How Foods Affect Hormones: Neal Barnard (Transcript)

And then, several days later, the disappointed uterus discovers, “We’re not pregnant again; this didn’t work.” And so, the amount of estrogen falls, and menstrual flow proceeds. But this can all be changed by what you eat.

The whole curve goes up, and the whole curve goes down. So, the way this looks anatomically is, this is the uterus, those are the ovaries off on the side, and depending on where you are in the month, that uterine lining will thicken up. But, let’s say I’m eating a not-so-healthy diet. What can happen is, it thickens up too much, and as it does, it releases maladjusted chemicals called prostaglandins that cause pain.

So, that’s what was happening as the young woman was calling me on the phone to say, “I’m miserable.” Prostaglandins were just wreaking havoc with her. So, I thought, okay, I think I know how to dial your estrogens down, and it has to do with what you eat. You with me so far?

Okay, so, what is it about hormones, and how can I use foods for this? Because, if I can tackle the hormones that cause cramps, then I can tackle a lot of hormones, including the ones that might cause cancer or other things. All right, I’m getting ahead of myself.

How do foods affect hormones?

Let me share with you a story. This is Catherine. Catherine grew up in Louisiana. She was in the Air Force. She was an aerospace engineer, and she was one of the first people to go into Iraq in 2003, because she designed the military bases for the Air Force.

And when you’re in a war zone, and you’re eating what the military gives you, and you’re working really hard, you don’t gain much weight. You stay trim and sort of some variant of healthy. However, at the end of her tour of duty, she went back home to Louisiana, and her friends all said, “Catherine, what did you miss while you were gone?” She said, “You know what I missed? I missed cheese. I missed macaroni and cheese, and cheese snacks, and all the things that we just didn’t have.”

So, her friends took her out to eat cheese dinners, and one of her friends actually gave her an entire case of macaroni and cheese dinners, 48 of them, that she ate for 48 days straight. Yes, she did. She gained weight.

But she also developed some symptoms, where her stomach started to hurt her, and it got worse, and worse, and worse, and as the months went by, it wasn’t getting better. So, she finally went to see a gynecologist who did a laparoscopy. That’s where you make a little incision below the belly button.

You look inside with a scope. The doctor did this, sent her into the recovery room, and when she was able to talk, he said, “You have endometriosis.” Cells that line the uterus have escaped. They go up the fallopian tubes, we believe, and they implant all around the abdomen. They can implant on the intestine. They can implant on the ovaries. They can implant on the fallopian tubes and strangle them, leading to infertility in addition to terrible pain.

So, that’s what endometriosis is. And you can treat it with painkillers. You can treat it with hormonal treatments, none of which was helping Catherine. So, eventually, the doctor said, “I’ve got one other treatment. We can just go in, laparoscopically remove your uterus in a hysterectomy, and that’ll cure the problem.”

She said, “Well, my husband and I are newlyweds, and we weren’t really thinking that we were kind of hoping to have a family.” But as fate would have it, she just really couldn’t get better medically, so she scheduled the procedure for six weeks from this point.”

During that six-week duration, a friend said, “Catherine, I want you to see somebody about your diet.” And she met with a dietitian who said, “Don’t you know about this diet? Plant-based diet. Get rid of all the animal products, including cheese. Keep oils really low.”

She thought, “All right, I’ll try.” And rather reluctantly, she started this vegan diet. Very little oil, very healthy diet. And she found it wasn’t really that hard, but more importantly, she found that she felt better. And she started losing weight, and her energy was better, but her pain was getting better day by day by day.

But six weeks came up, and she thought dutifully she would go to the hospital and just do this procedure and get it done with. So she went into the operating room. She was anesthetized. The doctor made an incision. About an hour later, she woke up in the recovery room, and the doctor had his hand on her shoulder, and he said, “Catherine, I didn’t do it. I didn’t do the hysterectomy. Your endometriosis is effectively gone.” Her mother was sitting with her in the room. Her mother said, “She went vegan.” The doctor said, “Stop it. Foods do not cause endometriosis, and a diet change is not going to cure it. There’s only one explanation. This is a miracle.”

So I think that’s in her chart, that she had a miracle. And so anyhow, she lost a lot of weight. She felt great. She never had the procedure. She’s got three kids now, and she doesn’t have endometriosis anymore. And in fact, Catherine now works for the Physicians Committee with our Food for Life program, teaching other women how to take back their health.

Okay, so I mentioned that she loves cheese. So what’s the deal with cheese? Does cheese have hormones? Well, yes. Cheese comes out of milk. Milk comes out of the cow. Cows are impregnated annually, and so for nine months out of every 12, dairy cows are pregnant, making estrogens. It gets into the blood plasma, and from the blood plasma, it gets into the milk, and the longer the pregnancy proceeds, the more estrogen there is. Now, it’s only a trace, but it’s there.

