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2009-11-20 Daphne Miller MD The Jungle Effect

An Interview with Daphne Miller, M.D.

November 20, 2009, By Kirkham R. Hamilton, PA-C
© copyright 2009, Prescription 2000, Inc.
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KIRK HAMILTON: Hi, my name is Kirk Hamilton, your host of Staying Healthy Today, and our mission is simple: To provide you credible usable health information from interviews and our educational resources to help you Stay and Be Well in the busy modern world. Please take a few moments before or after listening to this interview to browse through the Prescription2000.com website, the home of Staying Healthy Today Radio, for our free educational services.

Today's show topic is "Learn How Indigenous Diets Can Show Us How To Prevent Chronic Disease, And, Provide Lasting Solutions For Real Health Care Reform."

Our guest today is Dr. Daphne Miller, a graduate of Harvard Medical School in 1993 who has traveled around the world to find authentic indigenous recipes and traditions that can help us preserve health and prevent many of today's modern diseases caused by the Western lifestyle. Dr. Miller spends part of her time teaching nutrition and integrative medicine nationally and internationally. Dr. Miller is also in private practice in San Francisco where she frequently prescribes whole foods as medicine rather than drugs. She is the author of the very intriguing book entitled "The Jungle Effect: A Doctor Discovers the Healthiest Diets From Around the World. Why They Work and How to Bring Them Home."

So welcome Dr. Miller and thank you so much for coming on the show today.

DR. DAPHNE MILLER: Thank you Kirk. It's a pleasure to be here.

KIRK HAMILTON: Well I loved the book and as a clinician always trying to share to a patient how to get a message across of something, I guess seems simple to you innately. And I watched how you wrote the book and what I really like is you take a patient, and maybe part of their cultural background related to a healthy society or a warm spot so to speak - or a cold spot, excuse me. And then you correlate the indigenous lifestyle with their present lifestyle, and then educate them on how to change it and then travel there. It's really ingenious.

DR. DAPHNE MILLER: Thank you. For me being in clinical practice and really trying to help people change their diet is one of the most challenging things that I feel that I do as a family doctor and I also think it's one of the most important things I do. And for years I was really frustrated trying to work with patients because most of the options that they're given for how to change are ones that are not terribly appetizing. And they're really what I call ‘cookie-cutter diets' that are just only slightly more attractive than, you know, the Wasa cracker and those slices of smoked salmon on top morning, noon and night.

KIRK HAMILTON: Well maybe that's why I'm not as successful as you (laugh). I'm not as creative! Tell me, what's an indigenous diet?

DR. DAPHNE MILLER: An indigenous diet is a diet that has grown up in an area very much in pace with that culture. So it really is a diet that reflects all the local resources from the foods that are grown locally, the traditions and how those foods are prepared and the traditions in how those foods are eaten.

KIRK HAMILTON: You talk about cold and hot spots in your book. Can you explain what that is?

DR. DAPHNE MILLER: Yes. When epidemiologists who are the scientists who study the patterns of disease, when they look at diseases what they often talk about are disease hot spots which are areas that have a very high incidence of a certain disease. For example, I am from Northern California and it so happens that Marin County is a hot spot for breast cancer for a variety of reasons. So what I was really interested in was in studies that are a little less common, but studies that are actually tracking cold spots or areas that have a remarkably low rate, or low incidence of certain diseases, and I was really interested in what they were eating in those cold spots.

KIRK HAMILTON: Well let's jump right into it then. You had a patient called Arturo and he was your typical, I guess business person. He was a CPA, I believe, and he'd gained a few pounds and he was Hispanic, and he had a risk maybe for diabetes. And so tell me about how you decided to educate him about his native diet and why you ended up in the Tarahumara Indian area in Copper Canyon, Mexico.

DR. DAPHNE MILLER: Well Arturo really led me there because he came in telling me about what his favorite foods were, and they were actually foods that he felt had a really strong connection to his ancestral foods. He was living in San Francisco and mainly eating out in restaurants, but he was eating foods that he thought were really similar to the foods that his grandmother and great-grandmother made, and he liked them because they had an emotional significance for him, and also because they tasted good to his taste buds, and his foods specifically were foods that he got at the taqueria down the street from his house. So burritos and enchiladas and tacos. And I realized that the foods that he was eating were similar to what his great grandmother prepared, but there were some really significant, and some really kind of devastating differences in the that the burrito that he chose to eat was one that was filled with cream and cheese and lots of meat and lots of white rice. You know it was a flour tortilla and so on. So -

KIRK HAMILTON: Why don't you hang with that burrito story because I was going to get to it at the end because you had this wonderful chart where I think it (the burrito) was over 2500 calories, and then indigenous tacos were like, I can't remember, but it was like less than a third of that.

