Plant Based Symposium: Dr. Joel Fuhrman

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I don’t want to exclude people who don’t want to be vegans but instead incorporate them. I want to pull those people in to healthier eating and tell them if they don't want to give up their animal products, then they can use them as a flavoring or condiment in relatively small amounts, but still eat a diet whose vast majority consists of natural plants while recognizing that your animal products have to be held to minimal amounts. You can’t just do a paleo diet and think the more animal products you eat the better because that’s just poor science, it’s sloppy science, and it’s particularly irresponsible science. It’s irresponsible because we have too much data today, we have too many long-term studies on a large number of people that demonstrate how dangerous those diet styles are.

I’ve been a board-certified family physician for more than 25 years. I decided to go to medical school because I had a passion for nutritional science and wanted to use nutritional excellence as the cornerstone of my medical practice. I was on the US world international figure skating team in the early 1970s. So, I was a competitive athlete and I used nutrition to help better my stamina and my continual not-getting-sick in competition and while studying nutrition. My father was overweight and sickly when I was younger. As a family, we tried to encourage him to eat better and eventually succeeded in changing his diet.

He got healthier and we solved a lot of his problems that he had had with his health when I was young. So, I started to learn about nutrition at home and how to use it to improve my athletic performance when I was a teenager. So, I went to medical school with the specific goal to be a specialist in human nutrition. Over the years and decades, I cared for tens of thousands of people with serious chronic medical conditions with autoimmune diseases like lupus, ulcerative colitis, and psoriatic arthritis. I showed that nutrition can powerfully reverse these diseases stronger than drugs can. I also treated patients with heart disease, diabetes, and other chronic diseases caused by poor nutrition, showing that nutrition is not only effective to prevent disease but that it can also reverse disease.

The bottom line is that food is more powerful than drugs and the current state of medical care in the world today is barbaric. We allow the medical tragedies to occur and people to die needlessly, which it’s very sad. People are so confused about nutrition and what nutrition can do; It’s a massive human tragedy! Because poor nutrition doesn’t just lead to heart disease, diabetes, and obesity. It also leads to lack of intelligence, aggressive behavior, and food addiction which can be the gateway drug, that is, the gateway, you can say, to drug addiction. It leads to increased crime, exponential medical expenses that can’t be afforded, economic decline, and lack of jobs. A foundational problem in the world today is the fact that modern nutritional science is not taught adequately to our population. Niko: Thank you so much, Dr. Fuhrman, for joining the symposium. You are one of the leading experts in the field of nutrition and you’re a classically trained medical doctor.

Could you share with us how much nutritional science you learned in school? And can we really trust the average medical doctor in terms of nutritional advice? Dr. Fuhrman: An insignificant amount. And no matter what the medical doctors and dieticians learn in school, it’s almost irrelevant anyway. Because it’s outmoded and it’s wrong. if you’re taught many hours about nutrition in medical school but it’s the wrong information – what good are those hours? Most registered dieticians come out of a lot of nutritional training and they still teach wrong information that hurts people rather than helps them.

So, in other words, what I’m saying is that nutritional science made radical advances in the last ten or twenty years. We have to filter those advances down to our population while at the same time learning more and more about how ineffective and even harmful drugs can be with diabetes and blood pressure in the long term. For example, recent studies showed that people who are on calcium channel blockers to lower blood pressure for ten years and more can double their risk of breast cancer. Were those people giving informed consent when they were not told that those calcium channel blockers could increase the risk of breast cancer? What about people being put on statin drugs which cause weight gain, diabetes, and even increase the risk of invasive breast cancer? What if you have a statin drug addict using calcium channel blockers? In other words, patients today aren’t given enough information to make intelligent choices for their future and they’re not even told that proper nutrition can be a hundred times more effective at reducing the risk of a future cardiac event than medications can.

A hundred times more effective, not ten times more effective! So, without given the proper information, they’re essentially not given the opportunity to make the right choice. My feeling is that millions more would choose to make these nutritional improvements to protect themselves, had they just been given the facts. Niko: Thank you very much, that is a really important point. If we could now move on to your remarkable books. You authored a wide variety of different bestselling books. In many of the books, you talk about your nutritarian diet. Can you share with us the difference between a vegan or plant-based diet and your nutritarian diet?

Dr. Fuhrman: First of all, I’m not sure what “plant-based diet” means because that is a non-specific term. Nutritional scientists all over the world don’t recognize the word or the term plant-based to mean vegan. That’s a term coming from people of the vegan community in the United States. “Based” just means more than a half. So yes, your diet should be largely made of natural plants. But I don’t know if just half is enough. In other words, the American diet right now – the standard American diet – is about 32% of calories from animal products. That means it’s about 68% of calories from plants which is not sufficient. It should be 90-100% of calories from plants. I call it plant-rich. I just want to be more specific when we’re using terms in the cited literature, so nutritional scientists the world over recognize that we’re talking about a diet that predominantly plants: not just based on plants, not just half plants. So yes, I’m in agreement with the approach that if we’re looking at people who are at significant genetic risk for heart disease, reducing the animal product consumption to 15 to 20% is not sufficient for those with high genetic risk to prevent heart disease.

