Eat to Beat Disease

Introduction

We are truly at a turning point in the fight against disease. Each of us has an enormous opportunity to take charge of our lives using food to transform our health. You can make decisions about what to eat and drink based on scientific evidence gleaned from testing foods with the same systems and methods that have been used to discover and develop drugs. The data generated when we study food like medicine clearly show that food can influence our health in specific and beneficial ways.

First, a bit about myself. I’m a medical doctor, an internal medicine specialist, and a research scientist. In college, I studied biochemistry (now called molecular and cellular biology), and I spent the first half of my career immersed in the world of biotechnology. For the past twenty-five years, I’ve led the Angiogenesis Foundation, a nonprofit organization that I cofounded in 1994 with a unique mission: to improve global health by focusing on a “common denominator” shared by many diseases: angiogenesis, the process our bodies use to grow new blood vessels.

As a scientist, finding common denominators of disease has long been my interest and passion. Most medical research is dedicated to exploring the individuality of disease, searching for what makes each disease distinct from every other as the path toward finding cures. My approach has been the complete opposite. By looking for common threads shared by many diseases and asking if those threads might lead to new treatments, I’ve found it is possible to achieve breakthroughs for not only one disease, but many diseases at the same time.

Early in my career, I chose to study angiogenesis. Blood vessels are essential for health because they bring oxygen and nutrients to every cell in our body. My mentor, Judah Folkman, was a brilliant surgeon-scientist at Harvard who first came up with the idea that targeting abnormal blood vessels feeding cancer could be an entirely new way to treat the disease. Angiogenesis gone awry is not just a problem in cancer, but also a common denominator in more than seventy different diseases, including the world’s other top killers: heart disease, stroke, diabetes, Alzheimer’s disease, obesity, and more. In 1993, I had an inspiration: what if controlling blood vessel development could be a singular approach to address all of these serious diseases?

Over the past twenty-five years, along with a long roster of amazing colleagues and supporters, this work is precisely what the Angiogenesis Foundation has been doing. We have coordinated research and advocated for new treatments taking this common-denominator approach. We’ve worked with more than three hundred of the brightest scientists and clinicians from North America, Europe, Asia, Australia, and Latin America; more than one hundred innovative companies in biotechnology, medical devices, and diagnostic and imaging technologies; and visionary leaders from the National Institutes of Health, the Food and Drug Administration, and major medical societies from around the world.

We have been very successful. By coordinating collective efforts, a new field of medicine called angiogenesis-based therapy has been created. Some of the innovative treatments stop blood vessels from growing in diseased tissues, such as in cancer or in blinding diseases like neovascular age-related macular degeneration and diabetic retinopathy. Other treatments that have changed medical practice spark new blood vessels to heal vital tissues, such as in diabetic and venous leg ulcers. Today, there are more than thirty-two FDA-approved drugs, medical devices, and tissue products based on angiogenesis.

These treatments, once just glimmers of ideas, have become important new standards of care in oncology, ophthalmology, and wound care, helping patients live longer and better lives. We’ve even worked with veterinarians and developed new treatments that have helped save the lives of pet dogs, dolphins, reef fish, raptors, a rhinoceros, and even a polar bear. I’m proud to have been part of these advances, and given the more than 1,500 ongoing clinical trials in angiogenesis, there are certainly more to come.

But, despite all of the success, the sobering fact is that the rates of new disease are skyrocketing. The biggest health threats for people worldwide are the noncommunicable diseases, which include cancer, heart disease, stroke, diabetes, obesity, and neurodegenerative conditions. We each know someone in our lives who has suffered from or succumbed to one of these diseases. According to the World Health Organization, cardiovascular disease killed 17.7 million people in 2015; cancer, 8.8 million; and diabetes, 1.8 million.

Even with remarkable treatment breakthroughs and FDA approvals, treatment of disease alone is not a sustainable solution for noncommunicable diseases, in part because of the stratospheric cost of new drugs. It can cost more than $2 billion to develop a single new biotechnology drug. The expense of using some of the latest drugs after they’ve received FDA approval is staggering, ranging in some cases from $200,000 per year to more than $900,000 per year. Since few can afford these price tags, the most advanced treatments don’t get to everyone who needs them, while the growing and aging population keeps getting sicker.

Drug treatments alone cannot keep us healthy. The question then becomes, how can we do a better job at preventing disease, before we have to cure it? One modern answer: food. Every doctor knows that poor diet is linked to preventable disease, and food is becoming a topic of ever greater importance in the medical community. Some avant-garde medical schools have even added culinary classes to their curriculum. Food is easily accessible and dietary interventions do not rely on expensive pharmaceutical treatments.

Not many doctors know how to discuss a healthy diet with their patients. This is through no fault of the individual doctors, but rather a side effect of how little nutrition education they receive. According to David Eisenberg, a professor at the Harvard T.H. Chan School of Public Health, only one in five medical schools in the United States requires medical students to take a nutrition course. On average, medical schools offer a mere nineteen hours of coursework in nutrition, and there are few postgraduate continuing education classes on nutrition for doctors already in practice.

Compounding this problem is that the different branches of science that study food and health have traditionally worked independently, as separate fields. Food technologists study chemical and physical properties of edible substances. Life science researchers study living organisms, including humans. Epidemiologists study real-world populations. Each field contributes important perspectives and ideas, but they rarely converge to answer practical questions about which foods and beverages might be responsible for a health benefit in the human body, in what amounts, and what is within a specific food that causes the effect.

What this all means for you is that your doctor, while armed with deep skills and invaluable knowledge about medicine, may not be fluent in advising you on what to eat for your health to beat disease.

I experienced the ramifications of this firsthand in my own practice of medicine. When I was taking care of older patients at a hospital for veterans, I often wondered what had happened to their bodies. These patients, mostly men, were once specimens of perfect fitness, trained as warriors to fight for their country. By the time I saw them decades later, they were often overweight, if not downright obese, diabetic, ravaged by terrible heart and lung diseases and, often, cancer.

As their doctor, I would give them the news of a terrible diagnosis. They would ask me: How bad is it? What is the treatment? How long do I have to live? I would give them my best estimate. Then, as they were leaving my office, they would almost invariably turn and ask me: “Hey doc, what can I eat so that I can help myself?”

I didn’t have an answer to that question—because I hadn’t been educated or trained to deal with it. That struck me as wrong, and thus I began the journey to seek the answers that led me to write this book.

In order to understand the benefits of food for health, we need to first understand the definition of health. To most people, health is the absence of disease. But it is much more than that. In fact, the definition of health needs a major upgrade.

What is clear is that our health is an active state, protected by a series of remarkable defense systems in the body that are firing on all cylinders, from birth to our last day alive, keeping our cells and organs functioning smoothly. These health defense systems are hardwired in our body to protect us. Some are so powerful they can even reverse diseases like cancer. And while they function as separate systems of defense, they also support and interact with one another. These defense systems are the common denominators of health. By recalibrating our approach to disease prevention and focusing on these common denominators, we can take a unified approach to intercepting diseases before they set in. This can be as powerful as finding common denominators to treat disease, as we did two decades ago.

Five defense systems form key pillars to your health. Each of the systems is influenced by diet. When you know what to eat to support each health defense, you know how to use your diet to maintain health and beat disease.

When I teach other doctors and students about diet and health, I use the analogy that the body is like a medieval fortress, protected not only by its stone walls, but by a host of other clever built-in defenses. Indeed, in castles, some of these defenses, such as the talus, the trou de loup, and murder hole, were not even apparent until the enemy tried to invade. Think of your health defense systems as the hidden defenses of the body fortress. These defenses heal the body from within, so it is now possible to systematically examine how to shore up your health.

The five defense systems are angiogenesis, regeneration, microbiome, DNA protection, and immunity.

Angiogenesis

Sixty thousand miles of blood vessels course throughout our bodies and bring oxygen and nutrients to all of our cells and organs. Angiogenesis is the process by which these blood vessels are formed. Foods like soy, green tea, coffee, tomatoes, red wine, beer, and even hard cheese can influence the angiogenesis defense system.

Regeneration

Powered by more than 750,000 stem cells distributed throughout our bone marrow, lungs, liver, and almost all of our organs, our body regenerates itself every day. These stem cells maintain, repair, and regenerate our bodies throughout our lives. Some foods like dark chocolate, black tea, and beer can mobilize them and help us regenerate. Other foods, like purple potatoes, can kill deadly stem cells that spark cancer growth.

Microbiome

Almost 40 trillion bacteria inhabit our bodies, most of which act to defend our health. Not only do these bacteria produce health supporting metabolites from the foods that we swallow and deliver to our gut, but they also control our immune system, influence angiogenesis, and even help produce hormones that influence our brain and social function. We can boost our microbiome by eating foods like kimchi, sauerkraut, cheddar cheese, and sourdough bread.

DNA Protection

Our DNA is our genetic blueprint, but it is also designed to be a defense system. It has surprising repair mechanisms that protect us against damage caused by solar radiation, household chemicals, stress, compromised sleep, and poor diet, among other insults. Not only can certain foods prompt DNA to fix itself, but some foods turn on helpful genes and turn off harmful ones, while other foods lengthen our telomeres, which protect DNA and slow aging.

