Fat Doesn’t “Flush”!

Wouldn’t it be great if you could just “flush” your excess body fat down the toi­let? Over­weight peo­ple love that idea, so they’re vul­ner­a­ble to any­one who promis­es that they can sim­ply “flush” their fat away. The prob­lem is that “fat flush­ing” doesn’t work.

Body fat isn’t waste, it’s stored ener­gy. It’s like mon­ey in the bank. Your body doesn’t want to “flush” that away! Even if it want­ed to, it couldn’t.

Your body has a lim­it­ed num­ber of ways to get rid of waste. Car­bon diox­ide leaves your body through your lungs. In hot weath­er, you can lose a lot of water and salt through your sweat glands. How­ev­er, most of what we think of as waste leaves the body through either the kid­neys or the liv­er.

You can’t flush fat from the body through the kid­neys. If you could, you’d end up see­ing an oil slick on top of your urine. It’s not nor­mal to pass any sig­nif­i­cant amount of fat in the urine. The pres­ence of even small amounts of fat in the urine is called lipiduria. It’s a sign of a seri­ous med­ical con­di­tion, such as severe kid­ney dis­ease or a frac­ture in a large bone.

The liv­er breaks down a lot of tox­ins and oth­er sub­stances. It can also put some waste prod­ucts into a flu­id called bile. The bile then pass­es into the small intes­tine. How­ev­er, the intestines then reab­sorb much of what the liv­er had put into the bile. The mate­r­i­al that is reab­sorbed then gets car­ried straight back to the liv­er.

If your liv­er were flush­ing fat out of your body, the fat would be going into your small intes­tine. Then it would get reab­sorbed and car­ried straight back to the liv­er. If you were los­ing a sig­nif­i­cant amount of fat through your intestines, you would end up pass­ing a lot of fat in your feces. So unless you are find­ing lots of fat in your toi­let bowl, you sim­ply aren’t “flush­ing” fat from your body.

One pop­u­lar author of diet books pro­motes what she calls a “fat flush” diet. How­ev­er, her diet can’t over­come the basic biol­o­gy of the human body. Although that author doesn’t have the kind of sci­en­tif­ic cre­den­tials that she pre­tends to have, she prob­a­bly knows that you can’t flush fat from the liv­er. That’s why her “fat flush” reg­i­men also includes a severe­ly low-calo­rie diet. So while the dieters imag­ine that they are flush­ing their fat, they are actu­al­ly los­ing weight the con­ven­tion­al way, by eat­ing a low few­er calo­ries than they burn up.

Bourbon and potato chips are vegan!

My Web site and blog are about healthy food. I want peo­ple to know what sci­ence real­ly says about how diet affects human health. For exam­ple, we know that eat­ing ani­mal-based foods rais­es the risk of a whole host of dis­eases, includ­ing heart dis­ease, many can­cers, and autoim­mune dis­eases. The less ani­mal-based food you eat, the safer you can be from those dis­eases. So the health-opti­miz­ing diet for human beings would be free from ani­mal prod­ucts. It could there­fore be clas­si­fied as veg­an. Although all healthy foods are veg­an, not all veg­an foods are healthy. For exam­ple, no one would con­sid­er bour­bon and pota­to chips to be the basis for a healthy diet.

The first veg­e­tar­i­ans I met were veg­e­tar­i­an for reli­gious rea­sons. They includ­ed some Hin­du peo­ple who had been born in India and some Sev­enth-Day Adven­tists from the USA. I’ve also known obser­vant Jews who would eat in veg­e­tar­i­an restau­rants because every­thing that’s veg­e­tar­i­an is auto­mat­i­cal­ly Kosher. I also know a lot of peo­ple who refuse for moral rea­sons to eat any prod­ucts that come from ani­mals. All of the peo­ple I’ve just described can eat at my house with­out vio­lat­ing any of their dietary laws. Since I’m aller­gic to wheat, every­thing that I cook is even kosher for Passover. How­ev­er, not every­thing that pass­es muster in their dietary laws is good for them.

To be tru­ly health-opti­miz­ing for the aver­age per­son, a diet also has to be low in fat (<10% of calo­ries) and high in fiber. Some of the foods that con­tain no ani­mal prod­ucts are nev­er­the­less high in fat or low in fiber. A high-fat, low-fiber veg­an diet could pro­mote ath­er­o­scle­ro­sis, even though it doesn’t con­tain any cho­les­terol. That’s why even veg­ans occa­sion­al­ly die of heart attacks.

