AN INTERVIEW WITH AN EXPERT ABOUT THE NUTRITARIAN DIET
Have you heard of the diet focused on maximizing micronutrients? The one that is based on the principle that to maximize healthy life expectancy, you should eat a diet dense in micronutrients per calorie? This diet is called the Nutritarian Diet and was founded by Dr. Joel Fuhrman.
To find out more about this diet – offering therapeutic benefits for diabetes, cholesterol, weight loss, cancer prevention and cardiovascular disease – I spoke with Dr. Barbara Sarter about her experience with the diet, how it helps her patients and the best way to practice it.
STICKING TO THE NUTRITARIAN DIET
The Nutritarian Diet seems to have a lot of rules. I understand that Dr. Fuhrman used motivational counseling with his patients to help them adhere to the diet. However, it seems that through the incorporation of the Nutritarian Diet his patients perceived hunger differently and that was a motivator in itself?
Yes, part of that was based on preliminary scientific research that people who consume nutrient dense foods, and don’t consume junk food, experience hunger [differently]. I think it makes it possible for them to adhere to it. I’ll just speak for my own self. After my husband went through [a] fast, then he started on a nutrient dense diet and I also did. I’ve been following that diet ever since. Both of us have. I rarely feel hungry. I’ve maintained a reasonably healthy body weight and BMI, even though I’m in that part of the life cycle where your BMI tends to go up. I rarely feel hungry, and when I do it’s not miserably uncomfortable.
HOW DOES IT COMPARE TO OTHER DIETS
With regard to your experience and to your work with his patients, when it comes to the Nutritarian Diet and what you’ve seen, how would you say it compares to other approaches like the DASH Diet or the Mediterranean Diet? Does the hunger experience differ?
I can’t testify to the hunger experience of the DASH Diet and the Mediterranean Diet, but in terms of micronutrient density and macronutrient density they’re quite different. I’d say both of those diets are much heavier in carbohydrate even though they are complex carbohydrates. In terms of the macronutrient carbohydrate, there’s a lot more in the Mediterranean and especially in the DASH [diets]. The Nutritarian Diet [contains] much less carbohydrates.
Are the other macronutrients also affected by the Nutritarian Diet?
You know, a lot of people express concern about [protein] in [a] vegetarian diet. [They will ask], “Are you getting enough protein?”. But actually there’s a lot of protein in green leafy vegetables and in nuts, seeds and legumes. [These] are really the foundation of the food pyramid in the Nutritarian Diet. So protein-wise my guess is that they’re probably equivalent in terms of protein.
In terms of fat, [the Nutritarian Diet is] definitely lower in fat, especially animal fat. Dr. Fuhrman definitely distinguishes between animal, non-animal and plant-based fat sources. So nuts, seeds, and avocados are part of the daily Nutritarian Diet. But they’re not unlimited. For a person who’s trying to lose weight, generally he would recommend an ounce a day of nuts and seeds. And a person who’s trying to maintain, then a couple of ounces a day of nuts and seeds.
I did notice that in one of his articles on Dr. Fuhrman’s website, it said that supplementation, in conjunction with the Nutritarian food part of the diet, may be required. Could you tell me a little bit more about that?
I can tell you what he now recommends in terms of supplementation. Vitamin B12. He actually recommends a multivitamin, [especially one] that has a good amount of B12 because there’s [a minimal amount of] meat and eggs in a Nutritarian Diet. [He recommends] vitamin D, which in my experience everybody needs vitamin D supplementation. I’ve never tested a person’s vitamin D levels that have not been suboptimal. He also recommends DHA, a vegetarian sort of DHA/EPA product available now that’s based from algae. Those are really the big three, I’d say.
In your opinion, how can one translate to a patient that the Nutritarian Diet is a complete diet even though supplementation may be necessary?
It’s complete in the sense of the macronutrients. But there are specific vitamins that are really hard to get adequate amounts of when you’re a vegetarian. [The Nutritarian Diet is] kind of unique to a vegetarian diet and pretty much, across the board, no matter what kind of a diet a person is on nowadays, [for example] omega-3 fatty acids are recommended as additional supplementation. That’s how I would address that issue.
HOW TO GET STARTED
When it comes to adopting the Nutritarian Diet, how would you recommend to someone the best way to adopt it if they’ve never really done anything like this before? Especially if they find it really difficult or they’ve gone through a lot of yo-yo diets.
I approached it a little different than [Dr. Fuhrman]. He used to just want his patients to radically change and start on this diet a hundred percent from the beginning. [This] is really hard for most people. So the way I approached it was very much gradually. I would start out [by encouraging the patients to add] just one big salad a day into the diet.
I would emphasize more what you should be eating, and not what you shouldn’t be eating. Almost every patient I saw I would start out by saying, “Now I know you must be anxious because you’re here to talk with me about dietary modifications. I’m not gonna tell you what you shouldn’t be eating. Let’s talk about what you should be eating.”
The first thing I would ask them is, “Tell me what your hang ups are. What can you not live without? And we’re not gonna [remove that food from your diet]. Or maybe we’ll just say have a little less of that [food], but I’m not gonna say there’s anything that you absolutely have to eliminate, even if you’re diabetic.”
I can help [people who have diabetes] plan how they’re going to eat their sweets, so that [it has] less of an impact on their blood sugar. I call it “smart eating”. [For example], if you’re gonna have your ice cream, don’t have it at night before you go to bed. Have it after a meal that has plenty of protein in it. Then it’s going to slow down the absorption of the glucose and not cause such a huge spike in your blood sugar.
A good way to start is to adopt “smart eating”.
A couple of other guidelines I would give people is to just look at what you’re eating in a meal on a plate. [Next] take one third of that plate and replace whatever it is with a salad or vegetable. It’s the one third rule. You can be sure for most people that’s going to dramatically lower their caloric intake probably by almost one third. And you’re adding in something healthy. So that was another thing that people seemed to respond well to. Rather than, “You can have so much of this and so much of that,” or quantities and portions. Most people just are averse to that kind of thing.
The third thing I like to emphasize is color. Just make your plate as colorful as possible. If you do that, you’re going to be eliminating most refined carbohydrates. At least you’re gonna have brown rice instead of white rice, and whole wheat bread instead of white bread, and a good variety of vegetables and fruits.
Barbara Sarter, PhD, RN is a core faculty member of Bastyr University in San Diego, CA. Her extensive background in nursing and medicine includes a MA and PhD in Nursing, a career as a family nurse practitioner, homeopathic practitioner and faculty positions at USD and USC.
To find out more about the Nutritarian Diet, Dr. Fuhrman and related research, you can check out: www.drfuhrman.com.