How Not to Die: Discover the Foods Scientifically Proven to Prevent and Reverse Disease

✏️ Highlights

This was a live-in program where everyone was placed on a plant-based diet and then started on a graded exercise regimen. They wheeled my grandmother in, and she walked out. I’ll never forget that.

Why were doctors still prescribing drugs and using Roto-Rooter-type procedures to just treat the symptoms of heart disease and to try to forestall what they chose to believe was the inevitable—an early death?

This was my wake-up call. I opened my eyes to the depressing fact that there are other

This was my wake-up call. I opened my eyes to the depressing fact that there are other forces at work in medicine besides science.

The U.S. health care system runs on a fee-for-service model in which doctors get paid for the pills and procedures they prescribe, rewarding quantity over quality. We don’t get reimbursed for time

If doctors were instead paid for performance, there would be a financial incentive to treat the lifestyle causes of disease. Until the model of reimbursement changes, I don’t expect great changes in medical care or medical education.

During my medical training, I was offered countless steak dinners and fancy perks by Big Pharma representatives, but not once did I get a call from Big Broccoli.

During my first interview for medical school, at Cornell University, I remember the interviewer emphatically stating, “Nutrition is superfluous to human health.” And he was a pediatrician! I knew I was in for a long road ahead. Come to think of it, I think the only medical professional who ever asked me about a family member’s diet was our veterinarian.

my goal was to speak at every medical school in the country every two years to influence an entire generation of new doctors. I didn’t want another doctor to graduate without this tool—the power of food—in her or his toolbox.

Although my original motivation was health, over the years, I’ve grown into quite the animal lover. Three cats and a dog run our household,

care about the welfare of the animals we eat, but first and foremost, I am a physician. My primary duty has always been to care for my patients, to accurately provide

I care about the welfare of the animals we eat, but first and foremost, I am a physician. My primary duty has always been to care for my patients, to accurately provide the

I care about the welfare of the animals we eat, but first and foremost, I am a physician. My primary duty has always been to care for my patients, to accurately provide the best available balance of evidence.

Now a self-sustaining nonprofit organization itself, NutritionFacts.org has more than a thousand bite-sized videos on nearly every conceivable nutrition topic,

In a recent national survey of doctor office visits, only about one in five smokers were told to quit.

Just as you don’t have to wait for your physician to tell you to stop smoking, you don’t have to wait to start eating healthier.

From a study of more than forty-two thousand consecutive autopsies, centenarians—those who live past one hundred—were found to have succumbed to diseases in 100 percent of the cases examined.

people don’t die as a consequence of maturing. They die from disease, most commonly heart attacks.

Our diet is the number-one cause of premature death and the number-one cause of disability.

One study found that people off the street sometimes know more about basic nutrition than their doctors, concluding “physicians should be more knowledgeable about nutrition than their patients, but these results suggest that this is not necessarily true.”9

Back in 1903, Thomas Edison predicted that the “doctor of the future will give no medicine, but will instruct his patient in the care of [the] human frame in diet and in the cause and prevention of diseases.”

A study of thousands of patient visits found that the average length of time primary-care doctors spend talking about nutrition is about ten seconds.13 But hey, this is the twenty-first century! Can’t we eat whatever we want and simply take meds when we begin having health problems? For too many patients and even my physician colleagues, this seems to be the prevailing mind-set. Global spending for prescription drugs is surpassing $1 trillion annually, with the United States accounting for about one-third of this market.

the science shows that our genes often account for only 10–20 percent of risk at most.15 For instance, as you’ll see in this book, the rates of killers like heart disease and major cancers differ up to a hundredfold among various populations around the globe.

while a sixty-year-old American man living in San Francisco has about a 5 percent chance of having a heart attack within five years, should he move to Japan and start eating and living like the Japanese, his five-year risk would drop to only 1 percent.

Japanese Americans in their forties can have the same heart attack risk as Japanese in their sixties.

Back in 2011, a disturbing analysis of mortality and morbidity was published in the Journal of Gerontology. Are Americans living longer now compared to about a generation ago? Yes, technically. But are those extra years necessarily healthy ones?

We’re actually living fewer healthy years now than we once did.20

The researchers also noted that we’re living two fewer functional years—that is, for two years, we’re no longer able to perform basic life activities, such as walking a quarter of a mile, standing or sitting for two hours without having to lie down, or standing without special equipment.21 In other words, we’re living longer, but we’re living sicker.

