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April 2005
The Doctor is In
The Satya Interview with Neal Barnard


Photo courtesy of Dr. Neal Barnard

Founder of the Physicians Committee for Responsible Medicine (PCRM), a nonprofit that promotes preventive medicine, conducts clinical research, 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 and 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 or cherries.

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 healthy.

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 schools 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 today.

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 by charities 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 To find a list of humane charities go to Learn more about the Cancer Project or download the Survivor’s Handbook at



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