Food Over Medicine: The Conversation That Could Save Your Life

2. THE PROGRAM

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GM: Let’s talk about the optimal diet. There’s a theory out there that we’re all different and we should choose our diet according to our blood type or our genetic makeup or our personality type or our astrological sign, and that the optimal diet is one thing for one person and a vastly different thing for another person. Is there any truth to the idea that different people need wildly different diets, or are we mostly alike in what we ought to be eating?

PP: We’re shockingly alike. The only thing that differentiates us significantly is food allergies. My attorney, who died a couple years ago at sixty-one, was in his fifties when I met him. He had been allergic to cherries, peaches, and apricots since he was five. Well, he could eat a plant-based diet, but since cherries, peaches, and apricots sent him into anaphylactic shock, we kept him away from those foods. That would be an example of a genetic situation; stay away from three specific foods.

GM: Wait a minute. He ate a plant-based diet, but died at sixty-one?

PP: Well, he cheated a lot. He died of noncompliance. He would say he was on a plant-based diet, but he never gave up cheeses and salmon, and he ate olive oil and sweets. One day it caught up with him and he had a massive heart attack. He was a successful man and he liked to live large; as a consequence, he died in an instant. It was a tragic example of how you have to get the whole diet right, not just get half of the equation right.

But with reference to this idea that people are different and therefore some people should eat different types of diets because of their ethnicity or their blood type, there’s no solid evidence. I come to all my conclusions based on medical evidence. If you wonder whether there’s anything to the blood-type diet, do PubMed searches. Anybody can do it. You’ll find absolutely no published evidence indicating that blood type makes a difference in long-term health outcomes. I get very frustrated because the promoters of these blood type diets and metabolic diets and caveman diets have made millions and millions of dollars promoting these programs to patients and the general public. And they spend none of that money on proving their hypotheses. I love the way Dr. T. Colin Campbell, the author of The China Study, put it when he was going head-to-head on the Internet with someone who was criticizing him: “Put your theory to the test because what you’re essentially saying by refusing to do so is that research is a luxury to be enjoyed by some but not required by all.” And that’s a rather insulting attitude to those of us who are serious because I, for one, rigorously adhere to what the science says about all aspects of nutrition. There simply isn’t a shred of evidence that the caveman diet or these other fad diets help achieve or maintain optimal health in populations today. These people are writing storybooks. They may be very interesting, but they’re not to be confused with science. They cite a lot of studies, but a close look shows that they misinterpret them to promote their diet, and they never conduct a single study of their own to prove their case.

Let me give you an example of how storytelling can confuse the issue. When I conduct lectures, invariably I’ll have somebody raise his hand and say, “My uncle ate bacon, eggs, and cheese three times a day and he lived to be ninety-four and died in his sleep. How do you explain that?” And I will say, “I believe you. I believe that happened. But if you delve into the published scientific information that we have, it clearly shows that is not the likely outcome for other people who engage in that behavior.” So that’s a story. It’s probably a true story. It has nothing to do with the advice that we should give to the general population.

GM: You’ve got to love the premise of the caveman diet books, that we should, for some reason, eat the diet of our primitive ancestors. Maybe to prove that civilization has not come that far. I actually have a theory that the first vegan was a caveman who discovered that it’s easier to sneak up on a plant.

Anyway, since we’re shockingly alike as humans, what should our diet be? Let’s begin with fat. What percentage of calories from fat should we have in our diet? There are those who recommend a plant-based diet and emphasize that it should be low-fat, roughly 10 percent of calories as fat. And there are others, even some who recommend the vegan diet, who say no, we need a healthy amount of nuts and seeds and avocados, a higher percentage of fat. And then, of course, there are the diet book hucksters, like Dr. Barry Sears and the late Dr. Robert Atkins, who promote a diet that’s 30 percent fat or more.

