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Authors: Joel Fuhrman

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Following a correct diet and exercise plan as a remedy should not be labeled alternative or complementary medicine. It is simply the way all properly educated doctors should be practicing. Everything else should be called malpractice medicine. Offering patients drugs and surgical interventions without informing them that, for most diseases, nutritional excellence and exercise are safer and more effective in the long run is not adequate informed consent to the use of medications. The risks of medicines are downplayed and their supposed benefits greatly exaggerated by a medical profession and drug industry who offer drugs as the panacea to all that ails us.

Most often alternative, or complementary, medicine offers the same treatment mentality as the physicians focused on dispensing drugs. Rather than dealing with the dietary and lifestyle factors that caused the condition, alternative physicians are also offering some magic in the form of an herbal pill or IV vitamin drip. Natural herbs or other modalities can sometimes offer similar effects as drugs. There are plenty of natural substances that have therapeutic effects, but they do not deal with the cause of the problem, so their benefits are limited. A diet-induced disease needs a dietary solution, not more treatment options. It is typical to find an alternative physician offering chelation, IV nutrients, hormones, and an expensive assortment of supplements and remedies while the patient remains fifty pounds overweight. Effective weight reduction will not be achieved. Remedies can change the expression of symptoms, but they never make patients well. They just cause people to become more dependent on doctors and their remedies. Physicians and consumers are quick to embrace doctor-recommended medical interventions while they ignore simple, inexpensive, and dramatically effective lifestyle interventions. Optimal lifestyle medicine would free these people from needing medical care. They need less and less therapy and medical intervention. This path of advice is not a moneymaker for the professional. There is no huge economic incentive to promote the basics of good health.

The problem with lifestyle medicine today is the varying opinions and dietary programs that are popular but not ideal. These in turn result in a few studies showing limited effectiveness—all of which help the current medical approach make its case for prescriptions.

Wouldn't it be simpler if we all could agree on one program? If there was one program that was most logical, most effective therapeutically, and beat out all the others when subjected to scientific scrutiny and long-term evaluation, it would change the health conversation radically, and all doctors and healers would naturally begin embracing such a protocol. I have been developing, teaching, and fine-tuning this program over the last twenty years. Studies continue to show it can meet any scrutiny and testing. It is ready for implementation and documentation. It works effectively for a surprisingly wide array of chronic diseases and does not have to be overly complicated. As we've explored, significant research already supports its use, and further research is presently in process. Test it for yourself, and you will be shocked with its effectiveness.

CHAPTER THREE

Standard American Diet Versus a Nutritarian Diet

When I started Dr. Fuhrman's program, I weighed 206 pounds and had had diabetes for seven years. His nutritional program enabled me to lose sixty-three pounds and get rid of my diabetes, high blood pressure, and high cholesterol without medication. My LDL went from 168 to 73 in five months (without drugs), and I am now maintaining my healthy weight of 143 pounds.

The most amazing thing is that my ophthalmologist had told me I required laser surgery to treat diabetic retinopathy. When I went back to see him again three months later, after eating the high-nutrient diet, he canceled the surgery because he found that damage to my eyes was no longer there.

I am extremely grateful because I know this life-saving information has added many quality years to my life.

—Martin Milford

M
ore than 85 percent of the SAD consists of foods from low-nutrient, high-calorie processed foods, animal products, dairy products, and sweets. These all contribute to excessive weight, high cholesterol, and high blood pressure, so it's no wonder we have an epidemic of diabetes. Natural plants such as vegetables and beans contain thousands of protective micronutrients, such as antioxidants and phytochemicals. When we eat a diet rich in colorful plant foods, we glean a full symphony of nutritional factors that enable better cell function and resistance to aging and stress.

What happens when we combine high-calorie foods without sufficient amounts of protective micronutrients? Cells become congested with waste products such as free radicals and advanced glycation end products (AGEs). The buildup of free radicals and AGEs in cells is sometimes called oxidative stress. It can lead to inflammation, cell damage, and premature cell death. AGEs are the critical toxins that cause nerve damage, blindness, and other complications of diabetes. They build up faster in people who eat low-nutrient junk food and also in diabetics with elevated glucose levels.
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When we gain weight, we not only produce more damaging toxic waste in our cells, but we also dilute our body stores of nutrients, lowering the micronutrient concentration in our cells. The simple key to a long, disease-free life is to weigh less and keep a high level of micronutrients in our cells. We need to be relatively thin but well-nourished with micronutrients.

