Food Therapy in Practice
Jeff Hush and Rachel Hedrick
Food Therapy rejects the old model (“nutritionism”) of calorie counting and calorie restriction and dieting to lose weight. The goal is not to lose weight, though weight will be lost in our therapy. (And the weight that is lost will stay off for life, unlike with other weight-loss diets.) This is not a temporary diet or even a “lifestyle intervention.” This is a lifestyle transformation, in which patients learn to enjoy eating real whole foods and learn to handle their own cravings. The goal is to rebuild each patient’s healthy gut microbiome, so that health has a chance to flourish and the immune system can function as originally intended.
Patients come to realize that their own health depends on what they eat. And they discover, usually to their surprise, that excess medications—just as with alcohol and smoking—are toxic stressors that damage their gut microbes and their livers. They learn how important a healthy gut microbiome is—how it produces essential neurotransmitters and vitamins—and how they can remake their own guts by eating the right foods. There are now hundreds of scientific studies to support this work, as well as four key new books analyzing these, and related, studies: The Microbiome Diet (Raphael Kellman, 2014); The Diet Myth (Tim Spector, 2015); The Case Against Sugar (Gary Taubes, 2016); The Telomere Effect (Elizabeth Blackburn and Elissa Epel, 2017). These books suggest specific foods (especially “prebiotics”) and valuable methods to employ.
Three new journal articles establish the baseline of our Food Therapy program. They show what works and what doesn’t. The first study (from the “Look AHEAD Research Group”) shows how a certain type of “intensive lifestyle intervention for weight loss” is a failed concept when it involves simply restricting calories and not specifying foods. This old nutrition model does not improve “cardiovascular” health (NEJM 2013; 369: 145-54. “Cardiovascular Effects of Intensive Lifestyle Intervention in Type 2 Diabetes”). This study even uses “meal-replacement products” (p. 147; i.e., Ensure, which is a toxic brew of all the worst low-quality ingredients so prevalent in American processed foods: corn maltodextrin (MSG), sugar, soy protein isolate, canola oil, and milk protein). This long-term trial followed “the goals recommended by the American Diabetes Association,” and was shut down “early on the basis of a futility analysis” after “9.6 years.” All that time and money wasted on a project that had zero understanding of the complexity of human metabolism and the value of whole foods.
The other two studies show the positive effects of a “Mediterranean Diet”—“without energy restrictions” (meaning, no calorie restrictions)—and how this diet helped reduce both “diabetes risk among persons with high cardiovascular risk” and “major cardiovascular events . . . for a relative risk reduction of approximately 30 %, among high-risk persons . . . initially free of cardiovascular disease” (An Int Med 7 Jan 2014; 160 (1): 1-11 and NEJM 2013; 368: 1279-90.) Both studies are based on the PREDIMED “multicenter trial after a median follow-up of 4.1 years” with “7447 persons . . . enrolled (age range, 55 to 80 years).” Eating lots of fruits and vegetables, whole grains, olive oil, raw nuts, and little meat and dairy, is proven to be the way forward.
By pairing traditional whole-foods diets with the newest microbiome research, Food Therapy has created a program that improves health for many categories of patients. Once the gut functions efficiently and smoothly—and there is a wide range of nutrients in that gut—health improves for most patients dramatically. Those who are best suited to our program are Type 2 Diabetics, the obese, people with high blood pressure and cardiovascular problems, those with digestive problems like IBS and IBD, those with autoimmune diseases, those with autism or depression or anxiety, those with eating disorders, those who are fighting other addictions, and those who are trapped in cycles of food cravings.
Key facts that explain why Food Therapy is so crucial now.
First, most Americans get derailed from eating right by a flood of misinformation about food (the competing claims shouted at them by the mass media and paid for by the food industry that either pronounce something a “superfood” or denounce it as dangerous). Suddenly new labels appear in supermarkets pronouncing “natural” or “whole grain” or “omega 3” or “chia” or “low-fat,” and people get swept along in the tide of new health claims, adding a bit of this or that flotsam to a diet that remains largely toxic and highly processed. People need an overarching plan and concept—whole foods in quantity feed the microbiome which feeds health.
Second, most doctors have very little training in nutrition, so they cannot run these programs (this, of course, leaves out the exceptions like Drs. Fuhrman, Ornish, Esselstyn, Spector, Kellman, Eppel, etc.). Whole foods compete directly against prescription drugs, with the healthiest people taking the least drugs, and this goes so strongly against standard American medical training and practice, that most doctors still can’t see the truth here.
Third, most of the people trained and working in America as “nutritionists” and “dietitians” (with the exception of “holistic nutritionists” and “whole foods chefs”) are part of the larger toxic food industry in America—their university programs and professional associations are funded almost entirely by the most toxic companies in this industry. Remember, these so-called nutrition professionals are the ones who have long devised the horribly inadequate food services provided in schools, hospitals and prisons, and they are the ones who recommend toxic products like Ensure to their patients. They still follow the nineteenth-century model of nutritionism, in which “a calorie is a calorie”—meaning that foods are simply “units of energy” with no intrinsic value in the real food itself. Synthetic versions of foods are the “same” as whole foods—for them. Unfortunately, for them, study after study in the past ten years has proven the superior nature of whole foods over chemicals. These are the last people who should be teaching the general public about healthy foods. Their practices and beliefs have helped create the current epidemics of obesity and diabetes in America. We need a new direction.
The Food Therapy Program
A Food therapist acts as a guide and a support. Most of the time people have an instinct about what they are doing wrong, but they need the strength of a third party to enter such a confusing realm as food; they have so many questions that need answering, and this takes time.
A Public Lecture on Food is a great way to start the program. This allows people to see the enthusiasm and curiosity of a community of other people. The lecture should be about 60 minutes with a long Q & A session after. (Recently Mr. Hush gave such a lecture “Eating like a Champion: How Elite Athletes Build their Power” at Russell Library in Middletown. He focused on celebrity athletes to spark interest.)
Within two weeks of the food lecture, every patient interested should be able to meet individually with the Food therapist. The first meeting (60-90 minutes) should be an interview to find out what a typical day in his/her diet looks like and what the particular ailments are. All the medications currently being taken should also be noted, as the less important ones can soon be reduced or eliminated as the diet improves. The patient should be given two tasks: finding new foods and replacing regular foods with healthier versions (whole instead of processed foods).
A second session one week later should review any new feelings or changes and continue the process of cleaning up the diet and answering all the follow-up questions that grow out of this lifestyle transformation.
A third session of going with the patient to a supermarket is central to her progress. Pushing the patient to try new foods, getting her to read labels, and suggesting healthy substitute foods is best done on site.
A fourth session (and more if funding is available) will work with the patient to cook simple and nutritious dishes using the new and often strange ingredients. This session can turn into a whole series of group classes with several patients working together with the Food therapist, so that, as in the introductory Food Lecture, people start to build a community around healthy whole foods.
Patients are now ready to enter the full twenty-one day whole foods/elimination diet in which they strictly follow the specific plan created with their Food therapist. This can be vegan, vegetarian or omnivore, depending on the wishes of the individual patient.
During this 21-day food therapy diet, the patient can text or call the Food therapist to get answers to specific questions. However, the Food therapist’s larger goal at this point is to encourage the patient to take responsibility for his/her own food choices.
After the 21-day diet is finished, there should be a face-to-face meeting with the Food therapist (60-90 minutes) to discuss the overall progress and weaknesses that emerge from this immersion in whole foods. Many deep emotional and physical issues will have emerged by now, about cravings and about resistance within the person’s family, and these need to be addressed immediately to make this diet into a permanent lifestyle transformation.
A meeting with the patient’s primary care doctor should follow closely upon the diet’s completion to discuss improvements in the microbiome and to do the necessary blood work for glucose and inflammation and other relevant factors for this patient.
After 1 to 3 months of healthy eating, patients should come together in a support group to ask questions of the Food therapist and to share their struggles and triumphs.
The most successful graduates of the Food Therapy program can become the leaders and mentors of peer support groups for other patients. They should be encouraged to share their experiences and spread the wealth of their knowledge in their communities.
One year after graduation from the 21-day diet, two things should happen: another doctor’s appointment should check out the gut microbiota and the patient’s blood work and there should be a final discussion with the Food therapist about ongoing issues and about plans for the future.
Food & Movement Therapy (famtusa.org): changing the healthcare landscape of America one body at a time.