Relative
to	total	calorie	intake,	only	5–6%	dietary	protein	is	required	to	replace	the
protein	regularly	excreted	by	the	body	(as	amino	acids). About	9–10%
protein,	however,	is	the	amount	that	has	been	recommended	for	the	past	fifty
years	to	be	assured	that	most	people	at	least	get	their	5–6%	“requirement.”
This	9–10%	recommendation	is	equivalent	to	the	well-known	recommended
daily	allowance,	or	RDA. 5
Almost	all	Americans	exceed	this	9–10%	recommendation;	we	consume
protein	within	the	range	of	about	11–21%,	with	an	average	of	about	15–16%. 6
The	relatively	few	people	consuming	more	than	21%	protein	mostly	are	those
who	“pump	iron,”	recently	joined	by	those	on	high-protein	diets. It	is	extremely	puzzling	that	these	new	government-sponsored	2002	FNB
recommendations	now	say	that	we	should	be	able	to	consume	protein	up	to
the	extraordinary	level	of	35%	as	a	means	of	minimizing	chronic	diseases	like
cancer	and	heart	disease. This	is	an	unbelievable	travesty,	considering	the
scientific	evidence. The	evidence	presented	in	this	book	shows	that	increasing
dietary	protein	within	the	range	of	about	10–20%	is	associated	with	a	broad
array	of	health	problems,	especially	when	most	of	the	protein	is	from	animal
sources. As	reviewed	earlier	in	this	book,	diets	with	more	animal-based	protein	will
create	higher	blood	cholesterol	levels	and	higher	risks	of	atherosclerosis,
cancer,	osteoporosis,	Alzheimer’s	disease	and	kidney	stones,	to	name	just	a
few	chronic	diseases	that	the	FNB	committee	mysteriously	chooses	to	ignore. Furthermore,	the	FNB	panel	had	the	audacity	to	say	that	this	10–35%
recommendation	range	is	the	same	as	previous	reports. Their	press	release
clearly	states,	“protein	intake	recommendations	are	the	same	[as	previous
reports].”	
I	know	of	no	report	that	has	even	remotely	suggested	a	level	as	high
as	this. When	I	initially	saw	this	protein	recommendation,	I	honestly	thought	
that
it	was	a	printing	error. But,	no,	it	was	correct. I	know	several	of	the	people	on
the	panel	who	wrote	this	report	and	decided	to	give	them	a	ring. The	first
panel	member,	a	long-time	acquaintance,	said	this	was	the	first	time	he	had
even	heard	about	the	35%	protein	limit! He	suggested	that	this	protein
recommendation	might	have	been	drafted	in	the	last	days	of	preparing	the
report. He	also	told	me	that	there	was	little	discussion	of	the	evidence	on
protein,	for	or	against	a	high	consumption	level,	although	he	recollected	there
being	some	pro-Atkins	sympathy	on	the	committee. He	had	not	worked	in	the
protein	area,	so	he	did	not	know	the	literature. In	any	event,	this	importantrecommendation	slipped	through	the	panel	without	much	notice	and	made	the
first	sentence	of	the	FNB	news	release! The	second	panel	member,	a	long-time	friend	and	colleague,	was	a
subcommittee	chair	during	the	latter	part	of	the	panel’s	existence. He	is	not	a
nutritional	scientist	and	also	was	surprised	to	hear	my	concerns	about	the
upper	limit	for	protein. He	did	not	recall	much	discussion	on	the	topic	either. When	I	reminded	him	of	some	of	the	evidence	linking	high-animal	protein
diets	to	chronic	disease,	he	initially	was	a	little	defensive. But	with	a	little
more	persistence	on	my	part	about	the	evidence,	he	finally	said,	“Colin,	you
know	that	I	really	don’t	know	anything	about	nutrition.”	How,	then,	was	he	a
member—let	alone	the	chair—of	this	important	subcommittee? And	it	gets
worse. The	chair	of	the	standing	committee	on	the	evaluation	of	these
recommendations	left	the	panel	shortly	before	its	completion	for	a	senior
executive	position	in	a	very	large	food	company—a	company	that	will
salivate	over	these	new	recommendations.A	SUGARCOATED	REPORT
The	recommendation	on	added	sugar	is	as	outrageous	as	the	one	for	protein. At	about	the	time	this	FNB	report	was	being	released,	an	expert	panel	put
together	by	the	WHO	(World	Health	Organization)	and	the	FAO	(Food	and
Agriculture	Organization)	was	completing	a	new	report	on	diet,	nutrition	and
the	prevention	of	chronic	diseases. Professor	Phillip	James,	another	friend	of
mine,	was	a	member	of	this	panel	and	a	panel	spokesperson	on	the	added
sugar	recommendation. Early	rumors	of	the	report’s	findings	indicated	that
the	WHO/FAO	was	on	the	verge	of	recommending	an	upper	safe	limit	of	10%
for	added	sugar,	far	lower	than	the	25%	established	by	the	American	FNB
group. Politics,	however,	had	early	entered	the	discussion,	as	it	had	done	in
earlier	reports	on	added	sugars. 7
	According	to	a	news	release	from	the
director-general’s	office	at	the	WHO,
8
	the	U.S.-based	Sugar	Association	and
the	World	Sugar	Research	Organization,	who	“represent	the	interests	of	the
sugar	growers	and	refiners,	had	mounted	a	strong	lobbying	campaign	in	an
attempt	to	discredit	the	[WHO]	report	and	suppress	its	release.”	They	did	not
like	setting	the	upper	safe	limit	so	low. According	to	the	
Guardian
	newspaper
of	London,
7
	the	U.S.	sugar	industry	was	threatening	“to	bring	the	World
Health	Organization	to	its	knees”	unless	it	abandoned	these	guidelines	on
added	sugar. WHO	people	were	describing	the	threat	“as	tantamount	to
blackmail	and	worse	than	any	pressure	exerted	by	the	tobacco	industry.”
7
	The
U.S.-based	group	even	publicly	threatened	to	lobby	the	U.S.	Congress	to
reduce	the	$406	million	U.S.	funding	of	the	WHO	if	it	persisted	in	keeping
the	upper	limit	so	low	at	10%! There	were	reports,	after	a	letter	was	sent	by
the	industry	to	Secretary	of	Health	and	Human	Services	Tommy	Thompson,
that	the	Bush	administration	was	inclined	to	side	with	the	sugar	industry. I,
and	many	other	scientists,	were	being	encouraged	at	that	time	to	contact	our
congressional	representatives	to	stop	this	outrageous	strong-armed	tactic	by
the	U.S.	sugar	companies. So,	for	added	sugars,	we	now	have	two	different	upper	“safe”	limits:	a
10%	limit	for	the	international	community	and	a	25%	limit	for	the	U.S.	Why
such	a	huge	difference? Did	the	sugar	industry	succeed	in	controlling	the
U.S.-based	FNB	report	but	fail	with	the	WHO/FAO	report? What	does	this
say	about	the	FNB	scientists	who	also	devised	the	new	protein
recommendation? These	wildly	different	estimates	are	not	a	matter	of
scientific	interpretation. This	is	nothing	more	than	naked	political	muscle. Professor	James	and	his	colleagues	at	the	WHO	stood	up	to	the	pressure;	theFNB	group	appears	to	have	caved	in. The	U.S.	panel	received	funding	from
the	M&M	Mars	candy	company	and	a	consortium	of	soft	drink	companies. Is
it	possible	that	the	U.S.	group	felt	an	obligation	to	these	sugar	companies? Incidentally,	the	sugar	industry,	in	their	fight	against	the	WHO	conclusion,
has	relied	heavily
7
	on	the	FNB	report	with	its	25%	limit. In	other	words,	the
FNB	committee	produces	a	friendly	recommendation	for	the	sugar	industry
which	then	turns	around	and	uses	this	finding	to	support	its	claim	against	the
WHO	report.THE	INFLUENCE	OF	INDUSTRY
This	discussion	still	leaves	unanswered	the	question	of	how	industry	develops
such	extraordinary	influence. Mostly	industry	develops	consultancies	with	a
few	publicly	visible	figures	in	academia,	who	then	take	leadership	in	policy
positions	outside	of	academia. However,	these	industry	consultants	continue
to	wear	their	academic	hats. They	organize	symposia	and	workshops,	write
commissioned	reviews,	chair	expert	policy	groups	and/or	become	officers	of
key	professional	societies. They	gravitate	toward	the	leadership	positions	in
science-based	organizations	that	develop	significant	policy	and	publicity. Once	in	these	positions,	these	people	then	have	the	opportunity	to
assemble	teams	to	their	liking,	by	choosing	committee	members,	symposia
speakers,	management	staff,	etc. The	kinds	of	people	most	helpful	to	the	team
are	either	colleagues	with	similar	prejudices	and/or	colleagues	who	are
oblivious	to	who	is	“calling	the	shots.”	It’s	called	“stacking	the	deck,”	and	it
really	works. In	the	case	of	the	FNB,	its	panel	was	organized	while	under	the
chairmanship	of	an	academic	who	had	strong	personal	ties	with	the	dairy
industry. He	helped	in	selecting	the	“right”	people	and	helped	in	setting	the
agenda	for	the	report,	the	most	significant	roles	that	anyone	could	have
played. Is	it	surprising	that	the	dairy	industry,	which	must	be	ecstatic	with	the
panel’s	findings,	also	helped	to	finance	the	report? You	might	be	surprised	to	learn	that	academic	scientists	can	receive
personal	compensation	from	industry	while	simultaneously	undertaking
government-sponsored	activities	of	considerable	public	importance. Ironically,	they	can	even	help	set	the	agenda	for	the	same	government
authorities	who	have	long	been	restricted	from	such	corporate	associations. It
is	a	huge	“conflict-of-interest”	loophole	allowing	industries	to	exercise	their
influence	through	the	side	door	of	academia. In	effect,	the	entire	system	is
essentially	under	the	control	of	industry. The	government	and	academic
communities,	playing	their	respective	roles,	mostly	do	as	they	are	expected	to
do. In	addition	to	M&M	Mars	company,	the	corporate	sponsors	of	the	FNB
report	also	included	major	food	and	drug	companies	that	would	benefit	from
higher	protein	and	sugar	allowances. 2
	The	Dannon	Institute,	a	leading	dairy-
