Food Over Medicine (3 page)

GM:
So it’s simplistic and misleading to say that carbs are fattening?

PP:
When people tell me carbohydrates are fattening, I tell them, “You know, two billion Asians never got that memo.”

GM:
What are the foods you recommend that have sufficient calorie density that make you feel full? What are the best foods to make the staples of your diet?

PP:
Whole grains, legumes, and starchy vegetables. More broadly, I tell people to make the staples of their diet the four food groups, which are whole grains, legumes, fruits, and vegetables. We have our own little pyramid that we use here at The Wellness Forum. Beans, rice, corn, and potatoes are at the bottom of the pyramid. Then steamed and raw vegetables and big salads come next, with fruits after that. Whole grains, or premade whole grain foods like cereals and breads, are all right to eat. Everything else is either optional or a condiment.

As for high-fat plant foods—nuts, seeds, avocados, olives—use them occasionally or when they’re part of a recipe, but don’t overdo it; these foods are calorie-dense and full of fat. No oils, get rid of the dairy, and then, very importantly, you need to differentiate between food and a treat. I don’t think you can get through to people by telling a twenty-five-year-old that she can’t have another cookie or a piece of cake for the rest of her life. Where you can gain some traction is to say, “Look, birthday parties are a good time for cake, Christmas morning is a good time for cookies, and Valentine’s Day is a good time for chocolate, but you don’t need to be eating that stuff all the time.” People end up in my office because they’re treating themselves several times a day.

GM:
I had obese relatives who are gone now, my aunt and uncle. When I told them at the age of seventeen that I had gone vegetarian, they became terribly concerned that I wouldn’t get enough protein. They weren’t tall and must have weighed more than two hundred pounds each. Their kids were overweight, but they were worried about
me
. Usually they were on one diet or another, but they would make an exception for cake and ice cream on special occasions. And the special occasions were their birthdays, their kids’ birthdays, their kids’ spouses’ birthdays, anniversaries, holidays, Earth Day, National Organ Donor Awareness Week … the list went on and on.

PP:
Right. You really have to put some common sense into this. My sister turned fifty a couple of years ago, which is a pretty big deal. We had cake and champagne, but there was no cake and champagne the next day or the next day or the next day. These have to be occasional treats; I tell people to make them situational. In other words, don’t keep this stuff around the house because they’ll call your name from the kitchen. I have no trouble staying away from cheese and animal food. But sweets, that’s a different story; they’re not as easy to resist. Not having any around is the easiest way to avoid them. If I want something sweet to eat after I get off work at ten o’clock, I’ve got bananas, plums, oranges, some apples, and some strawberries in my house. That’s it. If I want anything else, I have to get in the car and go out and get it, something I’m not going to do at ten o’clock at night. It’s a much better plan than standing in the kitchen saying, “Huh, I could have soy ice cream or I could have some cookies or I could have a banana or an apple.” That’s a choice that puts me in a position to have to use willpower.

GM:
I used to have a sweet tooth. From the time I was a kid, I would always have cookies and cake and ice cream in the evening. Even when I became concerned about health as a teenager and became first a vegetarian and then, close to twenty years later, a vegan, I would still have a few vegan cookies in the evening. In the summer, I would follow that up with some soy ice cream. And then it turned out that my cholesterol kept creeping up on what I thought was an excellent diet. It was embarrassing. I had already coauthored with Howard Lyman two books on diet, and yet my cholesterol was 212 and my triglycerides were 203. My doctor recommended that I consider taking a statin drug to lower my cholesterol, which would have been really embarrassing. Now, I have bad genes. There have been a lot of heart attacks in my family, which is what led me to vegetarianism at seventeen; my relatives were dropping like flies while I was growing up.

