Joel Fuhrman: The Doctor Is Out There
Credit: Photograph by Nathan Perkel
Nutritarianism is part of a growing school of research-based dietary thinking that insists that, in terms of wellness, you really are what you eat. Call it plant-based libertarianism. The U.S. has the world's highest healthcare costs – $2.7 trillion in 2011 – while consistently scoring lowest among developed nations for quality of care. Practitioners of plant-based libertarianism believe that every person needs to take full responsibility for his or her own health. This means adopting a wellness-focused diet, mostly vegan.

Comprehensive improvements in diet have long been shown to reverse, slow, or prevent what are called "diseases of affluence," largely self-inflicted maladies like obesity, coronary heart disease, stroke, and type-2 diabetes. More recent research suggests that such dietary improvements also combat Alzheimer's and cancer. This movement shares some of the life-extension dogma of the calorie-restriction crowd and a little of the anti-agribusiness, eat-local moralism of writers like Michael Pollan ('The Omnivore's Dilemma') and films like 'Food, Inc.' Its primary concern, however, is wresting control of America's health back from the insurance and drug companies and returning it to the hands of citizens. As Fuhrman puts it in 'Eat to Live,' "only you, not your physician, must take responsibility."

"In the future, it's going to become more and more impossible for the economy to support how expensive medical care is and the number of sick people we have," Fuhrman says. "Why don't we just get our population healthier so we don't need medical care?"

Along with Fuhrman, the leaders of plant-based libertarianism include nutritionist T. Colin Campbell, co-author of The China Study, and his comrade-in-arms Dr. Caldwell Esselstyn, a cardiovascular surgeon. Last year, Campbell and Esselstyn starred in the hit documentary 'Forks Over Knives' – the title reflects a preference for dietary intervention over the surgical variety – and published a bestselling book of the same name. Perhaps the biggest brand name in the field is Dr. Dean Ornish, whose near-vegan diet helped Bill Clinton drop 24 pounds following a second coronary surgery. Fuhrman is something of an outlier among this group in that he argues that small amounts of fish, eggs, and low-fat dairy are permissible so long as a person cranks up the rest of his diet to meet the ultrahigh nutritional benchmarks set by the H=N/C standard. "The right raw materials can...double or triple the protective power of the immune system," he writes in his latest book, 'Super Immunity: The Essential Nutrition Guide for Boosting Your Body's Defenses to Live Longer, Stronger, and Disease Free.'

The nutrients that most interest Fuhrman aren't found in supplements or multivitamins. He focuses instead on the immunity-boosting power of micronutrients. These include antioxidants and phytochemicals, which he calls "the most important discovery in human nutrition in the last 50 years," though most of them have yet to be named or even identified. The foods highest in micronutrients per calorie are unprocessed plant foods, mostly fruits and vegetables, which make up 90 percent of an ideal nutritarian diet. In Fuhrman's system, calorie-dense olive oil (nine points) scores lower than white bread (18 points) because its phytochemical load is so low relative to its fat content.

"If you want ideal health, you need to overcompensate and eat an excellent diet," Fuhrman says. He estimates that if all Americans were to adopt a nutritarian diet, "the immediate impact is that cancer rates might decrease by half. But the long-term impact, over generations...." He picks up a pencil and draws a downward-sloping line. "If we get kids eating right, we could decrease cancer rates by 90 percent."

Like most evangelists, he maintains few barriers between his professional and personal life. At least one patient recalls arriving for an initial consultation and receiving an invitation for her family to swim at the Fuhrman home in New Jersey later that day. Fuhrman's wife, Lisa (age 53; looks a very fit 40), manages his online business and co-stars in his cooking DVD. The four Fuhrman children, ages 10 to 24, have been raised on a plant-based diet but are allowed to make their own food choices outside the home. According to their father, they almost always stick with the program: "One of my daughters once joked that for her, a cookie would be like shooting up heroin or smoking pot." Fuhrman often cites his children as examples of the benefits of nutritarianism – he cannot recall a single ear infection or case of the flu among them. Unlike most family practitioners, Fuhrman gleefully picks fights with other doctors, particularly those whose diets he disagrees with. "The Dukan Diet, the one Kate Middleton was on? That's the stupidest diet in the world," he says, scoffing at the high-protein plan.

The competitive fire that once drove Fuhrman as a skater is now largely channeled into marketing. Drfuhrman.com offers free nutritarian eating plans, with consultations, for overweight brides-to-be who wish to lose 50 or more pounds by their wedding day and are willing to provide a testimonial online "and possibly in magazines and on television." Fuhrman's "3 Steps to Incredible Health" special – essentially a stylish infomercial for nutritarianism – has become a staple during the self-improvement bloc of PBS pledge drives. As an author, Fuhrman has one distinct advantage over virtually all his neighbors in the diet-book aisle at Barnes & Noble: He is an entertaining writer with a gift for plucking fascinating facts and figures out of dry journal articles. (Two random examples: Three servings of cruciferous vegetables per week lower the risk of prostate cancer by 41 percent. Linebackers are six times as likely as endurance athletes to die young.)

If you've set foot in a Whole Foods, you may have noticed that the fruits, vegetables, and dairy products are labeled with an ANDI (Aggregate Nutrient Density Index) score, a number calculated with Fuhrman's H=N/C formula. (Leafy greens, like kale, low in calories and packed with phytochemicals, score a perfect 1,000.) "In my 31 years at Whole Foods, these scores are one of the biggest successes we've had," says Margaret Wittenberg, the company's global VP of quality standards and public affairs. "There's times we've had stores run out of kale." Fuhrman also recommends large quantities of onions, garlic, berries, and mushrooms, all of which he credits with anticancer properties. "Women who ate mushrooms in China had a 64 percent lower incidence of breast cancer," he says, citing a recent study. "That should've been on the front page of the New York Times."

Micronutrients, Fuhrman contends, are also one of the unacknowledged keys to understanding the American obesity epidemic. Americans get less than five percent of their calories from unprocessed fruits and vegetables that aren't white potatoes; 62 percent of our calories comes from nutrient-poor processed foods that are usually loaded with carbohydrates. Fuhrman believes that we overeat these foods not only for the dopamine rush they supply but also in a futile attempt to make up for a micronutrient deficit. The more junk we consume, the more toxins, like free radicals, amass in our tissues. "We become addicted to this toxicity buildup like it was cocaine or nicotine," Fuhrman says. "When we try to stop eating, we get withdrawal symptoms." These include the gnawing sensation in the stomach, irritability, and light-headedness that 99.9 percent of us would identify as hunger.

Fuhrman says these pangs are fake signals, an overriding of natural appetite that should kick in only once the body has exhausted its glycogen stores. The not-unpleasant sensation he calls "true hunger" is felt in the throat, neck, and mouth rather than the belly. It can be satiated by consuming almost any healthy food. Any urge that might qualify as a craving is, by Fuhrman's definition, a sign of food addiction.