And in fact, some dairies have gone to the FDA and said, “We want to label our milk as hormone-free because they don’t inject bovine growth hormone.” But the FDA has said, “Wait, there is no hormone-free milk because the cow is making estrogens, whether they’re pregnant or not, but when they’re pregnant, they make more and more and more, and it gets into the milk, and it gets into the cheese.”

Okay, wait a minute. So we’re talking about estrogenic disorders that seem to be related to milk, cheese, animal products? Maybe, and maybe not just for women. Researchers in Rochester, New York looked into a fertility clinic, and they brought in a group of men, and some of them ate relatively little cheese, and some ate a lot of cheese. The sperm counts on the men who ate a lot of cheese were noticeably less than the men who ate relatively little cheese, raising this theory that the traces of estrogens in milk and in cheese are just enough to take a fragile thing like a man’s fertility and knock it off kilter.

Or the regulation of endometriosis in a woman, or her sexual cycle, all of these things could be knocked off balance by hormones that nature didn’t think she would get. By the way, speaking of men, vitamin Z. The guy goes into the doctor’s office, and he says, “Doc, I can’t raise the flag anymore.” The doctor knows what he means. He writes out a prescription for Viagra, hands it to the guy, the guy winks at the doctor, and walks out of the room. “If this is a good doctor, the doctor will suddenly drop his pen, race out of the room, grab his patient before he goes down the elevator, and say, ‘I forgot to tell you one thing. Please come back in.'”

The patient sits down, and the doctor has to explain to him, “Your erectile dysfunction is not caused by performance anxiety. It’s caused by narrowed arteries. You’ve got atherosclerosis. This is from cholesterol and fat. It’s narrowing your arteries, and the most narrow arteries are the ones that go to your private parts.”

The male sexual anatomy is a hydraulic system. It was obviously designed on a Monday, because things are going wrong with it all the time. But the main thing is, if you don’t have good blood flow, it just doesn’t do its thing, right? So if you have narrowed arteries, so you don’t get blood flow there, the doctor explains to the patient, you’ve got narrowed arteries in your heart.

You’ve got narrowed arteries, and your carotid’s going to your brain, meaning you might have erectile dysfunction now, but in two to three years, you’re going to have a heart attack or a stroke. You’re a high-risk patient. So take your Viagra if you want to, but we’ve got to talk about reversing your systemic atherosclerosis, which will kill you. Please see the dietitian before you leave. You just saved this patient’s life.

Erectile dysfunction is a canary in the coal mine of systemic atherosclerosis. Are you with me? Okay, all right. So note to self, skip the cheese. What else affects our hormones, though? Your body has a certain amount of wisdom. It tries to get rid of excess hormones.

Your liver, you know, we don’t respect our liver. It really cares for us. Things that we swallow, it tries to just get rid of them, including excess estrogens, and the estrogens go through that green, down the biliary tree. “This is the common bile duct, and from there it goes into the intestinal tract, and the estrogens go around and then out. You literally flush them down the toilet.”

However, this depends on something. It depends on fiber. Fiber is in your intestinal tract, and it carries the estrogens out, but here’s the trick. Fiber is only in plants. It’s not in animals at all, and so if you had salmon for lunch, or an omelet, or cheese, or something like that, there’s no fiber in that, and so the estrogen in the intestinal tract is absorbed back into the bloodstream. And it goes back to the liver eventually, and it goes around and around and around, and a woman then has too much estrogen circulating 24-7, and same with a man.

Too much testosterone circulating 24-7. I’ve often wondered what would happen to politics in this country if men had a little more fiber in their diet, but that’s another comment. So, spam. Animal, plant, what is it? Fiber? Yes, no? No, trash can, goodbye, see ya, anyway.

So, KFC? Sorry, gone. But also, some plant things have had the fiber removed in the process of refining, so we’re going to get rid of them too, okay. So, we’ve been talking about estrogens in foods, and we’ve been talking about how the body has a way of getting rid of them, getting you back into balance, but there’s yet a third thing, and that’s in dairy products, but it’s not the fat, and it’s not the protein.

Something else, Daniel Kramer at Brigham and Women’s Hospital in Boston started looking at the loss of fertility. As you know, when a woman is in her, maybe she’s in her early 20s, she’s at maximal fertility, but she might say, ‘You know, I’m starting my career. This is not the time when I really want to take time off and raise a family, I’ll put that off,’ and as she reaches 30 and 35, her mother says, ‘You know, don’t wait too long, the biological clock is ticking, your fertility is declining.’ She says, ‘I know, I know, I know.'”

Dan Kramer looked at the drop in fertility between the late 20s and the late 30s in a woman’s life, and in Thailand, where the diet is not an ice cream and cheesecake diet, there’s relatively little dairy consumed, during that time period, the late 20s to late 30s, the drop in fertility, about 25%.

In Brazil, a little more cheese, a little more rapid drop in fertility. In the United States, a lot more dairy products, especially milk, high fat, low fat, and whatever, and the drop in fertility is about 80% during that time period.