“A Potential Decline in Life Expectancy in the United States in the 21st Century” concluded that “the steady rise in life expectancy observed in the modern era may soon come to an end and the youth of today may, on average, live less healthy and possibly even shorter lives than their parents.”22

public health school, students learn that there are three levels of preventive medicine. The first is primary prevention, as in trying to prevent people at risk for heart disease from suffering their first heart attack. An example of this level of preventive medicine would be your doctor prescribing you a statin drug for high cholesterol. Secondary prevention takes place when you already have the disease and are trying to prevent it from becoming worse, like having a second heart attack. To do this, your doctor may add an aspirin or other drugs to your regimen. At the third level of preventive medicine, the focus is on helping people manage long-term health problems, so your doctor, for example, might prescribe a cardiac rehabilitation program that aims to prevent further physical deterioration and pain.

But people seem to forget about a fifth concept, termed primordial prevention, that was first introduced by the World Health Organization back in 1978. Decades later, it’s finally being embraced by the American Heart Association.25 Primordial prevention was conceived as a strategy to prevent whole societies from experiencing epidemics of chronic-disease risk factors. This means not just preventing chronic disease but preventing the risk factors that lead to chronic disease.26 For example, instead of trying to prevent someone with high cholesterol from suffering a heart attack, why not help prevent him or her from getting high cholesterol (which leads to the heart attack) in the first place?

eating healthier (for example, lots of fruits and vegetables), having below-average cholesterol, having normal blood pressure, and having normal blood sugar levels.27 The American Heart Association’s goal is to reduce heart-disease deaths by 20 percent by 2020.28

Their diets were scored on a scale from zero to five to see if they met a bare minimum of healthy eating behaviors, such as meeting recommended targets for fruit, vegetable, and whole-grain consumption or drinking fewer than three cans of soda a week.

How many even reached four out of five on their Healthy Eating Score? About 1 percent.

Medical anthropologists have identified several major eras of human disease, starting with the Age of Pestilence and Famine, which largely ended with the Industrial Revolution, or the stage we’re in now, the Age of Degenerative and Man-Made Diseases.33 This shift is reflected in the changing causes of death over the last century.

In 1900 in the United States, the top-three killers were infectious diseases: pneumonia, tuberculosis, and diarrheal disease.34 Now, the killers are largely lifestyle diseases: heart disease, cancer, and chronic lung disease.

In 1990 around the world, most years of healthy life were lost to undernutrition, such as diarrheal diseases in malnourished children, but now the greatest disease burden is attributed to high blood pressure, a disease of overnutrition.

China is perhaps the best-studied example. There, a transition away from the country’s traditional, plant-based diet was accompanied by a sharp rise in diet-related chronic diseases, such as obesity, diabetes, cardiovascular diseases, and cancer.38

People who once ate vegetarian diets but then started to eat meat at least once a week experienced a 146 percent increase in odds of heart disease, a 152 percent increase in stroke, a 166 percent increase in diabetes, and a 231 percent increase in odds for weight gain. During the twelve years after the transition from vegetarian to omnivore, meat-eating was associated with a 3.6 year decrease in life expectancy.39

We eat almost as if the future doesn’t matter. And, indeed, there are actually data to back that up. A study entitled “Death Row Nutrition: Curious Conclusions of Last Meals” analyzed the last meal requests of hundreds of individuals executed in the United States during a five-year period. It turns out that the nutritional content didn’t differ much from what Americans normally eat.

If we continue to eat as though we’re having our last meals, eventually they will be.

adhering to just four simple healthy lifestyle factors can have a strong impact on the prevention of chronic diseases: not smoking, not being obese, getting a half hour of exercise a day, and eating healthier—defined as consuming more fruits, veggies, and whole grains and less meat. Those four factors alone were found to account for 78 percent of chronic disease risk.

For some cancers, like our number-two cancer killer, colon cancer, up to 71 percent of cases appear to be preventable through a similar portfolio of simple diet and lifestyle changes.52

the CDC’s definitions were pretty laid-back: By not smoking, the CDC just meant not currently smoking. A “healthy diet” was defined merely as being in the top 40 percent in terms of complying

Of course, people sometimes fib about how well they eat. How accurate can these findings really be if they’re based on people’s self-reporting?

