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May 2014The McDougall NewsletterVolume 13 Issue 5multiple failed attempts for a cure, the patient may become sufficiently motivated to takewhat seems to be the most drastic step of all, which is to radically change his or her diet.!My 36-years of seeing patients, along with many scientific papers, has lead me to theconclusion that a healthy low fat, vegan diet (the McDougall Diet, for example) dramaticallyimproves and in most cases cures inflammatory arthritis. The diet consumed cannot simplybe "vegan" (without animal foods). Meals must be based around unrefined starches with theaddition of vegetables and fruits. Vegetable oils (olive, corn, canola, flaxseed, etc.) arestrictly forbidden.!When patients first start, I usually recommend that they follow the basic McDougall Dietwithout wheat or soy foods. (This request is made only for general health reasons because iteliminates refined flours found in breads and cereals, and processed soybeans, includingfake meats and cheeses.) A gluten-free diet (no wheat, barley, or rye) is a next reasonablestep for anyone not achieving rapid improvements from the basic McDougall Diet. A fewpeople will have to follow the stricter McDougall Elimination Diet (see below). A temporarywater-only fast maintained for a few days is the ultimate dietary restriction and is a finalstep I have resorted to for a few difficult patients.!Benefits for arthritis usually begin to appear within four to seven days of strict adherence tothe new diet regime. This is the amount of time required for the bowels to eliminate all ofthe foods previously consumed. After the remnants of unhealthy foods are emptied from theintestines, the animal-food-derived protein antigens slowly clear out of the bloodstreamover the next few days. Products of inflammation, such as the antibodies attacking thebody's own tissues, may persist for weeks. Complete resolution of active disease may take aslong as four months; only then can the full benefits be appreciated from following the newdiet therapy.!Unfortunately, small indiscretions often result in big penalties. That error could be a tinybite of cheese or a bowlful of oily vegetables. One of my patients had been free of all of herarthritis pain and swelling for four months when she ventured out to a Chinese restaurant.The food served may have been vegan, but the peapods and sprouts were drowning inpeanut oil and swimming with questionable ingredients. The next day she was in my officewith both knees red, hot, and swollen.!People on medication must keep in contact with their private doctors. As they improve withthe new diet regime then their doctors should be recommending, sooner rather than later,reductions and eliminations of medications. Remember, the medications are primarily forsymptom relief. The cost of too aggressive reduction of medication is an increase in pain,which can be remedied by restarting the drug regime. Most people, like the ten examples inthis article, will be able to stop all medications and live comfortably. The program isessentially cost-free, side effect-free, and risk-free. Of course, patients should consult theirhealthcare provider before making any changes in their diet or medication, especially if theyare ill or on powerful drugs.8

May 2014The McDougall NewsletterVolume 13 Issue 5THE MCDOUGALL ELIMINATION DIET:The following foods are allowed without calorie restriction. Portion control (based on a visual estimate)should result in about 80% of the food coming from starches; the remainder will be from vegetables andfruits. Cook all foods thoroughly. Heat breaks down and deactivates proteins and other troublesomecomponents of the food. Boiling and steaming are the healthiest ways to cook.Starches (all cooked), include:!Brown rice (or white rice)Sweet potatoesWinter squash (Acorn, Butternut, Pumpkin, etc.)Taro (or poi)Condiments include:!SaltSugar!Only common table salt and table sugar are!Non-starchy green and yellow vegetables (all allowed,if not restricted for other healthreasons. This means no salad dressings, mustard,cooked) include:lemon juice, vinegar, pepper or s!Water (sparkling water is OK)Beet greensCelery!Managing the Elimination Diet:ChardKale!After one week of being strictly on the new Diet,LettuceSpinachString BeansSummer squashproblems should be ending and the dieter shouldbe feeling much improved. If this is the case,then the dieter can begin adding other foods(those not listed above) back to his or her diet,Almost all other non-starchy yellow, orange, red, but only one at a time, in order to determine ifgreen, and purple vegetables are allowedany of these cause unpleasant reactions. For(cooked). Avoid onions, green pepper,testing purposes, each "new" food should becucumbers, and radishes, especially when raweaten in large amounts three times a day for twobecause they can be very troublesome for thedays. If the food does not cause a reaction, thenstomach, causing indigestion.the dieter can conclude that this food is not atroublemaker. Most reactions occur within a fewFruits (all cooked) include:hours, but some may not show up for severaldays. Each food must be tested individually; doApricotsnot introduce two new foods at once. WhenBananasthere is a reaction to a specific food, the dieterBerriesmust wait for four to seven days before testingCherriesthe next item. This interval gives the timePapayarequired to clear the intestines and to rest thePeachessystem from that allergy-causing food.PlumsAvoid all citrus fruits, including oranges,The foods added back during the eliminationgrapefruits, tangerines, lemons, limes, etc. and diet should not be from animal products of anyalso tomatoes.kind or from vegetable oils for general healthreasons. No one should follow a diet "moreliberal" than the basic McDougall Diet.!!!!9