And then Dr. Kramer filled in lots of other countries, and the pattern is not perfect, but you can see that there is a pattern, that with more dairy, there seems to be a more rapid loss of fertility. Why is that? He laid the blame on sugar. Lactose sugar, lactose is the dairy sugar, and it’s the most plentiful nutrient in milk.

There’s more of it than there is of protein or fat or anything else. And in your digestive tract, assuming you can digest lactose, it breaks into galactose and glucose, and galactose is toxic to the ovary. So what he believed, and has suggested, and there’s substantial evidence that this is true, that the more you expose the ovaries to galactose, the more you knock out fertility, you knock it out faster and faster and faster.

Well, infertility won’t kill you, but researchers looked at the same kind of relationship with ovarian cancer. And this was a Swedish study looking at women who consumed less than two servings of dairy a day, two to three, three to four, and four or more, and you could see ovarian cancer just goes right up with it.

There are also some rare genetic conditions where kids can’t eliminate galactose effectively, and they have massive infertility and much higher galactose toxicity. So you hear people promoting milk for calcium and all kinds of other reasons, but at the same bargain, they’re promoting something that has estrogens, that has other poisons to the body.

Okay, we’ve talked about cramps and erectile dysfunction and infertility. None of those things are going to kill you, but what about breast cancer? Estrogen’s a sneaky hormone. All hormones, if you have too much of them, they can kill you. If you have too little, it can be fatal as well. In every case, you need to be in a sweet spot. That’s true for insulin. If you have too much, it can be fatal. If you have too little, same story.

With estrogen, they’re tiny. These little estrogen molecules can sneak through the cell membrane. And once they’re inside the cell, they can go through the nuclear membrane, and they can attach to your DNA, damage it, causing cancer cells to arise. I’m talking about your own estrogen, not necessarily estrogen that you’ve swallowed.

And studies show that the higher your estrogen level in your blood, the higher your risk of postmenopausal breast cancer. Okay, so let’s say a woman has been diagnosed with cancer in the past, and she’s got one thing on her mind, which is, “Is this cancer ever going to come back? Or am I going to be able to survive this?” The Women’s Intervention Nutrition Study brought in a group of women, a very large group, more than 2,000 postmenopausal women.

They had all been treated for breast cancer. And what they asked them to do was to make some pretty big diet changes and really cut the fat content in their meals. And what they found was that their risk of a cancer recurrence was cut by 24%, we’ll take it. For estrogen receptor-negative cancers, it was cut by 42%. And for estrogen receptor-positive cancers, down by 15%. So this was not a vegetarian or vegan diet, but just these rather modest changes of cutting the fat were helpful.

On the flip side, researchers started looking at, well, what makes you more likely to succumb to your cancer? And they came back to milk. This was a California study that looked at women previously diagnosed with cancer and those who drank the most milk products, and particularly fatty dairy, whole milk, and butter, and cheese, and so forth. They had a 49% higher risk of dying of their cancer compared to women who generally avoided these products.

Okay, so when you go home after this lecture and you talk to a friend about this, they’ll say, ‘Wait a minute, it’s soy. Have you heard people talk about soy products?”

Soy has, let’s see, what did I read in Men’s Health? Soy has estrogens in it, or something that’ll give you man boobs. You know what I’m talking about?” And if a woman consumes them, she’ll get cancer. What they’re talking about is, in 1931, I believe it was, genistein, which is an isoflavone, was discovered in soy. And it does look sort of like estrogens. This is estradiol.

And in lab studies, people discovered that, in fact, it does attach to the estrogen receptor. So if a man consumes tofu, he’s going to get man boobs, apparently. Well, if someone suggests that to you, you can do an experiment that I think will disprove it. Go to the beach in August.

And you’ll see some kind of heavyset guys who have taken their shirts off. And some of them do have some breast augmentation. Go up to one of them and ask, ‘How much tofu have you had this past week? Tempeh, miso, edamame?’ And what he’s going to say is, “Eda what?”

Like burgers, that’s me. Here’s what’s happened. That’s a fat cell. He’s been gaining weight from eating cheeseburgers. Fat cells are not innocuous blobs of calories. They are little factories. And they take his testosterone, and they convert it into estradiol. You with me?

Testosterone in a man’s body is converted into female sex hormones, causing him not to just have fat around his breast area, that’s breast tissue that he’s developing. The same thing will happen in women as well. Okay, but what about cancer? Could soy cause breast cancer?

Well, we’ve had enough time to sort this out. And it turns out, on the basis of many studies, a high soy intake. And if you could compare, say, Asian-Americans who consume lots and lots of tofu and soy milk compared to others, the high soy consumers have roughly 29% less risk of developing breast cancer compared to people who ignore it. And then researchers have looked at women previously diagnosed with cancer.

Those who avoid soy have the highest mortality. Those who consume a lot of soy, whether it’s tofu or soy milk or miso or whatever, they have the lowest mortality. And that’s true whether it’s estrogen receptor-negative or positive tumors. These are just two different varieties of tumors.

