Why don't more people eat this way?

[dailycarbs]

Incrementalism is a failing strategy. There will be a small percentage of people who will take this diet on (be it all at once or a slower, incremental approach). It does not follow that incrementalism will result in larger numbers of adoption. I base this on simple human observations:

- most people don't have what it takes to stick to a diet over the long haul. If they don't see noticeable results very quickly, they assume it's not working in short order. Incrementalism is less likely to produce noticeable results soon enough for most people. But if you can convince someone to go 100% for 30-90 days, you have at chance that they'll see the beginning of real change and that can motivate some (but not all) to follow through.

- people given to the incremental approach are often using it—even with their sad diet. They've cut out or cut back on meat (or at least eliminated processed meat). They substitute healthier options here and there: fish instead of meat, reduced alcohol intake, eat some soy and other plant meats and cheeses regularly but not exclusively. They may not be McDougallers but compared to their sad indulging friends, they have had more success, are healthier, and trimmer. I know quite a few such people. They already eat foods made of soy and other plant substitutes. But they'd never in a million years completely give up their vices: cheese, yogurt, fish, chicken, oil, the occasional meat splurge and especially the processed baked treats of their choice. You have less chance of converting these folks than fat and diseased sad eaters because they already think they're eating healthy. And if you compare them to their friends, they're right. As for comparing themseleves to McDougallers, well, we all know we're this way strictly due to genetics and luck.

[wade4veg]

Incrementalism is a failing strategy. There will be a small percentage of people who will take this diet on (be it all at once or a slower, incremental approach).

Baloney... its crazy to tell that group of people who do well on a step by step method that they are somehow inferior or doomed to fail. By passing on that idea you narrow down the potential success field to its current tiny percentage.

But even worse---

- most people don't have what it takes to stick to a diet over the long haul. If they don't see noticeable results very quickly, they assume it's not working in short order. Incrementalism is less likely to produce noticeable results soon enough for most people. But if you can convince someone to go 100% for 30-90 days, you have at chance that they'll see the beginning of real change and that can motivate some (but not all) to follow through.

You seem lost from the very beginning, going right to the habit of calling this a diet.... that everyone who joins in must be bringing along their "diet" mentality.
That none of them can see or be satisfied with losing 1 or 2 pounds a month, where as anyone with even a little bit of investigation knows well that there aren't any significant group diets that even offer 24 pounds a year loss in conducted studies.
You assume everyone is stuck in that mental prison... that they can't be smart enough to stick with a long slow return to health.
You are selling them short. With a little encouragement lots of people can do very well with a gradual approach.
Some may continue to a 10% diet and others may decide that 15% is far as the need to go.
Both are full success stories, and you'd be hard pressed to show either group to have superior outcomes.
The important part is that they have both improved on their own schedule.

[colonyofcells]

I would guess that there is probably not many people doing the mcdougall diet 100% and there is probably lots of cheating.

[Spiral]

There are some obvious pitfalls with telling people that going 70 percent McDougall is acceptable.

If someone is being told by their cardiologist that they must have coronary bypass surgery to deal with arteries that are 90 percent blocked, telling someone to eat the McDougall diet 70 percent of the time might result in eventually having the bypass surgery and/or early death.

Another pitfall is that it can be very difficult to know whether we are eating a diet that is 70 percent McDougall or 40 percent McDougall. How many tablespoons of oil did the cook at Macaroni Grill use in making your entrée? How many ounces of fish did you eat at Red Lobster? Did you bring a scale to Red Lobster with you? Oh, wait. How many greasy soy burgers did you eat this week? Three or five? Can't remember, right? It's been a busy week.

Some advocates of the plant based diet have advocated alternatives to going 100 percent whole foods plant-exclusive on day one.

Nathan Pritikin advocated a diet that includes significant amounts of animal based food.

Dr. Dean Ornish, in his book "The Spectrum" offered his readers a "spectrum" of dietary pattern choices, ranging from very healthy to moderately unhealthy and some options in between.