DR. DAPHNE MILLER: Exactly. It was I think under 200. I don't have it in front of me either. I had a nutritionist do the calorie count on both of them. After hearing Arturo's story and finding out where his grandparents and great-grandparents were from I decided I would go there and really learn more about what his indigenous diet truly was, and it so happens that there is a community there that is very near where he grew up that is still very culturally intact and which epidemiologists have done studies and have definitely identified it as a cold spot for diabetes. And it's the Tarahumara Indians of Copper Canyon who are in the same zone, the same state as Arturo's family was from, which is Chihuahua in Mexico.

KIRK HAMILTON: People always want to say, "Well it's not the lifestyle, it's genetics!" Can you relate that the area around that they were from. Wasn't there a high incidence of diabetes, or in that part of Mexico, and just in this area there wasn't?

DR. DAPHNE MILLER: Well what's actually even more interesting is that the Tarahumara Indians who are really a separate ethnic group are genetically related to the Pima Indian of Arizona. They have the same - a lot of the same ancestry. And yet the Pima have some of the highest rates of diabetes in the world and the Tarahumara have very low low rates of diabetes. So that in-and-of-itself this really offers us proof that genes, while they may play a role, are certainly not the major factor.

KIRK HAMILTON: Can you address the carbohydrate issue? There's a term called the ‘Three Sisters,' because you hear, you know most people are carb phobic in the West. Can you explain that?

DR. DAPHNE MILLER: Yes. I think that's changing hopefully that people are understanding that not all carbohydrates are created equal. But what came as a surprise to me, and to other people when I reported back was how many carbohydrates the Tarahumara eat. As I said, the Tarahumara are this group that have this very low incidence of diabetes and their diet really gets about 80% of its calories from carbohydrates, but when you look at the kinds of carbohydrates that they're eating it's not at all the carbohydrates that Arturo was getting in his burrito. They're not eating white rice, they're not eating flour tortillas, they're not eating a lot of processed corn. What they're eating is whole grain carbs. They're really carbs that look very much like they do when the come from the earth. So the backbone of their diet is the ‘Three Sisters,' which are beans, the black beans and red beans and scarlet runner beans, and corn that's in a minimally processed - whole grain tortilla, corn tortillas and pozole which is another form of corn and then -

KIRK HAMILTON: You have some of the foods are jicama, napole, and some of the herbs that are beneficial...

DR. DAPHNE MILLER: And squash. I'm sorry.

KIRK HAMILTON: Squash. That's the third ‘Sister'.

DR. DAPHNE MILLER: And the third is squash. And they eat squash once again in a really minimally processed form.

KIRK HAMILTON: Well let's go international. You have five areas I want to just dabble a little bit in. That's why I just loved your book. Let's go to Greece or Crete and talk about - just give me the bullet points of the healthy components in their diet.

DR. DAPHNE MILLER: Yes. The reason that I went specifically to the island of Crete was because they have a low incidence of heart disease and what was so interesting for me there was that I was really trying to find the silver bullet. Sort of a magic food that really was singularly responsible for their low rate of heart disease. And what I found was that there really wasn't one food that I could point to. It really had to do with the whole diet and they way it came together. And the recipes from Crete are just really these healing recipes in- and-of-themselves and you start to look at the foods and how they're put together and it really starts to make sense that they protect the heart. So the things like the lemon is always a part of a side dish, bringing out other nutrients in the greens, and the olive oil when it's cooked with the tomatoes and the greens actually making antioxidants in these foods more absorbable. So lots of amazing synergies and interactions in the food. They also have a diet that's really rich in omega-3 fats from the seafood and that's very good for your heart, and they get a lot of magnesium from the whole grains. They get a lot of antioxidants from the greens. They eat a lot of wild greens there.

KIRK HAMILTON: How about their bread? Was it a dense bread?

DR. DAPHNE MILLER: It was. It was actually what we call a "rusk."

KIRK HAMILTON: I thought that's where I remembered hearing it.