based	consortium	promoting	its	own	brand	of	nutrition	information,	and	the
International	Life	Sciences	Institute	(ILSI),	which	is	a	front	group	for	about
fifty	food,	supplement	and	drug	companies,	
both	contributed	funding	for	the
FNB	report. Corporate	members	include	Coca-Cola,	Taco	Bell,	Burger	King,
Nestle,	Pfizer	and	Roche	Vitamins. 9
	Some	drug	companies	sponsored	thereport	directly,	in	addition	to	their	support	through	the	International	Life
Sciences	Institute. I	don’t	recall	private	corporations	providing	financial
support	for	the	NAS	expert	panels	that	I	served	on. It	seems	as	if	there	is	no	end	to	this	story. The	chair	of	the	FNB	has	been
an	important	consultant	to	several	major	dairy-related	companies	(e.g.,
National	Dairy	Council,	Mead	Johnson	Nutritionals,	which	is	a	major	seller	of
dairy-based	products,	Nestle	Company	and	a	Dannon	yogurt	affiliate). 10
Simultaneously,	he	was	chair	of	the	Dietary	Guidelines	Committee	that
establishes	the	Food	Guide	Pyramid	and	sets	national	nutrition	policy
affecting	the	National	School	Lunch	and	Breakfast	programs,	the	Food	Stamp
Program	and	the	Women,	Infants	and	Children	Supplemental	Feeding
Program	(WIC). 1,	10
	As	chair	of	this	latter	committee,	his	personal	financial
associations	with	the	food	industry	were	not	publicly	revealed	as	required	by
federal	law. 11
	Eventually	a	court	order,	initiated	by	the	Physician’s	Committee
for	Responsible	Medicine,
12
	was	required	to	force	him	and	his	fellow
colleagues	to	reveal	their	relationships	with	the	food	industry. Although	the
chair’s	industry	associations	were	more	substantial,	
six	of	the	eleven
committee	members	also	were	shown	to	have	ties	to	the	dairy	industry
. 10,	11
The	entire	system	of	developing	public	nutrition	information,	as	I
originally	saw	with	the	Public	Nutrition	Information	Committee	that	I	once
chaired	(see	chapter	eleven),	has	been	invaded	and	co-opted	by	industry
sources	that	have	the	interest	and	resources	to	do	so. They	run	the	show. They
buy	a	few	academic	hacks	who	have	gained	positions	of	power	and	who
exercise	considerable	influence,	both	within	academia	and	government. It	seems	curious	that	while	government	scientists	are	not	allowed	to
receive	personal	compensation	from	the	private	sector,	their	colleagues	in
academia	can	receive	all	that	they	can	get. In	turn,	these	conflicted	individuals
then	run	the	show	in	collaboration	with	their	government	counterparts. However,	restricting	academics	from	receiving	corporate	consultancies	is	not
the	answer. That	would	only	drive	it	underground. Rather,	the	situation	would
be	best	handled	by	making	one’s	industry	connections	a	matter	of	public
disclosure. Everyone	needs	to	know	the	full	extent	of	each	academic’s
associations	with	the	private	sector. Disclosure	and	full	transparency	is	in
everyone’s	
interest. These	associations	should	not	be	something	we	have	to
go	to	court	to	discover.SETTING	US	BACK	FOR	YEARS
Lest	you	think	that	this	Food	and	Nutrition	Board	report	is	merely	a	five-
second	news	bite	that	then	gets	filed	into	a	dusty	old	cabinet	somewhere	in
Washington,	let	me	assure	you	that	tens	of	millions	of	people	are	directly
affected	by	this	panel’s	findings. According	to	the	summary	of	the	report
itself,
13
	the	recommended	levels	of	nutrient	consumption	that	are	set	by	this
panel	are
the	basis	for	nutrition	labeling	of	foods,	for	the	Food	Guide	Pyramid
and	for	other	nutrition	education	programs	…	[They	are]	used	to
determine	the	types	and	amounts	of	food:
provided	in	the	WIC	(Women,	Infants	and	Children)
Supplemental	Feeding	Program	and	the	Child	Nutrition	Programs
such	as	School	Lunch,
served	in	hospitals	and	nursing	homes	for	Medicare
reimbursement,
found	in	the	food	supply	that	should	be	fortified	with	specific
nutrients,
used	in	a	host	of	other	important	federal	and	state	programs	and
activities	[such	as	establishing	reference	values	used	in	food
labeling]
13
The	School	Lunch	Program	feeds	28	million	children	every	day. With
officially	recommended	consumption	patterns	like	these,	we	are	at	liberty	to
put	any	agricultural	commodity	we	want	into	the	hungry	mouths	of	children
already	suffering	from	unprecedented	levels	of	obesity	and	diabetes. By	the
way,	the	2002	FNB	report	does	make	one	special	exception	for	children:	it
says	that	they	can	consume	up	to	40%	of	calories	as	fat,	up	from	35%	for	the
rest	of	us,	while	minimizing	the	risk	of	chronic	disease. The	Women,	Infants
and	Children	Program	affects	the	diets	of	another	7	million	Americans,	and
the	Medicare	hospital	programs	feed	millions	of	people	every	year. It	is	safe
to	say	that	the	food	provided	by	these	government	programs	directly	feeds	at
least	35	million	Americans	a	month. For	people	who	are	not	directly	fed	by	the	government,	this	nutrient
information	still	has	significant	consequences. From	September	2002
onwards,	nutrition	education	programs	around	the	country	
have	incorporated
these	new	guidelines. This	includes	education	in	primary	schools,
universities,	health	professional	programs	and	other	community-basedprograms. Food	labels	also	will	be	affected	by	these	changes,	as	will	the
nutrition	information	that	seeps	into	our	lives	via	advertising. Almost	all	of	the	wide-ranging	effects	of	this	2002	FNB	report	will	be
profoundly	harmful. In	school,	our	children	can	be	fed	more	fat,	more	meat,
more	milk,	more	animal	protein	and	more	sugar. They	will	also	learn	that	this
food	is	consistent	with	good	health. The	ramifications	of	this	are	serious,	as	a
whole	generation	will	walk	the	path	of	obesity,	diabetes	and	other	chronic
illnesses,	all	the	while	believing	that	they	are	doing	the	right	thing. Meanwhile,	our	government	and	its	academic	hacks	can	feel	free	to	unload
more	meat,	more	fat,	more	animal	protein	and	more	sugar	onto	the	neediest
among	us	(e.g.,	the	Women,	Infants	and	Children	(WIC)	participants). I
consider	this	to	be	an	irresponsible	and	callous	disregard	for	American
citizens. Of	course,	these	women	and	infants	are	not	in	a	position	to	pay	for
research,	donate	to	politicians,	give	academics	special	favors	or	fund
government	panels! For	others	concerned	about	nutrition,	every	time	they	see
a	dietitian,	every	time	they	see	their	doctor,	every	time	they	see	a	nutritionist
and	every	time	they	go	to	a	community	health	center,	they	may	be	told	that	a
diet	high	in	fat,	animal	protein,	meat	and	dairy	is	consistent	with	good	health,
and	they	needn’t	worry	about	eating	too	many	sweets. Posters	that	deck	the
bulletin	boards	of	public	institutions	will	now	feature	these	new	government
guidelines	as	well. In	short,	this	2002	FNB	report,	which	represents	the	most	sweeping,
regressive	nutrition	policy	statement	I	have	ever	seen,	will	either	indirectly	or
directly	promote	sickness	among	Americans	for	many	years	to	come. Having
been	a	member	of	several	diet	and	health	policy-making	expert	panels	over	a
twenty-year	period	I	harbored	the	view	that	these	panels	were	dedicated	to	the
promotion	of	consumer	health. I	no	longer	believe	this	to	be	true.UNFUNDED	NUTRITION
Not	only	is	the	government	failing	to	promote	health	through	its
recommendations	and	reports,	it	is	squandering	an	opportunity	to	promote
public	health	through	scientific	research. The	U.S.	National	Institutes	of
Health	(NIH)	is	responsible	for	funding	at	least	80–90%	of	all	biomedical	and
nutrition-related	research	that	is	published	in	the	scientific	
literature. To
address	various	health	topics,	the	NIH	is	comprised	of	twenty-seven	separate
institutes	and	centers,	including	its	two	largest,	the	National	Cancer	Institute
(NCI)	and	the	National	Heart,	Lung	and	Blood	Institute. 14
	With	a	proposed
2005	budget	of	almost	$29	billion,
13
	the	NIH	is	the	center	of	the
government’s	gigantic	medical	research	efforts. In	terms	of	nutrition	research,	however,	something	is	amiss. None	of	these
twenty-seven	institutes	and	centers	at	the	NIH	is	devoted	to	nutrition,	despite
the	pivotal	nature	of	nutrition	in	health,	and	despite	the	public	interest	in	the
subject. One	of	the	arguments	against	having	a	separate	institute	for	nutrition
is	that	the	existing	institutes	already	concern	themselves	with	nutrition. But
this	does	not	happen. Chart	16.3
	shows	the	funding	priorities	for	various
health	topics	at	the	NIH. 16
Of	the	$28	billion	NIH	budget	proposed	for	2004,	only	about	3.6%	is
designated	for	projects	that	are	related	in	some	way	to	nutrition
17
	and	24%	for
projects	that	are	related	to	prevention. That	may	not	sound	too	bad. But	these
figures	are	seriously	misleading. Most	of	the	prevention	and	nutrition	budgets	have	absolutely	nothing	to	do
with	prevention	and	nutrition,	as	I	have	written	in	this	book. We	won’t	be
hearing	about	exciting	research	on	dietary	patterns,	nor	will	there	be	serious
efforts	to	tell	the	public	how	diet	affects	health. Instead,	the	prevention	and
nutrition	budgets	will	be	designated	for	developing	drugs	and	nutrient
supplements. A	few	years	ago,	the	director	of	the	NCI,	the	oldest	of	the	NIH
institutes,	described	prevention	as	“efforts	to	directly	prevent	and/or	inhibit
malignant	transformation,	to	identify,	characterize	and	manipulate	factors	that
might	be	effective	in	achieving	that	inhibition	and	attempts	to	promote
preventative	measures.”