May 2014The McDougall NewsletterVolume 13 Issue 5Recipes"!!!!This month's featured recipes are contributed by Katie Mae, MSof PlantBasedKatie.com.!!Along her path, she realized her passion for good health wenteven deeper when it came to pregnancy and children. In orderto best support women before, during and after pregnancy, shewas trained as a Post-partum Doula through Natural Resourcesin San Francisco.!!From cooking demos to nutrition presentations to individualcoaching, she loves playing with and talking about food. Katie'swhole foods cooking style is 100% plant-based, gluten-free, andmore importantly, free of sugar, oil and salt. When she's not in the kitchen or talking nutrition,you may find her practicing yoga and meditation, jamming to live music, dancing out in natureor giving into her travel bug.!!Sweet Potato Tostadas!!3 medium cooked sweet potatoes,mashed!1½ cup cooked black beans (or 1can drained and rinsed)!2 tablespoons water!½ tablespoon ground cumin!1 teaspoon ground coriander!1 teaspoon garlic granules!½ teaspoon chili powder!1½ cups spinach!6 corn tortillas, oil-free!!!!!Preheat oven to 350F. Set freshly cooked and mashed sweet potatoes aside. If the sweetpotatoes were cooked previously and are cool, warm them up on the stove top.!!In a medium saucepan over medium low heat, add black beans, water cumin, coriander, garlicgranules and chili powder. Heat the beans for 5-10 minutes, stirring occasionally.!!Lay tortillas in a single layer on a baking tray. Put tortillas in the oven for 3-5 minutes,depending on how soft you want them to be. Remove from oven and lay on a serving plate.!!To make a tostada, start with 1 cooked tortilla. First add a thin layer of spinach - about ¼ cup.Then scoop a little of the sweet potatoes onto the spinach. Carefully spread the sweetpotatoes across the tortilla. Add about ¼ cup of the black beans on top of the sweet potatoes.10

May 2014The McDougall NewsletterVolume 13 Issue 5Add your favorite toppings, such as Strawberry Mango Salsa (recipe below) or a deliciousguacamole.!!Makes 6 tostadas!!Fresca Bean Salad!!1 can (15 ounces) black beans,drained and rinsed (1½ cups)!1 medium carrot, shredded (about 1cup)!½ small red onion, minced (about ¼cup)!1 cup cherry tomatoes, halved!2 tablespoons fresh cilantro, diced!1 avocado, diced!½ lime, juiced!1½ tablespoon garlic granules orpowder!1 teaspoon ground cumin!2 generous pinches of cayennepepper, or to taste!!In a large bowl, mix the beans, carrots, onion, tomato cilantro and avocado. Stir in the limejuice and spices. Stir well.!!Makes 4 cups!!!!!Caramelized Onion & Pepper Quesadillas!!¾ cup raw cashews, soaked for 2hours!½ cup nutritional yeast flakes!1 lime, juiced!½ tablespoon stonegroundmustard, no-salt added!¾ cup water!1 yellow onion, sliced thin!1 red bell pepper, sliced thin!1 yellow bell pepper, sliced thin!1½ tablespoons ground cumin!1½ teaspoon chili powder!8 organic 100% corn tortillas, nosalt or oil added!2 cups fresh spinach, loosely11

