Food Over Medicine (10 page)

GM:
Which brings us to another high-fat, high-protein, zero-fiber, low-carbohydrate animal food: dairy.

PP:
I think that’s the most toxic of all. When I give lectures, I get asked, “If I were going to do one thing and one thing only, what would you suggest I do?” Well, one change alone won’t do the trick if you’re eating the standard American diet. But if you’re going to make an important first step that would improve your health, get the dairy out of the diet. Dairy products have no upside. On the downside, dairy proteins have been linked to asthma, allergies, chronic constipation, chronic ear infections in children,
^42
,
43
multiple sclerosis,
⁴⁴
autoimmune diseases, breast cancer, prostate cancer,
⁴⁵
and osteoporosis.
⁴⁶
The likelihood that a genetically susceptible child consuming dairy products will develop juvenile diabetes is actually greater than the likelihood of a smoker developing lung cancer.
^47
,
48
,
49
That’s kind of hard to wrap your arms around when you think about it, particularly since our government actually promotes the consumption of dairy products by children.

GM:
People who follow the federal dietary guidelines, the ever-changing pyramids and plates that the United States Department of Agriculture (USDA) spends untold millions revising, believe they’re eating a balanced diet. Are they so wrong in believing that their diet of fruit and vegetables and grains on the one hand, and dairy and eggs and meat on the other hand, is at least balanced?

PP:
Only in the sense that it can lead to a balanced need for various types of medical interventions. Here’s something I’ve observed: a family of four people sits down to eat dinner in a restaurant and there’s absolutely nothing on the table they’re eating that I would put in my mouth. You have one person eating a cheeseburger and fries. The next is eating chicken and cheese quesadillas. And the next one is having a spinach quiche. The last one is having a turkey sandwich. They’re all drinking sodas and lemonade. This is the whole family’s dinner. It would probably be heartily endorsed by the USDA and there’s not a single worthwhile, nutritious thing on the table. They just have no idea that the meal they just spent fifty or sixty bucks on is worth nothing nutritionally. “Oh, cheese is good for your bones, the chicken is lower in fat than the beef, and the fries must be better because they’re housemade. Oh, and it’s Diet Coke.” They use all this ridiculous criteria to justify the choice of these foods and believe that they’re doing reasonably well, but it’s all just horrible.

GM:
Beyond animal foods, there are other sins in the standard American diet.

PP:
There’s the fat content in general, but what makes it really horrendous are the oils; people cook with oils, packaged foods and baked goods contain oil, salad dressings are full of oil, and restaurants overuse it. So people consume enormous amounts of oil and fat in the diet. And enormous amounts of plain junk foods.

GM:
What about sugar and sweets?

PP:
Well, I always tell people that we can’t vilify individual constituents because it’s the pattern that makes the difference, but sugar is just empty calories and is also addictive. I don’t know very many people—I can think of a handful—who can be around sweets without eating them. I personally don’t like those people. I’m very envious of them because if it’s in front of me, I want to eat it. Dr. Neal Barnard, in his book
Breaking the Food Seduction
, writes that there are studies that have shown that the effect of sugar on the dopamine receptors of the brain is very similar to the effect of drugs like heroin and cocaine on those dopamine receptors. Most people don’t understand when they buy this stuff at the store that it has a highly addictive quality and that they’re going to want more and more of it.

Not only do sweets not provide any nutritive value, and one could argue that they’re destructive to health in terms of elevating blood sugar levels and suppressing immune function, but they displace healthy foods in the diet. If someone eats eight hundred calories’ worth of cookies and brownies in a day, that’s eight hundred calories that aren’t going into sweet potatoes and vegetables and rice and other foods that would actually have some protective value.

The other thing to remember is that these refined sugary foods elevate triglycerides. And triglycerides are blood fats waiting to cause mischief. Triglycerides and cholesterol will go down when you get rid of all that refined and processed sugar-filled stuff.

GM:
Now, is there anything wrong with buying a box of crackers, whether it’s something like Ritz crackers, or even crackers you might see in a health food store made with whole wheat flour and organic sesame seeds and so forth?

PP:
There’s definitely something wrong with the Ritz crackers. The top ingredients for your regular, store-bought cracker brands, the ones that most people would know about, are sugar, white flour, and some type of fat. This is just absolutely junk food. There’s no nutritive value to it; you don’t want to buy it. When it comes to crackers in a health food store, you can find a few that don’t contain oil. However, any type of processed food like that is going to be calorie-dense. You really don’t want to be filling your diet with calorie-dense food.

I don’t completely abstain from eating crackers, but they’re not a staple of my diet. I like fat-free hummus; I use it for vegetable wraps, but I also like to eat it as a dip. Now most people would dip crackers in it; I dip mushroom slices, sliced cucumbers, carrots, and things like that in the hummus. They’re much better for you than crackers. If I were having a party this weekend, I might have some crackers, but I’m working alone this weekend, so I’ll be dipping my mushroom slices in the hummus.

GM:
Okay, let’s talk about fatty plant foods. Let’s assume you’re eating these foods in their whole state. Avocado—anything wrong with that?

PP:
Well, there’s nothing wrong with any of these foods for a relatively healthy person. Avocados, nuts, seeds, olives—I love them. What I tell people is that they don’t want to be going out of their way to consume them, though, because they can end up eating a diet that’s quite high in fat with those foods. Our Chef Del is a good example. On a totally vegan diet, he ate himself to 475 pounds.

GM:
What the heck was he eating?

PP:
High-fat plant foods, fried food, baked goods … Del used to eat lots of avocados and almonds by the handful. Now he’s lost half of himself. I want to make that clear; he’s done a great job since he’s been here. So my rule is that I eat these fatty plant foods when they occur in a dish, but I don’t go out of my way to eat them. A restaurant near my house makes black bean wraps and the chef puts slices of avocado in them; I eat that. We have a dish here called vegetable byriani that has almonds in it; I eat that. But I don’t buy avocados at the store and put them on all of my salads. Nor do I have a bag of almonds at my house to nosh on because these are densely caloric, high-protein, high-fat foods. I tell everybody I could easily be a three-hundred-pound vegan. I’m at a healthy weight because I minimize this kind of stuff in the diet.

GM:
What about coconut? I’ll go into a health food store and there will be all these raw desserts, these supposedly healthy alternative desserts. However, they have so much coconut in them that they’ll have eighteen grams of saturated fat. Is coconut as unhealthy as it appears to be?

PP:
Absolutely. It’s full of saturated fat. Now, having said that, I love it. If you told me I could never have coconut again, I might have to end my life. So I don’t want to give it up, but I’m very clear that it’s a treat. Raw food desserts and raw food dishes in general are very high in fat. They often accomplish the textures they desire by using really high-fat foods.

This issue of food-versus-treat is something we just have to drive home. On the one hand, we certainly don’t want people to think they’re making a sixty-year commitment to never having dessert, birthday cake, or wedding cake, etc.; that’s not going to fly. Nor do we want people stressing out thinking they blew the diet. That’s a bad idea. On the other hand, this stuff can’t be part of the daily fare. We need to make the whole foods our daily fare and make the treats occasional. And this is something that people get into all the time: “Well, what do you mean by occasional?” And I tell them it should be situational. Do we have a reason for having this item that is not part of the daily fare? If you graduate first in your class, a glass of champagne is okay. But today’s Tuesday, it’s a pretty normal day, we’re not celebrating anything around here, so I think we ought to just eat our beans and rice and vegetables.

GM:
On the subject of plant foods that you have to watch your intake of, what about dried fruit?

PP:
There are two issues with dried fruit: First, it’s high in calories. You can sit down and eat half a bag of dried apricots pretty easily. Just think about how many calories you consumed. It’s like eating three dozen apricots, which you would never do. Second, you have to make sure the dried fruits you’re buying aren’t adulterated. There are lots of sulfites, coloring agents, and sugar in many dried fruit products. Any time you buy cranberries that taste good right out of the package, you know that they’ve had sugar added to them because cranberries are actually sour. Be careful when you buy dried fruits; you don’t want to be eating a lot of that stuff. Again, I’ll eat it when it’s in a dish. Del makes a great salad here that has raisins in it, or I’ll put raisins on my oatmeal every so often. But I’m not eating handfuls of dried bananas, dried apples, dried pineapples, that kind of stuff.

GM:
How about fruit juice?

PP:
Never.

GM:
Okay, what’s wrong with fruit juice?

PP:
It’s concentrated calories and sugar. Instead of drinking apple juice, eat apples; instead of orange juice, eat oranges.

GM:
What about salt?

PP:
Well, now we get into a contentious issue. Salt restriction is one of those things that became part of the conventional wisdom; we’ve been told it’s necessary for people to restrict salt in order to have normal blood pressure.

Early in my career, I heard Dr. McDougall buck the establishment by saying that salt restriction is not only inadvisable but may be detrimental. I got curious about it, so I reviewed the studies that had shown that salt restriction was beneficial; the difficulty was that salt restriction is usually accompanied with other dietary changes. The famous DASH (Dietary Approaches to Stop Hypertension) diet, promoted by the USDA to lower hypertension, is probably the best example of this. The participants of the DASH study were eating more fruits and vegetables, less animal foods, higher fiber, and less salt.
⁵⁰
I don’t think we can attribute the improvement in their health to the salt restriction alone, when people were making so many other changes to their diet at the same time. I just really could not find a lot of clear evidence that salt restriction was important. On the other hand, according to the 2007 National Health and Nutrition Examination Survey, which included almost one hundred million adults, people who eat more salt have a lower risk of death from heart attack and stroke.
⁵¹
There are many populations on the planet that eat a lot more salt than we do that enjoy great cardiovascular health.

GM:
Is Japan one of those?

PP:
Japan is one of those, yes. And parts of China.

We’ve used salt to cure and flavor food for centuries. I don’t think we can attribute our current epidemic of hypertension to salt. The bottom line is this: when you adopt the diet that we recommend, your consumption of salt is going to ratchet down quite a bit because you’re not going to be eating processed meats and as much packaged foods as you were before. And another very important thing is going to happen, too—your consumption of other minerals and nutrients like potassium will go up. I think that one of the issues is the ratio of salt to other nutrients, particularly potassium, in the diet, so you’re going to experience salt reduction. Also, if you salt your food at the table instead of in the cooking process, you’re going to use less salt, and I think that’s a good idea. In any given year, we end up with half a dozen people here who have to restrict because they really have some salt sensitivity; their blood pressure goes up when they eat salt, and it goes down when they don’t.

GM:
So you’re not denying that that relationship could exist?

PP:
Oh, it does exist. But as public policy, what we’re doing is restricting millions of people to try to help a handful who need the restriction.

GM:
Aren’t we salt-restricting millions of people primarily because of their blood pressure?

PP:
Well, yes, but they don’t need to be restricted.
⁵²
In other words, if they lost weight and they ate a plant-based diet without salt restriction, their blood pressure would come down naturally, without restricting it overtly. If you look at the mechanism of action for high blood pressure, a lot of it is related to damage to the endothelial tissue. If the endothelial cells can’t produce nitric oxide, which is a vasodilator, the vessels start to close a little bit. Add in a little arterial plaque and the lumen in the vessels start to narrow even more; essentially, you’re trying to force more blood through narrower arteries. That’s the recipe for high blood pressure. Well, when you put people on a low-fat, plant-based diet, the plaque deposits stop forming and the narrowing of the lumen of the blood vessels isn’t happening anymore. We stop assaulting the endothelial tissue and it starts to regenerate; it begins to produce nitric oxide and opens up those blood vessels. It’s amazing, over a period of time, how many people will have their blood pressure return to normal. Add in some exercise and take off a few pounds and most people will be able to get their blood pressure down without salt restriction.