MamaSezz Talks to…
As we at MamaSezz well know, changing to a plant-based diet can change your life in ways you never expected. In this series, we talk with some of the world’s most soulful, dedicated (and often funny) leaders in plant-based eating. We get to hear their stories of suffering, transformation, and service — and we learn how food is an essential part of their journey.
DR. NEAL BARNARD
Today you get to meet the fabulous Neal Barnard, MD and Fellow of the American College of Cardiology.
Dr. Barnard is an Adjunct Associate Professor of Medicine at the George Washington University School of Medicine in Washington, DC, and President of the Physicians Committee for Responsible Medicine.
He’s also one of the leading experts on plant-based diets and health. Among other things, he has researched the effects of diet on diabetes, body weight, and chronic pain. One of his groundbreaking studies laid the foundation for type 2 diabetes to be viewed as a potentially reversible condition. Through the Barnard Medical Center in Washington, DC, he’s a pioneering advocate for making nutrition a routine part of all medical care.
And he’s so fun to talk to! Dr. Barnard shares with us his path to plant-based eating, his research-backed recommendations for recovery and health after breast cancer diagnosis, and why music can be an important and joyful part of our lives.
We hope you enjoy meeting this delightful and inspiring leader — and feel inspired and encouraged in your own plant-based journey.
MEG: How does somebody who grew up on a cattle ranch in Fargo North Dakota go on to become one of the leading vegan doctors in the country?
DR. BARNARD: I have to say I did spend the first half of my life eating all the wrong things and, and being kind of clueless may I say about what health really meant.
But for me, really the seeds of understanding things were sown the year before I went to medical school. I was working in the morgue of a Minneapolis hospital. When anyone would die in the hospital, my job was to assist at the autopsy. The pathologist would come in to determine the cause of death and I would weigh things and hold things and clean up afterward and all that stuff.
Because he knew I was going to go to medical school, [the pathologist] would give me quite an elaborate education as we were looking at what had killed these people. One day there was a guy who died of a heart attack in the hospital (and probably from eating hospital food, but that's another story). Anyhow, the pathologist made an incision through the skin and then he pulled off this big section of ribs from the chest and put it on the table. And then he said, "Look at the heart."
He sliced open a coronary artery and explain to me, "These arteries are called coronary because they crown the heart. They're on the surface of the heart, bringing oxygen to the heart muscle." And he sliced one open and he said, "Look inside."
Inside was not a nice wide-open artery. It was filled with plaque. If you put on a glove and you stick your finger on it, it's like concrete, it's hard and he said, "You know, this is bacon and eggs and whatever that causes these problems." So then we looked at the carotid arteries, going up to the brain and they had the same issue there and the arteries, the femoral arteries going to the legs and the renal arteries going to the kidneys; they all had the same disease.
That was an eye-opener. But then, at the end of that particular exam, the pathologist left the room and I had to clean everything up and I put the ribs back in the chest and I sewed up the skin and everything. And when I went up to the cafeteria, they were serving ribs for lunch and it looked like a body I had been working on and the ribs smelled like a body. And I realized, "This is a body you're eating."
I didn't become a vegetarian on the spot, but I just couldn't eat that. And as time went on, that kind of got me thinking more and more about these connections between the foods that we put in our bodies and the effects that they end up having.
MEG: I watched a video that you did that was really fascinating to me, an eye-opener about your realization about breast cancer awareness month, on Delta Airlines, and I wonder if you could just talk a little bit about that and about your work with breast cancer
DR. BARNARD: Every October, you know, it's breast cancer awareness month (and I have to say it's always in October when I'm on a plane). I open up the little in-flight magazine and [see], Help us support breast cancer awareness. If you buy one of our pink Martini's, we'll donate $2 to breast cancer awareness, or research or something like that.
If there's any fact that we know about breast cancer risk it’s that alcohol clearly increases risk. Now, I know that puts people in a tough spot because alcohol is part of many people's lives and so forth. But whether we like it or not even one drink a day, if it's every day, will measurably increase a woman's risk.
