By Mark Huberman

This interview originally appeared in the Spring 2015 issue of Health Science magazine, the member magazine of the National Health Association, of which interviewer Mark Huberman is the president.

Dr. Erwin Linzner completed his undergraduate training at the California State University, Los Angeles. He then went on to graduate Magna Cum Laude and as class valedictorian from Western States Chiropractic College. Dr. Linzner worked as an accountant and computer programmer prior to becoming a doctor. In 1994 he became affiliated with the TrueNorth Health Center. Dr. Linzner understands the importance of addressing the entire individual, physical as well as emotional, in guiding his patients in their process of healing. He incorporates soft tissue manipulation in the treatment of myofascial and connective tissue disorders, and spends the time to correct joint problems in the extremities as well as the spine.

MH: When you were first introduced as a new hygienic physician to the readers of Health Science magazine way back in January of 1997, I recall that your door to Natural Hygiene came from reading Fit for Life. What was it about that book that you found thought-provoking?
EL: It was an accumulation of things. I’ve learned over the years that we always reject information at first, even if it’s true, and I did this in my twenties. I had a good friend who was eating plant-based; I’m pretty sure he was vegan. And he would make salads and baked potatoes for me when I’d visit him. Then I would go to McDonald’s afterwards. But then in my thirties, I guess I was about 34, I read the book Fit for Life, and it really made sense to me that we are designed to have an optimum diet, and if you deviate too much then things aren’t going to work as well. And that made sense to me, just like nobody puts sugar and dirt into their gas tanks; we shouldn’t be doing that either with our food. One day I said, “Okay, I’ll give this a trial for a full week,” and luckily for me I woke up after three days of plant-based eating and my energy just bounded; it was just phenomenal.

Were you having any health problems at the time?
Yes. I never had energy. I’d get up at 8AM but I didn’t feel like I was actually moving until about 11AM. And I had frequent cold, and would be out of work for two or three days. I knew something wasn’t right.

One of the great things for the NHA was that Fit for Life and its authors, Harvey and Marilyn Diamond, didn’t have an organization of their own, and so they referred people who wanted to gain more information about the program to us. Is that how you were introduced to the NHA?
That was it. I started getting literature from the NHA, about once a month, and then one day I got a flier that Dr. Alan Goldhamer was giving a talk in Santa Monica, and I became interested. Also on the program were Dr. Jennifer Marano and Dr. Alan Immerman. Dr. Goldhamer spoke about water fasting and getting people well with fasting and healthy eating. It made so much sense to me and got me excited about wanting to make a difference in people’s lives; so I decided to follow in Dr. Goldhamer’s footsteps and go to Western States Chiropractic College.

Were there there other books that you read that helped frame your thinking?
I, of course, read almost everything from Dr. Herbert Shelton, and I was particularly inspired by his book, Fasting Can Save Your Life.

After reading the book, did you undertake a fast yourself to fully understand the experience?
At the time, my wife needed it more than I did. So I thought I’d let her be the guinea pig. So I sent her up to Dr. Goldhamer.

What a generous husband!
Well (chuckle), she had a history of smoking and was a little overweight, so I said why don’t we send you up there to clean out a bit. She was open to it, and did quite a long fast of over 20 days at Dr. Goldhamer’s first facility in Penngrove, California, called the Center for Conservative Therapy.

Was that eye-opening for her?
Oh, yes! It was eye-opening for us both. She lost weight and really looked radiant. It was just amazing. After that I did a fast as well, but only for about five days. (Dr. Linzner and Carolyn pictured at right.)

Do you remember the first NHA conference you attended?
I think it was Georgetown University back in 1994 right after I joined Alan.

Were there other hygienic physicians that you met who were influential in your thinking?
Two that impressed me a lot were Dr. Alec Burton and Dr. Keki Sidhwa. Believe it or not, on my bus ride from the airport I found myself sitting next to Dr. Sidhwa. It proved a wonderful opportunity to begin picking his brain.

How did you wind up working at TrueNorth?
After doing my fast at TrueNorth, I was really impressed with the work that Dr. Goldhamer was doing, so I said to him, “I went to your talk in Santa Monica last year, and it really motivated me to do this kind of work; so I am going to go to Chiropractic College to involve myself in the same kind of work.” To my surprise Alan said, “Great! As soon as you graduate, give me a call.” 

And you did?
Indeed I did. Of course I checked with him as things went along to make sure he was serious about it and that he would still bring me on when I graduated. And he said, “Yeah, yeah, keep working. We’re waiting for you.” Immediately after graduating, he gave me the opportunity to do an internship, and when that was completed he made me part of the staff. It was a great experience.

I know that Dr. Goldhamer still offers internship opportunities to young physicians. Why is it important to do an internship in fasting supervision?
It’s the best, and probably only, way for doctors to actually learn what works and what doesn’t. And it’s pretty phenomenal to actually see people get well from diet changes and fasting. I’ve seen some pretty miraculous recoveries.

Are there any that really stand out in your mind?
There have been many. In my first year at TrueNorth I helped care for a gentleman in his forties who was a drug addict, obese, and in congestive heart failure. When he was dropped off at the center, he was huffing and puffing just trying to get to the door. And I remember thinking, “Oh boy, this isn’t good. We are actually going to fast this guy?” I think he was referred by a medical doctor in Santa Rosa who told him that this was his last chance to get healthy. And that if we couldn’t help him, there probably wasn’t anything that could be done for him. Because of his situation, he was prepared to do whatever we asked of him. I don’t recall how long we fed him before we started fasting him, but we fasted him about 34 days. Amazingly, after breaking his fast, this guy who couldn’t walk from his car to TrueNorth’s front door ended up walking up a significant hill nearby! He then started walking 10 miles a day and truly started a new life. It was really amazing to see.

During my recent interview with Dr. Frank Sabatino, he felt there was a great place for fasting and a hygienic lifestyle in the true recovery from addiction. Do you agree?
Yes, I do. However, people recovering from addiction are often tougher to manage. But if they’re motivated and are willing to do the hard work, they’re going to get better quicker.

Over your past 18 years at True North, are there other conditions that you’ve seen respond particularly well to fasting?
I remember a young woman, maybe in her late twenties, with severe rheumatoid arthritis. She could not reach her head to do her hair. She fasted close to three weeks and had a great result. I remember how excited she was when she was able to do her own hair again.

What do you think the power of fasting is?
Fasting does a lot of things, but the one big thing it does is rejuvenate the body. During a fast you are breaking down old tissue and diseased cells that actually get rebuilt with new material. You get enzymatic induction, and you clean out your arteries. Excess fluid and salt leave your system. And your immune system strengthens; not necessarily during the fast but certainly afterwards.

Do you think that everybody needs to fast, or that everyone would benefit from fasting on some level?
Yes, I think everyone could benefit from periodic fasting. Even if you eat a really healthy diet, I think every four to five years it’s a good idea to undertake a fast to cleanse the palate, detox, and give your body a rest from digestion in a way that will allow the body to heal.

Is there a danger for people fasting themselves, and is there a limit to how many days people can go without supervision?
Fasting of any significant duration should be done under supervision by a medical professional. This is particularly the case for people on medications, because dramatic things can happen during the fasting state. However, if you are not on medication, a fast of two or three days is generally safe.

Can people get off their medication following a period of fasting and diet modification?
Absolutely! I have probably seen a thousand patients with hypertension who had normal or near normal blood pressure after fasting and no longer needed medication. I can count the number of failures on one hand. That’s pretty phenomenal. And even if they don’t get full resolution, they still see substantial improvement. The same is true for many people suffering from diabetes who were on medications.

How do you motivate people to adhere to the health program after a fast, and not slip back to hold habits and temptations once they return to their homes and jobs?
For most people it’s a process. The majority of people don’t make changes overnight. What I see is that people get better each time they come in. So they may come once a year or maybe even twice a year. The first time they give up the cigarettes and the second time they give up the beer and they eat more vegetables. For others, they just get it and they do the right things for a while. However, stresses get in the way when loved ones die and people lose jobs, for example. After those types of emotionally charged events, people can fall back into old habits of trying to get pain relief by eating crappy food.

Is that what Drs. Goldhamer and Lisle call the “Pleasure Trap”?
Yes. You feel a little better because you have some endorphin releases from the fatty foods you’re eating. But this is very short-term. The damage, however, will last for days, and if you do that for any period of time, health problems start up again.

My late father used to say that if you went to a hygienic facility or you came to an NHA conference, it would “recharge your battery.” Do you also find that to be the case at TrueNorth?
Yes—not only physically but mentally. I think one of the most important things we offer is the daily lectures. We offer people two a day, affording them a wonderful opportunity to understand the things we recommend them to do. People often deceive themselves into believing that they are eating healthy but they actually are not. I had a new patient today who started just that way. He said, “I eat pretty healthy.” But he was on hypertensive meds and he was a diabetic on medication. I told him gently, “Well, you know, the plant-based way is much better than what you’re describing.” I added, “If you were actually eating healthy you wouldn’t be taking those medications.” That seemed to get his attention, and I was able to convince him to make dietary changes during his first visit.

People must find it very liberating to get off of their medications.
Absolutely! You know, most people know that their medications are doing them damage. They don’t feel well when they take them, since there are almost always toxic side-effects. So they know that they’d rather not be on medication; but it’s still so hard for people to make the necessary changes.

