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Many of you have returned from holiday travel, or perhaps you're about to embark on your last trek of 2022 or the first one of 2023. All of our new year's resolutions abound, this is a period of rest, reflection, family, and perhaps an overindulgence or two. It's also a time of year when sickness rears its ugly head and we're more concerned for our immune systems. Something for which we should probably be concerned year-round.
To open this discussion in our quest to develop super immune systems, I'm honored to be joined by Dr. Joel Fuhrman. Dr. Fuhrman is a Medical Doctor, Board Certified in Family Medicine. He's a seven-time New York Times Best-selling Author and internationally recognized expert on nutrition and natural healing.
Dr. Fuhrman specializes in preventing and reversing diseases through nutritional methods. He shares his learnings broadly through his writing, speaking engagements, and guest appearances on shows like this one. He wrote the book, Super Immunity: The Essential Nutrition Guide for Boosting Your Body's Defenses to Live Longer, Stronger, and Disease Free. Dr. Joel Fuhrman, welcome to the show.
I'm excited to be here.
It's so great to have you. I have been a fan of your work for some time and piecing through this particular book because I wanted to interview you specifically about the immune health that people build throughout the year, not just in the holidays. I didn't realize at the time I started that this was written back in 2011, but it feels so prescient now.
The reality is every bit of this book could support people in a time like this. There's this little byline at the bottom, "No shots. No drugs. No sick days." Taking a personal day now and then is a healthy thing, but I'd love to know as we get started, what inspired you to write this book back in 2011 and what you're working on now.
Even the World Health Organization back then predicted a spike and recorded a tremendous growth in people suffering and dying from infectious-related ailments, which has continued now. We're talking about ailments other than COVID. The number of infections has climbed as also infectious-related deaths. Also, infectious-related deaths other than COVID from many different reasons. One is the overuse of antibiotics, making more super bacterial strains. Another is the deteriorating nutrition of our population, the growing waistlines, the fat cells, suppression of immunity, and how overweight people have abnormal immune systems.
There's no such thing as a healthy overweight person. That's a myth because as you get heavier and eat excess calories in foods that are low in nutrients, you dilute the density of the nutrient levels in your cells. You also suppress immune function, natural killer T cells, all the white blood cells, and create chronic inflammation in the body. Fat cells spew out lymphokines, cytokines, and reactive oxygen species, which keeps your immune system hyperactivated all the time. When you're then exposed to a microbe, then you can react because it's like keeping the flashlight turned on all the time. It doesn't work very well when you need it.
The other thing I'm saying is that Americans and much of the modern world are ubiquitously deficient in micronutrients, particularly the antioxidants and phytochemicals found in colorful plant foods. The intraepithelial lymphocytes that build up on the wall of our digestive tract behind the villi and the small intestines are the defenders of the gates of the castle. Those intraepithelial lymphocytes have a robust protective function against toxins, microbes, viruses, and mold. They get atrophied in response to the processed foods that people eat and they grow and get healthy in response to a high intake of green vegetables.
We are green vegetable-dependent animals like the other primates. Our immune system doesn't function normally if we don't eat a lot of green in our diet. I predicted, as you can see, way before COVID, that these new infections emerge in the modern world and will happen in another 5 years or 10 years from now. Another new infection that the human body is not used to will emerge and kill another batch of people. We can't suddenly build a great immune system by taking a supplement, something right away, taking a drug, or an antiviral. We have to have a good immune function that takes months or even years to build through excellent nutrition.
We have to have a good immune function, which takes months or even years to build through excellent nutrition.
I wanted people to control their health destinies and also let them know that this explosion of cancer-related deaths doesn't have to happen. Cancer is a relatively new phenomenon in human history and it doesn't have to happen to you and us. We can arm our bodies against viral infections, bacterial illnesses, and cancer. It's not inevitable. We're not helpless. It's not just attacking us. It's not predominantly genetic.
We can talk about how we can win the war on cancer predominantly through nutritional excellence and removing environmental toxicity and chemicals in our environment. Cancer has a lot to do with exposure to asbestos, smoke, toxins, and chemicals, but also the body's ability to remove toxins and eliminate them before it comes and damages the tissues are totally dependent on the nutritional state of the host.
You mentioned in your book that Americans and much of the Western world overconsume protein to the tune of about 100 grams of protein per day. In fact, most protein shakes that bodybuilders and other athletic leaning people will consume start around 20 to 30 grams of protein in a single-serving drink. Those products are often also ameliorated with something to our systems, but the argument you're making is that when we go to animal proteins first for all of these things, we have worsening health outcomes and stimulate something called IGF-1. Can you talk a bit about that and why we should be thinking about our diets a little bit differently, specifically as it relates to building a strong immune system?
First, let me say that as a starting point. If you were to ask me, what was the most profound and important evidence from the scientific literature and nutrition for several years, it would be all the studies that corroborate each other that show that as animal protein increases in the diet as a percentage of its total calories, so does premature death in proportion. We're talking about an increased risk of both heart attacks, strokes, and also cancer deaths.
Premature death is defined as people dying before the age of 70 and later life deaths are people defined after the age of 90. We're talking here about the combination that protein regulates lifespan through various mechanisms. One is IGF-1another is TMAO or trimethylamine N-oxide. It is leading because of endothelial inflammation from bacteria in the gut that grows in response to high animal protein diets. I'm not just talking about animal protein. We're talking about plant proteins. The studies show that as plant proteins increase in the diet, we see more later life deaths and longer lifespan, and intake of plant proteins are linked to being a healthy centenarian or pushing the envelope of human longevity.
It's not that protein doesn't matter. It does matter, and having adequate protein does matter, but we're trying to achieve more adequate protein from plants as opposed to protein from animal products, which says to us that we want to reduce animal products and increase plant protein sources. The foods that are primary sources of plant protein are green vegetables, beans, legumes, nuts, and seeds. Foods like green vegetables, beans, nuts, and seeds that are high plant protein foods show a close association with extending the human lifespan in our species.
I always make the joke, "If you don't like green vegetables, you better live close to a hospital," because we're a green vegetable-dependent animal. Our immune system is dependent on it. The NRF2 transcription proteins are predominantly fueled by antioxidants, particularly by the isothiocyanate or the ITCs in green cruciferous vegetables.
Also, the sulfoquinovose from lettuce fuels the growth of the healthiest type of gram-positive bacteria in the gut, which sets the stage for the body's natural immune function. Simple foods that people don't even think of as being superfoods, like green lettuces and cruciferous vegetables mixed together in a salad, have incredible power to raise human immune function and to establish what scientists call gene silencing.
Gene silencing means the body has the ability to recognize abnormal gene sequences, either inherited or acquired, and silence them so they don't express and cause damage. If the intake of green vegetables and isothiocyanates in the diet is sufficient, even genetic defects like the BRCA1 gene and GSTP1 gene that increase a woman's risk of breast cancer are silenced and don't create an increased risk of cancer in people that have adequate green vegetable consumption.
You also mentioned in the book that sometimes when people hear all this information, and start to buy in and say, "I'm going to make a shift in how I consume foods. I might not have thought before of my spinach as being a protein source. I would've thought it was cellulose and some other micronutrients," but understanding that it too has proteins in it.
Animals that are high utilizers of protein like elephants, giraffes, and gorillas all get the protein from green vegetables, which are mostly protein, not carbohydrate or fat. Their greens are high-protein foods.
We've been taught something that's simply not true, but you mentioned in the book that often people will make the shift and they'll do so somewhat dramatically like, "I'm going to cold turkey. I'm going to stop eating chicken. I'm no longer going to eat fish." They might feel worse for a little bit so they give up and go back to their old ways and diet, and they're eating the bagels and the lox, and the meats that they might have eaten going through the drive-through or whatever.
They're right back in their old patterns. Can you talk about why that happens? If there are any ways that we can approach this so that we might lessen the impact and improve our chances of success, if we're trending towards vegan or mostly vegetarian, following the research and what it has to say about health and longevity?
The point you're bringing up right now is crucially important for people to recognize and that is that when you are smoking cigarettes three packs a day and stop smoking cigarettes, you don't feel better when you stop smoking. You feel worse when you stop smoking because the body regains the ability to remove the buildup of obnoxious agents that are going to kill you from the cigarette smoke.
Often smokers develop a cough that's chronic for a while when they quit.
The body sets into motion, a series of events to try to heal and reconstitute damaged tissue from smoking. When you're healing damage, your body's mobilizing toxins and you're feeling lousy and even fatigued. When you stop heroin or any drug, being an alcoholic, eating fast food, or overdoing protein poisoning, you start to eliminate this nitrogenous waste that builds up in the body and age. We're talking about urea, ammonia, uric acid, and excess nitrogen because it becomes toxic.
People who think they're hypoglycemic don't feel well when they detox from excess nitrogen, but they have to keep the high-protein food coming in. They become addicted to high protein because they feel worse when they're stopping. It means it shows the damaging effects of something that's toxic. You don't feel sick when you stop broccoli. You feel only sick when you stop doing something that's harmful or self-destructive. You temporarily feel bad.
The good news is that those feelings of increased fatigue, agitation, or even mild headaches only last for 3 or 4 days. By day 5 or 6, that's gone, but if you're going to see and go take 2, 3, or 4 that you're not feeling better, then it's good you're feeling worse because feeling worse means you're getting better and feeling better means you're getting worse.
In other words, in the short or long run, you're going to feel great about eating healthfully but immediately temporarily feel worse. Anything that makes you change symptoms very rapidly is usually toxic. We learn in medical school that drugs are poisons. They're toxic. That's why we're trying to control their use with prescriptions even though doctors don't, they over-prescribe, but drugs work by blocking, interfering, or poisoning natural body action. I can give you a natural herb that can speed up your heart, slow it down, put you to sleep, wake you up, make you urinate more or less, or kill an infection, but the efficacy is proportional to its toxicity.
For example, I can give you a drug to stop your headaches like Esgic, Wigraine, Vanquish, and Fiorinal which the active ingredients are narcotics, barbiturates, and caffeine because they push the poisons back in, making you feel better. That then sets the stage for a chronic headache syndrome from taking these drugs. We're saying the toxins coming out is the repair, the healing, and feeling worse is the healing. Most people overeat calories because they think fatigue is a sign of hunger, and it's not.