So here you have this airline trying to encourage people to drink martinis, so they can give money to help women protect themselves from breast cancer. And it's not just that. You probably remember, what was it? A few years ago, KFC said, "Buy a big bucket of fried chicken and we'll support breast cancer."
Oh my God, you know, people will call it pinkwashing, and I think with good reason. But the fact of the matter is that there are parts of our lives that can affect our risk of getting not only breast cancer but other forms of the disease. And if we modify those parts of our lives in the right way, I'm talking about what we eat, what we drink and how often we laced up our sneakers and all those things, we can affect our risk. But people have only rather muddled ideas about how to go about that and so it's important for us to get the word out in a good way.
MEG: Is soy healthy, isn't it healthy? Everyone has an opinion and I would love to hear yours
DR. BARNARD: You hear a lot of worries: “If a man consumes tofu, he'll get man boobs." More seriously, (people fear that) if a woman eats a lot of soy products that their risk of breast cancer could be higher. And if a woman has had breast cancer that soy could cause it to progress or to recur.
So those are the worries, those are the questions. The next thing is, what does research actually show? And where I think the research is really most meaningful is it's been done in Asian-American women and Asian women. And the reason that they are very good population to study is that some Asian women consume enormous quantities of soy and others don't consume any. As opposed to the population of Peoria, where people just don't get too much of it at all. It doesn't give you much of a test.
But in these studies of Asian American women, some of them consume huge amounts of soy. Back in 2004, there was a meta-analysis that summarized the results of eight prior studies and the women who consumed the most soy milk, tofu or other soy product had about a 30% reduction in their likelihood of getting breast cancer. And then in 2014, a larger meta-analysis was published with more than 30 trials and there they showed an even greater protective effect. Soy does affect cancer risk, but it doesn't increase cancer risk. It does the opposite. It reduces risk.
Soy contains compounds that could affect cancer risk and the compounds are called isoflavones. And some of these isoflavones, one called genistein, for example, it appears to be able to attach to the estrogen receptor. And so people kind of got the idea that it's sort of like pushing on the gas. You push down your foot and your car goes faster. If you attach the estrogen receptor, the cancer is going to grow.
However, your car also has a brake and if your foot goes down on the brake, you stop. If the genistein attaches to the receptors that put the brakes on cancer, then you're going to see a reduction in cancer risk among people who consume a lot of soy. And that's exactly what we do see.
There was a good meta-analysis of five different studies with about 10,000 women, all of whom had had breast cancer in the past. And those who...avoided soy products had the highest mortality of any group. They were the most likely to die of their cancer if they didn't eat soy. The women who consumed the most soy products had about a 30% reduction in their mortality, and that was true whether they had estrogen receptor-negative cancer or estrogen receptor-positive cancers. Meaning, their cancer cells either have their receptors on them or didn't, either way, the soy was protective.
Women don't have to have soy, it's totally optional. They don't need to have it but it does not cause cancer. And you can follow a healthy plant-based diet without soy products, but there does seem to be a benefit to them, both for prevention and also for survival.
I would suggest that it's probably a good idea to choose organic soy products, tofu, or soy milk. It says organic right on it because by law if it's organic, it cannot be GMO. But let's say you eat chicken breast, the chickens have been eating GMO soy all their lives and that's true if you eat meat; beef or pork or whatever. GMO soy, which is raised all around Fargo where I was growing up. All the fields are full of it. That's not for human consumption, that's for livestock. So bottom line, soy is okay.
MEG: A lot of our customers who have been diagnosed with one form of cancer another. As far as breast cancer, what do you suggest after the diagnosis to help their recovery and health?
DR. BARNARD: First, see your physician and maintain regular medical care. Some people get rather concerned about how doctors sometimes neglect nutrition and neglect lifestyle and they get sick of dealing with them. But I encourage people to work with their health care providers, whoever they may be, and don't hesitate to have a second opinion if you have any questions. Do work with your health care providers, but never forget that you're in charge though.
