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Eat to LiveThe Revolutionary Formula for Fast and Sustained Weight Loss
By Joel Fuhrman
Little Brown & CompanyCopyright © 2003 Joel Fuhrman, M.D.
All right reserved.
Chapter OneDIGGING OUR GRAVES WITH FORKS AND KNIVES
THE EFFECTS OF THE AMERICAN DIET, PART I Americans have been among the first people worldwide to have the luxury of bombarding themselves with nutrient-deficient, high-calorie food, often called empty-calorie or junk food. By "empty-calorie," I mean food that is deficient in nutrients and fiber. More Americans than ever before are eating these rich, high-calorie foods while remaining inactive - a dangerous combination.
The number one health problem in the United States is obesity, and if the current trend continues, by the year 2230 all adults in the United States will be obese. The National Institutes of Health estimate that obesity is associated with a twofold increase in mortality, costing society more than $100 billion per year. This is especially discouraging for the dieter because after spending so much money attempting to lose weight, 95 percent percent of them gain all the weight back and then add on even more pounds within three years. This incredibly high failure rate holds true for the vast majority of weight-loss schemes, programs, and diets.
Obesity and its sequelae pose a serious challenge to physicians. Bothprimary-care physicians and obesity-treatment specialists fail to make an impact on the long-term health of most of their patients. Studies show that initial weight loss is followed by weight regain.
Those who genetically store fat more efficiently may have had a survival advantage thousands of years ago when food was scarce, or in a famine, but in today's modern food pantry they are the ones with the survival disadvantage. People whose parents are obese have a tenfold increased risk of being obese. On the other hand, obese families tend to have obese pets, which is obviously not genetic. So it is the combination of food choices, inactivity, and genetics that determines obesity. More important, one can't change one's genes, so blaming them doesn't solve the problem. Rather than taking an honest look at what causes obesity, Americans are still looking for a miraculous cure - a magic diet or some other effortless gimmick. Obesity is not just a cosmetic issue - extra weight leads to an earlier death, as many studies confirm. Overweight individuals are more likely to die from all causes, including heart disease and cancer. Two-thirds of those with weight problems also have hypertension, diabetes, heart disease, or another obesity-related condition. It is a major cause of early mortality in the United States. Since dieting almost never works and the health risks of obesity are so life-threatening, more and more people are desperately turning to drugs and surgical procedures to lose weight.
Health Complications of Obesity
• Increased overall premature mortality o Lipid disorders
• Adult onset diabetes o Obstructive sleep apnea
• Hypertension o Gallstones
• Degenerative arthritis o Fatty infiltration of liver
• Coronary artery disease o Restrictive lung disease
• Cancer o Gastrointestinal diseases
The results so many of my patients have achieved utilizing the Eat to Live guidelines over the past ten years rival what can be achieved with surgical weight-reduction techniques, without the associated morbidity and mortality.
Surgery for Weight Reduction and Its Risks
According to the National Institutes of Health (NIH), wound problems and complications from blood clots are common aftereffects of gastric bypass and gastroplasty surgery. The NIH has also reported that those undergoing surgical treatment for obesity have had substantial nutritional and metabolic complications, gastritis, esophagitis, outlet stenosis, and abdominal hernias. More than 10 percent required another operation to fix problems resulting from the first surgery.
Another tempting solution is liposuction. Studies show that liposuction begets a plethora of side effects, the main one being death! A recent survey of all 1,200 actively practicing North American board-certified plastic surgeons confirmed that there are about 20 deaths for every 100,000 liposuctions, whereas the generally acceptable mortality rate for elective surgery is 1 in 100,000.10 Compared with the 16.4 per 100,000 mortality rate of U.S. motor vehicle accidents, liposuction is not a benign procedure. Liposuction is dangerous.
