• A study conducted in France has concluded that children of fathers who work in the meat trade are at greater risk of developing childhood cancers. 103 The study examined over 200 cases of leukemia diagnosed in the Lyons area, and found that
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a significantly large number of fathers of children with leukemia worked as butchers or in slaughterhouses. The scientists suggest that bovine leukemia virus could be to blame. In another experiment, chimpanzees were fed from birth on milk taken from cows known to be infected with bovine leukemia virus, with the result that two out of six of them died from leukemia. 104 To defend unpleasant experiments such as these, the idea is often advanced that they are necessary in order to improve human health. One is forced to wonder, however, whether "inconvenient" results such as this are acted upon or simply swept aside.
Statistical analyses of human deaths from leukemia and other cancers have shown that people who have close contact with food animals (vets, farmers, butchers) run a significantly higher risk of dying from certain types of cancer than the general population. For example, in a Nebraskan study, it was shown that men who had regular contact with cattle were twice as likely to die from leukemia. 105
In a study from Poland it has been shown that farmers, butchers, and tanners are more likely to develop leukemia than other people. 106 And another Polish study concluded, "It should be inferred that cattle affected with leukemia may, in favoring circumstances, be a factor disposing man to neoplasms [cancer] especially to the proliferation of the lymphatic system, either through longer contact with a sick animal or the longer ingestion of milk and milk products from cows with leukemia. The fact that with a rise in the incidence of leukemia in cattle there also appears an increase in proliferating diseases of the lymphatic system is particularly worthy of attention." 107
A study conducted in Minnesota among leukemia sufferers showed that a surprisingly high number of them were farmers who had regular contact with animals. 108 A similar study conducted in Iowa found a connection between leukemias in humans, cattle density, and the presence of bovine leukemia virus in cows. 109 A study of mortality from leukemia and Hodgkin's disease
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among vets has shown that they run a significantly higher risk of dying from lymphoid cancer than the norm. The vets were in clinical practice, in close contact with food-producing animals, and the authors of the report suggested that a viral cause may be responsible. 110
• A study conducted in France and Switzerland in 1990 reveals that male sufferers from breast cancer (generally rare in men) were most likely to work as butchers. 111
• Like the French study previously mentioned, an Italian study conducted by scientists at the University of Turin has confirmed that the children of butchers are more likely to contract cancer. 112
All this evidence should be considered very seriously, because it has extraordinarily profound implications. "The Food and Drug Administration states that many unanswered questions remain about BLV," says Dr. Virgil Hulse, a physician who spent fifteen years as a milk inspector for the state of California: "Such as transmission, infectiousness, and whether it's a threat to humans. Some of the questions fuelling the controversy are whether pasteurization, which inhibits infection, destroys the aspect of the virus capable of producing cancer. Also, how great is the risk of pasteurized milk being accidentally contaminated with raw milk? If we wipe out BLV, will we see a reduction of those cancers related to fat consumption? Might it be the viruses, and not the fat, that are linked to some human cancers?" 113
How could an animal cancer virus induce the disease in humans? There are several possible ways. One theory suggests that a "helper virus" can form an association with another relatively harmless one, and in the process produce a virus that can induce cancer. An animal virus may not, therefore, directly precipitate the disease in humans, but it may be able to convert otherwise harmless human viruses into killers.
It will certainly be many years before every feature of the complex process of zoonotic carcinogenesis (cancers caused by or transmitted from animals) has been resolved. And there will, no doubt, be many people who will not wish to see these rather dark and disquieting fringes of medical and veterinary knowledge examined too closely.
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But that, of course, is no reason not to ask questions, nor to take prudent defensive measures.
You can see from all this how difficult it is to isolate just one component of the vegetarian diet, and pin an "anticancer" label on it. Once more, it is the totality of the healthy vegetarian diet—the whole thing—which naturally works to reduce disease.
What Else Can You Do?
Vitamin A. Beta-carotene is the form of vitamin A available in plant foods, and is strongly suspected of having cancer-preventive properties (several studies are currently underway to validate this). 1,4 In particular, it is thought to protect people from cancers of the lungs, bladder, larynx, and colon. 115 Most researchers believe that beta-carotene offers more protection from cancer than retinol. It is unlikely to cause toxicity, is a powerful antioxidant, is taken in and used according to the body's needs, and it comes in a "packages," which includes secondary plant constituents—nonnutritive compounds that seem to inhibit the onset and growth of cancers and may be vital to beta-carotene's anticancer action. To obtain beta-carotene, eat any of the fruits and vegetables with a deep, bright green, yellow, or orange coloring. Look for carrots, pumpkin, squash, spinach, broccoli, cantaloupe, sweet potatoes, and papaya. Eat these foods lightly cooked or raw, and organically grown if possible.
Vitamin C. This vitamin helps to minimize the effects of pollutants and carcinogens in your food and environment. In particular, vitamin C seems to block the formation of nitrosamines, which are known to be powerful cancer-causing chemicals (they are particularly associated with cancers of the stomach and esophagus). The good news is that if a vitamin C-rich food is taken at the same time as foods containing nitrates or nitrites, then the production of nitrosamines is greatly reduced. 116 Women with abnormal cervical smear results often have low amounts of vitamin C in their body. 117 This may shed new light on the underlying damage caused by smoking, because it has long been established that women who smoke have higher levels of cervical cancer, and smoking impairs the absorption of vitamin C.
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Vitamin E. This vitamin also has antioxidant properties, and can combat the production of free radicals in your body. It is available in cold-pressed vegetable oils, nuts, seeds, and soy beans.
Selenium. This trace mineral is essential to health, though only required in minute quantities. In America, the National Research Council has recommended a daily intake of 50 to 200 micrograms of selenium for adults (a microgram is one thousandth of a milligram, so 200 micrograms equal 0.2 milligrams). However, one authority, Gerhard Schrauzer, Ph.D., of the University of California, says that 250 to 300 micrograms can protect against most cancers, and that most people consume only about 100 micrograms daily. 118 At higher doses, selenium can be toxic to the human body. Although it is not certain at precisely what level selenium begins to cause adverse effects, it has been found that doses of 900 micrograms (0.9 milligrams) per day can make hair and nails fall out and can affect the nervous system. 119 Selenium works best in conjunction with vitamin E, since both are antioxidants and can increase the production of antibodies by up to thirty times, 120 thereby greatly enhancing your immune response. Together they help to detoxify your body and prevent the formation of free radicals. Selenium is naturally present in the soil, and the quantities available in our food relate to soil levels of selenium where the food was grown. A study undertaken at the University of Tampere, Finland, involved taking blood samples from 21,172 Finnish men. The samples were then frozen. Eleven years after the samples had been taken, 143 of the men had contracted lung cancer. The researchers found that the men who eventually developed lung cancer had less selenium in their blood than those who did not. Overall, it was found that people with the lowest selenium levels were 3.3 times more likely to develop lung cancer than those with high levels. The researchers said their results were "in accord with other studies which strongly suggest that poor selenium nutrition is a highly significant risk factor for lung cancer." 121 In West Germany, a study conducted at the University of Bonn has shown that selenium can protect against the harmful effects of ultraviolet radiation. Blood selenium levels were examined in 101 patients with malignant melanoma (a lethal form of skin cancer) and compared to a control group of healthy people. The skin cancer
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patients showed a significantly lower level of selenium, and the researchers concluded that their results "strongly suggest that sub-optimal selenium nutrition preceded the onset of the disease and may even have contributed to its genesis." 122
Calcium and vitamin D. Calcium may be important in preventing both breast and colon cancer, and it has been suggested that it may reduce the risk of colon cancer by two-thirds when taken with vitamin D. 123 Vitamin D is necessary for the proper absorption of calcium. Your body manufactures this vitamin when sunlight reacts with dehydro-cholesterol, a substance in your skin. Obtain vitamin D either from fortified foods or by ensuring that you have ten minutes of daylight on your face and hands each day. Calcium is available in tofu; dark green, leafy vegetables, such as, spinach, watercress, and parsley; seaweeds; nuts and seeds; dairy foods; molasses, and dried fruits.
Calories. A high-calorie diet may increase your risk of cancer. Cancer seems to be more common in obese people, especially those who are more than 40 percent over their ideal weight. 124 Do your best to keep your weight within recommended limits.
Cabbage. Cruciferous vegetables include cabbage, broccoli, cauliflower, brussels sprouts, and kale, all of which contain secondary plant constituents. 125 These compounds, (i.e., indoles, phenols, flavones) are present in many plant foods, but are particularly abundant in cruciferous vegetables. They are not available in supplement form. Eat a serving of cruciferous vegetables at least three times per week.
CONSTIPATION
What Is It?
Approximately four people out of every ten in Western countries are constipated. In two out of ten, constipation is so severe that laxatives are used regularly. Here's another startling fact: 77 percent of the population only excrete between five and seven stools per week. That's over three-quarters of the total population! On top of that, a further 8 percent of people only pass three to four stools a week. That
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makes 85 percent with sluggish bowel movements. 126 Although constipation, and its unwilling products, are subjects to talk or write jokingly about, there is a serious side, too. As you will see, constipation is a very clear sign that the body is functioning poorly. And when that happens, many serious diseases can follow.
Chronic constipation occurs when you retain your stools in the colon and rectum so that the water they naturally contain is reabsorbed by the body. The stools then harden even more, making defecation more and more difficult. Eventually, your bowel will lose its muscle tone and constipation becomes a way of life. Conventional medicine treats the symptom of constipation and brings about short-term purgative relief through the use of laxatives, most of which fall into these categories:
Bulk laxatives. These substances increase the size of stools and stimulate bowel motion. They include ingredients such as bran and methylcellulose. They are generally safe, if somewhat slow to take effect, although internal obstruction may be caused if insufficient water is taken or if excessive amounts of the substances are consumed.
Irritant laxatives. This group includes such substances as danthron, senna, aloes, rhubarb, and cascara (known as "anthraquinone laxatives") and phenolphthalein and castor oil. They are thought to work by stimulating the intestinal smooth muscle, creating contractions and motion that lead to the passing of a movement, but they also may increase the amount of fluid in the intestines. As with all laxatives, overly frequent use can damage natural bowel functions.
Saline or osmotic laxatives. These substances, which include magnesium sulphate, potassium sodium tartrate, sodium sulphate, lactulose, and magnesium hydroxide, work by attracting water to the bowel and so increase the bulk of its contents, leading to a watery evacuation.
Lubricant laxatives. Lubricant laxatives soften and lubricate the stools, making them easier to pass. Liquid paraffin and sodium dioctyl
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sulphosuccinate are two examples of lubricant laxatives and fecal softeners. Liquid paraffin can dissolve fat-soluble vitamins, and if inhaled it may cause a type of pneumonia.
As you can see, conventional medicine offers us a veritable armory of cathartics with which to goad our sluggish bowels into action. However, you should know that the continuing use/abuse of laxatives can make you dependent on them, thus precipitating further health problems. Although some types of constipation are not diet related (such as drug-induced constipation), most are. It is, therefore, much better to treat the underlying cause, rather than the eventual symptom.
How the Vegetarian Diet Can Help
Dr. Denis Burkitt, a famous advocate of dietary fiber, performed a classic experiment that revealed just how effective the vegetarian diet can be at preventing constipation. 127 He carefully collected information from various populations concerning the size of their stools, the average time it took food to pass all the way through their bodies, and the types of diets they ate. You can see some of his results in Figure 4.12.
His findings were extremely revealing. From left to right on the chart, the first group, with the shortest stool transit time, were schoolchildren living in rural Africa, who ate an unrefined diet. Their food positively shot through their insides, taking on average less than a day and a half from one end to the other. Next came another group of Africans, this time adults living in villages in Uganda. Once again, their food hardly touched the sides on the way down.
But it is the next group that is so interesting from our point of view. This consisted of ordinary vegetarians living in the United Kingdom. Despite enormous differences in environment and food availability, the Western vegetarians' diet came close to equaling the African results.
The next group on the chart consisted of nurses living and working in southern India. Once again, their diet tended to be meat-free, and their transit times were only slightly longer than the U.K. vegetarians.
The really big jump comes with the next group on the graph— labeled schoolchildren—with nearly twice as long a transit time as any
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African African U.K. Nurses U.K. U.K.
rural rural non (from school naval
children villagers meat southern children personnel eaters India)
Figure 4.12. The Western way of toilet straining.
of the preceding ones. This group was drawn from children at a boarding school in the U.K., who ate a refined diet typical of institutionalized catering—greasy, meat dominated, and low in natural fiber. And the next group is even worse—naval ratings and their wives, all shore based in the U.K. This group had a mean transit time of 83.4 hours, and the longest time was 144 hours! That's 6 whole days for the food to hang around someone's intestines!
This study revealed something else, too. You might suppose that small stools would whiz through the system quickly, but you'd be wrong. For Dr. Burkitt found that the larger the stool, the faster it was processed. So, for example, the mean weight of stools passed by naval ratings was a mere 104 grams. On the other hand, the mean weight for rural Ugandan villagers was more than four times as heavy. This is also very significant, because stool weights of below 150 grams a day denote an increased risk of bowel cancer. 128 Somewhere in the middle
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came the U.K. vegetarians, with a mean weight of 225 grams, who compare very favorably with South African schoolchildren (275 grams) and Indian nurses (155 grams).
This information is crucial to our understanding of the importance of a diet high in natural fiber. Further evidence has shown that, without exception, countries that have a refined diet in which meat is predominant face a whole range of diseases that the so-called "less developed" countries rarely see. Some of these western plagues are:
• Appendicitis. The commonest abdominal emergency in the West. Over 300,000 appendixes are removed every year in the United States alone. It has now been shown that a low-fiber diet makes the risk of suffering appendicitis much greater.
• Diverticular disease. Thirty percent of all people over forty-five years have symptoms of this.
• Cancer of the large bowel. One of the commonest causes of death from cancer in the West.
