Improved moodThis book is for John Doyle.
Soon after John retired, he and his wife relocated from Ohio to Clearlake, north of Napa County, California. They came to be close to their son, to watch their new grandbaby grow, and to play in a four-season outdoor paradise. But weeks after relocating, John picked up his two-year-old granddaughter and felt a searing pain shooting through his back. What should have been a simple strain that might have resolved itself in a few days simply got worse—to the point that he needed help taking a shower. A stoic man, he endured the pain for two weeks before going to see his doctor. An X-ray showed a funny shadow, and the follow-up MRI identified a benign mass growing around his nerve that his doctors thought might be contributing to the pain. He counted himself lucky that the tumor was caught before it became inoperable. So John and his wife came to the hospital where I worked, in Napa, for what should have been a routine neurosurgical procedure. And that’s when his luck ran out.
The routine surgery turned out to be not at all routine. It was complicated by an infection, and the infection was complicated by a blood clot in John’s spinal cord that, by the time we met, made it impossible for him to walk or control his bladder and bowel. As his primary care physician, I saw John multiple times a week, and always there was a new problem. It was tragic. To this day, I remember his case in detail; I remember the frustration of dealing with a new medical issue each time he came in for an office visit only to see another problem pop up a few days later. Everything I’d hoped to help people to avoid—by writing books and posting articles on my blog and speaking in public—and all the work I’d done, was to prevent bad things from happening to good people the way they were happening to John. His body was falling apart, and in spite of how easily it all could have been prevented, I’d never had the opportunity for early intervention. John was not my patient until it was already too late.
This book is for John’s wife, Margaret. Six months after we met, John Doyle was dead. His infection never cleared and he developed another clot that stopped his heart. After her husband of almost fifty years passed, the RV Margaret and John were going to travel in together became difficult to manage, and aside from her son and grandchild, she didn’t know anyone in Clearlake. She relocated to a retirement community in Napa, where I continued to treat her for insomnia, depression, and anxiety. Unlike John, she’d always tried to eat right, so aside from stress-induced conditions, she was in good shape. Unfortunately, their son followed John’s eating habits more than Margaret’s, giving low priority to healthy eating and, unknowingly, putting his offspring at risk.
This book is for John’s young granddaughter, Kayla. Her dad and his girlfriend were dedicated parents, and when baby Kayla developed eczema, her mom’s pediatrician advised switching to formula. It didn’t help. But by the time they figured that out, her mother’s breast milk production had stopped. At age three, Kayla developed a limp that turned out to be the result of a brain tumor. Margaret took her RV back up to Clearlake and parked it in her son’s driveway so she could help out. Like so many of my health-conscious patients, she found herself staring down at two generations of failing health, a scenario that too many health practitioners would just chalk up to bad luck.
The story of the Doyle family—a story of life interrupted, of hopes, dreams, and plans taking a sudden, unfortunate turn—is one I see play out in my office all the time. These are stories that could have happier endings.
The narrative of this entire family would have played out differently had they benefited from preventative intervention. But in the current healthcare system, people don’t receive the most powerful form of preventative medicine—a comprehensive dietary education. We hear about barriers to healthcare all the time, but that was not John Doyle’s problem. He was lucky enough to have had excellent insurance; it covered all his bills and granted him plenty of access to every specialist he needed, whenever he needed it. What John’s medical providers couldn’t offer him—what few doctors can offer any of their patients—was a crash course in healthy eating. Without this knowledge, he was left vulnerable to a most insidious killer: the standard American diet.
His previous doctors never spoke to him about diet. And why would they? Medical doctors are simply not trained to consider how a person’s diet might contribute to medical conditions other than obesity, diabetes, or heart disease. What little we physicians do learn about preventing illness is so useless that few of us even abide by it ourselves. Since there’s not much by way of standardized nutrition training, any doctor interested in nutrition must take it upon himself to study on his own. And any physician hoping to fully understand how nutrients and toxins act in the body would need a particularly strong background in biochemistry and cell physiology.
When my own health took a turn for the worse in 2001, I leaned heavily on my undergraduate training at Rutgers University and graduate work at Cornell studying biochemistry and molecular biology as I tried to flush out any possible connection between my health problems and my diet. The deeper I dug, the more critical that training became. The revelations were so profound, I immediately started putting them to use to help my patients.