But in both cases, it seems to work. So in your car, you have a gas pedal. And if you step on the gas, it goes. But you’ve got another pedal in your car, right? And it is the brake. Soy hits the brake. It does attach to estrogen receptors. You’ve got alpha receptors, you’ve got beta receptors. It attaches to the beta receptors and it helps slow down cancer growth. Totally optional, you don’t have to have it. Although soy is very handy. If you have soy sausage, it beats the heck out of pork sausage.

One day they’ll make snow tires out of it, probably. They make all kinds of great things. But it does not cause cancer, if anything, it’s a cancer preventer. Okay, so we’ve talked about estrogens and testosterone.

Let’s talk about thyroid hormones. So many people have thyroid issues, but they’re vague. Your thyroid gland is at the base of your neck. And it regulates energy in the body. So if you’re hypothyroidism, you’re low. And you feel weak and you feel sensitive to cold. You might be constipated, you might have weight gain. You might feel depressed, your skin and hair change.

And doctors won’t know what to make of this. Because these are sort of everyday symptoms. But sooner or later, the doctor will do a blood test and that will tell the story. The opposite can happen if you’re hyperthyroid. The thyroid is cranking out too much thyroid hormone. And that means you can lose weight. Sometimes you can gain weight. Your pulse will become irregular. You’ll find that you’re nervous, you’re irritable. You feel warm, you’re basically just kind of revved up. And the doctor can do some tests. And it’s not a terribly difficult diagnosis to make.

So why are so many people having thyroid problems? Well, problem number one is obvious from the hormone itself. Those big purple blobs, that’s iodine. And back in 1924, the Morton Salt Company said, “Let’s put iodine in salt.” And so people were getting plenty of iodine. And they had more than enough to make thyroid hormone.

However, I started using Himalayan salt, or sea salt, or other kinds that are not, in fact, iodized. So I might not be getting the iodine that I need. And so my thyroid hormones are starting to go a little bit out of whack.

Now, milk actually has a little bit of iodine in it. And the reason is that cows are not super hygienic. The toilet paper roll never seems to be adequately filled. So when they milk, when they put the milking thingies on the udder, before they do that to kill any fecal bacteria, they spray them with iodine-containing disinfectant, some of which leaks into the milk. So you can get iodine that way.

My favorite and more hygienic source, am I cheering you up? Um, sea vegetables have iodine. They have a lot. So you go with your friends to the sushi bar. Don’t have the fish sushi, unless you’re really well-insured. But the nori that they wrap around it, and by the way, not just nori, but the wakame that’s in the miso soup and that kind of thing, the erame that’s on your seaweed salad, they are very, very high in iodine.

And so when people were coastal, living coastally, the seaweed that anybody could easily gather was a very high natural source of iodine. But if you grew up in Fargo like I did, you don’t recognize any of this stuff. And you can easily become hypothyroid. Okay, but the bigger reason for thyroid problems in the United States has nothing to do with iodine.

It has to do with antibodies. Antibodies are torpedoes. Your body is invaded by a virus. And so you make antibodies to kill that virus or a bacterium or a cancer cell. But sometimes antibodies attack you. And there wasn’t any virus at all.

And doctors can measure these in blood tests. Somehow your body is making antibodies that are attacking your own thyroid. Some of them shut it down. Some of them, unfortunately, will hit the gas pedal and cause the thyroid to create out too much thyroid hormone.

So could food be the cause of this antibody reaction? The reason we thought maybe yes is that most autoimmune reactions seem to have a dietary link. We’ve seen this with asthma. And by the way, if anybody has a child with asthma, run, do not walk to a completely plant-based diet and see if that doesn’t help your child. A person has rheumatoid arthritis or Sjogren’s disease. These are autoimmune conditions where diet changes seem to help because you’re eliminating a trigger for antibody formation.

So, researchers in the Adventist Health Study 2 brought in a large group of people, more than 60,000, and they looked at thyroid conditions and they classified people based on their diet. And they found that the people who did the worst were the lacto-ovo vegetarians. These are the people who are skipping the meat and they’re replacing it with huge amounts of cheese. And the people who did the best, who had the least type of thyroidism, were the vegans.

And then they looked at hyperthyroidism. They found, once again, the vegans do the best. They’re not exposing themselves to animal antigens and the omnivores seem to do the worst. So we clearly need more research here, but we’ve had more than enough for people to start trying this on their own.

So, this is Mike. Mike is a neurosurgeon in North Carolina. And at age 52, he was in generally good health, but every year he’d have a physical and one year his doc said, “Mike, your thyroid is a little low.” And the way they measure this is with a blood test called TSH or Thyroid Stimulating Hormone.

TSH pushes the thyroid to get active. And if TSH is getting higher and higher, that means that for some reason your thyroid is sluggish and needs to be pushed really hard. So his TSH was going up and the next year and the next year and the next year, after five years his doctor said, “Let’s face it, you’ve got hypothyroidism. Let me write you out a prescription for thyroid replacement.”