I ran into Dr. John McDougall (
www.drmcdougall.com
) at an event and asked him why my cholesterol had gone as high as 212 and if it was just my bad genes. After all, I was on a basically low-fat, vegan diet. And he said, “Fructose.” I said, “Well, my blood sugar is fine; it’s just my cholesterol …” And Dr. McDougall said, “Fructose.” He’s a very efficient guy—he gave me a one-word diagnosis. It was like the “plastics” scene from
The Graduate.
I don’t know if there’s another doctor in America who would have instructed me that my problem was fructose, and certainly there isn’t another who could have helped me in just one second. Other doctors would have put me on drugs and run countless tests on me and increased my stress level. He met me at a party and said “fructose.” Arguably, I owe him my life.

I went home and Googled “fructose and cholesterol” and discovered that indeed there was a theory that there was a direct relationship.
⁵
So I experimented. For the next several weeks, instead of having for breakfast commercial, organic fruit-flavored soy yogurt, which comes sweetened with cane sugar, into which I had typically added fruits and raisins, I had oatmeal with oat bran, cut out the cookies and the soy ice cream, and cut out dried fruit. I made
absolutely no other changes
. Seven weeks later my cholesterol was 146 and my triglycerides dropped from 203 to 81. But the reason I mention this is that after I went cold turkey on the sweets for a couple months, now if I try to eat one of those cookies that I used to eat, it tastes too sweet to me. It doesn’t taste good.

PP:
Well, you bring up a really good point, which is the neuro-adaptation of the taste buds over time. I’m the same way. I went to a wedding of a very good friend of mine. We made the cake—Wellness Forum Foods made the cake, so it was a vegan cake. I had a tiny bit of the frosting, and it was unpleasantly sweet. I ate a couple of bites of the cake without the frosting and didn’t finish it. It wasn’t because we don’t make good cakes. I mean, everybody else was licking the plate and looking around for more, so I know the cake was really good.

I really am a lot happier with fruit, even though I find I still have a bit of a sweet tooth. The evenings in particular are when I feel like I want something, but I’m just as happy with a nice crisp apple or a bowl of pineapple or strawberries. A bowl of strawberries makes me perfectly happy; I really don’t miss the other stuff. And speaking of Dr. McDougall, he often says in his lectures that humans do have a sweet tooth and nature builds in a great way to satisfy it; it’s called fruit. Go have some and you will find that you don’t have to have all this other garbage.

GM:
Now, in my case, Pam, I more or less cut sweets cold turkey. When people have very unhealthy diets, do you find that it’s more effective for them to make major dietary changes right away, just stop what they were doing before and do something radically different, or is it more effective for people to change gradually? Or does that depend on the individual?

PP:
I think the best thing to do is make a great big leap into the land of what we call dietary excellence. There are a couple of reasons for it. The first one is that, if you want to get people to stick with this—and that’s my goal; I want people to do it and keep with it for the rest of their lives—they’ve got to see results. You know, people read
Prevention
magazine and go to their cardiologist, who will tell them to eat more fish and eat less chicken. So they work at this, making small changes to include a little more of this food, a little less of that food. They try hard, but at the end of the day, they’re in worse shape from a weight and health perspective than they were before they started. That’s not much motivation to keep paying attention to diet.

GM:
Which could be why the medical establishment often downplays the role of diet.

PP:
Yes, because they don’t see results from the minimal, half-assed dietary changes they typically recommend. So I found that when we make great big changes, we see great big results, and the motivation lasts. You give somebody some phenomenal results and you don’t see them going back. They’ll experiment with some junk food—I call it going off the reservation—and then they’ll find out how poorly they feel eating some of this stuff. They’re pretty compliant after that. If we want people to be compliant, we’ve got to show them great results. That only happens when they do the whole diet.

I was explaining this to somebody recently. Everywhere I go, food becomes the subject of conversation. I was at my friend’s wedding, sitting at this table full of people—none of whom eat like I do—and they were all curious about the way that I eat. They were saying things like, “I cut out this and that and I haven’t lost a pound.” “My cholesterol is still high.” “I still have to take blood pressure medication.” And so on. I explained to them that diet is like a combination lock. If you have to dial four numbers to open a combination lock and you dial three correctly, you don’t get 75 percent of the results. You get nothing until you get that fourth number right. We have a society filled with people who are doing 75 percent of what they need to do or 50 percent of what they need to do. They don’t get 50 percent or 75 percent of the results; nothing happens until they get the whole thing right.

