Sugary drinks linked to 1,600 Canadian deaths a year: Study

Report ties sugar-sweetened beverages to diabetes, cardiovascular disease and cancer


Liquid candy is killing us.

So say the results of a new study, which holds sugary drinks responsible for the death of 1,600 Canadians annually.

That’s more than four deaths per day, and higher than most other wealthy industrialized countries, said Dariush Mozaffarian, senior author and dean of the Friedman School of Nutrition Science and Policy at Tufts University in Boston.

“We know that sugar-sweetened beverages are cause-and-effect for obesity and diabetes,” he told the Toronto Star. “There’s no intrinsic health value to it. There’s plenty of replacements. This is an easy problem to fix.

“We just have to stop drinking sugary beverages,” he added.

Those beverages include soda pop, energy and sports drinks as well as fruit beverages, sweetened iced teas and homemade sugary drinks like frescas.

The global report, published recently in the journal Circulation, evaluated statistics to estimate how many deaths were directly attributable to sugar-sweetened beverages in 2010. The conclusion: 184,000 worldwide.

The study found that diabetes induced by excessive consumption of sugary beverages was responsible for more than 70 per cent of those deaths, with cardiovascular disease and cancer trailing behind at 25 per cent and four per cent respectively.

And while 40 per cent fewer Canadians per capita die as a result of sugary drinks than in the United States, at least twice as many of us die due to the habit than in Great Britain and France, the study found.

Mozaffarian stressed the need to change the culture around soft drinks, “so that it’s not cool to drink a one-litre Big Gulp with your friends.”

He criticized sports and film celebrities for promoting energy drinks and soft drinks.

“Those movie stars would never do commercials and advertise tobacco to kids.”

Sugary drinks are the main source of added sugars in the Canadian diet, said Lesley James, a health policy analyst at the Heart and Stroke Foundation.

“Canadians are often unaware of how much sugar they’re consuming in beverage form. And the more you drink, the higher your risk is of these adverse health effects,” she said.

The foundation is pushing for a levy on sugary drink producers to force them to hike the price in hopes of scaring away customers. It says the revenue would go toward healthy lunch programs in schools across the country.

It is also calling for a legislated ban on free refills of fountain pop at chain restaurants.

“It’s liquid candy,” said Corinne Voyer, director of the Quebec Coalition on Weight-Related Problems.

A bottle of pop hits the body a lot harder than, say, a cookie, “because the sugar goes so fast into your body and your liver has to work to metabolize it all,” Voyer said. “It makes the liver very fat.”

Health Canada announced plans earlier this month for redesigned nutrition labels that will highlight added sugars and standardize portion sizes on food packaging.

“Health Canada is in the process of reviewing the evidence base for its current guidance on healthy eating to Canadians, including how the existing guidance is being used by health professionals, educators and consumer,” spokesperson Eric Morrissette wrote in an email.

Earlier this year, Ontario passed a law requiring large food chains to post calories for food and beverage items on menus.

The Tufts University study examined dietary surveys and national data across 187 countries from 1980 to 2010.


The Myth of High-Protein Diets

The Myth of High-Protein Diets
by Dean Ornish March 23, 2015
MANY people have been making the case that Americans have grown fat because they eat too much starch and sugar, and not enough meat, fat and eggs. Recently, the Dietary Guidelines Advisory Committee lifted recommendations that consumption of dietary cholesterol should be restricted, citing research that dietary cholesterol does not have a major effect on blood cholesterol levels. The predictable headlines followed: “Back to Eggs and Bacon?”
But, alas, bacon and egg yolks are not health foods.
Although people have been told for decades to eat less meat and fat, Americans actually consumed 67 percent more added fat, 39 percent more sugar, and 41 percent more meat in 2000 than they had in 1950 and 24.5 percent more calories than they had in 1970, according to the Agriculture Department. Not surprisingly, we are fatter and unhealthier.
The debate is not as simple as low-fat versus low-carb. Research shows that animal protein may significantly increase the risk of premature mortality from all causes, among them cardiovascular disease, cancer and Type 2 diabetes. Heavy consumption of saturated fat and trans fats may double the risk of developing Alzheimer’s disease.
A study published last March found a 75 percent increase in premature deaths from all causes, and a 400 percent increase in deaths from cancer and Type 2 diabetes, among heavy consumers of animal protein under the age of 65 — those who got 20 percent or more of their calories from animal protein.
Low-carb, high-animal-protein diets promote heart disease via mechanisms other than just their effects on cholesterol levels. Arterial blockages may be caused by animal-protein-induced elevations in free fatty acids and insulin levels and decreased production of endothelial progenitor cells (which help keep arteries clean). Egg yolks and red meat appear to significantly increase the risk of coronary heart disease and cancer due to increased production of trimethylamine N-oxide, or TMAO, a metabolite of meat and egg yolks linked to the clogging of arteries. (Egg whites have neither cholesterol nor TMAO.)
Animal protein increases IGF-1, an insulin-like growth hormone, and chronic inflammation, an underlying factor in many chronic diseases. Also, red meat is high in Neu5Gc, a tumor-forming sugar that is linked to chronic inflammation and an increased risk of cancer. A plant-based diet may prolong life by blocking the mTOR protein, which is linked to aging. When fat calorieswere carefully controlled, patients lost 67 percent more body fat than whencarbohydrates were controlled. An optimal diet for preventing disease is a whole-foods, plant-based diet that is naturally low in animal protein, harmful fats and refined carbohydrates. What that means in practice is little or no red meat; mostly vegetables, fruits, whole grains, legumes and soy products in their natural forms; very few simple and refined carbohydrates such as sugar and white flour; and sufficient “good fats” such as fish oil or flax oil, seeds and nuts. A healthful diet should be low in “bad fats,” meaning trans fats, saturated fats and hydrogenated fats. Finally, we need more quality and less quantity.
My colleagues and I at the nonprofit Preventive Medicine Research Instituteand the University of California, San Francisco, have conducted clinical research proving the many benefits of a whole-foods, plant-based diet on reversing chronic diseases, not just on reducing risk factors such as cholesterol. Our interventions also included stress management techniques, moderate exercise like walking and social support.
We showed in randomized, controlled trials that these diet and lifestyle changes can reverse the progression of even severe coronary heart disease. Episodes of chest pain decreased by 91 percent after only a few weeks. After five years there were 2.5 times fewer cardiac events. Blood flow to the heartimproved by over 300 percent.
Other physicians, including Dr. Kim A. Williams, the president of the American College of Cardiology, are also finding that these diet and lifestyle changes can reduce the need for a lifetime of medications and transform people’s lives. These changes may also slow, stop or even reverse the progression of early-stage prostate cancer, judging from results in a randomized controlled trial.
These changes may also alter your genes, turning on genes that keep you healthy, and turning off genes that promote disease. They may even lengthen telomeres, the ends of our chromosomes that control aging.
The more people adhered to these recommendations (including reducing the amount of fat and cholesterol they consumed), the more improvement we measured — at any age. But for reversing disease, a whole-foods, plant-based diet seems to be necessary.
In addition, what’s good for you is good for our planet. Livestock production causes more disruption of the climate than all forms of transportation combined. And because it takes as much as 10 times more grain to produce the same amount of calories through livestock as through direct grain consumption, eating a plant-based diet could free up resources for the hungry.
What you gain is so much more than what you give up.

