Fall 2005 issue of Dr. Michael Greger's quarterly newsletter
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CONTENTS (online at http://www.DrGreger.org/newsletters.html )
I. Latest Updates in Human Nutrition
A, Ornish Takes on Cancer
B. Peppermint Oil for Irritable Bowel Syndrome
C. Atkins Diet: Dead Meat
D. Arteries--Open Sesame!
E. Childhood Brain Tumors and Maternal Diet
II. Personal Update
III. Mad Cow Update:
FDA gutless, brainless; our food and cosmetic supply should be so lucky
IV. Bird Flu Update:
On a Wing and a Prayer
V. Mailbag: ""What sources do you use to write the newsletter?"
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I. LATEST UPDATES IN HUMAN NUTRITION
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A. Ornish Takes on Cancer
Until Dean Ornish published his landmark study in 1990, most cardiologists saw heart disease as an inexorable part of old age and treated it largely palliatively, going to great lengths--even open heart surgery--to alleviate the pain and disability. What Dr. Ornish showed was that heart disease could be not only slowed down, but actually reversed with a plant-based diet and other lifestyle changes.[1] People learned they could quite literally take their life in their own hands and cure themselves of a debilitating life-threatening disease once thought incurable. The broader implication, of course, was that a plant-based diet could potentially prevent heart disease in the first place.
Largely ignoring the evidence Ornish presented, physicians of today, however, continue to talk of merely decreasing the risk of heart disease. As Dr. William Roberts, editor of the American Journal of Cardiology, points out "Pediatricians do not focus on decreasing the risk of mumps, measles, pertussis, or rheumatic fever. They focus on preventing these illnesses entirely. The same concept needs to be applied to atherosclerotic events."[2] Having demonstrated we could prevent and cure our number one killer without drugs and surgery, Ornish has now decided to take on killer number two, cancer.
Ornish knew that many plant foods--certain vegetables, tomato products, and soy--seem to reduce one's risk of prostate cancer and many animal foods--namely milk, cheese, eggs, fish[3] and other meat--have been shown to increase one's risk of dying from prostate cancer.[4] So Ornish wondered what would happen if he took patients who already had cancer and fed them a strictly plant-based diet--"predominantly fruits, vegetables, whole grains, legumes and soy products." As prostate cancer is the number one cancer among men, the Department of Defense provided funding for the study.
Ornish found 93 men with early biopsy-proven prostate cancer who volunteered to forgo radiation, chemo and surgery. He then randomized the cancer patients into lifestyle modification group, which included a strictly plant-based diet along with other healthy behaviors such as walking 30 minutes six days a week, or a control group which just watched and waited. A year later the results were tallied and published in the September 2005 issue of the Journal of Urology, the official journal of the American Urological Association.
By the end of the year-long study, six of the control group patients had dropped out because their tumors were growing. MRI's or diagnostic tests of cancer activity showed that their tumors were growing at such a rate that they decided they could wait no longer and opted for a combination of radical surgery, chemotherapy or radiation. Not one of the vegan diet group suffered the same fate. In fact, while on average cancer activity increased in the control group, as measured by PSA tests, the cancer markers DECREASED in the lifestyle modification group. By the end of the year the cancer growth rate, as measured by these tests, was highly significantly different between the two groups. For those on the plant-based diet, the cancer markers were going down.[5]
These results are nothing short of revolutionary. "This is the first randomized trial showing that the progression of prostate cancer can be stopped or perhaps even reversed by changing diet and lifestyle alone," Ornish told the Washington Post.[6] Cancer takes years--sometimes even decades--to grow. The fact that one might be able to make a difference this late in the game is astounding. If you smoke and get lung cancer, even if you choose to then finally stop smoking, it is very often too little, far too late. The cancer is already there and chances are it will still kill you. How could dietary changes have such a dramatic effect in people already diagnosed with cancer? Maybe a vegan diet boosts the cancer-fighting arm of your immune system? Ornish and his fellow researchers were intent on finding out.
The researchers took flasks of human cancer cells and incubated them with the blood taken from the cancer patients at the year's end. The blood serum taken from those that did nothing but watch and wait for a year only weakly inhibited the cancer cells, reducing their growth by only 9%. But the serum taken from those who spent the past year on the plant-based diet inhibited cancer growth 70%, almost an 8-fold difference! And Ornish found that the closer the patients stuck to the program, the better their results were--the more their own cancer seemed to be dwindling and the better their own blood was at killing cancer cells in the lab.
