Most Americans don’t realize medication is not the answer to lower disease rates; the answer is in the foods we eat. Food Over Medicine (Ben Bella Books, 2013) starts a conversation about the dire state of American Health and the key to getting and staying healthy for life. In this excerpt from chapter 2, “The Program,” authors Pamela A. Popper, PhD, ND, and Glen Merzer discuss the optimal diet and how to find the best eating plan for you.
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GM: Let’s talk about the optimal diet. There’s a theory out there that we’re all different and we should choose our diet according to our blood type or our genetic makeup or our personality type or our astrological sign, and that the optimal diet is one thing for one person and a vastly different thing for another person. Is there any truth to the idea that different people need wildly different diets, or are we mostly alike in what we ought to be eating?
PP: We’re shockingly alike. The only thing that differentiates us significantly is food allergies. My attorney, who died a couple years ago at sixty-one, was in his fifties when I met him. He had been allergic to cherries, peaches, and apricots since he was five. Well, he could eat a plant-based diet, but since cherries, peaches, and apricots sent him into anaphylactic shock, we kept him away from those foods. That would be an example of a genetic situation; stay away from three specific foods.
GM: Wait a minute. He ate a plant-based diet, but died at 61?
PP: Well, he cheated a lot. He died of noncompliance. He would say he was on a plant-based diet, but he never gave up cheeses and salmon, and he ate olive oil and sweets. One day it caught up with him and he had a massive heart attack. He was a successful man and he liked to live large; as a consequence, he died in an instant. It was a tragic example of how you have to get the whole diet right, not just get half of the equation right.
But with reference to this idea that people are different and therefore some people should eat different types of diets because of their ethnicity or their blood type, there’s no solid evidence. I come to all my conclusions based on medical evidence. If you wonder whether there’s anything to the blood-type diet, do PubMed searches. Anybody can do it. You’ll find absolutely no published evidence indicating that blood type makes a difference in long-term health outcomes. I get very frustrated because the promoters of these blood type diets and metabolic diets and caveman diets have made millions and millions of dollars promoting these programs to patients and the general public. And they spend none of that money on proving their hypotheses. I love the way Dr. T. Colin Campbell, the author of The China Study, put it when he was going head-to-head on the Internet with someone who was criticizing him: “Put your theory to the test because what you’re essentially saying by refusing to do so is that research is a luxury to be enjoyed by some but not required by all.” And that’s a rather insulting attitude to those of us who are serious because I, for one, rigorously adhere to what the science says about all aspects of nutrition. There simply isn’t a shred of evidence that the caveman diet or these other fad diets help achieve or maintain optimal health in populations today. These people are writing storybooks. They may be very interesting, but they’re not to be confused with science. They cite a lot of studies, but a close look shows that they misinterpret them to promote their diet, and they never conduct a single study of their own to prove their case.
Let me give you an example of how storytelling can confuse the issue. When I conduct lectures, invariably I’ll have somebody raise his hand and say, “My uncle ate bacon, eggs, and cheese three times a day and he lived to be ninety-four and died in his sleep. How do you explain that?” And I will say, “I believe you. I believe that happened. But if you delve into the published scientific information that we have, it clearly shows that is not the likely outcome for other people who engage in that behavior.” So that’s a story. It’s probably a true story. It has nothing to do with the advice that we should give to the general population.
GM: You’ve got to love the premise of the caveman diet books, that we should, for some reason, eat the diet of our primitive ancestors. Maybe to prove that civilization has not come that far. I actually have a theory that the first vegan was a caveman who discovered that it’s easier to sneak up on a plant.
Anyway, since we’re shockingly alike as humans, what should our diet be? Let’s begin with fat. What percentage of calories from fat should we have in our diet? There are those who recommend a plant-based diet and emphasize that it should be low-fat, roughly 10 percent of calories as fat. And there are others, even some who recommend the vegan diet, who say no, we need a healthy amount of nuts and seeds and avocados, a higher percentage of fat. And then, of course, there are the diet book hucksters, like Dr. Barry Sears and the late Dr. Robert Atkins, who promote a diet that’s 30 percent fat or more.
