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Nutrition for health—not proven by clinical studies?

In this article I want to begin to share examples in my practice of valuable therapies not proven by randomized double-blind, placebo-controlled (RDBPC) clinical trials. The first is nutrition. Treatment success comes from my own clinical experience, but also the clinical experience of others, and even some large studies.

Nutrition—the science is mounting

I was recently reprimanded by a physician of the large medical group where I provide Urgent Care services. It wasn’t for prescribing antibiotics over the phone for patients with just two days of cough and cold symptoms as I witnessed this doctor did just 2 weeks ago…but it was for writing my nutrient-rich smoothie recipe in the medical record Plan section for a patient who really deserved to learn this!

Why do mainstream doctors discount nutrition’s benefit due to lack of studies? This is simply because (a) they have never really studied or been taught about nutrition’s effect on health, (b) private organizations do not want to fund studies on nutrient-rich foods since there is no financial return expected, though government studies do exist, and (c) human studies on nutrient-rich plant-based diets are difficult to adequately perform due to participant unreliability. Remember, I received one 60-minute lecture on nutrition in my entire four years of medical school training!

Let’s consider what studies we do have on nutrition and health.

In 1996 there was a very impressive observational study reported in the British Medical Journal[1] of 10,771 healthy subjects who were recruited from health food shops, vegetarian societies, and magazines and followed for approximately 17 years. Scientists tracked their diets for vegetarianism, but also for consumption of whole grain bread, bran cereal, nuts or dried fruit, fresh fruit and raw salad. They measured the death rate from all causes, heart disease, stroke and cancer. They found the death rate from all causes to be half that of the age-matched general population. Moreover, they found that the daily consumption of fresh fruit was associated with a significantly reduced death rate from heart disease and stroke (atherosclerosis).

In 2005 T. Colin Campbell, PhD. of Cornell University reported the findings more than 20 researchers, and spanning 40 years of compiled data from both animal studies and a population of approximately 650,000 rural Chinese people. Investigators analyzed mortality data for more than 50 diseases, including 7 cancer types, from 65 counties and 130 villages in rural mainland China. Their findings are impressive, in favor of a plant-based, nutrient-rich predominately raw whole-foods diet (“frequency of intake of green vegetables).

The report in the American Journal of Cardiology[2] notes that in rural China, fat intake was less than half and fiber intake was 3 times higher that in the United States. Animal protein intake was very low, only about 10% of the US intake. Mean serum total cholesterol was 127 mg/dL in rural China versus 203 mg/dL for age-matched adults aged 20-74 years in the United States. Coronary artery disease mortality was 16.7-fold greater for US men and 5.6-fold greater for US women than for their Chinese counterparts.

The also noted that, “Rates of other diseases were also correlated with dietary factors. There was no evidence of a threshold beyond which further benefits did not accrue with increasing proportions of plant-based foods in the diet.” Moreover, they concluded that approximately 97 percent of chronic illnesses such as heart disease, cancer, and diabetes are attributed to an unhealthy, and only 3 percent to genetics. [3]

Physicians also report clinical success with teaching and promoting a plant-based diet. In his recent book, Eat to Live,[4] for example, Dr. Fuhrman reports his successful treatment for many illness types of thousands of patients with a diet that requires the consumption of at least two pounds of green leafy vegetables per day. Only one of is several hundred heart disease patients underwent repeat surgery, and none died of a heart attack.

And there are other doctors who have proven their clinical success in disease reversal using plant-based nutrient-rich foods including John McDougal, M.D.,[5] [6] Nathan Pritikin,[7] [8] [9] and Michael Gregor, M.D.[10] who heads the[11]

I also one of those doctors who sees this in clinical practice quite routinely. This week I met with 69-year-old John, who came to me six months ago with a total cholesterol level of more than 250 mg/dl. He stated he wanted my guidance because he would not take statin medicine as recommended by his former physician. His wife supported him in taking on a plant-based diet, which he did. He dropped 8 pound naturally, and now his total cholesterol is down to 131 mg/dl.

Please note that their work is not a call to eliminate saturated fat necessarily. The claim that animal fat itself directly contributes to heart disease has been skillfully refuted.[12] For example, in 2004, researchers from Tufts University published a report in the American Journal of Clinical Nutrition called "The American Paradox." In postmenopausal women who were followed over three years for the change in atherosclerosis measured by coronary angiography, the higher their saturated fat intake, the slower their progression of atherosclerosis. Also, in the highest fourth of dietary saturated fat intake, atherosclerosis was reversed. There are other studies to support the fact that saturated fat has an important role in health and so do plant-based nutrient-rich foods.

In my next final article on the subject I will tell you how I treat patients who have difficult conditions such as neuropathy, anxiety, intestinal pain, chronic allergic rhinitis, and more.

To long term health and feeling good,

Michael Cutler, M.D.


[1] Key TJ, Thorogood M, Appleby PN, Burr ML. Dietary habits and mortality in 11,000 vegetarians and health conscious people: results of a 17 year follow up. BMJ. 1996 Sep 28;313(7060):775-9

[2] Campbell TC, Parpia B, Chen J. Diet, lifestyle, and the etiology of coronary artery disease: the Cornell China study. Am J Cardiol. 1998 Nov 26;82(10B):18T-21T.

[3] Campbell T, Campbell TM. 2005 The China Study: the most comprehensive study of nutrition ever conducted. Benbella Books, Dallas TX.










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