In addition to undergoing extremely risky surgeries, Americans have been bombarded with a battery of gimmicky diets that promise to combat obesity. Almost all diets are ineffective. They don't work, because no matter how much weight you lose when you are on a diet, you put it right back on when you go off. Measuring portions and trying to eat fewer calories, typically called "dieting," almost never results in permanent weight loss and actually worsens the problem over time. Such "dieting" temporarily slows down your metabolic rate, so often more weight comes back than you lost. You wind up heavier than you were before you started dieting. This leads many to claim, "I've tried everything, and nothing works. It must be genetic. Who wouldn't give up?"
You may already know that the conventional "solution" to being overweight - low-calorie dieting - doesn't work. But you may not know why. It is for this simple yet much overlooked reason: for the vast majority of people, being overweight is not caused by how much they eat but by what they eat. The idea that people get heavy because they consume a high volume of food is a myth. Eating large amounts of the right food is your key to success and is what makes this plan workable for the rest of your life. What makes many people overweight is not that they eat so much more but that they get a higher percentage of their calories from fat and refined carbohydrates, or mostly low-nutrient foods. This low-nutrient diet establishes a favorable cellular environment for disease to flourish.
Regardless of your metabolism or genetics, you can achieve a normal weight once you start a high-nutrient diet style. Since the majority of all Americans are overweight, the problem is not primarily genetic. Though genes are an important ingredient, physical activity and food choices play a far more significant role. In studies on identical twins with the tendency to be overweight, scientists found that physical activity is the strongest environmental determinant of total body and central abdominal fat mass. Even those with a strong family history of obesity effectively lose weight with increased physical activity and appropriate dietary modifications.
Most of the time, the reason people are overweight is too little physical activity, in conjunction with a high-calorie, low-nutrient diet. Eating a diet with plenty of low-fiber, calorie-dense food, such as oil and refined carbohydrates, is the main culprit. As long as you are eating fatty foods and refined carbohydrates, it is impossible to lose weight healthfully. In fact, this vicious combination of a sedentary lifestyle and eating typical "American" food (high-fat, low-fiber) is the primary reason we have such an incredibly overweight population.
Killing the Next Generation
This book may not appeal to many Americans who are in denial about the dangers of their eating habits and those of their children. Many people will do anything to continue their love affair with rich, disease-causing foods and will sacrifice their health in the process. Many American consumers prefer not to know about the dangers of their diet because they don't want to have their pleasures interfered with. This book is not for them.
If you have to give up something you get pleasure from, your subconscious may prefer to ignore solid evidence or defend illogically held views. Many ferociously defend their unhealthy eating practices. Others just claim, "I already eat a healthy diet," when they do not. There is a general resistance to change. It would be much easier if healthful eating practices and the scientific importance of nutritional excellence were instilled in us as children. Unfortunately, children are eating more poorly today than ever before.
Most Americans are not aware that the diet they feed their children guarantees a high cancer probability down the road. They don't even contemplate that eating fast-food meals may be just as risky (or more so) than letting their children smoke cigarettes.
The 1992 Bogalusa Heart Study confirmed the existence of fatty plaques and streaks (the beginning of atherosclerosis) in most children and teenagers! You wouldn't let your children sit around the table smoking cigars and drinking whiskey, because it is not socially acceptable, but it is fine to let them consume cola, fries cooked in trans fat, and a cheeseburger regularly. Many children consume doughnuts, cookies, cupcakes, and candy on a daily basis. It is difficult for parents to understand the insidious, slow destruction of their child's genetic potential and the foundation for serious illness that is being built by the consumption of these foods.
It would be unrealistic to feel optimistic about the health and well-being of the next generation when there is an unprecedented increase in the average weight of children in this country and record levels of childhood obesity. Most ominous were the results reported by the 1992 Bogalusa Heart Study, which studied autopsies performed on children killed in accidental deaths. The study confirmed the existence of fatty plaques and streaks (the beginning of atherosclerosis) in most children and teenagers! These researchers concluded: "These results emphasize the need for preventive cardiology in early life." I guess "preventive cardiology" is a convoluted term that means eating healthfully.
Another recent autopsy study appearing in the New England Journal of Medicine found that more than 85 percent of adults between the ages of twenty-one and thirty-nine already have atherosclerotic changes in their coronary arteries. Fatty streaks and fibrous plaques covered large areas of the coronary arteries. Everyone knows that junk foods are not healthy, but few understand their consequences - serious life-threatening illness. Clearly, the diets we consume as children have a powerful influence on our future health and eventual premature demise. There is considerable data to suggest that childhood diet has a greater impact on the later incidence of certain cancers than does a poor diet later in life.
It is estimated that as many as 25 percent of schoolchildren today are obese. Early obesity sets the stage for adult obesity. An overweight child develops heart disease earlier in life. Mortality data suggests that being overweight during early adult life is more dangerous than a similar degree of heaviness later in adult life.
Drugs Are Not the Solution
New drugs are continually introduced that attempt to lessen the effects of our nation's self-destructive eating behavior. Most often, our society treats disease after the degenerative illness has appeared, an illness that is the result of from forty to sixty years of nutritional self-abuse. Drug companies and researchers attempt to develop and market medications to stem the obesity epidemic. This approach will always be doomed to fail. The body will always pay a price for consuming medicines, which usually have toxic effects. The "side" effects are not the only toxic effect of medications. Doctors learn in their introductory pharmacology course in medical school that all medications are toxic to varying degrees, whether side effects are experienced or not. Pharmacology professors stress never to forget that. You cannot escape the immutable biological laws of cause and effect through ingesting medicinal substances.
If we don't make significant changes in the foods we choose to consume, taking drugs prescribed by physicians will not improve our health or extend our lives. If we wish true health protection, we need to remove the cause. We must stop abusing ourselves with diseasecausing foods.
Surprise! Lean People Live Longer
In the Nurses Health Study, researchers examined the association between body mass index and overall mortality and mortality from specific causes in more than 100,000 women. After limiting the analysis to nonsmokers, it was very clear that the longest-lived women were the leanest. The researchers concluded that the increasingly permissive U.S. weight guidelines are unjustified and potentially harmful.
Dr. I-Min Lee, of the Harvard School of Public Health, said her twenty-seven-year study of 19,297 men found there was no such thing as being too thin. (Obviously, it is possible to be too thin; however, it is uncommon and usually called anorexia, but that is not the subject of this book.) Among men who never smoked, the lowest mortality occurred in the lightest fifth. Those who were in the thinnest 20 percent in the early 1960s were two and a half times less likely to have died of cardiovascular disease by 1988 than those in the heaviest fifth. Overall, the thinnest were two-thirds more likely to be alive in 1988 than the heaviest. Lee stated, "We observed a direct relationship between body weight and mortality. By that I mean that the thinnest fifth of men experienced the lowest mortality, and mortality increased progressively with heavier and heavier weight." The point is not to judge your ideal weight by traditional weight-loss tables, which are based on Americans' overweight averages. After carefully examining the twenty-five major studies available on the subject, I have found that the evidence indicates that optimal weight, as determined by who lives the longest, occurs at weights at least 10 percent below the average body-weight tables. Most weight-guideline charts still place the public at risk by reinforcing an unhealthy overweight standard. By my calculations, it is not merely 75 percent of Americans that are overweight, it is more like 85 percent. The Longer Your Waistline, the Shorter Your Lifeline As a good rule of thumb: for optimal health and longevity, a man should not have more than one-half inch of skin that he can pinch near his umbilicus (belly button) and a woman should not have more than one inch. Almost any fat on the body over this minimum is a health risk. If you have gained even as little as ten pounds since the age of eighteen or twenty, then you could be at significant increased risk for health problems such as heart disease, high blood pressure, and diabetes. The truth is that most people who think they are at the right weight still have too much fat on their body. A commonly used formula for determining ideal body weight follows:
Women: Approximately ninety-five pounds for the first five feet of height and then four pounds for every inch thereafter.
Excerpted from Eat to Live by Joel Fuhrman Copyright © 2003 by Joel Fuhrman, M.D.
Excerpted by permission. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.