|
|
Physicians Committee for Responsible
Medicine (PCRM) |
Information
about changes in nutritional recommendations proposed by the Physicians Committee
for Responsible Medicine (PCRM)
CONTENTS
|
|
|
Your tax-deductible donation supports research by the non-profit foundation National Center for Nutrition and Fatty Acid Research, Inc. Please help us bring you useful information. PO Box 10187 Dept L, Gaithersburg, MD 20898. |
Letter to
Edward Siguel, MD, from Andrew Nicholson, MD,
Director of Preventive Medicine (excerpts)
|
Dear Dr. Siguel, I am writing to ask you to join some of our nation's leading physicians in recommending an important revision of the federal government's Food Guide Pyramid. As you may know, the new Dietary Guideline for Americans, unveiled by the federal government in January, emphasizes fruits, vegetables, and grains--a vital step in helping our patients prevent cancer and other serious illnesses. Vegetarian diets are now permitted, and meats and dairy products, which are linked to many serious health problems, are optional, rather than required. Although the Food Guide Pyramid was conceived as the pictorial representation of the Guidelines, it has not been updated since its release in 1991. It needs to be brought into synch with the new guidelines. ......(additional paragraph). The physicians on the enclosed list have signed onto an effort to revise the Pyramid to reflect current nutritional knowledge on the benefits of plant-based diets. ......(additional paragraph). Sincerely, Andrew Nicholson, M.D. |
Excerpts of
letter to Hon. Daniel Glickman, Secretary,
USDA, sent by PCRM to Dr. Siguel requesting Dr. Siguel's signature (excerpts)
|
Heart disease, cancer, stroke, hypertension, obesity, and other serious illnesses are epidemics in America, taking an enormous personal toll and contributing tens of billions of dollars to America's annual health care costs. Dietary factors play an important role in the etiology and course of these diseases. However, the current Food Guide Pyramid does not fully reflect current knowledge regarding optimal dietary guidelines and requires revision. Dietary changes that go further are both feasible and timely, and can potentially save many lives. The scientific literature clearly supports dietary guidelines which encourage the use of vegetables, fruits, legumes, and grains as staples. In contrast, diets based on meats, dairy products, and added vegetable oils are linked with a variety of chronic, degenerative diseases. To the extent that more Americans adopt plant-based diets, a reduction in the prevalence of chronic disease and of the costs associated with them is likely. ............(Additional Paragraph) We recommend a revision of the Food Guide Pyramid or future nutrition graphics such that the staples of the diet consist of fruits, vegetables, grains and legumes. Meat and dairy products should be optional, rather than recommended or required. Plant-based diets are a nutritionally sound approach to reducing today's chronic disease epidemics. |
Probable sponsors to recommended revisions of the Food Guide Pyramid
as indicated by PCRM (some names which PCRM sent to me)
Benjamin Spock, M.D., Author, Baby and Child Care
Henry Heimlich, M.D , Founder, The Heimlich Institute
Wiliam C. Roberts, M.D., Editor-in-Chief, American Journal of Cardiology
Dean Ornish, M.D., Preventitive Medicine Research Institute
John Farquhar, M.D., Director, Stanford Center for Research in Disease Prevention
William Castelli, M.D., Chief Investigator, The Framingham Study
Neal Barnard, M.D., President, Physicians Committee for Responsible Medicine
Frank Oski, M.D., Distinguished Service Professor of Pediatrics, Johns Hopkins University School of Medicine
Oliver Alabaster, M.D., Director, Institute for Disease Prevention, George Washington University
John McDougall, M.D., Internist and Author
David T. Nash, M.D., Syracuse University School of Medicine
Many more.
Response from Dr. Siguel to
Nicholson, MD, Director of Preventive Medicine
|
Edward Siguel, MD PhD |
|
Drs. Andrew Nicholson and Neal Barnard October 2, 1996 Dear Drs. Nicholson and Barnard, I received your letter requesting my signature on a letter to the USDA, recommending that the Food Pyramid be revised to emphasize eating mostly plant-based foods. Although I agree that the Food Pyramid ought to be revised, and that all current descriptions of the Food Pyramid and government nutrition policy ought to be destroyed because they are dangerous to the health of the American people, my research shows that your proposed changes are likely to cause more harm than good. You propose that the nutritional recommendations clarify that eating meat and milk (and I presume other animal products with fat) is optional. The implication of this statement is that there is no nutritional requirement for any of the types of fats found in animal foods (i.e., humans do not need to eat these fats). Thus, a vegetarian-type diet is healthy and ought to be followed. You further reinforce these concepts by encouraging a shift to plant-based foods. However, your recommendations failed to state whether some groups of people with certain diseases could die prematurely if they followed a vegetarian diet. I believe the following statements in your letter to myself and Secretary Glickman implying that eating animal foods cause disease are incorrect because these foods may be safe for a subject of ideal weight on a balanced diet.
