It is the number one question I get from people who hear me speak about obesogens: What is the first thing I should do today? And my answer is always the same: Clean up your diet. This is easier than you think. You do not have to move to the wilderness and grow your own food off the grid. Nor do I mean that you should launch yourself into a fad diet designed for weight loss, start juicing exclusively, or become vegetarian or vegan. Cleaning up your diet means following a few basic guidelines that I will give you in this chapter. I call them the “Anti-obesogen Rules.” They will reduce your burden of obesogenic chemicals and other EDCs, while helping you to avoid additional exposures. And as an automatic side benefit, you will be supporting local farmers who produce food responsibly and sustainably.

We live in a world of choices now when it comes to our food, but we also live in a world of confusion as a result of food industry tricks that make us think we are eating “healthy” meals. Even the most educated consumers can fail a test about the definition of natural, organic, local, gluten-free, and grass-fed. Journalist Kristin Lawless has written an excellent book on this topic entitled Formerly Known as Food.¹⁷⁵

RULE #1: THINK WHOLE, FRESH, AND UNPROCESSED

Make it your main goal to prepare as many of your meals and snacks as possible yourself, using whole, fresh, unprocessed ingredients that you select (therefore, you will know precisely what is in your food). I try to make all my meals at home. I’m in charge of the grill, and my wife is a great cook who makes everything from fresh ingredients. Together we can do better than any food bar in a market and any restaurant. We do better in food quality and flavor than all but perhaps the highest-end gourmet restaurants. When you do venture outside your kitchen, patronize places that use fresh, organic, and locally grown ingredients. Even better would be where you can ask the chef questions about the food. The “farm to table” movement is growing everywhere across the country and is no longer confined to places such as my state of California. Look for those types of restaurants in your area. In general, top-quality restaurants do have better standards and suppliers than the alternatives. But beware: a 2016 study done at the University of Illinois showed that when you go out to eat, whether at a full-service or fast-food restaurant, you will consume an average of two hundred more calories, 10 grams more of fat, and twice the sodium than if you had eaten a meal prepared at home.¹⁷⁶

If you buy preprepared foods at markets, which should be minimized, look for fresh ingredients devoid of artificial preservatives, colors, flavors, sweeteners, and hydrogenated fats. Keep in mind that if you didn’t make it, you simply do not know what is in the food you buy.

You have probably already heard about the benefits of “shopping the perimeter” of a store. This is where most of the fresh (meats, produce) and least processed (dairy) foods are located. The inner aisles are where the foods sold in boxes, bags, and cans are found. If you buy anything that comes with a nutrition label (note that most fresh items such as produce, fish, and meats do not), become skilled at reading those labels. When she was little, my daughter used to ask me, “Papa, how do you know that this food is not good?” My answer was simple: “Do you put that many ingredients in foods you make with your mom?” Long lists of ingredients automatically tell you that the food is highly processed and probably not nearly as good as food you make yourself from fresh ingredients. Words you cannot pronounce or define are probably chemicals you should avoid. In addition to avoiding chemical obesogens, you want to stay away from ingredients that qualify as nutritional obesogens:

Added and processed sugars (for example, high-fructose corn syrup). Stick with foods that do not list sugar at the top of their ingredients. Better yet, avoid foods with added sugar at all. Honey and agave syrup contain high amounts of free fructose—avoid them unless you are a diabetic who cannot tolerate sucrose.

Artificial sweeteners (for instance, acesulfame potassium [Sunett, Sweet One], aspartame [NutraSweet, Equal], saccharin [Sweet’N Low, Sweet Twin, Sugar Twin], sucralose [Splenda], and neotame [Newtame]). Remember, recent studies show that many artificial sweeteners can damage your metabolism by altering the composition of your microbiome.¹⁹ They make you much more susceptible to overeating and can also trigger transient increases in insulin levels (increasing storage of fat). Food companies are now responding to the increasing public concern by using obscure names to hide these synthetic sweeteners in their products. The list of artificial sweeteners is long and continues to grow with new formulations. They not only lurk in many prepared foods such as salad dressings, baked goods, processed snack foods, “lite” and diet foods, and breakfast cereals, but can be found in unsuspected places such as toothpaste, liquid medicines, chewing gum, and frozen desserts. Note also that the jury is still out on sugar alcohols such as sorbitol, mannitol, xylitol, maltitol, erythritol, and isomalt. While these sugars may not produce as significant a rise in blood sugar as other sugars (and are often marketed as healthier alternatives to regular and artificial sugars), not enough studies have been performed on them. For example, we don’t know anything at all about the effects of sugar alcohols on the microbiome and, in turn, metabolism.

Monosodium glutamate (MSG). This flavor enhancer is famously linked with “Chinese restaurant syndrome” (although this might not be completely true), but it is also found in a variety of processed, packaged foods such as chips, frozen dinners, cold cuts, dressings, and salty-flavored snacks. Food manufacturers know that you are avoiding MSG, so they label it in the ingredients with euphemisms such as hydrolyzed protein, glutamic acid, yeast extract, or autolyzed yeast.

