CHAPTER 4 
Special Health Targets
NOW YOU’VE GOT THE BASICS DOWN. BUT YOU MAY WANT TO GO a step further. If you have a specific health concern—weight you would like to lose, diabetes, high cholesterol, or something else—you can build extra power into your vegan eating plan. In this chapter, I’ll show you how.
Losing Weight
If you are trying to lose weight, going vegan will help enormously.1 For starters, there is no longer even a drop of animal fat on your plate. That’s great, because every gram of fat holds 9 calories. That’s a lot more than are in carbohydrates or protein (just 4 calories per gram). To take an example, white-meat chicken—even without the skin—is about one-quarter fat, as a percentage of calories. In contrast, nearly all foods from plant sources—beans, grains, vegetables, and fruits—derive less than 10 percent of their calories from fat. So if you are skipping animal products and building your meals from plants, you’re skipping a lot of unwanted calories.
There are a few fatty foods in the plant world that you will want to be cautious about: vegetable oils, nuts, seeds, and avocados pack a fair amount of fat. Yes, their natural plant oils are much healthier than animal fats (most animal fats are high in the saturated fat that raises cholesterol levels and is linked to Alzheimer’s disease, while most plant-derived oils have very little saturated fat). Even so, all fats and oils have 9 calories in every gram. So if weight loss is your goal, it’s good not just to avoid animal products, but also to minimize oily foods, such as nuts, peanut butter, guacamole, and oils used in cooking. You will soon see what a difference this step can make.
What’s a good goal? If you are aiming for weight loss, a total of 20 to 30 grams of fat in a day’s meals is a good limit. That is much less than what most people get. But it is easily achieved when you’re skipping animal products and limiting fatty foods.
If you are tracking your fat intake, fruits, vegetables, and other foods in the produce aisle do not have nutrition labels, so don’t worry about them. For packaged foods, favor those that have no more than 2 to 3 grams of fat per serving. You’ll see that, over the course of the day, you’ll stay under your fat limit.
CUT THE FAT 
In addition to avoiding animal products, here are some easy ways to cut the fat and all the calories that go with it.
Instead of frying in oil, try sautéing in water, in vegetable broth, or even in a dry pan (e.g., for onions or garlic). Or use just a spritz of cooking spray or a nonstick pan.
Skip nuts and nut butters. Yes, peanut butter and roasted almonds are tasty, but they are very high in fat calories.
Top salads with nonfat dressing, lemon juice, balsamic vinegar, horseradish, or seasoned rice vinegar instead of oily dressings.
On a sandwich, use mustard or pickle relish instead of mayonnaise. A squirt of seasoned vinegar works great on a sub.
On toast, there is no need for butter or margarine if you’ve bought a good-quality bread.
Top baked potatoes with black pepper, mustard, or salsa instead of butter.
Fiber: Your Weight-Loss Friend
For powering weight loss, it also pays to think about fiber—that is, plant roughage. Yes, “fiber” is a boring word from nutritional science. But it really does pack health power. Here’s why: Fiber is filling but has essentially no calories. So although you might imagine you have eaten quite a lot, the truth is that fiber reins in your appetite and keeps your calorie intake in bounds. With high-fiber foods on your plate, you will push away from the table before you have overeaten.
Animal products have no fiber at all—zero—which is another reason why meaty, cheesy diets tend to fatten people up. But every bite of vegetables, fruit, beans, and whole grains includes fiber. At the top of the list is our humble friend the bean. Check out the numbers:
Notice that, although whole-grain cereals brag about their fiber, the real fiber champs are beans and vegetables. And whole grains are better than refined grains. Notice what happens when brown rice sheds its bran coating to become white rice. It loses half of its fiber. That is also the case when you compare white bread to whole-grain breads. So, to power your weight loss, you’ll want to put beans, vegetables, and fruits front and center in your routine, and favor whole grains over refined grains.
Simple, isn’t it? By avoiding animal products, keeping oils low, and emphasizing high-fiber foods, you can make your weight loss easy—even without counting calories or saying no to seconds. These foods are naturally modest in calories, and they satisfy your brain’s natural satiety mechanism so that your appetite turns off. Our research also found that a vegan diet gently boosts your metabolism in the after-meal period.2 In other words, after people have been following a vegan diet for a few weeks, their bodies are better able to turn calories into body heat, rather than storing them as fat. The effect is small—your after-meal metabolism increases about 16 percent. But considering that the effect lasts three or more hours after each meal, it adds up to a helpful extra calorie burn.
What about exercise? It helps, too, but modestly so. Running full tilt for two miles burns fewer calories than are in a 20-ounce soda. So exercise in addition to eating a healthy vegan diet, not instead of it. 