Dr. Ornish may have been naive to think that the cardiology profession would embrace his earlier work demonstrating as essentially unnecessary the majority of procedures by which cardiac surgeons derived their income. He was prepared, however, for the backlash from urologists, who's bread and butter include radical prostatectomies and brachytherapy (the implantion of radioactive pellets in through the rectum). One urologist attached a note to Ornish's paper trying to downplay the fact that the diet group's blood serum was so much more efficient in killing cancer cells. "Experimental serum seemed to contain something that differentially inhibited cell line growth but so what?" the urologist wrote. "Just because these serums were different does not mean that there were good. They might have also killed normal cells."
This shows how mired some physicians remain in the slash and burn mentality that too often typifies allopathic medicine. Ornish responded "Although it is true that chemotherapy and radiation may kill normal as well cancerous cells, we are not aware of any evidence that fruits vegetables, whole grains, legumes and soy products kill normal cells." He then of course goes on to cite all the evidence that in fact the reverse is more likely the case, as many of the phytonutrients in whole plant foods are actually protective of normal cells.[7]
Typical side-effects of conventional prostate cancer treatments are impotence and incontinence. What were the side-effects of the diet and lifestyle group? First off, a highly significant improvement in their cholesterol--dramatically decreasing the risk of these men dying from a heart attack while they were waiting for their cancers to disappear. The same diet that prevents heart disease also prevents cancer. And diabetes, and obesity, and hypertension, and constipation, diverticulitis, appendicitis--the list goes on and on. Yeah, but how was the quality of life of those undertaking these "intensive" lifestyle changes? I have often had patients jokingly ask if they are going to live longer on a healthy diet or is it just going to SEEM longer. But patients in this study dramatically changing their diet reported a marked improvement in quality of life overall. As Dean Ornish put it, "While fear of dying may not be a sustainable motivator, joy of living often is."[8]
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B. Peppermint Oil for Irritable Bowel Syndrome
Irritable Bowel Syndrome (IBS) affects millions of Americans with painful abdominal cramps, bloating, gas, and bouts of diarrhea and constipation. Eliminating dairy and caffeine often takes care of the problem, but if not I often put patients on peppermint oil--and there is finally now solid evidence to support this centuries-old practice.[9]
The latest volume of the journal Phytomedicine reviewed the evidence--16 clinical studies, most of them double-blind placebo-controlled crossover studies (one of the most scientifically rigorous study designs). The majority of these studies showed a consistent and significant improvement in IBS symptoms compared to placebo. The recommended dosing for adults is 1-2 enteric-coated peppermint oil capsules three times a day for 2 to 4 weeks. As always, pregnant and breast-feeding women should consult their physician before putting any new substance in their bodies.
The effect of the peppermint oil was so powerful that some of the studies even performed a head to head comparison between the peppermint oil and the current pharmaceutical drugs on the market and found comparable results. Of course the drugs in current use have side-effects including everything from dry mouth and blurred vision to confusion and memory impairment. The most common side effect of the peppermint oil was, well, let's just call it the "perianal tingle," as the minty freshness exits the body.
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C. The Atkins Diet: Dead Meat
My latest book, "Carbophobia: The Scary Truth Behind America's Low Carb Craze": published February 1st, 2005. The multibillion dollar Atkins corporation: files for bankruptcy August 1st.[10] Six months. Not bad (though I was hoping to topple them in four :). Seriously, though, all the I-told-them-so satisfaction is lost upon reflection of the thousands of families shattered by pork-rind and egg-yolk fueled heart attacks spawned by these high-fat frauds. Americans are now fattening at a rate never before seen, with a recent report showing rising obesity rates across 48 states. Right now two thirds of Americans are overweight. By 2008 the number is predicted to approach 75%.[11] And just when we thought we couldn't get any fatter comes the follow-up to the Framingham Heart Study published last week in the Annals of Internal Medicine, suggesting that over the long haul as many as 9 out of 10 men are likely to become overweight.[12] The answer, according to two new studies piling onto the mountain of evidence, is a plant-based diet.
