Dr Joel Fuhrman's approach

[mccoy]

I've just read 'Superimmunity' by Dr Joel Fuhrman, a book suggested by Gordo.

It is a very interesting and advised reading. surprisingly, Dr Fuhrman ignores the epicatechins from cocoa and the polyphenols from EVOO. Otherwise, there is lots of useful advice on immmunity- boosting foods.

 

I'm also interested on his nutritarian approach. He proposes a pyramid whose base is vegetables, 30 to 60% of caloric intake.

 

Now, we have a serious problem. Let's say we are all right with 30%. In my case, that's 705 kCal. I should be eating this daily to meet this first requirement:

 

2.5 kg of vegetables, I do not eat that much even when on Longo's FMD. This diet is unsustainable. 60% would mean 5 or more kg of vegetables daily. the diet of an horse. 

In my hypothetical case, startin from the minimum 30% of vegetables, I might add 30% fruit (5 apples and 5 oranges), 10% legumes, 20% nuts and seeds, 20% whole grains, 10% dairy. My daily menu would be the following.

 

I'll never have such a hunger to eat all that bulk.

I wonder what I 'm missing. Are those amounts in volume? But by reading the book I remember %s are in calories (I'll check).

 

All in all, a very healthy, mostly plant-based diet, if you survive the heaps of vegetables. And half of'em should be raw...

[mccoy]

I just read an article from Mark Adams in mensjournal,there it's told that the vegetables must amount to 2 pounds (900 grams), which is about 6% in calories in my setup. But the quantities below amount to a limited caloric intake, about 1300 kCal. if we allow 2 ozs of nuts and 4 ozs of bread. Sure it's not easy to set up this diet, maybe I need to read other books.

 

 

 

"Completely rethink your idea of what a portion is: Make it huge," he writes. That means at least one pound of raw vegetables a day, plus a pound of cooked; four fresh fruits; and a cup of beans. Limited amounts of raw nuts, seeds, whole grains, and avocado are allowed. No calorie counting is required. No snacks are permitted.

[mccoy]

Now I found this reference on his guidelines presumably published in 'Eat to live'. However, they are not exactly the same as those provided in 'superimmunity'. Also, dairy products and even meat are not forbidden, just very restricted. Anyway, the diet below is far more approachable than the 30-60% veggies diet.

http://hellonutritarian.com/nutritarian-eat-to-live-plan/

 

 

[drewab]

I often plan meals with his G-BOMBS nemonic in mind.

 

Greens

Beans

Onions

Mushrooms

Berries

Seeds

 

I too find it difficult to meet his nutritional requirements, so often add in much more starch than he calls for. Besides that fact, eating so many veg can get quite expensive (if you prefer organic as I do). Lots of people have had much success following his approach though and I think there is much to learn from his work. 

 

So days I do eat extraordinary amounts of veg (and raw veg). For example, if I have some organic produce that is going to go to waste, I won't let that happen!

[mccoy]

Drew, probably your milder approach to Dr Fuhrman's suggestions is shared by many people. Gordo, as far as I noticed, also follows the G-BOMBS approach but I'm wondering if he has been able (or interested) to be strict. Dean's diet appears to follow closely Dr. Fuhrman's guidelines.

 

Actually, I've read some of his bio. He's been a patient of Dr. Herbert Shelton (an extreme vegan and fasting doctor) and himself underwent a 46 days fast to get rid of an ankle problem (successfully). I've read quite a few books of Dr. Shelton in the past and I understand that Dr. Fuhrman has basically adopted such an approach in a more modern and practical and flexible way.

 

Most probably, a strict adherence to his nutritarianism is advised to those who want to loose weight, those who want optimal health and are a little overweight and those with an health condition who want to heal. A great drawback, as far as I understood, is palatability. Since he rules out oils, it is not easy to make dressings for those raw and cooked vegetables. People are trying and Dr. Fuhrman himself provides many recipes, but it requires time and organization, I would not be able to do that, it just takes so much time to buy stuff, to wash and cut produce, to cook them and so on. 

 

All in all, nutritarianism appears to be a formidable concept, although not suited to everyone, at least if strictly interpreted. In my case, I'm sure I would loose a lot of weight, which I do not wish to.

But I'm already adopting many of his ideas and suggestions and following his ANDI score to choose vegetables.

[drewab]

I too find the ANDI index to be useful. For members who aren't familiar with it, here is a sample: (you can google it for the various versions of it). It reminds me of why I choose berries instead of bananas and collards instead of iceberg lettuce!

