Thursday, April 17, 2008


by Mark Hyman

The Modern Myths Quiz

How knowledgeable are you about today's medicine? Take this test to find out.

1. As a busy professional, you must often eat many meals out that you might otherwise prefer to skip or prepare at home. Tomorrow you have a breakfast date. Because you are starting to pay more attention to your diet, you are determined to order the healthiest breakfast possible. Which of the following would be your best choice?

a. Half a bagel with a tablespoon of jam and a glass of orange juice b. Instant oatmeal and two slices of whole wheat toast with a small amount of margarine c. Raisin-bran cereal with a cup of skim milk d. A mushroom, onion, and pepper omelette Answer:

If you picked (a) you have been misled by too many ads for low-fat foods. This breakfast has little nutritive value. It is made up almost entirely of empty calories and has a high glycemic index. In other words, its main ingredient is sugar.

Choice (b) sounds good, but it isn't. Processed and instant oatmeal, as well as most breads labeled "whole wheat," are actually surprisingly low in fiber, no matter what the ads on television say. And the addition of the hydrogenated fat in margarine makes this breakfast downright unhealthy -- among other problems, consuming such fats can lead to premature aging.

If you chose (c), you are once again falling into the sugar trap. Most commercial raisin-bran cereals have a great deal of added sugar, which probably negates the benefit of the small amount of fiber in the bran.

The correct answer is (d). Despite suffering from a lot of bad publicity, eggs are very low in saturated fat, and do not increase your cholesterol. Organic omega-3 eggs are particularlyhigh in healthful fats, and are an excellent source of protein and folic acid. And as you probably know, the veggies add nutrients that are important for your antioxidant and detoxification systems.

2. You are finally slated to take that physical examination you've been avoiding. But your busy, much-in-demand doctor is always rushed, and you want to remind him to give you that one crucial test that will provide you with an inside track on preventing diseases such as heart attack, stroke, dementia, and some forms of cancer. The test is for levels of:

a. Cholesterol b. Blood sugar c. Vitamin E d. Homocysteine Answer:Cholesterol levels (a) alone tell very little about the risks ofserious illness; checking the type of cholesterol is much more valuable. Levels of LDL, or bad cholesterol, are important, but now we know there are even good and bad LDL types. And, of course, levels of HDL (the good cholesterol) may be more critical than LDL numbers in many people. Add in your triglyceride levels (which may indicate possible heart disease, brain deterioration, and potentially stroke) and you have a much more telling tale of yourrisk.

If you picked (b), sorry -- by the time your blood sugar has become elevated, the imbalances that lead to diabetes have been progressing for years! There are much more sensitive and earlier ways to detect and prevent this tendency.

Although vitamin E (c) is an extremely important nutrient, it does not act alone but in concert with many other nutrients and antioxidants. Checking your antioxidant system is far more valuable than checking this single antioxidant component; this involves looking at the status of various nutrients in your body, certain levels of antioxidant enzymes and reserves of antioxidant nutrients, as well as the activity of free radicals.

If you chose (d) -- correct! More than any other single test, homocysteine correctly identifies the risk of such conditions as heart attack, stroke, and dementia years before the onset of any symptoms. More important, if found to be elevated, homocysteine can be easily lowered using the correct dose of B vitamins such as folic acid, B6, and B12. (What is homocysteine? You'll find out on page 42.)

3. Like anyone else who reads the papers regularly, you have become increasingly aware of the dangers in our day-to-day environment. But because it sometimes seems as though everything can be hazardous, it's hard to remember what's really bad for you. This weekend you are going to a friend's country home where you may encounter all of the following. Which is the most common toxin with the potential to become the most serious toxic threat in the United States?

a. Pesticides b. Artificial sweeteners c. Radiation d. Mercury Answer:

If you picked (a), sorry -- although pesticide exposure can be quite toxic and serious, pesticide residues are unlikely to be the single cause of diseases such as cancer, Alzheimer's, or degenerative ailments.

