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Can't lose the weight? It could be the nuts

Jeff Nelson, vegsource.com | 07/26/12

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Read More: absorption, cholesterol, diabetes, health, nuts, research, science, study, weight loss

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We recently ran an article by Chef AJ talking about how she dropped the extra weight she had been trying to lose for years.  AJ had been eating a healthy plant-based diet – that included regular rich desserts and chocolate.  She says she was also eating 1.5 ounces of nuts a day.  AJ said she gave up all desserts and chocolate for one year, but lost no weight.  Then she gave up the nuts, and her excess weight rather effortlessly disappeared in a matter of months.

Some were surprised by AJ's success because there are studies suggesting moderate nut intake doesn't promote weight gain.  Others said that nuts are calorie-dense and can definitely raise weight, even in moderate amounts.

So I decided to look further. 

What I Found

Though I'm not a medical or dietetic professional, I do know quite a few.  So I spent a substantial amount of time talking with several leading doctors and dietitians, from a variety of perspectives, to help me understand the literature and statistics in a fair and unbiased way, and had them review this article before publication.  Not that they all agree about everything, but I wanted to be sure I didn't make any glaring errors here.

What I found is that there is research showing both things: a) that moderate nut consumption does cause weight gain and b) that moderate nut consumption does not cause weight gain. 

Here is some of what I concluded, after reviewing a number of studies:

  • Moderate intake of nuts should not cause weight gain, BUT –
  • Looking at the research, “moderate intake” seems to be defined most often as about 1 ounce of nuts, two to five times a week.
  • There is a very very modest cholesterol lowering effect when consuming nuts, and it mainly applies to people eating the Standard American Diet (SAD); it appears there would be little to no cholesterol-lowering effect with nuts for those following one of the healthy plant-based diets advocated by McDougall, Fuhrman, Barnard, Esselstyn, Novick, etc.
  • Nutrient absorption from raw vegetables, which can be improved by nut consumption due to the fat, is largely a non-issue for people on a healthy plant-based diet; I could find nothing in the literature that suggests inadequate absorption of nutrients is a problem for those on plant-strong, starched-based, or nutritarian diets, and I could find no published evidence suggesting that not absorbing “enough” nutrients is a contributor to ill health of plant-based eaters.  Getting more absorption on a poor diet may be important, but getting more on an already healthy whole food plant-based diet has no proven value.
  • Nut consumption appears to be associated with longevity and with lower risk of ischemic heart disease in populations eating the SAD diet who substitute nuts in place of meat or junk food; however the diets of some of the longest-lived mostly plant-based populations, such as the Okinawans, contain only a tiny amount of nuts, and heart disease is virtually nonexistent.
  • In order to show nut consumption doesn't promote weight gain, most of the published studies use calorie-restricted diets as a major feature.  That is, study subjects are put on a calorie-limiting program, rather than simply adding nuts to their existing diet.  (This is important because many plant-based programs are unlimited and do not require calorie counting.)  When the same researchers add nuts to diets without calorie restriction, they report weight gain in subjects.
  • Some major studies, which conclude that nut-eating does not promote weight gain – actually show the opposite when you look at the study data, including often-cited reviews by Loma Linda.
  • Many of the studies purporting to show weight and health benefits of nuts – have been paid for by the nut industry.  And despite intense Congressional lobbying and nut industry funding of a great deal of research, the FDA has graded most health claims around nuts with only a C grade, based on quality of evidence, which “represents a low level of comfort among qualified scientists that the claimed relationship is scientifically valid.”  This is the same grade as the health claims made for olive oil.  The exception is walnuts, which get a B.  


The bottom line for me after spending time looking at numerous studies:  All in all, nuts are good and have health benefits, especially walnuts.  If you eat the SAD diet, you will see some modest benefits by substituting nuts for animal products or junk food.  If you eat a healthy plant-based diet, then eating a few ounces a week can be healthy.  But if, like AJ, you're having trouble getting to your ideal weight while otherwise eating a healthy plant-based diet, remember that those fatty little guys do pack the calories and can make it hard to lose weight.

 

The Details

For those who want to read and see some of what my conclusions are based on, the rest of this article contains references and discussion.  I reviewed many more studies than these but I felt these tell the story pretty well, and these are some of the studies often cited by those promoting nuts.

As I said, “moderate intake” is generally defined as 1 ounce of nuts, 2 to 5 times a week.  To put that in perspective, here is what a 1-ounce serving of cashews looks like:

1oznuts.jpg.jpg

 

 

 

 

 

 

 

 

 

 

(Photo credit: me)

That is 17 nuts.  I just took that photo on my kitchen scale.  So that's your day's worth – if you can stop there.  Many people, probably including Chef AJ, can not.

Nuts & Weight Loss

Here is a brand new study looking at nuts and weight loss, along with a link to the full study itself:

  • A randomized trial of the effects of an almond-enriched, hypocaloric diet in the treatment of obesity.  Foster GD, Shantz KL, Vander Veur SS, Oliver TL, Lent MR, Virus A, Szapary PO, Rader DJ, Zemel BS, Gilden-Tsai A.  Am J Clin Nutr. 2012 Jun 27. [Epub ahead of print]   PMID:22743313  Free PMC Article  http://www.ajcn.org/content/early/2012/06/26/ajcn.112.037895.full.pdf

This is a study where individuals were put on a calorie-restricted diet in order to lose weight.  There were two groups: one ate an almond-enriched diet, the other ate a nut-free diet.  

At the end of 18 months, the almond-enriched dieters lost an average of 8 pounds (3.7 kg), while those who had no nuts in their diets lost an average of 13 pounds (5.9 kg – see Table 2 of study). 

So the dieters who didn't add nuts lost 62% more weight than the nut-eaters.

Interestingly, the study's authors concluded:  “There were no differences in weight loss or cardiovascular disease risk factor outcomes between groups at 18 mo.”

But as you can clearly see yourself, the data shows that non-nut-eaters lost 5 pounds more the nut-eaters lost. 

It's important to note that this study was paid for by the Almond Board of California and the study's principal author, Gary Foster, serves as an advisory member of the Almond Board.  The study is currently being used to promote Almond sales (along with sales of other “healthy snacks” like canned tuna and low-fat milk) through press releases and “news” posts such as http://www.huffingtonpost.com/2012/07/25/almonds-healthy-weight-foods-snacks_n_1701850.html

Loma Linda University is a very vegetarian-friendly place, and has done much to advance understanding about nutrition. Here is an often-cited paper by Loma Linda researchers looking specifically at nuts and weight:

  • British Journal of Nutrition (2006), 96, Suppl. 2, S79–S86  Nuts, body weight and insulin resistance.  Sujatha Rajaram* and Joan Sabate´ Department of Nutrition, School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA

I have put a copy of the review here:
http://www.vegsource.com/nuts/Rajaram_2006_Nuts_body_weight_and_insulin_resistance_British_J_Nut.pdf 

The authors review the research on nuts and health, and the bottom line from this review appears to be that nuts cause weight gain approximately 2 pounds per year, on average.

Now interestingly this is not the authors' conclusion in the paper.  But it is the conclusion you will quickly arrive at as you look at the evidence for yourself, specifically on page S81.  I should say that overall this review is very good and the researchers have been careful.

But when you look at the details that the data shows, you see the following:  First, the authors make the point that, in general, people who eat nuts are not heavier than other people. However, that appears to be due to the fact that people who eat nuts tend to be health-conscious in other respects, not due to anything special about nuts. This is the same phenomenon seen with dairy products. People who drink milk tend not to be heavier than other people. In fact, they are often thinner. But it is not because milk causes weight loss; it is because these are health-conscious people in many respects. We know this because, when people are fed dairy products in controlled studies, they do not lose weight at all and can easily gain weight.

The Loma Linda review shows that when researchers specifically ask people to eat nuts in controlled research studies, adding them to their existing diet, the participants tend to gain weight. This is on page S81 of the paper, linked above.

There were three studies, and in each one, the participants who were encouraged to add nuts to their routine gained weight, unless they were specifically instructed to leave out other foods to make room for the added nuts. The amount of weight gained ranged from about 1 to 2 pounds (0.4 – 1 kg) in time periods ranging from 8 weeks to 6 months. That would mean that a person who hears that nuts are healthy and starts to add them to the diet could expect weight gain of roughly 2 pounds per year, on average.

Two pounds a year doesn’t sound like much, except that, multiplied by 10 years, it starts to get more serious. Also, a 2-pound “average” weight gain means that, for every person who does not gain weight at all, someone else gains 4 pounds over a year’s time to average it out.

For one of these studies, the review summary says that men gained 0.65 kg (about 1½ pounds) over six months, while women did not gain any significant weight. However, the actual weight gain among women was 0.27 kg over six months, which is just over a half-pound in six months.

So even though the conclusion in this published review is that nuts don’t contribute to weight gain, the details in the paper show that they clearly do.

The researchers do point out that the weight gain for the nut-eaters in these studies was less than would have been predicted, given the calories in the nuts, due to several compensatory mechanisms; the calories in nuts are poorly absorbed, and people filling up on nuts are likely to compensate by leaving some other foods out, though not enough to completely prevent weight gain.  

I should say the lead author of this Loma Linda review, Joan Sabate, MD, DRPH, is an advisor for the Pistachio Health Board.  Not surprisingly the nut industry funds much of the research at Loma Linda on the benefits of nuts.

When you look into the “nuts do not promote weight gain” studies, you keep finding one theme, which is that nuts don't promote weight gain as long as the subjects are dieting and counting calories.  Otherwise they do.

Another such study is:

  • Asia Pac J Clin Nutr. 2007;16(4):588-97.  A review of the evidence: nuts and body weight. Natoli S, McCoy P.

Quoting from the article:

“The findings show that the role of nut consumption in body weight management is varied. Nuts, when included as part of an energy-controlled [ie, calorie-restricted] diet, were found in some instances to assist with weight loss. However, when nuts were added to an existing diet without controlling for energy intake, body weight increased, although to a lesser extent than theoretically predicted.”  (emphasis added)

When you hear from someone promoting nuts for weight loss, check and see if any of these studies above are nut industry ones above they are relying on.  (Or post in comments below which studies they cite, and we can check them out.)

Nuts and Cholesterol

Nut consumption has been shown to have a cholesterol lowering impact in multiple studies.  Just how significant is that, and how much does it apply to people who are already eating a healthy, plant-based diet?

It turns out that in the best case scenario, nuts only lower cholesterol and LDL about 6.5%. I will round that up to 7%.

This figure is from the largest meta analysis that is cited when many experts talk about this effect -- Nut consumption and blood lipid levels: a pooled analysis of 25 intervention trials. Sabaté J, Oda K, Ros E. Arch Intern Med. 2010 May 10;170(9):821-7.PMID: 20458092  http://www.ncbi.nlm.nih.gov/pubmed/20458092

A 7% reduction means that if your cholesterol is 300, the best case scenario is that by adding nuts, your cholesterol would go down to 279.  Not exactly earth-shattering.  Even if your cholesterol was 250, a 7% reduction would only lower it to 232, which means it would still be too high.

If your LDL is 200, a 7% reduction would bring it down to 186.  If it was 150, it would lower it to only 139.5 – still too high.

Looking at the analysis, participants achieved these very modest improvements only when 20% of their total calories came from nuts, or about 400 to 450 of their calories a day (e.g., 3 ounces of cashews).  A lesser amount of nuts produced less improvement.  

So according to this analysis, when nuts make up 400 to 450 calories of your diet per day, you get a small benefit in cholesterol lowering – a benefit, which may be statistically significant but probably not very significant clinically.  

But one of the most important points the authors of the analysis make in their article was this:  

"Greater cholesterol lowering effect is found when nuts replace saturated fat than when olive oil or carbohydrates are replaced."

This means that the cholesterol improvement when you add 400 to 450 of nuts -- is going to be most significant when the nuts replace 400 to 450 calories of bacon and cheeseburgers.  You won't get nearly as much of this modest cholesterol improvement if you replace 400 to 450 calories of sweet potatoes or brown rice with the nuts.

So in other words, if you already avoid meat and butter and other foods with saturated fat, and you're already eating a healthy plant-based diet, the beneficial impact of nuts to lowering your cholesterol will likely be very very small, if at all.  Certainly nothing to get excited about.  

The study on cholesterol and nuts was paid for by the International Tree Nut Council Research and Education Foundation, and was conducted by California Almond Board director Sabate (the same Loma Linda researcher who ran the previous nut-industry-funded study I cited which purported to show weight loss with nuts, when in fact the reverse was true).  This study on cholesterol reduction is one of the most often cited by many as the basis for recommending adding nuts to lower cholesterol.  

Based on a nut industry petition, the FDA allowed a “C” level qualified health claim that “scientific evidence suggests but does not prove that eating 1.5 ounces of most nuts per day, as part of a diet low in saturated fat and cholesterol, may reduce the risk of heart disease.”  The FDA also insisted the label also contain a caution: “See nutrition information for fat content.”

Nuts and nutrient absorption

One thing I sometimes hear is that nuts are important because they can play a significant role for helping absorb other nutrients, especially in regard to raw veggies and salad.  If you eat a poor diet, like someone who is on the Standard American Diet (SAD), and don't eat many fruits and veggies very often, getting a little additional absorption may be a good thing.  

But do most of the plant-strong, starch-based or nutritarian eaters need "extra" absorption, when quality plant foods already constitute the vast majority of their calories, and greatly exceed the nutrient consumption of all the populations being studied?

I am unaware of any evidence in the literature that speaks to the question of healthy plant-based eaters significantly increasing their absorption with nuts or other fats, nor do I know of any evidence suggesting not absorbing “enough” nutrients is a contributor to ill health for plant-based eaters.  

I invite anyone who knows of such studies in this area to post them in the comments below, so we can review them.  If there aren't any, then the issue is just speculation.  Speculation can be useful and important, but it's not science per se.

Here is a chart showing the bioavailability of carotenoids in various foods or components of foods:

bioavailability.png

You can see that raw vegetables (on the bottom) have lower absorption than fruits and starches (toward the top). 

In any case, it's well known you can increase absorption by simply cooking and/or chopping up raw foods before eating. 

Any healthy plant-based diet from any of the leading experts – Ornish, Fuhrman, McDougall, Barnard, Esselstyn -- already far exceeds the amounts of all recommended carotenoids and other nutrients.  All of these diets are way more nutrient dense than the healthiest diet any of the subjects in any of these studies is consuming, and already providing 30 to 90 times the amounts of various nutrients shown to be of benefit in several of these studies.

And I don't know of any studies suggesting that the many – probably millions – of people with nut allergies have nutrient absorption problems which lead to medical problems.

The Okinawans get less than 1% of their calories from nuts, which is about one ounce (or 17 cashews total) every two weeks.  That is well below nut industry-funded study recommendations.  Yet the Okinawans are some of the longest lived people on the planet.

The nut-funded research of the Adventist Health Study are done on vegetarians and vegans, and suggest the more nuts people eat, the healthier they are.  But the healthiest diets of the Adventist people, while clearly healthier than the Nurses Health Study group, are nowhere near as healthy as the diets recommended by Fuhrman, Barnard, McDougall and Esselstyn.  

Most importantly, in the same Adventist Health Study data suggesting that greater nut consumption equates with greater longevity, we see that the fruitarians eat more nuts than the vegans, who eat more nuts than the vegetarians, who eat more nuts than the meat-eaters: (click first image to enlarge)

table12.png

table1.png

 

 

 

 

 

 

 

 

 

 

 

 

 

So it's very clear that nut consumption is probably just a marker for an otherwise healthy diet, in the same way that nuts appear to be a marker in the Nurses Health Study for women with a healthier diet, lower body weight, who don't smoke and exercise more often.  The data could simply be indicating: go vegetarian to become healthier, vegan to become healthier than that, or raw to become even more healthy, rather than claiming that it's just because of nut consumption.  Obviously the overall picture of what the vegetarians, vegans and fruitarians were eating is far more important in explaining their superior health, than saying it's all due to nuts (and then trying to use this to sell nuts to people eating an otherwise bad diet).

Diabetes and Nuts

Research from the Nurses Health Study also shows that consuming as little as 2 ounces of nuts per week (not per day) was beneficial to participants in regard to heart disease.  (Again, 2 ounces per week is not that much nuts, and more than many are eating.)

Now if you eat a largely unhealthy SAD diet, like most in the Nurses Health Study, perhaps you could see benefit by adding 2 ounces a week of nuts – if you consumed those nuts in place of roast beef, cheeseburgers, or processed junk food.  

The Nurses Health Study also showed that women who ate 1 oz of nuts 5 or more times a week had a lower risk of diabetes.  The review is called: 

  • Nuts as a Replacement for Carbohydrates in the Diabetic Diet. JJAMA, 2002 Nov 27; 288:2554-2560. Rui Jiang, MD; JoAnn E. Manson, MD; Meir J. Stampfer, MD; Simin Liu, MD; Walter C. Willett, MD, DrPH; Frank B. Hu, MD, PhD

The data shows these women were also less likely to smoke, more likely to exercise and had a higher dietary fiber intake, all of which we know are also protective against diabetes.  

Perhaps most importantly, the authors recommend that you substitute reasonable portions of nuts for refined grain products, meat or processed foods – but that you do not simply add nuts to your present diet.  Here is their conclusion from the study:

“Our findings suggest potential benefits of higher nut and peanut butter consumption in lowering risk of type 2 diabetes in women. To avoid increasing caloric intake, regular nut consumption can be recommended as a replacement for consumption of refined grain products or red or processed meats.” (emphasis added)

Another study looked at replacing unhealthy carbohydrates with nuts, to see what the impact would be for diabetes.  The study is: 

In this study, subjects received either a muffin or 2 oz of nuts. Those who received the nuts were said to have “improved glycemic control.” However, when we look closer at the numbers what we find is their glucose only went from 132 to 130 and their HbA1c only dropped from 7.1 to 6.9 and leveled off after the 8th week with no further improvement. Normal blood sugar is under 100 and normal HbA1c is under 5.5.   So as we can see, both of these numbers are still fairly high, and the improvements were minimal at best – and were only seen when compared to those getting a muffin, which by the way was made with apple concentrate, egg whites and skim milk powder.  Hardly a health food.

Here are three other randomized controlled studies of nuts and diabetes:

  • Diabetes Care. 2010 Feb;33(2):227-32. Epub 2009 Oct 30. Effects of walnut consumption on endothelial function in type 2 diabetic subjects: a randomized controlled crossover trial.

This study found that "The walnut-enriched diet increased fasting serum glucose" i.e., blood sugar.  Ooops!  Not good for diabetics.

  • Am J Clin Nutr. 2002 Nov;76(5):1000-6. Effect of diets enriched in almonds on insulin action and serum lipids in adults with normal glucose tolerance or type 2 diabetes.

This study concluded: "Almond-enriched diets do not alter insulin sensitivity in healthy adults or glycemia in patients with diabetes."

  • Diabetes Care. 2004 Dec;27(12):2777-83. Including walnuts in a low-fat/modified-fat diet improves HDL cholesterol-to-total cholesterol ratios in patients with type 2 diabetes.

This study found that: "There were no significant differences between groups for changes in body weight, percent body fat, total antioxidant capacity, or HbA1c levels."

So for the one study that says nuts are better than a muffin made with eggs and milk, those are three studies that show nuts don't help diabetes at all, or may make blood sugar worse.

If you already eat a healthy low-fat plant-based diet (like probably no one in any of these studies did), and you aren't eating red or processed meat, or refined grains (junk food), then this information is pretty meaningless to you.  And if you're still eating bacon, well don't just add some nuts to your diet that won't do much if anything -- become a healthy plant-based eater instead, and get some real benefits! 

The same research that says nuts are health food says oily salad dressing is health food

Remember that the Nurses Health Study – where too much of this comes from – is an observational study.  It's not a study on nuts.  

The truth is dietary patterns matter much more than any one food, good or bad.  Taking isolated information based on an isolated aspect of an isolated food...is not very useful at all in the big picture, when there is no context or perspective.  Major scientific bodies agree.

I see too often in the veg health community people being told to they really must tweak their diets this way or that, or worry about this food or that – based on research conducted on people eating the awful Western diet.  We all know the scientific literature abounds with studies showing olive oil and the Mediterranean diet have big benefits.  In fact, all the same data from the Nurses Health Study, cited to promote nuts, also shows that olive oil is healthy and protects against fatal ischemic heart disease.

The Nurses Health Study began in 1976 and has grown over the years.  In 1984 a group of about 80,000 women filled out a 116-item food-frequency questionnaire.  Researchers then looked 10 years later, saw how many had died and of what diseases, and what the health was of others still alive, and began drawing conclusions from the self-reported questionnaire data.  What did they say they were eating in 1984?  What did some of them die of?  Who is still alive and healthy?  Do we see patterns?

The same data from the Nurses Study which says nuts can help prevent heart disease also says oil will do the same thing.  The Nurses Health Study has been used to suggest higher consumption of oil-based salad dressings to reduce the risk of fatal ischemic heart disease, see: http://www.ncbi.nlm.nih.gov/pubmed/10232627

Well no credible plant-based health professional I know is recommending adding oil – or any other processed foods – in order to prevent heart disease.  All of these programs seek to limit or eliminate oil.  It's well known that even olive oil consumption impairs endothelial function, and a lot has been published to show this (not funded by the food industry), e.g. see
 http://www.ncbi.nlm.nih.gov/pubmed/11079642   A meal enriched with olive oil impairs flow medial dilation (blood flow) by a whopping 31%, similar to the effect of eating a Big Mac.

While plant-based experts with clinical experience do not recommend oil to “fight heart disease,” data from the Nurses Health Study says peanut butter and oily salad dressings are health foods that can do just that.  In truth, substituting olive oil for other saturated fats like butter IS an improvement on an otherwise unhealthy diet.  And for people eating an awful diet, they may see some small improvement by switching from butter to olive oil.  But adding oil into a healthy plant-based diet is obviously not an improvement.

The Nurses Health Study is silent on how to improve healthy plant-based diets.  Attempting to use this research to do so is at best a guess.

It's interesting to note that Dan Buettner, author of Blues Zones, which examines research on factors for longevity, cites nuts as one of the factors for long life – though not all the long lived populations include them.  Buettner also cites drinking alcohol, eating olive oil, and believing in God as longevity factors.  Well there is a lot of booze, oil, and prayer in Mississippi, so shouldn't it be a pretty healthy place?  

And of course the Adventist population doesn't drink alcohol – one of the "keys to longevity" – and yet they're still among the long lived populations, just like the Okinawans who eat very few nuts.

You can see the profound problems of using population studies to try to make guidelines focusing on one aspect or one food or one disease.

Buying health claims

Industry spends a lot of money trying to produce studies that make their products look as healthy as possible, so that they can assert health claims to help sales.  The FDA reviews and “grades” the research involved when determining whether to let the claims be made.  The research for nuts gets a “C” grade (level 3) ranking, meaning that the evidence for nuts for weight loss and heart health reflects a “low level of comfort among qualified scientists that the claimed relationship is scientifically valid,” and that the scientists have “a low degree of confidence that results [of studies backing the claims] could be extrapolated to the target population.”

On the other hand, the evidence that a diet heavy in fruits, veggies and whole grains produce many health benefits gets an A rating, the “highest rank of scientific evidence to support the substance/disease relationship meets the 'Significant Scientific Agreement among qualified experts' standard...reflects a high level of comfort among qualified scientists that the claimed substance/disease relationship is scientifically valid.” 

Nuts and weight loss: My conclusion

All in all, nuts are good and have health benefits, they certainly are not poisons.  If you eat the SAD Western Diet, research “suggests but does not prove” that eating nuts as a replacement for meat and junk food can have some benefit.

If you're eating a whole food plant-based diet, eating a few ounces a week can also be healthy. 

If you're eating a healthy plant-based diet including nuts, and can't seem to lose the weight you want, I would recommend following the research that shows nuts will put on weight, and lose the nuts.



FACEBOOK COMMENTS:


29 Comments | Leave a comment

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Good article! I've always felt that so many reports on the health benefits of nuts, olive oil, low-fat milk, etc, are based on improvements seen primarily when people replace SAD (Standard American Diet, or JUNK)foods with these items. It was great to see this validated in the scientific literature. Thanks for this!

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Good article! I've always felt that so many reports on the health benefits of nuts, olive oil, low-fat milk, etc, are based on improvements seen primarily when people replace SAD (Standard American Diet, or JUNK)foods with these items. It was great to see this validated in the scientific literature. Thanks for this!

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Let me give you an honest, personal account of what happened with a diet I was placed on, when I was about 30 years of age. Aside from being a completely vegetarian diet, I was advised to eat 3 ozs of nuts daily, of various kinds (almonds, brazil nuts, walnuts, pecans, etc.). I usually ate more than the prescribed 3 ozs. By age 35, after 5 years on this diet, my weight was lower than it was when I was 30. I was thin at 30, but was thinner after being on this diet, that included nuts as the primary protein source. I also was advised to eat "up to" 1 oz, each morning, of sunflower seeds, alternating with pumpkin seeds, along with vegetable juice, a serv. of fruit and a few leaves of lettuce. The diet included 2 large vegetable salads each day, and steamed vegetables in the evening. I can only say to you, that on this diet, I achieved and experienced a degree of healthfulness, strength and vibrancy that I didn't think was possible for a human being. Not only was I thin, I was strong as on Ox, could work 12 hours, if necessary, with ease, and my sleep was perfect. Now, nearly 40 years later, I still have the diet, on a 2 page document on which it was typed, by a simple, vegetarian, country doctor, named Dr. Gerald Benesh, who, after having experienced a car accident, which put him in a wheel chair, finally died at age 90. The last photo I saw of him, he had in his hands, in his 80s, two 30lb dumbells, high over his head, had all his hair, all his teeth, and a smile on his face. Had he not had the auto accident, he probably would have lived past 100.

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Yes, Benesh was one of the modern day promoters of Natural Hygiene and this is the old Natural Hygiene diet. It was a very low calorie dense, calorie controlled diet. It's what I would call a "high raw" diet.

For those curious, here are the guidelines of that diet:

- - - - -
From Benesh:

People have made food tastier by adding and/or increasing things such as MSG, fats, sugars, and salt. As a result, nerves have adapted to this higher level of stimulation so that natural food often seems bland and offer little pleasure. Readaptation to natural foods can take up to 3 months. It can also be accomplished by a week-long water fast.

Natural Hygiene diet guidelines from Gerald Benesh, D.C:

Eat only when hungry.
It is best not to eat between meals or at bedtime.
Do not drink water with meals. Drink water 15 minutes before meals or two hours after a meal.
Eat moderately and chew your food well. Use no condiments, salt or spices or alcoholic drinks. That includes coffee and tea.
Do not eat when tired or emotionally upset. REST and wait until you have recovered from either state.
Do not eat immediately before or after intense physical or mental exertion.
Eat only natural, live, unprocessed foods.
Fresh air and exercise are part of a nutritional program. Get your daily quota. Positively NO SMOKING.
Try to rest after each meal, if at all possible.
Strive for physical, mental and emotional balance.

General dietary instructions from Dr. Benesh:

With fresh fruit salad (a lunch or dinner) have dark green leafy lettuce, celery, and sprouts.
A little olive oil or sunflower seed oil may be used as a dressing. A few drops of lemon, lime, orange or grapefruit juice may be added. [Use no other salad dressing.]
Use sweet butter or sunflower oil on the steamed vegetables, sparingly.
All nuts and nut butters should be unroasted, RAW and unsalted.

Information picked from Dr. Benesh's recommendations and specific diets.

Jump on a trampoline once or twice daily to help lymph flow.
Breakfast is fruit, preferably apples.
Have lots of salad and include plenty of lettuce (not iceberg) and sprouts.
All vegetables are fresh or steamed.
No starches except brown rice, corn, potato, and sweet potato; and only one per day.
"Fast" one day per week on juice or watermelon. (Watermelon is a better cleanser.)
Have 8oz. juice before every meal, if possible; otherwise, have about 10oz. at breakfast and dinner. "Juice" varies with the diet, but it is always fresh. Common are carrot-celery and apple-celery. Wait about 10-15 minutes before eating meal.
Nuts are eaten at the end of a smaller meal (breakfast or salad). Wait 10-15 minutes after meal. Recommended amount varies from 3 to 5 oz.

- - - - - End of Natural Hygiene diet info

I understand much of the diet Dr. Fuhrman advocates actually has its basis in the early Natural Hygiene movement...true hunger, eating 2 meals a day, 2 lbs of veggies etc can all be traced back to that group.

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I have been eating an 80/10/10 hygienic diet without any nuts and my weight has been dropping very slowly over the past few months, without controlling food intake (I eat "ad libitum"). My BMI has dropped from 20.7 to 19.2 (that "stubborn" bit of belly fat that never went away even when I was eating a low-fat cooked vegan diet without nuts, seeds, coconut or avocado). I don't blend, juice or eat dehydrated foods either, or so-called "superfoods." Just whole, fresh, ripe, raw, minimally processed fruits and vegetables, including at least 1 pound of tender leafy greens each day. I have no problem with nuts and would eat a little here and there, but it is impossible to find nuts that meet the above criteria (whole, fresh, raw & minimally processed), since it would have to be in the shell and not dried or dehydrated. The nuts and seeds bought in stores, even if they are raw, are usually dried or dehydrated, which means they are no longer a whole food, and they are unshelled, which affects their freshness (they began to go rancid immediately after being harvested).

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Seems like the last 5-10 lbs are always the hardest and by following the diet that you are now, you have significantly lowered the overall calorie density of the diet.

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A very enjoyable and well-balanced article.
For me, I like Joel Fuhrman's approach to using nuts. I use them to make yummy salad dressings without added oil. Using his plant-based approach, the weight is coming off effortlessly. Using nuts so sparingly gives my salads an enjoyable richness WITHOUT adding a LOT of nut-derived fats.
I don't have heart disease etc., so I believe using a VERY modest amount of nuts is fine.

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Thank you for doing that article Jeff. It is timely and personally helpful.

My husband & I started eating a McDougall diet back in 1985. We rarely had any nuts or seeds, and maintained perfect weight & health.

A few years ago, we began "treating" ourselves more often with nuts & chocolate, and yes, the weight began to creep up.

Last week, I realized that my weight was at the very top of my healthy BMI range. It was time to make some changes.

Chef AJ's report inspired me to watch Dr. Doug Lisle's lecture on her website on the topic of losing weight.

It helped me finally really understand what Dr. McDougall has often said "The fat you eat is the fat you wear".

So, I stopped eating the nuts & chocolate, although I am still having 1/2 a tablespoon of ground flax seed in my breakfast.

For this past week, even though I have increased the amount of low-fat plant foods, I have already lost a pound.

So basically, I have returned to eating the tried-and-true McDougall diet that served me so well for many years.

Thanks again for maintaining this website Jeff. It really helps me feel connected to a vegan community.

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Glad to hear this and I would love to know your results as you lower the fat in your diet. I can completely understand those who are not overweight holding on to their nuts, but I am surprised at the many people I have heard from who are still overweight that are not even willing to consider decreasing the amount of fat they eat or even giving them up temporarily to see what happens. If eating fat truly facilitates weight loss, than why are so many people still so fat?

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Thank you for your interest Chef AJ. I have been hearing "a calorie is not a calorie" since back in the early 1980s when I first began this journey. Then, it was the Diamonds, authors of "Fit for life" who asked us to intuitively understand the difference between 100 calories of eggs/bacon, compared to 100 calories of fresh fruit.

That much made sense to me. And now, thanks to Dr. Doug Lisle's lecture on your website, I am further understanding the difference between high fat plant foods and low-fat plant foods.

I am noticing a lot of subtle improvements happening as my body adjusts. One, is how quickly and remarkably well I am adapting to fully enjoying the low-fat menu.

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I am noticing another encouraging change... I am feeling enthusiasm for breakfast now. When I ate high fat foods... even small amounts... I tended to feel very lethargic about eating in the morning. I think my poor system was having to catch up on the processing even by the next day! Now though, I am enjoying waking up hungry and looking forward to my satisfying breakfast of fruit(s) & whole grain hot cereal.

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More good news I have just realized since eliminating high fat plant foods from my vegan diet: I am about 15 years post-menopausal but I was still experiencing some menopausal symtoms, specifically occasional (mild) hot flashes and breast tenderness.

In this past week, the hot flashes have dwindled significantly and my breast-comfort is also noticeably improved.

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It's been about a month of eating the truly low-fat vegan diet once more. I've lost 3 pounds so far while eating all I want, and even better, my blood pressure has dropped easily and naturally down to ideal normal.

In your reply, you posed a question about why so many people refuse to give up nuts when they could benefit from doing so. I think Dr. Neal Barnard talks about that in his lecture on food addictions. Fat is addictive and enhances food flavours.

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It's been just over 2 months now of eating 100% low-fat, whole plant foods (eliminated ALL oil, avocado, nuts, seeds, chocolate, Durien. I've lost 11 pounds while eating all I want. There are other improvements too: I always used to enjoy cooking and trying new recipes, which went by the wayside once I got into "treating" myself with high fat foods. I have started opening my recipe books again! Yay!

I added up the calories from fat that I had been eating before the change; it was amazing how fast it added up! According to my calculator (9 calories per gram of fat) I was eating about 500 calories JUST from fat. I had been "justing" myself into gaining weight: JUST a 1/4 of an avocado on my salad,JUST one piece of Durien, JUST 1 ounce of chocolate, JUST 1/4 cup of unsalted cashews... as if saying "just" somehow magically takes away the high fat content.

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Hello everyone who is interested in this topic. It's been about 4 months for me now of eating only low-fat whole plant foods, and to date, I've lost 20 lbs. I've been stable at this point for several weeks, so I suspect this may be the bottom of my weight loss. I look & feel much better. When I was going up a steep flight of stairs recently, I realized how much easier it is now. That 20 lbs was like carrying 4 five pound gym weights with me everywhere!

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Thank you so much for the time and energy in writing this beyond excellent article.

Finally, a voice of reason. I joined this website just to give you deserved kudos after reading this article.

I'll be saying this until I die: It's all about the calories. The percentage of macronutrients in your diet doesn't matter regarding weight loss. It's all about calories in, calories out.

Cutting out nuts, or any other food won't magically make you lose weight. You lose weight because you are cutting calories.

I eat a plant-based diet, but I must count calories and will until the day I die to keep my weight down. Otherwise I will be a fat vegan. For me personally, it's as simple as that. No, I can't eat a bucket of Mcdougall's fat free rice recipe while avoiding fats and keep my weight down. It's all about the calories.

Thanks for telling it like it is...finally a voice of reason.

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Not a doctor, but the studies from medical journal articles I read both in the back of The Starch solution and just today in the New York Times say a calorie is not a calorie. While it is better to not overeat, the studies say that fat calories are store effortlessly and immediately as fat, whereas the calories from excess protein or carbohydrates are burned as heat. So, ostensibly, you could overshoot your caloric intake from these other 2 sources and not gain weight, but not if the calories come from fat.

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Chef AJ, unfortunately for me that is not true. For example, I can't eat all the brown rice or whole grain pasta (lowfat foods) I want and still lose or even maintain my weight. I will gain.

I find that by counting my calories I will naturally eat less fatty plant-based foods as they are more calorically dense. One will eat way more fruits and vegetables than nuts if they keep their calories in check.

I noticed in your original article you also mentioned in passing your grain servings were tweaked, although that was not the focal point of your article. I'm assuming you are also eating less grains than before, which would also lower your calories and encourage weight loss.

I read a book that has no agenda other than weight loss and exercise. It is called The No-Beach, No-Zone, No-Nonsense Weight Loss Plan by Jim Johnson, who is a Physical Therapist. This book opened my eyes and set me on the right track toward weight loss. He could care less if you are vegan or eat meat. He has no diet agenda. This book opened my eyes to the bottom line of calories in/calories out. Another great book on the subject is Why Calories Matter by Professor Marion Nestle.

But most importantly, congratulations on your weight loss! In the end, we all must find what works for us.

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Actually, now that I gave up all over fats including seeds and avocados I eat tons of grains and am still losing more weight. As Dr. McDougall always said "the fat you eat is the fat you wear:.

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I totally agree with Sheryl. I eat a plant based diet as well. It is mainly about calories. Of course, each gram of fat has more calories than each gram of carbohydrate. Therefore, the actual portions of fat has to be smaller than that of starches. Starches can be measured in measuring cups. Fats, such as oils have to be measured with spoons and not cups. One cannot eat as many ounces of nuts as of vegetables or fruits. The way to lose weight by exercise is to increase the number of calories burned by activity, without increasing the number of calories consumed. Really increasing one's exercise enables many to lose weight without cutting, while not increasing caloric consumption. I have been far more successful losing weight (95 pounds lower than my highest) than I ever have and I would credit counting calories and exercising as well as eating a lot of fiber rich plant food. The daily exercise enables me to maintain my weight on a higher calorie level than I would have been able to otherwise. Figuring out the calorie level that maintains my weight and continuing to count calories has enabled me to keep my weight steady without even one pound of regain for two straight years now. Fiber rich plant foods control hunger.

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Dan, congratulations on your weight loss! 95 lbs! FANTASTIC! Another calorie counter..ha ha...!!

I have it down to such a science now that it's a no-brainer for me. And yes, I agree that exercise lets us eat more...thank goodness.

Job well done! You should be so proud of yourself.

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This was an awesome and highly informative article but I feel that you've glossed over the true value of nuts. The key is here:

"To avoid increasing caloric intake, regular nut consumption can be recommended as a replacement for consumption of refined grain products or red or processed meats."

I can tell by reading this that Jeff (and perhaps most readers as well) is a long-time vegetarian and so this statement probably does not have much personal impact. However, for people who have just recently chosen to abandon the standard American diet this statement is significant. More explicitly, if you are trying to give up meat and dairy then nuts and seeds provide an important source of alternate nutrition.

