5

How the Modern Diet Makes You Fat (and Sick)

You are probably still unsure whether that long list of conditions (including being overweight) found here can be resolved by following the Plant Paradox Program. But as has been shown in peer-reviewed medical journals, simply changing your diet and making some lifestyle changes can effect amazing changes in your overall health. As the sixteenth-century British naturalist and physician Thomas Muffet wrote, “Men dig their graves with their own teeth and die by those fated instruments more than the weapons of their enemies.” Five centuries later, his words still ring true, as does Hippocrates’s famous declaration: “Let food be thy medicine and medicine be thy food.”

Now, my belief in these complementary statements is not just a matter of faith. It stands on the bedrock of evidence: my research, the research of others, and the thousands of people who arrived in my office complaining of a variety of ailments and have since cured themselves by following my eating plan. Many of my patients initially were also carrying around excess pounds. Once they began the program, weight loss was almost inevitable, usually without major effort.

A Healthy Weight

I KNOW THAT many of you are eager to get to the weight-loss part of this book, but hold your horses just a bit longer. It’s important to first understand that any tendency to pack on extra pounds and any difficulty slimming down are not because you are a lazy or undisciplined person. If you are carrying around extra baggage, the likely reason is because you are eating the wrong foods and/or not eating the right foods. In my experience, what the Plant Paradox Program removes from your diet is more important than what it adds. That’s my first point. But second, disease issues and weight issues are often inextricably linked, which is why this chapter deals with both.

Another key point that is not on most people’s radar is the role that our gut bugs play—not only in health and disease, but also in maintaining a normal weight. Some microbes help keep you slim and healthy. Other gut bugs contribute to weight gain. Still other bugs that make you sick may interfere with the absorption of nutrients and make it difficult to maintain a healthy weight. You could be stuffing yourself with food, but if your gut bugs aren’t facilitating proper digestion, you may be missing out on both calories and micronutrients. Celiac disease is just the tip of the malnutrition iceberg; numerous other conditions can interfere with proper digestion and nutrient availability as well.

SUCCESS STORY

Usher Loses Pounds and Gets the Role

My assistant got a call from a Mr. Raymond who wanted to thank me personally for what I had done for him with the Plant Paradox Program. I was puzzled since I didn’t know anyone by that name and didn’t recall ever giving a Mr. Raymond my two-page list of foods to eat and avoid; but I was intrigued, so I picked up the phone. Usher Raymond IV was on the line. Yes, that Usher. It seems that he had been cast to play Sugar Ray Leonard in the movie Hands of Stone. When the real Sugar Ray met Usher, the boxer sized him up and said he was too fat to play him! Now, if you have ever seen Usher, “fat” would not be a description that you would use. Seven percent body fat is not fat. But there it was; Usher was too fat to play Sugar Ray. So Usher went on the Paleo diet, then a gluten-free diet, and finally a raw vegan diet. He also worked out for five or six hours a day. Nothing worked. Did he need to exercise more, or cut more calories? He was so frustrated he nearly gave up.

Around this time, Usher’s agent was visiting a girlfriend in New York who had been following the Plant Paradox Program with great success. The agent took a copy of the food list off the refrigerator and went back to Usher. Fifteen dropped pounds later, Usher was on the phone with me. He was now Sugar Ray! He had been eating everything he wanted from the “good” page and avoided everything on the “bad” page. By following this two-page list, he had lost the weight he needed to. Miraculous? Not at all—just the perfect functioning of a perfectly designed system. Now Usher wants the world to know about the plant paradox.

I know how frustrating diets and exercise can be in attaining an elusive goal. What if that goal was just waiting for you to attain it? What if perfect weight and health was the natural consequence of allowing your own nature to thrive, once the obstructions from “healthy” foods and “all-natural” products were removed from your life? That is what the Plant Paradox Program can do.

The Weight War—and More

BEING OVERWEIGHT (or underweight) is a clear signal—but only one—that there is a war being waged within your body. If you are reading this book, I can assume that you are concerned about the state of your health—and likely your weight. You are in good company. In hindsight, something started to go awry with our collective health in the mid-1960s. You’ll recall that today, 70.7 percent of American adults are overweight. Of those, almost 38 percent are obese, up from less than 20 percent two decades ago.¹ Additionally, there has been a huge increase in the incidence of diabetes, asthma, arthritis, cancer, heart disease, osteoporosis, Parkinson’s disease, and dementia. One in four people now has one or more of the dozens of autoimmune diseases. Despite the fact that most of us now work only seven- or eight-hour days and are better fed than our grandparents, many of us suffer from low energy. There’s also a dramatically higher incidence of allergies. There are now even EpiPens, syringes filled with adrenaline, marketed to worried parents for their kids to carry to school so they can inject themselves in case some other kid opens a package of peanuts. Peanuts didn’t kill us back in 1960.

We’ve blamed the Western diet, the environment, and inactivity for our poor health and excess pounds. Although the current advice on each of these subjects may contain a grain of truth, each misses the big truth. Not that these actions or inactions don’t also contribute to poor health, but they are not the primary cause of our health crisis. That’s why a diet or an exercise program may work for a few weeks, or maybe even a few months—but then it all falls apart, and you’re back to square one. Sound familiar? The reason none of these “solutions” produces lasting change is that they do little or nothing to end both the battle of the bulge and the related battle within your body.

SUCCESS STORY

The Artist Who Couldn’t Make Art

The sister of a seventy-seven-year-old Japanese sculptor brought him to see me. Hobbled and stooped over, walking with a considerable limp, he reached out his gnarled hand and I was shocked to see the arthritis that wracked his body. He spoke little English, but his sister recounted the sad story about how this revered sculptor of massive wood carvings could no longer create his art. He was unable to hold a hammer and chisel, a carving knife, or a brush (he also painted, usually on large canvases). On the advice of his orthopedic surgeon, the sculptor was chewing Motrin, Advil, and Aleve like candy, and he was scheduled for a knee replacement, to be followed by a hip replacement. He had come to me for cardiac clearance for the operations. I suggested the Plant Paradox Program and he agreed. With a little help from his sister, I showed him the two-page list and the foods to avoid. He also stopped the NSAIDs immediately.

Four months later, the sculptor returned, this time with no limp. He jumped out of the chair and shook my hand vigorously. Then, acting like he had a paintbrush in his hand, he waved it on an invisible canvas, smiling and saying, “Paint, paint, paint!” While doing this, he was literally prancing about the exam room. “What about the knee operation?” “No,” he replied. “Knee good! No operation!”

That was two years ago. I saw him and his sister recently and he brought in a cover story from the Los Angeles Times on an exhibit of his collected works at the Hammer Museum. Many of his finest and largest were done in the last two years. No longer wracked with pain, he was enjoying presenting his great talent to the world.

Amazing but True: Smaller Bodies and Brains

Based on ancient skeletal remains, we know that twelve thousand years ago humans averaged six feet in height. However, by 8000 BCE, the average human had shrunk to four feet ten inches—that’s a whopping fourteen inches in just a few thousand years! Our ancestors became much shorter after the agricultural revolution, which is when grains and legumes became staples of the diet. And prior to that time, there is no evidence of arthritis in skeletal remains. In contrast, all skeletons of modern people, except those who don’t eat many lectin-containing foods, have arthritis. (You’ll recall that the mummified remains of ancient Egyptians revealed that they suffered from arthritis a mere two millennia after starting to cultivate grains.) And it doesn’t stop there: the size of the human brain was 15 percent larger twelve thousand years ago than it is today! And we call that progress?

The Failure of “Diets” and the Exercise Conundrum

AN INDICATION OF our concern with our health and weight is our obsessive focus on weight-loss diets, despite our ongoing failure to convert that concern to lasting results. “Diets” are among the myths that have distracted us from the real issues regarding our health. But weight-loss diets are doomed to fail because they don’t address the underlying sabotage of our foods and other products we come in contact with. The recent revelation that most of the “winners” on The Biggest Loser reality show had regained most of their weight after their original “success” was ballyhooed on TV should come as no surprise to most “dieters.” If you have come to the conclusion that 99 percent of all such weight-loss programs are useless in the long run, I commend you for seeing the harsh light of day.

End the war within your body and you will find your weight normalizes as well. An integral part of self-healing is achieving the weight your body “wants” to be. You’ll also significantly increase your longevity odds. But dieting to slim down and then reverting to your past habits is never a real fix. On the other hand, changing your way of eating and other habits once you understand the effects of certain foods (and certain products) on your system is a whole different ball game. And that is the game plan I will be presenting to you. Diet, as in a way of eating, is the key to success.

Numerous studies show that exercise doesn’t help you lose weight. One problem with exercise is it makes you hungry. Another is that for the vast majority of people who are significantly overweight, it hurts to exercise so they don’t stick with it. But this is not to say that exercise, as in living an active lifestyle, is pointless. A huge study shows that regular exercise (and not just as a workout at the gym, but an overall commitment to being active) can be a valuable aid in helping you maintain your weight.² Moreover, staying physically fit has numerous other benefits, including improving cardiovascular health, moderating your blood pressure, boosting your HDL (“good”) cholesterol, and lowering your triglycerides. Both aerobic exercise and weight-bearing exercise also improve your balance (so you are less likely to injure yourself in a fall), lift your mood and alleviate stress, up your energy level, and enhance the quality of your sleep. And that’s just for starters.

What Research Is All About

EVER SINCE DEFENDING my thesis on the biological and social factors driving human evolution for my graduation requirements at Yale University, I have been fascinated with the effect of food and the choices of food on human evolution and population growth. I used this knowledge and the subsequent human research studies I performed at my institute to develop the program that resulted in Dr. Gundry’s Diet Evolution. However, this was just a stepping-stone to what I have learned in the years since. Just as humans have evolved as a species, my research has resulted in an evolution in my thinking—and it started with a visit to Metagenics, a major nutriceutical manufacturer. I had been asked to address its scientific team about the principles of my book. At that time, I was a full-bore carbophobic—a code word for one who believes that carbohydrates (sugars) are evil and the cause of all disease. I had severely restricted them in my dietary plan. After I presented my data and hypotheses, one of the Metagenics researchers stood up and asked, “How do you explain the Kitavans?”

Those darn Kitavans! This South Pacific tribe is the bane of existence to low-carb, fat-is-king researchers. Kitavans smoke like fiends and get approximately 60 percent of their calories from carbohydrates and 30 percent from coconut oil. Despite this, they don’t have heart attacks, strokes, or other indicators of cardiovascular disease and they are remarkably thin, all the while living long and disease-free lives with little need for medical care. Low-carb advocates, my former self included, have long dismissed the Kitavans as exceptions to the rule, citing (without evidence, I might add) that their remarkable health is secondary to eating a calorie-restricted diet, with its known positive effects on health and longevity. Case closed, right?

Not so fast. The primary duty of a researcher is to constantly test your hypothesis. Indeed, the actual purpose of research is to prove that your hypothesis is wrong! Only if you cannot prove it wrong can it possibly be right. So, after initially waving off the Kitavans as calorie-restricted freaks of nature, I went back to my research from Yale and beyond, looking for the driving forces behind any culture’s food selection. And I discovered, thanks to the work of Staffan Lindeberg, that despite the fact that they consume a large number of calories, the Kitavans are very skinny. The calorie is a calorie (calories in equals calories out) argument seemingly doesn’t apply to Kitavans. Research (re-search) means to look again, and so I did. This chapter is the result of that second look, and of observing what happened to my patients when I applied these new insights.

The Real Reasons for a Choice

WE HAVE ALREADY discussed how approximately ten thousand years ago, most humans traded a nomadic hunter-gatherer existence for an agriculture-based lifestyle. The foods previously consumed were primarily seasonal fruits (available only once a year), seasonal big game, and fish and shellfish, along with a significant reliance on starches in plant tubers, which could be utilized by roasting after mankind discovered how to harness fire about one hundred thousand years ago. Although this regimen would have provided abundant calories, the number of humans on the planet remained minuscule. Then, suddenly, calories began to come from the grains of grasses, legumes, and—in the case of all cultures except Asians—milk from cows, sheep, and goats.