DR. DAPHNE MILLER: It's a really hard barley bread that you really need your molars in order to break off a chunk but very high in fiber, very high in magnesium, very high in iron actually, and, great source of a lot of different B vitamins.

KIRK HAMILTON: What were their papas called? You always said you'd go out and there'd be all these little dishes?

DR. DAPHNE MILLER: Oh, they are called meze or mezedes, and that's another part of - that's something else that I really saw in all these cultures. It's not just the individual ingredients, and it's not even the individual dishes. It's oftentimes how they're eaten together. So both in Crete, and then in Japan, there's a tradition of eating a variety of small plates and then you get all these different nutrients in your foods at once. There's also some evidence that when you have more varieties of flavor per meal, you're less likely to overeat, so rather than sitting down to a big plate of one thing, really tantalizing your taste buds with a variety of things is quite wonderful.

KIRK HAMILTON: Well let's jump now to where it's cold. And this was, you know, the vegan that I am, this was the most fascinating for me was Iceland. Number one, I didn't know that it was an area where it's called the ‘Happy Land' or the land - it doesn't have a lot of depression. That, I would think, you know, no vitamin D, no sun? I was thinking just the opposite.

DR. DAPHNE MILLER: Yes. You know there's a caveat there that they just had this huge financial meltdown so I don't - I actually haven't gotten the follow-up studies. And I wonder if that sort of overrides everything else. But the research that was very interesting was sort of comparing rates of depression in Iceland to other northern countries like Finland, and Iceland had much much lower rates of both seasonal affective disorder and bipolar depression and postpartum depression and there's, you know, a variety of theories out there as to why and of course one can never separate out culture from you know everything else but it really - they used very good questionnaires to ask, and it seemed, even with you know culturally appropriate questionnaires the Icelanders had lower rates of depression.

KIRK HAMILTON: Well I took - it was interesting how much, you know, fish products they eat and all kinds of fish products, but to me it was a lesson for if somebody wants to eat animal food all their animal food, whether it be fish or the mutton, or the lamb I think it was. They eat really rich omega-3 food.

DR. DAPHNE MILLER: Right.

KIRK HAMILTON: That comes back to them.

DR. DAPHNE MILLER: Right. You know what your ‘meat eats' matters for sure. And their meat is eating really really healthy food. It's eating the little Arctic tundra grass that's filled with alpha linolenic acid, which is a precursor to the omega-3 that you get from fish. So they're actually eating animals that have flesh that's pretty high in omega-3 fats.

KIRK HAMILTON: One of the interesting stories you - there also was the vegetable hothouse I think, and I was asking the same question like, "Where are they are going to get their phytonutrients and antioxidants?" And then you talked about these, I don't know if they were tomatoes or what they were, but they were these ‘cardboard stiff' kind of foods and then you talk about bilberries. Can you relate that a little bit?

DR. DAPHNE MILLER: Right. So the vegetables and the greens that we traditionally think of as vegetables really grow very poorly on the island and are kind of specialty foods, and the truth is that most Icelanders think they taste terrible because they're grown in these hothouses and don't have a lot of the sun and soil that we get here to make those sweet delicious cucumbers and tomatoes. So most Icelanders really avoid them (vegetables), and the same with salads. It's usually too cold out to get good growth of the greens so when you talk to most Icelanders they actually sort of identify themselves as ‘vegetable haters.' But then you find out that they're getting a fair amount of these phytonutrients from things like bilberries, and then skins on the little new potatoes and cabbage, and they even use the moss that grows on the hillside as a supplement in their breads. So they're getting it in sort of unorthodox ways, but it still is plenty to give them the antioxidants they need and so I think it's great news for salad haters, you know, that there are other ways to get these nutrients and you don't have to sit down and eat a big bowl of leafy greens.

KIRK HAMILTON: Now they boiled their potatoes and by boiling it with the skin on I think you said that that reduced the glycemic index correct?

DR. DAPHNE MILLER: Boiling then cooling, and then even if you reheat, it seems to, yes.

KIRK HAMILTON: Now was there dairy products? Because I know you give the story of the two gentleman sloshing down milk like it was two big mugs of beer. Was that organic raw milk or how was that?

