Transcript of Interview 3:

S.J.: If all one’s siblings have gotten breast cancer for example, does that mean it’s in the genes and one should play it safe by getting mastectomies as a preventative measure?

T.C.C.: Well, all the diseases as you know, Sylvester, really begin with genes of one kind or another not just one gene usually but a cluster of genes. So all of the normal and abnormal biological processes begin with genes and so breast cancer too has a genetic basis just like all the others. And there are a certain small percentage of breast cancers that are pretty strongly influenced by genes, namely genes called BRCA1 and BRCA2. And those two genes they have what we refer to as pretty strong penetrates, that is their influence is pretty strong and they can raise the risk for this small group of women to fairly high levels and can end up causing breast cancer or at least being associated with breast cancer. But that is about 5% or so of women who have that problem with those genes. And so we see a higher risk for breast cancer among those women, of course, but the interesting thing about this is that diet, namely the diet we’re talking about, a plant-based diet, low fat, is obviously associated with lower risk of breast cancer. And we know a lot about how it works and it similarly works, as far as I can see in the literature, even for that small group of women who in fact are at high risk because of those genes. So I sort of look at the genetic equation in a way in which, since all disease begin with genes, that is the starting point essentially, corrupted genes let’s say, or genes that people were born with. Since everything starts at that point, that is not enough to conclude that therefore they’re going to get the disease, because diet and nutritional patterns that we’re talking about can actually repress and actually completely bar the expression of those genes that ultimately lead to disease, and that even includes the people that have something like BRCA1 and BRCA2 which I call mischievous genes. We all have some genes I think that raise our risk for one thing or another, but we don’t really know what those genes are for the most part.

S.J.: So genes function only by being activated or expressed and nutrition plays a critical role in determining which genes good or bad get expressed.

T.C.C.: Absolutely. Absolutely, it’s not the presence or absence of the genes that make the difference it really is the expression of these genes. And another way to look at this, that I have been thinking about that no one ever really does I think, and that is if you look at the relationship between dietary fat and breast cancer or animal foods and breast cancer or animal foods and colon cancer, or whatever, we know that the dietary effect is strong, from various points of view. Now it turns out that all those diseases are starting with genes and that is a demonstration right there that nutrition and diet are prominently operating; every disease begins with genes so we can say everything is genetic. Genes are involved with everything, yet we can also say that genes, if we did things right, are involved in nothing. It almost sounds like a paradox but it just shows in fact you know how strong this nutritional effect is.

I am thinking of genes incidentally, too, that get corrupted during our lives that then can lead to serious diseases, like the liver cancer case—that we worked on in our laboratory fairly intensively for many years—that cancer starts when a chemical carcinogen comes in, in this case it was aflatoxin. When it comes in it gets metabolized to produce a metabolite that is very reactive and it binds to the DNA and it corrupts, therefore, a gene and we know pretty much which gene it is. In one sense we can say that is a chemical carcinogen disease but really in reality that carcinogen, like most carcinogens, are interacting with genes so it’s really a genetic beginning.

S.J.: The body has an amazing and very well researched and proven, as far as you can prove in biological terms, set of strategies to repair genes.

T.C.C.: Yes, true, absolutely, and in fact we have genetic corruption or attack going on all the time during our lifetime from various and sundry things and so genes are being damaged, if you will, but there are some estimates that somewhere in the neighborhood of 99 to 99.9% of all those genes are repaired. We have repair mechanisms in our cells that actually repair them, so fortunately almost all that stuff gets repaired, but that tiny, tiny little bit, it only takes just one slipping through the cracks from time to time, when the gene is sitting there and doesn’t get repaired at the time the cell divides, now that gene gets incorporated into the daughter cells. So now suddenly, in an extreme case, we have one cell that has a corrupted DNA structure, and that one cell can divide into two and so forth and so on and eventually just grow out to form what we call a clone of the mother cell. And eventually it can be the wrong kind of clone andt can go towards cancer.

S.J.: So if repair mechanisms and immune system have been made less robust by the effects of animal based foods, then the cancers can begin to get a foothold.

T.C.C.: Yeah. There are other ways too incidentally; we just talked about the cell having the ability to repair itself, to repair this kind of damage. At the same time, the body has a mechanism, routine kind of mechanism that tends to kill bad cells even after they’re formed, and are there, and start to grow. All of our tissues have the ability to wipeout and discard mischievous cells, and that’s a phenomenon called apoptosis in the case of cancer. So it’s a good thing we have this apoptotic mechanism that works and incidentally, nutrition again plays a role in affecting apoptosis and it’s the same kind of diet in effect. And the evidence we have so far is that this kind of diet, it does so many things, it stops the metabolism of the carcinogen to give the metabolite to bind to the DNA, it affects DNA repair in the same sort of direction it also affects apoptosis. The wrong kind of diet does everything in the wrong way, that is what I find so fascinating about biology in this case, that when we’re doing the wrong thing everything goes wrong, not everything, but there are a whole lot of things going wrong at the same time.

S.J.: How about a different class of disease such as Parkinson’s, if both my parents got it’s my fate sealed?

T.C.C.: No, I am saying that a little bit obviously without enough knowledge to know the whole story on that one for sure, but there is some evidence already that diet can play a role in preventing Parkinson’s disease, and it’s the same kind of diet again. And I find this not surprising that that might be true, because this diet has such a broad effect. What troubles me about something like Parkinson’s especially, but also some others is the fact that we don’t have an interest in medical research to really go in and look at a question like that. It would seem to me if we had some evidence even though it’s not conclusive, that’s exactly the kind of question that we should be studying. People should be putting money into ‘let’s have a closer look at this dietary effect’, to see how, in fact Parkinson’s disease doesn’t have to happen. And from what I can see—obviously, I am an enthusiast for diet, but the fact that it has such a wide array of effects that—we’ll discover someday that Parkinson’s can be largely prevented, by dietary means.

S.J.: So improving diet might well help even if a disease runs in the family, in the genes, for a whole variety of diseases?

T.C.C.: Absolutely. This whole ‘running in the family’ is an interesting expression, as you know. That tends to mean to most people that it’s a genetic disorder and that kind of philosophy, that kind of assumption, is really quite a fatalistic assumption. Because if we sort of preclude that ‘oh it’s in my family’, or ‘I know, it’s a genetic disease’, ‘it’s going to happen anyhow’, then people are really disinclined to do the right thing. They know it’s going to come and that is the way it’s and I just cannot subscribe to that kind of fatalism. It’s just not appropriate, and when you study it a little more closely, of course, we find out that nutrition has such a strong effect, that’s to me a great ray of hope. And in science and in the funding of research, that I have been so involved in myself on both sides of the table, I am really troubled by the fact that in our national health budget, health research budget, we don’t devote money to try and understand the nutritional connection well enough so we can really tell the public, ‘here’s how it all works’ kind of bit. They always look for the drug.

S.J.: What is meant by the term acidosis and how can animal products increase the possibility of experiencing it?

T.C.C.: Well, with acidosis usually, the lower the pH the greater the acidity or greater the concentration of acid. Acidosis, often times also called metabolic acidosis, reflects acid being produced in excess because of metabolism of one sort or another. And it turns out that animal based proteins, when they’re metabolized, first digested to their amino acids and then amino acids are further metabolized, have a little higher concentration of so-called sulfur amino acids, which when metabolized can produce the sulfate ion, it’s an acidic ion, and that’s just one mechanism, there are some other ways. It turns out that animal based proteins have been shown to actually increase acid a bit and decrease, therefore the pH and the amount of pH decrease that I have seen, or the increase in acid. In terms of numbers it doesn’t look like much, but that change really quite major in terms of its effect on various enzyme systems.

S.J.: How well do the people who consume the most milk products do with osteoporosis?

T.C.C.: You mean why do people consuming the most dairy products have more osteoporosis?

S.J.: Yes.

T.C.C.: For one thing the dairy food, of course, is a good source of protein and in many cases it can comprise a fairly large fraction of the protein that a person is consuming, especially in dairy producing countries. And that protein, animal protein, like we just said, can lead to an acidic-like condition. And also that same protein can make some other biochemical changes too, any one of which lead to the need by the body for reducing the amount of acid being produced. And it does that most effectively by drawing on the best buffer that’s around which happens to be the calcium in the bones. And so consuming dairy creates a little excess acid, that has to be neutralized and that neutralization is coming about because of the drawing of the calcium from the bones—that is one mechanism by which that occurs.

There is another one not terribly well talked about, a couple of others actually, it has to do with the fact that the dairy contains a lot of calcium, and so for a lot of societies who are consuming lots of dairy, they’re getting a very high fraction of the calcium from dairy. And when people become accustomed to a high calcium diet then the immediate cascade after they go off that, let’s say, or they come to some other event in their life such as menopause—when estrogen is decreased—at the point they’re accustomed to this very high calcium intake, suddenly the calcium intake might drop or certainly the estrogen will drop, that in turn portages most of the calcium, at that particular point in time the body is not as well adapted to a lower calcium intake and therefore is at greater risk to osteoporosis for various kinds of mechanisms.

The dairy industry has argued and lots of nutritionists have agreed that we should be consuming these high levels of calcium for much of the earlier part of our life, especially women, as if that is a good thing. I disagree; I think we set ourselves up by doing that. We set ourselves up for the body adapting to these very high levels of calcium that is going to then make us vulnerable to the effects of menopause and its subsequent effects on osteoporosis. I could go on and on about this. There are some other sorts of mechanisms too. We gathered a lot of evidence now to show how dairy and fat, rather conclusively can show how dairy really causes osteoporosis it does not prevent osteoporosis. There is no evidence that dairy prevents osteoporosis and makes stronger bones as they have said for so many years; it just doesn’t work.

S.J.: Sometimes a point of confusion arises because the gastric fluids in the stomach are already highly acidic so people wonder why acid is a problem.

T.C.C.: Well, of course, there are different kinds of acid conditions these are separate phenomena. Obviously, in our stomach, the stomach contents are highly acidic, very acidic. If we were to take the gastric juice of the stomach and put it on paper it could burn through the paper in fact, it’s that strong. And so that’s nature’s way at having a first look at the food that is being consumed, well it’s the second look in a sense salvia is the first look. But in any case, the food gets to the stomach, the acid is there and begins to hydrolyze many of the constituents and in a sense prepares the food for further digestion; when it gets beyond the stomach into the lower intestine and that is when the enzymes can come into play. That acid is strong, and there are certain conditions—and incidentally given the fact that it’s so strong it also means that the stomach lining, the cells lining the stomach, the mucosa as we call it, mucosa cells, they’re of a special nature to protect the tissue from that acid. It’s fascinating: the biology! Sometimes though, that lining can be disrupted and destroyed and the acid can begin to eat into the underlying tissue in which case we can start getting ulcers and various kinds of conditions which create that too. But that is one pool of acid that should not be confused with the kind of metabolic acidosis that I am talking about, nor should it be confused with the kind of acid that we might see in certain foods, such as citrus fruits. And we have alkaline foods we have acid like foods. The extra acid maybe in citrus fruits and some other foods and that shouldn’t be confused with the acid in the stomach and it should not be confused with the metabolic acidosis in the stomach, acid is not the same for these different pools, altogether different phenomenon.

S.J.: And really other than in the stomach the body wants to keep itself pretty alkaline.

T.C.C.: Yes. Absolutely, and our tissues beyond the stomach inside of the cells, it tends to exist on the more alkaline side of the acid base balance.

S.J.: Some pharmaceuticals have the result in bones of increasing the mineral density but that doesn’t necessarily mean stronger bones more robust bones to impulses and impacts.

T.C.C.: Yes, bone density has often been equated with stronger bones, at least that is the general assumption that has been used for many, many years. There are some exceptions to that, exceptions in a sense that you don’t need to consume a lot of calcium and therefore a lot of minerals to get stronger bones, that sort of makes some simplistic sense but that’s not really necessarily true. Bone strength is related not only to the minerals present, the calcium, the magnesium, and some other minerals, it’s not really related to the amount of mineralization in the bones. It’s also strongly related to the structure of the bone itself, the interstitial kinds of things made up of protein, and collagen, and things like this, it kind of holds things in order. I don’t think we have paid enough attention to totality of the bone structure. There is some evidence, I shouldn’t quite say that so glibly because there are obviously some good researchers who are in fact beginning to point this out—bones are more than a concrete slab that we have dumped a bunch of minerals in and watched them calcify.

S.J.: Speaking of concrete, that is a good analogy because without reinforcing rods, that mesh of steel that is wired in first before the concrete is poured, the concrete would be very brittle and not robust at all to impacts and severe stresses, but with the reinforcing rods it has got that kind of strength that will allow it to be robust to all kinds of impacts. So bones when they have got high mineral density but no reinforcing fine mesh then they’re like brittle chalk.

T.C.C.: Absolutely. It’s an excellent example. You put your finger right on it. I couldn’t have said it as well as that, that’s perfect.

S.J.: What’s meant by negative calcium balance and how do animal products cause it?

T.C.C.: Well, before we talk about negative calcium balance, calcium balance in the old literature and still to some extent in the minds of some people today, is nothing more than a relationship between the total calcium being consumed compared to the calcium being excreted in the urine and the feces. Positive calcium balance means that we’re consuming more than we’re excreting, perfect balance it’s equal, negative calcium balance more is being excreted than being consumed. And the loss of calcium, as we just talked about before, is arising in large measure because when animal foods are being consumed creating a metabolic acidosis, drawing calcium from the bone to neutralize all of this, it eventually ends up out in the urine for the most part, we loose calcium from the body by that measure. Incidentally there is another interesting point about calcium balance studies, in the older days in fact when I was a young graduate student, calcium balance studies were often considered to be the key measurement, the principle measurement of calcium health, you just determine how much is going in, how much is going out and always try to err on the side of more going in than going out, that was very simplistic. In fact the first job that I had as a masters student at Cornell University was washing the glassware of this researcher who was simply doing nothing more than calcium balance studies, how much going in, how much going out. And we now know shortly after that time in fact a very well known professor at Harvard, I’m a great admirer of his work, by the name of Mark Hegsted. He did some really brilliant studies along with some people in Sweden, showing that if we determine how much calcium we need according to balance studies, to keep things balanced, if we do it that way we will find as was shown in these famous Swedish studies, we will find that the amount of calcium that we need at some point in time is pretty much a reflection of what we have become accustomed to in the recent past. If we have been accustomed to a fairly high calcium diet, we do a balance study, we need pretty high calcium intake; that is the way the body has adjusted to this condition. In contrast, you are taking people on a high calcium diet and switch them to a low calcium diet for a while, in the neighborhood of two, three, four months according to what the data showed, if they come to a low calcium diet and you go back and do these calcium balance studies again, same people, you find out that they need less calcium. So the body is always adjusting, always adjusting, that phenomena is exciting and it was really clearly demonstrated in some famous research. It was done in Sweden by a guy studying for his Ph.D. over a period of about 10 years, he did large numbers of human trials and Mark Hegsted of Harvard University expanded on that and showed the same thing. So balance studies are kind of silly, they have actually been abandoned to some extent by the more serious researchers but still unfortunately to some extent people still talk about them.

S.J.: Can milk products cause negative calcium balance?

T.C.C.: I would say yes, but actually I don’t know.

S.J.: Even though they’re loaded with calcium?

T.C.C.: That’s right. I know there has been some dispute, argument about that, you know some will argue that milk because of all the extra calcium can overcome essentially, they will argue this that the extra calcium in milk will overcome the negative effects of the extra protein. But I don’t believe that in a larger context, even though in a short term experiment one might show that from time to time and might be a well done experiment, the problem is that people routinely consuming more dairy have more fractures, it doesn’t make sense, it doesn’t compute. So even though there is a bit of confusion and controversy in the field involving whether dairy doesn’t, at least from my limited knowledge, I need to go back and actually look at that more carefully.

