"The Actual Benefit of Diet vs. Drugs"
One of the reasons people may undervalue diet and lifestyle changes
is an overconfidence in the ability of pills and procedures to prevent disease.
For example, people tend to wildly overestimate the power of things
like mammograms and colonoscopies to prevent deaths from breast and bowel cancer,
or the power of drugs like Fosamax to prevent hip fractures,
or the power of cholesterol drugs to prevent fatal heart attacks.
Patients believe statin drugs like Lipitor are about a 100 times more effective
than they actually are in preventing heart attacks.
Most people wouldn’t take multiple blood pressure medications
if they knew the truth, which raises a dilemma for doctors.
Most patients want to be told the truth,
want to be told what the chances the drugs will actually benefit them,
but there’s this tension between the patient’s right to know
and the likely reduction in patient's willingness to take the drug if they were so informed.
If taking a cholesterol-lowering drug would reduce your risk
of getting a heart attack over the next 5 years by, you know, 100%,
well then, everyone would take it.
Even if it were a 50% chance of benefiting, most would still want to take the drugs.
But if the chances of benefiting is just a few percent,
hardly anyone would be willing to take the drugs every day for the rest of their lives.
And that’s the actual benefit.
For most people the chance of benefit is normally less than 5% over 5 years
for cholesterol, blood pressure, and blood thinning drugs.
It’s no wonder that doctors seldom share these figures with patients.
So even high risk patients have less than a 5% chance of benefit,
whereas patients, you know, don’t want to take drugs unless they have at least a 20% chance—
even those who just had a heart attack.
The study therefore suggests that informing patients
of the percentage chance of benefit from preventive drug strategies
will substantially reduce the uptake of such drugs.
Now they recognize that for the individual, this is unlikely to be detrimental.
After all, there’s a 95% chance it won’t do anything for them.
But for the population at large, it would make a difference.
So doctors and drug companies tend to oversell the benefits
by conveniently not mentioning how tiny they actually are,
knowing that most patients wouldn’t take them if doctors divulged the truth.
To practice non-lifestyle medicine is to practice deceptive medicine.
The best cholesterol-lowering statin drugs can do here
is an absolute risk reduction of 3.1% over 6 years.
If Dr. Esselstyn’s work can be replicated in a randomized control trial,
then a whole food plant-based diet will be shown to work 20 times better,
an absolute risk reduction of 60% after less than 4 years.
Overall, 99.4% of patients that stuck with the diet
avoided major cardiac events, such as death from heart attack.
So when we have to decide whether we want to go diet versus drugs,
it’s not a choice between eating healthy to prevent a heart attack,
or taking a pill to prevent a heart attack,
because in 97% of cases the pills won’t do anything.
We’re risking side effects for nothing.
Whereas if we treat the underlying root cause of the disease,
by eating this healthy cholesterol-free diet,
we may even reverse the progression of the disease.
Stop eating an artery-clogging diet and our bodies can start dissolving that plaque away,
opening up arteries in some cases without drugs, without surgery.
This wasn’t an Ornish study,
so no exercise requirement, no meditation, no stress management, no yoga.
Just a healthy whole food plant-based diet
may work 20 times better than drugs to combat our #1 killer.
Now that’s something doctors may want to tell their patients.