Good medicine - Spring 2016 by WEngelbrecht

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PUBLISHED BY THE PHYSICIANS COMMITTEE FOR RESPONSIBLE MEDICINE | SPRING 2016 | VOL.XXV, NO. 2

Averting Drug Disasters How to Stop the Next Pharmaceutical Catastrophe

EDITORIAL

Developing Drugs and Saving Lives

SPRING 2016 | GOOD MEDICINE

STEVE SHAPIRO/COMMERCIAL IMAGE

Neal Barnard, M.D. President of Physicians Committee

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edications are lifesaving. Antibiotics tamed the infections that were killers a century ago. Anesthetics made modern surgical procedures possible. Antiretroviral medications meant that HIV was no longer a death sentence. But recent decades have seen a troubling change. Instead of focusing on lives saved, the pharmaceutical industry is focused on dollars in stockholders’ pockets. Drug developers are less and less interested in medications that cure illnesses. They are now looking for drugs that people need to be on forever. The tale is told in television advertisements. If you have diabetes, high cholesterol, arthritis, or psoriasis, drug manufacturers have their eyes on you. That means we have two problems: First, drugs can be dangerous. As we will see in this issue, getting drugs on the market often means a series of animal tests that do not predict what will happen in human patients. The leukemia and arthritis drug TGN1412 in the UK and a painkiller in France were thoroughly animal tested before going into human trials in which they caused severe adverse events or proved deadly. Even before these headline-grabbing disasters, researchers knew the limitations of animal tests. For estimating drugs’ short-term risks, animal tests have had a spotty track record. And when it comes to gauging a drug’s potential for causing birth defects or cancer, animal tests are notoriously poor. Routine animal tests for cancer risk take two years. And that’s just to run the test; interpreting the results adds much more time, and the results are often ambiguous or just wrong. Testing on individuals who do not share your DNA is a bit like testing the temperature of the water in your sink before you jump into the bathtub. You can easily get burned. Which is why drug commercials are often followed by ads from attorneys. Clearly, we need better methods. Second, the search for marketable pharmaceuticals has become a distraction. With so many medications for managing diabetes, patients are not likely to think about getting rid of it. Type 2 diabetes is caused, to a great degree, by dietary habits, not by a metformin deficiency. Not every diabetes patient benefits from a diet change, but many do, and Testing on individuals who sometimes the disease does indeed become undetectable. But our do not share your DNA drug culture suggests that healthful eating is somehow too difficult and it’s much easier to pony up money for drugs and needles. is a bit like testing the The government is similarly distracted, funding robust efforts to temperature of the water in find more drug targets and neglecting research on prevention and your sink before you jump nutrition. into the bathtub. So where does that leave us? We need better ways of assessing safety. And that shift has already begun, with new computerized methods that can gauge a drug’s dangers based on its molecular structure before it has even been produced, as well as new cellular methods based on human biology. Also, we need to ask, not just are drugs safe and effective, but are they necessary? It is hard to make a case that we need yet another statin, another diabetes drug, and another blood pressure pill. If we were to focus only on the pharmaceuticals we actually need, and give most of our attention to the preventable causes of disease, we would revolutionize medical practice.

CONTENTS

SPRING 2016

Good Medicine® FROM THE PHYSICIANS COMMITTEE FOR RESPONSIBLE MEDICINE SPRING 2016 | VOL. XXV, NO. 2 Editor in Chief Neal D. Barnard, M.D., F.A.C.C. Managing Editor/Designer Doug Hall Editors Michael Keevican | Carrie Clyne Production Manager Lynne Crane Senior Web Designer Lisa Schulz SCIENTIFIC ADVISORY BOARD Ron R. Allison, M.D., 21st Century Oncology Ted Barnett, M.D., Rochester Lifestyle Medicine, PLLC; Borg & Ide Imaging, P.C. T. Colin Campbell, Ph.D., Cornell University Neil Cooper, M.D., M.H.A., M.Sc., Kaiser Permanente Brenda Davis, R.D. Garth Davis, M.D., The Davis Clinic Caldwell Esselstyn, Jr., M.D., The Cleveland Clinic Wellness Institute Joanne Evans, A.P.R.N., Healthy Nurses…Healthy Communities, LLC Joel Fuhrman, M.D., Nutritional Research Foundation Roberta Gray, M.D., Pediatric Nephrology Consultant Daran Haber, M.D., Riverview Medical Center Henry Heimlich, M.D., The Heimlich Institute David J.A. Jenkins, M.D., Ph.D., D.Sc., St. Michael’s Hospital, Toronto Lawrence H. Kushi, Sc.D., Division of Research, Kaiser Permanente John McDougall, M.D., Dr. McDougall’s Health & Medical Center Jeffrey I. Mechanick, M.D., Mount Sinai Hospital Baxter Montgomery, M.D., Montgomery Heart and Wellness Carl Myers, M.D., Switch Healthcare Ana Negrón, M.D. Robert Ostfeld, M.D., M.Sc., F.A.C.C., Montefiore Medical Center Affiliations are listed for identification only. Physicians Committee for Responsible Medicine Staff | Nabila Abdulwahab Data Processor | Zeeshan Ali, Ph.D. Program Specialist | Laura Anderson Communications Coordinator | Court Anker, Research Policy and Toxicology Assistant | Elizabeth Baker, Esq. Senior Science Policy Specialist | Neal Barnard, M.D. President | Aryenish Birdie Regulatory Testing Policy Specialist | Jason Chow Helpdesk Administrator | Andrea Cimino Human Resources Specialist | Carrie Clyne Communications Director | Sierra Coppage Communications Assistant | Deniz Corcoran Data Entry Manager | Lynne Crane Production Manager | Cael Croft Associate Designer | Sossena Dagne Data Processor | Dania DePas Associate Director of Communications | Paula Diaz Leite Human Resources and Office Services Assistant | Jill Eckart, CHC Nutrition Program Manager | Wikus Engelbrecht Digital Content Manager | John Evans Web and Database Developer | Morgan Feder Medical Office Assistant | Ashley Felder Human Resource Specialist | Rosendo Flores Nutrition and Clinical Research Coordinator | Carolyn Forte Project Manager | Jessica Frost Public Relations Manager | Noah Gittell Director of Philanthropy, Eastern Region | Stacey Glaeser, SPHR Director of Human Resources | Doug Hall Publications Director | Erica Hanna Director of Information Technology | Jodie Hayward Accounts Payable Coordinator | Karen Horrocks Web and Database Developer | Meghan Jardine, M.S., M.B.A., R.D., L.D., C.D.E. Associate Director of Diabetes Nutrition Education | Eric Jonas, Ph.D. Development Coordinator | Stephen Kane, C.P.A. Finance Director | Christine Kauffman, Research and Education Programs Coordinator | Michael Keevican Managing Editor | Jessica Kelly Project Manager | Mark Kennedy, Esq. Director of Legal Affairs | Ann Lam, Ph.D. Medical Research Specialist | Susan Levin, M.S., R.D. Director of Nutrition Education | Feng-Yen Li, Ph.D. Research Fellow | Bonnie MacLeod Director of Institutional Giving | Lynn Maurer Associate Designer | Jeanne Stuart McVey Media Relations Manager | Lauren Clyne Medley Online Fundraising and Advocacy Manager | Ryan Merkley Associate Director of Research Policy | P.J. Murphy Senior Director of Philanthropy | Margaret Neola Dietitian | Josh Oviatt Educational Outreach Manager | John Pippin, M.D. Director of Academic Affairs | Reina Podell Communications Assistant | Dawnyel Pryor Educational Programs and Marketing Director | Leslie Rudloff, Esq. Senior Counsel | Rose Saltalamacchia, Assistant to the Preside and Nutrition Project Coordinator | Alyssa Schaefer Membership Assistant | Lisa Schulz Web Designer | Karen Smith Senior Dietitian | Erica Springer Director of Philanthropy, Western Region | Kristie Sullivan, M.P.H. Director, Regulatory Testing Issues | Kalpesh Suthar Senior Accountant | Caroline Trapp, M.S.N., A.P.R.N., B.C.-ADM, C.D.E. Director of Diabetes Education and Care | Francesca Valente Nutrition Programs Specialist | Anne Marie Vastano Special Events Manager | Ashley Waddell Director of Philanthropy, Western Region | Betsy Wason, C.F.R.E. Vice President of Development | Ali Wasti, Systems Administrator | Rod Weaver Data Manager | Cameron Wells, R.D., M.P.H., C.D.E. Associate Director of Clinical Dietetics | Christopher Wright Staff Accountant | Jia Xu, Ph.D. Program Specialist | Craig Ziskin Director of Annual Giving | Barnard Medical Center Staff | Manuel Calcagno, M.D. Medical Assistant | Angela Eakin, M.D. Medical Doctor | Natalie Evans Medical Practice Manager | Mandy Gleason Medical Office Coordinator | Emily Kasmar, N.P. Nurse Practitioner | James Loomis, M.D. Medical Director | Nile Mahbuba, Medical Office Assistant | Steven Neabore, M.D. Medical Doctor |