PP: Let’s disregard the hucksters because they’re not worth our time. But between the serious scientists advocating a low-fat, plant-based diet and the serious scientists advocating a plant-based diet that’s somewhat higher in fat, I think the answer is in the middle. I don’t like to restrict people more than is necessary; my general recommendation to people is an upper limit of 15 percent, which is still pretty low. It’s very achievable if we get oils out of the diet and use nuts and seeds and olives and avocados as parts of dishes that we eat, but don’t go out of our way to eat a bunch of fatty plant foods all the time. Now, for somebody who has coronary artery disease, or who needs to lose a hundred pounds, we want to get him down to the 9 to 11 percent range in terms of fat, which means he’s not going to be consuming avocados and nuts and olives. I recommend an upper limit of 15 percent and a lower limit of 9 to 11 percent for people who have certain kinds of diseases.

GM: Allow me to cite a mainstream nutritionist: Walter Willett of the Harvard School of Public Health. He argues that low-fat diets show no improvement in health outcomes compared with higher-fat diets; the important thing is to have good fats—polyunsaturated and monounsaturated fat. He cites a Journal of the American Medical Association study published in 2006,1 an eight-year study of more than 49,000 women that he says demonstrated no improvement in outcomes from a low-fat diet.

PP: Willett is not the only person who finds that a low-fat diet does not provide benefit. The problem is his definition of a low-fat diet, and definitions are something that plague nutritional research. In Willett’s Nurse’s Study, for example (I think the government has invested roughly a hundred million dollars in this whole project), the lowest amount of fat these women ever consumed was in the vicinity of 29 or 30 percent! I don’t think any of us who advocate a plant-based diet has ever told anybody that a diet that contains 30 percent of calories as fat is protective against anything. The other thing I’ll point out about Willett’s research and the Nurse’s Study is that one of the ways in which people accomplish a “low-fat” diet is often to eat fat-free dairy products. The detrimental effect of the concentrated protein in those dairy products often overcomes the benefit of any fat reduction, even if it were to reach the target level.

GM: Okay, so let’s say I’m convinced that I should aim for roughly 10 to 15 percent of my calories as fat. How do I execute that? I couldn’t tell you with any accuracy the percentage of calories I ingest is fat. Are you recommending that people somehow count their calories and calculate the percentage derived from fat?

PP: I tell people, if you’re eating according to our pyramid, you’ll be just fine. I can’t teach people to be either calorie counters or nutrient counters because it can’t be done. And I use myself as an example. Today for lunch I had a salad with one of Wellness Forum Chef Del Sroufe’s fat-free dressings and a rice and vegetable casserole. So I had a nice big portion of this casserole and a big plate of salad with dressing. In order for me to tell you how many calories I ate, I’d have to come back here to my office with a database and feed in fairly accurate information about how many pieces of broccoli I ate, how much rice was on the plate, and how much dressing I put on the salad. Of course I would have no clue. So if somebody like me, with my background in nutrition and my resources, can’t figure out what I had for lunch from a calorie and nutrient standpoint, how do we take a busy CPA who’s preparing somebody’s tax return and teach her to do it on a lunch break? It’s obviously not doable.

What you have to do is teach the right dietary pattern. Just stay attuned to the principles of the diet. The only way you’re going to mess it up is if you start treating yourself all the time, or the oils start creeping into the diet and you start eating those items at the top of the pyramid with a great deal of liberalism. But if you stick with the basic food groups that we’re talking about, you’ll get full, you won’t develop a weight problem, and you’ll lose weight if you need to. You just can’t overeat. I couldn’t have possibly eaten another plate of food today; it would have been too much bulk.

THE WELLNESS FORUM’S

Eating Plan

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GM: We’ve discussed fat. How about protein? I find that when people talk about nutrition, their concerns tend to be their weight and their protein intake. Do you find that’s what people are most concerned about?

PP: Those are two major anxieties, but people have lots of misdirected concerns. I have people coming into my office with serious health and weight problems, and they’re worried about the plastic in water bottles and about all kinds of things that may be concerning but they’re hardly the main issue. Americans are very distracted by information that isn’t pertinent at the expense of getting to the information that is pertinent.

People are concerned about their weight, but not enough of them, in my opinion. There’s an interesting phenomenon going on in our country and it’s the way that we’ve simply accepted our increasing weight. When I was in high school, there were more than seven hundred kids in our graduating class and only a handful of them were overweight. Now most of the students in graduating classes are overweight. People who are overweight look around and everyone looks like them; they don’t feel particularly bad about it or feel compelled to do something about it right away. And that’s an insidious trend because being overweight puts you at additional risk for every disease you don’t want to get and for dying from those diseases.

Regarding protein: it’s all but impossible to design a diet that has enough calories every day that doesn’t contain enough protein because protein needs are so low. Excretion studies have shown that protein needs for normal adults may be as low as 2.5 percent of calories.2 Human breast milk, which fuels most rapid growth of humans during our entire time on the planet, contains only 6 percent protein.3 So there’s not much chance of protein deficiency in any diet of caloric sufficiency. I’ve told people, just go to the USDA food database and start entering any combination of foods that add up to 1,500 or 2,000 calories a day; you’re going to see that it’s impossible to become protein deficient eating any combination of food. Our problem, by contrast, is that we eat way too much protein.

GM: What’s the risk there?

PP: We now know that animal protein consumed in excess of what humans need becomes a powerful cancer promoter, based on Dr. Campbell’s studies as reported in The China Study.4 Even if you consumed a really high-protein, plant-based diet, the fact remains that the body’s need for protein is actually very low. So if you consume too much protein, even plant protein, you simply have to get rid of the excess; we can’t store much protein. What the body will do is convert some of the surplus protein to carbohydrate because that’s readily usable for energy. In the process of doing this, the body has to get rid of nitrogen from the amino acid chains, as carbohydrate does not include nitrogen.5As the body releases nitrogen from the amino acid chains, the nitrogen throws off a lot of toxic by-products like urea and ammonia, which are detoxified by the kidneys and liver, causing a lot of stress on those organs.

GM: So we basically have this word—protein—that enjoys a great reputation. We have whole industries that are set up to provide us with an abundance of protein, whether it’s in the form of a snack bar or a highly concentrated protein supplement. And you’re saying that it’s really just a myth that all this protein is good for you? That if protein had the lousy public relations guy that starch has, we might not have all these protein bars in health food stores?

PP: Yes, and we would be healthier. The myth goes back, as I learned from Dr. Campbell, to protein’s origin as one of the first nutrients discovered. A lot of benefit was attributed to it because if you withheld protein from lab animals, they died. It was around 1839 when protein was discovered, and researchers at the time attributed all this magical quality to it. My gosh, without it people will die! And that’s true—it’s a necessary nutrient—but they exaggerated the benefit, especially by assuming that since a little is indispensable, a lot must be salutary. The belief never got corrected, even when evidence began to show that their inferences were wrong. Russell Chittenden did some experiments back in the early 1900s on students eating a low-protein diet and found that they thrived; even the athletes performed better on it.6 But once an idea takes hold and becomes part of the conventional wisdom in the health field, it is very hard to undo. It’s very frustrating. People in the health field are not easily persuaded by facts.

GM: I have a friend who told me that he eats meat for protein to build muscle. I pointed out that elephants manage to grow pretty strong on a diet of plants. This gave him pause. He pondered for a long while and then said, “Yeah, but I don’t want to get fat.”

Muscle builders will generally eat a high-protein diet. They’ll have egg whites and fortified protein foods because they believe it helps them bulk up. Are they right about that, that it helps them develop muscle?

PP: Well, if protein built muscle, if you could build muscle in the kitchen, we’d live in a land full of Arnold Schwarzeneggers. The issue with bodybuilders is something I call error of attribution. In other words, bodybuilders need more food and more calories, but it doesn’t necessarily mean that they need more protein. However, when they start doing aggressive bodybuilding and athletic activities, their coaches and advisors tell them to increase their protein intake; they do and they feel better as a result. But what they’re really doing is adding the extra calories that they need to their diets; they would feel equally well if they ate a diet like the one that you and I eat.

