Heart disease is our country's greatest health problem, affecting 58,800,000 Americans (AHA, 1999). The American Heart Association states that cardiovascular disease accounted for 41.4% of all deaths in 1996, and they estimate that the disease will cost America $286.5 billion this year. Cancer is our nation's second-leading killer. One out of every four people will die of some form of this disease, and the disease costs America $107 billion each year (ACS, 1999).
The calamitous death toll and financial burdens caused by these two diseases are enormous. Yet as practicing physicians, you have the ability to influence your patients to dramatically reduce their chances of contracting either one of these diseases. The key to reducing the chances of getting this disease does not lie in a breakthrough surgical technique or the latest wonder drug. The answer is beautifully simple, but tragically overlooked by most of today's physicians. The answer is vegetarianism.
Unfortunately, the meat industry is a powerful force in American society - one that has successfully sought to hide the effects of meat on health for many years. However, as these facts are gradually being revealed to the general public, we are seeing the consumption of meat steadily decline. Twenty million Americans are now dedicated vegetarians (PETA), and these people are reaping the health benefits of their diet. In particular, they are seeing a dramatic decrease in the incidence of heart disease and many forms of cancer. Coincidence or scientifically-based fact? Let us decide by looking at the facts regarding the consumption of meat as well as the effects of a carnivorous lifestyle on the human body.
Cardiopulmonary Disease and Vegetarianism
"Although we think we are one and we act as if we are one, human beings are not natural carnivores. When we kill animals to eat them, they end up killing us because their flesh, which contains cholesterol and saturated fat, was never intended for human beings, who are natural herbivores." (Messina, 1996, p. 27) --William Clifford Roberts, M.D., Editor-in-chief, American Journal of Cardiology High Blood Pressure
Every 45 seconds, someone dies from a heart attack (Robbins, 1987, p. 204). The positive correlation between high meat intake and a greater risk of heart disease is well-documented. The heart disease mortality rate of vegetarians is one-third as much as the rate of meat-eaters (Robbins, 1987, p. 214). The religious groups know as the Seventh Day Adventists and the Mormons have similar health habits-strict members of each group will not ingest coffee, alcohol, tobacco, or tea. Yet in a group of vegetarian Seventh Day Adventists, systolic blood pressure was found to be eight to nine points lower, and diastolic blood pressure was found to be six to eight points lower, than in a group of meat-eating Mormons (Barnard, 1993, p. 49).
The Japanese, long a culture in which very little meat was consumed, experienced a great increase in overall cholesterol levels as animal-food consumption increased in their country between 1960 and 1980 (Messina, 1996, p. 33). In fact, vegetarians have cholesterol levels 10 to 20 percent lower than those of meat-eaters.
Another documented cause of high blood pressure, and hence, heart disease, is high salt intake. The recommended daily requirement for salt intake is 5 grams, or about one teaspoon (Lappé, 1991, p. 127), yet most Americans consume 6 to 18 grams. What role does meat consumption play in this statistic? Not surprisingly, processed meat is laden with salt. A typical frozen beef dinner provides one teaspoon of salt-an entire day's allotment. Two hot dogs provide another half-teaspoon, and a typical dinner at Kentucky Fried Chicken provides a whole teaspoon.
Cholesterol and Fat
Why the discrepancy? We have known for many years that a diet high in cholesterol and fat leads to atherosclerosis and eventual heart disease. In a survey of 200 scientists, 92% of them recommended that we reduce the fat in our diet to reduce our risk of heart disease (Lappé, 1991, p. 122). However, the trend in America has not reflected this recommendation. We now eat 27% more fat than our relatives in the early 1900s, especially due to the doubling of meat consumption and tripling of poultry consumption since World War II (Lappé, 1991, p. 123).
Since vegetarians are found to have healthier hearts and blood vessels than meat-eaters, we would naturally expect vegetarian foods to be lower in fat and cholesterol. And that is just what researchers have found. Look at the following chart, taken from Diet for a New America by John Robbins, comparing the percent calories from fat of various foods. It can be seen that the meat products have fat levels ranging from 83% to 47%, while the vegetables have fat levels ranging from 49% at highest to 1% at lowest, with the vast majority of vegetarian foods in the 1-10% range.