Like most doctors, I had an average of seven minutes with each of my patients. So although there was no time for a wholesale revision of their dietary program, I could at least leave them with some key advice—like cut out vegetable oils and reduce sugars—that would, more often than not, produce amazing benefits. I’m talking about reversing high triglycerides, hypertension, eczema, recurring infections, migraines, and more.
As much as hospitals and clinics like to talk about wellness and prevention, the truth is, a real discussion about healthy eating cannot take place in a doctor’s office. This is why in order to check off the “nutrition-discussion box” they rely on sound-bites, like “eat your colors,” which doesn’t really mean much, or “everything in moderation,” which, in a world where toxins are marketed as health foods, can be harmful advice. Providing real dietary guidance requires far more time with patients than insurance models currently allow. You could fill a book with what needs to be discussed for anyone to adopt a truly healthy diet—which is why, in 2003, I started writing this one.
Five years later, Deep Nutrition was complete, and the book started to catch on. People around the world wrote me, sharing stories of how their lives had been changed for the better by implementing its principles. Soon thereafter, the L.A. Lakers took interest. Head trainer Gary Vitti and strength and conditioning coach Tim DiFrancesco felt that good nutrition was being underutilized in the NBA. And so, with me as a member of their training staff, we developed the PRO (Performance Recovery Orthogenesis) Nutrition Program and created a partnership with Whole Foods Markets to ensure that no player, whether on the road or at home, would have to rely on junk food if they didn’t want to. Since that time other NBA teams have developed relationships with Whole Foods Markets with excellent results—a trend toward real food in professional sports that is certain to grow.
I don’t think of Deep Nutrition as a diet book. It’s a book that gives you control over your own health destiny. It’s an alternative to handing that control over to the financial interests of hospitals and multinational corporations—institutions that see you as little more than an image on an X-ray and will turn a blind eye to lucrative procedures performed without proper medical indication. You don’t want to have to depend on anyone else—well-meaning or not—to set your life back on track. And you don’t need to.
Deep Nutrition isn’t just a diet book. It’s an I’m going to enjoy my retirement book. It’s an I’m not dependent on medications book. A My kids are healthy book. It’s an I have all the energy I need book. An I get to see my granddaughter’s graduation book. An I can play whatever sport I want book. An I can do anything I put my mind to book. It’s first and foremost an I’m getting to live the life I want book, because to live the life you want, the life you imagine for yourself, you first need to take control over your health.
You can think of diet as a strategy, a tool—the most powerful of all tools—to accomplish the task of optimizing your health. When my husband, Luke, and I wrote the first edition of Deep Nutrition, my intent, as a physician, was to give that tool to as many people as I possibly could. And it brings me such joy and satisfaction that the original edition did help a lot of people. Every time a patient bought dozens of copies to share with their families, I felt grateful. When athletes like Kobe Bryant, Steve Nash, Dwight Howard, and Bryce Salvador started adapting its principles, becoming role models for their fans, and even helping to implement these principles inside the leagues in which they operate, I felt grateful. And when leading health experts, bloggers, physicians, nutritionists, and authors began to incorporate many of our ideas into their own work, I felt grateful. I felt grateful because I knew that each of these people were using the book as a tool to change the course of their own health destinies.
As I had hoped, Deep Nutrition changed the conversation.
But it didn’t do enough.
Sadly, the general trajectory of America’s health has not changed—not even close. Statistics show our country is less healthy than it was in 2008. There are now more people struggling with obesity, more children with autism, more food allergies, more traumatic brain injuries from which athletes and soldiers don’t fully recover. There’s much more work to be done. And thankfully, there is also now new, powerful scientific data at our disposal to bring the concepts of Deep Nutrition up-to-date, and plenty of additional research that reaffirms the basic tenets of the book as well as research demanding an expansion of some of those concepts into new territories.
For those of you who purchased the original edition and have lived in accordance with my advice—those of you who knew in your bones that traditional food using well-sourced produce and humanely raised animal products made intuitive sense—I’m happy to be able to say that all the new science available confirms that you banked on the right ideas. But as the science of nutrition continues to evolve, and the wellness conversation right along with it, there’s a lot more to talk about. With this new, updated edition, I hope to bring you four categories of information I believe you’ll find useful in your journey towards optimizing your health.
