Elliott Carter Finally Writes an Opera.

Show: FRESH AIR
Date: MARCH 16, 2000
Time: 12:00
Tran: 031601np.217
Type: FEATURE
Head: Dr. Andrew Weill Explores Food and Nutrition in His New Book
Sect: Medical
Time: 12:06

This is a rush transcript. This copy may not
be in its final form and may be updated.

TERRY GROSS, HOST: From WHYY in Philadelphia, I'm Terry Gross with FRESH AIR.

On today's FRESH AIR, proteins, carbohydrates, fats, and sugars -- how much do we need, and what foods should we get them from? We put our questions about nutrition and fad diets to Dr. Andrew Weill. His new book is called "Eating Well for Optimum Health." Weill is a pioneer of integrative medicine, which means integrating Western medicine and alternative medicine.

And classical music critic Lloyd Schwartz reviews the Chicago Symphony Orchestra's production of Elliott Carter's comic opera, "What Next?"

That's all coming up on FRESH AIR.

First, the news.

(NEWS BREAK)

GROSS: This is FRESH AIR. I'm Terry Gross.

If you've been reading the popular diet books of the past few years, you might find yourself too confused to eat. A few years ago, we were advised to minimize protein and eat lots of carbohydrates. Now popular diet books are urging us to eat lots of protein and avoid carbohydrates.

My guest, Dr. Andrew Weill, has written a new book whose purpose, he says, is to explore the issues and controversies surrounding food and nutrition in order to bring clarity to the subject.

Weill is a pioneer of integrative medicine, which means integrating the best of Western medicine and alternative medicine. This approach emphasizes nutritional and other lifestyle influences on health and illness.

He directs the program in integrative medicine at the University of Arizona College of Medicine. He's also the author of several best-sellers, including "Spontaneous Healing."

Dr. Weill is skeptical of any diet that is extreme in its emphasis on any single food group. I asked him why.

DR. ANDREW WEILL, "EATING WELL FOR OPTIMUM HEALTH": First of all, I'm trying to shift the conversation about diet away from just a focus on weight loss, to a focus on promoting health. I think that's a better way to look at food. And the fact is that most of us who go on diets or read diet books, there's an interest in a quick fix to -- usually to a weight problem.

So I think that's the motivation behind a lot of these diets. I think people in our culture are looking for magical fixes. Personally, I think that if you make radical rearrangements of proportions of fat, carbohydrate, and protein in the diet, you're likely to get into trouble. The trouble may not become apparent immediately. And many of these diets will work as crash diets for short-term weight loss, but I don't think they're healthy for long-term plans.

GROSS: Let's talk about carbohydrates, a food type that is really on the outs right now. You know, protein's in, carbohydrates are out. You've described carbohydrates as being a kind of quicker source of energy. Tell us what you like about carbohydrates and why we need them in spite of the fact that they're unpopular for many diets at the moment.

WEILL: You know, carbohydrates came into the human diet in a big way with the invention of agriculture and the domestication of cereal grains. And that invention allowed enormous growth in human populations and development of civilization. Bread has been called the staff of life throughout the millennia, for good reason. It's a very nutritious food, and the body can very easily turn carbohydrate into glucose, blood sugar, which is the fuel that the brain must run on.

So I think if you drop carbohydrates out of the diet, in the first place, you run the risk that the brain is not functioning optimally, because it does not easily get a supply of glucose. I think there is some merit in the anti-carbohydrate arguments that we've seen out there in that they call attention to the fact that not all carbohydrates are created equal.

There is a quantity called the glycemic index that I talk about in my book which rates how quickly carbohydrate foods turn into blood sugar and provoke an insulin response. It is clear that a fraction of our population, maybe 25 to 30 percent, is carbohydrate-sensitive. These are people who, if they eat a lot of carbohydrate foods, especially high-glycemic-index carbohydrate foods, will develop central obesity, that is, weight gain in the abdomen, high blood pressure, elevation of blood fats, and, in the extreme form, adult-onset diabetes.

So if you think you are carbohydrate-sensitive, if you've got these problems in your family, you have experienced them yourself, that doesn't necessarily mean that you should avoid carbohydrates, but you should learn about these different gradations of carbohydrates and try to cut way back on the highly refined and processed forms of carbohydrate foods.

The real problem I see are all the fluffy white things in the American diet. It's fluffy bread and pastries and pretzels and crackers. These are all very high-glycemic-index carbohydrate foods that stress that insulin system and can produce insulin resistance, leading to these common problem.

GROSS: What I find interesting too about this glycemic index is that -- well, there's a lot of surprises. For instance, not all potatoes are the same. Sweet potatoes have much lower glycemic index and absorb more slowly than regular potatoes.

WEILL: And even looking at regular potatoes, small, waxy new potatoes have a lower glycemic index than big, starchy, floury potatoes. Basmati rice has a lower glycemic index than the sticky rice that you get in Japanese and Chinese restaurants. Bread, dense, grainy, chewy peasant bread, has a lower glycemic index than ordinary kind of whole wheat bread in which the flour, even though it's a whole grain, is very finely milled.

