The Starch Solution (27 page)

For the next 2 years I wallowed in self-pity as my condition worsened. I planned for my future care, made sure the house was fully accessible, and took out long-term disability insurance. I joined an MS support group, but it only depressed me more. I read everything I could find on the disease, but it was one short paragraph in a mountain of books that caught my eye: Dr. Roy Swank, doctor and neurology professor at the Oregon Health & Science University medical school, suggested a low-fat diet might help.

Seventy pounds overweight, I returned to Weight Watchers, where I’d once shed 50 pounds for a class reunion. I began walking with a friend; my first mile took 40 minutes. When I reached my goal weight 9 months later, I was walking 6 miles most days. I met Dr. John McDougall when he spoke at the North American Vegetarian Society Summerfest. I was semi-vegetarian at the time, eating just a little chicken and shrimp. He was committed to getting people out of the health care system and off medications and supplements, an appealing notion as I was spending over $100 a month on vitamins and supplements. I followed his suggestions.

I’ve lived beyond the decade that was expected to land me in a wheelchair, with some mild imbalance and slight memory loss to show for my MS. I take a low dose of thyroid medicine and no other drugs or supplements. I’ve dropped from 203 to 135 pounds and my cholesterol is down to 155 from 192 milligrams per deciliter (mg/dL). I look and feel great.

For the first 6 years of my disease, MRIs showed continued progression of MS activity and an increasing number of lesions. Things changed after I switched to a very low-fat diet. After that, my MRI report read, “Compared to two years earlier the multiple brain lesions are slightly smaller and show no interval
increase in size.” Two years later my report showed no interval MS activity: The old lesions were stable and no new ones were forming.

The following year, I participated in the McDougall 10-day live-in program in Santa Rosa and became a Star McDougaller by sharing my story. This diet saved my life. It’s a simple truth that I know can help others. Even those who, based on their doctor’s outlook, might believe there is no hope for their recovery.

In the 10 years since I’ve been a Star McDougaller, I’ve continued my regimen of walking daily and strength training twice a week. I continue to study the effects and connection between diet and disease. Last year I retired from the performing arts center of the University of Illinois after 30 years in personnel and payroll administration. I am able to enjoy my retirement no longer fearing the future effects of my MS, something I never thought I’d see after the dire predictions of the neurologist 17 years ago.

T
he shift to a starch-based diet requires a little discipline at first. In the beginning, you may fear that leaving behind your favorite foods will cause hunger pangs and profound feelings of loss. I promise it won’t be long before you prefer to fill your plate with healthy, satisfying starches, and turn your nose up at the overly rich, fatty, chemical-infused foods you may now love. Until you reach that point, it is essential that you stick with this new way of eating, because sticking with it is the only way you are going to become and stay healthy.

I have good news: I’m going to make this adjustment easier by inviting you to add two flavor-enhancing ingredients to the food you eat—ones you probably assumed were off limits on a healthy diet: salt and sugar. Are they nutritious? No, but they cause no real harm for most people.

You may recall from high school biology class that the tip of your tongue finds salt and sugar pleasurable. In fact, you are physiologically designed to seek out these two substances essential to providing for your energy and mineral needs. Most critical is that they will help you to adopt and stick with a plan that leads to shedding excess pounds and
improving your lifelong health. This makes these two ingredients well worth including.

The reason you may believe these two added ingredients represent the core of culinary evil has more to do with marketing than with science. Scapegoating salt and sugar deflects attention from the real problems: meat, dairy, fats, oils, and processed foods.

Sodium restriction is the most widely publicized, nonmedicinal recommendation for preventing heart disease and stroke. This advice is based mostly on older research and largely reflects studies involving extreme changes in sodium intake, such as reducing sodium to less than 500 milligrams per day in order to lower blood pressure.
¹

Has this recommendation made any difference in the average person’s health? Not according to recent research and careful analysis of the data. Why? First, almost no one has been able to follow this advice because a low-salt diet simply is not palatable. People would rather risk illness and death than make this kind of sacrifice. If handfuls of costly
blood pressure—lowering pills will allow them to get their salt back and avoid a bland-tasting diet, swallow them they will. The second reason is that reducing salt consumption is of little medical benefit and may even be hazardous to your health.
²

