I want to post this comment made yesterday by someone on the McDougall Forum, James Brown. He’s been eating the starch-based McDougall diet for several years. He made the transition when he was confronted with heart bypass surgery. I like his comments. I find them encouraging and articulate, and most of all, realistic.

Most people evaluating this way of eating will NOT adopt it. It will only be a small number of people that will embrace this way of eating in a world where it has become so foreign given our culture. Yes, people ate this way and in some places still do. But usually because they didn’t have a choice. Given a choice most will choose the diet of Kings and Queens. [Recall my post about what this King of England ate.]

But hopefully you will pull out enough bits of nutritional help to make your health respond. It’s why we are all here no matter our level of adherence.

This won’t be news to you….You have been around this too long….Some only adopt this way of eating because their health deteriorates to their point of desperation. I only made changes when facing my own mortality over heart disease. If not for that I would probably not be eating this way today. In fact, my best guess is I would not be alive. Some simply get fed up with their weight or appearance and are willing to do ANYTHING to correct this. All of us knew going in this is a diet that appears extreme to those on the “outside” But to those on the “inside” we have a real secret we keep hidden most of the time. This way of eating is really simple, terribly satisfying, and highly addictive once you jump in with both feet. I get the honor of meeting up with many that have been following this program adherently for many years and we love to share with each other just how easy it is to eat this way on a daily basis. We bask in the simplicity and economy of a starch based diet. We marvel that more people haven’t caught on to this. Yet, we do see more and more people joining the club. The movement to eating like a peasant is catching on out there.

Seeing this program as extremely rigid and limiting is but a mind game with yourself. It can also be seen as a door to the freedom good health brings. Not much is more limiting than the results of chronic disease. This way of eating can free us from those shackles.

But to assume this diet will be attractive to everyone is naive. It won’t be. Some will only see what they can’t have and not see what they can have. It can be a monumental head game with yourself if you let it. Where the real struggle is when you know it’s the healthiest way to eat but you fight with yourself over adopting it. Sometimes the inner struggle can be too much for some. If it is maybe it isn’t worth the benefits. We all have that choice. Life can be pretty special to allow us that choice.

The science? Yes the science is what brought me to this way of eating. Looking for that alternative to a bypass made me look at the literature about heart disease and the more I dug into it the more it became apparent that the real source of good health was a diet like this. For over 7 years the medical science and data has only reinforced this position. Not just the anecdotal evidence but the peer reviewed data in the most respected journals. The data that drove Nathan Pritikin, Dr. McDougall, Dr. Esselstyn, Dr. Ornish, Dr. Campbell, and many many more use this diet therapeutically.

I bolded a few things he said that I really agree with. I also like how he describes the diet, unapologetically, as “eating like a peasant.” I can learn from that.

Here’s a testimonial video Brown did for McDougall. The upload date is 2008 when he was 51 years old, so he’s been eating this low-fat, starch-based diet for at least 6 years. He describes having very high blood pressure which started in his 20s, and the emergence of chest pain which sent him to his doctor and led to a recommendation for bypass surgery. He never had it, against his cardiologist’s wishes. Instead, he adopted the McDougall diet. His cholesterol fell from 339 to 119 in 11 weeks. He eventually went off all 3 of his blood pressure medications and his weight dropped from 206 to 157 lbs (he’s 5’7″).

It’s the food.

I stumbled upon this infographic this morning, from VisualEconomics:

The average woman is 5’4″ and weighs 164 pounds? You’d never think this by watching television, or movies, or advertisements, or just about any visual media.

By measuring food by weight, it misrepresents consumption a bit. Food that contains a lot of water may be heavy but may not contribute so much to calories as drier, fattier foods. A grapefruit weighs about a pound and provides ~200 calories, while a pound of donuts provides ~2200 calories. (A Krispy Kreme plain cake donut weighs about a tenth of a pound and provides ~220 calories.) So, this graphic appears to show we’re eating a lot more water-laden fruits and vegetables than we really are, and a lot less refined grains.

I think this graphic, put together by the New York Coalition for Healthy School Food, healthyschoolfood.org, better represents Americans’ diets:

It’s saying that Americans eat just 6% of their calories from unprocessed “vegetables, fruits, legumes, nuts & seeds, whole grains.” In a whole food, plant-based diet, most of the food comes from this category, save for some refined grains (e.g. pasta) and sweeteners (e.g. maple syrup).

For a few years now, I’ve been posting evidence that describes the benefits of eating a whole-food, plant based diet. Dr. John McDougall, in his book The Starch Solution, describes his version of that diet. I think it’s a great version. Below is the diet in a nutshell.

From Chapter 13: Practicing The Starch Solution:

• The core of the diet focuses on eating starches complemented with nonstarchy vegetables and fruit.
• The diet excludes all animal foods (meat, poultry, fish, dairy, eggs) and all isolated fats and oils, including olive oil.
• It does not restrict calories or limit eating. You eat until you are satisfied. If you are hungry an hour later, you eat again.
• Foods can be combined in any way, with any preparation.

