How Not To Die

  The Role of Diet in Preventing, Arresting, and
Reversing Our Top 15 Killers - A Book by Dr.
Michael Greger

   The book “How Not To Die” is a reminder that
lifestyle matters.  As Dr. Michael Greger takes the
reader through the 15 most likely causes of death in
America, it becomes clear that something is wrong
with what most of us were taught about how to live a
long and healthy life.

   For those not familiar with Dr. Michael Greger,
you will find him to be an excellent source of
information amount nutrition and to some degree,
lifestyle in general.  Each year Dr. Greger’s mission
is to review every new research report about
nutrition and discover its importance or lack
thereof.  That’s an amazing feat and one which I
appreciate since there are not enough hours in a
day for me to take that job on top of running a
medical practice.  What distinguishes Dr. Greger is
his mission to educate the public with easy to
understand information on a website that is free to
use and free of commercial influences.  While Dr.
Greger does offer his books and videos, the same
information is free to anyone interested in browsing
his website.  Now back to the book.

   The book begins with a personal story about the
author’s Grandmother, who had been diagnosed
with a terminal heart condition.  She had received
bypass operations and finally reached a point where
no further surgeries could help and was sent home
to die at age 65.  After changing to a plant-based
diet, she recovered, began walking 10 miles a day
and went on to live another 31 years.  

   The amazing recovery would have seemed a
miracle except that it wasn’t a new story.  Actually,
missionaries in Africa had long before noticed the
positive effect of diet on heart disease.  What they
had observed was rates of heart disease 100 times
less than in the United States. They had also
noticed far fewer cancers of the colon, hemorrhoids,
varicose veins, hiatal hernias, obesity, diverticulitis,
appendicitis, and gallbladder disease.

   Learning about this amazing effect of diet on
health, a young engineer, Nathan Pritikin, chose to
try the diet as a cure for his own heart disease.  His
success in treating himself led to establishing a
clinic and ultimately to the Pritikin Diet.  At first, he
hoped to slow the progression of his disease or
perhaps stop the disease.  Instead, something
unexpected happened.  His heart disease began to
reverse. When he stopped eating an artery-clogging
diet, his arteries started opening up.  As he would
later learn, even some cases of severe triple-vessel
heart disease could respond well.  For many, their
bodies had wanted to be healthy all along but had
never before had a chance.

   While Dr. Greger has a compelling story with
science on his side, he also realizes that it’s up to
each of us to make our own decisions about what to
eat and how to live.  Educating us about the
consequences of our actions is his mission.  Dr.
Greger reminds us that on the Standard American
Diet (SAD), coronary heart disease and
atherosclerosis begin in childhood.  By age 10, the
arteries of nearly all children raised on the standard
American diet already have fatty streaks, the first
stage of the disease.  The plaques that continue to
form in our 20s, 30s, and 40s then start picking us
off.  When a blockage happens in our heart, we call
it a heart attack. In our brains, the same disease is
called a stroke.  As Dr. Greger explains, if over the
age of 10 and not on a heart-healthy diet, best to
reconsider and be sure you have made the life
choice you prefer.  While not all cardiovascular
disease can be reversed, with a strict diet,
improvements in blood flow are sometimes seen
after only three weeks of eating healthy.

   To explain why what we eat makes a difference,
Dr. Greger offers the example of a man that whacks
himself on the shin three times a day.  Of course,
the man’s shin becomes inflamed, sore, and never
completely heals.  Similarly, eating foods that have
an inflammatory effect three times a day will never
allow our gut to heal.  Call it the best-kept secret in
medicine if you like - given the right conditions, our
body often heals itself.  Just as the man whacking
himself on the shin could have healed just fine by
stopping the whacks, we usually begin healing
internally when we stop the three SAD meals a day
that is causing the inflammation.

   Far too often, inflammation is treated as an acute
condition with analgesics or other medications that
suppress symptoms.  Had the man whacking himself
gone to a doctor, he might have explained, “Oh, my
shin hurts so bad.”  From the doctor, “No problem,
an Rx for painkillers can get you going.”  Thanks to
modern medicine, the man could now continue to
whack his shin three times a day while feeling so
much better.  Thank heavens for modern medicine.  
It’s like taking nitroglycerine for crushing chest pain.  
There is a tremendous relief, but you’re not actually
treating the underlying cause or the disease.  
Stopping smoking is another opportunity for healing.
Within 15 years of quitting smoking, a person’s lung
cancer risk approaches that of a lifelong non-
smoker.  The body’s ability to heal when we stop
whacking it is amazing. In 15 years, the lungs can
clear out all the tar and eventually it’s almost as if
the person never smoked.  Unfortunately, for the
smoker, every puff is just another whack at the
lungs.

   In an age of amazing scientific discoveries, you
may wonder why you can’t count on science to make
amends for all of your habits.  In some cases you
can, in most, you can’t.  Take the case of a man with
severe angina (chest pains), that couldn’t walk to
the mailbox.  With the aid of expensive anti-angina
drugs that cost thousands of dollars a year he could
prolong exercise duration as long as 33.5 seconds.  
In contrast, by eating a strict diet for a few months,
he might not need the medicine and be ready for
active living.  Dealing with the root cause of the
disease is usually safer, less expensive, and
provides better long term outcomes.

   So, what about cancer?  What happens if you put
a person with cancer on a plant-based diet?  Dr.
Dean Ornish and colleagues found that in the case
of the prostate, progression of cancer could often
be reversed with a plant-based diet and other
healthy lifestyle behaviors.  In women, they found
similar results for breast cancer.  It seems that our
immune system has an ability to reprogram cancer
cells and force them into early retirement.  Even
better results were found when the diet was
combined with exercise.  Of course, this approach
has not been proven for all cancers, and for more
aggressive cancers traditional treatments still have
remarkable value.  Fortunately, most cancers grow
very slowly and if not given a lifestyle environment
that encourages growth may remain small enough to
never be a significant concern.

   As previously mentioned, strokes are another
reason people die prematurely.  As Dr. Greger
points out, strokes are the fourth most likely reason
you or your loved ones will die.  And yet, reducing
the risk for strokes may require no more than eating
more potassium-rich plant foods.  Unfortunately,
98% of Americans don’t reach the recommended
minimum daily intake.  If that thought made you
reach for a banana, be aware that all plant foods
have potassium and that while bananas have
potassium, many common foods have more per
serving.  In fact, of all foods commonly eaten
bananas come in at 1,611, right after Reese’s
Pieces.  Among the most concentrated whole food
sources of potassium in the American diet are
beans, greens, and dates.

   As Dr. Greger continues his assessment of the 15
most common reasons people die prematurely, he
discusses the preponderance of evidence
implicating lifestyle as a cause for Alzheimer’s
disease, diabetes, kidneys disease, mood disorders,
mental health, infections, hypertension, Parkinson’s
disease, osteoporosis, and more.

   In closing, Dr. Greger offers a thought
experiment.  If you were a smoker in the 1950’s,
would you stop smoking or wait?  Even if living in the
early 1960s and waiting for unassailable scientific
proof, you would have continued to smoke another
15 years and would have likely died from cancer.  If
on the other hand you had carefully considered the
epidemiological data indicating that you had a 10
times higher risk of lung cancer than non-smokers,
you might have stopped smoking and never had
lung cancer.  Today, we have a similar situation.  
Proof that diet is linked to heart disease and cancer
is quite compelling but still lacks the level of cause
and effect proof that would remove a specific food
from the market.  However, epidemiological studies
show a greatly increased risk.  So what is a person
to do?  Would you stop eating foods that have a
high probability of causing disease or wait another
15 years for definitive proof?

   From the first research showing that smoking was
implicated as a cause for lung cancer, it took 25
years before the Surgeon General’s report was
released to the public.  During those years over
7,000 studies demonstrated the likely link between
tobacco and cancer.  As Dr. Greger likes to point
out, “You’d think maybe after a couple of thousand
studies the Government would have given a little
heads up.”  Unfortunately, powerful industries had
the ability to dilute and suppress information.

   If considering changes in how you live, I
recommend Dr. Greger’s book, “How Not To Die:
The Role of Diet in Preventing, Arresting, and
Reversing Our Top 15 Killers.”  If not sure whether
this book is for you, consider watching
the YouTube
video by the same name as the book.  In this one-
hour video, Dr. Greger provides what you might call
the “Cliff Notes” for how not to die prematurely and
not have it be your own fault.

Nancy Neighbors, MD



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