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 www.drmcdougall.com. 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

He’s still a clown hawking junk food

Ronald McDonald just got a makeover. He’s still a clown hawking junk food, but now he’s dressed up in a blazer and bow tie instead of a jumpsuit. As McDonald’s sales and share values keep going down, it’s pulling out every trick in the book to pump up sales. Rather than improve its product, McDonald’s has kept its menu as stale and deadly as ever.  McDonald’s cheeseburger Happy Meal comes with 20 grams of fat, 50 milligrams of cholesterol, and a whopping 880 milligrams of sodium. Worst of all, it is marketed to children. Instead of an updated Happy Meal mascot, McDonald’s should get with the times and offer a veggie burger kids meal.   McDonald’s new mascot. (Screenshot from Twitter.)  More and more fast food outlets are offering vegetarian and vegan options because that is what customers are asking for. Chipotle launched the vegan Sofritas nationwide earlier this year, and profits during its first quarter skyrocketed 24 percent. Subway released a falafel sandwich in select locations and is now rolling out a hummus spread for its sandwiches. TCBY has added coconut- and almond-based vegan fro-yo flavors to its menu. Plant-based fast food outlets are also expanding nationwide. Native Foods Café, a fast-casual plant-based chain, has received a $15 million investment toward its goal of reaching 200 restaurants coast-to-coast in the next five years.  Hopefully McDonald’s gives consumers a little credit. A healthful menu overhaul is the way to bring back business. But a clown in a bow tie taking selfies? That’s just silly.  Last updated by Dr. Neal Barnard at June 18, 2014.Ronald McDonald just got a makeover. He’s still a clown hawking junk food, but now he’s dressed up in a blazer and bow tie instead of a jumpsuit. As McDonald’s sales and share values keep going down, it’s pulling out every trick in the book to pump up sales. Rather than improve its product, McDonald’s has kept its menu as stale and deadly as ever.  McDonald’s cheeseburger Happy Meal comes with 20 grams of fat, 50 milligrams of cholesterol, and a whopping 880 milligrams of sodium. Worst of all, it is marketed to children. Instead of an updated Happy Meal mascot, McDonald’s should get with the times and offer a veggie burger kids meal.   McDonald’s new mascot. (Screenshot from Twitter.)  More and more fast food outlets are offering vegetarian and vegan options because that is what customers are asking for. Chipotle launched the vegan Sofritas nationwide earlier this year, and profits during its first quarter skyrocketed 24 percent. Subway released a falafel sandwich in select locations and is now rolling out a hummus spread for its sandwiches. TCBY has added coconut- and almond-based vegan fro-yo flavors to its menu. Plant-based fast food outlets are also expanding nationwide. Native Foods Café, a fast-casual plant-based chain, has received a $15 million investment toward its goal of reaching 200 restaurants coast-to-coast in the next five years.  Hopefully McDonald’s gives consumers a little credit. A healthful menu overhaul is the way to bring back business. But a clown in a bow tie taking selfies? That’s just silly.  Last updated by Dr. Neal Barnard at June 18, 2014.

Potatoes: In-depth nutrient analysis:

Potatoes

Potatoes, baked
(Note: “–” indicates data unavailable)
1.00 medium
(173.00 g)
GI: high
BASIC MACRONUTRIENTS AND CALORIES
nutrient amount DRI/DV
(%)
Protein 4.32 g 8.64
Carbohydrates 36.59 g 16.26
Fat – total 0.22 g
Dietary Fiber 3.81 g 15.24
Calories 160.89 8.94
MACRONUTRIENT AND CALORIE DETAIL
nutrient amount DRI/DV
(%)
Carbohydrate:
Starch 29.88 g
Total Sugars 2.04 g
Monosaccharides 1.35 g
Fructose 0.59 g
Glucose 0.76 g
Galactose 0.00 g
Disaccharides 0.69 g
Lactose 0.00 g
Maltose 0.00 g
Sucrose 0.69 g
Soluble Fiber 0.95 g
Insoluble Fiber 2.85 g
Other Carbohydrates 30.74 g
Fat:
Monounsaturated Fat 0.01 g
Polyunsaturated Fat 0.10 g
Saturated Fat 0.06 g
Trans Fat 0.00 g
Calories from Fat 2.02
Calories from Saturated Fat 0.54
Calories from Trans Fat 0.00
Cholesterol 0.00 mg
Water 129.56 g
MICRONUTRIENTS
nutrient amount DRI/DV
(%)
Vitamins
Water-Soluble Vitamins
B-Complex Vitamins
Vitamin B1 0.11 mg 9.17
Vitamin B2 0.08 mg 6.15
Vitamin B3 2.44 mg
Vitamin B3 (Niacin Equivalents) 3.16 mg
Vitamin B6 0.54 mg 31.76
Vitamin B12 0.00 mcg 0.00
Biotin — mcg
Choline 25.60 mg 6.02
Folate 48.44 mcg 12.11
Folate (DFE) 48.44 mcg
Folate (food) 48.44 mcg
Pantothenic Acid 0.65 mg 13.00
Vitamin C 16.61 mg 22.15
Fat-Soluble Vitamins
Vitamin A (Retinoids and Carotenoids)
Vitamin A International Units (IU) 17.30 IU
Vitamin A mcg Retinol Activity Equivalents (RAE) 0.86 mcg (RAE) 0.10
Vitamin A mcg Retinol Equivalents (RE) 1.73 mcg (RE)
Retinol mcg Retinol Equivalents (RE) 0.00 mcg (RE)
Carotenoid mcg Retinol Equivalents (RE) 1.73 mcg (RE)
Alpha-Carotene 0.00 mcg
Beta-Carotene 10.38 mcg
Beta-Carotene Equivalents 10.38 mcg
Cryptoxanthin 0.00 mcg
Lutein and Zeaxanthin 51.90 mcg
Lycopene 0.00 mcg
Vitamin D
Vitamin D International Units (IU) 0.00 IU 0.00
Vitamin D mcg 0.00 mcg
Vitamin E
Vitamin E mg Alpha-Tocopherol Equivalents (ATE) 0.07 mg (ATE) 0.47
Vitamin E International Units (IU) 0.10 IU
Vitamin E mg 0.07 mg
Vitamin K 3.46 mcg 3.84
Minerals
nutrient amount DRI/DV
(%)
Boron 215.82 mcg
Calcium 25.95 mg 2.60
Chloride — mg
Chromium — mcg
Copper 0.20 mg 22.22
Fluoride — mg
Iodine — mcg
Iron 1.87 mg 10.39
Magnesium 48.44 mg 12.11
Manganese 0.38 mg 19.00
Molybdenum — mcg
Phosphorus 121.10 mg 17.30
Potassium 925.55 mg 26.44
Selenium 0.69 mcg 1.25
Sodium 17.30 mg 1.15
Zinc 0.62 mg 5.64
INDIVIDUAL FATTY ACIDS
nutrient amount DRI/DV
(%)
Omega-3 Fatty Acids 0.02 g 0.83
Omega-6 Fatty Acids 0.07 g
Monounsaturated Fats
14:1 Myristoleic — g
15:1 Pentadecenoic — g
16:1 Palmitol 0.00 g
17:1 Heptadecenoic — g
18:1 Oleic 0.00 g
20:1 Eicosenoic — g
22:1 Erucic — g
24:1 Nervonic — g
Polyunsaturated Fatty Acids
18:2 Linoleic 0.07 g
18:2 Conjugated Linoleic (CLA) — g
18:3 Linolenic 0.02 g
18:4 Stearidonic — g
20:3 Eicosatrienoic — g
20:4 Arachidonic — g
20:5 Eicosapentaenoic (EPA) — g
22:5 Docosapentaenoic (DPA) — g
22:6 Docosahexaenoic (DHA) — g
Saturated Fatty Acids
4:0 Butyric — g
6:0 Caproic — g
8:0 Caprylic — g
10:0 Capric 0.00 g
12:0 Lauric 0.01 g
14:0 Myristic 0.00 g
15:0 Pentadecanoic — g
16:0 Palmitic 0.04 g
17:0 Margaric — g
18:0 Stearic 0.01 g
20:0 Arachidic — g
22:0 Behenate — g
24:0 Lignoceric — g
INDIVIDUAL AMINO ACIDS
nutrient amount DRI/DV
(%)
Alanine 0.13 g
Arginine 0.21 g
Aspartic Acid 1.01 g
Cystine 0.05 g 19.23
Glutamic Acid 0.74 g
Glycine 0.12 g
Histidine 0.07 g 7.78
Isoleucine 0.14 g 11.20
Leucine 0.21 g 7.64
Lysine 0.22 g 8.63
Methionine 0.07 g 10.45
Phenylalanine 0.17 g 19.10
Proline 0.13 g
Serine 0.16 g
Threonine 0.14 g 14.43
Tryptophan 0.04 g 15.38
Tyrosine 0.10 g 13.70
Valine 0.22 g 13.10
OTHER COMPONENTS
nutrient amount DRI/DV
(%)
Ash 2.30 g
Organic Acids (Total) 0.94 g
Acetic Acid 0.00 g
Citric Acid 0.80 g
Lactic Acid 0.00 g
Malic Acid 0.14 g
Taurine — g
Sugar Alcohols (Total) — g
Glycerol — g
Inositol — g
Mannitol — g
Sorbitol — g
Xylitol — g
Artificial Sweeteners (Total) — mg
Aspartame — mg
Saccharin — mg
Alcohol 0.00 g
Caffeine 0.00 mg

Note:

The nutrient profiles provided in this website are derived from The Food Processor, Version 10.12.0, ESHA Research, Salem, Oregon, USA. Among the 50,000+ food items in the master database and 163 nutritional components per item, specific nutrient values were frequently missing from any particular food item. We chose the designation “–” to represent those nutrients for which no value was included in this version of the database.

Spud Sunday: What’s In A Spud?

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I’ve been called many things in my time, though “Guardian … of the Spud” was a new one.

That title was kindly bestowed by Aoife McElwain (she of I Can Has Cook) in her brand newFoodie News column in the Irish Independent weekend magazine. Needless to remark, it is a moniker that I will wear with pride (and perhaps even, as suggested by some, with an accompanying superhero-style cape).

foodie to follow

So, as Guardian (not to mention Promoter) o’ the Spud, it seemed as good a time as any for a no-holds-barred, down ‘n’ dirty nutritional profile of what is, after all, the world’s most widely cultivated vegetable. So brace yourselves, folks, you’re about to find out that there’s a whole lot more to this tuber than starch. Let the facts begin.