First, a study of over 50,000 Swedish women around age 50. The vegetarians were, not surprisingly, significantly leaner than the meateaters and those who eliminated all saturated animal fat from their diet (meat and dairy and eggs)--the vegan group--was the leanest of all. The study suggests that by choosing to eat vegetarian, people can cut their risk of becoming overweight in half, and eating vegan seems to cut out two thirds of the risk. The researchers note that the results are also likely "generalizable to younger women and to men."[13] The study understandably prompted press reports like "Skip This One Food. You'll Weigh Less."[14] The title of the Washington Post report was less cryptic: "To Cut Fat, Eat Less Meat."[15]
The weakness of the Swedish study, though, is that it's a cross-sectional study based on comparing populations. Maybe the vegetarians are slimmer because they are just generally more health conscious and exercised more? (Although they also might tend not to smoke which might bias the results the other way.) How do we know if there's a cause and effect relationship between a plant-based diet and a healthier weight? What we need, frankly, is a study that controls for exercise--a randomized interventional study. You put half of people on one diet, half on another and see what happens. Enter: September 2005 American Journal of Medicine study "The effects of a low-fat, plant-based dietary intervention on body weight, metabolism, and insulin sensitivity."[16]
Researchers at Georgetown and the George Washington University School of Medicine took 64 overweight and obese postmenopausal women and randomized them to one of two diets. The control diet approximated the official National Institutes of Health "Therapeutic Lifestyle Changes" diet, which emphasizes plant foods but includes lean cuts of meat, low fat dairy, and up to almost a whole egg's worth of cholesterol every day. So they compared this "strict" American Heart Association diet the federal government prescribes to those who've already had a heart attack or are at exceptionally high risk of heart disease to a completely plant-based diet akin to the Ornish prescription of a diet centered on vegetables, fruits, grains, and legumes.
Now dietary intervention studies are tricky to put together. Sure, if you lock someone up in a metabolic ward and measure out calorie-controlled portions to the gram you could show that eating almost any diet can cause significant weight loss, but that's not how the real world works. Realizing this, researchers typically allow people to remain at home, but hand-deliver precooked meals three times a day for the study's duration. This of course makes researchers nervous because who knows if they're actually eating what you're giving them. And what else are they hoarding away in their kitchens? But of course even this tends to artificially exaggerate the benefits of the diets given the convenience of hand-delivered meals. To translate a study's findings into real life, what you need to do is put people on different diets out in the real world. Encourage them to maintain the diets under study, but make the participants prepare their own meals or eat out in restaurants. So that's exactly what these researchers did--sat down each diet group and told them how to eat, but then basically set them lose to try to make it work in their own lives. Obviously this is a conservative approach which would tend to underplay the actual effects of the experimental diet under study, but these researchers realized that for practical purposes, it doesn't matter if a diet works in a lab. The real question is does it work in your life.
With unlimited servings, no limits on calorie intake, no hunger, no exercise requirement, the plant-based diet group lost significantly more weight (over 50% more) than the diet currently recommended to reduce disease risk. "Reductions in body mass index and waist circumference were also significantly greater in the intervention group, compared with the control group." "In conclusion," the researcher wrote, "in a controlled trial, the consumption of a low-fat, vegan diet was associated with significant weight reduction, along with improvements in measures of glucose tolerance and insulin sensitivity."
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D. Arteries--Open Sesame!
People who have lived with me know about my "magic powder." I sprinkle it on almost everything. It's a combination of ground flax seed, dulse flakes, vitamin B12-fortified nutritional yeast and toasted and ground sesame seeds. The flax is for my Omega 3 fatty acids (although as little nutritional powerhouses they are much much more); the dulse is for iodine since I don't use salt (I've always wanted to include sea vegetables in my diet, because I knew they were so amazing trace mineral-wise, but I never liked the taste. Dulse is a gorgeous purple seaweed with but a mild flavor); and the nutritional yeast is for my B12 (although again there's so much other nutrition in this stuff it turns your pee yellow :). But the toasted sesame seeds (just spread a layer of raw sesame seeds in a toaster oven tray and toast until golden brown) are just to make the whole thing edible. Sesame seeds are the first recorded seasoning ever, dating back over 5000 years and no wonder--the rich sweet nutty flavor and fragrance of freshly toasted sesame seeds is out of this world. Little did I know that all this time they were helping to keep my arteries clean. And I love hearing good news about my good habits.
I've known about sesamin and sesamolin, two natural compounds found in sesame seeds that the good bacteria in your gut convert into powerful anticancer agents. I've known about sesaminol and sesamolinol (scientists aren't known for being a terribly creative bunch), two powerful vitamin E-like antioxidants. But I never thought of sesame seeds as being useful in cholesterol reduction, until now. Researchers at Chung Yuan University in Taiwan tried feeding a few tablespoons of toasted and ground (coffee grinders work well) sesame seeds to people every day for a month. Not only did it significantly lower the subjects' cholesterol (bad LDL cholesterol down 10%) but dramatically improved the antioxidant status of their blood.[17] Sadly, all the benefits vanished once they stopped eating the sesame powder. So you'll either have to come over to my fridge (you're welcome anytime!) or try making some healthy "magic powder" seasoning of your own. If only Morgan Spurlock (of "Super Size Me" fame) had just picked off the sesame seeds on the Big Mac and thrown the rest away, he probably would have felt better.
