What the Health

Copyright © 2017 by Eunice Wong with Kip Andersen and Keegan Kuhn.

The information in this book is presented for educational purposes only. This book is not in any way a substitute for the advice of a physician or other medical professionals based on the reader’s specific conditions. The authors and publisher specifically disclaim all responsibility for injury, damage, liability, loss, or risk, personal or otherwise, that may incur as a direct or indirect result of following any directions or suggestions given in the book.

All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner.

Rev. date: 03/23/2017

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Contents

Part One: YOU

PROLOGUE

1. Genetics: The Writing on the Cell

2. Medical School: The Doctor of the Future

3. Diabetes: Deadly Sweet

4. Chicken: What the Cluck?

5. Flesh Food

6. Cancer: Feeding the Growth

7. What is Milk?

8. Eggs: Cracked

9. Fish: Pollution Sponges

10. Blood Vessel Disease: The Tree of Life

11. Our Children

Part Two: THE WORLD

12. Post-Antibiotic Era

13. A Civil Rights Issue

14. Hens in the Fox Den

15. Pharm to Table to Pharm

16. Exploding Myths

17. The Next Stage in Human Evolution: Vegan Athletes

18. Things Spiral Around

Acknowledgements

Notes

Selected Bibliography and Films

For my darling Chris, the love of my life,

the clear natural light,

and for Konrad and Marina:

"If we lay a strong enough foundation/

We’ll pass it on to you/ we’ll give the world to you/

And you’ll blow us all away/ someday, someday."

—E.W.

Dedicated to those who speak up for truth and justice for the planet, for the animals, and for all of humanity working together toward a thriving future.

—K.A. & K.K.

All truth passes through three stages.

First, it is ridiculed.

Second, it is violently opposed.

Third, it is accepted as being self-evident.

—Arthur Schopenhauer

Part One

YOU

PROLOGUE

My name is Kip Andersen. I’m a documentary filmmaker in San Francisco.

When I was in high school, my dad suffered third degree heart block, a life-threatening condition. Third degree is the most serious kind. He was only 49.

It happened in the middle of the night. We lived in the suburbs, and the ambulance didn’t put on its siren. The paramedics quietly came in and got my dad.

I slept through it all. My parents didn’t want to scare me.

But when I woke up, I was very scared. My dad was in the hospital. None of us ever imagined that he would have a dangerous heart condition. He had high cholesterol, sure, but he was on medication for that. He was a lifelong military man, fit and proud—in fact, when he was hospitalized, he was about to be promoted to Captain. But in the military, once there’s something wrong with your heart, you’re essentially forced to retire.

My father came back from the hospital with a pacemaker in his chest and an honorable discharge from the career that had defined him for decades. He had to start over.

My image of him—my dad, the embodiment of strength—shifted. I knew now there was a frightening vulnerability hidden inside his body. I was afraid for him, and I was afraid for myself. All my life I had heard about the inescapable link between genetics and disease. I didn’t know what was going on beneath my own skin.

My mom’s father died of a diabetes-related heart attack when he was around 60. I was maybe 6 at the time. I loved him very much. Then my dad’s father died of prostate cancer, and my grandmother died of stomach cancer. My mom’s sister has had diabetes for 25 years and is losing her eyesight. My mom’s brother also has diabetes.

You’ll get diabetes, too, they tell me with concern.

My family’s health history hangs over me. Diabetes, heart disease, cancer. I’m meticulous about my check-ups. When I was 18, I used to take Metamucil and an aspirin every day. I run, I bike, I do yoga. I don’t smoke or drink soda; I get enough sleep. I eat organic.

There must, I thought, be a tiny window of influence on the diseases that run in my family, that I can affect through my lifestyle.

Then one morning, I was brushing my teeth when I heard something on TV.

…World Health Organization this morning has classified processed meat, such as bacon and sausage, as carcinogenic, directly involved in causing cancer in humans…

I rushed in, my mouth full of toothpaste, but the segment was over. They had moved on to The 1-second trick to rocking an off-the-shoulder top!

I turned the TV off.

