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

Editor’s Note: This is a guest post from Allie Beatty of Allies Voice and does NOT necessarily represent the opinions of DiseaseProof or Dr. Fuhrman.

For every time someone told me the answer to diabetes is blood sugar control – immediately I knew the question cannot possibly be ‘how do I prevent complications”. Complications are now known to be caused from AGE (advanced glycation end products). AGEs are released into the body after glucose metabolism. If insulin helps metabolize glucose – why doesn’t the body make something that protects it from complications of diabetes? It does – it’s found in proinsulin.

The beta cells make proinsulin. Proinsulin is a combination of insulin and C-peptide. Insulin breaks off from proinsulin (like the launching of a space shuttle) to carry glucose out of the blood and into the cells. C-peptide lingers in the blood to ‘clean up’ the AGEs created from glucose metabolism. People with diabetes develop complications in their eyes, nerves and kidneys. Analogues (synthetic ‘insulin’) only lower blood glucose and leave AGEs in the blood to complicate the tissues of the eyes, nerves and kidneys. This occurs in both Type 1 and Type 2 diabetes.

Mother Nature is forgiving and reasonable. For she realized these membranes would need a secondary source of prevention from complications if insulin and c-peptide were in short supply. As it turns out – vitamin B1, also known as thiamine, reverses damages from AGEs, much like C-peptide. Because vitamin B is water-soluble, and people with diabetes tend to urinate frequently – over time the body becomes dangerously depleted of vitamin B, including vitamin B1 – thiamine.

Studies have shown that vitamin B1 (thiamine) is essential for the metabolism of glucose from the blood (aka ‘blood sugar’). Vitamin B1 (thiamine) is keeps your mucous membranes healthy and is essential for nervous system, cardiovascular and muscular function. It leaves me puzzled as to why doctors aren’t religiously checking patients’ with diabetes thiamine levels. Nearly every complication of diabetes can be prevented (and in some cases treated) with consideration to thiamine.

Alas, you know my gripe will eventually meander into the nefarious patents and suppression of BIG PHARMA. So I’ll spare you the drama and leave you with one simple call to action. Don’t wait for your thiamine levels to drop. Get yourself a good B-complex with plenty of thiamine. Keep a running tab on your thiamine levels and if they start to drop – discuss with your doctor a plan of action to replenish the Bs.

UPDATE: Dr. Fuhrman had a reaction to Allie's post. His thoughts:

This is misleading and it exaggerates the known benefits of thiamine supplementation in the diabetic. It is also harmful to the extent that diabetics think they can adequately protect themselves with supplements, (as it subconsciously de-emphasizes the critical nature of aggressive dietary and lifestyle changes), instead of changing their diet and exercise habits, which has the potential to remove the diabetes completely.

 

Sure, diabetics are low in thiamine (vitamin B1), as well as other micronutrients, and sure thiamine deficiency as well as deficiencies with other micronutrient) can accelerate the enhanced micro-vascular damage from diabetes. However, that does not mean that thiamine supplementation (alone) will prevent or even help prevent the micro-vascular complications to the kidney, nerves and eyes in diabetes. Those studies are ongoing and no definitive conclusions at this point can be made.

To encourage high dosages of supplemental B1, without mention of a diet, rich in B1 (vegetable and bean-based), will continue the nutritional folly of the last decades. There are thousands of micronutrients needed to maximize your health and type-2 diabetes is a disease that develops because of nutritional ignorance and the subsequent food addictions that develop from low nutrient eating. Becoming thin is the first step. When you eat the micronutrient-rich diet I recommend you get appetite suppression, dramatic weight loss, enhanced exercise tolerance, and most people can actually get rid of their diabetes. A type-1 diabetic can reduce their insulin needs by about half, and protect themselves from the complications of diabetes.

Caring for thousands of diabetic patients in my practice and weaning them off their medications while watching their condition melt away, has been one of the most rewarding aspects of my medical practice. So if you have diabetes, instead of looking for a pill, supplement, or medication to protect you, which will never be maximally protective, I want to encourage you to take the bull by the horns and strive to get rid of your diabetes. That should be the take away message.

My nutritional protocol has already been confirmed by medical studies to be the most effective for lowering cholesterol, and a pilot study has also shown it to me the most effective for weight loss. For diabetics, it can be a life-saving. If you are diabetic, I implore you to learn more.

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Editor’s Note: This is a guest post from Howie Jacobson, PhD of FitFam and does NOT necessarily represent the opinions of DiseaseProof or Dr. Fuhrman.

Packing school lunches is always a challenge in my house. So it was with some surprise that my 9-year-old son suddenly started asking for apples for lunch about a month and a half ago.

To me, apples are the perfect food. They resist most mild forms of travel abuse, unlike plums and peaches. They come in nice colors and can be eaten one-handed while you do your school work.

But for finicky kids, apples present a problem. The skin!

Skin the apple ahead of time, and it turns brown. Leave the skin on and a third grader will see ammo-deflecting armor surrounding his fruit, rather than a thin and delicious protective layer. The apple will come home untouched or worse, thrown away with one guilty bite taken out of it.

Back to the point, why was my son so excited about apples?

Turns out his teacher, who has a keen interest in all things mechanical, had brought to class an apple peeler and corer. Now, all of a sudden, my son's apple was the coolest thing at lunchtime, because he could crank this simple machine and magically peel and core it in front of his classmate's amazed and appreciative eyes.

Now all the kids want apples for lunch. Probably an overstatement, but I'm a little excited here!

So what's my takeaway? Presentation matters. The experience of food matters. Peer pressure matters. And most of all, if you want to change behavior, use toys. The apple gadget provided immediate gratification prior to the first bite. The apple jumped to the front of the awesome-dessert line because it started with momentum.

When you get a strong spasm of intention to eat right, to exercise, to meditate, to do whatever it is that supports your highest good and yet doesn't happen as often as it should. Use that POWER MOMENT to shift your future environment.

Buy an apple peeler, go for a fun run, clean out your study and make it a meditation room, use that momentum! Create ongoing favorable conditions, so doing the right thing becomes fun and easy.
 

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Editor’s Note: This is a guest post from Scott Wharton of HealthandMen and does NOT necessarily represent the opinions of DiseaseProof or Dr. Fuhrman.

Do you take your health for granted? Chances are if you're reading this right now, you don't. However I was heading home late last night and I noticed a billboard for a wellness radio show and for some reason it got me to thinking about how many people probably drive by that everyday and think, “Why?”

When you go to the grocery store the first section that is in most markets is the produce. Perhaps one of the most important sections of the super market, filled with the healthiest items in the store. How many people pretty much bypass this section almost all together and go about buying the same things they bought the last time?

How many people give no thought to simply eating healthy food and fill their shopping cart with the same garbage each and every time? You'd be surprised. Sure they might buy some canned vegetables, but that’s only because they feel that they have to have a vegetable on their dinner plate and don’t really want that vegetable for its nutritional value.

Most people don't become health conscious until the errors of their ways catch up to them and they suffer a heart attack or a simple cholesterol test show dangerous levels. They go about their daily lives and have the mentality that they feel healthy so they must be healthy.

Health insurance rates for men are normally higher than women's rates. One reason is because men can be ignorant. They brush off minor aches and pains and don't get regular check-ups. Those minor aches and pains could be symptoms of bigger underlying issues and sometimes it's not caught until it's too late.

I think women are more health conscious for various reasons. One is the fact that women are generally more self-conscious about their weight and often do research on what they can do about it. When they research they learn all sorts of things that they never knew before and they start becoming more aware of their personal health. Also, most women are not as stubborn as men and normally get themselves checked out when they feel something isn't right.

It goes back to the mentality that I feel fine, so I must be fine. There are also people that just don't care. They live for the moment and live unhealthy lifestyles. They may be happy, but it can create hardships for themselves and other people in the long run when they are beating up their bodies from the inside out. You don't have to be paranoid about your health, just be aware.

