Eat to Live: a Unifying Principle to Maintain a Healthy Weight and Gain Longevity The following information is taken primarily from Eat to Live by Joel Fuhrman, M.D. Dr. Fuhrman’s professional credibility lies in the fact that in over 30 years he has helped tens of thousands of people permanently cure their obesity and helped many thousands of people cure their “terminal” chronic diseases: all in conformity with the latest science. Most Americans follow such a poor diet that 75% of us are overweight or obese, while the majority of us die of diet related chronic diseases (more than any other society in the world). The standard American diet (SAD) is truly sad. Generally we eat until we feel full or satisfied. Our stomach tells us “when.” Biochemical nerves lining the digestive tract monitor nutrient intake and tell us when we have consumed sufcient nutrients. Biomechanical stretch receptors in the stomach signal satiety by detecting the volume of food eaten. Overeating arises when we have eaten sufcient calories, but the stomach is tricked by being given foods that lack nutrients and fiber and so the stomach does not tell us when to stop eating. Because many popular foods are “empty calories” (calories mostly devoid of nutrients and fiber) we consume too many calories before we get stomach signals to stop eating. Thus, we become unhealthy from nutrient deficiency and from being overweight. The key to eating a diet that promotes a healthy weight and body is to eat foods with high nutrient and fiber densities per calorie (not per weight or per volume). The formula is: H = N ÷ C where H is health, N is nutrient content and C is calories. This formula is the key to Dr. Fuhrman’s professional success. MORE FIBER PER CALORIE MEANS MORE BULK TO SIGNAL A FULL STOMACH Eating to enhance nutrient-per-calorie density in one’s diet will: 1. Cause weight loss that is permanent 2. Promote longevity 3. De-rail hunger and food cravings 4. Increase immune function and disease resistance 5. Provide therapeutic efects to reverse disease 6. Protect against heart disease, stroke and dementia 7. Fuel cellular repair mechanisms protecting against cancer Micronutrients are those food components that make us healthy and help our bodies fight and avoid disease. These include phytochemicals, antioxidants, vitamins and minerals. Many hundreds have been identified. Many hundreds await discovery. Macronutrients are the only source of calories (energy) and there are only three: protein, carbohydrates and fat. When eating only micronutrient-dense whole foods, the correct proportions of macronutrients and the correct amount of calories (to maintain a healthy weight) will be automatically consumed, if one consumes a diverse diet and practices portion control for calorie dense foods like nuts, seeds, avocados, dates, raisons and other dried fruit. Fiber intake from whole foods (not isolated fiber like Metamucil) is a very good indicator of disease risk. High fiber foods promote weight control, lower insulin levels and contain many anti-cancer and anti-diabetes properties. Around the world, people who consume the most high-fiber foods are the healthiest and have the most longevity. The Nutrient Density Spectrum Nutrient density is defined as the quantity of micronutrients in a food divided by the number of calories in that food. Micronutrients are those food components that make us healthy and help our bodies fight and avoid disease. The nutrient-density scores below are based on identified micronutrients (not macronutrients) such as phytochemicals, antioxidant activity, and total vitamin and mineral content. Highest nutrient density = 100 points Lowest nutrient density = 0 points Group Nutrient Number Density 1 100 Dark green leafy vegetables kale, mustard greens, collard greens, Swiss chard, watercress, spinach, arugula 2 95 Other green vegetables romaine, bok choy, cabbage, Brussels sprouts, asparagus, broccoli, string beans, snow peas, green peas 3 50 Non-green nutrient-rich vegetables beets, eggplant, mushrooms, onions, radishes, bean sprouts, red & yellow bell peppers, radicchio, cauliflower, tomatoes, artichokes, carrots 4 45 Fresh fruits strawberries, blueberries, other berries, plums, oranges, melons, kiwifruit, apples, cherries, pineapple, peaches, pears, grapes, bananas 5 40 Beans (legumes) lentils, kidney, great northern, adzuki, black, pinto, split peas, edamame, chickpeas 6 30 Raw nuts and seeds sunflower, pumpkins, sesame, flaxseeds, almonds, cashews, pistachios, walnuts, pecans, hazelnuts 7 25 Colorful starchy vegetables butternut and other squash, sweet potatoes, corn, turnips 8 20 Whole grains/white potatoes old-fashioned oats, barley, brown and wild rice, buckwheat, millet, quinoa, bulgur, whole grain bread 9 18 Fish 10 15 Fat-free dairy 11 15 Eggs 12 15 Wild meat and fowl 13 8 Full-fat dairy 14 6 Red meat 15 6 Refined grain products white flour, white rice, white bread, non-whole grain pasta 16 3 Cheese 17 1 Refined oils 18 0 Refined sweets cookies, cakes, candy, soda, fruit juice The horizontal line separates those foods that are rich in fiber (above) and those foods that have no or insignificant amounts of fiber (below). Foods below the line contain so few micronutrients per calorie (lower scores) and are so devoid of fiber (below the fiber line) that they are referred to in nutrition and dietary literature as “empty calories.” The key to a permanent healthy weight and a body with a strong ability to resist and reverse the chronic, diet-related diseases contributing to premature deaths in most Americans (e.g. cancer, stroke. heart disease, osteoporosis, diabetes, arthritis, hypertension, obesity, and dementia) is to move your diet (gradually if personally necessary) up the nutrient-density spectrum. The healthiest goal is to seldom or insignificantly eat below the fiber line and to eat a diverse diet of food groups (groups 1-8, both cooked and raw) above the line. Even small upward steps can be helpful. It is common to justify eating below the line by a focus on one or very few nutrients. For example, “I eat beef for the iron and protein content.” Other examples are: chicken (protein), fish (omega3), dairy (calcium) and eggs (B vitamins, protein). There is no nutrient type available below the line that is not available in greater abundance above the line. The one exception is vitamin B12 which is provided by an inexpensive pill supplement taken daily. The nutrients in animal products came from the plants that the animals ate. Plant foods have more nutrients than animal products. Is it possible to be overweight and healthy? Maybe, if one looks for only superficial symptoms. It is very unlikely if one looks inside the body. Chronic diseases often start at an early age, proceed undetected for decades and are strongly correlated with being overweight. Important note: It is possible to look thin and be susceptible to chronic diseases and depression if regular exercise and maintenance of muscle mass and metabolism is neglected. Proper and frequent exercise is as essential as good diet for regaining and maintaining vitality, mental health and longevity. Carbohydrates (4 calories per gram) are our main and necessary source of energy. They are a diet mainstay of every healthy society throughout the world and history. A low-carb diet is necessarily high in protein and fat and is never sustainable because it contributes to chronic diseases over time. Healthy carbohydrates only exist above the fiber line. Protein (4 calories per gram) is a necessary nutrient and all the essential amino acids that make up protein are available above the line in abundance (exceeding human requirements). Since the body stores these protein components for several days, same-day food combining is not necessary to obtain complete protein from plants as long as one eats a variety from the groups above the line. The human need for protein is about 4-8% of calories consumed. The high correlation between cancer and animal/dairy protein has been well documented for many decades. Fat (9 calories per gram) is a necessary nutrient and is consumed in a healthy way by eating high-fat foods like nuts, seeds, olives and avocadoes. Refined oils are physically removed from their plant sources. All the fiber and most nutrients are left behind. What remains are the empty calories of liquid fat which has the most calories per gram of any food. The common practice of adding oil to foods and frying with large amounts of oil greatly reduces the nutrient-density score. Fat calories in the standard American diet average 30-40%, while the healthy requirement is about 10%-15%. The high correlation between heart disease and animal/dairy fat has been well documented for many decades. Refined grain products such as white flour and white rice are created through a milling process that removes most fiber, all micronutrients, the bran and the germ. Fortifying these empty calories by replacing a few micronutrients does not make them healthy. They are still processed foods with very little nutrient value per calorie. Carbohydrates are necessary for health, but refined grain products give carbohydrates a bad name, are not healthy and are well below the fiber line. Fruit juices are made by physically removing the liquid from the fruit. The vast majority of the nutrients and all of the fiber are left in the pulp and what remains in the juice is empty calorie sugar that is metabolized like soda drinks. Dairy products are highly promoted foods that are popular for their calcium content. Osteoporosis occurs most in countries where calcium intake from dairy products is the highest. Eating animal protein (including dairy protein) results in a heavy acid load in the blood. This causes calcium to be leached from the bones to help neutralize the acid. This calcium release weakens the bones and causes bone fractures.