Starches are grains, legumes, and starchy vegetables:

• Grains include barley, rice, whole or bulgar wheat, farro, corn, millet, oats, rye, spelt, triticale, amaranth, quinoa. You can eat the grain or products made from the grain.
• Legumes include all beans (adzuki, black, navy, pinto, kidney, cannellini, chickpeas, great northern, lima, mung, soybeans), peas (black-eyed peas, split green and yellow peas), lentils (green, red, brown). Although peanuts are a legume, they “should be minimized or avoided altogether, especially if you are trying to lose weight.”
• Starchy vegetables include potatoes, root vegetables, and winter squashes (baking and boiling potatoes, sweet potatoes, yams, burdock, cassava, taro, acorn squash, kabocha, butternut, kuri, Hubbard, pumpkin).

Nonstarchy vegetables are summer squashes (zucchini, patty pan, yellow), root vegetables (carrots, beets, jicama, radishes, onions, garlic, fennel, ginger, turmeric), beans (green beans, snap peas, snow peas), mushrooms, and other plants (broccoli, cauliflower, cabbage, asparagus, celery, rhubarb, lettuce, kale, collards, spinach, eggplant, tomato, cucumber).

Fruit. You name it, but avocados, olives, and dried fruits, should be minimized or avoided altogether especially if you are trying to lose weight.

In the above description of what to eat, I named three foods that McDougall flags – peanuts, avocados, and olives. Here is his full flagged list along with his reasoning:

There are a few foods that won’t spoil your success with the Starch Solution, but will slow your progress. If you seek to accelerate your weight loss, or if you suffer from a chronic disease or are on the cusp of developing one, I recommend avoiding these foods altogether. If, on the other hand, you are already happy with your weight or not in a hurry to lose, and you do not suffer from chronic illness, you might wish to consider including small quantities of these higher calorie foods in your starch-based meals:

• Avocados
• Dried fruits
• Flours (whole grain, white, all-purpose)
• Fruits and vegetable juices
• Nuts
• Peanuts and peanut butter
• Seeds
• Simple sugars (table sugar, maple syrup, molasses, agave)

In my experience, it seems the last thing to go for people eating this diet is oil. They continue to use oil to cook with and as a dressing. There is evidence that a combination of carbohydrates and fat is worse (puts weight on faster, raises blood glucose) than eating carbohydrate or fat alone.

Peasant couple harvesting papyrus (Sennedjem and wife Ti). “In the cemetery of Deir el-Medina, this wall painting is in the vaulted tomb chamber of Sennutem, a necropolis officer of the early Ramessid period (13th to 11th centuries BC). Wikipedia

After posting that researchers have been finding very little evidence of cancer in ancient Egyptians and others who lived several thousand years ago (e.g. in South America), I wondered what they ate. This new study says that ancient Egyptians, the middle classes, ate largely vegetarian diets, “animal proteins were rare.”

Diet Of Ancient Egyptians Inferred From Stable Isotope Systematics, Journal of Archaeological Science, June 2014

They start off by saying:

Ancient Egypt stands out as one of the first great civilizations that emerged at the end of the Neolithic period (6000 B.P.) and is particularly renowned for its exceptional longevity.

They don’t define longevity here, but I’d guess it’s something shorter than how we view it today. Maybe.

Based on ancient art, food remains, and what is known of the culture and environment at the time:

Large consumption of gritted bread is certain because of the notable common dental wear in human remains. As for other food sources such as vegetables, fish or meat, only indirect inferences can be made by considering the salaries paid in kind to pyramid workers and craftsmen from the King’s valley. These indicate that ancient Egyptians consumed large amounts of cereals through bread and beer, and also ate vegetables (e.g. onions, lettuce) and legumes (e.g. peas, fenugreek, lentils). Meat is not mentioned and probably represented a very small portion of the diet, except for the wealthiest people. For the working classes, animal proteins were rare and came from dairy foods, fowl, and fish.

These researchers expanded on this knowledge by performing isotope analysis of the remains of ancient humans and animals – their hair, teeth, and bones, “with the possibility of estimating the relative proportions of plants and animal proteins of terrestrial or aquatic origin.” Here were some of their findings:

• Wheat and barley were consumed more than sorghum and millet.
• Animal protein represented about 29% of the protein in the diet, “similar to that of 32% observed in present-day ovo-lacto-vegetarians, and lower than the average of 64% of present-day omnivores.”
• “Ancient Egyptians most likely consumed less protein of animal origin than do modern humans.”
• “Sulfur isotope ratios of mummy hairs further indicate that freshwater fish, such as the Nile perch, was not consumed in significant proportions.”
• Analysis of nitrogen isotopes indicated that chronic diseases were not apparent at death. High nitrogen isotope ratios point to a rapid death in an otherwise healthy individual.
• “The constancy of [these findings] over a duration of ∼3000 years [from 5500 to 2000 BP*] is striking considering the various political, technological, and cultural changes that impacted the Egyptian civilization during this time interval.

