PCRM is known as a research watchdog. We sued the federal government over its experiments in which short children were injected with a genetically engineered growth hormone. We exposed unethical whooping cough vaccine experiments on infants, stopped the Army’s notorious cat-shooting experiments, and called attention to the March of Dimes’ animal experiments and to the ways other health charities spend their research dollars.

We promote ethical, applicable research and are now embodying those values in our own research and scientific publications.

Over the past few years, PCRM has had a growing involvement in research. In studies in the early 1990s, PCRM elucidated the factors that make it easier for people to change their diets.

Our study on the medical costs attributable to meat consumption, published in Preventive Medicine in 1995, elicited a great deal of publicity in the New York Times and elsewhere. A follow-up paper, demonstrating the Medicare costs attributable to meat consumption, was presented at a recent medical conference by PCRM’s Andrew Nicholson, M.D., and will be published in the American Journal of Clinical Nutrition.

This past winter, three of our scientific reviews on different aspects of breast cancer were published in scientific journals. These studies showed that nutritional factors are linked to breast cancer risk, that milk may play a particular role in cancer risk, and that, regrettably, most women are not yet aware of the links between diet and breast cancer.

These research projects advance knowledge in essential areas of prevention, nutrition, and health. They also spark media attention, which is critically important, since most of what people know about nutrition comes from the popular press. For example, most of us did not learn much about calcium in school, but the “need” for extra calcium is drummed into our heads by endless articles in the health section of newspapers and magazines. These, in turn, are typically sparked by research studies, often funded by the dairy industry. PCRM’s research work is always tied to media efforts that prevent our findings from simply gathering dust in medical libraries.

In 1996, Dr. Nicholson conducted a study with Georgetown University, supported by the Diabetes Action Research and Education Foundation, using a very-low-fat, vegetarian diet in diabetic patients. It turned out to be a much more powerful regimen than standard diabetic diets based on exchange groups. The study subjects had marked improvements in their diabetes, lost weight, and felt better than they had in years.

In a new and ongoing research project, physicians from PCRM and Georgetown University are using nutrition to influence the amount of estrogens in the blood in a group of volunteers. Estrogens are female sex hormones that are involved in many normal functions, but also stimulate the growth of breast cancer cells. Over the long run, reducing estrogen is expected to reduce breast cancer risk. Of course, you cannot feel your breast cancer risk, but the same diet and hormone changes may also affect symptoms you can feel, such as menstrual pain, PMS, and water retention. The research volunteers all have moderate to severe menstrual pain, and the study aims both to measure changes in the amount of estrogen in the blood and changes in menstrual symptoms.

Looking toward the future, PCRM researchers are planning to measure the benefit of a similar nutrition program in women with breast cancer and are also evaluating a hormonal testing procedure that would allow women to measure their breast cancer risk and then take steps to reduce it, much as people now routinely check their cholesterol levels to assess their heart attack risk.

Research at PCRM

Helping Patients Change Their Diets

Left on their own, patients find it hard to break old habits. But this review of all research studies in which heart patients were asked to cut the fat in their diet shows the factors that help people make the switch: family involvement, group support, providing food, frequent monitoring, use of vegetarian diets, and stricter limits on fat intake. Doctors in practice can use these same factors to help people improve their eating habits.

Barnard ND, Nicholson A, Ahktar A. Factors that facilitate compliance to lower fat intake. Arch Fam Med 1995;4:153-8.

Acceptability of Heart Disease Reversal Diet

Dr. Dean Ornish’s program for reversing heart disease revolutionized the approach to America’s number-one killer. This study addressed the next question: whether patients will accept a change in their diet and lifestyle. In quantitative studies, no difference was found in the acceptance of a low-fat vegetarian diet and a more modest (and much less effective) diet emphasizing poultry and fish.

Barnard ND, Scherwitz L, Ornish D. Adherence and acceptability of a low-fat, vegetarian diet among patients with cardiac disease. J Cardiopulm Rehab 1992;12:423-31.

Diet and Breast Cancer

A wealth of research shows that diet changes offer the potential for reducing breast cancer risk. While fatty foods have received the most scrutiny, there also appears to be a role for alcohol, organochlorine contaminants, and growth factors in dairy products among the contributors to breast cancer risk. Protective factors include high-fiber foods, vegetables, and fruits—which contain many protective micronutrients—as well as regular exercise.

Nicholson A. Diet and the prevention and treatment of breast cancer. Alt Ther 1996;2:32-8.

Cancer Prevention Awareness 1991 to 1995

Although the federal government prints brochures and booklets about how diet changes can help prevent breast cancer, only 20 percent of women were aware of this link in 1991. Four years later, that figure had barely improved at all—to just 23 percent. Levels of awareness were lower among poorer and less educated women. Many women mistook methods for finding cancer, such as mammography, for methods to prevent it. The study shows that much greater educational efforts are essential.