GM: So their muscles could get just as big on our diet?

PP: Yes, because the way muscles get big is resistance training, which is somewhat limited to gender and genetic predisposition. There is nothing that most men can do to look like an NFL linebacker. They’ll just never have that body type, no matter how much they exercise, no matter how much they eat. We do have genetic limitations, but it is possible for somebody with the right genes to become just as big or strong by eating a plant-centered diet. (Interested parties can check out www.veganbodybuilding.com.)

Athletes may be the key to turning popular opinion around because what they do is high profile and they’re always looking for an edge. There are some pretty high-profile athletes who have converted to a plant-based diet and their performances improved. The triathlete Dave Scott was vegan when he won six Ironman Triathlons in the 1980s. Carl Lewis was vegan when he was setting track records, and he attributes his success to the vegan diet. And then there’s Tony Gonzalez, one of the older players in the NFL, who adopted a plant-based diet.

GM: There are more and more vegan athletes all the time. NFL running backs Arian Foster and Montell Owens, boxer Timothy Bradley, former NBA basketball players John Salley and Salim Stoudamire, tennis champion Venus Williams, ultimate fighters Mac Danzig and Jake Shields, and “the world’s toughest woman,” Juliana Sproles, winner of the “Tough Mudder” competition.

PP: Tough Mudder bills itself as the toughest obstacle course on the planet, and it’s now clear, for any who may have had doubts, that you can win it without ingesting any animal protein.

GM: Okay, so an increase in animal protein doesn’t result in an increase in the size of your muscles or in improved athletic performance. What are the differences between animal protein and plant protein?

PP: Well, The China Study shows that the cancer-promoting effect was limited to animal protein. We didn’t see this effect when it came to plant protein, but that doesn’t mean that high amounts of plant protein don’t become problematic. That’s why people need to consume a high-carbohydrate, low-protein, low-fat diet.

GM: So we have an upper limit of 15 percent of calories from fat, and an upper limit of 10 percent from protein. By my math, I’d say we’re talking a lower limit of 75 percent from carbohydrate?

PP: Yes, from whole, unprocessed foods. Legumes, vegetables (including the starchy vegetables), fruit, and whole grains. Fiber-rich foods are the basis of the diet. Not the carbohydrates found in processed foods, fruit juices, and sugar. The label “carb” gets applied in common usage to both unhealthy processed foods and healthy whole grain foods and vegetables; that’s why it’s important to focus on eating whole plant foods and forget about the useless label “carbs.”

GM: Let’s get more specific about your dietary plan. What do you advise that people eat for their three meals a day?

PP: Well, first of all, I don’t advise eating just three meals a day. We have them eat four or five or even six meals a day. I want them to do that for a couple of reasons. The first is that I don’t want people getting ravenous because it leads to overeating. If you eat breakfast at 6:30 in the morning and don’t eat lunch until 12:30, you’re likely to be so ravenous by the time you sit down for lunch that you’re going to overeat. While it’s not that you want to eat when you’re not hungry, you want to eat when you’re beginning to get mildly hungry; for most people, that’s every three or four hours or so. The second thing is that when your blood sugar levels get low enough, if you really wait until you’re out of fuel, you won’t feel or think well. I like to get up in the morning and operate with high-speed cognitive ability and energy all day long; that’s really hard to do when your system’s completely empty. So we like four, five, six meals a day, with smaller amounts of food at each meal than one would consume on a three-meal-per-day plan.

And we like to offer people specific suggestions for what to eat for breakfast. Oatmeal is always good and it’s really simple. Oatmeal and raisins, for example, and a sliced banana. Or I make a fruit smoothie in the morning that has vegetable powders, almond milk, a banana, frozen berries, some flaxseeds, food-grade green tea, and brewer’s yeast. You might wonder what’s up with brewer’s yeast and vegetable powders. I’m all about maximizing my intake of superfoods—chopping up kale and adding it to soup, using romaine lettuce to make wraps instead of tortillas, for example. So I had Wellness Forum Foods develop a smoothie mix with simple ingredients—dehydrated vegetable powders in the morning is a good thing—brewer’s yeast because it is such a concentrated source of several vitamins and minerals; food-grade green tea, which is a powerful source of antioxidants; and flax seeds. Mix in a blender with almond milk, a banana, and some frozen fruit, and you have a nice twenty-ounce drink with fourteen grams of fiber. It tastes kind of like a milkshake with frozen fruit in it. I look forward to it every morning.

