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2010-04-28 Alan Goldhamer DC Chronic Disease, Medically Supervised Fasting And "The Pleasure Trap" Foods

An Interview with Alan Goldhamer, D.C.

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 "The Role Of Fasting In Disease Prevention And The Treatment Of Chronic And Acute Medical Problems."

Our guest today is Dr. Alan Goldhamer, who is the founder of TrueNorth Health Center in Santa Rosa, California. He is a chiropractic physician and author of "The Health Promoting Cookbook" and co-author of "The Pleasure Trap: Mastering The Hidden Force That Undermines Health and Happiness."

So welcome Dr. Goldhamer. Thank you so for being on the show today.

DR. ALAN GOLDHAMER: It's my pleasure.

KIRK HAMILTON: How is it in Santa Rosa? It's it rainy?

DR. ALAN GOLDHAMER: It's beautiful today.

KIRK HAMILTON: So tell me what got you interested in medicine in the first place, and then more alternative or diet related medicine.

DR. ALAN GOLDHAMER: Well, I met a doctor when I was about 16 years old and he told me that being a physician was the best job in the world because the patient did all the work, the body did all the healing, and the doctor got to take credit for it, and I decided that was the job for me.

KIRK HAMILTON: That was good. Why did you get interested in chiropractic, being a chiropractic physician?

DR. ALAN GOLDHAMER: Well my real primary interest was in this idea of health promotion and disease prevention and I had read some books early on by Herbert Sheldon and others that led me to believe that you know diet and lifestyle were the key to health. And at that time, this was 26 years ago, chiropractors were on the forefront of health promotion on nutritional management issues and integrative medicine. Now of course, coming fast-forward that type of interest is becoming much more generally accepted by all health professions whether it is naturopaths or osteopaths or medical doctors today. But at that time it was the chiropractors that were speaking the most about the importance of diet and lifestyle. And so I was naturally attracted to going to chiropractic college. And when I finished chiropractic college I had the opportunity to go to osteopathic college in Australia and I attended the Pacific College of Osteopathic Medicine. And I did an internship there with a chiropractor-osteopath named Alec Burton who taught me how to use fasting as a means of giving the body a chance to heal itself.

KIRK HAMILTON: So then kind of fast-forward. Tell me the history then - you're the director of TrueNorth which is a medical center in Santa Rosa, California. How did you come full circle to become director of that?

DR. ALAN GOLDHAMER: Well when I returned from Australia my wife, who is also a doctor, Jennifer Marano and I decided that in order to apply what we had learned in Australia, that is the use of diet and fasting in helping chronic disease patients recover their health, we needed to have a facility where they could come and live with us. Because with fasting it really needs to be done in a supervised and controlled environment and setting. And so we opened up the TrueNorth Health Center back in November of 1984 and we've been operating here since then. Of course now the center has grown to be a much bigger facility. We now have a staff of nine doctors including doctors of medicine and chiropractic and osteopathy and naturopathic medicine and psychology. And we have a large facility here in Santa Rosa, California, that allows us to treat several dozen patients at a time as well as provide all kinds of supportive care from our staff.

KIRK HAMILTON: Let's talk about fasting for a moment. Do you think it's more the foods or the things you are inputting into your body that you get off of that help you improve when you get on a fast, or is it more what happens during the fast that your body takes care of certain toxicities for lack of a better way of saying it, or both?

DR. ALAN GOLDHAMER: Well it's certainly both. Fasting is a biological adaptation. We as a species had to be able to fast for our species to survive because humans have this large bulbous neuronal net at the end of our spinal column called the brain, and the brain is our biggest and disproportionate burner of glucose which is sugar, our primary fuel. And so if our species with our big brains had not had the capacity to conserve glucose which would be derived from proteins, our species would have died the first time spring came late. Fortunately, we and a few others animals on the planet have what is considered a bi-fuel brain. We can actually shift from burning glucose or sugar to burning the byproducts as fat metabolism or ketones. And as a consequence, we are able to fast for prolonged periods of time. In fact, the average 154 pound male could for fast for 70 days or longer even with relatively limited fat reserves because we are so efficient at converting over to burning fat byproducts.