 

    • For one thing, there’s water, and lots of it. H2O accounts for about 80% of a typical potato tuber, though this percentage can vary significantly depending on the type of potato. Waxy varieties will have a higher water content, floury types, less.
    • The rest of the potato is mostly starch, though I’m guessing you knew that already. Your average potato also contains small amounts of simple sugars, which are important for developing the golden-brown colour of fried and roasted potatoes. Overall, a potato has a lower carbohydrate content than other roots and tubers and a plain boiled potato has less calories than the equivalent weight of plain boiled rice, pasta or bread. Honest.
    • Over time, some of a potato’s starch will convert to sugars when stored below about 10°C, and markedly so at 6°C and below. So it’s best not to store your spuds in the fridge, unless uncharacteristically sweet potatoes are what you’re after.
    • While only 2% of a potato is protein, the protein is high-quality and the potato boasts a good carbohydrate to protein ratio. When compared with rice and cereals, it has a higher lysine content and lower concentrations of other amino acids such as cysteine. For those not averse to a bit of carb-on-carb action, this means that putting rice or pasta on your plate alongside potatoes will actually provide a better quality protein than either one or the other. Who’d-a-thunk-it?
    • Fat content is very low, as is, consequently, the occurrence of fat-soluble vitamins. If your spuds are fried or roasted, however, that’s a fatter matter entirely.
    • Both the flesh and the skin of a potato contain dietary fibre, though (unsurprisingly) there’s a greater concentration in the skin. The skin also prevents or reduces theleaching of vitamins and minerals into cooking water when boiling, so it is better (nutritionally) to peel after boiling, if you’re going to peel at all.

New Potatoes

    • It’s said that when men were dying from scurvy during the Klondike Gold Rush, potatoes were sold for their weight in gold. This had everything to do with the fact that potatoes were, and are, a very good source of vitamin C. 100g of freshly harvested spuds, boiled in their skins, gives about 50% of an adult’s typical recommended daily intake. Long term storage (which is increasingly common) and cooking, especially if potatoes are peeled beforehand, will, however, deplete vitamin C levels.
    • Spuds have much else in their nutritional vitamin arsenal, being well-equipped with B complex vitamins, especially B1, B6 and niacin.
    • There’s a goodly array of minerals, such as magnesium and phosphorous, residing spudside too. They’re particularly rich in potassium, the consumption of which, if thisrecent article is to be believed, may predispose a woman to conceive male children. Many’s the royal spouse who could, no doubt, have done with that information.
    • Sodium quantity is low, which is good for those who need, or want, to avoid excessive amounts in their diet.
    • You’ll find a host of trace elements in a potato, from aluminium to zinc, and its ironcontent can contribute significantly to daily requirements.

Salad blue and highland burgundy red

  • Highly-coloured potato varieties – those with blue, purple, red or even just yellow flesh – are rich in antioxidants, though specific concentrations will vary with different varieties. Recent research has shown that their consumption may lower susceptibility to certain chronic diseases, when compared with eating white-fleshed potatoes.
  • Overall, potatoes are an alkaline food source, with high levels of potash and alkaline salts. This makes them a good thing to eat if you’ve got a hangover, when acidity levels in the body are elevated.
  • While the focus of the book Potatoes, Not Prozac is about managing biochemical imbalances brought about by sugar sensitivity, consuming complex carbohydrates, such as potatoes and their skins, is part of its dietary solution for mental health and well-being.
  • All potatoes contain glycoalkaloids, which can be toxic if present in large quantities. Whilst levels are safe in our cultivated varieties, concentrations will increase with exposure to light. This exposure also results in greening of the potato and, although it’s a separate process, it acts as a useful indicator of increased glycoalkaloid content. What I’m trying to say is, don’t eat the green bits, ok?
  • Finally, If you’ve eaten potatoes for long enough, you’ve probably come across those that show browning or a hollow at the heart of the spud (which occurs due to abrupt changes in growing conditions). These browned centres are known in Irish as cuasán(pronounced coo-a-sawn). My father’s mother’s mother, I’m told, regarded it as a delicacy, while my mother’s father’s father maintained that the best part of the potato was that found around the cuasán. All I can say is that, if it was good enough for them, it’s plenty good enough for me.

Liver Disease

Dr. McDougall's Health and Medical Center

Liver Disease, Hepatitis, and Liver Failure

Standard Practice:

The function of the liver is to detoxify and excrete a variety of substances consumed in the diet and waste products of our body’s metabolism. The liver also produces proteins necessary for the clotting of the blood and a protein called albumin that serves to keep fluid in the blood vessels. A failing liver results in the accumulation of breakdown products of metabolism, edema, and finally coma and death.

There are many causes of liver disease; the most common are infections with viruses and alcohol. Continuous injury with either of these agents results in permanent loss of liver tissue. One of the changes in the liver that occurs during injury is the accumulation of fat within the liver cells. This condition known as fatty infiltration commonly occurs in alcoholism, diabetes and obesity, and is in part due to a high-fat diet. With severe liver damage, liver cells are replaced by extensive scar tissue–the condition is known as cirrhosis of the liver.

Current Treatment:

Liver damage is first treated, whenever possible, by stopping drinking alcohol, especially when alcohol is the primary cause. The recommended diet for anyone suffering from liver disease is high in carbohydrate, low in protein, low in fat diet, and low in sodium.

Drugs are used to help control some of the complications of the ailing liver. Diuretics are often given to help relieve the edema and partially compensate for the patient’s poor compliance to a low-salt diet. Drugs, such as lactulose, decrease the absorption of protein from the intestine, and thereby further reduce the protein load to be handled by the liver. Steroids are sometimes used to decrease inflammation.

Drawbacks:

Medications deal primarily with symptoms and fail to prolong the patient’s life in most cases. Survival is not improved with the use of steroids and other antiinflammatory drugs. Unfortunately, strict adherence to a healthy diet is rarely encouraged by the physician until liver disease is far advanced. By this time there is too little liver left to make much of a difference.

The McDougall Program:

The McDougall Program: (Dietary and Lifestyle Implications):

The treatment of liver disease is primarily with a low-fat, low-protein, high-complex carbohydrate starch-based diet started early–long before liver failure is advanced. A healthier diet will relieve much of the burden on the diseased liver, since a large part of the liver’s function is to metabolize excess proteins, cholesterol, fats and additives from the diet. The low-fat quality of the McDougall diet helps relieve the fatty infiltration stage of the liver disease; there is a gradual disappearance of fat from the liver in four to eight weeks along with the improvement in diabetes and weight loss following the introduction of the diet. Progress can often be measured by reduction in the liver enzymes, SGOT and SGPT, seen by blood tests.