I have seen no evidence that vegetable oils high in PUFAs, chicken, or egg yolks are linked to degenerative diseases. Quite the opposite. I have scientific data that shows that an exclusively plant-based diet such as the one you recommend would be hazardous for people who eat low calorie diets. Low calorie diets require nutrient dense foods to provide adequate nutrition, and often require PUFA-rich oil supplements to provide enough PUFAs. I submit that your recommendations are based on faulty scientific data or no scientific data. There are two fundamental issues which need to be addressed before the USDA Food Pyramid is changed:
For our purposes, we can assume that there is no disagreement over the nutritional requirements for protein, carbohydrates, vitamins or minerals. I believe that the major dispute on these issues pertains to the matter of fat. Moreover, when comparing alternative foods, we implicitly compare isocaloric diets. Few physicians dispute that obesity is not healthy. Definitions Saturated, monounsaturated, polyunsaturated and trans fats refers to fatty acids (SFA, MUFA, PUFA and TFA, respectively). Saturation and isomerization refer only to fatty acids, not fat, but this simplification is common both in medical and lay literature. I coined the term "essential fats" for PUFAs. PUFAs are a mixture of two families, the w3 and the w6. They consist of the essential fatty acids (EFAs) linoleic (w6) and linolenic (w3): PUFA = EFA3 + EFA3 derivatives + EFA6 + EFA6 derivatives Fat or calories? For many years, the cornerstone of US nutritional policy has been to encourage Americans to eat less total fat and less SFA. A variant sometimes known as the "Mediterranean diet" or the "Mediterranean pyramid" recommends eating more MUFAs and less SFAs. A cornerstone of heart disease prevention has been lowering total cholesterol and reducing cholesterol intake from the diet. Recent research has shown that the emphasis on total fat, SFA and cholesterol is scientifically faulty and leads to undesirable health results. Americans believe that they cannot get fat if they do not eat fat; as a consequence, they consume huge amounts of calories from low fat processed foods. The result of these nutritional changes has been an increase in weight (or an increase in the number of obese individuals) and a likely decrease in the percent of PUFA in the bodies of many Americans. This is the condition I named EFA Insufficiency (EFAI), which is associated with cardiovascular disease, hypertension and abnormal cholesterol levels. The treatment currently recommended (more low fat foods) is now known to reduce HDL, increase Total/HDL cholesterol, and increase total triglycerides, thereby increasing the known biochemical risks for heart disease. Recent research, including research funded by the USDA, has shown that total calories and the percent of PUFA in the body are more significant determinants of lipid levels and cardiovascular risk than either total fat or SFA. In fact, diets high in fat are safer than diets low in fat and high in carbohydrates (of course, isocalorically speaking). In contrast to the current emphasis on total fat and cholesterol, my treatment program aims to correct biochemical abnormalities of fatty acid metabolism by changing the diet so that the fatty acid profile of a patient moves closer to the fatty acid profile of an ideally healthy person. The treatment involves foods high in w3 and w6 PUFAs. Thus, I propose that the nutritional recommendations emphasize total caloric intake, balanced nutrition, and balanced intake of w3s and w6s rather than avoidance of particular foods such as meat. Within the context of a balanced diet containing only the calories necessary to maintain ideal weight, I submit that meat is much healthier than processed bread, pasta and cereals such as those sold at supermarkets and advertised on children's TV shows. By recommending that people eat more cereals, breads and pasta, and consider meat as "optional", I believe you are encouraging people, particularly children, to continue to eat large volumes of highly processed carbohydrates, which the body will convert into SFAs. Do we need animal fat? None of the published studies I have read have answered the question of whether or not humans must eat some of the EFA derivatives such as arachidonic acid and EPA. Many popular publications such as the book The Zone advocate avoidance of meat, chicken and egg yolks because they contain arachidonic acid. However, my research has failed to find any evidence that arachidonic acid is dangerous. Recent USDA-sponsored research found that eating arachidonic acid causes no known harm to healthy humans. I asked many scientists whether or not humans need to eat animal fat. They all told me that there is no nutritional requirement for animal fat. At a recent lecture at Harvard University, I asked Drs. Willett, Sacks and Schaefer (whom I believe you know) whether humans must eat some type of animal fatty acids. My understanding is that they said no; that is, humans can rely exclusively on fat from vegetable sources, namely linoleic and linolenic acid. I found no published research to answer the question of whether or not all humans can live on a vegetarian diet alone. It is possible that genetic differences in the ability to process foods exist. In the US, where there is great genetic variability, a single recommendation may be dangerous. What may be healthy for an Inuit living in Alaska or an African-American living in Florida, could be dangerous for the Inuit living in Florida or the African-American who lives in Alaska. The biochemical needs of Orientals and whites with green eyes may be quite different from white men with dark skin and brown eyes. More specifically, the fatty acid requirements of these groups could be quite different. General comments Let me clarify that the recommendations which you propose are supported by the majority of scientists and physicians in the US and abroad. A few scientists agree with me that EFA abnormalities and deficiencies are highly prevalent in the US. Some physicians believe that there are significant deficiencies of 3 fatty acids, but practically none of 6 fatty acids. I found no credible scientific evidence publicly available that humans (or some humans) cannot be vegetarians and live on plant-based food alone. My extensive experience in lecturing to physicians and researchers, as well as observation of the responses to my internet home page, has shown that practically all health professionals consider a vegetarian or plant-based diet to be healthy for all population groups. The only exception appears to be studies of some population groups, such as patients with alcoholism or diabetes, that may require GLA. Thus, I stand practically alone in my position that low fat diets and vegetarian diets may not provide enough PUFAs to a large segment of the population. My position, that vegetarian diets may not be optimal and that some humans may need to eat EFA derivatives, is shared by few, if any, scientists. I have seen no published data indicating that vegetarian diets may not be optimal for everyone. However, I have unpublished data showing that low fat or vegetarian diets may be dangerous for many groups of people with specific diseases. As a minimum, we need funds to determine the types of people that could be harmed by following the nutritional recommendations that you propose. I have proposed to the USDA and NIH numerous times that we study the fatty acid metabolism of different populations and evaluate the extent of EFA abnormalities in different US populations. My proposals have been rejected. In the meantime, public health organizations continue to recommend diets that are known to have minimal desirable effects on lipid levels, allowing companies to continue making fortunes selling drugs. I can make investment decisions based on medical meetings and nutritional brochures which are heavily funded by drug money: choose the ones which provide incorrect nutritional advice, which forces people to continue taking the drugs to prevent cardiovascular disease or correct abnormal lipids and thus insure huge corporate profits. I used to waste considerable time preparing proposals requesting funds to investigate fatty acid abnormalities, the results of which would have been used to improve nutritional guidelines. Instead, my time is now used far more effectively speculating on the stock market and profiting from drug stocks. Although I can make much more money from the stock market than I ever made from federal funds, I still believe that we need to drastically change nutrition policy and the allocation of research funds. Otherwise we will need to spend more than $100,000,000,000 each year in drug treatments ($2,000 per individual per year for the more than 50,000,000 Americans with hyperlipidemia, hypertension or cardiovascular disease): It is a strange irony that my taxes subsidize drug companies so their stock will go up and I will make more money. Unfortunately, I do not believe that many Americans earn enough money from investments in drug companies to pay for their drugs. As a nation, we give children the message that the best way to take care of problems is to take drugs. Consumer publications and TV now contain huge numbers of ads which advocate particular drug treatments for anything from high blood pressure to depression to obesity. Individual responsibility, healthy behaviors and proper eating habits would take too much effort; people want a solution that is literally "easy to swallow." This is the wrong message. I believe that neither President Clinton nor Senator Dole wants to send this message to the American people. Before you recommend a nutrition policy that my research has shown to be flawed, I respectfully suggest you wait until my research findings are published. I was particularly surprised to see your recommendations. As I remember, both of you, Andrew Nicholson and Neal Barnard, attended one of my talks at NIAA where I explained the scientific basis for evaluating EFA abnormalities. I believe you have seen my articles in Metabolism and Lipids, where I explain why current diets fail to lower Total/HDL cholesterol and how to decrease the risks of cardiovascular disease using foods high in PUFAs. You also know about my exchange of letters with the USDA published in the Am. J. of Clinical Nutrition, and can read my exchange of letters with Dr. Schaefer and with Dr. Ornish published in JAMA. These references and discussion on low fat diets are in my home page www.efafood.com. At the request of Dr. Ornish's staff, I had a conference call with his primary nutritionists to discuss the role of EFAs within the context of his nutrition program. It would be beneficial to evaluate the EFA profiles of some of the subjects participating in low-fat diet treatments such as the Ornish program, to determine whether such treatments may be detrimental in the long term. My research indicates that subjects who eat low calorie diets without weight loss for prolonged periods of time become deficient in EFAs. Many people, particularly elderly people and slim professional women, may not eat enough calories from vegetables to obtain the minimum amount of EFAs required for optimal cell function and reproduction. In addition, my research has shown that many individuals, such as those with diabetes, need EFA derivatives which are not found in the foods you recommend. You have assembled a distinguished panel