An Interview With Dr. Joel Fuhrman on the Importance of Diet

Dr. Glass: I recently bought your book Fast Food Genocide and have been blown away with the data you present on the topic of processed foods. It has a very comprehensive reference list at the end, which shows that what you are saying is backed up by scientific literature. What made you want to write on this topic?

Dr. Fuhrman: I think many people are aware of the link between poor diet and obesity, diabetes, heart disease, stroke, and even cancer, but very few understand and are knowledgeable about the link between fast food, lowered intelligence, and how food addiction can lead to drug addiction and criminality and even mental illness. We have vulnerable populations whose lives are being destroyed by their food environment, and we act like access to medical care is the problem, when the overwhelming issue is lack of access to fresh produce and healthy food.

Dr. Glass: Do you have any recommendations for the medical student, resident, or fellow who says that he or she has no time to prepare meals?

Dr. Fuhrman: Make a big pot of vegetable-bean soup on the weekend and utilize it all week for lunches. Go to salad bars and eat lots of vegetables. Have fruits and raw nuts in your apartment and carry them with you so you don't feel the need to resort to eating junk foods or commercial baked goods.

Dr. Glass: Please explain more about the connection between fast food and certain psychiatric illnesses.

Dr. Fuhrman: Some studies document a strong link between commercial baked goods, fast food, and major depression, even from just two servings a week. A hundred years ago, one in 100 Americans suffered from depression, anxiety, or other mental illnesses; now it is one in five. Studies document micronutrient deficiencies in the etiology of these common conditions. The brain is exquisitely sensitive to the lack of phytonutrients and antioxidants in the diet and needs continual access to omega-3 fatty acids. Pellagra, caused by niacin deficiency and [can cause] mental illness, was a major problem from the end of the Civil War to the 1920s when it was finally accepted as a nutritional issue. Today, we also have widespread and ubiquitous nutritional deficiencies in our populations due to the high intake of processed foods and the low intake of unprocessed vegetables.

Dr. Glass: I have seen many overweight patients who complain of being depressed and anxious. There is literature to support the use of psychotherapy plus psychopharmacology in such cases. I have been somewhat shocked by how often psychiatrists do not ask their patients about diet. What are your thoughts on this?

Dr. Fuhrman: Diet and nutrition [are] likely the major contributor[s] to anxiety and depression, not life's circumstances. The use of medications without addressing the nutritional and biochemical causes of the problem leading to prolonged suffering and dependency is ineffective and suboptimal psychiatric care. Asking patients about diet is not sufficient; physicians have to be knowledgeable about dietary recommendations that can aid in … treatments and be able to motivate their patients to make the appropriate changes.

Dr. Glass: Can you comment on your thoughts regarding diet and autism?

Dr. Fuhrman: The diet of the mother and her use of folic acid supplements (instead of eating green vegetables for folate), not just during pregnancy but even prior to conception, [can] increase risk of autism and also childhood cancer and brain tumors. Fast food, maternal obesity, and pregestational diabetes have been associated with autism for decades, but the combination of all these factors mentioned above is particularly troublesome and not sufficiently guarded against. This is predominantly a disease of maternal dietary folly.

Dr. Glass: Many children who see psychiatrists are started on stimulants. It would seem that a comprehensive dietary approach should be first line. What have been your observations with the way attention deficit hyperactivity disorder (ADHD) is being diagnosed and managed here in the United States?

Dr. Fuhrman: I think most of the way physicians treat chronic dietary-induced medical concerns is hurtful in most cases, as physicians prescribe drugs that have long-term detrimental effects without first seeking and removing [the] cause. Whether it is high blood pressure, headaches, heart disease, or diabetes, they overprescribe drugs that often increase cancer risk and other serious problems and give a service that is inappropriately risky, whereas dietary excellence would be more effective and considerably less expensive. ADHD is no different. I have been helping families overcome this issue and avoid medications for decades.

Dr. Glass: Please tell us about how fast food affects different demographics in the United States. Do you feel that certain racial groups are targeted by the fast food industry?

Dr. Fuhrman: I am not sure if the industry is targeting the poor specifically. They target everyone, but we know the foods are designed to be addictive, and the dangers of fast food and processed foods fall more on vulnerable populations with poor supermarket and poor access to fresh produce. Our price incentives, subsidies, and tax structure keep processed foods less expensive and fresh produce more expensive, further exacerbating this problem.

Dr. Glass: For readers who are not familiar with your diet recommendations, can you explain the importance of G-BOMBS?

Dr. Fuhrman: G-BOMBS greens, beans, onions, mushrooms, berries, and seeds are simply those foods with the strongest scientific support to protect against later life cancers. We have landed the man on the moon already, and what I mean by that is that the science is strong showing we can win the war on cancer right now if people would eat properly. In other words, we have the answer, but it is not the answer that people want to hear.

Dr. Glass: Is there any evidence that certain diets can prevent amyloid plaque buildup in those with an apolipoprotein E (ApoE4) gene mutation?

Dr. Fuhrman: Even in countries where the prevalence of the ApoE4 gene is high, when people's cholesterol is low and when they eat more plant produce, Alzheimer's is not seen. In other words, the gene mutation is a minor risk factor that is not expressed when people eat a vegetable-rich diet.

Dr. Glass: On certain days of the week, I treat individuals who are incarcerated. I have asked many of them to describe what their diet was like prior to incarceration. The majority have told me that fast food was their main source of food. Do you think fast food may increase the risk for an individual to commit impulsive or violent behaviors?

Dr. Fuhrman: Of course, that is what the scientific literature indicates, and inmates who are fed more produce have better outcomes for behavior and recidivism after discharge.

Dr. Glass: Many psychiatric patients suffer from high blood pressure and diabetes. Can you please describe your thoughts on what role meat and dairy plays in such cases? What about organic meat and goat cheese?

Dr. Fuhrman: A Nutritarian diet resolves the vast majority of cases of high blood pressure and type 2 diabetes within a few months. Animal products raise trimethylamine N-oxide production, inflaming the endothelium and setting the stage for atherosclerosis. The excessive production of IGF-1 from high amounts of animal products (protein) in the diet also accelerates the damage and promotes heart disease. Whether the meat is organic or not has little to do with the pathological effects of high meat diets and heart disease and cancer. The World Health Organization has classified red meat and processed meat as a class 2 carcinogen.

Dr. Glass: When I told one doctor about your diet recommendations, he responded, "I have tried several diets, all of which eventually proved to be wrong in the end." How do you respond to that kind of comment?

Dr. Fuhrman: There is no such proof as stated; diets are not right or wrong but rather healthy or not healthy. There is overwhelming evidence from large-scale studies with hard end points that diets higher in produce and lower in processed foods and animal products reduce both cardiovascular deaths, cancer deaths, and all-cause mortality.

Dr. Glass: Is a "cheat" day always bad? I know some people who try to diet throughout the week but dream about eating that pizza or hamburger on Friday.

Dr. Fuhrman: That may be acceptable for some people, but for many food addicts, that "cheat" can trigger a whole week of bingeing and suffering. For food addicts, abstinence aids them in recovering their taste preferences, losing their addictive drive to overeat and diminishing and resolving their cravings.

Dr. Glass: Thank you, Dr. Fuhrman, for shedding light on such a neglected topic.