgery. Many a yOllng person with Yersinia
infecrion has llndergone an appendectomy.
The reason for this is thac the germ causes
fever and severe lower abdominal pain rhar
mimics acute appen,dicicis. 106 Foods conraminated wirh Yersinia include pork, raw
and pastellrized milk, choco[are milk, and
rhe Southern delicacy, chimerlings l07 (made
of pig intesenes, known as "chitlins").

Clostridium Perftingens Infection

Clostridillm perfringens is anorher COn)mon cause of food-borne ouebreaks of infecrious ilIness in the Unieed $rates. UsuaUy, over J 000 cases are reported each year
ro t!le Cemers of Disease Comrol, but again,
this is an underestimarion of the actual
cases. 10 & lr is particularly common when
rhe fcod souree implicared in the ourbreak.
is cooked beef. 109 In addition to beef,
chicken meat is also ofren infested with this
germ. When infect ion develops, abdominal cramps and vomiting are the rule, aJthough the symptoms usually last less than
72 hours and hospitaliz.\tions are unusua1.

Beyond Vpset Stomachs

It should be apparenr that food-borne
intecrious iJlnesses C.111 c;U\se many problems
beyond me simple incestinal upscr or diarrhea. As we have already seen, many ofmese
germs can cause life-rhreacening infections.
Orhers can cause chranic crippling diseases.
Campylobacter, as we have noced, can cause
Guillain-Barre syndrome mar onen cripples
wheo ic does not kiIl. Salmonella can eause
a chranic and permancnr anhritis.
The fact is mat more and more infecrious diseases are being Jinked ro chronic
medical problems. A new infectious link
has emerged ro an oftcn-devastacing ineurable intestinal illness known as Crohn's disease. Crohn's can cause such symptoms as
bloody dianhea, fever, severe abdominal
pain, arrhricis, and incapaciry, as well as
obstrLIction of che intestines rhat requires

SALMONELLA DISEASES
SalmoneUa causes two miUion iUnesses annually.
There are many large outbreaks, witb up
to 200,000 peoplle linfected at a time'.
Symptoms are diarrhea, pain, and dehydration.
The infection may lead to meningitis, sepsis, and
chronic arthritis.
Tbe bacteria has been found in raw milk,
pasteurized milk, eg,gs, chocolate, ice cream
(commercial and homem'ade), beef, sausage,
OI

salami, aud chickeu.

I_......;~

Figure 18
surgery. This disease up to now has had no
koown cause and has bewildered medical
seiemists for years. 1 clinencly treat many
Crohn's parienrs and alcllOugh I have had
suecess in colltrolling the condiron in mosr
patienes, rhe disease remains a lifelong one
wirh no cure. Researchers now have nored
a link tha( ac leasc some cases of Crohn's
may be caused by nfeetion with a germ
c.a.lled mycobacrerium pararuberculosis. IlO,
III This organism is exuemely common in
animals Iike sheep and canle. The bacrcria
eause a chronic inrestinal disease called
Johne's disease (hat affecrs approximate1y 25
perccm of U .S. dairy caule. 112 One of the
mosc frighcening aspecrs of this disease is
that healrhy-appearing cows can be infecred
and transmit the germ in dleir milk. In one
study of a heavily infected Ohio herd, over
one in four healthy-appearing cows had the
germ in meir srools and onc in 12 had the
germ in cheir milk. l13 These are parriclIlarly cbilling statistics when you reaJize thar
che germ can survive common paseeurization methods. 114

Leukemia/rom Cows?
Mally people rhink (har cancer is only
an adult discase. Norhing could be {urrher
fronl rhe umh. Cancer is che second leading cause of death among U.S. children. ll5
Only aeeidencs daim more young lives.

227

PROOF POSITlVE

CANCER IN CHlLDREN
Cancer is the number 2 cause of
deatb among children (accidents
are the number j cause).
Leukemia is the le'ading
cause of childhood
cancer dea'ths.

Figure 19

POTENTIAL DANGER OF THE

BOVINE LEIJKEMIA VIRUS
The bovine leukemia virus is present in up to
70% of U.S. dairy cattle.
. It can cause a cattle disease called bovine

Iymphosarcoma.
Most BLV-infected cows
release infectious
viruses or infeded
Iymphocytes in
their milk.
Figure 20

BLV INDUCES TUMORS

BLV milk has been fed to sheep. Sheep
have developed Iymphosarcoma.
BLV milk has been fed to chimpanzees.
Chimps have developed leukemia and
pneumocystispneomonia.

Figure 21

228

Lellkemia, a cancer of the bJood and blood

forming tissues, is rhe leaeling cause ofchildhood cancer deaths in our country, as srateel
in Figure 19. 116
Why is this ofspecial concern in a chaprer on djseases in animals? Becallse mere is
anorher disease rhat is rampam il) the
American cattle populat ion. This disease is
bovine leukemia virus (BLV). The possible
connection ofleukemia in children wirh rbis
carele disease is explained in Figure 20. 117
Notice, as wirh BSE, rhere is a direct
connecrion ta cattle. Bovine lellkemia virus (also called the Bovine Leukosis Virus
or BLV) refers, of course, ro a form of leukemia occurring in canle. Noce how prevalenr chis virus is in American dairy herds.
Beer carde usually have a lower rate of infec[ion. Nonetheless, ar any time, roughly
20 percent of che U.S. caule popularion is
infecred. 11S In addition to leukemia, rhis
virus can cause bovine lympbosarcoma, a
cancer of c!le Iymph tissues in cacde.
Nore thac the leukemia-infecred cows
chemselves are nor the only ones ar risk. The
virus passes inro che milk. 119 This milk appcars ca have che pore.ntial ro cause disease
in animals of orher species who drink the
infecred beverage. BLV-comaminaced milk
char is unpasreurized, when fed ro sheep and
chimpanzecs, has been linked ro serious diseases, as shown in Figure 21.110.121
Srill orher species have been shown ro
be susceprible co BLV: white tail decr, pig,
tbe domesric rabbit, anei car. 122 Ferrer and
associates cired evidence years ago rhat in
the laboratorv human cells also become
infecteel widl 'the bovine leukemia virus. 123
Pasceurization kills rhe virus, 124. 125 bur we
have already seen thar milk can become
tainred due ro conramination afier the pasreurization process ar because of mechaJ1i
cal problems wich pasteurization equipmem. Ourbreaks ofhuman infections rrom
pasteurized milk duc ta germs like E. Coli,
salmonella, aod Yersinia aII provide examples of pasceurizaron's shoncomings. In
shorr, alrhough pasreuri7.<1rion is a useful
procedure dl:lr has increased milk safery, it
by no means sterilizes dairy products. EVeJ1
after pasreuri7.ation, milk is actuaJly teeming with vintscs and bacceria. Chapter II

ANIMAL OISEASES ANO HUMAN HEALTH RlSK

entitled "Milk, Friend or Foe?" has more
information on rhis subjccr.
Ulrimarely we ask ourse1ves, i.s BLV a
tlueat [O human health? The 3n$Wer so far
is rhar we do not know. AJrhough a single
srudy showed more cases of human leukemias in areas that had more carde, 126 other
stlldies reviewed by Dr. Reginald Johnson
of rhe U.S. Animal and Plant Health lnspection Service found no relationship between BLV and human disease. Ir must be
poinred out, however, rhar bovine leukcmia
virus is vel)' similar ro the human T-cellleukemia virus Type.I (HTLV-I ).127 Borh are
in the family of reeroviruses mat also include
HIV. The abiliry of rhis family of viruses to
infect ceJls and rhen cause discase years later
is of particular concern. Consequenr1y, rhe
propensiry for human risk seems to be
presem a.1rhough I am currenrly unaware of
any definite human rhreat.
In shon, BLV may ar may not be causing human healrh problems. However, rhe
BSE story provides an eloquenr example of
how an infecrious disease may appear ar firsr
eo presen{ no human risk only to turn out
later ro be a serious rhreat. The face rhat
BSE and BLV can both infect a wide variery of species is wonhy of a final note. It
seems prudent [O avoid any germ mat can
cross species barriers and cause life-threatening illnesses in unre1ated creatures.

Cow AIDS (BIV)

Jn 1991 the Wall Srreer Journal captllred
rhe aerention ofits readership with a healrh
segmene enrirled "AIDS Cousin Infecrs
Canle." 128 The Journa.l went on to depreciate any pocemial risk from "Cow Al OS."
Their reporring was accuratc; so far, medical research has noe raised aoy grave COI1cerns about this disease. 129 However, chere
are worrisome fearutes abol)[ che virus.
Some evidence of immune alrerarion has
been observed in infeceed cows. I3O Crossspecies cransmission of the virus ro sheep,
rabbies, and goars has also been demonstrated. 13 \ Th is combinarion offacrors raises
similar conctellS tO rhose I havc cxprcssed
wirh regard ro rhe bovine leukemia virus.
[n view of rhis, combined wich rhe realiry
of rhe long incubation period of HIV, [ raise

concern abouc rJle long-term he<\lrh eftecrs

of chis agent, panieularly if ir ultimardy
proves ro be transmissible ro humans.
Since BIV c..ln affecr the immune function of cattle and can cross specics boundaries, it scems prudent ro take measlIfes ro
avoid rhis virus umil we are cerrain there is
no human risk. [n f.1Ct some, such as Jeremy Rifkind from the FOllndation for EconomicTrends, have advocaeed rhat BIV-infeceed cows should not be milked or eaken
[O slaughter umil che long-cerm human
healrh implicarions of this virus are clarified. 1 am sure {har many in {he livestock
industry feeI this is lInnecessary. But in
other cOllnuies such as Swirzerlalld, chis is
exacdy what is being dane, as described in
Figure 22.

Bovine Leukemia Virus

(BLV) inftcts up to 70% of
ddiry cows in some
regions and can Ctluse Iymphosarcoma

us.

SWITZERLAND'S PROTECTION
AGAlNSTBIV
Switzerland eliminates their cattle that have
the BIV virus.
They allow RO imported caUle 0r beel
infected by BIV.
The U.S. caD no longer export beef to
Switzerland because we have
DO eradication program
set up for BIV.
Figure 22
Swirzerland has also been concerned
abouc r!le similarities between BIV and HIV
Until long-rerm studies darify {he issues,
they do nor want [O expose their cirizens ro
chese infectioLls agents found in cattle ar
rheir milk.

Most Food Poisoning Involves Animal

Products
Animal products are not the ooiy prodUCtS Ihat can be contaminared wirh bacteria. However, che vast majority of infected

229

PROOF POSITIVE
foods are red mear, dairy prodUCIS, fowl,
eggs, and seafood, according ro che Cemer
for Disease Control's reporrs on infectious
illncsses from foods. A significam decrease
in these serious diseases would occur if a
vegerarian cliel were more widely adopted.
A summary lisr of the aforememioned
diseases of aniOla1s rhar are a dueat ro rhe
healrh ofhumans is shown in Figure 23.

The Risk ofHuman Association with

Animals
Other (han risks from eating animal prodare there hazards merely from UJorking
with animals? The allswer is yes. Dai ry farmUCIS,

LIST OF AFOREMENTIONED
ANIMAL DISEASES THAT
THREATEN HUMAN DEALTU
BSE and other
prion diseases

Cow AlDS (BIV)

Crohn's disease

E. Coli bacteria disease

Listeria
Salmonelia disease
Bovine leukemia virus
(BLV) disease

Cancer
Clostridium
perfringens
Campylobacter
Yersinia

Figure 23

DISEASES ASSOCIATED WITH

TDE BANDLING OF ANIMALS
Hodgkin's disease
Multiple myeloma
Leukemia
Cancers:
melanoma
Iym~phoma

ers, vererinarians, and mear handJers have signil1candy increase<! rares of a number of seriOUS diseases, as (isred in Figure 24. 1 2
Ahhough faemers have exposure 10 peslieides <md chemicals, many of rhe research artides foeus on the possibiliry of exposure [Q
c1l1cer-inducing viruses as being a fu.cror.I~J
Ofren dle selrings in which animals are
raised are so unhealthhl( rhar humans working in rhose siruarions are more susceprible
ro illness. Specific caregories of liveSlOck
workers are also exposed 10 unique risks. For
example, beeause pigs aee usually raised in
enclosed "facwry houses," hog farmers may
develop a variery of respirarory ailmenls
from (heir work in rhese closed buildil1gS.
Srudies show rhar nearly half of rhose working in such enclosed buildings (pig or
chicken) complain of bronchiris asrhmalike conditions, inllamed sillllses, or flu-like
illnesses. 134 . \35 This has becn amibmed ro
brearhing duse and gasses from pig feces and
uri ne. Confined employees in poulrry farms
have similar respirarory problems. 136
Perhaps (he area ofgreaecse occllpariona!
concern reiares ro rhose who work in slaughrerhouses and mear packing planrs. A rccem study looked ae some 10,000 of such
individuals over a period of nine years. 137
The resulrs revealed an exeess risk ofali cancers combined. A number of pecific caneers were also increased. These induded:
cancer of rhe lung, C1.ncer of ule mourh and
rhroat (bueeal caviry and pharyn..x), aud GUIcers of rhe esophagus (rhe swallowing rube),
colon, bladder, kidncy, and bone. The inereases in risk were oflen impressivc.
Hodgkin's disease dearhs were increased sixfold, morraliry from orher Iymphomas was
rripled, and leLlkemia dearhs were more (han
doubled. The invesligarors raised rhe quesuon as ro wherher such increases cOtlld be
relared ro exposure to BLV alld ocher callcer-inducing viruses. Their research leaves
us wirh serious concems abour (he possibiliry of oceuparional risk ro stlch workers.

stomach cancer

prostate cancer
Paget's disease
Figure 24

230

A More Complete List ofHuman

Diseases Contractedfrom AnimaLs
The information in (his chapter has provided appreeiable evidenee regarding rhe

ANfMAL DISEASES ANO HUMAN HEALTH RlSK

serious nature of disease in animals :wd rhe
risk ro humans. However, 1 have only
rouched rhe surface of an exrrcmely broad
subjecr. Dozens more pages couJd have been
included thar deal wirh rhe roxicologic and
infecrious diseases that are increased byeating animal produc[s Of having contact wirh
animals. IfI were making a more complete
lisr of animal-relared condirions rhar affect
humans, it would include aii of those listed
in Figure 25. 138

Futuristic Animal Jnsights

About one hundred years ago a.n amazing warning was wrirrcn concerning rhe
dangers of eating dairy products. Ellen
Whire went on record wirh this admonitjon: "Jfmii k is used, ir should be thorough~y
sterilized. With dus precaution, rhere is less
danger of conrracring disease from its
use."139 How do you thoroughly srcrilizc
milk? Ir is simply old-fashioned boiting.
She funher explains: "Let ... diet reform be progressive. Ler rhe people be
raughr how ro prepare food withour [he use
of milk or buner. Tel! them rhar rhe rime
will soon come when there will be no safery
in using eggs, milk, cream, ar blltrer, because discase in animal.s is increasing in proportion ro (he increase ofwickedness among
men."140 The scientific dara prescmed in
this chaprer has proven thar rhis prediction
was correct.
A sraremenr by rhe same author in 1898
provides insighr into why rhis ropic is 50
imporram. "The lighr rh:u Gad has given
me is rhat rhe curse of Gad is an rhe earrh,
rhe sea, rhe carde, on rhe animals. There
wiU soon be no safery in rhe possession of
Aocks ar herm. The eanh is decaying under rhe curse of God."'41 The Scriprures
presem a similar picrure for r!le lasr days.
Thjngs are nor going ro get berrer; ehey are
desrined (O ger worse. Sbe conrinued. "By
precepr and example. make it plain chac rhe
food which God gave Adam in his sinless
stare is rhe besc for man's use as he seeks ro
regain rhar sinless srarc."142 She is referring
ro rhe Bible book ofGenesis dut lisrsAdam's
original diet, which was eorally vcgerarian.,
devoid of ali animal producrs. 143 TIle evi-

OTHER DISEASES ANO CONDITIONS

ASSOCIATED WIm EATING ANIMAL

PRODUCTS OR EXPOSURE TO ANIMALS
trichioosis (also called
triebincllosis)
gjardia lamblia
vibrio vulnificus
psittaeosis
hookworm
rabies
leptospirosis
vibrio eholera (the
agent causing cholera
fish l.apcworm
(dipbyllobotbriumlalum)
isospora belli

scombroid
bantavirus
roundworm
bruceUosis
plague (thc agent causing
bubooic plague)
pork tapeworm (tacnia solium)
bec! tapeworm (taenla saginata)
antbrax
dguatera poisooing
ring worm
giardia Jamblia
tularemia
eryptosporidiosis

Figure 25

clence sllggeStS rbar much of rhe gloorny dat.a

presenred in chis chapter is just a small
glimpse of what fhe furure has in storc. I
do nor presem rhis facrual data ro terrify
anyone, bur insread ro warn you of rhe possibilities sa rhat you can begin now ca learn.
a new way of earing [har escapes rhese porcnrially dismal diseases.

Now ls Decision Time

Mosr of liS pur off ;lny decision abollC
changing our lifesryle umil we tire fiJrced to.
However, when ir comes ro dielary changes,
often rhose "musr change' siruarions come
roo Iare. Changes in dier will nor help mllch
ifyou are diagnosed wirh Crelltzfeldt Jakob
disease. When Salmonella, Lisreria,
Cam pylobacrer, ar anorher food-boroe
acute infecton srrikes, you could be one of
rhe "unlucky ones" and nor live ro choose a
berter dier. Even survivors can develop irreversible physical problems rhar no nueritional program can ..esolve.
The documenred informarion in this
chaprer calls for a decsion. The decision
rime is now. In lighr of rhe evidence of rhe
numerous and serous dise<tses in animaJs,
choosing rhe safest clieI is cerrainly reasonable. Ir makes sense. Focus noe an whar
you are giving up, bur rarher 011 rhe wide
variery of frujrs, grans, nues and vegcrables
r11:lt c.1n be hearrily enjoyed on chis optimal
diet.

231

PROOF POSITIVE
Gibbs CJ Jr. Ashc.r DM. er al. TransrnissiOIl ofCrcun:fcldt-Jakob disl':lSC
by e1eclroelcs conl3minated during ncurosurgery.} Nrurol
Nml'OJllrg Ps)'cbil/lry 1994 Jun;57(6):757-7511.

Reftrences -

li

, Thc Briti.h The Spongiform EncephaJoparhy Advisory eAl1lmince. Reporr ro ParliatllCIH on March 22, 1996 (prinred reporl downJoaded from
Microsoft Network's BSE forum).

10 a chimpanu,e

rrm K. Bwi", Spongiftrm Enap/liI/opmby. Vpdnte. Animal and Pbm

Heal.!> Inspc:ction Serviccs (API-US). U.S. Deparrmt'nr of Agricuhure.
19%1'. J.

Minislr)' of Agriculrurc. Fisherics. and Food (MAFF). United Kingdom

(UK): BSE: 12'monlh summary of devdopmenls. Http://
ww.....maff.gov.uk.3nimalhfbsclbscanni.hml. Updalcd ro Fcb. 28, 1997.
!

l'alter901l W). De:tllcr S. Bovine spongiform t'ncephalopathy and the

public h<:ahh. } f'lIb/h- Hro/r/JMrd 1995 Sep;17(3):261-268.

} World Hcahh Org31liz:uion Press Release (WHO/28). Inrernational Experrs Proposc ]Vle-asures To limit Sprc"d Of BSE And Reduce Possible
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10

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');) OUlbre:tk o( Salmonella cl1Icrilidis :Issoeiaeed wid, Il:lliollaliy di tribured ;cc cream producIS-MinJleSOl:l, Soulh Dakora. and Wisconsin, 1994.
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OUlbrcak of SaJmoneUa elllcrilidis associaecd \Vilh n:leionally dislribulc:d ice cream producls--Minncsora, Sourh Dakola, and Wisconsin, 1994.
MMWR Morb Mor/IIi Wkry &p 1994 OCt 14;43(40):740-741.
100

Hellnessy TW, Hedberg CW, CI al. A narional outbreak of Satmonella

enlerilidis infeclioos from ice cream. The Invesug'lIion Tearo. N ElIgl J
M/!d 1996 May 16;334(20): 1281-1286.
101

,nI HennessyT\V, I-iedbcrg Cw, CI al. A nalional olllbr....Jk ofSalmonclla

elllcrilidis ;nEecrions hom ice cceam. Thc !nvcslig:llion Team. N Engl J

Med 1996 May 16;334(20):1281-1286.

234

Il,

USDA:APHIS (AJlimal and Planl Healeh Inspection Service).

P. 6-7. {Nole: Florida in rhe 31 quarlcr of 1995 had 31 o( 42 canle leStc:d

pOSilivc (or a rale of approx. 74%).
'" USDA:APHIS (Animal and l'bnr Heahh Insp('clion Service).
DxMOl/itor: AlIimlll J-Ie,dtb R,'Port. Winler 1995. Fon ColJins, Colorado.
p. 6-7.
119 )ohllsoll R. K:lncclle JB. Bovine Lcukemi'l Virus. Pan III. Zoonol;c
POlcllrial, Molecular Epidemiology. :Ind an Animal Model. Compendium
on Concinlling Educmon (or rhc I)ra licing Veterinarian 1991; 1.3{1 O): 1631
1637.

IlO Baumganenc.e L, Olson C, Onuma M. ElTece o( paslcuriz.1tion and

heal rreallllelll on bovinc lcukemia virus. J Am Vt-t Md /ts,OC 1976 Dec
1; 169(11): 1189-1191.
I I McClure HM, Keding ME, CI al. Eryehrolcukemia in rwo infam chimpall7.Ce5 fed miJk from cows nalurall)' infcClcd wieh Ihe bO"ine C-eype "irus. Cllnar Re, 1974 Oct;34{1 0):2745-2757.

Il.!

Baumgancllee LE. Bovine Lcuktmia Virus 'Transmissioo Sludics. Diss

I1b,tr JIU ( ci) 1982;42(11):43J9-B.

Il,} Ferrer JF. Ken)'on SJ. GUpl:' P. Milk of dairy cows fre(lucml)' concaillS
a lcukemogcnic virus. Scimce 1981 Aug 28;213{451 1): 1O14-1 O16.

ANIMAL OISEASES ANO HUMAN HEALTH RISK

Il'; Rui>ino M), Oonham K). InaClivalion of bovine lcukcmia virus-i.nfCCtcd lymphoCYlcs in rniLk. Am] Vrt &5 1984 Aug:45(8):1553-1556.
IlS Baumganener LE. Bovine leukemia Virus Transmission Studics. Diss
Absrr ITII ($ci) J982;42(11 ):4319-B.

Donham KJ. Berg )W, Sawin RS. Epidemiologic relalionships of lhe

bovine populatioll and human leukcmia. in 10w:L Am] Epidnlli{l/ 1980
)ul; 112(1 ):80-92.
116

)oh/lson R. !<m<xoc JB. 199). Bovi.n~ Leukemi. Virus. Pan III.

Ioonolic POlemial. Mole ular Epidemiology, and an Animal Modd. Compendiulll on Cominuing Educalion for lhe Practicing Velerinarian 13(10):
1631-1637.
Il

118

Ingersoll B. AJDS Cous;n Infeecs Canle; No Oanger SeCll. Th,' W'ilU

Slrm JOl/mtd. 1991. Friday, May 31.

Donham K}, MerchaOl )A, el al. Prevcnling respiralory disea.e in

wine conhnell1CI1t workers: ilHervelllion through applied epidemioJogy,
ooucalion. and collsuJI:lrion. Am J hul Mrtl1990; 18(3):241-261.
134

13' Zuskin E, MUS'lajbegovic), CI. al. Rcspiralory IUncoon in poulrry workcrs

and pharmacoJogic dlaracleriz:llion of poulrry dUSI e.xlraCI. I:.1/IJron 1W
1995 )uJ; 70(1): lJ-19.

136 Pederscn B, (versen M, CI al. PiS farmers havc signs of bronchia! inOammarion and ;ncreased numbers oflymphocYlcs and nClIlrophiJs in BAL
Ouid. E'II' R''pir J 1996 Mar;9(3):524-530.
137 ]ohJ\son ES, DaLmas O. el:U. Cancer mOflalily among workers in
aballoirs and meal packing plaols: an updalc. Am JInd l\1ed 1995
Mar:27(3):389-403.
I 8

OUlbreak of lrichinellosis asso ialed wilh ealing c.ougar jcrky-ldallo.

1995. MM\'(/R Morb Mortlll Wk& Rep 1996 Mar 15;45(10):205-206.

Van Oer Maalen MJ. Whelslone CA. Sludics of C.1lde NalUrally and
Expnim(:mally Infect d Wilh Bovine lenli\irus. Imrnllnobiology of Vi rai
Infeclions. Proc. 3'" Congress Europ. Soc. Ver. Vi ro!. 1995. (~ 353-357.

1)9 \'<o'hile EG. C{ll/web on Din 1I11d Foods. HagerstOwn. MO: Reviewand
Herald Publishing Associarion. 1976 p. 357. (iltl1C5 supplicd)

130 Van Oer Maarcn M]. Upd:ue of Bovine Leukosis Viru and BO\'ine
Immunoddieiency Virus. TNAVC 1993 Procecding.. Pagcs 614-615.

1 o WhilC EG. COl/web 011 Diet II/Id Foods. Hagersrowo, MD: Reviewand
Herald Publishing J\SSoci:lljon, 1976 p. 349.

131 Archa.mballh O, NacLill-Davis S, el al. The Bovine Illlmunodefecicncy

Virus: 1990-1992 pdalc. \1/:1 Re; 1993;24(2): 179-187.

1 1 WhilC EG. COllme!> {In DcllI1ul Foods. HagerSlOwn, MO, Reviewand

Herald Publish ing Asso ialion, 1976 p. 414

1 1 Blair, A Ooseme i M, Heinel11an EE Canc.a and olher ClUSCS of dcalh

:1Illong male and (emalc farmels from rwcllly-lhree Sl'lIes. Am} Irul Med
1993 May;23(5J:729-742.

142 Wh.ilc EG. 01l1rH,I. on Din nI/ti Food. Hagerslown. MD: Rcview and
Herald Publishing Associalion, 1976 p. 460.

119

14J

Gcnisis 1:29. Tlte H{I(Y Bible. Aurhonzcd King )amcs ve!'Sion.

]ohnson ES. MOflalily among 1I0n while rnen in rhe meI{ induSlry. }
Oemp Med 1989 Mar 31 (3):270-272.
1.1.3

235

PROOF POSITIVE

236

CHAPTER ELEVEN

ILK:
Priend or Poe?

r was an unuslial conflicL The amagooises represemed ewo grollps ehar lISUaJly ery ro work rogerher. an oile side
were members of rhe rnedical research
commullicy, and on rhe orher was a major
player in American big busilless. Whar exacuy was going on? Scienrific comrnuniry
mernbers rhrough their research publicadons were, in effecr, eaking 10 rask the forces
of ehe American Dairy Associarion. The
clear conrenrion of rheir medical research
W;IS rhar rhe Association was engaging in
misleading advertising by using the slogan
"Everybody needs milk." When ehe Federal
Trade Commissio.n looked inro rhe matter,
r11ey carne ro a surprising condusion: ehey
agreed solidl)' with rhe researchers and issued a "proposed complaim" citing ehar rhe
slogan Everybody needs milk" represenred
false, misleading, a.nd decepeive advertising. '
This FTC judgrnenr in 1974 called artcnrion (O a consistent srraregy of the dairy
indusrry: devise marketing slogans aod approaches rhae impress people with rhe
healrhfuJness and desirabiliry of milk producrs. Somc of these slogans, often accompanied by an attractive arhlere or a beaurifui person wirh a white rim ar their upper
lip, are summarizcd in Figure 1.1
Ir is one rhing lO try to awaken a desire
for a service or product-afeer aII, ehar is

rhe basis of mosr adverrising rhar bombards

froUl day ro day. But it is quite anoeher
rhing ro pass something off as healeh giving
if ir really is nor. In view of rhis, the 1974
decis ion of rhe Federal Trade Commission
raised a very important issue. Why would
rhe govcrnmel)( seeI' into rhe [ray and disalJow a claim that mosr Americans accept?
Whether it is today's U.S. Deparrmem of
LIS

Milk, What a Surprise

Real Men Drink Milk
Everybody Needs Milk
Milk is a Natural
Milk is the Perfect Food
Milk: Drink It For AII Jt's Worth
Milk Dr,nkers Make Better Lovers
Milk "as Something For Everybody
Figure 1

237

PROOF POSITIVE
Agriculture's Food Guide Pyramid ar rhe
four food groups ofyesreryear, the implieation for decades has been that aU Americans do indeed need milk. Whar. (hen,
could have prompted the FTC ro object ro
the dairy indllsrry's saying rhar "everybody
needs milk"? The Ilmwer 10 the questionforms
thc basis JOI' this chtlpter. Immediately after
the 1974 deeision., the dairy indllstry
challged their slogan ro "Milk Has Some-

ODe food dollar out of seven

is spent on dairy products.
The average persoD currently
consumes 586 pounds of dairy products per year.
Five cents is spent 00 milk advertising per 100
pounds of dairy products sold.
ODe out of seven congressmen receive election
support from the dairy industry.
Figure 2

rhing for Everybody." Although 00 one ehallenged the aceuraey of thar slogan, the real
quesrion is: do you re.'llly wanc that "somedung"?
Some may feei iliar merely suggesting
rhar there may be problems associared with
milk and dairy producrs is almost un-Anlercan. This chapter is nor promoting a new
smear campaign. 1 am merely poinring out
that a litde-known FTC eomplaim against
the dairy indusrry over 20 years ago eloquently argues rhat every American should
become weB acquainred with rhe medical
faers regarding milk. Aft.er alI, good healdl
is nor based on following our preeolleeived
ideas or cuJr.ivated preferences-ir is based
on cooperaring wirh rhe laws ofhealrh rhar
govern us. Ir thus behooves every American
ro put senrimenrs aside and look seriously
ar why [he U.S. governmenr would reject
rhestatemcnt [hat "everybody needs milk."
We deserve ro be able ro make an intelligem decision regarding our personal use of
milk and milk products.
The mes..~age thar wiU emerge c1early in
this chaprer is rhat medical experrs have
known abolit health problems wirh milk for
decades, bur these eoneerns have nor reeeived much publiciry. We need ro recognize thar it is very difficult for preventive
medicine messages ta be heard c1early when
powerful commerciaJ inrerests are pmting
millions of dolJars behind promulgaring a
message of half-ulIrhs.

The Power ofthe Dairy Association

Cow's
Milk

84.7

Human
Milk
Death rate at 9 months, per 1000 infants
Figure 3

238

The magnirude of the dairy industry's

influence on rhe sale of their products and
the political scene in the U.S. is enormOllS,
as shown in Figure 2. Few of uS arc aware
that 14 percenr of the U .5. food budget is
spent an dairy producrs,3 providing an average of more than one and a half pounds
per day of the.se products per person. 4 With
such an immense sales volume, it is no woncler rhat the Amcric;1ll Dairy Association is
a powerful and well-financed organiz."lcion.
A large portion oftheir da.iry reveoue is Strategically channeled into a hllge advenising
budget dedieated ta a variet)' of milk
promocionals. s This is wlty you see so many
dairy ads an television, radio, and in prim.

MILK
~urrhermore, fhe ADA holds a eonsiderable
amoum of political dom n Washington.
Some amibure rhis ro irs panerns of politica] SUppOT[ thar is secured by providing cleerion campaign funds ro as many as J 5 percenr of U.S. congressional represenrarives. 6

Infants Need Their Mothers'

Antibodies
Scienriftc research began turning Lip
problems wirh milk as far back as 1930,
when infaM dearh rares were examined in
re/arian ro the use of cow's milk. Prior ro
rhe discovery ofanribiorics, researchers studied 20,000 infanrs in Chicago. Ooe grOllp
of infanrs was fed human breasr miile and
rhe orher group was fed boiled cow's milk.
Thc resulrs are shown in Figure 3. 7. s
A pediatrician's slandard medicaJ texrbook roday will srate rhar in rhe currenr era
ofimproved medical rreatmenr, breasr-feediog is unlikely ro provide a sllrvivaJ benefic
However, it srill acknowledges thar rhere are
.,imarions where ir can save infams' lives.
One rexrbook srares, "AJdlOUgh fiule if any
difference exisrs in mortaliry rares in formula-fed and breasr-fed infanrs receiving
good care, among the lower socioeconomic
groups and those living n unsanirary condirions. the breast-fed iofam is more likel)'
to survive."9 Regardless ofliving conditions
and (he available drllgs, an infanr's immune
system is compromised by feeding it cow's
milk rarher rhan human milk. Srudies [0day stiU favor breast feeding over infanr formula 01' cow's milk feeding. lO II, 12 For instance, even in r!le era of anribiotics in rhe
Unired Starcs, infanrs fed formula OI' cow's
milk are 80 percenc more likely ro develop
diarrhea and 70 percenr more likely ro develop ear infecrions when compared wirh
inGnrs who arc cxdusively breast fed. 13
What is it abollt human breasr milk rhat
provides infams wirh such al) advantage in
rerms of immuniry? We prohably srill do
nor know alI the answers, bur severaJ important facrors arc deal'. They are (isred in
Figure 4.
The firsr advanrage of human miJk is
(hat ir provides a child with the morher's
anribodies, and rnose antibodies are very

prorecrive when it comes ro infecrious illnesses. 14 onversely, cow's mlk or infam

formula is devoid of rhese prorect.ive agenrs.
Second, white blood cells caJJed macrophages can be passed from morher ro child
rhrough breasr milk. 15 These macrophages
may be able ro provide usefuJ immllne funcrions while in rhe child's inresrinal system.
Third, breast milk comatns a compollnd
called laeroferril1. This agem rends ro block
ilie growth ofE. Coli in rhe inresrine. 16 This
is no smalt maTter roday when many are weU
aware of the deadly E. Coli srrains rhar have
daimed rhe lives ofyoung children. Fourth,
breasr milk is usually sterile (exeepr when a
morhcr has a breast iJtlecrion or widespread
bodily infeetion). This can significand)' decrease the child's exposurc ro infectious
ageurs. On rhe other hand, cow's milk is
dcscribed as being "regularly contaminated"
as well as being a "good clllrure medium"
(place ro grow) for dangerolls infecclous
agcnts,17 as we shall see.

Other Advantages ofBreast Milk

Human milk is also differenr from many
mammalian milks because of irs relatively
low comenr of phosphorollS. As 1 poinr out
in Chapter 7 an prorein, phosphorus appears ro make calcium absorption more

Mother's antibodies are passed

00

to baby.

Mother's white blood cells are passed

00 to baby.
Bre-ast milk contains lactoferrin,
which blocks E. Coli
bacteria growth.
Breast milk is usually sterile,
unlike cow's milk.
Figure 4

239

PROOF POSITIVE
difficult. Thus, a child wiU tend ro absorb
more ca!ciulll from Mom's low phosphorus
milk rhan from phosphorus-rich cow's milk,
as explained in Figure 5. 18
Funhermore, high phosphorus imake
presents orher problelJls that human mjlk
also avoids. Some of these benefits may further explain why breast-fed infants fare ber-

LOW ABSORPTIO OF CALCIUM

FROMMILK
DnJy 25% of tbe calcium in cow's milk is
absorbed by tbe body.
Human milk, although cootainiog less than half
the calcium of cow's milk, is a beUer
source of calcium because of its
high absorption.
Kale, turnip greens, or sesame
seeds are beUer sources as weU
for tbe same reason.

Lactose (Milk Sugar) Intolerance

Figure 5

crASE DEFICIENCY
HEALTHY ADULTS
Bantus
Filipinos
Thais
Japanese
Greek Cypriots
Taiwanese
Greenland Eskimos
Arabs
Ashkenazi Jews
American blacks
Peruvians
Israeli Jews
Indians
Finns
Danes

90%
90%
90%
85%
85%
85%
80%
78%
78%

70%
70%
58%

50%
18%
2%

Mi/k will produu lower abdominal cranlps, gas, and

Wdtery stools in lactase deficient individuals.
Figure 6

240

rer in r!le face of infecrions. 19 First, on a

lower phosphorus dier children have more
acidic colon comenrs, thus making ir difficult for disease-producing germs ro grow in
the intestine. SecondJy. newborns rhat are
on a lower phosphorus breasr milk regimen
are less likely ro come down with a evere
complicatiol1 of infection ca!led meraboljc
acidosis.
Beyond the p,revenrion of infecrion,
breast miJk has a number of additional benefits. The fat from breast milk is much more
easily digested than rhe far from cow's
milk. 20 Although fat may get a bad rap an
toda}"s commercials and talk shows, it is a
critica! ingredient for early childhood developmem. Cow's milk is also deficient in
Vitamins C a.nd O, whereas breast milk generaJJy gives 5ufficient quanrities of these rwo
essemial nutrients. 2 !

American humanitarian ajd backfired

severaJ years ago when our nation attempted
to help cenain SOllth American coumries.
We disrributed large quamities of powdcred
milk rhat resulred in widespread cases of
cramping and diarrhea. 22 Cow's milk is rich
in a simple sugar called lacrose, or "milk
sugar." However, aher infancy, many people
Iose cheir abiliry ro digest lacrose. Tbey develop an insufficiel1cy of the enzyme la.ctl1Sf
rhat is needed ro break down lactose into
rwo simpler sugars so that it can be absorbed. The resulr is thar undigested lactose
rravels ro the large intestine where bacreria
break rhis sugar down, producing anyrhing
from gas, ro cramps, ro diarrhea. L1ctose
imolerance appears to be the main factor in
as many as a third of cases of recurrem abdominal pain in chjldren. n
Well over half the world's population is
lactose-imoleranr. 24 Some races tend to Iose
the lacrase cnzyme earlier in life than mhers. As a rule, individuals of northwesrern
European descent maimain cheir abiliry to
digest IactDse bencr than most races, such
rhat a greater proporrion of them are able
ro drink milk imo adulehood wirhout unroward nte-srinaJ effecrs. The frequency of
lacra e deficiency among differem races is
lisred in Figure 6.25.26.27

MILK

Broad Extent ofHealth Problems

with Cow's Milk
The late Or. Frank Oski was head of rhe
Johns Hopkins Children's Medical and Surgery Cenrer for 10 years and professor of
pediarrics and deparrment chairman ar
Johns Hopkins Universiry. He was editor
and founder of the jouma! Conremporary
Pediatrics and was a member of rhe edicoriaJ board for The Europe<tn Journal of Pediarric Hematology and OncoJogy. He
aurhored or co-aurhored 300 academic papers and 20 books, including rhe recently
published The Pracrical Pediatrician. He
was nor ol)ly a credible scienrisr, bur was
also one of rhe mosr vocal advocates of rhe
dangers of cow's milk. Or. Oski wrore rhe
wclJ-documeored and very readablc book,
Oon't Orink Your Milk. Perhaps one of rhe
grearcsr contribucions ofhis book is its demonsrrarion of rhe broad exrem of heafth
problems linked wirh rnilk drinking. From
his book and orher sources, 1 have drawn
up a list of my 10 major eoncerns wirh the
ehildhood heaJrh effecrs of cow's milk. Six
adult hea.lr.h coneerns relared co eow's milk
are listed and examined larer in rhe chaprer.
The ehildhood concerns are lisred in Figure 7.

Milk ALlergies
Firsr an the list is aJlergics. Allergies and
asthma are an a dramaric rise in America.
Infams not exposed ro cow's milk develop
far fewer allergics compared ro those being
fed cow's miJk. 28 Human milk may help
prcvenr rhe dcvelopment of allergic diseases
larer in ljfe by boosring an infanr's immune
sysrem. 29
Nor only is human milk beneflcial ta a
child's immune system, i[ also avoids what
is probably rhe mosr common aJlergen in a
child's dier-name!y, cow's milk. Nelson's
Textbook ofPediarrics is quire dear an rhis
relarionship: "Mosr auention has focused
an cow's milk protein as rhe major cause of
.
. 1 fi00d a II ergy .
c
"30
gaSrtOlIHesUO;l
tn 'JnIallts.
Allergies are common in ehildren and food
allergies are no exception. Estmarcs of [he
number of children affecred are djfficulr ro
aseenain, since many may have minor

symproms thar do not carne ro medical atremion. However, one study in Swedcn esrimared rhar as many as 1 in every 70 children sllffers from food allcrgy.31 Other srarisrics indicare an even more prevalem problem in cenain age groups. Aetual milk or
casein (milk prorein) allergies can manifesr
rhemselves in seve rai ways. These symproms
include mourh 111cers, diarrhea ar consriparion,32 reeral bleeding, vomiring, recurrenr
arraeks of nasaJ congesrion, skin rash, and
reeurrem bronchiris. 33 . 31.35,36 One of rhe
major rrearmems for childhood food aJlcrgies is a period of cow's milk abstinenee. If
rhe allergy is duc ro cow's I)),ilk, acme symptoms are usually gone within rwo days, whjle
chronie problems may last a week ar
10ngcrY For rheir child ro ger well, SOme

USI G COW'S MILK

Allergies
Iron-deficiency anemia
Lowered intelligence
"Milk sensitivities"
Earlyatherosclerosis
Juvenile diabetes
Acne
Rheumatoid arthritis
Dental decay
Infectious diseases
figure 7

241

PROOF POSITlVE
morJlers who arc breasr feeding ma)' a1so
need ro eliminare cow's miJk ti-om rheir own
diers. Apparenrly, cow's milk prorein ingesred by rhe morher can make irs way inro
her own milk supply.38
The bane of many a young parenr's life
is colic. "Colic" refers (O episodes ofextreme
abdominal pain in infants. The artacks rypically occur wirhour warning and may lasr
for hours; rhey are ofren accompanied by
comnuous crying. 39 lnfanrile colic occurs
in abolit 20 percenr of aII in.fanrs. 5rudies
indicare rhar in about one-rhird of breasrfed infams wirh colic, the symproms disappeared when rhe mother adopc.s a dicr free
ofcow's milk. 40 This lends funher evidence
ro (he concepr thar ar teasr ome cases of
colic are due ro an allergic reaction ro cow's
milk consriruenrs.

lron-Deficiency Anemia
Tron-deficieney anemja can also resulr
from an inrolerance ro cow's milk proreins. 4 l.42 In f.Kr, when you look ar ali U.S.
cases of severe iron deficiency in infanrs, as
manyas one- rhird of c.hem have blood loss
due ro exposure ro a prorein in whole cow's
milk. 43 Exposllre ro this prorein results in
sloughing off of rhe intestinal lining cdls,

"MILK SENSITIV TY"

Chronic fatigue
Tension headache
Musculoskeletal
pain
Hyperactivity
Bedwetting
Figure 8

242

Aggravation of
allergies and
congestion
Asthma aud other
respiratory
difficulties

causing smaH amounrs of bleeding. When

blood js losr, iron (a constituem of blood)
is lost as well. Problems are compounded
because cow's milk does lirt.1e ro helI' replace
iron loss. It has only abolit one ftfth the
amount of iron fOllnd in human milk. 44

Loweredlntelligence
The presrigious American Academy of
Pediatrics recently enunciared one of rhe
most sobering messages regarding iron deficiency: "iron deficieney in early childhood
may lead to long-term changes in behavior
tllat may not be reversed even wirh iron
supplementarion slIfficienr ro correct rhe
anemia."45 For example, premature inf.1nts
who were raised on formula or cow's miJk
have an eight to ten poinr lower IQ rhan
breast-fed preemies. 46 . 47 0rher E\ctors besides iron deftcieney are involved in cow's
milk-rdared inrellectual impairmem. Dr.
Crook lisrs "learning difficulries" :lmollg rhe
manifestarions ofmilk allergy.48 SriJl another
reason for lowered intelligence ma)' be duc
in pan tO the lack of omega-3 fars in cow's
milk and cow's mitk-based formula. 49 . 50. 51
These fars appear ro be necessary for optimal brain growth and deve!opmenr.

"Milk Sensitivities"
One of rhe most hody comesred areas
in medicinc is the domain of ;IIJergies anei
sensiriviries. Regarding dair)' foods, some
I'hysiciam insisr rhat rhere are fonns of milk
intolerance that are nor true allergies, but
srill conrribute ro a broad range of physical
ills. They refer to rhese disorders collecrivel)'
as "m il k sensitivi des." The problcm wi rh the
alleged milk sensiriviries is rhar rhe)' are believed [Q comribure to relativei)' common
conditions, condirjons that are ofren re1ared
ro multiple f:.1.cwrs. It can rherefore be difficult ro pinpoim milk as clIC gllilr)' culprir.
Some of the condirions fOlllld in (he medical lieerarure include chronic fatigue syndrome,52 tension headaches,53 muscllloskderal pain,54 hyperacriviry,55 and even
bedwerting. 56 For reference I'urposes, this
list of disorders along wirh rwo more is repeated in Figure 8.
I rhink tbe most construcrive way ro look
ar (his area is ro be open ro rhe possibiliry

MILK
rhar sorne of (hese comrnon condirions
may-in certain situarions-be re1ared, ar
leasr in pan, ro milk ingcstion. By no means
would 1 jmply that milk is the sale cause or
major cause of these problcms. However
this iltlormation is in ilie medicalliterature,
and a triaJ of a monrh wimoue any dairy
produccs is considered a wonhwhile experimenr for most people -particularly if rhey
are having significanr problems witil rheir
healrh.
Alrhough many physicians may be skeprical of these milk sensriviey associations, 1
have had enough real-life experiences ro
cause me ro be ver)' open ro rhe possibiliey
rhar dairy food allergies can have a mIe in
more conditions than we would normali)'
imagine. For example, as an Internal Medicine specialist who liS li al 1)' deals with adulrs,
1 personally have seen a number ofchildren,
mostl)' boys, who were still bedwetting ar
eighr or ren years old. Upon disconrinuing
the use of dairy producrs, rheir bedwerting
ceased.
Anomer big concern in the area of milk
sensiriviry is irs conrriburion ro respirarory
problems. 1 have already menrioned that a
full-blown dai!)' food allergy can aggravare
respirarory disorders, bur now 1 am referring ro individuals who have symproms [har
cannor be explained by eheir immune
syseem's responses ro cow's milk. For some
reason, dairy consumption seems related in
some children to mucus producrion,
coughs, and lung disorders. Nelson's Texrbook ofPediarrics poinrs out rhar X-ray lung
abnormalities calJed "pulmonary inft.ltrates"
have been relared ro cow's milk,- 7 The texr
also lisrs a serious lung condirion called "pulmonary hemosiderosis" as somerimes being
reversed by removing dairy products from
a child's dieI. S8 Ir is inreresring rhar some of
rhe children wirh this rare lung disorder also
have a chronic runny nose, reCllrrenr ear
infecetons, and chronically enlarged Iymph
tissue in rheir nose and throar. S9 AII of rhis
raises a serious question: couJd a significanr
number of children wim chronic ear, nose,
and rheoar problems have dai!)' food sensitiviry--even though they havc nor developed devasrating lung problcms? Many physicians would answer unequivocally, "yes."

Early AtheroscLerosisfrom Milk?

Evidence suggesrs rhar oxidized cholesterol has a role in beginning ar worsening
rhe artery-narrowing process calJed atherosclerosis. Iffoods cooraining cholesterol are
exposed ro air rhe cholcsterol can oxidize
(combine with oxygen), which makes it
more damaging ro anerics. Whole milk and
particularly powdered whole milk-based
formulas meer rhesc criteria, and provide an
ideal sertil1g for cholesterol oxidation. More
information on cholesrerol oxidarion i presenred in Chapter 3 on heart disease. Children may be ger [ing an early srare roward
deam from America's leading killer by ingesting cow's milk prepararions. On rhe
o(her hand, when a child consumes cbolesterol from the mothcr's breasr milk, it flows
direcrly from the n ipple to (he cb iJd's
mourh. There is considerabl)' less opportuniry for oxidarion ro occur. In facr, when
comparisolls are made berween counrries
regarding hearr disease and dierary irems
consumed, dairy producrs emerge as the
mosr reliable food indiC<1.tor for predicting
[he rare of hean disease. 60 . 61, 62. 63

Juvenile Diabetes and Cow's Milk

Cow's milk may rrigger diabetes in genericall)' suscepeiblc children. A growing
number of seientitlc papers suggest this relaelonship. Researchers have now uncovered
cow's milk proreins rhar resemble proreins
found on rhe surface of the beta ceIls of the
pancreas. The rechnical namcs of t\vo of the
implicated milk proteins are ABBOS (a fraction of bovine serum aJbumin),64 and beta
cnsein. 65 The research suggesrs rhat a geneticaII)' sllsceprible child may begin ro make
anribodies against one of rhese or orher milk
proteins. Thosc anribodies may then arrack
look-alike proreins on rhe bera cells of me
pancreas. Beta cells are rhe insulin facrories
of the body. If rhe immune sysrem desrroys
them, diabetcs results. Dt. KarjaJainem, an
author of onc of the srudies, said, "We ma)'
have llncovered a wonderful suaregy ro prevene Type 1 diaberes. lf we are righr, it may
be the beginning of rhe end of this rerrible
disease." Ofcourse, mar would mean e1iminating cow' milk from the Jiers of ali SlISccprible individuals.

243

PROOF POSITIVE

Aerle andMilk
Acne is a well-known major concern of
adolescence. Alrhough for years. momers
have dispensed free dietar)' ~ldvice w their
children ro control lhis problem, mosr phl'sicans have moved to a medication approach and rarell" if ever, advocate dictarl'
change. Nonecheless, research indicares chat
diet plal's some role. Cenain fars (wirh medium chain lengchs of 8 ro 14 carhons) are
identified bv Nelson's text as a "minor
provocator)" factor. "66 The same souree
memions that far may have a role in the
formation ofblackheads.
Alrhollgh mose people do not ehink of
miIk as a high fat food, abollt 50 percent of
the calories in whole milk came from ['1(.67
Mally cheeses are higher than that; SOme,
like cream cheeses, approach 90 perccnr of
theie ealories from fat. 68 (Of note, 15 ro 20
percenr of rhe fac calories in dairy products

Oski's argument was (har the progesterone

is converred imo nule sex hormones (androgens) which in turn increase acne.?1

Rheurnatoid Arthritis, Dental Deca)~

and lnfectious Diseases
Some cases of the crippling form ofjoint
disease known as juvenile rheumatoid arrhritis mal' be related to dairy lIse. 72 Othcr
reports implicate milk prodllces as a risk factor for some forms of demal decal'.73 Infectious diseases, however, are some of (he
greatcst risks to a child's healrh rhat caJ) rcsllh from daily foods. We will take a fur(her look ar (his subjece larer in rhe chapler.

Adult Dairy Food Diseases

Having looked at my major concerns
wirh rhe healrh effects of milk in childrell,
we shall now look in derail ar seriollS dairylinked diseases rhar are lIsually manifest in
adllJthood. The six condirions rhar 1am most
concerned abolit are lisred in Figure 9.

Coronary Artery Disease

Coronary artery disease

Cancer
Neurologic
diseases
Allergies
. Digestive
problems
Infectious diseases
Figure 9

244

are generally from the implieaced medium

chain faes of 8 ro 14 carbolls i Il chai n
length).69Wheeher it is because of this fat
connec(ion or for other reasons, Dr. Frank
Oski reported that aene often c1ears up when
milk is disconrinued.?o
Oski seemed ro favor an explanaeion
apare from fat for the diet-aene link. Significam portions of milk cows are pregnant
and (hus give off progesterone in their milk.

Most individuals who are eirher (rying

ro prevent or reverse coronary anery disea.~e have the impression that skim rnilk and
one pereel)( f;'H milk are good opeions. However, t!le program in a 1990 smdy thac gave
the 1Ie1:Y best remlts in treating hean disease
with lifesryle changes essentiaIly rtrrlO-lIcd
rnilk from the dier. 74 The same concerns
previously mentioned in the chapter regarding oxida(ion of cholesterol are even more
worrsome for adllirs than they are for children. In children, the isslle is usuaHy rhe
prevention of an early beginnng of atherosdeross. In adults, many rimes the issuc
lakes on life and dea(h proponions as they
are seeking to keep arteries open tlur may
already be significantly blocked.
Fur[hermore, in Chapter 7 [hat deals
with procein isslles, we learn that one of [he
very wors( pro(ens that raises blood cholesterollevels is casein, a common milk prorein.?5 Ali levels of cow's milk, including
skim and one percenc milk, colltain both
casein and choles(crol. Two percenr anei
whole milk are worse rhan eirher skim or
one percem milk because they have more

MILK
cholesrerol and are higher in sarurared fat,
which increases rhe btood cholesterol.
One pariem. Norman Mayo, age 61
from Seattle, recently made headlines when
he annoullced that he was taking the dairy
industry ro caurt for nor pllrting a waming
Iabel o,; milk informing the consumer abOlit
the increased risk ofhean disease and stroke.
He stared that he drank whole milk his enrire life bealtlse he believed it was a heahhy
practice. Now he has c10gged arreries and
has already suffered a stroke. After he knew
abOlit his anery blockages, he learned abour
rhe artery-damaging effecrs of dair)' products from his healrh advisors.

The Link between Dairy Foods arzd

Cancer
Dr. David Rose and colleaglles at the
American Healtb Foundarion examined rhe
international de,uh rares fi-om a variet)' of
cancers.iG They found rhat the more milk
and meat eaten in a cOllnuy, the greater the
risk of breasr cancer. Prostate and ovarian
cancer r15ks were al50 associared with milk
li e. La Vecchia and coworkers in Iraly have
shown thar prostate cancer risk increases in
a 'dose response" fashion wirh milk drinking. Thus, rhe more milk a person llses t!le
greater the risk of rhis filtal cancer. SpecificaHy, rhose who used one ro rwo g1a.~ses of
milk per day increased rheir risk by 20 percent. However, when milk intake exceeded
rwo glas es per day, prosrare cancer risk
jumped 400 percenr.7 7 A srudy in Spain
addcd yet another cancer ro rhe list ofdairyrelared malignancies. Researchers rhere
found rhat milk producrs tended ro rriple
rlle risk of cancer of rhe recCllm.7 8
These are nor isolared internarional sruelies. There is a growing body of researchright here in America-rhar tends ro implicare milk along wirh other animal products
in increasing c.1ncer risk. For example, a fascinaring U.S. srudy compared srate-by-srate
data an dairy food lIse with the risk ofbreasr
c.1ncer. The more milk a state consumed the
greater rhe risk [heir populace had of dyjng
rrom breasr cal1cer.79

Neurologic Diseases
One very devasrating neurologic disease
is called Amyotrophic Lareral Sclerosis
(ALS). It is commonly know by a less imposing name: Lou Gehrig' disease (afrer the
famous baseball player who contracred rhis
illness). ALS tends ro cause progressive paralysis. The average victim dies within rhree
years of the diagno is. 80 Alrhough the disease can rarely be inherited, most of the case
are nor. There is some concern from popularion studies (hat some cases of ALS may
be cause-d from an infectious agent rransmined thraugh dairy productS. 81
Multiple Sderosis (MS) is anorher porentially disabling neurologic disease. This
condition strikes the tissue (ca.lled myelin)
rhar insulates nerve cdls in rhe brain, eye
nervcs, anei spinal cord. The disease appears
ro be due ro an imml.lne system abnonnaliry rhat causes inf1ammation and deStfllction of ilie myelin rissue. 82 One srudy reported in rhe prestigious British medical
joumal, Lancer, suggesred thar MS might
have a relarionship ro dairy consumprion. 83

Atlergies and Digestive Problems

Dajry foods may have a role in a whole
hosr of other diseases rhat strike in adulthood. We have alread)' observed thar childhood aHergy is ofrell relared to milk prodllcrs; these irems can cause adulr allergic
manifestarions as wel!. Lacrose inrolerance
has already been addressed ro some extent.
We learned (hat a signific.'lnt porrion of abdominal problems in c1tildren resulrs from
malabsorprion of milk sugar. Lactose inrolerance also poses pl'Oblems for millions of
adw[s. Often they do not realize that milk
is eirher a conrributing cause ar rhe sale
cause of their intestinal problems.
Milk use is also being linked ro a growing nllmber of diseases rhar we have yet nor
rouched an in rhis chapter. Perhaps rhose
thar are t11e mos[ worrisome are the growing number of serious infeerious diseases.
We willlook at rhese nexl.

Contaminl1nts in Cows Milk

So far, we have been looking at problems re1ared ro hyporherically pure, unadulrerated cow's milk. FrankJy, as a former milk

245

PROOF POSITIVE
drinker, 1view this list of problems as qllite
sobering. Howcver, pure cow's milk does nor
really exist. because whacever a cow is exposed [Q cends ro show up in her milk. For
example, what comes with aur breakfast
milk raday is the cow's lunch yesterday. This
explains why milk can taste sa different at
times; when cows ear diflerenr foods, the
milk rakes on a different taste. In a sample

BACTERIA
MILK"LIMITED"
T020,OOO
U.S. Public Health Service Regulation
"Mlk, after pasteurization, should
contain DO more than 20,000
bacteria per milliliter of milk
and DO more than 10 coliform
bacteria in each milliliter."

figure 10

of milk from processing plams in hve staces,

over one-third of the milk samples contained Aavors of the feed recendy eaten by
the cow. 84 This induded thc tasre of wild
garlic or wild onion, corn, oats. rye, aJld
binerweed. The sobering message is [hat
whatever is in the cow's blood at the time
tends ro show up in rhe milk. Unfortunately,
more than flavor is passed in this manner.
Bacreria, hormones, pes[icides, and other
conraminalHs can nnd cheir way imo milk.

lnfectious Agents in Milk

246

Infcctious agenrs can be very effeccively

transmitted rhrough milk These agcnts include both bacreria and viruses. Many COllsllmers believe that drinking pasceurized
milk eJiminates aII potential disease-bearing agents. This is far from the case, alchough pasreurized miLk is safer to drink
rhan raw miile However, pasreurization does
nor srerilize rhe milk. Srerilization would
require a minimum of212 degrees Fahren-

heit for a period of rime. Pasteurization hears

milk ro only 161 degrees Fahrenheit for a
SCa.lH 15 seconds;85 rherefore, it merely reduces the number of potenriaLly infecrjous
germs, bur does nor eliminate them.
Government agricultura] stJnda_rds bear
witness ro rhe expecration thac milk wiIl be
contaminated wirh microorganisms aner rhe
pasreurizarion process. Current U.S. Public Healrh Service regulations are srated in
Figure 10.
In plain English, rhis regularion means
rhar a glass of milk can have nearly five milbon bacteria in it and stiil be t1ccepttlbfe. The
coliforms are of evcn more concern. These
bacreria are germs rhar come from rhe cow's
Stool. Milking, especially auromaced, can be
messy in spire of precaurions; it is not uncommon for milk to be colltaminated. We
see thar our govcrnmem aHows up ro 10
coliform bacreria from stool per miUilirer
afler pasreurizarion. Granred, ren bacreria
do not sound like much. However, ren per
milliliter translares ro nearly 2500 per 8-

otmce gltus.
Just as bacreria survive rhe pasrcurization process, so do many viruses. Some of
the c1assic research looked ar rJle survivaJ of
rhe foor and mauth disease virus afrer pasreurizarion. 86 . 87 Other viruses have been
cited as being pasteurizacion-resistant. These
include the maloney leukemia virus, rhe
rous sarcoma virus, ilie rauscher leukemia
virus, and the bovine papilloma virus. sS
These diseasc-causing viruses could be destroyed by boiling, bur not simply by pasteunzll1g.
A number of epidemics have occurred
as a resulr of infeerious agenrs geuing into
rhe eommercial dairy supply. There was a
recent oucbreak of Salmonella from a narionaJly disrributed iee cream brand. Over
rwo thousand cases--and severa! faralirieswere verined in Minnesora, Somh Dakota,
and Wisconsin. S9 Food poisoning can also
occur from cheese. In 1989. a Salmonella
ourbreak siekened ar leasr 164 people in
Minnesota, Wisconsin, Michigan, and New
York. The infecrion was traeed ro conraminared mozzarella cheese. 90 Whar was suiking about d,is c.1se anei orhers is the relarively few bacteria rhar are needed ro pro-

MILK
duce infeetion. In the mozzarella ourbreak,
unopened blocks of rhe colltaminared
cheese were ana1yzed. They found /e.r.r thlm
tUlO safmonefla organisrns per one ou-nce sertJing of cheese. These and orher repons sug-

gesr rhar dairy producrs wirh seemingly insignjficanr levels ofcontamination may play
a greater mIe in disease ourbreaks rhan previously recognized.A whole hosr of infec(ious diseases have been rraced ro milk use.
These include relarively comrnon infecrious
agenrs like salmonella ar srrep,?1 or rhey can
include rarer diseases. One such illness is
brucellosis, a somerimes chronic and unrecognized disease rhar C<"lIl cause headache,
f.1tigue, weakness, and mllscle aches as weB
as more familiar infecrion signs like fever
. 9'
an d swcanng.The bacteria dut Gl.Use Q fever (anorher
somerimes-cllronic illness rhar ofren e1udes
diagnosis) can also be rransmirred in cow's
milk. 93 Alrhough unfiuniliar ro most COI1Slllllers, yersinill enurocofitica is a hlirly commOIl infecrious agent thar causes abdominal pain, fevet, and diarrhea. 94 It has rhe
dubious disrinction of mimicking appendicitis, and is dOllbdess rhe cause of many
unnecessary surgeries each year. Yersinia is
generally des[royed by pasreurizarion. However, documented cases demonstrare rhar if
rhere are sufficien.r l1umbers of this germ in
rhe raw milk, some yersinia can survive pastcurizarion and larer multiply during refrigeration. 95 The list of organisms mar can
contalninate raw and even pastellrized milk
is quire exrensve. 1 provide more informarion in Chaprer 10, "Animal Diseases and
Human Healrh Risk," including information on orher relatively common and dal1gerous infecriolls agenrs such as Listeria96
and Campylobacrer. 97
There is also a growing lisr of other diseases mat we are now becorning aware of
having a lillk tO infecton aod ro dairy foods
specifically. The chaprer an animal diseases
provides fllrther infonnation. For example,
mycobf1cterium paratubermlo)'iJ rransmirred
through dairy foods may be a cause of
Crohn's disease, an often incurable, debilirating disease of rhe bowd.91l Evidence indicates thar mycobacterittm pllrlltuberculoJiJ
is nor desrroyed by rlle mosr cornmon form

of pasreurization, which arrains 161 degrees

Fahrenheir for 15 secondsY9
In view ofsuch pervasive problems wirh
inf(xtion, rhose who plan ro continue drinking milk sho1l1d seriously consider srerilizing dleir milk. Boiling is rhe simplest way
ro sterilize dair}' beverages. Some people do
not like the rasre of boiled rnilk, bur this
sreriLizarion process definitely decreases rhe
risk of rransmissible diseases.
However, even boiling may not prevent
ali risk. Oile of the most fe~ued animaJ-related diseases is Crelltzfeldr Jakob disease
(CJD). One of rhe ways thar rhis condirion
is believed ro be transmitted ro humans is
through prions from carde WiTh "mad cow"
disease. These prions are not living organisms and can wirhsTand temperar.ures far
higher [han rhe boiling poinr of warer. In
Chaprer 10 on animaJ diseases, J point out
rhe evidence rhat dangerolls prions call enrer human breasr milk if a woman is sliffering with CJD. A1rhough it is feh llnlikely
ro be conraminating dairy sources in rhe
U.S. ar rhe presenr rime, some have srill
raised concerns (hat some of (he American
milk supply could be tainted with prions.

Beyond Bacteria and Virttses-Other

Milk Contaminants
As damaging to human heaJrh as bacteria and viruses are, other contamina.nts can
be just as damaging. Let us look ar the antibiotic conraminarion problelll.

Antibiotics in Milk
Antibiotics are commonly found in milk
roday. These drugs come from a variery of
SOllrces. Since rhe early 1950s amibiorics
such as penic.iJLin and tetracydine have been
added ta livesrock feed ro prevem infection
and boosr growth. IOO Antibiotics are a1so
milized ro ["reat sick cows. Alrhough milk
fTom ;ltlimals undergoing drug rrearmell( is
discLlrded for a period of time, drugs can
sriJl be presem in a cow's mjlk even after iT
has finished a course of anribioric.s.
Iwo major concems have arisen abour
rhe use of anribiorics as rhey reiare ro dairy
prodllcts. First, [here are worries rhar widespread antibiotic use in livesrock is f.1Voring

247

PROOF POSITIVE
rhe rise of organisms rhar are resistant (O
[he common anribiorics. Second, there are
legitimare fears rhar human cxposure tO
antibiotic residues in milk prodllcts will re
suit in illness.
Increasing resistance ro antibiorics
among microbes has becn recognized for
some time. Many diseases like pneumonia,
gonorrhea, or salmonella thar formerlywere
easily ueated with cenan antibiorics have
now become resisranr ro those dfllgS. IOI
Some blame rhis problcm of growing resisrance on indiscriminare lIse of anribiotics
in borh rhe hllman popuiarion as well as ill
livesrock. Research suggesrs rhat rhe livesrock connecrion is very likely a f.1.cror in
this process.
The likelihood of an)' canon of milk
having one or more drug residues is fairly

SCO
G
FO BREAKFAS ?
r.

The cow's lunch from yesterday

,. Bacteria
r

Viruses

,. Prions
r

Antibiotics

,. Hormones
. ., Organic pesticides
Figure 11

248

high. Milk from manycows in a 'milkshed"

area is pooled; rhus, milk rhat reaches rhe
consumer has constituelUs that may have
come from lirerally hundreds of 'Cows. Researchers ar Rurgers Universiry found rhat
a signi6canr ponion of rniLk samples showed
more rhan oile drug residue. I02 The presence of these antibiotic rcsidues in milk is
emerging as a facror f.1.Voring rhe develapment of antibiotic resistance.
In another Rurgers srudy, staphylococcus
aureus (a cause of serious skin and bone in-

fecrions) was exposed ro small doses of six

anribiotics. The study employed some anribiotjcs rJ)3t are commonly lIsed in lhe livesrock industry, includ ing eryrhromycin terracycline, and ampicillin. The drugs were
used in amounrs small enough ro be legaUy
sold in commercial milk (i.e., rJley were
belaw rhe cur-off for what the FDA considers a "safe" dose). These drugs were used
singly or in combinarions of three drugs.
(The rarionale for using a combination of
drugs was rheir knowledge of the frequency
of mulriple drugs finding rheir way imo the
milk supply). After rwo weeks, acrnal me.asuremem showed that the drug-exposed staphylocaccus aureus samples were rapidly
developing antibiotic resistance. When
comparcd tO staph germs tlur were not exposed ta antibiotics, those subje.cred ro resi
dues of a singlc drug developed resistance
six times as fast. However, rhose exposed to
three anribiotics developed resistance OVCt
27 rimes as fast. 103 This research suggesr5
rhat milk should be frec of aII anribiorics if
we waU( to reduce rJle rapid developmenr
of resisranr bacreria.
A summary list of rhe various Imown
conraminanrs in milk is shown in Figure Il.
Alrhough I have tried ro differenriarc
berwccn conditions rhar are relared ro milk
irself and oUler condiuons due ro conraOlinanrs in rhc dairy supply, such a division is
very renuous. The problem is rhar milk is
so pervasively conraminared rhar it is oftcn
merei)' cOlljecrure as ro wherher problems
are relared [Q milk itself or ro rhe everprescnr conraminanrs. For example. although 1 have presented cancer risk as being due to milk itself. evidence suggesrs thar
at least somc of the milk-cancer link may
be related to cOIHaminants.
One study dcaling with lung cancer provides a good ilJusfr<lron of rhis possibiliry.
Researchcrs found increased risk from
drinkjng full far milk bur nor from the low
fat varicry. Although the pure dajry fat itself could be rhe culprir, another inrerpretarion is that conraminants in milk fat arc
rhe facrors mosr responsible for increasing
risk. The idea that conraminanrs are involved is not ar aJi far-ferched. Many of the
mosr worrisome poisolls are fat-sollible

MILK
toxins rhar reside in the fat portion of mlk.
Anorher example thar illusuares the difficlIlry n disringuishing the effecrs of conraminams from the effeccs of unadulterared
miJk comes from [he area of allergy. AIthough many cases of cow's milk allergy
seem ro be re!ared ro milk proreins, conramnancs may a1so be part of rhe problell1.
The coromon finding of respirarory problems following milk drinlcing (such as more
mucus producrion. cough. ar infeerions)
may somerimes be due ro amibioric residues in rhe milk. A person may be allergic
ro penicillin. erythromycin. ar some orher
drug rhar is presenr in low amouncs in milk.
There is nor enough drug rhere ro callse a
serious generalized aJlergic reacrion. but rhe
small amoum present is sufficienr ro produce the annoying respirarory symproms.

larionship. Increasing the protein in the diet

of SOll\eone who Gonsumes liberal amounrs
ofcalcium-as much as 1400 mg per daycan acwally resllh n a Ioss ofcalcium from
their body on a daily basis. Third, there
seems to be a Ilurnber of biochemical factors that accollnt for the calcium-depleting
effecr of meat in particular. These incIude
effects of the higher protein contem itself,
as well as problems with the excess phosphorus and suJfur that is found in meat.
It is important also ro note that in Chapter 7 previously referrecl ro, 1 provide rabies
listing food sources that sllpply liberal
Jmounts of calcillm whi1e avoiding problems ofexcess protein. sul fur, and phosphorus. Among rhe real srars are rhe green leafy
vegetables.

If Dairy Foods are Out) Where Do we

The Narional Dairy Council recenrly

published a book promoting dairy foods
from rhe scientific srandpoinr. 105 The book
was written by lWO of its employees and a
paid consultanr. Most of rhe benetlts
claimed by dairy can be easily boiled down
ro one mineral-calcium. Other benefirs
mentioned include the consumption o[Vitamin D, which is added ro milk as a supplement. Yitamin D can eeasily be obr.ained by
lDoderate exposure [O sunlighr and is mus
nOI a necessary constiruent of the human
diet. IfVitamill D-sllpplemenred dairy food
is elimnated from the eliet anei customary
sunlight exposure is not possible, 1 recolllmend sllpplemenrng the e1iet with 400 International Units of Yitamin D a day.106
Vitamin D is acrually more imporranr in
preventing osreoporosis rhan a high intake
of calcium.
Most of the remainder of the so-caIled
"postve" dairy research does not control
for oeher dierary Of lifesryle factors. For instaJlCe, a recent srudy suggested that middle
aged men who were milk drinkers had a
slightly less risk for developing a Stroke later
in life. However, rhe srudy did not separate
our (control for) other factors rhat are known
ro decrease me risk of srrokc, such as daily
exercise and earing several serving of fruirs
and vegetables a day.IO? Even the sruely's
aurhor himself srated. "There's something

Get Dur Caldum?

Americans are rightly afraid of osreoporosis. a condirion rhar refers lireraJly
ro a rhinning of rhe bones. The disease affeers aii races and borh sexes. causing appro,Jmarely 70 percenr of ali fracUlres in
All1ericans over 45. 104 The dairy industry
has been quick tO eapitalize on mese concerns. They advertise milk, eheese. and orher
dairy products as food irems ro help
serengrhen bones because of [heir cakium
conrenL However, despite what most
Arnericans "know," more ca1cium is not
whar is needed fOf improving me bone
health of Americans--or anyone e1se for
that maaer.
In Chapter 7 an protein, 1deal with rhe
true nuuirionaI culprir relared ro osreoporosis. The real villain is excess consumption of
protein. not inadequate calcium intake. 1
presem [he full argumenr rhere, but let me
review the key concepts briefly here. Fim.
studies an populaton groups (epidemiology) show that the more animal protein n
the dier. the greater the risk of osreoporosis. One of rhe classic groups srudied is rhe
Eslcimo. Despite their hgh conswnprion of
up to 2500 mg ofcalci li m per day. they have
rampam osteoporosis. Second, actual huOlan experimems have shown a similar re-

The Pro-Dairy Side

249

PROOF POSITIVE

The U.S. governm.ent recommends that the diet

contain less than 30% fat and be low in cholesterol
and saturated fa,ts.
Federallaws requiTe schools to provide fatty
wholemilk.

media as advocat.ing the liberal use of milk,

they really do nor give reliable informarion
abour milk. The !atest scienrific book pur
out by the National Dairy Council in parrnership with rhe NationaJ Dairy Promorion
and Research Board rhar endeavors "ro provide a baJanced review" ofmilk is complerely
silent abour the many concerns expressed
abour milk in this chapter, wirh the exceprion of lacrose intolerallce. 108

SchoolluDcbes are over 40% fat.

School Milk and Politics

Butter aud cheese amouut to 113 of

goveroment schoollunch expeudtures.

Wich aII rhe problems associated with

dairy producrs, it seems prudent for our
COllntry ro avoid giving messagcs rhar appear ro recommend the free use of milk.
Unforrullarely, cuereJlt legislarion (probably
due in pat( to dairy indusuy influence) requires public schools ro provide a wide range
of da.iry producrs. The complexiry of the
issue is illustrated in Figure 12. 109
Ir seems thar rhe governmenr is callglll
in a conflict ofinceresc. On rhe one hand il
widely promores rhe recommendarion of
bringing aur narionaJ tu consumption ro
30 perceJlt ar below, and ro especiaJly reducingsarurared far in rhe diel. On rhe ot.her
hand, older USDA regu1arions help dUl11p
excess dairy producrs (high n far and especially high in sarurated far) imo our school
IllJ1ch program. It has been argued ehat nsread of rhe healrh of children solely determining the goaJs ofschoollunch programs,
powerful commerciaJ nteresrs such as che
dairy indusrry are alrering the priorries. A
public watchdog organizarion for tood and
heahh has poinred out ehar rhe USDA regllJations have pur Amerc.1JlS in an unacceprable posrion; rheir st.aremem s quoted in
Figure 13.' 10

Only 1% of fruits aud vegetables

provided are fresh; 90% are canned.
Figure 12

e1se in milk [cakium], ar in the lifesryles of

milk-drinkers, rhat's offering prorection.
These faccors are difficult ro idenrify, bur
milk drinkers [in this srudy] tended ro be
leaner and more physically active and to
consume foods rhar were more likely ta be
healthy." He the.n added thar it would be
"... inappropriate (O recommend thar milk
consumption be increased to reduce rhe risk
of stcoke."
Thus, although rhese srudies are widely
touted by rhe dairy jndustry and t.he ncws

"The Agri,cultural Department may be creating

a dUrmping ground for surplus high fat and dairy
products ilO the national school Junch program.
We are in the unacceptable position of having tbe
economic well-being of dairy interest calling the
sbots ht a program that
should be providing good
nutrition."

Figure 13

250

M)' Own Experience with Milk

A number of years ago 1 weJlt rhrollgh
an experience that persuaded me ro discontinue my llse of milk. Beginning in my teen
years, 1 e.xperienced repeared respirator}'
uacr infectons. 1 would ger over one infCcrion, tllen a week larer r would come dowll
wirh another. AH during college and medical schooJ my moeher would rell Lne 1
needed ro see a speciaJist ro find out what
was wrongwith my immunesysrem. 1 flnalJy

MILK
wen! rhrough rhe immllne syseem blood
reses bll[ noehing was abnormal. 1 was
cempted ro conci ude rhar 1 was a sickJy person and wouJd always have upper respiratory uaC(. infecrions. Then 1 learned during
ro)' speeialry rraining in Inrernal Medicine
aboli[ some of rhe complicacions of milk
rhar 1 have becn describing in this chaprer.
1decided ro discontnue using milk, wh.ich
was racher difficulc since 1 was accustomed
to lIsing ic in qllanriry. 1experimenred with
several of the soy, riee, and nut milks on rhe
market and fOtlnd rhem aeeepcable. Even
ehe soy ice creams were good and frec of
animal produClS. When 1 scopped llsing
miLk, my respirator)' infeceions went away
and 1clid not corne down with another cold
for many years.
Elim Whire cHlrioned years ago, "... if
orher foods ro supply rhe needed elemenrs
(Imnot be obeained, milk anei eggs should
noe be wholly discarded. Grea! care ShOllld
be raken, however, ro obrain milk from
healchy cows and eggs from healthy fowls,
cJlat are well fed and weU cared for... "111
Of course, even healthy-appearing cows
may be sick for days before mani{esring any
symproms. Ali during the tjI11e of [heir unrecognized illness, people ~ould still be
drinking rJleir milk. Wh.ire gave advice ro
deal with this possibility: "If milk is used, ir
should be thoroughly seerilized; wich this
precaucion, there .is less danger of conrracring disease from irs use."112
She also wisely wrote, "Lec rhe dier reform be progressive. Let rhe people be
e:lught how to prepare food withoue the use
of milk or buner. Tell them che rime wiJJ
soon come when there will be ilO safery in
using eggs, milk, cream, or buuer, because
disease in animals is increasing in propordon ro ehe ncrease of wiekedness among
men."113 Since most of the world populae.ion does well withollt rhe use ofda.iry foods,
1 believe that Americans can do so as weB.
My own personaj experienee, my work with
patien!s, and medical research all poinr in
the same direction-rhae a decision co give
lip rhe use ofdairy foods willlikely bring us
significanr heaIrh benefirs.
1 could wish (hat the news media were
more objective in reporcing t!le problems

wich dairy prodllcts. Since they are nor, 1

believe it is my responsibility as a physieian
ta let people know the dangers associated
with {hem. When we look ar {he overaJl pierure, 1 can honestly recomrnend thar cow's
milk should be reserved for baby cows. Their
calves new a high-powered somce of energy to start walking the day chey are born.
The American Academy of Pediatrics
now recommends rhar no one under the age
of rwelve momhs be fed cow's rnilk. 114 They
add, "the American Academy of Pediatrics
recommends chat infanes be fed breasc rnilk
for (he fifS( 6 ro 12 months." Clearly, ehildren develop besr on their own mother's
milk. Consequently, 1 eommend and appreeiare rhe movemenr in our counuy among
professionals and lay peoplc alike advocating breast-feeding. Perhaps rhe time has
come to publicize a new slogan for miLk rhar,
concrary to {he American dairy inclllsrry 510galls in Figllre 1, has an honest sciemific
basis. A slogan sllch as shown in Figure 14
would be fitting.

--

-~

.><-

- -

-~

,
Fgure 1.4

Cow's Milk Alternatives are Now

Available
For children rhar are weaned-and
adtllcs as well-there are uow an abllndance
ofmilk-like producrs on rhe market mac are
suitable tO use on breakfast cereals. Heallh

251

PROOF POSITIVE

Type ofmilk (per Clip) Protein Calcium Phosphorus

g

rog

tt.g

Vitasoy (unfortified)

80

WholeMilk

290

228

West Soy Mrilk

300

250

Human Breast Milk

79

34

Rice Dream Milk

300

150

Figure 15

food srores uSllaHy have a liberal supply of

soy milk products ofsevera/ brands and flavors, and other planr-based milk a/ternaoves
such as oar, poraro, rice, and almond milks.
Wirh their populariry growing and more
Americans realizing rhe dangers of dairy
foods, rhese irems are IlOW beiug srocked in
regular grocery chains. Nor only have many
consumers been surprised to see rhese prod-

ucrs on rhe aisles of their local supermarker, bur rhey aJso have been amazed ar how
nurririous and sarisfying some of mese beverages are. A comparison of rhe Ilutriems
in cow's milk wirh various soy milk produns is shown in Figure 15.
Severa I observarions of rhe dara in rhe
figure are in order. Firsr, rhe high content
of phosphorus in cow's milk causes a rarher
poor absorprion rare of calcium, ar 2S percent, or abour 7S mg per cup. Second, rhis
amOUJlt is equa! ro rhe amount of highly
absorbable calcium in human breast milk,
which subsralltiates rhar the nursing illfant
will absorb as mllch calcillffi from morher's
milk as one who is on cow's milk. Notice
also rhe desirabJy low comem of phosphorus in tllorher's milk. Third, procein Jevels
of soy milk producrs are generaJly similar
la rhar of cow's miJk, and CalCilltll levels for
t!le forcifJed soy milks are also similar ro that
of cow's milk. Fourch, che phosphorus level
of fortified Wesc Soy Plus is slighdy lower
(han that of whole milk, which would suggesc chat the absorbable Ievels of caJcium
wou!d be similar. Inscasoy, anocher milk alternative, has slightly higher levels of pro(en and c.1lcium, with a slightly lower concent of phosphorus. A listing of quamities
ofB I2 and orher nurrienrs in various brands
of milk alrernatives and cercals is found in
Appendix IX.

Conc1usion

In DO mammalian species, except

for the "iDdustrialized"
human, is milk
consumption
continued after
the weaning
period.
'Figure 16

252

The eu!mination of my exrensive research on rhe subject of milk is rhar [here is

absolurely no reason why any adlllc human
should feei tlur rhey need rhe milk of another species for health. AH [he nutriems
we need can be obrained wichollC resorring
to dairy foods-and we eln avoid a host of
problems by shunning this harmfu! group
of foods. De. Oski roade a simple bur foecefu! observarion regarding the uniqueness of
a full-grown marnmal thar consumes a food
meanr srriccly for babies. His sratemenr appe-ars in Figure 16. 115
1 challenge you 110W. Take a bold srep
and derermine ro do something thar wilJ
likely make a significanr difference for your
healrh and for rhe healrh of your family.
Derermine mar by your influence and ex-

MILK
ample you will help orhcrs ro break free of
a disease-bearing producr line--even if you
feei perfecrly healthy roday. Make a choice
ro cease purting money into rhe cofiers of
an industry thar is relling half-truths at rhe
expense of rhc healrh of the American public. Visir your local grocery srore or healrh
food srore, pick lip a sample of several soy,

!lut. or orher planr-based milk alrcrnarives,

and embark on a new habir of dajry-free
living. You \ViII be surpriscd at how rasry
today's alrernarives are, and you will know
that Y0l! are following a course calcularcd
ro improve your own health, and rhe healrh
of orhers arallnd you.

RejCrmces New York Timc "Fedcl1ll Trade CommissiOIl Finds Milk Advenising
Campaign Deecpljve: April 1974. As dcscribed In: Oskj FA Dont Drink
YOII' Milk-9tlJ nlition. Brusluon. NY: TEACH Services, Ine., 1983 p. 6670.
I

1 Oski FA. Don't Drink Your MilJ.'-9th edition. BrllS!Hon, NY: TEACH
Services, 1ne.. 1983 p. 2, 66-68.

Oski FA. Don't Drink ieur Milk-9tb edition. Brushron, NY: TEACH
Scnices. Inc. 1983 p.2.
4 PlItnarn

JJ, AlIshouse JE. Food Consumptioll. Prim, tind E'<pmditlt1't'S, 1996.

SWislica1 BuJlelin

o. 928, US DeparrrncJH of Ab'TiClII mre. p. 16.

; Oski FA. Don't Drink l'aur Milk-9th editioll. Brusillon. NY: TEACH
Serviccs. Inc., 1983 p. 2.
Oski FA. Doni Drink Yollr Milk-9tb dition. Brushlon. NY: TEACH
Scrviccs, Ilie.. 1983 p. 2.

ZO Barncss LA Nmrilioll and Nurrirional Disorders.ln: Behrman RE, edjlor. Nebo" TextbOlJk of PedifltriCJ-1411J tdition .. PhiJadelphia, PA: WB
Sallnders Company, 1992 p. 122.

B,lrness LA Nurrition and Nurririona1 Disorders. In: Oehrman RE. edilOr. Nelson Textbook of PulitltricJ-14tlJ l'dition.. Philadclphja. PA: WB
Saundcrs Company, 1992 p. 122.
11

120ski FA. Dont Drink Your Milk-9tlJ l'r/ilion. Brushloll. NY: TEACH
Serviees. Ine.. 1983 p. Il.
Barr RG. Levine MD. Walkins JB. Recurrelll abdominal pain of childhood duc 10 bClOSC imolerallce. N Engl} Mtd 1979 JlIn 28;300(26): 14491452.

MacDonald. 1. C.1rbobydrares. In: Shils ME, Young VR, edirors. MOlIe", Nutrilion in HtilltlJ ilnd DiuilJt-7tlJ ~dilion. Philaddphia, PA: Lea

and Fcbigcr, 1988 p. 43-44.

Grulee CG, Sanford HN, Herron PH. Brc:asr amI Anillcial Feeding.JAMA
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S Grulee

CG, Sallford HN. Schwarn H. Breasl and Anificially Fe<! Infallls.

JAMA 1935:104:1986.

Barness LA Nurririon al1d Nurriliollal Disordcrs. In: Bcbrman RE, edilOr. Nr/son Tnabook of hditltricl-14tlJ editiorJ.. Philadelphia. PA: WB
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9

10 ClInningham AS Morbidity in brc3Sl-fed and ana.cially fed infill1rs. ]

PtdilJlT 1977 May;90(5):726-729.
11

Cunningham AS. Morbidity in brcasl-fed and anificially fed infams. II.

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Il

Scarial PD, Grummer-Strawn LM. Fein SB. A longitudinal analysis of

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13

Baylcss TM. Huang SS Recurrenl abdominal pain duc \0 roiJk and IacIOse imolerancc in sehool-aged children. Ptdiatrics 1971 Jun;47(6): 10291032.

25

Baylcss TM. ROlhfdd B. el al. LaCloSC and milk imoler.rnce: dinical

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16

Oski FA. Dont Drink You, MiJk-9t1J edition. Brushton, NY: TEACH
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17

Wilson NW. Hamburger RN. AJlergy 10 eow's milk in lhe first year of
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18

29 Saarincn UM. Kajosaari M. BrcaSlfeeding as prophylaxis againsl atopic

disease: prosp<:clive follow-lIp sludy umil 17 years old. !Anut 1995 OCI
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30

HamillOn, JR. Dierary PrOlcin IlIloleranee. In: Bchrman RE, ediror.

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JI

HamiilOn, JR. Diclary Proteill Imolerance. In: Behrman RE. edilor.

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14.

beono G. Carroecio A, et al. Chronic constipalion as a symplOm ofcOw

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.H

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35

lInningham AS. Morbiclity in breasl-feel and artificially red inf.mrs. J

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15

Barncss LA NUlrilion and NUlrilional Di orelc:rs. In; Behrman RE, edilOr. Ncborr Textbook of Pedil1triCl-14tb tdition .. Philadelphia, PA: WB
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J3

Speer F. The allergic ehild. Am Fam PlJysician 1975 Feb: II (2):88-94.

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18

We:aver CM. C.,lcium bioavailabililY and irs rehlion

10

osreoporosis.

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Oski FA. Doni Drillk Your Milk-91h tditioll. Brushloo. NY: TEACH
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36

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37

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19

253

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3R

HamiltonJR. Oicr:u)' PrOlcin InlOlcr:mce. In: Behrman RE. edilOr. N~/soll

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pan)'. 1992 p. 971-972.
Barness LA. Nurrilion :md Nurrilional Oisorders. In: Behrman RE, edilor. N~/son Talbook of Pet/ia/Tia-J4tb editioll. Philadclphia, l'A: WB
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9

40 counrries bur nor in France and Finland. A paradox. CiTCIIlllfioll )993

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63 Sc"aU JJ. Dierary iaClose a a possible risk faclor for ischacmic h(",'\"
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K.1rjalainen J , Manin JM . el al. A bovine albumill pepridc as;l possible

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.(0

10

-lI

.(20ski FA. lron deficiency in inf:mcy and childhood. N ElIgLJ M~d 1993
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U

Slockman JA 3rd. lron Ochccncy Anemia. [Il: Bchrman RE. edilOr.

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'5

AmeriCln AcadelTl)' of l'ediauics Comminee on Nurrilion: Thc use of

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-l1

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.(9

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R, er

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Crook WG. Food aUergy-thc grear masquerader. PrdialT C/in NOTth

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).( Specr F. The allcrgic child. Am Flrm PJ~rsicion 1975 Fel>; J J (2):88-94.
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'>6

Specr F. Tbe allergic chiJd. Am FO/ll Physidl1l1 1975 Fel>; II (2):88-94.

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p:Ul)', 1992 p. 608-610.

SI)' RM. Adverse Re:1ctjons ro Foods. In: Bchrman RE. cdilor. Nrlson
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Srern Re. Pulmon:tf}' Hemosiderosis. In: Bchnnan RE. ediror. Nl'!soll

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60 Sedy S. OiCI and coronary discasc: a survey of morraljey ralCS :l.nd food
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(,1

6> Arraud-Wild SM, Connor SL, cr. al. OifFercnccs in coronar)' morraljry
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254

64

Eslerly NB. Acne. In: Bt'hrman RE, ediror. N,,/son Textbook ofPedilu~dirioll .. Philadelphia. PA: \Xfll Sallnders Compan)', 1992 p.
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66

Ties-JiTll

PenninglOn .IA. Suppkmelllary 'f:lbles: lIgars. In: Bowes IlIId ClmrC/ls

Food IIttlllrs ofPol'tiollJ Commoll6' Vsed, FifirnnlJ Etlitioll.l'hjladclphi;l, PA:
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Pcnnington JA. Supplcl11cmary T.lbles: Sugars. In: BOIveJ alltl Ch"rrh

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69 The Food Processo! fOf \XIindows: NlIlIilio/l An:llysis & FilllCSS So[ware [c<>mplller program]. ESHA Re-s{~llch. Salem, Oregon.
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Serviecs. Inc.. 1983 p. 56.57.

Oski FA. DOllf DTillJ.' You,. Milk-9rb editioll. Bellshron,

Inc., 1983 p. -6.57.

Y: TI::ACH

Oski FA. DOII't Drillk l'aur Milk-9lb ~ditioll. BrushlOn.

Services. Ine.. 1983 p. 59, 63. 64 .

Y: TEACH

7J

Scrviet~~,
7

7\ Oski FA. DOlli DriuJ. l'auT MilJ.-9tb editioll. BrushlOn, !'-TY: TEA H
Service. Ine.. 1983 p. 59,64-65.

74 Ornish O. Brown SE. ('r al. C~n lifesryle ehangcs reverse coronary beatr
discase?The LifcslYIc Heart Trial. Lmlm 1990 JuI21:336(8708): 129-133.
7

Sinori CR . Agradi E. el al. Soybean-prorein cliet in lhe ltcauuelll of

rypc-)I hypcrlipoprolcin;leruia. Lanm 1977 Feb 5; 1(8006):275-277.

Rose O[~ Boyar AR \XIyndcr EL. Jlllcrnarional comparison of mort ali ry
rares for cancer of thc brt"a 1, ovar)'. prOSlale. and colon. ;Ind per capila
food conSllrnplion. Cllleer 1986 Oec 1;58(11):2363-2371.

76

n b Vecchia e. Negri E, et al. Dairy producrs :md thc risk o prostatie

cancer. Ollcolog'y 1991 ;48(5):406-41 O.
78 Benito E , Obrador A . et al. A popularionbased case-colllroi slud}' of
colorccral cancer in Majoral. J. Dierar>' faClOrS. l/lt J Cancer 1990 Jan
)5A5( I ):69-76.

GaskiJI Sl~ McGuire WL, er al. Brea.~l cancer monalicy :Uld dicr in rhe
Unieed Srales. (,mee" Rrs 1979 Sep:39(9):3628-3637.

79

so Layur RB. I-leredirary aod Acquircd [ntrinsic. Moror

curoll Disea es.

In: Benneu Je. Plum cdirors G'ol 7i'Xtbook o/Metlicilll'-20tIJ ,ditiolJ.
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r.

SI Oski FA. Dorti Drink l'all,. Milk-9lh etlitioll. BrushroJ\,

Serviccs. Inc.. 1983 p. 63.

Y: TUCH

sz Rudick RA. Mulliplc e1erosis and Rdalcd C<>ndilions. In: BCnlJCll Jc,
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WB aunders Company, 1996. p. 2106-211 .
AgranofT BW; Goldberg D. Oier and Ihe geographical dimiburion of
multiple sderosis. Llllim 1974 Nov 2:2(7888): 1061-1 066.

SJ

84 Oski FA. DO/li Drillk .Yollr Milk-9th etlitioll. Brushwn, NY: TEACH
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85

TlJc \'Vorld Book Ency"/oprtlia. Chicago. IL: World Book, Ine., voI. 13,

1993.

MILK
Hyde JL, Blackweli JH, CIUis JJ. Effeet 01 pasleuri2.:ltion and evaporalioo on 1001-a.nd-mOlllh discasc virus in wholc mllk Irom inlcclcd cows.
CtmJ Comp Med 1975 )llJ;39.(3):305-309.

86

100 Nad"ka.vukaren A. FQOd QUl1liry in Mall fI1ul EnlJiromnmt: A Healtb

Pcrspcetiv"-3rd cditioll. Prospect Heighls, IL: Wavcland Press Ine., 1990

p.243.
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BladwclUH , Hyde JL. EITcel 01 heal on IOOl-and-momh dise'lse virus

(FMDV) in lhc components of milk from H,,'IDV-infccled cows. J Hyg
(Lond) 1976 Allg;77(I):77-83.

Pe/~pccrivt-3rd

ilS Rubino MJ. InnctiViuion ofbovine Imkemiti vims in milk. TImis, Uuiversiry of Iowa. December 1980. As cited In: Hulsc V. Mad eOUl! /Ind Mi/k
Glue. Phoenix, OR: Marble Moumain Publishers. 1996 p. 157.

IMI o.fFood

87

Ccnrers for Disease Comrol and Prevention (CDC). Outbrcak of,almo"dIa cnreritidis assocjaled wirh nationally dislributed jee cream produetsMilmesota, SOlllh Dakora, aud Wiseonsin. 1994. MIvf\'(lR 1994 OCl. 14;
43(40):740-741.

3?

'10 Htxlbcrg CW. Korlath JA, el al. A muhisl31e ombrcak of Salmonclla

javi.ana and Salmonclla oranienburg infeaions duc 10 consumplion ofeon~lIl1inaled ehcese.JAMA 1992 Dcc 9;268(22):3203-3207.

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150.
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236.
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LM. WaJlace RE. Maxcy-Rosenall-L1St, P"blii' Hi'llltb ami P,"'JCIIrivr M1.icine-J3rh cdition. Norwalk. CT: Applclon 'Ind unge, 1992 p.
199.

101

102

Brady MS, Karl. SE. AmjbiolicJAnlimierobiaJ Rcsidues in Milk. JourProtectio" 1988;510):8-11.

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10'1 US Prcvcmive Service.s 'lask Force. Screening for Poslmcnopausal Oslcoporosis. In GlIitic ro Clinical PrelJellliuc SerlJiw. Bahimore, MD: Williams and Wilkins, 1996 p. 509-516.
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D.1wson-Hughes B, OaJlal GE, CI al. ERecl of viramin D supplcmcnlaon winwnime and overall bone loss in hcaJthy postmenopausaJ womell.
AnnlntemMedI9910cll;115(7):505-512.
IOb

d011

'07 Abboll RO, Curb JO, el aJ. Effcel of dielary c.1Jcium and milk conSUlllplion on risk of rluQlllhocmboJic slroke in older mjddle-agcd meu.
l'he Honolulu Hem Progr:un. Strokc 1996 May;27(5):8 13-818.

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Public Voiajor FOl)tI rI",I Hralth Polic)', 1992.

IlO

Ellen Ham. Public Voicc for Food fllld Hcalth Poliry. 1992.

While EG. C()uw,l, mI Din aY/d Foods. Hagcrslown, MO: Review '.Ind
HcraJd Publishjng Assoei<ll.ioll. 1976 p. 365.
111

LaSI LM, WaJlace RB. Maxcy-Rosenau-La8t, Public Hc,dtb 11",1 PUlIC}}tirJC Mcdicinc-l3rh et!iriOIl. orwalk, CT ApplelOn and b,llge. 1992 p.

95

199.

WhilC EG. Coumrls OII Diet tind FOQtis. Hagc.rstown, MD: RcviL"W alld
Herald Publishing Associarjon, 1976 p. 357.

LasI LM. WaJlace RB. Maxcy-Roscnau-Llst, Public Hmltb IInd Prt.'IJeJ1tive Medicinl!-13tb edililJlI. Norwalk, el: Applewl1 and langc, 1992 p.

113 \V1hite EG. U>llIIst:ls on Dier Illltl Foods. Hagcrstowll, MD: Rcvicw and
Herald Publishing A.sociatioll, 1976 p. 460,

96

591.
laSI LM, Wallaec RB. Maxcy-Roscll.1u-b t, Public Hmlth illld ?relJtll!ilie Medicille-13th edi,ion. Norwalk, el': ApplcwlI :Ind Llnge, 1992 p.
591.
97

Hulse V. Crohu's disc.1se from miJk. In: MiIIi Curvs fmd Milk
Ilix, OR: Marble MOlllllain Publishers, 1996 p. 251.

98

Grile.

112

II American Acadcrny of Pedialrics COll1nlillCe on NUlrilioo: The use of

.....hole cow's milk in infalley. I'edi{I1,ic.s 1992 JUll;89(6 Pl 1): 1J05-1109.

115 Oskj l'A. DOII~ D,.ink yo"r Milk-9th Jitoll. BrushlOJl. NV: l'EACH
Services, Ine.. 1983 p. 4.

Phoe-

99 Gram lR.

BaU HJ, et aJ. lnactivatioll ofMycobactcrillm parambcreulosis

in ClJws' miJk al p:lSlcllrizarion lempaalurcs. ilppi b/lJiron Miuobiol1996
fcb;62(2):63 1-636.

255

PROOF POSrTIVE

256

CHAPTER TWELVE

THE

RONTAL
OBE:

The Crown ofthe Brain

SECTION I.

Function ofthe
Frontal Lobe.

hen the sun rose on Septcm-

bec 13, 1848, no one then liv-

ing could have imagined ,rhe

.
momenrous evems that would
bcgin ro shake the world of.medical science
that day. The suange uain of evenrs centered on a respected 25-year-old railroad
consuuction foreman in Vermollt named
Phineas P Gage. I imagine tlle day began
like ;U1y other workday. Phineas probably
are breakfasr, gor ready for work. ki sed his
wife and children, aud thcn headed off to
his railway construction job. As he was
walking om the door he may well have said,
'TU be home for supper ronight." Bur
Phineas did nor make it home for rhe
evening me.,.!.
His Cllrrenr assignment was laying railway track rhrough a mounrainolls region.
A significam amount ofblasring was necessary. Phineas was the man in charge of rhe
blasring. The fOurine was wdl esrablished:

drill a long hole ioto tlle rock, fiU it partially full wirh explosive powder, then CQver
rhe powder wirh sand. A ramping iron was
nex( used to pound down on the sand, consolidating the charge. Finally, a fuse would
be lit ro detonate the explosion. an mat
farefuJ September l3 u" everything was going as planned. The long hoBow hole had
been drilled, and rhe explosive charge was
carcfully set in (he hole. But a glicch developed in rhe romine. Wherher Phineas was
disuacted or wherher his assistant simply
failed to CQvcr the charge with sand is unclear. In any evenr, Gage was sranding ar
rhe hole unaware thar no sand was covering
rhe explosive charge. The unwitring Gage
began ramping direcdy over (he powder.
Apparendy rhe rod generated a spark as ir
glanced a srone inside rhe hole. The uncovered powder ignited and ser off a powerful explosion. Instead of going through
t!le rock, rhe force of rhe blast came srraighr
roward Phineas. The 13-pound ramping
iron, abour 1 inch thick and 3 feer long,
was hurled direcdy ar him. Wirh rne force
of a missile, tbe iron went under his left
cheekbone, behind his left eye, through his
brain, aod rhen our again. The bar exired

257

PROOF POSITIVE
severa! inche bebind his hairlioe after passing rhrough Phineas' skull, sdp, and hair
on its way out. SA powerful was the blast
rhat the raroping bar stiH had enollgh force
ro fIy airborne out ofPhincas' head and "lod
Olaoy yards away. The iocat.ion of Gage's

----!t

_,..-'r..... T ....

Figure 1
injury is shown in Figure 1.
You would assume ehat che dramaric
explosion eerminated Phineas Gage's youog
life. Bue it did not. Gage was briefly
stuoned, bue wiehin a shorr cime he regained
ful! consciousness and was able t.o talk and
even walk with rhe assistance of his workers. Despite how well he did iJliriaUy, infeceion did rhreaten his life over the next.
several weeks. Amazingly, in chac pre-ancibioeic age, Ph ineas Gage did not come down
with any fatal infecrions. He survived aod
made a nearly compleee recovery-as far as
his physieal healeh was coneemed. The only
physical traces that remained were the loss
ofvision in his leh eye, a seM undeI' his left
cheekbone where the tamping iron enrcred,
and a scar On the eop of his head where it
exited. There was juse ooe major problem:
he was no longer Phineas Gage.

258

Dl1maged Frontl11 Lobe Cl1used

Deteriorl1tion ofChl1rl1cter
Before rhe accident Phineas was a well
loved, re.sponsible, and incelligem worker
and husband. He was known as a person
with high mora.ls and was described accord
ing tO one accounr as ua pious aod reverent
ehurchgoer." So excellent was Phineas' charaeter that work reeords lauded him as uthe
most efficient and eapablc foreman" employed by ilie Rudand and Burlington Raii
road. Aftcr rhe accidem, Gage seemed ro
be physiea1l)' jusr as fit and memally just as
illtelligem. He could work and speak JUSt
as well as he could before the accident. His
memory was just as good.
But soroe major things were different
aEcer che accident. His moral decline was
im mediately eviden c. He became very emotional abolit things and would gec angry
qll-ckly. Nor long afrer rus injury he lost
interesr in chureh and spiritual things.
Phineas becameirreverent, and prone to
excessive profaniry. He lost ali respecr for
social custoOls and beca-Ole torally irresponsi bie. He wene from a prized employee to
the unemploYOlent roUs. His company dismissed him when he cOlild no longer responsibly discharge rus duries. Dr. John
Harlow, his physician, srared iliac the accident descroyed Gage's "cqllilibrium or balance, so to speak, between his inreUecwal
faculry and his animal propensieies." He
ended up forsaking his wife and family and
joining a travcling circus. Phineas Gage's
rfaumaeic froncal lobotomy cost him his
personajity, his moral sean'dards, and his
comrnirmem ro famil)'. church, and loved
ooes.
f>hineas died abollt 13 years afrer the
accident. Dr. Harlow found ouc abolit his
death some five years aher ilie fact, aod apparently for the sake of science, made an
unusual re'quesc. He asked Phineas' family
if they would allow his body ta be exhuroed
and his skull kept as a permanent medical
record. The family agreed, and ro chis day
rhe skull along with che tamping iron (which
was buried alollgside Phineas) are hOllsed
in (he Warren Anatomical Medical Museum
at Harvard University.1

THE FRONTAL LOBE

Since 00 auropsy was done, specularioo
has conrinued throughoUl rhe years as to
where precisely the injury occurred. The
landmark sracus of rhis illusrrious case was
further resrified ro in 1994, when one of
the world's mosr presrigiolls sciemific journ,t1s, Science, devoted irs cover story ro
Phineas Gage. 1 The journal feamred an artide co-authored by scientisrs ar Harvard,
the Univcrsiry of Iowa, ami the 5,11k Institute in San Diego. These researchers used
advanced computer modeling and X-ray
studies of rhe skull ro rry ro pinpoinr rhe
exaCT paft of the brain that actllally had been
dalllaged. They concluded rhar Phineas
Gage had lost an important area on both
sides of the front parr of his brain, known
as rhe left and right regioJls of rhe frontal
lahes.
Whar do we leam from Phineas Gage's
unique case? It demonsr.rated lhat a section
of the brajn, r!le frontallobe, is responsible
for moral reasonjng and social behavior.

The Features ofthis Chapter

The chapter begins with an explanation
of the funcrion of the frontal lobe. Next,
facrors rhar impair rhe action of rhe frontal
lobe will be e,"plored. Then, we examine
the benefirs aod harm ro the fromal labe
rhar dier can cause. Finally, other actons
that we ean take ro enhanc; the f1.1nction of
r11e tronrallobe will be presented.

Lifestyle Faetors Can Also Damage the

Frontal Lobe
This area of rhe brain has taken on even
greater sigllificance roday for ar leasr two
reasons. Firsr, rJlere is a growing emphasis
on personaj developmenr and menraJ performance. Second, man)' feel duc socieral
norms and moral reasoning are crumbling.
50me ncufOscenrisrs are wondering if there
are physical reasons to explan such pllfporrcd ch,wges. Can there be lifestyk filCtors that may damage rhis critical paft of the
brain and affcct, in essence, who we are?
The answer is definitely "Yes."
OUl' daily lifeslyle practices can indeed
affect aur remperament, aur emotions, and
our behavior. The front paft of our brain

G.111 either be enhanced or eompromised by

our habitul1lchoices. This revelation ofbrain
science has profound implieaeions for aII of
us. By understanding rhe facrors rhat af:'
feer our frontai lobes, we G.1.n improve our
performance in work ar 5chool, develop
beuer social skjlls, be more responsible parenrs, neighbors, or spouses-and rhe list
goes ono Alchough most people do not pick
up a health book ro read abolit their frontal
Iabes, ch.is may be ehe mosr important chapcer in my emire book. I encourage you ro
reaei what follows carefully. Your abiliry to
successfully implement the healthy lifestyle
changes advocated in chis book may weB
depend an your front al labe operating at
peak efficency.

Functions ofthe Frontal Lobe

The brajn is divided inco severa! sec[jons,
or Iabes. Each lobe has specific functions.
Behind che forehead are the froneai lobes.
For cOllvenience, we refer ro both the righr
and the lefc froncal lobes collectively as "the
fronr.u lobe." It is t!le largesc labe of ehe
brain. 3 It is rhe sear of judgment, reasoni.og, nrellect, and the wi11. 4. s. 6 It is the
control center of our emire being. Some
scienrisrs refer ca the fromal lohe as rhe
"crown" of the brain. Studies show ehat rhis
so-called "crown" performs a variery of

THE
OWN
Scentific stlldies show tlle Ironta/tobe is tire seat of

spirituality
morality frontd lotle --I:n~~iJ'\
the will

figure 2

259

PROOF POSITIVE
viral funcri~ns. Some of these are listed in
Figure 2. 7
Spirirualiry, character, moraliry, and will
are the characreris{ics thal give us our unique
individuality. Therefore, a person with a
damaged frontaI lobe may look ilie same as
they always did, but if you interact wirh
lhem, it is usually apparent {har rhey are
"jusr nor rhe same."
The Book of Books alludes ro the significance of rhe frontal lobe in knowing

"And they shall see His

face; and his, name
shall be in their
foreheads."
Revelation 22:4
Figure 3

SIZE OF
LS
30!------25

%of
brain in 20 r - - - - - - - - froDtal
lobe I S r - - - - -

10
S

o
figure 4

260

Cats

Dogs

Chimpanzees

Humaos

Gad. The last book of the Bible makes a

provocarive srarement, quored in Figure 3This rext suggests thar God's characler
C'His name") is reproduced in our charactcr (exemplified by rhe fronral lobe, which
is JUSI behind our forehead).

Brain Size and Function

It is fascinaring to observe how rhe size
of rhe fronral lobe differs among men and
various bcasrs. It is the fromal lobe that
large1y sers humans apan from rhe rest of
t!le animal kingdom, as shown in Figure 4. 8
Those wirh rhe smallesr fromal lobes
have limited inslinet-driven ways of life.
Those Wilh Iarger frontal lobes are able ro
perform more complex funcrions. Cars,
wirh only 3.5 percent of {he brain in rhe
frontal lobe, are limired in judgmenr and
reasoning power. They have a very limired
capabiliry ro analyze informarion and make
judgmenrs based an new informaron; rhlls,
rhey basically rely on instinct. Dogs are
more rrainable because 7 percent of rheir
brain is in rhe fronrallobe. Among the animals, chimpanzees have rhe largesr frontal
lobe-up ro 17 percenr of their brain.
Humans, on rhe other hand, have 33 ro 38
percel1t of their brain in t.he fromallobe.
Some animals have other ponions of the
brain thar are more deliel<Jped rhan human
beings. For insrancc, compared ro hllmans,
chimpanzees have much largcr cerebellums-me brain area rhar conrrols coordinarion. This stands ro reason, bccause
chimps need weU-honed baJance and agiliry ro swing f~om tree ro trec. Birds aJso
have very weB developed cerebellums for
flying, landing, and hunting. Ali of rhese
activities require a high le-vei of coordination. Other animals may have a much more
generolls occipilal lobe-the brain center
where vision is housed. Hence, thcir eyesight is generally much better rhan thar of
humans. StiH other animals have more developed parietal lobes. However, for humans. the difference is c1early our much
larger frontallobe. Thus, we have r.he capaciry for elevared spiritual reasoning and
superior learning abiliry.
1'0 fully appreciarc rhe significance of rhe
fronlallobes. it is valuable lO examine a few

THE FRONTAL LOBE

more cases from (he annals of medical hisrory. One of che reasons for rhis is rhar
Phineas Gage only lost pan of his frontal
lobes. Lifesryle choices can affecr our entire
fi"o11tallobes-albeir in less dramatic ways
rhan Phineas' loss.

Other Case Studies ofFronta! Lobe

DarJUlge
In rhe late 1800s psychiarrists began using a surgical procedure called a "frontal
loboromy" (Iiterally meaning removal of rhe
fromal lobe). Although someeimes a porrion of (he labe was physic.'lUy removed, at
ocher times it was "funcriona1ly" removed
by severing its nerve connecrions. The operation inieially was used ro "help" peoplc
who were violenrly or criminally insane. 9
The pracrice of fromal loboromy bec.1me
increasingly popular in the 1930s aod
1940s, so much so that one of che pioneers
of rhe more modern eechnique, Dr. Egas
Moruz, received the 1949 Nobel Prize for
Medicine. 10 Anoeher measure of its populariry was its accepcance by rhe cultural elite.
Rosemary Kennedy, John F. Kenoedy's
miIdly retarded sisrer, underwent froncal
loboromy.l J Since the procedure's heyday
in the mid 1900s, we have more fully appreciatcd its side effecrs of devastating psychological consequences. Consequenrly,
this operarion is rarely used today.

Patricia's Frontal Lobotomy

Patrcia was a very successful surgical
nurse who was preparing for a froncal 10boromy. The hope was [hat the surgery
would tesolve her man)' guilt problems ehar
she had struggled wirh for several years.
Following rhe procedure there were striking changes in her incere rs, attirude, work
performance, and integriry. It was obvious
that Patrieia was a diffcrent person. Her
characteristics before and after the loboromy
are summarized in Figure 5. 12

Fronta! Lobe Damage in aFouryear-old

M.H., a fouryear old giel, was seruck by
a car and suffered damage to both sides of
her froncal lobe. After the accidenc he ex-

n A ' .........

-------------Before lohotomy:
Extremely efficieot operatiog room nurse
Very fond of books aod belonged to the
nurses' Iiterary circle

After /ohotomy:
Lost much of her ambition
Lost interest in her work, and lost sympathy
with her patients
Could only perform subordinate work. Rer attitude:
"1 do not care if 1 make a mistake; it wiU turn out aII right
in tbe eod."
Lost interest in books
Figura 5

Temper outbursts when frustrated

Verbally and physiciilly assaultive in an abrupt,
unpredictable, and short-Iived manner
Sexually Ipromiscuous from early teens
No sustained friendships
Intermittent heavy user of alcohol and
mari~uana,

ImpuJsively attempted suicide twice

Figure 6
hibited depraved behavior ebat persisced
inro her adult life. The changes in her character were as seriking as (hose of Parricia.
These tragic changes are liseed in Figure 6. 13

Damage to a Baby's Fronta! Lobe

Baby G. K. suffered bilateral fromallobe
damage in the firsr seven days of !lis life.
From childhood to age 31 he had the rypical characreriseic.~ of someone who had experienced Eroncallobe damage, as described

261

PROOF POSITIVE

Common Effects ofCompromised

Frontal Lobes

As the ehUd developed, he

did Dot respond to parental discipline
always sought gratification of his immediate needs
Dever developed adequate friendships
blamed his difficulties on others
was irresponsible and tended to wander
was easily influenced by other deviant children
masturbated regularly and was bisexual
Figure 7

Impairment of moral principle

Social impairment
(Ioss of love for family)
Lack of foresight
Incapable of abstract reasoning
Cannot interpret proverbs
Diminisbed ability for matbematical understanding
Loss of empathy
Lack of restraint (boasting, bostility, aggressiveness)

Figura 8

262

in Figure 7. 14
At firsr his f.1mily thought his irresponsible behavior was due [Q the fact chac he
was merely a child. Unforrunately, these
traits persisted inco adulthood. Parental
discipline seemed to have no effecL He had
no meaningful friendships, and he could nor
see his many faulrs. Insistence upon immemace gratificaeion (including sexual promiscuiry) is a common characteriscic wilh froncal lobe impairmem.

Through srudies of accidemal damage

ro rhe fronrallobes combined Wilh rhe resulcs of fromal loboromies and studies of
drugs rhat aifecc the front brain, sciemisrs
have idenrified many of rhe effecrs of compromised fromal lobes. These effecIs are
listed in Figure 8. 15 . 16. 17. 18.. 19
As an illusrration of the moral and social effeccs of the fronrallobe, consider ilie
following rrue story. One woman prior ro
going inm surgery was asked. "What would
you do ifyou had lost a watch rhat you had
borrowed?" The lady answered, "1 would
need ro pay for che watch or buy one and
return it." Afeer her froncal lobe was re.moved in surgery and she had recovered,
she was asked the same quescion. This rime
she answered, "1 wOllld have ro bocrow anomer warch!"
As a child matures, lhe effect of fronlal
lobe developmenr is apparenc. A smalt child
can only see ahead one day ar a cime. You
can cell him someching is going ro happen
lomorrow and he wiD remember it only if
you remind him. As chat child m:llUres he
will begin ro gain more foresighr. 8y che
rime he reaches second grade, he real izes rhar
neXl year he will be in rhe third grade. As
he cominlles ro mature, he will evemllally
be planning for his career. The frontallobe
continues ro develop for 30 years. 10 Wirh
proper craining, as rhe child matllIeS into
an adulc, he wiU ultimarely reaJize (hat his
aerions roday have a bearing on his ererniry
ahead. This indic<lres some of the highes{
development of che fronrallobe.
The abiliry to use abstract ideas such as
imerpreting proverbs is a special acr of inreilecL If you ask someone who does nor
have full ucilizarion of rheir fronrallobe ro
incerpret a proverb like "people in glass
houses shouldn'c rhrow srones," iliey will
answer very concretely. They ma)' repl)',
"Obviously, {hey will damage cheir houses."
This example illustrares concrete reasoning-a mental process rhat rends to miss
abstract conceprs.
Regarding marhemaricalundersranding.
calcularion actually occurs in che back paft

THE FRONTAL LOBE

of rhe parierallobe. ThllS, wirhoue lhe frontal lobe funcrioning, you can have great
marhemarical skills iJ\ adei ing, subtraccing,
and mulriplication. However, when it
comcs ro higher mathematics that reqllires
reasoning, such as algebra, geom.erry, and
cspecialJy calculus, fromallobe funcrions are
required for flawless resulrs.
An lUlimpaired fronrallobe is also a musr
if you wane ro empaehize mosr dTecrively
wirh someone who is bescr wirh a problem.
This is especially rrue if rhey are going
rhrough somelhing thar you have never personallyexperienced.
A lisr of mher common effecrs of fronrallobe impairment is shown in Figure 9. 2 1.
l2, 23

'!r

~. \~,.

(!f'

Memory impairment (especially of

recent events)
Distractibility and restlessness
~...;
Flight of ideas (fantasies,
...-...
emotional instability)
Apathy (Iack of initiative)
. Indifference to one's condition
(happy-go-Iucky)

Psychological Diseases Rooted in an

Impaired Frontal Lobe
It is no surprise thar some p ychological
diseases have rheir roors in frontallobe problems. A lisr of rhese disord r is shown in
Figure 10.
Mania is an emorional elisorder characterized by remarkable acriviry, exciremenc,
rapid passing of ideas, insomnia, and unsrable anention span. It can have irs root in
compromised frontaI lobe funcrion. Obsessivc compulsive disorder characrerized by
a seemingly uncontrolbble persisrent and
reperirive inrrusion of unwanted rhoughrs,
urges, or acrions, can aJso arise from froncal
lobe impairmenL Anention deficit hyperactiviry disorder also can resll!r from fronrallobe problems. 24 Since 1990, rhe nllmber of people diagnosed as having arrenrion
deficir hyperacriviry disorder in rhe U.S. !las
risen from 900,000 ro more rhan two million in 1995. 25
Many cases of depression may also be
relaeed ro the frooral lobe. Sophisticated
brain Sc..1JlS (PET scans) reveal mar depressed
parienrs ma)' have a 60 percent redllC(ion
in frontal lobe blood flow. 26 In working
wirh depressed parienrs, (here is evidence
mar if OJ)e can enhance rhe aceiviry of their
frontaI labe, blood flow ro rhar arca will
incrcasc, and rhe depression can be markcelly lfnproved or correcred.

Figure 9

Mania
Obsessive compulsive
disorder
Appetite increase
Attention deficit
Ityperactivity disorder
Depression
Figure 10

Appetite and the Frontal Lobe

Many common physicaL heaLth probLems
rhat 1 cncollnter in my work as a physician
have meir roor cau es in rhe froncallobc of
rhe brain. Appetire control is onc such problem rhar is prevalenr in our sociery. Nor every overweight person has an apperire conrrol problem, but many do. The rising level
of obest)' in America raises concerns rhar
appctire cOfl.rrol problems are becom,ing
more prevalenrY 28 Even appctirc disorders

263

PROOF POSITIVE
such as bulimia appear to have their origin
in the frontal lobe. The highest renter of
appetite control is in the frontallobe of the
brain. No.maner how hllngry you are or
how srrong your desire may be for someming rhat may be harmflll, you can generaHy suppress rhar desire if your frontallobe
is fllncrioning optimally. Those wirhouc a
capable frontallobe have great difficulry in
suppressing sllch urges. Some overweight
individuals who kllOW rhey are earing too
much wiU continue ta eat because their frontallobes are not fuUy able ro say "no."

Jmplications ofFrontal Lobe Research

These srudies demonsrrate the frontal
lobe's vital role in dererminillg our character. An impaired fronr.1llobe results in an
impaired characrer. Self conrrol, rrusrworrhiness, reliabiliry, serious reading, abstract
reasoning, and interpersonal reIarionships
are ali complex funcrions ehar depend upon
a well-funcrioning frontal lobe. The actUntal or surgically planl1ed damage ro me
fronta1lobe rypified in our case srudies is
one ming, but whar abouc damage that 111.1y
unwiningly result from an unhealtlry liftstyle?
The chief message of chis chaprer is nor
to encourage you ro avoid professions where
you are working wim dynamite, or to be
eareful when erossing the street, or ro avoid
surgery for psychiarric illness. AU of rhese
things are important. However, the most
common causes offronrallobe impa.i.rment
roday are not surgeries, occuparional injuries, or other rraluna. The main causes of
compromised frontal lobe fimetion are im-

proper iifestyle habits.

264

Indeed, this chapter's main message is

that the negarive character traits of the individuals we have examined rhus (ar are nor
limited lO those who have missing or damaged frontallobes due ro trauma. Many in
our soeiery roday suffer rhe same rragic charaerer defects as rhe resulr oflifesryle ehoices.
Many of our mosr cherished habits give LIS
short-rerm grarification but silendy rob us
of that which is ofinestimable value-who
we reallyare. Unknowingly, our habits lOday are impairing rhe performance of our
fronrallobes both roday and tomorrow.
One purpose of rhis chapter rhen is ro

show rhar frontal lobe impairment is not

Iimited ro the efTecr.s of traumatie damage
ar surgical removal. In my opinion, the effecrs ofJifesryle aod nurririon on our fronrallobe are ulrimately more important than
rheir effecrs on heart disease, cancer, osteoporosis, kidney failure, and ali rhe orher
degencrative diseases combined. The brain
deserves prioriry for protection when you
realize [hat this is where our qualiry of life
ongmates.
Jusr as Lifestyle choices proteet the frontaI lobe, a healthy frontal lobe purs us in
me best position ro take charge of our lives.
This means thar as I make healrhier choices,
my (romal lobe performance improves,
making furure lifesryle changes even easier.
Perhaps no [romal lobe function is as vital
ro making lfesryle changes easier rhan the
power of the will. Willpower may nor seern
ali rhar important in our daily lives but it
really is essenrial. 1 have seeu many paricms
die because of deficient willpower. No, 1
am not talking abour individuals who Iose
rhe will ro live, as important as thar is. 1am
referring ro the c.'lSes of rhousands who die
because rhey fdc they did not have the willpower lO dlange rheir lifesryles before it was
roo late. Today tens of rhousands are langllishing on rheir deathbeds beeause of will
power deficiencies. There are diabetics who
for years did nor have che strengrh of wiU ro
exereise, cat right, or keep eareful warch of
rheir blood sllgars. Now they are in the end
stages of hearr and kidney disease. There
are smokers who Jid nor have the resolve ro
"qllit for good." Now they are dying with
terminal cancer. There are orher individuals who did nor have the willpower ro make
necessary lifesryle changes for cheir blood
pressure problems. Now they lie paralyzed
as the aftermath of illcapacitating srrokes.
These eases and many odlers tesri/y ro
the great deanh ofwillpower in our land. In
faet, ooe of my greatest concems wirh wriring rhis book is that many ofthe imponantancllife cha.nging-insighrs that 1discuss will
never g,\in a foothold in many readers' lives.
The reason? Lack of wiUpower.
From this perspective, 1 underscore me
faer mat one of me frontallobe's mosr viral
fuocrions is the will. Scientists have dem-

THE FRONTAL LOBE

onstrar.ed rhar whar we caII "willpower" resides in rhe frontal lobe. 29 Dr. Bernell
Baldwin, Ph.D., neurophysiologisr ar
Georgia's Wildwood Institute, summarized
some of iliis imporranc literaeure on rhe will
in an article ro leaders of fairh conununities. Baldwin poimed out rhar research on
shrapnel wounds in World War 1 vereraJ1S
uncovered deficirs in willpowe.r among rhose
who injured thc from of their brains. Those
who sustained injuries ro rhe back of their
heads, however, experienced no impairmenr
of thei r wilpo
Closdy related ta willpower is aur abiliry co discern where the banle teally is. If
we do not sec issues clearly, we will nm likely
recognize rhat we need ro exert OUt willpowet ta ovetcome a chaHenge. Ta illustrate this poillr, Dr. Baldwin cited the rcsearch of the Russian scienrist, A.R. Luria.
Luria found that individuals with normal
[rontai lobes had the abiliry ta draw rapid
conclusions about rhe meaning of ca refu lIy
designed piceutes. IndividuaIs with fromaI
lobe impajrmenr could accurate1y describe
componenrs of the picture-bllt rhey
tended nor ro see "the big pcrure"-rhe
broader meaning behind rhe derails. This
is very relevanr in rhe arena of lifestyle
change. Deficiencies in insighr leave us destined ta overlook how key lifesryle concepts
apply to aur own lives. WiUpower shorrfalls,
on the orher hand, predispose us ro f.'tiIure
even in the are.'tS where we dearly recognize
we have a problem. In shon, the twin frontai labe fi.mctions of insighr anei will are indispensable ta a successful applicarion of ali
rhe material that 1 presenr in rhis book.
There is a final conretnporary reason
why arrenrion to rhe frontal lobe is so important. Today psychological counseling
and behavioral rherapy are popular, and
somerimes beneficial. However, some mental healrh pracrieioners overlook the fact rhar
current lifesryle habies may be important
factors conrriburing ro psychological illnesses. lf those who feei rhe need for such
counseling would adopt a rmIy heahhy
lifesryle by paying careful artenrion ro whae
rhey pur into their bodies and expose their
minds to, many would experience a happier, more fulfilling existence.

SECTION II

Frontal Lobe
Impairmentfrom
Drugs, Nicotine,
Alcoho4 Caffeine, and
a Toxic Chemical.
What Lifestyle Factors Affect our
Frontal Lobes?
To maximize the eHiciency of our frontal lobes we must focus on boch che positive things we shoulel be doing and the negarive things we should be avoiding. In fact,
by fully recognizing the ways rhar we often
compromise our fronrallobes, we can better appreciate how the he.alrhful facrors can
aid us in expanding brain capaciries. From
this perspecrive, I will begin by looking ar
lifesryle habits rhat impair frontaI lobe fi.mcrion. 1 will later address some of ilie key
facrors that are calculated ro impro1Je frontallobe function.
A list of drugs ro avoid in order ro protect our frontallobc is shown in Figure Il.

illicit drugs
certain p'rescription drugs
other legal social drugs:
alcobol
caffeine
nicotine
Figure 11

265

PROOF POSITIVE

Effict ofDrugs on the Fronta! Lobe

Many Americans have becn wringing
rheir hands of late regarding our narion's
heav)' and increasing use of drugs. There
has been a sharp upturn recenrly in borh
the acceprance of illicir drugs and che use
of rhose drugs among American youm accord ing ro m3ny widely publicized surveys.3\ Parents are afraid rheir children wiJl
use illicic drugs because of cheir addicrive
nature and rhe physical, mental, and social
implicarions of rhar addiction. They also
fear whar rheir children mighr do while "under the in1luence," such as engaging in highrisk behaviors rhar cOllld ulrimarely cur shorr
their young lives. This lasr concern i especially important. Even a pe.rsol1 who does
nor appear ro be i 11 toxica red ca n have
blunced fromal lobe funcrion. Such impairmenc predisposes ta risk-taking behaviors
char can result in an automobile accident,
comrac[ing HIV jnfection, or ome od1er
Ijfe-changing or life-shortening event.
Drugs otber tbtln il/icit drugs impair fronrallobe fllncrion. Many feel cheatedif rhey
pay ro see a doctor and do nor walk away
wirh ar least one prescriprion for a medicinaL drug. Television, radjo, and magazine
ads bombard LIS wirh our need foc over-checOllncer cemedie.s. Caffeine and alcohol ace
culrurally accepted drugs. Nicoeine use is
socially stigmatized in many settings, but is
stiU rreated legally as a lifescyle choice, not
a powecfully addicrive mind-altering drug.

I!licit Drugs and Menta! Impairment

266

The dallgers of illieir drllgs 00 menral

performance are well recognized. There
seems ro be LinIe need ro belabor how such
"mind alcering" drugs alter tIle mind-inc1uding rhe frontal lobe. This problem,
however, is even worse chan previously
thoughr. There is growing evidence char
drugs of abuse affecr rhe brain long after
rheir acute effects have wom of[ Recent
ceseacch funded by ilie National Institute
on Drug Ahuse found chat college scudents
who were regular marijwma users had defec[s in their Ilttention, memory, Ilnd learning even 24 hours afrer their last lIse of rhe
drug. 32 Long aher rhe high was over, t11e
brain was sti II srruggling along in low gear.

Marijuana, like its cousins alcohol and nicorine, has now been demonsrrated ro harm
rhe brai!) of [he developing fetus. A morhcr
who lIses macijuana givcs her child a lifelong legacy of brain impairment. 33 The
message from marijuana research applies to
the use of alcohol, which is covered later in
rhis chapter; namely, che brain performance
of chose who use alcohol aJld ocher mindalrering drugs can be impaired long after
the Llser chinks rhe effecrs have wom off.
For optimal froncal lobe funcrion, leave illicic drugs ouc of ilie pictl1re.

Lega! Drugs Can Also Assault the

Fronta! Lobe
Many peescriprion and over-the-counrer
drug medicarions CaJl also depress fromal
lobe funecion. If you go ro a library and
read a drug reference abolit rhe effecc r.har
various drugs havc, you will find rhar mally
have an inflllenee on rhe ceneral nervous
system, and one of rhe moSt commonlv affecred areas of t11e central nervolls syst;m is
the frontal lobe. Many people are on medications chat are nor acrually necessar}', and
their side effeers may be harmful ro che personaliey and characcer. This is why, beforc
deciding ro raxe medicarions. rhe benefits
need ro be carefully weighed againsc che
risks. A lisr of c1asses of drugs thac commonly affecr the mind is shown in Figure
12. 34 If you are cllrrenrly on one of rhese
drugs, do not stop it 11bruptly. Instead, work
wich yOlle docror. Afrer aII, ir is nor an easy
decsion ro know whar ro do wirh man}' of
these medicmions. A good case in point is
provided by t11e high blood peessure drugs.
Some of those medkations may impair frontaI lobe funcrion. However, if the high
blood pressure is nor adequately created, a
srroke may be ilie resulr, causing much more
profound frontallobe impairmenr. For this
reason, many physicians are advocaring
lifescyle therapies as che oprimal means of
conrroJling blood pressure. Chapter 6,
"One Narion Under Pressure: pre ents sud,
rherapies. More informarion is given later
in this chapter on rhe imponance of controlling blood pressure for maximizing fcontallobe function.

THE FRONTAL LOBE

It is now becoming a part of mainsueam
medical practice tO hdp people ger offdrugs
rarher man adding new medicarions ta their
program. Research an older Americans
shows rhat they are ar higher than normal
risk for impaired memal function, drug side
effects, and also deleteriolls effects from high
blood pressure. The Cenrers for Oisease
Conrrol and Prevenrion (COC) recendy
pointed out thar Americans 65 and olcler
have nearly rwice the risk of adverse drug
reactions compared ro those rhat are
younger. 35 Furthermore, they highJiglued
the facr that high blood pressure drugs frequently cause adverse side effects in this
population group. The COC from chis
perspective asserted: one important
straregy for preveming adverse drug reacrions among e1derly persons is ro limir me
number of drugs tJsed." 36
Ofcourse, conccrns for drug side effects
and a resul ring advocacy ofljfesryle change
for disease trea(menr have exisred long before this recent COC proclamatian. One
of che more inrercsring hisrorical statemenrs
along mese lines was wrirren by Ellen White.
Her words are quoted in Figure 13. 37
Social drugs ofeen inreracr wirh prescription drugs ro produce side effects. For example, alcohol adds significanrly ro rhe risk
of adverse consequences of drugs-induding effecrs on mental clariry. In a smdy of
over 100 recendy hospitalized individuals
who represenred a broad cross seetion of rhe
popularion (men and women, 14 ro 88 years
old), 10 percenr had inrtraccioJls berween
alcohol and (he medications rheywere given
upon leaving rhe hospiraJ.38

A!cohollnjures the Fronta! Lobe

A1cohol has direct effecrs on the froncal
lobe in addition ro it worsening (he risk of
medicarion side effecrs. In facr, ir is one of
Americ.a's most popular frontaJ labe assailants. Ler ilS exarnine some illuminaring research along these lines.
Several years ago, alcoholics and nonalcoholics were srudied by rwo modern di.
.
agnosrlc rests: magnetic resonance lmagtng
(MRI) and posirron ernission ropography
(PET scalUling). The MRl is a now-f.1rniliar scan rhar can look ar rhe actual structure
"

Asthma medic.ations-Beta agonists

Blood pressure mcdications-Beta blockers, calcium cbannel
blockcrs, centrally acting agcDts (CJonidinc,
Methyldopa, etc.)
Tranquilizers and slccping pills--benzodiazepines
antidepressants (Note: tricycllc antidepressants
are also used for headachcs, insomnia, etc.)
Anti-ulcer pills-H,-blockers (Tagamet, Zantac)
Anti-inflammatory drugs- NSAIDS
Pain relievers, narcotics
Cold aud allergy medications-antihistamincs (also used for
insomnia, etc.), decongestants (espcciall)' in children; c.g.,
preudoephedrine as in Actifed)
Figure 12

L
l. "Many are Iiving in violation of the laws of health, aDd are

ignorant of the relation tbat thcir hahits of eating, drinking,

aud working, [bave) to their health."
2. They are not a,warc of their condition

UQliI

diseasc occurs.

3. If, at tbis point, the individual would make the appropriate

Iifestyle cbauges: " ...the patient will generally recover without
beiDg debiltated."
4. However, instcad of changing lifestyle, medicatioDs are
gencrally employed. "Tbe liver, heart, and brain, are
frequentJy affected by drugs, and often aII these organs are
burdened with disease."
Figure 13

of the brain. Among rhe alcoholics, it revealed a srriking amouIl{ of loss of.fontal
lobe grlly malta. The gray matter is where
the bodies of rhe brain nerve cells are COJlcenuared (in contrast ta the deeper Iying
whire marter where rhe nerve fibers (eavillg
rhose cells predominare). Techl'tically caHed
"cortical arrophy," rhis condi(ion of gray
marter loss indicares an actual (05S ofbrain
ceUs thar are involved in cri(-ical froJltallobe
fUJlctions. On the omer hand, PET scanning looks ar brain funttion. In rh-is test-

267

PROOF POSITTVE
ing, rhe alcoholics showed a lower glucose
merabolislll-indic:uive of less fi"ontallobe
. .

actllJ/ty.

