#360Mentor is a continuation of the #40DayMentor series. In this episode, Robert Kabushenga (RK) speaks to Dr Paul Kasenene (PK) on Eating Healthy.

RK: From the time I announced that you were to be hosted on the show, many people have come up to defend their food. The audience can’t wait on what you have to offer today. Welcome Paul! Good to have you on #360Mentor.

PK: Thank you Robert, you wouldn’t know that as a child, I was small in size and I struggled with my appetite so my parents let me eat whatever I wished. My favourite food were meatballs, chapatti, bread with peanut butter and margarine.

RK: Wow!

PK: Yeah, I grew up not eating as well as I should have. In retrospect, I do understand the sentiments of most of the people coming from a background where I ate what I now do consider to be unhealthy. We grew up in Swaziland, a little country in Southern Africa and believe it or not, I know in Uganda KFC came a few years ago. But back then when I was like 5, we were eating KFC, so it’s been a big part of my life eating things like that. My journey hasn’t been one where I have always advocated for eating healthy, if I can put it that way.

RK: How much of that actual experience influenced your thinking about diet and health?

DK: We are a family of 4 children. Growing up, I was the only one who had asthma. The others didn’t have. At the time, you don’t think much about it. At medical school while learning about medicine they tell you it’s genetic, but when I began to appreciate the impact of our diet on our health, I began to look back and think that perhaps it was because of my eating habits that I was the one who had so much of the allergies, so much of the asthma. I ate the things that, looking back, I can now see in my patients. That experience for me was very profound because it actually made me realise that what you eat in your childhood is actually important. And on my journey I met a doctor who challenged my thought of what many of us believe that our genetics determine our health. He made me believe that I was responsible for having asthma. My parents didn’t have a role to play besides giving me the genes. I kind of triggered them. When I dealt with my diet, asthma went away. It’s now 10 years and I don’t own an inhaler, I don’t have asthmatic attacks. I don’t struggle with allergies.

It was very clear to me that you can influence and impact your health in more profound ways that you think and that even the things you could be doing now that you think don’t have an influence actually do have an influence.

RK: Let’s go back to your past, where did you go for medical school?

PK: I went to Makerere University Medical School.

RK: Had you done your high school here?

PK: We came back from Swaziland in 1994 and I joined S3 at Kings College Budo in 1995. I was there for both O& A level

RK: Then you went to Makerere University?

PK: Yes. In 4^th year, we’re supposed to do electives where you go to either a hospital or another institution to get some kind of experience of how their people view and perceive health. I went to Cambridge University and I was there for three months.  Prior to my leaving I was 58 kilos. When I returned I was about 73 kilos.

RK: What happened?

PK: The whole experience shocked me. My dad had given me some pounds and I didn’t know the value of the pounds. I quickly ran out of money because I was eating what I thought was normal stuff. And then I realised I had to survive. The cheapest food was the unhealthy stuff.

RK: What did you specialise in when you were at medical school?

PK: Like most people, when I finished medical school, I was a general practitioner. I had wanted to be a Paediatric Heart Surgeon. But I got corrupted by money. When I finished medical school, there was this opportunity at an HIV Research facility and I was very ambitious and very proactive in life. I managed to convince the panel to give me a job. At the time, they were not giving people straight from medial school jobs, but I told them I was the guy for the job. This was in 2005. My starting salary was USD 2,470.

RK: What! Man, you’re loaded. You’re killing it.

PK: You can imagine what I mean that I was corrupted by money. My whole dream of heart surgeon vanished, I mean I was earning more than my lecturers. I worked at Mulago. As I drove down the road, I would see them waiting to get a taxi, so I decided to change my direction. The money is not in chemical medicine. It is in public health. So I actually went on that journey. I found myself sitting a lot doing a lot of desk work.

I had no wife. No children. I had a lot of disposable income. I could eat whatever I wanted comfortably. I realised that the weight was increasing some more but at this point I didn’t really like the weight. It made me sluggish. After 3 to 4 years on this job, I wasn’t feeling well. I went to see a doctor. I was 28. He checked my blood pressure. My blood pressure was 140/90. Now that is the level where they say you are developing high blood pressure.

He checked my cholesterol and it was high and what struck me most was how quickly he got a notepad and wrote cholesterol lowering drugs. I tell people that that was the turning point in my life. I suddenly realised what it was like for patients- to be sentenced on medication. He even said it to me, “You’ll need to take these drugs all your life if you don’t something about it.”

It dawned on me that this is what we do to patients.  I did not want medication but I had never bothered to think about it when I prescribed it. So I realised I needed to be healthy. I was not going to take these drugs. And sadly, the doctor also didn’t know what to do. He just said go do some exercise or something.

One random day, I was sharing this with my wife’s sister. She’s called Sarah. She lives in New Jersey, she’s like there’s a doctor called Joel Fuhrman. He can help you. I checked him out. People think I am radical; they need to check out this guy. When I read his book ‘Eat to live’, I thought to myself, this guy is either a genius or he’s crazy. Because what he recommended, if I recommend it, people would just shoot me. He had testimonies in his book, I wrote a book ‘Eat Your Way to Wellness’.

One of the testimonies in the book is of a guy who had cardio vesicular disease (cholesterol that has blocked your arteries) and without surgery one has no chance. He said he was reversing that medically. We were told (in medical school) that that is not possible but he was saying he was reversing it.

I decided to try out his diet just for the sake of it. I even got in touch with him. He was surprised that a guy from Africa would be interested in reaching out to him. He thought guys were dying of malnutrition in Uganda.

One thing that struck me in our engagement, he asked me; “Do you enjoy having asthma?” I think he had sensed my apprehension, my disbelief and all. He asked me to just change my diet for one week. If there is no change then we would not even have to be in touch anymore. But you have nothing to lose. He asked me not to eat cooked food for seven days.

RK: For 7 days, you were living like a goat?

PK: Yes. My wife was cheering me on. A year later. She noticed I was no longer rubbing my nose, allergies were no longer there, I was not snoring anymore. I was like wow! Whatever I am doing is kind of working.

One year later, I had lost so much weight. I was feeling much better. My blood pressure was back to 100/60.  In my heart, I was thinking this is what patients really need. Patients don’t need good medication. They want to be well. They need someone to tell them they are well. So I made a conscious decision in my head that I needed to transition from what I was doing. In 2010, I left my job. By this time, I was earning more than USD 2470. I was given better offers but I decided to leave.

I opened Wellcare. People didn’t listen to me, but I would tell anyone who cared to listen. From my family and friends to organisations. All I wanted was for people to hear about what I was doing. Long story short, here we are today.

RK: So it’s not something you went to school to study; nutrition and all that?

PK: Initially not, but along the way I went and studied it. I first did a course in nutrition studies with Joel Fuhrman. He was my first mentor. And he told me that food is not nutrients. Food is food. Nutrients are just components of food. But everything that is in the food also enters your body. So if you ever ate say chicken because it’s white meat for protein that’s true. But if that chicken was fed ARVs by an ambitious and overzealous farmer who wants to grow his yield, you will also have ARVs in your system. He said, ‘don’t think nutrients, think food’. And whenever you think food, ask, what is the best source of what I want. It has to be the best source with no harm to you. That is where the arguments come from. I believe people should eat the best food without any harm caused to their body.

I also did a course in Functional Medicine from the Institute of Functional Medicine for about 3 years. I have done lots of other courses on nutrition and nutritarianism studies. But the fundamental thing I want people to understand is that I am not a guy of nutrition – the focus on nutrients. I focus on food.

RK: Let me ask you this Paul, can you just breakdown what is wrong with our cuisines? What did you find that you have issues with? What is the problem?

PK: There are a couple of things that are a problem. The first one is, our understanding in food is very simplistic. Most of us our understanding of food and nutrition is based on our primary school education. In primary school, they teach us like children: protein is meat, carbohydrates are maize, fat is margarine. From that perspective, people are looking for a balanced diet. Get protein, carbohydrate, fats, vitamins and minerals. If somebody thinks he is getting that, he thinks he is eating well. That kind of approach is not wrong but is just part of the story, so you find people eating food thinking it is healthy without regarding the fact that along the way the food could have been exposed to chemicals, the food could have refined or processed. The three big issues are:

• We are eating a lot of processed food. And processed here means you are changing it to make it more suitable for consumption either by flavouring it or adding chemicals.

RK: What actually happens during processing of food?

PK: Processing is not bad per say. Even cooking is processing. But some of the things you add to the food are what make it bad.

RK: Could you talk about the challenge that Jackson and I are taking on?

PK: This is a day challenger where we get to take 5 days of only juicing and no cooked food. It is a cleansing process where you get to eliminate toxins from your body. Every year if you get to do this you give your body a chance to eliminate toxins and harmful substances.

It is a 5-day program, only vegetables, fruits, nuts and a bit of green tea. But no sugar, no meats, no carbohydrates. No starches. No grains. And nothing processed.

RK: I need to tell the guys that I intend to do this challenge fully and I will come out alive at the other end. We are going to go through with it.

