Consider the Evidence When You Make Life-or-Death Decisions

In the 1940s and ’50s, the American Medical Association was not only saying that “smoking in moderation” wasn’t a problem, but that, on balance, it may even be beneficial. After all, most physicians themselves smoked, so how bad could it be? With such a position taken by one of the country’s leading medical groups, where could you turn if you just wanted the facts?

According to one tobacco company ad, “science advances new data that may completely change your idea of cigarettes!” And what might those new data tell us? “She was too tired for fun…and then she smoked a Camel.” (You can see the unbelievable ads in my video Evidence-Based Eating, starting at 0:29). In another ad, baseball legend Babe Ruth told us, “Now! Medical science offers proof positive!” that the brand he was hawking is the safest to smoke of all the leading cigarettes—well, he told us, that is, when he still could talk, before he died of throat cancer.

Now, some of the science-based evidence did leak out, causing a dip from an average of 11 or so cigarettes a day per person down to 10, as you can see at 0:50 in my video, but those who got scared of possible health risks from smoking could always choose “[t]he cigarette that takes the FEAR out of smoking!” Even better, why not choose the cigarette that “gives you the greatest health protection?”

Had a SmokingFacts.org website existed during the time of these outrageous ads making such outrageous claims—a site that delivered the science directly to the people, bypassing commercially corruptible institutional filters—it would have featured a study of Seventh-day Adventists in California in 1958 that showed that nonsmokers may have at least 90 percent less lung cancer than smokers. With so much money and personal habit at stake, there will always be “dissenters.” Given the seriousness of these diseases and the sum total of evidence, though, we shouldn’t wait to put preventive measures in place.

If you’re a smoker in the 1950s in the know and privy to the science-based realities of smoking, you realize the best available balance of evidence suggests your smoking habit is probably not good for you. So, what do you do? Do you change your smoking habits, or do you wait? If you wait until your physician tells you—between puffs—to quit, you could have cancer by then. If you wait until the powers that be officially recognize it, like the Surgeon General did in the subsequent decade, you could be dead by then.

It took more than 7,000 studies and the deaths of countless smokers before the first Surgeon General report against smoking was finally released in the 1960s. Wouldn’t you think that after the first 6,000 studies or so, they could have given people a heads up? One wonders how many people are suffering needlessly right now from dietary diseases.

Let’s fast-forward 55 years to a new Adventist study out of California warning Americans about the risks of something else they may be putting in their mouths: “Vegetarian diets are associated with lower all-cause mortality.” It’s not just one study either. According to a recent review, a total sum of evidence suggests that mortality from all causes put together, including many of our dreaded diseases were significantly lower in those eating more plant-based diets. As well, “[c]ompared with omnivores, the incidence of cancer and type 2 diabetes was also significantly lower in vegetarians.”

So, instead of someone going along with America’s smoking habits in the 1950s, imagine you or someone you know is going along with America’s eating habits today. With access to the science, you realize the best available balance of evidence suggests your eating habits are probably not good for you. So, what do you do? Do you change your eating habits, or do you wait? If you wait until your doctor tells you—between bites—to change your diet, it could be too late.

Just like most doctors smoked back then and didn’t tell their patients to change, despite the overwhelming evidence published for decades, most doctors today continue to eat foods that are contributing to our epidemics of dietary disease.


For more on this topic, check out my series of videos on parallels to smoking and the tobacco industry’s tactics, including:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

What’s the Secret to Latino Longevity?

Latinos living in the United States tend to have “less education, a higher poverty rate, and worse access to health care” and “represent the ultimate paradigm of healthcare disparities,” with the highest rate of uninsured, lowest rates of health screening and counseling, and poorest levels of blood pressure and blood sugar control, as well as “other measures of deficient quality of care.” So they must have dismal public health statistics, right? According to the latest national data, the life expectancy of white men and women is 76 and 81 years, respectively, and that of black men and women is shorter by a handful of years. And Latinos? Amazingly, they beat out everyone.

Latinos live the longest.

This has been called the Hispanic Paradox (now also known as the Latino Paradox), which I explore in my video, The Hispanic Paradox: Why Do Latinos Live Longer?. Latinos have a 24 percent lower risk of premature death and “lower risks of nine of the leading 15 causes of death,” with notably less cancer and heart disease. This was first noticed 30 years ago but was understandably was met with great criticism. Maybe the data were unreliable? No, that didn’t seem to be it. Maybe only the healthiest people migrate? Turns out the opposite may be true. What about the “salmon bias” theory, which “proposes that Latinos return to their home country…to ‘die in their home’” so they aren’t counted in U.S. death statistics? That theory didn’t pan out either.

Systematic reviews “confirm the existence of a Hispanic Paradox.” Given the strong evidence, it may be time to accept it and move on to figuring out the cause. The very existence of the “Hispanic Paradox” could represent “a major opportunity to identify a protective factor for CVD [cardiovascular disease] applicable to the rest of the population.” After all, whatever is going on “is strong enough to overcome the disadvantageous effect” of poverty, language barriers, and low levels of education, health literacy, quality of healthcare, and insurance coverage. Before we get our hopes up too much, though, could it just be genetic? No. As foreign-born Latinos acculturate to the United States, as they embrace the American way of life, their mortality rates go up. So, what positive health behaviors may account for Latino longevity?

Perhaps they exercise more? No, Latinos appear to be even more sedentary. They do smoke less, however the paradox persists even after taking that into account. Could it be their diet? As they acculturate, they start eating more processed and animal-based foods, and consume fewer plant foods—and perhaps one plant food in particular: beans. Maybe a reason Latinos live longer is because they eat more beans. Although Latinos only represent about 10 percent of the population, they eat a third of the beans in the United States, individually eating four to five times more beans per capita, a few pounds a month as opposed to a few pounds per year. That may help explain the “Hispanic Paradox,” because legumes (beans, split peas, chickpeas, and lentils) cool down systemic inflammation.

In my video, you can see the mechanism researchers propose in terms of lung health. While cigarette smoking and air pollution cause lung inflammation, which increases the risk for emphysema and lung cancer, when we eat beans, the good bacteria in our gut take the fiber and resistant starch, and form small chain fatty acids that are absorbed back into our system and decrease systemic inflammation, which not only may inhibit lung cancer development, but also other cancers throughout the body. Latinos have the lowest rates of chronic obstructive pulmonary disease (COPD) and lung cancer, and also tend to have lower rates of bladder cancer, throat cancer, and colorectal cancer for both men and women.

This “systemic inflammation” concept is also supported by the fact that when Latinos do get cardiovascular disease or lung, colon, or breast cancer, they have improved survival rates. Decreasing whole body inflammation may be important for both prevention and survival.

Asian Americans also appear to have some protection, which may be because they eat more beans, too, particularly in the form of tofu and other soy foods, as soy intake is associated with both preventing lung cancer and surviving it.

Hispanics also eat more corn, tomatoes, and chili peppers. A quarter of the diet in Mexico is made up of corn tortillas, and Mexican-Americans, whether born in Mexico or the United States, continue to eat more than the general population. Looking at cancer rates around the world, not only was bean consumption associated with less colon, breast, and prostate cancer, but consumption of rice and corn appeared protectively correlated, too.

Since NAFTA, though, the North American Free Trade Agreement, the Mexican diet has changed to incorporate more soda and processed and animal foods, and their obesity rates are fast catching up to those in the United States.

In the United States, Latinos eat more fruits and vegetables than other groups, about six or seven servings a day, but still don’t even make the recommended minimum of nine daily servings, so their diet could stand some improvement. Yes, Hispanics may only have half the odds of dying from heart disease, but it’s “still the number one cause of death among Hispanics. Therefore, the current results should not be misinterpreted to mean that CVD is rare among Hispanics.” Ideally they’d be eating even more whole plant foods, but one thing everyone can learn from the Latino experience is that a shift toward a more plant-based diet in general can be a potent tool in the treatment and prevention of chronic disease.