How to Prevent and Treat Degenerative (Osteo) Arthritis

Dr John McDougall

The most common form of arthritis afflicting humans is osteoarthritis, often referred to as “degenerative arthritis,” because the joints slowly deteriorate as a result of “normal wear and tear associated with aging.”  Doctors commonly advise people to lose weight, especially if they have disease of the joints of the lower extremities, and to avoid prolonged and strenuous use of the affected joints.

Beyond this commonsense advice, if you see a doctor for a painful joint condition you will almost certainly receive a prescription for a “pain-killer.”  More specifically, you will be given non-steroidal antiinflammatory drugs (NSAIDs).  Common, over-the-counter varieties you may be familiar with are Motrin and Advil.  Unfortunately, many of these same drugs have been shown to damage the very joints that they are supposed to help.  Obviously, there is a need for better approaches to this common condition.

A Healthier Diet, First

Osteoarthritis is not an inevitable part of growing older – people can live a lifetime with pain-free, fully-functional joints – actually, I think that is the way it is supposed to be. However, commonly, in developed (Western) countries the joints of people worsen with age.  Only 2% of women less than 45 years old in the United States show signs of osteoarthritis; eventually this form of crippling arthritis is seen in x-rays of the hands of over 70% of people age 65 years and older.  However, this same disease is comparatively rare in African and Asian countries, where people physically labor to survive.2   The difference is that the diet of these arthritis-free people is based on unrefined plant foods with few animal products and added fats.  In Western societies, joints wear out while doing such usual activities as driving a car past a drive-through window at McDonald’s and lifting a fork full of cheese to the lips.

The typical American diet damages the joints in several ways.  Over two-thirds of the people on this high-fat, high-calorie diet are overweight and almost one-third are obese.  This extra weight damages the joints of the lower extremities (hips, knees, ankles, and feet) simply through excess stress (the exaggerated effects of gravity).  But there are other reasons an unhealthy diet injures joints:

  • Malnourishment from the Western diet deprives the bones and joints of the raw materials they need to become strong enough to resist the normal wear and tear of daily activities.
  • Circulation to these joints is also compromised by fat floating around in the bloodstream after a typical meal.
  • Possibly the most damaging effect is from the components of the Western diet, that cause inflammation which damages the joints, especially the proteins from dairy products – causing arthritis and eventually permanent destruction of these moving parts.  

The overall benefits of a healthier diet and weight loss were shown in a recent study published in the American Journal of Clinical Nutrition.3  Three-hundred and sixteen older, overweight or obese, sedentary men and women with x-ray evidence of knee osteoarthritis were randomly assigned to one of four 18-month treatments: healthy lifestyle control, diet-induced weight loss, exercise, and diet plus exercise.  Those who lost weight due to an improved diet showed a decrease in inflammation measured by a variety of tests.  Exercise did not seem to make a positive difference in this study.

At least 25 studies have been published to date that show the benefits of a low-fat, plant-based diet on inflammatory arthritis (see my home page article “Diet: Only Hope for Arthritis”).  Most of this research has been done on people who have been told they have rheumatoid arthritis, which is an arthritis characterized by severe inflammation.  In reality, all arthritis conditions have elements of both inflammation and destruction – and the overall condition of the patient can range from one end of this spectrum to the other.

There is hope for people suffering from osteoarthritis, because the inflammation component can be reduced or stopped with corrective measures, such as a healthy diet and accompanying weight loss.  I believe a low-fat, pure-vegetarian diet, combined with non-injurious physical activity, provides the best chance to avoid osteoarthritis later in life; and even help those who already suffer with this condition.  But there is another “medication” approach that should be used when further benefits are needed.

A “Natural” Arthritis Medication that Really Works

The joints are the locations in the body where bones make their connections.  Cartilage covers the connecting surfaces of two bones where they join, allowing them to effortlessly glide one bone over the other. This articular cartilage is made of two types of large molecules, proteoglycans and collagen.  Proteoglycans provide elasticity and stiffness on compression; collagen provides the strength.  Substrates for the building blocks of joint proteoglycans can be provided in the form of a nutritional supplement made from seashells, called glucosamine.  Medical benefits for glucosamine have been reported in the scientific literature for more than 35 years.4  This medication can lead to long-lasting pain reduction and functional improvement by increasing cartilage building activities, reducing enzymatic destruction of the cartilage, and by providing anti-inflammatory effects.  Glucosamine also acts to prevent the death of cartilage cells – not only halting joint destruction, but reversing it.