Number One: Adopt a plant-based diet.
Throw out the meat and dairy products and eggs and also keep oils to a real minimum. Why do that? It's partly because of what's in it and partly because of what you are now hopefully going to avoid. If your diet is really rich in vegetables and fruits, it's rich in vitamins, it's rich in folate, which is a B vitamin, vitamin C, many others that are antioxidants. They're helpful for you and you're also accessing a lot of fiber.
Plants have fiber in them, every mouthful of a bean dish or vegetables or fruits or whole grains, there's lots of fiber. Fiber is important because fiber helps your body to get rid of excess estrogens and that's really important. That's kind of surprising to people but every minute of the day, your liver is removing estrogens for your bloodstream, and it sends them into the intestinal tract and only if there's fiber in your digestive tract can the estrogens be escorted out by that fiber and then they get flushed down the toilet.
If your lunch was chicken breast or Velveeta or a steak or shrimp, these are animal products and animal products don't have any fiber at all. And so those estrogens that the liver pulls out are reabsorbed back into your bloodstream because there's no fiber to capture them. So a plant-based diet make sure that you got the most fiber possible and you want that for survival.
The other thing about what's not in your diet now, the meat is gone, the dairy is gone and that's good because dairy products contain estrogens, not a lot, but they do. Especially cheese and it came from the cow, who was more than likely pregnant at the time that she was milked; that's the way dairy works. You don't want any estrogen in your body that came from a cow. You want only the amount that your body has naturally.
Another benefit of a plant-based diet, by the way, is it will help you to maintain a healthy body weight. That's kind of a separate goal, is to have weight in a healthy range and to not beat yourself up to get there. Some people try to starve their way down. Some people will do an unhealthy diet like a ketogenic diet. Don't do those kinds of things because they pile unhealthy foods on your plate.
But if women have excess and unwanted weight, at the time of diagnosis if they can lose that weight, however much of it they lose, that improves their survival a lot. This doesn't mean get under-weight. If you've got some weight that you don't want, now is a good time to follow a healthy plant-based diet. And that's really the best way to get down there. Avoid animal products, keep oils really low. That'll help you get to a healthy weight.
Number Two: Lace up your sneakers, go out there and get sweaty.
I would do it about three times a week, maybe even as much as an hour. Everybody's different with their tolerance. The usual rule of thumb, people say, a half hour a day or an hour three times a week. Whatever works with you. Do it with a buddy, do it with a friend, sign up for a class at a gym so they'll know that you missed. They'll make it so, "All right, darn it. I'm really gonna go." Because that's our big problem.
Nowadays, we are so busy that we neglect ourselves and things we know are really good for us. We kind of put them on the back burner and you do need this in your life.
For preventing cancer, I'm going to also add avoiding alcohol.
MEG: We’re hearing more and more about the impact of diet on mental health. Is that something that you've done the research on or can you speak to it? How might a diet help mental health or harm it?DR. BARNARD: When it comes to mental health, I really feel like the body of research is quite anemic and we need to do more. It's still the research frontier.
However, a few years ago, we did a research study at Geico, the car insurance company. Every week at lunchtime, the people at Geico who wanted to try a healthy plant-based diet to see if it would help them improve their diabetes or help them lose weight, they could come to classes and we did that over an 18-week period. And what you thought would happen is exactly what happened. People's diabetes got better and people lost weight and their cholesterol levels improved.
So we then did another study in 10 different cities with Geico again. Will this work in Macon, Georgia or Dallas, Texas or San Diego or Buffalo? And again people who had diabetes improved and people with that extra weight, they lost weight and other things got better.
In the course of this research, we also asked people about their moods and we did it with a special paper and pencil test that it has been validated. It's a good indicator of a couple of things.
We look at depression: how low is your mood versus how unbalanced do you feel? And we also looked at anxiety. And the third thing we looked at was job absenteeism: how many days are you just not here?