Well, he decided to try a dietary approach as kind of a coincidence. And he went on an entirely plant-based diet, joined the vegan subgroup. And what happened was that his TSH fell back down into the normal range. He lost a lot of, not a lot of weight because he was never really heavy, but he lost seven or eight pounds he wanted to get rid of.

And he got his energy back. “Okay, other people have found much the same thing. I personally think we need more research in this area, both on hypo and hyperthyroidism.” But we know more than enough now, before we say to a person, “You’re going to have to be on medication forever or you need surgery or you need radioactive treatments, let’s have a look at what’s on your plate.”

One more hormone. I just want to share with you a few things about insulin. The National Institutes of Health gave us a grant in 2003 to see if we could improve the dietary treatment of people who have type 2 diabetes. And we tested the best current diet that’s cutting calories and limiting carbohydrate and so forth versus a completely plant-based diet.

And this will not be on the test, but what we tracked is hemoglobin A1c, which indicates your blood sugar control. And the red line is the control group on the conventional diet. And they improved, they did well. They improved by about 0.4 absolute percentage points. The vegan group dropped by three times more, about 1.2 absolute percentage points.

That drop is better than any oral diabetes medication you could get. And that’s just from eating beans and asparagus and brown rice and fruit and things like that. No calorie limiting, no medication changes. To show what this means, this is a man named Vance who was one of our first research volunteers.

He came into the study. He said, “Diabetes, it’s been in my family.” His dad was dead at 30. He was 31 when he was diagnosed. He came in to see us in his late 30s. He said, “Diabetes means I’m going to lose a leg. Means I’m going to go blind.”

So anyway, he joined our research study and he was randomly assigned to the vegan diet. And after about three weeks, he said, “You know, this is a pretty easy diet.” I said, “What do you mean? People think of a vegan diet as meaning you have to have a taste for folk music and tie-dyed shirts. You have to be a kind of half philosopher to go vegan, right?”

He said, “Look, instead of eating meat chili, you eat bean chili.” He said, previous diabetes diets had told him cut calories, count carb grams, calibrate your insulin doses, da, da, da. He said, “You don’t tell me to do any of that. Instead of Alfredo sauce, it’s tomato sauce. This is not hard.”

And over the course of about a year, he lost 60 pounds. His doctor, his outside doctor stopped his diabetes medications. And his A1C dropped from nine and a half, which is out of control diabetes, to 5.3. Now, if you’re not familiar with these numbers, I got his lab slip and I paced around in my office for about 20 minutes staring at this lab slip.

That is, that’s not diabetes. That is a normal value. This man had a terrible family history and he himself was diagnosed with this disease and was out of control before he came in. Now he’s on no medications at all and he has absolutely no trace of diabetes in his body. Here’s my question. Do I tell him he doesn’t have diabetes anymore?

I know that sounds like a funny thing to say now, but at the time, what everyone said is, “once you’re diabetic, you’ll always be diabetic. Don’t you tell that patient that they’re cured.” And there was some logic to that because the idea was people with diabetes need to take it seriously. They need to be really careful.

They need to be careful with their medications and their exams. Nobody ever thought that the disease could go away. My dad, my dad grew up in the cattle business, but he left the cattle business, I’m happy to say, and he went to medical school. He became the diabetes expert for Fargo, North Dakota.

And all throughout the eastern part of the state, people would come see my dad. At six o’clock every day, thereabouts, give or take, he would open the front door and come in and sit down in his medical bag. Never once did I hear him say that any patient ever was cured. Never once did anybody really get better.

My dad’s job was to fight a slowly losing battle, trying to keep people from having symptoms, trying to keep their feet attached, trying to keep them away from dialysis as long as possible, trying to keep their vision as long as possible, knowing that in almost every case, they would lose 10 years of life, or 12, or 13 years of life, and that the same problem would happen in their kids. I never heard success.

So here I am looking at Vance’s lab slip, thinking, “I don’t think he’s got diabetes anymore.” And of course, now it sounds silly because we see this all the time. Diabetes, we have shown and proven to be a two-way street, but it will never be a two-way street if we don’t change it. By the way, when I asked his permission to share his story with you, he said, ‘Make sure you tell everyone that my erectile dysfunction went away too.’ So, okay.

All right, so let me show you the cause of types of diabetes. You have glucose in your blood, which is a good thing. Its job is to get into this, this is a muscle cell, this big thing. Your muscles run on glucose, just like your car runs on gasoline. So, the glucose has to go through these funny little channels to power your cell, and insulin is the key that’s going to open them up.

You with me? Okay, so the insulin is made in your pancreas. It arrives at the surface of the cell, just like a key, and then it opens these channels and lets the glucose in. The reason that the insulin is not working in type 2 diabetes was something my father never heard of, because they didn’t have magnetic resonance spectroscopy at the Fargo Clinic.