I recently switched to a pescetarian diet which consists of some fish but otherwise no meat or dairy. (My doctor allows fish, but I was never a big fan so my diet is practically vegetarian.) I've found a small handful of nuts or seeds after a meal consisting of fruits, grains, and vegetables to be very satisfying. It makes the meal feel "finished". I started this diet in early March 2012 and as of late July 2012 have lost about 45 pounds. I do not count calories or restrict food intake but I do limit myself to healthy plant-based foods occasionally supplemented by fresh fish. (Oddly, although I don't generally like fish I have learned to enjoy fresh sashimi.) I eat as many nuts and seeds (mostly sunflower and pumpkin) and if they have slowed my weight loss then that is fine; my current rate of weight loss is more than satisfactory.

People who have not achieved their weight goals and who include nuts in a healthy plant-based diet should certainly consider eliminating nuts from their diets but people who are eating the standard American diet should concentrate on eliminating dairy, meat, and processed foods and utilize nuts as a substitute.

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Thanks, Dave. I'm not sure I exactly understand the distinction you're making. This article arose mainly out of a discussion within the plant-based world, so you are right about that, this is a discussion pretty much in relation to people already eating this way and trying to sort through information to know what benefits are true, how true, and how much they apply to people already eating a healthy plant-based diet.

And truth is, nuts can cause weight gain, rather than weight loss, even though not all the calories *estimated* to be in nuts are absorbed, when eaten whole. I'm not telling people to stop eating nuts. I eat nuts and seeds myself, by the way. I am saying for those trying to lose weight, try losing the nuts for a while and you may lose the weight, just like the studies show.

Anyway I do very much agree with you, I think, that people eating a regular Western diet would benefit by substituting nuts for meat and other animal products and junk food. That is in the literature and I think it's a good finding. You can get some fairly modest cardio improvement if you lose the burgers and have nuts in place.

Plus there is the satiety issue that you mentioned, that nuts can be satisfying. I do agree. And yes, it's better to add nuts and take away junk food and meats.

Cheers.

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I totally agree about the nuts. I went back and read my posts, and it sounds like I don't eat nuts. But I do! I just count the calories for them! They are filling and satisfying and loaded with fiber and protein. I think nuts are a great food. I just can't sit there mindlessly eating half a jar of peanuts like in the old days.

In fact, the other day I ate 3 ounces of nuts in one day! Can you believe it? They were part of a recipe and two snacks and planned for with my calories.

I've found once I cut out all meat, fish, fowl, eggs and dairy, I had plenty of room left over for nuts. I just balance my calories now and do fine. I think nuts are a great food and don't want to make it sound like they are not. I just don't eat half the jar anymore!

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What you say is exactly what I think. I don't want to offend anyone, but I lost my weight while still eating meat- I was raised eating meat, and this made it a deeply ingrained habit. I don't think my parents really believed strongly in eating meat, but it was habitual for them as well. If I hadn't continued counting calories, I wouldn't have been able to give up meat. This helped me quit because writing down everything I eat makes me much more mindful of what I eat. I mainly stopped eating meat and most other animal products for ethical reasons since losing my weight. Plant foods helped me lose weight by their fiber content. The point is, that when a person counts calories, nothing has to be completely forbidden in order to lose weight. A person can eat nuts and still lose weight, if they cut back on something else and the nuts don't make them go over their allotted weight loss calories for the day. Since I always budget the calories for the nuts, I don't gain weight from them. And remember, my exercise gives me a higher overall calorie budget. Even when I was still eating meat, I budgeted the calories for that and still lost weight. I have also been able to lose weight even eating sweets, but I am not able to eat every sweet I want to eat. Remember the man who lost weight eating twinkies? He just made sure he had a calorie deficit and he still lost weight. If some people can lose weight still eating meat and twinkies, then certainly most people can lose weight while eating nuts, which are far healthier, if they budget their calories for them. So, no particular food that is portion controlled makes me gain weight, but eating too many overall calories does. The only time I begin to gain weight is when I go out to eat and lose track of the number of calories I am eating, and not even by eating some nuts or some sweets. The restaurants I go to are salad bar restaurants, so I eat a lot of vegetables, no meat, but higher calorie breads as well.

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I have posted on Dr. McDougall's site a detailed piece about the nut question and in response to a nut-pushing piece by Dr. Greger.

You can review it at:

http://www.drmcdougall.com/forums/viewtopic.php?f=1&t=31052&p=311172

Thank you.

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Inspiring! I want o challenge myself to go without any overt fats (no nuts, seeds, avocado etc.)for all of August to see what happens.

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How's it going?

I've been 3 weeks off all high fat foods: no oil, no nuts, no avocado, no Durien, no chocolate... all of which I had been eating increasingly in recent years. I've lost about a pound. I was hoping for more weight loss by now, but I'm feeling lighter & more energetic, & it's going in the right direction. Slow weight loss is to be expected when already within one's healthy BMI range.

Another important advantage of eating only the low-fat plant foods is protection of the colon. Dr. McDougall explains how high fat foods trigger the release of bile acids, which increase our risk of developing colon cancer.

I found some details on that on Dr. Mirkin's web sites: "Eating a high-fat diet causes your liver to make more bile, and bile is loaded with a chemical called lithocholic acid, a bile acid that helps digest fat. Lithocholic acid is probably the most toxic compound that your body makes. Lithocholic acid damages the DNA, the genetic material in cells to cause cancer."

http://www.drmirkin.com/morehealth/G210.htm

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Dr. Greger says exactly the opposite: http://nutritionfacts.org/video/nuts-may-help-prevent-death/

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