Diet and Disease

No illness which can be treated by diet should be treated by any other means.
Maimonides

There is now an increasing volume of evidence linking the way we eat with our physical and mental health, leading to a widespread and growing interest, among both medical professionals and the public at large, in applying diet as a solution to the modern health crisis.

There is no question that our health needs have changed over the last eighty years. At the turn of the century, the most important diseases in the United States were infectious diseases such as influenza, tuberculosis, and pneumonia. Since then, the incidence of infectious disease has declined. However, during the same time, the rate of chronic illnesses, such as cancer, heart disease, and diabetes, has risen substantially.

During the 20th century, a profound change took place in the way people eat, leading many to believe that modern dietary habits are the leading cause of the increase in chronic illness. That was the conclusion of the landmark report issued in 1977 by the Senate Select Committee on Nutrition and Human Needs, entitled Dietary Goals for the United States, and of reports issued by public health agencies around the world.

To date, more than a dozen international health organizations have issued reports that implicate the modern diet in the rise of chronic disease. Most of these reports make dietary recommendations aimed at prevention. There are signs that preventive dietary guidelines issued over the last decade are producing positive results. For example, the rate of heart disease in the United States and several other countries has declined somewhat over the past tell years. There is evidence supporting the view that this may be due to health conscious dietary changes.

Although many of us have had direct experience with degenerative illness-either personally or through family members or friends, we tend to think that on the whole, those of us in the affluent nations have the best medical care and the most abundant diet, and are thus healthier than ever before. Consider, however, that of the ten leading causes of death in the United States, six-heart disease, cancer, stroke, diabetes, cirrhosis of' the liver, and arteriosclerosis are degenerative diseases. These disorders are directly linked to diet. In 1977, about 75 percent of all deaths in the U.S. were from one of these causes, a clear indication that our population is not as healthy as we would like to believe, despite the increasing deployment of medical technology and the convenience of the modern food system.

It is commonly believed that this degenerative epidemic is due to our lengthened lifespan that the conquest of infectious diseases and consequent lowering of infant and child mortality, in other words, have actually allowed more people to grow older, and that more old people naturally means more degenerative disease. In fact, an increasing proportion of younger persons are suffering from chronic disease. Cancer, for example, is the number one cause of death, excepting accidents, of children under fifteen. According to the Summer 1978 issue of Working Papers, "The percentage of people under seventeen years old limited in activity due to chronic ailments nearly doubled from 1968 to 1974." Degenerative disease is not an old people's disease, nor is it a necessary result of gains in child survival rates. It affects all people, at all ages, in virtually all populations.

The Changing Modern Diet

Studies of overall patterns of food consumption during the 20th century reveal a number of interesting trends: (1) there has been a substantial increase in the intake of saturated fat and cholesterol, due largely to rising meat and poultry consumption; (2) there has been a substantial increase in consumption of refined sugar, resulting largely from the addition of sugar to processed foods and increasing soft drink consumption; (3) there has been a tremendous increase in the consumption of chemicals, additives, and preservatives, and a variety of artificial or highly fabricated foods; and (4) there has been a substantial decrease in the consumption of complex carbohydrate foods such as cereal grains, beans, and fresh local vegetables.

In the early part of the 20th century, Americans derived about 40 percent of their caloric energy from complex carbohydrates cereal grains, beans, and vegetables. This percentage has declined to less than 20 percent. Whole unrefined grains and grain products are practically nonexistent in the modern diet. At the same time, the consumption of fats and simple sugars has risen so that these items now comprise over 60 percent of the diet.

From 1889 to 1961, the ratio of complex to simple carbohydrate dropped more than three times. In 1976, the average person in the United States ate about 120 pounds of refined sugar compared to less than 40 pounds per person in 1875; an increase of over 300 percent. A large portion of the sugar consumed in the U.S. is eaten in processed foods and beverages, including soft drinks, canned foods, bread, candy, cake, ice cream, breakfast cereals, and others. Soft drink consumption doubled in the United States between 1960 and 1975, increasing from an average per-person intake of 13.6 gallons to 27.6 gallons. In 1975, the average person drank about 295 12-ounce cans of soda, containing 21.5 pounds of sugar.

In 1976, the average person ate nearly 165 pounds of red meat (pork. beef, mutton, veal). The rising popularity of beef is largely responsible for the overall increase in meat consumption. For example, in 1910, the average person ate about 55 pounds of beef. In 1970, this figure had risen to over 113 pounds.

These changes in diet parallel the rise of chronic illness in the 20th century. The connection between diet and disease becomes even more apparent when we review evidence linking diet arid cancer.

Cancer and Diet

Much of the scientific evidence linking cancer and diet has come from two sources: (1) epidemiological studies, such as those of overall cancer incidence and changing dietary patterns in the United States, Japan, and other countries; and (2) animal studies such as those which suggest that a restriction of caloric or protein intake has an inhibiting effect on the development of tumors.

Examples of the epidemiological links between diet and cancer are represented below.