And what we found is that depressive symptoms improved quite significantly and anxiety improved as well and job absenteeism fell. That would be remarkable, it is remarkable — except that other researchers have found the same thing.
There's a researcher named Bonnie Beezhold, who brought in not a very large group of people, but she compared people on an omnivorous diet, people on a vegan diet. I know what you're thinking; you think, "Wow! Those vegans must be really depressed because everybody asks them where they get their protein." Everybody hassles them all the time about why are you on a vegan diet, you trying to guilt me? You'd think being a vegan would make you depressed because you have to deal with all that.
That's not what she found. What she found is that the vegans actually had a better mood. They had had less depression, less anxiety and they tend to be better adjusted. And so that was remarkable. She did a much larger trial then and pulled people off the internet and she would look at what diets they were on and check their moods. And the same theme applied and so she then did a small pilot study of actually putting this to work in omnivores and putting them on a vegan diet and did find some reductions in their symptoms over a really quite a short period.
So bottom line, for some reason, a plant-based diet does augment the mood a little bit. And this raises the question of why. The short answer is, I don't know why but we have suspects. One is that you're healthier and it just makes you feel better to feel that you have mastery over your health. Instead of torturing myself with an Atkins diet, I could get my weight down naturally. Also, the blood is less viscous, the blood flow is better. You have more antioxidants in your diet and less inflammation in your body.
We have learned, probably over the last 15 years, that depression is largely an inflammatory condition in the brain, which was kind of a shock to us. But in the same way as athletes use vegan diets to reduce inflammation and to improve their performance, the inflammatory conditions of the brain seemed to get better with the plant-based diet.
So these are speculations — not entirely speculations, all these things do happen. Your health improves and you're inflammation goes down, but what we're speculating is that those changes are the reason that people report less depression and less anxiety.
MEG: I wonder if you have seen that and if you have some practical tips to help people kind of keep on the path, whether or not they end up having a piece of cheese or not? How do you keep moving forward?
DR BARNARD: If a person goofs up, you don't beat them up or guilt them or feel that you've been a failure. [Falling back in old habits] is the nature of addiction.
Suggestion number one is to get social support.
That's what we learned with alcohol. That's why people go to Alcoholics Anonymous as opposed to sitting in their room under a bare lightbulb. If you're with other people who are going in the same trajectory as you that helps you. So we do that here in our studies. [People] come in every week and just that one hour a week of getting together and kind of problem-solving and realizing, I'm not alone, that's really supportive.
So what's your social support? Your spouse, your partner, your kids, your parents, your friends, your workmates, whoever. If they antagonize you or if they're dangling foods in front of you that you're trying to get away from, that makes it harder. So I encourage people if they're making a diet change, grab somebody else and say, "Do you want to do is with me? I'm gonna do three weeks on a vegan diet, do you want to do that with me?" And chances are people will say, "Okay."
After that period of time, you'll have more momentum. Let's say, you're in a household and your partner, your spouse, your kids, whoever, they are not going with you on this diet, what you must say to them is, "This is important to me and you're important to me. I'm going to be tempted by other things. Could you help me to avoid temptation?"
And then they become your defenders. So they'll put their food in a different part of the fridge or a different cupboard. And when you go out to eat, if you're tempted, they'll try to help you stay on the straight and narrow and ideally they'll change with you.
Frankly, I think it's the nicest gift for one member of a couple to support the other member of the couple in things that are important to them and to change with them but social support helps a lot.
Social support can take other forms. You can go online and see all the websites that are out there now and you can be part of a community. Like your community where you realize, "I'm not alone. There's a whole lot of other people doing this with me." And frankly, this is cool and it's better than what you're doing before. It pumps you up.
As a person who both went vegan and quit smoking at the same time, actually, I have to say that quitting smoking is hard, going vegan is easy because there is stuff to eat. It's not challenging to do so, people can succeed.
MEG: Someday, people will talk about what we served in hospitals the same way we talk about how people used to smoke cigarettes. You know, they will say, "Can you believe they gave that heart patient a grilled cheese sandwich?"
