The Lifesaving Plan for Health and Longevity
John Mackey
A whole-foods, plant-based approach to eating that is evidence-backed and sustainable every day.
Diet-related disease kills more people than tobacco, alcohol, and physical inactivity combined. Mackey makes the case that whole, plant-rich foods are the default diet humans thrived on — and the science behind why they work at the cellular level.
Everything Mackey wants you to walk away with
When twenty-one leading nutritionists of varying persuasions were convened to find common ground, they all pointed the same direction: minimally processed foods close to nature, predominantly plants, are decisively associated with health promotion and disease prevention.
A whole food retains all its original edible parts with nothing bad added and nothing good taken away. Your great-grandparents would recognize it as food. It spoils. It usually has no ingredient list — or a very short one.
Corn at 500 calories per pound becomes corn oil at 4,000. Sweet potatoes at 389 become chips at 2,400. Your stomach's stretch receptors never fire, so you keep eating even though you've consumed more calories than you need.
Start every meal with a big salad or vegetable soup. Whole fruits and vegetables fill you up with low-calorie, fiber-rich, nutrient-dense food that leaves you less hungry for processed options. You don't need portion control when you eat real food.
Fiber feeds good gut bacteria, stabilizes blood sugar, aids detoxification, and performs a cleansing function. But merely adding fiber as a supplement does not bring the same health benefits. Your body needs the real thing, which only comes in whole plant foods.
The China Study tracked 6,500 people across 65 provinces: those who ate the most animal-based foods got the most chronic disease, and those who ate the most plant-based foods were the healthiest. Adventist vegetarians live 9-11 years longer than average Americans.
Okinawa, Sardinia, Loma Linda, Ikaria, Nicoya. They eat greens and about a cup of beans a day. They eat meat only as a condiment or celebration. Nothing they eat has a plastic wrapper.
3,500 extra calories equals one pound of fat. Liquid calories bypass satiety signals entirely. When you eat whole plant foods, the stretch and calorie receptors work together accurately so you stop eating at the right time.
Kale scores a perfect 1,000 on the nutrient density index. Shifting your focus from restriction to abundance changes the psychology entirely. You can't replicate a blueberry's benefits in a pill — the synergy of whole food compounds is irreplaceable.
A skillful eater has studied the science and evolved their tastes so that what they love to eat and what's good for them are the same thing. The Whole Foods Diet is not about deprivation — it is inclusive, flexible, and designed for a lifetime.
These notes are inspired by direct excerpts and woven together into a readable guide you can follow from start to finish.
By John Mackey, Alona Pulde, and Matthew Lederman
Food occupies a singular place in human life. We devote more time to procuring and eating food than to any other life-sustaining activity except breathing and sleeping. Food is one of our greatest sources of pleasure, and one we share with those we love—dining together even releases oxytocin, the “love hormone” that stimulates greater human connectivity. While every species must eat, the human imagination has imbued the simple acts of preparing and consuming food with a whole world of emotion and meaning. Food can express love, gratitude, compassion, creativity, and identity. Historically it has formed a building block of culture—cementing alliances, capturing the unique character of a people, marking significant events. Food is celebration. Food is connection.
Yet for millions of people, food is also synonymous with stress, weight gain, neurosis, confusion, and even disease. Americans today have the potential to be the healthiest human beings ever to have walked this earth, but we are quite the opposite. 69% of US adults are overweight and 36% are obese, and these numbers have been steadily rising over the past fifty years. According to a 2015 survey, 77% of Americans are actively trying to eat healthier, and researchers estimate that more than 50% of the population is “on a diet” at any given time.
You wouldn’t expect to play a sport or a musical instrument skillfully without dedicated study and practice—and the same applies to eating. Just because you’ve been doing it all your life doesn’t mean you’ve mastered the art of self-nourishment. You may simply be eating the way your parents brought you up to eat, or the way your friends eat, without deeply thinking about whether it will help you achieve your own health and life goals. A skillful eater is one who has studied the best of what nutritional science can teach us about food and the way it affects our bodies. She knows how to see past the fog of confusion created by the media and the latest diet fads, and his tastes have evolved along with his understanding, so that what he loves to eat and what’s good for him to eat are one and the same.
The science, approached with an unbiased mind, speaks with a clear and consistent voice. As Walter Willett, MD, chair of the Department of Nutrition at Harvard School of Public Health, and Patrick J. Skerrett, MA, confirm, there are “enough solid strands of evidence from reliable sources to weave simple but compelling recommendations about diet.” When Dr. David Katz, founding director of the Yale-Griffin Prevention Research Center, reviewed the medical evidence for and against each of the major dietary trends in the West today—Paleo, Mediterranean, low fat, low carb, low glycemic, vegetarian, and vegan—his conclusion was that “a diet of minimally processed foods close to nature, predominantly plants, is decisively associated with health promotion and disease prevention.” In 2015, together with the nonprofit Oldways, Katz convened twenty-one leading nutritionists of varying persuasions to seek common ground on dietary best practices. Despite inherent differences, the assembled experts were not so far apart: almost no one argues that we should eat highly processed foods, and just about everyone agrees that fruits and vegetables are vital to human health and that we should consume a great deal more of them.
Definition — The Whole Foods Diet
A whole foods, plant-based diet prioritizes eating whole or unprocessed plant foods; minimizes meat, fish, dairy products, and eggs; and eliminates highly processed foods. More specifically, it is a 90+% plant-based diet, meaning animal foods (meat, fish, eggs, and dairy) make up 10% or less of your calories.
This is not necessarily a vegetarian or vegan diet. It is a framework with tremendous flexibility: Mediterranean, Paleo, gluten-free, and vegan approaches can all be adapted to fit within its parameters. Within those parameters, there is ample room to create meal after meal that satisfies your needs, nourishes your body, and delights your senses.
In Michael Pollan’s now-famous distillation: “Eat food. Mostly plants. Not too much.” The beautiful thing about really following those first two instructions is that it becomes hard to eat too much. You’ll naturally find yourself satisfied and nourished without over-consuming calories—and you’ll experience the joy of no longer having to worry about portion control.
Definition — What Is a “Whole Food”?
A whole food retains all its original edible parts and has not been altered by the addition of other processed ingredients. As Dr. Michael Greger puts it: “Nothing bad added, nothing good taken away.”
By this measure, a bag of steel-cut or rolled oats is a whole food; a sugary oatmeal cookie is not. As Pollan adds: “If it came from a plant, eat it; if it was made in a plant, don’t.” As a general rule, the foods you choose—whether raw or cooked—should be as close as possible to the way they came off the tree, vine, or root.
The distinction between whole foods and highly processed foods is easy to recognize once you know what to look for:
| Whole Foods | Highly Processed Foods |
|---|---|
| Are close to their original state | Bear little resemblance to their original state |
| Spoil faster | Do not spoil easily |
| Are things your great-grandparents would recognize as food | Are things your great-grandparents probably wouldn’t recognize |
| Don’t usually have ingredient lists, or have short ones | Have (often long) ingredient lists |
| Are often sold without packaging | Are packaged or boxed |
| Are often found around the perimeter of the grocery store | Are often found in the center of the grocery store |
It’s important to understand that cooking is a form of processing—but a minimal one. This is not an argument for a raw-foods diet. Cooking is a wonderful human invention that often enhances the benefits of foods, makes them easier to digest, and in some cases releases more nutrients.
One reason real food cannot be replicated through supplements or isolated nutrients is the sheer complexity of what a food actually is. “Even the simplest food is a hopelessly complex thing to study,” writes Pollan, “a virtual wilderness of chemical compounds, many of which exist in complex and dynamic relation to one another.” You could attempt to identify all the nutrients in a blueberry and put them into a pill, but it would never have the same healthy effects on your body as eating a bowl of blueberries. To someone who is just trying to “get my protein,” there is no difference between a highly processed protein powder made from an isolated part of a soybean and the same amount of protein eaten as whole beans—but to your body, the distinction is profound. The good news is that you don’t necessarily need to understand all of this complexity if you simply eat real food; your body will break it down in the way it has evolved to do.
Plant-based diets have been shown to prevent and reverse many of the chronic conditions that afflict millions of Americans, including diabetes and heart disease. Imagine finding a way to eat that made you feel fantastic—nourished, vital, and satisfied—flexible enough to allow for your particular preferences but clear in its basic parameters, simple enough to explain to your kids and defend to your most opinionated friends. What if this way of eating could also help you maintain a healthy weight without tracking portions, prevent common ailments, and protect you from heart disease, cancer, and type 2 diabetes? The Whole Foods Diet offers all of this. A Whole Foodie loves great-tasting, life-enhancing food.
Featured Contributor — Dr. Michael Greger
Dr. Greger claims to read every issue of every English-language nutrition journal in the world “so busy folks like you don’t have to,” distilling the information into daily blogs and videos at NutritionFacts.org. His passion for food as medicine was inspired by his grandmother: declared beyond medical help at age sixty-five after multiple heart surgeries, she switched to a plant-based diet—and lived another thirty-one years.
Your body is equipped with a sophisticated system for regulating how much you eat. There are “receptors” in the stomach and digestive tract that measure the food you ingest in several ways. One of the most important is the weight and bulk of the food—the amount of “stretch” that occurs in the stomach to make room for it. This is why foods containing a lot of fiber fill you up more: they take up more space and trigger a signal to the brain that says enough has been eaten. Foods that have been refined and processed—with fiber and water removed—take up less space, so even though they contain more calories, the message does not get back to your brain that you’ve had enough. You also have receptors that ensure you are consuming actual calories and not just getting stretch without caloric content. When you’re eating whole plant foods, these mechanisms tend to work quite accurately together, ensuring you get the right amount of food and not too much.
Over the last few decades, however, the rise of processed food has fundamentally altered this algorithm. Processing tends to increase the calorie density of any given food by removing water, reducing or removing fiber, or adding sugar and/or fat. Consider what this means in practice:
Principle — Don’t Drink Your Calories
Three thousand five hundred additional calories equals one additional pound of fat. Overshoot your needs by as little as one hundred calories per meal—roughly two chicken nuggets—and do that three times a day, and you will gain a pound of fat every two weeks. That adds up to more than twenty-five pounds in a year.
Animal foods compound the problem: they lack fiber while being calorie dense. Today’s factory-farmed, grain-fed animals bear little resemblance to the lean wild game our ancestors occasionally hunted. When their meats are cooked in oil and eaten alongside other calorie-dense, fiber-deficient foods—white bread, fries, ketchup—it’s a recipe for obesity.
This also clarifies why dieting, which relies on portion control and calorie restriction, rarely works. It’s not that you lack self-control or willpower—it’s that the food environment in which you live makes available foods that subvert your body’s natural instincts and trick you into feeling hungry when you’ve already consumed more calories than you need. Hunger is a powerful survival mechanism, and it is very hard to defeat through willpower alone. Your brain interprets a lack of stretch as actual calorie deficiency and starvation, so it continues sending hunger signals. Sooner or later, you’re likely to respond.
Key Insight — The Veggie Paradox
Add at least one extra serving of vegetables (or fruit) to what you would normally eat at each meal, and eat those before anything else. The more whole vegetables you eat, the more weight you lose—because you fill yourself with low-calorie, fiber-rich, nutrient-rich foods that leave you less hungry for processed foods or animal foods. A good strategy is to start every meal with a big salad or a bowl of vegetable soup, or a bowl of fruit at breakfast.
To lose fat weight safely, you must eat a diet of predominantly unrefined foods that are nutrient- and fiber-rich. Dr. Joel Fuhrman’s concept of nutrient density is a powerful tool for shifting your focus away from what you shouldn’t eat and toward all the wonderful foods you should eat in order to maximize your nutrients. Fuhrman’s ANDI (Aggregate Nutrient Density Index) awards foods a score based on the ratio of nutrients to calories. Kale, for example, received a perfect 1,000—packed with phytochemicals and fiber but low in calories. When Whole Foods Market began using this system in stores, kale sales skyrocketed.
Exercise also plays an important supporting role. It has been shown to improve cardiovascular health, reduce blood sugar, improve bone health, and increase one’s overall sense of well-being—and it may even increase satiety and suppress the desire to overeat. One of the hallmarks of the world’s longest-lived cultures is that they all engage in “natural movement”: walking, gardening, getting up and down from the floor, herding goats in hilly terrain. They are not necessarily lifting weights at the gym, but they keep their bodies strong and flexible. And for those who worry about losing strength without large amounts of animal protein, plant-based athletes—from Olympian track and field medalist Carl Lewis to tennis stars Venus Williams and Novak Djokovic to ultra-athletes Rich Roll and Scott Jurek—are testimony that a whole foods, plant-based diet boosts power and speeds recovery without sacrificing performance.
Consider what it would mean if someone offered you a pill that had been shown to prevent and reverse heart disease and type 2 diabetes; lower cholesterol, blood pressure, and body weight; significantly reduce your risk of getting multiple types of cancer; extend your life span; and make you look and feel great. It may not come in a bottle, but a whole foods, plant-based diet has been shown to do all of these things. The scientific case for this is built on some of the most extensive nutritional research ever conducted.
The evidence against heavy consumption of animal foods is substantial. High consumption of red meat and processed meats has been connected with greater risk of death from all causes, including cardiovascular disease and type 2 diabetes. Eating large amounts of animal protein has been correlated with higher incidences of cancer and mortality. More than a thousand studies on bowel cancer risk have confirmed that red meat increases risk while high-fiber plant foods decrease it. Processed meats are particularly alarming: significant studies link them to stomach cancer, breast cancer, and colon cancer, and the World Health Organization classifies them as a carcinogen.
The landmark research that brought these patterns into the sharpest focus was The China Study (formally, the China-Cornell-Oxford Project)—a massive twenty-year epidemiological study examining the eating habits and diseases of 6,500 people in sixty-five Chinese provinces. A 1990 New York Times article called it “the most comprehensive large study ever undertaken of the relationship between diet and the risk of developing disease,” and reported that even its early findings were “challenging much of American dietary dogma.”
Key Insight — The China Study’s Central Finding
“People who ate the most animal-based foods got the most chronic disease.… People who ate the most plant-based foods were the healthiest and tended to avoid chronic disease.” — T. Colin Campbell
When the study was complete, researchers had accumulated more than 8,000 statistically significant associations between lifestyle, diet, and disease variables.
The study’s lead researcher, T. Colin Campbell, would once have seemed an unlikely advocate for plant-based eating—he grew up on a dairy farm in Virginia believing that “the good old American diet is the best there is. The more dairy, meat, and eggs we consumed, the better.” The data changed his mind entirely. A Chinese government survey covering 880 million citizens—96% of the population—had revealed that cancer rates were often geographic in nature, with little or no evidence of the disease in some rural areas and dramatic increases in others, particularly urban ones. That breadth of data inspired Campbell and his collaborator Chen Junshi to propose the extensive dietary and lifestyle survey that became The China Study.
One key finding was the association of a high-fiber diet with decreased rates of certain cancers, including colon cancer. Chinese consumption of dietary fiber averaged three times what is typically found in American diets. Fiber is a critical component of a whole foods, plant-based diet: it is the substance that gives structure to the cell walls of plants in the same way that bones give structure to animal bodies. Because of this, high fiber intake is one of the reliable markers of a plant-heavy diet.
Principle — Real Fiber Only
Fiber plays a critical role in feeding good gut bacteria, performs a cleansing and “scrubbing” function in the digestive tract, improves digestion, stabilizes blood sugar levels, detoxifies, keeps pH low, and helps with the excretion of unwanted substances from the body. However, there is good evidence that merely adding fiber as a supplement does not bring the same health benefits. Your body needs the real thing—which only comes in whole plant foods such as fruits, vegetables, legumes, beans, and whole grains.
The Adventist Health Studies provide a second major pillar of evidence—and a remarkable one. Seventh-day Adventists in Loma Linda, California, do not live on a remote island cut off from contemporary food culture; they are in the middle of southern California’s cultural melting pot, just south of the San Bernardino freeway. Yet healthwise, they might as well exist on a different planet. In the first Adventist study, conducted in the 1970s and ’80s, more than thirty-four thousand people were followed for fourteen years. Adventists who ate a primarily plant-based diet—vegans, lacto-ovo vegetarians, and pesco-vegetarians—were the longest-lived populations not just among fellow Adventists, but among all Californians, and possibly in the world. Loma Linda has since been identified as one of the world’s five longevity hot spots.
The life span numbers are striking. Vegetarian Adventist men and women live to about eighty-three and eighty-six, respectively, compared to seventy-six and eighty-one for the average American. Among those who also maintained healthy lifestyles—no smoking, regular exercise—the average life span jumps to eighty-seven and ninety. That represents an extra eleven years for men and nine years for women.
A subsequent Adventist study found that meat-eaters had the biggest waistlines and a higher death rate than their vegetarian counterparts. They also tended to have worse overall dietary habits, including greater consumption of highly processed foods such as sugar, soda, and refined grains. Lacto-ovo vegetarians, pesco-vegetarians, and vegans all had significantly lower mortality rates compared to the meat-eaters. One important caveat: it is entirely possible to adopt a vegan or vegetarian diet and still end up eating very unhealthy foods. Merely avoiding animal foods is not the answer to good health. The first dietary principle remains paramount: choose whole foods over processed foods. Don’t be a junk-food vegan or vegetarian.
Human beings want to live long lives, but they also want to live healthy lives—to be vital, able-bodied, and relatively free of chronic disease. The lure of longevity is less sweet if it only means extending the pain and suffering of a growing list of physical ailments. The power of a whole foods, plant-based diet lies in its capacity to fulfill our twin aspirations to extend both our life span and our health span. Research into genetics and longevity, including the well-known Longitudinal Study of Aging Danish Twins, has suggested that genetics account for only 20% to 30% of life span, with the rest due to environmental and lifestyle factors.
Journalist and researcher Dan Buettner identified five geographic regions where people consistently live the longest and healthiest lives—places he called the Blue Zones. Among all the lifestyle factors that distinguish these populations, one of the most significant is diet. While at first glance the plates of these different peoples look quite different, a closer look reveals striking common patterns. As Buettner observes: “Greens and beans. No matter where you go in the Blue Zones, they are eating a lot of green vegetables and about a cup of beans a day.”
Here is how each Blue Zone population eats:
Okinawa, Japan — Okinawa boasts one of the highest ratios of centenarians on earth: 6.5 in 10,000 live to be 100. The islanders over sixty-five enjoy the world’s highest life expectancy and have lower rates of disease than Americans in just about every category, with only half the dementia of those of a similar age. The longest-lived women in the world are Okinawan; they ate a little fish and pork, but only in small amounts.
Sardinia, Italy — The Blue Zone is the inland mountainous region of Ogliastra, the most mountainous area of the island, where pastoral people tend sheep and eke out a simple living on an unforgiving terrain. The longest-lived men on earth walk the rugged paths of Sardinia’s mountains. They ate pork, goat, and lamb, but traditionally only on special occasions. Their everyday diet centers on fava beans, chickpeas, fennel, and zucchini.
Ikaria, Greece — In this neighboring Mediterranean Blue Zone, the traditional diet includes a variety of wild mountain greens found on the island, along with chickpeas and black-eyed peas. In one extended cohort study, those doing the best at surviving were eating about a half cup of greens and a cup of beans every day.
Nicoya, Costa Rica — Nicoyans feast on black beans and locally available green vegetables, as part of a diet rich in maize (corn), squash, yams, rice, and tropical fruits.
Loma Linda, California — The Adventist community discussed in Chapter 3 eats mostly fruits, vegetables, unprocessed starch foods, beans, and nuts—with small amounts of animal products added by some. They are perhaps the overall longest-lived people in the entire world that we know of.
Several patterns hold across all five zones. Only a small percentage of the Adventists cut out animal foods completely—every other Blue Zone diet includes meat or fish of various kinds, but in very limited amounts. Blue Zones also consume very little milk or milk products; when dairy does appear, it tends to come from sheep and goats rather than cows. Olive oil, while praised as a Mediterranean staple, is one of the most calorie-dense foods that exists (4,000 calories per pound), and has lost all the healthy fiber and nearly all the nutrients of the olive in the extraction process. On the beverage front, most Blue Zones keep it simple: water, coffee, tea, and a little wine. They rarely drink fruit juices and completely avoid the sodas, sports drinks, energy drinks, and other calorie-laden beverages common in the United States.
Key Insight
“Longevity happened to these people. They didn’t seek it out.” — Dan Buettner
Blue Zone populations were not deliberately following a “longevity diet” or restricting foods because they perceived them as “bad.” In their often-remote regions, whole healthy plant foods were simply the cheapest and easiest to get. From walking to gardening to eating to cooking to socializing to living with a strong sense of faith and purpose, they followed patterns that fit conveniently into their community and culture—and they lived in tight-knit social networks that consistently reinforced the same behaviors.
The Blue Zones represent a rare combination of cultural, geographical, and historical conditions—lucky enough to benefit from the medical breakthroughs of modernity, yet remote enough to escape its nutritional downsides. The existing five are already under pressure from globalization and Western eating habits: in Okinawa, people under sixty now have higher rates of chronic disease than Americans. There are unlikely to be more Blue Zones discovered, Buettner says, though he continues to search.
As the Adventists demonstrate, the average person’s life expectancy could increase by ten to twelve years by adopting a Blue Zones lifestyle. The key lesson is that deep and lasting change happens through what Buettner calls “nudges and defaults” rather than organized, top-down intervention—because the Blue Zones show us that convenience matters and that we need to ensure our defaults become the healthy options, not the disease-promoting ones.
Action List — Creating Blue Zone “Nudges and Defaults” in Your Community
“When diet is wrong, medicine is of no use. When diet is correct, medicine is of no need.”
Killing more than 375,000 Americans a year, heart disease remains the number-one cause of death in the United States and takes more than 17.3 million lives annually worldwide. Coronary heart disease is an umbrella term for a number of distinct but often-related conditions, including high blood pressure or hypertension, heart attack, stroke, and heart failure. Many of these conditions stem from a hardening and/or narrowing of the arteries (arteriosclerosis or atherosclerosis), caused by a buildup of plaques made up of fats, cholesterol, and other substances on the artery walls. When these plaques rupture or burst, they can trigger a blood clot, blocking an artery and causing a heart attack or stroke. The narrowing of the arteries also contributes to an increase in blood pressure.
Principle
Genetics may load the gun, but diet pulls the trigger.
Pioneering researchers showed something remarkable: heart disease is reversible. And they did it with lifestyle interventions that had no negative side effects. Simply by stopping the consumption of foods that were clogging up their arteries and instead eating healthy plant-based fare—and, in Dr. Dean Ornish’s program, also practicing relaxation techniques, exercising, and participating in a support group—patients began to heal at any age. Their remarkable turnarounds show that it’s never too late when it comes to heart disease.
Key Insight
“The fact is, there’s only one diet ever that has been proven to reverse the number-one killer of men and women in this country—a whole foods, plant-based diet. So shouldn’t that be the default recommended diet until proven otherwise? Even if that’s all it could do—reverse heart disease—the whole debate should be over!” — Dr. Michael Greger
Beyond heart disease, a whole foods, plant-based diet has been shown to significantly affect a whole host of other chronic conditions, including type 2 diabetes, colon cancer, Alzheimer’s disease, high cholesterol, high blood pressure, and Parkinson’s disease.
When your doctor tells you that your cholesterol is elevated or your blood pressure is too high and prescribes medication to bring those numbers down, it is important to understand that those numbers are indicators of the disease, not the disease itself. The medications will adjust the indicators rather than addressing the underlying causes of the problems. High cholesterol is not a disease—it is a warning sign. The disease is damaged arteries. Imagine a leaky pipe in your roof: you can’t see the pipe, but one day you notice a water stain spreading across your ceiling. That stain is not your real problem—the leaky pipe is. If all you do is repaint the ceiling, you don’t fix the problem; you just remove the evidence. You may even forget for a while that anything is wrong, until you wake up one morning to a flooded living room. In the same way, “improving your numbers” through medication alone can lead to a false sense of security about the underlying condition.
The best scientific evidence currently available tells us that meat, eggs, cheese, dairy, and the saturated fats and animal proteins that accompany them should be minimized in a healthy diet—along with highly processed foods and added sugars. The recommendation: limit animal products to 10% or less of your calories.
“No disease that can be treated by diet should be treated with any other means.”
Diabetes refers to a condition in which blood sugar (glucose) cannot get into the cells and, as a result, starts to build up in the bloodstream. Transitioning to a whole foods, plant-based diet can be transformative for those managing or seeking to prevent this condition—though the adjustment is not always immediate. As one person who made the transition shared: “My road to health hasn’t been easy, and to be totally honest, I hated the food for about two months until my taste buds changed. People told me that would happen, but I didn’t really believe it until one day suddenly the food started to taste amazing. Meals with no salt, no oil, and no processed foods can and will taste good if you give them a chance.”
Key Insight
Never underestimate the body’s ability to heal, given the right foods.
One nuance worth understanding is the glycemic index, which measures how quickly a given food raises blood sugar. Unfortunately, the picture painted by the glycemic index can be misleading when it comes to health—its utility has been called into question by the American Diabetes Association, the American Heart Association, and the Academy of Nutrition and Dietetics. A low glycemic index rating does not mean a food is a healthy choice. It is also important to remember that we usually eat foods in combinations, and one food can change or balance out the glycemic effect of another.
“The best lies contain a kernel of truth.”
Throughout civilization and around the world, six foods have provided our primary fuel: barley, corn, millet, potatoes, rice, and wheat. Beans, sweet potatoes, and oats could probably be made honorary members of this list. Starchy whole foods are filling, nutrient-dense, and have historically been the dietary foundation of thriving cultures—yet the low-carb trend has cast them as dietary villains. The truth is more nuanced, and the evidence clearly favors whole-food starches.
Starch foods are especially satiating, which means we tend to consume fewer total calories when our diet is rich in them. They also provide a particular type of fiber—resistant starch—that has significant intestinal benefits, along with a wealth of vitamins and minerals. Dr. John McDougall argues that failing to center meals on starch undermines otherwise healthy plant-based diets: “People try to eat diets centered around kale, broccoli, cauliflower, celery, and so on, and it doesn’t work! You must have starch as the center of your meal plan. Once you get the starch foods as the centerpiece, then everything works.”
Definition — Whole Grain vs. Refined Grain
In a whole grain food, the entire wheat kernel is used. If it is whole grain flour, the entire kernel is milled, preserving its nutrients and fiber—a nutritional powerhouse. In a refined grain or white flour, only the endosperm is ground, leaving a starchy carbohydrate with some nutrients but stripped of many of the other nutritional elements of the original grain. Evidence shows that whole grain consumption is associated with less abdominal fat in adults, while refined grain consumption has the opposite effect.
When shopping, beware of misleading labeling. Some foods are labeled as containing whole grains, but check the percentage—they may not be 100% whole grain. “Multigrain” simply means the product contains more than one type of flour, and all of them can be refined. Even products that genuinely use whole grain ingredients too often add enough other questionable substances to make the whole package a nutritional no-no. This brings us back to the first rule: choose whole foods instead of highly processed foods. Specifically: choose brown rice over white, whole wheat pasta over refined alternatives, and whole grain breads made with coarse-ground flour and a high ratio of fiber to carbohydrates.
Unless you are among the 2% to 3% of people with celiac disease, wheat allergy, or gluten sensitivity, you can embrace glutenous whole grains and whole grain products—including wheat—and enjoy all their benefits.
Principle
Carbs do not make you fat or sick, so long as they are whole foods. Whole grains, starchy vegetables, and legumes should be the base of your diet—these foods are consistently associated with better health and greater satiety.
Throughout this book, a 90+% plant-based diet has been recommended—meaning up to 10% of calories can come from animal foods. This is not a concession or a compromise. The evidence, from a health perspective, does not clearly show that a 100% plant-based (or vegan) diet is a better choice than one that includes up to 10% animal products. Yes, studies show that people on vegan or vegetarian diets fare far better than people on the Standard American Diet, with its emphasis on highly processed foods and animal foods. Heavy animal product consumption is associated with higher rates of mortality, and as discussed in Chapters 5 and 6, diets with little or no animal products have been shown to reverse heart disease and diabetes. But no study has yet compared people who eat a 100% plant-based whole foods diet with those who include up to 10% animal products—so the evidence for that specific comparison simply does not yet exist.
To more skillfully optimize your health potential, the recommendation is to make the Essential Eight whole food groups a regular part of your diet, and to consider the book’s supplementation recommendations as well.
To change the way you eat for the long haul, you need to decide how dramatic you want the changes to be—and then you need to feel empowered to make those changes. The optimal human diet for health and longevity is 100% whole foods, 90+% plant-based: lots of fruits, vegetables, whole grains, and legumes, plus some nuts and seeds; no highly processed foods, especially refined flours, sugars, and oils; and, if you choose to eat animal foods, keeping them to less than 10% of your calories.
The only time to exercise caution within the category of whole plant foods is with calorie-dense varieties like nuts, seeds, olives, avocados, and dried fruits. While these play a part in a healthy diet, they contain a much higher ratio of calories to weight.
Action List — Four Dietary Limits to Monitor
When it comes to beverages, whole fruit is always preferable to juice.
Definition — Why Juice Falls Short
“Fruits and vegetables are perfectly packaged. The sugars in fruit are designed to work almost like a time-release pill, due to their relationship and binding with the fiber. When you juice, you uncouple this perfect package by removing the fiber.” — Dr. Garth Davis
This also undermines the case for juice fasts as detoxification: “Fiber is the most detoxifying substance we can consume. It literally scrubs your insides. You can’t detox without fiber.” Rather than drink a juice, consider blending fruits and vegetables into a smoothie—or, better still, eat them whole.
If you choose to include animal foods in your diet, quality and sourcing matter. Mark Bittman’s VB6 (“vegan before six”) approach—eating only plants until the evening meal—is one practical strategy people have used to shift their intake in the right direction.
Action List — Guidelines for Animal Food Consumption
One of the most persistent anxieties people bring to a plant-based diet is protein. First, recognize that plants contain protein—after all, how do you think elephants and giraffes live off of them? Beans and other legumes, whole grains, seeds, nuts, and even green vegetables are all excellent sources. Government recommendations are 46 grams per day for the average woman and 56 grams per day for the average man. Yet the average American woman aged twenty to forty-nine already gets more than seventy grams, and the average man well over one hundred. Excess protein can stress the body and make the kidneys and liver work too hard—getting too much may in fact be the bigger concern.
Key Insight — Protein Deficiency Is Not Your Risk
It’s virtually impossible to be protein deficient if you eat enough whole food calories. Eating lots of whole plant foods not only provides enough protein—it also protects against getting too much.
You can also set aside the common myth that while meat is a complete protein source, rice and beans must be deliberately combined to deliver all the essential amino acids. Rice or beans—like almost any other whole plant food—are complete in and of themselves. You can verify this on any nutrition calculator.
On the question of oils: the Whole Foods Diet recommends staying away from all refined, extracted oils—including canola, olive, sunflower, corn, and coconut oil. Many Americans are surprised by this, particularly given that olive and coconut oils are often marketed as superfoods. The core problem is that oils are largely devoid of nutritional value beyond fat. Olives, corn, coconuts, and sunflower seeds all contain nutrients in their whole food forms, but the extraction process removes these beneficial nutrients along with the fiber, leaving only empty calories. Extra virgin olive oil and coconut oil barely contain more nutrients than sugar, yet deliver more than double the calories. A single tablespoon of oil contains 120 calories, with no fiber to provide bulk or satiety. For optimum health, avoid all oils: be aware of foods that have added oils in the ingredient list, steer clear of fried and sautéed foods, and learn to love oil-free salads.
If you want to satisfy a sweet tooth, fruit is the recommendation. For dessert experiments, dates make a good whole-food sweetener. There is nothing health-promoting about added sodium other than when it helps get whole plant foods into your body—so use as little as necessary, and when you do use it, add it to your plate rather than cook it into a recipe; you will get a better result because you can taste more and use less.
On alcohol: while much is made of studies showing possible benefits of wine in particular, there is not yet convincing evidence that alcoholic drinks should be considered a health food. Whatever choices you make around alcohol, keep in mind that it is also high in calories and may deter efforts at weight loss.
On pesticides and produce: one study estimated that if just half the US population increased fruit and vegetable consumption, approximately 20,000 cancer cases per year could be prevented, while only up to ten cancer cases per year could be caused by the added pesticide consumption. On calcium: many Americans have grown up associating calcium exclusively with dairy products, but the body actually absorbs calcium from many plant foods—like kale and broccoli—more easily than from milk, and nuts, seeds, and legumes are also significant plant sources of calcium.
Finally, the one nutrient indisputably lacking in a vegan or mostly plant-based diet is vitamin B12. B12 supplementation should be nonnegotiable for pure vegans and is also likely to be beneficial for those eating 10% or less of their calories from animal foods.
To more skillfully optimize your health, make the following eight whole food groups a regular part of your diet. These are the foods that the evidence most consistently points to as health-promoting and life-extending.
Sweet and earthy yams, hearty winter squashes, tender juicy corn, and the much-loved potato, as well as all the varieties of tasty, satisfying whole grains can find a regular place on the Whole Foodie plate. This category also includes grainlike seeds—quinoa, millet, amaranth, buckwheat, and teff—which are nutritionally similar to grains.
Not only should you be sure to eat whole grains and starchy vegetables—they should make up the bulk of your calorie intake. They improve bowel health, helping to maintain regular bowel movements and promote the growth of healthy gut bacteria. And contrary to popular opinion, carbs in the form of whole grains can actually help you lose weight: they leave you feeling full and satisfied, which combats snacking and overeating.
The legume family includes all the varieties of dried or cooked beans available at grocery stores: black, pinto, navy, cannellini, kidney, garbanzo (chickpeas), black-eyed peas, and more. It also includes soybeans and the foods made from them, and peas and lentils in all their many colors. Some varieties—fava beans, lima beans, English peas, and edamame—are eaten fresh.
Most legumes contain significant amounts of fiber and resistant starch, which helps regulate bowels, remove toxins, and keep blood sugar levels in check. Beans also lower blood pressure and reduce cholesterol.
Key Insight
Scientists have identified legume consumption as “the most important dietary predictor of survival in older people of different ethnicities.”
Eat berries regularly—perhaps every day if you enjoy them. Choose organic when possible, as conventional varieties often receive an unhealthy dose of pesticides. Frozen berries are a good choice, retaining all the health benefits of the fresh fruit. Be careful with dried berries such as raisins, dried currants, goji berries, or dried cranberries: although still a healthy choice, the loss of water concentrates them, making them more calorie-dense. Eat them in limited quantities, especially if weight loss is a goal.
Crunchy apples, creamy bananas, juicy peaches, exotic mangoes and papayas, zesty citrus, thirst-quenching melons—the variety is nearly endless, and your wholehearted consumption is encouraged. The only exceptions are avocados and olives—both technically fruits but also high in fat, so best consumed in limited quantities when weight loss is a goal.
Fruit offers extraordinary versatility: fruit salad for breakfast, an apple as a snack, a peach in a green smoothie, mango salsa for tacos, orange slices in a salad, baked apples or apricots for dessert, grilled nectarines—or a frozen banana blended with soy milk as a whole foods alternative to ice cream.
Also known as brassica vegetables, the cruciferous family includes broccoli, radishes, cabbage, collard greens, Brussels sprouts, cauliflower, artichokes, arugula, and kale. Not only are these diverse foods all related—they also share extraordinary health benefits, particularly for preventing cancer.
Principle
Dr. Joel Fuhrman points out that cruciferous vegetables are the most micronutrient-dense of all vegetables, and calls them “the most powerful anticancer foods in existence.”
Some of the top-scoring greens also fall into the cruciferous category: kale, collards, arugula, and bok choy. Other particularly potent greens include watercress, Swiss chard, spinach, romaine, and other salad greens.
