"There are no studies that prove the benefits of nutritional or integrative therapies..."

It's a refrain that I hear time and time again. And I hear it from my colleagues. But they couldn't be more wrong! They just have not done their homework -- or perhaps they are reading the wrong medical journals. One of my favorite medical journals is the "American Journal of Clinical Nutrition," which every month publishes more than 300 pages of research with NO ADVERTISING.

This is very unlike my other medical journals -- such as the "Journal of the American Medical Association" or "The New England Journal of Medicine" -- which have pages and pages of color glossy drug ads. So today, I thought I would take you on a journey through just one issue of the "American Journal of Clinical Nutrition" to see just how much research is being done on how food and nutrients affect our health.

The sad thing is that it can take 20 years before this knowledge becomes commonplace or used in medical practice. Unfortunately, there is little money available for large-scale studies or to publicize the findings of the role of nutrients and food in health and disease. Unlike in the pharmaceutical industry, there are no "food reps" that drop off food samples in doctor's offices. Except perhaps in my case!

You see, I have been sent walnuts, whole-food bars, wild salmon, and even whole-kernel rye bread from Germany -- all of which I like much better than the pens and cups and Post-it notes with drug names all over them. And I certainly like these better than the "free" drug samples I'm sent that are meant to get my patients hooked on the latest and most expensive (though not necessarily the best) medications.

Advertising medications directly to patients used to be illegal. They still are in Canada and the European Union. But, boy, have things changed! Since "direct-to-consumer" advertising has been allowed in the United States, we have seen dramatic increases in the use of those drugs. In fact, when a person sees an ad for a drug on TV and then asks their doctor for it, they are likely to get it about 50 percent of the time. Just look at the numbers.

According to a recent article in "The New England Journal of Medicine," pharmaceutical advertising and promotion grew from $11.4 billion in 1996 to $29.9 billion in 2005 -- and direct- to-consumer ads grew by 330 percent! (1) I can assure you that NO ONE is spending $30 billion promoting the benefits of food and nutrients to support health and cure disease, even if they are more effective. You don't hear about the best or most effective treatments, just the ones that are most heavily promoted.

Now let's get back to the nutrition journal and a sampling of the types of research out there that demonstrate the healing power of food. These are all from the May 2007 issue (I am a little behind on my reading!). The most important study in that journal was on nutrigenomics -- the foundational concept of my book UltraMetabolism. The basic idea is that food is information, not just calories. In this study, researchers from Finland took two groups people with metabolic syndrome (pre-diabetes) and gave each group a different diet. Well, sort of. It was different ONLY in the type of carbohydrates they consumed for 12 weeks. The rest of their diet was identical -- the same calories and the same amount of fat, protein, carbohydrate, and fiber.

The first group had wheat, oats, and potatoes as the source of their carbs. The second group ate rye as their source of carbohydrate. (As I mentioned in my book, UltraMetabolism, rye has some very special properties because it is slowly absorbed by the body and has phytonutrients that help you lose weight and improve metabolism.) After the 12 weeks, the researchers took a fat sample or biopsy and analyzed it to find out which genes were turned on or off. So what happened?

In the wheat, oat, and potato group, 62 genes were activated that increased inflammation, oxidative stress, and the stress response, worsened blood sugar balance, and generally amplified all of the forces in the body that lead to obesity, heart disease, cancer, diabetes, and Alzheimer's disease! It was a 100 percent effect -- NO good genes were turned on. In the rye group, 71 genes were turned on that prevent diabetes, lower cholesterol, reduce inflammation, and improve blood sugar control. This was a 100 percent GOOD gene effect. (2) Now that should have been headline news -- but the rye lobby is just not that powerful!