Researchers reporting in the April 2004 issue of the journal Menopause found (for the first time in a properly executed study) that the use of this seashell-derived supplement will stop the progression of osteoarthritis (degenerative arthritis) of the knee of postmenopausal women. 5   In fact, there was actually a small improvement, on average, in the joints of the 319 women studied.  The placebo group showed a small amount of worsening.  Three times as many in the placebo group showed narrowing (evidence of destruction) of their joints compared to the glucosamine group (33 vs. 11).  A dosage of 1500 mg was given once daily by mouth.  Two other recent and important studies have also shown improvement in pain and halting of progression of the joint deterioration.6,7

Glucosamine is very well tolerated by patients of all ages under short- and long-term treatment.  At the very most, mild gastrointestinal upset, drowsiness and headache may occur – in most research, this medication has been found to have no more adverse effects than placebo.  Glucosamine comes in a sulfate and hydrochloride form – both are equally effective.  Cost of this medication is less than $20 a month for 1500 mg daily.  Often you will find glucosamine packaged with chondroitin – a byproduct of cow cartilage.  My concern is that this cow material may contain infectious microbes, such as those that have been found to cause mad cow disease.8   You will also find combinations of glucosamine with calcium, magnesium, boron and other minerals.  The effects of these minerals have not been determined and they may cause unwanted imbalances in your system.  Therefore, I recommend that you purchase a product that is made only of glucosamine.  Finally, people with healthy joints should not be taking glucosamine in order to prevent a future problem that may never occur, since we really do not know for sure whether or not there are any long-term adverse effects from taking daily doses of powdered seashells.


1) Ding C.  Do NSAIDs affect the progression of osteoarthritis?  Inflammation. 2002 Jun;26(3):139-42. Review.

2)  Brighton SW.  The prevalence of osteoarthrosis in a rural African community.
Br J Rheumatol. 1985 Nov;24(4):321-5.

3)  Nicklas BJ.  Diet-induced weight loss, exercise, and chronic inflammation in older, obese adults: a randomized controlled clinical trial.  Am J Clin Nutr. 2004 Apr;79(4):544-51.

4)  Vetter G.  Glucosamine in the therapy of degenerative rheumatism. Dtsch Med J. 1965 Jul 5;16(13):446-9.

5)  Bruyere O, Pavelka K, Rovati LC, Deroisy R, Olejarova M, Gatterova J, Giacovelli G, Reginster JY.  Glucosamine sulfate reduces osteoarthritis progression in postmenopausal women with knee osteoarthritis: evidence from two 3-year studies.Menopause. 2004 Mar-Apr;11(2):138-43.

6)  Reginster JY.  Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial. Lancet. 2001 Jan 27;357(9252):251-6.

7) Pavelka K.  Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study.  Arch Intern Med. 2002 Oct 14;162(18):2113-23.

8)  Mad cow disease and chondroitin sulfate. Harv Health Lett. 2001 May;26(7):3.

Phyllis Heaphy: Cured of Rheumatoid Arthritis

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Phyllis Heaphy cured her rheumatoid arthritis and got her life back by following a simple diet of delicious foods, no pills, side effects, or expense.

Former Rheumatoid Arthritis Patient

I have overcome rheumatoid arthritis (RA) by following Dr. McDougall’s dietary suggestions, and my recent trip to Paris has inspired me to tell everyone about my recovery. My goal with this account is to help others suffering with crippling arthritis.

About eight years ago, at the age of 46, I began suffering with pain after standing still for long periods of time. My feet would become tender and very sore. Soon thereafter, I began experiencing “traveling” inflammation to various parts of my body: one week it would be in one or two fingers, the next week in one of my wrists, a month later in my shoulder. I became so stiff that I could hardly bend over to tie my shoelaces. I was becoming a cripple; I limped all the time. I could not even think about traveling. Almost every night I was awakened with pain. My efforts to ignore my obviously deteriorating health failed as I became progressively worse. The turning point was four years ago when I spent two days unable to walk – the pain was so intense in the balls of my feet that the slightest pressure was unbearable –- I cried as I tried to make my way across the room. I knew that whatever I had (I had not been diagnosed yet), would only get worse.

I made up my mind to see a doctor. The rheumatologist I visited in September 2000 spent almost an hour examining me and questioning me before giving her diagnosis of mild-to-moderate RA. It sounded like a death sentence. She began to write out a prescription for methotrexate, a powerful immune-system-suppressing drug often used to treat cancer, and told me that I would need to have blood tests every few weeks to monitor the drug’s effects on my liver. She summarized her rationale with, “we had to hit early and hit hard”. When I asked her if any types of food might cause or exacerbate RA, she said “definitely not”, although caffeine might aggravate the condition. She told me that I would be back before long. I thanked her for her careful diagnosis.

I felt shocked and frightened as I walked out of her office. I realized that I had an incurable disease, treatable by powerful drugs with serious side effects, and I would be sick and on drugs for the rest of my life. I never filled the prescription. Instead I searched for months on the Internet for any connection between food and RA – which I was convinced there must be.

Finally, one day I stumbled onto a reference to Dr. McDougall’s ultra-low-fat vegan diet for arthritis. From e-mail exchanges with Dr. McDougall I learned about the importance of also eliminating wheat, corn, and citrus fruits from my diet. He said that there are five common plant allergens, in addition to the dairy and other animal foods, namely: wheat, corn, citrus, tomatoes, and strawberries. The results were nothing short of miraculous: within a few days of eliminating unhealthy foods I became almost (perhaps 90%) pain-free, and I have continued to improve ever since.

I occasionally have bouts of inflammation in one joint or the other, at which time I will take one 200-milligram Advil (purchased over the counter). Since December 31st, 2003, I have taken only 8 regular-strength Advil. This means that I have had inflammation only 8 times in over 9 months. I take an Advil the instant the inflammation starts, and only one Advil is necessary to eliminate the inflammation. My hands, fingers, wrists, elbows, shoulders, and feet (all areas where the RA was established in the past) are all normal and pain-free. This is even more remarkable because I workout every weekday vigorously, including weight-training. Most of what little inflammation I have comes from overdoing the exercising.

My work used to require me to eat out frequently and I was surrounded by (usually overweight) people eating the Standard American Diet. One of Dr. McDougall’s expressions that I like the most is: “the fat you eat is the fat you wear.” I have almost no fat on my body now, after losing about 10 pounds, and I feel lean and svelte. I come from a family with “genetically” high cholesterol. My own cholesterol was at the 230 mg/dl, which my doctor considered to be “on the high side of normal, but not worry about it.” After giving up all simple sugars, including fruits, it dropped to 178 in a few months.

My husband and my parents were skeptical, but they were supportive. I am also lucky to have a family doctor who understands my need to help myself first. She has never reproached me for not following the advice of the rheumatologist, who she had referred me to. And I believe she is just as amazed as I am to see the inflammation completely gone.