All these diseases were comparatively rare in the West until the beginning of the twentieth century. Then the amount of animal fat in the diet began to steadily increase, and the amount of natural fiber began to decrease. Figure 4.13 shows how the American diet has changed in less than 100 years.
One hundred years ago, meat, fat, and sugar between them contributed only 15 percent of the total number of calories in an average diet. Today, the figure is nearer 60 percent. Perhaps the biggest change in the diet has been the tremendous fall in the quantity of cereal fiber, which dropped by 90 percent. Most scientists now accept that there is a definite connection between the increase in modern diseases and the radical change in our eating patterns. Dr. Burkitt explained:
There are basically two types of fiber, insoluble fiber and water-soluble fiber. The classic insoluble fiber is wheat fiber, with bran and all the bran products. That is highly effective for combating constipation, increasing stool weight, and preventing things like
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Figure 4.13. How fiber fell from favor.
hemorrhoids and diverticular diseases. It's very good for the guts. But it does almost nothing for what we call the "metabolic diseases" associated with lack of fiber, particularly diabetes and coronary heart disease. Now soluble fiber, on the other hand, does have an effect on combating constipation, but it also has an effect on lowering raised serum lipid [i.e. fats in your blood] levels, and also on glucose tolerance, so that it has a profoundly beneficial effect on diabetes. Now, as to how this fiber works in lowering the blood lipids, there are many suggestions. It affects bile acids and so on, but the main way in which soluble fiber is beneficial for diabetes is that it enormously slows down the absorption of energy from the gut. So instead of all the energy being absorbed, a high-fiber product makes the intestinal content into a sort of a gel, so that the energy is only absorbed into the circulation very slowly, and so you don't have great and sudden demands on insulin, and so on.
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The scope of diseases that Dr. Burkitt mentions is quite breathtaking. Suddenly, instead of merely being a useful preventive measure to ward off constipation, it seems as if fiber (in all its many natural forms) lies at the heart of healthy living. Once regarded as revolutionary, Dr. Burkitt's views on the importance of fiber are now universally accepted. Actually, it is almost impossible to overstate the huge range of diseases to which our drastic change in eating patterns has contributed. Colon cancer, for example, appears to be due to carcinogens created in the colon itself 129 —which can be negatively influenced by consuming a high level of saturated fat in the diet, and positively influenced by a good consumption of dietary fiber. High-fiber diets have also been shown to reduce the incidence of breast, uterine, and ovarian cancer. Experts at the U.S. Department of Health and Human Services estimate that if Americans ate more fiber and less fat, 20,000 deaths from cancer could be avoided every year. 130
It is barely possible to be vegetarian and not eat a diet high in natural forms of fiber. But you'd have to work very hard to do so. You'd have to eat a diet composed exclusively of junk food—chocolate, ice cream, sweets, and so on—and you'd have to punctiliously avoid contact with anything remotely plantlike. In reality, both vegetarians and vegans can't help but get lashings of dietary fiber in their everyday diets, which accounts for their lack of constipation. By the same token, it is barely possible to be a meat eater and have the same high intake of fiber as vegetarians. But again, you'd have to work very hard at it. Meat is a dense food and fills you up quickly (scientists term this "satiety"), and so meat eaters have neither the room nor the appetite to eat significant quantities of food with fiber (meat, of course, contains none). Figure 4.14 shows how, in the real world, various diets compare in fiber intake.
Studies confirm what common sense suggests. In Britain, scientists measured the actual fiber content of daily food intake for meat eaters, vegetarians, and vegans, and found that the meat eaters did worst of all (a meager 23 grams a day). Next came the vegetarians (37 grams) and at the top of the league came the vegans (47 grams)—twice as much as meat eaters. 131
Fiber intake varies from one country to another, depending on the supply of fruit and vegetables, and on the time of year, and methods
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Meat eaters Vegetarians Vegans
Figure 4.14. Vegans get high on fiber: fiber intake compared.
of analyzing fiber intake vary as well. But the all-important difference between the fiber intake of vegetarians and meat eaters is usually constant. In America, another study found that meat eaters were consuming just 12 grams of dietary fiber per day, compared to 28 grams for vegetarians. 132 In Sweden, a similar experiment found that vegans consume three times as much fiber as meat eaters. 133
One question that is sometimes asked is: Can you consume too much fiber? It has been suggested that fiber may have undesirable nutritional effects—that the phytate it contains, for example, may prevent other nutrients from being absorbed. Although this may be demonstrated in the laboratory, in practice it looks as if this should be the least of our worries. Eating a good, nutritious, plant-based diet, as described on page 288-89, provides a naturally high level of both fiber and other nutrients. This is confirmed by a careful analysis of vegetarians' diets performed in Israel. 134 The scientists found that the intake of iron and magnesium was significantly higher in vegetarians compared to meat eaters, and they concluded that a long-term vegetarian diet does not lead to mineral deficiencies. Another scientific paper examined the benefits of dietary fiber in 1987, and pointed out that "vegetarians routinely consume 40 to 50 grams dietary fiber daily
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without ill effect." 135 A painstaking examination of the effect of dietary fiber confirms these same findings. In this study, the participants were divided into three categories: a group of 68 people who regularly supplemented their diet with an average of 3 tablespoons of bran a day for a year, 43 "controls" who didn't consume bran supplements, and 20 vegetarians who had a very high fiber consumption for many years. Then the scientists carefully measured the blood level of nutrients in all three groups, including serum iron, total iron binding capacity, calcium, phosphorus, zinc, and magnesium. In their own words: "We evaluated the hypothesis that a healthy population taking a high-fiber diet may develop deficiencies of various minerals and nutrients. . . . There was no correlation between the amount of bran consumed and the blood level of nutrients. The fiber consumption of the vegetarians was very high, more than three times that of the controls. Our study indicates that a moderately or even extremely high consumption of fiber for a long time does not by itself cause mineral or nutrient deficiencies in a western type population." 136
These findings have since been confirmed by an American study, which also concluded, "The higher level of fiber intake did not appear to affect mineral utilization by the vegetarians." 137 If any group were to be vulnerable to this effect, it would probably be infants. Comments Dr. Gill Langley, "It has been speculated . . . that a vegan diet may not be suitable for infants and small children. In fact it is easy to ensure that infants eat enough suitably prepared high-energy foods such as beans, grains and nuts." 138
What Else Can You Do?
Here are a few further suggestions for the natural relief of constipation:
Beet juice. Either bottled or freshly juiced, it is a very useful, short-term natural stool softener and laxative.
High-Fiber Salad. This salad really has get up and go! Ingredients: Canned kidney beans, carrots, beets, cabbage, watercress, broccoli, potatoes, tofu, sunflower seeds, almonds, pumpkin seeds; plus any seasonal vegetables, including winter roots. Pick any six from these
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twelve! There's no need for lettuce, but make it a romaine if you want it: it's got some flavor and it won't go limp. Next, get a really large bowl. Cube the potatoes and lightly steam them and the broccoli. Roast the pumpkin seeds. Cube the tofu. Grate the raw carrots and beets (don't slice). Thinly shred the cabbage. Finely chop the watercress. Wash and roughly chop the lettuce, don't forget the sunflower seeds and almonds. All this is quick to do, but get a food processor if you want to speed it up even more. Now prepare your favorite dressing. Two suggestions: olive oil, cider vinegar, and French mustard (real French mustard, please—no appalling English substitutes). Or, for the most unusual dressing you've ever tasted—try this and you'll never use anything else—buy some powdered black salt from an Indian market. Add 2 teaspoonfuls to oil and cider vinegar, and shake thoroughly until dissolved. Finally, place the lettuce in the bottom and round the side of the bowl, if desired. Mix the other ingredients together and put them on top. Pour on the dressing. One serving of a salad like this will give you a third of your total daily requirement of protein, almost twice your vitamin A requirement, all your vitamin C, and half your iron and fiber. It's so good you'll want to eat it every day! Tofu and, even nicer, marinated tofu are available in health food stores.
Take your time. Set aside half an hour a day to do your business—yes, literally: you can take a phone in there with you if you want, or at least read the paper. Never suppress an urge to go—this is giving your body entiiely the wrong message. If you can do some simple exercise just before going—stretching or yoga is good—this will help.
Colonic irrigation. This can provide you with an internal spring cleaning, and set up your bowels so that you're starting all over again with a nice, clean intestinal passage. Much more natural and pleasant than an enema, colonic irrigation is nothing more complicated or sinister than an internal bath to remove poisons, gases, fecal matter, and mucus deposits. Sterilized equipment with an inlet and outlet attachment is used to flush filtered water through the rectum, into the colon and out again, taking the waste products with it. Unlike regular use of laxatives, it is not habit forming!
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DIABETES
What Is It?
Diabetes mellitus is a disorder in which the body is unable to control the amount of sugar in the blood, because the mechanism that converts sugar to energy is no longer functioning properly. 139 It is a disease of the Western world, brought about by both genetic and environmental factors. An estimated 30 million people are thought to suffer from it worldwide.
Normally, the food you eat is gradually broken down and converted to glucose (blood sugar), the source of energy for all your body's functions. The conversion of glucose into energy requires insulin, a hormone produced in the pancreas. Insulin is released into your system in order to control the level of glucose in your blood, especially to prevent your blood sugar level from climbing too high. However, in diabetics, there is either a shortage of insulin or the available insulin does not function as it should. The result is that glucose is not converted into energy, but builds up in the blood and eventually spills over into your urine. This is often one of the first signs of diabetes.
Though there is an abundance of glucose in your blood, the body is still deprived of the energy it needs (because the glucose has not been converted to energy), and so the liver begins to produce yet more glucose to meet demands. Shortly, your body's stores of fat and protein begin to break down in another attempt to supply more glucose. The resulting weight loss is often another sign of diabetes. Thus begins a chain of events within your body that can eventually cause severe health problems, even death. In the U.K. alone, approximately 20,000 people die prematurely each year from diabetes-related problems. 140 There are two main classifications:
Maturity-onset diabetes; non-insulin dependent. "Overfed, overweight and underactive." That is a common description of many, but not all, adults who develop diabetes in their middle years. Maturity-onset diabetics experience the basic symptoms of thirst, fatigue, hunger, and frequent urination. However, their health may improve by losing weight, increasing their level of exercise, and monitoring their food
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intake to avoid foods high in calories, fats, and sugar. In some people, diabetic symptoms can actually disappear following a strict regime of dietary control and exercise. Others must live the rest of their lives with the precautions, medications, and attention to diet that have for so long been associated with the disorder. In maturity-onset diabetes, the adult need not become insulin dependent.
Juvenile-onset diabetes; insulin dependent. Although a person of any age may develop diabetes, those who develop it under the age of forty years are most likely to suffer the more severe, insulin-dependent form. Children who develop diabetes are almost always insulin dependent. The insulin-dependent diabetic produces very little or no insulin and so relies on insulin injections. Without a supply of insulin, he would not survive. Before the discovery of insulin, diabetes was considered to be invariably fatal, and most patients died within a short time of its diagnosis. Diabetes can be treated effectively today, although it does increase the risk of suffering other serious illnesses, such as cardiovascular disease, eye disorders, gangrene and other circulatory problems, nerve and muscle problems, and an increased susceptibility to ordinary infections.
Diabetes is a serious disorder, and unfortunately, its incidence is increasing. The number of children diagnosed as diabetic has doubled in the past twenty years, and this appears to be a worldwide trend. Yet there are simple, effective steps that may prevent the onset of diabetes or minimize its erosion of your health if you already have it.
How the Vegetarian Diet Can Help
According to a report submitted by Diabetes Epidemiology Research International (DERI) to the British Medical Journal, between 60 and 95 percent of cases of insulin-dependent diabetes can be prevented. 141 The DERI scientists believe that environmental factors are largely responsible for the increase in diabetes, claiming that genetic factors could not account for such great increases over such a very short period of time. Of the possible environmental causes, diet is perhaps the most significant and certainly one over which we have control.
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We also know that diabetics can benefit from a high-fiber vegetarian diet. A study carried out at the Veterans Administration Medical Center in Lexington, Kentucky, compared two diets for the treatment of nonobese diabetic men, all of whom required insulin therapy. 142 The "control" diet provided 20 grams per day of plant fiber—an average amount in a Western meat-centered diet. The other diet included over three times as much fiber— 65 grams per day. The researchers found that the men on high fiber, high carbohydrate diets needed 73 percent less insulin therapy than those on ordinary diets—quite a remarkable reduction.
Further, it seems that the same dietary measures used in prevention of diabetes can be used with great success in treatment. There have been several clues pointing to this possibility. For instance, Nauru, a remote island in the Pacific, had never had any cases of diabetes until it suddenly became rich and began to import American-style fast food. Now, more than 40 percent of its population over the age of twenty have diabetes! Similarly, diabetes is noticeably rare in parts of Africa and China where the traditional diet is intact and free of Western influence. So what are the dietary influences that can prevent or treat diabetes?
The American Diabetes Association suggests that diabetics eat a diet in which carbohydrates make up about 60 percent of total calorie intake, these carbohydrates to be mostly unrefined, complex and high in fiber. 143 Fat intake should total less than 30 percent of calories consumed, with an emphasis on reducing saturated fats and cholesterol, replacing them with monounsaturated fats such as olive oil. Protein intake should be moderate.
The fact is, diabetes is more common among meat-eating people than non-meat eaters. Meat eating increases consumption of saturated fats, which may affect insulin sensitivity. Also, the N-nitroso compounds in meat may actually be a trigger to the development of diabetes.
Some very significant research from the School of Public Health at the University of Minnesota reveals how we can reduce our risk of contracting diabetes. 144 They started a massive study of the subject in 1960, which lasted for twenty-one years and involved 25,698 adult Americans. They belonged to the Seventh-Day Adventist church, a
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group of people who are often used by scientists investigating the vegetarian diet, because half of them never eat meat.
