Tag Archives: Greg Feinsinger M.D.

Problems with our Health Care System: Big Pharma Needs Fixing by Greg Feinsinger MD

Following the discovery of antibiotics ninety years ago, the medical field became pill and procedure-oriented. Initially, the business of medicine was altruistic. For example, in 1955 Jonas Salk developed the polio vaccine, which saved millions of lives and prevented millions of cases of disabling paralysis worldwide. When Dr. Salk was asked who owned the patent, his reply was: “Well, the people, I would say. There is no patent. Could you patent the sun?”

In the last twenty-five years, American medicine (hospitals, the pharmaceutical/medical device industry, medical insurance companies, physician specialty societies) has become big business—all about making profits rather than about what’s best for the citizens of this country. Following are some reasons it has become easy—in this environment of greed–to dislike the pharmaceutical industry:

  • They have too much influence on Congress, through campaign contributions and lobbying–for example convincing them to make importing cheaper drugs from Canada illegal, convincing them to forbid Medicare from negotiating for better drug prices for seniors.
  • They have too much influence on medical education and on practicing physicians: Drug reps develop cozy relationships with doctors in their offices and convince them to use their products, even though better and cheaper alternatives often exist. Medical journals contain drug ads. Most speakers at medical conferences have ties to pharmaceutical companies (which they now have to disclose).
  • Pharmaceutical companies charge as much as they can get away with—especially for products that are critical for people with diseases such as M.S.
  • When patents on brand-name products are about to expire, drug companies make minor changes and sell these “new” products at brand-name prices. Or they pay potential generic competitors to delay making lower-priced products.
  • Although game-changing drugs have been developed over the years, most new drugs are “me too” drugs, that offer nothing new—a practice that isn’t allowed in most other developed countries. For example, losartan came out as an ARB drug for hypertension many years ago, but there are now several of these ARB drugs with no real advantage over the original losartan.
  • They market directly to consumers—a practice that is only allowed in the U.S. and New Zealand.
  • They justify over-charging for their products by saying that Research and Development is expensive—but they pay their CEOs inflated salaries and spend more on marketing than on R and D.

Can you imagine the altruism that Dr. Salk displayed in 1955 happening today? Now we have Goldman Sachs analysts warning biotech firms to stay away from drugs that offer “one shot cures.” They are referring to a new drug that cures hepatitis C, which “has gradually exhausted the available pool of patients.” The analysts suggest sticking to cancer drugs, “where the potential for a cure poses less risk to the sustainability of a franchise.”  Drug companies benefit most from chronic diseases such as diabetes and hypertension, which—unless patients with these diseases make dramatic lifestyle changes—require medications for years. (As noted in previous columns, the U.S. doesn’t have a healthcare system, but rather a disease management system—we wait until diseases occur and then spend trillions trying to manage them. Big Pharma loves this dysfunctional system).

The PNHP (Physicians for a National Health Plan) developed with the following principles for fixing the pharmaceutical industry:

  • “Access to medications should be determined by medical need, not financial means.”
  • “Drugs must be affordable to society.”
  • “Drug development should be geared toward real innovation that maximizes population health.”
  • “The human right to health must take precedence over intellectual property rights (patents).”
  • “The safety and effectiveness of medications must be independently and rigorously evaluated.” (This refers to the pharmaceutical industry having undue influence on the FDA).
  • “Comprehensive and unbiased information on drugs should be available to prescribers and patients.”

 

 

 

Signs that the Medical Establishment may be Starting to get Healthy Eating by Greg Feinsinger M.D.

In the 1940s Dr. Walter Kempner proved that severe hypertension could be reversed by diet. Over 25 years ago Dr. Dean Ornish, and later Dr. Caldwell Esselstyn, proved that our biggest killer—heart disease—can be reversed by plant-based, whole food nutrition with avoidance of salt, sugar and added oil. But unfortunately, the medical field is bound by tradition; doctors are paid well to do procedures but not for counseling; and physician training and practice are unduly influenced by the pharmaceutical and food industries. As a result, the power of food to prevent and reverse disease has been neglected by traditional medicine.

Finally, there are some hopeful signs that this may be changing. Dr. Kim Williams, who was recently the president of the American Collage of Cardiology, decided to go plant-based a few years ago, after reviewing several different diets. When people asked him why, he said “I don’t mind dying so much, but I don’t want it to be my fault.”