The decline in cancer incidence in Holland following World War II food shortages. Between 1942 and 1946, the incidence of cancer in Holland dropped 35 to 60 percent, depending on the region of the country. A Dutch epidemiologist, Dr. F. De Waard, has correlated this decline with the changes in diet that occurred as a result of the German occupation of the Country. During the occupation, the Germans took most of the cheese, butter, milk, eggs, and meat in the country, leaving the Dutch to live on home-grown vegetables, bread, whole grain porridge, and other basic staples. With the return to normal conditions after the war, the cancer rate jumped back to its pre-war level.
Changes in cancer incidence among Japanese immigrants to the United States. The rates of colon and breast cancer in Japan have, until now, remained rather low, while the incidence of stomach cancer has been high. The opposite is true in the United States. Within three generations, however, Japanese immigrants in the U.S. shift from the cancer incidence patterns common in Japan to those common in the United States. This shift correlates with a change from the standard Japanese way of eating to the modern American one, with a corresponding increase in the intake of meat, chicken, cheese, and dairy food.
The worldwide correlation between meat and fat intake and a high incidence of breast and colon cancer. In countries where the intake of meat and animal fat is high, such as Scotland, Canada, and the United States, the mortality rates from colon and breast cancer are high. Countries such as Japan and Chile, where meat and fat consumption are low, have correspondingly low incidences of these diseases.

The difference between the high incidence of these illnesses in the United States and their low incidence in Japan is consistent with the differences in fat intake between these two countries, and correlates with the increase in the incidence of colon cancer in Japanese migrants to the United States following their adoption of Western dietary habits.

Evidence from specific population groups in the United States reinforces the connection between fat consumption and cancer. Groups such as the Seventh Day Adventists, who generally follow a semi-vegetarian regime with a limited fat and meat intake, have a much lower rate of some forms of cancer, especially breast and colon. These diseases have been found to correlate with a low intake of cereal grains which contain dietary fiber. For example, certain African populations who, like the Japanese, have a low-fat, high-fiber regimen, have been found to have correspondingly low incidences of colon cancer. The same appears true for the Seventh Day Adventists.

The correlation between the incidence of breast and colon cancer in the United States and increasing consumption of meat and saturated fat, and the declining consumption of grains. The rising incidence of' these illnesses correlates with significant changes in the American diet since 1900, especially the rising consumption of meat and saturated fat. and the declining consumption of grains and their products.
The increasing incidence of breast and colon cancer in Japan following the Westernization of the Japanese diet. The rising consumption of milk and milk products. meat, eggs, oil, and fat that has occurred in Japan since World War II correlates with an increase in the incidences of breast and colon cancer over the past several decades. According to the National Cancer Institute, this increase is "consistent with the Westernization of the Japanese diet during recent decades, particularly with an increased intake of fat."

While epidemiological evidence has been accumulating, animal studies have reinforced the link between cancer and diet. Examples quoted below are from the 1977 Status Report of the Diet, Nutrition, and Cancer Program of the National Cancer Institute.

Studies showing that a restriction of calories inhibits the development of tumors. A number of animal studies have shown that of all dietary modifications tried so far, the restriction of food intake has had the most regular influence on the development of tumors. A restriction in overall caloric intake has been regularly found to inhibit the formation of tumors and increase of expectancy of experimental animals. Similar trials have shown that among rats fed identical diets, the incidence of tumors is consistently higher in heavier animals.
Studies showing a higher incidence of tumors in animals fed high-protein diets. According to the NCI report, a lower protein intake inhibits the development of spontaneous or chemically induced tumors. Comparisons of a 5 percent and a 20 percent casein diet on aflatoxin induced tumors showed rats on the higher protein diet had a 50 percent greater incidence of cancer. All of the high protein rats developed tumors or precancerous lesions, while those on the lower protein diet had no tumors or precancerous lesions.
Studies showing a relationship between a high-fat diet and higher incidence of breast and colon cancer. A number of studies have shown that an increase in the amount of' fat in animal diets produces an increase in the incidence of certain cancers, and that the cancers tend to develop earlier in the life of the animal. According to the NCI report, "Tannenbaum has shown that an increase from 25 percent to 28 percent fat in the diet of mice results in a double incidence of spontaneous mammary cancers."
Studies suggesting that a natural foods diet contains "protective factors" against cancer. In one group of studies mentioned in the NCI report, irradiated mice consuming a natural foods diet had a markedly lower incidence of tumors than similar mice receiving a highly refined diet. According to the report, these studies suggest "the presence of a protective factor in natural food diets."

Cancer Recoveries

Together with scientific evidence, a small but significant number of case histories amid personal accounts have been gathered and publicized, pointing to the use of the macrobiotic diet in the prevention and control of cancer and other chronic illnesses. Although much of' the evidence is anecdotal, and has come from outside the realm of official research, many of these accounts begin to seem plausible when considered together with mounting scientific evidence linking diet and cancer.

Since 1975, the East West Foundation has compiled and published case histories, which show that a balanced macrobiotic diet can aid in the recovery from cancer. These published case histories (such as those in the book Cancer-Free, Japan Publications. 1992) represent only a small number of the thousands of similar experiences that have yet to be documented and published.

Toward a Preventive Nutrition

As we saw in our study of changing dietary patterns in the United States, the modern diet has become much more extreme. Overall consumption of humanity's traditional, centrally balanced staples whole grains, beans, and fresh local vegetables has declined, while more extreme foods, such as meat and sugar, chicken and tropical fruit, eggs and chocolate, have become the mainstay of the diet. The modern shift in dietary patterns has had a disastrous effect on human health, and is the underlying cause of the rise of degenerative illness in the 20th century. Regardless of whether we approach the modern decline in health from the more traditional, macrobiotic perspective, or through modern epidemiological studies, our conclusion is similar. In order to secure health, both individually and as a society, we must return to a more naturally balanced way of eating in harmony with our environment and with our dietary traditions.

Source: This essay is from an article entitled, Diet and Disease: An Overview, published in Cancer and Diet, East West Foundation, Boston, Mass., 1980.