Is that because taking drugs is so easy and offers a short-term suppression of their symptoms?
That’s right. I try to get people to realize that health is not free. You have to do a lot of work to actually be healthy. Health is not a given, and if you’re not willing to pay the price of the hard work, you’re going to be paying a different price, such as heart disease, cancer, diabetes, stroke, dementia, and/or a long list of very unpleasant conditions that western populations face. So which price do you want to pay? We hope that people choose the price of short-term deprivation where you’ll go through a withdrawal period while not engaging in your usual short-term pleasure seeking activities. And that process may take two or three months. But if you’re not willing to pay that price, you’re going to be paying a much bigger price: poor health.

I think when I interviewed Dr. Caldwell Esselstyn, he said it was his belief that nearly all of the degenerative diseases you were just describing actually need not exist. Do you agree with him?
Oh, absolutely. It is so true. Obviously some of the cancers are not clear, and even healthy people get ill, but the vast majority would not exist if people followed our whole-foods, plant-based lifestyle. And then when people did have heart attacks, we’d be writing them up in the health journals because they’d be so rare!

Does everyone come to TrueNorth to fast or can they just come to eat and learn?
You can do both. Dr. Goldhamer has hired a wonderful chef, and his staff does such a great job of presenting healthy foods. We actually get many people that come just to eat and exercise who can’t fast due to their myriad of health conditions. We also have lots of people that come in just to eat or maybe to go on a modified juice fast because they’re still on some medication. (Pictured at right: Dr. Linzner at TrueNorth in Penngrove in 1996)

How does juice fasting differ from water fasting?
Both juice fasting and water fasting use the body’s ability to burn fat and accelerate the detox process. Water fasting, however, is a much faster process of getting people healthier. This may mean, however, that there are more symptoms, such nausea, vomiting, back pain, headaches, itching, etc. So, people who don’t want to go through the rigors of water fasting can choose to do juice fasting, which is typically less symptomatic. Also, for some patients who are on medications and/or where the doctor feels that water fasting is inappropriate, juice fasting can be a safer alternative.

How has the center changed from those early days when it was called the Center for Conservative Therapy (located in Penngrove) to TrueNorth Health Center (located in Santa Rosa)?
One of the biggest things is that we’ve brought on medical doctors. When I first came on staff, we had Dr. Ron Cridland, but he left shortly thereafter, and for a while we didn’t have any medical doctors. Today we are fortunate to have several serving the facility, and that is very helpful because we get patients with more significant health problems than we used to; and our medical doctors also have the ability to manage patients’ medications and complex conditions. We get sicker people nowadays, but often even they can get off of most of their medications despite not being able to fast.

When patients stay at TrueNorth, do you collaborate with the other physicians there, concerning their care?
We have weekly meetings, and the doctors discuss each patient’s case to see what we can do better.

Do you have a specific role at TrueNorth Health, or are you just one of the staff physicians that do everything?
I have two roles. I do the morning rounds for fasting supervision to make sure everyone is having a safe fasting experience. I also do chiropractic treatments for both our residential participants and local patients for a variety of musculoskeletal conditions.

What impact do you think documentaries like Forks Over Knives have had on this country’s health consciousness?
A lot. I’ve been on a plant-based diet for 28 years now, but when I first went vegan my family went ballistic. I remember one of my cousins saying, “You’re crazy. You’re going to get sick and die; you’re going to have protein deficiencies.” I just looked at him and chuckled. But you know, that was the mindset back then, not just by family and friends, but also the medical society, the media, and the American Dietetic Association. That’s changed a lot, and much of the credit goes to that great film and the wonderful work of the physicians profiled in it. Today, when you talk to people about getting on a plant-based diet, they usually have heard of it and more often than not even respect it.

Do you still have to defend such questions as, “Where do you get your protein?” and “Why don’t you drink milk?”
Yes, but not as often as 25 years ago. But many people still believe that protein only comes from meat and that cow’s milk is necessary for strong bones.

What do you think of the “super food” emphasis being given to greens like kale, spinach, and bok choy? Is this the wrong way to think about simply good eating?
Not at all. Dr. Joel Fuhrman talks a lot about micro-nutrient density, and he is right on. These green leafy vegetables are some the most important foods to eat because they are very high in vitamins and minerals, as well as nutrients we probably haven’t even discovered yet. So it’s very important to eat your greens.

Isn’t one of the great benefits of following a hygienic, plant-based, minimally processed diet is that you don’t have to worry about how much protein, vitamins, and minerals you are taking in?
Yes, it’s such a relief. I know if I just stick to eating whole foods that are plant-based, with maybe a little exception of B12 and vitamin D, I really don’t need to worry about anything else.

Are you optimistic that we are becoming more health conscious in America?
Oh, definitely. As I mentioned earlier, there’s been a major shift in awareness, and even fasting seems to be catching on. We’re so busy here at TrueNorth because so many people are now interested in fasting. Recently, a major national magazine had an article detailing the experience of one of their writers who came and had a wonderful experience fasting with us. That article generated quite a bit of interest and business. So we’re getting a lot of exposure, even in the mainstream media, about fasting.

Are you also getting a lot of interest from young physicians wanting to learn about fasting and your health program?
Yes we are. We’re getting medical doctors, naturopaths, and chiropractors who are coming here to learn what we do, and it’s affecting how they think about health. And that’s really how the change is going to happen in the future; it isn’t what they’re going to be teaching in medical school. What medical schools teach will only change after enough people say it’s time to change.

So tell me about the Linzner Family?
My wife Carolyn and I have an adopted son who is 32 and he’s got three kids. Carolyn is the office manager at TrueNorth.

And has she stayed disciplined with the lifestyle as well?
Pretty much. She had a little more trouble a few years ago, but she’s been very good now for a couple of years, and she has lost a lot of weight. Everyone has to make those decisions for themselves; nobody can make them for you.

What do the Linzners do for recreation when they are not admitting or caring for patients at TrueNorth?
We do some hiking and occasionally go dancing, but my favorite thing to do is play Bridge.

Bridge!!? That doesn’t sound very vigorous.
It’s not, but its very competitive, and it exercises your mind.

It’s been great talking to you doc and catching up with you after all these years.
Good to talk to you, Mark!

This article originally appeared in Cell Metabolism 19, February 4, 2014

Authors: Valter D. Longo and Mark P. Mattson

Abstract: Fasting has been practiced for millennia, but, only recently, studies have shed light on its role in adaptive cellular responses that reduce oxidative damage and inflammation, optimize energy metabolism, and bolster cellular protection. In lower eukaryotes, chronic fasting extends longevity, in part, by reprogramming metabolic and stress resistance pathways. In rodents intermittent or periodic fasting protects against diabetes, cancers, heart disease, and neurodegeneration, while in humans it helps reduce obesity, hypertension, asthma, and rheumatoid arthritis. Thus, fasting has the potential to delay aging and help prevent and treat diseases while minimizing the side effects caused by chronic dietary interventions.

To read this article in its entirety (12 pages), please click here or on the attachment below.

By Mark Huberman

This interview originally appeared in the Winter 2015 issue of Health Science magazine, the member magazine of the National Health Association, of which interviewer Mark Huberman is the president.

Peter Sultana, M.D. is a board-certified family physician in Santa Rosa, CA. His training includes a bachelor’s degree in Physics and Art History from Fordham University, a doctorate of Medicine from Case Western Reserve University, a diploma of specialization in Family Medicine from the University of Missouri, a certificate in Medical Aspects of Natural Family Planning from Creighton University, and a certificate in the Supervision of Therapeutic Fasting from the IAHP. He has worked in a broad spectrum of various clinical and research settings over the years, and currently runs a small family practice, and serves as a medical consultant to the participants of TrueNorth Health Center.

MH: You are a rare breed within the modern-day Natural Hygiene movement since, to my knowledge, it has only attracted a handful of medical doctors: Ron Cridland, Joel Fuhrman, Michael Klaper and, most recently, Stephan Esser. How did you as a physician arrive at this esteemed plateau?
PS: I think the concept of Natural Hygiene has probably been with me my whole life, but I wasn’t aware of it as a system. I think it was just the idea of living in harmony with nature that I grew up with. So the seeds were already there by the time I discovered Natural Hygiene in my twenties.

I was trying to eat a healthy diet and people noticed it. One day, one of my workmates said, “You know, you would really fit in well with this group of health-minded people that I know who meet once a month.” I decided to check it out, and I became part of a small group of about six people who were studying Natural Hygiene. I thought, “Yeah, this is for me.” One thing led to another, and I ended up going to NHA (National Health Association) conferences and meeting different people who worked in this field. I think the very first conference I attended was in 1989 in Miami Beach, Florida.

Were your parents vegetarians or at least health inclined?
My parents were health inclined but not vegetarian. As I grew up, I started asking questions like, “Which of these foods is healthier?” and noticed that the answers pointed toward more vegetables and less meat. Dairy and eggs were still the darlings of nutrition at the time, so it took me longer to see them for what they were.

A lot of people come to this way of living because of a health crisis. Was that the case with you?
No, however, I did notice changes as my diet got cleaner, and I definitely felt better internally. I recall having some acne on my back that dramatically cleared up when I changed how I ate. I think this occurred as a result of giving up dairy foods, which was probably one of the last things I did.

Was there one book or one hygienic physician in particular that inspired you?
Before I started going to NHA conferences, I tried to follow the advice from the people in my local hometown Natural Hygiene group, but none of them were health professionals. They had strong opinions and lots of advice, but in retrospect they had little experience and no accountability. I know they were well intentioned, but following their advice I ended up eating far too much raw food and found myself eventually declining in health.