Other additives (for example, nitrites and nitrates, potassium bromate, artificial colors). There are more than ten thousand additives allowed in food, most of which are classified as “generally recognized as safe,” or GRAS.^x Why is this bad? To qualify for the GRAS designation, it is only required that there is a substantial history of consumption for food use by a “significant number of consumers” (whatever that means).¹⁷⁷ In nearly all cases, there is little or no testing to support this designation—only a substantial history of use. I recommend referring to the website of the Environmental Working Group (EWG)¹⁷⁸ for their list of top additives to avoid. You can also look up your food in their database for more information. Not all additives are obesogens per se, but avoiding them will help you go a long way toward cleaning up your diet in general and steering clear of EDCs and potential obesogens that have not been identified yet.

It is probably unrealistic in the modern world to avoid all packaged foods, so do the best you can. For example, when you purchase condiments and acidic foods such as peeled tomatoes, aim to buy them in glass rather than plastic. Minimize canned goods overall. Store your own foods in glass or stainless steel so that you eliminate exposure to chemical obesogens found in storage containers that can leach into the clean fresh food you worked so hard to make (more on this in chapter 7).

RULE #2: BUY ORGANIC, GRASS-FED, AND WILD WHENEVER POSSIBLE

Buying organic has become much easier and more economical in recent years, and choices have increased greatly. You once had to shop at gourmet specialty stores, a few national retailers who charged very high prices (you know who they are), and farmers’ markets to find organic foods. Happily, the increased demand has compelled mainstream grocery chains and big-box stores such as Costco and Walmart to sell certified organic foods. What does it mean to be certified? The USDA Organic Seal indicates that a food was produced without synthetic pesticides, genetically modified organisms (GMOs), or fertilizers made from petroleum. When it comes to organic meats and dairy products, the seal bears even more weight: it also means that the meats or dairy products are from animals that are fed organic feed and forage, are not treated with antibiotics or hormones, and are raised in living conditions that accommodate their natural behaviors, such as grazing.¹⁷⁹

Let’s take the bull by the horns and talk about the costs vs. the benefits of organics. There are a variety of recent studies that purport to test whether or not organic produce is more or less nutritious than conventionally grown.¹⁸⁰^-¹⁸² Many of these miss the point nearly completely. While we can argue endlessly about whether or not one batch of organic spinach has more or less nutrients than a batch of conventionally grown spinach (and organic probably has at least a bit more), it is indisputable that the organic spinach contains little or no potentially toxic or endocrine disrupting agrochemicals (pesticides, herbicides, fungicides, and fertilizers). The point of eating organic is that you dramatically reduce your exposure to these chemicals, not that the food is necessarily more nutritious. At the same time, organic agricultural practices (crop rotation, tilling the soil, plowing leftover vegetation back into the soil) improve the quality and nutrition of the food as well as the health of the soil and environment. Patrick Holden in the United Kingdom has been leading the charge for wholesome, sustainable food production. Visit the Sustainable Food Trust website ¹⁸³ to learn more about how important this is.

Organic labeling can also be misleading. Only foods made with 100 percent organic ingredients can indicate that on the label. If a food was made with at least 95 percent organic ingredients, then it can say just the word “organic.” Products that say “Made with organic ingredients” were created with a minimum of 70 percent organic ingredients, with restrictions on the remaining 30 percent, including no GMOs. This is why I recommend trying to purchase foods that have the “USDA Organic” or “100% certified organic” label. I also suggest that you try to buy organic products grown in the United States and avoid those produced in foreign countries, even if they are sold with the “100% certified organic” seal. Not only has the Washington Post¹⁸⁴ reported on large imports of conventionally grown food that were improperly labeled as organic, but a newer audit¹⁸⁵^,¹⁸⁶ conducted by the USDA’s Office of the Inspector General has confirmed serious concerns about imported foods labeled as “organic” but are anything but. Until all the loopholes and weak links are dealt with in the global supply chain, it behooves us all to be extra skeptical of “organic” goods produced on foreign soil and sold in the United States.

You can also find foods produced in the United States that are sold as organic but do not carry these official certification labels. I would be suspicious about these. Although there may be nothing wrong with these foods, they clearly do not meet the standards to be labeled “USDA Organic.” This might be because the farmer does not have the resources to have his farm certified, or it could be because the farmer is using organic practices, but insufficient time has passed for the farm to be certified. The lack of USDA certification means that you must know where these foods came from and how they were made or farmed in order to trust them (see sidebar). To this end, shop at reputable markets (often larger regional or national chains) where you can trust the origins of your foods and feel comfortable asking questions at the butcher and fish counter or in the produce section. While I don’t mean to denigrate small, independent markets, large chains have more to lose by cutting corners. On the other hand, small, independent markets can offer personalized services that the chains do not. They may also offer fresh foods that are grown more locally and with minimal time spent being transported.

If you have a farmers’ market near you, you will likely run into merchants selling goods they claim are “organic” and/or “locally grown” but that do not have official certification labels on them. Some of these foods are in fact fine to eat (and might meet organic-certifiable standards). Here are some questions you can ask:

Where is your farm located?

Are your foods 100 percent certified organic? Certified by whom?

How is this [fruit/vegetable] grown?

How do you control for insects and weeds? Do you use pesticides or herbicides?

Trustworthy organic farmers tend to be proud of their practices. They will openly engage with you and share their farming methods. If you are buying foods that come from animals, such as cows or chickens, ask what they feed them. And if at any time you feel you are not getting clear answers when you ask questions, then move on to the next booth.