The American diet contains very little nutrient-rich food. Overall, Americans consume 62 percent of their calories in processed foods and 25.5 percent from animal products. This is the crux of the problem. Both processed foods and animal products are deficient in antioxidants and phytochemicals.

We could not design a better plan to prematurely kill off our population. Only 10 percent of American food intake is from vegetables, beans, seeds, nuts, and fruits—the natural high-micronutrient foods that help prevent and reverse diabetes.

 

The secret: eating more nutrient bang for each caloric buck.

USDA Economics Research Service, 2005; www.ers.usda.gov/publications/EIB33; www .ers.usda.gov/Data/FoodConsumption/FoodGuideIndex.htm#calories

Much is known about nutrition and its power to create disease or protect against disease. But the unanswered questions for the majority of our population are: What constitutes a healthy diet? How do we know if our chosen diet is disease producing or disease protecting? What degree of dietary excellence makes a diet reverse a disease?

A nutritarian diet is not just about weight loss. It answers these issues with logic, math, and science. It gives individuals the ability to measure and intuitively judge the nutritional quality of their diets and discern whether it is adequate. What constitutes a healthy diet for a healthy person with good family history and no health problems? How do we design the right diet for those with multiple risk factors or a poor family history? What about people who are faced with serious health challenges? How should their diets be structured for maximum therapeutic effects?

 

A Nutrient Breakdown

There are two kinds of nutrients: macronutrients and micronutrients. Here's a simple definition of each:

 

•  Macronutrients are nutrients that supply the calories our bodies need for energy and growth.

•  Micronutrients are nutrients that appear in trace amounts in foods but are essential for health and growth and that do not contain calories.

 

There are four macronutrients in the foods we eat: water, carbohydrates, proteins, and fat. Because water is calorie-free, we will not consider it now. All the foods we eat contain some combination of the three calorie-containing macronutrients. If you eat too many macronutrients, you are overeating calories, which causes weight gain, chronic conditions, and premature death.

Yes, to lose weight and improve your health, you need to eat less fat, less carbohydrate, and less protein, reducing total caloric intake. But the secret is not to count calories to reduce calories. That never works. The secret is to focus on micronutrients. I know it defies logic, at first, but true health lies in a high-quality diet—eating foods packed with micronutrients.

Micronutrients are where the magic happens. These nutritional substances in the foods we eat don't contain calories, but they
do
contain the very nutrients that heal the body. Micronutrients are needed for your body to rid itself of waste, repair damage, and support normal day-to-day functions.

Micronutrients include fourteen vitamins and sixteen essential minerals known to be vital to human health, and the importance of incorporating them into your diet for overall health cannot be understated. Their impact on health is broad and vast. However, these vitamins and essential minerals, identified over seventy-five years ago, are just two types of micronutrients.

Phytochemicals are the third type of micronutrient and were identified more recently. The various kinds of phytochemicals are still being discovered, and a comprehensive list of their many functions has yet to be completed. In the last decade, we found that foods contain thousands of beneficial micronutrients in addition to the original vitamins and minerals discovered back in the 1940s. Now we know the major micronutrient load in food is not vitamins, not minerals, but phytochemicals. These substances pack a powerful punch. They function to improve human health and longevity. We found the fountain of youth, and it was right in front of our noses all along. There are tens of thousands of phytochemicals in natural, whole, vegetable-based foods. These plant nutrients are essential in helping protect you from disease. If you are already sick, they can help you recover.

All of these life-protecting and life-saving nutrients are found in whole foods. Vegetables, beans, berries, and seeds are particularly high in these nutrients. They are the key to optimal health as well as disease reversal and protection.

Remember my health equation:

 

H = N/C

 

This means your health is dependent on the nutrient-per-calorie density of your diet. The quality of a diet can be judged based on three simple criteria:

 

1. Its level of micronutrients (vitamins, minerals, and phytochemicals) per calorie

2. Adequate macronutrients (fat, carbohydrates, and protein) to meet individual needs but without excess calories that may lead to overweight or health compromise

3. Avoidance of potentially toxic substances (such as trans fats) or substances harmful in excess (such as sodium)

 

My health equation H = N/C expresses this simple concept of eating for micronutrient per calorie density. The foods with the highest micronutrient density have the most powerful therapeutic effect and are the most effective in promoting weight loss and reversing diabetes.