The drop in mortality risk among those with healthier habits was equivalent to being fourteen years younger.55 It’s like turning back the clock fourteen years—not with a drug or a DeLorean but just by eating and living healthier. Let’s

you have forty-six strands of DNA coiled into chromosomes. At the tip of each chromosome, there’s a tiny cap called a telomere, which keeps your DNA from unraveling and fraying. Think of it as the plastic tips on the end of your shoelaces.

oversimplification,57 telomeres have been thought of as your life “fuse”: They can start shortening as soon as you’re born, and when they’re gone, you’re gone. In fact, forensic scientists can take DNA from a bloodstain and roughly estimate how old the person was based on how long their telomeres are.58 Sounds like fodder for a great scene in CSI, but is there anything you can do to slow the rate at which your fuses burn?

smoking cigarettes is associated with triple the rate of telomere loss,60 so the first step is simple: Stop smoking. But the food you eat every day may also have an impact on how fast you lose your telomeres.

consumption of fruits,61 vegetables,62 and other antioxidant-rich foods63 has been associated with longer protective telomeres.

the consumption of refined grains,64 soda,65 meat (including fish),66 and dairy67 has been linked to shortened telomeres. What if you ate a diet composed of whole plant foods and stayed away from processed foods and animal foods? Could cellular aging be slowed?

published in one of the most prestigious medical journals in the world. The accompanying editorial concluded that this landmark study “should encourage people to adopt a healthy lifestyle

plant-based nutrition and other healthy changes could significantly boost telomerase activity, the only intervention ever shown to do so.

suggesting a healthy lifestyle can boost telomerase enzyme activity and reverse cellular aging.71

Weight loss through calorie restriction and an even more vigorous exercise program failed to improve telomere length, so it appears that the active ingredient is the quality, not quantity, of the food eaten.

individuals on the plant-based diet exercised only half as much, enjoyed the same amount of weight loss after just three months,73 and achieved significant telomere protection.

Some people have expressed concern that boosting telomerase activity could theoretically increase cancer risk,

as we’ll see in chapter 13, Dr. Ornish and his colleagues have used the same diet and lifestyle changes to halt and apparently reverse the progression of cancer in certain circumstances.

heart-healthy diet is a brain-healthy diet is a lung-healthy diet. The same diet that helps prevent cancer just so happens to be the same diet that may help prevent type 2 diabetes and every other cause of death on the top-fifteen list.

disease—a healthy diet can benefit all organ systems at once, has good side effects, and may treat the underlying cause of illness.

In this book, I don’t advocate for a vegetarian diet or a vegan diet. I advocate for an evidence-based diet, and the best available balance of science suggests that the more whole plant foods we eat, the better—both to reap their nutritional benefits and to displace less healthful options. Most doctor visits are for lifestyle-based

In this book, I don’t advocate for a vegetarian diet or a vegan diet. I advocate for an evidence-based diet, and the best available balance of science suggests that the more whole plant foods we eat, the better—both to reap their nutritional benefits and to displace less healthful options.

Dr. Ornish “realized reimbursement is a much more powerful determinant of medical practice than research.”97

“Too often, physicians ignore the potential benefits of good nutrition and quickly prescribe medications instead of giving patients a chance to correct their disease through healthy eating and active living.… Physicians should consider recommending a plant-based diet to all their patients, especially those with high blood pressure, diabetes, cardiovascular disease, or obesity.”

major downside Kaiser Permanente’s nutritional update describes is that this diet may work a little too well. If people begin eating plant-based diets while still taking medications, their blood pressure or blood sugar could actually drop so low that physicians may need to adjust medications or eliminate them altogether.

Ironically, the “side effect” of the diet may be not having to take drugs anymore.

The primary reason diseases tend to run in families may be that diets tend to run in families.

Colon cancer mortality in Japan in the 1950s was less than one-fifth that of the United States (including Americans of Japanese ancestry).102 But now colon cancer rates in Japan are as bad as they are in the United States, a rise that has been attributed in part to the fivefold increase in meat consumption.

Research has shown us that identical twins separated at birth will get different diseases based on how they live their lives. A recent American Heart Association–funded study compared the lifestyles and arteries of nearly five hundred twins.

It found that diet and lifestyle factors clearly trumped genes.104 You share 50 percent of your genes with each of your parents, so if one parent dies of a heart attack, you know you’ve inherited some of that susceptibility.

Queen bees and worker bees are genetically identical, yet queen bees lay up to two thousand eggs a day, while worker bees are functionally sterile. Queens live up to three years; workers may live only three weeks.105

The difference between the two is diet. When the hive’s queen is dying, a larva is picked by nurse bees to be fed a secreted substance called royal jelly.

even if you’re born with good genes, cancer can sometimes find a way to turn them off. A number of chemotherapy drugs have been developed to restore our bodies’ natural defenses, but their use has been limited due to their high toxicity.107

beans, greens, and berries—that appear to have the same effect naturally.

Three hours after eating a cup of broccoli sprouts, the enzyme that cancers use to help silence our defenses is suppressed in your bloodstream110 to an extent equal to or greater than the chemotherapy agent specifically designed for that purpose,111 without the toxic side effects.112

In part 1—the “why” to eat healthfully section—I will explore the role diet can play in the prevention, treatment, and reversal of the fifteen leading causes of death in the United States.

in part 2, we’ll take a look at how best to eat them—we’ll explore such issues as how many greens to eat every day and whether they’re best cooked, canned, fresh, or frozen.

