Starchivore

Dr. John McDougall has coined the term "starchivore" to describe his diet regime which is based on the observation that populations that eat little animal products and refined oils rarely suffer from heart disease, diabetes, cancer or auto-immune disease. Many excellent epidemiological studies have confirmed this. McDougall advocates a low protein, low fat diet which includes some fruit and vegetables but is mainly "comfort foods": potatoes, yams, rice, pasta, whole grains and other starches. Small amounts of salt and sugar are okay to increase palatability. Initially he taught that a few lower fat animal products were acceptable but in recent years he advocates staying vegan.

McDougall designed his medical practice around this diet which he created based on work of Pritikin, Kempner and Burkitt. He has successfully treated many thousands over the last 40+ years, first in private practice in Honolulu and later through clinics; 10, 5 and 3 day programs in Santa Rosa, CA; many books and an active free internet site which has access to many talks given at his "Advanced Study Weekends" plus patient interviews describing dietary success treating various chronic diseases and obesity. Deb and I  attended his 10 day program and found it a powerful, instructive and pleasant experience. We've also attended many of his weekend and travel programs, befriending many "McDougallers." The seed for many of my blogs was from his programs.

McDougall just announced his retirement from active practice; his Advanced Study Weekends and travel programs ended last year, but 3, 5 and 10 day treatment programs under the supervision of his colleague, Dr. Anthony Lim, continue as does his excellent educational website( link is on right side of this blog's home page.)

                         Nutritarian

Much writing and study of diet revolves around what not to eat: too many calories, fats, carbs, protein, refined oils, or some combination of these. Some research and advice centers more on what to eat. One of the most prominent of this group is Joel Fuhrman, a New Jersey family practice physician who has devoted his career to promoting diet as the principal way of maintaining health and treating many diseases.

Fuhrman has had a family practice for decades where he has treated thousands using his dietary approach, "nutritarianism," which is to eat a large variety of vegetables, fruits, legumes, nuts and seeds- the more variety the better. Sharing meals with him is fun since he eats huge quantities of very low calorie foods which includes a few starches but emphasizes salads and smoothies. His salad building technique is amazing: after filling his large plate with a variety of greens he takes another plate, puts it on top of his greens, presses down crushing them into a smaller volume and then adds another layer of greens. His comment is that otherwise he can't get enough on his plate.

I've known Joel for more than ten years, visited his practice in Flemington, NJ, and attended multiple conferences where he was the only presenter. He is a remarkably energetic, enthusiastic scholar who knows as much about nutrition literature and research as anyone I've met on my odyssey searching for dietary truth. Initially, when I first met him he indicated that a small amount of animal products, especially eggs, were a reasonable part of a good diet but over the years he's evolved to a diet which does not include any animal products. Fuhrman has many books to his credit plus DVD's and very successful PBS shows. He's an engaging, enthusiastic speaker. Concepts he espoused years ago have become more mainstream and accepted over the years (eg intermittent fasting.) He maintains an active website which includes a good way of linking with others about dietary issues and questions. Unfortunately this requires dues to participate. He also sells many products, various supplements and foods, in addition to his books and DVD's. These products all seem to be highest quality but I have an issue with too much supplementation which is well shown to be wasteful and occasionally harmful. 

                                M and M

In medicine we have M and M conferences. Often we'd have preferred that this meant we sat around and ate M and M's, since the subject matter was morbidity (serious illness) and mortality (death) in patients under our or our colleagues' care. The purpose was to understand what went wrong and what we could have done to prevent it.

Much of medical science revolves around the same theme: cause and prevention of death and disease. Eleven years ago, around the time of my 66th birthday, reading and study made it obvious to me that much M and M was due to changeable lifestyle and that modern medical practice paid little heed to this while emphasizing drugs and procedures for patient care. My wife Deb and I changed our own diets since this was by far the major cause of M and M. We had no health problems at the time but felt that we wanted to share this information and couldn't preach what we didn't practice. If you've read many of my prior blogs you know that the dietary change was to cut out or minimize animal products, refined oils, refined carbohydrates and added salt, effectively eliminating most processed foods.

I've recently swapped emails with a high school classmate whose wife has dementia. His observation  that many older people in his retirement community have poor quality of life in their "golden years" led him to muse that perhaps early death was a better option. But what if you can have both low M(ortality) and low M(orbidity)? Several excellent large epidemiological studies make it clear that this is so. Not only do you live longer with good diet but the quality of your last years is much better. It is very reasonable to dread final years with dementia or taking drug after drug for cancer, advanced heart disease, diabetes. Life in a hospital, extended care facility or making regular rounds of doctors' offices is no one's choice for the golden years, but that is the path made very likely by ignoring sound dietary guidelines. Another friend of mine died earlier this year after several miserable years of chasing health from doctor to doctor. A few months before he died he said, "Jack, I sure wished I had taken your advice about diet years ago."