No one has presented any evidence that Pritikin and/or Ornish have been more successful in converting people to plant based diets than McDougall and Esselstyn.

I think some people can successfully adopt this way of eating by approaching it gradually. But the idea that no plant based advocate has ever offered "The Spectrum" approach (Ornish) or a more moderate approach (Pritikin) is fiction.

This really isn't about saints versus sinners. This is about the principles of healthy eating.

If you want to eat a slice of birthday cake on your birthday, that's your choice. But Dr. McDougall is not obligated to recommend birthday cake in his books or on this web site. After all, what happens when your neighbor shares a birthday cake on her son's birthday? What happens when your niece and her fiancé offer you a slice of their wedding cake? What happens when your co-worker shares her retirement cake with everyone in the office, including you?

Pretty soon, you are eating cake several times a week and it's all "acceptable," according to these more open-minded, less judgmental guidelines. But if you have a heart attack because you eat too many slices of cake, is that acceptable? Must Dr. McDougall take responsibility for that heart attack because he decided that he didn't want to appear to be too tough of a taskmaster?

[dailycarbs]

You seem lost from the very beginning, going right to the habit of calling this a diet.... that everyone who joins in must be bringing along their "diet" mentality.

di·et1
ˈdīət/
noun
1.
the kinds of food that a person, animal, or community habitually eats.
"a vegetarian diet"
synonyms: selection of food, food, foodstuffs;

[iowamv]

I'm in the camp of folks who characterize others' approach to unhealthy foods as "addiction." You can't talk rationality and logic with people who are adamant that they want to keep their SOOOOOOO delicious foods. There needs to be a clean break, a realization that going with the crowd and eating foods accepted by society (e.g., just about everything on a restaurant menu) is killing you. All of those things JeffN calls "CRAP" and full of "SOS" are just like meth or crack. People cling to them like Gollum clings to his "Precious," for those who read Tolkein. When I tell people what I willingly give up, they look at me like I've got two heads. They are addicted. And they'll do whatever mental gymnastics it takes to preserve their consumption of that CRAP. Just about everything that folks consider "comfort food," especially as they are served in restaurants or listed in recipes in Allrecipes.com, have to be tossed.

If that weren't the case, why would so many people respond negatively when we say "I'll show you my test results. Watch Forks Over Knives, and then realize that the narrator who got all his testing done with amazing results-- that's me too!" You're offering them a chance to lose weight, lower cholesterol, feel great, etc. "What do you have to lose? Try it for a month or so." They never do. They are choosing their "drug" over health. People who see the way I eat would rather see my success as a result of my unique personality-- "That's great for you, but I could never do that." Why? Because to think otherwise means they are willingly choosing pleasure over health.

"My Precious!!!"

[frozenveg]

There may be some folks for whom a gradual approach works; a section of humanity that can internalize a long-term goal. I am not one of them! I, also approached McDougalling "gradually," but gradual was about 6 weeks, not 6 years. I, also, will have something off-plan occasionally; but "occasionally" is 3 - 4 times A YEAR, not 3 - 4 times a week. (That last is a huge bone of contention that I have with my husband, whose "occasions" seem to be 3 - 4 times a day.)

So I try to be gentle with folks who are just getting onto this program, and applaud any and all efforts to start getting it right. But if they are expressing frustration at lack of results, or asking advice as to why they are not seeing those results, I will not be shy in giving an opinion about the choices they may be making. So that they CAN get it right.

I cannot imagine what it would have been like for me, at 226 lbs., to start "trying" this way of eating in January 2010, and losing 1 or 2 pounds a month. I might be reaching my goal now (as opposed to 4 and half years ago), or I could possibly have had developed the diabetes or heart disease that my doctor was warning me about in the meantime, because I had not ever really gotten with the program.

Most humans are not about long stretches of delayed gratification towards some seemingly impossible goal. The gratification that can be had--by our more rapid giving up of the gratifications of greasy, sugary, processed food--need to come fairly quickly, or we lose heart. That's my observation, anyway. FWIW.