My family has been in the food industry for generations. My grandparents on both sides of the family owned competing grocery stores on South Street in Philadelphia (my parents’ marrying was a sort of Romeo and Juliet love story with a mostly happy ending). Both of my grandfathers were butchers, as was my father. I worked in the seafood department of a local supermarket in high school to pay for my car and to take my high-maintenance girlfriend on dates. When I turned eighteen, I served a three-year apprenticeship and became a journeyman butcher, which is how I worked my way through college and later financed my relocation to California before entering graduate school in 1982. As you can imagine, I got to see what goes on behind the scenes, and it was not a pretty picture. Remember the old adage (misattributed to Otto von Bismarck) about how we should not know how laws or sausages are made? So true, but I am not so certain that lawmaking is cleaner than sausage making today.

I can tell you that in the meat departments of many markets I worked in over the years, large chain, small chain, and independents (more than one hundred overall), it was commonplace to put a “prime” sticker on the prettier steaks for a higher price, even when they were not prime. Ground sirloin? Haha, that’s a good one. This was ground meat with a higher proportion of tasteless imported beef, colloquially called “bull meat” to give it the stated fat content. At more than one market I worked at in New Jersey, the butchers were instructed to spray something on steaks and roasts that had gone off-color to restore them to red. We called it “dynamite” because it blew away the green color. This was known to be illegal, but few stores were ever caught in the act. At least a few stores I knew of used frozen chicken giblets to make their hamburger bright red. Some small, independent markets I worked at sold their off-color steaks to local restaurants at a discount (no doubt supporting a few “kitchen nightmares”). Shenanigans in the meat and seafood industry are widespread. Now there is a high-tech mechanism to identify the species in food known as the FoodExpert-ID DNA chip.¹⁸⁷ This is not something that you can buy, or even that your local board of health can afford, but it is at least slightly comforting to know that it exists.

I am not saying that this sort of behavior is common today, but knowing what I know, I would not exclude the possibility either. Not all markets hold themselves to high standards. When I go shopping, I most frequently purchase meat and seafood at Costco, which sells in very high volumes—selling in great quantities quickly so nothing sticks around long enough to get old—and the employees have little time or motivation for shenanigans. Other good choices might be a high-volume store in a regional or national chain. If you know of a reputable meat market or fish shop, by all means support it. Sadly, there is a reason why we hear all-too-frequent reports of food contamination in the news—corners are being cut. In my day, every wholesaler had an on-site USDA inspector who had the power to shut the entire place down in an instant if a violation was observed. I don’t know exactly when that stopped (I left the industry in 1982); now there are only a few USDA inspectors per city to monitor what happens at the wholesalers.

Here are some quick tips to protect yourself:

Meat that did not sell fast enough and got a little green will be ground up first thing in the morning—we called them “rewraps.” Needless to say, do not buy ground meat first thing in the morning, particularly the very lean, higher-priced stuff—it is almost guaranteed to have the less fresh meat in it.

Steaks and chops might be seasoned to sell quickly at a discount. Avoid pre-seasoned meats, particularly when the seasoning covers the surface so you can’t see whether it is off-color (in other words, old) or not. I never once saw fresh meat seasoned like this before sale—it was always the off-color stuff.

Trust your nose. Fresh meat and fish have only the faintest of smells.

I myself would never, never, not ever buy pre-ground meat from any market, anywhere. Select a steak, roast, or package of stew meat and ask the butcher to grind it up for you. And watch him do it so that he does not substitute something else. Better still, buy a KitchenAid or similar multifunction mixer with a grinder attachment and make your own ground beef, pork, chicken, turkey, and so on.

When cattle are fed grains, usually a feedlot made with corn and soybeans, the quality of their meat products will be different from what they would be had the cattle been fed their normal diet of grass and hay. Grass-fed cows are raised exclusively on hay or grass after they are weaned, and the beef produced from them is leaner than conventional beef, yet their fat tends to have a higher proportion of omega-3 fatty acids (the good fat). But be careful: ask whether the meat is 100 percent grass-fed. It is commonplace to graze the animals for most of their lives and then “finish” them in high-density feedlots where they are crowded, exposed to diseases, given sub-therapeutic levels of antibiotics, and fed with cheap, GMO corn (here) to quickly fatten them up for market.

Grass-fed does not imply organic, either. Grass-fed cattle can still be pumped with hormones and antibiotics, so look for grass-fed organic meats. These do exist, and the meat can be excellent. I have eaten many a beautifully marbled, grass-fed steak in Buenos Aires, Argentina. Beware of markets selling organic meats that have not been USDA graded (for instance, USDA Choice or USDA Prime). My wife spent almost $30 a pound on some grass-fed New York steaks sold by a famous national retailer that were chewy, gamy, and mostly inedible. The meat may have been free of hormones and additives (hence the organic labeling), but that does not mean it was high quality with respect to taste, texture, and tenderness. It wasn’t. I returned the uneaten bits to the market and told the meat manager that these steaks he was selling at an extraordinarily high price were, in my expert opinion, not even up to pet-food-quality standards. He was not amused, but neither was I.

When buying eggs, you will sometimes see “pastured eggs” in addition to “organic eggs.” The difference? Organic eggs come from chickens that are not treated with antibiotics or hormones and that eat organic feed. They also have limited access to the outdoors. Pastured eggs, on the other hand, are similarly not treated with antibiotics or hormones but are produced by hens allowed to roam more freely and eat their natural food, plants, and insects. Pastured eggs tend to cost a lot more than organic, and it’s fine to stick with the organic eggs.