RESEARCH ISSUES

6 Averting Drug Disasters: How to Stop the Next Pharmaceutical Catastrophe 9 Could Human Intervention Studies Prevent Birth Defects? 10 Legislation Could End Animal Use in Medical Training Take Action: Ask Vanderbilt University to Modernize Medical Training

PREVENTION AND NUTRITION 12 Invitation to the International Conference on Nutrition in Medicine 13

Debunking the Paleo Myth

14 Patients Need Chickpeas—Not Chick-fil-A 13

Billboards Target Cancer 'Hot Spots': Keep Hot Dogs Out of Schools

Investigation into Dietary Guidelines’ Cholesterol Money Trail

Plant-Based Makeover for Congressional Cafeterias PHYSICIANS COMMITTEE 15

17 Join Our Team! DEPARTMENTS 4 THE LATEST IN... 11 MEDIA What’s Trending? 18 MEMBER SUPPORT

20 PCRM MARKETPLACE 23 INFOGRAPHIC Averting Drug Disasters 24 PHYSICIAN PROFILE Assessing the Effects of Soy: Xiao Ou Shu, M.D., M.P.H., Ph.D. COVER PHOTO: THINKSTOCK

19 PhysiciansCommittee.org Good Medicine is published by the Physicians Committee for Responsible Medicine, 5100 Wisconsin Ave., NW, Suite 400, Washington, DC 20016, tel 202-686-2210, fax 202-686-2216. It is distributed as a membership benefit to Physicians Committee members. Basic annual membership is $20 (tax-deductible). Physicians Committee promotes good nutrition, preventive medicine, ethical research practices, and compassionate medical policy. Readers are welcome to reprint articles without additional permission. Please include the credit line: Reprinted from Good Medicine, Spring 2016, Physicians Committee for Responsible Medicine. Articles are not to be reprinted for resale. Please contact Physicians Committee at permissions@pcrm.org regarding other permissions. ©Physicians Committee 2016. Good Medicine is not intended as individual medical advice. Persons with medical conditions or who are taking medications should discuss any diet and lifestyle changes with their health professional. “Good Medicine”, “Physicians Committee for Responsible Medicine,” “PCRM,” “The Cancer Project,” “Humane Charity Seal,” and “The Gold Plan” are registered trademarks of The PCRM Foundation.

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GOOD MEDICINE | SPRING 2016

THE LATEST IN…

RESEARCH TOXICITY TESTING

Chemical ‘Map’ Could Reduce Animal Testing TOXICITY TESTING

Tox21 Tests 10,000 Chemicals without Animals

he U.S. government’s Tox21 program, which uses robotics for large-scale in vitro toxicity screening of chemicals, recently tested 10,000 chemicals and concluded that in vitro test data performed better than animal tests in predicting human toxicity, according to a new paper published in the journal Nature Communications. The authors say that toxicity testing conducted using animal models is expensive and that it is often difficult to extrapolate the test results to human health effect because of species differences. Huang R, Xia M, Sakamuru S, et al. Modelling the Tox21 10 K chemical profiles for in vivo toxicity prediction and mechanism characterization. Nature Communications. Published online January 26, 2016.

here are 100,000 chemicals in products we use every day, but 90 percent of the safety information on those chemicals is still needed. To help remedy this problem, researchers from the Johns Hopkins Bloomberg School of Public Health have created a catalog of safety data on 10,000 chemicals that could be used to predict the toxicity of many of the 90,000 untested substances in consumer products. Thomas Hartung, M.D., Ph.D., the study’s leader, says it could also save billions of dollars and millions of animals from chemical tests. The “map” groups chemicals by their known hazards, such as allergic skin reactions and eye damage. If an untested chemical lands in a part of the map where similar chemicals are considered safe, that chemical could be deemed safe. If it landed in a place where nearby chemicals are known to cause skin allergies, for example, it would be given that label. ENVIRONMENTAL PROTECTION AGENCY

Luechtefeld T, Maertens A, Russo DP, Rovida C, Zhu H, Hartung T. Global analysis of publicly available safety data for 9,801 substances registered under REACH from 2008-2014. ALTEX. Published online February 11, 2016.

TOXICITY TESTING

Innovative Technology Identifies Heart Toxicity Without Using Animals

niversity of Toronto engineers have used human cells to develop laboratorygrown heart tissues that can be used to test heart toxicity for pharmaceutical companies. Engineers developed the innovative technology known as Biowire by creating scaffolds for the heart cells to grow on and using electrical currents to stimulate the heartbeat, in order to train the cells to behave as they would in a human. This existing technology can be used to identify negative human effects early in drug development and eliminate animal testing for heart toxicity.

SPRING 2016 | GOOD MEDICINE

THINKSTOCK

Irving T. Lab-grown heart cells to improve drug safety. U of T Engineering News. http://news.engineering.utoronto. ca/lab-grown-heart-cells-to-improve-drug-safety/. Accessed February 22, 2016.

