21-Day Weight Loss Kickstart

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A Note to the Reader

As you get started, let me mention two simple, but important points:

See Your Health Care Provider. If you are taking medication, are seriously overweight, or have any health concern, let me encourage you to work with a physician or other health care provider, and to follow his or her advice about all aspects of your medical care. This is not because changing your diet is dangerous. Just the opposite; a diet change can be very powerful for health. So powerful, in fact, that your doctor may need to change your medication regimen, or perhaps discontinue medications altogether. Do not do this on your own. Work with your health care provider to reduce or discontinue your medicines if and when the time is right.

Also, sometimes a new way of eating can make you feel so good and energetic that you might feel like really ramping up your exercise routine. But be careful. If you have been sedentary, have any serious health problem, have a great deal of weight to lose, or are over forty, have your health care provider check whether you are ready for exercise, and how rapidly to begin.

Get Complete Nutrition. Anytime you alter the way you eat, you'll want to make sure you're getting all the nutrients you need. The way of eating presented in this book greatly improves your overall nutrition—more so than other diets. But even so, please read the information on complete nutrition presented in chapter 5. And be sure to take a daily multiple vitamin or other reliable source of vitamin B₁₂, such as fortified cereals or fortified soy milk. Vitamin B₁₂ is essential for healthy nerves and healthy blood.

Introduction

I'm guessing you're reading this book for one of two reasons. Maybe you've tried, like many people I've worked with, to get control of your weight and health and have not been as successful as you'd hoped, and you're looking for a proven solution. Or perhaps you've heard about the life-changing and weight loss benefits of a plant-based diet and want to give it a try, but don't know where to start. Either way, you might be asking yourself questions like: Will it be easy? Will I get plenty to eat? Can I avoid feeling deprived?

The good news is that the answer to all these questions is yes—we're actually going to make it fun!

Welcome to the 21-Day Weight Loss Kickstart! This book is based on a program I launched in August 2009 through the Physicians Committee for Responsible Medicine, which I founded in 1985 to change the way we think of medicine and research, and to help people learn how to prevent disease rather than just treat it. For 21 days, participants get to "test-drive" a diet that is as close to perfect as is humanly possible. They experience the weight loss, energy boost, and health improvements that come from truly healthful foods. The response has been overwhelming—well over one hundred thousand people have gotten on board for the Kickstart and have finally been able to break old habits and embark on a whole new way of eating that has changed not just their waistlines, but also their overall health and sense of well-being.

And now you get to jump in and take control of your weight loss and health, like so many others. You'll discover a whole new way of thinking about food as well as a chance to try a slimmer, healthier, rejuvenated body. And that will bring you a whole new outlook on life. In just three weeks, you'll break old habits, start new ones, and revolutionize your health.

The program is called the Kickstart because it focuses on a very short-term immersion experience that almost always inspires long-term changes. Once you finish the 21-day challenge and see how easy it is to gain control over your weight and health, you probably won't want to return to your former habits. Why? Because you'll be eating delicious meals, you'll never be hungry, and you'll look and feel great.

Clinically Proven

In a recent research study, we tested the Kickstart approach in a group of sixty-four women. All were moderately or severely overweight. They were all past menopause and really felt stuck with their weight. Most had tried many different diets, without lasting success.

We asked everyone to do two simple things: set animal products aside and keep oils to a minimum. That was the whole "diet." They were free to start their day with pancakes with syrup, veggie sausage, fresh fruit, or other foods, with no calorie limit at all. If they had lasagna or chili for lunch, it would be the meatless versions of these foods. If they stopped by a Mexican restaurant, we asked them to favor the bean burrito (hold the cheese) over the greasy meat taco. At an Italian restaurant, it might be spaghetti with an arabiatta or marinara sauce, pasta e fagioli, garlic-sautéed broccoli rabe or spinach, and roasted vegetables. And they could eat all the warm bread from the oven that they liked.

There were no calorie limits, no carbohydrate restrictions, and no exercise, because this was intended as a study of nutritional changes only. But we were serious about the changes we prescribed, and we helped our participants stick to them.

To their delight, the participants started losing weight. It was gradual at first—with some women faster and some slower. After fourteen weeks, we published the results in the American Journal of Medicine. Even without calorie counting, the weight peeled away at an average rate of about a pound per week, with some of the women losing much more quickly.¹

But that was just the beginning. We followed them for the next two years, and, unlike typical weight loss diets that are soon followed by weight regain, these women were, on average, slimmer at one year than at the beginning, and slimmer at two years than at one year.² In other words, weight loss had become a one-way street.

So we went a step further to try to tease apart the biology of it all. We wanted to discover why it was that, even without exercise or calorie counting, participants were still able to lose weight. In chapters 2 and 3, I'll show you the secrets we found. As you'll probably guess, they relate to fundamental changes in their bodies—a new and surprising level of appetite control and calorie-burning speed.

We have tested this approach in men and women, in young people and older people, in healthy people and in those with health problems, in people with massive amounts of weight to lose and in those who only needed to trim a little weight. We have also tested it in people who were already at a healthy weight and just wanted to eat better. Many of these people had little or no time for food preparation or exercise, and yet it still worked well for them.

We have found that people not only slim down, but also see their cholesterol levels plummet and their blood pressure fall. If they have diabetes, it typically improves and sometimes even disappears. Arthritis pains and migraines often vanish, and energy comes racing back. Sluggishness vanishes, and they look and feel radiant.

Quick Changes, Permanent Results

The most exciting part of this Kickstart program is that it is not a five-year plan, a three-year plan, or even a six-month plan. This is three weeks. Now, it's certainly true that, to be effective, a change in the way you eat needs to be carried into longer-term good habits. But let me put things in a slightly different light:

Although my academic appointment is currently in the Department of Internal Medicine at the George Washington University School of Medicine, I began my medical career following a different path.

Initially, I wanted to tackle the issues of why we do the things we do, and how it is that things go off track behaviorally. So, after medical school, I completed a residency in psychiatry and took a position at St. Vincent's Hospital, a large medical center in downtown New York. I not only ran a psychiatric ward but also had a busy consulting practice, treating people with medical illnesses—diabetes, heart disease, cancer, and others—that were complicated by depression, anxiety, or other problems. In the course of this work, I became concerned that, in American medical practice, we were not very good at prevention. We did nothing to stop a heart attack until it arrived at the emergency room door. We were similarly slow to deal with diabetes, hypertension, cancer, and other serious problems until they became full blown or even life threatening. And doctors then, like doctors today, tended to overlook the power of nutrition. Barely any time in medical school was devoted to it. Even though food is central to so many health issues, we were quick with prescriptions and slow with nutritional information.

I founded the Physicians Committee for Responsible Medicine to restore the role of nutrition and disease prevention in medical practice. I wanted to also ensure that good research was conducted to improve medical practice, and that this research was done intelligently and ethically. My research team began conducting studies in diabetes, cholesterol, weight problems, and other health issues.

In the course of this work, it became clear to me that biology is only half the issue. In other words, how or why some foods satisfy the appetite or enhance the metabolism is not at all the whole story. The other half is psychological: How do we get the motivation to get started? And how do we stick with a healthful way of eating? How do we avoid temptation? How do we motivate our friends and family members and how do we get them to motivate us? It's important to have a powerful diet, but it is just as important to make it work in real life.

So we have investigated not only what are the best and most powerful foods for weight loss and health, but also how to make healthful habits stick.

It turns out that one of the most important keys is to focus on the short term. What I have found over and over is that, once we have made short-term changes, they tend to change our long-term habits.

So the first step is to get you out of your dietary rut, onto a better path. And by making that change really enjoyable, and by getting results along the way, you'll get the motivation you need to stay with it for the longer term. So we are going to focus on quick changes that are fun and effective, and that will make you want to continue with the plan.

If you were to kickstart a motorcycle, it would take just a second or two to make the engine ignite and roar into action. You would then roll out onto the highway and off you'd go. It is the same idea when you kickstart a change in your life. With a quick and easy program, you'll ignite powerful changes that will help you long into the future.

Here is just some of what you'll accomplish with the Kickstart program:

• You will gain a new level of control over your appetite. The success of this program is not based on willpower. Instead, it is based on using the power of foods to change the basic body processes that determine your size and shape. Certain foods trigger the appetite centers, causing you to overeat. Others trigger the satiety centers—the parts of your brain that tell you to stop eating—so you eat less. What this means is that if you've felt like your appetite is stronger than it should be, this very likely has a simple nutritional cause. By choosing the right foods—which you'll learn how to do—you can easily correct the issue.
• You'll ramp up your after-meal metabolism—your calorie-burning speed. By choosing certain foods, you will boost your cells' ability to turn more of what you eat into energy, not fat. I'll show you which foods work this magic.
• You'll kickstart your health. Some quick weight loss diets force you into semi-starvation; others let you "enjoy" less-than-healthy high-protein foods that can harm you over the long run. In this program, we go beyond those shortsighted ideas. Instead our goal is to have the best of all worlds—a healthy weight and a healthy body. By focusing on cardioprotection—choosing foods that rejuvenate your heart and blood vessels—you will carry good health deep into your tissues and have renewed energy and a strong measure of resistance to the health problems that trouble so many people.

What We Won't Do

There are three things this program does not do:

• We will not count calories. In theory, calories matter. But when we zero in on what you eat, rather than how much you eat, calories will take care of themselves.
• We will not push you to exercise. In this plan, exercise is totally optional. Surprised? Well, let me be clear: As a doctor, I highly recommend exercise, for many reasons. But some people can't do meaningful exercise, due to a weak heart, painful joints, tremendously excessive weight gain, or other reasons. If that includes you, it is important to be aware that our research studies have shown dramatic results with nutrition alone. So exercise is great, and it adds to the benefits of a nutritional change, but even if you never exercise, you can lose weight easily and gain tremendous health advantages.
• We will not make you feel guilty about carbohydrates. Many people have become nervous about bread, potatoes, and rice, fearing that these foods are fattening. What they have missed is that, once you know how to choose carbs the right way—and how not to ruin them in your kitchen—you can enjoy carbohydrate-containing foods and still lose weight.

As a matter of fact, we won't make you feel guilty about anything. When it comes to food, for some reason, guilt and morality often rear their ugly heads. People sometimes talk about tasty foods as being "sinful" and "decadent." We are "bad" if we eat something that is less than healthy, and we are "good" if we resist temptation. If we fall ill, we tend to blame ourselves, our parents, our genes, the government, the food industry, or perhaps someone else.

Well, there are some moral issues when it comes to foods and health. But in this book, we are setting all of them aside. Guilt, blame, and moralizing will have no place here. Instead, we are jumping into a program that you will enjoy and that brings results. We will zero in using the power of foods for health. And if you ever eat something that is not the best choice, well, just dust yourself off and get back aboard the program.

How the Kickstart Works

As the program begins, your first job, surprisingly enough, is not to change your diet. Rather, we'll start by checking out the possibilities of healthful foods to see which ones you like the most and which ones work best for you. This takes just a few days. And you're not changing your diet; you're just trying new things. I think you will be very surprised to see how easy and delicious a plant-based diet can be!

If you like to cook, you'll have an abundance of recipes to choose from, created by Jason Wyrick, one of the world's most remarkable chefs. Jason's work has influenced many other cooks and chefs who are looking for a new emphasis on health, as well as delights for the palate. He demonstrates his deliciously easy approach to food to standing-room-only crowds, showing how easy it can be to make truly wonderful meals. Page through the menus and recipes in this book and you'll see what I mean.

If cooking is not your thing, we'll look at convenience foods and how to make the best choices at restaurants. If you think that restaurants or fast-food places are off limits, you'll learn that it's much easier than you think to enjoy a delicious meal while you're out on the town, without breaking your healthy stride.

I'll also share tips on how to shop, how to adapt your favorite recipes, and how to turn the volume down on temptation. By the time you're finished with your exploration, you'll know exactly which foods will work for you and fit your tastes and your schedule.

Then, once you're ready and you know which foods you like best, we'll jump in and put them to work. For 21 days, you'll enjoy the healthy foods you've chosen, and you'll see what they'll do for you. I'll stay by your side every step of the way, with information and support. I'll check in on how you're doing and whatever challenges might be ahead of you. I'll give you new insights on health topics. And I'll keep you pumped up and motivated.

You'll also have friends pulling for you day by day. Best-selling author Alicia Silverstone will tell you her secrets for youthful beauty. NBA champion John Salley and ultramarathon athlete Scott Jurek will share their tips for explosive energy. Bob Harper from The Biggest Loser will help you develop the right attitude and mind-set. Marilu Henner, Rory Freedman, Kathy Freston, Kris Carr, and many others will share their insights as experts—and as people who have made the life-changing transition you are about to make.

The book is divided into three parts. In part 1, I'll share with you the easy ABCs of the program:

You'll learn how foods affect your body—which ones ramp up your appetite control, help your metabolism, and keep you healthy.

Part 2 is the Kickstart program itself. I'll give you everything you need to get ready. And then I'll have a short reading for you each day for 21 days.

Part 3 has the tools to keep you healthy for life, with menus, recipes, cooking tips, and more inspiration to keep exploring your healthy new body and the foods you can enjoy.

So let's get started. I hope you enjoy every part of this exciting new journey, and that you share what you have learned with others. If you would like to get more involved with our efforts to spread a healthful message far and wide, you will find plenty of resources at www.pcrm.org. I'm looking forward to working with you.

Part I

METABOLICALLY ACTIVE FOODS

CHAPTER 1

Power on Your Plate

Welcome to the Kickstart! In just 21 days, you're going to be thinner, healthier, and more energetic. As you'll soon see, the program is quite easy and very effective. You may not yet realize how powerful the foods you eat are—and what a difference a few small changes can make in your life.

There are so many different approaches to nutrition, weight loss, and health. It is important for you to know that the dietary changes recommended in this book have been carefully tested, with the results published in peer-reviewed scientific journals. Not only are they more enjoyable than other dietary methods; they are potentially more effective than any other approach ever devised.

Before jumping into the Kickstart, I thought you might like to hear how the simple changes in the program have worked for others—and will work for you, too.

Everyone knows GEICO, the car insurance company whose spokesperson-logo is a little green gecko with an English accent. GEICO's headquarters happen to be near my office. A few years ago, the company became interested in seeing whether a plant-based diet might help its employees. Because the company provides medical insurance for its employees, every employee who starts a cholesterol-lowering drug or needs a heart bypass costs the firm money.

So my team did a research study with GEICO with just two simple steps: First, the company cafeteria included vegan options, along with the other foods it served. By the way, if this is a new word for you, a vegan is not a person from the planet Vegus. The word simply refers to a diverse diet that leaves out animal products. So in addition to the usual bacon-and-egg breakfast, GEICO provided an oatmeal bar and fruit. At lunch, the cafeteria served hamburgers and all the usual fare, but added veggie burgers, portobello mushroom sandwiches, red bean chili, and vegetable lasagna.

Second, employees who wanted to give a healthy diet a try were offered a one-hour group meeting once a week. The idea was to provide cooking instruction, health lectures, and time to talk together about how the diet change was going. At the GEICO site in the Washington, DC, area, sixty-eight people volunteered to try the program out for five months. They saw this as a chance to lose weight, gain more energy, and break some old habits. A separate GEICO facility in Fredericksburg, Virginia, agreed to serve as a comparison site, with no diet changes.

Hillary and Bruce worked at the Washington-area GEICO office and decided to join the study. They are real people, and those are their real names. They are upbeat and fun loving. But Bruce described their weight problems as serious and long standing, and he was not looking for excuses. "We definitely both loved our food," he said. Fast food, doughnuts, and just about everything else called to them on a daily basis. "It was really pretty terrible, the way we ate."

But solving the problem was another matter. They had tried various diets in earnest, but nothing seemed to last, and each diet failure was a demoralizing experience.

Exercise presented a different set of challenges. "You're embarrassed to go to the gym," Bruce said. "You're embarrassed to go out jogging. You really don't want to go out in public and be seen running around and jiggling everywhere."

Hillary said, "It was really difficult to find clothes that would fit and that were appropriate for work. And also knowing that it was really my fault and that there was something I should be doing about it but that I wasn't able to do—that was very frustrating."

When the GEICO study started, Bruce weighed 283 pounds, and Hillary weighed 239. But they supported each other in the change, and they put healthy foods to work 100 percent.

Weight started to melt away almost immediately. "I think eight to ten weeks into the study, I had already lost thirty pounds and had been able to go shopping for new clothes," Hillary said. "It was very, very exciting. It was also very exciting to start seeing the reactions of other people as I would attend a conference and see people I hadn't seen for several months. People really noticed. They could see that there had been a big difference in my attitude and in how I looked physically. It was very inspiring."

"The pounds were dropping like crazy," Bruce said. "My cholesterol was plummeting. It was fantastic. This was something that was working better than anything we'd tried before. And I think that we knew we were on the right path."

After five months, the study participants stood on the scale. At Fredericksburg, the average person got nowhere, of course. They had made no diet changes, and so their weight didn't fall at all. But at the Washington site, participants lost weight easily. The largest weight loss was forty-six pounds over five months; a more typical weight loss was between ten and twenty pounds. Waistlines shrank by two inches, on average, and hips slimmed by nearly two inches, too. We published the results in three scientific journal reports.¹,²,³

But for Hillary and Bruce, something even more profound had happened. The short-term experience had eased them out of their routine. It had shown them a better way and had broken all their not-so-healthful habits. So when the study ended, they kept going.

Within a year, Hillary had lost eighty-five pounds, and Bruce had lost more than a hundred. They sent me a photograph showing the dramatic change. Not only were they trim, healthy, and beautiful, but I also noticed they were wearing athletic clothes—with no jiggling parts—and had numbers pinned to their T-shirts. Because their energy had come roaring back, they did something they had never done before—they signed up for a half-marathon! Changing what was on their plates allowed them to shed the weight and to gain so much energy that they wanted to exercise.

Today they look great, and they feel great. And eating has become a new adventure. At first, they started trying out new foods in order to participate in our program—just as you will during the next 21 days. Then as they discovered new tastes, new recipes, and new products, they gained a whole new way of thinking about food. They love their new, healthy relationship with food and their new healthy bodies, and the same is in store for you.

By the way, their tremendous weight loss started without exercise. They began the diet change first, and then, as their energy ramped up, they found that they wanted to get active. What this means is that, like Hillary and Bruce, you are about to embark on a simple but profound change, not just in weight, but in your energy level and in how you feel about yourself.

Hillary's and Bruce's story can be anyone's story. If you are looking to lose a little weight—or a lot of weight—or conquer a serious health problem, a change in diet can be powerful. It can help you gain a level of health you had not thought possible.

Not Just Thinner. Healthier, Too

Weight loss is an issue for many people and will be a central focus of this book, but it's just as important to look beyond the scale, at your overall health. And that's the beauty of the approach you're about to put to work. The menu changes that help you lose weight also have a decisive effect on health.

One of the most amazing studies ever conducted was led by Dr. Dean Ornish, a young Harvard-trained physician, who showed that a low-fat vegetarian diet, along with other healthy lifestyle changes, not only led to impressive weight loss and huge changes in cholesterol, but actually caused heart disease to reverse.⁴ In other words, arteries that had been narrowed slowly but surely over decades actually began to reopen—without drugs or surgery. As blood flow improved, chest pain disappeared, and people felt young again. The heart attacks that had threatened Dr. Ornish's patients were suddenly much less likely to ever occur.⁵

At the Cleveland Clinic, Dr. Caldwell Esselstyn, MD, went a step further. In patients with severe heart disease, he prescribed an Ornish-style diet. If a patient's cholesterol level did not fall below 150 mg/dL, he added a cholesterol-lowering medication. The results were astounding. Although the patients had been very sick at the study outset, their health turned around completely. In twelve years of study, not a single person who followed Dr. Esselstyn's approach had any heart complications at all.⁶

Meanwhile, Dr. David Jenkins at the University of Toronto showed that foods alone could lower cholesterol levels nearly as well as cholesterol-lowering drugs.⁷ The trick was to start with a plant-based diet, and then emphasize specific foods that have a known cholesterol-lowering ability: oats, barley, soy products, and almonds, for example. His patients cut their LDL ("bad") cholesterol by nearly 30 percent in just four weeks. A similar diet effectively lowers high blood pressure.⁸