Zucchini, carrots, peppers, mushrooms, green beans, onions, eggplants, celery, asparagus, and many more. This broad and varied category rounds out the plant-based plate with color, texture, and a wide range of micronutrients.
Featured Resource
Mary McDougall—best-selling author, teacher, coach, and partner at Dr. McDougall’s Health and Medical Center—has been a pioneer in creating whole foods plant-based recipes, developing over three thousand of them and influencing people around the world with optimum lifestyle practices. See: The New McDougall Cookbook.
While some people raise concerns about the relatively high calorie density of nuts, they are also extremely filling and generally not associated with an increase in weight or BMI. That said, if weight loss is a goal, limit nut and seed intake to less than a handful a day.
Many people will do anything—exercise intensely, take pills, even go under the surgeon’s knife—before they will consider changing what’s on their plates. We guard our relationship with food like a jealous lover. Science may convince us that change is a good idea, but science alone won’t persuade us to actually transform what we’re eating, because when it comes to food, we tend to be more emotional than rational. Food is a significant source of happiness in life, and no diet that deprives us of that pleasure for too long is ultimately sustainable.
Understanding why processed food is so hard to give up helps. Whatever diet you consume regularly will begin to taste better to you and provide a similar level of arousal. Once those higher levels of stimulation begin to feel normal—through a process called neuroadaptation—going back to healthier foods with a lower dopamine surge can feel like a loss. Like people who can no longer experience simple joys without artificial stimulation, food addicts cannot appreciate the delights of nature’s bounty until food has been unnaturally concentrated or adulterated with fat, salt, and sugar. They are caught in the “pleasure trap,” convinced they will never enjoy eating again if they give up highly processed favorites. But you can escape this trap. Your body can acclimate back to its normal baseline—it just takes a little time and the right food choices.
Principle — Give Your Palate Time
Drs. Douglas Lisle and Alan Goldhamer recommend allowing thirty to ninety days for neuroadaptation to take place and for the palate to become resensitized to the more subtle pleasures of eating whole, natural foods.
Most diets rely on portion control, achieved through willpower—and this is both an unpleasant way to live and quite ineffective. The feeling of deprivation that comes with portion control often makes people more likely to binge on calorie-dense foods. When you deprive yourself of adequate nourishment, your body feels it needs to make up for a deficit, generating even stronger cravings for calorie-dense food. Eventually your body will overcome your best intentions through sheer biological drive, resulting in the binge cycle that dieters know all too well. When you eat whole foods, plant-based meals that include plenty of satiating foods like whole grains, starchy vegetables, and beans, you should feel full and satisfied after eating—and because these foods are less calorie dense, you’ll be able to eat more, not less. Don’t make the mistake of going hungry.
It’s also important to be mindful of what’s driving your cravings. If it’s not hunger, food won’t fill the hole. Pausing to drink a full glass of water and assess what you really need can make a big difference. If you do reach for a comfort food, try to make it a healthier, whole food version. If you find yourself comfort eating regularly, it may indicate that some unacknowledged emotion or unmet need is lurking below the surface. Imagine wearing shoes you love but that are tight and hurting your feet. Instead of changing your shoes, you get a back massage—which makes you temporarily feel good, but doesn’t address the real problem. You may be momentarily distracted from your discomfort, but you will continue to feel worse over the long term.
Finally, taste is influenced by familiarity—as you get to know a new food, your affection for it tends to grow. Don’t overwhelm yourself with unfamiliar foods when you’re just beginning to make a change; start slowly with the most familiar. Skillful eating is about giving health-promoting foods a chance, finding out which ones you love, then focusing on those and making those meals your easiest options.
“You can’t go back and make a new start, but you can start right now and make a brand-new ending.”
When you’re thinking of radically revising something as significant as your daily eating habits, it’s worth taking stock of your head and heart before jumping into the kitchen. That taking stock starts with your why. Maybe you’re trying to lose weight and improve your general sense of vitality. Maybe you’re thinking of it as upping the odds that you’ll be active and thriving well into old age. A friend, a book, or a film may have convinced you to give it a go. You may already be suffering from a chronic condition like heart disease or diabetes and want to reverse it and get off your medications. You could have decided for ethical reasons that you no longer want to eat animal foods. All of these are worthy reasons. Embrace your reason and take full responsibility for it.
Take time also to envision the positive outcomes you’d like to see—not just the bad things you want to avoid, like a heart attack, but the positive things you’ll gain: the grandchildren you’ll see grow up, the retirement you’ll be able to enjoy, the places you may travel if you’re fit and vital into old age, the athletic goals that may come within reach at an ideal weight.
If you decide to stage your transition, consider changing one daily meal each week to a whole foods, plant-based one—starting with breakfast, then lunch, then dinner. Or you might focus your first week or two on eliminating processed foods, then scale down your consumption of animal foods over several weeks. If you decide to go all in, the 28-Day Eat Real Food Plan in Chapter 14 is designed to guide and support you through four weeks of whole foods, plant-based eating.
Don’t panic when cravings hit. Take a deep breath, then be mindful of what particular flavors you’re drawn to and challenge yourself to include them in a healthy way. A healthier version exists for almost all foods: longing for corn chips and guacamole? Make oil-free tortilla chips, or replace the chips with crunchy raw vegetables. Missing your favorite ice cream? Blend frozen fruits with cashews or unsweetened plant milk, and add unsweetened cocoa if you crave chocolate. Wishing you could grab a soda on a hot day? Blend frozen berries into a puree, then add sparkling water. Build your transition around the foods you love—but in new, healthier versions.
Definition — “Crowd Out”
One of the most useful concepts from the world of nutrition: “crowd out” simply means fill up your plate, and your stomach, with the good stuff and there won’t be much space left for anything else. The focus shifts from what you shouldn’t eat to what you should eat—from “cutting out” to “crowding out.”
A practical way to apply the crowd-out principle every day is the three-course meal system:
Action List — The Three-Course Meal System
First Course — Mandatory: Fruits or vegetables. Think of this as your “weight-loss medicine and multivitamin.” A bowl of berries or other fruit before breakfast, a salad with steamed veggies before lunch, or a vegetable soup before dinner. Eat a big portion.
Second Course — Mandatory: Highly satiating whole foods—whole grains, starchy vegetables, and beans. Think of this as your “filler.” Eat a large portion.
Third Course — Optional: More rich or calorie-dense foods: nuts, seeds, avocados, olives, dried fruit; minimally processed foods (whole grain pastas or bread, nut milks, tofu); and animal foods if you include them. If you’re already full, skip it. If you do eat it, keep the portion smaller—and before having seconds of course three, make sure you’ve had seconds of courses one and two.
Once eating this way becomes second nature, you can put everything on one plate. The three-course structure is a training tool for building the right priorities.
Another important strategy: make healthier foods in advance. Don’t wait for the craving to come on—that’s not the time to start fixing things in the kitchen. Have healthy options readily available whenever cravings hit. You may not know exactly what you’ll crave, but you can probably predict your patterns.
We all have certain foods or drinks we love above all else, and these are often the first things that come to mind when someone suggests a diet change. Too often, the idea of never having that food again becomes a dietary deal breaker—a reason not to change at all. For this reason, follow the old saying: never say never. If your favorite food is a highly processed, calorie-dense snack or a form of processed meat, we don’t recommend including it regularly. But it’s also not worth derailing your entire transition. Turn deal breakers into allies by allowing yourself an occasional indulgence, and don’t let them become a slippery slope back to old habits. Write your deal breakers on a piece of paper and take them off the table for now. Focus on all the other meals and occasions. After some time you may be surprised to discover that the deal breaker is not nearly as important as it used to be. What matters is what you do most of the time, not the small exceptions you might make for a special moment.
Eating out is the next frontier for many people. When possible, choose the restaurant yourself—if you’ve done your homework on local options, you should be able to suggest several places your dining companions can choose among. If you’re not choosing the restaurant, crowd out before you leave the house: fill up with a green smoothie, some leftovers, or a quick whole foods meal, then order a salad with balsamic vinegar as dressing. If you choose to indulge, at least your full stomach will deter you from eating too much.
When traveling, planning is equally essential. Do your homework on local restaurant options and nearby grocery stores. While it may be tough to eat as well as you do at home, you may be pleasantly surprised by what’s available when you know where to look.
Action List — Foods to Pack When Traveling
Almost every doctor and nutritionist consulted for this book cited support as a critical factor in the success or failure of this kind of transition. It makes all the difference to have people to talk to about the changes you’re making, the challenges you’re facing, the strategies that work, and the new foods you’re discovering. You might get this from a medical professional, a health coach, a nutritionist, a support group, or an online community—or you could create your own.
If you are currently on medication, be sure to consult your doctor before beginning. Switching to a whole foods, plant-based diet can have highly positive effects in a short time, so your doctor may need to adjust your dosages accordingly—especially medications to lower blood pressure and blood sugar—because you could quickly become overmedicated. Request a full blood workup before you begin so you can monitor changes in your cholesterol numbers and other important indicators.
For some people, keeping a food journal during the transition is useful—not as a calorie-counting exercise, but to keep you mindful of what you eat and help you or your doctor identify areas that need tweaking. Write down exactly what you ate, including snacks and beverages, along with how you felt before, during, and after: how hungry were you? How satisfied afterward? What other feelings did you notice? Note how you feel at the beginning and end of the day—sleep quality, energy levels, digestive comfort, heartburn, or headaches. Review your journal once a week. If you become stuck on weight loss, feel constantly hungry, or notice sensitivity to certain foods, your journal can help you decode the problem.
Finally, keep it simple. Get the basics right, learn to cook a few meals you love, and eat plenty of them. Don’t worry about whether kale should be eaten raw or cooked, or whether potatoes should be boiled or baked. Just eat whole plant foods—prepared the way that tastes best to you. Once the whole foods, plant-based lifestyle becomes second nature, you can study the details of creative food preparation. When you’re just starting out, simplicity is your greatest ally.
Key Insight
“I don’t think there is a single greater act of environmental activism than moving to a plant-based diet.”
The environmental case for eating differently is compelling and urgent. From climate change to emptying the oceans to land use and forest destruction, to habitat loss, water depletion, and straightforward pollution—our current system of farming and eating is not doing human health, animal health, or the health of the natural world any favors. It is an inconvenient truth that can no longer be ignored.
The numbers are striking. Even low-end estimates suggest that animal agriculture contributes around 18% of global greenhouse gas emissions—more than the combined exhaust of all transportation. Growing feed crops for agriculture consumes 56% of the water in the United States.
It’s worth noting, too, that it’s quite possible to be an unhealthy junk-food vegan. Veganism and health are not the same thing, and we shouldn’t equate them. But the science is clear: you don’t need to eat animals to have excellent health. A 100% whole foods, plant-based diet can be one of the healthiest diets you could possibly eat, in terms of both health and longevity—and it happens to be the diet that most lightens your environmental footprint as well.
In preparation for twenty-eight days of eating real food, there are two critical steps: clean house to get rid of the foods you’ll no longer eat, and stock up on new, healthy options. Take time to prepare your kitchen both practically and symbolically for your new lifestyle. If you feel bad about throwing out food, consider donating it to a local food bank or community kitchen.
Whole Foodie Basics — Shopping List
Once your kitchen is stocked, the key to keeping things manageable is planning. Plan a week of meals at a time—if you work Monday through Friday, plan on Friday evening or Saturday morning, make a shopping list, and use some weekend time to shop and prepare. Make your ingredients multitask: especially if you’re cooking for one or two, plan several meals that use similar ingredients so you won’t end up with half-used bags of produce, cans of beans, or jars of condiments going to waste.
Batch-cooking is one of the most time-saving habits you can build. Set aside a couple of hours once a week—Sunday afternoon is a popular choice—to prepare staples in large quantities: cook a big pot of grains, a pot of beans, roast a tray of vegetables. Store them in serving-size bags or containers for use throughout the week, or freeze them for nights when you simply don’t have time to do more than defrost, warm, and serve.
The following recipes are organized by category. Technique guides—how to cook oatmeal, how to sauté without oil, how to cook beans, and more—are woven throughout, alongside the recipes themselves.