Pasta has a lower glycemic index than bread, and it's even lower if you cook it really al dente, in the Italian manner, so that it's resistant to the teeth. In that case, digestive enzymes have a harder time turning the starch into sugar, so it lowers the glycemic index.

I think many of the writers of these anti-carbohydrate books who are promoting very high-protein diets fail to point out to readers that there are these differences, so that all pasta is condemned, all bread is condemned, all potatoes and rice are condemned. And that's not the way it is.

GROSS: Do you think that there is such a thing as a carbohydrate addict?

WEILL: Yes, I do, and I think that there are many people who, for -- if they are anxious, if they're stressed, if they are hungry, not necessarily in the physical sense, go for these starchy, high-glycemic-index or sugary high-glycemic-index foods. And also, I think there's no question that for people who are carbohydrate-sensitive, that this kind of addictive eating of carbohydrate foods is disastrous.

I live in southern Arizona, and the Native American populations there are rich in these so-called thrifty genes that allow them to turn available calories into fat very easily. They're very carbohydrate-sensitive. The Oodam (ph), who used to be called the Papagos (ph), who live just to the west of Tucson, now have 80 percent rate of adult-onset diabetes. And adult-onset diabetes has started to appear in children, something we've never seen before. And many of these people weigh 300 and 400 pounds. This is commonplace.

And they're, you know, far from their traditional diet of corn, beans, squash, and low-glycemic-index nuts and starchy tubers. They're now eating Big Gulps of soft drinks and candy bars, and you can imagine. And it's had disastrous consequences on their health.

GROSS: Let's talk about protein a little bit, because so many people seem involved with this, you know, high-protein diet, and are cutting down or cutting out completely carbohydrates. How much protein do you think we really need?

WEILL: I recommend between 10 and 20 percent of calories as protein. So if you're eating a -- let's say 2,000 calories a day, that would translate to a maximum of about 200 protein calories a day. Protein has about 9 -- about -- sorry, about 4 or 5 calories a gram, so you're looking at something in the range of 40 grams of protein.

Now, if you eat more protein than that, and some of these high-protein diets people are eating 40 percent of their calories as protein, the excess is going to be burned as fuel, excess over what your body needs for repair and maintenance of tissue. And I have concerns about running the body on protein fuel.

In the first place, protein is not a clean-burning fuel. It leaves nitrogenous residues that have to be turned into -- that produce ammonia in the body. Ammonia is extremely toxic, especially to the brain. So when your metabolism is generating ammonia, the liver has to do a great deal of work to detoxify that by turning it into a less-dangerous compound called urea. And then the kidneys have to do a great deal of work to get rid of the urea.

So one of the consequences of living on a high-protein diet is that you're putting a huge workload on the liver and kidneys. And I have great concerns about the health consequences of that that may not show up until a long time afterwards.

In addition, protein is not a very efficient fuel relative to carbohydrate and fat, so you're also putting a large workload on the digestive system. There's a lot of work put in to get energy out.

So I don't think it's healthy to begin a high-protein diet over long periods of time.

GROSS: Well, you gave us an example of how many protein grams per day, or calories, the average person might want to take in. Can you translate that to a serving of fish or meat or eggs?

WEILL: Well, you know, a reasonable serving of a protein food is about the size of a deck of cards. You know, that's a good little visual aid to use.

And by the way, one of the reasons that Americans are fat is that they're simply eating too much and not getting enough activity and eating too much of the wrong kinds of foods. And one way in which we eat too much is to eat gigantic portions. People from other cultures are astonished at the size of portions that Americans eat, both in restaurants and in movie theaters and at home.

And I think that, you know, many of us have learned to feel terrific if we're served a meal that's built around an enormous serving of animal protein especially.

GROSS: Do you have favorite sources of protein, sources that you think are the most nutritious and easiest on the system to digest?

WEILL: Well, I'm a big believer in the health benefits of fish, and some of that is based on my readings of epidemiological studies that clearly suggest that populations that eat more fish are healthier. And I don't think that's just a matter of the omega-3 fatty acids in fish. I think there may be other benefits in fish. Possibly it's that people who eat fish are eating less of other animal foods that may be more dangerous. I recommend that people eat some fish. You know, I'd like to see them eating two to three servings a week.

I also am a big fan of vegetable protein in the form of legumes, beans of all sorts, and especially soybeans. I think soy foods are very nutritious. The fat in them is less harmful than many of the fats that occur in other protein sources. They contain phytoestrogens, which I think are protective against prostate cancer and breast cancer. I think Americans would do well to learn to like soy foods and substitute some of them for some of the animal foods now on the diet.

GROSS: I'm glad you brought up soybeans. There's a lot of processed soy foods. There's, like, soy meats and soy cheeses and all kinds of things. What do you think of those processed soys -- soy foods? Are they as healthy as basic soy? Because they're more processed.

