Disease Proof

Dr. Fuhrman on Dietary Misinformation

Dr. Fuhrman responds to many of the common criticisms of his nutritional recommendations and he addresses some of the dietary misinformation circulating around the internet:

DiseaseProof is intended to promote, engage and support people in discussions about nutritional excellence, but, it is often flooded by people with dissention from other school of thought about what constitutes an ideal diet. Obviously, the high protein, “saturated fat is good, not bad” camp, Atkins and Weston Price enthusiasts have a large following of supporters on the web that will vehemently defend those views. So I decided to make another post on this subject and not let all their comments go unchallenged. I simply do not have the time to post as much as these guys can.

The most typical rebuttal to my recommendation to eat a diet that gets the vast majority of its calories from high-nutrient plant material is that we need lots of meat and lots of saturated fat. Then they attempt to cite logic and science to prove me wrong. These people hold dearly the message that a diet that gets the majority of their caloric intake from animal products including red meat, butter and whole milk is lifespan and health promoting. This is their consistent message and other members of their group has often used this to obscure research, quoting their own writers in footnotes to attack the mass of evidence accepted by most nutritional scientists to bolster their apparent agenda that places no limit on the amount on animal products in a healthy diet.

The Weston Price Foundation members and supporters often bring up the Inuit’s or the Masai (short-lived populations) as examples of healthy, long-lived population surviving almost totally on foods of animal product origin in support of their “saturated fat is good and the more animal products eaten the better” message. Of course the majority of meat and cheese eating Americans are looking to embrace messages that support their food preference and addictions and, as the intense popularity of the Atkin’s diet showed, will buy into the even the most fraudulent and unsupported claims.

These groups and their supporters would have us believe that a diet with 80 to 90 percent (or more) of calories from animal products is health supporting. It could take years to see the ill effects but a sudden stroke, heart attack or cancer diagnosis is too big a price to pay for a misinterpretation of nutritional science.

The American diet contains about 40 percent of calories from animal products and as I have explained in the past, with so much calories coming from animal products (and processed foods) the diet people eat is dangerously low in phytonutrients found in unrefined plant products. I recommend that animal products be held to less than ten percent of total calories for a diet to offer dramatic protection against heart disease, strokes and cancer. I base my advice on a rigorous review for more than 25 years of the world’s scientific literature as well as my own experience treating patients for the last 15 years with nutritional excellence and watching not only heart disease, high blood pressure and diabetes melt away but also having my patients make complete recoveries from migraines, autoimmune diseases, allergies and asthma. My patients and other people who have been following my advice have not only made dramatic recoveries from advanced heart disease and other severe life-threatening diseases, but also seen them live fit and healthy into their elder years. Nutritional excellence works.

I teach and promote a diet of natural foods, which considers the micronutrient per calorie density of a diet to assure it is naturally rich in an assortment of antioxidants and phytochemicals. This interprets into a diet with an emphasis on green vegetables, beans, fruits, nuts and strongly restricts or admonishes against the consumption of processed foods which include sweeteners, white flour, salt and oils. Not only do I want health-seekers to reduce animal food consumption but I also recognize that the type or animal product matters (fish and white meat is better than cheese, luncheon meat or barbequed burgers). I also modify diets, including recommendations to increase or decrease animal products depending on individual needs, digestive impairment, medical condition or age, but still, I recommend much lower level than Americans presently consume.

I insist that American’s eat too many animal products because as animal products hold a larger and larger share of calories of your daily allotment, there is insufficient room to intake our requirement of foods that are antioxidant and phytochemicals rich. Therefore I consider a bagel similar to a piece of chicken in that they are both relatively low in micronutrients in relation to their caloric load. If one’s diet is rich in chicken, pasta and olive oil, it will be low in vegetable, beans, seeds, fruits and nuts. So we need to eat less of those foods that make up the American plate and eat more foods naturally rich in protective phytochemicals.

While the Atkin’s diet and the Weston Price dietary patterns get higher amounts of calories from animal products compared to the American norm of 40 percent, I claim we need less animal products in our diet, not more. Since I am putting a figure of 10 percent of calories as a suggested upper limit, the voices on this blog speaking on behalf of the Weston Price camp and sometimes from the Atkin’s high protein camp chime in occasionally against this advice. And some of those comments especially by Mr. Chris Masterjohn sound scientific and even intelligent. Even though Mr. Masterjohn’s comments are scientific, polite and he sounds like a sincere nice guy, I can’t let the discussions go completely unchallenged because I do not want people to be confused or have their health harmed following imprecise advice.

