"People have felt that will power was the whole issue in weight control," said Dr. Barnard during a recent interview. "It's actually a physical issue. A trigger operates in the brain for certain foods. It's not as strong as for heroin and so on, but these foods give a feel-good sensation that makes you come back to it."
While the couch-potato syndrome and "super-sizing it" are factors in America's obesity epidemic, he believes a major culprit is cheese-and not just because of the fat it contains.
The typical adult American consumed an average of 15 pounds of cheese per year back in 1975, he said, while this year the expected per capita consumption level will be 30 pounds. That's the caloric equivalent of about seven and a half pounds of added weight per year.
"Some people find it impossible to give up cheese," he reported. "In fact, 'cheese cravers' have been identified as a group, and are targeted for marketing."
"Scientifically," he said, "cheese is a special case, because it contains casomorphins." He explained that these substances, which are one-tenth as powerful as morphine, have a similar effect on the brain, triggering opiates-and some people are more susceptible than others. The opiates lead to craving, which leads to consumption levels that go well beyond satisfying hunger.
He is critical of the the US government for feeding into these known cravings, pointing out that the US Department of Agriculture, rather than issuing warnings, actually assists the dairy producers.
"By law, we're putting [taxpayer money] into promotion and research of dairy products," he observed. "That's where the 'Ah! The Power of Cheese' campaign came from. The USDA works with fast food companies to push to have cheese featured on their menus."
Eating cheese, he believes, "is especially bad for kids," yet the USDA annually provides $200 million for the purchase of dairy products, including cheese, for the school lunch program. (An equal sum goes toward purchasing beef.)
Cow's milk, he notes, not only contains caseins that break down into casomorphins, but also contains lactose, a sugar. "Skim milk is fifty-five percent sugar," he pointed out.
And that's not the end of the dairy indictment. "The biggest worry about cow's milk now is prostate cancer," said Dr. Barnard. "It's been found that men who consume more milk have more prostate cancer." Consuming dairy products, Harvard scientists have found, increases the quantity of IGF-I (insulin-like growth factor-1) in the blood-and IGF-1 is known to aggressively promote the growth of cancer cells. It has been linked to the incidence of breast cancer as well as prostate cancer.
The scientists have also found that a high fat intake in the diet encourages the production of testosterone, which in turn is related to an increased incidence of prostate cancer.
"Cancer," he said, "is not genetic, it's diet-related. One in three Americans now get cancer, and it will be one in two soon."
Dr. Barnard said 16 studies have confirmed the findings of the Harvard researchers.
He added that, in addition to cancer and obesity, dairy products have been linked to migraines, asthma, digestive problems, and rheumatoid athritis, among other health problems. And as a further salvo against the powerful messages of the dairy industry, Dr. Barnard cites the Harvard-based Nurses' Health Study, involving 38,000 nurses. Those who have been consuming three glasses of milk per day have experienced no measurable influence on the incidence of osteoporosis as compared to those study participants who did not drink milk. "Osteoporosis is not a condition of low calcium intake," he sais. "It's a result of too much animal proteins in the diet. Other factors are high salt intake, smoking, and lack of physical activity."
The doctor pointed out that the American way of eating, which is being emulated all over the world, is bringing the same array of health problems to cultures that did not have them before. "Rice consumption is down in Tokyo, and fat [consumption] is up," he said. "They're experiencing a major downside with health problems."
It seems clear that animal proteins are not Dr. Barnard's foods of choice, and indeed he has been a vegan-someone who does not consume any animal products-since he was a medical student. "It's the best diet," he said flatly. He didn't come by this path naturally. He was born and raised in a family of ranchers near Fargo, North Dakota.
He added that, though the USDA underwrites the consumption of foods that he believes are not healthy for the public in the quantities now being consumed, the National Institutes of Health (NIH) has awarded his research group, Physicians Committee for Responsible Medicine, a $400,000 grant to study the effect of a vegan diet on Type II diabetes.
Dr. Barnard has no use for the USDA's so-called "food pyramid," which is designed to show Americans the relative quantities of food types they should be consuming. "They do this every five years," he said, "and the insanity is about to begin again. An eleven- to thirteen-member committee meets to decide what Americans should be eating, but the lobbyists all have a say." He mocked some of the slogans he has heard: 'alcohol is part of life' or 'chocolate-if you're a woman you need it.' "Salt, sugar, dairy-they all have a say," he said. "Scientists are buffeted."
Progress in changing the way Americans eat is coming slowly, but Dr. Barnard points out, as evidence of progress, that most supermarkets now have sections featuring health foods.
He is advising fellow physicians to suggest to patients that they may be hooked on unhealthy food habits. "There shouldn't be any guilt or blame," he stressed. "The doctor and patient should deal with food choices like any physical [health] issue."
Not surprisingly, Dr. Barnard does not think genetically modified organisms are a good idea. "I think it's a mistake," he said. "Why do I want a tomato that lasts four weeks?" Besides, he added, "When they insert a gene, they insert a whole genome [a set of related genes]. There may be other effects we don't yet know about."
Would Dr. Barnard condone filing lawsuits against fast food chains that push foods with known addictive qualities? "I know I'm a minority to say this, but yes," he responded. "The tobacco industry was forced to declare the risks of their product. Today, if you go to any fast food company, they will not tell you about the risks. It's not sufficient to just tell about things like fat grams. They should be more forthright."
He pointed out that Kraft Foods was sued because their Oreos cookies contained transfats. "Kraft said, 'Okay, we'll take it out,' and they did."
What would Dr. Barnard recommend as a starting point? "Eat a healthy breakfast," he said. "Especially old-fashioned oatmeal." This will keep the blood sugar steady all day, he said, and make it easier to resist unhealthy food temptations. Other pointers: get enough rest and sleep, find buddies to watch your weight with, find out what motivates you and do it. And of course, read his book.
"Normal eating" is what Dr. Barnard prescribes the whole time-but it's different from what Americans normally eat. Instead of dieting, he suggests eating plenty of fruits, vegetables, and whole grains, especially old-fashioned oatmeal, with tofu and nuts as primary proteins. Breads are not forbidden, but should be pumpernickel, whole grain or rye-certainly not white; and potatoes are permitted, preferably red-skinned new potatoes. Sugar, most fats, wheat flour products, dairy products, eggs, and meats are to be avoided. If one must have meat, serve it for flavor in the manner of a condiment; and try to choose organic foods where possible. Dr. Barnard says a person will become accustomed to eating this way-a vegan regime-in about three weeks, and tastes will change so that the new way becomes second nature.
To help the person who wants to "break free," Dr. Barnard's book includes suggested menus and nearly 100 pages of recipes that sound pretty good: "Orange-Scented Corn Muffins," "Phenomenal French Toast," "Bean and Barley Chowder," "Tunisian Potato Salad," and "Steak Fries."
The book has fire and energy, and is clearly written by someone who believes in his mission to help people become healthier. They say that people often won't change unless they have to change; for those who want to avoid disease, ease pain, or stop the spiraling scale in its tracks and roll it back, this book will be a godsend.
An Experiment and a Challenge
As an experiment, on September 2 this reviewer began eating old-fashioned oatmeal each morning (even splurging by accompanying it with half a whole-grain bagel and applying all-fruit jam to both), has nearly succeeded in eliminating meat from the diet, and has cut out dairy products completely. Desserts are history. Four weeks later, this writer's feeling energized, clothes are looser (Dr. Barnard cautions that losing a pound a week is the maximum one should try for), and everything's tasting good. (There's been a little slippage in the cheese department.) Watch for a complete report in September 2004. Meanwhile, get the book and get started yourself.