When I was grow­ing up, I was taught in school that the meat group (which includes eggs and fish) and the dairy group (which includes all milk prod­ucts) are an essen­tial part of a bal­anced diet for human beings. How­ev­er, when I grew up and start­ed read­ing nutri­tion and med­ical text­books and sci­en­tif­ic jour­nals, I found strong evi­dence that those foods are dan­ger­ous and unnec­es­sary. So far, I haven’t found any evi­dence that any human beings would real­ly ben­e­fit from adding ani­mal-based foods to an oth­er­wise healthy plant-based diet. I found plen­ty of evi­dence that cats need cer­tain nutri­ents that occur only in ani­mals, and are not pro­duced by plants or bac­te­ria. How­ev­er, I’ve seen no such evi­dence for human nutri­tion. If I find it, I will report it. Then, the deci­sion of whether to eat those foods will be a moral deci­sion, not a health deci­sion.

Quick, but temporary weight loss! This time from France!

I just heard about a “new” diet: the Dukan diet. It’s from France! It promis­es four steps to per­ma­nent weight loss! It promis­es that peo­ple will lose weight while eat­ing as much as they like! The prob­lem is that this “new” diet isn’t real­ly new. It’s just South Beach with a French accent. The quick results from the first phase aren’t from fat loss. Nor will your weight prob­lem be per­ma­nent­ly cured by the end of the pro­gram, regard­less of what Dr. Dukan says. It’s just more false hope for des­per­ate peo­ple.

Like many fad diets, the Dukan diet starts with a low-carb phase. As if by mag­ic, this phase caus­es peo­ple to lose sev­er­al pounds very quick­ly. Unfor­tu­nate­ly, the weight that peo­ple lose so quick­ly does not rep­re­sent fat. Instead, it rep­re­sents the loss of the body’s glyco­gen stores. Glyco­gen is a starch that is stored in the liv­er and mus­cles. When the body needs quick ener­gy, the glyco­gen is bro­ken down into glu­cose, which is a sug­ar that is the body’s favorite fuel.

Like oth­er car­bo­hy­drates, glyco­gen pro­vides about 4 calo­ries per gram of dry weight. How­ev­er, the glyco­gen in the body isn’t dry. Each gram of glyco­gen absorbs about 2.7 grams of water. As a result, each gram of wet glyco­gen in the body rep­re­sents rough­ly 1 calo­rie of stored ener­gy. If you sud­den­ly deprive your­self of car­bo­hy­drates, your body will run through its glyco­gen stores very quick­ly, releas­ing water that will leave the body through the kid­neys. You would have to burn up almost 9 times as many calo­ries to lose that much weight from fat.

The rapid weight loss that results from cut­ting out car­bo­hy­drates may be thrilling to the frus­trat­ed dieter, but it is mean­ing­less. Nobody is over­weight from hav­ing too much glyco­gen, and your body will replace that glyco­gen and water as soon as it can. What peo­ple real­ly want to lose is fat. Besides, los­ing your glyco­gen can make you feel crum­my. When marathon­ers “hit the wall,” it’s typ­i­cal­ly because they’re run out of glyco­gen.

So the first phase of the Dukan diet or the South Beach Diet will cause a quick but tem­po­rary and mean­ing­less weight loss that could end up zap­ping your ener­gy. If the Dukan diet even­tu­al­ly helps you lose fat, it does so by mak­ing your body think that you are starv­ing or seri­ous­ly ill. Dur­ing a sud­den fast, the body’s sup­ply of car­bo­hy­drates is cut off. The body has to rely on its fat stores and the pro­teins in its tis­sues instead. A low-carb diet mim­ics this con­di­tion. The body may respond to this emer­gency by sup­press­ing the appetite. The per­son may then lose weight the old-fash­ioned way, by tak­ing in few­er calo­ries than he or she burns up.

The Dukan diet is based on a lie: that peo­ple get fat from eat­ing a high-carb diet. In real­i­ty, fat is fat­ten­ing, and starch­es are slim­ming. That’s because starch, like glyco­gen, holds water. It’s actu­al­ly hard to fat­ten your­self on starch­es. For exam­ple, con­sid­er what hap­pened when the head of the Wash­ing­ton State Pota­to Com­mis­sion went on an all-pota­to diet to protest the exclu­sion of pota­toes from the fed­er­al Women, Infants, and Chil­dren (WIC) pro­gram. He lost 21 pounds in 60 days, even though he was eat­ing about 20 pota­toes per day. He also cut his total cho­les­terol by over a third, and low­ered his blood sug­ar. In oth­er words, he also improved his health.

A starchy diet works on both sides of the weight loss equa­tion. You end up eat­ing few­er calo­ries, because the starchy foods are so bulky. Boiled starch­es often pro­vide only 1 calo­rie per gram, where­as fat pro­vides 9 calo­ries per gram. You also end up burn­ing more calo­ries on a low-fat, high-carb diet, because you become much more sen­si­tive to insulin. If you still man­age to have a few calo­ries left over, it’s hard for your body to store them as fat. You’d lose about 30% of the calo­ries in the con­ver­sion process, so your body just gen­er­al­ly revs up your metab­o­lism to burn off the excess. You may end up doing more activ­i­ty, or sim­ply gen­er­at­ing more body heat.

For­get Dukan’s false promis­es. The only proven way to achieve healthy, per­ma­nent weight loss is to switch to a low-fat, high-fiber, high-car­bo­hy­drate diet. That’s because it’s the kind of diet that is appro­pri­ate to the human body. If you sim­ply train your­self to eat­ing the right kinds of food, you can eat as much as you like and still stay slim.

Don’t Snatch the Food out of Your Child’s Mouth!

I just read a real­ly dis­turb­ing arti­cle on Peg­gy Orenstein’s Web site. In Fear of Fat­ness, Oren­stein talks about the bias that even young chil­dren have against fat peo­ple, and the trou­bles that fat girls and their par­ents face. I was par­tic­u­lar­ly hor­ri­fied by the plight of one moth­er, who was so frus­trat­ed by her 5-year-old daughter’s fat­ness that she admits that she “fights the urge just to snatch the food out of the child’s mouth.” This is an unnat­ur­al prob­lem.

No moth­er in nature tries to pro­tect her off­spring by snatch­ing food out of its mouth. This unnat­ur­al prob­lem results from the unnat­ur­al diet that is stan­dard in the Unit­ed States. Moth­ers are sup­posed to feed and nur­ture their chil­dren. Why are Amer­i­can moth­ers strug­gling to lim­it their children’s por­tions?

If the child were being fed the kinds of food that nat­u­ral­ly slim pop­u­la­tions eat, then the weight prob­lem and the strug­gle for por­tion con­trol would sim­ply van­ish. The child would also avoid ear­ly puber­ty and have a low risk of breast can­cer in adult­hood.

Oren­stein men­tions that the par­ents turned to the child’s pedi­a­tri­cian for dietary advice. Unfor­tu­nate­ly, med­ical doc­tors typ­i­cal­ly know lit­tle about nutri­tion. Back in 1963, the Amer­i­can Med­ical Asso­ci­a­tion report­ed that doc­tors weren’t learn­ing enough about nutri­tion and dietet­ics in med­ical school. A few years lat­er, their fol­low-up report showed that noth­ing had changed. Peri­od­i­cal­ly, some oth­er expert pan­el stud­ies the prob­lem and comes up with exact­ly the same con­clu­sions: our doc­tors are not being ade­quate­ly trained in nutri­tion and dietet­ics. Thus, it’s not sur­pris­ing that the child’s pedi­a­tri­cian has giv­en the fam­i­ly hor­ri­ble advice that is cor­rod­ing the moth­er-child rela­tion­ship.

The pedi­a­tri­cian has been work­ing with the fam­i­ly to con­trol the child’s por­tions. No ani­mal in nature con­trols its weight by eat­ing less than it wants to eat. Nor does any ani­mal force itself to go to step aer­o­bics class. Wild ani­mals rely on their appetite to reg­u­late their weight. Appetite works well for reg­u­lat­ing weight as long as the crea­ture is eat­ing the kind of food that is appro­pri­ate for its species. We have an epi­dem­ic of obe­si­ty in peo­ple in the Unit­ed States because the stan­dard Amer­i­can diet is far too dense in calo­ries. It has too much fat and not enough fiber. It over­feeds us before it sat­is­fies our appetite. When peo­ple try to “cor­rect” this prob­lem by lim­it­ing their por­tions, they end up even more unsat­is­fied. They end up strug­gling against a pri­mal urge, and the pri­mal urge usu­al­ly wins in the end. When par­ents end up need­less­ly strug­gling against their children’s pri­mal urges, their rela­tion­ship with the child will suf­fer.

How can we tell what kind of diet is appro­pri­ate for human beings? We can rely on sev­er­al kinds of evi­dence. First, we can use the same approach that sci­en­tists use to fig­ure out what kind of diet a dinosaur ate. They fig­ure that out by com­par­ing their teeth to those of mod­ern-day ani­mals. If you look at human teeth, you’ll see that they look almost exact­ly like the teeth of chim­panzees. Chimps are clas­si­fied as fruit-eaters, but they also eat a lot of leaves. So our teeth sug­gest that we should be eat­ing a diet with a heavy empha­sis on fruit and veg­eta­bles. Although chim­panzees do some­times hunt and eat meat, they actu­al­ly eat less meat than prac­ti­cal­ly any human pop­u­la­tion.

Chim­panzees and human beings are almost com­plete­ly alike genet­i­cal­ly. Some of the key dif­fer­ences involve genes that con­trol brain size and body hair. One inter­est­ing dif­fer­ence is in the gene for the enzyme that digests starch. Chimps have one copy, where­as humans have sev­er­al copies. In oth­er words, our genes tell us that human beings are spe­cial­ly adapt­ed to a starchy diet. It’s one of the rea­sons why human beings are among the world’s elite long-dis­tance run­ners.

Sev­er­al dif­fer­ent kinds of sci­en­tif­ic stud­ies have shown that human beings thrive on a diet of unre­fined starch­es and veg­eta­bles and fruit. Peo­ple who switch to that kind of diet can solve their weight prob­lems auto­mat­i­cal­ly. They can also pre­vent or cure many of the chron­ic degen­er­a­tive dis­eases that are com­mon in the Unit­ed States but rare else­where.

As I explain in detail here, a high-fiber, low-fat diet works on both sides of the weight equa­tion. Peo­ple end up eat­ing few­er calo­ries and burn­ing more calo­ries. In oth­er words, a starchy diet is slim­ming, while a fat­ty diet is fat­ten­ing. A low-fat, plant-based diet also helps to delay puber­ty.

Of course, if a fam­i­ly were to feed a child the low-fat, plant-based diet that would solve her weight prob­lem, they would be bom­bard­ed with crit­i­cism from peo­ple who ask, “But where will she get her pro­tein? Where will she get her cal­ci­um?” In response, the par­ents could ask, “Well, where do you think a goril­la gets its pro­tein and its cal­ci­um?”

Goril­las don’t hunt. They don’t fish. They don’t milk cows or gath­er eggs. They get 99.9% of their food from veg­eta­bles, fruit, and a few nuts. Yet those foods pro­vide enough pro­tein and cal­ci­um to enable a sil­ver­back male goril­la to grow to be 500 pounds and become 10 times as strong as a man.

It makes sense for par­ents to rely on a pedi­a­tri­cian for med­ical care for their chil­dren. But for nutri­tion­al advice, par­ents should turn to some­one who has been trained in nutri­tion and dietet­ics. A lot of peo­ple claim to be “nutri­tion­ists,” but not all of them have real train­ing in the sci­ence and prac­tice of nutri­tion and dietet­ics. When I had a health prob­lem that was poten­tial­ly food relat­ed, I got advice from a reg­is­tered dietit­ian. An RD has at least a bachelor’s degree in nutri­tion, has com­plet­ed a hands-on train­ing pro­gram in dietet­ics, and has passed a nation­al exam­i­na­tion. To keep their reg­is­tra­tion, they have to pur­sue con­tin­u­ing pro­fes­sion­al edu­ca­tion.

The Amer­i­can Dietet­ic Asso­ci­a­tion and the Dieti­tians of Cana­da have issued a posi­tion paper that argues that a well-planned veg­e­tar­i­an or veg­an diet is appro­pri­ate for all stages of the life cycle and pro­vides cer­tain advan­tages. If your child has a weight prob­lem, or any prob­lem that might be diet-relat­ed, it makes sense to talk to a reg­is­tered dietit­ian about a plant-based diet.