Paul, we need to resolve the national question that everyone was talking about the whole day. Chapatti, mandazi, sausages. Let’s first go down on that road before we go to the red and white. Sort that one out for us.

PK: I start off from the angle that the hardest food for me to psychologically drop was chapatti. It is such an amazing food. But we have got to understand that (the common) chapatti is not a healthy food.  Like I explained, with maize is the same thing with wheat. The wheat is refined. When you see white flour that is basically sugar though it doesn’t look that way. Refined wheat is carbohydrate. Your blood will be very quickly converted into sugar/ glucose. It is very important to note that that is even worse than sugar. Sugar is just sucrose. A simple carbohydrate of glucose and fructose. There are thousands of glucose molecules put together in flour. When you eat that, it’s going to spike your blood sugars. When that happens, the body is going to increase insulin to reduce the blood sugars. Very high levels of insulin make us store fat. They make us hungry and also make us crave sugar. And they lead to abnormal growth changes in the body that have probably been linked to problems like cancer. The impact of refined flour in our bodies is in fact bloody, if I may use that word. And so we must not think of chapatti as something very simple.

From refined wheat, we go to the refined oil. Oil is worse than wheat and oil causes a weight problem and the heart disease. Refined oil has inflammatory effects and in its nature begins to block our blood vessels. The oils that we typically use like sunflower oil, palm oil, sun seed oil, these are healthy oils even though they are plant based.

Refined oil, refined salt and refined wheat are good when you are chewing the food in the mouth but the bodily harm thereafter is very crazy. Constipation, high blood pressure, diabetes and obesity.

Chapatti is a low fibre food, it just leads to constipation and blockage of blood vessels. I know this sounds very unfortunate and sad but we’ve got to rethink the chapatti.

Then we’ve got the sausages (processed meats). I read a book that said that 90% of our diet should be plant based because human beings are primates. We cannot run away from this. Primates are animals like chimpanzees and gorillas. We are not like them but we shave a similarity in structural, physiological and anatomic make up.

What we need to take from this is that our digestive system is long and coiled. Food takes 1-3 days to pass through our digestive system. On average it takes 40-50 hours. Animals like cats, dogs, lions with short digestive systems take between 3 -8 hours. Animal foods typically go bad after 12-15 hours. For human beings this petrifaction starts to take place in the colon. The food usually sits in the colon for at least 24 hours. When you eat foods like sausages, have chemicals which lead to very serious inflammatory and degenerative conditions that have been confirmed by WHO to cause cancer. So we are eating food that has been prescribed by WHO as food that causes cancer.

We usually see the impact of sausages and processed foods in children. Our children are developing faster than they were designed to. We know this because in girls, the age of the first period has moved from 15-17 which actually was the ideal age to start periods at 9-10, 11. Our children are beginning at 9,10, 11. My peers started at 12, 13, 14 and our parents started at 15, 16,17. If you are to ask yourself what the cause is, our children have started to develop hormones in their bodies early.  To cut this story short, we know that when you start your period at the age of 9 or 10, probably your fist child will be at 25 or even 30. So you will have a 20 year window of constant periods. Some of these hormones if developed quickly are food for what we call cancer like prostate cancer, ovarian cancer and breast cancer. Cancer takes 10 to 20 years to develop. When I see a 28 old lady in my office with cancer, I immediately realise this began when she was 10.

I can ask you three questions and tell your risk for disease:

1. How long did your mother breastfeed you? If three months, you are in trouble
2. Where did you go to school? If you went to Budo like me, that’s trouble
3. What did your father do? If you grew up eating bacon, that’s trouble

Processed foods are terrible foods and should not be eaten.

RK: Let’s resolve the other problem; is pork white meat?

PK: I hope Robert; you will take care of my family after this show (laughter)

This question of red meat is a serious one. Red meat has been showed to increase risk for cancer, heart disease and many issues. Myoglobin is a red pigment in meat. It is similar to haemoglobin in humans. Myoglobin is the pigment in muscles that allows them to use oxygen to run and be very active. Animals that have red meat have a lot of myoglobin and that gives them the red pigment. They are found in goats, cows and sheep. Pigs have been found to have even higher myoglobin than some of the other classical red animals. The problem comes in that pork after slaughter, tends to look white. Even in the preparation it tends to look white. People call it white meat to feel comfortable but pork is red.

The other thing that makes meat red or white is the fibre. It helps with the contraction of muscles.  It is hard to knock a flying bird but very easy to knock a pig. Chasing a local chicken is such a hard job. The Muslims are blessed not to eat pork. The pigs literally eat everything. They clean up the earth. Even besides being red meat, even what they eat has negative consequences. I think it is one of the unhealthiest food to have.

RK: Let me bring in the other aspect called exercise. If I work out like Herman Kambugu who is always climbing mountains, why shouldn’t I knock myself out on my foods?

PK: Because you cannot exercise your way out of a bad diet. The only good exercise will do for you is to help your heart to run excessively fast. Of course if you are exercising, you are better off than someone who is not. But you cannot remove toxins from meat that are potentially cancerous by exercising. We are going to appreciate that exercising is an important part in our health journey but we must be careful with thinking at the end of a heavy workout, I can go and indulge in pork and beer. In fact, you could even be undoing the benefit that got you in the gym. I don’t want people to leave here thinking of quitting exercise. No. continue with exercise but do not look at it as an antidote to bad food. 

Solomon Tumweisgye: How do you stop yourself from falling back to the foods that you love?

PK: 90% of our foods should be healthy. Keep your diet healthy Monday to Friday. Then have the weekend to have the occasional treat. It is not that to eat healthy you should never eat what you want, no. it’s just that the balance has to be right. I do that Monday to Saturday. On a daily, I do 3-4 glasses of water in the morning. I will have my breakfast of only fruit and chia seeds at 10am, then I will do smoothies throughout the day. In the evening, I can indulge in a treat. Find a balance that works for you. 

Jackson Twesigye: For those going for the 5-day challenge, which hours are going to be hard to go through? I encourage other people to take on the challenge.

PK: I did it for 7 days and I didn’t die. The human body has enough reservoirs for fat and energy for most people that lasts for 40 days. We should never really wonder whether you will have energy. You will have energy to run you through the day but you may not be as active as your usual days. For many, the hardest day is transitioning from the 3^rd day to the 4^th. The body transitions from the glucose to fat metabolism. That’s when you feel cranky and low on energy. You just have to keep hydrated.

If your diet has not been that good, you may get into withdrawal. It is the same thing which people who have been smoking go through when they withdraw. You have to get started.

Martin: I am battling around breakfast. Are oats good for breakfast? What are the other options? Is olive oil good for cooking?

PK: It is always important to hydrate. You shouldn’t eat breakfast before you hydrate. In the night, the body is digesting, detoxifying, healing. Your blood is very concentrated. Always start your day with water.

Breakfast means “Break-the-fast”. It doesn’t mean eat in the morning. It’s important that you start your day with energy rich substances and water rich substances. Fruit is good. Eat the fruit whole. Avoid making juice out of the fruit. Two to three servings using your fist as a measure. Then have grains. They too are a good breakfast option.

Millet, maize porridge is good or whole grain cereals. If you have an issue with sodium, avoid processed foods. The biggest problem is not even the salt, it is in the processed foods and soda.

Olive oil is a healthier oil. For oils and cooking, after establishing the type of oil in the food, we look at the smoke point. When you heat the oil, it turns into smoke. Some oils easily become denatured when heated. Using olive oil for high heat cooking is not a good idea. Extra virgin oil is good for low heat or salads. But for high heat, avocado oil, almond oil, coconut oil or ghee.

Doreen Uwera: Uganda is well known for rolex, discuss! 2) Our weddings, how do you advise your service provider to cook something healthy?

PK: A foreigner in Uganda has to try a rolex. However, it cannot be your daily bread. It will get you into problems. There is always room for ice cream, chocolate or anything provided it’s in moderation.

Unfortunately, the things we tell people to avoid, they eat 3-4 time a day. Chappati, bread, pizza, pasta, these you eat very seldom. On weddings, they are always my favourite place to eat. If you have a wedding as the caterer to prepare all kinds of food as long as we do the right thing.

Qn: How would you recommend this challenge for a daily meal plan as a family? Could you advise on healthy meals at work?

PK: I wouldn’t encourage you to get your family on to the health eating challenge unless they want to. Every time they bring children to the clinic, I have never found a child I had to tell what to eat as healthy food. I simply ask them to tell me which food is unhealthy and they do. Even for cake which you might think they will say is healthy, they know its unhealthy. They are always willing to comply. Do not discuss healthy eating at the dining table. Get a time when nobody is eating and talk about it. They will be very willing. Then make the changes of what people do not want to eat. We buy the food. We cook it and then condemn the child for eating unhealthy food. That’s not fair.

Have a lot of fruit and drink in the home, these are the easiest things to buy. Eating healthy should be done by everyone from the age of 2 but it should not be forced.

2) A study was done that people tend to look at the food they want as healthy. If you like the food, the brain will tell you, this is okay. The food apps too have healthy food but we don’t want to see it. We want to see what we want to see. But you have to take responsibility.

Brenda: What impact does exercising have on our bodies away from the foods?

PK: All exercise is designed on the background that the body is mobile. Movement is not optional. It is mandatory. We have got to get the body moving at least 30 minutes a day. Exercise wakes up your immune system, wakes up your brain cells, it’s good for your heart. Those who think they don’t have time for exercise will have to find time for illness. Always have 2 and a half hours a week for cordial vascular. 30 minutes of stretching. If you have no time, cut it out of sleep. You will always have the best.

Chris & Susan: Should we pay attention to blood type dieting?

PK: We don’t need to focus on eating according to blood type.

• Eating according to blood type does not have a long term impact on your health unless your body was sensitive to those foods in the first place.
• People who have not known their blood type have lived for a long life. They never bothered to even know about the type.
• Practicality. I know of a home where they have all blood types.

However the good thing about eating according to blood type is that they always recommend eating good healthy food. Follow the blood group diet if you find it practical and if it makes sense to you or if you are sensitive to certain food.  

Moses:  What is your recommendation on the amount of coffee to take?

PK: For all a long time, literature said coffee was bad but currently it says it is good. Coffee is very good. It has caffeine and other components that have mailed toxic elements to the body. To some people coffee triggers some response that could be very beneficial. Coffee can help stimulate memory and blood sugars. I recommend that people should not have more than two cups of coffee a day.

Herbert: Many people consume supplements, what is the doctor’s take on them?

PK: In an ideal world, we don’t need supplements. All the supplements are supposed to be got from the food. Sometimes you find that even when you try to live a healthy life, you may not get all the nutrients. Sometimes they are beneficial. They are supplements not substitutes. They only bridge a gap. Always get supplements from someone who knows what they are talking about.

Lilliana: Could you highlight what someone with ulcers can eat

PK: You need to first confirm that you have ulcers. Many people just have inflammations and not ulcers. If you have an ulcer you have to treat it. But if you have an ulcer like pain unusually caused by inflammation triggered by certain foods in periods of heightened stress. The foods that we find useful in helping people not to develop ulcers in terms of elimination are gluten which comes from wheat, dairy and others to groundnuts, some to soy or fish, I would encourage people to stay away from foods that tend to increase digestive sensitivities. It is also important to avoid foods that tend to increase irritation of an inflamed line like lemon or a pineapple or passion fruits, oil foods and carbonated foods.

Look for healing foods like cabbage juice or a smoothie. Add a bit of ginger or apple. Drink cabbage juice half a litre to a litre a day. Eat a lot of natural food.

Stella: Could you advise on the idea of drinking three litre of water a day. 2) What type of raw food can one eat in a day so they don’t get hungry very fast.

PK: It is important to keep our bodies hydrated throughout the day by drinking water and water rich foods throughout the day. The human body is 70% water. Without water, the body won’t work very well. Get your weight in kilos and divide that by 30, that is the amount of water you require in litres each day. Tea without sugar, or milk or anything that is not caffeinated amount to your water intake. Coffee, alcohol, tea with milk do count as water intake. In fact you have to drink the same amount of water on top of your drinks for your daily intake. Use the colour of your urine to guide you.

Raw foods tend to have low calorie which means you get hungry sooner. Eat whenever you are hungry as long as you are eating healthy.

Mark: I have an issue with migraine headaches. But when I drink milk, they go away but I hate milk, how can I go about it.

PK: Milk is a healthy food. Anyone feeding on milk like a human baby can live healthy but it is only designed for infants. There is no animal besides human beings that drinks milk beyond infancy. Keep this in mind, milk is designed for infants and by the age of three, most of the enzymes from digesting milk are gone and that’s why people will struggle with digesting milk.

Secondly, no anima drinks like milk for another animal. Cow milk is very good food for the cows not human beings. The composition of cow milk is not the same as that of breast milk for humans. However, the things we need from milk can be got from other foods including calcium. Science now confirms that a diet richer in cow milk leads to weaker bones and not stronger bones. Calcium comes from leaves, roots, soil etc. That is where the goats and cows also get their calcium. Eat your green vegetables you won’t need milk. 

Doreen: There are people who eat anything they want and remain slim

PK: That does not mean you are healthy. Size does not mean you are healthy. Size is a risk factor. It is important to know your muscle and fat percentage other than focusing on your weight.

RK: Where can people find you for professional level consulting?

PK: Bandali Rise, Bugolobi, Kampala, Uganda. www.drkasenene.com 07014504450

RK: I want to say Thank you. Thank you Paul.

PK: You are most welcome, Robert.