DR BARNARD: If you go into my hospital now, on Saturday morning, you’ll see what they're serving for breakfast. It's bacon, eggs, sausage; all the things that we know cause heart disease and cancer. The doctors are lining up and eating them.
[But] it's not all bad news. The AMA came out very strongly saying that the hospital shouldn't serve bacon, sausage or any processed meats at all to anybody. Not to their patients, not to the staff, not to visitors, nobody. And they also said that hospitals should be serving vegan meals. They might have other meals too but they have to make these available. So there is pressure to change. We are now with food where we used to be with tobacco. We're now in that battleground and we're going to win it.
Dr. Neal Barnard
MEG: As I was doing research about you, I came across this body of music that you have and I was just really blown away by it. I haven't heard you talk about it a lot, and I would just love for you to share the impact of music on health, and then also your relationship to music and how it's been a part of your life.
Then when the Beatles arrived, I thought, "Wow! Now you're talking about real music." So without much of a blessing of my parents, I took up the guitar and was in bands...all through medical school and still today, I like to write music a lot. You know, some people just really like writing, reading books and things like that. For me, I always liked writing music and composing music. Some of my music does have a message, and if I can't reach your head, maybe I can reach your heart a little bit. My current band is called CarbonWorks, as in, we are made of carbon and these are our works.
DR BARNARD: When I was a little kid growing up in Fargo, my parents had the idea that any civilized person ought to be able to read music and should play at least two instruments. And so, before I went to school, every day, I would have to practice the cello and I was part of the orchestra and all this kind of stuff and play piano as well.
If you go on YouTube and you look, there's a whole CarbonWorks channel. There's a song called “Louder Than Words,” which is about our relationship to animals. There's another one called “Samurai” about this little girl who fancies herself to be the samurai who's going save her animal friends. At least in my view, they're touching songs and kind of cute and there are some others that are more hard-edged.
But you asked about the medical side of it. There are some people who just don't have normal dopamine activity in their brain. Dopamine is the reward chemical. And if you have a lot of dopamine in your brain, you feel at peace, you feel good — and some people just don't have much. They learned a long time ago that if they take drugs — cocaine, heroin — or drink a lot or eat to excess, the brain fires a little bit extra dopamine and unfortunately, they're getting the dangerous results of those bad habits.
There are certain ways of getting dopamine naturally and one of which is music. At McGill University, people have put research participants in scanning devices and you can track the effect of music on the brain. It's amazing to see. If it's the kind of music you don't like, whatever it is, bluegrass or wrap or whatever, it's just not your thing, you don't get any dopamine from it at all. But if it's music that is yours — you like rock and roll, you like opera, you like country western, whatever it might be — suddenly the brain just starts producing and releasing dopamine into the brain.
So my thought is, all right, let's say you're having trouble reaching your health goals and you can't stick with exercise and you're eating junk food and all this kind of stuff...bring some beauty into your life. It won't necessarily make all the unhealthy foods go away but it gives you dopamine naturally.
By the way, two other things [release dopamine]. Exercise causes dopamine release and, this will surprise you, socialization causes dopamine release. And this is actually because nature set up the human brain — I didn't design a system, don't blame me for this — when people find a receptive mate, they get more dopamine release. And so all the way from just saying, hello to friends, all the way to having a more intimate relationship to touching each other to sexual intercourse, you get more and more and more [dopamine] release.
But let's say you're just in a room with other people, the brain starts firing a little bit of dopamine that it wouldn't if you were in isolation. So suddenly, you're in an Alcoholics Anonymous meeting, you're with a group of people who have become friends and you get dopamine release there and also, it turns out if you're speaking about yourself for whatever reason people get more dopamine there too.
So my point is, bring in healthy sources of dopamine release, and you're going to find that you're at more at peace with making changes in your life. And if music is maybe going to be part of it, have fun! There are lots of videos on the Carbon Works channel and I hope people enjoy them.
Listen to: CarbonWorks, Dr. Barnard’s band