When you take a patient with type 2 diabetes and stick them in a magnetic resonance, you stick them in a huge magnet, and you’re looking inside their muscle cells, and what you see is fat. They can be real thin, but inside the muscle cells are particles of beef fat, and chicken fat, and fryer grease, and olive oil, extra virgin olive oil, extra extra virgin olive oil. It’s building, doctors hate words like fat, because it has only three letters, so we’ll call it intramyocellular lipid, but it’s fat inside the muscle cells, and it’s also inside the liver cells.

And our group, working with Yale University, has shown that when you change your diet, you can drain that fat out, and so diabetes becomes a two-way street. You’re attacking the cause, and correcting the cause, and how many people with type 2 diabetes go and sit down with a doctor, and have this explained to them?

No, that doesn’t happen. They read in a magazine that you shouldn’t eat bread. That has nothing to do with the cause. It’s your body can regulate this hormone once you bring it back into balance.

Okay, so does this matter? I’m going to argue that it does matter. This is Tony Sadalero. Anybody know Tony Sadalero? Anybody heard of him? Tony Sadalero was a very good doctor. He was the head of Methodist Hospital in Philadelphia, and in his mid-40s, he was running the hospital there, building a new wing, and every year, he had an employee physical, and so including a chest X-ray.

He went down, had a chest X-ray, went back up to his office. He was doing things when his phone rang, and it was the radiologist who was a friend. He said, “Tony, get back down here.” Tony went back down to radiology, and the radiologist put his chest X-ray on the screen, and he said, “Tony, what do you make of this?”

And Dr. Sadalero looked, and he saw densities all in his chest, and to a doctor, this means, do I have cancer? And he didn’t wait. They went ahead and did a bone scan that very day, and they found he had metastatic cancer in his sternum, in his ribs, and in his skull, and it turned out to have started in his prostate gland.

Now, a lot of men have prostate cancer, and if you’re 80 years old, this very slow-growing cancer is probably not going to kill you, and so doctors take their time about doing surgery. They track a blood test called PSA, and if it’s not rising too fast, they just let it go, because this cancer is so slow-growing, but he had such an aggressive cancer, it had already metastasized when he was in his mid-40s.

This was an extremely aggressive cancer, and this was a death sentence. He had a matter of just months to live, so in a moment, he went from being an active, productive doctor to being a patient who was about to die, and to make everything worse, his father had lung cancer and did die just very shortly after his own diagnosis. So Tony drove up to New Jersey from Philadelphia, and he buried his father, and he consoled his mother as best he could.

And he thought, in the time I got left, I’m just going to run that darn hospital as best I can and turn it over to somebody else. So he got on the New Jersey Turnpike, and he started driving down to Philly, and he saw a couple of hitchhikers beside the road, and he picked them up, mostly just to have somebody to talk to, and as fate would have it, they had just gotten out of macrobiotic cooking school.

And they said, “Doc, so you got cancer. Okay, you know, brown rice, tofu, you can eat these things, you can be yang, you can be yin, you can be, these were the most annoying kids you could imagine.”

They didn’t understand that he is a doctor. He doesn’t need this, getting his chakra aligned mumbo jumbo to try to make him feel better about some kind of quackery. But as they got out of the car, they pried loose his address, and they promised to send him a book, which they did, 67 cents postage due, and so he read the book, and he thought, this is just silliness, except there was a story of a woman with breast cancer who happened to be a physician who had done very well on this diet. And he thought, well, that’s curious. I’ll call her up, and he did, and he rang up her home, and her husband answered the phone. He said, “Is Dr. So-and-so there?”

“Yes, but she can’t come to the phone. She’s very, very ill,” and her husband explained that she was dying of her breast cancer, and so Tony said, “I got it. Okay, never mind. Sorry for bothering you, but before he hung up, he said, ‘Wait a minute. I read about her in this book, that she was supposed to be an example of how good this diet was,’ and her husband said, ‘Yeah, she did great. She was on that diet, and it was the best thing that ever happened to her.'”

It just turned her around, but she didn’t stick with it. She’s dying now. Tony thought, okay. My choices are, I’ll try it, so he went to the macrobiotic cooking center, and he learned how to make brown rice, and that night, he blew up his pressure cooker in his apartment, and he was just all thumbs. He found this like impossible, and every day, he would go into the physician’s dining room with his chopsticks and his brown rice, and the doctors would kind of say, “Look at this poor slob who’s, you know, let’s humor poor Tony in his dying days,” but Tony didn’t die.

A macrobiotic diet is a largely plant-based diet that goes from really ancient Chinese medical principles kind of distilled through Japanese cuisine, and so they’re extremely down on dairy. They’re down on meat, very big on grains and vegetables and that kind of thing, so this is what he’s eating, and he started to feel better. He started to feel, in fact, a lot better. His aches and pains went away, and at three months and four months and six months, Tony was still alive, and after a year, he just felt like old Tony, so he went back down to radiology, and he said, “Let’s look.”

