Listening in With … Andrew Weil

Wellness pioneer Andrew Weil, M.D., learned about healing first from Harvard Medical School and then from indigenous peoples on three continents. Recognizing value in both allopathic and alternative treatments, Weil made his life’s work melding the two to create a more holistic discipline he called integrative medicine. He’s since made major strides in both reforming medical education and teaching consumers the lifestyle choices that will greatly improve their health. In this discussion with Unity Magazine editor Katy Koontz, Weil shares his thoughts on nutrition, the benefits of breathing right, and why time is on his side for integrative strategies to become standard medical practice.

Katy Koontz: What’s the biggest hurdle to attaining optimal health?

Andrew Weil: Society’s inability to encourage people to make better lifestyle choices that really prevent disease and promote health.

KK: Do you think that when the FDA’s regulations take effect requiring food labels to list the amount of added sugar, people will be appalled at those numbers?

AW: I’m not sure food labels change behavior. When fast-food restaurants had to put nutritional breakdowns on menus, people’s buying habits didn’t change. If there’s one place we should concentrate on, it’s getting people to stop drinking sweetened liquids—including fruit juice, which is a concentrated sugar source. If you can eliminate those, that’s a big step.

KK: Do you approve of natural sweeteners like Stevia?

AW: They may be useful for diabetics but not so much for the rest of us. If the brain gets a message that sweet calories are coming and then they don’t, this sets up cravings. My observation is that the people who use the most nonnutritive sweeteners— artificial or natural—have the worst relationships with food.

KK: Americans are known for having a sweet tooth. Is there hope for us?

AW: I once met a Swiss pastry chef who said she had to double the amount of sugar she put in recipes for Americans, but it is possible to unlearn that taste. I was addicted to Coca-Cola in my teens and 20s but can’t bear the taste now—it’s way too sweet for me. We can also unlearn habits, like adding sugar to coffee and tea. I grew up drinking iced tea with a lot of sugar, and now I don’t put any sweetener in it.

KK: What other lifestyle factors are important for optimal health? What should we be doing?

AW: Avoid refined, processed, and manufactured food as much as possible—that’s my main advice. Also, be physically active—an overwhelming amount of evidence shows that maintaining physical activity throughout life is a crucial determinant of health, disease risk, and longevity. Get good sleep, practice methods for neutralizing the harmful effects of stress, and learn how to breathe properly.

KK: You mean belly breathing?

AW:  That’s part of it, but also making the breath deeper, slower, quieter, and more regular in general. We have not been taught how to pay attention to and work with the breath.

KK: This goes beyond techniques used only during meditation, right?

AW: Yes. It's part of meditation and yoga, but breathing exercises can also be done as a separate practice. I recommend the “4-7-8 Breath.” It’s a natural tranquilizer that costs nothing, takes no equipment, and requires very little time. Place the tip of your tongue on the roof of your mouth and exhale completely through your mouth, making a whoosh sound. Then close your mouth and inhale quietly through your nose as you count to four. Hold your breath for a count of seven. And then exhale completely through your mouth, making another whoosh sound, for a count of eight. Go through that cycle four times, and do it at least twice a day. It’s a powerful technique that gets more powerful over time. It calms stress or anger, controls cravings, and helps you get to sleep.
Another element of optimal health is making intelligent and selective use of preventive medical care with immunizations, screening tests, appropriate medical exams, and so forth. I stress intelligent and selective—not necessarily everything that’s recommended.

KK: You feel the same way about medical treatments, yes?

AW: Yes. The body has a tremendous innate wisdom and ability to heal itself. It’s important to really trust and build up confidence in that. This requires learning how to use medical interventions judiciously, whether conventional or alternative.

KK: Will herbal supplements ever be regulated in this country the way they are in Germany?

AW: We do have some regulation. The FDA requires good manufacturing practices, so it’s gotten better. Canada also has a much better system in that labels can say what products are actually for. Again, I think this will slowly change as the market for these products continues to grow and as more research is conducted.

KK: You recommend cutting back on red meat. Do you think being vegetarian is healthier?

AW: I’m a pescatarian—I eat fish and vegetables. I don’t tell people to become complete vegetarians, but I do strongly recommend cutting down on animal foods and making red meat more of an occasional food than an everyday one. But being vegan is more problematic because unless you are careful, it is easy to become deficient in key micronutrients. It’s certainly possible to be a healthy vegan, but it takes a little homework and knowledge.

KK: What’s your opinion of soy?

AW: Regular, moderate consumption of whole soy foods is very healthy, and the earlier in life you start, the greater protection you get against breast or prostate cancer. Whole soy foods are tofu, tempeh, edamame, soy milk, and soy nuts—not fake hot dogs with isolated soy protein, not soy supplements, not functional foods spiked with soy isoflavones. If more people replaced some of the animal foods they eat with soy products that would be a positive change.

KK: How healthy is dairy?

AW:  I do recommend some dairy products on my anti-inflammatory food pyramid, such as yogurt and cheese. Some interesting research shows that whole-fat dairy products are much better for you than nonfat or low-fat products. I don’t particularly recommend milk or drink milk, but I think it is much better to drink whole-fat milk than reduced-fat milk.

KK: So much for the skinny latte.

AW: Exactly.

KK: What role does spirituality play in optimal health?

AW: I make a great distinction between spirituality and religion, although religious practices can overlap with spirituality. To me, spirituality is acknowledging the nonphysical aspect of one’s being, and people can do many things to increase spiritual well-being —having fresh flowers around, listening to music that makes them feel good, spending more time with others who raise their spirits, and so forth. That dimension of human life has a very important influence on our health—both mental and physical—that’s often not taken into account in conventional medical settings.