WEILL: I eat some of them. Many of them are based on what's called isolated soy protein. They may not give you all of the benefits of whole soy foods. One kind of soy food that I think is very easy to like are whole green soybeans in the pod. They're called edamame (ph) in Japanese. And they're becoming more and more familiar to Americans. They're served as snacks in sushi -- at sushi bars, they're eaten hot or cold in Japan. They're a very popular snack food in the summer, often eaten cold with beer.

I think anyone who likes peanuts would like edamame. You pop them out of the pod into your mouth. They're fun to eat. They're not scary. They don't have a strange texture like tofu. That's a good soy food to get to know, and it's giving you all the benefits of whole soy.

GROSS: I want to get back to the processes. What do you think of, like, say, soy cheese or the soy meats?

WEILL: Well, I eat some of them, and I have an 8 1/2-year-old daughter who I give soy cheese to. She eats some dairy cheese as well. Personally, I think the taste of the soy cheeses are not terrific, and you know, that's an area where I think if you like cheese, you're going to be disappointed when you try soy cheese.

However, the fat in soy cheese is a healthier fat than butterfat, which is one of the most saturated fats in the diet. So if you could learn to like some of this, it's probably a good thing. But as you know, from reading the book, I'm a great believer in not sacrificing the pleasure of eating in the name of health. So if you're going to eat soy foods, they have to be items that are tasty and delicious, and you know, the things you really want to eat.

GROSS: What do you think of soy milk?

WEILL: I think soy milk is good. I use it sometimes on cereal. I have -- I recommend it often to patients who should not be eating much cow's milk, because, let's say, they have asthma or bronchitis or sinus conditions or allergies or auto-immune conditions. In all of those, I think milk aggravates the medical problem. And soy milk is a reasonable substitute. You can get low-fat versions, you can get calcium-fortified soy milk. I think it's a good idea to get organic soy milk.

But I think that's a reasonable substitute.

GROSS: My guest is Dr. Andrew Weill. He directs the program in integrative medicine at the University of Arizona College of Medicine. We'll talk more after a break.

This is FRESH AIR.

(COMMERCIAL BREAK)

GROSS: My guest is Andrew Weill, and his new book is called "Eating Well for Optimum Health."

Let's talk about fat. Everything about food seems controversial now.

WEILL: Everything.

GROSS: (laughs) But you know, there's such extremes about fat. There's, you know, the low-fat diet, the completely nonfat diet, and now a lot of people are saying, No, we've gone too far in that extreme direction, we need fat. What's your sense of the right proportion that fat should play in our diet.

WEILL: You know, I recommend up to 30 percent of fat -- of calories as fat, but I strongly recommend that that be mostly in the form of monounsaturated fat, which is -- which should principally be olive oil and the fats that occur in most nuts, for example, also in avocados, and that it include substantial sources of omega-3 fatty acids, which our culture is generally deficient in. These are the fatty acids that occur in oily fish, in -- like salmon and sardines, in walnuts, in a couple of seeds like flax and hemp, and small amounts in sea vegetables and green leafy vegetables. They're not easy to get in the diet.

The anti-fat people are very reluctant to admit that there are differences in fat. They would like us to see all fat as bad and to get the total amount as low as possible. But while we have great evidence that the percentage of saturated fat in the diet is a health risk for many of us, there's no comparable evidence for total fat in the diet. And in some countries, the Mediterranean countries, the island of Crete in particular, people are eating up to 40 percent of their calories as fat, but they have relatively low incidence of heart disease and cancer, and they're eating mostly these monounsaturated and omega-3 fatty acids.

So I do believe there are differences in fat. A problem that I see with the very low-fat diets is -- are two. The first is, as you drop fat calories below 20 percent of calories, food becomes very uninteresting. And when you get it down to about 10 percent of calories, I think that diet is very austere and unpalatable to most people. And while some people who are strongly motivated to reverse heart disease can go on it, I think it is very difficult for most of us to stick with that kind of diet for a very long time.

The other problem is that I think it increases the danger of essential fatty acid deficiency, since most of us are already not getting enough omega-3 fatty acids. If you go on these very low fatty -- fat diets, you're more likely to increase that deficiency. And I think there are all sorts of consequences of that, not just on heart function but on brain function, on healing responses, on immune function.

So my general take is that it's OK to increase the palatability of food by allowing more fat in, but you've got to be very careful about the kind of fat.

GROSS: What's so good about the omega-3 fatty acid?

WEILL: Well, this is a really interesting subject, and it's one that I would urge people to keep an eye on emerging research. These fatty acids are used by the body as the basis for synthesizing hormones called prostaglandins that regulate almost every aspect of cellular function. They are involved in blood clotting, they're involved in immune function, in all sorts of healing responses.

If the diet is deficient in omega-3s, the synthesis of these hormones goes in a direction that favors inflammation, increased clotting of the blood, increased cell proliferation, which may favor cancerous change, and so forth.

I'll give you just one example. One of these omega-3s is called DHA. That's no relation to the hormone DHEA. This is docosahexenoic acid, and it's one of the constituents that's found in the oily fish. It is the major constituent of cell membranes in the brain. And there's reason to think that if the body is deficient in DHA, that the architecture of the central nervous system is weakened, that this may produce diminished brain function, diminished intellectual function, decreased memory. It may predispose to conditions like autism and attention deficit disorder in children. In older people it might leave us more susceptible to diseases like Parkinson's disease and ALS and Alzheimer's Disease.

You know, this is really an emerging very interesting area of research, and especially, as I said, I think most Americans are deficient in these fatty acids. It would be -- it's very interesting to think about how many common diseases could be prevented or treated by increasing intake of them.

GROSS: The one kind of fat you really recommend against is margarine. I remember when margarine was the highly recommended alternative to fatty butter. What's the problem...

WEILL: Exactly.

GROSS: ... with margarine now?

WEILL: The problem is that these are artificially treated oils, that the process of hardening them involves heating oils to very high temperatures, several hundred degrees, reacting them with hydrogen gas in the presence of metal catalysts, and this violent treatment alters the chemistry of fatty acids in a direction that I think increases their toxicity.

It's not just margarine, by the way, it's partially hydrogenated oils, which are ubiquitous in commercial foods. If you go through a supermarket and look at chips, cookies, pastries, crackers, it's almost impossible to avoid partially hydrogenated oils.

Ironically, when consumers got very upset about the tropical oils -- palm and coconut oil, which are very saturated -- and forced manufacturers to take them out of food, what the manufacturers replaced them with were these partially hydrogenated oils, which are probably worse for us.

It's -- they're in everything. And I think it's most important to read labels and try to avoid them.

Let me just cite one study that illustrates some of this danger. There was a study done in Australia in the past year in a small number of human subjects, and needs to be replicated. The researchers fed each subject three different meals on three different occasions. The first meal was a meal that was high in fat, really of substantial portion of fat, and the fat was used cooking fat that had been heated and reheated from the deep fryer of a fast food restaurant.

The second meal had exactly the same percentage of fat, but it was fresh oil. And the third meal was a low-fat meal.

Four hours after consumption of the meal, blood flow was measured in the main artery going to the arm by a non-invasive technique. They found immediate reduction of blood flow going into the arm in the subjects who ate the first meal but not in the other two. And this was interpreted as arterial dysfunction due to oxidative damage to the lining of the artery from eating used cooking fat.

That was one meal. So I think it's worth thinking about that if you're tempted to eat things that are deep-fried in any restaurant, and certainly in fast food restaurants. And this also is in the same general territory as the dangers that come from eating these partially hydrogenated fats, which have been treated so roughly.

GROSS: Dr. Andrew Weill is the author of the new book "Eating Well for Optimum Health." He directs the program in integrative medicine at the University of Arizona College of Medicine. He'll be back in the second half of the show.

I'm Terry Gross, and this is FRESH AIR.

(BREAK)

GROSS: Coming up, dairy products and sugar. We continue our conversation with Dr. Andrew Weill. And Lloyd Schwartz reviews the Chicago Symphony Orchestra's production of Elliott Carter's comic opera, "What Next?"

(BREAK)

GROSS: This is FRESH AIR.

I'm Terry Gross, back with Dr. Andrew Weill, author of the new book "Eating Well for Optimum Health." Weill directs the program in integrative medicine at the University of Arizona College of Medicine. He's a pioneer of integrative medicine, which means combining the best of Western medicine and alternative medicine. This approach also emphasizes the importance of nutrition and lifestyle on health and healing.

Now, our listeners might think, Oh, Dr. Andrew Weill, he's really into, you know, holistic medicine. He probably is staunchly against sugar, which you're not.

WEILL: I'm not. I think sugar makes life interesting, and actually, if you look at it from the point of glycemic index, its rating is not all that high, because table sugar, sucrose, consists of one molecule of glucose, which has a very high GI, linked to one molecule of fructose, which has a very low GI. So the GI of sucrose is intermediate, not so bad.

That doesn't mean that you should eat sugar in unlimited quantities, especially if you're carbohydrate-sensitive. But it's not the worst thing in the diet. I think that I'm as much concerned about all of the highly refined, pulverized white flour starch that we eat, which I think has at least as major an effect on blood sugar and insulin, and I'm really more concerned about the unhealthy fats in the diet than I am about sugar.

GROSS: Now, there is a sugar you recommend avoiding, the high-fructose corn syrup that's used as an additive in a lot of processed foods.

WEILL: I raise a question about this. I don't claim to have the answer here. But this is a new product of food technology that has never been in the world before. It's cheap and easy to make and manufacturers love it, and it has replaced cane sugar in many manufactured sweet products, including almost all jams, jellies, soft drinks, fruit juices that have added sugar.

So human beings are now consuming vast amounts of fructose, which they never did before. The body has a very limited capacity to metabolize fructose. Just one interesting observation is that if you have a hospitalized patient who can't eat, you can maintain life by giving an intravenous glucose solution. If you try to give intravenous fructose, very quickly you produce severe liver dysfunction and the possibility of death.

There is concern that if people eat a lot of fructose, this can disturb liver metabolism and have a negative impact on blood fats. So I just raise a question here that since we don't have any assurance that it is safe to eat fructose in these quantities, I worry a little bit about how prominent this has become in the food supply.

GROSS: So you're just waiting for more research.

WEILL: I keep an eye on it. But I make an effort myself not to eat foods that have high-fructose corn syrup in them, and in general these tend to be low-quality foods anyway. I mean, this is an easy one to try to -- you know, if you read that on a label and say you're not going to eat it, it's a way of reducing consumption of foods that probably aren't terrific for you anyway.

GROSS: I want to ask you about the dairy conundrum. On the one hand, (laughs)...

WEILL: (laughs)

GROSS: ... you know, on the one hand a lot of adults have lactose intolerance. They can't digest -- I guess it's the sugars in milk. On the other hand, yogurt is supposed to be an incredibly healthy food, and it has the good-guy bacteria for our digestive system.

WEILL: Right.

GROSS: And you know, cheeses are really tasty and can perk up any meal. What are your thoughts about adults eating milk products?

WEILL: Well, first of all, just on the lactose question, in yogurt and in cheese, the lactose has been digested for us by bacteria. So even adults who can't tolerate lactose can eat those kind of products which are cultured or fermented. The problem is if they try to drink fresh milk or things made from fresh milk that are unfermented in that way.

But there's other problems with milk. It's not just the lactose. The fat in milk, butterfat, is the most saturated fat in the diet and is a major culprit in atherosclerosis for many people. The protein in milk -- and this is the one -- area where I think there's least medical evidence, but the one that I find very interesting -- seems to have an irritating effect on the immune system. It increases mucous production, it creases allergic responsiveness. And I think it's the problem in people who have asthma, sinus conditions, bronchitis, a lot of allergic skin conditions, that that milk protein, if you get it out of the diet, there is improvement of these conditions.

So I don't think milk is nature's most perfect food, and I don't think that you never outgrow your need for milk. There are a lot of people out there who are upset with the -- with government recommendations that clearly have been influenced by dairy industry lobbying, saying that milk and dairy products must be in the diet to produce optimum health. A lot of people see that recommendation as being ethnocentric at least and racist as worse, because a large fraction of the world's population, especially the nonwhite population, can't handle lactose.

So I think that it is not necessary to include dairy products in the diet. They are good sources of calcium, but you can get calcium elsewhere, for instance, in calcium-fortified soy milk or orange juice, or in sesame seeds or collards or broccoli or sea vegetables or sardines, mashed up with the bones in them. There are other ways of getting calcium.

But I think that there are problems with dairy foods, and those problems are greatest for some people.

GROSS: And those are people with asthma and other auto-immune disorders?

WEILL: People with -- right, and people who have a tendency to run high cholesterol, if they're eating whole milk products, and people who are lactose intolerant.

GROSS: So if your problem goes beyond lactose intolerance, if you bought, like, like, lactose-free milk or lactose-free cheese, you'd still be facing other possible problems.

WEILL: Other possibilities. Now, one recommendation I would make is for children. If one or both parents is allergic, I think it's very important to try to keep cow's milk out of the diet totally for some critical period of early childhood. And I don't know what that period is. I think it's at least two years, it might be three years. I think after that point it's OK to introduce dairy foods on a moderate basis.

But I think if you introduce them too early, if there's that genetic history, you're likely to set the immune system up for allergic problems that might be lifelong. So that's one recommendation I'd make.

GROSS: Let's take a look at eggs, another food that has really become part of this whole swinging-pendulum approach to diet. You know, eggs used to be great, then they were awful, don't eat them, and now eggs on the good guy list again, particularly egg whites.

WEILL: Well, actually it's the -- I'm more interested in the yolk. The white has always been good. That's a -- you know, that's pure protein, it's an easily used protein. But the yolk has been the bad guy because the yolk has a lot of cholesterol in it. But the egg yolk also has essential fatty acids in it. And if chickens are lucky enough to have been able to scratch on the ground and eat wild plants, they're going to get omega-3 fatty acids, which they'll put into the egg yolks.

There's now a new egg on the market which is a high-omega-3 egg, in which the chickens have been fed an algae supplement that gives them omega-3s in supplemental form that they then put in the yolk. So this is, I think, a good omega-3 fatty acid source for people who like to eat eggs.

I think eggs have gotten a bad rap. I think that in the general diet, their contribution to serum cholesterol has been overrated. I think modest consumption of eggs is OK, say one a day. And I would certainly recommend eggs from free-range chickens, and especially these new omega-3 fortified eggs.

GROSS: And you recommend maybe one egg a day. What if you're just eating egg whites?

WEILL: With egg whites, I think it can be -- it's unlimited. That -- you know, this is good protein, and as long as you're not overloading in protein, I think it's fine. There's never been a concern raised about egg whites. Again, I think it would be better to try to get these from chickens that were not fed antibiotics and hormones, but the protein in egg white is a good-quality protein, and it does not pose any kind of cardiovascular risk.

GROSS: My guest is Dr. Andrew Weill. His new book is called "Eating Well for Optimum Health." We'll talk more after a break.

This is FRESH AIR.

(BREAK)

GROSS: My guest is Dr. Andrew Weill. He directs the program in integrative medicine at the University of Arizona College of Medicine.

You recommend eating a lot of fruits and vegetables. Then you get the pesticide problem that you have to encounter.

WEILL: You certainly do. And...

GROSS: Yes, and your book kind of goes through what are the fruits an vegetables (UNINTELLIGIBLE) lowest dangerous pesticides. So why don't you give us some advice on how to choose the right fruits and vegetables?

WEILL: OK, well, first of all, I think you should wash -- you should peel fruits and vegetables where appropriate, the ones that you can, and you should wash them as well. There was a recent study at the University of Texas which showed that if you made up a solution of a teaspoon of dish detergent in a gallon of warm water and swirled fruits like grapes in this for 10 to 20 seconds and then rinsed them in warm water, that that simple act could remove at least half of pesticide residues.

And in other vegetables, something like acorn squash, that if you peel it, you really remove all of the pesticide residue. So I think that's useful information to know.

You may know that I'm a very strong proponent of organic agriculture. I think one of the great things that's happened in our culture is that in response to consumer demand, organic produce is now much more widely available. I mean, even in ordinary supermarkets in many cities you'll find a section of organic produce. This is clearly all in response to consumer awareness and consumer demand.

It is still worth trying to find out which crops are the most dangerous so that you can try to reduce consumption of those or really make an effort to get organic versions of them. Strawberries always top the list, and...

GROSS: Why is that?

WEILL: It's because a chemical called methyl bromide, used as a pesticide, is applied to the soil and is taken up by the whole plant. And this is something you can't wash off, it's in the fruit. It's a known carcinogen. There has been a very strong consumer movement to get it out of agriculture in California. But the manufacturers and growers have successfully stalled implementation of that legislation for a long time, and so methyl bromide is still in strawberries.

GROSS: You know, peaches are on your list of fruits with problematic pesticides. What's wrong with peaches?

WEILL: The sprays that are used. It's peaches, apricots, cherries grown in the U.S., grapes that come in from Chile, which are the ones that we get in the winter, Mexican cantaloupes, green beans, celery. These are the ones that in testing always show the highest residues.

So as I say, if you -- if it's too difficult to get organic food, if it's too expensive, if it's inconvenient, it's worth learning these crops. There aren't that many of them. There may be a dozen of them that you can track, and that in those instances, to try to reduce consumption of conventional versions, or really make a special effort to get organic versions.

GROSS: Let me ask you, when you go to a restaurant, say -- and it's not, like, a health food restaurant, this is, like, a regular restaurant -- and there's foods on the menu that you like but you'd prefer it without the sauce and without the butter and maybe you want the vegetables steamed instead of fried or with a sauce or -- How comfortable are you giving all these directives to the waiter about how you want the food prepared, as opposed to how the chef wants to prepare it?

WEILL: (laughs) You know, I usually ask. I don't give a whole list, but I'll certainly ask that things not have butter on them and could they prepare them with olive oil, or could they serve sauces on the side. And I find that most places are very accommodating. I think if you ask in a nice way and if you're not too demanding, that, you know, that's all very reasonable, and I think more and more restaurants are accustomed to that.

There's also -- you know, there's a lot of other tricks for restaurant eating that I think can be very helpful. One that I try to use now and that I recommend is asking waiters not to bring bread and butter or bread and olive oil until the food is served. You know, it's so easy to pack away an enormous number of calories while waiting for the first course. I mean, that's just a simple thing to do. Or you could ask them not to bring it at all.

And really, I think this is a kind of modern trend because if you think about it, I'm sure in most cultures throughout history, the way that bread has been used is to sop up juices and sauces and parts of food. It was eaten with the meal. It wasn't something you ate before a meal to fill up on, especially fill up on high-glycemic-index fluffy carbohydrate calories.

GROSS: Yes, I'm glad you mentioned the bread too, because the bread is often, particularly in Italian restaurants now, brought out with a side ord -- side dish of oil instead of butter. And I'm thinking, OK, the oil might theoretically be healthier than butter, but if you kind of dip the bread in oil, and you're eating a lot of oil, is this a good thing?

WEILL: It's fat, you know, and it's fat, and it all goes into the total of fat calories. So I don't think one should fall into the habit of thinking that olive oil is a positively good influence on health. I think in moderation, it is a superior fat to butter. It may offer certain health benefits. But I don't think that gives us license to sop up large quantities of it on bread before we even start to eat.

GROSS: I remember years ago on the show you were recommending that if we could, that we cut out caffeine. What are your beverages of choice now in terms of hot and cold beverages?

WEILL: Well, for hot it's green tea, and I'm really impressed by the research on green tea. It has such strong antioxidant properties, anti-cancer effects, beneficial cardiovascular effects. The one caution I would say is that it's worth getting good-quality green tea, and I think your best way to do that is to go to an Asian grocery store. I meet many Americans who drink green tea, and say it's OK, and when you make them real green tea, they say, Wow, this is green.

