Family physician Joel Fuhrman specializes in preventing disease through a high-nutrient, plant-based diet. His latest book follows the hugely successfully Eat to Live with a companion cookbook. In it he details the “nutritarian” lifestyle, with recipes that demonstrate how easy and delicious a plant-based diet can be.
In Eat to Live Cookbook, you write that “a plant-based, nutrient-dense diet enables you to lose weight and keep it off permanently—without hunger or deprivation.” What factors are involved in weight loss?
Successful weight loss is more complex than just “eating less.” The problem with the standard American diet, a primary cause of our current obesity epidemic, is the fact that the majority of foods consumed are high in calories and low in micronutrients. Eating this standard diet results in approximately 90% of calorie intake coming directly from animal products or processed foods (composed primarily of white flour, sugar, and oil). These foods contain very large amounts of calories and don’t meet our micronutrient needs, so we crave more food. High-calorie, low-nutrient foods activate pleasure pathways in the brain (like addictive drugs) and produce withdrawal symptoms often misinterpreted as hunger. I call this “toxic hunger.” Most weight loss diets center around portion control, which is just trying to eat smaller amounts of the same addictive foods. This approach inevitably fails. High-nutrient, low-calorie foods contain a great deal of fiber and takes up a lot of room in the stomach; you consume a smaller amount of calories, but you are eating a greater amount of food, which promotes satiety and blunts your appetite. Since high-nutrient foods are not toxic or addictive, you can get in touch with true hunger, breaking free of the constant cycle of addictive overeating.
What do you say to those who cite benefits of animal-based foods or high-protein or “paleolithic” diets?
Superior nutrition will never go out of style. The vast preponderance of evidence in modern epidemiology shows that those who eat more whole plant foods and fewer animal products and processed foods have lower rates of chronic disease and longer lifespans. There is plentiful evidence explaining the reduced risk of chronic disease, showing beneficial biological effects of green vegetables and other plant foods, not animal products. Plus, intervention studies have shown reversal of diabetes and heart disease with diets composed primarily of whole plant foods, not with high-protein diets. Protein is not the miracle nutrient that the general public believes it to be. High animal protein consumption raises blood concentrations of insulin-like growth factor 1 (IGF-1), a hormone that promotes tumor growth and is associated with increased risk of several cancers. Meats cooked at high temperatures produce toxins that can cause carcinogenic changes in the colon; plus red and processed meats are now considered a probable cause of colon cancer, and have been associated in many studies with increased risk of death.
What do you see as the greatest benefit and the largest barrier to adopting this style of eating?
The greatest benefit is enjoyment of life. The goal of my diet-style is eating for optimal health and longevity. What greater benefit could there be than living healthfully and actively into old age with no dependence on medications and almost no risk of heart disease, diabetes or dementia? The largest barrier for many people is starting—making the initial commitment. Many people create excuses why they can’t follow this plan based on their addictions, fear of letting go of their favorite low-nutrient foods, preconceived ideas about how difficult it would be, or unwillingness to appear different from their peers. There is a short adjustment period when switching from a typical diet to a diet of natural foods. However, over time, your taste buds change, and your preferences change. You lose the addictive drives associated with your old toxic diet, and then it becomes easy. There is no portion control or deprivation. Many people claim this information set them free from their prison of food addiction.
There is a large spectrum of dietary advice available, even among advocates of plant-based diets. One of the largest areas of contention is fats: while some use coconut oil with abandon, others eschew even the smallest amount of any added oil. What are the facts about fats, oils, and health?
The claims touted by coconut oil fans have not been substantiated by science, and olive oil, contrary to popular belief, is not the major factor that made Mediterranean diets healthful. It was the overall Mediterranean dietary pattern—rich in unrefined plant foods like vegetables, fruits, nuts, beans, and grains and the smaller amounts of meat—that provided the bulk of the health benefit. Oils are nutrient-depleted processed foods and I recommend avoiding them. I recommend using high-quality, high-nutrient, whole food sources of fat: nuts, seeds, and avocado. The cardiovascular benefits of nuts and seeds are well documented in the medical literature. Eating nuts and seeds daily lowers cholesterol and translates into a reduction in heart disease risk of over 30 percent. Nut consumption is even associated with longer lifespan. Several scientific studies have shown that eating nuts and seeds actually helps to maintain a healthy weight. The same can’t be said for oils. Oils do not boast the heart health benefits of nuts and seeds, and contain 120 calories per tablespoon; oils can easily sabotage weight loss efforts.
Do you have another book project in the works?
My next book, The End of Dieting, is scheduled to be published in March, 2014.