Fatigue is a sign of detoxification from a poor diet. This is why people can't lose weight because they eat for energy to keep their energy up because when their body is toxic or doesn't have enough nutrients and in a high level of metabolic waste like reactive oxygen species and advanced location end products, as they build up more metabolic wastes, those elements are repaired or removed in the non- digesting when you finish digesting food.
The minute a person finishes digesting, they start to feel fatigued. They got to eat again to get back into the digestive cycle again to stop the healing of the detox. This is important to recognize that you shouldn't be eating in response to fatigue and that fatigue will go away. That's why you have to eat so healthfully and put nutrients in the body so you don't feel fatigued or detox between meals driving you to overeat. When you switch your diet from one that's not as healthy to one that's significantly healthier, you might temporarily feel worse for 2 to 4 days.
You coined the term nutritarian, which is my new favorite health-related word. I wanted you to have the opportunity to explain the concept. People will automatically get it, but I love it and I feel like you should define it for us.
What's a good word for describing a diet that's super healthy and that you can't define by whether you're a plant vegan, eating the animal product, high carbohydrates, or low fat? The best way to describe a very healthy diet is nutritarian. It has to do with achieving a high level of nutrient density in your diet to therefore achieve high nutrient density in your body's tissues. We have to have adequate nutrients in the body's tissues and we could measure that.
We can measure nutrients in the body's tissues with a skin carotenoid scanner to give you an idea of your skin carotenoid concentration. We find that as people eat diets that are richer in nutrients, their body's tissues become richer in nutrients. As people lose weight, their bodies can increase the nutrient density of their tissues because rather than fat cells sequestering nutrients and diluting the nutrient load in your body, you have the same nutrients in a smaller vat of tissue.
The combination of getting to a favorable weight and eating healthier increases the nutrient density of our tissues. Diets of all descriptions fail and people aren't comfortable eating fewer calories so they're driven to overeat because the nutrient density of their diet isn't adequate. Even though we're striving for a diet with a good nutrient bang per caloric buck, I'm also saying that striving for a high nutrient bang per caloric buck makes you satisfied with the right amount of calories.
You can therefore eat instinctually. You can eat the number of calories you desire, but the number of calories you now desire is not excess anymore. It's what the body requires and no more. If you're requiring excess calories, then you're eating improperly because you're wanting more calories, and the food is very addicting. People aren't even responsible for their being overweight. We have a toxic food environment that turns them into food addicts because we're eating the wrong foods. When you eat the right foods, then you would gravitate towards a favorable weight and not want to eat excessive calories.
People aren't even responsible for their being overweight. We have a toxic food environment, which turns them into food addicts because we're eating the wrong foods.
A nutritarian is a person who's eating healthfully and at their ideal weight or they're eating healthfully and moving in a direction towards their ideal weight every single week. If they're remaining overweight or gaining weight, then they're not on a nutritarian diet because their diet still needs a lot of tweaking to achieve good health.
Paging through the book, you do also include some actual recipes, everything from salad dressings to encourage people to eat more vegetables in their raw state, but you also make comments about what you would need to consume in a day to get to 50 grams of protein. It wasn't that much in my mind. A few cups of vegetables and some fruits, and make sure you get a cup or so of beans in your meals for the day. That could be kidney beans you throw on your salad, lima beans later, or something in a soup. I would like for you to talk about this so people get an understanding of what you might consume in a day while on this.
As you may know, I have this acronym GBOMBS and which stands for the foods with the most scientific evidence for powerful anti-cancer effects and promoting human longevity. The same foods that protect against cancer also fight off infection-related deaths at the same time. There's not one diet that prevents cancer and another diet to prevent long-term COVID, deaths from COVID, harm from COVID, harm from pneumonia, or harm from flu. It's the same dietary elements, foods, and supplements. The same immune-boosting substances have the effect to fight both.
The GBOMBS stands for Greens, Beans, Onions, Mushrooms, Berries, and Seeds. Berries can include things like cherries, pomegranate, loquats, kumquats, and other low-sugar fruits, but predominantly berries. It's very critical to eat seeds like flaxseeds, chia seeds, and hemp seeds as a source of immune-boosting foods that have dramatic protection against cancer and other beneficial effects. Mushrooms have tremendous power on improving immune and gut function.
They're very low in calories too.
These are all foods that people can eat in larger amounts and enjoy what they're eating. Lose weight without eating thimble size portions of food, but I want to say this one sentence to have people write it down and memorize it. It's what you said about raw vegetables. Raw vegetables have the most consistent and powerful association with the reduction of cancers of all types. The mantra is, "The salad is the main dish."
Raw vegetables have the most consistent and powerful association with the reduction of cancers of all types.
That means at least once a day, eat a big salad in a nine-inch bowl, not a six-inch soup bowl, and put in lettuce, cruciferous greens, red onion, and chopped scallion raw. Use a dressing made from nuts and seeds with tomato sauce, all kinds of oranges, cashews, toasted sesame seeds, blood orange vinegar, lemon, or all different dressings that are made from nuts and seeds. Nuts and seeds facilitate the absorption of anti-cancer compounds. In their own right, they're very lifespan-enhancing by themselves.
People automatically think that when they're going to eat salads, they're going to use a salad dressing. One of the things I often speak out against is the overconsumption of salad dressing because it's a lot of omega-6, generally speaking. You go to the grocery store and it might say olive oil or avocado oil on it, but it's got canola oil, soybean oil, safflower oil, or one of the other highly processed omega-6 oils that increase your inflammation levels and makes it harder to get to that omega-3 to omega-6 balance. You have a food pyramid in this book too, which puts oils up at the very top where you're telling people to consume a lot less oil. Can you talk about that?
Number one, I'm saying that the consumption of raw nuts and seeds is probably the most proven methodology in the history of nutritional science to lower heart attack rate and cancer rates and extend human lifespan to replace oils with whole nuts and seeds. We give something more credence or some theory when there are numerous studies from around the world with different researchers that all show the same findings with large numbers of people looking at hard endpoints.
The hard endpoints they looked at here were death, age of death, and death rates. As paired to a soft endpoint might be, "Your cholesterol went down. Your triglycerides improved," but a hard endpoint was how long you live because smoking cigarettes can make you lose weight and improve your triglycerides, but it's going to cause premature death. Taking statins may lower your cholesterol but they may increase the risk of diabetic-related deaths.
In other words, we have to look at hard endpoint studies. Nuts and seeds consumption shows a 40% reduction in cardiovascular death, which is unheard of for any intervention. The oils also are 100% bioavailable and they're an appetite stimulant because so many calories rush into the bloodstream so rapidly. They stimulate the appestat in the central nervous system in the hypothalamus.
The dopamine centers in the brain are stimulated. It'll make you more dopamine insensitive and want to eat more calories. Oils are an appetite stimulant. They're concentrated calories. They're linked to overweight gain. Whereas nuts and seeds, the fats are absorbed more slowly, the body can preferentially burn them for energy, have more effects at ratcheting down the appetite, and their calories are not all biologically accessible. The calories are lost in trying to digest them. They also attract fat in the gut and LDL cholesterol to be sucked out of the bloodstream into the gut for elimination in the stool lowering cholesterol and particularly oxidized LDL.
We're talking here about using the judicious use of nuts and seeds and removing oils from the diet where I'll make a Thai curry sauce by using nuts and seeds with lemon grass, turmeric, and curry and making a delicious salad dressing I mentioned with a navel orange with blood orange vinegar, lemon, cashew nuts, and toasted sesame seeds blended together or making an almond dressing with almonds, sunflower seeds blended with the rich tomato sauce with sundried tomato, roasted garlic, and some black thick vinegar in there. In other words, we're making delicious dressings. The inclusion of nuts and seeds with the vegetable-based meal facilitates the absorption of the anti-cancer nutrients from the meal 20 to 50 times as much as eating a salad without a dressing.
One of the hallmarks or one of the most important features of a nutritarian diet is that the fat comes from nuts and seeds rather than from animal fats and oils. The American diet or Western world gets its fat from animal products and oils. Nutritarian gets their fats from nuts and seeds in avocados. Not the avocado oil, it's the avocado. Not the walnut oil, it's the walnut. Not the pistachio oil, it's the pistachio nut. We're also paying attention to the omega-3 omega-6 ratio.
Two ways, 1) we want half our nut and seed intake to be the high Omega-3 fat nuts we're talking about walnuts, hemp seeds, flaxseeds, and chia seeds being half the intake of nuts and seeds. The other half can be pistachios, pecans, cashews, and other ones. 2) For people who are overweight, we're moderately using nuts and seeds two ounces or less, except if you're an athlete or need more calories or have more.
When we're monitoring the omega-3 index in the blood, make sure that you use an algae-based omega-3 fatty acid and make sure your omega-3 index is at least 5.5 because numerous studies show that now in the lower quintiles of an omega-3 index, you not only have more risk of brain shrinkage, dementia, and brain susceptibility toxins like that can cause Parkinson's, but you also have reduced immune function, ability to keep toxins out of the brain and shorter lifespans with lower omega-3 indexes.
The question is, is it possible to have a plant-based diet with a high level of exposure to phytochemicals and still keep these toxins out of our body and keep the omega-3 index in the most favorable range? With no deficiencies present, make sure there's sufficient zinc, B12, D, K2, iodine, and omega-3 and still have a diet rich in phytochemicals and antioxidants and it's protein adequate because it's not a rice-based diet or a fruit-based diet, but we're doing using a lot of different types of foods, going for a lot of nutritional variety. Nuts and seeds add more protein. Bean which then makes this diet protein adequate for a child, a toddler, or for an elderly person with lower protein bioavailability and digestibility.
In other words, we're saying here that in the middle ages, people are so efficient at digesting protein, you can be more sloppy and people can get away without having much protein, but when you're a growing child or a person over the age of 80, you need to make sure you have protein adequacy, especially on a plant-based diet. Some of the diets where people are doing okay in their middle ages would not do well as they age unless they have enough high-protein plant foods that we're talking about here, like green vegetables, beans, nuts, and seeds.
There are certain foods in the book that you described that require extra chewing. Some might require being steamed to make it easier to chew and digest, too, like broccoli. I wonder if you could comment a bit on that. I then want to dig into specifically the deficiencies that we need to watch out for on a vegetarian or mostly plant-based diet.
