Photo courtesy of Dr.
Founder of the Physicians Committee for Responsible
Medicine (PCRM), a nonprofit that promotes preventive medicine, conducts
and encourages higher standards for ethics and effectiveness in research, Neal
Barnard is not only a doctor but also an advocate for compassion
in the medical and scientific communities. Author of Breaking the Food
Seduction and founder of a new nonprofit, the Cancer Project, Dr. Barnard
emphasizes the importance of vegan diets in maintaining a healthy lifestyle.
Dr. Barnard has dedicated the past 20 years to PCRM in which they have successfully
waged and won campaigns to eliminate the use of live animal labs in the majority
of the nation’s medical schools, challenged federal dietary guidelines,
developed the first cruelty-free insulin assay, and established the humane seal
of approval for charities. In addition to showing that alternatives to the use
of animals in medical research and training can be as or more effective than
traditional methods, Dr. Barnard also believes it’s important for scientists
and doctors to change their perceptions about animals.
Sangamithra Iyer had the chance to speak with Neal
Barnard about vegan diets,
ethical issues in medical research, and about the 20th anniversary of PCRM.
When and why was PCRM founded?
In 1985, I was in my first year of practice at Saint Vincent’s Hospital
in Manhattan. It seemed to me that the medical practice did a pretty good job
of diagnosing illnesses, sometimes a good job of treating illness, but an abysmal
job of preventing them. We did nothing about heart attacks until they came into
the emergency room. We didn’t do anything about cancer until you saw it
on a mammogram. I thought that was wrong. We needed to bring nutrition into medicine.
I was also concerned about ethical issues in human research—there have
been many disturbing revelations about how humans are treated in studies—and
with animal research where regulations are terribly minimal.
Can you tell us when and why you made the switch to a vegetarian diet?
It was a gradual thing. The year before I went to medical school, I had a job
helping out with autopsies in a Minneapolis hospital. For most people, a stroke
or colon cancer are just theoretical concepts. But if you are the guy who runs
the scull saw and you open up a person’s head to find a big golf ball-sized
hole filled with blood—a hemorrhagic stroke—it makes an impression
on you. We would weigh the colon tumors and the lung cancers and we would dissect
the coronary arteries filled with atherosclerosis, and the pathologist would
let me know how diet played a role in these various conditions.
One day, we opened up the chest of a person who died in the hospital from a massive
heart attack (probably from eating hospital food, but that’s another issue).
We removed a big section of his ribs and set the ribs on the table. We saw the
arteries filled with [fatty buildup]. The pathologist told me that this was present
in about three quarters of Americans by age 23, about the age I was at the time.
At the end of the exam, I put the ribs back in the chest, covered the heart,
and sewed up the skin. Then we went up to the cafeteria for lunch and it turned
out that they were serving ribs. Somewhere between the smell of it and the look
of it—which was very much like the dead body—I was just unable to
eat it. I didn’t become a vegetarian immediately but that did register
in my consciousness.
What are the four food groups proposed by PCRM? Can you tell us about your campaigns
against the USDA?
In 1956, the department of agriculture unveiled the original four food groups—meat,
dairy, grains, vegetables and fruit. Vegetables and fruit had to share a group
and meat and dairy got half of the four, yet there is no nutritional requirement
for either one, in fact you are much better off if you skip them completely.
So in 1991 a group of scientists and I held a press conference in Washington,
DC, and we announced that a healthy diet consisted of four new food groups: whole
grains, vegetables, fruits, and legumes. The federal dietary guidelines as to
what Americans should eat is a continual battleground, and every five years they
are revamped. In the year 2000, we brought a lawsuit against the federal committee
because out of the 11 members setting the guidelines, six of them had financial
ties to the meat or dairy industries. We felt that was inappropriate. I’m
happy to say that we prevailed and won that lawsuit. Nonetheless, despite that
victory, it is still a challenge to turn this battleship of dietary guidelines
because it is so heavily politicized.
What advice do you have for vegans with respect to staying healthy and with regard
to vitamin B-12 intake and omega-3 fatty acids?
