Disease Proof : Disease Proof : Health & Nutrition News & Commentary : Dr. Joel Fuhrman

From Dr. Fuhrman's book Eat to Live:

Our bodies need carbohydrates more than any other substance. Our muscle cells and brains are designed to run on carbohydrates. Carbohydrate-rich foods, when consumed in their natural state, are low in calories and high in fiber compared with fatty foods, processed foods, or animal products.

Fat contains about nine calories per gram, but protein and carbohydrates contain approximately four calories per gram. So when you eat high-carbohydrate foods, such as fresh fruits and beans, you eat more food and still keep your caloric intake relatively low. The high fiber content of (unrefined) carbohydrate-rich food is another crucial reason you will feel more satisfied and not crave more food when you make unrefined carbohydrates the main source of calories in your diet.

It is usually the small amount of added refined fat or oils that makes natural carbohydrates so fattening. For example, one cup of mashed potatoes is only 130 calories. Put just one tablespoon of butter on top and you have added another 100 calories.

Protein, fat, and carbohydrates are called macronutrients. Vitamins and minerals are referred to as micronutrients. All plant foods are a mixture of protein, fat, and carbohydrate (the macronutrients). Even a banana contains about 3.5 percent protein, almost the same as mother's milk. Fruit and starchy vegetables, such as sweet potatoes, corn, carrots, and butternut squash, are predominantly carbohydrate but also contain some fat and protein. Green vegetables are about half protein, a quarter carbohydrate, and a quarter fat. Legumes and beans are about half carbohydrate, a quarter protein, and a quarter fat.

One of the principles behind the health and weight-loss formula in this book is not to be overly concerned about the macronutrient balance; if you eat healthful foods, you will automatically get enough of all three macronutrients as long as you do not consume too many calories from white flour, sugar, and oil. So don't fear eating foods rich in carbohydrates and don't be afraid of eating fruit because it contains sugar. Even the plant foods that are high in carbohydrate contain sufficient fiber and nutrients and are low enough in calories to be considered nutritious. As long as they are unrefined, they should not be excluded from your diet. In fact, it is impossible to glean all the nutrients needed for optimal health if your diet does no contain lots of carbohydrate-rich food.

Fresh fruits, beans and legumes, whole grains, and root vegetables are all examples of foods whose calories come mainly from carbohydrate. It is the nutrient-per-calorie ratio of these foods that determines their food value. There is nothing wrong with carbohydrates; it is the empty-calorie, or refined, carbohydrates that are responsible for the bad reputation of carbs.

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Dr. Fuhrman reacts to the recent buzz surrounding claims that low-carb meat-based diets cure diabetes:

Research on extremely low carbohydrate diets and diabetes illustrates that both the safety and effectiveness are poor. Just because the standard American diet (rich in processed foods) is so dangerous, does not make the small improvements in weight or glucose with low-carb or Aitkin's type diets favorable. We don't purchase a car by comparing it to a junk yard wreck.

Even the researchers, who studied these meat-based diets which demonstrate only modest benefits in glucose or weight loss, continually warn against the potential long term risks and that benefits of these diets are only moderate at best.1 Furthermore the lower amount of phytochemicals in a diet and receiving the majority of one's calories from animal products predisposes followers to higher inflammatory markers, which are associated with cardiovascular disease.2

I have reviewed over 60,000 research articles on nutrition and disease and reference more than a thousand in Eat to Live. Obviously, I only offer a few articles here but the point is that I come to my recommendations based on the vast preponderance of the evidence not on the basis of one or two studies. My recommendations are not designed to appeal to the many who are addicted to harmful foods, but rather are for those who want the most effective and most longevity-promoting diet-style.

It is accurate to say that vegetarian diets in the manner they are most typically designed (heavy in processed foods) are not ideal either. Nevertheless, the studies done on vegetarian diets and diabetes are at least as favorable as those done on very low carbohydrate, meat-based diets.3

The vegetarian diet contains a portfolio of natural substances that protect against inflammation and lipid abnormalities in diabetes and has various metabolic advantages for the prevention and treatment of diabetes and its complications. DiseaseProof has discussed this in the past (Vegetarian Diets are Not All Created Equal: An Example), my Eat to Live program differs from a vegetarian diet and because of some critical differences has been shown in the scientific literature (Metabolism, April 2001) to improve lipid parameters and reduce weight and blood glucose much more significantly. So the issue for diabetes is not whether one is a vegan or not, the issue is the nutrition per calorie and micronutrient quality of the diet.