Current Therapy:

A person with liver failure must be as kind to his or her body as possible primarily by avoiding toxic substances and making food choices that are not excessive in fats and proteins. Low-sodium may be important in advanced liver failure to reduce fluid accumulation. Because all foods are naturally plentiful in protein it is often necessary to make-up as much as half the diet from “empty calories” foods in the form of simple sugars such as white sugar or corn syrup in order to dilute the protein content of the starches, vegetables and fruits to a tolerable level.

When Friends Ask: Where Do You Get Your Protein?

April 2007 Vol. 6, No. 4
When Friends Ask:
Where Do You Get Your Protein?

If you don’t know where you get your protein while following a plant-food-based diet, you’re in good company.  The Nutrition Committee of the American Heart Association, scientists from the Human Nutrition Research Center and Medical School at Tufts University, and registered dietitians, research nutritionists and physicians of Northwestern University, and the Harvard School of Public Health are just a few examples of “experts” you look to for advice who have the protein story wrong.1-4 Consequences of their shortfall are as grave as a lifetime of sickness and obesity, and premature death, for innocent people. These professionals must be held accountable.

Wrong Statements from the Experts 1-4
Although plant proteins form a large part of the human diet, most are deficient in 1 or more essential amino acids and are therefore regarded as incomplete proteins. (American Heart Association)

Plant protein sources, although good for certain essential amino acids, do not always offer all nine essential amino acids in a single given food. For example, legumes lack methionine, while grains lack lysine. (Tufts Human Nutrition Research Center)

Single plant protein foods usually are lower in protein quality than most animal proteins because they lack significant amounts of various essential amino acids. (Tufts University Medical School)

Other protein sources lack one or more amino acids that the body can’t make from scratch or create by modifying another amino acid. Called incomplete proteins, these usually come from fruits, vegetables, grains, and nuts. (Harvard School of Public Health)

Plant sources of protein (grains, legumes, nuts, and seeds) generally do not contain sufficient amounts of one or more of the essential amino acids. Thus protein synthesis can occur only to the extent that the limiting amino acids are available. (Feinberg School of Medicine, Northwestern University)

Ignorance Sickens and Kills People

Don’t think it matters little if our public policy makers and educators remain ignorant about our nutritional needs. Misinformation leads to disastrous outcomes.  People have serious health problems like heart disease, type-2 diabetes, multiple sclerosis, and inflammatory arthritis that can be easily resolved by a diet based solely on plant foods. However, advice to make this dietary change may be withheld from you or a family member because of the erroneous fear that such a diet will result in a greater catastrophe, like a nutritional collapse from protein deficiency.

Consider this scenario:  Your loving husband of 35 years has a massive heart attack.  He recovers and both of you pledge you will do anything—even eat cardboard—in order to avoid a repeat experience.  On your first follow-up visit you tell your doctor that your family is going to follow a low-fat, vegan diet (all plant foods) from here on out.  Your doctor says, “You can’t do that; you will become protein deficient—plant foods are missing essential amino acids—you must eat meat and other high quality animal foods.”  Even though you vigorously explain meat, dairy, and eggs are the reasons you almost lost your husband, your doctor insists that you would be foolish to embark on such a course and defends that position with the writings of the Nutrition Committee of the American Heart Association.

The Nutrition Committee of the American Heart Association Has It Wrong

In an October 2001 research paper published in the Heart Association’s journal, Circulation, the Healthcare Professionals from the Nutrition Committee of the Council on Nutrition, Physical Activity, and Metabolism wrote, “Although plant proteins form a large part of the human diet, most are deficient in 1 or more essential amino acids and are therefore regarded as incomplete proteins.”1 My letter to the editor correcting this often quoted, but incorrect information, about the adequacy of amino acids found in plants was published in the June 2002 issue of Circulation.5 Another letter from me in the November 2002 issue of Circulation demanded a correction.6  But, the head of the nutrition committee, Barbara Howard, PhD, would not admit she was wrong and used research from the world’s leading expert on protein, Professor Joe Millward, to defend her position.6

Joe Millward, PhD, Professor of Human Nutrition, University of Surrey (England), reviewed the published letters of disagreement between the American Heart Association (AHA) and myself, and wrote the following to me on July 10, 2003, “I thought I had made my position quite clear in my published papers. In an article I wrote for Encyclopedia of Nutrition (Millward DJ. 1998  Protein requirements. Encyclopedia of Nutrition. Academic Press pp  1661-1668) I said ‘Contrary to general opinion, the distinction between dietary protein sources in terms of the nutritional superiority of animal over plant proteins is much more difficult to demonstrate and less relevant in human nutrition.’  This is quite distinct from the AHA position which in my view is wrong.”7

I informed the American Heart Association about Dr. Millward’s position, but so far they have chosen to remain silent—and annually, 1.25 million people in the USA alone suffer with heart attacks—an often fatal condition entirely preventable by following a low-fat diet based solely on plant foods—all of which contain all of the essential amino acids in ideal amounts for humans.

Plants–the Original Sources of Protein and Amino Acids

Proteins are made from chains of 20 different amino acids that connect together in varying sequences—similar to how all the words in a dictionary are made from the same 26 letters.   Plants (and microorganisms) can synthesize all of the individual amino acids that are used to build proteins, but animals cannot.  There are 8 amino acids that people cannot make and thus, these must be obtained from our diets—they are referred to as “essential.”

