You may not rob yourself of your life nor cause your body the slightest injury….Only if the body is healthy is it an efficient instrument for the spirit’s activity….Therefore you should avoid everything which might possibly impair your health….And the law asks you to be even more circumspect in avoiding danger to life and limb than in the avoidance of other transgressions.—Rabbi Samson Raphael Hirsch1
HEALTH CARE ISSUES ARE CLEARLY AMONG THE MOST critical facing many countries today. National health care costs in the United States have been soaring, increasing from six percent of the United States gross national product in 1970 to about fifteen percent in 2000. Efforts to reduce medical expenditures have caused major changes in the U.S. health care system, with treatment decisions often made for economic rather than medical reasons. Over forty-three million Americans lack adequate health insurance. Costs of prescription drugs have soared. In spite of billions of dollars spent on medical research, degenerative diseases still afflict many people.
Most doctors today focus on the treatment of diseases rather than on their prevention. Medical schools primarily teach that prescription drugs are the most powerful tools doctors have for treating disease. Diet and other lifestyle changes are almost never emphasized as preventive tools. Once a doctor enters medical practice the drug message is reinforced: drug companies give out free samples; virtually all the advertisements in medical journals are for prescription drugs; the bulk of medical literature relates to the use of drugs and drug comparisons. Hence, the most common response to many diseases today is to prescribe medications first and perhaps recommend lifestyle changes as an afterthought.
Judaism’s historical approach is fundamentally different from the approaches of most physicians today.2 While treating sick people is certainly a Torah obligation, Judaism puts a priority on the prevention of disease.
The foundation for the Jewish stress on preventive medicine can be found in the verse in the Torah in which God is described as the rofeh (healer) of the Israelites:
And God said: “If you will diligently hearken to the voice of the Lord your God, and will do that which is right in His sight, and will give ear to His commandments, and keep all His statutes, I will put none of the diseases upon you which I put on the Egyptians; for I, the Lord, am your healer.” (Exodus 15:26)
Rashi interprets this verse:
I, the Lord, am your healer, and I teach you the Torah and the commandments in order that you may be saved from these diseases—like a physician who says to a person: “Do not eat this thing lest it bring you into danger from this illness.”
What are the implications of this Torah approach for modern medicine? Just as God’s healing role in this Torah verse above is to prevent illness, so, too, a physician must emulate the Divine role by emphasizing the prevention of illness. For we are obligated to “follow in God’s ways” (Deuteronomy 11:22).3
The following anecdote about Maimonides is instructive:
During the period when Maimonides served as the royal physician to the Sultan of Egypt, the Sultan never became ill. One day the Sultan asked Maimonides, possibly in jest, “How do I know that you are an expert physician, since during the period that you have been here, I have never been ill, and you have not had the opportunity to test your skills?” Maimonides replied, “In truth, the great and faithful physician is the Holy One, Blessed be He, as it is written, ‘I, the Lord, am your healer.’ And this Great and Faithful Physician was able to promise His people that because He is their Physician, He will be able to protect them from all the illnesses that were inflicted on Egypt.” Maimonides concluded, “Therefore, we learn that the ability of a physician to prevent illness is a greater proof of his skill than his ability to cure someone who is already ill.”4
The Torah imposes another moral obligation which might impel physicians to practice preventive medicine: “Do not stand idly by the blood of your neighbor” (Leviticus 19:16). One must not remain passive if another person is in danger. For example, the sages indicate, if someone sees a person drowning or being attacked by robbers, he or she should do everything possible (short of seriously endangering oneself) to rescue the person.5 Based on this verse, the Chafetz Chaim taught in his classic work Shemirat HaLashon that one must not withhold information that can save another from death or any type of injury. The following Talmudic teaching reinforces this principle: “Those who have the capacity to eliminate a wrong and do not do so bear the responsibility for its consequences.”6 Accordingly, it would seem that the Jewish approach is that physicians should emphasize preventive medicine, advising their patients about the dangers of smoking and animal-based diets and the benefits of positive lifestyle choices.
The Torah does not place the entire responsibility for maintaining good health on physicians. In fact, the Talmudic sages place the major responsibility on the individual. To take care of one’s health is a mitzvah, and the sages find this mandate in the words, “take heed to yourself and take care of your lives,” (Deuteronomy 4:9) and, “be extremely protective of your lives.” (Deuteronomy 4:15).
Judaism regards the preservation of physical well-being as a crucial religious commandment. Jews must take care of their health and do nothing that might unnecessarily endanger themselves. Life is regarded as a very great value and we are obligated to protect it.
A vital Jewish principle is pikuach nefesh, the duty to preserve a human life. The Talmudic sages applied the principle—“You shall therefore keep my statutes and ordinances, which if a man do he shall live by them” (Leviticus 18:5)—to all the laws of the Torah. Hence, Jews are commanded to be more cautious about matters concerning danger to health and life than about ritual matters.7 If it might save a life, one is obligated to violate the Sabbath, eat forbidden foods, and even eat on Yom Kippur.8 The only laws that may not be violated to preserve a life are those prohibiting murder, idolatry, and sexual immorality.9
Maimonides summarizes the importance that Judaism places on the preservation of health:
Since maintaining a healthy and sound body is among the ways of God—for one cannot understand or have any knowledge of the Creator if he is ill—therefore one must avoid that which harms the body and accustom oneself to that which is helpful and helps the body become stronger.10
Rabbi Hirsch writes passionately about the importance of preserving health in his classic book, Horeb: “Limiting our arrogance toward our own body, God’s word calls to us: ‘Do not commit suicide!’ ‘Do not injure yourself!’ ‘Do not ruin yourself!’ ‘Do not weaken yourself!’ ‘Preserve yourself!’ ”11
Although their primary purpose may be spiritual purification, many Torah commandments promote proper hygiene and good health. Hygienic living and prevention of disease are religious mandates designed for the preservation and well-being of the community. For example, to keep the Israelites’ camps clean, latrines were established outside their bounds, and soldiers were equipped with spades with which they were to dig holes and bury their excrement (Deuteronomy 23: 13–15). Lepers and others who might spread serious diseases were excluded from the camp for specific quarantine periods (Leviticus 15:1–15; Numbers 5:1–4).
The rabbis also emphasized the importance of public measures to protect health. The Talmud states that no tannery, grave, or carcass may be placed close to a human dwelling,12 and stresses that streets and market areas are to be kept clean.13 The sages declare it forbidden for a scholar to reside in a city that does not contain a public bath.14
The rabbis regard the human body as a sanctuary.15 They give much advice on types of food conducive to good health16 and stress the importance of regular nutritious meals.17 They mandate that one must wash one’s face, hands, and feet daily in honor of one’s Creator,18 as well as wash one’s hands on specific occasions, including after urination and/or defecation.19 It is an especially important mitzvah to ritually wash hands before eating a meal.20
The seriousness with which the rabbis regard proper individual hygiene for the preservation of health is illustrated by this anecdote from the life of the sage Hillel:
Once when Hillel was leaving his disciples, they said to him: “Master, where are you going?” He replied: “To do a pious deed.” They asked: “What may that be?” He replied: “To take a bath.” They asked: “Is that a pious deed?” He replied: “Yes. If, in the Roman theaters and circuses, the images of the king must be kept clean by the man to whom they have been entrusted, how much more is it a duty of man to care for the body, since man has been created in the Divine image and likeness.”21
The Torah, Talmud, and codes of Jewish Law stress the avoidance of danger through the positive commandment of making a parapet (guard rail) for one’s roof so that no one will fall from the roof (Deuteronomy 22:8). Rabbi J. H. Hertz, in his commentary on this commandment, states that failure to protect human life renders one guilty in God’s eyes of the spilling of blood.22 The Talmudic sages extend this prohibition to cover all cases where negligence endangers life, such as placing a broken ladder against a wall or keeping a dangerous dog.23
In his classic legal code, the Mishneh Torah, Maimonides describes a variety of prohibitions, all based on the necessity to do everything possible to preserve human life:
It makes no difference whether it be one’s roof or anything else that is dangerous and might possibly be a stumbling block to someone and cause his death—for example, if one has a well or a pit, with or without water, in his yard, the owner is obliged to build an enclosing wall ten hand breadths high, or else to put a cover over it lest someone fall into it and be killed. Similarly, regarding any obstacle which is dangerous to life, there is a positive commandment to remove it and to beware of it, and to be particularly careful in this matter, for Scripture says, “Take heed unto yourself and take care of your life” (Deuteronomy 4:9). If one does not remove dangerous obstacles but allows them to remain, he disregards a positive commandment and transgresses the prohibition: “Bring not blood” (Deuteronomy 22:8).
Many things are forbidden by the Sages because they are dangerous to life. If one disregards any of these and says, “If I want to put myself in danger, what concern is it of others?” or “I am not particular about such things,” he must be prevented from such behavior.
The following are prohibited acts: One may not put his mouth to a flowing pipe of water and drink from it, or drink at night from rivers or ponds, lest he swallow a leech while unable to see. Nor may one drink water that has been left uncovered, lest he drink from it after a snake or other poisonous reptile has drunk from it, and die.24
Maimonides’ statements clearly indicate that Judaism absolutely prohibits the placing of one’s health or life in possible danger. He disallows the popular rationalization, “What concern is it to others if I endanger myself?”
Similar prohibitions against endangering one’s life appear in the Shulchan Aruch of Rabbi Joseph Caro (1488–1575) and other Codes of Jewish Law.25 In Choshen Mishpat 427, Rabbi Caro devotes an entire chapter to “the positive commandment to remove any object or obstacle which constitutes a danger to life.” In his commentary on Caro’s Shulchan Aruch, Rabbi Moses Isserles (the Rema) concludes:
One should avoid all things that might lead to danger because one is obligated to be stricter about danger to life than about a prohibition. Therefore, the Sages prohibited walking in a place of danger such as near a leaning wall [for fear of collapse], or alone at night [for fear of robbers]. They also prohibited drinking water from rivers at night…because these things may lead to danger…and one who is concerned with his health [literally: watches his soul] avoids them. And it is prohibited to rely on a miracle or to put one’s life in danger by any of the aforementioned or the like.26
The Talmud relates that Rabbi Huna would personally inspect all the walls of his town of Sura before the onset of the winter storms. Any walls that he found unsafe, he would order torn down. If the owner could not afford to rebuild the wall, Rabbi Huna would pay for it from his own funds.27
Life is considered so sacred in Judaism that the tradition asserts that “if a person saves one life, it is as if he [or she] saved an entire world.”28 The preservation of human life is so important that it takes precedence over acts of reverence for a dead person, even if that person is a leader or great hero: “For a one-day-old child [who is dangerously ill], the Sabbath may be profaned; for David, King of Israel, once he is dead, the Sabbath must not be profaned.”29 Also, one must sooner rescue from flames any living infant than the dead body of one’s own parent.30 As will be discussed in detail in Chapter 5, the Jewish sages prohibit the unnecessary destruction of anything of value. This prohibition is extended to include the intentional destruction of any part of one’s own body by Rabbi Israel Lipshutz, (d. 1782), author of the mishnaic commentary Tifereth Yisrael.31
People rationalize and justify continuing dangerous habits, such as smoking. But Jewish tradition rejects all such defenses in the name of pikuach nefesh, the requirement to preserve human life.32 If it can be clearly and convincingly shown that consuming is dangerous to people’s health, it would be prohibited by Jewish law. As the following sections demonstrate, there are strong indications that this is indeed the case.
Results When People Have Lived Under Vegetarian Diets
During World War I, Denmark was cut off from its meat supply because of a blockade by the Allied forces. To avoid acute food shortages, the government sought the aid of Denmark’s vegetarian society for advce about nutritious alternate foods. Dr. Mikkel Hindhede writes about the results in the Journal of the American Medical Association. He points out that only the wealthy could afford to buy meat, and most of the population ate bran, bread, barley, porridge, potatoes, greens, milk, and some butter.33 This primarily vegetarian diet led to better health and reduced mortality rates (by seventeen percent) for the Danish people during the first year of the new diet.34
Similarly in Norway when food rationing was instituted during World War II and the consumption of meat was sharply cut, health improved. With this primarily vegetarian diet, the Norwegian death rate dropped from thirty-one per 10,000 people in 1938 to about twenty per 10,000 people in 1944 (a thirty-six percent decrease).35 After the war, when the prewar diets resumed, the mortality rate rose sharply, reaching twenty-six per 10,000 people in 1946.36
Unlike the short wartime experiences of the Danes and Norwegians, the Seventh Day Adventist churches have followed a vegetarian diet for over 100 years. Many Adventists also abstain from smoking, alcohol, coffee, tea, spices, hot condiments, and highly refined foods. A study of their health shows that colonic, rectal, and intestinal cancer are fifty to seventy percent lower than in the general population.37 In another study, Seventh Day Adventist women, about half of whom were vegetarian, had lower blood pressure and forty percent less endometrial cancer than women in the general population.38 An Australian study found the blood pressures of Seventh Day Adventist vegetarians between thirty and seventy-nine years of age to be “significantly less” than the levels found in non-vegetarian control groups.39 The study concluded that dietary factors, probably intake of animal protein, animal fat, or other dietary components associated with them, were likely responsible for the differences in blood pressure readings.40
After studying the mainly vegetarian diet of the Hunzas of Kashmir, noted for their longevity, Major General Sir Robert McCarrison, once physician to the king of England, wrote: “I never saw a case of asthenic dyspepsia, of gastric or duodenal ulcer, of appendicitis, or mucus colitis or cancer.”41 Dr. Paul Dudley White, the famous heart specialist, visited the Hunzas in 1964. His studies showed that the ninety and 110-year-old men tested showed no evidence of heart disease and that there was a correlation between their diet and lifestyles and the low incidence of heart disease.42
The Bible contains an interesting case of people eating only vegetarian foods. The Book of Daniel tells how Daniel and his three companions were captives in the court of Nebuchadnezzar, king of Babylon. They refused to defile themselves with the king’s meat and wine, which were not kosher. The king’s servant was fearful that their health would suffer and the king would blame him. But Daniel said: “For ten days, give us pulse (peas, beans, and lentils) to eat and water to drink. Then look at our countenances, and the countenance of those children that eat of the portion of the king’s meat; and as you observe (the differences), deal with your servants.” The king’s servant consented to wait the period and “at the end of the ten days their countenances appeared fairer and fatter in flesh than all the children who did eat the portion of the king’s meat.” The king’s servant then took away from the others their meat and wine and fed them also pulse and water (Daniel 1:8–16).