The American Heart Association publishes the respected medical journal “Circulation.”  In the June 5th issue there is an article titled “Medical Nutrition Education, Training and Competencies to Advance Guideline-Based Diet Counseling by Physicians.”  The article notes that “training physicians to provide diet and nutrition counseling as well as developing collaborative care models to deliver nutrition advice will reduce the health and economic burden of atherosclerotic cardiovascular disease to a degree not previously recognized.” It goes on to note that “despite evidence that physicians are willing to undertake this task and are as credible sources of diet information, they engage patients in diet counseling at less than desirable rates and cite insufficient nutrition knowledge and training as barriers to carrying out this role…These data align with ongoing evidence of large and persistent gaps in medical nutrition education and training in the United States…”

The American Family Physician journal is getting on board as well. The June 1st edition contained an article titled “Diets for Health:  Goals and Guidelines,” which reviewed the pros and cons of various diets that are touted as being healthy. The article points out that plant proteins are preferable, and cites the health benefits of fruits and vegetables, legumes (beans, lentils, chick peas), whole grains, healthy fats and spices. In a high-lighted box titled “What is New on This Topic:  Diets For Health,” the article notes:

  • Large, prospective cohort studies show that vegetarian diets reduce the risk of coronary heart disease and type 2 diabetes mellitus, and that vegan diets offer additional benefits for obesity, hypertension, type 2 diabetes, and cardiovascular disease.”
  • “Eating nuts, including peanuts, is associated with decreased cardiovascular disease and mortality, lower body weight, and lower diabetes risk.
  • “In a prospective cohort study, consumption of artificially sweetened beverages increased the risk of type 2 diabetes…”

Of course, Drs. Esselstyn, Fuhrman, Greger, McDougall, Barnard and others have been telling us these things for years—this information really isn’t new. What’s new is that the medical establishment is finally listening.

At my 50th medical school reunion in Denver last month, graduating medical students told me they still aren’t being taught much about nutrition or prevention. But maybe this will finally change, and in the near future medical students will learn that health isn’t all about pills and procedure—that inexpensive, low-tech lifestyle changes can prevent and reverse many of the chronic, costly diseases that afflict so many Americans.

 

How to Avoid Blood Cancers by Greg Feinsinger M.D.

There are basically 3 types of blood cancer: leukemia, lymphoma and myeloma.

  • Leukemia involves propagation of mutant white blood cells in the bone marrow. Normal white blood cells fight infection but leukemia cells lose this function. Furthermore, they crowd out normal red and other types of white blood cells in the bone marrow. Around 52 thousand cases of leukemia occur in the U.S. annually, and 24 thousand people die from it.
  • Lymphoma involves mutation and propagation of another type of white blood cell—lymphocytes. The most common type is non-Hodgkin’s lymphoma, of which there are 70 thousand cases diagnosed in the U.S. every year, with about 19 thousand deaths.
  • Myeloma involves plasma cells—white blood cells that produce antibodies. Some 24 thousand Americans are diagnosed with myeloma every year, resulting in 11 thousand deaths.

Treatment of blood cancers has variable results, with the greatest success being childhood leukemia, which now has a 90 percent ten-year survival rate. As with other diseases, prevention is best. In his book “How Not to Die,” Dr. Michael Greger reviews foods associated with decreased blood cancer risk. As discussed in the last several columns, what we eat don’t eat can lower the risk of many types of cancer. Dr. Greger says that studies have shown that “the greatest protection appeared to be against blood cancers.”

  • Sulforaphane* is a strong cancer-fighting micronutrient present in cruciferous vegetables—arugula, bok choy, broccoli, brussels sprouts, cabbage, cauliflower, collard greens, horseradish, kale, mustard greens, radishes, turnip greens, and watercress. Sulforaphane kills human leukemia cells in the lab, and studies have shown that high daily dietary cruciferous intake decreases the risk of lymphoma.
  • In a Mayo Clinic study, people who ate 5 or more servings of green, leafy vegetables a week had a 50 percent lower incidence of lymphoma compared with those eating less than 1 serving a week.
  • There is preliminary evidence that turmeric can slow or stop pre-myeloma changes in humans.
  • Acai berries have been shown in the lab to be effective against leukemia cells, although studies proving that they prevent leukemia in living humans have not been done yet. Of course, Big Food jumped on the favorable lab evidence—beware of “superfood” supplements and shakes, which have not been proven to have any benefit.

Dr. Greger also cites certain foods that increase the risk of blood cancers:

  • People who grow up on poultry farms and workers in the poultry industry are at higher risk for blood cancers. Eating poultry regularly also increases risk. The cause is thought to be certain viruses that cause cancer in poultry and probably in humans (we don’t know for sure yet).
  • Exposure to cattle and pigs has been associated with non-Hodgkin’s lymphoma, and eating them may prove to increase risk of lymphoma although again, we don’t know for sure yet.

