By Duane Graveline, M.D., M.P.H.
In regard to the FDA's diet guidelines, McCully unequivocally states:
"The Food Pyramid is wrong on two counts: First, it is based on the false premise that cholesterol and saturated fats are the underlying cause of coronary heart disease. Second, it erroneously implies that all carbohydrates - whether refined or from whole food - are preferable to fats."
McCully's diet is simple: Protein in the form of meat, fish, poultry, eggs, milk, cheese and beans should comprise about 25 percent of our daily caloric intake. Another 25 to 30 percent should come from the consumption of fats, which includes the fat of ingested meats plus olive oil, butter and cream. The remaining 45-50 percent of our daily caloric intake should be derived from the consumption of complex carbohydrates in the form of fruit, vegetables and whole grains.
Balance is key in this diet, primary to maintaining balance in the body.
In his discussion of his carbohydrate restrictive diet, McCully devotes special attention to foods that have abundant amounts of folic acid and the B6 and B12 vitamins so important for holding homocysteine in check. He also advises the necessary cooking techniques that minimize the loss of these substances during food preparation.
He generally goes along with the mid-section of the Food Pyramid but recommends a few modifications. Although milk, cheese and yogurt are good sources of calcium and protein and the recommendation to eat two or three servings per day is valid, he takes issue with the recommendation to eat only low fat or fat free products. He is concerned about the associated risk of deficiency of fat-soluble vitamins, since these nutrients are found only in the fat portion of the foods we eat.
Another area McCully would modify is the FDA recommendation to consume two or three servings of meat, poultry, fish, dry beans, eggs or nuts a day. Putting beans and nuts in this group is problematic, he says, because it suggests that plant and animal proteins are interchangeable: "The truth is that plant protein, lacking in the essential amino acids, is quite different from animal protein, which contains plentiful essential amino acids. Therefore, depending only on plants for protein is not a good idea because the protein is inferior."
He suggests a daily intake of two or three servings of protein from fish, meats, poultry, eggs or cheese. Yes we have said eggs, which along with whole milk and fresh butter represent a major departure from the failed low cholesterol / low fat diet of the past. Fallon and Enig's "The Oiling of America" should be required reading for every primary care physician in this country. A return to the farm diet of rural American youth with lard, butter and whole milk is now very much back in vogue.
McCully agrees with eating more vegetables and fruits, which are an excellent source of vitamins, minerals, fiber and complex carbohydrates, but reminds us that although "carbohydrates are essential we must choose beneficial carbohydrates--fruits, vegetables and whole grains--not refined carbohydrates like sugar and flour products."
He deplores the tendency of so many Americans to turn to highly refined, vitamin and mineral depleted, readily available, processed foods, which, for the most part, tend to be high in refined carbohydrates. As stated earlier, that excessive reliance on such carbohydrates in our diet has lead to the present carbohydrate catastrophe, the obesity epidemic.
You won't find processed foods or white bread or french fries in McCully's diet but you will find some remarkable similarities to the food nutritionists who postulate what our diet must have been like 10,000 years ago. Not only has McCully focused his diet on the prevention of arteriosclerosis but he also presents a diet to which we are already well suited, genetically speaking. We are still hunter-gatherers like our forebears, he says, but we must now confine our searches to the aisles of supermarkets in our quest for just the right foods.
Dr. McCully's persistent, even tenacious, adherence to his almost 'Eureka' concept of homocysteine toxicity causation of arteriosclerosis has gained wide acceptance from researchers in the field. From his first lonely review of arteriosclerotic changes in children who died from genetically pre-ordained homocystinuria, he now seems to have proven his point: cholesterol is not the cause of arteriosclerosis, homocysteine elevation secondary to vitamin deficiency appears to be the major player.
Needless to say, to depart so radically from prevailing concepts takes a man with determination but it does not stop there. McCully's historic work also points to vitamin deficiencies as playing the primary contributory role in arteriosclerosis. Homocysteine, the new villain, becomes predictably elevated in the body only when one or more of the B complex vitamins - folic acid, B6 or B12 - are deficient. Arteriosclerosis, it would seem, is a deficiency disease, which, according to McCully (and now many others) makes it potentially treatable by dietary supplementation.
Cholesterol is not completely off the hook but its role, when sufficiently elevated, has now become a passive one, that of contributing to the pre-existing arterial disease. Most authorities now accept these findings but are quick to point out homocysteine elevation, by itself, cannot account for all arteriosclerosis and atherosclerosis observed.
Other factors such as trans fats, omega 6, magnesium, oxidants, platelet malfunction, and even low levels of Coenzyme Q10 may be involved but this major departure from traditional thinking now has widespread research support.
Duane Graveline MD MPH
Former USAF Flight Surgeon
Former NASA Astronaut
Retired Family Doctor
Updated August 2011