Over 500 years ago English philosopher, Sir Francis Bacon said "Scientia Potentia Est", which translates to today's "Knowledge Is Power" and in U.S. Military leadership they teach "Know yourself and seek self improvement". These are words to live by in both a moral sense and health sense.

Don't take your health for granted and encourage others to do the same.
 

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Editor’s Note: This is a guest post from Laura Klein of OrganicAuthority and does NOT necessarily represent the opinions of DiseaseProof or Dr. Fuhrman.

The New York Times reported that positive eating trends are on the upswing!

Remarkably the percentage of people who are currently dieting is on a decline to 29 percent in 2007 from 33 percent in 2004. In place of calorie counting, starvation and deprivation, people are adding tasty whole foods to their diets, and 53 percent more are cooking more and from scratch!

This is exciting stuff! It has always been my advice that if you don’t know where to begin in transitioning your diet to a healthy one, start by adding more delicious organic fruits and vegetables to your diet every time you grocery shop and if you can swing it, on a daily basis. Keep it simple and easy.

If you are inclined to count something, start counting chemicals in your food instead of calories. Studies are now showing that chemicals in our food are leading to serious health issues like obesity, cancer and more. If you are inclined to reach for diet sodas and diet foods, take a few seconds (literally that’s all it takes) and scan the list of ingredients and ask yourself how familiar you are with the ingredients in that packaged drink or food product.

Other reports have shown number of farmers markets across America have more than doubled since the mid-1990s. And the sales of organic foods continue to rise. We are finally beginning to follow in the footsteps of Europe.

One of the things I have discovered in my quest to discover the most delicious foods on the planet is the remarkable healing qualities of tasty, whole, organic foods. There are so many miraculous healing stories of people who have cured themselves of serious diseases, like cancer, obesity, diabetes, and more, by simply eating a delicious, organic, whole foods diet. Bottom line, delicious, whole, organic foods are commonly overlooked as one of the most powerful healing tools on the planet.

If you are concerned about the price of organic foods during these tight economic times here are some of my recommendations for creating room in your budget to add tasty, whole, organic foods to your shopping cart:

• Buy fewer prepackaged processed food products and add more whole foods to your shopping basket. Buying less junky fast foods creates room in your budget for tasty, whole organic foods!

• Eat out less. Eat at home at least one to two times more per week (or more). This will create a huge amount of room in your budget for quality organic foods.

• Buy at your local farmers markets! Not only are you buying local but many times organic produce can be up to 20-40% cheaper.

• Don't rule out non-organic when it comes to local farmers. While you are at your local farmers market, get to know your farmer! Ask if they grow organically even if they aren’t a certified organic farm. Many times local farmers can’t afford the certification but grow organically the way Mother Nature intended.

• Use a grocery list! This may seem obvious, but studies show that people who use grocery lists and stick to them save money on their grocery bill.

Overall, think about your values when you shop. Do you shop merely on price and large quantities? Or does quality and nutritional value count for something? Remember: consuming foods that are tasty and rich in nutritional value is what will keep you healthy, help in keeping the weight off and add up to less doctor visits. And knowing it's better for the planet is a nice perk!

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Editor's Note: This is a guest post from Jennifer McCann of Vegan Lunch Box and does NOT necessarily represent the opinions of DiseaseProof or Dr. Fuhrman.

I swear by the magical super power of a Vita-Mix to blend otherwise objectionable foods to a lovely smooth consistency that will meet the approval of picky children, and adults! I use it to blend chunky soups into smooth purees for my son, so he can avoid the distress of having to dissect his stew before eating. I also blend his tomato sauce, and manage to sneak in some cooked kale and carrots while I'm at it!

But the main reason we love the blender is for making SMOOTHIES! Smoothies are a great way to make fruits (and, to a lesser extent, vegetables) fun and easy. We make smoothies every day for breakfast or a healthy snack.

Now that my son is almost 10 he likes to show his independence and make his own. However, we started having problems with his idea of how much frozen fruit to use; it was not uncommon to find that he had thrown over 3 cups of frozen blueberries in the blender to make one breakfast smoothie. Healthy, yes, but talk about expensive!

So here's what I did to get smoothie-making under control and turn it into a kid-friendly activity: I purchased clear square bins at a wholesale grocery store, just like the kind they use in restaurants, along with a 3 oz. (approx. 1/3 cup) ice cream scoop.

Then I posted a smoothie recipe template on the refrigerator for my son's reference. It's practically impossible to go wrong with it: 1 cup of nondairy milk or 100% juice (or a mix of the two), 1 scoop of ice, 1 container nondairy yogurt, and 3 scoops of fruit. Voila! A yummy smoothie!

Of course, you can leave out the yogurt if you prefer, and add all sorts of nutritious extras to any smoothie: one or two tablespoons nuts or nut butter, a tablespoon of ground flaxseed, a Pixie-Vite or other supplement, handfuls of cooked or raw greens, slices of avocado, etc. My husband even likes to add raw oats to his, to thicken it into a hearty breakfast shake.

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Editor’s Note: This is a guest post from Jim Foster of Diet-Blog and does NOT necessarily represent the opinions of DiseaseProof or Dr. Fuhrman.

Do you ever feel baffled, overwhelmed, and fatigued by all the diet advice that’s out there? Over the last few decades we’ve seen books that cover a bewildering array of nutritional combinations. Some become instant bestsellers – while others are thrown in the bargain bin before you can say “revolutionary new plan“.

It becomes mind-numbingly banal after a while – and in my view most people simply want to get on with life - enjoying their food and experiencing good health. Following rigid plans can feel empowering for a while – but in an ever-increasingly hectic life – simplicity begins to look very attractive.

Today’s information highway is strewn with 30-point plans for achieving better bodies. We have more assistance and guidance at our fingertips than ever before. How much of that knowledge we actually retain is up for debate.

Let’s distill all the complexity down into one easy sentence. It won’t lose you “4 pounds in 7 days”. It won’t “melt fat”, and it is no “revolutionary secret”.

Here we go, 6 words: Eat more fruit and fibrous vegetables.

Don’t stress, don’t strain. Don’t count, don’t obsess. Focus on which fruits and veggies you enjoy. Buy (or grow) them. Eat them.

Life is too short to spend it on angst and worry.

You may be surprised at the number of positive follow-on affects from simply focusing on fruit and vegetables. It’s more helpful to focus on foods you can add rather than stressing about what you have to avoid. If you’re stomach has filled up on broccoli – you’re unlikely to binge on a tub of ice cream.

Keep it simple. Keep it positive.

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Here’s an article from Dr. Fuhrman's colleague Dr. Steven Acocella, MS, D.C., DACBN, Board Certified Clinical Nutritionist, American College of Lifestyle Physicians, and a Diplomat of the American Clinical Board of Nutrition:

In disease free individuals resting pulse rates reflect our current state of fitness. Being aware of our pulse rate can help us avoid injury when beginning an exercise regime, measure the effectiveness of various exercise routines and determine if we are under or over training. By monitoring our heart rate throughout an exercise session we can adjust our efforts in real time so that we achieve our desired results and goals. Using our heart rate as a guide we can specifically focus on improving cardiovascular health, maximizing body fat reduction, improving stamina and endurance or build lean-muscle mass. As we become more fit, plotting our resting heart rate over a period of time on a graph will demonstrate our progress as clearly as fitting into those skinny jeans again!


Heart rate training is based upon a key anchor point, our maximum heart rate (MHR). From our MHR we derive heart rate training zones. As we will see later, these zones help us target the results we want and achieve those goals from our efforts. There are 3 ways to determine what our individual MHR is, a strictly mathematical formula based on age or by measuring our heart rate during actual exercise. There are 2 methods that use our ‘perceived level of exertion’ (how we feel) during actual exercise. I prefer these exertion-based methods of capturing MHR as they better reflect individual fitness level and ability. However, a resent study reviewed some 50 different mathematical MHR formulas and identified the most reliable and accurate calculation method. The study found that the maximum heart rates obtained using this formula varied only fractionally when compared to exercise derived MHR’s in the same subjects. Certainly, for the average fitness enthusiast, both methods are useful and valid. I will present the mathematical and exercise derived methods in this article.