The appetite for food is not the only pri­mal urge that is cre­at­ing con­flicts between Amer­i­can chil­dren and their par­ents. Peg­gy Oren­stein has point­ed out in arti­cles and books that girls are being urged to be inap­pro­pri­ate­ly “sexy” at ear­li­er and ear­li­er ages. This trend is bad enough. What’s worse is that girls’ bod­ies are becom­ing sex­u­al­ly mature at inap­pro­pri­ate­ly ear­ly ages. Thus, girls are being plagued by pow­er­ful pri­mal urges long before they are emo­tion­al­ly mature. If you think that the din­ner table wars are ugly, just wait for pre­ma­ture puber­ty. The good news is that the same kind of diet that ends the strug­gle over food por­tion size can also post­pone the child’s puber­ty to its nat­ur­al age.

Polycystic ovary syndrome: the diabetes of bearded women

Poly­cys­tic ovary syn­drome is a major cause of infer­til­i­ty among young women in the Unit­ed States. It’s also nature’s way of telling women that they’re eat­ing the wrong kinds of food. Cut­ting her fat intake to 10% or less of her total calo­ries can restore the woman’s fer­til­i­ty and is impor­tant for pro­tect­ing her health, espe­cial­ly if she becomes preg­nant.

A woman with poly­cys­tic ovary syn­drome has irreg­u­lar peri­ods or may have stopped hav­ing men­stru­al peri­ods alto­geth­er. Because she sel­dom ovu­lates, it might take a long time for her to become preg­nant. Besides hav­ing irreg­u­lar peri­ods, the woman may also be over­weight and have acne and facial hair. The infer­til­i­ty, acne, and facial hair result from an excess of male hor­mones, which in turn result from abnor­mal­ly high lev­els of the hor­mone insulin. In oth­er words, poly­cys­tic ovary syn­drome should be viewed as a mild form of type 2 dia­betes. As far back as 1921, some French researchers referred to this prob­lem as “the dia­betes of beard­ed women” (la dia­bète des femmes a barbe).

Dia­betes mel­li­tus, or sug­ar dia­betes, means that the per­son tends to pass large amounts of a sug­ar called glu­cose in the urine. This hap­pens when the amount of glu­cose in the blood­stream has reached tox­ic lev­els. There are sev­er­al types of sug­ar dia­betes. Since the terms that Amer­i­cans use for the dif­fer­ent kinds of dia­betes are con­fus­ing, I’ll use the French terms, whose mean­ing is obvi­ous.

Back in the 1870s, French researchers divid­ed cas­es of sug­ar dia­betes into two gen­er­al cat­e­gories: thin dia­betes (dia­bète mai­gre) and fat dia­betes (dia­bète gras). Thin dia­betes was a cat­a­stroph­ic, incur­able prob­lem that often occurred in chil­dren and young adults. These patients wast­ed away and died with­in a few weeks, regard­less of treat­ment. At autop­sy, you could usu­al­ly see that some­thing had gone wrong with their pan­creas. Even­tu­al­ly, some Cana­di­an researchers fig­ured out that the pan­creas of peo­ple with thin dia­betes had lost the abil­i­ty to make a hor­mone called insulin. The Cana­di­an researchers devel­oped a way to iso­late the insulin from ani­mal pan­creas­es to use as a drug for human dia­bet­ics.

The devel­op­ment of insulin ther­a­py was a life-sav­ing mir­a­cle for peo­ple with thin dia­betes, often enabling them to live a near-nor­mal lifes­pan. How­ev­er, insulin has much less of an effect on blood sug­ar in peo­ple with fat dia­betes. Fat dia­betes is a com­par­a­tive­ly mild con­di­tion that tends to occur in over­weight, usu­al­ly mid­dle-aged to elder­ly peo­ple. It could be cured by weight loss and exer­cise. Peo­ple with fat dia­betes can make their own insulin. In fact, they typ­i­cal­ly have abnor­mal­ly high lev­els of insulin in the blood. Their bod­ies just don’t respond nor­mal­ly to insulin. They have insulin resis­tance.

