Sunday, August 7, 2011

Another dietician's advice

I’ve recently been reading and watching material from Jeff Novick, a dietician who used to work with Dr. Fuhrman and now works with Dr. McDougall.  It’s been interesting to compare advice from all three of these guys.  I think they all offer very healthy eating plans.  The average advice is pretty similar but the ranges are different.   Here is a description of Dr. McDougall’s Maximum weight loss program.  Here is a description of Dr. Fuhrman’s 6 week plan.

From what I’ve read, I think all three would agree that 1-1.5 oz of nuts and seeds per day is an okay amount to eat.  All of their food plans include some nuts and seeds in some of their recipes, and none in others.  They differ in their minimum recommended amounts.  Mr. Novick says you shouldn’t go above 1-2 oz for normal activity, or 2-4 oz for very active folks per day.  Dr. Fuhrman says active people and athletes can go up to 4 oz or more.  Both Novick and McDougall say your minimum can be 0 and I think they recommend that when trying to lose weight.  In Novick’s video on fats, he says you can get all you need from vegetables:  “Where do you think corn oil comes from?”   I’ve asked Dr. Fuhrman explicitly even for small people or overweight people with low metabolism, and he says everyone should eat a minimum of 1 oz of nuts or seeds per day and more active people should consume more.  I find nuts hard to digest and feel better when I stick to under 2 oz per day.  Dr. Fuhrman says that some people need nuts to regulate their heartbeats and I have found that in the past too.  However, I don't need much, as little as 1 teaspoon of flaxseed will do it for me.   Dr. Fuhrman says you need to eat fat to burn fat.  Dr. Mullin, who is on Dr. Fuhrman's staff, explains why:

Healthy fats communicate with your genes in a different way compared to unhealthy fats. Healthy fats bind to receptors called PPAR receptors which improve insulin sensitivity and enhance fat burning. Trans fats do the opposite. 

I'm not sure that fully answers it for me or demonstrates that it's a big effect.  I think women are fat producing machines and that combined with our lower metabolism when we hit our mid-fifties, makes me wonder if we all really need 1 oz a day.  Plus it squeezes out other calorie-rich foods that I might enjoy more.

Regarding sweets, I like the advice of Novick.  He says all sweeteners are the same as far as health goes.  Pick whichever one you want and keep it to less than 5% of your calories—and he includes that with all unhealthy calories including oils, etc.  So he’s saying your total unhealthy calories should comprise 5% of the total, not just your sweets.  This is consistent with Dr. Fuhrman’s “Life Plan”, where he says no more than 10% of your calories should come from less healthy sources.  Dr. Fuhrman distinguishes refined sweeteners (sugar, agave nectar, honey, maple syrup)from dried fruits such as dates and raisins, which are whole foods.  Almost all of his dessert recipes use dried fruits as sweeteners.   I think many Fuhrman followers go overboard with their use of dates and other dried fruits.  I know I did for a while.  I thought it was okay because it was a whole food.  But after a while I realized it’s having the same effect on my body, a sugar surge (probably an insulin surge too), and cravings for more.  Combine this with nuts and you have very high-calorie, hard to digest food.  I once got sick on “healthy” brownies made from dates and walnuts and cocoa powder.  I learned the hard way that I can eat too many dried fruits or nuts.  I tend to agree with Novick and prefer to think of all sweeteners, including dried fruit, as in the 5% category.

With salt, Fuhrman wants you to include no added salt in your diet.  McDougall is more relaxed about it.  He allows people to add salt at the table in small amounts and most of his recipes include some sodium in the form of salt or soy sauce, though it is much less than processed foods have.  McDougall’s advice might be easier to follow and it still cuts way back on salt.  I started out following McDougall’s advice and then eventually decided to go cold turkey, following Fuhrman’s advice.   There is an advantage to this, which is that you taste all the subtle flavors in produce.  I can taste the difference in sweetness from one carrot to the next, and one pea pod to the next.  Even kohlrabi and broccoli taste sweet when your taste buds are sensitized again.  My sweat still tastes salty, so clearly my body has learned to extract what it needs from whole foods. Dr. Fuhrman talks about the many harmful effects of salt in his teleconferences, mainly related to heart disease and stomach cancer and the increased risk of hemorrhagic stroke for people with lower cholesterol.  There are two disadvantages to going without salt completely:  1) Some recipes and especially grains can taste bland.  However, this can be solved with spices or a little sweetening (e.g., carrot juice, fruit, dried fruit).  2) It makes it harder to find acceptable food to eat in restaurants.  Soups are especially bad.  Your best best is salads without dressing or fruit plate.  Unfortunately, these can be pretty lame at a lot of restaurants.