KIRK HAMILTON: So you do water fasting or juice fasting or what is your philosophy?

DR. ALAN GOLDHAMER: At the TrueNorth Health Center, we do what is appropriate for the individual patient. We do water fasting when that is appropriate and we've water-fasted over 7000 individuals in the past 25 years. We do juice fasting when water fasting is too vigorous a process for an individual given their condition or medication use. And we do healthy eating and exercise programs that either don't need to fast or aren't ready for fasting.

KIRK HAMILTON: What would be a reason why you would do a water fast versus a juice fast or delineate the type of patient?

DR. ALAN GOLDHAMER: Well, be clear. Fasting by definition is the complete abstinence from all substances except water in an environment of complete rest. And so when we talk about fasting we are talking about water-only. Now sometimes juice diets or modified feeding programs can be very appropriate and helpful but they are not fasting. Fasting is a unique biological adaptive process the body goes through and it only does those particular changes under a water-only situation.

KIRK HAMILTON: What are some of the things then that are the beneficial things that happen during a fast - a water fast?

DR. ALAN GOLDHAMER: Water fasting is a tremendous facilitator. It speeds things up. For example, we published a study in 2001 in JMPT, along with our colleagues at Cornell University including Dr. Colin Campbell, where we looked at the use of fasting in the treatment of high blood pressure. And we demonstrated the largest effect sizes that have ever been shown in treating high blood pressure in humans. In that study we took 174 consecutive patients with high blood pressure and 174 people were able to achieve blood pressure low enough to eliminate the need for medication. The fact is we have an average drop in stage 3 hypertension of over 60 points. That's the largest effects that's ever been shown by anybody in treating this condition. Water fasting is the most effective way of taking an essential hypertensive patient and normalizing their blood pressure in a rapid way. And the advantages to that, you can get them off their medication. And you can begin the process of nutrition and lifestyle education so that people can sustain the results when they go home.

KIRK HAMILTON: It's obvious then that when you are dealing with people on multiple medications you would have to have a physician supervised fast because you are going to be tapering down medications fairly quickly.

DR. ALAN GOLDHAMER: Well we have two full-time medical doctors that are consultants at the center, Dr. Michael Klapper, who has been in practice for you know several decades, as a hard-core vegetarian advocate and Dr. Peter Sultana who has been with us since he graduated from medical school over 12 years ago. So we have two excellent physicians that are experts at helping people eliminate the need for medications. Obviously you first have to get rid of the need for the medication before you can just arbitrarily discontinue anything and we do that by getting people to live healthfully. We believe that health is the result of healthful living. So our entire focus, whether it is fasting or juice fasting or feeding, is teaching people to live in such a way that their body can do what it does best and that's heal itself.

KIRK HAMILTON: When you're on a water fast, one obvious question that comes up is, and let's say you were extended period of time, a couple of weeks, do you loose muscle protein? What happens with that?

DR. ALAN GOLDHAMER: Yes. There is some mobilization of protein during particularly the first couple of days of fasting where your body still has a relatively high glucose need. As the body converts to fasting of course by the end of the second week for example, the vast majority of calories are being derived from fat mobilization, so that preserves protein and limits its glucose utilization. That's one of the reasons that we restrict activity during fasting, to keep people in a relatively passive state. Because you don't want to have extra activity because that would double caloric utilization and increase protein utilization and thus glucose needs. So when you have a controlled setting you can make sure that most of the energy that's being derived is actually coming from a person's fat stores rather than burning protein. Any protein that is lost in fasting is actually labile protein. You don't lose any muscle cells. You're just losing a little bit of the juice that's mobilized for nutrient reserves until the body has converted into the fasting state. And after fasting, of course, people build up as we begin them eating properly and exercising and restoring their strength and vitality.

KIRK HAMILTON: Tell me about the first couple of days of a fast. The cravings, the not feeling well, and when does that pass and why does that pass?