The traditional theory of why our forebears transitioned to these foods was that these crops could be stored and the animals herded. You could grow grains and beans in one season, but once dried and properly stored, they would not wilt or rot. Cows and other bovines could be milked, and the milk could be used immediately or turned into cheese (which could also be stored). Because these foods could be consumed throughout the year, it allowed populations to remain in place, despite changes in weather and even times of crop failure. That’s the theory that I was taught and accepted. But suppose that there was another “hidden” reason that the first farmers chose grains, beans, and milk.

Whenever I get into an argument about the benefits of exercise with a long-distance runner, I point out that, by definition, the most successful animal is the one that finds the most calories for the least amount of effort. That is the genetic definition of success. But the corollary that was staring me in the face was this: The most successful animal is the one that stores the most amount of fat from any available calorie. Perhaps we had gotten it all wrong. Maybe our ancient ancestors didn’t opt for grains, beans, and milk because they could be stored. Suppose if, instead, it was because they discovered that this trio of foods had the unique ability to literally turbocharge fat storage for any given calorie, relative to any other foods?

SUCCESS STORY

Good-bye to Diabetes and Thirty Pounds

I see a lot of Hispanic patients, and they often share the same confluence of health problems as my other patients. They, too, have diabetes, autoimmune issues, and excess weight, in this case in large part attributable to the replacement of their ancestral diet with modern substitutes, and with moving from an agricultural society to an urban lifestyle. Maria S. is representative of many such patients. She was forty-seven years old and had severe diabetes and was on insulin injections when I first saw her, with an HbA1C (a marker of diabetes) at 7.9—when the upper limit of normal is 5.6. Within a year, Maria had cut her positive markers for autoimmune disease in half. Her HbA1c is now 5.9, approaching normal. Her fasting blood sugar level has dropped from 146 to 109 and she is now off all medications, including insulin. As a bonus, Maria has lost thirty pounds. The wonderful thing is that although she speaks no English, she was able to follow the Plant Paradox Program, thanks to her children acting as translators.

The Best Way to Fatten Up

IF I’VE HEARD it once, I’ve heard it ten thousand times from my patients: “Whole grains and beans are key to a healthy diet.” But I am here to tell you that the evidence with animals is exactly the opposite. I grew up in the 1950s and 1960s in Omaha, Nebraska, which at that time boasted the world’s largest stockyard. In our stockyards, as any Cornhusker knows, we fattened our beef on corn! Why truck cows from all over the midwest to Omaha to fatten them on corn? Because cows don’t get fat eating hay and grass—every farmer knows that. As early as the nineteenth century, pigs raised in the Ohio River Valley were fattened with corn before being herded to slaughterhouses in Cincinnati. The farmer could make more money walking corn-fattened pigs to market than putting the corn on barges to send to pig farms. The popular expression of the day was that you drove your corn to market in a pig.

This may surprise you, but a pig is not normally a fat animal. Wild boars and feral pigs are lean, sleek, muscular animals. You Arkansas Razorback fans know what I mean. But you may not know that a pig has the identical digestive system and cardiovascular system to a human, which is why I use pig valves to replace defective human valves. Think about that next time you are accused of eating like a pig! And as with pigs, eating corn fattens up us humans.

A number of my patients seek my treatment for weight loss, but at least half of them see me for the relief of autoimmune diseases. Many of those folks are of normal weight. As I mentioned earlier, one of the happy side effects of my program is returning to a normal weight, regardless of the patient’s original reason for seeing me. But over the years I’ve had a small group of patients who, once they make the food changes that I ask for to cure their autoimmune disease, keep losing weight and can’t keep it on. Early in my new career, I asked them to eat more fat, particularly avocados, but that didn’t help. As the years passed, patient after skinny patient would return three or four months later carrying some additional pounds. Invariably, they had added bread, pasta, corn, or beans to their diet. Yes, when all else failed to restore their lost weight, grains and beans did the job. But to everyone’s chagrin, it also elevated the markers of inflammation in their blood. My more recent and effective solution to this problem is to have them eat large amounts of macadamia nuts.

There it was again, the plant paradox in action: the very foods that promoted our ancestors’ ability to gain weight and survive a harsh winter, making them more likely to produce a new genetic copy (aka a baby), were the same ones that would hasten their eventual demise—and ours. If you’ve read my first book, then you know that our genes will always choose this route: maximize calories from food in order to reproduce, then assure the destruction of the parent after the child is grown so that there is sufficient food for that child or grandchild.

Here, then, is the reason grains and beans took over the world. It wasn’t because they were “healthy.” It wasn’t because they could be stored. No, it was merely because such foods promoted greater fat deposits per calorie than any other food source. That was good then, but it certainly isn’t now. Nor is the fact that such a diet also does a better job of shortening the postreproductive years.

You’ll recall that it isn’t just grains and beans that turbocharge fat storage, but also milk products. Lactating animals use milk for one thing: to promote rapid growth and weight gain in their offspring. All milk is loaded with insulinlike growth hormone. Sadly, multiple studies show that another component of milk, casein, and in particular casein A-1, becomes the lectin beta-casomorphin, which encourages fat storage by promoting inflammation. Remember, inflammation indicates a state of war, and the war effort requires fuel for the troops, stimulating the storage of more fat for fuel.

Unbelievable but True: The Power of Poop

If you take feces from obese rats and feed it to skinny rats, presto change-o, the skinny rats become fat! The reverse is also true: a skinny rat’s poop makes fat rats thin. Yes, you are interpreting that correctly: the organisms in your intestines control how skinny or fat you will be. Recent studies have shown that feces from fat humans given to skinny rats will make them fat; it works even better if you throw in some “fertilizer” in the form of sugars and fats! Still not impressed? Consider this: In the 1930s, institutionalized patients with severe depression were given laxatives to clean out their colon, and then given fecal enemas from happy people. You guessed it: the depressed individuals became happy.

