Eat to Live: a Unifying Principle to Maintain a Healthy Weight and Gain Longevity

The following information is taken primarily from Eat to Live by Joel Fuhrman, M.D. Dr. Fuhrmans
professional credibility lies in the fact that in over 30 years he has helped tens of thousands of
people permanently cure their obesity and helped many thousands of people cure their terminal
chronic diseases: all in conformity with the latest science.

Most Americans follow such a poor diet that 75% of us are overweight or obese, while the majority of
us die of diet related chronic diseases (more than any other society in the world). The standard
American diet (SAD) is truly sad.

Generally we eat until we feel full or satisfied. Our stomach tells us when. Biochemical nerves
lining the digestive tract monitor nutrient intake and tell us when we have consumed sufficient
nutrients. Biomechanical stretch receptors in the stomach signal satiety by detecting the volume of
food eaten. Overeating arises when we have eaten sufficient calories, but the stomach is tricked by
being given foods that lack nutrients and fiber and so the stomach does not tell us when to stop
eating. Because many popular foods are empty calories (calories mostly devoid of nutrients and
fiber) we consume too many calories before we get stomach signals to stop eating. Thus, we
become unhealthy from nutrient deficiency and from being overweight. The key to eating a diet that
promotes a healthy weight and body is to eat foods with high nutrient and fiber densities per calorie
(not per weight or per volume). The formula is: H = N C where H is health, N is nutrient content
and C is calories. This formula is the key to Dr. Fuhrmans professional success.

MORE FIBER PER CALORIE MEANS MORE BULK TO SIGNAL A FULL STOMACH

Eating to enhance nutrient-per-calorie density in ones diet will:

1. Cause weight loss that is permanent
2. Promote longevity
3. De-rail hunger and food cravings
4. Increase immune function and disease resistance
5. Provide therapeutic effects to reverse disease
6. Protect against heart disease, stroke and dementia
7. Fuel cellular repair mechanisms protecting against cancer

Micronutrients are those food components that make us healthy and help our bodies fight and avoid disease. These
include phytochemicals, antioxidants, vitamins and minerals. Many hundreds have been identified. Many hundreds await
discovery.

Macronutrients are the only source of calories (energy) and there are only three: protein, carbohydrates and fat. When
eating only micronutrient-dense whole foods, the correct proportions of macronutrients and the correct amount of calories
(to maintain a healthy weight) will be automatically consumed, if one consumes a diverse diet and practices portion control
for calorie dense foods like nuts, seeds, avocados, dates, raisons and other dried fruit.

Fiber intake from whole foods (not isolated fiber like Metamucil) is a very good indicator of disease risk. High fiber foods
promote weight control, lower insulin levels and contain many anti-cancer and anti-diabetes properties. Around the
world, people who consume the most high-fiber foods are the healthiest and have the most longevity.
 The Nutrient Density Spectrum
Nutrient density is defined as the quantity of micronutrients in a food divided by the number of
calories in that food. Micronutrients are those food components that make us healthy and help our
bodies fight and avoid disease. The nutrient-density scores below are based on identified
micronutrients (not macronutrients) such as phytochemicals, antioxidant activity, and total vitamin
and mineral content.

Highest nutrient density = 100 points Lowest nutrient density = 0 points

Group Nutrient
Number Density
1 100 Dark green leafy vegetables
kale, mustard greens, collard greens, Swiss chard, watercress, spinach,
arugula
2 95 Other green vegetables
romaine, bok choy, cabbage, Brussels sprouts, asparagus, broccoli, string
beans,
snow peas, green peas
3 50 Non-green nutrient-rich vegetables
beets, eggplant, mushrooms, onions, radishes, bean sprouts,
red & yellow bell peppers, radicchio, cauliflower, tomatoes, artichokes,
carrots
4 45 Fresh fruits
strawberries, blueberries, other berries, plums, oranges, melons, kiwifruit,
apples, cherries, pineapple, peaches, pears, grapes, bananas
5 40 Beans (legumes)
lentils, kidney, great northern, adzuki, black, pinto, split peas, edamame,
chickpeas
6 30 Raw nuts and seeds
sunflower, pumpkins, sesame, flaxseeds, almonds, cashews, pistachios,
walnuts, pecans, hazelnuts
7 25 Colorful starchy vegetables
butternut and other squash, sweet potatoes, corn, turnips
8 20 Whole grains/white potatoes
old-fashioned oats, barley, brown and wild rice, buckwheat, millet,
quinoa,
bulgur, whole grain bread
9 18 Fish
10 15 Fat-free dairy
11 15 Eggs
12 15 Wild meat and fowl
13 8 Full-fat dairy
14 6 Red meat
15 6 Refined grain products
white flour, white rice, white bread, non-whole grain pasta
16 3 Cheese
17 1 Refined oils
18 0 Refined sweets
cookies, cakes, candy, soda, fruit juice
The horizontal line separates those foods that are rich in fiber (above) and those foods that have no
or insignificant amounts of fiber (below). Foods below the line contain so few micronutrients per
calorie (lower scores) and are so devoid of fiber (below the fiber line) that they are referred to in
nutrition and dietary literature as empty calories.

The key to a permanent healthy weight and a body with a strong ability to resist and reverse the
chronic, diet-related diseases contributing to premature deaths in most Americans (e.g. cancer,
stroke. heart disease, osteoporosis, diabetes, arthritis, hypertension, obesity, and dementia) is to
move your diet (gradually if personally necessary) up the nutrient-density spectrum. The healthiest
goal is to seldom or insignificantly eat below the fiber line and to eat a diverse diet of food groups
(groups 1-8, both cooked and raw) above the line. Even small upward steps can be helpful.

It is common to justify eating below the line by a focus on one or very few nutrients. For example, I
eat beef for the iron and protein content. Other examples are: chicken (protein), fish (omega3),
dairy (calcium) and eggs (B vitamins, protein). There is no nutrient type available below the line that
is not available in greater abundance above the line. The one exception is vitamin B12 which is
provided by an inexpensive pill supplement taken daily. The nutrients in animal products came
from the plants that the animals ate. Plant foods have more nutrients than animal products.

Is it possible to be overweight and healthy? Maybe, if one looks for only superficial symptoms. It is
very unlikely if one looks inside the body. Chronic diseases often start at an early age, proceed
undetected for decades and are strongly correlated with being overweight. Important note: It is
possible to look thin and be susceptible to chronic diseases and depression if regular exercise and
maintenance of muscle mass and metabolism is neglected. Proper and frequent exercise is as
essential as good diet for regaining and maintaining vitality, mental health and longevity.

Carbohydrates (4 calories per gram) are our main and necessary source of energy. They are a diet
mainstay of every healthy society throughout the world and history. A low-carb diet is necessarily
high in protein and fat and is never sustainable because it contributes to chronic diseases over time.
Healthy carbohydrates only exist above the fiber line.

Protein (4 calories per gram) is a necessary nutrient and all the essential amino acids that make up
protein are available above the line in abundance (exceeding human requirements). Since the body
stores these protein components for several days, same-day food combining is not necessary to
obtain complete protein from plants as long as one eats a variety from the groups above the line.
The human need for protein is about 4-8% of calories consumed. The high correlation between
cancer and animal/dairy protein has been well documented for many decades.

Fat (9 calories per gram) is a necessary nutrient and is consumed in a healthy way by eating high-fat
foods like nuts, seeds, olives and avocadoes. Refined oils are physically removed from their plant
sources. All the fiber and most nutrients are left behind. What remains are the empty calories of
liquid fat which has the most calories per gram of any food. The common practice of adding oil to
foods and frying with large amounts of oil greatly reduces the nutrient-density score. Fat calories in
the standard American diet average 30-40%, while the healthy requirement is about 10%-15%. The
high correlation between heart disease and animal/dairy fat has been well documented for many
decades.
Refined grain products such as white flour and white rice are created through a milling process
that removes most fiber, all micronutrients, the bran and the germ. Fortifying these empty calories
by replacing a few micronutrients does not make them healthy. They are still processed foods with
very little nutrient value per calorie. Carbohydrates are necessary for health, but refined grain
products give carbohydrates a bad name, are not healthy and are well below the fiber line.

Fruit juices are made by physically removing the liquid from the fruit. The vast majority of the
nutrients and all of the fiber are left in the pulp and what remains in the juice is empty calorie sugar
that is metabolized like soda drinks.

Dairy products are highly promoted foods that are popular for their calcium content. Osteoporosis
occurs most in countries where calcium intake from dairy products is the highest. Eating animal
protein (including dairy protein) results in a heavy acid load in the blood. This causes calcium to be
leached from the bones to help neutralize the acid. This calcium release weakens the bones and
causes bone fractures. Calcium is abundant above the line.

Caloric density is defined as the amount of calories per gram or per liter of food. For the three
macronutrients, fiber and some food items and categories we have the following charts. Note the
contrast between a baked potato and potato chips/fries; the difference is fat. If you are curious, the
fat content (as a percentage of total calories) is easily calculated for any food with a Nutrition Facts
label. The formula is: F T where F is calories from fat per serving and T is calories per serving. F
and T are on every label.

Macronutrient/Fiber Calories per Gram

Fat (all types) 9
Carbohydrates 4
Protein 4
Fiber 0

Calories Calories Protein Protein per Protein as %

Food Categories Food Items Calories
per Gram per liter (grams) Calorie of calories
Most vegetables 0.3-1 200-600 One banana 1.2 105 0.01 5
Most fruit 0.3-0.5 300 One cup cooked brown rice 4.8 220 0.02 9
Most cooked legumes 0.6-1.1 500 One corn on the cob 4.2 150 0.03 11
Prepared whole grains 0.5-1 1,000 One baked potato 3.6 120 0.03 11
Potato, baked 1 600 One cup of regular pasta 7.3 216 0.03 14
Potato chips or French
6 3,000
fries One 6 oz. fruit yogurt 7 190 0.04 15
Two slices whole wheat
Fish 1.5 1,400
bread 4.8 120 0.04 16
One Burger King
Poultry 2 1,600
cheeseburger 18 350 0.05 21
Meat 4.4 3,000 One cup frozen peas 9 120 0.08 30
Cheddar Cheese 4 3,400 One cup cooked lentils 16 175 0.09 36
Butter 7.2 6,900 one cup of tofu 18 165 0.11 44
Oils 9 7,700 One cup of frozen broccoli 5.8 52 0.11 45
One cup cooked spinach 5.4 42 0.13 51
Losing weight (according to the science presented) involves permanently moving the center of
gravity of your diet up the nutrient-density spectrum. The more you eat at and near the top, the
more weight you will lose. Losing weight by simply eating less of the diet that originally made you
fat is rarely successful over time because through portion control only, your calorie cravings and
tastes are not altered and they will eventually win and take your weight back up (yoyo dieting). By
eating whole foods that are as nutrient-dense as possible you will reprogram your tastes and
automatically and permanently desire fewer calories (absent emotional or addictive eating which is
common among obese people).

Fuhrmans book contains many testimonials with before/after pictures and stories of individuals
who permanently lost tremendous weight in a short period of time and were able to go off whatever
meds they were on. It probes the relationships between specific chronic diseases and diet and it is
highly documented and annotated. It contains detailed weight loss programs and a big section with
recipes. It is for people who want to permanently lose weight and maximize their longevity, but it is
only for those who believe in science and who want to learn and change.

The world of food is filled with almost infinite choices. From a health standpoint the choices
boil down to only two: empty calories vs. health-full calories. The distinctions among omnivore,
vegetarian and vegan becomes less important because for each category there are many empty
calorie choices that lead to poor health and being overweight. The alternative label of Nutritarian
expresses the idea that a person is not nutritionally indifferent, but rather is striving to move their
diet higher on the nutrient density spectrum by eating an increasing percentage of delicious meals
made with foods above the fiber line. In other words, a Nutritarian is one who knows not to put
coal in a rocket engine. What are you putting in your rocket engine?

Summarized by Dale Van Metre, PhD