The renowned author of books relating to healthy eating, Michael Pollan wrote in his book Food Rules, “Eat food. Not too much. Mostly plants”. In just three sentences, he is able to summarize how we should all be approaching our daily eating habits.  I actually have this quote framed on my office desk to remind myself and my patients the importance of eating properly.

“Eat food” means we should be nourishing ourselves and not eating “food-like substances.”  What are “food-like substances”?  These are things that look like food but are adulterated by man-made chemicals.  Did you ever have trouble pronouncing the ingredients on a packaged item?  If so, then you may want to skip that food.

“Not too much” refers to the fact that we should be eating reasonable portions relative to our activity level.  Most of us these days live primarily sedentary lifestyles, sitting in an office, relaxing at home on the couch, or even me writing this blog right now.  We need to eat accordingly and avoid excess calories.  This can also refer to the fact that we should reduce our intake of high calorie foods such as fats and sugars.

“Mostly plants” references the fact that a lot of the studies regarding diets and health are finding that ingesting too much meat increases our risks of cardiovascular disease.  Almost all animal protein will also come with some fat, usually the saturated type which can clog our arteries.  Eating plants is also usually associated with a lower caloric intake.  Plant fibers make us feel more full without providing a lot of calories compared to the same amount of meat protein.

Currently, there are so many fad diets out there such as Paleo, Whole30, Ketogenic, Intermittent Fasting, to name a few.  While there are benefits to some aspects of some of these diets, most of them are not sustainable in the long run.  Sure, maybe someone could follow it for six months or even a year, but for the rest of your life?  Not likely.  I recommend we eat sensibly most of the time and live by Mr. Pollan’s three simple sentences.

Whole grains are amazingly good for you.  They are high in fiber, which helps to lower cholesterol.  They act like tiny sponges that can suck up cholesterols and fats that we eat and pass them out of our body.  They are also very filling without adding many calories.  Increased fiber in our diets has also been shown to reduce colon cancer.  The thinking is that they keep things moving along in our digestive tract including some chemicals known to cause cancer, called carcinogens.

Types of whole grains include: quinoa, wheat berry, spelt, amaranth, farro, buckwheat, barley, and oats.  These are great substitutes for rice in meals and go great with all sorts of seasonings.  They keep for a long time in the pantry without refrigeration and are relatively inexpensive.  Recently, I was making dinner and realized I didn’t have quinoa to make for dinner.  However, I did find steel cut oats.  Oats for dinner?  It was actually quite good and I felt amazing the next day!  I didn’t cook it into a porridge as one would have for breakfast, but I removed it from heat while it was still grainy, but slightly soft.  I also added some fresh herbs and spices.  As I have said in previous blogs, don’t let traditional concepts of what foods are “breakfast/lunch/dinner” foods guide your diet.  I will definitely be cooking oats as a side dish for dinner in the future and maybe even incorporate them into salads for lunch.  Look out for my posts in the recipe section in the near future!

We all know refined sugars (e.g. white cane sugar, corn syrup) are not healthy for us and can be dangerous in larger amounts for people with diabetes.  In my practice, I’ve been noticing that people are overlooking certain other dangerous foods lurking in their kitchen pantry.  I usually remind patients to avoid the “white foods”, which consist of:  white flour products (white bread, white pasta), white rice, white potatoes, and the aforementioned white sugar.  While most of these white foods don’t taste sweet to us, when they get digested by our bodies, they raise our blood sugars and spike insulin levels (insulin is  the hormone that helps to take sugar from the bloodstream into muscle).  Over time, these elevations in sugar and insulin can lead to nerve and blood vessel damage which are commonly found in uncontrolled diabetes.

Here are some suggestions to move away from these “white foods”

• Change to whole wheat bread/pasta.  Whole grains have their fibrous brown husks intact, which prevent us from absorbing all of the sugars.
• Eat brown rice instead of white rice.  In addition to having higher fiber, brown rice makes us feel fuller.  You may notice that you can’t eat as much of it as white rice.  Less food equals less calories.  For people not used to cooking brown rice, I would advise soaking the brown rice a minimum of 8 hours before you intend on cooking it.
• Replace rice with quinoa, farro, or another whole grain.  I find these grains a delicious substitute for rice.  Many have a nutty taste which pairs well with sauces and vegetables.  An added bonus, these grains usually cook in less time than rice!
• Replace white potatoes with sweet potatoes.  Keep the skin on.  Yes, I did say “SWEET” potatoes instead of white potatoes will not raise your blood sugar as high.  Sounds odd right?  Sweet potatoes contain a larger amount of fiber compared to white potatoes and the sugar in sweet potatoes is not easily absorbed by our bodies as white potatoes.
• Cut out white sugar.  Many studies have found white refined sugar is the main cause of obesity worldwide.  If you must add a sweetener, use stevia, which is a spice which makes food taste sweet without adding calories.  Another option would be to use small amounts of honey.  Since honey is concentrated, we typically use less of it than white sugar to add the same amount of sweetness.
• Make your own food.  Processed and packaged foods (store bought cookies, cakes, snack bars) are often loaded with refined sugars.  If you make your own snacks, you will be able to control what goes into them.  By the way, there are TONS of recipes on the internet for healthy versions of your favorite treats.  In general, substituting white sugar with honey or stevia and whole wheat flour for white flour are two simple changes you can make to any recipe to achieve a healthier product.
• Add protein to reduce the impact of the white foods.  While white foods raise sugar and insulin levels, when taken with protein the effect is lessened.  For example, if I gave a diabetic person two slices of white bread, their sugar levels would spike in about an hour.  However, if I gave that same person two slices of white bread with a chicken breast in the middle, their sugars would not be as elevated.  Good sources of protein include beans, tofu, lean chicken, fish, nuts, edamame, chia seeds, eggs, Greek yogurt, and quinoa.
• Make changes gradually.  If you have been eating something for years, it may be shocking or even depressing to suddenly be changing your familiar meal staple.  For example, you could mix up white rice with brown rice, starting at a ratio of 3:1 for a few months, then gradually change to 1:1 until you get used to the consistency.