 

 

[mccoy]

Presently he seems to have revised the score, the top score (1000) is shared by 5 veggies, spinach has lost a littel ground, romaine has gained, this is what is on his site now.

Unfortunately, among the top fiver, only swiss chard is common in Italy. Kale is rare here and inordinately expensive, whereas watercress, mustard green and collard green I never saw.

 

[Cloud]

I've just read 'Superimmunity' by Dr Joel Fuhrman, a book suggested by Gordo.

It is a very interesting and advised reading. surprisingly, Dr Fuhrman ignores the epicatechins from cocoa and the polyphenols from EVOO. Otherwise, there is lots of useful advice on immmunity- boosting foods.

 

I have read that book too and i liked it, but the title isn't a little misleading? From a scientific point of view is not proprerly correct saying that some foods can improve immunity. The proof on human beings I think are still non conclusive.

[mccoy]

Cloud, as far as I have understood, Fuhrman talk of 'immunity' as the ability to react to pathogens and also the auto-protective mechanisms against cancer proliferation. So it's a pretty general term. It stands to reason that an healthy diet boosts the immune system, and the protective effects of cruciferous vegetables and other phytochemicals are well discussed in the literature.

 

Superimmunity sounds to me like just an attractive and easy-to-grasp term. 

[Gordo]

Hey Mccoy, yes my approach is similar to the Fuhrman way of eating, but I admit sometimes the sheer bulk required is "difficult".  I do get a lot of calories from nuts, avocados, and now EVOO too which makes it more manageable.  Most of my meals are large volume.  I also eat plenty of grains and sweet potatoes pretty much daily.  I will also use a small amount of honey or maple syrup most days (both of which have interesting phytonutrients not found in other foods).  Occasionally some dark chocolate as well.  To keep my immune function strong I do try to get the alliums, cruciferous, and mushroom categories daily.

[mccoy]

Gordo, now you cited honey which is a favourite of mine. Some varieties must indeed contain specific phytochemicals, it's evident from the taste. Not a much discussed subject though.

[Sibiriak]

Honey contains a range of phytochemicals,  including phenolics such as  quercetin, caffeic acid, phenethyl ester, acacetin, kaempferol, galangin, etc.

 

Generally, the darker the honey, the more phenolics.     I've taken a liking to Russian buckwheat honey.    A  spoon of that with a large glass of fresh sea buckthorn (облепиха) juice.  Wow!

[mccoy]

Generally, the darker the honey, the more phenolics

 

Sibiriak, I couldn't agree more, chestnut honey is bitter, fir honey ditto, some rare honeys like strawberry tree and dandelion are just pungent and not very sweet, so replete with phytochemicals.

 

Now, some honeys contain phytochemicals which probably are contained in higher quantities in other sources, like hesperidin, contained in orange honey, which is abundant in orange peel. Ditto quercetin, which is common in so many foods like apple peels, onions and so on.

 

Whereas other phytochemicals maybe more rare and not commonly found in other  food sources.

 

Caffeic acid is contained in chestnut honey. But sunflower seeds have 8 mg/100 grams. After a short search, I found that the braziaian honeys from momosa scrabella contain among the highest concentrations in caffeic acid , 33 micrograms/g, =3300 micrograms/ 100 grams = 3.3 mg/100 g, less than a half the sunflower seeds. But they have many esters of the caffeic acid, and here we might have something not found in other sources. Also, the polyphenols in honey might be more bioavaliable.

[Todd Allen]

Presently he seems to have revised the score, the top score (1000) is shared by 5 veggies, spinach has lost a littel ground, romaine has gained, this is what is on his site now.

Unfortunately, among the top fiver, only swiss chard is common in Italy. Kale is rare here and inordinately expensive, whereas watercress, mustard green and collard green I never saw.

 

Andi scores.JPG

 

At least he bumped olive oil from 2 to 10...  Doesn't even bother with listing evoo separately.  Also, seems to be biased against B12, fat soluble vitamins and Omega 3s.

[mccoy]

Todd, I concur that ruling out olive oil is a weak point in Fuhrman's proposals. If the purpose is weightloss or curing CVD, then OK, extreme measures → extreme remedies.

He seems to focus on he high caloric value of vegetable oils, neglecting their high specific polyphenols content. The reasons he gives are weak, like pure oils have no fibers, they are absorbed immediately by the system, and so on. In my view he should add one tablespoon of EVOO in his suggestions.