*In order for sulforaphane to be released from cruciferous vegetables, an enzyme called mycrosinase is necessary, and this enzyme is inactivated by cooking. One strategy you can use is to eat some raw cruciferous veggies, such as cauliflower or broccoli, before you eat cooked cruciferous veggies—that way microsinase is available to release the sulforaphanes in the cooked veggies. A second strategy is to chop or blend cruciferous veggies at least 40 minutes before you cook them, which allows mycrosinase to do its job. A third strategy is to add mustard or horseradish to cooked cruciferous veggies (mustard greens and seeds, and horseradish, come from cruciferous vegetables and contain mycronase). Frozen cruciferous vegetables are flash-heated prior to freezing, to prolong shelf life—so frozen cruciferous vegetables need to be considered “cooked.”

How to Prevent Cancer of the Pancreas by Greg Feinsinger M.D.

The pancreas is a large gland located behind the stomach. It secretes insulin, necessary for blood sugar control, directly into the blood stream. It also secretes digestive juices necessary for digestion of proteins into the small intestine. About 46,000 Americans develop pancreatic cancer every year, which is impossible to screen for, and is difficult to diagnose early and to treat successfully—few patients diagnosed with pancreatic cancer survive more than a year. Therefore, it’s particularly important to prevent pancreatic cancer.

Here’s how you can stack the deck in your favor to avoid pancreatic cancer, according to Dr. Michael Greger in his book “How Not to Die” and on his website nutritionfacts.org:

  • Don’t smoke—about 20 percent of cases of pancreatic cancer are related to smoking.
  • Maintain your ideal body weight, because obesity is a risk factor for pancreatic cancer. Check your height and your weight and google your BMI to find out if you’re overweight.
  • Avoid heavy drinking, which is another risk factor for pancreatic cancer. More than 1 drink a day for women and 2 drinks a day for men is considered unhealthy (note that any alcohol except perhaps a little red wine is a risk factor for breast cancer in women). One drink is defined as 4 ounces of wine, 12 or beer, or 1 oz of hard alcohol.
  • Avoid fat from animal products. Dr. Greger notes that older studies have been conflicting but that the large, NIH-AARP study showed that “the consumption of fat from all animal sources was significantly associated with pancreatic cancer risk, but no correlation was found with consumption of plant fats.” This means that you should avoid meat including chicken, seafood, eggs, and all dairy products including cheese and yogurt. Instead, get the fat you need in your diet from nuts, seeds (sunflower, pumpkin, flax, chia, hemp), olives and avocados.
  • If you want to avoid pancreatic cancer, it’s particularly important that you avoid chicken. In a study of 30,000 poultry workers, their risk of pancreatic cancer was found to be 9 times the risk in the general population. This is thought to be due to cancer-causing poultry viruses, that can be transmitted to humans. Regarding people who eat chicken, a large European study found a 72 percent increase in pancreatic cancer for every 50 grams of chicken eaten daily (50 grams is about 1/4 of a chicken breast).
  • Eat 1/4 to 1/2 teaspoonfuls of turmeric a day, which in the lab has been shown to reverse early cancerous changes in pancreatic cells. Larger doses of turmeric taken daily have been shown to be as effective as chemotherapy in delaying progression of pancreatic cancer.
  • Avoid foods with a high glycemic index—in his book “Fast Food Genocide,” Dr. Joel Fuhrman notes that these foods are linked to several cancers, including pancreatic. These are foods such as sugary or refined foods, that raise you blood sugar rapidly (if you eat an orange, your blood sugar doesn’t go up much because of the fiber in the orange—orange juice, which is basically flavored sugar water, raises your blood sugar rapidly).
  • Avoid processed meat (such as sausage, lunch meat, bacon, ham) and fast food. Dr. Fuhrman notes that “increased consumption of processed meat, and meats cooked with typical fast food cooking techniques, correlates positively with the likelihood of developing…pancreatic… cancer.” Carcinogens such as heterocyclic amines are formed when muscle meat “including beef, pork, fish, and poultry” is cooked at high temperatures, such as pan frying and grilling.
  • Eat cruciferous vegetables daily, such as broccoli, cauliflower, kale, cabbage, bok choy, brussels sprouts. Dr. Fuhrman cites a study showing that one or more servings of cabbage a week reduced risk of pancreatic cancer by 38 percent.

How to Avoid and Survive Breast Cancer (by Greg Feinsinger M.D.)

