January nonfiction: Super Immunity by Dr. Joel Fuhrman

Here are my book notes for my January non-fiction book.

I read Super Immunity by Joel Fuhrman, M.D.

I don't remember why this was on my list. I must have heard him speak. Or maybe I read him someplace. I don't know.

Super Immunity was published in 2011. That is a long time ago in biohacking time.

But I read the whole book twice. To summarize the entire book in 2 words: Eat vegetables.

I'll put my conclusion here so you don't have to read the book notes if you don't want to.

Heather's conclusion:
If you are interested in this topic, you might look for a more recent publication. Things have changed since 2011. Example, the fact that he says fruit is ok to eat and doesn't even suggest that this is controversial, would actually be a controversial statement among nutritionists today. However, I have no doubt that he's on the right track, but do not take all of his hypotheses as any more than hypotheses at this time. His website is sales-y, but so are basically all M.D. websites that have books to sell. Dr. Fuhrman is not listed as one of Tim Ferriss's "Titans", and when I looked further, it appears that TF has never interviewed him, but TF's community indicates that Fuhrman is "biased" and has very weak sources for his "evidence" that meat is bad for you, for example. Since I checked a few of his sources myself, and 2 of the 3 that I personally checked were weak, I would certainly not consider him an expert researcher. Not to mention additional statements he made that were either flat out wrong, or misleading, though I believe in the cases I identified, he did not intend to mislead. But advising people to supplement with vitamin D without a blood test first is not a good idea. It is a bad idea. But now that I think about it, I believe in 2011 we didn't know that yet.

The term "superfood" today is being challenged, but I do not think he intended the term in a misleading way, either.

The basically vegan diet that he promotes is more challenging for someone to follow if they have a number of food allergies or sensitivities, like I do. However, there was still plenty left for me to eat even taking into account my food allergies. But I would not be able to follow his 7-day menu. I was glad to learn about the (alleged) benefits of cruciferous vegetable over other types of vegetables, mainly because those are the ones I'm not sensitive to. I will be able to incorporate many of his superfoods into my diet without much effort, but I do need a tracking system (one of my 19 for 2019).

Book notes:
Page 3: "Our immune system protects us from developing cancer." Goes on to say that a weakened immune system causes weight gain, allergies, infections, etc.

Page 7: quotes a JAMA study providing evidence that the use of antibiotics is associated with an increased risk of breast cancer. This could be anywhere from 1 to 25 prescriptions over an average period of 17 years. (my note: the study sounds reasonable, but I wonder where they found a control group of women who had not taken any antibiotics at all for an average of 17 years, and then proved that they never developed breast cancer. That sounds like an incredibly long and implausible study.)

Page 9: "Food gives us energy and the building blocks to grow in the form of calories, but we have not fully appreciated the noncaloric micronutrients in food, including those that are neither vitamins nor minerals, but phytochemicals..."

Page 12: "With the recent discovery that superior immune function in humans is dependent on a broad array of these plant-derived chemicals...some people prefer to use the word phytonutrients..." He says these phytochemicals number in the hundreds. Examples, page 16, carotenes, alpha-lipoic acid, allium, etc.

Page 13: he specifically recommends berries, pomegranates, green vegetables, mushrooms, and onions. Page 23 he adds beans and seeds to the list.  "A combination of these compounds is more effective than a single agent, even in a high dose."

Page 16: "Neither processed foods nor animal products contain a significant load of antioxidant nutrients or any phytochemicals."

Page 17: "Phytochemicals have a broad array of beneficial effects outside of their antioxidant role, and these effects are still being studied and need to be further understood."

Page 18: Refers to a method of measuring vegetable intake. It is a blood test for alpha-carotene. This is a preferred measurement because it is not present in most multi-vitamins or supplements, and pretty much only comes from dark green or orange vegetables. Researchers found that increased alpha-carotene was associated with decreased risk of death "from all causes". And this was measurable across the scale. Just remember that the alpha-carotene was just a measurement and is correlation, not necessarily causation. What is troubling is that even after he explains this to people, he then goes onto list foods high in alpha-carotene. This is misleading the reader.

Page 19: Many phytochemicals are lost or destroyed in processing, including cooking.