So I think a lot of what's out there on the American market as green tea is pretty low-quality. But good, good-quality green tea tastes great. I think if you want to drink caffeine, that's probably the best form of caffeine to use.

In terms of cold beverages, I think my favorite is water. You know, I really -- I love to drink good water. And I also drink iced tea, regular iced tea.

GROSS: Is there a food model that you particularly like? You know, there's the American food pyramid, there's...

WEILL: Yes, yes.

GROSS: ... there's the Mediterranean diet, there's the Asian diet. Obviously there's a lot of variations in all of these. But is there any particular model that you think is...

WEILL: Yes, I...

GROSS: ... very healthful?

WEILL: You know, I love Asian food. I have spent a fair amount of time in Japan. I'm very interested in the traditional Japanese diet and the fact that at least until very recently, when Japanese have started to eat Western food, they've had the best health and longevity on the planet. I think the problem with these Asian cuisines is that they -- for us is that they include a lot of strange ingredients. They're very labor intensive to prepare. They're often high in salt. They're difficult to export, except to restaurants.

On the other hand, the Mediterranean diet I think has the advantage of being quite adaptable. I mean, most people like this. It's not rigid, it's a diet that seems to work. The health of populations that eat it seems good. And it's not a diet of deprivation and austerity.

So I suppose the model that I would like to use as a template for designing a healthy eating plan would be the Mediterranean diet. That is a diet in which meat and animal foods are eaten relatively infrequently, fish is eaten much more frequently as a protein source, there is modest consumption of dairy products, mostly in the form of yogurt and cheese, a lot of whole grain, chewy breads, some pasta, lots of fruits and vegetables.

I think that's, you know, a diet that most of us could live with, be happy with. I find that it works very well for me, you know, it satisfies me. It's the one that I think would be the best to look at as a model. I don't think we have to take it just as it is. I think it allows a lot of variations. But it's a good template to start with.

GROSS: You're a strong proponent of integrative medicine, of doctors combining the best of the high-tech and pharmaceutical Western approach to medicine along with alternative medicines, like acupuncture, stress-reduction techniques, and so on. I'm wondering if you think that Western medicine has a long way to go in using diet as part of its approach to understanding medical problems and treating them.

WEILL: That's putting it mildly.

GROSS: (laughs)

WEILL: But, you know, essentially nutrition is still not taught in medical schools, at least not the kind of nutrition we're talking about on this program. Very few doctors use dietary change as a strategy for impacting health and illness. You know, when patients ask doctors about diet, the typical answer they get is, Oh, just eat a good diet, or just eat a balanced diet. That's very unhelpful.

The food served in hospitals in this country is so bad that it should be a national disgrace. And that includes the cafeterias of major medical centers where doctors and nurses and medical students eat. I think we have a very long way to go.

And it always amuses me when people call this sort of stuff New Age or radical. You know, Hippocrates in the fifth century B.C. said, "Let food be your medicine and medicine be your food." I would love to see, and I think it's beginning, the development of the field of nutritional medicine, and I think there are two main aspects to this. One is really doing the necessary research, doing the epidemiological studies, to try to help us design an optimum diet for people, that is, a diet that would most reduce risks of preventable diseases, extend longevity.

And the other aspect is using dietary change as one aspect of the therapeutic approach in working with patients. This is something that I've always tried to do with patients, it's something we do in our clinic at the University of Arizona that I'm teaching other doctors to do. I think this is a field in its infancy. But we know enough to begin creating it.

GROSS: Well, Andrew Weill, thank you very much for talking with us.

WEILL: I enjoyed talking with you, and enjoy your meals. (laughs)

GROSS: (laughs) Thank you, and you too.

WEILL: Thanks.

GROSS: Dr. Andrew Weill directs the program in integrative medicine at the University of Arizona College of Medicine. His new book is called "Eating Well for Optimum Health."

Coming up, Lloyd Schwartz reviews the new production of Elliott Carter's comic opera, "What Next?"

This is FRESH AIR.

(BREAK)

TO PURCHASE AN AUDIOTAPE OF THIS PIECE, PLEASE CALL 877-21FRESH
Dateline: Terry Gross, Philadelphia
Guest: Andrew Weill
High: Dr. Andrew Weill specializes in holistic medicine. He's the author of the bestseller "Spontaneous Healing." His new book is "Eating Well For Optimum Health: The Essential Guide to Food, Diet, and Nutrition." Weill is the founder of the Foundation for Integrative Medicine in Tucson, Arizona. His Web site is www.drweil.com.
Spec: Health and Medicine; Food and Beverages; Science; Lifestyles

Please note, this is not the final feed of record
Copy: Content and programming copyright 2000 WHYY, Inc. All rights reserved. Transcribed by FDCH, Inc. under license from WHYY, Inc. Formatting copyright 2000 FDCH, Inc. All rights reserved. No quotes from the materials contained herein may be used in any media without attribution to WHYY, Inc. This transcript may not be reproduced in whole or in part without prior written permission.
End-Story: Dr. Andrew Weill Explores Food and Nutrition in His New Book

Show: FRESH AIR
Date: MARCH 16, 2000
Time: 12:00
Tran: 031602NP.217
Type: FEATURE
Head: Critic Lloyd Schwartz Reviews Elliott Carter's `What Next?'
Sect: Entertainment
Time: 12:56

This is a rush transcript. This copy may not
be in its final form and may be updated.