There are two ways to obtain your pulse, manually by feel or by using a heart rate monitor. Heart rate monitors use a transmitter housed in a chest strap worn during exercise; this device detects the heart’s electrical activity and then send this information to a receiver, usually housed in a wrist watch which displays heart rate and other data. Once only available to professional athletes, personal heart rate monitors are quite inexpensive and accessible to most of us weekend warriors. If you shop for a monitor I recommend you find one with a built in “Fit Test”, a program to calculate your heart rate zones via a guided exercise routine. Many home and most club gym exercise machines have heart rate monitor receivers built right into them. If you have access to these machines you may only need to purchase the chest strap. Some machines with built-in receivers even adjust the workout intensity automatically based upon the user’s target heart rate zones!

If you don’t have a monitor here are a few tips on taking your pulse directly. You can take your pulse on the underside of your wrist on the thumb side using your 1st and 2nd fingers (never use your thumb to take a pulse). Or, some prefer to take the carotid pulse located on the front side of your neck about 1/3 of the way down and about an inch on either side of center. Practice locating your pulse. Once you’re good at finding and feeling the pulsing blood vessel, use a second hand watch and count the pulses for 60 seconds, this is your current heart rate. Once you’re proficient you can count the pulse for 30 seconds and simply double the number. Be sure to master pulse taking before you need to do it during a heart rate test or when exercising.

Firstly, let’s determine your MHR mathematically. Simply plug your age into this equation: MHR = 205.8 – (0.685 x AGE)

For example, the MHR for a 45 year old is: MHR = 205.8 – (0.685 x 45) = 175 Beats per Minute

Now let’s look at the methods that use exercise to capture MHR. The first method, known as the Sub-Maximal HR Test is useful for people that are just beginning an exercise program, recovering from an injury, medical procedure or anyone not in good enough shape to push themselves to their absolute limit. This method instead derives MHR by estimating or extrapolating from a heart rate obtained from a less than all out effort. This test is most accurate when supervised by a professional but an average test is still quite useful.

Using walking as the ‘control effort’ - map out a 1 mile course, a ¼ mile track is optimal but not mandatory. Walk briskly (without jogging) pushing yourself into a challenging but comfortable stride. A good rule of thumb is the talk test, i.e., you should be able to maintain a conversation during this level of effort. At about the ¾ mile mark, without stopping, take your pulse. Keep walking and repeat taking your pulse a couple more times during the last quarter mile. If there is more than a few beats difference in each heart rate simply add them together and take the average to obtain a more accurate number. If you are using a heart rate monitor simply note your HR 3 times during the last ¼ mike and take that average. Now that you have your sub-maximal heart rate, add 50 beats per minute (BPM) to that number to calculate your MHR. Again, this is a working ball-park average but it’s still very useful especially for those of us closing the doughnut box and getting off the couch for the first time.

Finally, we’ll look at obtaining a MHR from the Maximal Effort Method. This method should be utilized only by those whom are already fit and in good cardiovascular health. Be forewarned that this method is quite challenging. Choose an activity such as biking, an elliptical machine, treadmill or any aerobic activity in which your body position is upright. I do not recommend recumbent exercises or swimming for the Maximal HR Test as MHR can be sport specific and these activities have the greatest variation.

The Maximal Effort Method test is designed to last about 15 minutes. Begin to exercise and after about a 3 minute warm-up begin to exercise at the level of effort described for the sub-maximal test. Maintain this level for a full 10 minutes. Once you are at this 10 minute mark the fun begins. Over about a minute, accelerate and intensify your effort until you can push no more. You should be at a level of effort that is very uncomfortable and barely sustainable. After pushing yourself at this highly competitive pace for about a minute note the reading on your heart rate monitor or take your pulse (ask a partner to help you by tracking the time for you) while maintaining your pace. It is this pulse rate during this final minute that is your MHR. Once you have obtained it you can then slow down, cool down and then fall down!

So, now that you have obtained your MHR from the mathematical or effort derived methods we’ll apply this information to get results from our workouts. The broadest application is to define a single target heart rate range to make sure you are getting something out of your workouts. This is a general heart rate range that is required to improve respiratory capacity, cardiovascular health and general overall fitness. This HR range is 60 – 85 percent of our MHR. To find your range simply calculate these 2 numbers:

• Lower limit of Heart Rate Range = MHR X .60
• Upper Limit of Heart Rate Range = MHR X .85

So, our 45 year old with a MHR of 175 BPM would have a beneficial heart rate training range of 105 BPM – 149 BPM (175 X .60 and 175 X .85).


Here’s where monitoring your heart rate during exercise begins to become useful. As we become more fit, activities that initially brought our heart rate into a beneficial range become too easy. But many of us continue our routines and hence our efforts become less productive as they no longer stress our bodies to the point of gaining improved fitness; this ‘staleness’ is avoided by heart rate guided training. We can engage the same activities but are forced to work harder to bring our heart rate into this beneficial zone. But this is only one application. MHR can be tailored for much more specific training goals.

By breaking this wide training range into more narrow ‘zones’ we can use heart rate data to customize our workout intensities for optimal and specific results. Generally, I use 4 reference zones. All are expressed as a percentage of MHR with an upper and lower limit. Although there are overlapping benefits, generally speaking each zone has a particular result associated with it. The percentages of MHR for each zone are:

• Zone I – Light Intensity 60 -70 percent of MHR
• Zone II – Moderate Intensity 70 -80 percent of MHR
• Zone III – Heavy Intensity 80 -90 percent of MHR
• Zone IV – Maximum Intensity > 90 percent of MHR

So, again using our 45 year old as an example our target heart rates would be:

• ZI = 105-122 BPM
• ZII = 123-139 BPM
• ZIII = 140-157 BPM
• ZIV = 158-175 BPM

Here’s an overview for each zone:


Zone I – This is the easiest level of intensity you can work at and still gain benefit. It’s best used for overall health, flexibility and agility and maintaining a weight reduction. This is an excellent zone to stay within during the first 1 -3 months of beginning an exercise plan to avoid injury, especially for those who have not engaged in a fitness program for a long time. It’s also the warm-up and cool down zone to enter into or come out of more intense exercise.

Exercise at this level should feel easy and pass the ‘talk test’. You should never be out of breath, feel any pain or burning and be able to maintain this effort indefinitely.

Zone II –Working out in this zone effectively builds endurance, stamina and muscle tone without significant increase in girth. It’s also excellent for cardiac strengthening and building co-lateral circulation (adding more small blood vessels in the extremities). This is an excellent zone to stay in during the first 2-4 months of training.

When in this zone breathing should be slightly labored but not difficult. You can still converse comfortably. You should not be in a ‘no-pain, no-gain’ condition but may need to vary your effort from time to time. When fit you should be able to maintain this level of effort for a few hours.

Zone III - This is the best zone to use stored fat for energy, i.e., the most efficient weight loss or ‘fat burn zone’. Zone III balances maximum caloric demand while still remaining under the anaerobic threshold, the key criteria for burning fat. In less fit people training in this zone too soon uses more glucose than fat for energy. As we become more fit and can maintain this level of intensity for longer periods of time it becomes fueled by an increasing percentage of energy from stored fat. This is why you often hear people say that they started working out and are “exercising like crazy but not losing any weight”. This is exactly why I recommend to patients that want to lose weight and are just starting out that they exercise in Zone II for a while. Pushing too far too soon can be counter-productive. It takes time for the chemical plant in our muscles to adapt to the new demands of exercise. The cells that use oxygen in producing energy increase over time (this is known as Davis’s Law) so that we can sustain a Zone III level effort for longer and longer. It’s the physiological equivalent to learning to walk before you can run, or perhaps this analogy can be applied literally!