Same with (b) -- artificial sweeteners can have deleterious effects on the brain and nutrition, but they are not as dangerous as other common toxins.

Ditto for (c). Radiation is extremely toxic, but except in high-risk workers (e.g., X-ray technicians, radiologists, nuclear facility workers, et cetera), excessive exposure to background radiation is unlikely to be as common as exposure to...

Mercury (d). Toxic levels are now epidemic as a result of eating contaminated fish (especially large predatory marine fish such as tuna, swordfish, and halibut, and coastal shellfish) as well as the prevalence of silver (amalgam) dental fillings containing mercury. Mercury, one of the more toxic substances common to everyday life, has been associated with such conditions as dementia, heart attacks, neuro-pathy, multiple sclerosis, and congestive heart failure. This means that you are not doing yourself any favors when you eat your friend's special swordfish for lunch.

4. Although you've been able to accomplish many goals in your life, you've always struggled with your weight. No matter how virtuous you seem to be, dietwise you're never able to maintain any long-term weight loss. Your weight just keeps creeping up, maybe three to five pounds per year. The most helpful exercise regime to reach your goal would be:

a. Go to a spa for a week b. Begin walking thirty minutes three times per week c. Perform strength-training exercises with weight machines three times per week d. Chew gum all day long Answer:

(a) Going to a spa is a great way to jump-start your overall health program. But although you're likely to lose a few pounds in a week, unless you make some meaningful long-term changes and stick with them, a spa week alone won't solve your problem.

Although (b) sounds right, it's not. Walking is relatively good for you, but unless you walk up hills very briskly, the number of calories burned isn't very high.

Strength training (c) is correct; especially focusing on large muscle groups such as the thighs, hips, and buttocks builds the large muscles that are the engine of your metabolism. Building muscle is like adding two cylinders to your car's engine -- it will burn more gas even when idling. Strength training has the greatest effect on improving metabolism and will actually help you burn calories while you sleep.

Chewing gum (d) is not as silly as you might think. Chewing gum all day can burn significant calories and can produce weight loss of up to eight to ten pounds per year. But it's not as good as (c), and it might put you at risk for TMJ (temporomandibular joint) syndrome, or pain in the jaw.

5. Today you opened your daily paper and read about another danger from another commonplace activity. By now you've read so many of these stories you don't know what's hazardous and what's hype. Among the following, which is the most perilous?

a. Golfing three times a week b. Taking antibiotics periodically c. Sending your clothes to the dry cleaners d. Talking on your cell phone daily Answer:

We don't mean to scare you (too much) but the answer is all of the above.

Golf courses (a) are maintained using large amounts of chemicals, which means that while on the greens, your body, as you walk, drive, and putt, must expend energy detoxifying itself. Most adults already have overburdened detoxification systems; repeated exposure to these chemicals can lead to accumulation of these fat-soluble toxins in the body.

Antibiotics (b), although occasionally necessary (and at times even lifesaving), are grossly overprescribed. This has led to extreme antibiotic resistance and superbacteria that aren't killed by any of the known antibiotics. Every course of antibiotics leads to your body being inhabited by more and more resistant organisms, which are tougher and tougher for your antibodies to fend off. Periodic antibiotic use also kills many of the healthy, beneficial bacteria in our bodies that live in harmony with our immune systems.

The dry-cleaning process (c) employs many toxic chemicals that leave a residue on clothes. This may explain the link between socioeconomic status and breast cancer in women.

The electromagnetic fields and radiation levels emitted from most cell phones (d) are above those considered safe by the government. They have been linked to many problems, including high blood pressure and cancer (as well as to more frequent car accidents).