There is no reason whatsoever to be concerned about this. In fact it’s
much easier to have a healthy well-balanced vegan diet than it is to have a healthy
non-vegan diet. A vegan diet is loaded with vegetables, fruits, beans and whole
grains—all very rich in vitamins and minerals, much richer than you would
find in a typical meaty diet. These foods bring us fiber while meat, dairy, and
eggs contain no fiber at all. It’s almost impossible to have a truly healthy
diet that includes muscle tissue, eggs, and milk.
B-12 is something you do want to consider, but it’s not made by animals
or plants. It is made by bacteria, and we presume that up until the advent of
modern hygiene the bacteria in the soil on our hands, in our mouths, probably
provided the roughly one microgram per day that you need. I’m certainly
not encouraging us to go back to an earlier way of living, but there is B-12
in every multiple vitamin, so take your multi-vitamin. Or if you’d rather
not do that, have a fortified product like soymilk or cereal.
I don’t think omega-3s are an issue at all. The body needs relatively little
omega-3 fatty acids. There’s not much fat in beans or vegetables but what
there is, is quite high in omega-3.
Oftentimes I think people feel that going vegan requires such a lifestyle
diet change that it is too difficult. But then I’m shocked that they are
willing to go on these crazy fad diets. While most fad diets are unhealthy and
risky, do you think there is anything we can learn from them in terms of getting
large volumes of people to radically change what they eat?
I think we’ve learned some bad news which is that certain foods, like cheese
and meat, behave like addicting substances. I believe that is the reason people
have trouble giving them up. I wrote a book a few years ago called Breaking the
Food Seduction which summarizes this. I argued there are four really addictive
foods that have opiate effects in the brain—sugar, chocolate, cheese, and
meat. You clearly see this with what I call my ‘7-11 test’—what
food would you get out of bed at 10:30 at night and go down to the 7-11 to buy?
A lot of people do that for chocolate. There are people who do it for junk food,
a sugary donut, or a fast food burger. That is a sign of addition. But nobody
ever got in their car at 9:30 at night because they had a craving for asparagus
We also see this with people who get stuck at the ovo-lacto stage, where they
realize meat is cruel, unhealthy, environmentally unsound, and they get away
from it. But they are stuck on cheese despite the fact that the dairy industry
is the source of the veal industry and despite the fact that cheese has as much
cholesterol as a steak. We have identified cheese opiate compounds called casomorphins
that are released as the cheese is digested and the strongest of them has about
one-tenth the narcotic power of pure morphine. It’s not enough to really
register any kind of chemical high, but I suspect that this is the reason why
people tend to get hooked on cheese.
The other bit of bad news is that healthy foods don’t have an addiction
potential. I can sell you tobacco smoke, but can I sell you clean air? No. People
will crave a caffeinated beverage, but can I encourage you to drink pure water?
Our taste buds and brain chemistry are not set to get hooked on things that are
Diabetes is a major health problem in the U.S. and is a growing epidemic that
is affiliated with consumption of many of those addictive foods you mentioned.
I understand PCRM is involved in nutritional diabetic research that promotes
a low-fat vegan diet. Can you tell us about this?
We completed a randomized clinical trial several years ago as a pilot study.
Just a small group of individuals, half of whom went on a typical American Diabetes
Association (ADA) diet—a standard “healthy” diet used in most
hospitals today that includes chicken and fish—and half on a low-fat vegan
diet. We found that the vegan diet was hands down better. It caused blood sugars
and weight to drop. These individuals lost an average of 16 pounds in 12 weeks.
We are now involved in a study with 99 participants—half on a vegan diet
and half on an ADA one. We are intensively following all participants, so they
are getting a tremendous amount of support. We expect both groups to do well
because we really don’t let them set a foot wrong. We really want to see
if a vegan diet is better. If so, is it more sustainable? We think it may be.
Because with diets such as the ADA or the American Heart Association diet, every
day is a tease. You can have a little bit of meat or cheese but not a lot. Many
people say it’s easier in our vegan group. It’s like quitting smoking.
Yes you’ve got to learn a new habit, but it’s easier than teasing
yourself with an occasional cigarette or an occasional bit of bad food.