After we eat our foods, stomach acids and intestinal enzymes digest the proteins into individual amino acids. These components are then absorbed through the intestinal walls into the bloodstream.  After entering the body’s cells, these amino acids are reassembled into proteins. Proteins function as structural materials which build the scaffoldings that maintain cell shapes, enzymes which catalyze biochemical reactions, and hormones which signal messages between cells—to name only a few of their vital roles.

Since plants are made up of structurally sound cells with enzymes and hormones, they are by nature rich sources of proteins.  In fact, so rich are plants that they can meet the protein needs of the earth’s largest animals: elephants, hippopotamuses, giraffes, and cows.  You would be correct to deduce that the protein needs of relatively small humans can easily be met by plants.

People Require Very Little Protein

The World Health Organization (WHO) recommends that men and women obtain 5% of their calories as protein.  This would mean 38 grams of protein for a man burning 3000 calories a day and 29 grams for a woman using 2300 calories a day.  This quantity of protein is impossible to avoid when daily calorie needs are met by unrefined starches and vegetables. For example, rice alone would provide 71 grams of highly useable protein and white potatoes would provide 64 grams of protein.8

Our greatest time of growth—thus, the time of our greatest need for protein—is during our first 2 years of life—we double in size. At this vigorous developmental stage our ideal food is human milk, which is 5% protein.  Compare this need to food choices that should be made as adults—when we are not growing. Rice is 8% protein, corn 11%, oatmeal 15%, and beans 27%.8  Thus protein deficiency is impossible when calorie needs are met by eating unprocessed starches and vegetables.

The healthy active lives of hundreds of millions of people laboring in Asia, Africa, and Central and South America on diets with less than half the amount of protein eaten by Americans and Europeans prove that the popular understanding of our protein needs is seriously flawed.

WHO Recommendations:
(With a wide safety margin)
   
Men: 5%
Women: 5%
Pregnant: 6%
   
Percent of Calories of Proteins16
(Selected Foods)
Food % Protein
   
Grains & Flours:  
Cornmeal 9
Brown Rice 9
Oatmeal 15
White Rice 7
Whole Wheat Flour 16
White Flour 11
   
Starchy Vegetables  
Black Beans 27
Cassava 10
Corn 11
Kidney Beans 27
Peas 28
Potato 8
Sweet Potato 7
   
Green Vegetables
Asparagus 42
Broccoli 42
Carrots 10
Lettuce 40
Onions 32
Mushrooms 12
Spinach 51
   
Animal Foods
Beef 53
Chicken 46
Pork 29
Salmon 43
Whole Milk 21
Skim Milk 39
Human Milk 5
Cheddar Cheese 25
Cottage Cheese 68
Egg 32
   

Faulty Observations Lead to High Protein Recommendations

People commonly believe: the more protein consumed the better.  This faulty thinking dates back to the late 1800s, and was established without any real scientific research.  An assumption was made that people who could afford to do so would instinctively select a diet containing the right amount of protein. After observing the diets of laborers, soldiers, and workers in Western Europe and the USA, recommendations of 100 and 189 grams of protein a day were established.9  People’s innate ability to select a proper diet is disproved by the present day popularity of burger joints, donut shops, and pizza parlors.

Further confusion about our protein needs came from studies of the nutritional needs of animals.  For example, Mendel and Osborne in 1913 reported rats grew better on animal, than on vegetable, sources of protein. A direct consequence of their studies resulted in meat, eggs, and dairy foods being classified as superior, or “Class A” protein sources and vegetable proteins designated as inferior, or “Class B” proteins.9  Seems no one considered that rats are not people.  One obvious difference in their nutritional needs is rat milk is 11 times more concentrated in protein than is human breast milk.  The extra protein supports this animal’s rapid growth to adult size in 5 months; while humans take 17 years to fully mature.

The recent popularity of high protein diets has further popularized the fallacy that “more protein is good for you.”  True, high protein diets, like Atkins, will make you sick enough to lose your appetite and temporarily lose weight, but this fact should not be extrapolated to mean high protein is healthy—in fact, the opposite is true.

The Truth Has Been Known for More than a Century

In 1903, the head of Yale’s department of biochemistry, Professor Russell Henry Chittenden, reported profound health benefits gained by cutting popular recommendations for protein held at his time by half to two-thirds (from 150 grams to 50 grams daily).  His research included detailed dietary histories and laboratory studies of his subjects.9

In the 1940s, William Rose performed experiments on people which found daily minimum protein needs to be about 20 grams a day.  Further research on men found single plant foods consumed in an amount sufficient to meet daily needs easily met these human requirements for all 8 essential amino acids.9  (A more detailed discussion of the history of protein recommendations is found in my December 2003 newsletter article:  A Brief History of Protein: Passion, Social Bigotry, and Enlightenment.)

The results of Dr. Rose’s studies are summarized in the following chart, under “minimum requirements”.  From the chart, it is clear that vegetable foods contain more than enough of all the amino acids essential for humans.10