As a student at the Medical College of Georgia in the 1970s, I witnessed cure after cure of a severe infection of the colon called Clostridium difficile colitis, which had occurred in patients given newly introduced broad-spectrum antibiotics. Again, the method was to give patients fecal enemas, in this case made with the poop of healthy medical students. In fact, once a week, the “honey pot” was passed around to all of us medical students to make a deposit, in order to have fresh poop available to treat this horrible disease. Little did we know then that the antibiotics had disturbed the intestines of these patients, and that the microbes in our feces restored them to health.

The Lectin Link to Obesity and Ill Health

I HAVE ALREADY introduced you to wheat germ agglutinin (WGA), and explained that it is implicated in celiac disease and also bears a striking resemblance to the hormone insulin. Now let’s take an in-depth look at the actions of insulin and problematic effects that occur when WGA mimics insulin.

Normally, when sugar enters the bloodstream from our gut, the pancreas secretes insulin into the bloodstream, and the insulin then travels to three main places: fat cells, muscle cells, and neurons. Insulin’s primary job is to open the door to any cell to allow glucose to enter and provide fuel, particularly to three important types of cells.

1.     IN FAT CELLS, insulin attaches to a docking port on a fat cell membrane and flips a switch that tells the fat cell to convert that glucose to fat and store it. When insulin has done its job, it separates from the docking port and no more sugar can enter the cell.

2.     IN MUSCLE CELLS, insulin unlocks the door to the cell and ushers in glucose to be used as fuel.

3.     NERVE CELLS (neurons) also require insulin to admit glucose through their cell membrane. The fact that neurons require insulin to get glucose is a relatively new finding, and we now know that insulin resistance also occurs in the brain and nerves—it is called type 3 diabetes.

Once insulin docks in the appropriate ports and releases information, the fat, muscle, or nerve cells tell the hormone that the message has been received. The hormone then backs out of the docking port, leaving it ready and available for the next hormone to attach.

Problems arise when lectins mimic insulin and bind to those docking ports on cell walls instead. The lectins either give the wrong information or block the release of the correct information. To understand the consequences, imagine that you are a passenger on a plane after a long flight, and another plane is still sitting at your Jetway at the terminal. You can’t get off the plane (release your information) until that plane moves. But suppose it never moves! Now what? As long as lectins occupy the “Jetway,” the proper messaging is interrupted or silenced—indefinitely.

Now let’s look at what happens when the lectin WGA fits into each type of insulin receptor docking port:

1.     In the case of a fat cell membrane, WGA locks on for good and continues to instruct the cell to make fat from any sugar floating by—ad infinitum. Think about it: if you were living eight thousand years ago, any plant compound that could enhance your ability to store fat from the meager calories you obtained would be a great plant. But that’s no longer a great benefit—and lectins such as WGA and a host of others in every grain do far more just to potentiate fat storage directly into fat cells.

2.     If WGA attaches to a muscle cell, it likewise permanently locks on to that insulin receptor—but in this case, the opposite effect results. WGA blocks the real insulin from docking, just as another plane sitting at your arrival gate means you cannot deplane. The result is that the muscle can’t get glucose; instead, it is shunted to a waiting fat cell, where WGA continuously pumps in sugar. Would it surprise you to learn that early man was far more muscular before the advent of grains and beans? Take a look at any ancient Egyptian frescoes and statues: these were skinny, nonmuscular people. As it turns out, insulin mimicry is the true cause of the muscle wasting as we age! The more lectins we eat, the more the receptors for insulin on our muscles are filled with WGA and other lectins, and the more muscle we waste.

3.     When WGA and other lectins lock on to the insulin receptor in nerve cells and neurons, they block the entrance of sugar there as well. With no sugar reaching its neurons, the hungry brain demands more calories. If you block insulin receptors with WGA, you get a hungry human—one who will eat more and hopefully be a big winner when winter arrives. This may have been fine in the short term, promoting mankind’s early survival; but if this process continues, more WGA and other lectins bind to insulin receptors in the brain and nerves, causing brain cells and peripheral nerves to die, resulting in dementia, Parkinson’s, and peripheral neuropathy.

The cumulative result is less muscle mass, starved brain and nerve cells, and plenty of fat. Sound familiar?

Recently, it has been found that lectins climb the vagus nerve from the gut into the brain and can be deposited in the substantia nigra,³ the switching center in the brain, damage to which causes Parkinson’s disease. This explains why, according to a large Chinese study, patients who have had a procedure called a vagotomy back in the 1960s and 1970s (in which their vagus nerves were surgically cut to treat ulcers) have a 40 percent lower incidence of Parkinson’s compared to age-matched controls.⁴ Lectins weren’t reaching the brain as readily, and therefore weren’t able to cause as much harm. It also explains why Parkinson’s is more prevalent among vegetarians, as they consume more plants (and therefore more lectins). Remember, the plant is just doing its job: ridding the world of unwanted pests, including you!

To summarize, in ancient times when food was scarce, weight gain from consuming the lectins in grains and beans was a huge benefit, but today, the same result works against us. Now let’s move to the second way lectins work for us and against us.

Preparing for War

I MENTIONED ABOVE that my patients who needed to replace lost weight had resorted to grain- and bean-based foods, but in doing so, most of them found that their inflammation markers had begun to rise. Was inflammation also promoting their weight gain? Remember, LPSs and lectins act like foreign invaders, which cause TLRs to alert the body that it is under attack and to go into “war mode.” During a war, the troops must be well nourished in order to fight the enemy, so food is often rationed for noncombatants. White blood cells and the immune system serve as the troops, while the muscles represent the civilians at home. By making muscles and the brain resistant to the effects of both insulin and leptin (the hormone that makes you feel full), calories are shunted away from the muscles and the brain, ensuring there are sufficient calories to fuel the white blood cells on the battlefront. Moreover, if there is a war going on, your body sends signals to encourage you to find more calories for the war effort. The more lectins you ingest from grains and beans, the hungrier you are.