18
	This	so-called	prevention	is	all	about	manipulation
of	isolated	chemicals. “Identifying,	characterizing	and	manipulating	factors”
is	a	not-so-secret	code	for	drug	discovery.CHART	16.3:	NIH	2004	ESTIMATED	FUNDING	FOR	DIFFERENT
HEALTH	TOPICS
17
Considered	from	another	perspective,	the	NCI	(of	the	NIH),	in	1999,	had	a
budget	of	$2.93	billion. 19
	In	a	“major”	5-A-Day	dietary	program,	it	was
spending	$500,000	to	$1	million	to	educate	the	public	to	consume	five	or
more	servings	of	fruits	and	vegetables	per	day. 18
	This	is	only	
three	hundredths
of	one	percent
	(0.0256%)	of	its	budget. That’s	$2.56	for	every	$10,000! If	it
calls	this	a	major	campaign,	I	pity	its	minor	campaigns. The	NCI	also	has	been	funding	a	couple	of	multi-year	large	studies,
including	the	Nurses’	Health	Study	at	Harvard	(discussed	in	chapter	twelve)
and	the	Women’s	Health	Initiative,	mostly	devoted	to	the	testing	of	hormone
replacement	therapy,	vitamin	D	and	calcium	supplementation,	and	the	effect
of	a	moderately	low-fat	diet	on	prevention	of	breast	and	colon	cancer. These
rare	nutrition-related	studies	unfortunately	suffer	from	the	same	experimental
flaws	described	in	chapter	fourteen. Almost	always,	these	studies	are
designed	to	tinker	with	one	nutrient	at	a	time,	among	an	experimental
population	that	uniformly	consumes	a	high-risk,	animal-based	diet. These
studies	have	a	very	high	probability	of	creating	some	very	expensive
confusion	that	we	hardly	need. If	very	few	of	our	tax	dollars	are	used	to	fund	nutrition	research,	what	do
they	fund? Almost	all	of	the	billions	of	dollars	of	taxpayer	money	expended
by	the	NIH	each	year	funds	projects	to	develop	drugs,	supplements	and
mechanical	devices. In	essence,	the	vast	bulk	of	biomedical	research	funded
by	you	and	me	is	basic	research	to	discover	products	that	the	pharmaceuticalindustry	can	develop	and	market. In	2000,	Dr.	Marcia	Angell,	a	former	editor
of	the	New	
England	Journal	of	Medicine,
	summarized	it	well	when	she
wrote
20
:
…	the	pharmaceutical	industry	enjoys	extraordinary	government
protections	and	subsidies. Much	of	the	early	basic	research	that	
may
lead	to	drug	development	is	funded	by	the	National	Institutes	of	Health
(ref. cited). It	is	usually	only	later,	when	the	research	shows	practical
promise,	that	the	drug	companies	become	involved. The	industry	also
enjoys	great	tax	advantages. Not	only	are	its	research	and	development
costs	deductible,	but	so	are	its	massive	marketing	expenses. The
average	tax	rate	of	major	U.S.	industries	from	1993	to	1996	was	27.3%
of	revenues. During	the	same	period	the	pharmaceutical	industry	was
reportedly	taxed	at	a	rate	of	only	16.2%	(ref. cited). Most	important,
the	drug	companies	enjoy	seventeen-year	government-granted
monopolies	on	their	new	drugs—that	is,	patent	protection. Once	a	drug
is	patented,	no	one	else	may	sell	it,	and	the	drug	company	is	free	to
charge	whatever	the	traffic	will	bear. 20
Our	tax	dollars	are	used	to	make	the	pharmaceutical	industry	more
profitable. One	could	argue	that	this	is	justified	by	gains	in	public	health,	but
the	alarming	fact	is	that	this	litany	of	research	into	drugs,	genes,	devices	and
technology	research	
will	never	cure	our	chronic	diseases. Our	chronic
diseases	are	largely	the	result	of	infinitely	complex	assaults	on	our	bodies
resulting	from	eating	bad	food. No	single	chemical	intervention	will	ever
equal	the	power	of	consuming	the	healthiest	food. In	addition,	isolated
chemicals	in	drug	form	can	be	very	dangerous. The	National	Cancer	Institute
itself	states,	“What	is	clear	is	that	most	of	our	current	treatments	will	produce
some	measure	of	adversity.”
21
	There	is	no	danger	to	eating	a	healthy	diet,	and
there	are	far	more	benefits,	including	massive	cost	savings	both	on	the	front
end	of	preventing	disease	and	on	the	back	end	of	treating	disease. So	why	is
our	government	ignoring	the	abundant	scientific	research	supporting	a	dietary
approach	in	favor	of	largely	ineffective,	potentially	dangerous	drug	and
device	interventions?PERSONAL	ACCOUNTS
In	terms	of	public	nutrition	policy,	I	want	to	leave	you	with	one	short	story
that	says	so	much	about	the	government’s	priorities. One	of	my	former
graduate	students	at	Cornell,	Antonia	Demas	(now	Dr.	Antonia	Demas),	did
her	doctoral	research	in	education	by	teaching	a	healthy	food-and-nutrition-
based	curriculum
22
	to	elementary	school	kids	and	then	integrating	those
healthy	foods	into	the	school	lunch	program. She	had	been	doing	this	work	as
a	volunteer	mother	in	her	children’s	schools	for	seventeen	
years	prior	to	her
graduate	studies. I	was	her	advisor	for	the	nutrition	part	of	her	dissertation
research. The	U.S.	Department	of	Agriculture	administers	the	school	lunch	program
to	28	million	children,	largely	relying	on	an	inventory	of	government-
subsidized	foods. The	government	program,	as	it	now	stands,	uses	mostly
animal-based	products	and	even	requires	that	participating	schools	make
available	cow’s	milk. At	the	local	level,	this	usually	means	that	consumption
of	milk	is	mandatory. Dr.	Demas’s	innovative	research	on	the	school	lunch	program	was	a	great
success;	children	loved	the	learning	style	and	were	excited	to	eat	the	healthy
foods	when	they	went	through	the	lunch	line. The	children	then	convinced
their	parents	to	eat	the	healthy	food	at	home. Dr.	Demas’s	program	won
national	awards	for	the	“most	creative	implementation	of	the	dietary
guidelines”	and	“excellence	in	nutrition	education.”	The	program	has	proven
to	be	of	interest	to	more	than	300	school	lunch	and	behavioral	rehabilitation
programs	around	the	U.S.,	including	schools	in	areas	as	widely	dispersed	as
Hawaii,	Florida,	Indiana,	New	England,	California	and	New	Mexico. In	this
effort,	Dr.	Demas	has	organized	a	nonprofit	foundation	(Food	Studies
Institute,	Trumansburg,	New	York)	and	written	a	curriculum	(“Food	is
Elementary”). And	here’s	the	kicker:	Dr.	Demas’s	program	is	entirely	plant-
based. I	had	the	opportunity	to	go	to	Washington	and	talk	with	Dr.	Eileen
Kennedy,	who,	at	the	time,	was	the	director	of	the	Center	for	Nutrition	Policy
and	Promotion	at	the	USDA. Dr.	Kennedy	was	deeply	involved	both	in	the
school	lunch	program	and	the	dietary	guidelines	committee,	on	which	it	was
revealed	that	she	had	ties	to	the	dairy	industry. She	is	now	the	Deputy
Undersecretary	for	the	USDA’s	Research,	Education	and	Economics	division. The	topic	of	our	discussion	was	Dr.	Demas’s	innovative	school	lunch	program
and	how	it	was	garnering	national	attention. At	the	end	of	this	discussion,	I
said	to	her,	“You	know,	that	program	is	entirely	plant-based.”	She	looked	at
me,	wagged	her	finger	as	if	I	were	being	a	bad	boy,	and	said,	“
We	can’t	havethat
.”
