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Eat More, Weigh Less

            It’s hard to imagine a more suspicious sounding diet than one called “Eat More, Weigh, Less” and yet that’s the title of a book published some 40+ years ago by Dr. Dean Ornish.  Interestingly, Dr. Ornish had no particular interest in weight loss diets until he noticed that patients on his heart healthy plant-based whole food diets were not only reversing heart disease but also losing weight.  Most impressive was the observation that weight once lost didn’t come back no matter how much his patients ate.

            The book, “Eat More Weigh Less” by Dr. Dean Ornish was one of the first books to gain wide recognition for explaining the merits of a plant-based whole food diet.  In time, his findings were repeated by others and reported in a wide range of peer-reviewed research reports that provided credibility for both the health benefits and the claim that a plant-based whole food diet was effective for long term sustainable weight loss.  For many, this double win was almost too much to believe.  Forty years later, what seemed radical at the time has now been verified by hundreds of studies.

            It’s often observed that animals feeding on food in their natural habitat don’t get overweight except for those planning to hibernate. Cows graze all day long and the same for horses and none get fat.  Monkeys stuff themselves with banana any time they like and yet, no fat monkeys.  So, the thought occurred to early researchers that perhaps humans could manage their weight as effortlessly as other species if they ate the foods that they were genetically adapted to eat.  Following hundreds of studies, it became clear that a plant-based whole food diet was the only diet that normalized weight for most people.  As a pleasant bonus, it was also the diet that provided the best health outcomes.

            Often when a new theory about nutrition, health, or weight loss come into vogue the claims are backed by a bestselling book, celebrity endorsements and even some endorsement from people with credible academic credentials.  In short order, others pile in with their ‘me too books’, courses, and must have products.  Soon enough the many echoes begin to sound like a consensus of experts.  To confuse matters, many of these fads work for a while.  Suppose you are ecstatic about having lost ten pounds on a new fad diet.  Now your good news needs to be shared, right?  And share it you will with every friend you meet and those on social media to boot.  When the weight comes back six months or a year later, will all the friends get an update?  Alas, probably not. And so it goes, fad after fad runs on false enthusiasm until one day it becomes obvious that almost no one loses weight and keeps it off for over a year. Not to worry, new fads are in the wings and even fads in their death throes can be revived with a new name, another theory, or another celebrity sales pitch.

            Chemotherapy, starvation, amphetamines, and smoking are all effective ways to lose weight but each comes with challenging health issues over the long term.  Inevitably, the missing element is a lack of credible long term studies that confirm the original claims.  Given that thoroughly testing a new diet may take longer than the life of the fad, it’s not surprising that opinions manage to survive unchallenged as ‘facts.’  It’s easy to get enthusiastic about an idea that’s promoted as the answer to your dire need.  Even very smart people get hoodwinked.  Cold fusion sounded like the answer to unlimited cheap energy until it was put to the test by independent researchers.

           In contrast, claims for the plant-based whole food diet and in particular for its value in weigh normalization have been backed up by hundreds of studies that have been peer-reviewed and survived intense scrutiny.  Studies have confirmed that the average person following a plant-based diet can expect to lose about 24 pounds in the first year without regaining the weight. 

            Unfortunately, what scientists have learned about the root causes of weight gain and most chronic illness over 40 years ago has not become common knowledge.  The message, that it’s not how much you eat but what you eat, is not yet reaching the public.  As is often the case when habits are involved, compelling evidence doesn’t mean there will be a rush by the public to use the advice.

            It would be wonderful if I could tell people that more bacon, sausage, milk, eggs, and refined foods were the keys to health.  Of course, I can’t do that but the Government and agribusiness industries can.  As a result, we still have recommendations for the Mediterranean Diet and the DASH diet which are both better than the Standard American Diet (SAD) but far from an optimal diet for weight normalization and health.

            Confusion about nutrition is often the subject of seemingly objective articles in magazines.  Even the editorials, the one place you would hope to find a voice of reason on a seemingly non-political subject, manage to mangle the facts.  As often happens, when billions of dollars of profit are at risk, the facts at hand will be politicized and food science is no different. As for editorial objectivity, who really expects editors to tell readers that their advertisers sell unhealthy products?  For a person that gets their nutrition education from news articles, magazine articles or TV programs this is a formula for confusion.

            You might imagine that people would be moved to take preventive health measure if they understood that the same lifestyle measure that provides sustainable weight loss also helps

  • Prevent heart disease,
  • Reverse high blood pressure,
  • Reduce cholesterol,
  • Slow early-stage prostate cancer,
  • Slow early-stage breast cancer, and
  • Avoid over 100 diseases

            While most of these health issues had long been assumed to be the result of genetics, or environment, it’s now understood that the effect of lifestyle on epigenetics is the far more significant effect.  In practice, lifestyle (diet, exercise, stress, sleep, etc.) has a powerful effect on which genes are expressed and which genes are turned off.

