C. Difficile Superbugs in Meat
There’s a new superbug in town: Clostridium difficile. C. diff, as it’s commonly known, is one of our most urgent bacterial threats, infecting an estimated quarter of a million Americans annually and killing thousands at a cost of $1 billion (£650 million) a year.134 It causes a condition called pseudomembranous colitis, which manifests as painful, crampy diarrhea. C. diff has traditionally been considered a hospital-acquired infection—something you pick up in health care settings—but it was recently discovered that only about one-third of C. diff cases can be linked to contact with an infected patient.135 What’s going on?
Well, another source of infection may be meat. The CDC found that 42 percent of packaged meat products sold at three national chain supermarkets sampled contained toxin-producing C. diff bacteria.136 The United States, it turns out, has the highest reported levels of C. diff meat contamination in the world.137
C. diff has also been found in chicken, turkey, and beef, but pork contamination has received the greatest attention from health officials, as it most closely matches the same strain found in nonhospital-related human infections.138 Since 2000, C. diff has increasingly been reported as one of the leading causes of intestinal infections among baby piglets.139 Carcass contamination with this diarrheal pathogen at the time of slaughter is considered the most likely source of the contamination of retail pork.140
Normally, C. diff won’t do anything to you. Even if it gets into your gut, your good bacteria can usually muscle it into submission. It can lie in wait, though, until the good guys are out of the way. The next time you have to take an antibiotic that disrupts your normal gut flora, C. diff can rear its ugly head and cause a range of inflammatory bowel conditions, including a life-threatening condition that’s as bad as it sounds: toxic megacolon.141 (It carries a mortality rate as high as a flip of a coin.)142
Doesn’t cooking wipe out most bugs? Well, C. diff isn’t like most bugs. For most meat, 71 degrees Celsius is the recommended internal cooking temperature. But C. diff can survive two hours of cooking at that temperature.143 In other words, you could grill chicken at the recommended cooking thermometer temperature for two hours straight and still not kill the bug.
You’ve probably seen advertisements for those alcohol-based hand sanitizers that advertise they kill 99.99 percent of all germs. Well, C. diff falls into that 0.01 percent. They don’t call it a superbug for nothing. Residual spores of the pathogen have been shown to be readily transmitted with a handshake even after using hand sanitizer.144 As one of the lead researchers who discovered another superbug in the U.S. meat supply, MRSA,145 has advised,146 people who handle raw meat may want to wear gloves.
Facing a Post-Antibiotic Age
Dr. Margaret Chan, Director-General of the World Health Organization, recently warned that we may be facing a future in which many of our miracle drugs no longer work. She stated, “A post-antibiotic era means, in effect, an end to modern medicine as we know it. Things as common as strep throat or a child’s scratched knee could once again kill.”147 We may soon be past the age of miracles.
The director-general’s prescription to avoid this catastrophe included a global call to “restrict the use of antibiotics in food production to therapeutic purposes.” In other words, only use antibiotics in agriculture to treat sick animals. But that isn’t happening. In the United States, meat producers feed millions of pounds of antibiotics each year to farm animals just to promote growth or prevent disease in the often cramped, stressful, and unhygienic conditions of industrial animal agriculture. Yes, physicians overprescribe antibiotics as well, but the FDA estimates that 80 percent of the antimicrobial drugs sold in the United States every year now go to the meat industry.148
Antibiotic residues can then end up in the meat you eat. Studies have revealed that traces of such antibiotics as Bactrim, Cipro, and Enrofloxacin have been found in the urine of people eating meat—even though none of them was taking those drugs. The researchers concluded: “Consumption amounts of beef, pork, chicken, and dairy products could explain the daily excretion amount of several antibiotics in urine.”149 These antibiotic levels can be lowered, however, after merely five days of removing meat from the diet.150
Nearly every major medical and public health institution has come out against the dangerous practice of feeding antibiotics to farm animals by the ton just to fatten them faster.151 Yet the combined political might of agribusiness and the pharmaceutical industries that profit from the sales of these drugs has effectively thwarted any effective legislative or regulatory action, all to save the industry less than a penny per pound of meat.152
Healthy living may help protect you against both airborne and foodborne illnesses. Eating more fruits and vegetables and exercising more frequently can boost your immune system to help you fight off respiratory infections like the common cold. And sticking to mostly plant foods can help prevent you from becoming another food poisoning statistic by reducing your exposure to some of the deadliest fecal pathogens.