I rinsed my mouth and went straight to my computer. I quickly found a report from the cancer agency of the World Health Organization. After thoroughly reviewing the accumulated scientific literature, experts from ten countries had classified processed meat as a Group 1 carcinogen (the same group as cigarettes, asbestos, and plutonium¹), and red meat as a Group 2 carcinogen.²

I was shocked. Everyone knew hot dogs weren’t health food, but carcinogens?

My first thought was that this was new information. It wasn’t.

On September 24, 1907, the New York Times had run a front-page headline: CANCER INCREASING AMONG MEAT EATERS…On the Other Hand, Italians and Chinese, Practically Vegetarians, Show the Lowest Mortality of All. The results of a two-year, exhaustive study of cancer proved conclusively that diet is a most important factor in the increase of the disease and its death rate.³

This was information from over a century ago. I had been living in low-grade dread for years, believing that my genetics sentenced me to crippling, chronic, and maybe fatal diseases in the years to come. Diet seemed like too easy an answer.

I’d eaten meat since I was a baby, starting with Chicken and Rice baby food. My parents believed meat was an essential part of a healthy diet. That’s what they’d been taught all their lives.

But was this like I’d been smoking my entire childhood? My brain was flooded with questions. Was there a cancer connection with chicken and pork? What about dairy and eggs? Fish? Other diseases? If there’s been a scientific connection between meat and cancer for over 100 years, why weren’t there warning labels on meat by now, like tobacco? Why wasn’t this public knowledge?

I discovered that every 50 grams of processed meat eaten daily raises your risk for colorectal cancer by 18 percent.⁴ Fifty grams is less than two pieces of bacon, or two slices of ham.⁵ I also found that eating meat only 4 times a week increases your cancer risk by 42 percent, according to an Oxford study.⁶

This was crazy. Almost everyone I know eats meat at least four times a week.

I checked out the American Cancer Society website. In several spots they recommend limiting red meat. In their Ingredients for a Healthy Kitchen, however, they counsel stocking up on extra-lean hamburger, ground turkey breast, chicken breast, fish, eggs, cheese, milk, and yogurt.⁷ They provide recipes for dishes like quick-easy-chili with extra-lean ground beef,⁸ and advise people to choose lean meats—look for the words ‘loin’ or ‘round’ in the name.⁹

This would be like the American Lung Association telling you what kind of tobacco to smoke and how to roll cigarettes.

I got on the phone.

Thank you for calling your American Cancer Society, the friendly young man said. My name is Sam. I’m a cancer information specialist. How may I help you today?

Yeah, hi, I said. I was wondering why your website encourages people to eat processed meat, which is a Group 1 carcinogen, the same group as tobacco and asbestos, as well as red meat, which is a Group 2 carcinogen.

There was a short silence.

Let me just place you on a brief hold, Sam said.

It was a brief hold. We got disconnected.

I dialed a different number.

Keegan? I said, when my friend and fellow filmmaker picked up. We have to make another film.

CHAPTER 1

GENETICS: THE WRITING ON THE CELL

When I visited my dad in the hospital, the room was mostly dark. The only light came from the fluorescent bar on the wall. My father was asleep, his skin gray. His hands lay palm up on the hospital blanket. A monitor beeped and I heard laughter from the nurses’ station in the hall.

A wave of helplessness and deep anxiety for my dad washed over me.

I remember thinking, how many years before it’s me lying in that bed?

I feel the same helplessness when I see my aunt or uncle. They both have diabetes. My mom’s dad died of diabetic complications. My aunt is becoming blind.

I’ve always been careful to keep my weight down and not eat too much sugar. But it’s in my genes.

I wondered, though, after the little bit I’d learned about meat and cancer, if there was a larger picture to genetics and disease. I was particularly preoccupied with the diabetes in my family. You’ll get it too…

It was worth looking into.

What I found was remarkable. I turned up study after study showing that eating animal products—meat, dairy, or eggs—significantly increases your risk for developing Type 2 Diabetes.¹

But when I went on the website of the American Diabetes Association (ADA), their Diabetes Meal Plans recommended lean meats, poultry, fish, and non-fat dairy products.² Their recipes included Moroccan Lamb Stew, oven-barbecued chicken, Asian pork chops, barbecued meatballs, and blackened tuna with tangy mustard sauce.³

Maybe I was missing something. The scientific reports linking animal products and diabetes are filled with numbers and language I don’t understand.

Perhaps an expert at the ADA could clarify things for me.

***

With Type 2 Diabetes, there’s an enormous genetic component, Dr. Robert Ratner, Chief Scientific and Medical Officer of the American Diabetes Association, told Keegan and I.

His words hit me in the pit of my stomach.

There’s no question that we’re in the midst of a diabetes epidemic, Dr. Ratner said. "The Centers for Disease Control and Prevention do population-based surveys in which they ask people about diseases, and then follow up with blood tests to confirm it. Their most recent report, in 2014, estimated that 29 million people in the United States have diabetes. Of those, approximately 8 million people do not know they have the disease. It only showed up on the blood test.

We’re seeing an increase in new diagnoses of both Type 1 and Type 2 diabetes in the US and around the world. Worldwide, we’re looking at approximately 350 million people with the disease.

Why are there so many more people with diabetes now? I asked.

It’s unclear why the incidence of Type 1 diabetes is going up, Dr. Ratner answered. With Type 2 diabetes, as I said, genetics plays a huge role. That risk is brought out by the interaction of diet, exercise, environment, genetic propensity—you need all of that together for the disease to occur.

I made a mental note. If the disease requires all those factors, then—maybe?—genetics wasn’t playing such a huge role.

There are two populations of Pima Indians who are virtually genetically identical, Dr. Ratner said, going on. "The ones in central Mexico are subsistence farmers: thin, with virtually no diabetes. The other group lives on an Arizona Indian reservation. They’re obese, with a 50 percent prevalence of diabetes.

Another example, he said, is the case of first, second, and third generation Japanese, starting in Japan, who move to Hawaii, and then to Seattle. You see a progressive increase in the development of Type 2 diabetes the farther they get from Japan, and as more generations pass.

What’s happening in Japan that’s different from Seattle? Keegan asked from behind the camera.

There’s no question that lifestyles are different, Dr. Ratner replied. They’re walking more. Their diet is clearly very different. There’s no question that the Western-type diet seems to correlate with an increased risk of diabetes.

Huh.

Which part of the Western diet is the culprit? I asked.

There are so many potential confounders. There is no such thing as a diabetes diet.

I thought of the recommendations on the ADA website, but said nothing.

More recently, Dr. Ratner said, new devices have been developed for the delivery of insulin, and the ability to monitor glucose in patients without having to go to the doctor’s office. The convenience of treating diabetes has been revolutionary in the last thirty years.

I looked down at my notes. What’s the best way to prevent diabetes?

It’s unclear.

I’ve come across a lot of studies, I said, saying diet is a huge contributor, and you could potentially cure or reverse diabetes with a purely plant-based diet.

Dr. Ratner seemed to stiffen just a tiny bit.

I don’t believe there is sufficient evidence to demonstrate that, he said.

How does a low-fat plant-based diet compare to the ADA diet you recommend?

We don’t recommend a specific diet. We recommend healthy eating.

The one on the website.

"We recommend healthy eating."

I tried again. You have a meal plan, and recommended foods on your website—

They are selections of foods to consider.

If you compare those selections, then, to a plant-based—

No one’s done that study.

I rifled through my papers and pulled one out. "There was one in American Journal of Clinical Nutrition in 2009, I said, reading from it. A 74 week study⁴ comparing a low-fat plant-based diet to the ADA plan in Type 2—"

Dr. Ratner grabbed his coffee mug and swiveled away in his chair. I think we’re done here. I’m not getting into an argument about—

I looked up, startled. No, no. I just want to know if this is true—

Any diet works, he said, turning to face me. He leaned in with his eyebrows raised. Any diet works. If. People. Follow it.

I was a little thrown. But—if it’s not the proper diet—

I’m not going to get into that. He shook his head.

Into diet?

No. If that’s where you want to go with this, I’m sorry, I’m not the person you should be talking to.

Then—who do we talk to about diet? I was completely confused. He had just told me there was no question the Western diet was associated with an increased risk of diabetes.

He looked at me. "You can talk to anybody you want. It sounded like a big FU. We do not advocate a specific diet."

Why not?

Because the data doesn’t exist to support it.

We have data here—

Dr. Ratner stood up abruptly. We’re done.

I looked up at him. I’m sorry?

We’re done. I’m not going to get into that argument with you. He plucked the microphone off his tie.

Why is it an argument? I just have this study here—

There are lots of studies, he interrupted, standing over me. "Lots of studies in the literature. Many of which have never been replicated, or, frankly, are wrong. That’s why we do peer review, okay?"

"The American Journal of Clinical Nutrition isn’t peer-reviewed?"⁵

I don’t know what study you’re referring to, he said, pocketing his phone. In the absence of being able to see that study, I’m not going to comment.

I could show it to you, I said hopefully. I just want to know whether—

I’m sorry, I don’t have time for that. He turned his back and walked out of the room.

I looked over at Keegan behind the camera. He was as dumbfounded as I was. My heart was thumping.

That was bizarre, said Keegan.

After a moment, we packed up our gear in silence. I noticed my hands were shaking.

***

The ancient Greeks believed in three goddesses, more powerful than any others. Sometimes they were depicted as a maiden, a matron, and an old crone.

Three days after a child was born, they would arrive at the cradle to determine the course of the baby’s time on earth. The first goddess spun the thread of life. The second determined the length of the thread. And the third—the most feared, known as the inevitable—cut the life-thread. The baby’s path was fixed from that moment on.

The Greeks called them Moirai. We know them as The Fates.

In 21st century America, not many of us still believe in the three goddesses with their spindle and shears. But we have replaced them with a modern substitute: genetics.

There are diseases and disorders that are 100 percent genetically determined. No matter how or where you live, if you have the genetic combination for these conditions, they will manifest. These include Down Syndrome, sickle-cell anemia, cystic fibrosis, hemophilia, and Huntington’s Disease, a degenerative brain disorder. Every single person with the gene for Huntington’s will eventually develop it.⁶ It may indeed feel, for those with such disorders, that the Fates had woven them into the cloth of life.

But I want to unpack the genetic component of the top causes of death in our country, like heart disease, cancer, stroke, Alzheimer’s, and diabetes,⁷ along with contributing factors like obesity. People often believe their genetic lot is the most powerful influence over whether they’ll fall victim.

I’ve believed that since I was a teenager. I did everything I thought I could to stave off my family’s diabetes, cancer, and heart failure. But deep down, it felt like running away when a monster is chasing you. You have a choice: you can run or stand still. If you stand still, the monster will get you far sooner. If you run, you’ll buy some time, but ultimately—come on, we’re talking about a monster here. It’s going to get you in the end.

I kept going over the interview with Dr. Ratner. He was very emphatic about genetics playing a major part in the development of Type 2 diabetes, but almost everything else he said—before he refused to talk to me—actually contradicted that statement.

He was the one who brought up the Pima Indians, who did or did not develop the disease depending on how they lived. He brought up the Japanese, whose Type 2 diabetes soared when they moved away from Japan and its traditional lifestyle and diet.⁸

Diet, exercise, environment, genetic propensity—you need all of that together for the disease to occur.

There’s no question that the Western-type diet seems to correlate with the increased risk of diabetes.

Those were his statements, not mine. But when I asked him to hone in on how diet might prevent or reverse the disease, I flicked a switch I didn’t even know was there. It shut everything down, and I was left in the dark.

Time to grope around for some lights.

***

When I first heard the news snippet on meat and cancer, I had no idea there was a health revolution brewing all around me. Throughout the country, there’s a growing movement of doctors challenging the conservative teachings that I—and everyone I know—had grown up with.

Keegan and I packed our cameras and hit the road.

Dr. Neal Barnard, a trim man with light brown hair, is president of the Physicians Committee for Responsible Medicine (PCRM), a non-profit organization of 12,000 doctors.⁹ He’s also on the medical faculty at George Washington University. Keegan and I visited him at the PCRM offices in D.C.

I think of genes in two ways, Dr. Barnard told us. "There are dictator genes. Those genes give orders—blue eyes or brown hair—and you don’t have any choice. The genes for diabetes, heart disease, or certain forms of cancer, they’re more like committees giving suggestions. But you’ve got a lot of control over whether those genes ever express themselves.

The vista on diet-related disease is spreading out in a bigger way than we ever imagined. We thought maybe diet affected heart disease and a few cancers. Then there was diabetes. Now it’s also brain disease—not only stroke but also Alzheimer’s. We thought that was entirely due to genes and age. Now we know it’s due, to a very substantial degree, to diet. We’ve got control. Not perfect control, but certainly control we never had before.

Our journey had begun.

Keegan had heard about a bariatric surgeon in Texas named Dr. Garth Davis. In addition to running the Davis Clinic, one of the busiest surgical weight loss clinics in the country, he’s also Head of Bariatric Surgery at one of Houston’s biggest hospitals.

Dr. Davis starred in the TLC show Big Medicine, and wrote a bestselling book in 2008 called The Expert’s Guide to Weight-Loss Surgery. In that book, he recommended eating a high-animal-protein diet. But while following his own advice, he felt sicker and sicker, and got fatter and fatter. He began poring through the scientific literature on nutrition and diet, examining epidemiological, experimental, and prospective cohort studies, analyzing research designs and conclusions, and even went back to 19th century accounts of African eating patterns. He ended up overhauling his previous, very publicly stated beliefs on nutrition.¹⁰

On the flight to Houston to visit Dr. Davis, I looked through my plastic oval window. I could see the plane’s wing, and the bright blanket of clouds beneath us. Next to me, Keegan was reading Dr. Davis’ new book, Proteinaholic, a strong rebuttal to his previous book.

I thought back on our interview with Dr. Barnard. His words made me feel like a prisoner watching the heavy cell door open just a tiny sliver. Was this for real, or was that door going to slam shut again?

We talked with Dr. Davis in an examining room at his clinic. I’d watched Youtube clips of him from Big Medicine, and was surprised to see he looked far more youthful and powerful in person, despite his salt and pepper hair and starched doctor’s coat. In the Big Medicine clips, he looked puffy and tired. He’s now a prize-winning Ironman triathlete.¹¹

In order to get many diseases, two things have to happen, Dr. Davis said. "First, you have a genetic predisposition. Second, something sets that gene in motion. Let’s take Okinawans, from one of the Japanese islands. They’re skinny, they don’t have a lot of cancer, and they’re one of the most long-lived cultures in the world.¹² But if you move an Okinawan to America, they gain weight rapidly. They get heart disease, they get diabetes. In China, they used to think they didn’t have diabetes. Now suddenly they have a huge increase in the disease, and they’re blaming it on Western food, specifically the large amounts of meat."

I found it fascinating that Dr. Davis had essentially given us the same migration-disease model that Dr. Ratner from the ADA had used. But Dr. Davis was following the example through to its conclusion.

We heard something similar from Dr. Caldwell Esselstyn, a celebrated cardiologist who has been practicing medicine for over 40 years. He works at the Cleveland Clinic, rated the best cardiac care center in the country by US News and World Report.¹³ He’s also a former Olympic rowing gold-medalist.

Let’s suppose you were to look at the genetics of the Papua Highlanders, the Tarahumara in Northern Mexico, or the rural Chinese, Dr. Esselstyn said to Keegan and I in his library. "They have different genetics, but there’s no heart disease in these populations. The field of epigenetics is breaking through in spades right now, in which you can actually alter genetic expression. You can turn genes on and off, and by what? By the environment, and perhaps nothing is as powerful as food.

And it’s not just heart disease, Dr. Esselstyn continued. When you look globally, there are certain cultures where breast cancer is much less frequently identified than in the US. Kenya. Rural Japan in the 1950s. Yet, what happened to the Japanese women, when they migrated to the US for the second and third generation, still pure Japanese American? They had the same rates of breast cancer as their Caucasian counterparts.

The World Health Organization (WHO) pinpoints four factors as the main causes of death before the age of 86:

1) poor diet

2) high blood pressure

3) obesity

4) tobacco use.¹⁴

Three of the four are diet-related.