Another way I agree with Novick is that he seems to like simple recipes, and he isn’t a big fan of smoothies and juices and other ways of processing your food.  I think of smoothies, “ice creams”, and sorbets as treats, a once a week type thing rather than daily.  Even carrot-juice sweetened beans and soups I save for special occasions, partly because it’s more work, ha. 

Regarding supplements, I think McDougall and Novick say that you only need to supplement B12.  On vitamin D, Novick says get your levels tested and if you are deficient, take a supplement.  McDougall is anti-Vitamin D and says you can get enough D from exposure to sunlight.  Dr. Fuhrman says that vitamin D is so important to your health (in fighting cancer for one thing) that if you don’t want to take the supplements, get your blood levels checked to verify that you are not deficient.  He says the same thing about DHA.  I'm following Fuhrman's advice on this currently but I kind of wonder if I really need the DHA. 

Regarding animal products, I think McDougall would recommend an all-vegan diet, Novick probably too, though I’m not sure, and Fuhrman says animal products could be included in your 10% of unhealthy calories, unless you have certain conditions such as heart disease and some autoimmune illnesses where an optimal diet is required to reverse your condition.

Then there is the grain/starchy vegetable debate.  Again I think all their recommendations intersect and you can design a diet that agrees with all of them.  Dr. Fuhrman emphasizes eating more leafy green vegetables.  He also emphasizes cruciferous vegetables, onions and mushrooms to fight cancer.   That sounds good to me.   Then how should you fill out the rest of your calories?  I think many Fuhrman followers eat too much fruit and nuts and therefore too many calories (I speak from experience)—and for me, that also leads to a stomach ache which I have no interest in getting.  Novick says it’s better to fill out your calories with starchy vegetables and grains.  Dr. Fuhrman would say the best starchy vegetable to eat is beans.   Novick and McDougall don’t put particular emphasis on beans and include it as one of many healthy options, including white potatoes.  Fuhrman thinks white potatoes are one of the least healthy vegetables and would recommend other vegetables above them.  Fuhrman recommends a minimum amount of beans per day (1 cup).  Novick and McDougall have no such minimum.  Once you get your GOMBS in, (Greens, Onions, Mushrooms, Beans/Berries, and Seeds/nuts), Dr. Fuhrman is fine with filling out your calories with starchy vegetables and grains, though he would prefer you eat sweet potatoes instead of white.

What do I do?   I really like Novick’s advice, which is practical and makes a lot of sense to me.  I think McDougall’s or the Engine 2 plans might be easier to adopt for a person starting out.  I eat a starch-based diet--that is, things like potatoes, squash, corn, beans, intact whole grains like brown rice, quinoa,  oats, and whole grain pastas.   I eat yellow and green veggies (e.g., leafy greens, bell peppers, broccoli, zuccini) but because they are of low calorie density, they don't comprise the majority of my calories.  I eat some fruit, about 2 1/2-cup servings a day.  I don’t like to eat many dried fruits or smoothies or juices, in agreement with Novick, though I put a small handful of raisins in my daily oatmeal.   I like the idea of 5% play calories, even though I usually eat much less.  But I like the idea that I can indulge occasionally if I want to.  That is of great psychological value to me, given the culture we live in. 


Cindy Marsch said...

Excellent post, Barb. It fits my not-so-specific understanding of these guys, and I think your conclusions are pretty sound, too.

kneecap said...

HI Cindy! I'm glad to get your confirmation on this.

Sam At H.E.S.H. said...

I think whole food fat is still the best source of fat for out body. Thanks for sharing this here! :)

Anonymous said...

Weight is still resistant to getting lost! But, Dr. Furhman's plan minus animal products is a plan I cam live with.

Essie said...

This is a terrific post summarizing the basic differances and the wide swath of overlap! :)

Carrie (Carrie on Vegan) said...

This is a wonderful comparison of these diets. I'm an avid Fuhrmanite and I think you represented it well. I've also been guilty of overdoing it with the dates while following Dr. Fuhrman's plan and need to be careful about that. Thanks for the wonderful info!

Michelledw said...

Thanks for writing this post, Barb. Sometimes I wonder if it is foolish to follow one man's opinion out of thousands of others, but I feel better when I'm following an opionion that is shared by a few others out there (even with slight variations between all of them). Nice job!

Suz said...

Wow, what a clear and helpful post. I love your ability to succinctly summarize differences, and add your personal experience. Your blog is wonderful!

kneecap said...

thanks Suz and everyone else for the comments.

Anonymous said...

Very clear and balanced comparison. Good food for thought and helpful. I am like you, find I feel better with more starches. I also have issues with the nuts/seeds - overeating them in my case. Thanks for this great blog post, Barb.