39

TI;ese fronrallobe-impairing dfects are

nor conflned ro heavy alcohol users. Researchers found a measurable decrease jn
absrracr rhinking abilit)' :unong 1300 men
and women who were social drinkers. These
inelividuals drank as linIe as oue alcoholic
betJerage per llJeek. The average man in rhe
srudy only had abour rwo drin.king occasions per week and consumed rwo OI' duee
alcoholic drillks on rJlOse occasions. The
women drank even less. On the average,
they only dran.k every fifrh day and consumed twO alcoholic drinks. Even wirh

"The child of the druukard or tlle tobacco inebriate usually has tlle
depraved appetitcs aud passioDs oftbc father intensified."
"Thcir children often receive tllis stamp of character before thcir
birth."
"Thus unborn generations arc af.flictcd by the use of tobacco and
Iiquor."
"Parents Iboth thc father and motber) who freely use
wine and Iiquor leave to thcir children Ilie legac.y
of a fccblc constitution, mental and moral debility,
unnatural appetites, irritablc tempcr,
and an inclination to vice."
Figure 14

268

mese low levels of use, assessmems of menraI funcrioning ..howed iJ'J'lpairmem. In fact,
as akohol inrak:e increased, [heir abiliC)' ro
think ab.macrly (a measure of fromallobe
pertormance) decreased evel) morc. 40 These
changes eould not be explajned by acute
alcohol effecrs or imoxicarion, because aII
assessmems of menral funcrion werc done
at leasr 24 hours aher rhe last consumption
of akohol.
Many people believe tiuc aucomobile
accidenr.s are more fre<]uenr :Ul1ong drinkers primarily because of rhe protound ef..
fects on coordination. judgment, anei alertness seen in "drunks' and orhers who are

manifesdy intoxicated. However, in many

cases rhe problem may actually relate to
more subrle deficirs in judgment rJlac occur
in apparently unimpaired social drinkers.
Such alcohol-using drivers may have no
impairmenr in coordinacion. Their speech
may weU appear normal. However, a few
momems later they may find themselves
skjdding off rhe highway OI' involved in a
collison. The reason? TheiJ impared judgmem f.1iled co provide adequatc warning
abolit the speed ro successfully negotiare a
curve or stop in rime in rhe face of an impending roadway emergency. Individuals
wirh a blooel alcohollevel of 0.05-0.09 percem, Jess than rhe legal limir in mosr starcs,
have ar leasr nine rimes rhe rsk of a hltal
rraftic :lCcidencs rhan at zero. 4 ) This is
Iargely duc co the facr thar alcohoJ impairs
[he frantallobe long betore it impairs otller
parrs of rhe brain such as rhe coordination
cenrer.
Alcohol also incerferes with [he developmeI)( of rhe tera1 brain. It is well recognized
tlur women who usc alcohol during pregnancy adversely affecr rheir offspring for life.
The Alcohol chaprer (Chapter 17 emirlcd
"WaJlt a Drink?"), explajns rhis turrher. This
has been demonsrr:ued in animal resrs as
well. 42 The animal reseatch is particularly
imeresting-and sobering-because ir poinrs
(O anorher risk factor tor childhooel brain
impairment: parerna.! aJcoholllse. 43 F:uhers
who drink are likely impaiJing cheir chiJdren's
frontaJ lobes. Ellen Wh ire decades ago wrore
abolit (he imporrance of rhe inHllence ofsuch
paternaJ factors. Her COllunenrs are qlloted
in Figllre 14. 44 45

Caffiine Undermines the FUJ1ction of

the Frontal Labe
Caffeine has f:u'-reaching effectS on the
brain. This is nor unexpecred. since it is
America's drug of choice for an early morning lift. However, ~I heavy price is paid for
rhar srimularion. Let LIS loole at bow caffeine works anei rhen explore some of ies
assocared side effects.
Caffeine impinges on the br;un's communic;lrion sysrem in a number of ways.
In exploring rhese relationship we need ro

THE FRONTAL LOBE

recaU thar brain cells ralk to one anorher
lhrough chemical imerchanges. Nerve ceUs
release chemicals caUed neurotransmitters
(ar "chemical messengers") (hat are picked
lip by neighboring cdls. These neurorransmirrers rhen cause changes to occur in rhe
ceU thar receives rhem. Some neurotransmitrers c.ause srimll.larjon of the recipient
nerve ceU, while others callse depression.
Caffeine's widespread influence focuses primari!y an its abiliry ro affect the levels of
[\\'0 tr<lnsmirrers: accrylcholinc and adenosnc. Caffeine disrllpts the brain chemisrry
by increasing the levd of acerylcholine and
interfering with the transmission ofadenosnc. Thus, caffeine upsets the delicate balance of nerve rransmission in the brain,
which may have devasta ring conseqllences.
Adenosine tones down (or purs the brakes
on) many aspects of brain nerve transmission. But caffeine weakens its power to do
irs work. thus aJlowing artificial stimulation
of the brain from rhe caffeine.
Ta a Iar person, adenosine may secm like
a "bad guy." ~frer aH, who waJlts [O depress their brain uallsrnission? Perhaps we
can see this issue more e1early by looking at
an ;lllalogy: (he importance of good brakes
an an automobile. You do not get into yom
automobile ro stop-you get jlltO it ta go
somewhere. However, you would not feei
comfortable driving a car that did nor have
rhe capaciry ta stop. Caoe! brakes are essential-espceially on a vehicle dcsigned ro
go. Similarly. neurorransmirrer. like adenosine [hat have a large role in "pucring rhe
brakes on' are very imporraJH for balance
in the brain. There are serious conce(ns in
{he psychia{ric lircramre abolIt caffeinc's mIe
in "unbalancing" [he mine!. Caifeine has
bccn linked with anxiery. allluery neurosis.
psychosis (a state where a person loses rouch
wirh reality), and schizophrenia, the 50called "spli[ pcrsonalif),,, disorder. 46 O[her
rcsearchers add ro (his lisI caffeinc-induced
delirium and anorexia nervosaY
A rhird neuro{ranslllittcr callcd dopamine also rises when yOLl dril1k a cafTeine bev'
erage.48. 49
This is extremely worrisome. Some of
rhe mosr profollnd psychia[ric diseases such
as schi20phrenia appear ro be due in pan ta

excess amounts of dopamine. In fact. standard drug rherapy for these serious menr.al
disorders involves rhe use of dopamineblocking agems. 50 Consequendy, i( does nor
secm surprising [hat caffeinc-an agclH [hat
raises dopamine levels-increases [he risk
of cerrain mental illnesses, even (hough it
may appear harmless on [Ile surf."lCe.
Orher psychiatric diseases-wirh profound fronrallobc effecrs-may result from
rhe unbalancing of brain commllnica[ions
by caffeine. This is particularly true of depression. Decreased fromat lobe fllnction
and blood flow appear ta be a characteristic
of depression. -1. 52 Re-seareh indica[es [hat
these changes may bc partly relared to
dopamine levels in (he frontal lobe. H
Recognizi ng rha[ caffei ne coun [eracts
adcnosine's role in providing good blood
flow to the brain and unbalances dopamine
physiology, we would naturaliy wonder if
there was a link betwecn caffeine use and
depression.
The inrernarionally acclaimed Norwegian research projeet known as the Tromso
hean seudy has provided :lt leas[ a partial
answer. The Scandinavian researchers asscssed l43,000 men ,1l1d women and fOtlnd
a significant increase in depression in
women who were heavy coffee lISers (but not
in men who usee! similar amoums ofeoffec).
The fmdjngs are shown in Figure 15. 54

COI~

- ..- - Coll't. eon$umpl.ion (;up'/d3Y)

_ mort Ihao 8
_ 8 or 1

16
14
Peru.nt of
Comp/o;IIers 1.2
(Womell)
10

8
6
4

2
O
Depre:s~';on

CopillC

Pr(}b/em~'

lm'omllio

Figure 15

269

PROOF POSITIVE
In addition ro the link wieh dcpression,
women who llsed more coffee also had more
problems coping with stress. The reason
why ehese effecrs did nor show up in ehe
men is not clear. It may indicate that
women are more slisceprible ro caffeine, ar
ie may reflecc caffeine's exploitation of a
grcater female predisposirion to deprcssion.

The Brain's Adjustment to Caffiine

Creates Dependency
lf caffeine is so good for us, as somc lay
peoplc (and even some scientisrs) would like
llS ro believe, it is interesting 1.0 note thae
the brain purs forth great effort tO ery ro
unda ehe cffeces of chis popular legal drug.
Under a siruarion of chronic exposlire ta
caffeine, the brain tries ro compensaee il' ac
teast nvo ways. Firsc, it decreases its prodllceion of acerylcholine, as previously
srared. ss This appears ro be a way ro lessen
the impace of ehe increased acecylcholine
levels brollghr an by caffeine. Second, the
brain increases ies number of adenosine receprors. 56 This is likely a response ro give
adenosine more of a voice in brain communicarion-in spite of caffcine blocking irs
role CO some extenr. Unfoftllnately, these
brain changes contriburc tO caffiine dependmcy. ThllS, braill sr.ructure and fllucrion

Tcnds to produce dependence

Can cause drug withdrawal reactions
Can cause or worsen psychiatric iIInesses
Impflirs physical and mental performance
Interferes with sleep
May influence the risk of other iIInesses that in turn
exert frontallobe effects through physical or mental
stress
May exert effects that impact 00 spiritual and social
dimeosions of our character
Can cause toxicity, and' evcn deaUI
Figura 16

270

-----

have chaoged and consequently the brain

acrually comes tO expecr caffeine in its environment. This is one of the reasons why
cofee llsers are so committed ro rheir morning brew. lf they do noe get their caffeine,
rhey feei ehar they are running ar less than
half-throttle. Even more so, if coffee users
stop using rhe bcverage, rhey are likeIy to
develop withdrawaJ symptoms such as headache in addirion ro fatigucThe qllick "remedy" for caffeine Wilhdrawal headaches is ingesting coffec,
caffeinated sada pop, or one of the many
over-rhe-coumer headache pills rhar comain
caffeine. However, none of these options is
as good as "collghing our" ehe withdrawaI.
Usually, within a day or rwo, ilie brain adjusrs ro a normal internal enVlronmem wirhout caffeine; the headaches will be gone; and
rhe brain will be well on its way co better
chemicai balance. However, I have had a
few patjems rhat had severe headaches for
up ro rwo weeks aher caffeine wirhdrawal.
In tllese cases, there may have been an underlying teudency ro headaches that was
triggered by caffeine withdrawal.
In practical terms, caffeine's bra.lll chemisrry disruption sers the stage for more than
juSt caffeine withdrawal problems and ehe
frank psychiauic illnesses that we have already memioned. It may also weaken physical and I)lencal perform.ance in those who
have no psychiatric symproms and are noe
undergoing withdrawal. Caffeine's effecrs
on worsening performance have been documcnccd. Alehough the drug tcnds to he1p
pe-ople do simple tasks more quickly, there
is evidence rhae it is "disruprive on more
complex tasks of moror reacrio!) rime and
fine motor coordination."57 The dccreased
pro~uceion ofacecylcholine thae resu1ts from
regular caffeine use, may aJso play a rale. 5a
Rcsearchers consiseendy hnd rhar a decrease
in brain aceeylcholine is associaeed with
impaired menral funccioning. 59 . 60 Furehermore, despite common Iare, the aurhors of
an exrensive medical review an caffeine
found no evidmce (hat dus drug helped ro
improve inrelleccual capacicy.6J A summary
ofsome ofrhe effecLS ofcaffeine an rhe brain
is liseed in Figure 16.
h comes as no surprise thae caffcine in-

..-.i'-l

THE FRONTAL LOBE

rerfeles wirh sleep. Caffeine consumed
wirhin an haur ofbedrime makes ir haIder
tO fali asleep, decre;'lses rhe roral amoul1C of
rime slept, and significantly worsens sleep
qualiey.62 Specifically, caffeine decreases rhe
deepesr, mosr resrorarive stages of sleep
(scages 3 and 4). Perhaps more sllrprising
is lhar excessive amOllnts of caffeine can
callse severe brain problems, indllding seizures. 63 There are also descriptions of huOlan falalities due ro caffeine. 64
1would be negligent not ro mention m:lt
caffeine has a host of effecrs lhar may indircctly affecl froncal lobe funcrion. By inducing disease and both physicii and psychological srre.ss due ta those condilions, rhe
frontal lobe can suffer furrher under
cafTeine's woeful cuie. Some of lhe orher
healrh consequences ofcaffeine use are lisred
in Figure 17. 65 . 66. 67. 68, 69. 70. 71. 72
AJrhough some of these effecrs are conrroversial (wirh some studjes finding a caffcine link, bur olhers nor), we must ask
ourselves if ir is worrh raking chances wirh
c.affeine when we have already discovered
so many other problems with it.
Anorher imporrant fronrallobe effect of
caffeine relates ro our spiritual dimension.
This was highlighlecl by Ellen Whire yeaIs
ago. She explained rhar caffeine's brain
srimulation could cause rhe tongue ta
"Ioosen" in conversarion. as explained in
Figure 18.73
A definirion of gossip is rhe sharing of
privare informarion wirh someone who is
not parc of r!le problem ar pan of itS solulion. The laclies' rea parry has been histOrieally viewed as the SCIt of gossip. Note,
however, gender is nor meluioned. The
srarcmenr would apply ro men's or mixed
garherings as well, pacc.iclllarly if "rhe right
beverages" were being imbibed. Whire suggesrs mar one of the root causes of gossip
may be rhe eype of beverage rhat is served
ar social garherings. An undersrandjng of
the effecrs of caHcine on rhe froncal labe
resrihes to the reasonableness of heI concerns.

Caffeine may be a co-carcinogen, contributing to the

development of cancers ofthe kidney, breast, colon,
pancreas, ovaries, aud bladder.
lncreases risk of low birtb weight in infants
born to caffeine-consuming mothers.
Elevates blood pressure by 3-5 mm Hg.

:_:;.-_

Can cause palpitations and more dangerous beart rhythms.

Stimulates excess stomach acid production and
gastroesophageal reflux which is a cause of severe
heartburn (for both caffeine and decaffeinatcd coffee).
May increase symptoms of premenstrual syndrome (PMS).
Figure 17

CAFFEINE AND G ---IP

"When these tea aud coffee users meet together
for social entertainment, the effects of their
pernicious habit are manifest. AU parta1ke
freely of their favorite beverages, and as the
stimulating influence is felt, their tongues are
I00sened, and they begin the
wiciked work of talking
against others. Their
words are not few Of'
well chosen."
Figure 18

Nicotine's lmpairment ofthe

Frontal Lobe
1 devote an entire chapeer (Chapter 16,
"Dying for a Cigarene? Kick rhe Habit and
Live") ro rhe subject of rucorine addiction.
Suffice it (O say rhar nicotine has srimulant
effecls on the nervous system similar ro caffeine and should ehus be avoided. lronically, qualilY ofsleep, performance, and even
271

PROOF POSITIVE
srrc.ss conerol alI sufler whjJc using cigarettes.
For example, smokers are less able ro perform complex mental tasks than nonsmokers.74 I say alI this is ironic because many
smokers believe mental qualicies are actually improved by rheir smoking. The carch
is thar when they quir, rhese problems
worsen initially beforc gerting berrer.
Shorrly after some individuals become nonsmokers they misrakenly rhink rhar smoking was helping rhem in these areas, and so
they rerurn ro rheir cigarertes after several
days of abstinence.
In addirion ro short-rerm memaJ effecrs,
smoking rakes a roU on brain nmction over
rhe long haul. Compared ro nonsmokers.
smokers face doubJe the risk of developing
dcmenria (permanent, significam loss of intelligence) fiom A1zheimers ,md od)cr causes.7 s
A lasr noreworrhy effecr of nicorine re[ares [Q prenatal effeers. The nieorinc lIsed
bya pregnanr woman impairs brain funeaon in her child, perhaps for life. Research
has shown mental deficits in children of
srnokers that can onIy be explaincd by the
effecrs of nicotine. One study made a comparison of mental funcrion between dueeyear-old children of women who smoked
rJuoughour their entire pregnancy wirh rhe
childrcn of rhose who quir during pregnancy. Children of those who had kicked
the habir re ted significandy berrer.76

SECTION III

Effects ofDiet and Nutrition on the Function

ofthe Frontal Lobe.
Thus far we have seen [he detrimenral
frontallobe effecrs of drugs, alcohol, nicotine, and caffeine. Soroe of mese facrors
exerr their primary or major effect on the
froncal lobe. On the other hand, most of
the rhings that mhllrJce fronc brain function
often have a generally beneficial effect on
che entre bran. A classic example in this
regard is nurrition. The more we Jearn abour
nutricion. rhe more we realize rhar oprimal
nutrition is vital tO superior brain perfor-

mance. Wc will sec thar our dierary choices

can either ellhance brain performance or
.Impalf..It.

Enhancing Brain Funetion through

Breast Feeding, PolyunJaturated Fau,
And Vitamins.
Our earliesr dietary choices are nor really ours to make. Those who were formnare enough ro have morhers tlur chosc ro
breasr fced mem were bequeathed a preciolls
frontal lobe legacy. Research shows rhal
children who are breasr-fed have a menlal
edge mat persists at leasl for ycars aod probably for a lifelime. 77 . lI! AlI of rhe reasons
for rhe breasl-mjlk advanrage are not clear.
However, one factor appears to be rhe fat
contenr ofbreasc milk. Or. Yokota of]apan
sbowed rhar newborn rats need adequale
amOllllts ofomega 3 fars in rheir dier. Withour rhose fals, learning is impaired. 79 Olher
international research reams such as Bourre
and his Freneh colleagues80 have made similar discoveries in animal rests. All have demonsuared rhe vital need for me omega 3 f.'HS
in the deve10ping marnrnalian brain. It is
weU recognized in research circles thar traditional human infam formula provides
subsrandard amounts of omega-3 fars when
cornpared ro breasl milk. 81 Supplemenring
the child's dier with foods orher rhan formula cannoc reasonably make up rile
omega-3 deficit. One group of researchers
aune ro this srunning conc1usion: "Ir is COIlc1uded tiut it is virtually impossible 10
supplemcm rhe diet of formula-fed infanrs
ro march the long-chain PUFA inrake of
brcast-fed infants with currendy available
whole foods. "82
The superioriry of breasr-feeding is ohviously important informarion for expeclam parents. However rhe proper rype of
fat also seems ro be necess,~ry for shorr term
learning in adtdts. Or. Coscina and colleagues demonsrrated this faer a decade
ago. 83 They fed twO groups of adult ralS
diets that had idenrical amounts of fat.
However, rhe fat came from di.fferent sources.
After only rhree weeks, rats given a cliel
based on a modera re amounr of vegerable

272
_ _ _ _ _ _ _IIiiiiiiiii

...

THE FRONTAL LOBE

fat (20 pereenr polyunsaturaced soybean oiI)
exhibited improved leaming skills compared
to mose fed a dier based on 20 percenr sacuraced fat (lard). The auchors saw rhis as solid
evidence "thac shorr-cerm variarjons in rhe
qualiry of dierary far can enhance mammaliallle-<l.rning." Israeli researchers have also
found mac animals on a diec mat is adequate
in such planr fars as alpha linolenic acid and
linoleic acid can improve memory and help
rhe brain tolerare pain becter. 84
Dr. Bernell Baldwin suggesrs one explanarian for why rhe rype of far may make a
difference. The saturared fars mar are rypically found in animal products may make
brain nerve communicarion more difficult.
His hyporhesis is chat rhe membranes where
brain communication rakes place (called
synapses) are renderell more rigid bya dier
rich in sarurated fat; while unsaturared fars
from vegecables, seeds, and Iluts induce
more flexible membranes chat promote
more effieienr brain communications. 85
Some of rhe most recent researeh has continued ro demonstrate the harmful effects
of saturated fat on brain performance, bur
!las noc found evidence ro suggest that sllch
membrane changes are responsible. 86 Another possibiliry is rhat some of the unsarurated fats acrually have beneficial effecrs
that may be bJocked by meir sarurared cousins. If rhis is true, unsarurared fars such as
the omega-3 fars may be especially importanc for adult leaming as well. Fonunarely,
for adulrs, mere are omer sOllrces of these
high gualiry fars besides breast milk. In
Chaprer 5, "The Truth About Fish," explores a unique c1ass of fats called Omega-3
fars, and lisrs a number of excellenr vegetarian sources of rhese nutrients.
Ingestion of polyunsaturated fats arc nor
the only nutrirional keys ta optimal brain
funccion. Adeguare viramin :lnd mineral
intake also appear ta be essential for human
brain performance. Some of the mieronurrienrs thar have a role in improving our
brain's achievements include thiamin, riboflavin, niacin, 8 6 , B 12 , folie acid, the antioxidant vitamins A, C. and E, and iron. 87.
88.8? The growing lisr of such nutrients argues for a well-balanced die[ that is rich in
a broad array of tllese compounds.

Lessons[rom Carbohydrates
Other parcs of the body can use far, pro(ein, ar carbohydrace for energy, but not the
brain. The brain uses glucose, a simple carbohydrace, almosr exclusively as irs source
of energy.90 Apparencly as a resulr of the
brain's very rapid metabolism ir is dependenr on minure-ro-minute supplies of this
simple carbohydrate. This becomes easier
(O appreciate when you understand mac the
brain has a merabolic rate 7.5 times greater
rhan the average body ussue. 91 Although ir
makes up only 2 percenr of our body's mass,
the brain accounrs for 15 percenr ofour (Oral
metabolism.
The brain, however, does not ha-ve much
room ro store nuuienrs-space is exrremely
limired by rhe hard shell of the skull. Only
a rwo-minure supply of glucose is available
ro r!le brain cells-and chis is in the form
of glycogen-rhc storage form of sugar.
Thus, for peak performanee, the frontallobe
requires blood wirh a sundy and adequate
glucose lroei. In me ehapter on sugar and
diabetes (Chapter 8), I point out how a ruec
containing lots of refined foods can cause
rhe blood sugar ro rise quickly, and then
fall below normal. Sllch food options
abound ar snack machines and dessert
counrers. They are besr lefr out of aur dicrs. It would be benCf ro ear liberally of a
wholesome variery of complex carbohydrares sueh as those found in pot.atoes, rice,
whole grain breads, and cereals. Simple
sllgars are carbohydrates tOO, bur ir is imporcant ro undersrand rhc distinetion be[ween the simple sugaes in eoneentrated
snack foods and rhose found in natural fruirs
rhar carne packaged with a wealth of ftber.
Years ago when scicntists flrsr discovered
rhar the brain funcrioned besc with c.'Ubohydrare fuel, some people began referring
ro candy bars as "brajn food." Evenrually
we learned (hat, for sustained performance,
refined sugar was not brain food at all; ir
was just rhe opposite, as stated in Figure 19.
One study of 46 five-year old boys was
parcicularly revealing. n Boys with linie
ugar in cheir diet had superior artenrion
spans and more aceurate responses than
their high-sugar consuming peers. The differenee could nor be explained by IQ ar che

273

PROOF POSITIVE

SUG

AND THE FRONTAL LOBE

, Large amounts of sugar

in the diet have been
demonstrated to impair
frontallobe
functions in
school age
childrel1.
Figure 19

parent's social or educarion srarus. When

resred, rhe boys on a low refined-sugar dier
performed rhe equivalenr of one whole
grade !erter higher in sehool. Tl~is pr?vocauve srudy suggesrs rhar a berrer dlcr wIII help
transform a B-srudenr inro an A-Ievel
scholar.
If sugar is a carbohydrare and carbohydrare is rhe fronrallobe's preferred fuel, rhen
how could a h.igh sugar dier impair brain
funeron? Ler me rry ro give you rhe besr
explanaron J have found of this apparenr
paradox. Our bodies wcre crearcd ro e~1r
foods sueh as fruirs aod grains in a narural,
unrefined srare. These foods help ro keep
our blood sugar at a fairly constant level.
However, when I't:fined sugary foods emer
rhe digeStive system, the blood sugar rises
dramarica!ly, and the bod)' reaers as ifir were
JUSt exposed tO a grear volume of narural
food. In response. rhe pancreas produces a
large aJllounr ofinsulin. However, the rapid
rise in blood sugar is deeeprive. Ulllike natural planr foods, foods rich in refined sug~
rend ro be quickly absorbed. The resulr IS
rhar rhe (apid rise in blood sugar is shorrlived.Wirh insulin stiU presenr and no more
sugar comin ba in via [he digesrive . traCt, rhe
blood sugar level ean plunge. It IS nor lInusual for (he blood sugar ro drop well below where ir was before the sugary food was
eaten. If a person's blood sugar level fa!ls

274

low enollgh, fronrallobe funcrions ean suffer due ro iJ1adeqllare fuel supplies.
1'0 make m:.mers worse, probably rbe
mosr eommon response ro hypoglycemia is
ro ear yer anorher sugary nack. AJrhough
th.is will drive rhe blood sugar up quickly
again. research demonsrrares rhar ir rake tI.le
brain anorher 45 ro 75 minures ro regalll
normal iIHe!lecmal funetion afler the blood
_19394 Th e message
suoar rerurns ro norm.u.
I t~ke away from this re 'e~lrch is rhar adulrs
as well as school ch.ildren need ro make correct dierary choice if (hey W,lnr ro function
ar peak m~nra1 efficiency. Each day sho~ld
begin wirh a high-quality breakfasr ehar 11)c1udes a balanced selecrion of planr sources
of nurririon, 1 prefer a variery of frui(s and
whole grains along wirh ;I fe"''' nIlts. These
i(cms tend ro keep rhe blood sugar in (hc
proper range rhroughour ehe enrire 11l0r~1
ino withoUl a need for snacks. 1 explatn
m~re fully rhe imporranee ofearing a \Vholesome breakfasr in Chapter 1, "Principles for
Oprimal Healrh."
A liberal slIpply of fruits, vegerables, and
grains provides rhe besr nourislunenr for rhe
frontai lobe. AII of [hese foods comain a
healrhy quanriry of carbohydrares.
n rh,c
orher hand, essentially every rype of meat IS
devoid ofearbohydrares. If you look at food
rabies, you will see a reCUrriJ1g rhemewherher ir is red mear, fish, or ehiekenthey aiI score a big zero (01' veI')' close ro it)
in rhe earbohydrare Clregory.9 Thcse foods
arc generally high in fat and prorein, bur
de6cienr in carbohydrare, which may be oile
reason why meat appears ro bc associa[ed
wirh subrle fromal lobe impairmem.
The.re is, however, irony in ali this data.
BeclLlse [he brain is very adaptable and becomes used ro rhe lifcsryle you are on, even
healrhy changes ma)' eause a short-ierm deeline in brain dTtcieney before any improvement oecurs. It is analogous ro the siruation wirh nicorine thar 1 describe in Chaprer 16 in kicking rhe smokil,lg habic. Despire nicotine's deleterious brain effects.
when a person srops smoking, sleep qua!iry
and menral agiJiry tend ro ger worse beforc
they ger bener. The. ame is probably true
with dier. Researeh sugges[s rhar when
pcople dramatically increase rheir imake of

TIfE FRONTAL LOBE

fat or even crtrbohydrace, mental performance can slIffer in che shon term. However, concinuing wich che bener lifestylc will
bring the expecled benefirs in time. The
messagc is: no marter how diffjcult il may
be il) lhe ShOIl cerm, develop new heahh
habirs and stick with them. 96

False Transmitters in Rich Foods

Confuse Brain Cells
Orher dietary SllbSlances C<1n have a decrimental effecr on rhe froncallobe. Oue of
rhem is the chemical called cyramine.
Tyramine is found abllndantly in cheeses,
wines, and ocher rich foods. 97 No doubt,
SOll1e of cyramine's frontallobe impairmenr
resulrs from irs stimulacion of rhe body's
Slress hormone sysrem. When chis agent is
ingesred, che symparheric nerve endings are
stilUulared co release a chemical called norepinephrine, which is che primary chemical
chac rriggers the body's scress response. 9R
Slress dcfinitely causes an incrcase in alenncss; howevcr, it ofren incerfeles wirh the
fine con croI of choughc processes needed for
leaming, analytically caccgorizing icems,
creative thinking, and opcimal recal!. This
comes as no surprise ro those who still have
vivid memories of poorer school tesc performances due ro che stress of examinations.
Dr. Guycon poims our dtac c11e Slress hormooe system can actually decrease blood
Ilow ro the brain. 99 This may provide one
explanarion for the deteriorarion in beain
performance while under real stress or the
strcss-like condicioo brollglu on by tyramine
mgcsuon.
Because of ryramine's abilicy to stimulale nerve chemical changcs (specifically the
release of norepinephrine), ic has been
dubbed a false neurocransmicter. As such,
ryramine can be looked at as an agenc chac
on a cellular level conrnses brain cells. 100.
101, 102 It acts Ilke a brain chemical messenger or neurocransminer; however, it comes
from rhe food we eac rather rhan from communications iniciated by the brain ceUs
themselves. In ocher words, tyramine's
stimulation of brain cells daims to bear a
message when rhere is none, in realiry, co
bear. Thus anocher way of conceptllalizing

ryramine's front braiJl impainnene is as a

result of meneal confusion from false commUlllcatlon.
Another related chemica1 tiut causes
brain transmission problems is tryptarnine.
Like cyramine it is classed as a "biogenic
amine." Tryptamine is known for its mindaltering effeccs. It has been associated with
nighrmares and is even dassed with drugs
like LSD and psilocybin because ie can cause
hal1ucinogeniceffeCls. 10J Interestingly, food
sources of tryptamine often contain
tyramine as well. Examples of foods with
reported concentracions of these mind-destabilizing e1ements include cheese, 104
fish, 105 and sausages. I06 . 107 AIso, early spoilage of poultry prodllces these compounds
because a high percemage of bacteria ehae
conraminate domesric fowl have rhe ability
tO breal< down poulery tissue imo these toxic
sllbstanccs. 108 The issue of spoilage of animal prodllcts and its relacion ro mind-altering chemicals sholild not be taken lightly.
Research now indicaces that significanc
spoilage can cal<e place even ac normal refrigeration temperamles. One report on fish
found that spoilage occurred during refrigeration and produced another biogenic
amine ca1led trimechylamine. 109 (lncidencally crimethylamine is also fOllnd in other
seafoods and tends ro form cancer-causing
chemicals. IIO)
Tryptamine may also play a role in cancer prodlletion. This compound when combined wirh aJcohol (and in the presence of
che common stOmach dwelling germ,
Hclieobaeter pylorz) can give rise ro members of che harman familylll-a c1ass of
chemicals that have known C<1J1Cer causing
properties l12 . 113 as well as mencal effeccs. 114
A further intcrcsting sidelighr on the
harman compounds is thar chey are found
in alcoholic beverages like beer and wine. 115
Sorue of che miod-alcering effecrs of aleohol as well as some of alcohol's now established cancer risks may be related in parc ro
harmans. These same hannan chemicals
may even play a cole in perpemating the
desire for alcohol. I16
What is che practicaI signjficance of
some of this daca on che biogenic amines
and their dcscabilizing effect on the mind?

275

PROOF POSITIVE
There are many pertinent applicarions. Let
me bridly menrion tWO of ulese. Fim, rhere
may possibly be a relarionship bct\veen the
biogenic amines like trypt<lmine anei
ryramine and a hosr ofmild behavioral conelirions. For insrance, these compollnels may
be one of mall)' factors inl1l1encing hyperactivity in children. 1l7 Second, nighrmares
may actual1)' be a comJl10n problem tollowing rrypramine anei lyramine-rich food consumprion in the evening. (Late nighr pizza
Jovers, beware). Concerns about rhese
chemicals may provide furrher insiglusinw
why Ellen Whire wrorc that "cheese ShOlllei
never be inrroeluced imo rhe sromach."118

Arachidonic Aeid and Large

Moleeules in Meat Weaken
Frontal Lobe Funetion
Anorher food chcmical rhat callses brain
problems i.s arachidollic acid. This COIllpound inrerferes wirh rhe manufacture and
storage of acetyleholne, rhe imporranr nellrotransmitter mentioned earlier thar is exrensively nvolved wirh [rontaI tobe function. You will recaB (har a decrease in brain
acerylcholine is associated wirh impaired
mental funcrioning. 119 . 120 Thus, rhe result
of arachidonic acid is to elecrease the ability

" ... Eating much flesh will

diminish inteUectual
activity. Students would
accomplish much more
in their studies if they
never tasted meat.
When the animal part
of the human nature is
strengthened by meat-eating,
the intellectual power
diminishes proportionately."
Figura 20

276

of the fromallobe to fl.lnction efficiently.'21

One of rhe mase common dierary sources
of arachidonic acid is mcat. In faer, arachidonic acid is found a.Imosr exclusively in
animal proc!uccs. 122
Anorher problem with meat is irs adverse
effect on rhe brain. Russian scientists have
founel thar a single meaJ of mear can increase a particular srress hormone cal1ed 17hydroxyconicosteroic! (17-HCS). Baldwin
suggestS that chemic.1ls of rhis nature, be
cause of rheir large size, may not srimulate
ali regiolls of rhe brain equally. m The
higher rationale portions of rhe brain a.re
prorecced by somerhing cal1eel rhe "blood
brain batrier" which appears to be imperviol.lsrochemiealslike 17-HCS. On rhcorher
hand, such large srrcss-provoking molecules
are able ro stimulate the lower porcions of
the brain where no such barrier exisrs, such
as che piruirary gland where many hormones
are proeluced. Ali chis is excremely imporranc because these lower brain areas are
where our more animalisric anei less rational faculties reside. [n ocher words, earing
mcac may have a srimulating e/Tect duc ro
compounds like 17-HCS, bur rhe srimuladon may lInbalance rarional rhinking in fa
vor of more impulsive behaviors. Ellen
Whire wrorc words of camion abour the
derrimenral eflecrs of eating meat on imellecrual activiry. They are quoreel in Figure
20. 124
In fact, both physical and mental benefits are provided by ea(ing ilie right foods.
Ellen Whire made. recommenelations for
such a diet as srated in Figure 21. 1,25
We see rhar Ellen White haei significant
knowledge and lIJldersranding of the efTects
of lifesryle on (he fllnction of rhe brain. In
previous chapters wc have seen herinsights
in many other areas of human health and
disease. How is rhis possible in liglu of tbe
bygone era in which she wrore, from the
1860s ro 1915, long before ilie explosion
of sciemifrc medical informacion thar we
have roday? The extent and validarion of
her admonitions, and evidence of rhe means
by which she received ir, are explored in
Appendix X.

THE FRONTAL LOBE

PCBs lmpair Brain Development

A vegecarian dier for a pregnant woman
also may benefir fetal brain development.
As I descrihe ir.. rhe chapecr on nsh (Chaprcr 5), rhere are growing concerns wirh tQxins in our foods-parriclllarly in meae
sources. In a weU-puhlicized example, ic was
dcrermined rhar women who are Lakc
Michigan osh during pregnancy had grearer
exposure ro polychlorinared biphenyls
(PCBs) and relared conraminanrs. Ar the
rime of delivery, researchers eseil11ated rhe
PCB exposure in newborns by measuring
rhe amounr of ehese chemicals in umbilical
cord blood. When che exposed children
underwenc brain resring faur years later, rhe
invesrigarors found rhar rhe children with
higher PCB levels had brain impairment
including decreased reading comprehension. diminished arrention span, and a
weaker memory.126

A Spartan Diet Can hnprove Brain

Performance
For years researchers have known rhat
animals live longer if they arc caloric:illy
depriyed (i.c., givcn less ro car rhan thcy
wOllld normaUy choose}.1l7 An American
research ream under the direcrion of Dr.
L.W. Means added new evidence of ehe beneors of a more sparran diet. Means and his
colleagues, by direcr l11easurement, have
shown impro1Jed brain peljorn7lUlce on it lower
ca/orie diet. 128 Furrhermore, cheie research
demonsrrated rhar animals received rhest'
brain henefirs even iftheydid nor begin such
a restricred dier until rhey were middle-aged.
This is nor an isolated piece of research.
Researchers from [mly firsr demollsrrared
the obyious: rats on a normal diec Iose menral funcrion as rhey age. However, the invesrigarors wene on ro discover rhac old rars
rhar had been on a low ca.lorie dier since
birrh had memaJ ahiliries as good as rheir
younger counrerparrs.
OUl' brain performance roday can be
affecred by rhe number of calories we COI1sumed 15 years ~tgo. Ninery-nine subjecrs
age 750(' older were resred in California for
meneal performance by raking the Mini-

"Grains, fruits, nuts, and vegetables constitute

the diet chosen for us by our Creator.
Tbese foods, prepared in as simple aud natural
a manner as possible, are the most bealthful
aud nourisbing.
They impart a strength, a
power of enduraoce,
and a vigor of intellect
that are not afforded
by a more complex
and stimulating diet."

Figure 21

Menral Srare Examinarion. Those who consumed more calories in 1976 had lower rest
scores in 1991. This sClIdy indicarcs rhar a
higher consumption of c.11ories in middJe
age accelerares rhe dedine in menral funcrion wich aging. 129
These srudies suggesrs rhar overearing
(also referred co as "incel11perace eating") can
impair rhe whole brain. Such global mencal decline would be expecred ro also compromise rhe fronrallobc. Decades ago, E.G.
Whice expounded on the harmful effeers on
rhe brain ofsuch pracrices. Her statements
are shown in Figure 22. 130
1nremperanee is usually assoeiared wirh
drinking aleohot, and rhe dangers are ,"vell

ITE

--.CEA

"It s not necessary to drink aJcoholliquors in order ro be

intemperate.

ni/iij

The sin of intemperate cating, eating roo

~
frequently, too much, and of rich, unwhole~ome food:
destroys the healthy action of the digcstive organs
affccts the brain and perverts the judgmcnt
prevents rational, calm, healthy
thinking and actiog.
This is a fruitful sourcc of church trials."
Figure 22

277

PROOF POSITIVE
recognized. We have seen in rhis chapr~r
rhe addirional dangers of inremperance In
eariJlg, and irs serious impact on the fromal
lobe. AJrhough rhe author of rhis sraremcnr.
Ellcn Whirc, wrote exrensive!y about healrh,
she was primarily concerned wirh rheological and spiritual issues, as i.ndicared by rhe
final sraremenr: "And this is a fruirfuJ source
of church rrials." The coot cause of conrenrion, even ar a church board meeting,
may not be due to a surfacc iss~c, ~u~ ro
the food caten beforchand, making It unpossible to see thc issu.c c1earl~ and rationaJly. IfilHemperate eatUlg applies ro church
board conr.enrions, wouJdn't ir apply ro contentions in business meetings, family reJationships, aod life in general?
Anothcr sratemcnr from rhe same author fits weB wirh the informarion in
this chaprcr. "Few ... realize how l~uch the!!"
habirs of diet have ro do wlth thelr
healrh... "131 When thiswaswrirten in 1865,
there was Iiule understanding of rhe coerelation berween dier and heaJth. Today, rhe
scienrwc lirerarure is full of srudies {hat
c1early indicate the cOllsequences of nutrition and lifcsryle an aur health, many of
which have been referred ro in rhis book.
Thc completed sraremenr reads, "Few ...
realize how much rheir habirs of diet have
ro do wirh meir healrh, their char~lCter, rheir
usefulness in rhis world, and their eternaJ
desriny." 132 It is a somber thoughr, and one
we should seriously consider-that what we
put imo our body afTects the .parr of rhe
brain where spirirualiry, morallry, and rhe
will reside. This underscorcs the imponaJlce
of living and pracrjciJlg the mosr he~lthfut
lifesryle possible. We need aII rhe tro.maJ
lobe we have been given, and we need It ro
funcrion ar irs optimallevel.
When we think of the cffecr of a properly nourished fromallobe on rhe ~orenrial
for a fuller, richer life, it is cncouraglllg. We
do nor have ro be a paft of mental health
sratisrics; rarher, rhe oppoftuniry is there to
provide for a high qualiry of life, wi~h longeviry as a bonus. Nurrition and 1Jfes~le
do deserve aur mosr serious efforrs. T he
resulrs wiU be felr day by day and year by
year.

278

SECTION IV

Effects ofHypnotism,
Jl.{ and Music on the
Frontal Lobe.
Hypnosis and the Frontaf Lobe
Ler liS now move from rbe field of dict
and nurrition ro anorher area rhar can impacr the healrh of aur fronraJ lobes. We
now turn aur attention to a very popular
merhod for dealing with rhings rallging
from cornmon bad habirs ro emorionally
devasraring childhood trauma. Thar
method is hypnotism. Despite irs innocent
demeanor culrivared by circus perforlnances, media presenrations, and mass
smoking-cessation programs, hypnotism
can callse some serious ide effects. Among
the down sides of dus popuJar "rherapy" is
fronrallobe impairment.
The connection berween hypnotism and
rhe fromaJ labe comes as no surprise ro those
who understand rhis rechnique. Hypnosis.
by design, bypasses rhe fronral lobe a~ it
helps rhe subject enter imo a trance-like
srare. Dr. Freda Morris, a former professor
of medical psychology ar UCLA, has writren several books an hypnosis. In her words,
hypnosis is a stare characterL~ed ~y. a sing.leminded focus an only one dlmg, IJke a blrd
watching a snake."133 Wlule hypnorize~,
dle subjecr is ina((emive tO aII orher en.vlronmel1taJ cues. A hypnorisr can ohen induce such a srate fim by he1ping the subjects ro remajn quier and stiU, free from ~Il
ollrside diversions. Next, the hypnorlsr
helps rhem dcvelop thar new Crocus " on.a
certain poinr." On.ce rhey emer a hypnonc
stare, rhey are encouraged ro follow the
hypnorisr's mind.
.
rf brain waves were measured wlth an
EEG (e1ecrroencephalogram) during rhis
process, we would see rhat the hypnotized
person loses bela waves from rhe ?r~n. This
beta activirv indicares sound thmkmg mar
involved d~namic frontaJ lobe acriviry. Ll
the hvpna'rized stare, however an alpha
. operative,'
.
1,4 d
' w I1('ch
brain .pa((ern IS
Uflng

THE FRONTAL LOBE

we do not criricaHy analyzc incoming informarion. J3S Alpha wavcs are brain waves
of a lower frequency than beta waves. In
this state, an individual will record inform.ltion and suggeseons withom imerpreration and wimoll( fromallobe f1lrering.
A flickering light ehat trains (he eyes ro
focus in one place has been noted ro easily
induce a hypnoric state. Ouring the hypnoric srare, individllals can receive information of variOllS kinds, and can mcncaJly
record the duties the hypnotisr asks them
ro perform. lndeed, their memory works
well, their emorons work tIne, and rhey can
laugh and cry. Bur as rhey cominue ro foClIS 00 rhe flickering lighr rhe)' do nor cririeaU)' analyz.e rlte ioformaeion rhey receive. J36
None of the information is fIltered according ro their sense of values ar moral worth;

their lJery reasoningpowers '.lre being bypt1-fsed

The fTontal tobe hm bem short-cirmited.
Humans have been given large fromal
Iabes for a good reason. To compromise
this control cemer of the bmin, even tempararily, is dangerous. Today, hypnotism
has become quite popular and comes in severaI forms. The medicalliteracure is f1lled
with examples of hypnosis being used for
psychiarric aod/or behavioral problems,
spanning a broad speClrum from rrallmatic
events of childllOod ta current problems
Ivith overeating or nicotine use.
There are other more sllbtle forms of
hypnotism: Easrern mediration, or yoga, is
promoted for Slress control, but Dr. Freda
Morris poinrs Out that in rnany Cases it is
reallya tcchniquc of self.-hypnosis.1 37 For
rhis rcason, such mediration is porentiaJly
dangerous. The paraHels between Eas(ern
mediration and hypnotism are examined in
Chaprer 14,
UStress WirJlOUt Oisrress." Differences
berween Eastern and Christian mediearion
can be found in rhe same chaprer.From my
perspective, stress control can be obtained
in a much safer way by entering inro an experience of meditarion and prayer ro a personal God, speaking ro Him as we would a
respecred friend. One of rhe reasons 1 make
such a recommendation is because of my
undersranding of (he mental effecrs of different types of spiritual disciplines. For ex-

ample, if you connect srressed individuals

to a biofeedback monitor (a stress-measucing device), whether (hey practice yoga OI'
Eastern mediration, OI' pray ro God, they
will aU very likely show signiftcant stress
reducuon. However, only those who are
praying sriH havc their reaJoning powersj;/.lly
intact. The healthy, thinking beta brain
waves will be present dllring prayer at (he
same time measurable stress reduction is
occurring. Thus, comrnunicating with God
in prayer provides a more balanced form of
medit;uion.

Prayer
Even honesr skeptics are fillding it inescapable thar prayer has unique beneftts (har
eastern meditation cannor provide. A case
in point is provided by Or. Larry Dossey, a
physician fi-om Texas. Dr. Dossey was rJised
in the evangelical Protestant uadirion of rhe
"Bible belt;" however, he became a self-prodaimed agno tic while in coHege. 138 Some
years later he became intereseed in eastern
philosophies like Bllddhisrn and Taoism,
anei began ro practice meditatioll. However, his spiritual perspecrives were sharrered
when he found that there were a host of
scientiflc studies dut showed thar prayer
aeruaJly made a difference in (he healrh of
patienls who were prayed for. As Dossey
described his initial reaction ro the compelling data, he wanted nothjng ro do with
"t:llking ta God." Ultimately however, he
carne ro a conclusion: "J decided chat not ro
employ prayer wirh my patienrs was rhe
equivalem of withholding a potent dmg ar
surgical procedurc."J39 Dosse)', coovinced
by tlle power of prayer, was 00 longcr content ro only meditare; he nude it a daily
practjce ta commune with the Absolute
Source of power.
Whar 1 haye shared about Dosscy's experience does not yet address r11e effecr of
prayer on the fronrallobe. However, it does
demonstrare that from the perspecrive of
rhinking scienrjsts, prayer has benefits that
exrend beyond mere meditation. Dossey
does, however make profouod connecuons
bceween prayer and the fromal lobe in his
book, Healing Words: The Power of Prayer
and the Practice of Medicine. The book is

279

PROOF POSITIVE

280

perhaps more powerful because Dossey is

nor a religiolls zealot who is rrying ro promote a particular sece. He comes across as
an honest scientist who was forced ro acknowledge rhe power of prayer despire his
preconceved biases. AJrhollgh my understanciing of prayer diflers from o ossey's, [
believe he has puJled rogerher some vaJuable
insighrs thar are relevant ro dlis chapter.
Oile of the mosr inreresring framaJ lobe
connections occurs wllell Oossey links
prayer wirh one of U1C mosr enigmatic occurrences for secular physicians, the spontaneous regression ofcancer (SRC). [n SRC,
a persan wirh a faral cancer survives \Virhout undergoing ally treaunent. The individual ma)' actuali}' be cured and ror.aJly free
of cancer or rhere may still be evidence of
rhe cancer's presenee withour ir taking any
roU on rhe person. Oos ey quores rhe research of Yujiro [kemi in Japan on cancer
regression. He rhen makes r!le following
observarion: "Often a prayerful, prayer-like
atrirude of devarion and acceptance-nor
robusr aggressive prayer for specific omcomes, including eradication of the cancer-precedes dlecure.."140 lnreresringly, ir
may be rhe fronrallobe's connecrion wirh a
higher power rhrough prayer-and a resuJring acceprance of ill healrh or adversil)' rhar
helps ro pave rhe way for healing. Larer in
his book when Dossey again discusses
Ikemi's research, he poinrs aur rhar "alJ tlle
pariems [who experienced SRC] gave themselves toraLly ro rhe wiU of God afler learning they had cancer."14J
There is actuaJly evidence (har rypicaJ
medirauon or re1axarlon rraining can shorr
circuit rhis proce.ss and be deleteriolls. A
srudy of srress hormones before, immediarely foilowing, and (hen [wa days aher sucgeries seemed ro supporr rhese canrenrions.
Oossey poinrs out rhar Brirish researchers
fotlnd rhat the imU1une-weakerting srress
hormones significantly increased only in
{hose rhar had formal relaxarion rraining.
Those rhat addressed rhei r anxieries and
fears-withour using re1axation technques-did nor show rJle rise in stress hormones. 142 Prayer's focus is nor denial or
dealing wirh sympeoms but bringing the
person praying inro rouch wirh Gad.

Prayer at rimes can be primarily receprive: consenting ro God's will. Ar orher

times, prayer can be exrremely acrive. Examples include: struggling widl God for
answers (O difficulr questions, or seeking ro
know His wjJI in a perplexing situat ion. [n
rhis Ianer context, prayer can be viewed as
one of tbe ultimate frontllilobe IlClivities. lt
could be argued thar wirhollt a fromal labe
rhat is sound and intact, we cannot optimaJly pray sllch acrive, focllsed prayers.
Jntercessory prayer by deflnirion is focllsed
prayer. [n such siruations, we pray for specific individllaJs, ofren requeStillg specific
resulrs.
Such pdyer has been demonstrated ro
result ill scienriflcaJly measurable effecIs in
and of irself. One of rhe mosr widely cited
sfudies is rhar performed by heart specialist
RandolfB)'rd. Or. Byrd randomly assigned
half of nearly 400 intensive care heart patients to receive additional prayer. They
were unaware of the prayers. Those tim
were prayed for had remarkably less lung
problems, required less anribiotics, and experienced fewer dearhs (aJthough dlis latrer
outcorne was "nor sraris(ica11y signiflcan("meaning (har roo few people died ro derermine wherher or nor rhe difference in death
rare was duc ro prayer). 143 Jndeed, a heahhy
Frontal lobe can help liS ro fully avail ourselves of prayer. And such prayer is vastly
differenr from a hypnoric-like memal srare
rhar some caH meditation.

The Home Hypnotist

There may be something in your home
(har unwi ([ingly pl.lrs you inro a rype of
hypnoric trancc. [f you are like the average
American, severa1 rooms in yOllr hOlJse are.
equipped wirh somerhing rhat you focus
your eyes an, Oickers every few seconds, and
can produce a hypnoric-like rrance. It is
one of the most popular devices ofolll" rime:
rhe relevision ser. More rhan 96 percenr of
American homes have at lease one. 144 AIthOllgh rhere are many ways ro be hypnotized, Jerry Mander found ehat a number
ofhypnorism expens deflned the process in
sllch a way rhar relevlsion aptly Ars rhe description. Tile c1assic se({ing forlV warching is similar ro a rypic.:1l enviranmenr for

THE FRONTAL LOBE

hypnorism inducrion: a darkened room, a
flickering lighr (rhe TV ser) as a singleminded focus and frcedom rrom aII omside diversions. 145
People wareh programs provided by TV
starions cable companies, and sareilire ne[works, or rhey watch videos. The range of
programming in any ofthese cases is diverse:
movies, documelHaries, sir-coms, sponing
evems, music, educaronal, naeure shows,
news broadcasts. and ad inflnirum. Does
whtlt you watdl make any djffere.nce on your
minei and characrer? The aJlSwer is both
yes and no. Although the comem you view
exerts a powerful effecr on your mind, the
medium itselfalso appe.1rs ro have profound
menraJ efTects. Evidence suggesrs rhat the
very vehicle of relevision is-in irself-usllally derrimental. This delererious frontal
lobe effect appe.1rs ro be the resuh of rhe
camera-switching work in mosr videos and
other programming. The rechnical problem with lhe filming rechnique is refened
ro as a "rapidly changing scene of reference."
Speeiflcally, rhe average television program
changes ilS scene of reference every duee to
five seconds. The perspecrive from which
you are viewing the event suddenly changes
many times each minme, wherher you want
it tO or nor. This is in sharp contrast ro
how we normally view the world aI"Ound
us: we sec reallife scenes from one perspective (where we are located at the rime the
evenrs happen). We can change our perspecrive onl)' b)' voluntarily moving.
Dr. Monis sires rdevision's rapid change
of reference as comribucing ro the hypnoricrype effecr. 146 Research by Dr. Thomas
Mulholland looked ar children's EEGs as
rhe)' watched their favorite television programs. The researchers assumed rhar since
rhe$e programs were their favorite shows,
the kids would be menrall)' involved wim
whar they were viewing and would experience an oscillation berween alpha brain wave
acriviry and bettt. Tnsread, ;.lfter JUSt (WO or
duee m inures of the show, they sar back and
srayed almost entirely in an Illphll p:Htern.
This meant that while rhey were watching
rhey were "nO{ reacting, nor orienting. nor
focusing, just spaced-out."147
Dr. Herbert Krugman, a brain wave re-

searcher, has gone an record: "lelevision i5

a comJJlllnicaton mediulll that effonlessly
transmits hllge quanriries ofinformation not
thoughr abollt a( the rime of exposure."148
Dr. Erik Peper, anomer inf1uelltiai brain
wave researcher and wrirer, once said, "The
hOTror of television is rhat rhe information
goes in, bur we do nor react ro ir. It goes
righr into our memory pool and perhaps
we reacr ro it later, but we do nor know what
we al'e reacring ro. When you warch television )'ou are training yourself nor ta react
and so larer an, you're doing things wimout knowing why you're doing rhem or
where the)' came from."'49
Under the inf1uence of modern fasrmoving television, rhe frontal lobe cannot
fl1l1crion at its full capaciry. The brain
records information; sighr, mcmory, and rJle
emorions are aII functioning well; nevenheless, fhe brain is no longer crirically analyzing rhe infonnarion. Terrible scenes can be
depiered but the viewer rends only ro laugh
or shrug them off. Normally, if those kinds
of events happened in reailife rhe individual
would be appaJled. (Even thjs, however, is
gradually changing as pcople become more
de.sensiri'led over rhe years.) Despire how
one responds-whether by laughing, aparhetically sraring, avening rhe eyes in disgust, OI' a hundred other ways-rhose scenes
are indelibly imprinted upon the mind.
When you see a rerun, once ir begins, you
know you have seen it before. The memory
is there, alrhough rhe last time you saw ir
yOLlr frontal lobe was not any more active
rhan it is this rime.
Alvin Tomer, the aurhor of rhe 1970's
best seller, Fmure Shock, gave a particularly
lucid aCCOUl1t of the effeccs of artificial
stimuIation. His worels sti]] strikc me as an
apt descriprion of television's subtle effecrs.
His remarks address more than the subjecr
ofhypnorism. "Con. tam srimulation of the
senses shurs down rhe analyrical processes
of rhe minei and uJrimately shuts down ilie
abiJiry ro think and face life rarionaJly. This
leads to escape rechniques and adaptive responses which rend ro involve wirhdrawal,
apath)', and rejectiol1 of disciplined thinking when faced wirh difficulr duries and
decisions." 1SO

281

PROOF POSITIVE

Television Weakens Brain Power

T
Activities that strengthen the ",ind:
Playiog Bridge
Crossword puzzles
Activities that do noi:
Bingo -- "it kills the mind"
Television -- "tbe worst thing
that could be do ne is to sit and
watch television"
Figure 23

Even well over a decade ago, rhere had

been more than3,OOO sejenrifle srudies pubJished on rhe eftect5 of television on the
mind. 151 Researeh eonriuues an rhis inrerrelationship. Over 500 books have been
wrircen an [he subjecr. Ir is one of rhe most
well-researehed subjects in our cu1rure, yet
most people have lirrle awareness of TV
viewing's solemn consequences. Television
news programs often publici1.e lifesryle-reIared scienrifie srudies, but we do not hear
much about the srudies do ne on the effeers
of television 00 the mind. We should not
expect rhe relevision media ro confess ro
anyrhing. bur we do Ilor have ro stay uninformed.
The referenccs at the clase of this chapter provide a range of sources deal ing wirh
television. Most libraries have books thar
explain rhe dTecrs of relevision on rhe mind.
and university libraries are usually eonnecred
ro scienrific dara sources rhar can put yOll
in rolleh wirh hundreds of artides written
on the subject. Six deeades afrer David
Sarnoff, Presidenr ofRCA, ullveiled the [ust
relevision ar rhe 1939 World's Fair, it i time
ro ask-what is relevision doing to our
coumry? More specifleally, what is television do ing ro me?

282

Thc efTecrs of relevision are far-reaching. One of rhe grearesr eoncerns in academic eircles is rhar rhe TV viewer's imeIesr in rCf/.ding is markedly redueed. The
more relevision w;ltched, the grearer rhe
ill(eresr in reading suffers. Children who
spend many hours each day watching
rend ro be poor readers. Their reading abiliry and reading comprehension scores borh
suffer. n Learning omer sllbjects such as
hisrory, geography, marhemaries, and English is based an reading; thus, poor readers
have a general learning hand.icap. The reSlllt has been a consisrenr decline in rhe average reading skills of our yourh sinee TV
began ro be influenrial in the 1950's. Television affecrs more than reading skills. Ir
weakens brain power in general. This is true
at any age, from early ehildhood ro rhe
'golden years." A recenr srudy revealed rhar
cenain acriviries ofrerired persons increased
menral capaciry while other aaiviries decreased il. 1B The resu1ts are shown in Figure 23.
These reswrs are encouraging: byavoiding mind-numbing acrivities like warching
television 3nd engagiug in ehallenging acriviries, evel) people of reriremellt age can
improve mental abiliey. Retiremell( does nor
mean rhat yom br<lin has ro waste away.
A.nother way that televisiol1 undermines
healrh is b)' encouraging poor lifesryle habits. As we explored earlier in the chaprer,
nutrition is importanr for rhe brain tO funerion properly. Mally children and teenagcrs are nOt fUllctioning ar rheir full frontal
lobe eapaciry because of rheir earing habitS.
If you view a few children's programs (and
some adult programs for that marter), you
will notice rhar a variery ofsugar-Iaden, high
far foods are frequently adverrised. 154 Ltrge
secrion ofour supermarkets are loaded with
rhese television-advertised snack foods, nor
becallse rhey are good for llS, bur becausc
rhey sell well. As we have a1ready seen in
this chaprer, mese items are really "anri-brain
foods." This research demonstrates a principle commonly seen: compromise of the
fronrallobe by one acriviry (in rhis case, relevision) favors poorer ehoices (for example,
junk food consumprion) whieh in turn lead

rv

THE FRONTAL LOBE

ro furrher compromise of rhe fronrallobe.
Thc poorcr lifesryle habirs fosrered by
TV appear ro be a major facror in rhe epidemie of childhood obesity. Many studies
reveal rhar relevision watching and obesiry
in children are direcrly relarcd: rhe more TV
a child watches, rhe heavier he or she remis
ta be. In addirion ro eausing poorer food
choices, Universiry of Tennessee researchers helped tO c1arify some orher re-asons for
rhis relarionship. They srudied rhe effect of
telcvision viewing on 31 children berwcen
8 and 12 years old. Fifreen of the children
were obese and sixrcen were norlllai in
weighe. Each child's merabolic rate was
measured borh during relevisjon viewing
and when at rest doing norhing. The findings are shown in Figure 24. 155
Tdevision viewing requires no physical
involvemenr, yer occupies an avcrage of26
hours a week for mosr children. They are
spending many hour~ wirhout any significam mental orphysic.u activiry. 1 sr. In addidan to increasing passiviry in rhis way, rhe
medium of television tself aerually slows
merabolism more than if you were jusr sirling in a room resting. IS7 This provides a
furrher argument in favor of rhc alrered
"rrance-like" srare mar relevision is ablc ro
induce. AII of these factors contdbute ro
the rise in childhood obesiry, which has become epidemie in [he U.S., afTecting over
25 percenl of our kids. ISB Obese children
ofren beeome obese adults. 1'0 further compound marrers, obesiry in adulrs increases
rhe risk of "slecp apnea"159 wirh its fromal
tobe aod overall brajn impairmenr. Whcn
an individual wirh sleep apnea relaxes during sleep, rhe "overweight' airway ofren
c1oses, causing up ro a minute of apnealirerally no breathing-bringing about a
dramaric fali in oxygen saturarion. Such
individuals not only snore loudly, but they
do not obrain a rcstful sleep, and thus are
frequenrly found unintenrionally falling
asleep during dayliglu hours. If the individualloses weight, rhe sleep apnea is ofren
cured and the brain and frontal lobe abilities improve.

TVO NOTTV:
FAT IS THE QUESTIO
Metabolic rate of children ages 8 to 12 during
television viewing was significantly lower than
when the children were at rest doing nothing.
Lower metabolism combined with the h'igh fat
snacks eaten during thc hours in front
of the TV places children at high risk for obesity.
Kids watch 26 hours of TV weekly
on the average.
Chndhood obesity now affects
1 out of 4 kids.
Figure 24

Television Increases Daydreaming and

Non-Reaction
There are other important effecrs of television viewing. In general, TV increases
daydreaming, fostering rhollghrs about a
non-practical fanta y world dlar many children seem lO virtuali)' live in. as do some
adults. 160 Ar the same time, relevision decreases a persons crearive ingenuiry, or creative imagination. 16 1. 162
Some peopte misrakenly believe tiut
daydreaming and creative ingenuiry go rogerher. Acrually, rhe more daydreaming, the
less creative ingelllliry. As already alluded
ro, daydreaming is nor producrive because
it rends ro draw thoughts away from rasks
at hand ro dwell on image.~ rhat re..~ide in
rhe memory. On me other hand, creative
imagin<lrion is called inta play when the
mind goes ro work ro solve a problem, make
up an illustrarion, ar create a drawing.
Daydreaming is usuaHy an involuntary mental acriviry that "pop into the mind," whDe
creative ingenuiry is a power dl;lt is voluntarily harnessed. 163
College professors an reH which children have grown up on relcvision by observing their level of creatviry. Those few
coHege srudems who have grown up wirhout relevisioo are much more crearive and

283

PROOF POSITJVE

eTelevision viewers - 52% detected the tie

(similalr to f11pping a coin)
eNewspaper readers - 64% detected ,the tie
eRadio listeners - 73% detected tfie lie

Figure 25
have grearer learning abiliry when compared
ro cheir relevision-raised peers. 164 One staIding scudy compared small rown residenrs
of aU ages before ;lnd aher the inrroducrion
ofTV Wirhin two years of television coming ro a media-isolated Brirish Columbia
rown, both chiJdren and aduJcs suffered a
20 percenr decrease in creariviry. rn addition, rhe residelHs became generally less
persistenr when rackling a problem. '65 , 166

Ability to Discriminate Suffers under

the Influence ofTelevision

284

Television reduces aur powers of discrimination. rf you were interesred in receiving the most accurate aCCOLlIH of the
news, which form of media wouJd you uusr
rhe most? Would it be television, the newspaper, ar rhe radio? As parc ofa psychology
experimene, a prominenr Brirish commentaror purposely gave conflicting answers on
rwo separare TV inrerviews. His eelevised
fabrication fooled abour baiE rhe number
ofviewers. His deceptian was less successfui when individuals rcad his uanscripr in
rhe newspaper or heard him on the radio.
In the experimenr, it wa.~ annollnced that
rhe well-known politicaJ commenraror, Sir
Rabin Da)', would name his favorite movie
in a 25 second interview, and rhen name a
differenr movie as his favorite in a subse-

quenr inrerview. The viewers were cold that

he was deliberarely Iying in one of rhe interviews; rhat is, one of the stared favorites
was truly his favorite, and rhe other was nor.
The twO inrerviews were also published in
a major ncwspaper and broadcast on radio.
The TV viewers, newspaper readers, and
radio lisreners were invired ro guess which
one was false and ro vote by caUing either
of rwo phone numbers. Over 41,000 caUs
came in. The voring is rabulated in Figure

25. 167
Norice rhar rhe people who watched the
inrerview on television could have fared almost as well ifrhey had /lipped a cain. But
those who read rhe same inrerview ar listencd to it an rhe radio were signific;uuly
more likely co be corrcct. The experimelll
indicared rhat it s somerimes more diffi.
cult [O discriminare berween rhe true and
rhe faJse when somerhing is presenred an
TV rather duo occurring on radio ar in
prinr. 168

TV Trains in Non-Reaction
Both rhe Emerys and Dr. Erik Peper
poine aur that viewing of television also
rrains individuaJs ro be non-reacrive. This
srate of non-reacrion deseribes a passive donorhing arritude when eonfronted wirh
needs and problems. Even watehing the
news day after day rends ro induce a nOI)reacrive arci rude, which is a prorecrive
mechanism. When you view srarving children in Somalia, you cannor go ro rhe television set and give rhem soroe food. When
you see war-ravaged lands, you cannor lend
a helping hand. Yes, you could send mOlle)'
ro some humanitarian organization (which
may or may nor address rhe problem), but
the nCxt day's evening news likely presents
the same tragedy [hat you just donaeed
money ro help. Perhaps even worse, two
days later you will probably see another
shocking evenr rhat, were we presem ar rhe
scene, wOllld again caII for our wholehearted involvement. The more we see tragedies rhat we cannor respond ro, the less we
tend ro reacr: we are learning ro be nonreacrive. Wherher it is on rhe news, i.n serial programs, or full-Iengrh movics, when
we sec su/Tering repeatedly porcrayed bur

THE FRONTAL LOBE

cannoe do anything (O correct it, we become
desensitized. Thc conseqllences of training
people in non-reaction are demonsrrated by
violent crimes with wirnesses passively looking on, none lifting a finger to inrervene.
Television and its Iegacy of non-reacrion can
Icad viewers ta regard violence lighdy.

AL

TV

EWE

AGGRESSIVE BEHAVlO DECREASED

AFTER FIVE MO TUS WITHOVT IT
Verbal aggression decreased 32 percent.

Television Strengthens Negative

Qualities in Children
Children who waech television are prane
have bad areitudes aod are more irritable.
lV-watching kids themselves repon thar
relevision encourages chem [O show disrespecr for rheir parents, ta lie, and ro engage
in aggressive behavior. 169 Typical television
viewing fare a1so fosrers greaeer sex-rale seereotyping and a dtamaric increase in verbal
and physicll aggressive behavior in borh
sexes.'70
The increase in aggressiveness is one of
rhe mosr worrisome e/tects of TV an our
sociery. Many psychologisrs believe mat
relevision-viewing shares a significanr porrion ofblame for rhe high rates of violence
in our sociecy. Many srlldies have sOllghr
ro determine rhe effects oflV 01\ yomh violence. These studies are more thorollghly
examined in Chaprer 13 enrided "Stemmillg [he Tide ofViolence."
re is important (O recognize [har nor ali
[elevision programming is equaJly damaging. Some programming is c1early more
decrimenral chan ochers, especially in the
area of violencc. Inrerestingly, ie is nor only
violenc fl1ms per se mat are linked wirh problems. One of d\e most trollblesome kinds
of programing is [hat typified by MTV; a
narional cahle TV channel rhar specializes
in fast-moving photagraphic images synchronized wirh heavy rock mllsc.
10

MTV--Problems with Violence

There is a concern [bat many reenagers
are moving from more cypical celevision
options to MTV and ies imitacors. This rype
of music programming con randy stimulaces rhe visual senses through its provocatve, f1eeting images of rapidly changing
scenes. Not only do rhe images rapidly
change (even multiple images per second

Aggression against objects decreased

52 percent.
Aggression against other people
decreased 48 percent.
figure 26

on occasion) bllt the ear is seimuiated as well.

This eye-ear combinalion seems calculared
ro induce an even more profound shurdown
of the anaJyrical proccsses.
One study chac lIniquely demonstraees
mis was dane in ~l maximllm-securiry menrai hospiral with 222 paricms. During a
period ofabolJt a year, parienrs were exposed
ca seven months of MTV followed by five
months wirhollr ir (normal TV Optiolls remained available). The resulrs are shown
in Figure 26. 171
We have alrcady seen thar r.he standard,
modern, rapid-paced relevision !las a wellproven negarive inf1uencc an the frontaJ
lobe. However, we sec here indicaeions rhar
the effecrs of MTV are even worse.

TEE

~~ULTS

Tbc current bigh level of teen sexual activity

results in:
Teens dealing with responsibilities and
problems far beyond their physical
and emotional resources.
Teens with diseases that are
sexualJy transmitted.
Teens' entire future changed
for the worse.
Figure 27

285

PROOF POSITIVE

Television and Sex

Television a1so effectively increases sexual
acriviry in [eens aod younger children. Srudies show ir signi.ficanrly decreases the age of
ftrsr sexual intercourse. The more celevision warched, ilie lower rhe age for thar fim
sexual encounrcr. 172 Nor onJy do srudies
show it, but ilie children themselves repon
thar relevision encourages mem ro rake pan
~n sexual actjvity too soon. 173 The damagIng effeccs of teenage sex are spelled our in
Figure 27.

Television Is Addietive

286

Most people do nor realize rhar re1evision is addicrjve. They find rhemselves
gravirating roward rhe ser without rhinking
about ic, and some leave it on aH day. In
1976, the Derroit Free Press conducted a
survey ro help derermine why rheir newspaper circulation was decreasing. The survey resu1rs showed mat mosc people received
cheir news and information from television.
This is unfotnmate because, as we have seen,
in some respects ir is rhe poorest source of
informarion. We can learn so much more
from reading newspapers, news magazines,
or online computer news services rhan by
watching one-sided news clips pass before
our eyes in rapid succession. Also, we may
miss a poinr, bur cannot go back and rake
anomer look. Reading is by far a berter way
to review the news, learn new things, and
involve our frontallobe.
The Detroit Free Press did nor STOp with
rheir survey. They went an ro offer $500 tO
auy family wha would give up relevision for
one monrh. The paper extended rhe invitarion to 120 familics. A total of93 ofthem
could not be enriced ro part wirh their television for even thirry days. However, 27
families accepred rheir offer. To make sure
they could nor cheat, the newspaper company installed e1eerronic devices thar would
interfere with any relevision used on their
premises.
The reswrs of rhe one-momh triaI were
amazing. Family members manifesred actual withdrawal symptoms. Insomnia and
headaches were common. One man, noted
for being a kind husband, lost his cool during me firsr week, became irrirared, and

began beating his wife. However, mroughout the mondl artitlldes changed. At ilie
end of rhe monrh, ro almost everyone's surprise. aii 27 families said mat it had been a
good experience. Mosr of rhe famiJies put
their extra rime ro good use by gerring rhings
do ne :Iround the house. One of ilie most
rewarding findings was rhat rhe families
were able to rdare to each omer in ways they
had n.or done for ye-ars. They found mings
rhey could do rogether, their minds were
more creative, and rhey were acrually enjoying life more than when they had relevision.
Would they go back ro relevision now
rhat rhey earned their $500? They were
generaIly convinced rhat they would do
much better if rhey kept tdevisiol1 viewing
ro a minimum. The study helped to illus[rare rdevisions' addictive aJlure alld demollsrrated thar in many respects TV viewing works against LIS rather rhan for us.This
study actually provides a glimpse inro anorher danger ofTV viewing: rhe in.fluence
of parenrs is greatly dimillished when TV
becomes rhe main companion ro children
in a home. This lack of parental involvemem in the lives of children direcdy relates
back ro anorher frontal lobe robber: aleohol and robacco use. Researchers from
Louisiana Sr.are Universiry Medical Center
in New Orleans demonsrrated rhis when
rJley srudied over 2000 fifth and sixth grad.
ers for rhree ro four years. 174 Children who
reporred (hat rheir parems spenr more rune
wirh chem and had more communicarion
wirh rhem were less likely ro llse a1cohol and
tobacco. They were also less likely ro choose
friends who used these substances. Unforrunately, rescarch shows what we aII would
expecr: with more television viewing, rhe
amount of time spenr in acrive conversa
rion wirh family members signilicancly decreases. If relevision viewing is depriving
LIS of aClive rime spem tOgerher as a family,
parems may likely reap an extremely bi[[er
harvesL

Television Robs Spiritual Qualities

Television viewing, because of the rime
it rakes, can keep us away from omer meaningful activities and pursuirs, including
spending time with Gad. When we look ar

THE FRONTAL LOBE

an ave rage person's weekly activicies before
and aher che arrival of celevision, we see chac
rhe amounr of time in church ar in reading
spiritual material such as che Bihle, has noriceably decreased. 175 The reason for chis
prohably has ro do wich more rhan TV subcly scealing away our rime. Remember, celevisioll depresses activiry in the frontallobe,
which is che se~l.t ofspirirualiry, moraliry, and
the wilJ. We wouJd expecc a corresponding
decrease in such incangible frontal lohe
qualities as spiriruality and faim in God.
However, if we consider celevision from
just me standpoinc of time: ir often captivaces rhe few hours ofdiscrecionary rime chat
we have in aur day. Before celevision,che
rhree most profound influences on American vaJues were che family, rhe church, and
rhe school. If the amOWH of cime we spend
in an activiry directly corresponds (Q irs
power ro shape aur values, chen in ilie 1950's
releyision superseded the church. In che
1960's TV superseded ilie family; and hy
me 1970's it superseded the school. Currenrly. U.S. children spend approximately
20 percem of cheir waking hours watching
television. 176 The average American child,
by rhe rime he graduares from high school,
has spent more rime in franc of ilie celevision ser man he spenc in 13 years in (he
c1assroom.'77, 17H
Many believe char chese chousands of
hours of random exposure to television programs h:'lVe profoundly affected our narion.
They blame TV as one of che prime reasons
for a dedioe in our nation's moral values.
Some critics would like ro use legislation ro
fix rhe problem, but we should nor and cannor legislare whar people do in rheir homes.
Families should set lheirown rules. But how
can a family be rnocivared ro ser cules wirhaur being adequately informed of rhe injurious effeclS of television? Somehow, accurace information as ourlined in chis chapcer
should go ouc co every family in America so
that informed decisions can be made. If
simple, heahhy, and enjoyable TV-Iess family accivities became r.he foundation of the
home life, 1 believe chere wiH be generally
few regrers abour abandon ing the former
life in which the TV sec held full cOlUrol.
rf any are stiH wavering as co whether

1. Produces bypnotic efTt,

bypassiog frootallobe filtering

2. Reduces interest in reading
and learning
3. Wukens brain power
4. Encourag6 poor lifestyle babits
S. Eoeourages obed!)'
6. Inereases daydruming
7. Weakens creativi\)'
8. May reduce our powers
of discriminalion
9. Traiol io non-reaelion

10. Inf1uences viewers to

regard violence ligbtly
II. Makes cbildren more
irrit,ablc
12, Increases aggrcui"eness
13. Accelerates sexual activi!)'
14. Addietive
IS. ReducC3 time ...allable for
producti\'e achievemcot
16. Steals lime from family
inleraction
17. Advenely afTects spiritual
punuits

Figure 28

television should be emphasized less in cheir

homes, lec me summarizc 17 delererious
effects ofTV warching rhat 1 have covered
in chis chapcer. A lisring in rhe sequence in
which chey were presenred appears in Figure 28.
These harmful effects colleccive1y build
a scrong case for personal aerion-roday.
After ali, rhe very moral conscience of yOll
and your family-residing in your frontal
lobes-may be hanging in che balances. For
those wondering if and how life can he enjoyably lived wimollt television, examine ilie
related secrion in che following chapter.
"Stemming the Tide ofViolence."

SIC~,v
Musie enters the brain tbrough its emotional
regions, whieh include the temporallobc
and limbie system.
From there, some kinds of music tendto produce a
frontal lobe response tbat influenccs the wilJ,
moral worth, and rcasoning power.
Other kinds of musie will evoke very JiUle, if any,
frontallobe response, but will produce a
large emotional response witb very little
logical or moral interpretation.
Figure 29

287

PROOF POSITIVE

Music and the Frontal Lobe

288

Few people undersrand [he power(ul

nfluence [hat music has on [he fronral lobe.
Music enrers the brain tluollgh irs emotional
regions as explained in Figure 29. 179
Depending on rl1e type of music, it can
eirher inf1uence the brain beneficially or
derrimenraUy. Music therapists tell us rhat
cenain rypes of music, such as rock wirh its
syncopar.ed rhYThm, bypass [!le fronrallobe
and rhus escape our abilicy tO reason and
make judgmenrs abour it. Evidence suggests that ir. like relevision, can produce a
hypnoric effecr. 180 For many years some
have argued mat rock music was ruining
America's youth. Recentlya neurobiologist
and a physicist teamed up ro pllt this generali7..ation to a test. They designed a srudy
ro evaluate rhe neurologic.-u reaction of mice
to difTerent musical rhyel-ulls. ISI For eight
weeks they exposed each of three groups of
mice ro differenr music seteings. One group
heard rock-like disharmonic drum bear.s
playing sofdy in cheir environmenr, a second group heard classical music. while rhe
third heard no music whatsoever. AlI (he
mice wenr through a standard maze test
(with food at the end of the maze). On the
fim day, aii [hrec grollps pcrformed egually
weU. They groped abolit (he maze in search
of (ood. By rhe end of cight wecks, however, ir was noted (hac (he second and rhird
groups had leamed [he direcr parh tO rhe
food. The "rock group," however, was stiU
groping for ir. raking much longer ro find
che food [han rhe other rwo groups.
Next t.here was a rhIee week break in
rheir maze rraining withollt Jl)usic foUowed
by maze re-cests ro see how much kJlowledge chey had rerained of che maze's course,
and ro see if rhe dfecr of che rock beat had
wom of[ Again rhe rock group performed
poorly. They conrinued ro have difficuhy
remembering how ro get ro cheir food. while
rhe orher rwo groups sril! found i[ quick.ly.
The rock group seemed almost ro be scarring from scrarch. They groped around and
seemed disoriented. Both rhe control group
and che harmonic group. on tlle other hand,
could mll the maze considerably fasrer,
proving rhar rheil" learning had sruck.
To determine why dte poor performers

were having so much trouble, the researchers examined rheir brains, looking for
changes in the hippocampus, a region in the
temporal labe near the brain stern, which is
usually associaeed wieh alerrness, memory,
and learning. They fOllnd evidence of abnormal branching tind sproueing ofthe nerve
ulls, and also disruptions in the normal
amounts ofmessenger RNA, a chemical crucial ro memory srorage.
The researchers concluded ehat ilie culprit causing rhe memory and learning problems was the music's rhythm, not its harmonic or melodic structure. The theory is
that cenain musical rhythms help ro synchronize natural biological rhythms, mus
enhancing body functions, wltile other
rhythms rend ca dash wirh, ar disrupe, those
internal rhyrhms. This is noe surprising
since ali of our body syseems function in
rhythm. The study's auchors postulate that
if ehese natural rhythms are disrupted by
some kind of disharmony, detrimencal effects can result, includingpermanent uarningdifficulties. This could help explain why
rock music listeners are more prone ro lIse
drugs and engage in extramarital sex, and
why heavy meral listeners are much more
Like1y to consider suicide. 182
Not only did che disharmonic rock-like
music cause damage ro the temporallobes,
ir also caused arrophy of the frontal lobe.
This arrophy would be expeceed eo affecr
moral worth, learning, and reasoning power.
Harmonious rypes of hyrnns and symphonies, on ehe oeher hand, can produce a
very beneficia! frontal labe response. This
is the kind of musical environmenc in which
aur children should be raised-music that
can produce a positive radler dlan a negaeive effect. Classica! music has been demonstrated to help college studencs Jearn spatial relationships in geometry.183 A seudy
showed that listening ta Mozan piano soIlaras significantly incre..sed spatial-temporal reasoning. l84 Interesringly, Mozan began composing music at the age of four.
In a follow-up of rhe Mozart study, children three to five ye..rs of age who received
eight months ofgroup singing and keyboard
lessons scored significanrly higher on rhe
"object assembly' task (arranging pieces of

THE FRONTAL LOBE

a puzzle ro form a meal1ngful whole, re
quiring frontal labe function) when compared eo children in ehe same pre-school
who did noe receive music lessons. 185 Anorher swdy showed that musicians who
possess perfece piech were soundl)' exposed
to music before rhe age of seven. 186
The impace of music on shaping the
characrer (and hence rhe frontal lobe) was
recognized ar leasr 23 cenruries ago.
Arisrorle, rhe Greek philosopher of the 4,h
ceneury B.C., recognized thar music an
cirher be beneficial or derrimenral ro aur
characrer, depending on rhe kind of music
we expose ourselves ro. He wroee, "Music
direcrly represenrs [he passions ar srares of
rhe soul-gentlencss, anger, courage, temperance, and their oppositcs and orher qualiries; hence, when one listens ta music t11at
imitatcs a cerIain passion he becomes imbued wirh the same passion; and if over a
long rime he habieually listens ro ilie kind
of music rhar rouses ignoble [degraded ar
vulgar] passiolls his whole characrer will be
shaped ro an ignoble form. In short, if one
lisrens ro rhe wrong kind of music he will
become the wrang kind of per an; bm, conversely, ifhe lisrens ro rhe righr kind of music
he will tend ro become the right kind of
person. "187 Arisrorle unwittingly referrcd
ro the fronrallobe, where we now MOW the
scat of our characrer residcs.
Ellen White wfOte a summary statemenc
describing rhe effeces ofcerrain amusemenrs
on the frontal lobe: "The enemy of rightcousness has every kind of pleasure prepared for youth in aH condirions oflife; and
they are nor presenred alone in crowded ciries. bur in every spor inhabitcd by human
beings. Satan loves ro secure rhe youth in
his ranks as soldiers. The arch-fiend weU
kn,ows wirh what material he has ro deal;
and he has displayed ILis infernaJ wisdom in
devising customs and pleasures for the yourh
which wiU separare cheir affecrions from
Jesus Chrisr. "188 She further stared, uThe
various amusements ofsociery have been the
ruin of rhousands and teHS of thousands
who, had it nor been for t!lese arrracrions,
would have been obedient children, respectfuI ta rheir parents. uprighr, pure, and noble
in rheir pursuirs and in cheir characrer." 189

Cerrainly from rhe studies we have reviewed, much of the relevision programming, induding MTV, and rock-like music in general, would fit inro the carcgory
she menrions. lf our young people could
grow up in a posirive, supporrive environmenr, imagine how many of them would
become wholesome, eiliical individuals who
would be numbered among the greatest men
and women of our day.

SECTIONV

Summary List OfSeven

Actions to Take for Enhancing the Function
ofthe Frontal Lobe.

1. Protect it from mechanical injury.

2. Prevent or control underlying diseases that may

damage tbe frontallobe.
3. Give it an adequate supply of oxygen from
the blood.
4. Supply it with good nutrition by eating the right
foods and avoiding the wrong ones.
5. Get adequate sunshine.
6. Exercise it.
7. Provide proper inputs by controlling
what we sec and hear.
Figure 30

A summary lisr of actions we can take

enhance fronral lobe function is shown
in Figure 30.

10

J. Protect the Frontal Labe/rom

Mechanicallnjury
Mechaillcal injury can infljcr permanenr
brain damage. Boxing. football, and mororcycJe riding are examples of high-risk

289

PR:OOF POSITIVE
fIict fromaJ lobe damage. For this reason,
car seat belts and shoulder harnesses are a
must. Flirthermore, work place injuries are
not confined ro the Phineas Gages of yesteryear. Take aJl reasonable safery precalltjons on the job.

Results ofMRl brain scans ofhypertensive

and normal subjects
1. Hypertensive subjects had 10 times the
Dcidence of white matter lesions.

2. Prevent Diseases That May Damage the Frontal Lobe

2. Intelligence tests showed a Iower level of overaU

bram ability and intelligence in those with white
matter lesions.

The proper use of preventive medicine

principles can also heJp you to prese.rve frontaJ labe functon. A number ofdiseases can
lead ro loss of frantaJ lobe capacity. Mauy
of these maJadies are potemiaJly preventable.
Srrokes are among the most worrisome; yer,
they can ohen be prevemed by controlling
risk facrors such as high blood pressure.
Independem risk factors for stroke in people
between rhe ages of 16 and 60 include: high
blood pressure, diaberes, currene tobacco
use, heart disease, and a.lcohol consllmption
{within 24 hours preceding [he onset of the
stroke).190 Women need ro add oraJ conrraceptives ro this srroke risk factor lisc. 191
Recent research indicates mat high blood
pressure itself can affecc brain efficiency.192.
193 In one ofthese sflIdies, 42 hypenensives
(high blood pressure paeienrs) were compared wim 42 people wichollt high blood
pressure. They alI undcrwenr MRI sc.mning, a widely available procedure [hat takes
derailed pictures of tbe brain. Intclligence
reses were a1so given to the sllbjects. The
results are shown in Figure 31. 194
Note thar high blood pressure inf1icted
visible (romaJ lobe white matrer damage as
weB as damage ro rhe subjects' intelligence.
The white matter poreion of the brain is
involved wirh ncrvc impulse conduc(ioll
and is rich in nerve fibe[s. Irs color comes
from thcse nerve fibers (hat are insulared
wirh a whire substance called myelin. Note,
funhermore, dur [he white maner lesiolls
were prcscm 110 marter how successfully rhe
blood pressure had been treated wirh drug
rherapy. This research suggesrs thar only
by conrroIJing blood pressllre wirh lifesryle
can such brain damage be prevented. Chaptel' 6 explains how high blood presSlIre can
be addressed or avoided by namraJ means,
wirhout medication.

3. The lesions were present no

matter how weU the blood
pressure had been treated
wtth drug therapy.
figure 31

actlvH/Cs. Blows ta the head while boxing

frequently damage t!le tiny blood vessels,
particularly in the fromaJ lobe. A boxerwith
these injurie.s is sometimes referred to as
being "punch drunk." Othet sporcs can lead
ro similar injuries. Ali such avocations are
besr avoided by those who wanr ro prorecr
good fromaJ lobe function.
FrontaJ lobe injury by mechanicaJ means
is not limited ro spons parricipants. Head
injuries from automobile collisions can in-

G
Results of MRJ measu.rements ofbrain size:

Significantly more brain atrophy occurF,ed in

hypertensive subjects compared to those with
normal blood pressure.

figure 32

290

THE FRONTAL LOBE

SriH orher research has doclIlllented anorher brain damaging effecr of high blood
pressure; namely, brajn arrophy, or brain
shrinknge. Brajn size as measured by MRl
,is smaJler in those wirh high blood pressure.
Th is is described in Figure 32. 195
High blood pressure and srrokes are nor
rhe only condirions rhar can jeopardize rhe
frontal lobe. Physical condirions ofren affccr brain performance. Hearr condirions
can lead ro problems that later affect rhe
brain. Nervous sysrem disorders of .many
sorrs compromise brain funct1on. In facr,
juSt being ill wirh any serious disease will
relld ro have measurable brain effecrs. The
bonom line is ro follow a heaJrMullifesryle
that addresses YOur body's toral needs.

3. Jmprove the Quality o/Your Brain's

Blood Supply
Enhanciog rhe qualiry of aur braills'
blood supply is imporrant. Again, this factor srands to help the enrire brain, nor jusr
the frontal labe. How can we provide ir? By
brearhing dean, &esh. well-oxygenared air.
1discuss in some derail the benefirs of fresh
air an mental performance in Chapter 20,
Beyond the leading Causes of Death. There
rdiscuss rhe body of research suggesring rhat
llegatively charged ions in fresh air enhance
menral performance. However, more rhan
air qualiry may well be affecring mental performance. Our habirs ofbreathing may also
make a difference. In a classroom o)" oftice
serring we may nor reaHze thar mosr of llS
reod ro rake shallow breailis. This may be
onc reason why aner 30 minutes we may nnd
it somewMt more difficu1r ro concentrare.
Shallow breathing may have SUd1 delererious effecrs by alJowiog our blood ox:ygeo level
(c.1l1ed "oxygcn saruracion") ro dip below rhe
leveJ necessary for optimal fronral lobe performance. l96 Consciously taking decp
breadlS periodically may heJp ro coumer rhis
rendency. By taking deep brearhs, parricularly offresh air, we may be able to boosr oxygen sarurarion sufficienrly ro improve fronrai labe funcrion. In addition ro raking deep
brearhs while sirting, regular aerobic exercise
(ourdoors preferably) wiU cause ilie hean ro
pump vital, ox)'genated blood ro rhe brain.

4. Provide Good Nutrition

I have foclised a targe ponion of thi
chaprer an the role of good nurririon in
optimal frontallobe fUllcrion. A rotal vegerarian diet thar is free from aii srimularing
agen rs appears ro be rhe besr djer ro improve
rhe abiliries of aur fronr brajns. Nursing
infanrs should be breasr-fed.

5. Get Adequate Sunshine

Sunlighr may increase seroronjn production in the daytime. This, in turn, can heJp
prcvem depression and fatigue. 197 I deaJ
wirh some of rhese relarionships in the conrexr of sunshine's sleep-enhancing cole in
Chapter 9 on mclaronin. Funher derails of
sllnshine's benefirs on whole person healrh
are chronicled in Chapter 20, "Beyond the
Leading Causes of Dearh."

6. Challenge Your Frontal Lobes

ByaU means, exercise the rhinking power
of your brajn! JUSt as our muscles shrivel if
we do nor use them, so ir is witll our fromal
lobe. ChaJlenging memaJ rasks will help ro
maimain our menral acuiry by stimularing
the fromallobe. Seriolls reading, rhe study
of nature, asking questions abour ilie vast
world surrounding us aod other wholesome
uses of our mental capaciries rend to produce salutary [roma) lobe effects. One recent srudy found that imagining a cerrain
activiry srmulared 80 percem of rhe brain
circuiuy thar would be lIsed ro physically
perform rhe very task imagined. J?8 Such
menral pracrice srrengthens rhe brain cell
connecrions. and when the rime comes ro
execute {he acriviry, {he individual is berrer
prepared.
Menral acriviry in children and {eenagers is especialJy important in enhancing the
abiliry ro leam. Scientisrs have now discovered rhe firsr srrong evidence thar imellecrual scimulation can significandy increase Jhe
number ofbrain cells in a crucial region of
rhe brain. Previously it was rhoughr iliar
the number of active brain cells was moreor-less ser early in chiJdhood. This landmark srudy was performed ar rhe Salk Institute for Biological Studies. 1?? There,
young mice were provided wirh an enriched
environmem, with more games and toys,

291

PROOF POSlTIVE
and room ro roam in exer<l large cages.
When rhe resulrs were in, rhose mice had
developed 15 percem more brain cclls in a
key pan of rhe brain responsible for memory
and !eaming than genetically idenricaJ mice
living in sparse surroundings. The exrra
brain cclls enabled them ro negotiate complex mazes f.1Ster and more efllcienrly. Researchers say mar rhere is every reason tO
sllppose rhar similar reslllrs would hold rrue
for humans. The impoHam conclusion is
dlat the environmem we provide for our
children and reenagers may actllaJly influence their number of brain cells and their
abiliry ro learn.

1. "The undcrstanding adapts itself to the dimensions

of the subjccts with which it is required to deal.
2. If occupied with trivial, commonplace matters
only, nc\'er summoned to earnest effort to
comprebend great and eternaJ trutbs, it
becomes dwarfed and enfeebled.
3. Hcnce tbe value of the Scriptures
as a means of intellectual culturc."
Figure 33

292

7. Control What we See and Hear

The Ilnal point on rhe lisr is relared (Q
the previOllS point. Exposing our minds ro
grear inspirarional material wilJ enlarge rhe
mind anei srrengthen rile imdlecr. Since
spiritllaliry, morality, and rhe will are cenrered in rhe fromal lobe of rhe brain, the
inspirarional material chosen ShOllld ideally
appeal ro our spiritual and moral being. The
study of tile Word of God fiUs this requiremem ji1<e no orher can. Ellen Whire outJined rhe impact of stlldying rhe Scriprures
an rhe mind, saul, and imellecr, as quoted
in Figure 34. 201
1 have used considerable space in dlis
chapter making (he poim r11ar proper physical and memal habits are important for optimal fromal labe funcrion. C1early, riglu
mentlll habits promote memaJ excellence.
Ar the same rime, "right physic,u habirs promore mental superioriry."202 These are thc
laws of nature, laws [har rhe Crearor has pUl
iora aur being. "Imellecrual power, physical srrengrh, and longeviry depend upon
immlltable laws. There is no happen-so,
no chancc, abolIt rhis marter. Heaven will
not interferc ro preserve men from the COI)sequenccs of rhe violarion of narure's
laws."203

Conclusion

~r::

. .

1. "The Bible, just as it reads, is to be our guide."

2. '"'Notbing is so ealeulated to cnJarge the wind and
strengthen thc intellcet as tbc study of tbe Bible."
3. uNo other study wiII so elevate tbe soul and give
viRor to the faculties as the study of the living
o'raclcs.."
4. "As the mind is brought to the study of God's Word,
the understanding will enlarge and the
hi~her power will de\'elop for the
eomprehension of high and
ennobling truth."
Figure 34

Ellen White described the effects ofchallenging rhe brain as quoted in Figurc 33.200

God has provided each one of us with

rhe power ro freely choose how Vie:: willlive.
Anei He llsually doc:; not ilHerfere, evel)
when we make bad choices. Truly, "there is
much truth in rhe adage that every person
is ule archi tect of !lis own fOI rlllle. "204 IIl
view of this ucmendolls power rhar you have
been given ro shape your own fmure, won't
you take some time today tO again seriollsly
look ar your lifesryle. 1 chaJlenge you ta
reflect on your cllrrenr hcalth habirs and ask
yOllrselfwhat you can do ro rake advanrage
of whar you have Icarned from rhis chapter.
Try ta idenrify some concrete steps rhar you
can rake wthin rhe nexr week ro help protect and enhance your frontallobe-and of
course with it, your entire body. A healthfui lifesryle makes sense. Do nor merely

THE FRONTAL LOBE

follow your old ways of doing chings just
because iliey are comforrable, or "because
everyone else is doing it." In che words of
Scri ptu re, "Be not conformed ro rhis world:

bur be ye transfonned by the renewing of

mind, thar ye may prove what is rhar
good, and acceprable, and perfect, will of
God." Romans 12:2.
yOUl"

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195 Salcrno JA. Murphy DG. CI al. Br:un alrophy in hypcncnsion. A volumelric magnetic re.wnance imaging srudy. HypautlSion 1992
Scp;20(3):340-348.

1% Moss MC. choley An. Oxygen administralion cnhances mcmory

fOrIllJlion in hcallh)' young adalrs. PSyCIJplllmnJlt%g)' 19% Apr 124:255260.
197 R-10 MI-, Mullcr-Ocrlinghallscn LI, cr al. '111C inJ]ucncc of phOlOlbcrapy
on scroronin and me!alonin in non-seasonaJ depressioll. P/;armacopsyc/;i'tlry
J990 May;23(3): 155-158.
198 rephan KM, Fink GR. CI al. Funcrional Jnalomy o( lhe mCJlIaI represemalion of upper e.Xlremiry mo"emel1ls in heallhy subjeclS. J Nl'llroph)'Siol
1995 Jan;73( 1):373-386.
1')9 RodriguC'L-Esteban
. hwabe]W, el al. Radical fringe posilions lhe
apical ecrodermal ridge ar ilie dorsovemral boundary of rhe vertebrare limb.
Nahm 1997 Mar 27;386(6623):360-366.

100.

\'V'hil" EG. The Bible a Ml';lnsofBolh MCl1lal and Moral Culrure. In:

Advl'IIl Rr/lil'llIlmd S'lblllllb Hrrald, 1883 Sepl 25. p. 25. round In: Ellen
G. Wh.ile Esmc. Thr P7IblislJrd Wrilings of Elim G. Wbiu. Version 2.0
(CD-ROM), 1995.
Whilc EG. Mind. ChnTIICll'T, d7Jd Ptmonll/ily. HagerslOwn. MD: Review and Herald l'ublish.ing Associalion, 1977 p.93.

2uI

WhilC EG. COIIIlSl'IJ on Dil'llllld {.'oodJ. Hagerstown, MD: RI"Viewand

Herald Publishing Association. 1976 p. 29.

10'

Whitc EG. R.fll'cring Christ. HagcrslOwn, MD: Rcview and Herald

Publishing Assoc-iarion. 1985 p. 142.

203

w.W.N01'1011 & Company. ) 980.

188 Whilc EG. Guiding Principlcs. In: MtSJages
407-408.

I?O Haapaniemi H. Hillboll1 M, Juvela

. Lifeslylc-associmell risk faclors
fl r aCule bl"J-in in(arclion among persons o( working age. Srrokc 1997
Jan;28( I ):26-30.

10

YlJfmg ,topI/.'. 1930 p.

White EG. We Choosc rhe Bcsl. In: SOnJ alld DauglJleT5 o/God. 1955

Whire EG. RJ.fli'CIillg Christ. HagcrslOwn, MD: Review and Herald

Pllblishing Associarjol1. 1985 p. ) 42.

2M

p. J77.

297

PROOF POSITIVE

298

CHAPTER THIRTEEN

STEMMING
THE TIDEOF

IOLENCE
D

o you feel safe walking down

your streer late ar nighr? Even
if you do, there are milJions in
aur councry who do noI. For
many individuals nothing is more unsenling
than ta live in a place where chey reaUy do
nor feei "ar hame." They are surrounded
by violence and wonder when it wiU eome
knocking at their door. Even those gifted
wirh. pleasant home surroundings ohen 6nd
their feelings ofsafery confronted when tiley
go ta work, travel, ar even run a few errands. The loss of securiry wirh our living
scuarjons is understan.dable. Violence in
rhe Un iled Stales seems ro increase dramarcally wirh each passing generarion.
The pervasive scape. of violent and abu~
sive behavior is hard ro measure. Statistics
only give us a glimpse imo thc magnitude
of the problem. For example, each year 2.2
million Amerieans are the vierims of violent injuries. 1 Over 3 million more violent
crimes oeeUT annually where rhe vietim does
nor get hun. 2 Suicide anei homicide combined amounced ta rhe fourth leading C'luse
ofyears oftife lost before age 65 in AmeriGl,3
When you look at one of America's leading
killers, injury-related deaths, over one-chird
ofrhese 145,000 allnual fatalities are reLated
to violenc and abusivc behavior. 4 This statistic does not count rhe many dearhs rhar

are cL1ssified as aceidenrs alrhough tIley were

actually homieides. Alrhough sratistics may
occasionaUy show improvemenrs in certain
areas of our coumry for shon periods of
rime, despire all our reehnological advances
violence colltinues on a generally upward
trend. There really does not appear ro be
any lasting solution on the horiwn.
Concerns are espeeially warramed abollt
vi.olence perpetrared by America's yomh and
young adults. Suicide and homicide are
eaeh in the top causes of death among ali
15 ro 24 year olds.',6 Homieide is rhe leading cause of dearh among blaeks aged 15
through 34. 7 The lifetime risk ofdearh from
homicide is a staggering 1 in 28 for black
males, and 1 in 164 for whitc males. 8 Or.
James Fox, Oean of the Col1ege of Criminal Jusrice ar Nort.heasrern Universiry, srares
thar murders commined by ehildren ages
14 ro 17 have increascd 165 percem since
1985, ancl (hat the number of murders will
surge even more as some 40 million young
chjldren mature ro rheir teeus. He fureher
declares, "Unle.'>S we act taday I uuly believe we will have a blood barh in ten years
when aii of these kds grow up."
Are we headed for a blood bath because
reens and young adults are becomil1g progressively more out of control? Unless we
do somerJling abour it, that is what many

299

PROOF POSITIVE
experrs are predlcting. Alld rhe problern is
nor confined [Q urban areas as illllsrrared
by the [acr thar New Mexico, largcly a rural
Srare, has rhe highesr homicide rarc for children ages 10 rhrough 14.
We have a narionwide problcm. And ir
is a problem thar we need ro seriollsly address. Ir fim demands recognirion rhar CUfrenr efforrs are insufficienr ro adeqllately
address aur violence-relared problems. Then

III

Homicide

III

Suicide

III

III

Aggravated assault
(often with a weapon)
III

Spouse abuse
III

III

III

Elder abuse
Robbery (theft
directly from a
person)
Arson

Rape and sexual

assault
Child abuse
including ehild
sexual abuse

Figure 1

Whites are at greater risk for suicide, but blacks aud

Hispanics are at greater risk to be victims of homicide.
Compared to women, men are at grcater
risk of both homicide aud suicide.
Teenagers and young adults uoder 25
are at particularly high risk of suicidc;
bowever tbey are at less risk of
bomicide when compared to individuals 25 to 44 years old.
Unemployment ahd substance abuse are risk factors for
committing eith~r suicide or homicide.
Serious pbysical iIIness is a risk factor for suicide, but is not
usually associated with bomicide.
Figure 2

300

it requires ilie commltmem, rime, and energy

ro work out and implemcnt a solution.

What Are the Causes ofthe Violence

Epidemie?
To taclde any problem, we musr begin
by being aware of why the problem exisrs.
Ouce we have rhat awareness, rhen we can
look at solmions. The sciemists rhar give
us some of the earliesr indicarions of causes
of social condjrions are epidemiologisrs.
They study groups of people anei examine
how problems are relared ro meir lifesrylc.
rheir enviJ'OlUnenr, and other factors. However, in cite case of violence, ir can be difficult to derermine which rhings are really
causes and which rhings are merely coincidelHallyassociated. For example, ifwe look
c10sely ar American crenels, we would find
rhar in rhe last century violence has increased dramaricllly; so has rhe purchase of
nylon srockings. Just because these rwo
characrerisrics have risen in frequency togerher does nor mean thar buying nylons
causes violence or vicc versa. Careful analysis is rherefore needed once we identify associated facrors ro dcaw conclusions that
uulyare reasonable and rhus wonhy of rhe
rime and energy ir takes to address them.
What then do rhe epidemiologic srudies suggest are really rhe causes of violence?
Before we can even answcr the quesrion, we
need to recogni7..e rhat violence is a problem \Virh many di/tercnt faces. Some factors cause one rype ofviolence. bur nor others, while other facrors are common causes
for many or even aII rypes of violent acr.5.
Some of rhe torms of violence dut need ro
be considered are lisred in Figure 1.9
As you could guess. each of rhese differem forms of violence has differenr causes
ar "risk facrors" that increase the like1ihood
rhar such an evcnr will occur. Ler us compare some of rhe risk factors for suicide and
homicide ro provide an indicarion of how
facrofs rhar contribure ro differenr rypes of
violence can be both scriklngly similar and
remarkably differenr. 10 11 Figure 21isrs mese
factors.
One of rhe rhemes of this emire book is
{hat you can, ro a Iarge extcnr, play a role in

STEMMING THE TIOE OF VI0LENCE

dcrermining your own hea.lrh anei rhe healrh
of aur natjon. From rhis perspective, 1 believc rhar rhere are cenain key tasks rhat r
shouJd engage iJJ personally, and do my urmost ro encourage others to undertake.
Thesc Tasks should nor be misconstrued as
offering a rotaJ solurion [O rhe problem of
violence in aur nation. They are, however,
a series of personal commirmems rhar can
make a profound difference regardless of
what exrernal facrors look like. Wherher or
nor gun control laws are implememed; regardless of who your neighbors are; in spite
of any deficiencies in our nation's meneal
health services; no marter how we deal polirically, eelucarionally, ar legally wirh child
;lbuse and spousal abuse; the rasks presenteel
here can anei will make a difference. As a
society we do need ro address as many of
violence's risk f.crors as possible, but as inelividuals we can begin now ro promore severai facrors that individually and collecrive1y
will dramariC2l1y decrease rhe roU ofvolence
in our lanel.
Whar then are rhese key individual rasks
rhat 1 believe every American should personallyaddress? Fim, avoid aU illicit drugs
anei alI mind-altering lnedicarons-unless
absolurely necessary. Second, espouse sound
values and be secure wirh rhose values.
Third, spend your recrearional rime in acrjviries dur builel your characrer, rather rhan
undermine your vatues. These few succincr
suggesrions may seem simplisric, bur r believe rhe)' hold rhe keys ta many of rhe deepesr roors of the problems we face regarding
violence.

TtlSk Number One: Avoid Mindaltering Drugs

The U.S. Deparrment of Health and
Human services has dcrermined rhar an
important facror associated with homicide
is the use, manufacrure, and disrribmion of
illicir drugs. 12 They cire rhree reasons for
violence occurring in rhis conrexr. Firsr, the
mnd-alrering affects of drugs can increase
the likelihood dur violent actviries will
occur as a result of bcing under the influence. Second, ro secure funds for drugs,
addicts engage in crimes rhat sometimes pur.

lives at risk. Third, [he "drug business" carries mulribillion doUar srakes: violent dearhs
can resulr from confrontarions regarding the
manufacrure.. sale, or dislribution of drugs.
No national staristics are available rhat give
LLS a feel for rhe percentage of homicides
re!ared ro [he illegal drug indusrry. Howcver, studies in New York Cir)' and Miami
indicare rhar ar teast 25 percenr of ali rhe
homicide,~ in those cilies are re1arcd ro drug
use. J3
AIcohol is a key player among rhe causes
ofviolcnr dearhs. Many srudies have shown
rhar roughly 50 perccnr of rhe vicrims and
pcrpeuators of assaultive violence are under the influence of aicohol. 14 AIcoholism
is ranked as rhe second mOST commonly reponcd mental illness associated wirh suicide
(only depression olltsrrips it) .15 Concerning child sexual abuse, alcohol use occurred
in conjuncrion wirh anywhere [rom 19 ro
70 percent of the offenses. 16 Statistics like
rhese provide a srrong argllmenr for ratai
abstinence from alcohol and iI1icit drugs if
a person is concerned abour being ei(her a
vicr.i.m or perperraror of violent acrs. 1 explore the broad range of iS5ues deaJing with
alcohol more rhoroughly in Chaprer 17,
"Wanr a Drink?"
Many prescription elrugs also have
mind-alrering effecrs. Wherher il be
Valium, Ativan, Xanax, Codeine, Lonab,
Percocet, or a hO$r of oIher Jess familiar
drugs, many of Ihe agenrs rhar we resort to
for pain, anxjery, OI' discomfon can mpair
aur mental c1arity. We shollld look ar such
drugs as rhe cause of problems rarher than
the sollirion. There m,ay be a legirimare
short-rerm use for some of rhese agents.
However, if you are using an)' mind-alrer~
ing drugs on a regular basis, you sholild view
thar as an indicarion rhar you need furrher
help.

Task Number Two: Espouse

Sound Valttes
Even standard medical rextbooks focus
on issues relaring ro value.s and spirituality
when they discuss violent crimes. For cxample, Dr. Donald Balaban, when describing risk factors for eirher commitring or

301

PROOF POSITTVE
being a vicrim ofhomicide. sires duee parricular areas ofpsychosocial deficieney. Specifically he Jisrs "Iack of rradirional supporr
sysrems (such as family and religious insricurions)." lack of"moral consciollsness' and
lack of a "sense of identiry."17
The concern for a lack of moral consciousness srrikes a resonaring chord wirll
many Americans. Many feei rhar aur nation is experiencing a steady moral decline.

75% of adults and teens reject. the concept of

absolute moral truth.
Over half of teenagers say that lying is sometimes
necessary-- "not merely convenient, common,
understandable or acceptabie,
but necessary."
Young people today look at suicide as
8 viable option and a rational choice
depending OQ circumstances.

Figure 3

Crimes committed by our youth:

Carjacki'ng
Knoekout
Ride-by shootings on bieycles
Wilding (ficndish gang aetion)
Their philosophy: "Hatred is hip. Killing is cool."
"We are seeing a eallous disregard
for human life that we have
never seen before."
Figure 4

302

and rhis sers rhe srage for violem acIS. Is

such an assessmelH justified?
George Barna and his Barna Research
Group have condllcred exrensive inrerviews,
parricularly of rhe young Americans who
are somerimes referred ta as "Generarioll
Xer ." He has drawn some srriking conclusions thar provide insighr inro our narion's
furure generarion ofleaders. 18 Some of rhese
conclusions are Jisred in Figure 3.
FlIrrhermore, yOllng people rhroughour
urban-and rural-America are displaying
a call1lsed disregard for hllman life. In mally
cases, rheir ignominious deeds are "crimes
of fashion" according ro Jack Levin, a wellknown criminologisr ar Nonhwesrern Universiry. Some of rhe crirnes al)d Jack Levin's
qllotes are listed in Figure 4.
Many cire evidence like rhar presenred
by Barna and Levin as jusrificarion for reasoning [har rhe moral underpinnings of aur
sociery are coming loose, and rhar rhe rise
in violence is one of rhe consequences.

Task Number Three: Choose Character-Building RecreationalActivities

Whether we ralk abour drug use ar vallIes in general, ir is necessary ta look ar rhe
inpurs rhar impacr an [hese areas. Many
believe rhar one of rhe prime conrriburors
ro aur values is who we spend our leisurc
hours wirh and whar we do during rhar rime.
There are man)' recrearional acriviries rhar
we could profJrably discuss in rhis chaprer.
Some would be powerful morivarors for
good. and orhers would have significam
delercrous consequences.
Let LIS focus an two of rhe mosr pervasive leislire acrivirics in aur sociery. 1 agree
wirh rhe researchers who believe rhar rhese
two acriviries share no small pan of r!le
bJame for rhe American violence epidemie.
They may even be rhe mosr dangerous, bur
rhey Jook so respecrable and are sa well accepred rhar ir renders rhem more capable of
enricing people ro faH under rheir influence.
The clrst of rhese inf1l1ences is tefevision.

STEMMJNG THE TIDE OF VIOLENCE

TV tind Attitudes toward Violence in

Americtl
Srarisrically, relevision viewing i rhe
major leisure rime acciviry ofAmericans. In
fact, media as a whole occupies more of our
day rhan eicher work or sleep-an ave rage
total of nine hours. The largesr share of
mose nine hours is spent facing rhe TV cube:
an average of more than four hours daily.19
One of the mosr disrurbng characrerisrics
of chis leisl1re acriviry is irs power ro hape
our values. TV programming is feeding
Americaos a sready diec of violencc-and
che amount of violence depicted seems ro
beeveron rhe rise. Forexample, from 1980
(when rhe relevision industry was dereguIared) ro 1990, children's programming
showed a dramatic 40 percenr increase in
violence (going from 18.6 violenr aers per
hour up ro 26.4 violent aers per hour).lO
There are some who exeuse TV vio1enee
by saying. "We eaeh derermine for ourselves
whac we will ar wiU nor be inOueneed by.
Watching a (itele violence an relevision
should noc h ave any sign i ficam effece." lc
is inreres[ing ehat ilie adverrisers sharply
disagree with the concept rhar behavior is
nor affecred by whar a person sees an rhe
TV screen. They are willing LO spend hllndreds of chousands of dollars for a few flcecing images. They have learned thac opinion polls ofconsumers always underescimare
rhe influence of adverrising an marker demand and sales. They are well aware rhar.
even though \Ve may not remember seeing
cheir commerciaJ. we will be unwittingly
inflllenced ro huy rheir product.
Look ac a case in poinr: TV adverri 'ing
rhae rargers children. The average child pays
plenty of anenrion ro Madison Avenlle
warching more rJlan 20,000 commercials
each year. 21 Abour two thirds of rhose eommercials are for food, lIsuaJly sugar-rich
irems. 22 There seems ta be linIe question
char rhe adverrising rraregy is working. A
srudy conducred in a supermarket demonstrared [hac pre-school children attempced
ro influence rheir morhers' purchases approximarely once every rwo minllces, primarily for C<"lndy 3nd sugared cereals. 23 If
aur purchasing judgmenr is inflllenced by

advenising. it follows rhar aLU moral judgmem will be influenced by me greater rime
spenr in viewing rhe images seen before and
after rhe adverrising.

Dangers o/IVProgramming Are

Recognized
Ir is becoming more and more difficule

ro deny rJlar TV's portrayals of sex and violence are damaging our sociery. Umil recenrly, mosr liberal rhinkers have raken rhe
po irion rhar freedom of expression is paramoune in America. Their rhetoric became
very familiar: "We are in a free country 311d
we shouJd place no resrricrions on rhe por[rayal of violence or sex."
However, some of [!le mo t sraunch proponenrs of freedom of expression 011 rhe
airwaves have now reversed themselves.
Some are even caJJing for restricting damaging TV marerial from home viewing. A
seJf-proclaimed liberal organization, che
Child Developmenr Unir ar Nottingham
Universiry. Eogland issued a sratemenc
signed by 25 psychologisrs and pediarricians
in which r11ey confessed thar mey had made
a serious misrake in rhis regard. -4 An. excerpr
from cheir sr3rement is shown in Figure 5.
Ir is remarkable rhar they confessed rhar
meir former srance assening rhe harmless-

"Many of us hold our liberal ideals of freedom

of expression dear, but now begin to feei that
we were naive in our faUure to predict tbe
extent of damaging material (on TV] and its
all-too-free availability to children. .."
"By restricting such material from horoe viewing,
society must take on a necessary
responsibility in protecting
children rrom this, as from
other forms of child abuse."

Figure 5

303

PROOF POSITIVE
ness of TV violence was incorrecr. Even
more srarriing is rheir description of some
relevision viewing f.ue as a form of chiM
abuse. Despice such admissions, ehere remain some who seitl deny rhe hannfulness
ofTV violence. They hold ehac rhere is 1\0
absolute proofof a cause and effect re1aeonship, assening that rhere are roo many O!her
facrors thar inf1uence yourhful behavior,
sueh as home envirotunenc, moral rraining,
and peer pressure. However, as a WalJ Srreer

"A eausal relation between TV violenee and

aggressive behavior by the young (has been
denied] by u.nreconstructed liberal academics."
"IHowever], there is an abundance of
circumstantial evidence that points
to the existence of sucb a relation
-- evidence so strong as to raise DO
reasonable doubt in tbe minds of
ordinary people."

Figure 6

11, Notei, CANADA:

,II. Hitting, sho"ing, and biting increased 160% in
fint and second grade shldents within Iwo years.
2. Violent crime had a spectacular increase, cspecially
among Ibe young.
In Soutlt Africa:

1, In the 30 year span of timc beforc TV was introduced,

tbe bomicide rate decrcased 7%.
2. }lomicide jumpcd 130% in the 12 year period after TV
was introduced (1975 to 1987).
J. This jump is grealer than that which occurrcd in Ibe U.S.
12 years after TV was introduced (1945 to 1957).
4. TV was more violent in Ihe1975 to 1987 era Iban in Ihc 1945
10 1957 era, whicb may explain the greater homicide jump
in South Africa.
Figura 7

304

JournaJ edirorial ofMay 31, 1994 indieated,

rhe circumsrantial evidence overwhdmingly
poil1ts ro TV sex and violence as being one
of ehe rom causes of aggressive behavior in
yourh. 25 Their assessmenc of rhe evidence
is recired in Figure 6.

Evidence ofHarmful EjJecu ofTV

Violence
Ler LIS examine some of rhe evidence ehae
supporrs the Wall Srreec JOllfllal's srarcmenr.
Dr. Brandon CenrerwaJl, professor of epi.
demiolog)' ac rhe Universicy ofWashingron,
explored rhe effece of relevision when inrroduced inco eornmuniries rJlae previously
had no TV. The firsr communiry, referred
ro as "NoreI" by sOllle of the original researchers, was il cown in a remore area of
Canada which for years had problems wirh
television signa) reeepeion. Those difficulries were finali)' resolved in 1973 and rhe
residents gained access [Q TV.
The second eommuniry scudied were a11
of rhe [wo million Callcasians living in
Sourh Africa in rhe middle 1970s. This
group included a variery of lifescyles: rich
and poor, urban and rural, educared and
uneducared. For cultural aud political reasons the $outh African government did nOt
allow TV broadcaseing in eheir counrry untiI 1975.
The inerea e in violence when TV recepeion became available in rJ1ese [\Vo COI\1
IHuniries is summarized in Figure 7.2C'
Bath srudies were very carefuUy done so
thae ehe effece of eelevision could be isolated
as complerely as passible. In ehe Canadian
research, noe only were children in Notei
evaluated; children in rwo similar communiries also underwenr behavioraJ measure
ments. These comparison communities
\Vere similar excepr for rhe fact rhar rhey had
had access ro television for some rime. Furthel'more, dlOse measuring rhe children for
aggressive behavior were "bInded." In or.her
words, r.hey did nor. know which children
were gcuing rheir first exposure ro TV and
which had been viewing ie for years. Physical aggression did noe ehange in rhe rwa
companion communires-bur jumped t!le
starding 160 percenr in NoteI.

STEMMING THE TIDE OF VlOLENCE

The Sourh African smdy .1.Jso used a carefui research plan. The srudy's allthor cornpared rhree similar cuhural groups ro evaluare rhe impacr of rdevision. The groups
smdied were Caucasians in rhe U.S. and
Sourh Africa, and aII Canadians (of whorn
approxim:uely 97 percent were Caucasian
araund rhe rime of rhe srudy's inirial focus).
In borh Canada and the Unired Stares, homicide rares nearly doubled wirhin 10 ro
15 ye:m following the introduction of television. By 1974, borh narions were seeing
a yearly rare of homicide deaths rhat was
dOllble where ir staod in 1945. Imeresringly, it was during lhis same rime period
rhar Sourh Africa haei ballned TV broadcasting in irs entire narion. (Afrikaner
whires did nor wanr English whires ro ger
an unfair cultural adv'Ulrage by lISillg a medium rhar was dominared by U .5. and British producrioos). Concerns abour violence
did not inf1ucnce rhe decision.
Whilc othcr nations were seeing homi
cide rares SOflr, Sourh Africa saw irs homicide rares fir" seven percem between 1943
and 1974. Aher the TV ban was lifred in
Somh AFrica, rheil' homicide rate more than
doubled in 13 years. During mose years,
ending in 1987. the rares in the U.S. and
Canada srayed essenrially r!le same as rhey
were in 1974. Careful analysis of orher facrors dur could have affected these rrcnds
left Dr. CenteIW:lJl wirh no orher condusion bur that relevision was the culprir.
Whar more can we lcam from this phenomenon? Centerwall's exrensive research
on the subject of television and violence has
led him [O conclude rhar TV has ies greatesr
effecr on children prio,. to adoLescence. 27 AJrhough we hear ofviolenr crimes beiJlg committed by chiJdren, most homicides are
commirred by adulrs. For this reason, we
wouJd expecr mally ofTV's cffccrs on violence ro be delayed some IOta 15 years.
Afeer .1.11, it wOllld take rhis long for preadolescenr children ro age sufficienrl)' ro commit rhese heinous crimes as adulrs.
These srudies establish beyolld a reasonable dOllbr mar relevision viewing is a promiIlenr mor cause of aggressive ,Uld violent behavior. Canadians and Sourh Afi'icans found
rhar rheir lack of access to television had

unwiningly been a benefir ro their COIl"'IIT\Uniries by keeping violence ar a lower level

rhan it wOllJd have been orherwise.
A srud)' mar seemed to conrradicr the
experiences in Canada and Sotlth Africa
cOllcluded rhat eelevision "increases aggression in only cighr percenr of d1e population." Mr. Cenrerwall examined this srudy
and found thar rhere was no conrradiction.
His summary is shown in Figure 8. 28

AVERAGE Ilriliil~)j

EX. a'-Il:o'I.Y.~
"Aggressive impulses, like most human phenomena,
are distributed along a bcll-shaped curve, and it is at
the margin where the signifieant effcet is to be
observed: 'It is an intrinsic property of sueh beII
curve distributions that small changes in the average
imply major changes at the extremes. Thus, it' an
exposure to television causes 8%
of the population to shift {rom
below-average aggression to
above-average aggression, it
follows that the homicide rate
will double.'"

Figure 8

Staristical srudies of rhe relarionship berween youthful aggressiveness and TV can

be deceptive if rlte}' focus an the overall average response-which indeed seems to indicate a doubrful relatiollship. However, a
smaLlpercentge increase of rhe entire popu!arion that becomes more aggressive. such
as eighr percent, tmnslates into a doubLing
of rhe homicide rare, because it is only a
small percenrage of the population rhar produces the many violent acts ar the ourser.
Orher research has established a [ink
between an early experience wirh relevision
and violence in adulthood. An exrensive
srudy fim gauged how much and what kinel
of TV violence eight-year-old boys were
watching. Afrer 22 years. che history ofthese
boys was evalu;}red wirlt respect ta law enforcemenr records. The re,mlt: television
violence viewing ar 8 yeal'S old frighteningly
predicted rhe seriousnesS of rhe cril11es rhey
commirred by age 30. 29

305

PROOF POSITIVE
Without these studies, many would find
ir hard to believe that viewing of violence
during rhe ehildhood years collie! influence
crimes ill adulrhood. Yet, the facts speak
for rhemselves. I see an iIHeresting paralJei
ro the effects of smoking. When a yOllngster starts smoking, rhe damage being done
is not apparenr, but we now know thar years
larer it may ulrimate!y Qluse significamand even life r.hrearening-consequences.
Ta prevem problems years later, we righrfully rry ro inJluence our children ro avoid
smoking. Why shouldn'r we rake rhe same
approach regarding television viewi ng?

Small Children and Television

306

Parellts are pleasamly amazed ar how

early their infa.l1rs imitate rhem. Widun a
shon time ofbirrh an infam smiles back ro
their sJniles. But bcware-infams do not
possess the ability ro screen Out rhe good
from the bad; rhey imit<lte wharever rhey
are exposed ro. Infants as yOllng as 14
months of age nor anI)' eop)' friends and
rdatives, but have been shown ro borh observe and iocorporare behaviors viewcd on
television. JO,31 That is fearful, considering
the fast pace and low moral valllCS of mose
programs. As of 1990, t!le ave-rage tWO IO
five year old in America was warching over
27 hours ofTV per week.:l 2 Tclcvision has
become Americlll's preferred baby sitter, bur
like it or not, babies learn ham rheir
caregivers. Can we rcaJly be comfortable
c.xposing our linIe olles ro ilie fare (hat television 50 b!atanrly provides?
Solid sciemmc research shows that childrcn rhree and four years old are seill simply unable ro disringuish realiry from fanrasy when it eomes ro television. :l Even if
adulcs try to "rrain" rheir children, (his men(al inability generally persisrs. Therefore,
when children sec violence on relevision
they believe rhey are viewing <l realistic re;resenultion of rhe wodd araund dlem. OI'.
Centerwall pUts rhis in perspective: " ... rhe
earliesr and deepesr impre.ssions were laid
down when ule child saw re1evision as a facruaJ source of information abollt a world
ourside their homes where violenee is a dai!y
commonplace [occurrenceJ and rhe COI1)mission of violence is generally powerflll,

cxciting, charisma tic, and efficacious."34 In

shon, when ehildren see the m<lny murders
and orher violent aets portrayed hourly on
relevision, they believe whar they se.e. This
comcS as lirde surprise ro [nosr parents who
have l)oriced their children becoming teose
:md emorionally involved during frighrful
TV scenes. Adults may react siJnilarly, but
wirh menraJ effon may be able ro remind
themselves that what they are seeing is not
really happening. Children, an the orher
hand, believe whar rhey see despite what you
may teU rJlem. In 1992. Don Oldenberg
published his summarizalioll of an Atnerican Psychological Associarioll repon in the
Washingron Post. There he relayed the sobering st<1tistics: a child who watches a typical rwo ro four hour of re1evisioll daily wiU
havc warched 8,000 murders and 100,000
ocher acrs of violence before complering che
cighrh grade. 35
As we have seen, the critical period where
television exaers irs mosr costly toll is in the
pre-adoleseenr ye.ars. If in those most impressionable years children were inundated
wirh f1etirious depietions of violence, rhen
iUicit sex and oUler cri'mes were illdelibly
imprinred on their min,ds. Theywill have a
harder time later in life ro resisr being iIlfluenced ro some exrem by these mental
pictures. 5uch "mind pollurion" may have
permanent eA-cers on irs owners. When ilie)'
become adults and face moral choices, especially while under srress, wiU such images
resurface and shape rheir behaviors? Like
aH of us, (he basic personal resource we each
possess is the cirade! of aur soul, the human minei. Is it any wonder rhat violence
!las increased dramarically in our sociery
roday while moraliry has markedly deereased?
However, the payoff from ehiJdren viewing violence does nor only come in cheir
adult yeaJ's. As demonstrated in tJle Note!
srudy presented earlier in the chapter, a few
years of TV viewing can eause a dramatic
ri e in aggressive behavior in childrell.
Orher sIudies demonsrrate the same dire
faer. 36 Dozens of swelies have consistently
demonsrrated that ehildren imitate dle violence rhar they have just watched on televisionY For example, children of ages five

STEMMING THE TIDE OF VlOLENCE

nine who were exposed w a mere 3.5
minutes of a violent television program
("The Unrouchables"), were more willing
ro hurc anoeher child man were childrcn
who viewed a nonviolcnr program. 38
To make mareers worse, childrm's televjlO

sion programs are more violmt than adult television. TV Guide. which usually sides with
the television industry, recendy conrained
a surprising arride entided, Is TV Violence
Banering Our Kids?"39 One of the saJienc
points in the arride was the idenrification
of the most violenr form of programming:
C;Utoons. This was not surprising to media
scholars. Earlier data rhat compared childhood and adult viewing fare found thar children were exposed ta six times as much violenu as their parenrs. 40
The problems creared for young children
by TV watching are summarized in Figure
9. 41 Each sraremenr is based on che resulcs
of one ar more fac tu al srudies; ehey are not
in toe rcalm of opinion.

E.ffects o/TVon Teens and Adults

As prc:viously sratcd. Centc:rwall argues
rhar rhe primary damage from celevision
violence COlues from that which we view as
young chiJdren. However, chac which reenagers and adulrs vie:w also has its effcccs. The
Iare adolescent and early teen years are a
panicularly high-risk time. Ooe of [he reasons for this is rhar many in this age range
have an i nordinate amounr offree unsupervised rime on rheir hands. A summary statement issued by the Carnegie Corporation
is shown in Figure 10. 42
This unsupervised rime is of particular
concern because one of dle most popular
celevision networks with chis age group is
MTV. In Chapter 12, "The Fronca) Lobe:
ilie Crown of the Brain," I have poinred OUt
thar research imo the ohen expljcidy violent themes of music television has demonsrrated chat, in general. even adulr viewets
dramatically increase aggression againsr borh
objec[s and people.
Sexual porrrayal on TV increases reenage and adult sexual drives. It has been
shown [har rhe more TV a reenager views
the younger the age of the firsc sexual incercourse, and it is usually ouc of wedlock.

1. [nfants are unable to judge wbicb behaviors should be

imitated and which should not be.

2. Infants at 14 months of agc Imltate behaviors seeI!

on TV.
3. American chiJdren ages two to fivc sec an average of 27
hours of TV per week, and cannot distinguisb rct from
fantasy even wben coacbed to do so.
4. TV exposure bas been demonstrated to

significantly increase cbildren's

aggressiveness in tbeir
spontaneous, natural
behavior by at least
160% in two years.
Figure 9

1. An estimated half of 20 million kids

age 10 to 15 are at risk.
2. They have too much free unsupervised
tirne after school.
3. Parents and others raii to
provide healthy activities.

Figure 10

1. Decreased interes,t in reading

2-. Decreased interest in learning

3. Poor health habits
4. Poor attitudes
5. Increased sexual activity and decreased
age for first sexual encounter
Figure 11

307

PROOF POSITIVE

1. Television violence viewing at age 8 in

boys significantly predicts the seriousness

of crimes for whicb they are convicted by
age 30.
2. Up to 34% of imprisoned felons report having
consciously imitated crime techniques
learned rrom TV programs, usually successfuUy.
3. Aggression also increases in late teens and adults
with TV viewing.
4. The evil effects of TV are
responsible for half of the
current number of homicides,
rapes, and assaults in the U.S.
Figure 12

The annual crime rate in the U.S. would be

lowered as follows il TV technology had
never been developed:

10,000 fewer homicides

70,000 fewer rapes
700,000 fewer injurious
assaults
Figure 13

308

-----

When heaJrhy activities are provided for

teenagers in place ofTV waeching, they wiU
be mllch less likel)' involved in this kind of
behavior. Thc negaeive effecrs ofTV on rhe
lives of ceens aJld adulcs are shown in Figure 11. 43 .41
Althollgh chese effeccs are eechnically
separace from violenc behavior, ehey ean be
indireccly relared ro violenee.
As ro rhe pocencial for relevision ro affeer adulrs, consider rhe tollowing example.
Research bas demonsrrared rhar 22 ro 34

percent of violent male criminals who are

serving rime for erimes like murder, rape,
and assaulr, admir having consciously imitl1ted crime teclmiques dur rhey learned from
TV-usllally successfully.45 In addicion,
how many fdons are chere who may have
been unwiningly inf1uenced by relevision,
and do nor recognize che conneccion berween cheir crime and TV?
Consumer surveys show rhac when
people are asked why chey buy a cerrain
brand of soap, mal1Y rimes chey do nor
know, bur willusually deny chac TV advertising had any inf1uence on rheie choiee.
Pcople are more inf1ueneed by relcvision
advercising rhan dley realize, as proven by
rhe decJine in sales of a producr whcn TV
adverrising is cuc back. le follows rhar rhe
inf1uence of viewing violenee on TV will
have rhe same unwirriog effect.
A summary of Brandon CeneerwaJl's
analysis of eesearch on celevisio/1'S effecrs on
adulr criminal acriviry is provided in Figure

12:16
Haw many violent crimes are commrced because of TV viewing in America?
Again, epidemiologisr and physician Of.
Brandon Cemerwall demonsrrares his COlllmand of [he subjeec. Althollgh he recognizes rhar a number of orher t1.crors have a
mie in our nacional epidemie of violence,
Dr. Cenrerwall has acrempred ro isolace che
effecr of relevision by using staristical cools
co analyze rhe avaibble researeh. He chus
has esrimarcd how mueh violel\[ crime
wOllld have been prevemed had relevision
never been incroduced in America. His resulrs are shown in Figurc 13.47
In short, relevision viewing appears (O
be responsible for fully one-half of today's
violent crimes. Thus, ic likely is che largesr
single underlying cause and eonrribucor to
violent crime in rhe develaped world.

What Can Ee Done?

Wirh such a devasr:uing impacr ofTV
on our sociery, many have rhe mi raken
nocion rhar we need ro appeal ro Hollywood
and the TV induscry ro voluntadly reduce
rlle immoralic), and crime being poruayed.
Many appeals have already bccn made from
cangressmen, U.S. Presidenrs. a.nd variolls

STEMMING THE TIDE OF VIOLENCE

altruistic organizations, bur ro no avail. Dr.
Ccnrerwall has exposed the f:1l1acy of sllch
reasoning. He compares it ro appealing ro
robacco companies to volumarily reduce
their cigarene sales 50 that Americans will
experience be[(er healrh.
His analogy tIrs. The Surgeon GeneraI's
pllblshed repon on Television anei Social
Behavior back in 1972 concllleled thar televisioD viewing was Lnked ro violenr behavior. In the wake of that public;ltion, TV network officials promised (Q reduce levels of
violence in ilieir programming. However,
when ilie inelustry's pracrices were analyzed
een years larer. they haLi not delivered on their
promises. 48 What could have prevelHed (he
TV magnates from decreasing violcm programming? le is a simple f:1cr: rhe more violent and groresque scenes thar are poruayed
on V, tne higher the Nielson rarings. which
dicrare rhe income from advertising.

Should TV Programming be
Regu!4ted?
Should we have governmenraJ conrrols

as advocared by rhe Nottingham Universiry

group whom I quoeed earJier? The previollsly menrioned Wa1J Srreer Journal editorial al50 supporred such a concept. 4? The
writer acknowledged thar such conecols
would limir rhe enrertainmel1t choices of
adulrs, as statee! in Figure 14.
We see ehat ilie preference ofadultI for
freedom ro choose rheir relevision encercainment may be It large part of the problem.
Many lamenr rhe damage ehar TV infucts
on aur children, bur at rhe SJme rime are
willing to allow it [O conrinue because of
cheir own desires for emen:ainmenr. Are OU1'

chi/drm being Jacrificed for adult pLeasure

seeking?

