An Interview with Joel Fuhrman, MD
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, "Toxic Hunger, Weight Loss and the Benefit of a High Micronutrient Dense Diet." Our guest today is Dr. Joel Fuhrman, a board-certified family physician who specializes in preventing and reversing disease through nutritional and natural methods. He has developed a "Nutritarian" approach to diet and health with emphasis on a high micronutrient dense diet. He has coined the term the "Health Equation." Health = Nutrients/Calories." He is the author of the best-selling book "Eat to Live: The Revolutionary Plan for Fast and Sustained Weight Loss," with its newest edition just being released. Dr. Fuhrman recently co-authored an article entitled "Changing Perceptions of Hunger on a High Nutrient Dense Diet" in the Nutrition Journal, 2010, which is the focus of today's show.
KIRK HAMILTON: Welcome, Dr. Fuhrman. Thanks so much for taking time out of your busy schedule to be on the show today.
DR. JOEL FUHRMAN: Oh my pleasure.
KIRK HAMILTON: You know if I'd listen or seen your website correctly and your emails, you've been traveling quite a bit. Weren't you in the United Kingdom doing a talk a couple of weeks ago?
DR. JOEL FUHRMAN: Yes, it was exciting. I was speaking at Parliament in London for the World Preservation Society. And it was a lot of politicians and heads of state from around the world were learning about how nutritional excellence can reduce healthcare costs, but more importantly save lives.
KIRK HAMILTON: Wow. That's excellent. Um, then you were in LA last week. Are you promoting your new book, or the new edition of "Eat to Live"?
DR. JOEL FUHRMAN: Kind of. I was actually filming some brief like video commercials for my "Getaway" this summer in Park City, Utah where we have a Dr. Fuhrman "Health Getaway" and people come from all over the world, and we have a good time together and we learn about modern nutritional research.
KIRK HAMILTON: And they can find out, people can find out about that going to your website?
DR. JOEL FUHRMAN: Absolutely. And you just go to drfuhrman.com and they can just click on the events page.
KIRK HAMILTON: Excellent. Well what intrigued me was you had an article in the Nutrition Journal about high micronutrient dense diets and toxic hunger and so I wanted to kind of jump in and talk about that. What led you to come up with the term "toxic hunger?"
DR. JOEL FUHRMAN: Well you know I've been in practice for 20 years and from the very start I've been a physician specializing in nutrition. And I've noticed that when I put people on a diet that's very, you know designed to reverse diabetes, reverse heart disease, get rid of headaches, when they eat a diet that's very superior in micronutrient intake they won't just lose weight effortlessly, but they'd all report back and say you know instead of feeling shaky and weak and headachy and stomach cramping those symptoms are lost, and now I have a new sensation of hunger that I feel in my neck or my throat. So I've seen this occur you know thousands of times through the years, and of course on myself, on my family, on people that seemed to eat a diet that's extremely nutritionally sound. This sensations that most people describe as hunger seemed to melt away and they're - and people aren't driven to eat as much. So over the years I've come to this theory, and now this theory I've tested it out with thousands of people and found out wow this is true and I've studied the biochemistry behind it, and I think I've added to the body of research and body of science helping people understand the nature of hunger and what I'm claiming is something quite radical. Because I'm claiming what people consider to be hunger and what the medical textbooks and medical literature describe as hunger I'm claiming that's not hunger. Actually what it really is are withdrawal symptoms that occur during the catabolic phase of digestion when the body is living off the substances it's stored when it was eating and storing the calories in its body. In other words, when you eat food it's the anabolic phase, when you're digesting it because you're storing -- turning that glucose into glycogen, turning the - storing the fat as fatty acids in the tissues, and then when you're not eating food and you're finished digesting you're living off it, like the wick of a candle burns down the wax like you filled up your car with gasoline. Now you're gonna drive the car and use up that gasoline. And what I'm saying is when digestion ceases, an enhanced phase of detoxification and cleaning, self-cleaning begins, and it results in symptoms from the buildup of metabolic waste products that occur from a diet that's not sound, that's micronutrient deficient. Because you build up free radicals, you build up advanced glycation end-products. We build up also other toxins that are measured in the urine as aldehydes and people who are obese have a higher amount of these toxic byproducts that are found in their urine. And they feel worse when they're not constantly eating food because they don't tolerate the catabolic phase of digestion. They don't tolerate not keeping their digestive tract busy digesting food all the time.
