Page 1

Good Medicine ®

PUBLISHED BY THE PHYSICIANS COMMITTEE FOR RESPONSIBLE MEDICINE | AUTUMN 2017 | VOL.XXVI, NO. 4

Ending Dog Labs in Advanced Medical Training


EDITORIAL

Are You Kidding? THINKSTOCK

T

he seismic change was first noticeable at the American Medical Student Association annual convention. Years ago, students filed by our booth, picking up educational materials and watching our videos. And when they saw that we were advocating for eliminating animal use in medical schools, many said, “Are you kidding? What are the alternatives?” Their schools used dogs or other animals in laboratory exercises, and they couldn’t imagine any other way. As the years went by and we succeeded at replacing more and more of these laboratory exercises with nonanimal teaching methods, those words changed. Students filed by and looked at the list of medical schools still using animals. “Are you kidding?” they asked. “Why would anyone use animals to train medical students?” Today, of course, all U.S. and Canadian medical schools have stopped using animal laboratories in teaching. Then it was trauma training. “Are you kidding?” some asked. “How could you teach trauma procedures without animals?” And as simulators proved far superior to dogs, goats, and pigs at replicating human anatomy, the question shifted. “Are you kidding? Who would think that training on a pig would prepare an ER doc for handling emergencies?” A similar phenomenon is occurring in research per se. When we began to advocate for human-based studies in Alzheimer’s disease research, some asked, “Are you kidding? We need to model Alzheimer’s in rats and mice to find the causes of the disease and to make new drugs.” But as The more we focus on animal tests have failed miserably to produce useful Alzheimer’s drugs, more and more people are asking, “Are you kidding? Why would anyone human genes, human try to study Alzheimer’s disease in rats and mice?” Meanwhile, human biology, human nutrition, epidemiologic studies have revealed the dietary risk factors for Alzheimand human behavior, not er’s disease that are now being tested in Alzheimer’s prevention research. only will we spare animals Human studies have shown us the genetic contributors and pathology of a great deal of misery; we the disease process itself. The same is true for diabetes, cancer, and many will make progress that other conditions. Shifting the research enterprise is not easy. But the more we focus on much more quickly. human genes, human biology, human nutrition, and human behavior, not only will we spare animals a great deal of misery; we will make progress that much more quickly. Yes, it will take time no matter what. But we look forward to a day, however far off, when people are able to say, “People really used to get Alzheimer’s disease, cancer, and diabetes? Are you kidding?” Neal Barnard, m.d, f.a.c.c.

President of the Physicians Committee 2

AUTUMN 2017 | GOOD MEDICINE


CONTENTS

AUTUMN 2017

Good Medicine® FROM THE PHYSICIANS COMMITTEE FOR RESPONSIBLE MEDICINE AUTUMN 2017 | VOL. XXVI, NO. 4 Editor in Chief Neal D. Barnard, M.D., F.A.C.C. Managing Editor/Designer Doug Hall Editor Michael Keevican 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 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 Specialist | Court Anker Research Policy and Toxicology Assistant | Kyle Ash, Director of Government Affairs | Elizabeth Baker, Esq. Senior Science Policy Specialist | David Ballinger Online Fundraising and Advocacy Specialist | Neal Barnard, M.D. President | William Brown Senior Director of Philanthropy | Nora Burgess Clinical Research Assistant | Melissa Busta, R.N. Clinical Research Coordinator | Manuel Calcagno, M.D. Clinical Research Coordinator | Andrea Cimino Human Resources Specialist | Sierra Coppage Communications Coordinator | Deniz Corcoran Data Entry Manager | Lynne Crane Production Manager | Cael Croft Associate Designer | Lee Crosby, R.D. Dietitian | Sossena Dagne Data Processor | Dania DePas Director of Communications | Paula Diaz Leite Human Resources and Office Services Assistant | Jill Eckart, C.H.C. Managing Director of Nutrition | Rosendo Flores Nutrition and Research Content Manager | Carolyn Forte Project Manager | Jessica Frost Public Relations Manager | Noah Gittell Director of Philanthropy, Eastern Region | Stacey Glaeser, S.P.H.R. Vice President of Human Resources | Doug Hall Vice President of Publications | Esther Haugabrooks, Ph.D. Toxicologist | Jodie Hayward Accounts Payable Coordinator | Meghan Jardine, M.S., M.B.A., R.D., L.D., C.D.E. Associate Director of Diabetes Nutrition Education | Hana Kahleova, M.D., Ph.D. Director of Clinical Research | Stephen Kane, C.P.A. Vice President of Finance | Christine Kauffman Research and Education Programs Specialist | Noah Kauffman Communications Assistant | Michael Keevican Managing Editor | Mark Kennedy, Esq. Vice President of Legal Affairs | Ann Lam, Ph.D. Senior Medical Research Specialist | Susan Levin, M.S., R.D. Director of Nutrition Education | Feng-Yen Li, Ph.D. Medical Research Specialist | Bonnie MacLeod Director of Institutional Giving | Elizabeth Mader Senior Corporate Liaison | Lynn Maurer Associate Designer | Jeanne Stuart McVey Media Relations Manager | Ryan Merkley Director of Research Advocacy | Margaret Neola, R.D. Dietitian | Josh Oviatt Food for Life Program Manager | Brandalyn Patton Fundraising Program Manager | John Pippin, M.D. Director of Academic Affairs | Reina Pohl Communications Coordinator | Dawnyel Pryor Educational Programs and Marketing Director | Cindy Ripley Human Resources Specialist | Leslie Rudloff, Esq. Senior Counsel | Rose Saltalamacchia Assistant to the President and Nutrition Project Coordinator | Alyssa Schaefer Development Coordinator | Lisa Schulz Web Designer | Karen Smith, R.D. Senior Manager of Clinical Dietetics | Krisie Southern Membership Assistant | Erica Springer Director of Philanthropy, Western Region | Kristie Sullivan, M.P.H. Vice President of Research Policy | Jeff Surak Senior Digital Strategist | Kalpesh Suthar Senior Accountant | Caroline Trapp, M.S.N., A.P.R.N., B.C.A.D.M., C.D.E. Director of Diabetes Education and Care | Anne Marie Vastano Special Events Manager | Ashley Waddell Director of Philanthropy, Western Region | Betsy Wason, C.F.R.E. Vice President of Development | Rod Weaver Data Manager | Christopher Wright Staff Accountant | Jia Xu, Ph.D. Program Specialist | Craig Ziskin Director of Annual Giving | Pablo Acosta e-Commerce and Fulfillment Coordinator | Barnard Medical Center Staff | Ginnette Badran Medical Assistant | Brenda Brown-Igboegwu Medical Office Assistant | Mandy Gleason Medical Office Coordinator | Mellissa Gohacki Medical Practice Manager | Gretchen Housel, N.P. Nurse Practitioner | Emily Kasmar, N.P. Nurse Practitioner | James Loomis, M.D. Medical Director | Nilufa Mahbuba Patient Care Coordinator | Stephen Neabore, M.D. Medical Doctor | Dominica Roberts, R.N. Medical Assistant | Kristine Slatkavitz, N.P. Nurse Practitioner | Jane Suthar, R.N. Medical Assistant