We don’t see heart disease totally disappear for those with an even stronger genetic risk until the animal product consumption of the diet moves below 10% and we don’t generally see predictable reversal unless that percentage of animal products drops below 5% of total calories. Looking at a therapeutic diet to reverse disease, especially to maximally protect against diabetes and heart disease, we want the animal product consumption to be as low as possible in that zero to 5% range which results in a predominantly vegan diet. I’m concerned that the word plant-based isn’t specific enough. Scientists must know exactly what we’re talking about and we’re talking about getting animal product consumption in that zero to 5 % range of calories. We don’t know for certain that going to zero is better than going to 5% yet but we do know that going to 5% is better than 15%. These are things that time will tell. When my patients got the severe cardiovascular disease, they go all the way to a vegan diet. I advocate they have no animal products in their diet.

However, if they choose to use some animal products in their diet they can use them as a condiment – a few ounces a few times a week – because we think at that low level the effects won’t be significantly negative. But in any case, did I answer your question precisely? And what makes a nutritarian diet different? A nutritarian diet and the word nutritarian means containing nutrients – a lot of nutrients – in the diet. We want to make sure the diet is nutrient rich. In other words, we want to make sure it has an adequate amount of all the known vitamins and minerals humans need as well as a high amount of antioxidants and phytochemicals which are present in colorful plant foods. So, number one, we let people know that if they’re mildly calorically strict in an environment of micronutrient adequacy, which means consuming an adequate amount of micronutrients with a relatively low amount of calories for keeping a slim body frame, then that’s going to maximally extend the human lifespan and promote the reversal of the disease.

We don’t want people to eat empty calorie foods and excess calories even if they’re plant foods. For example, white rice or white bread might not be a favorite food because they have a high glycemic load and low nutrient levels. However, if we rate carbohydrates on a hierarchal scale of micronutrient quality, fiber content, its resistant starch qualities and other beneficial factors, we can see that brown rice is an improvement over white rice but red kidney beans and lentils are an improvement over brown rice. And we see the same thing with diabetic parameters. When people switch from white bread to whole wheat bread their diabetic parameters might improve 30%, when the improved go from whole wheat bread to beans they get another 30 % improvement in diabetic parameters.

We have to look at the hierarchal scale of what foods are the very best, what foods are moderately good and what foods are the worst and structure the diet to be, how should we say, weighted heavier in the foods that have more fiber, lower amounts of resistant starch, a lower glycemic load, more micronutrients and phytochemicals to prevent cancer. We want to load the diet to make it maximally nutritionally ideal. And at the same time, of course, minimize exposure to those foods that albeit being plant foods have a high glycemic load or poor nutritional content and poor fiber content.

I think in the world of nutrition science today almost everybody recognizes the dangers of high glycemic carbohydrates, which include maple syrup, honey, agave nectar, white rice and white flour. These foods have detrimental effects on longevity and health. The nutritarian dietist takes that a step further. The second thing is that certain foods that don’t have the most stellar level of micronutrients, still have individual phytochemicals that help them fight disease and fight cancer, such as mushrooms.

Mushrooms may not have the highest nutritional density score in the world, but they contain aromatase inhibitors, angiogenesis inhibitors, antigen binding lectins, and other substances that prevent cancer and lower estrogen and testosterone stimulation in the prostate. In other words, they have effects that increase lifespan and reduce the risk of chronic disease and cancer. They’re beneficial to eat. They have these beneficial phytochemicals. Just flaxseeds and chia seeds are full of lignans and interlinks that have hormonal blocking effects on breast tissue and reduce the risk of breast cancer. So even though flaxseeds may not win the award of the highest level of all the micronutrients the government keeps score of, they’re still a superfood. We should recognize that some foods have beneficial therapeutic benefits. I made up an acronym called G-BOMBS which stands for greens, beans, onions, mushrooms, berries, and seeds.

It means that in spite of the fact that flaxseeds or mushrooms may not have the highest nutrient score in the world or that onions aren’t as rich as kale, we still want people to eat those foods on a regular, almost daily basis, because of their documented benefits on extending the human lifespan and reducing the risk of cancer. A nutritarian diet advocates people to eat a lot of green vegetables such as a nice raw salad every day with raw onion on top and raw cruciferous vegetables like some arugula, or kale or watercress or bok choy. We want people to get those isothiocyanates because of the regular consumption of cruciferous vegetables. And we want them to eat a lot of colorful vegetables in their diet and proportionally eat less bread and potato and rice. You can even eat some grains though mostly intact grains if you can. We want people to pay attention to getting enough colorful vegetables in their diet, particularly remembering to eat G-BOMBS regularly because of their protective health effects. We’ve taken the whole food plant-rich diet which is nutritionally complete and are giving people guidance how to implement it in their lives.

It helps them better control the glycemic effect of each meal and raises the nutrient, fiber, and resistant starch content of their diet. This makes it more therapeutic i.e. it reverses heart disease and diabetes. Moreover, this diet makes sure people get exposure to these phytochemicals which increase longevity and prevent cancer. This way they can push the envelope of human longevity and avoid getting cancer. Guidance is necessary because a lot of people adopting these new diets have been eating unhealthily since birth. They have eaten unhealthy for the first twenty, thirty, forty or fifty years of their life, and just changing their diet to a so-called “plant-based diet” is not going to be aggressive enough to totally protect them against future cancers.

We need to target the diet to make it more phytochemical-rich so the immune system can fight off the damage to the DNA methylation defects and other damage that’s occurred from the way they ate prior. Thirdly, the common vegan movement and the nutritional gurus advocating vegan diets across the world haven’t paid enough attention to the drawbacks of a vegan diet. In my thirty years of being practiced as a medical family physician caring for this community, literally, tens of thousands of people from across the country and even across the world are coming to my practice who are getting into trouble on a vegan diet. What are these people doing wrong that’s getting them in trouble? And we’re seeing the same mistakes occur over and over again today as they did twenty and thirty years ago. One of those basic mistakes is not consuming enough vitamin B12. The RDA amount of Vitamin B12 of 4 to 5 micrograms today is not sufficient for a lot of vegans, especially as they age. They need more. They need about 100 or 200 micrograms a day, not 4 to 5. Because when you’re taking a supplement rather than ingesting it with food, your requirements are much higher.

You don’t get as much absorption from the supplement. So that’s one mistake. And secondly, over my career I’ve seen many, many people develop trouble with mental function, depression, brain function, and dementia on long-term vegan diets because they were not paying attention to the omega 3 content of their diet. That means many people don’t have enough activity of the conversion enzymes that make short chain ALA alpha-linolenic acid into the long-chain EPA DHA. We supported a study that was done on 166 vegans who are not supplementing EPA DHA showing that about 1/3 of them had severe deficiencies of DHA. It’s a lot of genetically determined factors here and we’re seeing a very cavalier, almost irresponsible attitude by certain individuals in the vegan community saying you don’t have to supplement EPA DHA on a vegan diet. I’m saying that may be true for some people, but to make a blanket statement that all people don’t need to supplement is completely irresponsible because the damage could occur.

Now I know you can quote studies and say here’s a study that vegans who were not supplementing had adequate DHA. But if you look at the data from thousands of people in the study only seven were vegans. The point is that unfortunately people advocating their own diet styles often have a bias and try to proclaim what they said in the past. They don’t want to look at the new data and potentially reevaluate their viewpoints based on accumulating evidence or evidence collected by somebody else that is not them. I think that we have to be more conservative and cautious here to not get people in trouble and make sure that people take enough problem nutrients. We need to make sure that we’re talking about common deficiencies that could occur on a conventional diet and common deficiencies that occur on a vegan diet.

Why get anybody in trouble? And those common deficiencies could be vitamin D, for example, which can occur to everybody on a vegan diet or not, that is if they don’t get enough sunshine, right? We’ve been talking about B12 in particular, whose requirements are much higher. EPA and DHA are available in vegan sources as well, of course, you don’t have to compromise the idea of being on a vegan diet to have that. We want to make sure we don’t leave anybody with potential risks that are unnecessary. Niko: Alright, thank you very much for making this clear. You already mentioned your concept of the so-called G-BOMBS, an abbreviation for different types of food that we should include on a daily basis, so can we now come a little bit closer to this topic and speak about the different kinds of G-BOMBS.

The first letter G is an abbreviation for greens. Can you tell us, why should one include greens on a daily basis? Dr. Fuhrman: The point is, that dark leafy greens like kale, collards, mustard greens, turnip greens, arugula, and watercress are so incredibly rich in protective longevity promoting nutrients. And the thing to remember about those green vegetables is that the protective ITCs, those protective isothiocyanates are not in the vegetable until you break down the cell wall and chew or crush the vegetable. You have to chew them very well. And keep in mind that heat inactivates the enzymes that make the ITCs. So, eating them cooked is not as beneficial as eating them raw.

A little bit raw goes a long way: A little bit of arugula or watercress on your salad, a little bit of shredded cabbage on your salad, a little bit of kale or baby bok choy on the top of your salad. A little bit goes a long way to eat it raw and to chew it well with your salad because it supplies those protective enzymes. Drink a little bit of green vegetable juice. We’re talking here about supplying that myrosinase enzyme that converts the glucosinolates in the green vegetables into the ITCs and if you cook the vegetable first, you’re not going to form any ITCs because you deactivate that enzyme. On the other hand, if we put the bok choy or the kale or the turnip greens in a blender with a little bit of juice or water in there and we blend it, then we allow the chemical reaction to occur while it’s still raw, and then we pour that into our soup.

The heat from the soup won’t deactivate the ITCs because they will have already been formed. The other thing to remember is that when making soups or stews, blend or crush all those cruciferous vegetables while they are still raw and then add them to the liquid or soup. Use just a little bit of liquid to blend them raw so they don’t dilute the chemical reaction. Use just enough liquid to make it blend into a pudding-like consistency or a thick slurry. Do the same thing with the onions, scallions, and leeks. Because the alliinase enzyme in onions, scallions, and leeks forms a lot of the anti-cancer organosulfur compounds which are also heat-sensitive compounds. A little bit of raw onion on your salad or a little bit of scallion on your salad is very important for your long-term health. And if you’re going to use the leek and the onion and scallion in your soup then blend it while still raw and then pour it into the soup to cook because you don’t want to deactivate the enzyme.