S.J.: Dispute regarding the calcium balance aspect but not dispute regarding the increase in hip fractures for example with respect to increasing milk consumption, or cheese, or whatever product of milk.

T.C.C.: Right.

S.J.: How can people get their calcium if not from dairy?

T.C.C.: Well from a couple of sources of course I mean natural sources, leafy vegetables certainly have a good share of calcium in them, and whole grains, all whole grains are a good source because when we’re consuming the whole grains the outer bran layer obviously has calcium and some other minerals too as well as the B vitamins. It raises another interesting point, we tend to take these grains and separate out the good from the bad and we give the good stuff to the animals and we keep the bad stuff for ourselves.

S.J.: So what is the key to bone health?

T.C.C.: Well one of the important things to good health is exercise, weight bearing exercise.

S.J.: For bones.

T.C.C.: For bone yeah, staying active and of course weight bearing exercise…

S.J.: Some might say that getting exercise puts stress on bones, so you should get as little as possible.

T.C.C.: No, exercise has positive effects across the board.

S.J.: It sends an electrical stimulus along the bone and that challenges the bone to grow cells instead of depleting them.

T.C.C.: Perhaps. Exercise is a good thing and as far as bone strength is concerned weight bearing exercise is good, incidentally that idea of weight bearing exercise making stronger bones has been used in a rather strange way a couple times recently arguing that people who are overweight, it’s one of the advantages of being overweight, because when they walk around they’re getting weight bearing exercise and therefore should have stronger bones, that is kind of a silly argument.

But exercise, coming back to your original question, exercise is obviously important, sunshine is also important because we have got to maintain a good source of vitamin D, and obviously eat the right food—the combination of exercise, getting outdoors with adequate amount of sunshine and eating the right foods and also a couple of other things by the way, salt. Excessive salt intake has a negative effect on bone health for some people, so not overusing salt, consuming the right food, getting some exercise, keeping the body hydrated making sure there is enough water—these are all factors that can give good bone health.

S.J.: How much salt should a person consume?

T.C.C.: Oh I should know this number, I have forgotten.

S.J.: Isn’t the allowance something like 2400mg of sodium?

T.C.C.: Yeah 2400mg sounds right.

S.J.: About a teaspoon of salt, but that seems like a lot of salt to me, maybe I don’t use much salt, that’s the reason my taste buds just aren’t in need of it as much since I don’t use so much.

T.C.C.: I should know these numbers, and once knew them and have forgotten, but we on average consume really excess amounts of salt. And something like if it’s still true today what I knew from some ten, fifteen years ago data, we’re consuming in the neighborhood of 5 to 10 times as much salt or more than we actually need. And it’s something like 80-85% of that salt is coming from processed foods rather than the kind of salt that we add at the table. And so it’s one of the big arguments against processed foods. So we’re really over consuming salt and for about 20% of the population who are particularly vulnerable to high salt intake in terms of high blood pressure, they’re going to see high blood pressure from all that excess salt too as well.

We’re way over consuming salt. Salt is, interestingly, I don’t know if you want to go into this or not, but our taste for salt is influenced by our recent past. If we’re accustomed to consuming a high salt diet and then we’re put on a taste panel and given a choice of foods containing various amounts of salt, we will choose the foods that are most nearly like the foods that we have just been consuming in terms of salt content. And so for a high salt diet, we prefer high salt diets, very simply. In contrast, let’s say we’re accustomed to a high salt diet and now for some reason we’re made to consume a low salt diet for some period of time. It turns out that about 3 or 4 months maybe less, maybe more is required and then we go back on this taste panel and now we’re going to choose the low salt diet so our preference for salt is very much influenced by what we have been consuming in the recent past. And if preference for salt is mistakenly used as an indicator of how much salt we need then that is a big error, that’s wrong. The amount of salt that we need is really as you indicated before, fairly low and it’s much lower than what we actually are consuming.

S.J.: Besides problems for bones what other damage can a high salt diet do?

T.C.C.: Hypertension, blood pressure is the big thing. Blood pressure and all the sequelae that arise from hypertension, obviously hypertension is going to lead to increased risk for stroke and cardiovascular diseases and things like that. Hypertension is not a good thing and by consuming all that excess salt and keeping these high blood pressures is just a bad thing, it’s not good.

S.J.: What about the chloride ions that get eaten in salt?

T.C.C.: I don’t know about the chloride ions, I just don’t know that well enough. I know that the cation sodium actually compared to potassium, another monovalent cation, if you compare sodium and potassium salts the potassium salt is better and it appears that we clearly need in our diet a certain ratio of sodium to potassium ion intake. By consuming a plant based diet, it tends to put us in the right direction. And we know also that there is a balance between sodium and potassium activities throughout our bodies. In reference to what is on the inside of the cell and what is on the outside of the cell. So the shifting of those two ions in particular does play an important role in maintaining so-called osmotic activity inside and outside the cells.

S.J.: Just as an example of how sensitive the body is to these salts even potassium in excess can cause some misfiring of nerves and when that comes to heart problems that could prove critical.

T.C.C.: That is a good point, yeah that is an excellent point, just because potassium is a little better than sodium obviously doesn’t mean we should go out and consume a whole lot of potassium to solve our problems, it just doesn’t work that way.

