The Gene Therapy Plan

Description

Your genes are not your destiny: learn to prevent disease, improve brain function, and reverse the course of obesity and premature aging through easy-to-adopt nutrition and lifestyle changes that target your DNA
 
While we cannot alter the genes we are born with, we can prevent and reverse disease with foods, supplements, and lifestyle choices that turn good genes on and bad genes off. In his pathbreaking plan, Dr. Mitchell Gaynor—a renowned oncologist and pioneer in integrative medicine—focuses on obesity, heart disease, diabetes, cancer, and aging to explain what we can do to keep our bodies on their natural paths toward healthy, balanced functioning.
 
The Gene Therapy Plan presents practical, evidence-based approaches to diet, including juices, recipes, and comprehensive meal plans. And it explains the cutting-edge science that is revolutionizing what we know about how our biology and our behavior intersect. Empowering and informative, with inspiring stories from Dr. Gaynor’s decades of clinical practice, this forward-looking book puts our genetic destiny back into our own hands.
 
Praise for The Gene Therapy Plan:
“If you want to learn how to use food and nutrients to prevent and even reverse most chronic disease, read this book!” —Mark Hyman, M.D., author of the #1 New York Times bestseller The Blood Sugar Solution
 
“Dr. Gaynor provides insight and an action plan.” —Deepak Chopra, M.D.

Praise for The Gene Therapy Plan
 
“A guide to harnessing the power hidden in food to subvert a ‘genetic predisposition for disease.’ . . . Gaynor’s informative tome is worth reading.”
—Publishers Weekly

“The Gene Therapy Plan identifies how the lives we lead, and in particular, the foods and nutritional supplements we ingest, are a key determining factor in whether latent disease (which most people have to some degree) materialize or stay dormant. By identifying researched nutritional protocols that target specific conditions, and by providing a range of rich case studies from his practice as a leading oncologist and internist, Dr. Gaynor provides insight and an action plan into how the body operates that will benefit medical practitioners and patients alike.”
—Deepak Chopra, M.D.
 
“The Human Genome Project promised to create a new era of genetic medicine, new drugs, and therapies to advance human health. But the real awakening has been the understanding of food—real whole foods, herbs, phytonutrients—as medicine and how it can literally upgrade your biologic software by improving the expression of your genes. In The Gene Therapy Plan Dr. Gaynor makes the healthcare of the future available to you today. If you want to learn how to use food and nutrients to prevent and even reverse most chronic disease, read this book!”
—Mark Hyman, M.D., Director of the Cleveland Clinic Center for Functional Medicine and author of the #1 New York Times bestseller The Blood Sugar Solution
 
“The Gene Therapy Plan is a comprehensive and practical approach to the science of epigenetics—and how to apply it to your life right now. This book is a godsend that could save your life.” 
—Christiane Northrup, M.D., author of the New York Times bestseller Women’s Bodies, Women’s Wisdom
 
“A brilliant and important piece of work from one of our most distinguished and creative medical thinkers. Do yourself and your family a huge favor: Read this phenomenally important book and learn why and how you can live a healthier life.”
—Devra Davis, Ph.D., M.P.H., founder and president of the Environmental Health Trust, author of The Secret History of the War on Cancer
 
“Dr. Gaynor is a visionary healer. This is a comprehensive, coherent, practical, and easily digestible resource for all who wish to ‘tip the balance’ away from disease toward health and wellness.”
—Sheldon Marc Feldman, M.D., Vivian L. Milstein Associate Professor of Clinical Surgery, Columbia University College of Physicians and Surgeons
 
“Dr. Gaynor presents a comprehensive strategy for readers to re-orient their diet and lifestyle using everyday activities that can help one live longer, and live better. With The Gene Therapy Plan, Dr. Gaynor brings his own integrative philosophy and practice to readers in an engaging and actionable way.”
—William Li, M.D., president and medical director of The Angiogenesis Foundation
 
“Dr. Gaynor has and always will be at the forefront of integrative medicine. The Gene Therapy Plan empowers you to take control of your health and life.”
—Mimi Guarneri, M.D., president of the Academy of Integrative Health and MedicineMitchell Gaynor, M.D., is the founder and president of Gaynor Wellness and a clinical assistant professor of medicine at Weill-Cornell Medical College with more than twenty-five years of experience treating patients. His work has been featured in the New York Times, and he has appeared on many national television programs, including Good Morning America, The Dr. Oz Show, and The Martha Stewart Show. He lives in New York City.

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First published by Viking Penguin, a member of Penguin Group (USA) LLC, 2015

Copyright © 2015 by Mitchell L. Gaynor

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LIBRARY OF CONGRESS CATALOGING-IN-PUBLICATION DATA

Gaynor, Mitchell L., 1956–

The gene therapy plan : taking control of your genetic destiny with diet and lifestyle / Mitchell L. Gaynor, MD ; foreword by Mehmet C. Oz.

pages cm

Includes bibliographical references and index.

ISBN 978-1-101-61848-6

1. Genetic disorders—Diet therapy. 2. Nutrition—Genetic aspects. 3. Cooking for the sick. 4. Diet therapy. I. Title.

QP144.G45G39 2015

616'.042—dc23

2014038544

Neither the publisher nor the author is engaged in rendering professional advice or services to the individual reader. The ideas, procedures, and suggestions contained in this book are not intended as a substitute for consulting with your physician. All matters regarding your health require medical supervision. Neither the author nor the publisher shall be liable or responsible for any loss or damage allegedly arising from any information or suggestion in this book.

The nutritional information in this book is not a substitute for professional medical care. Because everyone is different, a physician must diagnose and treat all health problems. All doses of supplements discussed in this book are for adults only. Always discuss your plan for supplemental nutrition with your physician before beginning any new regime.

The patients featured in this book have consented to the use of their clinical vignettes. To protect their privacy, their names have been changed.

Foreword

INTEGRATIVE MEDICINE IS progressively sweeping across the nation’s medical schools, hospitals, and clinics. Academic and residency programs are helping to prepare young physicians to challenge the status quo by thinking beyond the borders of how we’ve been treating patients in Western society for seventy-five years. Integrative medicine is really about treating the entire patient.