This is a key point: You are insulin- and leptin-resistant not because you are overweight; rather, you are overweight because your body is at war and is saving calories for the war effort. This is the complete opposite of the common wisdom of why we bulk up. However, if the body senses that there is no war because no lectins and no LPSs are getting into the body, there is no reason to hoard calories, by either conserving food or seeking more food. Weight loss is a “side effect” of ending the war. No wonder almost everyone was slim fifty years ago, back when our bodies weren’t constantly at war!

Fat Storage

YOU’VE PROBABLY BEEN told that if you store fat around your midsection, it is the dangerous fat pattern known as apple-shaped, but if you store fat on your buttocks or hips, what is called pear-shaped, you are okay. There is a lot of truth to this finding. To understand why fat is stored in the gut, let’s return to our war analogy. The troops need fuel and it needs to be near the front lines, where the troops are battling the lectins and LPSs. And where is the war? Right, it is at the wall of your intestines, in your gut, where lectins and LPSs have broken across the border. Fat is not the culprit; rather, it is a sign of the battle being waged in your belly. It’s not called “belly fat” for nothing.

As a heart surgeon, I have known for years that when I open up a patient to do a coronary artery bypass I will find a large amount of fat surrounding these arteries on the surface of the heart. That fat is really thick and hard, and it’s there even if you are skinny. If there is a lot of fat, I know that a war is being waged nearby and that the call for supplies is constant. The war is in your arteries, and I am doing a bypass because you lost the war. In fact, multiple studies show that pericardial fat (fat on the arteries) directly correlates with the amount of disease inside the blood vessels.⁵ What are the implications? Wherever we find excess fat, that means there is a war being waged. Fat in your gut signifies not only that there is a war going on in your intestines, but that sadly it is spreading to your heart and brain, much like terrorist sleeper cells.

SUCCESS STORIES

An Alternative to Surgery

Surgery or a different diet—that’s the choice I give many of my patients. Although I am a heart surgeon, if the patient is a good candidate for my dietary approach and indicates interest in this alternative, I always discuss the Plant Paradox Program with him or her. As long as someone adheres to the diet, the results are remarkable. Offering patients this option has earned me the nickname No More Mr. Knife Guy! Here are just a few of the many people who have avoided major surgery with simple lifestyle choices.

BLOCKED NO LONGER. When Vincent P., a sixty-seven-year-old theatrical producer, developed chest pain while exercising, an angiogram showed a narrow lesion in his right coronary artery, which had been previously treated by implanting a stent. His cardiologist referred him to me for dietary treatment of several other arterial lesions, which were 60 percent blocked and not eligible for stents (but still of concern). After following the Plant Paradox Program for ten months, Vincent had another angiogram, which showed that all of the remained blockages had been resolved, making surgery or other stents unnecessary. Six years later, Vincent takes no medication, routinely passes his stress tests, and recently opened an off-Broadway show.

A PROMISE KEPT. Sonja R., a fifty-eight-year-old farmer and severe diabetic, was scheduled for an emergency triple bypass after having a heart attack. Five of her arteries had severe blockages. In the pre-op room, she asked whether any other option was possible. After I told her about my dietary approach, she said she would be my best patient if I would not operate on her. She kept her promise: three years later she has lost forty pounds, is no longer a diabetic, takes no medications, has no chest pain, and has a normal response to my cardiac stress tests. Sonja now raises pastured chickens and goats, makes goat yogurt, and hauls wheelbarrows of manure and soil daily.

GOODBYE TO DIABETES. At sixty-nine, Howard L. was obese and took eight medications daily for diabetes and other conditions. He had suffered a heart attack and was scheduled for an emergency five-vessel bypass surgery. In the pre-op room, I could tell that he was extremely anxious. After we spoke for a while, Howard told me he didn’t think he was going to make it through surgery and asked whether there was another option. When I offered him my diet, he jumped at the chance. Now, five years later, his diabetes and chest pain are history, he takes no medications, he has lost thirty pounds, and he regularly passes his annual stress tests.

An Abundance of “Successful” Diets

WHY ARE THERE so many diets? And why do so many of them work (at least temporarily)? Do they have anything in common? Step back and tick off a few of the most successful and popular diet philosophies of recent years: low-carb, high-protein (Atkins, Protein Power, South Beach, and Dukan, to name a few); low-carb, high-fat, high-protein (Paleo, ketogenic-Paleo); low-fat, high-carb (Ornish, McDougall, Fuhrman, Esselstyn). Each of these approaches can lay claim to immense success among its followers. Alan Levinovitz, Ph.D., recently parodied the popularity and success of these totally different diets in The Gluten Lie and Other Myths About What You Eat. The book presents a fictional UnPacked diet, which is based on eliminating plastic wrappers (I kid you not). He cites websites to visit, pretends to sell products, and provides testimonials from patients. After you avidly read the multiple arguments Levinovitz makes in support of his program, you are suddenly confronted with the fact that he carefully cherry-picked his data, used other diet gurus’ own words, and stole testimonials from most of the wildly different programs listed above about the great results. The joke is seemingly on us. (But what Levinovitz misses is the fact that all the data he quotes about the dangers of plastics are actually true, as you learned in the last chapter.)

I have had the privilege of treating a number of patients who were firm adopters of each of the above-mentioned programs. They may have controlled their weight, yet they continued to have troubling medical issues, including advancing coronary artery disease and autoimmune disease, to name just two. Let’s dig deeper into what really happens on these diet programs.

The Problem with Most Low-Carb Diets

A LOW-CARBOHYDRATE DIET—think Atkins or South Beach—often works well in the short term. Heck, it worked well for me initially. However, if and when you return to eating significant amounts of lectin-containing carbohydrates, those lost pounds usually make a comeback. Even if you stick with the program, your weight loss typically stops or slows significantly at a certain point. All low-carb plans are inherently high-protein diets, and thus restrict carbohydrates, all grains, and legumes—and with them, their lectin load. When the South Beach and Atkins diets reintroduce grains and beans in the maintenance phase, and people invariably start to gain weight, what is suggested? You guessed it: go back to the first phase and cut out grains and beans!