It is an interesting phenomenon to me to view these individuals searching to find small pearls of dissent in the scientific literature to support their views as they ignore thousands of well-performed studies, I wonder why they are so attached to their diets or views that they can’t accept the preponderance of evidence and modify their stance. I attempt to have Mr. Masterjohn, who seems so reasonable, to at least agree that in today’s society the majority of calories should come from unrefined plant foods and the amount of animal products recommended should not be unlimited. I would ideally like Mr. Masterjohn to consider our diseased population and the foods they consume and agree that it seems downright irresponsible to not advise a significant limitation on animal product consumption.

He and many of the people that believe his point of view keep bringing up the nutrient values of wild chickens and wild eggs of yesteryear compared to those factory farm produced. I heartily agree that wild animal foods from a pristine environment would not have all the ill effects of those available to the masses in the modern world. But so what? It may be true that those better quality animal products would not be as harmful and more of them may be safe to eat in a diet than the 10 percent of calories limit, I impose. But that still is almost irrelevant; those foods are virtually non-existent in today’s polluted world with factory farms. We already have a vast body of knowledge compiled from all types of studies to show that in today’s world with the quality of animal products available, people develop life threatening diseases when they eat too much animal products and not enough fruits and vegetables, beans, nuts and seeds.

So if someone wants to point me to numerous interventional studies that document the effectiveness of a diet rich in saturated fat and animal products to promote heart disease-reversal and enhance lifespan, I would be grateful to review them and modify my advice. I did write a few books, Eat To Live and Disease-Proof Your Child, which contain over 2000 different references supporting my advice. In the last 25 years I have made it my business to read all the nutritional journals and almost all the relevant scientific papers. I have also posted additional supportive studies here to counter some of the ridiculous claims made by Barry Groves of the Weston Price Foundation and other people who are angry with me for my contradictory advice. I take such comments seriously as it is important to me that people are not hurt by listening to dangerous nutritional advice that may allow or promote even a few unnecessary deaths. I would not feel this way if in their support of the virtues of consuming animal products these individuals put a recommended upper limit on their consumption and tried to support a minor role of these foods in an otherwise nutrient rich diet, but this is not the case.

When comparing the long lived Okinowans to the general population of Japan the animal product intake is lower (and it is mostly fish), the vegetable intake is higher and the salt intake is lower and of course their diet is not as high in white rice. The most important beneficial aspect of the Okinowan’s diet is that it is lower in calories. So the Okinowan’s have in the past eaten somewhat healthier than other areas of Japan and most other areas of the world. But their average age of death is not spectacular and with better nutritional advice to eat better than the Okinowan’s we should expect to have a much longer average lifespan than the 81.2 years of the Okinowan’s and the 75 years of the Americans. And when looking at any population eating a diet high in fish we must consider the source of that wild fish, the amount of pollutants such as mercury and the quality of the fish available today to the American consumer, which may be very different.

There are a few important points we should make when looking at the Japanese. Even though overall their health and longevity is comparatively better than Americans, they eat lots of salt, lots of white rice and because of this significant morbidity and mortality from stroke. The minute you consider a high salt diet that promotes strokes as a leading cause of death, you have to consider that nutritional modifications that decrease sodium consumptions will be lifespan favorable. This was the main finding from the studies on the elderly in Japan. If you look at some of the original research in their entirety, salt intake and increasing the intake of any food that was low in salt is lifespan favorable in the elderly.

But when trying to interpret the results of a claim made about one study it would be wise to place it in the context of multiple other studies testing the same and other variables. The totality of these studies make some interesting points:
1.The most critical and reliable predictor of elderly survival was adherence to a diet-style rich in anti-oxidant vegetation and adherence to a “Mediterranean Diet” was measure by the amount of serum carotenoids which is a good marker of vegetable intake. And high consumption of meat was associated with higher mortality (early death).

Diet and mortality in a cohort of elderly people in a north European community. Int J Epidemiol. 1997; 26(1):155-9. Osler M ; Schroll M. This study showed that a higher meat consumption meant higher mortality and higher vegetables lower mortality.

Diet and overall survival in a cohort of very elderly people. Epidemiology. 2000; 11(4):440-5. Fortes C ; Forastiere F ; Farchi S et al. This study showed that a higher meat consumption meant higher mortality and higher vegetables lower mortality.

Does diet matter for survival in long-lived cultures? Asia Pac J Clin Nutr. 2005; 14(1):2-6. Wahlqvist ML ; Darmadi-Blackberry I ; Kouris-Blazos A ;et al. Adherence to a diet rich in a variety of plant materials like the older Mediterranean type extended lifespan.

2.Legume or bean intake recurs as an important variable promoting long life. The conclusions of an important longitudinal study shows that a higher legume intake is the most protective dietary predictor of survival amongst the elderly, regardless of their ethnicity in multiple cohorts or populations studied. The study found legumes were associated with long-lived people in various food cultures such as the Japanese (soy, tofu, natto, miso), the Swedes (brown beans, peas), and the Mediterranean people (lentils, chickpeas, white beans).