The results of this investigation showed that people on meat-free diets had a substantially reduced risk (45 percent) of contracting diabetes when compared to the population as a whole. They also found that people who consumed meat ran over twice the risk of dying from a diabetes-related cause. The correlation between meat consumption and diabetes was found to be particularly strong in males. The study was carefully designed to eliminate confusion arising from confounding factors, such as over- or underweight, other dietary habits, or amount of physical activity. The results are summarized in Figure 4.15.
You can see that there is, of course, a striking difference between
Ages 70-89
Ages 50-69
Ages 30-49
Total
Females
Males
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100
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300
Standardized mortality ratio ■ Expected
□ Observed
Figure 4.15. Deaths from diabetes among Seventh-Day Adventists: what was expected and what really happened.
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the number of people who were expected to die ("Expected") and the number of people who actually died ("Observed"). 2>ut the study went even further than this: By analyzing death certificates over the period under study, it was possible to assess the increased risk of dying from a diabetic illness for those who consumed meat. Figure 4.16 shows how it looks graphically.
This shows that including any meat in the diet increases the risk, on average, by 1.8 times. For light meat eaters (people who eat meat only once or twice per week), the relative risk compared to a non-meat eater is 1.4 times. But for heavy meat eaters—those who consume it six or more times a week—the risk rises steeply to 3.8 times.
Why should this be so? One explanation may be that diabetics are particularly vulnerable to high levels of fat in their blood, and meat is a prime source of saturated fat. There may be an associated problem with excess protein consumption, too. Several clinical studies have shown that a low-protein diet along with good blood glucose control can help slow the decline in kidney function that diabetics may expe-
rience.
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Figure 4.16. Frequency of meat consumption and the risk of diabetes mortality.
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What Else Can You Do?
• It seems that babies who are breastfed early in life may be less prone to developing diabetes, whereas children given cow's milk appear to be more likely to suffer from it in later life. 146 A recent study examined international milk consumption patterns, and found a strong correlation with the incidence of insulin-dependent diabetes. "The study raises the possibility that when diabetes runs in families, parents may be able to protect their children by eliminating dairy products during the formative first nine months or so after birth," reported The Associated Press. "If true, we should be able to do something to prevent diabetes altogether," commented Dr. Hans-Michael Dosch, senior author of the study at the Hospital for Sick Children in Toronto. This study suggests that milk proteins cause an autoimmune reaction in which the body mistakenly attacks its own insulin-producing cells.
• Coffee raises the concentration of sugar in the blood. As this is the major symptom of diabetes, coffee consumption may have serious implications for diabetics and potential diabetics alike. If you drink large amounts of coffee while pregnant, your children will become more susceptible to diabetes. 147
• Diabetics are commonly lacking in B 6 , which is vital for insulin production. So give preference to foods in your diet that are rich in vitamin B 6 —oat bran and oat germ, hummus, avocados, bananas, brewers yeast, yeast extract, brown rice, parsley, spinach, and other green, leafy vegetables, molasses, and whole grains.
• Vitamin C is needed to metabolize insulin and glucose; a deficiency can lead to cell degeneration in the pancreas, where insulin is produced. Eat plenty of citrus fruit, alfalfa sprouts, and vegetables such as potato, green pepper, and broccoli.
• Diabetics often have a deficiency of the trace mineral chromium and can benefit from supplementation, with elderly and non-insulin dependent diabetics responding particularly well. Chromium acts with insulin to transport glucose through cell walls. Highly processed foods always have reduced levels of chromium, and years of eating such foods can invite the
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onset of maturity-onset diabetes. A diet rich in chromium may prevent this. Eat plenty of wheat germ, brewer's yeast, whole grains, and corn oil.
• Zinc plays a crucial role in the synthesis and storage of insulin in the pancreas. It is a mineral that many of us, not just diabetics, are continually short of. Eat mushrooms, sunflower and pumpkin seeds, brewer's yeast, and soy beans to boost your zinc intake.
• Foods rich in magnesium may help to prevent retinopathy, a deterioration of the retina that is a real threat to diabetics. Foods rich in magnesium include nuts, whole grains, dark green vegetables, and molasses.
• Although there may be a genetic component in diabetes, obesity is very strongly implicated in its development. In Japan almost all sumo wrestlers become diabetic before they are thirty-five years old, and it is strongly suspected that this is induced by the amazingly high-fat diet they are given.
ECZEMA AND PSORIASIS
What Are They?
Most of us are familiar with the red, scaly, often painful skin that typifies psoriasis and eczema. Both are chronic, noncontagious skin disorders that affect people of all ages. The joints, scalp, back, chest, bottom, hands and legs, and in acute cases, virtually the whole body, can all be affected. Both conditions can be brought on by allergy, stress, anxiety, viruses, flu, exhaustion, or injury—especially if you have a history of either disorder in the family. Rather than accept the problem as inevitable, however, there are dietary changes that can help to minimize or solve these skin problems.
How the Vegetarian Diet Can Help
A poorly functioning digestive system results in the proliferation of various toxins within the gut, some of which may contribute to the development of psoriasis and eczema. 148 Adopting a dairy- and gluten-free diet for at least two to three weeks is certainly worth trying to determine whether your skin problem is aggravated by these food
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groups. In addition, there are several other dietary steps you may take to improve digestion and therefore prevent or minimize your skin problem.
What Else Can You Do?
• Adopt a low-sugar or even a sugar-free diet to prevent an overgrowth of the Candida albicans yeast in your gut. This yeast is normally present in a healthy person, but when present to excess, can cause disease or reduced immunity. Psoriasis is particularly responsive to a reduction in your sugar intake, and a few days or weeks on a sugar-free diet (sometimes called an antifungal diet) may improve your condition. 149 Remember, sugar includes honey, molasses, concentrated fruit juices, and syrups.
• In some people, a deficiency in the B complex of vitamins can hinder the proper metabolism of fats and proteins and problems such as psoriasis and eczema can result. To correct a deficiency, you may take a B complex supplement daily. Simply ensure that your supplement includes the whole range of B vitamins because they work best when taken as a group. The B vitamins are essential to the health of skin, mucous membranes, and nerves. In fact, as stress is so often a trigger for eczema and psoriasis, a sufficiency of the B complex may help prevent an attack by reducing the initial effects of stress on your body. Foods especially rich in the B complex are yeasts, such as brewer's or nutritional yeast, and whole grains. Legumes (peas, beans, lentils) and seeds are also useful sources. Ensure that you have a serving of each of these foods in your diet each day.
• Gamma-linolenic acid is a substance that we produce in our bodies. Some people, however, do not produce enough and are more likely to suffer from eczema as a result. A bowl of porridge each day is a good source of gamma-linolenic acid, 150 as is a supplement in the form of evening primrose oil. 151
• Omega-3 fatty acids reduce the itching and scaling of eczema and psoriasis in many people. 152 Sources of omega-3 fatty acids include flaxseed and soy oils.
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• Selenium and vitamin E are both antioxidants and work together to preserve and promote healthy metabolic processes. Of particular importance to sufferers of eczema and psoriasis, this combination can retard the oxidation of essential fatty acids, which are so crucial to healthy skin. Selenium is a mineral found in whole grains, especially the bran and germ, and vegetables such as onions, celery, cabbage, and broccoli. Vitamin E is abundant in the cold-pressed vegetable oils, in soybeans and in all raw nuts and seeds. Supplements are also available.
• Increase your intake of dietary fiber. Start by altering your diet to include an abundance of fresh fruit and vegetables as well as 2 to 3 servings daily of whole, unprocessed grains.
• Boost your intake of folic acid as some psoriasis sufferers have been shown to have low blood levels of folic acid. 153 Folic acid is found in green, leafy vegetables and brewer's yeast. Supplements are also available.
• Zinc is essential for the production of hydrochloric acid in your stomach, a shortage of which produces digestive problems that can lead to eczema or psoriasis. Zinc is found in whole grains, pumpkin seeds, and brewer's yeast. It may also be taken in supplement form.
• Vitamin A is necessary for the health of all body tissue, especially the skin and mucous membranes. Skin problems such as eczema and psoriasis can be one sign of deficiency and may respond well to increased intakes of vitamin A or carotene, the vegetable substance that your body converts to vitamin A. To boost your intake of vitamin A, eat plenty of carotene-rich foods, including dark green, leafy vegetables, such as spinach, and vegetables of a dark orange color, such as carrots and pumpkin.
• Some people's eczema or psoriasis is an allergic response. If you suspect this might be true for you, try amending your diet in these ways: Eat only fresh, organic produce to avoid chemical residues and unnecessary additives. Eliminate the foods that most commonly cause an allergic response. These include dairy products, eggs, fish, peanuts and soybeans, chicken, citrus, tomato, and corn. 154
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Moderately high alcohol consumption can aggravate psoriasis. A Finnish study concluded that men who consumed 5 or more units of alcohol per day were likely to suffer a worsening of their condition. 155 Try keeping your alcohol intake to the recommended 21 units per week for men, 14 units per week for women.
GALLSTONES
What Are They?
Gallstones are more common among women than men—25 percent of all women and 10 percent of all men will develop gallstones before they are sixty years old. This is how they occur: the liver secretes bile, a substance that is high in cholesterol (which literally means "solid bile" in Greek), and is stored in the gallbladder. Lecithin (found in soybeans and corn) and bile salts together help to keep the cholesterol dissolved in the bile. However, if the level of cholesterol becomes so high that no more can be dissolved, then it begins to precipitate, and gallstones are the result. Stones vary considerably in size. The largest reported stone was almost seven inches in diameter, but that is very rare. Most are between one-eighth and three-quarters of an inch. When the gallbladder contracts to release bile, a stone may shoot up and plug the opening of the cystic duct. Then, no matter how hard the gallbladder tries to empty itself, bile cannot flow out. The result is intense pain in the upper abdomen, which increases until, after several hours, the stone falls back into the gallbladder, ending the attack. About half of all those people with gallstones feel no symptoms. But for those who do, the suffering can be intense. It's like "being kicked in the guts by a horse—all the time," as one sufferer has described it. Gallstones can also lead to infection, resulting in inflammation of the gallbladder, colic, peritonitis, gangrene of the gallbladder, and jaundice. As an indication of the prevalence of this condition, it is surprising to discover that over one million Americans are diagnosed with gallstones every year, and in half of these cases, the symptoms are so severe that their gallbladders are surgically removed. 156
As the Western diet has changed, so has the incidence of gallstones, quadrupling since 1940 in many areas. Significantly, Asians and rural
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Africans, who traditionally consume a low-fat, high-fiber diet, suffer very little from them, and only humans and domesticated animals experience them—wild animals do not. All this strongly suggests that the problem is connected with our modern, Western way of eating.
How the Vegetarian Diet Can Help
In an experiment carried out in Oxford, England, two groups of women were compared to see if their diets might have any influence on the occurrence of gallstones. 157 The first group, consisting of 632 meat-eating women, were selected at random. The second group consisted of 130 women who did not eat meat, and had a diet naturally higher in fiber. All the women were thoroughly examined, using ultrasound detection techniques, for gallstones. The experimenters found that the meat eaters were two and a half times more likely to develop gallstones than the non-meat eaters. The scientists concluded that the low-fat, high-fiber diet of the vegetarian women gave them protection.
Building on this study, the scientists then undertook a further investigation of 121 nonvegetarian women suffering from gallstones, who were then age-matched with other nonvegetarian women without gallstones. 158 The aim was to find out if there was any particular factor in the diets of the women with gallstones that made them more prone to suffer—for example, did they eat more fat? After analyzing the diets of both groups, the scientists found out that there was actually very little difference between the groups in terms of their nutrient intake. They concluded, "This may indicate the existence of a threshold effect where virtually all non-vegetarian women in affluent societies have a diet high in saturated fat, animal protein, and simple sugar to the extent that it is not possible to distinguish between cases and controls." In other words, only vegetarian (and vegan) diets are sufficiently low in saturated fat, and high in fiber, to result in a lower incidence of gallstones.
What Else Can You Do?
• If you are obese you are four times more likely to suffer from stones. But a word of warning—rapid weight loss can actually increase your risk of suffering from gallstones. Obese people who lose a lot of weight on very low-calorie diets are quite
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likely to form stones. Once the weight has been lost, however, and relatively normal eating patterns are restored, the stones may dissolve of their own accord. This, and all other treatments, should naturally be supervised by a doctor.
• Fatty foods are known to stimulate gallbladder contractions, which can cause a painful gallstone attack. So consider trying a reduced-fat diet. Also, consuming smaller, more frequent meals may help limit gallbladder contractions and gallstone attacks.
• Research suggests that aspirin can inhibit substances that may cause cholesterol to crystallize into stones. 159 It could therefore prevent gallstones in obese people during weight loss; or halt the recurrence in people who had their stones dissolved with drugs.
• Taking estrogen or oral contraceptives can increase the amount of cholesterol in your bile fluid and thus the chances of having gallstones. 160 At least three studies have found an increased risk of gall bladder disease among women who use oral contraceptives.
• Recently, there has been speculation that a diet high in soluble fiber might increase the solubility of cholesterol in the bile, and so prevent, and perhaps even reverse, the formation of gallstones. Good sources of soluble fiber include oat bran, pectin, and beans.
• And finally, a word of warning: the so-called olive-oil cure, which involves fasting for three days and then drinking a mug of olive oil and lemon juice to make the gallbladder contract and push through extremely small stones, can be dangerous. If larger stones are ejected in this way, they could stick in the bile duct, causing jaundice, infection, and a possible medical emergency.
HEART DISEASE
The Size of the Problem
You may be shocked to learn that the first clinical account of someone suffering a heart attack was only recorded as recently as 1912. Until then, it seems that heart attacks were so rare they just weren't written about or recorded. Today, heart disease is the commonest
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cause of death in the Western world. Within the past century, an ominous change has occurred in our lifestyles—a change that has made a once rare and unusual form of death the most common.
What Makes You Tick?