*According to Wikipedia, 5500 BP (Before Present) means 5500 years before 1950 CE (Common Era), which is 3550 BCE (Before Common Era). So, 2000 BP is 50 BCE. This work spans a period lasting about 3500 years, from 3550 BCE to 50 BCE.

So, the bulk of ancient Egyptians’ diets was grains, specifically wheat and barley. (No wonder they called gladiators “barley men.”) They also ate beans/peas/lentils and some vegetables. Interesting that fruit wasn’t mentioned. Animal foods were rare, even fish and dairy. Fats and oils did not make up a significant portion of the diet (e.g. olive oil was introduced during the Roman Period which occurred later in this study range).

The diet of ancient Egyptians described here is essentially the whole food, plant-based diet recommended by several contemporary physicians (McDougall, Campbell, Esselstyn, Barnard) and institutions (Kaiser Permanente, the largest managed care organization in the country).

The tomb image is from an article by Alexander Hellemans, What Did Egyptians Really Eat?. The author includes a good discussion about how isotope analysis is done. He also includes a quote from an archeologist who said, “All this makes it a bit surprising that the isotopes should suggest that fish was not widely consumed,” since wall reliefs show spear and net fishing.

Baked potatoes are a healthy component of a low-fat, whole food, plant-based diet.

For years, I’ve been citing studies that provide evidence for the contribution of dietary fat in the development of insulin resistance and type 2 diabetes. Here’s another, and it’s one great study. It shows that consumption of a high-fat diet makes you spectacularly sensitive to any amount of carbohydrate you eat. This could be why people say that eating carbs makes you fat … the carbs are being eaten against a backdrop of a high-fat diet. Strip away the fat and the carbs you eat won’t make you fat. They also won’t increase your cholesterol, blood glucose, blood insulin, or make you insulin resistant. So says this study:

A Small Amount of Dietary Carbohydrate Can Promote the HFD-Induced Insulin Resistance To A Maximal Level, PloS One, 23 July 2014

Mice were fed one of 5 diets:

• Control diet: 65.1% carb, 23.1% protein, 11.8% fat
• Various High-Fat Diets (HFDs) with increasing amount of carbs: 0.1%, 5%, 10%, 25.5% carb, 58% fat, (protein was varied to keep calories constant)

After 5 weeks:

• “Mice on all high-fat diet (HFD) groups took less food and fewer calories than the mice on chow diet.”

Yet the high-fat-fed mice gained more weight, more body fat, and had higher levels of blood lipids:

• Animals on HFD gained more weight when the level of dietary carbs was increased.
• Mice on HFD with 5% carbs caused absolutely more body weight gain and the HFD with 10% carbs caused equal amount of body weight gain as the HFD with 25.5% carbs.
• White fat proportion was increased in mice on HFD with little (0.1%) dietary carbs, but the increase was further enhanced by dietary carbs in a dose-dependent manner.
• Serum levels of cholesterol, triglyceride (TG), and free fatty acids (FFA) were increased in all groups of HFD
• Together, these results show that dietary carbs are not essential for the HFD-induced body fat gain but can enhance the HFD-induced body fat gain in a dose-dependent manner, and a very small amount of carbs (10%) in the HFD can cause the maximal level of body weight gain.

The high-fat-fed mice had higher levels of blood glucose, blood insulin, and development of insulin resistance:

• Fasting blood glucose level was increased in mice of all HFD groups including the HFD with little (0.1%) carbs starting from week 1, and the increase was promoted by dietary carbs in a dose-dependent manner.
• Fasting plasma insulin level was also increased in mice of all HFD groups, and the increase reached a maximal level when the carbs in the HFD reached 10%.
• Insulin tolerance was significantly decreased in mice on HFD with little (0.1%) dietary carbs, and addition of carbs to HFD worsened insulin tolerance in a dose-dependent manner.
• Animals on chow diet that is a typical high carb (65.1%) and low fat diet (11.8%) did not have insulin resistance.
• Together, these results show that dietary carbs are not essential for the HFD-induced insulin resistance but can promote the HFD-induced insulin resistance dramatically¹, and 10% calories from dietary carbs can promote insulin resistance to a maximal level in mice on HFD.

The high-fat-fed mice also had more fat accumulation in and around the liver. The high-fat diet also induced oxidative stress, not seen in control mice.

Did you see that? The control mice ate more, both in weight of food and calories. But all their lab values were better … and they weighed less!  This has been demonstrated in human studies, both clinical trials (e.g. Barnard’s 2006 study), and population studies, and recently in the experience of Benji Kurtz, who lost over 100 pounds in a year eating his fill of a low-fat, whole food, plant-based diet.

One reason the control mice didn’t gain weight was, as the authors noted, more thermogenesis or heat generation. Eating a low-fat, high-carb diet leads to more thermogenesis, while eating a high-fat diet leads to less body heat (and so more fat accumulation).

¹ “Results from this study show that mice on HFD containing little carb (0.1%) developed severe insulin resistance (Fig. 2). How did that happen? … Glucose from gluconeogenesis is sufficient to stimulate sufficient secretion of insulin, which is necessary for the fat- or glucose-induced insulin resistance.”