Now that I think about it, in answer to your earlier question, I actually did have a health crisis. The irony is that contrary to the typical path you just alluded to, Natural Hygiene was actually causing my health crisis, not solving it. So I started going to NHA conferences and met more responsible people, and learned that there was a balance you had to hit between raw and cooked food. I talked to most of the doctors individually, and they gave excellent advice, particularly Dr. Ralph Cinque, whose compassion and earnestness touched me as he coached me out of the crisis. What I learned from this is that broad principles are a great starting point, but there are many factors that go into tailoring them to each individual. At this point, I began to appreciate the value of licensed health-care professionals in Natural Hygiene.

You hold a dual degree in Art History and Physics from Fordham University. That sounds like a long way from a career in medicine. Are you actually an artist?
I love art and have some talent, but few people would ever accuse me of being an artist. Growing up, I never aspired to being a doctor. My interests were in art and drama, as well as goodness, truth, beauty and God. So in college I started off by majoring in Art History. It was my way of getting a big picture of art in the world. Eventually, around sophomore year, the question came up, “Well, what are you going to do with this?” I certainly wasn’t a good enough artist nor an actor to even think about making a living with those. But I was told that architects got paid, so I started looking into that.

I needed to take some science classes, particularly physics, which I had never taken before. So I took the introductory physics class and ended up loving it. I was fascinated by the universal language and beautiful balance and symmetry of the natural world. Halfway through the semester, the chairman of the department invited me into his office and said, “You are doing extremely well with this; you would make a good physics major.” My first response was, “No thanks; I already have a major,” but later I thought about what he said and found that if I worked at it I could add a second major without giving up the first, and still graduate on time. I never really developed a strong passion for architecture, so I just finished college with that dual degree and then took a break.

That summer, I moved back home to Cleveland and found a summer job at the Cleveland Health Education Museum. It was there that I started learning more about human biology. I worked on exhibits and taught guests about them. At the end of the summer, the job was over and I needed to find another one. Just down the road, the Cleveland VA Hospital had just posted an opening for a technician. I answered it and found myself in a research project focused on using electrical impulses controlled by computer technology to restore walking in paralyzed people (see photo at right). It was a lot of fun working with this multinational, multidisciplinary group of students, surgeons, Ph.D.s, and research subjects. The project had a great goal, but after a couple of years I found myself more interested in the lives of the human research subjects I worked with. I soon began to realize that the subjects’ mobility issues were often the least of their problems, and I was drawn into taking a more holistic view in helping them. That experience, combined with several of other storyline threads, ultimately came together at the age of 25 when I found myself being called to work as a doctor.

Tell me about attending Case Western Reserve Medical School.
It was wonderful, mostly. After college I chose to live in a cultural hub of Cleveland called University Circle, a one-square-mile neighborhood of major museums, colleges, music schools, and more. The thing that drew me there initially was the famous Cleveland Art Museum, the Cleveland Orchestra, and the Cleveland Institute of Art. So I was surrounded by all kinds of brilliant and broad-minded influences. I eventually came to know students and faculty at Case Western Reserve Medical School, and it started to grow on me; so it was an easy first choice for medical school. Once I was in the school, I found many of my classmates quite receptive to my perspectives on natural health. So, overall, it was a very good environment to learn and train. The hardest part was sleep deprivation. I think it took me seven years to recover from that.

Very few physicians are medical doctors in the Natural Hygiene movement; most of them have been chiropractors. I’m told that one of the reasons is the fear of the medical indoctrination in drugs and cures. Chiropractic takes a more holistic approach to health and recovery. Was this a challenge for you in becoming an M.D.?
Yes, some of it was. However, I started medical school with the firm conviction of health through natural healing, and I think that helped me absorb the information from a good perspective. In the first year you’re mainly studying basic anatomy, physiology, and how the body works, and there was little conflict with that. In the second year, you start learning more about diseases where things go wrong, and there wasn’t much conflict there either. However, in the third year, we started to bring in medicines, and I could see that some of the thinking was starting to go in the wrong direction.

I was surprised to find that a lot of our teachers were extremely biased. The only reason many were teaching there was not because they were good teachers, but because they had research grants. These grants came from pharmaceutical companies, and the more they were able to bring in that money, the more they were there teaching. It was hard being taught by people whose goal was to develop a product; often, that was a conflict of interest.

But at the same time I also felt like the world was going through a change. There was a growing specialty called “Family Medicine,” and the department was filled with holistic-minded people. There were a lot of medical students that shared my interest and focus on health. We would go out together to see talks by Drs. Dean Ornish and Neal Barnard. There were student groups that were interested in alternative medicine. I was actually asked to lead the AMA “Student Group on Humanistic Medicine” (an odd name, but that’s another conversation). I accepted, and the first thing I did was to invite Dr. Caldwell Esselstyn from the Cleveland Clinic to give us a talk. My fellow students were very receptive to his message, which is still consistent with the message he is giving today. He was just as intense and captivating then as he is now. Incidentally, I also invited Dr. D.J. Scott to speak, but he declined because he, and maybe wisely so, did not feel that it was his role to teach convictions. He was happy to teach people who wanted to follow natural living, but he wasn’t going to try to convert people.

Where did you do your residency after graduation?
I did my residency training in Missouri. It was sort of on-the-job training. As a resident you are a licensed doctor and you are in charge of people’s medical care. My specialty was in Family Medicine, so my residency trained me for a broad range of things. It was surgery, medicine, geriatrics, intensive care, and neonatal units: the whole range of life and the whole range of diseases (see photo at right). In addition, I had my own practice in the outpatient clinics. At the end of my residency, we moved east to be closer to family. However, finding people to work with who could reinforce a truly health-promoting practice was challenging, so I gravitated more toward the West Coast.

Speaking of similar mindsets, how did you find your way to TrueNorth Health?
I had always been aware of Dr. Alan Goldhamer and Dr. Jennifer Marano’s project that has come to be known as TrueNorth. I was impressed with its stable and steady growth. When I graduated they invited me to do an internship with them. When I arrived, we all hit it off really well, and I was warmly welcomed by not only them, but also Drs. Isabeau, Linzner, Dina, Anderson and Kim. It was a great resonating experience to have so many people working together, teaching the same message, and reinforcing each other. I think we each became more effective in what we did that way.

On the TrueNorth website it states that you have an interest in natural approaches to fertility. Have you found that couples who have adopted the hygienic lifestyle have better success with this very challenging area?
Thank you for appreciating how challenging and heart-wrenching that can be. It is true that many families we have worked with have called us back to give us good news on achieving pregnancy; and many women have reported the resolution or improvement of problems and pains in their reproductive organs. But there are so many factors involved in healthy fertility that we can’t say in isolation what made the difference. The field of Natural Family Planning studies the natural processes of fertility, and conservatively uses technology in a way that cooperates with those processes. I try to combine teaching a hygienic lifestyle with natural procreative technologies to get the best outcomes.

I think it was Dr. Joel Fuhrman who once said that it was important to distinguish between historical hygiene and hysterical hygiene, and give some traditional hygienic thinking more thoughtful and sober analysis. I would like to ask your view on some of these areas. The first and perhaps oldest notion is that “all drugs are poisons” and, therefore, you want to avoid them like the proverbial plague. As a medical doctor you have these tools at your disposal, but is there a place for them?
I do believe all drugs are poisons, but you’re right that there is a role for them. Sometimes taking a toxic medication is less damaging than doing nothing. There is no wonder drug without side-effects; you have to weigh the risks and benefits in each situation. Lots of people have high blood pressure, but each person may have a different problem causing it. Amazingly, with the aggressive, holistic changes we promote, most of the time the blood pressure improves no matter what the cause was.

Sometimes, however, despite these changes, blood pressure remains too high to be safe, and the patient bears the risk of blowing a blood vessel in their brain and ending up with a stroke. Often they would then be better off taking a toxic medication than having a stroke. Keep in mind that the body, besides wanting to be healthy, is very aware of the reality that there are toxic things in the environment. The body is built to handle toxins. So if you put a toxic medicine in, for the most part (if you’re doing it intelligently), it can clear away a lot of the toxicity and you can live with it in a way that is safer than if you had left it alone and risked having a stroke.

Above: Dr. Sultana in the kitchen of TrueNorth Health Center when it was located in Penngrove, CA.

Another issue is the advocacy or efficacy of raw foods, and the old hygienic notion that “cooked foods are dead foods” and that the pristine diet is a raw one. You mentioned earlier that in the early stages of your journey to Natural Hygiene you focused too much on raw foods. What is your perspective on the raw food diet?
The raw food diet was probably the thing that first drew me to the Natural Hygiene community. The idea of just picking up food in its natural state and eating it is very attractive. In reality it doesn’t really work well for most people because they don’t have the capacity to digest and be satiated on food that is 100% raw. You can make the food more bioavailable by conservatively cooking it, mainly steaming or baking. But the notion that “cooked food is dead food” is really missing the forest for the trees. Is food supposed to be “alive” when you eat it? What does that mean? If that refers to enzymes that are destroyed by cooking, keep in mind that the bulk of our digestion is done by our own internal enzymes. If you try to take in food that you cannot digest with the hope that it is carrying enzymes that will do it for you, you are going to be very disappointed. Very few nutrients are destroyed through cooking our food relative to the hundreds of good nutrients that are absorbed and active.

So does conservative cooking preserve or destroy the enzymes?
Mostly it preserves the nutrients, some are destroyed, some only become bioavailable by cooking, and most are retained. You can conclude by physical examination and blood tests just how much nutrients a person is getting. Someone on a mix of raw and cooked whole foods can actually have a much better nutrient profile than someone on a purely raw diet. Cooking can destroy some nutrients and deliver other nutrients. Most people need both to thrive.