S.J.: As you have said mother’s milk is the healthiest food possible for babies to grow and prosper. Why has the American Academy of Pediatrics recommended that infants under a year old not receive any milk other than human?

T.C.C.: Well as far as I am aware and this is just from the literature and not having been involved in these panel discussions, so with that advisory, it’s my understanding that the reason that the American Pediatric Association for example and other organizations like it made a decision to recommend not consuming dairy food, cow’s milk, and that was generally for two years rather than one year, babies should stay away from it for two years. That came about not coincidentally just after some pretty convincing data was coming forth that cow’s milk consumed too early in a baby’s life could give rise for some individuals to the onset of type I diabetes. And that research had been done by some excellent research groups mostly in Finland and to some extent in Canada. And it really created quit a howl the thought that cow’s milk might be related to type I diabetes. The whole story really started in the beginning from the observation that when babies are cut short on their weaning for example, those babies that were weaned early had a higher risk of type I diabetes of course being the really serious kind where they end up not being able to produce insulin. And so that was the original observation, just cutting short weaning. But then it was observed that when the weaning period was decreased in contrast they were also going onto cow’s milk earlier, and so then it became more a function of the real relationship that was of interest was the fact that the cow’s milk consumed early could give rise to this autoimmune disease called type I diabetes. It think that the pediatric associations were obviously being really cautious in this case and passing out the word “don’t feed cow’s milk” for at least a couple years.

But we also know from some of the literature too that type I diabetes can be initiated in a similar fashion beyond two years, on up to 3, 4, 5, 6, 7 maybe even later.

S.J.: What mechanism, how does the peptide get into the blood stream?

T.C.C.: The peptide you are referring to is the incompletely digested cow’s milk protein. All proteins in theory are digested down into their individual amino acids but that process is somewhat incomplete as we know in many cases. And so rather than getting complete digestion to the individual amino acids we can end up with a few amino acids not completely separated one from another in which case then we get a little chain of them, called peptides. If those peptides are absorbed into the blood and they can be, especially in infants whose absorptive process in the intestines is not yet complete not yet mature, the body sees those proteins as foreign, foreign proteins and treats them as such. And anytime the body sees a foreign protein, and those foreign proteins are called antigens, at that point the body wants to get rid of them and it gets rid of them by making antibodies or using other components of the immune system to deal with that. And so it makes antibodies to the antigen and that is a very interesting reaction because the antibody itself being a protein creates it in such a way that it makes a prefect match to look at that specific protein that is coming in, so antibody antigen interaction is very, very, very specific. Antibodies are specific for specific proteins. And in the case of type I diabetes, it was discovered that there was a certain peptide of some 17 amino acids all hooked together that kind of slipped into the bloodstream. The evidence showed that an antibody was made against that 17 amino acid peptide and it was specific for that peptide—and all those amino acids in that peptide were in a very specific sequence—it just so happens that a similar 17 amino acid fragment was found in the surface of the pancreas cells that produce insulin, the pancreatic islet cells. And so the antibody now being produced to kick out the foreign cow’s milk protein, or peptide in this case, that antibody then essentially could also be used to attack the pancreatic islet cells that produce the insulin and that was ‘Katy bar the door’, because when the antibodies start attacking these infant pancreatic cells and destroying their capability to produce insulin, that was a very bad deal, because then that meant that infant no longer could produce insulin, for the rest of it’s life and so obviously very, very serious.

There has been a lot of discussion on that questioning the literature in the last 15 years, since that was first discovered, or so. Some very extensive and in depth research has been done on the question. It turns out that whole process is more complex than what I have just described, so it involves some other components of the immune system as well, but what is shown and what one can conclude at this point is that cow’s milk protein given early can in fact initiate an antibody kind of response, however complex it may be, that then can in turn affect these very important cells such as the pancreatic islet cells and destroy their capability, it can have life-threatening, life-long certainly, consequences. And unfortunately in my view at least the pediatric associations and other health research people, the medical community, haven’t emphasized this enough. Sure they say ‘don’t drink milk’ but they don’t go out and tell women, they don’t speak this very loudly. In fact, when this first came out, one of the major reports that came out in the beginning was in 1992 and an organization in Washington was interesting in publicizing this for the public and invited me and the late Dr. Spock and another very famous pediatrician to come to New York to have a news conference to publicize this fact. I didn’t agree to do it at the time because I thought I had enough trouble before I saw more information on the question, but it was also very clear from that experience and subsequent experience that everything has been done to keep the public from knowing this information. Only modest attempts have been made to let the public know and I think the mere fact that it exists that cow’s milk can have this kind of damaging effect early in life, for certain individuals—and incidentally those certain individuals that I am speaking of are those who may have a genetic predisposition for it, that is one thing that has been demonstrated and that genetic predisposition might in turn might be related to some viral interaction such that they end up with a so-called leaky gut, the gut doesn’t mature quickly enough and so it slips in there.

S.J.: Well, leaky gut can develop for many reasons and at any age.

T.C.C.: Right, it can.

S.J.: So with infants, researchers first became aware of the problem with infants and pointed the finger at the problem particularly in infants because their digestive tracts are trusting that they’re only going to be fed foods that are completely compatible with robust health, for instance mother’s milk. But when you feed an infant something that can cause a problem, such as really any kind of milk other than human, then indeed the problem arises more readily with infants, but at any age a person can develop leaky gut syndrome due to some kind of an infection, as you mentioned, or perhaps due to gastroenteritis of some kind and all of a sudden be challenged with even adult onset type I diabetes.