When buying fish, try to avoid farmed fish and go wild; choose to eat smaller, presumably younger fish. Why do I say this? Everyone knows that commercial fishing can be very destructive to the environment and to wild fish stocks. Unfortunately, fish farming, as commonly practiced, is even more destructive to the environment, although it can preserve wild stocks. Since this is a book about our health, I must urge you to protect your own health first. Farmed fish are often fed unnatural diets that lead them to be contaminated with antibiotics, PCBs, and other toxic chemicals. Wild salmon typically eat small crustaceans and zooplankton. Farmed salmon are fed a food based on soy and fish meal and need added coloring to attain their normal color. Try to avoid (or at least limit your consumption of) fish high on the food chain, such as shark, swordfish, pike, albacore, bluefin tuna, halibut, king mackerel, and tilefish. Persistent pollutants such as DDT, PCBs, and mercury are bioaccumulated up the food chain, leading to high levels in top predators. Examples of fish low on the chain that can be consumed more liberally include wild Pacific salmon, pollock, anchovies, sardines, herring, sablefish/black cod, and sole. Avoid freshwater fish from the Great Lakes and other polluted, industrialized areas. I avoid buying fish imported from places that I know or suspect have lax environmental and food-quality standards.

The best way to know whether or not you’re buying high-quality fish is to inspect the fish yourself. Be discerning. Whole fish should have clear eyes. Fish should never have a strong odor. Anything more than a very slight smell indicates that the fish is probably at least four or five days old. You also want to be sure that you are getting what you intend to buy. Mislabeling is a pervasive problem today in both stores and restaurants. At many California markets I worked in, we received a common local fish called “rock cod.” With the skin on, this was sold as “red snapper”; with the skin side down or off it was “ocean perch”; and particularly thick pieces were labeled “sea bass.” Numerous investigations in recent years have uncovered other unsettling bait-and-switch cases. Is that Chilean sea bass or Patagonian toothfish? Wild Pacific salmon or farmed Atlantic? Giant sea scallops or plugs of shark meat? Looks can be deceiving, so ask questions. This issue is more important than just paying too much for the wrong fish. There are health consequences to eating a contaminated, farmed fish when you expect to be eating a wild-caught fish free of antibiotics, hormones, toxic chemicals, or bacteria from poor husbandry.

The produce department also has many potential issues. When you cannot access or afford organic produce, at least make it your mission to avoid the “Dirty Dozen.” These are fruits and vegetables that consistently have the highest levels of unhealthy pesticides, herbicides, and fungicides many of which are EDCs and could also be obesogenic. The Dirty Dozen is a list compiled and updated annually by the Environmental Working Group upon analyzing pesticide residue testing data from the U.S. Department of Agriculture and the U.S. Food and Drug Administration.¹⁸⁸ The EWG also maintains a “Clean 15” list to indicate which produce in a particular year contains the lowest amount of pesticide residues and is therefore safer to buy “conventionally grown” if organic is not available.¹⁸⁹

Go organic when you buy any of the 2017 “Dirty Dozen”:

1. Strawberries

2. Spinach

3. Nectarines

4. Apples

5. Peaches

6. Pears

7. Cherries

8. Grapes

9. Celery

10. Tomatoes

11. Sweet bell peppers

12. Potatoes

Instead pick from the 2017 “Clean 15”:

1. Sweet corn^*

2. Avocados

3. Pineapples

4. Cabbage

5. Onions

6. Sweet peas (frozen)

7. Papayas^*

8. Asparagus

9. Mangoes

10. Eggplant

11. Honeydew melon

12. Kiwi

13. Cantaloupe

14. Cauliflower

15. Grapefruit

If you want a fruit or vegetable listed among the Dirty Dozen and local, fresh organic is not available, I recommend an alternative organic selection, even if it is not local. Or consider organic flash-frozen produce, which can be more tasty and healthful than some of the fresh produce sold in grocery stores. Fruits and vegetables destined for freezing are typically processed at their peak ripeness when they are most nutrient packed. Unfortunately, these are packaged in plastic bags, which is not ideal, but it is better than fresh non-organic, in my opinion.

A Note About GMOs:

Although everyone seems to have an opinion on genetically modified organisms, commonly called GMOs, I will wager that relatively few people can define exactly what GMOs are and why they might be troublesome. GMOs are plants or animals that have been genetically engineered with DNA from other living things, including bacteria, viruses, plants, and animals. The genetic combinations that result do not happen naturally in the wild or in traditional crossbreeding. This is the heart of the controversy—that these are “unnatural.” Let’s dig into this issue for a moment.

GMO foods are often created to fight pests that can destroy crops, or to cultivate crops with certain desired characteristics. The reason a lot of Hawaiian papayas are GMO, for example, is that the ring spot virus decimated nearly half of the state’s papaya crop in the 1990s. In 1998, scientists developed a genetically engineered version of the papaya called the Rainbow papaya, which is resistant to the virus. Now more than 70 percent of the papayas grown in Hawaii are GMO.

Many crops, in fact, have been engineered to create a product that is more robust or nutritious. A sweet potato grown across Africa has been made to be resistant to a particular virus. GMO rice has more vitamins and iron. There are fruit and nut trees that are engineered to yield crops years earlier than they would normally. Bananas can even be genetically modified to produce human vaccines against diseases such as hepatitis B. So what is my position on GMOs and whether or not they are bad?