PP: Let’s disregard the hucksters because they’re not worth our time. But between the serious scientists advocating a low-fat, plant-based diet and the serious scientists advocating a plant-based diet that’s somewhat higher in fat, I think the answer is in the middle. I don’t like to restrict people more than is necessary; my general recommendation to people is an upper limit of 15 percent, which is still pretty low. It’s very achievable if we get oils out of the diet and use nuts and seeds and olives and avocados as parts of dishes that we eat, but don’t go out of our way to eat a bunch of fatty plant foods all the time. Now, for somebody who has coronary artery disease, or who needs to lose a hundred pounds, we want to get him down to the 9 to 11 percent range in terms of fat, which means he’s not going to be consuming avocados and nuts and olives. I recommend an upper limit of 15 percent and a lower limit of 9 to 11 percent for people who have certain kinds of diseases.
GM: Allow me to cite a mainstream nutritionist: Walter Willett of the Harvard School of Public Health. He argues that low-fat diets show no improvement in health outcomes compared with higher-fat diets; the important thing is to have good fats—polyunsaturated and monounsaturated fat. He cites a Journal of the American Medical Association study published in 2006, an eight-year study of more than 49,000 women that he says demonstrated no improvement in outcomes from a low-fat diet.
PP: Willett is not the only person who finds that a low-fat diet does not provide benefit. The problem is his definition of a lowfat diet, and definitions are something that plague nutritional research. In Willett’s Nurse’s Study, for example (I think the government has invested roughly a hundred million dollars in this whole project), the lowest amount of fat these women ever consumed was in the vicinity of 29 or 30 percent! I don’t think any of us who advocate a plant-based diet has ever told anybody that a diet that contains 30 percent of calories as fat is protective against anything. The other thing I’ll point out about Willett’s research and the Nurse’s Study is that one of the ways in which people accomplish a “low-fat” diet is often to eat fat-free dairy products. The detrimental effect of the concentrated protein in those dairy products often overcomes the benefit of any fat reduction, even if it were to reach the target level.
GM: Okay, so let’s say I’m convinced that I should aim for roughly 10 to 15 percent of my calories as fat. How do I execute that? I couldn’t tell you with any accuracy the percentage of calories I ingest is fat. Are you recommending that people somehow count their calories and calculate the percentage derived from fat?
PP: I tell people, if you’re eating according to our eating plan pyramid, you’ll be just fine. I can’t teach people to be either calorie counters or nutrient counters because it can’t be done. And I use myself as an example. Today for lunch I had a salad with one of Wellness Forum Chef Del Sroufe’s fat-free dressings and a rice and vegetable casserole. So I had a nice big portion of this casserole and a big plate of salad with dressing. In order for me to tell you how many calories I ate, I’d have to come back here to my office with a database and feed in fairly accurate information about how many pieces of broccoli I ate, how much rice was on the plate, and how much dressing I put on the salad. Of course I would have no clue. So if somebody like me, with my background in nutrition and my resources, can’t figure out what I had for lunch from a calorie and nutrient standpoint, how do we take a busy CPA who’s preparing somebody’s tax return and teach her to do it on a lunch break? It’s obviously not doable.
What you have to do is teach the right dietary pattern. Just stay attuned to the principles of the diet. The only way you’re going to mess it up is if you start treating yourself all the time, or the oils start creeping into the diet and you start eating those items at the top of the pyramid with a great deal of liberalism. But if you stick with the basic food groups that we’re talking about, you’ll get full, you won’t develop a weight problem, and you’ll lose weight if you need to. You just can’t overeat. I couldn’t have possibly eaten another plate of food today; it would have been too much bulk.
Reprinted with permission from Food Over Medicine: The Conversation That Could Save Your Life by Pamela A. Popper, PhD, ND and Glen Merzer and published by BenBella Books, 2013. Buy this book from our store: Food Over Medicine.