In the first edition of Deep Nutrition I presented the key ideas I thought were important to anyone wanting the big picture of human health. It was really my book. This expanded edition is your book.
I have not just updated the science and added new chapters. I’ve also responded to all the insightful questions, feedback, criticisms, and demands for fuller explanations that I’ve heard from readers in response to the first edition. Many are built into the expanded chapters. Others, particularly topics that are on everyone’s minds right now, such as detoxification, genetically modified organisms (GMOs), animal rights and sustainability, gluten, brain health, and the microbiome, are addressed in a separate Frequently Asked Questions chapter.
While practicing medicine in Kauai, Hawaii, I asked Luke if he could help me write a small pamphlet to explain what I knew to be true about nutrition in simple terms for my patients. Soon, that pamphlet grew into the first edition of Deep Nutrition. Never did I anticipate that it would give rise to a community. Some of my readers have taken the ideas presented in the book and added to them, lecturing on nutrition or even writing their own books. Many have started businesses—hip new broth bistros, catering companies—that celebrate the dietary concepts I describe. It’s been incredible to hear from this community. Six years after its publication, I still receive daily phone calls, emails, and comments on social media from people whose lives have been changed for the better by implementing the ideas in the book. I’ve heard hundreds of stories of hope from young families with new children; from adults healing from chronic pain; from people who have recovered from disease, who have experienced physical rejuvenation, or who feel better in their sixties than they ever did in their twenties. Stories like this reassure me that this book is as relevant today as it was when we first wrote it.
Since its publication, I have witnessed hundreds of my clinic patients experience astonishing health reversals after applying the Deep Nutrition principles. I have watched happily as they return with lower blood pressures, cholesterol abnormalities eradicated, skin conditions cleared, migraines resolved, moods stabilized, auto-immune diseases—sometimes disabling—drastically improved or in remission. And I have received a flood of testimonials that confirm the body’s seemingly miraculous capacity to heal when provided a true, human diet.
Here are just a few of the ways adopting Deep Nutrition has changed the lives of its readers:
FOR ADULTS
Improved mood
Hunger is curbed and need for snacking disappears
Stronger joints
Smoother skin
Improved fertility
Fewer infections
Near elimination of heart attack and stroke risk
Allergic reactions diminish
Reduced risk of dementia
FOR CHILDREN
Improved learning capacity
Fewer tantrums and behavior problems
Improved jaw growth and reduced need for orthodontia
Improved immune system and reduced allergies
Increases in potential height
Puberty occurs at the normal age and rate
But the stories that touch me most deeply speak to a kind of awakening when it comes to our relationship with food. This is a trend that started long before Deep Nutrition, but I feel that I’m augmenting that new awareness when people tell me how our book “completely changed their relationships with food.” They rhapsodize passionately about clearing their kitchen cupboards, dusting off their grandmothers’ cookbooks, seeking out farmers whose practices include revitalizing overworked soil, and treating their animals with the respect they deserve.
That brings me to something else I’ll be discussing in this edition: important lessons to be learned from the vegan/vegetarian community that benefit the animals raised for food, the environment, and of course, our health. While omnivores and vegans necessarily disagree about one of the central ethical questions of our time—Is it ever okay to eat animals or dairy?—there is much vegans and conscientious omnivores already agree about, and the sooner those two groups get together and discuss those commonalities, the sooner we can start to make a significant change in human health, and the healthier our planet.
It’s one thing to know what’s good for you. But the real work begins when you decide to organize your daily routine around a new way of eating. The number-one request I receive is for more specific, practical instructions on how to implement the Deep Nutrition concepts into our lives. So this edition includes an entire section that will guide you, step-by-step, on how to make the switch to the ultimate healthy lifestyle. Much of what is included in this new chapter has come from our readers, who have generously shared not just their success stories, but also the nitty-gritty details of exactly what they did first and how they handled the complexities of building these better habits into the swirl and chaos of daily life. And of course this edition includes what everyone has asked for most of all: meal plans and recipes!