KIRK HAMILTON: So a craving then is to keep away adverse symptom in a way?
DR. JOEL FUHRMAN: Withdrawal from their poor diet.
KIRK HAMILTON: Right. And how long does it take when you put someone on your high micronutrient dense diet, how long does it take before these - well real hunger comes back and this toxic hunger goes away?
DR. JOEL FUHRMAN: Well people start to feel ill and sickly you know the first three or four days usually. So that, you know we call, in the white belt phase. In other words that's another thing that prevents people from losing weight. They try to cut back on calories, try to eat healthier. And unless you explain the addictive nature of the American diet, they just think well they can't eat that diet. You know so it's very important to understand this science of people who have weight loss success. So the answer to your question is, they start to lose the toxic hunger symptoms maybe within four to eight weeks in most cases. But the real intense discomfort usually leaves them the first week. And then usually within that four to twelve week period they start to be able to be back in touch again with what we call true hunger which is accompanied by salivation, enhanced taste sensation and a throat sensation.
KIRK HAMILTON: How do you keep people then - well how long does it take for them to feel better on your dietary regimen for weight loss or just for improved health so they don't give up?
DR. JOEL FUHRMAN: Well you know the - when people change their diet they stop eating all the high calorie unhealthy food and they start eating salads, beans, fruits and vegetables, berries, mushrooms and onions, start eating healthy foods. They could go through withdrawal like coming off tobacco or coming off cocaine and they could feel headachy and shaky and weak and fatigued for a few days. But like I said for 95% of people those symptoms of feeling ill go away in three days. It might reach its peak on day two. By day three they're not feeling that bad and by day four most everybody's feeling okay again. So the point is for the vast majority it's only a feeling of mild discomfort that lasts a few days. They may not be in touch with true hunger yet but they're not going to feel that ill.
KIRK HAMILTON: How long have you been practicing weight management medicine? And when I say that when did you get an "aha" that you really had a in-road to being very successful, being a weight management specialist?
DR. JOEL FUHRMAN: Well keep in mind I really am a physician who specializes in nutritional medicine. And you know even though the majority of my patients may be overweight, and I've had all these people lose 300 pounds, 200 pounds, 100 pounds, you know so many people lose more than 100 pounds a year, it's really phenomenal. Hundreds of people lost more than 100 pounds, and I have a great reputation and as you know my book "Eat to Live" has a reputation for being so effective for weight loss. But I don't consider myself a weight management physician because I really see people with high blood pressure, who want to reverse it, with diabetes and want to get rid of it, with chest pains and heart disease and don't want to go through bypass surgery and angioplasty. They want to reverse it. With headaches and you know fibromyalgia and pain syndromes and inflammation in other words. I see myself as a family physician who's progressive and uses nutrition as my primary interventional therapy. And the side effect is people achieve their ideal weight and people needing to lose weight lose it effortlessly and very effectively. But it's all in the context. You know I don't want to separate the idea that weight loss is separate from achieving ideal health because they're both the same thing because you can't be healthy unless you're a good favorable weight number one. When you eat in a manner to get rid of your diabetes, part of reversing your high blood pressure, lowering your cholesterol, getting rid of your diabetes has to be getting back to a favorable weight so it's all wrapped into the same program and protocols.
KIRK HAMILTON: What is a high micronutrient dense diet versus let's say you were just on a plant-based diet? Tell me the difference.
DR. JOEL FUHRMAN: Well you know the macronutrients are the calories. Those are the fat, carbohydrate and protein. The micronutrients are all those antioxidants and phytochemicals that really arm the body and protect us against cancer and give the body the -- enhance the body's repair and the detoxification mechanisms. So the point here is that if we look at all the discovered and undiscovered nutrients and we add up all the - and look at all the anticancer nutrients, for example the angiogenesis inhibitors in mushrooms and onions and the aromatase inhibition and the you know in other words all the carotenoids, all the isothiocyanates in cruciferous vegetables, these things have powerful effects to protect (against) cancer. And we can win the war on cancer if people design a diet style that is high in these anti-cancer superfoods like green vegetables, like cruciferous greens, like berries, like seeds. So a high micronutrient diet is - it means that we design a diet so that the preponderance of the food and the majority of what we eat are foods that have beneficial properties to protect the human body against the chronic diseases that ravage other Americans so people don't have to have heart and strokes and get cancer. So it's really like a longevity diet that happens to work phenomenal for weight loss because people don't get hungry and don't feel like eating as much once they start eating so healthfully.
