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There has been an incredible amount of science coming out of late in support of a plant-based diet, and how it helps you to lose weight and turn your health around. It is becoming all the more evident that a nutrient-dense, high-fiber diet can not only tame obesity, but it can prevent and reverse the killer diseases of our time: heart disease, Type 2 diabetes and even some kinds of cancer. So, how do you shift gears and start eating better, when meat, dairy and eggs is so ingrained in your daily regimen? One of the best programs I’ve seen to assist the process is Dr. Neal Barnard’s 21-Day Vegan Kickstart Program. It’s doctor supervised, medically sound and chock full of tips, recipes and support. In the following interview, I’ve talked with Dr. Neal Barnard, president of The Physician’s Committee for Responsible Medicine about exactly what happens in the program. Barnard is an adjunct associate professor of medicine at the George Washington University School of Medicine and the author of numerous scientific articles in leading peer-reviewed journals, as well as a frequent lecturer at the American Diabetes Association’s scientific sessions. His diabetes research was funded by the National Institutes of Health, the U.S. government’s research branch. He is also the author of “21-Day Weight Loss Kickstart: Boost Metabolism, Lower Cholesterol, and Dramatically Improve Your Health.” KF: Why did you create this program and how has the response been? NB: The response has been huge. We’re zeroing in on something like 200,000 participants so far and they have loved it. It all started with the research studies we do here at PCRM, where we help people to transition to a plant-based diet, and then we track the results. People lose weight, their cholesterol and diabetes improve, and so forth. In helping people change their diets, two tricks seem to make all the difference: First, we focus on the short term — so there is no commitment at all about what you’re going to eat six months or a year from now. And second, we work as a group. All our research participants get together every week. They share successes and challenges, swap recipes and keep each other going strong. The question then was, how can you get the same kind of support if you don’t live near our office in Washington, DC? So we launched the 21-Day Vegan Kickstart program in the fall of 2009 so people can do it wherever they are. It’s all online. They get tons of support, they can talk with each other, and the whole program is fun and very quick — just three weeks — and it’s free. People like the personal and social aspect of it. Every day, participants get an email from one of our Kickstart coaches — celebrities, doctors, athletes — with embedded short videos, recipes, menus and lots of tips. I might mention that your tips have been especially valuable, Kathy. And people feel like they get to connect with their coaches a bit and profit from their knowledge. KF: That’s great. Thanks, Neal! So, is the program primarily for weight loss or getting healthy? NB: It’s really for both, depending on what you need. In our research, we’ve found that most everyone loses weight, unless they are already at their ideal weight. And their cholesterol levels fall, too. If they have high blood pressure or diabetes, those conditions improve and sometimes go away. And what matters most is that you’re being pulled out of an unhealthy rut and getting into a good healthy groove that will bring you toward your goal. KF: Can you give us some inspiration? What have past participants experienced? NB: We hear from our Kickstarters all the time. So many people describe it as just the experience they need to break away from unhealthy habits. Let me share a message that just came in from a participant who jumped into the program earlier this year: I’ve been a Kickstarter and a vegan for a little less than five months now, and I just hit the 50 pounds lost mark. I have tons of energy and walk twice a day with my dog. I was on the verge of having to take meds for Type 2 diabetes, but that is no longer an issue. I no longer have to take cholesterol meds. The dosage of my blood pressure med has been cut in half and I’m hoping I’ll be able to go off that entirely soon. Before going vegan, I had a very strong sense that I wasn’t going to live very long. I knew that you couldn’t weigh what I weighed and eat what I ate and live to a ripe old age. It just doesn’t work that way. I would look at my young nieces and nephews and wonder if I would live to see them graduate from college, get married, have children. And I honestly didn’t expect to. I truly expected to die from a heart attack at a young age. I don’t feel that way any longer. I feel healthy and hopeful. I expect to be here for a long, long time. Many people have found their diabetes