In my mind, I divide GMOs into three broad categories:

Category 1: A Category 1 GMO in my view is one that has been engineered to produce a nutrient that it would not otherwise contain. Golden rice is an example of a Category 1 GMO. It is rice that has been engineered to produce beta-carotene, a precursor of vitamin A. Vitamin A deficiency kills an estimated 670,000 children under the age of five each year in some parts of the world. The introduction of a fortified food easily grown to address this problem is, in my book, a good thing. I have no issue with this type of GMO.

Category 2: When a plant is engineered to be resistant to some pathogens, such as the case with Hawaiian papaya, I call this a Category 2 GMO crop. In principle, I am not totally against such crops because they provide a benefit, for example, by reducing or preventing crop loss due to viral infection without bringing along much risk. How effectively they do this is another matter. In addition, there are some cases of people being allergic to the product of the genes that have been added. Another issue is that the traits that have been genetically engineered into these crops spread to other crops, including those in a farmer’s nearby organic fields, which is an unintended but largely unavoidable and unacceptable consequence. Last, the use of such pathogen-resistant crops can lead to monocultures, where a huge portion of a particular crop is genetically identical. As has recently been found in India, the use of a GMO cotton resistant to one type of pest did not prevent the crop from being devastated by other pests and produced a much lower yield than had been promised by the developer. For all of these reasons, some degree of caution is indicated in the use of such GMO crops.

Category 3: Crops that are engineered to be resistant to one or more chemical pesticides and weed killers (such as glyphosate) are Category 3 GMOs. In my view these are the most concerning, because the added chemical resistance leads to (1) more chemicals being used, which leads to the development of resistance and increased levels of the chemicals in the environment; and (2) higher levels of potentially toxic chemicals on the GMO product. Big agribusiness is heavily promoting such pesticide-resistant crops for a variety of self-serving reasons, mostly concerned with increased profits, which I think is detrimental to both environmental and human health. Perhaps you have followed the recent controversy about the widely used herbicide glyphosate being carcinogenic? If not, you may want to read Carey Gillam’s book, Whitewash: The Story of a Weed Killer, Cancer, and the Corruption of Science.¹⁹⁰ As far as we know at the moment, none of these chemicals are obesogenic, but there are quite a number of other adverse health consequences that research has associated with them. I am strongly against the use of Category 3 GMOs.

Current farming practices to grow GMO foods are another reason I am strongly against Category 3 GMOs. The image of farm workers yanking out weeds from the fields by hand is reflective of a bygone era. Now farmers spray the powerful weed-killing chemical glyphosate on their crops that are resistant to it, hoping that the crops outgrow the weeds. This saves a lot of work, at the risk of increasing environmental exposure to a chemical that research has associated with adverse health consequences, including cancer.¹⁹¹ A burgeoning use for glyphosate is to kill and dry crops such as wheat so that they can be harvested when it is convenient for the farmers.¹⁹² Glyphosate is again applied to kill weeds and make it unnecessary to till the soil in preparation for a new crop—so-called no-till agriculture. No-till agriculture is beneficial in the sense that less energy is used to plant the crops and soil loss due to runoff is reduced, but at the expense of degrading soil health and promoting the development of herbicide-resistant weeds. These are detrimental to the long-term health of the soil and the environment.¹⁹¹

To protect crops from the herbicide, the seeds are genetically modified to be resistant to its effects. These GMO seeds and their crops allow farmers to use massive quantities of herbicides such as glyphosate. The increasing use of herbicides means that GMO and conventionally farmed crops are almost invariably contaminated with herbicides and other agrochemicals. Corn and soy are the top two GMO crops in the United States, and it has been estimated that GMOs are in as much as 80 percent of conventional processed foods. This is largely because GMO corn and soy are ingredients in those processed foods. Did you know that sugar beets provide half of all consumable sugar in America and that 95 percent of those sugar beets are grown using glyphosate-resistant GMO seeds?

Most GMO crops are not directly consumed by humans. GMO corn is used in animal feed and high-fructose corn syrup, and GMO soy makes soybean and vegetable oils, soy protein, and more heavily processed soy such as lecithin and flavorings that land in a trove of processed products. If you are a conventional meat, egg, or dairy eater, the animals those foods come from are eating lots of GMO corn and soy. Even strict vegetarians and vegans are unable to easily avoid GMOs because most of those veggie burgers and soy dogs are likely made with GMO soy. Certified USDA Organic is the only way to avoid exposure to these agrochemicals.

For the record, I have nothing against eating soy as long as it is unprocessed and organic. One exception: It is probably best to avoid giving a baby soy formula; not only does this contain GMO-derived soy, but soy contains phytoestrogens. Early life exposure to estrogenic chemicals can increase the risk of obesity and the development of hormone-related cancers later in life.

When you buy organic, grass-fed, and wild foods, you will automatically be lowering your risk for consuming GMOs and their associated agrochemicals without even needing to worry about labeling. Also keep in mind that “organic” does not automatically equate with “healthy.” Many organic junk foods line the shelves in supermarkets today, including candy and baked goods that are anything but healthy and waistline friendly, despite being organic. When in doubt, scrutinize the ingredients. Look for anything suspicious. The same goes for the gluten-free industry. Many people have chosen to go on a gluten-free diet today, and the popularity of this diet has spawned an industry of products labeled “gluten-free.” These products may be free of gluten, but that does not mean they are not filled with other obesogenic ingredients such as refined sugar and additives.