Exercising in this zone should be quite challenging but still not painful. It’s the highest zone you can be in and still be able to carry on a conversation, albeit difficult and in-between breaths. You should be able to maintain this intensity for up to about 1 hour but that may be much shorter initially and increase proportional to you level of fitness.

Zone IV – This is the anaerobic zone whereby we use primarily glycogen (glucose stored in muscle tissue) for energy. This zone contributes greatly to the efficiency by which our muscles can burn fat in the lower zones. By pushing ourselves into this zone we raise our ‘lactate threshold’, the line between using fat verses sugar as a caloric energy source. The more time we can stay in zone IV the higher our lactate threshold and the longer and stronger we can perform athletically. This zone ‘ramps-up’ our muscles to burn fat while we’re at rest by making our ‘oven’ more efficient. Most importantly, this is the zone where the most dramatic muscle building gains live. We could call it the Buff-Zone!

Exercise in this zone can be maintained for only very short periods of time, usually seconds to a few minutes maximum. If you can maintain this zone for longer than 3 minutes you are either not in this anaerobic zone or your name is Lance Armstrong. You can not talk during this level of exertion and are in significant pain. There is no significant fat weight loss in this zone but rather a break down of muscle tissue that leads to growth. This is the ‘no-pain, no gain’ zone and if you’re in it you should be hating life.

Remember, as you become more and more fit the beneficial changes that take place are reflected in your heart rate. Make a chart and plot your resting pulse by taking it first thing in the morning before you get out of bed. Do this for a few months and you’ll see over time the line slopes lower and lower! As your resting pulse plummets the range of your resting heart rate and your MHR increases allowing your heart to work less hard at the same level of effort. By using your heart rate as a barometer of how hard you are exercising you will avoid boredom, progress plateaus and stagnation.

You are now armed with valuable and useful information about heart rate training. You can now see how knowing and using your heart rate can help you maximize weight loss goals, achieve those 6-pack abs and keep you moving onward and upward to the fittest you possible. I applaud you for taking the time to read this article, see you in the gym!

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Written by Dr. Fuhrman’s colleague Jeff Novick, M.S., R. D. for the December 2002 edition of Healthy Times:

Believe it or not, according to a study presented at the European Society of Cardiology Congress, the amount of caffeine in just one cup of coffee could be enough to harden a person’s arteries for several hours afterward. Hardened arteries put extra pressure on the heart and increase the risk of heart attack and stroke.


“After drinking a cup of coffee, blood pressure can rise up to 5 or even 10 millimeters of mercury,” said Dr. Charalambos Vlachopoulos from the Cardiology Department of the Henry Dunant Hospital in Athens, Greece. Increases of this magnitude can increase a person’s risk of suffering from a stroke or a heart attack.

Elsewhere, Dr. M. O’Rourke and colleagues at St. Vincent’s Hospital, Sydney, Australia, presented data at the 22nd Congress of the European Society of Cardiology linking caffeine consumption with alterations in the aorta, the main artery supplying blood to the body. Their study showed that caffeine led to a loss of aortic elasticity and raised blood pressure. The elasticity of the aorta is linked to heart function and coronary blood flow.

In a Finnish study reported in the Annals of the Rheumatic Diseases, Dr. Maarku Heliovaara of the National Public Health Institute in Helsinki and colleagues found that people who drank four or more cups of coffee each day had twice the risk of developing rheumatoid arthritis, compared with people who drank less coffee. Rheumatoid arthritis is an autoimmune disease in which the body’s defenses attack its own tissues, resulting in a chronic destruction and deformity of the joints. Smoking, high cholesterol, being overweight, and certain dietary factors also have been linked with a higher risk of the disease.

Too much caffeine also has been shown to raise women’s risk for incontinence. According to a report in the July 2000 issue of Obstetrics and Gynecology, women who drink more than four cups of brewed coffee a day—or consume a lot of caffeine from other sources, such as tea, cola, or cocoa—may be more than twice as likely to suffer incontinence from a weakened bladder muscle as women who consume less caffeine.

A study reported in the February 2002 issue of Diabetes Care, found that moderate consumption of caffeine reduced insulin sensitivity by 15 percent. The researchers also found that caffeine increased catecholamines, plasma-free fatty acids, and both systolic and diastolic blood pressure. The moderate consumption of caffeine caused a fivefold increase in epinephrine. Epinephrine increases the production of glucose in the liver and interferes with the ability of muscle and fat cells to use glucose.

Found in coffee, tea, and soft drinks, caffeine is the most widely used drug in the world. In the Western world, 8 out of 10 adults consume caffeine in some form.

Do yourself a favor—wake up to the negative effects of caffeine and avoid it.

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Written by Dr. Fuhrman’s colleague Jeff Novick, M.S., R. D. for the May 2003 edition of Healthy Times:

Recently, I was teaching a nutrition class and describing the adequacy of plant-based diets to meet human nutritional needs. A woman raised her hand and stated, “I’ve read that because plant foods don’t contain all the essential amino acids that humans need, to be healthy we must either eat animal protein or combine certain plant foods with others in order to ensure that we get complete proteins.”

I was a little surprised to hear this, since this is one of the oldest myths related to vegetarianism and was disproved long ago. When I pointed this out, the woman identified herself as a medical resident and stated that her current textbook in human physiology states this and that in her classes, her professors have emphasized this point.

I was shocked. If myths like this not only abound in the general population, but also in the medical community, how can anyone ever learn how to eat healthfully? It is important to correct this misinformation because many people are afraid to follow healthful, plant-based, and/or total vegetarian (vegan) diets because they worry about “incomplete proteins” from plant sources.

How did this “incomplete protein” myth become so widespread?

No small misconception

The “incomplete protein” myth was inadvertently promoted in the 1971 book, Diet for a Small Planet, by Frances Moore Lappe. In it, the author stated that plant foods do not contain all the essential amino acids, so in order to be a healthy vegetarian, you needed to eat a combination of certain plant foods in order to get all of the essential amino acids. It was called the theory of “protein complementing.”

Frances Moore Lappe certainly meant no harm, and her mistake was somewhat understandable. She was not a nutritionist, physiologist, or medical doctor. She was a sociologist trying to end world hunger. She realized that there was a lot of waste in converting vegetable protein into animal protein, and she calculated that if people just ate the plant protein, many more people could be fed. In a later edition of her book (1991), she retracted her statement and basically said that in trying to end one myth—the unsolvable inevitability of world hunger, she created a second one—the myth of the need for “protein complementing.”

In these later editions, she corrects her earlier mistake and clearly states that all plant foods typically consumed as sources of protein contain all the essential amino acids, and that humans are virtually certain of getting enough protein from plant sources if they consume sufficient calories.

Amino acid requirements
Where did the concept of “essential amino acids” come from? In 1952, William Rose and his colleagues completed research that determined the human requirements for the eight essential amino acids. They set the “minimum amino acid requirement” by making it equal to the greatest amount required by any single person in their study. To set the “recommended amino acid requirement,” they simply doubled the minimum requirements. This “recommended amino acid requirement” was considered a “definitely safe intake.”

Today, if you calculate the amount of each essential amino acid provided by unprocessed plant foods and compare these values with those determined by Rose, you will find that any single one, or combination, of these whole natural plant foods provides all of the essential amino acids. Furthermore, these whole natural plant foods provide not just the “minimum requirements” but provide amounts far greater than the “recommended requirements.”

Modern researchers know that it is virtually impossible to design a calorie-sufficient diet based on unprocessed whole natural plant foods that is deficient in any of the amino acids. (The only possible exception could be a diet based solely on fruit.)

Pride and prejudice
Unfortunately, the “incomplete protein” myth seems unwilling to die. In an October 2001 article in the medical journal Circulation on the hazards of high-protein diets, the Nutrition Committee of the American Heart Association wrote, “Although plant proteins form a large part of the human diet, most are deficient in one or more essential amino acids and are therefore regarded as incomplete proteins.”1 Oops!

Medical doctor and writer John McDougall wrote to the editor pointing out the mistake. But in a stunning example of avoiding science for convenience, instead of acknowledging their mistake, Barbara Howard, Ph.D., head of the Nutrition Committee, replied on June 25, 2002 to Dr. McDougall’s letter and stated (without a single scientific reference) that the committee was right and “most (plant foods) are deficient in one or more essential amino acids.” Clearly, the committee did not want to be confused by the facts.

Maybe you are not surprised by this misconception in the medical community. But what about the vegetarian community?

Behind the times
Believe it or not, an article in the September 2002 issue of Vegetarian Times made the same mistake. In a story titled “Amazing Aminos,” author Susan Belsinger incorrectly stated, “Incomplete proteins, which contain some but not all of the EAAs [essential amino acids], can be found in beans, legumes, grains, nuts and green leafy vegetables.... But because these foods do not contain all of the EAAs, vegetarians have to be smart about what they eat, consuming a combination of foods from the different food groups. This is called food combining.”

A dangerous myth
To wrongly suggest people need to eat animal protein for nutrients will encourage them to add foods that are known to contribute to the incidence of heart disease, diabetes, obesity, and many forms of cancer, to name just a few common problems.

 

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Written by Dr. Fuhrman’s colleague Jeff Novick, M.S., R. D. for the January 2003 edition of Healthy Times:

The most powerful anti-aging tools available are diet and exercise. It is fair to say that just about everyone is looking for the fountain of youth—the secret to longevity. But most of us are not just looking for a long life, we want a long healthy life. After all, what’s the purpose of living long if you can’t enjoy it?


These days, we are bombarded with product after product promising to be the fountain of youth. There are even claims that aging is a disease that can be “cured.” Advertisers say that aging is caused by a decline in certain hormones (such as melatonin, testosterone, human growth hormone, DHEA, and a host of others).They say that if you just take these hormones (which are very expensive), you can stop the aging process. People are running to them in droves and spending huge amounts of money on them.

But is aging caused by a decline in these hormones? Or is the decline in hormones a normal part of the normal aging process? Here is what a few experts on longevity had to say about the subject. The PBS television show, “Closer to Truth,” is a series of discussions by leading scientists on the fundamental issues of science. Segment 108 dealt with the question, “Can you really extend your life?” The host of the show was Robert Lawrence Kuhn, Ph.D., and the panel of experts featured Roy Walford, M.D., professor at UCLA Medical School and author of The 120-Year Diet and The Anti-Aging Plan; W. French Anderson, M.D., Director of the USC Gene Therapy Laboratories and known as the “Father of Gene Therapy”; Arthur S. De Vany, Ph.D., professor of economics at University of California at Irvine and the author of Evolutionary Fitness; Sherwin Nuland, M.D., clinical professor of surgery at Yale University, where he also teaches medical history and bioethics, and author of the bestselling books, How We Die and How We Live; and Gregory Stock, Ph.D., Director of UCLA’s Program on Medicine, Technology, and Society, where he focuses on genetic engineering.

Drawing on all of the expertise and experience of this panel, it would be reasonable to expect that they would reveal a multitude of chemical, biological, and technological advances that might enhance longevity. But their recommendations were entirely physiological. They did not recommend any new products or technologies, but stated, in essence, that our longevity is entirely up to us. Here is what they recommended:

Eat a plant-based diet that is low in calories but high in nutrients; take low-dose supplements; exercise vigorously and regularly; and stay mentally and physically active.

Sound familiar?

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Dr. Fuhrman's colleague Dr. Steven Acocella, MS, D.C., DACBN, Board Certified Clinical Nutritionist, American College of Lifestyle Physicians, and a Diplomat of the American Clinical Board of Nutrition, discusses the Atkins low-carb high-fat diet-style:

The following case histories are presented to explicate some of the many risks associated with a high fat, high animal protein, low carbohydrate Atkins diet style. I have added background and ancillary information as well as an editorial discussion to aid in the understanding of these cases.

Atkins Case History: Kathy Barnett
Kathy was a healthy 16 year old teenage girl. She had no medical problems and was active and thriving. Like many teens, especially girls, she struggled with excess weight and body image. She decided to peruse the Atkins diet to lose weight. She stood 5 feet 8 inches tall was nearly 200 pounds when she began dieting. Based upon the low-carbohydrate strategy, her diet correctly consisted primarily of meat and cheese. She ate with regularity and did not fast.

A few weeks after beginning the diet, this otherwise healthy girl suddenly and unexpectedly collapsed [1]. Paramedics were dispatched to her high school to render care. Upon their arrival Kathy had no pulse and was not breathing. The electrical activity of her heart evaluated by paramedics revealed that she was in ventricular fibrillation, an exceedingly unusual finding in such a young patient. Inexplicitly, Kathy was in cardiac arrest at 16 years of age. Despite their best efforts, including CPR and defibrillation, paramedics were unable to revive her.

Discussion
At autopsy examiners could not find any underlying condition that could contribute to or explain her sudden and tragic death. No genetic or anatomic abnormalities of her heart or other organs were found. Kathy had no history of any heart or respiratory related problems. She had no prior complaints or symptoms that could be attributed to nutritional disturbances such as electrolyte or nutrient imbalances. Kathy was not only a medical tragedy but a medical mystery as well. But that was until Dr. Joseph Tobias and his colleagues at University of Missouri, Department of Child Health studied her case.

In an article appearing in the Southern Medical Journal, Dr. Tobias and his team reported on this case and proffer a cause and effect connection between Kathy's untimely death and her lethal diet. The article, titled Sudden Cardiac Death of an Adolescent During Atkins Dieting, focuses on the potential development of a fatal physiological disturbance inherent in this type of diet [1].

Information provided by Kathy's mother confirmed that her daughter was compliantly on the carbohydrate restricted diet long enough to be in ketosis, the metabolic result of relying on dietary fat to meet the body's energy needs. This is likely where this young girl's fatal medical problem began (Atkins refers to this as the 'induction phase').

Russell and Taegtmeyer demonstrated that active heart muscle relying on ketones for energy lost 50% of contractile function in a matter of hours [2]. Other studies have revealed the development of serious and fatal cardiac arrhythmias resulting from high dietary fat consumption [3, 4].

The most compelling finding in this case may provide the medical smoking gun that clearly implicates the Atkins diet as the cause of Kathy's sudden cardiac death. Electrolytes are micronutrients that are essential for many bodily functions. Critical to normal heart rhythm is the electrolyte potassium. But ketones also use potassium to enter the kidney for excretion. The more profound the state of ketosis the greater the depletion of potassium stores [5]. If there is a concomitant deficit of caloric intake, which leads to further depletion, a serious condition called hypokalemia (critically low levels of potassium) can result. Hypokalemia is directly associated with sudden cardiac death. During resuscitation efforts, when corrected for pH shift, Kathy's serum potassium was 3.8 mEq/L, a critically low level reflective of profound hypokalemia.

While is it difficult to establish an absolute nexus between Kathy's diet regimen and her untimely death a preponderance of all the aspects of the case raises an alarming index of suspicion. This is further supported by literature that reported an increased incidence of sudden cardiac death in patients on high protein diets [6]. The likelihood that the mortality in this case is directly related to this diet style was compelling enough for Dr. Tobias and his collaborators to warn against it in the conclusion of their presentation.

Atkins Case History: Jody Gorran
Jody was an active 50 year old when he decided to do something about his mid-life weight gain.7 He diet shopped and decided on the well advertised Atkins Diet. He liked that it was touted as the "no depravation diet" that excluded hunger, set not limit on the amount of food and included foods so rich that they are not included on any other diet [8]. At the time he had no other health problems other than being moderately overweight. In fact, Jody was compliant at having regular check-ups and screenings. In late December 2000, during a routine colonoscopy Jody also consented to a preventive cardiac CT scan (he had no history, symptoms or complaints of coronary artery or cardiovascular diseases). The results were excellent. Jody's plaque score was 0, no blockage of the coronary arteries. The reports reads, "Normal scan, no identifiable atherosclerosis with very low coronary vascular disease risk." Good news. Furthermore, his cholesterol levels were all well within the safe range at that time, these being - Total Cholesterol 153 mg/dl, HDLc 62 mg/dl, LDLc 81 mg/dl and triglycerides 42 mg/dl. Jody was in great cardiovascular shape with an excellent lipid profile and the CT scan to prove it. But this was all about to dramatically change.

Not long after beginning the Atkins Diet Jody had a repeat blood test. The results showed that he was in ketosis, a metabolic hallmark of one carefully abiding by the Atkins Diet. The lipid profile at that time was reported as: total cholesterol: 230 mg/dl, HDLc 65 mg/dl, LDLc 154 mg/dl and triglycerides 56 mg/dl. Jody had gone from maintaining a safe, low risk lipid profile to a dangerous, elevated risk profile [9]. Concerned about these results he consulted the Atkins Diet book and Atkins Website which addressed and allayed his fears. The Atkins literature reported that a few "fat sensitive" persons may develop a less favorable cholesterol level on a high fat [Atkins] diet. Jody read that, "less than one person in three falls into this [elevated cholesterol] category" And, although Atkins suggests eating leaner cuts of meat and "farmers cheese" as the solution, he states, "But if you're not happy [with these foods] don't bother with it; go back to the regular Atkins diet that you enjoyed more". [8] This is the Atkins advice rendered specifically to those who develop unhealthy cholesterol levels while on his diet. Relived by the supportive information from his nutritional guru, and pleased with the weight loss results thus far, Jody continued following the "stages" of the Atkins diet for another two years. In fact, a large quantity of his diet consisted of food products directly manufactured and marketed by Atkins, Inc.

In early October 2003, Mr. Gorran was not feeling well. For the first time in his life he began experiencing chest pain that was becoming increasingly severe. Jody consulted noted cardiologist Bruce Martin, M.D. in October of 2003. During his examination Jody's stress test was consistent coronary ischemia. The blood supply to his heart had become compromised. Dr. Martin scheduled an emergent cardiac catherization. The results were shocking. In less than three years Jody had gone from excellent cardiac health (zero blockages of the coronary arteries) to a critical 99% stenotic occlusion of the major coronary arteries. About two years after beginning the Atkins diet, according to Dr. Martin, Jody was on the brink of suffering a life threatening cardiac event. Mr. Gorran underwent immediate surgical repair to remove blockages, stent implantation and was prescribed several medications.

Noted in Dr. Martin's medical records is the recommendation to immediately and completely discontinue the Atkins diet. It specifies that, "Mr. Gorran has been advised to stop the Atkins diet because of the dangers of saturated fat allowed on this diet."[8] A few months following Jody's cessation of the Atkins diet his lipid profile returned to normal levels that were; total cholesterol 146 mg/dl, HDLc 53 mg/dl, LDLc 81 mg/dl and triglycerides 65 mg/dl.

Discussion
There is abundant, consistent scientific evidence that links excessive total dietary fat, cholesterol and saturated fat to dyslipidemia and the development of heart disease. The preponderance of an overwhelming amount of irrefutable data confirms that dietary saturated fat is especially atherogenic [9-14]. Because the Atkins Diet derives the majority of it's calories from animal sources the saturated fat content is extraordinary high.

Blood flow studies using myocardial perfusion imaging and echocardiograpy were preformed on subjects before and after starting the Atkins Diet. The study showed that blood flow to the heart diminished by an average of 40% after one year on an Atkins high fat diet. Serial blood studies also showed marked increased of inflammatory markers that predict heart attacks [15]. Another study did an intensive review of the Atkins Diet and concluded that the high fat content resulted in the progression of atherosclerosis [16]. Both studies are clearly consistent with the Atkins Diet and heart disease nexus reported in this case.

Dietary fat content of a typical menu by Robert Atkins, M.D. taken from Dr. Atkins' New Diet Revolution and a menu presented by Joel Fuhrman, M.D. in Eat to Live, The Revolutionary Formula for Fast and Sustained Weight Loss - an exemplary diet consistent with the consensus recommendations of the rational evidence-based scientific community [17-18], are in sharp contrast:

Per Day	Atkin's Menu	Eat to Live Menu
Total Calories	2550	1600
Grams of Total Fat	167	19
Grams of Saturated	60	2
Total Fat Calories	1530	171
Saturated Fat Calories	540	18
% of Calories from Total Fat	60	10
% of Calories from Saturated Fat	21	1

Clearly the total fat and saturated fat contained in the Atkins diet far exceed the daily intake recommendations cited by every reputable source. It is interesting to note that the fat calories alone for the Atkins Diet are about equal to the total calories for the Eat to Live Diet.

An extensive body of scientific literature supports the conclusion that the quantity of dietary fat consumption encouraged by Dr. Atkins is clearly atherogenic and that his diet is disease promoting. Additional long term prospective and retrospective studies will further evidence the significant dangers of the Atkins Diet.

Author's Comments
This well cited article is about more than the science behind it. These people trusted the promises and guarantees held out to them by a member of the medical nutrition community who continued to ignore the wealth of evidence-based dietary science. The books Kathy and Jody read and the infomercials they watched literally instructed them to disregard the warnings of hundreds of credible health professionals citing the dangers of the Atkins Diet. And these cases are neither anecdotal nor isolated, they're representative. The only conclusion that can be drawn regarding the motivation to promote a diet that thousands of pages of data consistently expose as disease promoting is that it's a pursuit that places profits over people. If a prescription drug is administered to a million patients and it results in the death of a just a few, physicians stop prescribing it and manufacturers stop making it. How many case histories about fatal heart attacks, cancer, kidney failure, stroke and other diseases directly attributable to high fat diets are published before Dr. Atkins' New Diet Revolution is finally pulled off the shelf? If their camp were smart they would place a black box warning right on the covers of Atkins' books to attenuate the torrent of litigation that they're undoubtedly headed for; but what ever defensive steps they take, my expert opinion will prevail. If I could write directly to Dr. Atkins I would send him at note that simply read: Kathy Barnett: 1985 - 2001.

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Dr. Fuhrman's colleague Dr. Steven Acocella, MS, D.C., DACBN, Board Certified Clinical Nutritionist, American College of Lifestyle Physicians, and a Diplomat of the American Clinical Board of Nutrition, discusses a popular supplement:

An herbal extract of the Hoodia gordonii cactus was found to be useful in quelling the thirst and hunger pangs of desert nomads during times of famine. The proposed mechanism, according to Dr. Richard Dixey, a spokesperson for Phytopharm Pharmaceuticals, who heads a research team efforting the synthesis of P57, the appetite suppressing component of the plant, explains how it works:

"There is a part of your brain, the hypothalamus. Within that mid-brain there are nerve cells that sense glucose sugar. When you eat, blood sugar goes up because of the food, these cells start firing and now you are full. What the Hoodia seems to contain is a molecule that is about 10,000 times as active as glucose. It goes to the mid-brain and actually makes those nerve cells fire as if you were full. But you have not eaten. Nor do you want to."

Pretty impressive sounding stuff, but does it work? That depends on whom you ask. Naturally, any advertisement is filled with glowing endorsements. But there is only one published, peer-reviewed scientific evaluation of P57 and that was preformed on rats. This study concluded that there was evidence of drug-induced anorexia using the extract from Hoodia1. But before you run out to the health food store consider a few facts of this study. The study was conducted on rats whereby researchers injected huge dosages of P57 directly into the brains (hypothamus) of the animals and then observed their eating behaviors for several days (apologies to PETA). To date there are no credible published human trials. Basing the use of any product on a single animal trial and purely anecdotal information is risky.