 

As far as I remember, he's against supplements of vit A and folic acid, since there is literature suggesting an increased risk of cancer when using high doses of such supplements.

 

The ANDI score as specified by Dr Fuhrman is a measure of micronutrient density (including phytochemicals and antioxydants) in isocaloric quantities of foods, expressed as a relative amount on the highest scores, in thousandths). Of course, speaking of veggies, calories are not too relevant, anyway kale has over 3 times the calories of iceberg lattuce, so 300 grams of iceberg have 13% the micronutrients of 100 grams of kale. The top guys here are pretty impressive!

The takeaway concept here I believe is that all foods in column one (127 to 1000) should be eaten in large amounts, possibly with a prevalence of the >400 points, rotating the lower scores.

 

For example, I tend eat now something like 50% swiss chard, spinach, romaine and brussel sprouts, at the same time differentiating the other half as much as possible. Of course that also depends on seasonal availability, but we know that the average dietary behaviours should be considered here.

 

 

 

To determine the ANDI scores, an equal-calorie serving of each food was evaluated. The following nutrients were included in the evaluation: fiber, calcium, iron, magnesium, phosphorus, potassium, zinc, copper, manganese, selenium, vitamin A, beta carotene, alpha carotene, lycopene, lutein and zeaxanthin, vitamin E, vitamin C, thiamin, riboflavin, niacin, pantothenic acid, vitamin B6, folate, vitamin B12, choline, vitamin K, phytosterols, glucosinolates, angiogenesis inhibitors, organosulfides, aromatase inhibitors, resistant starch, resveratrol plus ORAC score. ORAC (Oxygen Radical Absorbance Capacity) is a measure of the antioxidant or radical scavenging capacity of a food. For consistency, nutrient quantities were converted from their typical measurement conventions (mg, mcg, IU) to a percentage of their Dietary Reference Intake (DRI). For nutrients that have no DRI, goals were established based on available research and current understanding of the benefits of these factors. To make it easier to compare foods, the raw point totals were converted (multiplied by the same number) so that the highest ranking foods (leafy green vegetables) received a score of 1000, and the other foods received lower scores accordingly.

[AlPater]

My main concern about eating honey is the ridiculous macronutrient content, but there are other https://en.wikipedia.org/wiki/Honey#Health_hazards .

[mccoy]

My main concern about eating honey is the ridiculous macronutrient content, but there are other https://en.wikipedia.org/wiki/Honey#Health_hazards .

 

Of course it's not a food suited to the glucose-intolerant. I've been an avid honey eater for 40 years. Nothing ever happened, I reckon the pollen extracted by the rare poisonous plants is diluted among pollen from other specieses.

I remember that before my twenties, as soon as I started to change my dietary habits, sometimes I would lunch on pure honey and water. Usually it was 500 grams of honey (1.1 pounds), rarely I ate 1 kg (2.2 pounds). In such quantities, I only ate honey and water. I do not remember I ever felt heavy after that. And no problems related to fructose, which is currently being so demonized by the low carbers.

Presently, my quantities are much more moderate, 1 or two tablespoons max at one time. Sometimes just a teaspoon, to enjoy the strong taste of some peculiar varieties. And when I went low carb, one quarter of a teaspoon felt so pleasantly sweet.

[Sibiriak]

Cf. "Honey - A Novel Antidiabetic Agent"   Int J Biol Sci. 2012

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3399220/

 

 

Honey, which comprises predominantly monosaccharides and oligosaccharides, contains at least 181 constituents ^{8, 9}. It also contains other bioactive constituents such as phenolic compounds, flavonoids, organic acids, carotenoid-derived compounds, nitric oxide (NO) metabolites, ascorbic acid, Maillard reaction products, aromatic compounds, trace elements, vitamins, amino acids and proteins ^{5, 9, 10}. Evidence indicates that some varieties of honey contain kynurenic acid (a tryptophan metabolite with neuroactive activity) which may contribute to its antinociceptive and antimicrobial properties ¹¹. A number of enzymes such as glucose oxidase, diastase, invertase, phosphatase, catalase and peroxidase have also been documented in honey ^{9, 12}.

 

The use of honey in folk medicine dates back to 2100-2000 BC ^{4, 12}. In the past, most of the health benefits attributed to honey were based on mere observations or generalizations without any scientific support ¹³.