What Parents Can Do.to Control the

TV Monster
Nor aH parents are wi.lljng ro Jer TV's
educational influence conrinue ro permeate mcir homes. Somc wane ro do rheir parc
in sropping this injurious f,1ctor. WhJr can
such a parent do? One ste.p is [O sitnply use
the "OFF" button-tLlrn the TV off and

srop buying or reming violent aod sex-Iaden

videos. However, a person C3n itnplemenr
an even mOfe Iasring solurion---earry rhe set
ourside and put ir in rhe garbage can. Eelieve ir or nor, years aga, ehar is what we
decided [O do in our housc. We have never
regretred our decision.
Some wil! say, "How do yOll find OUt
whar is going on in America roday wehoue
relevision?" It is very simple. There are
plcm)' of sources of news rhar are more informaeive aod objective dlan the TV news.
Ca1ling it "news" is a misnomer. 1 here are
newspapers, daily news journals, weekly
news magazines, computer websites, and
on-line services, any of which wil! give yOLl
rlle "hard" news. This is much better and
more compleee informariol1 rhan the shallow TV news repons. You can even down-

"It is certainly true that any such

controls (on TV and videos] wiIl involve
some IJimitatioDs on the freedom of adults
to enjoy the kind of entertainment they
mi,ght prefer. But modest limits on adult
liberties ought to be perfectly acceptable
it tbey prevent tens of thousands 01" our
children from growing up
into criminal adults."

load news photOs and video dips of your

choosing on the computer.
We are living in an age in which rhe best
sources ofinformarion are noe provided by
relevision. Wheeler highliglm eh is facr
when he points aur, " ... rhe rexe of rhe entre evening news ,lJ110Ul1tS ro no more rhan
half a page of newspaper copy."so Funhermore, it is accompanied by a host of commercials thar stretches out rhe viewing time
that could be pur ro much berrer lIse. TV
is, in reality. an enrercainmenc box. Even
rhe nctwork news producers rhemselves
have stated openl)' rhae they consider

Figure 14

309

PROOF POSITfVE
eelevisioll news ro be elHenainmem. Consequemly, it needs to be phorogenic and exciting ro be acceprable ro viewers. lf the
programming is Ilor designed to be emertaining, mosr viewers switch ro anorher
channel.
The TV news has its own quantiry of
the porrrayal of violence. Violence now
pervades TV programming ro such an exrent t!lat it has crept into the Local TV News
broadcasrs in increasing amoullts. The
Detroit News surveyed 40 TV news broadcasrs on faur stations in December, 1996.
and January, ] 997 and found that "crime
was by far rhe most common type of story
on each st.1.(ion."51 They also discovered rhar
'disaster stories-accidents, floods, blizzards"-were second. "Largell' nonexisrem
an ali four stations were srories on local
politics and governmem, education, etc."
No longer can we escape the viewing ofvi 0Jence bl' switching ro the news.
Channel restrictors are now available
that wiU block out selected channels. Time
limiters can also be retrofined mat will block
our alI channels for seleaed inrervals oftime.
Other rechnologies are being discussed ehar
may provide concerned parenes with a measure of conuol. However, there are problems. Recent research deal ing with the V-

"By beholding we become changed. If you allow your

mind to dwell upon the imperfections a,nd moral
deformi,ties of others, you will be chan.g'ed into the same
image. You will become deformed tin character, and
mentally one-sided and urnbalanced.
Let the mind dwelll upon the perfect life of Christ. If
the thoughts are centered upon him, and the conversatioo
is 00 heavenly themes, you will be 'changed
into the same image from glory to glory.'
You will become 'partakers of the divine
nature, having escaped the corruption
that is in the world through lust~'"
Figure 15

310

chip reveals a sobering fact: regardless of

how sophistjeated the TV-resrricting gadgets, thel' are of lirnited use unless there is
some cype of cIear and uniform ratjng sys
tem rhar allows parems ro choose whar
shows to make of}".ljmirs. Even if rhe rating issues are solved, parencs must do their
homework and lltilize rhe rechnologywhich may be roo much ro expect from
many in our societl'. The simplest, lease
expensive, posirive, and most effective
method of control is probabty rhe one we
used in our famill'-compleee removal of
the sec. It complcrdy eliminates the problem anee and for alI.
A few years ago rhe news wires carried a
story abour some residems of Bombal" India, who rebelled against TV in a dramatic
wal'. Hundreds of people sick of tdevised
violence and sex hurled dlcir TV sers our
rheir windows in Deeember of 1994. Today, none of the 1200 residems in this fashionable Bombay ncighborhood owns a TV
set. They repon rhar their f:1.milies' lives
irnproved as a resulr.
Many feei that rhey colild nor cope wirh
the chaoges in their lifesryle necessitared by
giving lip TV. What could rhel' fiII ali of
thar rime wirh? There are a variery of family activities, hobbies, home improvements,
and orher pursllirs memioned near rhe cnd
of rhis chapter thar couJd pl'Ofltably fiU the
rme. In Chaprer ] 2 an rhe frontaI lobe, 1
cite a sttJdy conducred by dle Detroit Free
Press newspaper. When people were paid
to give lip telcvision for a lUomh, some iniriaUy had great djfficulties, buc by the eod
of r,he srudy they alI had fouod plenry of
consrructive activiries. In facr, if we are interested in character developmem and viaJence prevencion, rhe best dling we could
do with more free time is to plan activities
rhat help ro focus our minds an moral
thougIu.s.
Ellell White was afirm advoc.ate of this
concepe as she re-echoed the teaching of
Scripmre. Her admonition in rhis regard is
quored in Figure l5. 52
Evcn though rhis was wrinen long before rhe advent of television, it addresses d,c
concept ofdwelling "upon rhe imperfccrions
and moral deformities ofothers," which are

STEMMING THE TIDE OF VrOLENCE

depicted regularly an T'I. Such viewing
changes [he viewer "imo [he same image,"
resulting in ilie person becoming "deformed
in character and menmlly one-sided and
unbalanced." White's solUlion to this tendency is to "let (he mind dwell upon the
perfect life of Chrisc." 1, roo, believe we
shouJd help aur children do this. We should
tell them srories of the life of Chrisr. He
lived an illvigorating life that most children
have never hcard aboUl except for perhaps
one ar cwo events. Wilh ehe thoughts cenrcred upon Him and the conversation ceneered on "heavenly themes. you wiU be
changed inca (he same image from glory to
glory"SJ,s'l and "become panakers of the divine nature, having escapcd the corrupeion
that is in rhe world through Iust."))
Some parents may say, "1 am aware of
the damage [hat vile programs can inflicI
an borh children and adults. We do nor
walch them. My kids are spending meir
atter-school hours pan..icipating in competitive sports. At least rhere's no harm in that."
We will now examine the second recreational
concern and its relationship ta violence.

Competitive Sports-Do They BuiLd

Charader?
Well before the turn of the cenrury.
Americans had embraced a powerful
mindse( regardng competitive spores:
"SpOftS builds characrer." This perspective
seems ro have been perperuated-virrually
unchallenged-in our couoery for genera(ions. In fact. sa firmly ingraioed is chis
ethic, rhar ro question it seems un-American. However. Andrew Miracle, an anrhropologist, was rrained ro ask whar mght appear on rhe surface ta be foolish questions.
Dr. Miracle searched rhe research lirerarure
for proof of the "sporrs builds characrer"
truism. He had a vesred inrerest in rhe subject. He .had played competitive sports in
high schoo1 and college; he was also che son
ofa high school coach. But more rhan chis,
Miracle was a social sciemist. He wamed
ro be assured lhat sporcs did ali thar he grew
up bdeving ehey did. Furrhermore. the
answer was noe only of personal and academic inrerest-rhe re-sulrs of his quest

srood ro influence a myriad of social decisions. Should a smali rown bllild a new high
school foorball field? Should I encourage
my son ar daughter ro play comperirive
sporrs? Should the financially strapped .local school board ClIC che arhletic budget or
lay off teaehers of core subjecrs? The lisc
could go on and 00.
Surprisingly, Miracle's review of cite published research literarure did not turn out
me way he had hoped. It did not demonstrate a clear benefit of sporrs on character.
However, a number of unanswered questions were broughr ro light. In rhis context, Miracle collaborated with rwo other
scenrisls and embarked on their own
srudy.56 They fim identified a nationaliy
represenrarive sample of 1600 male high
school senors. Then they analyzedrhe S(Udencs' personalities ta altempt ta measure
me etrecrs of parricipation in varsiey arhleties. Miracle and his colleagues fOllnd thar
characrer trails were affected. but the effecrs
were "small in absolure size" sa rJlar dley
concluded. "high school sporrs did linie ro
benefic or hann rhe social developmcnr of
parricipams." However, rcading their resulcs carefully gives cause for concern. Al
though rhe effeccs on character may have
becn small, they wcre in fhe wrong direction as illuscrared by Figure 16.51
Aggression and irrirahiliry, instead of
decreasing. were increased. Honesty and

1600 male high school se"iors were analyzed as to t/te

ei/eet ofparticipation in v{lrsi(v utllleties. The effects:

Increased aggression
lncreased irritability
Reduced honesty
Decreased self control
Decreased independence
Slight increase in self-esteem

------------~
Figure 16

311

PROOF POSITIVE
self-control, instcad of increasing, were decreased. The anly change {hat was judged
ro be positive was an increase in self-esteem.
Nthough self-esreem mal' seem on rhe surface ro be desira bIe. rhere is reason tO believe fhar wherhcr ar nor rhis factor is desirable depcnds on why one esteems fJirnself
There are seriolls concerns rhar increased
self-esteem based on one's dominance of
orhers mal' fosrer pride, egotism, and aggression. This concern is re-echoed by
Chrisropher L. Srevenson in his dassie review ofthe lirerarure on sporrs and personaliry. Throughouc a multitllde of srudies,
he observed thar ath1eres generally scored
higher on the psychologicaJ fanor of"dominance. "58 AH in aII, rhe research raises the
question as ro whether competirive arhleries mal' be one factOr t-hat is subrly increasing rendencies that-given orher filCtors anei
circumstances-may actualiy predispose to
violence rarher rhan prorecting againsr it.
A New Zealand srudy of a thollsand 15
ro 18 l'eal" old boys and girls found tim juvenile delinqucncy is grearer for those involved in competirive sports. S'J Boys heavily
involved in sporrs ar age 15 were ewice as
likely ro be delinquelll as rheir peers ar age
18. Girls similarll' involved in sporrs ar age
15 were almost duce rimes as likell' ro be
ddinquenr as rheir peers ar age 18. Even at

The more CtullUIiIIn boys play youth hockey,

the more they:
feei cheatiug is important
think violent behavior is legitimate aud
expected
are likely to mimic iIlegal tactics used
by the pros on TV
Figure 17

312

a moderate parriciparion level, girls were

twice as likell' ro be delinquent. The delinquem behavior included C<1r rhen. burglary,
shoplifring, and fighting with a weapon.
One theory. called the "arhleric delinquent" hypothesis, views the aggressive behaviors associared with comperitive spom
as nor being Cdused by comperlriveness on
the playing fielel; instead, t-hey supposedly
are caused by contacr with delinquenr
groups t-har may be involved in ream sporrs,
rhus exposing yomh to older delillquenrs.
However, rhe stuely did nor supporr this
popular hypothesis. The sportS involved in
the snldy include rugby, cricket, baskerball,
soccer, and hockey.
50 far, we have seen d1e negative efTecrs
on characrer C<1useel by parricipation in high
school sporrs, both varsiry anei orherwise.
Whar abolit parricipation of younger children in SpOfts? Mirac1e anei Rees have surnmarized several Canadian studies that raise
concerns abollr character deteriorat ion even
in an apparendy younger age groupf,o Researchers have found dut rhe longer young
hockey players are involved in rhe sporr, ilie
more negative character trairs rhey develop.
These characcer rrairs are listed in Figure 17.
In some places in rhe United Stares, ice
hockel' mal' seern like an example thar is
not very representative of the "more ennobling" sporrs rhar our e1emencary srudents
play. Bur how does a more mild sport such
as a good soccer march ar recess srack up?
Jusr such a quesrion was answered in a sruely
on t-Ile efiecls of competirive. SpOftS on S4
children, age 10 a.nd Il. Some were assigned
ro an experimental group t-hat playeel a Jcick
soccer "world series" durij1g recess for rwo
weeks. Scores were kept anei rrophies were
awarded ro alI fhe players on ilie winning
team. Orhers were assigned ro a control
group that did nOt compete in tlle tournament. The finelings are shown in Figure 18. 61
These findings are similar ro rbose of rhe
varsiry spons srudy anei rhe hockey srudies.
In rhe environment of competitive spom,
negative characrer rraics have rhe porenrial
ro be nurtured.
In spire of chis research evidence, Miracle
and Rees indic.are rhar rhe ctlrrem consensus among yourh spons experrs is rhat com-

STEMMING THE TIDE OF V10LENCE

peritive sports generally do not exerr a negarive effecr on rhe parricipanrs. However, if
we are concerned abolit sllbrle effecrs on
characrer, I rhink rhere is grave cause for
concern. Less ahruism or increased rivalry
may seem rrivial, and withollt any apparenr
sociaJ impact. Yet, whar happens if some
years larer rhese rendencies are superimposed on a job loss followed by an evicrion
notice? Is such an individual more predisposed (Q violence rhan a person wirhollt rhe
sporrs expericnce? Some "experrs" mighr
sa)' rhar rhe answer lies in rne field of conjecrure. However, 1 would respond: can we
afford ro rake chances when a body of research demollstrates r:har parriciparion in
sporrs has damaging effecrs. and we are in
rhe rhroes of an epidemie of violence? Furrhermore, because of the bell-shaped characterisrics of human aggression as ourlined
previously in Figure 8, a small increase in
ave rage aggression results in major changes
ar the eXtrenle ofhuman aggression and will
thus have a significam impact on violence
sratisrics. J have rcad enough ro conci ude
thar competitive spons do 110t bui/d chamctel' in e1emenrary $chool children or 12rh
graders; on the conrrary, they damage charaerer. The sharp increase in competitive
sporrs panicipauon byschool chiJdren could
very well be another reason why violence in
our sociery conrinues to increase among rhe
young.
What about older athJeres who compere
ar the college level? Do sporrs build their
character? Researchers recenrly looked ar
over 100 cases of rape, atrempted rape, 'Uld
fondling on NCAA college campllses. 62 Ar
10 of rhe schools srudied, 19 percent of the
assaulrs were committed by male athleres
even rhough they made lip a mere 3.3 percent of rhe male student body. This suggested rhat the ;uhleres had over f1ve rimes
the risk of engaging in violent behaviar.
Todd Crosset, who conducted rhe study,
said, "When you're rrained to be violent ir
can spill over ro your privare life."63

Sportsmanship-Faet or Fiction?
A sponsman is defined as someone
" ... who can rake a 10$s or defear wirhout

1. Quarreling occurred on a regular basis;

even a fist fight broke out.

2. Crying occurred on several occasioDs,
generally in the context of perceived
failure or injustice.
3. Rivalry with other children
increased.
4. AUruism significantly decreased.
Figure 18

Athletes tend to be less sportsmanlike than

non-athletes.
"Major" sport athletes are less sportsmanlike
than "minor" sport athletes.
-"Starters" are less sportsmanlike than
"substitutes."
-The longer an athlete is involved with a sport, and
the higher level at which he competes, tbe
more Iikely he is to believe that breaking
tbe rules and committing
injurious acts is legitimate.
Figure 19
complaint or vicrory without gloaring, and
wha trears his opponenr wirh fairness, generosity, and courresy."64 Many people faJsdy
assume thar rhe higher you advance in competirive SPOrtS the betrer yOUl' characrer becomes. Chrisropher Srevenson found jusi
the oppoJite when he reviewed six different
studies of college arhleres. 65 John Si!va's research r;lised imilar cOllcerns. 66 Their resulrs are summarized in Figure 19.
On average, the best-performing arhleres
have a rendency ro be the least sporrsmanlike. Ofcourse, mere are notable exceptions.

313

PROOF POSITIVE

Name
Mike Tyson
ScoUie Pippin
baseball
ba5ebaU
hec'key

Darryl Strawberry
WiU Codcro
Mark Fitzpat.rick

golf
footbaU

John Daly
Dan Wilkinson

footbaU

Warren Moon

football
football

Johnnie Church
Teako Brown

football

3 SMU players

football
foothall
football
football

Rabsctou Jeokios
Walter Smith
3 Idaho SI. players
Nilo Silvan

football

O.J. Simpson

rape
shoving his fiancee
against a car
several domestic beatings
beating rus wife
kicking his pregnant
wife
beating his wife
punching his pregnant
gl:Lfriend in stomach
slapping and choking
his wife
assaulting bis \Vife
slapping girlfriend,
throwing her to tbe
ground
aggravated sexual
assauIt 00 girl, ) 6
rape
assaulting his girlfriend
rape
assaulting and
raping girl, 17
murdering his wife
and her companion

Figure 20

the berter the arh~

lere (as reflecred by his reaching higher leveJs of competitive play), the greater the tendency to rhink rhat breaking rules and inflicring uljury on a competitor is jusrifiable.
This raises definite concerns regarding vio~
lene rendencies off the field. In some athletes, the impact may be nothing more man
acting more intense and hostile during an
informal church volleyball game. However,
could it predispose others to engage in behaviors that are more serious?
What about sportS beyond the college
level? Ifcompetitive spons reali)' build character, we would expect atllletes at this level
to rarely-if ever-be involved in violene
acriviry. In his insighrful repon on competitive sports, Rick Warner observed jusr
the opposite: "Rarely a week goes by withour a repore of a college or pro player bearing a woman, getring inco a fight at a bar or

Of stiU greater concern,

314

restallriUH, or starcing some mher rype of

physical altercalion." Wamer went on 10
idencify some of the high proftJe professional
arhleres who have recemIy been accused of
physical violence againsr women. 67 Some
have been convicted. A lisr ofsome of these
athletes is shown in Figure 20.
Actually, such examples probably represem only d)e tip of the iceberg. Before O.J.
Simpson stood rrial for murder, the wellpublici1.ed history of his alleged long-rccm
spousal abllse suggesred ro many rhar amletes often get off easy when it comes to [he
law. Miracle aJld Rees have raised the same
concern: "It is possible mat [law enforcemenc] auchorities may ueat arhletes differencly, more leniently, than non-athleres from
similar social posrions. "68
Furthermore, mally wonder how such
outsranding and disciplined arh!etes could
be so violent. Karhleen Holgerson of rhe
Universiry of Connecricllt Women's Center does nor seem surprised ar rhe record of
violence among foorball players. She points
ro rwo underlying problems:first, foorball
stars are applauded for beillg violent in their
games; second, respect for women is nor a
parc of their "macho culrure."69 In her
mind, these problems set the srage for violence direcred ar women.
But what abouc those who are involved
wirh other sporrs? Alrhough some sports
may tend to promote violence more rhan
ochers, as we have already seen competitive SpOftS in general seem ro atJect tlle parricipancs. If il child's kick-soccer world series can cause measurable effecrs in two
weeks, what influences do comperitive
spons have when they are the center of a
person's entire Ijfe? It does nor rake agreat
Icap of faith ro conclude thar intense spom
involvcme.nr can be a risk facror for engaging in violent crime.

Americans Raise the Stakes in Competitive Sports

Unfonunately, the fabric of American
life rends ro accenruare-rather rhan amcliorate--the deleterious effecrs of competirive SPOrts. AJmost every town and city in
America roday has athleric fields built for
the purposes of entertaining parems who

STEMMING THE TIDE OF VIOLENCE

warch rheir reenagers compcrc in foorbaJl,
baskerbalJ, soccer, and or.her sporrs. The
social symbol ofsporrs also has some of che
mosr. insightful experlS worried. In their
book, Lessons of rhe Locker Room,l researchers Miracle and Rees argue rhat
America's currenr spores obsessioo conf1icrs
wirh our narioo's rruc long-eerm needs. lf
America is ro successfully compete economicaJly in r.oday's global markerplace, we need
skilled workers, nor extraordinary athletes.
We cannor afford ro allow sporrs ta continue ro dominate edllcarion.
We are also surrounded by the fauaricism of spons enthusiasts who sUPPOrt a
muhi-biUion dollar indusrry thar rewards ies
top professional athleees wirh huge saJaries.
Mauy condemn r.he ar.hler.es and/or team
owners for rhese lavish paychecks, bur ir is
rhe American public that is large1y responsible. The fanatical inreresr in SpOftS provides rhe money for large salaries r.hrough
r.he sale of rickers and TV adverrising.
Sporrs faus are also well aware of rhe
unsporrsmanlike conducr ofsrar players; yer,
many applaud it. For example, in a oottOo-disrant season, the Deeroir Pisrons baskcrball players were finding chemselves
slapped with an unusllaHy high number of
penalties because of rheir unsportsmanlike
behavior. Mauy of their &os were proud of
ir, however, and dubbed rhe local heroes
"Derroir's Bad Boys." These words appea.red
an bumper srickers and T-shirts, and found
uleir way into newspapers and spons magaZlOes.

The American publ ic ac large seems blissfully unaware of rwo conclllsions rllar seem
clear in rhe scientific ar.hletic literature:
1. The idea thac "sports build characreI'n is a myth.
2. The trurh is mat sporrs acttlally have
a rendency ro cause a dedim: in characrer.
OI'. Mirade aud Rees in rlleI book Lessons [rom (he Locker Room stare it this way,
"Rcmlrs of in deprh analysis of moral reasoning in spon have shown Ular athleres
have a rendency ro shrug off moral decisions as not their responsibiliry and thar r11ey
also exhibic a self-serving bias when judg-

ing what violent behavior is appropriare.

Moreover, arllieres tend ro adopr a less aclvanccd form of moral reasooing to jusrify
aggressive behavior rhan do non-arhleres.
The belief rhar participarion in sports leads
ro the developmenr of pro-social personaliry trairs, rhar ir makes one a bercer persoll,
and dur. it builds characrer in high school
or in aoy other contexr, is in no way jllstified. On rne conuary, research an the moral
reasoning of athleres rends (Q painc a negative, nor a positivc, picture."71
UnriI we as a narion recognize these
problems aud make spending decisions accordingly, athlerics will srill draw huge sums
ofmoney. Those doUars invested in elcmenrary, high school, and college arhlerics will
continue (Q sap funds from educarionaJ activiries. Furthermorc, rhese invesrmenrs
speak (Q aur youth abour rhe presrige and
privilege of playing sporrs rarher rhan rhe
importance of being skilled, producrive
workers. And rhe big pOt ofgold ar rhe end
of the rainbow in rhe land of professional
superstardom will conrinue ro lurc many
young people into areas ofcompetirioll that
will uhimate1y mar r.heiT characrers.
1 am aware rhat rhis is a very sensitive
ropic. Spons have afirm grip on a broad
segment of our sociery, but we ali need ro
be aware of how comperirive sports aEfecr
aur YOllch. Mari)' parenrs believe rhar they
are inf1uencing their children posirively by
encollraging (hem ro compete in spores.
They spend rime and efi-of[ buying rhem
equipll1ent and driving them to practice
sessions and games. Unfonunately many
are largely Of rorally Wlawarc of rhe damage
rhey may be doing ro their children. It is
truc rhere are some arhleres rhat, because of
t11eir environmem and their ocher rrairs of
characrer, wiU oever have problems duc ro
rhese inf1uences. However, many oc11ers
wiII.
I should aJso emphasize rhat rhere are
ocher inf1uences 00 our yomh r.hat are worse
rhan sporr.s. IfI had ro choose berween my
child playing in an evening baskerba1l1eague
and running with an inner ciry gang, 1
would unhesiraringly choose rhe formeI'. In
fairness, 1 ulink rhat chis is one of the reasons thar sports rend ro "look good." If we

315

PROOF POSITIVE

"Some of the most popular amusements, such

as footbaU and boxing, have become schools
of brutafity."
"They are developing the samc cbracteristics
as did the games of ancient Rome."
"The love of domination, tbe pride in mere
brute force, the reckless disregard
of life, are exertiog upon tbe
youtb a power to demoralize
.hat is appalling."
Figure 21

"Other athletie games, though not so brutalizing, are

scareely less objectiooable beeause of tbe exeess
to which they are carried."
"They stimulate the love of pleasure and excitemenl,
thus fosteriog a distaste for usefullabor, a disposition
to shunpractical duties aod rcspoosibilities."
"They teod to destroy a relisb for life's sober realities
aod its tranquil enjoymeots."
"Thus the door is opened to
dissipation and lawlessness
with their terrible results."
Figure 22

"Vigorous cxercise Ihe pupils must have. Few evils are

morc to bc dreaded than indolence and aimlessness.
Vei the tendency of most athletic sports is a subject of
anxious thought to those who have al heart the wellbeing of Ibe youth."
'"Teachers are troubled asthey consider the infl'uence of
these sports both 00 the student's progress in school aod
on his success in afterlife. The games that oceupy so moch
of his time are diverting the mind from study."
"They are Dot helping to prepare fhe youfll for practical,
earnesl work in life. Their influence does not tend to\vard
refioement, generosity, or real manliness."
Figure 23

316

compare a young athle(e wi(h aJlother peer

who is into drugs or gang activiey, sportS
looklike a wholesome inf1uence. Ahhough
sporrs may have value in keeping someone
away from worse activities, we must always
remember that there are inherem probtems
with compec.itive ac.hletics. Better alternatives do exist, as we shall sec.

Jnsights about Sports[rom Yesteryear

Years ago, Ellen Wh..ite addressed rhe
slIbject ofcomperi(ive spom. She displayed
more insight into the true naeure of these
games (han many of rodays experrs. She
referred ro contact spons, such ,lS football
and boxing, as "schools of brurality," as
quoted in Figure 21. 72
What abolit spons o(her than cOlllact
sporrs, rhose that are nor so viciollS, like
baseball, rennis, or volleyball? Befor:c research was do ne in modern years, Jid Ellen
White foresee any problem~ wirh these activiries? Did she think it was possible rhar
dley wOllld produce good charac(er eraits
in Dur children? Her comments are recited
in Figure 22.7 3
Shortly before she wrore rhe sratements
above, Whi(e presented even srl'Onger rheroric. Her assessments of sporrs c.1me in the
contexr ofencouraging physical ac(ivity, yet
wariling of the problems with competirive
sporrs, as srated in Figure 23.74
A summary of EJlen White's concerns
abolit spom could just as well have been
enunciared by an up-ro-date research sociologist. These concerns are summari7.ed in
Figure 24.

Another Pitfall ofthe Sports Craze

SportS, whethcr you actively panicipa(c
in them, or observe them on TV are ar tlte
very teast agreat diversion. Those who regard thernselves as "sporrs fans" ullwittingly
acknowledge rhar rhey are fanatical abOli(
sporcs (rhe word "fan" is, of course, an abbreviation for "fanatic"). Dwelling on spons
leaves less room for God in our thoughts.
It tends ro prevent lIS from inquiring "How
is it wi(h my soul?" Those attcnding a SpOrting event would have a difficult (ime even
(hinking about thcir rclationship with their
Makcr, bccause rheir minds are captivated

STEMMING THE TIDE OF VIOLENCE

by ilie comperitive spirit and the excremenr
of the conresr. Indeed, rhere is little that is
morally uplifring abolit a sporring evene.
The minds of players and observers aIike
are /lxed on one objective-conquer rhe
opponent-beat him imo the ground.
We need ro provide supervised activities
for aur childIen rhar are healrhy, rhar fosrer
crea tjvi ry and imaginaron, and that provide
useful labor. EHen White slIggesrs a balance between lIsehtl work, recrearion, and
reading and srudy as olldined in Figure 25.75
If sllch activities ftlled a young person's
day. he OI she would nor have time ro parricipate in or view sporring evenrs that fosrer violent behavior. When compared ro
regulat competitive sporrs involvemem, they
would likely be more occlIpied and insllIared hom becoming involved wirh gangs,
drugs, or sex. Indeed, if American yOllng
people received guidance along these lines,
yourh violence would be sharply reduced.
tlleir learning skjlls would irnpIove, and life
in general would be brighter for rhem and
for ali of liS.

1. Interferes with stlldents' scbool progress.

2.
3.
4.
5.

Diverts tbe nlnd from academic studies.

Intensifies love of pleasure and excitement.
Produces a distaste for usefullabor.
Fosters a disposition to shun practical du'ies
and responsibilities.
6. Destroys relish for life's sober realities.
7. Undermines life's 'ranquil cnjoymenls.
8. Increases lawlessness.
9. Intensifies love of domination.
10. Foslers a reckJcss disrcgard of life.
I 1. Cultivates pride in brute force.
''''

1,

'Figure 24

While it is right and necessary for lehi/drenj

to have recreation, they !iIIOUld:
1. De taught to work

2. "ave regular hours for pbysicallabor

Historic Para/leL to the

Problems Facing America
In this chapter we have seen some of the
roors of violenee in our sociery. Making
decisions abOli( drug use, values. and recreation would have a tremendous impact even
if only a portion ofAmericans rook ro hearr
r11e need ro make changes in these pervasive risk facrors. lam realistic enough, howcver, ro recognize that many of rhose who
most need ro rake a stand in rhest areas will
only eriricize and ridieule my words. Their
value jlldgmenrs are beld by the majoriry
and thus rhey find it easy ro rarionalize: "everybody is doing it-how cOllld rhese things
possibly be harmful?"
Such argumenrs bring ro mind the similar excuses used in ;tnorher cui ture wllere
vice and violenee occurred in epidemic proporrions. Ir seemed rhar JUSt abour everyone was swept away in a tide ofcorruprion.
Alrllough I do nor believe rhat America has
yer came ro rlle point of this ciry, [here are
some srriking paralJels. The city in question is Sodom of [he ancienr Middle Easr.

3. "ave regular bours for reading and study

4. "ave employment suited to their years
5. De supplied with useful and
interesting books
Figure 25

"Behold, this was the iDiquity of thy

sister Sodom, pride, fulness of bread,
and abundance of idleness was in her
and in her daugbters, neither did she
strengthen the hand of the
poor and needy."
EzekieI16:49.
Figure 26

317

PROOF POSITIVE
The whole world has heard of Sodom.
Ies hisrory is doclImented in the Bible. The
word "sodomy" was derived from rhe name
of rhis city; ir denores oue rype ofcrime that
was freely commirted in Sodom. Violence
and sexual crimes seemed to be ar t11e top
of the lisr in rhar ancienr urban area. lnteresringly, rhe Bible provides four reasons for
mese crimes, as quotcd in Figure 26.
Note the four characterisrics of Sodom:
1. Pride
2. FlIllness of bread
3. Abundance of idleness
4. Lack of compassion for rhe less forrtmare

318

Let us examine (hese root causes. Thc

hrsr one, pride, may be difficulr ro differentiate [rom the cuerently popular concepr
of "self-esteem." What do we hear abolit
self-esreem roday? Many sociologisrs rell us
rhar me crime rare in our society is due ro
1JJw self-esteem, which seems on rhe surface
ro be at variance wirh me Scriptural aCCOllllt
ofSodom's problems. The highest and most
powerflll form of "self-esreem" is nor usually discussed. This trair arises from a sense
of our inflnire value becallse ofbeing God's
sons aod daughters and precious ro Him.
Whar is commonly called "self-esteem" in
our country comes from within rhe person
rarher than from a Higher Power olltside.
Commonly, those individuals who are dee1ared as exemplif)ring high self-esreem possess certain characterisrics, talents, or abilities which allow rhem ro stand wirh rheir
heads up rall. Alrhough often unrecognized,
this self-esteem is lIsuaHy based on comparing one's self with orhers.
Consider some examples. Shirley has a
good sense of self-esreem because she is rhe
most talented lawyer in (he ftrm-everyone
comes ro her when rhey have problems.
(Whar would her self-esreem be likc if her
skills were JUSt as good, but she was the least
skilled lawycr in rhe ilrm?) Bob has high
self-esreem becallse he is agreat football
player. (Great compared ta whom? lf he
played the game jusr as well, but aU rus competitors improved dramatically overnight,
would he sriH feei so good abourh.imself?)
Sue has a high sense of wonh because she is

intelligem and artractive. (Would she srili

feei good abour these same qllalities ifgiven rhe same abilities and appearanceshe was, Iloncrheless, less imelligent and
artracrive rhan ali her peers?). Harry hnds
special satisfaction in how weH he has done
as a farher: cach of his four children bas
grown up to be a professional. (How would
he feel if everyone he knew had lcids mat.
[Umed Otlt better than his-even ifhis children were jusr as accomplished?) Thesc illusrrariolls indicate thar the basis ofso-called
self-esteem is pride arising from a competitive spirit. Wc compare ourselves with o(hers, and then feel good abolH ourselves. The
scriprures speak ro this rype of self-esteem:
"Pride goerh before destruetion, and an
haughty spirit before a fall."76 A search of
the word "pride" in an exhaustive Bible COIlcordance reveals many warnings as to ilS
dangers. Those who feel superior ro orhers
are more prone ro inflict bodily harm as a
whim or even in a plor ro accomplish their
objecrives. The apostle Paul stated "Let
nothing be done through srrife Of vainglory;
bur in lowliness of lUind let each esteem
orher betrcr rhan rhemselves. "77
In some socieries, rhose who thought
rllemselves [Q be superior daimed the "right"
tO determine wherher rhe "inferior" ones
should be subdued or even exterminared.
A gbring example of mis occurred in ooc
of the darkesr chaprers ofAmerican hisrory:
the insrirution of slavery. Nazi Germany,
with irs "master race," provided anothcr sad
cOllunentary as to r11e resulrs of me human
tendency to pride.
Perhaps surprisingly, we also find soeiologises using some of the same language in
tallcing about rhe "macho" tendency fed by
competirive spons. They poinr Out how, in
essence, it causes some men ro boost rheir
self-image by demeaning the value of
women. We have already discussed some
of [!le reperclIssions regarding spouse abuse
and relared crimes.
The second reason given for rhe crime
n Sodom is "[ullness ofbread." Some sociology specialises, conversely, say that ir is not
fullness of bread bur poverty rhar is at fhe
root of ollr crime problem. This is agaill in
disagreemenr wirh rhe Holy Word's aCCOllllt

STEMMING THE TIDE OF VIOLENCE

of Sodom. Alrhough poverry is an importanc facror in violence, ic is nor the core
problem leading ro violence as some wOllld
have us believe. The Holy Word does bring
poverty inro the picture in rhe case of
Sodom. We wi1J de/ve inro rhac shorely.
However, Jer lIS consider how "full ness of
bread" can resulc in crime.
America roday is rmiy an affluenc socicty. Granred, aur country is dramaric31ly
differenr from Sodom. Today in America,
Jespitc recent "re(orms," wel(are stiH providcs more [han rhe basic necessiries for
many low income cicizens. Americans living in "poverty" own more dishwashers per
capita rhan aII people in rhe Netherlands,
England, and IraJy; more c10rhes dryers rhan
aU people in Sweden; more VCR's rhan 311
people in wesrern European narions except
for Brirain; and more microwaves rhan 311
people in any European counrry.7 8 Our
counrry rruly has "fullness of bread" as did
Sodom.
Even if it were true rhar many live in
real poverty, ir is nor a cause ofviolenr crime
as the media would have us believe. I( poverty caused violence, aur greare.~r violence
sholild nave been ar rhe rime of rhe Grear
Depression. Surprisingly, rhe crime rare was
much lower ar dle rime of ilie Depressiol1
rhan ir is now. People were srarving on rhe
succes, srarving in rheir homes. Foocl wa.s
scarce; money was scarce; anyrhing of v31ue
was scarce ar rhe rjme of rhe Grear Depression, yer our cirizens did nor kill each orher
as a resulc.
FuUness of bread, inseead of being a
blessing ro Sodom. became a curse. lr is
dosdy rela[cd ca che ehird cause lisred by
the prophe[ Ezekid, an abundance of idleness. Idlencss olien resulrs direcrly from
"fullness of bre-J.d." Apparenely in Sodom,
Illany did not need ro work ro keep bread
on rhe rabie. We have much idJeness in our
country for similar reasons. It is certainly
wonh cOl"lsidering thar idlencss, and not
poverty ieself, may be one ofthe reasons why
in America che "poorer dasse.s" have disproponionare crime rares. When people coJleet welfare or uoemploymenr checks, by
definition, rhey are nor working, rhus further opeoi ng fhe possibiiity for idJeness. An

old proverb stares rhar "idleness is rhe devil's

workshop." La cer in t!le chaprer we will say
more abolit idleness.
The fourrh reason identified for Sodolll's
crimes was failing ro helI' the poor. "Neirher clid she suengchen tIte hand of rhe poor
and needy." There apparenrly were some,
even in Sodom, that were truly poor. Our
sociery has rhe same problem roday. Many
have become insensitive regarding thase
who oeed help. They expecc rhe government to take care of rhe poor aod ullforrunaee. If someone is in need, the government is supposed ro provide housing and
suppon. Many seem ro feel rha[ if ('hey cannor qualifY ro get ir from che governmelll,
they are undeserving; rherefore, 1 will nor
help [Item. Thus, our great welfare sociery
is ar the coot of much of rhe lIoconcern for
rhe poor and needy.
As I have alluded ro, research does demonserare an associarion between poveny and
violent crime.?? The experience of Sodom
speaks ro the importance of addressing rhe
needs of rhe poor for che mental and spiriruaJ heair11 of rhose doillg r11e giving as well
as for those on che receiving end of acts of
kindncss. Althollgh welfarc programs no
doubr bring cenain benefits ro ehe needy, 1
am impressed again-in che contexr of [his
chaprer-rhar it would be fulfilling ro use
aur leisure cime ro help individu31s who are
in need. Thar help collld rake many forms.
le may be helping chem paint cheir apanmenr. le may mean baking chem a loaf of
bread. It may email raking some rime ro
helI' rhem with purchasing decisions. Imagine rhe bellefirs ro borh giver and receiver if
more time were spent he1ping others, and
less rime warching television or wraI'ped up
III SpOfts.

fdle Time)

ru and Violence

Ler LIS look furrher ar rhe rhird charac(eriscic, the abundance of idleness. What
are Americans doing with rheir idle rime?
Whar is the major acciviry dur occupies rhe
idle rime in America? It is no secret; ir
has been well publicized. Many statisrical
srudies have been made that verit)r ie. It is
watching television. Tdevision is rhe Ilumber oile" idle acriviry" ofAmericans across rhe

319

PROOF POSITfYE

Family councH me,etings

Teach children t6 express gratitude
Invite friends who wiU abide by
family rules
Special weekend meals
Special occasions witb exteoded family
Routine phone tradition
Give insclribed books as gifts
Make and show home videos
Figure 27

n:uion, across age groups, across even socioeconomic groups. As has already been
poilHed om, we are reaping r!le resulls of
rhis idle acriviry in the form of continually
increased violence and immoraliry.

Living Without TV
1 am often asked how 1 and my family
can live in eoday's warld wirhom relevision.
Mally people seem to respond wirh blank
looks when asked whar rhey would do with
cheiI rime iJ rhey did nor warch TV. 1 have

SE
Learn geography, science, math, or art
Learn to cook and bake
Develop hobbies and related skills
Visit the library
Quilting, sewing, etc.
Learn to handle money
Learn a musical skill
Subscribe to newspapers or magazines
Fgure 28

320

thus lisreel some of rhe wide choices of acrivities dtar can enrich your life and yom
family's life in many ways. You will now
have time for rhings rhar are meaningfulsuch rhings as family and social acriviries,
self-improve.menr acriviries, physicaJ acriviries, development of family values, aod recrearional acriviries.

What to Do 'ifter Pulling the Plug

Suggesred family anei socal activiries are
lisred in Figure 27. 80
The above figure deserves a few commenrs. It is remarkahle how many children
are starving for a home where wholesome
acriviries are r!le rule insread of rhe exceprion. Such home is possible ifit has 00 TV.
Ir is amazing ro me how mucb children
enjoy and parricipare in family cauncil
mccrings where dley arc given rhe opportlJniry tO help set the "rules of the house" and
even help set rhe possible punishmems, erc.
If they are involved in the planning process
rhey wiU be mucll more willing ro acknowledge rhe imponaoce of following the f~un
il)' rules.
Children do nor naturally express graritude. When rhey are given gifts ir is imporrant ro rake lhe rjme ro help them express
graritude nor only in worel bur also in wrring expressive rhank-yoll notes. If lhis is
dane r!ley will avoid growing up wirh rhe
ielea rhar rhe wotld owes rhem somerhing;
it will be a pleasure ro have dlem arounel.
When friends of yaur children are invited aver and are wiLling ro fo[Jow your
family rules, rhey will rend ro bring even
more joy ro rhe home in cheir association
wirh rhe f...mily. Planning, preparing, and
parraking in special weekend meals can be
a f:lmily evenr worrh remembering. Having ramine phone traditions where grandparenrs and exrcnded family are called, are
not only enjoyable at the rime, but will endear your children ro rhcse rautine phone
eraditioos when they grow up and have rheir
own children.
There are al50 maoy self-improvemel1t
activities rhat could be engaged in. Some
of rhem are lisred in Figure 28.
Designing games and orher graup ways
tO make the learning ofgeography, science,

STEMMING THE TIDE OF VIOLENCE

marh, and an will nor only be fun bur wiU
be rewarding in rhe ye.1r (O come.
1 ftnd it amazing how many children (as
well as adulrs) love ro learn to cook. We
have seen rhe imporrance of nurririon in this
book. Having rhe family learn togerher ro
cook hea1thfully as well as tasrcfuLly can be
another grarifying family event tim will a1so
be eminen.rly pracrica!.
Some youngsrers roday respond wirh a
blank stare when askcd whar rheir hobby
is. A child withour a hobby was unheard of
prior ro (he advcm of tdevision. Guiding
children inro Ln(cresting and wholesome
hobbies [har agree with their individual personalicies and preferences wiU noc only
stimulate crearivicy but wiil also bring lasting self-respect.
There are seemingly exhausrive resources
ar locallibraries rhac children should know
how ro tap. When your child asks you a
quesrion that you can't answer, rake rhem
tO rhe locallibrary nor just so rhey may seek
an answer, bur help [hem in an imeresting
way ro find answers ro rheir own quesrions.
Ofcen. by finding an answer ro their quesrion, many more rhoughrful questions will
surface and the library will become a fun
place where answers are found.
Quilrs can incorporate family hcritages
and rradirions and chis acrivicy as well as
Jearnlng co sew can be accomplished by both
sexes.
Children as well as adults can learn how
ro play a musieal insrrument or rwo much
more easily in a TV-Iess home. A number
of scientific studies demonscrare rhar rhe
developmenr ofdassical music skills in particular may actuaHy increase imelligence as
well as memory abilities. More is said abour
this in Chaprer 12 on rhe froma] lobe of
(he brain.
Wirhour TV you will have rime ro engage in physicaJ acrivities iliat will invigorare rhe mind and body. Some suggesrions
are listed in Figure 29.
AJrhough competitive sporrs are ro be
largely avoided for reasons oudined earlier.
(here are an abundance of ourdoor non~
competitive sports iliar can bllild endurance,
increase physical fitness) and involve rhe
entire family. Growing a garden can be aero-

bic, especially withollt a [iUer and the

ground is prepareel by digging. Our OWIl
children (pre-schoolers) are given a special
corner of rhe garelcn rhar rhey arc enrirely
responsiblc for preparing, planring, weeding,
warering, and harvesring. It is asronishing
ro sec how many lessons of life are learned
by rhe simple acr of gcowing a garden.
Even yOllng children can participare in
daily chores. At rJle enel of every day, rny
wife prepares a picrure lisr of the chorcs rhat
OlH five <Ind four year old boys are ro do me
following day. When rhey awaken rhey go
aur ro rhc kitchen ro see what chores they
each will be responsiblc for rhar day, such
as "chef's helper," setring rhe rabie, he/ping
wirh dishes aner rhe meal, emprying rhe
garbage, dusting, yard work, and purting rhe
toys away; al50 inclllded may be irems such
as a music pracrice, "school," erc. Ar rlle
time of this wriring. they each ger four or
five jobs per day ro accomplish. Each day
rhar rhey successfully complete their chores
WirllOut complailling or urgings r.o do so,
they ger a "srar" mar is pur under rheir individual name on rhe rcfrigerator. Afrer five
srars are accumulared they ger a "surprise"
which may be a few hours in the park with
Mommy ro ride bikes, a coloring book, a

Outdoor non-competitive 'exercise

Grow a garden
Participate in daily chores
Make home comfortable
and serene
Help others; offer your
services
Figure 29

321

PROOF POSITIVE

Use meal time as an educational

event
Daily devotioDS and Bible
study
Hymn singing
Prayer aud discussion of
spi1ritual values
Read tGgether

Figure 30

Figure 31

322

special coy, a book, erc. A1rhough rhere are

maJlyways ro teach cit Jdrcn tlte significance
ofchorcs, ir is important rhac they be taught.
The home should bc a place rhar is comfonable and ar times guier enough ro allow
crearive rhinking. Displaying the children's
artwork as well as having "masrer" arr\'/orks
or replicas around (har can be studied and
colltcmplaced wirhour a discraeeing celevision will bring greac rewards. Leuing chem
assisr wirhin cheir capabilities in laying ouc

the fumirure and artwork wiU add incerest.

Children need co bun how rewarding
ic is ro helI' orhers in need. There are people
in need in every communiry. Helping a
disabled person chat lives alone wirlt housework ar yard work as well as involving rhe
yOllllg in wholesome commllniry projeees
will teach the children [O seek our rhese rcfreshing and memorable experiences.
Spend rime in associaring with the famJy wirh a goal of developing famiJy values.
Some of the sllggesrions in Figure 30 1l.1ay
be helpful.
As a kjd, J remember my farher asking
me ar sllpper, "Wbat did you learn in school
roday?" It was nor only a reminder of why
1 was in school but ir lIsually generared a
discllssion that was mllch more educacional
and enrercaining chan the Ie.lrning experience ac school (har had prompted lhe discllssion. Family mealtime can be a nonintimidaring, rela.;(ing, but a highly educational event.
DaiJy spirirua.l devotions with associated
reading of the Bible, either in a group or
individllaHy, can gteac1y enhance ehe moral
and spiritual aspect oflife. Our young boys
have rhoroughly enjoyed learning some of
che great hYIllns. Their memory of rhe sranzas is grearly enhanced by the music. Taking rurns reading greac lieerature cogether is
not only pleasanr but thoughr provokjllg
and always gene.raees fascinaring discussion.
There are many kinds ofwholesome recre~eion available, some of which are listed
in Figure 31.
Withom TV in the home ir will be rnuch
easier to rolltJlely engage in ehese recrearional activiries lhat will likely be both
memorable and enjoyable.

Conclusion
Violencc in America is here ro stay unless we make some dramatic changes. 1 have
neithcr attempred ro denne the emire scope
of che probJem nor described ali rhe necessary changes ro fully address (his socieral
parasire. However, 1 believe we can do much
ro shift che momenrum away &om the growing problem ofviolence by individual commirrnenr ro rhe duce rasks olldined ar rlte
beginning of rhe chapter:

STEMMING THE TIDE OF VIOLENCE

Avoiding mind-aJrering drugs, including alcohol.
Re-prioritizing vaJues an.d embracing
high moral principles.
Choosing whote.some and true characrer-building acrivjries in our free
rime while avoiding activities assoc-

ared with fosrering unnecessary aggresslOn.

With each of us commining ro rhese
rasks, we will reverse rhe currenr rrcnd of
increased violence, and move in rhe direcrion of srcmming irs ride.

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21

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Professor Elizabclh cwson, head of rhe child dcvdopmcnt unit at

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1';

Kristoll. Sex, Violence, 3Jld Videolape. The WaJt StrurJouma/Tue day,

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25

10

Centcrwall BS. Tclcvision and violence. The scalc of rhe problem and
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IlCSSCS.

26

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18

Uoitcd Slates Department of HeaJlh and Hllman Scrvices. Violent and

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11

I
Unilcd Sl3les DepanmelH of Health :lIld Human Services. Violent and
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OCI;59(5): 1221 [229.

.10

323

PROOF POSITIVE
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EI/C)'cwpdii/ ofLeamini i/I/d Mtmory. New York. NY: Macmillan Publishing Co loc., 1992.

S7

AC Nielsen l"ompany. Nidsen Repon on lek'vision 1990. Nonhbrook,

III: Niclsen Media Research: 1990.

58

Flavell JH. The dcvclopmcm of childrcn's kJlOWledge "boutthe appeardislinClioJl. Am 1',-)'cbo/1986 Apr:41 (4):418-425.

19

32

J)

an<x-r~1Iil)'

}.( Cenlerwall BS. Tc1evision and violena. The scale of the problem and
where ro go from here. JAMA 1992 Jun 10:267(22):3059-3063.
~I

Oldenberg D. Prima! Screen. II1dJbingtoll PoIl April 7, 1992..

Bllshman BJ, Geen RG. Role of cognitiveemotional mediarofS and

individual di(ferenccs in the e/leets of media violcnce on aggression. j I'm
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)6

37 Lieben RM. E(fccrs of Idevision on childrcn and adolesce/lts. j Dcv

&liav Pcdiatr 1986 Feb;7( 1):43-48.
3B Zuckerman DM, Zuckerman BS. Tclevision's impact
diarrics 1985 Fcb;75(2):233-240.

OI)

childrcn. Pe-

Hickcy N. "Is TV Violcnc.c Bal'lcring Dur Kids?" TV Gllirk August

1992.

\9

'o ROlhel)berg MB.

E/fecr of rclcvision violence on childrcn and yomh.

JAMA 1975 Dec 8:234( 1o): 10431 046.

<1 Cenlcrwall BS. 'lelevision and violence. Thc scale of Ihe problem and
where ro go from here. JAMA 1992 JlIJl 10;267(22):3059-3063.
42

Carn(:gie Corpomion. Report, 1992.

43 Zuekerman DM, Zuckerman BS. lcJcvision's imJXlcr on chjldren. Pe-

diatries 1985 feb;75(2):233-240.

Peterson JL, Moare KA. Furstcnberg FF Jr. lelevision viewing and c.vly
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'S

Cenlerwal1 BS. Tdevision ami violena. Thc scalc of lhe problem and
where 10 go from bere. JAMA 1992 JlIn 10:267(22):3059-3063.

Cenlerwall BS. Television and violence. The scale of lhe problem and
\Vhere ro go rrom here. JAMA 1992 Jun 10:267(22):3059-3063.

.j]

.B Rubinslein EA. Tclevision and Behavior: Rescarch condllsion of lhe

1982 NIMH Report and lheir policy implicatiolls. Amcricitl/ Psye!JologiJt,
Jul)' 1983 p. 820-825.

<9 Krisloll. Sex, Violcllce. and Videola!'e. Tbe \'VIdISII>'l'ljourllJdTuesday.

May 31, 1994.

,0

Wbt:der JL. Remore C01llro/ltd: HOIIJ 7V Affiru YOII rl1ld Your Frwtily.
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,1 Drrroit NnllS.

Feb 16, 1997.

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Rees CR. Howell FM, Mir;leie AW Jr. Do High 5chool sports build
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60

61 KJeibcr DA, Roberts Gc. The EffeclS of polt Experience in rhe Dcvcl
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Todd Crossel. Univcrsiry of Massachuserrs (and coauthors ar Northea lern University .) quoled in \'V'arner R. AllItlysis: Football's lIiolma can

61

spi/l i11l0 priVflIt /ivrs, 1994.

6.'

Dmoil News

OC[

24, 1995 p. I IA, 13A.

64 Sportmllm: Gumlnik DB, editor. \flruslers New Word Dietio11dry-2'"'

Collegr erlition. lew York. NY: Simon ano Sehumr. 1984 p. 1377.

(os Srewnson. eL. College Alhletics and Characlet: Thc Oedinc and FaJl
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G6

r,7 Detroit NnllJ, OClOber. 24, 1995.

(. Mirade AW Jr, Rccs CR. Evioence of Ihe MYlh. In:

Less01/J oftbe Lock"

Room: Tbc mJth oj.fcbool ;poru. Amhersl, NY: Promelbeus Books. 1994 p.

223.
69

Quoltd in Detroit Nl'lVs. Oct. 24, 1995.

ro Mimde AW Jr, Rees CR. Ll'lJ011J ofrlu Loeker Room: TI)/' mytb Ofs{l1ool
spom. Arnhersl. NY: Ptomctheus Books. 1994.
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il

94-95.
\'Vl1ile EG. ErllICfllio1l. Nampa, 10: Pacilic Prcss Publishing Associarion, 1952 p. 210.

72

While EG. Educ{uion. N:unpa, ID: Pacific Press PubLishing Association, 1952, 1'.210-211.

73

'.\ While EG. EduClItion. Nampa, 1D: Pacific Press Publishing Association, 1952 p. 210.
\X/hile EG. MOlhers Helper's. In: Ad'femist Home. Hagersrown, MD:
Revic\V and Herald Publishing Associarion. 1952 p. 284.

7\

76 Proverbs 16: 18. TI}e Ho~y Bible. AUlhorized KingJames version.

77

PhiU;pians 2:3. TI1" Ho(y Bib/c. AUlhorized KjngJal1lcs vcrsion.

78

Banlert,B. NationaJ CelHer For Policy Analysis. QUOlcd in Detroit

Nnvs, OCI 23, 1995.

}} 2 Peler 3:4. T!J" Holy Biblr. AUlhorized Killg James version.

BaJaban DJ. Epidcmiologyand Prevenrion of Sdccred Chronjc 11Inesse. In: Cassens BJ, editor. Pr,.vmrive M,.dici",. anrl Public Hl'altlJ--2""
et!ition. Philadelphia, PA: Harwal Publishing, 1992 p. 147-149.

S6 Rees CR, Howell FM. Miradc AW Jr. Do High school SPOTI build
character? A quasi-c'xperimenl OI) a ualional sample. Social Scil'l1aJolimal
1990;27(3):303-315.

am ind"burlto lor! Whr,,/er fOr br/p in eompiling this and thefollotving

Wheeler JL Which DireClion 10 go? In: Remot" Colllrolkd: HOIIJ TV
Affim }Di arid }Dur Family. Hagerstown, MO: Reviewand Herald Pub-

\4

2 Corinrhi2llS 3: 18. TIu Holy Biblr. Authorized King James ve(sion.

79

80 /

li11L.

lishing Associalion, 1'.13.3-151.

324

CHAPTER FOURTEEN

STRESS
WITHOUT

"B

IST

uroed out." "Overloaded." "Exhausted." "Overwhe1med."

Many of the words we use ro describe life's rensious reflect the impact of stress an aur lives. lndeed, in aur
rime-pressmed sociery, few escape withour
feeling-at least sOlne of ehe eime-rhar
ehey are batding with srress. Thousands of
books and anicles have been wrinen an the
subjece of stress. Each, no doubt. has imparred some ideas on how co address stressrelared problems. However, 1 find that mase
people are sorely in need of soroe very
simple, basic understandings aboue stress
and how ro begin to master it. ConseL\uemly, my desire in chis is noe to deal with
srress n a compleee and exhaustive way. My
gaal is rather to provide a way of underseanding the srrcs-s process and ro share soroe
key ideas for deaJjng wirh seress in your Jife.
The imenr is nor ro give alJ rhe Jaresr breaking insighrs an how srress can affect aur
healrh-new repons seem ro come out daily.
Few need ro be convinced ehat suess can
undermine meir heahh. The great cry 1hear
is, "Yes, I know srress is affecring me, but
whar can I do abour it?" This chaprer is designed ta provide praceical answers ro rhar
queseion. When you have grasped rhe coneepts here, you should be able [O deal wirh
seress in a new and consrrucrive way.

SS
Seress affccrs us in cvery aspect of our
being, and the more hea1rhful aur lifesryle,
rhe bener we are able ro manage seress.
Implement.ing the complete lifesryle advocared in rhis book wilJ go far in enabling
you [O mascer the srresses in your life.
Before presenring ehe mcasures we can
take ro manage srress, we wiII fine describe
what srress is and what it is nor, and then
examine how it affects us physically, mentaUy, socia1Jy, and spirirually. We will aJso
look ar diseases and omer ailmenrs ehar can
be triggered by stress. Ar this poinr we wilJ
be ready to deal wieh ways ro maseer rhe
srress in Dur lives.

Differentiating between Stress"

and Stressor"
In dealing with stress, most of us already
have ewo serikes againsr us. The very language we rypically use ro describe srress decreases our abiliry ro deal with ir most effeceiveJy. Most people define seress by what
confronrs them-by the problems and concerns thar thel' have ro deal with. Such al1
understanding makes us victims of whaecver is going 011 around us. However, a huge
bodl' of research indic.1ees mat it is noe what
we have ca deaJ with bur ratber haw we deal
wirh it ehar diceaees ehe severity of seress in

325

PROOF POSITIVE
our lives. Simply pur, ro begin ro understand the mosr hllldamcnta! aspecrs ofstress,
we must unelersrand a critical disrincrion:
rhe difference between "srressors" anei
"srress," as iUusrrared in Figure 1.1

STRESSORS AND STRESS

Stress is your
response
to stressors

Good and Bad Stressors

Figure 1

EXAMPLES OF STRESSORS
Heat

Pollution

The flrst srressor on the list is rhe weltrecognized environmemal air pollurioll. Let
us as. ume rhar you mave from the country
nto a heavily pollureel foreign ciry. AJmosr
immediately you may begin coughlng as a
specific physical response ro rhe ph)'sical
strcssor of air pollution.
We see rhat srressors carne ar us an aII
aspects of our being. In addirion ro p/~ysical
srressors, rhere are mental stressors. These
may confronr us in rhe form of deadJines or
finances. The sociaL environmenr presents
irs share of srressorSj rhe)' ma)' occur in rhe
home, ar school, an (he jab, or in rhe neighborhood. There are 31so spiritual stressors.
These arise especially when aur externa! circumstances ar internal clecisions conflict
wirh our goals, values, ar religious beliefs.

Deadlines
Overload
Death

A popular misraken notion is ,hat srressors are ali bacl. Some may be good in rhemselves, bur may evoke a bacl response. For
example, 1 once heard a true story of a
woman who died when she was being
handed rhe gralld prize check from a lucrarive lotrery. Her anitude was emirely posirive, but rhe stress response was fatal.
Odler more common happy evenrs can
be significam Stressors. Family relarionships,
although they may be healu1Y anei pleasant,
can have periods of stress. Consider a family wedding. The prepararions leading up
ro the wecldjng day provide imense stressors for ali rhase imimately involveel. Incleed, the wedding experience is an example
of a joyful occasion dut is also srressful.
Anorher example is rhe srress associated with
bringing a new child imo rhe falluly.

Benefits ofStress
Finances

Ulness

Figure 2

326

"Stressors" refer tO olitside jOrces, which

are rhe problems anci concerns rhar we must
deal wirh in life. The rerm "srress" refers ro
rhe response of rhc individual ro rhese srressors. Some examples ofsrressors are depicred
in Figure 2.

Some stress responses ma)' be beneficia!.

AJulOugh mosr think ofsrress as somerhing
negarive, Dr. Selye recognizeel borh a good
anei a baei rype of srress. Selye deflned ('disrress" as the stress rhat was damaging or
llnpleasanr, 2 while rhe srress rhar resulted
in pleasurable ar satisfYing experiences he
called "eusr.ress."3 Or. Phillip Rice !las
poinred OUt thar eusrress can improve our
sense of awareness, promote aJertness, anei
can ultimarely resulr in superior perfor-

STRESS WTTH OUT DISTRESS

rnance. His examples are the scresses of
sports compedtion, a rhearrical performance, or a wedding ceremony.4 This relatjonship was fim published in 1908 by R.
M. Yerkes and J. D. Dodson. 5 The YerkesDodson law or curve described a relarionship berween srress and performance. An
adapearion of rheir curve is illustrated in
Figure 3.
The Yerkes-Dodson graph compares
work pressure and job performance. In place
of "work pressure" we could juSt as easily
Subs'lUre the term "stressor." Regardless of
what cerms you use, work pressure can affect job performance in a negative Of posirive way. 0,0 the far-left side of the graph
where work pressure is low, job performance
is aJso low. The individual is not sufficiendy
chaJlenged tO be very productive. Moving
lOward the righr, as rhe work pressure and
chaJlenge increase, job performance increases-finally ro its maximum amounr.
This is labeled "optimum work pressure."
Once a pe::rson reaches rhis optimal level of
performance, adding more pressure will
cause job performance (O dereriorate. Ultimare1y, r!le very hjgh pressure/high srress
environmenr resulrs in extremely poor performance. lf maximal ourpUl is rhe goal,
neirher over-pressure nor under-pressure is
optimal.
These observarions illusrrate ehat, contrary ro popular opinion, stress and srressors are essenrial ingrediems in our ]ives. In
fact, rhey are necessary components of an
efficient, useful, producrive, and sarisfying
life. These insights provide an explanarion
for individuals who seem to rhrive in rhe
face of many externa] pressures. Not onJy
are rhey producrive and positive; rhey are
also free of disease and have healrhy interpersonal relationships.
In realiry. each of us has our own YerkesDodson curve. Some need a large amounr
of work pressure, challenge, or stress ro
achieve cheir optimal level of performance.
This sarne level of stress would ovelWhelm
others. Nonetheless, [he principle is the
same for alI. Wc each do our best wirh a
certain level ofseress. Too Jiule ar too much
stress is coumerproducrive.
A certain level of srress is also necessary

WORK PRESSURE AND

JOD PERFORMANCE
Optimum work pressure
Inadcquate
work load

Added work
pressure

Work
underload

..- Work
overload

Low

Work pressure

High

Weak performance
Acceptable perlormallce
Peak performance
Figure 3

in aur social relarionships and orher aspects

of our lives. We would nor want ro evade
rhe pressures and stresses of life. They provide morivarioll and help us ro accomplish
more rhan we would orherwise. We allneed
ro havc a compelling reason ro ger up in rhe
morning. If our coping mechanisms are intacr, we will often be able lO rolerare and
even rhrive on more pressure and become
more efficienr and producrive.
One purpose of chis chaprer is ro offer
more powerful coping mechallisms. This
may al.low readers tO rolerare more srressors,
such rhar the increase wiU work for them
instead ofagainst rhem. As Rice put ir, "The
aim of stress managemenr is IlOt ro eliminare srress entirely, bur ro control ir 50 thar
an oprimallevel of arousa.l is presenr."6

List YtJUr Top Ten Stressors

Many people raday suffer from rhe impacr of srress in their lives and need he1p in
coping wirh jr. Ooe way rh:u 1 have rried ro
help is by conducting stress management
seminars. My rypical formar is ro meet with
the group one night per week for eighr
weeks. In rhe firsr meeting, 1 ask ali the artendees to lisr their tap ten s[ressors. The
reason for rhis is simple. The very fim srep
in learning ro cope wirh srress is tO recognize rhe sgnificam stressors in one's life. The
awareness tlur the stressor and the srress

327

PROOF POSITIVE
response are nor idenrica! is cririca! ro objectively examining life's streSSors. Thosc
wirh a faralisric arrirudc rhar porenr srressors are unconguerable are more prone ro
deny the prescnce of rhe very srressors rhar
rhey need ro idenrify and address. for example, if I rhink misrrearmenr \ViII likely
make mI" ill, rhen I am more Likely ro deny
ehar mistrearment exists, rarher rhan ro accept ir and rry ro deal wirh it. On t11e orher
hand, jf I recognize rllar my response ro
stressors is Iargely a personal choice, rhen 1
will be free ro acknowledge the stressor and
address it in a constructive way. Many
people have nor made a ddiberare evaluation of rhe primary stressorsin rheir lives.
IdentifYing the ten leading srressors opens
the wa)' for planning a process ta cope wid1
chem.
1 would encourage each reader ta wrire
down his or her most signiftcanr srressors.
The challenge in doing this exercise is ro

physical challenges Jike remperamrc C:ln bc

srressfuJ in rhe form of excessive heat or cold.
l Il rhis case, recognizi ng rhar you are living
in a c1imarc rhat is a ignificant stressor for
you may be rhe ftrsr srep in cbanging ro a
different line of work, ar making differeJll
living arrangemcnrs if you rema.n in dlar
c1imate. Remember ro also include rhose
'good strcs ors."
Finances, whether in povef(y ar in
wealrh, c.ln bc srressors. Individuals oflimired means often lisr ftnances as significant
srressors. However, insighrful wcalth)'
people may recognize ehar fUlances are even
gre.arer stressors for rhem. They may feei
great pressures in detcrmining whar ro do
\Vith rheir money, how (O invesr ir, aneI ho\\'
ro keep from squandering it. Others becolllc
plagued by a consranr fear of remrning ro
their former condition of poverry.
We will refer ro your lisr of ren srre.sses
in rhe nexr secrion.

Three Progressive Respon.ses to Stressors

REACTIONS TO STRESSORS
Phase 1

Alal'm reaction

Phase 2

State of resistance

Phase 3

Stage of exhaustion

Figure 4

328

apply what we have seen up ro uus poinr;

namely, srressors are not merely rhe mental
trials that lead us ro feei "srressed out.' They
include physicii illness and social relarionships. Dearh of a close family member is
known ta be one of rhe grearesr srressors on
rhe average individual and can have longterm implicarions. Even relarively mundane

_ _ _ _ _IIIIIIIIIIIi

Our response ro each of rbese srressor

is in parc a genera! response thar occurs as a
rea tion ro ali rypes of rressors. This is what
fhe srrcss pioneer, Dr. Hans Selye refecred
ro as the "General Adaprarion Syndrome."
He popularized a view of whar happens to
a person when exposed ro a suessor. AIthough mall)' stress rheorisrs have gone far
beyond Selye's insighrs, bis observarions
provide a good overview of rhe srress process. According ro Sell'e's observarions, an
individual's reacrion ro a new srressor is predicrable and progrcssive, moving rhrough
rhree srages. as illllsrrared in Figure 4. 8
As we explore rhesc reacrions, ask yourself it" you can see any of rhem transpiring
in your life. Particularly observe an}' associarion berween rhe tressors on your list and
rhese phases. Following rhar broader description of rhe stress process, l'ou should
be able ro determine how import;lllr it is
for l'ou ro masrer rhe srressors in )four life.
The fim phase is an alarm reaerion. This
is the body's "caII ro arms" and is somerimes
ciiled the acute or immediare srress response. Phl'sic.ll symptoms tend ro predominare in rhis rarher short-lived phase.
If rhe stressor cominues and rhe individual

\J

STRESS WTTHOUT DISTRESS

is "bie ro cope wirh it, Phase Il resulrs. In
rhis phase. the person is resisring rhe srresSOL The acure body [unction ehanges of
Phase Iare mosdy resolved ar this poinr,
and rhe person often appears ro be coping
weB. Those who are able ro cope with the
srressor ma)' remain in this sr.age in a heaJthy
state of resisrance. Orherwise, as rhe rressor is resisred, rhere is an expense. Energy is
expended as rhe person copes with rhe eOI\tinued presence of the srressor. Such a phase
can last for a prolonged period of rime; as
this stage progresses, coping ma)' become
more difficuit, anel menral and social efTects
of stress may surfaee. New physieal responses may al50 arise. If rhe srressor COI1rinues ro be present, it ma)' ultimately push
the person into Phase III, exhausrion. Onee
in rhis phase, if the suessor persists, disease
or even dearh ma)' be inevirable.

Body Responses to a Sudden Stressor

Upon sudden exposure ro a srressor, rhe
body auromaricall)' reaers to eause many sillluiraneous ph)'sieal effeets during Phasc 1.
Thesc efTect5 are designed to help in dealing widl the srressor. Let us illustrate how
these effecrs serve such a useful purpose by
imagining a siwarion where you are confronred by a stressor.
Assume that you are reading chis book
in your bedroom, and aJl of a sudden you
norice a full-grown riger beside your bed.
The feroclous animal has apparendy come
our of nowhere. and now it is growling ar
you, eyeing you as if you look like a good
mea!. This is a far-ferched illusrrarion, bur
it graphically illusrrares a stressor. lmmediately upon noricng the riger, your body
enters a stare of alarm wirh a number of
physical changes predom inati ng. These
changes are rhe result of far-reaehing nervous system eifects called symparheric nervous sysrem aerivation. Some of the cbanges
are lisred in Figure 5. 9
These responses have often been referred
ta as rhe "fight or Aighr response"-gearing you up ro eidler physcaJly do banle wirh
rhe sm:ssor or run from it. Your blood pressure rises as your hearr rate and the foree of
pumping increases. These changes allow for
grea(er dclivery ofblood to your museles so

that tl1ey can be active in rhe physical response of either fighring or running from
rhe srressor. While blood flow increases ro
the museles dlar need ro be active, (he blood
supply ro orher organs decreases. Since your
intestinal sysrem and kidneys ean get by for
a while wirh a redueed blood supply, rhe
body decreases blood flow (O those areas so
rhar more blood is available for rhe acrive
muscles. The pup ils dilace or open up ro
rake in more Jight. The bronchial tubes also
open up ro aHo\\! more air exchange in the
lungs. (More o"Tgen, ofcourse, will improve
physical performanee). Musele strength increases. Sugar is reblsed from rhe liver and
overall merabolism is stimulared. Even mental acrivity is quickened.
As helpfl.ll as chis alarm reaerion wOl.lld
bc in dealing wirh a tiger, man)' srressors in
OUl' lives do nor call for such ph)'sieal responses. Acrivation of Phase J may actllally
be counrerproducr.ive if rhe seressor is a
deadline, Ilnancial pressure, ar il home life
challenge. The body is geared up for aetiviry but physical responses will nor be hclpfuI.
Ahhough mental activiry is incrcased
under rhe aClIle effecrs of stress, the mind
ma)' actually be less foclIsed ro make an

PHYSICAL EFFECTS OF
A SUDDEN STRESSOR

Increased blood pressure

Increased beart rate
Increased beart contraction
~
Increased blood flow ta active muscles
Decreased blood flow to areas not needed for .
rapid activity such as the kidneys and intestines

Dilated pupils
Dilated bronchial tubes
Increased muscular strengtb
Release of glucose from Iiver
Increased mental activlty
Increased metabolic rate
Figu're 5

329

PROOF POSITIVE
intelligent decision. In fact, rJle mind ofren
has even greater problems when a seressor
persists and coping resources begin ro diminish. [n later stages ofPhase II, you may
begin ro notice some of the more worrisome
mental efTecr.s ofstress. Similarly, undeI' the
persistent effects ofa stressor, problems also
tend ro deve10p in your social relationships.
Ofren these deleterious mental and social
effecrs are closely related.

MENTAL EFFECTS OF AN
ONGOING STRESSOR
Mental fatigue with a loss of spontaneity
and creativity
Confusion, including forgetfulness and
difficulty in making decisions
Anxiety, including feelings of panic
TensioD, frustration, irritability, anger,
and resentment
Depression
Lower self worth
Lower inteUectual
functioning
Boredom

Mental and Social Responses to an

Ongoing Stressor
Dr. Phillip Rice has described the menrai and social effects ofpersistene job-related
seress. 10 His observations are generally applicable ta any ongoing mental seressor. His
descriptions of thc mencal and social effects
ofsuch stress in adapted and modified form
al'e preseneed in Figures 6 and 7.
Clearly, concillued exposure ro a stressor can remit in a variery of bodl mental
and social cffects. An awareness of the great
variery of ways that stress C'l11 rake its toll
can help LIS W be more undersranding when
we 01' others clase ro liS are dealing wirh rhe
ongoing effects of srress. Ali of the mental
and social effects of stfess are red flags that
should be inrerpreted as indicarors that
Phase 3, Seage of ExJ\austion, could be imminenr. In fact, some of the more dramatic
manifestations rhat 1 have poinced outsuch as depression, or loss ofcoutrol-may
even indicate that Phase III has been
reached. In such cases, immediace action ro
deal efTectively with scre.ssors is urgenr. lf
you f1nd yourse1f in such a situation, look
carefully ac yom ten major scressors. YOtl
need ro deal wirh rhese areas as soon as possible.

Figure 6

SOCIAL EFFECTS OF AN
ONGOING STRESSOR
Procrastination, avoiding important work and
home responsibilities
Lack of concern for others and a resulting deterioration
in relationships
Reduced effectiveness in communication, including an
inability to listen to others
Emotional hypersensitivity with a tendency to overreact
to others, or feelings of isolation and alienation with
a tendency toward suppression of feeliogs and
even witbdrawal
Loss of control, quick temper,aggression
Increased risk-taking behavior
mcluding gambling
Increased drug use aud abuse
Figura 7

330

Spiritual Responses to an Ongoing

Stressor
The likelihood of successfully dealing
witll ongoing stressors Cal\ be signiftcantly
enhanced by a strong spiritual basis in one's
life. Unfoftunarely, persistent stress can .also
erode our spiritual moorings. Indeed, not
oltly does scress affecr our physical, mental,
and social nalures; stress can a1so affect the
spiritual djmension of our charac[er. It is
interesting ro note mat some people seem
"inoculated" from spirirual disn:ess because
of the be1ief system they espouse. Since I
am a Christian, most of my experience with
strong spiritual beliefsys[ems comes from a
Christian perspective. 1 have noriced [hat
[here are some individuals who never seem
distressed no matter what confroms rhem.
In general, they have imernalized biblical
princples such as, "we know that aII things

STRESS WITHOUT DISTRESS

work rogerher for good ro chem dur love
God, ro [hem who are rhe called according
tO His purpose." (Romans 8:28). Even when
chings rhar look bad happen ro such individuals, chey believe mat some good wiJl
ultimately resulr.
On the orher h,Uld, rhere are peopleincluding Christians-who have incernalized ocher spiritual principles that are neirher helpful nor biblica!. One of rhese principles is the so-called "prosperiry docrrine."
This teaches rhar ifa person is good enough
(or has enough f..irh), rhen he or she will
have bendlrs such as financial prosperiry
and healing from any physical disease. It is
obviolls how desrrucrive (Jogoing srress can
be ro such a spirirual beliefsysrem. When a
spiritual sysrem can nor incegrace difficulry
and adversiry imo a positive life outlook,
chen chranic srress can produce some distressing spiritual effeces. Some examples are
listed in Figure 8.
Those who believe thac God will always
prevem adversiry may have difficulries ehat
can cause them ro qllesron their values and
faiili. lf rheir religion was rlle main influence in giving meaning :lnd purpose ro their
life, rhen such questioning usually leads co
a loss of chese critical emotional bulwarks.
Their fath may be blamed ar abandoned
in rhe face of che very difficulries rhar it was
supposed ta prevent. Solurions ilien must
be looked for beyond dle Spil'irual framework that rhey had once embraced. Ironically, rhis may be a very healrhy-aliliough
disrressing-process. It is often rhe case thar
significant spiritual dismss indicares a faulry
betief syscem and a need ro re-evaluate ilie
assumprions of spirirual convictions.
Throllgh such a process, many have carne
our of difflcllities with a stronger anei more
endllring faith.
Ooe of rhe c1assic examples of this is
found in rhe 73rd chapter ofPsaJms. There
ilie psalmist describes how he h;ld cspoused
rhe doctrine of prosperiry and experienced
severe srress as he wenc rhrollgb difficulry
while "wicked" people prospered. He describes his severe spiritual dstress in these
rerms: "
ali che day long have 1 becn
plaglled
~ and "... ir was tOo painful for
me." However, his questioning causes him

ro re-examine his fairh. As he reflecrs on

God's revelarion in "rhe sancUlary," he appreciares a new dimension to God's characreI' and faid). He wrires, "Unei! 1 wene inco
the sanctuary of God; chen understood 1
theu end." He rhen lIndersrands how a JUSt
God can a1low the wicked tO prosper il) rhis
life and someone like him wirh faidl ro
srrugglc. His burden is lifted and he ends
rile Psalm on a note of praise.

SPIRITUAL EFFECTS OF AN
ONGOING STRESSOR
Questioning your values aud faith
Losing the meaning aud purpose
of life
Blaming God for problems
Abandoning faith
Trying Ito tind solutions
apart from God aud
religion
Figura 8

1 nnd rhis Psalm very inreresring because

it depicrs someone who, becallse of s(ress,
qllesrioned his faith in God bur did nor give
it up. The individual only leii: ilie erroneous porrions of his beliefs.
It is a tragedy rhac many individuals (especially, but not exclusively, younger individllals) have misunders{,mdings about God
and rhe teachings of the Bible. When ehey
have problems, rhe)' rejecc (heir Elirh rather
rhan follow t\le Psalmist's example. lf rhey
would re-explore cheir [-uth in lighr ofGod's
reveJarion in rhe Bible, which may prompt
a deparrure from cheir former understanding of God, iliey may find answers ro life's
deepest problems. Spiritual discouragemcnr
reslliting from ongoing srress demonsrrares
dlat a person is nor coping well on a spiritual level. This is an indication of a need
for a higher power rhar can ilHegrate adversiry inro a healrhy ourlook on spirituallifC.

331

PROOF POSITlVE

Physiological Damage/rom an
Ongoing Stressor
We have aIready examined the physical
effecrs of sudden scress. Regarding an ongoing srressor (har produces serious ongoing stress, che social, memal, and spiritual
effects are often ilie mosc visible. Physical
effecrs of che srress may be occurring invisibly, under the surface, only ro explode in
an acute illness or a dramaric life-rhreacening evenr. Some of chase chronc effects are
relared ro a weakening of the immune sys-

STRESS-RELATED ILLNESSES
Stress affects the onset, treatment or recovery from , . , '
the following diseases and conditions.
1
~ajor

iIInesses

Other ai"~,ents

Cardiovascular diseases Muscle - rclated conditions

(e.g. coronary artery disease,
and Uroke)

Cancer .
DepreSSlOn
Angina pectoris
Diabetes mellitus
Tuberculosis
Rheumatoid arthritis
Hypertension
Ulcers
AIDS

(e.g., (ension beadacbes, oral condllions,

body aches and pain.)

Allergies (e.g., a,thOl., bin's, bay fever)

Common colds
Premenstrual tension svndrome
Warts
.
Skin rashes
Loss of hair
Graving of hair, dandruff
G "t
ou
Herpes

Figure 9

rem; others may reiare ro an acceleracion of

arherosc1erosis (hardeniug of the arreries).
There are many indicacions rhac chronic
scress cal1 be a ca/ISI! of disease, a factor in
intl!nsifYingan exisril1g djsease, Of an impediment ta the Tecavery from disease. There is
no scientific measuremem, however, such
as a blood resc, thar can verify or measure a
person's level of srress. AII Stfess level indicarors are subjective. A$ a resuJc, one can
never be cercain in any specific case rhar a
disease was caused by suess or rhac srress
was even a factor in che callsacioll or lack of
recovery from a disease. However, I have
seen cercain cases in which there were definice indicacions poincing ro stress as che
cause of a disease. 1 have seen other cases in
which srress appeared ro be one of severa!

332

causes, and still orhers in which suess appeared tO hinder recovery from a disease.
On the ocher hand, 1have seen patiems wid,
ca.rdiovascuJar disease, for example, in which
srress did nor seem tO be involved. A c.lassic
example is rhe happy-go-Iucky person who
from aiI appearances leads a low scress life,
yer smokes, fails ro exercise, and ears
unhealrhfully. A hearc arrack may oeeur for
obvious reasons, wirh no apparenr involvemem of srress.
Many rimes after a hearr attack is diagIlosed, (he pariem asks, "Could srress cause
this?" 1 respond dur stress can conrribure
ro hearr arracks. 1 aJso poinr ouc chac even
when stress is a faecor ic usually does nor
act alone. Typically, there are orher underIying factors such as parciaJly blocked arreries, an unhealchfuJ diec, and perhaps high
blood pressure and/or h igh cholesrerol.
Unconrrolled anger or soroe orher reacrioll
caused by scre. s eould have rriggered (he
hearrarraek. But such an emorional response
wouJd not likely have caused a hearr arrack
if che hearr's arceries had been free of cholesrerol blockages. Many illnesses are known
ca be affecrcd by suess. The major ones are
lisred in Figure 9 in the left hand eolumn. 11
1 have seen many cases of heaT( disease
and cancer in individuaIs who were deaIing
wich major life srresses. Afrer che deam of a
loved one, me surviving spouse has been
found to have a grearer risk of a heaT( actack, especially within six monchs of che
105s. 12 Similarly, in rhe comexc of bereavemenc, the remaining loved one may develop
a fatal canccr-presumably because stress
weakened his or her immune sysrem. The
mose exrensive research smdy thar 1 have
found on rhis subjecr observed over 1.5
million married Finnish persons for five
years. 13 The researchers conc.luded: "The
resuhs are consisrenc wirh rhe hypochesis
mar excess mortaliry afrer che death of a
spouse is partly caused by scress."
Diaberes ca.n be more difficulr ca control in patienrs under stress. 14 Infeccious
diseases such as ruberculosis are more likely
ro spread and dominare rhe body if me immune sysrem is weak; such weakened immuniry can occur if che pariem is unable ro
cope with srress. 15

STRESS WITHOUT DISTRESS

Ailmenrs other than major illnesses are
also stress-related. These are listed in the
right hand column ofFigure 9. You do nOt
have ta be llnder an excessive amount of
stress [O develop any of these ailmenrs. Howeve.r, stress seems sufficient ta increase rhe
risk of these conditions or ac least hasten
their presentation in mose genetically or
environmeneally predisposed.

Depression/rom an Ongoing Stressor

One of my particular concerns is the

great increase in the number oftkpmsion cases

rhae 1 have been seeing in my oftIce practice. O[her physicians are reporring similar
increases. 16 Somc facts about deprcssion are
listed in Figllre 10.
Fi rst episodes of major depression his~
torically occurred ac middle age. We are now
frequendy seeing mose initial episodes at age
25 or younger. Furrhermore, ehose who are
currendy ac middle age have a greater risk
ofsuffering a major depression now [han in
previous generations. What are [he reasons
for these increases? Some have suggested [hat
there is more to be depressed about in our
sociery. Others have asserted that fewer
people today have deve10ped adequate copillg mechanisms for suc.ss.
Thus far, we have examined some ofthe
widespread physical, mental, social, and
spiritual effeccs ofstress. AJI of this begs ehe
question-what can we do about it? How
can we bring suess under conrrol? The remainder of ehe chapter presenrs some key,
yet oh:en overlooked, stress conrrol concepes
ehat can revolurionize your dealing with life's
srressors.

Eight Keys to Successful Stress

Management
There are many techniques mat can be
helpful in dealing with srress. However. 1
have idemined eigbe key stress con eroi or
seress managemem measures duc I believe
are underurilized, but are of profollnd irnportance in helping us deal with srressors.
Review ilie list of ren leading stressors ehac
I encouraged you eo wriee earlier. With these
srressors in mind, look ac ebe control measures pre-semed below. Sec if you can iden-

rif)r ways ro use these me-.lSures ro address

your mose significam stressors.

Healthy Adaptation
The first key suess control measure is
what r caH "healthy adapr<ltion." Ta .illustrate, consider this situation: you are sleeping at Ilighe with the bedroom window
open, and awaken at 4.00 a.m. because yOll
are cold-ir is a physically stressing situation. Wha[ are your options? One is ro get
lip and pile on more blankets. A second is

DEPRESSION IS INCREASING
1. The number of people developing
depression worldwide hacs steadily
increased sinee 1915.
2. The disease appears to be striking
at an earlier age.
3. Major episodes of depression nQW
occur frequently by age 25.
4. OveraU risk of depression
bas increased over time.
Figure 10
ta turn up the heat. A rhird option is ro get

up and shut r.he window. A founh might

be co flrst close the window, and rhen get
dressed and prepare for the day's workpareicularly if you are wide awake and feel
refreshed. If you choose the final option,
rhe stressor may acrually have been turned
inta an advamage.lfyou really had adequate
sleep, the srressor worked for you instead of
againsr you. You got tip earlier and accomplished more than you would have orherwise. Ultimate1y, ehat 4:00 A.M. rising rime
probably helped you ro relieve stress. It
he1ped you ro ward off orher potential stressors: maybe you paid some bills, c1eaned ehe
kitchen. or finished up a projecr you
broughr home from work. Although we
eould debate the merits of each of ehe four
different options for dealing with the cold
room. aU of chem were accually examples of

333

PROOF POSITIVE
heaLthy adaptation. In each of those sce-

334

narios, l'ou addressed the srressOf and wem

an with your life.
What would rhen be an jl\usrration of
an unheaLthy response? One example would
be tO arrempt ro ignore the stresSor, continue lying in bed, and try ro go back ta
sleep. This approach may leave you shivering-and frustrared that you cannor sleep.
The message is that ignoring a srressor is
rarelya healthy response. However, when a
seemingly overwhelming srressor confrollts
liS (particularly on either ilie social, mental, Of spiritual level) sometimes the best
option that is apparent is ro ignore the stressar. We may be so stressed that we do nor
see construcrive oprions. Ignoring the presence of the stressor may allow us ta transi~
tion from the stage of "alarm" ro thar of"resistance" where we can then look more consrrucrive1y ar ways ta adapt.
There are mher unhe.1lrhy ways ro deal
wirh srressors. Another example in our cald
room scenario would be escapism. An application of this technique may fiud you
shivering at 4.00 a.m. as yau call yotlt 24hour national rravel agency and reserve a
place on the nexr plane ro Hawaii. While
you are on the beach in Hawaii, it may seem
that the stressor worked ro your advanrage.
YOl) have escaped the cald weather and are
enjoying Hawaii. However, when you return home ro find the window still wide
open, snow in your bedroom. and the bathroom pipes frozen, yau realize you should
have addressed c.be stressor by c10sing the
window before you leh:. Besides rhat, when
you are fired from your job for an unapproved absence and then get the credit card
biU from the trip, rhere will be more stress.
Escapism is not an optimal way ro respond
ta a srressor; it can sometimes email somc
hllge COSts. However, it may be the only
strategy someone identifies ro "buy time"
in the face of an overwhelming stressor.
Many see escapism as an extension of
ignoril1g rhe stressor. Whel\ you mentally
ignore a stressor, the implication is that you
are remail1ing in rhe environment where the
seressor is confroming you withollt addressing it. The stressor cominues ro work an
yOUf physiology no matter how successful

you rhink yau are in ignoring it. When you

physicaUy escape from a srressor's sphere of
inf1uence, yom body can get some respite.
The trip ta Hawaii il1usmHed this. Yer, if
rhe escape was impulsive, rhere may be
heavy prices ro pay. Most of the time, howcver, escapism occurs on a mental leveland is, indeed, an extension ofignoring ehe
srressor. The person remains in rhe presence
of the stressor, but tmns ro a mind-alrering
escape to help forget about its presence.
Such an escape can be as diverse as warching relevision ar raking a mixed drink. This
rype of escapism is worse than a futile artempr ro ignore rhe srressor. Since you are
stiU in the scressor's domain, your body conrinues through rhe phases of rhe General
Adaptation Syndrome with progressively
weakened coping reserves. Ar rhe same time,
your reserves are usually furrher sapped by
the agent used ta effecr rhe escape. For example, alcohol impairs rhe brain's frontal
labe where decision making and construcrive solurioIlS are based. On rhe other hand,
viewing television, even in ies highest form,
cakes time away from activities such as exercise that could help enhance your coping
reserves ar defuse srress.

A Healthy Lifestyle
The second key mechanism for coping
with srress is a healthy lifesryle. The more
efficienrly yOllr body fUllcrions, the better
you will be able ta have rhe coping resources
ehar you need. Expressed another way, a
healthy body aod mind give you the upper
hand in coping wirh the srresses that you
face. Even ifyou are exposed ta srressors (hat
you have not yer removed ar adapted ro,
better healrh will heIp ro shield you for a
longer period of time from some of rhe
healrh-robbing effects of mess.
One critica! element ofa healthy lifesryle
is proper nutrition. The consistenr dietary
plan that I describe throughour rhis book is
a general health-inducing program. The
same basic guidelines that help prevem hearr
disease and cancer also help to boost energy
levels (see Chapter 9 on melaronin), improve menral dariry (see Chapter 12 an the
fronral lobe), aJld thus enhance one's abilit)' to deal with life's stressors. Ideal with

STRESS WITHOUT DISTRESS

this in many ways througholit this book;
detailed repetition here is unnecessary. Suffice it to say mat eating foods exclusively
from plant sources provides oprimal nurririon (O help one cope mosr effectively with
Stress. Also beware of "refined foods"--even
if rhey are from planr sources. For example,
choosing refmed grains inscead of whole
grains (such as white flour in place of whole
wheat flour), deprives yourself of the oprimal mix ofvitamins and minerals found in
the natural planr produce.
Anorher key component of a healrhful
lifestyle is regular exercise. The medicallircrarure documenrs rhac regular physical exerc.ise is very beneficial in menral healrh and
srress control. l ? Regular moderate exercise
also appears ro help the immune syscem,
cJms conceivably helping ta ofTsee srress-related immune suppression. 18. 19.20 When my
paeients are under excessive stress, 1 instrucr
them co adopc a regular aerobic exercise program. A daily brisk walk in the fresh air for
45 minuces, or a cun, or a swim, or bicyding proves ca be very helpful. Within one
week's time chey are lIsllally coping much
bener wirh their stress. In face, many of my
parienrs have mld me that daily exercise is
one of [he most helpful seress-relieving recommendarons that 1have ever givcn rhem.
Beyond nucrition and exercise, chere is
mllch more rhat could be said abolit a
healthy lifestyle. It is one of the principle
theme.s of rhis emire book. I would refer
you particularly co r!le mapters on ilie frontallobe (Chaprer 12) and melatonin (Chaprer 9) for ocher aspects of lifestyle that deal
with enhancing menral and physiologic
functions mat are crucial to oprimal srress
management. In addition, 1 will address
anorher of che key lifestyle factors, adequate
resc, later in this chaprer when we look ar
dea!ing wirh arWety and worry.

Commitment to a Cause That Helps

Others and is Approved by God
The third key measure for conrrolling
srress is commirmenr co an honorable cause
thac he1ps others and is approved by God.
The Bible provides some exceUel\t examples
along rhese lines. One of my favorires is

found in Isaiah chapcer 58. This entire mapter is one of rhe Bible's mose sublime prescriptions for health. Ooe passage describes
ehe posirive rcsults experienced by those who
help others, as quoted in Figure Il.

SPEEDY RECOVERY
"Is not this the fast !bat-J--.,-ave-cho~? to loose
the bands of wicke(lness~'o undo the -heavy
burdens, and let thti~pressed go fr~~d
that ye break every 10~~? Is it not to ~eal ~ttiy
bread to thi hungry, ~d tbat thou brmg the
poor thatjre cast o~t'to thy bouse? when t u
seest the,Daked, th~t thou cover him; and t at
thou hide not thys,lf from tbine own fleh' Then
shaU t;t{y light brakl;forth as the mornin ,and
thin/health shall springforth speedi y: and
thy f-igllteo l l slU\SS shall go before thee;}be glory
of the Lord shan-beYflty-ure~

10

Isaiah 58:6-8
Figure 11

Isaiah states thac our OWI1 healrh will be

improved by helping others, sLlch as sharing our food wieh tile hungry Jnd providing dorhing for those that need it. AII this,
of course, includes helping our own family
members as weB as strangers. Modern science indicates thar there are quantifiable
healrh-giving benefits to this Bible-ordained
approach.
One way of looking ar rhis issue is to
scudy the medicalliterature 00 the subjece
of"volunteerism." In general, this rese-arch
seudies people who have made a commitmenr [O help those around them by giving
[heir services free of charge. In a recent srudy
of retirees, those who volunreered more rhan
10 hours weekly demonsrrated a grearer
sense of meaning as documented by significantly higher scores on a specific Purpose
in Life tese. 21 Helping others provides a sense
of meaning or purpose in life that is cricica!
in dealing with cerrain seressors. In one
study ofphysicians, those who had the gre-acesc sense of purpose in life had the least
amount ofanxiery regardi ng death-the fcar

335

PROOF POSITIVE
of which can be agreat stressor. 22
Panicipating in the lives of odlers on a
sociaJ basis has been found ro have significam physiological benefits. For example, in
one study of patiems who had recenrJy uodergone he.art surgery, higher levels of social parricipation were associaced with betcer health six months after surgery.23 This
cumulative evideoce in rhe research literature dearly indicaees the srrcss-relieving benefits of engaging in causes thar are respectfui ro both Gad and man. It is well established tim tbose who go through life fulfiJling their own personaJ desires, bue noe
being mindful of the needs of others, acwaJly deprive themselves of the healrh-giving
benefirs of altruism. We cach actually need
[O become personally involved in causes that
meer God's approval and help humaniry.
lsa.iah 58 provides further insighrs reiating personal healrh to performing deeds of
kindness. Notice the passage quoted in Figure 12.
As we "saeisfy ehe affiiered souL" we experience God's special guidance and blessing. When we go through our own personal
rimes of crisis, ir may look spirirually as if
we are in a rime of droughr-cur ofl from
ali spiritual aod emotional sustenance. How-

IMPROVING THE
IMMUNE SYSTEM
"Aud if thou draw out thy soul to
the hungry, and satisfy the afflicted
souI; then shall thy fight rise in
obscurity, aud thy darkuess be as
the Doonday: and the Lord shall
guide thee contiuually, aud satisfy
thy soul in drought, aud make fat
thy bones: aud thou shalt be Jike a
watered garden, and like a spring
of water, whose waters faiI not."
Isaiah 58:10,11
Figure 12

336

ever, even in mase situations, God promises ro satisfy our souls ifwe are helping orhers. We sec in rhis promise a profound description of a person under srress mat ultimateiy f1nds reliefas a result ofhelping othees. Parc of the hllfillmenr of that promise
comes as a God-ordained consequence of
assisring others in affliction.
God's promise ro "make fat ehy bones"
,couJd also be rranslated as "strengrhen thy
bones." The Hebrew word rendered "make
fac" or "srrengrhen" is ofren used in che Bible
wich strong miJitary connotations. Fot example, in Numbers 31:5 the Bible speaks
of "rwelve rhousalld rmen] armed for war."
The word rranslated "armed" is the very
same Hebeew word chac is rranslated "made
f.u" in Isaiah 58. This woed rhen has che
connoeation of equipping ca fighc. In other
words, God's promise tO "make fat ehy
bones" suggests mac our bones are ouctitred for banle, JUSt as a soldier is anned for
war. This banle imagery is very appropriaee
when we think of the role of aur body's
immune syseem. Whiee blood ceIls are critic'll immune syseem ceIls ehar form in t,he
internal recesses of aur bones known as the
marrow. ThllS, if an individual's immune
syscem has gone awry, it is noe uncommon
ro extracr a sample of rhe bone marrow eo
seudy the probJem. Our key immune system cells depend an a heaJthy banc marrow.
In addirion, ehe red blood celIs, which
carry vital oxygen ro ali pam of me body,
also form in [he bone marrow. Furrhermore,
the platelets, which protecr us from bleeding ro death when we are injured, are produced rhere. Our bones clearly play a vital
role in protecring our heaJth. It is thus no
idle promise for [he Scriptures ta pledge to
serengthen our bones. In mese words is a
sublime assurance of God's exua help in
fonjfying us againsl stress and ilJness if we
become involved in causes thar honor Him
as well as our felJow humans.

Plan Properly
The fourm key approach for conrrolling
stress is ro take cme to plan properly and
be organized. Many people sufTer srress-reIared problems because chey have noe

STRESS WITHOUT DISTRESS

planned properly. Life becomes confusing
and uncertain withour order and organi7.ation. In Luke chaprer 14 Jesus asked a reUing question thar sheds lighr on rhis ropic.
His words are quoted in Figure 13.
Proper planning and organizarion are
required ro determine whar it wiU rake ro
accomplish a task before you begin. We c.an
ali r.hink of insrances in aur own lives in
which rrouble-and perhaps even miseryresuhed from a lack of planning.

Do NOf Be Anxious About the Future

The f1frh key approach ro conrrolling
stress is to refrain Erom being anx.iolls about
the future. At first. this may seem inconsistent with the previous poinr that emphasized planning and organization. However,
rhe rwo ptinciples complemenr each other.
Without proper planning, it is natural ro
become anxious abour the future. A student
who is preparing for an upcoming tesr is
benefired bya cereain amounr ofsrress. This
rype of ('eustress" sholild provide motivation ro srudy and prepare for the examination. However. it would be self-defearing ro
be worried and anxious abour the test. Acrually, worry tcnds ro incapacitate, whereas
a healthy i1rritude roward rhe srressor-seeing it as a chaJlenge-rends [Q motivate.
Fearful of his lack of knowledge the student may be tempted ro say, "Wby even rry?
I can never master this subject in time for
rhe test." A more constructive arrirude
would involve organizarion and planning
wirhour worry. The student may say: "1 have
rhree hOUfS yet rhis evening; let me see what
1can leam." Agai n, rhe Scriptures are ofhelp
on this poinr. as quoted in Figure 14.
Jesus is nor speaking against planning.
This wOllJd conrradicr His previollsly
quoted statement in LlIke 14 rhar lends
implicit suppon ro rhe importance of planning. Jesus is saying. "Once you properly
plan and carry our rhar plan. do not worry
abour romonow." ln orher words, tOO1orrow will bring what jr will. However, in our
iUustration of taking a tesr. it would be foolish for a student who was nor srudying ro
say. "1 am ar peace. 1 wiU nor worry abour
the tesr nexr week. God will help me when
rhe day comes." On me ocher hand, the Stll-

PROPER PLAN
G
AN ORGAN ZATION
"For which of you, intending
to build a tower, sitteth not
down first, aud countetb the
cost, whether he have
sufficient to tiuish it?"
Luke 14:28
Figure 13

dent who is djfjgently studying should not

worry that the teacher will make rhe rest
roo diftlClllt, or rhat srudying willnor help,
or thar a failing grade will be rhe reslIlr.
Worry and anxiery abour rhings rhat we
cannor change are sdf-defeating. No one
roday can address what romorrow \Viii bring.
However. if r.he problem exisrs roday and
needs ro be addressed roday, men we should

DO NOT BE ANXIOUS
ABOUT TOMORROW

Figure 14

337

PROOF POSITIVE
address it roday. This takes planning, organization, and morivarion. Before we have
rhe rime or opporruniry ro address the issue, however, we should nOI worry abour
it. Jesus is calling us ro do whatever work or
planning rhat is necessary for roday. Ar rhe
same time He is advising us ro stop agonizing over rhe fmure. Such worrying wiU always be a source of significam srress, and
be counterproducrive.
This dimension of freedom from worry
may nor only have benefits concerning srress
management, it may also have profollnd
physiological bendtts regarding our body
funcrions. As 1 poinr out in the chapter on
rhe frontal lobe, spontaneous regression of
cancer (SRC) may be Linked ro a mental
arrimde that is free ofworry. In SRC a person wirh a fatal cancer survives independenr
of any rreatmem. Based on the research of
Yujiro lkemi, Dr. Larry Dossey bas observed: "Ohen a prayerfuI, prayer-like ani-

THINKO THESE THINGS

."FinaUy bretbren, ,vhatsoever things
are true, ~hatso~Ver things are 6&n,est,
whatsoever things are just, whatso~ver
things are pure, rhatsoever thingi are
lovely, -Whatsoever things are of good
report; if ther tie any virtue, ana if
ther.e/be any praise, think 00 thjse
thiQ:gs."
(
/ .
Phili ']Jians 4:8
'--~

Figura 15

338

rude of devotion and acceptance-nor robust aggressive prayer for specific omcomes,
includ ing eradication of the cancer-precedes the cure."24 He furrher pointed our
"aII rhe paeienrs [who experenced SRC]
gave themselves torally (O the will of God
after learning rhey had cancer."25 It may be
connecrion wirh God duough prayer-and
a willingness ro accepr even il1 healrh and
adversiry that besr paves rhe way for healing.

Furrhermore, anxiety has the abiliry ro

shorr circuit one of the most importam
suess-relieving lifesryle choices; namely,
adequate rest. Four dimensions of rest are
presemed in Chapter 20, "Beyond rhe Leading Causes ofDearh." Two observarions regarding rese are applic.1.ble here. First, sleep
is a needful rescoracive process thar is essentiaI ro mainrain our maximal coping resources. Second, sleep expens idemify srress
and anxiery as key causes of insomnia. Dr.
James Peri in his book, Sleep Righr in Five
Nights, observes rhar anger-one of rhe
most common human responses ro srressors-is a cause of insomnia for many
people. 26 These two poinrs lay rhe foundarion for a "vicious cycle." Srress interferes
wirh sleep leadillg ro more difficulry dealing wich scressors. This in turn can promore
more distress and furrher worsening ofsleep
difficulries.
One way to break the cyde is ro address
rhe anxiery or anger by bringing your concerns ro God rhrough an acrive process of
medirarion and prayer. Realizing rhar you
can trUSt God wirh the future may be che
missing ingredient in addressing rhis dilemma. Orher cycle-breaking approaches
focus on maximizing rest and sleep even in
the midsr of disrress. Please refer ro rhe information in Chapcer 9 and Chaprer 20 for
sleep-enhancing insighrs.

Think on Elevated Themes

The sixth key defense against srress

comes from thinking an elevaring rhemes.

The Holy Scriptures again provide meauingful guidanee here, as quored in Figure 15.
The Scriptures here admonish liS ro direct our minds tO e1evating arrribures such
as rrurh, honesry, puriry, and goodness. If
we wam ro masrer srress and have ir work
for liS rather than against us, we need [O
focus on uplifting themes. Unfoftunate1y,
most of us have a tendency ta dwell on rhe
negative. It is easy ro forger rhe many good
rhings rhar we have enjoyed in rhe pasr and
are presently experiencing. But is aur pessimistic bem withollt foundarion? Madison
Avenue is successful largely because rhe)'
foeus our attenrion an whar we do nor have,
awaken in us a desire ro acquire rhose very

STRESS WITHOUT DISTRESS

things, and make lIS disconrenr. Fanning [he
flames of disconrent Jnakes for good marketing. However, we make the choice to listen to the ads on the radio and watch them
on TV We c!toose to reaei newspapers ehae
coneain me ads. We need to realize chat what
we see and hear-even in che way of commercials-is largely under our comro!.
If we wanr to deal opeimally wieh scress,
we wiU do whaeever it takes to protect oursclves from ehe commercial cuhure of our
day and (he spirie of discol1tene thar it
arouses. We must srrive ro focus on what
we do have-rather than on what we Lack.
Let us nor allow the baei to overshadow (he
good. but in ehe words of the old hymn, let
us "coLIne aur many blessings, name chem
one by one." Such an aui rude wiU help ro
strengthen aur immune systems and our
abiLities to cope with difficulties. Advice mac
should be a hclp to alI who wanr ro opcimally manage stress is quoted in Figure 16. 27
Some families formaJly express gratirude
and praise (Q God ac mealtime. This is a
good start, bur a spirit ofgraeitude and praise
goes beyond a few shorr prayers each day. It
implies a cominuous auirude of ehankfulness for ali the good gifcs God has given us.
Such a realizacion ofGod's blessings will go
far in warding off diseress.
A "spiric of gracitude and prajse" should
be awakened in alt of us in this coumry because of rhe many blessings chac the Locel
has provided. There is a sharp conrrasc berween rhe many comforrs chat che average
American has in life wim ehe lack of such
comforcs in mally other parrs of the world.
The severiry of seressors in the life of the
average American is small by comparison.
In my stress conrtol seminars I give aJlocher assignmenr to the parricipants chat,
ironically, at nrse ehey usually find co be
srressful. The assignment is ro refrain from
saying a.nyehing critical about anyone or
anything for a minimum of twa weeks. Not
one crieical word is aJlowed. During chose
fourreen days, ifmcir children do something
good, they are encouraged ro prajse them
for it. If they did sometrung bad, no criticism is ro be given. In rheir work and ocher
associations, ilie scipu1ations are the same.
The class pareieipanrs can only say good or

nelltIal things. Criticism is srriccly forbidden. Fucchermore, if they cateh themselves

saying anything critical, the rwo-week process must begin again. Fortunately, the senunar spans eighr weeks because virrllaJly everyone finds it necessary ro begin again the
second da)'. Some may require a chird ar
even a fouerh beginning. The first few days
are very srressful. However, when the cwo
weeks ate successfully hnished, no oue as
yet has expressed regrec regarding (he assignmenr. In general, parricipams feei chat it was
a rewardillg experience ehat helped ro
chauge rheir olltlook on life and encollraged
chem ro focus on (he gaod.

"Nothing tends more to

promote health of
body and of soul
than does a spirit
of gratitude and
praise."
Figure 16

This does not mean chac critieism should

never be offered. The dass exercise is simpl)' caiculated to help people become more
aware of cheir habits of [;lUltfinding. Il is
designed ro demonstrate ta the panicipanrs
thac, with effon, chey can control (heir acrs
of criticism; and thereby realize benehcs to
ehemselves and others. Cerrainly, criricism
can be beneficial, if it is appropriate, conseructive, and eacefully given. However,
much ofour criticism has ics roOtS in a negarive ani rude. Worse scill. we often are critical of things that we have absolutely no
controlor influence over. Such criticism

339

PROOF
damages ourselves and orhers. Funhermore,
ir rends [Q foster negative anitudes in rhose
arouncllls.
Nearly 100 years ago Ellen White caprured the essence of such conccrns in the
powerful counse\ ro feUow Christians stared
in Figllre 17. 28

"Wben we arc tcmpted to murmur or

complain at sometbing someone bas done,
praise somcthing in that person. Say, 'Satan,
I have defeatcd your temptations this time.'
Cultivate the habit of thankfulncss. Praise
Cod over and over again for His wonderful
lovc in giving Christ to die for us. It never
pays to think of old grievances. Cod caUs
upon us to cultivate Ris mercy and Ris
matchless love, tbat we may be inspired with
praise."

Figure 17

Christian Meditation

340

The sevenrh mcasure for conrrolling

srress is Christian meditation. 1 believe we
have a crirical need for meditation anei
prayer on a daily basis. lt i$ a form of rest
and rejuvenation rhar few appreciare ro ies
fullesr extenc This topic is explained more
fully in the fronrallobe chapter and in rhe
final chapter in the book. However, the
imponance of this subjecr warranrs a descripeion here as well.
Meelitarion anei prayer have their gre~lt
est benefirs when chey provide a respite frorn
srressful rhollghrs and feelings, and an opponuniry ro find solurions for dealing wieh
life's mosr pressing srressors. [n order for
slich processes ro occur, the reasoning pOUJers of the brain must be active during rhe
meditative pwcess. Our highest illtellecrual
powers, including spiritual reasoning. resiele
in parr of the brain called the frontallobe.
A5 described in (he chaprer on rhe frontal
lobe, when rhis brain region is intimately
involved in our thinking, a type of brain

posn (VE
wave caJled the beta wave predominarcs. If
you were ro measure brain acrivty with an
e1ecrroencephalogram (EEG) anei it shows
ehe bera wavc, it would indic.1te tlur healdlY
rhinking is occurring, characteri'led by dynamic frontallobe acriviry.
Smc!es show tiut Christian meditation
involves the frontal lobe anei beta acriviry.
This is what one woulel expecr. After aLI,
prayer from the biblical perspective is an
exrremely active process. Whether \Ve are
re1lecting an God's goodness, rhanking Him
for helping liS in specific ways, seeki.ng ro
know His will in a perplex ing sitllarion, ar
praying for individuals who have specific
necds, Chrisrian mediration and prayer involve an active frontal labe.
Even rhough it can involve a high leveJ
of mental activitJ, ChristiaJl mediration and
prayer are also very relaxing. A biofeedback
monitor can be used ro detect the relaxation
inherenr in sllch mediration. For those UI1familiar wirh the process, biofeedback is
simplya means of making an)' internal process of the human bod)' cxtcmally visible
by rhe use of moniroring e1evice.s. 29
One method of assessing tcnsion is by
measurng rlte skin's electrica 1 resisrance. 30
\'V'hen a person is emotionally teme, rhere
rends ro be a drop in this resistance. The
skin more readily conducts an electric current which can be measured bvan electric
meter,31 The familiar lie derect~r testworks
an this principle. As parc of a medic.t1 school
class, 1carried a porrable biofeedback moniror rhar tOok such a measuremellt as I wenr
through my daily romine. 1 was impressed
rhat it demonstrated ehe !)lost relaxed state
when 1 was actively praying ro Gad.
Not every form of meditarion however,
is charaererized by bera activity aJld fronta]
labe involvement. In sharp contrast tO
Chrisrian meditarion stands ehe meditarive
pracrices popularized in (he eas(ern hemisphere. called "eastern medit<ltion." It appears rhat ies effecrivencss results from a
form of escapism. Many research srudes
have demonstrarcd an accemuation ofwhat
is called ;In alpha bran rhyrhm insreacl of
the bera rhythm when all experienced subjcct engages in such eastern-based practices
as yoga or Transcendental Medirarion.'2

STRESS WITHOUT DISTRESS

A1pha waves are brain wave of a lower frequcncy (8 ro 13 cyeles per second) 33 rhan
bera waves, that indicate a person has entered inro a trance-like srare where ji-onraL
tobe activily is wcak. When the brain has an
alpha rhyrhm, we cannor cririGIJly analyze
ilKoming inform'llion. !-rom the tandpoint
of borh rhis alpha brain rhyrh m and rhe
means ro induce the meditative stare, easrern mediwrion is srrikingly similar ro J~yp

110tism.
Hypnosis, by design, bypasses rhe frontallobe as ir helps ule subject cnrer il tranceljke srare. Easrem religions use rhe principle
of a solitary fOCl1S ro induce a meditarive
srate. As one author put it, mental focus for
Transcendental Medirarion can be achieved
b)' focusing on a single word (calJed a manna), a single shape, or a body parc He melltions thar "anorher ancieO( pracrice is ro
focus an the navei, the forchcad, OI' some
orher body pan."34 Jusr as the hypllorisr requircs this single-minded focus and an environmem free from ali outside diversiolls,
sa does fhe meditaror.
Dr. Herberr Benson, the Harvard rcsearcher and physician, has presenred what
some have cal led a "secular version" of easrern medirarion. However, Benson lIses rhe
same elements of the eastern meditator and
the hypnorisr: a quier environment and a
single-minded focus (in his case a word or
phrase of Hindu worship).35 Benson also
meJltjons al10ther "essential element" in this
process: "a passive auitude." In fact, he states
rhat this is "perhaps the most important of
rhe elements."36 Rice observes that ali of
these eastern-style meditative re1ax.ation
rcchniques "emphaslze a passive arrirude."37
It is rhis "passive attrude" with a prominem alpha brain wave rhar illusrrates one
of the greatesr problems wirh this meditarive sryJe. Alchough it may provide reliefand
relaxat ion by removing the mind's focus on
cerrain srressors, rhe practice does nor appeaJ able 10 help in cOllstrtlcrively addre-ssing srressors. This srands in sharp contrast
ro the reflecrive medirarion of me Chrisunn. Wirh biblical meditation and prayer,
the emphasis is an an active refIection that
helps ro foclls the fronrallobe. Rarher rhan
srriving for a passive state that represses

thought.i, hristian mediration emphasizes

communion witll God, thinking His
thou.ghts, sensing His presence, and knowing His will. In addition [Q providing release for srress, rhis rype of meditarion also
provides an opportuniry ro get lJ'Jetmingfitl
tl11swcrs arJtL solutions to problems.
There is further concern that rhe passive mental stare culrivated by cenain meditative techniques may do more harm than
good. It has long been known thar eastern
meditation and secular relaxation training
may have delererious effecrs on the nervous
sysrem. A classic srudy found higher levels
of s)'mpathetic activity with increased
adrenaline output resulring in rhe acute
pbysical effects of srress mentioned earlier
in rne chaprer in mosr measllfements made
on eastern yoga practitioncrs when COIllpared ro an American control group.38
In another srmly, subjccts who received
training in Transcendemal Meditation
actlJally displayed a higher cardiovascular
stress response after Iearning rhis meditarive practice. 39
It is possible mar problems arise when
escapist meditatve practices are employed
in place of constrllctive strategies ro deal
with srressors. Such a hypothesis i5 consistent wirh work cited by Dr. Lury Dossey.
Research that studied stress horrnones before, immediately following, and rhen twO
days after surgeries )'ielded a slIrprising resulr. lmmune-weakening srress hormones
signific.llHly increased only in those rhat had
formal relaxarion rraining. Those dlar apparently addressed ther anxieties and
fears-withoLlt lIsing escapism relaxation
techniques-did not show rhe rise in stress
hormones. 10
A third difficlllry with eastern methods
relates ro rheil' potential danger when employed in a group sening. Remember mar
in easrcrn-sryle meditatioll, alpha waves predominate and the reasoning powers of the
frontallobe aJe suppressed. In sllch a hypnotic-like stare an individual may record
informarion and suggestions withoLlt interpreration and withom fronrallobe evaillarion. $ome have mus wondered wherher
easrern religious CllltS talee advamage of adherems \vho enter a meditarivc Stare in a

341

PROOF POSITIVE
group selring. Such crirics point out thar
rhe brain would be in a S[<lte where ir would
nor crirically analyze any information ir received. The meditator would ilien be exrremdy susceptible ta mind control techniques. These concerns appear to be well
founded; such medirarion in a group setring shouJd be avoided.

Exercising Trust in Cod

Exercising rrusr in God is ilie eighth key
defense againsr stress. It is human narure ro
become overly concerned aboUf circumstances in our life anei ignore rhe help rhar
God is willing ro provide for us. Trusring
God involves complere confidence in our
Heavenly Farher. We pllt Him and His will
fim in our lives. Then we depend on Him
ro acr on aur behalf in the way and ar the
rime rhar is according ro His will, while using rhe energy that Gad has given LIS ta do
whar we are able to do. This defellse againsr
srress may be looked at as a direct extension
of rhe previous aspect of not beng anxious.
r find trcmendolls help in trusring God
when dealing wirh rempraeons ro worry.
Trust in God will provide a buffer againsr
srress and a hedge againsr anxiery.
Thousands-perhaps millions-of
fajrhfu1lives tesrity ro God's faithfulness and
rne reasonableness of placing our full conftdence in Him. We have many documented

PAUL'S BARDSHIPS
"Of the Jews fiye tirhes received 1 forty stripes save
ODe. Thrice was 1 beaten with rods, once was 1
stoned, thric' I suffered shipwreck, a night and a
day 1 bave)Jeen in tbe deep; In journeyings oftn, in
perils of waters, in perils of robbers, in perils ~y
mine owf countrymen, in perils by tbe beat~en, in
perils in the city, in' perils in tbe wilderness,/in perils
in the ~ea, in periJ~ ~moung false bretbren;/In
wea ness and painfUlness, in watchings o/ten, in
bunger and thirst, in fastings often, in coid and

Dakedn~

Figure 18

342

Corinthians 1J: 24-27

examples in rhe Holy Word of individuals

wlto, through rheir living faith in God, remained "in conrrol" despite facing staggering srressors. Chrisr srands out as rhe model
in demonsrracjng the power of faith in rhe
midst of stressful surroundings. Who has
f.1ced greatcr srressors chan JesllS? His 40 day
fasr followed by tempt<ttions in the wilderness, His he:art-rending bertayal, His agony
in Gechsemane, abandonmenr by His dosest friends, and His crud and disgraceful
rorrure JUSt before and during His crllciflXion, ali graphically illllsmlte rhis assertion.
Despite His srruggles, Jesus manrained
a fairh rel;uionship wirh His Farher and a
love for people. Even after being nailed ro
che cross, He said cll0se immortal words,
"Father, forgive them; for chey know not
wlw ehey do." (LlIke 23:34). lndeed, in His
last hours before His death, Jesus did nor
lIner even one wotd of criricism. He expressed no btterness to those who drove the
nails inco His hands, rhose who falsely accused Him, or those who condemned Hm
ro die and arranged for His execlHion. He
exhibired superior Slress conrrol as He swod
beforc His acclIsers as a slteep lead ta the
slaughrer.
He was ulljUStly punished for something
that He did noc do. His control of scress
was made possible by His unwavering faith
in Hs heavenly Farher. He is a wonderful
mie model for rhosewho wanc ro be in concroI of cheir words and actions raeher than
being conrroUed by suess. We would do weU
ro read and re-read abotlt His life and His
dealing wiclt the m3ny stressors He encountered. A knowledge of Chrisc's life provides
a srrong sourcc of encouragemenr for us

roday.
The Aposde Paul was anorher biblical
character wha was subjecced ro incredible
stress. He, roo, was ablc to rise above the srrcssors tluc ac cimes tmeacened ro englilf him.
In his second lerrer ro the Corinchian dmrch,
Paul summarized some of che srressors thal
plagued him, as quoted in Figure 18.
Despire the stressors ehat Paul suffered,
he was not overwhelmed. He couId say with
confidence: "1 have learned, in wharsoever
state 1 am, therewith to be conrent."
Philippians 4: 11. He revea/ed the results of

STRESS WITHOUT DISTRESS

rrusring in God for Sfre5S conrrol, as quoced
in Figure 19.
True srress conrrol does nor provide a
promise for diminaring srressors, but ir does
provide rhe necessary coping resources sa
rhar even rhough we may be [roubled on
every ide wc need nor be distressed. Paul,
himsel[ a champion of srress conrrol, provides rhe ride ro rhis chaprer, "Srress Wirhaur Disrress." He revealed rhe secrer of his
conrenrmenr in rhe leHer he penned ro rhe
Chrisrians in Rome. His words are reproduced in Figure 20.
Paul asks rhe rherorical quescion, "Who
shall separare LIS from rhe love of Chrisr?"
His answer is resounding: not even rhe mosr
harmful srressors can inrerfere wirh Chrisr's
love for liS. Through Christ, Paul starcs rhar
he won rhe vicrory: "in alI chings we are
more rhan conquerars rhrough Him char
loved us." Ycs, Paul's fairh was rewardedrJuough Chrisr he became a conqueror.
1believe rhat PauJ's use of rhe term "more
than conquerors" is significanr. Being a cooqueror should be enough, but why "more
rhan conquerors"? Paul was execured as a
Chrisrian, a member of a hated secr rhar was
falsely blamed for rhe burning of Rome.
(History reIls us rhar rhe Roman Emperor
Nera was acrually responsible for rhe cicy's
fire bur ne areempred ro fusten me blame
on rhe Chrisrians.) Tradirion holds [har
[here was a scame ofNero in ancienr Rome
wirh rhe inscriprion "Nero, Conqueror." It
is likely tlur Paul had pa sed thar sratue
many times. His sraremenr, "we are more
rhan conquerors" was in contrast ro rhe caprion on rhe scame. Yes, Nero was a conquerar. But because ofGod's [ove for us, we
are mQre rhan conquerars. We can conquer
rhe srressors rhar are around us mrough che
power given ro us by God.

Conclusion
To conclude chis chapter. ir is fitting ta
list the cighr key measures to conrrol stress
mat we have examined. The summary lisr
is shawn in Figure 21.
TIlese eight key scress management principles have been invaluable in my life. They
have also been a help to many who have
artended my srress seminars. They may

TRUSTING GOB IN
STRESS CONTROL
"We are troubled 00 every
side, yet not distressed; we
are perplexed, but not in
despair; Persecuted, but
not forsakeD; cast down,
but Dot destroyed."
2 Corinthians 4:8,9
Figure 19

CHRIST IN THE HEART

-

"Who shaU s--eparate us from the love

of Chris? Shall tribulation, or distress or perscution, or famin~or
nakedness, or perii, or sword? '!
NaY'/in aII thes~ things we are rqOre
thaJl conqUt;rOrs through him t)lat
lov'ed us." .
/ '"
Roma~s 8:35,37
Figure 20

KEYSTRESSCONTROL
MEASURES
Healthy adaptation
Healthy lifestyle - including good
Dutrition and exercise
Commitment to an honorable cause
that helps others and is approved
byGod.
Proper planning and organization
Dwell on the good
Christian meditation
Don'l be anxion. aboul lomorrow
~
Trust God
~J!!J

Figure 21

343

PROOF POSITIVE
sound coo simpJisric, bur rhar does nor detract from rheir power. 1am convinced rhar
rhere are (\vO reasons why many people who
rry co control srress fail in rheir atrempt.
Firsc, rhey misundersrand the basics of rhe
srress process and thus fail ta address rhe
srressors rhar are confroming rhem. Second,
even when rryilJg co coofronr rheir srressors,
rhey do nor use rhe basic key principles rhar

RefermcesI Sdye H. The evolurion of dle Slrcss concepL Am S 1973

Nov-Dec:61 (6):692-699.
Selye H. StTm Witholli Disrress. PhiJadelphia PA: LippincoH,
1974 p. 31.

Selyc H. The seress concept and SOllle of ies implicarions. In:

Hamileon V, Warburlon DM, cdirors. HUl1l1ln Stress And Cogl1ition: An lnjOrmlltioll PromsingApprollch. New York, NY: WiJey,
p.70.
3

4 R..ice PL. Stms Anei Hea"h: Principles And Practice For Coping
AndWelfness. Pacific Grave, CA: I3rookslCole Publishing Com-

1 have enumerared as rhe foundarion for

successful control of Dur srresses. 1 would
chaJIenge you anew ro openly assess your
stressors and apply rhe principles presemed
in rhis chaprer. You likcly will be surprised
as to how far they wiU go in heiping you
master srress-rarher rhan aJlowing Stress ro
master YOll.

14 Gonder-Fredcrick LA, Carrer WR, cr al. Environmental srress

and blood glucose changc in insulin-dependem diabetes mcllitus. Hcalth PsychoL 1990;9(5):503-515.

i; Shcrdan JF, Dobbs C, 8rown D, Zwilling B.

Psycho.neuraimmunology: strcss effecls an parhogenesis and immuniry during infeceion. elin Microbiol ReI} 1994 Apr;7(2):200212.
16 Johnson J, \Teissman MM, Klcrman GL. Service urilization
and social morbidty associated wirh depressive sympeoJnS in
rJl(: communily.]AMA 1992 Mar 18;267(11):1478-1483.

17

Glenisrcr D. Exercisc and mental health: a rev1ew. ] R SOl"

pany, 1987 p. 18-19.

Heaith 1996 Feb;1l6(1):7-13.

5 Ycrkcs

18 HofTman-Goetz l. Pedersen BK. Exercise and tbe immune

sysrem: a model of t11C seress response? lm 111111101 loday 1994
AlIg; 15(8):382-387.

RM, Dodson JD. The rclaeion of serengeh of Slinwlus

ro rapidiry of habie formation. ]ollmal Comparative and Neuro-

Ingiml PsychologJ 1908; 18:459-482. As cited In: Rice PL. Stress

And Health: Principles And Practice For Coping And WelLnm.
Pacific Grave. CA: Brooks/Cole Publishing Company, J 987 p.
19.
6 Rice PL. Stress And Health: Principles And Practice For Coping
AJldWellness. Pacific Grove. CA: BrookslCole Publishing Company, 1987 p. 19.

Selye H. The evolUlion of lhc srress concep!. Am Sci 1973

Nov-Dec;61 (6):692-699.

Sclye H. The evolueioll of the mess concepl.. Am Sci 1973

Nov-Dec;61 (6):692-699.

19 Nieman DC, Henson DA, ee al. Physical acriviry and immllne funcrion in e1derly women. Med Sci Sports Ewrc 1993
JlIlj25(7):823-831.

211

Nieman De. Exercise, infeceion, and immuniry. lnt] Sporls

Med 1994 Oce;15 SlIppl 30:S13I-141.

21 Weinseeul L. Xie X, Cleancholls Ce. Purposc in life, boredom, ;tnd volumcerism in a group of reeirec$. Psychol Rep 1995
Apr;76(2):482.

22 Viswanarhan R. Dearh anxicty, locus of cOlUro!. and purpose

in life of physicians. Ther relationship ro pariene deaeh Ilotifieaeion. PsychoJ"omatics 1996 Jul-Aug;37(4):339-345.

l~ Rice PL.

CD. Srancon BA, Jono RT. Quancifying and predicling recovery after heart surgery. Psychosom Med 1994 MayJlIn;56(3):203-212.

Guycan Ae. The allloJlomic nervous sysrem: ehe adrenalmcJuHa. In: 7fxtbook ofMedical Physiology-8th etlition. Philadelphi3, PA;WB Saunders, Co., 1991 p.672-676.

StI"fSS twd Health: PriJlcipus tUrd Prtlctiee ftr Copirrg

23 Jenkins

tInd Wel/ness.

Pacific Grove CA: I3rookslCo\e Publishing Comp:my, 1987 p. 209-21 1.

2 Dossey L. Healing WOrth: The Power ofPmyer nnd l!Je Practice

ofMedicine. New York, NY: HarperCollins Publishers, 1993 p.

II

The American Instituee ofSeres . Suess-Americas #1 Helllth

Probum. Internet: hnp:llvAV\v.srress.org/problem.htlll (2/4197).

30-32.

Manikaincn P, Valkonen T. MonalilY after ehe deaeh of a

spouse: raees and cause.s of deaeh in a large Finnish cohorl. Am]
Publi.c Health 1996 Aug;86(8 Pr 1): I 087-1 093

ofMedicine.

\2

Maflikainen I~ Valkonen T. Morcalit)' afeer ehe deaeb of a

SpOIlSC: rates :lJld causes of death in a Iarge Finnish cohorl. Am]
Public Hcalth 1996 Aug;86(8 Pr 1): 1087-1093_
Ij

344

Dossey L. Henling Worth: The Powe,. ofPrnye,. and tIu Prtletice

Jew York, NY: HarperCollins Pliblishers, 1993 p.
241.

lS

PerI J. Sleep RigJn in Five Nights: A eLear and effictive Cuitlefor

Conqueri17g Insomnia. New York, NY: William Morrow and

26

Company Inc., 1993 p. 167.

STRESS W1THOUT D1STRESS

While EG. Mind Curc. In: T!Je Mit/istry ofHet11ing. Nnmpll.
ID: Pruijie Prt'Ss Pub1ishing Assocuuion, 1905. p. 251.
28 Whire EG. True Worship. In: Eible Tmining Sc!Jool 1902-

Rice PL. The Concemralion Techniques: Medit;llion and

Biofeedback. In: Stms t1l7d Heolth: Principiei and Practice for
Coping tind \flellnm. Pacific Grovc, CA: Brooks/Cole PlIblishing Company, 1987 p. 308.

27

34

1917 (a periodkal) OClOber p. 1. Found [n: Ilen G. Whire

Eslarc. The Pub1isheJ Writings of Elim G. W!Jiu. Version 2.0
(CD-ROM), 1995.

:}5

Rice PL. The Concencration Techniques: Medirarion and

Biofeedback. In: SITeSS and Hell1th: PrincipIes Ilnd Practice for
Copitlg aM Wel/ness. Pacific Grove, CA: Brooks/Cole PubJishing Com.pany, ) 987 p. 309.
29

Rice PL. The Concencrarion Techniques: Mediration and

Biofeedback. In: Strm and Health: PrincipIe-s tind Praniee foI'
Coping and Wellnm. Pacific Grove, CA: BrookslCole PlIblishing Company, 1987 p. 313.

.lQ

Ricc PL. The Concel1lrarion Techniqlles: Meditarion ;Ind

Biofeedback. In: Strl'S'S and Healt!J: Principles and Practice for
Coping and We1lnm. Pacific Grove, CA: Brooks/Cole Publishing Company, 1987 p. 313.

31

Rice PL. The Concemralion Techniqlles: Meditarion and

Biofeedback. In: Stress tJnd Health: PrincipIes tlnd Practice for
Coping tJnd Wellnm. Pacific Grove, CA; Brooks/Cole Publishing Company, 1987 p. 305-312.
32

Benson H. The Relaxa.tion Response. New York, NY: William

Morrow and Company Inc.. 1975 p. 19.

Benson H. TIu Relax,ltion RespotlSe. New York, NY: William

Morrow aud Company Inc., 1975 p. 19.

36

Rice PL The COllcemrarion Techniques: Medirarion and

Biofccdback. In: Sems aud HenLth: Principles tlnd Practice for
Coping and \flellness. PacifIC Grave, CA: Brooks/Cole Publishing Company, 1987 p. 308.

37

Wenger MA, Bagchi BK. 51l1dies of auronomic funCtion in

practilioners of Yoga in India. Behavioml Seieince 1961 ;6:3] 2323.

38

Puentc AE. Beiman I. The efTecrs of behavior rherapy, selfrelaxarion, ,Uld rransccudeuraJ medirarioll on cardiovasclllar srress
response. J elin P5)l cho11980 Jan;36( 1):291-295.

39

40 Dossey L. Hctr/ing Words: The POUJcr ofPrayer dlld tIu Practice

ofMedicil1e.. New York, NY. HarperCollins Publishers, ]993 p.

62-63.

AC. Textbook ofMedical Physiology-8th eJition. Philadelpbia, PA: WB. Saunders Co" 1991 p.662-663.

33 GlIyton

345

PROOF POSITIVE

346

----------

....U

CHAPTER FIFTEEN

IDS AND

The Untold Story

IDS: the diagoosis srrikes fear

into rhe hearrs of yOllng and old
alike. It is impossible to describe
rhe devasraring emotional impact
ofbeing told tIUt you have theAlDS virus.
Immediarely images rend to come ro mind:
an emaciated body, pain and suffering, men[al incompetence, and social exclusion.
However, perhaps more tragic than ilie
results of AlDS is [he faer mar most victims
eOliJd have avoided getting the disease in
ehe first place. Hence, it seems fining ta
focus primarii}' an how ca prevem becoming infeceed with ehe AIDS virus, known as
{he HlIman Immllnodeficiency Virus
(HIV). This virus paves me way for AIDS.
!nsighes into how HfV-infeceed individuals can boose their immllne syseems ro live
ehe longest and fllllest life possible will also
be emphasized.

AIDS Definitions
AIOS stands for "acquired immllnodeficiency syndrome." This na.me aptly describes
man)' of rhe key aspects of rhis condieion.
Firse, AIDS involves immunodeficiency. This
mea.ns thar me disease cUlses a weakening
of ehe immune sysrcm. Becallse of {his
we.akened immune seate, AlOS parienrs can
develop devaseaeing condirions such as lifedHeaeeniog cancers and infectiollS.

Second, AlOS is properly defined as a

syodrome. The word "syndrome" eonveys
rhe idea ehar a number of sympeoms or
problems can occur rogeeher in this condition. This is an especially appropriarc designation for AIOS where intestinal effecrs.
nervous system changes, and a host ofother
problems can accompany (he headiine-grabbing cancers and infeceions.
Third, this syndrome wirh its immune
system weakness is acqllired. An individual
moves from a siruation of normal immllne
stams ro a compromised one as the result
of something ehar he or she acquires. One
th.ing [hat is acqllired. of course, is the virus
called rhe human immunodeficiency virus
or HIY. A person cannor ger AIDS unless
they are infected with HlV. However, not
aH individuals with H IV infection will necessarily develop AlOS with ies profound
immune system weakness and accompanying symproms. Even after 10 ye-ars, only
abOlit half of those infected with HIV have
actually developed AlDS,l
This distinceion is crieica!. The disease
ofAlOS with ies weakened immune syseem
and relaeed findings is very diffcrenr than
simply having HIV infection. Again, HIV
infeceion is necessary for AIOS ro develop.
However, millions of people worldwide are
HIV-il1fected but have not yee come down

347

PROOF POSITIVE

MAGNITUDE OF THE AIDS

PROBLEM IN THE U.S.
Over 575,000 AIDS cases sinee it was
discovered in 1981
Over 350,000 dead
Over 40,000 deaths in 1996
Leading cause of deatb in ages 25 to 44
Figure 1

MEDICAL COST OF HIV

INTRE U.S.
Lifetime medical cost per HIV-infected
patient = $119,000.
As bigh as 15
billion in allDual
medical costs
in the U.S.

Figure 2

HIV WORLDWIDE
Over 21 million people bave HIV.
8500 people become infected with HIV each day.
By the year 2000, AIDS will have killed more than
8 miJIion people.
By the year 2000, 30 to 40 million people could
bave HIV infection.
By the year 2000, over 5 million
children will be infected with
HIV and another 5 to 10
miJUon children will bave
been orpbaned by AIDS.
Figure 3

348

wirh it, and some may nroerdevelop AIOS.

Seriousness ofAlDS in the Us.

The number of people in ilie U.S. infliered with rhis dreaded disease is lisred in
Figure 1. 2
Only 39 percent of rhose wirh MOS
have survived at dus writing. 3 Most of rhe
deaths are in an age group rhat is ofren considered ilie prime oflife. 4 AlOS deaths have
ourpaced even the classic killers ofthe young
like accidenrs and homicides. 5 It is now ilie
eighth leading cause of death across aiI age
groups in the United Stares. 6 Even ehough
ie has nor reached the yearly dearh toll of
diseases like hean disease, cancer, or srroke,
AIOS is still a major killcr in America.
Along wirh aII the human suffering
caused by AIOS, the disease has taken a
heavy financial ro1l on our nation. Medical
costs are shown in Figure 2. 7 ,8
Worldwide, HIV has caused mauy difficulties as well, as shown in Figure 3.9. 10. II
Over 90 percent of those with HIV
worldwide live in developing counrries. In
hve Afric.'lII counrries, more than 10 percenc of ehe population is infected.

How the AlDS Virus is Transmitted

How can 1 avoid ilie AIOS virus? Ta
answer that question, we must first examine how it is transmirted from person ro
person. You can only ger the AIOS virus
by receiving it from someone else. Whar
are the various ways it is erallsmined? The
mosr common way it is transmirred in ehe
U.S. is through homosexual contact. But
mere are aJso orher ways, as Ijsted in Figure 4.
Heterosexual contacr can also transmit
the AlOS virus. HIV acquired by iliis
method has bec~ome more prevalent in recent years.
Contaminared blood or blood plasma
rhar is used in blood rransfusions can cause
a person ro become HIV-nfected. Ncedle
sharing of drug abusers is a high risk practice that !las been increasing in relative imporrance. The number of AIOS parients
who reporred ilie practice ofinjecting drugs
was 17 percenr during 1981 ro 1987, and
illcreased to 27 percent during 1993 ro
October 1995,12

AIDSAND HIV
Not only are illicit drug users ac risk of
comracting the virus from a contaminaeed
needle. Healrh cuc workers can acquire che
infeccion ifebey are inadvertelltly stuck with
a needle mar had been used on an HIVpositive patient. However, this appears eo
be a relatively uncommon cause of viral
rransmissiofl. Through rhe end of 1995,
less than 50 healch care workers have developed HN infecrions ehac were c1early documenred as being relared to rheir work. 13
Even parienrs can be ar risk from contaminared needles. Alrhough ehe re-use of
UJlsrerilized needles is not a problem in the
U.S., ie is in ocher parts of rhe world. This
is one of rhe reasons why AIDS has risen so
fast in Romania. 14 Financial pressures combined with poor hospital supervision lead
ro me re-use of unseerilized needles for injections-parricularl.y ro young patienrs.
Many innocent young people have devcloped HIV infection as a resulc.
Contact wirh blood or mher HIV-infeceed body fluids can, ofcourse, occur wichaur sexual contact or needle sticks. le is
cheoreeica1Jy possible ro ger rhe virus if an
open WOUJ1d or sore is exposed to discharge
from an HIV-positive pariem. Transmission may a1so occur if those infected secretions come imo comact with che mucus
membranes of rhe moueh ar ocher body
openings. However. sllch memods oferansmission are unlikely. A recent documented
HJV infecriol1 C3me from a human bice
from an AlDS paeient. 's The U.S. Ceneer
for Disease Control and Prevention has gone
an record rhat HN may be able to be eransmitced by oral kis-sing, a1chough rhey state a
person is "noe likely" to become infected in
this manner. 16 They acknowledge char there
have never been auy documenced cases of
the virus being transmitted in this manner.
In concrasr, oral sex may be the highese risk
aaiviry in developing HTV infectionY
Ocher rouces of transmission for ehe
AJDS virus include transmission from a
lTlomer eo her child. The vase majoriry of
children who develop AlOS (approximaeely
90 percenc) acquire the virus from cheir
HIV-infecced moeher either while in the
womb. during the delivery process. or in che
eatly days of life. 's There is no qucscion

KNOWN ROUTES OF

TRANSMISSION OF mv
Sexual:
Heterosexual (male to (emale and vice versa)
Homosexual (male to male)
lnoculation ofblood:
Transfusion of blood and blood products
Needle sharing among intravenous drug users
Health care workers - needle stick, open wouod,
and mucous membrane exposure
Human bite
Iujection Wth unsterilized needJes
Newborn:
Within tbe womb
In tb.e birth canall
Figure .4
that while n che womb. HIV can be carried from the mother's blood inro rhe baby's
circulation. Newborns can also acquire the
infeceion when going through the birrh canalac rhe eime of delivery. The virus apparencly infecrs these children by entering eirher rhrough mucus membranes (Iike rhose
lining the mourh ar privaee area openings)
ar through small skin wounds due eo normal birth trauma.
Transmission from rhe mother to the
child accouncs for only a relatively small
number of toral AlDS C3ses (slightly over
one percent of the rotal cases 19 ). However,
the numbers are significanr when measured
in terms of the human suffering of infancs
and children. Nearly 1000 children each
year in the U.S. are diagnosed wieh AlOS
that they acquired from cheir mothers. 20 Of
particular imporrance is {hat many of ehese
cases C3n be prevenred. If an expectant
morher is tes{ed for HIV and knows {har
she is infecced, precautions can be raken
during pregnaney and delivery thac wiU dramacically decrease rhe risk of her child becoming infected. Wichout such preclUcions, an HIV-infecred mocher subjects her
child ro a ] in 4 cbance of becoming infecred. The odds drop ro 1 in 12 when appropriare precaucions are taken. 21
Since che beginning of the AIDS epi-

349

PROOF POSITlVE
demic, roughl}' rwo perccnr of U.S. AJOS
cascs have been naced to blood rransfusions,
other blood products (Iike c10tting factors),
or tissues (such as organ donarion). This
figllfe has dropped to one percent of cases
in more recent years (1993 through 1995).22
The number ofcases rdated ro rranstlJsions
and relared producrs should conrinue ta
decrease due to rhe careful scruriny rhat
blood now gets in the Unired Statcs.
Recenr studies of rhe risk of H IV rransmission from blood banks are encouraging:
the risk of HIV rransmission is onl)' about
rwo cases for every one million units of
screened blood. 23 However, some HIVrainced blood stiU gets inro our narion's
blood bank supplies. This blood comes
from donors wirh early HIV infecrion who
have not yet tesred positive for rhe infecrion. The reason for rhis de1ay is thar rhe
standard HIV blood tesr measures amibodies ro HIV-and it takes rhe bod}' up ro
rhree monrhs tO develop rhose anribodies.
Nmosr aII people who are infecrcd wirh
HIV will have sufficienr anribodies ro show
in a resr wirhin rhree months;2,j before rhat
rime, rhe rest can miss rhe illfenion. This
period of time where HIV infection is
presenr bur nor derecred by the standard
HIV blood resr is c.alled the "window period." Fortunately, other special HIV tem
are done tiUt allow blood centcrs ro discard
some infected bJood even when it is in this
window period. 25

RlSK OF HETEROSEXUAL TRANSMISSION

OF HIV IF PARTNER IS HIV-INFECTED
Womao infected
byman

20

Risk
10 -

Mao infected
by woman
1
Figure 5

350

HemophiLiacs (individuals Wilh hereditary bleeding problems) have historicaUy

suffered a hcavy toU from transfusion-related
AlOS. Ahhough only abour one percent
of toral AIDS cases are hemophiliacs,26
many contracted rhe infect ion before blood
could be reliably screened for HIV, Tbe
reason fOf dus is that hemophiliacs require
man)' blood transfusions throughollt rheir
lifctlme. Many received contaminated
blood in rhe days before blood was screen.ed
for HIV,
The material we have juSt cxamined is
vital, for it rcveals how HIV is commonly
spread. Every person should understand
exactly what consrirures high-risk behavior.
Only in rhis way can personal risk be optimall}' minimized.