My family (husband and two teenage daughters) recently spent ten days in Paris. We walked everywhere, visiting as many sites and museums as we could everyday. The days were long and it was not unusual for me to be on my feet for four to five hours at a stretch. It is times like this that I realize that my life has been restored, since just four years ago I was facing the possibility of being crippled and maybe wheel-chair bound.

In Paris, we stayed in an apartment hotel, so that I could cook all my own meals. To save time, that meant I had a large bowl of oatmeal for breakfast, and rice or potatoes, along with canned beans and tomatoes for most of my other meals. I was satisfied and full of energy. Are you shocked to hear that I took a trip to the “food capital” of the world, and ate rice, beans, and tomatoes? That I could walk by the bakeries with delectable pastries and French breads, and bistros spewing irresistible aromas – and not partake? When I look at that food, I simply think, “That food represents severe pain to me. I’ll pass on it.” My arthritis is just “lurking” in my body, ready to scream at me if I go back to my old way of eating. So I must be vigilant for the rest of my life. I think that this is a small price to pay for my health.

Dr. McDougall’s Comments:

You can cure serious arthritis for free, like Phyllis. Most (70%) patients who have inflammatory arthritis are dramatically improved within one month by following our diet. The McDougall diet – starches, vegetables, and fruits and no animal products of any kind and no added oils – must be followed strictly. Sometimes wheat and corn must be eliminated, too. The last step in searching for offending foods is the “elimination diet,” found in my December 2002 newsletter article: “Diet for the Desperate.”

You should also read “Diet: Only Hope for Arthritis” and “Star McDougallers” – Jean Brown, Vanessa, Sabrina, Mayra, and Rolling Back Dermatitis… These are found on my web site at There are free recipes at the end of the newsletters.

…Or you could spend more than $15,000 a year on medications, and keep your arthritis and your doctors. You would think making the obvious choice would be easy. But many people don’t because:

1) They do not know that at least 25 studies published in the scientific literature show that rheumatoid arthritis, lupus, psoriatic, and non-specific arthritis are caused by the Western diet and in most cases can be cured or dramatically improved with a low-fat, plant-based diet.

2) They do not believe they are capable of making lifelong changes in their diet.

3) They do not appreciate the obvious fact that a starch-based diet is the tastiest diet imaginable and much more enjoyable than yellow and brown foods that taste of grease and salt (the Western diet). (Just look at the foods and you will see the obvious difference.)

4) They falsely believe the medications will cure them, or at least significantly slow their painful journey to a cane or wheelchair.

5) They cannot find a doctor to support their efforts. Yet most have not asked for such help from their doctor.

6) They incorrectly believe a healthy diet will be costly, when the truth is they could save hundreds of dollars on their food bill, thousands on relatively useless medications, and hundreds of thousands on hospitalizations and long-term nursing care.

7) They believe they will get no support from family members. However, faced with your loss from death or disability, or maybe worse yet, caring for you as an invalid; who could refuse to support your change in diet?

8) They believe they will not be able to stick with a change in diet. Not true because the pain of arthritis will keep you on track. Good health through good nutrition is a self-rewarding (and punishing) treatment.

9) They believe starches will make them fat, and carbohydrates will cause them insulin resistance and raise their triglycerides. Actually, a starch based diet will restore their trim appearance, vitality, and health.

10) They think, “If this was so easy and effective then everyone would know about this and every doctor would treat patients in this manner – not just McDougall.” This is a well kept secret only because the economics do not favor wide distribution of the knowledge.

If you know someone with arthritis, make their day by challenging them with this cost-free, self-cure. As an added incentive, tell them that soon they can be a “Star McDougaller,” and learn the true joy of helping others, just like Phyllis Heaphy.

Diet: Only Hope for Arthritis

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A dentist writes, “In April of 1994 I met you briefly at the Michigan Dental Association Annual Meeting in Grand Rapids. During this seminar, I asked you about my 4-year-old son having juvenile rheumatoid arthritis. Bryan was on 35 mg of prednisone (a powerful steroid) and 1200 mg of Advil daily. He was in so much pain he screamed and cried day and night. In one year he lost weight and did not grow one inch. His blood work reflected a sed rate of over 40 (This is a measurement of severity of inflammation and should be below 5). The suggestions you gave me that day lead me to remove all animal products from his diet, as well as refined carbohydrates.” “Within six months, we had Bryan off all his medication. He was free of pain, gaining weight and growing again. His last blood work was superb with a sed rate of 1 – can you believe it!” That’s how bad it can get. But for millions arthritis is much more subtle. Marvin Burk (Louise’s husband–Louise works in the McDougall Health Center office) couldn’t hardly get out of the chair. Then he would walk straddle-legged halfway across the room until he could loosen up enough to get his joints moving. His hands were so stiff he could not use his tools and he often dropped things. He figured a man of 65 shouldn’t be so crippled and decided he’d do whatever it takes to get well. He changed his diet 8 years ago with immediate and dramatic results. Now he pops out of the chair, walks without a bit of stiffness or pain and he handles his tools with no trouble. Many of us can relate to Marvin’s troubles.

People’s Most Common Affliction

Diseases of the muscles and bones are among the most common of all human afflictions, affecting all ages, but becoming more prevalent with years. Government surveys indicate in the United States approximately 33% of adults currently suffer from troublesome arthritis with symptoms of swelling, limitation of motion, or pain. Approximately half of all people over 65 years report having arthritis. The regions of the body most affected are the neck, lower back, hip and shoulder. Arthritis means inflammation of a joint–no more, no less. The fact that a person has arthritis tells nothing about the cause or the cure. Joints can be inflamed as a result of an injury, such as from tripping and spraining an ankle. That’s called traumatic arthritis. Joints can be infected with bacteria resulting in suppurative arthritis. Uric acid crystals can accumulate in the joints causing gouty arthritis. The causes of all three of these forms of arthritis are known and once the causes are stopped the joints heal. Unfortunately, most forms of arthritis are said by doctors to have “no known cause.” And whether or not they will admit it, there is no cure to be found in modern drug therapy either.