Six years after I helped defend Oprah against her meat-defamation lawsuit, I received my own legal threat. The Atkins corporation accused me of “defamatory” statements in my book Carbophobia: The Scary Truth About America’s Low-Carb Craze. Their lawyer claimed my words “continue to harm Atkins’ reputation and cause injury to Atkins.” My book certainly couldn’t have caused more injury to Dr. Atkins than his own diet. You see, he died the year before, overweight and—according to his autopsy report—suffering from a history of heart attack, congestive heart failure, and hypertension.153
However, the lawyers were talking about damage to Atkins Nutritionals, Inc. Rather than let them shut me up, I posted their legal threat online with a point-by-point rebuttal.154 Thankfully, under the law, the truth is considered an absolute defense against defamation.
Atkins’s attorneys never made good on their threat. Within four months of my book’s publication, the Atkins corporation filed for bankruptcy.
CHAPTER 6
How Not to Die from Diabetes
A few years ago, Millan, a member of the NutritionFacts.org community, was kind enough to share her story with me. When she was thirty years old, she was diagnosed with type 2 diabetes. Millan had struggled with obesity all her life and suffered through the highs and lows of years of yo-yo dieting. She had tried nearly every fad diet she could find but, not surprisingly, would quickly gain back whatever weight she’d lost. Diabetes wasn’t a stranger to her. Millan’s parents, brothers, and aunt were all diabetic, so she figured that her own diagnosis was inevitable. It’s age related. It’s genetic. There was nothing she could do. Or so she thought.
Millan’s initial diagnosis was back in 1970, and she lived as a diabetic for two decades. Then, in the 1990s, she switched to an entirely plant-based diet and completely turned her life around. Today, her energy levels are better than ever, she looks and feels younger, and she’s finally been able to maintain a healthy weight. More than four decades after being diagnosed as a diabetic, Millan, now in her seventies, is fit as a fiddle. She even teaches high-intensity Zumba classes! She didn’t find some wonder drug or trademarked diet. She simply decided to eat healthier food.
The disease called diabetes mellitus comes from two words: diabetes (Greek for “to pass through or siphon”) and mellitus (Latin for “honey sweet”). Diabetes mellitus is characterized by chronically elevated levels of sugar in your blood. This is because either your pancreas gland isn’t making enough insulin (the hormone that keeps your blood sugar in check) or because your body becomes resistant to insulin’s effects. The insulin-deficiency disease is called type 1 diabetes, and the insulin-resistance disease is called type 2 diabetes. If too much sugar builds up in your blood, it can overwhelm the kidneys and spill into your urine.
How did people test urine before they had modern laboratory techniques? They tasted it. Diabetic urine can evidently taste as sweet as honey. Hence the name.
Type 2 diabetes has been c
alled the “Black Death of the twenty-first century” in terms of its exponential spread around the world and its devastating health impacts. Instead of the bubonic plague, though, the pathological agents in obesity and type 2 diabetes are identified as “high-fat and high-calorie diets,” and instead of fleas and rodents, the causes are “advertisements and inducements to poor lifestyle.” 1 More than twenty million Americans are currently diagnosed with diabetes, a tripling of cases since 1990.2 At this rate, the CDC predicts that one in three Americans will be diabetic by the midcentury.3 Currently in the United States, diabetes causes about 50,000 cases of kidney failure, 75,000 lower extremity amputations, 650,000 cases of vision loss,4 and about 75,000 deaths every year.5
Your digestive system breaks down the carbohydrates you eat into a simple sugar called glucose, which is the primary fuel powering all the cells in your body. To get from the bloodstream into your cells, glucose requires insulin. Think of insulin as the key that unlocks the doors to your cells to allow glucose to enter. Every time you eat a meal, insulin is released by your pancreas to help shuttle the glucose into your cells. Without insulin, your cells can’t accept glucose, and, as a result, the glucose builds up in your blood. Over time, this extra sugar can damage the blood vessels throughout the body. That’s why diabetes can lead to blindness, kidney failure, heart attacks, and stroke. High blood sugar can also damage your nerves, creating a condition known as neuropathy that can cause numbness, tingling, and pain. Because of the damage to their blood vessels and nerves, diabetics may also suffer from poor circulation and lack of feeling in the legs and feet, which can lead to poorly healing injuries that can, in turn, end as amputations.