The National Research Council and Institute of Medicine came to the same conclusions, finding that diet and activity patterns—far ahead of tobacco, alcohol, drug abuse, gun violence, and car accidents—are the primary factors behind premature deaths in this country.¹⁵

No more than 10-20 percent of risk for the primary causes of death come from our genes.¹⁶ Only about 5-10 percent of cancer cases are attributable to genetic defects, with the other 90 to 95 percent rooted in lifestyle and environment.¹⁷ Colon cancer, the second most lethal cancer in the country,¹⁸ is the cancer most directly affected by what you eat.¹⁹ According to WHO, 80 percent of all heart disease, stroke, and Type 2 diabetes can be prevented.²⁰

We have known now for decades that the ‘actual’ causes of premature death in the United States are not the diseases on death certificates, but the factors that cause those diseases, Dr. David Katz, director of Yale’s Prevention Research Center, said in Time magazine.²¹

Scientific literature from the mid-1980s shows that eating saturated fat, which is mainly found in animal products like meat, dairy, and eggs, is more strongly associated with death than smoking cigarettes.²²

Think about that!!! I’m not normally a multiple-exclamation-mark kind of guy, but seriously, think about that. If you took your family to a neighborhood cookout, and the dad next door offered you—and your child—a cigarette and a light, how would you react? And yet we accept, with thanks, the glistening beef burgers from that same dad.

What’s the difference between taking the cigarette and the burger? The smell and the taste. The social assumptions. The habits. The lack of knowledge.

People think heart disease, cancer, and diabetes are inherited, not realizing that what they’ve actually inherited are the eating habits of their parents and grandparents.

People are exposed as children to a certain way of eating that they carry into their adulthood. They pass it on to their children. That’s why they develop the same diseases their parents and grandparents may have had before them, but it is not inevitable, Susan Levin, director of nutrition education at PCRM, and a registered dietitian with a specialty in sports nutrition, told us. She’s also an avid runner, and when we interviewed her, she was 39 weeks pregnant. It was poignant to hear Levin talk about how parents influence their children, knowing how close she was to giving birth.

We have much more control over our lives than sometimes we even want, she said. That’s why a lot of people take the medications. They really want to believe, ‘I don’t have control over this. This happened to my parents, so just give me the drugs. I don’t need to change because it’s inevitable.’

I thought of the Greek Fates and particularly the third goddess, the inevitable, standing with her shears over every cradle. Levin is right. The thought of predestination can bring a peculiar comfort to many. It takes away responsibility.

The majority of conditions that kill people in this country, said Levin, are completely preventable for most of us. It’s up to us to take that responsibility and change—change the culture and the epidemics. I think we could do that within a generation.

Dr. Michael Greger is a physician and New York Times bestselling author—an intense, hilarious, and excitable guy with encyclopedic knowledge—who runs the non-profit website NutritionFacts.org. NutritionFacts provides daily nutrition updates collected from the most current medical literature. Dr. Greger and his team read through every issue of every English language nutrition journal in the world—so you don’t have to. Like Dr. Garth Davis, Dr. Greger is a research junkie.

The reason we know cancers like colon cancer are so preventable is because rates differ dramatically around the globe, Dr. Greger tells us. "There can be a 10, 50, 100 fold difference in colon cancer rates, from some of the highest measured in Connecticut, down to the lowest rates in Kampala, Uganda, for example.²³ There are places where colon cancer, our number two cancer killer, is practically non-existent.²⁴ It’s not some genetic predisposition that makes people in Connecticut die from colon cancer while people from Uganda don’t. When you move to a high-risk country, you adopt the risk of the country. It’s not our genes; it’s our environment.

"We can change the expression of our genes—tumor suppressing genes, tumor activating genes—by what we put into our bodies. Even if you’ve been dealt a bad genetic deck, you can reshuffle it with diet.

Tell him about your family history, Keegan prompted me. I did.

Wow, you’re perfect, Dr. Greger said. "People with a family history of disease often throw up their hands: ‘I’ve got bad genes.’ No, these are the people who have to eat exquisitely healthy. Bad diets often run in families. You eat how you were taught to eat. For most Americans, that’s not good news.

"But we can regain our health—by eating the plant-based diets of populations that don’t suffer from these diseases. Much of what we know about diet comes from studies going back to rural Africa and rural China in the 1920s, where Westerners set up missionary hospitals. They saw millions of people, and to their surprise, they weren’t suffering from Western diseases.

There were populations where high blood pressure rates were zero. Heart disease rates were zero. Thousands of autopsies found no heart attacks. It’s not like these Western-trained doctors couldn’t recognize heart attacks. The diseases weren’t present. If you want to avoid them, you have to change your diet.

I love Dr. Greger. Ask him a question and it’s like pressing the ON button for information. He was still talking.