They redid the bone scan, and this made history because his cancer was no longer detectable, and this was not just somebody. This was the president of Memphis Hospital in Philadelphia to whom this happened, so he said, “Alright, I cannot keep this a secret,” and he wrote a book called Recalled by Life, and he went on all the talk shows saying, “I don’t know how this works, but we have to study this. We have to understand this. I’m an N of one.”

Let’s bring people in and figure out how this works, and this is a very well-written and engaging book about his story. So, I read this book, and I called him up, and he was vibrant, and I went and visited him, and I looked at his scans, and it’s true. This man was cured, or seemed to be cured, at least, but as I got to know him, and we compared notes and so forth, and time went by, one day, he told me something kind of frightening. He said, “I’ve been well for so long. It’s been about 10 years. I decided to stop the diet.”

What? You know, I want to see how I am if I kind of liberalize this a little bit, and he didn’t do well. Very rapidly, he started to get edema in his hands, which he couldn’t really explain, and his energy level was going down. He could feel something was not right, so he tried to go back on the diet, and his macrobiotic counselor said, “Tony, curing cancer once is a really good thing. Curing it twice is really hard.”

I called him up one day, not too long after this, and his voice was strange, like a person on drugs. I said, “Tony, what’s with you?” He said, “I’m sorry, it’s the narcotics.” I said, “What do you mean?” He said, “My cancer’s back.” Two weeks later, he was dead.

Now, you cannot know from one person, did diet cause his cancer, although we do have very good studies. Harvard has two very large studies linking dairy products to prostate cancer, and also linking certain compounds to protecting against prostate cancer, like antioxidants, like lycopene, to reduce the risk. But you can’t know if that was the case in his case, and you cannot know if the diet is what cured him or if there was some other thing, some other reason.

And you also cannot tell if, had he continued the diet, would he be alive today, but what we do know is that we have more than enough evidence and more than enough explanatory biological mechanisms to say that medical science can no longer ignore these and rely simply on detecting it and zapping it. We’ve got to look at what the body can do for itself, and my message is this: The body can heal.

If you cut your hand, a Band-Aid doesn’t heal you. Built into your DNA is all of the instruction that the skin cells need in order to rejoin to each other and the broken blood vessels will reattach. If you break your leg, the cast doesn’t heal you. Built into your DNA is a program to allow that bone to rejoin.

Arteries can heal, but they will never heal unless you get the cholesterol out of your diet and the animal fat out of your diet, and the menstrual pain and the fertility issues, and even the cancers. The healing capacity of your body has to be supported, and it is so easily frustrated by diet choices that we make all the time. It’s the equivalent of having a broken leg and an insecure cast that never allows it to be stabilized or picking at a cut so that it can never possibly heal. That’s what we do with the foods that we choose and that we feed to our families.

What’s a healthy diet? A healthy diet is four things. It’s fruits and grains and vegetables and legumes. What are legumes, what are they? Beans, peas, foods that grow in a pod. Beans, peas, lentils, okay. So in our clinic at the Barnard Medical Center, we have thousands of people who come in and with many, many medical problems, and we talk about a healthy diet and they wonder, how can I do this? “You want me to go vegan? I’m going to get divorced.” “I’ll have to live in the garage.”

What do I do? So what we do is we break this into two steps and I have never seen anyone unable to do it. If you’re in this audience because you were dragged here by somebody else but you’re kind of intrigued and thinking, maybe there’s something to this, here’s what you do. There’s a two-step method for just trying it out for yourself.

You first check out the possibilities and what you’re going to do is for seven days, take a piece of paper like this and fill it out, looking for things that are plant-based that you would like. What do I mean? I mean, for breakfast, I everyday have cornflakes with milk. “I’ll try almond milk. I don’t know, is it any good? I don’t know, you can go to the store and buy it or oat milk or hemp milk or rice milk or soy milk, whatever, give it a try.”

Next to it are the vegan sausages. I don’t know if they’re any good. I can try it. You got seven days to fill out your list. Every night I eat in an Italian restaurant and I have my angel hair pasta and now I guess I could try the arrabbiata sauce which they tell me has no animal products or I go to Subway and I make a submarine sandwich.

I guess I could throw off the ham and have the vegan sandwich instead. All right, so we’re filling it out and what you discover very rapidly is that there are lots and lots and lots and lots of healthy choices. And by the way, in my new book, ‘Your Body in Balance,’ Lindsay Nixon made all the recipes for it and when she sent them to me, she sent me a note saying, ‘Dr. Barnard, I didn’t tell you this, that my own cramps went away in the course of eating a low-fat vegan diet.’

So these are everyday things. Anyway, the point is there are lots and lots of wonderful foods that you can choose, including at restaurants when you eat out, lots and lots of choices. So you got seven days to try it out. If you go to the sushi bar, you’ll find that you could get your iodine and lots of exotic things that we never had in Fargo, North Dakota, including maybe even Taco Bell, not the pinnacle of culinary art, but they’ve got vegan things for you. So after seven days, you discover you’ve got your list filled out. That was the first step.

