Can the food you eat be as powerful as cancer-fighting drugs? Dr. William Li, a world-renowned physician-scientist, speaker, bestselling author of Eat to Beat Disease and Eat to Beat Your Diet, and leader of the Angiogenesis Foundation, believes so. He shares his groundbreaking research on how food can be a powerful tool for healing, energizing, and thriving. This article delves into the complexities of diet, drugs, and overall health, drawing insights from Dr. Li's work and other expert opinions, while addressing the evolving landscape of weight loss and well-being.
The Power of Food: Beyond Deprivation
Dr. Li emphasizes the importance of focusing on what to add to your diet rather than what to restrict. He argues that human nature abhors deprivation, and telling people what not to eat often backfires. Instead, he advocates for "swapping things in" - focusing on the good foods you already love.
According to Dr. Li, the key to great metabolism lies in consuming foods that promote gut health. Our gut microbiome, comprised of 39 trillion bacteria, plays a crucial role in energy production, inflammation reduction, and overall well-being. Inflammation can lead to fatigue, and many people in developed Western societies experience chronic inflammation due to sedentary lifestyles, poor social connections, and suboptimal diets.
The produce section of the grocery store is a great place to start when it comes to improving gut health. Leafy greens, broccoli, kale, bok choy, pears, apples, and kiwi are all excellent sources of dietary fiber. Avocados and mushrooms are also beneficial. Tree nuts like almonds, pecans, and walnuts provide additional benefits.
Dr. Li notes that Mother Nature is clever, and foods rich in fiber are often packed with polyphenols, which are also beneficial for gut bacteria. Colorful fruits and vegetables like carrots, bell peppers, eggplant, and berries are excellent sources of polyphenols. Raspberries, in particular, are a dense source of dietary fiber.
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Healthy food cultures around the world, such as those in the Mediterranean and Asia, offer inspiration for delicious and easy-to-prepare meals. These cultures emphasize fresh, local, and seasonal foods cooked simply with ingredients like olive oil, garlic, herbs, and spices.
The Ultra-Processed Food Problem
Ultra-processed foods are engineered to be addictive, contributing to chronic diseases like diabetes, metabolic syndrome, cardiovascular disease, cancer, and dementia. These foods often raise inflammation and damage gut bacteria, disrupting systems that protect our health.
Dr. Li suggests rethinking our food supply and being mindful of what we buy in the grocery store. He acknowledges that ultra-processed foods are tempting, but their long-term health consequences are significant.
Navigating the World of Weight Loss Drugs
The emergence of GLP-1 receptor agonists like Ozempic and Wegovy has revolutionized the weight loss landscape. These drugs can transform the health of people with obesity, quiet "food noise," and potentially level the playing field. However, experts are concerned about the potential for increased weight stigma, medicalization of larger bodies, and the exacerbation of eating disorders.
Meghan Dressler, a lawyer who lost 70 pounds using a GLP-1 drug, is working with a therapist to address an emerging obsession with the scale and navigate societal judgments.
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Psychologists play a vital role in helping patients become more knowledgeable, manage their emotions, support healthy behavior changes, and address any disordered eating behaviors, anxiety, or depression that may arise.
While GLP-1 drugs are effective at improving cardiometabolic risk factors and physical functioning, they can also cause side effects like gastrointestinal distress and muscle loss. Some studies have linked GLP-1s to an elevated risk of anxiety, suicidal behavior, and depression.
It's important to remember that these medications aren't a magic bullet. Lifestyle changes, including diet and exercise, remain crucial for long-term success.
The Role of Psychology in Weight Management
Psychologists can help patients strengthen their body image, deal with body dysmorphia, and work through grief that may arise when old pleasures associated with food are no longer satisfying. They can also help patients ensure they get enough protein, engage in resistance exercise, and eat a varied diet to prevent muscle loss and malnourishment.
Weight loss, regardless of the method, can lead to shifts in relationships, social life, routines, and body image. Psychologists can provide support and guidance during these transitions.
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GLP-1s and Addiction
Researchers are exploring the potential of GLP-1 receptor agonists as an intervention for addictions. A study found that people with alcohol use disorder who took low doses of semaglutide had fewer heavy drinking days, fewer drinks when they did drink, fewer cravings, and less alcohol intake overall.
Scientists believe that semaglutide may curb alcohol cravings by interfering with the brain's reward system and inducing satiety. However, more clinical trials are needed before these drugs can be approved for treating addiction.
The Expertise of Dr. David Kessler
Dr. David Kessler, former FDA Commissioner, has written extensively about diet, health, and weight loss. His newest book, Diet, Drugs, and Dopamine: The New Science of Achieving a Healthy Weight, explores the complexities of these issues.
Dr. Kessler argues that the traditional approach of blaming the patient for weight gain is flawed. He believes that addictive and hormonal circuits, as well as the brain's reward response to ultraformulated foods, make it difficult to escape the pull of food addiction.
He introduces the concept of "toxic fat," which refers to visceral fat that accumulates around the waist and surrounds vital organs. This type of fat is metabolically active and can lead to various health problems.
While acknowledging that GLP-1 drugs have changed the landscape of weight loss, Dr. Kessler emphasizes that they are not a panacea. He notes that these drugs work by causing people to eat less, often by triggering gastrointestinal effects like nausea.
Dr. Kessler stresses that diet and exercise remain the foundation of improved metabolic health. Medications are not the only solution.
The Conflicting World of Dietary Advice
Public health messaging regarding food and diet is often confusing due to conflicting scientific findings. Experts offer varying advice on calorie counting, carbohydrate restriction, and the importance of natural foods.
The recent surge in popularity of diets like intermittent fasting, gut bacteria nurturing, and carbohydrate cutting highlights the public's desire for simple solutions. However, the scientific basis for these diets is often questionable.
Regan Bailey, a professor of nutrition at Texas A&M University, notes that it's difficult for consumers to find consistent dietary advice. For every study that supports a particular approach, another contradicts it.
Research on food is challenging because it requires tracking people's eating habits over long periods and keeping them on diets they may not like. Health problems tend to emerge over many years from complex causes, making it difficult to trace them directly to diet alone.
Bedrock Principles of Healthful Eating
Despite the conflicting advice, some bedrock principles of healthful eating remain.
Calories Matter
Reducing calorie intake is essential for weight loss and overall health. Howard Sachs, a physician and associate professor at the University of Massachusetts Chan Medical School, emphasizes the importance of considering the risk of cardiac disease, high blood pressure, diabetes, arthritis, and sleep apnea in overweight patients.
Research has shown that diets involving calorie tracking are more effective than other approaches to losing weight and keeping it off. However, most people struggle to adhere to these diets long-term.
Alternatives to Calorie Tracking
Recognizing the challenges of calorie restriction, some experts have proposed alternatives, such as very-low-carbohydrate diets (keto). The theory behind keto is that people gain weight not from consuming too many calories, but from their bodies losing the ability to deliver energy from food to muscles due to insulin resistance.
While keto can lead to weight loss and reduce the risk of diabetes, it also carries risks, such as high cholesterol levels and nutrient deficiencies.
The Mediterranean Diet
The Mediterranean diet is a more highly-regarded healthy-eating scheme. It emphasizes unsaturated fats, vegetables, whole grains, and lean sources of protein while limiting sugar, red meat, and saturated fat.
Studies show that people who follow a Mediterranean diet tend to have a reduced risk of heart disease and obesity.
Other Diet Approaches
Other diet approaches include plant-based diets, gluten-free diets, microbiome diets, and intermittent fasting. While each approach may offer some health benefits, there is no conclusive evidence that any one is superior.
Precision Nutrition
Precision nutrition aims to tailor a diet to suit each individual's unique biology, health, lifestyle, and goals. While still in its infancy, this approach holds promise for personalized dietary recommendations.
The Ultra-Processed Food Villain
Researchers have increasingly focused on the role of ultra-processed foods in the obesity epidemic and related health problems. These foods are often high in fat, sugar, and calories, and some researchers believe they attack health in ways that go beyond their macronutrient content.
Carlos Monteiro, a nutrition researcher at the University of Sao Paulo in Brazil, defined ultra-processed foods as those prepared with ingredients and equipment not found in most kitchens.