Imagine if terrorists created a bioagent that spread mercilessly, claiming the lives of nearly four hundred thousand Americans every year. That is the equivalent of one person every eighty-three seconds, every hour, around the clock, year after year. The pandemic would be front-page news all day, every day. We’d marshal the army and march our finest medical minds into a room to figure out a cure for this bioterror plague.

annually than have all our past wars combined. It can be stopped not in a laboratory but right in our grocery stores, kitchens, and dining rooms.

This particular biological weapon may not be a germ released by terrorists, but it kills more Americans annually than have all our past wars combined. It can be stopped not in a laboratory but right in our grocery stores, kitchens, and dining rooms.

fatty deposits in the walls of your arteries called atherosclerotic plaque. For most Americans raised on a conventional diet, plaque accumulates inside the coronary arteries—the blood vessels that crown the heart (hence “coronary”) and supply it with oxygen-rich blood.

buildup of plaque, known as atherosclerosis, from the Greek words athere (gruel) and sklerosis (hardening), is the hardening of the arteries by pockets of cholesterol-rich gunk that builds up within the inner linings of the blood vessels.

occurs over decades, slowly bulging into the space inside the arteries, narrowing the path for blood to flow. The restriction of blood circulation to the heart muscle can lead to chest pain and pressure, known as angina,

In Uganda, a country of millions in eastern Africa, coronary heart disease was described as “almost non-existent.”

The Ugandans experienced more than one hundred times fewer heart attacks than the Americans. The doctors were so blown away that they examined another 800 deaths in Uganda. Out of more than 1,400 Ugandans autopsied, researchers found just one body with a small, healed lesion of the heart, meaning the attack wasn’t even fatal.

When people move from low-risk to high-risk areas, their disease rates skyrocket as they adopt the diet and lifestyle habits of their new homes.

Though Chinese and African diets are very different, they share

It means heart disease may be a choice. If you looked at the teeth of people who lived more than ten thousand years before the invention of the toothbrush, you’d notice they had almost no cavities.9 They never flossed a day in their lives, yet no cavities. That’s because candy bars hadn’t been invented yet.

But what if instead of the dental plaque on our teeth, we’re talking about the atherosclerotic plaque building up in our arteries? We’re not just talking about scraping tartar anymore. We’re talking about life and death.

it: “Given this and other negative meta-analyses, our job [as doctors] should be to stop highly marketed fish oil supplementation to all our patients…”19 Heart

want to reverse the heart disease you very likely already have.

development of heart disease. Researchers

This was a live-in program where everyone was placed on a plant-based diet and then started on a graded exercise regimen. They wheeled my grandmother in, and she walked out. I’ll never forget that.

Why were doctors still prescribing drugs and using Roto-Rooter-type procedures to just treat the symptoms of heart disease and to try to forestall what they chose to believe was the inevitable—an early death?

This was my wake-up call. I opened my eyes to the depressing fact that there are other

This was my wake-up call. I opened my eyes to the depressing fact that there are other forces at work in medicine besides science.

The U.S. health care system runs on a fee-for-service model in which doctors get paid for the pills and procedures they prescribe, rewarding quantity over quality. We don’t get reimbursed for time

If doctors were instead paid for performance, there would be a financial incentive to treat the lifestyle causes of disease. Until the model of reimbursement changes, I don’t expect great changes in medical care or medical education.

During my medical training, I was offered countless steak dinners and fancy perks by Big Pharma representatives, but not once did I get a call from Big Broccoli.

During my first interview for medical school, at Cornell University, I remember the interviewer emphatically stating, “Nutrition is superfluous to human health.” And he was a pediatrician! I knew I was in for a long road ahead. Come to think of it, I think the only medical professional who ever asked me about a family member’s diet was our veterinarian.

my goal was to speak at every medical school in the country every two years to influence an entire generation of new doctors. I didn’t want another doctor to graduate without this tool—the power of food—in her or his toolbox.

Although my original motivation was health, over the years, I’ve grown into quite the animal lover. Three cats and a dog run our household,

care about the welfare of the animals we eat, but first and foremost, I am a physician. My primary duty has always been to care for my patients, to accurately provide

I care about the welfare of the animals we eat, but first and foremost, I am a physician. My primary duty has always been to care for my patients, to accurately provide the

I care about the welfare of the animals we eat, but first and foremost, I am a physician. My primary duty has always been to care for my patients, to accurately provide the best available balance of evidence.

Now a self-sustaining nonprofit organization itself, NutritionFacts.org has more than a thousand bite-sized videos on nearly every conceivable nutrition topic,

In a recent national survey of doctor office visits, only about one in five smokers were told to quit.