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E. Childhood Brain Tumors and Maternal Diet
Cancer is second only to accidents as a leading cause of death for our children these days. Brain tumors are the most common solid form of pediatric cancer. The development of childhood brain tumors is a chief reason why pregnant women no longer get X-rayed. Evidence has been building, though, that the mother's diet during pregnancy also plays a significant role.
Nitrites are found naturally in cigarette smoke and are artificially added to cured meats like bacon and bologna. They increase the shelf life of lunch meats, but seem to decrease the human life of those that consume them. They also may cause brain tumors.
A recent review of ten major epidemiological studies found that eight of them showed significant associations between maternal intake of cured meats during pregnancy and the risk of giving birth to a baby that would develop a brain tumor, usually within the first 5 years of life. Mothers eating lots of foods like sausages, ham, hot dogs, etc. had up to 6 times higher risk. The nitrites in meat under extreme chemical conditions (like in the acidity of the stomach) react with amides like creatine and creatinine (also found in meat) to create potent carcinogens called nitrosamides. The researcher suspect that the "nitrosamides formed endogenously in the mother's stomach could also be transported transplacentally to the brain of the embryo or fetus, passing the blood brain barrier, and resulting in brain tumor development in the child."[18]
In terms of other dietary factors, most of the studies that measured fruit and vegetable intake found (not surprisingly) that both fruit and vegetable intake during pregnancy seemed protective. Not all plant foods were found protective, though. A study published last month from the Children's Hospital of Philadelphia, found that unhealthy plant foods like french fries may also increase risk.[19] But otherwise, fruits and vegetables were found protective across a wide variety of tumors. One study published this Summer, for example, found that fruits and vegetable consumption even proved protective against retinoblastoma, a rare form of brain tumor that forms on the back of the eye and for which treatment typically requires the removal of one or both of the child's eyes.[20]
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II. PERSONAL UPDATE
Alas, what was once monthly is now sadly only quarterly. As much as I really enjoy working on this newsletter it takes me at least a week to research and write, and now with a more than full time job, on top of the writing, and traveling, and speaking I just can no longer afford to spend a quarter of my month on it. So, I'm now sadly down to the seasons. You can expect the Winter issue this January (hopefully with tellings of the hatching of my new bird flu book!). I'll put a Spring issue out every April, a Summer issue out in July and a Fall every October. It kills me to have to pass over so many important juicy articles I see every month, and I miss the feeling of more frequently reaching out to everyone that has reached out to me over the years, entrusting me with a piece of their family's health. I hope you can understand. If you'd like to see me in person, I'm just now piecing together my Spring 2006 speaking schedule. Please fill out the speaking request form on my website and keep an eye on my speaking schedule at http://www.DrGreger.org/dates.html
Because I am not able to speak as much as I used to, I've been tossing around the idea of doing a speaker training. A weekend-long intensive crash course in writing talks, public speaking, organizing speaking tours--basically everything I've learned in my long years of doing this in hopes that others can go out and spread the word about healthy eating. People in this country are hungry for no-nonsense practical tips about protecting their family's health from the barrage of big-money junk food interests. Email me if you're interested mhg1@cornell.edu. If it's popular enough, maybe I'll make it an annual event.
As you can imagine, this has been an overwhelming time for The Humane Society of the United States, having led in the Noah-scale effort to save the animals so many were forced to leave behind when hurricane Katrina struck. I was down in East Texas during hurricane Rita to assess damage (with--I couldn't help it--a quick jog over to San Antonio to debate National Cattlemen's Beef Association Executive Director Gary Weber). In my fifth month now with The HSUS, I am proud to be part of an organization that saved the lives of over 7,000 animals trapped by Katrina's fury.
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III. MAD COW UPDATE:
FDA gutless and brainless; our food and cosmetic supply should be so lucky
Early last month, while all eyes were on Katrina, the FDA quietly announced that it was even backtracking on the few rules it had already put in place. You may remember my April 2004 mad cow update ( http://www.drgreger.org/april2004.html ) in which I encouraged everyone to put pressure on the FDA to follow the European example and exclude not only small intestine from the human food and cosmetics supply, but all cow/calf colons and rectums as well. Not only did they refuse to ban these potentially risky tissues, but the exclusion of all smaller intestines was evidently so costly to the sausage industry that they've decided to allow them back in, forcing producers just to cut off the last few feet.[21] As one public health commentator commentated: "So while the FDA may be gutless, your food and cosmetics won't be."[22]
What about all the other rules that the FDA promised? Perhaps realizing that the internal contradiction--barring blood donors from the UK for fear of prion transmission through blood on the one hand,[23] but on the other continuing to allow the feeding of cattle blood to calves--the FDA held a news briefing January 2004, a month after the first discovered U.S. case of mad cow disease, and finally announced that they would ban the feeding of cow blood and chicken wastes to cattle. "Today we are bolstering our BSE firewalls to protect the public," the FDA Commissioner said.[24] The New York Times reported that the FDA commissioner said the new rules would actually take effect "in a few days," as soon as they were published in the Federal Register (thereby making the ban official). The move was congratulated by the Secretary of the Department of Health and Human Services as "a giant step forward." Consumer groups offered praise. Andrew Kimbrell, executive director of the Center for Food Safety, a consumer group in Washington, said: "This is long, long overdue. I wonder whether it's too little too late."[25] It turns out it was nothing at all. The FDA never published the rules, allowing U.S. farmers to continue these risky practices. The "few days" turned into over 20 months and counting.
