THE EFFECTS OF THE AMERICAN DIET, PART II
Now you know my formula for longevity (H = N/C) and that the key to this formula is the nutrient density of your diet. In other
words, you must eat a diet rich in nutrients and fiber, with a very low percentage of foods that are not nutrient-and fiber-dense.
It is the same formula that will enable your body to achieve slimness.
To help you learn how to apply this formula to your life, you first need to understand why you must follow it, exploring the
relationships between diet, health, and disease. To do so, you need to take a look at the reality of how most people eat and
what they gain or lose from such eating practices.
The Pros and Cons of Our “Natural Sweet Tooth”
Even though we have many unique human traits, we are genetically closely related to the great apes and other primates. Primates
are the only animals on the face of the earth that can taste sweet and see color. We were designed by nature to see, grasp,
eat, and enjoy the flavor of colorful, sweet fruits.
Fruit is an essential part of our diets. It is an indispensable requirement for us to maintain a high level of health. Fruit
consumption has been shown in numerous studies to offer our strongest protection against certain cancers, especially oral
and esophageal, lung, prostate, pancreatic, and colorectal cancer.1 Thankfully, our natural sweet tooth directs us to those foods ideally “designed” for our primate heritage—fruit. Fresh fruit
offers us powerful health-giving benefits.
Researchers have discovered substances in fruit that have unique effects on preventing aging and deterioration of the brain.2 Some fruits, especially blueberries, are rich in anthocyanins and other compounds having anti-aging effects.3 Studies continue to provide evidence that more than any other food, fruit is associated with lowered mortality from all cancers
combined.4 Eating fruit is vital to your health, well-being, and long life.
Regrettably, our human desire for sweets is typically satisfied by the consumption of products containing sugar, such as candy
bars and ice cream—not fresh fruit. The U.S. Department of Agriculture (USDA) estimates that the typical American now consumes
an unbelievable thirty teaspoons of added sugar a day.5 That’s right, in one day.
As we shall see, we need to satisfy our sweet tooth with fresh, natural fruits and other plant substances that supply us not
just with carbohydrates for energy but also with the full complement of indispensable substances that prevent illness.
Nutritional Lightweights: Pasta and White Bread
Unlike the fruits found in nature—which have a full ensemble of nutrients—processed carbohydrates (such as bread, pasta, and
cake) are deficient in fiber, phytonutrients, vitamins, and minerals, all of which have been lost in processing.
In a six-year study of 65,000 women, those with diets high in refined carbohydrates from white bread, white rice, and pasta
had two and a half times the incidence of Type II diabetes, compared with those who ate high-fiber foods such as whole wheat
bread and brown rice.6 These findings were replicated in a study of 43,000 men.7 Diabetes is no trivial problem; it is the seventh leading cause of death by disease in America, and its incidence is growing.8
Walter Willett, M.D., chairman of the Department of Nutrition at the Harvard School of Public Health and co-author of those
two studies, finds the results so convincing that he’d like our government to change the Food Guide Pyramid, which recommends
six to eleven servings of any kind of carbohydrate. He says, “They should move refined grains, like white bread, up to the
sweets category because metabolically they’re basically the same.”
These starchy (white-flour) foods, removed from nature’s packaging, are no longer real food. The fiber and the majority of
minerals have been removed, so such foods are absorbed too rapidly, resulting in a sharp glucose surge into the bloodstream.
The pancreas is then forced to pump out insulin faster to keep up. Excess body fat also causes us to require more insulin
from the pancreas. Over time, it is the excessive demand for insulin placed on the pancreas from both refined foods and increased
body fat that leads to diabetes. Refined carbohydrates, white flour, sweets, and even fruit juices, because they enter the
bloodstream so quickly, can also raise triglycerides, increasing the risk of heart attack in susceptible individuals.