Now, step two is let’s do a three-week test drive. We’re going to do it all vegan, all the time, but only for 21 days. And 21 days, you can do anything. Plus, you already picked out the foods. So let’s try it. At the end of that time, two things will have happened.

The first is you are physically healthier. You feel better. You’re losing weight. If you have diabetes, your blood sugar is coming down, but the other thing is that your tastes are changing, and they’re changing a lot.

So we have some other things that you can use, other resources. We have an app called the 21 Day Vegan Kickstart which you can get on your smartphone. It’s free, nobody’s selling anything. It’s menus and recipes and all kinds of stuff. This is my new book which I’m hoping you’ll enjoy and share with others. For clinicians, we have the nutrition guide for clinicians. Everything from Alzheimer’s to varicose veins, it’s a free download. We have nutrition continuing education for all those doctors who didn’t learn this in medical school.

We will help you for free. The AMA accredits that and also accredits our International Conference on Nutrition and Medicine. It would make your heart sing to see 1,000 or more doctors in one room all deciding maybe we’re doing too much with pills and not enough with food. Let’s change that.

The last thing that I want to just spend just a couple of minutes on if I may and that’s to say we need to change the world that we live in a little bit. You might think that hospitals would take advantage of the teachable moment where the patient is in the hospital and whatever they’re there for now is a chance to hook them on healthy food. But have you looked at hospital menus lately? Some of them are not so healthy for you including processed meats.

This is my hospital, the George Washington University Hospital. There’s a helicopter bringing them in more bacon and sausages. I took this picture in our own hospital cafeteria. “Bacon causes colorectal cancer.” It clearly increases the risk of many other forms of cancer as well.

And by the way, let me show you this from the New York Times, “cancer increasing among meat eaters,” 113 years ago. Hospitals haven’t changed in all this time. I want to tell you something. Things can change. I wrote a resolution that I brought to the American Medical Association which years ago was silent on diet.

And I want to tell you something. The American Medical Association in 2017 passed this resolution saying that we call on US hospitals to improve the health of patients, staff, and visitors by providing plant-based meals, low in fat, sodium, and added sugars, by throwing out the bacon and the sausage and the ham and the hot dogs completely, and having healthy beverages. The world really can change. Yes, I praise my colleagues at the AMA for doing that.

They’ve done a lot more. This is Albany and Albany, as you know, and many of you helped with this last year. Governor Cuomo signed a bill saying that hospitals have to provide plant-based meals. So I applaud those of you who made this happen. But we’ve really got to change this world, and that means three things.

It means learning, understanding information. Now there are limits to what we know, and we have to be humble about that. And we do need more research, and we have to explore and learn as we go. But then we have have to connect with other people and we have to share information. The people who need this message the most are not in this room. The people who need this message the most are 12 years old and in school, they’re eating chicken nuggets.

And on the way home, they’re getting string cheese, and their parents put a cheese pizza in the oven, and then they turn on the TV and half the commercials are snack foods and the other half of the commercials are medications to undo the effects of the snack foods. And that’s the world that kids grow up in. They’ve never heard any of this.

And the girl’s now 16, she’s got menstrual cramps. She’s told that’s just what it’s like to be a woman. The couple is dealing with infertility, and they’re told this will be hundreds of thousands of dollars for you likely. And somebody has a cancer diagnosis in their family or they themselves have it.

And they’re told here are your options. It’s chemo, it’s radiation. Yes, those are important in many cases. But if we’re not focusing on food, then we are deciding that we do not care that the body has healing properties of its own that are more powerful than anything else and need to be shored up.

So we have to make some noise, and that’s what it is. So I’m hoping that every one of you will take your personal megaphone, which might be your Instagram page, or it might be Facebook or Twitter account or whatever it is, let’s make some noise. Let me also ask you to please join us. If you would, when you can, turn on your smartphone and actually go to pcrm.org/slash balance.

Join our network, and we have lots more resources there, and also an opportunity to sign up for more alerts. We are working on legislation all the time, including here in New York. We’ve got a bill coming in shortly that would require doctors to actually have continuing medical education related to nutrition three hours a year. It’s a start.

We are going to get pushed back like you’ve never believed, but I think we can win it if we just insist that this is the case. We recently did a poll. 64% of doctors actually support it, but the medical community itself, the organized medicine, is not yet there. So help us to arm wrestle this.

Governor Cuomo signed the bill. Hospitals need to put it to work. Let me ask you to help us arm wrestle with the hospitals. And the big area then has to be schools. There is no reason that a seven or eight-year-old child should get a great education and even a look at their morals, but they’re getting foods that are going to make them unhappy and hurt them and possibly even kill them later in life. We’ve got to change that.

So I want to thank the JCC and I want to thank all of you for allowing me to share this time with you tonight. Thank you very much. Thank you.

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