DR. ALAN GOLDHAMER: Well first of all people often experience a foul taste in their mouth. That tastes like something crawls in there and dies. And they often have headaches, low back pain, irritability, skin irritation. They have diarrhea, bile or even have some vomiting. They can get sleep disruption, irritability, they can get all kinds of elimination from mucous organs and mucous membranes. You know it's funny. I was telling this to a patient one time and she interrupted me and she said, "My, you're quite a salesman. Where do I sign up?" Because it doesn't sound very good and it's not. Fasting can be a very intense but also very productive experience. And the first days of fasting are basically acclimation to this. What's interesting is after two or three days for most people hunger goes away, a lot of these acute symptoms begin to subside and other things begin to show up. So there's basically a characteristic pattern of symptoms and problems that people go through. But if they know what they're going to be going through and they're aware of what those individual symptoms are associated with, oftentimes they tolerate them quite acceptably.

KIRK HAMILTON: When people throw the word "detoxification" around and it's used a lot, do you have a nice unique paragraph to explain detoxification?

DR. ALAN GOLDHAMER: Well there's two kinds of toxins that you're detoxifying. Endogenous toxins are basically not technically toxins. They're things like cholesterol and uric acid and lipofuscin and intracellular pigments and other types of materials that, although not particularly toxic per se, when there's too much of them, or they're in the wrong place, they can interfere with cellular function and are actually thought to be part of the aging process itself. The other type of toxins are what you normally think of as exogenous toxins. Toxins of substances that come from outside the environment that shouldn't really be there. For example, PCPs or dioxin or pesticide residues. Materials, heavy metal contaminants like mercury and lead. Things that really shouldn't even exist in our environment except for we've created them and put them there. As a consequence, these materials build up inside the cells of the body and can cause a variety of very significant health-compromising manifestations. Interestingly enough, if you actually do fat biopsies on humans and figure out what's there, you will find virtually everybody has various levels of exogenous toxins. And if you track back where they came from, the vast majority of toxins are that most people will find in a human being come there from eating animal foods. The biologically concentrated animal foods that people eat have large quantities, 10 to 1000 fold more of these various toxins than you might in an equivalent number of calories of plant-based foods. And as a consequence, people over a lifetime build up large quantities of some of these substances and they can be particularly in vulnerable people problematic. When you fast, it is thought that these materials are mobilized, processed, and eliminated primarily by the kidneys and eliminated in the urine because that's kind of the byproduct of purifying the blood. And so what ends up happening in fasting is there's a rapid mobilization and elimination of these materials that may be responsible for some of the symptoms people have in fasting, but the net effect, and in fact studies have shown with pre- and post- fat biopsies on humans, and looking at total body loads, that fasting is in fact effective way of mobilizing and eliminating a lot of these poisons. In fact, some people criticize water fasting because they say the body is so efficient at mobilizing and detoxifying itself in fasting that the billion years of evolution isn't enough for the body to know what to do and how to do it, and therefore you have to take proprietary supplements or something in order to make it safe. Our experience has been just the opposite. Fasting is when it is properly done a safe and effective means of giving the body a chance to mobilize and eliminate these accumulated materials in the body.

KIRK HAMILTON: Do you have an entry diet before the water fast like just vegetables or something like that? And then can you explain, do you have an exit diet where you go back on food?

DR. ALAN GOLDHAMER: Yes, we have - we definitely have an exit diet. We believe that the healthiest diets for most people is a plant-based diet so that's fruits and vegetables, grains, legumes, nuts and seeds, but a diet that avoids the animal foods like meat, fish, fowl eggs and dairy products, added oil, added salt, and added sugar. So we're pushing a diet that's based on basically lots and lots of plant based foods, both raw and cooked, and that minimizes the animal foods and eliminates the processed foods, what we call "The Pleasure Trap" foods. Foods that fool the brain and result in people becoming fat, sick and miserable. The diet before the fast is the same as the diet after the fast except that we particularly restrict caloric density for 48 hours before fasting so we are getting people on basically fruits and vegetables only. And that tends to make people a lot less miserable as they transition through the fasting state.

KIRK HAMILTON: How about after the fast? How do you break a fast?

DR. ALAN GOLDHAMER: You break a fast usually on the juice of either fresh fruit or vegetables or broths that we prepare and we do that usually for about a day of that for every 10 days of water fasting. So a person say has a 30 day water fast, they have about three days of juice, and then we use a day of raw foods for every 10 days of fasting, and then we slowly reintroduce more steamed and starchy foods and get the person on the diet that's suited to meet their particular needs.

KIRK HAMILTON: What is the shortest fast to get benefit and what would be your average fast at your facility?

DR. ALAN GOLDHAMER: Well the shortest fast is the one that every single person does every single day when they go to dinner and have their last meal and then they wake up in the morning and they eat something called "break-fast." And that essentially breaks the fast that might have been eight to 12 hours that virtually everybody does. So the shortest fast is the one that everybody does. The longest fast, we tend not to go over 40 days if at all possible. We have to on occasion do longer fasts, but typically it's going to be between 5 and 40 days of fasting. The average fast depends on the patient's condition. With high blood pressure, average fasts range between two and four weeks. With diabetes, it might be three to five weeks. With autoimmune disease, it will range from five to 40 days. Patients that are just coming here preventatively where they're trying to kind of reboot their - kind of like you would with a computer when you turn a computer off and you turn it on, it kind of reboots the hard drive, kind of clears everything out, again sometimes five to ten days is enough to get a person to the point where good foods taste good. So our fasting duration is very individual. It's based on each person's needs and to a large extent fasting is diagnostic as well as therapeutic so you can watch how the person responds in fasting and get great insight into what is actually going on inside the body.

KIRK HAMILTON: We are talking to Dr. Alan Goldhamer, the director of TrueNorth Health Center in Santa Rosa, California. We are talking about fasting and I think we've covered fasting pretty well. Are there some other things you would like to comment on before I go to --

DR. ALAN GOLDHAMER: Well I just wanted to mention that when we talked about water fasting, this is something that is done under medical supervision. Everybody has a medical history taken, a physical exam, appropriate laboratory testing, they are visited twice a day by our staff doctors. We collect vitals, we monitor them carefully. We are doing appropriate blood and urine testing. They are in a contained and controlled environment. I am not suggesting that people can be at home, go off to work, etc., etc. and do this safely. The reason it is safe is because it is done in a very controlled and well supervised manner.

KIRK HAMILTON: Who shouldn't - is there ever a person you say no, we're not going to fast you?

DR. ALAN GOLDHAMER: Yeah, we actually turn away probably more people that we accept for fasting because people have to be good candidates for fasting based on their conditioning and history and mostly by their attitude. People that are looking for some magic bullet or aren't prepared to make the necessary diet and lifestyle changes shouldn't be looking at fasting as some kind of magic cure. No matter how well a person does fasting, unless their prepared to make diet and lifestyle changes and adopt healthful living habits, they're going to be very disappointed with the outcomes. In our facility, a big part of our program is a twice daily educational program with lectures and cooking classes and individual consultations with individuals so that we can teach them what they need to do to get and stay healthy. So a huge part of our program is actually educational.

KIRK HAMILTON: Sounds good. Now, if you weren't somebody going to a fasting clinic, how would you do a "home cleanse?"

DR. ALAN GOLDHAMER: Well what I would do first of all is recognize that the advantage of fasting is one of speed. In other words it makes things happen quicker. Quicker isn't always better. And sometimes what we would need to do is adopt what we call a health-promoting diet. A diet that avoids animal foods and avoids the Pleasure Trap Foods like oil, flour and sugar, and focuses on whole natural foods of fruits and vegetables, grains, legumes, nuts and seeds, just adopting a health-promoting diet will allow a person to begin getting healthier faster than they get sick. And as long as they're making progress, then that's what they should be doing. Focusing on diet, sleep and exercise. If you want to speed it up, you can restrict the diet even further in terms of going on maybe just fruits and vegetables or fresh fruit and vegetable juices. But as you restrict the calories down to a lower level you need to then also restrict activity. So the mistake people make is they will go on a juice fast but they continue to work or they continue to be too active. And so they put an extra load on the body and you minimize then the detoxification effects in exchange for further increased activity.

KIRK HAMILTON: That's a great little pearl because I think I've done that to myself.

Well let's switch over to your book, "The Pleasure Trap: Mastering The Hidden Force That Undermines Health and Happiness." So when did you write this book and tell us the basics about it.