A powerful notion among hygienic physicians is that the body has a pretty remarkable ability to cleanse, repair and restore itself? Is that the case?
The body does indeed have a remarkable ability to do so. However, I am concerned that in our 21st century we are hitting the limit on that. I do not think the body is equipped to keep up with the amount of chemicals and toxic exposures that it’s being hit with these days. The early hygienists were right; the body was able to recover and handle toxicities if they were reasonably managed. Now we are living in a soup of toxic pollution, and the body doesn’t keep up as well. Dr. William Esser, one of the early hygienists, had one of the longest careers in supervising people through healthy transformations and fasting. He had a huge amount of wisdom built up over the years, and one of the observations that he made toward the end of his career was that people weren’t getting as well with fasting. He was not seeing as many of the dramatic recoveries that he used to back when he first started doing this. He recognized, wisely so, that the world had changed and the old principles written back then aren’t so simple anymore. We can no longer think that all you have to do is eat some healthy food and do a little fasting, and you will recover. There is a lot of damage that has been done, and the body is at the edges of its ability to try to undo it. Yes, people still get amazing improvements, but there are some injuries that cannot be undone. This is why our message of prevention is so important.

Above: Dr. Sultana in 2014, at far left, with his fellow TrueNorth clinicians in Santa Rosa, CA.

What conditions do you see that still respond well to fasting and a hygienic diet?
Organ damage can be difficult. For example, if the kidney, which is a major detoxifying organ, has been damaged, there is little room for improvement. It can reach a level of tissue damage and scarring that is final. At that point, the high blood pressure is not going to turn around. But in general, the body’s organ systems are very resilient. If you remove the toxins, the body recovers and the symptoms decrease: the blood pressure goes down, the sinuses clear out, the aches and pains clear up, and there is an overall rejuvenation that occurs. As for particular conditions, hypertension and diabetes are two of the easier, measurable things we see that turn around. While fibromyalgia is not as measurable, the subjective reports of healing are very exciting.

Do most people fast who come to TrueNorth?
I think maybe 50% to 60% do a fast. More than fasting, TrueNorth is an environment to take time out of life to cleanse, get empowered, and then resume life with a touched-up or, in some cases, much overhauled daily routine, particularly a food routine. Fasting may not be part of a stay at TrueNorth, but everyone cleanses. It turns out that many people think they are living a healthy, whole-food, plant-based diet when in fact they are not. When they come here, they find the diet is much more cleansing that they were even aware of, and it takes their health up a level.

Isn’t it fascinating that this is essentially the kind of superior nutrition that Dr. Shelton, Dr. Esser, Dr. Benesh, Dr. Gross, Dr. Scott, and their many colleagues advocated 50 years ago?
It is fascinating. And it tells you that we have a natural instinct for what’s right for our body. They knew it; they didn’t need the science. Dr. Shelton ridiculed “science” because the scientific community had betrayed its role. We don’t need so many studies to tell us what good healthy living is; we knew what it was years ago. While it is great to have so many studies coming out affirming this, it does seem silly to hear the news that eating a diet rich in fruits and vegetables actually prevents cancer. So I think it is important to listen to those instincts and think them through clearly, and not just write them off as unproven teaching. Shelton and the other teachers were right. They had the right instincts, and what they taught followed from that.

Above: Dr. Sultana with his wife and children.

So tell me about the Sultana family.
Well, that could be a very long story, as our family spans the globe. But here at home is my lovely wife, Constance, whom I have known since I was 18 years old. She has nourished my life more than any vegetable you could name. We have two kids at home, Michael, age 17, who is just finishing up high school this year, questioning everything, and is currently tackling the big question of what to do next; and Valerie, age 9, who is currently mentoring me in sensing the joy in every moment.

Do you have your own heroes in the Natural Hygiene movement? You mentioned Dr. Cinque and Dr. Esser. Are there others who inspired you along the way?
Dr. Cinque was a great connection because he was very humane and caring. Dr. Scott was always wonderful to learn from; and since he and I were both in Cleveland, he was always available for questions. He would share with me his own observations on physiology and healing. Also around that time a young Dr. John McDougall came to speak at my town hall, and he got my wheels turning. At NHA conferences it was always inspiring to talk to Drs. Goldhamer, Fuhrman, Sabatino, and the Burtons. At one conference, I had the great fortune of meeting Dr. Michael Klaper, who at the time was a “lone ranger” professor of health through nutrition, and has since brought his wisdom and experience to TrueNorth. And of course there was Dr. Ron Cridland. He was the medical doctor who was working at TrueNorth when I first looked into working there. He was incredibly generous and forthcoming in his advice on how to set up a practice in affiliation with TrueNorth. I can’t say enough about his role in getting me started.

Above: Peter Sultana in his college years, chatting with Dr. D.J. Scott.

What is your role at TrueNorth? Do you see all of the patients, and do you have your own private practice?
I keep an office now in the TrueNorth building, and serve as a medical consultant to the program participants. For many years I did see each one, coordinating their program, care, fasting, medications, and diet from start to finish. But TrueNorth has grown, and there are now so many people that come through every year that more doctors are needed. Fortunately, more doctors have come in the last few years, namely Drs. Klaper and Lorn, and more recently Dr. Veress. But we are just the medical layer. As you know, the underlying backbone of the TrueNorth program has always been the chiropractic staff of Drs. Goldhamer, Linzner, Isabeau, and Yuen. They see all of the patients day-in and day-out, guide them in their healing process and, when needed, help them with traditional drugless treatments. 

Do you and your TrueNorth colleagues group-consult about patients?
All the time. One of the best things about having all of us working under one roof, and with the same patients, is that we get to meet formally at least once a week to go over every single patient. Throughout the week we keep the conversation going informally as we bounce around ideas and remind each other of the overall patient goals of function, relief, empowerment, and healing.

Dr. Sultana, I think if Dr. Shelton were reading this interview he would be smiling right now. Thanks for your great contributions to the Natural Hygiene movement and your support of the NHA over the years. Thanks for sharing your wonderful experience and perspective.
You’re welcome, I hope it is helpful.

Intermittent Fasting and Weight Loss
A form of calorie restriction, intermittent fasting may help you lose those extra pounds.

By Jennifer Marano, D.C.

For many people, following a whole-food, plant-based diet is the key to maintaining optimum weight and health. However, for some of us, strictly adhering to a health-promoting diet as well as engaging in a regular exercise program is not enough to keep us where we want to be weight-wise. We just like eating too much; or perhaps we have extremely efficient digestive systems; or our internal calorie counters are a bit off. Whatever the reason, I and many others tend to maintain a body weight 5 to 10 pounds heavier than what would make us look and feel our best. I have been trying various tricks for years—decades, really—to get rid of those final pounds, and I think I have finally found the answer: intermittent fasting.

I have been involved with fasting for over 30 years as co-founder of TrueNorth Health, a fasting and health center in Northern California, and I am very familiar with the tremendous benefits of fasting for maintaining or restoring optimum health. But we have never recommended fasting as a solution for weight loss. It may jump-start a weight-loss program by resetting our appetite so that we enjoy health-promoting food; but maintaining optimum weight is done by consuming a proper diet every day, not by prolonged fasting followed by a return to bad dietary habits.

But what is a “proper diet”? Is it the same for everyone? Over the past few years I have read a lot about the value of intermittent fasting, both for weight control and general health, and what struck me from the beginning is that the daily eating habits we follow in the developed world—three meals a day supplemented by coffee breaks, mid-afternoon pick-me-ups, and evening nibbles—is a very recent development in human history. For most of the world this abundance of food has not been available until very recently; and in undeveloped areas it is still not the norm. But just mention that you are skipping a meal here and there, and you are met with looks of horror and comments about how unhealthy that is.

But is it unhealthy? What happens when we don’t eat for a period of time? We know that when we eat more than we need to maintain our function, the excess is stored as fat. This is one of the adaptations we possess to keep us going during times of scarcity. When food isn’t available we burn our stored fat to keep us going until we can locate more food. We need certain enzymes to help us store fat and other enzymes to help us mobilize our fat stores. But if we are eating all day long there is never a time when we need to burn fat. It takes 8 to 12 hours to digest and assimilate the food from a meal, so most people in the developed world really never have to mobilize fat. And if the body doesn’t need to do something, it tends to not maintain the equipment (think enzymes) necessary to do that task. You know what happens to your muscles if you don’t exercise. And you know what you have to do to get back into shape. The ability to burn fat waxes or wanes in response to use, just as your muscles respond to use after exercise. You can develop the enzyme systems that allow you to switch easily from burning glucose to burning fat, but it takes some time. And while you are developing them you feel hungry; sometimes very hungry. And it is uncomfortable. Even after you develop these systems you still feel hungry (although it isn’t quite as uncomfortable). But it’s okay—feeling hungry is okay.

What is Intermittent Fasting?
So what is intermittent fasting (IF)? How does it apply to humans? Why do it? What can it do for you? And how do you do it?

IF is a form of calorie restriction, which has been studied for a long time, mostly in animals like rats and mice. It was observed that animals fed a restricted diet lived a lot longer than animals allowed unlimited food. There are people who are practicing calorie restriction with the hope that they will greatly extend their lives. But it is a very uncomfortable way to live, and these people can become very gaunt and weak. Not very many are successful at maintaining this lifestyle. The difference between IF and calorie restriction is the “intermittent” part. Yes, calories are restricted, but only some of the time. And recent animal studies have shown that the benefits are actually greater for the intermittent fasters than for those on a calorie-restricted diet; they both live just as long, but the intermittent fasters don’t lose muscle mass or become stunted. And that makes all the difference when it comes to applying the idea of IF to human health and weight control.

Before getting into the various types of IF, I would like to say a little about the physiological changes that occur with IF and how they impact health. One change is that the level of insulin-like growth factor 1 (IGF-1) goes down. High levels of IGF-1 in adults are associated with accelerated aging and development of cancer, so lowering this factor may be one explanation for the life-extension effects seen in animal studies. In addition, genes whose function is to repair are turned on by fasting. An organism needs to be in top shape during times of scarcity in order to successfully find food, so the stress of the fast causes this activation, much as the stress of drought or insect pests causes plants to produce more antioxidants. And a third effect is increased insulin sensitivity. Insulin resistance is associated with type 2 diabetes, and high levels of circulating insulin lead to excessive fat storage. Keep these physiological changes in mind as we discuss the various forms of IF; it will increase your understanding of why IF works for weight loss and also why it can be a healthy lifestyle choice, even after you have reached your ideal weight.

The Alternate Day Fasting Plan
One popular form of IF is “alternate day fasting” (ADF, or ADMF for “alternate day modified feeding”). The modified feeding title refers to a system developed by researcher Dr. Krista Varady of the University of Illinois at Chicago. In her system the fasting days actually involve eating a small meal (500 calories for women and 600 calories for men), while feeding days allow unrestricted eating. Dr. Varady found that, contrary to expectations, her subjects did not go crazy on feeding days. They tended to eat about 110% of what they would eat on a normal day before beginning ADMF. This makes ADMF a very effective weight loss program, but it has its difficulties, particularly socially. Friends and family have a hard time keeping track of when you are feeding and when you are fasting. But it is a good choice for people who have a large amount of weight to loose.

The 5:2 Plan
A more easily followed, yet still very effective version of IF is the “5:2 plan,” which was popularized by Dr. Michael Mosley with his Horizon TV program on BBC and in his excellent book, The Fast Diet. On this plan you choose two fast days a week (perhaps Monday and Thursday) when you will eat 500 to 600 calories. The other five days you eat whatever you want, but preferably a health-promoting diet. This plan has been studied extensively. In one study by Dr. Michelle Harvie in Manchester, England, three groups of women were compared for three months. Group 1 was asked to eat 1,500 calories a day on a Mediterranean diet. Group 2 followed a 5:2 plan, eating 650 calories of low-carbohydrate food on the two fast days. Group 3 was asked to avoid carbs two days a week, but was not given any specific calorie target. At the end of three months the 1,500-calorie group lost an average of 5.28 pounds, and the 5:2 groups lost an average of 8.8 pounds!

The Restricted Eating Window Plan
A third version of IF, perhaps the easiest to follow, is the “restricted eating window plan.” This method was based on a mouse study at the Salk Institute for Biological Studies where two groups of mice were each fed an unhealthy, high-fat diet. Each group received the same amount of food, but one group had constant access to the food, while the other group had to do all their eating in an eight-hour period each day and fast for the remaining 16 hours. After 100 days the “unlimited” group had high cholesterol, high blood glucose, and liver damage, while the “fasting” group put on 28% less weight and suffered less liver damage. The fasting group also had lower levels of inflammation, which we are learning is a very important factor in heart disease, cancer, stroke and even Alzheimer’s disease.

Intermittent fasting can be a powerful weight-loss tool with a bonus of improving your overall health. You can design your own program depending on your goals: ADMF if you have a lot of weight to lose, 5:2 as you get closer to your goal, and you can try a 6:1 plan when you get to your optimum weight so you can continue to reap the physiological benefits of IF. Or restrict your eating window to six or eight hours. If you get a bit off track you can throw in a 500- to 600-calorie day here and there. This approach is endlessly flexible—you just have to figure out what works best for you! And just remember: it’s okay to feel hungry.

Jennifer Marano, D.C., is a graduate of Western States Chiropractic College and along with her husband Dr. Alan Goldhamer is the co-founder of the TrueNorth Health Center in Santa Rosa, California.

This interview originally appeared in Integrative Medicine: A Clinician’s Journal (IMCJ), June-July 2014, vol 13, no 3

Interview by Craig Gustafson

Alan Goldhamer, DC, is the founder and education director of TrueNorth Health Center in Santa Rosa, California. Under his guidance, the center has supervised fasts for thousands of patients and grown into one of the premier training facilities for doctors wishing to gain certification in the supervision of therapeutic fasting.

Dr Goldhamer is on the faculty at Bastyr University in Seattle, Washington, where he teaches a course on clinical fasting. He is the primary investigator in two published, landmark studies that demonstrate the benefits of water-only fasting, and is the author of The Health Promoting Cookbook and co-author of The Pleasure Trap: Mastering The Hidden Force That Undermines Health and Happiness.

Integrative Medicine: A Clinician's Journal (IMCJ): What made you interested in pursuing the effects of fasting?

Dr Goldhamer: I got started very young—about 16, actually. I wanted to be a better basketball player than my friend, Doug Lisle, who currently is the director of research and a clinical psychologist at TrueNorth Health Center. We grew up together and he could always beat me in basketball. I was looking for an edge.

So I started reading and came across the books on natural hygiene by Herbert Shelton and others, and it made a lot of sense. Ultimately, I met Alec Burton, MSc, DO, DC, who specialized in fasting supervision. He was the president of the Pacific College of Osteopathic Medicine. After I graduated from chiropractic college at Western States, I went to Australia, attended Pacific College, and did an internship with Dr Burton.

There, I had a chance to see what happens when you do nothing intelligently or use fasting appropriately. And it was pretty mind-bending. So I saw a lot of people who I had been trained to not get well, get well, and they did that consistently through the use of fasting and a vegan SOS-free diet—a plant-based, whole-foods diet free of sugar, oils, and salts.

They applied this regimen in a variety of conditions from diabetes and cardiovascular disease to autoimmune diseases. Conditions that seemed to be tied to dietary excess tended to respond predictably to the use of fasting followed by a health-promoting diet.

To read the article in its entirety (7 pages), please click here or on the attachment below.

Though current medical and surgical treatments manage coronary artery disease, they do little to prevent or stop it. Nutritional intervention, as shown in our study and others, has halted and even reversed CAD.

Authors: Caldwell B. Esselstyn Jr, MD; Gina Gendy, MD; Jonathan Doyle, MCS; Mladen Golubic, MD, PhD; Michael F. Roizen, MD; The Wellness Institute of the Cleveland Clinic, Lyndhurst, Ohio

This original research article appears in the Journal of Family Practice in July 2014, vol 63, no 7

ABSTRACT
Purpose: Plant-based nutrition achieved coronary artery disease (CAD) arrest and reversal in a small study. However, there was skepticism that this approach could succeed in a larger group of patients. The purpose of our follow-up study was to define the degree of adherence and outcomes of 198 consecutive patient volunteers who received counseling to convert from a usual diet to plant-based nutrition.

Methods: We followed 198 consecutive patients counseled in plant-based nutrition. These patients with established cardiovascular disease (CVD) were interested in transitioning to plant-based nutrition as an adjunct to usual cardiovascular care. We considered participants adherent if they eliminated dairy, fish, and meat, and added oil.

Results: Of the 198 patients with CVD, 177 (89%) were adherent. Major cardiac events judged to be recurrent disease totaled one stroke in the adherent cardiovascular participants—a recurrent event rate of .6%,
significantly less than reported by other studies of plant-based nutrition therapy. Thirteen of 21 (62%) nonadherent participants experienced adverse events.

Conclusion: Most of the volunteer patients with CVD responded to intensive counseling, and those who sustained plant-based nutrition for a mean of 3.7 years experienced a low rate of subsequent cardiac events. This dietary approach to treatment deserves a wider test to see if adherence can be sustained in broader populations. Plant-based nutrition has the potential for a large effect on the CVD epidemic.

To read the article in its entirety (11 pages), please click here or on the attachment below.

The below article was featured in the November 2013 issue of GQ Magazine.

What if there were a cure-all treatment for high blood pressure, migraines, chronic pain, arthritis, and, of yeah, fatness? The catch: You'll be really, really hungry. Ben Marcus spends a long and profoundly satisfying week on a strict diet of absolutely nothing but H2O.

DAY ONE: “HORIZONTAL IS YOUR FRIEND”
On my first morning at TrueNorth Health Center, the only medically supervised water-fasting clinic in America, a Dr. Michael Klaper shows up to check my vitals. He is tall and lean, with white hair and the glowing young face of the little brother I never had. He is either 75 years old and absurdly youthful or 30 with a case of premature white hair. A hunger artist? I want to see health and wellness on these premises, impossibly fit bodies with a blinding glow. Something post-human, to prove that fasting works. Dr. Klaper will do fine. He makes me think I can fast my way back to childhood. Maybe infancy. I could return home a smooth, cooing baby and see if my wife will still have me.

It's the first day of my six-day fast at TrueNorth, an anonymous-looking cluster of buildings on a quiet street in Santa Rosa, California. A water fast is not a juice fast or a honey-lemon-cayenne fast or any of the body-hacking protocols or superfood regimens, sometimes rich in calories, that are mistakenly called fasting, however cleansing they might be. This is hard-core, a diet of nothing, a full-body reboot. Dr. Klaper and his colleagues tout their regimen as a potent balm for not only weight and digestive problems but a litany of ailments that plague mankind. Detractors, including my wife, liken fasting to starvation, because without food we turn into ashen little wastrels, crying for help in tiny voices. Right?

Dr. Klaper tells me the rules. No leaving the grounds. I might get confused, or I might fall down. It turns out you get dizzy without food. “Horizontal is your friend,” the doctor advises me. Also, no toothpaste, no lotions or creams. And no showering. Not because they want me dirty, but, again, because I might slip and fall down.

Dr. Klaper takes my pulse and pronounces it “lovely.” He thumps my chest, sounding the cavity, and says my heart is normal-size. I shudder at either alternative.

A technician draws my blood. They're testing lipids, vitamin D, inflammation markers. I ask if they'll test for allergies, because I've always suspected I'm allergic to animals, plants, people, maybe even myself.

They can do that, Dr. Klaper says, but after hearing my description of the nose faucet I wake to every day, and the leaky, bloodshot eyes, he smiles and tells me not to bother with a test. Those symptoms will be gone after my fast.

I like this man.

The good doctor dismisses me, and I stroll outside to sit in the sunshine, waiting for hunger, watching the other fasters come and go. Some are here not to fast but to eat clean for a while, to see the doctors and maybe get some treatments. But the water fasters stand out, because they cling to the wall when they walk. They take the stairs slowly.

TrueNorth lacks the whorehouse comforts of a spa. There isn't even a pool, which seems to violate some central tenet of California apartment complexes. It feels more like a scientific-research center. There are daily lectures and cooking demos, and the guest rooms are stocked with DVDs of slightly NSFW health documentaries. Today at the clinic they showed a grim video called The Pleasure Trap, an unflinching lecture on why we eat, and eat, and f***ing eat, what isn't good for us. Salt, sugar, and fat, combined with chemicals in processed foods, trick the brain in the same way as cocaine, and the brain flushes our bodies with dopamine, perhaps the most blissful, and addictive, homemade chemical we have. Once we find a way to trigger it, we kill ourselves to get more. Literally.

That evening, with no dinner to cook, eat, and clean up, I prepare my water smoothie, made of nothing but distilled water, and turn on the Food Network. If I can't eat food, I'll watch some. On TV, pre-scandal Paula Deen and her son are making corn dogs, fried okra, croissant-dough muffins with caramelized pecans. These things look gorgeous and obscene, like the invented genitalia of a new species. But after watching The Pleasure Trap, it seems wrong to refer to this stuff as food. More like recreational drugs for the mouth, with nasty side effects like diabetes. Still, I'm drooling. I love these recreational drugs. I go to foreign countries just to try exotic versions. I'm a user. I do food.

Just not today, and, if I survive, not for the next five days.

DAY TWO: WHAT WOULD GANDHI DO?
When I first called to arrange my stay, the co-founder of TrueNorth, Alan Goldhamer, cautioned me about the difficulty of water fasting: “It can be an intense, miserable experience, but when people are successful they forgive us.”

On my second day of fasting, I wake up at 4 A.M. in an unforgiving mood. Rise and do not shine. Rise and moan. It's dark and cold. Once you take digestion out of the equation, you save tremendous energy, which can make you restless at all the wrong times. Like the middle of the night. I take my sad glass of water and weigh myself in the kitchen. I'm down three pounds from yesterday. And then I notice that there is something seriously wrong with the air.

Guests are asked not to use scented cosmetics, because fasters have, I'm told, heightened smell. This morning that fact hits hard. I smell breakfast. Maybe miles away. Down the road someone is whipping eggs in a bowl, touching them off with cream and herbs. Butter sizzles in a pan, and when those eggs seize in the hot fat, the smell hurtles up the street. Gandhi said to chew your water, but mine keeps sliding out of my mouth. I guzzle it instead.

Over lunch with Alan Goldhamer—his lunch, my water—he refers to water fasting as “doing nothing, intelligently.” Some of our most common diseases, he claims, including diabetes, hypertension, some forms of heart disease, asthma, arthritis, and certain autoimmune conditions, are diseases of excess, not deficiency. They used to be called the diseases of kings, since only the wealthy could afford to shovel down ultra-rich, low-nutrient food in banquet quantities. Peasants did not get diabetes. Of course, this was before processed food, which is often the cheapest thing to “eat” now, and also the most damaging. Too much of this toxic stuff overloads our livers and kidneys, whose job it is to get rid of waste. As this material accumulates in our system, it can lead to inflammation and sickness. Fasting, the theory goes, treats these diseases by purging the excess. The digestive system gets a rest.

But how do we survive without nutrients? Some doctors argue that fasting is a counterproductive detox tool, robbing the body of the nutrition it needs to effectively cleanse itself. But our bodies are designed for scarcity, or at least well prepared for it. We store fat, and store it, and store it—sometimes renting a whole bunch of extra storage space inside our backs and bellies and asses—precisely because our bodies might need it someday, when the food is gone.

There are, of course, downsides to relying solely on your natural larder. So far they include vicious headaches, dizziness, and a sad, hollow feeling that water does not soothe. But I still want this, mostly for what might wait for me on the other side, when I get my food back. I don't have diabetes, and I'm not fasting to lose weight. I played contact sports in school, and now, in my middle forties, it hurts. I have a ripped-up knee, a trick neck, toes that feel stiff all the time. Sure, I wouldn't mind losing a few pounds, but mainly I'm fasting to relieve my chronic pain, a body ruled by arthritis and a paralyzing nerve disorder that cold-cocked me a couple of years ago.

One morning back in 2011, I woke to searing pain in my arms. A flamethrower directed at my arms is what it felt like. The hospital offered morphine, but one shot did nothing. A second and then a third shot only made me sob more quietly. Finally Dilaudid, at ten times morphine's strength, cooled off the pain. Several doctors and hospitals later, I was diagnosed with a rare autoimmune disease in which the nerves that branch from the neck and power the arms are bulldozed by the immune system. There's no cure, just a blitz of medicines to blanket the suffering. So I embarked on a grisly medical protocol: monster doses of steroids, antiseizure agents for nerve pain, and a lot of craft beer, ice cream, and chocolate for the larger problem of what it now felt like to be me.

I've since weaned myself off the steroids and quit the nerve-pain drugs. But a disease like that, out of nowhere, coming on hard and weird, makes you wonder not just what the hell happened but what exactly you can do to stop it from happening again. I'd tried the brutal meds, and now it was time to try the absence of them, the absence of everything. I was ready, or so I thought, to take the nothing cure.

DAY THREE: BED, BOREDOM, BATHROOM
Fuuuuuuck.

Life without food is darkness and headaches and restlessness. I can't sleep. I can't read. Music—even soft, ridiculously washy music—seems jarring.

My wife calls and asks how it's going at Camp Starvation: Am I dead yet? Not dead, but pissing the day away. Pissing on the hour and the minute and the second. If all else goes bust here, at least my man-Kegels will be super ripped.

I hadn't bargained for so much bed rest, and if you can't sleep or have sex in a bed, it's just a slightly softer floor, and you're lying on it in the middle of your room, starving, wondering when they will come and find you.

DAY FOUR: PROGRESS? MAYBE?
I wake up feeling slightly better, if hollow and weak. My headache is nearly gone, and I've lost another three pounds. My stomach growls so slowly I can almost pick out words. Weirdly, though, I am not hungry. Shouldn't my body be tweaking with hunger right now? Apparently it should not. This is just the physiology of fasting at work. Even though I'm eating nothing, I am feeding very well, thank you. On my own damn self.

DAY FIVE: DRAWING THE LINE AT SALT
I've lost twelve pounds. They say it's mostly water weight. Why am I carrying around all that water? Dr. Klaper lectures me on salt, a piece of nutritional apocalypse he clearly enjoys sharing. When you eat too much salt, your blood gets saltier, so your brain tells your body it's thirsty. So you drink more water, diluting your salty blood, and with more blood pumping through your system, you get high blood pressure. Boom.

I blink at him hopefully. There must be a loophole. Please? My wife packs a little Ziploc of Maldon sea salt whenever we leave the house, and we litter it over even perfect bowls of food, like ice cream. Klaper and I will have to disagree here, even though he has decades of credentials and experience over me.

DAY SIX: I WAS FAMISHED BUT NOW I SEE
On my final day without food, I wake up at 5 A.M. I slept in! And all of a sudden, I feel tremendous. Light, energetic, unreasonably cheerful. This is maybe the runner's high of fasting, and it's hit me just as my fast is ending.

Throughout my stay, a six-day fast has been regarded with amused smiles. Pathetic amateur, they don't say. One doctor says everyone should do a long fast at least once in their lives. What's long, I ask. Twentyone days. Maybe thirty. Now I see the appeal. Once you get over the misery of the first few days, things start to look up and you get this feeling that something profoundly necessary is happening inside you. I've lost sixteen pounds, and a deep bend at the knees is surprisingly pain-free. My hands no longer ache. My skin is clear. The whites of my eyes look Photoshopped.

Dr. Klaper comes by to discuss my food plan going forward. A water fast is pointless if you kill it with a cheeseburger. In the morning I'll have a juice of watermelon and celery, some grapes and melon at lunch. For dinner I get something they refer to as sloppy, wet greens. Perhaps they did not want to use the word watery.

Then we discuss what I'll eat when I get home and, ideally, for the rest of my life. It's pretty clear now what's really being promoted at TrueNorth. Fasting is not the star but just a tool to get you to radically change the way you eat. They call it a plant-strong diet. I call it vegan minus joy, where joy equals salt, sugar, and oil. Processed foods are out, and so is anything scooped from an animal's body, however local or hand-groomed the beast was. Some people would rather die than eat this way. Actually, if you believe that the diseases of kings are nutritional diseases, diseases of excess—some do. In ever increasing numbers.

DAY SEVEN: (AND BEYOND)
On my first morning among the eaters, down seventeen pounds, it takes me an hour to drink my juice. The mouthfeel of this liquid is superior. Why even swallow? But when I do feel that juice roll down my throat, it's killingly decadent, as delicious as anything I've ever tasted, and the calories hit me like a jolt. I feel brand-new.

I re-feed slowly, as advised, but it takes me days to feel deeply hungry again. That ache and itch I used to have in my mouth, only to be soothed by salt and sugar and fat, is gone. My arthritis has eased up, too. My blood pressure, usually around 125/80, is now 95/69. Dr. Klaper says I have the stats of a teenage boy. Not quite the infant I was shooting for, but it's close.

It's time to go, and what I feel most strongly is that I could have fasted longer. A week more, maybe two. On the flight back my ears pop, easily, and the noise rushes in. My ears have never popped well in the air, and the pleasure of this effortless head-clearing is nearly sexual. It feels like someone has Hoovered out my sinuses.

When I get home, I'm still pecking lightly at food, suspicious. Every meal looks like my undoing. Salt looks like lye. Oil looks, well, really oily. We eat that why? Oh yeah, because it's a thick golden pleasure-delivery system. I take the stairs down to the street, and something is different. They've redone the steps in my building. They're easier, almost horizontal. But of course they aren't. It's me who's easier. I have no pain in my toes or knees, and I can make a fist, no problem. It's days after my water fast ended, I've been eating solid food again, and it would seem that my arthritis is really gone.

But it's hard to believe this sudden absence of pain will last. Maybe the fasting spooked my system, scared me out of pain. Check with me after the extreme reverse fast I face now that I'm home: the summerbarbecue months. And that's the problem. If there's a downside, it's not with the fasting itself. It's that the diet required to sustain the tremendous effects of a fast is rigorously difficult and, for many, probably unrealistic. The challenge in the kitchen is how you get to delicious—or maybe how you learn not to care, which is too grim to contemplate. Fasting helps kill your cravings, and it stokes your passion for fruits and vegetables, whole grains, and nuts. To a certain degree. But what I notice is that I start to look at food as medicine, and the decisions I make at mealtimes have to do with what kind of medicine I want to be taking: the clean, bland kind with maximum benefits and zero negative side effects, or the lewdly delicious bad medicine with too many side effects to name?

There's a deep canyon between the real world, or at least my real world, and the spartan ways of the plantbased whole-foods diet. If I lived alone and shopped and cooked for one and had no life, this would be a cinch. If this sounds like I'm blaming my friends, I probably am. For now, I'm going to see if that old, sad approach called moderation has any sway here. It's never worked for me before. I tend to want my cake and your whole family's cake, too. But if I feel the pain coming back, seizing my joints, I know now that I won't be reaching for pills. Particularly when doing nothing at all seems to work so much better.

BEN MARCUS's next book, a story collection called Leaving the Sea, comes out in January. This is his first article for GQ.

(Click on the attachment below for a PDF of this article)

Fasting at the TrueNorth Health Center goes mainstream with an article featured in this month’s GQ magazine. Click here to read the entire article. 

Resolving Corruption: How to “Reboot” Your Brain so that Healthy Eating is Preferred

By Alan Goldhamer, D.C. and Jennifer Marano, D.C.

Reprinted from Health Science magazine, Spring 2012

Adopting a health-promoting diet in the modern world is among the most difficult challenges facing humans living in industrialized societies. In the world of our ancient ancestors, the biological imperative of life was getting enough to eat while avoiding being eaten. Most early humans were unsuccessful and did not live long enough to reproduce. The few that survived (our ancestors) lived exclusively on whole, natural foods. They never ate refined carbohydrates or processed oils because these artificially concentrated food-like substances did not exist.

Drugs like alcohol and cocaine create intense pleasure feelings by fooling the brain into producing increased quantities of pleasure-inducing neurochemicals, including dopamine. Eventually, the body becomes dependent on this artificial dopamine stimulation and the person must continue to use increasing quantities of these substances to avoid the pain of withdrawal. They have become addicted.

When we include these processed “chemicals” in our diet, including sugar (C6H12O6) or oil (C17H35COOH) we enjoy the resulting feelings that the production of dopamine induces. We become habituated. If we stop adding these substances, we may experience whole, natural foods as tasteless and unappetizing in comparison. Withdrawal symptoms may be similar to drug withdrawal symptoms, including headache, fatigue, nausea, joint ache, pain, irritability, etc. We have been caught in the dietary pleasure trap. We are addicts.

Unlike our ancient ancestors that usually died from deprivation and predation, modern humans increasingly suffer and die from the results of excesses associated with being caught in the dietary pleasure trap. The resulting obesity, diabetes, cardiovascular disease and autoimmune disorders make up the majority of the deaths and disability that plague humans today. 

Alcoholics must struggle to avoid the use of alcohol, even when they realize their lives are being devastated by the consequences of their addiction. Even with the support of a 30-day, in-patient program, regular attendance at a 12-step outpatient program and family support, well over 70 percent of alcoholics will fail to quit drinking and sustain sobriety.

When it comes to the dietary pleasure trap, the results are even more startling. Over 97 percent of attempts to loose substantial weight and keep it off will fail. We live in a world that is designed to give us what we want (pleasure) not what we need (a health-promoting diet and lifestyle).

The majority of conventional medical care is aimed at treating the symptoms of diseases, particularly our chronic diseases associated with dietary excess. If you have high blood pressure and you follow your doctor’s advice, you will be guaranteed to never recover. You will be on the drugs for the rest of your life (however long that may be), as these drugs will not correct the cause of your high blood pressure. This is also true for diabetes, arthritis, asthma, colitis, and many other chronic conditions.

If your goal is to lose weight and keep it off, conventional medical advice fails. Some doctors have become so frustrated with universal failure that they give up and tell people to just accept themselves as they are, because achieving optimum weight and health can’t be done. Or, they may resort to drastic (and very lucrative) surgeries with all of their attendant problems and risks.

For the past 30 years the doctors at the TrueNorth Health Center have worked with over 10,000 patients, many of whom struggle with the dietary pleasure trap. Some start off unaware of what a health-promoting diet is and have been deluded into thinking that their lean meat, low-fat dairy products, sugar-free sodas, dark chocolate, sugar substitutes, such as honey or agave, and their red wine ARE health promoting.

Others understand that health is the result of healthful living, and that means eating a plant-based diet that is also SOS-free (free of added sugar, oil and salt) but they have trouble sticking to the program, given the temptations that they face each day.

The result for both groups of patients, regardless of their knowledge is the same: obesity, diseases of dietary excess, and premature disability and death. Both groups find that the more the dietary pleasure trap has ensnared them, the less appealing are whole, natural foods. Our work at the TrueNorth Health Center is focused on helping people overcome this trap and adopt a diet and lifestyle that will control and even reverse this process instead of just treat symptoms. It is not easy or simple, but it can be done, as the following examples illustrate.

When the program at the TrueNorth Health Center gained acceptance as a fully covered benefit of a major labor union, we admitted a crane operator who was a very large and rather gruff man. Almost 100 pounds overweight with a history of high blood pressure, diabetes, digestive difficulties and impotence, he questioned me immediately about the need for him to stay at our facility and undergo a period of medically supervised, water-only fasting. I explained that the combination of obesity, hypertension and diabetes increased his chances of dying. 

He reminded me that “we all have to die sometime.” I reminded him that his deteriorating health had led to his use of eight prescription medications costing over $1,000 dollars a month. He countered that his union paid for his medications which cost him nothing. In desperation, I suggested that if the fasting and diet change were successful, there was a good chance we could get him off his medications and do something about his “little problem” he was having with “Captain Johnson.” When he looked up suddenly at the mention of his impotence problem, and I noticed that his neck was bigger than my thigh, I was worried I may have just poked an angry lion in the eye. He looked at me and said, “Well, why the hell didn’t you just say so.” He picked up his bag and checked into his room. 

We tried to feed him a very nice plant-based, SOS-free final meal before starting the fast, but he was clearly having difficulty eating the food. I thought he might have an esophageal stricture from the difficulty he was having swallowing. With each bite his face cringed as if he were swallowing the most bitter and disgusting fare you can imagine. I sat down next to him and said, “It looks like you’re having some trouble eating.” He said, “This stuff is AWFUL! If I have to eat tasteless swill like this in order to get healthy, I would rather DIE!” He suggested that rather than guiding him through a fast, he would prefer that I just go out to his truck, bring in his 12-gauge and SHOOT HIM IN THE HEAD!

After almost three weeks of fasting, the loss of almost 40 pounds and the elimination of all of his medications, the time came to begin refeeding. This time he was able to chew AND SWALLOW his health-promoting fare. When I commented on his improved ability to eat and enjoy whole, natural foods, he suggested that our chef was FINALLY getting the “hang of it.” I told him it was the same food he had tried before. He vehemently denied that and said that the food I had fed him three weeks ago was tasteless swill, but this stuff was “not bad.”

He returned to work as a crane operator. Six months later I ran into him while I was doing blood pressure screening at a union health event. I asked him how he was doing. He said he had stuck to the rabbit food diet, had lost an additional 60 pounds, had used NO medications and, as he made a fist and held his arm up in an “erect” fashion, he assured me that he was doing “JUST FINE.”

Without the benefits of a fast, it would have been very difficult to get compliance with diet change. Improving health enough so that good foods “taste good” is a very powerful benefit of fasting. We call this change "taste neuroadaptation." It lasts as long as people keep eating well. 

One sure sign that someone may need to consider fasting is when health-promoting foods lose their natural appeal. Patients caught in the dietary pleasure trap cannot fully enjoy (or in some cases even tolerate) the pleasure of eating whole, natural foods. For people who have the motivation and determination to stick to a vegan, SOS-free diet for long enough periods of time, many problems of dietary excess will begin to slowly improve. For those who are unable or unwilling to give up their addictions easily, or who do not respond quickly enough, a period of medically supervised water-only fasting can, in some cases, save their life.

Free phone consultation: If you would like to have a no-cost phone consultation with Dr. Alan Goldhamer to determine if a stay at TrueNorth Health Center might be helpful to you, go to the Center’s website at www.TrueNorthHealth.com and click on the "registration forms" button. Answer the health history questions and click "submit" and then call (707) 586-5555 ext. 2022. Dr. Goldhamer will help you evaluate your options.

How does our program work?

1. First we review your medical history and offer a free phone consultation to determine what program might be appropriate.
2. You will receive a physical examination and appropriate testing by a TNH medical doctor.
3. We’ll discuss our various programs: healthy eating, juice fasting or water fasting to eliminate the dependence on medications and dietary chemicals, etc.
4. We’ll help establish a program for flexibility, strength and endurance as well as relaxation and healthy sleep.

Alan Goldhamer, D.C., is the founder of TrueNorth Health Center in California. He is a member of the NHA Board of Directors. Dr. Goldhamer is the author of the Health Promoting Cookbook and co-author of The Pleasure Trap. Jennifer Marano, D.C., is the co-founder of TrueNorth Health Center. Both are Life members of the National Health Association.

By Alan Goldhamer, D.C. and Jennifer Marano, D.C.

Reprinted from Health Science magazine, Fall 2012
 

When readers of Health Science are asked, “What should I eat,” the first thing that probably springs to mind is to recommend a vegan, meaning plant-based, diet. But just recommending a vegan diet is not enough. The average American diet is not health-promoting, as we can tell by looking at the average American: most likely overweight or obese, and frequently suffering from such degenerative diseases as diabetes, high blood pressure, cardiovascular disease, cancer, and arthritis.

So, to tell the average American to stop eating animal products is not a sufficient amount of information. If the average person just removes the animal products from his/her diet and ate more of the non-animal products they were currently eating, they might be in far more danger than before. There are many very bad vegan choices out there, and it is entirely possible to consume a totally vegan and terribly unhealthful diet.

Dietary choices will have a profound effect on the quantity and the quality of each person’s life. You and everyone around you are faced with thousands of decisions a year regarding what fuel you will feed your body, so it is imperative that everyone have a basic nutritional information framework to help guide them in making these choices.

In order to make wise choices we must think about the caloric density of foods. Our brains are wired to crave the most concentrated sources of food available. This ability to distinguish between calorically dense foods, such as bread and avocados, and foods less dense in calories, such as salad and vegetables, was a useful talent in times of scarcity. This talent seems so obvious to us today that we tend to ignore it. We don’t think about why we prefer bread or pasta to salad. We don’t think much about why gelato tastes “better” to us than non-fat ice cream. In the distant past we never had to think about what to eat — we just ate whatever we could get our hands on. Consequently we are not well prepared to live in an environment of abundance, not only of natural foods, but an environment of artificial food-like substances designed to seduce our brains and extract money from our wallets while making us sick. At TrueNorth Health Center we call this modern dilemma the “pleasure trap.”

Two main keys to making wise dietary choices are knowing the difference between caloric density and nutritional density, and understanding the role of food processing. That probably sounds a bit complicated, but it isn’t, as we shall see.

First, density: Fats and oils contain more calories per gram than any other nutrient, so any food that contains a lot of fat or oil is a high-calorie food. All natural foods contain some fat. Most vegetables and fruits have small amounts, while nuts, avocados, and olives, and, of course, meat and fish contain a lot more. Natural foods also contain carbohydrates and protein, and again, amounts vary. Grains and root vegetables are more concentrated and contain less water, and thus have more calories, while fruits and green vegetables are less calorie-dense. But natural foods, particularly fruits and vegetables, are very high in nutrients other than calories. These include vitamins, minerals, antioxidants and other compounds that are essential for our health. This is what is meant by nutritional density.

The second key is understanding food processing. Processing is anything you do to the food to alter its natural state. You can cut it into smaller pieces to make it easier to eat. You can cook it, which softens it and makes the nutrients more available. You can grind it up to avoid having to chew, as in blended salads. These are fairly minimal forms of processing, and thus do not change the nature of the food too much.

But humans have learned to do a lot more than simple processing. We can squeeze the juice from fruit and get rid of all the fiber, leaving a very sweet, concentrated liquid. We can remove the fibrous coating from grain and grind it up very finely to make flour and then turn that into bread, a highly concentrated food. We can extract the fat or oil from foods and bottle it to be sold separately or add it to other foods. We can extract the sugar from cane or beets or corn and then use the concentrated sugar to concoct foods that do not exist in nature. Essentially, we’ve learned to isolate the various components of foods that we find most desirable (mainly sugar, starch and fat) and combine them to form cookies, cakes, ding-dongs — you name it! And it is these artificially concentrated, food-like substances that lead us straight into the pleasure trap.

We have to think about the food we put in our mouths if we want to promote optimal health. There just isn’t any getting around it. We don’t live in an environment where we can rely on “instinct.” We need foods with high nutritional density and we need to be aware of, and probably limit, how much high calorically dense food we eat. We need to avoid foods that have been processed to the extent that the fiber has been removed and the sugar and fat content has been concentrated or artificially enhanced.

We know that smoking is addictive, that heroin and cocaine are addictive, and that alcohol can be addictive. But we don’t often think about how artificially concentrated foods packed with added sugar, oil and salt can act just like drugs by over-stimulating the reward centers in our brains. But large food processing companies understand how this works, and they put a lot of effort into designing products that activate this addiction-like reaction and keep us coming back for more.

As a result of this dietary pleasure trap, many people are suffering from the diseases of excess that were previously mentioned. Fortunately, adopting a health promoting diet is a cost effective and reliable way to achieve optimum weight and avoid, and even reverse, the diseases associated with dietary excess.

The most effective way to get the proper nutrients without overdoing the calories is to include large quantities of high nutritionally dense and low calorically dense vegetables in your diet. This includes salad greens (lettuces, spinach, mesclun, sprouts), root vegetables (carrots, beets, jicama, sweet potatoes, white potatoes), dark greens (kale, chard, collards, purslane), cabbage family (broccoli, cauliflower, bok choy), and green beans and squashes. Most of these can be eaten raw, juiced, blended, steamed or baked. If you are trying to lose weight, these vegetables should be eaten first, before any more concentrated foods are eaten.

In addition to vegetables you will want to include fresh fruit and whole non-glutinous grains like brown rice, quinoa, millet or corn. Also, beans, including lentils and peas, may be included. Limited quantities of high-fat vegetable foods such as nuts and avocado may be included, depending on your goals regarding weight.

A vegan diet lacks a significant source of vitamin B12. We recommend that all vegans consume 1000 mcg per day of vitamin B12 in the form of methylcobalamin in order to insure that adequate vitamin B12, an essential nutrient, is present.

An excellent resource for preparing this type of diet is a cookbook called Bravo! written by our own chef here at TrueNorth Health Center.

Alan Goldhamer, D.C., is the founder of TrueNorth Health Center in California. He is a member of the NHA Board of Directors. Dr. Goldhamer is the author of the Health Promoting Cookbook and co-author of The Pleasure Trap. Jennifer Marano, D.C., is the co-founder of TrueNorth Health Center. Both are Life members of the National Health Association.

Bastyr University & TrueNorth Health

“Fasting and Alternatives to Standard Therapeutics (FAST): Determining the Molecular and
Physiological Mechanisms Responsible for Adult Hypertension and Obesity”

Please Help Us Learn About

Fasting and Vegan Diet

Is medically supervised water-only fasting an effective treatment for High Blood Pressure?

Vegan, Low Salt and Low Fat Diets, are shown to be an effective lifestyle therapy to reduce blood pressure and promote weight loss. Another potentially effective therapy to reduce blood pressure and promote weight loss is Short-Term, Medically Supervised, Water Only Fasting.  Safe and effective alternatives for the treatment of high blood pressure and obesity are increasingly needed.  This study aims to find out whether short-term fasting, combined with dietary modification, is more effective at reducing blood pressure and increasing weight loss than dietary modification alone.

If you have High Blood Pressure and are Obese and between the ages of 21 and 65, you may be eligible to participate in a research study about fasting and diet.

Study participants will be asked to get a baseline screening and get periodic blood work in addition to your normal health care.  Participants with a normal physical exam and blood work who also have greater than 140/90 mmHg and are Obese at the initial screening will be eligible to participate in the study.

If a screening visit and blood work results show you are eligible, you will be able to undergo the vegan diet and the fasting treatment as a part of this research study. At the end of the 6-week study, you will also be asked to attend one more study visit after 6 months to obtain additional blood work and physical measures.