Type 1 diabetes, previously called juvenile-onset diabetes, represents approximately 5 percent of all diagnosed diabetes cases.6 In most people with type 1 diabetes, the immune system mistakenly destroys the insulin-producing beta cells in the pancreas. Without insulin, blood sugar rises to unsafe levels. Type 1 diabetes is therefore treated with injections of insulin, a type of hormone-replacement therapy, to make up for the lack of production. The exact cause of type 1 diabetes is unknown, though a genetic predisposition combined with exposure to such environmental triggers as viral infection and/or cow’s milk may play a role.7
Type 2 diabetes, previously known as adult-onset diabetes, accounts for 90–95 percent of diabetes cases.8 In type 2 diabetes, the pancreas can make insulin, but it doesn’t work as well. The accumulation of fat inside the cells of your muscles and liver interferes with the action of insulin.9 If insulin is the key that unlocks the doors to your cells, saturated fat is what appears to gum up the locks. With glucose denied entry into your muscles, the primary consumer of such fuel, sugar levels can rise to damaging levels in your blood. The fat inside these muscle cells can come from the fat you eat or the fat you wear (i.e., your body fat). The prevention, treatment, and reversal of type 2 diabetes therefore depends on diet and lifestyle.
The CDC estimates that more than twenty-nine million Americans are living with diagnosed or undiagnosed diabetes—that’s about 9 percent of the U.S. population. Out of one hundred people you know, chances are six of them already know they are diabetic and about three have diabetes but haven’t yet been diagnosed. More than one million new cases of type 2 diabetes are diagnosed each year.10
The good news: Type 2 diabetes is almost always preventable, often treatable, and sometimes even reversible through diet and lifestyle changes. Like other leading killers—especially heart disease and high blood pressure—type 2 diabetes is an unfortunate consequence of your dietary choices. But even if you already have diabetes and its complications, there is hope. Through lifestyle changes, you may be able to achieve a complete remission of type 2 diabetes, even if you’ve been suffering with the disease for decades. In fact, by switching to a healthy diet, you can start improving your health within a matter of hours.
What Causes Insulin Resistance?
The hallmark of type 2 diabetes is insulin resistance in your muscles. As we’ve learned, insulin normally enables blood sugar to enter the cells, but when the cells are resistant and don’t respond to insulin as they should, it can lead to dangerous levels of sugar remaining in the bloodstream.
What causes insulin resistance in the first place?
Studies dating back nearly a century note a striking finding. In 1927, researchers divided healthy young medical students into multiple groups to test out the effects of different diets. Some were given a fat-rich diet composed of olive oil, butter, egg yolks, and cream; others were given a carbohydrate-rich diet of sugar, sweets, pastry, white bread, baked potatoes, syrup, bananas, rice, and oatmeal. Surprisingly, insulin resistance skyrocketed in the fat-rich diet group; within a matter of days, their blood sugar levels doubled in response to a sugar challenge, far more than those on the sugar and starch diet.11 It took scientists another seven decades to unravel the mystery of why this happened, but the answer would provide the key to what causes type 2 diabetes.
To understand the role of diet, we must first understand how the body stores fuel. When athletes talk about “carb loading” before a competition, they’re referring to the need to build a fuel supply in their muscles. Carb loading is a more extreme version of what you do every day: Your digestive system breaks down the starch you eat into glucose, which enters your circulatory system as blood sugar and is then stored in your muscles to be used for energy as needed.