I know people who like rice and vegetables for breakfast, so I tell them to go for it. You don’t have to wait until noon or six o’clock to have rice and vegetables. If you want a baked potato for breakfast, that’s fine. We have some strange biases in this country about which foods can be eaten at which times of the day. On a typical day for me, I start with my smoothie and then I’ll have some cereal midmorning. Today I had broccoli casserole and salad for lunch. If I get hungry midafternoon, I’ll have some leftover broccoli casserole. For dinner, I’ll have a great big salad and baked potatoes or rice and vegetables. My sweet tooth sets in during the evening, so I’m most likely to eat fruit for a snack.

That’s the basic plan. It doesn’t have to be fancy. I still love to go out once in a while and eat elegant food, but once your taste buds get down-regulated, you find that you’re perfectly satisfied with simple fare. It’s not that you don’t focus on flavor—the food I eat is really delicious—but I’m happy with baked sweet potatoes and a salad. Steamed vegetables and rice and a salad. Baked potatoes and black bean soup. A lot of simple fare that’s really, really good.

GM: Let’s list the grains that could be the basis of a diet.

PP: Rice, quinoa, wheat, corn, barley, buckwheat, any of them.

GM: Now, wheat is something people generally eat in the form of bread, pasta, and couscous—

PP: Right, but wheat berries are also swell. I wish I ate more of them, actually, because they’re really good. They’re very filling and people generally like them; they’re kind of chewy and have a great texture.

GM: You make it like you make rice. You just boil wheat berries?

PP: Yes, and that’s an important point. People generally know what to do with rice, but they’re less familiar with other grains. People say, “I know how to cook rice, but what do I do with barley or quinoa?” And the answer is, substitute it. You know how to make rice and vegetables, rice and beans, you know how to put a cup of rice in soup—do the same thing with barley, quinoa, buckwheat, wheat berries, any grain. Boil it just as you would boil rice and use it the same way in the meal. That gets people experimenting with different grains. And it’s the simple substitution for rice that gets them to step outside their usual eating pattern a little bit. Later they take it a step further; there’s an abundance of cooking classes and healthy-eating cookbooks using plant-based food. You just have to get to the place where you understand what it is you want to learn how to do. It isn’t eating chicken and fish instead of beef; it’s eating plants instead of animals. And once you get that distinction in your mind and understand that by “plants” we don’t mean tofu hot dogs and fruit juice–sweetened cookies, you’re on your way. We’re talking about whole, unprocessed plant foods. It’s then easy to source out information with that distinction made.

GM: Speaking of tofu, for people who are used to having chicken or fish or meat—high-protein deceased animals—as a centerpiece of their meals, how do you feel about replacing animal protein with tofu, tempeh, seitan, or some other high-protein plant food?

PP: They’re fine. Over time we want to be getting closer to the beans, rice, corn, potatoes, steamed vegetables, raw vegetables, and fruit diet, rather than so much high-protein meat substitutes. It’s also important to differentiate between minimally processed meat substitutes, like tofu and tempeh, versus the tofu hot dogs, fake pepperoni, and other highly processed meat substitutes that are really just vegan-friendly junk food. These junk foods are okay while you’re first transitioning to a plant-based diet, or when you’re going to a holiday picnic, but they should not be part of the daily fare.

GM: Is giving up the traditional meat, chicken, or fish the hardest part for folks?