GM:
As with me. I was doing most everything right, but I was taking in too much sugar.

PP:
That’s why we teach dietary pattern. We really work to make people leave their old life behind and embrace dietary excellence. If we produce the changes for them that they’re looking for, they’ll stick with it. There’s another issue, too, and it goes back to these bad foods calling their names from the kitchen. As long as the stuff is around, as long as they’re teasing themselves with it every day, they’re going to revert to their old ways. It’s just going to go on forever. So we tell them, “Look, if you’re going do this, then let’s do it. Get rid of the stuff.”

GM:
What would you say are the most outrageous and self-destructive nutritional habits of Americans?

PP:
Milk drinking would be right up there. All cow’s milk products: cheese, butter, yogurt, cottage cheese, skim milk, all that stuff. Call me crazy, but I find the idea of consuming another mammal’s secretions kind of gross. Here’s how I recommend thinking about it: all cow’s milk has estrogen metabolites because it comes from lactating cows.
⁶
So the next time you’re getting ready to put a slice of cheese on a sandwich, just think, “I’m really looking forward to a big slice of estrogen between my slices of bread.” Next time you’re getting ready to put skim milk on your cereal, say, “I’d really love to have estrogen with my Cheerios this morning.” Doesn’t that sound delightful?

GM:
So how does the estrogen in cow’s milk affect women who consume dairy products?

PP:
Most breast cancers are estrogen receptor positive, so elevated blood levels of estrogen increase the risk of breast cancer. There’s also another issue. Cow’s milk is designed to help a calf grow to several hundred pounds within a short period of time, so cow’s milk increases production of a hormone called insulin-like growth factor, or IGF-1, which helps to fuel this growth.
⁷
But dairy products also increase IGF-1 levels in humans; the dairy industry’s own studies show this.
⁸
The problem is that IGF-1 is a powerful cancer promoter in humans; there are clear links between IGF-1 levels and breast, lung, colon, and prostate cancers. In fact, the link between low-fat cow’s milk and prostate cancer is stronger than the link between smoking and lung cancer.
⁹

Estrogen levels in milk increase during the cow’s pregnancy. Farmers aren’t supposed to milk their cows during the last two months of pregnancy, when estrogen levels are highest, but milk products still contain lots of estrogen. So that’s why I’d say that consuming dairy is right up there as one of the most pernicious and dangerous dietary practices.

GM:
What are some of the other worst practices?

PP:
Drinking calories is another terrible dietary practice. I spoke at a large local school about improving foods in the school system. They’ve already made one very important advance: the kids can buy only water to drink. Water is the only drink available to them other than the milk that’s unfortunately served with the lunch. The milk, of course, is a disaster, but at least if the kids want to buy something in the vending machines, it’s water or nothing. And the reason that’s important is that one thing all nutritionists pretty much agree upon is that liquid calories don’t reduce the calories consumed in food. There are so many people consuming soft drinks, sports drinks, flavored milk, and juices—we’re talking between 500 and 700 calories a day that don’t reduce by a single calorie what they’re consuming in solid foods. That’s certainly one reason why people develop weight problems; drinking calories is a major contributor to obesity.

The other major dietary nightmares in the United States are too much protein, too much fat, and too little fiber, with animal foods a leading cause of all three problems. In the fat category, oil is a close second with the havoc it causes on the body.

I’ll add one more thing that’s become an issue in recent years: taking supplements instead of eating well. The justification for that approach is, “I know I don’t eat well, but I’ll just take some pills. That’ll make up for my dietary indiscretions.” Unfortunately, the pills people take depend on which practitioners they go to and which magazines they read; they’re all fairly useless most of the time, but some of them can be dangerous.