Degenerative and Inflammatory

Arthritis of “no known cause” can be divided into two broad categories: degenerative arthritis and inflammatory arthritis. Degenerative arthritis most commonly represents a condition known as osteoarthritis. This is the most common arthritis found in people living in Western civilizations–seen in x-rays of the hands of over 70% of people 65 years and older. However, this same disease is comparatively rare in African and Asian countries, where people physically labor to survive (Br J Rheumatol 24:321, 1985). How can that be? Osteoarthritis is said to be due to wear and tear on the joints, so why is it less common among hard working people of underdeveloped countries? Nor does it explain why with light use, the hands of women often become twisted and deformed with age. The inflammatory forms of arthritis include juvenile rheumatoid arthritis, rheumatoid arthritis, psoriatic arthritis, lupus, and ankylosing spondylitis. These aggressive diseases affect less than 5% of the people living in the United States today. Classifying these inflammatory diseases by different names, such as rheumatoid or lupus provides no further benefits to the patient, because it does not lead to better understanding of the cause of the inflammation, or to the successful treatment of the disease. People diagnosed with degenerative arthritis (osteoarthritis) have inflammation in their joints in addition to the long-standing damage (degeneration). This inflammation can often be stopped with a change in diet and the swelling, pain, and stiffness relieved. What won’t change in either form of arthritis is the permanent destruction left by years of disease, leaving deformity, stiffness and pain. To understand how most people with arthritis can be helped by a healthy diet, I will focus on the more aggressive inflammatory forms of arthritis.

Hope for Arthritis Sufferers

Arthritis is not a genetic disease, nor is it an inevitable part of growing older–there are causes for these joint afflictions, and they lie in our environment–our closest contact with our environment is our food. Some researchers believe rheumatoid arthritis did not exist anywhere in the world before 1800 (Arthritis Rheum 34:248, 1991). It is well documented that these forms of arthritis were once rare to nonexistent in rural populations of Asia and Africa (Chung Hua Nei Ko Tsa Chih 34:79, 1995; Arthritis Rheum 34:248, 1991). As recently as 1957, no case of rheumatoid arthritis could be found in Africa. That was a time when people in Africa followed diets based on grains and vegetables. These once unknown joint diseases are now becoming common as people migrate to wealthier nations or move to the big cities in their native countries. With these changes they abandoned their traditional diets of grains and vegetables for meat, dairy products, and highly processed foods (J Rheumatol 19:2, 1992; Ann Rheum Dis 49:400, 1991). For example, although unknown in Africa before 1960, African-Americans lead in the incidence of lupus in the US (J Am Med Women’s Assoc 1998;53(1):9-12). The mechanisms by which an unhealthy diet causes inflammatory arthritis are complex and poorly understood, but involve our intestine and immune system.