Can you tell us about the new cruelty-free insulin assay?
In our current diabetes study, we measure a variety of things via blood tests
which don’t use any animal ingredients. But with the commercial insulin
assay, which measures how much insulin is in the blood, animals are typically
used. So we set out to develop an alternative. We did this partly because we
wanted to be able to obviate the use of animals from this particular assay, but
we also wanted to see if we could surmount any technical challenges that may
have existed. If we could do this, it could be done in many other cases.
There were two problems. First, the antibodies that are used to attach to the
insulin in the blood sample are typically grown in the abdomens of mice. Cells
are injected into their abdomen causing a huge weeping of fluid and the mice
become painfully distended. The technicians in the labs insert needles at regular
intervals into the mice and withdraw this antibody-filled fluid, which is then
put into the assay. Well we didn’t want to use that, so we identified cell
lines that are in-vitro, meaning they are frozen, can be grown in the test tube,
and we don’t need to use any new animals to create them. The second problem
is that this process almost universally uses fetal calf serum [as a growth medium],
which typically comes from the fetal calves of diary cows. When a dairy cow is
three or four years of age, their production declines, and the farmer sells them
off to slaughter. If a fetal calf is in her uterus—when she is hung up
by the leg and eviscerated—the calf is dragged out and a large pipe is
thrust into the heart and the blood is vacuumed out and separated into serum.
We decided we didn’t want to use that as a growth medium, so we had to
develop a non-serum containing medium to grow the in-vitro cells.
It was expensive and took a long time, about three years. We didn’t know
if the cells would work at all, if we could get them to grow on serum. But we
did it, and they abundantly produced antibodies. The assay actually worked as
well or just a hair better than the test that had been used all along.
The company that produces it now wants to offer it commercially to any lab. This
was a tremendous victory. When people say that it is impossible to have a non-animal
test, I think it is always possible to redefine the word impossible.
PCRM works toward the elimination of animal tests and the promotion of alternatives
in medical research. What are some of the challenges you have found in getting
alternatives validated and what strategies have you employed in promoting alternatives?
One of the biggest problems is that animal tests sometimes work for manufacturers
in inappropriate ways. When Vioxx was put on the market, it looked relatively
safe in animal tests. But in human clinical trials, Vioxx caused heart attacks
in some people. Well, the animal tests were very encouraging, and they allowed
this drug to be marketed, and the manufacturer made an awful lot of money. And
when the problems came up in human studies, there was a major effort to ignore
them and pay more attention to the animal tests. Because animals behave differently
from humans in testing and their results can easily be manipulated by researchers,
animal tests have worked well for industry and very badly for consumers.
One way to eliminate these tests is to show that there are ways of assessing
the safety of household chemicals, industrial chemicals, and pharmaceuticals
without the use of animals. There are a number of tests in the commercial arena
where you can test acute toxicity and various other forms of toxicity without
any animal use at all. I think some of them need to be refined, but the tests
are emerging and have been for some time.
We also need to help the scientific community think of animals in a different
way—not just as test tubes with whiskers, throw-away lives. A researcher
on our staff, Jonathon Balcombe, recently published a very important paper in
which he showed that if you don’t even look at the experiment itself, if
you simply look at routine procedures—picking animals up, weighing them,
drawing a blood sample—you see that the animal’s pulse races. Their
blood pressure goes through the roof. They have a tremendous influx of stress
hormones that persists up to 90 minutes, indicating they are terrified, just
as you or I would be if someone had captured and instrumented us. This kind of
observation suggests to me that there is no such thing as an ethical experiment
as long as the animals are being treated in any of these ways.
You’ve been pretty successful in eliminating live animal labs from
medical schools. What do you think has been the most effective tool in getting
to change their curriculum and eliminate animal labs?