"Nathan Pritikin and other lifestyle medicine pioneers started asking, ‘What if we put people with advanced chronic disease on the diet followed by these populations that don’t get the diseases in the first place? Maybe we could slow it down.’

"Instead, something miraculous happened. The diseases started to reverse."

Prevention, I now believe, is possible. But halting a disease in motion and turning it around? Miracle drugs, maybe, could manage that. Diet, I don’t know. Maybe Dr. Greger was talking about something atypical.

When Keegan and I got back to the West Coast, we visited Dr. Michael Klaper, a tall, lean man with a white beard and bright brown eyes. We first met him when we made our film, Cowspiracy. He’s on staff at the TrueNorth Health Center in Santa Rosa, California, and has been practicing acute care medicine for forty years. For the last thirty, he has focused on diet and lifestyle medicine, trying to keep people out of hospitals and off the operating table.

He greeted us warmly.

What are some of the leading causes of the country’s major diseases? Keegan asked him.

Oh my, Dr. Klaper sighed expressively. "If I could get all my medical colleagues in a room, I would say, ‘Please, I don’t care if you are an internist, a family physician, a rheumatologist, dermatologist, gastroenterologist—pick a medical specialty—Square One is to realize that the vast majority of patients in your waiting room are there because of what they eat.

"The current American diet is based on animal flesh and processed food: saturated fat, denatured animal protein, cholesterol, oils, refined sugars. This food is incredibly toxic to the blood vessels and the immune system, and it flows through our bloodstreams, and our children’s, every four or five hours. The results are predictable. We’re becoming grossly obese, arteries are clogging up. High blood pressure, diabetes, cancers. Autoimmune diseases have direct correlations with the meat and salt in animal products. The vast majority of diseases are created today by what people are eating in the West.

Until that is recognized, Dr. Klaper said, we’re just going to be treating symptoms. We’re not getting to the root cause of disease, and that is the great transgression that the medical profession inadvertently perpetrates on the public.

Dr. Klaper had pinpointed the question circling in my head, growing more compelling with every interview. With this landslide of evidence connecting chronic diseases with eating animal products, why did my doctor, who knows my family’s health history, never once tell me to lay off the meat, dairy, and eggs?

I started off asking, What don’t I know? Now, I began to wonder if I should be asking, What doesn’t my doctor know?

CHAPTER 2

MEDICAL SCHOOL: THE DOCTOR OF THE FUTURE

Thomas Edison, inventor of the light bulb and motion picture camera, said over one hundred years ago, The doctor of the future will give no medicine, but will instruct his patient in the care of the human frame, in diet, and in the cause and prevention of disease.¹

Fast forward to the early years of the 21st century. We live in a brave new world of billion-dollar pharmaceuticals and space age medical procedures. It’s no big deal for surgeons to inflate miniscule balloons inside congested blood vessels, leaving behind a stent (a permanent wire mesh to prop an artery open), or harvest an artery from a patient’s leg, cut through their breastbone, and splice the leg artery around the heart. (We can also suck fat out of your butt and put it in your lips. Now there’s medical progress.)

And yet our rates of chronic disease are smashing through the roof. In 2012, half the US adult population had at least one chronic health condition. One out of four adults had at least two.² Eighty-six percent of health care spending in 2010 covered people with one or more chronic conditions.³ $315.4 billion were allocated to heart disease and stroke.⁴ Cancer, that same year, cost $157 billion.⁵ $245 billion for diabetes.⁶ In 2008, obesity-related causes racked up $147 billion in medical costs.⁷

Drugs, hospitals, and surgeries. Edison’s prediction has not come true. Because doctors cannot teach what they do not know.

Dr. Alan Goldhamer is the founder and head of the TrueNorth Health Center. Unlike many doctors, he attended schools that prioritized nutrition and lifestyle as critical to sustaining and promoting health. This philosophy underpins his whole practice. Since 1984, he has been running TrueNorth, which has helped over 15,000 people recover from chronic conditions, with the help of plant-based nutrition, lifestyle changes, and sometimes medically supervised water or juice fasts.⁸

Learning about diet and lifestyle is an extremely minor part of medical training today, Dr. Goldhamer said to Keegan and I. "Medicine now is about the use of drugs and surgeries to suppress symptoms associated with