Just as you don’t have to wait for your physician to tell you to stop smoking, you don’t have to wait to start eating healthier.

From a study of more than forty-two thousand consecutive autopsies, centenarians—those who live past one hundred—were found to have succumbed to diseases in 100 percent of the cases examined.

people don’t die as a consequence of maturing. They die from disease, most commonly heart attacks.

Our diet is the number-one cause of premature death and the number-one cause of disability.

One study found that people off the street sometimes know more about basic nutrition than their doctors, concluding “physicians should be more knowledgeable about nutrition than their patients, but these results suggest that this is not necessarily true.”9

Back in 1903, Thomas Edison predicted that the “doctor of the future will give no medicine, but will instruct his patient in the care of [the] human frame in diet and in the cause and prevention of diseases.”

A study of thousands of patient visits found that the average length of time primary-care doctors spend talking about nutrition is about ten seconds.13 But hey, this is the twenty-first century! Can’t we eat whatever we want and simply take meds when we begin having health problems? For too many patients and even my physician colleagues, this seems to be the prevailing mind-set. Global spending for prescription drugs is surpassing $1 trillion annually, with the United States accounting for about one-third of this market.

the science shows that our genes often account for only 10–20 percent of risk at most.15 For instance, as you’ll see in this book, the rates of killers like heart disease and major cancers differ up to a hundredfold among various populations around the globe.

while a sixty-year-old American man living in San Francisco has about a 5 percent chance of having a heart attack within five years, should he move to Japan and start eating and living like the Japanese, his five-year risk would drop to only 1 percent.

Japanese Americans in their forties can have the same heart attack risk as Japanese in their sixties.

Back in 2011, a disturbing analysis of mortality and morbidity was published in the Journal of Gerontology. Are Americans living longer now compared to about a generation ago? Yes, technically. But are those extra years necessarily healthy ones?

We’re actually living fewer healthy years now than we once did.20

The researchers also noted that we’re living two fewer functional years—that is, for two years, we’re no longer able to perform basic life activities, such as walking a quarter of a mile, standing or sitting for two hours without having to lie down, or standing without special equipment.21 In other words, we’re living longer, but we’re living sicker.

“A Potential Decline in Life Expectancy in the United States in the 21st Century” concluded that “the steady rise in life expectancy observed in the modern era may soon come to an end and the youth of today may, on average, live less healthy and possibly even shorter lives than their parents.”22

public health school, students learn that there are three levels of preventive medicine. The first is primary prevention, as in trying to prevent people at risk for heart disease from suffering their first heart attack. An example of this level of preventive medicine would be your doctor prescribing you a statin drug for high cholesterol. Secondary prevention takes place when you already have the disease and are trying to prevent it from becoming worse, like having a second heart attack. To do this, your doctor may add an aspirin or other drugs to your regimen. At the third level of preventive medicine, the focus is on helping people manage long-term health problems, so your doctor, for example, might prescribe a cardiac rehabilitation program that aims to prevent further physical deterioration and pain.

But people seem to forget about a fifth concept, termed primordial prevention, that was first introduced by the World Health Organization back in 1978. Decades later, it’s finally being embraced by the American Heart Association.25 Primordial prevention was conceived as a strategy to prevent whole societies from experiencing epidemics of chronic-disease risk factors. This means not just preventing chronic disease but preventing the risk factors that lead to chronic disease.26 For example, instead of trying to prevent someone with high cholesterol from suffering a heart attack, why not help prevent him or her from getting high cholesterol (which leads to the heart attack) in the first place?

eating healthier (for example, lots of fruits and vegetables), having below-average cholesterol, having normal blood pressure, and having normal blood sugar levels.27 The American Heart Association’s goal is to reduce heart-disease deaths by 20 percent by 2020.28

Their diets were scored on a scale from zero to five to see if they met a bare minimum of healthy eating behaviors, such as meeting recommended targets for fruit, vegetable, and whole-grain consumption or drinking fewer than three cans of soda a week.

How many even reached four out of five on their Healthy Eating Score? About 1 percent.

Medical anthropologists have identified several major eras of human disease, starting with the Age of Pestilence and Famine, which largely ended with the Industrial Revolution, or the stage we’re in now, the Age of Degenerative and Man-Made Diseases.33 This shift is reflected in the changing causes of death over the last century.

In 1900 in the United States, the top-three killers were infectious diseases: pneumonia, tuberculosis, and diarrheal disease.34 Now, the killers are largely lifestyle diseases: heart disease, cancer, and chronic lung disease.