Immunity

Our immune system defends our health in sophisticated ways that are much more complicated than we previously thought. It is influenced by our gut, and it can be manipulated to successfully attack and wipe out cancer, even in the elderly. Recent discoveries have completely changed our understanding of the immune system. Foods like blackberries, walnuts, and pomegranate can activate the immune system, while other foods can dampen its activities and help reduce the symptoms of autoimmune diseases.

This book was written to give you the knowledge and tools to make better decisions when you choose what to eat every day. It is intended to help you live longer by eating foods that you actually like. If you are fit and in good health and want to stay that way, this book is for you. If you are starting to feel your age, and you want to prevent decline and stave off chronic diseases, this book is for you. If you’re one of the millions of people living with heart disease, diabetes, autoimmune disease, or another chronic condition, this book is for you. And if you are actively battling a feared disease like cancer, or your family history makes it very likely that you someday will, this book is for you.

I want to make it clear that this book is not presenting a “total diet.” If you are using a diet plan to lose weight, deal with gluten intolerance, manage your blood sugar, slow Alzheimer’s disease, or reverse heart disease, you need to know that my goal is not to replace these specialized diets, but rather to provide you with the scientific evidence and recommendations about foods you may want to incorporate into your plan, choices that will make the plan even better. I’ve also included some tasty recipes to help you do just that.

Everyone is afraid of disease. If your goal is to stay healthy, and especially if you are battling a disease, you want reliable information based on science and fact, and actionable steps that you can take right away to improve your situation. The advice on foods I’ve included in this book is not intended to take the place of good medical care. I am not one of those doctors who rejects Western biomedicine and suggests that food is the magic solution. Quite the opposite: my training and experience in internal medicine guides my judicious use of evidence-based medicine, including surgery and cutting-edge medications, when it comes to diagnosis and treatment.

What’s missing in the toolkit of most doctors is the ability to guide an individual, whether they are healthy or sick, on how they can use food as a way to resist disease. How many people do you know who have asked their doctor about what they should eat to help themselves and gotten back either a blank stare or the flip answer: “Eat whatever you want”? This book provides a very different and empowering set of answers.

Eat to Beat Disease has three parts. In part 1, I share the fascinating story behind the power of the health defense systems, how they were discovered, how they work, and how we can harness their healing powers. Even more exciting, scientists are now studying food with the same tools and methods used to study pharmaceutical therapies. In part 2, I will reveal the foods that activate the health defense systems, including some surprises. I will tell you about astonishing research into more than two hundred health-boosting foods, with some results that will make your jaw drop. In part 3, I will give you easy and practical ways to incorporate these foods into your life. I have designed a flexible tool called the 5 × 5 × 5 framework that makes it easy for you to boost your health by choosing foods you love every day.

To get the most out of this book, I recommend that you first read it once, cover to cover, to get a total picture of how to eat to beat disease. You’ll learn about health defenses, foods, and why and how to eat them.

Next, return to the many tables and charts I’ve included that summarize the different foods (and beverages) and how they positively affect your health. Keep an eye out for the foods you know you like, and foods you don’t yet know but might be willing to try. You should always be eating foods you enjoy and that interest you.

When you are ready, go back to part 3, but now pull out a pen and paper. Make your personalized preferred foods list and complete the 5 × 5 × 5 Daily Worksheet in appendix A, as described in chapter 11. Then, go for it: use your worksheet to make choices about what you will eat each day to beat disease.

There is no “silver bullet” for any one disease or for overall health and longevity. No single factor in our life is going to prevent sickness. But my research shows we have something even better. There is a way to boost our own defense systems, so the body will heal itself. These revelations tell us that we have radically underestimated our power to transform and restore our own health.

If your goal is to extend the number of healthy years you have ahead, your food choices can tip the odds in your favor. By boosting your defense systems and keeping them in good shape, you’ll have a better shot at beating back disease and extending not just the length but also the quality of your life.

The decisions you make on food every day throughout your lifetime offer perfect opportunities for you to stay healthy while enjoying life. Just like taking the extra step of locking the doors before we go to bed at night or checking to be sure the stove is off before we leave the house, taking deliberate preventive measures using our diet is just plain common sense. Combined with regular exercise, good quality sleep, stress management, and strong social bonds, your diet can help you realize your full health potential.

We live in a time of enormous and exciting scientific progress, so good health should be within reach of most everyone. And yet millions suffer and die from avoidable chronic illnesses, even as more high-tech treatments are invented. Between the rising costs of health care and an increasingly toxic and imbalanced environment, better health is an issue of equality that affects us all. The crushing cost of medical care continues to rise, creating a precarious situation where the entire system of modern medicine is on the brink of collapse. The only way to comprehensively bring down the cost of health care is to decrease the number of people who are sick.

We each need to do our part, and the best way to make the world a healthier place is to start with the choices you make for yourself and the people you care about. Let go of the idea that health is the absence of disease and start eating to beat disease every day. Bonne santé, and bon appétit.