Every time you eat such processed foods, you exclude from your diet not only the essential nutrients that we are aware of
but hundreds of other undiscovered phytonutrients that are crucial for normal human function. When the nutrient-rich outer cover is removed from whole wheat to make it into white flour, the
most nutritious part of the food is lost. The outer portion of the wheat kernel contains trace minerals, phytoestrogens, lignans,
phytic acid, indoles, phenolic compounds, and other phytochemicals, as well as almost all the vitamin E in the food. True
whole grain foods, which are associated with longer life, are vastly different from the processed foods that make up the bulk
of calories in the modern American diet (MAD).9
Medical investigations clearly show the dangers of consuming the quantity of processed foods that we do. And because these
refined grains lack the fiber and nutrient density to satisfy our appetite, they also cause obesity, diabetes, heart disease,
and significantly increased cancer risk.10
One nine-year study involving 34,492 women between the ages of fifty-five and sixty-nine showed a two-thirds increase in the
risk of death from heart disease in those eating refined grains.11 Summarizing fifteen epidemiological studies, researchers concluded that diets containing refined grains and refined sweets
were consistently linked to stomach and colon cancer, and at least fifteen breast cancer studies connect low-fiber diets with
increased risks.12 Eating a diet that contains a significant quantity of sugar and refined flour does not just cause weight gain, it also leads
to an earlier death.
If you want to lose weight, the most important foods to avoid are processed foods: condiments, candy, snacks, and baked goods;
fat-free has nothing to do with it. Almost all weight-loss authorities agree on this—you must cut out the refined carbohydrates,
including bagels, pasta, and bread. As far as the human body is concerned, low-fiber carbohydrates such as pasta are almost
as damaging as white sugar. Pasta is not health food—it is hurt food.
Now I can imagine what many of you are thinking: “But, Dr. Fuhrman! I love pasta. Do I have to give it up?” I enjoy eating
pasta, too. Pasta can sometimes be used in small quantities in a recipe that includes lots of green vegetables, onions, mushrooms,
and tomatoes. Whole grain pastas and bean pastas, found in health-food stores, are better choices than those made from white
flour. The point to remember is that all refined grains must be placed in that limited category—foods that should constitute
only a small percentage of our total caloric intake.
What about bagels? Is the “whole wheat” bagel you just bought at the bagel store really made from whole grain? No; in most
cases, it is primarily white flour. It is hard to tell sometimes. Ninety-nine percent of pastas, breads, cookies, pretzels,
and other grain products are made from white flour. Sometimes a little whole wheat or caramel color is added and the product
is called whole wheat to make you think it is the real thing. It isn’t. Most brown bread is merely white bread with a fake
tan. Wheat grown on American soil is not a nutrient-dense food to begin with, but then the food manufacturers remove the most
valuable part of the food and add bleach, preservatives, salt, sugar, and food coloring to make breads, breakfast cereals,
and other convenience foods. Yet many Americans consider such food healthy merely because it is low in fat.
Soil Depletion of Nutrients Is Not the Problem—Our Food Choices Are
Contrary to many of the horror stories you hear, our soil is not depleted of nutrients. California, Washington, Oregon, Texas,
Florida, and other states still have rich, fertile land that produces most of our fruits, vegetables, beans, nuts, and seeds. America provides some of the most nutrient-rich produce in the world.
Our government publishes nutritional analyses of foods. It takes food from a variety of supermarkets across the country, analyzes
it, and publishes the results. Contrary to claims of many health-food and supplement enthusiasts, the produce grown in this
country is nutrient-rich and high in trace minerals, especially beans, nuts, seeds, fruits, and vegetables.14 American-produced grains, however, do not have the mineral density of vegetables. Grains and animal-feed crops grown in the
southeastern states are the most deficient, but even in those states only a small percentage of crops are shown to be deficient
in minerals.15
Thankfully, by eating a diet with a wide variety of natural plant foods, from a variety of soils, the threat of nutritional
deficiency merely as a result of soil inadequacy is eliminated. Americans are not nutrient-deficient because of our depleted
soil, as some nutritional-supplement proponents claim. Americans are nutrient-deficient because they do not eat a sufficient
quantity of fresh produce. Over 90 percent of the calories consumed by Americans come from refined foods or animal products.
With such a small percentage of our diet consisting of unrefined plant foods, how could we not become nutrient-deficient?
Since more than 40 percent of the calories in the American diet are derived from sugar or refined grains, both of which are
nutrient-depleted, Americans are severely malnourished. Refined sugars cause us to be malnourished in direct proportion to
how much we consume them. They are partially to blame for the high cancer and heart attack rates we see in America.
It is not merely dental cavities that should concern us about sugar. If we allow ourselves and our children to utilize sugar,
white flour products, and oil to supply the majority of calories, as most American families do, we shall be condemning ourselves
to a lifetime of sickness, medical problems, and a premature death.
