Dr. Chris Knobbe, an ophthalmologist, has written an excellent book — “Ancestral Dietary Strategy to Prevent and Treat Macular Degeneration” — which, like the title suggests, tells you how to address the most common cause of legal blindness in the United States.
One of his heroes is Weston A. Price, the dentist who wrote the classic book “Nutrition and Physical Degeneration.” I did not know this when I read Knobbe’s book, but it is very clear to me that Knobbe is the 21st century equivalent of Dr. Price.
The difference is that Price focused on the teeth and general physical degenerative diseases, like arthritis and cancer, whereas Knobbe is concentrated on his specialty, the eyes. But their findings are nearly identical: Industrially processed food is the root of most chronic disease. The first chapter is available free of charge on cureamd.org, where you can also order the book. Knobbe says,
“Ultimately … the next step I want to do is to … physically go out into the world and evaluate … the few niches around the world that are still consuming ancestral diets and analyze their macular degeneration,” he says.
Still, without venturing into foreign lands, Knobbe has amassed a wealth of knowledge by sifting through the published research, and what he’s found is shocking. Physicians are taught that macular degeneration is an inevitable consequence of aging and genetics, primarily, and has always existed. This, it turns out, is an absolute untruth.
Westernized diets are synonymous with chronic disease
As for so many others, Knobbe’s interest in diet and nutrition grew out of a personal experience. He’d suffered with arthritis for 15 years when he heard of the paleo diet, and within 10 days of switching saw significant improvement in his symptoms.
“In a nutshell, in about eight or 10 days, my arthritis was 80% better. This was so incredibly shocking to me after suffering for 15 years that I really wanted to know all I could know about nutrition. It just changed my life. I started investigating then.
This was in 2011. For the next couple of years, I investigated nutrition as much as I could. I learned so much but I was lost, until I came across the research of Weston Price …
Price was a highly-accomplished scientist, researcher and dentist who, in the 1930s, spent the better part of that decade evaluating people all around the world … as they transitioned from native, traditional diets to westernized diets …
He defined [the western diet] as refined white flour, sugars, canned goods, sweets, confectionery and vegetable oils. What Price found was that as people transitioned to those foods, they began to develop all of these diseases of civilization …
The take-home point here is that native, traditional foods contained 10 times as many fat-soluble vitamins, which are vitamins A, D and K2, four times as many water-soluble vitamins, which are all the B vitamins and C … and one and a half to 60 times more minerals than did the American diets of his day …
I’ve simplified it down to refined white flour, sugars, polyunsaturated vegetable oils and trans fats. When we consume these foods, we develop … chronic non-communicable disease. This includes heart disease, cancers, stroke, [high blood pressure], Type 2 diabetes, obesity, all the autoimmune disorders and so forth.
I understood this in 2013. Later that year, it finally hit me. I asked myself, ‘Could macular degeneration be another one of these diseases?’ Might it be a disease that follows processed food consumption? That question changed the course of my life …
I left ophthalmology practice and pursued this full-time, because I felt like it was the only way that I could … do all the research, write a book and publish papers … to try to get the word out … that our research supports the hypothesis with every last detail.”
Macular degeneration is not a natural part of aging
The amount of work Knobbe has put into his book is truly extraordinary. For starters, he did a complete historical analysis of macular degeneration, reviewing ophthalmology textbooks from more than 100 years ago. As mentioned, the orthodox, conventional view taught in medical school is that macular degeneration is a disease driven by aging and genetics.
According to Knobbe, 52 gene variants — single-nucleotide polymorphisms or SNPs — have been linked to macular degeneration. Smoking, obesity and lack of exercise are also thought to play a modest role. “Of course, with the hypothesis that was in my mind, I questioned that,” Knobbe says.
“I knew that if I was going to be able to draw connections between Westernized diet and macular degeneration, the first thing I needed to do is to go back and explore all the history of macular degeneration.
Honestly, I thought that I would be able to go onto PubMed or Google Scholar and I would find some excellent reviews and some papers that had covered this.
There was nothing of the sort. In early 2015, I spent three or four months doing nothing but trying to research the history of this, because I couldn’t find any kind of review that had ever been done of this.”
Here’s a quick summary of some of the history he discovered:
• Ophthalmologists were first able to view the macula, the central retina, beginning in 1851, thanks to the ophthalmoscope, invented by German physician and physicist, Hermann von Helmholtz. Within 10 years, ophthalmoscope use had spread to every continent of the world.
• In 1855, ophthalmologists started producing atlases of the retina and began taking pictures of it.
• Macular degeneration was described for the first time in 1874 by British ophthalmologist Jonathan Hutchinson.
• In 1895, German ophthalmologist Otto Haab reviewed 50,000 ophthalmic patient records, coming to the determination that macular degeneration was as rare as traumatic maculopathy and myopic maculopathy (a nearsighted kind of macular degeneration) — two exceptionally rare conditions to this day.
• 1889, Austrian ophthalmologist Ernst Fuchs — who went on to become one of the most prominent ophthalmologists in the world over the next several decades — published his first textbook.
It’s an 800-page book, and it contains but a single sentence about macular degeneration. “It was basically like a footnote, [that] this condition does exist in the elderly,” Knobbe says. The second edition, published in 1919, stated the main cause of macular degeneration was myopia.
Medical books published over the following decades, all the way up to 1940, contained little or no mention of macular degeneration. Sir Stewart Duke-Elder was the world’s most esteemed and published ophthalmologist from approximately the 1920s to 1970.
In Duke-Elder’s 1927 textbook, there was no mention of macular degeneration at all. But in his 1940 second edition textbook, macular degeneration was given 13 pages. Here, Duke-Elder referred to it as “a common cause of failure in central vision in old people.”
“In 1927, I don’t think he even knew what macular degeneration was, which was typical. By 1940, it was becoming common,” Knobbe says. “By 1975, in the U.S., we had the Framingham study. At that point, 8.8% of Americans over the age of 52 had macular degeneration and 27.9% of those over the age of 75 had macular degeneration.
If you do the math, that translates to about 4.5 million Americans affected with macular degeneration. If you look back 50 years previous to 1925, there was no more than about 50 cases of macular degeneration in all of the world’s literature.”
Now, let me just say that ophthalmologists, their first kneejerk reaction to this is, ‘Well, they weren’t looking.’ I’m telling you, they say that because they haven’t read these textbooks. If you look at these textbooks from the 19th century, these clinicians were extraordinary.
Their attention to detail makes ours look pathetic because they didn’t have magnetic resonance imaging. They didn’t have optical coherence tomography scans like we use, fundus cameras and fluorescein angiography. They didn’t have any of that. They had an ophthalmoscope and they had their eyes. They did extraordinary exams … It [was] just an extraordinarily rare disease.”
According to Knobbe, in 2020 there will be 196 million people with macular degeneration, and it’s expected to increase to 288 million by 2040. As of 2006, 3.15 million people worldwide were legally blind in both eyes due to it. “I did the math and it turns out that in this world, at least 270 people will go blind every single day due to macular degeneration,” he says.