Connections Between Diet and Health
Comprehensive discussions of health issues and their relation to diet may be found in The Power of Your Plate by Neal D. Barnard, M.D., McDougall’s Medicine: A Challenging Second Opinion by John McDougall, M.D., and MegaHealth by Marc Sorensen, Ed.D. Graphs and charts connecting nutrition to health and illness can be found in the The Scientific Basis of Vegetarianism by William Harris, M.D. These books provide many primary sources from established medical journals. The Physicians Committee For Responsible Medicine (PCRM) has documented information about the relations between diet and disease. The tremendously important message documented in these sources is that vegetarian diets can help prevent, and in some cases reverse, a wide variety of degenerative diseases and medical problems that have been strongly linked to the consumption of animal products, including: arthritis; asthma; breast cancer; colon cancer; constipation; diabetes; diverticulosis; gallstones; heart disease; hemorrhoids; hypertension; hypoglycemia; impotence; kidney disease; obesity; osteoporosis; peptic ulcers; prostate cancer; salmonellosis; and strokes. Readers are urged to consult the sources mentioned above and other sources in the annotated Bibliography for more information on health issues. Additional information on nutrition and health appears later in some of the questions and answers in Chapter 8.
Because of the abundance of documented evidence in these books and other sources, and because of space limitations, this book does not focus on dietary connections to each disease. Rather it focuses on issues not generally discussed, including:
1. The position on nutrition and health of the American Dietetic Association;
2. The Cornell/China/Oxford Study, perhaps the largest epidemio- logical study in history;
3. Studies led by Dean Ornish, M.D. that show that heart disease may be reversed without surgery or medical drugs;
4. A book by a veteran breast cancer surgeon who believes many scientific studies show that the risk of contracting breast cancer (and, by implication, other diseases) can be sharply reduced;
5. The negative health effects of the overuse of antibiotics in medicine and in animal feed.
Position of The American Dietetic Association: Vegetarian Diets
The following information from the “Position of the American Dietetic Association: Vegetarian Diets” (Journal of the American Dietetic Association (ADA), November, 1997, Volume 97, Number 11) indicates that a well planned vegetarian diet is not only nutritionally adequate, but can reduce the risk of many diseases. A summary of the position follows:
Scientific data suggest positive relationships between a vegetarian diet and reduced risk for several chronic degenerative diseases and conditions, including obesity, coronary artery disease, hypertension, diabetes mellitus, and some types of cancer. Vegetarian diets, like all diets, need to be planned appropriately to be nutritionally adequate.
It is the position of the American Dietetic Association (ADA) that appropriately planned vegetarian diets are healthful, are nutritionally adequate, and provide health benefits in the prevention and treatment of certain diseases.
Among the many other positive statements the ADA 1997 position paper makes about connections between plant-based diets and health are the following (they cite appropriate peer-reviewed scientific articles in each case):
1. Studies indicate that vegetarians often have lower morbidity and mortality rates from several chronic degenerative diseases than do non- vegetarians. Although non-dietary factors, including physical activity and abstinence from smoking and alcohol, may play a role, diet is clearly a contributing factor.
2. Vegetarian diets offer disease protection benefits because of their lower saturated fat, cholesterol, and animal protein content and often higher concentration of folate (which reduces serum homocysteine levels), antioxidants such as vitamins C and E, carotenoids, and phytochemicals.
3. Not only is mortality from coronary artery disease lower in vegetarians than in non-vegetarians, but vegetarian diets have also been successful as part of comprehensive health programs to reverse severe coronary artery disease.
4. Vegetarians tend to have a lower incidence of hypertension than non-vegetarians.
5. Type 2 diabetes mellitus is much less likely to be a cause of death in vegetarians than non-vegetarians.
6. Incidence of lung and colorectal cancer is lower in vegetarians than in non-vegetarians. Reduced colorectal cancer risk is associated with increased consumption of fiber, vegetables, and fruit.
7. Plant sources of protein alone can provide adequate amounts of essential amino acids if a variety of plant foods are consumed and energy needs are met.
Recent Major Health Studies
There have been two major health studies that have the potential to radically affect medical practice. They dramatically show how dietary changes and other lifestyle changes can prevent and in some cases reverse diseases.