Every living cell in your body has a specific job to do, and in order that each cell may do its job well, it must somehow take in essential products and put out waste material. To meet this requirement, the cells of your body need a reliable transport system that will perform both deliveries and removals. The circulation of blood is such a system. It is called the cardiovascular system because it is structured around the heart ("cardio") and the blood vessels ("vascular") and all the functions included in the relationship between them. With almost unbelievable speed and efficiency, your blood is able to maintain the health of every living cell in your body by supplying it with nutrients and oxygen specific to its needs, and then removing waste material and carbon dioxide as the nutrients and oxygen are utilized.
Blood is composed of red cells, white cells, and platelets suspended in plasma. If you've ever made a salad dressing from vinegar, oil, and a few herbs you'll understand the idea of suspension. When you stir the mixture vigorously, it changes in consistency and, temporarily at least, the oil, vinegar, and herbs are evenly distributed, making a smooth emulsion. Blood is, for the sake of analogy only, a similar mixture. All four components—plasma, platelets, and red and white cells—are present in measured and changing proportions to make healthy blood.
Plasma. If any substance on earth could be called "primordial soup," it would have to be plasma. To make it, take several liters of water and add microscopic portions of several dozen compounds, such as amino acids, hormones, antibodies, "tissue salts" (e.g., sodium, potassium, calcium, and chloride), and proteins (e.g., albumin, globulin, and fibrinogen). These nutrients are transferred to your needy cells in exchange for waste material for eventual excretion. Here's how: Every cell in your body is surrounded by a plasmalike liquid called "tissue fluid." This fluid gets right up next to the cell, every cell, and removes any waste material that the cell generates as it functions. This waste is
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transferred through the tissue fluid to the plasma and, at this point, is exchanged for whichever of the compounds in the plasma the needy cell requires. These compounds are again transferred from the plasma, through the tissue fluid, to the waiting body cell. This whole cycle happens about 100 times faster than it took you to read about it!
Red Blood Cells. These cells (also called "erythrocytes") are suspended in your plasma. They are red because they contain a red pigment, called hemoglobin, which has a little bit of iron in its center. However, hemoglobin does more than color your blood red: it is the aspect of each red blood cell that enables that cell to carry oxygen and transfer it, eventually, to your body tissues. In environments where there is a high concentration of oxygen, such as in your lungs, hemoglobin actually combines with oxygen. Then, when that red blood cell moves into an area where the concentration of oxygen is low, such as tissue in your limbs, it releases its oxygen. In other words, the oxygen is transferred from the red blood cell to the needy tissues.
White Blood Cells. Also called "leucocytes," these cells are much larger in size than the red blood cells, but there is only one white cell to every 500 or 600 red, depending on where they are measured in your body. The white blood cells come in three forms, each with its distinct function; their collective purpose is to destroy or protect you from foreign organisms such as viruses and bacteria. So next time you cut your finger, give a special thought to those white blood cells that are rapidly gathering at the site to carry off dead tissue and destroy invading bacteria. And during the next cold or bout of flu you fall victim to, trust your white blood cells to do battle. It's what they are there for.
Platelets. These are tiny cells that are present to help in the process of clotting. They are necessary in order for fibrinogen (a protein in your plasma) to convert to fibrin. Fibrin forms fine threads, which surround the blood cells and then contract to form them into an ever more solid mass—a blood clot.
The average man has 5 to 6 liters of blood in his body at any one time; the average woman has 4 to 5 liters. In order for this wonderful liquid
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to do its work, however, it needs to move around the body, to circulate. Your body achieves circulation of the blood in a fairly mechanical way using a pump, a network of channels or conduits, and a variety of valves. Using this equipment, your blood is circulated to all of the organs and tissues of your body. Let's look at each aspect of this circulation.
The heart. Your heart is a small, muscular sac about the size of your clenched fist. It is located in a fairly central position in your body— just behind and slightly to the left of your breastbone—so that its pumping action can be performed efficiently. Your heart pumps blood to every part of your body between sixty and ninety times each minute, every day of your life, just by contracting its muscles. Let's look inside the heart to see how it is made and precisely what is happening as it pumps. A thick wall divides the inside of your heart into two completely separate halves, left and right. Within each of these halves are two further divisions—the top chambers, called "atria," and the bottom chambers, called "ventricles." That is four chambers in total: the top chamber on each side communicates with the chamber beneath it, but the left chambers do not communicate with the right chambers.
The top chambers, the atria, have thin walls of muscle, and these chambers act as "waiting rooms" for the blood that enters them. Once the blood enters the atrium, it cannot leave except by passing through a valve, a sort of one-way door, into the lower chamber. This door only opens when it is forced: the muscular walls of the atrium contract and push the blood against the valve, causing it to open, and allowing the blood to flow through into the lower chamber.
The lower chamber in each half of your heart is called a "ventricle." The ventricles have thick walls of muscle because they have to work harder than the atria. Once blood is pushed out of the atria and into the ventricles, it cannot return to the upper chamber (remember, that valve was one-way). Instead, it will be pushed out of the ventricle, through another one-way valve, into a narrow conduit. This conduit will channel the blood to a number of destinations in your body— your toes, fingertips, lungs, and brain. Wherever it is traveling, it will need a very strong push to keep it going. The initial push given to that
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blood occurs when the muscles of each ventricle contract. Now you can see why the muscle walls of these chambers are thicker than those of the atria.
This transfer of blood from the atria to the ventricles takes place in a rhythmic cycle every moment of your life. By and large, one remains unaware of this cycle but, after exertion or by putting a stethoscope or your ear to another person's heart, you may listen to its rhythmic workings. The characteristic "lubb dupp" sound of the heartbeat is caused by the valves closing: the "lubb" indicates the closing of the valves between the atria and the ventricles, while the "dupp" indicates the closing of the valves between the ventricles and the conduits, or arteries.
The arteries. Arteries are the conduits that channel blood away from your heart to your limbs and organs. Arteries are round tubes constructed in three layers: The outer layer is tough and fibrous, to protect the artery and give it strength. The middle layer is predominantly muscle tissue, with a small number of elastic fibers. This combination gives the artery flexibility as well as the ability to adjust its internal diameter (caliber) to increase or decrease both the amount and the pressure of blood flowing through it. The third and inner layer is in two parts: a lining, which is in contact with the circulating blood, and an elastic layer between the lining and the muscular, middle layer of the artery. Arteries vary in size considerably—the aorta and the pulmonary artery are quite large as they leave the heart but gradually branch off into smaller and smaller arteries. Most arteries have specific names, which help doctors and other interested persons locate their position in the body. When arteries become very small they are called "arterioles." Arterioles link up with the capillaries, the smallest form of conduit, to supply blood to all the body tissues.
The Capillaries. Capillaries are tiny channels whose walls are only one cell thick. They are loosely formed to allow cells to pass through them. Capillaries form a very dense network throughout the body to ensure that all the body tissues are supplied with blood. As the blood passes through the capillary walls, it transfers oxygen and nutrients to the tissue cells and collects waste material and carbon dioxide from them. Because the capillary walls are permeable, this transfer is able to
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take place instantly without the flow of blood being impaired. The permeable nature of the capillaries also accounts for the speed with which white blood cells accumulate at the site of a wound or infection. Once the blood cells have exchanged oxygen and nutrients for waste products, they must move away from the tissues in order to excrete that waste. The flow of blood continues, but now it is flowing toward the heart. To accomplish this return circulation, the capillaries gradually join up to form venules (small veins), and these, in turn, join and thicken to become veins.
The Veins. Veins are, externally, slightly narrower than arteries but with larger interior diameters. Their walls are constructed of the same three layers of tissue that arteries have, but each layer is much thinner because the pressure of blood within a vein is much less than the pressure within an artery. Veins are also less elastic than arteries, so there are valves within some veins to prevent the backflow of blood. These two factors, reduced pressure and reduced elasticity, mean that the veins in your body function at their best when your overall muscle tone is good. Your muscles support the veins and help to prevent collapse of the vein or backflow of blood, which happens in varicose veins. The veins always carry blood back to the heart. Blood returning to the heart from the lungs enters the left side of the heart through the pulmonary veins. Blood returning from the head and arms enters the right atrium through the superior vena cava; blood from the heart, through the coronary sinus; blood from the middle and lower body through the inferior vena cava. Each of these main veins are the result of many smaller veins and venules merging together.
When Things Go Wrong
This beautiful system works with remarkable efficiency and, unlike circulatory systems constructed by humans (for example, your central heating system), it is capable of decades of faultless use without any obvious maintenance. The truth is, of course, the human circulatory system is busy repairing itself all the time. Unfortunately, while this repair work is going on, many of us seem determined to inflict as much damage on our precious life-support system as possible. Some of the main ways we choose to self-destruct are:
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• Smoking
• High blood pressure
• Obesity
• High cholesterol
• Lack of exercise
Sometimes, you hear about a genetic factor in heart disease—that people with a history of heart disease in the family are more likely to contract heart disease themselves. Scientific evidence shows that this is true, and doctors have termed this inherited high level of blood cholesterol as "familial hypercholesterolemia," or FH for short. However, it would be a great mistake to assume that either you are "doomed" to suffer from heart disease simply because one member of your family has suffered from it, or, alternatively, that you will miraculously escape it because no close relative has succumbed. Here are some important points to bear in mind:
• FH is not a diagnosis you can make for yourself. Just because a relative died from heart disease doesn't mean that you have FH.
• Only 1 in 500 people has FH, whereas 1 in every 5 adults has an excessively high level of blood cholesterol.
• If you do have a history of heart disease in your family, it is even more important that you take preventive measures.
Arteriosclerosis is the name given to three distinct disease processes that cause a gradual and significant hardening and narrowing of the arteries. In one form, the arteries are hardened by a gradual deposition of calcium in the middle muscle layer of the artery walls. In a second form, the small arteries, or arterioles, become hardened and thick. And in the third, most familiar, form, the large and medium arteries acquire a buildup of cholesterol, fats, blood cells, and calcium on their inner layers. This last form is called atherosclerosis.
It is thought that hypertension may be one cause or contributing factor in the development of atherosclerosis. Certainly, once either disease is apparent, the other is usually not long in manifesting. Whichever disease comes first, the resulting loss of arterial flexibility increases the likelihood of further damage being done to the lining of
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the arteries and eventually to the heart itself. Here is the process described:
When the artery lining is weakened or damaged, muscle tissue from the middle layer of the artery wall multiply and grow into the artery. Then fat molecules already in the blood begin to collect at the site of the damage. Blood normally carries fat molecules, so that it may transfer them to body tissues. But when the concentration of fat in the blood is too high, or when the artery wall is damaged, these molecules begin to form into plaques, which adhere to the artery walls. A buildup of fat at specific places along the lining of an already weak and damaged artery increases the stress placed on the artery and it bleeds into the fatty deposits. The white cells in the blood try to fight off bacteria and inflammation while the red cells combine with the platelets in the blood and begin a clotting process. This combination of fatty deposit and clotting blood is called "atheroma." No one can feel atheroma accumulate. Even when an artery becomes more than half blocked by this fatty, cholesterol-rich sludge, you still may not be aware of any warning signs to tell you that something is badly wrong. In fact, an artery usually has to be more than 75 percent blocked before blood flow is seriously impeded. But by this stage, time is definitely running out. When a deposit eventually blocks an artery, the blood flow is stopped and, with it, the supply of oxygen to tissue cells. This causes death to the deprived tissues and, if occurring in the heart muscle, a heart attack follows (see below).
Once the buildup of fat and blood begins, calcium deposits begin to harden the atheroma—especially in people entering late middle age. As the atheroma hardens and becomes brittle, it, too, can break from the artery wall and float away in the blood where, further along, it may block the artery. This form of blockage is called an "embolism." The place in your artery where the brittle atheroma broke away is left raw and bleeding and a blood clot soon forms, called a "thrombus." That clot may either block the artery there and then, or it too may break away and block the artery further along.
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When an embolism and/or thrombosis occur, there is further damage done to the artery. More important, both create an obstruction of the blood flow through the artery. Loss of blood flow means loss of essential oxygen and nutrients; therefore, an obstruction such as this usually means the subsequent death of the affected tissue. If the obstruction occurs in or near the heart, a heart attack occurs. If in the brain, a stroke occurs. If this obstruction occurs in the eye, a degree of blindness may ensue, and if in the extremities, death of tissue may cause gangrene and require amputation of the affected part.
Strokes
There are two basic types of stroke. The first is an aneurysm or hemorrhage. This is the rupture of a blood vessel, such as an arteriole or capillary, that has been weakened by consistently high blood pressure. The second type is an obstruction of a blood vessel by an atheroma (embolism) or by a blood clot (thrombus). Both types of stroke have the result of killing nerve cells in the brain, leaving the area of the body controlled by those nerve cells unable to function. Typically, a stroke victim may suffer paralysis, impaired speech, loss of memory, confusion, or death. Those who experience a mild stroke have a chance of good recovery through the many therapeutic methods currently employed, such as physiotherapy, speech therapy, and correction of diet and lifestyle habits.
Ischemic Heart Disease
During exercise, stress, or when you are cold, your heart needs to pump harder to maintain a sufficient supply of blood to your tissues. In a healthy person, this occurs without any problem, though you may become slightly flushed or breathless. However, when the arteries and arterioles are constricted, as in atherosclerosis, hypertension, or through a nervous reaction, your heart must work even harder to supply adequate blood to your body tissues. Sometimes it doesn't succeed.
"Ischemic" means "an insufficient supply of blood." Therefore ischemic heart disease is an insufficient supply of blood to the
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myocardium, or heart muscle. There are three forms of this disease: angina pectoris, myocardial infarction, and sudden death.