of scientists. Your sponsors are quite impressive. I am afraid that if you send this proposal letter, your recommendations may be adopted by thousands of physicians and health providers. In fact, low fat diets are already recommended by thousands of physicians across the country. Unfortunately, I believe that your proposed recommendations are misleading and probably lethal for some people. I do believe that scientific data exists to support your position; however, I have scientific data which proves that your position is suboptimal. I have written that these diets are potentially dangerous and that patients are rarely informed about the likely EFA abnormalities associated with low fat diets. You recommend that vegetable oils high in PUFAs be avoided; I make the opposite recommendation. Millions of Americans have deficiencies of PUFAs which ought to be corrected. Using (uncooked) PUFA-rich vegetable oils and certain animal foods are the best way to correct those abnormalities. If your recommendations were implemented, we would probably see an initial improvement in many people, primarily associated with weight loss, but millions of Americans would develop deficiencies of w3 and w6 fatty acids if they continued on these diets for many years. The result would be an impairment of brain function which could be avoided by using diets with adequate amounts of EFAs. You can find recommended daily amounts for EFAs in my publications. Soon, I will submit data for publication which will significantly change our understanding of the role of fat in cardiovascular disease. My research is likely to show that millions of Americans will die prematurely if they follow your recommendations. Unfortunately, I have been unable to obtain federal funds to support my research, and publication of my findings will be delayed until I obtain adequate private funding. However, I think you will make a mistake if you discourage Americans from eating meat, chicken, eggs and vegetable oils rich in PUFA. Next year I am co-chairing a symposium at the American Oil Chemistry Society that will address these issues. You are invited to submit the name of a person who can represent your views in an articulate and scientific manner (copy of the program is in my home page and was sent to you by fax). We plan to publish reports with replies, counter-arguments, etc. Adequate opportunities will be available for dissenting views. The intention is to present a fair description of relevant scientific positions. We need more research on fatty acid metabolism and less research on drugs to lower cholesterol. I urge you to help me raise at least $1,000,000 to study fatty acid metabolism and find an answer to the questions I raised-- before we change nutritional recommendations. This money is a tiny fraction of the hundreds of millions currently spent on nutritional education and food marketing, which fail to answer the critical questions about the role of fats. In the meantime, we can save considerable amounts of money by eliminating all nutrition education programs that emphasize the current USDA food pyramid. I also recommend that clinical trials studying the role of fat in health and disease be stopped or postponed until we have an answer concerning the recommendations for fat vs. calories and amounts of PUFA vs. total fat in the diet. Otherwise, besides wasting millions of tax dollars, we risk placing many people at risk of premature death: researchers often fail to provide adequate informed consent. We should focus our resources on educating consumers, particularly minority groups such as Hispanics and African-Americans, on how to make wise supermarket and health decisions. The airwaves are crowded with commercials encouraging drug use and reliance on psychic healers (estimated to be over $100,000,000 year business in America alone). Stores have long shelves stocked with a wide range of products, each promising longevity, sex, health and good looks. Consumer magazines contains hundreds of millions of advertisements promoting easy cures for all ills. The commercialism, pseudoscience and misrepresentation of material facts is reaching astronomical proportions. It lowers the status of science when prestigious scientists recommend nutritional changes that are not well proven, are misleading, or omit material facts. Any nutritional recommendation that omits references to the role of w3 and w6 fatty acids omits key material facts that consumers ought to know. One may argue that such statements are intrinsically fraudulent and in violation of FTC and consumer protection acts in most states. It seems foolish for scientists and physicians to sign such a statement. I propose that we target several areas where the volume of data is overwhelming and wide scientific agreement exists:
Thank you very much for your consideration. Sincerely yours, PS. The nutritional changes you proposed affect millions of Americans. We, as physicians, must inspire confidence in the public by providing recommendations based on sound scientific research and knowledge. As far as I know, I have the only data on the fatty acid composition of humans (obtained during the Framingham Heart Study) measured with the accuracy required to diagnose lipid disorders. As the holder of the only patent for the diagnosis of fatty acid abnormalities associated with cardiovascular disease, I would have been informed if someone was using my methods to diagnose EFA abnormalities. |
|
By
reading this web site, you agree to read & comply with the following
instructions: You agree to pay us $300 for each unsolicited communication to sell us unsolicited products/services (by e-mail, mail, phone, etc.). Read details. |
|
|
© 1998 Edward
Siguel. All rights reserved |
modified 1/15/00 |