KIRK HAMILTON: You coined a term "Nutritarian" and if you could explain that. And then go into your "Health Equation" that I think is I guess similar to what you just talked about, but explain that for us.
DR. JOEL FUHRMAN: Exactly. I mean you know in other words in trying to describe a diet style a lot of people call my, you know a lot of the people who read the book "Eat to Live" you know they call themselves - it's called the "Eat to Live diet" or they're an "eat to live-er" And I said well that's the name of a book you know let's - what's a really - what's a descriptive term of the type of diet? It's not really vegetarian. A vegetarian or a vegan diet could be very unhealthy. It could be full of white rice and white potato and white bread and sugar and Fritos and potato chips, it could be anything. So a "nutritarian" diet doesn't have to be vegan though it could be. It could be vegetarian or it could have a little bit of animal products, but the hallmark of a nutritarian diet is that it's a conscious effort to eat foods that have the highest micronutrient density. And that brings ups, in other words we're looking at foods as therapeutic, as lifespan enhancing, and a nutritarian is a person who's trying to eat a diet that's protective for their health. And lots of people would consider themselves a philosophical nutritarian. They'd say, "Oh I know eating healthy is good for us, I want to live longer, I want to eat a lot of healthy foods, I'm trying to eat more vegetables." Everybody knows they're supposed to eat more vegetables and mushrooms and beans and things. But I think I want to turn people into actually a practicing nutritarian and show them how delicious this can taste, how fun this can be and how we can enhance the pleasure of your life eating healthy. Not decrease it. This is what people don't understand. This is a fun, you feel great, you age slower, you keep youthful vigor, food tastes better, your taste and smell is improved, and actually you can learn great tasting recipes on how to make nutrient-dense foods taste phenomenal and that brings us to your next question which is H = N/C, the health equation, right? And H=N/C means, the H means your healthy life expectancy. A healthy life expectancy means not just how long you're gonna live, but the quality of your life in your later years. And the World Health Organization sets a criteria and they look at countries around the world and people who live in various locations and they rate their "H," their healthy life expectancy score. And how healthy and how vibrant and how physically active and mobile and have full mental faculties intact and the quality of their life, how much they're enjoying their life. And they find that in America we have the worst healthy life expectancy of the top 25 you know other Western countries, industrialized countries. And I'm saying that your "H," your healthy life expectancy, is proportional to the N/C, the micronutrient per calorie density of your diet. In other words, to have a healthy expectancy and not lose brain function, not have dementia, not get strokes, not have you know chronic diseases of aging, you have to eat a diet with a high micronutrient per calorie density. In other words we have to pick foods that have a higher micronutrient per calorie ratio than other foods and of course an example of a food with a high N/ or micronutrient per calorie density is broccoli or brussel sprouts or kale or bok choy. An example of food with a low micronutrient density might be something like bagels or pasta, sugar or olive oil. And I stuck olive oil in there on purpose because people think that oil is so healthy and I'm saying actually it's a food with a tremendous amount of calories. There's 4000 calories per pound and it's got a very low level of nutrients and leads to obesity and it ages us. So the idea that oil is a health food is just really a myth.
KIRK HAMILTON: And you've ranked them, correct? Is it a MANDI score you call it?
DR. JOEL FUHRMAN: It's an ANDI score. The word ANDI stands for "aggregate nutrient density index" and the word aggregate means we just add up all the measurable micronutrients the US government keeps track of in foods. So instead of giving the food, you know how much vitamin E, how much vitamin C, how much selenium, how much zinc, how much alpha carotene, we just added up all those things that are recorded and give one number to represent it on a 0 to 1000 scale. That gives a good estimate of the total micronutrients per the equal amount of calories for every food.
KIRK HAMILTON: How much of your diet is raw versus cooked food?
DR. JOEL FUHRMAN: Um, well you know there's a lot of leeway there. In other words, so I do want people to eat a big salad every day, at least three fruits a day, so I think you know let's say about 50/50, but a person could do it on a 70 raw 30 cooked, or 30 raw 70 cooked. So I think we do want to emphasize the importance of eating raw vegetables. The exact precise ratio is not as rigid as some other diets.
KIRK HAMILTON: What is a basic "Eat to Live" or high nutrient density diet? If you went from breakfast, lunch and dinner. Just some basics.
DR. JOEL FUHRMAN: Well breakfast might be you know fruit or oats with, you know flax seeds and walnuts and berries and something like that. You know sometimes I just have a piece of fruit in the morning, but lunch might be a vegetable bean soup with a salad with a pistachio mustard dressing, or a cashew sesame orange dressing or something. You know so vegetables, maybe a bowl of soup or salad and maybe you know a soup, piece of fruit for dessert, some cherries or something. Dinner might be some cooked green vegetables with mushrooms and onions with a, maybe a shepherd's pie made with chopped hazelnuts and sweet potato, so all kinds -- so we're trying to make, in other words the highest nutrient vegetables into fantastic tasting recipes. Maybe even a pie or cake made of beets and carrots with dried apples and a Muscat wine with a macadamia nut cream sauce. You know make a delicious dessert. People can use animal products as flavorings, in small amounts as a condiment, but not as a major portion of the you know -- major portion or core portion of the meal, just as a flavoring of something. Make food taste good.
KIRK HAMILTON: We're talking to Joel Fuhrman, author of the book "Eat to Live" and also he co-authored an article entitled "Changing Perceptions Of Hunger on a High Nutrient Density Diet" in the Nutrition Journal in 2010. Could you just briefly go over that study you did and kind of what it said?
DR. JOEL FUHRMAN: Sure. I mean what we did is we tracked 768 people who followed the nutritarian high nutrient density diet. And because when you - well to write something for the medical literature other doctors you know you can talk up all about this all you want, but they'll say, "Ah, you know what, what are you talking about? Maybe it's just thirst, maybe it's just this, that, maybe it's just you know a few people." So having a large number of people track their results was very important and I'm very excited about the publication of that article in the Nutrition Journal." And it's one of the most highly accessed articles in the last couple of months on the web on...from all medical doctors looking at nutrition articles. And essentially we showed that the vast majority, you know 90% of people that changed their diet to be more nutrient dense, with more high nutrient foods has a lessening of their hunger drive and a changing perception of course of the sensation of how they feel hunger leading them to desire less calories. So what I'm saying here, which is very profound and very important here is that it's not about trying to eat less calories. It doesn't work because people as they cut back on calories want to - they're always gonna feel like they want more. That the quality of the food you pick to eat is critically important because it's the quality of the food you eat that make you desire less calories. And only if you desire less calories are you going to be able to stick to something long term and maintain that weight loss forever because the person, people just yo-yo their weight up and down because they're trying...it's like telling the person to breathe less air for a few minutes and they come up gasping for air and like all these diets they can't maintain it because they want more food. And the point is, is that we've found that these people were successful losing weight, successful keeping it off, and lost more weight than any other study in medical history because they pay attention to their nutritional quality of what they eat, not just cutting back on calories.
KIRK HAMILTON: I know you had a history of doing some fasting. I actually reviewed one of your papers in my book about some people with autoimmune disease and water fasting, but I just, do you still do that at all?
DR. JOEL FUHRMAN: I do. I do incorporate fasting for some people with Crohn's disease and ulcerative colitis who need bowel rest you know. And for some people with asthma who go on a high micronutrient diet and we try to get rid of their asthma. Some episodic fasting can help expedite that. So yes, I do sometimes use fasting as a therapeutic tool to help push a person over the hump on to better health because what we're really looking to do is have people with chronic diseases achieve complete remissions and so I use natural...that's an extra tool I sometimes can utilize.
KIRK HAMILTON: Is it a water fast or do you do just juice fast or what...you flip it back and forth or what?