RULE #3: CLEAN UP YOUR WATER

Regardless of how much you love the taste of your tap water or what the glowing report from your water supplier says about the contents of your water, I recommend buying a household water filter, at least for all of your drinking and cooking purposes. This is because most of the chemicals we produce and use in industry and agriculture eventually make their way back into our drinking water. The water industry is wrestling with how to deal with and remove these “contaminants of emerging concern.” These also include pharmaceuticals we take that ultimately end up in the toilet after they pass through our bodies. Most of these contaminants are present at low levels, but we are better off without them in our water in the first place. How can we accomplish this? Or should we trust the water suppliers to do this for us? Perhaps you recall what happened starting in 2014 with lead in the water in Flint, Michigan? Similar conditions exist in many other cities and municipalities around the country. Trust in yourself, rather than in the EPA or some local agency, to protect your family’s health. This is even more important today as the Trump administration systematically dismantles the already small amounts of protections provided by EPA regulations.

There are a variety of water treatment technologies available today, from simple and inexpensive water filtration pitchers you fill manually, to under-the-sink filtration systems with storage tanks, to whole-house carbon filters that will filter all of the water coming into your home from its source. The latter is ideal, particularly if you subscribe to a service that changes the filters regularly, because you can then mostly trust the water used in your kitchen as well as the water in your bathrooms. Choose which filter technology best suits your circumstances and budget: whole-house carbon; individual carbon filters on water spigots, refrigerators, and the like; reverse osmosis filters in the kitchen. Each type of filter has its strengths and limitations, and one type does not accomplish all goals. You will want to avoid water pitchers with filters because of their plastic containers.

An entire book could be written on how to remove contaminants from your drinking water. The Environmental Working Group just developed its national “Tap Water Database,” which can tell you something about what sorts of contaminants are in your water and what health effects they might cause.¹⁹³ In turn, this can give you some idea of which filter technology might be most useful for you. Generally speaking, carbon or activated charcoal filters do a reasonably good job of removing cancer-causing organic chemicals (such as trihalomethanes) from your water but do a poor job of removing minerals such as lead, arsenic, or hexavalent chromium, which can also cause cancer. Reverse osmosis filters do a better job of removing minerals from water than carbon alone but may not remove all of the organic chemicals unless multiple carbon prefilters are used.

Remember to include the cost of maintenance and filter changes in your calculations. Most areas have companies whose business it is to provide pure water solutions. Talk with several to discuss what contaminants you wish to remove considering how much water you use. In my opinion, a whole-house carbon filter coupled with a kitchen reverse osmosis drinking water system is an excellent choice. I keep coral reef aquariums and also have a reverse osmosis deionization system that provides the extraordinarily pure water such aquariums require.

Note that while reverse osmosis systems do an excellent job of removing a broad variety of contaminants, they may not be a good choice if you live in a drought-prone state such as California. These systems waste a lot of water in the purification process—they typically use three or four gallons of raw water to produce one gallon of filtered water. If you want to use such a filter, then it is probably only reasonable to use it in the kitchen for filtering your drinking water. If you are contemplating a reverse osmosis system and expect to use a lot of this water, consider getting a higher-pressure stacked filter with high-efficiency membranes, which reduces waste water production. Whichever type of filter you choose, follow the recommended maintenance procedures to ensure that it continues to perform optimally. If you are a renter, a whole-house carbon filter may be out of the question, but you can still install removable carbon filters on showers and faucets or a reverse osmosis filter in the kitchen.

As contaminants build up, carbon filters will become less effective and can release adsorbed chemicals back into your filtered water so change them regularly. If you choose not to install a whole-house water filtration system, then consider putting filters on your showerheads. Shower filtration systems are easy to find, inexpensive, and they eliminate your exposure to vaporized chemicals (that is, in the steam you breathe in the shower). If you really want to get on top of what is in your water, consult the EWG database, read the water reports from your local supplier, and consult with a water filtration company to understand what contaminants can be removed by which types of filters. If you have well water, it is definitely worth having the water tested at least yearly to monitor for the presence of contaminants of concern (particularly if you live in a farming region where agrochemicals such as atrazine or glyphosate may contaminate groundwater).

Drinking or using water from plastic bottles and containers should be avoided as much as you reasonably can. The longer water is stored in plastic bottles, the higher the concentration of potentially harmful chemicals, obesogens included. Bottled water samples have been shown to contain phthalates, mold, microbes, benzene, trihalomethanes, even arsenic. Moreover, bottled water is subject to approximately the same standards as the EPA drinking water standards, most of which have been set politically rather than scientifically.^xi In addition to the problems associated with contaminants leaching from beverages stored in plastic, the plastic itself is an issue now; plastic pollutes our environment and oceans the world over. According to the International Bottled Water Association, U.S. consumers purchased 11.7 billion gallons of bottled water in 2015, which translates to 88 billion half-liter bottles,¹⁹⁴ which is approximately equal to annual soft drink sales. Nearly all of these bottles are discarded and become litter, rather than being recycled. Consider this also: Toxins from degrading plastic containers will leach into watersheds, soil, and the oceans for a very long time to come. You can help stop this flood of chemicals continuing to enter our environment by removing plastic water containers from your life. If you want to tote a water bottle around, choose a durable, reusable container made from stainless steel, glass, or ceramic. I prefer stainless-steel vacuum bottles to keep my water cold and fresh.