I	have	come	to	the	conclusion	that	when	it	comes	to	health,	government	is
not	for	the	people;	it	is	for	the	food	industry	and	the	pharmaceutical	industry
at	the	expense	of	the	people. It	is	a	systemic	problem	where	industry,
academia	and	government	combine	to	determine	the	health	of	this	country. Industry	provides	funding	for	public	health	reports,	and	academic	leaders	with
industry	ties	play	key	roles	in	developing	them. A	revolving	door	exists
between	government	jobs	and	industry	
jobs,	and	government	research	funding
goes	to	the	development	of	drugs	and	devices	instead	of	healthy	nutrition. It	is
a	system	built	by	people	who	play	their	isolated	parts,	oftentimes	unaware	of
the	top	decision	makers	and	their	ulterior	motivations. The	system	is	a	waste
of	taxpayer	money	and	is	profoundly	damaging	to	our	health.17
Big	Medicine:	Whose	Health	Are	They
Protecting? W
HEN	IS	THE	LAST	TIME
	that	you	went	to	the	doctor	and	he	or	she	told	you	what
to	eat	or	what	not	to	eat? You’ve	probably	never	had	that	experience. But	the
vast	majority	of	Americans	will	fall	prey	to	one	of	the	chronic	diseases	of
affluence	discussed	in	
Part	II
,	and,	as	you	have	seen,	there	is	a	wealth	of
published	research	that	suggests	these	diseases	are	a	result	of	poor	nutrition,
not	poor	genes	or	bad	luck. So	why	doesn’t	the	medical	system	take	nutrition
seriously? Four	words:	money,	ego,	power	and	control. While	it	is	unfair	to
generalize	about	individual	doctors,	it	is	safe	to	say	that	the	system	they	work
in,	the	system	that	currently	takes	responsibility	for	promoting	the	health	of
Americans,	is	failing	us. No	one	knows	this	better	than	the	tiny	minority	of
doctors	who	treat	their	patients	from	a	nutritional	perspective. Two	of	the
most	prominent	doctors	in	this	minority	have	spent	many	years	emphasizing
diet	and	health,	both	in	public	within	their	profession	and	in	private	with	their
patients. They	have	had	exceptionally	impressive	results	protecting	their
patients’	health. These	two	doctors	are	Caldwell	B.	Esselstyn,	Jr.,	whose	work
I	discussed	in	chapter	five,	and	John	McDougall,	an	internist. My	son	Tom
and	I	sat	down	with	these	men	recently	to	discuss	their	experience	advocating
a	whole	foods,	plant-based	diet	in	the	medical	setting.DR. SPROUTS
Long	before	our	country	was	founded,	Dutch	pioneers	had	settled	in	the
Hudson	Valley	north	of	New	York	City. One	of	these	settler	families	were	the
Esselstyns. They	started	farming	a	plot	of	land	in	1675. Nine	generations
later,	that	farm	still	belongs	to	the	Esselstyn	family. Dr.	Esselstyn	and	his	wife
Ann	own	the	several-hundred-acre	Hudson	Valley	farm,	just	over	two	hours
north	of	New	York	City. They	spent	the	summer	of	2003	living	in	the	country,
working	the	farm,	growing	a	garden,	hosting	their	kids	and	grandkids	and
enjoying	a	more	relaxed	life	than	what	they’re	used	to	in	Cleveland,	Ohio. Ess	and	Ann	have	a	modest	house:	a	large,	rectangular,	converted	storage
building. The	simplicity	of	it	belies	the	fact	that	this	is	one	of	the	oldest
family	farms	in	America. Only	upon	closer	inspection	does	it	become
apparent	that	there	is	something	unusual	about	this	place. Hanging	on	the	wall
is	a	framed	certificate	from	New	York	State	given	to	the	Esselstyn	family	in
recognition	of	their	family	farm,	a	farm	that	has	now	seen	parts	of	five
different	centuries. Nearby	an	oar	hangs	on	the	wall. It	is	the	oar	Ess	used	in
1955	as	an	oarsman	at	Yale,	when	Yale	beat	Harvard	by	five	seconds. Ess
explains	he	has	three	other	oars:	two	from	beating	Harvard	in	other	years,	and
one	for	winning	the	gold	medal	in	the	Olympics	with	the	Yale	crew	in	1956. Downstairs,	there	is	an	exceptionally	old	photograph	of	Ess’s	great	great
grandfather	on	the	farm. Around	the	corner	there’s	an	impressive-looking
museum-style	schematic	of	the	Esselstyn	family	tree,	and	on	the	other	end	of
the	hall,	there’s	a	large	black	and	white	picture	of	Ess’s	father	standing	in
front	of	a	microphone,	exchanging	comments	with	John	F.	Kennedy	during	a
White	House	address. Despite	its	humble	appearance,	it	is	very	clear	that	this
is	a	place	with	a	distinguished	history. After	touring	the	farm	on	a	tractor,	we	sat	down	with	Ess	and	asked	him
about	his	past. After	graduating	from	Yale,	he	was	trained	as	a	surgeon	at	the
Cleveland	Clinic	and	at	St.	George’s	Hospital	in	London. He	remembers
fondly	some	of	his	most	influential	mentors:	Dr.	George	Crile,	Jr.,	Dr.
Turnbull	and	Dr.	Brook. Dr.	Crile,	a	giant	at	the	Cleveland	Clinic,	eventually
became	Ess’s	father-in-law	upon	Ess’s	marriage	to	Ann. Dr.	Crile	was	a	man
of	exceptional	accomplishment,	playing	a	courageous,	leading	role	in
questioning	the	macabre	surgery	called	“radical	mastectomy.”
1
	Dr.	Turnbull
and	Dr.	Brook	were	also	renowned	
surgeons. In	addition,	Ess’s	own	father
was	a	distinguished	physician	with	a	national	reputation. But,	as	Ess
remembers,	despite	being	“health	experts,”	all	four	of	these	men	were
“ravaged	by	cardiovascular	disease.”	His	own	father	had	a	heart	attack	at	age
forty-two	and	Dr.	Brook	had	a	heart	attack	at	age	fifty-two.These	were	the	men	he	looked	up	to,	and	when	it	came	to	cardiovascular
disease,	all	of	them	were	helpless. Shaking	his	head,	Ess	said,	“You	can’t
escape	this	disease. These	people,	who	were	giants	in	the	prime	of	their	years,
just	
withered
.”	As	he	took	a	moment	to	remember	his	father,	he	said,	“It	was
the	last	year	or	two	of	my	dad’s	life,	and	we	were	just	strolling	along	one	day. He	was	saying,	‘We	are	going	to	have	to	show	people	how	to	lead	healthier
lives.’	
He	was	right	on	it. He	was	intensely	interested	in	preventive	medicine,
but	he	didn’t	have	any	information.”	His	father’s	interest	has	been	a	driving
influence	in	Ess’s	life. Following	in	these	men’s	footsteps,	Ess	went	on	to	amass	an
extraordinarily	impressive	list	of	awards	and	credentials:	an	Olympic	gold
medal	in	rowing;	a	Bronze	Star	for	military	service	in	Vietnam;	President	of
the	Staff,	member	of	the	Board	of	Governors,	chairman	of	the	Breast	Cancer
Task	Force,	and	head	of	the	Section	of	Thyroid	and	Parathyroid	Surgery	at	the
Cleveland	Clinic,	one	of	the	top-ranked	medical	institutions	in	the	world;
president	of	the	American	Association	of	Endocrine	Surgeons;	over	100
professional	scientific	articles;	and	inclusion	on	a	list	in	1994–95	of	the	best
doctors	in	America. 2
	He	remembers,	“For	about	a	ten-	to	fifteen-year	period	I
was	the	top	earner	in	the	department	of	general	surgery. As	Dr.	Crile’s	son-in-
law,	I	was	panicked	about	not	pulling	my	weight. I	didn’t	get	home	until	late
at	night,	but	I	had	a	position	that	was	secure.”	When	the	then-president	of	the
American	Medical	Association	needed	thyroid	surgery,	he	wanted	Ess	to	be
the	one	to	operate. But	despite	the	accolades,	the	titles	and	the	awards,	something	was	not
right. So	often,	Ess’s	patients	did	not	regain	their	health,	even	after	his	best
efforts. As	Ess	described	it,	he	had	“this	haunting	feeling	that	was	really
beginning	to	bother	me. I	kept	looking	at	how	the	patients	were	doing	after
these	operations.”	Slightly	exasperated,	he	said,	“What	is	the	survival	rate	for
cancer	of	the	colon? It’s	not	so	great!”	He	recounted	the	operation	for	colon
cancer	on	one	of	his	best	friends. During	surgery,	they	saw	that	the	cancer	had
spread	throughout	the	intestines. Ess	lowered	his	voice	ever	so	slightly	in
remembering	this,	saying,	“You	get	there	after	the	horse	has	left	the	barn.”	In
thinking	about	all	the	breast	
surgery	he	had	done,	the	lumpectomies	and
mastectomies,	he	expressed	disgust	at	the	idea	of	“disfiguring	somebody
when	you	know	that	you	haven’t	changed	their	chances	for	recovery.”
He	began	to	do	some	soul	searching. “What	is	my	epitaph	going	to	be? Five	thousand	mastectomies! You’ve	disfigured	more	women	than	anybody
else	in	Ohio!”	Dropping	the	sarcasm,	he	said	with	sincerity,	“I	think
everybody	likes	to	leave	the	planet	thinking	that	maybe	…	maybe	you’ve
helped	a	little.”Dr. Esselstyn	began	studying	the	literature	on	the	diseases	he	commonly
treated. He	read	some	of	the	popular	work	of	Dr.	John	McDougall,	who	had
just	written	a	best-selling	diet	and	health	book	called	
The	McDougall	Plan
. 3
He	read	the	scientific	literature	that	compared	international	disease	rates	and
lifestyle	choices,	and	a	study	by	a	University	of	Chicago	pathologist	showing
that	a	low-fat,	low-cholesterol	diet	fed	to	nonhuman	primates	could	reverse
atherosclerosis. He	came	to	the	realization	that	the	diseases	that	so	often
plagued	his	patients	were	due	to	a	diet	rich	in	meat,	fat	and	highly	refined
foods. As	mentioned	in	chapter	five,	he	got	the	idea	to	treat	heart	patients	with	a
low-fat,	plant-based	diet,	and	in	1985	went	to	the	head	of	the	Cleveland	Clinic
to	discuss	his	study. She	said	that	nobody	had	ever	shown	that	heart	disease	in
humans	could	be	reversed	by	using	dietary	treatment. Still,	Ess	knew	he	was
on	the	right	track	and	went	about	quietly	conducting	his	study	over	the	next
several	years. The	study	he	published,	of	eighteen	patients	with	heart	disease,
demonstrated	the	most	dramatic	reversal	of	heart	disease	in	the	history	of
medicine,	simply	by	using	a	low-fat,	plant-based	diet	and	a	minimal	amount
of	cholesterol-reducing	medication. Esselstyn	has	become	a	champion	of	dietary	treatment	of	disease,	and	he
has	the	data	to	prove	his	case. But	it	hasn’t	been	easy. Rather	than	recognizing
him	as	a	hero,	some	in	the	medical	establishment	would	rather	he	disappear. Somewhere	in	this	transition	from	top-ranked,	self-described	“macho,	hard-
ass	surgeon”	to	dietary	advocate,	he	has	become	known,	behind	his	back,	as
Dr.	Sprouts.A	DAUNTING	TASK
What’s	interesting	about	this	story	is	that	a	man	who	had	reached	the	pinnacle
of	a	highly	respected	profession	dared	to	try	something	different,	succeeded,
and	then	quickly	found	himself	on	the	outside	of	
the	establishment	looking	in. He	had	threatened	the	status	quo	by	his	circumvention	of	standard	treatments. Some	of	Ess’s	colleagues	have	disparaged	his	treatment	as	being	too
“extreme.”	Some	doctors	have	dismissed	it	by	saying,	“I	think	the	research	in
this	area	is	pretty	soft,”	which	is	an	absurd	comment	considering	the	breadth
and	depth	of	the	international	studies,	the	animal	studies	and	the	intervention
studies. Some	doctors	have	said	to	Ess,	“Yeah	okay,	but	nobody	is	going	to
eat	like	that. I	can’t	even	get	my	patients	to	stop	smoking.”	Ess’s	response
was,	“Well,	you	really	have	no	training	in	this. This	requires	just	as	much
expertise	as	doing	a	bypass. It	takes	three	hours	for	me	to	counsel	a	patient,”
not	to	mention	the	diligence	required	for	the	constant	follow-up	and
monitoring	of	the	patient’s	health. One	patient	told	his	cardiologist	that	he
wanted	to	see	Ess	and	commit	to	a	dietary	program	to	reverse	his	heart
disease. The	cardiologist	responded,	“Now	you	listen	to	me. There	is	no	way
to	reverse	this	disease.”	You’d	think	that	doctors	would	be	more	excited	about
healing	their	patients! In	talking	about	doctors	and	their	unwillingness	to	embrace	a	whole	foods,
plant-based	diet,	Ess	says,	“You	can’t	get	frustrated. These	aren’t	evil	people. There	are	sixty	cardiologists	[at	the	Cleveland	Clinic],	any	number	of	whom
are	closet	believers	in	what	I	do,	but	they’re	a	little	afraid	because	of	the
power	structure.”
