That Paradigm Thingy, #WFPB-style

No question, 2019 is the year of veganism in general and the Whole Foods, Plant-Based diet in particular. It should be noted however that these are two very different concepts. The important impetus behind veganism is part animal welfare and part environmentalism, as much as vegetarianism was traditionally mostly for religious reasons (Hindu, Jain, Buddhism). Many people fail when they try to go “vegan,” for the simple reason that the absence of something (animal products), does not good nutrition make. Famously, potato chips and Coke are vegan, but hardly healthy. So let’s try again.

Of Vegans and Vegetarians

For the sake of sanity, I consider “vegan” to be a sociological term, connoting people who do not use animal products. The label “vegan” leaves unanswered if the motivations are religious, environmental, animal welfare, or health. It’s all mixed together. Worse, the myth of human beings needing to worry about proteins is pervasive, even in veganism, setting us up for failure. There simply is no known case of protein deficiency. Optimal levels of calories from protein might be 10-12%, but we can get by on as little as 5% (men) and 3% (women), according to the research of T. Colin Campbell.

Vegetarian is arguably even more confusing, for there the historical emphasis is almost exclusively either a general spiritual concern – the respect for life in all forms, a more comprehensive understanding of “thou shalt not kill,” as it is manifested in hinduism, jainism and parts of buddhism, extended in the west by an understanding that out of a concern for animal welfare, we might accept eating animal products if the animal does not have to be killed to obtain them. In other words, it is an aversion for eating dead animals, but not animal products per se. Also in the West it has been associated with certain spiritual traditions, but not exclusively, one famous example is the seventh-day adventist movement. Within the theosophical movement, with its strong hindu influence, vegetarianism was also prevalent, but again absent our modern understanding of plant-based nutrition, it remained stuck in a nutritional concern over protein intake, which we now know to be false, all of the forms of it do occur from lacto-ovo-vegetarianism, to lacto-vegetarianism, ovo-vegetarianism and veganism. Here is a summary of the theosophical views on vegetarianism, and we should note that the theosophical movement became an important precursor to the modern new-age movement, with the work of Edgar Cayce being another important influence. The Rosicrucian author Max Heindel can be considered another important pre-cursor of the new age movement with his New Age Vegetarian Cookbook. Wikipedia has a most excellent summary of the relationship between religion and vegetarianism.

Whole Foods, Plant-Based Nutrition

Whole foods, plant-based nutrition is modern, evidence based, and T. Colin Campbell’s work laid the foundation., even if many clinicians preceded him. Cllinical experience and nutritional science are finally meeting up and presently merging in the new discipline of Lifestyle Medicine. It is critical to understand that whole foods, plant-based nutrition is indeed nutritional science and a nutritional paradigm, not just a “diet,” for “dieting” in the popular sense evokes pictures of calorie counting and other forms of deprivation within the context of the accepted nutritional model, whereas, once you make the switch to the new nutritional paradigm of Whole Foods, Plant-Based nutrition, you can eat just about what you want within the paradigm, and the only supplement you will ever need is some B12, and possibly some vitamin D. With the benefit of hindsight, it is remarkable how far back the connection between plant-based nutrition and health actually goes. Peta recognizes no fewer than eleven instances in the Bible that would seem to promote a vegan lifestyle, the most significant of which is this one from Daniel, which goes back to the historical period of the second century:

But Daniel resolved that he would not defile himself with the royal rations of food and wine… then Daniel asked … ‘Let us be given vegetables to eat and water to drink.’ … At the end of ten days it was observed that they appeared better and fatter than all the young men who had been eating the royal rations.

DANIEL 1:8, 11–12, 15

Of Stereotypes, and Magical Beliefs

The scientific revolution of whole foods, plant-based nutrition is truly a paradigm shift in the full meaning of Thomas Kuhn’s classic, The Structure of Scientific Revolutions. One of the more interesting things about plant-based nutrition is that it keeps surfacing throughout history and yet it keeps getting ignored. The above account from the book of Daniel goes back to the second century in the Judaeo-Chrisitian world, and it clearly makes the argument for plant-based nutrition on the basis of health. The book was hugely influential, yet it seems this passages was honored more in the breach than in the observance as to its nutritional implications. And we ignore it at our own peril. It seems that in spite of the story in Daniel, what stuck was the magical belief that what the King ate must be better than what the oppressed ate. Such stereotypes have haunted the development of cooking and nutrition ever since.

The Japanese thought when they met Commodore Perry that they should better eat what these big Americans ate: meat. Instead, they began to import American style disease with that fateful decision. The message keeps getting lost. Part of the belief is unquestionably rooted in the primitive magical belief that if you ate something, you acquired its strength, which was reflected in cannibalism – eating your enemies, but also in the carnivore culture. Somehow eating meat always became associated with being wealthy, powerful, and so on, like in the story in Daniel, where the king’s household ate meat, but Daniel abstained and ate his veggies instead.

For similar reasons, during the colonial period, polishing rice was invented by the colonial regimes and it became popular in the 19th century. The obvious reason it became popular is because the oppressed peoples assumed that because the more powerful oppressors ate it, it was a sign of luxury and affluence. It became the cause of the increased incidence of beri-beri disease in Asia in the late 19th century. In typical dysfunctional manner that set the pattern for Western nutrition, instead of realizing we should be eating brown rice instead, the general conclusion seems to have been that we needed to supplement vitamin B1 (thiamine). Today, we understand that white rice is a nutritional disaster in general, because all nutrition is removed.

In America, the story of black nutrition, soul food and Southern cuisine is another disastrous tale of how the nutrition of an oppressed population was shaped by the oppressors, and in this case the slaves ate what the whites would not, and although certain things were highly nutritious, such as kale and collard greens, many things were not. Yet, after abolition, the slave-food traditions made a virtue out of necessity, and as a result the incidence of diabetes and heart disease in the African American population exceeds national averages.

Practical #WFPB: Nutrition, not Diet

The Whole Foods, Plant-Based lifestyle is about nutrition, not just another “diet” within the existing paradigm and apart from some very simple, basic rules, the two most obvious stumbling blocks are the concept that we don’t need to worry about proteins, and in fact in the standard American diet, we tend to get too much protein and the notion that we want to forego added oil. The general precepts are:

  • Whole (i.e. minimally processed) foods, i.e. cooked or raw, but no processed foods, such as sugars and oils, white flours and other heavily processed foods.
  • Plant-based, i.e. absolutely no animal-based foods
  • No ADDED Sugar, Oil or Salt.

The bottom line is #WFPB is not a diet in the sense of a restrictive protocol that operates within the existing nutritional protocol, but with some restrictions – like calorie counting etc. Those types of diets all leave the “accepted” nutritional concepts in tact, and just try to modify behavior.

The Whole Foods, Plant-Based diet flowed from the research of Dr. Campbell, and it was really the first time that we developed a comprehensive evidence-based, scientific nutritional paradigm. Within that paradigm, you can eat as much as you want. Personally, I first attempted to make the switch to #WFPB based on the work of Dr. Esselstyn, but, for me, it was The China Study that caused the dime to drop for the first time. That is what made me see this was about a nutritional paradigm, and not a diet, or a modification of the existing nutritional paradigm.

It turns out that historically the sequence of discovery of the macronutrients (fiber, fats, protein, carbohydrates and water) determined much of nutrional theory. Protein was the first to be discovered and understood and we seem to have developed a fixation as a result. For the rest, the basic nutritional paradigm was a set of normative assumptions going back to 19th century Germany about what people actually ate and what was simply assumed to be healthy, always laboring under that mistaken impression that protein was so important, when the real story is that protein is so plentiful, even in plant-based nutrition, that we never need to worry about it. Other nutrients were discovered often almost by accident, such as the story of vitamin C as a cure for scurvy in British sailors (who came to be called limeys because limes and lemons were found to prevent or cure scurvy). The history of vitamin B, thiamine deficiency and beri-beri is similar. But with the Whole Foods, Plant-Based diet we have, for the first time, a complete, evidence-based paradigm for optimal human nutrition. It is fully as revolutionary as the Copernican revolution.

A close corollary is the kitchen and dinner table variant of this paradigm shift, which I now recognize personally from my experience in making the transition to a whole foods, plant-based diet. Simply put, depending on how you were raised, you tend to have a certain archetype for what a meal looks like, or what foods belong at breakfast, lunch or dinner, etc. I can honestly say that in my transition from a more or less omnivore lifestyle (although mostly whole foods, and gravitating towards vegetarian), I had two Aha! moments, one being the reading of The China Study and the realization that this was a new nutritional paradigm, which solidified even more when I took the Certificate in Plant-based nutrition at the T. Colin Campbell Center for Nutritionstudies, the second was that even being raised as a vegetarian, there was a paradigm for a meal: potatoes, vegetables, and some supposed protein food – utter ignorance of the proteins in vegetables. I would say it took me two or three years before I simply realized that my concept for a meal had been dramatically changed. It is now instinctive that when I see the typical foods on display, I go hunting for real food. There is not the slightest bit of attraction for the standard fare.

Medical Paradigm: Maximizing Health vs Maximizing Treatment

Increasingly, many doctors are balking at the symptom suppression model of Western medicine (aka #Pharmageddon), which may produce big incomes, but little health. A good heart patient may be worth as much as $5 million in lifetime billings, but all of that could be avoided by putting them on a Whole Foods, Plant-Based diet at the first opportunity. These days that opportunity sometimes comes knocking already in the twenties for some patients in the form of ED. You can suppress the symptoms with Viagra and let the disease process rot on, and later begin with baby aspirin, then statins, stents and heart procedures, or you can put the patient on a whole foods, plant-based diet, and reverse the problem altogether, sometimes in as little as three days – in many cases, ED has been known to be reversed in as little as three days by switching to a strict whole foods, plant-based diet.

For many doctors, the path of Lifestyle Medicine is the path of new-found meaning in their professional life, as cardiologist Dr. Elizabeth Klodas tells it. We should note that with the change of the model, in the long run, doctors will hardly become superfluous, though we might need less of them over time, this is going to be a slow transition over a lifetime. Cardiologist Dr. Kim Williams offers some powerful reflections on how this will impact doctors in the long run, apart from the short term diminished prospects.

Currently, Dr. Saray Stancic’s Code Blue Documentary is raising the issue in a major way and it went into general release on January 11th, so I am eagerly awaiting an opportunity to see it myself. Here is an interview with her, which is very worthwhile.

Dr. Stancic has publicly commented on the gruesome rate of suicide among doctors, who can’t take it anymore. I grew up in a doctor’s household, my father was a psychiatrist, and our dinner table was frequently the place of many professional conversations between my father and various colleagues, some of whom had been in therapy with him at one point or another. This was the time in the fifties and sixties when #pharmageddon was starting to go into overdrive on the strength of the chemical industry that was growing explosively after the end of WW2. Even then some doctors felt their profession was being usurped by the pharmaceutical industry. This is now clearer than ever. The path of symptom suppression with pharmaceuticals leads doctors and patients down a slippery slope of unchecked disease progression hidden from view by treating symptoms, not cause, and inexorably leading to drugs and more drugs, procedures and more procedures, side effects, drug interactions and iatrogenic illness, without any prospect for real healing. Yet, a simple change of diet is often proving superior to: “You’ll have to take this drug for the rest of your life,” which is the favorite concept of the pharmaceutical industry.

The emerging field of lifestyle medicine is reversing the trend. It restores meaning to the professional life of doctors and health to patients. The early adopters are doctors who are fed up with the pointless treadmill of #pharmageddon and patients who are motivated to take charge of their own health.

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