RESEARCH ISSUES 6 Ending Dog Labs in Advanced Medical Training 5

8 USDA Restores Animal Welfare Database, Sort of 9 Framework to Identify Asthma-Causing Chemicals Could Reduce Animal Tests

Take Action: Ask Vanderbilt University to Modernize Medical Training

10 Helping Scientists Worldwide Replace Animal Tests 6

PREVENTION AND NUTRITION 12 ‘Prevention over Pills’ at International Conference on Nutrition in Medicine 14 New York Times to Sydney Morning Herald: Physicians Committee Nutrition Research in the News

10

15 AMA and ACC Tell Hospitals to Add PlantBased Meals, Eliminate Processed Meats

Doctors Say Hospitals Should Not Partner with McDonald’s

16 USDA’s MyPlate Is Making Americans Sick Healthy on the Hill 17 Doctors Encourage Detroit Residents to Eat More Fruits and Vegetables 12

American Medical Association Calls for Healthier Foods in SNAP Program

DEPARTMENTS 4 THE LATEST IN... 11 MEDIA What’s Trending? 16

18 MEMBER SUPPORT 20 PCRM MARKETPLACE 23 INFOGRAPHIC Power Up with Plant-Based Protein 24 PHYSICIAN PROFILE Helping Patients and Physicians Get Healthy: Michelle McMacken, M.D. COVER: THINKSTOCK

18 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). The 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, Autumn 2017, Physicians Committee for Responsible Medicine. Articles may not be reprinted for resale. Please contact the Physicians Committee at permissions@pcrm.org regarding other permissions. ©Physicians Committee 2017. 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.

PCRM Phone Extensions 202-686-2210 Research Issues..........................ext. 336 Literature Requests......................ext. 306 Media........................................ext. 316 Membership (change of address, duplicate mailings, renewal questions).........ext. 304 Nutrition.....................................ext. 395

GOOD MEDICINE | AUTUMN 2017

3


THE LATEST IN…

RESEARCH RESEARCH POLICY

Physicians Committee Advises Government on Replacing Animal Tests

ANIMAL TESTING

Medical Testing on Animals Is ‘Morally Wrong’

M

edical testing on animals is “morally wrong,” say 44 percent of Americans in Gallup’s annual Values and Beliefs poll. That’s up from 26 percent in 2001. Gallup says young adults are driving attitudinal changes on animal medical testing.

ADVANCED RESEARCH TOOLS

Organs-on-Chips on International Space Station

T

he Center for the Advancement of Science in Space, which manages the International Space Station, is sponsoring research that will use organs-on-chips to study the effects of microgravity on human physiology. “The organs-on-chips approach to human physiology research aboard the International Space Station may lead to more reliable and predictable results for drug development and reduce the need for animal testing,” says CASIS. The organs-on-chips will also be observed for changes in gene expression, cell communication, and patterns of differentiation that may lead to changes in organs and other body systems. Rainey K. CASIS partnership brings “organson-chips” research to space station. June 20, 2017. Available at: https://www. nasa.gov/mission_ pages/station/ research/news/ casis_partnership

ongress established the Interagency Coordinating Committee on the Validation of Alternative Methods (ICCVAM) in 2000 to promote acceptance of tests that either refine procedures to lessen animal pain or distress, reduce the number of animals Elizabeth Baker, Esq., (right) at NIH used in a particular test, or with Nicole Kleinstreuer, Ph.D., replace animals with test meth- the deputy director of the National Toxicology Program Interagency ods such as cells, tissues, or Center for the Evaluation of Alternative predictive computer models. Toxicological Methods, who coordinates ICCVAM ICCVAM recently held its annual public forum with representatives from 16 member agencies, including the Environmental Protection Agency, the Food and Drug Administration, and the National Institutes of Health sharing updates on progress and plans. The Physicians Committee’s senior science policy specialist, Elizabeth Baker, Esq., provided comments at the meeting, commending good work from some member agencies and calling on others to do more to advance alternatives.

THINKSTOCK

Jones JM. Americans Hold Record Liberal Views on Most Moral Issues. May 11, 2017. Available at: http:// www.gallup.com/poll/210542/ americans-hold-record-liberal -views-moral-issues.aspx.

C

DRUG SAFETY

Human Cells Predict Danger of Lethal Drug That Animal Tests Missed

L

ast year in France, a previously healthy man died and four others experienced brain damage during a clinical trial of the experimental drug BIA 10-2474, which had previously been tested in animals. To understand why BIA was not safe, a group of researchers recently screened the compound using human cells and brain tissues. The researchers found that BIA may disrupt how neurons in the brain metabolize lipids. These effects were not seen in preclinical experiments on mice, rats, monkeys, and dogs. As a result of the tragedy, the European Medicine Agency has revised its regulatory guideline on risk mitigation for first-in-human and early clinical trials to recommend additional approaches involving in vitro human cell systems or human-derived material for risk assessment. Van Esbroeck ACM, Janssen APA, Cognetta AB 3rd. Activity-based protein profiling reveals off-target protein of the FAAH inhibitor BIA 10-2474. Science. 2017;356:1084-1087.

4

AUTUMN 2017 | GOOD MEDICINE

THINKSTOCK

European Medicines Agency. Strategies to identify and mitigate risks for first-inhuman and early clinical trials with investigational medicinal products. July 19, 2017. Available at: http://www.ema.europa.eu/ema/.


THE LATEST IN…

NUTRITION COLON CANCER

It Pays to Avoid Meat Even After Colon Cancer Diagnosis

THINKSTOCK

THINKSTOCK

P

eople with stage III colon cancer have better outcomes when they avoid meat, consume more plants, and have a healthy body weight, according to a new study from the University of California San Francisco. Researchers analyzed the diet and lifestyle of 992 stage III colon cancer patients over a period of seven years. Those with a body mass index between 18.5 and 24.9 kg/m2 who exercised and followed a diet high in fruits, vegetables, and whole grains and low in red and processed meats had longer overall survival and disease-free survival rates, compared with patients who did not meet these parameters. Van Blarigan E, Fuchs CS, Niedzwiecki D. (2017, May) American Cancer Society (ACS) Nutrition and Physical Activity Guidelines after colon cancer diagnosis and disease-free (DFS), recurrence-free (RFS), and overall survival (OS) in CALGB 89803 (Alliance). Paper presented at the 2017 American Society of Clinical Oncology (ASCO) Annual Meeting, Chicago, IL.

ENVIRONMENTAL HEALTH

GUT HEALTH

Healthy Gut from Eating Plants Prevents Chronic Diseases

A

diet high in whole grains, legumes, fruits, and vegetables can reduce inflammation and prevent obesity and diabetes by enhancing the growth of healthy bacteria, according to a recent article by the Physicians Committee’s Meghan Jardine, M.S., R.D., C.D.E., published in Practical Diabetology. A diet high in fat and animal products can lead to overgrowth of bacteria that cause inflammation and increase the risk of diabetes and certain types of cancer. Other healthy lifestyles choices such as exercising, getting enough sleep, and managing stress can also help. However, most experts agree that nutrition plays the most prominent role in improving gut health. Jardine M. The relationship between microbiota and the environment, nutrition and metabolic disease. Pract Diabetol. 2017;36:6-14.