DR. DAPHNE MILLER: You know, I'm not sure if it was pasteurized or unpasteurized milk. But my guess is that it probably was unpasteurized and you know what we would call raw. And it was also obviously local from dairy that had eaten that same little Arctic tundra grass. And what the research shows is that organic milk, whether or not it is pasteurized, does have more omega-3 fats in it than milk that is obtained from cows that you know are raised in a barn and on feed.

KIRK HAMILTON: Let's jump across the world then to Africa, West Africa, or Cameroon and give a few pointers of how to avoid colon cancer with lessons from that part of the world.

DR. DAPHNE MILLER: Once again another cold spot, this time for colon cancer and what was so interesting to me is that African-Americans in the United States obviously have some of the highest rates of colon cancer. And yet so many of them can trace their ancestry back to West Africa where people who are living a traditional lifestyle have very low rates of colon cancer. So once again, we can't say that genetics are the predominant factor. There's one dish in particular from the village I was in Cameroon, a village called Ntui, that I think is really emblematic of why there's such low rates of colon cancer there and it's a dish called endole. And it has wild greens in it which would be sort of equivalent to our dandelion or collard greens or even kale and wild greens are really rich in folate which blocks the reproduction of cancer cells in the colon. This same dish also has fish in it and we know that omega-3 fats probably play a role in colon cancer prevention. The same dish has meat, but it's really more as a spice and that's one of the key factors there is that when they do eat meat because it's so expensive and so precious it's not eaten as a huge chunk in the middle of your plate. It really is smaller pieces.

KIRK HAMILTON: Wouldn't you say that that's the case probably from most cold spots around the world that when they, I mean except for the Iceland experience, but when they're eating their meat generally they're poor and so they don't kill their animals as much and they eat small amounts?

DR. DAPHNE MILLER: Smaller amounts for sure and really using it more as a flavoring. Yes, in Iceland I did have some delicious, you know lamb chops and cuts of meat, but even there it's not every day. It tends to be, you know, once a week or a couple times a week. And the other thing about the endole is that it's served over some kind of fermented food, either fermented millet or fermented manyok root. And fermentation, the healthy bacteria you get from fermented foods, whether it's yogurt or sauerkraut, whatever culture, seems to be really helpful in maintaining a healthy intestinal lining and also preventing the growth of colon cancer cells, the polyps in the colon.

KIRK HAMILTON: Well we're going to jump now because we gonna get to my favorite group of people to study, and that's the Okinawan people. So now we're over in Okinawa, Japan, and there's what's called, you know, I've heard, and I always talk to my patients, and I have read the Okinawa Program by the Willcox brothers and Dr. Suzuki. One of my favorite books of all time. And I'm always sharing that with patients. And there's the Okinawa Paradox. We hear about the elders living a long time and yet their children and their grandchildren who are living the traditional Western diet, you know, get the diseases like everyone else. And I love your story where you get dropped off at the market, and I think you actually are in the airport, and you notice that the paradox. You were going what's happening here? The kids are all looking modern and you're going to study the elders.

DR. DAPHNE MILLER: Yes. One of those things that I saw in every culture I was in was the younger generation is just so ‘beguiled' by modern food that's finally made its way there, and they're getting sick just like we are here in the United States, and they're getting all the same chronic diseases. And yet there's the grandmothers right next door who are incredibly healthy and living to over 100 and not getting any of these diseases.

KIRK HAMILTON: Let me jump into the soy debate because I get it all the time and I want to make sure I get your ‘two cents' in because I loved your chapter in the book, that two or three pages in the book. In fact I copied it for everybody because I go back and forth. And my own feeling is if you're eating whole foods that are soy made, like an Okinawan tempeh, tofu, etc, I just can't see the harm in incorporating that into my diet. Now if I was drinking, you know, three quarts of soy milk a day and eating all these fake meats then that might be a different story. Can you shed some light on that?

DR. DAPHNE MILLER: That's exactly what the research seems to point to. Now you know this is all evolving and you could say something different next week, but what the studies so far really show is that eating whole soy, and not eating it in excessive amounts, so eating tempeh and edamame and tofu and even soy milk you know as part of a more complicated meal, and having it, you know, kind of worked into your week is a very very healthy option. What happens here in the United States is, we actually per capita eat more soy than they do in Asia. We just do it in a much more confusing form. We do it in our power bars and in our energy drinks and even in our meat. When you go into fast food chains a lot of them are serving hamburgers that are mixed with soy and a lot of that soy is highly processed and what you're actually getting is soy isolates. And there is some suggestion in terms of the research that that really works differently on your hormones and on your cells than eating whole soy.