Lowering Cholesterol
Animal products drive cholesterol levels skyward. First of all, meat, dairy products, and eggs contain cholesterol—with eggs at the top of the list—and roughly half of the cholesterol you eat ends up in your bloodstream. Much worse is the saturated (“bad”) fat in dairy products, meat, and eggs. It stimulates your body to make extra cholesterol.
Plants are just the opposite. They have very little saturated fat and are essentially cholesterol-free. So simply going vegan typically makes cholesterol levels fall sharply. If you like, you can boost your cholesterol-cutting power even more. Using a plant-based diet plus the “special effect foods” in the box here, University of Toronto researchers lowered low-density lipoprotein (LDL, or “bad”) cholesterol levels by nearly 30 percent in just four weeks.3
You don’t need a lot of these foods. Just start with a vegan diet and include a serving of oats, barley, or beans, plus a soy product each day. If you add almonds, limit your intake to just an ounce (a small handful) a day. And cholesterol-lowering margarines are strictly optional.
One other point: Although almost all plant foods are very low in saturated (“bad”) fat, two big exceptions are coconut oil and palm oil. They are loaded with it. And even though they are added to many snack foods and other products for their buttery mouthfeel, they will raise your cholesterol (and pad your waistline), and you should skip them. Check the package label if you’re buying prepared foods.
Tackling Diabetes
One of the most exciting breakthroughs in recent years is the discovery that type 2 diabetes is a two-way street. It can improve and sometimes even go away. Our research team has been studying diabetes for many years, and we have found that, although a conventional “diabetes diet” that focuses on cutting calories and counting carbohydrate grams has only a limited benefit, a more powerful regimen brings more powerful results.
To see how this works, let’s first understand what causes diabetes. Many people imagine that diabetes comes from eating sugar. That is certainly an understandable idea. After all, blood sugar levels are high in diabetes, so one might think that eating sugar somehow triggers the disease process. Many doctors and dietitians believed that, too, and they put diabetic patients on diets that limited sugar and carbohydrate-rich foods, such as rice and bread, because carbohydrates release sugar as they digest. They also cut calories, hoping to starve the weight off. But these methods have not helped very much. None of them make the disease go away. Most patients still need to start medication; then they need a second medication and a third, and before long they are on insulin injections in ever-increasing doses.
A revolutionary view of diabetes came from a look inside the muscle cells. Using high-tech scanning technology, researchers found that people with type 2 diabetes have particles of fat inside their muscle cells. That fat comes from foods, for the most part. And the fat buildup inside the cells makes it harder for sugar to pass from the bloodstream into the cells. More specifically, these fat particles interfere with insulin, the hormone that normally escorts sugar (glucose) from the bloodstream into the cells. Looking at the liver, the researchers found the same thing: Fat buildup in the liver cells meant that they could no longer remove sugar from the bloodstream normally.
Insulin is like a key. It attaches to receptors on the surface of the muscle and liver cells, like a key in a lock. Once the insulin “key” attaches to the receptor, it signals the cell to let in glucose. In type 2 diabetes that signaling process is not working and the culprit is fat buildup inside the cell.
As an analogy, imagine what would happen if a prankster put chewing gum into your front-door lock. Your key would no longer work. Fat buildup in your muscle and liver cells is a bit like that. It makes your insulin “key” malfunction. So, even though your natural insulin continues to attach to the receptors on each cell, it has more trouble opening the channels that allow glucose to come into the cell. Scientists call this fat buildup in muscle cells intramyocellular lipid.
That shows us the answer to the problem. If fat buildup in muscle cells and liver cells causes blood sugar levels to rise, the solution ought to be a low-fat vegan diet. After all, a vegan diet has no animal fat at all, and if vegetable oils are kept to a minimum, there is very little of any kind of fat. So that fat buildup in muscle and liver cells ought to start to dissipate. As I mentioned in Chapter 1, my research team was funded by the US government to do a head-to-head comparison of a low-fat vegan diet and a conventional diet that limited calories and carbohydrates. We found that a low-fat vegan diet is much more effective at controlling blood glucose levels.4
If you would like to try this for yourself, here is how to do it: Begin with the weight-loss steps mentioned at the beginning of this chapter (even if your weight is in the healthy range). That means, first, a vegan diet and, second, keeping added fats to a minimum. So skip the added oils and oily foods and the nuts and avocados, and favor high-fiber foods.
Then add one more step: When you choose breads or other carbohydrate-containing foods, pick those with the least effect on your blood sugar. These are foods with a low Glycemic Index. Here’s how:
Instead of added sugars, have fruit. Yes, fruit is sweet, but it has much less of an effect on your blood sugar compared with sugar itself.
Instead of white and wheat breads, choose rye or pumpernickel.
Instead of white baking potatoes, have sweet potatoes.
Instead of typical cold cereals, have oatmeal or bran cereal.
