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The Cureality Diet
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Including the Six Cureality Nutrition Principles

People have experimented with just about every kind of diet imaginable: Low-fat, ultra low-fat, high-fat, low carbohydrate, high carbohydrate, high protein, low protein, vegetarian, Mediterranean, Oriental, rice, grapefruit, Atkin’s, “Zone,” Paleo and on and on . . .

Is there one diet that’s right and all the rest are wrong?

Probably not. In fact, every diet has taught us something new. The American obsession with diet has amounted to a nationwide experiment in the value—or danger—of various nutritional manipulations. To add to the confusion, because people vary genetically, they respond to the same diet in different ways. A diet, for instance, that drops one person’s LDL cholesterol 30 mg/dl could cause someone else to increase LDL 30 mg/dl.

The diet advocated by the American Heart Association is a modest fat-restricted program designed to reduce LDL cholesterol by 10% but typically worsens blood sugar or causes weight gain. Surely we can do better than that. Likewise, the USDA Food Pyramid/Plate advocates a diet that contributes to obesity, pre-diabetes and diabetes, fatigue, abdominal symptoms like cramping and diarrhea, and does little to reverse abnormal health conditions. “Official” diets tend to be guilty of a one-size-fits-all and a people-really-can’t-stick-to-diets-anyway mentality. They are also disturbingly distorted by commercial interests—Big Food and agribusiness— that influence the message.

For further proof of the misguided nature of conventional diet advice, you need only take a look at programs like the American Heart Association “Heart-Check Mark” Program stamp of approval on boxes of Cocoa Puffs, Count Chocula, and Berry Kix to understand that marketing and financial motivations lie behind much diet advice, rather than nutritional wisdom.

How about ultra low-fat diets often advocated by those who claim they “reverse” heart disease? Many years ago, I prescribed the Ornish diet. This program advocates 10% of calories or less from fat, along with fruits, vegetables, and whole grains. In my experience, people following this diet showed two varying responses: A few initially did well—reducing LDL cholesterol, losing weight, and apparently slowing their heart disease. Others enjoyed little or none of these benefits. This much larger second group lost weight at first, then gained weight (especially fat around the waist), followed by reductions in HDL cholesterol, increased triglycerides, and increased blood sugar to the near-diabetic or diabetic range. When lipoproteins were examined, there was marked increase in small LDL particles. These are all changes that encourage growth of coronary plaque. Needless to say, I abandoned the ultra low-fat approach.

Can we construct a diet that benefits from these lessons? Is it possible to obtain the benefits we desire yet maintain flexibility and not force you to adhere to strict menus and formulas? Can we use diet to lose weight, reduce blood sugar and reverse diabetes, reduce or eliminate risk for heart disease, reduce blood pressure, and yet feel great and provide options that are delicious?

Yes, we absolutely can. The Cureality nutrition principles maximize the health benefits of diet, minimizing, often eliminating, the need for treatments including statin drugs, drugs for hypertension, acid reflux, and arthritis, and helps you achieve other health goals, including reduction in waist size and weight loss, often dramatic.

Not another diet!

The Cureality nutrition program is not a precisely structured program with percent calories from fat, carbohydrate, etc. dictated to you. Instead, it educates you about important principles that create diet habits. This approach is therefore flexible, permitting modification to suit personal tastes and varying metabolic patterns.

The Cureality Diet includes animal products, though it can be adapted to a vegetarian lifestyle, as well. The traditional argument against animal products has been saturated fat. Let’s put aside the saturated fat question for a moment. Beyond saturated fat, several questions emerge:
  • If humans were meant to be vegetarian, why do omega-3 fatty acids yield substantial health benefits, including dramatic reduction in sudden death from heart disease?
  • Why would vitamin K2 (from meats and milk, as well as fermented foods like natto and cheese), obtainable in only the tiniest amounts on a vegetarian diet, provide significant benefits on bone and cardiovascular health (Geleijnse 2004)?
  • Why would vitamin B12 (from meats) be necessary to maintain a normal blood count, prevent anemia, and lead to profound neurologic dysfunction when deficient?
Omega-3 fatty acids and vitamins K2 and B12 cannot be obtained in satisfactory quantities from a pure vegetarian diet. The consequences of deficiency are not measured in decades, but as short as a few months. The conclusion is unavoidable: Evolutionarily, humans are meant to consume at least some foods from animal sources.

It pains me to say this, since I’m concerned about inhumane practices in factory farm-raised livestock operations and the health and safety of consuming the products from those operations. But, stepping back and objectively examining what nutritional approach appears to stack the odds in favor of optimal health, I believe that only one conclusion is possible: Humans are omnivorous, meant to consume some quantity of animal products.

Let’s take this argument a step further: If humans were meant to consume the kill of Stone Age hunters, what role is there for cultivated grains? Grains, of course, had little to no role in the diet of hunter-gatherers, who were nomadic by necessity, never staying put long enough to till a field and plant seeds.

Vocal proponent of this Paleolithic diet concept, Dr. Loren Cordain, and author of the book, The Paleo Diet, has pointed out that the profile of human disease (judging by analysis of bones and teeth of primitive humans, examination of last meals from stomach contents, and other such piecing-together-of-the-puzzle) shifted dramatically 8,500 years ago (a mere second on the evolutionary time scale)?just at the time when humans learned to gather and cultivate wheat and other grains. While hunter-gatherer predecessors died of trauma and infection, grain-consuming humans began to develop explosive tooth decay, cancer, diabetes, and heart disease, diseases that were previously rare (Cordain 1999; Cordain 2005).

Fast-forward to the 21st century and the “healthy whole grain” craze has seized everyone from the USDA and AHA, to Kelloggs and General Mills, all the way down to the grain-consuming obese pre-diabetics or diabetics on Main Street, U.S.A. If we average the wheat flour intake of every infant, child, and adult in the U.S., the annual per capita consumption is 133 lbs (USDA/Economic Research Service), the equivalent of around 300 loaves of bread per year. Wheat now provides 20% of all calories consumed worldwide; wheat, rice, and corn provide 50% of all calories. Since no infant or child eats 133 lbs of wheat per year, it means that many adults consume far more. Because of the destructive health properties of wheat, wheat elimination has become a major point of focus of the Cureality Diet.

We will therefore focus on principles of healthy eating and generally not dictate what proportion of this or that component of diet we should consume (with a few exceptions, such as sugar and carbohydrate intake). While it may seem more lax than other approaches, it has achieved extraordinary results to date, yielding effects like weight loss and reversal of diabetes. We construct a diet based on what is evolutionarily appropriate for Homo sapiens, a diet that includes animal products and minimizes or eliminates grains. Following an approach like this, issues like percent calories from fat or proteins just seem to take care of themselves.

The new thinking on diet

If the members of the American medical establishment were to have a collective find-yourself-standing-naked-in-Times-Square-type nightmare, this might be it. They spend 30 years ridiculing Robert Atkins, author of the phenomenally-best-selling ''Dr. Atkins' Diet Revolution'' and ''Dr. Atkins' New Diet Revolution,'' accusing the Manhattan doctor of quackery and fraud, only to discover that the unrepentant Atkins was right all along. Or maybe it's this: they find that their very own dietary recommendations?eat less fat and more carbohydrates?are the cause of the rampaging epidemic of obesity in America.”

Gary Taubes
What If It’s All a Big Fat Lie?

Since the original diet principles advocated in the Track Your Plaque program that preceded Cureality were released in 2004, a number of new developments have surfaced. While some new concepts are simply passing fads that should not impact our thinking, there are also some lessons to learn. All of these have been incorporated into the Cureality Diet.

First of all, I believe that we can all agree that:

Hydrogenated, or “trans” fats, synthetic fatty acids created by food manufacturers to replace saturated fats, are a failed experiment that has resulted in more heart disease (via its LDL-increasing, HDL-decreasing effects), high blood pressure, and cancer. Hydrogenated oils should be entirely removed from our diets. Any product with a label disclosing hydrogenated or partially-hydrogenated oils should be avoided.

Polyunsaturated fats represent yet another failed experiment. The “official” dietary advice of the 1970s and 1980s was dominated by recommendations to reduce saturated fat and replace them with polyunsaturates like corn oil, safflower and sunflower. While this reduces LDL and total cholesterol, it has more recently been shown to increase oxidation and inflammatory responses. Polyunsaturates are rich in the fatty acid, linoleic acid (not to be confused with the healthy linolenic), a precursor to inflammatory prostaglandins like arachadonic acid (Lahoz 1997). Polyusaturates are subject to oxidation and thereby more atherogenic (plaque-causing), both at time of ingestion, as well as in the body (Reaven 1991). Polyunsaturated fatty acids are also readily incorporated into coronary plaque, more so than saturated fats. Polyunsaturated oils should therefore play a minor role in diet and we do not purposefully add oils like corn of mixed vegetable oils. They should not be eliminated, however, since linoleic acid remains an essential fatty acid.

Commercially produced meat today is not the same as that eaten by our ancestors, particularly if compared to wild game caught by our hunter-gatherer predecessors. Factory farm-raised chicken, beef, pork, and even fish are modified by confinement in small spaces, administered antibiotics to accelerate growth, being fed corn or other industrial meal, growth hormone, among other “modern” strategies used to increase yield. The accelerated maturation and grain and corn feed yields an obese animal at time of its kill. (Cattle, for instance, go from birth to slaughter in as little as 18 months, compared to the usual 3-4 years.) The end product that arrives on your dinner table has slightly greater linoleic fatty acid content, along with substantially reduced linolenic fatty acid, not to mention antibiotics and hormones (Tollefson 2000; O’Keefe 2010).

There are other new developments that we should incorporate into our nutritional thinking:

Total fat composition of the diet is not important

In past, we often obsessed over what percentage of calories fats should comprise in the diet: 10%, 20%, 30% etc. The focus on saturated fat as a cholesterol-increasing fat fraction led us to initially believe that elimination of saturated fat along with a reduction in total fat would reduce risk for heart attack?it does not. Reductions in saturated fat and across-the-board reductions in total fat do not result in reduced risk for cardiovascular events (Siri-Tarino 2010). Total fat intake is not an important aspect of health at all, although it can become an adverse factor if purposefully restricted?a phenomenon directly opposite to what we had previously believed.

Saturated fat is not bad

The low-carbohydrate craze has uncovered an unexpected phenomenon: When excessive carbohydrates are removed, the undesirable effects of saturated fat are reduced, perhaps eliminated. While saturated fat sources do indeed increase (large) LDL cholesterol (but also increase total HDL, large HDL or HDL2b, and reduces lipoprotein(a)), the association with increased risk of heart disease is weak or non-existent. But combine saturated fats with excessive carbohydrates and the combination causes the dreaded small LDL particles to skyrocket. So, saturated fat is not the culprit; it is soaring small LDL triggered by carbohydrates, only worsened by saturated fats.

"Healthy whole grains" are not

This phenomenon has become a particular bugaboo for the Cureality program. In past, it was a real struggle to help people successfully lose weight and improve patterns associated with overweight and obesity, like low HDL, high triglycerides, small LDL, increased blood sugar and blood pressure. It began with advice to eliminate wheat flour-containing products?all breads, bagels, muffins, pretzels, crackers, breakfast cereals, pasta, etc.?simply to reduce blood sugar, since wheat raises blood sugar higher than table sugar. Lo and behold, people began to lose weight, often precipitously. Blood sugar dropped, blood pressure dropped, triglycerides dropped, HDL and small LDL corrected, appetites shrunk dramatically. Some diabetics became non-diabetics. Unexpectedly, many people suffering chronic bowel problems, like cramping and diarrhea, experienced dramatic relief, rashes resolved, some arthritis improved or disappeared, asthma improved sufficient for many people to toss their inhalers, rashes improved or disappeared, mood and energy improved. Grains, particularly wheat, are the causes of an entire panel of undesirable health effects; elimination reverses them. There has since been no turning back. Of course, this information goes against the “grain” of conventional advice from the AHA and USDA. But the strategy of reducing, even eliminating, wheat from the diet to correct many common lipoprotein abnormalities is among the powerful strategies in diet and health that we will consider at greater length.

The Cureality Diet incorporates the collective wisdom gained through this grand nationwide nutritional experiment. But we also apply our unique perspective on healthy eating and nutrition in a program of gaining control over multiple heath conditions, from bone health, to heart health, to achieving ideal weight.

Will I lose weight?

The Cureality nutrition principles promote weight loss. Weight loss can, in fact, be dramatic.

Starting with an average American diet, many people lose a pound per day for the first 7-10 days—similar to starvation—slowing to about 5-10 lbs every 30 days thereafter. Losses of 20-30 lbs. in the first 3 months are therefore typical, followed by a more gradual downward trend over the ensuing year. Losing excess weight significantly impacts lipid and lipoprotein patterns, reduces diabetic tendencies, and make you feel better, all of which contribute to improved overall health. What makes the rate of weight loss incredible is that we do not limit calories.

People who begin the process substantially overweight usually experience as much as 50-70 lbs weight loss over the first year. (The pace and total quantity of weight depend on how overweight you are to begin with, as well as other factors, such as adherence to diet, amount of physical activity and exercise, genetic factors, thyroid status, and others. Males will generally lose faster than females.)

There is a hidden “secret” built into the Cureality nutrition program: We eliminate foods that trigger appetite. Four food ingredients are powerful stimulants of appetite: wheat flour, cornstarch, high-fructose corn syrup, and sucrose (table sugar). Wheat, in particular, can powerfully drive appetite for many people, causing food obsessions in the most susceptible. It often underlies what people call a “sweet tooth”—a desire for sweets caused by the gliadin protein of wheat (see below).

The first step in the Cureality nutrition program is to eliminate these ubiquitous components of processed foods. Usually within a few days to weeks, appetite plummets. Remove these four common processed food ingredients and appetite will be driven by the need for sustenance, but not abnormal impulses to eat . . . and eat and eat.

Because appetite is dictated by need, rather than impulse, the average calorie intake on the Cureality Diet drops by 400 calories per day—without hunger, without cravings.

In fact, a common conversation we have around Cureality is “Am I too skinny?” I have to frequently remind people that, because most of their friends and neighbors are overweight or obese, people who are at their normal weight tend to stand out in a crowd. For the great majority of people, the Cureality approach achieves ideal weight.

Can medication make up for a bad diet?

Just how important is diet?

Some people ask, “What if I follow the program—I’ll take the medicines and supplements and exercise—but I really don’t want to give up my pancakes and waffles, bagels, and chips. Can I still achieve ideal health?”

People who fail to adopt the principles discussed here and continue to follow unhealthy eating habits do not enjoy the kind of control over health as people who pay attention to diet—not even close. For one thing, eating an average American diet virtually ensures excessive weight gain over time. When you ingest large quantities of refined carbohydrates from processed foods, many lipid/lipoprotein abnormalities and other metabolic factors like blood sugar are more difficult to control, necessitating more medication and ultimately more likely to cause health problems such as diabetes, cataracts, hypertension, kidney disease, arthritis, heart disease, cancer, and dementia. And you may not necessarily perceive anything wrong while this all develops.

There are also many aspects of diet that cannot be controlled by any medication or supplement. For instance, the after-meal flood of lipoproteins in the blood that occurs during the first few hours after eating is largely influenced by the content of diet. The foods you choose are crucial determinants of whether you will or will not shower your arteries with excessive lipoproteins for the 6 or so hours after a meal. Fat content of the diet is only a minor determinant of the composition and magnitude of after-meal lipoproteins. Carbohydrate content of the diet is the principal determinant; the higher the carbohydrate content of the diet—such as the inclusion of “healthy whole grains” and sweeteners like high-fructose corn syrup—the worse the after-meal flood of lipoproteins (Volek 2009).

In fact, without the diet changes discussed here, the only medications that are capable of reversing at least some of the metabolic derangements triggered by diet are diabetes medications. Given a choice of diet versus taking diabetes medications, I believe the choice is easy.

Let’s now discuss the six Cureality principles of healthy eating.

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