Substituting Beans for Beef Beneficial for Environment

S

wapping beef for beans would help the United States reach targeted greenhouse gas emission reductions, according to a report published in Climatic Change. Researchers compared simulated net emissions of legume production, subtracted those from average beef production rates, and used U.S. reduction goals for 2020 as a reference. Based on the results, legume substitution could account for 46 to 74 percent of the required reductions. Forty-two percent less cropland would be needed as well. International surveys and increased availability of plant-based options demonstrate a willingness to make dietary changes for environmental benefits.

THINKSTOCK

Harwatt H, Sabaté J, Eshel G, Soret S, Ripple W. Substituting beans for beef as a contribution toward US climate change targets. Clim Change. 2017;143:261-270.

GOOD MEDICINE | AUTUMN 2017

5


RESEARCH ISSUES

Ending Dog Labs in Advanced Medical Training

THINKSTOCK

“D

on’t kill man’s best friend for medical training.” That was the Physicians Committee’s message to Cleveland Clinic South Pointe Hospital on billboards that went up on Aug. 21 in Ohio. The hospital’s emergency medicine residents were being trained on live dogs at Northeast Ohio Medical University. Cleveland Clinic heard the message loud and clear. Within 24 hours of the billboards going up, the dog laboratory was halted. “Initially, we were planning to end this portion of the

6

AUTUMN 2017 | GOOD MEDICINE

South Pointe Hospital Emergency Medicine residency training at the conclusion of this year. Upon greater reflection, we have expedited its discontinuation and are looking into other alternatives to continue properly training our Emergency Medicine residents,” the Cleveland Clinic said in a statement. The change does more than spare dogs. “Cleveland Clinic’s decision to end this use of dogs will lead to better training for its South Pointe Hospital emergency medicine


RESEARCH ISSUES

residents,” says John Pippin, M.D., F.A.C.C., director of academic affairs for the Physicians Committee. “The medical training technologies available today provide the best educational experience and allow residents to practice procedures more than once, allowing them to develop and strengthen their skills with repeated experience.” With billboards, federal complaints, demonstrations, and member e-mails and phone calls to decision-makers, the Physicians Committee continues working to ensure that human-relevant methods replace live animal use in emergency medicine residencies, such as the Cleveland Clinic’s, and other advanced medical training including Advanced Trauma Life Support (ATLS) courses, pediatrics residencies, and paramedic training programs. The Physicians Committee and its members have already ended live animal use in all U.S. and Canadian medical schools. In 2016, the last two U.S. medical schools using live animals to train students switched to simulators. Stabbed in the Heart

The Physicians Committee had also planned on filing a complaint with the U.S. Department of Agriculture on Aug. 24, but canceled that plan after the Cleveland Clinic’s announcement. The Animal Welfare Act (AWA) requires “that a principal investigator—including course instructors—consider alternatives to procedures that may cause more than momentary or slight pain or distress to any animal used for research purposes.” The complaint cited violations of the AWA and inadequate oversight of the training protocol by the university’s animal care and use committee. The emergency medicine training involved cutting into live dogs to practice procedures. Trainees were instructed to make incisions into a dog’s throat and chest to insert tubes, cut into veins, and insert needles into the chest to remove fluid surrounding the heart. They also split open the breastbone in order to access the heart and perform various cardiac procedures, including a stab wound to the animal’s heart. If the dogs survived the procedures, they were killed following the training session.

ical Center: Using Animals to Teach Human Medicine? SwitchToSimulation.org” opposed the Minnesota institution’s use of live rabbits and sheep to practice emergency medical procedures. Up to 200 animals per year are used, all of whom are then killed if they survived the procedures. In conjunction with the billboards, the Physicians Committee submitted a request for an animal cruelty investigation to Hennepin County Attorney Mike Freeman. Signees included the Physicians Committee’s Dr. Pippin and Physicians Committee member Matthew Clayton, M.D., M.B.A., F.A.C.S. In Massachusetts, Physicians Committee member Margaret Peppercorn, M.D., led a demonstration in June, urging Baystate Medical Center to stop using live animals for ATLS training. The training at Baystate in- Matthew Clayton, M.D. volves cutting into live pigs to practice surgical skills. The Physicians Committee also filed a federal complaint with the USDA. “I’m out here because I’m outraged that Baystate is still using live animals for its advanced trauma life support training. It’s cruel, and it violates the Animal Welfare Act,” Dr. Peppercorn told MassLive.com. And in July, the Physicians Committee filed a federal complaint with the USDA against the University of Missouri Columbia School of Medicine for using live pigs in its emergency medicine training program. According to the protocol obtained by the Physicians Committee, the procedures continue even if the animal dies while on the operating table. Any animals who survive are killed before the end of the training. Hennepin, Baystate, and the University of Missouri all have simulation centers that could replace the use of animals. This year, the Physicians Committee has also held demonstrations, filed federal complaints, and erected billboards to end live animal use at Dartmouth-Hitchcock Medical Center in New Hampshire for emergency medicine training; North Dakota State University for ATLS training; and Laval University in Canada for pediatrics training.

Students Deserve Better

This summer, Physicians Committee doctor members and supporters were also working to end live animal use in other advanced medical training programs across the country. In June, billboards reading “Hennepin County MedGOOD MEDICINE | AUTUMN 2017

7


RESEARCH ISSUES

Switching to Simulation

Today, 90 percent of surveyed emergency medicine programs and 99 percent of Advanced Trauma Life Support course use only nonanimal methods. Laval University in Quebec, Canada, is the only pediatrics residency in the United States and Canada that continues to use animals. The TraumaMan System—a realistic anatomical human body simulator with lifelike skin, subcutaneous fat, and muscle—is just one of many simulators that can be used to replace the use of live animals for numerous procedures. TraumaMan / Simulab

SimMan / Laerdal Medical

Premie / Gaumard

TraumaMan is now used by a majority of ATLS programs, and it is endorsed by the American College of Surgeons for trauma and surgery skills training. Earlier this year, following months of pressure from the Physicians Committee, the University of North Carolina at Chapel Hill announced that it had ceased the use of live animals in its emergency medicine training program and “residents will solely use simulation models for emergency medicine training.” Montgomery County Hospital District in Texas followed suit when it announced an end to the use of live pigs in its paramedic training program at Baylor College of Medicine in Houston after the Physicians Committee filed a federal complaint citing violations of the Animal Welfare Act. MCHD also cited its commitment to nonanimal training methods: “We believe it’s in the best interests of our patients and the community to provide our staff with the most up to date tools and methods of training...” The Physicians Committee will keep working until all other advanced medical training programs agree. PCRM.org/Action