DR. JOEL FUHRMAN: Yeah, you know sometimes with a patient with lupus or asthma we do a water fast. It depends on the condition you know, obviously yes. Depends on the reason why you're fasting. And you know obviously we're talking about if people shouldn't just go and fast on their own and we don't want people who are not healthy to fast either. So in other words if it's medically supervised, if you know what you're doing, and if we're doing it in the proper fashion it can be an important modality to help people facilitate a recovery.
KIRK HAMILTON: Your book "Eat to Live" is one of my favorite nutrition books and I know that the new edition just came out. I just ordered it. And I was wondering if you could just tell us what's new in it and what you added to it that you think makes it better.
DR. JOEL FUHRMAN: Well I added a whole chapter on food addiction and toxic hunger and in other words, the things that we're talking about today in brief I added in detail. Because it's so important to help a person really understand this, and because people even when they read the old "Eat to Live" they would still kind of like be under this idea they have to like force-feed themselves as much food as they can possibly eat. And I wanted to really get the people to get back in touch with the sensation of hunger and let hunger drive their decision of how much to eat and let them actually learn how to get back in touch with their natural instincts and sensation of the body, besides the food quality and quantity. So I think like more attention to that, a lot more of the new research showing how effective you know some of these high nutrient foods actually can dramatically lower cancer rates. So there's a lot of more factors to give people more motivation to eat a diet this way. And of course lots in the interim years of eight years I threw in a lot about a lot of different case studies and a lot of people's success stories in the book to motivate people. Well if this person can lose 120 pounds in 10 months so can I, or 140 pounds in a year. You know and they were on their death bed with heart disease and it melted away, so maybe it could save my life too. So of course adding all those case studies was a lot of fun, too. So research, new information, took out some of the things that dated the book. You know not as much analysis of the diets that were en vogue back when I wrote it in 2003, the first "Eat to Live" and just more solid scientific information.
KIRK HAMILTON: One thing I wanted to get. You know, your diet people would perceive it as a plant-based diet and how much animal food do you allow? Give me a ballpark percentage that you think is reasonably healthy.
DR. JOEL FUHRMAN: You know, because there's a hormone called IGF-1 insulin growth factor 1 that raises when you have significant amounts of animal products and that shortens life span and increases risk of breast cancer and prostate cancer. I really like people to think of animal products as a condiment. So we're saying not more than a couple of - maybe not more than two ounces, let's say, you know. Maybe two ounces three times a week or something. You have a total of six ounces a week, flavor on foods so you make a soup or a salad or something taste a little better. So we're talking about the amount of animal products people might eat in one meal. Like you know four to eight ounces in a meal. I'm saying make that the amount you eat in the whole week. Maybe use it, a smaller amount in a condiment of flavor, a soup or vegetable dish or something like that.
KIRK HAMILTON: How can people find out about, you have a "Getaway" you have books, you have a newsletter? I enjoy your updates, your little news blurbs. How does someone get ahold of you or get on those lists?
DR. JOEL FUHRMAN: Just go right to DrFuhrman.com. You know, DrFuhrman.com, and you know I actually take care of most of my - give people advice and give patients and clients information right through the web, so people can actually join a member site where myself and my medical staff can actually - they can communicate with other people, they can communicate with me. I can answer their questions and it's so much fun because we have people from all over the world supporting each other, motivating, sharing recipes, sharing ideas, making...so people if they have a certain problem they can't - make it so they can't fail and people need that extra support so it's really been very rewarding.
KIRK HAMILTON: Anything else you want to add?
DR. JOEL FUHRMAN: No. I just wanted you know, thanks for the interview. And I love to give the message that people don't have to suffer, they don't to have be sick and they don't have to have heart disease, diabetes, headaches and all these problems. That nutrition really is - people don't understand how effective that nutritional excellence could be to reverse diseases and to give people hope and get back to being healthy again. So that's like a great message for the New Year.
KIRK HAMILTON: Well thanks so much Dr. Fuhrman for taking time out of your busy day. I know you were traveling back and forth, so I really appreciate the time.
DR. JOEL FUHRMAN: Oh my pleasure Kirk. Good talking to you.
KIRK HAMILTON: 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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