6. You know you're supposed to take your vitamins daily. But you don't do it -- and you're armed with a ready excuse if your doctor questions you. Join the crowd. Everyone has a host of excuses. Which of the following is the most valid reason for not taking vitamins?

a. Vitamins have never been shown to be beneficial in scientific studies b. Recent studies show that vitamin C can clog arteries c. As a vegetarian I watch what I eat carefully, so I get all my necessary vitamins from food d. I eat plenty of good food so I don't need to take an additional supplement e. I eat lightly Answer:

Statement (a) is simply wrong. Multiple studies have proven the value of several vitamins in the treatment and prevention of a number of disorders. Misleading studies looking at supplementation with single nutrients have erroneously created a myth that taking vitamins is bad for you, or that you can meet all of your nutritional needs through food alone.

Not long ago a highly publicized study supporting (b) appeared in the media -- but it did not actually show any clogging of arteries. It talked about a potential, but unproved, thickening of the artery walls in older male smokers. This study was misinterpreted and overpublicized by the media before it could be peer-reviewed or published in any medical journal.

And (c) is also wrong. Vegetarians who do not take supplements cannot get enough vitamin B12, since plants do not produce it (and vitamin B12 is essential for memory, nerve function, energy metabolism, regulation of homocysteine, red blood cell formation, and much more).

Actually, the opposite of (d) is true. The more people eat, the more vitamins they require. Excessive food intake (calories) is the main cause of oxidative stress and increases the body's antioxidant requirement significantly. (In brief, oxidative stress, which you will read about on pages 145-46, means that you are suffering from free radical damage, which can be compared to our bodies developing too much oxidation, or "rust.")

This means that (e) is correct. Eating less means a lower antioxidant and vitamin requirement. Vitamins and antioxidants are required for the processing of food; less caloric intake means lower vitamin and antioxidant requirements.

7. Although for years you didn't care, recently you've made a real effort to improve your health and you see your doctor for checkups regularly. Now, after improving your blood pressure and your weight, your doctor is telling you to lower your cholesterol level. The best way to do that is to:

a. Start taking a cholesterol-lowering medication, such as Lipitor, Zocor, Mevacor, or Pravachol b. Increase your exercise by going to the gym and lifting weights with a trainer three days per week c. Reduce your fat intake: cut down on red meat, butter,and eggs d. Eat more fat from sources such as walnuts and avocados,eat more eggs, cut out bread, sugar, and pasta Answer:

Yes, the medications listed in (a) will lower your cholesterol, but they won't change the fundamental reasons why your cholesterol is high, which is a poor diet, hydrogenated fats, insulin resistance, and so on. In other words, for the most part, these drugs are just a temporary fix.

Although strength training (b) is an important form of exercise and can help build up metabolism, it does not have as much of an effect on cholesterol levels as aerobic exercise.

Eating lots of red meat and butter is not necessarily healthful, buteliminating these (c) won't help lower your cholesterol as much as (d).

The best answer is (d). Your body needs these healthy sources of fat. Cutting down on refined carbohydrates will help your cholesterol levels much more than cutting down on fat. Walnuts, by the way, are tremendously helpful in lowering cholesterol.

8. Life is pretty good. You've got a wonderful family and some hard-earned financial security. Now that you've worked so diligently to get where you are, you'd like to make sure you can enjoy life for years to come. Specifically, you'd like your brain to function well past the time that you're supposed to be old and feeble. The best "brain insurance" you can buy right now is:

a. Cut tuna fish and swordfish from your diet b. Reduce your intake of sugar and refined carbohydrates c. Drink one glass of red wine daily d. Take 1 mg of folic acid daily Answer:

Once more, all of the above. Fish is supposedly "brain food," but tuna and swordfish (a) are extremely high in mercury, a toxic heavy metal that deposits in the brain and accumulates over long periods of time, causing neurological damage that can lead to further disease.

Sugar and refined carbohydrates (b) can aggravate insulin resistance, a common cause of brain fog and long-term brain injury.

Research shows that red wine in moderation (c) may protect the brain from oxidative stress. But drinking too much reduces any benefit you might be getting.Folic acid (d) controls levels of homocysteine, which is closely linked to Alzheimer's disease.