[colonyofcells]

Most people probably prefer to eat turkey every day or every week rather than on just thanksgiving. Eating party food every day is very tempting for most people which is why demand for animal products is going up in both china and india. There goes the factory farm neighborhood.

[roundcoconut]

My main thought on why some people need to take only a few steps at a time, is that people when people set achievable guidelines for themselves, they have a fighting chance at attaining those goals. Set yourself up for success, not failure!

I feel that people should engineer their transition(s) for both short-term and long-term success. If cut out meat, dairy and oil in month one, but do not even try to tackle your liquid calories till month two, I think that is totally legitimate.

And what if you wait till month six to give up cigarettes? Or alcohol? Isn't that still a pattern that represents extreme gains in health?

What if you don't incorporate any exercise until month 11? Is it still worth doing? Were months one through ten somehow a failure because you weren't the healthiest person you could be? Of course not!

A person who challenges themselves to make substantial well-defined permanent changes is probably much smarter than a person who challenges themselves to make vague, meaningless dietary shifts. So, someone who says, "Let's see if i can make starch the center of every single meal, and eat fruit exclusively for my mid-morning snack" -- well, that's really defined -- very cut and dry -- and every meal or snack you eat will tally up as a win or a loss -- there will be no gray area

But someone who says they will try to "use less oil" or "eat better" or "work toward better patterns with food" -- that isn't the kind of incrementalism that seems clear or easy to follow.

By the same token, someone who adopts infinitessimally small changes might not be on a path to long-term success. But that doesn't mean that people need to go 100% in month one.

Dr Greger talks about the all-or-nothing approach in his interview on the No Meat Athlete podcast. He is really funny! Click ahead to 15:30, using the +30 button:
http://www.nomeatathlete.com/radio-119/

He says it so much funnier than I can, but his basic argument is that if someone says, "I could give up anything but pepperoni pizza", then his response is always like, "Great! Let's get all junk food out of your diet except pepperoni pizza." He also kinda makes fun of people who say that you "can't" improve your health unless you are willing to cut out every single non-recommended food right now. He says, "WHAAAAAAT???? I mean ... that's not even how the body works! Of COURSE you're going to improve your health by eliminating all junk foods other than pepperoni pizza. Are you kidding me?!"

[baardmk]

I guess this debate is far from being over as long as there are plenty more straw-men to erect.

[wade4veg]

The bottom line is that all people who are working their way towards better eating should be welcomed and encouraged.
The person who brings their diet from 38% fat down to 19% fat as a percentage of calories is doing a fantastic job in year one.
If in year two they get to 15% fat as a percentage of calories, everyone should cheer them on.
Three years to hit the 10% level is still a amazing change given that such a person still has 30 or 40 years of eating ahead of them.

Some here seem to forget that even in the published MS study that Dr. McDougall funded, those participants only averaged 15% of calories as fat over 12 months. I'd hardly call them failures because they didn't reach 10%.. They lowered their weight by 19 pounds and dropped their TC from 178 to 159... Again, fantastic results over 1 year.
You'd be hard pressed to find any sizable study with better results.
If you have one, send me the link.
The only study I've seen that was lower was the smaller Ornish study's one year and five year results.
That involved less than 20 participants in the experimental wing.(who were not also on statins)

[dailycarbs]

The bottom line is that all people who are working their way towards better eating should be welcomed and encouraged.
The person who brings their diet from 38% fat down to 19% fat as a percentage of calories is doing a fantastic job in year one.
If in year two they get to 15% fat as a percentage of calories, everyone should cheer them on.
Three years to hit the 10% level is still a amazing change given that such a person still has 30 or 40 years of eating ahead of them.

