Neal Barnard, M.D., F.A.C.C., is an adjunct associate professor of medicine at the George Washington University School of Medicine and Health Sciences in Washington, D.C., and president of the Physicians Committee for Responsible Medicine.
Dr. Barnard has led numerous research studies investigating the effects of diet on diabetes, body weight, and chronic pain, including a groundbreaking study of dietary interventions in type 2 diabetes, funded by the National Institutes of Health. Dr. Barnard has authored more than 70 scientific publications as well as 18 books, including the New York Times best-sellers Power Foods for the Brain, 21-Day Weight Loss Kickstart, and the USA Today best-seller Dr. Barnard’s Program for Reversing Diabetes.
As president of the Physicians Committee, Dr. Barnard leads programs advocating for preventive medicine, good nutrition, and higher ethical standards in research. He has hosted three PBS television programs on nutrition and health and is frequently called on by news programs to discuss issues related to nutrition and research.
Originally from Fargo, N.D., Dr. Barnard received his medical degree at the George Washington University School of Medicine and completed his residency at the same institution. He practiced at St. Vincent’s Hospital in New York before returning to Washington to found the Physicians Committee.
Barnard Medical Center. In 2015, Dr. Barnard founded the nonprofit Barnard Medical Center, which opened in January 2016, in Washington, D.C. Barnard Medical’s board-certified physicians, nurse practitioners, and registered dietitians provide complete primary care. Barnard Medical also helps patients tackle the causes of illness, with extra attention on improving health through prevention and nutrition. Barnard Medical takes advantage of years of research conducted by the Physicians Committee research team and other researchers, showing how a new approach to medicine and nutrition could help prevent and reverse serious health problems, such as obesity, diabetes, heart disease, high blood pressure, elevated cholesterol, migraines, and arthritis. Barnard Medical’s focus on nutrition includes comprehensive nutrition counseling with registered dietitians and group cooking classes.
Caryn Hartglass: Hello, everybody. I’m Caryn Hartglass and it’s time for It’s All About Food. It’s All About Food, thanks for joining me today.
It’s a lovely April day, and one of the things that I love about spring—well, maybe I don’t love it. It’s very appropriate though right now because I hear the Mister Softee truck passing through my neighborhood, and the Mister Softee truck is filled with dairy products appealing to all the kids in the playground where I’m looking at them from my room. And it’s an appropriate thing because we’re going to be talking a lot about dairy today—cheese and dairy. So (chuckles) it’s kind of humorous to hear that song competing with me right now; I don’t know if you can hear it.
Well, let’s get right to it then. My guest is Dr. Neal Barnard and he’s the author of a new book The Cheese Trap. He’s a clinical researcher, author, and health advocate. He is an Adjunct Associate Professor of Medicine at the George Washington University School of Medicine & Health Sciences and president of the nonprofit Physicians Committee for Responsible Medicine. Barnard is a frequent lecturer on issues of health, nutrition and medicine, and is the author several New York Times best selling books including the 21-Day Weight Loss Kickstart and Power Foods for the Brain and The Cheese Trap—I think may be my favorite.
So, Dr. Neal Barnard, welcome to It’s All About Food.
Dr. Neal Barnard: Thank you, it’s great to be with you today.
Caryn Hartglass: Thank you. Another wonderful, wonderful book. I’m so glad that it is out there for people to access. And The Cheese Trap, as you call it, cheese is definitely a trap. The title is so appropriate.
Dr. Neal Barnard: Well, I have to take it—
Caryn Hartglass: So let’s just—I just want to jump right into that. Can we talk about the opiates, the addictive nature of cheese? I’ve been telling people about this program and to listen in, and everyone, as you know, who eats cheese, it’s, “Oh, I can never give up cheese!” And there’s a reason for that.
Dr. Neal Barnard: That is right. And it is funny how when The Cheese Trap came out, I was really wondering how people would react and we seemed to really have touched a nerve. Because so many people will say exactly what you said: “I could never, never give it up” or “I could be vegetarian, but I couldn’t possibly become vegan because I wouldn’t have cheese.”