A major ongoing health study is the “Cornell/China/Oxford Study,” a collaborative effort between Cornell University, represented by T. Colin Campbell, Ph.D., the Chinese Academy of Preventive Medicine, the Chinese Academy of Medical Sciences, and Oxford University, England, as well as scientists from the United States, Britain, France, and other countries. It is an epidemiological study that has looked at the eating habits and diseases of 6,500 people in 65 Chinese provinces. The summary below is based on material in The China Project: Keys to Better Health, Discovered in Our Living Laboratory, by T. Colin Campbell, Ph.D. and Christine Cox (see the Bibliography).
The China Project differs from other scientific studies in several important ways:
1. It utilizes the most comprehensive database on the multiple causes of disease ever compiled; the Chinese government provided background data on eighty million Chinese people.
2. It examines relationships between health and diet in a holistic way, by considering ways in which complete diets and other lifestyle patterns affect health. By contrast, most contemporary studies focus on relationships between single nutrients or foods and single diseases.
3. China provided a “natural (living) laboratory” for the study of nutrition and disease that is unmatched anywhere else in the world; while people in most of the world’s countries frequently change their places of residence, and eat foods from many different regions of the world, most Chinese live their entire lives in one area, and eat the same kinds of locally grown food throughout their lives. Yet, diets (and disease rates) vary sharply from one area to another.
The China Project has received much critical acclaim. Jane Brody, nutrition editor of the New York Times, has called it “the grand prix” of epidemiology, and has hailed its “tantalizing findings” from “the most comprehensive large study ever undertaken of the relationship between diet and the risk of developing disease.” The East West Journal has called the study “one of the most rigorous and conclusive [studies] in the history of health research,” one that has “unprecedented authority.”
Here are some of the “tantalizing findings” that can (and should) have a global impact:
1. The Chinese diet, composed primarily of rice and other grains, vegetables, and legumes, such as soy products, is far healthier than the standard American diet. While Americans get an average of thirty-seven percent of their calories from fat, Chinese get an average of 14.5 percent, with a range of about six percent to twenty-four percent. The Chinese get only ten percent of their protein from animal sources, while Americans get seventy percent. One result of the healthier Chinese diets is that the range of cholesterol levels in China vary from seventy mg to 170 mg, while in the United States, the average cholesterol level is over 200.
2. In China, regions in which people eat the most animal products have the highest rates of heart disease, cancer, and other degenerative diseases. In many cases, the differences are extremely large; for example, in one part of China where people eat more meat, the rate of esophageal cancer for men is 435 times greater than the rate for men in another region, and twenty times as many women in one county with high meat consumption suffer from breast cancer as women in another county where meat consumption is much lower.
3. Degenerative diseases are associated with high levels of blood cholesterol and urea nitrogen (what is left over after the metabolism of protein in the body), and both of these factors increase as people eat more meat, dairy products, and eggs.
4. The more a diet is composed of foods of plant origin, the better. Even small increases in the amount of animal products (meat, eggs, and dairy products) consumed result in significant increases in chronic degenerative diseases.
5. Because cholesterol levels in the United States are almost double those in China, heart disease deaths among American men occur seventeen times more often, per thousand men, than for Chinese men. Also, Chinese at the lower end of the cholesterol range have significantly less cancer and heart disease than those at the upper end.
6. Deaths from breast cancer are linkd to five factors associated with diets high in animal-based foods: high intakes of dietary fat, high levels of blood cholesterol, high amounts of estrogen, high levels of blood testosterone, and early age at first menstruation. The Chinese’s plant- based diets give them benefits in each of these areas. For example, Chinese girls reach menstruation when they are fifteen to nineteen years of age, significantly later than the ten to fourteen years of age for most American girls.
7. Chinese eat very few dairy products, and low levels of calcium-rich foods; yet they get far less osteoporosis than Westerners. For example, hip fractures per thousand people in China are only one-fifth of what they are in the West. (As will be discussed in more detail in Chapter 8, the reason is that excessive animal protein causes calcium to be excreted from the body.)
8. While the Chinese eat an average of almost 300 calories per day more than Westerners do, they are generally thinner. Dr. Campbell believes that in a very low-fat diet, a higher percentage of calories may be burned up rather than stored as fat.
9. The amount of animal protein in the diet correlates well with overall cancer rates, Hence, dietary protein may be a bigger health problem than dietary fat. Thus a shift from red meat to fish and chicken is generally not helpful since, while dietary fat is reduced, dietary animal protein is not.
A second major study that can have a major impact if its lessons are heeded is the “Lifestyle Heart Trial,” conducted by Dean Ornish, M.D. of the Preventive Medicine Research Institute in Sausalito, California and his medical colleagues. The objective was to study if changes in diet, exercise, and stress levels can unblock clogged arteries and save lives, without the use of expensive surgical techniques or drugs. Dr. Ornish spells out the philosophy, science, and diet behind his approach in Dr. Dean Ornish’s Program for Reversing Heart Disease (see Bibliography).