In fact, in an accompanying editorial called "Putting your genes on a diet: the molecular effects of carbohydrate," Harvard researcher David Ludwig, MD, PhD, wrote that "Molecular pathways involved in hormone action have been the target of a multi-billion dollar pharmaceutical research effort. However, many of these pathways may normally be under dietary regulation." (3) If there were a drug that could turn off all the disease-promoting genes and could turn on all the health-promoting, anti-aging genes, it would be a blockbuster.

But you don't see ads on TV telling you to eat more whole-kernel rye bread! Findings from a few other key studies from just that one issue are worth noting:
-- Supplementing with conjugated linoleic acid (a special fat from meat and dairy fats) caused a modest loss in body fat. It also may prevent cancer, heart disease, and inflammation.

-- Long-term fish consumption protects against arrhythmia or irregular heart beats.

-- Eating a diet high in monounsaturated fats from olive oil can help reduce blood pressure while a high refined-carbohydrate diet can increase blood pressure.

-- Combining fish oil supplements with regular aerobic exercise helps improve body composition and reduce heart disease risk factors (lower triglycerides, higher HDL).

-- Women need more choline (a nutrient that is needed for cell membrane formation and to make the neurotransmitter acetylcholine necessary for brain function) after menopause or are at risk of liver and muscle damage.

--If women with HIV are given a multivitamin, they have less anemia and their children also have less anemia. Anemia in HIV is associated with a much faster rate of disease progression and death.

-- In Bangladesh, where arsenic poisoning is common, giving folate, vitamins B12 and B6, choline, and niacin reduced the toxic effects of arsenic.

-- People who eat more meat and saturated fat have a higher risk of skin cancer. And those are just from May!

The June 2007 issue, which I am just getting through, has a fantastic randomized controlled study of calcium and vitamin D, which shows that those nutrients substantially reduce risk for all cancers and that the blood level of vitamin D is the most important predictor of decreased risk. So what are we to learn from all these studies? This is just a smattering of the research out there -- only a few out of the many in that one issue alone. And it is stuff you are not hearing about. So if you hear from your doctor that eating better and taking supplements has no "real" scientific evidence to support it, ask them if they have read the "American Journal of Clinical Nutrition" lately.

It is also interesting to note that the main medical journals publish mostly positive studies on drugs and mostly negative studies on nutrients, foods, and herbs. And the findings correlate 4 to 1 for a positive outcome for a drug if the study was funded by the drug company. The same is true for nutrients. Dr. David Ludwig published a study that showed that if a food company or industry, like dairy, for example, funded a study, there was a zero percent chance that the outcome was unfavorable for the funder. But if it was independently funded, the negative outcomes were about 40 percent. (4) That is exactly what happened in another study I saw on the effects of high fructose corn syrup. It showed no adverse effects -- and was funded by the American Beverage Association.

Surprise!

So I encourage you all to beware when someone tells you there is no research to back up the use of food or nutrients as the primary mode of treatment of disease and prevention of chronic illness. The evidence is overwhelming -- just ignored.

To your good health,

Mark Hyman, M.D.


(1) Donohue JM, Cevasco M, Rosenthal MB. A decade of
direct-to-consumer advertising of prescription drugs.
(2) Kallio P, Kolehmainen M, Laaksonen DE, Kekalainen J, Salopuro T,
Sivenius K, Pulkkinen L, Mykkanen HM, Niskanen L, Uusitupa M, Poutanen
KS. Dietary carbohydrate modification induces alterations in gene
expression in abdominal subcutaneous adipose tissue in persons with
the metabolic syndrome: the FUNGENUT Study. Am J Clin Nutr. 2007
May;85(5):1417-27.
(3) Salsberg SL, Ludwig DS. Putting your genes on a diet: the
molecular effects of carbohydrate.
Am J Clin Nutr. 2007 May;85(5):1169-70.
(4) Lesser LI, Ebbeling CB, Goozner M, Wypij D, Ludwig DS.
Relationship between funding source and conclusion among
nutrition-related scientific articles.
PLoS Med. 2007 Jan;4(1):e5