And yet, there are I think two things that need to be said. The first is why would you want to get away from it, and the second thing is why is it so darn hard? Can I tackle that first thing for just a second?
Caryn Hartglass: Please.
Dr. Neal Barnard: Because there are things in cheese that people don’t know about.
To state the obvious, cheese comes from milk; milk comes from a cow; the cow is pregnant. People may not think about that, but cows don’t give milk until they’ve been impregnated and then they give birth. It’s about nine months pregnancy; it’s very similar to humans. And the farmers impregnate the cows every single year. Not personally, but they arrange to have them impregnated so that they maximize their milk output.
And so nine months out of twelve, the cow is pregnant. Pregnant cows make estrogens (female sex hormones). These estrogens end up in the milk and they’re just traces. But when you turn the milk into cheese, you concentrate the fat and the hormones go with the fat. And still it’s just traces.
However, researches in Rochester, New York went into a fertility clinic and found that the men consuming the most cheese had the worst sperm counts, and the lowest sperm motility and morphology, meaning that there’s something about ingesting little traces of female sex hormones that’s not good for guys. It’s not good for their fertility. At least, we think that’s the case.
Then researchers in California had looked at women who have had been treated for breast cancer in the past. Those who ate cheese had a 49% higher risk of dying of their cancer compared to the others. And this was terrifying because what it means is these little bits of hormones that we think are innocuous in dairy—even if they are concentrated in cheese—we didn’t really expect that the effects would show up in women having a higher risk of hormone related cancer deaths, men’s fertility.
And then it starts you to thinking about, “Well, what if you give this to your child?” Well, of course Americans do give it to their children in very high quantities. And so maybe this hormone interaction is a big issue.
Caryn Hartglass: Maybe indeed. So that’s number one.
Dr. Neal Barnard: Yes. Number two is—well, there’s lots of other things that we can talk about the health effects, but maybe let me cut to what you were talking about at the beginning which is why we get hooked on it.
Caryn Hartglass: Well, you know, the reason why I wanted to talk about that is I don’t want people to feel bad about having a hard time giving up cheese.
Dr. Neal Barnard: Right. It’s not hard to not eat it. It’s an easy thing to eat a veggie burger without the cheese or to have the bean burrito without the cheese. People don’t do that. So it’s not hard, but what they mean to say is, “I find myself craving it. And if I haven’t had it, it’s sort of calling out my name and I look forward to it.” And what’s that about?
Well, it turns out that there are opiate chemicals in the cheese, and they’re produced by the cow. They’re packed into the protein, which is called casein (c-a-s-e-i-n) protein, which is in milk but is concentrated in cheese.
When you digest the protein, these opiates come out. They pass through the brain and they attach the very same brain receptors as heroin or morphine would attach to, only the difference is that they’re not as potent as heroin or morphine. They’re not going to make you pass out. But they appear to be just strong enough that the person says, “Oh, that was nice. Let’s do that again tomorrow. Let’s have a little bit more.”
Caryn Hartglass: (chuckles)
Dr. Neal Barnard: “So what if I gained fifteen pounds?” “Okay, well, all right.” You see what I mean?
Caryn Hartglass: Mm.
Dr. Neal Barnard: So that little devil on your shoulder has a lot more sway over you if the fattening food happens to also be addicting.
And so cheese is very high in salt. Two ounces of cheddar has more salt than two ounces of potato chips. It’s high in fat and that’s salty fat. The fatty part gets us kind of hooked, but I think these opiates are probably the real reason for that addictive quality that it seems to have.
Caryn Hartglass: People have such a problem or craving, like you said, with cheese, and it’s really important to understand why that is. Especially in today’s time. We’re living in a really stressful environment. We may touch on politics later because it is connected to the dairy industry, but there’s so much going on that’s very frustrating. And just that little moment of “ah!” (chuckles), that little bit of comfort—you know, I can see why people will reach out for it because times are hard. Now, there—
Dr. Neal Barnard: Ah, yes. We may love cheese, but cheese does not love us back. That’s for sure.