The promised "no-brainer" exclusion of all cow brains from chicken and pig feed? Too expensive. As reported by the New York Times, "Getting rid of the vertebrae, spines, nerves, eyes, intestines and other potentially infectious parts of all cattle" would be a "big expense for the industry,"[26] The FDA is thinking now of just excluding older cow brains: "Getting rid of just brains and spines from older cattle," FDA director Stephen Sundlof explained, "would create only 64 million pounds of waste that would have to be burned or buried at a cost of about $14 million."[27] The lesson, I guess, is that it's cheaper to feed potentially hazardous waste to the chickens and pigs people eat, rather than place the burden on the meat industry to have to dispose of it properly. The New York Times summarizes: "The new proposal would still allow animals to be fed material that some scientists consider potentially infectious, including the brains and spinal cords of young animals; the eyes, tonsils, intestines and nerves of old animals; chicken food and chicken dung swept up from the floors of poultry farms; scrapings from restaurant plates; and calf milk made from cow blood and fat."[28] Oh, and the "new proposal" will be adopted "sometime next year."[29]
Of course there's no guarantee the "gutted" rules will ever even be effectively enforced. In response to Freedom of Information Act requests initiated by Ralph Nader's group Public Citizen, the USDA finally just released it's records showing more than 1,000 violations of the current mad cow rules just since 2004.[30]
The one glimmer of hope is the possibility that the ban on feeding America "downer" cows too sick or injured to even stand may soon be made permanent. September 20, 2005, the US Senate voted in favor of such a proposal, and thanks to Senator Akaka (D-HI) and Representatives Gary Ackerman (D-NY) and Steve LaTourette (R-OH), the Downed Animal Protection Act has been reintroduced to permanently exclude all downer livestock from the American food supply. Please urge your Senators and Representatives to vote yes on Senate Bill 1779 and House Bill 3931. For updates on this and other important legislations, sign up to Humanelines at https://community.hsus.org/humane/join.tcl
In other mad cow news, if thoughts of consuming the infected guts of calves weaned on the blood of cows fed pig brains and chicken feces doesn't dull one's appetite, how about feeding cows human remains?
The origin of mad cow disease has always been a bit of a mystery. We know it spread because of industry-mandated cow-eat-cow cannibalism, but how did the first cow get it to trigger the chain reaction? Did it come from scrapie, the sheep form of the disease? Cows have, after all, been forced to eat sheep brains, bones and blood for decades to cut feed costs. The latest theory, though, published in the prestigious Lancet medical journal,[31] is that it may have originated from cows being fed what human cannibals have called "long pork." The other, other white meat.
During the 60's and 70's Britain imported hundreds of thousands of tons of whole and crushed bones from the Indian subcontinent in part for use as animal feed. Bone collecting is an important source of income for many Indian peasants. The problem is that dead animals and dead Hindus float side by side down the Ganges. Religious custom in India has people disposing of half-cremated human corpses in the rivers which may wash up downstream and be picked up during bone collection. If one of those corpses died of Creutzfeldt-Jakob disease, the human form of mad cow-like diseases, the prion pathogens could have been waiting riverside in the bone marrow only to be picked up and picked off by a cow thousands of miles away.[32]
Indian officials have dismissed the theory, claiming that they have very few CJD cases (they don't, after all, tend to eat many cows). In any case, natural herbivores like cows shouldn't be forced to eat brains, guts, blood or bones from any species. Instead of feeding cows Soylent Green, perhaps we should let them stick to the soy, and the greens.
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IV. BIRD FLU UPDATE:
On a Wing and a Prayer
Two weeks ago a Dr. "Frist" wrote an op-ed in the Washington Times warning that the bird flu virus "poses an immense potential threat to American civilization."[33] A threat to civilization? Who is this guy? This "guy" is Bill Frist, M.D., Majority Leader of the United States Senate.