DR. ALAN GOLDHAMER: Well we finished - the book was published just a few years ago. And we wrote the book because we really wanted to tell the story of healthful living. And we believe that the reason why, for example people in our society are sick is largely due to certain conditions which used to be rare but which are now common and they're called the diseases of kings. Conditions that only the wealthy elite kings ever used to get in the world of our ancient ancestors but today they're ubiquitous and are caused by dietary excess. And they're caused by dietary excess because we're basically discovered that there were certain chemicals that you could add to food, that would allow people to perceive the food as being more tasteful and they would eat more of it. And in fact it turns out it's not only people. If you add these particular chemicals to the feed of rats, those rats if they're given ad libitum eating will get to a certain size. If you add these particular chemicals, those rats will gain 49% of their body weight in just 60 days. The birds will get so fat they can't fly. And with people, if you give these chemicals to people, two-thirds of the population becomes overweight and that's exactly what we've done. And the chemicals that we add to food that are responsible for us being fat, sick and miserable, developing the disease of excess are; oil, flour and sugar, as well as dairy products. These substances don't exist in that form in a natural setting. There is no oil bushes, there are no sugar trees, and as a consequence when they artificially concentrate these chemicals we put them into the food supply, the people or animals that eat that food will systematically overeat and that is why people today are fat, that is why we are developing disease, coronary artery disease, diabetes, and autoimmune disease, and ironically enough those are the very conditions that respond so well to fasting. Because fasting rapidly allows the body to undo the consequences of dietary excess.

KIRK HAMILTON: So is it that foods that have oil, refined flour and sugar in them cause calorie excess? Or is it do they cause something metabolically that causes us to eat more?

DR. ALAN GOLDHAMER: Both. For example, if you fill up a human stomach with just steamed potato, it holds about 600 calories. You fill up a human stomach with bread, it holds 1600 calories. Three times the caloric density in bread than say potatoes or beans or rice. As a consequence, what happens - part of the way your brain tells you that you're full is based on volume, you know in terms of fiber and feedback. It's one of the mechanisms. There's also caloric density and other issues. But the point is when you have something that only takes a small amount of space that has a higher amount of caloric density, the tendency is to eat more of that before the brain signals that you have had enough. And frankly bread does not exist in the world of our ancient ancestors. You know it was only post industrial revolution and post discovery of agriculture, maybe 10, 12,000 years ago, we even had grains in concentrated form. And then we learned to grind it into flour and bake it at high temperatures and do all the things we do to make these artificially concentrated high caloric density foods. So part of it is you know fooling the brain satiety mechanisms and part of it are in fact the chemical changes that occur when you artificially stimulate the body whether it be with the chemicals of foods or the chemicals of drugs, whether it be cocaine, alcohol, nicotine, etc. See, I'm going to tell you that the addiction to drugs and the addition to these chemicals in foods are essentially the same kind of addiction. They stimulate the same kind of neurochemical events. They're all dopamine based. Dopamine is that neurochemical produced by the brain that signals pleasure. When you, for example, if you smoke cocaine you will get ten times as much dopamine secreted as having an orgasm during sex. It's one of the reasons cocaine is so addictive. Well when you eat artificially concentrated foods you also get more dopamine secretion which is why your brain perceives those foods to be more valuable. Because that brain evolved in an environment of scarcity where that was the biological imperative of life - get enough to eat, don't get eaten, live to reproduce. So what happens today is we eat those foods and our brain tells us, oh that's good, that's valuable, keep it up. And we do and we get fat, sick and miserable as a consequence.

KIRK HAMILTON: Let me backtrack to grains a second because I want to get clear on what I think you said. Bread, even if it was a whole grain, sprouted grain product, is not essentially a natural product. Correct?

DR. ALAN GOLDHAMER: Not at all. In fact, if you boil wheat berries, they have 500 calories per pound per serving size. But you eat bread, you get 1500 calories per pound serving size. As a consequence, you are going to get fat eating bread, not eating wheat berries.

KIRK HAMILTON: Correct. So in your dietary regimen, bread is down the -

DR. ALAN GOLDHAMER: We don't use bread.