Refined sugars include table sugar (sucrose), milk sugar (lactose), honey, brown sugar, high-fructose corn syrup, molasses,
corn sweeteners, and fruit juice concentrates. Even the bottled and boxed fruit juices that many children drink are a poor food; with no significant nutrient density, they lead to obesity
and disease.16 Processed apple juice, which is not far from sugar water in its nutrient score, accounts for almost 50 percent of all fruit
servings consumed by preschoolers.17 For example, apple juice contains none of the vitamin C originally present in the whole apple. Oranges make the most nutritious
juice, but even orange juice can’t compare with the original orange. In citrus fruits, most of the anti-cancer compounds are
present in the membranes and pulp, which are removed in processing juice. Those cardboard containers of orange juice contain
less than 10 percent of the vitamin C present in an orange and even less of the fiber and phytochemicals. Juice is not fruit,
and prepackaged juices do not contain even one-tenth of the nutrients present in fresh fruit.
Empty calories are empty calories. Cookies, jams, and other processed foods (even those from the health-food store) sweetened
with “fruit juice” sound healthier but are just as bad as white-sugar products. When fruit juice is concentrated and used
as a sweetener, the healthy nutritional components are stripped away—what’s left is plain sugar. To your body, there is not
much difference between refined sugar, fruit juice sweeteners, honey, fruit juice concentrate, and any other concentrated
sweetener. Our sweet tooth has been put there by nature to have us enjoy and consume real fruit, not some imitation. Fresh-squeezed
orange juice and other fresh fruit and vegetable juices are relatively healthy foods that contain the majority of the original
vitamins and minerals. But sweet fruit juices and even carrot juice should still be used only moderately, as they still contain
a high concentration of sugar calories and no fiber. They are not an ideal food for those desiring to lose weight. I often
use these juices as part of salad dressings and other dishes rather than alone as a drink. Fresh fruits and even dried fruits do contain an assortment
of protective nutrients and phytochemicals, so stick with the real thing.
Enrichment with Nutrients Is a House Made of Straw
White or “enriched” rice is just as bad as white bread and pasta. It is nutritionally bankrupt. You might as well just eat
the Uncle Ben’s cardboard box it comes in. Refining the rice removes the same important factors: fiber, minerals, phytochemicals,
and vitamin E. So, when you eat grains, eat whole grains.
Refining foods removes so much nutrition that our government requires that a few synthetic vitamins and minerals be added
back. Such foods are labeled as enriched or fortified. Whenever you see those words on a package, it means important nutrients
are missing. Refining foods lowers the amount of hundreds of known nutrients, yet usually only five to ten are added back
by fortification.
As we change food through processing and refining, we rob the food of certain health-supporting substances and often create
unhealthy compounds, thus making it a more unfit food for human consumption. As a general rule of thumb: the closer we eat
foods to their natural state, the healthier the food.
Not All Whole Wheat Products Are Equal
“Whole grain” foods are not always nutrient-dense, healthy foods. Many whole grain cold cereals are so processed that they
do not have a significant fiber per serving ratio and have lost most of their nutritional value.
Whole wheat that is finely ground is absorbed into the bloodstream fairly rapidly and should not be considered as wholesome
as more coarsely ground and grittier whole grains. The rapid rise of glucose triggers fat storage hormones. Because the more
coarsely ground grains are absorbed more slowly, they curtail our appetite better.
Whole grain hot cereals are less processed than cold cereals and come up with better nutritional scores. They can be soaked
in water overnight so you do not have to cook them in the morning.
Unlike eating whole grain foods, ingesting processed foods can subtract nutrients and actually create nutritional deficiencies, as the body utilizes nutrients to digest and assimilate
food. If the mineral demands of digestion and assimilation are greater than the nutrients supplied by the food, we may end
up with a deficit—a drain on our nutrient reserve funds.
For most of their lives, the diets of many American adults and children are severely deficient in plant-derived nutrients.
I have drawn nutrient levels on thousands of patients and have become shocked at the dismal levels in supposedly “healthy”
people. Our bodies are not immune to immutable biological laws that govern cellular function. Given enough time, disease will
develop. Even borderline deficiencies can result in various subtle defects in human health, leading to anxiety, autoimmune
disorders, cancer, and poor eyesight, to name a few.18
Fat and Refined Carbohydrates: Married to Your Waist
The body converts food fat into body fat quickly and easily: 100 calories of ingested fat can be converted to 97 calories
of body fat by burning a measly 3 calories. Fat is an appetite stimulant: the more you eat, the more you want. If a food could
be scientifically engineered to create an obese society, it would have fat, such as butter, mixed with sugar and flour.