Because I do talk a lot about the value of animal products to our health, it’s not always obvious that there’s a benefit to be gained by following the Deep Nutrition principles even without eating meat. So I’ve created a plant-strong meal plan to help readers following a vegetarian or vegan lifestyle to optimize their nutrition as well.
To those of you who went out and spread the word about Deep Nutrition among your family and friends, whether you’re a dietician, doctor, nutritionist, or trainer who made it required reading among your clients and patients, or a chef, student, foodie, science enthusiast, or homemaker who simply believes in the message and wants to spread it, I thank you. Your way of thinking is starting to catch on. More people are talking about the harms of sugar—even doctors! More people are refusing to take antibiotics unless they’re absolutely necessary. More people are taking the need for sleep seriously. More people are interested in fostering a relationship with beneficial bacteria: taking probiotics, avoiding antibacterial soaps and lotions, even fermenting their own kombucha, kefir, yogurt, sauerkraut, and more. More people are concerned about animal welfare and are willing to pay more for meat if it comes from farmers who are conscientious about being good stewards of the land and taking proper care of their animals.
If you are already on board with all of that, this edition will arm you with the new science that has come to light since 2008. These fascinating new insights—from research in all areas of health—show that you were right to believe in the Deep Nutrition message. Like me, you probably believe that if everyone (or at least most people) do not get on board in a big way, then health in the United States, and elsewhere, is certain to decline even further. So it’s not just a matter of your personal health improving; it’s a matter of whether or not you want to live in a society where our failing health is the only thing people talk about.
The good news for us is, according to all the research in all the health-related fields that has come out since the first edition of Deep Nutrition was published, those of us who believe that diet is central to good health are on the right page. And every day researchers around the world release more evidence that a good diet can do more than anything else to improve quality of life. The bad news is that we’re still not all in agreement about what a good diet is. And because of the continued misinformation supporting consumption of a continually less nutritious food supply, we now are experiencing the predicted results of worsening health. In fact, in some areas of health, the problems are picking up pace—incidents of food allergies, diabetes, and mental illness have only increased since 2008. This updated edition offers those of you who are on the cutting edge of educating others more ammunition to help you do the good work you do.
In 2012, I walked into my office where a fax placed on my desk labeled “FROM CIA PRESIDENT” was marked “URGENT.” In this case, the CIA did not refer to the international agency based in McLean, Virginia. It stood for the Culinary Institute of America. The fax was sent in response to an article Luke and I wrote for the Napa Register entitled “The Canola Blob.” Our article explained that this toxic oil, touted as “heart healthy,” had displaced not just butter and cream but also olive, coconut, and peanut oils from the menus of most of the Napa Valley’s finest restaurants—including one that was once described as “the best restaurant in America.” We intended to sound the alarm that canola—together with other refined, bleached, and deodorized (RBD) vegetable oils—was anything but heart healthy. To the contrary, I warned that canola and other vegetable oils are largely responsible for the majority of fatal heart attacks and disabling strokes, as well as a raft of other familiar diseases, in the United States. We hoped to draw the attention of chefs and start a conversation. So we were actually quite pleased to be issued, from the president of the CIA, a summons to call him “to discuss [our] spreading wrong information.”
It turned out the president, Charles Henning, was an affable gentleman who kindly invited us to “break bread” and discuss the source of our difference in opinion. Several days later, Luke and I found ourselves sitting at a table with Mr. Henning at the open-air restaurant overlooking the rolling green vineyards and stately oaks in the valley below. He had prepared quite a treat for us, including a tasting flight of olive oil paired with chocolates. He was quite passionate about the quality of his olive oils, and spent a few moments detailing the great care taken to preserve the delicate antioxidants responsible for its pale green color and complex flavors. I was genuinely impressed at the breadth of his understanding of biochemistry, so I told him, “Not many people could explain the science of oxidation in such clear detail. But as we’re here because of our difference of opinion on canola, I have to ask, If you recognized that care must be taken to protect the nutrients in olive oil, why not consider what the processing does to canola, which is never treated so gently? If canola is so healthy, why aren’t we having a canola tasting?”
And that’s when I got a taste of the bitter truth. “We have to feed the masses. There’s just not enough olive oil for everyone,” Mr. Henning told me. So there we had it.