Legumes: the most important dietary predictor of survival in older people of different ethnicities. Asia Pac J Clin Nutr. 2004; 13(Suppl):S126. Blackberry I ; Kouris-Blazos A ; Wahlqvist ML ; et al.

3.Over the age of 80 nutritional factors that predict lifespan change somewhat. As people pass this age absorption and assimilation of protein decreases related to overall level of health and well being and albumin may gradually lower, especially in the sickly or with the premature signs of aging, increasing the need for a diet with a better quality or percentage of protein if this occurs. However, plant protein should still be emphasized as the major protein source. Care should be taken to eat sufficient high protein plant foods such as sunflower seeds, beans and greens, not to have a rice, sweets, oil or bread centered diet. Individuals have varying needs and animal products or protein supplements may have to be increased in the diet somewhat if blood tests illustrate abnormally low levels.

Mediterranean diet and age with respect to overall survival in institutionalized, nonsmoking elderly people. Am J Clin Nutr. 2000; 71(4):987-92. Lasheras C ; Fernandez S ; Patterson AM.
Nutritional factors on longevity and quality of life in Japan. J Nutr Health Aging. 2001; 5(2):97-102 Shibata H.

4.High saturated fat intake not only increases risk of cancer but is strongly associated with shorter lifespan in people already diagnosed with cancer. I already published numerous enough articles disputing the high saturated fat intake does not cause heart disease argument. Heart disease is ubiquitous in the modern world at all common ranges of saturated fat intake because most of the modern world today eats a diet very low in protective foods; vegetables, beans, seeds, nuts and fruit. I have never seen a person following my nutritional recommendations develop coronary artery disease and the heart disease they do have melts away. I am not the only physician to observe this.

Cancer of the prostate: influence of nutritional factors. General nutritional factors. Presse Med. 2001; 30(11):554-6. de la Taille A ; Katz A ; Vacherot F ; Saint F ; Salomon L ; et al.

Dietary fat and breast cancer risk revisited: a meta-analysis of the published literature.Br J Cancer. 2003; 89(9):1672-85. Boyd NF ; Stone J ; Vogt KN ; Connelly BS ; Martin LJ ; Minkin S. Combined estimates of risk for total and saturated fat intake, and for meat intake, all indicate an association between higher intakes and an increased risk of breast cancer. Case-control and cohort studies gave similar results.
Looking at the three groups of the most healthy and long-lived populations well-documented in recent human history that John Robbin’s discussed in his book, Healthy At 100 we see that all these very long-lived and very healthy populations ate a diet almost exactly like my recommendations described on DiseaseProof, in my books and newsletters and embellished on in the member center on DrFuhrman.com. The overwhelming similarity of these groups were the high consumption of unrefined plant materials that were nutrient rich including fruits, nuts and vegetables. These were not societies living mostly on white potatoes or grains such as wheat and rice, and all of them only consumed animal products in limited amounts. Here is a chart from John Robbin’s book and I strongly recommend his book, it is well researched and well written and does not merely promote a vegan agenda. By the way, I highly respect John Robbins as a man with integrity, intelligence, honesty and kindness. He is a person to emulate.

Giving John Robbins a large margin of error here, it still looks like the super long-lived human societies ate much higher amounts of natural plant material.

I tried to make it clear in Eat To Live, I have no strong health view against the consumption of clean animal products in small amounts in a good diet. The emphasis of the book was not to demonize animal products, but to claim that we had to wipe a good proportion of them off our plate, along with processed food and oil, to leave room for the large percentage of high-nutrient plant material that is necessary to adequately reverse the diseases of nutritional extravagance seen in America. Clearly I make the point that consuming a large amount of high nutrient vegetation is what will enable protection from disease, not only the exclusion of animal products. I consider most vegans to be on very unhealthy diets; including those fat phobic people who won’t have a drop of fat in their diet but who eat a diet that gets most of its calories from sugar, pasta, bread and other processed foods.

The idea proposed by Chris Masterjohn and others from the Weston Price Foundation is that we need to eat dairy fat and cannot get satisfactory levels of Vitamin K with a diet heavy in green vegetables could not be further from the truth. Studies have already found that the absorption and use of Vitamin K from greens is very high. For example Dr. Booth led a study at Yale University School of Medicine to compare the absorption and use—known as bioavailability—of vitamin K from broccoli and from oil fortified with the vitamin from animal products. For 5 days each, volunteers consumed a helping of broccoli or fortified oil along with a base diet. This increased their phylloquinone intake to around 400 µg/day—five to six times the RDA. "What's really exciting," Booth says, "Is to look at the functional markers for vitamin K status. There were no differences between vitamin K from broccoli and vitamin K from oil overall. That's good because green leafy vegetables contain so many other nutrients." And when the volunteers ate broccoli, blood levels of an important carotenoid—lutein—increased compared to when they ate the base diet only.