           When it was discovered that lifestyle can affect the length of telomeres, the editor of the Lancet called it evidence that aging can be slowed at the cellular level.  The evidence continues to accumulate. Studies have demonstrated that diet directly affects blood vessels, heart health, strokes, varicose veins, brain health, etc.  Encouraging research now shows the possibility of stopping or reversing Alzheimer’s disease. Along with dementia, a wide range of immune disorders and metabolic diseases are now implicated as being caused by the effect of animal protein and refined foods on the gut.

            The remarkable understanding is that heart disease, diabetes, prostate cancer, Alzheimer’s disease, obesity, and breast cancer are not fundamentally different diseases.  Most of these chronic conditions have the same root cause but manifest themselves in different ways.  Even angiogenesis, the process through which new blood vessels are formed from pre-existing vessels, is part of a common thread that runs through these seemingly different diseases.  Interestingly, this common root cause is the reason people often have multiple diseases at the same time.  This is also the reason why medications that target one disease often have minimal effect on overall well being or longevity.

            With the overwhelming evidence for a low fat plant-based whole food diet, it’s hard to believe that so many would still be attracted to fads recommending high fat or high protein diets.  Of course, there are people that will say just about anything to sell a book.  And, of course, there are plenty of people that will buy a book that tells them what they want to hear.  While Dr. Atkins of the “eat more meat Atkins diet” was obese, and suffered from heart disease, this fact was never revealed until his death.  Today, his followers continue to promote the diet under names like Ketogenic diet or the Paleo diet. Unfortunately, it’s essentially the same diet repackaged for the gullible seeking quick results without an understanding of the long term health effects.

            In a paper by Stephen Smith in the New England Journal of Medicine, he showed what arteries look like on different diets.  On a plant-based whole food diet, blood flow is clean and unrestricted.  On the Standard American Diet (SAD) arteries become clogged.  Worst for the arteries are diets promoted as being low carb, Paleo, Ketogenic (high fat) or high protein where the long term result is severely clogged arteries.

            There is compelling evidence that the primary source of food for our species and other species close to ours has been a plant-based diet for at least the last 100,000 years.  Of course, in a few cultures, representing less than one percent of humans, animal protein was a significant part of the diet.  Interestingly, there are no societies with a large amount of animal protein in the diet that also had good health and good longevity outcomes.  At any age, and especially over the age of 30, this is an observation worth heeding if quality of life and longevity are personal objectives.

            One of the earliest indications that an animal diet was a poor choice comes from evidence collected from Egyptian mummies that underwent CAT scans.  These studies show that over 3,000 years ago people were developing heart disease, artherosclerosis, and congenital diseases.  Interestingly, it was the affluent that could afford to eat rich foods that suffered.  The common man that was eating plants was spared. The same story appears again in ancient Rome. The gladiators (think NFL players today) ate barley, not because it was cheaper than meat, but because it was a plant-based whole grain that supported superior strength.

            Today, in a world of abundance everyone has access to the rich foods once reserved for the wealthy.  The result is visible in maps of national obesity which now affect every state and which affect larger numbers of people each year.  In effect, we have an epidemic that now affects almost 75% of people, that in the past affected only the very richest segment of society.

            The good news is that plant-based whole foods can be far less expensive than animal products and refined carbohydrates.  As a bonus, these can also be the tastiest foods given that the flavors we like come from plants. To make it happen, new cooking habits need to be cultivated.  While changing the nations’ food habits may take a generation or more, there is nothing to stop you from having the benefits today if quality of life and longevity are in your goals.

            To encourage your interest in personally adopting a plant-based whole food diet Dr. Dean Ornish packaged a surprise in his book.  Knowing that habits are hard to change, he sent his specification for the foods that could be used for best health to the leading chefs with the challenge of creating their best recipes.  These recipes represent over half of his book although about half have some dairy.  Since then we have learned that most would be wise to eliminate dairy or at least significantly reduce it in their diet.

            What more could you ask for in a book? You get health recommendations backed by research that has withstood over 40 years of critical peer-reviewed evaluation along with tasty recipes from the world’s best chefs.

            Nancy Neighbors, MD

Spiralized Sweet Potato & Beet Noodles
with Lemon and Ginger

            These veggies noodles are made with raw vegetables that make them high in nutrition and low in calories.  Find the recipe at The Culinary Gym.

By Nancy Neighbors, MD

... Dr. Neighbors provides a blend of traditional family medicine and evidence-based lifestyle medicine in Huntsville, Alabama. When indicated, lifestyle change is recommended as the first line of therapy.

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