9. You're walking on the beach and you stub your toe on a large object in the sand. You uncover it and find that it's an old lamp. You know the rules, so you rub the lamp and out pops a white-coated genie. However, he's not just any genie; he's the healthcare genie, and because of recent cutbacks from the Genie HMO, he's only allowed to grant one wish instead of the usual three, and it must be from the list below. Your best choice would be:

a. Protect me from cancer for the rest of my life b. Allow me to eat as much as I want and never gain an ounce c. Protect me from the dangerous effects of our health care system's errors d. Eliminate all stress in my life Answer:

Although (a) would certainly be nice, the leading cause of death is not cancer but heart disease -- you're much more likely to die of a heart attack or stroke than cancer.

And (b) would also be nice, but it's not our weight that leads to disability and disease so much as the amount that we eat. Eating fewer calories reduces oxidative stress, the chief cause of disease.

Adverse effects of our health care system (c) are not only common but often fatal, and add up to the third leading cause of death after cardiovascular disease and cancer. But a better choice would be...

Stress (d), which plays a major role in disease and disability, and contributes to all of the leading causes of death, from heart disease to stroke to cancer. That is why this is your best health care wish. Stress also causes weight gain, loss of muscle and bone strength, Type 2 diabetes, brain atrophy, and loss of sexual function.

10. (For women only.) You're healthy and you take good care of yourself. But your main concern is breast cancer, because your grandmother died of it. The most important step you can take to reduce your risk of breast cancer is:

a. Eat more broccoli b. Get on a diligent schedule of monthly breast self-exams c. See a breast specialist every year and have an annual mammogram d. Reduce fat in your diet Answer:

Yes! Broccoli (a), and other members of the brassica family, such as cauliflower, brussels sprouts, cabbage, kale, and bok choy, are important in that they provide an excellent means of preventing breast cancer by assisting your body in the processing and elimination of harmful hormonal or toxic substances.

Unfortunately, there is no good evidence that monthly breast self-exams (b) actually reduce mortality from breast cancer. Monthly exams do not seem to detect breast cancers in a more curable stage than do occasional or periodic exams or annual mammograms.

Although an annual mammogram (c) may be one of the best ways of detecting breast cancer, it in no way prevents or reduces the risk of breast cancer. Mammography is simply a screening test for detection. There is also considerable debate as to whether annual mammograms actually reduce mortality from breast cancer.

Statement (d) is simply wrong. Low-fat diets could potentially increase the risk of breast cancer, particularly if your diet is high in sugar and leads to weight gain. Omega-3 fat from flaxseed and fish, and monounsaturated fats (found in olive oil, avocados, and nuts), reduce the risk of breast cancer, so it's important to include these sources of healthy fat in your diet.

If you answered all of these questions correctly, you are one of the few people in this country who isn't confused by the many myths of modern medicine. You may not even need this book. In fact, you could probably come to Canyon Ranch and help us spread the word.

The rest of you, however, should take this next little quiz. What do all the following statements have in common?

  • Tylenol is a safe over-the-counter drug.
  • The more you eat, the less vitamins you need.
  • Your sex life worsens as you age.
  • When you have a sour stomach, you should take antacids.
  • Eggs cause heart disease.
  • Heart disease is a disease of the heart.
  • There's no need to worry about dental fillings.
  • Antibiotics are a practical way to deal with infections.
  • Vitamin RDAs meet your nutritional needs.
  • Chocolate is always bad for you.
  • You can't reverse biological aging.
  • Disease is genetic.
  • A calorie is a calorie.
  • Water is a healthful drink.
  • Milk is the best source of calcium.
  • My lab tests came back okay so I must be healthy.
  • Doctors know what they are talking about.

The answer? It's not unlikely that you believe some, if not all, of these statements to be true. But they aren't. They are myths, myths that have been promulgated by the media, by uninformed health care consumers, and, unfortunately, by doctors.