The major medical concern about salt is that it raises blood pressure, and high blood pressure—more than 140/90 millimeters of mercury (mmHg)—is a risk factor for heart attack, stroke, and kidney disease. Randomized clinical trials, however, show that reducing high sodium intake by an average of 1,725 milligrams (a teaspoon and a half of salt) to 2,300 milligrams per day, the current USDA recommendation, lowers the systolic blood pressure (the top number in your blood pressure reading) by 1 to 5 points and the diastolic (bottom number) by 0.6 to 3 points.
^3
,
4
On the McDougall Diet, with no limitation of the amount of salt added to foods at the table, the average reduction for people starting out with this level of blood pressure (140/90 mmHg or greater) is 15 points systolic and 13 points diastolic in just 7 days. This is especially remarkable considering that in almost all cases, blood pressure medications are stopped on the first day of my 10-day live-in program. This profound change in blood pressure is due to the overall impact of a healthy diet that is low in fat, animal protein, and calories, and high in potassium, dietary fiber, and carbohydrates.
⁵
These healthy dietary components improve the health of the blood vessels and overall circulation, significantly lowering elevated blood pressure as a result.

• Roman soldiers were paid a
  salarium
  of salt, the derivation of the modern “salary.”
  
 

• Greek slave-traders often bartered salt for slaves, giving rise to the expression that someone was “not worth his salt.”
  
 

• Covenants in both the Old and New Testaments of the Bible were often sealed with salt, the origin of “salvation.”
  
 

• Jesus referred to his disciples as “the salt of the earth.” We still use this term to speak well of good, honest, hardworking people.
  
 

• The French greeting
  salut
  is derived from the word for salt.
  
 

• The Romans called a man in love
  salax,
  or in a salted state, from which is derived the word
  salacious.
  
 

• “Sitting above the salt” refers to the place of aristocracy above the common folk.
  
 

What I observe in my patients can also be seen in society as a whole. Hypertension is rare in indigenous communities with diets that are based on starches, even when the diet is quite high in sodium.
⁶
When these healthy indigenous people move to urban settings and adopt a Western diet rich in animal products and processed foods, they develop hypertension, type 2 diabetes, heart disease, and obesity. The importance of the overall diet, rather than any single component (sodium), is the fundamental reason that vegetarians tend to have low blood pressure regardless of how much salt they consume.
⁷

In 2007, the Third National Health and Nutrition Examination Survey (NHANES III), studying nearly 100 million US adults, reported “a robust, significant, and consistent inverse association between dietary sodium and cardiovascular mortality.”
⁸
In other words, people who ate
more
salt had
less
risk of dying from heart disease and strokes.

In a population study published in 2011 in the
Journal of the American Medical Association
involving 3,681 participants without cardiovascular disease, investigators found that the less sodium a person consumed, the higher his or her risk of death from strokes and heart attacks.
⁹
The authors’ conclusion: “The associations between systolic pressure and
sodium excretion did not translate into less morbidity or improved survival. On the contrary, low sodium excretion predicted higher cardiovascular mortality. Taken together, our current findings…do not support the current recommendations of a generalized and indiscriminate reduction of salt intake at the population level.”

The Cochrane Collaboration, an international, independent, not-for-profit health care research organization funded in part by the US Department of Health and Human Services, reported in 2011 in the
American Journal of Hypertension
its review of seven major studies.
¹⁰
It concluded that there was no strong evidence of benefit from salt restriction, and that this restriction increased the risk of death in people with congestive heart failure.

Why would cutting back on salt harm your cardiovascular system and increase your risk of dying? We are physiologically designed to seek out and eat salt. When we do not eat enough of it, the body changes in ways that include increasing its production of adrenal hormones, reducing salt losses from the kidneys and skin, and many other adjustments that help us to retain salt. Furthermore, salt restriction raises cholesterol and triglyceride levels.
¹¹
Over the long term, stresses caused by these physiological adaptations for survival may injure our blood vessels and lead to more heart attacks and strokes.

The desire for salt leads us to consume minerals essential to life, sodium being just one of them. Attempting to deny this innate drive could be harmful and, more importantly, prevents many people from adopting a healthy diet because they simply won’t tolerate food that doesn’t taste right.

Thirty-five years ago, as an internal medicine resident in training at The Queen’s Medical Center in Honolulu, I had the job of convincing my patients with severe kidney disease to eat salt-free butter and cheese. The most common response was, “You must be kidding,
Doc—this tastes like a glob of grease.” People who eat steak also rely on salt to bring out its flavor. Without the salt, that slab of beef tastes pretty disgusting (think of boiled beef).

The natural instinct to eat salt in balance with all of the other healthy components of food was well and good until the food industry found clever ways to turn our drives against us. Nearly all of the salt we now eat—80 percent of it—is processed into our foods rather than added at the table. That leaves most people following a Western diet with no choice but to eat loads of salt, with the highest levels found in the unhealthiest foods: processed meats, cheeses, and packaged foods.

It’s not the sodium that’s to blame, but rather the foods it is mixed up with. Consider these common foods, with sodium expressed in milligrams per 100 calories.