The Drs Eades on PPLP

[Mitra]

An interview with Michael R. Eades, M.D. and Mary Dan Eades, M.D., authors of The Protein Power Lifeplan

By Gwyneth Doland

JANUARY 31, 2000: Drs. Michael and Mary Dan Eades are the Boulder, Colo.- and Santa Fe-based authors of the 1996 New York Times bestseller Protein Power. Their new book, The Protein Power Lifeplan, was published last month by Warner Books.

They were in the middle of a 10-city book tour last week when I caught up with them in San Francisco and asked them a few questions about the book and the diet.

Everybody's talking about these high-protein diets, but there seem to be a million of them. What makes your plan different from all the others like the Atkins, Carbohydrate Addict's and Zone diets?

Mary: Well, it's better! Five years ago, when we wrote Protein Power, everybody wasn't talking about protein diets, and we really brought this whole kind of nutritional strategy back to the forefront. Since then, you're right, everybody and their uncle has their take on the protein diet. ... we have been doing it clinically for 15 years, and we are physicians, and we have been using this in our practice to treat patients with not just weight problems, but with cholesterol and triglyceride problems and heart disease. I think we bring some sanity to protein dieting. ... What we have been able to do, from years of working with patients, is to figure out which of the carbohydrate foods are going to be most problematic for most people and restrict those, eliminate some of them and still allow people to have lots of colorful vegetables and low sugar fruits and melons and berries and squashes and peppers and all the kinds of things that make a plate so beautiful to look at and so delicious to eat.


[B]So, you're not saying that we can never eat carbohydrates again?

Mary: Absolutely not!

Michael: No, no, not at all! The whole name of the game is keeping insulin levels down. It's interesting because most people only associated insulin with diabetes a few years ago, and now everybody seems to know that ... too much [insulin] is bad for you. And what we've focused on is getting that down, because when you get it down, good things happen. Cholesterol goes down, triglycerides go down, blood sugar gets stabilized, fat comes out of the fat cells, people lose weight, they get rid of ... bad heartburn, their gout improves, they sleep better. I mean there's just a whole multitude of good things that happen when you get elevated insulin levels down. And so, basically what we've figured out [is which] foods that you can use to get it down, but still give you a lot of variety, you know, asparagus and tomatoes and all those things that she was mentioning. She never mentions asparagus and tomatoes, which are my favorites. ...

Mary: (laughs ) Those are the only two foods you know.

Michael: That's right! But the foods that she was talking about, none of those things really raise insulin at all, and so if the goal is to keep insulin down, it doesn't matter if you eat those things. And it brings a lot of variety to the diet, it gives you lots of phytochemicals, lots of antioxidants. You know, there are a lot of good things in these plant foods, and what's really nice is that the ones that we do eliminate, or have people cut back on, are potatoes and the grains. They're really not as concentrated a source of nutrition as these others are. They're much, much less nutritionally dense.


I noticed in the book that you say diabetes, heart disease and obesity are all caused by eating grains.

Mary: That's really true. [Those conditions] are caused by raising insulin, and when people eat heavy doses of those kinds of starches, they raise their blood sugar, and as a consequence they ultimately damage that whole metabolic system and, if they're susceptible to it, develop diabetes or heart disease, cholesterol and triglyceride problems. When you think about it, we were hunter gatherers for the vast, vast bulk of the time that we've been on this earth, recognizable as humans or proto-humans, at least for the last 2.8 million years of time since the first upright, walking humanoid creature, and we were meat eaters. And it was only about, depending on where in the world, up to 10,000 years ago -- actually in our corner of the world, in the desert Southwest, maybe as recently as a thousand years ago -- that people started planting grains and using them as a staple. So, before that time, that whole bottom of the food pyramid that everybody sees everywhere, was not even a part of the human diet.


In your book you call that the "Paleolithic diet" and you describe modern humans as, "cavemen in designer suits with cell phones."

Michael and Mary: That's us!


But haven't our bodies evolved since our ancestors first walked upright?

Michael: Our clothing has evolved since then.

Mary: And we now have cell phones!

