Ultimately, sugar is mixed in with almost everything—pay attention to the fine print next time you go shopping. We find it in frozen pizzas, ketchup, yogurt, sausage, and almost every convenience product. With the aid of sugar (and salt) it’s possible to cover up any boring or bad taste. But it’s not only the tricks of the food industry that cause us to eat too much sugar—there’s also the fact that sugar is addictive. Our brain derives its entire energy requirement solely from sugar, and since it was scarce in the past, the brain reacts strongly to it, with happiness among other things.
Sugar is most radically condemned by the Californian pediatrician and metabolism researcher Robert Lustig. He has shown that lab animals, once used to sugar, react with the same symptoms as if they were suffering from heroine withdrawal when sugar is removed from their diet.32
So what can you do to eat healthier? Eat, for example, whole-grain instead of white-flour products whenever possible. The taste of whole-grain products have improved significantly, and as with everything, it’s just a matter of getting used to it. Cake, pizza, and pasta can all work well with whole-grain flour. And don’t fall into the fruit sugar trap. Many products are now labeled “with natural sweeteners” or “only contains fruit sugar.” Using the word “fruit” here is designed to make us believe that the content is healthy. But unfortunately, that is not the case. Fruit sugar boosts fat synthesis in the liver and barely contributes to any feeling of satiety.33, 34 For years, fruit sugar, aka fructose, was recommended to diabetics, because it causes no release of insulin. But, in turn, there is not a feeling of satiety in the brain—the hunger remains. A few years ago, the German Federal Institute for Risk Assessment advised diabetics to avoid foods sweetened with fructose. By now we know that fructose heightens unhealthy cholesterol levels and causes fatty livers. In fruit, fructose is not that big of a problem because fibers, nutrients, vitamins, and phytochemicals ensure a healthy balance. Honey contains fructose, too, but also many valuable ingredients beyond that.
What’s particularly bad is high fructose corn syrup, which is often used in industrial food production because it is nonperishable and cheap. It’s suspected to be a risk factor for many illnesses.35
If you want to avoid fructose, you shouldn’t consume too much agave syrup, which is advertised as an alternative sweetener in organic supermarkets. Agave syrup actually contains a lot of fructose—and so does dried fruit. Today, a lot of people suffer from fructose intolerance, or more precisely, from fructose malabsorption.36 Our bodies are no longer able to sufficiently digest the amount of fruit sugar we consume. The consequence is that without it having been digested, the fruit sugar reaches the small intestine and large intestine, where bacteria begin to ferment it. Decomposition gases are thus formed, which causes diarrhea, flatulence, and pain.
A THIRD OF THE GLOBAL POPULATION IS SENSITIVE TO SALT
Another component that is often hidden in food is salt. Roughly a third of the global population is sensitive to salt—which means that they react to salt with an increase in blood pressure.37 Still, that doesn’t mean that we should automatically recommend reducing salt to people with hypertension. I advise my patients to perform a self-experiment over the course of four weeks: Hardly use any salt and eat as little bread as possible. If they can observe blood pressure clearly decreasing in that period of time, then they have a salt sensitivity. Bread is one of the major sources of salt. During such a self-experiment, you should also stay away from frozen and other convenience foods that have a high salt content. There is also a lot of salt in sausage (even more so in organic sausage, because it lacks other preservatives) and in cheese. For years, physicians and other scientists have been trying to get the food industry to reduce the content of salt, fat, and sugar in their products. But since there is a lot of money to be made from them, this effort has not yet come to fruition.
That some people react sensitively to salt is probably due to the fact that the buffering capacity of the kidneys, where sodium is egested, is overextended. Looking at evolutionary history, it makes sense that the body has the ability to retain salt, since natural foods are low in salt. With the beginning of preservation, such as pickling, the daily consumption of salt has increased from 0.04 ounces to 0.4 ounces—and that’s where the problem begins.38 Salt is contained in almost all ready-made foods, even in cookies. If you try cooking without salt for a while and substitute it with many delicious spices, you’ll find that you hardly need any of it.
GLUTEN: A MARKETING PLOY?
Whole wheat grain? Some are going to be taken aback by this recommendation of mine and ask about gluten. Gluten is a “glue” protein that causes the excellent baking characteristics of wheat. All other cereal flours produce bread with a smaller volume and a less elastic interior, which is why they are less popular. The “glue” proteins found in wheat consist of hundreds of protein components, among them gluten. It is imagined that during the Neolithic revolution about ten thousand years ago, when wheat entered the human diet, the immune system was faced with the challenge of developing an immune tolerance to the hitherto only very seldomly consumed gluten. So, the fact that most of us are able to process gluten is a very recent quality when we consider the whole of evolutionary history—and it can quickly be lost again, as a result of an intestinal infection for example.39, 40
Right now, the rows and rows of gluten-free products available in supermarkets are growing steadily, and these products are usually expensive. And so, naturally, everybody is talking about wheat. But it’s a complicated matter, because we have to differentiate between three distinct disorders. The best-known and most severe disorder is celiac disease (formerly called sprue). This is an autoimmune disorder that can be assumed from the presence of specific blood values and genetic diagnostics and the diagnosis can then be verified by means of a gastroscopy. This disease actually does make it necessary to avoid gluten throughout one’s lifetime. This means staying away from wheat, rye, and barley. About 0.71 percent of the population (1 in 141) in the United States suffers from celiac disease.41
Next, there is wheat allergy, which occurs quite rarely—the characteristic IgE-immunoglobulins can be traced in the blood of about 0.1 to 4 percent of the population. In 10 percent of millers, bakers, and pastry chefs, such an allergy develops as a consequence of the flour that is inhaled and which can lead to skin rashes and asthma.42 Here, it’s only wheat that needs to be avoided completely.
The third disease that exists is a sensitivity with a more complicated name—non-celiac gluten sensitivity (NCGS). This is what is commonly known as “gluten intolerance.” An increasing number of people seem to be afflicted by it—estimates range from 0.6 to 6 percent—but at the same time, it’s not certain whether this syndrome has anything to do with grains at all.43
In the United States, the number of people who avoid gluten has grown massively in the past couple of years, but no tests are able to provide physiological reasons for this development. Professional athletes state that they are able to perform better when their diet is gluten- or wheat-free. Popular books, such as Wheat Belly by the American cardiologist William Davis, claim that wheat is to blame for the increasing number of obese people. Davis in particular holds club wheat (Triticum compactum), which is widely cultivated nowadays, responsible for that. But there is no sufficient scientific proof for this claim and it seems a bit too simple for my liking. The gluten-free diet is just big business.
Physiologically speaking, it’s unclear what non-celiac gluten sensitivity is and what causes it. You could put it like this: This syndrome is always present when people avoid wheat because of health problems. This can but doesn’t necessarily have to be connected to gluten. Just like a positive outlook supports self-healing powers, the worry that something might be indigestible to us can cause health problems. This would be the placebo’s counterpart, a “nocebo.”
And yet this gluten sensitivity, or wheat intolerance, whatever you would like to call i
t, exists—especially in people suffering from irritable bowel syndrome. By now, the culprits of this disease are assumed to lie in certain proteins contained in wheat, the amylase and trypsin inhibitors (ATI) that are predominately found in newer types of wheat like club wheat. They protect plants from pest damage, but they can also have a negative effect on the immune system. If you suffer from irritable bowel syndrome, it might be worthwhile to try and adopt a gluten-free diet. In a study, patients with this disease were offered gluten-free or glutenous muffins without knowing which kind it was they were eating. Results showed that 70 percent of the patients who ate the muffins containing gluten encountered health problems, while only 40 percent of the patients who ate the gluten-free muffins encountered health problems.44
It’s important to diagnose celiac disease unambiguously and to isolate it from other symptoms. In patients with celiac disease, as little as 100 milligrams of gluten a day can cause an inflammation of the bowels—that’s three crumbs of bread. The tolerable amount is higher in people suffering from wheat intolerance. The wide choice of gluten-free products is a good thing for people afflicted with celiac disease, but I advise people with gluten intolerance to keep trying gluten and wheat every once in a while, in the form of whole-grain and organic products, and then observe their reaction. In our clinic, we learned that the Ayurvedic diet, for example, which contains hardly any bread or pasta, is able to help with this problem without people having to spend too much money on special foods.