 

However, in the last few years, there has been a renewed interest in research that investigates the potential health benefits of natural and unprocessed honey in the management of various diseases. This has resulted in findings that attribute several medicinal effects to honey. These include cardioprotective ¹⁴, hepatoprotective ¹⁵, hypoglycemic ¹⁶, antioxidant ^16-21 and antihypertensive effects ^{22, 23}. Other effects such as antibacterial ²⁴, anti-fungal ²⁵, anti-viral ²⁶, anti-inflammatory ²⁷ and antitumor ²⁸ have also been documented and attributed to honey.

 

In this review, the first of its kind, we summarize both experimental and clinical findings which demonstrate that the effects of honey in the GIT, on the gut microbiota, in the liver as well as in the pancreas may result in improved glycemic control and metabolic derangements.

 

 

 

A closer look at the proposed mechanisms of action of antidiabetic effect of honey (figure ​(figure5)5) suggests the following:

1. Honey, through its GIT effects, would possess characteristic effects of α-glucosidase inhibitors such as acarbose.
2. Honey, through its hepatic and/or pancreatic effects, would possess characteristic effects of insulin secretagogues such as sulfonylureas (glibenclamide) as well as repaglinide and nateglinide.
3. Honey, through its hepatic and muscular amelioration of oxidative stress-induced insulin resistance, would possess characteristic effects of thiazolidinediones and biguanides such as metformin.
4. Honey, through its effects on incretin and appetite-regulating hormones, would possess characteristic effects of dipeptidyl peptidase-IV inhibitors such as sitagliptin and GLP-1 mimetic such as exenatide.
5. Honey, through its anti-lipidemic effects, would possess characteristic effects of anti-obesity drugs.

All these clearly indicate that honey possesses characteristics of most of the currently prescribed antidiabetic drugs and suggest it is a novel antidiabetic agent.

[Sibiriak]

Cf. "Effect of Fructose on Established Lipid Targets: A Systematic Review and Meta‐Analysis of Controlled Feeding Trials"

 

Journal of the American Heart Association. 2015

 

http://jaha.ahajournals.org/content/4/9/e001700

 

 

With the global rise in obesity, diabetes, and cardiovascular disease, there is growing concern about the role played by fructose‐containing sugars (fructose, sucrose, and high fructose corn syrup [HFCS]).^1–2 In response, various heart and diabetes associations have set strict upper limits for added fructose based on achieving and maintaining healthy blood lipids. For example, the American Heart Association³ in their statement on triglycerides and cardiovascular disease has recommended reducing intake of fructose to <100 g/day, 50 to 100 g/day, and <50 g/day in people with borderline, high, and very high triglycerides, respectively, while the Canadian Diabetes Association⁴ recommends limiting added fructose to <10% of total energy in people with diabetes.

 

The evidence on which these recommendations are based comes chiefly from 2 earlier systematic reviews and meta‐analyses of controlled feeding on the effect of fructose on lipids. Livesey and Taylor in 2008⁵ identified a threshold of ≥100 g/day for fasting triglyceride effects in different participant types, while Sievenpiper et al in 2009⁶ identified a dose threshold of >60 g/day or 10% of total energy in people with diabetes. Since these systematic reviews^5–6 were published, numerous additional controlled feeding trials on the effect of fructose on fasting lipids have been published.^7–18

More recent systematic reviews and meta‐analyses of the effect of fructose on other related cardiometabolic risk factors have suggested that fructose only has adverse effects on body weight, postprandial triglycerides, glycemic control, uric acid, and markers of nonalcoholic fatty liver disease insofar as it contributes to excess calories.^19–24

Whether these dose thresholds for the effect of fructose on lipids remain in isocaloric comparisons or are confined to comparisons with fructose provided as excess energy is unclear. To address these issues, we undertook an updated systematic review and meta‐analysis of controlled clinical trials to assess the effect of fructose on established therapeutic lipid targets for cardiovascular disease (low density lipoprotein cholesterol [LDL‐C], apolipoprotein B [apo B], non–high density lipoprotein cholesterol [HDL‐C]) and metabolic syndrome (triglycerides and HDL‐C).      [emphasis added]

 

 

Conclusions    Overall, the updated evidence for the effect of fructose on established lipid targets for cardiovascular disease risk reduction does not support earlier identified thresholds on which current clinical practice guidelines are based. There was no significant effect of fructose on LDL‐C, non‐HDL‐C, apo B, triglycerides, or HDL‐C in isocaloric comparisons with other carbohydrates across individuals with different metabolic phenotypes. There was, however, evidence of a significant triglyceride and apo B–raising effect in hypercaloric comparisons in which fructose supplemented diets with excess calories. In the absence of an effect in isocaloric comparisons, the effect of fructose seen in hypercaloric comparisons appears more attributable to the calories rather than fructose per se.  [...]   [emphasis added]

[mccoy]

Honey, through its hepatic and muscular amelioration of oxidative stress-induced insulin resistance, would possess characteristic effects of thiazolidinediones and biguanides such as metformin.

 

 

The above may have huge practical usefulness, in that we'd have a natural metformin-like molecule, with its alleged longevity-boosting effects. With no collateral problems like in the drug. It should be researched though which varieties carry more and in which amounts

[Mechanism]

Edited

[Mechanism]

Edited

[mccoy]

What appears evident is that trying to maximize micronutrients and non-nutrients by maximizing the intake of vegetable may turn out to be a distressful factor.

In my case, I'm an absolute glutton of vegetables and last evening had no probs in eating one kg  plus some legumes and nuts, but I had to stay up until 1 am until the gastric distress petered out.

 

In my case (similarly as it turns out to other guys), reaching painlessly the minimum suggested threshold of 1 kg vegetables per day would entail to adopt an adequate strategy, like distributing them thorughout the day and prioritize such strategy to the possible expense of other food sources.

 

Another strategy should be to eliminate EVOO as a dressing and minimize other foods, to make the vegetables more quickly digested and leave room to another big bulk of vegetables the next meal.

 

This might eventually cause deficiencies in macronutrients plus the added stress could counteract the benefits of such a diet, whereas an optimization by a more moderate approach and by choosing often veggies high in the ANDI scores is probably the best.

 

My bottomline, presently is this:

 

• Adoption of a rigid Fuhrman diet is advised only as a drastic CR regimen or as a cure for some diseases or as a drastic preventive measure for some health hazard
• Adoption of a flexible Fuhrman diet appears to be one of the best dietary optimization strategies as far as health and longevity is concerned.

 

A 'flexible' Fuhrman diet in my definition includes the following elements (the numbers have an undefined interval of uncertainty):

 

• 500 to 1000 grams cooked and raw vegetables, divided in two groups:
• 1): 65 % of those with ANDI scores >400, which should be rotated-varied;
• 2)35% of those with ANDI scores <=400, which should be varied
• 150 to 750 grams fresh fruit
• Inclusion of the three following groups of foods, according to individual requirements and with a minimum of 50 grams (2 ounces) of each (max one cup according to Fuhrman) :
• a)legumes
• b) seeds and nuts
• c) cereals
• Occasional to Less frequent inclusion of moderate quantities of animal proteins (dairy products, fish, meat) according to individual needs, idelly no more than 10% of total calories 
• Inclusion of EVOO at least one tbsp a day
• Moderate inclusion of addictional phytonutrients contained in foods not cited by fuhrman like cocoa, honey

Pls feel free to suggest additions or subtractions to the above list, which I believe reflects the dietary regimen of many members of this forum

[Mechanism]

Edited

[mccoy]

 

If you wish to include more bulk, I would suggest first rule out any medical conditions such as pancreatic enzyme insufficiency, biliary issues, gastrointestinal reflux, etc., & address. Otherwise, the stomach can stretch tremendously and comfortably with experience, but over weeks, months, or years as it takes time to adjust. I can have 2000-3000 grams of food ( not including drinks) in under 60-75 minutes. These perhaps 6.5 pounds are dwarfed by Dean's 8.5 pounds that he may have in 3 hours or less. And his are far dwarfed by records held by any professional food eater (though I do not expect that to be healthful or comfortable!). But if going slow and getting accommodated to a new routine is not your path, I see no reason it is a requirement for optimal health and longevity.

 

Hope that helps perhaps a little bit. You are one of the healthiest guys I know. There is a lot of wisdom in the body, your proposed changes sounds great, but if no underlying conditions and yet slow change towards more bulk does not agree with you, it may be telling you something!

 

Mechanism, 

I've read your comments and the posted links. Unfortunately, I have not the gastric elasticity you and Dean exhibit, and probably will never achieve it. At this point it is probably evident that the amounts of veggies suggested by dr Fuhrman may have the distinct advantage to pack the stomach and avoid to eat significant macronutrients. So, the effect is perhaps more a mechanical one (satiation caused by reaching max gastric capacity), than a chemical one (more micronutrients). Hence, Dr Fuhrman's diet might be viewed as a CR regimen, and beneficial in some diseases since when metabolism is not overloaded manteinance & repair prevail and the immune system is given priority.

Jeff Novick's considerations in the McDougall's forum are pretty sensible.