(grams per day)
Amino Acids
Rose’s Minimum Requirement Rose’s Recommend Requirement Corn Brown
rice
Oatmeal
flakes
Wheat
flour
White
beans
Potatoes Sweet
potatoes
Tryptophan .25 .50 .66 .71 1.4 1.4 1.8 .8 .8
Phenylalaline .28 .56 6.13 3.1 5.8 5.9 10.9 3.6 2.5
Leucine 1.10 2.20 12.0 5.5 8.1 8.0 17.0 4.1 2.6
Isoleucine .7 1.4 4.1 3.0 5.6 5.2 11.3 3.6 2.2
Lysine .8 1.6 4.1 2.5 4.0 3.2 14.7 4.4 2.1
Vailine .8 1.6 6.8 4.5 6.4 5.5 12.1 4.4 3.4
Methionine .11 .22 2.1 1.1 1.6 1.8 2.0 1.0 .8
Threonine .5 1.0 4.5 2.5 3.6 3.5 8.5 3.4 2.1
Total Protein 20 37 (WHO) 109 64 108 120 198 82 45
(grams per day)
Amino Acids
Taro Asparagus Broccoli Tomatoes Pumpkin Beef Club Steak Egg Milk
Tryptophan 1.0 3.9 3.8 1.4 1.5 3.1 3.8 2.3
Phenylalaline 3.0 10.2 12.2 4.3 3.0 11.2 13.9 7.7
Leucine 5.2 14.6 16.5 6.1 6.0 22.4 21. 15.9
Isoleucine 3.0 11.9 12.8 4.4 4.3 14.3 15.7 10.3
Lysine 3.4 15.5 14.8 6.3 5.5 23.9 15.3 12.5
Vailine 3.5 16.0 17.3 4.2 4.3 15.1 17.7 11.7
Methionine .6 5.0 5.1 1.1 1.0 6.8 7.4 3.9
Threonine 2.7 9.9 12.5 4.9 2.7 12.1 12. 7.4
Total Protein 58 330 338 150 115 276 238 160

You Don’t Need Beans or to “Combine” Your Foods

Many investigators have measured the capacity of plant foods to satisfy protein needs. Their findings show that children and adults thrive on diets based on single or combined starches, and grow healthy and strong.10Furthermore, no improvement has been found from mixing plant foods or supplementing them with amino acid mixtures to make the combined amino acid pattern look more like that of flesh, milk, or eggs. In fact, supplementing a food with an amino acid in order to conform to a contrived reference standard can create amino acid imbalances. For example, young children fed diets based on wheat or corn and supplemented with the amino acids tryptophan and methionine in order to conform to the standard requirements set by the Food and Agriculture Organization of the United Nations (FAO) developed negative responses in terms of nitrogen balance (the body’s utilization of protein).10

People who are worried about getting sufficient protein will sometimes ask me if they can still follow the McDougall Diet if they do not like beans.  From the chart above, you will notice that any single starch or vegetable will provide in excess of our needs for total protein and essential amino acids—thus there is no reason to rely on beans or make any efforts to food combine different plant foods to improve on Nature’s own marvelous creations.

Potatoes Alone Suffice

Many populations, for example people in rural Poland and Russia at the turn of the 19th century, have lived in very good health doing extremely hard work with the white potato serving as their primary source of nutrition. One landmark experiment carried out in 1925 on two healthy adults, a man 25 years old and a woman 28 years old had them live on a diet primarily of white potatoes for 6 months. (A few additional items of little nutritional value except for empty calories—pure fats, a few fruits, coffee, and tea—were added to their diet.)11  The report stated, “They did not tire of the uniform potato diet and there was no craving for change.”  Even though they were both physically active (especially the man) they were described as, “…in good health on a diet in which the nitrogen (protein) was practically solely derived from the potato.”

The potato is such a great source of nutrition that it can supply all of the essential protein and amino acids for young children in times of food shortage.  Eleven Peruvian children, ages 8 months to 35 months, recovering from malnutrition, were fed diets where all of the protein and 75% of the calories came from potatoes.  (Soybean-cottonseed oils and pure simple sugars, neither of which contains protein, vitamins, or minerals, provided some of the extra calories.)12  Researchers found that this simple potato diet provided all the protein and essential amino acids to meet the needs of growing and small children.

Excess Protein Causes Diseases of Over-nutrition

Unlike fat, protein cannot be stored.  When it is consumed in excess of our needs, protein is broken down mostly by the liver, and partly by the kidneys and muscles. Consumption in excess of our needs overworks the liver and kidneys, and can cause accumulation of toxic protein byproducts.

Proteins are made of amino acids, and are, therefore, acidic by nature.  Animal proteins are abundant in sulfur-containing amino acids which break down into very powerful sulfuric acid. These kinds of amino acids are abundant in hard cheese, red meat, poultry, seafood, and eggs, and their acids must be neutralized by buffers found in the bones. The bones dissolve to release the buffering materials; eventually resulting in a condition of weakened bones, known as osteoporosis.  Released bone materials often settle and coalesce in the kidney system, causing kidney stones.  Fruits and vegetables are largely alkaline, preserving bone health and preventing kidney stones.13 (A more detailed discussion of the health consequences from excess protein is found in my January 2004 newsletter article: Protein Overload.)

Diseases of over-nutrition are directly connected to planet health, too.  Recommendations to eat animal foods for protein have resulted in an environmental catastrophe.  Livestock produces 18% of the greenhouse gases; these food-animals occupy 26 percent of the ice-free surface of the Earth and 33 percent of the total arable land is used to produce their food. One telling tragedy is they account for the deforestation of 70 percent of Amazon rainforests, which act as the “lungs of the Earth.”14 (A more detailed discussion of the environmental damage from livestock is found in my December 2006 newsletter article:  An Inconvenient Truth: We Are Eating Our Planet To Death.)