The GroU/ing Role ofHeterosexual

Transmission
Before 1988, heterosexuaJ transmission
accoumed for onl}' rhree percenr ofaLI AIOS
cases. 27 Since 1993, however, the figUIe has
more rhan rripled. Currendy, II percenr
of AJOS cases contracred HIV by heterosexual relations. 28 About 13,000 new Al OS
cases each year in che U.S. are concracted
from hererosexual re!ations. Most of rhese
case$ are women who have been infected by
men. Approximare!}' 40 percenc ofaII AJDS
cases among women have been associared
wirh heterosexual intimacy.29 The AIOS
virus uansmits much more easil}' from an
HIV-infecred oun ro a woman rhan ir does
from a woman ta a Olan. 30This is illustratcd
in Figure 5.
Heterosexual relations aCCOUlH for onJy
six percenr of AJOS cases among men. A
comparison of rhe number of new AIOS
cases each }'ear in rhe U.S. caused by homosexual and heterose:ma! contact in men
is shown in Figure 6. 3 1. 32
Worldwide, when compared wirh ali
ocher l1leans of rransmission in boch men
and women, homosexual contact is rhe
souree of a relatively smaller proportion of
cases. In srarisrics published in late 1995,
homosexual transmission explained only 45
percenr of roralworldwidc AIOS cases,
down from 64 perccnt carlier. 33 . 34 Ho\\'-

Al OS ANO HIV
ever. in rhe V.S . homosexual rransmission
remains ilie major cause ofAlDS infeclion.

NEW AIDS CASES OCCURRING AMONG

HOMO.. AND HETERO..SEXUAL MEN

How H1V is NOT Spread

It is aho essenrial ro recognize how HIV
does nOf appear t.o spread. There are ali
kinds of rheorerical concerns aboue routes
of (ransmission over which we have no coneroI. However, worries aboue these unavoidable conraces are coumerproduceive when
we consider ehe ways (hae we know HIV is
rransmitted. This is not just an ac.'ldemic
poinc. If you focus on .111 (he questions (har
are not complerely answered-and over
which you have no control-you are likely
ro neglecc co take the precaucions rhar C3n
vircually ensure ehat you will not become
HIV-infecced. A list of ehe ways tim che
AIOS virus is nor spread appears in Figure 7.
Clase personal contact (wirhoue che type
of exposures already menrioned) has noe
been shown ro eransmit the disease. Contacr wirh an HIV-infec(ed person in the
household. ilie work place, the school, (he
public resrroom, ar even (he hospi(al is of
no consequence. 3S The reason for chis is
ehar rhe AlDS vi rus C.1nnO[ survive for very
long in [he normal environmenc olltside of
a living cre;uure. The virus is also easily
destroyed by common disinfectants. Furthermore. (here appears ro be no risk of
rransmission Eram insect5 such as mosquitoes. 36 If we are going ro dramarically decrease ilie rate ofHIV infection in the world,
we need ro focus on (he known risk facrors.

40,000
New
AIDS
cases
per
J'car

30,000
20,000

in U.S.

10,000
3299

Homo-

Relero-

Figure 6

WA

us

s o

Close personal contact:

Housebold
Workplace
School
Health-care workers without
exposure to blood

lnsects
Figura 7

NOT ALL WITH IV GET A DS

1s the AlDS Virus a Death Sentence?

Jusc rwo weeks prior [O chis writing, I
had tO rell another person in my office (har
they were HIV posi(ive. Mose of my HIVposj(ive parienrs are younger men; bue rhis
rime it was a woman in her seventies. She
was seeing me for orher problems, and we
were borh surprised rhar she was HIV posirive. Ir rurned out rhat she contracted rhe
virus from a wayward husband who had
divorced her three or four years ago.
Now, whar abour rhis woman and the
thousands of others who aJready have ilie
AIDS virus? Is the AIDS virus a death senrence? Can they be sure ro develop ilie disease

27,316

60

50

40

38
151038

Pereenl
who gel

perrenl
d('~nding

AlDS
20

upon aee and

olber (atlon

o
After 3 years

AfIer 10 years

Figure 8

351

PROOF POSITlVE
ofAI OS sooner or lafer? HIV stJristics provide some good news in this regard. JUSt
because l'ou are infected wirh the virus does
nor mean iliat you are going ro ulrimatell'
come down with Al OS. Srudies have been
made by tracki ng thousands of Americans
who have conrracted HTV infecrion since
its discovery in the early 1980's. Many have
survived, as illustrared in Figure 8. 37 . 38
Note fhat even aher 10 vears, ani" 50
percenr had developed AlOS: This suggests
thar having the HIV infection does nor
mean thar l'ou will necessarily get AIOS.

STREET DRUGS THAT WEAKEN

THEI~UNESYSTEM

Opiate Drugs (Narcotics such as Heroin)

High Doses of Cocaine
Amyl Nitrate
Alcoholic Beverages
Tobacco Smoke
Figure 9

PRESCRIPTION DRUGS THAT WEAKEN

THE IMMUNE SYSTEM
Anesthetics--at least in conjunction with surgical stress
(includ ing elher, h.alolhane, nitrous oxide,
pentobarbitol, etc.)
A variely of agents used to treat infectious diseases:
antimalarials, antihelminthics (used 10 Ireat worm
infections), antibiotics, and antivirals
Cortisone and related steriods
Cancer chemolherapy drugs
Major tranquilizers
Tricyclic antidepressants
(cxample: Amitriptyline)
Progesterone
Figure 10

352

The Path /rom HIV Jnfection to

AJDS
In rhis secrion we willlook ar the path
from HIV infecrion (Q AIDS. This irtlormarion is critica!, because ir could help an
H1V-infeercd person ro delal' or even avoid
rhe onser of AlOS. The healrh of rhe imrnune sysrem ar rhe rime a person is exposed
tO HIV appears (Q be viral. If l'au become
infecred wirh HIY: keepingyour immune system as hetllthy fIS possible also appears ro be
crucial.39
A growing number of r:esearchers are
focusing on issues other (han HIV infection rhar conrribure ro lhe dcvelopmenr of
AIOS. In facr, if rhe immune svstcm's C04
cells (a cerrain rype of whire blood cell or
Iymphocl're) are verl' healthy, it will take
up to 200 times the numbcr of viruses [Q
infect thcsc cells :md bring abom an HIV
infecrion. 40 This probabil' cxplains whl'
some people dur are repeatedly exposed ro
the AIOS virus never: becomc infccted wirh
HIV, 1 have rwo separate parienrs who have
AIOS and have been HIV posirive focl'ears.
Up umil thel' wcre diagnosed wirh AlOS,
however. they were reguJarll' having unprotecred inrercour e wirh their wives, both of
which are stil1 negative for HIY: These
women had been rcpearcdll'exposed tO HIV
in a wal' known to be very dangerous, yer
have nor come down wirh rhe disease. Robert Roor-Bernstein, Associarc Professor of
Physiology ar Michigan Srare Universiry, has
documenred much literatllfe on rhe immune sysrem anei AIOS in his rivering book,

Rethinking AlDS: The Tragic Cost Of Premature Consensus. 41 His well-researched

book does nor necessarily mini mize the
imponance of the human immunodeficiency virus in the AIOS disease process.
However, it suggeslS that although HfV infec(ion may be rhe fim srep leading ro
AIOS, other facrors cal) ulrimate!l' hasten
rhe developmenr of rhe disease. Manyof
rhese facwrs directll' impair the immune
sysrem. Avoiding these facrors as much as
possible will be ro the advanrage ofan HIVinfected person.
The fim group of facrors is srreer drugs.
They are lisrcd in Figure 9.42. 43 . 44

AIDSAND HIV
Som.e prescription drugs will also reduce
thestrength of ehe irnmunesystcm and help
to bring on AlOS. They are lisred in Figure 10. 45 46
1n addition ro drugs, other factors will
damage rhe immune system. They are liseed
in Figure 11. 47 ,48.49.50
There are stiH orher factors that, rather
than doing damage ro the immune system,
seern to srimulate activiry of the HIV, as
listed in Figure 12. 5 1. 52
Figures 9 rhrough 12 help us begin ro
appreciaee some of the facrors that may ultimately inl1uence rhe developmel1t ofAlOS
afla HIV infecrion has occurred.
Many of rhese factors are under an
individual's personal control. The mcssage
is rhat we should avoid anything ehat cends
[O supprcss the immllne function or stimulate the acriviry of the virus.
In view of its frequency of use, one class
of immune-suppressing drugs seems worthy of special arreneion. This dass is alcoholic drinks. Thc consumpeion of aleohol
is a cwo-pronged danger, as shown in l'igure 13.
Alcohol suppresses me brain's fronral
lobe--the seat of judgmenc and reasoning
power. This suppression poses a risk for
HIV transmission. Undcr ehe inl1uence of
even socially accepted levels of alcohol, a
person is mote likely ro follow impulse
rather than principle. and may engage in
acrivities (hat would have been avoided if
ful1y sober.
MiIJions ofalcohol drinkers are unaware
of its effecr in deprc.ssing the immune system cven when consllmed in "social" or
"moderate" amoul1ts. For some time now
rhere has been evidenceli.llkingalcohol with
HJV infeccion. In one srudy, researchers
showed thar social dri.nki.ng can increase the
likelihood that you wil1 become HIV infecccd if you are exposed to the AIDS virus.
In their experiment, Or. Omar Baga ra and
colleagues found thac drinking four beers
made human white blood cells more susceptible to HIV infecrion. The aJcohol
C<'lused measurable harm ro rhe T-cells of
rhe social drinkers. These cells, of cOllr c,
are ofcritical imporcance in HIV infeceion.
Even seven hours after aU che alcohol was

OTHERFACTORSTHATWEAKEN
THE MUNE SYSTEM
Malnutrition
Multiple lnfections:

Herpes
Syphilis
Hepatitis B
Cytomegalovirus
Toxoplasmosis
Tuberculosis
Figura 11

FACTORSTHATAPPEARTO
STIMULATEHIV AC VITY
Cocaine use
Viruses:
Hepatitis B
Epstein-Barr (EBV)
Herpes Simplex, Type 6
Human T Cel! Lymphotrophic Virus, Type 1
Cytomegalovirus
Figure 12

ALCO OL AND A

Alcohol suppresses the frontal

lobe of the brain, which
weakens reasoning
power and causes a
lack of control of
sexual desires.
Alcohol weakens the
immuoe system.
Figura 13

353

PROOF POSITlVE
removed from the blood, testing srill revealed immune system impairment. S3
Other research suggests that in addicion ro
alcohol helping ro cause HIV infeccion, ie
may also adversely affect a persons immune
system after becoming HIV-positive. 54
ThllS, the immune-weakening effeccs of
habitual social drinking may increase rhe
likelihood mat an HIV positive person will
develop full-blown AIOS.
Unfoftunately, che media has largely ignored the impact of alcohol consumprion
and other lifestyle facrors on HIV disease.
It may be that the me.ssage of an immuneenhancing lifestyle could have done more
ta prevenc me rapid spread of Al OS than the
more popular message of condom usage.

Stress andAIDS
Srressfullife events associated wieh depression can worsen HN infectioll,5S probably due [O an additional suppressanr effect
an rhe immune system. Severe life scre.sses
increase ehe odds of HlV progre.ssing into
AJOS four-fold. Ir may not aJways be possible to control the stressors in one's envronmenr, but devdoping the coping mechan.isms ro combat scress may be cricicaJ for
an HIV positive patient. Ways te accomplish chis are deeaiLed in Chaprer 14, "Srress
Wirhour Disrress."
Besides avoiding facrors rhar harm our
immune sysrems, there are posicive things

AIDS EMOG..-.... ....

THE U.S.

cs

New Coses in 1996

Three popu/alion groups Duounl for Ihe "asl majorily

Homosexual
IV drug use

54%
l7%

Homosexual &
IV drug use

5%

11%

Heterosexual
Newboro
Transfusion
Hemophiliac
Figure 14

354

Preventing HIV Infection

<1%

10

we can do ro enhance aur immune mechanisms. One example ofan immune-e.nhancing life.style measure is physical exercise. In
individuals wirh HrV infeccion, moderate
exercise may decrease the likelihood of progression ro AlOS. S(,
Studie.s have shown that mase with the
highesr blood levels of vitamin E (anained
by a diee rich in rhe viramin and nO( with
supplements) have a 34 percenc reduction
in rhe risk ofcoming down with AIDS COI11pared ro those with low blood levels of the
vitaminY The whoJe plant foods, because
they are high in beneficia] phytochemicals,
have many cheoreeical advamages over viramin E supplements. Chaprer 2, "Good
News About Cancer-It Cari Ee Prevented,"
Iim foods rich in vitamin E. Orher blood
levels of vieamins sucb as vitamin B I2 are
aJso important. Those HIV posrive subjects wirh low viramin B'2 levels had twice
the risk of progressing ro AIOS compared
wirh rhose with high blood leve1s. S8 Since
plam foods are nor usually rich in vieamin
B12 , 1 recommend ro rhose thar subsisr eneirely on a tocal vegerarian diet ro rake a B12
supplement. A high planr-food diet may
al50 increase blood levels of glutarhione, a
patent amioxidanr pcoduced by the body.
High levels of glutathione may have a pivoca] cole in slowing the progression of the
HIV infection. People wirh HIV who have
low glurarhione levels have a much lower
probabiliry of surviving over rhe course of
duce years ehan do people with normal glueathione levels. S9
There are many mher ways ro boosc ilie
immune system. The borcom line is that
stronger ml11l1ne systcms render us less
likely ro become HIV infecccd-and feasibly Icss likely ro develop A10S if we are already HIV positive. More information an
how ro keep {he immllne syscem strong aJld
heaJmy is presented in ehe cancer chapter
(Chapter 2).

20

30

40

50

60

Ir is much bener not te contracr HIV

chan [O attempr ta boosc the immune system oncc it is diagnosed. Whac is che mose
effective way of ensuring rhat you never
become infected with che AlOS virus? Let

AIOS ANO HfV

us look at the popularion groups that have
developed AJOS in 1996 in Figure 14,60
which provides rhe basis for the answer ro
rhis quesrion.
Nore that 97 percent of AJOS parieIHs
would nor have rhe disease if it were nor for
rlle personal choices that they mode regmding
sexual activiry or drug use. Oespire what
many seem ro want us ro rhink, ilie answer
ro the AlOS epidemie h.1S not becn nor is it
condoms. Condoms are nor a reliable barrier against HJV infecrion. Sinee condoms
sometimes allow pregnancies to oecur, rhey
can much morc easily pass ilie AIOS virus
as well 3S orher sexually rransmitted diseases.
The AIOS virus is l11ueh smaller rhan a
sperm. So whar is rhe besr prevenrive approach?
AJberr Whiring, M. O., made a bold
sr.arement rhat blends praetiealiry and realiry in a way rhar few are willing ro eeho.
His sratement is shown in Figurc 15. 61
Monogamous marriage wirh a liferjme
commirmenr would certainly help us take
a quanrum Icap roward the solurion of rhe
AIDS problem. Who is rhis physician who
expresses such an unpopular assessmCIH?
Or. Whiting is rhe Hcalth Direccor for the
emire Sevenrh-day Advenrisr Church. In
rhac posieion, he has a unique perspeccive
on world healrh issucs. This is because Seventh-day Advenriscs are doing organjzed
medical work in nearly 500 church-owned
hospirals and clinics throUghOlH the wodd. 62
From his involvement wirh rhe worldwide
work of this global church, Or. Whiting has
a unique v:mrage poim. AIOS is a global
problem, and is much more prevalent in
many orher counrries rhan in che U.S.
[s it roo much ro restrice sexual activiry
ro monogamous lifelong marriages berween
rwo members of opposite sex? 1 believe
Whiting's words hold rhe key ro prevenring
HIV infecrion. The doctor's sta temem,
howevcr, is not novel. It is a clear expression of the Bible's timcless ideals. Beyond
rhar, from a public healrh srandpoinc, Or.
Whiting's words make sense. Becallse of rhe
imporrance of chis perspective on preven(ion and irs relationship ro moral srandards,
it is warranred ro examine carefully rhe biblical principles mar have a bearing on HIV

GOD'S SOLUTIO TO
THE AIDS P OBLEM
God's ideal is monogamous mardage with
a lifetime commitntent.
Sexual activity outside this commitInent is a sin.
This single pcindple followed wou1d
do more to solve the AIDS
problem than any appcoach
currentlyavailable.

Figure 15
transnusslon. The principles and rhe spiritual power ro implemenr them are c1early
described in rhe SeriptlJres. However, before looking ac thcse timeless biblica! il1sights, we need ro expand our focus. The
inspired counsel that we will examine has a
bearing not only in dealing wirh AJOS but
aJso an a hosr of orher sexually rransmirted
illnesses ehar are eaking a rremendous roll.

Other Sexually Transmitted Diseases

Sexual pracrices ean put individuals ar
risk of ocher diseases and fatal eondieions
besides AIOS. Seven common sexually

OTHER SEXUALLY TRANSMITTED

DISEASES IN U.S.
Human PapUloma Virus
cer~i.'( cal/cer
Hepatitis B
chronic Iiver infecJion
Iiver cancer

5000 dcalhs and 15,000 new

cases per year
--- ----.---1600 deatbs per year

Pelvic Inflammato~' Disease

tubaJ pregllaflcy

Genital Herpes (incurable)

GonorrhCll
Syphills
heDrt problems
brDin diseDSe
nervous system diseDSe
Chlamydia

1 miUion new cases and 150,000

sterile women per year

20 millIOD infected, 270,000 new

cases per year
_~.~!Jjoo new cases per year
35,000 new cases per year

2 miUion cases per year

Figure 16

355

PROOF POSITIVE

WOMEN A LOW RISK

FOR CERVICAL CANCER
No sex until after age 18
No more than two sexual partners throughout
their Iifetime.
Each partner must not have had sex
with more than ODe other partner.

figure 17

transmitted diseases and some of ilie maladjes that can result from them are listed in
Figure 16.

Sexually Trammitted Diseases

Cancer of rhe cervix or opening of the
womb is one of the mosr common cancers
occurring in women. In the U.S. alone, each
year there are over 15,000 new cases and
oearly 5000 deaths. 63 Worldwide, cervical
cancer is the second mosr common cancer
(following breast cancer) and afflicts
471,000 women each year. 64 Although
there are a variery of lifesryle facrors that
have a beariog on whether or 00( someone
wiU develop cervical cancer, rhere is ooe factor rhar is almost always preselH if rhis cancer develops. This single faCtor is infecrion
wirh rhe human papiUoma virus. A receor
National Institures ofHeaJrh (NIH) expert
panel emphasized rhe srriking relarion between this infecrion and cancer: "Cervical
cancer is unique in rhat ir is me fim major
solid tumor ro have been shown ro be virrualJy induced in mentiai/y every case. Humao papillomavirus (HPV) DNA is found
in yinually aU cervicaJ carcinomas ... worldwide. "65 It is important ro emphasi7..e that
HPV is a sexually transmitted disease.
Women contract rhis cancer-causing infection through sexual reIations with someone
who has rhe virus.

356

Dr. Patrica S. BraIy, a gynecological cancer specialist at. Louisiana Scate Universiry
and co-chairperson of the NIH cervic..'l1 cancer expert panel, has identified rhe srartling
prevaIence of chis cancer-causing infection.
She has poinred out that one in every four
women who become sexually active in college wiU become infecred with HPV within
one year. This oecurs even though such
women only ave rage two maIe partners.
Based on the frequeney with which HPV
strikes, Dr. Braly has gone on record that
che only women who are not ar high risk of
this devastaring cancer meet each of duee
criteria, as listed in Figure 17.
HPV and other sexuaUy transmined diseases are stiU afflicting Americans in epidemic proportions. 66 Each year 12 million
people in America will be newly infected
with a sexually cTansmitted disease. Even if
a person e1udes HIV and HPV infeetion,
the stakes in other infecrions can stiU be very
high. Heparitis B is orren sexuaJly rransO1i[[ed. It can cause chrooic uver infection
with cirrhosis and even liver cancer. Esrimates are mar each year 1600 Americans
die from sexually acquired Hepariris B. 67

Sexually Trammitted Diseases and

Quality ofLift
Sexually transmitted diseases (STDs) do
more than pur individuals ar risk for early
death. They c.m aJso rob {hem ofquaJiry of
life. For example, each year in America
abour one mi/lion women deveIop pelvic
inflammarory disease (PID), a severe complication of common infections like gonorrhea aod chlarnydia. Nor only is this disease painful, bur it reoders lip ro 150,000
women sterile each year. 68
A woman who has had pelvic inflammarory disease is suseeprjble ro a rubaJ pregoancy. In rhis siruarioo, rhe fertiLized egg
can become lodged in one of rhe scarred
Fallopian rubes rhar lead from rhe ovary ro
the womb. As the fetus grows rhe rube
srrerches, and if undcrecred, will rupture.
This cau be a life-rhrearening evenr. 10deed, [he physical and emotionaJ costs ro a
woman who has had PID can be great.
Sociery as a whole a1so incurs a significaIlr
financiaJ cost for rID with irs associared

AJDSAND HIV
inferciliry and eccopic pregnancies. One
study put the yearly COSt jl) the U.S. ar $2.6
billion. 69
Women and men alike are afflicted wirh
genical herpes. Each year in che United
States there are some 270,000 new cases,
while 20 million are already iJlfecred and
suffer with recurrenr episodes of this incurabJe condition.7 Gonorrhea and syphilis
may be our of rhe limelight, bur rhey: r?o,
are alive and well. Each year rwo mlll10n
Americans are affiicted wirh gonorrhea, and
35,000 carne down with syphilis. 71 The
laner condition, if nor prompcJy and CQfrectly treaced, can resuh in hean problems
as weU as brain and nervous sysrem disease.
Perhaps one of me greatesr rragedies of
the epidemie ofsexually transmined djseases
is rhar reenagers and young adulrs are rhe
hardesr hir. Of rhe 12 million STDs mat
oaur each year in our country, 86 percenr
occurs in individuals berween rhe ages of
15 and 29. 72 Stanlingly. among sexually
acrive recnagers, one in four wiIl come down
wirb an STD whiJe rhey are still in fheir
reens. 73

Sexual Behavior Ranks 5ixth in

Causing Death
We sec ehar sexual behavior js responsible for causing pain, misery, and death in
many ways. It perhaps carne as no surprise.
but the data was sril! shocking when researchers McGinnis and Foege, aher anaIyzing 1990 sratisrics, stared rhar abou r
30,000 Americans clie every year because of
rheir sexual behaviors. This was a resulc of
cheir studies on "The Actual Causes of
Dearh" in which the researchers found that
sexual behavior ranked sevenrh in the externa! faccors rhar cause deach.74 Unfortunacely, sexual behavior has been a rapidly
iocreasing cause of deach in the U.S. since
1994, when about 40,000 Americans died
as a direct reslllr of cheir sexual behavior.
Consequendy, sexual behavior is now the
sixrh leading acmal cause of death.75

Condoms versus Abstinence

As we have seen. despice years of HIVprompted messages urging rhe increase .in
condom usage, non-HIV sexually uanstnuted diseases are on the i~lCrease. This has
occurred in spice of the increasing condom
usage in America. Many experrs had taughr
that the solurion to HIV and sexually rransmitted diseases was ro increase condom usage. Condom sales and usage are up, buc
so are sexlIally rransmitted diseases
(STDs).76 This has been qllite perplexing
ro mally condom advocates bur rhe message we hear from them is that we need tO
use mal1Y more condoms. Alchough
condoms, if pur co lIse, can prevenr the
spread of Hrv and STDs (alrho~gh the)'
are by no means 100 percenr reltable), a
much berter message is how 10 practice abstinence, sJlCe ic works every time it is tried.
Those who have sex outside of marriage,
more often than not, are allowing the emorions and desires to take precedence over
meir beuer judgmem, foresighc, and reasoning abiliry. They have permirted the
fromal lobe of their bra.n to become suppressed so thar desire will mie over reas~n.
No one who is in such a state can be relted
on ro go rhrouoh an objective check1ist ("1
will not do chisb 1IlUeSS 1 have a condom")
before parraking in the acr. This is why che
condom message has largely failed in
America. It is analogous to che following
reasoning:
1. Many accidents occur on the road
with drivers who are lInder the inf1uenee of alcohol.
2. We must put out the message "Be
exrra careful on the road when you
drink alcohol."
But wait a minute, alcohol suppresses
che froncal lobe of the brain so becoming
"carefu1 enough" is nearly impossibJe. So it
is wich illicic sex. Becoming "careful
enough" is l1exr ro impossible because of ~he
slIppressed fronrallobe state. The solutJon
ro the alcohol-related accidenrs and ro the
sexually transrnitced diseases is notto be sa~er
when parraking, but not to partllke ~ll; 111
a word. abscinence. Teaching al1 indIvIdual

Il:

357

PROOF POSITIVE

THESEVENTHCOMMANDMENT
"Thou shalt not commit adultery."

Exodu.~ 20:14

"But 1 say unto you, That whosoever looketh

a woman to Iust after her hath committed
adultery with her already in his heart."
Matthew 5:28

00

Figure 18

how ro be abscinenr is actuaJly much casier

and will mecc with m,uch more success, since
rhe froncallobe of che brain will remajn in
control on such a program.

Changes Needed to Combat AIDS

and Other STDs
The consequences of HIV and other
sexually transmiered diseases remind us mat
our sexual practices have a far-reaching im-

THREE BIBLE PRECEPTS THAT

PROTECT AGAINST AIDS
"Thou shalt not tie with
mankind as with
womankind: it is an
abomination." Lev. 18:22
Prostitution strictly forbidden.
Deut. 23:17
Sex with beasts strictly forbidden.
Ex. 22:19
Figure 19

358

pacr on our healrh and well being. Whar

changes are necessary ro decrease rhe bUIden of death and destruccion? Ler us look
at some cimeless principles thar deal with
this important ropic.

The Bible Reveals the True "Safe Sex"

Early in rhe Scriprures God spoke with
His own voice and wrote wirh Hjs own hand
a unique set of ren moral imperatives known
as rhe Ten Commandmenrs. The Bible does
not call mese words ten suggescions or ren
good ideas but rather Ten Commnndments. 77
Their very namc coupled wirh rheir unique
manner of delivery-the only ponion of
Scriprure wreren direcdy by God Himselfshould provide re.ason enough for solemn
reflection.
Those Ten Commandmems provide a
moral compass thar many lack raday. They
speJl our me difference bcrween right and
wrong. Reflecr for a momenr on rhese ten
inspired rules for living as found in Exodus
20. The ftrSt group offour commandmellts
describes haw we should rdace to God. Thc
last group ofsOc commandments focuses on
inrerpersonal relarions. Ar rhe hearr of thar
last group, we find commandment oumber
seven presenred in the Old Tesrament. Jesus
a150 referred ro chis specific commandmenr
in the New Tesrament. Both rexrs are
quored in Figure 18.
Merriam Wehster's Collegiate Dictianary describes today's understanding of rhe
word "adultery" as "volunrary sexual intercourse berween a marrieel man and someoile other than his wife or berween a married woman and someone other rhan her
husband. ~78
However, the sevenrh commandmeru's
injunction ro sexual puriry deals with more
than JUSt physical acLS berween married individua1s. In His famous Sermon an thc
MouJlt, Jesus revealed mat the sevenrh commandmenr was so broad thar it even exrends
ro rhe levd of our thoughts. This New Testament quote refures rhe myth mat ollly the
Old Testament, but nor the New, calls for
sexual puriry.
Elsewhere in the fim five books of the
Bible (aD ofwhich are believed ca have been

AlDS AND HIV

penned by Moses under inspiration), we
read even more aboli[ the high st:tndards of
sexual pUTiry embodied by the sevemh commandment. Three additionai aspects of
sexual puriry are referred ta in Figure 19.
We see tiut the Scriprures forbid homosexualit)', prostirurion, and besriaIity. If the
world's populace had heeded the principle
prohibiring homosexual relations, HIV
likely would never have become a worldwide epidemie. Furrhermore, note rhar chis
command is nor given wirh any reference
ro marital srarus. The Scripture's caU for
sexual puriry exrends to ali individuals-not
jusr the married.
The command forbidding prostiturion
is no surprise-we have civil Iaws today forbidding it. The breaking of this commandmenr has had a major impact on the spre.ad
of AIDS throughollt the world. Regarding
the forbidding ofsex wirh beam, some have
theorud mar HN was firsr introduce<! imo
the human popularion by such proscribed
practices wim animals. It should be poinred
out rhar rhe ape famiiy does harbor an
AIDS-like virus called Simian Immunodeficiency Virus (SIV).7 9 If there was an animal-human AJDS link, it is conceivable mar
AlDS never wouJd have afflicred humans
had this commandmenr been foJIowed.

God's Primary Pocus is an Our

Thoughts
AlI of rhe Old Testament principles we
have looked ar are reinforced in the New
Testament--ohen in even srronger terms.
The words ofJesus earl)' in His ministry illustrate tne sinfulness of Iooking "on a
woman ro Iust afrer her." This admonition
highlights a recurring biblical cheme. Gad
al1d His Scripeures are not jusr concerned
with sinful acrs, e.hey are concerned wirh a
more central issue: sinful thoughes. Invariably, before sin is carried out in the life, it is
conceived in the mind. This is why the Holy
Wrjt is direcred toward rhe citade! of the
soul, which is the human mind.
Jesus' c1arification rhat the commandments extend ta snful thoughts s nor bad
news. Instead, this insighr provides a powerful force in conrroUing the behaviors chac

seem ro be rhe mase difficuh ro hamess. If

we never make a break with a behavior ar
che level of our thoughrs, we are desrined
ro eirher succumb ro temptation ar ro live
in a consrant stare of frustrarion. For example, if you long for and dream of a forbidden acriviry, ulrimately you will likely
eirher engage in that sin or wiU feel cremen
dOllsly deprived. If, an the other hand, you
choose to accepc che Bible counse! thac sllch
acrs are inappropriate ro even rhink abolit
(ler alone engage in), chen you wiJl make
real progress.
IfI am tempted ro sin "in my rhoughcs,"
r can shifr my menral focus in anorher direction. This very pracrice will soon become
habirual, and my mind will develop rendencies to think in different direcrions. The
Bible rells us "...whacsoever things are true,
whacsoever things are honest, whatsoever
rhings are jusc, wharsoever things are pure,
whatsoevcr rhings are lovely, whatsoever
things are ofgood repon, ... think on these
rhings. "80 Rather rhan adding ro my discomfort and sense ofdeprivarion, these new
mental habirs will assisr me in resisting
rempcacion. They will help me ro experience the freedom ofbeing conrroUed by my
will rar.her than having emotional drives
comrol me. Success in this line will require
a person ro avoid reading and viewing sexladen films, videos, books, and magazines
rhat are in direct opposition ro puriry of
rhought. The parh t.o success wUllie very
dose co the efforc in guarding the avenues
of rhe soul.

The Bible Elaborates on Homosexual

Relations
As previously srated, homosexual reiations are srill che number one callse ofAIDS
in rhe U.S. For mis reason, ir is imperarive
to funher darify rhe biblica! counsel on this
tOpic. The prohibitiol1s agaiosc homosexual
relations are nor confined to t!le Old Testament, bur are enunciated in rhe New Testamem as well.
In the New Tesramenr in Romans chapter L we read abolit the "vile affecrions"
(verse 26) ofindividuals who are characrerized by 'ungodliness alld unrighreousness"

359

PROOF POSITIVE

OMOSEXUALI Y ADDRESSED
THE NEW TESTAMENT
"Wherefore God also gave them up to unclcanness
through the lusts of their own hearts, to dishonour
their own bodies bctween themselves..' .
God gave them up unto vile affectiolls: for even
their women did challge the iDaturall use iO'to
that which is against nature:
And likewise also the men, leaving the nS1tuul use
of tbe woman, burned in their Iust one toward
anotber; men witb men working that which is
unseemly, and receiving in themselves that ~;---....
recompence of their error which was meet."
Romans 1:24, 26-27
Figure 20

RISK
"Know ye not that the unrighteous shall
nof inherU the k1ingdom of God? Be
not deceived:
neither fornicators, nor idoJaters, nor
adulterers, nor effeminate, nor abusers of
themselves with manki,nd, n9r thieves, nor
covetous, Dor drunkards, nor revilers, nor
extortioners, shall inherit the kingdom
of God."
1 Cor. 6:9~10
Figure 21

360

(verse 18), Among ehe "vile" practices thac

are menrioned is a c1ear reference ro homosexual relatiolls, as described in Figure 20.
As cxpecred. mis passage is in full harmony wirh che previoLJsly quored Old Testament prohibieions againsr homosexual aces.
h is very importanc (Q disringuish between homosexual /lCU and homosexual tendmcies. There is evidence suggesting ehat
some homosexual eendencies are rhe resule
of foeces beyond che individual's concrol or

choice. Both human and animal research

are beginning ro provide some valuable insiglns in chis regard. For example. Dr.
Gumer Domer and colleagues have published a series of reports chat identifies an
association between highly stressed mothers and birch ofmale homosexual offspring.
In one scudy they found chac a signiftcantly
higher numberofGerman homosexual men
were horn during ehe stressful late World
War Il and early pOSt war years. 81 They have
do ne anjmal research suggeseing mac prenacal hormonal differences (which can he
affecced by such chings as seress) can increase
the likelihood of male offspring being born
wi ch homosexual cendencies. 82 83 Studes
like ehese suggest chac ac lease some of che
homosexual populacion may have inborn
desires for cheir sexual preferences. This is
importanc ro underscand. It should be made
clear ehac oriencaeion does not provide license (Q engage in activities chac the Bible
forbids. The Bible does not permit an individual with heterosexual tendencies to engage in sexual accs outside of marriageeither in chought or in deed. Neicher does
che Bible permit chose with homouxuaLtendencies such license. In shore, che issue of
sin /ies noe with the orimtation but wich what
we do with that orimtation.
Thete are many documented cases of
individuals who formerly had a homosexual
oriencacion. but now-through the power
of God's grace-have heterosexual tendencies. Some of these individuals have encered
into monogamous heterosexual reiat ionships.84. 85 The desire for homosexual relationships is parallel ro ehe desire. for adulcerous heterosexual relacionships ar the desire to steal. Ali ofchese desires can be overcome by the grace of Gad in a person's life.
The New Testament has another warning
co homosexuals. as quoted in Figure 21.
The phrase. "abusers of memse/ves with
mallkind" in the New Testamem's original
Greek indicares a man who engages in sexual
activicywith anocher man. 86 Such individuals are classed with adulterers, rhieves,
drunkards, etc. The cexe explains ehar those
who are guilcy of such sins are risking cheir
eternal destin}'.

AlDSAND HIV

WOrse Than AIDS?

Whar could be worse rhan geuing
AIDS? This Scripmral warning presents the
thought that the eternal consequences of the
sexual act that caused AlOS is worse than
ilie eanhly suffering ofhaving AIOS. Consider this: wouldn'r it be better ro suffer and
die with AIDS (even at a young age) and
have eternal life in the Kingdom of God
than to live prosperously" for 75 or 80 years
but not have the privilege ofenjoying God's
eternal Kingdom? This is the essence of the
meaning of the Scriptural passage. The text
spells ir Out c1early: those who engage in
fornication, adulrery, and homosexual acrs
will not inherir rhe Kingdom ofGod. Contirnuing in sexual pracrices that pur lIS ar high
risk for AIDS has worse consequences than
conrracting physical diseases.

God is More Interested in Giving

Than in Taking Away
Far from God talcing someming away
from homosexuals, He is rrying co give them
something of infinirely greater value. He is
asking chem ro forgo their currenr sexual
desires in view of a better existence for eterniry. Yer, as we have noted, God's counsel
is /lot only "other-worldJy," it poincs out the
way to rhe happiesr, healrhiesr existence in
the "here and now."
In realiry, God asks norhing more from
rhose with homosexual tendencies than He
does from [hose wirh a heterosexual orientation; namely, follow My words rhar are
spoken with your presenc and eternal welfare in mind. le is nor cruelry but love mar
asks a person co forsake a damaging desire
in exchange for somerhing betcer. The recovering akoholic may often srruggle with
strong desires ro drink. He may long for
thar which he once found grear pleasure
in-jusr one drink. Yer, those who uuly
[ove him will provide every encouragemenc
ta say no ro even the first sip. He is not
being unfairly rreared-he is being loved.
Yes, he may find instanr satisfaction in
drinking, but if he jusr says no to rhis one
pleasure-rhe door is open for him ro avoid
the devastarng effecrs of alcoholism and

enjoya thousaJld more pleasures in this life

and in rhe world ro come. Sa it is with
rhose who have sexual desires rhat the Word
ofGod describes as destructive. Manywith
heterosexual rendencies as well as rhose with
homosexual rendencies will have to say no
ro forbidden sexual aets rhar once gave rhem
sarisfacrion.
Probably me greatesr irony is rhar wirh
aii of r!le marital mife and discord in our
eoul1try many married couples virrually
curse rhe day thar rhey were wed, longing
ro "break frec from a galling yoke." Some
!lave broken free in rhe divorce couns. In
spire of this, many of t!lose who are unable
ta emer iota a marriage relationship feei
cheared. Those rhat cannot emer inro a
mOllogamous relarionship duc ro past infideliry, homosexual rendellcies, or some
other reason-feel mar they are being deprived of something rhat is desirable.
Despire what sociery may rry ta [eli us,
rhere are plenry ofindividuals who are perfecrly comem and happy who do not have
a lover." Clearly, rhere is norhing that says
happiness is dependent on being married
and living wth a committed parrner. For
instance, the Aposrle Paul felr that his not
being married was better for his spiritual
mini~rry (l Corimhians 7:7-8,32-34).

A HAPPY AND FULFILLING LIFE

" ...in thy IGod's] presence is fulness of joy; at thy
right hand there are pleasures for evermore."
Psalm 16:11
"1 lJesus! am come 'hat they migbt have Ilife, aud tha.
tbey might have it more abundantly." Johll 10:10
"And the Lord commanded us to do aII these sta.utes,
for our good always, that he might preserve us alive,
as it is this day." Deuterollomy 6:24
"O taste and see that the LORD is good:
blcssed is thc man that trusteth in
Him." Psalm 34:8
Figure 22

361

PROOF POSITIVE

[s the Bible Really Contrary to an

Enjoyable Lift?
There are rwo common myths about the
Bible commandmenrs rhar should be
brollght into focus. We have already been
looking ar one of rhem in some derail;
namely, thar following biblical principles
"rakes ali rhe fun our oflife." Let us examne some Scriptural passages rhar refer ro a
sarisfying life, quored in Figure 22.
Those who 1 hear complaining about

REASONS FOR BETTER HEALTH

AMONG RELIGIOUSLY OBSERVANT
PEOPLE - AS PROPOSED BY SCIENTISTS

Emotional wellbeiog fostered by a sense of

belonging to a religious community
Relief in God
A relaxation response induced by
frequent prayer
Higbly stable maribl and family
bonding
Social support providing a buffer
against stressfullife events
Figure 23

GOD'S LOVE IS STILL EXTENDED

TOALLOFUS
"God created man perfect and holy. But mao fell from
his holy state because he transgressed God's law.
Since the faU there has been a rapid increase in
disease, sufferlng, and death.
Vet notwithstandiog man has insulted his Creator,
G6d's love is stiJI extended to the race...
... in order to Iive a perfect life, he must live in
harmony with those naturallaws which govern
his beiog.
Therefore it is of tbe greatest importance that he
know how to live so that his powers of body and
mind may be exercised to tbe glory of God."
Figure 24

362

whar rhe Bible asks them ro give up often

have never tried ro follow the Bible's way of
life. But norice the phrases in ehese eexes:
"fuJness ofjoy," "pleasures," "Iife more abundanr1y," "for our good always," "blessed is
rhe man."
Followiug a scriprural principle here or
rhere may leave us feelillg deprived. However, we will experience the blessing ofa true
sense offreedom ifwe accepr the Bible's (Oral
message rhar includes an awareness of God's
love, repenrance for pasc sins, forgiveness,
and a commitmenr ro a Jifesryle mac is pleasing ro our Saviour. ''And ye shall know the
rfUth, and rhe trurh shall make you free."
Oohn 8:31-32). Far from resrricting our
libereies and enjoymencs, following God's
ways frees lIS from ehe ryranny ofbad habirs and other de1ererious ways of living.
We arc freed ro live the most satisl)ring, fulfilliug, and gllilr-free life. Indeed, to ehe
person fearful of contracting AIDS, ehe
Bible poinrs tO a way of safery. To an individual suffering wieh the disease and dealing with guilt, the same Bible otlers the keys
ro resolving the very guilr lJ1any accuse it of
causlllg.
In (he medical lieerarure there are indications that individuals who truse God live
longer. For example, Dr. Jcremy Kark and
colleagues recencly compared two ethnically
Jewish groups ehar seemed ro be very similarexcept for religious observance. 87 Among
members of a secular communiry, ehe risk
of death ar any age was nearly dOllble rhat
ofthose members of a religious comll1unity,
rhat is, rhose who were religiously observam.
In a similar srudy, recent stressfullife evcnts
increased the risk of health problcms in a
secular communiry. Members ofa comparison religious communry seemed ro be protecred from me negative effeces ofstress. Dr.
Kark's tcam proposed some reasons why the
members of rdigious communities expericncc srress-buffering and improved longevity. They are liseed in Figure 23.
Perhaps just as imporranr as Kark's reasons is that true believers have rhe assurance mat ifehey know what is right and trusr
in God, He will give them me power ro do
what is right, which will rhen spare them
numerous diseases.

AIDS AND HIV

The disease.s ofhumankind have muhiplied since the beginning of man's sinful
existence. However, if we live in hannony
wim natural laws, che risk of contracting
disease is greatly reduced. God's love is ca1ling us ta sllch a lifesryle, as expressed by
Ellen Whire in Figllre 24. 88

GodAddresses YtJUr Power Shortage

A second myth about the Bible principb relacing ro sexuaIity is thar even if we
ali wanted ro follow them, we Iack the power
tO do so. Many believe chac it is impossible
for che average adult (Jet a!one a reenager ar
yourh) ro follow rhe scriptural commands
deal ing wich sexualiry. Consequenrly, rhey
promote merhoru mar when compared with
abstinence, actually increase the risk of
spre<lding AI DS, such as condom usage. As
we have aheady nored, condoms by no
meam eliminare the risk ofconrracring HIV.
As De. Whiring poinred our, ic is by following biblical principles thar we can b~st prevene chis tragic infeccion.
You may say, "1 understand rhe principles-buc where rhen do 1 get the power
ro follow them? How do 1 tap imo God's
power ro do righr?" Fim, we need ro know
what is righc and whac is wrong. Afrer we
know rhar. we an overcome aur sinful cendencies by trusring in God and cooperaring wirh Him. Our focus in rhis book has
been on natural lifesryle measures to prevent and trear disease. Probably rhe most
neglecced of aH natural measures is "Trusr
in Divine Power." Th is ofcen-forgonen
measure poines us ro rhe very help rhar we
need.
When people are diagnosed wich HIV
infecrion, they ofrcn must address very real
feelings of personal guiit. This guilt may
be the resulr ofknowing char rhey violared
cheir personal erhical code. Some have
thought [he best way tO deal with such guile
is tO help people challge tbeir sense of right
and wrong. Such an approach is e1early
delererious if it resulrs in people rcjcering
God's law. Do nor rry ro convince yourself
[har something is OK when deep down inside you Imow ir is wrong. Yes, such mental gyrations may help you ro forget your
guilt for awhile, but they do not provide

lastillg solucions. The mast sllccessful way

tO deal wirh guilr is ro acknowledge our guilr
and seek the forgiveness of the one we have
wronged.
The very admission of wrongdoing is
difficulr for many of us. In chis era it has
become unpopular ro admit doillg anyrhing
wrong. We are a people who go ro grea[
lengths ro avoid saying we made a misrake.
Blaming circumstances or someone else
seems Like a much easier course. However,
accepting thac you have sinned (done
wrang) is the fim srep in spiritual healing.

Forgiveness is Abundantly Available

The Bible is aha plain mat God's forgiveness is avajlabJe. The Scripcures reveal
that if we humbly curn ro God, confident
ofHis desire ro forgive us, and repent (Jeave
behind our sinflll wavs) then God wiU forgive us (" ... He will abundandy pardon."89).
Fairh (confidence) in a loving anei forgiving Saviour leads liS to true repentance (sorrow for sin) and a desi re for reformation ("...
the goodness of God leadedl chee ta repencance. "90). This, in rurn, prompts us ro confess and forsake our old ways of wrongdoing. Individuals who have cOlllmitted sinfu! acrs can indeed inherir che Kingdolll of
Gad rhrough faith and repentance. Even
when individuals become HIV-infecred because of pracrices condemned by the Bible.
their situarion is noc hopeless. Chrisc will
and does forgive mem. Tha[ is indeed good
ncws.

The Nature ofGod's Coming Heavenly Kingdom

Man)' misunderscand God's forgiveness.
Althougll God forgives us when we exercise
faith in Him, rhis does not provide a license
ro sin. In Romans 3:31, Paul addresses rhis
direcdy. He says that by fairh we acmaUy
establish the law rarher than abolish it.
Alrhough rhe Bible promises a new body
when believers emer into heaven ar che resurrecrion (" ... rhe elead shall be raised incorrupcible [indesrrucrib!e]"91), ir does nor
promise a new characrer. It is true, we are
given a "new birrh" when by faich we embrate Chrisr as our persona! Saviour. The

363

PROOF POSITIVE
devdopmenr of a new character Jiarts with
chis new beginning, and continues throughout aur liferime as we allow Gad ro develop
in us a nature chac is in harmony widl His.
Ali of rhis is important because aur loving
Father is now seeking ro prepare che cluracters of rhose who love Him for an erernity of joy in heaven.
Whar will heaven be Iike? The principles
of sexual purity wiJl nor be changed there.
Homosexual re1ations, prostirmion, and
bestiality will not suddellly bc "ali righr."
What would heaven be like if tl1e inhabitams there (lever conrrolled SUcil sexual desires? There woutd be no pleasure in an eternicy of hea.ven for rhose whose charac(ers
llad nor a1ready been cleansed of (heir sinfui paHerns of thinking. So when Gad
speaks againsc sexual sins in ali their forms,
He does so in [ave, wich aur good in mind.
Our heavenly Facher is showing us whac aur
characcers need to be like ro enjoy ecemit}'
wirh Him. As rhe aposde Paul put it: "Al1d
be noc conformed ro chis world: but be ye
cransformed by the renewing ofyour mind,
rhar ye may prove whac is that good, and
acceptable, and perfect, will of God."92
Furthermore, Gad is cOJnmitted ro give success in this work of character cransformation ro aII who choose it; otherwise, He

would not command it. Indeed, God never

asks us ro do anyching chac we cannot accomplish by worlcing together wirh Him.
Let us look at severat Bible promises rhat
give us assurallce rhar God will give lIS the
power ro live che very tife He has called us
ro live; rhey are showll in Figure 25.
In rhe believer's life, God rakes t!le responsibiliry both for rhe desire to do right
("ro will") and che doing of righc (' ro do").
It is important ro emphasize rhat when \Ve
choose ro cooperare wirh God and rely on
His power, He changes our wiU. The sin fui
desires, rhe tendencies ro sin thar have seemingly erched ineletible channels in our
minds, are overcome by God who causes llS
"ro will and ro do" whar He has revealed is
righc.
The mie of human and divine cooperacion is similar ro driving a car wirh power
steering. 1 must make che choices, 1 must
turn the wheel, bm when I cllrn the wheel,
a power beyond my humall.ity (ellgineers
caII it 't "power assist") makes che rufll easy
for me. YOl! will find more biblical ioformat ion 011 how yOll can obtain access ro rhis
Source of Divine Power who forgives our
wrongeloing and aSSllfes liS ofvictoriolls living in Chapter \8, "DeaJing Wirh Bad Habits and Addictions."

HIV Jnfection and the Brain

Figure 25

364

Unfortunately, many HIV-infected individuals do noc rake advancage of che forgiveness tiUt God makes freely available. In
fact, as rhe HIV disease process peogresses,
ir may become difficult-if noc impossible-ro choose God's forgiveness. How
can J make such a bold statemenr? My conc1usion comes from an understanding of
how HrV affects chc body. Lec us look al
some additional dimensions of HJV infcecion {hac have raught me (his importanr
message: che sooncr an HTV-infecced individual addresscs the spiritual issues, the
be{cer.
Onee the AIDS virus gains access imo a
person, ic cends ro proliferace and multiply:
It has ac !e.asc two primar)' effecrs an {he
human body. One is fhe weal(ening of the
immune system, and tlle orher is rhe dererioration of che br.lin, The infC::(;lions and

AlOSAND HIV
cancers are secondary effeCls ofHI'/, caused
by rhe weakened immune sysrem. The damage ro rhe brain is described in Figurc 26. 93
A very important practical considerauon
aJses from aur undersranding of HIV's attraCrlon ro rhe brain. Namely, rhose who
are diagnosed as being HIV posirive should
"ger rheir life in order." Even if a person
CaJ1 survive rhe severe infecrions and orher
disorders rhar stalk rhe HIV-infected, brain
funcrion may rapidly dereriorare due ro the
AlOS Oementia Complex. In orher words,
once a person is diagnosed wirh AIOS, rhere
is no guarantee of how mueh rime is lefr
before losing menral comperence. The
hours rem;lning are golden. A personal
reJarionship wirh God should bc fim prioriry. before rhe opportuniry slips away into
ererniry. If rhere are financial afElirs ro arrange, now is rhe rime to arrange chem. lf
rhere are misunderstandings to clear up
among friends or family, there should be no
delay.

Conclusion
Wherher you are seeking to avoid HIV
infecrion or deal wirh an already csrablishcd
infection, [ can poinr you to no more powerful answers rhan rhose found in [he Bible.
In facr, when we rhnk of [he sobering realicies of AJOS, none of us has any rime ro
wasre. Those who are nor HIV positive
eould become infected as the result of jusr
one incident ofbreaking God's commandments. Those wirh [he infecrion may al~
ready be movng down rhe slippery slope of
AIOS dementa.
lam convinced rhar God never wanred
rhe disease of Al OS ro ravage humaniry. He
poinred out a way ofliving rhar would have
prevenred rhis scourge from ever gaining a
foorhold. Yet, it is nor too Lare (O redis-

AIDS . . . . . . . . .
The most important direct clinica! effect of HIV
infection is 00 tbe nervous system.
The brain appears to serve as a privileged sanctuary
for mv replication [multiplication ofthe virus].
Fully two-thirds of those with AlDS have AJDS
Dementia Complex, causing progressive behavior
changes and loss of intellectual faculties.
There is also a slowing of movements, as
well as changes in discrete areas of the
brain that resemble a stroke.
Affected individuals may Iose strength
or develop paralysis in an arm or a leg.
Figure 26
cover lhe power of God's commandments
and God's promises. We, as individuals, as
a narion, and as a world cOllununiry can
beat the AIOS epidemic. We can bear ir
wherher or nor a vaccine or "magic eure
drug" is ever devdoped. I believe we can
stop HIV rransmission dead in ilS uacks by
rerurning ro the Bible, rhe Bible's Gad, and
His inspired tules for living. Nor only will
HIV rransmission be dramarically eurtailed,
bur 40,000 lives will be saved each year in
aur nation. not ro mention the diminishing of lIJltold suffering and finallcial loss
from sexlIally uansmirrcd diseases,94
Now is indeed rhe rime ro take advantage of God's graciolls offer of forgiveness.
Now is rhe rime to rely on Him for rhe
power ro live a life rhar is in harrnol)y wirh
His commandmenrs. Such a life wiU enhance our immllne sysrems, keeps us from
high-risk acrivities, and mOSt imporranrly,
prepare us for an erernry of jay wirh Him.

365

PROOF POSITIVE
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Adapte,l frorn Centers for Disease Control and Preventioll (CDC). HIVI
AIDSSurveilltJnu Rrporr. 1996 D('<:;8(1):10. Aod from Fim 500,OOOAJDS
cases-Uniled States. 1995. MMWR Morb MorttlJ Wkly R"p 1995 Nov
24;44(46):849-853.

87

Whiring A. He:thh & Temperance Dep!., General Conference of Se"elllh-day Advenlis15. Silver Springs MD. Publi.shed in the Mvmtist Rl'vit./IJ
1992.

8;

60

61

General Conference of Sevenul-day AdvenriSlS. Health Dep'trtmelll.

Stlver Spring, MD. Pl'I'solllll communiCtllioll. (RWS) ,1996.
(,2

National in5tilUlCS ofHe;I.hh Consenms Dc.:vdopmelll Conference Slatement on Cervicai Cancer. (Dmit of st,uemem preparcd based on April4,
1996 bascd on ApriJ 1-3. 1996 oonference).

63

(,.( NalionallnstiruresofHealth Conscl.lSus Deve10pmcllI ('.on(erence StalemCIll on CervicaJ Cancer. (Draft of stal<;meJlt prepareJ basl,d on April 4,
1996 based on April1-}. 1996 conferenee).

Domer G. Geicr T, el aL Prenatal stress as possible aetjogenelic factor of

homosexuality in human mal" . ElIIJokrillologie 1980 Jun;7S(3):36S-368.

81

Domer G. Poppe 1, el al. Gene- ;Ind en\'ironmelll-dependenl neuroendocrine etiogenes.is or homosexualiI}' and transsexuaJisrn. Exp Clill
EndoL"'iIl011991 :98(2): 141-150.

Dame! G, Doeke F. ce al. Sexual ditTerellli,uion of gonadotrophin sec.retion. sexual oricmalion and gender role bcha\'ior. } Staoid Bioebem
1987;27(4-6): I 081. -1 087.
Onee Gay Always Ga)'? Foms Oll rb" Fami" Ml1g'lzint, 1994 March p.
3-5.

84

81 O\'crcoming the biologieal impemri\'e. Leners ta the Editor. WaJl SlTrl'r

}OIlYllfll, Feb. 2 1997.

StrongJ. AbingdoJ/5 511'01Ig5 ExbllwtiVl' Crmeorr/Ilnce ofthl! Bibll'. Nashville, T : Abingdon Pres>. 1986. (New 7csta/f/mt refirme" /lI/mbm 730.

'6

733, tll/d 2845).

367

PROOF POSITIVE
Kark }O. Shemi G. el al. Oocs rcligious observ:locc promate heahh'
morulicy io secular \'li rdigious kibbut7.im iJ' Israel. Am j P"biic Ht'ltlt!J
1996 Mar;86(3):341-346.

8;

While EG. TrJtimollif$ for tiu CJmrr!J (Volume. 3). Nampa.10: l'acific
Press Publishiog Associ:lIion. 1872-1875 p. 162.

l!8

Th~

Holy

Bibl~.

81

Isaah 55:7.

'JO

Romaos 2:4. TIu Holy

91

1 Corjnthians. 15:52. Th~ Holy Bib/~. Author7.cd Kiog James version.

92 Romaos 12:2. Th~

368

Bib/~.

Authorizcd KingJames version.

Authorizcd Kiog Jamcs versioo.

Holy Bibk. Aurhoriz.cd Kiog }ames version.

Rubin RH. Acquircd Immuoodeficieocy Syndrame, 1993.

tific AlIlt'riClt1l Mdicin~ (CO-ROM), 1995.

93

10:

Scim-

EX1r:tI'Qbrcd rrom. McGinnis JM, Fo(-ge WH. Acrual causcs of dcarh in

the Unite<! Sr:ltc,s. JAMA 1993 Nov 10;270(18):2207-2212. mmbioed
Wilh Ceolcrs ror Disease Colllfoi and Prevemoo(CDC). HIV/AlDS S"rwilln.nce Repon. 1995 Dcc;7(2):19. Eram 1220 !O 1294 lhecslimared AIDS
dealhs dlle 10 sexual behavior went rrom 21.000 tO 31.000. rhus t!le 1994
ypdared 6gurc above.

94

CHAPTER SIXTEEN

DYINGFORA

IGA

TTE?

KICKTHE HABIT
ANDLIVE
r wasn'r supposed ro happen chis way.
Sure, Melissa knew that she was cur
ring her life shorr by smoking. "Buc
who cares," she reasoned, "wherher I
live inco my 70s or my 80s. Besides, I can
aIways quir long before men." No one had
prepared her for chis, however. At oniy 42
years of age she had heard those terrible
words: "Jung cancer" and "terminal." Like
most smokers who get lung cancer, Melissa's
disease had already spread far beyond her
lungs. It was too late for lifesaving surgery.
Now in a desperate atlempt for a few more
weeks or months, Melissa was going through
rhe ordeal of chemomerapy aud radiation.
Melissa never reaUy wanted ro smoke.
She sraned in grade school because "ali the
other girLs were doing iL" The habit was
popular in high school, (00, so she stuck
wirh it-"just sociaUy." She knew rhac she
could quir ar any time. She would never
become addicred. Bur a yea! aher she graduared from high school me rerrible realiry
sunk in: like over 95 percent ofsociaJ smokers, Melissa had become adrucred. After
severa! unsuccessful quir arrempts, she reasoned mat she enjoyed the habit anyway and
would wait until she was older-or had

healm problems-before she rried ro quir

again. Unfortunare1y, her first smoking-reIated health problem was eerm i nall ung cancer. She uJtmately rud guit. Aboue faur
monrhs afrer rhe djagnosis of cancer, MeIissa was dead. l
Tobacco addicron. Ir is by far America's
leading addjcrion when assessed in terms of
damaging our narion's healrh. However,
(obacco docs nor need ro have d1is unenviable distinction. Millions of America.ns atresc thar this Iubit can be kicked, bcc.1.use
they have done it. And rhe best news of aII
is that if you are a smoker, YUli c.1.n be successful in "kicking the habit." This chapter
is divided into eight sections:
Section I explores the widespread damage dane by smoking.
Section II examines the various cancers
related ro smoking.
Section III addresses heare disease and
diseases of blooe! vessels.
Section IV deaJs with che far-reaching
effecrs of smoking on nonsmokers.
Section V deals wid1 chronic lung diseases caused by smoking.

PROOF POSITIVE

INFORMATION ON THE DANGERS Motivation to Quit

There is no quesrion ehar rhe knowledge
OF SMOKING HELPS SMOKERS
of smoking's physical harms can provide
some of rhe mosr powerful motivations co
KICK THE RABIT
J. In 1963, per capita tobacco consumption in tbe U.S. peaked,
witb smokers estimated at 42 percent of the population.
2. The following year, tbe U.S. Surgcon General announced
that smoking caused lung cancer.
3. From that poiot on, ~here bas been a steady decline in the
number of smokers by about 1 percent every two ye.ars.
4. Only 25.5 percent smoked in 1990 compared to 40.4
perccnt in 1965.
5. Over 44 million Americans Ihave quit siDee 1964.
6. Thc steady decline in smoking ratcs following the
1964 Surgcon General's rcport is evidencc that I
knowledge of smoking's harros potentiates the
pow.~_r to quit the habit.

.-

Figure 1

Seetjon VI covers healrh problems

callsed by cigarettes (hat rob us of

qua.liry of life.
Sectan VII presenrs the deva5t<lring aleernarives ro smoking. such as marijuana, snllff. and chewing tobacco.
Section VIII emis on an extremei)' posir.ive note, as 1 share rhe good news
abom how tO break free from tobacco
addicrion.

SECTION]

The Cumulative Impact ofSmoking

Alrhough rhe majoriry of smokers express a desire ro quir smoking. only a minoriry have real plans ro (ake mat step in
rhe near fumre. What are ule facrors rhar
lcad up ro someone finally saying. "It is rime
for me ro lcick the habir"? Aud of equal
imporrance. whar facrors will help a person
who makes rhat decision be successflll? This
chaprer is dedicared ro helping nonsmokers remain nonsmokers. helping smokers see
mar the besr time ro quir is roday. and giving everyone t!le {Ools ro be free of robacco
in alI its forms.

370

quit. Such information has helped morivare mally ro kick rhe habir. as shown in
Figure 1. 2
The rrends following the Surgeon
General's announcement provide srrong
evidence that knowledge of smoking's dangers can help a smoker decide ro quit. Some
of [he information in rhis chapter on the
physical harms of smoking will be familiar.
However, much of it will not be. The full
scope ofsmoking's damage has not been \VeI!
publicized. In a 1983 Harris survey, healrh
professionals rared "not smoking" as tile very
fjrsr prioriry among acrivities that Americans could do ro proreCt meir healrh. The
public, however. rated "nor smoking" a distanc 10rh on t!le lisr of imporranc health
prorecrive behaviors. 3
Public healrh professionals oCren srand
amazed at how complacenc we are as a sociery regarding smoking. For nearly 20 years,
influenrial public health voices have called
smoking rhe most dangerous public issue
marwe face. In 1979, me U.S. publichealm
service called smoking uthe largesr single
prevenrable cause of illness and premature
death in rhe United Srares." C. Everett
Koop made a bold pronouncement duee
years later during his renure as Surgeon
General. He pronoul'ced smoking "the
mosr important public hea)rh issue of OUT
rime." Dr. RonaJd Davis, in citing such
statements, poincs out, uFurure hisrorians
willlook back wirh amazemenc that it rook
sociery so long ro conrrol rhe use of {Obacco."4
Why does the public seem ro have a diIferem view of rhis addiction rhan professionals? Parc of thc rcason re!ates ro robacco
industry pracrices of exercising a rype of
ccnsorship againsr bad press regarding nicorine and smoking. They accomplish rhis
by influencing the coverage of informarion
in magazines rhar are dependent on robacco
advercising dollars for their exisrence. S Ac[Ual research srudies show rhar magazines
(har depend largely ou cigarene adverrising
are less likely ro feature arric1c.s dealing wirh

DYING FOR A CIGARETTE?

smoking's hazards. This is particularly noticeable in women's magazines. 6
There are mher risks from smoking besides rhose that affecr the personal healrh of
smokers. We will also examine rhese issues
in this chapcer. Each can play a role in helping a smoker see more clearly rhe negacive
aspects of the smoking habit. This will help
each smoker advance in the process of ultimately quirring for good. Some of rhese
orher risks include the damages of secondhand smoke, the COStS of smokiJ\g-nor
only ro che indiyidual-bm ta his or her
family ;lJld employer, and the smoker's personal example and ies effecc on the nexe generarion ofAmericans.

The Far-reaching Devastation of

Smoking
As a physician, 1 find myselfin a significanc role regarding robacco. 1 have seen sa
many people suffer and die premacurely as
a direct resulc of smoking. As a result, 1 feel
a heavy burden ro do ali 1 possibly can ro
help smokers e1iminace chis deadly habic
from their lives. Few things quantify the
dangers of smoking berrer than a knowledge of how many deaths are caused by iL
Various eSUmares ofsmoking morraJiry have
been made by speciaJisrs in epidemiology.
Epidemjologisrs srudy groups of people and
rheir diseases; chey draw conclusions using
advanced statistical mechods as ro how
much of a rale various factors play in conuibming ro disease and death. One of the
more widely published epidemiologic studies was co-authored by the former Director
of rhe Cencers for Disease Control, Dr.
William Foege. He and his colleague, Dr.
J. Michael McGinais, compared deaehs due
ca smoking wich those from seven other
c.1uses, as illustraced in Figufe 2. 7
Notice that over 450,000 deaths per year
are caused by smoking. Other seudies indicate chat in the U.S. alo ne, smoking accounrs for as many as one ouc of every five
deachs, and a toral of five miII ion years of
porenriaJ life lost annually.8 Clearly, robacco
is the leading single lifistyle ftctor chac produces mass kiJling. But much more publiciry is given to ocher causes of dearh, such as
drugs or AJDS. Consider aII of rhe money

poured iara agencies ro stop illicic drugs;

aII of che international attempts ofour government to get ro the center of the drug
cartels; and alI of the information about
drug trafficking rhat we hear abollt daily.
Yet, there are 20 times as many deaths each
year due to smoking as comparedto drugs. The
news coverage of the damage tobacco inflicts on our heaJrh is smalJ compared ro
the magnitllde of the hayoc chac it causes.
Smoking silenr.ly performs its insidious devasration, whereas drug buscs are more dramatic aJ\d exciting to news consumers.
Similarly, massive pllbliciry is given ro
AIOS, slightly over 40,000 deaths per year 9
which is onJy abolit nine percentof the nUJnber caused by smoking. The news media
has given ample personaj interviews ofAI OS
viceims who are shown wasting away. Have
you ever seen a news interview of a smoker
who is wasting away with a facal disease
caused by smoking? Many cimes the neighbors of an afflicced smoker do noc eveo
know that smoking was {he callse of the
disease. lf that person had AIOS, it would
be newswonhy.

Smoking Shortens the Lift Span

What is rhe expected life span of smokers? Some may say, ''!'m going ta die of
something; ifit is noc from smoking, it will

ANNUAL MORTALITY FROM

SMOKING VS. OTHER CAUSES
Smoking
Alcohol
Microbial agents
Toxic agents
Sexual behavior
Firearms
Motor vehicles
IIlicit drugs
Figure 2

371

PROOF POSITIVE
be from something else." Many are nor
aware how much the average smoker's life
is shonened. Estimates vary depending 00
the group stlldied and who conducts the
research. One of the mosr sobering sraristics comes from the U.S. Depanment of
Heahh aJld Human Services. They srare
mat one quarrer ar more of ali smokers die
premarurely from a smoking-induced illness
with an average loss of life of 21 years. 1O

MORTALITY OF SMOKERS
At least 25 percent of aII smokers die
prematurely rrom a smok1ing-induced Ulness.
Those individuaJ.s Iose an av.erage of 21 years
oflife.
In other words, if 30 year old nonsmokers
could eX'pect to live to 82, 30-year-old smokers
are playing Russian roulette witb a
four cylinder gun.
If they get tbe loaded chamber, they are
Iikely to die at 61 years of age.
Figure 3

EUROPEANS ARE DYING

FROM SMOKING
Eastern European men
HaU die at middle age
Half the cancer deaths are due to smoking
Tbey bave the world's highest
deatb rates from smoking
Western Europeans
One-tbird of the men die at m,iddle age
A half million die from smoking each year
Figure 4

372

Figure 3 furrher emphasizes rhis relationship.

What a tragedy ro die in your carly 60s
and be cheated out of 15 or 20 years of reriremenr! I rhollghr abour rhis recenrly
when one of my smoking patienrs died. He
had been smoking alI of his adult life, yet
was relarively healrhy unril the age of 64.
Wirhout warning, he sliffered a brain stern
stroke caused by robacco and died a few days
later. Ifhe had nor smokcd, since there were
110 obvious problems with his generics, risk
facrors, or orher lifesryle habirs, ir is likely
that he would still be alive and well today.
Instead, he losr his life before he had a
chance ro enjoy rhe "golden years" of retiremenr aod see his grandchildreo grow up.
Even more sobering are cases like
Melissa's rhar opened chis chaprer. Some
die from smoking ar a very young age. re is
true, however, rhat some smokers seem ro
beat the odds by living inco rheir 70s, 80s,
or beyond. However, even rhey are likeIy
suffering health consequences, as we wilJ see
as rhis chapter lInfolds. Premarure dearh ar
disabiliry docs nor have ro be your experience. You can make a difference srarting
roday by stopping your tobacco habir.
Of course, premature dearllS from cigarette smoking are not confined ro America.
Ir is a major scourge worldwide. The World
Health Organization recenrly published a
paper enrirled: "The Tobacco Epidemie: A
Global Public Health Emergency."l! Ifyou
rhink we have problems here in rhe Unired
Srares, consider rhe following sratisrics.
When rhe World Health Organization
ranked 87 cOllnrries by the pe.rcenrage of
ma1e smokers wirhin their borders, rhe
Unired 5rares ranked 7Bth. Based an male
smoking paererns, we have some of ilie lowest smoking rares in the world.
Even regarding female smoking rares
(which have riscn dramatically in aur counrry), rhere are sriU 30 aur of those same 87
nations who have more women per capita
smoking than here in the U.S. As women
make progress in social equaliry globally, we
can expeCt [Q see rising numbers ofwomen
smokers in developing economies. These
faets are revealing; they teU us (hat robaeco's
burden of suffering will impact orher na-

DYING FOR A CIGARETTE?

tions even more heavily than here in rhe
U.S. Ifyou are impressed with this chapter's
srarisrics on death, disability, and disease rhar
1quore mainly for America, remember rhar
this is only rhe rip of t.he iceberg.
The impacr ofsmoking in ilie eountries
of Europe is srared in Figure 4. 12
Nor are these impressive death fares confined co Europe. Throughour the devdoping coullrres, more than one-third of men
of age 35 to 69 die from smoking. 13 Furthermore, globally, women's deaths are
catching up. The rese.arch indicares rhat we
are looking at a female epidemic of smokillg-relared morraJiry. As I a1ready have alluded to, women's smoking rates are highesr in rhe developed nations. Staristics involving middle-aged women in those countries arc sobering. In 1955, ooly rwo percem of those women died from smoking.
In 1995 the figure was lip ro 13 percent and
was stiH rising rapidly.14
The impact ofsmoking on morraliry in
the developing coumries of the world will
be even more devasraring if tlle present
trends cominue. Sinee more Amerieans are
giving up smoking, the tobacco companies
are vigorously promoring their deadly producrs in foreign lands. Tobacco induscry's
aC[ions in pouring advertising moncy ioro
ulese narions suggest an attempt tO regain
lost profits from reduced sales in this
eounrry.
As the smoking habir spreads abroad,
devastarion follows. The World Hea1rh
Organization (WHO) estimates that smoking causes over 3 miHion dearhs per year
worldwide. 15 Even more sobering are rhe
WHO predictions. lfclIrrem rares ofsmoking continue, by the 2020s or early 2030s
the yearly dearh coU is expected ro reach 10
miJIion. 16 Furthermore, 500 minion now
living will u1timately clie as the resulr ofcigarerte smoking. 17 These statistics arefurrher
profiled in Figure 5)8. 19

Effects ofSmoking on Dur Youth

Most smokers begin smoking when rhey
are young. Statistics indicate that 60 percem of aU currenr smokers in the U.S. begin by the age of 14. 20 And over 90 percen t
begin by (he age of 19. 21 Experimemarion

GLOBAL IMPACT OF SMOKING

-It present trends continue. 500 minion people worldwide wiU die
from smoking.
This translates to app,roximately 10 % of the
entire world popullation and roughly double
tbe entire D.S. population.
. Half of these deaths, or 250 million,
wiU occur in the developed
countrie-s.
Thus, smoking wUl accouDt for
200/0 of aII deaths in these nations.
Figure 5

SMOKING AND YOUTH,

AGES12TO18
54% do not expect to be smoking a year later.
75% who try to quit are unsuccessful.
Girls are as Iikely as boys to smoke.
White teens are 3 times more
likely than blacks to smoke.
Teens are more likely to smoke
if familly aud friends do.
Risk takers are more Iikely
to smoke.
Figure 6

with cigarettes sometimes begins in children

as young as 5 years of age. 22 Every single
day in America 3000 children begill to use
robacco. 23
Why do the young pick up trus habir?
What informarion do they lack that would
help them tO see the folly of acquiring rhe
smoking habit? The American Cancer Soeiety questioned 10,000 yourhs, age.s 12 ro 18.
abom smoking. Figure 6 lists the resulrs.

373

PROOF POSfTIVE
Notice rhat half do nor expecr (O bc
smoking a year later. [n oU1cr words, lUany
young people who are JUSt beginning ro
smoke believe thae wiehin a year chey will
no longer be smoking, and will have no ineencion of srarring agail\. They regard it as
a temporary phenomenon, someebing [Q do
for u1e rime being, perhaps because cl1ey feei
that the situation demands it because of
peer pressure, ar for some other reason.
They do nor visllaJize thar ehey are beginning a )ifetime habic. They do I)Q[ reaJiz.e
chac 75 percenc who rry ro quit are unslIccessful. Althollgh a majoriry thinks they
will qllit, a greater majority will not pur
fonh the effon ro qllit even rhough they
walH to. This statistic holds rrue across the
board, an r1uough the life of a smoker-75
percenc who cry ro quic each year are lInsuccessful. This low rate ofSllCCesSfui "kickers of rhe habic" can be increased, as we will
sec in Pan VII 1; rhis habir can be kicked by
everyone who applies rhe proper procedllre.
!f the p1'Ocedu.re is faUll], the effim wil! fail.

Prevention Efforts Must be Focused on

Youth

374

We need ro focllS a good share of our

prevenrion effons on children and adole.scenrs for a number of reasons: 24
1. It is easier for young people never ro
srart smoking than ro stop once ehey
become addicted.
2. The earlier individllaJS Start smoking,
rhe more years rhey are exposed ta the
injurious effecr.s of tobacco, and rhe
greater the risk of seriOllS diseases. 2S
3. Smoking has immediarc physical and
social effects rhat can undennine
healrh, impair performance, and
weaken career opportllnities.
4. The tobacco industry is acrively rargeting yOllng people as theic hope for
rhe fururc;26 we musr actively foclls
on this age group ta help empower
them to determine rheir own fmure.
5. lf we reaJly believe in prevention, we
wiJl start wirh rhe group who has not
yet taken lip the habir-rhis is the
grearest way to minimize rhe health
risks of sllloking.

Ali rold, of rhosc 3000 young people

who stan smoking today, ar leasr 750 of
rhem will clie prematllrely from a smokingre!ared llness. 27 Funhermore, each of rhose
750 vietims will Iose 21 ye.1rs of life on average. This eranslaces ro a flgure of 15,750
life-years fost-a total rhat is 5 to 6 times
tlJllt

e.'..:aeted by tmffic accidents and murders

combined.
The dangers of youth smoking do not
relate ro merely rhe damage wroughr by the
nost of toxic chemicaJs in cigarette smoke.
Many cxperrs look ar tobacco as a "gateway
drug." What this means is that smoking
(~wd other forms of Wb;lCCO use) ofren opcns
the gate ro the use of illicir drugs larer on.
Research suggests rhar dliJdren who use {Qbacco are more likely to go on ro use in sequence aJcohol, marijuana, and rhen orher
illegal drugS. 28
The emphasis throughour this book is
on prevenring diseases as opposed to rreating U1em afrer they become problems. The
approach in this chapcer is no di.fferem. The
best way ro prevem diseases C<lused by smoking is to help individllals avoid nicotine
addicrion in the f"irsr place. This facr has
not been lost on rhe public health commllniry. Nonerheless, chere are indicarions chat
we may be losing rhe war. Recent sraristics
indicate rhar smoking among high school
seniors is on the increase, rising from 17
percem ro 22 percenr in four years (1992
ro 1996).29 Currently abolit 30 pereent of
American yomh drop om of school before
becoming high sehool scniors, and dropoLlts
are duee ta four rimes more likely ta be
smokers than r.1)eir peers who complete high
school. 30 AH eold, more than rhree million
U.S. children under rhe age of 18 are reguIar wbaceo users. More rhan rwo milliol1
others are aetively experimenting wirh tobacco produecs. 31
The stakes are high. Not onJy are lives
involved, bur an incredible amounr of
money also hangs in the balances. Escimates
in 1989 indicared rhat che robacco companies collecrively were raking in SOme $1.25
billion dolJars per year from rhe sale of rheir
wares to minors. 32 The robacco industry
spends $265 million dollars (1988 statistic) giving free cigaretrc samples through

DYING FOR A CIGARETTE?

coupons. This is an effecrive way ro pur
cigarenes in rhe hands of )'oung people ar
no COSt ro rhem, and wirh linie chance of
their being caught. A recene Camel adverrisement was obviollsly directed ar yomh.
Along wim rhe collpon it suggested that you
have a friend or a "kind looking stranger'
redeem ilie coupon for you ifyou were "uneam fortable. n 33
And the free sample strategy works.
Consider the case of Sean Marsee. Ths
OkJahoma yourh gOt his firsr raste of tObacco as a minor when a robacco company
represenrarive gave him a free pack ofsn uft
ar a rodeo. Sean's habit carried a heavy price,
however. Ar the age of 18 he died from
mourh cancer caused by smokeless (0bacco. 34 In (hose who have objectively studied smokeless tobacco markerng, there s
no queston mar the robacco indusrry has
been rargeting minors in rheir placemenr
of adverrising as weU as in their distribution of free samples.J~
How can we help our reenagers aod
younger children avoid this deadly habit?
For chldren 3 ro II years old, me rask may
be as si mple as convincillg them rhar smoking is dangerous ro rheir health. 36 However, by the rime rhey reach puberry, mosr
researchers feei mar knowledge of healrh
consequences is nor enough. Parc of the
problem is me rendency ofyoung people ro
view rhemselves as "immonal." Even if rhey
acknowledge thar smoking is dangerolls,
rhe)' ofren do nor see it as a personal risle 3?
A grear variery of facrors seem ro play a
cole in youth smoking, stlch as the influence offriends, poor scholastic performance,
etc. Some experrs feel that efforts focllsing
on robacco alone are doomed ro fail wirh
r!lis age group. They argue mat messages
tO quir smoking will only be bro:rdly effecrive if rhey are part of more comprehensive
efom eo address some of [he social cond.irions [hac feed imo smoking behavior.
Pareneal smoking is one factor th:1t influences chldren ro smoke. Parents are role
models wherher they recognize it or nor. 38
In fact, Dr. Flay, in his comprehensive chaprer on yomh robacco, says rhat maoy srudies demonstrate (hac parental smoking is che
very scrongesr prediccor of whecher ar noc a

child will smoke. 39 This role-modeling effeer is especialJy important with yOllnger
children. ChiJdren may gec che Illessage
from rheir parems rhar smoking is acceptable, and rhat ic is a legitimare way ta deal
with seress or boredom. This poinr emphasizes thac aparent stopping the smoking habit
is one ofthe most important strategies for pre-

IJmting tobacco use by their childrm.

An approach to the social aspecrs inf1uencing youch smoking involves more rhan
rhe example provided by parcnts and orher
adults. Research indicues that dassroombased programs are mosr dTecrive when ehey
address social influences in a scrucrured way.
Such progra.l11s obrain filr better sllccess rhan
programs thac only impart knowledge about
smoking's healrh effecrs. 40 Some of the elemenrs rhac dle mosc successflll programs
ueilize are enumer:Hed in Figllfe 7. 4 1, 42

ELEMENTSOF SUCCESSFUL
YOUTH SMOKINGPREVENTION PROGRAMS
1. They provide information on the results of tobacco use,
with special emphasis on short terrn health effects aod
social effects.
2. They combat misconceptions about tbe percentage of
aduJts and peers who smoke.
3. They educate on social inf1ueoces 00 tobacco use,
dispelling myths provided
by the media, peer groups,
parents, aud other adults.

4. They help children to

know how to resist
pressures to smokc.
Figure 7

Clearly, for chiJdren aod youth who see

rhemselves as imJnorcal, a good case can be
made for emphasizing rhe shorc-term derriments of smoking. Thcse may include
decreased athJeric endurance, case, scained
fingers, premature graying and baldness, bad
breath, cough, phlegm prodncrion. shortness ofbreath, body odors, cigarette butns,
and risk of srarting a fire. 43 . 44 Even armed
with this knowledge, ir s sciH important ro

375

PROOF POSITIVE

EXPECTATIONS OF TEENS
"Teenagers greatly underestimate the
addictivenes,s of tobacco and greatly
overestimate their ability to control it.
By far, the surest way to be a
Donsmoker is to never start."
Dr. Louis Sullivan, former
Secretary ofHealth and
Human Services.

Figure 8

A SMOKING CATASTROPHE
Even if current rates of smoking were
merely to stay the same, 20 million of
the 70 million children in the United
States today would become smokers.
At least 5 million
ofthem can
expect to die of
smoking-related
diseases.
Figure 9

376

impart an awareness dlat smokers are in che

minority, and co dispel mychs abolit
tobacco's benefics. In the face of aU of these
good teasons nor [O smoke, experts chen
recognize a need for special training in refllsa! ski Ils. 45 YOllug people need [O leam ro
say no in a way rhar they feei is acceprable
co t.heir peer group. Giving reasons [O peers
may actuaJly be one of rhe most effeccive
ways ro legitimatize their Slance. The child
may say," o thanks, it makes my c10ules

smell", or "No chanks, ic will interfere wirh

my playing SpOfts."
Anorher element char may help decer
yomh ti-om smokiJlg is by confroming t.hern
more squarely wirh the addictive natllre of
nicorine. Recenc researeh confirrns thac
young people who smoke daily tend ro
smoke for the same reason that adults c1odley are addicted. Furrhermore, statistics
also illustrace che deceptive powers of cigarettes. Many young smokers apparently take
up the habic thinking char they can remain
"in conrrol."46 But here is where rhey are
deceived. That small paper roll of tobacco
conrains nicotine-a powerfuHy adclicrive
chemical. Dr. Louis Sullivan, former U.S.
Secretary of Health and HlIman Services,
sums up the relacionship berween teenagers
and smoking as quoted in Figure 8.
Even if we can halr the emerging rrenel
ofan increase in yomh robacco lIse and keep
sl)loking initiacion at ics presenl level, the
furure stiH looks bleak for aur children.
Figure 9 expresses the grim realiriesY
The death of five million children is a
carastfophe rhar we must do our utmost ro
prevenr. The informarion in this chaprer
cao play a pivotal role in preventing this
epidemie. lf smokers take these message
ro heart and qllir now, and if aU parelll:s can
impart this informarion ro t.heir own children, we can make a sign.ificant impact.

The Dollar Costs to Society

ofSmoking
When yOll think of rhe human devastat.ion eaused by smo1cing, any finan~ial coSts
tend ro paie in significance. However, in
an environment of shrinking hea.lt.h care
resources, we must look at the financial
impact of this habit as weB. What are the
healrh care cosrs for smokers? Figure 10
i!Jusuares some of rhe beSl curtent estimares. 48
We have seen startling escalaling health
care COStS each year in America. One of che
major reasOlls lS [he hllge price tag dut robacco cHries. Many parienrs rhat 1take care
of in our hospital intensive care unt on a
daily basis 'lrt chere because of rhe effecrs of
robacco. If you have not been a patient in

DYING FOR A CIGARETTE?

an inrensive care unic, consider yourselfforrunare. The diseases thac land l'ou ehere are
tlsually serious and rhe daill' price eag is very
high. Hean aceack parients rypicall)' are
caken inco intensive care unirs for a number of dal's. Orher smokers find chemselves
in che intensive care unic because che)' need
a ventilator (a mechanical breaching machine). Alc.hough these machi nes can be lifesaving. rhe)' are probabl)' among che mose
difficuh procedures for the patiem ta colerare. Just imagine lying awake wich a large
plascic rube going chrough l'our nose or
mouch, down your c.1uoac, and into l'our
windpipe. On top of ali chis, the machi ne
breathes for l'au. In man)' such circumsrances, you are actually unable co eake a
breach an )'our own, even if you want to.
What is rhe best wa)' ca end up 00 a ventilator? Continue smoking. As l'our lung
efTecciveness dereriorates, normal recoverl'
from surgerl' or normal improvement from
pneumonia mal' well e1ude l'au. When l'ou
get inca such sicllarions, p;trt of l'our recovc.rl' mal' rake place in c.11e inrensive care unir
an a ventilator.
Noe only are c.1lOse inrensive care stal's
demanding on rhe pacient phl'sically; chel'
are, ro repeat, extremely cosell" Where does
aII the monel' come from? From Medicare
fllnds, medical insurance companies, and,
yes, even rrom patienrs' OWI1 personal bank
accounrs. Regarding illnesses due ro smoking, alI of rhe expense arise$ from wholll'
prevenrable condirions broughe an by an
individual's own acrions. le was a volunrarl' ace by the individual in adopring the
smoking habir rhat collecrively rotals 50
billion dollars per year in healrh care cam.
Ifwe cOllld eliminare e!le smoking problem in America, we would cerrainly relieve
r!le crisis in !lealth care cost. The problem
of escalaeng cosrs or rhe need co cur those
COSts would be diminished. The need tO
clase down aur hospirals or medical research
programs for lack offunds would be diminished ar even disappear. Fifty billion dollars of savings each l'ear would surdy go a
long wal'. Cercainl)', rhe pressure ro make
"Medicare cutS" would disappear enrirell"
Some have framed rhe I1nancial argumenr in ocher rerms. When rhe additional

HEALTH CARE COSTS OF

LIFEWNG SMOKERS
AII told, the excess lifetime medical expenditures for ali
of those smoking today in America will amount to
approximately $500 bUlion.
This amounts to $50 billion in annual medical expenses
for smokers.
Expressed another way, each year more
than one miUion young persons start to
smoke, addiog an estimated $10 billion
during tbeir lifetimes to the cost of
health care in the U.S.
Figure 10

costs of ehings like disability and premaCllre

death are added inco the equarion, every
family of faur in our counrry is probabil'
paying c10se ro $1000 per year (in raxes and
increased inSllJance premiums) so rhar oeher
Americans can have the "privilege" of smoking. 49 In view of chis, manl' cieizens are
concluding rhac ir is wrong for the American raxpayer ro, in essence, be subsidizing
rhe tobacco companies and smokers.
Orhers have made even bolder sllggesrions. One of the boldesr is the proposal ta
reStfUCtllre Medicare sllcb ehar aII smokers
are rotally barred from Medicare benefits.
I menrion rhis radical proposal because it
highlighrs the economic issue.s. Merely discussing some of r11ese more eccenrric proposals may hetp smokers be[(er realize mar
io the pre.senr U.S. system ehey are not only
harming cheir health, buc the)' are asking
someone else ro pal' for maol' of ehe related
costs.

Smoking Reduces Productivity

on the Job
le is noe juse raxpayers and health insurance compallies, however, who pa)' chese
bills. Smoking puts a toll an a person's
employer. Employers face cOStS bel'ond
ehose involved in providing insurance.

377

PROOF POSITIVE

Over 4,000 different

compounds have been
identified in tobacco smoke!!

more per year d1an nonsmokers and, an

average, rhey miss more days from work. so
0ther sources suggest rhat toral excess costs
per year for employing a smoker may reach
$1200. SI Srill orher dara indicares rhar over
rhe liferime of a twO pack per day smoker
in his early 40s, an employer could save
abolit $30,000 if rhat individual sropped
smokingY The cosr of a one week live-in
smoking cessation program is onJy a fracrion of dlat amount. The message ro employers is c1ear: rake advantage of every opporrunit)' ro hclp your smoking employees
"kick the habiL"

Pollutants in Cigarette Smoke

Figure 11

378

These include the cosrs ofdecreased produc{iviry because of absenreeism, and expenses
to train new employees when smokers leave
me work force early due ro smoking-related
disabiliry or premature rnorraliry.
A physician friend rold me of a young
lady who, in de perarion ro srop smoking,
enrolled in a live-in stop smoking program.
Mrcr rhe week-long program, he realized a
previollsly unattainable goal-she became
a nonsmoker. However, she found rhar her
employer would nor help with any of the
stop-smoking program co ts.
This is nor an isolated instance. re is
difficulr ro undersrand why employers are
nor more supporrive of nicotine addiction
trea[mem. Numerous employee assi. rance
programs will pay for akohol and illicir drug
treannent ro the tune of rhousands of dollars. Why won' r dley fund programs for
nicorine addiction rhar are muci, less cosrly
and have me porential ro save rhem even
more money, panicularly when rhe number of employees affected are considered?
Statisrics suggest rhar the employer
would acrual.ly save money in hnancing a
stop-smoking program for an employee.
Compared (O nonsmokers, smokers in rhe
work force have nearly twice as many hospiral admissions and spend over rwice as
many days in rhe hospir.aI. Their yearly
healrh care c1aims average $400 ro $500

When we recogllize ilie number of toxic

chernicals in tobacco smoke, ir comes as
litde surprise rhat these products callse exrensive bodily harm. The number of mese
polluranrs is srared in Figure 11. 53
Many of rhe 4000 compounds are
known ro be carcinogenic; many are toxic
ro arrerie.s. Many, as individual componenrs, should have been dedared as pollurants and regularcd by laws rhar require them
ro be bured safely benearh the earth in tOxic
waste durnps ro prevenr LIS from being exposed ro rJlem. There are no such regularions becausc rhey arc in a commercial wrapper and profits are being nude from selling
tobacco.

SECTION II

Smoking and Cancer

As was prcviously starcd, in lQ64 rhe
Surgeon GeneraJ accurately and empharcally srated {har robacco c.1uses lung cancer.
It is hard ro hnd a smoker roday {har does
nor. accept thar fact. The lung cancer messagc has been heard loud and dear by smokers. Whar has nor been pllblicized is rhar
smoking increases [he risk of many other
cancers. There arc ar Icast 16 other cancers
related ta smoking. They arc listed in Figure 12. S4. S5. 56. 57. 58
These cancers are in 16 crtical areas of
[he body. AII rold, estimates indic.1rc rhat
every year in the U.S. some 150,000 smokers die from cancers rhat are a direcr resulr
of their smoking. 59. 60 Nearly one-third of

J..

DYING FOR A CIGARETIE?

aII cancer dearhs are due to moking. 6J
Some of tbe cancers that smoking causes
rend ro be rapidly fatal, such as cancers of
[he esophagus lung, pancreas, and liver.
Orhers offer more chance for cure, bur aU
are potentially devastating iI nor facal.

Dozens ofCarcinogens in
Tobacco Smoke
Tobacco smoke conrains a vericabJe
wicches' brew of compounds rhac aJmos[
seem purposely designed to cause cancer. Of
the 4000 idenrifled chemicals, 43 are knOWll
co be carcinogens. Carcinogens are able, in
and of chemselve~, tO cause rhe beginnings
of cancer. For rhis reason they are sometilne referred ro as cancer nciarors. Also,
tohacco itself concains a variery of carcinogens. Thesc compollnds are unable ro cause
c.'U1cer themselves, bur when rhey are presenr
in rhe company of full-blown carcinogens,
they increase rhe risk of cancer. 62 There are
srill mher chemicals in rne smoke thac are
calJed tumor acceleraro rs. As rheir name
indicaees, these speed up fhe growrh of cancer once it has begun.

Tobacco Jmpairs the Mucus-C!earing

Mechanisms ofthe Lungs
Tobacco impair.s rhe normal. c1earing
mechanisms of rhe lungs. Microscopic
hairs, caJled cilia, Jine rhe air passages and
help ro keep t!le lung dean. These minure
hairs are immersed in a layer of mllCUS rhar
is viscous enough ro cling ro dle lining of
[he lungs, bu[ fluid enough ro bc propelled
by chose lirele hairs. Healrhy ciJia work ro
conrinuously propeJ the mucous marcriallining the air passages away from the lung. Thc)'
funcrion like oars an a ship, aII beating in a
single direcrion from the lung up coward rhe
mourh. As they beat concerredly, rhe mucus
layer movcs up the roain brearhing tube
and finafly inco rhe region of rhe mourh
and rhroar where ir s either cOllghed out
or swallowed. This process provides signiFicanr lung prorcction. Most foreign
parricles become imbedded il) che mucus.
Unforcunately, however, the cilia of
smokers are paraJyzed. Becausc of deficient

SMOKING CAUSES MORE

THAN LUNG CANCER
It may also cause these cancers

Lip
Liver
Mouth (oral cavity)
. Pancreas
Throat (pharynx) . BI.adder
VOlce box (Iarynx)!.~dney
C.
ervlx
Trachea
. Leukemia
(wind pipe)
. Colon
Esophagus
. Skin
Stomach
Penis

acrion of thesc rin)' hairs, when a smoker is

exposed ro cancer-stimulating chemicals,
rhe bod)' is less likely to get rid of them.
Somc of [he more nororiOliS agenrs found
in robacco smoke thac are direcdy poisonous ro the ciJia are: formaldehyde, hydrogen cyanide, oitrogen dioxide, and amlllOnia. 63 Carbon monoxide generated by cigarectes ilio can impair rhe clearing functions
of rhe lungs and air passages. 64 Thus, we
sec thar agents like formaldehyde in cigarette smoke acruall)' er rhe srage for more
harm from tobacco's orher consriruents.

Figure 12

Nicotine and Carcinogens

are Jnseparable
As a resulr of aII of r.he combinarions of
chemicals in robacco smoke, it has long been
recogni7"cd rhar cigarette moke is even a
more potent cancer-causing agent rhan rhe
stim of aII rhe cffects of irs known carcinogens. 65 Some other points are woerh noting. It is impossible to malle ti cigarette that
has no carcinogens. Soene of rhemost toxic
carcinogens are rhe resulr of chemical
changes involving nicorine ir.self. These
changes can occur during curing and ocher
processing procedures performed an leaI
tobacco, ar they Gln occur during robacco
burning as rhe cigarette is smoked. 66 Thus,
as long as Il cigllrette contains nicotine, it wilf

379

PROOF POSITNE
have carcinogens in it. Since rhe cobacco
indusrry has already experimemed with and
rejected nicorine-free robacca cigareues,
smokers are doomed ro be exposed ro cancer-causing agents for as long as they smoke.

Tobacco Smoke Contains Cancercausing Radioactive Substances

Today many are wary of rhe effeccs of
radiation. Conscienrious consumers minimize demal or medical X-rays because of
concerns about unnecessary radiation.
Probably che mosc frightening case of radiarion exposure in history was caused by
cbe Chernobyl nuclear reactor accident in
rhe former Sovier Union. Europeans and
even the Middle Easterncrs were lcgicimately
concerned about rhe radiarion exposure
from mar terrible nuclear catasrrophe. A
recene report in The (oumal of che American Medical Associarion examined exposures in Israel relared ro Chernobyl. The
auchor poinred our thar rhe average Israeli
wilJ have absorbed an average of flur units
(mrem) of excess whole body radiation due
ro ehe Chernobyl accidenr. 67 This would
be expecred ro resulr in only four cancer
dearhs among Israel's 4 million people.
However, one cigarette exposes a smoker's lungs

to as much as sevm units. 68

LUNG CANCER MORTALITY

BY NUMBER OF CIGARETTES
SMOKED PER DAY

Morta.lity

Rate

20
15

10
5
Non-Smoker

1-9

10.-19

20-39

Cigarettes Smokcd Per Day

Figura 13

380

40+

Over rhe course of a year, chis would

translacc inca over 12,000 times che
Chcrnobyl exposure. The radiation comes
from radioaccive Polonium-210 that is
fOllnd in cigarette smoke. The polonium
finds ilS way inco cobacco in rhe fie1d because the glandular hairs of the robacco Icaf
can rake rhis [face pollutanr out of che air
and concentrate it in the plam. 69 Ocher
sources of polonium in eobacco are impurities in some phosphate ferrilizers used ta
ralse tobacco'?o Animal stlldies have demonsrrated thar polonillm-21 is a carcinogen in its own righe. Furrhermore, radioactive polonillffi acts together wich other
cancer-causing agems ro c.ause even more
cancers lhan you would predicr from adding their effects. 71 Unfortunare1y, the radiacion is nor rescricted [O ehe smoker;
greacer rhan 75 percem of rhe radiation is
found in side-scream (secondhand) smoke. 72
This radiarion appears ro be doing irs
share ofdamage. Recent repom have Iinked
smoking ro leukemia and che rheory is rhat
radiation may be the causarive facror.7 3 This
linkage combined wirh the recognition of
higher amoums of radiation in side-stream
smoke may be the explanacion for a long
recognized re1ationship: ilie offspring of
smokers have more leukemia.

Lung Cancer
Ar rhis point we will concentrare on the
number one cancer killer of American
smokers: lung cancer. Lung cancer is rhe
leading cancer-killer in America for both
smokers and nonsmokers, and me.n and
women.7 4 Some years ago, lung cancer surpassed breasc cancer as being the leading
final malignancy in women. It long has been
[he leading cancer kiIJer of men.
Each year over 100,000 Americans die
from lung cancer caused by smoking?S
MortaIiry from this cancer s proportional
co ehe number of cigarerres smoked daily,
according to a 25-srare study performed by
the American Cancer Sociery, as shown in
Figure 13. 76
Norice rhar the more cigarerres smoked
per day the greater che risk. Those who
smoke ewo or more packs per day (40 or
more cigarencs) have an excremely high risk

DYING FOR A CIGARETTE?

of lung cancer, over 18 rimes thar of the
nonsmoker. Even the person who smokes
very linie (Iess rhan 10 cigarerres a day) sriil
mns nearly five rimes rhe risk of contracring rhis deadly cancer.
Some feei rhey have made grear srrides
by cuning down ro slighrly more rhan half
a pack daily. Yes, they are helping themselves. bur they sriU have over eighr rimes
rhe risk of developing-and likely dying
from-America's number one cancer. .As
expecred, rhe nonsmoker has the lowesr risk
of alI; rhar risk would be lower yer ifir were
n.or for secondhand smoke, an issue rhar we
wiU examine larer in rlle chapter.
Although rhe risks of lung cancer as a
resulr ofsmoking are impressive, even more
sobering is rhe risk ofpremature death from
lung cancer. Researchers calculared rhe risk
of dying from smoking fTom a number of
diseases ar difFerenr ages. 77 They based their
calcularions on an average 35-year-old man
who was smoking somewhae over a pack a
day (25 or more cigarerres daily). When
compared ro a nonsmoker, chis individual
had 30 times the risk ofdyingjYom lung can-

ence in who developed anorhcr cancer? The

answer is illusrrared in Figure 14.79
Quicrers had only 1/3 rhe risk of deve!oping a second primary lung cancer (a new
lung cancer rhar was nor of the small cell
rype) compared with rhose who conrinued
ro smoke. Resulrs from scudies like chis

SMOKING CESSATION REDUCED

CANCER RISK IN CURED
CANCER PATIENTS
55 smaU celliung cancer patients
survived 2 years.
Some continued to smoke.
Continued smokers had nearly triple the risk
of developing a second lung cancer compared
to those that quit during treatmenf for their
original cancer.

cer before he reached 65 yea" ofilge. 78

Some people, when rhey learn rhar they
have lung cancer, may say, "Since 1 already
have lung cancer, why should I quic smoking? Ir's roo Iare. Chances are ehar chemorherapy and radiarion will noe help much.
Besides. I am addicted: It is roo hard ro
quit." The informarion available raday indicares rhar chis is nor logical chinkjng. A
research srudy looked ar some 540 smokers
who developed a particular rype of smoking-relared lung cancer called "small ceU
cancer." In keeping wirh rhis generally fatal cancer, 90 percenr of rhe parienrs had
eirher died or were scill scruggling wirh rhe
cancer a shorr MO years larer. However,55
parienrs (ren percenr of rhe original 540)
Were cancer-free ar rhe end of MO ycars.
1 hcse individuals were appropriare1y considered cured. (Due ro rhe aggressive narure of
srnall celliung cancer. a rwo year djsease-free
survival usually means rhar rhe cancer is
cured.) Mosr of chose surviving parienrs had
afready quir smoking; however, 12 conrinued rheir robacco habir. Thc quesrion was:
would conrinued smoking make auy differ-

Figure 14

show rhar stopping smoking am help prevent

a second mflcer. This fact brings rhree basic
messages abour cancer and smoking inco
focus.
1. If you have no known cancer, kicking the habir will sharply reduce your
risk of getting it.
2. lf you have cancer and are cured,
kicking the habr gives you a much
berrer chance of avoiding addirional
cancers.
3. Recognirion of rhese benefirs can be
an aid ro helping you Stop riIe habir.

Bladder Cancer
Recent research indiones rhar both cigarenes and coffee increase rhe risk of cancer
of rhe bladder, rhe organ thar stores urine
prior ro irs e1iminauon. "Bladder cancer"
may not be a hOllsehold word, bur ir is
among rhe top five cancers rhar kill older
American men. 80 Heavy smokers rriple
rheir risk of rhis dangerous cancer. 81 On
the other hand, heavy coffee drinkers-

381

PROOF POSITIVE
defined as those using rwo ar more cups
d;~ily-double {heir bladder cancer risk.
Since ilie cigarette-relared bladder carcinogens are held in the bladder, it is expected
chac smokers who drink more water aud
void more frequently may be able ro decrease the risk of this cancer somewhat.
However, the best preventative is ro leave
of[ the cigarerres and coltee alrogether.

Smoking lncreases Colon Cancer Risk

Colon c.1ncer (cancer altecting rhe large
intestine) is one of the most recent malignancies ro be added ro the list of robaccordated cancers. Although prostare cancer
kills more meo and breast cancer kills more
women, colon cancer is the second leading
cancer kilter when men and women are
combined. We have known for years that a
poor diet can cause colon cancer; this is
documented in the chapter on cancer
(Chapter 2). However, few ever imagined
rhar colon cancer was relatcd ta smoking.
Now, Harvard researchers have confi rmed
this relationship in both Olcn and women,
as stared in Figure 15. 82. 83
Why wasn't the effect of smoking an
colon cancer risk recognized sooner? The
authors speculate that because of the insidiDUS nature of the chemicals in tobacco, colon cancer risk increases decades afier expo-

SMOKING ANO COLON CANCER

Smokers can d&uble their risk of
colon cancer.
Smokin,g leaves caocer-producing
effects on the large intestine that
probably persist throughout Iife.
Therefore, the sooner you quit, the
better, regarding the risk of future
colon cancer.
Figure 15

382

sure. Simply put, the research does suggest

tluc chemicals in cigarette smoke have a
carcinogenic cltecr an rhe colon lining. Yet,
this effect does not appear ta be sufficienc
in itself ta causc a full-blown colon cancer.
The cigarette toxins prime the large intestine ta develop cancer years from now. Because of this, yOllr risk of colon cancer taday has more ta do with your smoking habies 35 years aga rhan ie does with how much
you smoked yesterday. Thus, smoking can
nave cancer-producing effeees long into rhe
fumre. The less you sllloke now, the less
those risks will be. This evidence illustrates
that taday is rhe very besr time ta quit. At
the poinc in time when colon cancer srrikes,
it ooly indicates thac you should have
stapped smoking long aga. Furehermore,
the persistent elfect of smoking an colon
cancer underscores the need ta impress on
young people that smoking at a young age
may catch up with chem up ta 35 years ar
more later.

Breast Cancer, MeLanoma,

and Penis Cancer
Breast cancer, [he second cause of cancer deaths in WOll1en, is yet another cancer
chat has been found ro be reLated ta smoking. Unlike the other cancers mentioned
in chis chapter, smoking may not eduse
breasc cancer; therefore, 1did nor include it
in rhe figure that imroduced this secrion an
cancer. The best evidence so far suggests
that smokcrs do not have more breast cancer, but if chey ger it cheyare more likely ta
die from it. 84 One theory is that smoking's
well-documented power ro weakcn the imml1ne system provides a better chance for
spreading breast cancer and ultimately killing the victim.
This evidencc is based an at least rwo
studies. 85 . 86 The most recent looked ar over
600,000 women who had nearly 900 cases
ofbreast cancer in some 10 years of evaluation. The findings appear in Figure 16.87
Smokers who develop melanoma have a
greater risk of bJood-borne spread of the
cancer than nonsmokers. 88 Anorher rype
of skin malignancy, squamous cell cancer,
is increased by 50 percent in currenr ciga-

DYlNG FOR A CIGARETTE?

rette smokers compared ro rhose who never
smoked. 89
A cancer rhar has relarively recenrJy been
linked ro smoking is cancer of t1JC penis.
Compared ro mose who never smoked, current smokers had nearly uiple the risk of
thjs devasraring caneer. 90 This malignancy
may also have an immune sysrem link.
Research has linked cancer of rhe penis wim
geniral wans. 91

What About Ali Those Pictures of

Attractive Heaithy Smokers?
Tobacco advertisers have bombarded us
since childhood wirh images mar are nor
depicred as images ofdisease aud death. We
have seen attracrive women and masculine
men, alI apparemly in rhe peak of healrh,
holding or pufftng an cigarettes. The magazine ads and billboards of roday continue
ro glamorize smoking. In realiry, rhe smoking models such as rhe "Marlboro Men"
have paid a priee as a resulr of rheir labors.
Man)' of these individuals who achieved
Carne in tobacco company ads have been
disabied or losr their lives because ofsmoking. Five examples of such rragedies are
lisred in Figure 17. 92
The rwo survivors 0/1 rhe lisr have rried
ro undo rhe tie ehey have helped perperuare. Borh David Goerlitz and Janet
Sackman have become ourspoken critics of
smoking's harms.

Stop Smoking, Change the DietfOr

the Best Protection Against Cancer
Therc is no doubr rhar cancer is "muleifactorial;" many facrors add togerher ro uleimarely resulr in cancer. There are smokers who never get cancer. Perhaps they were
relarively prorecred by meir genetics or ocher
lifesryle facrors. Unforrunarely, regarding
genetics, we can ger an idea of whar we are

at risk oJ but not what fUe are protected/rom.

For example, it borh your parems smoked
and died ar age 40 from lung cancer, and
you, roa, are a smoker, yau run a very high
risk of dying from lung cancer at an early
age. However, ifborh yom parenrs smoked
and died of narur:I1 causes in cheir 90s, ehar

SMOKINGAND
BREAST CANCER
Compared to nonsmokers, women who
smoke suffer a 25 to 75% increased risk
of fatal breast cancer.
The more they smoked and the
longer they smoked, the
higher ,their risk.
Figure 16

FIVE ILL-FATED
"MARLBORO MEN"
Name

Tobacco ~
Company.

Wayne McLaren Marlboro

Fate
dead -lung cancer - age 51

Janet Sackman

Lucky Strike

cancer - voice boxllung

removed

David Goerlitz

W,inston

had a stroke in bjs mid~30's

!David Millcr

Marlboro

WiII Thorobury

I Camel

I dead - emphysema - 1987

I dead - lung cancer - age 56

is no guaranree rhar jf you smoke you will

escape dearh from lung cancer in your 40s.
"Recessive gencs" are one of rhe hereditary reasons why children can suffer from
diseases mat rheir parenrs never had. Yes,
borh parems can bave a generic tendency
10 an illness thar chey never experienced. It
is only when both of rhose parenrs comributed a gene with rhis rendency that it shows
up in their children.
In addirion ro the unconrrollable factor
ofgenerics, many Iifesryle facrors, which are
conrrollable, also influence cancer risk-

Figure 17

383

PROOF POSITlVE

384

even among smokers. Dierary choices play

a profound role in cancer risk. For example,
rhere are over 25 srudies rhat show ehat earing pleot)' of fruits and vegetables rich in
beta-carorene, a vramin A family compound, can hclp decrease lung cancer risk
in borh smokers and nonsmokers.')3 Men
in Western New York who are more beracarotene from the fruirs and vegetables in
rheir diet had only abour 55 percenr of the
lung cancer risk as those earing lirde beracaroreney4 However, rhe prorective effecrs
were most beneficial in never smokers and
ex-smokers. Alistair Moodie, in his excellent review of rhe role of nurrition in slllokers, idenrifies a wealth ofimporram research
on this ropie. He presems dara demonstrating rhar sllloking lowers blood levels ofcancer-protecrive vit.unins like bera-carorene as
well as viramins C and E. Furthermore.
Moodie cires scenrific evidence linking low
levels of these vitamins {Q a number of
smoking-related cancersYs
The point that concinues ro come
through in the medialliterarure is rhat eating more fruirs and vegetables has a role in
cancer prevenrion-bur rhe benefirs are
grearest if a person has first stopped smoking. Funhermore, taking supplemenrs will
not provide rhe same benefit as eating rhe
plant foods rhat are naruraJJy rich in rhese
prorecrive vitamins. A case in poim was
provided by a Finnish srudy rhar looked ac
male smokers-some who were raking vitamins and others who were nor. The male
smokers who {Qok both vitamin E and betacarorene supplements showed 110 elJidmce of
lung cancer prevenrion. 96 In fact, raking
bera-carotene supp1ements acrually appeared ro il1crease the risk of Jung cancer.
Or. Robert Jacob, a PhD research chemisr wirh the U.5. Oepartmem of Agricu1rure, made an insighrful sraremem that purs
rhe medical [irerarure on nutrition and
smoking in perspective: "Besides quirrjng
smoking, the most useful change (hat smokers can make is ro increase cheir imake of
fruirs and vegerables."97 Dr. Jacob went on
ro menrion that taking supplemcnrs was not
an equal alternative: many of ilie beneficial
compounds found in fruits and vegerables
are noe yet available in piUs.

It is clear rhar ~'wb9.1af an abun. mg orhcr candance of planr fpoas a:

cer-prorecrive bene6ts besitIe vltamins. The
average American-and espeeially the average American smoker or e,x-smokerwould be wise to eat mpre fcuits and vegetables. However. alrhot1gh a good dier
helps, it does not came close ro undoing
rhe risks of smoking. ~p.r. li}! kicking rhe
habir. Then improVe yoUr pier ro help your
body repair t11e daina~il}flK;ted by smoklOg.
~

Conclusion ofSeetioii

...

The information in'dUs ~rion regarding rhe devasration wroughr by smoking is

massive. Ir is consifen.r~rpre are no conrradictions in the dar~.t Ci~rettes cause
disease. desrru"';Q-,' ~jni -aeath: Being a
nOllsmoker ill:tbe tUQS 'p~~ful wayw prevem cancer. If yau snlolff, yrtlove Iife and
wanr ro live, rhe very be5t de~ion yau can
make is ro kick the habu 1l0~

SECTION III

1:

Smokin:g, Hei,rt

Disease, aiul ~Otber

Diseases ,ofBIo'oil
~sseb
Many are aware- tha tobacco causcs cancer, but few of my paticmt's stern ro realize
rhar smoking causes dis.eases of rhe heart aod
blood vessels. 98 Corop?-.ry hearr disease
(hean disease caused l>Y blockage. of rhe
hearr arteries) is the "J:lmher ooe killer in
America roday partly because of the large
number of people who are addicted to robacco. Another top l{UI~r. sr.roke, is a1so
relared ro smoking. 99 Diseases of rhe blood
vessels of rhe arms and legs, known as peripheral vascular disease, are a1so dramarically increased by smo<.iJlg. 100 The cammoo denominaoc~~ aU~f rhese diseases is
a process caUesJ a(Qero le-rosis. which is
greatly accelerated by smokjng, 101
How many Americans die.of diseases of
the hearr aod blood vessels? When added
eogcrher, srrokes, coronary hean disease, aod

DYJNG FOR A CIGARETTE?

peripheral vascular disease chim nearly a
million lives each ycar. Clase ro 300,000
of thesc dcarhs are rhe direct resuh of cigareue smoking and its effects upon rhe blood
vessels. 102 Simply pur, if rhese people had
not been smokers, rhey wouJd probably srill
be alive roday.
It is well esrablished thar a singular factor, smoking, is the cause ofa massive number of dearhs cach year because of irs eEfe.cr
on me blood vessels alone. The whole world
should bc made aware of rhis tragic ncws.
A nurnber of years aga, fhe Surgeon General sem a lereer ro every American abolit
the AIDS virus. 1 received one, as did evcry
mher American who had a mailing address.
The lener served a good purpose: it rold us
how ro avoid dying of AIDS. However,
comparing the bigh number of hean discase deaths caused by smoking Wifh rhe
much smaller numbcr of AIDS dearhs every year, rhe Surgeon General should have
sene out five letters ro each American ro warn
us of fhe cardiovascular evils ofsmoking.

How Much Does Smoking Jncrease the

Risk ofa Heart Attack?
Studies show rhar those who are berween
rhe ages of 45 and 54 and smoke more rhan
one pack per day increase their risk of a hem
attack by ovcr four rimes. 103 Older smokers increase rheir risk berween 70 and 200
percem depending an their age. 104 Moreover, when combined wirh other risk factors such as high cholesrerol and hypertension, rhe effccr of smoking is even greater,
according ro a summary ofsrudies an smoking published by rhe Pooling Project Research Group.105 The findings are lisred
Figure 18.
Notice mat 23 of 1000 nonsmokers wirh
diasrolic blood pressures below 89 and cholesrerollevels below 249 had rheir fim hean
attack before they were 59 years old. For
ulOse who smoked (wirh neither of rhe orher
risk factors). rhe risk was more than
doubled, al 54 hean anacks. On the orher
hand, (hose nonsmokers wirh high blood
pressure and high cholesrerol had a risk faur
rimes thar of someone wirhour those risk
facrors. However, if rhose persons add

IMPACT OF SMOKJNG, mGH BLOOD

PRESSURE, AN mGH CHOLESTEROL ON
FIRST MAJOR HEART AITACK
Males aged 30-59 (10 year iocldence)
Nont of 3 major
ri.k faclors
Smoking only
HigJl diaslolic blood
pressure :> 89 or Iligh
tholellleroJ > 249 only
High dilolit bJood pressure and
higb choleslerol; wilhoUI smoking
Smoking wilh dthcr hiJ:h blood
presture or high tholulerol
Smoking and high blood pressure
and high cholesterol b-'--

.....J

20 40

60

80 100 120 140 160 180

RaJe pe' J 000 MaJes.

Figure 18

SMOKING ANO CORONARY

HEART DISEASE
Cigarette smoking is a major cause of
coronary heart disease in the U.S. for both
men and women.
It is estimated to cause 30% to 40% of aU
coronary heart disease (CHD) deaths in the
U.S. each year.

In those younger than 65, smoking

is responsible for 45% of male
CHD deaths and 41 % of female
CHD deaths.
smoking tO rheir lifesrylc, rhe risk jumps ro
eighr rimes thar of the low-risk individual.
Those with aH rhree risk facrors are obviously in the most dangerous group; rhey are
living on rhe brink ofhaviog rheir firsr major heart arrack. In ilie Pooling Project data,
wirhin 10 years, nearly I in 5 of rhese relariveJy young individuals (30 ro 59 years old)
had a hean anack. This is a greater risk
than expecrcd, when compared to totaling
up the risk of cach factor separarely.
The condusions drawn from this and a
host of ofher srudies are compelling. Some
of thc key poirtrs are listed in Figure 19. 106
Many find the srrong relationship between smoking and hearr disease deaths
hard ro accept. Nonetheless, (he s(atisriGlI

Figure 19

385

PROOF POSITIVE

THE PILL, SMOKING, AND

HEART ATTACKS
NODsmoker, DO pili
NODsmoker USiDg
the pili
Smoking > 25 cig/d,
DO pili
SmokiDg > 25 cig/d,
using the pili
10

20

30

40

Risk
Figure 20

S OKI G ELEVATES
SUDDEN DEAm RISK
Sudden death risk for smokers is 2 to 4
times greater than for Donsmokers.
The risk increases with the number of
cigarettes smoked per day.
The risk appears, to diminish
as soon as the habit
is kicked.
Figure 21

386

researeh is ciear. Amang Amerieans wha

are under 65, smoking is responsible for
fuUy 45 pereem of male hearc auaek dearhs
and 41 pereenr of female heart attaek easualties. In yaunger women, che risks may be
even greater. One researcher suggescs that
about 76 percenr of heart actacks in young
women are due ro cigarette smoking. 107

Similar relacionshps are fOllnd in omer

Western nacions. For example, a recenc
Bricish srudy fOllnd rhac smakers in their
30s and 40s were, remarkably, five times
more likely ro surfer heart arraeks thaJlllonsmokers. I08 This researeh indicates thac, in
the United Kingdom, robacco is ro blame
for the majoriry of heart auaeks scriking
chose younger chan 50 afborh sexes. Young
women who smoke can fllrrher increase
cheir risk of hearc attaek if chey also use che
oral concraeeptive piU. These striking relaeionships are shown in Figure 20.
NOlce that combining smoking wieh
pilI usage causes a mueh grearer increase in
hearc arlack risk rhan expecced when compared tO che effecc of eicher one a1one.

Fatal Heart Attacks Caused

bySmoking
Not only are smokers more likely to have
a hearr arraek, chey are more likely ro die
from one. Furthermore, chey are ac higher
risk from slldden death due to hearc disease. When death occurs wichin 24 hours
of some distinct change in an individual's
state ofhealch, it is calJed sudden deach. 109
le can happen ro an apparendy healthy individual while on che job, enjoying leisure
time, or wim che f.1Jnily. Ir rypiC.111y eomes
suddenly, withouc warning; life may lip
away in a matter of minuces. Figure 21
quantifies che inereased risk ofsudden death
in smokers. IIO 111
Notiee that smokers have up ro four
rmes rhe risk ofsudden death compared ro
nonsmokers. Fortunately, however, (he risk
diminishes dramacieally when a person srops
smoking. In fact, so quickly does che risk
fali, rhat within one year che risk of sLJdden
deach from a hearc attack has dropped 50
percenL
Why is chere sllch a rapid decrease in
sudden dearh risk? One of (he answers
seems ro lie with nicotine. Nicotine in cigareeces increases rhe risk of sudden dearh by
predsposing ro facal hcart rhythm problem.i.
In other words, if a smoker has a hearc :ltrack, sudden deach is more likely because
nicoc:ine in me blood renders the hearr more
irricable. Nicotine, however, is rapid]y

DYING FORA CrGARETTE?

c1eared rrom rhe blood O/1ce a perSO/1 srops
smoking. Within just a few days of the last
cigaretre, we would rherefore expeer a person ro be ar much lower risk of death from
a hearr artack.
Your dotting sysrem also rapidJ)' changes
when you srop smoking. One of the key
accors in this process is rhe platelecs. Whae
are rhe place1ers and whar is rheir funcrion?
Plarelers are very riny subsrances in our
bloodscream thac are smaller (han white or
red blood ceUs. They go into acrion when a
blood vessel is cut. Wiehout plarelers, a cut
would continue to bleed umil ir was fatal.
PlateJers prevenr this from happening by
c1umping rogether and seaJiog off the cur.
The clump (or c1or) grows until it is large
enough ro seal rhe broken blood vessel, sropping the bleeding. Plate!ers do a wonderful
work for rhe body in seaJing off broken
blood vessels, usually wirhin minutes.
These c10ui ng cells become more sticky
and rend tO c1ump in an unnarural way
when a person smokes. 112 They reod ro
c1ump inside a vessel where there is no cur,
usually ar pJaces where rhe blood vessels
/}arrow down. lf the narrowing is located
in a coronary arrery or ilie blood vessel ehar
carries blood ro rhe brain, c1umped platelets may Stop me flow of bJood. This may
affecr rhe control oflimbs, affect speech, or
evcn result in sudden dearh. When a person stops smoking, plare1et functioll begins
ro rerurn ro normal-in JUSt a marter of
days. 113 Since the average plate1et only lives
10 daYS.114 in less than two weeks you wiIJ
have a whole new population of normal
platelers in rhe body. These changes seem
to play a significanr role in decreasing hearr
disease risk within a shon rime of sropping
smoking.
The facrs regarding hean rhyrhm stabili.zarion and normalizatiol1 ofc10tting function should provide further encouragemcnr
for smokers ro kick the habit. The rapid
change in risk of sudden dcarh is jusr onc
example of the body's marvelolls abiliry ta
repair irself and recum ta a normal state of
funcrioning. 1 will cite more examples of
how rhe body can bOllnce back from srnok~
ing-related damage iater in the chapter.

Smoking Jnjures the Brain

The hean is nor the only organ mar suffers from ill effects induced by smoking-related cardiovascuJar disease. The aneries
supplying (he brain also rend to experience
accelerated amerosc1erosis due ro smoking.
rf rhe narrowing becomes severe enough, a
"brain attack" can occur-commonly called
a srroke. The evem is similar ro a heart atrack, excepr that the blockage occurs in a
blood vessel supplying rhe brain, causing
desrruction of brain tissue. This is known
as cerebrovascular disease. The facrs regarding the impacr of rhis disease have been determined by a wealth of seudies, and are
lisred in Figure 22. 11 S
Compared ro women wha never smoke,
rhose who used 1 to 14 cigarettes per day
have over double rhe risk of both faral and

CEREBROVASCULAR DISEASE
Smoking increases risk of cerebrovascular
disease.
15 percent of the nearly 150,000 stroke deaths
occu.rring each year in America are due
to smoking.
Risk is most evident in younger age groups.
However, even after age 65, sOloking
significantly iDcreases stroke risk.

nonfaral stroke. Heavier-smoking women,

using 25 or more cigarcrres per day. have
nearly faur rimes rhc srroke risk. 116
Smoking more profoundly increases
srroke risk in younger individuaJs. Risk of
srroke dearhs in both men and women under 65 is generally tripled. 117 However,
older individuals also pay a price for smok~
ing. Men over 65 have a risk of deaeh from
srroke thar is 94 percenr greater than nonsmokers their age. FemaJe smokers over 65

Figure 22

387

PROOF POSITIVE
experience a 47 percent increased risk of
IIS

srroke deam.
These srudies arc in harmony wirh my
hospical emergency room experience as a
consulcant physician. JUSt a few days before rhe rime of chis wriring, 1was called ta
examine a 45-year-old stroke vietim who
had arrived at the hospical; she had Iose che
funetion ofher right arm and right leg and
could not speak. 1 knew she was a smok~r
befoee I examined hee. Large thrombotle
strokes (strokes caused by blood vessel
blockage) of chac severity generally do not
happen ro people at that age who do. not
smoke. Young people, beware. By cont1nl1in a tO smoke, you dramaticaUy inceease your
risk of a devascating disability ac a young
age. Imagine che tragic conseql1enc~s! T.his
45-year-old woman had been expenencl~g
the joys of caring for her rwo young c~J1dren. Despice state-of-the-arr aggresslve
treatment, che srroke brought an abrupc end
ro mac experienee. She eould not even speak
ro her ehild.ren; rhe stroke damaged the
speech area of her brain. Her personaliry
changed. She was subjecced ro ,:eeks and
weeks of rehabiliration. AlI of dus resulted
from the body-desrroying cobacco habir chat
she had ehosen.

ATHEROSCLEROTIC
PERIPHERAL VASCULAR
DISEASE AN AORTIC ANEURYSM
Smoking is the major risk factor for
atherosclerotic peripberal arterial disease,
increasing the risk ten times or more.
Kicking tbe habit is effective in aiding the
medical and surgical management of
the disease.
Death from rupture of an abdominal
aneurysm is two to five times more
commOD in smokers.
figure 23

388

Smoking Damages Other Blood V'essels

We have nored the profound effecrs of
smokin a on the he-an and brain. We need
now {Q examine its effecr on ocher blood
vessels including those in rhe abdomen,
arms, and legs. Smoking is a major ~u~e
of the fatry buildup of arherosclerosls In
blood vessels throughouc the body. "Atherosclerorie peripheral vascular disea:e" is
the term used ro deseribe a peoeess of narrowi.ng of the aneeies mat most co01mol11y
affeccs aneries ;11 the legs. Compaeed ro
nonsmokers, evel1 smokers ofless than onc
paek per day have 1.I:S times tl~e risk of
developing chis condltlOI1. Heavler smokers of more dlan one paek per day increase
cheir risk 15.6 rimes. 119
An aonie aneurysm is one particulari)'
devasrating conseguence of rhis process ~f
fatcy buildup in the aneries. The aona IS
r11e large blood vessel in che cemer of ilie
body ehar carries blood away fron~ che hearr
ro the leg-s. If chis major vessel IS severely
affecced wid1 atherosclerosis, it ean be weakened and Iose irs abiliry tO rolerare the high
pressures generaced by che heart. In r11is
simarion, che aorea tends ro balloon ourward like a weak spot on a cire. Thar ballooning is called an aneurysm. Under the
persistent high pressures that resulr from
normal hean pumping, rhe aOTrie aneurysm
wiU continue to grow in size until it ultimatelv ruprures. If [har happens, the result
is lIsu'ally sudden death. Medic.11 re.search
eonfirms thac cigarene smoking is a major
cause of this fatal disease, as documented
.In F'Igure 23 . 120 ' 121
.
.
There is a dose-response relatlonshlp
berween the amount smoked and rhe risk
of death from aonie aneurysm. This is
SI)Qwn .111 F'Jguee 24 . 122
Noce me sharp rise in risk thar results
me number of cigarerres
from increasinO'
o
.
smoked. Ar rwo packs per day, ehe flsk of
death from this cause is inereased eight
times. Even one ro nine cigarettes per day
more rhan doubles the risk of dying from
rhis signifieanr e3use of sudden deaili. It is
worth pondering whar really happens ro
your body every cime yOll take a drag on a
c.igarene. It is clear that robacco smoke can

DY1NG FOR A CIGARETTE?

be devasraring ro blood vessels rhroughour
rhe enrire body.

AORTIC ANEURYSM MORTALITY

RATIO BY AMOUNT SMOKED

How Smoking Damages BIood \1esselr

for Men and Women at age 40-79 at entry

We have already seen rhe effect of

smoking on plarelets in [he blood. The
chernicals iJl cigarerre smoke have orher farreaching effecrs thar increase [he risk of cardiovasculaI disease for a number of reasons.
Some of rhe likely reasons are lis[ed in Figure 25. 12 . 124. 12
Smoking a1so affecrs more conventional
heaC[ disease risk facrors. Research indicares
thar smoking tends ro bo[h lower [he "good
cholesrerol," HOL, and raise [he "bad cholesterol," LOL. 12 6 The resulrs of one study
iliat documenred rhe cffec[s of smoking on
lowering HOL are shown in Figure 26. 127
No[ce tbar rhe more you smoke the
worse your HDL tends ro be. This is anorher example of rhe so-called dose response
effect, which provides a reiltaJe sign thar
rhere is a genuine relationship between The
two irems in question-in chis case smoking aod lower HOL levels.
Smoking is also a powerful oxidant iliat
would be expecred ro oxidize cholesterol.
Oxidized cholesterol is covered more fuUl'
in Chaprer 3, "He.1rt Oisea 'e-Conquering rhe Number One Killer." IT is particulari)' damaging (Q rhe blood vessel waJls and
appears (Q play a kel' role in arherosderosis.

S...kiIIg Ctdegory

MOrlllllty Rist

NODsmokerl

1.0
-

1-9 CigaretteslDay

2.6

1~19

CigaretteslDay

3.9

2~39

CigarettesJDay

4.5

40+ CigarettesJDay

8.0
Figure 24

WAYS THAT SMOKING CONTRIBUTES

TO ATHEROSCLEROSIS

-----------------

Platelets become more sticky under tbe

influence of tobacco smoke.
Cigarettes raise fibrinogen levels, which tend to
make blood elot.
Carbon monoxide in tbe smoke damages the lining
of blood vessels.
Carbon mODoxide increases beart work while
decreasing oxygcn delivery.
Smoking lowers HDL lcvels in a dose response
relationship.
If an individual has high blood pressure,

smoking worsens blood pressurc control.

SECTION IV

Dangers ofPassive
Smoking

Figure 25

SMOKlNG LOWERS HDL

(Ages 20 to 69)

Passive Smoke Jncreases Heart

Disease Risk
Tt is bad enough thar smoking affects the
smoker. In addirion, ir increases the risk of
hearr arrack dearhs in nonsmokers by 20 ta
30 percenr. Ors. Glana and Pannley of rhe
Universiry of California ac San Franci co
ideorified a number of reasons for illcreased
hcarr risk in nonsmokers in their comprehensive review ofilie subjecc. 128 Orher srudies have added ro rhis body of informarion.ll9.130.131 Secondhand smoke damages
nonsmoker as shown in tile following lisr.

C;garettes per diIy

HDL v.lues for

meu
HDL values for

womeD

1-19

20 or more

46.2

43.9

40.9

59.7

55.2

SI.I

CholesteJ'ol/e",!ls "djuslttdfor "ge, uinsil), "/,,ohol. and cnrds'-

Figure 26

389

PROOF POSITlVE

U.S. DEAmS PER YEAR FROM

PASSIVE SMOKING (EST.)
Heart disease deaths:

35,000

Lung cancer deaths:

5,000

Deaths from other

cancers:

10,000
Total

50,000

Figure 27

EFFECTS OF PASSIVE SMOKING

1. Reduces che blood' abilit}, ro deliver
oxygen ro che hearc
2. Compromises me hean muscle's abilIt)' ro use oxygen
3. Lowers HDL Jevels as much as in aceive smokers
4. Increases plardec accivicy
5. Damages ehe lining of blood vessels

CANCER RISK FROM

"PASSIVE SMOKING"
Women who have never smoked face
over twice the risk of developing lung
cancer it they Iive for a
signUicant period of
time with smokers.

Figure 28

390

6. Jmpairs dilarion ofblood vessels rhac

normally occurs during exercise and
oeher conditions
7. Causes blockages in hean bJood vessels eo form faseer
8. Increases ehe amoum of hean damagc following a hean aeeack
We see ehar smoking affecrs the cardiovascuJar syseem of me passive smoker and
rhe smoker in rhe same way. The dear message as enunciated by Glamz and Parmley
is "Nonsmokers exposed ro secondhand
smoke in everyday life exhibit an increased
risk of borh fatal and nonfaral cardiac
evencs. 'uz
An emire chapter of Drs. Orleans and
Slade's definitive book on nicocine addicrion is devored ro "robacco smoke pollueion." There they quancify [he oumber of
deams caused by second hand smoke each
year in our counrry.I:B Their estimaees are
lisred in Figure 27.
Abouc 50,000 passive smoking deaths
from hean disease and cancer is a significam number. The tragedy ofpassive smoking is thae ie hurcs innocenr people, rhose
who ehemselves have chosen oot ro smoke.
Outcries againsr rhis infringemem on rhe
righrs of nonsmokers have largely been responsible for legislation prohibiring smoking in public areas.