THE LATEST IN…

NUTRITION WOMEN'S HEALTH

Processed Meat and Fish Increase Breast Cancer Risk

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rocessed meats and fish increase risk for breast cancer, according to a study published in Cancer Causes & Control. Researchers followed more than 8,000 women from the Breast Cancer Health Disparities Study and monitored their intake of fish and red and processed meats and cancer incidence rates. Among Hispanic women, those with the highest intake of red and processed meat increased their risk for breast cancer by 42 percent, compared with those who ate the least. Non-Hispanic women with the highest intakes of tuna increased their risk by 25 percent, compared with those who ate the least amount of tuna. Chemical contaminants found in tuna and early exposure to red and processed meats may account for the increased cancer risk. Kim AE, Lundgreen A, Wolff RK, et al. Red meat, poultry, and fish intake and breast cancer risk among Hispanic and Non-Hispanic white women: The Breast Cancer Health Disparities Study. Cancer Causes & Control. Published online February 22, 2016.

high-fiber diet protects lung function, according to a study in the Annals of the American Thoracic Society. Researchers monitored dietary fiber intake and lung function in 1,921 participants from the National Health and Nutrition Examination Surveys (NHANES). Those who consumed more than 17 grams of fiber per day from fruits, vegetables, and legumes had better lung health, compared with those who consumed the least. This study supports previous research that showed fiber’s association with a reduction of inflammation, a cause of lung disease.

MEN'S HEALTH

Fruit Helps Prevent Erectile Dysfunction

Eggs Increase Risk for Type 2 Diabetes

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High-Fiber Diet Good for Lungs

Hanson C, Lyden E, Rennard S, et al. The relationship between dietary fiber intake and lung function in NHANES. Ann Am Thorac Soc. Published online January 19, 2016.

DIABETES

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RESPIRATORY HEALTH

aving just three eggs per week increases your risk for type 2 diabetes, according to a meta-analysis published in the American Journal of Clinical Nutrition. Researchers analyzed 12 cohort studies that encompassed more than 200,000 participants and their egg consumption and risk for type 2 diabetes. In the United States, those who consumed the most eggs experienced a 39 percent higher risk for diabetes, compared with those who consumed the least. In studies conducted outside the United States, egg consumption was not associated with diabetes risk, for unclear reasons. Djoussé L, Khawaja OA, Gaziano JM. Egg consumption and risk of type 2 diabetes: a meta-analysis of prospective studies. Am J Clin Nutr. Published online January 6, 2016.

ruit reduces a man’s risk of erectile dysfunction, according to a study published in the American Journal of Clinical Nutrition. Researchers followed the diets of 25,096 men as part of the Health Professionals Follow-Up Study. Those with the highest intakes of anthocyanins, flavones, and flavanones, phytonutrients found in strawberries, apples, blueberries, and citrus fruits, lowered their risk for erectile dysfunction by 14 percent when compared to those who consumed the least. Erectile dysfunction is typically an indicator of narrowed arteries, the same disease process that causes coronary heart disease. Cassidy A, Franz M, Rimm EB. Dietary flavonoid intake and incidence of erectile dysfunction. Am J Clin Nutr. Published online January 13, 2016.

GOOD MEDICINE | SPRING 2016

RESEARCH ISSUES

Averting Drug Disasters How to Stop the Next Pharmaceutical Catastrophe

SPRING SPRING 2016 2016 || GOOD GOOD MEDICINE MEDICINE

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hen Ryan Wilson enrolled in a phase 1 clinical trial for TGN1412—a drug for leukemia and arthritis that was tested on monkeys in preclinical experiments—he never imagined the consequences. While in the hospital in London, England, where he received the drug intravenously, Mr. Wilson, then a 22-yearold trainee plumber, began experiencing adverse reactions. He would spend 147 days in the hospital with heart, liver, and kidney failure, leading to doctors amputating all of his toes and several fingertips. Wilson was one of six men in the 2006 clinical trial who, after taking TGN1412, began experiencing serious adverse events, including organ failure. One of the men was said to look like “the elephant man” after suffering angioedema— which causes swelling under the skin—in his head. After the adverse reactions began, doctors told all six men that they would likely develop cancers or autoimmune diseases. In the world of pharmaceutical clinical trials, this was not an isolated event. In January 2016, one man died and five others were hospitalized in France—three with possible brain damage—after taking part in a clinical trial for a

RESEARCH ISSUES

humans. As evidenced by the unfortunate events described above, this system often fails. In fact, today, 95 percent of new drugs fail because they are unsafe or do not work in humans, despite previously appearing safe in preclinical animal tests. According to a 2014 FDA presentation, adverse drug reactions cause about 100,000 human deaths annually, making adverse drug reactions the 4th leading cause of death in the United States. Pharmaceutical Research Reform

After years of work by the Physicians Committee and others, the Institute of Medicine determined in 2011 that

The existing preclinical system largely depends on animals to predict what will happen in humans. This system often fails.

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painkiller that had been deemed safe enough to proceed to human trials after preclinical experiments in chimpanzees and other animals. Rats, mice, dogs, and monkeys were all used in the preclinical toxicity tests of the drug, but “no ill-effects were noted in the animals, despite doses 400 times stronger than those given to the human volunteers,” according to a report France’s National Agency for Drug Safety released in March. In the affected human patients, the drug had “astonishing and unprecedented” reaction in the brain that was “unlike anything seen before.” And this February, the Food and Drug Administration halted the phase 3 clinical trial of the cancer drug pacritinib after patients died from intracranial hemorrhage, cardiac failure, and cardiac arrest. Preclinical safety tests of the drug were conducted on mice and dogs. The drug development process is largely the same in the United States as other countries. Preclinical research is critical to gathering safety information before a drug is tested in humans. However, the existing preclinical system largely depends on animals to predict what will happen in

GOOD GOOD MEDICINE MEDICINE || SPRING SPRING 2016 2016

7 7

RESEARCH ISSUES

Many human-relevant technologies that will improve safety and reduce preclinical animal tests already exist, and many more innovative methods are in development. Wyss Institute's Lung on a Chip

co-authored by Elizabeth Baker, Esq., currently a senior science policy specialist for the Physicians Committee, the FDA should:  Amend existing regulations that currently mandate preclinical animal data to reflect stated FDA policy that drug sponsors have the option to submit data from nonhuman and/or human-based test methods.  Accept modern test methods that are demonstrated to be more predictive of human response than currently mandated test methods.  Issue FDA Guidance for Industry that clearly communicates when modern test methods are accepted. The Physicians Committee is addressing this crucial problem by taking a collaborative and comprehensive approach that includes:  Working with Congress to make legislative change.  Working with the FDA to establish an optimal approach to acceptance of new methods.

 Developing training programs for FDA reviewers and industry scientists. the use of chimpanzees is not essential for any area of disease research, prompting the National Institutes of Health to end federally supported chimpanzee experimentation. Given that our closest living relatives are not required for research and testing, what does this say for research and testing using animals even less similar to humans? Each year, hundreds of thousands of animals—primates, dogs, cats, mice, rats, pigs, guinea pigs, and others—are still used and killed for preclinical drug research. A recent commentary in BMC Medical Ethics highlights major issues related to animal experiments, including profit-driven motivations and a general denial of the limitations of animal models by scientists. To address the “serious issue stemming from flawed animal research, which needs to be addressed in the interests of human health and safety,” the author recommends strategies including “systematic reviews of existing animal studies” and “a full scale inquiry into why unreliable animal data are accepted by regulatory authorities while at the same time non-animal models and technologies with predictive value are less likely to be adopted.” The FDA has the discretion to accept nonanimal methods for preclinical drug testing. But in practice, FDA provides little guidance or encouragement to drug developers regarding the use modern methods that could improve drug safety. According to a recent commentary in the Food and Drug Law Institute’s Food and Drug Policy Forum, 8

SPRING 2016 | GOOD MEDICINE

 Advising companies on FDA policies and use of human-focused methods. Better Technology

Many human-relevant technologies that will improve safety and reduce preclinical animal tests already exist, and many more innovative methods are in development. Earlier this year, the Johns Hopkins Bloomberg School of Public Health announced that researchers have developed “mini-brains” made up of human brain neurons and cells. The “mini-brains” may be superior to animal experiments and could dramatically improve preclinical drug testing for Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, and even autism. At the University of California at San Diego, researchers used 3-D printing technology to create a model to that could be used for patient-specific drug screening and disease modeling for conditions such as hepatitis, cirrhosis, and cancer. The team organized stem cells derived from patient skin cells into a structure that accurately mimics the human liver. Physicians Committee scientists and staff are developing and promoting innovative modern technologies and influencing the laws and policies that govern their use. Ultimately, the Physicians Committee’s work in this area will lead to better outcomes for patients and a shift away from animal testing for human drugs.

WYSS INSTITUTE

 Assisting the FDA in communicating through updated regulations and drafting FDA guidance documents.

RESEARCH ISSUES

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Could Human Intervention Studies Prevent Birth Defects? C

ould birth defects be prevented by avoiding alcohol? That’s what the Centers for Disease Control and Prevention recently recommended for any woman not using birth control between the ages of 15 and 44, igniting a debate on how to best address fetal alcohol spectrum disorders (FASD). Drinking while pregnant costs the United States $5.5 billion annually. Up to one in 20 U.S. school children may have FASD, which can result in problems with the heart and kidneys, brain damage, behavioral and intellectual disabilities, and lifelong mental health and substance use issues. But of the 4,000 FASD studies published between 1970 and 2014 only 72 were clinical (human) studies. The U.S. National Institute on Alcohol Abuse and Alcoholism (NIAAA) spends more than $15 million a year on FASD experiments in animals ranging from worms to nonhuman primates. Animal experiments are not helping us understand or prevent this highly complex human problem: A recent review of 127 studies in The Lancet found that 428 distinct disease conditions can co-occur in people with FASD. Many of the animals used have genetic and physiological differences that mean that findings do not translate to understanding FASD in humans. Physicians Committee scientists recently worked with American Public

Health Association (APHA) members who passed a new policy statement recommending that the National Institute on Alcohol Abuse and Alcoholism increase its focus on studies of human biology and behavior—rather than animal models—to more effectively address this uniquely human disease. The APHA statement cites several recent prevention and intervention studies with humans that outline effective methods for reducing the impact of harmful drinking. A 2011 study found that women using a Web-based assessment and intervention tool—which gave personalized feed-

back or information regarding alcohol use and pregnancy—showed a significant decrease in risky drinking behavior. The CDC recently gave a University of Missouri-Columbia researcher a $1 million grant to provide education and training to OBGYNs and to mental health professionals to help them discuss alcohol use with patients. “Prevention is the only way to curb fetal alcohol syndrome disorders,” says the Barnard Medical Center’s Angie Eakin, M.D. “Health care professionals must make it a priority to discuss with patients the risks associated with prenatal alcohol exposure.”

What Happened to

Rodney…

Should Never Happen Again! Read Rodney’s story at PCRM.org/Rodney, and join the Remembering Rodney Society by starting your monthly donation today! GOOD MEDICINE | SPRING 2016

RESEARCH ISSUES

Legislation Could End Animal Use in Medical Training

SPRING 2016 | GOOD MEDICINE

his testimony. Dr. Bruno works at the Johns Hopkins University Bloomberg School of Public Health. Currently, 195 of the 197 accredited medical schools in the United States and Canada use only human-based training

Take Action

methods to teach medical students. Of the 44 medical schools that have opened since 1979, none has ever implemented animal use for training students. BaltimoreDeservesBetter.org

Ask Vanderbilt University to Modernize Medical Training

LAERDAL

nimal use at Johns Hopkins University School of Medicine could end, if a bill introduced in the Maryland House of Delegates passes. Johns Hopkins is only one of two schools in the country that continues to use and kill animals for this purpose. House Bill 289 would prohibit the use of animals for medical training when alternatives are used by another medical school in the state. Both the University of Maryland and the Uniformed Services University of the Health Sciences implemented alternatives to their uses of animals many years ago. At Johns Hopkins, medical students cut into a pigâ&#x20AC;&#x2122;s abdomen and insert long endoscopic tubes. The pigs are killed after the procedure. Johns Hopkins already owns the human-based devices needed to replace the use of animals. â&#x20AC;&#x153;Surgical skills can be taught using modern simulators, which are currently used at 99 percent of medical schools in the U.S. and Canada,â&#x20AC;? said Physicians Committee member Richard Richard Bruno, M.D. Bruno, M.D., in

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Maryland Delegate Shane Robinson, Barbara Wasserman, M.D., Angie Eakin, M.D., and Richard Bruno, M.D.

Maryland House of Delegates chamber

lease ask Vanderbilt University School of Medicine to immediately end the use of live goats and pigs in its emergency medicine residency. Eighty-six percent of surveyed emergency medicine residency programs in the United States use human-based methods to train students. In fact, Vanderbilt already has a stateof-the-art simulation center that

that could easily replace the use of animals with modern medical simulation. To ensure that our future emergency care physicians are receiving educationally and ethically superior training methods, please ask Vanderbilt to end the use of animals immediately. NashvilleDeservesBetter.org

MEDIA

WHAT'S TRENDING?

(The Physicians Committee, of course!)

“The Physicians Committee … announced that they were filing a lawsuit against the government over its decision to drop the 300-milligram cholesterol limit from the guidelines. The group said that members of the dietary guidelines advisory committee had close ties to the egg industry and that they had relied too heavily on industry-funded studies.” —New Dietary Guidelines Urge Less Sugar for All and Less Protein for Boys and Men

“The Physicians Committee… has for years picketed, petitioned and sought legal action against Hopkins. … Several doctors from the group, including some who trained at Hopkins and plan to testify at the hearing, say use of animals is now unnecessary and outdated.” —Bill Would Prohibit Hopkins from Using Pigs to Train Doctors

“Many of the hospitals that host Chick-fil-As are in states with high rates of diet-related diseases, making hospitals part of the overall toxic food environment.” —Barnard Medical Center physician Angie Eakin, M.D., in Doc Group Wants Hospitals to Ditch Chick-fil-A, Push “Eat More Chickpeas”

Does Obama’s ‘Cancer Moonshot’ Miss the Mark? Applying knowledge we already have about diet and lifestyle could prevent about half of all cancer cases. Countering Chocolate Milk Concussion Claims Chocolate milk doesn’t help concussions. But the dairy industry wants you to think it does. So it funded a study on high school football players that’s now being called into question.