USDA Restores Animal Welfare Database, Sort of

T

8

| GOODMEDICINE AUTUMN AUTUMN2017 2017| GOOD MEDICINE

PATRICK GAVIN

he U.S. Department of Agriculture shut down its online animal welfare database without warning in February. In August, the USDA restored the database, thanks to thousands of Physicians Committee members and others contacting their members of Congress and the USDA. But the database, now known as the Animal Care Public Search Tool, is very different from what it used to be. No longer will the USDA post its enforcement actions. Instead, the agency plans to post only “statistical summaries each calendar quarter.” The database previously included inspection reports, annual reports, and other documents regarding enforcement of the Animal Welfare Act. In response to the shutdown in February, the Physicians Committee and a coalition of other organizations filed a lawsuit in federal court. In June, the Physicians Committee worked with Sen. Ron Wyden (D-Ore.), Rep. Vern Buchanan (R-Fla.), and Rep. Earl Blu-

Congressman Earl Blumenauer speaks during June 8 Capitol Hill briefing organized by the Physicians Committee.

menauer (D-Ore.), and other groups to hold a Capitol Hill briefing on the issue. Rep. Blumenauer said that an accurate and current database allows those concerned about animal welfare “to be able to track what’s going on, to be able to hold people accountable, to under-

stand that everyone’s playing by the same rules and, those that aren’t, be able to do something about it.” The Physicians Committee is continuing its legal efforts until the database and its information is fully restored. TAKE ACTION> PCRM.org/Database


RESEARCH ISSUES

TIM BARKER

Framework to Identify Asthma-Causing Chemicals Could Reduce Animal Tests

A

nimal tests are often used to try to identify the toxic effects of chemicals. However, in addition to being cruel, these tests often give unreliable results. Adverse outcome pathways (AOPs) could reduce these animal tests, according to a new research paper co-authored by the Physicians Committee’s Kristie Sullivan, M.P.H., in Applied In Vitro Toxicology. For example, chemical respiratory allergens cause an immune reaction in humans, leading to coughing, wheezing, difficulty breathing, and narrowing of the airways that can worsen upon repeated exposure. Currently, there are no standardized, validated, and regulatory-accepted models for detecting these chemicals, and animal tests are often used. AOPs compile existing data on how exposure to a particular chemical may trigger a series of biological changes in the body resulting in illness or injury to an individual or population. Scientists can then use this pathway to identify the most needed tests, which can increase testing speed, lower costs, and reduce animal testing.

“The immune and respiratory systems of mice and rats react differently to chemicals than human systems do, making it difficult to detect chemical respiratory allergens and prevent people from developing these reactions,” says Kristie Sullivan, M.P.H., vice president of research policy for the Physicians Committee. “This AOP will help speed the further development of tests that could be used to detect chemical respiratory allergens and lead to the regulatory acceptance of nonanimal approaches Kristie Sullivan, M.P.H. to protect workers and consumers.” Macromolecular

Cell/ Tissue

Organ/ Organ System

Individual

MIE: Covalent binding to proteins; potential preference for lysine over cysteine residues

Celluar danger signals: Activation of inflammatory cytokines and chemokines and cytoprotective gene pathways (Th2)

Dendritic cell activation (Th2) and migration

T-cell activation-poliferationpolarization (Th2)

AO: Sensitization of the respiratory tract

TAKE ACTION

Ask Vanderbilt University to Modernize Medical Training

THINKSTOCK

P

lease ask Vanderbilt University School of Medicine to immediately end the use of live goats and pigs in its emergency medicine residency. Ninety percent of surveyed emergency medicine residency programs in the United States use human-based methods to train students. In fact, Vanderbilt already has a state-of-the-art simulation center 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. www.NashvilleDeservesBetter.org GOOD MEDICINE | AUTUMN 2017

9


RESEARCH ISSUES

Helping Scientists Worldwide Replace Animal Tests

Physicians Committee experts recently shared their research on replacing animal use in research with scientists from many countries.

10th World Congress on Alternatives and Animal Use in the Life Sciences Physicians Committee scientists gave five oral presentations and five poster presentations at the 10th World Congress on Alternatives and Animal Use in the Life Sciences this August in Seattle.

Esther Haugabrooks, Ph.D., discussed her worldwide survey of LD50 tests, which measure the dose of a chemical that kills 50 percent of the exposed animals.

Ryan Merkley highlighted problems with institutional animal care and use committees (IACUCs) at facilities covered under the Animal Welfare Act. Kristie Sullivan, M.P.H., (right) discussed adverse outcome pathways (AOPs), a method to replace animal use in identifying toxic chemicals.

Elizabeth Baker, Esq., shared progress and plans for replacing animal use in pharmaceutical testing.

The Physicians Committee also held an event the day before the World Congress to discuss roadblocks and solutions to replacing animals in medical research. The event highlighted the need for more funding and training in nonanimal research methods and the availability of human tissues and cells.

International Society for Stem Cell Research Annual Meeting

Alzheimer’s Association International Conference

Ann Lam, Ph.D., presented research on replacing animal-derived components in stem cell research at the International Society for Stem Cell Research annual meeting in Boston in June.

Feng-Yen Li, Ph.D., attended the Alzheimer’s Association International Conference in London, England, in July, where she presented research on how a plant-based diet can modify dietary risk factors for Alzheimer’s disease.

| GOOD | GOOD 10 2017 MEDICINE 10 AUTUMN AUTUMN 2017 MEDICINE


MEDIA

WHAT'S TRENDING?

THINKSTOCK

(The Physicians Committee, of course!)

“Moderation, as a concept, applies to healthy things, not to carcinogens. And processed meats are indeed carcinogens.” —Physicians Committee president Neal Barnard, M.D., in Carcinogens Should not be Consumed, Even in Moderation

“Maternal diets high in plant foods may reduce risk of complications, including gestational diabetes.” —The Physicians Committee’s Susan Levin, M.S., R.D., in Can You Have a Healthy Vegetarian or Vegan Pregnancy?

“A pig is not a human. It’s not the same as working on a patient. If I had an acute injury I’d want someone working on me that was trained on something more relevant to humans.” —Physicians Committee member Margaret B. Peppercorn, M.D., in Protesters want Baystate Medical Center to Stop Killing Pigs for Surgical Training

What the Health! NFL’s Trent Williams Goes Vegan! Congrats to NFL player Trent Williams who is going vegan to up his game for the 2017 football season! What inspired him? The new documentary What the Health, which I’m glad to be part of!

CONNECT Facebook.com/PCRM.org • Facebook.com/NealBarnardMD • Facebook.com/21DayKickstart Twitter.com/PCRM • Pinterest.com/PCRMorg • Instagram.com/PhysiciansCommittee Youtube.com/PCRM • PCRM.org/NBBlog

Find out more at PCRM.org/NBBlog

PCRM.org/Trending

GOOD MEDICINE | AUTUMN 2017

11


PREVENTION & NUTRITION

‘Prevention over Pills’ at International An urgent health care message for the nation: Prevention over Pills.