T.C.C.: You’re right.

S.J.: In other words, death of the Islets of Langerhorn and hello needles, hello insulin.

T.C.C.: You are absolutely right, that is one of the things that I said before that it’s too bad that they sort of narrowed this concern down to the first year or two of life, because in reality we know that this kind of phenomena can arise in later years. We know for example that type I diabetes as you just said, can arise in some people on into their teen years and even older maybe, they’d loose their capacity to produce insulin altogether and it needs to be assumed that more or less the same thing is going on, that has already been demonstrated in infants.

S.J.: What can a baby be fed if the mother can’t lactate enough?

T.C.C.: Gosh, I’m not a pediatrician, so I am not sure I can answer that question well enough, but obviously good water is always important.

S.J.: I mean for nutrition.

T.C.C.: For nutrition, I going to beg off that one because I don’t know enough about it, you can start them in on purees of vegetable matter. My wife and I had five children and she used baby food like that, that was for the most part vegetable. Our grandchildren have been fed that entirely as we have sort of really gotten into this. I don’t know, just regular food that we would otherwise be consuming, put in a physical form that they can actually consume is about what the size of it is. As far as liquid is concerned they can drink fruit juices too, my wife did that quite a bit.

S.J.: So many young children suffer from severe earaches, do milk products have anything to do with that?

T.C.C.: Yes, they do. It’s now acknowledged even by the defenders of the dairy industry—I just happened to have seen this information recently—it’s being acknowledged that cow’s milk is the number one food allergen that we consume. It’s also being acknowledged, even in the conservative literature, that the effect of cow’s milk on creating allergies it can take many different forms, ranging all the way from behavioral patterns, to skin eruptions, to other kinds of issues and ear aches, the excessive fluid accumulation and other kinds of responses like that is just one of those kinds of allergies. And we know that dairy is a strong effecter of these ear aches that are occurring in very young children.

S.J.: Also just as a film forms at the back of the glass as it gets emptied, milk can enter the inner ear canal as the head is tilted back to drink and that provides a perfect ambient for bacteria and other pathogens to grow.

T.C.C.: Oh really, that I didn’t know, interesting. Do you know of some evidence that that has been demonstrated?

S.J.: That I can’t cite; it just seems very plausible to me.

T.C.C.: Yeah. But it’s clear, I think we agree, that dairy, drinking cow’s milk, is certainly a major factor in causing ear problems for young children. One of our grandsons had exactly that. The two youngest they have been pure vegans from the beginning, no milk at all, but in one case our grandson’s mother wanted to let him have some milk from time to time, or maybe some ice cream to join his kids, but every time that that was done he got ear problems, and suddenly they just realized “no way” even the slightest bit of dairy could cause problems, it was just back and forth, back and forth demonstrated so many times.

S.J.: What about acne?

T.C.C.: Acne was recently demonstrated in some fairly good research, a good report out of Harvard, showing that there is a strong link between teenage acne, usually occurring between the years of about 14 and 18 I think, there is a strong link between teenage acne and dairy consumption. And again it’s another kind of allergic response. And acne although it’s not life threatening, it certainly is a difficult problem for a lot of teenagers. And I just wish that they knew because they certainly don’t want to have that problem and they usually go to their dermatologist and try to get some creams and this and that and everything else, when in fact all they need to do is quit consuming dairy. That is not going to clear up all the acne problems, but it’s certainly going to according to the recent evidence address a lot of the acne problems.

S.J.: Because teenagers have burgeoning hormones that cause a secretion of oils in the pores and sometimes dry skin blocks the oils and that causes an eruption. And if you add more hormones that are naturally occurring in milk products then that just adds to the problem, does that make any sense?

T.C.C.: That could be, sure it could be. Also the issue of consuming all that milk and getting extra protein, actually will tend to turn on the synthesis of our own hormones, so our so-called endogenous hormones, the ones that are produced in our bodies, can be increased in their production, just simply from consuming a dairy based diet.

S.J.: What foods can cause headaches?

T.C.C.: Dairy again is a big one, migraine headaches are classic symptoms, and I have heard it said by a number of people that dairy is the principle cause of migraine headaches.

S.J.: By dairy you don’t mean eggs, rather milk products.

T.C.C.: Of course, I mean just cow’s milk products: ice cream, cheese

S.J.: Goat milk products, do you think?

T.C.C.: I don’t know about goat milk, there are people that say that goat milk is different and it doesn’t create the same response and so forth.

S.J.: Not as much lactose.

T.C.C.: Perhaps, I just don’t know enough, again it’s a question of I wish we could do the kind of research of comparing goat’s milk with cow’s milk a one on one kind of comparison with respect to these kind of responses. But I haven’t seen that kind of information, maybe it’s been done, but I do hear from time to time that goat’s milk is not as problematic as cow’s milk. But I might be just be reflecting an impression rather than pertinent data.

S.J.: So far as other aspects, such as protein content and perhaps hormone content that would occur naturally goat’s milk would cause problems?

T.C.C.: Yeah it should. There should be some problems with goat’s milk but you know the difference between goat’s milk and cow’s milk these days in the modern sense is pretty significant because cow’s milk is pretty loaded up with exposures at least to all kids of other agents, that goat’s milk tends not to be exposed to—hormones, and pesticides, and antibodies and so forth.

