Excerpt: What the Health

In 1946, R.J. Reynolds Tobacco Company launched a major ad campaign with the centerpiece slogan, “More doctors smoke Camels than any other cigarettes.” Print and TV spots featured capable, kindly doctors in white coats puffing on their Camels. In the early 1940s, Reynolds created a “Medical Relations Division”—which was actually part of the company’s advertising firm—that directly recruited the help of physicians and researchers to support the faux health claims made in Camel ads.

It wasn’t hard to do. During the American Medical Association convention in 1947, doctors in the hundreds lined up for free cigarettes.

Many people believed that the dangers of smoking were dependent on the individual. That myth was very useful to the tobacco industry. As long as the public was convinced that some people could smoke without damaging their health, while unlucky others—for whatever reason—would suffer ill effects, then anti-smoking measures would remain on a private level.

But despite powerful marketing forces, science began to fracture the façade. The first major study to link smoking and lung cancer was published in 1950. It was the first rock in an avalanche of scientific literature warning against tobacco use.

Fourteen years later, in 1964, the US Surgeon General released the first federal report, based on over 7,000 medical studies, cautioning the American public of the significant connection between smoking, lung cancer, and heart disease.

In 1965, the year after the Surgeon General’s warning, 42.4 percent of adults in the US smoked. That number fell to 15.5 percent in 2016.

And those Camel-loving doctors? Their smoking rate plummeted to 3.3 percent.

In the 1960s, public awareness of the connection between cigarettes and fatal, preventable disease precipitated a crisis for the tobacco industry.

The country was on to them. Something had to be done.

In 1969, Brown and Williamson Tobacco Corporation circulated a now famous internal document:

Doubt is our product since it is the best means of competing with the ‘body of fact’ that exists in the mind of the general public. It is also the means of establishing a controversy.

And the tobacco industry has continued to manufacture doubt, even in the face of irrefutable scientific evidence and social stigma. Perhaps more significantly, it has provided a blueprint for other industries wishing to manufacture doubt.

“If there’s enough controversy, people throw up their hands,” Dr. Greger said. “‘I’m just going to eat whatever I like.’ That’s what the food industry wants. The strategy is to confuse the public.”

“The animal agriculture industries, like the tobacco industry, know exactly what they’re doing,” Dr. Barnard said. “They know meat and eggs contain saturated fat that affects your blood cholesterol; they know dairy doesn’t build strong bones. But they fund research to say, ‘Maybe these products aren’t so bad,’ and run enormous ad campaigns. If you can’t promote the fact that beef is going to damage your heart health or contribute to cancer, what can you say? ‘Well, it’s got a good sizzle.’ And when the bottom falls out of their North American market, they go overseas.”

“My patients tell me, ‘You say milk fat is bad for me, but these studies say milk fat is good for me. I don’t know what to believe, so I’m eating the cheese,’” Dr. Davis said. “If the food industries can get my colleagues to speak against myself and other doctors who are advocating a health-promoting, plant-based diet, and make me look extreme, then they’ve neutralized my message. And that’s the goal.”

(“Being vegan is extreme?” Dr. Greger exclaimed. “How about being bisected in half, having your chest cracked open, surgeons taking veins from your legs, rewiring your plumbing and trying to literally bypass the problem metaphorically and literally!?”)

…

In 1965, a year after the Surgeon General’s warning, Congress required warning labels to be put on cigarettes.

I thought back to the day I heard that the WHO had declared red meat a carcinogen, launching me on this journey. Even then, I wondered why the Surgeon General hasn’t gone after meat.

“I think it’s a matter of time,” Dr. Barnard said. “It took time to show that tobacco was linked to lung cancer, but eventually we could say, ‘Tobacco industry, fight all you want. We’ve got enough evidence now.’ We’re now at the point where we have enough evidence against eating animal products. There’s no question that people who avoid animal products are healthier in many ways than those who eat them. It’s a matter of time before the government tackles this more seriously. We’re already seeing that movement. Every five years, the dietary guidelines inch closer to a plant-based diet. In 2011, the meat group was thrown out of My Plate. They’ve now got a protein group, which could be beans or tofu. There’s a dairy group, but to their credit, soymilk is included. It’s not perfect, but we’re moving along.”