PP: Well, sometimes they give it up for something even more deadly. At the wedding I talked about earlier, while I was eating a plate of broccoli, everybody else ate veggie lasagna. Now, veggie lasagna, you think, “Hey, that sounds pretty healthy, right? That’s got to be better for you than meat.” This veggie lasagna had four kinds of cheese in it and was topped with a cream sauce. And really there isn’t any red meat they could’ve served at this place that would be more deadly than the veggie lasagna that they served as the centerpiece of the meal.

GM: Four kinds of cheese and cream? That’s not really a whole lot better than deep-fried butter on a stick.

PP: Exactly. At best we’re talking only a difference of degree between what health-conscious, sophisticated people at an urban wedding are eating and the crap that we think only unsophisticated rubes would eat. So the centerpiece of the meal can be something that appears to be healthy and often isn’t. I’ve been at people’s houses when they’ve said, “Oh, we know you’re a vegetarian, so we made a vegetarian meal for you.” And they serve pasta and vegetables. I figure, okay, that’s not bad, how can you mess that up, right? Well, if I take pasta and vegetables and douse it in olive oil, I’ve just consumed enough fat for the week in one meal. So even people trying to accommodate me on a vegan plan mess it up, despite the best of intentions.

GM: Would you say that, in addition to a surfeit of unhealthy ingredients, like dairy products and meats and oil and sugar, Americans suffer from a lack of nutrients that they need?

PP: Yes, and that happens in a couple of different ways, actually. For example, people take in gargantuan amounts of salt on the standard American diet and virtually no potassium. And it’s not just the excess salt that’s the problem; the lack of potassium is a problem, too. So they adapt a plant-based diet, potassium levels go up, salt consumption goes down, and the body is much healthier. People overconsume some nutrients and underconsume others. A lot of people in this country are overfed, but are still malnourished. Also, people who eat the standard American diet generally have pretty messed-up gastrointestinal tracts due to constipation and inflammation. That makes it difficult for them to absorb the nutrients that they’re taking in. So the nutrient deficiencies happen two ways: what they’re putting (or not putting, actually) in their mouths and how much of it actually gets into the system.

GM: Let’s talk about inflammation. Inflammation can be systemic, is that right? If your body gets inflamed, it’s throughout the tissues of the body?

PP: Yes. You could have localized inflammation. You have surgery and the site of the incision becomes inflamed; there are some things you can do about that, and we all understand that. Inflammation can also be generalized, which we can measure with something called a CRP test, for C-reactive protein. It doesn’t tell you where the inflammation is, but the most likely place is the lining of the blood vessels, the endothelial cells that produce nitric oxide and keep the blood vessels open. That’s usually where the inflammation resides, which is why CRP is considered a pretty good marker for a risk of coronary artery disease.

GM: What’s causing this inflammation?

PP: Animal foods contain something called arachidonic acid. In small amounts, it’s really not so bad for you. However when you consume a lot of it, it’s a precursor to something called series-2 prostaglandins, which are inflammatory. Again, it’s good to produce some series-2 prostaglandins; too much, though, and you get some inflammation. So that’s one way some inflammation happens.

Another cause of inflammation is obesity itself. We used to think that adipose cells and tissues were just sort of benign and didn’t do much; now we know that these cells are busy all day long pumping out substances like hormones and inflammatory cytokines. So the fat cells of overweight people are pumping out inflammatory chemicals all day long, leading to generalized inflammation. That’s why it’s so important to address the weight issue. Even a person eating a plant-based or vegan diet can be maintaining extra weight and is therefore still at high risk for lots of health issues.

GM: How does CRP rank as a marker of heart disease compared with cholesterol and homocysteine?

PP: They’re all good markers and they all should be low numbers. Cholesterol should be under 150 mg/dl, CRP should be 1.5 mg/L or lower, and homocysteine under 6 micro mol/L. So you want low numbers all the way around. But here’s the big problem: we’ve gotten to the place now where we focus on those numbers and don’t necessarily care how we get there. People go to the doctor and they’re diagnosed with high biomarkers. The doctor puts them on drugs to bring those numbers down without actually changing the health status of the individual. And what’s the result? A new phenomenon in this country, as Dr. McDougall points out: people dying of sudden heart attacks with great blood work.