Do Smokers Cause Cancer in Priends

and Loved Onest
The Journal of me National C;mcer Institute reported on a seudy of2.10 wom.en
who developed lung cancer but never
smoked. Results are shown in Figure 28. 134
The risk ofdeveloping lung c.::mcer more
rhan doubled for mase nonsmoking women
who lived wirh one or more smokers. This
is only ol\e of many swdies that show ehe
same results: "passive smoking" is dangerDUS ro your healch. Of course, ir is nor as
dangerous as "acrive smoking;" [hat is,
smoking your own cigareues rather than
rhose of someone else's. Remembcr, active
smokers can increase their own lung cancer
risk la {O 20 ar more rimes, compared ro
the doubLing or tfipling in risk secn wieh

DYING FOR A CIGARETTE?

passive exposure. It is noteworthy mar omer
smoking-related cancers a]50 may be increased by rhe smoke of rhose around you.
For example, published repons link cancer
of rJle cervix (the opening of rhe womb) not
only wirh acrive smoking. but also wirh secondhand smoke. 135
Anomer message from rhe medical studies on secondhand smoking is fhat ir is most
devastaring for the most defenseless: the
young and rhe unbom. Recalling rhe study
pubLished by rhe Narional Cancer Institute,
smoke exposure in childhood and adolescence was nearly twice as potent at increasing cancer risk as exposure in adulrhood. 136
An even mort' chiJling report was published
by De. Dale Sandler and coJleagues ar the
Nalional Insrittlte ofEnvironmental Healrh
Sciences. Their research indicared thar
childhood exposure ro parenral smoking
(eirher in the womb or after binh) increased
cancer risk years larer when the child became an adult. One group of cancers that
was markedly increased was rhe hematopoiet ic cancers. These are cancers of the bloodforrnillg tissues and include rhe infamous
leukemia. When one parenr smoked, risk
of these devastating cancers jumped 70 percent. However, when both smoked, ehe risk
increased 360 percent.
When ali cancers were looked at, risk was
acmally greater if the falher smoked rhan if
the mother was a smoker. Risk of cancer
across the board was increased by 50 percenr. 137 Orher research has demonsrrated
lhar children whose mothers smoked during pregnancy are at iJlcreased risk of childhood cancers. 138 Inrerestingly. if rhe child's
farher (but not mother) smoked, the chUd
was al increased risk ofbrain cancerP?
Upon discovery of these and other dangerous effeCIS of secondhand smoke, citi~
zens throughout our nation have passed legislation prohibiting smoking in resraurancs,
airplanes, and the work place. After all. the
public reasoned, \Vho has rhe righr ro endanger rhe health of innocent bystanders by
Iighting up a cigarette? Such an aCI is one
of "people abuse." In the wake of ali ehe
attention direcred ar passive smoking, a
newspaper carroon picrured a horse Iying
on ilS back in a hospital bed. The animal

was ill and emaciared. It was receiving medicat ion by vein labeled "chemorherapy." The
caprion under the carroon said "alI t!lose
years wirh the Marlboro Man." The horse
was a victim ofhis masler's smoking-a victim of passive smoke exposure.
Smoking kiJls tu more people from beart
disease and cancer than from any other
single healrh-rdated problem. Similarly,
when we look at passive smoking, many
casualties come at the bands of these two
leading killers. However, in many minds,
secondhand smoking's greatest emorional
impact comes from lhe damage ir does ro
aur children and grandchildren, with some
being affected rhroughour their lifetme.

Jnfants and Children Are Damaged

by Passive Smoke
Studies show that infants and children
are subjecred ro some of the highest risks
ITom secondhand smoke-and rhe staustics
are more sobering [han most Americ.1.ns realize. For example, children whose parents
smoke as few as 10 cigarettes per day are
more likely ro develop asthma, and if ehey
do develop rhar disease ir is more likely ro
be severe. Children's risks of asrhma may
be tripled from SmOkiJlg by women. 140, 141
Estimates are rhat up tO 26,000 new cases
ofchildhood asmma develop each year from
this C<1use a]one. 142
Children of active smokers also have
more coughs, colds. sore rhroats, ear
infections, and tonsillectomies. 143 , 144 For
childrcn younger than 18 months fhere is
special risk. Each year in this age group, secondhand smoke causes up ro 300,000 respiracory infeclions such as bronchitis and
pneumonia. 145 As many as 15,000 of these
cases require hospitalization. One study
indicared rhar for every five cigarerres per
day that a mother smoked, her children's
risk of problems wirh pneumonia and
bronchiris jumped 2.5 to 3.5 percenr. 146 Of
additional concern is the f.1.Ct that childhood
smoke exposure may perlllanencly i.nceease
the risk of developing emphysema as an
adult. 14i

391

PROOF POSITIVE

Parental Smoking and Sudden Infant

Death Syndrome
Perhaps mosr frightening, howevet, is rhe
s(<leiscc thar infanrs exposed to tobacco
smoke arerwo times more likely ro die of
SIDS-me "sudden infam death syndrome."
The Iink berween maternal smoking and infam dearh is ouriined in Figure 29. 148

MOM~S SMOKING LINKED

TO

SUDDEN INFANT DEAm SYNDROME

Babies whose mothers smoked

during pregnal1cy aud after are 3
times more Ukely to be victim.s of
SIDS than babies of nonsmokers.
Those only exposed to smoking in
utero are twice as likely to be victims
ofSIDS.
Figure 29

THE SMOKING MOM CAUSES

MULTIPLEDAMAGE
Maternal smoking has bee" /inked to increased risks of:

Tubal pregnancy
Low birth weight babies
Infant death
Respiratory infections
Asthm'a
Impairm:ents of thinking
Other developmental impairments

Figure 30

392

Sudden infam dearh syndrome oecurs

in apparendy healrhy babies. Everything
abollt the child seems normal. The mother
and baby are bonding well; she is so happy
ro have rhe (itele one. The child is put in
rhe erib for a nap; when the morher rerurns
ro rhe crib at rhe usual wake-up rime, rhe
baby is dead. The pa.in and suffering of rhe
parenrs are indescribable in such a deadl.
The bahy of a morher who smokes during
pregnaney and afrer is tfme times more likely
ro become a vicrim than rhe baby of a
nonsmoker. Even ifa woman stops smoking
ar rhe rime she delivers, her baby who was
exposed eo her smoking in the womb is
rwice as likely ro be a SIOS victim. Yes,
kicking the habir ar bireh reduces rhe risk,
bur ir i5 stiH grearer rhan for rhe baby of a
nonsmoking mom. le is dear ehar smoking
shollld eease before a woman becomes
pregnanr.
Research published in rhe Brirish
Medical Journal presenced similar findings.
In rheir research, a morher who smoked
during pregnancy increased the risk of het
child dying with SJOS before eighr wee.ks of
age. The risk ofdeath jumped by 55 pereel)(
for every 5 cigarerres per day rhat she
smoked. 149 Amazingly, the father's smoking was an even more powerful risk facror;
however, the results were ooly apparent in
infams older than 24 weeks old. Every five
cigareeees rhar dads smoked each day essenrially rripled rheir child's risk of 5105. 150
Clearly, rhe risk of SIOS appears ro be
relarcd bodl ro parental smoking arollnd the
infam as well as ro rhe parents'. smoking
habirs durng conceprion and pregnancy.
These considerations caiI atcention ro rhe
facr rhar parentaJ smoking first exens irs
effecrs on children long before they are born.
Other kinds of damage dur can be done ro
an infam whose mother smokes during
prcgnancy are lisred in Figure 30.

Tubal Pregnancy Risk/rom Smoking

Probably rhe earliest prenatal effect of
smoking is an increased risk of tubal
pregnancy.151. 152 A tubal pregnancy occurs
when a fertilized egg lodges in one of rhe
rubes that lead from the ovary to rhe womb.
The condition almosc aJways resulrs in the

'/t

; 'DYING FORACIGARETTE?

.-

'f .1,
r f.,' b
,<
loss of rhe n~Rls, '.u-t it also poses a serious
risk ro the Morher. In America, such
pregnancies are ~ leading c:ause of dearh
In early pregnancy (fim mmestcr). Of
particular conc.ern., nearly four times as
mauy eubaJpregnanc;:ies occur in the U.S.
roday as occuf~~ I\, 1%5. 153 The condirion
accounrs fet fltlly ~3 percent of aII
pregnaney-re~te' deith~.15.j Parc of rhe
i.llcreased ruQal preJllaney risk may be due
tO rhe fact tn~r s oking increases the risk
of rhe female infecrion called pelvic
inf1ammarory disease (PID).
Lower hirth wcight has bcen known for
years ro resule fl.nm maternal smoking
during pregnancy. 'Ah:hough chis may sound
desirable, it ac~ fOC!taSes the risk of
stillbirrh aJldtdrnet mplications.15S.1SG
.~

..

More Miscttiidg,es A-m~ng Smoking

WOmen
',"
.t(r'\
Miscarriages are more frequenc among
pregnant women who smoke. It is
surprising Ulat the effcct carries through ro
the daughtef
~ smoker, 1Iltimate!y
affeeting rhe thirq en~ation. Or. Golding
from rhe f.o\tieur.e ot Child Health.
Universiry ofBj-is(~1, UK, has indicared rhe
amounr of risk, sJP.vn i~ Figure 31.
The cffeet of smoking on future
generarions furrher undcrscorcs the urgency
of helping womcl\: qreak free from rheir
nicotine ~d ct~t,:
The ferllS 's iil"lohmrarily exposed ro
secondhand ;smo~c when mom smokes.
However, the unhom child can also be
exposed to "third' hand smoke." III rhis
situation. the pregnant morher is not a
smoker. but is exposed ro environmenral
tobacco smoke.R.?pu'tion. She. in turn.
passes (he stoo ' ~p.stituents to her baby.
The expos~(iJ dJtd ~o develops more
slowlyl57 and lnJ(;ro beborn smaller. 158
159 These efTecrs testify ro the poteney of
thc cox.ins found
tobacco smoke.

ar

ip,

Many Tobacco-related Stzllbirths

Even if we put aside considerations of
the father's smokliig
ocher sources of
"third hand" feral etposurc. the impact on
ilie unborn i friU fttens!ve. If no pregnant

ana

"

,.

women in rhe United Srates smoked, thousands of lives would be saved. Recenr Statistica! analyses indicate thar cach year in
America mere are anywhere from 19.000
ro 141,000 tobacco-rclated stiIlbirms. 160 In
addition, there are other far-reaching eftecrs
of maternal smoking: berween 32.000 and
61,000 infanrs with low birth weight;
14,000 to 26,000 infanrs admitted ro
newborn inrensive care units; and 1.200 ro
2,200 deaths from SIOS.161

More Malformed Babies From

Smoking Moms
Some parenrs regard a malformed child
as being worse rhan the death of a child.
They would rather Iose a child than give

MISCARRIAGE AFFECTS EVEN

THE THIRD GENERATION
Smoking mothers are 27% more likely to
miscarry than nonsmoking mothers.
Nonsmoking expectant motbers whose
mothers smoked during
pregnancy are 29% more
likely to miscarry.

Figure 31

birrh to an infanr who is severely maJformed. Sadly. when a mother smokes during pregnaney, she aho purs her children ac
increased risk of malformations. 162 These
defects include major malformatons such
as limb deficiencies. 'G3 They aJso include
cross-eyes 164 and cleft lips and palates. 165
Such oral c1efts are among the mase
common birrh defects. Approximately 13.5
perceJl( of rhe population have a genetic
tendency to such problems. However, if a
generically susceptible mother does nor
smoke. her risk ofhaving a child with sllch
a defect is only 20 percent greater mao
mothers wirhour that genetic tendency. Buc

393

PROOF POSITlVE
ifa woman with rhe impaired gene smokes,
her child's risk increases 500 pe(cenr. Sadly,
once she finds out she is pregnaIH it may
:~lready be coo Iare. A Johns Hopkins srudy
found that, in many cases, rhe damage was
already done before rhe woman even knew
she was pregnam. This provides aIlorher
morivation for ali women of childbearing
age to scop smoking.

CHILDRE OF SMOKING
MOMS: LOWER IQ
When compared with offspring of
nonsmokers, mothers who smoke
at least 10 cigarettes a day during
pregnancy give birth
to children with IQ's
that average 9
points lower.
Figure 32

THE INTELLIGENCE QUOTIENT

(lQ) SCALE
145-160 aud above

very superior

130-144

superior

115-129

bright average

---

85-114

average

70-84

55-69

40-54

retardation
I _moderate
_.'._0' - mental
--

1---'"

25-39
..

.-

les. tban 25
Figure 33

394

borderline
-mOd mental retardation

--

severe mental retardation

-

profound mental retardatiou

Lower IQ among Children Whose

MomsSmoked
Mental impajrmellt is a common remit
of smokil1g during pregnancy. When
intelligence was measured ar the age ofrhIee
or four, imelligenee quotiems (1Q) were
lower among children whose morhers
smoked during pregnancy, as stated in
Figure 32. 166
It only rakes a half paek per day for a
pregnant woman ro damage her baby's IQ.
Other studies have showed similar results. 167
Nine poims in the IQ may nor seemlike
much, but it ean make a significanr
difTerenee. For those staristically minded,
15 poims are one standard deviarion in the
IQ sca.le. Classific..1tions of illteiligence are
therefore somewhat arbitrarily made on the
basis of 15 point categories. where the
middle rwo fifteen-point categories arc
considered average, 168 The IQscale is listed
in Figure 33.
Tbis sca1e indicates thar a ch.ild can move
imo a whole different illtelligence category
by moving JUSt nine poims. It is nOI
accurate ro use dus nine poillt statistical
avertlge from population data ro predict rhe
impact on any individual child. One child
may be penaljzed with a 15-poim drop in
IQ, while another may have only a slight
penalty. However, any penalt), in a ehild's
lQ is unjusr.
The mental effeers of smokjng persist
throughour childhood--causing the child
ro have a poarer mental c1paciry than wotlld
orherwise be. How unfair ro the ebi..ld-ro
be penalzed for life with Il lower IQ because
o/maternal smoking.
SmOkitlg nor only lowers childIen's IQs.
but it c.1.n cause suffering from other brain
and nerve-related problems. Among the
problems reponed in children of morhers
who smoked during pregnancy are
abnormal muscle t.one, increased tremors,
aud proble1ns processing sound ("changes
in auditory responsiveness").1 9 They also
have been demonstrated ro have a decreasc
in rheir ability ro deal with spatial
information. 170 In fact, researchers from
Duke Universiry now suggest thar cigarettes
ma)' be more harmful to r!le unborn child

DYING FOR A CIGARETTE?

(han even coc~ine.171
Whae does smoking do co cause sllch
profound menral and nervous sys(cm
effecrs? Tobacco rhrough ies widespread
dfccrs on blood vesscls reduees the supply
of oxygen and nuerienrs to ehe fecus. l72
There are also indieaeions ehae mat.ernal
smoking acruaUy decreases the number of
brain nerve cdls in rhe developing fetus. 173

Mort Problem Kids ofSmoking Moms

According ro recent scudies, a chiJd's

behllvior can also be affecred by secondhand

smoke aner birrh, as srared in Figure 34. 174
Secondhand smoke can affecr rhe brain
of rhe young child, and as a cOllsequence,
rhe characrer. This srudy rried ro very
earefully account for any orher factor ehar
would have impacred on a child's behavior.
The researchcrs made sraris(ica! aUowance
for sucn facrors as (he chi/d's race, age, sex,
and birrh weighc. They a1so included in
(heir scarlsrical analysis measuremenrs of
family srruccure. income, and divorce or
separaeion. Ma(erna! facrors wcre measured
and accolllHed for. Spedfically, they looked
al rhe morher's educarjon, her inreLligence,
sclf-esreem. employmenr srarus, healrh
conditions, and her use of a1cohol during
pregnancy. The research ream even used a
special scale ro measure che quaJiry of rhe
home environmenr. Jn spice of aU cheir
drom (O explain che effec(s as a resulr of
somerhing e1sc, (he momer's smoking afrer
birrh still emerged as a powerflll factOr
afTec(ing chiJdhood behavior. The sca(isrics
indicare a cause-and-effecc relacionship
although (he reason rhar sll10king causes
poor behavior has nor yer been dcrcrmined.
[n a sociery where childhood behavioral
problems oh-en cause greae perplcltiry, it
somcrimes may be inaecuraec eo blame rhe
difliculries on parenring sry!es-pareneal
smoking may be the culprc.

Smoking Parents-A Form of

ChiU Abuse?
For reasons sucit ;\S these, obste(ricians
anei pediarricians have become ehan1pions
of smoking cessaron.
Almose aII

SMOKI G MOMS RAVE

PROBLEM KIDS
1. The more a mother smokes after giving

birth, the more behavioral problems her

chiJdren are likely to have.
2. Researchers think the behavior problems
could be caused by cigarette smoke
altering brain structure or
function, or somehow affecting
the central nervous system.
Figure 34
obsretricians inform rheir pregnant parients
ro qwt smoking. Pedjarricians generaIJy give
rhe same advice ro rhe smokitlg paren ts of
(heir young parienrs. Truly. ir is rragic
enough (har smokers damage their own
bodies, but the tragedy rakes on much
grearer proporrions when the habit harms
cheir own children aud grandchildren. No
normal parenrs would wam ro deliberately
rhreaten rhe healrh or well-being of meic
child. bur ie is happening daily n our soeiery.
When parcurs realize che damage eheir
smoking inf1icrs on rheir innocellc children,
would it provide enough incenrive for chem
ro kick rhe habi(? In America roday, child
abuse has become a major iSSlle. Some are
suggesting (har a smoking parem is guiley
of a sllbrle form of child abuse.

SECTIONV

Chronic Lung Diseases

Caused By Smoking
Abour 60,000 Americans dic each year of
chronjc lung condieions slld1 as emphysema
and chronie bronchiris caused by cigarerre
smoking. 175 These lung condirions are ofren collectivelv referred ro as chronie obsn:uctive puJmon;ry disease (COPO). Another
published sratistic is (har smoking causes
85,000 deaths per year in our coumry from

395

PROOF POSITIVE
various pulmonary diseases, including borh
COPD and pneul11onia. 176 A whole hosr
of changes n body funcrons induced by
smoking sers r!le srage for chronic lung
problems. Smoking CaUses widespread damage ro rhe lung's defense sysrems. These
changes also ser the srage fOr chronic ob
srrucrlve lung disease.

The Cause of"Smoker's Cough"

Chronic bronchiris is one of the lung
coudirlons dur oecurs under rhe int1uence
of cigareuc smoking. This il/ness seems ro
be a direcr re~;ulr of rwo ofsmoking's effecrs:
paralysis of rhe cilia and irriration ofrhe lung
lioing rissues. You will recall rhar in
nonsmokers, microscopic cilia help ro keep
rhe lung clean. Bur because of chemicals
like formaldehyde, hydrogcn cyanide,
nirrogen dioxide, and ammonia, rhe cilia of
smokers are paralyzed. To make marrers
worse, rhere are a hosr ofirriram chemicals
in robacco smoke rhar cause rhe lung ro
make more mucus and rhicker mucus. The
resulr is grearer mucus buildup in the lung.
With deficient cilia] function, rhe onll' wal'
rhar rhe bodl' can dear rhis I11UCUS is by
coughing. Thus,ehe haUmark of chronic
bronchiris is a persisrent "smoker's cough."
A cough mal' sound hann]ess enough, bur
chronic bronchiris is a progressive disease.
In its advanced srages ir can cause severe
impajrmenr and even death.

Smoking Causes Emphysema

A]rhough chronie bronchiris kills, ies
cousin, emphl'sema, is generally more feared.
Emphysema also is re!ared djrecrll' ro changes
callsed bl' smoking. Unforrunare!y, many
smokers never realize thel' have emphysema
umil rhel' begin having brearhing diffieulries. By rhat rime mllch of rlle damage has
a]ready been done. Once lung tissue is losr,
it ca.n never be regenerated.

Asthma Aggravated by Smoking

396

Asthma is often grouped with rhe

chronic obsrructive lung diseases. Srnoking
also gready aggravaees asduna. We have seen
ehar chis can be especially imporranr in
asrhmaric children, manl' of who never
wouJd have developed rhe disease had rhey

nor been exposed to cigaretre smoke.

Forrunaeely, many of ilie lung effects of
smohng are fully reversible. When asr.hma
parienrs Stop smoking, r11ey immediarely
remove rhe 4000 chemicals in robacco
smoke thar have been providing a potent
stimulus for [beI airwal's ro rigbren and
obsrrucr air ilow. Chronic bronchi{is is a]so
generally reversible if a person srops smoking
soon enough. Even many long term heavy
smokers wirh chronie bronchiris who srop
smoking will see rheir bronchi{is vanish over
severa] months ofbeing smoke-free. However, ir is imporranr ro stop smoking now.
The longer a person sJnokes, rhe greater ehe
ehance (har rhe chronic bronchiris wiJl becarne irreversible.
Wieh emphysema, rhe picrure is nor as
brighr. As already mentioned, ollce lung
risslle is desrroyed it can never be rcgenerated. However, rhere is good news. Because people wirh emphysema almosr always
have some component of boeh chronic
bronehiris ;md asthma, rhey generally improve some when they srop smoking. The
improvemenr can be eonsiderable. Even
more importanrly, whcn rhey stop smoking, rhey preserve life, exrend longeviry, and
improve (heir qualiey of life as rhey cease
rhe rapid loss of lung funcrion rhar results
from smoking. 177 . 178. 179

Smoking Causes Shortness OfBreath

lndividuals \,vithout any diagnosis of
chronie lung problems may sem suffer lung
impairmenr from smoking. Whether or nor
rhel' have asrhma or emphysema, sJllokers
suffer shorrness of brear11. AmI whether or
nor they bave chronic bronchiris, rhe)' have
more problems with cough aud spururn production. These cOlild be signs of a more serious disorder, or rhe symproms may nor have
yer progressed ro a disease srare.

SECTIONV1

Smoking Degrades the

Quality OfLift
As Americans get older, many fear disabiliry more rhan rhel' fe.1r dealll. The good
news is rhar medical researeh has found rhar

DYING FORA CIGARETTE?

paying attention ro good health habits oow
decreases our risk ofdisabiliry Iater. One of
fhe key facrors in preveming disabiliry is
avoiding smoking. Some of the mosr convincing research comes from srudying individuals berween 60 and 94 years old from
Alameda Counry. California. 180, 181 Ongoing research on thar populatioll has determined rhat cigarette smoking significantly
increascs the risk of disabiliry. Healthyeatng habits and reguldr exercise also helped ro
decrease rhe likelihood of disabiliry as rhe
parricipams' aged. 182
There is no question rhat smoking causes
life-rhrearening diseases. It also incrcases
aur risk ofdisabiJiry and decreases the qualicy of life in a number of ways orher man
disabilicy; rhey are lisred in Figure 35.

Smoking Weakens Bones

The srrength of aur bones depends on
thcir densiry. The more dense our bones.
fhe srronger rhey are. A decrease in bonc
density and strength is undesirable: risk of
fraceu re escalates. We have k.nown fo r some
time rhar cigarette smoking contributes ro
tlle los5 of bone density. There is a hosr of
other risk facrors that conrribure ro bonc
10ss; however, smoking is a major one ro
reckon wirh. 183
Many research srudics have condusively
demonsuated rhat smoking women have
less bone densiry. Problems, however,
usuall)' do nor surface umil they go rnrough
menopause and suffer further bone densiry
losses. Ac rhac poior they become much
more like!y to suffer a hip or other fracwre
as a resulc of osreoporosis (thinning of rhe
bones). Hip fracrures are serious ijl older
Americans. The risk ofrhe most serious complication, dearh, increases witll the age of the
patient. In older Americans, within one year
of the hip frac rure, roughly 20 percenr of
fhe victims will die. In rhe nexc year, another 13 percen c wi Il die. 184 Th us, roughly
one ch ird of older hip-fracture patients do
nor survive rwo years following rhe episode.
The good news, howcver, is char aher rhose
!WO years rhe risk ofdeath is similar co (nose
who have never had a hip fracrure. 185
Even if a broken banc docs not cause
death, it cerrainly degrades fhe qualiry of

SMOKING DECREASES
QUALITY OF LIFE
Smokers tend to have:
1. Reduced bone strengtb aod more fractures

Greater ,risk of back [pain aod injlury

!

Hormonal aboormalities

/ More rapid loss of pbysical capacUy

1--- Accelerated skin wrinkliiog

Accelerated hair loss aud graying

l, Accelerated loss of vision
1. Difficulty sleeping

1- Heartburn problems

__ . More cases of stomacl!

u~lc~e~rc:"s:..--_ _-.E===-_ _""'''''''''~~

Figure 35

life. Anyone who has been incapacitated

by a hip fracrure recognizes rhe impact on
life's quality. The inconvenience and miseey of surgery, hcaling, recovcry, including
physical therapy ta leam ro walk again. can
be a discouraging experience that stretches
out for maurhs. The sratisrics suggesc [hat
in many cases ali chis mjsery could have been

SMOKING ROBS BONES

41 pairs of identical female twins were studied
in which one of the pair smo1ked significantly
more than the other.

Those who smoked one pack per day had

lower bone densi;ty than those who were
nonsmokers.
The rate of bORe density loss was
sufficient to increase the
risk of fracture by the time
of menopause.
Figure 36

397

PROOF POSITIVE
avoidecl haei tl1ar vicrim chasen nor to be a
smoker.
Other fracrures due ta rhin bones can
also rob life's qualiry. Consider vertebral
compression fracrures. These fractures of
rhe backbones are nor only generally painful,
bur rhey also cause a decrease in height and
can cause a humpbacked posture. A srudy
ar Melbourne University measured the los-s
of bone dcnsity caused by smoking. The
results are shown in Figure 36. I 6
This sruely of rwins on smoking and
bone densty is sigllificanr. Since identical
rwins have identical genes, the possibility
of generic differences was c1imina.red. One
pack per day is enough ta cause dallgerous
weakening of rhe bones.

Smokers Have MOfe Back Pain

Back pain is costly for rhe individuaj and
for his or her employer. In bce, back pain
cam employers over 10 billion dollars each
year. Nearly halI of aII days missed from
rhe workforce are due ro back pain-and
rhe condition affecrs 80 percenr of rhe
working population ac some rime in rheir
careers. 187 Among rhe risk f.1crors for back
injury are che obvious rhings: poor posrure,
poor lifring rechniques, being overweighr,
lack of firness. and excessive ness. I 88 How-

SMO
G LOWERS AGILITY
AN HASTE S AGING
Wome1l 65 and over performed 12 different physical
tasks. Smokers did poorer OII 11 ofthe tests. Areas
evaluated included:
. Agility
. Strength
. Coordination
Walking
. Balance

. Smokers' performance was c1ear ly inferior

to tbat of nonsmokers.
Smokers' performance was often as poor
as nonsmoking women five years older.
. Smokers' risk of injuries from falls
may thus be increased.
1

Figure 37

398

ever also 00 the lisr is cigarerre smoking..189

Cigareue smoking is an important and
often llnrecognized risk faccor for back pain.
A swdy of workers in Maine found ehar
smokers of more rhan I pack per day had
triple !!le risk ofsignificanr back pain. Other
srudies have found rhar cigarerre smokers
are more likely ro slIffer from seriou!> spinal
disk disease. And following sllccessful
surgery for low back pain, smokers have a
grearer risk ro again experience disabling low
back paill. 190 One serious form ofback pain
is caused by problems wirh rhe disk
srruccures rhac provide cllshioning ber"veen
rhe backbones 01' verrebrae. A leading
theory is thar smoking limirs blood supply
ro rhe dsks so {hac rhey become more
susceprible to everyday wear and tcar and
ulrimately susrain damage sooner.

Smoking and Homonal Function

Current evidence indicates rhat smoking
can alrer a hose of hormonaj facrors. Sex
hormone leve1s are affeereel, including rhe
importanr follicle-srimularing hormonc
(FSH) anei lureinizing hormone (LH).191 It
is likely thar these hormonal effecls pIay a
rale in rhe premarure menopallse mar rencls
ro oceur in smokers. Pararhyroid hormone
is a critical hormone involved in mineral
balanee; it is deereased in smokers. ,n
Furrhermore, evidenee indieares ehar
smoking ma)' worsen mild ehyroid
deficiency. A recenr Swiss srudy evalualed
over 80 wOlnen wirh mild chvroid
prablems. 193 Those who smoked haei' worse
thyroid jimctio1J anei significantly higher
cholesteroL levels (28 percenr higher lOtal
cholescerol values and 16 percenr higher
LDL levels). In fact, rhe more rhe women
smoked, che more meir eholesrerol levcls
rase. The research suggests that smoking
may incerfere with che aeron of thyroid
hormones.

Aging, Early Skin Wrinkle~' are Accelerated by Smoking

Those smokers who live ro see ilie age of
65 are likely to funcrion at a poorer level
their nonsmoking peers. A srudy of nearly
10,000 women 65 and older demonsrrared

man

DYING FOR A CIGARETTE?

thar rhose who smoked had a hasrened aging proce.ss. More rapid dedines in physica1
performance were documemed in a number
of rasks, as Jisred in Figure 37. 194
Physical performance in smokng
womell over 65 is reduced to a level ofren
found in women five years older. Their
"health age" is thus significamly greatcr than
rheir chronological age. The profout\d
reducrioll in muscular srrengrh and balance
would also tend to make rhose women mo re
prone to falling aod orher accidenrs. Ths
particular eEfece of smoking does nor
necessarily rrans[are into an earlier death,
bur it surely takes fhe fun Olll of Iife duri ng
rhe much-anricipared years of rerirement.
Truly, smoking can rob a person ofthe joy
oE rhose "golden years."
[n 1992, researchers at rhe Universiry of
California ar San Francisco analyzed nve
seudies rhar looked ar smoking and skin
wrinkling. The conclusion was lIndeniable:
in whire men and women, skin 'VrinkJing
was measurably increased by smoking. 195
Once smokers reach middle age, rhey rend
ro look rnuch o[der because of skin
wrinkling. The repom are nor pretty.
One group of researchers studied 244
women wha ranged between 35 and 84
years of age. They described what they
called "cigarerre skin;" a paie, grayish
wrinkJed skin wim rhick skin between the
wrinkles. These unbecoming changes were
found in 79 percem of smokers and only
19 percenr of the nonsmokers. l96
A more recent Brifish stlldy found a
pattern of prominem wrinkJing, gaunt f.'lcial
feaeures, and skin color changes in 46 percent of smokers, 8 percem of ex-smokers,
and nooe in {he nonsmokers. 197 I have
become so accustomed [Q a smoker's skin
appearance rh.ar 1 usually do not need tO
ask a patiem if he or she srnokes. Those
wrinkles tell the story. Anyone who wams
(O avoid early skin wrinkling shouJd quir
the habit now.
Why do smokers get more wrinkles?
Drs. Grady and Ernster have provided a
compelling exp[anarion. 1?8 They poin( our
(har cigarette smoking eauses a decrease in
blood flow through (he (illy skin blood vesse1s. They suggesr that a chronic lack of

adequate blood supply may be one of the

reasons for increased wrinkling.
Smoking hastells orher processes that
aflecr the smoker's appearance. Smoking
i..r1Cre~lses the likelihood ofearly ba.1dness anei
premature grayillg. 19? A stllely of over 600
individuals founel that smokers faced
approximately four times rhe risk of
premarure graying as nOllSmokers. A.nd
when compared ro nonsmoking men, those
who smoked were almost rwice as like1y ro
go bald. The researchers speculate rhat (his
and other studies indicate that smoking
speeds up a person's biologica[ cJock.

Eye Diseases More Prevalent

among Smokers
The rapid aging effecrs of smoking are
not limited ro (he nerves, muscles, skjn, and
hail'; they affecr rhe eyes as well. Cataracts,
age-related clouding of the eye lenses. are
more- prevalent among smokers; rrearment
usually involves Sll rgery. Smokers a[so
increase cheir risk of an untreacable eye
disease (har can le.ad ro blind ness. The
condirion is called macular degenerarion,
and rhere is no medical treatmenr for it. The
Harvard Univers(y-sponsored Nurses'
Health Srudy has followed 60,000 female
nurses for 12 years. A similar smdy of
21,000 maJe docrors for 14 years has comc
ro similar conc1usions. Namely, [har
cigarene sll10king can more than double the
risk ofblindness from macular degenerariol1.
Although most lay people are unfamiJiar
wirh this condition, rhe disease is
surprisingly common. Each year in rhe U.S.
macular degenerarion callses 1.7 million
cases of vision loss. Almost ali of rhose
affecred are 65 or over.

Smoking Deereases the

Quality ofSleep
Sleep qllaliry appeal's ro sllffer in smokers. Recene research Erom rhe Deparrmen(
of Preventive Medlcine at the Universiryof
WiSCOl1sin has dernonstrared (har smokers
have more problems faUing asleep and more
difficulry with llon-restorative sleep. 200 The
researchers sllggest a llumber of facrors thar

399

PROOF POSTTIVE
may contribure ro these problems. Pirsr,
rhe srimulane effecrs of nicotne make it
more diffieult for rhe average smoker ro ger
ro slccp. Second, as nicorine levels drop in
the blood, smokers begin ro go through
subrle wirhdrawal syrnproms. Thcy may nor
awaken, but inrerference wirh sleep quality
is rhe flIle. Third, smokers rendencies ro
respirarory problems may a1so interfere wirh
rheir slcep qualiry. lronically, ali of rhe sleep
problems caused by smoking may actually
keep {he smoker coming back for more. In
order ro compensare for ilie resulrs of impaired sleep quaJiry such as fatigue and mild
feelings ofdepression, rbe person ofren rums
ro smoking. This behavioral "viciou cycle"
is best broken by sropping smoking cold
rurkey." However, be persistent. During
earlywirhdrawal, sleep difficulties ofren ger
worse before you see improvemenr.

Smoking Aggravates the Digestive

System

400

Are you troubled by hearrburn? Buming

pain in rhe mid-chesr or sromach area GUl
occasionaHy be a sign of serious disease.
Usually, however, hearrbllrn oecurs when
sromaeh acid rravels back up rhe swallowing
rube known as rhe esophagus. Irrirarion of
{he esophagus as a result of rhis backwards
acid movemenr causes rhe pain. Technically
ir is called reflux. Unforrunareiy, hearr
disease, ulcers, and even cancer can
masquerade as simple hearrburn. For chis
reason, a medical evaluacion is wise if you
have a new or recently worsened bearrburn
problem.
If your discomforr fUms oLU ro be due
simply ro reflu.x, then some relatively simple
lifesryle solurions may go a long way roward
curing your problems. One of rhe
cornerstones is ro stop smoking. Like
alcohol and caffeine, nicorine rends ro
inerease sromach acid prodllcrion. Toral
avoidance of aII tobacco producrs is
rherefore rhe besr approach.
However, kicking the habit provides
other beneflrs ro your esophagus. Nicorine
has direct effecrs on a band of musde rhar
lies berween ilie stomach and esophagus.
This muscular band is called rhe lower

esophageal sphincter. le is designed [O be

dosed at aII rime.s e.xcept when food passes
from rhe esophagus downward inro the
sromach. It normally c10ses immediarcly
after food passage ro prevenr reverse flow of
acid and orher sromach coneenes. Nicorine,
however, weakens rhe sphincrer muscles,
causing rhe sphincter ro sray open. 201 This,
in cum, allows sromach acid ro'How upward
inro the swalJowing rube. The combination
ofa weakened sphincrer wirh more acid sers
rhe stage for hearrburn in susceprible
individuals. Alrhough there are a variery of
medicarions rhat can rreat rhis condirion,
sropping smoking is a mosr prudent firsr
srep. Kicking the habir decreases aeid
prodllction and allows rhe sphinerer ro
rjghren up and work more normally, ofren
ending rhe hc.arrburn.
Sromach ulcers are al o mllch more likely
ro oecur in smokers. Some srudies indicare
rhar smokers have from two ro rhree times
rhe risk of such problems. 202 Ulcers can
C'luse bleeding wirh or withour accompanying pain. It can be difllcllir [O heal an
ulcer and keep it f(Om recurring if an individual conrinlles ro smoke, even when patent medications like Zantac, Tagamer,
Prilosec, and Cuafare are raken. However,
if the ulcer vierim kicb the habir, the cure
is ofren nor difflculr.

Smoking Diminishes Vitality and

Other Qualities Of Lift
1 could conril1ue ro document on man\'
pages furrher derails of qllaliry oflife issu;s
dlat are relared ro cig,l(erre sllloking. Some
of {hose issues would be extensions of
information we have already presenred in
chis chaprer. Examples may include
suffering from a cancer rhar is ulrilllare1y
eured but renders a person disfigured;
disabiliry from a non-faral, yer crippling
smoking-relared hean arrack or srroke; ar
the mental anguish ofan adulr moker Living
wirh a child who is menrally or physically
disabled due ro rhe cfTecrs of the smoker's
habit.
Recent work by Dr. Ronan Lyons and
colleaglles plIC aU of these facrors inro
perspective when rhey used el special survey

DYING FOR A CIGARETTE?

measure qualry oflife. 203 The questionnairc cmployed was an established evaluation called the SF-36. le asked 36 questions that provide a usefuJ way of measuring qllaliry oflife in eight categories. Arnong
the more imporcalH areas mea.sured were
physical fi.1nctioning, pain, general hCdlth
perception, and vitaliry. When rhose who
ever smoked were compared with those who
never smoked, the results were srartlng.
They are depicted in Figure 38. 204
The vaJues stared in this figure mean rJ)at
the physical fllnctioning of 44-year-old
people who ever smoked is equal to the
physical functioning of 50 year olds who
never smoked. The ever-smokers are OVtr 6
(Q

yean' oMer than their actual age in thiJ regard.

Regarding pain, general healrJ) perceprion,
and vita!iry, the ever-smokers are 14 to 15
years older than their actualage. Ifthese were
the only derrimenral effects ofsmoking. they
should be enough ro motivare smokers ro
quit. and for nonsmokers tO keep their
distance from robacco.
Lyons' work provide an eioquent
capstone ro t!Lis segment of rhis chapter.
Tobacco is nor jusr a killer. It can do things
that are worse in the eyes ofsome--stealing
life's qU:lliry. destroying happiness. aud inducing disabiliry. Every smoker can significantly increase rhe probabiliry ofa full quanriry and qualiry oflife by choosing roday ro
become a nonsmoker.
Many people fail in rheir multiple
arrempts ro quit rhis powerfllJ addicrion
bccause they do not lIse rhe right methods.
A descriprion of the keys ro become a
slIccessfuJ ex-smoker is found in Secrion
VlIl. 1 do nor Stop there, however; the
secrion also includes practicaJ soluriolls on
how you can kick the misel) om of kicking
the habit. Before r cover rhar vira] material,
we musr examine one orher indispensable
ropic. All ofthe documenred problems wlrh
cigarerre smoking have led some ro abandon
cigarerres in favor of other robacco producr or other addictive substiturcs. lfhedlth
is your goal. rhose cigarette "aJrernativcs" are
nor viable oprions.

EFFECTS OF SMOKING ON FOUR

QUALITY OF LIFE AREAS
Ever-smokers' scores
are equivalent to never
smokers who are:

Heallh area

6.6 years older

Pain

15.6 years older

General health perception

14.6 years older

Vitality

14.0 years older

SECTIONVII

Figure 38

ro

"Alternatives"
Cigarettes Are Also Health
Hazards
When people give up [obacco, t.here is a
danger that they will gravitate ta alrernatives
thar are perceived ro be safer, bur may be
equally or more dangerous in cerrain
respects. A detailed presenration of such
alrcrnarives is beyond the scape ofthis chapter. However, it is importanr ro menrion
severa1 popular "alrernarives" ro robacco
Clgarerres.

Marijuaruz-Dangerous DrugNot an Alternatt've to Tobacco

One popular alternarive seems ro have
[he repur<ltion ofbeing harmless and simply
a )'ollthful pleasure-marijllana. However,
marijuana is a dangcrous and addicrive drug.
Marijuana sllloke, like robacco sllloke,
includes a host of chemicaJs. Even some
lay people can spew out the name of
terrahydrocannabinol (THC) which is the
main acrjve consrituenr of marijuana. 20S
Few realize rhar this drug is JUSt one of over
60 cannabinoids (a class of drugs) that are
fOllnd in marijuana.- OG JUSl as robacco
smoke is more than a few chemic~ls, o it is
wirh marijuana smoke. There is a host of

401

PROOF POSITlVE
drugs in this iL/egal substance.

402

Jusr as nicorine exens deleterious fetal

effecrs, 50 does marijllana. Marijllalla. like
ies cOllsins aJcohol and nicOline, has now
been demonstrated ro harm the beain of rhe
developing ferus. A morhcr who uses
marijua.na gives her child a lifdong legacy
of brain impairmenr. 207 Animal tests
demonsrrare rhar decreased oJ\.)'gen delivery
occurs when morhers are exposed ro
marijuana, similar ro rhar noted wirh
nicorine exposure. 2 0 8 Of note, wirh
marijuana, fhe decrease in oxygen delivery
ro rhe fetus is prolonge.d, lasring long
beyond any effeers on rhe morher.
Furthermore, afrer birth, marijllana can
also inrerfere behavioraHy, diminishing rhe
morher's desire ro care for her newborn. 209
lr also rends ro decrease breasr milk
producrion and release. 210
Some of rhe grearesr fears ahour
marijuana are not rhe effecrs on Olhers but
rhe effecrs an rhe long-term lIser. Tetrahydrocannabinol bears a srriking chemical
similariry ro corticosrerone, one of fhe cortisone-rype hormones of the body.211 Currene research indicare.s rhar bCCdllse of rhis
similarity in structure to rhe corrisone rype
family of drugs, Tl-IC exerrs toxic dunges
in a central parc of the brain known as rhe
hippocampus. 1n fact, borh rhe natural
srress hormones of the body and Tl-IC have
been demonsrrared to acce/emte aging ofthe
brain. For example, in one animal srudy,
rats exposed ro marijllana showed a dOIlbling in fhe progression ofbrain aging. At
rhe end of the sUJdy, the marijuana-treared
rats had brains that tested rwice as old as
rheir age. AII of this is extremely importaor. The hippOGllnpUS is one of the mosr
vulnerable 5tfUcrures to brain aging. It is
particularly hard hir in brain-deteriorating
condiriolls such as Alzheimer's disease. 212
Currenr research suggests rhar the hllge
numbers of Americans who habitually use
marijuana may be puning rhemselves at significantly increased risk of brain deteriorarion as rhey age. Recent srarisucs indicate
char 4.8 percenr of clIe entire U.S. popularion smoke marijuana at leasr once per
monrh. More than 3 million are daily ar
"almost daily" users. 213

As covered in Chapter 12, "The Froncal

Lobe: The Crown of the Brain," marijuana
a150 affeccs day-ro-day mental performance.
For example. recent research funded by rhe
Narional Insrirure an Drug Abuse found
rhar college stlldents who were regular
marijuana lIsers had defecrs in their
arcemion, memory. aud Jearning even 24
hours ;lftcr rheir lasr use of rhe drug. 214
Marijuana use measurably affecred brain
performance long afeer rhe user thoughr rhe
efTeces had wom ofI
Marijuana also appears ro pose a threar
ro the hearr and blood vessels. When
combined wirh exposure ro everyday
stresses, marijllalla significantly increases tbe
heart rare and blood pressure responses tO
rhose srresses. 215 Since blood pressure is a
significallt risk facror for borh heaer disease
and suoke, switching from cigarertes to
marijuana is nor a protecrive move for your
hean.
Marijuana also appears to incre.ase cancer
risk. Canllabis has been idenrifred as a
source of carcinogens as well as being an
imll)une system suppressantJI6 Recent
research on the subject bas come from the
Universiry of California ar San Francisco
and orher centcrs. These reporrs sllow rhar
marijuana and robacco smoking cause similar lung chaJlges-wirh one differencemarijuana has a much more poum ejject. In
terms of lung dmmlge, one joint is equivalent ro a JUli pll.ck of20 cigarettes.
Corn1'ared tO tobacco, our national experience wirh marijuana is relarively
brief-but rhe currem resulrs suggest rhar
it adversely affecrs unborn children. The
drug leads ro shon term and long rerm
menral dereriorarion. Ir is also a powerful
respiratory 1'oison, a cancer-causing agent,
an immune sysrem suppressant, and a drug
ehat likeJy increases hean disease risk.
Clearly, marijuana is nor a safe alternarive
ro tobacco.

Cigar and Pipe Smokers Have Incret/sed Risk ofDeath

There are orher supposed alrernarives to
smoking cigareues than illicit drugs. There
are a number ofmher robacco producrs rhar

DYING FOR A CIGARETTE?

seem ro have acquired rhe repuration of
being safe ways 1O enjoy a nicotine high.
Cigar smoking is one; some misrakenly belicve that cigars are safer than cigarerres.
However, cgar and pipe smokers do put
dlemse1ves at increased risk ofdearh because
of their habie ome srudies suggest their
monaliry rates are 20 to 40 percent higher
than nonsmokers. 217 However, the more
often an individual smokes a pipe or cigar,
the greater the risk. h is important tO note
thar, as a group, rhose who have previollsly
smoked cigarenes tend ro smoke more if
they switch to a pipe or cigars. 218 Current
eigarerre smokers elearly should make a cLean
break wirh ali forms of robacco.
The imporranee of making a elean break
with aU forms of robacco becomes apparenc
when we look ar heart disease risk. Cigar
and pipe users pUt themselves at
significantly increased risk of rhi' leading
cause of dearh among cigarene smokers.
One c1assie tudy from Copenhagen,
Denmark, looked at a group of middle-aged
men berween the ages of 40 and 59. Among
the group were 3,772 slllokers that were
c.~tcgorized by the type of robacco rhey used
and 1,440 men who had never lIsed
robacco.2I') The re ults are illustrared in
Figure 39.
Over rhe cOllrse of seven years, rhere
were 170 hean anacks in this combined
group of over 5,000 men. The results
showed more than double the risk for
srnokers of cigarenes, cigars, pipes, anei
cherooe Pipe smokers' risk was increased
by 50 petCenL

Snuffand Chewing Tobacco Increases

Cancer Risk
Smoke1ess (Obacco also c.arries the seeds
of dearh. Most norably, llse of these
products is a pocent cancer risk faccor. In
1992, then Health and Human Services
Secretary, Dr. Louis Sullivan stated, "It is
time that smokeless robacco take irs righrfl.ll
place next to cigarene smoking...as a seriol.ls
health risk that must be s(Opped." Dr.
Sullivan's strong langl.lage seemed
appropriate when you realizc his sratcmenr
introduced a scielltific book of ovcr 300

SEVE -YEAR INCIDE CE OF FIRST

BEART AlTACKS IN TOBACCO
USERS ANO TOBACCO ABSTAINERS
Cutegoryoj
smoking hahi/

Amoullt Myocardial illjarction

per 1,000 men
smoked

Relative
risk

Never smoked

17

1.0

Cigarette smokers Total

36

2.1

Total

42

Chcroot smokcrs* Total

Total
Pipe smokers

48

2.4
2.8

26

1.5

Cigar smokcrs

'Ch"ool is ba<iclll(I' Il cigllT ,h", has b,m cui <qull,e '" bOlh ends.

pages thar detailed che hazards of smokeless

tobacco. 220
The subject represenrs no small probtem. Over 30,000 new cascs of oral cancer
occur in the U.S. each year. Researchers
have now idenrified 28 diffcrenr cancercausing chemic.als in chewing (Obacco and
Sll li ff.221
Ir is ilO wonder rhat users of
smokeless wbacco increase their risk of oral
cancer severaJ-fold. Tlle risk increase is even
greater for some sites in the momh; longterm snuff lIse increases a person's risk of
cancer by over 50 times.
Likc cigarenes, the use of smokeless (0bacco prodllcrs rypically start5 at a yOl.lng
age. Tlle far-reaching effects of this habjc
should nor be underestimated. In somc
parts of the V.S., 25 ro 35 percenr of
adolescent males admit ro the use of
smokeless wbacco. 222 YOl.lng people sholl.ld
realize rJlat even adolescems have died from
mourh cancer as a result of smokeless (0baceo. n3
Whether ir is marijuana. cigars. pipes,
or smokdess robacco, none are an alternative
to cigarettes if a person is seeking ro
maximize health. C1C'drly, the best option
is (O make a elean break with cigarenes and
ali of irs cousins. AH forms of nicotine
delivery have long term derrimenral effecrs.
No nicotine-conraining product is safe.

Figure 39

403

PROOF POSITIVE

SECTION VIII

How to Kick the Habit

Most smokers try ro quit smoking at
some poinr in their life. The sad fact is that
most attempts to quit u1rimately end in failure. As we have already noted, when most
young people begin smoking. they believe
mat rhey will be able ro quir easily ar any
urne. Surveys. done on younger smokers
rypically find a majoriry believing that
UJithin ayear rhey will srop and never smoke
again. However, this is far from the case.
Nationwide statisrics regardjng smokers of
ali ages paint a grim picrure as illusrrated in
Figure 40. m

K1CKING THEHABIT: MANY TRY,

BUT FEW SUCCEED
Over 15 miJIion smokers try to quit
per year
Only 8 percent succeed
Smoking restrictions
at work and
public places can
help people quit
Figure 40

404

Why only an eight percent SllCCesS rare?

Thcrc arc many reasons; thousands of pages
of scienrific literature address {he subjecr.
However, independent of aII the other
factors involved. 1an1 convinced thar mauy
would have been stlccessflll if they had only
used the rghr approach. In rhis section, 1
present an approach for kicking the habit
rhat will bring success ro almost any
individual who is derermined ro put
smoking behind rhem for good.
Funhermore, we will see how ro kick the
misery out of kicking the hllbit. Using rhe
techniques ourlined in this chaprer, you can
be successful in kicking the habit with a

minimum of withdrawal discomfort.

Ifyou are curiOliS abour the hasis for ilie
infonnarion in this section. it comes from
many scienrific artic1es and books in
addition ro Illy personal experiences in
he1pingsmokers ro break free from nicorine.
1 have also drawn from rhe expetiences of
my colleagues who have. along wirh me,
conducted one of rhe mosr successful stopsmoking programs ever presenred: "The
Five Day Plan ro Stop Srnoking. "225 This
was one of the firsr formal programs
presenced ro the public to help smokers quir
the habir. Since irs developmem in rhe late
50s, esrimares are that the Five Day Plan
has been utili7..cd by over 14 million smokers
o single
in 150 different cOllntries.
program has helped more people ro
succcssfully quir smokjng. The program
used today is a reviscd fonn known as "The
Brearhc Free Plan ro Stop Smoking."

The Taper OffMethod SelMm Works

Why do many of rhe common approaches to smoking cessarion faiJ? One big
problern is rhat many use rhe "raper-off"
method. Unforrunate1y, the taper-oIT
merhod does nor usually work for rhose rhar
are serious about quiuing smokjng. The
reason is rhat nicotine dependence is an
addiction. The 1988 Surgeon Genetal's
Repore tevealed thar nicorine is six ro eighr
rimes more addictive than alcohol. In
comparison ro orher drugs, ncotine is as
addicrive as crack cocaine. 226. 227
Notwirhstanding its addictivcness, tobacco
companies ralk abOlit rnaking sure smokers
remain "free ro smoke." Most smokers really
are not frec ar aH-better rhan 95 percenr
are lucodne addicts.
What are some of the reasol\S why
robacco is so addicrive? First, nicorine
affects rne chemistry of the brain. Ir acts
primarily as a srimulant but it also releases
chernicals rhar give a feeling of reward or
p[easure. Second, nicorine works fast. It
gives the brain a "hit" wirhin ten seconds of
the firsr puff. 228 Th.ird, smokers smoke more
frequently rhan rhey do aimost any other
dailyactiviey. The familiar hand-ro-mouth
rourine of a smoker is commonly repeated

DYlNG FOR A CJGARETTE?

200 or more rimes per day or in excess of
iO,OOO rimes per year. 229 230
Since nicorine dependence s an
addiction, ie musr be dealt wirh like any
orher addicrion. No one would e1ream of
relling an alcoholic to jusr Cut down over
rime. We would nor give a cocaine addict a
program ro gradually decrease use. Why,
then, do we rhink such a schedule would
work with nicoune? Acldicrs neeel ro make
a clean break wirh rhe addjcrive substancetile)' must sa)' good-bye tO nicor ne once and
for aiI. Ir is a prolongeel self-torturing
experience ro caper of[ You conrinue ro
feecl rhe addiction by cOlHinuing ta smoke.
The smoker makes a srrong effore,
experiences consrant rorture, anei
accomplishes linie or norhing. The raperolT merhod is llsually a setllp for failure.

"Cold Turkey"-the Most Successful

Method
The memod mosr likely ro succeed is
called rhe "cold rurkey" meehod-you srop
smoking immediarely, with no taper-off.
There are 46 milJon adult AmericaJls who
coneinue ro smoke. 231 However, almosr as
many have quir over the years since the 1964
an nouncemenc by r.he Surgeon General
linking smoking ro lung cancer. In facr,
more than 3 miltion Americans stop
smoking every year. The success of quitters
is sumrnarized from the 1991 Cenrers for
Disease Control and Prevenrion data in
Figure 41.
Therc are severa! important poinrs in rhis
f1gure. First, it is possible ro quir, and tbat
anyone who quirs has lots of company.
Second, most of the successful quirrers used
the cold rurkey method, and have
accompljshed it on tbeir own wirhour rhe
bcnefit of a sl110king cessarion dinic. 232
However, ewelve monrhs later, only 8 ro 25
percenr were still free from sJlloking. Tbird,
individua1s ehar took advanrage ofsmoking
cessarion dinics hacl a greater likelihood of
remaining nonsmokers.
The fim rcacrion of man)' smokers to
rile moughr of quirring abruptly is, "It takes
roD much wiU power to quir by che cold
rurkey merhod. r am nOI sure I can do iL"

MOST QUIITERS USE

"COLD TURKEY" METHOD
al's
9 percent of successful quitters bav
quitting strategies.
8 to
percent of self-helpers remained no
12 mo
ter quitting.
JHttNlile:'lI)rtm~kJ' ng-cessation

ontbs.
Figure 41

Whether you raper off or qui[ abrupely, will

power is required bec.ause rhere likely wiU
be withdrawal symproms. The weakness of
r!le tapering off method is rhat it is too easy
ro relieve the symptoms by lighring up. The
nicotine rush brings relief, and you feei
much better again. You sense [hat
everything is going ro be ali right. But the
urge rerurns, followed by other symptoms.
You give in and smoke anorher cigarette.
Progress roward your goal is minimal. Each
day you hope ro smoke a linIe lcss. This
rortllfing pracess generally contimlCS umil
you finaUy quir cold rurkey or ulcimate1y
fali back inro your unrestricted habit.

Withdrawal DiscomfortMore Shortlived With Cold Turkey Method

When you quie smoking abruprly, it is
nor necessarily easy. However, tvithdrawal
symploms do noI last as long with ehe cald
rurkey method. A1r.hough mose smokers
have some uncomforrable witbelrawal
symproms, abolit 25 percenc go through no
significallt physical withdrawal. Others
have a very difficult time with ehese physical
symptoms. In my private medical practice
ancl in conducring smokiog cessarian clinics
for ehe generaJ public, I have ofeen observed
witbdrawal symptoms first hand. The
American Psychological Associarion nores

405

PROOF POSITIVE

COMMON NICOTINE W1TB-

DRAWAL SYMPTOMS
Nicotine urges/cravings Restlessness
Headaches
Anxiety

Frustration
or anger

Irritability

Sleep disturbances

Difficulty
concentrating

Hunger/ increased
appetite

Figure 42

thar within 24 hours of abrupe smoking

cessation ie is common ro have wirhdrawal
sympcoms like rhose listed in Figurc 42. 233
If you experience thesc withdrawal
Symptoms, how long will they lase? For
many smokers wiehin 24 hours of quiuing
"cold tllrkey," ehe worst of the withdrawals
are already behind them. For orhers. their
worst day withollf cigareues is day number
two. However. aLnosr withour exception,
ar rhe end of 72 hours ehe worsr of the

OTHER PHYSICAL EFFECTS OF

KICKlNG THE RABIT
Gastrointestinal problems
like constipation
Increase in smoker's cough
Tremor
Sweating
lmpatience
Dizziness
Nausea
Figure 43

406

withdrawal symptoms are history for those

who make a complere brcak wirh cgarertes.
A1rhough the mosr severe symptoms pass
wirhin a few days. orher symproms can
linger for several weeks. Some of these
bothcrsome symproms include increased
irrirability and having erouble concenrrating. For the majority of smokers, aII of
these remaining effects are gOlle by the end
of a momh. Staristics indicate ehar cvery
smoker has f1nished wieh cven the most
subtle withdrawal effects by cight weeks.
Orhcr annoyances are common when a
person stopS smokillg. These are usually
nor classed rechnically as withdrawal
sympeoms; however. they often add ro rhe
physical difftculry of rhc qU((ing process.
Some are very responsive ro orher lifesryle
changes and usually lase on.!y a ver)' shor(
time. Others may rake longer ca run theie
collrse. They are detailed in Figllre 43. 234 H5
Withdrawal symptoms and orher physical changes are ofren feared as [!le worst pan
of quitting smoking. No one will say they
are fun. However. rhey are actually a sign
of the body beginning to heal itself.236 Despite rhe horrible destruerive work rhar nicotine and other chel11icals have been doing,
your body h,1S beeome t1sed t(~and even
dependent on-nicorillc. Wirhdrawal
symptoms largely demonstrate thar your
body is getting back ro rhe healehy stare of
living thar it experienced in the days before
yOll smoked. JUSt as your body probably
rebelled against smokingwhen you had your
fim cigarert.e, now rhe body is agonizing
again ro readjusr to rhe wCly it was designed
ro work-withollt nicotine and those other
4000 chemieals.

Cravings and Mood Swings

Let liS take a few minures now ro look
both at rhe c1assie wirhdrawal symptoms as
well as ilie othel' symptoms that may resulr
from smoking eessarion. For many formeI'
smokers, among the mOsr worrisome
withdrawal syrnptoms are eravings, desires
for cigarettes, and urges ro smoke. These
eommon symptoms may bc srronger in
some individuals than orhers. Howevcr,
regardless of their inrensicy, cravings rypically becomc rare after a few weeks. 237 The

DYlNG FOR A CIGARETTE?

other good news abolit cravings is that they
aJways go away-cven in the short termwhedlcr or nor you smoke. In fact, the average craving lasr.'> only a few minures and
then subside .238
Nicotine does have both stimulanc and
depressant effects. However, within a short
time, the regular nicotine user becomes
toleram ro the sedative effecrs. Therefore,
in c1uonic nicotine users, the effects are
mainly stimuJating. 239 The temoval of rhis
stimulation probably lies at tlle root ofIllany
of the physicaJ symptoms thar occur when
people stop their tobacco habit.
Rapid mood swings may occur-you
feel grcat one minute and rerrible the next.
A few minutes later you fee) good again.
Rapid flucruarions in moods are very
eOlllmon during (he hrst duee ro five days
afrer you quic smoking. Somc wiU
experience tremors, which are smaJ) quivering morions of the hands. GastroinrescinaJ problems and headaches are aJso
commonly reported by rhose who stop
slllolcing. 240 My upcoming commenrs on
"kjcking the misery out ofkieking the habir"
should afford he1pfuJ insights regarding
these sympcoms.

Smoker's Cough May Linger

In about 20 percenc of those who quit,
smoker's cough, surprisingly, becomes warse
before it improves and disappears. 241 Tllis
problem can be discouraging, especiaJly for
those that chose ro quir because of a cough
or orher respirarory problem. Despice the
tendency ro be discouraging, a worsened
cough is viewed as a good sign. It is evidence
[har the lung's abiliC)' ro remove phlegm is
acruaUy improving-ir isasign ofimproved
lung defense mechanisms. 242 Apparenrly,
rhe reason has [O do with the retLlrn of cilial
fUJlccion. Earlier in this chaprer we learned
rhar chemicals in cigaretre smoke paralyzed
the acrion of rhe ciny hairs called ci/ia char
help keep [he lungs elean. When people
stop smokiog, rhey remove the [obacco
conslituenrs that depressed and paralyzed
the tioy cilia. Wirh rhose roxins gone, ilie
cilia are frec to begin working again. As ilie
cilia begin to regain function, they start ro
mobilize the excessive amounrs of mucus

that are stiH being produced by the now exsmoker's lung. The remit is rhat coughing
may worsen as rhe lung 15 "eleaning irself
out." The good news is thar chis is a shorcrerm phenomenon; witll the irrirams from
[obacco smoke Out of the piemre, [he lung
will begin to produce less mucus. And as
dle excess mucus is c1eared out, che smoker,s
cough generally abates.

Sleep Disturbances and Hunger

Sleep disturbances are common, and
some may have insomnia. lf problems of
sleeping are the results of nicotine wirhdrawal, chey should disappear within 2 co 3
weeks. 243 When a person stops smoking
they [cnd ro be hungrier for a few days.
Many are aware ofthe inereased hunger thar
results from lciclcing [hehabir, and they may
choose co continue smoking because of che
fear of becoming overweight. There is no
need to have such a fear. uter in chis chapter 1 poin[ aur how you can avoid weighr
gain when you scop smoking. Fonunately,
no individual wilJ encoullter aII of rhese
wi[hdrawal symproms. My experience is
[har [he average person gers abom five symptoms. In most cases, four of those hve wiU
be gone wirhin 72 hours. One may linger
for a few more days-a1most as if ro make
sure thar yOll maintain your resolve ro remain a nonsmoker and once and for ali kick
[hc habiL
Some smokers, familiar with withdrawal
sympcoms, do not want ro experience any
leve! of discomforr or sllffering. Thcse
individuals ofcen choose ro continue
smoking. However, in rhe long term [bey
willlikely suffer much more by colltinuing
to smoke. For rhis reason, even from the
srandpoinr of minimizing physical
discomfon, the wisesr choiee is [O quit now.
Even tlle maximum of three days ofimense
withdrawal symproms is a smaJt priee ro pay
for rhe joy tmd the permanent benejits ofbeing
Il

non-smoker.

Ten ~ys to Kick the Misery out of

Kicking the Habit
Ir is p05sible ro kjck much of che misery
out ofkicking rlle habir. In my work wirh

407

PROOF POSITrVE
smokers, 1 emphasize ren primary ways ro
accomplish this. Many of these rimehonored techniqucs were popularized hy rhe
previollsly menrioned "Five Day Plan" and
rhe subsequenr "Brearhe Free Plan ro Quit
Smoking." The milliollS ofpeople who have
successfully gone through chese programs
worldwide provide a living restimony tllar
you can dramaricaJly reduce borh the
wirhdrawal symproms and tlle other
changes mar occur with smoking cessarion.
The ren approaches ro kicking rhe misery
out of kicking the habit center arollnd
bringing rhe body back inro balance as
quicklyas possible. Remember. yom hody
has become t1sed ro nicotine. Witlldrawal
symproms indicate the body's struggle to
again come ilUO balance as you readjust ro
a new nicotine-free way of )iving. Some
peoplewho fol1ow iliis ren-poinr act ion plan
wiU not have a single signific.1m witlldrawal
symprom. Orhers still have symproms, but
rhey are decreased compared ro whar they
wOllld be if such a program were not
foUowed. The more of these ten acrjons you
take. the fewer, the less imense. and the
shorrer-lived the withdrawal symproms.
They are Jisted in Figure 44.
Choosing not /0 mlOke is thefint step. Th is
is probably the most imporranr principle of

TE WAYS TO KlCK TBE MISERY

OUT OF KICKING THE HABIT
1. Choose not to smoke! 9. Avoid high risk situatioDs
2. No hidden cigarettes
sucb as:
special chairs
3. Deep breathing
work breaks
4. Daily exercise
. people who smoke
(walking)
10. Expect that others will
S. Get more sleep
understand
6. Water inside
7. Water outside
8. Avoid: caffeine
alcohol
beavy meal
heavily spiced foods
Figure 44

408

alI. rf you do nor make a personal choiceentirely on your own volition-ro be a

nonsmoker, failure is vireually ensured.
Obviously, if success is rhe aim, you will
decide to be a nonsmoker because you wam
ca do it, not hecause someone eold you ro
quic. Furthermore, keep focused on your
ehoiee nOt ro smoke: rhis is vital eo success
in quining for good. rf you are a smoker, 1
eneourage yOtl to make rhe deeision now eo
bre.1k free from tobaeeo. Take a few minlHes
and actually pick a 'quir date" within the
ncxt three weeks. On that day )'ou wiU have
)'our lasr cigarenc and quit eold rurkey.
From thar poinr on, you will need ro keep
focu ed on your goal-no more cigarerres
for rhe resr of your life.
Some immediarely say. "Thar's impossible-I can'r deal wirh rhe thoughr ofhaving ro go rhe resr of my life wirhollt a cigarerre." Those feelings are natural. StiU tllere
needs ro be a realizarion rhar even one cigarerre is nor acceprable: ir wiU likely throw
you righr back inro rhe rhroes of rhe
addiction rhar you lelt behind. On the oilier
halld, you only should rake one day at a
time, one hour at a rime, one minute ar a
rime. Ir is only in this minure rhar you need
ca mainrain your frcedom from rhe ryranny
of nicorine. Choose ro conrinue ro live free
from nicorine on a momenr-by-momenr
basis. Do not worry about how you will
reman smoke-free romorrow. Today's
challenges are big enough witholH worrying
abom romorrow.
Second, eliminate all hiddm cigarettes.
There are ro be no cigarettes around
anywhere. Many people fail ro rake this
importa.nt step. They reaJly plan ca fail by
keeping cigarertes in the glove
comparrmenr, on top of the refrigeraror, in
rhe Ilight stand, or in some orher easily
accessible place. rf rhey do nor succumb,
rhe nearness of cigarerres ofren brings rhem
a form of torrure. When cravings or od1er
wirhdrawal symproms are intense, rhe
rhought comes ta mind: "Tobacco is c10se
by; 1 can lighr up and end my misery."
Therefore, when you rmly make a choice
ro qur smoking, rhrow ali of your cigarerres
away. When rhe wirhdrawal sym.peoms
comc. rorrure wil1 be minimired-iliere will

DYING FOR A CIGARETTE?

be no tempration ro rake an easy escape.
Thi,-d, practice deep breathing. This may
sound very simple bur ir is an extremely
effective method for dealing wirh urges.
When you feei a craving coming on, take a
deep brearh. Hold it for a few seconds. rhen
exhale slowly. Do it at least duce rimes. In
many cases rhe craving will leave. The
rechnique also plays a role in defusing
anxiety and tension. Oeep breathing
probably works [or a variery of reasons. rr
focuses rhe mind on a positive acriviryrarher rhan allowing you ro dwell on what
you are nor dojng (i.e., smoking). lr also
helps ro improve oxygen saturaton, thus
enhancing mood and central nervolls syseem
performance. Oeep breathing a1so helps ta
fosrer a sense of relaxat ion. Breathing out
is a passive process where the brcarhing
muscles are acruaJly rebxing. Some fccl rhar
an awareness of this re1axed muscular state
helps bring more re/ax;uion horn the deep
breathi ng exercise.
Founh i.s daily exercise. For mosr people
ule very best exercise is brisk walking. AI, a
physician, 1 must encourage any smoker ro
have some medical inpur before srarting on
a new vigorollJ exercise program. Because
of rhe exrensive silem damage mat smoking
generally causes. smokers can have a seroke,
hearr arrack, injury, ar omer pwblem ifthey
embark on a program of injudiciotfs exercisc.
Oaily moderate exercise is recommended
such as swimming, bicycling. or brisk
walking. Unless you are a man over 40 al/d
have ;'In addirional risk factor for heart
disease (besides smoking) such as high blood
pressure, family hiseory ofhean trouble, Of
high choleseerol. you do nor need a medical
consulr:lrion prior ro initiating a judicious
moderate exercise program. Women do nor
need a medica.J consulrarion unless they are
over 50 and have an additional risk factor
for he<lf( di.<.ease. 244
Exercise nas far-reaching effects in the
effon to Stop smoking. Jr is a natural reliever
ofanxiery and ren.sion and a powerful mood
devatOr. Physical activiry funhermore helps
ta undo many of the changes caused b}'
smoking: jr is a factor in reducing risk of
borh hean arrack and cancer. Espeeially
when faced wirh cravings, exercise is an

exceUel)( oprion. (If circumsrances do nor

allow an exerci e break, rake 30 seconds for
a deep breathing break.) It is no surprise
rhar research has dernonsrrated thar an
exercise program ma)' improve rhe chances
of successfully sropping smoking. Brown
Ulliversiry researchers found rhar women
who exercised were less likely ro begin
smoking again. 245
For many people, an ideal time to get
regular exercise is earl)' n rhe morning. This
is [he rime thar 1 prefer both from the
standpoinr of scheduling as well as for its
beneficial health effeces. lf a morning
schedule is nor possible, f1nd some ocher
rime in )f0ur daily rourine, such as duriIlg a
work break. Remember, roD, exercise can
be a powerful weapon in your armament ro
deal wirh urges on rhe spor. You wiJI be
amazed as ro exercise's effecriveness n
decreasing rhose withdrawal symproms.
Exercise can aJso hel.p you conuol stress,
fighr lerhargy and combar rremors. Exercise
is even more beneficial if do ne in the Eresh
air. Fresh air in itself has a mood-e1evating
eftect and improves the dearing aerian of
rhe ciI ia. Whar abOlit bad wearher, yOll ask?
There is an old saying [har applies to
ourdoor exercise: "There is no sllch thing
as bad weather, only bad (inadequare)
c1orhing." Of course. that is a bit of an
exaggerarion. 1 do nor advise outdoor
exercise in rhllndersrorrns, hurricanes.
tornadoes, etc. But if rhe wearher is cold or
windy-or even snowy or rainy, dress
appropriare!y and get your outdoor exercisc.
lf i[ is nor reasonable OI' practicat. indoor
exercse s a second best choice. One way
or rhe orher, pur exercise into your daily
schedule.

Recommendation number five is to get

more sleep. When wirhdrawing from the
srimularing effecr of nicoeine, smokers rend
ro require more sleep. Exrra sleep will have
a benefit rhar extends rhroughour rhe day
especiall)' as it affects wirhdrawal sympcoms
involving rhe cemral nervous system and
cravings for food or cigaretres. How much
exrra slecp is needed? It varics from persoll
ro person. 1 recommend ro rhose who have
recend)' sropped smoking rhar rhey arrange
rheir schedule so {har they are able ro spend

409

PROOF POSITrvE
an exrra rwo hours per day in bed. This
does not mean tiut they have ro sleep two
exrra hours. It just means that rhey have
that opeion available if they need rhe extra
rime.
The need for extra sleep is most necessary for the hrst hve days or so. Some may
beneht from a nap in ilie midd1e of the day.
Oehers may need to go ro bed earlier. Instead of sraying up ro waech the evening
news, it would be well ro ruek yoursclf inco
bed earlier. By gening extra sieep, you will
provide more opportunity for your nervous
system [O be in baJance. Adequate rest goes
a long way in preventing mood swings and
rendencies roward irrirability, frusrration,
and anger.
Sixth is "water inside. " This means you
shou1d drink plen ty ofwarer rluoughotlt rhe
day. 1 reeommend at unst eight glasses daily
of plain, simple water. Exceptions are only
made for individuals who tfuly eannot accommodate an increase in water intake such
as chose wirh cerrain heact condjtions, kidney failure, or other physical problems with
fluid balance. Orher beverages are nor as
effeetive. Caffeine specifically is a diuretic
and rhus promotes UJater loss. Adequate water inrake is important tO keep you adequately hydrated. Dehydrarion seems ro
make a number ofwirhdrawaJ effeas worse.
Drinking water is also an aid in bringing
the body back ioto equitibrillm. The body
is under considerable physicaJ srress during
che early withdrawal period. In this state,
we expect the waste proclucts of normal
metabolism ro be generared at a faster rate
than in norma! circumsrances. Adequ:lre
water intake helps ensure good blood flow
ro the kidneys, a.nd more optimal excretion
ofrhose waste products. Some also feei that
keeping well- hydrated helps ro hasren nicotine e1imination sinee nicotine is primarily
e1iminated rhrough (he urine. Within two
hours, half of alI the nicotine in a person's
blood is eliminated. 246

The smenth principle is "wata otltside. "

410

Water outside refers ro the liberal exrernal

use of water. If you are lIsed [O taking a
bath Of a shower onee a day, you will wanr
co increase it ro twice a day, or perhaps even
more frequenr1y. The reason for frequenr

bathing is rhat water has a nemendous

equalizing effect on rhe nervous .system. If
you are feeling lethargic, a cooler shower can
wake you up. If you are struggling wirh
anxiety or tension, a warmer showcr can
help calm you down. Funhermore, the liberaJ external use of water helps to keep you
dean. And c1ean pores ensure optimal eHminacion of toxins rhrough rile skin. This is
an important adjunct to oprimal kidney
function as your body deaJs with an increased roxin load from the srress of smoking cessation.
A~ ridicuJous as ir may seem, the shower
is also one of the safesr havens for avoiding
smoking. 1 have had encOlJllters with thousands of smokers. Only on perhaps rwo
occasions have 1 heard of someone who i llsisted rhat rhey acrually smoked in tne
shower. lf you jump in the shower in rhe
midsr of an intense craving, you willlikely
find yourself in surroundings thac you do
not associate with your nicotine habit.
While the water is doing its work at nelltralizing wirhdrawaJ effects, you are efTectively removed from temptation.

Number eight is 12 list ofothel' .rubstanw

to I2void As alluded ro in our discussions of
water, caffeine should be avoided. Many
people say ar this pOillt, YOll are helping
me to get ofT of robacco, and rhat's fine. But
why get rid of my cofTee habit too? What
are you trying ro do to me?" 1 find it much
easier to he1p individuals kick tne cobacco
habit if rhey also remove caffeine from their
daily roucine. Caffeine may acmaJly undermine a person's besr efforrs to stop smoking. The continued use of cafTeine incretlses
the intemity ofsome aspects of nicorine withdrawal. The reason for this is that your
body's eliminarion of cat-Teine slows when
you stop smoking. This atlows caffeine
blood levels ro risc. In facr, afrer fOllI da)'s
ofbeing a nonsmoker, cafIeine blood levels
may have risen as mueh as 50 percenr. 247
As a result, symptollls like anxiety, irricabilit)', and difficlllty sleeping will li.kely be
worsened as your body has tO reckon wirh
higher levels of caffeine.

DVlNG FOR A CIGARETTE?

More Quitters Have Rel-apse if Coffeedrinking Continues

Caffeine aho appears [O have far-reaching behavioral effects. Some nClIrophysioJogists have dllbbed it "bad habit gJue."
By rhis they mean rhat caffeine lIsers have a
harder time deveJoping new habirs because
caffeine alters brain clJemistry. More informarion on this sllbjecr is found in thc fronta] lobe chapter (Chapter 12). Smokers IOho
stop smoking hut continue drinking coffie have
a higher relLlpse TIlU ehan smokers who have
swpped using tobacco and coffee simultaneously.
Caffeine beverage.s-parricularJy coffee-are ofeen behaviorally linked wirh
smoking. le is almosr inconceivable for
maoy smokers to have a cup ofcoffee wiehout accompanying it with a cigarcue. Consequendy, ehe mose successful oplion s eo
do away wth the caffeinated or even
deca.ffeinared drinks lhar you associare wirh
smoking. This will have che cendency ro
deaea-se cravings following meal eimes or
ocher cimes when you habiruaJly reach for
your brew. In fact, by e1iminating caffcinc
in the morning, many hnd ehat ehe urge ro
smoke is subdued or even absent. Avoiding caffeine may be one of your secrets ro
success.
Researchers at Johns Hopkjns Unversiry published srarrling rese.arch rhar demonsrrared that "caffeine has rhe cardinal features of a protorypie drug of abllse."248 In
other words, based on irs drug effecrs, caffei ne acrs much like allY classic addictive
drug. The implication is thar habiruaJ affcine users are as much drug addicts. in rile
chemical sense of rhe rerm, as coaioe addicrs, heroin addicrs, or nicorine addicts.
This rhought is repugoam to maoy of rhe
upsral1ding American cirizens who cnjoy
their morning cup of coffee. Nonerheless,
many of those who resenr rhe implicarions
of the research are no less hooked on caf[ei ne. The realizarion ehar caffeine is an
addictive drug has been motivation enough
for a number of people ro break free from
{his habit as well. Alehollgh avoidance of
caffeine is most important in your 6rst few
weeks of being a nonsmoker, it would be

beneficial ro continue to avoid rhis addicrive stimlllant as well.

Like aH drugs of abllse, caffeine has a
well-characrer2ed withdrawa] syndrome. In
the Hopkins research, rhey discovered rhar
afrer an average of abour 19 hours from rhe
last consumprion of caffeine, wit.hdrawal
symptoms begin ro become evident. These
symproms consist of increased headache.
sleepiness and laziness, and decreased alertness and activity.249 These wirhdrawal
sympwms were rhe most seve.re for only a
day or MO at most. Over rhe nexr five ro
six days the symproms generally resolved.
The decreased alertness and increased sleepiness can actt1ally be an aid in dealing wirh
smoking wirhdrawal. Thc agirarion thar
often accompanies nicorine e1imination is
thus counrered by rhe caffeine withdrawal
symproms. Thus, many individuals have
an casier rime wirhdrawing from nicorine if
caffeine is avoided.

AvoidAlcoholand Spicy Foods

Alcohol is also ro be avoided. Why? It
suppresses the performance of rhe froma]
lobe of [he brain where judgmenr resides
and decisions are made. Alcohol will suppress your abiliry ro srick wirh rhe decision
ro be a nonsmoker. 1recommend complete
avoidance from a]cohol for ar leasr as long
as you are srill having urges ro smoke. As 1
describe in rhe chaprer on akohol (Chapter 17, "Wanr a Drink?"). popular press repom not\...irhstanding. total avoidance of
a]cohol is [he heahhiest oprion for everyone. Heavy meals are to be avoided, especiaJJy in rhe evenng. They rend ro bring
on rhe urge ro smoke. Surprisingly, being
overly hungry can also be a higher risk time.
The best oprion is ro ear ar regular intervals, no more rhan duce times daily. And
keep your evening meal Jight.
For some people, spiced foods increase
smoking urges as well as orher withdrawal
sympeoms. One lady in our smoking cessarion program was fajling in her anempts
ro kick rhe habit umil she e1iminared cnnamon from heI" djer. Animal research suggests [hat cinnamon is a digestive irritant,
and can cause srimlllarion of certain brain
centers. Thjs may be rhe reason for inereased

411

PROOF POSITIVE
withdrawal problems. Although some
people have successfully useel cinnamon
sticks as an alternative ta cigare((cs, for mhers this may be treading an dangerous
groulld. Ir is prudent to avoid a11 spices dur
irrirate rhe digestive lining, including mild
ones such as cinnamon.
The nimh Jtep is ta atJoid situatiom that
you assoate with smoking. After rhe even ing
meal you may have a habit ofsirring in your
special chair ro watch rhe TV news ar a11orher program. Associared wirh d1ar special chair is an afcer-dinner cigarette. Avoiding rhe chair will help avoid che urge ro light
up. Your break ar work a1so may be associated wirh your smoking lubil. It is common for smokers co liglH up rogether at thar
time. YOLl can choose ro work rhrough the
break, or avoid the usual place where you
spend break time. Instead, take a walk in
the fresh air, or cngage in some other hea1thenhancing acrivty.
Furthermore, be careful of your smoking friends. Explain ro rhem your decision
and ask for their supporl. Lec chem know
(hat you do nor expect chem ro stop smoking just because you did. However, also let
chem know thar smoking in your presence-ar leasc for now-is dcfinre1y not an
Opt ion. You will likely wanr ro meer with
those friends in senings where smoking is
not an option. Some smoking friends may
not bc supportive ofyour decision and may
try ro undermine your resolve or rempt you
ro smoke. Those individuals may not reaUy be your frienels: in filct, you may need
ro avoid them, Avoidance may nor be an
option if rhe tempter is a farnily member.
Narurally, 1 do nor recommend that you
leave your smoking parenrs, spouse, or children. However, ie s generally bese ro come
ro some agrecmenc as co where smoking is
allowed in your homc, and rhen avoid dlOse
areas.
Expect that othm wiilunderstand. This
is dle final key tO kicking the misery out of
kicking rhe ha bir. Many people fear rhar
they will fajj ro get through rhe withdrawal
period becallse of orhers. You fcar rhar you
wiIl bc more irritable roward your fellow
workers. YOll know tiut you may even
"b1ow up" on the job and cause someone

412

else ro Iose his temper. As a resulr of an

actual or anricipated episode, you may say,
"1 am hllrting my work mares and rhe
people I work for as a resulc of giving up
smoking. 1 sholild sran smoking again for
their benefil." In reality, Others willunderstand. People al'e aware that giving up (0bacco is very difflcult, as proven by the facr
that so few are sllccessfuJ. [f you realize ehar
others will understand, thar chey k:now ic is
a heavy addiceion, and realize thar your
behavior wiU be differenr during rhe critical
cime of withdrawal, you will be able ro get
rhrollgh it. It would bc a tragedy for yOll (O
give up on YOl1l'se1fbecause ofsomeOne e1se.

Help From Dur Maker

There is one other f."lcror that man)' of
rny colleagues and 1 have founel i.nvaillable
in kicking rhe misery our of kicking the
habie. 1 be1ieve rhac no one bas given up
the robacco habir withour dle conscious or
subconsciolls aid of the Spirir of God. For
many people, a consciOllS recognition and
dependence on God anei His power are
necessary ro provide the srrengrh to give lip
che robacco habit. They find God ro trul)'
be "A help in rime of need."250 Trusr God
ro provide ehe help dlat He has promised,
submitting yOUI" will to His will. "M)' God
shaH supply aH your need."2S1 God may
not get rid of ali of the withdrawal
syJllpCOms for you. The Bible describes how
Christ suffered and learned obedience by
chc chings which He suffered. Gad does
nor ask us tO go rhrough life free ofsuffering:
an che conrrary, he warns us that we wiU
face difficulcies and hardships. The God of
heaven is always willing ro give us the power
ro overcome. Our parr is co be willing ro
endme whaeever it rakes ro be successful.
More information an d1e mIe of sllffering
and hardship is presemed in Chapter 18,
"Deal ing wirh Bad Habits and Addictions."

Quitting Brings Immediate JO)'5

We have seen that rJ1e damage done ro
your body by your smoking habir is largely
repairable-rhe repair process begins
immeeliately. When you quir, your risk of
gerring robacco-related diseases begins ro
decrease lirerally from day oue. Some of

DYlNG FOR A CIGARETTE?

rhe immediaee benef1es in seore for you wiU
improve yom qualicy oflife. They arc liseed
in Figure 45.
You have more energy when exereising;
your rasee and smeU become sharpened;
your c10ehing loses ies seench; you have more
money because of rhe savings in Life, hea.leh,
and car insurance premiums. and no longer
need ta buy rhe cigarerres rhemselves. le is
surprising ro many ehar smokers are much
more likely ro get iJHO auto accidenrs; as a
resule, some companies evcn have discoumed car insurance rares for rhose drivers who do noe smoke.

IMMEDIATE BENEFITS IN THE

QUALITY OF LIFE FROM QUITIING
Easier breathing when walking, running, cycling,
and swimming.
Food has more flavor.
Everything smeUs better-food, flowcrs,
perfume, you.
Extra money (no cigarettes to buy, reduced health
care costs, reduced Iife insurance costs).
Satisfaction of conquering an undesirable habit.

Long Term Benefits ofQuitting

When wiU your risk of disease reach a
significandy lower level? The rime span is
differenr for diff'crcnr discases. Figure 46
lisrs rhe :tI})Otlnt of rime required for various
diseases.252. 153. 2 4, 25This flgure demonsrrarcs rhe miraculous
power of rhe body ro heaJ irself when
offending subsranees are removed.
Whar abolit thc effecrs of quitring an
rhose wim lung diseases? A swdy was nude
ofover 5800 smokers with ehronie obsrrucrive pulmonary disease in which some of
rhem kieked rhe habic. The findings are
shown in Figure 47. 256 This scudy shows
r11at chronie obsrnterive pulmonary disease
re ponds well ro {he eJjmination of cobaceo.
Chronie bronchitis is ofren [uUy reversible, as we have seen-espeeially if you qllit
soon enough. Your smoker's cotlgh disappears. You have berrcr "wind" for arhlerics
and orher m,uscular exerrion.
Coronary hearr disea.~e ri.sk reduction was
liseed in Figure 46. Anoeher srudy looked
ac the numberofdellthsdue ro coronary hearr
disease among ex-smokers who formerly
smoked more rhan one pack per day. Figure
48 shows rhe resulr.s. 257
Noee that the Iargest reducrion in rhe
chance of dying of a hearr :mack occurs in
rhe fim year. The risk cOlUllues ro drop
over a 20-year period. :u which time it is
aJmose down ro ilie level it would have been
had you never smoked.
Pregnant smokers wha stop smoking at
any urne up tO 30eh week ofgeseaeion have
infams wim a higher birth weight than do

Figure 45

REALTU BENEFITS OF QUIT"f'ING

Redllced Risk

Disease
Lung cancer
10 yurs afler quilting

l6 or mor~ ~ean afler q!!t1og.

Oral cavity cancer
Esophagealcancer

30-50%
80-90%
50%

5 years afler quitling

Bladder cancer
First few
quittioll

~'ears

after

50%

...._... Cervical cancer

SubSlanliall~'10'Ner

FinI few years

Coronary heart disease

FinI year afler quiiting

Aner 15 )'cars

50%
Similar 10 a ne\'er-smoker

Stroke
5-15 years aner quitiiog

Similar 10 a ne\'er-smoker

Figure 46

BENEFIT OF QUfITlNG:
DEALTHIER LUNGS
Those with chronic obstructive pulmonary
disease who stopped smoking experienced
substantial benefit in lung function.
The benefit was most evident in the first year.
Further benefit continued for five years.

--~~-----

413

PROOF POSITIVE

BENEFIT OF QUITTING: LOWER

RISK OF FATAL HEART ATTACK
Risk of Corollary Heart Disease deaths ofex-smokers former/y
smoking more than 20 cigarettes per day:
Smoking category
Never smoked
Current smokers

>

Quit less than 1 year

Quit 1-4 years

) ,.

Quit 5-9 years

QuJt 10-19 years

Qut 20+ years ~_ .-..-----J~

o
Figure 48

.5

1.5

2.5

Morlality ratio

women who srnoke throughour pregnancy.

Quirring in [he t'rst three or four monrhs
ofpregnancy and absr.aining t1uoughouc the
remainder of pregnancy protects the fetus
[rom Ule adverse effcC(s ofsmoking on birth
weight.
The difficulry ofhealing ulcers in smokers was previously menrioned. Smokers
wirh gastric or dllodenal ulcers who stop
smoking tend ro do signiflcandy bencr rhan
smokers wha continue ro smoke. Sucit ulcers heal ro uch more easily when the smoker
qUits.

Will J Cain Weight?

414

One pressing concern of many wilo are

conremplating quitting is "Will I gain
much weight?" Others who have tried to
quit respond, <lI know I wiU gain weight
bCClllse ir happened before when I stopped
smoking." It is true ehat 80 percenr of rhose
that srop smoking put on some pOllnds. 2SS
However, ehar statisric is deceprive because
of the rate ar wbich aII Americans are
enlargng cheir girths. Abolit 56 percent of
those who continue to smoke al'o gain
weighr. 2S9 Furthennore, t11e average weight
gain after guitting is only about five
POUl\ds. 260

And not ali of that weighr srays with [he

person. Most smokers Iose SOOle of rhe excess weighr rhey pur on during the early
phase of quiuing. Only 40 percenr of
smokers gain and retain more (han abolit
faur or five pounds. The negative effecr of
rhis arnounr of weiglu gain an health s
negligible compared ro rhe huge benefirs of
kicking rhe habit. Some experes estimate
thar you would have ro gain 100 pounds to
even corne clase ro somf of rhe heahh
damage rhat smoking has been doing. 26 !
But the besr news is rhar 20 percenr of
smokers do nor gain weight. Althollgh they
are rhe minoriry, rhey consrrure a group of
mllons ofliving wirnesses who restil), rhat
you can indeed stop smoking wirhollt
gainillg a pOllnd.
It i5 a fact, however, ehar most people
do nor even wam ro gain one pound, ler
alone four or more. How can it be avoided?
Before rhar quescion is answered, we will
examine the cause of weight gain when
kicking (he habit. There is a number of
reasons for this rendency. Let us look at
four of che more important Olles. Fim.
foods aften ta te berter. Within hours or
days of sropping smoking, your nose
becomes more sensitive. Commonly, exsmokets discover a new appreciaeion for
sccms and rasrcs. Unforrunatdy for some,
the stage is set for overearing. Second, there
is ofcen a cendency ro substitute foods for
cigarettes. The ex-smoker often rurns to
[ood ta substitute for the oral pleasure chat
smoking broughr. Third, metabolism slows
down. Snce nicorine functions primarily
as a srimlllanr, rhe body's engine has been
revved up during aU those ycars ofsmoking.
YOllr merabolism slows abOlit 10 percent
when you kick the Iubit. If you do nor eat
fewer calories or exercse more, weighr gain
may well result.
FOllrth, the sromach empties more
q u ickly. Researchers havc found char
smoking can delay stomach emprying by up
ro 40 percent. 262 If your stamach normally
empties after a given mcal n two hours
withouc smoking, rhat same meal eaten
whjle smoking wou.ld sir in your sromach
for Ilearly three hours. This would be
expecred ro increase yom risk ofhearc burn

DYING FOR A CIGARETTE?

and acid re(lux. However. it also may help
yOll to feei full for a longer period of rime
,lfter eating.

How to Avoid Weight Gain

With aII of rhese changes in mind,
consider now a four-poioc program ro avoid
weight gain. It is described in Figure 49.
None of these points are difficult ca accomplish. The fim twO have aJready been
mencioned as helpful in kicking che misery
out ofkicking the habit. and are good health
practices within themselves. The last rwo
have been well publicized as good for rhe
health. They represent a modest cha.nge in
lifestyle.
The fim poinc. increasing physical
activiry. nor only helps ro control srress and
cravings as previously mentioned, but a1so
speeds lip your metabolism. This is an
important poiot, snce, as we have seen,
metabolism slows when you quit smoking.
Thus, the same rype ofexercise program that
wjll help you kick the habit will help you
keep off excess pounds.
The second point highlighrs alcohol.
This subcly add.iccive beverage is a problem
on a number of froncs. It is first of ali a
significant source of caJories. More than
this, however, it depresses will power and
has been shown to make it easier to overeat.
The third and fourth poims deaJ with
food choices. AlI emphasis on foods that
are low in fat and sugar is best accomplished
by a diet dur includes liberal aOlOullts of
fruits, whole grains, and vegetables. A given
volume of rhese foods is much lower in
caJories [han rhe higher sugar, higher fac
standard Fare. As a result, you can actuaJly
eat more food whLle taking in less calories.
This is anomer important way ro address
the issue of metabolic slow-down.
Incidemally, such a dier ilio helps ro deal
wim constiparion, which can be a problem
when soroc individuals fim "kick the
habit."l63 Avoiding che high fac and high
sugar foods a1so eliminares d1e mose COO1mon food choices that people use as oral
subsritutes for smoking. Clearly, rhe best
oprion is co completely avoid substtuting
eating for smoking. Howcver. in a rime of
weakness, it is rnuch better ro chomp on a

HOW TO GIVE UP CIGARETTES

WITHOUT WEIGHT GAIN
Increase physical activity
Abstain from alcohol
Restrict intake of high-fat foods
Restrict intake of high-sugar
foods

Figure 49

celery srick than light up again.

The bOHom line is simple: continue rhe
lifesryle recommended for kicking ehe misery our of kiclcing the habir and you should
have no problem with weight gain. For
rltose who are interesced in funher pointers
on losing weighc, refer to rhe chapter on
hyperrension (Chapter 6, "One Narion
Ullder Pressure").
Before leaving rhis subject, I should
mention rhat rhere are a number ofs010kers
who are wIderweighr and aceually need to
put on pounds. Surprisingly, rhey can gain
weight by lcicking the habit aod combining
it with daily exercise, resulting in
mainraining their ideal weight. Excrcise
helps ro Iose or gain weight according ro
me need. For those who are overweight, it
helps them ro Iose wcighr; in rhosc who are
at meir ideal weight, it helps to keep weight
stable. For those who are undcrweight, ir
helps rhem tO gain muscle mass and rhe
needed pounds.

A HalfMillion DolLar Decision

not to Smoke
The our-of-pocker coscs to suppon a
smoking habit are enonnous-to the tune
of over $500,000 in a lifetime. This is rhe
amount of nest egg a person would have ac
agc 65 if he invesred inscead of smoked.

415

PROOF POSITIVE

ADVANCEDWARNINGS
REGARDING TOBACCO
Tobacco is a slow, insidious, but most
malignant poison. In whatever form it
is used, it tells upon the constitution; it
is aII the more dangerous because its
effects are slow and at first hardly ,\ '/~
perceptible ... its effects are
difficult to eradicate rrom
the system.
Figure 50

OTHER HARMFUL EFFECTS

OF TOBACCO PREDICTED
Habit formiog idol
Slow malignant poison
Poisons the atmosphere for o'hen
Mental inability and physical weakness can result
from parcntal smoking
Destroys oervc braio power aod weakeos 'he braio
Stimulates the relaxed nerves, 'hen has a paralyzing influence
Causes an inability discrimina'e between right aod wrong
The example set by parents is the reason mauy children
begin smokiog
Tinte squandered in smokiog could be roade of higbes' value
in being witb their chiJdren
Money spent on smoking deprives tbe family of more
necessary items
Smoking health care workers are offcnsive to their sick clicn.s

'0

Figure 51

Investing rhe cosr of rwo packs per day for

50 years (age 15 ro age 65) in a good mutual fund. ar $2.00 per pack ar mis wriring,
would reslllr in a fund worrh $538,000 in
roday's purchasing power ar rhe end of rhe
SO-year period. This assumes rhar rhe fund
earned an average of 10 percel)r per year. 264

V(lrapping it Vp

416

1opened rhis chapter widl rhe grim srory

of Melissa. There are literally rhollsands of
"Melissas"-ofborh sexe -who go ro rheir

graves premarurely each year because of

smoking. Ir is aii so tragic-and so
absollJtely needless. Beyond this, rhe blame
for alI this suffering is often subcly laid at
aur Crearor's feec. "It just mu t have been
her time ro die," we ofren hear. However,
God has nothing ro do wirh the deaths
caused by rhis poison. In fact, a loving God
has been taking pains for decades ro keep
people from ever starring rhis healrhdesrroying habir. aver a hundred years ago
Ellen Whire was inspired to make people
aware of the dangers of rhis habit-borh ro
themselves-as welJ as ro rhose exposed ro
secondhand smoke. Note her words found
n Figure 50. 265
White's insigllts did not end rhere. She
wrore about her concerns wirh robacco over
800 times. Her broad knowledge of rhe
effects of robacco on the human system and
her undersranding of omer aSpects ofhealrh
and lifestyle decades before they were
scienrifically proven are explored in
Appendix X.
The basis for her persisrence in agiraring
rhe subject she attributed ro God's
reveIation. When you see the accuracy of
her words in rhe lighr ofmodern science, ir
is hard ro doubt her c1aims as ro rhe divine
sOllrce of rhe informarion. Consider some
of the mher concetl)s she voiced, as recited
in Figure 51.
1 see God's hand nOt in me dearh of
smokers. but rather in rhe millions of
individuals who have sroppcd smokingor never began the habit-and are eujoying
life as a result. Whet.her dley made rheir
decision based on informarion from Elien
Whire ar because they were convicred by
the research of rhose rhat God led ro prove
scienrifically rhe dangers of robacco is nor
really important. What is important is rhar
many have nor given God rhe credit for rhe
misery He has prevenred. Conversely, He
has been blamed for [he narural consequences of robacco use.
JUS[ as mere are thousands of"Melissas."
[here are also rhousands of people like
Catherine. Carherine, ar 91, lives on her
own in comforrab1e surroundngs. She stiU
enjoys life and has special pleasure in seeing
heT grear grandchildren grow up. Catherine

DYlNG FOR A CIGARETTE?

would probably nor be alive roday ifshe did
not make a decision years ago ro become a
nonsmoker. Her decision to Stop smoking
was rnade in her 60s, bm it seems ro have
paid big dividends. This is an educared
guess. 1 cannot be sure rhar Catherine
would not sriU be alive and doing weU roday
if she had nor made rhe decision-bur
sratistical srudies indicate r11at it wou/d bc
extreme/y unlikely.
Every day, every single smoker makes a
solemn choice. Not choosing ro quir today
is making a choice ro colltinue ro ernbrace
a destructive habir dur is likely ro kilJ,
maim, or in some orher way incapacitate
you-long before youl" rime. Unfortlll1ately,
rhere often are ilO warnings before ilie cancer
diagllosis or rhe heart arrack, or even rhe
osteopororic fracture or dle realizarion that
you look 15 years older than your
nonsmoking peers. Can 1 implore you ro
stop playing Russian roulerre? The loaded
chamber is SUIe tO come up sometime.
Some of you no doubt are saying, "Ye ,
Docror Nedley. 1 know aII rhar you are
saying is true. l am gambling wirh my life.
Bur 1am powerless over rhis addicrion." For
those of you who only see your weakness
and your Failmes, take hearr-you can be
successful. FoUow {he guide1ines presenred
in this chapter; they can make aii rhe
difference bet\veen success aud faiJlIre. AJso
be sure tO read Chapter 18. "Dealing wirh
Bad Habits and Addicr.ions."
If you have rried ro qllir on your own
and have given up, work wirh your physician
or other health professional. Usc rhe
material in rhis chapter ta undergird the

pracrical counse! al1d encouragcmenr you

get from working wirh a professional. lf
rhar opuon does nor sound feasible, rhen
look imo rhe Bre1.rhe Frec program offered
hy rhe Sevellth-day Advenrisr church or
od1cr ourpariem STOp smoking programs
offered in your communiry. Group suppon
from orher smokers who are going through
the same process of kicking rhe habir can
really reinforcc aII rhar we have shared in
rhis chaprer.
If you have gone rhar roure and lack
confidcnce in al1 outpaticnr approach, ler
me make anorher suggesrion: rake a week
off anei trel.t yourself ro a good live-in
lifestyle program. The Cemcrs for Diselse
Control have gone on record: "the limited
research available suggests that these [livein programs ro stop smokingl can be quite
effecrive. "266 In faer, I can hcarrily recommend such a cemer in my region. The
Lifesryle Cemer of America in Sulphur,
Oklahoma 267 draws people from ali over the
counrry to cake advanrage of their live-in
programs dut include smoking cessaron.
They actually use this chapter of my book
a their primary wrinen educarional resource for their panicipanrs.
However you use rhis chaprer, wherher
on yom own, widl your doctor, as an adjunct tO an ourpatiem class, or in conjuncrion wirh a live-in program, 1am convinced
it can help you to be flnally successful. The
good news is rhar you can stop smoking.
YOl! can begin roday on a new smoke-free
parh thar will enable you tO live a much
higher quaJity life anei cnjoy the many beneflrs that we have presemed in this chapter.

ReftrmcesMrlimt's S/ory ""pl'rsmts II

CllSr liistol'y.
I

of INlr stor;rs rombi/lld imo

Ih;s

singlr

1 Fiore MC, Newcomb P, McBride l~ N3[ural Hisrory 3nd epidemiology

of lob3CCO usc and addic[ion. In: Orleans CT. Sbde]. editOr. Nicot;ut
AJd;rt;otl: Principm lltul Mllnllgrmtllt. New York: Oxford Uni""rsiry Pr
1993 p. 89-104.

) Fisher EB Jr., Lichtcos[cin E, Hairc-Joshu D. Multiple dc[erminalHs of

robacco use and c=oon. 111: Orleans CT. Slade J. edirors. N;cor;llt Add;rtion: Pril/cip/ts 1l1ll/lvfl1lragemmt. ew York: Oxford niversiry Pres.

1993 p. 71.

Davis Rlvl. Foreword. In: Orlean ef. Sladc]. cdirors. N;cotill~ ALUiclioll: A-;lIciplts ITfld Md'Jtlgtmml. New York: Oxford Univcrsiry Press, 1993

mOlllllg"

p. vijviii.

; Flay BR. Youlh rob3cco u.'c: risb, partcrns, and conrrol. In: Orleans
CT, Slade J. editors. N;colinc Atldiclion: Pr;ncipm llnd Ml11tdgtmfflr. New
York: O ford Universiry Prcss. 1993 p. 372.
6

Warner KE. Goldcnllar LM. McL~lIghlin CG. Cigarctle advcnising alJd

m:Ij.IZinc covcra.gc of rhc h:tl.ards ofsmoking. A st3tistical analysis.

J Meci 1992 Jan 30;326(5):305-309.

N Eng/

Aebpled from McGinnis JM, Foegc WH. Actual causes of death in thc
U"i[ed t31cs. JAMA 1993 Iov 10;270(18):2207-2212. Upper rallges

417

PROOF POSITlVE
uscd for lobaca> aRd aJcohol duc 10 addilional informalion presented in
chis book. Sexual bc.havior dc:nhs updal.ed 10 reRecl 1995 rates.
Cigarcllc smoking-auriburablc mO(lality and yl:ars of porenlialllfe 10 t Unired SI<lICS. 1990. MM\'(IR Morb Mortal \'(fkl)' R~p 1993 Allg
27;42(33):645-649.

"gmU11l. New York: Oxford Universiry Prcss. 1993 p. 367.

2, U

Deparrmenr ofHealrh and Human Services. SmokillgalllJ H~alth.1l

IllUionill sUltus TrpOTl. A n:poTl of the Stlrgeon Gl'1Imd. /986. Rockville.

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p.3.

10j

Chiang CN. R.3paka RS. Pharmacokinelic.~ and Disposition of C:rnllabinoicls. In: R.1pab RS, Makriyannis A, "dilOrs. StNlr/ure-Aetillity Relll/ioruhips o/tiu C,mtlllbilloids. NJDA RCSc:lICh Monograph 79. US Dep!.
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Fried PA, W:~llcinson B, Gray R. A follow-up srudy of ~llenlionaJ

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l.O')

HutchillgS DE. Brake S, CI al. DevclopmcllIaI Toxiciry of Prenalal

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pw.

L.1ndlleld
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ll6 Srarr K. Renneker M. A cYlologic ev.t1ualion of splllum in marijuana

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Pechacck TF, Foisom AR, el al. Smoke cxposlIIe in pipe md cigar
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Numbcr 93-3461.1992.
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Numbcr 93-346\, 1992 p. 115.

m Epps RP, M:lnley MW ClinicallllIervenrions 10 Prevellt lobacco Usc

by children and adolcscenls. In; Glynn 'IJ. MaJlley MW How to Heip
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Your Patimts Stop Smoking: A NIl/ionlll Gmur Imlifllu Mamuli for PJ'}siciom. Nauonal lnslilUlcS of Health Publication Numbcr 92-3064. Reviscd Nov. 1991 p. 72.
Michael Eriksen. Ccncers for Disease Control and Prt"VeJllion. Office
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ll) L.1.ndo HA. Formal Quit Sllloking Trcarlllen!. In: Orleans ef, Slade J,
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216 Dcparrnwlll of Healh and Humall Serviccs. TIu hM/l1J coml!'J1fellUS of

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MD: Depamncnt ofHeaJth and Hum3n Services. Publicarion no. DHHS

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Henningfield JE. Cohen C. Pickwonh WB. psychopharmacologyof
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U7

218

PefCIS JA. Nicorine-rep\acemenr thcl'2py in ccssalion ofsmoking. MllJO

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BOlvin GJ. The ps}'chology of cigaretle smoking. P.imnry GIre fJ11d

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Cltl/rer. November 1986; p. 22-31.

l..lO

CigaIelle smoking am011!\ adulls--Unilcd Srares, 1993. MM\'(TR Morb

Mortal Wk& RJ.'P 1994 Dec 23:43(50):925-930.

U.5. Preventive Serviccs 'Task Force. Counscling 10 Prevem Tobacco
Usc. Jn: Guidr to Clinicnl Prt'lleJllilleSertlicl'.<-2"" cditio11. B:dlimore, MD:
Williams and Wilkins, 1996 p. 599.
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2 2 Glynn TJ, Manley MW. In: Glynn TJ, Manley MW How to He/p Your
Pa/iCll/J Stop Smoki"g: A Nnrionol unc" Jmtilllu Ma11t1al for Physiciam.

National Instilules ofHeallh Publicalion Number 92-3064. Revise.d Nov.

1991 p,37.
Naliorutl Hearl, Lung, and Blood InSlitule. HoUl YOIJ c'w Help Yotlr
Patimts Stop Smokil/g: Opportrlllity for Respimlory CAre Prorri/iolltrS. US

l.l3

Dep!. of Healrh and HUlllan Services Nalionallnslil'ulcs of Hcalth Publication Numbcr 89-2961, 1989 p. 35.

Cons/ijM/ion .fom: alional Hearl, Lung, and Blood InsulUte. How

un Hl/P }'ofir Pntimts Stop Smoking: OpporLtllliry for Rapimt{}ry ure
Pmailioners. US Dep!. ofHealrh <Ind Human Serviccs NalionallnSlilUlCS

2J4

~II

423

PROOF POSITlVE
of Hcalth PubJicuion Number 89-2961, 1989 p. 17.
2.lS

[ncrcase in smokcr's cough from: Glrnn 1]. Manie}' MW. HOl/} 10 Htlp

!'Our Parinm SlOI' Smo!.:i1rg: A iValioml! Cana,. InSlilult MalllulI for PJ~ysi
cians. Nalional IllSlillllCS of Hc:aldl Publication Number 92-3064. Revised Nov. 1991 p.37-38.
G1rnn TJ. Manley MW. HOlV 10 I-Mp YOllr Pllliml-< SlOI' Smo!.:iug: A
MllioJllr! Canc" Instilule MflJllI1l1for !'I1jsit1lIIS. Nalionallnslirulcs ofHeahh

l)(,

Publicacion

umber 92-3064. Rcvised Nov. 1991 p. 43.

Glynn l'J. Manley MW. HOl/} ro Hal' Your Pnrimrs SlOI' Smokiug: A
Ml/ional C01lur !tlJfillllr MantlaljUr Pbysicil1llS. Naliolla.l JnsrilU(esofHea.ILh

2j;

I)ublicllion Number 92-3064. Reviscd Nov. 1991 p.38.

Glynn TJ. Manie)' MW. How 10 Hrlp Your Plltimls Stop SlIIokiug: A
MllioJlll1 C/1ltl!r Inslilult' MlunrnljtJr I'hysiriafIJ. Nalioll<lllnsorulCS ofHcahh
J>ublicllion Number 92-:~064. Revised Nov. 1991 p. 38.

l.l8

239

Maany 1. Woody G. Fou.lks E. Nicolinc and panic a((acks. Am}

Psyehi,rrry 1987 Feh; 144(2):255..

Jarvik ME. HellningllcJd JE. PharmacoJogicll adjnncrs for (ht: lrt"atn\C/lI of tObacco dependence. In: Orlcan ef. Slade J. e'<.!irors. NicOlille
11IltIierion. New York: Oxford Universiey Pres.~. 1994 p. 245-246.
240

Glynn TJ, Manley MW. How 10 Hrlp !'O,,!' Plllimts SlOI' SlIIokillg: A
Nalio/llli Callrer !Jmilltu Mmltlillfor Pbysicians. National InsIi (tIICS of Healrh
Publicarion Nllmbcr 92-3064. Revised Nov. 1991 p.37.
il

GI)'nn TJ, ManIe}' MW. HolO to Help Yollr Plltimu Stop Smoking: A
Nntionll! Caltcer !lmilllle MawlJ1ljor Ph)'Siam. alionallnstilules ofHeaIth

2$]

Philippians 4: 13. Tbr Holy Bible. AUlhorized King Jamcs vcrsion.

Shopland DR. Bmn OM. Medical and Public HcaIth Implicarions of

Tobacco Addiction. In: Orleans Cl'. SladeJ. edirors. Nicotiltt' Addirliol/:
I'riltplrs /lltd M'magemml. New York: Oxford Universiry Prcs.~. 1993 p.
122-124.
2j2

~53 U.S. Preventive ervices Ta-<k Force. Counsc1ing 10 Prevenr Tobaeco

Use. IIl; Gllidt' 10 Clillical PrrumlilJe Servic.

WilUams and Wilkins, 1996 p. 599.

2"" rdi;ioll. l3aleimore. MD:

National Cancer InSlilllte. Smoking dlld Tobllreo olltroi MOllogmpb 4.

Rrspinllory HI'I111b E./fim OfRusivt' Smoking: LIIJlg Caltcer AJld Olher DisOI-ders. The Rl'P0rl OfT}}e US Elluiromllt'llll/I Prolerliolt Agmry NIH Publioltion NUlllbn 93-3605. 1993 p. 96
lj

lS Newcomb PA. Carbone PP. The hC:llrJl conseqllcnecs ofsll1oking. Cancer. Mt't! Clill North Am 1992 Mar;76(2):305-331.
2$6 Amhonisen NR, COJlnetl JE. et al. ElTects of smokjng iJllervemiOIl
and fhe use of an inha.lcd amicholinergic brond\odil:uor ~n rhc rale of
decline of FEVI. The Lung Heallh Seudy. }AMA 1994 Nov
16;272(19): 1497-1505.

257 Dep:rrrmcnr ofHearh "nd HUl11an Services. Tbc bNIIlh bmefilS ofsll1okiJl,ftwSlllion:A reportoflbeSllrgt'oll G'eneml, 1990. Rockvillc, MD: De-

p"rllllelll ofl-leahh and HUlnan Services. PlIblica(ionllo. DHHS (COC)

90-8416. 1990 p. 239-240.
~5~ Cenrcrs for Discase Contl'ol. Tht Ht'IIJrJJ Bmrfils o/Smokillg Cmalion:
A Rt'jJorl ofrlJI' Sltrgt'OIl Gmrrnl. 1990 Al a GI:lncc. 1990 p. 2.

243

2;? Cenrers for Disease Control. n)r Hl'ltJlb Bmejit of 'moking Cmation:
A Rt'porr ofrlu SUrgt'OIl Gt'lIl'r1I1, 1990: Al a Glancc. 1990 p. 2.

Puhlicllion Numbcr 92-3064. Revised Nov. 1991 p.37.

l6<J Cemcrs for Disea. e Couuol. 77u Hra/rh Bmefi/s ofSmokin.fJ Cml1lioll:
A Rrporl o/riu SUrgtoll Gmern/, 1990: A( a Glance. 1990 p. 2.

NIH Consensus Collfcrencc. Ph)'sical AClivi!)' and Cardiovascular

hcalrh. JAMA 1996 Ju.ly 17: 276(3): 241-246.

261 Glynu TJ, Manley MW. Holtl ro Nrlp YOllr Plllil'llu SlOI' Smoking: A
Nuwn/li CII1Ct'r Imri/tiu MJ1llllaljor PJ1J~illllJ. NationallnstillllC;S ofHcalrh

Marcus BH. Albrecht AE. CI al. Usefulness of physic:l) excrei t for

mainlailling smoking ce alion in wOmen. Am j G,rdiol 1991 Aug
1;68(4):406-407.

l'ublic:lfion NUlllber 92-3064. Revised

Publiallion NUlllber92-3064. Rcvised

ov. 1991 p.37.

Glynn TJ, Manley MW. How 10 He/p YOIIT PlIlimu SIOP Smokiltg: A
National Cnltcer !lWillllt' MtlIlllalfor PI1jsiril1llS. Naljonalln.tirulCS of Healr.h

i'

Henningficld JE. Cohen C, Pickwonh \X'B. Psychopharmacology of

niCOline. In: Orlt:an Cl: Slade J. edilOrs. Nicotillt' IulditJiolt. New York:
Oxford Universiry l're s, 1994 p. 26.
246

Brown CR Jacob P 3d, el al. Changes in rale and pattern of cafreine

mClabolism aflcr cigarclle abstinencc. Ciilt Ph(JYnlllcol Thl'l' 1988
May;43(5):488-491.
24

Griffiths lUt, Bigclow GE. Liebson IA. I-Iuman ColTexo Drinking: Re:inforcing and l'hysicaI Dept'ndence-I'roducing Effects ofCaffcinc In: Harris LS, cdil.Or. ProblmuofDrug Drprndmee, 1986. NIDA Rcsearch Monograph 76. U Dep!. Of I-Iealrh AmI Human Serviccs l'ublicalion Nu.
(ADM) 87-1508. 1987 p. 75.
248

Griffirhs RR. Bigdow GE, Lieb on IA. Huma.n Coffcc Drinking:

Reinforcing and Physical Dcpendence-Producing EHcclS of CllTeinc In:
Harris LS. editor. hobll'lllS of Drug Depmdmrr, 1986. NIDA Researdl
Monogr:apb 76. US Dcpc. Of Heahh And Human Services Public:llion
No.(ADM) 87-1508.19871'.75.
2i9

250

Hebrew 4; 16. TlJe Holy Sible. Amhorizcd King Jarnes vcrsion.

424

ov. 1991 1'.33.

Zr.2 No"'ak A. Jondt'rko K. el al. Cigarelee smoking delay gastric cmpryin of a radiolabcl.led olid food in h~.lrh)' slnokers. Srl/nd} Ganrol'llleroi
1987 Jan;22( I ):54-58.

arional Hearr. Lung, and 8100d Institute. HO/v YoII Ct1l1 Help Yollr
Plllialli Stop Smokillg: OpportltIJily for &spimlory Clrr Pmcliliollt'n. US

l6

Depl. of Healrh and Human erviees NationalI nSlilllles of Hcalrh PubliaHian Nurnber 89-2961. 1989 p. 17.
an avcragc anllu'll inllarion ralC of 3%, rJH: COSI of cigarencs
increlScs al rhe sa.lllt: tale. and the nonsmoker ups his deposits tO equallht:
rising priee ofc;gatwes. The IIn,,1 habnce would bc $2,357.000. bur due
10 inilarion. ilS buying powcr wou.ld bc t'<Juivalelll 10 $538.000 in totlay's
dolla.rs.
l64 ASSUIllL's

26S Whirc EG. Tllt' Mit/islry o/He,ding. Nampa.lD: Pacillc Prcss PlIblishingAssociarioll. 1905 p. 327-328.
'66 Ccnrers for Discase Conrrol. 0111. ofllle Ashrs: Choosing a nltlhod10 'Illil
smoking. l'ubli 'ltion numbcr: DHHS (COC) 90-8418' 1990 p. I 1.

The Lijmyl" vmer ofAmeriCII can bc reached al 1-!l00-596-5480 ar

405-993-2327. Addre. s wriuell inquiric 10: Tbe Liftsry~ VI1l~rofAl11erim;
Roule 1. Box 4001; Sulphur, OK 73086.

267

CHAPTER SEVENTEEN

WANTA

RINK?

r. Arnold was caJled (O rhe emergency room. When he arrived he

found Jane Archley, a lechargie 70.
ycar old woman, Iying an rhe bed
in moro 3. After a brief exam, he realized
her case was nor critica!. However, she was
nor abJe to speak intelligibly-he wOllJd
have to look e1sewhere for a medical history. His qllcsr took him iora rhe wailing
mom where !te found rhe Archley family.
After Of. Arnold took the Atchley family
ro a more seclllded spor, they told him the
derails of a uagic scory. Jane, it eurned Out,
had been a woman in good health up
lhrough her reriremem years. Bur a few
years ago she srarted baving problems. Her
appedrc was Iloe good, and she began losing weighr from her already chin frame. A
physician had suggested (hat ir would be
well for her ro rake a linIe alcohol before
meals. This, he cold Jane, would likely help
ro srimulate her appelire. Despice a liferime history as a nondrinker, Jane followed
the physiciao's advice. The remedy worked!
Her appetire increased dramatically. There
was a major problem, howcver; rhe main
apperire ic stimu1ared was an appetite for
a1cohol. When Of. Arnold metJane on thar
fareful day in rhe emergency room, she \Vas
in a drunken slupor.
Despice thousands of cases like Jane's,

where weJl-meaning individuals become

ensnared by alcohol's deceplions; aod despire an esrimared 100,000 Americans who
dic prematurely every year because of alcohoti; ir has become very popular ro extol
(he benefirs of "moderate drinkiog.' Some
of the recent populariry of alcohol as a
"healch-giving" tonic comes from news fearures purpOrriJlg to show benefhs from
moderate drinking in France. The media
has been preoccupied wirh whac some have
called "the French Paradox."

The French Parad{)x

AJthough rlle French consume more aIcohol rhan Americans, they have less hearr
disc,ase dearhs. Hearr disease is the number
twO killer in France, while it remains nUJllber one in America. Some scientisrs believe
rhat France's lower hean disease rate is due
ro rheir more liberal alcohol imake. Ar fim
giance, the studies seem ro point il) rhar
direcrion. However, addicional srudies have
provided a different solurion to rhis paradox. We willlook ar rhem in deraillarer in
the chapter.
No one today is suggesling thac heavy
alcohol consLUnption is health fu 1. However,
some are interprcring dara (like (har from
France) as showing rhar "moderate"
amounrs ofalcohol are healrhy for the hearr.

425

PROOF POSITlVE
Unforrw1ately, many of these advocates have
totally ignored rlle harmfiJ.! efficts of even
moderate alcohoi use. In this chaprer we will
look at ilie evidence regarding various leve1s of akohol consumpeion, from light ro
moderate ro heavy. We will a1so sec mher
srudies examining rhe French Paradox which
explain the underlyillg reasons for France's
lower level of heart disease. AII of (his information sholild be lIseful ro anyone who
is asked, "Wanr a drink?"

The Widespread Use ofAlcohol

Few people advocate prohibiring aleohol anymore, even though it is a dmg. AcruaUy, ir is one of the most widely used drugs
in our nation; it is ofren addictive, and is a
known kiUer. Governmenc research reveals
dur alcohol causes more than 100,000
deaths per year in the U.S. 2 Thus, among
drugs, akohol is second only ro robacco as
a cause of premature deaths in our nation
and is d1e third leading actual cause ofdeath
overalL For more information on acruaJ (underlying) causes of death, see Chaprer 1,
"Principles for Optimal Health."
When researchers look ar the deam coli
from aJcohol, they do not advocare "moderate amolll1ts" for purporred heart. health
benefirs. Even if research did show de.uly
thar alcohol could help aur heam, how
could health professionals advocate any
amollnc of a potentia1ly addictive drug ehat

PUBLIC ENEMY NO. 1

1. Alcoholic beverages are regarded by

social analysts as America's number one

public enemy.
2. This "beloved enemy" c1aims at (east
100,000 American Iives per year.
3. This is five times as mauy
as aU illegal drugs
combined.
Figure 1

426

,an cat/se great harm to other organs? Alcohol is dangerous even ar levels currendy
called "moderate," but like any dangerous
drug, it is even more hazardous in higher
amOUlHS. And, where is that line between
"moderate" aud "heavy," if iodeed mere is
one? As we saw in rhe true case history of
]ane,3 what begillS as moderate drinking can
qllickly escalate ro frank abuse in some
people. It is estimaced rhar up to 15 percent of those thar use alcohol will ar some
poinr become eicher problem drinkers or
acrual aJcoholics. 4 . sIt is esrimated that the
number of aJcohol ahllsers in rhe U.S. is
more man 15 million. 6
The use of akohol often is mulriplied
into rhe use of other dangerous and damaging drugs. A parellts' organizat ion caJied
"National Parems' Resource Institute for
Drug Educarion" (PRIDE) condllcts an
annllal survey of middle aod high school
srudents regarding substance abuse. DOllg
HalI, PRIDE executive djrecror, says, "Use
ofevery illicir drug ... is ar the highesr level
PRIDE has ever recorded" by studenrs
mosdy 11 ro 18 years old. In rheir 1996
swdy of about 130,000 srudems, 69 percent of marijuana users a150 drank a1cohol,
compared wirh orny about 7 perecn(. ofnonmarijuana users. Regardjng cocaine users,
13 percent lIsed akohol compared to less
rhan one perecnt of non-users. Use ofdrugs
is preceded and accompanied by the lIse of
aJcohol. Campaigns to educate our yourh
an the da.ngers ofakohol wouJd be expected
ro result in a corresponding reduction of
hard drug usage as well.
Srudenrs who use drugs are gerting more
imoxicated than before. About 36 percent
of 12 1), grade beer drinkers said rhey ger
very high, bombed, or stoned," compared
wirh 27 percem nine years ago.
Most people are somewhar aware of rhe
social problems caused by alcohol. It is involved in mariral problems, divorce, problems in parcllting, violence in the home,
poor job performance, missed days ofwork,
unsupervised children, ilJicit sex, aod the
list goes Oll and 011. Even many homicides
aod suicides arc ofren directly re1ated ro me
use of alcoholic drinks. For mese reasons,
a1coholic drinks are rcgarded by many so-

WANT A DRlNK?
cial analysls as America's number one public enemy. Some of me damage do ne by
aleohol is conveyed in Figure 1.7

Dollars Spent on Alcohol

How much money do Americans spend
each year to buy alcoholic beverages? 1 have
asked this many times in my public lectures.
Some say. "Perhaps twO miLlion doLlars. perhaps ten million dollars." The highest eslimate [ have ever received is 100 miII ion
doHars. These estimares are extremely low.
T!te acrual amounr is srared in Figure 2. 8.
'>These sratistics rranslate inro an average
expendicure 0[$330 peryear for every mao,
woman, and child in America for the purchase of alcohol, and over $450 per year for
alcohol-relared damages, according ro omcia.! record-s. Off dle record, there are large
quanriries of alcoholic drinks made and
purchased "underground." This producrion
and consumption are nor reflecred in the
sralistics-the 86 billion-doUar ftgure is a
conservative estimare.
1 he nexr rime you go ro a resrauram,
think of rhese cosrs as an exrra amounr
added to your bill. YOll order no aleoholic
drinks. bur when you sec rhe bill you notice an alcohol surcharge of $8.80. The
wairer cxplains that me four diners sining
at an adjacent table each ordered a one
ounce drink of alcoho\, and you must cover
your share of "aleohot damage to society'
which amoums ro $2.20 per ounce con
sumed. 'o He funher Sfares thar 80 cenrs of
rhe amounr is for drunk driving, $1.00 is
for the cost of violenr crime commirred
under rhe influence ofalcohol, and 40 cenrs
is for medical and healrh care cosrs. If we
were aii forced ro pay lhese costs in this
manner, how long would we eoierare ir? In
aII fairness, rhe cosr should be borne by rhe
user. The surcharge should be paid by
drinker and placed in a fund ro cover rhe
damage ro sociery. The grearcsr benehr of
this plan would be the reduction in sales of
alcohol duc ro rhe increased price.
Truly we have made a dramatic "about
face" in aur relarively brief hisrory as a narion. From a sociecy that once prohibircd
alcohol use, we arc approaching 100 billion
do/lan per yetlT in legal alcohol sales. The

DOLLARS SPENT ON ALCOHOL

1. More tban 86 billion doHars are spent
annually to purchase alcobolic beverages.

2. As mucb as 116 billion doHars are spent

annuaHy for the cost of damage to society
rrom alcobol (divorce courts, health care,
lost work, premature deaths, etc.).
3. AII told, the total annual
cost of alcoholic beverages
is $202,000,000,000.

Figure 2

very menrion of prohibirion reminds me

mar, in modern hisrory, aleohol srarisrics are
almost always shrouded in a cloal< of deceprion. For example, ask any high school
srudenl abollt rhe "Prohibirion Era" in
America. They likely will be able ro rell you
what a miserablc failure thar experimenr
was. They wiIl describe quire c1early (har it
dicl nor prevent people from drinking alcohol nor did it reduce rhe physical harms of
alcohol use. To rhis day, many even in the
medical communicy wiU circ the desperate
failure of Prohibirion as grounds for legalizariOI) of everything [rom marijuana [Q
coca.ine. There is only one problem wirh
"rhe facrs" abour the failure of prohibition:
rhey are nor facma!. Lisren ro oile of the
most aurhorirative voices in Public Hea[rh
and Prevenrive Medicine, rhe definitive textbook on this subject edited by Drs. Lasr and
Wallace: 'The comrnonly helel view of
Prohibition in the United States is t.hat ir was
a failure. but t.here are major limirarions to
rhis view, since during Prohibirion, healrh
and social problems associared with alcohol
use cenainly were reduced dramarically."ll

The Broad Nature OfAuohol's Destructiveness

Ler us look now ar fhe widespreael damage rhar aleohol inflicrs on a number of
front. Before we do so, we must dispei sev-

427

I)ROOF POSITIVE
eraJ myths. Firsr, rhere is a common belief
rhat wine and beer are nor ncarly as damaging as "hard liquor" and mixed drinks. The
truth is rhar mosr of rhe adverse consequences of aleohot consumprion seem to be
more related ro rhe toral 3mOllnt consumed
rarher ehan where ir came from. As surprising as ie is ro mosr people, a srandard can of

EQUIVALENT AMOU TS
OFALCOHOL
There is roughly 1/2 ounce (15 grams) of
pure alcohol in each ofthe following:
llf2

oz. of80 proofliquor

5 oz. of table wine

12 oz. of beer

Figure 3

PERSPECTIVES ON THE DANGERS OF

MODERATE ALCOHOL USAGE
1. Tbe risk of alcohol-related healtb problems is greatest
among tbose labeled "heavy driokers."
2. However, because "social drinkers" outnumber "heavy
drinkers," the majority of alcobol-related problems occur
among "social drinkers."
3. " ...acute alcohol intoxication or rdatively low levels of
chronC alcobol consumption can produce serious adverse
effects in individuals who otherWise tit within the social
norms of alcohol use."
4. "As in formation grows 00 how alcohol is
;-~..,
hazardous to health, we tind ourselves
less secure in defining what is safe.
Rather, alcobol use iDvolves a
continuum of risk..."

ca,

Figure 4

428

beer OI' glass of wine has just as much alcohol as a cockrail nude Wilh 1 1/2 ounces of
80 praof liquor. 12 (For those not familiar
with alcoholic beverages, mOSl mixed drinks
cal1 for 1 1/2 ro 2 oz. of liquor. 13 The 1 1/
2-ounce measure in bar terminolog)' is caJled
a "jigger."14). Irs equivalence ro wine ami
beer is shown in Figure 3.
The essenrial equivalence of aIcohol
exposure from beer, wine, and mi.xed drinks
is imporrant for research pllrposes as weli.
When 1 refer ro s[lldies ular measured how
man)' drinks a person had, rhose drinks can
be made up of any comhination of standard glasses of wine, cans of beer, OI' mixed
drinks. Keep rhis in mind rhrougholH rhe
chaprer. As f.'lr as [he research is concerned,
a person rhat averages rwo beers each
evening is drinking "two drinks" per <ky just
as much as rhe individual who averages a
couple of mixed drinks-or a couple of
glasses of wine-every da)'.
A second myrh thar musr he dispelled
ofren arises in the form of an objection.
Individuals often say ar rhis juncrure, "I am
not a he<J.vy drinker-I only drink occasionally. 1 do nor need to worr)' abour rhesc
alcohol-related problems." There are rwo
poinrs rhar are relevam here. Firsr is [har
Olany alcohol-relared iUnesses do nor occur
merei)' in hea"y drinkers. They mn also oecur in socird drinkers who on occasion have
"one too many. " Even individllals who consisrendy consume alcohol "in moderation"
and are careful never to "drink roo much"
are sriU at risk for some of alcohol's problems. Drs. Rankin and Ashle)' made some
insighrful observaeions in rheir excellenr
chapter, "Alcohol-related Healrh Problems."15 Tbese are summarized in Figure
4. A second relevant poinr dealing wieh
moderare aIeohol use comes from the World
Heahh Organization. They havc underscored the face thar anyone who drinks socially today is potentially tomorrow's heavy
drinker. lf you have "a genetic rendency
roward alcoholism," rhat is, an inherited
rendency ro become a heavy drinker, ehar
potential will be greatly illcreased. However, even individuals wirhour an)' apparent family hisrory of alcohol problems can
become alcoholics. The message is simple:

WANT A DRlNK?
rhe only sure way to avoid becoming a heavy
drinker is ro be a non-drinker. Do nor srart
drinking in rhe fim place.
Since my argumelHs have dispelled rile
ewo common myrhs, we have esrablished a
framework for evaluating even rhe moderate use of beer aud wine. Widl rhis in mind,
ler us now turn our areenuon ro soroe of
alcohol's physical effects.

GastrointestinaL ProbLems Reltlting to

AlcohoL Use
In considering the diseases and physical
conditions rh:H can resulr from this addictive drug, ler us look inirially at the parc of
the body where alcohol fim exerrs irs effecrs---on the sromach and intestines. Alcohol is an important cause of a number of
gasrrointesrinal maladies, as listed in Figurc 5. 16,17. 18
Cirrhosis of the liver ranks among rhe
ren leading causes of dearh in rhis counuy.
MallY are not aware thar nearly 25,000
Americans die each year [rom liver cirrhosis aod orher chronic Ijver diseases. 19 Esophageal varices are large veins rhar form in rhe
esophagus (swallowing rube), llSually duc ro
cirrhosis of the liver. These veins may bleed
profUsely and even C<1.use sudden death j[
rhey ruplUre.
Alcoholic hepatiris, aoother debilirating
liver condirion, can be caused by alcohol
withollt <lny exposure ro hepatitis-causing
viruses. AicohoI is also rhe mosr common
cause of pancreatits,20 accounting for approx..imately 65 percenr of the cases of rhis
vcry painful condirjon. Pancrearitis involves
infIammauon of the pancreas, and is associared with syrnptoms such as severe abdominal pain, nausea, and vomiring. 10variably, an individual with pancrearitis
must be hospitalized. It is not uncommon
for such a hospitalizarion ro last a number
of weeks, with paft of thar time in rhe inrensive care unit. If the drinking habit coorjnues, the person can progress from acute
attacks of pancreatitis ro chronic pancreatiris. The latter condirion can result in a very
painfuJ exisrence, aod often reqllires continuaI pain medications. The individual can
even develop diabetes ifthe alcohoI-indllced

DRINKING IMPACTS TBE

GASTROINTESTINAL SYSTEM
Cirrhosis of the liver
Esophageal varices
Gastroesophageal Reflux
Disease
AlcoholC' hepa,titis
Acute pancreatitis
Chronic pancrreatitis
Gastritis
Peptic ulcer disease
Figura 5
process destroys so much of the pancreas
dlar it is unable ro secrete enough insulin.
Akohol may aIso cause sromach inflammarion calIed gastriris. This condition can
become so severe (hat the individual devdops stomach bleeding. Even moderate alcohol ingestion can be a factor thar rips rhe
balance in favor of gasrriris in a susceprjble
person. AkohoI is one of the most damaging substances ro the sromach's mllCliS laycr.
This layer provides the stomach with vital
prorecrion from irs own acid environmem. 21
Whereas gasrritis is inflammarion of the
sr.omach lining lIkers represenr sores in the
stomach uning. Heavy alcohoI intake appears ro increase fhe risk of ulcer recurrence. 22 Ciam llIcers can eat deep imo the
stomach wall and erode imo an artery, causing profuse and life-threatening bleeding.
Even in moderare drnkers, rhe llse of a.lcohol wea.kens the defenses of rhe stomach,
and increases r.he risk for both gastritis and
1Ilcers. As an internist dlat has a dedicated
interest in g;mroenterology and gasrroinresrU1,ll endoscopy, 1 sec the aforementioned
condirions caused by alcohol on a daily basis, and ohen many times a day. One of the
mosr common discharge insrrucrions rhat 1
must give to my gastroemerology patienrs
is "No alcohol."

429

PROOF POSITNE

LIGHTDRINKING WEAKENS
THE IMMUNE SYSTEM
The body's ability to figltt bacteria
aud viruses is reduced by 67 percent
in Iight drinkers
with only two
drinks.

figure 6

Immune System Damage

From Aicohoi
A large body of research srudies proclaims that even moderate amounts ofalcohol used by social drinkers should be regarded as damagiltg to the immulte system.
Wich growing concerns regarding both infectious diseases and c.wcee, the illlmuneweakening effcccs ofaJcohol are same ofthe

ALCOHOL INCREASES
CANCER IN RATS
1. Rats were injected with breast cancer cells.
2. Some drank alcoholic drinks to produce
a blood level of 0.15%, equaI to 4 or 5
drinks per bour for a human.
3. Others drank more, producing a 0.25% blood level.
4. A third group drank no alcohol.
5. Those that drank at the lower level had twice as many
cancerous tumors as the non-drinking rats.
6. The higher level drinkers had 8 times as many tumors.
Conclusion; The harmful effects ofalcoJlO1 on cancer
lIIay be vastly underestimated.
Figure 7

430

mast worrisome.
Some of the most sobering research
comes from che AlOS literature. A number of rescarch studies suggesc chac alcohol
use increases the risk ofA10S. 2 3 CercainJy,
aleohol weakens one's judgmenc so dur
proper precaLltions ta avoid virus exposure
may noc occur. 24 More imponanrly, perhaps, alcohol--even in "moderarion"-is an
immune systcm sllppressant. Rese~lrch sl.lggescs that a moderate drinker exposed [Q
HLV has a greater likelihood of becoming
HIV positive. 25 Omar Bagasea, M.D.,
Ph.D. found that social drinkers developed
increased sllsceptibility ro AIDS virus
infection folJowing the consumption of
faur bcers. Other signs of iIlUllU ne suppression persisred for rhree [Q seven hours after
their hodies had metabolized ali the aleoho1. 26
Let llS examinc more dosely some ofthe
effects of alcohol on the immune systcm.
The B-Iymphocyrcs produce antibodies in
t11e blood. Alcohol impairs their normal
funcrion. It takes only two drinks [O reduce amibody production by twa-thirds, as
shown in Figure 6YThis rcpresencs a significant immune system weakening with
social aleohol use. The sUldy's aLlthor, Dr.
Aldo-Benson concluded: "These and previous studies suggest that even. small amolmts
ofalcohol ttlken ftequently Ilre harmfuli they
can inhibic the normal immune funcrion anei
could increase bacrerial or viral infeccions."