KK: Do you think complementary and integrative medicine is ever going to be the standard in this country?

AW: I hope so. I really believe that integrative medicine, as I practice and teach it, is really the future—and spirituality is a strong component of that. We train doctors in our fellowships to take a spiritual inventory of patients as part of a medical history.

KK: How many doctors practice integrative medicine now?

AW: Our center has graduated almost 1,300 physicians and some allied health professionals from very intensive fellowship training. They’re in practice in every state and in a number of other countries as well. Half the nation’s medical schools have now joined the Academic Consortium for Integrative Medicine and Health. So it is moving quickly.

KK: Half of all medical schools? That’s really quite impressive.

AW: It is, especially because to join, a dean or a chancellor has to request admission and demonstrate that their school not only has a curriculum in integrative medicine but is also active in at least two of three areas: clinical practice, research, and education.

KK: What about the other half? What has to happen for them to get onboard?

AW: Integrative health has long been a consumer-driven movement, but that’s shifting. Now it’s economically driven. As the health care system continues to collapse, the wisdom of integrative medicine will become more apparent because it can contain and lower costs while improving outcomes. It does that by focusing on prevention through attention to lifestyle and by bringing treatments into the mainstream that aren’t dependent on expensive technology.

KK: In other words, it works. So let’s do it.

AW: Right. And time is on our side. As the health care crisis deepens, more people will open up to seeing why integrative medicine is the promise of the future.

KK: I remember when health insurance first started covering acupuncture; it wasn’t because most Americans accepted it. It was simply because it worked and it was cheaper.

AW: Absolutely. When I was in medical school in the late 1960s, acupuncture, if it was mentioned at all, was considered a superstitious practice of unenlightened people. But that changed instantly when James Reston of The New York Times had an emergency appendectomy in China and reported that acupuncture relieved his postoperative pain. Suddenly people began to take it seriously.

KK: What areas in integrative medicine that are relatively unknown now will become popular next?

AW: Certainly nutritional medicine. Doctors receive almost no practical teaching about nutrition, yet I’ve been able to use dietary change as a primary treatment strategy for years. We have an enormous amount of research on the influence of diet on health. We also have research now on the value of medicinal plants, so I think herbal medicine will be taken much more seriously in the future.
The whole field of mind-body medicine is underutilized and not taken seriously. Doctors aren’t trained in it, despite a lot of research showing that broadly applicable practices like hypnosis, imagery, visualization, biofeedback, and others can work faster and are very cost-effective. That’s going to come much more into its own.

KK: Why are doctors not given more training in nutrition? I think that comes as a shock to a lot of people.

AW: The only explanation I have is that to the academic medical mind— and I’m tempted to say to the male academic medical mind—nutrition looks like home economics. It does not look like pharmacology or biochemistry or what’s considered to be real science. It’s always given short shrift , and that’s disastrous.

KK: What about the consumer testing showing that supplements don’t necessarily contain what the label says they do? How can we deal with that?

AW:  There are good products out there. It’s a matter of doing homework and nding reputable companies. You can subscribe to websites like consumerlab.com that do independent testing and rate products. I think Consumer Reports has also published articles on dietary supplements. There’s been a steady drumbeat of negative publicity in medical journals and the popular press about dietary supplements being worthless or dangerous. Many doctors have bought into that even though the research on it is faulty and has been poorly interpreted.

KK:  There’s so much concern about how toxic our environment is becoming. What can an individual person do?

AW: Educate yourself and join political action groups. Avoid food (especially acidic food) from cans with BPA in the linings. I’ve tried to phase plastic products out of my life because plastics we consider safe later turn out not to be, and there’s every reason to think that’s going to continue. I use wax paper instead of plastic wrap when I can. I don’t use pesticides or herbicides around the home.
I support organic agriculture. The Environmental Working Group’s guide shows which crops are most likely to be contaminated, so avoid those or choose organic versions. For the others, it probably doesn’t matter as much. I also think it’s worth it to have your drinking water tested. It’s up to us to be vigilant because the government tends to side with industry unless it’s really called into question by the public.

KK: Even if we make good lifestyle choices, between the effects of these environmental toxins and the role genes play, how much control do we really have in regard to our health?

AW: I think we’re all dealt a certain hand of cards—some good, some bad— but we have a lot of choice in how we play them. Just because you have bad genes doesn’t mean they have to express themselves. More evidence shows we can modify gene expression through what we eat, by exercise, and even by our emotional state. I think there’s a lot we can do to protect ourselves from toxic injury in the environment as well; so we have a considerable amount of control. The essence of health is resilience. Cultivate resilience and you can interact with things that are potentially harmful while not being harmed by them.

KK:  That reminds me of that line from Star Wars: “These aren’t the droids you’re looking for.”

AW: Exactly.

KK: I love that you brought up how emotional factors can boost resilience, which gets back to the mind-body techniques you discussed earlier.

AW:  They can be quite powerful. Some studies have been published in Japan showing that laughter can turn off the expression of some genes involved with type 2 diabetes. Not many Western doctors are familiar with this research.

KK: That’s amazing! Would anyone fund that kind of research here?

AW:  That’s a big question because so much research is funded by the drug companies, who have a clear agenda. It’s the same with breathing techniques. There’s been very little research on the effects of breath on health because it just seems too simple. How could a breathing exercise possibly work? It doesn’t involve a drug or a device, so people don’t take it seriously.

KK: I hope that thinking will change.

AW: I think it will change as we have a new generation of researchers trained in integrative medicine and mind-body interactions.