RULE #4: AVOID SUGARY BEVERAGES

Sugar is a major source of our daily calories, and much of that sugar is coming in quickly guzzled liquid form from sweetened beverages. Every single day, half (five in ten) of adults and more than half (six in ten) of youths in the United States consume sugary drinks.¹⁹⁵^,¹⁹⁶ The average can of sugar-sweetened soda or fruit punch contains about 150 calories, almost all of them from sugar, usually high-fructose corn syrup. That is the equivalent of nearly ten teaspoons of table sugar in one beverage. If you do the math, that means you could gain up to five pounds in a single year if you drank just one can of a sugar-sweetened soft drink every day without reducing caloric intake elsewhere in your diet.

Soft drinks do not include just your typical soda or carbonated, sweetened beverage. The term “soft drink” refers to any concoction with added sugar or other sweetener and includes soda, fruit punch, sweetened powdered drinks, sports and energy drinks, coffee, iced tea, lemonade, and other “ades.” These drinks, even fruit juices, are nutritional obesogens. Aim to avoid or strictly minimize them—drink sparkling water from a glass bottle instead, perhaps with a squeeze of lemon, lime, or other flavors you enjoy. Consider sugary beverages as fun foods, as you would a doughnut or other calorie-laden, sugary dessert. Remember, people who consume sugary beverages do not feel as full as if they had eaten the same number of calories from solid food. Studies also show that those who drink sugary beverages do not counterbalance their high-caloric content by eating less food.

I should add that you would also do well to avoid or limit artificially sweetened drinks. These beverages can be even more damaging than those made with real sugar as a result of the effects artificial sugars have on the microbiome, resulting in a dysfunctional metabolism and higher risk for insulin resistance.¹⁴⁴ Also aim to reduce your consumption of fruit juices, even if they are 100 percent “pure and natural.” A morning glass of orange or other fruit juice is not a bad idea, but consider that a twelve-ounce glass of orange juice, organic or not, contains about nine teaspoons of sugar, nearly the same as a twelve-ounce can of regular soda. If you insist on drinking fruit juice, choose unsweetened juices that contain no added sugars (or fruit juice concentrate, which is a euphemism for added sugar). Better yet, go for a pulpy vegetable juice. When choosing between a sugary beverage and bottled water, go with the water.

RULE #5: CHOOSE A WEIGHT LOSS DIET THAT WORKS FOR YOU

The byline spoke volumes: “Eating fatty foods has a ‘shocking’ effect.” Indeed, the health news media was quick to cover Dr. Matthew Rodeheffer’s 2015 paper,¹⁰¹ which completely changed how we think about the effects of sitting down to a high-fat meal (let alone many high-fat meals). Dr. Rodeheffer is a member of the Department of Molecular, Cellular and Developmental Biology at the Yale University School of Medicine. Rodeheffer and his colleagues showed that in contrast to what was previously believed, a high-fat diet increased the number of fat cells before the existing fat cells were filled. That is, the mechanisms controlling fat cell number were thwarted by overdoing the consumption of fat. Worse yet, fat consumption led to more fat cells where you definitely do not want them to be: in the visceral fat depot. We do not know yet whether these new fat cells remain after you revert to a low-fat diet, but our work with TBT suggests that once the number of fat cells has increased, the animals remain fat even when diet is returned to normal for several months. Rodeheffer’s results shifted how I view high-fat diets such as Atkins or Paleo and its variants. When you eat these high-fat diets, are you unwittingly triggering the fat machinery in your body to turn against you? This needs to be tested in carefully controlled clinical experiments. But until we have the definitive results, I think it is best to avoid high-fat diets. This is not simply a matter of weight. There are long-term consequences to triggering the body to create new visceral fat cells that may be there permanently.

Weight loss diets abound today, and I am frequently asked which one is “best.” To many people’s surprise, and contrary to the trends constantly circulating in health circles, I do not believe there is one diet that fits everyone. If we accept the idea of personalized medicine, and that we are all different to some biological—and metabolic—degree, then each of us must find what works for best for us, so long as we base our dietary choices on unadulterated, fresh foods. As I outlined earlier, everyone responds uniquely to identical foods. Recall the 2015 Israeli study that tracked the blood sugar levels of eight hundred people over a week and found that the same exact diet in different people led to radically dissimilar effects on blood sugar.¹⁹ The findings demonstrated that personalized medicine extends far beyond pharmaceuticals and encompasses diet, because how the same foods are metabolized changes from one person to another. This strongly supports the power of personalized nutrition in helping each of us to identify which foods can help or hinder our health and weight loss goals.

To be fair, it is definitely true that if you eat fewer calories than your body needs to sustain your level of activity, you will lose weight. The popular press is littered with fad diets that will help you lose weight: the ice cream diet, the Twinkie diet, the Hollywood cookie diet, the cabbage soup diet, the baby food diet, the grapefruit juice diet, and so on. These will all work to some degree, just as long as you consume fewer calories than you burn. However, as soon as you stop dieting and your caloric intake increases, you will gain weight and return to at least your programmed weight, if not higher. Remember that more than 83 percent of people who lose substantial amounts of weight will gain it back in a few years.³⁸^,³⁹ Consider the fate of The Biggest Loser contestants who worked so hard to lose weight but gained it back.⁵⁷ You can’t diet to create sustained weight loss. As television personality Richard Simmons used to say, “You have to live it.” What he meant was that the only way to change how your body looks in a permanent way is to permanently change the way you eat and exercise. Perhaps author and food activist Michael Pollan gave the most simple and easy-to-follow advice: Eat real (whole, unprocessed) food, not too much, mostly from plants.¹⁹⁷