KIRK HAMILTON: You don't use bread at all. And I understand that calorie density part. I got that. That would make sense. That's why when you take oatmeal and you dilute it with water, you get a low calorie dense food, correct?

DR. ALAN GOLDHAMER: Yeah. Interestingly enough, we talk about bread. Let's say we were trying to do the opposite. Let's say we wanted to put weight on people. Let's say our goal was to get people fattened up. What you would do is you would increase the caloric density of foods. You would do things like take grains and turn them into flours. And use artificially concentrated substances like sugar or oil with 4000 calories a pound, and feed that to people and you could fatten them up.

KIRK HAMILTON: The problem, though, is that it ends up being excess calories per se. For example, a Sardinian goat herder lives 80, 90, 100 years of age. They were in The Blue Zone book. Takes this loaf of bread with him. But in totality, he's not consuming as many calories even though he's eating bread. We have -

DR. ALAN GOLDHAMER: Yeah. Interestingly enough, if you go to central China, you will find people on average are consuming slightly more calories than we do actually in western cultures, but because they are so active you have virtually no obesity.

KIRK HAMILTON: And isn't it also because a vegetable based diet somehow stimulates metabolism a little bit different?

DR. ALAN GOLDHAMER: Well there's all kinds of relatively intricate mechanisms brought to be at play, but we don't even have to go that far. I mean I remember a trip I did in China. I went down the Yangtze river in a little boat. And I thought, you know I'm going to find some Chinese people that are fat and find out how they get fat since we certainly don't have any shortage of them here in the United States. And I was amazed to find that I saw thousands of people literally over several days and there virtually was no obesity. In fact the only people I finally found that were obese were two people I met in an internet café and they turned out to be tourists from Chicago.

KIRK HAMILTON: But now you can go to Shanghai and the big cities and you can find fat people.

DR. ALAN GOLDHAMER: Well now that we've got KFC and we've got you know Nike building plants and people, you know things are changing of course. We're going to end up seeing the same thing that we see here. Because anytime you introduce Pleasure Trap Foods people line up for them because it is a drug like effect.

KIRK HAMILTON: What is the "myth of moderation?"

DR. ALAN GOLDHAMER: Well moderation can really only be talked about in relation to something that has a normal relationship to the body. For example, if you have a patient that is an alcoholic, you don't tell the patient, well, you're an alcoholic, your life sucks because you can't control your drinking. We need to teach you to learn to drink moderately. You just drink beer and wine and you'll be fine. Or you just, here put your alcohol in a smaller cup and swish it around in your mouth a few times before you swallow, then you won't overdrink anymore and you won't be an alcoholic anymore. We don't tell them, well put your cup down between each sip and everything will be fine. We don't do that because we know it will fail virtually 100% of the time. The only answer in alcoholism is to teach people every day to not drink. And if they do that, you know you can get a certain percentage of success. With obese patients we tell them the same thing, well the problem is you overeat, so eat less, or put your food on a smaller plate, or chop your food into little bits, chew your food into more bites and you won't overeat it. Of course it fails virtually all the time. We know this failure rate in obesity is 95 to 99% Because we lie to people. We tell them they need to learn to eat moderately. What we need to do is tell people, listen, you're fat because you're eating oil, flour and sugar or dairy products. Stop it! Stop eating the things that are causing the problem, and then the problem will go away and it does. And we see that every single day here at the TrueNorth Health Center.

KIRK HAMILTON: Well speaking of that ending, tell us how to contact TrueNorth and also how you get your book.

DR. ALAN GOLDHAMER: Well, our book is available everywhere, from Amazon.com to our website at HealthPromoting.com. You can go onto our website. We have all of our published studies available you can download. You can get an email address from me or call us at 707-586-5555. I will be happy to answer any questions that people have or tell them how it is that we can help them get where they want to go.

KIRK HAMILTON: Dr. Goldhamer, thank you so much for taking the time to be on the show today. I know you are busy, but thanks a lot. That was great.

DR. ALAN GOLDHAMER: It my pleasure. Any time.

KIRK HAMILTON: That was what we call not a calorie dense show, but an information dense show. You do a great job.

And I want to thank you, the audience, for listening to this edition of Staying Health Today Radio. And until next time, Stay and Be Well.

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