GM: The classic good news, bad news kind of thing.

PP: It’s sad but true. Instead of curing the individual, we’re curing his biomarkers. Here’s an example to illustrate how terrible our system is. Tim Russert, NBC News’ political guru, died a few years ago. He had a great job, great insurance, and money. He went to the best doctors and had all the right tests done. He was diagnosed early, which is supposed to be a good thing, right? He was treated for all his problems: he took a drug for blood pressure, statin drugs, a drug to treat his pre-diabetic condition, and a daily aspirin. And he still died at fifty-eight of a heart attack because none of those drugs addressed what was wrong with him: the amount of unstable plaques throughout his arteries from the animal food and fat that he was eating. He trusted his doctors and they offered what Western medicine traditionally offers, which did him no good at all.

On the other hand, you get the critics of the Western pharmaceutical approach, the advocates of a more holistic approach to pharmacology, who say that Russert shouldn’t have been taking those drugs. Instead, they say he should have been taking high-dose cinnamon for his diabetes, hawthorn berry for his blood pressure, and high-dose niacin or red rice yeast extract for his cholesterol. And you know what? He’d still be a dead guy with great blood work because none of those things address what killed him. So, we’ve gotten very carried away with biomarkers. While we need to look at them, we also need to recognize that all methods to bring them down aren’t equal. The only thing that brings those numbers down in a way that matters is diet. The other things change your blood work, but don’t change your health outcome.

GM: I remember when Tim Russert died; all his colleagues talked about what a great guy he was and how they loved going to the ball game with him and having hot dogs together. Of course, they didn’t seem aware of the irony that it was those very hot dogs that helped cause his death.

PP: Right, and unfortunately, he just dropped dead. Other people survive a heart attack and end up going to the average dietician or cardiologist, who tell them to eat fish and lean meats and poultry. Their cholesterol keeps going up, so the doctors say, “Well, you know, it’s a genetic issue.” The doctors put them on a pharmaceutical drug because that’s really all they know to do.

If people really understood, in clear terms, what food did to them, they’d have a whole different attitude about it. I know when people come to my lectures, they leave with a whole different attitude. They don’t all change overnight, but they leave with a different attitude about the whole thing.

GM: What’s their attitude about giving up the animal foods that they grew up eating and have been encouraged to eat all their lives?

PP: Well, first of all, at The Wellness Forum, we don’t ask people to give up animal foods entirely. The Wellness Forum is not an explicitly or exclusively vegan program.

GM: Okay. Why not?

PP: Because I’ve yet to see the evidence that people who eat a low-fat, starch-centered, plant-based diet, while including up to three servings a week of animal foods, have worse health outcomes than people on a similar, but purely vegan, diet. There just is no such evidence. I believe, and my experience with The Wellness Forum confirms my belief, that we will help more people convert to a healthy diet if we espouse a more moderate message, if we don’t scare people away by insisting that they abstain from animal foods entirely.

Now when I say “moderate,” I’m not repeating the shibboleth that everything in moderation is okay, like cheeseburgers and ice cream sundaes; I’m saying that it’s not a dealbreaker to have two or three small servings—three to five ounces—per week of wild-caught salmon or organically raised beef. There’s no wiggle room on the diet; when we say two or three servings, that doesn’t mean four or five or six, and dairy is absolutely out. And it’s important that, if you choose to include two or three portions of animal foods per week, that they be from organically raised animals or wild-caught fish, which in almost all cases is going to mean that you’re going to have to prepare these meals at home.

Let’s not forget that we have this phenomenon of the unhealthy vegan. There are a lot of people who’ve renounced animal foods for ethical reasons. I respect their decision; that’s an admirable reason to give up animal foods. I have no quarrel with their reasoning, but many of these people are no healthier than their meat-eating counterparts. They’re living on veggie cheeses, fake meats, olive oil, margarine, potato chips, and French fries. You’ll be much better off from a health standpoint if you eat according to The Wellness Forum program, even if you choose to include two or three portions of organically raised meat per week, than if you eat a fat-laden, nutrient-poor vegan diet.