Ornish’s initial study involved forty-eight patients with severe heart disease. He randomly divided them into two groups: twenty-eight received his experimental regimen, and the other twenty were put into a control group, so that they could serve as a basis of comparison. The experimental group was put on a strict diet including only plant-based foods, supplemented by egg whites and one cup daily of nonfat milk or yogurt. Their dietary fat content was a very low ten percent of calories, and their cholesterol intake was only five mg per day. To control stress, they did stretching exercises, meditated, and performed other relaxation techniques. In addition, they walked for at least half an hour three times a week, and met as a support group twice weekly.
After one year, most of the experimental group indicated a complete or nearly complete disappearance of chest pains. Arterial clogging was significantly reversed for eighty-two percent of the patients. In one case, the change was especially dramatic. Werner Hebenstreit, a seventy-five- year-old retired businessman who reported that before starting the program he could barely cross the street without chest pains, was able to hike for six hours in the Grand Tetons at 8,000 feet by the end of the program. Other patients also experienced significant improvements.
What makes the results even more spectacular is a comparison with the findings for members of the control group. They received standard medical care, generally following the recommendations of the American Heart Association and/or their doctors: up to thirty percent fat in their diets; dietary cholesterol limited to 300 mg per day; no red meat, but chicken without the skin and fish were permitted; a moderate amount of exercise, but no set stress reduction activities. None of these patients got better; in almost all cases, their arterial blockages worsened significantly, and they reported an increase in chest pains. Evidently, the standard recommendations of the medical establishment were not sufficient, at least with regard to reversing heart disease.
Although Dr. Ornish initially found it difficult to find funding for his study because of the medical establishment’s skepticism about reversing heart disease without surgery or drugs, there are several indications of the increasing acceptance of his approach:
1. In 1990, Ornish’s initial findings were published in the Lancet, a highly respected British medical journal, and later results were published in the Journal of the American Medical Association in 1995.
2. In a break from previous policies of medical insurers, which only reimbursed patients who underwent surgery or drug-related therapies, at least forty insurance companies now reimburse patients who receive the Ornish treatment. The insurers found that, of the patients motivated enough to try the Ornish approach, ninety percent stuck with it, and, of those, almost eighty percent avoided bypass surgery or angioplasty. Since these surgical approaches are much more expensive than Ornish’s approach, insurance companies are saving about five dollars for every dollar invested.
3. At least eight hospitals throughout the United States, including Beth Israel in New York City, now provide outpatient treatment using the Ornish approach.
4. There have been many television programs and news reports about the success of the program.
Since more Americans die from heart and blood vessel diseases annually than any other cause of death, and more money is spent in the United States on the treatment of heart disease than on any other illness, Ornish’s results have the potential to revolutionize health care.
Taken together, Ornish’s study and the China Project, along with many other recent scientific studies, clearly show that a shift to plant- based diets can have enormous health benefits and can sharply reduce today’s huge health care expenditures. It can only be hoped that increasing numbers of people will become aware of the “tantalizing findings” from these studies and change their dietary habits accordingly. The health of billions of people and, ultimately, the entire planet is at stake.
Can Breast Cancer Be Prevented?
An analysis of many additional significant health studies is found in a very important book, Save Yourself From Breast Cancer: Life Choices That Can Help You Reduce the Odds, by Robert M. Kradjian, M.D. (see the Bibliography). Dr. Kradjian, a breast cancer surgeon for thirty years, knows cancer as an expert and his conclusions are very important. After analyzing a wide variety of scientific studies, Kradjian has concluded that the main cause of breast cancer is animal-based diets. He contests the medical establishment’s position that breast cancer is “all in the genes” and he demonstrates that prevention, not early detection, is the best defense against the disease.
Among the studies that Dr. Kradjian investigated are:
1. Human population studies (epidemiology). His dramatic findings show that, without exception, countries with high fat contents in the diet have high rates of breast cancer and vice versa. As he points out, “this information alone should be enough to cause a thoughtful woman to markedly reduce her dietary fat intake.” The differences in cancer rates are also great—as much as twenty-five times greater for countries where high- fat diets are the norm, compared to countries where fat consumption is low.
2. Migration studies. Eleven migration studies have all shown that when people move from an area of low consumption of animal products, where the breast cancer rate is low (such as Japan), to an area where the consumption of animal products is higher, their breast cancer rate rises substantially and soon approaches that of the host country’s population. These studies demonstrate that genetics is not the key factor in causing breast cancer.
3. Time trend studies. The average fat content in the Japanese diet increased from seven-and-a-half percent of total calories in 1950 to twenty-eight percent in 1994, and it has continued to rise. This has resulted in a major increase in the breast cancer rate, a fifty-eight percent increase between 1975 and 1985 alone. There are similar findings in other countries where meat consumption has been increasing.
