Dr. Neal Barnard is not the kind of physician who tells you what you’d like to hear. He often does just the opposite, especially when it comes to your favorite dietary staples.
When confronted with familiar comforting platitudes like, “All things in moderation,” the doctor doesn’t hesitate to squash them. He does so without apology or qualification, feelings be damned.
In a recent opinion letter published in The Washington Post, Barnard responded to an article that suggested that processed meats like sausage and bacon could be part of a healthy diet when consumed in moderation. He began by citing a grim statistic: Those meats are a major contributor to 50,000 colorectal cancer deaths in the United States each year. He went on to say, “And while some folks like to yuck it up with bacon on everything, it’s not so funny when we see that we are passing potentially fatal habits on to the next generation. Do the math: A child who grows up with bacon for breakfast, hot dogs for lunch or pepperoni pizza for dinner has about an 18 percent increased risk of cancer for daily servings of processed meat.”
He ended by setting the record straight on a principle he believes has become a dangerous cliche: “The notion of moderation applies to good things, not to hot dogs. If your daughter loves to play the violin, after a few hours, it is time to set it down and do some homework. But how many cigarettes should she have? How much heroin? Moderation, as a concept, applies to healthy things, not to carcinogens.”
Barnard engages in similar stark realities—along with some arguably uplifting ones—in his lectures and best-selling books. An alumnus of and adjunct professor at the George Washington University School of Medicine and Health Sciences, he has published some 70 research articles and 18 books for the lay reader, including his most recent, The Cheese Trap, which probes the addictive and detrimental health effects of an American favorite. Like many of his other books, it builds the case for shunning both dairy and meat in favor of a plant-based diet, providing recipes and other practical guides. Barnard has also produced a slew of online videos and DVDs and plays a central speaking role in the documentary What the Health, a scathing expose of the food industry and the far-reaching influence of its dollars. He makes regular appearances on PBS and popular television shows—all efforts to promote his belief that you really are what you eat.
It might be easy to turn the page or hit the off switch on the doctor’s message, except that it’s backed by major health organizations like the American Medical Association and the National Institutes of Health. Insurance companies like Geico and Kaiser Permanente have occasionally funded his studies in the interest of promoting the health of their employees and customers—and thereby protecting their bottom line.
At 64, the slim, steely-eyed doctor is a research pioneer and iconoclast of startling dimensions. He is a man of science who also displays a stunning artistry in realms where you might not expect to find him.
At his downtown office, Barnard apologizes for a meeting that ran late as he sits down to share his story. He speaks briskly, eyeing the clock and displaying a hint of annoyance at questions clearly meant to garner mercy for deli meats and other deplorables.
He looks askance when asked, “Wouldn’t an organic, non-nitrate-containing sausage be considered fairly benign?”
It turns out that no type of meat passes muster with him; his research shows they all do harm for a variety of reasons. He makes no distinctions between gently grilled chicken breasts and the stuff that’s laden with chemicals, or between red meat and white. Chuck it all, he advises, “even if it’s kosher—even if it’s been blessed by the pope!”
It wasn’t always that way. Growing up in Fargo, North Dakota, the descendant of cattle ranchers, he ate a typical American diet of meat and potatoes. Roast beef figured prominently. Like so many of the people he has counseled over the years, he would later reinvent the ways he thought about food.
Barnard’s father was a doctor who specialized in diabetes and was one of that region’s top experts in the illness. But the elder Barnard’s approach to treatment—teaching his patients to curb their carbs and take insulin injections, practices that still reflect conventional wisdom—is a far cry from what the younger doc prescribes.
His revolutionary approach to treating diabetes and other conditions through a plant-based diet is the culmination of years of study and research in a variety of medical specialties. In a Psychology Today article published last March, Barnard called his medical background “unclassifiable.” He explained the peculiar evolution of his career, noting that his earliest passion was the brain. “I was only interested in how the brain works and how things go wrong. So I’m a board-certified psychiatrist. But as time has gone on, I’ve gotten involved in research on diabetes and metabolic problems. So I’m now in GW’s Department of Internal Medicine, and in 2015, I became a fellow of the American College of Cardiology. It’s been a bit of a journey, but it all works together.”
That vivid sense of how things work together in the human body—food, metabolism, the functions of the brain and other organs—inspired Barnard to start spreading the message in a world where health matters are frequently compartmentalized. Understanding that “it all works together” is, he believes, the starting point to achieving good health.
In 1985 he founded the nonprofit Physicians Committee for Responsible Medicine, located just off the Metro in D.C.’s Friendship Heights. The organization’s 150,000 members include some 12,000 physicians. Its aim is to address what Barnard believes inhabits the core of a growing health crisis in America, where two-thirds of the adult population and an alarming number of children suffer from obesity and where chronic conditions like diabetes and heart disease are on the rise. It’s a health care culture centered on sickness. (“We wait until a heart attack comes through the emergency room door,” he told Psychology Today.)