For	Ess,	however,	it	has	been	impossible	to	avoid	his	share	of	frustration. Early	on,	when	he	was	first	suggesting	dietary	treatment	of	heart	disease,
colleagues	greeted	the	idea	with	caution. Ess	figured	that	their	attitude	was
born	out	of	the	fact	that	scientific	research	showing	effective	dietary
intervention	of	heart	disease	in	humans	wasn’t	yet	strong	enough. But	later,
scientific	results	of	unparalleled	success,	including	Esselstyn’s,	were
published. The	data	have	been	strong,	consistent	and	deep,	yet	Ess	still
encountered	reluctance	to	embrace	this	idea:
You	take	a	cardiologist	and	he’s	learned	all	about	beta	blockers,	he’s
learned	about	calcium	antagonists,	he’s	learned	about	how	to	run	this
catheter	up	into	your	heart	and	blow	up	balloons	or	laser	it	or	stent	it
without	killing	you	and	it’s	very	sophisticated. And	there’s	all	these
nurses	and	there’s	lights	out	and	there’s	drama. I	mean	it’s	just,	oh	my
god,	the	doctor	blows	up	the	balloon	in	his	head. The	ego	of	thesepeople	is	enormous. And	then	someone	comes	along	and	says,	“You
know,	I	think	we	can	cure	this	with	brussels	sprouts	and	broccoli.”	
The
doctor’s	response	is,	“WHAT? I	learned	all	this	crap,	I’m	making	a
freakin’	fortune,	and	you	want	to	take	it	all	away?”
Then	when	that	person	comes	along	and	actually	cures	patients	with
brussels	sprouts	and	broccoli,	as	Esselstyn	did,	and	gets	better	results	than	any
other	pill	or	procedure	known,	you’ve	suddenly	announced	that	something
works,	hands	down,	better	than	what	99%	of	the	profession	is	doing. Summarizing	his	point,	Ess	says:
Cardiologists	are	supposed	to	be	expert	in	diseases	of	the	heart—and
yet	they	have	no	expertise	in	treating	heart	disease,	and	when	that
awareness	strikes	them,	they	get	very	defensive. They	can	treat	the
symptoms,	they	can	take	care	of	arrythmias,	they	can	get	you
interventions,	but	they	don’t	know	how	to	treat	the	disease,	which	is	a
nutritional	treatment.…	Imagine	a	dietitian	training	a	heart	surgeon! Esselstyn	has	found	that	merely	saying	that	patients	can	have	control	over
their	own	health	is	a	challenge	to	many. These	experts,	after	all,	are	built	up	to
be	the	dispensers	of	health	and	healing. “Intellectually	it’s	very	challenging	to
think	that	the	patient	can	do	this	with	greater	alacrity,	dispatch,	safety,	and	it’s
something	that’s	going	to	endure.”	With	all	of	the	doctor’s	gadgets,
technologies,	training	and	knowledge,	nothing	is	more	effective	than	guiding
the	patient	to	make	the	right	lifestyle	choices. But	Ess	is	quick	to	point	out	that	doctors	are	not	malicious	people	engaged
in	a	conspiracy:
The	only	person	that	likes	change	is	a	newborn,	and	it’s	natural,	it’s
human	nature. Anywhere	you	go,	99%	of	the	people	are	eating
incorrectly. The	numbers	are	against	you,	and	it’s	very	hard	for	those
99%	to	look	at	you	in	the	1%	and	say,	“Yes,	he’s	right,	we	are	all
wrong.”
Another	obstacle:	lack	of	nutrition	knowledge	amongst	physicians. Ess	has
had	his	share	of	interaction	with	ignorant	doctors,	and	his	impression	is	that
“it’s	absolutely	daunting,	the	lack	of	physician	knowledge	that	there	is	about
the	fact	that	disease	can	be	reversed. You	wonder,	what	is	the	literature	that
these	guys	read?”
Physician	knowledge	often	involves	only	the	standard	treatments:	pills	and
procedures. “What	does	the	twentieth	century	of	medicine	
have	to	offer? Wehave	pills	and	we	have	procedures. Right?”	Esselstyn	leans	forward	and,	with
a	slight	grin,	as	if	he’s	about	to	tell	us	the	emperor	has	no	clothes,	he	says,
“
But	who	ever	says,	‘Maybe	we	ought	to	stop	disease’? ”	In	Dr.	Esselstyn’s
experience,	stopping	disease	does	not	figure	prominently	into	the	status	quo.LACK	OF	TRAINING
The	medical	status	quo	relies	heavily	on	medication	and	surgery,	at	the
exclusion	of	nutrition	and	lifestyle. Doctors	have	virtually	
no	training	in
nutrition	and	how	it	relates	to	health. In	1985	the	United	States	National
Research	Council	funded	an	expert	panel	report	that	investigated	the	quantity
and	quality	of	nutrition	education	in	U.S.	medical	schools. 4
	The	committee’s
findings	were	clear:	“The	committee	concluded	that	nutrition	education
programs	in	U.S.	medical	schools	are	largely	inadequate	to	meet	the	present
and	future	demands	of	the	medical	profession.”
4
	But	this	finding	was	nothing
new. The	committee	noted	that	in	1961	the	“American	Medical	Association
Council	on	Foods	and	Nutrition	reported	that	nutrition	in	the	U.S.	medical
schools	received	‘inadequate	recognition,	support	and	attention.’”
4,	5
	In	other
words,	over	forty	years	ago,	the	doctors	themselves	said	that	their	nutrition
training	was	inadequate. Nothing	had	changed	by	1985,	and	up	to	the	present
time,	articles	continue	to	be	written	documenting	the	lack	of	nutrition	training
in	medical	schools. 6,	7
This	situation	is	dangerous. Nutrition	training	of	doctors	is	not	merely
inadequate;	it	is	practically	nonexistent. In	1985,	the	National	Research
Council	report	found	that	physicians	receive,	on	average,	only	twenty-one
classroom	hours	(about	two	credits)	of	nutrition	training	during	their	four
years	of	medical	school. 4
	The	majority	of	the	schools	surveyed	actually
taught	less	than	twenty	contact	hours	of	nutrition,	or	one	to	two	credit	hours. By	comparison,	an	undergraduate	nutrition	major	at	Cornell	will	receive
twenty-five	to	forty	credit	hours	of	instruction,	or	about	250–500	contact
hours;	registered	dietitians	will	have	more	than	500	contact	hours. It	gets	worse. The	bulk	of	these	nutrition	hours	are	taught	in	the	first	year
of	medical	school,	as	part	of	other	basic	science	courses. Topics	covered	in	a
basic	biochemistry	course	may	include	nutrient	metabolism	and/or
biochemical	reactions	involving	certain	vitamins	or	minerals. In	other	words,
nutrition	is	often	not	taught	in	relation	to	public	health	problems,	like	obesity,
cancer,	diabetes,	etc. In	conjunction	with	the	1985	
government	report,	the
president	of	the	American	Medical	Students	Association,	William	Kassler,
writes
8
:
Most	nutrition	in	the	formal	curriculum	is	incorporated	into	other
courses. Biochemistry,	physiology	and	pharmacology	are	the	courses
most	often	alleged	to	contain	some	nutrition	instruction. Too	often	in
such	courses,	nutrition	is	touched	on	briefly,	with	the	primary	emphasison	the	major	discipline. It	is	quite	possible	to	finish	such	a	course	and
not	even	realize	that	nutrition	was	covered
	[my	emphasis]. Nutrition
taught	by	those	whose	interest	and	expertise	lie	elsewhere	simply
doesn’t	work. It	gets	even	worse! When	nutrition	education	is	provided	in	relation	to
public	health	problems,	guess	who	is	supplying	the	“educational”	material? The	Dannon	Institute,	Egg	Nutrition	Board,	National	Cattlemen’s	Beef
Association,	National	Dairy	Council,	Nestle	Clinical	Nutrition,	Wyeth-Ayerst
Laboratories,	Bristol-Myers	Squibb	Company,	Baxter	Healthcare	Corporation
and	others	have	all	joined	forces	to	produce	a	Nutrition	in	Medicine	program
and	the	Medical	Nutrition	Curriculum	Initiative. 9,	10
	Do	you	think	that	this
all-star	team	of	animal	foods	and	drug	industries	representatives	is	going	to
objectively	judge	and	promote	optimal	nutrition,	which	science	has	shown	to
be	a	whole	foods,	plant-based	diet	that	minimizes	the	need	for	drugs? Or
might	they	try	to	protect	the	meat-centered,	Western	diet	where	everyone
expects	to	pop	a	pill	for	every	sickness? This	organization	is	creating	nutrition
curricula,	involving	CD-ROMS,	and	giving	them	away	to	medical	schools	for
free. As	of	late	2003,	112	medical	schools	were	using	the	curriculum. 11
According	to	their	Web	site,	“Plans	are	underway	for	developing	versions	for
undergraduate	nutrition	students,	continuing	medical	education	and	other
health	 professions	 audiences.”