S.J.: What about animal products could contribute to impotence, including both erectile function and sperm count and motility, the ability to have children?

T.C.C.: Well, one thing is that erectile function is in fact an expression of vascular health and vessels throughout the body, obviously, are subject to atherosclerosis, occlusion. And when one is consuming a high fat animal based diet this kind of phenomena doesn’t occur just in the heart, it obviously also occurs in the brain in which case if it breaks it creates a stroke. With erectile function, obviously, it’s affecting the tissues in that area as well and blood is what’s required, a good flow of blood, and when blood flow is impeded that is the problem.

Sperm count, I don’t know about sperm count. There is a fairly well known book that was published recently with good information showing that sperm count’s actually decreased quite substantially in the last few decades throughout the world. And some estimates now that it may only be 50% as high as it once was, that is pretty alarming. And there’s a projection by this author who wrote that book that if it continues on this track pretty soon men are going to have no need, there is no need for men, or they’re not going to be able to function, that is the end of the human race I suspect. But the thesis on the part of that author and others like it, they weren’t focused so much on the question concerning dairy. In that case they were talking about these endocrine disruptors, the chemicals like the chlorinated hydrocarbons, or the chlorinated pesticides, and things like dioxin, things like that that tend to be spread around the world in the environment. And may very well be the cause of sperm count going down. I haven’t heard the questions concerning dairy though on sperm count.

S.J.: How old do men have to be to experience problems with erectile function, due to dietary effects?

T.C.C.: How old do they have to be? Well, I’m told it starts in late 40s early 50s, just like atherosclerosis symptoms begin too.

S.J.: The symptoms, however, the reality of atherosclerosis can begin at what age?

T.C.C.: Oh, much earlier, these days there is now talk of plaques existing in children as young as 8 and 9 years of age.

S.J.: Those studies might not have considered if maybe erectile function could be problematic for younger people?

T.C.C.: Yes, right. I am just not familiar with the literature and the numbers on that but that is certainly a very real possibility I would think.

S.J.: Due to plaque forming, atherosclerosis, hardening of the arteries and not allowing blood flow. On a plant based diet could one possibly stay virile and avoid impotence much longer naturally even until quite elderly without spending a fortune on pharmaceuticals and risking their side effects?

T.C.C.: Yes. I can tell a little story about that. Dr. Esselstyn, the famous doctor who reversed heart disease, in his 18 patients, one of whom we met for breakfast one morning. He was ecstatic about the fact that his heart disease was all better. He was actually a very wealthy man, by the way, extremely wealthy, but he just told us, told my wife and I at breakfast that morning at a conference that he had been brought to by Dr. Esselstyn, that much to his surprise he wakes up one morning and he didn’t have the erectile dysfunction problem. And he was amazed and so word has spread, it has been noticed many other times, it can be corrected if people get on the right diet just like heart disease can be corrected, so it’s a reversible process. I don’t know if it’s always reversible, or if it’s reversible after some period of years, I don’t know that, but yeah erectile dysfunction is nothing more than an expression just like coronary heart disease.

S.J.: Well, so cleaning up one’s diet, helps one clean up one’s arteries, allowing extra blood flow or recovered blood flow and more joy in many ways.

T.C.C.: Absolutely. Let’s extend that just one more step too, it’s kind of interesting. You know menstruation is very much a function of how fast the girl grows. And young girls and boys, of course, the rate at which they grow is a function of how rich their diet is. If they’re consuming a really high protein diet, lots of animal foods and so forth, they’re going to grow faster and have earlier age at menstruation. In our China Study age of menstruation on average was 17 years compared to about 11 and 12 in this country. We recorded averages for some 65 counties, I mean there were some counties where the average age of menstruation was as high as 19 years. That is a big change and so what it sort of suggests is that if people are consuming a plant based diet, not pushing the growth of the children so hard, their reproductive years start later. And it could solve the teenage pregnancy problem according to an associate of mine who was in my high school class by the name of Gloria Steinem in her magazine, Ms. Magazine. That is where that idea first came from.

S.J.: How about animal products and constipation?

T.C.C.: Constipation, of course, has been most directly attributed to how much fiber one is consuming. And so consuming low fiber diets, obviously can give rise to constipation. And the late Doctor Dennis Burkitt, who traveled all the length of Africa in some of his studies, made a lot of observations, amongst people living in the rural areas on plant based foods that their stools are much looser then Western. He gave some very comical seminars that I attended on that question. But he pointed out as had some of his predecessors before him that constipation was pretty much a disease of the west, of western societies. It didn’t exist in the societies that consumed a lot of plant based foods. And now we know it’s very clear that people consuming plant-based diets don’t have that problem, that people who have that problem, people who need the what do you call it the H formula something like that, I forget?

S.J.: Preparation H?

T.C.C.: Yeah, that whole thing is related to the fact that people are consuming animal based foods.

S.J.: Hemorrhoids.

T.C.C.: Hemorrhoids and animal based foods.

S.J.: Constipation

T.C.C.: Exactly.

S.J.: So hemorrhoids resulting from constipation.

T.C.C.: Yeah, hemorrhoids resulting from constipation, absolutely. That’s right Preparation H was for hemorrhoids it wasn’t for constipation per se, but it was related to the same complex of problems.

S.J.: How do the protein fragments called opioid peptides in dairy protein worsen constipation?