You will find more details at glycemicindex.com.
If you have diabetes, it is essential to talk with your doctor or caregiver before making a diet change and to stay in touch as you begin, because a low-fat vegan diet can reduce your blood sugar quickly and powerfully. So if you are also taking medications, especially insulin, your blood sugar can even drop too low, to the point of being dangerous. Speak to your caregiver so he or she can reduce your medicines when the time is right. For more details, have a look at Dr. Neal Barnard’s Program for Reversing Diabetes.
Improving Blood Pressure
Keeping blood pressure in a healthy range protects your heart, your kidneys, your brain, and all the rest of you. If you can do that without medications, you will skip their side effects and expense. In research studies, vegan diets consistently improve blood pressure.5 They do that in three ways:
1. First, the saturated fat in dairy and meat products makes blood “thicker” (more viscous) and makes the artery walls stiffer, so it takes more pressure to move blood through the arteries. A vegan diet reduces blood viscosity and makes arteries more flexible, improving blood flow.
2. Second, plants are naturally low in sodium (which raises blood pressure) and rich in potassium (which lowers it). Contrast that with dairy products, especially cheese, which is loaded with sodium. Because many canned soups, other canned products, and snacks have added salt, you will want to favor low-sodium brands.
3. Third, losing unwanted weight brings blood pressure down. As a vegan diet naturally helps your body shed unwanted pounds, you will see your blood pressure improve more and more as the weight comes off.
So the first two factors (the improvement in blood viscosity and the preference for potassium over sodium) will bring down blood pressure fairly quickly, and weight loss adds to the improvement gradually as the pounds melt away. If you add exercise, you’ll lower your blood pressure even more.
Once again, let your caregiver know you are changing your diet, so that your medications can be reduced when the time is right. Do not adjust them on your own. And if these steps have not lowered your blood pressure to the healthy range, follow your doctor’s advice about medication.
Preventing Cancer
A plant-based diet is a powerful way to reduce cancer risk. For people who have been diagnosed with cancer, it is an important way to improve survival. The reasons are not hard to find.
As chicken or other meats are cooked, carcinogens called heterocyclic amines form within the muscle tissue. That can happen when meats are fried, baked, or heated in any other way. And grilling produces additional carcinogens. In turn, these carcinogens can alter your DNA, turning a normal cell into a cancer cell.
Meats also alter the gut bacteria so that they are more likely to produce carcinogens in your intestinal tract.
Dairy products have been linked to prostate cancer.6 Part of the problem is that milk increases a compound in the bloodstream called IGF-1 (insulin-like growth factor), which stimulates cancer cell growth. In addition, as the calcium in milk floods into your bloodstream, your body reacts to limit the influx of calcium to a safe level. To do that, it reduces the amount of vitamin D in your blood (vitamin D helps the body to absorb calcium). But because vitamin D also has cancer-preventive effects, this loss of vitamin D increases cancer risk. At least, that is the theory. Men who avoid milk, cheese, and other dairy have been shown to have substantially less risk, compared with their milk-drinking friends.
Avoiding animal products allows you to sidestep these risks. And plants have specific anticancer effects.
A cancer-prevention diet skips animal products and emphasizes healthful vegetables, fruits, beans, and whole grains in as natural (unprocessed) a form as possible. The weight-control steps outlined earlier in this chapter are helpful, too; a trimmer waistline reduces the risk of several forms of cancer.
Red wine may be in the “fruit group,” so to speak, but alcohol in any form increases the risk of breast cancer, colon cancer, and other forms of the disease.
Cancer Survival
Foods do more than reduce the likelihood that cancer will strike. For people with cancer, foods can improve survival. Although more research on the effects of foods on cancer survival is needed, certain keys have emerged. For women diagnosed with breast cancer, it pays to avoid excess fats and to emphasize fruits and vegetables.7,8 Adding exercise appears to be helpful, too. For men diagnosed with prostate cancer, a low-fat vegan diet has been shown to improve survival.9 Similar diet changes may help with survival from colorectal cancer. There is less information on how foods affect other forms of the disease.
Soy products reduce the risk of developing breast cancer and improve survival in women previously diagnosed with breast cancer. That’s right. While some people have raised the question as to whether soy products might increase cancer risk, studies have shown precisely the opposite; they have a beneficial cancer-preventing effect.
The biological explanation for this benefit is not entirely clear. However, women who consume the most soy (soy milk, tofu, etc.) have about 30 to 40 percent less risk of developing breast cancer,10,11 and those previously diagnosed with cancer are about 30 percent less likely to die of their cancer, compared with their soy-avoiding friends.12
Protecting Your Brain
In 2003, Chicago researchers reported a stunning finding: People who generally avoided “bad” fats dramatically reduced their risk of developing Alzheimer’s disease.13 In this case, “bad” fats mean two things: the saturated fat (solid fat) found in dairy products and meat and the trans fats (partially hydrogenated oils) found in snack foods. So a vegan diet is a great start because it avoids most of the saturated fats. And kicking out pastries or fried snacks that include partially hydrogenated oils (you’ll see them on the label) is a good idea, too.