gradually vanishes, their arthritis pains go away and they really feel good again. KF: What are a few of the changes participants will be making? NB: We are going to jump into a vegan diet for three weeks. But because that sounds a little daunting, we will get you ready with recipes, restaurant and fast-food tips, and lots of information about how to plan healthy meals. So a few days ahead of time, you’ll get daily emails that walk you through it bit by bit. Then, on Day 1 of the program, we’ll again detail what’s in and out of the program. What’s in are fruits, vegetables, whole grains and beans. And, what’s out are animal products — including meat, cheese, dairy and eggs. And that’s it. KF: How does switching out cow’s milk for non-dairy milk affect weight loss? Health? NB: It is so much better to pick soymilk, almond milk, rice milk or one of the other nondairy milks. Cow’s milk contains so much saturated fat, not to mention cholesterol. Low-fat cow’s milk is lower in fat, of course, but it’s high in sugar — that is, lactose sugar. In fact, the calorie content of skim milk is the same as a typical soda. Other dairy products, such as cheese, yogurt, butter and ice cream also contribute significant amounts of cholesterol and fat, and you’re better off without them. Many people find that arthritis, migraines or other problems improve or disappear when they get away from cow’s milk. Several studies have linked cow’s milk to prostate cancer — apparently due to various hormonal effects of milk products. KF: A lot of people think they are doing well by eating eggs — especially the whites. What’s the skinny on eggs in terms of weight and health? And what do you propose as an alternative? NB: Well, there are actually two parts of the egg that you’ll need to avoid: the yolk and the white! Egg yolk is loaded with cholesterol. There’s more cholesterol in a single egg yolk than in an 8-ounce steak. Egg white is just a solid mass of animal protein, which is a problem for the health of your bones and your kidneys. You are much better off getting your protein from plant sources. Oh yes, and I forgot to mention salmonella …. So, if you are baking and the recipe calls for eggs, you can substitute with egg replacer, which you’ll find at any health-food store. Some people use applesauce or tofu as binders, too. If you are looking for a breakfast scramble, try a Tofu Scramble. It is lighter, cholesterol-free and beats the socks off eggs. KF: Some doctors still recommend “lean meats” to their patients, but you say that’s not a good idea — why not? NB: They are not really lean. Even skinless chicken breast gets about 23 percent of its calories from fat, and it has plenty of cholesterol and saturated fat that contribute to heart problems. American now eat more than one million chickens per hour. And collectively, we are in the worst shape we’ve ever been in. For some reason, many people have not yet gotten the message that animal protein is unhealthful, too — just as animal fat is. As I mentioned, it’s a major contributor to osteoporosis and kidney problems. KF: What is the harm in an Atkins or Ducan, high-protein type diet? NB: Let me describe what can happen. A man in Florida contacted us because he had gone on an Atkins diet trying to lose a few pounds. He was only slightly over his ideal weight, but the diet was popular and he figured it must be safe. He followed the instructions about avoiding fruit, bread, cookies, pasta, rice, potatoes, beans and every other source of carbohydrate — and he did lose a bit of weight. In the process, he let his meat intake increase, because the Atkins book allowed that. As the weeks went by, his cholesterol started to climb steeply. But he believed that, if he followed the diet instructions, this should not pose a problem. But then one day, out of the blue, he felt as if an anvil was crushing his chest. He couldn’t move. The pain was excruciating. He got to the emergency room as soon as he could, and, needless to say, he had life-threatening heart disease. He then abandoned the Atkins diet and switched to a vegan diet. He found that a plant-based menu solved both of his problems. It kept the weight off and helped his heart at the same time. Normally weight loss causes cholesterol to fall. But for about one-third of Atkins dieters, everything goes in the wrong direction, and their cholesterol levels sometimes go through the roof. They also lose calcium, as researchers have found with urine tests. Over the long run, the concern is that that could lead to osteoporosis. KF: For the record, how much protein do we need per day? NB: Less than you might imagine. An average-sized woman should get roughly 50 grams per day, or perhaps a bit less than that. An average-sized man should get slightly more than that. Americans now get about twice as much protein as they need. Plants give you plenty of