4. Wartime studies. Consistent with the studies mentioned above, there were dramatic decreases in breast cancer rates in several countries during both World Wars I and II when wartime conditions resulted in large decreases in the consumption of animal products.
Based on these studies and other considerations and analyses, Dr. Kradjian concludes that the evidence that breast cancer is a dietary disease is “clear, convincing, and compelling.” He asserts that the remedy required is simple: “a switch from the traditional high-fat/low-fiber diet to a low- fat/high fiber diet.”
Since breast cancer is feared so much by women, and increasing numbers of women are being afflicted by this disease, and since the China study discussed above and other studies show similar results for other chronic degenerative diseases, it is essential that Dr. Kradjian’s recommendation of a shift toward plant-based diets be widely heeded.
Threats Due to Increased Antibiotic Resistance43
Over half the antibiotics produced in the U.S. are routinely fed to animals in their feed.44 It would be impossible to maintain healthy animals under the cramped conditions of “factory farming” without these drugs. Further, for reasons not fully understood, the antibiotics also seem to act as “growth promoters,” leading to heavier animals and thus more weight for the market, providing even greater incentive to administer drugs.
Unfortunately, this practice places enormous “selective pressure” on the bacteria that inhabit these animals to develop resistance to the antibiotics in the feed. Genes which neutralize the effects of antibiotics arise as a result of this selective pressure (i.e., in the presence of antibiotics, only those organisms that have the capability of neutralizing the antibiotics will survive). These resistant genes are easily transferred from one bacterium to another, and they may protect germs that cause human disease from antibiotic treatment.
There has already been a tremendous increase in antibiotic resistance in common food poisoning bacteria like salmonella,45 but the problem is even worse than simply the antibiotic-resistant bacteria in the food animals themselves. Bacteria also have the capability of rapidly transferring and spreading the antibiotic-resistant character to other bacterial species, including those which cause other diseases. Therefore, diseases that are not even related to food consumption may become resistant to antibiotics, and hence a much greater threat. For example, staphylococcus bacteria have been isolated in recent years that are resistant to every known commercially available antibiotic.46 If this organism gets into one’s blood stream, you will very likely die.
As a result, there is a scientific consensus that the extensive use of antibiotics to produce meat and other animal products, along with their over-use in medicine, has increased resistance among bacteria and jeopardized human health by causing diseases that are difficult or impossible to cure. For example, in 1997, the World Health Organization called for a ban on the routine use of antibiotics in livestock feed.47 In 1998, the journal Science called the meat industry “the driving force behind the development of antibiotic resistance in certain species of bacteria that cause human disease,”48 and, later that year, the Centers for Disease Control blamed the use of antibiotics in livestock feed for the emergence of salmonella bacteria resistant to five different antibiotics.49 As Joshua Lederberg, M.D., a Nobel Laureate, has said: “We’re running out of bullets for dealing with a number of these infections. Patients are dying because we no longer, in many cases, have antibiotics that work.”50
The widespread use of antibiotics in animal feed is thus a global threat to human health for every individual on earth. People need prescriptions for these drugs, yet the animal industry uses them casually. This irresponsible misuse of antibiotics is unilaterally disarming our species from a last line of defense, and devastating epidemics may well be the legacy of the hunger for inexpensive meat.
Since medical and statistical evidence demonstrates that the eating of animal products is hazardous to health and can lead to fatal diseases, it is significant that Orthodox Rabbi Alfred Cohen concludes his comprehensive article, “Vegetarianism From a Jewish Perspective,” with this statement:
Following the many precedents prescribed in the Code of Jewish Law, we would have little difficulty in arriving at the conclusion that, if indeed eating meat is injurious to one’s health, it is not only permissible, but possibly even mandatory that we reduce our ingestion of an unhealthful product to the minimal level.51
Rabbi David Rosen, former Chief Rabbi of Ireland, is more emphatic: “As it is halachically prohibited to harm oneself and as healthy, nutritious vegetarian alternatives are easily available, meat consumption has become halachically unjustifiable.”52
In view of all of the material in this chapter and many well- documented books, it would seem that the numerous halachic rules prohibiting dangerous activities should be extended to include a mandate reducing the ingestion of meat to a minimal level, and there should be a recommendation that those who continue to eat small amounts of kosher meat, possibly as an interim step, should only use organically raised meat from animals not raised under cruel “factory farm” conditions. Such an extension by leading rabbinic authorities of our time, with proper publicity, would save many lives and improve the health and life expectancy of the Jewish people and many others.