And the other thing is if you’re eating some brussels sprouts or cooked broccoli or cooked greens the fact that you had some raw greens in that meal to supply some of that myrosinase enzyme increases the beneficial anti-cancer benefits of the cooked greens that you eat in that same meal. So, talking about greens my general checklist for a nutritarian diet is eat a big salad every day at least once a day.

And on that salad put some shredded red cabbage or shredded kale or some shredded green vegetables that are cruciferous and put a little thinly sliced red onion or scallion on there too. In other words, make that salad the right way. And have that at least once a day. And then use a dressing or put some nuts and seeds, sunflower seeds, or walnuts on top. One of my favorite dressings is taking a tomato sauce with roasted garlic and a little bit of balsamic or black fig vinegar with some almonds or sunflower seeds and whip it up together with a fig or some raisins. The point is, make a dressing made of nuts and seeds, not of oil.

When you make a fat-free dressing on the salad and you don’t add nuts and seeds to it, you don’t absorb all the beneficial anti-cancer compounds. The presence of fat in the meal in the form of nuts and seeds rather than oil has far-reaching beneficial longevity-promoting effects to reduce the risk of heart attack, cardiac arrhythmia, and cancer because we’re absorbing more of those anti-cancer compounds. We’re talking about G, the greens. The next one is B, the beans. Well, the beans help people recognize and remember that hierarchal scale of carbohydrates that beans are at the top of. Beans are rich in inositol ponticus phosphate and have very powerful anti-cancer effects. In the Nurses’ health study, they found that beans show the most protection against breast cancer of any foods eaten. And they’re also very glycemically favorable because they have very slowly digestible starches. They’re fed into the bloodstream very slowly like an IV-drip, just a little bit every 5 or 10 Minutes. So, if you have a cup of beans of 200 calories those 200 calories are absorbed slowly over a 3 to 4 hour period. They’re not coming into the bloodstream in 15 minutes like if you ate some white rice or even a white potato.

The point is that the body doesn’t have to secrete much insulin, because they’re coming into the bloodstream very, very slowly and they’re rich in resistant starch. Those starches don’t even get broken down into carbohydrates. They are fermented by bacteria in the gut into short-chained fatty acids. And those short-chained fatty acids have anti-inflammatory and beneficial anti-diabetic effects. But mixing is very important here. Mixing raw onion with raw greens and cooked beans and mushrooms in your diet, cooked mushrooms, we’ll talk about that in a minute, the important part of mixing these g-bombs together and including them in your diet is not just the value of the g-bombs themselves, it’s also that the combination of these factors create a bacterial biofilm. In other words, these foods fuel the growth of beneficial bacteria and that beneficial bacteria biofilm is so robust, and so adhering to the villi in the small intestines, that they have an effect of lowering the glycemic effect of other things you eat in the diet.

So, if you had your oatmeal in the morning, your oatmeal had a lower glycemic effect, even with the mango and raisins you put in it, because you ate the g-bombs the day before which had the effect to create a biofilm or adhesive coating over the villi that slow the absorption of glucose from other foods that are not greens and beans and onions and mushrooms. Niko: Alright, thank you very much for making this clear. You already talked about the health benefits of beans, but many people complain that after eating beans they get a little bit bloated. What can we do to not feel as bloated after eating beans and legumes? Dr. Fuhrman: That’s correct, but the microbiome changes to make them easier to digest. If you just titrate down to a level you can tolerate, don’t make it totally tolerable, there still may be some gas in there, but just keep having that amount that is not too uncomfortable for you, just so it’s tolerable, and then over time if you keep eating them every day you will see that the bacteria will change and you will be able to digest them better with time and you can eat some more of them.

If you eat these foods infrequently they always cause problems with digestion. If you eat them every single day, even a little bit every day you almost always will get better at digesting them. Niko: Alright. That’s good news for most of the people. What is the perfect way to prepare the beans? Do you recommend to always soak them or what do you do to make them perfectly digestible? Dr. Fuhrman: It’s probably better to soak them and to pour off the water and use fresh water.

It helps to get some of the dirt off and stuff, makes them cook a little quicker, but that’s not absolutely essential. They can be washed and cooked in a soup for a long period of time, but most people find it better if they are soaked first I think. Niko: Perfect, and then we come to the third letter of the g-bombs. First, we got the greens, then the beans and now the onions. Why should one include onions on a daily basis? Dr. Fuhrman: Right, the onions we started to talk about. They show about 50 to 88% reductions of all common cancers for people eating a large amount of onions. We’re talking about a quarter cup to a half cup of onion a day.

At least half of that consumed raw by the way, just put raw onion or scallion on your salad. Try to put that into your regular diet. It has lifespan promoting and anti-cancer benefits. And, of course, onion tastes great cooked. You can add it cooked to soups and cook to flavor other foods, but I’m encouraging people to chop them finely or to crush them or blend them while they are still raw and then add them to the cooked food and not to fry them of course, because that destroys some of the benefits. Cook them in a soup or a stew or wok but don’t fry them. We’re talking about avoiding heated oil, avoiding heated fats, people cooking in fats. When you cook fats at a high temperature it degrades the fats, causes rancidity and production of free radicals that are carcinogenic, toxic compounds that are carcinogenic.