May 2014packed!!!!The McDougall NewsletterVolume 13 Issue 5!Make the cheese sauce: Add the cashews, nutritional yeast, lime, stoneground mustard andwater to a blender. Blend until it the sauce is creamy. Set it aside.!!Make the onion-pepper filling: Place a sauté pan over medium heat. Add the sliced onion andbell pepper. Stir in the cumin and chili powder. Cover and cook for 5 minutes, stirringoccasionally so the veggies don't stick to the bottom of the pan. Then stir in a tablespoon ofwater and continue cooking uncovered. When the water evaporates stir in another tablespoonof water, continuing to sauté until the onions are caramelized.!!Turn the heat to low. Pour the cheese sauce into the onion and peppers. Stir well and thencover with a lid so the mixture doesn't dry out.!!Make the first quesadilla: Place a non-stick pan over medium heat. Let it heat for 5 minutes.Then place one of the tortillas into the pan. Set a timer, letting the first side toast for 2 minutesand then flip. Set the timer for another 2 minutes. As you wait, carefully scoop about ¼ of thefilling onto the tortilla and spread it evenly, forming a single layer of peppers and onions. Layer½ cup of spinach across the onions and peppers. Place the second tortilla on top of thespinach.!!Once the timer goes off or the bottom side is toasted, use a large spatula to carefully flip theentire quesadilla. Toast the second side of the tortilla for 2-3 minutes.!!When the quesadilla is done transfer it to a plate. Repeat this process with the remaining fillingto make a total of 4 quesadillas. Note that subsequent quesadillas may require less cookingtime because the pan will be hotter. You may want to turn the heat down slightly after the firstcouple. Slice the quesadillas into triangular pieces and serve with toppings of your choice.!!Serves 4!!Strawberry Mango Salsa!!1 cup strawberries, diced!1 cup mango, diced!2 tablespoons white onion, minced!2 tablespoons jalapeno, seededand minced!2 tablespoons fresh cilantro, diced!1 lime, juiced!!!!In a medium bowl, combinestrawberries, mango, jalapeño,12

May 2014The McDougall NewsletterVolume 13 Issue 5onion, cilantro and lime juice. Mix well. Serve immediately or chill in refrigerator.!!Makes 2¼ cups!!!!!Fry-less Refried Beans!!1 yellow onion, chopped!2 jalapenos, seeded and chopped!3 cups cooked pinto beans (or 2cans drained and rinsed)!¾ cup water!½ tablespoon garlic granules!!Place a non-stick pan or stainlesssteel saucepan over low-medium.Add onion and jalapenos. Coverwith lid to keep the moisture in thepan. Stir occasionally to preventsticking. After 5 minutes transfer theonion and jalapeno to a blender.!!!!Add beans and water to the blender. Blend until beans have a creamy consistency.!!Transfer the blended bean mixture to a sauce pan. Cook on low-medium heat for 20 minutes,stirring occasionally. Careful not too turn the heat too high because air pockets will form, popand splash pinto beans. The beans will thicken as they cook – the cooking time will depend onyour desired consistency. Serve in tacos or as a side dish.!!Makes 3½ cups!!Tempeh & Broccoli Rojo!!½ small yellow onion, diced!3 cups broccoli florets!1½ cups corn!2½ cups dried chili sauce (separaterecipe)!3 ounces tomato paste!8 ounces tempeh, diced!1 tablespoon dried oregano!1 lime, juiced!1 avocado, chopped!!Place a medium-size sauté pan orpot over medium heat. Add onion,13

May 2014The McDougall NewsletterVolume 13 Issue 5broccoli and corn and cover with lid. Cook for 3 minutes, stirring occasionally so the vegetablesdon't stick to the bottom of the pan.!!!!!Add the chili sauce, tempeh, oregano and lime juice. Once the sauce comes to a boil turn heatdown to medium-low and remove the lid. Cook for 10 minutes. Remove from heat and stir inavocado. Serve immediately.!!Makes 5-6 cups!!Dried Chile Hot Sauce!!3-6 dried New Mexico chiles!2½ cups water!½ small yellow onion!1 tablespoon garlic granules!!Add all ingredients to a high-speed or standard blender. Blend until smooth. Stores in thefridge for up to 2 weeks.!!Makes 2½ cups!!!!!!!!!!!!!!!14

May 2014The McDougall NewsletterVolume 13 Issue 5Evaluation of the Chowdhury Meta-Analysis on the"Association of Saturated Fatty Acids with Coronary Risk, Part 3"!They “can’t see the forrest for the trees”1"Fred Pollack!May 31, 2014!!This is the concluding chapter (i.e. part 3) of my reviewof the Chowdhury meta-analysis study [1] that waspublished online at the Annals of Internal Medicine onMarch 18, 2014. The study effectively said that thecurrent guidelines on saturated fatty acid (SFA) intake( 10% of calories from SFA) were not justified by theevidence and should be reconsidered. That led MarkBittman, the NY Times Magazine’s lead food columnist towrite, Butter is Back, and said, “Julia Child, goddess offat, is beaming somewhere. Butter is back, and whenyou’re looking for a few chunks of pork for a stew, youcan resume searching for the best pieces — the oneswith the most fat.”!!About Fred!!I live with my wife, Iris, in MiamiBeach. We are both 66. I workedat Intel for 23 years, and retired inearly 2001. For most of my last 8years at Intel, I directed theplanning for Intel’s futuremicroprocessors. In January 1993,I was named an Intel Fellow.!!My wife and I have been eating alow-fat whole-food plant-based dietsince February 2009.!!From my own extensive reading of the medical/nutritionalresearch, I doubted Chowdhury’s conclusion, and thus was compelled to do an in-depthreview. And, the only way to do this is to read and analyze all 20 of the SFA intake studies thatwere used in the Chowdhury meta-analysis. I have now completed that analysis, writing upeach and every one. The result is a 100 page document that you can download the PDF, byclicking supplement.!!The purpose of this newsletter article is to provide an overall summary of my analysis. Section1 will provide the big picture (i.e. the forest), including a very brief overview of just 3 of thestudies that are illustrative of the big picture view. Section 2 will highlight the common flawspresent in almost all of the 20 studies. Section 3 will provide a brief synopsis and grading ofeach of the 20 studies. And, of course, the last section is the conclusion.!!Big Picture"!In part 2 (McDougall April Newsletter), I began with a chart from Finland that showed CoronaryHeart Disease (CHD) mortality for men in 1973 from various countries. Here is that samechart again (top of the next page). Note that Finland has the highest CHD mortality and Japanhas the lowest. But what about the most recent data. Below is the most recent data fromOECD 2013 Health at a Glance Report, measuring Ischemic Heart Disease Mortality (IHD)2 for1Meaning: /can t see the forest for the trees 149.htm.2IHD and CHD are used interchangeably.15

May 2014The McDougall NewsletterVolume 13 Issue 5CHD Mortality per 100,000 men in 19731. HEALTH STATUS1.3. Mortality from cardiovascular diseases691.3.1. Ischemic heart disease mortality, 2011 and change between 1990 and 2011 (or nearest year)2011Change erlandNorwaySloveniaAustraliaCanadaUnited KingdomGermanyOECD33SwedenUnited StatesPolandIcelandIrelandAustriaMexicoNew ZealandFinlandCzech Rep.EstoniaHungarySlovak 0Age-standardised rates per 100 000 0-47-5518-41-6-75-50-2590255075Change in % over the periodSource: OECD Health Statistics 2013, http://dx.doi.org/10.1787/health-data-en.1 2 http://dx.doi.org/10.1787/8889329160972011, including both men and women. The chart next to it, also shows the changes by countrysince 1990.1.3.2.Goingback to the 2009 OECD Health at a Glance Report, you can see the IHDCerebrovascular disease mortality, 2011 and change between 1990 and 2011 (or nearest year)mortality data for 2006,as well as a graph for rates going back to 1980for the OECD average2011Change 1990-2011plus a 41few select countries.3 For the countriesin which the 20 studiestook place, I wanted to-56Switzerland-5341France42 to 1970. So, I’ve included a table fromgo backOECD Health at-59 a -46Glance from 2003 for justIsrael43Canada4!-4343United Statesthese 76768697080818392Note that the graph on the right is not quite comparableOECD population.”4From table 1.15 (page 98 of the PDF).NetherlandsSpainAustraliaGermanyDenmarkto SwedenMexicoNew ZealandFinlandUnited 62-55-50on the left. The graphis “age-standardised to the 2116-39

1.4.1. HEALTHSTATUS211Czech Republic123303Hungary177Mortalityfrom heart disease209and stroke 324Slovak Republic0100200300Czech RepubliPortugaHungar400MayIschemic2014 heart disease, mortality rates,The McDougall NewsletterVolume13 Issue 51.4.11.4.2 Stroke, mortalityrates,Age-standardisedrates per 100000 population2006 (or latest yearavailable)2006 (or latest year nited KingdomAustriaIrelandNew ZealandUnited StatesPolandFinlandCzech RepublicHungarySlovak RepublicFemales4728Females34Canada2935United States32 Denmark40Ireland37Japan42Austria34Netherlands35 10042Age-standardisedrates per000 population4238300 Australia44Norway37New Zealand46 444437250 Germany45Iceland3646Sweden384740200 Mexico49Spain3851United nland4310060OECD4861Japan36Greece88 865089Slovak Republic6194Poland6997Korea640Czech 2161123661266612764130621321387514167781427914515

inflammatory arthritis conditions are labeled as "rheumatoid arthritis." Even when one or a few body parts are predominantly involved, such as the hands and/or knees, the disease is . Dr. McDougall's Experience with Diet and Inflammatory Arthritis ! Over the past 36 years I have learned many valuable lessons about treating inflammatory