protein. Beans, grains and vegetables are loaded with it. Broccoli doesn’t like to brag, but it’s about 30 percent protein. KF: How should someone deal with intense cravings, whether they are for cheese, a burger or a piece of cake? Will the cravings ever pass? NB: The best way to get past cravings for unhealthy foods is to just be away from them for a period of time, like three weeks. The 21-Day Vegan Kickstart helps you do just that and before you know it, going back to that meaty cheeseburger is not the pleasurable experience you remember. KF: We are hearing so much about fiber these days — about how it is so essential if you want to lose weight and prevent disease. Can you bottom line the science on it for us? NB: Fiber is plant roughage. And, yes, it really is the key to so many health issues. It fills you up, but has essentially no calories. It also helps your body eliminate cholesterol and excess hormones. Beans, vegetables, fruits and grains are loaded with fiber, but animal products have none at all. KF: What’s the scoop on sugar? How does it make one overweight and unhealthy? NB: A teaspoon of sugar has only about 15 calories — much less that the calories in chicken fat or other fats. The problem with sugar is that it dissolves — so you can’t see how much is actually lurking in foods. A 20-ounce soda has the equivalent of 16 teaspoons of sugar in a single bottle. That’s a lot of calories that you don’t need. Also, if you look at sugary foods — cookies, cakes and candy bars — they have a lot of fat mixed into them. So the sugar lures you in and the fat is what ends up on your thighs. KF: If someone has a sweet tooth, what do you recommend (other than fruit, of course!)? NB: Well, I do recommend fruit, in all its varied forms. I always keep oranges, apples, tangerines and mangoes on my desk, and it really beats plugging quarters into a snack machine! If you want to get more elaborate, you can make a smoothie with fresh fruit, nondairy milk and a banana. Also, in the 21-Day Menu, we share a dynamite vegan chocolate mousse recipe that will satisfy any sweet tooth. KF: Can you explain how it’s ok to eat pasta?! That’s usually verboten in weight loss plans, isn’t it? NB: It’s only verboten only on those primitive low-carb diets that seem to have long outlasted their usefulness. Pasta is a grain, so it is not especially high in calories, and it has no animal fat or cholesterol. People in Asia or Mediterranean regions who eat noodles every day are healthy and thin. When researchers feed pasta to volunteers, they find that it has very little effect on blood sugar. That is, it has a low glycemic index. The reason is simple: Unlike bread which is spongy and light and very quickly digested, each pasta noodle is densely packed. So no matter how much you chew it, it will digest more slowly, and its effect on blood sugar is very gentle. What does matter is what goes on your pasta. Meat, cheese and greasy toppings are out. In my 21-Day Weight Loss Kickstart book, I have a recipe for linguine with artichoke hearts and seared oyster mushrooms that will seriously make you happy. Or how about a spicy arabbiata sauce? Or fresh basil, chopped Roma tomatoes, minced garlic and sautéed shiitakes? KF: How much and how quickly can you lose weight on your program? NB: It depends on how much weight you need to lose. If you need to lose just a few pounds, then off it comes. But if you need to lose, say, 50 or 100 pounds or more, the three-week program gets you started. It helps you learn about the foods that will burn that weight off and it resets your after-meal metabolism to a slightly higher level. In our studies, we found a 16 percent increase in after-meal metabolism that lasts for about three hours after each meal. Now, if a person is losing weight gradually, I’m perfectly happy to see a weight loss of about a pound per week. After all, there are 52 weeks in a year. So let it come off in a healthful way. KF: A lot of us eat out most days; do you have a guide to show what to order or where to go when dining out? NB: We sure do; the Kickstart program has a great little pocket guide you can print out and stick in your wallet. It tells you what to look for when you are dining out whether it is Italian, Mexican, Japanese, or American cuisine. KF: What’s a simple way to carry your program forward after the 21 days is over? NB: We encourage people to keep up their nutrition changes for the long-term. Many people continue with our message-board community more or less indefinitely. I also encourage everyone to ask their friends and family to jump in, too. Ditto for our friends at work. Creating support in your community or workplace is a great way to stay on the path to health. I also wrote the 21-Day Weight Loss Kickstart to give people lots more information and recipes that they can use for life. KF: Thanks, Dr. Barnard!