The combination of fat and refined carbohydrates has an extremely powerful effect on driving the signals that promote fat
accumulation on the body. Refined foods cause a swift and excessive rise in blood sugar, which in turn triggers insulin surges
to drive the sugar out of the blood and into our cells. Unfortunately, insulin also promotes the storage of fat on the body
and encourages your fat cells to swell.
As more fat is packed away on the body, it interferes with insulin uptake into our muscle tissues. Our pancreas then senses
that the glucose level in the bloodstream is still too high and pumps out even more insulin. A little extra fat around our
midsection results in so much interference with insulin’s effectiveness that two to five times as much insulin may be secreted
in an overweight person than in a thin person.
The higher level of insulin in turn promotes more efficient conversion of our caloric intake into body fat, and this vicious
cycle continues. People get heavier and heavier as time goes on.
Eating refined carbohydrates—as opposed to complex carbohydrates in their natural state—causes the body’s “set point” for
body weight to increase. Your “set point” is the weight the body tries to maintain through the brain’s control of hormonal
messengers. When you eat refined fats (oils) or refined carbohydrates such as white flour and sugar, the fat-storing hormones
are produced in excess, raising the set point. To further compound the problem, because so much of the vitamin and mineral content of these foods has been lost during processing, you naturally crave more
food to make up for the missing nutrients.
Our Oil-Rich Country, or From Your Lips Right to Your Hips
An effective way to sabotage your weight-loss goal is with high-fat dressings and sauces. Americans consume 60 grams of added
fat in the form of oils, which is over five hundred calories a day from this form of no-fiber, empty calories.19 Refined or extracted oils, including olive oil, are rich in calories and low in nutrients.
Oils are 100 percent fat. Like all other types of fat, they contain nine calories per gram, compared with four calories per
gram for carbohydrates. There are lots of calories in just a little bit of oil.
ANALYSIS OF ONE TABLESPOON OF OLIVE OIL
| Calories |
120 |
| Fiber |
none |
| Protein |
none |
| Fat |
13.5 gm |
| Saturated fat |
1.8 gm |
| Minerals |
none (trace, less than .01 mg of every mineral) |
| Vitamins |
none (trace of vi ta min E, less than 1 IU) |
Fat, such as olive oil, can be stored on your body within minutes, without costing the body any caloric price; it is just
packed away (unchanged) on your hips and waist. If we biopsied your waist fat and looked at it under an electron microscope,
we could actually see where the fat came from. It is stored there as pig fat, dairy fat, and olive oil fat—just as it was
in the original food. It goes from your lips right to your hips. Actually, more fat from your last meal is deposited around
your waist than on your hips, for both men and women.20 Analyzing these body-fat deposits is an accurate way for research scientists to discern food intake over time.21 Having research subjects remember what they ate (dietary recall analysis) is not as accurate as a tissue biopsy, which reports
exactly what was really eaten.
Foods cooked in oil or coated with oil soak up more oil than you think. A low-calorie “healthy” food easily becomes fattening.
Most Americans eat negligible amounts of salad vegetables, but when they do eat a small salad, they consume about three leaves
of iceberg lettuce in a small bowl and then proceed to pour three or four tablespoons of oily dressing on top. Since oil is
about 120 calories per tablespoon, they consume some 400 (empty) calories from dressing and about 18 from lettuce. They might
as well forget the lettuce and just drink the dressing straight from the bottle. One key to your success is to make healthful
salad dressings from my recipes in chapter nine or use other low-calorie and low-salt options.
The message Americans are hearing today from the media and health professionals is that you don’t need to go on a low-fat
diet, you merely need to replace the bad fats (saturated fats mostly from animal products and trans fats in processed foods)
with olive oil. Americans are still confused and receive conflicting and incorrect messages. Olive oil and other salad and
cooking oils are not health foods and are certainly not diet foods.
There is considerable evidence to suggest that consuming monounsaturated fats such as olive oil is less destructive to your
health than the dangerous saturated and trans fats. But a lower-fat diet could be more dangerous than one with a higher level
of fat if the lower-fat diet has more saturated and trans fats. Also, reducing fat and adding more low-nutrient carbohydrates
such as bread, white flour, pasta, white rice, and white potatoes is not a significant improvement in nutritional quality.