Caryn Hartglass: Yes. (chuckles)
Dr. Neal Barnard: People can get into chocolate, sugar, alcohol, cocaine, and all kinds of things for comfort. But cheese it’s got—we talked about the hormone effects that are going to hurt you if you’re a man or a woman, according to the best science that we have. Stay tuned, there’s more to be said, but it doesn’t look helpful.
It’s 70% fat. Cheese and other dairy products are the number one source of bad fats, saturated fats. So read that as heart disease; read that as Alzheimer’s disease. The proteins that are concentrated in the cheese happen to be the proteins that trigger problems like asthma, migraine headaches, Rheumatoid arthritis for many people.
So the price that we pay for that gooey, wonderful mouth feel is huge, and the only reason people have put up with it is that they never realize that cheese was the reason that their kids are chubby or that they’ve got migraines or that they have these health problems. Once they realize it, they’ve got tremendous power.
Caryn Hartglass: You mentioned children being chubby. I know cases where doctors will recommend that children consume dairy and cheese when they’re slim to gain weight. How does that affect them as they get older?
Dr. Neal Barnard: (chuckles) If you’re a farmer and you’ve got a steer and you want to fatten up this steer for slaughter, what do you do? They use hormones in them, and it’s perfectly legal to do. And you’ve never thought about the fact, “Well, if I want my son or daughter to fatten up like a steer, I’ll give them hormones.”
Obviously, no one would ever do that in a billion years. Or never, never want to do that. But that happens to be exactly what we’re doing.
The average adult consumes more than 60,000 calories worth of cheese every year. I’m speaking just of the cheese. It’s about 35 lbs., and I’m not eating any so somebody else is getting 70 probably.
Caryn Hartglass: (chuckles) I’m not eating any either. (laughs)
Dr. Neal Barnard: Oh, oh. Then we’ve got a couple people getting 70 lbs.
Caryn Hartglass: (chuckles)
Dr. Neal Barnard: So the point being: people listening to this show might be thinking, “Why are you talking’ about cheese? It’s just one food.” That one food has piled so high in the American diet that I think it’s the real reason for the obesity epidemic. Unless someone thinks that can’t true.
All the people listening to this program would probably say, “Oh, we’re eating too much sugar. Isn’t sugar the big problem?” Sodas and so forth, that’s the whole issue. Well, sodas are not health food. But soda consumption—in fact, all sugar consumption and sweeteners have been falling for almost twenty years. Since 1999, we’ve turned the corner on sugar and it’s been less and less and less and less and less.
But what’s been going up? Cheese. So I really think that’s the big issue with the road to obesity.
Caryn Hartglass: I’m glad you brought up sugar because we talk a lot about sugar on this program, and there are some that really believe that the addictive nature of sugar is what many people have as a problem. I think sugar is more addicting than cheese, but cheese has its own properties that make it very appealing to many people and hard to kick.
Dr. Neal Barnard: Different people pick different drugs.
Caryn Hartglass: (laughs)
Dr. Neal Barnard: There are some people who are smokers and that’s their whole thing. “I don’t care how many warnings the Surgeon General’s may give; I just can’t live without it.” There are others for whom alcohol is their drug; for some people, it’s a cup of coffee; for some, it’s a Dr. Pepper in the morning. There are people where sugar is their thing and they are going back and forth to the refrigerator at night.
But one this I will say for people who are having sugar: they never took a box of Domino’s sugar, poured it into a cup, and ate the whole thing. When they say they are sugar addicts, what they mean is, “I’m eating a sugar cookie.” The sugar cookie is—some of the calories are sugar, but half the calories comes from fat, and that’s a real issue because fat in your cookies adds to your body fat without any conversion. To turn sugar into fat is a challenge for your body.
So the fat part of it is a big issue, and cheese happens to be 70% fat. That’s, I think, a big reason why our kids are getting chubbier.
Caryn Hartglass: I know a lot of people who listen to this program, who are pretty conscious about food, struggle with their weight because I hear from them all the time. So if you’re eating cheese, The Cheese Trap is for you.