Angina Pectoris. In angina pectoris the heart itself becomes deprived of the blood needed to supply its own muscle tissues. This may be due to atheroma, which narrows the coronary arteries, or it may occur when the arteries are constricted by a nervous reaction from stress or the cold. In either case, the result is a strong, distinctive pain in the region of the heart. This pain is often described as "vicelike, aching, tight, heavy, or dull" and is usually felt in the chest. In some angina sufferers, the pain may radiate to the neck, arms (especially the left arm), or even the back. The pain of angina pectoris is usually eased with rest (unlike a heart attack, where the pain is prolonged and does not disappear with rest). Additionally, the underlying cause of angina may be treated in several ways so that the symptoms are minimized or disappear altogether. Drug treatment is an obvious means of affecting the course of angina pectoris, which can disable or cause death if left to progress. However, improving one's level of fitness and finding ways of coping with all forms of stress in everyday life are measures that may be taken immediately to prevent or relieve the threat of angina. Diet and lifestyle are, once again, important factors in both the cause and the prevention of angina pectoris.
Myocardial Infarction. The myocardium is the muscular wall of the heart and, like all muscle tissue, it is supplied with oxygenated blood that circulates through the arteries. The coronary arteries that supply the myocardium may become obstructed in the same way as other arteries in the body. When obstruction is only partial, some blood gets through and the heart only suffers when it is challenged—as with angina pectoris. When the obstruction is total, however, the area of myocardium that is completely deprived of blood dies. This area of dead tissue is called an "infarct." the process of obstruction, pain, and death of tissue is called a "myocardial infarction," or heart attack. Heart attacks may be caused by obstruction of the coronary arteries due to atherosclerosis, embolism, or a blood clot (thrombus). In some cases, atheroma and coronary thrombosis are both present and
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together contribute to the heart attack. The area of myocardium affected by the obstruction stops contracting, or pumping, when it is deprived of blood, and that area of tissue dies shortly after, usually within hours. This period of time is very painful for the victim. If the victim survives the heart attack, the myocardium in the region of the obstruction becomes scar tissue. Scar is dead tissue, which the body cannot replace. If the obstructed artery supplied a small area of myocardium, then the infarct, or scar, will be relatively small also. If, however, a larger coronary artery is obstructed, the infarct will be larger. A large infarct is more likely to cause a loss of heart rhythm and, in some people, the sudden loss of heart rhythm due to infarct causes immediate death. In other victims the area of muscle tissue affected is so small that no symptoms are felt. This is called a "silent infarct." A number of "silent infarcts" may occur before a major heart attack is experienced. During a heart attack, the victim suffers from persistent pains similar to those described for angina. That is, vicelike, tight, crushing pains that radiate to the neck, jaw, arms, and sometimes the back. These pains may last for hours or even days, and do not disappear with rest or by altering the victim's position. In addition, the victim may have symptoms such as profuse sweating, vomiting, nausea, chills, and a sense of doom. In the event any of these symptoms appears in someone close to you, get hospital treatment immediately to prevent death.
Sudden Death. Sadly, this is often the first sign of any cardiovascular disease. Although it may be caused by injury, it is more often due to atherosclerosis and ischemia (deficiency of blood supply), which acts swiftly and profoundly on the victim. Such people are often said to die "instantly." There is no treatment for this form of heart attack, and no way of predicting it. The causes, which are the same as those for all other forms of cardiovascular disease, provide the only insight as to how it may be prevented.
For the majority of heart attack victims, their attack was the first they knew of any cardiovascular problems. Only one in every four or five victims were known to have had symptoms of hypertension or angina
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prior to their heart attack. Yet, undoubtedly, hypertension and its companion, atherosclerosis, are the basic disorders underlying myocardial infarction. Therefore, it is important that we consider how to prevent or minimize these conditions if we wish to reduce the incidence of stroke, angina pectoris, heart attack, and sudden death. Make no mistake—this is one epidemic we can prevent.
How the Vegetarian Diet Can Help
In 1990, the editor in chief of The American journal of Cardiology wrote these telling words in an editorial:
"Although human beings eat meat, we are not natural carnivores. We were intended to eat plants, fruits and starches! No matter how much fat carnivores eat, they do not develop atherosclerosis. It's virtually impossible, for example, to produce atherosclerosis in the dog even when 100 grams of cholesterol and 120 grams of butter fat are added to its meat ration (This amount of cholesterol is approximately 200 times the average amount that human beings in the USA eat each day!). In contrast, herbivores rapidly develop atherosclerosis if they are fed foods, namely fat and cholesterol, intended for natural carnivores. . . .
"Thus, 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." 161
It was an astonishing editorial, because most doctors rarely use such clear and forthright language in support of vegetarianism. But the evidence has been clear for decades.
The Big Picture
In the first chapter, we examined a major Japanese study that tracked the health of 122,261 people over sixteen years (see pages 12-14). 162 Apart from showing that vegetarians cut their risk of all kinds of cancer by more than one half, this study also provided a large
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volume of high-quality data on deaths from heart disease. Remember, the scientists were particularly interested to discover the effects of four lifestyle components on mortality:
• Smoking
• Drinking alcohol
• Eating meat
• Eating green and yellow vegetables.
The findings confirmed previous studies, and are shown graphically in Figure 4.17. The lowest-risk lifestyle was found to be people who don't smoke, drink, or eat meat, but who do eat green and yellow vegetables. The next group up the "ladder of risk" were people who lived the same lifestyle except for smoking. Among this group, the risk of dying from ischemic heart disease was nearly 1.5 times that of the lowest-risk group. Further up again are people who also drink; for
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Figure 4.17. How the odds are stacked against meat eaters: comparison of the risks of ischemic heart disease.
THE MANUAL OF VEGETARIAN HEALTH 239
them, the risk is increased 1.7 times. Finally, at greatest risk of all of heart disease are those who smoke, drink, eat meat, and don't eat vegetables. Compared to the lowest-risk group, they are nearly twice as likely to die from ischemic heart disease.
Another interesting result of this study was the scientists' ability to quantify the extra risk that eating meat confers upon an otherwise low-risk lifestyle. By computer analyzing all the causes of death, it was possible to calculate that the effect of meat consumption on a nonsmoking, nondrinking, plenty-of-green-vegetables lifestyle was to increase the risk of dying from heart disease by nearly 30 percent.
These findings are corroborated by various other studies, described below:
• British scientists recruited over 1,000 vegetarians and 1,000 meat eaters and compared their health. The meat eaters served as the "control" group, and were chosen from the family and friends of the vegetarians, so that other lifestyle factors would be as close as possible between the two groups. Blood was taken from each person in the study, and analyzed. The researchers found that the meat eaters had the highest level of cholesterol in their blood, followed by the vegetarians, and then the vegans. "Our data confirm the findings of several other studies," the scientists wrote, "that lower concentrations of. . . cholesterol are found in vegetarians than in meat eaters." By comparing cholesterol levels in the two groups measured, the researchers calculated the relative risks of heart disease, and concluded, "Our data suggest that in Britain the incidence of coronary heart disease may be 20 percent lower in lifelong vegetarians and 57 percent lower in lifelong vegans than in meat eaters." 161
• The German Cancer Research Center investigation cited on page 14 also recorded deaths from heart disease. 164 They found that out of the group of nearly 2,000 vegetarians, 25 of them would have been expected to die from ischemic heart disease—if they had the same mortality rate as equivalent nonvegetarian Germans. In reality, only 5 had died, meaning that the vegetarians had reduced their death rate to just 20 percent of the meat eaters' rate.
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• From Norway, a study was published in 1992 that had tracked the health and cause of death of vegetarian Seventh-Day Adventists from 1962 to 1986—an impressive 24 years. 165 It confirmed that their lifestyle was protective against heart disease—death rates were significantly lower than the general population's: men had only 44 percent of general population's risk of heart disease, and women, 52 percent. The scientists found that the earlier in life the vegetarian diet was adopted, the lower the subsequent risk became.
The scientific and medical communities have generally responded to these and similar studies by asking the simple question, Why? This has, in turn, spurred more research undertaken with the intention of pinpointing the precise reason for the considerably reduced risk of heart disease conferred on vegetarians and vegans. Many possible explanations have been put forward, but none of them are universally accepted or proven beyond doubt. Suggested factors include lower consumption of saturated fat, higher intake of fiber, and greater intake of protective nutritional factors such as beta-carotene, vitamin C, and vitamin E.
One really has to question the ethical basis of some of this type of work. If it is established that a certain lifestyle considerably reduces the incidence of the Western world's major cause of death, surely the correct medical response should be to advocate those dietary changes at once, and start saving lives? Undertaking yet more research into every last detail of the process by which the meat-free lifestyle bestows protection is at best perfectionist, and at worst downright immoral. Countless lives could have been saved if our medical masters had not been so reticent to recommend vegetarianism to their patients.
Luckily for some people, a few scientists haven't been quite so reactionary.
The Best News Of All
In recent years, irrefutable scientific evidence has emerged that a vegan diet can actually heal the damage inflicted on our clogged-up arteries. It sounds too good to be true, but here is the proof. It's worth reading closely, because the science is so neat and tidy.
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In 1985, a very significant paper was published in the New England Journal of Medicine.^ 66 A team of scientists from the University of Leiden in the Netherlands studied a group of 39 patients, all of whom suffered from angina, and all of whom had at least one blood vessel with 50 percent blockage, as revealed by coronary arteriography. Then they put the patients on a vegetarian diet.
After two years, the scientists took further measurements. In 21 of the 39 patients, the blockages had gotten worse. However, in 18 patients things hadn't deteriorated. What was more, it was clear that the coronary lesion growth correlated with the ratio of total cholesterol to HDL cholesterol in the blood—the higher the ratio, the more the disease had progressed. By contrast, in those patients where the ratio was low, there was no progression. This evidence opened up a whole new line of tackling heart disease. First, Dr. David Blankenhorn of the University of Southern California and Dr. Greg Brown at the University of Washington both performed scientific trials that showed that the buildup of arterial plaque could be reversed in some people by a combination of drugs and a low-fat diet. 167
Then, in 1990, a landmark paper was published in The Lancet. For the first time, scientists irrefutably proved that a vegetarian diet— without the assistance of medication or drugs—could be used to regress coronary heart disease. 168 The science was impeccable. The study was both randomized and controlled (meaning that patients were randomly assigned to either the experimental group, or to a control group that was used for comparison). Patients in both groups had their coronary artery lesions carefully measured at the start of the study, and after one year.
Members of the experimental group were asked to eat a low-fat vegetarian diet, consisting of fruits, vegetables, grains, legumes, and soybean products. Remarkably, they were allowed to eat as much as they wanted to—no calorie counting was required. Now, that's not even "dieting" by most people's standards!
No animal products were allowed except for egg white and a maximum of 1 serving per day of low-fat milk or yogurt. The diet contained 10 percent of its calories as fat, 15 to 20 percent as protein, and 70 to 75 percent as complex carbohydrates. No caffeine, very little alcohol. Relaxation was encouraged, and patients were asked to exer-
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cise for a total of 3 hours a week, even though at the beginning of the study, many participants suffered from such severe chest pain that they could barely walk across a room without resting.
Now for the results: After 1 year, blockages in the arteries of two-thirds of the control group (the group that hadn't followed the vegetarian diet) had worsened. But for 18 of the 22 in the experimental group, the blockages had reduced in size, resulting in an increased blood flow to the heart. And the more severe blockages showed the most improvement.
So was this regression entirely due to a lowering of cholesterol? Dr. Dean Ornish, leader of the team, doesn't think so. "If lowering cholesterol were the primary factor in causing reversal of heart disease," he believes, "most of the patients in the studies by Dr. Blankenhorn and Dr. Brown who were taking cholesterol-lowering drugs should have shown reversal, since almost all of these patients had substantial decreases in blood-cholesterol levels. Yet only a minority showed reversal." 169
Once again, it strongly suggests that it is the totality of the vegan diet that can work this miraculous effect. "Nutritional factors other than fat and cholesterol play a role in heart disease," asserts Dr. Ornish. And one such may be beta-carotene (vitamin A). "People who consume a low-fat vegetarian diet naturally consume not only beta-carotene," he explains, "but other anti-oxidants that may play a role in preventing and reversing heart disease." 170
This pioneering work has since been confirmed by similar studies published in The Lancet and The American Journal of Cardiology in 1992. 171 ' 172 If you, or a loved one, might benefit from this research, make sure you bring these studies to your doctor's attention.
HIGH BLOOD PRESSURE
What is It?
Hypertension is the medical name for high blood pressure, one of the key risk factors in the development of heart and cerebrovascular disease. Thirty-three percent—one third—of all deaths that occur in people under sixty-five are attributable to hypertensive causes.
Blood pressure is measured by the height in millimeters of a column
THE MANUAL OF VEGETARIAN HEALTH 243
of mercury that can be raised inside a vacuum. The more pressure there is, the higher the column will rise. Since blood pressure varies with every heartbeat, two readings are taken—one measures the pressure of the beat itself (called "systolic blood pressure") and the other measures the pressure in between beats, when the heart is resting (this is called "diastolic blood pressure." These two figures are written with the systolic figure first followed by the diastolic figure, like this— 120:80.
When we're born, our systolic blood pressure is about 40; then it doubles to about 80 within the first month. Thereafter, the increase is slower, but inexorable, for the rest of our life. Many people do not realize they suffer from hypertension. There may be no symptoms, and it may only be discovered during a visit to the doctor's office for another complaint. In its later stages symptoms may include headache, dizziness, fatigue, and insomnia.
A pressure of 150:90 would be considered above average in a young person, and 160:95 would be abnormally high. In older people, systolic pressure could be 140 at age sixty, and 160 at age eighty years. Comparatively small changes in the pressure of those people who are in the "at risk" category could have very worthwhile results. This was emphasized by a government report, which stated:
"It has been estimated that a relatively small reduction (2-3mm) in mean blood pressure in the population, if the distribution were to remain similar to the present distribution of blood pressures, would result in a major benefit in terms of mortality, and that a shift of this magnitude would be comparable to the benefit currently achieved by antihypertensive therapy. This estimated benefit seems applicable to mild as well as severe hypertension." 173
If a small change in the population's blood pressure could be as beneficial as all the drugs that people are now taking, then what are we waiting for?