Remember, the well known Leptoprin commercial, the "when is a diet pill worth 153 dollars a bottle�when it works" people? In it they state the effectiveness of their product is "backed by two major scientific clinical trials," what they don't tell you (and don't have to tell you) is that its effectiveness has also been debunked, refuted and disproved by 50 other clinical trials! It's up to us, the consumer, to do our own research.

Taking any substance that has not been thoroughly evaluated, or in which studies yield inconsistent or irreproducible results is a poor choice. Professionally I could never recommend, and personally I would never use, anything for which the credible scientific community has not reached a positive consensus. I don't experiment on my patients and I don't rely on social proof.

Smoke and Mirrors Weight Loss
The use of this substance as a weight loss aid really comes down to how you view health. The larger question we need to ask here transcends assessing if Hoodia is safe and effective, if it really works or is it is a scam. If we are desirous of losing weight and improving our health consider this:

Many of the Hoodia manufacturers boast that their product is safe because it is not a drug. And according to the Food and Drug Administration they're right; but relative to what Hoodia actually does in the body (if it really works) they're wrong. Hoodia is not a drug by FDA standards simply because it has not been approved by them (the FDA) to be "safe and effective in the treatment of aliments or conditions." Any substance that has been isolated, concentrated and ingested for the intent of producing a physiological response is a drug. I don't think anyone could have a problem with my definition here. With that said, during my pharmacology clerkship the first thing that my professor said is that every drug, no matter how trivial or potentially lifesaving has damaging negative side effects on the body that always accompany its intended beneficial use. There is always a 'health-tax' to pay with taking any substance. It's the nature of biochemistry and all drugs have negative side effects, no exceptions.

Okay, so let's say a thousand years of Hoodia use by the San tribesmen in the Kalahari Desert have got to give this stuff credibility, their Shaman can't be wrong, and it actually works well. Consider some potential negative side effects specific to taking Hoodia. Hoodia is said to suppress thirst as well as hunger. People taking it run the risk of dehydration which can lead to the development of kidney stones and other fluid related problems. More importantly, specific to weight loss, taking it over time it will do nothing to increase metabolism so you won't burn more calories at rest; as a good aerobic training regime will do for you. So, as soon as you stop taking it the body will go into a highly efficient fat-storage mode and store even more fat at an accelerated rate, the old diet rebound "yo-yo" syndrome. This phenomenon has been seen with every magic diet pill ever used. You've not changed any metabolic set points by taking Hoodia and your brain wants those stored calories back, big time. And, if you just continue taking it, it's possible that you'll begin to lose lean body mass and weight loss at that point can become deceptive and dangerous.

Also, what about those reduced calories you do take in? If you're on a reduced calorie diet style and in caloric deficit (the only way to lose weight) then you'll have to pay very close attention to what you eat to maintain excellent nutrition. A diet that does not contain the full complement of antioxidants, phytochemicals and other micronutrients and the right macronutrients (fat, carbohydrates and proteins) is disease promoting. If you've reduced your caloric intake 40% by using this substance then you'll have to get all of your nutrition from 60% of the amount of food you normally eat.

The problem is that the vast majority of Americans are already not getting nearly enough of the life-extending, health maintaining food elements eating 100% of their present calories to begin with! More food, or rather more higher quality food, not less low quality food is a much better way to get the appetite centers in the hypothalamus to cooperate and to lose weight. "Turning off" hunger can be achieved by not only the caloric component of food, but the bulk volume and nutrients present in the food as well. So, you can "suppress" (or better yet satisfy) your appetite with lower calorie, higher nutrient-dense foods and at the end of the day you've not only controlled your appetite, reduced your calories (and therefore weight) but you've also improved your nutritional status. Now we're talking!

Gee, what foods have all the following attributes at the same time?

A. High bulk, like lots of healthy fiber
B. Are extremely rich in nutrients
C. Are also much lower in calories

If you don't know the answer to this food trivia question we have a lot to talk about!

When it comes to Hoodia or any other quick fix medical breakthrough�flavor of the month diet pill�we just don't get something for nothing and there's always a price to pay. The arsenal in the war against being over fat and against obesity has got to include more than just weight loss; weight loss by itself does not necessarily equate to improved health. I regularly consult with patients that have lost large amounts of weight and are very unhealthy. What's the point of losing a bunch of weight only to develop some other diet-related morbid condition? Any change in body weight, up or down, should always result in an elevation of health and clearly this is not always the outcome of change, the scientific journals are full of such cases. I have seen several patients that have resorted to bariatic surgery (stomach stapling) and lost nearly 100 pounds each and are enduring tremendous nutrition-related health problems. And the damage I seen in victims of the Atkins weight loss scheme could fill volumes, but that's another article. A diet rich in Phen-Phen and Red-Bull can pretty much guarantee you rapid weight loss but it can be a bit hard on the system. Using some gimmick to fool the body to lose weight can result in the perfect body�corpse-weight! Write that down.

The smoke and mirror weight loss results you get from taking herbs and other diet drugs might win the battle short term but because it doesn't result in elevated health we still lose the war. Clearly Hoodia will not improve our nutrition and can further compromise our health over time. The only possible way it might be useful is if we were to learn how to eat healthfully while taking it, but if you learned how to do that you wouldn't need Hoodia anyway. Trust me; I see real weight loss success every day.

Allow me to leave you with the words of that pop-culture icon and high profile celebrity promoter of Hoodia, Anna Nicole Smith: "Hoodia works; it's the new miracle diet pill that aids in weight loss by suppressing appetite!"

Sorry Anna, we're not buying and neither should you. Now, how about you get with the program and go get a copy of Eat to Live by Dr. Fuhrman.

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Following is written by Dr. Fuhrman's colleague Dr. Steven Acocella, MS, D.C., DACBN, Board Certified Clinical Nutritionist, American College of Lifestyle Physicians, and a Diplomat of the American Clinical Board of Nutrition:

A young university pre-med student was called from class one day. It seems that unexpectedly and without warning, or even prior symptoms his dad had collapsed on their kitchen floor and was rushed to the emergency room; his dad had had a major heart attack.

At the hospital several hours later, with his father fortunately in stable condition, the son and his mother spoke about what to do "if dad makes it though this". Anxiously, his mom suggested that the son place a call to her doctor, whom she had been seeing for many years and trusted implicitly. And, this doctor was a cardiologist, so what could be better?

Calling directly from the hospital the son was able to get the doctor on the phone. They spoke at length about his dad's sudden and near fatal heart attack. What the son sought most from this kind hearted and concerned physician was advice and guidance. The son wanted to make sure his dad would recover and would never have to endure such suffering again.

The supportive doctor spoke of all the right medications, tests and about lowering his father's stress level at work. The son remembers learning the word "prognosis" that day. When the son specifically asked about diet (he told him dad had always loved barbeque and bacon) the cardiologist assured him that any connection between heart disease and food is a complete myth and that his dad's diet was fine. The doctor went on to tell the son that even if there was a connection between diet and heart disease it wouldn't help to change anything this late in his father's life. At that time his father was 53 years old. The son appreciatively took the advice from this very successful M.D. and dutifully passed it along to his parents.

Twenty-five years later the dad is still alive. He's 79 years old. In the past 20 years he has remarkably survived 5 subsequent heart attacks and a triple open-heart by-pass surgery! The mom is still alive too. She's 72 years young, but severe obesity has left her totally wheelchair bound. Both his mom and dad remain loyal to and follow the advice of their beloved doctor, even today. Their loyalty is a bit surprising considering each of their own maladies.

Well, at least they're both still alive and the family remains close. And as for the son, he knows a lot more now than he did that day in the emergency room. After completing his Master of Science degree in Human Nutrition he went on to become a doctor. In fact, the son has dedicated his professional career to the prevention and recovery of heart disease and other killers like diabetes and cancer through nutrition. Although he has become vehemently opposed to the brand of advice the kind cardiologist gave him so long ago he still does his best to help his parents with their unfortunate health problems. But sadly, despite the son's successes with his own patients, his parents remain set in their ways; they still recite their beloved doctor's rhetoric every time the concerned son tries to help.

The nice cardiologist on the phone that day in the emergency room was Dr. Robert Atkins, and that concerned son was me.

This is part of a weeklong review of the popular Dr. Atkins high-protein low-carbohydrate diet-style. Throughout the week DiseaseProof will examine:

• How a High-Protein Diet Works
• Increased Risk of Cancer Associated with The Atkins Diet
• Short and Long-Term Dangers of High-Fat Diets
• What Happens When You Tell the Truth About Atkins

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Written by Dr. Fuhrman's colleague Dr. Steven Acocella, MS, D.C., DACBN, Board Certified Clinical Nutritionist, American College of Lifestyle Physicians, and a Diplomat of the American Clinical Board of Nutrition.

As of January 1, 2006 a new law requires food manufacturers to list the amount of trans fat contained in their products. This is the first major addendum to the Nutrition Facts packaging label since its inception in 1993. Although the manufacturing process of trans fat was originally discovered over a hundred years ago its large-scale use by the food industry began in the late 1970's and early 1980's. During that time an alarming body of scientific evidence emerged directly linking saturated fats, like lard, tropical oils and butter to vascular disease, heart attack and stroke. The food industry scrambled to offer a healthier alternative to the vilified saturated fats and embraced trans fats as the answer. Many of us remember the 'I Can't Believe It's Not Butter' ad-campaign. In addition to the marketing boom touting the healthier trans fat containing products the food industry enjoyed further economic benefits from the greatly enhanced shelf life of foods made with solid trans fats (just look at the expiration date on a Twinkie); this fostered even more extensive use of hydrogenated oils. But the benefits of this bit of food magic would be short lived.

Although very small amounts exist in nature, trans fat is almost exclusively a product of the laboratory. Through a process called hydrogenation, less health-offensive fats like those in vegetable oils are exposed to high pressure and temperature and bombarded with hydrogen gas. This processing changes the chemical structure transforming the oil into a waxy, gooey solid. But science leaped too quickly from the laboratory to our kitchen when it starting serving up this gunk. Research in the early 1990's uncovered that trans fat not only raises LDL (bad) cholesterol in the same way as saturated fat, it also lowers HDL (good) cholesterol. Furthermore, emerging science has shown that the altered chemical structure allows our bodies to more easily oxidize trans fat, an important step in the formation of artery clogging plaques. One example of the serious negative health effects of trans fats in our diets comes from the Walter Willett Nurses Study (Professor of Medicine, Harvard Medical School). The study of 80,000 women concluded that a mere 2% increase in dietary trans fat consumption increases a woman's risk of heart disease by 93%. Recently the FDA Food Advisory Committee voted in favor of recommending that trans fat intake be reduced to less than 1% of total caloric energy. This amounts to less than 1.5 g per day for a standard 1500 calorie diet.

Trans fat is lurking everywhere. It is extensively used in baked goods like crackers, cookies, pastries and cakes and in fried foods like French-fries, breaded fish, chicken and shrimp. Snack foods such as popcorn, chips and chocolate are loaded with trans fat as are sauces and condiments. Trans fat turns even some brands of healthy foods like tomato sauce and vegetable soup into artery clogging goop. And the next time you proudly go for that healthy salad take a closer look at that white sludge you're about to smother it in. Most salad dressings are loaded with trans fat. And don't forget that trans fat is commonly used in the food service industry and restaurants don't list the nutritional facts for the foods they serve.

It's very important to note that the new Nutritional Facts label law has a major loophole in it. Food manufacturers were able to preserve language in the rules that allows them to advertise and label their products as "trans fat free" if there is "an amount less than or equal to .5 grams of trans fat per serving". This is called the non-reportable amount. The key here is 'per serving'. Very often a serving size (an amount which is subjectively determined by the manufacture) is a much smaller portion then we realistically consume. For example, a popular 'trans fat free' golden cracker snack lists the per serving size of their product at "about 5 crackers". After the new law went into effect this particular manufacturer simply reduced their serving size to stay within the trans fat reporting threshold. There is actually .5 grams of trans fat in one serving. They just worked backwards and based their serving size on .5 grams of trans fat. The problem is that if you're like most of us, when you open that box and kick back with Jay Leno for some late night TV you're going for at least 3 to 5 servings. You'll be consuming an average of 2 grams (in excess of the FDA recommendation) of trans fat from a single snack that has a legal Nutrition Facts Label that clearly states - '0 Trans Fat'. What planet is this?

The new label law is confusing and misleading. Many American's will consume what they believe are healthier products because they are advertised as 'trans fat free'. But many of these products are loaded with equally unhealthy saturated fat or may have less than the reportable amount of trans fat per serving. The disease producing and aging effect of both trans fat and saturated fat is as clear as the link between cigarette smoking and lung cancer. Why try to calculate which one is the lesser of two dietary evils?

While the white coat geniuses at Kraft are back at the drawing board working hard on their next big chemical break though (like their last great invention, Olestra with its 'anal leakage' warning) I leave you with this simple solution to this dietary dilemma. The more calories you consume from natural foods the less you'll need to be concerned about processed food additives. Whole grains, fruits, vegetables, nuts, seeds and beans do not contain a list of unhealthy ingredients. And the last time I checked nature didn't need a nutrition label loophole.

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Written by Dr. Fuhrman's colleague Dr. Steven Acocella, MS, D.C., DACBN, Board Certified Clinical Nutritionist, and a Diplomat of the American Clinical Board of Nutrition.

Excess weight, especially in middle age dramatically increases the risk of developing heart disease, stroke and other morbid conditions even in the absence of more established indicators of risk such as smoking, high cholesterol and high blood pressure.

A new study published in the Journal of the American Medical Association (JAMA) concludes that excess weight itself puts people at greater risk for significant health problems. This massive study followed over 17,000 men and women ages 31 to 64 over an average of 32 years. Each participant was assigned to one of 5 groups based upon risk factors independent of weight that included past or present tobacco use, elevated blood pressure and elevated cholesterol. The low-risk group never smoked and had normal cholesterol levels and blood pressure. The moderate-risk group didn't smoke but had either slight elevations in cholesterol or blood pressure. The intermediate-risk group had either high cholesterol, high blood pressure or currently smoked. The elevated-risk group and high-risk group had any 2 or all 3 three of these risk factors, respectively. The results were alarming.

The incidence of cardiovascular disease, stroke, heart attacks and diabetes were observed as well as hospitalizations and deaths related to these conditions. The body mass index (height to weight ratio) was calculated for each participant and compared health status to BMI for each group. The study evidenced that individuals with no cardiovascular risk factors as well as for those with 1 or more risk factors who were overweight in middle age had a significantly higher risk of hospitalization and mortality from heart disease, cardiovascular disease, and diabetes than those who were of normal weight. In fact, the risk of death from heart disease was an ominous 43 percent higher within the low-risk group (no risk factors) for overweight and obese individuals as compared to those of normal weight.

I often hear overweight people proudly stating that their cholesterol numbers and blood pressure readings are normal intimating that in some way their weight is less of a problem. I have literally had patients say that although they know they're overweight it's "OK" because their cholesterol is fine. Not fine. This perception may grant some overweight people a false sense of security when it comes to their health. This fool's paradise is often fostered by the barrage of drug commercials, other media messages and even uninformed health professionals that overemphasize some risk factors while understating the importance of attaining a healthy weight, especially in middle age.

This important study clearly demonstrates that just because those lab results are great, excess weight alone puts you at almost double the risk for an untimely death.

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