Insulin acts as a key that unlocks an impor­tant door on the sur­face of cells. Unless that door opens, a cell can­not take in glu­cose. Peo­ple with thin dia­betes can­not make their own insulin. Unless they take insulin by injec­tion, their cells will starve even as those cells’ favorite fuel builds up to tox­ic lev­els all around them. Although peo­ple with fat dia­betes may make exces­sive amounts of insulin, their cells don’t respond nor­mal­ly to it. It takes a huge amount of insulin to pry open the doors to let glu­cose into their cells.

In women, the abnor­mal­ly high insulin lev­els cause the body to pro­duce abnor­mal­ly large amounts of male hor­mones. Besides caus­ing acne and facial hair, these male hor­mones dis­rupt the devel­op­ment of eggs in the ovary. Nor­mal­ly, each egg cell devel­ops in a tiny flu­id-filled fol­li­cle, which bursts to release the egg. The release of the egg is called ovu­la­tion. If the woman doesn’t ovu­late, she can’t become preg­nant. If the egg fol­li­cles stop devel­op­ing before ovu­la­tion, these lit­tle flu­id-filled cysts build up in the ovary. You can actu­al­ly see them if you look at the ovary with an ultra­sound machine. That’s why the con­di­tion is called poly­cys­tic ovary syn­drome.

Since women with poly­cys­tic ovary syn­drome sel­dom ovu­late, it can take a long time for them to become preg­nant. Doc­tors typ­i­cal­ly tell women with poly­cys­tic ovary syn­drome to lose weight. Doc­tors may also pre­scribe a drug called met­formin, which reduces the body’s resis­tance to insulin. Unfor­tu­nate­ly, the met­formin doesn’t solve the prob­lem. In the long run, it may make the prob­lem worse, because it tends to pro­mote weight gain!

Fat dia­betes results from fat: fat in the body and fat in the diet. Sci­en­tists have known since the 1930s that eat­ing a high-fat diet caus­es insulin resis­tance. Eat­ing a low-fat, high-car­bo­hy­drate diet restores the body’s sen­si­tiv­i­ty to insulin. If the woman switch­es to a low-fat (<10% of calo­ries), high-car­bo­hy­drate (>75% of calo­ries), high-fiber diet, she will cor­rect her insulin resis­tance and will prob­a­bly lose weight while eat­ing as much as she wants. In con­trast, met­formin tends to pro­mote fur­ther weight gain, which could make the insulin resis­tance worse in the long run.

If a woman is infer­tile because of poly­cys­tic ovary syn­drome, met­formin could help her become preg­nant. How­ev­er, it will not remove the cause of the insulin resis­tance. If the woman becomes preg­nant, her insulin resis­tance may get worse. She may even devel­op a full-blown case of ges­ta­tion­al dia­betes! In con­trast, a change to a healthy diet will not only help her become preg­nant, it will improve her health through­out the preg­nan­cy and increase her chances of hav­ing a healthy baby.

Pho­to by Warm­Sleepy

The Magic Realism of a Healthy Diet

Mag­ic Real­ism is a lit­er­ary style that explores the seem­ing­ly mag­i­cal effects of com­mon­place things. Con­sid­er, for exam­ple, the fol­low­ing scene from One Hun­dred Years of Soli­tude, by Gabriel Gar­cía Mar­quez. Melquíades is an old gyp­sy who nor­mal­ly comes to the vil­lage once a year with a group of gyp­sy ped­dlers who sell won­drous and mag­i­cal goods and ser­vices, such as mag­nets and mag­ic car­pet rides Melquíades looks old­er than his true age because he has lost his teeth to scurvy. Yet one year, Melquíades shows up with his teeth mag­i­cal­ly restored. To everyone’s amaze­ment, he can actu­al­ly take the teeth out of his mouth, along with his gums, mak­ing him­self look old again. He can put the teeth back in, mak­ing him­self look young again.

The read­er knows that there’s noth­ing mag­i­cal about a set of false teeth. How­ev­er, the vil­lagers have nev­er seen any­thing like it before. Den­tures are out­side the scope of their per­son­al expe­ri­ence. There­fore, the trans­for­ma­tion pro­duced by a set of den­tures seems like mag­ic to them. Sim­i­lar­ly, a tru­ly healthy diet is sim­ply out­side the scope of per­son­al expe­ri­ence for the aver­age Amer­i­can. As a result, we think that it’s nor­mal for peo­ple to get fat and sick in mid­dle age. We think that it’s nor­mal for mid­dle-aged and elder­ly peo­ple to have to take a fist­ful of pre­scrip­tion med­ica­tions every day. Thus, the effects of a tru­ly healthy diet might seem mag­i­cal to us.