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GOOD MEDICINE | SPRING 2016

Continuing Education Activity for Health Care Professionals Recent breakthroughs have shown the power of nutrition to prevent and treat diabetes, weight problems, heart disease, hypertension, and a great many other conditions. This conference will show you the very latest and give you powerful tools you can use in your practice.

July 29-30, 2016 Grand Hyatt Washington Jointly provided by The George Washington University and Physicians Committee

Learn more and register at www.ICNM16.org 12

SPRING 2016 | GOOD MEDICINE

PREVENTION & NUTRITION

Debunking the Paleo Myth C

hristina Warinner, Ph.D., co-director of the laboratories of molecular anthropology and microbiome research and assistant professor of anthropology at the University of Oklahoma, will debunk the Paleo diet at the Physicians Committee’s International Conference on Nutrition in Medicine on July 29-30, 2016, in Washington, D.C. Register for the conference at ICNM16.org. Below, Dr. Warinner gives an overview of some of the issues she’ll address at the conference.

THINKSTOCK

Paleolithic peoples are sometimes depicted as tireless hunters who consumed large quantities of meat. Is that accurate? You might be surprised to learn that the clearest examples of recent dietary adaptations in humans are for starch-rich plants. Rather than our hunting habits, the thing that appears to set humans most apart from our primate relatives is our evolved dependence on cooking. Perhaps the most interesting thing about our dietary evolution is that we are effectively “cookivores.” Modern “Paleo” diets eschew whole grains or legumes. Is there any evidence showing that Paleolithic peoples did eat these foods? Plant microfossils from the barley family have been found on the teeth of Neanderthals, and starches from grains and tubers have been found on Paleolithic grinding stones that predate agriculture by more than 10,000 years. Humans did not discover these foods during the Neolithic—they had already been eating them, albeit in smaller quantities, for a long time. How different are the foods we eat today from what Paleolithic peoples ate? Do not be fooled by the advertisements—there were no paleo protein bars or flourless chocolate cakes in the Paleolithic. And if you could magically transport yourself back in time, you would hardly recognize the ancestors of today’s lettuce, carrots, avocados, bananas, and apricots. Real Paleolithic foods are a far cry from what we may imagine, but that makes them all the more interesting. ICNM16.org

Christina Warinner, Ph.D. GOOD MEDICINE | SPRING 2016

PREVENTION & NUTRITION

Patients Need Chickpeas— Not Chick-fil-A

ospitals are dumping McDonald’s. In the last year, five hospitals have ended their contracts with the fast-food giant, and a sixth is about to follow suit. Many are also improving patient menus with Meatless Mondays, plant-based menus, and vegetables fresh from hospital gardens. But the Physicians Committee’s 2016 Hazardous and Healthy Hospital Food Environments Report, which ranked 24 U.S. hospitals, found that some hospitals still have room for improvement. Hospitals earned points for patient menus with healthful plant-based options, Meatless Mondays, gardens, and farmers markets. Points were deducted for contracts with

fast-food restaurants such as Chick-fil-A and McDonalds, which serve disease-inducing chicken and cheeseburgers. Two hospitals scored 90 points and tied for first place: Aspen Valley Hospital, in Aspen, Colo., which offers a “Chef ’s Café Vegan Special of the Day,” and Stony Brook University Hospital, Stony Brook, N.Y., which has a 2,242-square-foot organic rooftop garden that supplies vegetables for patient meals. University of Mississippi Medical Center, in Jackson, Miss., comes in last place with a score of 62 percent. The hospital hosts a Chick-fil-A and McDonald’s. The Physicians Committee also placed ads surrounding the 19 U.S. hospitals that host Chick-fil-As. The billboards, street kiosks, and other advertisements mock the Chick-fil-A advertising campaign with a photograph of three doctors in white coats holding signs saying “Eat More Chickpeas.” The public is encouraged to “Ask your local hospital to go #FastFoodFree!” EatMoreChickpeas.org lists Twitter handles and other contact information for hospitals that host Chick-fil-As. Large bus shelter ads were placed near Chick-fil-A headquarters in Atlanta. Several hospitals named in the Physicians Committee’s previous reports have recently improved their food environments by closing McDonald’s restaurants. These include Children’s Hospital of Los Angeles, Driscoll Children’s Hospital in Texas, Memorial Regional Hospital in Florida, Riley Children’s Hospital in Indiana, and the Cleveland Clinic. Abbott Northwestern Hospital in Minnesota has announced it will soon close its McDonald’s, ending its contract early. EatMoreChickpeas.org

SPRING 2016 | GOOD MEDICINE

PREVENTION & NUTRITION

Billboards Target Cancer ‘Hot Spots’

Keep Hot Dogs Out of Schools

THINKSTOCK

he Physicians Committee recently placed billboards urging cities in Arkansas, Louisiana, Mississippi, Nevada, Oklahoma, and West Virginia—the states with the highest colorectal cancer death rates—to keep carcinogenic processed meats out of school lunches. Mayors in the cities were also petitioned to request removal of processed meats from schools. The billboards coincided with National Colorectal Cancer Awareness Month in March. “Citizens in these colorectal cancer hot spots are facing death by deli meat,” says Physicians Committee dietitian Karen Smith, R.D. “Taking cold cuts and other processed meats like hot dogs and bacon out of school lunches could help prevent future fatalities.” The billboards—located in Blytheville and Little Rock, Ark.; Monroe and Baton Rouge, La.; Jackson and Vicksburg, Miss.; Carson City and Las Vegas, Nev.; Charleston and Martinsburg, W.V.—directed viewers to DropTheHotDog.org, where they can download fact sheets and infographics about the dangers of processed meats. A recent World Health Organization report found that processed meats such as hot dogs, pepperoni, bacon, sausage, and deli meats are “carcinogenic to humans.”

The authors highlighted a meta-analysis that found each 50 gram portion of processed meat—approximately the size of a typical hot dog— eaten daily increases the risk of colorectal cancer by 18 percent. The report also observed associations between red and processed meat products and stomach, pancreatic, and prostate cancers. In October, the Physicians Committee filed a petition calling upon the U.S. Department of Agriculture to stop offering processed meats for purchase, subsidy, and reimbursement under the National School Lunch Program and National School Breakfast Program. The petition asks USDA to encourage schools that offer processed meats to include alternatives to these products in menus. DropTheHotDog.org

GOOD MEDICINE | SPRING 2016

PREVENTION & NUTRITION

Investigation into Dietary Guidelines’ Cholesterol

ollowing a nearly year-long campaign including petitions, oral testimony, billboards, and threat of legal action by the Physicians Committee, the 2015-2020 Dietary Guidelines for Americans released this January retain— and strengthen—recommendations for Americans to limit cholesterol consumption. But the Physicians Committee is demanding an investigation into food industry financial pressures that nearly toppled cholesterol warnings. In February 2015, the Dietary Guidelines Advisory Committee (DGAC) recommended dropping limits on dietary cholesterol, motivated by industry pressure, according to documents recovered by the Physicians Committee under

the Freedom of Information Act. The documents revealed a money trail from the American Egg Board to universities where DGAC members were employed and persistent industry pressure to weaken cholesterol limits. In March 2015, Neal Barnard, M.D., president of the Physicians Committee, presented oral testimony at the National Institutes of Health, stating that “for all its good work, the Committee made a scientific error on cholesterol and to carry this glaring mistake into the Guidelines is not scientifically defensible.” The Physicians Committee appealed to Agriculture Committee chairman Rep. K. Michael Conaway in October with “Cholesterol Kills” billboards and a

letter, after he convened a congressional hearing over the Agriculture Committee’s “concerns with the process of developing the Dietary Guidelines.” On Nov. 12, 2015, the Physicians Committee fired a shot across the bow in the form of a demand letter to DHHS Secretary Sylvia Mathews Burwell and USDA Secretary Tom Vilsack, putting them on notice that it would litigate if warnings on dietary cholesterol were weakened, and the Physicians Committee followed up with a lawsuit on Jan. 6, 2016. However, instead of weakening the cholesterol warnings, the Dietary Guidelines issued an even stronger warning about cholesterol. The Guide-