In 1990 around the world, most years of healthy life were lost to undernutrition, such as diarrheal diseases in malnourished children, but now the greatest disease burden is attributed to high blood pressure, a disease of overnutrition.

China is perhaps the best-studied example. There, a transition away from the country’s traditional, plant-based diet was accompanied by a sharp rise in diet-related chronic diseases, such as obesity, diabetes, cardiovascular diseases, and cancer.38

People who once ate vegetarian diets but then started to eat meat at least once a week experienced a 146 percent increase in odds of heart disease, a 152 percent increase in stroke, a 166 percent increase in diabetes, and a 231 percent increase in odds for weight gain. During the twelve years after the transition from vegetarian to omnivore, meat-eating was associated with a 3.6 year decrease in life expectancy.39

We eat almost as if the future doesn’t matter. And, indeed, there are actually data to back that up. A study entitled “Death Row Nutrition: Curious Conclusions of Last Meals” analyzed the last meal requests of hundreds of individuals executed in the United States during a five-year period. It turns out that the nutritional content didn’t differ much from what Americans normally eat.

If we continue to eat as though we’re having our last meals, eventually they will be.

adhering to just four simple healthy lifestyle factors can have a strong impact on the prevention of chronic diseases: not smoking, not being obese, getting a half hour of exercise a day, and eating healthier—defined as consuming more fruits, veggies, and whole grains and less meat. Those four factors alone were found to account for 78 percent of chronic disease risk.

For some cancers, like our number-two cancer killer, colon cancer, up to 71 percent of cases appear to be preventable through a similar portfolio of simple diet and lifestyle changes.52

the CDC’s definitions were pretty laid-back: By not smoking, the CDC just meant not currently smoking. A “healthy diet” was defined merely as being in the top 40 percent in terms of complying

Of course, people sometimes fib about how well they eat. How accurate can these findings really be if they’re based on people’s self-reporting?

The drop in mortality risk among those with healthier habits was equivalent to being fourteen years younger.55 It’s like turning back the clock fourteen years—not with a drug or a DeLorean but just by eating and living healthier. Let’s

you have forty-six strands of DNA coiled into chromosomes. At the tip of each chromosome, there’s a tiny cap called a telomere, which keeps your DNA from unraveling and fraying. Think of it as the plastic tips on the end of your shoelaces.

oversimplification,57 telomeres have been thought of as your life “fuse”: They can start shortening as soon as you’re born, and when they’re gone, you’re gone. In fact, forensic scientists can take DNA from a bloodstain and roughly estimate how old the person was based on how long their telomeres are.58 Sounds like fodder for a great scene in CSI, but is there anything you can do to slow the rate at which your fuses burn?

smoking cigarettes is associated with triple the rate of telomere loss,60 so the first step is simple: Stop smoking. But the food you eat every day may also have an impact on how fast you lose your telomeres.

consumption of fruits,61 vegetables,62 and other antioxidant-rich foods63 has been associated with longer protective telomeres.

the consumption of refined grains,64 soda,65 meat (including fish),66 and dairy67 has been linked to shortened telomeres. What if you ate a diet composed of whole plant foods and stayed away from processed foods and animal foods? Could cellular aging be slowed?

published in one of the most prestigious medical journals in the world. The accompanying editorial concluded that this landmark study “should encourage people to adopt a healthy lifestyle

plant-based nutrition and other healthy changes could significantly boost telomerase activity, the only intervention ever shown to do so.

suggesting a healthy lifestyle can boost telomerase enzyme activity and reverse cellular aging.71

Weight loss through calorie restriction and an even more vigorous exercise program failed to improve telomere length, so it appears that the active ingredient is the quality, not quantity, of the food eaten.

individuals on the plant-based diet exercised only half as much, enjoyed the same amount of weight loss after just three months,73 and achieved significant telomere protection.

Some people have expressed concern that boosting telomerase activity could theoretically increase cancer risk,

as we’ll see in chapter 13, Dr. Ornish and his colleagues have used the same diet and lifestyle changes to halt and apparently reverse the progression of cancer in certain circumstances.

heart-healthy diet is a brain-healthy diet is a lung-healthy diet. The same diet that helps prevent cancer just so happens to be the same diet that may help prevent type 2 diabetes and every other cause of death on the top-fifteen list.

disease—a healthy diet can benefit all organ systems at once, has good side effects, and may treat the underlying cause of illness.

In this book, I don’t advocate for a vegetarian diet or a vegan diet. I advocate for an evidence-based diet, and the best available balance of science suggests that the more whole plant foods we eat, the better—both to reap their nutritional benefits and to displace less healthful options. Most doctor visits are for lifestyle-based

In this book, I don’t advocate for a vegetarian diet or a vegan diet. I advocate for an evidence-based diet, and the best available balance of science suggests that the more whole plant foods we eat, the better—both to reap their nutritional benefits and to displace less healthful options.

Dr. Ornish “realized reimbursement is a much more powerful determinant of medical practice than research.”97

“Too often, physicians ignore the potential benefits of good nutrition and quickly prescribe medications instead of giving patients a chance to correct their disease through healthy eating and active living.… Physicians should consider recommending a plant-based diet to all their patients, especially those with high blood pressure, diabetes, cardiovascular disease, or obesity.”

major downside Kaiser Permanente’s nutritional update describes is that this diet may work a little too well. If people begin eating plant-based diets while still taking medications, their blood pressure or blood sugar could actually drop so low that physicians may need to adjust medications or eliminate them altogether.

Ironically, the “side effect” of the diet may be not having to take drugs anymore.

The primary reason diseases tend to run in families may be that diets tend to run in families.

Colon cancer mortality in Japan in the 1950s was less than one-fifth that of the United States (including Americans of Japanese ancestry).102 But now colon cancer rates in Japan are as bad as they are in the United States, a rise that has been attributed in part to the fivefold increase in meat consumption.

Research has shown us that identical twins separated at birth will get different diseases based on how they live their lives. A recent American Heart Association–funded study compared the lifestyles and arteries of nearly five hundred twins.

It found that diet and lifestyle factors clearly trumped genes.104 You share 50 percent of your genes with each of your parents, so if one parent dies of a heart attack, you know you’ve inherited some of that susceptibility.

Queen bees and worker bees are genetically identical, yet queen bees lay up to two thousand eggs a day, while worker bees are functionally sterile. Queens live up to three years; workers may live only three weeks.105

The difference between the two is diet. When the hive’s queen is dying, a larva is picked by nurse bees to be fed a secreted substance called royal jelly.

even if you’re born with good genes, cancer can sometimes find a way to turn them off. A number of chemotherapy drugs have been developed to restore our bodies’ natural defenses, but their use has been limited due to their high toxicity.107

beans, greens, and berries—that appear to have the same effect naturally.

Three hours after eating a cup of broccoli sprouts, the enzyme that cancers use to help silence our defenses is suppressed in your bloodstream110 to an extent equal to or greater than the chemotherapy agent specifically designed for that purpose,111 without the toxic side effects.112

In part 1—the “why” to eat healthfully section—I will explore the role diet can play in the prevention, treatment, and reversal of the fifteen leading causes of death in the United States.

in part 2, we’ll take a look at how best to eat them—we’ll explore such issues as how many greens to eat every day and whether they’re best cooked, canned, fresh, or frozen.

Imagine if terrorists created a bioagent that spread mercilessly, claiming the lives of nearly four hundred thousand Americans every year. That is the equivalent of one person every eighty-three seconds, every hour, around the clock, year after year. The pandemic would be front-page news all day, every day. We’d marshal the army and march our finest medical minds into a room to figure out a cure for this bioterror plague.

annually than have all our past wars combined. It can be stopped not in a laboratory but right in our grocery stores, kitchens, and dining rooms.

This particular biological weapon may not be a germ released by terrorists, but it kills more Americans annually than have all our past wars combined. It can be stopped not in a laboratory but right in our grocery stores, kitchens, and dining rooms.

fatty deposits in the walls of your arteries called atherosclerotic plaque. For most Americans raised on a conventional diet, plaque accumulates inside the coronary arteries—the blood vessels that crown the heart (hence “coronary”) and supply it with oxygen-rich blood.

buildup of plaque, known as atherosclerosis, from the Greek words athere (gruel) and sklerosis (hardening), is the hardening of the arteries by pockets of cholesterol-rich gunk that builds up within the inner linings of the blood vessels.

occurs over decades, slowly bulging into the space inside the arteries, narrowing the path for blood to flow. The restriction of blood circulation to the heart muscle can lead to chest pain and pressure, known as angina,

In Uganda, a country of millions in eastern Africa, coronary heart disease was described as “almost non-existent.”

The Ugandans experienced more than one hundred times fewer heart attacks than the Americans. The doctors were so blown away that they examined another 800 deaths in Uganda. Out of more than 1,400 Ugandans autopsied, researchers found just one body with a small, healed lesion of the heart, meaning the attack wasn’t even fatal.

When people move from low-risk to high-risk areas, their disease rates skyrocket as they adopt the diet and lifestyle habits of their new homes.

Though Chinese and African diets are very different, they share

It means heart disease may be a choice. If you looked at the teeth of people who lived more than ten thousand years before the invention of the toothbrush, you’d notice they had almost no cavities.9 They never flossed a day in their lives, yet no cavities. That’s because candy bars hadn’t been invented yet.

But what if instead of the dental plaque on our teeth, we’re talking about the atherosclerotic plaque building up in our arteries? We’re not just talking about scraping tartar anymore. We’re talking about life and death.

it: “Given this and other negative meta-analyses, our job [as doctors] should be to stop highly marketed fish oil supplementation to all our patients…”19 Heart

want to reverse the heart disease you very likely already have.

development of heart disease. Researchers

nutritional disease of childhood but one during pregnancy. It’s become commonplace for pregnant women to avoid

The average cholesterol for people living in the United States is much higher than 150 mg/dL; it hovers around 200 mg/dL.

cholesterol-lowering statin drug Lipitor has become the best-selling drug of all time, generating more than $140 billion in global sales.32 This class of drugs garnered so much enthusiasm in the medical community that some U.S. health authorities reportedly advocated they be added to the public water supply like fluoride is.

Plant-based diets have been shown to lower cholesterol just as effectively as first-line statin drugs, but without the risks.39 In fact, the “side effects” of healthy eating tend to be good—less cancer and diabetes risk and protection of the liver

back and let your body work its magic. But what if you kept whacking it in the same place three times a day—say, at breakfast, lunch, and dinner? It would never

One of the most amazing things I learned in medical school was that within about fifteen years of stopping smoking, your lung-cancer risk approaches that of a lifelong nonsmoker.42 Your lungs can clear out all that tar buildup and, eventually, it’s almost as if you never smoked at all.

reinjure your lungs with every puff, you can reinjure your arteries with every bite. You can choose moderation and hit yourself with a smaller hammer, but why beat

Your arteries are not merely inert pipes through which blood flows. They are dynamic, living organs.

a single fast-food meal—Sausage and Egg McMuffins were used in the original study—can stiffen your arteries within hours, cutting in half their ability to relax normally.

Research showing that coronary heart disease can be reversed with a plant-based diet—with or without other healthy lifestyle changes—has

a report advising Americans to cut down on animal-based foods and increase their consumption of plant-based foods. As a founding member of Harvard University’s nutrition department recalls, “The meat, milk and egg producers were very upset.”

In more recent years, it was uncovered that many members of the U.S. Dietary Guidelines Advisory Committee had financial ties to everything from candy bar companies to entities like McDonald’s Council on Healthy Lifestyles and Coca-Cola’s Beverage Institute for Health and Wellness.

Sadly, the history of medicine holds many examples of the medical establishment rejecting sound science when it goes against the prevailing conventional wisdom.

“Tomato Effect.” The term was coined in the Journal of the American Medical Association in reference to the fact that tomatoes were once considered poisonous and were shunned for centuries in North America, despite overwhelming evidence to the contrary.

most medical schools don’t even require a single course on nutrition,

mainstream medical organizations actively lobby against increased nutrition education for physicians.59 When the American Academy of Family

mainstream medical organizations actively lobby against increased nutrition education for physicians.59 When the American Academy of Family Physicians (AAFP) was called out on their proud new corporate relationship with Coca-Cola to support patient education on healthy eating, an executive vice president of the academy tried to quell protests by explaining that this alliance was not without precedent.

they had financial ties to cigarette maker Philip Morris.61

“[t]here are no good or bad foods, just good or bad diets.” No bad foods? Really?

Smoking per se wasn’t bad, only “excess” smoking.62 Sound familiar? Everything in moderation.

So we can learn about eggs from the American Egg Board and about the benefits of chewing gum from the Wrigley Science Institute.63

doctors perceive that patients would feel deprived of all the junk they’re eating. Can you imagine a doctor saying, “Yeah, I’d like to tell my patients to stop smoking, but I know how much they love it”?

“Everything’s going to be okay,” I said. Immediately, I thought, What a stupid thing to say to someone choking to death.

America’s number-two killer, lung disease, claims the lives of about 300,000 people each year. And like our number-one domestic

lung cancer, chronic obstructive pulmonary disease (COPD), and asthma.

smoking. However, a healthy diet may help mitigate the DNA-damaging effects of tobacco smoke, as well as perhaps help prevent lung cancer from spreading.

COPD kills approximately 140,000 people annually, from either damage to the walls of tiny air sacs in the lungs (emphysema) or from inflamed and thickened airways plugged with thick mucus (chronic bronchitis).

toxic effects of cigarettes on the lungs. Tobacco smoke contains chemicals that weaken the body’s immune system, making it more susceptible to disease and handicapping its ability to destroy cancer cells. At the same time, tobacco smoke can damage cell DNA, increasing the chance for cancer cells to form and flourish in the first place.6 To test the power of dietary interventions