Low-Fat, Low-Salt, Whole-Food Vegan
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Low-Fat, Low-Salt, Whole-Food Vegan Staying Lean and Healthy into Ripe Old Age Mark F. McCarty NutriGuard Research, Inc. 1 Table of Contents 1. A Diet You Can Live With……………………………………………….…3 2. The Whys and Wherefores – Preventing Coronary Disease……….………10 3. Obesity and Diabetes – Preventable and Reversible………………………34 4. Avoiding Hypertension, Stroke – and Dementia?…………………………49 5. Preventing and Controlling Cancer………………………………………..67 6. Preventing and Treating Autoimmune Disorders………………………..104 7. Bones and Joints – Staying Intact……………………………………… 111 8. Coda – A Few Odds and Ends………………………………….……… 118 References…………………………………………….………………….148 2 A Diet You Can Live With Since my days as a medical student, I have been keenly interested in nutritional impacts on health. In particular, I have been studying for years in an effort to determine why many Third World societies, as long as they maintain their traditional diets and lifestyles, are relatively immune to so many of the disorders that take a devastating toll on the health and finances of elderly Americans. I have come to some provisional conclusions and recommendations that, while hardly original, are nonetheless quite controversial in some respects – at loggerheads not only with the health-destructive dietary practices of most Americans, but also with certain faddish views gaining popularity among many health scientists and the general public. It is precisely because my conclusions are controversial that they are worth setting down. If I were asked to describe in one sentence the type of diet that, in my opinion, would minimize risk for the chief killing and crippling diseases of Western civilization – scourges that include coronary heart disease, stroke, diabetes, hypertension, the major cancers, autoimmune disorders such as rheumatoid arthritis, and Alzheimer’s disease – I would suggest the following: Eat a low-fat, low-salt, whole-food vegan diet, very rich in potassium and relatively low in glycemic index. This single sentence encapsulates six separate pieces of advice, which I will explain in more detail before summarizing the evidence that motivates this recommendation. Low-fat: By this, I mean a diet in which fat constitutes not more than 20% of calories – the type of diet popularized by Nathan Pritikin and, more recently, Dr. Dean Ornish. This should not be confused with the so-called “low-fat” diet recommended by the American Heart Association, providing 25-30% of its calories as fat. Since the diet I endorse is vegan – thus excluding all fatty animal products – it is relatively easy to achieve the suggested fat target by simply moderating one’s intake of the few plant- derived foods that are high in fat: avocados, olives, nuts, seeds, and the oils and butters derived therefrom. Most grains, fruits, vegetables, and legumes – the core of a healthful vegan diet – are inherently low in fat. When buying processed foods, read the labels carefully and avoid foods that have significant amounts of added oils – saturated and partially hydrogenated fats are particularly bad for your vascular health. If your diet is quite low in fat in other respects, it may be appropriate to include not more than an ounce per day of unsalted nuts (or nut butter) in which monounsaturates predominate: almonds and hazelnuts are best in this regard. Occasional use of modest amounts of virgin olive oil or avocado – both monounsature-rich – is also acceptable. Sautéing 3 vegetables in a little olive oil to make them more tasty is probably not the worst thing you can do to yourself – but lay off the potato chips! If you are healthfully lean, or become so while consuming the sort of plant-based diet recommended here and exercising regularly, there may however be little harm in obtaining more than 20% of your calories from fats – provided that they are unsaturated plant-derived fats, preferably monounsaturated (e.g almonds, olive oil, avocado), and that you can remain lean while doing so. But a higher fat intake is something that you should first earn by achieving and maintaining leanness. My recommendation of low-fat eating is strongly influenced by the fact that Nathan Pritikin and the great physicians who have followed in his footsteps – including Drs. Esselstyn, Ornish, and McDougall – have achieved remarkable clinical benefits in vascular disease, diabetes, and obesity with dietary programs that are very low in fat. But Pritikin’s insistence on a very-low-fat diet effectively meant that his patients were eating a quasi-vegan diet, virtually devoid of animal fat. It is conceivable that the quasi-vegan nature of this diet, rather than its stringent avoidance of all fats, is largely responsible for its benefits. Within the context of a vegan diet, the optimal intake of unsaturated fats remains controversial; some vegan physicians such as Dr. Joel Fuhrman encourage the consumption of nuts at the expense of grain carbohydrates. Until