Alcohoi COnsttmption Increases

Cancer Risk
A number of ocher studies confirm that
tlle regular use of cvcn small amollnts of
alcohol can harm normal imrnllne funccion.
The result is often an increase in infections.
However, the immllne syscem weakening
effects of aleohol cxtend far beyond che B
cells. A group of white blood cells called
Natural Killer ceUs (NK cells) are also weakened by alcoholic drirlks. 28 These f..scinacing killer ce Ils have long baffied scienrists
because of their innate abiliry to identifY
invaders and eliminate them. They do noc
use anribodies, nor do they use otoer rypes
of chemical warfare like ocher white blood

WANT A DRlNK?
cells. NK cdls are panicularly imponam
in deaJing wirh viruses (such as HIV) Jnd
preventing the spread of nllnor ceUs in the
body.29 As expecred, alcohol-induced NK
cell impairmem increases cancer merasrasis
(causing cancer ro spread). 1 his has been
demonsrrated in rat srudies. The research
raises rhe concern that in humans JUSt one
binge may dramaricalJy increase rhe chance
of spr~adil1g an existing cancer. Results of
this research are shown in Figure 7. 30
Notice rhat twice as many new rumors
formed in rars wirh a 0.15 percem blood alcohol level compared ro the non-drinkers.
(This JeveJ ofblood alcohoJ is somewhar over
rhe legal limit for human vehicIe drivers.
which is generally ser ar O.l O) However, r::lts
with a blood aJcohol comem of 0.25 percenr
had eight times more merasracic mmors.
Extrapolacing mese results from rat studies
ro humans seems valid because we know by
actual epidemiologic research rhat alcohol
significanrly increases human cancer risk.
Hcavy aleohol consumption increases
rhe risk of human cancers of rhe l11outh,
throar, csophagus, liver, breast, and rectum.
31. 32. 33 Even moderare alcoholuse <:an raise
(he risk of some of rhese callcers. For exarnple, in a srudy of over 7,000 women, as
liule as thrte drinks per week increased rhe
risk of bretlSt cancer. The more rhe person
drank, rhe greater the risk. 34 Alcohol consumpcion poses a signific.1ndy greater risk
of cancer th;Ul minor chemicals in foods. 35
Many experts feei rhac the harmful effece of alcohol on human cancers has been
vasrly underestimated. Some physicians
have even raised concerns that some cancer
vicrims may have been afflicced because of
cheir behavior on a single weekend celebration. There are much berrer ways ro cel~
ebrace mao by volunearily weakening the
immune sysrem, ro say nothing ofbenumbing me mind. "Ler's have a good time this
evening," is che approach of some. But ehe
resuhs may be disaserous.
There are orher aspeccs of alcohol use
hesides ics immune sysccm effecrs chac are
likely rdated ro increased cancer rates. For
cxample. ehere is good evidence rhat aleohol use increasescscrogen levels in womeo. 36
,\7 Alchough this may sound helpfUl, it eould

also increase ehe risk of urerine and breast

cancer. When it comes ro cancers of the
head and neck, chronic irricacion from ,11cohoi may also be a cancer risk factor.

Increased Risk ofInftctious Diseases

In addicion to c.1ncer and chranic infection with HIV, aleohol can increase rJle risks
of more mundane-buc scill poccmially lechal infecrions-like pneumonia and tuberculosis. 38 Cenai n cypes of pneumonia are
more common in a1cohol users, such as
K/.ebsiella pneumonia and aspiration pneumonia. K/.ebsi.ella is a cereain strain of germ
ehar can cause aggressive lung infeccions.
Aspiracion pneumonia can a1so occur if a
person becomes severely inroxicared. While
in a drunken scupor, ::m individual who swaJlows his or her saliva down ehe windpipe
<:an get this life-rhreatening pneumonia.
There are ocher reaSOllS why rhe risk of
iofeceion is increased in those who use aicohol. Normally, a cype of whice blood eell
called ehe neutrophil or polymorphonucIear
Iymphocyre (PMN) circularcs with the
blood umil it arrives ac a location where an
early infection is presem. le chen leaves rhe
circulation and wages war with the invader.
Sociallevels ofalcohol consumpcion weaken
some of ehese whice blood cell funccons.
MeasurabIe effecrs begin ac levels well below rhar of legal imoxicarion, as low as 50
mg per decilirer (0.05 percem blood alcohol). As the amoullt of aleohol ingesrion
rises, rhe abiliey of PMNs ro go ro rJle site
of an infection and rheir abilicy ro gobble
up invaders becomes progressively impaired. 39 . 40 The more aleohol ehac is presellt,
rhe more cheir performance suffers. 41

Side Efficts OfAlcohol

Consumption
Besides affecting the intestinal and
immune syscems, Ulere are oc.her far-reaching side effeccs from alcohol consumpcion.
Some of rhese effeccs are shown in Figure 8.42.43.44.45.46
It is asronishing ro me [hat the news
media is so emhusiascic abour prodaiming
the virtucs of drinking aIcohol "n moderation" when rhere is such a long lisr ofsevere

431

PROOF POSITTVE

SIDE EFFECTS OF ALCOHOL USE

1.

10. Osteoporosis

2. Stroke

II. Gout

3. Heart problems

12. Rhabdomyolysls

4. Elevated triglycerides

13. Bod,y wcight control

5. [mpaired sexual function

14. Anemia

6. lL.ow blood sugar

7. Vitamin and mineral deficicDcy
8. Chronic fatigue

FS. Decreased number

of blood platelets
16. Increased severity
and duration of
menstrual cramps

9. Ketoacidosis
Figure 8

problems caused by both moderate aud

heavy aleohol consump[ion. Some of the
problems lisred in Figurc 8 can occur with
as litrle as one drink of alcohol per week.
Ler us rake a litde time ro more fully appreciare [hese a1cohol-rdared condi[ions.

AlcohoL and High BLood Pressure

(Item 1 ofFigure 8)
The fim malady in Figure 8, high blood
pressure, may occur as a direct resulr of al-

MODERATE DRIN:KING AND

STROKE IN YOUNG ADULTS
Young adull$ (16 10 40 yea~ old) wha drillk 2 10.~ drinks ar more
(40g elhanol) sigllificalll/y increQ.~e Iheir risk {Jjslroke wilhin U hou~.
8

6.0x

pressure medicine and drinking ftlcolJol even

in small amounts.

AlcohoL and Stroke (Item 2)

o
Standard Risk

Figure 9

432

cohol cOllsumption. Women seem tO be

the most stlsceprible. for example, as litt.le
as twO or cluee drinks per day increases the
risk ofhigh blood pressure by 40 percenr in
womenY Dr. Norman Kaplan, an international blood pressure authoriry, has gone
an record as saying rhar anyone wirh high
blood pressure who even lIses more man onc
drink a day "sho1l1d be aggressively encouraged ro cur down."48 For men and women
combined, thrce ro four drinks per day incrcases one's high blood pressure risk by 50
percenr; six or seven drinks per day doubles
the risk. 49 Alcohol plays a very imponam
cole in the high rate of hypertension in aur
nation. Estimates are that up ro 30 percent
of aII high blood pressure in American men
can be rclated ro alcohol consumption. 50
The detrimerual effeet of alcohol on
blood pressure imposes a particular burden
an older individuals in our coumry. The
most common causes of death and disabiliry amollg Americans 65 years of age and
older are diseases of rhe heart and blood
vessels. 51 High blood pressure is one of me
major risk facrors for such diseases and it
afflicrs greater man 54 perccnr of cllOse in
this age group. 52.53 Although fewcr Americans use alcohol after their 65th binhday,
of those that drink, {heir risks of alcohol
addicrion are just as high as among younger
drinkcrs. 5~
As we have seen, although heavy alcohol consumption does rhe mosr damage ta
blood pressure, mauy who consider themselves "Iight" drinkers are a1so ar risk. The
rcurh is rhar rhe more alcohol oile uses, rhe
higher his or her blood pressure rends to
be. 55 . 56 1 reeommcnd ro even my hea.lrhy
patienrs rhat they avoid any drug mar raises
blood pressure: akohol is no exception. Of
course, avoidance of alcoholie drinks becomes even more imporr.anr in rhose who
already have a blood pressure problem. It
simply cum not make sense to be taking bLood

Men

Women

Increased srroke risks, the second irem

in Figure 8, plague botb modeme and heavy
drinkers. Many people are nor aware that

WANT A DRINK?
alcohol increases the risk of bQ[h common
rypes ofstroke. he m'a rypes are rhe hemorrhagic stroke caused by bleeding in and
arolICld rhe brain, aud rhe rhrombotic srroke
c.aused by blood clOES.
Some young person may say. "1 am nor
a heavy drinker. 1 never have more rhan
three drinks even on a weekend evening."
$rudies show that even rhree djinks can have
tragic consequences. even in the young. as
shown in Figllre 9.57
Their risk is six 10 eight tinus greaterwrh
only rhree drinks. To die under rhe young
age of 40 by self-desrfllctive llse of alcohol
is a rragedy of unspeakable proportions.
Such levels ofconsumprion are nor unllsuaJ.
A 1990 nationwide survey of soroe 17,000
high school seniors found rhar 32 percent
of rhem reporred episodes of heavy drinking (five ar more drinks) wirhin rhe last twO
weeks. 58
Th15 recenr evidence on the dangerous
effecrs of moderate drinking is extremely
important. Previously some had suggested
rhat moderate aJcohol consumpton lowers
srroke risk;'9 however, mere are deflnirely
problems wirh rhac posiron. Fim, rhere is
no evidence rhat people already an an e.xcellen r 1ifes ryle ger an y furrher benefit from
alcohol when ir comes ro stroke prevenrion.
Second. as we have jusr seen, a couple of
exrra drinks on the weekend dramarically
ncrease srroke risk in younger adulrs.
Third. one of rhe mase devasraeng types of
srcoke, hemorrhagic stroke. has been known
for years 10 be increased by cven very small
amounts of akohol. The famous Honolulu
Hearr Srudy found rhac even lighe drinkers
of as liule as one ro foureeen ounces per
monrh havc more (han twice rhe risk of
having one of c!lese bleeding srrokes. 60 The
findi ngs are summarizedin Figure 10.
Notice. it is nor the blood pressure-raising effecr of akohol rhar accounred for these
suokes. Even a social drinker weh normal
blood pressure experiences chis increased
risk ofhemorrhagic srroke. G1

those who become acutely ilHoxicated run

the risk ofhearc rhythm disrurbances. Cardiac arrhychmias, as rhey are caUed. can be
as minor as a vague flllCccring sensarion in
rhe chest" or as major as sudden death. In
("lcr, rhe. high rare of suddcn dearh among
heavy alcoholusers is likeJy due in parc 10
t!lesc dangcrous rhyrh m disrurbances. 62
Cardiomyopathy 1S auorher dangerous
and somerimes faral hearc condirion which
is Jinked ro alcohol lIse. Cardiornyoparhy
Iirerally means "hearc mllscle dise."lse." 1
have seen many parienrs whose hean
muscles do nor \Vork as hard as ehey shouJd
bec.1use of akohol consumption. As a resuit, fluid builds up in rhe lungs and rhen
in orher parts of rhe body, and rhese patienrs are llsually unablc tel physically exert
rhemselves. When cardiornyoparhy becomes severe enough, rhe only erearmell(
available 15 hean rransplancation. Alrhough
coronary arcery disease an cause heart arcac1{S and subsequenr cardjomyopaehy, current eseimates are (har 20 ro 30 percent of
ali cardjomyopachy in aur counrry is due
ro alcohol aklJle. 63

ALCO OLANDSTROKE
Increased strokes caused by brain
hemorrhage occurred in drinkers
irrespective of blood pressure level.
Even Iight drinkers of 1 to 14 ounces
of alcohol per
month show,ed
more than two
times the risk
of nondrinkers.

Alcohol and Heart Problems (ltern 3)

AJrhollgh wideJy rau reci for ics hem benefits, alcohol is c!eltrly linked to several heart
problems. Boeh chronic heavy drinkers and

Figure 10

433

PROOF POSITIVE

ELevated TrigLycerides andALcohoL

(Item 4)
Aleohol, even in, the relativei)' small
amounts eOllsumed by "Iighr ro moderale"
drinkers, ma)' cause significanr triglyceride
e1evarion. 64 "Triglycerides" is the teehnical
term for rhe main srorage and rransport
furm of far in the body. Due ro elevation in
a hlood far curier called VLDL (very low
densiry lipoprorein), eholesrerol values may
be elevared by akohol use as well. Like eholesterol, rriglycerides when elevated appear
ro increase rhe risk of hearr disease. If trigI)'ceride levels are very high, the)' can also
dramarically increase the risk of pancreariris.

ALcoho! and SexuaL

Funetion (Item 5)

434

The fifth side dfeet of alcohol is a particularly distressing effect of heavier use of
alcohol-sheink:lge (arroph)') of the reseic1es.
This can accuaUy femini7..e affected men. As
a result iliey can acqwre female characterisries like enlarged breasts. Long term alcohol
use is also associated wirh impotence due to
hormonal elfects.65 Such resuhs are ironic,
panicularlywhen mally men rhink drinking
is a "macho' thing ro do.
For many individllals an even more
frighrening sexual specter looms on the horimn: homosexual rendencies ma)' resuIt
from aleohol exposure in rhe womb. We
h.we known for years that fital exposure to
alcohol dramaricaJ1y increases rhe risk of
problems with genital development in borh
male and female offspring. For example, in
rhe feral aleohol syndrome (FAS) over 12
percem of ehe children have geniral abnormalities. 66 Now there are seriollS concerns
rhar rhe brain itself ma)' experience impaired
sexual dilferenriarion-even when aleohol
exposure has been relarively mild and has
nOf caused FAS. The uumber of childrell
affected is significant. Whereas up ro
11.000 children are bom with feral aleohol
syndrome each year, as many as 30,000 or
more may have ocher aleohol- relared problems that are nor as distinguishable. 67 All
of this larger number are ar risk for problems wirh sexual differentiarion both of the

externa1 genital region and ehe brain. Of

particular concern ro ehe sexual differentiarion questloll. animal srudies show that male
raes exposed in utero ro alcohol have decreased maJe sex behavior, while femaJe rars
experience defeminizaeon (decrease in female sex behavior).

AlcohoL General Metabolism, and

Nutrition (Item 6)
Low blood sugar (hypoglycemia) can
occur iu both heavy and moderate drinkees. In ehildren, relatively small 3mOUlltS
of alcohol can be parricularly dangerous in
this regard. Dr. William Altemeier, director of the Pediarrics service ar General Hospiral in Nashville. Tennessee, poinrs oU( rhat
because ofhypoglycemia, severe irreversible
brain damage can resulr in preteen children
who are given relatively small amounrs of
akohol. 68 Normally low blood sugar is nor
a problem in he.alth)' individuals who are
nor on medications. However, alcohol
blocks the body's abiliry ro produce sugar
rhrough a process called gluconeogenesis. 69
Thus, if someone conslImes alcohol after a
period of ('lsting or limited calorie intake,
blood sugars can fali tO extremei)' low levels, and the brajn-which runs primarily
on sugar (glueose)-can sulfer irreparable
damage.
Ironically, drin.ki.ng aleohol can also raise
blood sugar levels. In faer, akohol is a
known cause ofwhat is called impaired glllcose rolerance.7 One of the Il)echanisms
for such an occurrence is also counrerilllllirive. You wOllld expect thar a depressanr like aleohol would )ower Stfess hormone
levels in rlle blood, bur it can actuali)' .rajse
those levels. With raises in srress hormones
like norepinephrine, blood sugar cends ro
rise?1

Vitamin and Mineral Deficiency

(Item 7)
The heavier the usage of alcohol, the
grearer ehe tendeney roward viramin and
mineral deficieney. From Viramm A to zinc,
almost every vitarnin and mineral makes the
Iisr of being porentiall)' inrerfered wirh

WANT A DRlNK?
direcrly by alcohol itself or by rhe damage
it can cause ro the liver, pancreas, and other
pans of the digestive sysrem. 72 SOll1e of (he
more common deficiencies involve magnesium, folie acid, and the B vitamins, thiamine and riboflavin.

Chronie Fatigue and Ketoacidnsis

(Items 8 and 9)
Another side efrec( of a1cohol rhar can
affecr producrivity and performance is rhe
chronic fatigue syndrome. This condirion
wirh irs symproms of "feeling wasted and
worn out" may result from moderare aleohol consumprion. Such a relationship may
be due ro immune sysrem eftects in rhe context of a chronic viral infecrion/3 AJcohol
s also a cause of keroacidosis, a merabolic
disease rhat can be faral.

Alcohol's E!feets on the Bones, Joints,

and Muscles (Items 10, 11, and 12)
Osteoporosis, or rhinning of rhe bones,
s also relared to alcohol consumprion.
Anomer cause of onhopedic problems ill
drinkers is gOli(, a very painful arehritic condieion rhae can aJso cause kidney problems.
SriU anorher alcohol-relared condition affecting rhe muscllloskeleeaJ sysrem is caJled
rhabdomyolysis. This problem is ofrell associaeed wi[h ce [[ai Il roxin exposures including heavy exposure ro alcohoJ.74 In
rhabdomyolysis, parc of the large mllscles
in [he body acrua1ly dies. This often resulrs
in hospiralization, kidney fajlure, and somerimes even death.

Body Weight (Item 13)

A more mundane efTecr of alcohol relares ro its relarionship ro maimenance of
body weighr. Alcohol is a concenrrared
source of calories, having nearly f\vice as
many calories on a gram for gram basis as
pure sugar (seven calories vs. four calories
per gram). Combining this wirh rhe facr
{hat a1cohol accounrs for 10 percen[ of rhe
caloric imake of adult drinkers in our narion. 7S rhe stage wOllld seemingly be ser for
significam weighe problems. Ir is, bu( for
reasons other ehan you may ehink. The cal 0-

ries in alcohol do nor secOl ro be efflciemly

srored as far, so excessive use ofa1cohol does
not seem ro conrribllte ro significam weighr
gain for rhis reason. However, many individuals who tend ro be overweighr wil! have
grearer problem.~ with weighr maintenance
if rhey are liS ing alcohol-even in moderaron. Overweight people who wisely take
special pains ro limie rheir calorie inrake
(somerimes caJled "resrrained eaters"), will

tend to el1t more iflJlcohoi is on boord. 76

Alcohol and Bwod Cells (Items 14

and 15)
In our commems an rhe inunune systern, we have already looked ar [he f..1r-reaching e/tects of alcohol an rhe white blood
cells. Anemil1, which is a low red blood cel!
COUnt,

js very common in helwy drinkers.

Even occasionalusers ofakohol can increase

cheir risk ofanemia if their a1cohol use coneribure.s ro blood loss from their sromach
or esophagus. Orher blood e1emems called
pla[ders (the body's cloning cells) ;ue ofren
decreased with a1cohol use. As a result, affecred individuals may bleed more easily.

AleoholAgg1'l1vates Menstrual Cramps

(Item 16)
A1cohol has been rhought to be efreceive as a treannent for mens(rual cramps. Ir
appears ro reduce the probabiliry ofhaving
cramps, bur research srudies show [har i[
increases the severiry and duraeion of rhose
that ger them. 77 It was found thar drinkjng
more rhan once per week doubles the odds
of pain lasring more rhan rwo days. Researchers advise rhar a1cohol "should nor be
recommended as a rrearmenr Uor menstrual
cramps ] ."

Summary OfPhysical Problems

Associated With Alcohol
There are many more problems with alcohol than 1have focused on here. However, whar we have examined [hus far should
be sufficie11t ro impress us wirh the broad
rallge of adverse effecrs broughr on byalcohol. The sad (hing abour rhese problems is

435

PROOF POSITIVE

HEAVY DRlNKING 18
ESPECIALLY RISKY FOR
YOU GER PEOPLE AND WOME

bodies more than any other lifesryle Fac[Ors.

[fyou could see through my eyes, you would
be strongly inlluenced to emphatically say
"no" rlte next time you are asked the quesdon, "Wanr a drink?"

[ncreased nlOrtality risk by drillking six or /IIore drinks* per day:

Drinking and Mortality

400%

320%

Figure 11

rhat ifAm ericam had recognized aJcohol for

what it was and avoided it, this extensive
!ist would nor even exist. As an Internal
Medjcine specialist, I deaJ every single working day wirlt people whose illnesses are
caused by alcohol and tobacco. People are
hospiralized duc ro rhese abuses of their

Malt
Heavier
Moderate
Ligbt
~I

Abstailler

10

20

Under 45

30

40

.45-54

50

60

55-64

70

80

90

100

75 ~Dd
older

65-74

Fttrlalr
Heavicr
Moderate

........_.-.

---~

Lighl
Abstainer
20

Figure 12

436

30

40

50

60

70

80

9(l

100

lncreased risk of dram from a variery of

causes has been linked to alcohol use. parriclilarly in heavy drinkcrs. However, moderate drinking also increases rhe risk ofpremature death. We wiJl see dara shordy thal
qllamif1es the increased risks of umimely
death from alcohol use. However, a few
more commenrs are in order regarding the
reLtrionship of heavier consumprion of alcohol ro dcarh.
It is commonly believed rhat rhe risk of
premature death from alcohol is contlned
[O older men who have been drinking for
years. This is nor true. Stuclies show thar
the deadly effecrs of heavy aJcohol use do
not discriminate based on age, bur is risky
for yOllnger individuals as well.7 8 Furrhermore, rhese effects do nor engage in gender
discriminarion. StlIdies have been made on
women as well as men regarding rhe lifeshoncning effects of a1cohoJ.7~ These increased risks are illusuated in Figure 11.
We sec rhar among rhose in the general
popular ion in their 40s and younger, consumption ofsix or more aJcoholic beverage.s
per day nearly doubles their risk of dearh.
We also sec thar rhe risk of early dearh is
parricularly worrisome in heavy drinking
WOH\en of aJl ages.
Afrer looking ar a hose of diseases aJld
condirions linked ro moderare alcohol consumprion, it is no surprise thar even "social" drinking can shorren one's life. Drinking hiswries were obtained of men and
women who died in 1986. They were caregorized as absrainers (Iess than 12 drinks
in their emire life); liglu drinkers (up ro 3
drinks in a week); moderate drinkers (berween 3 and 14 drinks a week) and heavy
drinkers (greater rhan 14 dril1.ks a week).
The results are illustrared in Figure 12. 80
Norice rhar for borh sexes of aU age
groups from childhood ro age 74. as drinking increases, rhe risk of death increases.

WANT A DRINK?

Alcohol and Decreased Mental

Peiformance
There are some rhings rhar are worse
(han "death" in irs general meaning. The
narional suicide epidemic makes chis selfevident. Whar kind of sieuaeions do individuals find so unbearable rlur ehey would
choose ro rake cheie own lives? We are aII
fmiJiar wieh rerminal illness and ies connecrion wirh suicide. However, mental deciine and social or work-relared problems
are alI high on ehe lisc for suicide motivarions. 81 Wirh rhis in mind, we need ro recognize rhar alcohol has the capacicy ro undermine (hac which has rhe greacesr bearing 00 who we really are-and rhar which
gives us the most meaning in life. Alcohol,
even in moderatioll, affects our brain.
Even small amounrs of alcohol are well
kJlown ro decrease a person's judgmenr, foresight, and moral reasoning. Tnis probably
re1atcs largely ta alcohol's dramaric impair~
menr of ehe brain's frontallobe where many
of our highesr nteUeceual aod moral funcrions reside. W1th jusr a single drink and a
low blood alcohol level of 0.02 percene,
rhere is bluming of froncal lobe capaciries
wirh a decrease in judgmenr and inhibirions. 82 Concrary ro popular belief, many
of our inhibirions are extremely useful and
are besr never compromised. Reservations
against relling business secrers or making
inappropriare commenrs ro another person's
spouse are jusr rwo examples of normal inhibirions rhar serve sociali)' useful purposes.
Funhermore, many rhink alcohol's memal
impajrmenr lam only as long as alcohol is
presenr in rhe blood. In realiry, rhe effecrs
remain long afrer rhe aJcohol has lefr rhe
blood srream. Srudies done on drinkers over
24 hours afrer rhey nave had their lasr drink
show thar abstracr reasoning abilicy remains
reduced.
In one srudy, over 1,300 social drinkers
in Derroir were assessed. Men drank on the
average of every rhird day ;l1ld consumed
rwo ro rhree drinks. Women drank 00 rhe
average every f1frh da)' and generally consumed rwo drinks on those occasions. AII
assessmenrs of mental funcrion were done
ar leasr 24 hours ,ifieralcohol had been con-

sumed. Nonerheless, in both men and

women who drank ar leasr once per week.

abstract thinking ability decreased IlS alcohol

intake inC1"ea.red. 8J
Worse rhan remporar)' impairing of reasoning alcohol consumprion ofren callses
even more seriolls long-rerm menraJ impajrmene. Acrualloss ofbrain cells wirh reslllring brain shrinkage (rcchnically called "cerebral auophy") is known ro occur in heavy
drinkers. This has bcen direccly observed
with scans (har can visualize the brain like
CAT scans and MRIS.84 Fonunare1y, rhere
is some good news abol\( rhis condirion.
Thc brain shrinkage may be reversed wirh
prolonged absrinence, especiaJly in young
iodi vidllals. 85 Unforrunarely, however,
brain ceUs ClOnot be regenerared once the)'
are Iose. So chis apparent reversal is likely
due ro new oerve connecrions rarher tJlan
replacing Iose brain cells. 86 This leaves us
wirh an imporr<lnr condusion: rime can
sometimes help ameliorare menral damage
done by heavy drinking, bur a person wiLl

never be mmtl1lly as gifted afla 11 histmy of

heallJ alcohol use. Ofbroader concern, [here
is evidence suggesting thar alcohol consumprion (regardless of age and quanriry)
may also hasten cerebral arrophy.87
Worse srill, heavy drinking can somerimes lead ro profound and irreversible neurological defects. Pcripheral neuropathy, a
pajnful condjrion of che feer, legs, and hands
rhar progresses ro loss of sensation in rhe
limbs is common among heavy drinkers.
Physicians are familiar wirh (he diagnosis
of Korsakoff's psychosis wirh irs memory
loss and disorient;lrion. This condirion occurs in heavy drinkers who also are deficient
in [he B viranln, rhiamin; 30 ro 40 percen(
ofuldividuals who develop rhis <.!evasraring
brajn wa5ringcondition musr be insriruuonalized. 88 Heavy drinking poremiares a common cause of seizures, alcohol withdrawal
seizures, and also porenriares rhe rerrible liferhrearening srare ofdelirium rremens (DTs)
where rhe alcoholic shakes unconrrollably
and hallucinares and becomes a danger ro
himself and others.
Furrhermore, (here is no quesrion that
psychiarric problcms and alcohol use go
hand in hand. Alcohol abuse or dependence

437

PROOF POSTTIVE

BEAVY DRINKI G IMPACTS THE

CENTRAL NERVOUS SYSTEM
Decreased judgment, foresight, moral reasoning
Stupor and coma
Periphe'ral neuropathy
Cerebral atropby
CerebeUar degeneration
Accidents
Mental illness
Physical dependence
Homicide
Suicide
Seizures
Delidum tremens (DT's)
Figure 13

s more common in individuals wirh diagnoses such as schizopluenia, depression,

antisocial personality, and anxiery disorders. 89 These relationships pose rhe chicken
or the egg quesc.ion: which carne firsr. rhe
psychiarric illness or the alcoholism? It is
likely rhar alcohol increases the risk for psychialric illness for some of the reasons already mentioned, such as mental impairmenr and incrcased psychosocial srressors.
However, ie also seems ro go rhe mller way.
People wirh psychiaeric illnesses may be

ALCOHOL'S EFFECTS ON OTHERS

BESIDE THE DRINKER
Adverse effects
on tbe fetus
Accidents
Social problems
including acts of violence

438

more prone ro resort ro alcohol in an arrempr to deal wirh rheir problems.

We now have proof rhar drug or alcohol
abllse callses specific brain damage thar can
be seen on a new high-rech brain scan called
BEAM, which measures change-s or disturbances in e1ecuical acriviry in rhe brain. 90
In a study of 111 subjecrs, major brail}
abnormaliries were seen in rhe fronr aud an
rhe sides of rhe brain thar increased wirh an
increase in sevcriry of substance abuse.
Some srudies have shown rhar up ta 90 percent of substance abusers have psychiatric
disorders. Some wirh such disorders use
alcohol ar drugs ro gain relief from their
problems, bur it is now kllown rhar rhey
are acrually making cheir problems worse
in rhe long run wirh slich self-trearmenr.
One of rhe mosr dangerous resu1rs of
both alcoholism and mental health problcms is suicide. There is no question mat
this final and often despcrare acr is srrongly
linked wirh alcohol consumprion. 91 Figure
13 summarizes {he abovc cffects of alcohol
an rhe central nervous sysrem.

Alcohoi lnflicts Severe Damage to

the Brains ofYouth
Small amounrs ofalcohol pose a dal1ger
to dle brains of young people. according ro
research ar rhe Duke Universiry Medical
Center. 92 Srudies of young rats show ehat
rhe developing brain sustains "far more
damage to memory and learning sysrems
rhan an adult brain receiving rhe equivalent <lmount of alcohol." The research Sllggesrs rhat as lilde as rwo drinks could inhibit learning and memory in a young perSOI\, bur would have less effeet on an adult.
Alcohol blocks e1ectrical signals lhat navel
within rhe brain during rhe learning process. The reseatch strongly suPPOrtS legal
bans on under-age drinlcing. In addition
ro a moral reason for sllch bans, there is now
a c1ear scienrific reason as wel!.

Alcohoi Affiets More than the

Drinker.
So far, we have focused on how aIcohol
affects rhe drinker. We looked ac a long Iisr

WANT A DRINK?
ofphysicat problems. Then we wem on ro
make observations abour aJcohol's mental
effects. However, alcohol affecrs more rhan
jusr the person consum ing rhis addicrive
drink. To Olan)', the social efTecrs are among
che mosr sobering realiries. These coodirions come as no surprise. However, 1would
be remiss nor to ar leasr devore some space
ro rhem in rhis chapter. A parriallisring of
the way akohol affecls olhers is found in
Figure 14.

Petal Alcohol Syndrome and Other

Alcohol~related Birth Defects
Regarding lifesryle and omer environmem.al facrors, Illcohol is the /~ading CIltlSC of
merltal retordation in the Wesrcrn world. 93
Inirially described in rhe Iare 1960s and early
19705, fetaJ alcohol ~)'ndrome (FAS) is lhe
designarion used for rhe worsr of rhe aleahol-rel:ued birrh defecls. These children
have rhree major sers of problems. 94 Firsr,
rhey rend ro lag behind in physical growm
both in rhe womb and after birrh. Second,
rhey show evidence of brain involvemenr
wirh such problems as nrelJecrual impairment, hyperactiviry, disrracribiliry, and impulsiviry. Third, rhey have a characrerisric
set of facial abnormalities including small
eye openings, a small head circumference, a
rhin upper lip, skin folds at rhe corners of
rheir eyes and a low nasal bridge.
Many children are impaired by mothers
who used aleohol in pregnancy, yet rhey
never develop me ful1-blown picture ofFAS.
These children have only some of rhe arrributes of the syndrome and are said ro have
FAE (fetal aleohol dTects) or ARBDs (a1eohol-relared birch defecrs). A partial liscing
of birrh defects relared ro maternal alcohol
use is round in Figure 159.5. 96
MOSI aurhoriries believe thar FAS is significandy underreporred; ic is no surprise
that the even less obvious defeccs of FAE
are frequendy missed. Currenr estimates of
FAS in North America range from as low as
duee cases per 10,000 live birms ro as many
as one in ni ne birms dependjng on r!le cultural group and orher risk factors. For example, individuals of African Americ.an or
Naeve American herirage have dramaricaUy

AS ORMALITIES RELATED TO
PRENATAL ALCOHOL EXPOSURE
Learning difficulties

Immune system
impairment

Skull aud facial

abnormalities
---

Vision problems
Hearing problems
Trouble breast feeding
(duc to poor
sucking patterns)

Genital
abnormalities
Abo,ormal balance
and coordination
Mental retalfdation
Growth deficienC'es
Figure 15

increased risks. AII rold, estmares are mar

up ro 11,000 U.S. children are bom wirh
feral alcohol syndrome each year, wirh
30,000 or more having other prenatal alcohol-relared problems. 97
The more a woman drinks me greater
rhe risks her child t1ces; however, ir does
not take large amoulHs of a1cohol ro affecc
rhe fetus. In facr, aleohot consumption well
within rhe legal limits for drivers can pose
serious threats to the fetus. One particularly dangerous rime is in che period ofvery
early pregnancy, before rhe woman even
recognizes she is pregnant. As many as 1.7
million American women of childbearing
age drank twO or more drinks per day when
assessed in 1988. 98 These women would
put rheir children ar high risk if they became pregnant. Such an assertion is not
mere eanjectllre. Numerous studies suggesr
thal moderate aleohol use-perhaps even
bifore conception---can influence ar leasr a
child's memal capaciry.99. 100
A study ar rhe Universiry of MiJlOeSOra
has shown rhar leukemia can resulr in an
infanc whose morher drank during pregnancy.lOI Women who consumed more
rhan 20 alcoholic drinks during pregnaney
were uuee cimes as likely as nondrinkers ro
have a baby wirh a cerrain rype ofleukemia
cal led acure myeloid Ieukemia (AML).
Children of morhers who drank during c!le

439

PROOF POSlTIVE
second and third uimester had a 10 rimes
greater risk of AML and (wice ehe risk of
anorher type oflellkemia, callcd acme lymphocytic leukemia.
The umh is rhar toral absrinence is thc
only way ro prevent alcohol-related birrh
dcfecrs i.n children. Such a stand has been
taken by rhe Surgeon GeneraJ aswell as ehe
American Medical Associ;uion. 102 J also
recommend rhar aH womcn of childbcaring age who have ehe poreIHial for inadverrenr pregnancy should remain [Otally absti-

HIGH RISK OF ACCIDENTS

CAUSED BY DRINKING
T"e sobeI' driver may "ave aII accidellt, but !lis risk
illCTeases as indicated below:
l.0 time with a 0.00%-0.01% BAC, *

IA times with a 0.02%-0.04% BAC,

11.0 times with a 0.05%-0.09%, BAC,

48 times with a 0.1%-0.14% BAC,

- - .' .
"

385 timcs w.itb. a BAC ~reater or equal to 0.15%

*Blood Alcol/ol COllcCTItrafiol!.

Figure 16
nene. A simple reminder is al50 warranted:
apare rrom a toral hystcreccomy (wirh removal of the ovaries), aH methods ofbirrh
control have failures. Every woman who
has noe gone through menopallse, even
ehose Llsing "reliable" birrh control measures,
should definiteIy consider tbe parh of total
abstinence-for the healeh of the unborn,
if not for her own hcalth. FlIrrhermore, in
view of the research linking fathers' drinking pracrces with (eraI impairmcm, 1 also
recomll1end rhar any husband remain [0rally abstinent ifhis wife could become pregnant.

440

Accidents and Violent Crime

Mowr vehicle accidenrs are a leading
callse of death amollg children anc! yOllng
adults, amollllting to rhe leading cause of
year of life losr before ilie age of 65. 103 In
the U.S. alone, over 40,000 lives are claimed
each year in moror vehicle crashes wirh over
three million more suffering nonfaral injllries. Whar is the record of a.lcohol regarding r11is national rragedy? Over 17,000
Americans die in moror vehide accidelHs
each vear who would be alive roday were it
nor for rhe effects of alcohol. I04 In shorT,
alcohol accounts for roughly 44 percellt of
traffic fataJities and 40 percem of the comprehensive crash costs which cotal in rhe
billions. J05 Even perfecrly legal blood aJcohollevels cause impairmellt and ncrease rhe
accidem rate. As expecred, the higher the
blood aJcohol level the grearer the risk of
accidcllts, as shown in Figure 16. 106
Notice a lirde-appreciated fact; namely,
yOll Can be driving legalI}' and sriU have your
accidcllt risk dramatically higher than rhar
of a sober person. Jusr a smaU :lmount of
alcohol increases your risk of death by 40
percent. A mere rwo drinks for a 140 pound
woman 107 pushes her over dut 0.05 percent blood aJcohol range and subjeers her
ta Il rimes the risk of death when behind
the wheel. Once you emer rhe legally inroxicated range your risk of dearh has incrcased nearly 50 rimes. Higher levels causc
an even greater risk of death. Clearly, ifyou
ger behind rhe whcel rhere is only one patrern of drinking that is safe-totaI abstinence from alcohol. Remember, after a
drink ar rwo, if you are like mosr people,
you wiU feei complerely in control, your
coordinarion wil! be good, but your esri
mare of youl" driving abilities uAII be e:x:aggerated. Your risk of deach on your way
home wiU likely be 10 rimes greater rhan if
vou were sober.
, Aircraft accidents also bear a relarionship to alcohol use. Duc [Othe relative rarity of such evenes, lirde research has been
dane on rhe rale of alcohol in ehese crcumstances. In one evaillation of medical
examiner's files for non-commcrcial aircraft
EHaliries, 35 percent rested posirive for aJcohol airhough onl)' abOli( 1 in 4 of (hose

WANT A DRINK?
wim alcohol on board were legally inroxictted. These resuhs carrelate well with omer
data that estimate that alcohol is involved
in up (O 30 percenr of fatal aviation
crashes. 108 One particularly imeresting aspect of the research on pilot performance
and alcahol is thar alcohol-re1ated impairmene is detectable even after alI the alcohol
has been eLiminated [rom the body.109 According to the Aeronaurical Informarion
Manual given by the Federal Aviation Reguhuions (FAR Part 91.17) no crew member,
including me pilot, is allowed co take flight
umil eight hours afeer the consumption of
any alcoholic beverage. Because a pilot may
stiU be under the influence of alcohol after
rhis eighr-hour period Administration
Safety Officcrs advise pilots co allow for at
lease 24 hours between "boule and
mrotde."I)O
Alcahol is also a significam comriblltor
w our currem national epidemie of violent
crime. I devore auelltion to this wpic in
Chapter 13, "Stcmming the Tide of Violenee."

The Great American Alcohol Cover-up?

The news media does not tend ro repOrt on medical smdies mat put moderate
alcohol drinking in a bad light. Does this
constiturc a deliberate "eover-up"? ar are
mere other faecors that help explain d)is
consistent lInderreporting? One reason
eould be that many members of che news
media are drinkers themselves. Occasionally you wiU heat a news reporter make jokes
abour drinking and rake pride in being a
"moderate" drinker. Many heavy drinkers,
in facr, ca.l1 themselves moderate drinkers.
It is hard to find a heavy drinker who wiU
own up ro it. Moreover, many politicians,
lawyers, and judges use alcohol. Could they
be consciously or subconsciously suppressing information 00 the evils of alcohol and
resisting legislation mat would help decre.ase
aJcohol use? Figure 17 summarizes some of
the effects of moderate drinking that are
sad1y ignored by many.
Despire such biased reporting, the message of alcohol's danger seeros to be sinking
in on the American public. There has been
a sready increase in the number ofindividu-

RESULTS OF MODERATE
ALCOHOL USAGE
Hypertriglyceridemia
Hypertension
Stroke
Decreased immune
function
Accidents
Suicide
Breast cancer
Colon cancer
Menstrual pain
Osteoporosis
Obesity

Gastritis
Gout
Chronic fatigue
Cerebral atrophy
Fetal alcohol syndrome
Leukemia in offspring
Potentiates heavy
drinking
Decreases jludgment,
foresigbt, moral
reasoning

als who do nor drink at aII, nor even on New

Year's Eve. Some of the key aspeCtS of recent polls are disrilled in Figure 18. 11 1. 112
lfyou have chosen nOt ro drink, or have
cur down on your akohol eonsumption, yOll
are parc of a swelling tide sweeping our nauon. This change in our eollecrive experience appears ro be in harmony wirh a charaeter trait exrolled by the Book of Proverbs.

Fgure 17

AMERICANS ARE DRINKING LESS

In 1983, 28% of men and 50% of women -----4
were abstainers; those figures
...
increased to 32% and 53%
o rfo
respectively by 1988.
A total of 34 % of the adult
popuJation never drank in 1983;
that figure increased to 44% by 1993.
In general, those that stiH drink are drinking less.
The largest category of dtiokers is the "ligbt
drinker" (1 to 13 drioks per montb). Among male
driokers in 1988,44% fell into this category. 64%
of women tbat year met this desigoatioo.
Figure 18

441

PROOF POSITlVE
There we are told lhat wise individuals are
aware of evil but do not partake of it.
whereas the foolish make no change in their
praccices and end up with c11e wretched consequences. The text is quoted in the t:1miliar King James Version in Figure 19. J 13

"A prudent mao foreseeth

tbe evil, aud hidetb himself:
but the simple pa'S's 00, aud
are punish,ed." Proverbs 22:3

F~gure

19

1 knew severa! tcenagers who died in an

autO accident recendy becallse of alcohol.
It happellcd on their way home aner an
evening of parrying. How tragic! They
could have refused to drink, but chey did
noe. Anei, as Proverbs says, rhe simple pass
on and are punished. Let us act accordillg
ro ehe knowledge that we have. Ler us do
whac we know is right for ourselves and for
our famiJies.

Are There Healthful Benefits of

AlcohoP

442

I have spent the blllk of this chapter

looking at rhe broad range of harmli.ll effecrs of alcohol. However, I have yet to [uUy
address one of today's most pressing issues:
mighr alcohol consumption help one's
hean? Notice. 1 did nor phrase che guestion as some do: Ilamely, "Collld moderate
alcohol use be heaIthy?" Many are quick to
answer thar question in the affirmatve.

However, aner seeing rlle extensive lisr of

toxic effecrs of alcohoJ. it should be easy
enough for the llnbiased reader ro see rhar
alcohol is nor a health-giving substance.
Srill, what about the hean effeces of al
cohol? Often the question is based in parr,
at leasr, on reporrs about the French. Wit11
rhat in mind. let us rerurn ro r!le subjece of
rhe French Paradox thar rhe news media has
so eagerly publicized. Pirse, we need ro
reframe ilie ssues. Afeer ali, ae lease one
news media repon posed ehis question:
"Why don'r the Prench have heart disease?"
Thar, of course, is a misstaeemenr. The
French have plenty ofhean disease: it is rheic
second leading C1.use of death. The correCt
question would be, "Why do ehe French
have ins hearr disease rhan Americ3ns?"
This is e!le question rhar we must address.
Some inreresr.ing srudies have apparently
unlocked dle mystery.
Before we look ar. this data, however. I
ehink it is imponanr to make a telling observation. Mauy in America have been say
ing in effecc, "Just thillk, if we only drank
more alcohol like ehe French. how much
better off our hearrs would be." However,
ehe French-who have been living with rhe
results of rJleir high alcohol consumprionhave had a complerely different response.
When Drs. Rankin and Ashley compared
ehe alcohol use trends for 24 nations in
Europe and North America, ehey made a
srartling discovery ehat iIIuminaeed rhe
French atrieude. On averag , from 1950 ro
1985, western naeiolls nearly doublcd cheir
per capita alcohol consumption. The median percentage i.ncrease was berween 70
and 82 perccnL In filet, cvery country but
one increased cheir alcohol consumptian.
Do you have any idea what coulluy was the
sale nation (O decrease alcohol consumprion? lfyou guess France, you are right. In
ehar 35-year period ehe average French citizen decreased his ar her use of alcohol by
23 percent. J 14
The explanation provided by dlese alcohol researchers is ilIuminaring: "The deciine in alcohol consumpeion in France was
almosr certainly in part due tO national
measures ro reduce consumption because of
concern abolit rhe health-related ouecomes

WANT A DRINK?
associared with the highesr national per
capi ta consum prion." 115 Thus, while France
has been working for years ro decrease their
aleohol consumption becausc of rhe healthrelated roll it has been raking in their counlCy, rhe American alcohol industry and the
media are idolizing the use of alcohol by
rhe French. It is ironic that rhase living fim
hand with alcohol's effects see it as a curse,
while tho e loaking on from a disrance idoJi7.e irs benefi rs.
What abom urIle French paradox"? Ler
us examine rhe French lifesryle ro see why
heart disease may be lower there than in
America. Along with comparing American
and French alcohol consumprion, we mUSt
also assess omer dietary f.1crors. We have
done chis in Figure 20. 116
Higher buner and lard consumption
coupled wi[h higher blood pressure and
cho\esrerol levels would lead one ro expect
more hearr disease in France. However, as
we nave already observed, just che opposire
is rhe case. The nexc poin[ in rhe figure is
generaUy used ro explain why their heart
disease is less: they have a much higher in[ake of red wirlC. Many have conduded mat
red wine reduces rheir risk of heart auacks.
However, we must look further. Cigaretle smoking and obesiry do not appear ro
be factors; French rates in these areas are
comparable to those in America. Tne
French also have another dietary disrincrion:
they driuk very little milk. The news media has failed ro publicize tJ1is facr. Dairy
fat is srro.ngly related tO heart disease. In
fact, ifyou look ar [he consumprion ofdairy
produc(s in one COUlltry compared ro anorl1er, ncluding France, tbe beart disft1se rate

is proportional to tbe amount ofdttiry products constlmed. 117 , 118. 119, )20 Thus, rhe lower
consumption of dairy fat would help tO explain [he lower levels of hearr disease in
France. Another factOr rhal would be expec[ed [O decrease French hearr disease risk
is rheir high consumprion ofvegetables and
fruirs. The heart-prorective benefirs of rhese
foods are presenced in Chapters 3 and 4.
This important facr has also nor been widely
publicized.
Ano[her important but unpublicized
filer: t here "'re certain groups in America tllat

LIFESTYLE COMPARISON OF
FRENCH AND AMERICANS
Compared to Amer;cans, the French
eat 3.8x the butter
eat 2.8x the lard
have higher serum
cholesterollevels
have higber blood
pressures
have a much higher intake of red wioe
have comparabie rates of obesity aod
cigarette smoking
But they
drink very little mUk
eat large amouots of vegeta'bles and fruits
have le-ss death from CAD
Figure 20

have a mucb IOUler rate ofdeaths due to beart

disease tban tbe Frencb. American Seventhday Adventisr vegetarians have far less risk
of hearr disease (han does rhe ave rage
Frenchman. 121 But tbey drink no wine or

alcohol.
Are there any factOrs in addition ro lower
milk eonsumprion aud higher frujr aud vegetable eonsumption that would explain the
apparenc French advamage? What about
wine-might there be something ro rhe
wine conl1ecrion aner aII? Having looked
carefully at the issues, we wiLl see rhar wine
does have some hearr-prorecrive benefits.
But before we jump ta any eonc!lIsions, 1
must poinr Out rhe obvious: wine conraills
mlleh more than alcohol. Or. Oemrow and
colleagues at the Universiry of Wisconsin
looked direcrly at d1e constiruents of red
wine, white wine, and juice made from red
grapes. 122 This seudy provides some amazing insiglus inco [he French paradox.
Before they embarked on the aforemelltioned rudy, [he Universiry of Wiscol1sin
group already knew several things. Fim, jf
the blood's c10rting ceUs, the plarelers, become

443

PROOF POSITIVE

A STUDY TBAT IIELPS EXPLAIN

THE FRENCH PARADOX
Arterial blood clots in 47 dogs
Beverage
given

Effect 00
blood flow

Group 1

Red wine

lncreased

Group 2

White wine

No effect

Group 3

Grapejuice

Increased

Condusion: Red wine alld grape juice /lave oile OT more

beneji.al sllbstallces for reducing b/ood elot
formation ;11 arteries Ihat white wille does
"01 have.
Figure 21

444

sricky, rhe risk of hean arrack and similar

problems increase. Second, wine and alcohol consllmprion had been elemonsrrared
to make plarelers less sticky. Third, the tendency of piare1ets [Q make heart problems
worse could be measured in a special dog
model ehat had been developed in rheir
laborarory. There WaS stiH a burning quesrion, however: how much of rhe effecr of
win,e was due ro alcohol and haw much was
due to other propenies in rhe grapes?
Ta find the answer, rhe researchers obrained 47 mongrel dogs. In preparation for
the test aEter anesrhesia, each dog had a
single coronary arrery experimenrally narrowed and damaged in a way that reproduced ehe blockages occurring in humans
wirh coronary anery elisease. These anery
changes included elamage ro the inner lining of the blood vessel known as rhe incima.
Intimal damage, in turn, srill)lIJared piatelers ro elump periodicaJly and form sticky
little c!ors referred ro as rhrombi. Colleceively, rhese processes callsed periodic interrupeions of flow in the affeereel corollary
arreries, known as "cyclic Aow redllCtions"
or CFRs. This experimemally induced condirion thus mimicked rhe exacr mechanism
for hllman hearr anacks.
After rhese changes were induced in rhe
elogs, rhey were then divided imo rhree
major groups. Group 1 received red wine,

Group 2 received red grape jllice, and Grollp

3 received white wine. Whar rhe researchers were looking for was a reducrion in the
rendency of rhe plarelets ro c1ump and a
resulting decrease in the cyclic Aow reductions (CFRs). They carefully measured
rhese CFRs ro see if adding rhe wines or
grape juice wOllld decrease platelet stickiness. Their resu!rs are sllmmarized in Figure 21. 123
The test resllirs indicated rhar rhere were
one or more substances in borh red grape
juice and red wine rhar ShOllld significantly
reduce rhe risk of a heart attack. That subsrance cannor be alcohol, because there was
none in rhe grape juice. Moreover, white
wine comains alcohol but had no significam effecr. In another study, the same lab
found rhat alcohol alone, in very large
amOllntS, could decrease CFRs. 121 Extremely high levels were needed-rhe
eqllivalenr of about 12 drinks for a 180
pOllnd manl2S_producing blood alcohol
levels well over double rhe legal limit for
drivers. In contrast ro the smcly wirh pure
alcohol, rhe red and white wine in the
Demrow study was given in amounts rypically arrained in social drinking-approximaring one drink in a 180 potlnd man 126_
only eigh r percenr of the amount needed ro
decrease CFRs. This amounr produces
blood alcohol levds within legal limits ar
abollt 0.02 or 0.03 gm/dl.
If it was nor the alcohol, what are the
subsrances rhar made rhe difference in the
effects of rhe red wine and rhe grape juice?
The mosr likely candidates were a grollp of
subseances called Jlavonoids thar are known
ro prevenr plarelet c1umping. They arc
found abunclamly in grape.~, reel grape juice,
anei reel wine. In fact, compared ro (he white
wine, rhe red grape products-rhe wine and
grape juice-had four ro flve times as much
of twO key flavonoids (quercerin and nain)
by acrual measuremenr. It is likely that t!le
presence of ehese substances causeel rhe reducrjon ofblood elot formarion. In earlier
research, the Universiry ofWisconsin group
haei demonsrrated thar both quercerin and
rutin couJd decrease platelet srickiness and
eliminaee the CFRs in rhe same dog
modcl. 127

WANT A DRINK?

GrapeJuice ~ A Multifaceted Food

Flavonoids, especially querceein, as
found in grapes and grape juice, have orher
beneficia! e/Teers in reducing tbe risk ofhearc
disease besides rheir plaeeler aceions. Some
of the benefits of flavonoids are iisred in
Figure 22. 128 129
Nore thar grapes conrain porent antioxidant5. Quercerin, for example, is even more
potene rhan Vitamin E. As described in
Chaprer 3 on heart disease, oxidized LOL
choleseerol is a major culprie in arherosclerosis and hearr disease. l3o Quercetin blocks
LDL oxidarion, and thus che process of arreria! narrowing. Addirionally, ancioxidant
effects are helpful in cancer prevenrion.
These hearr-heahhy compounds may rhus
decrease cancer risk as weU. Borh animal
studies 131 aod seudies of human cancers 132
UJ have demonsrrared such amicancer effects. StiU othcr flavonoid benefirs include
amivira.1 aceiviry.1J4
Grapes are noe alone in possessing such
hea!rh henefies. Figure 23 shows ocher foods
ehar comain signiflcam quanrieies of flavonoids.135. 136. 137
Some grapes also appear ro comain anorher hearr-protective subsrance, called
resveratrol. This naeural1y occurring fungie-ide also has promise bur did nor seem ro
be one of rhe main heart-proeecrive chemicais in Oemrow's wine research. Resverarrol
was found in signiflcH1r amouncs only in
the beverage thar had no significanr beneficia! aff'ect-rhe whire wine. No dereccable
amounrs were [ound in the red wine or the
grape juice in chis srudy. Nonerheless,
resveratroJ may have more benefits rhan we
have given it credit for. Whire grapes and
whire grape juice may thus also have some
cardioprorective benefies. And do nor coune
out red wine and grape juice regarding
resveratrol: other srudies suggest rhar they
a1so contain chis porenrially healthful compound. Consider resveratrol's beneflcial effects listed in Figure 24. 138 . 139 Resvcrau01
has recenrly been found ro prevenr cancer
in mice. 140
How does rhis information fir wirh the
French Paradox? The dog study evaluated
the diITerences in rhe eff'ecr of plarelets on
clouing. and nor rhe di/Terences in choles-

GRAPE FLAVONOIDS FIGHT

HEART DISEASE
Grape jllice cOlltains flavoltoids (especia/ly quercetill)
wlaich:

inhibit thc oxidatioo of LDL cholesterol.

are more potent antioxidaots tblln
vitamin E.
decrease platelet aggrcgation
(clumping).
arc llssociated with a dccrcllsed
incidence of and mortality from
coronary heart disease.
Figure 22

FOODS CONTAINING FLAVONOIDS

Fruits . .

Vegetables

Grains

grapes?'"

kale (Ieaf)'
greens)

cereai
grains

apples_
cberries

j.

strawberries
blueberries

roots and
tubers.
onions
tea

grapefruit

... Ce
Figure 23

GRAPE RESVERATROL FIGHTS

HEART DISEASE
White grape juice contains resveratrol
which:
lowers totall cbolesterollevels
increases HDL cholesterollevels
inbibits the oxidation of LDL
cbolesterol

Figura 24

445

PROOF POSITIVE
terol Jevels. The differences in cholesrerol
levels would have [10 effecr in such a blood
c10tting srudy. There is 110 conuadic[ion
here.
1 would be negligem [Q close clle copic
of grapes and grape jllice withollt ar leasr
listing some of [he omer beneficial qualities of this lIniqlle and delicious food grollp.
To illllsrrate rhe abllndance of necessary
nurrients in grapes and grape jllice, assume
[har yOll were [Q live on grapes alone (which
1 do nor and wOllld nor advocare), and
would eal enollgh ro mainrain your body
weighr. The varieey anei qllanriey of rhe
many nlltriems in such a die[ and clle lack
of some negative factors in rhe rypical
American diet are shown in Figure 25. 141

NUTRITIVE QUALITIES OF GRAPES

Percenlages ofRecolllmended Dai/y AlIowa"ce (if eale" in t!lIoltgh
quanrily 10 maintain weiglll).

DiclaryProlein ~

No cholcsleroJ

43J

liber _

.Vcry

Thlamln-B,
R1bona\'ln-B,

Onl)' 5% rat
low in sodium

26

Nil cin-B,
Vilamin-C
Vllamln-B;::E:::22:8~:,.+.::::::::
134

VII E-Ct equlv.

141

290

81

Follilc

Cakium_51

copper=
lron
Magncsium _

149
108

11

Pota5sium
Sclcnium

205

_511

100

200

300

400

500

600

100

_...

800

Figure 25
We see rhar grapes have signiflcallt qllanriries of 15 mnrienrs while conraining only
flve percent fat, a very low amouJlt of sodiuln, and no cholestcrol. Notice the high
quanriry of vitamins B, C, and E, as well as
iron and copper. They are also vcry high in
potassillm. which along wirh a low-sodium
dier helps ro lower blood pressure, and very
high in selenium, a trace elemenr rhar appears ro have a cancer-protective cole.

Back to the Paradox

446

Ali of rhese lines of evidence bring us

back ro the major ropic under discussion,

namely, the French Paradox. The best evidence Sllggests rhat the lower hearr disease
rarc in France has ro do wir.h much more
rhan alcohol. Conrrary to whar many lay
news reports have implied, the tllcohol in the

wine is 110t the ingredient that prOllideJ the

benefit. As we have seen, much of the benetlts amibuted to drinking wine should be
anribllted ro the main ingredient ofwinegrapes.
Alcoholic beverages do appear ro have
rhe rendency ro raise heart-protccrive HOL
cholesterol levels .in people who arc on a
poor lifesryle. A recel}[ Tufrs Universiey Oier
and Nurrition Lefter pllt rhis in perspecrive, however: "Whilealcohol boom HOLcholesterol levels, exercising and losing excess weighr raise rhem even 010re."142 The
truth is tllat no one !JIIS CtlCr proven that fi.
;erson on an excellent life~tyle gets tin} benefits whatJOCller ~y drinking in modmttion.
Considering HOL in particular, as we have
seen, a1coholic beverages are not ilie only
dierary facrors rhar hold promise for incrcasing HOL cholestecol. Wholesome grapes
and grape juiee may also raise rhis lipoprotein mrough such compounds as resverarrol.
Furthermore, no one is suggesting rhar. everyrhing rhar raises HOL is desirable. For
example, organic pes[icides can boosr HOL.
Yet, no one is reeommending pesricide consumprion for hean healrh: we recognize irs
harms ourweigh any benefirs.
Why add or continue to use a roxic
chemieal sllch as alcohol, when there is no
evidence that ir is as beneficial as a healrhfullifeseyle in redllcing hean disease? Even
the Tufts University speciaJ repon (r.hat on
the surface may have. looked pro 'alcohol
for your heart") reminded readers of soroe
of rhe bigger eoncerns rhar we have already
addressed. They cited recent Harvard data
rhar showed as lirde. as rhree drinks per week
raised the breasr cancer risk for women significandy. And rhey made this relling summary: "Researchers agree almost universally
rhar 00 one should rake lip drinking for rhe
express purpose of sraving oIT hean disease
. .. rhere are mllch safer and generally more
healrhful WllyS ro protecr rhe cardiovascular
sysrem." 143

WANT A DRINK?

Totl11 Abstinence is the Preftrred

Option
The World Healrh Organizarion has
become a strong advocate of total abstinence
from aJcohol even in rhe currenr context of
the "alcohol-for-your-heart" hype. Tbeir
thinking reflects rhe judgment of many scicnriscs, physicians, and public health professionals who are weB aware of the facts
mar 1 have documented in this chaprer. The
WHO roday lIses rhe phrase "the less you
drink, the berrer."144 It is highly signiftcant
rhar this inrernational body has raken rhe
stance rhat even moderare amollnts ofaleohol consumprion should be avoided. They
insighrfully made a nllmber of eri ti cal observarions rhat lead tO their conclusion.
Some of those insights are found in Figure

WORLD HEALTH ORGANIZATION

SAYS "NO ALCOHOL"
"Alcobol coosumption causes some o( tbe world '$ most
serious bealth problems."
"Drinking adversely affects a significant proportion of
tbe populatioD, not just a minority of alcoholics or
heavy drinkers."
o Light drinking is unlikely to lower beart disease risk in
people who are already takiog other lifestyle precautions
like exercising regularly. not smoking, and eating less (at.
The publicity given to the use of moderate amounts of
alcohol for beart disease preventioo is "not
the result of rigorous scientific research,
but is to a large extent inspired by
commercial purposes."
"The less you drink the better."

26. 145
Especially noteworrhy is th is international body's conhrmation of one of my
rhcses in this chapter: for people an an alre.:l.dy healrhful lifesryle (ar who are going
ro adopr sueh), rhere is no evidence rhar alcohol provides any hearr benehrs. The
World Healrh Organizarion's posirion conftrms in my mind mat we uuly are in an
enJightened age regarding tne effects of alcohol an. human health. Indeed, when alI
the infonnarion is taken inco aCCOllnr, the
only condusion that makes "health sense"
is cotal absrinence.

The ''Modified French Diet"for

Good Health
If you wanr ro get rhe benefirs that the
French are reaping, the besr plan is tO use
an abundance offruies and vegetables which
may include grape juice irself This pl:l.J1trieh diet defuses anocller argumenr of rne
wine proponenrs. While some have touted
rhe flavonoid conrenr of red wine as being
superior ta rhar of grape juice, rhe relarive
amouncs of .fIavonoids in grape juice and
wine probably vary considerably depending
an rhe rype of grape, where it was grown,
and the rype and year of the wine. For example, in the Demrow srudy, measurementS
of rhe acrual samples lIsed in rhe experimenr
suggesred ehat rhe grape juice had somewhat

Figura 26

more rmin, while the red woe had more

quereetin. 146 Even if wine consistenr!y had
more of aII rhe flavonoids (han grape jllice
(which the evidence daes not indicate), eating vegerables and othcr planr sources offlavonoids-in addition ro grapes--wouJd be
expcered ro provide a higher quanriry of
t!lese compounds than moderate wine
drinking alone. ThllS, the plam-rich diet

"MOD FIED FRE CH DIET"

FOR GOOD HEALTH
Eat large amounts of fruits and vegetables
like the Frencb.
Eat a low level of dairy products like
the French.
Substitute grapes or unfermented
grape juice for the wine that the
French drink.
Reduce meat consumption below
tbat of tbe Frencb.

Figure 27

447

PROOF POSITrvE
a1so furnishes a furrher rea.~on for a lower
he:m arrack rare arnong rhe French: they
consume higher guanrirjes of flavonoids
than Americ.1ns due ro rheir higher inrake
of fruirs and vegerables.
Ler us follow rhe example of the Frellch
in a rnodified \vayas ouclined in Figure 27.
With rhe "Modified French Dier,
Americalls' risk ofhearr disease will become
lower rhan rhar of rhe French.

GRAPE JUICE VI. WINE

"The pure juice of the grape,
free from fermentation, is
a wholesome drink. But
many of the alcoholic
drinks which are now
so largely consumed
contain deathdealing potions."
Figure 28

"The Bible nowhere teaches the

use of intoxicating wine, either as
a beverage or as a symbol of the
bJood of Christ." tIt::::~
~
~
~, .... ' , .......
::;:::::;;::::: ,,"- ...' ' .......
~
'- ' . . .~.
~ ..~ ~~

"-. . .10......0

Figura 29

448

::,. . .

"-

, ......

::'.::::

Whar a tragic misrake ir would be for a

person ro drink alcohol in an atrempr ro
reduce he:m disease risk, on Iy ro sufTer some
of rhe irreversible consequences of alcohol
use. If you re.111y are inrere red in your
healrh. why nor do rhings rhe rru1y healthfuI way? A firring summary of the heahhfulness of grape juicc comrasred wirh rhe
tragic eflecrs of alcoholic drinks appeared
in prim nearly one hundred years aga. I
have reproduced the sratcmenr in Figure
28. 147

The Christian Community's

Responsibility
Even rhough ilie scienrific communiry
has the answers regarding rhe alcohol question, why do 56 percenr of Arnericans sriU
drink?148 One partial explanation could be
thar our moral instirutlOns have Ice tlS down
when it COll1es ro their positian on alcoholic
beverages. Indeed, some church leaders
c1aim rhar the Bible sanctions-and even
encourages-ehe use of fermenred wine.
Thorough srudies on ali ehar rhe Bible has
ro say abolH alcohol have concluded rhar
the Bible nowhere approves of drinking a1coholic beverages; conversely, it gives clear
counsel ro avoid cheir use. If you have an
interest in the Biblical teachings concerning rhe use ofalcohol and have nor seen rhe
evidence, you may wanr ro read rhe resulrs
ofOr. Samuele Bacchiocchi's research. This
Italian theologian has aurhored a book entirled, Wine in rhe Bible: A Biblical Study
on rhe Use of Alcoholic Beverages. 149 The
conclusion of Ellen Whirc, on ehe same subject, is stared in Figurc 29. ISO
Our re1igious instiwrions have ler tlS
down. They need to carch up wirh rhe scientific facrs and wieh rhe eheologans who
have assiduollsly srudied rhe Scripeures and
have found rhat the Bible nowhere sanctions
alcohol consurnprion. In lighr of rhe overwhelming scienrific find ings againsr rhe lIse
of alcohol, even in low amounrs, religious
insrirurions must now accepe a major responsibility for rJle use of this legal drug and
alI of irs associated premarure dearhs, disrressing medical condirions, and social
trauma.

WANT A DRJNK?
The devasraring social aspecrs of aleohol use were forcefully dcmonsrrared in rhe
village of Barrow. A1aska. 151 In 1994. rhey
vored ro ban rhe sale and use of aleohol.
Many locals up ro rhar rime were nor able
ro work because of drunkenness. A top
police official said ehat before the ban
"There was mayhem and rragedy cver)'where." Rape. suicide, and drunk and disorderly conduct were rampanr. Feral aleohol syndrome rares had skyrockcrcd. However. abrupt changcs took place aJmost immediately aher the ban went imo effect, as
dcscribed in Figure 30. 152
A Narivc American he-altll care worker
from rhe 10~l Inupiar rribe caUed rhe ban
"rhe beginning of rhe salv3rion of our
people." An Inupiar [eader echoed similar
senrimems when he said. "For our people.
akohol means only bondage.' Wirh a 70
percem dmp in crime, Barrow became mOre
peacefuJ than ir had been in decades.
The Barrow srory on one hand demonsrrates rhe power of alcohol ro ruin lives.
On rhe orher hand, it epitomizes the bendlt5 of societal decisions ro break free from
aleohol's grasp. The tranquilliry rhar foi
lowed the ban should not come as a surprise. We are ali well aware of rhe moral
and societal cosrs of aleohol.
However. other than in Barrow, A1aska.
and a few orher isolated places in our nation, where are rhe public ourcries against
the damages rcsulring from alcoholic beverages? Dissemination of the srarisric;u and
scienriflc E1crs regarding alcohol, coupled
wirh publiciry given ro the moral evils of
aleohol by rhe religious instiwtions, would
have a powerful effect in reducing aleohol
consumption in our narion. The influence
of churdlcs in our nation as seen from rhe
perspecrive of a prolific Christian wrirer is
stated in Figure 31. 153

Alcohol-A Moral Issue

Dur sociery is greatly influenced by
moral scandards taught by the churches. Dr.
Bacchiocchi wrires, "lf America W:lIHS ro
deal effecrively wich che cragedy of alcohol,
ir must develop an entirely new cultlual acti rude rhrough the aggressive promotion of
abscinence."154 Bacchiocchi i.s dearly call-

P OHIBITION B
TOALASKA
The 3,900 people in Barrow, Alaska voted
to ban the sale and use of alcohol in 1994.
Alcobol-related crime and accidents plunged.
Crime feU 70 percent during a
ODe year period of prohibition.
Regarding acute health
problems: Emergency room "'"
alcohol-related visits dropped
from 118 per month tQ 23 per
montb in the first 30 . .\.;._ ......... ~- .
days of prohibition.
ing for a socicraJ arrirude thar rolerates no
a.lcohol wharsoever. The role of Chrisrians
in the promorion of rotal abscinencc is further described by De. Bacchiocchi: "Chrisrians can play a vital role in t!lis endeavor if
rhey recover the Bibuca.l imperarive for absrinence. It is onl)' when Chrisrians recognizc and accepe rJle fact (hat drinking aleohotic beverages is nor only physically harmfui, but also Biblically and morally wrong
ehae they are likely ro feei compelled. nor

Figure 30

A CHRISTIAN RESPONSIBILITY
Christian churches bear considerable
responsibility for inestimable human
and economic costs of alcohol
consumption, "because through their
beliefs, teachings, aud preaching
they are able to influence the
moral values and practices of
society possibly more than
any other institution."
Figure 31

449

PROOF POSITfVE

SERVE FRESH FRUITS ON

FESTIVE OCCASIONS
"Let us teach tbe people to eat
freely of the fresh grapes, apples,
lpeaches, pears,
berries, and ali
other kinds of
fruit that can
be obtained."
Figura 32

only ro abstain from incoxicating substances

rhemselves, but a1so ro help orhers do likeWiSC."155

In a social setting in which a light menu

s served, we have many becrer alrernarives

Refernues Ricc DP. Thc <:conomic cost o( alcohol abusc and alcohol dependen,ce:
1990. Auohol Htl1uh 6- RJ'Uorch Wor/d 1993; 17(1): IO-II.

Rice DP. Tbe economic cost of alcohol abuse and alcohol dependence:
1990. Alco!Jol HelIlth & Rmarch Workl1993; 17(1): 10-11.

NlImes wm' c/Jlrngtd 10 emure cOllfidnJlWIiry.

{ C.1lla<lian S(ariSlics ciled in: lunkin JG, Ashley MJ. J\kohol-related

Heahb ProbJems. lu Lasr LM, Walbce RE, editors. Maxcy-Rosenau-L'l5t,
Public HMlth Imd PmJenrive Medicine-13'}, tditioll. Norwalk, C-r:
ApplclOll and bnge, 1992 p. 744-745.
s US smlistic,5 summarized in: US Preventive Services Task Foree. Scrccning (ar AJcohol and Odler Drug Abllse. In: Gl/iiU to C!illiml mvmtive
S,7lJiw. Baltimore. MD: Williams and Wilkins, 1989 p. 277-278.

US Departmclll o(Health and Human Services. Epidemiology ofAleohol Usc and A1cobol-Rclared Consequenccs. In: Eigh/h Spuiol RepoTI (()
riu US COJlgrtss 011 Alcohol,md Htltlt!J. Nalionalln.\riuucs ofHealth (NIH)
Publication No. 94-3699. Sep 1993 p. 18.

McGinni5 JM, Focge WH. AClllal cause.s of deatb in thc Uniled Stales.

JAMA 1993 Nov 10;270(18):22072212.

B Purn:lffi JJ. A1ishouse J E. Food cOTlJl/mpon, prim. afld expentiil"res:
An"Udi Dala, 1970-91. Food 'lnd COllsumer Ec<>nomics Divisiol\, Economie Rescarch Scrvice (ERS). U.S. Depanmelll o( Agriclllllm:. Statisl;cal Bullctin No. 928, 19%.

Rice DP, Kclman S, eL al. The Eco1/omic UJSI OfA!rohoIA1/d Drug AbwI'
Ami Mmlol l/lnesm: 1985. U.S. Dcpanment of I-\calrh and HlIJ1lan Services. DHHS I'ublication No. (ADM) 90-1694, 1990 p. 22-23.

Mil!cr A. principal economist (or rese.lrch and evaluarion al the Pacific

1nsnru le. QUOtOO in dlc NIJlioTldl Gooa Tnnpidr 1997 Jan/Fel>; 17(1):7.8.
10

450

than alcohol. These alcernatives are good

casting, satisfying, and are compatible wlrh
a social, pleasant. or festive mood. Theydo
nor, however, exacr the price of a dulled
mind. Indeed, rhey are compatible wirh a
c1imatc thar fosrers uprighr and intelljgenr
conversation, a serring where we are lIsing
our fromal lobes for unclollded reasoning.
What are these alternatives? They are named
in Figure 32. 156
We have seen thar fresh fruics and their
juices in moderation canimprove and SllSrain our health as opposed ro che decline of
hcalth rhat, almost inevirably, accompanies
alcohol consumpron. We need 110 addi
rional evidence. The message is dear. As
Solomon, reportedJy the wisesc man char
ever Ijved said, 'Wine is a mocker, scrong
drink is raging (rroublesome): and whoso
ever is deceived rherehy is nor wise." Proverhs 20: 1. The only answer thac makes sense
when che quesrion is asked, "Wanc a drink?"
is, "No, rhank you, hut 1wou1d enjoy some
warer or juice."

11 Rankin JG and Ashley MJ. A1cohol-relatcd Ht"dldl Problems. In: LISI

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747-748.

""Vf.7l-

U.S. Dep!. of Health and Hlllllan Services. A1cohol. In: TIu Surgeo"
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12

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8.1

US Deparrmellt ofHeahh and Hum311 Services. Acrions of Alcohol OII

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~ Rou MA. Acker \VI, el al. Complltcrized IOmography of lhe brain in

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US Deparrmenr of Ht'alth and Human ervices. ACliolls of Alcohol on

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88

(I)HS) Public.1tio/l Number 88-50210. 1988.p. 653-655.

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OI

WANT A DRINK?
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Proverbs 22;3. 11Je Holy BibLr. AUlhoriud King Jallll:5 version.

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117 ecly S. DicL and rorona.ry djsease: a survey of morulilY rales "nd fooel
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99

II~ R.ank P. Milk and arreriosclerosis. Med HJpot!mes 1986 JuI: 20(3):317338.

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119 Arraud-\'V'ild M. Connor L. el. al DilTerenet'S in eoron;try morlaJity

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devclopmem. AlcohoL Ciill Exp Re! 1993 Fcb; 17( 1): 174-183.
\00

101 Sbu XO. Ross JA. Pendergrass TW. el al. ParemaJ aleohol con lImption. cigareuc sllloking. :llld risk of intanl leukelllia: a Childrens ancer
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U.S. Dept. of HCallh and Human Scrviccs. Akohol. In: TIu SlIrgeol1
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101

US Prevcmi\'c Services Ta k Force. Counscling to PreV('nl Motor Vehicle Injurics. In: Gllide to C/itJica/l'revrmive Senfiaf. Baltimo,,', MD:
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10J

US Pr(:vcJllivc Serviccs Task Forec. Counseling 10 PreveJll Motor Vehiele Injuries. In: Guidc ro CLillic,ti PrevemtJ(' Services. Baltimorc, MD;
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l()ol

US Preventive Servicc:s Task Foree. Counscling to Prevcnt MaIor Vehicle Injuries. In: Guitb ro Ctiniml fuVC7lrillr Servi/ef. Balrimore, MD;
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105

Zador PL. Alcohol-relaled relalive risk of f';lIal driver injurie in relaLion ro driver age and sex. J Smd A!L:ohol 1991 Jul;52(4):302-310.
106

107 Hammond, RL, edilOr. AJII1Q.f1 al/JOII evcr wIIJ1fed ro Imow' abOllr aleohol: 'bllr didni know who ro aik.' Speci:l.! Issue ofThe BOllom line on

Alcohol in Sociecy. 1991 11(2): 106.

108 US Deparrmenr of Health and Human Service;. Effecls of a1cohol on
bchavior and safer}'. In: EiglJfh Sprcid} &p0rl ro rhe US COIIg>'r;s on A/coho/
f1lld Hta/rh. Nalional Insuttllcs of Hcahh (NTH) Publicarion No. 943699, Sep 1993 p. 242-243.

US Depanmenl ofHL-alrh and Human Services. ElTcc.ts of aleohol on

behavior and safety. In: Eighrh Specia/ Rrport 10 tiu US Congl'tSi OII A1coho/
109

120 Seg;ll1 JJ. Dielary IaClosC as a possible risk faclor for ischaemic hearr
dj case; revicw of epidemiology. /m J Cttrdiol 1994 OeI; 46(3): 197-207
121 Phillip RL, Lemon FR ,el al. C:oronar)' heart discase monality alllong
Sevcnrh-Day Adventisrs ,,~th dilTcring dictary habils: a preliminar)' repon.
Am J C!ill Nttrr 1978 OCI;31 (10 Suppl):S 191- 19R.

Il~ DCJJlTo\V l-!S. Slane PR. Folts JD. Adminisltalion of wine and grape
juice inhibi(s in "ivo plaldet ,ctivit)' and ,hrombosis in len05ed caninc
coronolr}' ancries. Cirmlatiol/ 1995 Feb 15;91 (4): 1182-1 188.
123 Dcmrow l-!S, Slane PR. Folls JD. Ad(niniSlralion of \Vine ,md grape
jnice inhibits in vivo plmclcl acrivil)' and lhrombosis in slenosed e:lninc
coronar)' ar!erics. Circlf/fuion 1995 Fel, 15;91 (4): 1182 1188.
124 Keller JW, Folts JD. Relative e(fecls of cigarwe sllloke and cthanol on
aeUle plalclet thrombus formation n slenosed canine coron:uy afleries.
Ctmtiovf1Sc R(s 1988 Jan;22(1 ):73-78.
.

l-!ammond, RL. editor" A/mosf aliJOII (1)/'1' Wf111Utl ro knoflJ' 11bo"r It!cObm didn; Imow wbo to /l.!k f Special Issuc ofThe Bonom Line an
Aleohol in Socicty. 1991 11(2):106.
Il;

boL'

l-Ialllmond. RL, editor. Almosl ol/)'Ott etJer walf1rd ro kll()w' abolit a/co10 ask! Spt'cial lssllc of The BOllom Linc on
Aleohol in Saciel)'. 1991 I 1(2): J06.
Il6

bol: 'bttr tfitlni knollJ wbo

Il Slane pR, Qurcshi M, Folts J D. Platclel inhibilion in . tenosed c.lnine

artcries by qucrcetio and rUlin. polyphenolic fla\'onoids fOU1ld in red \Vine.
C!ill Res 1994;42(2): 162A. (Abslract)

L.S DClllrow HS. Iane PR, Folts JD. Adminislr:lIion of winc and grape
juicc inhibil in "ivo plalelet a tivily and Ihrombosis in stenosed caninc
coronary arterics. Cimrlnrion 1995 Feb 15:91 (4): 1182-1 t 88.

453

PROOF POSITIVE
Il9 Hcrtog MG, T'eskcns EJ, Ct al. Dierary anrioxidant navonoids and risk
of coronary bcaft dise3.~e: Ihe Ztuphen Elderll' Srudl" uma'r 1993 Oct
23;342(8878):1007-1011.

141 Tufts Un iversi 1)'. Special Report: Uncorking lhe facls aboul alcohol
and you hl:ahh. Tufts Univc",ity Diet aod NUlrilion Lener. Augusl 1995.
13(6):4-6.

13U Steinbcrg D. Path3.~arad\y S, el al. l3eyond choleslerol. Modific1tions

of low-density lipoprotcin thar increasc ilS athcrogeoicit),. N El1gl j Me/}
1989 Apr 6;320(14);915-924.

I j Tutts Universily. Special Reporr: Uncorking lhe f.1CtS aboUl alcohol

and l'ou health. Tuns University Oiel and Ulrilion Lener. AuguSt 1995.
13(6):4-6.

nI Henog MG. Hollman PC. el al. Illlakc of porenrially anliCircinogcnic

navonoids and lhcir dcrenninallts in adults in Thc Nelherlands. Nllrr Cmc"
I993;20( 1):21-29.

Iflorld Hea!Jh Orgll1liUlIio11 P1't'SS Relmlr. November 1. 1994.

SC1mbia G. Randlcuj FO, er al. Inhibitory clrCCI of quercerin 00

OVeA 433 cells and prescnce of type Il OC-Strogcn bindiog sites in primary
oV:Hian lumours and culturcd cdls. Br j Cmccr 1990 Dec 62(6):942-946.
I 1

I 1 Yoshida M, YamamolO M. Nikaido T Quercelin arresls human leuke

mic '1'- cii in Iare G 1 phase of rhe cel I cy le. (imea Res J 992 Oec
1;52(23):6676-6681.
IM Baylor NW, Fu T. Ct al. !nhibilion of hum;ul T celllcukernia virus by
l!le pbnl l1avolloid baicalin (7-glucuronic acid. 5,6-dihydroxynavone) . .1 IlIfcr Dis 1992 Mar;165(3): 433-437.

I.IS Henog MG, Feskens EJ. et al. Oielary amioxid:u\t Ihvonoids and risk
of coronary hean diseasc: lhe Zutphell Elderly Sludy. Ll1l1cn 1993 OCI
23;342(8878):1007-10 II.

Minisca!co A. Lundah! J, et al. Inhibition of dihyclropl'ridine melabo

lism in raI and human liwr miClosomes by Aavonoids found in grapcfruil
juice. j Phamlfleol Evp Tim 1992 Jun;26 1(3):1 195-1199.
lJ6

Ngul'en TO, Canad3 AT. CitTus Ilavonoid slimulate secretion by human colonic T84 exUs. J NUIr 1993 Feb; 123(2):259-268.
137

Demrow HS. Slane PR. Folls JD. Admnislr:llion of wine and gr3pe
juice inhibilS in vivo plalelcl activicy and thrombo is in slenosed Clnine
coronary arreries. Circularion 1995 Feb 15;91 (4): 1182-1 188.
13&

\j9 Frankd EN, Walerhouse AL, Kinsella JE. Inhibirion ot human LOL
oxid.uion by resvcr:lUol. unm 1993 Apr 24;341 (8852): 1103-1104.

Emblad. H. Moderate drinking: seri ou warning by WHO pedalists.

14~ Emblad, H. Moderale drinking: serious warning b)' WHO specialisls.

lVorlti Healrb Orgl1niultioJl Pms Rr/r/lir. No\"ember 1. 1994.

Demrow HS. Slane PR. Foles JD. Adminisrration of wine aud grapc
juice inhibits in vivo platclcl activity and thrombosis in steno "d canine
coronary arteries. CirmlatiM 1995 Feb 15;91(4):1182-1188.
146

1-17 While EG. COli/uel, OII Diu alU!Foods. Hagerstown. MD: Review and
Herald J'lIblishing Associaton, 1976 p. 436. 437.

HalDmond. RL. editor. A/mosr oII yOlll'vcr wanud ro knolV' I1bout alto10 'lsk! Special Issllc ofThe Bonom Line on
Alcohol in Soc;iell', 1991 11(2):77.
H8

hol: 'bUl ditlll1 know wbo

I 9 Bacchiocchi S. \\71"" in Ibe Bible: A biblical sIuJy on rbe USi! oftlkoboli,.

belltrllgn. Berriell Springs. MI: Biblical Perspcclives. 1989.

\~O White EG. timulallls. In: /1"I1/r/'jill LilJing. 1897 p. 113. .Emw.dl.n:
Ellen G. Whitc Estate. Tbe Publi.rlJed Wrilings of Elim G. VtllJiu. Version
2.0 (CD-ROM). 1995.

1<,

McCoy C. Booze flows back into Barro\V, Alaska aflcr rearlong ban.

TIu W'all Slrm }Olll"lllrl. Prob. No\'. 15. 1995.

'Il McCoy . Boo7.C nows back imo Barrow, Alaska ahcr yearlong ban.
he \'(/011 Srrl'l't jourJIl1l. Prob. Nov. 15, 1995.
1'3 Bacchiocch.i S. I,(/i,ll' in riu Biblr: A bibliC/li srlltiy on rhl' Ilse oftllt:oholi,.
brlJerIrges. Bcrncn SprilJgS, MI: Biblica! Pcrspeerives, 1989 p. 38.

l~' Bacchiocchi S. Winl' ill riu BiMe: A biblica! stlld:r 011 Ihe If,Jr ofalcoholie
brlJemgcs. Bcrricn Springs. MI: Biblical Perspccrives. 1989 p. 36.

140 Jang M, Cai L. Udeani GO, et al. Cancer chemoprevenlive aerivit), of

re$veratrol, a nalural product dcrived trom grapes. Sl'imu 1997 Jan
10;275(5297);218220.

ISI Bacchiocchi S. \\7Irll' in ti", Bible: A biblical SIlld,'Y OII riu IlU ofaltobolic
bl'llerlrger. Berrico Springs. MI: Biblical Pcr peerivcs. 1989. p. 36.

1 I Thc Food l'roc(:ssor for Windows: Nutrilion Allah'sis & Fill1css Sofrware [compulcr program). ESHA Rese:!rch. Salem, Oregon.

I 6 Whirc EG. Carmuls OII Diell11u/ Foods. Hagemown. MD: Review ;Ind
Herald PublishingAssociation. 1976 p. 309.

454

CHAPTER EIGHTEEN

DEALING WITH
BAD HABITS AND

DICTIONS
W

h Y do we ofcen break our mosr

noble New Year's resolurions?
Why-ar any rime of rhe
year-do we somecimes seem
so powerless ro make healchful changes in
our lifescyles? These are quescions chac my
pariencs ofcen ask when 1 speak co chem
abourlifescyle change. There is a myriad of
common problems char ehey struggle wirh.
There is rhe overweighc diaberic who cannor seem ro break away [rom chocolare, che
habicual smoker who cannor seem ro give
up cigarecces, aod rhe individual wirh high
blood pressure who caunoc seem ro srick
wich rhe exeecise program chac he knows he
needs. No maccer whecher your challenges
are similar ro or very diflerenc from chose
examples, aII of us ac rimes srruggle wirh
rhe need ro change our mosc esrablished
habics. Why do we find it so difficulc?
Some would say che problem is ehac we
are deal ing wid) addicrions. No doubr chere
is much Hurh in rhis insighe. However, nor
every lifescyle sHuggle is rhe resuh of an
addicrion, even rhough there are addictive
componenrs ro many of our behaviors.
Funhermore, even if the area we need co
change is nor a forrhright addiction, an underscanding ofsome of che basic approaches
ro dealing wich addiccive habits can help us
wirh rhose lifescyle challenges.

What is an Addiction?
Whar really s an addiccion anyway?
Surprisingly, even rhe expens give differem
dehnitions as ro whar conscicuces addicrion.
For example, 5redmans Medica] Dictionary dehnes it as "habitual psychological and
physiological dependence on a substance ar
practice thac is beyond voluntary control."l
This dehnirion is a good stare. To help
us get a elearer view of what constitutes
an addiClion, ler us look ar five common
characteristics ofaddictions, as liseed in Figure 1. 2 3. -1

cs
An overwhelming compulsioD to continually use au
ageut and a resulting drive to obtain it by any
mcans ncccssary.
A condition called "tolerance," where over time there
tcnds to be a need for increased amounts of an agent
to obtain tbe desired effects.
A psychological andJor pbysical dependence sucb tbat
failure to obtain the agent results in witbdrawal pain
or discomfort.
A high teodeucy to relapse, evco after a persoo bas
broken away {rom babitual use for a period of time.
A detrimcotal effect ou the individual and/or society.
Figure 1

455

PROOF POSITIVE
Not aII of rhese criteria have (Q be fiet
for a habir ta be classified as an addiction.
BUl the broad scope of effects arising from
addicrive agems is helpful ro be aware of.
Whether a habit is cla5sihed as an addiction is nor the important issue. Whar is
critical is rhat many habirs have addictive
componems and dettlil1g with the habit ilS
an addiction i5 Jikely (() meet wich success
where other approaches have [liled.
The mos( imponant aspect of an addicrion is crystallized in Sredman's dehnition
where it speaks of a loss of control. This
element of compulsion is the mase crirical
aspect of addictive behaviors. For example,
a person who decides ro eac just one chocoIare in a box bur. ends up ear.ing half the box
is likely demonstracing an addierion ro
chocotate based on (his probable evidence
ofcompulsive eating. True, the person may
not go through a wi(hdrawal syndrome if
rhe use of chocolare is sropped; rhere may
be no signs of desi ring progressivdy larger
amounts ofchocolare-yet. rhe crioGlI compulsive element is there. The same could
be truc of ice cream addicrs ar (hose who
compulsively wacch t.elevision. Of course,
those who are addicced co nicorine, alcohol, or drugs will fic the dassic addicrion
definicions more srricdy. However. the truth
is thar any habit in yom life lhat is not (()cally uneler your voluntar)' control displays
an addicrive e1emem-whether or not it is
called an acldiction.

The Problem with uModeration"

456

Why is a broader deflnition of addicrion so irnportalH? It is crucial in view of

the faer rhat many people never break free
of their most ingraincd hahirs because of
rhe faUaey of"moderaeion." I finei rhis true
especially in the area of problem foods.
Consider the example of rhe person who
could not control rhe consumprion of
chocolate. Mall}' healrh educators would
say it is fine to use chocolate-if it is lISed
in moderation. This advice misses an important poillt; thac is. an individual who has
a compulsive rclarionship ro a food can no
more use it moderatdy than an alcoholic
can rerurn ta "moderate" drinking or a nicotine addict can rcrum tO "moderate" smok-

ing. In deal ing with anyaddietive habit, total

ttbstinenu.fOr lift is necessary.

Needfor Total Abstinence

Some may thjllk that this is a cruel anei
narrow-minded approach. In the short run,
this may he a difficult concept tO embrace.
But if you have al1 addictive habit and really want success, you will need ta make a
c1ean break wirh iL The amazing ehing i$
rhat in the long run, commitring ro an immediate change is actually the easiese approach. We actually have the capacity ro
choose whar we wiU enjoy. Ifwe habitually
engage in cenain hehaviors, especially if ehey
give us some rewarel (such as better health
01' increased feelings ofsatisfaccion). we wiU
tend to develop an enjoymem for those new
habits; rhar is, we free ourselves ro develop
new enjoyments and new hehaviors. If,
however, we "reward" ourselves wirh ehe
"bad habit" periodically, as some people
advocare, we undermine our ahiliey ro develop enjoyment for a lifesryle that is free of
dut agenL
Let us draw anocher lesson from the person wirh a chocolare addictlon. That individual may break free from daily lIse of
chocolate and experience a los5 in weight,
better connol of blood sugar, and may feei
betrer as a result. However, if a "reward" of
chocolate is raken once a monch, ehe srage
is set for a downfall. Although the individual may still Iose weight and improve
diabetes control on the once-a-mollth
chocolate regimen, frcedom from rhe addiction of chocolate has not been attained.
The desire for chocolate is being kept
alive-and mayeven be increased. giving rise
ro feelings of a deep, distressing sense of
d.eprivation. In most cases, sooner Of iater
this individuaJ will be back ro the former
level of consumption-or worse. If, however, chocolare is permanently abandoned
and the rhoughrs directed towarel rhe joy of
being free of rhe subsrance, rhe chocolate
element in liJe would not be missed. The
taste buds actually become re-educared aod
the desire is gone.
Even if you are nor dealillg with an addicrive substance, a eemplere rejecrion of it
is the best srraregy. Consider, for example,

DEALING WITH BAO HABITS ANO ADOICTIONS

rhe person who realizes char the consumprion of red mear is cOlmibuting ro high cholesterol aod heat{ problems. Lcr us sa)' rhar
there was no element of compulsion in rhis
individual s cating habits. A small piece of
stcak, pork, OI' Iamb is sarisfYing. Nonetheless, chis persoo comes ro the convicrion
thar cven small amounts of red meat are
making cenain healrh problems worse. It
will LJsually be easier ro cut out red meat
completely, racher rhan ro cut down.
1 could give onc hundred more exampb
ta illusuacc rhar breaking ir dean will dramatically increase the likelihood of your
success. At chis poine, some of you may be
saying that it soullds good but it wiJI not
work for my probleOl. Maybe your worst
habir is overearillg-sure1)', you reason, you
cannot stop d'lis habit sucldenly. In problems like rhis, I recommend rhar you look
carefully at your lifesryle and make a change
in some aspect ofthe behavior. For example,
rhe overeater may have no problem wirh
overeating ar breakfasr or avere.atillg vegetables ar lunch ar supper. He ma)' have a
problem, however, with desserrs a/reI' supper. Perhaps a complete break should be
made with desserrs.
The premise of rhis chaprer is rhar we
need ro take a lesson from dassic addictions
and apply ic nor only ro the obvious addictio05 in our lives but ro orher habits d1ar
need changing. Those who are dealing wirh
smoking, a1cohol, eaffeine, ar addictive
drugs are probabl)' welJ aware tim they need
ro stop these habits entire1y. However, che
same applies ro ocher areas of addicrion and
habit-accepeing the need ro make a clean
break can frec you from che cyele of making and breaking your firmest resolurions
once and for aJl.

ldentify Habits that are Undermining

Your Health
1 would challenge you to 100k seriously
at yaur lifesryle and rhe habits that are undermining your healrh. You ma)' idel1ti~'
areas where. abrupt changes nee.d ro be made
in your life, yec you have no desire ro make
such drastic changes. Your lack of desire
may be re!ared ro the pleasure thar the habir

give , OI' your fear of railure. As )'OU read

rhe remainder of rhis chapeer, however, you
will learn ehar changing even your most
cllerished habits will actually give you more
pleasure in rhe long run. Furrhermore, regardlcss ofhow mally rimes )'OU have fatled
in rhe pasc, the material dlar follows can help
you be successful this rime.
I want ta give you one other encouragemenr as you think abolit addressing areas
ehat need changing in your life and ehe roor
causes of your problems. 1er Ole ilJusuate
wich an example. Let us say thac )'ou have
rwo problems: overeating and lack of exercse. As you analyze these problems, you
Mnd rhere is a rhird addiction that is the
roor cause which is comribueing ro [he mher
rwo. You realjze thar you are one of rhe
individuaJs whose biggese obstade berween
yOLl and a regular exercise program is rhe
tinu: spent with tele'lJision. You also recognize ehar rhe TV providcs tlle se((ing for
your biggesc problem wi[h overeating jllJlk
food. YOllr lifesryle goat then may be ro
address )'our televisioll addicrioll. If you
are in complere conerol of yOllr viewing
habies, it may be a matter of sening some
specific guiddincs as ro when, whar, and
how much you wiU waceh. Hawever, ifTV
Ilas taken the mie of an addicrion in )'our
life, a flrm and complete break may be necessary. It would allow )'ou time for dail)' exercise and desrroy rhe sening for overearing.
Do not underesrimaee rhe addictive elements of tdevision viewing. Those who are
addicted ma)' ar may not be aware of rlle
addiction. Television viewing is linked ro
mally bad habits and deleteriolls behaviors,
inciuding violence. Chaprer 12, "The FrantaI Labe, rhe Crown of the Brain,' and
Chaprer 13. "SremOling rhe Tide of Violenee," prescnts more informarion an this
subject. Television is also a "eime-rabber."
Mall)' individuals cannot control their televis ion viewing sufflciendy to aUaw cime for
other areas of lifcsryle rhat need ro be addressed. For rhose. an llncompromising
break with TV is in ardeI'.
For some individuals, simply recognizing rhe need ro completeIy discotltiI1ue a
lifesryle habit is aII rhe insighr lhe)' need.
Once the)' embrace this concepr and put it

457

PROOF POSITIVE
inco aerion, success is ensllred. However,
addictions and other habits ofcen hold enorOlOUS conrrol over us. Many feel powerless
to Stop chem althollgh rhey know ehar it is
necessary. Take the example of Ralph Jones,'
a patiem of mine wllo is in his early 50's.
Ralph is a nicotine adclict-a cigareue
smoker-and he knows rhar smoking is bad
for him. Ralph also has bad coronary artery disease, and has already had bypass surgery and angioplasry. The angiogram shows
thar his disease has beeome 50 advanced that
the blockage has extended ro ilie mosr disram parrs of rhe arreries rhar ean not be
bypassed. We cannot angioplasry him beC1Use ilie disease is so widespread: his hearr
arteries are narrowed vinualJy throughout
their entire length. RaIph needs ro qllir
smoking and he kuows it. He has told me
severaJ times, "1 know I am killing myself,
hut 1 juSt cannot seem ro quit." Clearly
RaIph needs more [han the imdleccuaJ acceptance; he needs ro break from rhe habit
completely. He needs a SOUTee of power.
The information presented in chis chapter
is for him as well as for rhe man)' others
(har have an addicrion ofany kind they "cannor" overcome.
When you ralk witb those who have broken free from an addiction or other dim

"But thanks be to God, which

giveth us tbe victary through
our Lord Jesus Christ."

1 Corinthians 15:57
Figure 2

458

cult habir, you will hear them give credir ro

a variery of sources. Some will attribute
Sllccess to their own resolve, others ro a program, sriH orhers ro friends or a sllpporrive
group. However, in my experience one power
more [han any other has been the most ef
fecrive in helping patients make needed
health behavior changes---':the power ofGod.
You can do somerhing abolit your addiction. Addictions do not have ro occur,
and neirher do chey have tO persist. I have
found thar it is necessary tO deal with deep
spiritual issues ro permanendy conquer an
addicrion. Otherwise, addicrions are very
di/licult ro get rid of Many heahh professionals who trear addictive patienrs have
failed becallse of rhe neglect of the spiritual
dimension. Those who have met with long
term SllCCess have approached addierion from
a spiritual aspect-trust in divine power.
1 have seen God's power at work in my
life and aid me in the area oflifesryle change.
Such personal SlICceSS has inspired me to
share that source of power wi th patiencs who
are looking for help in conqllering an ad
diction. Like any physieian, what has
worked n my practice is in parc what 1have
experienced in my own life and what has
worked in my patients' lives. The point is
that 1 am sharing things dlat I know will
work becallse I have seen chem work.
If you have nor yet found SllCCCSS, there
are methods that I have proven do work. 1
wam ro share from my experience how I
have seen the principles of God's power ill
His Word briug suceess in sitllarjons where
it seemed impossible. Some may be sur
prised that rhe Holy Wrir eomains help for
c1eaning out dle addicrions in OUT lives.

Christian Perspectives That Give

Power to Conquer Habits and Addictions
ter us begin by looking ar a powerflll
Bible text dlat teIls us where we can find
vicrory, and that has far-reaching implicarions for the subject ofaddiction. The verse
is quoted in Figure 2. 6
The apostle Paul's words in Firsr
Corinthians 15 reveal rhe ulrjmate victor)'

DEAUNG WITH BAD HABITS AND ADOfCTfONS

rhar God provides over the power of dearh
irself. From a Biblical perspecrive, [he end
resulr ofsin is death. Thus, God's promise
of vicrory over dearh implicirly means that
God will provide victory over sin. Wherher
we recognize ir or nor, most of [he habirs
[har we see a need ro change are indeed
mar(ers of righr and wrong. The book of
James puts it chis way, "Therefore ro him
rhat knowerh ro do good, and doeul it not,
to him it is sin. "8 rf we are harming our
bodies, rhe Bible makes it very clear rhar
this is wrong and sinful. 9 AlI this may sound
like a guilr rrip, but rJle verse offers vicrory,
not guilc. God promises rhe vjcrory over
sin and dearh. Sa, if we recognize (har a
bad habit is sio, we have the promise (hat
God will give us the victory over rhat habir.
The pOiOl is rhar vicrory over addicrion
is a gjFr rrom God rhar is provided t1uough
Jesus ChrisL We can be rhankful (har vicrory js oUrS if we merely trust aur Heavenly
Father. Yes, you can rhank Him in faith for
rhe victory [har He has given you, even befim: you see the success in your life.
Tobe successful in the arca of lifesryle
dunge, it is nor necessary ro recognize rhar
every habir is a sin. fu 1 have poinred out,
however, in most areas of addicrion and
pervasive habir. we are ralking about sin. We
should not be afraid ro caII an area of our
life sin-if ir really is exactly (hat. The recognition rhar a behavior is sin nO{ only gjves
liS the prom ise of God's powet and vicrory,
bur also frees us from the dual deceprions
of "moderation" and "curcing down." The
Bible never gives justificacion ca concinuc
in sin. 10 It musr be cut our of the life, JUSt
as [ruly as the surgeon curs a Clncer om of
rhe body.

Daes Tapering offWork?

Is it possible ro conquer an addiction by
cureing down, or tapering off? Do you know
of anyone who has acquired vicrory over
alcohol, for example, by gradually tapering
off? r have never seen it occur. It must
occur suddenly, abruptly-whar is called
"cold rurkey." If, for example, a person was
ro begin by cutting down on alcohol or caffeine or nicorine use, ar. some poinc there
must be a complere cessarion of rhe acriv-

ity. The recognitjon rhat a habic is sin calls

for complete CfSSlttion of rhe behavior nolV.
A word ofcamion is jn order here if you
are addicred ro alcohol, prescription medications, or illicir drugs: qui[ chesc habits cold
rurkey under medical supervision. Severe
withdrawal symproms ofren occur.
Receiving che gifc of vcrory as provided
by God calls for an appropriace response.
The individual makes a final break wirh the
addicrive subsrance. Some may ask. "Would
sllch a response be effecrive for someone
who has aH addicron ro TV?" le cenainly
would be. You will find thac relevision is
llor necessary. h is amazjng how one can
ger along withollt it. Wichollt going inco
rhe detailed a pecrs of every addiccion, rhe
method is rhe same for aII addicriolls and
troublesome habits-make a dean break.
The recognirion chat a behavior is sin provides the srrongest motivat ion for such a
dramatic departure. And it is a key elemenr
in appropriating the suresr source of success: rhe vicrory that Gad has already provided.

Victory-A Gift from God

Whar do we need ro do ro receive rhis
gift of vicrory [rom God? Scripmre makes
a very simple scaremenr, cited in Figure 3.

"lf ye then, being evil, know how

to give good gifts unto your
child.ren, how much more shall
your F'ather which is in heaven
give good things to them that
ask bim?"

Matthew 7:11
459

PROOF POSITIVE

"Likewise reckon ye also

yourselves to be dead indeed unto
sin, but alive unto God through
Jesus Christ our Lord."

reI' how foolish and wayward we have beell

in the past, God 1S wiUing ro forgive, ro COI11plerely forgive, if we ask Him. If we are
WilliJlg ro have Him guide LIS in :1 rcformarion in our life, He is wiUing ro provide rhe
power for a roral and complere change. The
Bible says dur wiJlingness ro have a compiere reformarion in the life is a necessary
illgredicIH in rhe process of obraining forgiveness. 11
AFrer we have asked for cllC gifr of victor)' over an addicr10n, we need to consider
it do ne, as expressed in Figure 4.

Make No Provision to Fad

Romans 6:11
Figure 4
Chrisr explains in this verse how ro obr;lin gifrs from God. We are to simpl)' ask
Him, just as a child mighr ask his or her
eanhly farher for somerhing. aur heavellly
Facher is willing to give if we ask. Lcr us
ralk ro God as ro a friend a personal frielld.
Aher aU. He has a deep interest and concern for our quality oflife. The love of our
Maker knows no bounds. He undersrands
our problems betrer rhall we do. No l11:1r-

"But put ye on the Lord Jesus

Christ, and make not provision
for the flesh, to fultil the lusts
thereof."
Romans 13:14
Figure 5

460

We are called on ro be "dead,' or unrcsponsive ro rhe dreaded subsrance, and (O

be "alive " Of responsive tO God through {he
grace of Chrisr. lf a person is dead ta somerhing, rhere is no movemenr in that direction. An individual who is Iying in a grave
has no moron. no breath. We arc admonished ro be in dIis relation ro an addicrion.
There should be no movemenr in thar direcrion. 1 a.Iways teU rny patieIHs who desire ro quir smoking, "Onee you have made
ehe choice ro give up smoking and have
picked the rime you are going ro do it, ger
rid of alI of your cigaretres-do oot keep
any in hiding." For mOSt peoplc, keeping
che addicrive agems arollnd increases [he
agony of wirhdrawal. Whcn you are seruggling, k1lOwiog dlat (he objece of your desire-such as a cigarette-is jusr aTOund [he
corner, it can become more difficulr ro say
"no." Ifthe cigareues are removed from rhe
environmene, temptarions are more easily
resisted. Therdore, jf we accept. rhe Biblical perspective ofcOllnring ourselves as dead
to ehe sinfllJ habie, we will nor wanr ro makc
any provision tO Gil. The Bible speaks e1oqllendy of rhis subject as seen in Figure 5.
Thc Bible speaks of "rhe flesh", in con
rrasr ro "dIe spirje." "Provision for the flesh"
wouJd dlUS be eonringency plans to go back
inro the ways of sin (such as bad habirs and
addicrions) thac God has called us [O be free
from. The danger of making sueh pTOvision is funher illusrrared by the story of a
young Iad named Johnny. Before leaving
for school one day. his mother said, "Johnny,
aftec school roday 1 do not wane you ro go

DEALING WITH BAD HABITS ANO ADOICTIONS

swimmjng; come straighr home." Johnny
said, "Yes, morher. 1 will come suaighe
home." Afrer school, however, he arrived
!lome Iare. When he came ln the door, his
morher saw ehae his hair \VaS wer. She said,
"Johnny, 1 rhoughe 1 cold you ro carne
srraighr home from school. You are Iare anei
.yom hair is wec. You wenr swimmin oo , &dn'r
you Johnny?"
"Yes, moeher, 1 did."
'Johnny, why clid )'OU go swimrning
when I rold you nor ro?"
"Bec:luse 1 was relllpeeel."
"Johnny, why c1id you eake your barhing suir wirh you?"
"Well, morher, because I rhoughr 1might
be eempeed."
Johnny made provision for rhe fle.sh. I
have found ehae many adults do ehe s;une.
They "think rhey mighr be rempred" and
eherefore make provision ca fa il, and fajlure
is ohen (he resulr. On rhe orher hand, mose
wha possess a rrue [aieh in Gad wiJl foUow
me scriptural advice and implemenr rhe
mosr effecrive plan: ehey will make no provisions rhar willlcad ro f.tilure. Imread, rhey
COUI}( (he victory as rheirs and ehe habir ro
be behind rhem. AJrhough rempra(ions and
cravings will carne, rhey k.now rhat God teUs
rhem ro consider rhemselve.s dead ro rhe
dreaded subsrance, and the)' live in the assurance thar Gad Himself will help rhem
ta coneinue an Ulat parh.
One reason (har people make provisions
to fail is thar they are afraid of suffering roo
much during rhe withdrawal process. Remember ehat rhere are cenain habirs you
snould nOf try ro simply walk away from
wirhout professional help. The fact rhar
medical supervision of wirhdrawal is best
for an alcoholic ar drug addicr in no wa}'
e1iminishes rhe power of Gad ro overcome.
It is merely recognieion ehar rhese habits can
occasionally cause life-rhreatening wirhdrawaJ symptoms rhar can be prevemed by
close medic.1l care. Bur whar abolit habirs
mat do nor need medical supervision? What
abolit getting rid of rhe TV. sugar, chocoIare, ar meat? Is it reaUy necessary ro be
willing lO suffer in order tO get rid of such
addicrions?

Willingness to Suffer to Get Rid of

Addictions
Lee liS step back for a minme, away from
(he issues of habits and addicriolls, and
merely look at living rhe Chrisrianlife. Our
model for such a lifesryle is Jesus Chrisr himself. one who was fully human anei fully divine. Bur He laid His diviniry aside when
He carne here ro live an this earrh. The

"For verily he took not on him the nature

of angels, but he took on him the seed of
Abraham. Wherefore in ali things it
behooved him to be made like unto hts
brethren... for in that he himself hath
suffered being
tempted, he is
able to succour
[help J the'm that
are tempted."
Hebrews 2:16-18
BibJe sraees ehat Hc clid not use any power
in overcoming thar we do nor have. The
scriprures are also very plain in describing the
suffiring of Cluisc. One of rhe rexrs rhar
memions His suffering is found in Figure 6.
The rext explains rhar Jesus v./as fully
human, of rhe seed of Abraham (not of
Adam). In ,tiI rhings Christ was made like
His brerhren. He suffered, being rempred.
This rexr is nor referring ro rhe suffering
that He experienced an rhe cross, bm rhe
sllffering He experienced from being
rempted. Mase of us are aware of the physimI tofture Jesus endured (hrough rhe events
leading up ro His cruciftxion. But His suffering while being tempred is related ro the
fact thar He was made like unro His brethren. He inl1erired a fully human nature like
Abraham had, a.nd having such a narure He
was able to be tempted JUSt as we are.

Figure 6

461

PROOF POSITIVE

"Forasmuch then as Christ hath

suffered for us in the flesh, arm
yourselves likewise with the same mind:
for he that hath suffered in the flesh
bath ceased from sin; that he DO longer
should live the rest of his time in the
flesh to the lusts of men, but to
tlle will of God."
1 Peter 4:1-2
Figure 7

462

Jesus' desires were nor ahvays in harmony

with rhe Farher's will. A dassie example of
this occurred in the wilderness of remptarion. There we are told rhac after 40 days
of fasring, Chrisr, wirh His human nalllre,
was hllngry.12 However, He did nor sarisfy
chis hllman desi re when tempted, but rarher
ehose God's will and clid not make food for
Himself 13 As a humall, He waced for His
Father to provide for His needs rarher rhall
caking mauers imo His own hell1ds aod lISing His mirade-working divinity. So ic was
with every remptaron in the Savior's life;
He never gave in to human desires. In spice
of being repeared1y tempred, He \Vas innocem of any sin fui acr. lr is exeeedingly important ro recognize that ic was possible for
Christ ta fail. If rhis wcre nor the case, He
cOllld not fllHy have experienced temptation.
How did Jeslls have the strengt.h ro keep
from yielding ro cemprarion? He relied
upon His Facher's srreogch ro overcome. He
conrinually surrendered His will ro rhe Fa[her. No doubr, Jeslis sutfered in the wilderness when He chose to stay hungry racher
m:Ul relieve the hllman desire for food. No
doubr, on ocher occasions, Jesus ofcen suffered in going againsc His own desires to go
forward with God's desires for Him. Chrisc
said, "1 do not my own wiU but rhe will of
Him who sem me" (John 6:38). This declaration reemphasizes che fact thar Jesus'

desires and His Father's wilI were not always

rhe same. Where rhey difTered, He chose
ta do His Facher's will and it resulted in suffcring. Perer, one of His dosest fo IIowers,
wroce furrher abour Christ's suffering as
qlloted in Figure 7.
Since Christ sufTered in the f1esh, we al50
should expect ro suffer in aur bodies and
minds as we gain the victory over addiccion.
Althollgh rhere are rare occasions where
God takes away al1Y struggle in dealing with
a particular Iubit ar addiction, for mosr of
us there is no victory withollt suffering.
Many Chrisrians have faltered on rhis poinc
of suffering.
Tragedy stfuck Jane Johnsoo. 14 Ar the
yOllng age of 44 she suffered her first hean
aerack. The prospecrs were even sc.1rier for
her rhan mosr. YOll sec, Jane had her chil
dren later in life, so she still had yOllng chil
dren at home. The heart attack mus threat
ened not only her fllwre but that of her
yOllng children. 1 worked witll Jane in rhe
hospiral to fry ro ensure th:1C she would
make an uneventflll recovery, and also to
try to prevenc any future hearr attaeks. One
of my first lines of insrrllcrion was to make
sure chac Janc, chen a smoker, underscood
chat she needed ta put smoking behjnd her.
I informed her how stopping smoking was
essemial to prevenr anorher heart anack and
funher hearr damage. 1 was gratified that
she did nor smoke during che week rhac she
was in che hospital. This was nude easier
because our hospiraJ, like most, has a 00'
smoking poliey. When 1 discharged J:U1e ar
rhe end of that week, sbe !efe as a nonsmoker
with a new lease on life. One weck withour
smoking was enough ro undergo aII of rhe
wichdrawal symproms and eonquer d1e addiction from a physiologic srandpoim. AU
she had ro do was continue on tbe good
course she was ono
Six weeks later Jane was back in my office for a follow-up appoinrment. 1 was
surprised ro leam dut she began smoking
again afeer she Ieft the hospiraJ. She stiH
had a psyehological adeliccion. 1said "Jane,
you have small chiIdren. YOll cold me whar
yom plans are for them, al1d how much yau
wanr co see them be sllccessful in life. How
are chey going ro be sllccessful withour you?"

DEALING WITH BAD HABTTS AND ADDICTIONS

She asked. "What do you mean?" 1 said,
"Your smoking will prevent rhem from having you around much longer. You ace rea11y raking a risk." She answered, "1 know I
am." I {hen reviewed with her the damage
{hat smoking was doing ro her health, and
assured her that {he Locd would give her
the vietory if she put her truSt in Him. r
fjna1ly said, "Jane, 1 know you are a C1uistian. Telllne why you conrinue tO buy cigare[[es when you know {hat God does not
wanc you to smoke? Pm your truSt in Him."
She said, "Or. Nedley, 1 have put my trust
in Him. Buc 1 wiU rell you why J haven't
quit smoking. It is because God has not
raken away m y desi re for cigaretres. Because
God hasn't taken away the desire, 1 am continuing ro srnoke."
Jane expecred mac me Lord wou.ld somehow corne in and perform surgery on her
wiU, taking away hec desire 50 that she wou.ld
never want ro smoke again. She was going
to continue tO smoke umil that happened.
Now 1 know of cases where God has sometimes done this very thing. However, I
know of many more cases where God heIped
someone duough rhe diff'iculr process of
saying "no" and gave them vicrory in the
midsr ofsuffering [hrough rhe pains ofwithdrawaJ. If we are not willing to undergo
some suffering from rhe withdrawal symptoms of an addiction, we will not have victory. We must take the fim step. God will,
rhrollgh the hand of faith and the power
thar He gives us, then give us the complete
victory. 1 shared {hese texts about sllffering
wirh Jane and I think she saw it in a new
[iglu.

Some Suffer More than Others

{ live in Oldahoma. in rhe heare of rhe
"Bible belt." so 1 have heard comments like
Jane's many times. Many Christians approach an addiction problem expecting ro
conquer it wirh linie or no effort an theiI
parr, and then wonder why they meet wirh
failure. In view of these pervasive sentimenrs, 1 wanc to be sure that this issue ls
complerely dear: not ali who conquer an
addiction suffer ta the same degree. 1 have
seen those who nave won the vicrory with a
minimum of difficulry and suffering.

The Lord takes away the desire from

some more quickly than orhers, which 15 a
fulfillment of anorher scriprure text abolit
tempt:ltion. It statcs mat God wiJl not aJlow us ro be rempted wirh anythlng rhat we
cannot bear, ar beyond what we are able ro
roIeratc. 15 Those who, for perhaps some
unknown reason, would not be able ro tolerate strong withdrawal sympeoms (or perhaps even any ar ali) will have the symp{ams and desires taken away by Gad. The
Lord removes or reduces thc desire and
makes ie possible for them ro gain the victary. Each of us can be assured that Gad
will nor allow us ro go throllgh more d1an
we can handle w1th His heIp.
However, even those rhat have it apparendy easy in deal ing with one addiction may
face a differenr stfllggle with another addiction in which God allows them to sufler
ro a greater degree. Gad does not generaJly
remove His people from difficulties. After
aII, the Bible teaches us that difficulties actually help ro deve/op Chrisrian virrues, as
we t(ust Godin the midst of aur hardships.IG Therefore, God's method ofworking i5 ro help us in the midst of challenges
and difficulties rather rhan by delivering us
from them.

Examples ofSuffering Which Led to

Victory
Bible history is replete wim examp.les.
God did not prevenr the Egyptians from
cornering !lis people ae the Red Sea, bur He
brought the Israelires throttgh that massive
bod}' of water. Gad did not keep Daniel
out of rhe lion's den, but brought him
throttgh the experience. Oaniel's [hree
friends were broughe through rhe fire. The
list goes on and an, bur rhe poim is rhat
God's purpose is nor necessarily ro keep us
from tempeaeions and difficu.lties but ramer
ro give us the power ta make it throttgh those
hardships wiehou{ falling. 17 El1ch experience

gilles us a strollgerfaith in God.

Let us now look at a dOcllmented experience of a person who was f.'1ced with a
deeply entrenched habit, yet was finally able
ta gain a (Oral ;md permanent victory. The
habit was one that many can reiate ro:

463

PROOF POSITIVE

"1 have thought for years that 1 was

dependent upon a meat ~Iiet for strength....
It has been very difficult for me to go
from one meal to anotber without
sufferilDg from faintness at the stomach,
and dizziness of the head.... Eating meat
removed for the time these faint feelings.
1 therefore decided that
meat was indispensable
inmy case."
Figura 8

addicrjon ro earing mear. The lessol1s

learned from rh.is experienee should be helpfuI to anyone wirh chis ar orher difficult
habi[s or addicrions.
There is an increasing l1ulIlber of people
IOday who have became aware of [he healrh
risks of earing mear. The media publicizes
public healrh srudies rhat implic.re mear as

"1 suffered keen hunger. 1 was agreat meat eater. But

when faint, 1 plaeed my arms across my stomaeh and said:
'1 wiU not taste a morseI. 1 will eat simple food, or I wili
not eat at aII. ~ Bread was distasteful to me. 1 eouM seldom
eat a pieee as large as a dollar. Some things in the (health]
reform 1 eould get along with very well, but when ] carne
to the bread 1 was especially set against it
When 1 made these changes 1 had a special battle to
fight The first two or three rneals, ] eould not eat ] said
to my stomach: 'You may wait un tii you ean eat bread.'
In a little while 1 could eat bread, and
graham bread, loo. Tbis 1 eould not
eat beforej but now it tastes good,
and ] have had no 105S of appetite."
Figure 9

464

a cause of cancer, hearr disease, and orhcr

diseases. Many are attempring ro remove it
from rheir clicI, and somc are discovering
rhar rheir apperircs cann.ot be sarisF.ed withOut it. Some have even experie.nced whar
may be rermed wirhdrawal symptoms.
Even rhough she was convinced rhar
me~r was hannflll, Ellen Whire, whase commenes an healr.h have appeared in many of
rhe chaprers in rhis book, had difficulry in
her persona1life e!irn.inaring ir from herdiet.
Prior ta her convicrion rhat she needed tO
break free from mear earng, she had come
ro a conflicring conclllsion: she could not
ger along wirhout meat. She kept a journal
as she wenr rhrough the batde. Her statemene in Figurc 8 expressed feelings rhar she
could nor slIrvive withollr meat. 1B
Some would labei this a c1assic case of
psychologica.1 addiction if not actual physical dependcnee. Regardless of whar we caII
her mear earing, it was withollt question a
firmly entrenched habit thar secmed Jlecessary ro her. Even with meat in her diet, she
was not in good healrJ1, bur the faine feelings and dizzincss were removed. Thus,
marrers became exrremely difficliit when she
came to the eonclllsion rhat meat was dallgerous ro her healrh-and she knew rhat
she had ro give ir up. The baale lines were
ser, for her emire experience tald her that
mear \Vas neecssary, in facr, "jndispensable.'
Nonerhe.less, she followed her convicrions
and left off meat. She recorded ilie inrensiry ofher srruggle, as quored in Figure 9. 19
Ellen Whire acknowledged her grear
dependence on meat. She freely admirred,
"1 was a grear meat earer." Those who have
a firmly enrrenched habir or an addiction
of anorher kind couJd perhaps make a similar sraremenr, subsrituring your own particular problem for the word "meat eater."
She endured rhe feei ing of fainrness, ancl
resolved ro go hungry uneil her stomach was
ready ro accepr bread, which was disrasrefuJ ta her, in rhe place of mear. She knew
rhar bread was a healthful food, panicularly
bread made from whole grain graham Rom,
bur she had no apperire for ir. In rhis bartJe,
she not only auempted ro eliminate the
desire for ~~ food rhar she loved, bucat rhe
same rime she endeavored ro generare a raste

DEALING WITH BAD HABITS AND ADDICTIONS

for a food that was distasteful ro her. Shc
described ilie experieocc as a "special battle
[O fight." The complere vicrory, which includes the loss ofde-si re for the harmful substance, was not instaruaneous--ir rook time.
Gradually, her apperite changed ro the poiJH
where she nor ooly rolerarcd bread, but it
t3sred good. She recorded rhe improvement
in her health after her dicrary change with
rhe words shown in Figure 10. 20
Her health was markedly improved. She
was using fruits and vegetables liberally; rich
foods were no longer part of her diet. The
former faint aud dizzy feelings were gone,
her srrengrh was improved, and her appclire was satshed. Furrhermore, rbe food
tasted better than ever. Her suffering resulted in ali of these positive effeccs. Enduring psychological and physiological disrress led ta wonderfuJ improvemenrs, greater
than she expected.
Was this radical change permanent? Was
she tempted (Q go back ro rhe old eating
hahits? Her answer is quoted in Figure ll.ll
She wroee this six years aner she changed
her diet. The change was permanent. She
had no desire ro turn back. She "refused to
yie1d to taste." Sbe acknowlcdged iliat ilie
Lord was glorified by her vicrory; it was the
power ofGod in her life {hat enabled her ro
win the conflict.

Choose }'our Suffering-Some Now or

Much More Later
This story is an encouragemeJH ro alI
who would conquer any addicton ar deeply
ingrained habic. The actual advaruages of
conquering a deleterious habit are onen far
heyond any theoretjcal knowledge ofpotential benehcs. Thus, the suffiring that must

be endured in orda to overcome isfitr less than

the sttffiring that we wilf ultimately experience ifwefitil to make a changefOr the bmer.
The severity and ilie duration of suffering
may boeh be of greater magnitude. Furthermore, the benefits and jay of the new
improved lifescyle far aurweigb the "bcnefits" or remporary "good fcelings" that are
experienced by indulging in a harmfuJ habit.
Nonetheless, evcry experience in conquering addiction and habit is a batde ro be won.

"Sinee the Lord presented before me in June,

1863, the subjeet of meat-eating in relation to
health,I have left the use of meat.... We use
fruits and vegetables IiberaJly.... My health has
never been better than for the past six months.
"My former faint and dizzy feelings have Iert
me.... We have no meat, eake, or any rich food
upon our table.... My appetite is satisfied. My
food is eateu with a greater
relisb than ever before... 1
have more strength than 1
have realized for years."

The barele is more intense for some and less

intense for oiliers. Trust in God and willingness ro suffer and pour atit rhe soul before God wiU lead ro vierory. The more
intense rhe barde, rhe sweeter [he vicrory.
Thank Him for rhe vicrory, and resolve thar
rhere will be no tlIrning back. You will feei

Figure 10

"1 have not changed my eourse a particle

since 1 adopted the health reforma 1 have not
taken one step back sinee the light from heaven
upon this subject first shone upon my pathway.
1 broke away from everything at onee--from
meat and butter.... When making these
ehanges in my diet, 1 refused to yield to taste
and let that govern mea ShaU that stand in the
way of my securing greater strength,
that 1 may therewith glorify
my Lord? Never!"
Figure 11

465

PROOF POS1TlVE

"The Christian's strongest

temptations will come from
within; for he must
battle against the
inclinations of the
natural beart."

Conquering Appetite

Figure 12

so much better (han you feel oow. You will

be so thaokful ro Gad for what He has accomplished.

The Strongest Temptfltions

In rhjs chap(er we havc seen that Chrisr,
our Grear Example, because of His human
nature, had desires (har were not always n
harmony wirh His Father's will. Ellen White

"Temptations to the induJgence of

appetite possess a power which can
be overcome only by the help that
God can impart. But with every
temptation we have tbe promise
of God that there shaU be a way of
esc8Ipe.
"Why, then, are so many overcome? It is because
they do not put their trud in God. Tbey do ROt avaiJ
themselves of tbe means provided for their safety.
The excuses offered for the gratificatioD of perverted
appetite are therefore of RO weight with God."
FigtJre 13

466

poimed om that the most critical batdefronr

in {he war is w bring our will imo harmony
wirh God's will. Her insights are srated in
Figurc 12. 22
The mosr difficulr banle that we each
face is an internal banle-a banle againsr
the inclinatioJls and desires of our natural
hean. The Holy Scriprures speli alU rhat
Clusr "was in ali poinrs rempted like as we
are, yet wirhollC sin." (Hebrews 4: 15). He,
roD, was tempred from within. just as we
are. Because He is rhe Savior of mankind
and Dur Example, ir was necessary thar He
experience the same temptations rhar we do.
He overcame ali temptation and thus He
can gve LIS rhe victory in cvery aJca of our
lives. He is willing ca besrow that vicrory
upon each of LIS if we merei)' reach our and
accept the gift.

We need divine power in our lives to

overcome some of rhe mosr subtle temp(ations: strong apperires for foods thar mosr
people consider wrally acceptable, bur are
not iJl harmon)' wirh God's will. This is
whar Jeslls needed when He refused ro make
food for Himselfin the wilderness of remptaron. This is what we need when rempr.ed
w indulge in any food or orller habit rhar is
nor good for us. Figure 13 speaks directly
w this point. 23
SalIle people who do nor even believe
in God may be able ro walk away from
remptarions to indulge apperire. They may
Stop smoking, ar earing harmful foods, or
using caffeine "an rheir own"-by rheir own
willpower. However, 1believe the statemenr
we have jusr looked at applies ro ali; namel)',
ir is hmnanly impossible ro gain full control
over appetire in nIL ir.s ftrms unless we. have
God's power. One who does not avail hil1lself of God's power lllay gain many apparent victories over apperire, bur ulrimately
rhere wil! bc orher barties rhat he loses because he lacks divine strength. The good
news is that God will help USi yet, ro receive that help we must avail ourselves of
His power. We have already looked ar (he
scriptural record of one of Christ's lllOSt
powerful remprarions on rhe point of apperire. 24 He ca1led on the Word of God ta

DEALING WITH BAD HABITS AND ADOICTIONS

gain rhe victory. Gad will provide a way of
esc.1.pe for every remptation. Let us then
stop oflering excuses for aur bad habits and
addicrions. Believe me, as a physician, 1
have heard many excuses for continuing
uohealthful pracrices. However, God acceprs no such excuses. He has promised ro
provide rhe power ro overcome.

Christ, Our Example,

Overcame the Temptation
to Indulge Appetite
The indulgence of apperire may sometimes seem a marrer of liule import. As 1
have already poinred our, by determined
self-effon sOl11e people can bring areas of
rheir life inro bener control wichollt fully
conquering the ryranny of apperire. For
example, a person may leave ofI cenain
foocis and thus Iose weight or improve the
cholesrerol and blood pressure, yer stiH have
oeher areas of apperire rhar remain
unsubdued. Some people may see no need
eo gain the vicrory over every aspecr of appecire bec.1.use mey have already reached
meir health goals. However, few reaJize rhe
far-reaching scope of apperire. Apperire
unconquered by God's power will ultimate1y
cause devastaring consequences. Indulged
apperite's far-reaching effecLS on mankind
are described in Figure 14. 25
"Indulged apperiec" in this context refers ro any human craving or desire [har
leads us ro go contrary ro God's wjll ro sarisfy. Such indulgence carries a heavy priee;
rhe craving is saeisfied ar the expense of our
hody and saul. Unresrrained apperi.re provides rhe foundaeion for many of the world's
probJems. Wherher ir is an apperire for
money or sex, land or power, or merely for
food-mosr of rhe world's grearesr con~licrs
can be rraced to seekillg ehe fulfillmenr of
rhese desires. Ir is true in aur personallives
as well. Many of me problems we face wim
our heaIrh ar among family members or ar
our workplace can be traced back to indulgence of apperire in some shape or fashion.
Thus, gaining full control over appetire
would resolve many of our personal difficulries and wouJd prevenr many of rhe prob-

"Satan comes to man as he carne to Christ,

with his overpowering temptations to indulge
appetite. Re well knows his power to overcome
man upon this point....
Entire cities have been blotted rrom the face of
tbe earth because of tbe debasing critnes and
revolting iniquity that made them a blot upon
tbe universe. Indulgence of appetite was the
.;.
foundation of ali tbeir sins.
..
Througb ap,petite, Satan
controlled the mind and being."
,

Figure 14

lems of suffering humaniry. The power of

apperire and our Lord's power ro deliver are
further illusrrated as we look once again ar
Christ's wilderness conflict in Figure 15. 26
We are gready encouraged to overcollle
apperire when we consider rhat Cllrist endured a fase for six weeks before being
eempred. In spire ofHis physical weakness
and intense hunger, He was sriU able ro overcome (he remptarjon. The fuI! significance

"The strength of the temptations to indulge appetite

can be measured only by the inexpressible anguish
of our Redeemer in that long fast in the wilderness.
He knew that the indulgence of perverted appetite
would so deaden man's perceptions that sacred
things could not be discerned. Adam feU by tbe
indulgence of appetite;
Cbrist overcame
by the denial of appetite.
And our only hope of
regaining Eden is
through firm self-control."
Figure 15

467

PROOF POSITIVE

Falling Back in the Struggle

"If the power of indulged appetite was so strong

upoo the race, that, in order to break its hold

tne divine Son of God, in man's behalf, had to
endure a fast of nearly six weeks, what a work is
before the Christian! Yet, however great the
struggle, he may overcome. By the belp of
that divine power which withstood the
fiercest temptations that Satan could
invent, he, too, may be entirely successful
in his warfare wtth evil, and at last may
wear the victor's crown in the
kingdom of God."
Figure 16

of this is described in Figure 16,21

Chrisr has provided rhe power we need
to overcome every aspeCt of apperire. Consideriog char rhe rewards of o;"ercoming are
even grearer than expecced, Gad is noc asking U5 ro give up anyrhing thac is nor in our
besr interest to rerain. He has blessings in
store for us rhar are beyond our imaginaflon.

"If you have made m'istakes, you

certainly gain a victory if yOD see these
mistakes and regard them as beacons of
warning. Thus yOD turn
defeat into victory,
disappointing the
enemy and hODoring
your Redeemer."
Figure 17

468

Some who gain che viCCOly over an addicrion for a rime hold fasc w cheir conviction ulfough che power of God but then
f.,11 back imo their old habic. In mosc of
such cases, cheir focus did nm remaill on
God and che vicwry thar He had provided.
Ac rhe poinr of a fuilure, rhe rendency is ro
become discouraged and say, "1 have been
defeated. It did nm work. It is nm for me.
I am going to give ir aII up." Such an altitude musc be avoided. Fim, realize rhat if
yOIl slip, yOll have nor undone aII rhe
progress you have made. Second, recognize
rhac rhe same God is rhere to help you begin a pattern ofsuccess again-righc ac cllat
point. Third, realize rhar you can Icam
by your mistakes. Failure sholild be regarded as beacons of waming as stated in
Figure 17. 28
Analyze rhe mistake-derermine why
and how it happened. Ask yourself, "How
did I Iose my focus on God?" or "Why did
1abandon my faith in the screngrh God bas
given me?" If rhe experience is viewed as a
beacon of warnjng, then your resisrance ro
another f.,ilure will actually be increased.
Your long-term success will be enhanced
because you have f.1iled, only ro rise up again
in God's power on che road ro success.
For rhose of you rhat have powerful
physiologic addiccions ro substances like
tobacco, alcohol, prescriprion medications
such as Valium, ar illegaJ drugs, I would
again remind you of rhe value of medical
he1p. Although not vital for tobacco addiccion, it is for rhe ochers on the lis!. In addirion ro chat professional assiSr<ll1Ce, I suggest that l'au read Chaprer 16, Pat( Ill, an
kicking rhe tobacco habit. There you will
find ten sreps ro "kick che misery out of
kicking ilie habir." These steps are designed
ro provide help in minimiziog your wirhdrawal symproms. They include physical
exercise, nurrirlona1 helps, and mher imporranr lifestyle eJemems. In fact, manyexperienee only slight wirhdrawal symptoms and
in some cases none at ali if rhey adhere carefuUy ro those guidelines. Those wirh psychologicaJ addictions and orher powerful
habits such as television viewing may also
find those ren sreps of great vaJue as rhey

DEALING WITH BAD HABITS ANO ADOICTIONS

break free from the behaviors chac have hdd
chem in bondage.

AII Things are Become New

One final scacemenc from Scriprure,
quoced in Figure 18, provides a ficcing conc1usion co the spiritual emphasis of chis
chapeer.
This admonition meets me needs of ali
ehose who wanr ro conquer an addiccion.
By allowing Chrisc to rule in our heam, ali
ehings will become new and t!le old life is
hiseory. Lee us eake hold of Chrise as our
own and rcad about Him in His Word.
Srudy His life daily. Claim viceory in Him,
the viccory that He has aJready won. Do
noe make provision 10 fail, because eruc f.1ieh
will noc make such provision. Through
God's grace, we can overcome every addic(ion and every deleeerious habiL Wc will
reap (he benefics ro che glory of God
ehroughouc our liferime on this earth and
in the ljfe co carne. Yes. (here is a special
promise 10 chose who overcome (he addictions, bad habics, and croubles of chis life:
"He chac overcometh shall inherit aU things;
and 1 will be his God, and he sha.ll be my
son." Revdaeion 21:7. those that over-

"Therefore if any man be in Christ,

he is a new creature:
old things are passed away;
behold, aH things are
become new."

II Corinthians 5:17
Figura 18

come wilJ enjoy eternalljfe with God aud

with ehe saints, a Ijfe chac you and 1 cannoc
even imagine. The Holy Writ says, "Eye
hacb noc seeo, nor ear he-ud, nei(her have
encered inco me heart of man, rhe ehings
which Gad ham prepared for them (hac love
him," 1 CoriJ)(hians 2:9

RefereluesAdtlirriol1: Sledmm's Electronic Medical Diclionary version 3.0 (CDROM). Based on S/rtl"liw's Medical Dictiol1llry-26'~ "didoll. Williams and

Wilk.in~,

1996.

A.ddiclioll: Frid JP. editor. Dor/muls Medic,,1 //IustTllted MediCiI/ DiClion12ry-28h cdilioll. PhiJadelphia, PA: WR Saunders Company. 1985 p.

Romans 6: 1-2.

2 Chronidcs 7: 14. TIu Holy Biblc. AUlhori7.ed KingJames version.

t2

LlIkc 4:2. The Holy Bibk. AUlhorizcd Killg)amcs version.

1)

LlIkc 4:3-4. Tbe Holy Bib/t'. Aurhorized King Jaml'S version.

14

NOI hrr TY!III "''''It:.

1 Corinlhians 10: 13. 1/u Hol)' Biblc. AulIlOrized KingJames version.

29-30.
j

Schu~lcr CR, Kilbey MM.

Prevenuon of Drug Abllse. In:

USI

JM,

Wallacc RB. edilOrs. MfL'<C)'-Rosnlall-usr Public HellltlJ Il11d Pmmuivr

Mrdi{int-/3"' cdi/ion. orwalk, Cf: ApplelOn and L1ng(' 1992 p. 769.

773.
JalT" JH. Drug Addiclion :Ind Drug Abuse. [n: Gilman AG. Goodman
LS, CI al, cdjlOrs. Coodmlllllmd Ci/mlllls TIu Pblrmlllc%gic Bmis 0ITlJeTIIpeurics-7rh cdilioll. New York, NY: MacMilh\ll Publishing Comp'Jny,
1985 p. 532540.
4

\ No/ his ~ol nonl(

6

I Corinlhians 15:57 TIu Holy Bib!t'. AUlhorizcd KingJames version.

Romans 6:23. Thc Holy Bib!c. AUlhorizeJ KingJames vc:rsion.

James 4: 17. Tlx Holy Bib!". AUlhorized KingJames version.

I Corin lhians 6: 18-20. 3: I ~ 17. TIu Holy Bib!c. AUlhoriud King Jame
verSlOn.

nu Holy Biblt-. AUlhorized King James version.

10
II

16

June 1:2-4. TI,, Holy Bib!e. AUlhorize.d King )arnes version.

