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Forks Over Knives

Documentary Film 2011 for Methods

Kristy Palomares

on 21 March 2013

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Transcript of Forks Over Knives

Forks Over Knives The documentary Forks Over Knives poses the question: Can a whole food plant-based diet prevent, reverse, or eliminate diseases? "A growing number of researchers claim that if we eliminate, or greatly reduce, refined, processed or animal-based foods, we can prevent, and in certain cases, even reverse several of our worst diseases."
-Forks Over Knives The Main Arguments Presented in Forks Over Knives Exploring Some of the Research and Studies
Presented in the Documentary How credible and reliable is the research that this documentary presents? Final Thoughts and Analysis What we make of the data presented... Forks Over Knives Trailer About the Director and the Producers China Study: “Diet, Life-Style and Mortality in China” 1990 The Norway Study 2008, Wendel read The China Study, by T. Colin Campbell and realized that the scientific case that a whole foods plant-based diet could prevent—and even reverse—disease was greater than he had ever imagined. Lee Fulkerson, Writer and Director Brian Wendel, Creator and Executive Producer Fulkerson has written, produced, directed or supervised nearly 170 hours of documentary programming, and has won 19 international awards for his work. John Corry, Producer Corry’s feature film credits include Universal’s The Rundown, The Ten Commandments and The Face of Evil: Reinhard Heidrich. Corry has produced over 200 documentary programs Allison Boon, Co-Producer Boon began working on documentaries in 2003. She became Director of Research and helped develop over 100 hours of programming for networks like History Channel, National Geographic and Bravo. A whole-food plant-based diet can reverse and even eliminate diseases, such as cancer, diabetes and and coronary artery disease http://www.forksoverknives.com/about/cast-and-crew/ Following a diet that contains animal products (cheese, milk, yogurt, meat, etc.) will greatly put people at risk of developing cancer, diabetes, high cholesterol, hypertension, and will increase the chances of a person having a heart attack and/or heart problems About Some of the Experts T. Colin Campbell, Ph.D CORRELATION Obtained master’s degree and Ph.D. from Cornell, and served as a Research Associate at MIT.
spent 10 years on the faculty of Virginia Tech’s Department of Biochemistry and Nutrition
Returned to the Division of Nutritional Sciences at Cornell in 1975 where he presently holds his Endowed Chair (now Emeritus). Principal scientific interests
Since the 1950s the effects of nutritional status on long term health, particularly on the cause of cancer
Has conducted original research both in laboratory experiments and in large-scale human studies
Has lectured extensively, and has authored more than 300 research papers Caldwell B. Esselstyn, Jr., M.D. CAUSATION Received his B.A. from Yale University
Obtained M.D. from Western Reserve University
1956, awarded a gold medal at the Olympic Games
He was trained as a surgeon at the Cleveland Clinic and at St. George’s Hospital in London.
1968, as an Army surgeon in Vietnam, he was awarded the Bronze Star 1991, served as President of the American Association of Endocrine Surgeons
1997, chaired the Summit on Cholesterol and Coronary Disease
2005, became the first recipient of the Benjamin Spock Award for Compassion in Medicine
Dr. Esselstyn and his wife, Ann Crile Esselstyn, have followed a plant-based diet for more than 20 years. The Norway Data (not in film) Exsalus: Medical, Nutrition, and Wellness Center Considers herself a pioneer in the current health care system as she unites two powerful and synergistic healing approaches: Chinese Medicine with the technological skill of Western Medicine Received his Bachelor of Science degree in Biology at The University of Michigan where he graduated with distinction Matthew Lederman, M.D. Alona Pulde, M.D. She is a board-certified practitioner of Acupuncture and Oriental Medicine and Family Medicine Physician specializing in nutrition and lifestyle medicine. Received his Doctor of Medicine degree at Temple University School of Medicine and completed his residency in Internal Medicine at The University of Colorado Health Sciences Center Has been seeking to change the way chronic illness is treated, with an emphasis on medication elimination and disease reversal through diet and lifestyle change. The China Project was a large observational study conducted throughout the 1980s in rural China jointly funded by Cornell University, the University of Oxford, and the government of China.