Similarly, let us look at another chart from the same book, comparing the cholesterol content of different foods. Here we can see the great difference between the cholesterol content of animal-based products and vegetables. Even chicken, generally considered a "healthy" meat, contains 60 mg cholesterol for a 100 gram portion, while no pure vegetable product contains any cholesterol. Therefore, people who continue to consume limited portions of eggs and dairy products will still greatly reduce their cholesterol intake simply by eliminating meat from their diets.
Cancer and Vegetarianism
"Whereas burgers and bacon strips lay a chemical welcome mat for cancer cells to arrive and thrive, tomatoes and tofu lasagna ward off cancer attacks." (Barnard, 1999) --Neil Barnard, M.D.
The American Cancer Society states that some form of cancer will be diagnosed in approximately 1,221,800 people this year, and it will claim the lives of 563,100. Not surprisingly, a high-fat, meat-filled diet is directly linked to breast and colon cancers, the two most prevalent forms of the disease.
The Physiology of the Colon
It is a fact that many carnivorous animals live long, healthy lives by subsisting on an almost exclusive diet of flesh. The question might then arise: why are carnivorous animals not dying prematurely from cancer if meat is so full of fat and cholesterol? A large part of the answer lies in the anatomy of the colon. The colon of a carnivorous animal is straight and smooth, with sides like a stovepipe. The colon of a human, as any physician knows, is quite different-long, twisted, and with deep pockets and puckers.
The colon of a carnivore is designed to shuttle fiber-free meat through quickly, before the body has a chance to absorb the toxins that meat produces as it decays. The human colon, however, cannot pass its contents as quickly. The extra effort that it needs to push the meat through its convoluted pathway requires the production of extra bile acids. One of these acids, deoxycholic acid, is converted by the bacteria clostridia in the stomach to a carcinogenic substance. That is why meat-eaters have such high levels of colon cancer in comparison to vegetarians. The more meat we eat in our daily diet, the less room or appetite we have for fiber-containing foods. Hence, 70% of the food the average American eats contains little or no fiber (Lappé, 1991, p. 130), and while the National Cancer Institute recommends consuming 20-35 grams of fiber a day, the average American consumes only about 10 grams (Saltman, 1993, p. 111). Some of the best sources of fiber include oat bran, shredded wheat, barley, asparagus, and green beans. Meat, in contrast, contains absolutely no fiber. And, since animal fats are solid at body temperature and clog the intestines, any meat that a person eats automatically negates the effectiveness of any fiber he or she might also consume. Incidentally, studies have also shown that a high-fiber diet also combats heart disease; it seems that if you ward off one disease, you may unknowingly fight another.
Free Radicals and Antioxidants
After many years of cancer prevention research, scientists have identified several nutrients and chemicals that naturally fight cancer. Two of these are antioxidants and folic acid, both of which are found in abundance in many vegetables, while they are sorely lacking in most types of meat.
As the body uses oxygen, some of the O2 molecules become unstable "free radicals" and attack the cell membranes and, eventually, the nuclei. This is the beginning of cancer, but the process can be stopped. Antioxidants are naturally-occurring chemicals that neutralize these free radicals, and thereby reduce the risk of cancer. Some common antioxidants are selenium, Vitamin A, and Vitamin C-chemicals found in copious amounts in broccoli, orange juices, squash, carrots, wheat germ, and whole grains.
Folic acid is a B vitamin found in large quantities in such leafy green vegetables as spinach, asparagus, and most beans. The vitamin is a built-in repair mechanism, which allows damaged cells to repair themselves. This is a critical process for preventing cancer, which is essentially the uncontrolled multiplication of cells.
The Iron Overdose
Conversely, iron is one element present in meat, traditionally touted as highly beneficial to the body, which is now being recognized as harmful in large amounts. Iron is a catalyst for the free radicals; although it is essential in small quantities, iron naturally encourages cell division. And since the fundamental principle behind cancer is the uncontrolled multiplication of cells, iron is one of cancer's best friends. Dr. Randall Lauffer, a Harvard biochemist, examined a study of the relationship between iron and cancer among 10,000 Americans. He found that, "For men especially, it was clear that higher iron levels were associated with increased risk for certain forms of cancer" (Barnard, 1993, p. 75). What foods contain the most iron, then? Although some vegetables contain small amounts of iron, the greatest supplier is meat. The iron in vegetables is also more easily resisted by the body than the iron in meat. The body can get more than enough iron from a vegetarian diet with moderate variation, but it will most likely get far too much from a meat-based diet.