The foundation actively promotes a culture of prevention, which begins when people recognize the close and immediate connection between diet and well-being. In addition to a multifaceted media campaign aimed at educating the public on personal nutrition, the PCRM devotes itself to exposing the machinations of a food industry it says profits shamelessly by sowing destruction. The doctor’s group also sheds light on the U.S. government’s hand in bolstering the meat and dairy industry through its policies and subsidies. In this realm, Barnard and fellow activists seem to operate on a premise reminiscent of muckrakers like Upton Sinclair in the classic novel The Jungle; in order to make us healthy, they need to first get us feeling a little sick.
The PCRM takes the fight to the top by encouraging citizens to petition the government on matters like school lunches and the Supplemental Nutrition Assistance Program (formerly called food stamps), castigating those programs for proffering food options brimming with sugar and fat. The organization also works to banish research involving animal experimentation, arguing that current technologies allow for a more ethical, human-based approach.
At the Barnard Medical Center, located two floors up from his office at the PCRM, primary care professionals and dietitians help patients adopt an individualized plant-based diet, which is centered on a few basic principles: avoiding all animal products (including eggs and fish), eating a variety of vegan foods and limiting oils. The program’s low-fat, no-cholesterol “power plate” features four food groups: fruits, whole grains, legumes and vegetables.
On The Ellen DeGeneres Show, guest Neal Barnard is exchanging a few laughs with his host, an avid fellow vegan and animal rights advocate, while expounding the particulars of cheese consumption in America. DeGeneres displays a table with two hefty slabs of packaged cheese to convey what 33 pounds of it looks like. That’s the amount consumed each year by the average American—a significant increase from a century ago, says the doctor, when per capita consumption amounted to less than 4 pounds.
Barnard ties the increase, along with a dramatic rise in meat consumption (up from 124 pounds in 1909 to a whopping 200 pounds in 2004), to an ever-expanding American waistline and its associated assortment of health woes. In The Cheese Trap, he labels cheese “the ultimate processed food” and outlines the various villains concentrated in each serving. They include bovine hormones, sodium, saturated fat, cholesterol and a heavy dose of calories—close to 1,000 in a cup of melted cheddar (compared to 149 in a cup of milk). “Cheese is more fattening—by far—than bread, potatoes or even pure sugar,” he notes. He also emphasizes a little-known hobgoblin: Cheese harbors mild opiates that make it extremely hard to break free from. “That fattening-addictive combination is what makes cheese a serious problem for your weight,” says the author.
In Barnard’s best-selling 21-Day Weight Loss Kickstart, the doctor asserts that with a vegan diet, dropping pounds is “essentially automatic,” provided that fat-containing foods like oils, seeds and nuts are consumed in moderation. (Those are “good things” in his lexicon, so the principle of moderation applies.)
When it comes to meat, he emphasizes two ominous characteristics, among others: its fat composition and its poor communication skills.
Both animals and humans, he says, store extra calories as fat. Such is the natural design of fat. “If you eat animal fat, you’re eating an animal’s calorie-storage organ,” he notes unappetizingly. He also points out that even leaner cuts of meat pack large chunks of calories from fat.
Compounding the problem is the fact that meat lacks the properties needed to make a person feel full—the bulk provided by fiber. “By the time you reach the satiety point, you’ve gotten more calories than you bargained for,” Barnard says in his book. He also reveals that you’ve gotten a heavy dose of substances that trigger all manner of chaos in the body’s various interconnected avenues—hormonal, metabolic, gastrointestinal, cardiovascular and more.
To anyone inclined to think that diet is only an issue for those who are overweight or suffering disease, the doctor says think again. He points to several studies involving autopsies performed on soldiers of war and other young, seemingly fit people. In each study, a large number of the deceased showed significant signs of atherosclerosis, a buildup of fats, cholesterol and other substances in and on the artery walls that is linked to poor diet.
But Barnard is also the bearer of good news: Thanks to the body’s innate ability to heal itself, the chaos is often reversible, he says. His books and videos are full of people who have overcome serious health conditions by following the uncomplicated directives of his plant-based diet. In dramatic before-and-after footage, they start out overweight, depressed, menaced by medicine bottles or otherwise beaten down by their condition—in some cases, leaning on a walker. They emerge leaner, happier, more mobile and far less fettered by prescription drugs.
The success stories include his own mother, who for years had spurned his advice on cleaning up her diet. (As the third child in his family, he was paid little attention, he laments.) But when she was told by a cardiologist that she needed to start taking cholesterol medication to avoid a heart attack or stroke, she read a few of her son’s books, adopted the plant-based diet and saw a 70-point drop in her cholesterol in just six weeks, all without drugs.
Then there’s the NFL star who recently became veganism’s most unlikely spokesperson: Trent Williams, famed offensive lineman for the Redskins. Williams decided to toss animal foods after watching What the Health in late July. About a month after starting the diet, Williams told The Washington Post that he was feeling energetic and hopeful about “upping” his game.