1. Rabbi Samson Raphael Hirsch, Horeb, Dayan Dr. I. Grunfeld, trans. London: Soncino Press, 1962, (Section 62, No. 428).
2. For a more extensive consideration of the Jewish approach to health care, see “Prevention: Torah Perspectives on Maintaining Health” by Yosef Ben Shlomo Hakohen, published by Nishma, Toronto, Torah paper No. IX, and “An Ounce of Prevention: The Jewish Approach to Maintaining Health” by Yosef Ben Shlomo Hakohen and Richard H. Schwartz, Emunah Magazine, Fall, 1995, 44–46.
3. Also see Sota 14a.
4. Yalkut Lekach Tov, Shmot, B’shalach.
5. Sanhedrin 73a.
6. Shabbat 54b.
7. Chulin 9a; Choshen Mishpat 427; Yoreh De’ah 116.
8. Pesachim 25a; Maimonides, Mishneh Torah, Yesodei ha Torah, 7.
9. Yoma 85b; Sanhedrin 74a.
10. Maimonides, Mishneh Torah, Hilchot Deot 4:1.
11. Rabbi Samson Raphael Hirsch, Horeb, Dayan Dr. I. Grunfeld, trans. London: Soncino
Press, 1962, Vol. 2, 298 (Section 62, No. 427).
12. Baba Batra 2:9.
13. Yalkut Shimoni 184.
14. Sanhedrin 17b.
15. Ta’anit 11a,b.
16. Chulin 84a; Berachot 40a; Avodah Zarah 11a.
17. Shabbat 140b.
18. Shabbat 50b.
19. Shulchan Aruch, Orach Chayim 4:18.
20. Chulin 105a,b.
21. Midrash Leviticus Rabbah 34:3.
22. Rabbi J. H. Hertz, The Pentateuch and Haftorahs, London: Soncino Press, 1958, 843.
23. Ibid; also see Babba Kamma 4:9, 15b, and 46a; Ketuvot 41b.
24. Maimonides, Hilchot Rotze’ach, ch. 11, part 4.
25. Fred Rosner, Modern Medicine and Jewish Law, New York: Bloch, 1972, 28.
27. Ta’anit 20b.
28. Sanhedrin 4:5.
29. Shabbat 151b.
30. Sefer Chasidim, No. 724.
31. Cited by Rosner, Modern Medicine, 30.
32. Ibid, 31.
33. Mikkel Hindhede, American Journal of Epidemiology, 100, No. 5:394.
34. Nathaniel Altman, Eating for Life, Wheaton, IL: Theosophical Publishing House,
35. John A. Scharffenberg, Problems with Meat, Santa Barbara, CA: Wadsworth, 1977), 28.
37. R. L. Phillips, “Role of Lifestyle and Dietary Habits in Risk of Cancer among Seventh
Day Adventists,” Cancer Research 35 (November 1975): 3513.
38. Morton Mintz, “Fat Intake Increasing Cancer Risk,” Washington Post, September 10, 1976.
39. B. Armstrong et al, “Blood Pressure in Seventh Day Adventists,” American Journal of Epidemiology 105, No. 5 (May 1977): 444–9.
41. Gene Marine and Judith Van Allen, Food Pollution: The Violation of Our Inner Ecology, New York: Holt, Rinehart and Winston, 1972, 19.
42. Paul Dudley White, American Heart Journal (December, l964): 942.
43. For much of this section I am indebted to Emanuel Goldman, Ph.D., Professor of Microbiology and Molecular Genetics, New Jersey Medical School, Newark, NJ, USA. and to material in The Food Revolution by John Robbins.
44. Stuart Levy of Tufts University School of Medicine, citing a 1998 Institute of Medicine report described in The Scientist, July 5, 1999 (Vol. 13, No. 14).
45. For example, Denise O’Grady, “Bacteria Cases in Denmark Cause Antibiotics Concerns in U.S.,” New York Times, November 4, 1999.
46. For example, Stuart Levy, “The Challenge of Antibiotic Resistance,” Scientific American, March 1998.
47. “World Health Organization Meeting on the Medical Impact on the Use of Antimicrobial Drugs in Food Animals, Berlin, Germany, October 4, 1997,” WHO Press Release, October 7, 1997.
48. Science, 1998; 279: 996–997.
49. Glynn K., et al, “Emergence of Multidrug-resistant salmonella enterica serotype typhimurium DT104 infections in the United States,” New England Journal of Medicine (1998) 338: 1333–1338.
50. Speech before Irvington Trust, New York City, February 8, 1994.
51. Rabbi Alfred Cohen, “Vegetarianism from a Jewish Perspective,” Journal of Halacha and Contemporary Society, Vol. 1, No. II, (Fall, 198 1), 61.
52. Rosen, Rabbi David, “Vegetarianism: An Orthodox Jewish Perspective,” in Rabbis and
Vegetarianism: An Evolving Tradition, Roberta Kalechofsky, ed., Marblehead, MA: Micah Publications, 1995, 54.<