Michael: But, genetically, we're essentially the same as we were 100,000 years ago. If you'll look at what the geneticists say about it, we're 99.9998 percent the same as we were then, based on DNA evaluation. So, it's a change that takes place very, very, very slowly. We're pretty much exactly the same as we were 10,000 years ago, at the threshold of agriculture. And what's interesting is that anthropologists and archaeologists can look at the skeletal or mummified remains of ancient people and they can tell at a glance whether they were agriculturalists or hunter gatherers because the agriculturalists didn't have nearly as good health. ... At the Smithsonian Institution, a researcher there has said that the agricultural revolution was actually a nutritional devolution because health definitely went in the tank as soon as agriculture came along. ... It brought a lot of good things, but good health for individual people was not one of [them].


So, what we're talking about is eating more meat and less grain, right? How would you counsel a vegetarian to follow this plan?

Michael: More meat, less grains!

Mary: Right. We have a surprising number of vegetarians who follow our plan, but you want to always find out from vegetarians why they're vegetarian. If they think they're doing it because it's a healthier way to eat, well we can go through with them why it's not a healthier way to eat, and many times they decide they don't want to be vegetarian. But a lot of vegetarians do so for either religious or ideological reasons, and you know, nobody's going to tamper with somebody's belief system. So, that person needs to learn where to get protein from vegetable sources. Now, if they'll eat dairy, and they'll eat eggs, that's great. Those are two good, complete sources of protein that at least ovo-lacto vegetarians can enjoy. Other than that, if they adopt a vegan way of life, they're going to have to get all of their protein from things like tofu or miso or texturized vegetable protein, and it's certainly difficult; not impossible, but a vegan existence is difficult.


All this meat -- it sounds like a lot of fat and cholesterol which is what they've always told us would cause heart disease. We keep hearing about the traditional Chinese diet which is low in meats and high in grains and how they have lower rates of cardiovascular disease. How do you explain that?

Michael: Well, in the first place, let's take the Chinese study. If you look at the most recent statistical abstract from the American Heart Association ... you'll find, surprisingly, that Chinese females have more heart disease than American females do and Chinese males have about the same amount as American males. So the whole idea that the Chinese don't have heart disease is a myth. It's one of these things that I call a vampire myth. I mean, no matter how many times it's dispelled, or killed, it keeps coming back to haunt you. ... So, it's not really true that the Chinese don't have any heart disease. If you'll look at the rural Chinese, they do have a little less heart disease, but if you go back to the insulin issue, insulin is a major risk factor for heart disease, and we all want to keep our insulin down, and there are a bunch of ways to do it. The easiest way is to restrict carbohydrates, but you can also keep it down with a lot of exercise, and you can keep it down by going on a real low-calorie diet, although you can't achieve the same results as just carb-restriction. But the rural Chinese work very hard, and they don't eat very much, and that helps keep their insulin levels down. ... Actually, 85 percent of the cholesterol in the blood doesn't come from the diet; we make it ourselves. As we're sitting here talking, 85 percent of the cholesterol flowing through our veins we've made, our livers have made. Only 15 percent comes from the diet. Cholesterol is an incredibly important molecule for the body, and virtually every cell in the body can make it because it is so important. And when we eat less, we end up making more. ... Our whole program had its genesis as a cholesterol-lowering diet. As we went on we found out, gosh, people were losing weight, their blood pressure went down, all these other good things were happening. ... As I've said many times, I'll go mano-a-mano with any drug company pitting our diet against the strongest drugs that they want to come up with, and we're gonna beat 'em because it works that quickly and effectively to lower cholesterol. That's the big thing that everybody worries about, but it's a non-issue, really.

[Mitra]

So are all fats good? Or are some good and some bad?

Mary: Definitely some are good, and some are bad.

Michael: Some are awful!

Mary: That's right, some are downright awful. The good fats are the ones that you really need to make healthy cell membranes and healthy nerve tissue and healthy immune systems and all those things. The ones that we miss the most, that we used to get a lot of when we were hunter gatherers and that the modern plate is deficient in, are the ones that come from cold-water marine sources: [the fats called] DHA and EPA. Those are two absolutely essential and critical fats for human health and unfortunately ... people don't eat as much fish as they used to. Cold water fish like sardines, salmon, mackerel and herring, those kinds of fishes are very rich in [good fats]. One of the things we encourage people to do if they don't eat a lot of those kinds of things is to supplement [with] a good quality cod liver oil. ... The health benefits of those fats are too important to ignore. You've really got to have them.

Neutral fats as a source of energy, of fuel, are important, [too]. That would be olive oil, [or] any kind of mono-unsaturated fat like avocados. Guacamole is a very good source of mono-unsaturated fat, and strangely enough, [so is] lard. A good quality lard is mainly mono-unsaturated fat like olive oil.


So, what would a typical day's meals be on this diet?

Mary: That's interesting. We just did that yesterday.

Michael: Yeah, it was amazing. ... We were on the "Donny and Marie Show," and they wanted a day's worth of food, and they laid it out on these two tables, and I was stunned.

Mary: It's a ton of food!

Michael: It's a huge amount of food.

Mary: We had a three-egg omelet made with sautéed squashes and mushrooms and onions and peppers and on the side of that three or four slices of tomato and some fresh basil leaves ... [and] a little bowl of melon and berries and coffee. Sour cream to put on top of the omelet, for those who like dairy. Then for lunch, they had a beautifully grilled piece of salmon, a big piece that we had on a traditional Caesar salad: romaine lettuce, Caesar dressing and anchovies. We had some feta ... and some walnuts. In our neck of the woods you'd use piñon nuts! Almonds to snack on in between meals. For dinner they had a large steak and mushrooms with grilled asparagus and broiled tomato halves with herbs and a big green salad, some orange sections for dessert. If you imbibe, certainly you can have a glass of wine with lunch or dinner. And you can have some nuts or jerky along the way. It was a ton of food, and it was scaled for one sort of normal-sized adult male.


It sounds delicious ...

Mary: It looked delicious! I wanted to eat it, but we had to leave!


... but it also sounds expensive.

Mary: Well, it could be. Actually, nutrition ought to be expensive. You should spend more on what you eat and less on a lot of other things, simply because the food you put into you is what you become. You want to build a good quality body. ... In fact, we're working on a project right now to do Protein Power meals in minutes on a budget. You just have to do like we did when we had all the kids in the house. ... You go to the grocery store, and you find where they've got the giant family-size thing of chicken thighs, and you buy them and freeze them when they're on a good price. ... When [our] three boys [were] at home eating a lot, we ate a lot of chicken!


Back to the carbohydrates thing. Don't you need carbohydrates for energy? You encourage exercise in your book, but how can you have energy without carbohydrates?

Michael: Carbohydrates for energy -- that's another one of those vampire myths that refuses to die. Actually carbohydrates are a source of energy, but they're a secondary source of energy. Fat is your primary source of energy, both your body fat and your dietary fat. The problem with that is that you can't get to the fat unless your insulin is down. You can't burn it. If insulin is up, that doesn't let the fat out of the fat cells. If you lower insulin levels by restricting carbohydrates, then you get the fat out of the fat cells and burn it. If you eat carbohydrates and fat and protein, you're going to burn carbohydrates.

Mary Actually, all the big triathelete and Olympic camps up around Colorado Springs are turning to fat loading versus carbo-loading because the burn is so much more efficient and predictable. ... Once they become adapted to eating that way, [the athletes'] endurance is tremendously better.


But how can you lose weight eating all this fat?

Mary: Well, again, because insulin is at work. Insulin is just a mighty hormone -- gosh, it does so many things. It gives the signal to the fat cells to store fat, so when you eat a diet that keeps insulin controlled, and insulin levels are low, the signal to store fat is muted and as a result, the calories just don't go into the fat cell. You don't store the calories. A perfect example of that [can be seen] in a juvenile diabetic. The first sign ... that [these children and adolescents] have become diabetic is this rapid and unexplained weight loss. They cannot keep fat in their fat cells. No matter how much they eat, they cannot keep it in there, and that's because that's insulin's job. When you have too much insulin, you store fat very easily. When you get insulin down, you can very easily get it to come back out of the fat cell and into circulation where you can burn it up as a fuel. MD: The saying goes, "Fat doesn't make you fat, insulin makes you fat."


So does that mean we get to eat bacon?

Mary: You bet!

Michael: We had it for breakfast this morning.

Mary: We'd prefer that it be a nitrate-free bacon, though.


One of the criticisms of high protein diets has been that people lose a lot of weight really rapidly and then just pile it back on. What's that all about?

Michael: Well, [the diet] is medicine, and it's just like blood pressure medicine. If you have a blood pressure problem and your blood pressure is up and you go on medicine and your blood pressure comes down, you'd think the medicine was working. If you went off the medicine and your blood pressure went back up, you wouldn't think the medicine had failed, you'd realize that you quit taking the medicine. When you put people on this and they do extremely well, if they go off of it, it's all going to come back. There's no question about it. [This diet] is nothing magic. They've got to stay on this, and that's why we call it a "lifeplan," because it's tough to stay on meat and cheese and eggs and nothing else for the rest of your life. So that's why we figured out how to add all of these other things in to make it a pretty rich and varied diet that people really don't have a problem staying on forever. We've stayed on it for 15 years ourselves. We raised our kids on it. It's something that you can do for the long haul.

Mary: If you know people who have these insulin-related problems, sugars and starches and high amounts of carbohydrates are like a poison to them. They absolutely don't tolerate them well and they can't fool themselves into believing that they will tolerate huge amounts of it.

[Mitra]

You know, whenever you mention this kind of diet to a dietitian, they always first mention ketosis. The risk of ketosis. What is ketosis and how does that happen?

Michael: Ketosis is actually a perfectly natural state. When you wake up in the morning, regardless of what you eat, you're probably in ketosis. We go in and out of ketosis every day. Ketoses are just breakdown products of fat. When fat first comes out of the fat cells, and it makes a pass through the liver, the liver breaks it down into these substances called ketone bodies. Ketone bodies are then used as energy by the tissues. In fact, the heart would prefer ketone bodies to anything. The brain can use ketone bodies, the organs can use ketone bodies. So, ketosis, in and of itself is not a harmful deal. If you've got plenty of carbohydrate, it kind of binds with these ketones and takes them in and burns them on up. If you don't have enough carbohydrates, the ketones burn up on their own, but they can also spill over into the urine, and into the breath. There's not a problem with that except it can give you some bad breath. ... The only people it's harmful to are type I diabetics, because the thing that shuts off the production of ketones is insulin. So, if you can make insulin, [and] your ketones get too high, you get a little squirt of insulin and that shuts the whole thing off. If you're a type I diabetic and you can't make insulin, and they get high, you can't produce the insulin, and they go into ketosis -- it doesn't matter what they eat. They can eat whatever and they go into ketosis ... but on a dietary program, it doesn't harm anything. We don't focus on it.


I've just been handed one last question by an eavesdropper in the office. It's been said in the past that the amount of carbohydrates required by humans is zero. How can that be?

Michael: It's been said in the past that we need oxygen to live! If you look at Eskimos for example, they eat no carbohydrates, or didn't before they became Westernized. The requirement for carbohydrates in the human diet is zero. We always ask in medical conferences, "Who can name a carbohydrate deficiency disease?" And nobody can. There are tons of protein deficiency diseases, there are fat deficiency diseases, but there are no carbohydrate deficiency diseases except boredom. Carbohydrates taste good, people like to eat them. If you don't get them, it makes for a boring diet, but in terms of our biochemical needs, we absolutely don't need them. We've got all the biochemistry to make carbohydrates that we need from protein. We convert protein to carbs and fats to carbs. We can convert carbs to everything, too. We can convert them to fat and certain proteins, and so we're set up to not need [carbs] at all. That's why it's never made sense to me that we should go on a diet that's filled with the stuff that we have the ability to make at the expense of the stuff that we can't make.