Doctor, what should I eat? Modern Diet in America Exposed

Anywhere I go, as soon as people find out what I do, they always ask, “Doctor, what should I eat?” Americans are obsessed with finding the right diet formula. Since 1990, the year I moved to New York, I have witnessed many theories and fads that swept the country, reshaped the industry, and left more casualties than all of the wars ever fought by the United States added together!

First was the war on fat. America’s full frontal attack on fat redefined life in America. With doctors and the media in agreement, the popula­tion was convinced that fat was a hidden weapon of mass destruction, so it was eliminated from every single product in the supermarket. The food industry was having a party. The supermarkets were inundated with everything fat-free, you name it. Even the impossible, fat-free butter, endorsed by cardiologists! The caloric void that fats left was filled with carbs. “Lean” was the buzzword, but not the result. Instead, Americans became the fattest people in the world.

At Lenox Hill Hospital, during my fellowship, the casualties of this war kept our cardiac catheterization lab open 24/7 reopening coro­nary arteries with balloons and stents to abort or avoid a heart attack. During one of those long nights, walking alongside a gurney on the way from the emergency room to the angioplasty room, I heard my patient laughing so hard, his oxygen mask flew off his face. Before put­ting his mask back on, I asked him what was so funny. He said, “I just changed my favorite phrase from ‘I can’t believe it’s not butter’ to ‘I wish it had been butter’!” Finding humor in tragedy sometimes car­ried me through those long nights on call. It also reminded me how believing in the latest product invented can be dangerous, even if it’s approved by the FDA and endorsed by cardiologists.

Before the wave of heart attacks slowed down, America found a new enemy, carbohydrates. It was war all over again, just as vicious and supported by most authorities. Getting leaner was not about eat­ing lean foods, as we once thought; it was about eating “sugar-free.” The calories missing after eliminating carbs were replaced with extra protein, not exactly by accident. High-protein, low-carbohydrate diets had been in use in America for a long time. Bodybuilders figured out early on that if you eat mostly protein, your muscles will grow faster and bigger. Bodybuilders are the leanest people not by birth, but by choice, great effort, and tons of protein. So to imitate them off went America on a rampage of consuming fish, chicken, steak, eggs, and cot­tage cheese (low-fat).

Years back, when I started my search to overcome depression, I knew only one thing for sure: being in shape helps. Before moving to New York, as a tae kwon do competitor I was in tiptop shape. I remembered clearly that everything was better in that state. I decided to force myself to run, and after a month I was running one hour every day. I avoided desserts and candy and drank more water than ever in my life. I got skinny fast, but except in my legs, my muscles were gone and my skin was saggy. I wanted to get toned and ripped. I wanted a six-pack, so I hired a per­sonal trainer who had one. He had the knowledge of the bodybuilders. He turned me on to many books, magazines, and products all created to assist the body in building muscle and burning fat. We lifted weights four days a week, did cardio two days a week, and rested one. One day every two weeks, I was allowed to splurge on pizza and ice cream. I was such a dedicated student that I beat his prediction about the time it would take me to look like him by a month. And in a graduation ceremony of sorts, he passed on to me the secret weapon, The Opus Diet.

The book was written by Dan Duchaine, himself a bodybuilder, who noticed that a high-protein, low-carb diet would only take him so far. There was that last fat reserve that seemed impossible to burn. In competition, the bodybuilder with the least fat wins. Duchaine, deter­mined to understand how to do it, studied physiology, endocrinology, and metabolism with such passion that he became an authority on those subjects.

His greatest discovery came from observing sick people. Poorly controlled diabetics develop a condition known in medicine as ketoaci­dosis. The lack of insulin prevents the glucose in the blood from enter­ing the cells to be used as fuel for energy. The body has a temporary survival trick to buy time. It converts fat into ketone bodies, which are similar to glucose in that they can be used as fuel in cells, but their molecular composition resembles alcohol. The reason they are only a temporary solution is that they eventually make the blood so acid it is deadly. Ketoacidosis is a life-threatening medical emergency.

