Eat to Live: The Amazing Nutrient-Rich Program for Fast and Sustain Weight Loss, by Joel Fuhrman, MD.

So all this started when I posted a review of a book on Ketogenics and a friend recommended (strongly) that this book was a better option. It is an excellent option and I appreciate the caring advice. However, that turned into a reflection on my own experiences with weight gain and loss, followed by an actual look at the book itself, until we get here with what I promise will be the last post on this issue. Diet science is as complex as the food we eat with its hundreds of components.

Those who developed and promote the Paleo diet did nail one thing of some importance: we spent millions of years co-evolving with our food. And prior to our creation of tools and organized hunting we were a second- or third-level predator. We lived on green stuff, roots, fruit when it was in season, and bone marrow because that’s what was left when the lions and hyenas were done. The creation of weapons for hunting raised us to top predator level, to where humans could make their own kills and scare away competitors. Since then our food has been “evolving” at a much faster rate than we have.

We’ve been separate species from Homo Erectus for about 60,000 years. Extracting sugar from its source plants (sugar beets and sugarcane mostly) became efficient in the 18th century. With it came evils both moral and tangible. Slavery was one. Sugarcane is grown in hot climates and African slaves were considered the perfect agricultural tool for harvesting.

Dozens of medical problems began to develop for sugar consumers as well. Consider a toothless George Washington as exhibit A of one of the earliest visible effects of sugar consumption.

Today the average American consumes between 99 and 126 grams of sugar per day. That includes sugars added into foods including sucrose, high-fructose corn syrup, and fruit sweeteners with fructose. That’s between 2.5 and 3 soft drinks per day for every man, woman, child, infant. And that’s just the straight stuff. The human body normally carries about 5 grams of glucose in the blood stream. Excess of that, when the body isn’t active and needing what cell mitochondria make from glucose, ATP or adenosine triphosphate, the excess gets converted stored as lipids in fat cells for later use. The stuff that helps the body manage that is insulin.

This does not include, by the way, sugars from starches. When these are eaten enzymes in the body clip pieces of these long hydrocarbons to make usable sugars for the body to use. So the number of grams of sugars from all carbohydrates may be much higher.

For the raw sugars the body sees no difference between a slurpee or a grape or a spoon of honey. In every case the body knows it’s digested a sugar and it spikes the body with a dose of insulin. The final result is known as “metabolic syndrome“, which medical science is happy to tell us it doesn’t fully understand but if you’d like to send them some grant money they’ll investigate further. The long version is available with multiple footnotes at the handy Wikipedia link provided above. The short version is that the constant ebb and flow of insulin from substances that represent .0001% of our evolutionary time on earth play hell with every other part of our body, from the biome in our gut to scarring of the veins and arteries which call on dietary cholesterol for healing. Further, the tumors that begin to form from all the other substances now added to our food, either directly or from bleedthrough from the packaging, thrive on serum glucose. Many of these, when starved of sugars, will stop growing or reduce.

So when any diet — and by diet I mean lifelong eating program and not a temporary weight fix — recommends daily carbohydrate intake of higher than 50 grams per day I cringe a bit. And saying that it’s healthy because it’s fruit really doesn’t fix the problem. As an example a cup of spinach has .8 grams of carbohydrates while a small banana contains 22. A teaspoon of sugar is about 4 grams and sugar has a 1:1 carbohydrate ratio, one gram of sugar has one carbohydrate. True, there are some foods with a high glycemic index, which means the sugars are tightly bound in starches or with fibers, so that insulin is less inclined to spike, but your body still gets them. The higher the intake of sugars the higher the risk of metabolic syndrome, which includes follow-up fun like high blood pressure, atherosclerosis, arrhythmia, alzheimer’s, depression, and the list goes on.

We evolved as eaters of plants and animals, not much removed from our chimpanzee and bonobo cousins. We often continued evolving in isolated pockets of population so that those from Tibet adapted enzymes to easily digest yak butter and milk, while those in Japan, with an ocean of seafood around them, are largely lactose intolerant due to the lack of the needed digestive enzyme. Many cultures, including a majority of those living in North America and Europe, came from people who discovered the easy food resource of grains, built cities around that agriculture to protect and exchange, and radically changed their eating faster than their bodies could adapt. We are million-year-old organisms with a diet created around 10,000 years ago.

The conclusion I’m shooting toward is that when Fuhrman in Eat to Live states that animal protein and saturated fats lead to cancer and heart disease (he never says “causes” because correlation≠causation) one has to ask “In what context?” Is this a culture that cooks the hell out of meat or brines meat to increase nitrates? Is it a culture that also (like the USA) has a high intake of sugar AND dietary fat? Tibetans’ national drink is butter tea: tea, salt, and melted butter. They have a low sugar intake and are very long-lived. Americans eat a double-cheeseburger on bread with sugared ketchup, deep-fried potatoes with salt, and a giant Coke (when just 12 ounces contains almost 9 teaspoons of sugar). When Morgan Spurlock ate nothing but McDonald’s in Super-Size Me the doctors working with him urged him to stop after 15 days or risk permanent liver damage.

Science is great. Context is king. Knowing the human body exhales carbon dioxide is great. Using that as a reason why climate change is a hoax is idiocy. Nutrition is not much different.

I’m done. I’ve written way more than I intended and I have books I have yet to tell you about. Thanks for your patience.