Breast cancer is the most common cancer in American women, after skin cancer. Every year about 230,000 women in this country are diagnosed with breast cancer, and 40,000 die from it. Mammograms and self-breast exams supposedly lead to early detection, but in reality, this is “late detection” because breast cancer has been present for years—up to 4 decades– by the time it is diagnosed. Some of the 2-billion cells in our bodies are always mutating. We evolved to eat plants, and plants contain micro-nutrients that destroy these mutant cells before they propagate– animal products lack this ability.

Caldwell Esselstyn, M.D. is one of the two doctors (Dr. Ornish was the other) who proved that plant-based, whole food nutrition with no salt, sugar or added oil reverses heart disease.  Dr. Esselstyn, now in his 80s, started out as a surgeon at the Cleveland Clinic decades ago. He was operating on young women who presented with breast cancer, and the treatment back then was radical mastectomy—a very disfiguring operation. Dr. Esselstyn started looking for a way to prevent breast cancer and found out that populations who ate a plant-based diet had an extremely low rate of breast cancer.

If you are a woman and want to do everything you can to prevent breast cancer, read the chapter on breast cancer in Dr. Greger’s book “How Not to Die,” and search breast cancer on his website NutritionFacts.org. If you are a breast cancer survivor, read “The Cancer Survivor’s Guide, Foods That Help You Fight Back!” by Neal Barnard, M.D. Following are some of the points made in these two books:

  • In 2014 the World Health Organization upgraded its classification of alcohol to “a definitive human breast carcinogen.”  The culprit is acetaldehyde, a toxic breakdown product of alcohol. Dr. Greger notes that the skin of grapes used to make red wine contains a compound that “may help cancel out some of the cancer-causing effects of the alcohol.”
  • Melatonin, the “sleep hormone,” appears to have a protective effect against breast cancer. Melatonin levels are lowered by bright lights including computer and TV screens during pre-bedtime hours and by eating meat (for unknown reasons). Eating vegetables raises melatonin levels (again, for unknown reasons).
  • Excess estrogen increases breast cancer risk, and women need to be hesitant about taking post-menopausal hormones (“bio-identical hormones” have not been proven to be any safer). Body fat produces estrogen, and therefore people who are overweight are at increased risk for breast cancer.
  • Diets high in saturated fat from added oil (coconut oil has the most), meat, dairy products and eggs increase breast cancer risk.
  • Regular exercise such as brisk walking for an hour a day lowers the percentage of body fat, and for that and other reasons exercise lowers breast cancer risk.
  • Heterocyclic amines (HCAs) are carcinogens produced by cooking beef, pork and other meat—and fish and poultry– at high temperatures, such as roasting, pan frying, grilling and baking. According to Dr. Greger, PhIP,  “one of the most abundant HCAs in cooked meat, was found to have potent estrogen-like effects, fueling human breast-cancer cell growth.”
  • Lignans are phytoestrogens that “dampen the effects of the body’s own estrogen” according to Dr. Greger. Lignans are particularly plentiful in flaxseeds, and are also found in berries, whole grains and dark, leafy greens. Flaxseed has even been shown to reduce breast cancer tumor growth. Antibiotics kill health-promoting gut bacteria which are important in activating lignans.
  • According to Dr. Greger, some studies have shown a link between high cholesterol levels and breast cancer risk, thought to be due to our bodies “using cholesterol to make estrogen or to shore up tumor membranes to help the cancer migrate and invade more tissue.” Using statins to lower cholesterol does not decrease breast cancer risk.
  • Fiber, which is found only in plant foods, helps remove estrogen via the GI tract and lowers breast cancer risk. For every 20 grams of fiber intake per day, there was a 15 percent lower risk of breast cancer in several studies.
  • Apple peels contain a compound that activates a breast tumor-suppressor gene.
  • Cancerous stem cells may be why breast cancer can sometimes recur years after apparently successful treatment. Sulforaphane, a component of cruciferous vegetables (e.g. broccoli, cabbage, kale, cauliflower), “suppresses the ability of breast cancer stem cells to form tumors” according to Dr. Greger. Cooking destroys the enzyme that activates sulforaphane so some cruciferous vegetables should be eaten raw (or eat some raw ones before eating cooked cruciferous vegetables).
  • Soybeans contain weak phytoestrogens (phyto = plant) called isoflavones, which attach to estrogen receptors in breast tissue, preventing stronger estrogens from attaching, thereby lowering breast cancer risk. It is thought that high soy intake is why the incidence of breast cancer is low in Asian women. If you are a breast cancer survivor, you should know that according to Dr. Greger, “women diagnosed with breast cancer who ate the most soy lived significantly longer and had a significantly lower risk of breast cancer recurrence.”