GM: I’ll accept that yours may well be the most effective approach to getting people to convert to a healthy diet; I just won’t go so far as to actually endorse eating any animal foods, since I believe that the optimal intake of such foods is zero.

People make their dietary decisions based on lots of factors, including convenience, taste, and habit. And to the extent that for any or all of these reasons, people decide to continue to consume some animal products in accordance with The Wellness Forum guidelines, I have no issue with that. But for those who are making their dietary decisions strictly based on health concerns, here’s what I would say: there is no direct scientific evidence that small amounts of flesh foods in the diet will have a detrimental effect on your health or your longevity. Indeed, some of the longest-lived populations, like the Okinawans, eat fish. But since we know that all flesh foods, including fish, have no fiber, are high in fat and cholesterol, are high in sulfuric animal protein, contain no antioxidants, and have no carbohydrate for the fueling of our cells, we might want to deduce that if you consume a little of it, to the extent that it affects your health at all, it might be in a negative way. At least, that’s my reasoning.

PP: Glen, you’ve made a personal choice. What you’re saying is, “It’s better for me to have no animal foods at all.” I’ve made the same choice. I just don’t want to say that’s the only choice available, or that one has to make that choice in order to achieve and maintain optimal health.

GM: Do you come across people who say, “I can try this Wellness Forum diet, but only because I can still have my chicken or fish a couple of times a week”? And then a year or two later they go vegan?

PP: Yes, lots of them. We call them the accidental vegans. We can almost tell in advance who they’re going to be. It’s an interesting thing; it’s the people who are most likely to draw the line in the sand and say, “I don’t want to be a vegan!” We tell them that we’re not asking them to be vegan. And then they make that decision on their own later on and announce it proudly. I’m an accidental vegan myself, by the way.

GM: Are you?

PP: Yeah. When I first converted to this diet, I still allowed myself to have fish a couple of times a month. I did that for a while and then more or less forgot about the fish. One day I woke up and said, “Huh, I don’t think I’ve had fish for six or seven months.” And then I thought, “Well, apparently I don’t miss it, so I don’t think I’m going to have it anymore.”

GM: Let’s stipulate that people are drawn to the vegan diet not just for reasons of health but also out of concern for the treatment of animals and for the environment. Half of the United States right now is suffering a severe drought; the grazing of animals contributes to drought by reducing vegetation, from which water transpires.7 Animal agriculture has been determined by a United Nations report to be the world’s leading source of greenhouse gases,8 and it’s a leading cause of water pollution; in countless ways, it’s creating an environmental nightmare. But I think we can also agree that the animal agriculture industry would worry more about 30 or 40 or 50 percent of the population scaling back to just a couple of servings of meat per week than it would worry about 1 or 2 or 3 percent of the population going strictly vegan.

PP: If half of the country ate animal food only a couple of times a week, and only organic animal food, the factory farms would be gone. You’d have some humane, small operations out there, but factory farming would not be remotely sustainable with such reduced demand. And if we could encourage millions of Americans to eat this way, the improvement in their health will encourage millions more, and a tipping point would be reached. And from that pool of enlightened people, there’s no telling how many accidental vegans might be created.

GM: And we do know for a fact that when people eat this way, others are inspired to join the fold because the effects are dramatic.

PP: Absolutely. People who have gone through The Wellness Forum program have improved the quality of their lives enormously, extended their lives, and brought new life into the world against the odds.

GM: Against the odds?

PP: Many of the members of The Wellness Forum have been women who were unable to conceive until they got on our program. We’ve had about a hundred babies delivered to women who hadn’t been able to conceive or who had had one or more miscarriages until they found us.

GM: That’s something I didn’t know. This diet can help a woman conceive?

PP: Absolutely. I say that for two reasons: a lot of anecdotal evidence that I’ve seen here at The Wellness Forum, and clinical studies that demonstrate that the proper diet can help a woman conceive.9,10,11

GM: And bring more plant eaters into the world?

PP: I certainly hope so.