Intestine and Immune System

Increased Intestinal Permeability The intestine forms an effective barrier to separate and exclude intestinal contents from the interior of the body. Only a single layer separates the individual from enormous amounts of antigens (foreign proteins) both of dietary and microbial origin. The intestinal mucosa absorbs and digests nutrients, turning large complex molecules into small simple ones. Normally, only the small molecules are allowed to pass through the intestinal wall, while the large ones that can act as antigens, causing immune reactions, have a limited ability to pass through. Infections and toxins can cause gaps in this barrier and allow large molecules to pass into the blood. This condition of increased intestinal permeability is referred to as a “leaky gut.” Patients with inflammatory arthritis have been shown to have inflammation of the intestinal tract resulting in increased permeability (Baillieres Clin Rheumatol 10:147, 1996). The largest amount of lymphoid tissue in the body is associated with the gut. This tissue protects the body from antigens that do get through the intestinal barrier. Unfortunately, an unhealthy diet–too high in fat, cholesterol, and animal protein–can compromise the capacities of the lymphoid tissue to destroy invading antigens that make it through the intestinal wall. Fasting is known to decrease intestinal permeability, thus making the gut “less leaky.” This may be one of the reasons fasting has been shown to dramatically benefit patients with rheumatoid arthritis (Scand J Rheumatol 1982;11(1):33-38). When patients return after the fast to a diet with dairy products, the gut becomes more permeable and the arthritis returns. An unhealthy diet containing dairy and other animal products causes inflammation of the intestinal surfaces and thereby increases the passage of dietary and/or bacterial antigens (Br J Rheumatol 33:638, 1994). A vegan diet (one with no animal products) has been found to change the fecal microbial flora in rheumatoid arthritis patients, and these changes in the fecal flora are associated with improvement in the arthritis activity (Br J Rheumatol 36:64, 1997). In addition to being devoid of animal products, the diet needs to be very low in fat for maximum benefits. Dietary fat has a toxic effect on the intestine of experimental animals, causing injury that increases the permeability of the gut allowing more antigens to enter the body (Pediatr Res 33:543, 1993). Feeding high cholesterol diets to young animals also increases their “leaky gut” (J Pediatr Gastroenterol Nutr 9:98, 1989; Pediatr Res 21:347, 1987). Those vegan diets that have failed to help arthritis patients have been high in vegetable oils, which are know to damage intestinal integrity. One dangerous paradox in arthritis treatment is that the drugs most commonly used to treat arthritis are toxins to this intestinal barrier. All commonly used nonsteroidal antiinflammatory drugs (like Advil, Motrin, Naprosyn, etc.), apart from aspirin and nabumetone (Relafen), are associated with increased intestinal permeability in man. While reversible in the short term, it may take months to improve the barrier following prolonged use. (Baillieres Clin Rheumatol 10:165, 1996). Foreign Protein in the Body Through the “leaky gut” pass foreign proteins from foods and bacteria into the blood stream. The food proteins are recognized by the body as “not self,”– as something harmful, just like it recognizes the proteins of viruses, parasites, and bacteria as foreign. Then it makes antibodies against these invaders. Elevated levels of antibodies to gut bacteria and to food have been found in various forms of inflammatory arthritis (Rheumatol Int 1997;17(1):11-16; Clin Chim Acta 203:153, 1991). Antigen-Antibody Complexes A “leaky gut” can lead to the formation of large complexes, made up of antibodies and the foreign protein (antigens) in the blood (Curr Opin Rheumatol 10:58, 1998; Ann Prog Clin Immunol 4:63, 1980). The healthy body has mechanisms that easily remove these large complexes from the blood. In some people, however, these complexes survive–because they are formed too rapidly for complete removal and/or the removal mechanisms are insufficient to handle the load. The persistent complexes are then filtered out by the smallest capillaries of the body which are found in the joints, skin, and kidneys. Stuck in the capillaries these complexes cause an inflammatory reaction, like a sliver of wood stuck in the skin. Molecular Mimicry Another fate of the foreign proteins is they can cause the body to make antibodies that are not solely specific to that foreign protein, but also interact with similar human proteins. This mechanism is known as molecular mimicry. The body attacks itself and the resulting diseases are referred to as autoimmune diseases. Rheumatoid arthritis, lupus, psoriatic arthritis, ankylosing spondylitis, and the other inflammatory forms of arthritis are autoimmune diseases. Molecular mimicry in rheumatoid arthritis has been identified with cow’s milk. One analysis showed that the amino acid residues 141-157 of bovine albumin were essentially the same as the amino acids found in human collagen in the joints (Clin Chim Acta 203:153, 1991). The antibodies synthesized to attack the foreign cow’s milk proteins, end up attacking the joint tissues because of shared sequences of amino acids between the cartilage and the milk proteins, that the antibody is directed to attack. The Defense System A healthy diet allows the defense systems to work to its full capacity removing antigens that enter the system and removing immune-complexes from the blood. Components of the rich American diet are known to impair its function. Vegetable oils, including those of the omega-3 and omega-6 variety, are particularly strong suppressors of the immune system. This immune suppressing quality of oils (for example, fish oil and primrose oil) has been used to suppress the pain and inflammation of arthritis, but like too many drug therapies the ultimate outcome may not be best for the patient. Suppression of the immune system prevents it from doing its work of removing invading foreign proteins. Low-fat diets have been shown to retard the development of autoimmune diseases, similar to lupus and rheumatoid arthritis, in experimental animals (Ann Rheum Dis 48:765, 1989). A healthy diet also supplies antioxidants and other phytochemicals that keep the joints strong and repair damage (Am J Clin Nutr 53(1 Suppl):362S, 1991). Animal studies have shown that the foods consumed on the rich American diet fail to provide adequate antioxidants to destroy the damaging free radicals that form in the joint tissues (J Orthop Res 8:731, 1990). Treatment of arthritis with diet became fashionable in the 1920s and many studies over the last 20 years have shown a healthy diet, one very different from the typical American diet, can be a very effective treatment of inflammatory arthritis for many people. In 1979, Skoldstam fasted 16 patients with rheumatoid arthritis for 7-10 days with a fruit-and vegetable juice fast, followed by a lactovegetarian diet for 9 weeks. One-third of the patients improved during the fast, but all deteriorated when the milk products were reintroduced (a lactovegetarian diet) (Scan J Rheumatol 8:249, 1979). In 1980, Hicklin reported clinical improvement in 24 of 72 rheumatoid patients on an exclusion diet. Food sensitivities were reported to: grains in 14, milk in 4, nuts in 8, beef in 4, cheese in 7, eggs in 5, and one each to chicken, fish, potato, and liver (Clin Allergy 10:463, 1980). In 1980, Stroud reported on 44 patients with rheumatoid arthritis treated with the elimination of food and chemical avoidance. They were then challenged with foods. Wheat, corn, and beef were the greatest offenders (Clin Res 28:791A, 1980). In 1981, Parke described a 38-year-old mother with 11-years of progressive erosive seronegative rheumatoid arthritis who recovered from her disease, attaining full mobility, by stopping all dairy products. She was then hospitalized and challenged with 3 pounds of cheese and seven pints of milk over 3 days. Within 24 hours there was a pronounced deterioration of the patient’s arthritis (BMJ 282:2027, 1981). In 1981, Lucas found a fat-free diet produced complete remission in 6 patients with rheumatoid arthritis. Remission was lost within 24-72 hours of eating a high-fat meal, such as one containing chicken, cheese, safflower oil, beef, or coconut oil. The authors concluded, “…dietary fats in amounts normally eaten in the American diet cause the inflammatory joint changes seen in rheumatoid arthritis.” (Clin Res 29:754, 1981). In 1982 Sundqvist studied the influence of fasting with 3 liters of fruit and vegetable juice daily and lactovegetarian diet on intestinal permeability in 5 patients with rheumatoid arthritis. Intestinal permeability decreased after fasting, but increased again during a subsequent lactovegetarian diet regime (dairy products and vegetables). Concomitantly it appeared that disease activity first decreased and then increased again. The authors conclude, “The results indicate that, unlike a lactovegetarian diet, fasting may ameliorate the disease activity and reduce both the intestinal and the non-intestinal permeability in rheumatoid arthritis.” (Scand J Rheumatol 11:33, 1982.) In 1983, Lithell studied twenty patients with arthritis and various skin diseases on a metabolic ward during a 2-week period of modified fast on vegetarian broth and drinks, followed by a 3-week period of a vegan diet (no animal products). During fasting, joint pains were less intense in many subjects. In some types of skin diseases (pustulosis palmaris et plantaris and atopic eczema) an improvement could be demonstrated during the fast. During the vegan diet, both signs and symptoms returned in most patients, with the exception of some patients with psoriasis who experienced an improvement. The vegan diet was very high-fat (42% fat). (Acta Derm Venereol 63:397, 1983). In 1984 Kroker described 43 patients from three hospital centers who underwent a 1-week water fast, and overall the group improved significantly during the fast. In 31 patients evaluated, 25 had “fair” to “excellent” responses and 6 had “poor” responses. Those with more advanced arthritis had the poor responses. (Clin Ecol 2:137, 1984). In 1985, Ratner removed all dairy products from the diet of patients with seronegative rheumatoid arthritis, 7 out of 15 went into remission when switched to milk-free diets (Isr J Med Sci 21:532, 1985) In 1986, Panush described a challenge of milk in a 52-year-old white woman with 11 years of active disease with exacerbations allegedly associated with meat, milk, and beans. After fasting (3 days) or taking Vivonex (2 days) there was no morning stiffness or swollen joints. Challenges with cow’s milk (blinded in a capsule) brought all of her pain, swelling and stiffness back (Arthritis Rheum 29:220, 1986). In 1986, Darlington published a 6-week, placebo-controlled, single-blinded study on 48 patients. Forty-one patients identified foods producing symptoms. Cereal foods, such as corn and wheat gave symptoms in more than 50% of patients (Lancet 1:236, 1986). In 1986, Hanglow performed a study of the comparison of the arthritis-inducing properties of cow’s milk, egg protein and soy milk in experimental animals. The 12-week cow’s milk feeding regimen produced the highest incidence of significant joint lesions. Egg protein was less arthritis-inducing than cow’s milk, and soy milk caused no reaction. (Int Arch Allergy Appl Immunol 80:192, 1986). In 1987, Wojtulewski reported on 41 patients with rheumatoid arthritis treated with a 4-week elimination diet. Twenty-three improved. (Food allergy and intolerance. London: Bailliere Tindall 723, 1987). In 1988, Beri put 14 patients with rheumatoid arthritis on a diet free from pulses, cereals, milk, and non-vegetarian protein foods. Ten (71%) showed significant clinical improvement. Only three patients (11%) adhered to the diet for a period of 10 months (Ann Rheum Dis 47:69, 1988.) In 1988, Hafstrom fasted 14 patients with water only for one week. During fasting the duration of morning stiffness, and number and size of swollen joints decreased in all 14 patients. No adverse effects of fasting were seen except transient weakness and lightheadedness. The authors consider fasting as one possible way to induce rapid improvement in rheumatoid arthritis (Arthritis Rheum 31:585, 1988). In 1991, Kjeldsen-Kragh put 27 patients on a modified fast with vegetable broths, followed by a vegan diet, and then a lacto-ovovegetarian diet. Significant improvement occurred in objective and subjective parameters of their disease (Lancet 2:899, 1991) A two-year follow-up examination found all diet responders but only half of the diet nonresponders still following the diet, further indicating that a group of patients with rheumatoid arthritis benefit from dietary manipulations and that the improvement can be sustained through a two-year period (Clin Rheumatol 13:475, 1994.) Patients dropping out with arthritic flares in the diet group left the study mainly when the lactovegetarian diet (dairy products) were introduced (Lancet 338:1209, 1991). In 1991 Darlington reported on 100 patients who had undergone dietary manipulation therapy in the past decade, one-third were still well and controlled on diet alone without any medication up to 7 ½ years after starting the diet treatment. They found most patients reacted to cereals and dairy products (Lancet 338:1209, 1991). In 1991, Skoldstam fasted 15 patients for 7 to 10 days. Almost all of the patients showed remarkable improvement. Many patients felt the return of pain and stiffness on the day after returning to their “normal” eating and all benefit was lost after a week (Rheum Dis Clin North Am 17:363, 1991). In 1992, Sheignalet reported on 46 adults with rheumatoid arthritis who eliminated dairy products and cereals. Thirty-six patients (78%) responded favorably with 17 clearly improved, and 19 in complete remission for one to five years. Eight of those 19 stopped all medications with no relapse. Favorable benefits appeared before the end of the third month in 32 of the patients (Lancet 339:68, 1992). In 1992, van de Laar showed benefits of a hypoallergenic, artificial diet in six rheumatoid patients. Placebo controlled rechallenges showed intolerance for specific foodstuffs in four patients. In two patients, biopsy of the joints showed specific (IgE) antibodies to certain foods (Ann Rheum Dis 51:303, 1992). In 1992, Shigemasa reported a 16-year-old girl with lupus who changed to a pure vegetarian diet (no animal foods) and stopped her steroids without her doctor’s permission. After starting the diet her antibody titers (a reflection of disease activity) fell to normal and her kidney disease improved (Lancet 339:1177, 1992). In 1995, Kavanaghi showed an elemental diet (which is an hypoallergenic protein-free artificial diet consisting of essential amino acids, glucose, trace elements and vitamins) when given to 24 patients with rheumatoid arthritis improved their strength and arthritic symptoms. Reintroduction of food brought the old symptoms back (Br J Rheumatol 34:270, 1995). In 1998, Nenonen tested the effects of an uncooked vegan diet, rich in lactobacilli, in rheumatoid patients randomized into diet and control groups. The intervention group experienced subjective relief of rheumatic symptoms during intervention. A return to an omnivorous diet aggravated symptoms. The results showed that an uncooked vegan diet, rich in lactobacilli, decreased subjective symptoms of rheumatoid arthritis (Br J Rheumatol 37:274, 1998).