During my time as a medical student, the education was very traditional in the sense that students were taught to view the mind and the body separately. And a lot of this educational approach is reflected in the way medicine is practiced today, especially as we are faced with growing specialties and diminishing primary care practices. By the time I completed my training, the dogma of medical practice focused on treating the body and its organs as separate entities. I was primed to pursue a career doing the same. But life whispers to us periodically, and the wisdom of forward-thinking physicians—including my father-in-law, the pioneering heart surgeon Gerald Lemole—shook me out of this rut and opened my mind to unconventional healing approaches. I began to push against the grain of conventional medicine in order to uncover ways of treating patients that weren’t taught to me in medical school. Now don’t get me wrong—I wholeheartedly believe in the power of science. But I’ve been in practice long enough and have come across many patients from all walks of life with different healing beliefs to appreciate the treasure of integrative medicine.

Fundamentally, I have been taught the importance of including the latest in cutting-edge ideas to help my patients, no matter what the source. As head of the Heart Institute at New York–Presbyterian Hospital, this includes developing the most innovative heart valve replacement approaches. As the director of the hospital’s Complementary Medicine Program, I supported the integration of Eastern medical practices such as yoga and meditation. Stretching the spectrum of potential tools also demands that we obtain a complete clinical picture so we are able to prescribe medicines or procedures as well as relaxation techniques, exercises, and even foods that can help prevent and treat health problems.

The Gene Therapy Plan educates both patients and healers to accomplish this comprehensive goal. Dr. Mitchell Gaynor focuses on how we can use food to promote health. But more than just being about eating foods that are healthy for us, this book is about harnessing the power hidden in foods to change our genetic predisposition for disease, drawing from a branch of genetic study called ecogenetics. Ecogenetics is a growing field that applies the philosophy of personalized medicine by using specific substances to target a patient’s genetic profile for developing diseases such as cancer, diabetes, and heart disease. By focusing on bioactive nutrients such as apigenin in pomegranates, EGCG in green tea, and curcumin in curry, physicians will be able to prescribe foods that operate at the level of your DNA to promote health. What’s interesting is that once you put into practice consuming foods that target your gene expression, you progressively begin to lose those cravings for foods that are bad for you—such as highly refined carbohydrates.

I met Dr. Gaynor years ago, when a patient of his approached me about a heart operation. I was confused by the request since the chart clearly outlined metastatic cancer that would kill him within months. The patient smiled and asked me to check the date in the chart again. The cancer diagnosis was over five years old! I found out that my patient had been cured by Dr. Gaynor, and I have been sending him challenging cases ever since, including friends and family. Mitch is the founder and president of Gaynor Integrative Oncology, and he serves as a clinical assistant professor of medicine at Weill Cornell Medical College. As a renowned specialist in the field of oncology and integrative medicine, he has dedicated his career to combining medicinal practices with proven complementary therapies to treat his cancer patients, which makes him well positioned to write this book on the nutritional aspects of disease prevention.

Part of Dr. Gaynor’s success as a well-respected cancer specialist is his ability to treat the entire person through a combination of allopathic approaches and alternative therapies. The Gene Therapy Plan offers practical advice as well as supplemental and juicing recipes that are easy to incorporate into your life. This book provides insight into the evolution of medicine by showing how ecogenetic food changes your genetic blueprint. The book provides scientific data to support age-old practices and alternative therapies, which is an important component to bridging the divide between Eastern and Western medicine. This is a key stepping point toward the globalization of medicine using conventional Western and unconventional alternative treatments with proven results together to treat the whole patient.

Mehmet C. Oz, M.D.

Vice Chair and Professor of Surgery, NYP–Columbia University

Coauthor, You: The Owner’s Manual health book series

Introduction

“YOU ARE WHAT YOU EAT,” my mother always told me. But it wasn’t until after I’d finished my medical training and become a cancer specialist that I learned just how profoundly right she was.

My mother started teaching me about food and health when I was six. She had just been diagnosed with breast cancer, and she wanted me to be able to look after myself. Like most parents, she was concerned that I not load up on Cheetos and potato chips, but, more than that, her diagnosis had brought her into the movement toward unprocessed foods and vitamin supplements launched by Adelle Davis. So she taught me how to make nutritious snacks, and how to blend fruit and vegetable juices to achieve the most healthful effects with a taste I’d like. She also taught me how to prepare nutritious meals, and when she had to be in the hospital for long periods I’d be the one to make dinner for my father and older brother.

Unfortunately, our lessons in nutrition were cut short by my mother’s death when I was nine. Her conversion to wholesome foods and supplements may have been too little, too late, but the odds were stacked heavily against her: during her pregnancy with my brother twelve years earlier, she had been treated with DES, a synthetic form of estrogen that we now know is associated with a much greater risk of breast cancer.

The loss was devastating, of course, but it also gave me a clear purpose in life. When my mother died, I made up my mind that I was going to find out why people’s cells turned against them, as hers had, to cause debilitating, even fatal diseases. I also determined that I was going to do something about it.

I went to medical school, then took specialized training in hematology, the study of blood, and in oncology, the study of cancer, which included doing research at Rockefeller University to study molecular biology. This is a relatively new field that explores the fundamental building blocks of life at the physical and chemical level, especially the processes of genetic control. What I learned from Rockefeller’s cutting-edge researchers gave me an entirely new perspective on the role of genes in determining health outcomes across the life span. And this new view of how genes function showed me that my mother’s emphasis on the role of nutrition in health was absolutely on target.

Genes, the microscopic bundles of DNA that reside in the nucleus of each cell, control all cellular processes, including cell division. (Cancer, perhaps the most feared disease of all, develops when normal cell division—the process that allows children to grow bigger and healthy tissues to renew themselves—goes haywire.)

We inherit our genes from our parents and—according to what I’d learned in medical school—each person’s genetic endowment was pretty much determined at the moment of conception and then remained stable throughout life. If the DNA you inherited from your parents made you robust and healthy, then—according to this theory—you were all set. If your genes made you susceptible to cancer, or obesity, or arthritis . . . well, that was just your fate. In this old way of thinking, health was largely the result of a genetic lottery, and there was nothing you could do to change the odds.

By the time I got to Rockefeller, though, advances in molecular biology had turned this static and predetermined view of health on its head. The new research showed that illness or health was not solely a matter of a “genetic destiny” coming from “good genes” or “bad genes” passed along from Mom or Dad. The picture that emerged was actually much more subtle and complex, and it gave each of us a much more active role to play in directing our own health outcomes through our nutritional and lifestyle choices.

Molecular biology teaches us that the individual’s entire complement of more than twenty thousand genes—called his or her “genome”—contains myriad bits of information that instruct the cells to carry out essential functions. But not all of these genes are active all the time. Many are dormant, and the question of whether or not they become active and begin to influence our biology—either by making us more robust or by making us ill—is called “gene expression.” The primary influence on gene expression is the environment in which we live, which is where our opportunity to exert a positive influence through nutrition enters in.

In the twenty-first century, our environment bombards us every day with an onslaught of pesticide residues, carcinogenic chemicals, large quantities of foodlike substances, which include refined sugar and dangerous fats. These substances in our food, in our air, and in our water interact with the genes in our cells, turning some on and some off. The worst of these chemicals can transform healthy cells into tumors, which is in large part why one in three Americans will develop cancer. In fact, 90 to 95 percent of cancers are linked to environmental toxicants.1 But it is not just cancer that is caused by this chemical stew in which we live. Today we have an epidemic of thyroid disease, especially among middle-aged women, which almost always originates as an autoimmune condition triggered by environmental toxins. Nearly 20 percent of our children have a learning, emotional, or developmental disability, and the incidences of diabetes and asthma are skyrocketing. The environment’s effect on our genes is implicated in all of these conditions as well.

But this dark cloud also contains a silver lining. We may have limited control over the level of toxins in our external environment, but each of us can exercise enormous control over what we introduce into our internal environment—which is to say, what we eat. By being more thoughtful and deliberate about our nutritional choices, we can not only reduce or eliminate many of the toxic influences interacting with our genes to cause disease, we can influence our genetic expression to activate the enzymes that can neutralize or remove toxic substances from our tissues, to stimulate cellular processes to boost our immune system, and to reverse the progression of disease, including cancer.

Using nutrients in this strategic way to combat disease and promote good health is called “nutrigenetics,” and it is the core principle of the Gene Therapy Plan. Nutrigenetics is actually a subset of a broader approach called “ecogenetics,” which is focused more broadly on how we live in our environment and how the environment as a whole interacts with the individual’s genome to produce either health or disease. Our level of physical activity, for instance, may encourage (or discourage) the production of more inflammation-suppressing enzymes. Meanwhile, whether we are fat or lean affects whether we send out weaker (if we are lean) or stronger (if we are obese) signals to suppress cancer-killing substances.

The Gene Therapy Plan takes all these interactions into account. It is designed to help you combat the most prevalent and troubling diseases of our time, and it does so in the context of promoting overall health and well-being through weight control, stress reduction, and exercise.

I’ve based the recommendations of the Gene Therapy Plan on my nearly thirty years of broad clinical experience. After my fellowships in hematology and oncology, I became director of medical oncology at the Strang Cancer Prevention Center, where I continued the study of nutrient-gene interactions I’d begun at Rockefeller. I also continued my exploration of toxicogenomics, the study of how environmental toxins affect gene expression. What I found was that many of the same underlying cellular functions that play a role in cancer—inflammation, signaling proteins, transcription factors, hormone regulation, toxin metabolism, the immune response—were factors in a wide spectrum of other diseases as well. More to the point, these functions could be influenced at the cellular level by the strategic use of nutrients regardless of the disease in question. This is precisely how my practice began to expand in scope.

When I first began incorporating nutrigenetic concepts into patient care, nutrition was barely on the radar for most physicians. Most medical schools and residency programs offered a few lectures on nutritional deficiencies and their associated diseases, but that was about it.

So what I was doing was considered highly unorthodox, yet I was a cancer specialist with mainstream training—I even had an academic appointment at one of the country’s best medical schools—so physicians began to refer patients to me, often those patients for whom traditional treatment methods had been exhausted. And because the results I was able to achieve through a nutrigenetic approach were often astonishing, the referrals increased and my practice grew.

Consider, for instance:

   • The patient mentioned by Dr. Oz in the foreword to this book who approached him for a heart operation five years after the diagnosis of cancer that was supposed to have killed him within months. My nutrigenetic approach had brought about the complete remission of his disease.
   • The dentist (who happened to be my father) who developed hepatitis C after accidently pricking himself with a needle. Before interferon therapy, at a time when there were no medical treatments for hep C, I treated him with a regimen of common Chinese herbs, seaweeds, and juices, and no trace of the virus remained or ever returned.
   • The woman with melanoma I began to treat after her oncologist had directed her to hospice for end-of-life care. Her cancer, which had started on her heel, had spread upward and the lesions became infected, making her left leg four times the diameter of her right. The disease had also metastasized to her lungs and abdomen. I treated her with low-dose chemotherapy, immune pharmacological therapy, green tea, and magnolia, and within three months she was in complete remission.2
   • The young man from Turkey with autoimmune hepatitis and liver failure. The Mayo Clinic had put him on high-dose steroids and told him he needed to be on the list for a liver transplant. I put him on glutathione, resveratrol, turmeric, alpha lipoic acid, and omega-3 fatty acids and his liver function began to normalize. He regained all the weight he had lost and within three months he was back in school. His autoimmune hepatitis resolved and he never needed a transplant.
   • The woman with stage IV pancreatic cancer whose oncologist told her she had four to six months to live. I put her on a dietary regime of cruciferous vegetables, supplements, and juices, combined with chemo, and she went into complete remission and has remained so for nearly twenty years.
   • The woman with the rare dermatologic condition perforating collagenosis, which led her to leading academic medical centers throughout the world before she found her way to me. She had diffuse, severely painful red skin lesions all over her arms, legs, and back, and they were spreading despite large doses of steroids and ultraviolet light therapy. I treated her for underlying inflammation, allergies, and immune imbalance. Within a few months the skin lesions on her arms had resolved and those on her legs had improved by 80 percent.
   • The twenty-three-year-old newlywed who developed severe psoriasis on her face and neck. She had been treated by several dermatologists with courses of prednisone, which temporarily helped, but the disease came back worse each time she was tapered off the drug and it was beginning to cause scarring. I treated her with targeted nutrition, and after one month all the lesions resolved, with no recurrence after five years.
   • The sixty-one-year-old barber who gained a significant amount of weight after a knee injury and became diabetic. On my nutrigenetic diet plan he lost seventy pounds over one year and is now taking only a small dose of metformin rather than insulin.

Today I divide my time equally between Gaynor Integrative Oncology, a practice focused on treating cancer patients, and Gaynor Wellness, in which I apply the same ecogenetic principles to treating people with a variety of concerns, ranging from general health maintenance and disease prevention to weight loss, insomnia, chronic fatigue, dermatological diseases, and Parkinson’s.

Both practices incorporate meditation, music therapy, guided imagery, and cognitive behavioral therapy in concert with activities such as restorative physical therapy, yoga, aerobic exercise, and qigong as well as nutritional counseling based on the same principles presented here in the Gene Therapy Plan. My aim is always to treat the entire person in a way that acknowledges the complex nature of chronic illness, and to work at every level of the body’s healing processes—physiological, genetic, psychosocial, and spiritual—to create an optimal state of well-being.

The recommendations in this book, with their powerful and targeted ability to influence genetic expression, actually lead us to a new definition of what we mean by health. In this new view, we should see ourselves not as being merely “healthy” or “ill,” but as being ecogenetically “well managed” or “poorly managed” across the life span. This is especially true as new developments in disease diagnostics make the distinction between being healthy and being sick no longer black and white, but more a shade of gray. In other words, we all have the seeds of illness within us. The question is whether that potential for disease will become active or will remain dormant.

Imaging technologies like MRIs and CAT scans, as well as more finely grained autopsy studies, show us that the more sensitive our instruments for detecting disease become, the more disease we will find, and at earlier stages. For a long while we have been finding these seeds of serious illness in the surprisingly young. For example, fully 45 percent of soldiers killed in action during the Korean War and 77 percent of those killed in the Vietnam War showed early signs of heart disease. Even children under three years old—sometimes even fetuses—can have these early indications. And the case is the same for almost any disease you choose to look at closely.

It is now plausibly estimated, for instance, that almost 100 percent of people, if they had their thyroids dissected for examination by the newest methods, would show signs of cancer or precancerous mutation. And no matter how finely you slice the tissue, there may always be smaller tumors that fit into the spaces between the slices. The same is true for prostate cancer. Almost 50 percent of men between sixty and seventy would show signs of the disease if examined in this way. Almost 40 percent of women between forty and fifty would show signs of breast cancer under the new microscopes.

The unsettling reality, once again, is that every one of us has these signs of illness in dormant or slow-moving precursor forms. But that doesn’t make us passive victims. Not when we are able to exercise control over what we eat, and thereby significantly influence how our genes express themselves to affect our health. The fact is, for good or ill, we are all practicing gene therapy on ourselves all the time. We breathe in the smoke from a cigarette, we gulp down a soda, we train for a marathon. In each case, we are participating in a process that involves the regulation of our own genetic status.

Once we grasp the implications of being able to influence gene expression, and once we align that fact with the prevalence of disease precursors well before symptoms appear, the case for the Gene Therapy Plan becomes incredibly compelling.

All diets have their goals. Some are focused on losing weight, others on reducing risk of heart disease. Some have a vague wish to “detoxify,” or purge the body of harmful toxic buildup from pollutants and metabolic waste.

The Gene Therapy Plan can achieve those objectives, but its purpose is much more basic and comprehensive. It is designed to keep dormant disease dormant, and to help active disease go back to being dormant. And it does so in an integrated way that keeps a multitude of health variables in proper balance.

Too many eating plans promote one kind of virtue (for example, weight loss) at the expense of others (such as cancer prevention). But it doesn’t make much sense to slim down if in the process we incur a higher degree of total-body inflammation, which can lead to other problems. In the same way, it makes little sense to eat for heart health while ignoring the possibility of cancers. The Gene Therapy Plan weaves all these elements into a consciously holistic picture of total human wellness that also addresses all the microscopic dormant and precursor conditions that could, given the wrong ecogenetic influence, turn into illness.

By far the biggest causes of death in the United States are heart disease and cancer, accounting for around 50 percent of all deaths each year. Diabetes is another major killer. Obesity, systemic inflammation, and exposure to environmental toxicants are contributing factors to all these and many other disease conditions. Aging is a process we all undergo, and while its effects can’t be avoided entirely, they can be managed in order to optimize quality of life.

Taken together, these conditions and processes are among the most significant obstacles to health and happiness. They are, therefore, necessarily the primary targets of ecogenetic nutrition and the Gene Therapy Plan.

The plan is designed to help you:

   • resist cancer
   • resist heart disease
   • resist diabetes
   • maintain a healthy weight
   • reverse low immunity
   • ameliorate the effects of aging
   • remove toxins from the body
   • promote energy

Anyone who wants to improve his or her health can benefit from the diet simply by following its general guidelines for better nutritional choices. There’s no rigid formula. You don’t have to sign on for a complicated program with steps and levels and layers. At the same time, though, anyone with specific concerns can follow the diet’s more directed recommendations and use it preventively to lower the risk of a specific disease long before any symptoms become apparent. And those hoping to reverse specific disease processes can use the plan in an even more targeted and nuanced fashion. In postmenopausal women, for instance, vitamin D deficiency can lead to osteoporosis and a greater likelihood of fractures, so increasing supplemental and dietary intake of vitamin D will help most women decrease the risk for fractures. But not all women. Differences in genetic makeup mean that not every postmenopausal woman has the same vulnerability. So increasing the amount of vitamin D should not be a blanket recommendation for all women.

At this point I know that some of you are probably thinking, “But what if I’m concerned about several diseases? Will the Gene Therapy Plan help me if I want to lose weight, have a family history of cancer, and want to prevent wrinkles?” In a word, yes! That is what the Gene Therapy Plan is all about—preventing and treating diseases at the level of your genes. In the case mentioned above, I discuss how vitamin D can help prevent bone fractures in postmenopausal women. But in addition to strengthening bones, vitamin D has many other benefits: it fortifies immunity, improves brain and heart health, and protects against cancer. So as you read these recommendations, particularly in the disease-specific chapters, keep in mind that these nutrients have many benefits. The book is organized by health conditions (e.g., heart disease, cancer); however, real-life medical problems are rarely so clean-cut. The nutrients presented here all have many bioactive substances whose healthful effects can be seen in the entire body. Good health begets good health: as you incorporate the advice laid out in the book, you’ll be on your way to living a happier, healthier life.

In the first chapter, I lay out what I call the Basic Plan, the general nutrigenetic principles of healthful eating that apply to anyone and everyone.

With those comprehensive guidelines established, I then move on to address the specific ecogenetic approach to the five most pressing health concerns of our population—obesity, heart disease, cancer, diabetes, and aging—each addressed in one of five targeted chapters.

I then provide menu plans and recipes that easily guide you toward incorporating the basic nutrigenetics concepts into your daily regimen.

Many of the recipes in this book were adapted from those passed along to me by my mother, which can give you some idea of the depth of my lifelong personal commitment to developing and sharing this approach to targeted nutrition.

Even though it was not acknowledged at the time, my mother always suspected that her cancer had been triggered by the DES she’d been treated with during her first pregnancy. But then, years later, in an undergraduate biochemistry course, my professor declared emphatically that pharmacologic estrogen had been shown to cause cancer in animal studies and that this had been known for thirty years. And yet those findings had not been absorbed into clinical practice. This was the first time it occurred to me that my mother’s life might have been spared if only existing knowledge had been acted upon.

Today we have vastly more knowledge about how substances affect gene expression, in ways both good and bad. It’s this knowledge that I’m now pleased to pass along to you in The Gene Therapy Plan.

Part I

Targeting Disease with Gene Therapy

Chapter 1

The Basic Plan

VIEWED FROM A NUTRIGENETIC PERSPECTIVE, the average American diet is not a pretty sight. In general, most Americans eat far too much food that is high in carbohydrates, high in saturated fat, and high in sugar. About 33 percent of calories in the average diet come from fat (around 11 percent in the form of saturated fat), about 15 percent from protein, and about 52 percent from carbs.

Having slightly more than half our calories come from carbs seems disproportionate in itself, but the picture is actually worse than that, because the average American’s diet is all too often filled with the worst kind of carbs: simple, processed sugars, high-fructose corn syrup, milled white grains. Among the highest-calorie sources for the average adult are sugary pastries, bread, soda, pizza, pasta, and alcohol. This is not just disproportionate but extraordinarily skewed in a single ruinous direction, massively tilted toward foods that contribute mightily to the five conditions that concern us most: cancer, heart disease, inflammation, obesity, and premature aging.

The Basic Plan is what I propose as a first step in changing direction and regaining solid nutritional footing. It is a broad-based approach to eating rooted in very sophisticated science, but I’ve deliberately kept it simple and made it practical enough to work for real people in real life. After all, a diet does not have to be a cult. And if a diet is too extreme in its demands—if it requires too great or too eccentric a deviation from “normal” eating patterns—people will lose their motivation and begin to backslide.

That is why the Basic Plan is centered on just a few basic concepts, and why the concepts themselves are offered as guidelines, not ironclad behavioral prescriptions.

The fact is, even with the strictest dietary regimens, positive, measurable results can and do often follow from only partial compliance. In other words, you don’t have to follow a diet perfectly in order to benefit from it.

Take, for example, the widely reported results of the yearlong 2007 Stanford study that compared weight reduction across four popular diets: Atkins, Zone, Ornish, and LEARN. As published in the Journal of the American Medical Association,1 the study seemed to demonstrate that the Atkins diet produced the largest weight losses—about 10 pounds against a range of 2.5 pounds to 5.5 pounds measured in the others. But was it actually the Atkins diet that was being tested? If you look closer at the details of the study findings, you find that those in the Atkins group did not actually eat the diet they were supposed to. According to the Atkins recommendations, the dieters should have stuck to less than 20 grams of carbs daily for the first two months, and then less than 50 grams for the remainder of the study. But the researchers reported that the Atkins group averaged around 60 grams at two months into the diet, around 113 grams at six months, and nearly 140 grams at the study’s end.

This is not to say that low-carbohydrate diets don’t do what they claim—indeed the better weight loss results for Atkins in this study suggest that lowering carbs (which the dieters did successfully do in comparison with those on the other diets) can be effective. But the point is that no one in the study actually did the Atkins diet. Or at least we must question whether we would want to attribute the study’s results to the eating plan that goes by the name “Atkins.” Or “Zone” or “Ornish” or whatever.

For in fact no one actually “did” any of the other diets either. The Zone eaters never achieved their goal of a 40-30-30 breakdown across carbs, proteins, and fats. The closest they came was at two months, when they averaged 42 percent, 24 percent, and 35 percent respectively. Thereafter, like every other group in the study, they faded back toward baseline. The LEARN eaters never once hit their 55 percent to 60 percent target for carbs. The Ornish eaters never came close to eating less than 10 percent fat, as prescribed. Similar variances can be seen in many other studies, including an impressively comprehensive and long-running 2009 trial done at Harvard.2

The point is, all you can ask is that you do the best you can, by first empowering yourself with the best available information so you know that what you’re committing yourself to is worthwhile. You then need to frame your choices in keeping with edible ecogenetic principles, so that you are reliably moving toward the bulk of the best benefits, without getting upset about a percentage point of difference here or there, or worried about being perfect in your compliance.

In keeping with the effort to be compliance-friendly, and to simplify and demystify the search for a more healthful diet, the Basic Plan is grounded first and foremost in what I call the Rule of One-Thirds.

Concept 1: The Rule of One-Thirds

Flying in the face of the high-protein, low-carb, reduced-fat orthodoxy that has dominated dietary thinking for more than a generation, my Basic Plan suggests that you consume roughly one-third of your calories from each of the three major macronutrient groups of fats, carbs, and proteins. According to the latest science, there is simply no rationale for any one group of nutrients to be favored or marginalized.

After all, human beings evolved eating a remarkable mixture of foods, often available at different times in different quantities and proportions. And the effects of many foods are synergistic, while the effects of many others are still unknown. Artificially skewing the slate in one direction or another can rob us, in ways that aren’t immediately apparent, of beneficial interactions between various elements.

An even distribution of nutrients allows you to benefit from the good qualities of each while avoiding the pitfalls of overdependence on any one thing. Too many carbs can lead to insulin insensitivity and inflammation. Too much fat deprives you of necessary fiber and phytochemicals. Too much protein is likely to be high in saturated fat, and in any case eating a high-protein diet is extremely difficult to maintain for long as it eliminates whole groups of foods that one’s body needs and craves over time such as whole grains, fruits, vegetables, and dairy. The high-protein, low-carbohydrate diet is actually a high-fat, low-carbohydrate diet that often contains 55 percent to 60 percent of calories from fat, especially saturated fat. People are not obese because they consume carbohydrates. They are obese because they consume too many of the wrong types of carbohydrates, just as eating too many of the wrong fats or proteins can cause the body to lose calcium and become deficient in carotenoids, critical nutrients like tocotrienols, vitamin B6, magnesium, and fiber. Solid research supports the idea that breaking macronutrients roughly into thirds is a healthy foundation for eating, not least because of the way it can liberate the way you think about food. Again, there is no need to be obsessive about maintaining a precise balance every day or with every meal. Simply be mindful of the principles outlined in the following chapters and follow the meal, juicing, and targeted nutrient recommendations at the end of the chapters and in the final section of this book. Beyond that, let common sense be your guide. For instance, if you have pizza for dinner on Monday, don’t continue the carbohydrate theme on Tuesday by having pancakes for breakfast.

To see more deeply into the rationale for the Rule of One-Thirds, let’s look at each of these three food categories in turn.

Fats

Fats have gotten a bad rap in recent popular nutrition. In the 1980s, even the standard-bearing USDA zeroed in on fat as a public menace. In a context of rising obesity, some of this is understandable: fats are nutrient dense (they have 9 calories per gram, as opposed to the 4 calories per gram of carbohydrate and protein), so any diet that simply wants to maximize weight loss, and equates weight loss with fewer calories, will tend to limit fat. But as with everything else, the true picture is more complicated, which in this case means there are good fats and bad fats depending on your goals.

The Seven Countries Study, one of the classic nutrition studies, tracked more than twelve thousand men in the United States, Europe, and Japan beginning in 1958 and looked specifically at diet, lifestyle, and heart disease risks. Of all the populations studied, Greeks from the island of Crete had the lowest incidence of heart disease, the longest life expectancy, and among the highest levels of fat intake, at over 40 percent of calories. What this suggested was that fat by itself does not harm you. But more than that, as we’ve learned since 1958, fat in the right forms can do you a lot of good.

In the 1950s and 1960s the Cretan diet was rich in fruits, vegetables, legumes, and whole grains, and the preponderance of the fat they consumed was in the form of olive oil.

Olive oil is a mainly monounsaturated fat; along with polyunsaturated fats, it promotes good (HDL) cholesterol and reduces insulin sensitivity. The dangerous fats—those that may increase risks for both heart disease and cancer—are saturated fats and, especially, trans fats. Trans fats, formed by the hydrogenation of vegetable oil and used to make processed foods harder so as to extend their shelf life, are among the worst things you can put in your body. They raise bad (LDL) and suppress good (HDL) cholesterol levels, make the bad cholesterol even worse by miniaturizing its particles (meaning it can sneak into smaller spaces and do more damage), and promote inflammation (and therefore diabetes and a host of related ailments).

As just one example of the harm trans fats can cause, a 2008 study published in the American Journal of Epidemiology showed that women with the highest serum levels of these fats had up to a 75 percent increased risk of breast cancer.3 Another study published in Cancer Epidemiology, Biomarkers & Prevention in 2008 found men with the highest serum levels of trans fats also had an increased risk of prostate cancer.4

The Four Fats

So what the Basic Plan recommends in terms of fat consumption is straightforward: replace bad fats (excessive saturated fats, all trans fats) with good ones (monounsaturated and polyunsaturated fats). There is no need for the average person to limit all fats indiscriminately; the evidence is that good fats have good effects, and they also can usefully replace an overreliance on carbs.

If you’re on a 2,000-calorie-a-day diet, just under 700 calories can come from dietary fat. Fat contains 9 calories per gram, so this translates to about 65 grams of fat a day. Aim for polyunsaturated fats to make up 10 percent of your calories, or about 22 grams each day if you follow a 2,000-calorie diet, and monounsaturated fats should make up the remaining fat in your daily allotment, adding up to 20 percent of calories, or about 45 grams per day. Good sources of polyunsaturated fats include fish, grapeseed oil, sunflower seeds, and soybeans. The best sources of monounsaturated fats include nuts, avocados, and olive oil.

Carbs

If anything, carbohydrates have been even more vilified recently than fats. “Low carb” has become almost as common an advertising ploy as “low fat.” Store shelves are filled with “low-carb” snacks and treats, all purporting riskless and convenient satisfaction. Look out! If the big processed-food companies are telling you that a food sounds too good to be true, it almost certainly is. Most prepackaged synthetic foods are the result of exactly those dubious chemical processes that, for the sake of your genome, you want to avoid.

