Tuesday, August 16, 2011

Fat, Sick and Nearly Dead: A Review

Do you like come-from-behind-to-snatch-victory movies? Do you like road trip movies? Buddy movies? Documentaries? If you do, you may like Fat, Sick and Nearly Dead, a movie in which financial entrepreneur Joe Cross seeks to lose weight and cure a rare skin disease through a two-month juice fast.

Do you enjoy testing your critical thinking and debunking pseudo-science? If you do, this movie will give you plenty to chew on.

My criticism isn't of Joe Cross or his friend Phil Staples--I admire their strength of will and Cross's compassion for Staples, who was just an acquaintance when he called Cross for help from halfway around the world. Nor am I critical of their break with nutritional orthodoxy or the short-term results they achieved: they both lost 90 pounds or more, their hives disappeared, their energy increased, and their blood pressure and cholesterol improved. They either reduced or quit medications (including prescription prednisone for their hives--that's the steroid they needed). That's impressive. What I have a problem with is the lack of information, lack of fact checking, and pseudo-science.

Early in the movie, Cross tells us there are two kinds of food: micronutrient (fruit, vegetables, seeds, beans and nuts) and macronutrient (everything else; the camera points at meat). He and Dr. Joel Fuhrman explain that micronutrients are found primarily in plant foods.

It's unclear why they make such a distinction. The three macronutrients are protein, fat and carbohydrate. Most fruits, vegetables and seeds are mainly carbohydrate, beans are carbohydrate and protein, and nuts are mix of all three. Meat is mostly protein and fat; there's a little carbohydrate in some meats. In other words, all foods are some combination of the macronutrients. Likewise, pretty much all foods (especially unrefined foods) have micronutrients such as vitamins and minerals. The movie gives the impression that meat doesn't have micronutrients. In a scene that was unintentionally ironic, Cross chats up some guys at a diner. One of them is eating liver (one of the most nutrient-dense foods out there) while Cross is having his vegetable juice, and Cross talks to them about healthy eating. Since spinach and apples seemed to be main ingredients in the juice recipe, take a quick look at the micronutrients in them versus the micronutrients in liver:

Nutrients in one slice of beef liver
Nutrients in one cup of apple
Nutrients in one cup of spinach(1)

I'm assuming what I consider reasonable amounts of food, and that the whole apples and spinach were used--none of this information is stated in the movie. But plug in pretty much any combination of fruit and veg, and the liver will still blow it away in nutrients.

Two important points regarding nutrients are those that are essential (meaning we need them but our bodies can't produce them) and nutrients' bioavailability (our bodies' ability to extract the nutrients from the food). In a review of Eat to Live by Dr. Joel Fuhrman (Cross's dietary advisor), researcher Chris Masterjohn of the Weston A. Price Foundation writes,

Fuhrman’s calculations of nutrient density suffer from three fatal flaws: first, he excludes from these calculations many nutrients known to be essential to the body while doubling the score of other putative nutrients whose physiological functions are uncertain; second, he fails to account for variations in the bioavailability of nutrients between foods; third, he groups all nutrients present in a food into a single score as if they were interchangeable, rather than acknowledging that different types of foods provide different types of nutrients.


Nutrients are often much more bioavailable from animal foods than they are from plant foods, a fact that Fuhrman’s ranking system does not take into account. The absorption of zinc, for example, is inhibited by phytate and a number of other plant chemicals, while it is stimulated by animal proteins. Absorption of zinc can be five times higher from animal foods than from high-phytate plant foods.9 Calcium is very bioavailable from some plant foods such as kale, broccoli and bok choy,10 but very little is absorbed from foods high in oxalate such as spinach.11 The absorption of fat-soluble vitamins and their precursors such as vitamin K and carotenes can be less than five percent in the absence of fat and still less than twenty percent with added fat.12,13 Pigments such as lutein are twice as available from egg yolks as they are from green vegetables such as spinach.14 As much as 80 percent of vitamin B6 in plant foods may be bound up with other substances that make it unavailable for absorption and use;15 even the portion that is available must be converted into its active form in the liver in a reaction that taxes the supply of vitamin B2.2 Fuhrman’s nutrient density chart would look very different if he adjusted a food’s score according to the bioavailability of the nutrients within it.(2)

Also, grains (which weren't part of the juice fast but are seeds--one of those "micronutrient foods") have nutrient blockers(3).

In another unintentionally ironic moment, we see ads for antacids as Dr. Furhman is speaking. Readers may know that I used to have GERD so bad that it gave me an esophageal ulcer. The two worst things for making my GERD flare up were wheat and fruit. Anecdotally, carbohydrates cause acid reflux and a low-carb diet--not a sugar and fiber diet (yes, fruit is full of sugar)--cures it. Dr. Robert Atkins, who treated thousands of patients, advised heartburn sufferers reading Dr. Atkins' Diet Revolution, "Go on [the Atkins Diet] immediately. Nothing clears up on this diet more predictably than does heartburn."(4) On the theoretical front, Norm Robillard, a microbiologist, developed a theory of heartburn, carbohydrates and gut bacteria that he wrote up in the book Heartburn Cured.