How the Vegetarian Diet Can Help
Scientists have known for a long time that some populations are apparently "immune" to hypertension, and do not display the rise in blood pressure that is associated in the West with getting older. These populations generally tend to have a high level of physical activity, are
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not overweight, have a low level of animal fat in their diet, and don't take much salt (sodium) in their food. In other words, hypertension seems to be an illness of our Western way of life.
As long ago as 1926, it was experimentally shown that certain dietary components could be connected to hypertension. In that year, a pioneering Californian study had showed that the blood pressure of vegetarians could be raised—by as much as 10 percent—in just two weeks of eating a diet that centered around meat. 174 Subsequent experiments have confirmed this effect. One was undertaken in Australia, where two groups of people were selected, one of which regularly ate meat in their diets, and the other didn't. 175 The results were extremely significant, and are summarized for you in Figure 4.18.
The top line charts the blood pressure of the meat eaters. The bottom line shows the non-meat eaters, and the bottom axis shows the five age groups that were surveyed. You can see that, at all ages, blood pressure is significantly lower among the vegetarians. Among the meat eaters, there is a steady rise in blood pressure with advancing age. But among the vegetarians, there is very little increase—and, in fact, a surprising drop in blood pressure in the oldest age group. These results
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THE MANUAL OF VEGETARIAN HEALTH 245
were adjusted to exclude other factors such as exercise, tea, coffee, or alcohol consumption.
Another study was carried out in Britain, and again compared the blood pressure levels in people who didn't eat meat to those who did. 176 The results showed exactly the same pattern. This was true in men as well as women. Figure 4.19 shows the mean results that were obtained.
The difference in the "underlying" blood pressure (diastolic), which is generally thought to be a better guide to the real health of the individual, is considerable. On average, diastolic blood pressure was 15 percent less in the vegetarians compared to the meat eaters.
In another study, a group of 115 vegetarians were compared to a similar group of 115 meat eaters, who were closely matched to the vegetarians apart from diet. 177 The results demonstrated that systolic blood pressure of the vegetarians was 9.3 percent lower than the meat eaters, and diastolic pressure a massive 18.2 percent lower.
In America, in another case, a vegetarian diet was devised that included much fiber from whole-grain cereals, bran cereals, whole-grain breads, vegetables, beans, lentils, and peas. 178 Interestingly,
Vegetarians
Meat eaters
Systolic BP □ Diastolic BP
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members of the group put on this diet were allowed to use as much salt in their food as they wanted. This group was then compared to a standard "control" group, who carried on eating normally. The average blood pressure of the men on the plant fiber diet was 10 percent lower than the control group.
A recent "crossover" trial has confirmed the results of the original 1926 study (see page 244). 179 Fifty-eight patients aged between thirty and sixty-four with mild untreated hypertension were put onto an ovo-lacto-vegetarian diet (including dairy products and eggs). Within a few weeks, the average systolic blood pressure dropped by 5 mm. When they started to eat meat again, it rose by the same amount— very clear evidence that the meat element of the diet was responsible for the improvement.
We know from studies such as those mentioned above that vegetarians generally exhibit lower blood pressure than meat eaters. But can a vegetarian diet also be used to treat high blood pressure? The evidence clearly shows it can.
Scientists at the Royal Perth Hospital in Australia found that people with high blood pressure could indeed reduce it on a vegetarian diet. 180 They wrote, "If the usual aim of treatment of mild hypertensives is to reduce systolic blood pressure to below 140mmHg then thirty per cent of those eating a meat-free diet achieved this criteria compared with only eight per cent on their usual diet." They concluded by suggesting that if drug therapy was required by a hypertensive, it might also be worthwhile to consider modifying the diet.
Another persuasive case for a vegetarian diet to help hypertensives comes from a year-long study in Sweden, where there is a strong tradition of using dietary means to prevent or cure a number of diseases, including hypertension. All the 26 subjects had a history of high blood pressure, on average for 8 years. They were all receiving medication, but even so, 8 of the group had excessively high readings (more than 165:95). Many of the patients complained of such symptoms as headache, dizziness, tiredness, and chest pains, symptoms that were either due to the disease or the medication the patients happened to be taking. They were put on a vegan diet, from which coffee, tea, sugar, salt, chocolate, and chlorinated tap water were eliminated. Their fresh
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fruit and vegetables were organic, when possible. When their diets were analyzed, it was found that they were higher in vitamins and minerals than most people on a meat diet!
"With the exception of a few essential medicines (for example, insulin)," wrote the scientists, "patients were encouraged to give up medicines when they felt that these were no longer needed. Thus, analgesics were dispensed with in the absence of pain, tranquillizers when anxiety was not experienced and sleep was sound, and antihypertensive medication when the blood pressure was normal." 181
The results were certainly impressive. First of all, the patients simply felt much healthier. None of them said that the treatment had left them unchanged or made them feel worse, and 15 percent said they felt "better." Over 50 percent of them said they felt "much better," and 30 percent said they felt "completely recovered." Reductions in blood pressure ranged from 7 to 9 mm, systolic, and 5 to 10 mm diastolic. "When the decrease in blood pressure was considered for the entire group," the scientists wrote, "it was found that it occurred at the time when most of the medicines were withdrawn. Of the twenty-six patients, twenty had given up their medication completely after one year while six still took some medicine, although the dose was lower, usually halved." Several other sorts of benefits were found as well. Their serum cholesterol levels were found to have dropped an average of 15 percent. And the health authorities computed that they had saved £1,000 ($1,500) per patient over the year, by reducing the costs of drugs and hospitalization.
Many studies have tried to identify the one, single factor that makes the vegetarian diet beneficial for blood pressure, but the evidence so far shows that neither polyunsaturated fat, saturated fat, cholesterol, potassium, magnesium, sodium, or total protein intake are independently responsible for this effect. 182 Again, we are forced to come back to the position that it is the totality of the vegetarian diet that is beneficial, and no single component. Hypertension is sometimes preceded by the word "essential," which rather confusingly means that the cause of it is not known. The studies above, and many others, give us convincing proof that a vegetarian diet can offer vital assistance in preventing, and treating, this modern silent killer.
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What Else You Can Do
A diagnosis of high blood pressure is not a death sentence. There is a lot you can do to bring it down—providing you are willing to try seriously. Much research now clearly shows that many "hypertensives" can lower their blood pressure by amending their lifestyle and dietary habits.
• Get to understand your own blood pressure. The common device that measures blood pressure, called a "sphygmomanometer," consists of an inflatable cuff that is wrapped around the arm, and is connected via a tube to the measuring device. Simple sphygmomanometers are quite cheap, and it might be worth buying one and tracking your blood pressure as it rises and falls over a period of time. Blood pressure fluctuates considerably even in normal individuals—the reading taken at the doctor's office won't be the same as the one taken at home later in the day. Physical activity, excitement, fear, or emotional stress can all send it shooting up. When you understand how your blood pressure changes, you're on the way to controlling it.
One recent study has found that as many as 20 percent of patients treated for hypertension could be receiving unnecessary medication, simply because their blood pressure rises in the presence of a doctor. They coined the term "white coat hypertension" for this phenomenon. 183 With your own sphygmomanometer, you'll be able to rule this out.
• Normalize your weight. Most hypertensives are overweight, and a 20-pound reduction in weight can result in a blood pressure reduction of 20 mm systolic and 10 mm diastolic. 184
• Reduce or avoid alcohol consumption. Most long-term studies have shown that blood pressure can be significantly reduced by cutting out or cutting down on the amount of alcohol consumed. For example, one study shows that among women taking more than 2 alcoholic drinks per day, one-third of all cases of hypertension are caused by alcohol consumption. This sug-
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gests that hypertension in these women may be treatable by restriction of alcohol intake. 185
• Stop smoking. Nicotine stimulates the heart and at the same time constricts the blood vessels, making it difficult for your blood pressure not to rise! If you are a man with high blood pressure and you smoke you are 3.5 times more likely to develop cardiovascular disease than if you were a healthy non-smoker.
• Learn to relax and to exercise. Both of these activities help you to feel more in control of your body and your life.
• Consider a drastic change at work. People in demanding jobs with little freedom to make decisions have three times the risk of developing high blood pressure compared to others who have either a less-demanding job or more decision-making latitude. 186
• Adjust your sodium and potassium intake. Both of these minerals are salts (sodium is table salt), which regulate the balance of fluid in your body. An excess of sodium increases the volume of blood, which puts more strain on the circulatory system, causing high blood pressure. Thus, sodium has been blamed for many cases of hypertension. However, it is now shown that potassium can protect the body from hypertension because it balances the effects of sodium. 187
• You can reduce your intake of sodium and increase your intake of potassium by limiting the amount of processed foods you eat, which are high in sodium and low in potassium. Instead, eat potassium-rich foods such as avocado, banana, broccoli, brussels sprouts, dates, prunes, and raisins. Potatoes with their skins on and cantaloupes are also good sources.
• Increase your intake of magnesium. This mineral is lost when you take diuretics—often prescribed for hypertensives. Yet 50 percent of magnesium deficient patients have high blood pressure, usually normalizing when this deficiency is rectified. Foods rich in magnesium include green vegetables, nuts, whole grains and yeast extracts. 188
• Boost your calcium intake. It has been found that people with
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high blood pressure often have low levels of calcium. 189 In one study, researchers demonstrated a 23 percent decrease in hypertension risk among women receiving 800 milligrams a day of calcium, compared with women consuming just 400 milligrams a day. 190 Foods rich in calcium include tofu, spinach, figs, molasses, seaweeds, nuts and seeds, watercress, and parsley. • Consider taking a selenium supplement. Although its role is not yet fully known, selenium may act to prevent hypertension caused by cadmium. Cadmium is a heavy metal that raises blood pressure; it comes from some water pipes, car exhaust, and other pollution, and smoking. Dr. Raymond Shamberger and Dr. Charles E. Willis, of the Cleveland Clinic, in Ohio, conducted an epidemiological study that has shown that people living in an area where the soil has a low concentration of selenium are three times more likely to die from hypertension-related diseases than people who live where the selenium level in the soil (and hence in the food they eat) is higher. "We don't known selenium's precise action concerning high blood pressure," said Dr. Shamberger, "but our study strongly suggests that it has a beneficial effect on high blood pressure problems in man." 191
MULTIPLE SCLEROSIS
What is It?
Multiple sclerosis (MS) is a degenerative disease of the central nervous system. In the course of the disease, myelin (a white, fatty substance that acts as an electrical insulator for the nerves) is progressively destroyed. The resulting formation of hard scar tissue on the protective myelin sheath that surrounds nerves stops the nerve cells from working. This scarring results in permanent loss of nervous control to areas of the body. MS is a crippling disease that attacks every body function. With time it can be fatal. It affects both men and women, and usually is first diagnosed between the ages of twenty and forty.
The cause of multiple sclerosis remains problematic. Literally dozens of explanations have been suggested over the years. A great deal of research has gone into investigating the possibility that MS is caused by a virus, although to date, it has not proved possible to pin-
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point precisely which one. Similarly, it has long been suspected that MS is an autoimmune disease, a sort of allergic reaction in which the body responds to an antigen by acting against itself. Again, pinpointing the antigen in question has proved difficult. Yet another theory proposes that giving cow's milk to infants predisposes them to nervous system injury later in life, because cow's milk has only a fifth as much linoleic acid (an essential fatty acid) as human breast milk, and linoleic acid makes up the building blocks for nervous tissues. 192 The list could go on and on, but while waiting for conclusive proof of cause, it is possible to deal with multiple sclerosis so as to minimize its crippling effect and, perhaps, prolong life.
How the Vegetarian Diet Can Help
Most health professionals have traditionally dismissed the idea that multiple sclerosis might be linked to diet. However, Dr. Roy Swank, former professor of Neurology at the University of Oregon, was intrigued by some wartime research. During World War II, the consumption of animal fat decreased in Western Europe. Meat and dairy products were rationed, and instead the consumption of grains and vegetables increased to replace them. It was noticed at this time that patients with MS had 2 to 2.5 times fewer hospitalizations during the war years, when saturated fat consumption was low. 193 Greatly excited by the possible implication of these findings, Dr. Swank began treating his own patients with a low-fat diet. Over the next thirty-five years, he treated thousands of MS patients in this way. By any medical standard, his results have been remarkable. Many of his success stories were told in a book published in 1977. 194 Patients generally fared better if the condition was detected early, but even longtime MS sufferers experienced a slowing of the disease's progression. The basics of Dr. Swank's diet are
• No more than 10 grams of saturated fat per day
• 40 to 50 grams of polyunsaturated fat (but not margarine or other hydrogenated fats)
• At least 1 teaspoon of cod liver oil daily
• No animal food (although fish was consumed 3 times a week). 195
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Protein intake should be kept up with a good supply of mixed vegetable proteins. The long-term results of the Swank diet show that of those who ate less than 20 grams of fat per day, only 31 percent have died (close to normal) and the condition of the rest has deteriorated only slightly. Of those who ate more than 20 grams, 81 percent have died. 196 However, many orthodox medical practitioners are still very wary of accepting such evidence. An editorial in the medical magazine The Lancet stated, "there are still no firm answers as to whether a relationship (between MS and dietary fats) does indeed exist and if so, what its mechanism might be. . . . more work is needed at the biochemical level. . . . Until such studies are undertaken, the role of lipids in MS cannot be said to be proven." 197 Yet in the words of another doctor who uses the Swank diet to treat patients, "I've been very gratified by the results of this dietary treatment, not only because the progress of most of my MS patients' disease has been halted, but also because their overall health has unquestionably improved." 198
OSTEOPOROSIS
What is It?
"Osteoporosis" literally means "porous bones." If you are a woman, by the time you are sixty, there is a 1 in 4 chance that osteoporosis will have caused you to break a bone. 199 And more than 10 percent of people who suffer a hip fracture caused by osteoporosis will die. 200 Both men and women can suffer from osteoporosis, but it is rarer in men (one estimate is that only 1 in 40 men are ever diagnosed with it. 201 Oriental and Caucasian women are most at risk, due to their tendency to have thinner, lighter bones. Women of African, Mediterranean, or Aboriginal extraction are less likely to suffer from it. You may not even realize that you have osteoporosis until you suddenly break a bone, by which time, the harm has been done. Other telltale signs can include severe back pain, loss of height, or deformities such as a curvature of the spine. It is estimated that more than 50,000 women fracture a hip each year due to osteoporosis. 202 And the number of deaths from fractured hips is greater than the number of deaths from cancers of the cervix, uterus, and breast combined, 203 which makes osteoporosis one of the major killers of our time.
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Osteoporosis is caused by a slow loss of bone mass. By the age of thirty-five or so, your bones will be as strong as they're ever likely to be. Hormones in our bodies are responsible for continuously balancing the growth of new bone with the reabsorption of old bone. When levels of these hormones fall significantly, as happens in menopause, this balance is lost and a gradual loss of bone mass occurs. Eventually, the bones can become very brittle and break easily. In some women this process is sufficiently slow to avoid fractures, pain, and loss of height. In others, however, the loss is rapid—some women can lose up to half of their bone mass within ten or so years of menopause, leaving them very vulnerable to fractures. Since it is clear that estrogen, the female sex hormone, plays a protective role in the maintenance of bone mass, one current treatment for women suffering from osteoporosis is hormone replacement therapy (HRT). HRT provides your body with a supplement of several hormones, including the female hormone estrogen. HRT has a number of very worthwhile advantages:
• It slows down the loss of bone mineral content, decreasing the likelihood of fractures of the spine, hips, and wrists.
• It prevents loss of height.
• It lowers LDL cholesterol in your blood and increases HDL cholesterol, thus prolonging life expectancy by decreasing the risk of heart disease.
• It decreases hot flashes, increases sex drive, and prevents vaginal dryness.
• It decreases the risk of ovarian cancer. 204
On the other hand, concerns have been expressed about its long-term safety (as they have for the estrogen-based contraceptive pill). Although many women—and some doctors—are concerned about an increased risk of cancer from HRT, most of the scientific evidence does not confirm these worries. While some studies do indeed show that estrogen therapy may increase the risk of developing cancer, 205 today's HRT includes other hormones (progestogens) that studies show can actually reduce the cancer risk quite appreciably. 206 This is an area of ongoing research, and it is worth keeping up to date with
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the latest findings. There are, however some problems associated with HRT, as with all drugs. These can sometimes include breast soreness, gallstones, weight gain, return of periods, and with them, breakthrough bleeding.
Is Milk the Answer?
Osteoporosis first hit the headlines in 1984, when the U.S. National Institutes of Health issued an advisory paper stating that women should increase their intake of calcium to prevent osteoporosis. The demand for calcium supplements suddenly hit the roof. And the dairy industry wasn't slow to appreciate the potential for increased sales. Since milk contains plenty of calcium (just the right amount for a fast-growing calf, not necessarily so right for humans), they clearly had a hit on their hands. So, with the help of the vast promotional resources of the dairy industry, the public quickly perceived that:
1. Osteoporosis is caused by a lack of calcium in the diet.
2. Milk contains oodles of calcium.
3. Therefore you should gulp gallons of milk to avoid osteoporosis.
On the face of it, it all sounds very plausible. Since osteoporosis is caused by a slow loss of bone mass, a heavy dose of calcium should put things right again, shouldn't it? The answer is no. Although the theory "has an intuitive appeal," an article in the British Medical Journal stated, "the logic is similar to that which might lead doctors to give ground-up brains for dementia." 207
Nevertheless, many people now seem to believe that a large intake of dairy products will safeguard them against this crippling condition. And the myths abound, as plentifully as ever, for example, take this piece of advice from a recent article in a health food magazine: "Vegetarians who do not use dairy products or take supplements are especially at risk in developing osteoporosis, either because they do not get sufficient amounts of nutrients from their diet or do not absorb the nutrients properly." 208
Meanwhile, the recommended intakes for calcium continue to skyrocket—up to 3,000 milligrams (3 grams) a day, in some cases. 209
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Now to get this amount of calcium from dairy produce, you'd have to drink 10 glasses of milk a day, which—even assuming you drank low-fat milk—would also give you a very unhealthy 180 milligrams of cholesterol and 30 grams of saturated fat. 210 Alternatively, you could munch your way through one pound of cheddar cheese, which would also give you a whacking 150 grams of fat, most of it saturated! 211
The fact is, you don't need to drink milk to prevent osteoporosis. For example, most Chinese consume no dairy products at all and instead get all their calcium from vegetables. While the Chinese consume only half the dietary calcium Westerners do, osteoporosis is uncommon in China despite an average life expectancy of seventy years. "Osteoporosis tends to occur in countries where calcium intake is highest and most of it comes from protein-rich dairy products," says Dr. T. Colin Campbell, a nutritional biochemist from Cornell University and the American authority behind the famous China study. He said, in conclusion, "The Chinese data indicate that people need less calcium than we think and can get adequate amounts from vegetables." 212
At the other end of the scale, the Eskimo population is known to have the highest dietary calcium intake in the world (over 2,000 milligrams a day, mainly from fish bones), yet they also have one of the highest rates of osteoporosis in the world. 213
Clearly, we haven't been given the full picture.
How the Vegetarian Diet Can Help
Says dietary reformer Nathan Pritikin, "African Bantu women take in only 350 milligrams of calcium per day. They bear nine children during their lifetime and breast feed them for two years. They never have calcium deficiency, seldom break a bone, rarely lose a tooth. Their children grow up nice and strong. How can they do that on 350 milligrams of calcium a day when the recommendation is 1,200 milligrams? It's very simple. They're on a low-protein diet that doesn't kick the calcium out of the body ... In our country (America), those who can afford it are eating 20 percent of their total calories in protein, which guarantees negative mineral balance, not only of calcium, but of magnesium, zinc, and iron. It's all directly related to the amount of protein you eat." 214
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Now we're getting to the truth of the matter. In fact, the difference in bone loss between vegetarians and meat eaters can be explained by several factors:
As Pritikin says, the more protein you consume, the more it "kicks the calcium out of the body." Since the 1920s, scientists have known that diets that are high in protein cause calcium to be lost through the urine. 215 In one typical study, young men were fed experimental diets whose protein content ranged from 48 grams a day right up to 141 grams a day. It was found that the higher level of protein consumption doubled the urinary excretion of calcium. 216 And a diet that is high in animal protein—as opposed to vegetable proteins—particularly increases this effect. 217 Scientists believe that flesh foods cause an acid load in the body, which must be neutralized by a release of calcium stored in bones. 218
It has recently been found that boron—a trace mineral—helps to prevent calcium loss and subsequent loss of bone mass. It is also thought to help in the manufacture of vitamin D in the body. The first study to look at the nutritional effects of boron in humans took place in 1987. 219 Twelve postmenopausal women were fed a diet very low in boron for 17 weeks, after which they were given a daily supplement of 3 milligrams for another 7 weeks. The addition of boron had a dramatic effect: the women lost 40 percent less calcium and 30 percent less magnesium through their urine. The study therefore concluded that boron can reduce bodily losses of elements necessary to maintain bone integrity and prevent osteoporosis. Nutritionist Forrest Nielsen, director of the U.S. Department of Agriculture's Human Nutrition Research Center, called it "a remarkable effect." 220
Even more extraordinary was the discovery that boron could double the most active form of estrogen (estradiol 17B) in the women's blood. Their estradiol levels actually equaled those of women on estrogen replacement therapy. Curtiss Hunt, of the U.S. Human Nutrition Research Center, said he "suspects the body needs boron to synthesize estrogen, vitamin D and other steroid hormones. And it
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may protect these hormones against rapid breakdown." He also suggested that boron could be important in treating many other diseases of "unknown cause including some forms of arthritis." And where can you get boron from? Why, by eating apples, pears, grapes, nuts, leafy vegetables, and legumes—in other words, a healthy vegetarian diet (one medium apple contains approximately 1 milligram of boron; researchers suggest our boron requirement is in the region of 1 or 2 milligrams a day). 221
These two important facts, and probably more yet to be discovered, are reflected in the results of a recent study performed by scientists from Andrews University, in Michigan. 222 They used a sophisticated technique called direct photon absorptiometry to compare the bone mass of vegetarians to meat eaters. After studying a group of 1,600 women, they found that by the time they reached 80, women who had eaten a vegetarian diet for at least 20 years had only lost an average of 18 percent of their bone mineral. On the other hand, women who did not eat a vegetarian diet had lost an average of 35 percent of their bone mineral. Interestingly, there was no statistical difference in the nutrient intakes between the two groups—in other words, the vegetarian's advantage was not due to increased calcium intake.
Just a word to the wise.
What Else Can You Do?
Get enough exercise. Especially important are weight-bearing exercises such as walking, dancing, running, and many sports. (Swimming and chess playing, are wo? weight-bearing exercises.) Proper exercise exerts the muscles around your bones, stimulating them to maintain bone density. Leading a sedentary life will increase the likelihood of osteoporosis developing later in your life.
Avoid smoking, caffeine, and excess alcohol. All of these can increase your risk of suffering from osteoporosis. 223 A study of women aged 36 to 45 found that those who drank two cups of coffee a day suffered a net calcium loss of 22 milligrams daily. The authors concluded that a negative calcium balance of 40 milligrams a day (i.e. about 4 cups of coffee) was enough to explain the 1 to 1.5 percent loss in skeletal mass in post-menopausal women each year. 224
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Get regular doses of sunlight. Sunlight reacts with a substance in your skin—dehydrocholesterol—to produce vitamin D. This vitamin is essential to the proper absorption of calcium, and a deficiency will cause you to lose bone mass. Most people get enough vitamin D just by being outside for part of the day with their face, hands, and arms exposed. 225
Avoid aluminum-containing antacids. If antacids containing aluminum are used for prolonged periods of time, they may produce bone abnormalities by interfering with calcium and phosphorous metabolism, and so contribute to the development of osteoporosis. 226 So if you must use an antacid, choose one that does not include aluminum.
Eat food rich in vitamin B complex, vitamin K, and magnesium. These are all believed to play a role in the prevention of osteoporosis. The B group is available in brewer's yeast, whole grains, molasses, nuts and seeds, and dark green, leafy vegetables. Vitamin K is present in cauliflower, soybeans, molasses, safflowers oil and, again, dark green leafy vegetables. Magnesium is a constituent of chlorophyll and so is abundant in green vegetables. Other excellent sources are whole grains, wheat germ, molasses, seeds and nuts, apples and figs.
Consider calcium carbonate. If you want to take a calcium supplement, it has a high content of calcium and a low price.
SALMONELLA
According to information that Britain's Meat and Livestock Commission gives to schoolchildren, "Meat itself doesn't cause disease or ill-health—it is only unprofessional or unhygienic handling and preparation which can bring about a problem." 227
This is a scandalous statement, because it neatly shifts the blame for food poisoning from the supplier onto the "handler"—usually, the poor beleaguered cook. Now if meat is smeared with animal feces because intestines are commonly ruptured during slaughter; if knives used for cutting meat in slaughterhouses are inadequately sterilized; and if the lesions and tumors on condemed meat literally spill out of waste bins—now, who's fault is that? 228 When I inter-
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viewed a slaughterhouse vet for the original You Don't Need Meat, he told me:
"We hear a lot about food poisoning cases these days, and in just about every case there's meat or poultry as the root cause. Now who gets the blame when patients in hospital die from it? It's almost always the cook, who's blamed for not cooking the beef long enough or for leaving it out in the open. But that's only partly true, because if the meat wasn't grossly infected with salmonella organisms to start with, there'd be no problem." 229
More than 1,500 types of salmonella have now been identified, usually isolated from the intestinal tract of humans and animals. Salmonella organisms are responsible for a variety of human diseases, ranging from typhoid fever to food poisoning, but it is salmonella typhimurium that has accounted for most cases of food infection. In 1988 a new strain—salmonella enteritidis phage type 4—emerged, and it is apparently more virulent than others and can cause a systemic infection in chickens, invading the ovary and oviducts, not just the gut. Consequently, the bacteria can end up deep inside the egg. 230
It is difficult to estimate how many animal carcasses are contaminated with salmonella, although, in the case of chicken, estimates have ranged from 25 percent to 80 percent. 231 When you learn that cases of salmonella poisoning rose by 25 percent in 1992 compared to 1991, it is clear that we are living in the midst of an epidemic. 232 In America, there are approximately 2.5 million cases of salmonella poisoning a year, 500,000 hospitalizations, and 9,000 deaths. 233 Rather than force the industry to clean up its act, the U.S. Agriculture Department announced that poultry processors would be allowed to zap chickens, turkeys, and game hens with gamma rays, in an attempt to destroy disease-causing bacteria. 234
The headline stories have become so commonplace that many of us seem to have become thoroughly inured to them. A cow with anthrax is slaughtered and left in the abattoir for twenty-four hours before being discovered, and even then, the slaughterhouse is allowed to continue killing and processing animals for human consumption. 235 Complacent officials allow pigs from a farm hit by the largest outbreak of anthrax for half a century to continue to be slaughtered for human consumption. 236 Beef officially stamped as fit for human consumption
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is later found to be riddled with arthritis and septicemia. 237 Things have got so bad that schoolchildren visiting farms should now be given an official health warning. 238 And incredibly, officials recommend that animal "rejects" from failed genetic engineering experiments should be sold for human consumption, to allow the experimenters to recoup some of their costs (the failure rate is colossal—for every 1,000 animals experimented on, 999 are rejected). 239
But these are merely the public scandals. It is only when you get a glimpse of the ordinarily unseen aspects of the meat business that you really begin to appreciate the enormity of the situation. A few years ago (the meat trade will undoubtedly say the situation has now improved—in which case, the onus is on them to prove it) I received an anonymous bundle of photocopied documents in the mail. No doubt I committed some heinous crime against the state by merely opening the envelope; in which case, I hope you will send me some food in prison. It contained copies of correspondence between the Ministry of Agriculture and a major operator of slaughterhouses. As I read, my jaw literally dropped. The papers revealed that
Sheep were being killed in full sight of each other. Cattle were being shot in the head two or three times before they were stunned; many were shot in the wrong place. Pigs were damaged in transit or dead on arrival at the slaughterhouse.