Barnard expresses hope for a culture deeply entrenched in bad habits. In an article he wrote in 2013, he cited lessons from the war on tobacco. He recalls that as an intern in 1980, he routinely bumped into senior surgeons in the hospital gift shop, where they all purchased their cigarettes. “The physicians’ lounge had air you could have cut with a knife.” He also confesses to a familiar mindset: “We were not fools. We knew that smoking caused cancer. But we had stressful lives and told ourselves that cancer was a long-term process. We imagined that we could take our time in quitting.” Today, thanks to a change in popular thinking driven by aggressive anti-smoking campaigns, smoking has sharply declined, and of course, “it would be tough to find a physician who puts match to cigarette.”
Barnard suggests that a dietary revolution similar to the war on tobacco is forthcoming and necessary. The potential benefits to public health are conveyed by the diversity of his book titles. They include Power Foods for the Brain: An Effective 3-Step Plan to Protect Your Mind and Strengthen Your Memory and Foods that Fight Pain, a primer for anyone suffering from arthritis, migraines and all things inflammatory. His research also indicates that ditching animal products, especially cheese, can fend off respiratory conditions like allergies and asthma—all of which underscores a maxim from the Greek Hippocrates that Barnard is fond of quoting: “Let food be thy medicine.”
Perhaps none of his postulations are as revolutionary as those outlined in his 2006 book, Dr. Neal Barnard’s Program for Reversing Diabetes. The program has implications for all diabetes patients but especially for those with the more common Type 2 variety (once known as adult-onset). His plan rests on his assertion that, contrary to conventional thinking, carbohydrates (sugar and starch) are not the true culprits in the condition; instead, the problem lies with an inability to process those substances. In a plant-based diet, the body often becomes better able to make the process work. “The improvement in blood sugar control can be dramatic, reducing the need for medications and sometimes making the disease disappear altogether,” he notes.
The villainy of carbs is one of the myths Barnard continually debunks. He urges listeners to eat nutrient-rich rice, sweet potatoes and whole grain breads without worrying about weight gain or diabetes. To champion their virtues, as he did on The Ellen DeGeneres Show, he habitually references traditional Asian diets. He told DeGeneres, “If you look at the thinnest people on the planet—they live in Japan, Thailand, Cambodia, China—they’re eating huge amounts of rice. That’s all carbohydrates. They don’t gain weight until the fast food restaurants move in and they start eating our way.”
Another thing we shouldn’t stress over, says Barnard, is getting enough protein from a plant-based diet. Incorporating a variety of foods from his “power plate” offers plenty. Throw in a multivitamin or a vitamin B-12 supplement to be safe, he advises.
“You’ll drive me crazy,” says the doctor, eyes closed in mock disdain. In the film What the Health, he is addressing a question that reflects common dietary misconceptions. One can only imagine the emotional challenges of continually confronting the health-sense equivalent of fake news.
But by his own account, Barnard is accustomed to resisting the status quo. Last March he told The GW Hatchet, “I always have wanted to break boundaries, whether it’s in medicine or in music or in literature.”
Indeed medicine is not the only field where Barnard blazes trails. A Google search of Neal Barnard yields, besides a wealth of material on plant-based nutrition, striking images of the doctor jamming on his guitar in an innovative 16-member band called CarbonWorks. Sometimes he plays the keyboard. (Comedian Alec Baldwin recently referred to Barnard as “Eddie Van Halen with a medical degree.”)
Like his medical career, the band has been around for several decades and sports a style that is rich and eclectic—what Barnard calls “genre-bending.” Its members hail from a legion of countries, including Italy and Vietnam. Last summer the band’s song “Louder than Words” climbed to No. 13 on the contemporary song chart. Barnard composed both the lyrics and music to this stunningly beautiful piece that evokes sympathy for animal cruelty—a sentiment that clearly factors into his medical philosophy.
Over the years some have alleged that the doctor’s humane penchants were the principle driver of his plant-based diet (as if a large body of clinical studies is merely icing on the cake). Even now there are websites that portray him as an animal rights extremist and the PCRM as his propaganda arm. They quote an American Medical Association official who chastised his positions back in the early ’90s, failing to mention that the association has long since embraced and promoted those positions—proof positive being the AMA journals that feature his articles and the fact that he recently spoke at its annual conference.
Asked to respond to those who argue that the polio vaccine might not have been developed without animal experimentation, the doctor replies: “California would not have been settled without covered wagons. But we have new technologies now and much greater awareness of animals’ sensitivities.”
In what he calls our “kooky culture,” old ways of thinking (and eating) die hard. Covered wagons stubbornly persist. Nonetheless, Barnard goes on being the change he wants to see in the world. He breaks down, but he also builds up, and he never stops pursuing his vision of a nation where health care means compassionate preventive care, and where that care is available to all—a right, not a privilege.
“We are not going to live forever,” says the doctor. “But while we’re alive, we can live well.”