This is tough to admit. In the first edition of Deep Nutrition, I made the argument that vegetable oil was toxic and that its consumption was also a leading cause of deadly heart attacks and strokes, among many other things. But for some reason, of all the arguments I made in Deep Nutrition, this is the one nobody cared much about.
Well, almost nobody. The L.A. Lakers did. And Mark Sisson did—he’s making the only currently available brand of mayonnaise you can find commercially that does not have vegetable oil. Thankfully, most of the people who wrote letters and most of the people I’ve spoken with have gotten the message. But unlike every other topic discussed in that original text (topics like nutrient density and the reduction of empty carbs, the health benefits of healthy fats and fermented foods to help support a thriving microbiome, the benefits of bone stock, and the value of pasture-raised animals), the vegetable oil argument has yet to really move the needle.
My failure to sound the alarm among chefs is especially upsetting because I put so much faith in chefs. As you will soon discover, I believe that flavor equals nutrition; seeking out and enhancing flavor almost invariably leads to the enhancing of nutrient value. If you understand this concept, then it’s no great leap to suggest that chefs are the original nutritionists and that the approach of gifted chefs is the same approach we should take as nutritionists and consumers of nutritional information. The problem is, when it comes to the vegetable oils, many chefs abandon their instincts, opting for the far cheaper vegetable oils because of their flavor neutrality or high smoke point. Some even claim to be looking out for their customers’ health or, commonly, for the safety of their peanut-oil-sensitive patrons. In reality, when chefs cook with these oils or drizzle olive oil atop a ramekin of canola and pass it off as pure olive oil, or instruct their staff to keep customers guessing about what oils they’re actually eating by answering all oil questions with the innocuous-sounding, “It’s a blend,” chefs are simply listening to the restaurant owner or, more specifically, to the owner’s accountants. But those chefs looking only to the bottom line are selling their customers, as well as their own food establishments, short.
I visited a popular chain restaurant with Los Angeles-based chef and restaurant finance consultant Debbie Lee, and together we looked over a buffet of sustainably sourced ingredients—all ruined by cooking in toxic oil. I asked Chef Debbie what it would cost per dish for a restaurant to use olive oil instead of vegetable oil. She estimated it to be roughly fifty cents per plate. Maybe that sounds like a lot in a restaurant that sells its salads for $2.75, where that extra fifty cents is a big bump, but vegetable oil has slithered its way into the best restaurants in the country. In fact, twenty-six of the twenty-nine five-star hotels on the NBA tour use vegetable oils or blends in place of olive oil for pizza sauces, salad dressings, hollandaise, marinades, mashed potatoes, baked goods—you name it. There’s no dish that cutting corners won’t ruin. At fifty bucks a plate for some of these high-end dinners, you’d think they could toss in a few pennies for you to enjoy your dinner without a dose of toxicity. When I learned that culinary great and restaurateur Thomas Keller, whose flagship restaurant was minutes from my office, uses vegetable oils in his restaurants (and recommends them in his cookbook recipes), I realized that vegetable oils like canola are not only ruining our health, they’re a threat to the entire culinary enterprise.
Maybe because I explained how vegetable oil is bad for so many reasons—from damaging arteries to causing fatty liver and interfering with cell development—I failed to get the message across. Perhaps I should have picked a single target. Maybe it was because I also said high levels of sugar are toxic. Maybe it’s because I didn’t say that the average health-conscious consumer gets 15–30 percent of their daily calories from this stuff, and the ordinary eater 30 to 60 percent.1 Maybe these oils are still so ubiquitous because they are tasteless and odorless and it’s hard to know when some cost-cutting corporation is sneaking them into your food. Perhaps these oils are still so prevalent just because there’s so much else gone wrong with the food we buy—from GMOs to endocrine disrupting pesticides to herbicides to worries over gluten—that the issues with vegetable oils get lost.
So in this updated edition of Deep Nutrition, I’ve added a chapter focusing on the harms of vegetable oils in the brain. Why the brain? First of all, any disease that damages your brain threatens your very identity. There’s nothing more devastating than that. Second, because we don’t screen for brain problems using objective testing. We rely on our patients to alert us when something is wrong inside their heads. But obviously there’s a catch: you may not realize there’s something wrong because your brain has stopped working right. Unlike the other vital organs, the brain lacks a sensory system to alert us when it’s in pain (headaches are thought to originate in intracranial blood vessels, not the metabolically stressed neurons). And last, because the brain often suffers when vegetable oils damage the other tissues in the body, like the gut, our blood and lymphatic circulations, the immune system, and even our genes. Damage to these systems can generate downstream effects that lead to specific impacts on the brain.