Protein Deficiency Is Really Food Deficiency

How many cases of the so-called “protein deficiency state,” kwashiorkor, have you seen? I have never seen a case, even though I have known thousands of people on a plant-food based diet.  How about those starving children in Africa?  The picture one often sees of stick-thin children with swollen bellies in famine areas of Asia or Africa is actually one of starvation and is more accurately described as “calorie deficiency.”10  When these children come under medical supervision, they are nourished back to health with their local diets of corn, wheat, rice, and/or beans.  Children recovering from starvation grow up to l8 times faster than usual and require a higher protein content to provide for their catch-up in development—and plant foods easily provide this extra amount of protein.10 Even very-low protein starchy root crops, such as cassava root, are sufficient enough in nutrients, including protein, to keep people healthy.15

Starving People Die of Fat, Not Protein, Deficiency

In 1981, 10 Irish prisoners from the Republican Army (IRA) went on a hunger strike. Nine out of 10 of these men died between 57 and 73 days (mean of 61.6 days) of starvation after losing about 40% of their body weights (the remaining striker died of complications of a gunshot wound).16,17  This experience gave doctors a chance to observe first hand the metabolic changes that occur during starvation. Protein stores were generally protected during starvation, with most of the energy to stay alive being derived from the men’s fat stores. It was estimated that the hunger strikers had lost up to 94% of their body-fat levels, but only 19% of their body-protein levels at the time of death.16 They died when they ran out of fat.  Since fat is more critical than protein, people should be asking, “Where do you get your fat (on any diet)?

Since Nature designed her plant foods complete, with abundant amounts of fat, protein, carbohydrates, vitamins and minerals, “Where you get a specific nutrient?” is almost never a relevant question, as long as there is enough to eat.  So, why have scientists, dietitians, medical doctors, diet-book authors, and the lay public become fixated on a non-existent problem?  Protein is synonymous with eating meat, poultry, fish, dairy, and eggs—the foods traditionally consumed by the wealthier people in a society—thus, protein-eating means higher social status.  High-protein foods are also high-profit foods. Therefore, propagating the protein myth is motivated by egos and money—and the usual consequences of pain and suffering follow closely behind these two human frailties.

References:

1) St Jeor S, Howard B, Prewitt E. Dietary protein and weight reduction: a statement for healthcare professionals from the Nutrition Committee of the Council on Nutrition, Physical Activity, and Metabolism of the American Heart Association. Circulation. 2001; 104: 1869–1874.

2) Tufts University:  http://www.thedoctorwillseeyounow.com/articles/nutrition/protein_2/
http://www.quackwatch.org/03HealthPromotion/vegetarian.html

3) Harvard School of Public Health: http://www.hsph.harvard.edu/nutritionsource/protein.html

4) Northwestern University:  http://www.feinberg.northwestern.edu/nutrition/factsheets/protein.html

5) McDougall J. Plant foods have a complete amino acid composition.  Circulation. 2002 Jun 25;105(25):e197; author reply e197.

6) McDougall J.  Misinformation on plant proteins. Circulation. 2002 Nov 12;106(20):e148; author reply e148.

7) Personal Communication with John McDougall, MD on July 10, 2003.

8) J Pennington.  Bowes & Church’s Food Values of Portions Commonly Used.  17th Ed. Lippincott. Philadelphia- New York. 1998.

9)  The December 2003 McDougall Newsletter: A Brief History of Protein: Passion, Social Bigotry, and Enlightenment.

10) McDougall J.  The McDougall Plan. New Win Publ. 1983; pages 95-109.

11) Kon S.  XXXV. The value of whole potato in human nutrition.  Biochemical J.  1928; 22:258-260

12) Lopez de Romana G.  Fasting and postprandial plasma free amino acids of infants and children consuming exclusively potato protein. J Nutr. 1981 Oct;111(10):1766-71.

13) The January 2004 McDougall Newsletter: Protein Overload.

14)  The December 2006 McDougall Newsletter: An Inconvenient Truth: We Are Eating Our Planet To Death.

15) Millward DJ.  The nutritional value of plant-based diets in relation to human amino acid and protein requirements.  Proc Nutr Soc. 1999 May;58(2):249-60.

16)  Leiter LA, Marliss EB. Survival during fasting may depend on fat as well as protein stores. JAMA 1982;248:2306

17) Zimmerman MD, Appadurai K, Scott JG, Jellett LB, Garlick FH.  Survival. Ann Intern Med. 1997 Sep 1;127(5):405-9.

How Plant-Based Diets May Extend Our Lives

News

July 10, 2014 by Michael Greger M.D. in News with 5 Comments

How a Plant Based Diet May Help you Live Longer

A recent review suggested that plant-based diets may prove to be a useful nutritional strategy for lifespan extension in part because they tend to be naturally low in the amino acid methionine (see my video Starving Cancer with Methionine Restriction). Apparently, the less methionine there is in body tissues, the longer different animals tend to live. But what are the possible implications for humans? See my video Methionine Restriction as a Life Extension Strategy.

I’ve talked before about the free radical theory of aging, the concept that aging can be thought of as the oxidation of our bodies just like rust is the oxidation of metal (seeMitochondrial Theory of Aging). Methionine is thought to have a pro-oxidant effect. The thinking is that lowering methionine intake leads to less free radical production, thereby slowing aging. Fewer free radicals would decrease the rate of DNA damage, which would curtail the rate of DNA mutation, slowing the rate of aging and disease and potentially increasing our lifespan.

There are three ways to lower methionine intake: The first is caloric restriction. By decreasing our overall intake of food, we would reduce our intake of methionine. Or, because methionine is found protein, we could practice protein restriction, eating a relatively protein deficient diet. The third option is eat enough food, eat enough protein, but just stick to proteins that are relatively low in methionine, which tends to mean plant proteins.

Caloric restriction is hard, because we walk around starving all the time. Something like every-other-day eating is described as “never likely to gain much popularity as a pro-longevity strategy for humans, so it may be more feasible to achieve moderate methionine restriction by eating a plant-based diet.” On a population-wide level, folks could benefit from just lowering their protein intake, period. Researchers noted that “the mean intake of proteins [and thus methionine] of Western human populations is much higher than needed. Therefore, decreasing such levels has a great potential to lower tissue oxidative stress and to increase healthy life span in humans while avoiding the possible undesirable effects of caloric restriction.”

