DR. PINEDA OCHOA: You direct a weight loss clinic here in New York. What does the data
show about what kind of diet would be most optimal for keeping weight off or reducing
weight? We just started on the Instagram account and saw your Instagram. And we saw a picture
that you had on there where you’re wearing a t-shirt that says —
DR. MCMACKEN: Carbs.
DR. PINEDA OCHOA: — carbs.
DR. MCMACKEN: That’s one of my favorite shirts.
DR. PINEDA OCHOA: You are the director of a weight-loss clinic here. Tell us what’s
the deal with carbs? Everybody’s afraid of potatoes and bananas.
DR. MCMACKEN: Right.
DR. PINEDA OCHOA: So what is your recommendation for that?
DR. MCMACKEN: So first of all, when it comes to weight loss, I think a lot of people — because
there’s so much frustration and sort of almost desperation around weight loss, I think
people are always looking for something that’s going to help them lose weight quickly and
get to their goal as quickly as possible. And the truth is that there’s an endless
number of different diets that you could put a person on and they would lose weight. And
to the extent that you limit calories, you’re going to lose some weight.
So as a physician and someone who cares about not just short-term but also medium-term and
long-term health, I’m really looking at strategies that help with weight loss but
also promote health. So for me, the strategies that are commonly recommended or that people
see, hear a lot about — the low carb strategies, for example – I don’t really recommend,
because people necessarily miss out on a lot of really important nutrients when they eat
that way. And the studies show that people have higher rates of cardiovascular disease
and cancer and even earlier death when they eat that way.
DR. PINEDA OCHOA: When they eat the low carb diet, which is basically high in animal protein
usually–
DR. MCMACKEN: Right.
DR. PINEDA OCHOA: –animal protein and fat, right?
DR. MCMACKEN: Right.
DR. PINEDA OCHOA: Which would be like Atkins, like paleo, those types…
DR. MCMACKEN: To some degree, paleo, but primarily an Atkins-style diet. And there’s a lot
of different variations on those diets. So for me, the big picture is short-, medium-,
and long-term health and achieving weight loss sustainably and healthfully at the same
time. So for me, again, that equates to a plant-based diet. And luckily, there’s a
lot of evidence that plant-based diets work great for weight loss.
We have studies showing, first of all, that, again, when you compare different types of
eaters, people that eat plant-based diets, like vegans, tend to have not only the — they
have the healthiest body weights. In fact, in the Adventist group, they were the only
group that were not overweight. And this has been reproduced in many other studies as well.
So epidemiologically, we know that people following plant-based diets tend to have healthier
body weights.
We also know that prospectively, looking forward in time, the foods that are most associated
with weight gain are actually animal products and meat and low fiber diets. So that’s
two strikes against some of the other diets that are out there.
And then finally, studies also show that people who follow mostly a whole food plant-based
diet, meaning eating plant foods in their less-processed forms, tend to be able to eat
as much as they want when they’re hungry without measuring portions or counting calories.
And they still can lose weight if they want to.
So to me, when I think about — I’m no stranger to counseling people to count calories
or measure portions. That’s a way that I used to practice. And I can tell you, it’s
not fun to do it, and it’s not fun to recommend it. And people don’t like doing it. And
it may work in the short term, but it’s not really a sustainable way to live your
life, and it’s not enjoyable.
It’s not a life of abundance, where my experience personally, and my experience with my patients
in following a plant-based diet, is that it is a life of abundance. And you actually end
up experiencing foods that you may not have tried before and eating when you’re hungry
and not feeling deprived and feeling more energetic and having all these other side
health benefits at the same time.
DR. PINEDA OCHOA: That’s wonderful. And you mentioned right now that, talking about
animal foods, that a lot of data links it to, people who eat the most animal foods have
the highest amount of body mass index, or weight. So that’s very interesting. And
I’m sure a lot of people don’t know that.
And you’ve written about common misconceptions that your patients express to you quite frequently.
What are some of the most common misconceptions that you see in patients that you feel are
most damaging in general and to their health that they just have no idea about this thing
or another thing?
DR. MCMACKEN: Yeah. I mean, I think we hit on it earlier when we started to talk about
protein and carbs. And I think those two top the list. And they’re related, of course.
So this exaggerated concern about protein that we have in our society, I think is very
damaging to people, because people seek out protein as if they were on the border of deficiency.
And in my entire years of practice and medical school and residency, I’ve literally never
seen a person who was protein-deficient.
But I can tell you that all day long, Monday through Friday, every day, I see people who
are deficient in fiber. That is the nutrient that we should really be concerned about.
And they’re opposite, right? Because animal products don’t have fiber.
DR. PINEDA OCHOA: None of them.
DR. MCMACKEN: None of them.
DR. PINEDA OCHOA: None of them do.
DR. MCMACKEN: So again, by fixating on protein, we end up, it’s this cost. You pay a price
for that. You end up losing out on nutrients that we actually really need to promote health.
So when you look at how much protein people are actually eating, the average person is
eating one and a half times the amount of protein that they need and often more.
So I think if we all ate the recommended amount and stopped there, we’d all be a lot healthier.
And luckily, if you eat a plant-based diet, you end up getting, magically, the recommended
amount through just following a plant-based diet. There’s enough protein in plant foods
that you get the right amount.
I think carbs is the other big misconception that’s out there. And we touched on that
earlier, that carbs will give your diabetes. Carbs will make you gain weight. Carbs will–
DR. PINEDA OCHOA: Bad.
DR. MCMACKEN: –they’re bad for you, just bad. And my experience, again, has been completely
the opposite. And of course, if you’re eating carbs in a very processed form, just like
any processed food, it’s not going to benefit you. But if you’re eating a plant-based
diet, which is naturally high in carbs, you’ll do great. You’ll probably lose weight if
you want to.
That’s the diet that’s been shown to prevent diabetes. Actually, the whole grains are the
most powerful food in terms of preventing diabetes. So it’s carbs that prevent diabetes,
ironically, even though we always think that people who have diabetes can’t eat carbs
or have to count their carbs.
DR. PINEDA OCHOA: And people think, well, if I’m going to be on a plant-based vegan
diet, then what is it that I have to eat to get my protein? Like, do I have to eat almonds
every day? How do you– just completely, people say, well, where am I going to get
my protein? So what is your response to that?
DR. MCMACKEN: Yeah, my response is that every plant food – every food has some protein.
And if you look at broccoli, it has more protein per calorie than beef. So people are often
surprised to hear that. And the truth is, broccoli has a lot fewer calories than beef.
And that’s probably one of its benefits. It has a lot of fiber and fills you up without
as many calories.
So I always tell people, if you’re getting enough calories, you’re getting enough protein.
Protein, it’s just extremely tied to your calorie intake. So you’ll know if you’re
getting enough calories, because you’re hungry or you’re not hungry.
DR. PINEDA OCHOA: Basically, if you’re filled, if you feel satisfied, and you are eating
a plant-based vegan diet–
DR. MCMACKEN: You’re good to do.
DR. PINEDA OCHOA: –you’re getting your protein.
DR. MCMACKEN: Yeah. There’s no need to specifically target protein sources in the diet, just eat
a diverse group of foods, make them as least processed as possible, and eat when you’re
hungry, and stop when you’re full. It’s so simple that it’s almost hard to believe.
But it works.