(
http://www.med.unc.edU/nutr/nim/FAQ.htm#anchorl97343
)
The	dairy	industry	has	also	funded	research	investigations	into	nutrition
education	in	medical	schools
12
	and	has	funded	“prestigious”	awards. 13,	14
These	efforts	show	that	industry	is	well	prepared	to	promote	its	monetary
interests	whenever	the	opportunity	presents	itself. You	should	not	assume	that	your	doctor	has	any	more	knowledge	about
food	and	its	relation	to	health	than	your	neighbors	and	coworkers. It’s	a
situation	in	which	nutritionally	untrained	doctors	prescribe	milk	and	sugar-
based	meal-replacement	shakes	for	overweight	diabetics,	high-meat,	high-fat
diets	for	patients	who	ask	how	to	lose	weight	
and	extra	milk	for	patients	who
have	osteoporosis. The	health	damage	that	results	from	doctors’	ignorance	of
nutrition	is	astounding. Apparently,	there	aren’t	enough	“nutrition-oriented	physician	role	models”
in	medical	education. A	recent	survey	found	“a	shortage	of	nutrition-oriented
physician	role	models	is	probably	the	major	constraint	in	teaching	nutrition	to
residents.”
12
	I	suspect	that	these	medical	programs	lack	nutrition-oriented
physicians	simply	because	they	do	not	make	it	a	priority	to	hire	them. Nobody
knows	this	better	than	Dr.	John	McDougall.DR. MCDOUGALL’S	CHALLENGE
Dr.	John	McDougall	has	been	advocating	a	whole	foods,	plant-based
approach	to	health	longer	than	any	practitioner	I	know. He	has	written	ten
books,	including	several	that	have	sold	over	a	half	a	million	copies	each. His
nutrition	and	health	knowledge	is	phenomenal,	greater	than	any	other	doctor
I’ve	met	and	greater	than	any	of	my	nutrition	colleagues	in	academia. We	met
recently	in	his	Northern	California	home,	and	one	of	the	first	things	he
showed	me	was	his	bank	of	four	or	five	full-	size	metal	file	cabinets	lined	up
along	the	back	of	his	study. There	can’t	be	many	people	in	the	country	with	a
collection	of	scientific	literature	on	diet	and	disease	that	could	rival	John
McDougall’s,	and,	most	importantly,	John	maintains	a	high	level	of
familiarity	with	all	of	it. It	is	not	unusual	for	him	to	spend	a	couple	of	hours	a
day	on	the	Internet	reviewing	the	latest	journal	articles. If	anybody	would	be	a
perfect	“nutrition-oriented	physician	role	model”	in	an	educational	setting,	it
would	be	Dr.	John	McDougall. Growing	up,	John	ate	a	rich,	Western	diet. As	he	says,	he	had	four	feasts	a
day:	Easter	during	breakfast,	Thanksgiving	at	lunch,	Christmas	at	dinner	and
a	birthday	party	for	dessert. It	caught	up	to	him,	and	at	the	age	of	eighteen,	a
few	months	into	college,	John	had	a	stroke. After	recovering	with	a	new
appreciation	for	life,	he	became	a	straight	A	student	as	an	undergraduate	and
then	completed	medical	school	in	Michigan	and	an	internship	in	Hawaii. He
chose	to	practice	on	the	Big	Island	of	Hawaii,	where	he	cared	for	thousands	of
patients,	some	of	whom	had	recently	migrated	from	China	or	the	Philippines,
and	some	who	were	fourth	generation	Chinese	or	Filipino	Americans. It	was	there	that	John	became	an	unhappy	doctor. Many	of	his	patients’
health	problems	were	a	result	of	chronic	illnesses,	such	as	obesity,	diabetes,
cancer,	heart	disease	and	arthritis. John	would	treat	them	as	he	was	taught,
with	the	standard	sets	of	pills	and	procedures,	but	very	
few	of	them	became
healthy. Their	chronic	diseases	didn’t	go	away,	and	John	quickly	realized	that
he	had	severe	limitations	as	a	doctor. He	also	started	to	learn	something	else
from	his	patients:	the	first	and	second	generation	Americans	from	Asia,	the
ones	who	ate	more	traditional,	Asian	staple	diets	of	rice	and	vegetables,	were
trim,	fit	and	not	afflicted	with	the	chronic	diseases	that	plagued	John’s	other
patients. The	third	and	fourth	generation	Asian	Americans,	however,	had	fully
adopted	America’s	eating	habits	and	suffered	from	obesity,	diabetes	and	the
whole	host	of	other	chronic	diseases. It	was	from	these	people	that	John
began	to	notice	how	important	diet	was	for	health. Because	John	wasn’t	healing	people,	and	the	pills	and	procedures	weren’t
working,	he	decided	he	needed	more	education	and	entered	a	graduatemedical	program	(residency)	at	the	Queens	Medical	Center	in	Honolulu. It
was	there	that	he	began	to	understand	the	boundaries	that	the	medical
establishment	had	set	and	the	way	that	medical	education	molds	the	way
doctors	are	supposed	to	think. John	went	into	the	program	hoping	to	find	out	how	to	perfect	the	pills	and
procedures	so	that	he	could	become	a	better	doctor. But	after	observing
experienced	doctors	treating	their	patients	with	pills	and	procedures,	he
realized	that	
these	authoritative	doctors	didn’t	do	any	better	than	he	did. Their
patients	didn’t	just	stay	sick—they	got	worse. John	realized	something	was
wrong	with	the	system,	not	him,	so	he	began	to	read	the	scientific	literature. Like	Dr.	Esselstyn,	once	he	started	reading	the	literature,	John	became
convinced	that	a	whole	foods,	plant-based	diet	had	the	potential	not	only	to
prevent	these	diseases	that	were	plaguing	patients,	but	also	the	potential	to
treat	them. This	idea,	he	was	to	find	out,	was	not	received	kindly	by	his
teachers	and	colleagues. In	this	environment,	diet	was	considered	quackery. John	would	ask,
“Doesn’t	diet	have	something	to	do	with	heart	disease?”	and	his	colleagues
would	tell	him	that	the	science	was	controversial. John	continued	to	read	the
scientific	research	and	to	talk	to	his	colleagues	and	only	became	even	more
baffled. “When	I	looked	at	the	literature,	I	couldn’t	find	the	controversy. It
was	absolutely	clear	what	the	literature	said.”	Through	those	years,	John	came
to	understand	why	so	many	physicians	claimed	diet	was	controversial:	“The
scientist	is	sitting	down	at	the	breakfast	table	and	in	the	one	hand	he	has	a
paper	that	says	that	cholesterol	will	rot	your	arteries	and	kill	you,	and	in	the
other	hand	he	has	a	fork	shoveling	bacon	and	eggs	into	his	mouth,	and	he
says,	‘There’s	
something	confusing	here. I’m	confused.’	And	that’s	the
controversy. That’s	all	it	is.”
John	tells	a	story	about	seeing	a	thirty-eight-year-old	man	and	his	wife
after	the	man	had	suffered	a	second	heart	attack. As	the	attending	resident
(not	their	primary	physician),	he	asked	the	patient	what	he	was	going	to	do	to
prevent	a	third,	fatal	heart	attack. “You’re	thirty-eight	years	old	with	a
beautiful	young	wife,	five	kids. What	are	you	going	to	do	to	keep	your	wife
from	being	a	widow	and	your	kids	from	becoming	fatherless?”	The	man	was
despondent,	frustrated	and	said,	“There’s	nothing	I	can	do. I	don’t	drink. I
don’t	smoke. I	exercise,	I	follow	the	same	diet	the	dietitian	gave	me	after	my
last	heart	attack. There’s	nothing	more	I	can	do.”
John	told	the	couple	what	he	had	been	learning	about	diet. He	suggested
that	the	man	might	reverse	his	disease	if	he	ate	the	right	way. The	patient	and
his	wife	received	the	news	with	enthusiasm. John	talked	with	them	for	quite	a
long	time,	left	the	room	and	felt	great. He	had	finally	helped	someone;	he	hadfinally	done	his	job. That	lasted	for	about	two	hours. He	was	called	into	the	Chief	of
Medicine’s	office. The	Chief	of	Medicine	wields	absolute	authority	over	the
residents. If	he	fires	a	resident,	not	only	is	that	person	out	of	his	or	her	job,
that	person	is	out	of	his	or	her	career. The	excited	couple	had	told	their
primary	physician	what	they	had	just	learned. The	doctor	replied	that	what
they	had	been	told	wasn’t	true,	and	promptly	reported	John	to	the	Chief	of
Medicine. The	Chief	of	Medicine	had	a	serious	conversation	with	John,	who
remembers	being	told	that	“I	was	stepping	far	beyond	my	duties	as	a	resident. I	should	get	serious	about	medicine	and	give	up	all	this	nonsense	about	food
having	anything	to	do	with	disease.”	The	Chief	of	Medicine	made	it	clear	that
on	this	point,	John’s	job,	and	his	subsequent	career,	was	on	the	line. So	John
bit	his	tongue	for	the	rest	of	his	education. On	the	day	of	John’s	graduation,	he	and	the	Chief	of	Medicine	had	a	final
talk. John	remembers	the	man	as	being	smart,	with	a	good	heart,	but	he	was
too	entrenched	in	the	status	quo. The	Chief	of	Medicine	sat	him	down	and
said,	“John,	I	think	you’re	a	good	doctor. I	want	you	to	know	that. I	want	you
to	know	that	I	like	your	family. That’s	why	I’m	going	to	tell	you	this. I’m
concerned	that	you’re	going	to	starve	to	death	with	all	your	crazy	ideas	about
food. All	you’re	going	to	do	is	collect	a	bunch	of	bums	and	hippies.”
John	paused	to	gather	his	thoughts,	and	then	said,	“That	may	be	the	case. Then	I’ll	have	to	starve. I	can’t	put	people	on	drugs	or	surgeries	that	don’t
work. Besides,	I	think	you’re	wrong. I	don’t	think	it	will	be	bums	and	hippies. I	think	it	will	be	successful	people	who	have	done	well	in	life. They’ll	ask
themselves,	‘I’m	such	a	big	success,	so	how	come	I’m	so	fat?’”	With	that,
John	looked	at	the	Chief’s	generous	belly,	and	continued,	“They’ll	ask,	‘If	I’m
such	a	big	success,	why	are	my	health	and	my	future	out	of	control?’	They’ll
look	at	what	I	have	to	say,	and	they’re	going	to	buy	it.”