"It is the position of The American Dietetic Association that appropriately planned vegetarian diets are healthful, are nutritionally adequate, and provide health benefits in the prevention and treatment of certain diseases." --The American Dietetic Association's Position Statement on Vegetarianism.
Based on the information already presented, the above conclusion by the American Dietetic Association seems like quite an understatement of the benefits of vegetarianism. However, society is slow to accept drastic change, and the traditional American diet is one of the hardest of all habits to break. Although the meat industry is doing everything in its power to protect its own interests, no amount of propaganda can change the fact that meat is simply a bad idea. If America switched to a balanced vegetarian diet, we would see a drastic reduction in heart attacks, cancer, and many other diseases common in today's society. Physicians have a moral responsibility to encourage their patients to do whatever they can to reduce their risk of serious disease. Therefore, physicians need to realize the truth behind meat and make dietary recommendations to their patients accordingly. For instance, physicians always admonish their patients to abstain from smoking. Why? Obviously, because smoke is harmful, and it can kill. The same principle then applies in this case. Meat can kill; therefore, physicians should encourage their patients to abstain from meat-eating.
Naturally, a healthy diet depends on many other factors besides abstaining from meat. For more information on other aspects of a healthy diet to recommend to your patients, see the appendix. However, it is clear that the time has come for a dramatic reinterpretation of the definition of a healthy American diet. America needs its health professionals to encourage their patients to switch to vegetarianism, and, as they say, the ball is in your court.
The American Cancer Society (ACS). 1999. Cancer: Basic Facts (26 April 1999).
American Heart Association (AHA). 1999. Cardiovascular Disease Statistics. (26 April 1999).
Barnard, Neal. (1993). Food for Life: How the New Four Food Groups Can Save Your Life. New York, NY: Harmony Books.
Lappé, Frances Moore. (1991). Diet for a Small Planet. New York, Ballantine Books.
Messina, Virgnia, & Messina, Mark. (1996). Total Health for You and Your Family: the Vegetarian Way. New York, NY: Harmony Books.
Physicians Committee for Responsible Medicine. 1999. Barnard, Neal. Getting a Head Start in the Race against Prostate Cancer. (26 April 1999).
Robbins, John. (1987). Diet for a New America. Walpole, NH: Stillpoint International, Inc.
Saltman, Paul, Gurin, Joel, & Mothner, Ira. (1993). The University of California San Diego Nutrition Book. Boston, MA: Little, Brown and Company.
Vegetarianism: Eating for Life (Factsheet). Washington, D.C.: People for the Ethical Treatment of Animals (PETA).
The Vegetarian Society. 1995. Cancers, Coronaries and Cash. (26 April 1999).
Diet for a Small Planet, by Francis Moore Lappé.
This is the book that started a revolution in nutritional circles when the first edition appeared in 1971. It exposes the fallacies of the traditional four food groups extolled by the majority of society. Going into detailed nutritional analysis, Moore demonstrates the harmful effect of the traditional American diet, as well as how it can be remedied by a healthy vegetarian diet.
Diet for a New World, by John Robbins
This was another groundbreaking book written by an heir to the Baskin Robbins empire. Robbins approaches vegetarianism from several different aspects, including the ethical and environmental aspects, but he also includes a detailed section on vegetarian nutrition. The book is a haven of statistics categorizing the ravages of an animal-based diet on human health. It also contains an invaluable chapter regarding the "Protein Myth"-the faulty logic behind the American obsession with getting enough protein.
Food for Life: How the New Four Food Groups Can Save Your Life by Neal Barnard
This is a book that outlines the "new four food groups," which redefine how we should look at the established Food Pyramid. Written by a medical doctor, it gives advice on how to make the transition to a strict vegetarian diet, at the same time making a strong case for the nutritional benefits of vegetarianism.