Barnard ND, Nicholson A. Beliefs about dietary factors in breast cancer among American women, 1991 to 1995. Prev Med 1997;26:109-13.

Diet and Medicare Costs

The prevalence of major illness among omnivores and vegetarians was compared in studies that controlled for other lifestyle factors, and the corresponding potential health care savings were calculated in 1994 dollars. If all Americans were vegetarians, the resulting annual Medicare savings could be estimated at $7.1 to $12.4 billion for heart disease, cancer, diabetes, gallstones, kidney stones, and appendicitis.

Nicholson A, Barnard ND. The Medicare savings attributable to vegetarian dietary practices. Am J Clin Nutr, in press.

Replacing Animal Laboratories

A 1987 survey of U.S. medical schools revealed that animals were used in teaching in 53 percent of physiology departments, 27 percent of pharmacology departments, and 19 percent of surgery departments. A follow-up survey seven years later showed that overall animal use had dropped substantially. Of schools for which information for all three departments was available, 49 percent had no animal laboratory exercises in any of the three disciplines in 1994. Alternatives are widely available for all animal uses in undergraduate medical education. Computer models and films were the most commonly used non-animal alternatives offered in physiology and pharmacology, while operating room experience was the most common alternative in surgery.

Barnard ND, Stolz J, Baron L. Use of and alternatives to animals in laboratory courses. J Med Educ 1988;63:720-2.
Wolfe M, Barnard ND, McCaffrey S. Animal laboratories in medical school curricula. ATLA 1996;24:953-6.

Unethical Human Research

Abuses in human research are less common than in the past, but they still occur, particularly where informed consent is difficult, such as in children. Recent research abuses were reviewed and the need for more vigilance in human research was underscored.

Barnard ND. Human experiments: redrawing the ethical boundaries. Appl Clin Trials 1994;3:34-6.

Meat and Medical Costs

In a conservative estimate, meat consumption is responsible for $29 to $61 billion in health care costs, measured in 1992 dollars, including $2.8 to $8.5 billion for hypertension, $9.5 billion for heart disease, $0 to $16.5 billion for cancer, $14.0 to $17.1 billion for diabetes, $0.2 to $2.4 billion for gallbladder disease, $1.9 billion for obesity-related musculoskeletal disorders, and $0.2 to $5.5 billion for foodborne illness. The costs of treating tobacco-related illnesses added an additional $50 billion to the total.

Barnard ND, Nicholson A, Howard JL. The medical costs attributable to meat consumption. Prev Med 1995;24:646-55.

Health Risks of Livestock Feeding Practices

A potential contributor to foodborne illness that has escaped public scrutiny is the feeding of animal excrement to livestock, a common practice in some parts of the U.S. In 1994, 18 percent of poultry producers in Arkansas collectively fed more than 1,000 tons of poultry litter to cattle, and the procedure is also common in some other geographic areas as a means of eliminating some of the 1.6 billion tons of livestock wastes produced in the U.S. annually. Some studies indicate that common methods for processing animal wastes do not reliably kill disease-causing bacteria. Feeding animal wastes to livestock may be part of the reason why salmonella and other diseases are as common as they are.

Haapapuro ER, Barnard ND, Simon M. Animal waste used as livestock feed: dangers to human health. 1997, in press.

Breast Cancer and Dairy

Several studies have shown that breast cancer rates correlate with dairy product consumption. The explanation is probably not just that milk contains animal fat. It also contains estrogens, growth factors, and contaminants that may play a role in cancer.

Outwater J, Nicholson A, Barnard ND. Breast cancer and dairy product consumption. Med Hypoth 1997,6:453-62.

Improving Diabetes Management

In a pilot study conducted with Georgetown University Medical Center and funded by Diabetes Action Research and Education Foundation, PCRM’s Andrew Nicholson, M.D., found that a low-fat, unrefined, vegan diet was markedly superior to a typical diabetic diet. Fasting blood sugars dropped fully 54 points on a vegan diet, compared to less than half this amount on the traditional diabetic diet. Weight loss over the three-month study averaged 15.6 pounds and 8.4 pounds in the two groups, respectively. The results indicate that an unrefined, low-fat, vegan diet is the dietary treatment of choice for diabetics.

Nicholson AN, et al. The effect of a low-fat, unrefined vegan diet on non-insulin-dependent diabetes mellitus. 1997, in press.

Estrogens, Menstrual Symptoms, and Cancer Risk

This study in progress, conducted by PCRM and Georgetown University School of Medicine, investigates the role of diet in reducing the amount of estrogen in a woman’s bloodstream as a way to reduce menstrual symptoms over the short run and breast cancer risk over the long run. The study is being conducted by Neal Barnard, M.D., Anthony Scialli, M.D., Donna Hurlock, M.D., and Lisa Talev.