Senator Frist gave a talk on Bird Flu recently at Harvard Medical School, his alma mater. He described the horrors of 1918. Fifty million dead, killed by a bird flu virus finally sequenced this month in the two most prestigious scientific journals in the world, Nature[34] and Science.[35] Dr Frist asked "How would a nation so greatly moved and touched by the three thousand dead of September 11th react to half a million dead? In 1918 - 1919 the mortality rate was between 2.5 and 5 percent, which seem merciful in comparison to the 55 percent mortality rate of the current Avian flu. In just 18 months, this Avian flu has killed or forced the culling of more than 100 million animals. And now that it has jumped from birds to infect humans in 10 Asian nations, how many human lives will it or another virus like it take? How, then, would a nation greatly moved and touched by three thousand dead, react to five or fifty million dead?"[36]
Or 150 million. Two weeks ago World Health Organization executive director Dr. David Nabarro was appointed the bird flu czar of the United Nations. At the press conference at UN headquarters in New York, Dr. Nabarro predicted as many as 150 million human deaths in the upcoming pandemic arising from bird flu. Progress, he said, will demand appealing "to people's recognition that we're dealing here with world survival issues - or the survival of the world as we know it."[37]
The pandemic is what reportedly keeps our Secretary of Health and Human Services Mike Leavitt awake. "It's a world-changing event when it occurs," Leavitt said in an interview. "It reaches beyond health. It affects economies, cultures, politics and prosperity - not to mention human life, counted by the millions."[38]
Yeah, but what are the odds of it actually happening? What are the odds that a killer flu virus will spread across the world like a tidal wave, killing millions? This morning it was reported that Secretary Leavitt answered that question. "The burning question is, will there be a human influenza pandemic," he told reporters. "On behalf of the WHO, I can tell you that there will be. The only question is the virulence and rapidity of transmission from human to human."[39] The Director General of the World Health Organization: "there is no disagreement that this is just a matter of time."[40] The Director of the Centers for Disease Control told Newshour with Jim Lehrer last week: "Most experts are saying that it's not really a question of if; it's a question of when."[41] As the Executive Director of the nonprofit Trust for America's Health put it, "This is not a drill. This is not a planning exercise. This is for real."[42]
And finally it's getting a fraction, at least, of the press attention it deserves. "It could kill a billion people worldwide, make ghost towns out of parts of major cities, and there is not enough medicine to fight it. It is called the avian flu." So started the ABC News Primetime special on bird flu on September 15th, 2005.[43] What, now we're up to a BILLION human deaths? Where did they pull that number from? They pulled it from Dr. Irwin Redlener, Associate Dean of Columbia University's School of Public Health and Director of its National Center for Disaster Preparedness.[44]
Within the last month it was the cover story of National Geographic, Business Week and TIME Magazine in Asia. What more attention could one ask for than for our President spending five minutes on it in the Rose Garden, openly musing about putting the military in charge when the pandemic hits. The Washington Post quoted Columbia University's Dr. Redlener calling the president's suggestion an "extraordinarily draconian measure" that would be unnecessary if the nation had "built the capability for rapid vaccine production, ensured a large supply of anti-virals like Tamiflu, and not allowed the degradation of the public health system." "The translation of this, Redlener said, "is martial law in the United States."[45]
Business Week's bird flu cover story "Hot Zone in the Heartland" quoted Department of Homeland Security associate director Dr. Michael Osterholm: "The difference between this and a hurricane is that all 50 states will be affected at the same time," he said. "And this crisis will last a year or more. It will utterly change the world."
So what can we do? Last week was Pandemic Flu Awareness Week, organized by a group of dedicated volunteers who have started Fluwikie.com, an unprecedented collaborative approach to problem-solving in public health, with the express purpose to "help local communities prepare for and perhaps cope with a possible influenza pandemic." We need to prepare within our families, our neighborhoods, our communities, our cities, states and businesses. First, though, we need to educate ourselves. Here is a list of resources to get everyone started:
Department of Homeland Security associate director article in Foreign Affairs:
http://www.foreignaffairs.org/20050701faessay84402/michael-t-osterholm/preparing-for-pandemic.html
Watch Dr. Osterholm on video at the Woodrow Wilson Center for International Scholars:
http://wilsoncenter.org/index.cfm?fuseaction=news.item&news_id=145329
How a pandemic might realistically unfold (I apologize for the broken link in the last issue):
http://www.nature.com/nature/journal/v435/n7041/pdf/435400a.pdf
ABCnews Primetime Investigation transcript:
http://abcnews.go.com/Primetime/Investigation/story?id=1130392&page=1
Trust for America's Health report:
http://healthyamericans.org/reports/flu/Flu2005.pdf
Senate majority leader's Harvard Medical School Health Care Policy Seidman Lecture:
http://frist.senate.gov/_files/060105manhattan.pdf
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V. MAILBAG: "What sources do you use to write the newsletter?"