We’re eating around double the protein we need, so the first thing doctors can recommend is to decrease the intake of protein, but we can also get our methionine even lower by eating a plant-based diet.

The fact that beans have comparably low methionine has been classically considered a disadvantage. But, given the capacity of methionine restriction to decrease the rate of free radical generation in internal organs, to lower markers of chronic disease, and to increase maximum longevity, this “disadvantage” may actually be a strong advantage. This fits well with the important role of beans in healthy diets like the traditional Mediterranean diet. Interestingly, soy protein is also especially poor in methionine, which may help explain the healthy effects iof soyfoods. Watch my video Increased Lifespan from Beans.

The reason why plant-based diets are so protective is not known. Yes, vegetables contain thousands of phytochemicals, but separately investigating their possible protective roles would be an impossible task. The idea that the protective effect is not due to any of the individual plant food components, but to a synergic “combined effect” is gaining acceptance. However, based on the relationship of excess dietary methionine to vital organ toxicity, as well as its likely mechanism of action through increases in free radical generation, the possibility exists that the protective effects of plant-based diets can be due, at least in part, to their lower methionine content. As one paper concluded, “The low-methionine content of vegan diets may make methionine restriction feasible as a life extension strategy.”

Plant-based diets can also mimic other benefits of caloric restriction, such as improving levels of the “fountain of youth” hormone DHEA. See The Benefits of Caloric Restriction Without the Actual Restricting.

Americans are living longer but sicker lives. That’s why we need a diet and lifestyle that supports health and longevity. I have a whole presentation on the role diet can play in preventing, arresting, and even reversing many of our top 15 killers: Uprooting the Leading Causes of Death.

I’ve touched previously on the irony that animal protein may be detrimental for the same reasons it’s touted as superior in Higher Quality May Mean Higher Risk.

-Michael Greger, M.D.

Rice Diet Founder Dr. Walter Kempner

In 1934 as a doctor at Duke Hospital, Dr. Walter Kempner starting treating patients with malignant hypertension (very high blood pressure) and kidney disease with what he called “The Rice Diet” when there was no other treatment available anywhere. He gave it the name as patients usually ate a bowl of white rice at every meal. It became obvious to Dr. Kempner that the prevention and treatment of these diseases would be best treated with a no salt added diet. Dr. Kempner found out very early that the low fat content of the diet also enhanced weight loss. When Dr. Kempner tried to have patients maintain their weight by increasing portion size and adding sugars to foods, patients still lost weight. They just couldn’t eat enough calories with so little fat in the diet. The program has continued over the years with the same philosophy of a low-sodium, low-fat diet.

In the 1930′s and 40′s, people that were diagnosed with illnesses such as high blood pressure and kidney disease were offered no hope for long-term survival. These diseases were considered lethal. Dr. Kempner experimented with animal tissue for many years and began to treat human patients in 1939. He began to see unprecedented results starting with a woman who reversed her kidney disease in a few months time and another who was comatose with malignant hypertension who regained alertness. There were no other drugs or treatments available other than this diet.
Dr. Kempner went on to research and publish revolutionary results on the Rice Diet’s dramatic beneficial effect not only on kidney disease and hypertension, but on cholesterol, cardiovascular disease, congestive heart failure and diabetes. He retired in 1992 in his 90th year (as Dr. Kempner would say) and he passed away in 1997. The Rice Diet has continued to produce these significant improvements and outstanding medical results for these diseases along with other disorders of lifestyle origin such as sleep apnea, psoriasis, pulmonary hypertension, edema and joint stiffness associated with arthritis.
Here are some of Dr. Kempner’s articles from his bulletins and other journals:
• Treatment of Heart and Kidney Disease and of Hypertensive and Arteriosclerotic Vascular Disease with The Rice Diet (1949)
• Kempner’s Research on Diseases of Blood Vessels, Kidneys, and Heart (1950)
• Treatment of Heart Disease and Kidney Disease with the Rice Diet (April 1951)
• Clinical Notes and The Patient’s Viewpoint (April 1953)
• Progress Report (August 1954)
• Family History (August 1954)
• Analysis of 177 Cases of Hypertensive Vascular Disease (1955)
• The Changing Attitude Toward Vascular Disease (June 1955)
• Who Wants Salt? (June 1955)
• “A Girl with a New Lease on Life” (June 1955)
• Why Rice? (1956)
• How to Be Happy with Rice (August 1956)
• Effect of Rice Diet on Diabetes Mellitus Associated with Vascular Disease (1958)
• Nephritis. Nephrosis. (1958)
• Coronary Artery Disease (1960)
• Diabetes (1962)
• Proofs for Optimism (June 1972)
• Metabolic Diseases: Research, Diagnosis, Treatment (June 1972)
• The Deadly Role of Salt in Kidney Disease (June 1972)
• Obesity (June 1972)
• Sodium-Restricted Diet (June 1972)
• Walter Kempner: A Biographical Note (1974)
• The Rice Diet: Forty Years of Progress (October 1982)
• The Importance of Oxygen Concentration (October 1982)
• The Rice Diet and Arthritis (October 1982)
• “Out of A Clear Blue Sky…” (October 1982)
• Notes of Interest: Cirrhosis of the Liver (October 1982)
• Disappearance of Psoriatic Lesions on the Rice Diet (1986)
• The Sodium/Diabetes Connection (June 1993)
• What the Fireflies Taught Us More Than 50 Years Ago (June 1993)
>> Publications by Dr. Kempner: Additional Listings