controlled studies are conducted to clarify this matter, I feel that it is prudent for those with vascular disease, diabetes, or obesity to adhere to the clinically-proven low-fat strategy; for those who are reasonably lean, insulin sensitive, and healthy, getting a higher proportion of their calories from plant-derived fats – preferably monounsaturated – may not be a bad thing if body fat doesn’t notably increase. Also, I believe it is prudent, particularly for vegans who don’t eat fish, to take a supplement featuring the long-chain omega-3 fats, which typically are found in fish, but which can also be obtained from some algae. Low-salt: Try to get your salt intake below 5 grams daily (which corresponds to 2 grams of sodium); the ideal target – not easy to achieve in modern society – is closer to 2.5 grams daily (1 gram sodium). Minimize or eliminate the use of table salt in your cooking – explore the wealth of alternative seasonings that are available. Fortunately, with the exception of dairy products (cows are fed salt to improve milk yields), natural unprocessed foods are inherently low in salt. But most of us eat some of our meals in restaurants, or rely on certain processed foods that come pre-salted; it is estimated that at least 80% of the salt in our diet comes, not from our use of the salt shaker at the table or in our cooking, but from the salt pre-added to processed foods or restaurant meals. So when you purchase processed foods, examine the sodium content, and choose brands that go light on the sodium. If the milligrams of sodium in a serving is no higher than 4 the number of calories (kcals) it provides, then it can be considered acceptably low in salt – particularly if you make a point of including a number of unsalted foods in your daily diet. You may need to shop in a health-food store to find a sufficient variety of unsalted or lightly salted processed foods. When dining in restaurants, don’t be afraid to ask the waiter to have your food prepared without salt – while this often won’t be feasible (they may rely on processed ingredients or on large pre-cooked batches of food they have already salted), it doesn’t hurt to ask. Whole-food: By this, I refer to food that not only retains all or most of its original nutrient/phytochemical/fiber content, but that also, to the extent feasible, retains the intact structure of the food as it grew from the soil. For example, whole grain flour is certainly far more nutritious than refined flour – but whole kernel grains are even better for your health. Structurally intact grains are usually more slowly digested than are finely-ground flours (implying a lower glycemic index - see below), and the relatively high water and fiber content of whole foods often means that their calorie content is more dilute – you tend to get filled up before you have eaten an excessive number of calories in one sitting. When cooking vegetables, try to use cooking methods – such as steaming – that don’t leach out the protective micronutrients, phytochemicals, and potassium that they provide. By all means, avoid processed foods that contain a significant amount of added sugars or oils – these are “empty calories” that effectively rob your diet not only of essential nutrients, but also of fiber, phytochemicals, and potassium. Vegan: This implies the absence of all animal products – flesh foods, dairy products, and eggs. While it is commonly accepted that the saturated fat and cholesterol found in most animal products (excluding non-fat dairy) are bad for vascular health, I subscribe to the much more avant garde view that animal protein is likely to be an important factor in our high rates of “Western” cancers, and may also contribute to high serum cholesterol and possibly even obesity. (This latter point will require some clarification, as I do not dispute the fact that diets high in animal protein can be useful for reducing appetite and achieving weight loss.) Contrary to much propaganda, a vegan diet featuring whole grains and legumes can provide more than enough protein to support buoyant health. Since strictly vegan diets are virtually devoid of vitamins B12 and D, and may often be suboptimal sources of calcium and selenium, vegans are well advised to use comprehensive nutritional supplements (“nutritional insurance formulas”). Furthermore, the long-chain omega-3 fatty acids found in cold-water fish (EPA/DHA) can provide various health benefits that cannot be adequately reproduced by the shorter-chain omega-3s (-linolenic acid) found in some plants; for this reason, I violate my veganisn 5 to the extent of taking an enriched fish oil supplement (a strategy endorsed by Dr. Ornish). Certain other non-essential nutrients found primarily in flesh foods – e.g. carnitine, taurine, creatine – may be beneficial to health in certain circumstances, and can be provided in supplements; nonetheless, since the human body is capable of manufacturing these nutrients, vegans are rarely significantly deficient in them.