I love libraries. I grew up in libraries. I would actually skip class in high school so I could spend more time in a basement--the science library at the local state university. Let's just say I was an uber-nerd.
So researching Latest in Human Nutrition is a guilty pleasure for me. I was fearful leaving Boston this Spring, fearful to leave Countway, Harvard's medical library. But here in Bethesda, Maryland, lies the National Library of Medicine. And I thought Harvard was good. I went from one of the biggest medical libraries in the world to THE biggest medical library in the world. But let me stop drooling on the keyboard. I review every issue of the top medical journals, the top academic and governmental nutrition newsletters and, as far as I can ascertain, every issue of every single English-language scientific journal of clinical nutrition on the planet. Here's the list:
American Journal of Cardiology
American Journal of Clinical Nutrition
Annals of Nutrition and Metabolism
Annual Review of Nutrition
Applied and Environmental Microbiology
Arteriosis and Thrombosis
Asia-Pacific Journal of Clinical Nutrition
Berkeley Wellness Letter
Better Nutrition
British Journal of Nutrition
British Medical Journal
Cancer Epidemiology and Biomarkers
Cancer Letters
Cancer Research
Canadian Medical Association Journal
Cancer Causes and Control
Cancer Detection and Prevention
Clinical Nutrition
Consumer Reports on Health
Critical Reviews in Food Science and Nutrition
Current Opinions in Lipidology
European Journal of Medicine
Emerging Infectious Disease
Environmental Health and Preventive Medicine
Environmental Health Perspectives
European Journal of Cancer Prevention
Food and Drug Administration Consumer
Food and Chemical Toxicology
Food and Nutrition Bulletin
Food and Nutrition Research Briefs
Harvard Health Letter
Harvard Heart Letter
Harvard Men's Health Watch
Harvard Women's Health Watch
International Journal of Cancer
International Journal of Epidemiology
International Journal of Food Science and Nutrition
International Journal of Obesity
International Journal of Vitaminology
Journal of Nutrition Education and Behaviour
Journal of Nutritional Science and Vitaminology
Journal of Nutrition
Journal of Applied Nutrition
Journal of Food Protection
Journal of Food Science
Journal of Human Nutrition and Dietetics
Journal of Medicinal Food
Journal of the American College of Nutrition
Journal of the American Dietetic Association
Journal of the American Medical Association
Journal of the Science of Food and Agriculture
Lancet
Molecular Nutrition and Food Research
New England Journal of Medicine
Nutrition
Nutrition and Cancer
Nutrition and Food Science
Nutrition Bulletin
Nutrition Research
Nutrition Research Reviews
Nutrition Reviews
Nutrition Today
Nutrition Action Healthletter
Phytomedicine
Phytotherapy Research
Planta Medicine
Preventive Medicine
Proceedings of the Nutrition Society
Public Health Nutrition
Tufts University Health and Nutrition Letter
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REFERENCES:
(Full text of specific articles available by emailing article-request@DrGreger.org)
[1] Ornish D, et al. 1990. Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial. Lancet 336(8708):129-33.
[2] Roberts WC. 1999. Shifting from decreasing risk to actually preventing and arresting atherosclerosis. American Journal of Cardiology 83(5):816-7.
[3] Allen NE, et al. 2004. A prospective study of diet and prostate cancer in Japanese men. Cancer Causes Control 15(9):911-20.
[4] Snowdon DA, Phillips RL, and W Choi. Diet, obesity, and risk of fatal prostate cancer. American Journal of Epidemiology 120(1984):244-50.
[5] Ornish D, et al. 2005. Intensive lifestyle changes may affect the progression of prostate cancer. Journal of Urology. 174:1065-70.
[6] Stein R. Diet, exercise and reduced stress slow prostate cancer. Washington Post, August 11, 2005: A06.
[7] Ornish D, et al. 2005. Intensive lifestyle changes may affect the progression of prostate cancer. Journal of Urology. 174:1065-70.
[8] Ornish D. 2002. Statins and the soul of medicine. American Journal of Cardiology 89(11):1286-90.
[9] Grigoleit HG. et al. 2005. Peppermint oil in irritable bowel syndrome. Phytomedicine 12 (2005) 601-606.
[10] LeSure E. Low-carb pioneer Atkins files for bankruptcy. Associated Press, August 1, 2005
[11] Trust for America's Health. F as in Fat: How Obesity Policies are Failing in America 2005. http://healthyamericans.org/reports/obesity2005/
[12] Ramachandran S. 2005. Estimated risks for developing obesity in the Framingham Heart Study. Annals of Internal Medicine 143:473-480.