Toward this end, if you want to lose body fat, in addition to the previous tips about avoiding obesogens, I recommend experimenting with eating habits to find what works for you. While I am not a “diet doctor,” I think that the following tips make good sense and have strong scientific support:

Just as you would do well to avoid high-fat diets, skip low-fat diets. Skip any kind of “diet” that restricts one or another type of essential nutrient (fat, protein, or carbohydrate) claiming to promote sustained weight loss. Low-fat protocols often have people eating too many carbohydrates and refined sugars. There is value in having the right amount of healthy fats in your meals to offer flavor and promote satiety. Healthy fats include the monounsaturated fats found in extra-virgin olive oil, avocados, and certain nuts such as almonds and cashews; and the polyunsaturated omega-3 fats found in cold-water fish (such as salmon and sardines), grass-fed beef, chia seeds, flaxseed, pine nuts, walnuts, and Brazil nuts. Replace margarine and other butter-like imitators sold as vegetable oil spreads with organic butter or ghee (clarified butter that works well when cooking at high temperatures). Coconut oil has become popular with the Paleo crowd lately and can generally be considered a healthy fat despite its high saturated fat content. Coconut oil is rich in medium-chain fatty acids, which are easily digested and can increase HDL (good) cholesterol levels. The American Heart Association has recently published an opinion piece that classifies coconut oil as an unhealthy saturated fat.¹⁹⁸ Interestingly, the AHA article neglected to mention that the AHA receives funding from Bayer’s Crop Science Division, the producer of LibertyLink soybeans, when they extolled the virtues of polyunsaturated oils such as soybean oil.¹⁹⁹ Journalist Gary Taubes wrote a blistering response to the AHA opinion piece.²⁰⁰

Try intermittent fasting, which is defined as planned pauses in eating that can be anywhere from fourteen to twenty-four hours, once or twice a week. Much of this fasting time can occur during sleep (for instance, not eating from seven p.m. one evening until breakfast or lunch the next day). Although the prevailing medical wisdom has always been to eat frequent small meals, recent findings indicate that the opposite is best for weight control.¹⁵⁹^,¹⁶⁰ How intermittent fasting affects our metabolism is not entirely clear, and more research is necessary. We do know from animal studies that intermittent fasting may have a positive effect on blood glucose levels and on the ability to metabolize fat, particularly bad visceral fat that increases risk of obesity and chronic disease. Moreover, as we saw in chapter 5, mice that ate exactly the same number of calories in three meals vs. whenever they wanted gained less fat on the three-meal plan.¹⁵⁹

Eat more of your daily calories before three p.m. and avoid gorging at dinner and in the evening hours. Try not to eat within three hours of bedtime. The power of eating lunch before three p.m. was highlighted in 2013 by a consortium of researchers from Harvard, Tufts, and the University of Murcia in Spain. They conducted their study in the Spanish seaside town of Murcia, where Spaniards make lunch their main meal of the day. To their surprise, the researchers found that when total calories consumed daily, levels of activity, and sleep quantity were equal, those who ate lunch later in the day struggled more with weight loss.²⁰¹ All 420 participants in the study were either overweight or obese. Each was put on the same twenty-week weight loss program. Half of the participants ate lunch before three p.m., and the other half ate after three p.m. Over the course of the twenty weeks, the early lunchers lost an average of twenty-two pounds, while the later lunchers shed only seventeen and at a slower clip. The mechanism appears to be related to how effectively fat is mobilized from the adipose tissue.²⁰²

Try to plan your meals and snacks in advance. Set aside a day, perhaps over the weekend, when you figure out your eating schedule for the upcoming week based on your calendar in terms of work and personal responsibilities. Then write out your grocery list and do as much shopping ahead of time as makes sense so that you avoid scrambling to find food to eat for breakfast or to pack for a lunch, which can lead to eating out.

During certain times of the year I travel a lot, so I know how challenging it can be to eat healthily while on the road. Fast food can easily beckon, I am often treated to elegant restaurant meals, and the stuff they feed us on airplanes bears only a passing resemblance to food. When traveling abroad, I try to eat the best fresh, local food using advice from colleagues or online tools to find excellent restaurants (I am a big fan of TripAdvisor). When traveling in the United States, I also try to find the best fresh, locally sourced food and to leave some on the plate, since we typically serve much larger portions here than abroad. Always be mindful of portions whether you are preparing foods yourself at home or eating out. Portion sizes have exploded during my lifetime. We have become accustomed to “supersizing” our meals and going back for more. We expect to get big portions—it is practically built into our culture now. If you have a well-balanced meal with a high-quality protein, complex carbohydrates, and healthy fats, you should have less trouble regulating your intake. Eating slowly and savoring your food often helps to prevent overeating.

Being an informed, smart consumer is not really difficult or challenging. The rules in this chapter will go a long way to get you started on a healthier path free of obesogenic and endocrine disrupting chemicals. Following these guidelines will almost certainly reduce the toxic load of hazardous chemicals in your body and should help you to see—and feel—positive results in your life, from your waistline to your outlook.

CHAPTER 6

Step 1: It Really Does Start with Food

Cleaning Up Your Diet