Dr. Hiromi Shinya, the Physician-Inventor of the Colonoscopic Polypectomy: What He's Learned About Diet and Health From Over 300,000 Colonoscopies

Dr. Hiromi Shinya in the early days of fiber-optic colonoscopy.  Gastrointestinal Endoscopy 60(6):977-982, 2004

 

"It is no exaggeration that the development of the colonoscopy technique and polypectomy made Dr. Shinya famous throughout the world.

His experience to date amounts to almost 300,000 colonoscopy procedures.

[The question Dr. Sivak often asks gastroenterologists]

Of the many endoscopic procedures you will perform throughout your career, which do you think is the most important?

[The Answer] As we now know, removal of colon polyps prevents colorectal cancer, and colonoscopic polypectomy is the "most important" achievement, because it is preventive medicine at its best.  Tell me, if you can, that there is something more important in GI endoscopy?"

-Dr. Michael Sivak, Jr., in "Polypectomy: looking back," Gastrointestinal Endoscopy 60:977, 2004-

 

A medical history lesson.  Back in 1969, a young Japanese gastroenterology fellow at Beth Israel Hospital in New York City, Dr. Hiromi Shinya, developed the equipment & technique to endoscopically remove polyps, avoiding what before then meant major abdominal surgery.   It was an historic breakthrough in the prevention of colon cancer.

Dr. Shinya is now 75 years old, he's still the Chief of Surgical Endoscopy at Beth Israel Hospital, and he's still performing colonoscopies, in the U.S. and Japan.

Why should we care?

A year ago, one of my readers from New York City mentioned that her long-time gastroenterologist, Dr. Hiromi Shinya, had written a book that was wildly popular (over 2 million copies sold) in Japan, called The Enzyme Factor.  She found it interesting that Dr. Shinya was also advocating a low-fat almost vegan diet, similar to what I blog about, and what Dr. Caldwell B. Esselstyn, Jr. and Dr. T. Colin Campbell recommend.

• Dr. Shinya published The Enzyme Factor in Japan in 2005
• Dr. T. Colin Campbell published The China Study in 2006
• Dr. Caldwell B. Esselstyn, Jr. published Prevent and Reverse Heart Disease in 2007.

Three weeks ago I finally got around to borrowing a copy of the English translation of The Enzyme Factor from my library--but I only had it for a short time--there's a queue of others waiting to borrow it.

Shinya's book was directed to the lay Japanese public.  It reads a little awkwardly, it's repetitive, it contains no scientific references, no statistics, no graphs or charts.  It's a compilation of his years of clinical observations, plain language explanations of how the health of the digestive system affects disease, and how certain foods & habits can seriously impair the GI system.  It can't compare to the scholarship of The China Study or Prevent and Reverse Heart Disease, with their depth of detail.  But it does corroborate their message--and it adds to the evidence of how dairy, meat, fats, and oils can damage the digestive system, and promote disease.

Bottom line, according, to Shinya:

 "Over the course of decades in clinical practice, examining literally hundreds of thousands of people as a gastrointestinal endoscopist, I have learned that when a person's gastrointestinal system is clean, that peson's body is easily able to fight off diseases of whatever type."

Whether one has a genetic predisposition toward heart disease, diabetes, colon cancer, prostate cancer, Crohn's disease, ulcerative colitis, or kidney disease---it's  your diet and lifestyle habits that will be the switch that turns on the disease.  And the switch to turn off the disease. 

Shinya's clinical experience with early stage colon cancer patients corroborates Dr. Campbell's China Study experience: "The same nutrition that prevents disease in its early stages (before diagnosis) can also halt or reverse disease in its later stages (after diagnosis)." and "Nutrition that is truly beneficial for one chronic disease will support health across the board."

Two years after Shinya started examining stomachs & intestines with a scope he started asking his patients about their dietary history.  Their were huge differences in the intestines he saw--the healthy ones were clean, soft, pink, with transparent mucous, invisible blood vessels, and uniform folds.  The unhealthy ones were swollen, spotty, with thin stomach linings, shriveled mucosa, unequal folds, pocket-like cavities that were often ulcerated, pitted, filled with mucous, as well as stagnant stool.  Shinya was determined to figure out if there was some connection between diet and intestinal health. 

Shinya's Enzyme Factor Theory:  Enzymes are the protein catalysts that are made within the cells of all living things--and they're needed to maintain life--think transportation of nutrients, digestion, excretion, synthesis, detoxification, decomposition, and supplying energy.  There are over 5000 kinds of vital enzymes, each with specific jobs--like the digestive enzyme amylase that's found in saliva & reacts to carbohydrates. 

Some foods like dairy products, meat, and alcohol require a greater-than-normal amount of a particular enzyme to break them down--creating a shortage of the necessary enzymes needed for digestion & absorption.  The solution:  Avoid the kinds of foods that deplete enzymes.  Consume a plant-based diet and practice the habits that replenish & sustain enzymes.  Shinya clearly admits that this is a theory, but one that he has personally practiced for over forty years--and one that has worked well for his patients.

After Viewing 300,000 Intestines & Stomachs, Dr. Hiromi Shinya Has Something to Say about Gastrointestinal Health

"Remember what over 300,000 clinical observations have told me:  A person with poor gastrointestinal function is never healthy.  When a person's gastrointestinal system is not clean, that person will be prone to suffer from some kind of disease.

In short, whether a person is healthy or not depends on what that person eats and how that person lives day to day.  What determines a person's state of health is the daily accumulation of things such as food, water, exercise, sleep, work, and stress."  Dr. Hiromi Shinya

Early on Shinya had his patients fill out a questionnaire detailing the foods they ate--and their lifestyle habits--things like, alcohol consumption, smoking, sleep habits, water consumption, laxative use, and bowel habits. 

Based on his questionnaires and the conditions of the intestines he scoped, here's what he concluded:

Shinya's List of Ten Foods to Avoid--All are Associated with GI Disease & an Unhealthy GI Tract

1.  Excessive Animal Protein--especially red meat 

2.  Dairy products such as cow's milk, cheese, yogurt, other milk products

3.  Japanes green tea, Chinese tea, English tea (limit to 1-2 cups per day)

4.  Coffee

5.  Sweets and sugar

6.  Nicotine

7.  Chocolate

8.  Fats & oils

9.  Regular table salt (use sea salt with trace minerals)

10.  Alcohol

Shinya's Keys to Good Health

1.  Eat a diet that is 85-90% plant-based foods  

• 50% whole grains, brown rice, whole wheat pasta, barley, cereals, whole grain bread & beans including soybeans, kidney beans, garbanzo beans, lentils, pinto beans, pigeon peas, black, white & pink beans
• 30% green and yellow vegetables and root vegetables, including potatoes, carrots, yams and beets, and sea vegetables
• 5-10% fruits, seeds & nuts
• Soymilk, rice milk, almond milk

2.  10-15% animal-based proteins (no more than 3 to 4 ounces per day):

• Fish of any type, but preferably small fish as the large fish contain mercury
• Poultry: chicken, turkey, duck--small amounts only
• Beef, lamb, veal, pork - should be limited or avoided
• Eggs

3.  Foods to add to your diet:

• Herbal teas
• Seaweed/kelp tablets
• Brewer's yeast (good source of B complex vitamins and minerals)
• Enzyme supplements
• Multivatimin & mineral supplements
• Fish oil--particularly DHA

4.  Good Water

• Water is essential for your health.  Drink "good water" such as mineral water or hard water, which has calcium & magnesium, and keeps the body at an optimal alkaline pH
• Adults should drink at least 6-10 cups of water every day
• Drink 1-3 cups of water after waking up in the morning
• Drink 2-3 cups of water about one hour before each meal

5.  Regular Elimination

• Start a daily habit to remove intestinal pollutants and to clean out your system regularly
• Do not take laxatives
• Eat high fiber foods--don't get your fiber from capsules or supplements

6.  Decrease dependence on prescription drugs by modifying your diet & getting exercise when possible

• Pharmaceuticals can tax the liver and kidneys
• Many chronic conditions such as arthritis, gout, diabetes, and osteoporosis can be managed with diet and exercise.

7.  Minerals are important to health

• Magnesium activates hundreds of different enzymes--and is required for good health.
• A balance of sodium & potassium is a prerequisite for life.  Laxatives, diarrhea, excessive exercise can deplete sodium.  A diet high in vegetables boosts potassium.
• Too much calcium after middle age can be harmful
• Small amouts of trace minerals work synergistically with vitamins, minerals, and enzymes:  boron, copper, zinc, iron, selenium, chromium, manganese, molybdenum, & iodine.

8.  Moderate Exercise

• Exercise appropriate for your age and physical condition is necessary for good health, but excessive exercise can release free radicals and harm your body
• Some good forms of exercise are walking (2.5 miles), swimming, tennis, bicycling, golf, muscle stregthening, yoga, martial arts, and aerobics

9.  Adequate Rest - Shinya is a daily napper

• Go to bed at the same time every night and get 6 to eight hours of uninterrupted sleep
• Do not eat or drink 4 to 5 hours before bedtime.  If you are hungry or thirsty, a small piece of fruit may be eaten one hour before retiring, as it will digest quickly.
• Take a short nap of about 30 minutes after lunch.

10.  Breathing and meditation

• Practice meditation
• Practice positive thinking
• Do deep abdominal breathing 4 or 5 times per hour.  The exhale should be twice as long as the inhale.  This is very important as deep breaths help to rid the body of toxins and free radicals.
• Wear loose clothing that does not restrict your breath.
• Listen to your own body and be good to yourself

11.  Joy and Love

• Joy and love will boost your body's enzyme factor sometimes in miraculous ways
• Take time every day for an attitude of appreciation
• Laugh
• SIng
• Dance
• Live passionately and engage your life, your work, and the ones you love with your full heart

Some Shinya Myth Busters

Shinya shares a lot information in his slim book.  Far too much to share in a blog post.  But, here are a few of the nuggets that caught my attention.

The Doctor's Sick Babies

Dr. Shinya's wife had difficulty breast feeding, so both of his children were put on formula made from cow's milk.  His daughter cried a lot, and at six month's she developed an itchy miserable rash all over her body.  At age three, his son developed chronic diarrhea & finally, rectal bleeding.   Around this time Shinya had acquired his first primitive colonoscope, so he was able to examine his son, and discovered that he had an inflamed, ulcerative colon.

Needing to know the cause of his daughter's chronic rash, and his son's colitis, Shinya started investigating.  Both of these conditions were uncommon in Japan, because at the time there was little dairy food used in Japan--but his young family were living in the U.S.  Shinya suspected a connection to cow's milk.  When he took away the milk his daughter's skin cleared up.  He realized that because his daughter was unable to digest milk, "the undigested particles that were small enough to pass from her intestines into her blood were attacked by her immune system, as if they were foreign invaders.  The same thing turned out to be true with his son."  When they stopped the milk, the colitis disappeared--as did his daughter's atopic dermatitis.

As milk consumption in Japan has increased since the 1960's, so have the cases of atopic dermatitis. 

According to Shinya, dairy foods can damage the intestinal environment, increasing the amount of bad bacteria, and destroying the balance of the beneficial intestinal flora, opening up the door to illness.

The Myth of Yogurt

Although yogurt is credited with improving intestinal flora, like lactobacilli, and benefiting digestion & relieving constipation, Shinya believes otherwise.  He says, lactobacilli is naturally present in a healthy human intestine, and any lactobacilli you were to ingest from outside of the body in the form of yogurt would just be destroyed by stomach acid.  Although yogurt might seem to "cure" constipation, what people are really experiencing is a mild case of diarrhea, because most adults lack enough of the enzyme lactase to completely break down lactose (and yogurt contains a lot of lactose).  The yogurt is not actually "curing"  constipation at all.

According to Shinya, "your intestine's condition will worsen if you eat yogurt everyday.  I can say this with confidence based on my clinical observations."

The Green Tea Myth

We've all heard about the antioxidant benefits of green tea. There are all kinds of benefits attributed to green tea.   Shinya disagrees.  Yes, it does have antioxidants, but in his clinical experience, people who drink a lot of green tea also have stomach problems.  Here's why:  although it contains polyphenols that can neutralize the damage of free radicals, it also produces tannin.  When tannin is exposed to hot water or air, it turns into tannic acid which coagulates proteins, and can have a negative effect on the gastric mucosa.   "The fact is, when I use an endoscope to examine the stomachs of people who regularly drink tea (green tea, Chinese tea, English black tea or coffee that contains a lot of tannic acid) I usually find their gastric mucosa has thinned due to atrophic changes.  It is a well known fact that chronic atrophic changes or chronic gastritis can become stomach cancer."

 Bottom Line: 

If not for the fact that Dr. Hiromi Shinya was a brilliant clinician and a pioneer in the field of colonoscopy, I would never have looked at this book.  For me, its style and lack of journal references gets in the way of its scientific authority.  But in spite of that, I can't ignore Shinya's clinical experience & his observations from over 300,000 colonoscopies.  He's seen health and he's seen disease--and it appears that he's been able to figure out what contributes to that difference--whether or not you believe his "enzyme factor" theory.

My own experience with a plant-based diet for the past 2 1/2 years seems to agree with Shinya's dietary observations.  I've ditched the dairy, the meat, and the oil.  I've upped the beans, greens, vegetables, and fruit, and my digestive health has never been better--"as regular as a Swiss passenger train."  Shinya claims his last illness was the flu, at age 19.   As for me, my last cold was exactly a year ago.  Should I credit my healthy intestines?

 

 

 

 

Comments

[Gerard Salomon]

Wow! Thank you for today's article. I learned a lot from your webside.

Sincerely,

Gerard

[Thomas Swanson]

No Coffee:( *sniff*

but I love coffee.... one of my few remaining vices.. That, and maybe a few too many beers on game day...

I already follow Dr. McDougall's diet.

[Healthy Librarian]

Thanks, Gerard! Happy New Year!

Thomas,
I love my morning coffee, too! No plans to give it up, either. Same for a little red wine! If you're following McDougall, I'm sure you'd have an A+ colonoscopy.

[Ken Leebow]

Thanks for another angle on health and health care.

Maybe we need a new diet book: The Colon Diet - I haven't seen that one yet, but I'm sure it's out there.

BTW, have you ever done a review if the Paleo Diet? I'm fascinated by the followers passion, support and dedication to it.

Happy New Year,

Ken Leebow

[Stacy]

Fantastic find. Thank you! I have requested the book from my own library...which thankfully does not have a waiting list. It is also available on Amazon.

[Cynthia Bailey MD, Dermatologist]

I always value the observations of senior physicians who have watchfully internalized the correlations between their physical exam findings and their patient's life experience. Even if their conclusions are more intuitive than we like to see in our western scientific culture, I value them. To see these observations based on peoples intestinal mucosal integrity is fascinating. I'm with him almost 100% in my own observations of people's skin findings. I am surprised about the tea and yogurt though and am going to have to think about those. I'm a big fan of goat kefir and other non-cow dairy fermented foods. I'm a big green tea fan too. Hmm.

Once again, thank you for finding this fascinating material and getting it in front of me. Happy New Year!

[William Kruidenier]

Fabulous post, Debby -- I've ordered his book (also his The Microbe Factor). Regardless of the lack of documentation, I will definitely trust the views of a man who has looked at 300,000 GI tracks! With his age and his experience comes a "gut" (sorry) feel for what works and what doesn't in the human body. Thanks for furnishing this info!

[Chris G.]

Very interesting nuggets indeed. Without the scientific precision behind it, its hard to know which aspects to put the most stock in. But as the Healthy Librarian points out, most aspects are entirely consistent with a plant-based diet. One correction of his facts: "Fish of any type, but preferably small fish as the large fish contain mercury." Its more the position in the food web than the size of the fish that dictates the mercury content. Top trophic predator fish such as swordfish, tuna, and shark are loaded with mercury and should be eaten as a small serving no more than 1x per week. DHA-rich salmon is very low in mercury as it feeds toward the lower end of the ocean food chain. Happy New Year.

[Healthy Librarian]

RE the fish: Chris G. knows what he's talking about! He's a professor of aquatic studies--with a specialty in aquatic biogeochemistry & phytoplankton. He knows his stuff.

Dr. Bailey, thanks for your professional perspective. I wish I'd had more time to include some more of Dr. Shinya's extensive observations--it's worth taking a look at his book.

Thanks, William--after 300,000 GI tracts he's formed some strong opinions. Let me know what you think of his latest book.

[Hank]

Okay, I'm finally convinced to drop the nonfat dry milk powder.
Sigh. It was so cheap compared to the oat/soy/rice-milk products.

These folks go through some of the labels:
http://www.vegan-weight-loss.com/vegan-foods.html

Their summing up on milk substitutes:
http://www.vegan-weight-loss.com/milk-substitute.html
"Once you start reading nutrition labels, you will discover that the perfect commercial milk substitute doesn't seem to exist. ... And they are all expensive. ... we make our own .... simple rice milk recipe, which you can easily make in the blender."