Some here seem to forget that even in the published MS study that Dr. McDougall funded, those participants only averaged 15% of calories as fat over 12 months. I'd hardly call them failures because they didn't reach 10%.. They lowered their weight by 19 pounds and dropped their TC from 178 to 159... Again, fantastic results over 1 year.
You'd be hard pressed to find any sizable study with better results.
If you have one, send me the link.
The only study I've seen that was lower was the smaller Ornish study's one year and five year results.
That involved less than 20 participants in the experimental wing.(who were not also on statins)

The question at hand is whether incrementalism is likely to lead to success or slipping and sliding back to old habits. You feel that it could/will lead to some success so you should encourage that approach to your friends and relatives.

I, otoh, do not believe it works so I would not encourage such an approach. My experience tells me that when people start modifying the diet early on with little no experience, they lack the proper judgement and fail. They don't know what they're eating, what percent fat, etc, and often their choices are just as bad before from a health perspective but "vegan" or "clean" or whatever marketing slogan they've been sold. When they then fail to get the desired results their conclusion is that the diet does not work or that they are different and thus need a different approach (more fat, animal products, etc).

Conclusion: You have your opinion and I have mine and that's about as far as we've gotten so far.

[hazelrah]

How many tablespoons of oil did the cook at Macaroni Grill use in making your entrée?

What! My standard line is that I'm 100% compliant, although I cheat a lot. But even I have never been inside a Macaroni Grill.

Aside from that I think I agree with most of what you say. If you are not putting effort into being 100% it all falls to pieces pretty quickly in my experience. As to the original question, I think most people associate food with life. I think Furhman called his program Eat to Live because he saw so many people who seemed to be living to eat. And, to be honest, I often wonder what my life would have been like without all those family meals, the dates at restaurants, and all the pathological eating I have done to celebrate victories or self-medicate psychological distress. I just got to a point where it seemed like, if I didn't change my ways I was looking at a series of unspeakable horrors in the forms of medical procedures and I didn't want to be so stupid as to wait until I had been sucked into that insufferable vortex before I took some action to moderate it. And after beginning it , I found it was not really suffering at all. But I'm not sure that, even now, I think life would have been worth living without the experience that my sister believes is what awaits her in heaven; the harvest crab and spaghetti dinner, with my grandfather at the head of the table in his lobster bib beside the half gallon jug of Gallo wine, and everyone ta;lking at once. Most families have the equivalent. Until the experience of this lifestyle can evoke the same memories, I believe it will be very hard for most people to adopt this lifestyle. The ASW buffets have a bit of the same sense of indulgence, but the blood relatives are missing, of course. Perhaps I am falsely identifying with other people, but until they have reached the same conclusion of how the SAD lifestyle will lead to an unbearable level of personal suffering, I believe they will have a difficult time attempting to eat this way.

Mark

[Skip]

I don't know of any habit or any endeavor where "incrementalism" isn't a factor to success. As you get closer to your goal, the increments decrease, however, there are always more positive incremental steps that can be made. This is what continuous improvement is all about. As you learn more, you fine tune things to become better at it. This is certainly true for this way of eating because no one knows it all when they start out--- just like anything, you need those 10,000 hours

[wade4veg]

I think a lot of people who have a poor history and psychological problems with food, simply can't see how a person without such problems can approach a gradual change for the better.
No different than a person starting out at a university expecting 4 years later to come out with a new set of skills that they can use for the following 50 or 60 years.
No different than a person who gradually gets physically fit and expects to keep it up.
Both those sets of people operate from sound and reasonable expectations and thus are not disturbed that their weight doesn't drop 5 or 10 pounds every month, or that their cholesterol doesn't fall from 220 to 150 in a month.

Its really amazing that so many can find fault with a well thought out plan to get healthy over 2 to 4 years... when such a person has decades after that to live.
Oh I'm sure there are some with immediate health needs that require drastic changes, but most folks would do fine if they have the right mindset to approach the subject from a long term perspective.

Given what a small percentage of people eat this way, it hard to argue that the overnight change method is vastly superior.
There is a person at Stanford and also seen in lectures such as TED, who makes a point of the value and benefit of tiny changes all the way to one's overall goals.
His name, BJ Fogg
He discusses "Tiny Habits" and how to make them. A avenue for the "other" group of people who choose to pursue this way of eating for long term health.