Food Over Medicine (11 page)

I want to mention one thing. This is not my idea—it’s a Dr. McDougall idea that’s worth sharing, and there’s a considerable amount of evidence in the medical journals to support it.
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Remember that our object is to encourage people to eat starchy foods and vegetables. And if salting the broccoli makes them eat a lot of it then, by gosh, let’s put some salt on it. I don’t want the vast majority of people who aren’t salt sensitive to think they’re cheating because they put salt on their broccoli and rice.

GM:
What about the meat analogs: the tofu hot dogs and the Gardein meats and so forth?

PP:
Well, some of them are pretty clean. Using tempeh to give spaghetti sauce the texture of something with ground meat in it, if it’s a clean tempeh product, like the ones we make at Wellness Forum Foods, I don’t have any problem with that. I do it; we do it here. What I have a problem with is these highly processed meat analogs that are just garbage food, like the tofu hot dogs and the fake pepperoni. Once in a while, it’s not a problem. People invite me, say, to a Memorial Day picnic and they say, “Pam, we’ve got veggie burgers for you.” They may be overly processed veggie burgers, but it’s Memorial Day and people are being nice. I’m not going to die from eating a veggie burger that isn’t clean. It’s only when this kind of garbage infiltrates the daily diet that you don’t really end up with the health improvement that you’re looking for. These fake meats are transitional foods and treats. If you’ve got to feed your kids some tofu hot dogs to get them through the transitional period, that’s fine. However, if you’re still doing it two years later, you’re just postponing making some serious health improvements.

GM:
How do you feel about the raw food diet?

PP:
That’s a complicated question. What typically happens to people who adopt a raw food diet is that they do really well for a while because of all of the things that they eliminate. Many people who start a raw food diet come from eating some version of a terrible diet, so they feel really great. But then, even with the meat and the dairy out of their diet, they start to feel badly. The biggest reason they feel badly is that they can’t get enough calories from eating only raw foods, or they have difficulty doing so. When they begin to feel the impact of the calorie deficiency, they start to increase their calorie count by eating nuts and oils and things of that nature. Then they start to get sick.

There are some people who are able to maintain a raw food diet well. Not everybody gets it wrong, but most people don’t do it well and end up worse off as a result. I think the bigger issue is that we really don’t have any evidence that shows that a raw food diet is better than a diet that includes cooked food. One of my philosophical issues around raw food is that what we’re asking people to do is a big enough change all by itself, without adding layers of difficulty to it that are unnecessary. Often I find that these added layers of difficulty attract a lot of attention at the expense of things that are much more important. I think it’s much more important to deal with fat in the diet, for example, than to eat all raw food. It requires an involved discussion about the effort that it takes to do the raw diet right and to teach people how to dehydrate foods and all that sort of thing; I don’t see that it’s worth it.

GM:
I look at it this way: there are two important goals in nutrition. One is to obtain nutrients and the other is to avoid poisons or deleterious substances. Now, if you eat a lot of raw greens, vegetables, and salads, you get a lot of nutrients, which is a positive. You want to have a healthy complement of raw foods in your diet. Then if we add to these some rice, potato, or other plant food that requires cooking, there’s no downside. We’re not getting any poisons. We’re not getting something that’s high in fat or full of toxins or has animal protein or anything else. I just can’t see the case for abstaining from healthy, cooked foods that satisfy our appetites, as long as we’re getting our full complement of nutrient-dense raw foods.

PP:
I agree with that. We want people to eat lots of salads and raw foods. But the extreme idea that you try to live on only raw foods doesn’t play out really well in real life. We need those cooked foods, those cooked starchy foods, because otherwise it’s difficult for the diet to be calorically adequate.

One fun dining adventure that I enjoy in many cities is to sample raw food restaurants. There are many in Los Angeles, and I’ve had the pleasure of dining in some of them. The food is just phenomenal at some of these places but—and this is a big but that could lead to a big butt—it’s also very high in fat. If I ate at those restaurants every day, I’d be a three-hundred-pound vegan.

The whole idea of adopting a health-promoting diet is not to separate yourself from the rest of humanity and make it impossible to interact with the rest of the world. That’s a terrible outcome, in my opinion. The emphasis on eating only raw food, and food combining, and a lot of other ideas that are circulating, make it harder and harder for a person to be out among the rest of the world. I don’t want to stop going to family gatherings and book club, or any of the other things that I do that involve interactions and meals with other people. I don’t want to adopt some eating style that’s incompatible with the way the rest of the world lives. I can eat the plant-based diet we’ve discussed here; I can practice dietary excellence anywhere I go. I can’t practice raw food-ism and food combining and a lot of these other extreme things every place I go.

GM:
How do you feel about the macrobiotic diet?

PP:
Well, that’s interesting. There’s some evidence that the macrobiotic diet is helpful for resolving cancer. We don’t really have a lot of studies that point in that direction, but we have a lot of stories, enough that I think if somebody wanted to do a study on macrobiotic diets and cancer, it could be justified from a funding standpoint. It’ll never happen because the drug companies will never let it happen, but I’ve read enough about it to believe there’s something to it.

One thing that’s misunderstood is that the macrobiotic diet isn’t just a diet; it’s a lifestyle, too. The people who have succeeded with it have not only adhered to the dietary principles but they’ve done a lot of the other things that are recommended in terms of the way they live their lives. I think if you’re going to do macrobiotics, you’re going to have to incorporate the whole program to get the benefit.

The macrobiotic diet can be difficult in terms of food preparation; it takes a lot of time. What we don’t know is if it’s the specific combination of foods that are included that’s causing the positive effect, or if it’s simply the elimination of some of the bad foods that’s causing the positive effect. In other words, do we really have to do all of this, or can we get the same results from just eating a plant-based diet? I’d love to see a study with leukemia patients comparing a macrobiotic diet to our Wellness Forum plan to see if there truly is a difference between the two. Will that ever happen? No, not in this country.

GM:
I lived in Boston in 1983 in a vegetarian group house near one of Michio Kushi’s macrobiotic schools (Kushi founded the Kushi Institute). Whenever we advertised for a new roommate, a lot of his students would come and interview with us to see if they wanted to live in our house. They would always ask the same question: “Do you eat vegetables that grow at night?” I would say, “I don’t know. I never get up to watch.”

Is there anything to this “nightshade vegetable” thing? Apparently potatoes and eggplants and I’m not sure what else grow at night; is there any basis for concern about that?

PP:
No, not generally. There are some patients with arthritis—it’s a very small minority—who seem to do better without nightshade vegetables. I think you bring up a great example of what I was just talking about. That’s a layer of difficulty added to eating a macrobiotic diet, and we just don’t have any research to show that added level of restriction and difficulty is necessary most of the time. I’d love to see it studied someday; maybe I will live long enough to see the right types of studies done about diet in this country, but right now we just don’t have the evidence for it.

GM:
Speaking of potatoes, what’s the best way to prepare a potato? Baked potato, boiled potato? Do you eat the skin, do you not eat the skin?

PP:
I always eat the skin. I love potato skins. Boiled, baked, steamed—those are the ways I usually have them. But it’s not necessary to eat the skin if you don’t want to.

GM:
Now what about a glass of wine in the evening? Anything wrong with that?

PP:
Every evening is a big deal. Alcohol is not beneficial for health. The several studies that have shown that occasional drinkers are healthier than abstainers have not, I think, accounted for the fact that many abstainers are abstainers because of health conditions. I don’t see a benefit from drinking, but I don’t want to take the enjoyment out of life. I know some real purists, and they’re a pain in the butt to be around. I don’t want to be one of them. It doesn’t attract people to our way of life. I enjoy an occasional cocktail and I don’t discourage our members from doing so unless they have a condition like pancreatitis or hepatitis C. I think the average person can certainly drink some alcohol, but not every day.

GM:
What do you say to those who believe that a daily glass of red wine explains the so-called French Paradox? They manage to eat a fatty, animal-based diet with less heart disease than Americans.

PP:
First of all, the incidence of heart disease and cancer in France is very high.
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It’s lower than the United States, but it’s still very high. I wouldn’t be attracted to that type of risk profile. Second, the French, as well as other populations in Europe that eat similar diets, eat an enormous amount of legumes, fresh vegetables, whole grains, and fruit. The people who truly abide by this diet are not overweight. And while they eat plenty of animal foods, they eat much smaller portions than we do in America. I’ve spent a lot of time in Europe; I’ve eaten the Mediterranean diet in Europe, so I know what I’m speaking about.

Having said that, their disease rates are still high. To the extent that their health is better than ours, it’s not because of the red wine or olive oil; it’s because of the entire way they live their life, which includes more walking and more physical activity. It’s their pattern of diet and lifestyle that is somewhat protective, not red wine and olive oil, and in any case they’re not as healthy as is sometimes reported. What happens here is that people look at various diets and they read about the Mediterranean diet and say, “I like the red wine and olive oil,” and they extract that and add that to the American diet, only to make things worse.

GM:
Chocolate has been in the news lately because of studies that allegedly show that it’s very good for the heart. That seems to be too good to be true.

PP:
And it is. The danger would be people thinking they can continue to eat the fatty Western diet and then protect themselves with fatty chocolate bars. The study that was in the news recently was a meta-analysis of seven studies. Only five of the seven showed some benefit. Even the researchers issued a caution about how to interpret the results because chocolate is high in fat and calories; even
they
did not interpret their own study as a mandate to begin eating chocolate as a preventive tool.
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If there’s some legitimate good news here, it’s that if you’re in good health and practicing a low-fat, plant-based diet, you can treat yourself occasionally to some chocolate without worry.

GM:
What about coffee?

PP:
Coffee has been a little vilified. There’s no question that caffeine is a drug. As with alcohol, if you abuse it, you’re going to have problems. I used to be a caffeine abuser, so I can speak to that from extreme personal experience. It used to take three pots of coffee a day to keep me going. I don’t think the occasional cup of coffee is a dealbreaker. When people who are completely compliant with the diet say that a cup of coffee in the morning is something they want to do, I’m not going to make an issue out of it. To do so would be choosing the wrong battle. But when I see people drinking coffee all day long to stay awake and masking symptoms of fatigue, which should signal to them that they’re overworking themselves and that their body is exhausted, I’ll make an issue of that.

GM:
I’m pleased to say that I’ve had only one cup of coffee in my life.

PP:
How’d you manage that?

GM:
Well, I was a seventeen-year-old high school student and visited the college I would ultimately attend, New College in Sarasota, Florida. Somebody told me that there would be a coffee klatch in the evening at the home of Professor Peggy Bates, so I went there to meet the students and some professors. Dr. Bates said to me, in front of everyone, “Glen, do you drink coffee?” Well, I never drank coffee growing up; it had never occurred to me to try it. But now I was going to college, joining the grown-ups, and I didn’t want to make a fool of myself, so I had to think on my feet.

I said, “I don’t know.”

She said, “Well, Glen, would you like to try a cup?”

I said, “Sure.”

So she gave me my first cup of coffee. And I drank a few sips. It tasted like mud. It was the worst tasting drink I’d ever experienced. I couldn’t imagine that people actually drank this crap. So I never had coffee again.