KIRK HAMILTON: Tell me - explain to the people the term "Hara Hachi Bu" and how that might relate to their longevity and health.

DR. DAPHNE MILLER: "Hara Hachi Bu" means literally "eat until you are eight parts full." And it really is the best diet prescription you could ever have. Unfortunately it doesn't sell a lot of books to have a diet prescription that's that short. But I really think it doesn't get any better than that. It basically is the concept that whatever you sort of feel like you need to put in your body, dial it down by 20%. And that is going to be the amount that is going to make you feel satisfied but not full. And it's really going to be the amount that's going to maintain you at your current weight or maybe even help you lose a couple of pounds rather than constantly gaining weight.

KIRK HAMILTON: Can you - I know you went, when you were talking in the book you talked about the low incidents of the cold spot for breast and prostate cancer, and I am assuming they're similar dietary patterns that account for that in the Okinawan people. Can you name three or four factors that might relate to why the Okinawan elders who eat the traditional diet that have a low incidence of breast and prostate cancer?

DR. DAPHNE MILLER: Certainly the idea that they're taking in less calories is an important one. We know that obesity and sort of carrying around extra fat tissue is a real factor in these hormone related cancers. The fat cells themselves produce hormones that act to stimulate the cancers. And that is something that's been very clearly shown and so that's one piece of it for sure. The other piece is that they eat a lot of foods that might be down-right protective For example, things like seaweed rich in iodine and other nutrients which actually might have sort of a dampening or blocking effect on a lot of the receptors that would stimulate a cancer. They also tend to eat a lot of antioxidants in the form of greens and tropical fruits and so on, and they eat a lot of fish, a lot of omega-3 fats. They also drink a lot of green tea which is filled with EGCG which I always - epigallocatechin gallates - and it's a catechin basically or you know a type of tannin that has very strong antioxidant effects and they really drink it all day.

KIRK HAMILTON: Let me close, because I am going to get you back to work. If you had three or four rules that you could apply, if you were the Czar of the United States, to dramatically make health care reform a non-issue what would you tell us to do diet wise, two, three or four things?

DR. DAPHNE MILLER: Well certainly to cook at home. Because I think the minute that you stop buying foods that are coming out of a box, or a can, or in a fast food bag, or in a restaurant you just have so much more control over what's going on in your diet and what you're putting into your body. Secondly, would be to buy foods that don't have any more than a couple of ingredients, and which you are able to pronounce all the ingredients, and that look close to something that comes from the earth or the sky or the water. And the third thing would be to eat with your family, to sit down with other people and eat. When you eat in that way you're just so much more mindful about what you're eating. Don't eat in front of the TV, don't eat in your car, don't eat in the supermarket.

KIRK HAMILTON: You just pegged me! I'm getting up from underneath the desk right here...!

DR. DAPHNE MILLER: And I think that you know the fourth thing - this is where a lot of Americans get their unhealthy foods and their unwanted calories is either in soft drinks or sweetened drinks or in convenience snacks. So to really pick a drink that's healthy like an unsweetened green tea that you make for yourself or better yet water. And in terms of convenience snacks I think you first of all have to really figure out do you need to snack? But when you do snack, have a little knuckle full of some healthy nuts like almonds, like roasted almonds or one of my favorite snacks is a little bit of humus that I make with carrots or celery or to take some seaweed strips or you know pick something that is for you satisfying and healthy and have that on hand so you're not buying - going in and buying the Reese's bar or something to tide you over until your next meal.

KIRK HAMILTON: Well we gotta run, and I just want to thank you so much Dr. Miller! Her book is called the "The Jungle Effect: A Doctor Discovers the Healthiest Diets From Around the World. Why They Work and How to Bring Them Home." And we will have that up on the website in a couple of weeks and your contact information will be there. And again thank you so much Dr. Miller for coming on today.

DR. DAPHNE MILLER: It was a pleasure. Thank you Kirk.

KIRK HAMILTON: And I want to thank you the audience for this edition of Staying Healthy Today Radio. And remember until next time, Stay and Be Well.

© copyright 2009, Prescription 2000, Inc.
www.prescription2000.com

No part of this interview may be copied or reprinted in any form, electronic or print, without written permission from Prescription 2000, Inc.