The study examined the diets, lifestyle and disease characteristics of 6,500 people in 65 rural Chinese counties, comparing the prevalence of disease characteristics and diet. The findings suggested some diseases of affluence (cancer, stroke, heart disease) were associated with the consumption of animal protein and dairy products. Joey visits Drs. Matthew Lederman and Alona Pulde
Dr. Lederman is shown grocery shopping and cooking with Aucoin Joey Aucoin, a landscaping company owner
He was diagnosed in 2006 with dangerously high cholesterol and type 2 diabetes Joey Aucoin, patient Dr. Campbell was influenced by a 1968 study by two unknown Indian scientists titled "The effect of dietary protein on carcinogenesis of aflatoxin." Importance of the "India Study" FINDINGS: rats fed 5% of their diet as casein were generally free from cancerous growths, whereas the rats fed 20% casein were riddled with cancer
Campbell bases most of his arguments on this study, BUT Campbell never tells us that the Indian researchers actually published this paper as part of a two-paper set, one showing that low-casein diets make aflatoxin much more acutely toxic to rats
The 2nd paper is called "The Effect of Dietary Protein on Liver Injury in Weanling Rats," and it shows that rats on low-protein diets experience much more actual liver damage than rats on high-protein diets when they’re exposed to aflatoxin
The rats DIDN'T get cancer, but they were sicker overall because they’re less capable of detoxifying aflatxoin, which led to fatty liver, liver necrosis, proliferation of bile duct tissue, and early death. Dr. Campbell's Study on how Animal Protein affects Rats: Vague and Information Inaccessible We were not able to find much information about Campbell's numerous studies We did come across a number of critics that claim that Campbell's studies do not present a complete picture, thus, are biased half-truths "International studies suggest a positive correlation between animal protein intake and ischemic heart disease rates across countries. Therefore, we tested this hypothesis directly in the Nurses' Health Study. By analyzing repeated measures of dietary data over 14 years of follow-up, we firmly rejected the hypothesis that high protein intakes increase the risk of ischemic heart disease. In contrast, our data suggest a modest inverse association for both animal and vegetable protein intake." --Walter Willett, author of The Nurses' Health Study II Rebuttal: Ultimately, the original thesis of the movie is thoughtful, balanced, and backed with supportive evidence. However, the film in its entirety doesn't live up to the moderate tone of the research question. The viewer is confronted with a false dichotomy of "the Western diet" consisting of oils, fats, sugars and huge slabs of meat or the "plant-based diet" approved by Drs. Campbell and Esselstyn. Is there no middle ground? Lee Fulkerson, test subject and patient The authors point to a lot of research - mostly their own - which they assert proves a causal link between dietary animal protein and degenerative diseases. They neglected to provide concrete evidence that plant-based foods and in particular, plant protein, is the wonderfood they claim it is. They use evocative language and imagery to provoke a negative reaction towards protein from the viewer. "cholesterol" "animal fat" Fulkerson: "On my way over, I drank these two Red Bulls. I also had a 12 oz. Coke. And another half of a 12 oz. Coke. I haven't always lived the healthiest lifestyle. And I've eaten more than my share of fast food...Like a lot of Americans, I thought my health was pretty good." "When Dr. Lederman gave me the results, it was a real wake up call." 240 and 241 for my cholesterol I got this 6 number. This six number was the result of something called a CRP test...This put me in the high-risk category for a heart attack So I committed to a 12-week nutrition program under Dr. Lederman's supervision "animal products" The plan was to treat my health problems by eating A WHOLE FOODS PLANT BASED DIET "In World War II, the Germans occupied Norway. Among the first things they did was confiscate all the livestock and farm animals to provide supplies for their own troops. So the Norwegians were forced to eat mainly plant-based foods." Dr. Esselstyn was very impressed by the accidentally beneficial side effects of Norway's imposed wartime diets. "Have we ever seen a population have their cardiovascular disease plummet like this [from emergency invasive surgical techniques]? No." "But look what immediately happened. With the cessation of hostilities in 1945, back comes the meat, back comes the dairy, back comes the strokes and heart attacks." --Dr. Esselstyn In a similar attempt to reduce the waste of food resources in Norway, the home economics institutes focused on how to exploit the local resources from the sea and from wild plants in a more efficient manner. This involved exploring the boundaries for what was commonly perceived as food, by experimenting with uncommon ingredients such as wild sea birds (including sea gull) and wild plants including moss...In the spring of 1943, the information office issued a list of valuable wild plant supplements that the housewives were recommended to include in their cooking. Many plants, such as nettles, goutweed and dandelions were recommended as excellent sources of iron and vitamin C. But here's what Dr. Esselstyn didn't mention... --Iselin Theien, "Food rationing during World War Two: a special case of sustainable consumption?" Anthropology of food Dr. Esselstyn's CAD Study In the mid-1980s, Dr. Caldwell Esselstyn was struggling to organize a study on coronary artery disease. His plan was to put a group of patients on a diet of low-fat, plant-based foods along with small quantities of low-fat dairy products and minimal amounts of cholesterol-reducing drugs. He started out with 24 subjects, but six dropped out in the first year. Evelyn Ostwick "“I ate all the chocolate I could eat, I ate every doughnut I could get my hands on… oh, I just loved things like that. A lot of gravy." Anthony Yen “But once I came to the United States [from China] you find beginning to experience fast food. The hamburgers and cheeseburgers, pizza. And I noticed my weight beginning to gain.” Two weak voices of opposition: San'Dera Nation “I’d been eating fatty foods and grease...as long as I can remember, so it was kinda hard to go from that to changing the next day completely.” At the end of five years, we had follow-up angiograms. And 11 of the group had halted their disease...And there were four where we had rather exciting evidence of regression of disease. These results were astonishing.
--Caldwell Esselstyn “I think the major message we got out of this correlation analysis is only one message: The plant-food based diet...is always associated with lower mortality of certain cancers, stroke, and coronary heart disease.” --Junshi Chen, co-author (pictured) Dr. Esselstyn has treated over 250 patients for heart disease using mainly a whole foods plant based diet. "Heart disease, as far as I'm concerned, is an absolutely toothless paper tiger." --Esselstyn Lee Folkerson's Results After 13 weeks on a whole foods, plant based diet... The Detractors Connie Diekman,
Director of Nutrition, Washington Univ.
Fmr. President, American Dietary Assn.
Advisor, National Dairy Council David Klurfield (USDA) "I don't think there really is a problem with industry connections between scientists and the food industry, primarily because if the beef industry has a question about their products, shouldn't they go to the best scientists? And if the best scientists are consulting for the food industry, I still want the best scientists on these committees that make nutritional recommendations." Weight 231
BP 142/82
Resting Pulse 92
Total Cholesterol 241
LDL ("bad" cholesterol) 157
CRP 6 Weight 211
BP 112/70
Resting Pulse 60
Total Cholesterol 154
LDL ("bad" cholesterol) 80
CRP 2.8 "Without any medications I significantly reduced my chances of getting a heart attack and many other diseases." "When you eliminate animal foods from your eating plan, you run the risk of inadequate protein content. Animal proteins provide all the amino acids that we need for cell growth, tissue repair, and overall health." The sheer number of medical and scientific experts starring in this movie gives the subject matter and findings credibility. Drs. Campbell and Esselstyn are among the most well-known and respected scholars in their respective fields. Both have written articles and have had their work published in peer-reviewed journals. But despite their lifelong dedication to their work, studies still have yet to definitively prove a link between specific micronutrients and disease. The research itself is reliable, but the manner of presenting it to the public through this medium is not. In particular, the slick editing of the documentary made the research and findings in the film seem less credible. Over and over again, gratuitous shots of enormous slabs of meat being sliced and fried and barbequed even though the narration may be talking about something else entirely. And the documentary is full of animated vegetables and colorful infographics that are pleasing to the eye but don't end up saying as much as they could. "open-heart surgery" "pink slime" "searing flesh" The authors chose to give them the minimum amount of camera time and they ended up saying not much at all. Having no opposition doesn't strengthen Campbell and Esselstyn's argument; it makes the documentary boring. Using pathos to persuade the viewer: In case the simple brilliance of switching to a whole foods plant-based diet doesn't appeal to you, the authors try to use the real-life stories of San'Dera, Anthony, Evelyn and others overcoming diabetes, cancer, heart disease, bad health and bad habits to convert viewers into believers. Before After They say it can cure cancer. But can it? CAN IT?!? THE END. Although Esselstyn's cardiovascular study and its results dovetail with the theme of the documentary nicely, there are some serious problems with Dr. Esselstyn's clinical study: 1. According to Esselstyn's report, "A Strategy to Arrest and Reverse Coronary Artery Disease: A 5-Year Longitudinal Study of a Single Physician's Practice," Dr. Esselstyn started out with 22 patients who agreed to start on the plants-based diet. Five dropped out within the first two years and 6 stayed on the diet but never recorded results. That leaves a sample of only 11 to analyze and draw conclusions from. 2. This clinical trial had no control group, leaving Esselstyn with a lot of variables and not a lot of answers. 3. It was also a non-randomized study. The patients volunteered, and Esselstyn accepted them as long as they had an angiogram showing severe coronary heart disease. The non-randomization of the sample and the fact that the subjects chose the study rather than the researcher randomly chose the subjects leads to a high selection bias. 4. Not only was there no control group, but Esselstyn changed everything about the subjects' diets and several components of their lifestyles. There are simply too many variables bouncing around this study. Esselstyn's study was a success in that all of his participants recovered from their severe heart disease, but the uncontrolled methods mean that there's no way of knowing which of the diet components had a positive effect on the heart disease. Dr. Esselstyn is essentially guessing (or lying) when he attributes his patients' success to cutting animal protein out of their diet. Only Connie Diekman and David Klurfield are interviewed for perspective on the other side of the whole foods, plant-based debate.
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