P

revention over pills: That was the urgent message from 700 doctors, medical students, and other health care providers who attended the International Conference on Nutrition in Medicine at the Grand Hyatt in Washington, D.C., on July 28 and 29, 2017. The conference—hosted by the Physicians Committee and the George Washington University School of Medicine and Health Sciences—empowered clinicians and future doctors to help patients treat, prevent, and, in some cases, reverse chronic disease with a plant-based dietary intervention. Presentations from an international group of doctors, researchers, and scientists included “The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers,” “Nutrition Essentials: What Every Clinician Needs to Know,” and “HeartHealthy Nutrition in Practice.” In addition to gaining insight about the science and practical applications of nutrition in medical practice, clinicians and medical students learned about cutting-edge research, from obesity and the microbiome to special techniques for helping patients break through weight-loss plateaus. The presentations will be available later this year for continuing medical education credit on NutritionCME.org.

Michael Greger, M.D., presented “The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers.”

Thank you to our generous sponsors:

STEVE SHAPIRO

The Physicians Committee’s Karen Smith, R.D., led a morning workout.

12

| GOOD | GOOD AUTUMN AUTUMN 2017 2017 MEDICINE MEDICINE

Attendees shared their thoughts on why nutrition belongs in medicine.


PREVENTION & NUTRITION

Conference on Nutrition in Medicine

Martha Clare Morris discussed “Diet and Alzheimer’s Disease.”

Medical students called for integrating nutrition into practice.

Attendees fueled their bodies with kale salads, harissa-spiked vegetable kabobs with toasted couscous and fresh preserves, and beet risotto with asparagus and corn succotash. Anthony Lim, M.D., J.D., who presented “Helping Patients Break through the Weight Plateau,” with Dr. Barnard.

Thank you to our generous sponsors:

Photo booth fun! GOOD MEDICINE | AUTUMN 2017

13


PREVENTION & NUTRITION

New York Times to Sydney Morning Herald:

Physicians Committee Nutrition Research in the News

Weight Loss

14

AUTUMN 2017 | GOOD MEDICINE

Dr. Kahleova, along with Physicians Committee president Neal Barnard, M.D., and Physicians Committee director of nutrition education Susan Levin, M.S., R.D., also published a report in the journal Nutrients, which analyzed research behind the effectiveness of plantbased diets to reduce disease risk including cardiovascular disease, obesity, and diabetes. They concluded that vegetarian and especially vegan diets are effective for weight and glycemic control and provide metabolic and cardiovascular benefits, including reversing atherosclerosis and decreasing blood lipids and blood pressure. Possible mechanisms include increased fiber, vegetable protein, and antioxidant intake and reductions in saturated fat, cholesterol, and caloric intake.

Kahleova H, Klementova M, Herynek V, et al. The effect of a vegetarian vs conventional hypocaloric diabetic diet on thigh adipose tissue distribution in subjects with type 2 diabetes: a randomized study. J Am Coll Nutr. 2017;36:364-369. Kahleova H, Lloren JI, Mashchak A, Hill M, Fraser GE. Meal frequency and timing are associated with changes in body mass index in Adventist Health Study 2. J Nutr. Published online July 12, 2017. Kahleova H, Levin S, Barnard N. Cardio-metabolic benefits of plant-based diets. Nutrients. 2017;9:848-861. Yokoyama Y, Levin SM, Barnard ND. Plant-based diets and plasma lipids: a systematic review and meta-analysis. Nutr Rev. Published online August 21, 2017.

Hana Kahleova, M.D., Ph.D.

TIM BARKER

“Vegetarian diets proved to be the most effective diets for weight loss,” Dr. Kahleova said in an interview with the Sydney Morning Herald about a study she presented at the American Diabetes Association’s 77th Scientific Sessions and that was published in the Journal of the American College of Nutrition. The study found that a plant-based diet leads to twice as much weight loss as a traditional diabetes diet. Researchers compared weight loss for 74 patients with type 2 diabetes on either a vegetarian or nonvegetarian diet of equal caloric

Heart Health

Dr. Barnard and Levin also published a review and meta-analysis in Nutrition Reviews, which found that vegetarian, especially vegan, diets reduce cholesterol levels. They reviewed 49 observational and intervention studies that compared vegetarian and vegan diets with omnivorous diets and their effects on plasma lipids. Vegetarian diets lowered total cholesterol levels as well as LDL and HDL levels when compared to omnivorous diets. The greatest benefit on lipid levels was seen in those who followed vegan diets. Plant-based diets typically reduce body weight and saturated fat intake, which may benefit cholesterol management. “The immediate health benefits of a plant-based diet, like weight loss, lower blood pressure, and improved cholesterol, are well documented in controlled studies,” Levin told Medical News Today.

THINKSTOCK

F

rom the New York Times to the Sydney Morning Herald, newly published research from the Physicians Committee’s clinical research team, led by Hana Kahleova, M.D., Ph.D., is making worldwide headlines with the evidence that plant-based diets help you lose weight, lower cholesterol, and improve heart health.

value. Those in the vegetarian group lost twice as much body weight and reduced their fat in and around their muscles at a higher rate, compared with the nonvegetarian group. The vegetarian group also experienced more energy and satiety during the dietary intervention. Another of Dr. Kahleova’s weightloss studies, published in the Journal of Nutrition, found that meal timing may aid weight management. Researchers compared meal timing and frequency to changes in BMI for 50,000 participants as part of the Adventist Health Study 2. Those who ate breakfast as the largest meal of the day, did not snack, and fasted longer overnight had the lowest increase in BMI when compared to those who consumed more than three daily meals with snacking in between. “The message is very straightforward: Make breakfast your largest meal of the day, and eat dinner as your lightest meal of the day,” Dr. Kahleova told the New York Times in an article on the study.


PREVENTION & NUTRITION

AMA and ACC Tell Hospitals to Add Plant-Based Meals, Eliminate Processed Meats

THINKSTOCK

T

he American Medical Association, the largest association of physicians in the United States, adopted a resolution in June calling on hospitals to provide plant-based meals and remove bacon, sausage, hot dogs, and other processed meats from menus. “RESOLVED, That our American Medical Association hereby call on US hospitals to improve the health of patients, staff, and visitors by (1) providing a variety of healthful food, including plant-based meals and meals that are low in fat, sodium, and added sugars, (2) eliminating processed meats from menus, and (3) providing and promoting healthful beverages.” The resolution was co-sponsored by the Medical Society of the District of Columbia and the American College of Cardiology.