The Paleo concept takes the high-protein diet a step further and is based on the faulty assumption that early man dined on buffalo and other large animals on a regular basis and that’s what made us healthy. In all likelihood, such kills were hardly a regular occurrence. Instead, our forefathers likely subsisted mostly on tubers, berries, nuts, and animal protein sources such as fish, lizards, snails, insects, and small rodents. Now, don’t get me wrong—our “ancestral diet” was designed to do what any diet does: ensure that you grow up, reproduce, and then get out of the way. Your genes designed the ancestral diet to make you an ancestor, if you get my drift. Enabling you to live long is counterproductive to maximizing the number of humans being born, just as making cars that last forever is counterproductive for the automobile industry. I hate to break it to you, but any success you may have experienced on the Paleo diet or another low-carb plan, whether as weight loss or improved health, was not the result of restricting carbohydrates and eating lots of protein and fat. Rather, any positive response was the result of—guess what?—eliminating most lectin-containing foods. Don’t forget that the Paleo concept is defined by what our Stone Age ancestors supposedly ate 100,000 years ago.

Finally, my Paleo colleagues somehow don’t realize that all our ancestors were originally from Africa and never encountered any lectin-containing food from the Americas. Sorry, folks, but tomatoes, zucchini “noodles,” bell peppers, goji berries, peanuts, cashews, sunflower seeds, and chia or pumpkin seeds are not ancestral foods—and they are loaded with lectins.

Another Approach to Restricting Carbs

A KETOGENIC DIET, which is traditionally prescribed to help people, including children, with diabetes moderate their blood sugar and insulin levels, is also a low-carbohydrate diet—but with a significant difference. Instead of replacing most carbohydrates with protein, a true ketogenic diet also limits protein, relying instead on certain fats for the majority of calories. (Ketosis refers to burning fat rather than glucose from carbohydrates for energy.) If you limit certain animal protein intake, as the Plant Paradox Program does, you will almost certainly lose weight. And when I limit it even more with a modified ketogenic version of the Plant Paradox Program, I see remarkable success not only with patients with diabetes (or who are extremely insulin-resistant) but also with those suffering from cancer, dementia, Parkinson’s disease, autoimmune disease, and a number of gut diseases. (Chapter 10 addresses this modification.) The question is: are most people on a ketogenic diet in ketosis, and is that why they are losing weight? The answer from my patients’ laboratory assessments is a resounding no! So, why the weight loss? Once more, removal of the vast majority of lectins from their diet, not the addition of fat, made the difference.

Hold the Fat and Push the Whole Grains

DO PEOPLE LOSE weight on low-fat, whole-grain diets such as those from Ornish, Esselstyn, and T. Colin Campbell (The China Study)? Indeed they do. I’ve seen a lot of them as patients because although they did lose weight, these diets failed to halt the progression of their coronary artery disease. But why the weight loss? I think it is the result of four factors:

1.     They remove the lectin-containing fats so prevalent in our American diet, namely soy, peanut, cottonseed, sunflower, and canola—all of which not only contain lectins but are also extremely high in polyunsaturated omega-6 fats, which are used by our TLRs to incite the inflammatory cascade. Inflammation equals war equals store fat near the war zone—in the coronary arteries.

2.     Because they have eliminated fats, low-fat diets do not allow LPSs, which have to travel on long-chain saturated fatty acids to sneak through the gut wall, where they would cause inflammation. That is a good thing, but the well-meaning physicians who had once demonized all fat and championed low-fat diets have come to realize that all fat is not the same. Fish oil is now an integral part of Dr. Dean Ornish’s program, and Dr. Joel Fuhrman has made fatty nuts an important part of his diet.⁶ Luckily, neither of these regimens allows lectins to cross the gut barrier, so they are “safe.”

3.     They use whole unprocessed grains, not ground-up “whole grains.” Now, I feel a little like Mark Antony here, when he said, “I come to bury Caesar, not to praise him.” So why am I defending whole grains? First, most whole-grain “foods” are not actually whole grains, but are ground-up versions. Do you ever actually see a lot of “whole grains” in that piece of bread or cracker? Their lectins have already been released, and, as a double whammy, their fats are treated with BHT to prevent oxidation.

4.     These physicians have correctly focused on organic grains, which are far more likely to be untouched by Roundup and the resulting death of the normal gut bugs. As a result, the diets enable the gut to handle gluten and prevent gang members from moving into the void created by that herbicide.

And then there’s this sad fact: these diets are generally intolerable, so you don’t eat much. Even the Kellogg brothers couldn’t get their sanatorium guests to eat whole grains, hence the birth of Kellogg’s cornflakes (ground-up grains). A review of Dr. Esselstyn’s original study shows a 50 percent dropout rate. It’s not a diet you can live with, so any positive results in terms of weight loss may be short lived.

Why have the followers of these programs who became my patients found that their coronary artery disease had progressed? The WGA in wheat continued to bind to the endothelial lining of their coronary arteries, which their immune system attacked. If you ever wondered why the southern Chinese, Japanese, and Koreans (all of whose staple grain is rice) have lower heart disease rates than Americans, remember this: rice contains no WGA. Nor does the taro root the Kitavans eat in abundance. Likewise, the millet, sorghum, and yams that are African staples contain no WGA.

What We Share with Elephants

WANT ONE MORE shocker about grasses and grains? In the wild, where they dine only on the leaves of trees (like our forebears), African elephants have no known coronary artery disease. Due to habitat destruction, however, herds of elephants now graze on grasslands or are fed hay and grains. These animals have a 50 percent rate of severe coronary artery disease, thanks to the lectins they were never designed to eat, which bind to their arteries and incite an attack.