17

)ude 24. Tlie Holy Bib!t'. Alllhorized King )ames version.

18 While EG. Experience. In: Spiri/llol Cifis (Volume 4a). HagerslOwn,

MD: Review and Herald PubJishing Associalion, 1864 p.153.
I? While EG. Chrislian Tcmperance. In: l't.<timollies for /IJ~ OJllrcb (Volume 2). Nampa, 1D: Pacific Press Publjshing Associalon, 1868-187\ 1'.371.

White EG. ConrroJ of Appe[ile. In: COllnseu 011 Din ond Food,.
Hagemown, MD: Reviewand Herald PublishjngAssocialion, 1938-1976
p.482-483.

lO

While EG. Chrisliar1 Temperancc. In: Testimoninft, Iht: Cburr:b (Volume 2). Nampa, ID: Pacific Prcss PlIbLishing Associarion, 1868-1871 p.37\.

li

While EG. "Icmplcd in Ali PoiJlls. In: Biblc Echo (1886-1913), December 1892 p. 1. FOllnd In: E!len G. While Estare. TIu Pllblish~d W,i,ing, 01Elim C. IV!Jiu. Version 2.0 (CD-ROM), 1995.

il

469

PROOF POSITNE
While EG. Conlrol of Appeli!e. In: COIIIIU/s Ofl Diri
Food;. Hagcrstown, MD: Revicwand Herald Publishing Associadon, 1938-1976 p. 154.

li

I1l1d

!1

Lukc 4:2,3. TIJr Holy Biblt:. AUlhorized KingJame

version.

WhilC EG. Pawlls as Rcformers. In: ,',/imollil!S for

C/JlIrch (Volume 3). Nampa, ID: Pacific Press Pub
lishjng Associ:uioo, 1872-1875 p. S61.

!)

tIJ~

470

Whjle EG. Control of Appelile. [n: COlltlSt:is 0/1 Din

Hagcrstown, MD: Review <Ind Herald Pub
li",ing Associalion, 1938-1976 p. 167.
26

afld Food;.

White EG. COlllrol of Appelile. [n: COl/flU/s 011 Din

HagerslOwn, MD: Rcview and Herald Publi hing Associalion, 1938-1976 p. 167.
27

afld Food;.

Whil" EG. Taiem. [n: ClJrists Obj~~/ Lmom.

Hagerslown, MD: Reviewand Herald Publishing As
socialion, 1900 p. 332.
!

CHAPTER NINETEEN

UTRITION
ANDTHE
ENVIRONMENT

eemingly overnight, the issue

vaulted [rom a marter of personal
health [O an issue of social jusrice
and respollsibiliry. Cigarerce smoking had loog been recognized as a killer.
Heart disea.~e,lungcancer, and emphysema
were well-known resuhs of [he robacco
habit. However, when rhe dangers of second handsmoke becaJUe more widely appreciatcd, perceptions changed. The decision
co smoke was no longer just a personal decision. but carried consequences for coworkers, family members, and orher "innocenc bystanders."
The awareness of [he social costs of
smoking caused smokers ro reassess their
habic. Pregnant women "kicked the habit"
when they recognized rhey were purring
[heir unborn children ,It risk. Parents broke
free of [he addicricn when they found ic was
linked ro their children's frequen[ respiracory problems and othcr maladie.~. Husbands aud wives walked away from the [0bacco habit when they realized rhey were
purting [heir nonsmoking spollses at risk.
Although millions of smokers now recognize rhar their habit has social implications, few individuals recognize [he COSt dlat
sociery bears from chcir dieta'] choices. A
wealth of evidence asserts that our food
choices have far-reaching consequences 00

our neighbors, aur na[ion, and rhe world.

In rhis chapter wewill examine soroe of this
evidence. We will see thar rhe optimal diet
from the standpoin[ ofsocial consciousness
is aJso [he finest dier for individual health.
This optimal eliet is rhe total vegetarian diet.
Its far-reaching benefits are described in
detail throughour this book.

The Global Jncrease in

Meat Consumption
Historically, in aJmosr every culture, raisillg lives[Ock was ioregrared wich crap farming in a way thar provided for a long-term
sustainable relationship. The twenrieth
cenrury's rapid rise in meat consumption bas
upset chis balance and is now exposing our
world [O a hosr of environmental thrtats.
A large portjon of ilie world popuJation
consumes very litrle meat. But when a
oation's standard of livi.ng increases, meat
consumptiol1 generally also increases.
Nadakavukaren poims ouc that the citizens
ofmiddle-income COUlltries are joining r!lase
of wealrhier nations i.n shift.ing to "a greater
reliance on animal produCtS."1 One of rhe
reasons for t!lis is thar mear-eating has bccome an international standard for affiuence.
Worldwarch's Lesrcr Brawn provi.ded ooe
glimpse imo this worldwide phenomenon:

471

PROOF POSITIVE

INCREASE IN MEAT PRODUcnO

Worldwide meat production
5

300% increase

3
2

o
1950

1990

Figure 1

LIVESTOCK REQUIRE ABUNDANT

AGRICULTURAL LAN
. Tbey eat buge amounts of grain, requiring an
enormous amount offarm land to produce it.
. They require huge amounts of graziug laud.

Figure 2

AMOUNr OF GRAIN TO RE A
MEAT-EATING WORLD POPULATION
The grain needed to feed a world
populatio'D of meateaters would be
equal to 150 percent
more than aU the
current global
grain production
used for aII purposes.
Figure 3

472

Last year, wllen asked by il reporter if

living conditons were improving, a Chinese
villager responded, "OveraJl, Iife ha gotten
much bener. My family eats meat maybe
four or hve times a week oow. Ten years
ago, we never had mear."l
Indeed, more and more developing
cOllnrries have now become able 10 afford
.mear. As a reslIlt, meat-eating has becomc
a global phenomenon. Meat production has
stcpped up to meet tlle demaod, as shown
in Figure 1. 3
This large rate ofinctcase is conrinlling.
Such il rrend raises the question as (Q
whether our e,urh can sustain a meat-based
diet for this increasingly larger portion of
the world's inhabitaJlts. Raising livestock
require.~ mllch agriculturalland as explained
in Figure 2.
If rhe enrire world population ate a mearbased diet similar ro the average American,
it would be necessary for world grain. production ro skyrocker, as shown in Figllre 3. 4
This starding esrimare was calculated by
Worldwarch, one of the mosr respecred organizarions deaJing wirh environmentaJ issues. For those nor familiar wirh rhis "rhink
rank,' Worldwatch is an independent. 110nprofit research organizarion thar serves as a
resource for world policy makers through
irs extensive research on global problems.
1r is fllnded by United ations agencies and
mher privare foundations.
Howcver, for some. rhe data from
WOrldw;ltch is nor starding enollgh. They
cire orher starisrics thar make Worldwatch's
estimares look very conservative. This COI1rroversy provides an appropriate backdrop
for an important digression. Throughollt
rhis chapter, as a rule, ali of the figures thar
1 quore are qure conservarive. As a resulr,
some may feei rJ1at 1 am not making the
case strong cnough regarding [he powerful
impacr mar dietary choices have on our
envronmenr. However, ironicaJly, 1 rhink
this chaprcr actuaJI)' makes a stronger case
because of rhe COl) crvarive n<lture of rhe
informarion cired. 1have arrcmpred tO use
only well documenred dara from replltable
scienrists, agencies, and even food prodllcer rhemselves. Yes, orhers are arguing that
the siruation is far worse than 1 have paiJlrcd

NUTRITION ANO THE ENVIRONMENT

ir, and rhar Illay be true. However, even
the conservative esrimates J share provide a
compelling reason ro soberly eX<\Inine aur
eating habits.
From my caurious review of the daca,
rhe rise in worldwide meat consumprion
undoubredly severely rhrearens aur environment. Scholarly papers that do nor even
deal with this growing threar lend tacit support ro it. Consider, for example, the work
of che renowned epidemiologist, Sir Richard 0011. This esteemed researcher rook a
frank look at t11e environmem in his artide
enrided "Health and the Environmem in
the 1990's."5 Surprisingly, DaU did nor put
popular Jay concerns abolit roxic exposures,
sucb as pollured air and water, at rhe cop of
his lisc. His main concerns are listed in Figure 4.
Population growth is considerecl by
many orhers beside Or. DaU as one of rhe
mosr critical environmenral issues. In aII
likelihood, however, popularion growth
would nor be anywhere near c!le problem ir
is, were it nor for individual dietary choices.
This brings us back ro rhe issue of mcarbasecl earing patterns. Consider this sobering (.,cr: rhe demand for mear in industrializ.ed countries !las shifted rhe economic balance even in developing n:uions. Pressures
now exisr in many of the less afI-luenr counrries ro raise animal producrs for export ro
more well-to-do nations. Even wirhin their
borders, dierary choices are posing problems
for rhe developing narions that are the hardest hit by popubtion growrh pressures.
When weaJchier individuals in rhose narions
dem:lnd animal proelucrs, land is lIsed for
gra'ling and growing feed for livestock rhar
would otherwise be availablc ta feed ilie
poor direcrly wirh planr sources of nurrition. G
Based an what we have already examioed, it should be apparenr (hat a
popularion's need for food can be severely
srressed if a large porrion of rhar popularion demands a mear-based dier. Relarively
small changes in meat consumprion can
make a significant global impact. Earing
les animaJ producrs would go a long way
ta il)creasing world grain srores. Lesrer
Hrown of Worldw;}rch has calclliared rhe

SIR RICHARD DOLL'JS

MAIN GLOBAL CONCE S
Poverty
Pressure of population growth
Production of
greenhouse
gases

Figure .4

SWlTCRING GRAIN CONSUMPTION

FROM LlVESTOCK TO PEOPLE
Livestock consumes 630 million tons
of grain worldwide.
Reducing meat eating by 100/0 would
red~ce tbe grain consumption by the
same percentage, or 63 million tons.
[f this

reduction in consumption would be made

available fO.r direct human consuO!Jlption, ilt
would feed the growth in world population
for more tban two years.
Figure 5

benefic of reducing mear earing by 10 percent, shown in Figure 5. 7

The rise in worldwide mear consumprion has produced a cascade of consequcnces. Grearer dcmand for mear increases
rhe demand for Livesrock feecl. This, in rurn,
pressures the world's fanners ro achieve
higher yielels from cheir fields. Such pressures may leacl rhem ta adopt intensive
farming pracrices rhar may CJuse irreversible damage ta [he earth. 8 Furrhermore, ar.remprs ro misc an inordinare!y large number of animals in a given area can damage
rhe environmenr. Consequences can include

473

PROOF POSITIVE

THE ROLE OF FORESTS

Protect top soU rrom erosion
Are vital sources of oxygen
Moderate and regulate
cUrnate
Prevent floods
Recyde and purify our water
Are homes for millions of
plants and animals
Figure 6

LOSS OF TROPICAL FORESTS

Tropical rain. forest losses were 28 million acres
per year (1982 estirnate).
An ,t'ropical forest loss was 38 milIion Heres per
year (1995 estimate) - equal. to twice tbc size
of the 'nation of Austria.
']n Central and Soutb America, 5 million aeres are
lost per year to cattle pasture.
']n Latin America, 50 miUion acres were lost in 20
years by conversion to cattle rancbes.
In Costa Rica, two-thirds of aU forests
lost are due to cattle ranching.
figura 7

INEFFICIENCY OF LAND USE FOR

RAISING ANIMAL FEED IN THE U.s.
6.9 Ib. feed per Ib. pork
4.8 Ib. feed per Ib. beef
2.8' Ib. feed per Ib. chicken
3.0 Ib. feed per Ib. cheese
2.6 Ib. feed per Ib. eggs

474

Figure 8

the loss of foresrs and even the creation of

new desens (a process called "deserrification").? There are some 8.2 billion acres of
rangeland worldwide. However, aJready
nC'<uly three quarrers of it is ar leasr "moderately desertified' according to che United
Nations Environment Program. 10

OfForests andMeat Production

Forests have severa! vitaJ funcrions in the
ecosystem, listed in Figure 6. 11
The rropical foresrs are of particular
imporrance. 12 Approximately one-fifth of
ali che industrial lumber used worldwide
comes from rhe tropicaJ forests. Millions
of people rhroughour rhe world depend on
rhese foresrs for their livelihood. A quarrer
of the pharmaceurical agents worldwide
comains extracts of rain forest plants. Furthermore, some drug researchers look at the
divetsiry of planrs in these tropical foresrs
as offering a bank of natura! compounds
rhar may in the fucure help ro creat cmerging diseases or currenrly untreatable conditia IlS. SadJy, we are losing our forests ar an
alarming rate. These losses are spelled OUt
in Figure 7. 13 , 14, 15. 16
The primary causes for dcforestation
vary depending on the area of the world in
question. However, raising livesrock is often a major contributot. A comparison of
the land requiremenrs ro supporr certain
"diet styles" can help us berrer appreciate
how eating choices eJlcourage rhe conversion of forests ro agriculrutalland. In ordet
ro suPPOtt their dietary choices, mear earers require the use of considetably more
agriculturalland than vegetarians. The reason is mat using cropland for raising animaJ
feed is exrremely inefficienr when compared
ro lIsing it ro provide food for vegetarians. It
requires many pounds offeed ro produce one
pound of animal product. The inefficiency
is illllstrared in Figure 8. 17 , 18. 19
Standard feed~ like grains, soybeans, and
soy meal were used as rhe basis for the chan.
Those fced inpurs for beefptoduction were
less intensive because cartle genetally graze
umil chey move ro the feedlot for their severaI months oflife. Note thar even the most
efficient animal produccs waste nearly two
thirds of the grain and soy thar it rook ro

NUTRlTION ANO THE ENVIRONMENT

raise iliem. These f1gures can be mueh worse
in omer councrie.s. In Russia, for example,
ic takes 5 to 6 pounds of grain (Q produce
one pound of chicken, or twice as much as
in che V.S. lO

Larger Land Areas Produce Less

Nutritional Value
Where does ali che grain go, since it is
nor converred pound for pound inca meat?
A significant ponion of livesroek feed is
never absorbed by [he animals. Rather, it is
e1iminaeed in [he form of solid waste. Of
mat which is absorbed, much is used for
bodily processes mroughout che eourse of
rhe animaJ's life. Still mher absorbed nucrienrs are diverred inco non-edible animaJ cissues such as bone and hair.
Some have referred ro ehe process of
feeding grain ro Jivesrock and [hen humans
earjng the Aesh of rhose animaJs, as "cyding
our grain rhrough livesrock." Mosr of rhe
nutrients are lost in chis cyde, as depic[ed
in Figure 9. 21 2213
Through this process, we can end up
with as liule as 15 percenc of che prorein
ehac was origi naUy ill ilie grain. These losses
are epiromiz.ed by [he intensive animaJ-raising pracriccs such as rhe indoor facrory
farms for pigs and pouJrry. Nor only does
this refleer a 1055 of protein for hwnan eonsumpeion but, as we will see, ir 31so exaces
"seriolls environmencal effeas" by accumulacing in animal manure. Nocice fhac ali
rhe 6ber is lost) as is almost aII rhe carbohydrace.
Where has chis ftber gone? By definicion, "fiber" refers ro any subsrance in a food
which a hurnan cannor digesf. AJthough
animaJs can digest some food irems rhar we
cannor) much of \vhat we c.111 "f1ber likely
goes righr rhrough the animaJs' intestinal
systems and is excrered as solid waste. On
me orher hand, fiber subscances chat are
digesTible by animaJs are broken down and
incorporated inca their tissues. In either
case, when people consume animal Aesh,
they do nor get any of ilie fiber ehar was in
rhe animaJ's originaJ feed. The animaJ either losr ilie fiber in ilS wasres or eonverred
it inro a form (hat is digesrible ro humans.

By now, mosr Americans realize why we

fuss over chis indigestible fiber. Ir is importanT in prevenring common concLtjons like
appendiciti , diverriculosis, consriparion,
cancer, high cholesterol, hemorrhoids, and
hiatal hernia.

Additional Environmental Damage

From Meat Production
Besides damage from deforesration, raising livesrock produces ecologicaJ damage in
severaJ other ways: the land is fim c1eared
for pasrure or for growing livestock feed; the
animaJs themselves then exerr adverse eftects

NUTRlENTS LOST BY CYCLlNG

GRA N THROUGH L VESTOCK
Nutrients

% Lost

Protein

85 - 90 %

Carbohydrate

up to 100 %

Fibcr

100%

Proteio
Wasted
Used
Calories
Figure 9

VI O MENTALDAMAGE
FROM RA SING LIVESTOCK
Clearing of forests
Killing meadow grass
Feedlot runoff
Topsoil erosion
Water shortages
Water poUution
Increase in greenhouse gasses
Figure 10

475

PROOF POSITTVE
on the environmem. Some of these effects
are listed in Figure 10.
The c1e.1.ring ofvi rtualI y millions ofacres
of forests in Central America alld Brazii in
response ta the demands of U.S. fast food
chains for cheap beef has been termed "the
hamburger connecrion." Meadow grass is
killed by overgrazing and t!le trampling of
land by livestock herds that overwhe1m the
carrying capacity of the land. Feedlot runoff is a concern snce damaging chemicals
can pollute the soil aod water around intensive animal-raising operarions.

u.S.

EROSION

Average depth oftopsoil

200 years ago = 21 iDches
N ow = 6 inches

Figure 11

YEARLY TOPSOIL OSS IN THE U..S..

(based on the world average)

Totalloss

almost
7 billion tons

Per capita loss = 50,000

Ib. per
person

Figure 12

476

The remainder of this chapter will explain how these damages occur and what
their far-reaching effects are.

Topsoil Loss
For at least 200 years, erosion has been
causing topsoilloss in the Unjted States. This
dramatic change is indicated in Figure II.
The effects of raising Ijveseock 011 the
Jand and soil are extremely importanr. Topsoi! is eroding around the world. Based on
estjmates from me FAO (The Food and
Agrieulture Organization of the Unieed
Nations), somewhere berween 11 and 15
million acres ofcropland are Iose worldwide
each year due to soil eros ion. 24 Each year,
ropsoil losses worldwide amount to 710
tonnes [a metric ronne is measurement
equivalem to 1.102 tons] per square kilometer. This calculates out ro approximate/y
3 rons per acre.
To pur chis in perspective, assume thar
the U.S. experienced this average world rate
ofsoil erosion across every square foot of its
land. The calculated loss n topsoil is shown
in Figure 12. 25
What causes this erosion? Much of it
occurs from plowing and cultivating ilie
land. Rainfall washes the loose soil into rivers and streams, and finally inro t11e oceans.
Muddy streams after a heavy rain provide
tangible evidence of this erosion. Erosion
tends ro be worse when the laud is imensively culrivated. Thus accelerated erosion
often results when farmers atrempt ro boost
meac production by raising greater amounts
oflivestock feed. In some places in the U.S.,
the ropsoiJ deprh has become so shallow that
it no longer can be used for growing anything but fie/d grass.
Some areas of the U.S. are losing 50 percent more than the world's average. The
Great Plains and Western states are losing
4.5 tons of ropsoil per acre per year. The
Wor1dwatch Institute atuibutes this 1055 to
wind erosion in the concext of"dry climate,
culrivation for raising crops, and excessive
livestock grazing."26
The economic cost of soil erosion is also
incredible. In the U.S., when ilie cost of
decreased yields, increased fertilizer requirements, and environmental cost.s of erosioo

NUTRlTION AND THE ENVIRONMENT

(runoff of sedimem and chemica! polluc.ams) are ali factored in, rhe price rag comes
out ro $18 biUion per year. 2?

Wizter Supply and Dur Food Choices

Our needs exrend beyond proper nurricion. We a!so need adequace supplies of
waUr. In facc. many beueve ehar loomjng
warer shorrages will c:!.lIse food scarciry ro
pa!e in comparison. Even in rhe United
States, many areas of the narion have become well acquaimed wieh wacer rarioning.
Prohibirions on car washing and lawn warering may seem like more of a nllisance
(han a crisis. Yec. water shorcages ean reach
crisis proporcions in relatively shoTt periods
of time. In America. some experrs believe
(hat eurrene dietary dlOices---and rhe agricultura! pracriees dllls made necessary-are
heading us loward che precipice of serious
warer shorrages. Whar could possibly be
jeopardizing rhe apparendy limitless supplies of warer in rhe U.S.?
A high volume of warer is required ro
produce me.'\{ prodllccs compared ro prodllcing grajn, as iUusrrared in Figure 13. 28 29
The amoum of wacer used co produce a
given amoum of mear prodllees cOllld grow
ren cimes as much corn. aod six lmes as
much wheat. Perhaps rhese f1gures become
more meaningful when you consider rhar
[he average U.S. ciriun demands approximarely t 00 gaHons of warer each day ro produce only rhe animal products he eacs in
che form of meat. miJk, and eggs. This is
an amounc eqllal ro rhac person's daily use
of warer for aII home uses. 30
The American Cacdeman's Association
has ciced U.5. Depanmenc of Commerce
and U.5. Geological Survey scacisrics rhac
beuer indicaee che intensive warer needs of
livesrock. Their data is in rhe form of rhe
percenrage of aur roca! warer usage raken by
agriculrure. The daca is shown in Figure J 4Y
Wirh these sracislics, we can readjly calcula te rhar 14 percenc of aII rhe \Varer used
in rhe U.S. goes lOward raising livesrock.
Anorher way of looking ae the huge
amounrs of wacer llsed in livesrock raising
is ro look ar some of the srarisrics quored by
the Beer Indusrry rhemselves. These are
shown in Figure 15. 32

WATER REQUIRED TO ODUCE

MEAT PRODUCTS AND GRAlNS
385 gal. water per Ib.
boneless pork
360 gal. water per Ib. beef
337 gal. water per Ib. poultry
S8 gal. water per Ib. wbeat
33 gal. water per Ib. corn
Figure 13

PERCENT OF WATER CONSUMPTION

FOR AGRICULTURE
42 % of total water consumption is used for
agriculture.
3 % of agriculture water is direct animal
consumption.
97 % of agriculture
water is for crop
irrigation.
30 % of irrigation
water is for animal
feed (hay, pasture,
feed crops).
Figure 14

FO
3.49 trillion gallons for irrigating feed crops.
2.97 tdlIion galloDs for irrigating pasturcs.

202 billion gaUons of drinking water.

Total water usage - 7 trillion gaUons

Figure 15

477

PROOF POSITIVE
Put another way, ifaII rhe U .S. beefcarele
were being raised an one huge range anei
farm. it would take 7 miII ion shipments of
one million gallons ofwarer each to supply
cheir needs just for one year.
In m;lny pans of the world, water availability is a life or death issue. Even here in
the U.S., our demands for foods wirh high
water requiremenrs have scriollS economic
and ecological consequences. Historically,
rhe economic COSts have been largely hidelen due ro federal and stare governmcnc
subsidization of rhe meat indusrry's warer
consumprion. Many may not rcahze thar
their [aX dollars have been helping ro provide the large quamiries of water needed ro
mise livestock.
Congress has esrimare-d rhat Wesrern
stares have received more rhan $2 billion in
water subsidies annllal1y. Up ro $1 billion
of rhis amounr has gone ta farmers who raise
animal feed. The farmers are able to raise
livesrock feed very profirably because rhey
can buy water cheaply from federal irrigarion projecrs. Somerimes they pay less rhan
ehe actual cosr ro deliver rhe warer ro their
farms. 33 As a case in poinr, the huge Cenrral
Valley Project in California supplies irrigarion warer to farmers ar a smaH fraerion ofirs
actual cost, as tablilated in Figure 16.34 . 35

Actual cost of 40 years

of irrigation water:

$1 biUion

Cost billed to farmers:

$50 million

Percent of cost bor.ne by farmers:

5%

Amount of irrrigation watcr

used for livestock feed:

33

Figura 16

478

O/o

Sandra PoSte! of rhe Worldwatch Insrirure poinrs om thar in the face of these huge
priee supporrs for water lIsed ro produce
livesroek feed-such a scenario wOllld nor
likely occur were the farmers ro pay what
rhe water reaUy cost.
Water subsidies are jusr one example of
how Iivesrock producers do nor pay their
fair share whcn t eomes ro envrolunenral
eoncerns. Durning and Brollgh, a1so of the
Worldw;lrch Institme. have made rhis observation: "AII rold, the price of meat might
double or triple if the fuIl ecological costS
were inclllded in rhe bill. These costs include fossil-fuel eombusrion. grollnd water
deplction, agrieultllral-chemical pol111rion.
and methane and amrnonia emission."36

The Efficts OfPolitics and Farm

Subsidies
The need ro reform the politics of agriculrure-wirh irs ofren-counrerproducrivc
subsidies-has not bern Iose on rhe World
Health Organi~ltion. The WHO is aware
of rhe need for counuies ta make changes
in political suucrures rhar have eneouraged
diers high in animal products n t.he pasc.
They recognize dur governmenr economic
policies dealing with food producrion can
often prevent people from making rhe
changes rhey need ro make. The reason for
rhis s that r!le economic policies are often
"based an ouunoded ideas abour what consrittltes a heahhful dier."37
The WHO wenr on ro make specific
recommendarions ro narions in 1990 in
t.heir book, "Dier, Nuuition. and rhe Prevenrion of Chronic Diseases." One of rhe
recommendarons broughr the iSSlle of food
choices into sharp focus: "Governmenrs
should consider their nvestmenr and subsidy policies in bot.h agricuJture and rhe food
indusuy ... Policies should be geared ro
promoring the growing of pJam foods, inc1uding vegerablcs and fruits, and to limiring ehe promoeion of fiberless [and cholesrerol-coneaining) producrs."38 By replacing
the nutrienrs Iose from reduced me.c\[ production wirh those from planr sourees,
much less water would be required.

NUTRITION AND THE ENVIRONMENT

Wter Poifution from Livestock

Beyond rhe excessive demands on water
supplies. animal raising can comribure directly to warer pollu-tiol1. Wealrhier narions
in pareicular musr cope wirh rhe problem
of handling huge volumes of wasre from
livesrock and dairy farms. 39 Feed lors pose
a notable probJem. A feed lor is a relarively
smalt, fenced plor of land rhar is crowded
Wilh sa many head ofcarrle rhar rhey hardJy
have space ro move. Such an arrangemenr
provides an economic benefir: rhe abiliry of
rhe animals ro exercise is limired and rhey
rhus gain more weighr in a shorter rime.
Since rhey are sold by the pound, fhe financial advanrages are obvious. Unfortunarely, lhe WHO has poinred ouc char rhese
currenr inrensive "'confinement" raising
pracrices can cause "localiy concenrrated
producrion of slurries and manures." The
wasres are generaJly high in nitrogen compounds. phosphare, and porassium. They
ofren are contaminared wich significam
amounrs ofheavy meraJs induding copper,
zinc. and cadmium. lf rhese wasres are applied ro agricultural land, they can cause
significanr problems. Some of these compounds can be raken up by the planrs and
reinuoduced imo rhe food chain. 40
The large amounrs of waste rhac accumulare in feed 10cs can also pollme wacer
sources when rain washes dle wasres away
from rhe lor. One common resulr of chis
feed loc runoff is an undesirable l'rocess
caJled eurrol'hjcation. Anyone who has seen
a pond covered wirh excessive algae growth
can relate co lhis process ofexcessive, harmfuI growrh of planr life in bodies of water. 41
Of additional concern is a groul' of
chemicals called ntrares. These compounds, when ingested by humans, can become involved in biological reactions thar
yield nierosamines, some of rhe most 1'0tenr cancer-producing chemicals known. 42
The WHO poinrs dle finger ar rhe livesrock
indusrry as being rcsponsible for nirrate
conraminarion of our wacers. They poilH
our thar applying animal wasres omo agriculturalland has pollured natural warer supplies wir.h ilie result dlar, "...drinlcing water
we!ls are ofren heavily polluted, conraining
nirrare levels of man)' hundreds of milli-

grams per lirer."43 As a frame of reference.

45 miJJjgrams per lirer is rhe maximum ni(fare concenrrarion allowed under U.S.
Drinlcing Warer Srandards. 44 The effecrs of
livestOck an water supplies are extreme!y
long-lived. According ro rhe WHO, even
if rhe poLiucion were sropped today. ir may
stiH rake literaJly cenruries for these environmental comaminams ro be e1iminated. 45

Livestock and the Production Of

Greenhouse Gasses
"Greenhouse gas" is a term used to refer
ro an)' gas in the earrh's atmosphere thar
helps ro crap heat on rJle earch, much as
panes of glass trap heac in a greenhouse.
Sciemisrs, politicians, busincss leaders. and
a hosr ofothers continue ro debace wherher
we are currencly experiencing global warming. For che sake of this chaprer, it is noc
importanr wherher you side wirh rhose wito
say rhere is a problem, or chose who insisr
ehere is nOL The important poinr is tluc
mere are legitimare concerns rhar gasses
known ro have hear-rrapping effecrs could
adversely affect the earch's remperanlrewherher or not we are currencly exl'eriencing such problems.
Actually, a narural greenhouse effecc has
been keeping rhe earrh habirably warm for
millennia. This effect is based an waeer vapor and carbon dioxide which accoum respecriveJy for 65 and 22 percent ofchis natural phenomenon. 46 le is roo much ofa good
ching, however, that has raised the currenr
concerns. The man-made gasses rhat appear ro be among rhe mosr worrisome are
excessive leve!s ofcarbon dioxide and methane. AJso players (but ro a less significanr
extent) are nirrous oxide, chlorofluorocarbons, and ozone. 47
Surprisingly, a vegerarian dier may also
oA-er signjficanr bendits when assessed from
rhe perspecrive of che possibiJity of a global
warming problem. Meat production increases rhe Ievels of greenhouse gasses and
the utilizarion of energy resources. The
duee major greenhouse gasses increa ed by
raising livestOck, and the causes for ilie increase, are lisred in Figure 17.
Regarding carbon dioxide. we have

479

PROOF POSITIVE

INCREASE IN GREENBOUSE GASSES

FROM RAlSING UVESTOCK
Gas

Cause OfIncrease
Defores/ation

Carbon dioxide
Forests consume man-made COl.
COl is produced by the decomposing
of cut-down trees and burning wood.

Methane

Animal waste

Nitrous Oxide

Animal waste

nor conrriburion (O the greenhouse warming effect, ir also decreases a protective

chemic..I: srratospheric ozone. 51 (Manywill
recaH thar ozone at this level of the atmosphere helps to prorecr us from rhe damaging effeers of inrense ultraviolet radiarion).
Nitrous oxide can be a byproducr of rhe
considerable amoulHs of ammonia produced by raising livesrock. Ammonia evaporares from srables and feedlots. Large
amounrs also rise imo rhe atmosphere afrer
manure is spread onta agrieulruralland. 52

Energy Requirementsfor Raising

Livestock
Raising livesrock enrails huge energy re'1uirements. David Pimenrel, an agricultural

Figure 17

480

already learned (har when animals are raised

rather (han planrs, rhe land yields less lISable calorie.~ per acre. We rhen need more
acres ta raise more animals ta produce rhe
calodes needed. This requires the clearing
of forests ro provide land for grazing pasrure or growing feed. Less foresrs means
more carbon dioxide because forests convert carbon dioxide into oxygen. To make
marters worse, decomposing cur-down rrees
and the buroing of wood generates more
carbon dioxide (7 ta 30 percenr of manmade carbon dioxide, according (O WHO
estimates).48 Furtherrnore, the animals
rhemselves exhale carbon dioxide in normal
breathing. whereas planrs absorb ir and
make oxygen.
Regarding armospheric merha.ne, The
World Healch Organization has idenrjfied
the world's growing cartle popularion ro be
one of rhe mOSt importanr sources. 49 LivestDck accollnr for 15 ro 20 percent of global methane emissions. The m~ljority of
rhis-perhaps 80 miII ion rons of the gas
annually-is produced by ferrnentation
which forms gas in the intesrines of cartle
and other cud-chewing aniruaIs. Another
35 tons per year are emirred from rhe hllge
amounrs of manllre produced in feed lors
and f,.Ctory farms. 5o
NitrOlIS oxide proclucrion is also relared
ro livestock raising. A1rhough it h,~s a mi-

energy specialisr, has disringuished himself

at Cornell Un iversiry. Pimenrel estimates
rhar even in energy-efficient livestock-raising narions like rhe U.5., it rakes the energy
ofabout one galion ofgasol.ine for every rwo
pounds of pork sold. Beef and chicken require abolit half this amount. Thar same
galIon of gas c.1n produce over six pounds
of eheese or eggs. S3
When it takes l4 ta 16 gaUons of gas to
fiII up an average American car, rhe amounr
of energy expended in animal producrion
may nor sound like mueh. However, when
you consider rhar rhe average American ears
over 250 pounds of meat each year,5 4 rhe
numbers beeome staggering. In facr. almosr
halfofali the energy used by the enrite U.5.
agrieulrural sector goes inro livestOck rearing. 55 JUSt ro produce the beef raised in our
counrry tak.cs the equivalenr of 3.9 biIlion
gallons of gas each year. 56 The energy required ro produce aU [he reci mear and pOllItry consllmed by Americans in any given
year probably approaches rhe equivalent of
13 bilJion gaHons of gas each year. S7 In fact,
Pimenral has esrimated thar we coulcl decrease our roral energy invesrment in food
production by fully 60 pereenr if we significantly decreased meat consumption.
There are many reasons for rhe heavy
energy reguirements of raising livestock.
Many currcnr animal-raising practices are
extremely energy intensive. For examplc,
livesrock is often raised in uonatural envi-

NUTRlTION AND THE ENVIRONMENT

ronmenrs referred ro as "f.'Krory farrns" such
as "pig-" or "chicken-houses." A governmenr publicarion recenely describcd a srarcof-rhe-an "chicken hOllse. "58 It was 600 feer
long-the Iengrh of rwo foorball fieldsand housed over 120,000 nesting chickens.
Large amoullts of cnergy are needed [O operate che equipmenr ehat cools the house in
che summer and hears ic in [he winter. Auromated feeding and watcring sysrems add
ro che energy requiremenrs of such factory
farms. StiH more energy is needed to clean
and mainrain rhese hOllses.
RegardJess ofwhether animals are raised
an facrory farrns, on che range, or in other
scnings, chere are other energy-demanding
requiremencs. Animal feed needs ro bc
grown, harvesred, and then rransponed ro
ehe animals. SriH more energy is e.,xpended
in cransporring rhe mamre livesrock ro
s!aughrerhouscs, and ulen processing the
animal afeer it is killed.
Besides rhe environmemal ethic of bcing frugal wich fossil fuel re..~erves, this incredible input of energy imo livesrock produaion has anorher important environmentaI effecL lncreased usage offossil fuels and
other energy sources produces more carhon
dioxide, a "greenhouse gas." Consequenc1y,
a vegecarian-st)'le diet would be expected ro
decrease fossil fuel use and provide a furrher dccrease in greenhouse gas accumularlon.

Relating to Farmers' Livelihood

Whar about farrners? Are che recommendatiolls in this chapter unusually harsh
on a group of people rhar embody rhe very
work ethic that has made America grear? It
sholild be emphasized thar curtenr Iivesrock
policics do not reOecr a moral failure of rhe
maoy honesr t:umers r.hroughout [Ile world.
In general, farmers have sought to serve cheir
nations well by meering rlle changing needs
th:n science, governments, and tlle populace articulared.

Similari)', rhere is no inteor here ro malign the legislarors responsiblc for current
agricultura! policies. In many cases, current governmenral policies reflect "oJd
chinking" abOlit nllrrition that grcw Out of
rhe World War II era. Throllgh subsidies
and omer means, farmers havc been encouraged economically [O foHow policies that
"sought ro maximize t.he production ofmeat
and milk."59
For ehose legirimately concerned about
rhe plight of farmers who raise livesrock,
there is good news. The WH O speaks
highly of the flexibility, resiliency, and social concern characterisric of farmers. They
assert: "farmcrs havc revolutionized rheir
agricultural pracrices over rhe last 40 years
in response tO (he demands for grearer food
producrion and seem willing tO change
again."60 1 belicve (hat farmers, iudecd,
would rise ro [he challenge and cominue [O
make strides ro provide heaJc11ier and more
environmelHally conscious foods for Americans and [he world.

Condusion
Jr seems thar we are sranding an the verge
of a major concepUial breakthrough. Just
as rhe maj ori ry ofAmericans recognize r.har
smoking habirs have both personaj and socierai cffecrs, so many are bcginning ro realize thar eating habits have effecrs far beyond rheir imp:tCt on personal healrh. Indeed, ir is amazing ro realize the large exteor that our dieeuy choices inf1uence nor
only aur own healrh, nor onIy rhe heaIrh of
aur children, but also the healrh and welJ
being of the entire world. It is no exaggeration to sa)' thar in some respecrs our seemingly small daily individual choices ultimarely affect (he destiny of life on our
plancr. And perhaps no choice impacts global destin)' as much as one decis ion [hat is
among our most basic and personal
choices-what we pur on our plare.

481

PROOF POSITlVE
ReferencesN"-Clabvukaren A. "fhc People-Food Predicamcllt. In: Man Imd ElIlIironmml, A Henil" Perspmivr--3'" edilioll. Prospect HeiglltS, IL: Waveland
Pc<:ss, 1990 p. 101.
1

Brown L FuI! HOllse. New Perspeetivet QUItlUrly. Voi. I 1, 1 Sep 1994 p.

6.
Durning AB, Brough HB. LiVCSIOCk Economy. In: Wor1duJlJldJ Pap'"
103: Toking SlOek: .Animal FI/rming IJnd tiu Environmt'nt. Washingron,
DC: Worldwatch [nStllllle, 1991 p. 11.

Dllrning AB, Brougll HB. Liveslock Ecollomy. In: Worldwaleh Paper

J03: Tolting Stock: Ani!tud J'ilrming alld the EmJirol1mml. Washington,

-1

DC: Worldwatch lrlSlirutc, 1991 p.40-41.

\ 0011 R. Health md thc cnvirOllmcll1 in the 1990s. Am} Public Hmlth

1992 Jul ;82(7}:933-941.
Duming AB. Brollgh HB. Livcsrock Economy. In: \'(/orUwJltch Pllper
103: Tltking Stock: Animal Farming Ilnd the EnvironmeTl1. Washington,

DC: Worldwalch InstilUte, 1991 p. 6.

Brown L. Avnling 11 globalfaod crisis. VoI. 98, Technology Review, I Nov
1995 p. 44.

Nadakavukarell A. Poplilation Dyoamics. 1n: MllTlltnd E"vironmeJlt, A

Health PtT1"peclivr--3"' edition. Prospect Hcigllts, IL: Waveland J'l'ess, 1990
p.45.
8

Nadakavubren A. FaU-Out from the "Popll1ation Botnb": Impacts on

Human Resourc<:s and &osystem.s. In: MIm Itlld Environmem, A Henlt"
PtT$perove-3'" edition. Prospect Heights. IL: WaveJand Press, 1990 p.
127-8.131-8.

Durning AB, Brough HB. Liv<:slOck Economy. In: Worldwl1tch Paper

103: Tizlt:ing Sioc},; Animal Farming I1nd the e'WiTOlmWJI. W1shingroo,
DC: WorldW:llch Instcute, 1991 p. 14.
10

WHO Commission On Heahh And Environmenr. Nalllra.l Rcsollrces

for Food, Agricultura! and Fisherics production. In: Reporl OfTh~ PII1/t1
O" Food And AgTiculnllY. Geneva, Swirlcrland: World HCaJlh Organiz.1lion, 1992 p. 28.
II

11 AcharyaA. Tropical Forcsts Vaoishing. 10: Brown LR. LellSsen N, Kalle

H. cdilors. Vital Sigm J995: hc Trelld.s Thal Are Sbaping Our FUlIIre.
W.W. NOTlon and Company. New York, 1995 p. 116-117.
1) WHO Comrrussion On Healt.h And Envi{onment. Natural Resourcc:s
for Food, Agricultura! and Fisheries ProdllClioll. In: Rrport ofnJe Pallcl
On Food And Agrieu/zurt!. Geneva. Switzerland: World Heahh Organizalon, 1992 p. 30.

I~ Acharya A. Tropic.ClI Foresrs Vanishing. In: Brown LR, Lcnssen N, Kanc

H. editors. VillII Signs 1995: 77u Trmds Tbat Are Sbapil1g Our }~ltur~.
W.W. NOTlon and Company. New York, 1995 p. 116-117.

Durning AU. Brough HB. LivcSlock Ecology. In: Wor!LlWlllclJ Pdper

103: liJkillg Stock: A"imal Fllrmillg alld tlle Ellvrollnu:nl. 'W:.'lshington.

lO

DC: Worldwalch Institulc. 1991 p. 16-17.

\XfHO Comrnission On Hcalth And Environmelll. Ellvuonrnclllai
Effects of Intensive Agricultura! P{OdUClion. In: &porl Of TIu' Pllntl 0"
F00l1 And Af:im1tuY(. Geneva, Swil2Crland: World HeaJrh Organi7"l.lion,
1992 p. 48.

11

U PennjnglOn JA. NUlrienr ColllCnl Chaptcrs on "Mears". "Pollhry", and

"Milk. Yogurt, Milk Beverages, a1ld Milk l3everage Mixcs. In: BOl/ln IIl1d
Ch"rclJ~ rood Valuei of PorlilJlJS Commonly Used, Fifri!eJlth Edi/ion. Philadelphia, PA: J. B. Lippincoll Co., 1989 p. 135-146, 150-155, 160-165.

PenninglOn JA. NlltrieOl COOlem Chaplers on "MeatS", "Poulr.ry", and

"Milk, YOgllTl. Milk Beverages, and Milk Beverage Mixcs. [n: Bowl'S and
Chtlrch's Food VaII/ei of Porliom Commonly Used, Fifut1IlIJ 1:.'l/iJioll. Philadelphja, PA: J. B. Lippincocr Co., 1989 p.135-146, 150-155, 160-165.
l3

l4 WHO Colllmission On Health And Environlllelll. Consequenccs of

EnvironmemaJ Change lor Food and AgricuJmral Prodllclion. In: &porr
OfThe PlltIelOIl Food AndAgrirulwTl'. Geneva, Swit1.erland: World HeaJdl
Organil.atioll, 1992 p. 76.

2S Gardner JL, editor. World Wormarion T.,ble. In:

Relldcr's Digm Atltts

oftlJ/! World. Pbl.sanrviJle, NY: The Reader'.s Digest A.s.socalion, Inc., 1990
p.I96.

WiJken. E. Soi] Erosion's Tol! Continues. In: Brown tR, Lenssen N.

Kane H, editors. Villil Signs 1995: The Ti,."ds TlJlu Are Shnpillg Ollr l;i,IIlrt. W. W. Nonon and Company. New York, 1995 p. 118-119.

26

WHO Colllmissioll On Health And Environmenl. Conse'luences of

Environrnel1lal Change for Foo<! and Agrieuhlllai Prodllction. In: &porr
OfTIJ~ P"nel On Foo"AmiAgrimlrrm. Geneva, Swil1.erland: World HeaJdl
Organizarion. 1992 p. 77.

17

Durning AB, Brollgh HB. LiveSlock &ology. In: WorltiwnulJ Pap"

103: '/iJking Stock: Anim"l Farmillg a"d the E,wironmem. Washington.

28

DC: Worldwatch Instilllle, 1991 p. 18. (convencd from "more lhan 3000
Iiters of waler 10 produce a kilogrellTl of American beer.")

Ifwe wam ro use a figure of"350-450" gallons of waler we would reference

il as: DUl'I1ing AB, Brough HB. Liv''5IOCk Ecology. In: WorldwalclJ Papa
103: Tnkillg SMck: Animal J'izrming IlIzd zile EnvirolJmmt. Washington.
DC: Worldwalch Insti[ule, 1991 p. 18 give ~ figure in lhe range of 350;
while the Catdeman's Associarion give a figure of 440 gallons; sec The.
American c.utleman's Association. 1995. SeClion "Environmclll" Ch.ptCT
F-2: "Waler Use." Thc Caltle a11d Beef Halldbook (On-line electronic
edition). Accessed al World Widc Wcbsite: http://www.co\Vtown.org/

15

US Depanmelll of Comlllercc. 1992 Census of Agriculture; Volume 3

ReJaeed Surveys; Pari 1 Fltrm and RllllclJ lrrigmioll Survey (J 994); AC92RS-l. US GOVt Printing Officc, Washington,
1996 p. 54,75.

16 Ach:uya A. Tropic21 Foresrs Vanishing. In: Brown LR, Lenssen N, Kanc

H, cdilOrs. Vilal Signi 1995: Th~ Trmds Thal Are Shapil/g OUl' Fllture.
W.W. NOrlon md Company. New York, 1995 p. 117.

Note: calculatcd by dcterminllg dle eotal continental US wheal harvcsl in

1994 from both irrig,lled ano non irrigatcd Iand and comparing wilh the
IOI~l amount of waler used for irrigarion based On 325,851 gallons being
equivalcm ro ooe acre foot of irrigarion waler. Basic data found in rabies 23
(page 75) and table 22 (page 54)

Achary:tA. Trol'ical ForCSls Vanisbing. In: Brown LR, Lenssen N, Kane

H. edilol'<. Villtl Signs 1995: TIu 7rmds Thlll ATi" Shaping Our Future.
W. W. NOTlon and Company. New York, 1995 p. 116-1 17.

Durning AB. Broug/t HB. Live5IOCk &ology. In: Worldwiltch Paper

103: 'loking 5l(xk: Allimal Farmillg and tiu Ellvirollmem. Washington,

17

DC: Worldwaech Institure, 1991 p. 16-17.

1. Durning AB, Brough HB. Liveslock &ology. In: WorUwnteb Pap"r
103: Toking Sr.otk: Animal Farmil/g nnd tIu ElIlIironmt1Jt. Washington.
DC: WorldW3tch Instirute, 1991 p. 16-17.
Durning AB, BrOUgll HB. Livcstock Ecology. In: WorMwatdl Pnper
103: Tuking Sr.otlr: Animal Farming and the Eflvirollme11l. Wa.~hinglOn,

29

De.

Obtaineci by personal corrcspondellcc Wilh USDA:

Il POlll1ds per bushcl for cach grain were: barJey: 48; Com: 56;
Oats: 32; Rye: 56; Whe:ll: 60
2) Gallons per acre foot = 325.851

19

DC: Worldw;llch InslilUte. 1991 p. 16-17.

482

Thi.s is a f.1ir oomparison because rhe bcefindu.my lake., into account onl)'
irrigarion water meci for feed needcd in ealtle raisillg - not non irrig<lted
crops lhat ale consllmed by ilie animals. Tbe t1gure of 440 gal of watcr per

NUTRlTJON ANO THE ENV1RONMENT

edible pound o( beer comcs (rom dividillg l!le total warer lISed br beer
oule and rhe feed rhey car by the total number of ediblc pounds o( betf
produced ycarly.

~2 Nichnlson WJ.
itrosamines. In: EIJlIJ'YOI/1IIr1llfll aTJd Ocrupational
Mrdicille-2'''' rdilioll. Bosron. MA: Littlc Brown and Co. 1992 p. 955-

965.

Note: S:unple caJculalion for W1Jcat

WHO Commission On HeaJth And Environment. Environmental Effccl. of Inlcn.ive Agricultural Produclion. In: Reporl OfTIJe Pallrl 011
Food And Agriclilel/rr. Geneva, Swit'ZerlaJld: World HcaJth Organiz..1lion.
1992 p. 38.

irrigale<l acrcs: 3.396.10 1 x 70 bushcls per acre x 60 Ibs per bushcl '"
14.263.624.200Ibs.

Ol5On BH. EnvironmelllaJ Wall:r POUUUOIl. In: EnvirbTtmtmllll flnd

OCCI/paliollfli Medicillc-2"J editioll. Boston MA: Linie Brown :10.1 Co.,

",heat non irrigaled aacs: 5.866. J 35 x 36 bushcls per acre x 60 Ibs per
bushd '" 12.670.851.600 Ibs.

15

IOtal )'idd = 26.934,475.800 pollnds

3.396. \0 1 x 1.4 acre feeI x 325.851 gallons per I acre foot ~
1.549.272.069.731 gallons
(an acre fool i.s 1he amounl of warer 1ilaI would cover 1 acre of land 1
foor dc<:pl

1992 p. 1263.
WHO Commission On Hcalth And Environmenr. Envronmcnral Effecls of Imensivc AgriclllrlluJ Prodllclion. In: Repbrl Of Thr Pt17l1'1 On
Food AJld Agrirolture. Geneva. 5witurlaJld: World Healrh Organization.
1992 p. 39.

WHO Commission On Hea!th And Environmcnr. Consequcnces of

EllvironmenraJ Change for Food alld Agricultura! Productinn. III: Reporl
OfTbl' P,lllei On FOOlI AndAgrimlturr. Gencva. SlViturland: World Hcahh
Orgalli'lA'\lioll. 1992 p. 72.

'.6

\VHO Commission On Healt.h And Environmcnr. Environmctl1a1 Ef.

(eas of Intensive Agriculrural J'roduclion; Conseqllenct's of Environmenrai Changc tor Food and I\griculruraJ Producrion. In: Report Of17)1 Pane!
On Food A,,,1 AgrimltuTe. Geneva. 5wit;lerland: World Health Orga.ni'l..ation, 1992 p. 38. 72.

17

1,549.272.069.731 gallons /26.934.475.800 pounds = 57.5 gaJlons of

WlIlCr ro grow one pound of whe.at
Durning AR. Brough HB. Livestock Ecolog)'. In: Worldwl1tcIJ P'lpU
103: Tnkillg Stbck: Allimnl F'lmlillg t1flli tlJt trwironmml. Washington.
DC: Worldwalch InslifUle. 1991 p. 18.

30

JI The American Gulemans Associalion. J995. Section "Environmenr".

Chapler F-2: "Warer Use." TIu Cutie I1Ild BeifHnlldbook (On-line electronic version). http://www.cowtown.org

J2 The American Cmlcman's Assoeiation. 1995. Secrion "Environmelll"

ChaplCl F-2: "Watcr Use." The Coltle a7J4 SeifHandbook (On-line e1eet ronic version). hrtp://www.cowrown.org

Durning AB. Brough HB. 5aac:d Cows. In: WorldwalC" Pl1per 103:
7itking Slbd/: Animal Farming and ch( EnvirOTJmml. Washington. DC:
Worldwalch InSlitUle. 1991 p.36.

POStei S. Worldwate" Pap" 93. Wolt'T fi)' AgriCll!tl/u: Facing lhe LimilS.
Washinglon DC: Worldwarch inslirure. 1989 p. 37.

}I

Poslel S. WorldUJdlc!J Alper 93. ~II'T for AgriCltftl/rc: Facillg fhc Limiu.
Washington DC: WOrldW:llCh Instirule. 1989 p. 37.

35

Durning AB, Brough HB. Sacrcd Cows. In: WorldwatclJ Paper 103:
7itkillg Slbck: AJJimal Ftmni1Jg a1Jd ehe Environmml. \XI;lShingron. DC:

.l6

WOrldW3lch InslilLlle. 1991 p.42.

Repun of 3 WHO 5wdy Group. Nurririon and Food Policies: Pasr
Experience .1Ild Implicarions for Aerion. )n: Din. NI/lrilion, alld lhe PTt'vmlion bfChronu Diu'lJm.. Geneva, Swilurbnd: Wmld Heallh Organiz:Hion. 1990 p. 141.
37

Reporl of a WHO SllIdy Group. NlIlrition and Food Policies: Past

o:perienec and Irnplicalions for AClion. In: Dia, Nlllrilioll, and tiu Prcumtio1J cjChroTJil' DiJetlSeJ.. Genev:l, Swilurland: World Hcalth Org:mi'lalion. 1990 p. 160.
JS

EI.AJ)ra( A. \Xlilli \V/V. el aL. Dield,in in lhe food chain: porential

heaJth effecrs of recycled animal manurc. jOl/rlUlI bfEnvi'bTl171eJltal Henlth
1990;53( 1): 17-19.

39

WHO Commission On Heallh And Env;ronment. EnvironmentaJ Effeels of Intensive Agnculwral Produclion. In: Repon Of77u Pmlitf On
Food AlJi Agriclilltlrt. Gencva. Swil2erland: World H~lth Organizalion.
1992 p. 38-39.

.0

~I Nadakavllhren,

A. Inlrodllelion ro Ecological Principles. irI: Mall tl1ld

Ellvimllme11l. A HeflltlJ Perspectivc-3'" tiilion. Prospecr Heights. IL:

.s WI-IO Commissioll OII HealrJl And Environmenr. Conseqllences of

Ellvironmcnlal Cha.lIge for Food and Agriculrural Production. In: Reporl
OfThr PomI OII FootlAndAgril'ultuTl'. Geneva, Switterland: World He:lhh
Organi;Gllion. 1992 p. 72.
WHO Collllnjsson On Health And Envi'onment. Environmenral Ef
feclS of Intensive Agricultural Produeoon. In: &pO" Of Tiu PallCl On
Footl AJIII AgrimltuTi'. Gcneva, Swir.a:r1and: World Heahh Organizalion,
1992 p. 39.

49

~ Durning AB, Brough HB.. In: Worldw'lub Paper 103: Talring Slock:
Animal Fflrming and tiu Enl'irolltnmt. Washington, DC: Worldwatch ln-

tilllle. 1991 p. 27.

;1 \VHO Cornmissioll On Hea.lth Nld Environmenl. Environmcnral Ef-

feas of Intcnsivc Agriculmral Producuon. In: &porl OfTIJ( Panl'l On

Food And AgricultuTC. Geneva. 5wit:lerl:md: World Heallh Organization.
1992 p. 38.
WHO Commission On Healrh And Environmenl. EnvironmentaJ Ef
fects of inrensive Agricuhural Prodllcrion. In: Reporl OfnJI' PaIul On
Fooll And Agriculturi'. Geueva. Swir:zerland: World Heahh OrgaJlization.
1992 p. 39.

52

DlIming AB, Brough HB. Livc:stock Ecolog)'. In: WorltlllJiltc" A'1"'r

103: 7itking SlOck: Anim,tI Farming tmd tiu Eiwironmmt. Washington,
DC: Worldwarch Insriture, 1991 p. 16-17.

>3

;~ Durning AB. Brough HB. LiveSlOck Economy. In: Worldl/JatelJ Papa

103: 7;lking Stock: Allimal Ftmning and thc Emlirb1lmem. Washington.

De: Worldwatch Institutc. 1991 p. 10.
-; Durning AB, Brough HB. LivcslOck Ecolog)'. In: WorldwalclJ Pap"
103: 7itking SlOl'k: Animal Fflrlning aud tIu E7wironmml. Washington.
De: Worldwalch InstituIe, 1991 p. 17.
Calculaled basc:d an C..urlemans Assoc:uiol1 data of 15.2 billion pounds
bonclcss/cdible weight beef r.used in 1994 eombined with During and
Brollgh's dala on energ)' inpur per kilogram ofbeef rai ed. See The Ameri<:'111 Cauleman's Assoeialion. 1995. 5eaion "Economics". Chaprer A-8:
"Produerion umbers." Tbr Cnlllrtmd BrifHandbook (On-line electronic
version). hnp://www.COwlOwll.org And DUJIling AB. Brollgh HB. Livestock Eeolog)'. In: \'(/orldwalC" Fape, J 03: 7'ieking Srol'k: A7Jima/ Farmiug
and r"e Enviroummt. Washington. DC: Worldwatch Inslilule. 1991 p.
17.

Wavebnd Press. 1990 p. 36.

483

PROOF POSITIVE
57

Calculared (rom dara pre. tu led in Duming AB, Brough !-iB.. In:

vcmion ofChro11ic DiJcouI.. Geneva. Swim:r1and: World He:Ulh Organi-

WorldwlJlclJ Pnpcr J03: Taking Slodr: A11imnl Fnmling nnd riu EnlJirOllmmr.

zalion, 1990 p. 121.

Washington, DC: Worldw<l.rch InslilUlc. 1991 p. 17.

GO Rep0rl of a WHO Srudy Group. NUlririon and Food Policies: PasI

Experience and Jmplicalion for Aerion. In: Dicl. Nlllririo11. flnd file PreIJmtion o/Chrollic DiUtlm.. Geneva, Swrzerland: World !-ic:l1lh Organizalion. 1990 p. 129.

C.rnpbcll D. The Goldcn Egg? Former CoopmuivC->. O.tOber VoI. 62;

Superimcndenr of Document., US Govermnenr, 1995 p. 12.
58

Repore of a WHO Sllld)' Group. Nurririon and Food Policies: PasI

Expericn e <l.nd ImpLicalion. for Acrion. In: Din. Nu/ri/ion. nnd tiu Pre-

59

484

CHAJPTER TWENTY

EYOND

THELEADING
CAUSES OF
DEATH

id you ever lay sleepiess in bed

wondering abol)( the best treat
menr for rheumawid arehriris?
The answer is probably no, uo~
less you have the disease yourself or know
someone who is srruggling wirh thac iUness.
Our interesr in the rreatmenr or prevemion
of disease is usually strong regardjng thc
disease char affects or duearens us and those
who are c10se to us. Most ocher topics may
sti muiate our curiosiry, bur unless we are
involved in a healrh profession, they rarely
river our artemion. For example, if a chaprer in this book was called "Living with Von
Hipple Lindau Disease," the average reader
may be curious ro look ac the chapter Ollly
uoril it is discovered rhar ic is a rare genetic
disease ehat affeces the brain ~lI1d eyes. However, fOf (he rare person wirh [hac condirion, ic probably would be rhe fim chapter
ro be read.
As I was comemplating rhe c10sing chaprer of [h is book, 1 asked myself che quesrion: whar about individuals who have other
diseases dut 1 have ooly barely memioned?
How can ) give them the message thar a
hea1rhy lifesryIe can help meec their de.sperace hcalrh needs? It is not possible ro wrire

a chaprer on every health problem recorded

in rhe annals of medjcal hiswry. FinaJly, I
arrivcd ar the answcr. In this final chapter 1
would give my readers a lasrjng legacy on
how (Q approLUh any diset1Se or conditionftom
it lifestyle perspective. This chaprer will address a number of common conditions rhar
are of great interest in themselves. We wiU
sec a Iifesryle approach to such diseases as
arr.hrirjs, osreoporosis, cararacrs, asthma, anei
a host ofother heaJth concerns. The theme,
however, should be of he1p ro those widl
orher diseases thar are not speeificaIly menrioned. The approach is nor a eure-aH, but
rarher a sysrem ro he1p strengthen your
body, improve your health, and decrease
your risk of diseases in general as weB as
their complicarions.

A System for Prevention and

Treatment
Back in rhe late 1970s, a number of
health professionals, spiritual Icaders, and
educators got rogether ro esrablish a new
preventive medicinc center ca.lled Weimar
Institute. The founders were nor Out so
much ro demonstrate something new as

485

PROOF POSITlVE
;tcronym ta make ir easier tO remember these
ciglu essenrial e1ements of health. The acronym consisred ofa simple phrasc that they
made into a single word: 'NEWSTART:"
Their choice of wording was fonuitous.
Those twO merged words nor only pointed
ro rhose eight essential e1emenrs, but (hey
also gave an accurate message that (he adoption ofrhese simple factOrs could help most
people begin a whole new phase of their
lives-to (rul)' get a "new start" ill life.
Let us look at what the letrets of
"NEWSTART" stand for. They are explained in Figure 1.
Mauy already J."ecognize aH or almost aII
of these eiglu "natural remedies" as necessary conditions for a long and abundam life.
Ln tact, these eight e1emenrs of health are
no surprise to thase of you rhat have been
reading rhis boak from caver tO cover. The
imporrance of each should have been apparent in the material that has been presenred lip to this poim.
We wiJl sec in this chapter a number of
important health isslles thar have nor yer
been explored. As we look ac condirions
that largely have a bearing an aur quality of
life, I bdieve we will sense anew [he vallle
of ilie comprehensive lifesryle thar this book
advoC;ltes. These eight e1emems provide the
fOundation for dealing with any health con-

riition S1tccessfuLly.
Figure 1
ehey were ta confirm rheir confidence in a
century-old approach ta comprehensive
wellness. They were convinced that ilie path
ro healrh for many people rested on eight
reLatively simple hettith concepts. These concepts were popularized by Ellen Whiee in
the 1905 he;tlth c1assic. The Minisrry of
Healing.
It may seem strange rJlat health concepts
ollrlined a cenrury ago could be of value
roday, considering [he advance in medical
knowledge roday compared wirh ehar era.
Elien Whire has been quored on a variecy
of health topics in many chaprers of this
volume. How could a person bave sllch
advanced knowledge? Appendix X probes
rhe answer ro this question.
Weimar deve10ped and crademarked an

486

For a specific person who has a specific

healrh problem or wishes ro avoid a certain
problem, rhere may be one or only a fewof
the eight e1emenrs ofNEWSTART dlarare
more imponanr rhan tile others. In some
stlIations, diet and exercise may appear to
be the mose important facrors. For other
people wich orher he-alrh problems, trust in divine power may seem (O hold the missing key.

NEWSTART ELement Number 1:

Nutrition
The first element of NEWSTART is
nurrition. [have devoted many pages in
this book ro the value of nutrition ro aur
health. We have seen that it can help prevenr hearr disease and cancer. We have seen
its value in helping ro stave off kidney failurc, kidney stones, and carly skin wrinkling.

BEYOND THE LEADING CAUSES OF DEATH

We have looked ar its role in avoiding seri~
infectious illnesses as well as in improving our mental heahh. But rhe toml vegerarian dier can produce many ocher bendirs rhat I have not yer memioned. Nuuition is, of course, just one elemenr of
NEWSTART bur its imponance can nor
be overemphasized.
OUS

~~

High protein &

high fat diet (high
in meat)

(li \)~

The Bottom Line on Diet and Health

In rhis era of medical cosr consciousness,
Dr. Synove KnUfsen has published some
fascJnaring data on rhe benefirs of [he veg~
eearian dieL I Hec resulcs provide a fitting
demonseracion to rhe benefits of a vegeearian eacing sryle regarding general healrh.
Knmsen found rhar among bom men and
women, rhere were approximare!y 15 percent less chronic diseaBcs among vegeearians
when compared ro non-vegecarians. Utilizalion ofhealrh care faciliries also decreased;
rhe non-vegetarians of both sexes reported
more hospiralizarions rhan rhe vegerarians.
Med'ieation use by non-vegetarianswas dramaricaJly more frequem. In general they
used abom twice as many medicarions as
rhe vegerarians.

Vegetarian Diet and Endurance

What aboli( the benefits of che vegerarian dice beyond ies resistance co many diseases? Many people feei that once they go
an a vegetarian dee they are going ro be
weaker. They worry rhar they will not feei
as s[rong ar robust. Many of us have grown
up wth rhe idea thac meac and milk builds
srrong bodies. Those ideas have tumed ouc
ro be myrhs. Competitive arhleres have
known for years chac animal fac aud protein ii> somerhing ro be kepc at a minimum
when rrying ro build endurance. [n general, eber engage in a practice known as "carbohydrare loading." Such approaches are
based on years of research in ebe arca of
sports medici ne.
One ofrhe classic srudies was performed
in the late 19605 when the Scand.inavian
researcher, Doctor Per-Olaf Astrand, studied nine highly erained acWetes. Dr. Astcand
changed cne diets of these athletes every
mree days. Ar the end of each three-day
period, he had each athlere pedal a bicycle

J1l111

il, 'III' I

1 hr 54 min.
(1.9 bours)

Mixed diet (Iower

meat, fat aRd
protein)
Vegetarian diet
(bigh caJ'bohydJ'ate)

I
1.5
2
0.5
______ Maximal Endurance
(rime 10 exhausrion)

2.5

Figure 2

ar high speed umil exhausrion. His resuJrs

are tabulated in Figuce 2. 2
We see thar wirh a high meat dier (high
in bom proeein and fat), chey became eJ(hausred after abour an hour. When on a
mixed diee, lower in meat, fat, and pcotein,
and higher in plant foods, they cOlild peddle
at high speed foc almost twice as long-a
toral of 1.9 hours. However, when on a
vegerarian diet, they weru for 2.78 hours
unril exhauston set in.
1'his dramatic improvemenr in endurance should noe surprise keen observers of
ilie animal kingdom. After aH, che ax, the
dephanr, and the horse have no problems
wieh strengrh oc cndurance an a vegetarian
diet. Horses can run ac high speeds for
hours. Elephants are noted for running 10
ar 12 hours srraight at high speed. Can you
imagine carryng a11 of that weight (over 6
r.ons) at 25 miles pec hour for cen or twelve
hours straight?
On the other hand, meat-eating big cacs
such as cheetahs, tigers, and others have
good speed at the stan, but they fatigue
within a shorc time, often wirhin less than
5 minutes. Indeed, in the animal kingdom,
endllrance, the ability ta provide top energy
for long periods of rime, is largely a characteristic of vegctarian animals.

487

PROOF POSITIVE

Food Supplements
TypicaJly, when I ralk ro people abour
the healch benefirs of nurrition, some are
nor contenr with my message ofearing more
fruies, whole grains, and vegetables. They
wane something more-and perhaps someching less. le reqlliees some effon, planning,
and acquisirioll of new habits ro dramaticaJly increase yom fruic and vegetable eonsumprion. Many feei rhat an easier solution is ro take sllpplements ("vitamin pills")
in order [Q reap rhe benefits of improved
nucrition. They anempt ro improve their
nutririon, not by eating subscantially betrer, but by holding ro che same foods ~tIld
addingvieamin and mineral sllpplemencs ro
rheir regimen.
Unfoflllnace!y, takillg extra doses of vitamins ean cause problems. Take {he B vitamin, niacin, /Or example. Niacin s acrually an acid (.nicotinic acid-nor ro be confused wi{h "nicotine" of tobacco fame3) but
acrs like a vitamin in rhe amoullts that i{ is
found in natuee. However, ifyou take Iarge
amounrs of this acid, t aers as a dfllg. 4 The
reason for chis is ehar (here is onJy sa much
of chis vitamin chac the body can use. The
excess, which cannot be used as a vitanun,
begins ro exen drug effeers. Among rhose

DANGERS OF TAKlNG EXCESSIVE

WATER SOLUBLE VTAMINS
Vitamin Suppkment 1_
Niacin

heart rhythm problems

peptic ulcer disease
Iiver disease
gout
diabetes
diarrhea

Folie acid

pernicious aoemia

.Vitamin 86

nerve pro.blems
Parkinson's
kiduey problems

.Vitamin C

diarrhea
vitamin dependence

Figure 3

488

Effect

Disorder

masks 812 deficienc)'

JPotentiallY irreversible
neuropathv
.
kidney stone forma.ion
Vitamin C deficiency
if supplement is decreased

drug effeccs are che lowering of cholesterol

and uiglycerides.> For chis reason, many
people calce niacin in drug doses to bring
their blood f.us into line.
Like ali drugs, niacin in drug doses can
cause side effecrs. lJ\ che case of niacin, these
side dTects include pepcic uJcers, diarrhea,
altered hean rares, liver disease, gout, and
worscning of diabeces. 6 . 7. 8 Like mher
drugs, niaein in large doses may have some
desirable effccts, but it al50 has some undesirable ones. The lIser of large amOUJ1[S of
niacin is really using a dIlJg-noc a mere
viramiJI. In face, a recent scientiflc paper
on niaein concluded with ilie following remarks: "Unfoflunace1y, the side effecc profile of rhis agent [niacin] warrams ies use
only in patients wirh marked dyslipidemia
[exeremely bad blood fars] in whom side
effeccs and potenrial toxiciry are closely
moniwred. "9
The B group ofviramins, includ ing niacin, is water-soluble aJld is chus easily eliminated. For this reason, many people who
lack a deeper undersranding of biochenusery think {hat rheie bodies would get rid of
any excess niacin and ic would cause no
haem. Howevee, tbey are sadly mstaken.
Orher B vicamins can cause problems in
excess. Laege amoums offolie aeit'! can cause
insomnia and other mental disorders. Vicamn 8 6 (pyridoxine) in large amoullts can
worsen Parkinson's disease and G1USe oeher
nerve problems. 10
Virarnin C anocher water-soluble vitamin, may increase the risk ofkjdney srones
if taken in exeess. 11 It can also cause darrhea and abdominaJ cl'amps.12 Those who
abrupdy swp {aking doses of vicamin C
greater {han 500 mg daily risk developing
vieamin C deficiency-apparemly because
the body becomes dependent on higher
doses of the viramin. '3 Their gums can easily bleed when brushing their reech. Figure
3 lists some of ehe problems caused byexcessive amollntS of wacer-soluble vitamins.
The fa{-soluble vitamins such as vitamins A, O, E, and K, a.re more difficliit for
the body [Q eliminate. Many people have
caken modest amounts of vilamin A in
slIpplemencs and have become ill as a result.
A dose 0(25,000 IU ofviramin A per day

BEYOND THE LEADING CAUSES OF DEATH

(abolit 5 times the amounr needed ro prevenr nutritional deflciency) can cause prohlems as diverse as liver trouble, headaches,
hair loss, dry skin, bone paill, and joint
aches. 14 Pregnant women who rake over
10,000 IU of the vranun pur rheir unborn
children ar increased risk ofbirth defecrs. 15
Excessive vitamin D can cause severe
problems by inrerfering with calcium
balance in the body, and can lcad ro calcium
buildup in me blood (called hypercalcemia).
This condition may produce anyrhing from
mild to life-ehre3rening sympro01s. The lisr
of re1ared problems includes nausea,
vomiring. farigue, confusion, high blood
pressure, kidney failure, and co01a. 16
Viramin E may be toxic in high amounrs,
causing problems with weakness and fatigue
as well as nausea and diarrhea. 17 Excess viramin E aJso predisposes cereain individuals ro bleeding problems, pareicularly rhose
who are an blood thinners (alllicoagulanrs). 18. l? Of. Sheldon Hendler is a widely
quoted aumoricy on vitamins and minerals. He holds a Ph.D. in biochemisrry from
Columbia Universicy and an M.D. degree
from the Universicy of California. He expresses much more camion for vitamin E
supplemenration rhan many supplemem
advocares. Dr. Hendler sees "no reason for
adults ro rake more rhan 400 IU daily" and
lisrs concerns for some side effeccs beginning at doses of as linie as 600 IU per day.20
There is a separare concern regarding the
pracrice of rourinely raking viramin and
mineral supplemelHs. Surprisingly, you can
cause a vicamin or mineral deficieney by
raking /arge doses ofsupplemenrs. How can
such a thing happen?
How can
conscienrious individuals who rake exrra
vitamins and minerals put memselves ac
greacer risk of deficiency? The answer lies
wilh a (rue undersraniling of rJle inreracrions
belWeen vicamins and minerals. There are a
number of ways in which vitamins and
minerals are cransported and urilized by rlte
body. Taking excessive amounrs of one
vitamin ar mineral reslllts in an lInbalancing
of the uptake and ucilizarion of orher
viramins and minerals. Some of these
inreractions are illusrraced in Figure 4. 21
In rhis figure, a line connecring any vi-

v
Zinc

Vite

Phosphorus

Vit B.
Figure 4

ramin ro a mineral indicares an inreraction.

For example vicamin C has a line conneccing it ro iron. This indicaces an inreracrion
belWeen chese substances. In this specific
inceracrion, if you rake large doses of vitamin C day afrer day, youe body will il1cmzse
irs absorprion of iron, which could cause

Vit BI!
Figure 5

489

PROOF POSITlVE
orher problems. Intcractions of orher sllbstances ma)' eause a decrel1se in the absorption of a subsrance. Many people are unaware of rhese potenrially harmful in[eracrions. The message is thar no one shollld
take large doses of supplemenrs without
careful considerarion. There are 11 separate interacrions shown on rhis f1gure.
Nor only do vitamins and minerals
illteraCt, viramins can inreract wirh orher
yiramins, and minerals can inreract wirh
other minerals as ilIl1srrared in Figures 5
and 6. 22

Vai:1adlum
Fluoride

n -.........-.L/

Copper
Manganese

Figure 6

490

There are 12 vitamins shown. and 27

possible interactions. Note [har rhree of the
popular vitamins, A, C, and E, interact with
each other. What about a simple multiple
vitamin pili, or the sllpplemenrs in a bowl
ofProdllcr 19 Of Total cereai? Unlikc many
supplements, rhese usuaLly do nor provide
large amOllntS of nutrienrs. It is lInlikely
thar seriolls repercussions will arise from
raking such products (alrhough rhe)'
probabl)' are not necessary ifyou are healrhy
and followng the diet recommended in this
book).
There are cerrain disease siruations in
wruch large doses of vitamins ean be of benefir. However, such supplemenrs are best
taken under the direction of someone who
is well aware of rhe risks as weli as rhe ben-

efirs ofsllch an approach. Indiscriminare use

of viramin supp1emcms may well increase
health risks rarher rhan decreasing rhem.
In Chaprer 2, "Good News About Cal)cer-It Can Be Prevented," 1 point Out a
be[[er way ro get many of the benefirs of
viramins withour rakjng supplemellts.
There 1 share some of rhe excitjng new
rese:trch rhat is championing whole planr
foods in the anrioxidanr domain where
vitamins were formecly rhoughr ro rein. For
example, Cllrrenr research indieates rhat you
can get an anrioxidanr benefit eqllivalenr ro
1100 IU of vitamin E by eating a cup of
rhe cooked green leafy vegerable, kale. Kale
does rhis wirhour exposing you ro the risks
of high vitamin E doses because it only
contajm 13 1U of rhe amioxidant vitamin
E. Bur it also cOlltains a host of orher
antiox.idanrs, making ir eqllivalent ro 1100
IU of a viramin E supplemenr. 23
The message thar 1 presented e1sewhere
in rhis book is rhar many fruits and
vegetables have powerflll amioxidanr efTects
rhat exceed expecrarions based on rheir
vitamin contene. Similarly, other naturali)'
occurring chemicals in plant foods may
sllbsriwre for funcrions rhar we llSllally
rhink of being associarcd with specific
Vlramms.
Furthermore, we know rhat eating an
abundance of fruj tS, grains and vegetables can
acrually add years ro yom life. Stlldies suggesr that a veget.arian dier ma)' exrend ilie
average person's life by more ,han a decade
over that which rhey colild expect on a heavy
mear, planr-poor djer. Ir shollld be obviolls
ro thase wbo have read rhis book s)'stematically [har ilie way a vegeraJian diet prOlTlores
longevity is by substamially decreasing the
risk of rhe rwo mosr powerfliI killers, hearr
disease alld cancer, as well as decreasing rhe
risk of orher degenerarjve diseases. Rarher
t11an thinking about rhe lIse of supplemenrs
when ill qllcsr ofgood nutririon, think abollt
healrhfllI food choices.
The use of supplemenrs begs ,Ulother
guestion: do viramin and mineral supplemenrs actuaLly increase one's lifespan? Forrunatel)'. rhey have been around long
enough for us ro ger a staristical answer ro
the quesroll.

BEYOND THE LEADING CAUSES OF DEATH

Vitamin Supplements and

}'Dur Lift Span
How mllch difference do food sllpplemems make? This was the quesrion addressed nor long ago by researchers ar the
Narional Cellter for Chronic Disease
Prevemion and Healrh Promorion. The
researchers used the extensive database f(Om
the Fim Narional Healrh and Nurrition
Examinarion Survey (performed [rom 1971
ro 1975), and rhen assessed [he dearh rate
of pareicipams through 1987. They found
rhar rhose who llsed supplemenrs did nor
live any longer rhan the non-users.2 4 They
concluded: "We found no evidence of
increased 10ngeviry among vitamin and
mineral supplemem users in rhe United
Srates. ,. Clearly, supplemems do nor appear
to be living up ro rheir promise.
it is obvious rhar rhe foundation for
nurririonai healrh does nor lie wirh viramin
and mineral supplemenration. It rests with
a dier based on an abundance of fruits,
grains, and vegerables. Nor ooly do rhese
foad choices provide the beneftrs of rhe
virami ns and minerals rhar we know about,
bur rhey also provide a hosr of facrors that
haue not yet bem discovered. lf you are on a
supplemenr program, you will nave to wair
for scientisrs ro discover more of rhe
healrhful compollods in plam foods, learn
how ro make or isolare rhem in rhe lab, and
rhen finaJly put (hem imo sllpplemenrs for
commercial sale. On rhe orher hand, ifyou
are earing frllits, vegetables, whole grains,
nurs and seeds in moderation, rhen you will
be gerring ali of the horresr prorecrive
phyrochemicals (planr chemicals) before
rhey are even discovered.
In spite of aU of rhe scienrific evidence
of rhe nurrirional complereness of rhe lOral
vegerarian dier, there are srill some members of "rhe old school" who believe thar
such a diet is nurririonally deficient in prorein and c.alcium. As poinred aur in Chapter 7, "The Grear Meat and Protcin Myrh,"
Harvard researchers in ilie 1950s showed
thar a roral vegerarian diet was /iJlly adequate
for prorein. In the same chapcer, ir is
poinred aur rhar toral vegerarians need a
smaller inrake of calcium than rheir meac

and dairy-consuming neighbars. There is a

variery of exceUem sources ofcakium in rhe
vegerarian diec such as [he green lealY vegecables.
Onlyone nurrient has been a perplexiry
for total vegetarians and rhar is viramin BI 2'
Interesringly, rhis viramin is needed in only
very riny amounrs. Less rhan one
hundredth ofan ounce is more rhan enough
B lO lasr a liferime (provided you rook ir
i~~mall incremems rhroughouc your life).
Despire our very meager need for rhis
viramin, a [Qrallack ofir am c.ause troubles
such as anemia and nerve problems. Unri!
recemly, no one had found a rcliable planr
sourcc for B 12 . As a result, man)' who are
vegerarians have felr thar becallse of the
possibiliry ofB I2 deficiency, they should eirher get rheir Vitamin B ,2 level checked by a
blood tese every year (ro be sure rhey are nor
becoming deficient) or sllpplement rheir dier
wich rhis viramin for securiry's sake.
Dr A. Moz.1.tar, a Swiss researcher, has
discovcred rhac cercain planrs do comain
viramin B12 .25. 26 Furrhermore, he conducred a srudy to derermine if plant foods
grown organically would have greater conceocratjolls ofB I2 in ilieir risslles rhan those
grown wirh chemical fercili'ler. 27 His resulrs
are shown in Figure 7.

16
14
12

Fertilizer
Chemical
Organic

nglg 10

dry
weight 8
6
4

B u in
Soybean

B u in

B u in

Barley

Spinach
figure 7

491

PROOF POSITIVE
Note [hat B I2 was found in soybeans,
barley, and spinach, and that when grown
organically, tlle amount of B]2 was
signflcantly higher. This stlJdy immediately
generared shock waves. Mozafar's work flies
in the face of a well-es[ablished nurrirolla!
position (held even by vegerarian scienrists)
thar B l2 is nor found in planrs as conventionally grown. Snce he reponed B J2 leve1s even in the chemically ferrlized plants,
some nucrirional experts have proclaimed
his work as suspect.

To Expelld 150 calories

Volleyball
Brisk walking
Rak.ing leJlves or
active gardeuing

,It

Swimming laps
Playiog basketball

NEWSTART Element Number 2:

Exercise

Running (1.5 miles)

Figure 8

10

20

30
Minutes

Increase in HDL arter 12

weeks of training
Decrease blood pressure
Improves i.nsulin scnsitivity
Decreases hematocrit
Decreases fibr1inogen
Decreases platelet function
lmproves fibrinolysis
Figure 9

492

The rescarch has promptcd many questions. Were there misrakes in the B 12 meaSllfemellts? Was rhere somerhing differem
abour rlle soil in the stlldy? Is there really
an increase in B12 content in cenain orgaJlically grown plalHs? More smdes are n,eeded
ro confirm Mozafar's results. Some are now
asserring that a (Orally planr-based clieI wirhout B12 supplements is sufficient for aII of
our Illlttitonal needs.
Unril alI tlle answers are in, however, 1
prefer ro erI' on rlle side of caucion. 1 still
recommend thar rora\ vegetarians rake a
regular B'2supplemem oreu foods in wllich
B12 is added, such as many of rhe brcakfast
cereals or meat subsrjtUtes. There are as teasr
12 dry cereai varie[ ies avalable ar rh s
wriring rhar comain substantial amounts of
B12 Some milk a1rernarives contain ,Ievels
of B I2 rhat are equal (O OI' greater than rhe
amounr in cow's milk. As linie as 5
micrograms every other day is prohably all
that the average person needs. A listing of
quantces of B 12 and orher nurrienrs in
various brands of milk alternatives and
cereals is faund in the Appendix:.

Reduces
tendency
ofblood
to elot

40

50

In rhis chapter thus far we have

examned the first element ofNEWSTART,
which is nurrition. The second element,
exercise, is also of critical imporrance in a
roral lifestyle approach LO healrh.
Throughout this book, exercise has been a
recurring rheme in disease prevention. As
physical activity increa.~es from Iess than 500
caJories expencled per week in exercise,
mortal iry rares decrease. 28 The greatest
benefir is for those wha expend greaIer than
3500 calorcs per week in exercse, but grear
benefit is obtai ned from exercising as Jitrlc
as 750 c.1Jories expended per wcek. 29 To
help you in planning an exercise program,
activities that wol expend 150 calorics are
lisrcd in Fgure 8. 30 .
In the 1990s, alroost everyone has heard
of the importance of exercise for decreasing
the risk of borh hean disease and cancer.
Some of the cardiovascular bcnefirs of
endurance training are listed in Figure 9,3l

BEYOND THE LEADING CAUSES OF DEATH

Notice dut the tendency for the blood
ro elor is a result of endurance exercise,
which wiU protect againsr hean atracks and
srrokes. HOL also increascs. We havc
known for years rhar exercise is important
ro boosr levels ofrhe good cholcstcrol. HOL.
However, research now suggests thar there
is a close response relarionship berwcen
exercise and HOL levels. Simply put, rhe
more yOl! cxercise the highcr yom HOL
level. This has only been recently
appreciared. The HOL was rneasurcd on
nearly 3000 men who were c;lregorized
according to rheir reporrcd exercise levels.
The resulrs are tablllated in Figure 10. 32
The rcsearch documenring a dosc
response relationship berween HOL and
exercisc provides anorhcr explanarion for rhe
heart-improving benefits of physical firness.
One special nore is in order regarding this
srudy. Because of the powerful HO depressing effects of smoking, ali srnokers
were excluded from rhe research. In orher
words. we do nor know from rhis research
wherher exercise boosrs HOL in a similar
manner for smokers. What we do know is
thar a smoker who is concerned abour his
hearr disease risk would be best ro stop
smoking in addition ro exercising :Ind eating
righr. ACCU311y. research suggesrs rhat exercise

i17lproves. tiu chances ofmccessfiJ.lly stopping

smoking. A recent Brown Universiry seudy
found rhar women who exercised were Jess
likely ro begin smoking again. 33
Exercise provides a well-recognized
benefit for rhose wirh diaberes or high blood
pressure. .Ir is also an essenrial ingredienr of
a program rhar boosrs our immune sysrems
and energy levels. There are many more
beneftrs of endurance uaining, as lisred in
Figure I 1. 34.35
One inreresring study involved an
arrempt ro improve rhe communicarion
skills of twO grollps of AJzheimer's parienrs.
One group was pllt in a walking exercise
program, and rhe other group was given
lessons in conversation. Over 40 percenr
of t!le exercise group experienced significanc
improvemenr in comlllllnicarion skills.
while the "conversat ion therapy" group
experienced no significanc improvemenr in
their communicarion skills. 36

58
56

Average 54
HDL
52
level
50
48
46
44

0-2

3-6

7-10
11-14 15-20
Miles run per week

21-60
Figure 10

Strengthens bones
Helps prevent or control diabetes
Helps control obesity
Decreases risk of certain cancers
Helps control anxiety
Treats depression
Improves stress coping mechanism
lmproves symptoms of AJzheimer's
Improves intermittent c1audication
(leg pain during exercise caused
by poor circulation)
Helps control osteoarthritis
Improves fibromyalgia disease
In considering aII of the rhrilling evidence abollt ilie benefirs of exercise, perhaps rhe mosc scarcling effecc is rhe widespre.ld prevenrion of disease rhar wOllld occur if everyone merely exercised regularly.
Currenr esrimates are tbac (he lack of
exercise in America callses up to one-rhird
of dearhs from the following chree major
diseases: coronary hearr disease. colon

Figure 11

493

PROOF POSITIVE
cancer, and diabeees.J7
The first rwo e!emcnrs of r11e NEWSTART program (nutrition and exeecise)
beautifully complement each orher. Nutrition worh eogether wirh exercise tO give more
benefirs rhan eithee one alone. This is truc
ofdiseascs like heart disease, cancer, and diabetes. However, it is aha true for qualiry-oflife concerns. Recall ilie elassic research thar
demonsmued t.he superioriry of the vegerarian diee regarding arhleric endurance.
Other qllaliry-oflife bcnefits are in the
arca of mental performance. For examplc,
middle-aged individuals-and even r110se
up illto theie 80s who do nor suITeI' from
Alzheimer's disease-have been demonstrared ta have a measurable improvement
in memory following aerobic exercise programs of tune ar ren weeks in durarion. 38
In fact, older Americans have a progressive
improvemem in meneal funcrlon as rhey increase their amounr of exercisc. As one research anicle put it: "There was a clear linear
relarionship berween rhe Ievel of activiry and
ilie level of cognitive [mental) abiliry."39 A
consensus panel convened by the National
Insti(ute of Mental HC'alth idenufied seill orher
imporrant quality-of-l.if{: benefits from exercise. They are listed in figure 12. 40
Alrhough healrh professionals have CIllphasized for years the imponance of exer-

A benefit to mental health and

well-being
Short-term reductious in stress,
such as anxiety aud tension
Long-term reductions in

~nxiety

Long-term reductioDs in depressioo

in moderately depresscd individuals
RcductiODS in muscle teDsiou, heart
rate, aud some stress hormone levels
Figure 12

494

cise in prevenring life-threaterting diseases

in order ro motivate rheir paticlHs ro exercise, this is probably nOf rhe most effective
straregy ro promote exercise. Improvcmenrs
in the various facers of rhe qualiry of Iife
appear ro be t.he most imponanr reasons rhat
many become regular exercisets.
RUNNER'S WORLO magazine published
the results ofan excrcise survey of700 of its
subscribers in 1990. Notice the various reasons for adopring an exercise program:
Thesc top reasons were aII rclared ro the
quality of life. Furrher down the lisr were
lifcsaving reaSOI)S thar professionals rhink
are the mose morjvaring. Onl)' 42 percenr
identified heart disease prevention as a
reason for exercising.
Medica.! rcsearch cominlles to uncover
more and more benefirs of exercise on
qllaJiry of/ife. Harvard researchers recently
docume\lted thar excrcise decreases the risk
of developing diaberes in adlllthood. 41 As
liule as one workollt a week cur diaberes
risk by 29 percenr. The prevelHive effeet
was nor merely the result of weighr redllction. Orhcr preljminary research suggcstS
rhat regular exercise may hdp ro foresrall
hearing 1055. 42 Or. Helaine M. Alessio and
colleagues from Miam.i Universiry in Ohio
exposed 28 people ro rdarively laud noise
(IOD decibels). The mase fir subjecrs retained more hearing capaciry man those
who were not as fir. One explanarion for
rhe difference s rhar regular exercise may
improve the flow of oxygen-rich blood
throllgh ehe riny blood vessels in the ear.
As a restimony ro rhe far-reaching benefits of exercise, whcn the Cenrer for Disease Control and the American College of
5porrs Medicine published recommendations in 1995, they presented an ideal
schedule of "daily exercise." Gone are ilie
days of recommending duce days a week as
being sufficienr. In the words ofrhe repon:,
"Every U.5. adult ShOllld accumlllare 30
minutes or more of moderate-inrensity
physical acejviry on most, preferably ali, days
of the wcek. "43
In Chapter 2 an cancer, auenrion is
facuse<! on the importance of exercse on
rhe immune system. There we sec some of
the encouraging research thar has demon-

BEYOND THE LEADING CAUSES OF DEATH

strated exercise's abiliry [O decrease cancer
in general 44 as well as providing special help
for devastating cancers like those ofthe lung,
colon, uterus, ovaries, vagina, :Ind cervix. 45 .
46. 47 Soroe of rhe reasons thar exercise has
such far-reaching stimulating effects on the
immune system are presenced. A number
of natural immune fighring cells and chemicals are enhanced by exercise. These same
beneftts ro ehe immune syseem that heJp ro
prevent life-threatening cancers can also heJp
to prevenr the annoying everyday illnesses
such as coughs, colds, and flues. 48
It is noe clear exactly how much exercise
is needed [O prevenr cancer; however, consistency appears [O be an imporcanr factor.
The same likely holds true for other immune
sysecm benefirs from exercise. The conclusion regarding ilie figheing ofinfecrions and
cancer is ehae exercise should be a pari of
aur daily Ijfesryle.
Many sedencary middle-aged ar e1derly
people shy away from iniriaring an e.xercise
program because of fear of experiencing a
heare atcack. However, if rhey searr slowly
and do nor exercise ta the point of
exhauseion, cnances are ehey wiJl nor need
a medical consulrauon before iniriaeing such
a program.
Those with cerrain physical condirions
should have an evaluarion prior ro in iriaring endurance training. 49 They are lisred
in Figure 13.
This figure quores direcdy Eram a
consenSliS conference pur on by rhe
Narional Institutes of Healrh in 1996 jn
which many exercise and hearr disease
experrs convened ro print consensus
sraremencs on physical exercise. According
ro rhe above consenSllS statemenrs, if a 45
year-old man smokes and has high blood
pressure, he would need a medical evaluaCon prior ro rraining because he has ~mul
tiple risk facrors" for hean disease. lf he
had only one risk factor he would noe have
needed an evaJuarion. More information
regarding cardiovascuJar risk factors is found
in Chaprer 3, "Hean Disease-Conquering rhe Leading Killer."
Years aga, Eilen White recognized the
benefits of physical excrcise as shown in Figures 14 50 and 15. 51

WHO

UATE
G
G

"Those with known cardiovascular disease."

"Men over 40 or women ovcr SO with multiple
cardiovascular risk factors who contemplate a
program of vigorous activity."
"Because the risks of physical activity
arc vcry low compared with the health
bcncfits, most adults do not nced medical
consultation or prc-testing before starting
a modcratc-intensity physical activity program."
Figure 13

"Tbe more we exercise, tbe better wiU be

the circulation of tbe blood. More people
die for want of exercise tban througb
overfatiguej very many more rust out
than wear out. Tbose wbo accustom
tbemselves to proper exercise in the open
air will generally have a good and
vigorous circulation."
Figure 14

"Morning exercise, in walking in the free,

invi~orating a,ir of heaven, or culnvating
flowers, small fruits, aud vegetables, is
necessary to a bealthful circulation of
tbe blood. It is the surest safeguard
against colds, coughs, congestions of
brain and lungs, inflammation of tbe
Uver, the kidneys, aud the lungs, and
a huodred other diseases."

495

PROOF POSITIVE

w
dia betie eomplieations
stroke
high blood pressure
heart disease
sYliIlptoms of intermittent
c1audjcation (leg pain due to
bl'oekage !n ,Ieg blood vessels)
Figure 16

One word of camion: althollgh moderate exercisc has e1early emerged as heaJrhful
ro rhe immune sysrem, excessive exet'cisc; is
noe. Exercise ro the point of complete e'Xhaustion-typical.in competirive arhlerescan work in rhe opposire direction by decretlSing immune responscs. 52

NEWSTART Element Number 3:

~ter

496

Thicker, more viscolls blood illcreases

stroke and hean elisease risk. One
measuremenr thar, in parc, derermines
blood thickness is caJled hematocrir. 1'his
ref1ecrs (he number of red blood cclls in rhe
blood, and usually c/osely parallds fhe
hemoglobin level. Hemarocrir values
grearcr than 50 perceot double the risk of
cardiovasclIJar evellts in men aJld increase
rhe risk fourfold in women. 53 lf a persoll is
not drinking enollgh water, hemarocrir rises,
rhlls increasing risk of hearr arracks and
srrokes. Also, a laek of warer callses
dehydrarion of reel blood eells, makillg theOl
less flexiblc, ,Ulei they have a greater rendency
ro c1or. 54
AlI told, a wealrh of nformation has
been published on rhe subject ofblood flow
characrersrics and irs mpacr on a variery
ofdisease sr;}rcs.'S' 56. 57. 5B The research oftcn

is published under rhe ride of

"hemorheology." 1'hi5 term comes from
"hemo" which refers ro blood and
"rheology" which refers ro the srudy of the
flow propcreies of complex marerials.
All)ong the implicarions of this research is
thar adequate warer drinking combined
wirh mher aspecrs ofa healrbfullifesryle may
help posrpone Of prevenr a variery ofdiseases
and their complicarions. A few of the
benefirs rhar may accrue from iluprovemenrs in blood Aow caused by a more liberal inrake of warer are shown in Figure 16.
Daberes is associared wirh increased
blood viscosit)' or thickness. As the blood
sugar level is broughr undeI' bener control,
viscosiry rends to improve. Unconrrolled
blood sugar Ievels may predispose individuals ro high viscosiry in paft becallse of dehydr,ttion. When blood sugars are rllnning
high, rhe kidneys Iose sugar, and rhe sugar
rakes watet' wirh iL 1'he issue ofblood rhickness in diabctes i5 of parrcular concern because high viscosiry levels may play a role in
dia bctes-rehucd kidney and nerve damage. 5~
Blood viscosiry also appears ro have a
role in high blood pl'essure. In popll1arion
stlldies, rhe higher a person's blood pressllre,
rhe higher their blood viscosiry rends ro be.
Ifa person can reduce hematocrt, the blood
pressure wil! rend ro decrease. This provides
a double benefic lower blood pressure anei
lower blood viscosity work rogerher to
funher decrease stroke risk. 60
Ironically, rhose on diuretics (warerlosing pills) for rheir blood pressure may in
some ways bc perperuaring their problems.
The reaSon is that dlcse drugs tend ro
decrease blood volume, and rhus can
conrribute ro an increase in blood thickness.
Diuretics may nor only cause loss of warer
from rhe body, bur ma)' also conrribure to
10$5 of fluid from red blood cells-making
ulem less flexible and deforrnable. 61 RecaB
that stlch changcs will, in cum, make rhe
blood more likely ro dor. The same ehanges
may also perpetuate rhe high blood pressurc.
Some have speculared rhar warer Illay
have :\Ilother mie in decreasing high blood
presstlre and in prevenring srrokes. Pure
warer actually acts as a mild diuretic. Ifyou
drink more \Varer rhan you need, the excess

BEYOND THE LEADING CAUSES OF DEATH

warer is e1iminated rhrollgh rhe kidneys.
There is one subde quaJificaeion: kidneys
can onl}' excrere warer rhar is accomp:Hlied
by sodiull1. As a resulr, excess warer
drinking resulrs in rhe loss ofsome sodjum.
Thus, drinking plemy of pure water helps
ro decrease bod}' sodillrn srores and thus
may conrribure (Q blood pressure lowering.
Orher lifesryle habirs can help ro
imp rove blood fluid iry. These [acrors
include sropping cigarerre smoking,
e1iminatng rhe lIse ofakoho!, Josing weight
Cif overweight), engaging in regular
moderate exercise,62. 63 and adopting a high
fiber, low far, low protein dier. 64 . 65. 66
Regarding exercise, modera re exerrion is
beneflcial ta rhe circularjon, bur excessive
exerdse may be harmful ro blood fluidity.
For example, rhose who exercjse in rhe hear
and are perspiring heavily ma)' be more
likel)' ro have problems wirh dorring due
to "rhickening of rhe blood" becallse of
blood volume loss.67
Water drjnking has srill other beneftts.
Your mother no doubt cold )'OU rhar it was
good for your kidneys and llrinary bladder.
However, she probably was nor aware of its
effect in helping ta prevellt gallbladder
disease. A number ofsrudies have indicared
rhat drinking liberal amounrs ofwarer helps
(O diluce rhe bile in rhe gall bladder and thus
decrease the risk of srone formarion .68.69. 70
Those who are ovenveighr, 01' have a family
hsrory of gallstones, or who have known
gallbladder disease would be wise ro
seriously consider rhe benefirs of drinking
more water.
In m)' medical pracrice I have found thar
insufficienr water jmake can even mimic
hypoglycemia. This problem scems ro be
more common in younger individuals wirh
lower blood pressures. I will never forgeI
the bllsinesswoman \Vho had extensive
laborator}' re-sts ro e1erermine why she had
"hypoglycemic fainting spells." None of the
rests provided :In answer. Afeer this exrensive evaluarion, 1 suspected rhe problem
resred with someth ing as simple as inadequate fluid inrake. I promptly encouraged
her to drink a minimum of 12 gJasses of
water every day. She followed my jnstrucrions and her problem was solv .d.

Drinking more warer decreases tlle risk

of kielney srones by e1illiting the mineral
conrenr in the urinary system. Consuming
liberal amounrs of warer mal' also dccrease
the rsk of urinar)' tract infections. Warer
drinking among srllokers mal' a1so help ro
decrease rhe risk of cancer of the bladder
for similar re.asons. Smoking gives rise ro
powerful carcinogens (as explained jn
Chapter 16, "D)'ing for a Cigareue? Kick
the Habir and Live"), some of which are
stored in rhe bladder. The more water one
drinks, rhe less concenrrarcd are those
roxjns, and rhe greater rlle srimullis ro void
and expel rhem. In [,1Ct, \Vater drinking has
sa many benefits, thar a recent issue of the
Journal of rhe American Medical
Associarjon calJed artenrion ro the particular
hazards facing oleler Americans from
inadequare fluid jntake.7 J Harvard
researchers esrmared rhar by makjng Stire
oldeI pc-ople dr~U1k enough f1l1iels, over one
million days of hospiralizarions anei over a
bilhon dollars each year wOllld be saved.
In chis secrion, I have rrjed ro provide in
broad srrokes JUSt a glimpse of rhe excting
rescarch th:\[ encourages LIS ro drink plenry
of waIer daily. The intemal use of \V'arer
can elearly reduce suffering and save dollars
as well as lives. However, water (an also be
applied externa!l)' ro deal with a host of
physical problems. Those observarions
apply in general wirh equal force ro orher
painful condiriollS such as muscle aches,
srrains, etc. A fuU discllssion of r!le broad
science of "hydrorherapy"-or waIer
rherap)'-is beyond the scope of rhis
chaprer. However, suHlce r ro say that
exrernal applicarions of warer have been
used with clinical success in condirioJls as
varied as headaehes, asrhma, mllscle tension,
and digesrive complainrs.

NEWSTART Element Number 4:

Sunshine
Slinshine has gOHen a bad rap. It is rrue
that exeessive ulrravjolet light from sUJlshine
can increase rhe rsk of skin cancer and
cararacrs, but judicious amounrs ofsunshine
c.an be extremelJl beneficia/. For exarnple,
sunshine can play a crirical rale in helping

497

PROOF POSITIVE
to prevent osteoporosis. $unlighr, you wiU
recall, is able ro convert cholesterol inco
vitamin O, ,m essentiaJ faceor in mainL.-uning
good bone healrh. 72
In Chapter 7 tiut deals with protein, we
saw thar high inrake of animal prorein
sources was also a signtleanc factor in
causing osteoporosis. In addition to
sunshine and nutrition, howevcr, other
NEWSTART factors are important in
dealing with osteoporosis. Exercise is vital
to sraving off age-re1ated loss of bone mass.
Recent research from Washington
University School of Mcdicine in St. Louis
has demonsrrat.ed mat a woman can increase
her bone mass by 2 ro 3 percenr per year by
exereise aJone. 73
But what about skin cancer? Why not
ger our vitamin O from pills or
supplemented foods, so we can avoid
sunshine's cancer risk? There's no question
abollt it: when many Americans rhink of
sunshine, rhey r.hink of an agent thar
inctedSes the risk of cancer.

Sun Exposure in High Doses

and Cancer

498

SunJight in high dom increases skin cancer risk. About 95 percenc of skin cancers
are of MO rypes: squamous cell and basaJ
cell. 74 Borh of these rypes of cancer are ncreased by substantial cumulative liferime
exposure ro the sun. Fortunately, however,
rhey are slow growing and lIsually remain
confined ro rhe skin. Even though SOme
750,000 squanlOus .'lnd basaJ celJ skin cancers are diagnosed each year in the United
States, only abOlit 2, I00 fataJiries (Iess rhan
one percent) result.7 5 The f.1taJties occur
mostly in r1lOse who fail ro get prompt and
complete removal of the cancer.
Melanoma, anOUler type of skin cancer,
provides a markedJy di/-Terenr situarion.
This usuaHy darkly pigmenced carlCer has a
fearsome rendeney ro spread and kill tlle
victim. Each year onl}' about 34,000 cases
of melanoma are diagnosed in our eoumry;
however, 7,200 (more than 20 percent) die
annllally from tllis dreaded skin cancer. 76
Melanoma is currently on a rapid rise
worldwide; in Europe, ir increases by three

to seven percem every year. 77 Regarding this

deadliest of skin cancers, ir appears that the
important facror is noe sa much the tOtal
amount of sunlight you are exposed ro, but
whether or nOt you get sunburned. Thus,
overdoses of sunlighr are ro be avoided.
More informarion on skin cancer is found
in Chapter 2.
Sunlighr in moderate amoullts, however,
is healthfl.1l, and may even be beneficial in
cancer prClJcntiol1. Research now suggesrs
that judicious sun exposure and the
production of vitamin D may also help to
prcvenr certain types of cancer. Colon
cancer is one of rhe malignancies that
sunshine exposure ma)' help ro prevent.
Researchers ar rhe University ofWashington
srudied c;wcer rates in (line differenr areas
of the United States. They discovered that
men from Southern states had much less
colon cancer than Nonherners,78 For example, when compared to men living in
New Mexico, men in Michigan, Connecticut, and Washington had colon cancer fates 50 ta 80 percent higher. The cffeet aJso seemed ro hold true for women,
aJthough it was nor as marked.
Another scientific uride reviewed
srudies possibly linking cancer prevention
wim sunshine exposure. H.G. Ainsleigh,
rhe author, poinred Out that there is a long
hisrory of medical documemation suggesting mar regular sun exposure substanti,llly
decreases the death rates from cenain cancers. 79 Like other researchers, Ainsleigh
observed rhat the linkage between sun exposure and cancer prevention appears ro be
due to vramin D. Viramin D and re1ated
compounds appear able ro suppress me abnormal growth of a variety of cancer cells.
These include leukemia and Iymphoma as
well as cancers of the breast aud colon.
Ainsleigh did not srop there. He went
on to make somc startling calculations;
namdy, fhat aJthough frequem regular sun
exposure statistically c.auses 2,000
cancer
fatalities per year, ir also acts to prevent

u.s.

another 138.000 U.S. annttal cancer

dcaths-and could possibly prevenr another
30,000 more if ali Americans adopted the
practice of regular, moderate sunning. He
even raised tlle concern that blame for a 17

BEYOND THE LEADING CAUSES OF DEATH

percem increase in breasc cancer incidence
duri ng 1991 and 1992 may have been
relaced to misplaced solar-phobia; with a
"decade of pervasive anei-sun advisories
from respected aurhorities. coinciding with
effeecive sun ereen availabiliry." Sunscreen
may induce orherwise caLltious sunbachers
tO ger overdoses of sun exposure.
Regarding sunshine and cancer, rwo facrs
clearly scand ou (. Fi rsc. excessive, injudicious amounrs of sunshine can increase
sIOn cancer risk. Second, avoiding sllnshine
is nor a good alternarive. It is likely thar
sunshine Jnd rhe vieamin O ie produces may
acrually play a role in c.ancer prevenrion as
weJl as in bone healm.

NEWSTARTElement Number 5:
Temperallce
The concepe of promoring personal
healch by J judicious exposure ro sllnshine
provides a perfecr backdrop for looking at
rhe flfth NEWSTART element. The fir c
"" stands for "eemperance.' Temperance
in rhe context of rhis book means "cotal
abstinence from subsrances rhar are harmful
and moderace use of subsrances that are
helpful." Applying rhe 'temperance"
concepc ro sunshine would lead us to use
this helpful factor in moderatjon. Often
rhe challenge concern ing remperance is ro
decide which substances ro use in
moderat ion and which co avoid coeal1y.
The concepr of rotal abstinence has
become very unpopular. Many healrh
educators promote che mistaken idea ehar
almose anyming we do is appropriate solong
as we do it in moderaeion. From a stlldy of
ehe research literature. coupled wirh
personal experience from my own life and
those of my pacients, it is evident that we
wOllld be better off tOlolly avoiding rnany
things ehar are popular to use "in
moderarion." Elsewhere in chis book
(Chaprer 17. "Wam a Drink?"), the case for
racal avoidance of alcoholic beverages from
a heaJeh perspective is presented. 1 am not
a tone voice crying for rotal abSlinence from
alcohoJ. The World Healm Organization
has eaken rhe sarne position, now advocating "no alcohol" as ehe standard. ao In sev-

erai chapters of chis book 1 have cited concern wirh another popular addictive drug:
caffeine. Caffeinared beverage present a
subtle mreat ro our heahh whjch some are
finally beginning ro grasp.

Problems with Moderate Caffeine Use

As poinced om in Chaprer 2 an c.1ncer,
medical research has raised concerns rhar
cofTee and omer caffeinated beverages may
increase the risk of certain cancers. The list
of chose malignancies include cancers of me
kidney, breasr, pancreas. ovar}', bladder, and
colon. 8 1. 82. 83. 4, 85 Theobromine is a
caffeine relative found parricularly in
chocalate anei tea. Research suggests thar
even small al1101lJltS of rhis compound raken
regularly can double a man's risk of proscare
cancer.sc, The concerns wirh cafTeine and
its re!atives are not whol1y cheorerical: rhese
drugs have porent cancer-causing effecrs. In
laborarory studies they are capable of
damaging rhe chromosomes ofborh plams
and animals. 87 . 88. 89. 90. 91
Cerrain experrs contesc some of mese
findmgs. Are you willing ro rake the risk of
concinuing your caffeine habit? Many have
become habiruated-if nor addicted-to
moderace or large amounrs of caffeine; the
suggesrion ofrota! avoidance brings up greac
barriers. To illuSlrale your approach ro this
decision, assllme th:u you are planning ro
build a new house. You find a place on a
nice piece of properry. but rlle land is over
an olcl coxjc waste dump. Some experts rell
you thar there is no proof of any risk from
living above thac dllmp. Others have
grounds for concern that living there will
increase your risk of cancers of rhe kidney.
breasr, pancreas, ovary, bladcler, and colon.
Do you roll ehe dice aJld move in, or do
you say. "why rake rhe risk?"
If you had never acquired the caffeine
habir, you would probably stay tocally clear
of iL However, if ic is a parc of yom life, is
it worrh giving up? I would say 'yes." I
have worked wieh many people who have
overcome the caffeine addiction. At first ir
may be a srruggle, bur over rjme they nor
only get along fine wirhout it but chey also
rcap rhe healrh benefits of their decision.

499

PROOF POSITIVE
Caffeine not only increases the rheorctlcal risk of cancer, it a1so brings a host of
orher problems in irs train. Coffee and/or
caffeine are linked ro an increased risk of
sllch problems as miscarriages, low birth
weighr babies, worsening depression,
anxiery and fatiglle, elevared blood pressure,
heart palpitations, heart elisease, bone loss
anei osteoporosis, and other maladies.
Furrher informarion is provided in Chapter
2 on cancer and Chaprer 12, "The Frontal
Lobe-The Crown of the BTain."

NEWSTART Element Number 6: Air

Throughout mosr of recorded hisrory,
it seems rhat people have taken frcsh air for
granted. However, with the advelH of the
industrial revolurion, folIowed by current
concerns for indoor and omdoor air
pollution, fresh air has become a more
valued commodiry. An excdlenr article on
fresh aiI" was penned some years ago by DI".
Bemel! Baldwin. Enrirled "Why is Fresh
Air Frcsh?"?2 Baldwin pointed our rhar fresh
air is chemically different than rhe
recirclllated indoor air rhat most America.ns
brearhe. High quality fresh air is acruaJly
dectrified. The life-giving oxygen molecule

1. lmproved sense of well-being

2. Inereased rate and quality of growth in plants

aud animals
3. Improved funetion of thc Iung's protective cilia
4. Tranquilization and relax'a,tioD
(decreased anxiety)
5. Lowered body temperaturc
6. Lowered resting Ileart rate
7. Decreased sun'h'al of bactcria and
viruses in the air
8. lmproved learning in mammals
9. Deereased severity of stomach ulcers
Figure 17

500

'l

...

:
'.,

. t

.wi' _-....."." . -

is negatively chas-ged or "negarively ionized."

This ncgatively charged oxygen gives rise ta
a nllmber ofbenehrs as lisred in Figure 17.93.
94. 95. 96. 97. 98, 99

An environmem of negative!y charged

ions truly has remarkable effecrs. SOll1e of
rhe most impressive have to do wirh
behavior. Some of rhe research has cemered
on animals rhat were raised in sllch a \Vay as
ro develop rhe equivalent ofhuman anxiery
disorders. When rhese animaJs were alJowed
ro breathe air wirh an abllndance of negarive
ions they were protecred againsr some of the
physicaJ ehanges linked ro anxiery. Animals
exposed ro negative ions showed a
normalizatioll of peninent brain chemisrry
measurements ..'Ind did nor show any
tendency ro high blood pressure 01' ulccrs. 100
(In faer, even in animals with 110 behavioral
disorders predisposing rhem ro ulcers, negative air ions helped tO promote less significam ulcer disease including smaller ulcers,
less bleeding :lIld less acid secrerion. lOl )
In smdies ofchildren, negative ions have
aJso demonstrared salurary effects. In one
srudy, norm.al children and those with
Iearning disabilieies showed measurable
irnprovemems in brain function. 102 The
authors concluded: "Negative aiI' ions are
seen ro be a cool wirh porential theorerical
and remedial applications. "103
Orher research further underscores the
fact rhat fresh-negarively ionized-air
helps to keep our mood huoyanr and
positive. Baldwin and orhers cite rhe Middle
Eastern "sharaw" (also eransliterated
"sharav") windstortns that bring an abtmdance of unwanted positive ions with
rhem. 104 105. 106. 107 During these storms, as
Illany as 30 percellt of individuals devclop
problems with increased anxiery and
sllspicion, migraine headaches, nausea,
vomiring, diarrhea, eye problems,
irritabi!iry, respiratory congestioll, etc. The
positive ions seem to alter brain levcls of
seroronin, an important mood-e\cvating
chemical. These hac desen winds rob rhe
air of helpflll negative ions.
Negatively charged air is also demoyed
by recirculating air in bllildings, robacco
smoke, ciry smog, and othcr pol\urams. On
the other hand, good qualiry negatively ion-

BEYOND THE LEADING CAUSES OF DEATH

ized air is found in abundance in naruraJ
ourdoor environmenrs, especiaHy around
evergreen crees, beach surf, or afcer a
chundersronn.
Researchers have been stlldying che
harmful effeccs of polJuced air an human
bengs. Their fjndings confirm chac
pollucion depleres ehe air of negarive ions.
In addition, che common poJluranc, ozone,
has been demonscrared ca eause eye
irrirarion, shormess of brearh, cough,
worsened lung fUllccion. and decreased
physical performance. I08 . JO? Worse yec.
women living in one of fhe nation's mosr
highly polluted regions, rhe Sourh Com Air
Basin ofCJifornia, experience increased risk
of cancer in proporrion ro cheir coral
exposure ro particulare pollurancs. 11D
C1e~rly. ic behooves aH of llS ro get as
much fresh air as possible. When we are
overcome by srress and worry. gecring away
from aur urban dweJlings aod workplaces
seems ro promise more chan a change of
venuc. The medicallicerarure indieares char
a drive ro che seashore, a local srare park, ar
ocher natural seuing promises improved
memal and physical healch as we brearhe in
cite refreshing fresh aiI with ics abllndance
of negarive ions. Bccrer yet, if ir can be
arranged, living in a more rural serring
would likdy yieJd dle blessillg of becter
quaJicy air as weU as other ameniries.

viramill. lec's calJ ir viramin R. Inchis hyporherical siruation. we can now forger
abour whether or noe we have rime to rest.
Afrer ali, every one of resr's advanrages can be
obrained from raking a pilI. Ler us now look
ar this aillazing "vicamin" and see if yOll wanr
ro include it as parr of your daily program.
However, before we go roo far wirh our
il!usrrarioIl, rShOllld clarifY rhe facc rhar resr
comes in a number of differenr forms. In

v
Vitamin

R}

Daily rest or sleep

Vitamin R 2 - - - - Weekly rest

R3

Recreation

Vitamin R 4

Meditation

Vitamin

Figure 18

NEWSTART Element Number 7'

Rest
1 am eonvinced rhac if che benents of
resr could be pm into apiU, ic would be
among rhe horccsr selling supplemcms on
che marker. Unfonunare1y, in order 10 rcap
che benehLS of rese, we must slow down and
rake cite rime co rest. SadJy, many of us do
nor believe dut we ean really pause 10llg
enough 10 eake advanrage of rhis vital
remedial and prevenc;lrive agency.
Therefore, mauy ace noc even inreresred in
learni ng abour che far-reaching benehrs of
rese. Thcy reason, why become eonvinced
of che advanrages of somerhing thar I do
nor have rime for anyway? Because of rhese
biases. I'd like ro challenge you ro rhink
abom resr as if jr were a newly discovered

faer, rhere are really four differenr eypes of

viramin R. Just as [here are a number of B
vieamins, sa rhere are faur siblings in rhe vicamin R family. They are lisreel in Figure 18.
Viramin R 1 is sleep, or daily rest. Viramin R, is rhe weeklv resr: in addirion ro
sleeping each nighr, ~e need a weekly day
of rese. Viramin ~ is recrearion; we need
ro take rime 10 get away from work, physical rensiolls, anei menral srresses of life.
Vitamin R.j is also essenrial: rhi.s viramin is
medicarion-and sholild be dane ar teast on
a daily basis. Lec's look more clasely ac each
of these faur types of viramin R.
RI. che sleep viramin, is in shorr supply
with many Americans. Research suggests
char rhe average person does besr an seven
ro eighc hours of sleep per day. This flgure

501

PROOF POSITNE

502

was associared witb the grearest longeviry

in the AJameda collnry healrh stlldy thar we
examined in the first ehaprer ("Principles
for Optimal Health").lll Statisrics slIggesr
rhar about rwo-rhirds of American adults
sleep berween six and nine hours per
nighr. 112 Sleep needs vary with OUT generics,
Dr. James Peri, a Ph.D, psyehologist and
sleep expert, poinrs out thar abour 20
percenr of the popularion genericaJly needs
less rban six hOllrs per nighr. He also
observes ehat 10 percenr of our popubce
geneticaJly needs more than nine hours per
night. 1I3
Regardless of your specific need, anyone
can come lip shorr on vitamin R 1, If you
do nor feel wide awake and energetic
rhroughoUt your walcing hOllrs, you are
likely sleeping roo liHle. And if that is your
problem, yOll are nor alone. In rhe U.S.,
farigue is one of rhe 10 mOSt common
reasons for visiring a physician. 114 In f.'lCr,
each year 3.3 million Americans visit their
docrors for insomnia alone. 115 Yes,
problems wirh inadequate sleep are exceedinglycommon in our narion. The evidenee
suggests rhar as many as 60 pereent of
Amerieans have some problems relating to
rheir sleep habits. 116 117
It may seem somewhar depressing ro talk
about how poorly rhe average American's
sleep needs are sarisfied. There is some good
news in rhis deparrmenr, however. Those
who bandle srress better appear ro require
less daily sleep. In orher words, if yOll are
emorionaUy healrhy and positive, your body
is likely ro sleep more dtldenrty.1I8 Exercise can also help you ro have more energy
on a given amOlllll of sleep. Pur anorher
way, reglllar exereise helps ro deerease our
sleep requiremenrs. In fact, exerdse bas been
demonsrrared ro deerease fatigue and boosr
mental aod physical vigor. 119
Alrhough positive moods and physical
exercise can help us in rhe sleep deparrment,
[here are things (har work against our abiliry
ro ger refreshing sleep. Television viewing
is one reason why we do poorly in rhe sleep
departmen (. The more relevision you
watch, rhe less rime yOll have ro sleep. This
is particulari)' a problem for American
)'omh. Many are nor getting enough sleep

because of rbeir liberal diel ofTV. There

are, of courst, many orher reasons for aur
national sleep debr. ] wiU nor go iora aur
tendency ro squeeze roo many activities illto
a finite number ofhours per day. I would,
however, llke ro srress one of the mosr fatal
deceptions of the sJeep-deprived. Most of
rhose who are shorrchanging themselves an
vitamin R 1 feellike they can ger by WthoUI
optimal amOUlltS of this vitamin.
Unfortunalely, rhe medica1lirerature is very
dear on the effects ofsleep deprivation aud
irregular sleeping habils (such as shift
work) , 120, 121. 122, 123 Such practices slow
reacrion rime and increase the risk of bath
faral and uonfalal accidents. Sleep
deprivation can c1early have life-threatening
consequences. Probably one of the mosr
notable is falling asleep while driving. One
imeresrng aspect of rhe currem re.search on
falling asleep at rhe whecl is that accid /l{S
and fatalities seem ro be rhe mosr common
in those who have not learned their limits.
In one U.5. study, 55 percenr of such
accidems occurred in individuals 25 years
old ar less, suggesting dur inexperience in
respecting f.1rgue's cues can be costly.124 The
toll of disabiliry and dearh from farigued
drivers is nor confined to the O.S., ofcourse.
A recenr German smdy indicates rhat falling
asleep ar rhe whed is the leading cause of
German roadway far.aliries, amounring ro
nearly 25 percem of the toral. J 25
However, the risk of orher rypes of accidenrs also increases dramarically in those
who are sleep-deprived. Aceidenrs ar rhe
work place also occur more commooly when
we are short on sleep, working unllsllal
hours, ar orherwise farigued. Large-scale
disasters like the Chernobyl fiasco, rhe
Euon Valdez crash, and rhe Three Mile Isbnd incident aII occurred in early pre-dawn
hours, when vigilance was at a low poinr.
Dr. Fred Hardinge, an expert looked ro by
the FederaJ Aviarion Adminiseration 011
issues re!aring ro fatigue and performance,
has poinred our that mosr of the "friendly
fire" problems in the Persian GulfWar were
due ta fatiguc. Some of rhese short-rerm
sleep deprivarion problems-wirh longferm consequenees, nonerheless-may resuit from whar are called "micro sleeps." In

BEYOND THE LEADING CAUSES OF DEATH

these seuings your eyes typicaJly are wide
open, yer your ;}nention lapses and you do
nor reaJize whar is happcning.
AJrhough short-rcrm problems wirh
sleep deprivation ofren grab rhe headlincs,
serious problems resuJc from chronically noe
gening enough slcep. Remember ehat evcn
six hours of sleep per night 1S insufficiene
for many people and sers rhe sragc for
problems. FrantaJ labe brain dal1lage ean
occur in sleep-deprived animals. PET scans
demonstrate deereased blood flow ro rlle
fronrallobe ofthe b~in in ehronically sleepdeprived individuals. 126 Wirh such chronic
s[eep shonagcs, irrirability and belligerence
rise wlule attention span drops further.
Rapid mood changes and rroub[e eoping
wirll stress can resulL Withdrawal from
group aetion and even depression are among
rhe ourcomes of chronie s[eep deprivation.
Ddusions and hallucinarons can also be
consequences of chis downward spiral.
Borh shon-rerm and long-cerm sleep
deprivatioo can aEfeer your resistanee ta
disease. Losing even rhree hours of sleep
an a given night can cut in half the dfccrivencss ofyour immune s)'stem. 127 A I1U1llber of immune a1eerarlons oecur with sleep
deprivarion: antibody levels are deereased 128
while inrerleukiJlS-l and -2 filil ta experience rhe risc that occurs wirh deeper stages
ofsleep. 129 Growd) hormone (GH) requires
sleep for optimal release. Absence of GH
furrher impairs immunity as imporranr
immune defenders, che cytotox.ie T cells (a
rype of wrute blood eell), are dependent on
this hormone. l3o Chronic fariguc also increases rhc risk of prob[ems ehat may nor
be so obvious: hearr disease, heart related
dearhs, and stomacll and imestinal prob[ems. 131
Even ifl'ou are spending nine hours each
day in bed, you mal' not be getring ehe
qualiry of sleep rhar you need. Sixty l'ears
ago, sleep was regarded as a staric process of
rest, but sleep quaJiry can radically differ
even if it [ooks like rwo people spend rlte
same amounr of rime in bed. Haw can you
increase sleep qualiry? FiguIe 19 [ays out
some of rhe basics. 1.'2
Sleep quality is actualll' relaced to the
enrire NEWSTART program. Although

daily resr is an importalH aspeer of healrh,

we rend not ro rest as well if we are nor fol10wing mher aspects of a heaJdlY lifestyle.
Perhaps nowhere is this seen more c1early
rhan in research re1aring sleep and aging.
Mosr have nor questioned rhe "faer" thar
s[eep quality derer10rates as a person gers
older.I:H However, new research from
Sranford Universiry Medical $chool and
orher centers is calling rhis assumption imo
question. What the newcr data suggeses is
rhar people who stay healrhy and follow a
good lifestyle are unlikely ta develop
changes in sleep qualiry as they age. 134 13S

Vitamin R2: The Weekly Rest

In America, ie is nor uncommon for
people to put in a seven-day workweek.
Many do chis repetltively and do not seem
ro suJTer for it. However, the medial evidence suggests that there may be both longrerm and short-rerm consequences ro such
a practice. Just as the body has a natural
daily c10ck (circ.'1dian rhytbm), it also has a
weekly c10ck (cireasepran rhythm). Circasepran rhythms are jusr (har: body rhyrhms
ehar run about seven days in length.
Medical research has demonsrrared such

WAYSTOIMP OVESLEE

ALITY

Sleep' ,in a cool, dark, comfortable, tidy, and quiet room

Set anxieties and worries aside as you get into bed
Daily exercise aod a clear conscience will help
Eliminate ,the "sleep robbersthree": aJicohol, tobae,co,
and caffeioe
Cbcek medications tba,t could interfere with sleep
Maintain a regular bedtime and do Dot
eat at least four bours before
Provide (resh air in your
sleeping room
Figure 19

503

PROOF POSITIVE

504

rhythms in connection wirh a variety of

physiological funcrions. Some rhat have
been idenrified included hearr rate, sllicides,
natural hormones in hllman breasr milk,
swelling after surgery. and rejecrion of
transplanted organs. Ta llnderstancl the
significance of tllese rhyrlllns, consider the
Iauer rwo items in the list. A person will
tend to have an increase in swelling on rhe
seventh and then rhe fourteenth day after
surgery.13G, 137 Similarly, a person wirh a
kidney transplant is more likdy ta rejecr rhe
organ seven days and [hen fourreen c1ays
after rhe surgery.138. 139 Research on
circasepran rhyrhms conrinues and new
relationships are conrinually being
discovered. There are seven day rhyrhms
thar have been observed in both humatl and
animal cancers and rheir response ro
trC4tment. J40, 141. 142 Fibrinogen, a blood
c10tting compound that has been
demonstrated ro increase rhe risk of hearr
Jrrack, has now also been obscrved ro have
a seven day rhyr.hm. '43 Further work has
shown rhat in addition ro inflammatory
responses operaring on a circasepran
rhythm, so do rhe drugs rhar we ofren use
ro rreat them. 144
An undersranding of circasep[an
rhyrhms has lead me to more fully
appreciate rhe facr thar 1 need ro pay
attenrion ro weekly rhythms to protect my
own healrh and rhe health of my parients.
Dr. Baldwin asserced some years ago thar
the cllrrenr research indicared tlur 'this
seven-day rhythm is a norma] built-in fearure ofaur physiology."145 Recent researchers have becn evcn more adamanr rhan
Baldwin. "From rhe medical poinr of view
so-called circaseptan (abollr 7 days) reacrjve
periods are of predominant inreresr. This
periodicicy can be observed in numerolls
adaptive aud compensaring processes. Ir
does nor depend on [he external week cyele
aod was already known ro rhe antiquiry."I46
Whar borh of rhese authors are saying is rhat
the imponance of the seven-day rhyrluns
should nor be underesrimJred. FlIrthermore, these rhythms are a part of who we
are; rhey are nor a funcrion of the fact rhar
we happen tO kcep a seven-day wcek in our
cu1rure. Thus, rhis seven day rhy[hm "does

not depend on tlle exrerna! week cyele."

From a hiswrical perspecrive the weekly
c)'ele is also of great interest. We keep a 24hour day based on rhe eanh revolving on
its axis. We keep a monrhly cyele based an
rhe periodiciry of the moon. The year is
based on rhe earth's cireling rhe sun. But
whar is tlle week based on? Some have
cOlljecrured rhat mankind over the years
carne to the conc1l1sion rhat 00 otller weekly
cyele harmonized well with our internal
rhythms. It is ilueresring ro note thar
although culmres have experimenrcd with
different weekly cyeles, aII those that
Baldwin is aware of have reverted ro the
seven-day program. He poinrs in particular
ro France during rhe rime of rhe French
revolurion. They then experimented with
a ten-day (meuie) week, with disasrrous
reslllrs. The mental institutions fiUed rather
quick1y ro capaciry and then some. Baldwin
amibures the abolition of thar program in
part to rhe logical rhinking of (he renowned
Iluthematician, Laplaee.
However, orhers have pointed ro an even
more compelling reason for the existence
of the weekly cyele: ir is (he way tllat Gad
creared liS. Indeed, in rhe firsr of the
scriptural books of Moses, the seven-day
weckly cyele is described as paft of God's
design in creation. Thar cyele is described
as consisring of six days of work followed
by a Sabbath day of rest. Baldwin sees significance in the Sabbath concept in relation
ro circasep[an rhythms. 147 He recognizes
this as a "zeirgeber" ("rime-giver" in German). Zeirgebers keep aur weekly rhydl.lIls
synchronized by pausing oue day in seven
for a rime of rese. Jn order for tllese rimegivers 10 work, however, ir must come ar
rhe same rime each week. In other words,
it is not sufficient ro get one day in seven
ofC; ir is optimal 10 get a specific day in seven
off on a regular basis.
My own experience agrees wirh this body
of Inedical research. I personally need one
day in seven where 1 ser thiJlgs aside and
experience a true rest. Thar does nor mean
1 sleep the whole day. Instead, 1 use it as a
day for recrearion, for reflection, for
meditation, and for focusing in on spiritual
values. Whether you keep the seventh day

BEYOND THE LEADING CAUSES OF DEATH

of rhe week as I do (from sundown an Friday evening to sundown on Sarurday
evening in h:umony wirh rhe biblica! injuncrion) or a differem 24 hom period, there
is a benefir ro observing one specific da}' in
seven as a day of rest.
One other observarion is in order. In
scheduling aur daily rest of sleep, we o[ten
have ro priOl'iri7-c sleep even though we have
nor finished aII of our work for rhe day.
Mal1Y have learned by experience rhar in
mosr circurnstances ie is be.sr ro go ro bed
on rime. In rhe same way, evcn if your work
for the week is noe compleeed, I would sriU
encourage you ro [ake rhar specific day in
seven ofI and rest as if )'our work was complered. In facr, a physician friend of mine
once said [hac such a proricy is one of the
beauries ofGod's Sabbath commandmenr.
Even rhough he is aware of ehe importance
of rhe week1)' resr, if Gad did nor speci/)t a
specific day, he feels he would nor be reguIar in keeping onc specific day per weck as a
"zergeber.' I have found the same rrue in
myexpertencc.

Vitamin Ri True Recreation

If you look at how mosr Americans
spend ilieir rime, you would think rhar [elevision i our nation's number one farm of
recreation. However, in rhe sense of [he
rerm as I u e ir, TV program ing does nor
meet my criteria for rrue recrearion. Whcn
discussed in rhe contexr of resr, 1 see recreatian as living up ro irs name, specifical1y:
"re-creation." 1 believe rhar afrer engaging
in true recrearion, 1should be more able ro
meer life's challenges, nor less able. True
recrearion is reviralizing and hdps me betrer accomplish the work and responsibili[ies [har 1 have. Wha[ kind of activities then
fir rhe bill as "truc recreation?" From my
experiencc and srudy, ourdoor recrearion
rops [he lisr. Oprions include a hose of acrivities such:l gardening, hiking, doing
pleasanr yard work, cross country skiing,
walk.ing, and dozens oforher oprions. These
activitjes provide a mental break from rhe
romi ne, as well as ofIer the advanrages of
many of the orher NEWSTART e1emenrs
sllch as exercise, sunshine, and fresh air.

Vitamin R/ Meditation and Prayer

Medirarion and prayer provide a form
of resr rhar has been praceiced for centuries.
Even secular Wesrerners are becoming more
inrerested in learning abour rhis potenr form
of release from stress, rension, and anxiery.
In my own expericnce, 1 have found medirarion and prayer ro be a virai pact of a balanced lifescyle program.
Prayer is rhe brearh of rhe soul, figuratively speaking. As moral beings and spirirual beings, we need ro spend sufficienr rime
in conremplaring our rrusr in divine power.
There is a connecrion berween [he "R" and
"T," speei.fically viramin Rt, and "T," mlsr
in Gad. It can help us in so many ways,
such as in conrcol1ing srress. srrengrhening
rhe immune sysrem, providing proeec[ion
against hean disease, cancer, erc. The lisr
goes an and an. Yes, rrusring in aur Maker,
Defender, Redeemer, and Friend. Bur how
can we (fUSt Him if we do nor really ra!k ro
Him rhrough prayer?
In Chaprer 12 on rhe frontal lobe, I
poinl ro rhe example ofDr. Larry Dossey as
an il1usrraron of how even honest skeprics
are now concluding (har prayer has unique
benefits. 148 Dr. Dossey bas collecred a hosr
of scientific srudies rhar demonsrrare thar
when people pray ro God on behalf of oehers, healrh benefits resulr. These results even
include rhe sponraneolls regression-or
cure-of cancer. Dossey's experience iIIusrrares rh:u from rhe perspective of thinking
sciencists, rhe benefirs of pra)'cr exrend beyond rhose of mere medirarion. It is remarkable rhat the anirllde of prayer makes
a difference in whether or nor healing
ensues. lr is rhe rrusrful prayer of fair.h in
commirring one's life ro God rhar mosr
likely resulr.s in healing-nor rhe aggressive
prayer [hac prays for whiee blood cells ro
desrroy cancer or arrcmprs ro raise self ro
leve\s of unresrrained optimism. 149
One of the rhcmes with viramins R, and
R., is rhat rhese subsrances must be 'ingesred" regularly ro provide oprimal benefirs. Jusr as \'le need daily rest in each 24
hour period, and week1y resr once in every
seven days, so do we need regular periods
for rccrearion on rhe one hand. and prayer
and meditarion on rhe orher. Acrually, each

505

PROOF POSITIVE
of rhe other rypes of rest affecrs vltamin R4
as well. As we have seen, lack of sJeep or
irreglliar andJor excessively long work hours
contributc ta some obviolls problems:
poorer qualiry and qua11tiry of sleep, increased fatigue, poorer work performance
and increased accidenrs. 150 However, inadequate sleep also affecrs us spirimally. The
frontallobe appears ta be parricularly prone
to sleep deprivarion. Surprisingly. our values even rend ro suffer when we are shorc
on s[eep.151

1. Religious attendance and private devotion strengthen

a person's relig.ious belief system.

2. Strong religious belief s.ystems, in turn, wben

accompanied by a bigh level of religious certainty,
have a substantial positive influence on wcll-being.
3. Individuals With strong religious faith report:
higher levels oflife satisfaction
greater personal happiness
fewer negative psychosocial
consequences of traumatic
life events
Figure 20

This last element of resr-medirarion

and prayer-also addresses the most potent
robbers of rest aud re1axation, namely srressors and our maladaptive ways of handlillg
mem. Al; pointed out in Chapter 14. "Srress
Wirhour Disrress," rhe use of meditation
and prayer offers powerful help on these
levels. There 1 emphasize rhat we have a
critical need for medirarion and prayer on a
daily basis. 1 go 011 record as defining these
elemenrs as forms of "rese and rejuvenation
that few appreciate" ta their fuUest exrellt.
The inreresced reader is referred ro thar
chapter on srress for a furrher discussionand pracrical application---of dlis vital viramin R 4.

506

NEWSTART Element Number 8:

Trust in Divine Help
After presenting the all-imporrant
spiritual element of rest ("viramin R/), rhis
secrion may seem redundant. However, rhis
final element of the NEWSTART cight
bears repeating. Throughollr rhis book, 1
have demonsrrarcd how research is showing
thar spiritllaliry and trust in divine power
have a role in deal ing with many common
diseases. We looked at the role of f.'lirh in
heart disease, rhe relarionships of spiriCllaHty
ro the AIDS epidemic, and the link berween
religion and cancer. Later in the chapter
the stress-religion-arrhritis connection will
be covered.
One fascinaring srudy looked ar the
religious experience of rhose Americans who
reached rhe golden age of 100. Among the
centenarians, thc researchers found rhar
religiosiry significantly enhanced physical
health. Alrhough rhere are stiH many
unanswered questions. the benefits of trUSt
in God are due (Q more rhan simply
attcnding
religious
services. 152
Furrhermore, che far-rcaching bendits of
faith seem ro rranscend age and racial
bOllndaries. A recent sClIdy of black
Americans found mar rhose who engaged
in organized religiolls activities had
improved hcalrh and life satisfactioll. 153
Even rhose who engaged in religiolls pursuirs olltside of an organizational structllre
experienced this boost in satisfacton. 1ndeed. one of rhe mose consistent findingsacross racial grollps-is dlat spirirualiry profOllnd1y improves qualiry of life. The profound bene6rs in the qualiry oflife brought
abour by exercising fairh are described by a
Duke Universiry researcher in Figure 20. 154
Another amazing aspecr of spirituaJiry
is thar it not only helps believers hur ir also
benefirs non-believers in rheir communiry.
Research has demonstrated rhar communiries gain healrh benefirs when they have
higher numbers of adhercnrs ro fairhs that
emphasize implicit obedicnce to God and his
standards ofconduct. 155 Oile theory for why
non-believers benefit is rhat social norms (;1vor conformiry 00 the healrhier lfesryle e01braced by cheir more relgious neighbors.