 

ANDI

The concept of micronutrient density is put into action by looking at an assortment of foods and analyzing the micronutrients they contain. I have ranked the nutrient density of many common foods in the table on page 49 using my Aggregate Nutrient Density Index (ANDI).
*
This index assigns scores to a variety of foods based on how many nutrients they deliver to your body in each calorie consumed. Each of the food scores is out of a possible 1,000 based on the nutrients-per-calorie equation. Because nutritional labels don't give you the information necessary to understand exactly what you are eating, these rankings do the equation for you and give you a sense of what foods score the highest. You can use this index to estimate the quality of your current diet or to plan for an improved diet. Using ANDI is simple—it is meant to encourage you to eat more foods that have high numbers and to eat larger amounts of these foods. The higher the number and the greater percentage of those foods in your diet, the better your health.

Because phytochemicals are largely unnamed and unmeasured, these rankings underestimate the healthful properties of colorful natural plant foods compared to processed foods and animal products. One thing we do know is that the foods that contain the highest amount of known nutrients are the same foods that contain the most unknown nutrients too. So even though these rankings may not consider the phytochemical number sufficiently, they are still a reasonable measurement of their content.

Vegetables clearly walk away with the gold medal—no other food is even close. So, of course, green vegetables have the best association with lower rates of cancer and heart disease. While the majority of most people's caloric intake is from the lower end of this table, people who move their consumption higher will substantially protect their health. And the recipes and meal plans in this book will help you reach this goal.

When you seek to consume a broad array of both discovered and undiscovered micronutrients via your food choices, you are a nutritarian. It is not sufficient to merely avoid trans fats or saturated fats. It is not sufficient for the diet to have a low glycemic index. It is not sufficient for the diet to be low in animal products. It is not sufficient for the diet to be mostly raw food. A truly healthy diet must be micronutrient rich, and the micronutrient richness must be adjusted to meet individual needs. Because the foods with the highest micronutrient- per-calorie scores are green vegetables, beans, colorful vegetables, berries, and other fruit, the consumption of enough of these foods is required to meet our micronutrient needs and to promote reversal of diabetes. Not only is it necessary to ingest a high enough absolute value of micronutrients, but the full breadth of micronutrient diversity is also needed for superior health. I call this comprehensive micronutrient adequacy CMA.

In diabetes research, the glycemic index (GI) of carbohydrates has long been recognized as a favorable aid for diabetics to control blood sugar. The same is now often the case in lipid research, as it has been demonstrated that high glycemic diets, rich in white flour, refined sweets, and processed foods are unfavorable to both glucose levels and lipid parameters.
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The GI is a ranking of carbohydrates on a scale from 0 to 100 according to the extent to which they raise blood sugar levels after eating. Foods with a high GI are those which are rapidly digested and absorbed and result in marked fluctuations in blood sugar levels. Low-GI foods, by virtue of their slow digestion and absorption, produce gradual rises in blood sugar and insulin levels, and they have proven benefits for health. Refined foods made from sugar and white flour are not only high-glycemic foods, but they are also nutritionally deficient and induce micronutrient loss. The glycemic load (GL) is the number that considers the glycemic index within a given serving of food and the actual calories of glucose produced, thereby making it more practical for calculating the overall blood sugar–raising effect of a serving, meal, or daily menu.

Those who advocate a high-protein (meat-based) diet, hang their hat on the low GI of animal products to explain the advantages of a diet rich in animal products and lower in vegetation. This view oversimplifies the multifactorial nuances of nutrition and results in a distorted understanding of nutritional science.

Ranking food on GI alone ignores many other factors that may make that food favorable or unfavorable. Because a carrot has a higher GI than a slice of bacon does not make the bacon a better food for a diabetic or heart patient. There are other important nutritional considerations besides GI, including the toxicity, micronutrient density, and fiber. Good examples of such nutritional nonsense include Dr. Barry Sears of the Zone Diet, who warns against the consumption of lima beans, papayas, and carrots because of their GI; and Dr. Robert Atkins, who excludes fruits and vegetables with powerful anticancer benefits from his diet.

BOOK: The End of Diabetes
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