Plant-Based Makeover for Congressional Cafeterias Congressional staffers

LAERDAL

BMC dietitian Maggie Neola

n the Friday before Super Bowl 50, the Physicians Committee teamed up with the Congressional Vegetarian Staff Association to bring plant-based Super Bowl snacks to Capitol Hill. Barnard Medical Center director James Loomis, M.D., who has served as team internist for the St. Louis Rams football 16

SPRING 2016 | GOOD MEDICINE

team, spoke about the health benefits of plant-based foods and described how Barnard Medical Center integrates nutrition and medicine into every visit. The nearly 200 congressional staffers loaded their plates with jalapeño poppers, sweet potato skins, tofu popcorn “chicken,” chocolate covered strawberries, and

two of Dr. Loomis’ own recipes—sweet potato hummus and fresh mango salsa. Barnard Medical Center dietitian Maggie Neola, R.D., L.D., offered tips for swapping typical Super Bowl snacks for more healthful options: “On Sunday, 1 billion chicken wings will be eaten. Swapping foods such as chicken

PHYSICIANS COMMITTEE

PREVENTION & NUTRITION

Money Trail lines state: “As recommended by the IOM, individuals should eat as little dietary cholesterol as possible … Strong evidence from mostly prospective cohort studies but also randomized controlled trials has shown that eating patterns that include lower intake of dietary cholesterol are associated with reduced risk of CVD, and moderate evidence indicates that these eating patterns are associated with reduced risk of obesity. … Dietary cholesterol is found only in animal foods such as egg yolk, dairy products, shellfish, meats, and poultry.” The new Guidelines also include details on following a Healthy Vegetarian Eating Pattern, including modifications for an entirely vegan eating plan.

Join Our Team! The Physicians Committee has several director-level career opportunities for doctors, scientists, and other health professionals with leadership experience and a passion for our mission.

Director of Nutrition Education and Policy Lead our effort to advance human health and longevity by promoting plant-based diets. This will involve strategy formulation and execution, research, writing, public speaking, coalition-building, lobbying, and supervising a team of doctors, dietitians, and other professionals. We are looking for an M.D., Ph.D., R.D., or other professional with a doctorate or master’s level degree in nutrition, public health, or another relevant scientific field.

Director of Clinical Research Design and implement clinical trials investigating the health effects of nutrition interventions, particularly plant-based diets. This will involve leading our experienced research team in the process of building partnerships, applying for funding and necessary authorizations, carrying out research interventions, and analyzing, publishing, and presenting results. We are looking for a M.D., Ph.D., R.D., or other professional with a doctorate or master’s level degree in nutrition, public health, or another relevant scientific field.

Director of Science Policy Develop and implement strategies to address ethical issues in human and animal research and to replace the use of animals in science with human-focused methods. This will include research, writing, public speaking, coalition-building, lobbying, and leadership and supervision of a team of doctors, scientists, and other professionals. We are looking for an M.D. or Ph.D. in the life sciences.

wings for plant-based versions, like our Buffalo Cauliflower Bites, will help you win the game.” Sodexo’s Frank Fimbres also attended the event and spoke about the company’s interest in working with staffers to add more vegetarian and vegan options to the cafeteria.

These are full-time positions located at the Physicians Committee’s headquarters in Washington, D.C. PCRM.org/Careers

GOOD MEDICINE | SPRING 2016

MEMBER SUPPORT

A Sublime Event in Fort Lauderdale

O Dr. Neal Barnard and Nanci Alexander

n Feb. 26, the eve of the Holistic Holiday at Sea cruise, Nanci Alexander hosted a very special evening for Physician Committee supporters at her legendary Sublime restaurant. Guests enjoyed the spectacular venue, fabulous drinks and hors d’oeuvres, presentations from Physicians Committee doctors

Use Your IRA to Make Your Charitable Gift in 2016

n December 2015, President Barack Obama signed legislation indefinitely extending the charitable IRA rollover, making it retroactive to Jan. 1, 2015, with no expiration date. Now you can confidently plan to use assets from your IRA to make a qualified charitable distribution. If you are age 70½ or older, you may direct a portion or all of your required annual distribution to support the lifesaving work of the Physicians Committee. When you make a gift this

and others, and a chance to rub elbows with many like-minded people. The event raised funds to support our lifesaving work, and after the reception guests stayed to enjoy the famous food that is touted by Sir Paul McCartney, Alec Baldwin, and a host of others who have experienced Sublime. Thank you, Nanci!

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way, you will not incur federal income tax on the withdrawal. To qualify, gifts must be made directly from a traditional IRA account by your IRA administrator to the Physicians Committee for Responsible Medicine. Funds that are withdrawn by you and then contributed do not qualify. To read more about this giving opportunity, visit PCRM.PlanYourLegacy.org or call our philanthropy office toll-free at 866-4167276, ext. 366.

Dedicate Your Birthday to Saving Lives!

Learn how to make a gift that costs nothing during your lifetime. Visit PCRM’s legacy website at PCRM.PlanYourLegacy.org.

sk your friends and family to support our lifesaving work in your honor. We make it easy for you.

 Please send me the article “Avoid These Pitfalls While Writing Your Will”

1. Sign up at PCRM.org/Birthday at any time of the year.

 Please send me information on how to include PCRM in my will

2. A couple of months before your birthday, we’ll let you know how to get your friends and family involved in the celebration.

 I have already named the Physicians Committee in my will, trust, retirement plan, or insurance policy. Activate my Lifetime Partner status!

3. Our easy-to-use website makes it simple to customize your very own donation page and send e-mails to your network.

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Please mail to: Physicians Committee, Attn: Betsy Wason, 5100 Wisconsin Ave., N.W., Ste. 400, Washington, DC 20016 or e-mail bwason@pcrm.org 18

4. And it’s fun—you can also earn a great birthday present for yourself. 5. Enjoy your birthday knowing you are helping others!

MEMBER SUPPORT

Fight Cruelty and Promote Health with Every Purchase!

pply today for a Physicians Committee Visa credit card. A percentage of each purchase will go directly to the Physicians Committee and provide support to keep our vital campaigns moving forward.

Certain exclusions and conditions may apply. For more details and information on how to apply, visit PCRM.org/Credit or call 1-800-821-5184 and mention the code PCRM.