Especially when you’re eating fried foods. Some of the fried foods and oils from these fast food restaurants are carcinogenic just to inhale the fumes from the oils! Even people working in the restaurants, who don’t even eat the food, who are just breathing in the fumes of those oils are at an increased risk. It can increase their personal risk of cancer which is dangerous. But anyway, getting back to the onions, we want people to eat the onions regularly both raw and cooked. They offer tremendous protection, especially when you use scallions in your food. And I’ll sometimes make a cooked vegetable. I make an eggplant charlotte, where I mix eggplant with onions and garlic and a little oatmeal and I bake it into a patty, put tomato sauce on top of this delicious eggplant patty and I sprinkle some raw scallions on top, or raw chopped up onions on top.

I’m saying to you, to our audience here: sprinkle some raw onion or raw scallion on top of the cooked vegetable you’re eating for flavor. A little crunch is good on the cooked vegetable with that tomato sauce or something you eat with it. And it adds beneficial health effects and it makes the foods taste really great and adds more nutritional variety in the diet. Niko: Alright. Well said. Thank you very much for the information. Now we come to the second B of the g-bombs, the berries. Why is it so important to include berries on a daily basis? Dr. Fuhrman: I think a lot of people know today that berries are very low on the glycemic index. They are rich in polyphenols and anthocyanins, they have very powerful anti-cancer effects that are surprising even the scientists working with them in these cancer reversal studies on animals.

Berries even have been shown to have beneficial effects against aging to the brain because the brain doesn’t produce its own antioxidants. Our body cells and our tissue cells in our body have their own antioxidant response elements that remove toxic radicals and remove hydrogen peroxide. There are a whole bunch of effects on the whole body to keep free radicals down. But the brain doesn’t do that well.

The brain can build up free radicals and age itself. The brain needs a chronic ongoing exposure to certain beneficial antioxidant chemicals that penetrate the brain wall and these dark compounds in berries penetrate the brain better than other phytochemicals do and have a beneficial effect in protecting the brain against dementia. Yes, so berries are a superfood. And in spite of the fact that they have sugar in them, they’re still low glycemic and one of the reasons they’re so low glycemic is that they also have an effect on those compounds slowly absorbing the glucose and they also have a beneficial effect on gut bacteria as well. Berries are another beneficial food in the g-bombs list.

Niko: Alright, perfect. And now we come to the last letter of the g-bombs list, the S. The S stands for seeds, why should one include seeds on a daily basis? Dr. Fuhrman: Right. The S stands for seeds. We’re talking about flaxseeds and chia seeds and sesame seeds and hemp seeds. These seeds are generally rich in omega-3 fatty acids, which are beneficial, and are a good source of ALA in the diet. But they also contain these lignans. Lignans have beneficial health effects. For example, there was one study that showed that women who already had a diagnosis of breast cancer followed for 10 years eating a small amount of lignans regularly had a 71% decreased mortality from breast cancer over that 10-year period. That’s so dramatic. Because don’t forget when you intercede with a nutritional intervention, the more the advance of the disease or the cancer is, the less likely the intervention is to show positive effects. So, we’re talking about women who already had breast cancer showing such a beneficial effect, which means the effects would be magnified significantly when people started doing it earlier in life before that diagnosis was made.

Secondly, those women only took in a third of a milligram a day, just a tiny amount, a teaspoon of flaxseeds has 7 milligrams of lignans a day. So, we’re showing that regular consumption of flaxseeds and chia seeds are protective against the common cancers like breast cancer and prostate cancer. They’re showing dramatically beneficial effects and they also lower blood pressure which has effects on restoring and enabling intravascular elasticity and the Houston endothelial inflammation. In other words, there are tremendous beneficial health effects from including seeds in your diet on a regular basis as there are tremendous health benefits in including walnuts in your diet on a regular basis as well. The exclusion of walnuts from a diet designed to reverse cardiovascular disease weakens the benefit of the diet and potentially puts the person at higher risk instead of lower risk. We have some people advocating using diets that are extremely low in fat, radically low in fat. People are then afraid to even put a walnut on their salad and they think it’s a benefit, but it really makes their diet more dangerous, not more beneficial. Niko: Alright, thank you very much for the good points.

Could you now share with us your opinion on the paleo diet? Dr. Fuhrman: Well, there’s a lot of problems with it, but the main problem is the excessive amount of animal protein. I’m not saying that’s the only problem but we know that in the natural world we have predators and we have prey. And when the predators eat too much of the prey they could devastate and wipe out the prey and cause them to become extinct. And then they’d essentially be causing their own species to become extinct. Like if the lynx doesn’t have any more rabbits to eat then the cats would become extinct. If the animal overeats their allotment and eats too much of the prey, it slows down their longevity interferes with reproduction and it actually slows down the lifespan of their offspring as well. Now we see this is particularly true in humans. We don’t consider ourselves predators because we’re buying meat in a plastic package in a supermarket.

When we overeat our amount of protein, protein becomes the major modulator of IGF1, insulin-like growth factor 1. A higher level of IGF1 is the major modulator of lifespan in animals that overeat on protein, i.e. that overeat their prey. Humans and monkeys and primates are particularly sensitive to excess IGF1 shortening their lifespan but the paleo advocates don’t recognize this. They don’t see it because they are trying to advocate a certain diet style that makes them feel macho and strong. But you have to give more credence to studies that follow many thousands of people for decades, for 10 years, 20 years, or 30 years to see the outcomes of these dietary suggestions and hypotheses. It’s ok to have a hypothesis, but how do we test the hypothesis. We could feed people twinkies, just a whole twinkie diet, they will be so sick of eating twinkles that they will reduce their calories, eat less twinkles and they will lose weight and look better after a year. But they’re not going to live a long time on a twinkie diet, we got a problem in 10 or 20 years.

They will dry off because it is not a healthy enough diet. We’re seeing the same thing with any long-term study going 15-25 years on a high protein diet. They show an increased risk of cardiovascular death or cancer death and increases of diabetes and an increased risk of all-cause mortality. One particular study followed a huge amount of people, we’re talking about 129.000 people for more than 20 years showing a 43% increased risk of overall death for those eating more animal products compared to those that ate relatively small amounts. We’re talking about multiple studies. There was another study done on people between the ages of 50 to 65 for 18 years showing a four-fold increased risk of cancer death on a high protein diet (30% or more) compared to people eating animal products at 7.5% or less in their diet. Americans eat already 30%, most people in Europe are at 25% almost 30%. We’re talking about the reevaluation of this idea that animal foods with high biological proteins are favorable. But the fact of the matter is they have to be limited in your diet to have a long lifespan and the most favorable source of proteins are natural proteins in plants.

Because they are not as high in biological value and the body has to mix them. And we mix them with the bacteria in the gut which get digested and absorb their protein. The cell lining the gut absorb the protein, in other words, we get complete proteins from plant proteins. The plant proteins come into the bloodstream more slowly and gradually, keeping insulin and IGF1 to lower levels that are more sustainable for a long life. We’re talking here about people getting more of their proteins from seeds, from nuts, from beans, from green vegetables.

From intact whole grains like steel cut oats. We’re talking about eating a diet of whole unrefined plant foods, that gives you adequate protein but not an excessive amount of animal protein. And if you absolutely want to utilize animal protein (I don’t want to exclude people who don’t want to be vegans and I want to incorporate everybody), I still want to pull you in to healthier eating and say if you don't want to give up your animal products, then use it as a flavoring or a condiment in relatively small amounts but still eat a diet whose vast majority is natural plants and recognize that your animal products have to be held to minimal amounts.

You can’t just do a paleo diet and think the more animal products you eat the better, because that’s just poor science, it’s sloppy science and it’s particularly irresponsible science. It’s irresponsible because we have too much data today, we have too many long-term studies on a large number of people that illustrate, that demonstrate how dangerous those diet styles are. Niko: Alright, thank you very much.

You already talked about including high-fat foods in one’s diet on a daily basis and this is somehow different from approaches on the high carb low-fat advocate group. So, can you share with us, why do people still think that they should exclude high-fat whole foods from their diet and what exactly is your approach? Dr. Fuhrman: Yes of course. I am saying that just like we have the data on a large scale number of people in major studies over many years showing high-meat diets are dangerous, we have the same studies on diets that are extremely low in fat. And we have studies on people excluding nuts and seeds from their diet like the Adventist health study where vegans who excluded nuts and seeds had a considerably shorter lifespan than those vegans who added nuts and seeds to their diet.

As a matter of fact, in the Adventist health study non-vegans who were flexitarians – eating some animal products – who ate nuts and seeds lived longer than the vegans who excluded nuts and seeds. The longest living demographic were the vegans who ate nuts and seeds of course. We’re seeing that occur in almost every study. These advantages of including some of these natural fats from walnuts and almonds and sesame seeds and flax seeds in your diet has the effect of increasing absorption of phytochemicals and they protect people against cancer. They help stabilize brain function and the degrading of intravascular blood vessels in the brain with aging. They prevent dementia and hemorrhagic stroke, which can be a cause of death in the vegan population. And they are better for the heart as well. Those extremely low-fat diets are making people fearful of eating a walnut and are even dangerous to people with advanced heart disease. You get more protection against irregular heartbeat and cardiac arrhythmia on a diet that includes some low amount of these beneficial fatty acids, fibers, sterols, stearoyls, other antioxidants, and omega-3 fatty acids present in these nuts and seeds.

This idea that we have to take nuts and seeds completely out of our diet because some people will overeat on them is really messing up 99 people for the one person that may eat them excessively. You can always find one person who is going to eat too much cruciferous green vegetables. They go on a diet of nothing but bok choy and drink four glasses of cruciferous juice a day and people could then say, “But cruciferous vegetables harm my thyroid gland so don’t eat cruciferous vegetables!” That’s not true, cruciferous vegetables don’t harm the thyroid gland, but if you eat excessive amounts of them, and if you drink like four glasses of juice a day they could have some negative effects, but that’s an insane amount that people aren’t supposed to eat.

The same thing here with nuts and seeds. If you eat them in reasonable amounts, we’re talking about a few ounces a day, they have beneficial effects. But that doesn’t mean people are okay to use them to exceed their caloric requirement and snack on them. They’re best eaten with a meal because of their benefits. They facilitate the absorption of other phytochemicals and you might absorb certain beneficial phytochemicals ten times better from the meal because you ate nuts and seeds. I’m saying the evidence is overwhelming today and as you’re aware I published a study in the American journal of lifestyle medicine in October 2015 showing on over 440 people a more blood pressure lowering effect with a nutritarian diet than any other study ever tested. They had nuts and seeds in their diet. Cardiac reversal! Advanced cases of heart disease, near death people getting well again, reversing heart disease and dropping their weight These people are reversing heart disease and dropping their weight with the inclusion of moderate amounts of mustard seeds in their diet.

I’ve been in practice 25 years. A lot of these patients had advanced heart disease 20 or more years ago. They’re still alive today, in their 90s, and they’re thriving and doing well. They don’t have high blood pressure and heart disease anymore. And the meta-analysis in cardiovascular illnesses of excluding and including nuts and seeds now, in recent years will come out showing beneficial effects of adding nuts and seeds to the diet of people with heart disease. Even Dr. Dean Ornish, in reviewing all these studies, has agreed now to put some small amount of nuts and seeds back on this program. So, essentially, we’re coming to more of a consensus here that a little bit of DHA and EPA to protect people is appropriate. We’re getting rid of this idea that the more you exclude fat the better. It’s an old way of thinking that’s been disproven. It’s not optimally safe for people looking to prolong their lifespan.

Niko: Alright, thank you so much for making this important point here Dr. Fuhrman. So, if I get you right it’s not about a certain ratio between fat and carbohydrates and protein, it’s about eating whole plant food and eating foods that are high in nutritional value. Is this true? Dr. Fuhrman: That’s right. We want people to eat a diet that’s nutrient-rich and nutritional complete to avoid being deficient in anything. That’s where some of the nutritional gurus might be falling off. They’re giving people a diet that might be nutritionally rich, but has them ending up being deficient in Vitamin D or B12 and who knows what. Also, we also to target those beneficial foods that have lifespan promoting effects and we want to make sure we make judgments and decisions. We err on the side of caution and don’t put any person into trouble. Because we recognize there’s a genetic variability from person to person. And even though some people don’t need as much B12, other people need more.

And even though some people may not need extra zinc or extra DHA some people do and we want to make sure we don’t put anybody into trouble. And make sure that we give broad advice to make sure that we’re giving people – you know – 999 of a thousand people will thrive on this kind of diet which isn’t the case let’s say on a raw food vegan diet. Because if a few people thrive on that, that doesn’t mean 999 of a thousand will thrive on that. A lot of people on a raw food vegan diet, for example, are not going to thrive, especially in their later years they’re going to develop more risk of fungal infections, weak hair, and nails, their immune system will decrease with higher probability.

Because of increased risk of sugar and lower amount of exposure to proteins in their diet. Whatever it is we’re talking about here, designing a diet style for the vast majority to make sure it’s perfectly safe is most important. Niko: Alright, Dr. Fuhrman, thank you very much. That’s a very important point. If we could now come to the topic of grains and wheat, especially. What is your opinion on grains and wheat and on all these books that say that grains are potentially harmful like wheat belly or grain brain? Dr. Fuhrman: It’s kind of sad because what we’re saying today isn’t controversial in my opinion.

I think most people recognize, number one, that refined flour, white products like white rice and white bread, high glycemic carbohydrates like sugar and maple syrup and honey, are not beneficial foods and scientists all over the world recognize that those foods hurt long-term health. Number two, we know that excessive amounts of animal products, not just the saturated fat but also the animal protein is lifespan shortening. And number three, exposure to a wide variety of whole plant foods extends the human lifespan and is optimal and number four, we shouldn’t be overweight.

We should be slim and muscular and we shouldn’t exceed our caloric requirements. We shouldn’t overeat or be eating all day long. We should maintain a reasonably right amount of food. What I’m saying is that it shouldn’t be that controversial. In other words, we should have more general acceptance. These books like wheat belly and grain brain are giving people the idea that wheat is the enemy and the cause of all the problems and it’s okay to eat all the animal products that you want and all the saturated fat is okay, all the animal protein is okay, it confuses people.

And it obscures the important issues that nutritional science is in agreement on. And then what they have done is give people what they want to hear. They make one food the villain, so people can now eat whatever they want. All of that just to sell books. It’s very sloppy science, it’s wrong science. And if you look at the references they cited to justify how wheat causing the problem is related to the disease. Well, pull those references apart and read the references. In almost every case the study used white flour products. It didn’t use an intact whole grain. We already know that white flour is dangerous. It’s not because of the gluten, it doesn’t make all wheat bad, because white flour is bad. A true scientist would have had to take the wheat berry, the intact grain, and cook it in water to remove the low glycemic effects, so to keep it as a whole food and then see if that whole food had detrimental effects when tested on populations containing wheat or not containing wheat. But they didn’t do that.