T.C.C.: I don’t know, I don’t know the answer. I know about the opiate–like substances in dairy food, certainly.

S.J.: What is the effect of opiate like substances?

T.C.C.: Well, there is some speculation, again I don’t know the literature well enough on this, but there is certainly some speculation about the role that they may play in brain chemistry for example and therefore in behavioral problems, such as with attention deficit disorder or attention deficit hyperactive disorder, ADD or ADHD, a serious problem according to many authorities. And the opiate like compounds in dairy could be playing a role.

S.J.: In fact some of the peptides are called casomorphines and act in the body a little bit like morphine, unfortunately since they’re absorbed right in the intestines they affect the intestinal muscles to slow peristalsis and slow the movement of the bolus along the intestinal tract, worsening risk of constipation.

T.C.C.: Oh is that right, that is something I didn’t know, good.

S.J.: Do animal products increase the risk of male pattern baldness?

T.C.C.: Not that I am aware of, but you know this whole question of animal versus plant–based food has such a broad array of effects, I tell you any more these days I am not surprised to see anything.

S.J.: The research has yet to be done.

T.C.C.: The research has yet to be done. Baldness is largely a genetic thing, it’s a very strongly genetic link we know that but whether that in turn can be influenced by diet I don’t know. I can make an argument that it could be, because the little hair follicles that eventually begin to die, their livelihood, their life certainly can be influenced by the biochemistry and physiology of our bodies influenced in turn by diet.

S.J.: Which diseases is high cholesterol associated with, only heart disease or with other chronic degenerative diseases as well?

T.C.C.: Well, it seems to correlate with, associate with, if you use the word associate; it’s associated with lots of things. It’s associated with increasing cancer rates, higher cholesterol levels. We saw that in China, we of course know that higher cholesterol levels are associated with heart disease, and with stroke, and often times with condition that relates to diabetes and obesity, if you call obesity a disease which I don’t. But in any case in a whole host of conditions like that, that are typically found in Western societies are associated with higher cholesterol levels. But I want to emphasis that I am using the word associate here not meaning causality, I am just simply saying association, And further more I should point out that as far as cholesterol levels are concerned we know now that a better estimate of these associations is not total cholesterol, but it’s the ratio of total cholesterol to the good cholesterol HDL, which also relates to how much of the LDL or bad cholesterol that we have. So it’s the LDL, HDL, total cholesterol complex that is more important than the total cholesterol in itself.

S.J.: If saturated fat and animal protein—but not cholesterol per se, if cholesterol is just a marker for disease—if they contribute to many diseases, especially atherosclerosis and heart disease, is it ok to have high cholesterol or not?

T.C.C.: You mean high dietary cholesterol?

S.J.: Or high…

T.C.C.: High blood cholesterol? Yeah, of course, the connection between dietary cholesterol and blood cholesterol is not a simple one to one relationship. And, in fact, the level of the cholesterol in our blood may be influenced slightly by the amount of cholesterol we actually consume, but it’s more influenced by the kinds of foods we’re consuming that contain let’s say animal-based protein or plant-based protein or how much fiber they contain, how much this and that; I mean it’s more than just dietary cholesterol intake. So your question is in reference to the high cholesterol intake or the high cholesterol in the blood, because they’re not necessarily the same?

S.J.: Well you were saying that cholesterol may not be causative of disease.

T.C.C.: Right, you mean dietary cholesterol, the cholesterol we consume?

S.J.: Or the cholesterol in the blood. So if it really is the animal fat and protein that are causative is it alright to have high cholesterol in the blood?

T.C.C.: One can argue that, that possibility exists and we do know that people can have high cholesterol and don’t get heart disease. And in the same fashion we can also see people who have much lower levels of cholesterol do have heart disease. So roughly speaking, the amount of cholesterol is related to heart disease risk for sure when you look at large populations, large groups of people, right, but there are deviations for individuals that are quite substantial at times—high cholesterol no heart disease, lower cholesterol heart disease. That paradox, so to speak, is resolved to some extent if we look at the ratio of total cholesterol to HDL that improves it a bit, so you don’t have as many of these exceptions. It’s further improved by examining how much of the bad cholesterol is actually oxidized and that’s pretty critical, because that indication says that to the extent that cholesterol may become involved in some of these diseases it could be related to the extent to which it’s oxidized. And that makes altogether eminent sense. Relatively high levels of oxidized cholesterol in the body come from people consuming animal based foods instead of plant based foods, plant based foods have a lot of antioxidants that therefore tend to decrease the amount of oxidized cholesterol. Now this oxidation sort of phenomenon that is so important in so many different disease processes, also it’s important in the development of plaque and the subsequent rupture of the plaque. We know, for example, that plaques alone that occlude the artery and blood flow are not sufficient in and of itself, unless it’s completely closed, it doesn’t explain very much of the heart attacks that actually occur. That is the closing of the lumen of the artery. Rather, we now know that these plaques to the extent that they do relate to heart attack or stroke, have to do with the rupture of the plaque and the plaques rupture when the covering over the plaque, the kind of thin layer of pretty tough stuff that forms over these plaques normally, when that covering becomes sort of thinned, something breaks that and then all the stuff on the inside of the plaque is extruded into the blood. That can give rise to a very quick clot and cause a heart attack. The rupturing of that plaque and the membrane over the plaque can in fact be related to oxidation phenomena. If a lot of oxidation’s going on, it could be kind of rusting away the cover.