Voices of the Food Revolution. John Robbins

is in cardiology.

      DR. CALDWELL ESSELSTYN: Those tax dollars are being spent on drugs, imaging, procedures, and operations that have absolutely nothing to do with the causation of the disease. So a poor patient today with a cardiovascular illness is going to have their first stent, their second stent, maybe their third, fourth, or fifth, and then a bypass, and then more stents. Eventually they'll have congestive heart failure and sadly end up dying of a food-borne illness that was never treated.

      Right now what we are doing in medicine is really sort of insane. A few years ago, it was disappointing that they didn't teach nutrition in medical school. Quite frankly, at this point it is disgraceful.

      JOHN ROBBINS: Your work was featured in the popular documentary, Forks Over Knives. The film basically examines the claims that most, if not all, of the degenerative diseases that afflict us can be controlled or even reversed by shifting away from our present diet of animal-based and processed foods. What do you hope people take away after seeing this film?

      DR. CALDWELL ESSELSTYN: I think that the film is powerful and enlightening because it is all evidence-based. It is so compelling when you see the science that whole food, plant-based nutrition trumps everything else. It is the absolute cornerstone of what I feel can be a revolution in health.

      Even in their teenage years people have coronary artery disease. Yet the human frame is so remarkable that it will go on for several more decades doing the very best it possibly can to resist this assault. Eventually, the assault on the vasculature gets to a point where the body can no longer protect against the development of these plaques and you see the rupture and clinical disease that have taken decades to develop.

      The same thing is true, of course, of what happens with hypertension. You don't suddenly wake up as a teenager eating horribly and have hypertension. No, you keep that up, and eventually your body can no longer keep your blood pressure normal. It starts to be elevated. The same thing is true with diabetes. Interestingly enough, the same thing is true of dementia. Why is it that at age 85, 50 percent of Americans or Swedes have dementia? You don't wake up at 85 suddenly with dementia. You have worked doggone hard all through your life to really mess up the vasculature to the brain as well as all the beta-amyloid and the tangles that occur in Alzheimer's. You have to work very hard to set the ground work for that to happen.

      It is so exciting to think that this seismic revolution will not only get the United States out of debt, but it will remarkably enhance the lives of so many.

      JOHN ROBBINS: One of the things that strikes me about your work is that you are asking people to change something basic, which is the food that they eat. People don't always like that. What keeps you going in the face of opposition and resistance?

      DR. CALDWELL ESSELSTYN: Well I think the tenacity of purpose comes from years ago when I used to do some athletics in college. I was on a boat crew, and we actually won a gold medal in the 1956 Olympics. We had a motto, and that motto was “press on, regardless.”

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      Neal Barnard, M.D.

      Eating to Thrive

      Neal Barnard, M.D., is one of America's leading advocates for health, nutrition, and higher standards in research. He is the president of the Physicians Committee for Responsible Medicine, and an Adjunct Associate Professor of Medicine at the George Washington University School of Medicine in Washington, D.C. The author of dozens of scientific publications, Dr. Barnard has also written fifteen books, including the New York Times bestseller, 21-Day Weight Loss Kickstart: Boost Metabolism, Lower Cholesterol, and Dramatically Improve Your Health.

      Find out what Dr. Barnard has to say about the latest findings in diabetes treatment, some of which come from studies he has personally directed. Hint: The most powerful tool isn't a drug, it's the food on your plate. Then, get his take on cancer, soy, weight loss, and many other crucial topics of our day.

      JOHN ROBBINS: You grew up in a North Dakota family of cattle ranchers and doctors. When you look back now, do you feel that those early experiences helped shape your current view of the world and your work?

      DR. NEAL BARNARD: My grandpa was a cattle rancher, and his father was a cattle rancher, and his father was a cattle rancher. And my own father was too, except that he really did not care for the cattle business and soon got out of it. He ended up going to medical school and then spent the later part of his life treating diabetes in Fargo. But we still ate like we were in the cattle business. I have vivid memories of bringing cattle to slaughter and that kind of thing. Now, all of those people were good, decent folks, and I am sympathetic to how people have gotten into these walks of life. At the same time, we can clearly do better. Science has moved on and shown us that there is a better path.

      JOHN ROBBINS: Speaking of science moving on, you were awarded a $350,000 research grant from The National Institutes of Health a few years ago to study the effect of a low-fat, vegan diet on diabetes. The study results, which you published in Diabetes Care, the peer reviewed journal, found that a low-fat, vegan diet did improve glycemic and lipid control and actually did so with greater results than those achieved on a diet that was based on the American Diabetes Association guidelines. Has the Diabetes Association made any changes in their guidelines as a result of your findings?

      DR. NEAL BARNARD: When you look around the world, people who tend to not get diabetes don't follow the sort of typical diabetes diet that American doctors hand to patients. A typical clinically recommended diet says that patients should avoid carbohydrates: “Don't eat bread, don't eat pasta, don't eat sweet potatoes, don't eat rice, etc.” But if you look in Japan and China in decades past, rice was a staple, and they were the thinnest, healthiest, longest-lived people on the planet—that is, until burgers and cheese came in. Then as rice consumption fell and fat intake rose, diabetes rates skyrocketed.

      What the NIH funded us to do was to test an entirely plant-based diet, loaded with vegetables, fruits, whole grains, and beans. It was very low in fat, and the animal products were eliminated. Several things happened. People lost weight very well, and their cholesterol levels improved. But what the diabetes researchers especially noticed was that their blood sugars improved so much that many of them ended up reducing their medications and in some cases, diabetes was no longer even detectable.

      In 2009, the American Diabetes Association began citing our research studies in its clinical practice recommendations, and we are grateful for that. We hear every day from people whose diabetes is improving dramatically. More importantly, when people make dietary changes, they may be able to prevent this disease from starting in the first place.

      JOHN ROBBINS: My father, who as you know was the founder and for many years the owner of the Baskin-Robbins (31 Flavors) ice cream company, developed a very serious form of diabetes in his 70s, and the prognosis was very poor. But as a result of reading my books and similar ones, he made some major changes in his diet and his diabetes went into remission. He no longer needed injections of insulin or even diabetic pills. The amputation of a foot or a leg that had been envisioned wasn't necessary, and he lived many more good years. He didn't go as far with his dietary changes as you or I might have ideally wanted, but he made major ones. I thought, if a person at that age with such an investment in the lifestyle that he maintained could make those changes and experience dramatic health results in a positive way, then perhaps there is hope for just about anybody.

      DR. NEAL BARNARD: Your father was very lucky to have you looking out for him. And we have seen the same sort of success many times. I vividly recall a man who came into our research study and told me about his family history. He had diabetes all up and down his mother's side and his father's side, and his own father was dead at age 30. This young man was 31 when he got his diabetes diagnosis. He came in to see us five or six years later. We put him on a plant-based diet. He was thrilled to do it, and he told us it was much easier than the diets he had been prescribed before. Because he could eat as much as he wanted,