[13] Newby PK, et al. 2005 "Risk of overweight and obesity among semivegetarian, lactovegetarian, and vegan women. American Journal of Clinical Nutrition 81:1267-74.
[14] Skip this one food. You'll weigh less Compuserve News, August 4, 2005.
[15] Squires S. To cut fat, eat less meat. Washington Post, June 21, 2005:HE01.
[16] Barnard ND, et al. 2005. The effects of a low-fat, plant-based dietary intervention on body weight, metabolism, and insulin sensitivity. American Journal of Medicine 118(9):991-7.
[17] Chena PR, et al. 2005. Dietary sesame reduces serum cholesterol and enhances
antioxidant capacity in hypercholesterolemia. Nutrition Research 25:559-67.
[18] Dietrich M, et al. 2005. A review: dietary and endogenously formed N-nitroso compounds and risk of childhood brain tumors. Cancer Causes and Control 16(2005):619-35.
[19] Bunin GR. Maternal diet during pregnancy and its association with medulloblastoma in children. Cancer Causes and Control (2005) 16:877-91.
[20] Orjuela MA, et al. 2005. Fruit and vegetable intake during pregnancy and risk for development of sporadic retinoblastoma. Cancer, Epidemiology, Biomarkers and Prevention 14(6):1433-40.
[21] U.S. Food and Drug Administration news release. FDA amends interim final rule "use of materials derived from cattle in human food and cosmetics." September 6, 2005.
[22] http://www.haloscan.com/tb/revere/112605411656695812/
[23] U.S. Department of Health and Human Services Food and Drug Administration
Center for Biologics Evaluation and Research (CBER). "Revised Preventive Measures to Reduce the Possible Risk of Transmission of Creutzfeldt-Jakob Disease (CJD) and Variant Creutzfeldt-Jakob Disease (vCJD) by Blood and Blood Products. January 2002.
[24] Martin A. "FDA Adds to Ban on What Cows May Be Fed." Chicago Tribune
27 January 2004.
[25] "FDA Partially Tightens Up Feed Rules to Stop Spread of Mad Cow." New York Times
27 January 2004.
[26] McNeil DG, jr. U.S. offers new animal feed rules, but critics assail them. New York Times, October 4, 2005..
[27] McNeil DG, jr. U.S. offers new animal feed rules, but critics assail them. New York Times, October 4, 2005.
[28] McNeil DG, jr. U.S. offers new animal feed rules, but critics assail them. New York Times, October 4, 2005.
[29] McNeil DG, jr. U.S. offers new animal feed rules, but critics assail them. New York Times, October 4, 2005.
[30] Fabi R. USDA finds 1,000 violations of mad cow rules. Reuters, August 15, 2005.
[31] Colchester AC and Colchester NT. 2005. The origin of bovine spongiform encephalopathy: the human prion disease hypothesis. Lancet 366(9488):856-61.
[32] Khamsi R. 2005. British duo probes origin of mad cow disease. Nature News, 1 September 2005.
[33] Frist B. The threat of avian flu. Washington Times, September 29, 2005.
[34] Taubenberger JK, et al. 2005. Characterization of the 1918 influenza virus polymerase genes. Nature 437(7060):889.
[35] Tumpey TM, et al. 2005. Characterization of the reconstructed 1918 Spanish influenza pandemic virus. Science 310(5745):77-80.
[36] Frist B. Harvard Medical School Health Care Policy Seidman Lecture
"Manhattan project for the 21st Century," June 1, 2005.
[37] Branswell H. 'World as we know it' may be at stake: UN pandemic czar. Canadian Press, October 2, 2005.
[38] Vieth W. The Health secretary is leading a drive to boost federal efforts, and funding, to prepare for a global outbreak if avian flu mutates. LA Times, October 3, 2005
By Warren Vieth, Times Staff Writer
[39] Mydans S/ Preparations for biurd flu are urent, Asia is warned. International Herald Tribune, October 11, 2005.
[40] Jolly L. Start moving on deadly flu. The Sun, March 3, 2005.
[41] PBS Newshour with Jim Lehrer. The Avian Flu Pandemic. October 5, 2005.
[42] Flu pandemic could kill half million in U.S. Report: America not prepared for large outbreak of disease. Reuters, June 24, 2005.
[43] Schwartz R, et al. Avian Flu: Is the government ready for an epidemic?
Virus Poses Risk of Massive Casualties Around the World. ABC News , September 15th, 2005.
[44] Branswell H. Avian flu may be the next pandemic. Woodrow Wilson International Center for Scholars, September 22, 2005.
[45] Loven J. Bush considers military role in flu fight. Washington Post, October 4, 2005.
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