“A generation ago, the AMA supported doctors who were working to get tobacco out of their hospitals. And that helped everyone, especially those patients who needed to break a bad habit,” Physicians Committee president Neal Barnard, M.D., said in testimony at the AMA House of Delegates meeting in Chicago. “In 2015, hot dogs and similar processed meats were listed as

IARC Group 1 carcinogens, clearly contributing to colorectal cancer. And many doctors and administrators would like to replace them with healthier foods.” Also this summer, the American College of Cardiology released its HeartHealthy Food Recommendations for Hospitals, which made similar recommendations. MakeHospitalsHealthy.org

THINKSTOCK

Doctors Say Hospitals Should Not Partner with McDonald’s

“Y

our Heart’s Not Lovin’ Those Cheeseburgers. Ask your local hospital to go #FastFoodFree!” read Physicians Committee advertisements in Macon, Ga., and Fort Worth, Texas, this summer. Hospitals in both towns have contracts with McDonald’s that expire in 2019. Bus shelter ads near the Navicent Medical Center in Macon, Ga., in July were timed to get the attention of Navicent Health’s board of directors ahead of the board meeting. The Physicians Commit-

tee also filed a complaint with the Macon-Bibb County Health Department. In August, ads displayed on the entire fleet of 134 buses in Fort Worth, Texas, were timed to get the attention of John Peter Smith Hospital’s board of managers. Physicians Committee dietitian Lee Crosby, R.D., addressed the board members, reminding them that unhealthful fast food, including burgers and shakes, can contribute to heart disease and other life-threatening conditions. The Physicians Committee obtained

copies of both McDonald’s contracts, which show the hospitals have a “percentage rent” agreement with the fast-food chain. This means that the more unhealthful food sold to staff, visitors, and patients, the more money the hospitals make. The campaigns received nationwide media coverage, including The Telegraph newspaper, NBC, and Fox News for Navicent, and the Star-Telegram, ABC, CBS, and an Associated Press story for John Peter Smith that appeared in dozens of outlets across the country. Several hospitals have closed McDonald’s restaurants, including Parkland Hospital in Dallas, Grady Memorial Hospital in Atlanta, Rady Children’s Hospital in San Diego, and Abbot Northwestern Hospital in Minneapolis which ended its McDonald’s lease 10 years early. Currently, about 12 U.S. hospitals host McDonald’s restaurants. TAKE ACTION> MakeHospitalsHealthy.org GOOD MEDICINE | AUTUMN 2017

15


PREVENTION & NUTRITION

USDA’s MyPlate Is Making Americans Sick

T

dairy products offer little if any protection for bone health and are the leading source of saturated (“bad”) fat in the diet. Dairy products may also increase the risk of prostate cancer, and are under investigation for their contribution to other forms of cancer, as well as to cardiovascular disease, Parkinson’s disease, Alzheimer’s disease, and early death. Dairy products also harm up to 50 million Americans who suffer from lactose intolerance. Although calcium is an essential nutrient, it is available from many other more healthful foods, such as beans, green leafy vegetables, tofu products, breads, and cereals. The petition also calls on USDA to replace the protein portion of the plate with a legumes food group. The average American actually consumes far more

USDA

he U.S. Department of Agriculture’s MyPlate diagram should ditch the dairy group and swap the protein portion of the plate for legumes to better help Americans stay healthy, says a federal petition the Physicians Committee filed in August. The MyPlate diagram divides a serving plate into three common food groups— vegetables, fruits, and grains—and one nutrient category—protein—an anomaly that perpetuates the myth that protein is absent in vegetables, fruits, and grains, and that people must take special care to include protein in their diets. The serving plate is accompanied by a smaller adjacent circle representing a dairy group. The Physicians Committee’s petition recommends removing the dairy group because scientific evidence shows that

protein than necessary, and most of it comes from animal products that promote diseases like diabetes, cancer, and heart disease. The USDA’s 2015-2020 Dietary Guidelines for Americans advise that teen boys and adult men “need to reduce overall intake of protein foods by decreasing intakes of meats, poultry, and eggs and increasing amounts of vegetables...” The Guidelines say that “legumes are excellent sources of protein” but that intakes of legumes are below recommendations. TAKE ACTION> PCRM.org/MyPlate

Healthy on the Hill

Nearly 100 congressional staffers attended.

Physicians Committee director of government affairs Kyle Ash discussed nutrition policy.

C

Karen Smith R.D., James Loomis, M.D., and Maggie Neola, R.D.

16

| GOODMEDICINE AUTUMN2017 2017| GOOD MEDICINE AUTUMN

hanges in federal nutrition policy were on the menu when the Physicians Committee and the Barnard Medical Center visited Capitol Hill this summer. While 100 congressional staffers at the Rayburn House Office Building feasted on roasted cauliflower steaks, roasted beet hummus with pita and vegetables, and other options, Physicians Committee director of government affairs Kyle

Ash discussed the need for federal nutrition policy to promote plant-based diets. Following Ash’s presentation, the Barnard Medical Center’s James Loomis, M.D., Karen Smith, R.D., and Maggie Neola, R.D., gave a cooking demonstration and answered questions about health and nutrition. Dr. Loomis prepared one of his own recipes—beet hummus. Neola cooked a zesty quinoa salad that contained three ingredients to add to any healthy meal: grains, vegetables, and legumes. Smith made a chocolate mousse made with tofu. Several staffers asked the experts about plant-based eating, and one attendee mentioned, “With food like this, I could definitely eat vegan!” Chocolate tofu mousse


PREVENTION & NUTRITION

Doctors Encourage Detroit Residents to Eat More Fruits and Vegetables

“D

etroit: Eat more fruits and vegetables, cut the meat and dairy.” That was one of the messages from Detroit-area health professionals who starred in billboards that promoted the Physicians Committee’s Kickstart Your Health program, which provided residents with resources to get healthy and reduce the risk of nutrition-related diseases. During the August program, Joel Kahn, M.D., Velonda Anderson, Ph.D., Paul Chatlin, Quiana “Que” Broden, and Kim and Marc Ramirez, invited the entire city to a free health fest showcasing local health organizations and offering free health screenings, nutrition and healthy lifestyle tips, a screening of Forks Over Knives, and cooking demos. Physicians Committee president Neal

The Kickstart Your Health Detroit team (left to right): Paul Chatlin, Quiana “Que” Broden, Joel Kahn, M.D., Velonda Anderson, Ph.D., and Kim and Marc Ramirez.

Barnard, M.D., also lectured at Henry Ford Hospital and Wayne State University School of Medicine, gave a presentation at the Community Health and Social Services Center, which serves Detroit’s underserved African-American and Latino populations, held a session for Physi-

cians Committee members at GreenSpace Café, and discussed his book The Cheese Trap on Detroit’s FOX affiliate. The program continued through August with Detroit residents participating in the 21-Day Vegan Kickstart. KickstartYourHealth.org

American Medical Association Calls for Healthier Foods in SNAP Program

THINKSTOCK

T

he American Medical Association adopted a resolution in June that calls on the federal government to improve the healthfulness of the Supplemental Nutrition Assistance Program, formerly known as Food Stamps. Physicians Committee president Neal Barnard, M.D., testified on behalf of the resolution. “Economically disadvantaged patients are at the highest risk for diabetes, obesity, and other serious problems. A big part of the solution ought to come from SNAP. One in seven Americans participates in SNAP, and if the program filled their grocery carts with vegetables, fruits, grains, and legumes, it would go a long way for health,” said Dr. Barnard in his testimony. “But SNAP retailers are paid dollar-for-dollar for candy, energy drinks, sausage, cheese, and other products no one needs.” Dr. Barnard and Yale University’s David Katz, M.D., recently edited the “The Supplemental Nutrition Assistance Program’s Neal Barnard, M.D. David Katz, M.D. Role in Addressing

Nutrition-Related Health Issues,” a special supplement of the American Journal of Preventive Medicine. In the supplement, Dr. Barnard recommended that SNAP incorporate a Healthy Staples program modeled after Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). SNAP would only reimburse retailers for selling healthful foods. They would stop profiting from selling their customers disease-causing junk foods. SNAP retailers would instead offer a range of healthful plant-based foods. PCRM.org/SNAP GOOD MEDICINE | AUTUMN 2017

17


MEMBER SUPPORT

CarbonWorks:

Music for the Animals

D

r. Barnard has been hosting unique musical evenings, showcasing his band CarbonWorks—featuring live performances, music videos, and presentations that make a connection between music and medicine. The songs and videos are, in many cases, a new channel for addressing animal issues in a very different way. His song “Louder than Words” has climbed to No. 13 on the National Radio Adult Contemporary Chart! The

most recent event was held in Nor- 19. Visit PCRM.org/Events to purchase folk, Va., and another special evening is tickets and to see a list of all upcoming scheduled in Washington, D.C., on Oct. events.