So much data has come in since 2008 that has convinced me these oils are particularly harmful to the brain that I was tempted to write a book on the topic. For example, researchers in Milan have shown one of the harmful compounds in vegetable oil degrades the internal highways of nerve cells called intermediate filaments.2 Another group at Mt. Sinai fed the metabolites of vegetable oil to mice in varying concentrations, and the mice that ate the most oil developed the equivalent of Alzheimer’s at the earliest age.3 Because of the avalanche of new evidence pointing to vegetable oils as the most powerful brain-killing chemicals, when the opportunity to publish this revised and updated edition of Deep Nutrition arose, I knew I needed to add this chapter. The information just can’t wait any longer. Because this chapter is so packed with information and has such serious implications regarding the many brain and mood disorders that are now commonplace, I hope you read it particularly closely—in fact, I hope you think of it as a book within a book.
The age of technological health solutions is coming to an end.
Our nation’s technophilia started in earnest just after World War II, when advancements in medicine and pharmaceuticals gave rise to the notion that if we ever got sick, modern medicine would come to our rescue, gradually turning more and more of the responsibility for our health over to government, corporations, and other perceived authorities. These same authorities convinced us that women could finally be freed from the confines of the kitchen if only they were willing to abandon traditional ingredients and recipes and place their trust, instead, in industrial products from corporations such as Dupont, which promised “better living through chemistry.” This idea caught on so well that now, when the natural requirements for health seem inconvenient, we’re conditioned to look to one or another corporation for a shortcut around those requirements.
And how’s that working out for us?
A quarter of infections are now resistant to antibiotic therapy, and we’ve recently discovered each course kills hundreds of species of beneficial bacteria that may never come back to help us fend off the bad bugs again.
Our war on cancer has had minimal effect, if any. In fact, cancer seems to be thriving in the U.S. population. In 1960 a woman’s lifetime risk of developing breast cancer was one in twenty-two. Now it’s one in eight.4 And the incidence of childhood cancer has increased nearly 60 percent.5
Cardiovascular disease is still the number-one killer of men and women.6 More Americans than ever are living with seriously impaired mental functioning from Alzheimer’s. According to the Alzheimer’s Foundation, 44 percent of the population between age seventy-five and eighty-five carries a diagnosis, and are, or will soon be rendered, dependent on others to care for their basic needs.7 What’s the point of spending all this money on living longer when the tarnish of Alzheimer’s robs any remaining shine from your golden years, taking from you every memory of who you are?
We’re sicker than ever. Healthcare is the number-one driver of the U.S. economy. The pharmaceutical industry now has the spare change to lobby Congress with more dollars than the combined expenditures of oil, gas, and military defense. Keep in mind, this is the very same industry that has failed to stem the tide of obesity, heart disease, diabetes, cancer, Alzheimer’s, autism, and the rest.
Technology has failed to keep us healthy. And now millions of people are getting wise to the fact that the only technology that has consistently provided us with healthy children, healthy hearts, and healthy minds is the technology that has been under constant development and quality improvement since life on Earth began: the technology of nature.
The more you plug into this technology of nature, the healthier you will be. This is the bedrock argument of Deep Nutrition. And of course the best way to plug in to nature is through well-sourced ingredients whose nutritional value is protected and enhanced using the same culinary techniques that have served us for millennia.
Whether you are one of the people who shared the first edition of this book with friends and family—and if you are, thank you!—or you are about to be introduced to Deep Nutrition concepts for the first time, I hope this book can serve as a science-backed articulation of the commonsense beliefs you already feel in your bones: fake foods are bad for us. Food has a powerful influence on your health. Source and tradition really do matter. Given the right diet, the human body has a remarkable ability to provide a lifetime of optimal health.
If you would like to better understand just how deep these truths run and how exactly to harness nature’s power to inspire better health, then this book is for you.