Low-fat does not mean nutritious and healthful.
In the 1950s people living in the Mediterranean, especially on the island of Crete, were lean and virtually free of heart
disease. Yet over 40 percent of their caloric intake came from fat, primarily olive oil. If we look at the diet they consumed
back then, we note that the Cretans ate mostly fruits, vegetables, beans, and some fish. Saturated fat was less than 6 percent
of their total fat intake. True, they ate lots of olive oil, but the rest of their diet was exceptionally healthy. They also
worked hard in the fields, walking about nine miles a day, often pushing a plow or working other manual farm equipment. Americans
didn’t take home the message to eat loads of vegetables, beans, and fruits and do loads of exercise; they just accepted that
olive oil is a health food.
Today the people of Crete are fat, just like us. They’re still eating a lot of olive oil, but their consumption of fruits,
vegetables, and beans is down. Meat, cheese, and fish are their new staples, and their physical activity level has plummeted.
Today heart disease has skyrocketed and more than half the population of both adults and children in Crete is overweight.22
Even two of the most enthusiastic proponents of the Mediterranean diet, epidemiologist Martijn Katan of Wageningen Agricultural
University in the Netherlands and Walter Willett of the Harvard School of Public Health, concede that the Mediterranean diet
is viable only for people who are close to their ideal weight.23 That excludes the majority of Americans. How can a diet revolving around a fattening, nutrient-deficient food like oil be
healthy?
Ounce for ounce, olive oil is one of the most fattening, calorically dense foods on the planet; it packs even more calories
per pound than butter (butter: 3,200 calories; olive oil: 4,020).
The bottom line is that oil will add fat to our already plump waistlines, heightening the risk of disease, including diabetes
and heart attacks. Olive oil contains 14 percent saturated fat, so you increase the amount of artery-clogging saturated fat
as you consume more of it. I believe consuming more fattening olive oil in your diet will raise your LDL (bad) cholesterol,
not lower it. Weight gain raises your cholesterol; unprocessed foods such as nuts, seeds, and vegetables, utilized as a source
of fat and calories instead of oil, contain phytosterols and other natural substances that lower cholesterol.24 Also, keep in mind that in Italy, where they consume all that supposedly healthy olive oil, people have twice the chance of getting breast cancer as in Japan, where they have a significantly lower intake of oil.25
The Mediterranean diet looked better than ours because of the increased consumption of vegetation, not because of the oil.
People who use olive oil generally put it on vegetables such as salads and tomatoes, so its use is correlated with higher
consumption of produce. Their diets were better in spite of the oil consumption, not because of it.
If you are thin and exercise a lot, one tablespoon of olive oil a day is no big deal, but the best choice for most overweight
Americans is no oil at all.
The Popularity of the Mediterranean Diet
I have only a few bones to pick with those advocating the Mediterranean diet style. First, they claim that cooking food in
olive oil increases phytochemical absorption and that eating vegetables without a high-fat topping is not as nutritious since
the phytochemicals are not absorbed. When vegetables are cooked, or eaten with fat, some nutrients are more efficiently absorbed
and other heat-sensitive nutrients are lost or rendered less absorbable. Many studies show that raw fruits and vegetables
offer the highest blood levels of cancer-protective nutrients and the most protection against cancer of any other foods, including
cooked vegetation.26 Any advice not recognizing that raw vegetables and fresh fruits are the two most powerful anti-cancer categories of foods
is off the mark. Plus, when you use raw seeds and nuts instead of oil, you receive dramatic health benefits without all the
empty colories because of the high micronutrient content.
Paul Talalay, M.D., of the Brassica Chemoprotection Laboratory at the Johns Hopkins School of Medicine is involved with researching
the effects of cooking on phytochemicals. He reports “widely different effects on the compounds in vegetables that protect
against cancer.”27 These compounds are both activated and destroyed by various cooking methods.
I recognize that raw, uncooked vegetables and fruits offer the most powerful protection against disease, and I encourage my
patients to eat huge salads and at least four fresh fruits per day. Diets with little raw foods are not ideal. As the amount
of raw fruits and vegetables are increased in a person’s diet, weight loss and blood pressure are lowered effortlessly.28
Additionally, raw foods contain enzymes, some of which can survive the digestive process in the stomach and pass into the
small intestines. These heat-sensitive elements may offer significant nutritional advantages to protect against disease, according
to investigators from the Department of Biochemistry at Wright State University School of Medicine.29 These researchers concluded that “most foods undergo a decrease in nutritive value in addition to the well-known loss of
vitamins when cooked and/or processed.” Most vitamins are heat-sensitive, for example 20 to 60 percent of vitamin C is lost,
depending on the cooking method.30 Thirty to 40 percent of minerals are lost in cooking vegetables as well.31 Consuming a significant quantity of raw foods is essential for superior health.