A Victory Celebration in Malibu

n January, Bobi Leonard opened her stunning cliffside home to host a celebration of the end of federally funded chimpanzee experiments. The Physicians Committee’s work was integral to this advance, and the event highlighted our work and our collaboration with other key organizations involved in the campaign. Thank you, Bobi!

Leadership Summit Los Angeles

Dianne Burnett, Bobi Leonard, Dr. Neal Barnard, and Cindy Landon

key group of members and leadership gathered in Los Angeles to discuss our work—victories, challenges, and strategies. The involvement of supporters from all across the United States is so valuable to our continued success, and spending a day immersed in our mission was energizing for all. Thank you to special guests James Costa, Kathy Freston, Moby, and Jane Velez-Mitchell! Invitations to future Summits will be extended to Guardian Circle members and Lifetime Partners. If you are interested in learning how you can participate, please contact our membership office at 202-527-7304. 

Moby speaks in support of the Physicians Committee’s critical role in bringing about systemic changes in health care. Dr. Angie Eakin demonstrates simulator technology. 

Sid Garza-Hillman, Jeff Stanford, Dr. Don Forrester, James Costa, Kathy Freston, Dr. Neal Barnard GOOD MEDICINE | SPRING 2016

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Resources for Physicians

You already know diet is a major factor in chronic disease prevention. Help your patients make the connection with our Waiting Room Literature Kits. Add our award winning educational literature to your office to start the conversation and help your patients make diet and lifestyle change a practical reality.

PhysiciansCommittee.org/LitStore

From the Physicians Committee Nutrition Guide for Clinicians, second edition Physicians Committee for Responsible Medicine

This comprehensive medical reference manual covers nearly 100 diseases and conditions, including risk factors, diagnoses, and typical treatments. Most importantly, it provides Many Physicians Committee fact sheets and booklets are downloadable without charge or available in print at minimal cost at PhysiciansCommittee.org/Lit The Nutrition Rainbow Poster The more naturally colorful your meal, the more likely it is to have an abundance of cancer-fighting nutrients. Pigments that give fruits and vegetables their bright colors represent a variety of protective compounds. The Nutrition Rainbow poster shows the cancer-fighting and immune-boosting power of different-hued foods. 18"x24", $6.00

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the latest evidence-based information on nutritionâ&#x20AC;&#x2122;s role in prevention and treatment. Includes an in-depth examination of general nutrition, macronutrients, micronutrients, and nutritional requirements for all stages of life. 745 pgs, $19.95 Special Discount $17.95

A Waiting Room Starter Kit A Waiting Room Starter Kit contains everything you need to start talking prevention with your patients. You will get samples of our most popular literature to share in your practice. $25.00, Free Shipping on this item!

Power Plate Poster These healthful food groups help you live longer, stay slimmer, and cut your risk of heart disease, diabetes, and high blood pressure.18"x 24", $6.00

Nutrition Education Curriculum DVD PCRMâ&#x20AC;&#x2122;s Nutrition Education Curriculum is designed for use in medical offices, worksites, and anywhere people will benefit from learning about the lifesaving effects of healthful eating. Please use the DVDs in this package where indicated on the curriculum found at pcrm.org/ curriculum. $8.00.Free Shipping on this item! Prescription for Health poster Finally, a prescription with side effects you want. This colorful 18"x24" poster is great for advertising the benefits of a plant-based diet. Encourage your patients to try food as their medicine with this Prescription for Health poster. $6.00

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From the Physicians Committee

From Neal D. Barnard, Physicians Committee President

The Best in the World, Volumes I-IV Boxed Set Healthful Recipes from Exclusive and Out-of-the-Way Restaurants

Power Foods for the Brain An Effective 3-Step Plan to Protect Your Mind and Strengthen Your Memory

Neal D. Barnard, M.D., Editor

Since 1998, the Physicians Committee has collected healthy, exotic recipes from distinctive restaurants around the globe. Now you can own all four hardcover The Best in the World cookbooks in one beautifully boxed set. 284 pgs, $40.00, Special Discount $37.95 The Best in the World Fast, Healthful Recipes from Exclusive and Out-of-the-Way Restaurants Neal D. Barnard, M.D., Editor

This popular collection of wonderfully healthy recipes comes from the world’s best and most unusual restaurants. Enjoy these vegan delicacies at home. Hardcover, 71 pgs, $11.95 The Best in the World II Healthful Recipes from Exclusive and Out-of-the-Way Restaurants Jennifer L. Keller, R.D., Editor

Travel around the world to discover treasures from side-street cafes and elegant hotel dining rooms. Attractively illustrated. Hardcover, 71 pgs, $11.95 The Best in the World III Healthful Recipes from Exclusive and Out-ofthe-Way Restaurants Neal D. Barnard, M.D., Editor

Discover delicious and unique recipes from restaurants across the globe. Join monks in a temple courtyard in the Far East, passengers on a French luxury yacht, or even a rock star in Akron, Ohio, for an unforgettable culinary adventure. Hardcover, 71 pgs, $11.95 The Best in the World IV Healthful Recipes from Exclusive and Out-ofthe-Way Restaurants Neal D. Barnard, M.D., Editor

Find delicious and healthful recipes from unique restaurants all around the globe. Visit a rustic hotel in England’s Lake District, enjoy a friendly street side cafe in Rome, and dine on a terrace overlooking black volcanic beaches. Recipes are designed to be within the abilities of any amateur chef. Hardcover, 71 pgs, $11.95

In Power Foods for the Brain, Dr. Barnard has gathered the most important research and studies to deliver a program that can boost brain health and reduce the risk of Alzheimer’s disease, stroke, and other less serious problems, including low energy, poor sleep patterns, irritability, and lack of focus. 320 pgs, $16.00 21-Day Weight Loss Kickstart Boost Metabolism, Lower Cholesterol, and Dramatically Improve Your Health Based on the Physicians Committee’s popular online Kickstart program, Dr. Barnard’s 21-Day Weight Loss Kickstart will help you get fast results: drop pounds, lower cholesterol and blood pressure, improve blood sugar, and more. With more than 60 recipes, daily meal plans, and tips for grocery shopping, this book will get you on the fast track to better health. 368 pgs, $15.99 The Get Healthy, Go Vegan Cookbook 125 Easy and Delicious Recipes to Jump-Start Weight Loss and Help You Feel Great These recipes are based on Dr. Neal Barnard’s landmark two-year study, which shows that a vegan diet effectively controls type 2 diabetes. In fact, it’s also beneficial for weight loss, the reversal of heart disease, and the improvement of many other conditions. Dr. Barnard and nutritionist Robyn Webb offer easy, delicious meals to improve your health. 248 pgs, $18.95 Foods That Fight Pain Did you know that ginger can prevent migraines and that coffee sometimes cures them? Drawing on new research, Dr. Barnard shows readers how to soothe everyday ailments and cure chronic pain with common foods. 348 pgs, $14.95

Dr. Neal Barnard’s Program for Reversing Diabetes If you have diabetes or are concerned about developing it, this program could change the course of your life. Dr. Barnard’s groundbreaking clinical studies, the latest funded by the National Institutes of Health, show that diabetes responds dramatically to a low-fat, vegetarian diet. Rather than just compensating for malfunctioning insulin like other treatment plans, Dr. Barnard’s program helps repair how the body uses insulin. Includes 50 delicious recipes. 288 pgs, $15.99 Breaking the Food Seduction We all have foods we can’t resist, foods that sabotage our health. But banishing those cravings for chocolate, cookies, cheese, or burgers isn’t a question of willpower; it’s a matter of biochemistry. Drawing on his own research and that of other leading institutions, Dr. Barnard reveals how diet and lifestyle changes can break the craving cycle. 324 pgs, $16.99 Turn Off the Fat Genes Genes, including those that shape our bodies, actually adapt to outside influences. Dr. Barnard explains the process and provides a three-week gene-control program complete with menus and recipes by Jennifer Raymond. Here are powerful tools for achieving long-term weight loss and better health. 350 pgs, $16.00

GOOD MEDICINE | SPRING 2016

PCRM MARKETPLACE The Cancer Survivor’s Guide Neal Barnard, M.D., Jennifer Reilly, R.D.