There are extra steps you can take:
Avoid Harmful Metals
Although your body needs traces of iron and copper, they are harmful in excess. In the same way that iron rusts and a copper penny gradually darkens, these metals can oxidize in your body, triggering the production of free radicals—dangerous molecules that can damage the brain. Aluminum, too: Evidence suggests that it can be toxic to the brain. A vegan diet helps you avoid the iron overload that can come from meat and liver.
It also pays to avoid cookware that puts iron, copper, or aluminum directly in contact with food. Yes, that old favorite cast-iron pan may actually be part of the problem if you are using it every day. (Stainless steel is okay, as is nonstick cookware, provided the layer under the nonstick coating is steel.)
Avoid multivitamins that contain iron and copper, and steer clear of aluminum-containing antacids. When selecting a deodorant, look for those that omit aluminum, as it can pass through the skin into the blood.
Get your vitamin E. Vitamin E–rich foods reduce Alzheimer’s risk. That means almonds, walnuts, sunflower seeds, pecans, pine nuts, pistachios, sesame seeds, and flaxseed. Go easy, because these are fatty, high-calorie foods. Just one small handful of nuts or seeds a day is plenty.
Eat for color. Some evidence suggests that grapes, blueberries, and other brightly colored berries can improve memory in older people with mild memory problems. Their color comes from anthocyanins, which are powerful antioxidants that can knock out free radicals.
Lace up your sneakers. A University of Illinois study showed that a forty-minute brisk walk three times a week improves memory and reverses brain shrinkage.14
Get plenty of sleep. Don’t forget to rest! Getting adequate sleep is essential for brain health. Sleep is when the brain files away the events of the day, integrating them into your memory reserves. During sleep, your brain also restores your emotional stability. Without it, your memory and emotional control will be less than optimal. Everyone’s needs are different, but eight hours a night is a good goal.
Stopping Inflammation and Pain
For inflammatory conditions, such as rheumatoid arthritis, a surprising culprit could be animal protein. To understand how, let’s take an analogy. Let’s say you accidentally get a splinter. The splinter triggers inflammation in your skin; that is your skin’s natural response to injury or invasion. Your blood vessels open up to bring blood flow to the region, so the area looks red, and the influx of blood and fluid causes swelling. Blood flow brings white blood cells to the region, and each blood cell is like a little Pac-Man trying to gobble up the splinter particles that don’t belong there.
Inflammation is caused not just by splinters but also by certain foods. Among the chief suspects are dairy proteins. Several different research teams have found that people with arthritis do much better when they set aside dairy products, particularly as part of a vegan diet. This is especially true of rheumatoid arthritis but may also be true of other forms of the disease, as well as other conditions, including migraine.
So if you have an inflammatory condition, it makes good sense to start a vegan diet, and to do it 100 percent, because even small amounts of problem foods can trigger inflammation.
If avoiding animal products does not fully resolve the problem, it is possible that you have more than one trigger. For example, some people might be affected by dairy products, in addition to eggs, wheat, or tomatoes—or perhaps by citrus fruits and nuts. So, to track down your trigger foods, you can try a simple elimination diet that removes all the potential food triggers and then reintroduces them one at a time, so you can see which ones cause problems. The details are in my prior books The Cheese Trap and Foods That Fight Pain.
Athletic Power and Endurance
Vegan diets have tremendous benefits for athletes. If you want to optimize your performance, whether in a game or in your workouts, cutting out animal products is one of the most effective ways to do that.
First, the anti-inflammatory steps described in the previous section help cut post-workout recovery times, so athletes are ready to get back in the game much sooner.
Second, vegan foods boost endurance. As we saw in the discussion of high blood pressure, plant-based diets make the blood “thinner,” that is, less viscous. That does not just reduce blood pressure. It also increases the oxygenation of the muscles and brain. That’s part of why vegan diets give athletes better endurance.
Third, plants are packed with healthful complex carbohydrates to build glycogen. Glycogen is a special form of glucose that your liver and muscles store for extra energy, like spare batteries. If you have heard of athletes “carbo-loading,” this is what they are talking about. They are eating plenty of rice, bread, pasta, sweet potatoes, and other healthy carbohydrate-rich foods in order to store extra glycogen in their muscles and liver for long-lasting power.
As you can see, a vegan diet provides extraordinary power for tackling health conditions. More details on using foods to tackle health problems are available in the Recommended Resources listed here.