They just showed that diets that are high in white flour are having negative effects. That’s what everybody in the world is in agreement on. That doesn’t mean there aren’t some people that are sensitive to gluten. There are about 2-5% of the population who are sensitive to gluten. But even those people who think they are gluten sensitive a large percentage of them won’t have any reaction at all when given a blind challenge to gluten where they’re given a food where they don’t know it has gluten in it.

I say it is dangerous to the degree that it encourages people to eat more animal products instead of eating more g-bombs or a large variety of plant foods. And, of course, it overstresses the danger of wheat containing products. I’m agreeing that most wheat products are dangerous. And it has to do with how finely they are ground into flour. I don’t recommend whole wheat pastries flour, it’s too finely ground. And if I’m going to eat some wheat products that are formed into bread or bagels, I prefer to get the manna bread or the Ezekiel brand. Or I’ll make it myself. I’ll grind the whole grains or I’ll cook them in water. In other words, if somebody sprouted grains or used more coarsely ground grains with lower glycemic effects, then those coarser bread are better choices.

I’m agreeing that the finely ground pastry flours and white flours are overly glycemic and not great foods and I’m agreeing that a diet shouldn’t be largely made of wheat either. Because there are other better carbohydrate sources that are better choices and more nutrient-rich and lower glycemic. But to make wheat the villain is not quite scientifically valid, it’s too sloppy. Niko: Alright, thank you so much, many people will feel relieved after your answer. If we now stick to the topic of whole grains you once stated that there is a huge difference between whole intact grains and whole grains that are ground into flour and the finer the flour is, the higher the glycemic index and the glycemic load of the food. Could you explain this to the audience? Dr. Fuhrman: Yes, that’s what I’ve just been saying right now. I’m saying that pastry flour, like whole wheat pastry flour, is more finely ground than regular whole wheat flour. And the finer its ground the higher the glycemic effect.

It’s almost like talcum powder or baby powder, it’s ground so fine. But what I’m saying now is that even whole wheat flour is ground too finely. And if you can get more intact grains or more coarsely ground flours or bread made from sprouted grains that are not ground into fine flours that are more healthful. Eat from sources of whole grains. If you make a breakfast out of spelt or kamut or whole wheat berries or an intact grain like oatmeal or steel cut oats, cooking them in water is an even more favorable way to prepare them as opposed to grinding the grain into a flour, to begin with. Sprout the grains, cook them and push them into a loaf, that is what the manna bread is like that comes in the frozen sections, here in America. I don’t know if you have it over there, it is a brand of bread that’s frozen. It’s just sprouted grains forced into a loaf, it’s not made from flour, and they’re a healthy way to use those grains.

Niko: Alright, thank you very much, Dr. Fuhrman. You also wrote a book about the health benefits of fasting. Could you share with us, what the health benefits of fasting are and should every person, either sick or healthy, go on regular fasting cycles or what are your recommendations? Dr. Fuhrman: That’s a good question, and it’s a question that is difficult to answer because of two things here. Number one, we see people who eat less frequently generally live longer and have lower rates of cancer.

Their body detoxifies and heals more in the non-feeding states when they’re not digesting food. For example, there was a study done where women finished eating dinner earlier, so they had 13 or 14 hours of not eating food at night as opposed to most other women’s 10 or 11 hours when they ate dinner later. Those women eating dinner earlier had a 26% lower risk of breast cancer followed over the years than women who didn’t have that extended period of fasting at night.

So, there is evidence with animal studies and some evidence in human studies that episodically not eating or going extended periods of time without eating has lifespan beneficial effects. And the other thing you said, we have a person with an autoimmune condition, ulcereal colitis, lupus, psoriasis, even asthma, I used it therapeutically over the years and there is some indication that shows that we can accelerate healing and have a person make a recovery if we can get them eating healthy for a few months and then withdraw their medications gradually and then put them on a fast to accelerate the repair and the healing of the tissue and lower inflammation.

It can lead to more sustained therapeutic benefits to help them reverse their asthma or reverse their psoriasis there are some therapeutic benefits there. So, the answer to your question is yes, there is likely some lifespan benefits to episodically fasting as long as the person doesn’t become emaciated or anorexic or too thin from the overuse of fasting. Any good thing could be taken too far, right? And we want people to maintain muscle mass, skeletal mass and skeletal strength for aging. The overuse of fasting could lower their IGF-1 too much. As they get older and IGF-1 gets lower their body strength could become too low so with the constraint to only moderately use fasting the answer is probably yes, it’s a lifespan promoter. As long as we don’t reduce muscle and body and bone mass as a result of doing that. Niko: Alright, thank you again for this great explanation. Now we come to the final question and, as always, the question is: what is the key message that you want everyone to take away from our talk and from your whole work?

Dr. Fuhrman: The key message is that you’re responsible for your health and longevity and the best health care is proper self-care. Don’t rely on physicians to drug you into wellness. When you develop diseases the main message is don’t think that treating your blood pressure, your glucose or your cholesterol with medication is going to protect you. If you want to be protected you must maintain a normal glucose, normal blood pressure and a normal cholesterol without medication. You have to achieve it, you have to earn good health. You can’t use medications to cover it up. So, the message you hear is, yes, we can control our health destiny, but you got to do what it takes yourself to accomplish good health, you can’t expect your doctor to medicate you into good health. That’s the main message…

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