A tru­ly healthy diet would rep­re­sent a rad­i­cal change from the way that Amer­i­cans have been taught to eat. When I was in home eco­nom­ics in sixth and sev­enth grade, I was taught that peo­ple are sup­posed to eat two serv­ings of meat and three serv­ings of dairy prod­ucts every day. Oth­er­wise, we’d sup­pos­ed­ly run a risk of pro­tein and cal­ci­um defi­cien­cy. Even today, I still see warn­ings against “fad” diets, which are usu­al­ly described as diets that “elim­i­nate entire food groups.” Unfor­tu­nate­ly, the “experts” who ped­dle this advice are not experts in nutri­tion. In con­trast, the Amer­i­can Dietet­ic Asso­ci­a­tion has come out with a posi­tion paper that pro­vides sup­port for a pure­ly plant-based diet.

A tru­ly healthy diet for a human being would get less than 10% of its calo­ries from fat and would be based exclu­sive­ly on high-fiber plant mate­r­i­al. It can include plen­ty of unre­fined starch­es, such as pota­toes, rice, or corn. In oth­er words, peo­ple real­ly ought to elim­i­nate two of the “basic food groups.” Some peo­ple also need to avoid par­tic­u­lar plant foods. For exam­ple, peo­ple with celi­ac dis­ease can’t eat wheat, rye, or bar­ley.

To see the seem­ing­ly mag­i­cal effects that this rad­i­cal change in food choic­es can have on ordi­nary Amer­i­cans, look at the “Star McDougallers’” page on Dr. John McDougall’s Web site. Many peo­ple show how they’ve man­aged to reverse sup­pos­ed­ly incur­able dis­ease sim­ply elim­i­nat­ing two of the basic food groups and cut­ting way back on fat. It’s not mag­ic. It’s mag­ic real­ism.

Weight and Cholesterol: When Average Is Abnormal

I just dis­cov­ered that I’m nor­mal, which means that I’m way below aver­age. I’m 5 foot 5 inch­es tall and weigh about 125 pounds. That gives me a body mass index of 20.8, which is nor­mal. Yet it also means that I’m skin­nier than about 95% of the Amer­i­can women my age. To become offi­cial­ly over­weight, I’d have to gain at least 25 pounds. To be as fat as the aver­age Amer­i­can, I’d have to gain a total of 40 pounds. To qual­i­fy as obese, I’d have to gain a total of 50 pounds.

If you live in the Unit­ed States, you have prob­a­bly noticed that most of the peo­ple around you weigh more than they should. That’s because you prob­a­bly know, more or less instinc­tive­ly, what healthy peo­ple are sup­posed to look like. Unfor­tu­nate­ly, we can’t auto­mat­i­cal­ly rec­og­nize that some of our oth­er mea­sure­ments, such as our total cho­les­terol val­ues, are also wild­ly abnor­mal. That’s because nobody has an instinc­tive feel for what healthy blood val­ues are sup­posed to be. It’s tempt­ing to eval­u­ate them by com­par­ing them to the aver­age val­ues for our pop­u­la­tion, but how can we tell if the aver­age val­ue in our pop­u­la­tion is nor­mal or abnor­mal?

The U.S. fed­er­al government’s “Healthy Peo­ple 2010” guide­lines regard­ed total cho­les­terol of 240 mg/dL as “high” and a lev­el of 200 mg/dL as “desir­able.” Yet peo­ple are still at risk for heart dis­ease as long as their total cho­les­terol is above 150 mg/dL. The last time my blood was test­ed, my total cho­les­terol was 120 mg/dL. Accord­ing to sta­tis­tics from the Cen­ters from Dis­eases Con­trol and Pre­ven­tion, my total cho­les­terol lev­el is unusu­al­ly low. More than 95% of the Amer­i­cans in my age-group have a total cho­les­terol val­ue that’s way high­er than mine. Yet I sus­pect that my cho­les­terol lev­els, like my weight, are nor­mal and healthy. It’s the aver­age per­son who’s dan­ger­ous­ly abnor­mal.

The num­bers are stag­ger­ing. Peo­ple whose cho­les­terol lev­el is “high” by Amer­i­can stan­dards (over 240 mg/dL) have more than twice as much cho­les­terol in their blood as I have. The aver­age Amer­i­can has a total cho­les­terol lev­el of about 200 mg/dL. This means that even the aver­age per­son has far more cho­les­terol in his or her blood than I do. No won­der their arter­ies are get­ting clogged!

My blood cho­les­terol lev­el may seem amaz­ing­ly low, but it’s about aver­age for some­one in rur­al Chi­na. In the late 1990s, the Chi­na-Cor­nell-Oxford Project found that the aver­age total cho­les­terol lev­el in rur­al Chi­nese peo­ple was 127 mg/dL. As a result, heart attacks were rare in Chi­na. Over­all, Amer­i­can men were 17 times as like­ly as Chi­nese men to get a heart attack. Amer­i­can women were about 6 times as like­ly as Chi­nese women to get heart attacks.

In some areas of rur­al Chi­na, coro­nary artery dis­ease was prac­ti­cal­ly nonex­is­tent. A pop­u­la­tion of a few hun­dred thou­sand peo­ple could go for a cou­ple of years with­out any­one under age 65 dying of a coro­nary. Not one per­son. The study didn’t ana­lyze the caus­es of death among the elder­ly, but there prob­a­bly weren’t many coro­nar­ies among peo­ple over 65, either.

Why were cho­les­terol val­ues and rates of coro­nary artery dis­ease so low in Chi­na? The study showed that diet makes the dif­fer­ence. Over­all, the Chi­nese were eat­ing only about a tenth as much ani­mal pro­tein and three times as much fiber as Amer­i­cans were eat­ing. The less ani­mal pro­tein peo­ple ate, the low­er their cho­les­terol val­ues were, and the less like­ly they were to die of heart dis­ease and var­i­ous can­cers. There didn’t seem to be any “safe” lev­el of intake of ani­mal pro­tein. Eat­ing even a small amount of ani­mal pro­tein pro­duced a small but mea­sur­able increase in risk. On the oth­er hand, the more veg­eta­bles peo­ple ate, the safer they were.

My cho­les­terol val­ues look like those of some­one from rur­al Chi­na because I eat no ani­mal pro­tein but lots of rice and oth­er grains and veg­eta­bles and beans and fruit. Any­one who thinks that this kind of diet is bor­ing or unsat­is­fy­ing has sim­ply nev­er had din­ner at my house.

I know from read­ing the sci­en­tif­ic lit­er­a­ture on nutri­tion that peo­ple in the Unit­ed States could dra­mat­i­cal­ly improve their health and increase their life expectan­cy by shift­ing from the stan­dard Amer­i­can diet, with its heavy empha­sis on ani­mal pro­tein and its heavy load of fat, to a diet based on unre­fined plant foods. This sim­ple cor­rec­tion in the diet would enable peo­ple to drop to a nor­mal weight with­out count­ing calo­ries or lim­it­ing their por­tions. It would prac­ti­cal­ly elim­i­nate heart dis­ease and great­ly reduce the risk of oth­er dis­eases. So why doesn’t our gov­ern­ment tell us about this?

Worse yet, our gov­ern­ment is still urg­ing peo­ple to eat ani­mal pro­tein. Although the Healthy Peo­ple 2020 goals sup­pos­ed­ly “reflect strong sci­ence,” their dietary advice flies in the face of what we learned from the Chi­na-Cor­nell-Oxford study. In par­tic­u­lar, the healthypeople.gov Web site says the fol­low­ing: “Amer­i­cans with a health­ful diet con­sume a vari­ety of nutri­ent-dense foods with­in and across the food groups, espe­cial­ly whole grains, fruits, veg­eta­bles, low-fat or fat-free milk or milk prod­ucts, and lean meats and oth­er pro­tein sources.” Since we know from the Chi­na-Cor­nell-Oxford study that eat­ing ani­mal pro­tein is the major con­tribut­ing cause of our major cause of death, and that there’s no safe lev­el of intake of such foods, why in the name of good com­mon sense is our gov­ern­ment say­ing that a diet that includes these foods is health­ful?