It is now time to reveal which sugar molecule the WGA and other lectins are after. As it turns out, there’s a particular sugar molecule that elephants—and humans—possess that causes this problem. This lectin-binding sugar, called Neu5Ac, sits on the lining of blood vessels and the absorptive cells on the gut wall known as enterocytes. Most mammals have a sugar molecule called Neu5Gc on the lining of their gut wall and blood vessel walls. But humans lost the ability to make this molecule at the time our species diverged from chimps and gorillas eight million years ago. Instead, we make the lectin-binding Neu5Ac, a characteristic shared with shellfish, mollusks, chickens, and elephants. (Yes, strange bedfellows!) Lectins, and particularly grain lectins, bind to Neu5Ac but cannot bind to Neu5Gc. This explains why captive chimps eating a human grain-based diet don’t get atherosclerosis (hardening of the arteries) or autoimmune disease, but the poor grass-eating elephants do get coronary artery disease. The chimps lack the lectin-binding sugar molecule, but elephants and humans possess it—and it gives us heart and autoimmune diseases in spades when we eat lectins in grasses and seeds.

The Anti-Aging Approach

REMEMBER, YOUR GOAL is to eat a life-enhancing diet, not just one that will help you shed excess pounds and keep them off. A serious problem with any low-carb or “ancestral” dietary approach is that consuming significant amounts of certain animal protein, particularly red meats, is known to be a major trigger of aging, as well as of atherosclerosis and cancer. How so?

Back to our old friend Neu5Ac. Stay with me, as it gets more complex before I can simplify it. Cattle, pigs, and sheep all carry Neu5Gc, which your immune system recognizes as foreign when you eat their meat. Now, Neu5Gc looks a lot like Neu5Ac (the bar codes are nearly identical). There is significant data suggesting that when our immune system is exposed to the foreign sugar molecule Neu5Gc from red meat, we develop an antibody to the lining of our own blood vessels, which has Neu5Ac. This causes the antibody to attach to the lining of our blood vessels, mistaking our own naturally occurring Neu5Ac for the Neu5Gc we’ve consumed, and calling in a full-fledged attack from our immune system.

This is the perfect example of friendly fire, and it provides further proof why shellfish, mollusk, and fish eaters have better heart health than meat eaters. Furthermore, it has been shown that cancer cells use Neu5Gc to attract blood vessel growth toward them, via production of a hormone called vascular endothelial growth factor (VEGF), which I measure in all my patients. VEGF production is promoted by an immune attack on Neu5Gc. Cancer cells even use Neu5Gc to hide from our immune cells, essentially cloaking themselves in an invisible shield. What’s more, human tumors contain large amounts of Neu5Gc, despite the fact that we have no genes to manufacture it. That means the tumor cells got it from that beef, pork, or lamb you ate, and nowhere else.

In plain English, the reason to avoid red meats is to avoid an autoimmune attack that promotes heart disease and cancer, all because of a genetic mutation of a lectin-attracting sugar molecule that’s found in humans.

A diet low in any animal protein has been shown to extend life, as will be discussed in chapter 9. So, a certain amount of animal protein is the actual mischief maker when it comes to longevity. This means certain carbs (those without lectins, or with lectins with which your microbes have been familiar for millennia) are not as problematic as the Atkins and Paleo folks have taught you, as long as you minimize certain animal proteins.

And hastening the aging process is not the only result of eating excessive amounts of protein. Remember, eating simple sugars increases production of insulin, the fat storage hormone, just as eating fat boosts the level of leptin, the hormone that signals your brain when you are full. But you may not know that when you consume sugars along with certain proteins more prevalent in animals than plants, they stimulate cells’ ultimate aging receptor, which senses energy availability. We will discuss this aging receptor in chapter 9.

Energy—think food—is usually available cyclically, based on the circadian rhythms of seasons and daylight. If energy is plentiful, then it is time to grow and make things, meaning babies. When energy is scarce, it is time to batten down the hatches, get rid of hangers-on, and wait things out. During scarce times we use the fat we stored; meanwhile, our mitochondria switch from sugar (glucose) burning to fat burning, in what is called metabolic flexibility. Most of my patients with multiple diseases have lost all metabolic flexibility. This means that a diet high in both sugars and protein encourages weight gain and makes a person more susceptible to disease—and therefore could and indeed does reduce life span, but also health span and life enhancement.

Here’s another paradox for you: Your genes want you to reproduce and replace yourself. Once that happens, your genes couldn’t care less how long you live—okay, you do need enough time to get your offspring to the point where they are able to survive on their own—and then they do everything they can to get out of the way. That middle-age spread is a perfect example of what I am taking about. We are supposed to die off once we replace ourselves. But if we want to live as long and as healthy a life as possible, we need to eat differently.

A Paleo Diet That Endures

LET’S RETURN TO my previous conundrum, the Kitavans, a small tribe of farmers who inhabit an equally small island in Papua New Guinea. According to Swedish physician Staffan Lindeberg, who has been studying the tribe’s diet for decades, the Kitavans obtain 60 percent of their calories from carbohydrates, 30 percent from fat (most of it saturated fat), and only 10 percent from protein. Most of the islanders smoke, they are not very active, but they live well into their nineties without medical care. Their diet seems to contradict most of the conventional assumptions about what constitutes a healthy diet, and yet the tribe seems untouched by most of the diseases of modern man.

Lindeberg’s study, in which he matched 220 Kitavans with as many Swedish subjects of the same age and gender, provided provocative results.⁷ Kitavan men age twenty and older had a lower body mass index (BMI), lower blood pressure, and lower total LDL (“bad”) cholesterol than those of comparable Swedish men. Both groups displayed similar HDL (“good”) cholesterol readings. Kitavan women over the age of sixty had lower levels of APoB (apolipopoprotein B), a marker for LDL cholesterol associated with heart and vascular disease, than their Swedish counterparts. Furthermore, Kitavans never experience strokes or heart attacks.

When Is a Carb Not a Carb?