It’s the Whole Diet

The importance of the overall diet cannot be overemphasized. Proper foods keep the intestinal barriers strong and the immune system in a fighting condition. Those foods are whole starches, vegetable, and fruits. In addition to being free of animal products, the diet must be low in fat of all kinds — vegetable oil (even olive oil, corn, safflower, and flaxseed oil) and animal fat. When it comes to blaming individual foods, dairy products seem to be the most troublesome foods, causing the most common and severe reactions. Many reports indicate grains, such as corn and wheat can also aggravate of symptoms. The truth seems to be almost any food can cause trouble, but few people react to vegetable foods. My experience and this research has lead me to prescribe for the past 22 years a starch-based diet with the addition of fruits, and vegetables (low-fat and devoid of all animal products). If no improvement is seen within 2 weeks, I suggest wheat and corn be eliminated. The final step is to follow an elimination diet based on the foods least likely to cause problems, such as sweet potatoes and brown rice with the addition of noncitrus fruits, and green and yellow vegetables. All thoroughly cooked. Water is the beverage. If improvement is found (usually within 1 to 2 weeks), then foods are added back one at a time to see if there is an adverse reaction. (A complete description of this diet can be found in The McDougall Program — 12 days to Dynamic Health). Nonsteroidal anti-inflammatory drugs should be stopped, and if necessary, replaced by aspirin or nabumetone (Relafen). Other medications are reduced and/or discontinued as the symptoms improve. I have just finished a study on 28 patients with rheumatoid arthritis using the McDougall Diet (with corn and wheat included) and the results were remarkable. Full publication will appear this fall.