Now early in the book, you talk about where cheese gets it “flavor” and “aroma”. I haven’t had cheese in almost thirty years, but it’s really disgusting. Can you talk about some of those bacterias just to whet people’s appetite about eating cheese?
Dr. Neal Barnard: Yeah, it’s a funny thing. Let’s say you were a freshman in college and you’ve never been out of home before, and your roommate starts to get socks that are a little bit ripe because nobody ever taught them.
Caryn Hartglass: (chuckles)
Dr. Neal Barnard: —to do his laundry, okay? After three or four weeks, you say, “What, really. What’s the deal here?” On the human skin there are bacteria called brebei (b-r-e-b-e-i) bacteria, and if a person hasn’t washed (chuckles) or whatever, then they get this stinky feet smell. People say cheese—it’s a kind of stinky feet cheese. Well, it’s not a coincidence. It’s the same genus of bacteria, so your Limburger or Muenster is actually treated with exactly brebei bacteria to make it stink that way.
But it gets worse. When you… When a person consumes food and digests food, in their digestive tract, barbituric acid is formed by bacterial fermentation. If you’re a grade school teacher, you have learned the smell when the little child gets upset and throws up on the floor. Vomit has a certain smell. As it so happens, the bacteria used in fermenting Parmesan cheese happens to create the same barbituric acid. Which is why it kind of has it vomity smell, the barbituric acid in the cheese.
My favorite of all is, if you go to Sardinia off the coast of Italy, there is a cheese called pecorino cheese. They leave it out and let flies land in it. The flies lay eggs; the eggs hatch; maggots come out; and the maggots start digesting the cheese. They refer to it as casu marzu, which means “rotten cheese.” You spread it on a cracker, maggots and all. And because the maggots kind of jump a little bit, what the diner does is take a good slog of red wine and then they put some of the casu marzu on a cracker—so cheese and maggots—and they pull it hard up under their nose so the maggots don’t hit them in the face; and they then put it in their mouth, maggots and all, and swallow it down. And… yes. Cheese is—
Caryn Hartglass: (chuckles) We’re an interesting lot, aren’t we?
Dr. Neal Barnard: Well, why is it that this food that everyone admits smells terrible but then people are also hooked on it? It’s one of these funny paradoxes in the food world.
Caryn Hartglass: Yeah, there are a lot of them, unfortunately. Now, you knocked down a lot of myths, and we have so many myths in the health world about food. So one of them you talk about has to do with goats and goat milk because some people think, “Okay, cow’s milk is probably not too good. So goat’s milk because I’ve heard the molecules in goat’s milk is similar to human milk, and so it’s better.“
Dr. Neal Barnard: Were that true, that would be good for your baby but not for you. Keep in mind, human breast milk was designed for a human baby only up until the age of weaning; and goat milk was designed only for a kid up to age of weaning; and cow’s milk is for a calf up to the age of weaning.
Goat’s milk has a certain cache about it, not because it’s healthier but the opposite reason. Because the fat in it has more what is called saturated fat. It’s a little bit more buttery. Plus, if you imagine the goats must be on some little farm, kind of not too far out of the suburbs, and maybe are treated better or something like that—from a health standpoint, it is no better. It is probably slightly worse than cow’s milk.
For the people who care about animals and are concerned about the treatment of cows on farms, the goats are impregnated every year just like cows are. The male goats are all killed because you can’t deal with them. And the same is true for cows: the male calves are all killed as well; it’s veal. No civilized person would eat veal, everyone knows how they’re treated and most people gave that up a long time ago.
The females are separated from their mothers—this is the only way you get milk; if you impregnate Mom; you take away her child so that she doesn’t give the milk to child; and then you take it from her. The next year and the next year, you impregnate her. Finally, when she’s not much use anymore, you send her to slaughter and replace her with her progeny who then become your new milk machine. And you impregnate them and separate their calves or kids away.
So, no. There’s nothing attractive about this industry in my view. The Cheese Trap is all about health, but I really felt the need to put in a chapter about what the animals actually go through. For all those sixteen-year-old kids who don’t worry about prostate cancer or Rheumatoid arthritis but do have a heart for animals—for many people, that’s their biggest motivator.