One, the two foods that the anti-cancer effects are tremendously magnified based on how will you chew them or the cruciferous family because they house the enzyme myrosinase in the cell wall. The myrosinase enzyme gets broken open as you chew it. The better you chew it, the more ITCs are formed. The ITCs are the most powerful anti-cancer nutrients in the dietary landscape. If you're having kale, arugula, watercress, bok choy, or broccoli, we want to have some of that raw in the salad, but some of it conservatively cooked so it's not overly cooked so the myrosinase enzyme is not deactivated. Nevertheless, we want to try to chew it to liquefy it in our mouth to break open every cell.
If you swallow the salad with a lot of pieces and swallowed it whole, you're going to lose the vast majority of potential anti-cancer nutrients compared to a person that's mindfully chewing and trying to liquefy in their mouth as much as possible. The other food that has the same effect are onions and scallions have an enzyme called alliinase.
It's the same as garlic.
Raw garlic is so strongly flavored that most people get most of their alliinase from eating onion, but if we cook it, it deactivates it. People know when they cut an onion, it forms sulfenic acid. It's the alliinase enzyme that's forming the sulfenic acid and the organosulfur compounds that prevent cancer. If you cut a cooked onion, you are not burning your eyes or tearing. It's cutting up the raw onion.
The point is to encourage people to put half an onion, cut it up small or a couple of scallions in their salads, and chew them very well to fully activate those beneficial anti-cancer compounds. It's a very powerful compound. When those compounds mix in the mouth and you chew them well mixing with the bacteria in the mouth and gums in between the teeth, you produce more nitric oxide, which also promotes longevity, lowers stress, dilation, vasodilatory effects, and anti-inflammatory effects in blood vessels.
The body works at the highest degree of efficiencies when you're chewing these things well and eating them raw, and then when we cook them, we're using cold blending. If I'm going to add leeks and onions to a soup, I'll blend it cold in the blender and lay a little soup liquid and then I'll let the chemical reaction occur in the blender. It'll break open the leek and onion into puree and then pour it into the soup to cook.
If I cook the onion first and then puree it, it wouldn't form as many anti-cancer compounds, but the anti-cancer organosulfur compounds are resistant to heat once they're formed, but they're sensitive to being destroyed if you heat the vegetable up too much or cook it before you break it down the cell wall. I might throw collard greens or kale into the blender, make a green puree, and then pour that into the soup to cook.
I'm Italian and I grew up with an Italian grandmother, teaching me to cook in the kitchen. She always said, "You have to crush the garlic before you cut it as one of the things that they automatically did as a part of the culture. You crushed the piece with the knife and then you would chop it up before you'd cook it." By crushing it, you're doing that as well. You're enabling this to form.
You have to break those. We're talking about the two families, the allium family, which includes onion and garlic, and the cruciferous family, which includes broccoli, cabbages, kale, collards, bok choy, Brussel sprout, arugula, watercress, and all those anti-cancer green vegetables.
Dr. William Li came on this show. He's a New York Times Bestselling Author as well. He wrote a book called Eat to Beat Disease and he spoke about the power of beets but also having the same issue where to get their full power, you need to fully masticate them, chew them very well, or even juice the beet to get that full potential from that vegetable which I thought was interesting. I didn't know it before. I learn something new every day.
We maximize the healing potential and elements of an immune building, when we have a diversity of foods in our diet, a wide diversity of natural foods chewed very well. That means a diet that contains a big salad every day. We want a salad, soup, and cooked vegetables because there are some foods that we absorb and do better when they're in the cooked form, particularly mushrooms and beans, their nutrients are better absorbed cooked, whereas the greens and the onion are better off raw. You can have them cooked as well, but you still should have some raw. I'm saying yes to utilizing those foods cooked. Beans and carrots are an example of foods that can be eaten both raw and cooked and you get benefits from having both types.
Before we dig into favorite supplements and the things that you recommend people check their levels of, especially if they're vegetarian and diving into that whole subject, I would like to know your perspective on a couple of diets that might be fads but which have gained a lot of traction and steam over the past few years. One of them is the whole30, a keto-related diet, and a more recent one, the carnivore diet. What would you have to say to somebody that's considering one of these perhaps extreme diets?
There's an overwhelming amount of evidence that is not even in the field of a hypothesis anymore. We know for a fact that those people following those dietary protocols are dying at a younger age. Even though this might be some initial benefits for a person with diabetes control or glucose control, on a keto diet, they're still going to result in too much-increased risk of cancer and other problems that accelerate death.
There are foolish diets, but there are a lot of people who have bizarre belief systems and political views, I don't think there's a strong popularity even though there are some extremists who've advocated a carnivore diet. Don't forget, we have hundreds of thousands of nutritional scientists the world over. We have the growth of the American College of Lifestyle Medicine, and tens of thousands of physicians that use nutrition and lifestyle medicine to help people get well.
No nutritional scientists advocate those ways of the carnivore diet or a high meat diet. All nutritional scientists know from the overwhelming amount of evidence from thousands of studies. I've reviewed more than 30,000 studies on this subject and I put probably 2,000 of those references in my most recent book, Eat for Life. Modern references show an increased risk of premature death with higher amounts of animal protein or diet in a dose-dependent relationship.
The keto diet is trying to keep your carbohydrates low enough to form ketosis means you have to heat carbohydrates below 30%, usually below 20% of calories. Those diets as you move below 30% of carbohydrates in the diet, you see dramatic increases in your early life death as well. Both are causes of death. Those diets are not good for people's long-term health.
That's not even a controversy anymore. People are so indoctrinated into their belief systems and they want to do what they want to do and they look for any person that's going to support them in this dangerous or bizarre way of thinking. Those are dietary belief systems. They're not science-based nutritional programs because there's too much overwhelming science now to show that, as a primate, we are dependent on eating an assortment of foods and plant colors to slow aging and maximize the human lifespan. There are no various avenues to be a healthy centenarian.
I'm saying the human lifespan should mostly fall between 95 and 105. It should center around 100 years old. If you want to have your full mental faculties past 95 to 100, I'm even suggesting 97 to 107 would be achievable if people adopt healthier eating styles and didn't wait until earlier in life. If the only way you can achieve having a healthy mind and body at that age is having exposure to a large number of plants and reducing animal product consumption. All the blue zones and long-lived centenarians are all people with higher plant intake. We're seeing this as very well-studied information at this point.
When you're talking about getting to that ideal of being in the blue zone yourself or creating the blue zone in your home, I would like to better understand what roles some of these other animal products like dairy in the whole picture. Some people will make the leap and say, "I'm most of the way to the plant-based but I'm still consuming cheese and milk in my coffee and things like this," and what would you say to those individuals?
First of all, I wanted to make it clear that even though the blue zones around the world are eating healthier than Americans eat and they generally live 8 to 10 years longer. I don't use the blue zones as the representative of the gold standard of eating because it's what people are eating culturally and what they grow in those areas.
A nutritarian diet is much more advanced than a blue zone diet and much more designed to utilize the epidemiology, the controlled trials, and the anti-cancer benefits of food and achieve more variety of organic food that these blue zones can't get. Sometimes they have more limited food exposure. We can have a wider food exposure and eat microgreens, sprouts, and berries, and we have all these abilities to do better than the blue zones can do. We have the expectation to live 20 years longer than the average American, not just 10 years longer than the average American. I wanted to make that clear.
I'm saying that most people think that red meat and processed meats are Class 1A carcinogens by the World Health Organization. There's more damage to the environment as far as global warming and pollution with red meats, including lamb and beef. We're talking about those things that are more utilizing the land and water. They're more polluting, have more methane production, and are much more dangerous to eat red meat and processed meats.
You then have people wanting to eat eggs, chicken, poultry, fish, and dairy products, which are probably a little not as carcinogenic but still in a category of negativity because we dump thousands of tons of plastic and other toxins in the oceans every hour. There's so much toxicity in fish nowadays that most Americans have plastic, have credit card amount of the microplastic in their body, which are hormone disruptors and also promote cancer.
There's so much toxicity in fish nowadays that most Americans have a credit card amount of microplastic in their body.
Take a woman eating the same amount of calories with the same amount of exercise as a woman several years ago or a woman who is 30 heavier. When you're full of toxins in your body, your body holds onto fat and fluid to the diluted toxicity of your exposure. We're exposed to so many toxins in our environment. Dairy products do raise IGF-1 more than fish and chicken do in total calories consumed. Cow's milk is designed for the baby calf to rapidly grow.
I'm not differentiating one animal product from another so much. A slice of white meat Turkey, a piece of chicken, some yogurt, or a piece of fish, I'm lumping it all together in one category and saying that those should be reduced to very low levels or eliminated. Whether you reduce it to low levels or eliminate, it is dependent on the individual.
Some people are so addicted that if they don't eliminate it, they keep craving this stuff, and it makes them overeat. They're better off becoming a vegan and not desiring and losing their attraction for those foods and it keeps wanting them to eat more and they eat too much. A person that's in a medical condition that might require total elimination and just goes strictly on plants might help a person. Let's say reverse heart disease or recover from cancer better, but for most populations, studies show that as animal product consumption goes above 5%, you start to see the emergence of genetic-related diseases and above 10%, you start to see deathly heart disease starts to occur in various populations.
Below 10% of calories from animal products, it's rare that a population living on natural foods sees a significant amount of people with heart disease or strokes if their diet is not salted. The Asian countries will use so much salt or a course of a different color because they save a lot of salt-generated diseases like hemorrhagic strokes.
Hemorrhagic strokes are different because lower cholesterol can increase the risk of hemorrhagic stroke. Having fewer animal products with such a high salt intake can lead to more hemorrhagic strokes because the atherosclerotic process from overeating animal products can because more fat to be deposited on the interior and exterior wall of blood vessels, protecting that thickening of the wall so it doesn't break open under the weakening effect of heating high salt diets.
We're saying here, eat right and cut the salt out of your diet. If you use animal products, use only small amounts or as a condiment. Eat a diet rich in colorful plants, a huge variety of them, and learn more about nutritarian eating because we have the ability to live longer and healthier than ever before in human history if we take advantage of these findings from modern nutritional science.