Dr. Klaper loved the idea of warning labels. “Just as a cigarette package says, ‘This has been shown to increase your chance of lung cancer,’ packages of meat, dairy, and eggs should clearly state, ‘These products have been scientifically shown to increase your risk of heart attacks, strokes, high blood pressure, diabetes, erectile dysfunction, autoimmune diseases, cancers of various types, and other conditions.’”

When a controversial fact is finally absorbed into public consciousness, a revolution happens. What was heresy becomes self-evident. The earth revolves around the sun. Global warming is driven by human activity. Smoking kills. Animal protein kills.

“Think of all those years in which it was considered rude if you told a guest not to smoke in your house,” said Dr. Goldhamer. “We put up with that crap for a long time before it became acceptable to say no.”

Nobody wants a smoker in their house, because you’re breathing the toxic byproducts of their bad habit. But someone else eating a burger doesn’t affect you…does it?

“Diet is not a personal choice,” said Dr. McMacken. “I understand how people think it is, but in reality, our individual food choices affect our nation, our planet, billions of animals, and they affect us as a human species.”

“Right now, we spend more on healthcare than any other country in the world,” Dr. Davis said. “We’re getting bigger and bigger, and sicker and sicker. That affects everybody. There’s a serious problem with people who say, ‘You do what you want, and I do what I want. Leave me alone with my decisions.’ A healthy person might be eating their vegetables and legumes, living disease-free, but a significant chunk of their tax dollars are going towards the unhealthy people, and that’s only going to get worse…”

Call it secondhand eating.

… And yet for all that healthcare spending, the US has the lowest life expectancy among 12 high-income nations, and some of the worst health outcomes.

“The average bypass operation is $70,000 to $200,000 or more,” said Dr. Mills. “Multiply that by millions, you’re breaking the bank.”

Our healthcare costs are bankrupting the country.

Economists Kevin Murphy and Robert Topel estimate that reducing the country’s mortality from heart disease or cancer by a mere 1 percent is currently worth nearly $500 billion. Reducing all causes of mortality by only 10 percent would be worth $18.5 trillion. That’s just 10 percent—remember, chronic diseases are responsible for 70 percent of deaths.

But our current medical system, as we’ve seen, is built on sickness, not health.

“It’s extremely tempting for medicine to continue doing these procedures for the income,” Dr. Esselstyn said. “What would really turn the system in the right direction is if we paid physicians for making people healthy. If a patient has a first, second, or third stent, somebody ought to be penalized for not treating the causation of the illness. Dr. Kim Williams made it clear that our motivation as cardiologists ought to be to put ourselves out of business. Thatis medical leadership with integrity.”

…

Plant-based solutions aren’t—yet—profitable to the medical and pharmaceutical industries. But they could be an incalculable boon to the insurance industry. That’s why Kaiser Permanente, one of the country’s largest non-profit health plans, began advocating in 2013 for its 17,000 doctors to actively encourage their patients to avoid eating animal products. Kaiser published a booklet called “The Plant-Based Diet,” steering their 10.6 million members to resources like PCRM and Dr. Greger’s NutritionFacts.org.

And in a “Nutritional Update for Physicians: Plant-Based Diets,” which references Drs. Esselstyn, Barnard, Ornish, McDougall, and Campbell, as well as the Adventist Health and EPIC studies, the Permanente Journal writes,

Healthy eating may be best achieved with a plant-based diet, which we define as a regimen that encourages whole, plant-based foods and discourages meats, dairy products, and eggs as well as all refined and processed foods… Physicians should consider recommending a plant-based diet to all their patients, especially those with high blood pressure, diabetes, cardiovascular disease, or obesity… Despite the strong body of evidence favoring plant-based diets, including studies showing a willingness of the general public to embrace them, many physicians are not stressing the importance of plant-based diets as a first-line treatment for chronic illness… The purpose of this article is to help physicians understand the potential benefits of a plant-based diet, to the end of working together to create a societal shift toward plant-based nutrition… 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…The future of health care will involve an evolution toward a paradigm where the prevention and treatment of disease is centered, not on a pill or surgical procedure, but on another serving of fruits and vegetables (emphasis added).

 BOOM. From an insurance industry giant. They want the people they cover to stay healthy because that saves Kaiser Permanente money. If the science showed that salmon and chicken breasts promoted health, Kaiser Permanente would be pushing that diet. It is all. About. Money.

 Excerpted from “What The Health,” by Eunice Wong, with Kip Andersen and Keegan Kuhn. Copyright © 2017 by Eunice Wong, with Kip Andersen and Keegan Kuhn. All rights reserved.