In animal labs, the medical students are given a dog, have to give the dog a
variety of drugs to see how the drugs affect the blood pressure, the EKG, then
they kill the animal. Those things don’t just kill the dog; they also kill
something in the student—compassion, which is all too frail in medicine
We work with medical students and with instructors. We track the practices at
all U.S. and Canadian medical schools. When we find a concerned medical student,
we send them materials. We made a video with Harvard Medical School and Massachusetts
General Hospital that showed their alternative, where they bring the students
into the human operating room to observe the drugs that are used in the course
of human medical treatment. We encourage medical discussion, we get the students
debating and talking and thinking, and get the instructors talking about it.
Once you do that, they become quite convinced that there are non-animal teaching
methods that are vastly superior to the use of animals.
When we started this virtually all of the medical schools used animals in various
ways. Today out of 126 U.S. medical schools, only about two dozen have any kind
of animal lab anywhere in their curriculum. It doesn’t mean they don’t
have research labs—they do—but they have eliminated the animal use
from teaching, which is a great step forward.
PCRM has also worked on promoting humane charities that don’t fund
animal research. Have you noticed any changes in the types of research funded
and is there a trend toward more humane research?
We have seen the beginnings of a trend, but it is still a new program. I hope
that anyone who wants to give to charities will look for the humane charity seal
of approval and give only to those charities that have it. Regardless of what
cause your are interested in, whether it be cancer, heart disease, diabetes,
or Alzheimer’s, there are good charities out there. The March of Dimes
does not have the humane seal, but Easter Seals does. We were very pleased that
after the tsunami UNICEF contacted us and asked if they could be granted the
humane seal because there were many people who wanted to give, but only if they
could do so with a 100 percent clear conscience. And I’m proud to say that
UNICEF is our most recent humane seal recipient.
Can you tell us about this new project you started, the Cancer Project?
We started the Cancer Project to help people understand about how foods affect
cancer progression. There is a reasonable body of research where different diets
have been put to the test and on our website we have a fully downloadable free
book called the Survivor’s Handbook, which summarizes this information.
We offer free classes for cancer survivors or their loved ones in many cities
across the U.S. It is expanding very aggressively right now. Whole Foods recently
asked us to provide these classes in their stores. We also need to get the word
out about prevention. So we have a series of television advertisements to promote
a healthier diet and that means a vegetarian one. Anthony Hopkins, the actor,
recently narrated a commercial for us that is out now.
I want individuals who are dropping their kids off at school to look at the cheeseburgers
and Salisbury steaks and gravy that are being served to their kids and recognize
that those foods are increasing their children’s long-term cancer risks
the same way as tobacco.
Do you have any advice for animal activists pursuing a career in medicine?
Go for it. I often hear from medical students or applicants who want to go to
medical school, but don’t want one with an animal lab. Go ahead, most of
the schools have eliminated them. And if they still have it, don’t take
part. Say, “I didn’t come here to kill my first patient.” They
will generally not give you a hard time. Get politically involved. Get involved
with the medical student organizations. They need to hear your voice.
I would also encourage every doctor to be an advocate also. Be willing to do
a news interview and give a speech to your local rotary and get the word out
about what we can really do if we don’t just prescribe pills, and actually
look at the contents of our plates.
Congratulations on PCRM turning 20 this year. What are you most proud of in your
20 years of work with PCRM?
I’m happy that we’ve been able to get out a lot of good information
about healthy diets and I’m glad to have been a resource. I’m glad
to have stopped a great many animal labs, but the challenges in front of us are
very large. Compassion doesn’t come naturally to many people. That doesn’t
mean it can’t be learned, but it does require a tremendous amount of effort
sometimes to help people see that people are being injured by a bad diet, that
animals are being injured and killed in labs, and to realize that those are serious
and urgent issues.
Where do you see PCRM in 20 years?
I would love to be out of business because we have achieved our goals. And if
we are a little bit lucky that’s where we will be. I check the headlines
every day [laughs], to see how close we are to that goal. I suspect we will still
be around because there is unfortunately far too much work to do, and I’m
in it for the long haul. We’ve got a really great team here and the good
fortune to work in a very cooperative spirit with other groups and I just want
to make that grow and continue to be more successful.
For more on PCRM visit www.pcrm.org. To find a list of humane charities go
www.humaneseal.org. Learn more about the Cancer Project or download the Survivor’s
Handbook at www.cancerproject.org.