Nutty Nutrition

Nutritional confusion is pervasive, even in the world of Whole Foods, Plant-Based nutrition, but there is no real reason other than big egos. Specifically, it pays to remember that the completely coherent and inwardly consistent nutritional paradigm that was developed by Dr. T. Colin Campbell, is the buoy to which all these clinicians are moored – without it, they’d still be in the position of floating their own nutritional theories and clinical histories. So do not let egos get in the way of the simplicity of the whole idea. The publication of The China Study and the book Whole, provided the backbone to this entire field and it pays to stick to the basics.

Some time ago T.Colin Campbell endorsed nuts as part of the #WFPB diet. Dr. Esselstyn and a few others however have been resisiting, particularly with a view to cardiovascular disease. So, nuts has been a controversial topic, and some, like Dr. Joel Fuhrman make a big fuss about nuts, but now it appears those days may be over – nuts in a plant-based diet negate some of the beneficial effects, so you’re shooting yourself in the foot if you eat any kind of nuts in quantity, even more so on a regular basis. Occasionally, as a condiment might be defensible, but you really want to avoid them as much as possible. They are certainly not a harmless snack.

It’s nuts to eat nuts on a plant-based diet

That, at least for now means that the mythology of how healthy nuts are is baseless, and Esselstyn seems to be vindicated in his caution about nuts – the oil will get you: nuts are a direct attack on your arteries. So what went wrong? Here is the whole series from VegSource on nuts:

The place most of these studies go wrong is if they are not controlled for diet. Which is the most pervasive problem in this area. In other words, if some ingredient creates an improvement for someone on a SAD diet, or even a vegetarian diet, that is one thing, but to what extent will it improve on a pure Whole Foods, Plant-Based diet? That is the key question. Dr. Michael Greger does incredible work but he skidded in in this area, and Dr. Joel Fuhrman has very much his own theories and wants to be an outlier in the world of the Whole Foods, Plant-Based diet and he promotes nuts, so he is vegan and not #WFPB. Too bad. The upshot is that you want to stay close to the classical model of Dr. Campbell as published on NutritionStudies. It is also brilliantly presented in the form of the 4Leaf Program.


Evidently, it is always possible for new things to be discovered, but for now, if you want the full health benefit of the Whole Foods, Plant-Based diet, stick to the basics. Ignore the fancy stuff. The upshot is that #WFPB is simple, and the 4Leaf Program is a great idiot’s guide. A modest amount of nuts seems to be OK, but if you add loads of nuts to #WFPB, that may be vegan, it is not #WFPB and you are an enabler for the nutritional obfuscation of the food industry which is widely exploiting the confusion about vegan nutrition to sell us more junk. If you add fish to #WFPB, you’re pescatarian, not #WFPB and so on.

On a practical basis, simply consider nuts as a condiment, but not so much as a primary food. In terms of the Esselstyn approach there has always been a distinction between the plant strong and plant perfect diet. For his acute heart patients, Dr Caldwell Esselstyn Jr. has always recommended staying away from nuts, avocado and coconut. For otherwise healthy people, his son, Rip in the Engine 2 diet, which he also calls “plant strong,” some nuts and avocado are allowable, in moderation. The upshot is that if you have hypertension or other wise are concerned about CVD, you want to minimize nuts.


Dr. Fuhrman tried to get the last word – he posted a rebuttal here. According to him there is no reason for panic. And, as with so many things, it seems that there is a lower threshold as well. Nuts in moderation are fine, unless you are really a serious heart patient. The question is what is “nuts in moderation,” and here Dean Ornish gives some guidance in his recent book Undo It!

One low-fat serving (around 3 grams of fat) equals any of these: 5 almonds 9 pistachios 1 whole walnut 3 pecan halves 2 cashews 6 peanuts 5 teaspoons of ground flaxseed 2 teaspoons chia seeds or shelled sunflower seeds 5 teaspoons pumpkin seeds

Dean & Anne Ornish: “Undo it!: How Simple Lifestyle Changes Can Reverse Most Chronic Diseases”

Perhaps that puts it in perspective. The upshot remains the same. In Esselstyn’s terms, the “plant perfect” diet (mainly Caldwell Esselstyn) is for serious heart patients and avoids nuts and avocado and coconut. The “plant strong” diet (mostly Rip Esselstyn) is more tolerant of modest amounts of avocado and nuts. So nuts in moderation are fine if you do not have stringent medical reasons for avoiding them. The typical industry claims that nuts are heart healthy are all done in comparison to SAD – the standard American Diet – and are therefore irrelevant in the context of the regular Whole Foods, Plant-Based diet.

Meanwhile the Fuhrman saga continues, as T. Colin Campbell is on record with his complete distrust on Dr. Joel Fuhrman, who has lied about the results he claims: