February 2006

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Vol. 5, No. 2

Moderation Is Impossible for Passionate People

Now that the “extreme” low-fat (Ornish-, McDougall-, and Pritikin-type) and high-fat (Atkins-type) diets have, according to news reports, failed, moderation is again the almost unanimous recommendation heard from the media, scientists, dietitians, and doctors.  Without a doubt, moderation works for some people with “moderate” personalities, but what about passionate (compulsive, lustful, obsessive, enthusiastic, etc.) people like me?

I am not a restrained person and neither are most of my patients.  In my youth I started the day with several mugs of strong coffee, I barely survived on all-you-can eat buffets and fast food restaurants, I smoked 2 packages of Marlboros daily, and too often unwound at the end of my stress-filled day with a whiskey or two. (I also paid a big price for this excessive behavior with a cholesterol level of 335 mg/dl, 50 pounds of excess body fat, major abdominal surgery, and a debilitating stroke all before the age of 24 years.)  I realize most people are not as wicked as I was, but on the other hand most people I know have at least one of these overindulgences in their lives—and that one is usually unending forkfuls of rich foods.


My Very Moderate Great-grandmother

My great-grandmother, Laura Bristow lived to be 106 years old eating a “well-balanced diet.”  I recall her telling me, when I was a child, “Johnny, you eat too much meat; it’s going to make you sick.”  Years later—I was approaching 30 and she was 102—I had become a strict vegetarian. One afternoon at her home in the suburbs of Detroit she asked me to drive to the neighborhood McDonald’s and buy her a hamburger—a 30 cent burger, made with a paper thin slice of ground beef, 2 pickle slices and a blob of mustard and ketchup, all hidden within two halves of a white bread bun.  Upon my return she proceeded to cut the hamburger into quarters and she shook one quarter in my face and advised me, “If you ate a little more meat you would be healthier.”  She then ate 2 quarters and put the rest away for later. My great-grandmother was by nature a very moderate person who picked at tiny platefuls of traditional American foods, drank ¼ cup of diluted coffee each morning, and had one small glass of red wine on holidays. 

Even with all her moderate tendencies, I believe my great-grandmother would have had a healthier life if she had consumed a more plant-food based diet.  Her doses of sugar, cholesterol, saturated fat, and animal proteins were smaller than most people’s, but they still took their tolls—after age 90, she lost her teeth (sugar), lost her hearing from atherosclerosis (fat/cholesterol) and had severe osteoporosis with both hips broken (animal protein). Let her example be a lesson to everyone—even to those people with moderate personality traits—to live as healthy as possible—otherwise, you may find yourself saying, “If I had known I was going to live this long, I would have taken better care of myself.”

The Current Health Crisis Deserves an Extreme Response

William Lloyd Garrison (1805 – 1879), known for his anti-slavery activities, clearly understood the shortcomings of moderation, “Tell a man whose house is on fire to give a moderate alarm; tell him to moderately rescue his wife from the hands of the ravisher; tell the mother to gradually extricate her babe from the fire into which it has fallen; but urge me not to use moderation.”

The startling observation that almost all people living in Western societies are fat and/or sick with diseases which will wreck and shorten their lives, should have health professionals up in arms, demanding an immediate and complete end to this senseless suffering—regardless of the expense and effort.  But, for some unexplainable reason, the loss of a father and husband to a heart attack, the disfigurement of a mother by breast cancer, and the blinding of a friend from diabetes are accepted consequences for our birthright to eat like aristocrats.  To mitigate these tragedies we are told to eat a little less of the same.

One Man’s Meat Is another Man’s Poison

The definition of “moderate behavior” lies in the eyes of the beholder.  An abstainer from alcohol would likely consider daily drinking an extreme behavior and would not be swayed by the scientific fact that the lowest risk of death is found among people who consume an average of one drink per day.1   An alcoholic would consider only one daily drink to be an extreme sacrifice.

By most people’s standards I am considered extreme because I eat a diet of starches, fruits and vegetables 363 days of the year.  On Thanksgiving I may have a small slice of turkey and on Easter I have been known to indulge in an egg white or two.  But to many ethical vegetarians my semi-yearly indulgences are traitorous and extreme acts.

When it comes to diet, what is commonly consumed by a population is considered “proper nutrition.”  For example, the Japanese of the early 20th century thought rice and a few vegetables were ideal foods, and late 20th century Americans thought meat and cheese were perfect nutrition.  However, a more rational approach would be to regard “proper nutrition” to be the diet that best supports human health and a robust appearance.  This would be the diet consumed by moderate people. 

Based on my understanding, the diet which is best for people is composed of chiefly unprocessed starches, vegetables and fruits—with the inclusion of minimal amounts of rich food for special occasions—but if you are very sick or are addicted to these delicacies, then these treats should be strictly avoided.

Moderation Is Too Hard

Westerners are completely addicted to their steaks, cheeses, and pies. Attempts at moderation guarantee continued dependence and continued failure.  “Everything in moderation” has been preached to every generation throughout human history.  Didn’t work way back then and it doesn’t work for folks today.

Have you ever met a smoker who quit by cutting down?—I haven’t.  Have you ever heard of an alcoholic who sobered up by switching to beer?—neither have I.  These moderate approaches keep the addicting agent within easy reach.  The only effective means to overcome these destructive habits is to remove the powerful substance from a person’s life—repeated teasing with small fixes of the drugs (tobacco and alcohol) means unending torture and a quick return to the usual levels of use to avoid the pain.

Cutting down on the portion size of fried chicken, gravy biscuits, and ice cream is slow torture and is one of the primary reasons diets fail.  Simply put, these high-fat, high-salt, high-sugar foods are just too attractive for most mortals to resist—especially for those of us with a passionate (compulsive, lustful, obsessive, enthusiastic, etc.) nature.

Extreme Change Returns Tremendous Rewards

After failing by trying to moderate their eating behaviors, people think “I give up!  The problem is with me—I just don't have enough discipline or maybe I’m genetically defective.”  But, moderate change must, by definition, return little benefit.  Consider this well-known approach for weight loss:  Of all popular diets encouraging sensible moderate eating behaviors, Weight Watchers was found to have the largest reported loss of 3.2% of initial weight at 2 years.2  That means a 200 pound woman can expect, on average, to lose a little over 6 pounds after 2 years of moderate eating. Big deal!

And another moderate approach that guarantees disappointment is the National Cholesterol Education Program Step 2 diet (30% of calories or less as total fat, less than 7% saturated fat, and less than 200 mg cholesterol per day).3  After one year dieters achieved a decrease in total cholesterol of 5 percent—that’s 13 points for someone starting at a level of 260 mg/dl.  Another big deal!

People trying to lose weight and improve their health with these approaches have to learn all new information on what foods to eat and how to fix the foods, and then they have to learn to like these new meals. After all this effort they lose a meager 6 pounds and drop their dangerously high cholesterol by only 13 points.  They are confused and discouraged, and feel hopelessly out of control.

Now consider what happens when someone goes through the same amount of effort to learn to prepare and enjoy a really effective diet.  After a month he or she has lost 10 to 20 pounds, cholesterol is down 50 points, indigestion, constipation, headaches and arthritis are gone.  The rewards are undeniable and they serve as motivation to continue.  Soon the new foods become that person’s favorite foods.  If regression (cheating) does occur, the immediate penalty can be a painful return of the indigestion, stomach aches and bowel distress.

I’m Me—and I Have Learned to Live within My Limits

Throughout my entire life I have been enthusiastic about everything—my schoolwork, my hobbies, my sports, the whole lot of life.  I was born this way—and scientific research establishes the fact that like the color of our eyes and hair, our personality traits are determined in part by complex genetics.4,5  Early life experiences fostered my exuberant nature.  So now, even if I wanted to, I could not become a “moderate person.”  Still, I love life and do not want my high-spirited personality to kill me.  So I have found the solution.

I now direct my energies towards supportive, not destructive, behaviors.  I have learned to love healthy foods.  Windsurfing is my passion.  I eagerly look forward to long walks with my grandson carried in a backpack.  I spend a little extra money to indulge myself with bottled water.  My favorite drink is herbal tea—and I do drink a lot of it.  I fill my lungs with fresh air cleaned by an air purifier.  I passionately pursue every “good thing” in life.

Irish poet and dramatist, Oscar Wilde said: "Moderation is a fatal thing. Nothing succeeds like excess."  I encourage you to take these words to heart and live life enthusiastically, and well-informed. 


1)  Poikolainen K.  Alcohol and mortality: a review. J Clin Epidemiol. 1995 Apr;48(4):455-65.

2)  Tsai AG, Wadden TA.  Systematic review: an evaluation of major commercial weight loss programs in the United States. Ann Intern Med. 2005 Jan 4;142(1):56-66.

3)  Hunninghake DB, Stein EA, Dujovne CA, Harris WS, Feldman EB, Miller VT, Tobert JA, Laskarzewski PM, Quiter E, Held J, et al The efficacy of intensive dietary therapy alone or combined with lovastatin in outpatients with hypercholesterolemia. N Engl J Med. 1993 Apr 29;328(17):1213-9.

4)  Reif A, Lesch KP.  Toward a molecular architecture of personality. Behav Brain Res. 2003 Feb 17;139(1-2):1-20.

5)  Noblett KL, Coccaro EF.  Molecular genetics of personality. Curr Psychiatry Rep. 2005 Mar;7(1):73-80.

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