BEYOND THE LEADING CAUSES OF DEATH

Another compelling explanation as w
why rrust in divine power is so important
in a comprehensive health program is
borrowed from an illusuarion by Zeno
Charles-Marcel, M.D., Medical Direcror of
the Lifesryle Center of America in Suiphur,
Oklahoma. The ba..~is for;m individllaJ's parricular health starus is depicced in Figme 21.
Aher a patiem undergoes a complere
"hisrory and physical" evaluation, including
appropria re la bora to ry a ndJ or o t h er
pertinent tests, 1 have a clear picrure of the
pariem's healeh status. That health srarus,
which is often tele by the patient in daily
liviog as his or her "qualiry of life," is JUSt
the visible rip of rhe iceberg. Undernearh
are reasons that increase in imporcancc as
we go decper in rhe iUustration. Health
status is direcrly dependent on rhar
particular individual's health habirs, as 1have
demonserated distinctiy and frequenrly in
this book, beginning in rhe first chapter.
For instance, consider the dictary babit
of eating red mear. The more red meat an
individual consumes, the higher t!le
cholesrerol, blood pressure, hean disease
risk, cancer risk, renal failure risk, etc. tends
ro be. But why is a cerrain individual a heavy
mear earer? We have to go deeper ro find
the answer. If a person grew up earing meat
and potaroes, guess what he tends to cat
now? If he grew up consum ing caffeine
beverages, guess what beverages he prcfcrs
now? The particular cuieure that individual
grew up in largely determines the habits he
has now. Fortllnate!y, the illusrrarjon does
nor end (here. There is always rhar "one
person" who grew lip eating mear and
poraroes and had paretlts that smoke and
drank who does noe smoke, doe.s nor drink,
and is a vegetarian. Why did that person
become "counrer-culrure" and choose
differenr habits? Thar individuailet his own
personal choices and values rake precedencc
over his culrure. Ultimare1y, every person's
own personal choices become a deeper
reason than eulrure for his ser ofhabit.s. The
kinds of choices a person makes and values
he possesses are directly relared ro !lis sense
of overall meaning and purpose in life; rhis
is where the spirituallife and truSt in divine
power have a direct bearing.

AL

IUre
Personal Choices and Values
--

--

Overall Meaning aud Purpose

Thus, trusring in a higher powcr besrows

cerrain healrh benefits. Thar same trust has
a direct connecc.ion ro the overall me.1ning
and purpose ofone's litc., which then affects
rhe personal vailles and choices, which then
affects the culrure one chooses ro adopt,
which direcdy influences the particular set
ofhealrh habits, which ar last direccly affecrs
the health. The original health benehrs
come full circle anei are reinforced and multiplied.
Cleady, rhroughour my personallife and
my work as a physician, I have seeu the
importance of inregraring rhe spiritual
e1emenr imo a roral approach ro healing.
The medical research shared tluoughout chis
book, and again mentioned in rhis secrion,
llnelerscores this imporranr agenc)' of rrust
in divine power as both a remedy anei a basic
tener of prevenrion.
Now rhar we have seen an overview of
each element in NEWSTART, let liS
illustrate how rhese elemenrs can be applied
ro some specifiC eliseases rhat have nor been
dealt with e1sewhere in this book. 1 begin
with rhe example of rheumaroiel arrhritis, a
common djsease.

Figure 21

Rheumatoid Arthritis
Arrhritis anei other bone anei joinr disorders are among the leading causes of disabilities in America. Currenr estimafes from

507

PROOF POSITIVE
the U. S. Centers for Disease Control are
rhar rhesc diseases aHlicr some 40 miII ion
Americans. I 56 O ne parc icularly desrructive
fOTln of arrhriris is called "rheumaroid arrhriris." Ir is a disease causcd when the body
acrually auacks irs own joims and ocheI' tissues. For reasons nor yer complerely undersrood, an afTecred person's immune sysrem goes awry and sram an:lcking rhe joinrs,
causillg what ofren becomes a permanently
crippling disease.
Scandinavian researchers placed
individuals wirh severe rheumaroid arrluitis
on a toral vegerarian dicr for an emire
year. I 57 Aher a single month on rhis ci ietary
program, they analyzed rhe patients and
founel a decreased number of render and
swollen joinrs. Their grip srrengrh was
bener. Furrhermore, {heir problems wirh
severe joint stiffness in rhe mornings had

TOTAL VEGETARIAN JET EL S

R8EUMATO D ARTBRlTIS
Al oile month, and after one year, total vegetarian diet
patients enjoyed a decrease in:
Number of tender joints
Number of swollen Joilnts
DuratioDi of rtlo rn ing stiffness
Total ibody ,inftammatioD
They also had:
Improved grip strength
Improved score 00 bealth
assessment questiooaire
Control group had /nild decreased pain but 110 other improvemellts.
Figure 22

508

improved. Even actual laborarory measuremeuts rha{ reflecred {he degree of intlammation in {he body wcre better. Two such
improved blood resrs were the sedimenrarion rare, and the C-reacrive prorein level.
These resulrs are demonsrrared in Figure 22.
Perhaps most importandy, the pariems
on the vegetarian e1ier felt ber.{er--by actual
measuremenr on a healrh assessmenr

quesrionnaire. The comrol group on rheir

regular dier haei a mild decrease in pain, but
[here were no orher measurable
improvemenrs. Of course, we cannor
conci ude from this rhat ali individllals wirh
rhellmaroid anhriris will be cured by a coral
vegerarian diet alone. However, the research
suggesrs rhar ir can significantly improve rhe
condirion. For rhe rheumaroid arrhriric,
nutririon alone may improve qualiry oftife,
blood resrs, and ma)' even help ro decrease
medic3rion needs. A decrease in drugs a150
rrans)ares inro good news. These agenrs
always carry some risk of side effecrs.
Dier is also important in rhe prevention
of rheumaroid arrhriris. There is a growing
awareness rhar some forms of rheumaroid
arrhriris are apparenrly rriggered by
infecr.olls illnesses. One wel1-described
linkage is between salmonella food infecrion
and rheumacoid arrhriris. 158 . 159 We have
already seen in Chapter la, "Animal
Diseases and Hliman Healrh Risks," rhar
much of rhe risk of exposure ro salmonel1a
can be avoided by moving ro a vegerarian
dieL
Besides rhellmaroid arrhriris, rhere arc
orher forms of anhriris callsed by the body
arracking irself. These forms of arrhritis
include luplls anhriris and a grollp of
anhritis
condirions
called
[he
spondyloanhroparhies. The Iauer include
ankylosing spondyliris and Reirer's
syndrome. Because they seem ro be ca li sed
by a similar process, we wOllld expecr rhese
djseases ro respond ro a similar nurrirional
approach. lndeed, a recent repon indicared
as much rcgarding spondyloarrhritis and
clier. loo There, 25 parienrs were placed on a
milk-free diet for six weeks. More than half
of rhem made dramatic improvemem 01) the
regimen, regisrering decreases in joint
sweUing, sriffness, and pain. They were .usa
able (Q decrease medication usage. Of
particular i Il reresr, some patienrs bad a
retllrn ofsymproms when [bey resumcd the
use of dairy producrs.

BEYOND THE LEADING CAUSES OF DEATH

The Effeet ofOther Elements of

NEWSTART on Rheumatoid
Arthritis.
E.'<ercise is also exrremely imporcaru for
dealing wirh rheumaeoid arrhritis. Nor long
ago, physician would PU( arthritics on
orders for bed rese. Now, however, recenr
evidence suggests (har rhe more we can help
a person exercise (he better off rJley wiU be.
Although inappropriare exercise can worsen
jOlnr problems, rhe experrs ;ae coming eo
rhe conclllsion thar an e.xercise program (ailored ro meer the needs of rhe parienr can ofren help them wirh rheir arthrieis. 161 . 162, 163
For example, a recenr sm:lll srlldy
showed rhar rhellmaroid arthri(is parienrs
could benefic from a program of highinrensiry exercise ((echnically, a high
inrensiry progressive resistance rraining
program).164 They demonstrared decreases
in self-reponed pain and fatigue. They
could waJk measurably berrerwlth improved
coordinarion and fasrer walking rimes.
There was no worsening of disease acriviry
ar joint pain. Parr of rhe benefit may relate
ro growth horrnone (GH). This viral
hormone is nor only imporranr for children.
Research suggesrs rhar GH srimulates (he
rebuilding of carrilage and bone even in
adulrs,165 and thus may play a key rale in
repairing the joi nts afrer (he wear and real'
of rhe da}'. Of cririca! importance ro che
exercise-anhriris link is rhe following faer:
grow(h hormone levels sllrge following
vigorous exercse. 166
Exercise is also exrremely imporranr for
anyone who is overweighr and has arrhrirjs.
This is (fue wherher we are deaJing wirn
rheumaroid arrhriris, osreoanhriris, or any
of rhe ocher forms of arrhriris. The more
weighr a person carries, rhe more srress rhere
is on weighr-bearing joinr.5 like rhe hips,
knees and ankles. Exercise anei proper dier
are rhe rwo corl)ersroncs for arraining and
mailHaining oprimal weighr. Dr. David
Felson, a professor of medicine ar Boston
Universiry has srudied knee osreoarthriris.
He has found rhar losing weight can make
arrhriris of (he knee signihcanrly beuer. 167
Overweighr individuals also run a higher
risk or developing arrhriris. Of. Chad

Helmick, a Cenrers for Disease Control expert has discovered (har adllirs of eirher sex
who carr}' exrra weighr-even if rhey are nor
so heavy as ro be c1assified meelically as
uobese"-were 30 pereenr more Iikely than
normal-weighr adults ro have arrhriris. The
risk for thase carrying excessive weighr was
even grearer: obese men increased rheir risk
of arrhriris by 70 percenr while obese
women had a 50 percenr higher risk. 168
Bur rhere appears to be more ro rhe
exereise-wcighr conrrol relationship (han
wear and tear on joinrs. RecelH research
suggesrs rhar overwcighr women have a
higher risk of even developing rhellmaroid
arrhrrjs.l69 Women in rhe upper 25 percem
of weighr for heighr haei a 40 percenr
increased risk of comiJlg down wirh
rheumaroid arrhriris. Some researchers
specliJare rhar (his linkage has ro do wich
sex hormone levels.
Water can be used exrernally ro benefir
rhose wirh arrhriris; ir is efleerive for rhe
rhellmaroid variery anei ocher forms ofjoinr
inf1ammarion.
The applicarion of
hydrorherapy (warer rherapy) can serve
many purposes in individuals wirh rhese
eondirions. Heac can be applied ro affecrcd
joinrs lIsing hor waler packs, whirlpools,
sream, erc. Such rrearmenrs ean be parricularly effeerive. For example, recem published work showed char rhe use ofhor mineral barhs and mudpacks could help borh
rheumaroid anhrris and rhe relared eondirion of ankylosing spondyliris. '70 . 171 Hearing of che tissues can have very desirable
benefirs. Alrhollgh rhe brain has difflculry
ro[erarng temperatures above 104 dcgrees
Fahrenheir (40 degrees Celsius), elesirable
e[feers occur on rissues orher rhan rhe brain
ar remperarures bcrween 104 anei 114
degrees Faluenheit (40-45 degrees Celsius)
for 5 ro 30 minures.!il Krusen's prestigious
cexrbook of Physical Medicine and
Rehabilirarion 173 Iim some of che benefits
ofhearing tissues-sllch as joinrs-inro this
range:
1. Decreaseel sciffness due ro increased
Aexibiliry of rissues (parricularly rendons
and ocher strucrures nude largely of rhe
fibrom rissue calJed collagen).
2. Relief of tnuscle spasm.

509

PROOF POSITIVE
3. lncreased tissue blood flow and inereased speed of body reactions.
4. Relief of some rypes of paiu. This
can be due ro decreased stiffness,
improvemellt in (SSllC o>..-ygenation OI' by
"collnterirritacion" wherc che stimlllation of
temperature receprors in [he skin decreases
pain sensation. Heat is aJso known to
increase chc pain chreshold, chus making
pain easier ro tolerate.
5. Mild heating ean provide assiscance
in removing fluid bllildup and
inflammation in areas with more chronic
congesrion. Application of high temperature heat can, however, worsen acute inDam mation.
Cald, on the other hand, can help
deerease acute inflammation. For this
reason, iee is the firs(-]ine natural rreatment
for a recent strain or sprain. Jee can al50
somecimes assist wirh pain control. This
may have ro do wirh the "collnterirritation"
phenomenon. le may aJso be a resllit of
nlll11bing of the pain sensors ar decreasing
inf1amrnation. Becallsc heat and cold each
have unique benefits. we wiU sometimes llse
a combination of boch hot and cold in
alteration. This is called a conrrast
treaement. A common partern for sllch a
trearmenr is ro apply duee milllltes of heat
ro an affecced joint and chen follow chis wich
30 seconds of cold. This consttlltes "one
cyele." Four LO five cyelcs are uSllally applied
at each rreatmenr. Two or duee creatments
are given each day.
One type of arthritis duc was previously
confllsed with rheumatoid arrhritis is now
eal1ed Lyme arrhritis. This form ofarehritis
results from an infection wirh a bacteriuJIl
called Borrelia burdorferi. 174 This germ is
eypically rransmitted from the bite of an
infected deer cick. The problem is greatest
in the American Nonheast, but also occurs
widely throughollt che U.S. There is
evidence thar t!lis form of arrhritis may be
able ro be improved by rhe lIse of extreme
heat referred to as hypenhermia. Alchough
the rcsllits are slill preliminary, rhis ilJuscrates
anocher linkage between a rheumatoid
arrhricis-like condition aJld infection, and
suggestS mat thete may be an important role
for more natural means of therapy.

510

One of the remaining questions is: may

what works for Lyme work for other eases
of rheumatoid arrhricis? The quese.on
demands an answer: cheorecically, some of
what we caII rheumatoid arthritis may be
ulldiagnosed chronie infection, as was the
case wirh Lyme. 175 . 176 Already other
infecrious agems are being linked ta
rheumatoid arcluitis-like diseases. 177. 178 We
have aJready noted (he link becween anhritis
and salmonella. Ofher baeteria cluc eause
intestinal infections have also been
implieated. These include Shigella and
Yersinia. 179 The Chlamydia family ofgerms.
known for their abiliey ro cause sexually
transmitted diseases as weB as upper
respiratory infcctions like bronchicis, have
now also been linked wirh a rheumatoid
arrhritis-like condicion. 1SO A number of viruses arealso currently listed as candidates
ro cause rheumacoid arrhricis. These include
Epscein- Barr virus and the parvoviruses. 181
Mycobacceria, c!le cypc of germs mat cause
tuberculosis and oeher infeetions. may aJso
be arrhritis culprits. 182 The reason for
highlighcing the linkage betwcen some rypes
of arthritis aod infeccion is thar preliminary
results sllggest thac generalized heating treatmenrs may help sueh forms of arthritis.
The interna! use of water also seems ro
be of value in many illnesses thac affeet the
bones, Il'luscles, and joims. Drinkillg water
improves the flow propetres ofblood-dus
is rechnically referred ro as enhanced
hemorheology. Such improvemenrs in
blood flow may have a role in a number of
conditions, such as dealing with back pain
(wher.her ar not it is related ro arthritis) aud
helping ro improve healing of joinrs and
other tissues. Marjotie Baldwill. MO. aud
Bemell Baldwin, a Ph.D. physiologist, borh
of Wildwood Lifesryle Center in Georgia,
inclllded infonnation on the imporrance of
water and blood flllidiry in cheir review of
arrJuitis therapies. 183 They site the research
ofKniselywho found that blood with poor
tlow properries was corrunon in rheumatoid
anhritis, and was unable tO supply the
optimal blood flow needed by [he joinrs. l84
We wOllld expect thac more liberal water
int:ake wOllld have had significant benefits
in thesc circumstanccs.

BEYOND THE LEADING CAUSES OF DEATH

Sunshine has been demonstrated ta affecc che immune system. Under the influence of sunlighr rhere is some level of immune suppression which may acrually be
desirable in diseases of aJl autoimluuue
nature like rheumaroid arthritis.
SpecificaJly, rlle Langerhans ceUs in the skin
have been srudied in relation ro rhe
immune-suppressing effeccs of sunlighr.
Suolight also boosrs vitamin D leve1s.
This vitamin is importanc for calcium
balance in che body. Viramin D may also
help tO prevent bone loss thar often
accompanies rheumaroid arthritis. At least
chis seems eo be che case in the other major
rype of arrhritis, osteoarrhritis. Researchers
ae Boston Universiry School of Medicine
found thar individuals with [ower blood
levels of vir.amin D were rwice as likely ta
have their disease worsen during the fouryear study.185 The researchers speculated
ehat higher levels of yiramin D might slow
cartilage destfUction. If mis is indeed ilie
case, then vitamin D may also offer help
for the person with rheumatoid arthritis.
The way Iuse the concept oftemperance
is unfamiliar ro most people. By chis word,
J include a very popular notion, rhat of
moderation. I am afirm believer in moderation-regarding healthy lifesryle factors.
For example, I believe we should be moderate in the amount and inrensiry of rhe
exereise we do (roo much can be harmful).
Similarly, I believe we should be moderate
in rhe amount of food we eae an the vegetarian diee (you can overeat and suffer the
health consequences of overeating even on
rhe best of foods). However, I am aganst
ehe concept of moderation when it applies
ro heal eh-robbing factors. Ta cite rwo common examples: cocaine or tobacco, even in
moderation, is harmful. In shon, 1 use the
ferm temperance to refer ro moderation in

(hose things thal tire good, but total avoidance

ofthose things that are harmfu./.
How does chis concept of rempcrance
apply ro rheumaroid archritis? Ta optimally
heal from chis illness, wc need to avoid
anyrhing rhat will impair our body's Ilatural
healing mechanisms. Some patients have
noted mat when ehey do not get to bed early,
cneir arrlutis is worse che next cGy-even

if they obtained the same number ofhours

ofsleep. This goes along with whac we know
abour melaton.n and growth hormone, rwo
compounds that are involved in building
up the body after ehe wear aud tear of ilie
day. Both of mese hormones may be made
in slnaller amounts fa person srays up Iare.
A review of Chapter 9, "Me1atonin-the
Natural Way," will remind you ofhow many
faceors can interfere wieh quality sleep.
These factors include tobaeco, nicotine, and
caffeine, to mention only a fcw. The bonom
line is ehar temperance teaches t1S ta avoid
ali of these agents as well as any other factor
that would sap aur body's reserves.
Fresh air is also important. Pollmed air,
such as that rainted by aceive ar passive
tabacco smoking rheoreeically may worsen
rheumaeoid arthritis. 186 There are
suggestions that active smoking inereases ehe
risk ofever developing rheumawid arthritis.
In a study of over 1500 women from
Washington State, researchers found thar
rhose who smoked had a 50 percene
increased risk of coming down with
rheumatoid arrhriris. 187 And these women
were not necessarily heavy smokers. One
pack per day for 20 years was enough.
Jnrere..stingly, a Scandinavian srudy demonsuated an even srrouger linkage berween
smoking in men and rheumatoid arthriris. IBa In rheir prospective study of over
50)000 individuals, they found that men
who were smokers had 3.8 rimes the rsk of
dcveloping rheumawid arthritis. Those
who were ex-smokers still had well over
double the risk of t~he never smokers. The
results could not be explained by age, place
of residence, marital searus, social class, percepeion of general health, ar weighe.
One ofthe strategies in cre-ating any rype
ofarthritis is to strengthen the surrounding
mllscles, other soft (issues, and bones so that
less srress is borne on the joinr. This is ooe
of ehe reasons why exercise is so important.
A very little known faet abolit exercise is
that outdoor exercse is much more
beneficiat (han dut done indoors. Years ago
researchers discovered that at.hleres could
develop greater sm:ngrhening an an olltdoor
exercise program than one dane indoors_
They amibured this difference to the much

511

PROOF POSITIVE

512

grearer number of negatively charged ions

of oxygen in outdoor air compared ro
indoors, and the ultraviolet liglu from rhe
sun. 189
Rest is necessary for oplimal recovery
from rheumatoid anhrieis. During the
hours of sleep, important hormones are
secreted rhae build rhe body up from wear
and tear sustained c!uring rhe day. 1 have
already identified rwo of rhe mose imporcant
hormones; namely, melaronin and growth
hormone. One of the ke)'s ro optilml!
melatonin production is adequate rest early
in the night. For more information on this
see Chapter 9 on Melaronin. The same
sleeping habits scem ro favor adequate
growrh hormone production. However,
anorher compound appears ro have a mie
in rheumaeoid arthriris ehat is <1lso helped
by ade<juare sleep. It is a hormone-like
compound caJled interleukin 1 (IL-l) tim
is made by white blood cells. The evidence
suggeses that a deficiency in inrerlellkin 1
acrivit)' may play a role in causing OI"
aggravating rheumatoid arthritis. 190 . 191. In
lL-1 is made bes[ when a person is gerring
adequate sleep. 1~3
In realiry, rest provides a special example
of temperance. It spcaks eo moderation in
work noe only on a daUy level, but on a
weekly level and beyond. We will explore
some of ilie addirional aspecrs of rest later
in the chapter. Ac this poinr, I would like
tO mention [hat rhere s a relarionship
berween rest and fresh air. Few realize thar
fresh air has stress relieving, mildl)'
rranquilizing, and sleep indllcing effecrs.
Do not hesit<lte ro keep your windows open
and a fresh current of air circularing
throughour your sleeping room.
Regarding rhellmatoid archritis per se,
there is no queston ehar srress can have a
role in the development or perperuation of
the problem. One of the mosr powerflll
bllffering agenrs is the final NEWSTART
element, Trust in Divine Power. In my
personal experience, the grealcst power for
spiritual suengrh and a posirive ollrlook on
lite comes from Gad.
In Anatomy of an IlIness, Norman
Cousins describcs how he emerged
victorious from his bour with rhcull1<ltoid

arrhrilis largely bya change in his spiritual

ourlook from cuhivating negativism ro
cultivating joy. Cousins' improvemenr
iIlustra tes (he im p0rtance of mental outlook
and the spiritual dimension.
Rheumaeoid arthritis s our nrst eX31l1ple
ofshowing how the NEWSTART e1emenrs
highlighred by Ellen White have power
roda)' ro improve qualiry of lift as well as
longeviry. We could demonserate ehe same
thing with dozens if nor hundreds of oeher
maladies. The main message is rhae these
remedies work in combinat ion ro promote
heaJeh. This book, however, is nor intended
ro provide medical explanations for every
disease seate, but it rather !ays down
prillCiples tO help individuals gain or
maimain healrh.
Next, we "viII see how the prncipJes of
NEWSTART can be applied to anorher ser
of common diseases.

Urinary Infections
The same Norwegian researchers who
demonsrrated a link berween the vegetarian
diet and rheumatoid arrhritis made a
startling observat ion about the total
vegerarian diet and urinary rract iofecrions.! 94 In a srudy of 22 individuaIs, rhese
researchers found thar their program of 7
ro 10 days of f:1seillg followed by a (Oral vegerarian (no animal product) diet tended
ro decrease fhe ability of mine w supporr
sorne of rhe common germs rhat can C<luse
urinary infecrion. Their findings relate nor
only IO the common scourge of bladder
infeerions, bur a1so ro rheumatoid arduiris.
As we noted earlier in rhis chapter, rhere is
evidence rhat illfecrious agems ma)' have a
role in this crippling fype of arrhritis. The
Norwegian group had previollsly l1:lund dur
on rheir program, rheumatoid arrhritics
decreased their blood antibodies ro a
common urille infecf'ious agent, called
ProteUJ mirabilis. This suggested that rhe
germ might have been involved in the
arrhriris process. Of note, Proteus mirabili)was one of rhe gerrns ehat measurably
decreased in abiliry ro infect the urinary craC[
of those on the fOtal vegetarian diee.
Other NEWSTART faceors also play a
role in urinary infecrions. It comes as no

BEYOND THE LEADING CAUSES OF DEATH

surprise that drinking significant amounts
ar water helps ro prellf:nt such infecrions.
Howcvcr, ,he drinking of orJlcr beverages
may increase the risk of urinary difficulties.
Cola drinking has been found to increase
urine minerals like oxal:lte and cirrate rhat
set the stage for kldney stones. (9) This is
important nor only because of rhe severe
problems ehat srones can cause in
themselves, but also because these rock-hard
partides can provide an ideal environmenr
for cerrain lypes of urinary illfecrions.
[nrerestingly, a beverage Olher than warer
may provide special help ro those with
frequent urina.ry infections. Recent research
has vindic.'l.ted mom's wisdom in advocating
CYl111berry juice. In a Harvard srudy of older
women (average age of78 1/2), researchers
found chat the llse of a ctanberry beverage
can decre:lSe rhe rendency 10 urinary
infection. '96

Asthma
Asthma is another disease rhat has a
special relalionship ro diet. In {his sectian
I will Jook al how a vegetarian diet can help
asthmatics. Before 1 do ehat, however, 1
wanr ro poinr our one of rhe most inrerest~
ing recenr findings an asthma lh.l! ,llso
brings into focus two of the orher
NEWSTART e1ements: waeer and trust in
divine power. In reading rhe Scriptural
books of Moses and looking at the plan thar
God oudined for rhc IsraeJires, 1 am stfuck
by how much His guidance dealt wirh issues
of a clean cnvironmenr. There wcre
scrupulous laws rhat dealt wirh washing and
cleanliness afrer contacl wirh dearh. There
were specific instructions rhar dcalt witb rhe
disposal ofhllman wastes. There were laws
,har gave explicit insrrucrions on whar ro
do wirh conragious diseases Jike Icprosy.
This empbasis on deanliness, ofcourse, only
had value as God's pcople trusled Him
enough to follow His counsel. Furthermore,
3ttcnrion 10 scrupulous dearuincss can bc
seen as an extension of rhe rhird element of
,he NEWSTART program. Warer is afren
lhe agent we lIse ro produce c1eanlincss.
Now whar does alI rhis have ro do Wilh
asthma? Quire a lor. The National
Cooperative Inner City Aslhma Study is

probably one of rhe largesc stlJdies on

asrhma ro date. It c.'lrried a price rag ofsome
$17 miII ion, and the resulr.s arc jusc now
being pllblished. This monumentaJ swdy
found a powcrfullinkage bcrween asrhma
and exposure t.o rhe proreins of rhe common
cockroach. 197 ASlhma suITerers are more
likely ro demonsrrar.e abnormal immune
reaCliviry ro chis pesky bug and irs
droppings. In faer, ofaII rhe foreign protcins
thar can uigger an allergic asthma :lnack,
cockroach proreins-called "anrigens"appear ta be the mosI powerhlJ. In rhe Inner
City Asthma Stlldy, 38 percenr of rhe
asrhmaric youngsrers were alJergic to
roaches. This relarionship helps ro cxplain
why urban Americans are more likely ro
suffer from asrhma. In addirion ro bcing
exposed ro known lriggers of asrhma in city
air such as ozonc, sulfur dioxide, nitrogen
dioxidc, and orhcr air polluranrs,198 ciry
dwelJers are likely ar incrcased risk of
exposure ro cockroach proteins duc to the
abundance of rhese pesIs in urban are-as.
This linkage provides at least one insight
inca why asrhma, ilic most common chronc
childhood ilJness, is sreadily an the rise. The
number of asthmaric in America has rise-n
45 percelH in rJ1e past decade. There arc
now same 15 miiI ion asrhma sufferers;
about a lhird of lhem arc under 18. 199 Since
]980, [he annuaJ death rate from asthma
in young peaple undcr 24 has risen
precipirously with a ]] 8 percent upsurgc
over rhat rime period. 200 Some racial groups
are hil harder rhan others. Black childrcn
and yourh were 4 ro 6 rimes more likely
than whites of similar age to dic ftOm
asthma. 201
Unfonunately, in living arrangements
which ofren include aparemenrs in crowdcd
citics, we are often affected by our neighbors'
Jack of c1eanliness as well as our own
practiccs. Howevcr, the evidence stiH makes
a powerflll case for a scrupulously c1ean
environmen t. How can people reduce cheir
expOSlire ro roach proteins-parrcularly if
iliey live in an apartmenc slIrrounded by
neighbors' roach-infested dwellings?
Experrs suggesr dlac four srrategics can go a
long way ro keeping yOllf premises free of
roac!t-proreins:

513

PROOF POSITIVE

71 % improved after 4 months.

92% improved after 1 year.
Significant improvements included:
stress test
pulmonary fUDction
capacity to do physical work
changes in blood tests
Figure 23

514

First, kill rhe roaches rhar are in your

home ar aparrment wirh fogs, sprays, all(1J
ar poison bajts.
Next, rhoroughly wash aU floors and
su rfaces ro ger rid of roach prorei ns.
Vacuum carpered surfaces for the same
reason. YOll may wanr ro consider even a
thorough carper c1eaning rhrollghout your
entire dwelling. (These procedures will also
he1p ro decrease rhe amounr of poison residues in rhe environment from the fim srep.)
Then, acr preventively. Do nor leave any
food out rhat would amacr roaches. 1'his
inc1udes everything from [he obvious food
on rhe rabie, crumbs an the floor, and food
scraps in an accessible garbage can. It is a
good idea ro remove ali accessible food immediarely after eating. Refrigerate thar which
you wish ro save. The resr can be diminated
through either a sink disposal, or by raking
rhe uash olltside of yom dwelling.
Lasr, sec roach [raps. This wil! help ro
catch any of the bugs rhar jusr happen ro
wander in.
Proliferation of al1ergies and oeher causes
have a role in rhe asrhma picrurc; however,
oehcr Iifesryle factors are also important. We
need ro look carefully ar the dier issue.
Research suggesrs thar ir may have a
profound role in dealing wirh rhis major
disease. A rorai vegerarian dier, which i5
completely free ofanimal producrs, has been

demonsrrared ro reduce medicarion needs

in asrhmarics.
Thirry-flve pacients who had sllffered
from bronchia1 asthma for an ave.rage of
cwelve years were rhe subjeers of ;l Scandinavian srudy.201 Ali of rhe panicipams
were receiving long-rerm medications; 20
were an some of the mosr porent astluna
medicarions rhar we use, rhecorrisone-rype
drugs such as Prednisone. These compounds can help people manage rheir
asrhma berter, bur rhey can a1so have significanr long-rerm damaging side effecrs. In
rhe research srudy, rhese 35 chronic asrhmarics were asked (Q go on a roral vegerarian dier for a year. Over rwo-rhirds of rhem
remained an this dier for the ful1 year. Almosr ali of rhose who Followed rhe nurritional program made significant improvemelH as omlined in Figure 23.
In general, asrhma symproms decreased,
while physical funcrions improved. Blood
tesrs also improved-including rhe IgE
level-suggesri ng rhar allergies were
improving. Funhermore, almosr ali were
able ro decrease rheir asrhma medicarions
significandy. The researchers conduded:
"Seleered paTents wirll a fear of side effccrs
of medicarion, who are inreresred in
alternarive healrh care, mighr get well and
replace conventional mediClrion wirh rhis
.
"?03
reglmen.
-.
1'his is exciring news. It suggesrs rhar
many asrhmarics ma)' be able ta significanrly
improve their healrh and decrease Of
eliminate rheir medicarions. Of course, a
word of camion is in order at rhis poinL lf
you ar a loved one has asrhma, cominue ro
work wirh your doctol", Make sure you do
nor change yom medicarion inrake muil you
ger approval from your physician.
Ar least parr of rhe reason for rhe sllccess
ofrhe vegerarian diet regarding asrhma likely
has ro do wirb a decrease in food aHergies.
Johns Hopkins researchers recently
discovered rhar food allergies play a major
role in aggravating childhood asrhma. 204
Lung funcriOll meaSllfcmems demonsrrated
rhar sllsceptible ch ildren develop more
irritable airways as a response ro rhe allergyproducing foods. This irrirabiliry sers rhe
srage for spasm of the air passages and

BEYOND THE LEADING CAUSES OF DEATH

asr.hma anacks. In those suscepcible children, their asthma will generally not improve unless the offending foods are removed f(Om rhe diec. Some of che foods
they were allergic co are common foods ehac
would be avoided on a vegecarian diet, such
as eggs, cow's milk, aIld fish.
Also on che high-risk food lise were items
likc wheat aod soy. These foods are good in
chemselvcs buc mosc Americans eat mese
foods daily. And that may be a p(Oblem.
Some allergists believe chat repeated
exposures to a given food tend ta promoce
allergies in susceptible individllals. The
inclllsion of wheat and soy ou the comm.on
aJlergen list eends ro lend suppon ro that
argument. If you read labels, it will come
as no surp,rise chat mosc Americans are
exposed ro wheac aud soy repeatedly every
single day. If you assent {Q che daily wheat
incake, but chink we as a nation do nOt use
11)1Ich say, think again. Say is used as flUer
in ground beef, as a source of lecit.hin in
many baked produccs, aud a comroon
source of oii (as weB as mono- and diglycerides used in proce..~sed foods). The.re
are licerally dozens of oeher uses.
If you chink abolit ic, eggs and cow's
milk, two of the other major foods
assaciated wich childhood allergy, are a1so
common dierary constituents. Fish
probably does not find its way anco
American places ne:lrly as often as these
orher items. Buc there is more ro the altergy issue rhan frequency of ingestion. In
my experieuce with pariems, dairy foods
seem tO be one orche mose aggravating foods
for allergy suffers. The medical literature
seems ro be consistent wieh myexperience.
Dairy foods have been linked wit.h everything from skin condirions205 ro immediare allergic reactions. 206 The bonom line
on che allergy-asthma linkage seems ta be
t.hac sufferers wirh lhis airway disease should
seriously consider a swirch tO a vegerarian
dieL They should a1so be c.1reflll ta avoid
repeared exposure ro certain comrnon foods.
Besides removing allergens, oeher diecary
facrors likely had a rale in che asthma improvemenr registered by [he Scandinavians.
There is evidence thar rhe vegetarian dier is
associated wirh less inf1ammation rhan a

meat-based diet. This appears ro be related

ro less inf1ammatory leukocrienes and proseaglandins producrion an ehe vegetarian

diet. Furchermore, t1lOse individuals on a
less refined diee are likely ro be consuming
less salt. A body of lirerature suggests rhat
asthma is worsened by a diet high in table
salt.. 207, 208

FOODS THAT TRIGGER

MIGRA E HEADACHES
U.S. h sicialls V.K. h sicians

Mai" dietary (actors

Chocolate
Alcohol
Cheese
O/her dietary factors

72
67
50

87

Monosodium
glutamate
Nuts
Citrus fruits
Meats
Dairy products
Coffee
Marmite
Fish
Nitrates
Onions
Hotdogs

29

Il

69

78

11

12
10

28
6

17
24
9

8
6
6
4
3

3
9

Figure 24

Food Allergies and Migraine Headaches

There is growing evidence that migraine
headaches are a1so related ca food a11ergies.
The worst culprirs in a recent study were
dairy products. 209 Orher repo,rts suggest
that cheese in particular is one of rhe worst
o f-Tenders. At a convemion of British and
U.S. neurologists (brain, ncrve, and
headache specialists), rhe parcicipating
physicians wcre asked co list which foods
triggered mgraine in rheir patienrs. Their
responses are lisced in Figure 24.
You will note that most of rhe dietary

515

PROOF POSITIVE
facrors implicared by rhese physicians are
not pan ofa hea1rhful vegerarian dieL There
are, however, a few foods on rhe list rhar are
healthful for most people, bur may be
unhea1rhful for certain sensirive individuals.
Examples include cercain nurs and cir rus
fruirs. There are omer connections in the
medical Jirerarure between migraine
headache and diet. These connecrions also
suggest that a healthful vegetarian diet
would prove beneficial. For example, rhe
fars in a plant-based diet tend ro be
monounsarurated and polyunsaturated ones
rarher than the saeurated variety. The
research suggests that this may help prevenr
mlgrames.
One of the reasons appears ro be rebted
ro platelcts. These c10tting cells of rhe body
can apparendy c1ump and release compounds
that rrigger a migraine headache. Platelets
that have more polyunsarurated fars in rheir
omer layer (caHed the "platelet membrane")
tend ro be associated with fewer migraines
rhan ifme plate1et membrane is rich in saru2lO
This research suggests that inrared far.
ereasing the plant producrs in the dier may
help ro decrease migraine arracks.
Furrher evidence of this linkage comes
from research on children who were prone
ro migraine. Dr Glueck and his colleagues
ar me Universiry of Cincinnati have found
that children wirh worse cholesterol leve1s
had more migraine beadaches. 211 In facr,
the deleterious eholesterol profile was the
same one rhat predisposes individuals to
hem disease (i.e., low HDLand high LDL).
The qllesrion, of course, is whemer che cholesrerol values are rhe resll1t of a eommon
process (sucit as higher polyunsatllrared far
he1ping plarelet membranes ar rhe same rime
it is lowering eholesrero]) or whether
cholesrerol in and of itselfhas a relacionship
ro migraine headaches. There is probably
some uuth in both possibiJicies.
We have already seen rhat dietary
polyunsaturated f.m may be beneficia! in
migraine pariencs if rhose fats become
incorporated into rhe plateler membrane.
However, research a1so indicares rhar
increased amounrs of cholesrerol in rhe
blood reud to make plarelers more sricky. 212

516

Stroke and Vegetarian Diet

Currem research indi<..-ates rhar a dier rich
in whole fruirs and vegerables decreases sriH
other diseases. For example, rhe Nurses'
Healrh Srudy has demonstrated a 68 percem
lower risk ofstroke in women eating five or
more servings of carrors per week. Those
rhatateaservingofspinachperdaydropped
their stroke risk 43 percem. The fan10us
Harvard study of residencs of Framingham,
Massachusetts has shown that meo, roo,
benefit from eating more fruits and
vegetables in preven ti ng strokes. 21 :l
Specifically, they fOllnd that aiI strokes and
mini-suokes" (rransiem ischemic attacks)
dropped over 20 percenr for each addirional
(hree servings of fruirs and vegerables per
day. The devastating bleeding strokes were
prevenred even more. Three more daily
servings of fruits and vegetables decreased
the risk of rhose strokes by over 50 percenr.
Neirher of the two srudies mar 1 have
commemed on reported specifically on meat
inrake. They were focusing simply on fruirs
and vegccables. But whar typica!ly happens
when you increase your fruir and vegetable
consumption? You decre.ase mear intake.
This Jink wirh mear eating, however, was
made explicir in some recenr AusrraJian
research. 214 Researchers rhere found thar
eating meat more rhan four times per week
increased the risk of stroke.
Whar is ir abour fruirs and vegerables
that help to decrease stroke risk? There are
severallike1yexplanarions. As we have seen
in rhe migraine headache research, a vegetarian-type diet appears ro make plarelers less
sricky. When rhese c10tting cells are thus
rendered less prone ro initiare a dor, we
would expecr a decrease in the rendency of
oarrowed brain vessels ro block off rotally
and cause a srroke. It is likely mar stroke
risk is also lowered as a resulr of che blood
pressure-Iowering effecr of fruits aJld vegetables. One c1assic srudy was published in
the British journal Laneer over a decade
ago. 215 For more informarion on the dierhigh blood pressure linkage, refer ro che
chapteron blood pressure (Chapter6," One
Nation Under Pressure").
In preveming srroke, the vegerarian diet
has becn documenred ro help reverse

BEYOND THE LEADING CAUSES OF DEATH

blockages in areeries. The sllldy rhar has
received probably che greacesr publiciry is
thar performed by Dt. Dean Ornjsh and his
colleagues. 216 1 include more infotmation
on the reversal ofblockages in heart atteries
in Chaprer 4, "Blocked Arteries-Clean
Them aur rhe Natural Way." It seems
reasonable ro think dur similar reversal will
occur in blood vessels supplying [he brajn.

Cataracts
Cataracts are among the most common
problems (acing older America.ns. Theyare
major causes of visuaJ impairmenr and
bli nd ness in rhese individuals. 217 Thc
evidence suggests rhar diet and lifesryle on
affect the risk of rhis condicion. Cararaers
apparenrly occur more readily wheo a
person. is exposed ta a grearer intensiry and
durarion of ulrravioler light as is found in
normal sunshine. 2lS The eye lens scems ro
be damaged when ultraviolet lighr converts
oxygen inca reactjve compounds called free
radicals or "oxyradicals."219 Thus, we have
seen a popular emphasis 00 the use of sunglasses that have {Otal UV blockjng capabilicies. However, even this suninduced
damage can be prevenred-at least in parrby a group of compounds called antioxidanrs. These compounds such as vicamins
A, C, and Eare fOWld in abundance in plant
foods.
Evidence of this conneccion was
provided by rhe Harvard's Nurses' Health
SLUdy. Rcsearchers rhere discovered chac a
diet higher in foods concaining Ylramin A
compounds decreased (he risk of
cacaracrs. 220 Regulat use of Vicamin C
supplemems a1so lowered otaraa tisk in the
Harvard r<.':search. In ocher scien[ific studies,
subjec[s who consumed fewer daily servings
of fruic andJor vegerabJes had an increased
risk of cararacrs, as shown in Figure 25. 221
Norice rhat rJlOse who ate less than three
and a half servings of fruics and vegetables
per day had nearly thirreen rimes the risk of
developing cataracrs as those wirh more
libera! inrake of rhese foods.

Peptic Ulcers
As many as 500,000 cases of stomach
and intestinal (duodenal) ulcets are

diagnosed every year in America. 222 The

direct casrs of these condjrions (called colleccively "pepdc ulcer disease") amounts to
nearly 2 biUion dollars annually.223 The
evidence suggesr.s mat li fes ryle plays a major
role in [he development of ulcers.
One known relacionship berween
sromach and intescinal (duodena/) ulcers is
with cigarettes. Tobacco has severa! effecrs
mat increase rhe risk of ulcers. First. tobacco
scimuJates acid secre(ion; nexr, ir decreases
blood flow co rhe Ijning of the stomach and
inteseines; and lasr, ir decreases the amoune
of a prorective subsrance called proseaglandin fhar is made by (he stomach lining. 224 The resuIc is rhac smokers have
double ro rriple rhe risk of ulcer problems. 225
If you currently have problems wich
ulcers-or believe yOll are ar risk for
problems-chere are ac leasc three further

OW

NTAKE

UIT AN VEGETABLE

OMOTES CATARACTS

Food Category with

Lowlntake

Risk of Getting a Cataract

Cortical
cataract
risk

Posterior
subcapsular
cataract risk

Low fmit intake (less

tban 1.5 servings daily)

2.9

8.6

Low vegetable intake (les

4.1

7.4

Low intake of fruits and

veg,etables combined (less I
than 3.5 servings daily)

5.0

12.9

I than 2.0 servings daily)

Figure 25

areas ehat relate to eemperance rhar warrane

concern. The firsr is the avoidance ofcoffee
and orher caffeine conraining beverages. It
is well esrabJished [har these beverages
stimulace acid secretion.226 For rhis reason,
caffeine beverages are on the hit lisr.
Secondly, decaffeinared beverages conrajn
rannins rhar a!so increase acid productian
and thus on interfere wirh the healing of

517

PROOF POSITIVE
an ulcer,227 The rhird factor is an unbalanced lifestylc with impaired srress managemem. Many srill quesrion rhe link between
psychological srress and ulcers. 228 It is cerrain rhat stress does not he1p these digesrive
problems, and because stress is linked wirh
other adverse ourcomes, ulcer sufferers
should auempe [O manage srress throllgh
changes in lifesryle.
Orher aspecrs of the healthy lifesryle rhar
1 advocare rhroughour rhis book may also
playa rale in prevenring ulcers. A vegemrian
dier wirh its abundance offtber a.nd vitamin
A-relared compounds may also be a winner
in rhe ftght againsr ulcers. Recent research
suggests that a dict rich in fiber and viramin
A may reduce rhe likelihood of deveJoping
d uodenal u1cers. 229
Cleanliness and hygiene may also be
major factors in prevenring ulcers. Such
concerns involve rhe rhird element of
NEWSTART, which is "W" for warer.
Simple hand washing would go a Jong way
in decreasing our risk of a host of diseases
as we have already Icarned. Although noe
aII of rhe infofmation is in, this simple
technique may also decrease ulcer rates.
One of rhe houesr recent discoveries in
the area of pepdc ulcer disease is rhe linkage
with bacreria called Heficobacter ?ylori.
Alrhough rhe relationship between chis germ
and ulcer disease was posrulated in 1982 by
rhe Australian physicians, Barry Marshall
and Robin Warren, it has only recently been
widely accepted as a key f:1cror in ulcer
disease. 230 SimpIy pur, those wirh a chronic
infection wirh H. pylori run a significandy
increased rsk of developing ulcers. One
inrrguing factor rhar has nor received much
attenrion is rhe rransmissibiliry of H. PyLori.
Infecrion is e1early relareel tO lower
socioeconomic statlls, and may be relareel
to scandards of hygiene. Z3l Thus, careful
auenrion to c1eanlness and slich simple
practices as hand washing may play a mie
in decreasing rhe risk of developing u1cers.
Flies h:lVe even been faunei ro transmir rhe
infection from one person ro anorher. 232
Another inreresling side1ighr ro the
infecrion-uker connection re1ates ro foods

518

coIHaining a1lillm, such as garlic, onions,

and scallions. These foods, specifically
garlic, are known ro have antimicrobial effecrs and therefore ma)' help ro decrease the
risk of H. pylori infectjon. 50 far, dlis connecrion has nor been confirmed. Yer, consider rhe followi ng facrs. H. Pylori nor only
ncreases rhe risk of ulcers, but it also increases thc risk of stomach CHlcer. AlliuJn
foods. on rhe orher hand, decrease rhe risk
of sromach cancer. 233 The results suggest
proteerion n both animaJ tesrs and hllm3n
research. Although rhese foods may work
by blocking cancer developmenr or grawth,
rhey may also exert a role in eradicatng or
decreasing H. pylori infection. In shorr, a
balanced temperatc lifesryle chac pays anenrion ro rhe NEWSTART principlescan hdp
ro prevenr OI' rrc~n ulcers as well as the ocheI'
condirions thar are presented in this chaprer.

Conclusion
1 began this chaprer wirh a problem: how
cOlild 1 possibl)' provide information that
wOllld help ro meer rhe needs ofreaders who
had problems nor speciftcally addressed n
m)' book? My solurio'l was ro provide a
framework for approaching an)' healthrelated concern. By championing a
cenruries-old approach ro wellness, 1 have
areempced to do jusr thar. AlthOllgh Weimar
Institute has recently popularized ehe
NEWSTART acronym, [he remedial agents
rhar they advocare are as old as [he Mosaic
Health Codes in the scriptures.
The NEW START program is not a
panacea, however. It is a complete, balanced
program rhar addresses rhe viral areas of
heaJthfulliving in OUl' lives. It is more rhan
a low-fat vegerarian eliel' or a regular exercise
program. It is a comprehensive approach
ro living designeel to fosrer oprimal heaJrhphysicaJly, menrally, sociaJly, anei spiritually.
The eighr elemems of rhe NEW START
program offer each of us an opportuniry ro
maximize healrh by focusing on the changes
rhar are calculated ro promore healrh and
happiness. Why nor begin chis new Stan
today?

BEYOND THE LEADING CAUSES OF DEATH

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KlIlll

Amand, Per-Olaf. Mllrilion

Man:us R, Coulslon AM. Waler-soluble "ilamins. In: Gilman AG.

Goodmal1 LS, el al, editors. Coodmnn nnd Cil"ulIIS TIu PbnTmncologic
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Company, 1985 p. 1557-1559.

, Bro\V1l MS, Goldslein JL. Drugs used in Ihe IrC:llmenl of

hyperljpoproleinemias. In: Gilman AG, Goodman LS. CI al, editors.
A

GDOdmnn Iwd Gi/numi Thr PbnrmncO/Qgic Bnsis of71l"npcurics-7 rdirion. New York. NY: MacMillan Publishing Compally, 1985 p. 834-835.
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Brown MS. Goldslein JL. Drugs used in Ihe Irealmenl of

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II

Hcndler SS. TIu Doctori Vifl1milland Millrrn/ Encyclopcdifl.

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Il

cw York,

13 Hcndler SS. The DoCtor', Vilall)in and Mineral Entyclopcdia. New

York. NY: Simon and Sd'USlcr. 1990 p. 91-92.

14

Napia K. Too M:uly Vit:lJ1lins? Hnrvnrd Hrfllth [rtur 1996 Jan 21 (3): 1-

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IB

BJl BrcakLhrough: Missing nutrient found in planls.

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Cornclisscn G. Ham E. el al. Circadiafl 10 circascmiseptan (abour 3.5da)') Yariancc transposirion in S3livary CA J30 in apparcnr health (MecI ing
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10\()

14l Blank M. Cornelisscn G, Halberg F. Circlscmisepmn (aboul-halfweekly) andlor circasepran (aboul-wcekly) paltem in hurnan milOlic aeri\'ily? 111 Villo 1995 )uJ-Aug;9(4):391-394.

Corndissen G. Berg H, CI al. Chronomc of urinar)' 6-suJfoxy-meialonin excrction, circuhlling CA 12S. cancer progres. ion :lnd IhcrapclIlic rcsponsc. 111 Villo 1995 JuJ-Aug;9(4):37S-378.
14l

K."Ulabrocki EL, Sothern RB. et al. Wcekly ,uld yearly rhYlhm in plasma
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I S;76(8):628-631.
'43

\.14 Labrccque G. Bllreau )E Reinbcrg AE. Biologica! rhYlhms in lhe inflammalory rcsponse and in lhe ellecrs of nOll-steroidal.lll1i-inlbmmalOr)'
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'

1~6 Hildebrandl G. Rcacti\'c m.odificuon of the aUlOnomous lime StTUC-

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J Hta/ilJ

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)60

161

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Cfin op Rhrumtltol

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IS6

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lOg

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19?

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lIS

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11)

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21S

Fielding)E. Smoking: Flealrh Effecls and Conlrol. In: LasrJM. Wallacc

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11

Aldoori WH. Giovannucci EL, el al. Prospeclive slUdy o( cliel and the
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129

524

You WC, Biol WJ el al. Allium vcgelables and ,,'<!uced risk o(sromach
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133

APPENDrx

APPENDIXI
OGE :

ALANC

EFITS AND
Estrogen 's Be!!-e

IlS

-Relief from the classic symptoms

of menopause: hot flashes, mood
swings, vaginal dryness, thinning
skin
-Proven reduced bone loss
(osteoporosis) associated
witb menopause, including
a probable reduction in hip
fractures

SKS

Estrogen 's Risks

- An increased risk of
,endometrial cancer whcb
may be partially countered
by adding progesterone to
a regimen of estrogen
- Symptoms similar to
premenstrual ones (swelling,
bloatIng, breast tendemess,
mood swings, headaches)

- A menstrual discharge
-Probable reduced risk of beart
(when progesterone is taken
disease by improving cholesterol with estrogen)
levels and the flexibility of blood
- Incr~ased risk of breast
vessels
cncer
-Possible improved memory and - Stimulation of the growth
of uterine tibroids and
better mental ~unctioning of
endometriosis
women with mild to moderate
Alzheimer's disease
- ProbabIe increased risk of
gallstones and blood clots
-Possible lowered risk of colon
- Possible weigh t gain
cancer
Eram the Publishers ofNew Eng/and Journa/ ofMedicine Hea[thnews

525

PROOF POSITlVE

APPENDIXII
Recommended Vegetarian Cookbooks
Country Kitchen Collection
Fanrastically Delicious and Nuuitious
Vegerarian Meals
Phil and Eileen Brewer
Family Health Publications
8777 E. Musgrove Hwy.,
Sunfield, MI 48890
Country Life Vegetaran Cookbook
Choleseerol Free
Diana J. Fleming. editor.
Family Heahh Publicarions
8777 E. Musgrove Hwy.
Suofidd, MI 48890

Of These Ve May Freely Eat

A Vegetarian Cookbook
JoAnn Rachor
Family Health Publications
8777 E. Musgrove Hwy.
Sunfield. MI 48890

Taste and See

AJlergy Relief Cookbook
No meae. dairy products. vinegar, sugar,
whear, bakjng powder or eggs aod linie or
no sale Ifae
Penny King
Family Health Publications
8777 E. Musgrove Hwy.
Sunfield. MI 48890

Ten Talents
Natural Foods. Vegetarian
Food-Combining Cookbook
and Health Manual
Frank J. Hurd, D.e, M.D .
and Rosalie Hurd, B.S.
Published by Dr. & Mrs.
FrankJ. Hurd,
Box 8GA.
Chisholm, MN 557\9
NEWSTAR'J' Lifestyle Cookbook
More (han 260 Hearc-HeaJ(hy Recipes
FeaCllring Whole Planr Foods
Weimar Insritute
1-800-525-9192, Products Depanmenr
Thomas Nelson Publishers
100% Vegetarian
Earing Naeurally [rom Your Grocery Store
Julianne Pickle
Pickle Publishing Company
Rt 1 Box 44\
Seale. AJabama 36875
Tastefully Vegan
Creative Vegerarian Cooking
~rhrynJ. McLane
Lifestyle Cenrer of Ame6ca
Route \. Box 4001
Sulfur, OK 73086
1-800-596-5480

The Seventh~day Diet

How the "Hcalrhiest People in America"
Live Berrer, Longer, Slimmer-And How
You Can Too!
Random House, New York
These books may be ordered from ehe publisher direct or from:

526

New Lifestyle Booh

30 Uchee Pines Road # 15
Seale, AL 36875
\-800 542-5695

APPENDIX

APPENDIX III
Lifestyle Centers Around the World
Cedacvale Hea1th Centre
2999 Moss Vale Rd
Firzroy Fatis, NSW 2577
Auseralia
phone and fax +61-44-651-362
Delhuntie Park Youth Care &
Lifestyle Centre Ine.
RMB 5540
Trafalgar E.asr, Vie 3824
Ausrralia
+61-356-331688
+6l-356-33l683 fax
Duke Universty Hea1th aud
Fitness CeRler
804 West Trinity Ave.
Ourham, NC 27201
1-800-677-2 177
(919) 684-6331
Eden Valley Institute
6263 N County Rd #29
Loveland, CO 80538
970-667-0809
970-663-7072 fax
Lifeseyle Cenrer
970-669-7730
Fredheim Health Center
Bergmannsveien 600
3600 Kongsberg
NORWAY
+47-32-76-6J50
+47-32-76-7150 fax

HanJand Institute
Hatdand 'WeUnes.s Center
PO. Box 1
Rapidan, VA 22733
1-800-763-9355

Health & Preventive Medicine Center

(CenrruJ de Sanatate & Medicina
Prevenriva-Romania)
Ser. A. Filimon rer 16
Tim Mures, Jud. Mures 4300

ROMANIA
phone and fax +40-65-165-353
Lifestyle Center of America
Route 1, Box 400 J
Sulfur, OK 73086
1-800-596-5480
405-993-2327
405-993-3902 fax
Poland Spring Hea1th Institute
226 Schellinger Road
Poland, ME 04274-6134
207-998-2795
207-998-2894 Lifestyle Cemer
207-998-2164 fax

Pritikin Longevity Center

1910 Ocean Fronr W11k
Sanca Monica, CA 90405

1-800-206-5813
(310) 450-5433
St. Helena Health Center
650 Sanearium Rd.
Oeer Park, CA 94574
1-800-358-9195
(707) 963-6207
Silver Hills Guest House
RR2, Site 10, Camp 18
Lumby, BC VOE2GO
Canada
604-547-9433 phone
604-547-9488 fax

527

PROOF POSITIVE

APPENDIX III, CONTINUED

Uchee Pioes Institute
30 Uchee Pines Rd
Seale, AL 36875-5702
334-855-4781
334-855-4764 Lifeseyle Center
Weimar Institute
(20601 W. Paoli Latle)
PO Box 486
Weimar, CA 95736
916-637-4 tii
916-637-4408

528

Wtldwood Ufestyle Ceoter

and Hospital
(1 Lifeseyle Lane)
PO Box 129
Wildwood, CA 30757
706-820-1493
706-820-1474

APPENDlX

APPENDIXIV
HOW ALPHA LINOLENIC ACID

CONVERTS TO EPA
Metabolic pathway ofomega-3 fatty acids
18:3
Delta-6 desaturase
Elongase
Delta-5 desaturase

0 ..

I
18:4 n-3
I
20:4 0-3
I
20:5 0-3

Alpha liooleDic

Eicosapentaenoic

Elongase
22:.5 n-3
Delta-4 desaturase

22:6 D-3

Docosahexaenoic

529

PROOF POSITIVE

APPENDIXV
One Gram Sodium Diet
This diet is /ow in sugar, eho/estero/ and .~aturateJifals. AJJ foods are prepared and served jthout salt
(except for 1/8 teaspoon a/lowed). A salt substitute m'ajl be used.

Food Group

Foods Excluded

Foods Allowed

Beverages

2 c. nonfat milk
soyalac concentrate
or ready-to serve

)( whole milk
)( bunermilk
)( exces, of DODfat milk

Breads & Cereai,

3 servings bread
(unsa/ted whole grain or enriehed
breads)
unsalted crackcrs
regulat cooked cereals made without
salt
puffed rice
puffed wbeat
shredded wheat
rice, macaroni, spaghetti, noodles
cooked without salt

any food made with egg, but1er,

shortening baking powder, soda,
x self-rising nour
)( quick breads
x quick cooking cereals
x dry cereals except as noted

Cheeses

unsalted Donfat cottage cheese oDly

unsalted hoop cbeese

Eggs

1 egg white
replace with scrambled tofu

x egg yolks
x egg substitutes

Proteln Rich Foods

dairy & eggs as noted above

Vegetable proteins:
uDsalted old-fashioned style
peanut butter
tofu
dinner cuts (DO salt added)
soyalac
Umit intake of poultry and fish

x
x
x
x
x
x

x
x

)(
)(

530

aU others

dairy & eggs as nored above

regular peanut but1er cream cheese
aII meat analogs except as Doted
salted nuts
bacon
organ meats
bot dogs
sausages
cold cuts
sheUfisb
pork

APPENDIX

APPENDIXV, CONTINUED

Food Grou,p

F'oods Excluded

Foods Anowed

Protein Rich
Foods (cont.)

)( salted meats smoked, processed,

canned meats
x ham
x corncd beef
)( kosher meats
x avoid aU other red meats

Fruits

aU [ruits & juices

)( fruit drinks, sweetened juices

Fats

unsalted margarine made with corn

or saffiower oi]
corn oiI
saffiower oi]
soybean oU
unsalted salad dressings roade with
polyunsaturated oib

)( bulter
x salted margarine
)( cream
x bydrogenated shorteDlngs
x Lard
)( mayonnaise
x palm oii
)( coconut 011
x cottonseed oii
x cream cbeese
x salted salad dressings
x nondairy creamers
x Mocha Mix

Vegetables

fresh or frozen vegetables

uDsalted canncd vegetables as desired
no salt should be added to froun
corn, !ima beans, peas, siDce salt is
used in processiDg

)( sauerkraut

Soups

aII homemade soups including clear

soups and ti cream 50UpS;' if tbey are
made without salt aud witb nonCat
milk within the milk aUowance
low sodium broth

)( olives

salted canned vegetables

)( potato chip!
x French fries
)( aoy prepared with exduded fats as
noted

)( regular canoed or debydrated soups

)( broth or bouiUon

531

PROOF POSITlVE

APPENDIXV, CONTINUED

Food Group

Foods Allowed

Foods Exduded

Desserts

agar flake gel made wUh Cruit julce

unsalted fruit pies if prepared with
oybean saffiower, or corn oii and
natural sugar
baked goods'" made wlth baking
power, unsaturated oii, and
natural sugar (dates, raisins, etc.).

)( ice cream
)( ice milk
x any desserts made with butter,
hydrogenated fat, egg yolks,
cream, wbole milk. saturated fat,
salt, sodium based baking
powder/soda
x salt water taffy
x puddings & custards

Miscellaneous

unsalted dry roasted nuts

unbuttered, unsalted popcorn
seasonings witbout salt

)( gravies unless made from uDsalted,

fat frec broth
x olives
)( meat sauces
x cream sauce
x cbocolate
x salt in excess of 1/4 tsp.
x salted nuu, popcorn pretzels
x pickles
x relisbes
x mustard
)( catsup
)( chili sauce
)( soy sauce
)( meat tenderizers
)( seasoned salts
x instant cocoa mixes
)( prepackaged stuffing mixes

'" If eaten remove one serving jrom bread and cereai group
532

'------------

APPENDIX

APPENDIXVI
FREE RADICALS
02 + single electron = 02- (superoxide)

U202 =} OU- (hydroxyl radical)

the most toxic oxygen based radical
Paired electrons ~
"'-

Unpaired elcctFon

"'''-.

Stable molecule

Free radical

533

PROOF POSITIVE

APPENDIX VII
MELATO IN'S ROLE AS
AN ANTIOXIDANT
Efficient neutralizer of OH-

.--11'--.._

- More effective than glutathione

Stimulates Glutatbione
Peroxidase to convert H 2 0 2 to H 2 0
Efficient scavenger of the peroxyl radical
- More effective than vitamin E

Protects against free radical damage rrom

certain carcinogens, herbicides and radiation

534

APPENDIX

APPENDIX VIII
BIOSYNTHESIS OF MELATONIN

p'J
Q

NR/

eUl cu

COO-

N./

UOOJcu......
Nn/
?
1 CU;

I I

"

N/
H

SerotoDiD

Tryptophan
___

ActtyJ.CoA

-RO

31

Rtqms N..cttyltrusfense (NA1)

NR/
I

RO

~CHC~~_
N/
R

5-Uydroxytryptophan

535

PROOF POSITIVE

APPENDIXIX
Milk Alternatives
Nutrients per Servin/!
,

Vit. A* ViI. B/ 1 * Vit. D* Calc.

Milk Type
Better Than Milk lite, plain
Dari Free
Instasoy
So)ait Original
Soy Good
Soyagen
West Soy, plain
Wbolle miIJ<
Reduced fat (2%)
No fat (skim)

0%

10%

0%

40
25

10
10

0%

15
25
10

15
25

15
25
25
25
25
25

30
30
30

10
10
10

O
I

I
I

15
15
15

Sugar Chol.
(g)
(mg)

50%
30
35
24
30
10
30

10
25

fron

7
6

5
7

10
10

12

12

12

12

Vitamin B 11 per serving,

% Daily Values

KeJlogg:
AJI Bran
A'pp,le Jacks
Crispix
Crispy Rice
Nutrigrain
ShTedded Wheat
Miniwbeats
Product 19
Post:
Frosted Shredded Wheat
Raisin Bran
Post Toasties
Genera) MiUs:
Total

536

25
25
25
25
25
25
25
100
25
35
25
100

O
O
O
O
O

B u COD. .t ofBreaIdUt Cereals

Breakfast
Cereai

33
18
4

APPENDIXX

APPENDIX X
Medical Enlightenment A Century In Advance

he informarion presenred in chis

book, as you are aware, is based on
a large number of references from
many sources. Mose of r!le sources provide
specialized information in a particular field,
and are referred (O in one or perhaps rwo of
the chapters. You may have noticed rhar
one source, Ellen Whire, is sprinkled
through more than half of ehe chapters, as
het writings cover a wide scope of health
and medical topics. Some may wonder,
"Who is Ellen Whire?" She was a wrieer
and lecturer of the nineteenth century. Her
books and artides cover a wide variery of
topics in addition to healrh.
She wrore volumes on topics rdated ro
healrh, healing, and lifesryle. MinisC!y of
Healing, Counsels on Dier and Foods,
Medical Minisrry, and Counsels on Healrh
arc four books that comain informacon and
advice an a wide variery ofdiseases and conditions. These books and others have UI1dergone many prinrings over the decades
and are stil! available and in demand raday.
As a physician, 1 have been amazed as to
the validiry and usefulness of her admonitions regard.ing health principles and rreatmenrs for disease.
A cenrury ago she laid out a formula for
personal healthfulliving in rhe areas ofdier,

exercise, temperance, rest, sunshine, hydrotherapy, and fresh air tiUt is sti]) valid today. However, it is only withiJl the last 30
years that most of her recommendations,
calltions, and warnings have been scientifically verined, and none have been refllted.
Mosr of her admonirions had no scienrific
suppon during her lifetime and rhus were
nor largely acceprcd by rhe medical communiry; some were in direct concradiction
ta common medical knowledge and practice of her day.
For example, in hcr day, tobacco was
rnought ro be lIseful as a medic3tion for rne
relief of rhe symproms of asthma. Some
medical associations actuaHy recommended
it for chis and other brearhing disorders.
Shorrly before her day, George Washington was bled ro death in an atrempc ro cure
him ofa diseasc. Medical doctors administered othcr treatmenrs that we now know
are damaging rarner ehan curative. He was
given heavy metals; he was actually poisoned; he was scalded in order ta "ler r.he
roxins Out of his body." These rreatmenrs
were accurately recorded, not ro show the
ignorance of rhe physicians, bur ro indicate
[hat chey applied aII of the known medical
rreatment in an attempt ro bring him back
to healeh.

Insights on the Devastating Effects

ofTobacco Use
It was in this medical dimare that Ellen
White wrore ehat tobacco is a stimulanr. and
a depressanr. She warned that tobacco
causes cancer, heart disease, and orher health
problems. She caurioned that it also inf1icts
damage [Q t!le mind, which has just very
recently been proven. She wroee of its
addictiveness, whjch has now been proven
and is widely recognized, evcn by the (0bacco companies. As late as the J950s, the

position of the American Medical Associarion regarding (Obacco was ehat its bcneflts
ourweigh ies harm. l
The format used in this survey of her
wrilillgs highlights an underlined topic,
shows Ellen White's words, and compares
them ro srarcmems from medical science.
A few observations on the subject of [0bacco made by her and her modern medical science counrerparts fo IIow.

537

PROOF POSITIVE

Nicotine Affects the Nervous System

Ellen White's Words: "Tobacco...excites

[stimubltesjan.d then paralyzes (suppres.resj tiu

nerves. "1
Medical Science Speaks; A medical eexrbook on smolcing says: "Nicorine is a cholinergic agonisr [a seimulant] at low d~ses
and an antagonisr [a suppressor] at hlgh
doses."3

The Addictive Power OfTobacco

Ellen White's Words: "Tobacco ... chairzs
the wil/,' it hoU its victims in the sblvery of
habits difficult to overcome... "-1
Medical Science Speaks:
Nicorine is six ro eight rimes more
addictive than a1cohOp6
Incravenous nicotine gave scores 5 to
10 times higher rhan even intravenous cocaine. 7

Tobruco as a Gateway Drug

Ellen White's Words: The "appetite far
tohacco is self-destructive. It!eads to a cravingfar something stro~ger,-fi:nne~te~ UJi?:s
and liquors, allofwhJch are mtoxJcatmg.
Medical Science Speaks:
Chitdren who use r.obacco are more
likdy to go on ro use in sequence alcohol, marijuana, and rhen orher illegal drugs. 9
The more children and adulrs smoke,
rhe more alcohol and omer drugs rhey
teod ro use. 1O

Tobacco's Far~reaching Health EfJects

ElJen White's Words: "Suffiring, disease,
and death are the sure penalty ofindulgente
fin tobacco I1nd a!cohol). "1 f
Medical Science Speaks:
AII told, more than 400,000 Americans clic each year from smoking. 12
One quaner or more of ~lll smokers
in our counery die premarurely from
a smoking induced illness with an
average loss of life of 21 years. 13
Worldwide smoking c1aims over 3
' l'Ives annu alI y. 14
m ill 100

Smoking And Cancer

538

E1len White's Words: White described

tobacco as a 'malignant" poison in her pub-

lished U)ritings throughout faur decades.

Medical Science Speaks:
Smoking increases rhe risk ofcan.cers
of t.he lung, lip, mouth (oral cavlcy),
rhroar (pharynx), voice box (Iarynx),
rrachea (wind pipe), esophagus, sromach, liver, pancreas, bladder, kidney,
cervix, blood (lellkeluia), colon, skin,
and penis. 15 . IG. 17. 18. 19
Nearlv one rhird of aII cancer dearhs
in our, narion are due (O Slll.O k'mg. 20

Tobacco: A stow, lnsidious

Carcinogen
EUen White's Words: "TObacco is a slow,
insidious, but most malignam poison.. .it is
alI the more dangerou.s because its efficts are
sloU) and at fim hardly perceptihle. '21
Medical Science Speaks: This faCt is weH
known roday. Its slowness required man)'
years oflarge staristical srudies to .derermine
that it causes cancer and oeher dlseases.

Youth and TObacco

El1en White's Words: "Btrys begin the u.se
oftohacco af a very early age. The habit :/JUs
farmed, when body and mind .are especral~
flIsceptible to ies efficts, rmdemllnes tiu phYSIcal Jtrength... "22
Medical Science Speaks: In both men
and womell, the earlier a persoll starts smoking, the greater the susceptibiliry ro lung
cancer. For example, women who started
smoking before age 18 had nearly double
the lung cancer rsk of ehose who srareed
beeween the ages of21 alld 34--and nearly
seven rimes rhe risk of women who picked
up the smokiog habit when 35 or 01der. 23

Smoking and Heart Disease

Ellen White's Words: "Lately I have read
... ofthe death ofmany men... 71Jeir deatll is
a/mos!always tlttributed to filure offhe hearl,
but in retllii)' ... the use oftobacco and liquor
had poisoned the system [of many of
tem
h ] ... ''24
Medical Science Speaks: Each year in
America as many as 300,000 cardiovascuIar disease dearhs are the direcr result ofcigarerte smoking. 25 26. 27

APPENDIXX

Smoking AjJects the Blood

EUen White's Words: "Tobacco... poiso1'lS
tbe Lift currerJt"28 "... many cbew and smoke
[tobaaoJ umiL tbe bLood is conupted... '~9
Medical Science Speaks:
Smoking acce1erates atherosc1erosis
by causing several changes in the
blood. [n lay language there would
probably be no berter way to describe
rhose changes as "smoking poisons
the blood." It decreases levels of a
c1ot-preventing compound called
pwst<lcyc1in..30. 31..32
le increases blood levels of carbon
monoxide and stress hormones, both
of which damage blood vessels;33. 31
it e1evates fibrinogen, a blood con
stiruen[ that illcreases the risk of arh
erosclerosis and c1orring. 35
It raises blood levels ofLDL and lowers HOt.

Smoking Damages the Brain

EUen White's Words: 7Obacco weakens
the brnin andparaLyzes itsjine sensibilities; '~6
it "beclouds the brain. '87
Medical Science Speaks:
Smokers are less able to perform complex menta] tasks than non-smokers. 38
Using as fewas 1 (Q 14 cigarerres per
day ean more than double rhe risk of
nonfatal stIoke,39 which can damage
our highest menral and moral funetJOJlmg.

No Safe Form OfTobacco

Ellen White's Words: "Tobacco, in whatever jOrm it is used, tells upon tiu constitution. It is il sloUl poison. "iO
Medical Science Speaks:
1. Morraliry rates of cigar and pipe
smokers are 20 to 40 percent higher
than rates for nonsmokers. 41
2. Ooe reason is that cigar and pipe lISer have a significanrly increased risk
of hean disease death. 42
3. Chew or dipping smokeless tobaeeo
is a potent cancer risk factor. 43
4. There are 28 differenr cancer-causing chemicals in chewing tobaeco and
snuff.44

Did Ellen Wllite understand the dangers of seeondhand smoke? Her insights
are c1early doclImented.

Dangers ofSecondhand Smoke

EUen White's words: "... by u,sing toba-cco,
[smokersj poison the [ord's frec atmosphere,
so that others are injured. "15 She reftrred ta
the air in a room with smokers as "tobaccopoisoned air. "16
Medical Science Speaks: Oeaths in the
U.S. per year from secondhand smoke is
estimated at 50,000.41

Children ofSmoking Parents are

Damaged
Elleu White's Words: Smoking parents
caTiSe ''the system of the infant [to bej flUed
withpoison...it acts upon some infants... causingspasms, )its, paraLysis, amisudden death. "18
Medical Science Speaks:
When compared ro the babies of
nonsmokers, infams whose mothers
smoked borh during pregnancy and
after are three times more likely ro
become victims of SIDS-the "sud
den infam dearh syndrome."49
Smoking f.1thers also increase their
infants' risb of SIOS. 50

Mental Damage to Children/rom

Secondhand Smoke
Ellen White's Words: "Memal intlbility
and physical weakness can resultji-om parentai smoJling; ''.51 'imbom generation5 are af
flicted by the {parental} tese oftobacco and liquor. lntellectualdecay is entailed upon them,
and their moralperceptions are bluntcd. "
Medical Science Speaks:
Maternal smoking accuaJly decreases
rhe number ofbrain nerve cells in the
developing fetus. 52
Inrelligence quotients (IQs) were an
average of nine points lower among
3 ro 4 year old childre.n whose mothers smoked during pregnancyY
Other secondhand smoke effects include difficulry in processing sound,
and dealing with rhree-dimensional
geometry concepts.,4. 55

539

PROOF POSITIVE

Summing up Ellen White on Tobacco

Ellen Whire did indeed bless rhe world
wirh accurare sciemific insighrs imo rhe
dangers of robacco. In addirion ro rhe benefirs ro millions of readers ofher books, she
gave aII natiollS another precious legacy: she
encouraged Sevemh-day Adventists to devote energy ro help smokers kick rhe habit.
Her philosophy is perhaps best summarized
in her own words: "Work for rhe inremperare man and the robacco user. .. "56
Following White's counsel, Seventh-day
Advemisrs have conducred one of rhe
world's mose successful srop-smoking programs. Since its inception in the 50s, rheir

"Five Day Plan ro StOp Smoking,"57 has

been used by an estimaced 14 million smokers in 150 different countries. The program
is stil! used today, somerimes in a revised
form known as "The Breathe Free Plan ro
Stop Smoking." Modern research shows
just what El!en White tallght a cemury ago:
tobacco is not jusc a killer. le can sr,eaJ life's
quaJiry, desrroy happiness, induce disability, and rob billions of dollars from society.
Our cournry and the world would be [,u
differenr roday if everyone had heeded
White's words when she firsr penned rhem.

Insights on the Superiority Of the

Pure Vegetarian Diet.
One ofWhite's most tireless recommendarions was the health benefits of the vegetarian dier. In literaJly hundreds of places
in her writings she upheld this dier as rhe
ideal.
Vegecarianism was linie known in the
1800s; the meaning of the rerm irself was
noc generaUy undersrood. Vitamins had not
yet been discovered, and the existence of
bacceria was just being discovered. The circulaton of rhe blood had recently been discovered. Modern scienriilc discoveries have
esrablished that heart disease, cancer, and
many other diseases have their origins in the
meat itself. Her undersranding of the rale
of diet in regard to health is aswunding in
ligllt of [he prevaiJing, primitive medicaJ
knowledge of her day.
She had much to say abolit other f.1Ctors relarng ro diet and eating habits. Let
liS look ar a few of her pronouncemenrs 00
dier that have been verified by modern
medical science.

Vegetarian Diet is the Most Healthful

ElJen White's Words: "Graim, fruits,
nuts, and vegetabLes eomtitute the diet ehosen

for w by our Creator. These ftods prepared in

540

as simple and natural a manller as possible,

are the most /u'althJUI and nourishing. "58
Medical Science Speaks: StatisticaJ stlldies combined wirh iocreased scienrific
knowledge of rhe immune system and the
action on che body of diecary fiber, carbohydrates, cholesrerol, protein, phycachemicaIs, ViraJllins, anrioxidants, sale, and many
other substances in foods, have proven rhe
superiority of che vegerarian diet. The diet
has been shown ca be beneficial in the prevention and rreaunenr ofmany diseases such
as rheumaroid arrhritis, stroke, hearr disease,
cancer, diabetes, cataracr.s, urinary infections, asthma, kidney falure. kidney stones,
seriolls infecriolls illnesses, and mental
healdl. Vegerarians have been shown to have
greater longevity, superior muscular endur'lllce, less chronic diseases, less lltiJization
of health care facilities induding hospicals,
and less need for medicacions.
The benefits of the vegetarian diet are
now found on the pages of even the mosr
conservative scientific pllblicarions.
Thraughouc chis book 1 have presented
much of che accllmulared evidence thar remarkably indicates rhe superiorry of rhe
vegerarian dier which Ellen White advocated

APPENDIXX
125 years ago. Information on how rhis
earing sryle is helpfl.ll in preventing or treating bean disease is found in Chaprer 3 an
hearr djsease and Chapter 4 on reversing
hean discase. The vegerarian diet aIso receives considerabie accenrion in Chapecr 2
an cancer. Chapter 8 on sugar aod diabe-

res shows some of rhe advanragcs of a diet

free of animal products on this leading discase. Benefits of rhe vegetarian fare in the
contexe of condirions like asrhma, rheumatoid arrhritis, cararacrs, and others are found
in rhe final chapter.

More Admonitions Regarding the

Vegetarian Diet
Vegetarian Diet Enhances Physical
Endurance
E1len White's Words: Craim,fiuits, nulS,
Imd vegetables constitute the diet choSerl joI' US
by aur Creator... They impart a strength, a
power ofenduranu, arId a vigor ofintel/cel,
that are noI afJorded by Il more complex and
stimu/atingdiet. 59 "... [!ndividuals} wi/l have
greater pa/vers of endurance if thry abstain
from meat than if they subsist largei; upon
it. '60 "It is a mist/lke to suppose that muscular
strength depends on the use ofilrlimalJod. 'rJ;
MedjcaJ Science Speaks:
Bicyde tests of athletes who follow a
high far, high prorein, high meat clict,
can eriple ther endurance by swirching ro a vegeearian rype of high carbohydrare diet. 62
Marathon runners among many others have discovered ehar mcar is a derrimel\( ro distance running ar other
endl.lrance activieies.
The belief that a dier srrong in mear
is essenciaI for people thae do muscular work has been prevalent up ro jusr
a few years ago.

Vegetarian Diet Enhances Mental

Peiformance
Ellen Whire's Words: Cmins,.fuits. nuts,
and vegetables... impart a vigol" ofinteL/eet,
that fis} not afJorded by il more complex and
stimulating diel. 63
Medical Science Speaks:
1. Meae conrains a subsrance mat impairs brajn acriviry and lacks a subsrance rhar the brain needs to func-

rion weJl. Arachidonic acid found in

mear impairs optimal funceoning of
rhe brain cemer for wisdom, judgment and foresighr-the fronral

10be.64. 65. 6e 67
2. Animal foods are devoid of carbohydrare, which is rhe primary source of
energy rhar rhe brain c.1.n use,6B but a
vegetarian diee conrains a plenriful
supply.

Meat Increases the Risk oflnfectious

Diseases
Ellen White's Words: "... the fiability to
ti1ke disease is increl1sed tm-jold by meat eat.
"69
mg.
Medical Science Speaks:
Infecriolls agems transmitted especially from animal prodllcrs include
salmonella,l0' 71 listeria,n. 73
campylobacrer, 74.75. 76 and dangerous varieties of E. coli (technically
referred ro as serorypes O 157:H7 and
O104:H21).n. 7B. 79.BO
Alrhollgh rhese agenrs often cause
norhing more than severe diarrhea,
rhey can cause blood infecrions (sepsis), permanent arthritis, nervous system disease, kidney failure. and far..'l1irjes.
Foods commonly associared with one
or more of rhese illnesses are soft
cheescs,81 orher dairy prodllcrs (inc111ding pasreurized items).B2. 8:l. 84
eggs, 85.86 sal.lsagc, 87 beef prodllcrs, 88
undercooked chicken,89. 90 and "nonreheared hor dogs. H91

541

PROOF POSITIVE

The Vegetarian Diet and Infectious

Diseases
Ellen Whte's Words: "we see that mttle
are becominggrently diseased. .. and wt ktlOlV
that tiu tinU! wiLl come when it lVill not be
best to me milk and eggs. 92 Even while Slll1Ctioning the use ofdairy products in ha day,
White wrote: "lfmilk is IIsed, it should be thol'oughly steriliud; with this precaution. t/ure
is less d4nger ofcontracting disease from its
use. '93
Medical Science Speaks:
Even today's pasteurized rnilk is conraminated. Thorough sterilizaeion
(boiling the milk) would have c1early
prevcnted ourbreaks of salmonclla
and listeria.
Crohn's disease (a serious, and sometimes life threatening inrestinal illness) may also be liuked ro milk.
Even pasteurized milk 94 may concain
.
. berculOSIS
' 95.96
rnycobacrenum
paratll
which may cause Crohn's in susceptible individuals.

Animal Praducts, Infection, and

Cancer.
Elleo White's Words: "Flesh WflS never
the bes! ftod; but its use is nOlv doubly objectionabie, since disease in animals is so rapld!y
increasing... People are continuflI!y eatf~/gflesh
that is flUed with. .. cancerous germs. 91
Medical Science Speaks:
The medical lirerature does nor yet
show a definire link berween animal
infectiolls illness anei human cancer.
However, rhere is growing cause for
concern. Animal diseases can eirher
cause cancer ar immune systern
changes in infecreel animals. The
bovine leukemia virus c.,uses a form
of leukemia in American cattlc. 98 . 99
An animaJ form of AIOS called rlle
. .lrnmunodefiIClency
.
. 100. 101
bovlIle
vIrus
affects canle.

542

Cancerftom Eating Animal Products.

EUen White's Words: "fanima{} flesh ...
is filled with. .. cllncerou,s germs. -102
Medical Sciellce Speaks:
American women who eat ilie most
red meat double rlleir risk of Iymphoma. 103 Eating hamburgers more
than four times per week more than
doubles a wOlllan's risk of nonHodgkin's lymphoma. ,04
Meat eating may also increase a host
of other cancers. I{ more {han
doubles the risk of colon cancer. IOS
106.107.108.109

When ir comes [O cancer, praof rhar {he

presence of cancerous "germs" in animals
dirccdy causes c.11\Cer has not yet beell esrablished, bur medical evidence raises rhe
question. We do know thar certain cancers
are caused bv bacteria, aJld cerrain other
cancers are c;u ed by eating meat. It is well
esrablished that chronic bacterial inIections
such as Helicobllcter Pylori can cause cancer
ofthe stomach and have been linked ro Iymphoma. 11O It is now well documcnred thar
Illany cancers are caused by a virus and thar
cenain viruses can be translllitted from animals tO humans. It is not surprising rhat
some of\X'hire's uncanny insighrs have nor
yer been confirmed by modern science.
Most of her counsels were not "medcaJly
proven" umil many years ;tfrcr they were
written.
Whire made the connection between
diet, disease, alld death: "Many die of diseases wholly due ta meat eating, when rhe
reaJ cause is scarcely suspected by themselves
or orhers. Some do not immediately feei
its effects, bm dus is no evidence that it does
not hun rhem. It may be doing its work
surely upan the system, yet for the rime
being rhe victim may realize nothing of
. 'III
It.

Fish are not Safe to Eat

Ellen White's Words: "Thefish that pa/'tflke of fhe filthy Sl71Jerage... mlly pass into
waters far distAnt from the sewerage, flnd be
caught in lomlities where he water is pure
/Ind fresh; but becauJe of the unwholesome

APPENDIXX
drainage in which rhey have bemfteding, they
are not saft to eat. 112
Medical Scence Speaks:
In 1996.47 ofour 50 sraces had consumpcion advsories warnng abour
earng cerrain species of fish. The
advisories covered 1.740 rivers and
lakes (including aII of (he Grear
Lakes) and large chunks of coastaJ
areas. 113
Each year in rhe U.S. rhere are over
100,000 reporred cases of foad poisoning due ro conraminared seafood. 114
Seafood causes as many as 15 rimes
as many food poisoning oucbreaks as
beer, poulrry, or pork. ll )
Raw shellfish pose (he greatesr risk. 116
They are commonly harvesred from
coasta! waters rha( have beel) conraminarcd wirh human sewage.

Fish are not Safe to Eat

Ellen Wh.ite's Words: "In many Localitj~s
rom fish ii unwholesome, and ought not to be
,;
use.d ... they are not saje
to eat. '117
Medical Science Speaks:
National Cancer Institure data show
an increased death rare from cancer
among people living in areas where
fish have exceptionally large amounrs
of tumors. 118
Lake Erie scdimenrs caused skin cancer when paimed Ollro (he skin of
mice. 119
Ir is commoll tO find fish conraminated by with halogenared organic
compounds (induding DDT). 120.121
Elevared levels ofhalogenated hydrocarbons have been found in rhe rissuc ofbreast cancer paeienes, suggesting a cause-and-effecr relationship. 122

Many fish are conraminared with

PCBs, diox.in, heavy mceals, anei halogenated organic compounds (induding O DT). 12). 126. 127
Halogenated organic compounds,
PCBs, and diox.ins may increase the
risk of a variery of condirjons such as
high blood pressure, arceriosc1erosis,
C\iaberes, and e1evared blood fars. J28
129

Fetal PCB exposure may cause nervous sysrem damage and loog-Iasring
menral impairmenr. 130, 131
In addition ro promocing vegerarianism,
EUen White ofren sil1gled aur particular
foods ar food categories because of rheir
unique effecrs an healrh. Sometimes ehose
effeces were derrimeoraJ, omer rimes they
were beneficial. 1:\2 She commenced on foods
rhat we now know have a bearing on hearr
disease.

Heart Disease Concerns with Cheese

EHen White's Words: "Chuse is
wholly tinfit for food. '~33
Medica! Science Speaks:
Oxidized cholesecroJ increases beart
e1isease risk. I34 . 135
Ripened cheese is a rop source of chis
oxidized cholesterol. 136
Cheese tenels ro be high in salt. In
suscep(ible people, (his will raise
blood pressure (another hearr disease
risk facror).
Many cheeses are high in saturated
fac, which tends tO raise blood eholesterol values.

Custards and Heart Health

Ellen White's Words: uEspecia/~y hnrm-

Fish are not Safe to Eat

fiti are the custartis (md Imddings in which

Ellen White's Words: "In many LocalitieI

rom fish ii unwholeIome, and ought ,JOt to be
Ilsed. .. they are not saft to eat. "123

milk, eggs' aml sugar are the chief ingredienti. "/37

Medical Science Speaks:

In ehe U.S., f1sh produclS conrain signitlcandy more pesricide residues
than fruits. grains, or vegetables. 124

Medical Science Speaks:

Dried cusrard mix (which typicaJly
conrains sugar, milk, and eggs) is one
of the worst offenders when ie comes
ro containing oxidized cholesrerol

543

PROOF POSITIVE
and producing measurable damage ro
blood vessel Jining cells. 138
The desrrucrion callsed by oxidized
cholesrerol appears ro bc a key factor
in callsing hardcning of rhe arrerics
and llitimarely hearr arracks. 139. 140

Nuts and Heart Health

EUen White's Words: "Mlts and mitflods
are coming largely i1'1lo use to take tbe place of
flesh meats. With I1Uts may be combined
grains, jruits, tind some roots, to make flods
that are bel1lthftl and nourishing. "HI
Medical Science Speaks:
Jusr when many hearr disease researchers were abour ro cross nurs off rhe Jisr
of"healrhflll foods" (due ro rheir high
far conrem), researchers ar Lama Linda
Universicy found rhar nurs could lower
blood cholesrerollevels and provide a
corresponding decrease in rhe risk of

hearr disea.~e. 142. 143

Nut Varieties and Heart Disease

Ellen Whire's Words: ".. . some

are
nOI so wholesome IlS othen. Almonds are pref
aable ta peanutJ... "14-4
nuts

Medical Science Speaks:

Peanur far has a spedllc chemicaJ
srructure rhar makes ir harder an hulllan arreries. 145 From rhis perspective, almonds (and a variecy of orher
nurs) are superior ro peaours.
A1monds boasr more yiramin E ehan
almosr ali orher Ollts. Inrake of rhe

amioxidam yitamin E is associared

widl a decreased risk of hearc disease. 146

The Jmportanee ofFiher

EUen Whire's Words: "For use in bretldmaking, tiu superfine white flour is 110t the
be-,t" .Finejlour bread is lacking in nutritive
elemmts to beflund in bread made from the
whole wbeat. It i-, (f frequent muse ofeonstipation and other tmhealthful cOl1ditiol1S. "111
Medical Science Speaks: Whole grajn
ourdoes whire flour in a hosr of nurrienr
comparisons. For examp[e, whire bread has
vinually no liber; whole grain bre.ad is a
good source. Fiber appcars able ro decrease
risk ofa hosr of diseases ndllding hcarr djsease, cancer, consciparion, appendiciris, and
varicose veins. 148. \49. 150. 15\

Benefits/rom the Allium Family:

Carlie And Onions
EUen White's Woras: "Tbere is great virtue in well-cooked onions. '152
Medjcal Science Speaks: Dr. Ben Lau
in his book, "The Health Benellts of Garlic,"lisrs a nllmber ofbenefirs from rhis food
family. Garlic seems ro help wirh e1evared
blood pressure, high cholesterol, and infcctions callsed by borh bacteria and ycasts.
Onioos oftcn. hdp these condirions as well,
due ro chemical simiJarities in rhese
plants. 153

Dangers OfFat in the Diet

Anorhcr area wbere modern science has
come around ro agree squarely wirh Ellen
Whire is on rhe posirion of dramaricaJly
decreasing far-and specif'icaJly s;ltllrated
far-in aur dier. This is important for borh
hean disease and cancer prevention. In
Whire's day, howcver, no one was ralking
abour "saturated far." Insread rhey used

544

rhe word "grease" ro designare the main cat~

egory of sarurared fars-mose from animal
sourccs. r devore considerable anenrion in
rhis volume ro issues dealiog wirh animal
fars (sec, for example, Chapters 2 and 3).
Some ofWhite's sratements thar arc in harmony wirh chis now well-accepred scicnrific
dicrum follow.

APPENDTXX

Ellen White Condemned High Saturated Fat Foods

1. ".. .prepare fOod properly. This can be
done in a simple, healthfid, and easy manner,
without tiu use of /ard, butter, or flesh
mealS. '~)4

2. "WC do not think fied potatoes are

healthful, fOr there iJ more or less grease or
butter used in preparing them. "155
3. "YtJU should keep grease oU! ofyourfOod.
It defiles any preparation offOod yOIl may
maRe. "

Elim White, Sugar, and Cancer

In addirion ro focLlsing attenrion on
animal produers and sarurared fars, Ellen
White provided orher insiglus thar lHay have
a bearing on cancer prevenrion. For example one sobering linkage involves sugar
and cancer.

'Wzrnings Against Sugar

EJlen Whire's Woros: "From the light
given me, mgar, when fargely lISeei, is more
injuriolts thl1.11 meat. "/56
Medical Science Speaks: A number of
different C<'lncers have now been srarisrically
linked to sugar consumption. The risk of
rhe following cancers appears ro rise when
more sugar is consumed: colon cancer, recrai cancer, breasr cancer, ovarian cancer, uterine c<wcer, prosrare cancer, kidney cancer,
and cancers of rhe nervous sysrem. 157

CofJee is Hurtful
Ellen White's Woros: Coffie is Il Imrtful
indulgenee. It temporarily excites the mind... ,
but tlle afier~ffect is exhaustion, prostmtion,
paralysis of the menta~ mora~ and physical
powers. "158 Tea acu as a stirnI/lant... The action ofcoffie. .. is similar. Fatigue is forgot-

ten, the strength seems to be increased. .. when

tIu influence ofthe stimulam is gone, the UIlnaturalfOrce ablues, and the resuit is a corresponding tiegree ofIdnguor and disability. 159
Medical Scieuce Speaks:
The imernarionally acc1aimed Norwegian research projecr known as rhe
Tromso heart study assessed 143 000
men and women and fOUJld a significam increase in depression in women
who were heavy cofTec uscrs. 160
Caffeine addicriveness has onJy recenti)' been proven ar John Hopkins
Universiry. Researchers at Johns
Hopkins published srarding research
rhar demonsrraccd [hac "caffcine has
ilie cardinal [eatures of a procotypic
drug of abuse."161 Based an irs drug
effeets, caffeine acts much like any
c1assic addietive drug. 1 he implicarion is rhar habitual caffcine uscrs arc
as much drug addicrs, in rhe chemical sense of che ccrm, as cocane addicrs, heroin addicrs, or niCOline addicrs.
She warned ofirs elfecl 011 rhe mind,
which also has only recently been
proven.

Insights on Eating Habits

The Jmportance ofBreakfast
Ellen White's Words: ''The habit ofellt-

ing a paring breakjast flnd a large dinner is

wrong. Make your bretlkfast con'l!spond more
nearfy to the hcartim meal oftiu day. "162
Medical Science Speaks:
Earing breakfasr appears ro be essen-

tiaI for maximum mental and physical efficiency. J6J

Regular breakfasr earers may be able
ro cur (heir risk ofdearh in half. 164. 165
A good breakfast and a lighter (or no)
supper may hclp improve blood sugar
control in diaberics.

545

PROOF POSITlVE

Fewer Meab' and No Snacking

ElIen White's Words: "In most cases two

meals a da} arepreftrable ta three. "16'6 "Three

meals a day and nothing bettveen menls-nol
elim an app1e-should be Ihe utmost limil of
indulgence. "167
Medical Science Speaks:
The more frequemly a person ears,
the greater !lis or her risk ofcolon cancer. 168. 169. 170
The original Alameda Counry Srudy
dara idenrified "no snacking" as a
hea.lth habir associared with longevIty.

Heavy Suppers Stymie Weight Loss

Ellen White's Words: "the lost meal [sup-

P"J is genmllly the most hear!)', and is oficn

takm just befOre retiring. This is rroersing
tiu TUlturt11 ord.er; It hearty meal shouU n~ver
be taken so late in the day. "171
Medical Science Speaks: Leaving off
supper ma)' be one of the besl ways IO deal
wirh excess weighr. One srudy doeumentcd
weighr loss in aII of ncarly 600 parienrs who
ale their lasr mea! no larer [han 3:00 p.m. 172

Benefits ofFasting
Ellen White's Words: "/n many coses of

sickness, the very best remedy is fOr the patient

to fllSt fir a meal 01' ttllO. . .. Many times a
short period of entire abstinence /rom ftod,
fillowed by simple, moderate eating, hllS led
to recovery through nature's oum recuperative
./1;
"173
ejjort....

546

Fresh Air Enhances Mental Clarity

Ellen White's Words: "Jn the comtmction of buiUings. .. care should be taken to
providefOr good l)entilation andplenty ofsunlight. . .. Neglect ofproper ventilation is responsible ftr much... drowsiness and du/lness. "171
Medical Science Speaks: Fresh air is
chemically superior ro re-circu1ared indoor
air. 17S High qualiry fresh air is actually e1ecrrified and gives risc ro a number of benents including:
Improved sense of well being.
Mild tranquilizarion and relaxarion
(decreased anxiery).
Irnproved learning in mammals. 176
177. 178.

17~.

180, 18!. 182

Health Risks ofCity Dwelling

EUen White's Words: The physical surroundings in the cities are ofien a perii to
health. .. the prevalence offlul air fis among}
the mt1ny evils to be met. "183
Medical Science Speaks:
Ozone pollution in urban air causes
cye irrirarion, shormess of brearh,
cough, worsened lung funcdon, and
decreased physical performance. 184 .
185

Women living in highly pollmed regions increase their risk of cancer in

proportion ro rheir rotal exposure ro
particulare pollurrtllts. 186

Exercise is Vital to Health

Medical Science Speaks:

A shon fasr may improve immune
funcrioning.
Resrricring ccrtain essential amino
acids sllch as phenylalanine and ryrosne may play a role in cancer tre-armem.

Ellen White's Words: 'The more we exerse, the better will be the circulation ofthe
blood. More people die fir Wlwt ofexercise
than thl'Ough overjatigtte; very many more nw
out tblln wellr 0111. Those who tUcustom themselves to proper ex"se in the open air IVill
gencrally have Il good and vigorous circulation. "187
.

Ellen Whire also singled.om many omer

facrors besides clier and add.icrve subsrances
thar can have a subsrandal a(fecr on healrh.
The following is a very small sampling. For
addirional exrcnsive commenrary on lifesryle
and hea1rh, you may be inreresrcd in acquiring one or more of rhe books menrioned ar
rhe beginning of this commenrary.

Medical Science Speaks:

Exercise lowers the risk of hean disease. 18g
Exercise lowersrhe risk of cancer.
Exercise benefirs physiology in general.
Regular exercise promotes longevicy.189. 190.. 191

APPENDIXX

Medical Advice 100 Iears Ahead ofHer Time

As we see in me foregoing, sc.iemifie discoveries made long aher her dearh have
proven the validicy of her medical advice.
Her advanced undersrandlug of the principles ofpreventive medicine and rrearment
of disease begs rhe quesrion, "How could
an individual who tived 100 years aga have
wrirren anything on healrh lOpics {har
would be of value roday?" No orher book
on heaJrh rhat was wrtten in her rime has
survived rhe resr of rime. The informalion
rhey conrain has been autmoded by the
rapid advances in medical science in rhe 20 rh
century regarcling rhe causes. rrearmenc, and

prevenrion of disease. She was obviously

100 years ahe...1.d of her rime. Paul Harvey,
in referring (O Ellen Whire in oue of his
nerwork news broaclcasrs, observed rhar
"Modern science continues more and more
ro say, 'She was righr!' "192 Was rhe advanced
information rhar she possessed rescricred ro
health ropics? Did she have advanced informarion ourside of the field of healrh? If
so, has rhe informarion been subsrJJltiated?
Ler us look at twa predicrions she made ar
rhe rime of rhe Civil War dlar are mareers
of record.

Civil \.far Predictions

Monrhs before rhe war began. one srare,
Sourh Carolina, had seceded from rhe
Union. The milirary and governmenr leaders of aur COUntTy, includng President Lincain, saw rhe seccssion as only a minor
rhrear. The renowned edicor of rhe New
York Tribuoe, Horace Greeley, wrore, "A few
old women wirh broom stieks could go
down rhere and beat our aii of rhe rebcllion
rhat there is in Sourh Carolina." hc week
before, he wrote, "lfsomeone wirh rhe firmness of Andrew Jackson should go down
rhere and say, Sourh Carolina, where are you
going? They would reply, back inro rhe
Union again, Sir." [n rhe same week, on
January 12. 1861, M rs. Whire gave a public address in Parkville, Michigan. Contradicrory ro rhe arrieudc of OUT governmenc
leaders and the press, she said ''A large number of scares will join mar srare and rhere
will be a mosr rerrible war." She cominued, "There is nor a person in ch.is house
mar has even dreamed ofrhe tIouble thar is
coming upon rhis !and. People are making
lighr of rhe secession ordinance of Soum
CaroLina. Bur 1 have jusc been shown thar
a large nllmber of srates will join char stare.
In this vision, 1 have seen !arge armies
ofborh sides gat.hered on rhe field ofbattlc.
1 heard the booming of the cannon anei 5..1W

rhe dead and dying 00 every hand. I saw

the field after the barele, ali covered wth
rhe dead and dying. Then 1 was carried to
prisous and saw me su/teriogs of rhose in
want who were wasung away." She coneluded by sayiog, "There are men in this
house who willlose sons in rhar war."
She was sco/ted ar in thc meering. Newspaper reponers rhac were ourside made light
of her speech. The semimem was "Now
we know she is nor a tIue prophec. This is
not gong ro happen." Some rhree months
larer, eleven srarcs had seceded and e1ecred
rhei! Confcderare president. But President
Lincoln called for a paltry 75,000 men for
rhree monrhs ro pur down rhe rebellion, He
felr rhat no more were needed.
The rest is hisrory. The Norch wOllld
have almost cluee mllion men 00 the ficld
ofbarde and rhe Sourh woulel have half rhar
number. The U.S. losr more people in rhar
war rhan aII of our mher wars combined ro
rhis date. Ellen Whirc's warniogs of me
coming war aod me rcrrible slaughrer ro
fo11ow, rhough rhey comradieted the rhinking of our cOllorry's lcaders, were accurate
and well founded. She was obviously getring her informauon from anorher sourec.
1ncidenrally, there were at least 10 men who
attended het leerure that losr sons in [he wa.r.

547

PROOF POSITIVE
The North did nor do well at firsr. Six
momhs into rhc war she was shown what it
wouJd take to bring it ro an end. The Non])
had begun national fast days because they
bdieved thar they were on ilie cause of righr.
They fasted and prayed for success. She
made a predicrion thar rhe ride of the war
wouJd mrn around if the North mer a cerrain condirion. She had wrirren much
aga1nsr the evils of slavery. She wrore on
January 4, 1862, "ls this not the fast rhar 1
have choscn? To Joose the bands of wickedness, ro undo the heavy burdens, and ro
ler ilie oppressed go free, and rhar you break
every yolk? [She quored from lsaiah 58.6J.

When our nation observes the fast which

Cod has choscn, then He will accept their
prayers as far as the war is concerned. Bur
now d1ey enter not ioto His ear." She was
predicring dut if the Nonh freed the slaves,
the ride of the war would turn.
On January 1, 1863, aJmose one year ro
the day larer, President Lincoln issued the
Emanciparion"Proc1amation which freed the
slaves. At rhar pOnr, the war turned complerely aroLlnd jusr as her words predicted.
Governor Sr. John of Kansas said in a public address, "Mter Lincoln isslled his famous
Emancipation Proc1amaeion, we had swung
round on God's side, and could not Iose."

Predicting the Healing Ofthe Rift ofthe

Protestant RefOrmation
History tells us that the Protestam Reformation eaused ehe Roman Church ro suffer a sharp decline in ies influence and presence in many cOLlotries of the world. Ar
rhe same rime, Protestanrs, in breaking away
from rhe Catholic Church, enjoyed a surge
in world accepranee and influence. Norwithstanding chis religious c1imate, Ellen
Whire in 1888 predicred that "The Prorcstants of the United Staees ... wiU reach over
the abyss to clasp hands wirh the Roman
powcr ... Papists [and] Pwrestan.ls ... will see
in chis union a grand movement for the
conversion of (he world and the ushering
in ohhe long-expectcd miUenium."193
Abolit 30 years aga, when the ecumenical movement was in iu infancy, a degree of cooperation berween Catholics and
Procestam leaders began ro be seen. On
Marcb 30, 1994 (100 years afrer her predic(ion and just 6 years before the
milleniwn), leading newspapers across the

548

U .S. posted headlines, "Catholics,

Evangelicals Huddle-Statement CaIls for
Aceeptance."194 Another headline was
"Christians Herald New Era-U .S.
Evangelicals, Conservative Catholics End
Discord, Urge Shared Vision."19S
A toral of391eading evangclicaJ Pro(estanrs and Roman Catholics signed a "historic declaration," a 25 page document urging (he nae10n's 52 million CathoJics and
13 miU ion evange1ica.ls ro ccase holding each
oeher at ann's lengrh, and instead work together in recognition of a common fairh.
Two major goals of the accord were sraredworld evangelism and common concerns for
society. The signers of rhis declaration are
the mosr visible and inf1uential in their respective organizations roday, such as Pat
Roberrson of rhe Chriseian Coalition,
Charles Coison, Cardinal John O'Conner
of New York, and the director ofthe Sourhern Baptisr's Home Mission Board.

APPENDIXX

Predictions ofthe Enduring Value ofHer Writings

Another predicrion rhar she made was
relarcd ro rhe torward reach ofher own wri rings. In ) 907, eighr years before her death,
she made a remarkable forecast. "Wherher
ar nor my life is spared, my wrirings will
consranrly speak, and rheir work will go
forward as long as time shalllast."I96 SOlUe
90 years later we see rhar her wrirings have
conrinued (O be reprinted in English and
rranslared and published inco language afrer language (O meer rhe demand.
This facr is evidenee rhar her writings
are relevanc in aur rime. She srressed rhe
imponanee of pre-naral ini1uences an rhe
health and mental developmenr of a ehild
ar a rime when medical science was wrally
unaware of such inf1uences. She warned
thar birrh defecrs eould resulr from rhe ex-

peeranr morher drinking alcohol. She wrore

on rhe relarionship berween ilie healrh of
rhe mind and body. She poinred our rhe
value of very early rraining of children in
rhe family serring, and deseribed rhe disrinel rales of rhe morher and father. Many
of chese coneeprs were new and differenr
from rhe convenrional wisdom of her day,
and have sinee proven ro be accura.re.
Whar was rhe excenc ofher formal education and rraining? Her biography reveals
rhac she was nor a medieally rrained person. Surprisingly, her formal educarion was
lil11ired ro ilie rhird grade. Whar eould have
been rhe souree of her informarion? How
did she acquire such insight? Ler us probe
ehe answers to rhese quesrioJls.

Source OfInfonnation Higher Than

Human Knowledge
Ir is obvious tlur her souree of informarion was higher tban human knowledgea higher power. le is rhe mosr plausible explanarion of her advanced knowledge.
What or who could this higher power be?

Could ir be psyclue phenomena? Hardly,

since her wrirings sound dear warnings of
the dangers aud deceptions of che psychic
world, rhe spirirs of the dead, and hypnot1sm.

Prophets Receive Higher Knowledge

From Power On High
Is it possible rhar she reeeived rhe informarion directly from ilie God of Ihe Universe? We are reminded rhar Gad, in rimes
pasr, has revealed information direerly ro
selected individuals ro be passed on for rhe
benefic of rhe human race. The person who
received the informarion is referred ro in rhe
Seripeures as a propher. The deseriprion of
a propher, rhen, is a messenger who receives
messages from God for the purpose of giving rhem ro mankind. The Bible is a eollecrion of wrirings of God's prophers rhar
were produeed rluoughouc che ages of rhe
histary of man up ta rhe year 100 A.D. Ir

clearly srares rhar rhe messages of che prophers eame from Gad. "Ali Scripeure is given
by inspirarion of Cod ... " (2Timorhy 3: 16).
Also, "Prophecy carne nor in old rime by
rhe will of man: bur holy men ofGod spake
as rhey were moved by rhe Holy Ghosr." (2
Perer 1:21).
Thus, Bible prophers are regarded as
spokesmen for Gad. The wrirings of rhe
prophecs of rhe Bible conrain much informarion rhar could nor ocherwise be known
by man. Thus, a srrucwral parallel exiscs
berween che wrirings of rhe prophers of
Scriprure and rhe wrirings of Ellen Whire.

549

PROOF POSITIVE
Her writings cOllrained information nor
known by the scientists and psychologists
of rhat era. This fact alone does nO[ establish that her information came from God,

bur is one piece of evidence that poims in

rhat direCTion. We shall sec {har mere s
more evidence in rhe same direction.

The Pattern ofBible Prophets

15 there a pattern of God's true prophets
of the Bible outlined in the Bible itself? lf
50, does EUen White fit the pattern? Is there
Scriptural information abour the prophets
of God thar might reveal other similarities
or dissimilarities berween Bible prophets

and Ellen Whire? 1know of no other somee

of reliable descriprions of God's prophets
than the Holy Word itself. rf we want ro
probe this mystery we must search the Scriptures.

Beware OfFalse Prophets-Test the Prophets

h is important ro note thac che Scriptures conrain many warnings against false
prophets. They also provide informat ion
for derecting a false prophet, and admonish us ro search for evidence. One of the
warnings is "For there shall ari se false
Chrisrs. and false prophets, and shaU shew
great signs and wonders ... " (Matthew
24:24).The Bible admonishes us ro make a
search for evidence to prove ar disprove the
validiry of a propher. The counsel is, "Be-

loved, believe nor every spirit, but rry the

spirirs wherher they are of God, because
many false prophers are gone our inro the
world." (1 Joha 4: 1-3). The warning is distincL We are ro put supposed prophets ro
the rest to derermine rheir validiry. If we
accept rhe advice in the Holy Word and
begin the search for evidence, we shollld be
able to answer rhe question as ro whether
Ellen White qllalifies as a prophet.

Prophets Make No False Statements

How do we derect a false prophet?
Deureronomy oudines a simple tese. "And
the Lord said unta me ... iftholl sa)' in (hine
hean, How shall we know the word which
the Lord hath not spoken? When a propher
speaketh in the name of the Lord, if the
thing foUow not, nor carne tO pass, that is
the rhing which the Lord ham not spoken,
but the propher harh spoken it presumptuously: thou shalr not be afraid of him."
(Deuteronomy 18: 17, 21, 22). Jeremi:m
also advises rhar " ... when the word of rhe
prophet shall corne ta pass, men shall the
prophet be known, that the LORD hath

550

(ruIy sem him." Oeremiah 28:9).

We are not to have an)' respect for a person who c1aims ro be a prophet if his statemenrs are shown to be false. We have seen
the evidenee of [he accurac)' and advanced
knowledge ofElIe!) White in [he wide scape
of subjects upon which she has wri{[en. 1,
personally, have nor fOllnd anyrhing in her
writings that has proven ro be wrong.
Thus far we have seen mat her writings
(1) colltain informarion rhar could not orhcrwise "be known ro man, and (2) have
proven ro be true. Th se 3ttributes are characteristic of Bible prophers.

APPENDIXX

Mode ofReceiving Prophetic Messages

A rhird cr;cerion for dereccing a false
propher is the mode of communication by
which the prophet receives messages from
Gad. "If chere is a propher among you, I
che Lord will make Myselfknown umo him
n a vison, and will speak unto him in a
dre.-ul1."197 Consulcing wieh "familiar spirits" such as a spirit OlediuOl, crysca! ball, ar
palm reader is rorbidden in rhe Holy
Word. 198
John the Revelator repeatedly wroce in
the Book of Revelarion, "1 saw... " and "1
looked, and 10..." His wrjrings were descriptions of chings rhac he saw in visions. The
Bible speaks of twO kinds of visiollS: "open
visions" and "nighc visions." In open visions, rhe individual could be seen while in
vsion. The aposrle Paul describes !lis well
known experience of receiving an open vision while on the road ro Damascus; he was
accompanied by severa! companions. He
sawa lighc and heard a voic.e. His companions did nor see rhe vision. '99 Daniel, in
receiving a night vision, wrore, "There remained no srrengch in Ole, neither is there
breach (efe in me." (Daniel 10:17). However, shortly afrerward, when he heard a
voice speakng ro him, he said, "} was
srrengrhened... " (Daniel 1O: 19).
Did Ellen Whice receive visions? She
used the phrase "1 have been shown ..."; "}
saw duc... "; and "It has been shown co me
chat...' These expressions indicate rhat she
had visons. Ellen Whicc was observed ro
have opm visions in public meecing halls,
in homes, and even while riding in a carrage. These visions were wirnessed by so
many in a large number o()oGuions over a

60 year span chac chey have been well documemed and have received much publicity.
Her demeanor during the visions has
been described in writing by many observers ar di!ferent cimes. John Loughborough,
a friend of Ellen and James White (her husband), wroce chac he had seen her in vision
an approximarely 50 differenr occasions
over a S8-year period. He describes a typical scene. She would experence a complece
loss of srrengch for abour a half minuce.
"When fairly in the vision, rhe accion ofrhe
hearr and pulse was natural, but rhe dosesc
tests by medical mell failed ro discover a
partide ofbreath in her body. The color of
che countenance was natural, and rhe eyes
were open, always looking upward, not wich
a vacanr stare, .. .1ike rhat of onc looking
ineenrly ar some objecr in the disrance. Afrer a momene of weakness, a superhuman
power carne upon her."200 Her lack of
brearh was dececred by holding a candle
flame dose ro her mourh and nose. The
brearh cest and ocher observations had been
made by various medical professionals ar
various times, but always wirh rhe same resuit. Those who were presene did nor see
the vision.
We see chat rhe mode of receiving illformarion thar she later reveaJed in wririog is
similar ro rhe experiences of the prophecs
of old. She acknowledged rhac ilie informarion carne from a source oucside herself.
Referring to chis higher-chan-human knowledge, she wroce in 1901, "The whys and
wherefores of this 1 know noc, but} give
you the insrrucrion as ic is given me."201

True Prophets are in Agreement

A fourch criterion for derecring a false
prophec is agreemenr with ocher prophecs.
A principle srared in ilie Old Testament is,
"If chey speak noc according ro chis word, it
is because chere is 00 Iighr in rhem." (Isai ah
8:20). The New Tescamenc simiJarly stares,

"And the spirits or ule prophers are subject

ro ilie prophers. For Gad js nor [he author
of collfusion, bur of peace, as in ali churches
of [he sainrs." (1 Corinchialls 14:32,
33).'] hus. [here will be complete agreemenr
from ooe rrue prophet ro anorher. There is

551

PROOF POSITlVE
ro be no confusion in comparing the mcssage ofone prophet wich thac ofanother. lf
the words of a propher are nor in agreemenc
wirh rhe Scriprures, the propher is false.
1 personally have found that Eilen
White's writings are in agreemenr wich the
Scriprures regarding the advice on health
and olher topics. There are millions ofher
readers chat would auest to that face. She
continually admonished her readers co
search the Scriptures for rhemselves; her

wrirings are full of quotations from Scripture. She made it c1ear that the purpose of
her writings "is not ro belirde the Word of
God, but to exalt it and artract minds tO it,
that the beautiful simpliciry of truth may
impress all."202 Unlike some others who
have c1aimed ro be prophets, she had no fcar
of seudents of rhe Bible scrutinizing her
writings because she was confident that they
would find no disagreement between the
two.

A Prophet 1800 lears after the Bible?

Some may be under the impression that
che final prophet of God was the apostle
John, who wrote che last book of the Bible.
The Scriptures do nor suppon the presupposition that there wiU be no more prophers aher John. The abiliry [O prophesy is a
gifr according to Ephesians 4.8. "Wherefore He... gave gifts uma men." Whac were
these gifts? "And He gave some, apostles;
and some, prophets; and SOUle, evangelisls;
and some, pasrors and reachers." (verse Il).
For whal purpose? "For the perfecting of
the sainrs, for the work of t!le ministry, for
the edifying of the body of Christ." (verse
12). For how long? "Till we aH come in
the uniry of the faith and of ilie knowledge
of rhe Son ofGod, UIltO a perfect ma.n, unto
the measure of the stature of the fulness of
Christ." (verse 1.3).
These passages establish several important poiors abollt prophets. The first is rhar
the ability co prophesy is a gift among severai omer gifrs given by God co cenain individuals ofHis choosing. That is, not everyone can be a propher, bur only rhose who
have rcceived the gift of prophecy. It also
confirms ehar a propher is noe appoinred

552

by any human being ar eieceed by any coostiruency of humank.ind, but is chosen direcrly by God Himself. The third point is
rhac the reasons for each of these gifts are
clearly srated ro be for the benefit of humaniry. The fourth poinc is that ali of the
purposes for prophecy and rhe oeher gifrs
have not been fulfilled, since Christians have
not "aH come in rhe unity of rhe fa.ieh."
Thus, according to Scripeure, ilie need for
a prophet exists ar ehis time for rhe sanle
reason rhat ehe gifts of evangelisrs, pascors,
and reachers are needed.
Does EHen White meet rhe criteria
stated in these verses of Scripture? We see
thar she had a gift thar no one e1se in her
time had, which enabJed her ro convey information from a higher-than-human
somce, as was true of Bible prophets. She
was not appoinced Of e1ected, but chosen
by rhar higher power. Her writings reveaJ
that she did not volunteer, but was chosen,
as was true ofaH of the Bible prophets. Her
writings have been and stiH are providing
benefit ro humaniry, also rrue of Bible
prophets.

APPENDIXX

Come Behind in No Gift in the End Time

Norice anorher rext of Scripture sraring
rhar we are tO Iack none of rhe gifts in mese
lasr days. "50 rhar ye come behind in no
gih; waiting for rhe coming of aur Lord
Jesus Chrisr: Who shall .usa confirm you ro
rhe end, rhar ye may be blameless in rhe
day of aur Lord Jesus Chrisr." (I
Corinrhians 1:7-8).
The Bible predicts in this and many
mher places rhat Jeslls will come back (Q
this earth.
His followers fhar are living ar rhe rime
of"rhe end" are ro "carne bdlind in no gi fr. "
We are ali aware thar rhe orher gifrs menrioned in Ephesians (pasrors, reachers, erc.)
srill exisr in rhe Chrisrian church in aur
rime. Is ir reasonable rhar rhe gift of prophecy miglH also be expecred ro exisr?
The Old Testament also predicrs rhar

rhere will be prophets ar the end rime. Tile

prophet Joel wrore about rhe fmure rime
when "The great and rerrible day of the
Lord" comes. "1 am the Lord your
Gad ... And ir shall corne ro pass a[rerward,
that 1shaH pom out my Spirit upon all flesh;
and your sons and your daughrers shaH
prophesy, your old men shall dream dreams,
yom young men shall see visions ... before
rhe greae and reHibIe day of the Lord come."
Uoel 2:27, 28,31).
We see tllat the gift of prophecy shall be
given rhroughollt rhe hisrory of mao umil
rhe eod of rime. We see rhat idelHifying
Ellen Whire as a propher is in keeping with
rhe concepr of a modern prophet. The
"dreams" and "visions" refer ro rhe merhods God has used ro communicare messages
ro His prophcts, as we have previollsly seen.

A UIOman Prophet?
Since ali of the propheric writers of rhe
Bible were men, does a woman prophet
deparr from rhe pattern of Bible prophets?
Female prophers, called prophetesses, are
menrioned in a number of places in rhe
Holy Wrie, such as:
"Miriam rhe prophcrcss, ehe sisrer of
Aaron" (Exodus 15.20)
"Deborah, a prophetess, ilie wife of
L1.pidorh" (Judges 4:4)
"Huldah the propheress, rhe wife of

ShaJlum" (2Kings 22: 14)

"rhe prophetess, Noadiah" (Nehemiah 6:14)
"Anna, a peophetess, rhe daughrer of
Phanllel" (LlIke 2:36)
We see rhar (here were prophetesses in
both the Old and New Tesramenrs. Ellen
White as a female prophee is in keeping wiili
the scriptural pattern.

Inspired Books That Are Not Part ofthe Bible?

Some may believe ehar (he Books of [he
Bible are the only writings that God has ever
inspired, and any wrirings rhar are not inc1uded in rhe Bible c.annoe be inspired. The
Holy Wrir mentions books written by rhree
prophers, none ofwhich are included in {he
Bible. "Now rhe acts of David rhe King,
fLrst aud lase, behold, they are written in the
book of Samuel the secr, and in (he book
ofNaehan rhe propher, and in the book of
Gad (he seer .. ." (1 Chronides 29:29).

A book by Jehu is referred ro. "Now the

rest of ehe acrs ofJehosaphat, fmr and Last.
behold, rhey are written in (he book of
Jehu ... " (2 Chronicles 20.34). Jehu is declared ro be a propher: "by rhe hand of the
propherJehu ... " (1 Kings 16:7).
Thus, Nathan and Jehu are c1early stared
ro be prophers, and each wrOte a book, bur
rheit books were never included in rhe Bible.
Again, EUen Whire's wrirings. altllOugh nor
paft of rhe Bible, fie a scriptural pattern.

553

PROOF POSITIVE

Did She Claim to Be a Prophet?

In rhe spirit ofhumility, BibJe prophers
did nor personalIy acclaim the title of
"propher," evcn though theyacknowledged
rhat their messages were givcn ro them by
God. Did Ellen Whire daim ilie tide of
propher? No, she never referred to herself
as a prophet. She wrotc, "Early in my yomh
1 was asked several times, 'Are you a
prophet'? 1 have evcr responded, 1 am me

Lord's messenger. 1 know rbat many have

caUed me a prophet, but 1 have made no
c1aim ta this title. My Savior dcclared me
ta be His messenger."203 Her attitudc roward rhe ride is in keeping with the prophets of the Bible.
They did refer ro each othcr as prophers. Ellen Whire also referred ro rhe Bible
wrirers as prophets.

Summary Ofthe Pattern ofBible Prophets

We see that Ellen Wllite firs rhe pattern
of Bible prophets in each of 9 categories:
1. Her writings, like rhose of Bible
prophers, conrain informarion that
could not otherwise be known ro
man.
2. Her predictions have corne true in a
rernarkable rnanner, which is consisrent with mose of Bible prophets.
3. She received her infonnation in visions and dreams, consisrenr with the
panern of Bible prophers.
4. Her wrrings uphold rlIe writings of
Bible prophets and are in agreernenr
wirh them. Bible prophers are in
agreement with each orher.
5. She was nor voted by any consrituency ro be a spokesman for God, but
was chosen direcrly by God. This is
true of the Bible prophers.
6. Her writings have been a benehr ro
mankind, consistent with the writings
of Bible prophets.
7. Her writings fit the Bible predicrion
of a living propher at a later rime in
world hisrory.

554

8. As a female, she fits the pattern of

fernale prophets set in rhe Bible.
9. Her writings are not paft ofrhe Bible,
which is consistent with soroe prophers in (he Bible.
Neirher Ellen White nor any Bible
prophet daimed ta be a prophet.
What do we conclude from aiI of [his?
The evidence indicates mat Ellen White's
wrirings are inspired by rhe God of the
Universe. What other plausible explanation
could there be? 1 know of none. 1 invite
each reader ro decide.
Wharever the decision, wiU it affCct che
benefit we receive from the wrirings? 1thin.k
not. They speak for themselves. As 1 h;we
indicated, chey have been a help ro me in
my medical work apan from any consideration as to wherher they are inspired by (he
God ofHeaven. Paul Harvey asserts, "Since
she has been right abolit so many things,
perhaps we should examine what else she
said." 204

APPENDIXX

How Extensive Is the Influence OfEllen White?

$he was a woman of remarkabJe spiritual gifts who livcd most of her life during
the nineteenth cel)(ury (1827-1915), yet,
throughoue ehe rwenriech cencury, her writings continue ta have a revolurionary impact an millions ofpeople around the world.
A large number consider her tO have had
the prophetie gifr.
During her liferime she wrore more rhan
5,000 periodieal arricles and 49 books with
25 million words; but raday, including compilations from her manuscriprs, more than
100 ticles are available in English. 5he is
rhe most translated woman writer in the
emire history of literarure and rhe mose
translated American author of either gender. 20S Her wric.ings cover a broad range of
subjecrs, including hisrory, religion, educa-

rion, healeh, work eehics, social rdationsbips, marriage and family relaeionships,
evangelism, moral issues, prophecy, publisning, and management.

N a young girl Ellen White suffered serious health problems that threatened her
life, yet she lived a full Jife eo age 87. 5he
rraveled widely in [he Unieed 5eares, Europe,
Australia, and New Zealand. Her varied
roles included speaking before audiences as
large as 20,000. Her insighrs inro healthful
living continue tO be remarkably accurate
concepts rhac are widely accepecd today by
the scientific and medical communicy. She
also helped ro esrablish a sysrem of hospitais, schools, and publishing houses rhar
circles the globe.

Scope Ofa Few ofHer Books

Her life-changing masterpiece on successful Christian living, 5reps ro Chrisr, has
been published in nearly 150 languages,
with well over 100 milJion copies in circulation. Chrisrians and non-Christians alike
find valuable counsel in rhis book. Her
crowning lirerary achievemenr is ene fivevolwne "Conflict of rhe Ages" series, which
traces the hisrory of the conflict between
good and evil rrom irs origin ro irs dramatic,
soon-ro-unfold conclusion. Four books ebat
she has wrirren on rhe subject ofhealeb have
previously been menrioned.
A very exci(ng and moving book ehar
has personally given me a deeper undersranding of [he life of Christ is rhe book,
Desire ofAges. The reader will gain insight
as ro the morivations of Jesus as He wenr
through some of the experiences recorded
in ehe gospels. Many practical Ies..~ons for
living a more abundant life are drawn from
His experiences and teachings. The book
begins before rhe concept ion of Christ and
concinues through His dearh, wnen He said
It is finished," and ends aher His resurrecrion and ascension.
Christ's Obiect
Lessom draws lessons
,

from ehe parables ofChrisr. Parriarchs and

Prophers is a hisroric book that deals with
the Sacred Record ofGod's people from the
time of the creation of rhe world through
rhe (ime ofKing David. It draws spiritual
lessons rrom the exodus experience and
mauy orher hiseoric experiences ofrsraeJ.
Educarion is a book rhat rescs an the
premise rhat true education embodies [he
developmenr of ali four aspecrs of our being: mental, physical, social, and spiritual.
le presenrs ehe concepr ehat learning is a lifelong experience. Each evenr in our lives
holds a lesson that, righrly interpreted, will
gttide LIS inca rhe more abundant life ehar
Gad inrended for us. The book recites specific experiences in the lives of Bible characters and poinrs our the lessons that were
inrended for those having rhe experience as
well as for aur benefic. The Great Controvers}' draws lessons from the history of man
aud his rdationship ro God rrom the rime
of rhe destruction of Jerusalem in 70 A.D.
umil the presenr cme. The conrroversy
berween truc and false worship is traced
through the hiseory of ebe dark ages and ehe
succession of rhe greae reformers up to the

555

PROOF POSITlVE
presenr. The progressive sreps through the
strife alld spiritual vicrories of the Reformation period are clearly ouclined. It culminares with Bible predicrions of lasr day
evenrs rhat lcad up ro the second coming of
rhe Savior.
Each of rhese books has stood rhe rest
of rime and alt are available roday. For rhe
convenience of rhose who may be inreresred
in probing her wrirings, a list of each ritle
folJows, wirh rhe name of rhe publisher.

Pacific Press
Ministry ofHeltLing
MedicaL Ministry
Patriarchs (md Prophets
Education
Great Controversy
Desire ofAges

RefermcesCaJdwdl C. How Trouble Came tO Marlboro Counrr)'. Wall StTW lourtllll.

Marell,12 1996. QUOlC from lAMA 1950's.
! WhilC EG. 71" Minimy ofHtoling. Namp. ID: Pacifi I'ress Publishing 1\ssociation. 1905 p. 327-328.

Henningfield JE, Cohcn C. Pickwonh WB. I'sychopbarmacology of ncotne.

In: Orleans CT, Slade J. l'<!ilOrs. NicUlillt AtiJielioll: Pril/riplt> al/d M'lnagtmtllt.
New York: Oxford Universily I'r('SS. 1993 p. 27-28.

j White EG. Tobacco. In: Ttn/pera'la. Nampa.lD: Pacific l'ress PublishingAssoCi.1lion, 1949 p. 58.

~ US Oepanmenl ofHcaJrh ;U1d Human Serviccs. Tht hMllb cOI/JtqutllrtS ofmlolt

ing: 25ytal"!ofpTOf,ffli. A T'tfOTtOfthtSllrgeon Gmtml, 1989. Rockville. MO: US

Depanmcm of Hnllh and Hum.n Services. Public Heahh Service. Cemers for
Diseasc ConlTol. Cenlcr lor Hdlh Promolion alld Edueation. Ofl:iee on Smolcing
md Heal[h. OHHS l'ublietrion no.(CO ) 89-8411.

Hennillg/idd JE, Cohen C, Picbvonh WB. I'sychoplunuacology of ncocinc.

In: Orlean cr, Slade J. edilOrs. /'v/colint Addiction: Princip~ and Manag'llll1l1.
New York: Oxford Univcrsiry I'ress. 1993 p. 24-45.
Henninglidd JE. Cohen C. Pickworth W'B. Ps)'choplurmacology of n;corine.
In: Orlnn CT, Slade J. ediror.. Nicotint Addierioll: I'Tinci;lfr alld Managmtfllr.
New York: Oxford Universiry I'rc"', 1993 p. 30-31.

Pacific Press Publishing Assodatjon

1350 Nonh Kings Road
Nampa, Idaho 83651
Tel: (208) 465-2500
Fax; (208) 465-2531
Review and Herald Publishing
Association
55 West Oak Ridge Drive
Hagersrown, Maryland 21740
Tel: (301) 791-7000
Fax: (30I) 791-7012

Conclusion
The purpose of rhis profile of Ellen
White is ro make you aware of rhe scope,
usefuLless, beaury, and spiritualiry of her
wrirings. You will frnd rhar they are uplifiing, and wiU lead you ro a higher plane of
personal life in four dimensions-physic.11,
mental, spiritual, and social. This is the
mote abundanr life (hat Chrisr referred ro:
"The rhief comerh nor, but for ro sreal, and
ro kill, and ro destroy: 1 am come rhat they
might have life, and rhat rhey mighr have ie
more abundanrly." Oohn 10; 1O).

Review and HeraJd

Counse/s on HeaLth
Counse!s on Diet and Foods
Steps to Christ
Christ's Object Lmons

The addresses of the publishing

companies are:

, Epps RI~ Manley MW Clinical lnrervcmions 10 Prevcm Tobacco Use by children and adolescents. In: Glynn TJ. Manley MW. HOUlto Htlp }'orIT PatimI'J SIOp
SI1wking: A Nillional Cal/CtT IlIslittm MI11U1alfoT PbyririallJ. Nalional JnsrirU[e.~ of
Hcallh 1\lblicalion Nurnlxr 92-3064. Rcvised Nov. 1991 p.63.
Hcnningllcld JE, Cohen C. Pickworth WB. Psychopharmacology of nic.otine.
In: Orleans CT, Slade J. edilOrs. Niculille AIldiction: Prii/tipIc; allrl MtllJlIgmltlll.
New York: O"Joed Uni"crsil)' Press. 19'>3 p. 30-3\.

10

Il

Whitc EG. Accivaling I'rinciples of a Changcd Lifc. In: Tlm/"rallcc. Nampa.

ro: Pacific Ple s PublishingAssocialion, 1949 p. 104-105.

McGinnis JM. Foegc WH. Actual e.lIUCS of de:uh in the United Sralcs. lAMA
1993 Nov I0;270( 18):2207-2212. Fig/lTf /ltL/prrd ani IIdjtl$ud/rom fiiII ,miclt.

11

Il US Departmelll of Hcahh and Human Serviccs. TII( beaM coIIJeq"tllw of

smohng: 25 JUli"! ~rprog"fS. A TlpaTI uflbt S/lTf((O'1 GmfTiJI, 1989. Rockvi/lc, MO:
US Oeparrmelll of HeaJrh and Human Scrviees, Public Hl'allh Service, CCllIers for
Di. case Control, CClller for Heal[h Prornot;on :wd Education, Office on Smoking
.nd HeaJlh. OHHS Publication no.(CDC) 89-8411.
It Murr.ay CJL, Lopcz A, edilOrs. S/lmmary: Thf Global BIITdrll ofDisfllSf. The
World HC'.uth Organualion. BoslOn: Harv.lrd School of Public Ht"Jlth Publishing. 1996 p. 28.

, ~'hile Ee. Tobacco. In: Ttmpera'lct. Nampa.IO: Pacific l'ras PublishingAssocialion, 1949 p. 58.

556

U.S. Prevenli"e Scrvices Task Forec. Counscling [O Prevel1l Tobacco Usc. In:
Gllitlt 10 Clinical Prtvt1liiVf Savim-? tiition. Bahimore. /viD: Wi/li:uns and
Wilkins, 1996 p' 597-609. (aII bmlip, lilltT. andeolonJ
Il

16 Newcomb PA. Carbone PP. Thc hcalrh consequcnces ofsmoking. Cancer. Med
Cii" Nortb A/111992 M,,;76(2):305-331.

APPENDIXX
li Gio\'annucci E. Rimm EB. cr al. A prospl'<:tive "lUd} of cigawle smoking and
risk of eOIOf1?Clal ad"llollla and colorecul cancer in U.S. mCI!. J Natl CltIlar but
19?4 Fcb 2;86(3):183-191.

Gim"\l1Il11cci E, Coldjtz GA, el al. Aprospoctive ml(ly ofcigarclte smokilJg ~nd

risk ofco!orecl1J adenoma and coloreelal anccr in U.S. women. JNilt! Gmur Imi
1994 Feb 2;86(3):192-199.
18

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alllp~.

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.2 Gymclbcrg E Lauridsen L. et al. Smokillg and ri,k of myocardia! nE..n::linn in

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Nalional Cancer Instimre. SmolngaiJdTobacco Comrol MOllogmph /. Smurgirs

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\7

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)<;

J7 While EG. Prl<:r j COllliul to

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)8

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t-!agerslOwn. MD:

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6fJ

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(,2

Aslr.lnd, Per-O!af, Murilion Today 1968;3(2):')11.

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APPENDIXX
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10')

Fcnncrry MB. HcLicobaclcr pylori Archivts offII/muti Mtdicillt. 1994 April

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181 Giannini AJ. Jones B'l: Loiselle RH. ReversibiHty of seroronin irritation syn
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Griflllhs RR. Bigelow GE. liebson L'\.. Human Coflt'" Drinking: Rcinforcing
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II'; BeUoc NB. Rd:uionship of heaJth pra liccs ~nd morraliry. PreIJ Mtd 1973
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183 Whire EG. Choice and Prepararion of rhe Home. In: Tii, MiT/islry ofHlolillg.
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104

Paul Harvey News, March. 1969.

Ellen G. Whire Estare Branch Ofllee. Andrews Universiry. Berrien Spring .

Michigan 49 J04. htlp://w"w.cgwestale.andrews.eduJabour.cgw.htmJ

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How to Reliably Combat Disease

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