For the best results, your diet should contain a huge amount of raw foods, a large amount of the less calorically dense cooked
vegetation, and a lesser amount of the more calorically rich cooked starchy vegetables and grains. Cooking your food in oil
will make your diet less effective and you will not lose weight as easily. You may not even lose any weight at all.
Keep in mind, weight loss slows down over time. Most people starting almost any diet after eating haphazardly lose some weight
initially. It is easy to drop a few pounds by merely counting calories, but many overweight individuals with a strong genetic
tendency to obesity and slow metabolism who need to lose lots of weight may lose very little or none at all. Some may lose
an initial five to fifteen pounds, but then when further weight loss becomes even more difficult, they give up.
Another problem with the Mediterranean diet is the preponderance of pasta and Italian bread, which not only causes difficulty
with weight control but is also an important factor in increasing colon cancer risk in populations with this eating style.32
For the very overweight individual, the Mediterranean diet, like other conventional weight-loss programs, is neither restrictive
enough nor filling enough to achieve the results desired. Because olive oil adds so many extra calories to their diet, the
dieters still have to carefully count calories and eat tiny portions. All those calories supplied by olive oil, almost one-third
of the total caloric intake, make the diet significantly lower in nutrients and fiber.
You can always lose weight by exercising more, and I am all for it. However, many very overweight patients are too ill and
too heavy to exercise much. As a former athlete, and today as a physician, I am an exercise nut and a fanatic about recommending
exercise to my patients, but many people cannot comply with a substantial exercise program until they are in better health
or lose some more weight first. They need a diet that will drop weight effectively, even if they can’t do lots of exercise.
I have tested my recommendation on more than two thousand patients. The average patient loses the most weight in the first
four to six weeks, with the average being about twenty pounds. The weight loss continues nicely—those following this program
continue to lose about ten pounds the second month and about a pound and a half per week thereafter. The weight loss continues
at this comparatively quick rate until they reach their ideal weight.
The bottom line about healthy fats is that raw nuts, seeds, and avocados contain healthy fats. However, you should consume
a limited amount of these foods, especially if you wish to lose weight. Also remember that oil, including olive oil, does
not contain the nutrients and phytonutrients that were in the original olive. The oil has little nutrients (except a little
vitamin E) and a negligible amount of phytochemical compounds. If you eat the quantities of oil permitted on the typical Mediterranean
diet, where all the vegetables are cooked in oil, you will have difficulty taking off the weight you need to lose.
You can add a little bit of olive oil to your diet if you are thin and exercise a lot. However, using a small amount of raw
seeds and nuts in salad dressings and dips is a better, more healthful option. Plus, the more oil you add, the more you are
lowering the nutrient-per-calorie density of your diet—and that is not your objective, as it does not promote health.
The “Magic” of Fiber—A Critical Nutrient
When we think of fiber, we usually think of bran or Metamucil, something that we take to prevent constipation and that tastes
like cardboard. Change that thinking. Fiber is a vital nutrient, essential to human health. Unfortunately, the American diet
is dangerously deficient in fiber, a deficiency that leads to many health problems (for example, hemorrhoids, constipation,
varicose veins, and diabetes) and is a major cause of cancer. As you can see, if you get fiber naturally in your diet from
great-tasting food, you get much more than just constipation relief.
HOW YOUR BODY BENEFITS FROM THE FIBER FOUND IN PLANT FOODS
When you eat mostly natural plant foods, such as fruits, vegetables, and beans, you get large amounts of various types of
fiber. These foods are rich in complex carbohydrates and both insoluble and water-soluble fibers. The fibers slow down glucose
absorption and control the rate of digestion. Plant fibers have complex physiological effects in the digestive tract that
offer a variety of benefits, such as lowering cholesterol.33
Because of fiber, and because precious food components haven’t been lost through processing, natural plant foods fill you
up and do not cause abnormal physiological cravings or hormonal imbalances.