Happy Healthy Heart Health Month!  To mark the occasion, we should all take some time to consider one of the most important organs, the heart.  Diseases affecting the cardiovascular system including myocardial ischemia (“heart attack”), strokes, and aortic aneurysms (ballooning of the large artery in the chest) account for the leading cause of death in the US.  Sadly, these deaths are largely avoidable through lifestyle changes and proper screening.  Are you at risk?  The American Heart Association has put together a wonderful self-assessment tool called Life’s Simple 7, that you can complete to find out.

In addition, here is my checklist of things you need to consider and discuss with your primary care provider:

• Know your numbers.  Blood pressure, cholesterol (including breakdown of LDL “bad” and HDL “good” types), blood sugar, heart rate, weight, height, and BMI are essential to an assessment of your fitness.  If you have any abnormalities in any of these, you should ask your primary care provider how you can improve them.
• If you have a blood pressure monitor at home (I believe everyone should have one of these, even if you don’t have high blood pressure.  They are inexpensive and can detect blood pressure issues early), check your blood pressure a few times a week and record these numbers.  Bring these readings with you when you see your provider.  Having multiple readings at different times can help your provider find out if you have a blood pressure issue.
• Do you have a family history of cardiovascular disease.  Ask your blood-relatives for their history.  It is important to find out about high cholesterol, diabetes and hypertension (high blood pressure) history since these are the main contributors to heart disease.  If you have any family members who have had a heart attack or stroke before the age of 50, this is a VERY significant piece of information as cardiovascular disease affecting younger people usually means there is a genetic component.
• What is your exercise capacity?  Has it changed recently?  The heart helps pump blood to muscles so that you can move around.  If you used to be able to climb three flights of stairs without getting short of breath, but now you climb just one and feel winded, something may be going wrong with your heart.
• Are you still smoking?  Smoking is the most significant risk factor for heart disease.  Quitting will reduce your heart disease risk significantly.
• Is your diet too high in saturated fats and sugars?  In general, most saturated fats are derived from meat.  However, there are also plant-based fats that are bad for you such as the “tropical oils” such as coconut oil or palm oil.  Reduce these in your diet as much as possible.  Sadly, many manufacturers of packaged goods will add these to make cookies and cakes taste better.  Be sure to read the labels of all the food you buy and if you see these oils, avoid buying those foods.  Sugar comes in many forms, some which are worse than others.  I would reduce intake of any corn-based sugars such as corn syrup as these have been shown to worsen blood sugar.  Honey or cane sugar, in moderation of course, would be better options.  Stevia, which is technically a spice that makes things taste sweet but doesn’t contain sugar and has no calories, would be the best option.
• What is your stress level?  More and more studies show that stress has a very negative impact on our health.  Stress induces our body to secrete hormones such as cortisol and epinephrine.  In small doses, these are great for helping us ‘weather the storm’ when we face challenges.  However, over time these can have deleterious effects on our body such as increasing blood sugar, weight gain, and raising blood pressure.  We all need to manage stress as much as possible.  Try meditation to help with stress, or start seeing a therapist to talk through your issues.

Be sure to get your annual physical exam, including bloodwork and possibly and EKG!

Not all fruits are created equal.  While most guidelines for good health say “eat 5 fruits or vegetables per day”, we should understand that they do not mean it is ok to eat 5 bananas which are very high in sugar to meet this requirement.  These fruits also are lower in fiber and contain certain types of sugar which may contribute to weight gain.  In general, you want to avoid these fruits in juices or dried forms as it would be easy to overindulge and consume too many calories at once.

Here is a list of fruits and the amount of calories they contain.  You want to limit if you are trying to lose weight or if you have diabetes.  However any of these fruits in moderation would be an ok substitute for any desserts (cookies, cupcakes, ice cream) if you need a “sweet treat”.  As a frame of reference, a typical person needs 2000 calories per day and one can of soda is about 140 calories:

• Banana or plantains:  9 inch=135 calories (ALMOST 1 can of soda!), 7 inch=105 calories
• Grapes:  (30 small grapes)=100 calories
• Raisins:  1 single serve box=129 calories
• Mangoes:  1 medium sized mango=200 calories (more than 1 can of soda!)
• Pineapple:  1 cup=100 calories
• Watermelon:  1 slice=140 calories
• Dried dates:  1 cup=400 calories!!!!

Here are some fruits/vegetables that may be better choices.  Some may be higher in calories, but due to their higher fiber content, you will actually absorb less of the calories.

• Apples:  medium=70 calories
• Carrots:  medium=25 calories
• Blueberries:  1 cup=85 calories
• Strawberries:  1 cup=40 calories
• Blackberries:  1 cup=60 calories
• Pears: 1 small=85 calories (4.6 grams of fiber)