TERRY GROSS, HOST: Verdi was nearly 80 when he wrote his last opera, "Falstaff." Elliott Carter was nearly 90 when he wrote his first, called "What Next?" Classical music critic Lloyd Schwartz was in New York on March 5 to hear Daniel Barenboim and the Chicago Symphony perform "What Next?" at Carnegie Hall. Here's his review.

LLOYD SCHWARTZ, CLASSICAL MUSIC CRITIC: People who love Elliott Carter's music had probably given up hope that he would ever write an opera. But now they finally have their wish. The aptly named "What Next?" is a delight, an inventive, semi-absurdist one-act comedy that you'd never guess was composed by someone about to turn 90.

Carter says he waited so long because he just couldn't find a situation that convinced him it should be sung. British novelist and "New York Times" music critic Paul Griffiths (ph) has given him a libretto that couldn't be anything else but sung, a kind of six characters in search of an opera.

"What Next?" literally begins with a bang, a brilliantly orchestrated crash with trash cans and brake drums joining the almost comically extensive battery of percussion instruments.

(AUDIO CLIP, INITIAL ORCHESTRAL CRASH, ELLIOT CARTER'S "WHAT NEXT?")

SCHWARTZ: There's been an accident. Six characters are starting to come to, trying to figure out who they are and where they were going. They never entirely succeed, though 45 minutes later, they're a little wiser, more self-aware than when they began.

The central character is a self-centered soprano, a diva named Rose. She almost never stops singing, mostly about how wonderfully she sings. Then there's an oddball named Harry or Larry. He and Rose may be on the way to their wedding. A woman named Mama might be Harry or Larry's mother. A burbling hippie-ish philosopher named Zen might be Mama's ex-husband. And a learned astronomer, Stella, might be Zen's new girlfriend.

In Griffiths' sometimes too-schematic quasi-allegory, Zen and Stella represent polar opposites. Stella wants everything measured, Zen wants to live by chance, by accident. They're like the history of 20th century music. There's also a hungry little boy called simply Kid, who wakes up dying for a Big Mac.

Carter's music is not what most people would call melodic. He gave up traditional melody years ago. But it ranges widely from the most jaggedly edgy and chattering to the long-breathed and lyrical. The singing starts with a hissing sound as if air were leaking out of a tire. But this sibilance is actually the beginning of the word "star." The soundings-out of these delicate syllables are like ethereal vocal warm-ups.

(AUDIO CLIP, "STAR" EXCERPT, ELLIOTT CARTER'S "WHAT NEXT?")

SCHWARTZ: In the middle of the opera, the characters leave the stage, and the orchestra plays one of the most ravishing passages Elliott Carter ever wrote, a haunting nocturne with a wreathing solo for English horn.

(AUDIO CLIP, NOCTURNE WITH ENGLISH HORN, ELLIOT CARTER'S "WHAT NEXT?")

SCHWARTZ: Carter has often said that everything he's written has been a kind of character piece, with each instrument or section of the orchestra expressing a different point of view. Some of his favorite musical reference points are the complex banquet scene from "Don Giovanni," in which three separate orchestras play on stage, or the famous Sextet from "Lucia di Lamermoor."

"What Next?" is really another sextet in which the six characters simultaneously express their diverse and conflicting, not to say conflicted, feelings. It's one of the things music can do best, and one of the things Elliott Carter can do better than almost anyone else.

GROSS: Lloyd Schwartz is classical music editor of "The Boston Phoenix." He reviewed "What Next?" the new opera by Elliott Carter.

FRESH AIR's executive producer is Danny Miller. Our engineer is Audrey Bentham. Dorothy Ferebee is our administrative assistant. Roberta Shorrock directs the show.

I'm Terry Gross.

TO PURCHASE AN AUDIOTAPE OF THIS PIECE, PLEASE CALL 877-21FRESH
Dateline: Terry Gross, Philadelphia, Lloyd Schwartz
Guest:
High: Classical music critic Lloyd Schwartz reviews the first American performance of Elliott Carter's new comic opera, "What Next?" by Daniel Barenboim and the Chicago Symphony.
Spec: Music Industry; Art; Media; Chicago

Please note, this is not the final feed of record
Copy: Content and programming copyright 2000 WHYY, Inc. All rights reserved. Transcribed by FDCH, Inc. under license from WHYY, Inc. Formatting copyright 2000 FDCH, Inc. All rights reserved. No quotes from the materials contained herein may be used in any media without attribution to WHYY, Inc. This transcript may not be reproduced in whole or in part without prior written permission.
End-Story: Critic Lloyd Schwartz Reviews Elliott Carter's `What Next?'
Transcripts are created on a rush deadline, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of Fresh Air interviews and reviews are the audio recordings of each segment.