“I’d like to give more to help—I just don’t have the cash.”

I

f you’ve wanted to make a bigger gift but thought you couldn’t, you might be surprised by the lives you can save through these noncash gift options. Stock Transfers

When you transfer shares of appreciated stock directly to the Physicians Committee, you can make a bigger gift for less. For example, with a direct transfer of stock (rather than giving cash) you can make a $10,000 impact that “costs” just $6,000!

the withdrawal. To qualify, gifts must be made directly from a traditional IRA account by your IRA administrator to the Physicians Committee. Funds that are withdrawn by you first and then contributed do not qualify. Donor Advised Funds

Make the most of your investment in a community or private foundation by initiating grants each year. The Physicians Committee welcomes gifts made through donor advised funds and will work with fund administrators to provide all necessary details and reporting.

Everyone’s situation is different and for many supporters these noncash options are a great way to save more animal and human lives. Please note: these examples are for illustration purposes. We strongly recommend consulting with your own tax advisor to determine your best giving option. Gifts of $1,000 and more made by Dec. 31, 2017, are eligible for inclusion in the Annual Report listing. For assistance or more information on any of these giving options, please contact our membership office at 202-527-7304.

Direct transfer of stock

Donate cash

Gift amount

$10,000

$10,000

Make Your Mark on the Future

Income tax savings

$2,800

$2,800

 Please contact me about a gift that pays me income for life.

Capital gains tax avoided

$1,200

Total tax savings*

$4,000

 Please send me information about making a bequest.

$2,800

*Assumptions: 28% federal income tax bracket, $2,000 cost basis. Contact your own advisor when making financial decisions. Donate your IRA Distribution

18

AUTUMN 2017 | GOOD MEDICINE

NAME

ADDRESS

CITY

E-MAIL

STATE ZIP

PHONE

Please mail to Physicians Committee, Attn: Brandalyn Patton, 5100 Wisconsin Ave., NW, Ste. 400, Washington, DC 20016 or e-mail bpatton@pcrm.org.

GM17AT

If you are age 70½+, you may direct a portion or all of your required IRA annual distribution to support our lifesaving work. When you make a gift this way, you will not incur federal income tax on

 I have already named the Physicians Committee in my will or trust or as a beneficiary of a retirement account of life insurance. Please activate my Lifetime Partner status!


MEMBER SUPPORT

Passion for Compassion at Sublime

C

elebrate Valentine’s Day with us at Nanci Alexander’s world-famous Sublime restaurant in Fort Lauderdale. This fundraising event for the Physicians Committee will feature a presentation by Dr. Neal Barnard, sweet treats and champagne, and a shared “love” for helping create a better world for animals and people. Stay for a special

Valentine’s Day dinner at Sublime— dinner is on your own but your impossible-to-get dinner reservations are included in your fundraising event ticket. Buy tickets now at PCRM.org/Sublime or call 202-717-8762. Party bus will be available for transportation to and from the official Miami Holistic Holiday at Sea cruise hotel.

Member Profile: Ari Nessel

Intentional Acts of Kindness

P

hysicians Committee member Ari Nessel says that over time philanthropy becomes effortless. During a fundraising event that he and his wife, Rebecca, hosted for the Physicians Committee at their northern California home, he spoke to guests about the importance of giving back. “Building your giving muscle takes time and practice,” says Ari, who suggests taking a moment of self-reflection to recognize the intention behind your gift. “But every gift helps, and the good feeling you get when you help others is a gift to yourself.” He also shares a story on the importance of giving that he heard from the author John Robbins: “A teacher asks his students, ‘If I have $500, and in the course of my life I give away $400, how much do I have at the end of my life?’ The students eagerly answer $100. ‘That’s what you might think,’ says the teacher. ‘But the deeper truth is that if I have $500 here on Earth, and I give away $400, then at my death what I will have is $400. Because in the end, all you have is what you have given.’” Ari grew up with a mother who served the underprivileged, and he witnessed her deep concern for others and how she gave her time and support to help those

who were struggling. Ari, Rebecca, and their children continue her tradition of caring, making philanthropy a priority. “The plant-based food movement— and its beneficial effects on humans, animals, health, and the environment—is the most impactful cultural shift of our time,” Ari says about his support of the Physicians Committee’s work. “By focusing on areas that create big, systemic shifts, such as federal food policies, together we are addressing changes that will support sustainable practices for the future.” He says that giving money can go a long way toward inspiring others, but that giving can go beyond a financial donation. “Consider donating your ‘social capital’,” he suggests. “Amplify the impact of your support by inviting friends, family, community, and political leaders to learn about and support the issues you’re passionate about.” Ari will give the opening remarks at our Jan. 27, 2018, Leadership Summit in Los Angeles. For information on the event, please call 202-717-8762. GOOD MEDICINE | AUTUMN 2017

19


PhysiciansCommittee.org/Shop

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

20

AUTUMN 2017 | GOOD MEDICINE

the latest evidence-based information on nutrition’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 PCRM’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


PhysiciansCommittee.org/Shop

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

The Cheese Trap How Breaking a Surprising Addiction Will Help You Lose Weight, Gain Energy, and Get Healthy

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

On Sale

The Cheese Trap is a fascinating tour though all the things you never knew about America’s favorite addiction—and how to break free. If you’ve been looking to lose weight, tackle cholesterol, skin problems, headaches, joint pains, or respiratory troubles, or you just wanted to take an important step for the animals and the Earth, this is the place to begin. 320 pgs, $27.00 Special sale price: $14.00 For additional health tips, tune in to Dr. Barnard’s new PBS special, the “Energy Weight Loss Solution.” Power Foods for the Brain An Effective 3-Step Plan to Protect Your Mind and Strengthen Your Memory 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

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

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

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

Foods That Fight Pain

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

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

Turn Off the Fat Genes

GOOD MEDICINE | AUTUMN 2017

21


PCRM MARKETPLACE

PhysiciansCommittee.org/Shop

Eating Right for Cancer Survival dvd

The Get Healthy, Go Vegan Cookbook

Neal Barnard, M.D., Chef Sualua Tupolo, Stephanie Beine, R.D.