Electric tongs were used to goad pigs.
Men's work wear and gloves were encrusted with fat, rarely cleaned.
Knife sterilizers were contaminated with foul blood and were fat encrusted.
No soap, nail brushes, or paper towels were in the washroom. Kosher carcasses were allowed to drag along the floor. The kosher butcher was not cleaning his hands and arms before inserting them into the animal's chest. A pithing rod (stuck into the animal's brain) was unsterilized. Green algae were growing on the walls.
There were "unsatisfactory procedures and a complete lack of regard for sanitation of the product and equipment."
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All these points, and many more besides, were made in the official reports of inspection. And in an internal memorandum, one of the employees had written the most telling comment of all: "Frankly I am amazed that we are not already under heavy pressure to change things."
If you think about it, there is a kind of logic to all this. An industry that treats its raw material—sentient animals—with such contempt and cruelty while they are alive is hardly likely to treat them any better when they're dead. And that means, of course, that consumers suffer too, which gives another meaning to the phrase "meat is murder." Apart from not eating the foodstuffs most likely to give you food poisoning, here are some further measures to consider:
• If you live in a household where some people eat meat, insist that it be kept scrupulously away from vegetarian food. A plate of chicken or beef, for example, on an upper shelf in a refrigerator can easily splash its nasty secretions onto vegetables further down.
• Store raw and cooked foods separately. Never leave leftover canned food in its tin. Buy salads and vegetables that are unprepared and unprocessed—nature's own packaging is usually the best.
• Wash food before you eat it—even if you've grown it yourself. Vegetables and fruit can occasionally harbor bacteria from the soil.
• Never reheat food more than once. Make sure it's not under-heated.
• Don't take chances. If your food smells "off," throw it away.
• Be certain that frozen food is thoroughly defrosted before cooking.
• Be sure all kitchen towels, sponges, surfaces, food equipment, and cutting boards are kept clean. When you're preparing a meal, it's also prudent to wash utensils and countertops between stages. Don't allow the same knife or chopping board to be used for raw meat and then for cooked food and fresh vegetables.
• Put all rubbish and scraps of food straight into the waste bin— and always keep the lid on securely, so that flies can't get in and germs can't get out.
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X, Y, Z . .. for the Unknown
When AIDS was discovered in cows, I admit I had a hard time believing it. There are, after all, just about as many theories about the origin of the human immunodeficiency virus (HIV) as there are about the assassination of President Kennedy. To add one more initially seemed to me to be way past credibility.
Then I thought again. If someone had told me, just a decade ago, that a disease as bizarre and mystifying as BSE would reach epidemic proportions in the cattle population, I would have disbelieved that, too. The plain fact is, there are lots of new diseases out there. But they're not staying out there.
The evidence shows that many new viral diseases are emerging at this point in our history—over a dozen previously undescribed viral diseases in humans and other animals have been discovered in the last decade. 240 There are many reasons why this should be so. The exploding populations of cities in newly industrialized nations creates unique breeding conditions for new diseases. Air travel around the globe provides an incredibly rapid and effective vector. And humanity's constant erosion of the world's last remaining wilderness areas may expose viruses that have been undisturbed for millennia—a kind of Gaia's revenge.
"Suddenly, it seems we are besieged with new diseases," writes Edwin D. Kilbourne in a thoughtful article published in the Journal of the American Medical Association. "The acquired immunodeficiency syndrome (AIDS), legionnaires' disease, Lyme disease, and others alien to these pages only a decade ago." 241 Kilbourne believes that the most frequent causes of "new" viral infections are "old" viruses, which are transmitted to us from other species. And viruses whose genetic material is contained in RNA, rather than DNA, are particularly worrying, because they mutate faster and can insert themselves directly into human genes.
"I certainly do think we should set aside resources and recognize that viral evolution is proceeding more rapidly," Nobel laureate Joshua Lederberg told a meeting of the National Institutes of Health, in Washington. "I'm just saying there is a faint possibility that the world will fall apart tomorrow." 242
So as soon as I heard the "Cow AIDS" story, I started to do some checking. And what I found made me feel very uneasy.
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NEW VIRUSES
OLD VIRUSES FOUND IN A NEW LOCALE OR USING A NEW VECTOR
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There are certainly ominous similarities with the BSE story. A disease called "visna" was first diagnosed in sheep and goats in Iceland in 1938-39. 243 Visna is Icelandic for "shrinkage" or "wasting," which pretty much describes the symptoms. The disease seemed to take two rather different forms: visna would be characterized by an infection of the brain and spinal cord, but the term maedi ("difficult breathing") would be used if the infected animal was also suffering from pneumonia-type symptoms. Thus, the lentivirus that caused this disease was sometimes known as "visna-maedi," or "maedi/visna." The symptoms are actually not unlike scrapie, without the persistent scratching. 244
The discovery of visna virus in cows was only of passing, academic interest to most scientists. 245 However, with the emergence of AIDS as a serious health threat in the 1980s, scientists began to look around for other similar animal viruses, and visna came under greater scrutiny. In 1987, the name "bovine immunodeficiency-like virus" (BIV) was proposed by researchers, "to reflect its genetic relationship and biological similarity to HIV." 246 A year later, a disturbing letter appeared in the pages of the Journal of the Royal Society of Medicine. 247 It made several key connections:
• Considerable doubt had already been cast on the "African green monkey" theory for the origin of HIV.
• HIV demonstrates great genetic similarity to visna found in sheep.
• Now that visna virus has been found in cattle (BIV), the worrying possibility emerged that humans could also have been contaminated with BIV.
One way humans might have been contaminated is as follows: To manufacture human vaccines, viruses are cultured in fetal calf serum.
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Although this serum is screened for "contaminants," it is entirely possible that not all such infections—such as BIV—would be detected. Consequently, humans might have been injected with BIV. The letter concluded, "It seems absolutely vital that all vaccines are screened for HIV prior to use and that BW [BIV) is further investigated as to its relationship to HIV and its possible causal role in progression towards AIDS." 248
Subsequently, the Journal published a reply to these points from two British government scientists, who concluded, "As far as we are aware there has been no report of the isolation of bovine visna virus [BIV] from fetal calf serum." 249
But this is hardly reassuring, in view of the fact that BIV is far more widespread than was first thought. Originally, it was presumed to be restricted to just one cow in Louisiana. Yet in a recent study in Mississippi, 50 percent of cattle examined were found to be infected. 250
There is enough here to make me feel uneasy. Although officials claim that "the potential for human infection from BIV is zero," my own natural caution and the Precautionary Principle suggest that discretion is the better part of valor. 251 Under the circumstances, we should be cautious and humble. Nature is more than capable of taking our species down a peg or two, and although we may delude ourselves into believing that we now control the very secrets of life itself, a nasty surprise could be just around the next corner. What, for example, would happen if the human immunodeficiency virus suddenly learned the tricks of airborne transmission? Recent studies suggest that this concern is not without foundation. 252 The outcome might be much the same as the devastation that myxomatosis wrought on rabbits.
What it comes down to is this: as long as we choose to ingest animals, we must also be prepared to ingest their diseases, and to cope with the consequences. To pretend otherwise is to indulge in pure self-deception, of the most dangerous kind.
Of course, there is another way, a better way. As the years go by, I believe that the consumption of animal flesh will increasingly be perceived as a barbaric relic from our distant past, much in the same way as public lynchings and slavery are viewed today. Instead of trying to
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win a losing battle with the consequences of a meat-based diet, science and technology will provide us with healthier, more logical foodstuffs. Many are already on sale today.
So there you have it. Eating a meat-free diet is kinder, cheaper, far more healthy, and indeed better for the health of our entire planet. So how do you do it? We'll cover that in the next chapter.
e
HOW TO GO VEGETARIAN
"What can I eat if I don't eat meat?"
That's the most daunting question of all for new or would-be vegetarians, and I'm going to answer it for you in this chapter. We'll look at the way you should structure a healthy vegetarian diet, and I'll give you some of my personal favorite recipes to try. But first, let's spend a moment examining how our food preferences are actually created.
One of life's biggest deceptions is the belief that we choose the food we eat for ourselves. Nothing could be further from the truth. You may think that your taste preferences reflect your own likes and dislikes, but in all probability they owe more to your parents than they really do to you. As human infants, we are more dependent upon our parents and more vulnerable over a far greater period of time than the young of any other species on the face of the Earth. It takes us years to achieve the same degree of control over even the most basic activities, which the young of other species manage to achieve in a matter of months, or even weeks.
Year after year, we rely upon adults to take most of our simple, everyday decisions for us. Now, biologically speaking, this works out very well because we have a lot more growing to do than most other species do, and while we're doing all this growing, we need the protection that parents can give us.
But parents give you more than just protection. They pass on to you their own values and beliefs, so that by the time you're old
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enough to take informed decisions for yourself, you've acquired a whole set of inherited likes, dislikes, and habits that, by sheer force of repetition, you've grown to regard as your own. Habits such as what you eat, the way you eat, and indeed, what you think about what you eat. All these habits have been largely predetermined for you. Other people made these decisions, because you weren't able to at the time. But you are able to now.
MEAT HOOKED?
The difficult thing with meat is that, just like tobacco and some other drugs, although you may not enjoy it at the beginning, your taste buds get hooked on its fatty, salty flavor quite quickly. Humans are not the only animals to respond like this. Gorillas are naturally gentle vegetarians, but when captive ones in zoos have been forcibly fed a meat diet they, too, develop carnivorous appetites—the more they eat, the more they must have. These behavioral changes are also accompanied by physical changes in their digestive system, whereby the ciliate protozoa (useful microorganisms we all need) in their intestines, which would normally help to digest the fiber in their natural diet, disappear. So returning to plant food isn't very easy for them.
It isn't so strange, then, that when young humans are fed animal flesh, they also become accustomed to the taste of it, and grow up believing that large quantities of flesh are an indispensable part of their diet. However, what has really happened is that we have been "taught" to eat meat, taught to regard its taste as palatable, and taught to consider it (if, indeed, we think about it at all) as a perfectly normal part of our diet. Many young children instinctively resist eating meat—I did, and perhaps you did, too. But by the time you were old enough to think objectively about the issue, you may already have been hooked.
The only chance to break this cycle is to do precisely what you're doing now: examine the evidence, and make an informed decision, based on your own personal feelings. I seriously believe that this may be the most important decision that you'll ever make. It may be the first time that you've ever had the chance to consciously and rationally
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reclaim control of a crucial area of your daily activity, that has, until now, been preprogrammed by a pattern of behavior that someone else decided upon decades ago. It's a great opportunity to get things right!
YOUR FIRST STEPS
Eating a vegetarian or vegan diet is not like taking holy orders, running for sainthood, or canvassing for the presidency. In fact, perfectly normal people do it all the time. The very phrase "becoming a vegetarian" can be off-putting, because it carries overtones of withdrawing from the world, even moral smugness. So let's remind ourselves that the only common ground that all vegetarians and vegans have is the fact that we don't do something—in this case, eat animal flesh. If that's all you want it to be, fine. It's your decision.
So do whatever you feel comfortable with. There's one thing, however, that you must never do. And that's apologize. Saying "I'm sorry, I don't eat meat" is demeaning to you, to other vegetarians and vegans, and to a healthy and deeply principled way of living. Subconsciously, it reinforces the prejudice that a few still have toward vegetarianism. It implies that vegetarianism is so freaky that it's "followers" have to apologize for it.
Words carry multitudes of meanings. When you say, "Don't cook any meat for me," you're often putting yourself into a minority. But turn it around, and say, "If you're going to eat animal flesh today, count me out." Then you're making people think about what they're really putting into their mouths. And they often squirm.
It's all a matter of perception. Here's something else that's a question of perception—the question that frequently baffles many would-be vegetarians and vegans: just how do you do it? When you live in a society that for the time being—views the eating of dead animals as the norm, how do you make the break? This can puzzle many people. If you're used to thinking of a meal as "meat and two veg," and you take away the meat, what are you left with? Just how long can you live on boiled potatoes and cabbage?
There's one group of people who are not puzzled by this question, however. And that's vegetarians and vegans. Now I have to tell you
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that—good as I hope this book is—the very best source of help and advice about the flesh-free way of living is actually other vegetarians and vegans. They can, and will, help you—in the same way you will help others, I hope, in the months and years ahead. However, I've noticed one strange circumstance in which vegetarians and vegans don't seem able to offer much in the way of assistance—and that's in the transition to vegetarianism. Here's why: Meat eaters find it difficult to imagine what vegetarians live on, but vegetarians find it equally difficult to imagine why that should be so. For many vegetarians and vegans, their lifestyles are so easy, and so natural, that they simply can't conceive of it ever appearing to be the least bit difficult or intimidating. I've frequently seen vegetarians look genuinely perplexed when asked, by an inquiring meat eater, "What do you eat?"
So be patient with your vegetarians friends and acquaintances if you ask them, "What's the best way to start?" and they respond by giving you an amazed look. Not long ago, that question probably bothered them, too. But now, they genuinely can't see what the problem is. Pretty soon, you won't either.
Making the Break
So what happens? Do you come home at six o'clock one Friday evening and have a nut cutlet instead of a lamb cutlet? Do you have to sign a pledge that meat will never pass your lips again? Or do you just do it in private, with consenting adults? Here are some ideas for making the break that I know have worked very well for other people. But do remember that fundamentally it's your decision—you're trying to find what genuinely suits you. So you should take everything that follows as suggestions, not as firm rules.