Data like this support my Daily Dozen recommendation for eating legumes ideally at every meal, and we have free apps for both iPhone and Android that can help you meet these dietary goals.

For more on the wonders of beans, split peas, chickpeas, and lentils, see my videos and love your legumes!:

What’s the best way to eat them? See Canned Beans or Cooked Beans? and Cooked Beans or Sprouted Beans?.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

How to Counteract the Effects of Alcohol

More than a million new cases of skin cancer are diagnosed every year, affecting about one in three Americans in their lifetimes. As I discuss in my video Preventing Skin Cancer from the Inside Out, although the chief risk factor is UV exposure from the sun, alcohol consumption may also play a role. Most of the cancers associated with alcohol use are in the digestive tract, from mouth cancer, throat cancer, and stomach cancer down to cancers of the liver and colon. These involve tissues with which alcohol comes in more direct contact. But why skin cancer?

A study of 300,000 Americans found that excessive drinking was associated with higher rates of sunburn. It “may be that heavy and binge drinking are markers for an underlying willingness to disregard health risks” and pass out on the beach, but it also may be because breakdown products of alcohol in the body generate such massive numbers of free radicals that they eat up the antioxidants that protect our skin from the sun. Plants produce “their own built-in protection against the oxidative damage of the sun,” and we can expropriate these built-in protectors by eating those plants to function as cell protectors within our own bodies. One might say fruit and vegetables provide the best polypharmacy—the best drug store—against the development of cancer.

The ingestion of plant foods increases the antioxidant potential of our bloodstream, which can then be deposited in our tissues to protect us against the damaging effects of the sun’s rays, but only recently was it put to the test.

Researchers studied 20 women and burned their buttock skin with a UV lamp before and after half of them ate three tablespoons of tomato paste a day for three months. There was significantly less DNA damage in the derrieres of those who had been eating the tomatoes. So, three months or even just ten weeks before swimsuit season, if we eat lots of an antioxidant-rich food, such as tomato sauce, we may reduce the redness of a sunburn by 40 percent. It’s like we have built-in sunscreen in our skin. Now, this isn’t as good as a high SPF sunblock, but “[m]uch of the UV exposure over a life time occurs when the skin is not protected; thus, the use of dietary factors with sun-protecting properties might have a substantial beneficial effect.”

It works both ways, though. Alcohol consumption decreases the protection within our skin. If you have people drink about three shots of vodka, within eight minutes—not after ten weeks, but within just eight minutes––the level of carotenoid antioxidants in their skin drops dramatically. If, however, you drink the same amount of vodka in orange juice, there is still a drop in skin antioxidants compared with the initial value, but drinking a screwdriver cocktail is not as bad as drinking vodka neat. Is the difference enough to make a difference out in the sun, though?

After the drinks, researchers exposed volunteers to a UV lamp and waited to see how long it would take them to burn, and the time span until they started turning red was significantly shorter after alcohol consumption than in the experiments in which either no alcohol was consumed or alcohol was consumed in combination with orange juice. It came out to be about an extra half hour out in the sun based solely on what you put in your mouth before heading to the beach. And, oranges are pretty wimpy––not as bad as bananas, but berries have the highest cellular antioxidant activity.

The researchers concluded that “[p]eople should be aware of the fact that the consumption of alcohol in combination with UV light [from sun exposure or a tanning booth] increases their risk of sunburn and therefore their risk of developing premature skin aging and even skin cancer.” If you are going to drink alcohol and be out in the sun, you should make sure you are using sunblock or, at the very least, drinking a strawberry daiquiri or something else to reduce oxidative damage.


Isn’t that wild? Antioxidant dynamics in the body change minute to minute so be sure to keep yourself topped off. See:

What else can tomatoes do? Check out Inhibiting Platelet Activation with Tomato Seeds.

Other videos on skin health include:

Alcohol doesn’t just raise the risk of skin cancer. See Breast Cancer and Alcohol: How Much Is Safe?. But, like the orange juice in a screwdriver cocktail, grape skin components may help mediate wine’s adverse effects. See Breast Cancer Risk: Red Wine vs. White Wine.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: