If It Comes From The Ground...EAT IT!

By Dan Mcdonald

Dr. John McDougall says his vegetarian diet regimen can ward off illness, cut out the pounds and taste good, too. It's a triple-threat promise he fights hard to defend.

As anyone can see by glancing at the diet section in any bookstore, there appears to be little consensus as to what constitutes a "proper" diet. Different approaches abound, literally from soup to nuts, with the occasional grapefruit thrown in. Nevertheless, a flow of studies consistently show that proper diet can add healthy years to the human life span. Eating the right food reduces the risk of cancer and other diseases, while the wrong foods increase the odds of dying prematurely. And yet, even though it's been established that a proper diet is essential for optimal health, most people do not eat a healthful diet because of inconvenience and unsatisfactory taste.

There is one medical doctor, however, who wants to cut through the confusion. John McDougall, M.D., 51, is an internist and authority on nutrition and preventive medicine whose diet regimen and instant vegetarian meals are part of his increasingly well-known "McDougall Diet." McDougall is the author of eight health books, the host of a national TV show, and medical director of his McDougall Program at St. Helena Hospital, in Deer Park, Calif., north of San Francisco.

McDougall is one of a handful of physicians who spoke out more than 20 years ago about the effects of nutrition on disease. He has documented how a proper diet can enable people to look better, feel great, and enjoy optimal health for a lifetime. (The Life Extension Foundation sells a line of McDougall's foods.)

The McDougall Diet has produced a broad range of long-lasting results, including fat loss, as well as amelioration (without drugs) of hypertension, Type II diabetes (non-insulin dependent) and heart disease. However, McDougall himself has attracted his share of controversy, including charges of fadism levied against him by more "mainstream" nutritionists. Some of this criticism may be prompted by McDougall's own criticism of traditional dietary notions. For example, he has attacked the American Heart Association's dietary recommendations for treating heart disease, calling them ineffective. And, he has argued that the Heart Association's recommendations are too high in fat and cholesterol, and do not protect against coronary atherosclerosis.

He certainly doesn't shy away from confrontation. In his 1983 book The McDougall Plan, he claims in the opening sentence, "The concepts of health and nutrition today are so far removed from the truth that our very lives are threatened from the day we are born." He argues in the book that eliminating dairy products, meats, and processed oils is essential for optimal health.

McDougall believes his tests show that a low-fat diet can reduce cholesterol, weight and blood pressure in just 12 days. Those with the financial wherewithal can check into St. Helena Hospital for those 12 days worth of intensive treatment using McDougall's nutritional approaches. The cost: $4,000.

The message you buy is rather simple: If it comes from the ground, eat it. If it doesn't, don't. McDougall cites the Japanese, whose longevity is the highest in the world, to substantiate the weight-loss benefits of his diet. He points out that the high carbohydrate diet consumed by the Japanese produces a healthy population that doesn't suffer from the kind of obesity and heart disease that exists in the Western world. However, when Japanese immigrate to the U.S. and start eating a Western diet, he notes, they begin to suffer from the same ills as Americans, often becoming fat, lethargic and sickly.

McDougall emphasizes his position that good health is born of nutrition, not genes.

McDougall did his undergraduate and post-graduate work at Michigan State University, and graduated from that university's College of Human Medicine. He interned at Queen's Medical Center in Honolulu, and did his residency at the University of Hawaii. It was while working in Hawaii as a plantation doctor in 1973 that he says he began to understand the link between a lifetime of good nutrition and living an active and full life.

McDougall noticed that older people-including native Hawaiians and Japanese immigrants-who ate a traditional diet of fruits vegetables and non-processed foods were vital into their 80s and 90s. However, their children and grandchildren who were eating a "rich" Americanized diet that included meat, dairy products, eggs and oils were heavier and more sickly.

"It became obvious to me that the basic four food groups was flawed," McDougall said. "While in Hawaii, I had a 93-year-old gardener. I was 25 and the man could outwork me. This was typical."

Besides anecdotal evidence, McDougall has researched his vegetarian diet, citing more than 10,000 sources from around the world. In his view, a vegetarian diet is an age-old plan to good health.

Eating to Live

"Rich foods are for special occasions," McDougall says, explaining his only exceptions: "Turkey is for Thanksgiving, ham is for Christmas, candy for Halloween and Valentine's Day, eggs for Easter, and ice cream and cake on birthdays. Most of us, however, eat like it is a holiday three and four times a day, seven days a week."

Both McDougall and the federal government agree that the foundation of a nutritious diet is healthful doses of grains, fruits and vegetables. However, guidelines from the Department of Agriculture advise that a diet also include daily servings of meats, fish, dairy and even limited amounts of fat and sugar. The federally advised formula is known as The Food Guide Pyramid, and is heavily weighted at the bottom with as many as 11 daily servings of grains, cereals or pastas, three to five servings of vegetables, and two to four servings of fruit.

The pyramid is topped off with two to three suggested servings of dairy, two to three servings of meat, poultry, fish or eggs, and fats and sweets used sparingly throughout the day. Most nutritionists might agree that if you follow these guidelines, you'll have a healthful diet, but McDougall argues that dairy, meat and the bad oils aren't necessary. He suggests you lop off the pyramid's top and use "McDougall's Trapezoid"-that is, take the fats and oils out of the cooking process, as well as meat, dairy and eggs.

As for vitamins and supplements in general, McDougall isn't opposed to them as a secondary road to good health. But for weight loss, McDougall points out, "I've never seen anybody who lost 100 pounds by taking a vitamin supplement."

Supplements do serve a purpose, he notes. For example, in treating someone for high cholesterol, besides the obvious dietary and lifestyle changes, McDougall would prescribe a combination of vitamins C and E with garlic, oat bran and an extract from the herb gugulipid.

Seeing the body's ability to recover from years of bad eating habits is what galvanizes McDougall in his work. "When you stop doing the things that make you sick, the body heals itself. There's a repeated injury caused by uncontrolled eating. Stop that behavior and the healing processes catch up."

For many patients who come to McDougall's clinic, habits have been a lifetime in the making. Patients learn about exercise, including simple things like morning walks or afternoon swims. They are taught what foods to eat, how to shop for and prepare them, and how to order a healthful selection of food when eating out.

McDougall claims amazing results in less than two weeks. He says patients with high blood pressure leave without need of medication. Those who have chronically used laxatives and antacids no longer need them, cholesterol counts drop by 30 points or more, and patients lose four to eight pounds without missing a meal. His research has found that 67 percent of the patients are still on the plan after the first year. He admits, however, that these people are motivated to make the diet work for them. After all, they've invested their time and $4,000 for the seminar.

But that amount, says McDougall is "about one-tenth the cost of a heart bypass operation." In fact, money is one reason, he believes, that diet and nutrition have been ignored by science and industry; there's a higher profit in prescribing a pill or removing a cancer-ridden organ that got that way after years of abuse than there is by prescribing a more healthful diet. The food industry lobbyists, he charges, have for years influenced government nutritional standards. Researchers who develop eating charts are rarely vegetarians, he avers.

Of course, critics might charge McDougall with his own brand of profiteering, since he sells his own product line, called Dr. McDougall's Right Foods. While it's a for-profit business, in his mind he's just fighting fire with fire. The large food companies make and spends millions to advertise their processed foods, he notes, and McDougall hopes that his food line is equally profitable and affords him the opportunity to advertise as well.

"I soon discovered the way to beat those guys is to build a bigger business than they have," he says.

McDougall's science does concern some nutritionists. Jeanne Goldberg, Ph.D., R.D., and director of the Center on Nutrition Communication at Tufts University, has found problems with McDougall's science, in particular as cited on his website. "His information is inaccurate," she charges. "The stuff is straight out of fadism."

Goldberg notes that among dubious McDougall claims is that one can grow hair by eating a low-fat vegetarian diet while using the drug minoxidil. Another claim that troubles Goldberg is that environmental factors such as diet causes acne, which goes against the findings of the American Academy of Dermatology. Another McDougall claim is that the right diet can prevent and even reverse arthritis damage, an idea that is contradicted by National Institutes of Health research which does not support any dietary protocol that will prevent or cure arthritis.

"The McDougall web site is full of information not substantiated by the literature," Goldberg said. (The Tufts University School of Nutrition Science & Policy rates the quality of nutritional information posted on a large number of health-oriented websites. For the record, Tufts also rates as unsatisfactory the nutritional information contained on the Life Extension Foundation's website.

For his part, McDougall questions Goldberg's independence. Her research is underwritten by Kraft Foods, he says. "She is paid by the food industry to support the status quo." McDougall claims Goldberg's bias is weighted heavily in favor of conventional nutrition guidelines, and that Goldberg didn't carefully read the documentation that backs up his claims that the proper diet can alleviate a wide range of medical disorders.

"They refuse to look at the basic research," McDougall says of Tufts review panel's criticism of his diet and website. "I disagree with the status quo. If you disagree with the status quo, you are wrong." Concerning the link of childhood diabetes and cows' milk, McDougall says, "I will debate you in any form. If the American Academy of Pediatrics can claim there is a link, why can't I?" And McDougall stands by his dietary program, saying that he wouldn't change a thing in his books, other than to recommend vitamin B12 supplementation.

"I'm not out there to win a popularity contest. I want to be the best doctor I can be to my patients. My patients get well. I prescribe a program that works."

While Goldberg admitted that Kraft Foods underwrites her research, she said the corporation has no say in what is approved or rejected by Tufts' website review panel.

On the question of weight loss, the Life Extension Foundation questions if a high-carbohydrate diet will help everyone who tries it to lose weight, or that the McDougall program will solve everyone's weight problem. For example, some people metabolize carbohydrates to produce excess body fat. The Foundation is aggressively exploring better ways to break down the cellular insulin resistance that develops with normal aging. Once youthful glucose metabolism is restored, a high-carbohydrate diet should produce significant weight reduction and other health benefits. The Foundation also suggests that more emphasis be placed on the intake of essential fatty acids from flax, fish, borage and perilla oils.

To some, good nutrition and a healthful lifestyle aren't difficult. Kristen McNutt, an editor of Consumer magazine who has earned a master's degree in nutrition and a doctorate in biochemistry, sums it up in one sentence-"Eat more plant foods, and start moving." However, she isn't advising the elimination of meat protein altogether. While eating animal fats prompt a concern about cholesterol, moderation is the key, she says. The healthful diet doesn't include a 16-ounce Porterhouse steak, she says...unless it is going to feed three people.

"I think it would be bad advice to eliminate animal products out of the diet," says McNutt. "However, if you eat more vegetables it tends to fill the stomach and you will probably end up eating less animal foods, which are higher in fat."

Fighting Vegetarian Resistance

One of Dr. John McDougall's personal challenges is to change peoples' prejudices about vegetarianism. "Our 'rich' diet has prejudiced us against vegetables," McDougall says.

He says people usually think of meat or fish when they think of dinner-meat loaf, ham, steak or hamburgers get top billing, rather than potatoes, broccoli or carrots. Meat is thought of as flavorful, vegetables are bland.

But, he says, the opposite is true.

"Beef, chicken and fish really have no taste to them. Boiled chicken or beef is not interesting. The only way we make them tasty is with sauces. The McDougall Program replaces this unhealthful food that is full of cholesterol, sodium and fat with healthful foods. Take the rice, pasta or potatoes and then use your favorite sauces that you used on the unhealthful meats." McDougall's wife, Mary, has developed several cookbooks, the most recent being The McDougall Quick & Easy Cookbook, that include more than 300 recipes that can be prepared in 15 minutes or less.

Detractors of McDougall's approach may argue that we need animal protein and calcium from milk for healthy bodies and bones. McDougall counters that these can be found in better supply in vegetables.

"People are concerned about osteoporosis due to a calcium deficiency, but osteoporosis is caused mainly from a high animal- protein diet," he asserts. McDougall believes that the proper vegetarian diet can provide adequate levels of calcium. In addition, of course, there are calcium supplements.

"Anecdotal evidence that a vegetarian diet can prevent osteoporosis can be found in African countries and China, that have a diet of starches and fewer hip fractures compared with Western diets. In Western countries, where more calcium is consumed through high-protein diets, there is still a larger instance of hip fractures."

For proof, McDougall refers to a study published in the American Journal of Clinical Nutrition (February 1985, vol 42; p 254), which found that protein may hurt the body's ability to absorb calcium. In the study, post-menopausal women drank three 8-ounce glasses of milk a day, worth some 1,400 milligrams of calcium. When compared with the test group that didn't get the added calcium, the milk drinkers still had a negative calcium balance at the end of the experiment. McDougall likes to cite this study because it was paid for by the dairy industry.

McDougall says that even those who eat a "poor" diet of starches obtain more minerals than those eating a "rich" diet of meat, dairy and processed oils. The minerals in meat don't come directly from beef cattle, he says; they come from what the animal eats. "The original source is the ground. These minerals dissolve in a watery solution, which are taken in by the plants. The animals then eat the plants. Go to the direct source."

McDougall is so concerned about cow's milk that he believes people shouldn't drink it at all. It's no coincidence that many babies have trouble drinking cow's milk, he said-it wasn't meant for them. He cites Pediatrics magazine (December 1997; vol 100, p 1035), which states, "Exclusive breast feeding is ideal for the first six months. Infants, when weaned in the first 12 months, should not receive cow's milk feedings."

McDougall's study of the changes that occur in humans over generations have left him startled as to how early this generation is maturing, and he believes that the animal protein diet of the West is to blame. Studies have shown white females reaching puberty as early as age 10, whereas a century ago (when people were eating a much less-rich diet) the age of maturity in women was normally 17. Hormones used in cattle are passed on to the people who consume it, he says.