But patients who had repeated episodes of ketoacidosis were some of the leanest people Duchaine had ever seen, and he wanted to recre­ate this condition. Eating only protein and fat, no carbs, was his magic formula. He would go for as long as he could without carbs, allowing his body to turn fat into ketone bodies. Then, to keep from entering a critical state, he would eat some carbs to stabilize his blood acidity. Once it was stabilized, he would repeat the process. And it worked.

Duchaine knew the risk of death when eating this way. He knew well what he was dealing with, and he was willing to accept the conse­quences. But when the Atkins diet exploded all over the world, I don’t think the majority of its followers knew what they were getting into. They still don’t. The Atkins diet works; it is guaranteed to make you fit in your bathing suit by beach time. What it doesn’t guarantee is that you will be alive to enjoy it. Ketoacidosis or not, high animal-protein content in our diet is acidifying, contributing to inflammation in gen­eral and to cardiovascular disease, cancer, renal insufficiency, gout, and osteoporosis in particular.

After this whole experience, whenever people ask me what they should eat, I first ask them, “What are you eating for?” If you are eat­ing to get lean, fast, Atkins is your best choice, but your worst choice if what you want is radiant health and longevity.

When we finally realized that eliminating one of the three basic food categories (carbs, proteins, fats) was not going to work, more reasonable and safer fads, such as the Zone, South Beach, and Body for Life, came and went without as much press as their predecessors. Throughout the rise and fall of the fads, always in the background, as if pretending not to be there, was the U.S. government’s food pyramid. It shows the different groups of foods and the number of servings per day that are considered healthy. The only thing I have to say about it is that it all starts with a lie; it turns out the pyramid is really a triangle.

Fads come and go; they often don’t survive because they have no lasting value to impart to followers. Some dietary trends, however— those based on sound information and with lasting value—turn into movements. They are often born from the experience of someone who shares and inspires others to benefit from the discoveries made. Bonds are generated and communities are born. There are many Web commu­nities that support these movements; they organize gatherings, lectures, and conventions as well as sell products and services. Movements can affect the country’s economy as much as fads. Some of these movements are worth learning about.

The raw-food movement explains that it is not healthy to cook your food. Cooking destroys the enzymes in raw foods that are necessary for their digestion. A famous experiment I heard about made me fully respect the theories behind it. In the early 1900s, Dr. Francis Pottage conducted an experiment in California. He kept two groups of cats sepa­rated, living in identical environmental conditions, except for one dif­ference. One group was fed raw meat and milk. The second group was fed the same amount of the same quality meat and milk, only cooked. After some time, the cats on raw food were healthy and thriving. The cats on cooked foods developed various diseases, such as cancer, arthri­tis, diabetes, and others—all diseases we see often in humans.

In my personal experience, eating only raw foods for a period of time is a great way to detox less intensely than juicing or water fasting. But after some time I myself could not sustain it. I was strongly drawn to eat cooked foods again, which invariably made me feel better. I do recommend that all my patients increase the percentage of raw foods in their daily diet. Small increases in percentage of foods eaten raw have proven to have significant benefits in lowering blood pressure and cho­lesterol naturally. The tenets of the raw-food movement are presented as the solution for a healthy body as well as a healthy planet. Shifting our habits to eating only raw foods would imply a total redesign of life as we know it, adherents explain, and will solve global warming, global toxicity, global hunger, and many other problems of modern life.

The live-food movement takes the ideas of the raw-food movement to another level. Simply being raw is not enough—food has to carry the energy of life. It cannot be eaten too long after picking or the energy of life will no longer be present. Seeds and nuts must be soaked to initi­ate the process of germination, before which the seed is inert, without any life energy.

Vegetarianism is the rare case of a dietary movement that people join for a whole host of reasons that have little to do with food, includ­ing religious and political ones. Still, whatever their motivation, they all reinforce each other, and the number of vegetarians is growing. Vegetarians eat both raw and cooked plants. Many vegetarians have to quit after some time, or they begin to look really unhealthy. Dr. Gabriel Cousens explains in his book Conscious Eating that becoming a healthy vegetarian is not as simple as having a salad for lunch and one for din­ner. Certain nutrients are harder to get from plants, such as the B vita­mins. There are ways around it, such as including fermented foods, so that all the needed nutrients can be obtained from a vegetarian diet. He explains that many people making the change to vegetarianism need to do so gradually. Dr. Dean Ornish was the first cardiologist to prove that blockages in the coronary arteries disappeared after switching to a vegetarian diet and meditating. He opened the door for modern medi­cine to begin to give food choices the importance they really deserve.

When it comes to diet, America is stuck in the wild, wild West. There are a thousand other theories that don’t qualify as fads or move­ments, but add to the popular confusion when it comes to something as basic as choosing what to eat. There is a lot of talk about the stan­dard American diet (SAD), but the reality is that there is no standard. More than anything, diets in America are substandard, lacking essen­tial nutrients due to soil depletion, unnatural growing conditions, and global toxicity. Instead, Americans are eating too many processed foods loaded with chemicals, simple carbohydrates, and fats designed in laboratories.

Mark, a senior entertainment executive in his late thirties, came to me with a conundrum. He was in good shape externally—a Division 1 athlete in college, he still went to the gym at least three days a week—but he was experiencing significant energy and emotional swings through­out the day, an inability to sleep properly through the night, and bouts of sluggishness, edginess, indigestion, and occasional heartburn. Worse, his recent physical examination had revealed high cholesterol, elevated mercury, and high blood pressure. The disconnect between his high fit­ness level and low state of well-being confused him. The first question I asked was what he ate. Breakfast was a double espresso with a half packet of sugar. “Not exactly the breakfast of champions,” he admitted, but something that fortified him for his stressful work environment. His lunches and dinners were stuck in the college era. They often featured pizza, ice cream, soda, steak and fries, cookies, candy, and burgers.

Though Mark said he needed a change, he was skeptical about cleansing—something he associated with the harsh colon cleanses he’d seen for sale at his vitamin store. I suggested he see it as a business ven­ture: outcome uncertain, but definitely worth the risk. His caffeinated, starchy diet was contributing to his roller-coaster energy and moods. It was full of dairy products, meat, and sugar—all highly acidifying, which contributes to indigestion and heartburn. It was also lacking in key nutrients needed to stay stable, like magnesium, which helps com­bat stress, or any kind of probiotic food, which would have benefited him in many ways. During the detoxification program Mark was required to go without all these things; I was especially interested to see what hap­pened when his sugars and starchy foods got the boot.

When Mark saw me after his third week, he looked great. He’d lost seven pounds as well as an inch from his waistline without los­ing any athletic strength. But more important, he finally got off the carb-induced roller coaster. “I have more energy, sleep well, and don’t crave bad foods or have the ups and downs in mood,” he reported, adding that he no longer felt dependent on caffeine. “My brain func­tions more clearly than at any other point in my life,” he reported. To his surprise, his taste buds had reset. “Now that I feel better than I ever have, I just want to eat better.” The skeptic had turned convert to an existence free of junk food and Starbucks.

The problem of not knowing what to eat is older than any theory ever invented to correct it. It started when humans began thinking about food. Animals in the wild don’t think about what they will have for lunch; eating happens. Humans lost touch with their instincts, and now we have to study thick books before we can safely prepare a meal. The only one I trust for such an important decision is the book of nature. When animals live in their natural environments, the way nature designed, they do not get sick. But even if observing nature will not tell us exactly what we humans should be eating by natural design, it becomes clear that whatever we are doing is not it. Animals eat plants, seeds, nuts, and each other, always raw. No animal always eats three times a day. No other animal eats every other living species on the planet. No wild animal eats for fun or out of sadness. No other mammals continue to drink milk after they stop breastfeeding. No ani­mal in the wild is obese, and diseases are rare, mostly a result of expo­sure to our chemical poisoning of the planet.

There are many other questions that will help you get a more com­plete picture of the present dilemma when feeding our families and ourselves.

How much and how often should we eat? With the thought, “If it’s good for us, having access to it all the time will make us happier,” we began to surround ourselves with food and make sure our bellies had something in them for most of the day. We figured out ways to grow crops cheaply in mass quantity. We take three meals a day for granted, but it is no more than a social construct. Eating constantly without resting the digestive system may be at the root of our inability to detoxify naturally.

Where do we buy our food? The best possible source of foods is the local farmers’ market. They sell foods that are in season, which is the way that animals eat in the wild. Buying organic foods at the super­market would be the next choice. There is some confusion with the labeling, so it can be tricky, since the word “organic” still means dif­ferent things. But if you buy truly organic food, you avoid many of the toxic chemicals described above. At my corner deli in New York, it is February and I find watermelon from Mexico, blueberries from Chile, apples from Colombia, bananas from Venezuela, and oranges from California. These were transported thousands of miles over many days. To keep these fruits from spoiling in transit, farmers had to pick them before they were ripe, before they had stocked up their nutrient reserves. This contributes to the depletion of nutrients in our diets.

What food did our food eat? The problem of nutrient depletion starts at the beginning of the food chain. Plants are grown in soils that are depleted of minerals. Mass production of food leads to abuse of the land, and fertilizers do not deliver their promise. Vital foods, such as vegetables and fruits, are rendered nutritionally inert, because they are deficient in trace minerals that used to be abundant in rich, healthy soils. (Soil degradation is one of Earth’s silent crises—it is only now beginning to get attention, but it is slowly harming the whole planet’s food-cultivating ability.) The Vitamin A in tomatoes has gone down 43 percent in the last six decades; the Vitamin C in potatoes has decreased 57 percent. Unless you bought your vegetables and fruits at a farm­ers’ market, they have most likely been harvested long before ripeness (depleting them of essential nutrients your cells need to do their chem­istry), and unless you know otherwise, your produce almost definitely came from nutrient-depleted soils.

The process of detoxification is significantly diminished when the nutrients needed for its chemi­cal reactions are not available. The most popular fertilizer, NPK, pro­vides only three (sodium, phosphorus, potassium) of the fifty-plus minerals needed for healthy plants. Therefore, plants from soil using NPK alone will develop weak immune systems. When irritated by insects or chemicals, such as insecticides, plants develop an inflam­matory reaction, increasing the content of omega-6 fatty acids, a pro-inflammatory nutrient, and decreasing the production of omega-3, a potent anti-inflammatory nutrient. When animals are fed in an unnat­ural way, they tend to get sick. Farmed fish have less fish oil (omega-3 fatty acids). Corn-fed cows develop gastritis, inflammation, and infec­tions and need antibiotics. When we eat these plants, fish, and cows, we are eating inflammation, which, among other things, makes us more prone to coronary artery disease (the blockages in the arteries leading to heart attacks), cancer, and other chronic diseases.

Who on this planet lives longer, healthier lives? There are a few com­munities in which people’s life expectancy is much higher than that of the rest of the world’s population. Their inhabitants not only live longer, but their lives are also more active, productive, and, ultimately, more fulfilling. The areas where they live are called blue zones. There is one in the south of Ecuador, one on the islands south of Italy, and one in the desert in southern California. When these and a few other blue zones were visited and observed, the people all shared similar habits. These habits were simple. They grew everything they ate using only compost, water, and sun (no chemicals). Food was predominantly plants, mostly raw and always seasonal. Their animals were fed and raised in natural ways. They took longer to prepare or cook their food, a process more like a ritual than a chore. They chewed their food ten times longer than we do on average. They spent time in the sun. They moved a lot. They also enjoyed rich foods and wine—occasionally. All of them had strong family bonds and treasured friendships. Meals were eaten sitting at a table with family and friends. Life was lived with a strong sense of purpose and belonging to the community.

One cannot argue with success. As a doctor, when I answer the frequently asked question of what to eat for a long, healthy life, my patients who follow my advice start eating like the people who live in the blue zones. What I prescribe is geared toward creating the condi­tions by which the digestive system is put to relative rest, so the detox­ification system can wake from its relative hibernating state and the organs and systems involved in the process of cleaning our insides can have everything they need, when they need it, to complete their job. This is what detoxification is about.