John	finished	his	formal	medical	education	having	had	only	one	hour	of
nutrition	instruction,	which	involved	learning	which	infant	formulas	to	use. His	experience	confirms	every	study	that	has	found	nutrition	training	among
physicians	to	be	sorely	inadequate.HOOKED	ON	DRUGS
John	touched	on	another	important	area	where	the	medical	profession	has	lost
credibility:	its	ties	with	the	drug	industry. Medical	education	and	drug
companies	are	in	bed	together,	and	have	been	for	quite	some	time. John	talked
some	about	the	depth	of	the	problem	and	how	the	educational	system	has
been	corrupted. He	said:
The	problem	with	doctors	starts	with	our	education. The	whole	system
is	paid	for	by	the	drug	industry,	from	education	to	research. The	drug
industry	has	bought	the	minds	of	the	medical	profession. It	starts	the
day	you	enter	medical	school. All	the	way	through	medical	school
everything	is	supported	by	the	drug	industry. John	is	not	alone	in	criticizing	the	way	in	which	the	medical	establishment
has	partnered	with	the	drug	industry. Many	prominent	scientists	have
published	scathing	observations	showing	how	corrupt	the	system	has	become. Among	the	common	observations	are:
The	drug	industry	ingratiates	itself	with	medical	students	with	free	gifts,
including	meals,	entertainment	and	travel;	educational	events,	including
lectures,	which	are	little	more	than	drug	advertisements;	and
conferences,	which	include	speakers	who	are	little	more	than	drug
spokespeople. 15–17
Graduate	medical	students	(physician	residents)	and	other	physicians
actually	change	their	prescribing	habits	because	of	information	provided
by	drug	salespeople,
18–20
	even	though	this	information	
is	known	to	be
“overly	positive	and	prescribing	habits	are	less	appropriate	as	a
result.”
17,21,22
Research	and	academic	medicine	merely	carry	out	the	pharmaceutical
industry’s	bidding. This	can	happen	because:	the	drug	companies,	and
not	researchers,	may	design	the	research,	which	allows	the	company	to
“rig”	the	study
23,	24
;	the	researchers	may	have	a	direct	financial	stake	in
the	drug	company	whose	product	they	are	studying
15,	25
;	the	drug
company	may	be	responsible	for	collecting	and	collating	the	raw	data,
and	then	only	selectively	allowing	researchers	to	view	the	data
23,	26
;	the
drug	company	may	retain	veto	power	over	whether	the	findings	are
published,	and	may	retain	editorial	rights	over	any	scientific	publications
resulting	from	the	research
23,	25,	27
;	the	drug	company	may	hire	a
communications	firm	to	write	the	scientific	article,	and	then	findresearchers	willing	to	attach	their	names	as	authors	of	the	paper	after	it
has	already	been	written. 26
The	major	scientific	journals	have	turned	into	little	more	than	marketing
vehicles	for	drug	companies. The	leading	medical	journals	derive	their
primary	income	from	drug	advertising. This	advertising	is	not	adequately
reviewed	by	the	journal,	and	companies	often	present	misleading	claims
about	drugs. Perhaps	more	disconcerting,	the	majority	of	clinical	trial
research	reported	in	the	journals	is	funded	by	drug	company	money,	and
the	financial	interests	of	the	researchers	involved	are	not	fully
acknowledged. 24
In	the	past	couple	of	years	there	have	been	well-publicized	scandals	at
major	medical	centers	that	confirm	these	charges. In	one	instance,	a	scientist’s
integrity	was	maligned	in	a	variety	of	ways	by	both	a	drug	company	and	her
university	administration	after	she	found	that	a	drug	under	study	had	strong
side	effects	and	it	lost	its	effectiveness. 27
	In	another	case,	a	scientist	speaking
out	about	the	possible	side	effects	of	antidepressants	lost	a	job	opportunity	at
the	University	of	Toronto. 26
	The	examples	go	on	and	on. Dr.	Marcia	Angell,	an	ex-editor	of	the	New	
England	Journal	of	Medicine
,
wrote	a	scathing	editorial	called	“Is	Academic	Medicine	for	Sale?”
15
:
The	ties	between	clinical	researchers	and	industry	include	not	only
grant	support,	but	also	a	host	of	other	financial	arrangements. Researchers	serve	as	consultants	to	companies	whose	products	they	are
studying,	join	advisory	boards	and	speakers’	bureaus,	
enter	into	patent
and	royalty	arrangements,	agree	to	be	the	listed	authors	of	articles
ghostwritten	by	interested	companies,	promote	drugs	and	devices	at
company-sponsored	symposiums	and	allow	themselves	to	be	plied	with
expensive	gifts	and	trips	to	luxurious	settings. Many	also	have	equity
interest	in	the	companies. Dr.	Angell	goes	on	to	say	that	these	financial	associations	often
significantly	“bias	research,	both	the	kind	of	work	that	is	done	and	the	way	it
is	reported.”
Even	more	dangerous	than	the	threat	of	fraudulent	findings	is	the	fact	that
the	only	type	of	research	that	is	funded	and	recognized	is	research	on	drugs. Research	on	the	causes	of	disease	and	non-drug	interventions	simply	doesn’t
occur	in	medical	education	settings. For	example,	academic	researchers	may
be	furiously	trying	to	find	a	pill	that	will	treat	the	symptoms	of	obesity,	but
not	be	devoting	any	time	or	money	to	teaching	people	how	to	live	a	healthierlife. Dr.	Angell	writes
15
:
In	terms	of	education,	medical	students	and	house	officers,	under	the
constant	tutelage	of	industry	representatives,	
learn	to	rely	on	drugs	and
devices	more	than	they	probably	should
	[my	emphasis]. As	the	critics
of	medicine	so	often	charge,	
young	physicians	learn	that	for	every
problem,	there	is	a	pill
	[my	emphasis]	(and	a	drug	company
representative	to	explain	it). They	also	become	accustomed	to
receiving	gifts	and	favors	from	an	industry	that	uses	these	courtesies	to
influence	their	continuing	education. The	academic	medical	centers,	in
allowing	themselves	to	become	research	outposts	for	industry,
contribute	to	the	overemphasis	on	drugs	and	devices.”
In	this	environment,	is	it	possible	for	nutrition	to	be	given	fair	and	honest
consideration? Despite	the	fact	that	our	leading	killers	can	be	prevented	and
even	reversed	using	good	nutrition,	will	you	ever	hear	about	it	from	your
doctor? Not	as	long	as	this	environment	persists	in	our	medical	schools	and
hospitals. Not	unless	your	doctor	has	decided	that	standard	medical	practice
as	it	is	taught	does	not	work,	and	decides	to	spend	a	significant	amount	of
time	educating	himself	or	herself	about	good	nutrition. This	takes	a	rare
individual. The	situation	has	gotten	so	bad	that	Dr.	John	McDougall	said,	“I	don’t
know	what	to	believe	anymore. When	I	read	a	paper	that	says	I	
should	be
giving	my	heart	patients	beta	blockers	and	ACE	inhibitors,	two	classes	of
heart	drugs,	I	don’t	know	whether	it’s	true. I	honestly	don’t	know	if	it’s	true
because	[drug	research]	is	so	tainted.”
Do	you	think	the	following	headlines	are	related? “Schools	report	research	interest	conflicts”	(between	drug	companies	and
researchers)
28
“Prescription	use	by	children	multiplying,	study	says”
29
“Survey:	Many	guidelines	written	by	doctors	with	ties	to	companies”
30
“Correctly	Prescribed	Drugs	Take	Heavy	Toll;	Millions	Affected	by
Toxic	Reactions”
31
We	pay	a	high	price	for	allowing	these	medical	biases. A	recent	study
found	that	one	in	five	new	drugs	will	either	get	a	“black	box	warning,”
indicating	a	previously	unknown	serious	adverse	reaction	that	may	result	in
death	or	serious	injury,	or	will	be	withdrawn	from	the	market	within	twenty-
five	years. 32
	Twenty	percent	of	all	new	drugs	have	serious	unknown	sideeffects,	and	more	than	100,000	Americans	die	every	year	from	
correctly
taking	their	
properly	prescribed
	medication. 33
	This	is	one	of	the	leading
causes	of	death	in	America!DR. MCDOUGALL’S	FATE
When	Dr.	John	McDougall	finished	his	formal	medical	education,	he	set	up	a
practice	on	the	Hawaiian	island	of	Oahu. He	began	writing	books	about
nutrition	and	health	and	established	a	national	reputation. In	the	mid-1980s
John	was	contacted	by	St.	Helena	Hospital	in	Napa	Valley,	California,	and
asked	if	he	would	accept	a	position	running	its	health	center. The	hospital	was
a	Seventh-day	Adventist	hospital;	if	you	recall	from	chapter	seven,	the
Seventh-day	Adventists	encourage	followers	to	eat	a	vegetarian	diet	(even
though	they	consume	higher-than-average	amounts	of	dairy	products). It	was
an	opportunity	too	good	to	pass	up,	and	John	left	Hawaii	and	headed	for
California. John	had	a	good	home	at	St.	Helena	for	a	number	of	years. He	taught
nutrition	and	used	nutrition	to	treat	sick	patients,	which	he	did	with	fantastic
success. He	treated	over	2,000	very	sick	patients,	and	over	the	course	of
sixteen	years,	he	has	never	been	sued	or	even	had	a	letter	of	complaint. Perhaps	more	importantly,	John	saw	these	patients	get	well. Throughout	this
time,	he	continued	his	publishing	activity,	maintaining	a	national	reputation. But	as	time	passed,	he	realized	that	things	weren’t	quite	the	same	as	when	he
first	arrived. His	discontent	was	growing. Of	those	later	years	he	says,	“I	just
didn’t	think	I	was	going	anyplace. The	program	had	150	or	170	people	a	year
and	that	was	it. Never	grew. Wasn’t	getting	any	support	from	the	hospital	and
we	had	gone	through	a	lot	of	administrators.”