What's also annoying is terms such as "reboot" and "detox" being thrown around without any definition. They aren't talking about computers or drug overdoses, of course, just some good but unexplained things happening to the human body.

Worse is putting the blame for obesity and other diseases (although not in so many words) on meat. This doesn't make sense from an evolutionary point of view. Lierre Kieth, a 20-year vegan turned omnivore, writes in The Vegetarian Myth,

Stone tools have laid beside the bones of long-extinct animals, buried in the silence of time, for 2.6 million years....We come from a long line of hunters: 150,000 generations(5)....you tell me what to blame [for coronary heart disease]: the saturated fats we've always eaten--for four million years--or the industrially manufactured oils that until recently were used in paint.(6)

Keith also presents as evidence that humans are natural meat eaters other anthropological finds, studies good and bad, field research, the expensive tissue hypothesis, and her own wrecked health on a vegan diet. Were the buffalo-eating Plains Indians of Colorado and the hunter-gatherer Aborigines of Cross's homeland fat, sick and nearly dead before or after they started eating flour and sugar?

If the movie is against refined or processed foods, as it states a few times, then there should be nothing wrong with meat. Unless you're knocking back hot dogs or somesuch, meat is merely cooked, not chemically extracted like the seed oils Keith refers to. Meat, as we've seen, is full of micronutrients, which Fuhrman and Cross say are important.

Nevertheless, even if the diet is on shaky scientific grounds, Cross and Staples (and a woman who got relief from migraines on a shorter fast) got some outstanding results. How? Nutritionist Julianne Taylor suggests some reasons some people do well (at least in the short term) on a raw vegan diet.

  • Elimination of dairy, grains, legumes, chemically extracted vegetable oils, alcohol and caffeine. "These health improvements are also similar to those that people rave about when they switch to a conventional paleo diet," she adds. (Add some meat to the juice fast, assuming you're using whole foods, and you'd have a version of a paleo diet.)

  • Some nutrient intakes are improved.

  • Protein restriction leading to autophagy, where "junk human proteins," bacteria and viruses are digested.(7)
Anecdotally, others mention getting a sugar high from the natural sugars in juice, and Dr. Michael Eades believes that intermittent fasting reduces inflammation.(8) But again, the movie doesn't make it clear whether this was an intermittent fast (i.e., going around 12 hours or more without eating or drinking) or if the juice was taken frequently. The movie does make it clear, however, that a long juice fast should be done under a doctor's care--and on that, I'm in complete agreement. They were honest enough to show people saying they tried the fast and didn't do well: headaches, bad mood, and terrible hunger. Indeed, every day, someone finds my post on my miserable fast on this humble blog by searching for fasting and bingeing. It's one of my most popular posts.

Diet wasn't the only thing that changed for Cross and Staples. Both tapered off of Prednisone, whose side effects include increased appetite and weight gain.(9) Additionally, Cross was head of an investment firm he started and Staples was a truck driver: both had high-stress jobs. They left those jobs for two months during their respective juice fasts. (Staples quit driving truck altogether.) Could the relief from stress, and probably extra rest, have had something to do with their autoimmune skin disorder clearing up?

Or was it the elimination of wheat? Or meat? Or refined oils? Or added sugars? We may never know.

1. Information from nutritiondata.com, August 16, 2011.
2. Chris Masterjohn's Review of Eat to Live by Dr. Joel Fuhrman. February 14, 2008. http://www.westonaprice.org/thumbs-down-reviews/eat-to-live
3. "Vitamin and Mineral Absorption: Stop Shooting yourself in the Foot" by Lori Miller. September 8, 2010. http://relievemypain.blogspot.com/2010/09/vitamin-and-mineral-absorption-stop.html
4. Dr. Atkins' Diet Revolution by Robert Atkins MD. 1972. P. 284.
5. The Vegetarian Myth by Lierre Keith. 2009. P. 140.
6. Ibid, p. 186.
7. "Health Problems on Low Fat Raw Vegan and Vegan Diets" by Julianne Taylor. March 16, 2011. http://paleozonenutrition.wordpress.com/2011/03/26/why-i-dont-recommend-a-low-fat-raw-vegan-diet/
8. Inflammation and Intermittent Fasting by Michael R. Eades, M.D. August 13, 2007. http://www.proteinpower.com/drmike/intermittent-fasting/inflammation-and-intermittent-fasting/
9. "Predisone Official FDA Information," Drugs.com. Accessed August 19, 2011. http://www.drugs.com/pro/prednisone.html


Gareth said...

Great post!! Just watched parts of the movie and basically didn't want to continue watching it due to the utter nonsense that doctor that saying about "micro nutrients" and "macro nutrients"...

Lori Miller said...

You missed a lot more nonsense.

RearSight PeepHole said...

This blog post sounds like alot of nonsense in of itself

Lori Miller said...

Wow, my first vegetrollian--and with poor English to boot! I finally feel like I've arrived. Thanks for sharing!