But some of the anticarb bias is well deserved. Modern diets worldwide, influenced by American patterns, tend to overemphasize carbs generally and many of the worst, highly processed carbs specifically. One important randomized study, the OmniHeart study,5 separated participants into three groups, each consuming a heart-healthy diet, but one emphasizing high carb consumption, one protein consumption, and one fat consumption. The study showed that risk factors for heart disease could be significantly improved simply by replacing 10 percent of a standard high-carb diet (54 percent carbs) with either unsaturated fat or protein. In other words, lowering your intake of carbs can indeed make you healthier.

I mentioned above that one good reason not to restrict carbs too drastically is that you don’t want to cut yourself off from all their beneficial micronutrients. Most carbohydrates break down into glucose—the main fuel source for all cells and the only type of nourishment your brain utilizes. And carbohydrate-rich fruits and vegetables are chockablock with vitamins and minerals. Spinach, broccoli, and kale provide vitamin K, which aids calcium regulation. Citrus fruits like oranges and lemons provide vitamin C, a powerful antioxidant that also prevents scurvy.

But there are plenty of other reasons to change your carb habits. Since carbs are basically digested into sugars, they are the primary regulators of insulin, the body’s sugar-shuttling hormone. Insulin, in turn, has a variety of crucial functions: not only moving sugar from the blood into the cells, but also signaling the body to store energy in the form of fat. Thus carbs can have a big impact on one of today’s primary health concerns, obesity.

Nearly all foods, with the exception of meat, eggs, and seafood, contain some carbohydrates, so it is vitally important to be consuming the right kind of carbs. There is so much junk out there—and not only the fast food you buy on the run, but all the cheaply made, conveniently packaged, heavily sweetened and texturized products that are the staple of American eating. If it comes in a box or a wrapper or a bottle, feels unnaturally smooth and tastes too pleasantly sweet, and has a long list of unpronounceable ingredients, it’s probably a processed carb that can do you almost nothing but harm. Even most bread and pasta, plain as it seems, has had most of the cancer-preventing, insulin-normalizing fiber stripped out of it. There’s almost nothing left but the soft, sweet interior of the grain, which we were never intended to eat without all the other healthy stuff too.

For example, over 80 percent of vitamin E and magnesium are lost from wheat when it’s processed. These nutrients are vital to insulin regulation, which is why it’s not surprising that people diagnosed with diabetes are often vitamin E and magnesium deficient. Chromium and zinc are also important minerals lost when sugar is highly refined, yet these minerals are necessary for digesting and metabolizing carbohydrates.

What does the body do when it can’t get necessary nutrients from food? For one, it constantly “feels” hungry. Then, as the body continues to be denied the nutrients it needs from food, it will start to deplete nutritional stores, leading to deficiencies.

Each gram of carbohydrate contains about 4 calories, so if you follow an average 2,000-calorie diet and you want one-third of those calories to come from carbs, you need about 180 grams of carbs per day. If you tend to stick to a 2,500-calorie diet, you’ll need 225 grams of daily carbs. So a good rule of thumb is to have roughly 45 to 60 grams of carbs per meal and 15 to 30 grams for snacks.

For a good carbohydrate snack, I tell my patients to choose Swiss cheese, four 1-ounce slices of which contain about 4.5 grams of carbs along with 319 calories.

Nuts are another healthy carb snack that, like cheese, also contain a lot of calories. One ounce of dry-roasted almonds (about twenty-two nuts) contains a little over two grams of effective carbohydrate. One ounce of dry-roasted pecans contains about one gram of carbs.

Proteins

Americans typically get around 15 percent of their calories from protein, mainly from meat and milk products. These, as we’ve already discussed, are high in saturated fat, so the goal of one-third protein will require eating not only more protein, but ideally protein that is more nutritious. As with fat, one very good reason to eat more protein is simply to substitute it for excessive carbs.

There is some evidence that eating higher than typical—though not extremely high—levels of protein has a number of independent beneficial effects. Some studies have suggested that protein can protect against heart disease. The protein-based diet in the OmniHeart study lowered LDL cholesterol further than the carbohydrate-rich diet did, and it scored better on some lipid markers than the fat-substituting version of the diet.

Protein also tends to have a satiating effect—you feel fuller when you eat more protein, in part because it moves more slowly than carbs through your digestive system. Similarly, because its effect on insulin is muted, it also doesn’t provoke the quick return of hunger after a meal. So protein can be particularly useful for weight maintenance. And because fighting obesity is such a crucial threshold for health, eating more protein can be considered an important part of the basic goal of resisting diabetes, cancer, heart disease, and the other nasty hallmarks of the self-perpetuating metabolic spirals.

A recent study demonstrated a way of maximizing the benefits of protein consumption by distributing your intake more evenly throughout the day. Researchers compared two groups of volunteers who consumed 90 grams of protein each day, primarily in the form of lean beef. One group ate 30 grams of protein at each meal, while the other group ate 10 grams at breakfast, 15 grams at lunch, and 65 grams at dinner. The volunteers who consumed the evenly distributed protein meals had a twenty-four-hour muscle protein synthesis 25 percent greater than those subjects who ate according to the skewed protein distribution pattern. Better muscle synthesis means a more efficient utilization of calories, and less protein being oxidized and ending up as glucose or fat. So balancing your protein intake throughout the day is key. Add an egg, a glass of mixed vegetable juice, Greek yogurt, or a handful of nuts to get closer to 30 grams of protein in the morning. Do something similar to get to 30 grams for your midday meal, and then consume no more than 30 grams of protein for dinner. Many of my patients are in the best shape of their lives after fifty by simply bringing back the balance that helps them shed the fat, build muscle, and look younger.6

Distributing your protein throughout the day is easier than you might think. Here are some suggested sources of protein and the amount each provides:

   • Lentils contain 18 grams of protein per cup cooked. They are easier than other legumes because you do not need to soak them to cook in advance and they cook quickly.
   • Whey or part-skim ricotta cheese contains 14 grams of protein per half cup. This is great to put on whole grain pancakes with honey for breakfast.
   • Shrimp contain 12 grams of protein per 3 ounces.
   • Eggs contained 6.3 grams of protein per large egg.
   • Beef contains 30 grams of protein per 4-ounce serving. This 4-ounce serving also contains only 275 calories.
   • Hempseeds contain 13 grams of protein per quarter cup. These are great to sprinkle on salads or other foods to add a crunchy texture.
   • Edamame contains 8 grams of protein per cup (in the pod). You can buy these precooked in the frozen section of the supermarket.
   • Greek yogurt (Fage 2 percent plain or Oikos traditional plain) contains 18 grams of protein per 6-ounce container or 24 grams of protein per cup. This is great with fruits, nuts, or honey.
   • Light or 2 percent fat cottage cheese contains 21 grams of protein per 6 ounces. This is great with berries or walnuts.
   • Quinoa contains 8 grams of protein per cup cooked. This is a great gluten-free choice for breakfast mixed with almond milk, banana, and honey.
   • Almonds contain 5.9 grams of protein (and 169 calories) per ounce (roughly twenty-two nuts).
   • Walnuts contain 4.3 grams of protein (and 184 calories) per ounce (roughly fourteen halves).
   • Cashews contain 4.3 grams of protein (and 163 calories) per ounce (roughly eighteen halves).

Concept 2: No Fads, No Faux Foods

As I’ve tried to show with my Rule of One-Thirds, there is no single food group responsible for all our ills. Nor is there a single food group or nutrient that can put us on the path to health. Yet the popular culture continually throws up new dietary villains or saviors to capture our attention.

Can you ingest too much wheat? Of course you can, but you can also ingest too much water. Is gluten bad for you? It certainly is if you are among the 6 percent of our population that has a gluten sensitivity. But that leaves 94 percent of the population with no reason to avoid it. Meanwhile, the other nutrients in whole grains are essential to health. The British Medical Journal recently reported the results of a ten-year study of four thousand Americans showing that those who ate the most cereal fiber had a 27 percent lower mortality rate from heart attacks during the study period.7

Is sugar bad for you? My response is that all sugars are not the same, and some actually confer health benefits. So I don’t ask my patients to adopt a total ban on sweets, but I do prefer that they rely on sweeteners derived from honey, maple syrup, coconut, or stevia, a sweet substance derived from a plant related to daisy and ragweed. These sweeteners have lower “glycemic indices” than refined cane sugar, meaning they require less insulin for them to be metabolized, thus avoiding the insulin imbalance that can lead to a number of chronic conditions, most notably diabetes.

My advice is to avoid extremes and avoid rushing to the dietary passion of the moment. It also pays to realize that we are subjected to billions of dollars in marketing money spent by the food industry each year to shape our thinking and our buying habits. For generations, convenience, packaging, and profits were the dominant considerations rather than health and nutrition. But then the same food industry discovered that they could build a new growth sector by promoting certain foods for their health and weight loss benefits. So knowing what’s actually good for us—as opposed to what’s good for the industry—becomes increasingly difficult. For instance, fat provides more than twice the amount of energy per gram than carbohydrates and proteins. Since fats contain more energy, and excess energy obtained from food is usually stored as fat, you can see how consuming too many calories precipitates weight problems.

Here are a few examples of food “posers” that appear to be healthy on the surface, but a closer look reveals that they are surprisingly high in calories, the wrong kinds of fats and sugars, and salt:

   • Whole ground turkey contains more fat than ground turkey breast or 97–99 percent lean turkey meat.
   • Store-bought smoothies are likely to have little fiber and lots of the wrong kinds of sugar, so you end up feeling hungry faster after drinking them. Blend your own smoothies with real fruit to promote fullness (see Chapter 9 for my healthy recipes).
   • Sports drinks contain electrolytes for people who need to replenish what they’ve lost after an intense workout, but they also contain lots of the wrong kinds of sugars. So my recommendation for the average person after an average workout: when you’re thirsty, drink water—and that means tap water. “Enhanced” water contains minerals and vitamins, but you’re probably already getting enough of these through your diet. Tap water is the most efficient and economical way to hydrate your body, although installation of a reverse osmosis water filter is a good idea if there is concern about your water quality.
   • Granola bars and flavored yogurt may be your breakfast pick du jour for a rushed morning, but these foods are packed with refined sugar. Instead, try steel-cut oats with fruit or add fruit or nuts to low-fat plain yogurt.

Beyond the simple guidelines of the Basic Plan, there is no need to seek out exotic, specially crafted foods, as these may in fact do more harm than good. Along with lowering carb consumption while increasing good fats and protein, I recommend moving away from the oversweet, too easily digestible carbs that will spike insulin and inflammation as well as promote cholesterol and weight gain (and thereby obesity, diabetes, cancer, and the rest). I also recommend moving toward the kinds of carbs that contain fiber and all the micronutrients that are bioactively beneficial. I encourage you to eat fewer boxed, wrapped, sliced, or synthesized carbs, and more whole foods, whole grains, legumes, fruits, and vegetables, and to eat red meat and dairy in moderation. I also encourage you to rely on walnuts, almonds, and cashews as a healthful snack food in place of chips or energy bars. They are filled with protein and the good fats we explored above, and have been shown to reduce heart disease.

I find that many of my patients appreciate having simple yes/no choices set out for them, which makes compliance a no-brainer. So here is a bare-bones guide that reduces the Basic Plan to a summary that could almost fit on the back of a business card and can help you remain steadily on course as you navigate the maze of dietary fads and conflicting food claims:

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Additional information

Dimensions	0.8400 × 5.5100 × 8.3700 in
Imprint	Penguin Books
ISBN-13	09780143108191
ISBN-10	0143108190
Author	Mitchell L. Gaynor, MD, Mehmet C. Oz M.D.
Audience	General / adult
BISAC	HEA010000, HEA039000
Subjects	health and wellness, public health, self help books, healthy living, clean eating, reference, clean, motivational books, motivational books for women, health books, fitness books, diet, health and fitness, diet books, nutrition books, medical books, self development books, self improvement books, motivational books for men, personal growth books, HEA039000, medical, self improvement, psychology, healing, wellness, self help, work, health, happiness, HEA010000, parenting, nutrition, motivation, aging, medicine, Cooking, Food, Cookbooks, fitness, cookbook