SO HOW DO the Kitavans stay slim and avoid heart attacks, despite eating mostly carbohydrates and a large amount of primarily saturated fats, both of which are considered a recipe for obesity (and heart disease, in the case of the fats) in the West? The answer lies in the fact that the carbohydrates the Kitavans consume are primarily resistant starches, which give you a free (well, almost free) pass when it comes to their caloric content. If that sounds too good to be true, welcome to the world of resistant starches. This subset of starches behaves differently in your GI tract than do corn, rice, wheat, and other typical starches or simple sugars. Instead of being quickly converted to glucose (blood sugar), which is burned for energy or stored as fat, yams, taro, plantains, and other resistant starches simply pass through your small intestine intact. These foods are resistant to the enzymes that break complex starches—hence their name.

That means you don’t absorb the calories as sugar, which would prompt an insulin surge—but what is even better is that these starches are just what the doctor ordered for your gut microbes, which happily devour resistant starches and grow, meanwhile converting them to short-chain fatty acids such as acetate, propionate, and butyrate (the colon’s preferred fuel, as well as a perfect fuel for neurons). Resistant starches also increase the proportion of “good” bacteria in your gut, just as a prebiotic does, not only enhancing digestion and nutrient absorption but also fostering the growth of bugs that nurture the mucous layer of your gut.⁸ More mucus means fewer lectins getting through to rip open the tight junctions and start the whole lectin-induced cycle of weight gain and misery.⁹

In addition to not raising blood sugar or insulin levels, resistant starch assists in controlling your weight by:

•   Reducing calorie count when substituted for wheat flour and other quickly metabolized carbohydrates.¹⁰

•   Making you feel full longer and therefore consume less food.¹¹

•   Boosting fat burning and reducing fat storage after a meal.¹²

You need not live on an island and eat taro day in and day out to get the benefits of resistant starch. In Part II, I’ll introduce you to more sources of the microbe-friendly food and explain how to prepare them to maximize their benefits.

How Leaves Become a High-Fat Diet!

A gorilla is a classic herbivore, subsisting primarily on leaves. (Yes, they do occasionally inadvertently scarf down an insect or three on the leaves.) Surprisingly, a gorilla eats sixteen pounds of “fat-free” leaves a day, but 60 to 70 percent of the calories the animal absorbs after digestion is in the form of fats! How can that be? Well, the gut microbes, good little guest workers that they are, break down the cell walls of plants and ferment the energy into usable fuel, principally the fats we just discussed, which the animal can absorb. As a result, the gorilla “eats” an extremely high-fat diet! Just like the Kitavans!

Other Long-ived Thin Peoples

I SHOULD MENTION that with the rise of globalization, traditional diets are increasingly giving way to the SAD, or perhaps more appropriately, what is now the typical Western diet. But the Kitavans don’t have a lock on longevity and good health. Okinawans, Cretans, and Sardinians are known for their longevity. Although their diets differ, both also consume foods that feed gut bacteria. If you carefully examine the diets of long-lived societies, including the Seventh-day Adventists of Loma Linda, California, where I was a professor for years, a remarkable pattern emerges from seemingly disparate diets. The Okinowans and the Kitavans eat a diet very high in resistant starches, from a purple sweet potato and taro root, respectively; the Cretans and Sardinians eat a very high-fat (olive oil) diet, while the Adventists eat a diet composed of 60 percent fat, despite being vegetarians.

What could possibly be the common thread? It’s the minimal intake of animal protein. Most of these long-lived cultures get most of their calories from sources other than protein. And even the high “carb” eaters, like the Kitavans and the Okinowans, turn their resistant starches into usable fat, courtesy of their gut bugs. We’ll revisit these long-lived societies in Part II.

Blame Pizza and Chicken for Fat Kids

IT’S OBVIOUS THAT the American diet has changed dramatically in the last century. In that same time, and particularly in the last fifty years, we (and our children) have become significantly heavier. For her 2009 doctoral dissertation in the urban studies and public affairs program at the University of Akron, Lisaann Schelli Gittner explored the connection between the changes in the American diet and the rise in childhood obesity.¹³ Her thesis, entitled From Farm to Fat Kids, explored one of the unintended consequences of government agricultural policies, which significantly changed the food supply. This created a niche for inexpensive processed and refined foods, and their increasing use correlated with the growing incidence of obese kids. Beginning in the 1960s, the intensive planting of crops such as corn, wheat, sugar beets, canola (rapeseed), and soybeans made for a very different supply of plant food than was available around 1900. This shift in crops led to a change in diet from grass-fed meats and their fats (butter and lard), chickens that ate bugs, lots of root vegetables, and very limited amounts of fruit to one high in polyunsaturated fats, sugar, massive amounts of fruit products like apple juice, and other processed foods, and one low in vegetables. The increase in BMI of children over these years mirrored these changing patterns in food consumption.

But despite all this, only two foods correlated perfectly with rising obesity rates in kids. Not surprisingly, they were pizza and chicken. In the 1970s, kids started eating lots of both these foods. Just check out the lunch menu in any public school. The more pizza and chicken kids consumed per year, the higher their average BMI. Although Gittner’s focus was public affairs, not lectins, both of these foods are lectin bombs. The typical pizza contains at least three ingredients full of them: wheat, cheese full of casein A-1 and insulinlike growth factor, and tomato sauce. How about the chicken? Unlike its forebears, which foraged in the barnyard for grubs and insects, today’s typical hen spends its brief life eating soy and corn, and laced with the estrogenlike compounds arsenic and phthalates. Dip this chicken in wheat flour breading mix and deep-fry it in peanut or soybean oil and you have a perfect lectin and estrogen bomb. Eat these two foods on a regular basis and your lectin load grows—and with it, your weight almost certainly will as well.

You now have a thorough understanding of how we got into this intertwined health crisis, thanks to subtle changes in your foods, personal care products, lighting, and a host of new drugs, and why your excess weight and health problems really aren’t your fault. Now it’s time to take back your body and your life. As I tell my patients, your body is the only home you will ever live in. If you spend the same effort on this home that you spend on your house or apartment or car, the dividends will last a long, vibrant lifetime. Let’s move on to Part II, where I’ll supply you with the tools and guidance you’ll need to achieve a healthy weight, along with vibrant health.