Sanjiv Chopra - Live Better, Live Longer: The New Studies That Reveal Whats Really Good---and Bad---for Your Health

I dedicate this book to my parents, Pushpa and Krishan Chopra, whose lives and work were luminous. Their humanity inspired and touched millions. If you, dear reader, garner even a few nuggets of wisdom from this book and thereby improve your health and well-being, whether in small or great measure, that will stand as a wonderful tribute to their memory.

Dr. Sanjiv Chopra

I dedicate this book to my wife, Lorelei, and my children, Julia and Sarah. Their support and encouragement made this book possible; I learn something new every day from them and hope that their curiosity comes through in this manuscript.

Dr. Alan Lotvin

Contents

Acknowledgments

Dr. Sanjiv Chopra would like to acknowledge:

Writing this book over the last two years with Alan Lotvin and David Fisher has been a remarkably delightful journey. We have had countless conference calls, innumerable meetings, and some marathon weekend sessions. We have learned beyond measure from one another. We experienced gales of laughter and good times, always ending each session with more tasks to complete by self-imposed deadlines. Alan and David are truly two of the most articulate, professional, and consummate perfectionists with whom I have had the privilege of collaborating.

I wish to express my sincere appreciation and gratitude to Ivan Kronenfeld, who guided us wisely at the initial stages. Frank Weimann has been immensely supportive, serving as a stellar member of our team, and I am very grateful for that. Tom Dunne and Peter Joseph have been invaluable with their advice and encouragement. I cherish their friendship.

I want to express my sincere gratitude to my family, large circle of dear friends, and colleagues for their untiring support. To my wife, Amita, my children, Priya, Kanika, Sarat, and Bharat, and to my grandchildren, Aanya and Mira, all I can say is that you are a constant source of pride, inspiration, and bliss.

Dr. Alan Lotvin would like to acknowledge:

Writing this book with Sanjiv Chopra and David Fisher has been one of the most enjoyable collaborations of my professional life. As friends, coauthors, and collaborators, these are two of the most creative, thoughtful people I have met. I would like to express my sincere appreciation to Ivan Kronenfeld, whose guidance has made this book possible. His intellectual challenges, advice, and mentorship have made an indelible impression on me. Natalie Casthely and our agent, Frank Weimann, were outstanding members of our team, and I thank them. I would also like to acknowledge the lifelong love of learning instilled in me by my parents, Rene and Seymour, and my sister, Nanci. Finally, I would like to thank several longtime friends for their unconditional encouragementDrs. Jonathan Sackner-Bernstein and Mehmet Oz; John Driscoll; Laizer Kornwasser; and Michael Waterbury.

David Fisher would like to acknowledge:

During the writing of this book, I spoke with scores of medical professionals and researchers, and without exception, one thing became strikingly clear to me: These are extraordinarily dedicated people who deeply love their chosen professions. I want to express my gratitude to each of those people. In my own life, there have been doctors who I greatly admirein particular, Dr. Joel Curtis of Beth Israel Medical Center in New York. I also would like to offer my appreciation to NYUs Dr. Steve Goldstein; Dr. Leslie Kahl of Barnes Hospital in St. Louis and Riverdale; and Riverdale, New York, dentist Dr. Paul Hertz.

Finally, it all begins and ends for me with my family, and I want to acknowledge the never-wavering support of my wife, Laura Stevens, the finest personal trainer in America, and our two sons, Taylor Jesse and Beau, as well as our feisty Chihuahua, Belle. Buck, the greatly loved couch-killing cat, was also with us for most of this work, kept alive and even thriving after two serious illnesses, thanks to another caring doctor, veterinarian Skip Sullivan of New Yorks The Cat Practice.

Preface

An apple a day keeps the doctor away.

WELSH PROVERB

One lovely evening while attending a medical conference, I was having dinner with several of my colleagues. These are men and women whom I consider to be among the finest, and wisest, doctors in the world. And like myself and my friend and collaborator, Dr. Alan Lotvin, they are people who love the practice of medicine. It is their passion as well as their profession. And fortunately there are many, many physicians like that. Not surprisingly, that night we were talking about the world of medicine and eventually we began discussing vitamin supplements. I asked each of them what vitamins they were taking. One of them, a man respected nationally as a leader in his specialty, replied, I used to take several of them, but then all those reports started coming out so now I dont take any of them.

I was surprised. You dont take vitamin D? I asked. The evidence about its benefit is quite clear. It seemed to me that everyone knew about it.

He shook his head. No. Should I?

Yes, I said, you should. A thousand international units a day. More if youre deficient. I began telling him about all the studies that had shown an association between a vitamin D deficiency and several potentially fatal diseases. I literally made him promise me that he would begin taking vitamin D the following morning.

Later I realized that I probably shouldnt have been so surprised. Almost every day in my practice a patient will tell me that he or she is terribly confused about the mountain of medical information that they are barraged with every day. Its an endless attack: Eat this and it will save your life. Dont use that because it might cause cancer. Do this, do that, dont do this, dont do that. Dr. Chopra, I often have patients tell me, its so confusing. What should I be doing?

Now let me share a secret with you: Most doctors are just as confused about all of this as you are. The pace at which discoveries are being made, the vast number of studies that are being done, and the extraordinary complexity of good science simply makes it impossible for anyone to keep up with all of it. Even your doctor. As my friend Dr. Howard Libman, a professor of medicine at Harvard Medical School reminded me, Even doctors are not immune from the media hype. Most doctors are more likely to see something on television than they are by opening up the New England Journal of Medicine. And often, if it does not directly affect their practice, they dont have an opportunity to search for the original article. So they remember the headlines.

We all see those headlines: THE PILL THAT CAN PREVENT CANCER! EAT ALL YOU WANT AND LOSE 10 POUNDS IN 10 DAYS! A GUARANTEED WAY TO AVOID ALZHEIMERS DISEASE! ACUPUNCTURE CAN HELP YOU GET PREGNANT! PISTACHIO NUTS LOWER BAD CHOLESTEROL! BREAST-FEEDING PREVENTS CARDIOVASCULAR DISEASE!

It never ends. How can you possibly know whats good for you? Once upon a time it was relatively simple. Taking care of ourselves meant eating healthy foods, exercising regularly, cutting out smoking and cutting back drinking, and making sure you got an annual checkup during which your family physician listened to your heart, knocked on your knee with a small rubber mallet, and checked your eyes, ears, nose, and throat.

But clearly that is no longer true. Patients have become health care consumers, and we all are barraged every day by a never-ending array of conflicting material designed to grab our attention and convince us that whatever is being promoted is something we cannot live withoutliterally. Its all terribly confusing.