Dr. Fuhrman, you've moved me closer to the decision to go full plant-based than I've ever been. I am someone who loves my eggs. I gave up my milk a while ago, but I still occasionally have cheese. I have to say that reading the book itself provides all the context I need to take the next leap. I appreciate that, but I also understand there are a few key nutrients that we need to be concerned about ensuring that we get enough of, including vitamin B12 and getting the right balance of our omega-3s. What do you recommend people take a checkpoint on now and then? You mentioned the omega-3 index. We're presently doing a study comparing fish oil to algae oil using the omega-3 index. I'd love your thoughts there.
As President of the Nutritional Research Foundation, we funded a study on 166 vegans who checked their omega-3 index and then used algae oils for those people who were very low. We gave them a normal dose of algae oil and rechecked them again in four months to see if the levels had come up or normalized. We did that study like that already using algae oil, which showed the effectiveness of even relatively low doses to affect the omega-3 index.
That's incredible. You say something so plainly in this book. I've been in the space of omega-3s for a long time, so I always appreciate it when someone like yourself, a medical doctor especially, can make it clear that some individuals might have a harder time making EPA and DHA from plant sources like flax, chia, etc. You might be consuming a lot of this omega-3s in balance, following your recommendations using these seed-based dressings that you've created in this book as well, and then still be out of whack. It's still important to check your levels maybe as part of an annual physical. What other nutrients do you advise people to check?
One, I don't want people to take folic acid and vitamin A because folic acid is not the same as folate found in real vegetables. You have a high intake if your diet should give you a high amount of folate, not take synthetic folic acid. That's the biggest thing that I'm worried about people do with supplements, but other than that, in a plant-based diet, you don't absorb zinc as much either as you do from animal products. It's important to take a little extra zinc in the diet.
It's not just B12, vitamin D, K2, zinc, and iodine and then we're talking about EPA and DHA. You can't monitor zinc and iodine that easily. I don't recommend people take blood tests to check that. I recommend they take the RDI if they're not even eating any seaweed or seafood to take a little extra iodine, 150 micrograms is the RDI.
I'm talking about a little bit of extra zinc. You get some zinc through natural plants but not as much. I'm talking about 10 to 15 milligrams of zinc extra a day in your diet. I'm also suggesting that most people on vegan diets do not have an adequate omega-3 index. We found that it was 67% had an omega-3 index below 4 and more than 75% had levels below 5.
It's a very small amount of people that were able to manipulate their diet and have sufficient genetics to convert the ALA into enough EPA and DHA to get the index high enough. My background and my entry into this field of natural healing came from my father's changing his diet from reading Dr. Shelton's books which were written in 1950. He was one of the Founders of the Natural Hygiene Movement. The people who I recognized as leaders in that field like Keki Sidhwa, Herbert Shelton, and Virginia Vetrano, all these people who were my mentors that got demented or had Parkinson's disease in later life because they didn't know about monitoring omega-3.
I'm saying that's the Achilles heel of a vegan diet more than anything else, even though most people think it's B12, but that's because they're aware of B12 when they're taking B12. The real Achilles heel that they're not aware of is making sure that the omega-3 index is adequate. The omega-3 index is not going to accurately reflect what you took unless you have taken that substance for at least four months.
I'm suggesting taking a reasonable amount of an algae-based omega-3 and then waiting 3 or 4 months, preferably waiting 4 or 5 months, and then checking the omega-3 index. If your level is still below 5, then take a little more. If it's above 5.5, continue doing what you're doing and then you could check a level a few years later. Once your level is adequate based on what you have to take to get an adequate level between like 5.5 and 8, then you don't have to keep checking every year. You could check your omega-3 once every 1 to 5 years because you've already figured out what's the dose would for you is.
I agree. There's this next piece, too, though. I persistently tested low for vitamin D3 for a long time until I started routinely supplementing with vitamin D3. What do you recommend and so far as vitamin D three is concerned, what levels do you want to see people at? They're saying adequate is 30 deciliters or something like that.
It's 30 to 50 and that's adequate. I don't want people to supplement themselves over 50. If you are taking 2,000 a day of vitamin D and your level falls 27, 28, or 29, stay there. Some people probably don't need as much. You're probably 27 or 28 is enough for you if you're already taking 2,000 but if your level falls below 25 and you're taking 2,000, then take an extra thousand.
I don't think people should be taking 5,000 or 10,000 of D. You should titrate, be taking 1,000 to 3000. It's rare that a person would ever need more than 3,000 to get their level above 30. There is some negative effect of potentially taking too much as well because it's a fat-soluble toxin, not like B12 where there's probably no danger of taking too much.
With vitamin D, people need to also consider making sure that they're getting enough vitamin K. If they're consuming green leafy vegetables or getting K1, they're not necessarily getting K2. You mentioned vitamin K2 and it's one of my favorite supplements because it helps your soft tissues remain free and clear of excess calcium, which is important, but if you're absorbing more calcium because you're consuming a lot of vitamin D and you don't have the K2 there to check it.
We don't recommend that people take a high dose of calcium at one time because it could be because of calcifications. If they need extra calcium like a postmenopausal woman, low-dose food-based calcium with each meal, not a lot at one time with some K2. The bodies can make some K2 from the K1 with the bacteria in the gut, but the science has not advanced enough at this point to know if your own K2 production is optimized for eating plants. We're recommending that people take some extra K2 in their diet. I'm saying that with B evidence thinking that it seems the conservative and sensible thing to do at this point. There are so many beneficial effects of K2 when we can't assure we're getting enough unless we supplement.