He	had	small	clashes	with	the	other	doctors	at	the	hospital. At	one	point,
the	heart	department	objected	to	what	John	was	doing	with	heart	patients. John	told	them,	“I’ll	tell	you	what,	I’ll	send	every	one	of	my	heart	patients	to
you	for	a	second	opinion	if	you’ll	send	yours	to	me.”	It	was	quite	an	offer,	but
they	didn’t	accept	it. On	another	occasion	John	had	referred	a	patient	to	a
cardiologist	and	the	cardiologist	incorrectly	told	the	patient	that	he	needed	to
have	bypass	surgery. After	a	couple	of	these	incidents,	John	had	reached	the
limit	of	his	patience. Finally,	after	the	cardiologist	recommended	surgery	for
another	one	of	John’s	patients,	John	called	him	and	said,	“I	want	to	talk	with
you	and	the	patient	about	this. I	would	like	to	discuss	the	scientific	literature
that	causes	you	to	make	this	recommendation.”	The	cardiologist	said	that	he
wouldn’t	do	that,	to	which	John	responded,	“Why	not? You	just
recommended	that	this	guy	have	his	heart	opened! And	you’re	going	to
charge	him	50,000	or	100,000	bucks	for	it. Why	don’t	we	discuss	it? Don’t
you	think	that’s	fair	to	the	patient?”	The	cardiologist	declined,	saying	that	it
would	just	confuse	the	patient. That	was	the	last	time	he	recommended	heart
surgery	for	one	of	John’s	patients.Meanwhile,	none	of	the	other	physicians	in	the	hospital	had	ever	referred	a
patient	to	John. Not	once. Other	physicians	would	send	their	own	wives	and
children	to	see	him	but	they	would	never	refer	a	patient. The	reason,
according	to	John:
They	were	worried	[about	what	would	happen	when]	their	patients
would	come	to	see	me,	and	it	happened	all	the	time	when	patients
would	come	on	their	own. They’d	come	to	me	with	heart	disease	or
high	blood	pressure	or	diabetes. I’d	put	them	on	the	diet	and	they’d	go
back	off	all	their	pills	and	soon	their	numbers	would	be	normal. They’d
go	to	their	doctor	and	say,	“Why	the	hell	didn’t	you	tell	me	about	this
before? Why	did	you	let	me	suffer,	spend	all	this	money,	almost	die,
when	all	I	had	to	do	was	eat	oatmeal?”	The	doctors	didn’t	want	to	hear
this. There	were	other	moments	of	friction	between	John	and	the	hospital,	but
the	last	straw	involved	the	Dr.	Roy	Swank	multiple	sclerosis	program
mentioned	in	chapter	nine. John	had	contacted	Dr.	Swank	when	he	learned	that	Swank	was	about	to
retire. John	had	known	and	respected	Dr.	Roy	Swank	for	a	long	time,	and	he
offered	to	take	over	the	Swank	multiple	sclerosis	program	and	merge	it	with
his	health	clinic	at	St.	Helena	Hospital,	preserving	it	in	honor	of	Dr.	Swank. Dr.	Swank	agreed,	much	to	John’s	excitement. As	John	said,	there	were	four
reasons	that	this	would	be	a	perfect	fit	for	St.	Helena’s:
it	fit	in	with	the	philosophy	of	the	Adventists:	dietary	treatment	of
disease
they	would	be	helping	people	who	desperately	needed	their	help
it	would	double	their	patient	census,	helping	to	grow	the	program
it	would	cost	almost	nothing
In	thinking	back	on	it,	John	said,	“Could	you	think	of	any	reason	not	to	do
this? It	[was]	obvious!”	So	he	took	the	proposal	to	the	head	of	his	department. After	listening,	she	said	that	she	didn’t	think	the	hospital	wanted	to	do	this. She	said,	“Well,	I	don’t	think	we	really	want	to	introduce	any	new	programs
right	now.”	John,	dumbfounded,	asked	her,	“Please	tell	me	why. What	does	it
mean	to	be	a	hospital? Why	are	we	here? I	thought	we	were	here	to	take	care
of	sick	people.”
Her	response	was	a	doozy:	“Well,	you	know	we	are,	but	you	know,	MS
patients	are	not	really	desirable	patients.
_OceanofPDF.com_The_China_Study__The_Most_Comprehensive_St_-_T_Colin_Campbell.txt
Summarize the following text section accurately and concisely. Maintain specific details and numerical information, and use anti-repetition mechanisms:

        Relative
to	total	calorie	intake,	only	5–6%	dietary	protein	is	required	to	replace	the
protein	regularly	excreted	by	the	body	(as	amino	acids). About	9–10%
protein,	however,	is	the	amount	that	has	been	recommended	for	the	past	fifty
years	to	be	assured	that	most	people	at	least	get	their	5–6%	“requirement. ”
This	9–10%	recommendation	is	equivalent	to	the	well-known	recommended
daily	allowance,	or	RDA. 5
Almost	all	Americans	exceed	this	9–10%	recommendation;	we	consume
protein	within	the	range	of	about	11–21%,	with	an	average	of	about	15–16%. 6
The	relatively	few	people	consuming	more	than	21%	protein	mostly	are	those
who	“pump	iron,”	recently	joined	by	those	on	high-protein	diets. It	is	extremely	puzzling	that	these	new	government-sponsored	2002	FNB
recommendations	now	say	that	we	should	be	able	to	consume	protein	up	to
the	extraordinary	level	of	35%	as	a	means	of	minimizing	chronic	diseases	like
cancer	and	heart	disease. This	is	an	unbelievable	travesty,	considering	the
scientific	evidence. The	evidence	presented	in	this	book	shows	that	increasing
dietary	protein	within	the	range	of	about	10–20%	is	associated	with	a	broad
array	of	health	problems,	especially	when	most	of	the	protein	is	from	animal
sources. As	reviewed	earlier	in	this	book,	diets	with	more	animal-based	protein	will
create	higher	blood	cholesterol	levels	and	higher	risks	of	atherosclerosis,
cancer,	osteoporosis,	Alzheimer’s	disease	and	kidney	stones,	to	name	just	a
few	chronic	diseases	that	the	FNB	committee	mysteriously	chooses	to	ignore. Furthermore,	the	FNB	panel	had	the	audacity	to	say	that	this	10–35%
recommendation	range	is	the	same	as	previous	reports. Their	press	release
clearly	states,	“protein	intake	recommendations	are	the	same	[as	previous
reports]. ”	
I	know	of	no	report	that	has	even	remotely	suggested	a	level	as	high
as	this. When	I	initially	saw	this	protein	recommendation,	I	honestly	thought	
that
it	was	a	printing	error. But,	no,	it	was	correct. I	know	several	of	the	people	on
the	panel	who	wrote	this	report	and	decided	to	give	them	a	ring. The	first
panel	member,	a	long-time	acquaintance,	said	this	was	the	first	time	he	had
even	heard	about	the	35%	protein	limit. He	suggested	that	this	protein
recommendation	might	have	been	drafted	in	the	last	days	of	preparing	the
report. He	also	told	me	that	there	was	little	discussion	of	the	evidence	on
protein,	for	or	against	a	high	consumption	level,	although	he	recollected	there
being	some	pro-Atkins	sympathy	on	the	committee. He	had	not	worked	in	the
protein	area,	so	he	did	not	know	the	literature. In	any	event,	this	importantrecommendation	slipped	through	the	panel	without	much	notice	and	made	the
first	sentence	of	the	FNB	news	release. The	second	panel	member,	a	long-time	friend	and	colleague,	was	a
subcommittee	chair	during	the	latter	part	of	the	panel’s	existence. He	is	not	a
nutritional	scientist	and	also	was	surprised	to	hear	my	concerns	about	the
upper	limit	for	protein. He	did	not	recall	much	discussion	on	the	topic	either. When	I	reminded	him	of	some	of	the	evidence	linking	high-animal	protein
diets	to	chronic	disease,	he	initially	was	a	little	defensive. But	with	a	little
more	persistence	on	my	part	about	the	evidence,	he	finally	said,	“Colin,	you
know	that	I	really	don’t	know	anything	about	nutrition. ”	How,	then,	was	he	a
member—let	alone	the	chair—of	this	important	subcommittee. And	it	gets
worse. The	chair	of	the	standing	committee	on	the	evaluation	of	these
recommendations	left	the	panel	shortly	before	its	completion	for	a	senior
executive	position	in	a	very	large	food	company—a	company	that	will
salivate	over	these	new	recommendations. A	SUGARCOATED	REPORT
The	recommendation	on	added	sugar	is	as	outrageous	as	the	one	for	protein. At	about	the	time	this	FNB	report	was	being	released,	an	expert	panel	put
together	by	the	WHO	(World	Health	Organization)	and	the	FAO	(Food	and
Agriculture	Organization)	was	completing	a	new	report	on	diet,	nutrition	and
the	prevention	of	chronic	diseases. Professor	Phillip	James,	another	friend	of
mine,	was	a	member	of	this	panel	and	a	panel	spokesperson	on	the	added
sugar	recommendation. Early	rumors	of	the	report’s	findings	indicated	that
the	WHO/FAO	was	on	the	verge	of	recommending	an	upper	safe	limit	of	10%
for	added	sugar,	far	lower	than	the	25%	established	by	the	American	FNB
group. Politics,	however,	had	early	entered	the	discussion,	as	it	had	done	in
earlier	reports	on	added	sugars. 7
	According	to	a	news	release	from	the
director-general’s	office	at	the	WHO,
8
	the	U. S. -based	Sugar	Association	and
the	World	Sugar	Research	Organization,	who	“represent	the	interests	of	the
sugar	growers	and	refiners,	had	mounted	a	strong	lobbying	campaign	in	an
attempt	to	discredit	the	[WHO]	report	and	suppress	its	release. ”	They	did	not
like	setting	the	upper	safe	limit	so	low. According	to	the	
Guardian
	newspaper
of	London,
7
	the	U.
5-6%
According to the text, what percentage of daily calorie intake is required for protein?
9-10%
What is the recommended daily allowance of protein intake, according to the FNB report?
The curriculum does not prioritize nutrition, and there is a lack of training in nutrition and health, with only 21 hours of nutrition education in four years.
What is the main issue with the way nutrition is taught in medical schools?
The majority of the funding goes towards developing new drugs and devices, rather than nutrition-related research.
What is the primary focus of the research funded by the NIH?
The curriculum is heavily influenced by the pharmaceutical industry, and there is a lack of training in nutrition and health, with a focus on pills and procedures.
What is the primary issue with the way doctors are trained in medical schools?