But always keep in mind, as these points are debated, free radicals are produced whenever you digest and metabolize food. The number of calories you consume affects your level of free radical production and all longer lived societies eat less food than Americans. Inhabitants of Okinawa and the neighboring islands of Amami consume a diet that is 20 percent lower in calories than those in the rest of Japan. Most practice a dietary philosophy known as "hara hachi bu" (eight parts out of 10), which means to eat until you are 80 percent full. Research in animals has proven the calorie restriction (CR) theory time and time again. Eat less, you live longer.

So when talking about the optimal diet, the first thing that comes to mind is the realization that the most proven technique and method of life extension is caloric restriction and we have to meet our nutritional needs, but not overeat on fat, carbohydrate and protein. Americans eat too much of all three sources of calories and we have to eat less protein, less fat and less carbohydrates; but those calories we do eat should be as nutrient rich as possible.

What makes my advice unique—aside from the delicious high-nutrient recipes and healthful eating style—is that I teach and show that low-nutrient eating leads to the desire to consume too many calories.
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Comments (5) Read through and enter the discussion with the form at the end
islandveggie - March 20, 2007 2:47 PM

My 2 year old son and I follow a mainly vegan diet similar to his style with the addition of about an ounce of fish every couple of weeks and a couple eggs each week. I recently read the book "The Whole Soy Story" and was shocked and dissapointed to hear so many bad things about soy products. We don't use any overly processed products like phony meats, tvp, protien powders, ect, however we do consume around 1 cup of unsweetened soymilk each day and about a combined amount of about 300 g of tofu, tempeh, and soy yoghurt each every week. What is Dr. Fuhrmans take on the safety of soy products? And if he thinks that they are fine are there any that should definately be avioded? Also on another note completely unrelated, what does he think about having kids immunized, pro or anti? Thank You.

Kyle Key - March 20, 2007 9:28 PM

@IslandVeggie: That book's author, as you probably know, is Kaayla T. Daniel--"Board Member of the Weston A. Price Foundation, Washington, DC."

It makes sense that someone advocating for a diet so high in animal products would want to ruin the reputation of the most popular alternative.

The next most popular writers from the same group are Sally Fallon and Mary G. Enig, so you'll want to shy away from their "teachings" as well. Really, it's just ridiculous when you think about it--their self-professed ideology is based on the findings of a dentist turned quasi-anthropologist in the 1930s, Weston A. Price himself; and after doing Medline searches for soy articles and studies (noting how few of them actually point to a negative consequence of soy consumption), it becomes easy to see how you'd have to ignore the last 60+ years of medical knowledge to come to their conclusions.

Mario Quesada - April 16, 2007 10:29 PM

Hey Islandveggie, I have a big famly myself and I won't give them something as dead as unfermented soy products.
In order for soy to be palatable it has to be overcooked. And the "soy milk" as well as the tofu are to concentraded in protein and very low in minerals and no vitamines or enzimes can survive the process.
Give you child real food like home made almond milk if you want to imitate milk for the pleasure of eating.
And it much more nutritious.
Get informed about the raw-vegan diet and the best way to do it.
I could informe you if you want to but I'm not posting here to make business, just to prone the most lively diet possible. Good luck and keep looking for new truths.

SS - May 7, 2007 11:33 AM

I am Indian and a Hindu. Low average lifespan due in India due to ingestion of insufficient animal products is not a logical conclusion when you actually examine what the average Indian vegetarian eats.

The standard Indian vegetarian diet is filled with fried foods (coconut oil is heavily used in the South). Furthermore, every-day vegetables are cooked with copious amounts of oil or butter. There is also an over reliance on grains and rice (depending on your locale). Many Indians, especially the middle class, lead sedentary lives. As you know, Cardiac surgeons make a great living almost everywhere, perhaps even more so in India.

So, as you say, the main factor is high infant mortality, then perhaps disease and relatively high foodstuff prices; but most likely not lack of animal products in the diet.

David - September 6, 2011 11:04 PM

I checked on three of Masterjohn's footnotes in his "master essay" on cholesterol. In all three cases, Masterjohn had distorted the findings in the studies he cited, and the actual studies vitiated his claims. In one case he ignored that the study was not about incidence of stroke, but incidence of death from stroke. In another he ignored the study's discussion of blood pressure as the most related factor. In the last, he stated that greater consumption of animal fat was associated with lower stroke incidence, but the study itself said that after multivariate analysis, this association was not statistically significant.

Masterjohn's scholarship is faux scholarship; he mischaracterizes those he cites, on all sides. He has also distorted remarks Dr. Campbell made about the China Study.

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