Find out how foods fight cancer and the advantages of a high-fiber, low-fat, dairy- and meat-free diet. Includes updates from the latest research, special prostate and breast cancer sections, tips for making the dietary transition, and more than 130 recipes. 245 pgs, $19.95

PhysiciansCommittee.org/Shop Food for Life Apron

Eating Right for Cancer Survival dvd Neal Barnard, M.D., Chef Sualua Tupolo, Stephanie Beine, R.D.

Created for the Physicians Committee’s Food for Life instructors, this Power Plate-themed apron in polyester/cotton twill features two large 7"x7" pockets and adjustable neck and waist ties. Blue, $20.00

This exciting two-disc set is designed to work hand in hand with the companion book, The Cancer Survivor’s Guide. Nine nutrition presentations and nine cooking lessons provide powerful tools for making changes in health and well-being. 270 mins, $19.95

DVDs from PBS Tackling Diabetes with Dr. Neal Barnard

Kickstart Your Health with Dr. Neal Barnard

Protect Your Memory with Dr. Neal Barnard

Drawing on the latest scientific research, Dr. Barnard explains how a low-fat vegan diet can fight diabetes by controlling blood glucose, weight, and heart disease risk. In many cases, it will even eliminate the need for some medications. 60 mins, $9.95

More than 400,000 people have participated in the Physicians Committee’s Kickstart program. Here Dr. Barnard describes the 21-day plan for a smarter, slimmer, and healthier you. Achieve lifelong results with this quick and easy approach. 60 mins, $9.95

Dr. Neal Barnard confronts yet another debilitating disease—memory loss. Through proven research, Dr. Barnard provides vital steps to boosting cognitive function along with valuable insight on how to protect your memory. $9.95

Power Plate Tote Bag

Unlocking the Power of Plant-based Nutrition dvd series

Share the Physicians Committee’s revolutionary Power Plate with this 10"x13"x15" polypropylene bag (20% post-industrial r e cy cl e d c o n t e n t ) w i t h reinforced handles and plastic bottom insert. Black, $5.00

You can buy all three Unlocking the Power of Plant-based Nutrition DVDs–Food for Life, Weight Control, and Heart Health–for $29.95. That’s a savings of nearly $15. Each disc features the segments “Getting Started” with Neal Barnard, M.D., and “In the Kitchen” with TV’s Totally Vegetarian chef Toni Fiore. Discs average 58 minutes in length. $29.95 Find more healthful resources at PCRM Marketplace Online PhysiciansCommittee.org/Shop

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INFOGRAPHIC INFOGRAPHIC

Averting Drug Disasters Animal Tests Fail to Predict Safety Results in Humans

Preclinical Testing: The FDA’s drug approval process largely depends on animal tests. More than 100,000 animals are used and killed in drug tests each year.

Lethal Dose 50 Test: This commonly used test measures how much of the drug is needed to kill 50% of a group of animals.

Clinical Testing: Once drugs are demonstrated “safe” in animals, they move to human trials. France 2016: A painkiller trial leads to one death and lands others in the hospital with brain damage.

Tested in rats, mice, monkeys, and dogs.

Seattle 2016: A cancer drug trial causes cardiac arrest and death in patients.

Tested in mice and dogs.

Many approved drugs still aren’t safe! Half of approved drugs are later withdrawn or relabeled due to adverse effects. Adverse drug reactions are the 4th leading cause of death in the U.S.

Responsible for 100,000 deaths!

Vioxx: 139,000 Heart Attacks 40% probably fatal Tested in rats and beagles.

The Solution: Modern, human-relevant testing methods can better predict drug results and protect public health.

Reconstructed human epidermis

Mini brains

3-D bioengineered liver

“The use of animals for therapeutic development is time consuming, costly, and may not accurately predict efficacy in humans.”

-Francis S. Collins NIH Director

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PHYSICIAN PROFILE

Assessing the Effects of Soy Xiao Ou Shu, M.D., M.P.H., Ph.D. national Conference on Nutrition in Medicine. Register for the conference at ICNM16.org. There is an ongoing debate about whether soy foods increase breast cancer risk and whether they are risky for breast cancer survivors. Below, Dr. Shu addresses that debate by answering a few questions that she will cover in depth at the conference. Please describe your study.

iao Ou Shu, M.D., M.P.H., Ph.D., is associate director of global health and co-leader of the cancer epidemiology research program at Vanderbilt University in Nashville, Tenn. Dr. Shu, who established the Shanghai Breast Cancer Survival Study, a cohort of more than 5,000 breast cancer survivors and who has also led several other epidemiological studies on soy food and breast cancer risk, will discuss the influence of soy food consumption on breast cancer risk and survival at this summerâ&#x20AC;&#x2122;s Inter-

We have applied both cohort and case-control study designs in our research. For the former, we followed up one group of women who were initially free of breast cancer for a risk association investigation or who were newly diagnosed with breast cancer for survival research. The risk of breast cancer or recurrence/death was compared for women who had high soy food consumption versus those with a low intake. Study participants for case-control study are a group of breast cancer patients and healthy control. We measured the risk association by comparing the soy

address has changed, please let Please keep Ifusyour know promptly. AddressChanges@ in touch. PCRM.org or 202-686-2210, ext. 304. 24 SPRING 2016 | GOOD MEDICINE

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food consumption of breast cancer patients to that of healthy women. Why are scientists looking at soy products in relation to breast cancer survival? Estrogen plays a central role in breast cancer development and progression. Soy foods not only have an antiestrogen effect but also have antiproliferation, antioxidation, and many other anticancer properties. Both laboratory and epidemiological studies have shown that soy food and soy components can reduce breast cancer recurrence and increase survival rates. Evidence is quite consistent that soy food consumption at the level of the traditional Asian diet is associated with a reduced breast cancer risk. Epidemiological research on soy food consumption has not shown any soy product to be more beneficial than others. How does general nutrition and lifestyle impact breast cancer? Vegetables and a diet enriched with antioxidants are also beneficial to breast cancer survivors. Red meat and a high fat diet, on the other hand, should be avoided. Low physical activity, obesity, diabetes, and likely chronic inflammation also play an important role in breast cancer development and prognosis. @PCRM

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