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Authors: Joel Fuhrman

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How much salt can I use safely? What about sea salt?

This book is designed for people who want to reverse their diabetes, lose weight, regain their health in general, and prevent further disease. If you are looking to get rid of diabetes and high blood pressure, any added salt—outside of what is contained in natural foods—is likely to hinder your recovery.

Sea salt is 99 percent chemically the same as table salt and is just as harmful. The very small amount of minerals found in special salts, touted for their health benefits, is insignificant and does not make consuming a high amount of sodium any less harmful. Salt consumption is linked to stomach cancer, high blood pressure, and heart attacks. For optimal health, I recommend that no salt be added to any food. The famous Dietary Approaches to Stop Hypertension (DASH) study clearly indicates that Americans consume five to ten times as much sodium as they need and that high sodium levels over the years have a predictable effect on raising blood pressure.
2

Salt also pulls out calcium and other trace minerals, which is a contributory cause of osteoporosis.
3
If that is not enough, high sodium intake is predictive of increased death from heart attacks. In a large prospective trial published in the
Lancet,
there was a frighteningly high correlation between sodium intake and all-cause mortality in overweight men.
4
The researchers concluded, “High sodium intake predicted mortality and risk of coronary heart disease, independent of other cardiovascular risk factors, including high blood pressure. These results provide direct evidence of the harmful effects of high salt intake in the adult population.”

There is controversy regarding the use of salt, as well as other points in human nutrition. Some studies indicate salt is not bad for health. However, those findings are always distorted by looking at a sickly population with high blood pressure and atherosclerosis that then attempts to lower salt intake later in life, when much of the damage is already done. It is always wise to err on the side of caution and not to incur needless risk. The earlier in life you begin the right choices, the greater the benefits. You would not want an error in judgment to cost you your good health or your life. For a hundred thousand years, our human ancestors and pre-human primates never salted their food. This is a recent phenomenon in the history of the human race, but natural plants supply all the sodium we need, as they have for those thousands of years. I heard gorillas go light on the salt shaker too.

My thousands of patients and website members have achieved dramatic reversals of heart disease, diabetes, and high blood pressure, and I am certain that removing salt from their diets was an important factor contributing to their health accomplishments. That said, a small amount is permissible; those parameters are discussed further below.

It's best not to add salt to foods, and I recommend looking for salt-free canned goods and soups. Because most salt comes from processed foods, bread, and canned goods, it shouldn't be hard to avoid added sodium. Use herbs, spices, lemon, vinegar, or other no-salt seasonings to flavor food. Condiments such as ketchup, mustard, soy sauce, teriyaki sauce, and relish are very high in sodium. If you can't resist them, use the low-sodium varieties sparingly.

Ideally, all your foods should have less than one milligram of sodium per calorie. Natural foods contain only about half a milligram of sodium per calorie. If a food has 100 calories per serving, yet contains 400 milligrams of sodium, it is a very high-salt food. If a 100-calorie serving has less than 100 milligrams of sodium, it is a food with little added salt and can be used in your diet. Overall, the guideline is for women to consume not more than 1,000 milligrams of sodium a day and men not more than 1,200. Since a natural food diet gives you 500 to 800 milligrams a day, that leaves you only a few hundred extra to be flexible with.

If you don't use salt, your taste buds will adjust with time and your sensitivity to taste salt improves. When you are using lots of salt in your diet, it weakens your taste for salt and makes you feel that food tastes bland unless it is heavily seasoned or spiced. The DASH study observed the same phenomenon that I have noted for years: it takes some time for a person's salt-saturated taste buds to get used to a low sodium level. If you follow my nutritional recommendations strictly, without compromise, avoiding all processed foods or highly salted foods, your ability to detect and enjoy the subtle flavors in fruits and vegetables will improve as well. Over time, you won't miss the salt and won't even want it.

 

What about alcohol—should I be drinking red wine for my heart?

Alcohol is not actually heart-healthy; it simply has anticlotting effects, much like aspirin. Researchers have found that even moderate consumption of alcohol, including wine, interferes with blood clotting and thereby reduces heart attacks in high-risk populations, such as people who eat the typical, disease-promoting, American diet. Thinning the blood with alcohol or aspirin is not health-enhancing unless you are eating the typical heart-attack-inducing diet. Once you are protected from heart attacks and strokes with superior nutrition, the blood thinning only adds risk in the form of gastrointestinal bleeding or a hemorrhagic stroke. Red wine contains some beneficial compounds such as flavonoids and resveratrol, a potent antioxidant in the skin of grapes associated with a number of health benefits. Of course, grapes, raisins, berries, and other plant foods also contain these beneficial compounds. You do not have to drink wine to gain these benefits.

Moderate drinking is defined as a maximum of one drink per day for women and two drinks for men. Consuming more than this is associated with increased fat around the waist and other significant health problems.
5
But more concerning is the link between drinking and cancer. Even a moderate amount of alcohol may also increase the risk of breast cancer.
6
A review of meta-analyses reported in 2009 concluded that one drink per day increased breast cancer risk between 7 and 10 percent.
7
More recently, a careful twenty-eight years of follow-up of the Nurses' Health Study found a significant increase in risk at even lower levels of consumption: the range of 5 to 9.9 grams per day (three to six drinks per week) was associated with a 15 percent increase in breast cancer risk.
8

Another problem with alcohol consumption, especially at more than one drink a day, is it can create mild withdrawal sensations the next day. These sensations are commonly mistaken for hunger, which leads people to overeat. Because of this, moderate drinkers are usually overweight. Furthermore, recent studies have also shown that even moderate alcohol consumption is linked to a significantly increased incidence of atrial fibrillation, a condition that can lead to stroke.
9

Overall, it is safer to eat a diet that will not permit heart disease. Don't rely on alcohol to decrease the potential of blood to clot. Strive to avoid the detrimental effects of alcohol and to protect yourself from heart disease with nutritional excellence. Having one or two alcoholic drinks a week or a few glass of wine per week is not a major risk, nor is it a major health asset. However, if consumed in excess, it can develop into a significant health issue.

 

Is it important to eat organically grown foods for good health?

The concern implicit in this question is about pesticides, and it is a real one. The Environmental Protection Agency has reported that the majority of pesticides now in use are probable or possible causes of cancer. Studies of farmworkers who work with pesticides suggest a link between pesticide use and brain cancer, Parkinson's disease, multiple myeloma, leukemia, lymphoma, and cancers of the stomach and prostate.
10
However, does the low level of pesticides remaining on our food present much of a risk? Some scientists argue that the extremely low level of pesticide residue on produce is insignificant and that there are naturally occurring toxins in all natural foods that are more significant. The large amount of studies performed on the typical pesticide-treated produce have demonstrated that consumption of produce, whether organic or not, is related to lower rates of cancer and increased disease protection. In short, it is better to eat fruits and vegetables grown and harvested using pesticides than not to eat them at all. The health benefits of eating phytochemical-rich produce greatly outweigh any risks that pesticide residues might pose.

It should be recognized that fruits and vegetables are not all subject to the same pesticide exposure. The following chart shows the pesticide breakdown by food in order of pesticide content. Spinach, strawberries, and celery have the highest pesticide residue and are the most important foods to consume organically grown.

If available, organic food is certainly your best bet to limit exposure to toxic chemicals. Even if you can eat organic versions of only the top twelve most contaminated fruits and vegetables, you can reduce your pesticide exposure by about 90 percent. In addition, organic foods usually have more nutrients than their conventional counterparts.
11
They also taste better and are generally better for farmers and the environment. Remember that cutting out processed foods, canned foods, and animal products already reduces your exposure to chemicals, toxic compounds, pesticides, antibiotics, and hormones, so that is a huge step in the right direction, even if your entire diet is not organic.

T
WELVE
F
OODS WITH THE
L
OWEST
P
ESTICIDES

1. Onions

2. Sweet Corn

3. Pineapple

4. Avocado

5. Cabbage

6. Sweet Peas (frozen)

7. Asparagus

8. Mangos

9. Eggplant

10. Kiwi

11. Cantaloupe (domestic)

12. Sweet Potatoes

 

T
WELVE
F
OODS WITH THE
M
OST
P
ESTICIDES

1. Apples

2. Celery

3. Bell Peppers

4. Peaches

5. Strawberries

6. Nectarines (imported)

7. Grapes

8. Spinach

9. Lettuce

10. Cucumbers

11. Blueberries (domestic)

12. Potatoes

 

Why not olive oil? I thought it was good for me.

No oil should be considered a health food. All oil, including olive oil, is 100 percent fat and contains 120 calories per tablespoon. Oil is high in calories, low in nutrients, and contains no fiber. It is the perfect food to help you put on unwanted and unhealthful pounds and sabotage your plan to rid yourself of diabetes and extra body fat.

Oil is a processed food. When you chemically extract oil from a whole food (such as olives and various nuts and seeds) you lose the vast majority of nutrients and end up with a fragmented food that contains little more than empty calories. You do need some fat in your diet, but when you consume whole foods, such as walnuts, pistachio nuts, sesame seeds, chia seeds, and flaxseeds instead of their extracted oils, you get all of the fibers, flavonoids, several phenolic compounds, sterols, stanols, and other nutrients they contain as well as all of their positive health benefits.

Foods rich in monounsaturated fats like olive oil are less harmful than foods full of saturated fats and trans fats, but being less harmful does not make them healthful. The beneficial effects of the Mediterranean diet are not due to the consumption of olive oil; they are due to antioxidant-rich foods including vegetables, fruits, and beans. Pouring a lot of olive oil onto food means you're consuming a lot of fat. Eating a lot of any kind of oil means you're eating a lot of empty calories, which leads to excess weight, which leads to diabetes, high blood pressure, stroke, heart disease, and many forms of cancer.

When you eat oil instead of seeds and nuts as a source of fat, the fat is absorbed and enters the bloodstream rapidly. Because you cannot utilize the surge of calories, the body efficiently stores them as fat on your body within minutes. When you consume oil, the calories go from your lips to your hips within minutes, and as you know by now, fat stored on the body promotes disease and causes diabetes. When you instead consume some seeds and nuts as a source of fat, the fat is bound to sterols, stanols, and other fibers that slow the absorption of the fat over many hours and limit all the absorption of the fat contained, enabling the body to burn the fat for energy.

While nuts and seeds have anti-inflammatory effects, oil has pro-inflammatory effects, so it is a horse of a different color. For example, a study compared an olive oil–containing Mediterranean diet with one which substituted pistachio nuts as a source of fat. The researchers documented improvement in endothelial function (health of the lining of the blood vessels). They noted reduced inflammation, increased youthful elasticity of the blood vessels, lowering of the cholesterol and triglycerides, as well as a lowering of blood glucose as a result of eating the nuts in place of oil.
12
Plus, as discussed earlier, whereas oil promotes weight gain, when nuts or seeds are substituted for oils or carbs without increasing the overall caloric load, the result is lower glucose, lower cholesterol, and lower body weight.
13

You can add a little bit of olive oil to your diet if you are thin and exercise a lot. However, the more oil you add, the more you are lowering the nutrient-per-calorie density of your diet—and that is not your objective, as it does not promote health.

Hopefully the answers in this chapter have proved useful as you begin your journey toward health. This approach may sound complicated at first, but I assure you that it will start to make sense very quickly. I have devised a very simple formula of nutrients per calorie. In the next section, I map out some meal plans that will allow you to see how to start building your own personal menu. Your health begins now.

BOOK: The End of Diabetes
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