Page 20: He reiterates that we don't know enough about individual phytochemicals, only that we need to eat a very wide variety of plant foods in order to achieve super immunity. He discourages eating meat, basically because it is not a plant, so it just wastes your time. However, note that in later chapters he describes other reasons he dislikes animal protein of any kind, for adults. (Animal protein is ok and necessary for children.)

Page 27: List of Fuhrman's favorite foods with a nutrient density score of his own design. It explains all the complicated math. The top 10 are kale, watercress, collards, brussels sprouts, bok choy, spinach, arugula, cabbage, broccoli, cauliflower.

Pages 29-36 discussion of a nutrient-rich diet as prevention for viral infection.

Pages 37-56 are an attack on prescription medications and the flu vaccine. References the Cochrane Database of Systematic Reviews and said they found weak evidence of flu vaccine efficacy. I checked for myself and found that what Fuhrman reported in the book was mostly reported correctly. Here is the review: https://www.cochrane.org/CD001269/ARI_vaccines-prevent-influenza-healthy-adults and it actually says the flu vaccine prevents only 1-2% of cases in healthy adults. Fuhrman goes on to say the Cochrane organization is openly critical of the CDC's flu shot recommendations, but perhaps that is in the full abstracts, which I didn't read.

Page 49: "The fact that flu vaccination is heavily promoted by government and medical authorities, despite the marginal benefits, fuels distrust of the entire medical/pharmaceutical/government health complex, which reeks of collusion and conflict of interest."

Page 50: Fuhrman says the Cochrane group calls out the CDC for not being impartial, but rather, for quoting "anything that supports their theory". Fuhrman says that the CDC Advisory Committee on Immunization Practices is made up of 15 people, and "almost all" of them have financial ties to the vaccine industry. His source: A year 2000 USA Today article, so now 19 years old.

Page 61: Cancer is cells growing wildly, this rapid division can be caused by methylation of a gene. This is adding a methyl group, but removing a methyl group also is associated with an increased risk of cancer. Researchers have found that people who ate more green vegetables had less DNA methylation and a lower risk of cancer. And vice versa, people who ate less green vegetables had more DNA methylation and a higher risk of cancer.

Pages 62-69: detailed chemical discussion of the cruciferous vegetables and the types of phytochemicals they contain that are proven to have anticancer activity, as well as anti-bacterial. Cruciferous vegetables are kale, cabbage, collards, broccoli, cauliflower, brussels sprouts, radishes, and turnips. He gives specific examples of cancer reductions from just 1-3 servings of cruciferous vegetables per week. Fuhrman recommends 1-2 servings per day, one of them raw.

Page 67: He says to get the beneficial phytochemicals out of the cruciferous vegetables, the vegetables have to be crushed. So, chew them really, really, good, or chop them, or blend/juice them. He said some benefit may be lost with boiling or steaming, so the maximum benefit is to eat them raw. BUT, you can also chop them first, and then cook or steam, and that is ok. Therefore, riced cauliflower or riced broccoli is ok to steam or cook into soup.

Page 69: discussion of mushrooms as a superfood because many (not all) types of mushrooms are said to contain a substance that enhances "natural killer T cells" that remove infected cells in our bodies. The best mushrooms, specifically associated with reduced breast cancer (page 71) are white button, white stuffing, cremini, reishi, and maitake.

Page 73: "Angiogenesis is a complex physiological process by which new blood vessels are formed from previously existing ones." This process is one that large cancer tumors initiate when they need their own blood supply.  Mushrooms inhibit angiogenesis, which can starve the cancer. This is true even of cooked mushrooms.

Page 75: There are also foods that promote angiogenesis, and those are white flour-based foods.

Page 75: "...increased consumption of allium vegetables is associated with lower risk of cancer at all common sites." It is guessed that the beneficial compounds are released when the vegetables are chopped, crushed, or chewed.

Page 76-77: references a specific study showing eating onions was linked to significantly reduced cancer incidences in specific cancers. In the study the highest consumption was about 1/2 cup chopped onions per day.