Do you have any thoughts on bacteria and the sorts of healthy bacteria that people might want to consume supplementarily, like probiotics out there?
Frankly, for healthy people, I don't think it's necessary to take probiotics. If they're eating a healthy diet and not having sweets, processed grains, white rice, sugar, honey, maple syrup, and alcohol, as I'm recommending, then they're going to have a good bacterial balance in their gut because of the huge variety of plant fibers.
First, I'm advocating that people make a radical change in what they're eating. They could decrease their need for certain supplements as they produce better bacteria and thicken the biofilm to cover the villi and the small intestines better. It lowers look glycemic excursion or glycemic low absorption from the meal because you have a thick coating of bacteria and those foods I'm talking about the raw foods, meaning the onions, the greens, and the cooked foods meaning beans and the mushrooms have the effect to have the right prebiotic and build the right type of bacterium milieu and have the right postbiotics effects with the anti-inflammatory benefits.
Lately, akkermansia is all the rage. It seems like there are more and more research studies coming out specifically for that particular probiotic. There are even companies now offering a product like that out on the market because apparently akkermansia and having a good healthy level of that in your gut is associated with healthier mucosal lining and lower weight in individuals or reducing their circumference, so to speak. I'm going to keep an eye on that myself. I wondered if you had specific thoughts.
You might know I have a retreat here in San Diego. I'm flying from all over the world and they stay here for maybe a few months. The minimum stay is a month, but they stay usually 2 or 3 months each live retreat because people are food addicts. Some people have trouble doing this on their own. By learning the recipes, doing it for a long time, and detoxifying, they're feeling great and learning how they can replicate it. They can drop 50 pounds and then go home and do it more successfully.
How long are your retreats?
The retreat is open all year round. It's always going on, but people are staying for 2 to 3 months. Some people stay 30, 60, or 90 days. Every month, new people come in. Some people leave and some people stay here for multiple months. They get rid of their diabetes and blood pressure. I'm deprescribing or taking them off their medications as their blood pressure goes back to normal, their blood cholesterol and diabetes goes away, resolve their heart disease, and get headaches go away, and their psoriasis clears up. They get well, are sent home, and learned how to live this way and how to love doing it.
I'm mentioning that because when you make such a radical change, it seems radical, but your taste muscle changes. People learn to enjoy it when they learn these good recipes. We can use supplements judiciously and also intelligently and conservatively. It's a combination. We're combining this excellent diet with the proper use of supplements so they don't have to overtake stuff, but they can feel confident and they're being the best version of themselves.
Supplements are there to supplement a healthy diet, but so few of us have that healthy diet.
You got to get a healthy diet down.
I would love to be a fly on the wall or even come for that retreat. Perhaps, one day I'll be able to do that and we can meet in person.
It's great to be here because it's such a beautiful place to be too. The food is fantastic.
I believe it. Having read a few of the recipes, I will encourage everyone to pick up Super Immunity: The Essential Nutrition Guide for Boosting Your Body's Defenses to Live Longer, Stronger, and Disease Free. For your newest book, I'd like to invite you to come back on and talk specifically about that.
We'll talk more about Eat for Life, and going over this one more time in the future would be very nice. It's a great talk.
That's lovely. Thank you so much, Dr. Fuhrman, for joining me. I so appreciate your time. You're a wealth of knowledge. Thank you.
Good luck, everybody.
I'll also include a few more treats on OrloNutrition.com. When you visit our page, you will see a couple of videos that he has performed as interviews before, and also some resources including 1 recipe or 2 from the book. I encourage you to check that out. I'll also remind you that everyone who reads is eligible for an extra 10% off your first order from OrloNutrition.com.
If you're sold on needing more omega-3s or an immunity boost offered by Orlo, then you can go ahead and check out at cart. Use the code NWC10 to receive your extra 10% discount. They are selling a holiday bundle and that holiday bundle provides the immunity boost, spirulina with vitamin D, B12, and some other B vitamins as well as one of the omega-3 products, whichever one was your choice for an inborn discount of 27% off with free shipping. If you buy it with NWC10 as your code, you get an extra 10% off. That's as much as 37% off your order.
If you have any questions about what we covered or topics that you'd like to see featured on this show in the future, please reach out via social channels at @OrloNutrition or you can send me an email note to Hello@OrloNutrition.com. As we close this show, I hope that you'll raise a cup of your favorite beverage, coffee, tea, or water, as I say my closing words, here's to your health.
Joel Fuhrman, M.D. is a board-certified family physician, seven-time New York Times best-selling author and internationally recognized expert on nutrition and natural healing. He specializes in preventing and reversing disease through nutritional methods. Dr. Fuhrman is the President of the Nutritional Research Foundation and on the faculty of Northern Arizona University, Health Sciences division. He coined the term “Nutritarian” to describe a nutrient-dense eating style, designed to prevent cancer, slow aging, and extend lifespan.
Dr. Fuhrman operates the Eat To Live Retreat in San Diego. At this residential facility, people from all over the world come to stay to recover from conditions ranging from cardiovascular disease to autoimmune disease, food addiction and more. They gain the skills and knowledge to make these changes permanent when they leave the retreat.