Low-carb or meat-based diet advocates may be able to critique a grain/flour heavy vegan diet, but not Eat to Live. It contains the benefits of a vegetarian diet, without the risks from all the lower nutrient, higher glycemic potatoes and grains. And Eat to Live's profound benefits to blood vessel health does not require total exclusion of animal products. It simply keeps to safer, reduced levels.

Regular readers of DiseaseProof know it is not a question of the precise balance of the three macronutrients (fat, carbohydrate and protein) that enables the body to get well, but the ratio of micronutrients per total calorie. My Eat to Live diet-style is unique and simply the healthiest way one can eat. It is not a vegetarian diet in the conventional sense, so studies on vegetarian diets do not accurately speak to the effectiveness of Eat to Live.

In fact, a recent study conducted by Dr. Sarter of USC (pending publication) revealed 63 people following my Eat to Live diet-style showed more weight loss, cholesterol lowering, and diabetic reversal than any other study in medical history. The average patient lost 52 pounds and they were followed for two years. The fact that this diet style is profoundly more successful for weight loss than the meat-based diets, illustrates it is significantly more effective for diabetics too. In fact, most of my patients quickly get rid of their diabetes and are able to stop all their medications following my recommendations even before all their excess weight is lost. My recommendations are mathematically and scientifically calculated to maximize micronutrients and food volume per calorie and enable people to rid themselves of their food addictions and naturally desire fewer and fewer calories.

However, the fact that my high nutrient diet is unique and not broadly studied in no way lends support to the benefits of other better investigated diets, such as the recommendations of the American Heart Association and the American Diabetic Association. In my advocacy of nutritional excellence for diabetic patients I actually speak negatively about all types of diets, including the aforementioned traditional vegetarian diet. So when I discuss the dangers of Atkins type diets, in no way am I supporting or advocating diets high in refined carbs, flour or sweets, they are dangerous too.

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According to Andrew Bridges of the Associated Press a new report suggests restaurants should monkey with menu offerings and portions sizes to help fight fat:

Today, 64 percent of Americans are overweight, including the 30 percent who are obese, according to the report. It pegs the annual medical cost of the problem at nearly $93 billion.

Consumer advocates increasingly have heaped some of the blame on restaurant chains like McDonald's, which bristles at the criticism while offering more salads and fruit. The report does not explicitly link dining out with the rising tide of obesity, but does cite numerous studies that suggest there is a connection.

The report encourages restaurants to shift the emphasis of their marketing to lower-calorie choices, and include more such options on menus. In addition, restaurants could jigger portion sizes and the variety of foods available in mixed dishes to reduce the overall number of calories taken in by diners.

Bundling meals with more fruits and vegetables also could improve nutrition. And letting consumers know how many calories are contained in a meal also could guide the choices they make, according to the report. Just over half of the nation's 287 largest restaurant chains now make at least some nutrition information available, said Margo Wootan, director of nutrition policy for the Center for Science in the Public Interest.

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A new study published in the New England Journal of Medicine contends that even slight weight gain can cause gastrointestinal problems. The research most directly points to the development of gastroesophageal reflux disease (GERD). Amanda Gardner of Healthday News reports:

"This sheds some light that any excess weight over ideal body weight may have a detrimental effect," said study author Dr. Brian Jacobson, an assistant professor of medicine at Boston University School of Medicine.

"Even if you were of normal weight and experienced a gain, you are more prone to reflux," added Dr. Anthony A. Starpoli, a gastroenterologist at Lenox Hill Hospital in New York City.

GERD occurs when the valve between the stomach and the esophagus fails to close properly. As a result, the contents in the stomach, including stomach acid, can spill up into the esophagus, leading to erosion of the esophagus and, in some cases, esophageal cancer.

Researchers have already established that overweight and obese people are at an increased risk for GERD, but there have been questions about the link between body-mass index (BMI) and GERD.

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