Page 77: lists many benefits of pomegranate berries and juice

Page 79: describes research of berries in lab rats. The results were very positive in reducing tumors. The studied berries included blackberries, blueberries, raspberries, and pomegranates. Dr. Fuhrman adds acai berries, goji berries, elderberries, and strawberries to the superfood list.

Page 80: Discussion of seeds as superfoods, including flax seeds, sunflower seeds, pumpkin seeds, and sesame seeds.

Page 83: GOMBBS: Greens, onions, mushrooms, berries, beans, seeds.

Page 85-107: discussion of the cold virus and all the things that do not cure it. Dr. Furhman says the following things are a waste of time at treating the cold: vitamin C, chicken soup, humidified air, neti pots, echinacea, increased fluids, any cough medine. And the following are helpful: zinc, vitamin D (at all times, it won't reduce cold symptoms once you have a cold), possibly elderberry extract, caloric restriction.  Never take acetaminophen as it is too hard on the liver.

Page 109: Health = nutrients/calories. A low-calorie diet is linked to longevity.

Page 113: Says we're allowed to eat steel cut oats and regular oatmeal.

Page 121: begin discussion of animal protein vs plant protein.

Page 124: What seems to be his biggest issue with animal protein, is that eating animal protein encourages our body to produce a hormone called IGF-1, which promotes growth. That is why this is important for children. But in adults, it only benefits a growing tumor. He goes on to list studies and examples illustrating why he promotes a mostly vegan diet. He is very insistent that animal protein and our excessive consumption of it is behind the cancer epidemic.

Page 130: Advises the following superfood summary in 5 points.

1. Eat a large salad every day.
2. Eat at least a 1/2 cup of beans/legumes daily.
3. Eat at least 3 fresh fruits a day (focus on the superfoods).
4. Eat at least 1 oz of raw nuts and seeds daily.
5. Eat at least 1 large serving of green/cruciferous vegetables daily.

Page 130: Advises avoiding these 5 deadliest foods, which is actually a lot more than 5.

1. Barbecued meat, processed meat, commercial red meat
2. Fried food
3. Dairy: cheese, ice cream, butter, milk, and for some reason he puts trans fats on this list even though that's not dairy
4. sodas, sugar, artificial sweeteners
5. white flour products

Page 136: Reiterates that it is the combination of adding fruits/vegetables AND reducing animal products which adds to the best longevity.

Page 143: exercise is key, heart rate to be elevated for at least 5 minutes per day.

Page 144: Begins discussion of vitamins and supplements. He recommends supplementation with vitamin D, B-12, zinc, and iodine. (Heather's note: it is not advisable to supplement with vitamin D without having a lab test first. Vitamin D must be within acceptable range. Excessive vitamin D is also linked to cancer.) P. 164, he does clarify that all nutrients can be harmful in deficiency or excess.

Page 145-151: He realllly doesn't like vitamin A and folic acid, so he cautions that if you are going to take a multivitamin, look for one without those things. Also see p. 146 where he doesn't like beta carotene supplements either. 

Page 146: his one sentence in the entire book about telomeres. Which is misleading, but then again most publications about telomeres are misleading.

Page 151: advises against supplementation of copper and iron.

Page 155: "Salt is the strongest factor relating to stomach cancer." (By salt, he actually means "sodium".)

Page 157: It appears that coffee contains phytonutrients. He's not sure.

Page 163: ok to avoid fish and just consume fish oil. Just make sure it is fresh. A vegan EPA or DHA supplement is ok too. He recommends getting a blood test if at all possible before you decided to supplement.

Page 166: questionable reference to the Environmental Working Group and the Dirty Dozen. (Heather's note: perhaps in 2011 Dr. Fuhrman was not aware that the Board of the EWG does not have a single unbiased/independent chemist or biologist or cancer researcher. There is one farmer, 2 MDs, and the rest are, well...it's actually pretty comical that these are the people who are telling us what we can't buy at the grocery store...see for yourself...https://www.ewg.org/about-us/board-members .I guess this is sad because earlier Fuhrman checked out the Board of the CDC and found them to be biased, but he either didn't check the EWG or didn't care to.)

Page 178: 7 day menu plan and a bunch of recipes follow. He does reference his own food products for sale but is not pushy and indicates the recipes can be made without purchasing from him.