For Whole Body Benefits

By no small coincidence the same diet that keeps the joints healthy also keeps the rest of the body sound. Diane of Walnut Creek wrote to me last year. “I had what I can only call a miserable life until about five years ago. Nothing seemed to go right for me. In late 1991 I was diagnosed with spinal stenosis and degenerative arthritis. I was declared permanently disabled and left my job as a daily newspaper journalist. My therapist gave me a wonderful gift–she suggested I try your program. I shrugged off her suggestion at first. I swore that I ate well anyway: only dairy and shellfish and white meats. Only! She did not push the point, wisely waiting for me to think about the idea. I did wait for two years. Then two years ago she suggested your program again. I told her I didn’t believe it would work, but agreed to try it for two months. I was overweight, very overweight, by 100 pounds, most of my life — carrying all that poundage caused a lot of wear on my joints. That was two years ago, and I’m a lifelong convert.” “Of course what you predicted happened: My migraines went away completely; I stopped swelling in my joints; I could sleep easily; I had no indigestion problems of any kind; and I began to drop weight. As you probably know, it was a lot easier than I thought it would be. Before I started the McDougall plan, I was losing weight slowly. Afterward, the weight loss was dramatic. After about six months, people started noticing and commenting. They kept saying things like ‘you look ten years younger,’ or most often, ‘You look great. What did you do?’ I no longer take the anti-inflammatory drugs and painkillers that I was taking before the McDougall way. My knee and low-back are virtually pain-free. Now, what I’ve found is that nobody believes it can be as simple as eating carefully and exercising. They all want some magic or some pill.” John McDougall, MD


Dr. McDougall's Health and Medical Center

Painful joints can be divided into “degenerative” and “inflammatory” forms of arthritis. Osteoarthritis is the name often given to the degenerative form and can be helped by losing weight. Inflammatory forms of arthritis, like rheumatoid, Lupus, psoriatic, and ankylosing spondylitis are all very responsive to the McDougall Program. About 70% of people with rheumatoid arthritis (the most common form of inflammatory arthritis) can expect dramatic benefits, and often a cure, in less than 4 weeks of diet change.

Eating Plants Made All the Difference!

Running for “Health” Wasn’t Enough … Eating Plants Made All the Difference!

By    |   Posted on January 5, 2014 


Alina 570x299 Running for “Health” Wasn’t Enough … Eating Plants Made All the Difference!I immigrated to the United States seven years ago from Russia. Right away the pleasures of American cuisine turned out to be irresistible to me. Going out to eat two to three times a week with my new American friends? Sure! All of the temptations at supermarkets and fast food places? Bring them on!


To compensate for all that fattening food, I took up running for the first time in my life and immediately fell in love with it. Running helped me avoid packing on weight, and I found myself in the trap a lot of active people fall into: “I exercise, so I can eat whatever I want, right?”

Over the course of three years, I ran seven half-marathons, one full marathon, and a few 5k and 10k races. As much as I loved running and exercise, I had a growing concern: my body was almost constantly sore, my joints ached … and I was only in my 20s! I was worried that the activity I loved so much was undermining my health. Plus, I kind of stalled in my fitness because of all that soreness. I knew that if I wanted to get stronger without ruining myself, I would have to look into what other athletes who were much better than me were doing.

This is how I discovered that a lot of really good endurance athletes were on a plant-based diet! I became curious and went on to do some research. I learned that eating animal products and junk food do a lot of harm to us, no matter how hard we exercise. One night, my husband and I watched the amazing documentary Forks Over Knives, and it blew my mind!

At first, I was afraid that adopting the plant-based lifestyle would be too hard: there are too many temptations out there … going out to eat could be a challenge … and what about the opinions of family and friends? I kept on reading wonderful books about plant-based athletes (like Scott Jurek’s Eat and Run) as well as articles by T. Colin Campbell, John McDougall, and others. Eventually, after watching Forks Over Knives — The Extended Interviews, I was completely convinced that a plant-based diet is the healthiest for us, and all my previous fears and excuses fell by the wayside.

The first couple weeks were all it took for me to believe that I was on the right track: my energy levels skyrocketed and stayed high throughout the day; I started waking up early with no problem, even though I considered myself an owl before; all the skin blemishes that had plagued me since adolescence cleared up; I was finally able to exercise harder and recover quicker; and my muscles and joints were no longer sore.

Leaving my old eating habits behind turned out to be no problem: I found a lot of delicious plant-based vegan recipes through Pinterest and bought a couple great cookbooks. My husband was a little skeptical at first, but after I showed him all the scientific information about plant-based eating and started cooking delicious vegan meals, he was convinced.

On November 10, I ran my first plant-fueled marathon in 4:08:18. I fully credit my plant-based diet for making me stronger than ever. I am living proof that plant foods alone can fuel a physically demanding lifestyle perfectly … and what could be more convincing than learning through my own experience!

It’s been six months since I became plant-strong, and I am proud to say that this way of life has not only made me healthier and assured me of my inner strength, it also gave me confidence to find my voice and inspire others — by sharing my story through my new blog!

Thank you, Forks Over Knives, for encouraging me to embrace this healthy lifestyle!

Plant-Based Diets For Psoriasis




Plant-based diets appear to decrease inflammation via a variety of mechanisms, including boosting our adrenal gland function. Glucocorticoids are circulating steroid hormones produced by our adrenal glands that suppress inflammation and also help our kidneys excrete potassium. When we eat a lot of potassium-rich foods our adrenal glands secrete more glucocorticoids to keep our potassium levels in check, which may have the side effect of decreasing the level of inflammation in the body. See my 3-min video Potassium and Autoimmune Disease for the effect this may have on autoimmune diseases such as psoriasis.

Where is potassium found? See my post last week, 98% of American Diets Potassium Deficient. Hint: bananas don’t even make the top 50 sources!

What about autoimmune arthritis? See my previous post Plant-Based Diets for Rheumatoid Arthritis and my videos Preventing Arthritis and Diet & Rheumatoid Arthritis. Eating healthier doesn’t improve everyone’s joint pain, but as with all nontoxic treatment modalities, they should always be tried first.

Plant-based diets may help with other pain syndromes: 

as well as other hypersensitivity diseases: 

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my videos for free by clicking here and watch my 2012 year-in-review presentation Uprooting the Leading Causes of Death. My 2013 review should be out in July.

Image credit: HoskingIndustries / Flickr