INTESTINAL BACTERIA: A WORLD FULL OF MYSTERY
Whether we are healthy or sick crucially depends on the microbiota, i.e., the cosmos of bacteria in our gut. The intestine is—in its capacity as a huge contact area with food, i.e., with the outside world—the place where the immune system is influenced to a great extent and where it’s decided whether autoimmune diseases, possibly even cancer and arteriosclerosis, develop. By now, it is well known that the microbiota plays a decisive role not only in many rheumatoid diseases, in arthritis, allergies, Crohn’s disease, and ulcerative colitis, but also in many neurological diseases like multiple sclerosis and Parkinson’s—though we cannot yet say which therapeutic consequences can be drawn from this knowledge.45
I do hope this knowledge will lead to nutrition receiving more attention from the medical community than it has so far. What we eat can influence the composition of the intestinal bacteria and their many different strands. Yet another reason to follow a vegetarian diet is that health-promoting intestinal bacteria feed mainly on fibers—that’s why they are called prebiotics. A study published in Nature showed that massive changes in the microbiota can be detected as soon as three to four days after a transition from an omnivorous diet to a plant-based diet. And when the matrix of the genes is sequenced, an anti-inflammatory effect can be observed immediately.46
It’s already possible to describe individual interdependencies rather well: The consumption of lecithin—a fat-like substance that is found in egg yolks, meat, and, to a lesser extent, in soy—causes the microbiota in the bowel to produce a metabolic factor that fosters atherosclerosis quite powerfully. If you kill the microbiota by using antibiotics, this factor disappears from the body—this is an instance where the role of the bacteria can be noticed very clearly.47
A positive example for this is beets, which naturally contain more than 1,000 milligrams of nitrate per kilogram. When we eat beets, this nitrate is concentrated in the salivary glands and then transformed into nitrite by the bacteria in the mouth. The nitrite is then swallowed and turned into nitric oxide, a substance that protects the vessels in the gastrointestinal tract. It is this cycle that makes beets so healthy—with the aid of the bacteria. Not only does beet juice lower blood pressure, but if you drink about 0.26 or 0.53 quarts of it a day, it is almost like natural doping: Several studies have shown that drinking beet juice improves athletic performance.48 Because of its vasodilating capacity beet juice is now even recommended to patients with congestive heart failure by cardiologists: It lowers the cardiac work.49
The crux, then, lies in the detail: Up until a few years ago, nitrate and nitrite were branded as undesirable components in food, because in conjunction with certain proteins they are carcinogenic. But there are subtle, yet important differences: If you consume nitrate in the form of meat, carcinogenic nitrosamine forms due to the amines also contained in meat. The nitrate contained in beet, however, doesn’t link to the protein. The advantages of consuming vegetables rich in nitrate strongly outweigh the disadvantages.
PATIENT HISTORY
Parkinson’s Disease
Ayurveda—Eating to Fight Tremors
The patient was 44 years old, of sturdy build, and was the father of three children. He had always eaten a “hearty” diet—until he was diagnosed with Parkinson’s (at quite a young age for this disease).
Parkinson’s causes the brain’s nerve cells to degenerate. Symptoms consist of shaking as well as other movement disorders. The patient suddenly lost the ability to fully stretch out his arm. His left hand shook when he tried to hold it still. He was able to work, but for how much longer?
People suffering from Parkinson’s deteriorate slowly. There is no cure for this disease, not even in naturopathy. The progress of the disease can, however, be slowed down with medication. And it’s possible to support the process of delay quite efficiently—especially with Ayurveda. This traditional Indian medicine achieves astonishing successes, particularly where neurological diseases are concerned.