In fact, it's not unlikely that because your doctors believe some of these myths to be reality, they may be damaging your health more than they are promoting it -- which is why we often say that what your doctor doesn't know may be killing you.

Not only that, but because your doctor isn't doing the best job of promoting your health, whether you're thirty, forty-five, or seventy years old, you are simply not feeling as good as you could, and should, be.

But you don't know that. This morning you woke up with a small ache in your back, your energy level was a little less than it was a few years ago, your stomach was a bit queasy. You're thinking: This is just what happens when you grow old.

But we're saying: Those little aches, those strange creaking sounds, those small pains -- you don't have to have them. That's why we tell our patients that, after they visit us, they will feel as though we've rewound their internal clock, making them feel five, ten, maybe even fifteen years younger.

We promise we can do this for you, too. Once you stop believing in these myths, and you start following our program, your chances of being healthy for the duration of your life will increase dramatically.

The fact is, health care in the United States is not as good as we tend to imagine. Most Americans think our health care is the world's best -- and when it comes to certain medical treatments, they're right. We often hear about patients around the world with burns, injuries, or unusual diseases being flown to the United States for emergency treatment of a kind that tops the rest of the world.

That's because our model of medicine is based on acute care -- we know how to deal with emergencies better than anyone else. But when it comes to medicine in general, the results are startling. A recent Journal of the American Medical Association article reviewed the status of health here and declared: "Of 13 countries in a recent comparison, the United States ranks an average of 12th for 16 available health indicators."

Not only is our system ailing, but the application of this acute care model to chronic illness creates an enormous burden of suffering (in-hospital errors or adverse reactions accounts for 225,000 deaths per year, amounting to the third leading cause of death after heart disease and cancer) and an economic disaster of $77 billion in extra costs resulting from the adverse effects of outpatient care alone.

There are two areas in which to fight this decay in our health. The first is on a national level, and that involves confronting politicians, drug and insurance companies, health maintenance organizations, and the other groups that constitute what we call the medical-pharmaceutical complex. That's a tough fight, and one for which most people don't have the resources, or the stomach. But there's another place where you can take on the health care system: in yourself. You don't have to fall for the myths that are creating an increasingly expensive system that seems to be failing in many ways.

How? First, read Part I, where you will learn to debunk all those myths you believe are truths.

Then move on to Part II, where you will learn the new reality of health and medicine in the twenty-first century. Here we talk about our theory of ultraprevention, a method of thinking, evaluation, and treatment derived from the scientific study of health. Through this system we provide our patients (and now our readers) with a personalized road map to health by addressing and controlling what we consider to be the five most important processes of health management -- five forces that are found wherever and whenever we trace an illness back to its roots. The five forces are:

  • Malnutrition, or what we call sludge
  • Impaired metabolism, or burnout
  • Inflammation, or heat
  • Impaired detoxification, or waste
  • Oxidative stress, or rust

These five forces are the new realities of modern medicine, unlike the myths you must dispel to understand health.

Finally, in Part III, we offer our six-week ultrapreventation plan, which will help you live your daily life in a healthy, reality-based manner.

There's an old Peanuts cartoon in which Lucy is lecturing her younger brother, Linus, about all sorts of information that makes no sense, such as how a little elm sapling will grow into a mighty oak. Meanwhile, Charlie Brown is watching. He eventually comments that poor Linus is going to have to go to school twice as long as everyone else: First he must unlearn all the nonsense that Lucy has taught him, and then he must learn the truth.

We feel that most of you out there are like Linus. You've been taught countless myths, which you believe as though they were truths. They're not. But unlike Linus, who learned harmless fabrications, you're building up a belief system that could endanger your health. It's time to change, by learning about the seven most common myths of modern medicine.

Copyright © 2003 Mark Hyman, M.D., and Mark Liponis, M.D

Excerpted from

Ultraprevention: The 6-Week Plan That Will Make You Healthy for Life

by Mark Hyman
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