Confusion in the Marketplace over the Role of Fiber
Some people are so confused that they do not know what to believe anymore. For example, two studies about fiber received sensational
coverage by the media after appearing in the New England Journal of Medicine.34 Newspapers proclaimed the bold headlines HIGH-FIBER DIET DOES NOT PROTECT AGAINST COLON CANCER. No wonder our population is so confused by conflicting messages about nutrition. Some people have actually given up trying
to eat healthfully because one day they hear one claim and the next week they hear the opposite. There’s a lesson to be learned
here: Don’t get your health advice from the media.
I am bringing up this issue so you realize not to jump to conclusions on the basis of one study or one news report. You can
see how research information is often (mis)reported in the news. I have reviewed more than two thousand nutritional research
papers in preparation for this book and many more in prior years, and there is not much conflicting evidence. As in a trial,
the evidence has become overwhelming and irrefutable—high-fiber foods offer significant protection against both cancer (including
colon cancer) and heart disease. I didn’t say fiber; I said high-fiber foods. We can’t just add a high-fiber candy bar or sprinkle a little Metamucil on our doughnut and french fries and expect to reap
the benefits of eating high-fiber foods, yet this is practically what the first study did.
The studies mentioned above did not show that a diet high in fresh fruits, vegetables, beans, whole grains, and raw nuts and
seeds does not protect against colon cancer. It has already been adequately demonstrated in hundreds of observational studies
that such a diet does offer such protection from cancer at multiple sites, including the colon.
The first study merely added a fiber supplement to the diet. I wouldn’t expect adding a 13.5-gram fiber supplement to the
disease-causing American diet to do anything. It is surprising that this study was actually conducted. Obviously, adding supplemental
fiber does not capture the essence of a diet rich in these protective plant foods.
The second study compared controls against a group of people who were counseled on improving their diet. The participants
continued to follow their usual (disease-causing) diet and made only a moderate dietary change—a slight reduction in fat intake,
with a modest increase in fruits and vegetables for four years. The number of colorectal adenomas four years later was similar.
Colorectal adenomas are not colon cancer; they are benign polyps. Only a very small percentage of these polyps ever advance
to become colon cancer, and the clinical significance of small benign adenomas is not clear. In any case, it is a huge leap
to claim that a diet high in fruits and vegetables does not protect against cancer. This study did not even attempt to address
colon cancer, just benign polyps that rarely progress to cancer.
In both studies, even the groups supposedly consuming a high-fiber intake were on a low-fiber diet by my standards. The group
consuming the most fiber only ate 25 grams of fiber a day. A high-fiber intake is a marker of many anti-cancer properties
of natural foods, especially phytochemicals. The diet plan I recommend is not based on any one study, but on more than two
thousand studies and the results I’ve seen with thousands of my own patients. Following this plan, you will consume between
50 and 100 grams of fiber (from real food, not supplements) per day.
In an editorial, published in the same issue of the New England Journal of Medicine, Tim Byers, M.D., M.P.H., basically agreed, stating, “Observational studies around the world continue to find that the risk
of colorectal cancer is lower among populations with high intakes of fruits and vegetables and that the risk changes on adoption
of a different diet.”35 He further explained that the three-or four-year period assessed by these trials is too brief and cannot assess the effects
of long-term dietary patterns that have already been shown to protect against colorectal cancer.
The reality is that healthy, nutritious foods are also very rich in fiber and that those foods associated with disease risk
are generally fiber-deficient. Meat and dairy products do not contain any fiber, and foods made from refined grains (such
as white bread, white rice, and pasta) have had their fiber removed. Clearly, we must substantially reduce our consumption
of these fiber-deficient foods if we expect to lose weight and live a long, healthy life.
Fiber intake from food is a good marker of disease risk. The amount of fiber consumed may better predict weight gain, insulin
levels, and other cardiovascular risk factors than does the amount of total fat consumed, according to studies reported in
the Journal of the American Medical Association.36 Again, data show that removing the fiber from food is extremely dangerous.
People who consume the most high-fiber foods are the healthiest, as determined by better waist measurements, lower insulin
levels, and other markers of disease risk. Indeed, this is one of the key themes of this book—for anyone to consider his or
her diet healthy, it must be predominantly composed of high-fiber, natural foods.
It is not the fiber extracted from the plant package that has miraculous health properties. It is the entire plant package
considered as a whole, containing nature’s anti-cancer nutrients as well as being rich in fiber.