Caryn Hartglass: I know it was my biggest motivator. But to get—
Dr. Neal Barnard: Well, that’s because you’re a civilized person.
Caryn Hartglass: (chuckles) Thank you very much.
Dr. Neal Barnard: But let me say: I wouldn’t be going through all of this if I didn’t have a way out. So the idea of The Cheese Trap is, yes, I want the first half of the book to get people’s attention so that they understand their hormones, and if there’s cholesterol or sodium.
But the second half of the book I worked with Dreena Burton who is a genius in the kitchen, and she has come up with the best fettuccine Alfredo you’ve ever had—no dairy at all. We have a cheesecake without a drop of dairy and a little raspberry swirl you can put on top. It looks beautiful and it tastes great. So we talk about the fun replacement for it. If you have kids, there are a million ways to engage them in really having fun with their food. If you’re a grown up kid and you want to try some nice recipes and a new product at the store, The Cheese Trap is full of ways to fuel your adventure in dairy-free eating.
Caryn Hartglass: I like it ending on a delicious note, and Dreena Burton definitely is a genius. Her recipes are wonderful. People who afraid to give up cheese, I’d like that you really have no idea what you’re missing because the plant-based cheeses and sauces and creamy spreads are, I think, so much better. And they don’t have that stinky sock thing going on. (chuckles)
Dr. Neal Barnard: And why not? Take Kite HIll cheese, for example, which you’ll see in all the stores now. Kite HIll uses a regular cheese-making process with cultures and they throw coagulant in; fairly traditional way. The difference is they don’t start with cow’s milk, they start with almond milk. Fair enough! You get cheese out of it. But there is no hormone in it, there’s no cruelty in it. It’s overall a healthier product.
There’s a brand called Treeline, Miyoko’s Creamery—there are many others. They might start with cashews for that kind of creamy flavor. So it is fun to try different ones and see which ones you like. Even so, you don’t really need these foods. They’re something to nibble on and to maybe serve at a party. They are miles ahead of the animal derived varieties. So try them.
My own secret weapon is nutritional yeast. You have kids coming over and we’re going to make a pizza. One kid’s got the green olives, one kid’s got the black olives, and one has the sundried tomatoes. One of the kids has a jar of nutritional yeast. It has zero fat but it has that cheesy flavor. They start sprinkling all these things on the pizza crust, and they add sauce and so forth. No cheese at all, but you got a delicious light pizza that has all the taste and no regrets.
Caryn Hartglass: We buy nutritional yeast in the five-pound bag. That’s how much we like it. (chuckles)
Dr. Neal Barnard: (chuckles) Yeah, exactly. It works really, really well on vegetables and all kinds of stuff. And sometimes we’ll—
Caryn Hartglass: Before I let you go, I just want to know a little bit about the Barnard Medical Center which started a little over a year ago. How is that going?
Dr. Neal Barnard: Oh, it’s really, really been a fun thing. We’re in expansion mode right now.
We started Barnard Medical Center here in Washington, D.C. because we wanted to provide medical care for people where we really focused on the cause of their conditions. So if you got diabetes, high cholesterol level, or high blood pressure, we can use medicine for those people who do need them. However, because all of these relate to food, we have a team of dietitians and we have a whole schedule full of classes that people can jump in and take advantage of. It just has been life changing. Actually, the doctors, dietitians, and nurses are really happy to be able to work in this kind of environment, but the patients are really happy too.
It’s the Barnard Medical Center. We’re here in D.C., and my home biz, before too long, will be able to transport this elsewhere.
Caryn Hartglass: My hope is that too. I’m glad you’re there. I’m in New York, and my little plan probably doesn’t include your medical center in it. But it’s a model that should expand and people can learn from, so thank you for creating that and everything that you’ve done. And for writing The Cheese Trap: How Breaking a Surprising Addiction Will Help You Lose Weight, Gain Energy, and Get Healthy. Thank you, Dr. Neal Barnard, for joining me on It’s All About Food today.
Dr. Neal Barnard: Thank you. It’s been fun.