Ayurveda distinguishes three constitutional types, the doshas. According to Ayurveda, the patient’s disease was connected to a surplus of vata, so he was recommended a diet that would alleviate this “windy” side of him, which was putting a strain on the nerves. In his case this meant eating grounding vegetables such as pumpkin, turnips, or potatoes; meals ideally with liquid or sauce-like consistency; curries rather than dry vegetables. To meet the requirements of kapha, his fundamental constitution, he was advised to season everything well, to make his meals slightly spicy, and not to let his portions become too large. Today, the patient has eliminated most animal products from his diet—instead, he eats healthy foods such as legumes, seeds, nuts, broccoli, or sprouts.
The second therapeutic approach may sound repulsive to many, but it helps: oily enemas. They channel harmful substances from the intestinal mucosa. Followers of Ayurveda believe that the end of the large intestine is the main seat of vata. Enemas have a localized unburdening function, but they also change the milieu of the entire intestine and thus the nervous system.
The patient also practices yoga, because the slow breathing soothes. Once a week, he undergoes an Ayurvedic oil massage that relaxes body and soul. He’s been able to continue his work as a freelance caterer, but he has reduced the number of jobs he takes.
MILK: NOT A HEALTHY FOOD
Metabolic processes in our bodies take place in a watery environment. The high number of enzymatic and other chemical processes demand a constant pH value, one that varies within a slightly alkaline range (between 7.35 and 7.4) as a standard value in the body. Even slight deviations from this are irreconcilable with being alive. In an intensive care unit, doctors work with a machine that measures the arterial-blood gas. Whether patients are approaching death can be detected, among other indicators, by the fact that the blood becomes acidic, that acidosis (acute overacidification) sets in.
But it’s not like pH value is the same all over the body. In the stomach, for example, it’s quite acidic—between 1.2 and 1.3. Bile is alkaline, measuring 7.4 to 7.7. Saliva has a value of 6.8. The feces should have a pH value somewhere between 6 and 7.
Acid-Base Balance
The modern-day diet, which contains copious amounts of animal protein, often leads to a slow progression of overacidification in the body. Eating foods with an alkaline effect and following a healthy lifestyle can return the acid-base homeostasis back to balance.
Regulation of t
he acid-base balance is achieved by an elaborate buffer system. The two most important organs in this process are the lungs, which exhale carbon dioxide, and the kidneys, which expel bicarbonate and thus regulate pH value. This system is highly efficient. But when it is overworked, the body mobilizes minerals that are removed from the bones—which leads to osteoporosis. A second mechanism takes place in the connective tissue, which dries out as a result and becomes sensitive to pain. An excess of acid in the body becomes increasingly problematic as we age, because as functionality of the kidneys decreases so does the general buffer capacity. When other factors such as chronic inflammation are added to that, and if acid-forming foods make up the majority of a person’s diet, health likely suffers.
Acid-forming foods do not necessarily have an acidic taste. Lemons, for example, have an alkaline effect. They contain volatile acids that don’t reach the bloodstream but are dissolved in the stomach so that only its alkaline components remain. Animal proteins and phosphoric acid (found in drinks containing cola, as well as in bread and other grain products) have an acidic effect. Apart from bone loss and connective tissue weakness, acids can presumably damage the articular cartilage, and they can also lead to an increased release of stress hormones such as cortisol, another factor that causes damage to the bones. This was discovered by the DONALD study (Dortmund Nutritional and Anthropometric Longitudinally Designed) on children’s health conducted at the University of Bonn.50 Diabetes is also more likely to occur when the body possesses an excess of acid.51
From a medical perspective, the acid-base balance is an exciting subject: Chronic kidney diseases can be treated effectively with alkaline therapy, meaning the intake of alkaline pills or powder. A diet low in animal proteins has long since been recommended in these cases.52
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