Blood sugar, though, is a little like a vampire: It needs an invitation to come into your cells. And that invitation is insulin, the key that unlocks the front door of your muscle cells so glucose can enter. When insulin attaches to insulin receptors on a cell, it activates a series of enzymes that escort in the glucose. Without insulin, blood glucose is stuck out in the bloodstream, banging on your cells’ front door, unable to enter. Blood sugar levels then rise, damaging vital organs in the process. In type 1 diabetes, the body destroys the insulin-producing beta cells of the pancreas, so very little insulin is present to let blood sugar enter your cells. But with type 2 diabetes, insulin production isn’t the problem. The key is there, but something has gummed up the lock. This is called insulin resistance. Your muscle cells become resistant to the effect of insulin.
So what’s jamming up the door locks on your muscle cells, preventing insulin from letting glucose enter? Fat—more specifically, intramyocellular lipid, the fat inside your muscle cells.
Fat in your bloodstream, either from your own fat stores or from your diet, can build up inside your muscle cells, where it can create toxic breakdown products and free radicals that block the insulin-signaling process.12 No matter how much insulin you produce, your fat-compromised muscle cells can’t effectively use it.
This mechanism by which fat interferes with insulin function has been demonstrated by either infusing fat into people’s bloodstreams and watching insulin resistance shoot up13 or by removing fat from people’s blood and seeing insulin resistance drop.14 We can now even visualize the amount of fat in the muscles using MRI technology.15 Researchers are now able to track the fat going from the blood into the muscles and watch insulin resistance rise.16 One hit of fat, and within 160 minutes, the absorption of glucose into your cells becomes compromised.17
Researchers don’t have to give their study subjects fat through an IV, though. All they have to do is feed them.
Even among healthy individuals, a high-fat diet can impair the body’s ability to handle sugar. But you can lower your insulin resistance by lowering your fat intake. Research has clearly shown that as the amount of fat in your diet becomes increasingly lower, insulin works increasingly better.18 Unfortunately, given the current diets of American children, we’re seeing both obesity and type 2 diabetes occur earlier and earlier in life.
Prediabetes in Children
Prediabetes is defined by elevated blood sugar levels that are not yet high enough to reach the official diabetes threshold. Commonly found among those who are overweight and obese, in the past, prediabe
tes was regarded as a high-risk state that presaged diabetes, but it was not thought to be a disease in itself. However, we now know that prediabetic individuals may already be experiencing organ damage.
Prediabetics may already have sugar damage to their kidneys, eyes, blood vessels, and nerves even before diabetes is diagnosed.19 Evidence from numerous studies suggests that chronic complications of type 2 diabetes begin occurring during the prediabetic state.20 To prevent diabetic damage, therefore, we need to prevent prediabetes—and the earlier, the better.
Thirty years ago, virtually all diabetes in children was assumed to be type 1. But since the mid-1990s, we’ve started to see an increase in type 2 diabetes among kids.21 What was once called “adult-onset diabetes” is now known as type 2 diabetes because children as young as eight are developing the disease.22 This trend can have devastating consequences: A fifteen-year follow-up study of children who were diagnosed with type 2 diabetes found an alarming prevalence of blindness, amputation, kidney failure, and death by the time these kids had reached young adulthood.23
Why the dramatic rise in childhood diabetes? It’s likely due to the dramatic rise in childhood obesity.24 Over recent decades, the number of American children considered to be overweight has increased by more than 100 percent.25 Children who are obese at age six are more likely than not to stay that way, and 75–80 percent of obese adolescents will remain obese as adults.26
Childhood obesity is a powerful predictor of adult disease and death. For example, being overweight as a teenager was found to predict disease risk fifty-five years later. Such individuals may end up with twice the risk of dying from heart disease and a higher incidence of other diseases, including colorectal cancer, gout, and arthritis. Researchers have found that being overweight as a teen could be an even more powerful predictor of disease risk than being overweight as an adult.27
How Not to Die Page 14