125 Easy and Delicious Recipes to Jump-Start Weight Loss and Help You Feel Great Neal Barnard, M.D., Robyn Webb

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

These recipes are based on Dr. Neal Barnard’s landmark two-year study, which shows that a vegan diet effectively controls type 2 diabetes. 248 pgs, $18.95

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

Unlocking the Power of Plant-based Nutrition dvd series

Many of Physicians Committee’s fact sheets are available for free download at:

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

PCRM.org/factsheets

Find more healthful resources at PCRM Marketplace Online PhysiciansCommittee.org/Shop

PCRM Marketplace Order Form (Please print.) SIZE

ITEM

(IF APPLICABLE)

QUANTITY

PRICE

SUBTOTAL

SHIPPING AND HANDLING CHARGES For orders shipped to more than one address, please add shipping for each additional address. Orders within the United States Shipping via U.S. Postal Service or UPS. For orders $1 to $20 = $5.75 For orders $20.01 to $40 = $7.50 For orders $40.01 to $70 = $10 For orders $70.01 to $100 = $13.50 For orders $100.01 to $200 = $15 For orders more than $200 = $20

NAME

SUBTOTAL

ADDRESS (Please include street address for UPS service.) CITY ZIP

SHIPPING AND HANDLING STATE

COUNTRY

SHIPPING CHARGE TO ADDITIONAL ADDRESSES

DATE DAYTIME PHONE

Send check or money order payable to PCRM or use your credit card. Sorry, no C.O.D.s. CARD NUMBER VISA

RESIDENTS OF CA, DC, MI, AND NY PLEASE ADD APPLICABLE SALES TAX.

MC

TOTAL (U.S. DOLLARS ONLY)

International and Express Shipping Orders: Shipping charges vary depending on country and/or express shipping method. Call for charges: 1-202-527-7306

Mail to:

PCRM Marketplace 5100 Wisconsin Ave. NW Suite 400 Washington, DC 20016 (Do not use the membership envelope in this issue.) Or call:

1-202-527-7306

9 a.m. – 5 p.m. (Eastern) Monday–Friday Or order online at:

EXPIRATION DATE

22 22

CARDHOLDER SIGNATURE

AUTUMN AUTUMN 2017 2017 || GOOD GOOD MEDICINE MEDICINE

PhysiciansCommittee.org


INFOGRAPHIC

Power Up

with Plant-Based Protein

Protein is an important nutrient required for the building, maintenance, and repair of body tissue. But many Americans get double the protein they need—often from animal products that are also packed with saturated fat and cholesterol. The good news is that eating a varied plant-based diet rich in vegetables, whole grains, legumes, nuts, and seeds will power you up with all the protein you need!

How much protein do you need? Multiply your weight (in pounds) by 0.36 to calculate the grams of protein you need per day. Example: 140 pounds x 0.36 = 50.4 grams of protein

= 50.2 grams Oatmeal, Fruit, Almonds, and Chia Seeds 12.8 grams

Vegetable Hummus Sandwich 14.4 grams

Brown Rice, Almond, and Chickpea Bowl 23 grams

= 50.9 grams Veggie Tofu Scramble with Toast 10.9 grams

Black Bean and Corn Salad 21 grams

Pasta Primavera with Lentils 19 grams

= 53.8 grams Blueberry Pancakes 7.7 grams

Lentil Soup and Hummus Sandwich 25.2 grams

Black Bean Fajitas with Brown Rice 20.9 grams GOOD MEDICINE | AUTUMN 2017

23


Non-Profit Org. U.S. Postage

PAID

Bolingbrook, IL Permit #491

5100 Wisconsin Ave., NW, Suite 400 Washington, DC 20016

PHYSICIAN PROFILE

Helping Patients and Physicians Get Healthy:

Michelle McMacken, M.D.

P

hysicians Committee member Michelle McMacken, M.D., adopted a vegan diet in 2007 and started incorporating plantbased nutrition into her medical practice in 2013. Below, Dr. McMacken, who is an assistant professor of medicine at the NYU School of Medicine and director of the Bellevue Hospital Weight Management Program, discusses teaching patients and physicians about the benefits of a plantbased diet. How has nutrition helped your patients? In a relatively short time, I’ve seen many patients avoid or decrease medications, prevent and reverse diabetes, dramatically lower their cholesterol levels, improve their blood pressure, lose excess weight, and reduce their cardiovascular and cancer risks by moving toward or fully adopting a plantbased diet. Even if a patient is not ready to make changes, I emphasize the idea that food has the power to transform health, and I keep checking back at future visits to assess readiness. Because I take care of a very diverse patient population, I’m always exploring ways to individualize my counseling across a variety of cultures, socioeconomic situations, and literacy levels.

What’s your advice to people who want to switch to a vegan diet but aren’t sure where to start? For people who are ready to start, I recommend online programs such as the 21Day Vegan Kickstart. For those interested in more gradual change, I suggest creating a list of plant-based foods and meals that the person already likes, and just working those into the rotation more regularly. These can be simple substitutions such as bean burritos instead of chicken burritos, or oatmeal with fruit instead of commercial breakfast cereal with dairy milk. As the person develops a routine, more and more plant foods can be added to “crowd out” the unhealthful foods, until the diet is mostly or fully plantbased. Another strategy is to work one meal at a time, building a repertoire of good meal options for breakfast, lunch, and dinner. Can you talk about your interest in educating health care providers and future health care providers about nutrition? I’m committed to spreading the message of nutrition beyond my exam room. Like most physicians, I received little training in nutrition. But in 2014, a colleague and I were awarded a small grant to study evidence-based nutrition and develop a curric-

address has changed, please let Please keep Ifusyour know promptly. AddressChanges@ in touch. PCRM.org or 202-686-2210, ext. 304. 24 AUTUMN 2017 | GOOD MEDICINE

Facebook.com/PCRM.org

ulum for our faculty and resident physician colleagues. It emphasized evidence-based dietary strategies for chronic disease prevention and included sessions on practical nutrition counseling skills for the primary care setting, as well as a cooking demonstration by a Physicians Committee Food for Life instructor. As a result of these sessions, many of our physician colleagues have reported increases in their nutrition-related knowledge and counseling skills, as well as changes in their own eating habits! We’ve also run sessions for medical students, nurses, and medical technicians at our hospital, including a 21-day plant-based challenge. Now our patients reap the benefits of this 360-degree nutrition training, learning about healthy eating from many different providers as they move through our system. What are your hopes for the future of medicine and health care? It is my hope that we can change the paradigm of health care from one that is reactive, largely treating symptoms and consequences of diseases, to one that emphasizes addressing chronic diseases at their root cause. Medications, procedures, and surgeries have an important role, but we can greatly reduce the burden of disease by giving our patients tools to make lifestyle changes, from individual counseling to educational support groups and coaching. Changes are needed at many levels, but educating physicians and medical trainees on evidence-based nutrition and lifestyle medicine is a key component. @PCRM

Instagram.com/PhysiciansCommittee

Pinterest.com/PCRMorg PRINTED ON RECYCLED PAPER

Good Medicine Autumn 2017