BASIC HEALTHY EATING

This way of eating, though near optimal for most persons, is best individualized to fit the needs of each person’s situation.  While this way of eating can be used as a good starting point for most people, if you have a chronic disease, (such as diabetes), you should seek guidance of a health professional to help you tailor your eating pattern to your specific needs. It is based on years of clinical experience and study of the nutritional and medical literature.  If you find that this way of eating is far from how you are eating now (an experience shared by many persons!), don’t be discouraged. Pace yourself as you learn to change your relationship to food, allowing at least several months to accomplish the necessary changes. You will be learning how to change your eating culture.  Because none of us are perfect, and our life situations are not perfect, if you are like most persons your eating will not always be perfect.  That’s ok – there’s no need for guilt or forcing.  Rather, if and when you are ready, start making small steps towards a healthier lifestyle, allowing yourself enough time to accomplish each small goal. Most people find this is best done with the supervision of a professional with expertise in clinical nutrition and a health coach.  If you take small steps regularly, over time you will finally reach the summit of good eating!

HEALTHY EATING:

• Eat a variety of foods that you both enjoy and are healthy for you.  Most foods should be from localsources so that they are fresh, minimally processed and safe. Freshness is crucial especially for foods containing perishable oils such as whole grain flour products and highly unsaturated vegetable and fish oils.  Food grown in third world countries may have unrestricted pesticide applications.  Though not mandatory, ideally try to obtain Organic produce, or at least that grown using Integrated Pest Management (IPM) methods, which minimizes pesticide use.

• Give the selection, preparation and eating of food the value and care it deserves.   Rediscover the joy of the simple act of preparing and eating wholesome food.  Include children and family members in the preparation of food to build a healthy food culture. We all rely on ‘Convenience foods’ occasionally when our schedule is hectic, but over reliance carries a heavy price not only in lack of balanced nutrients but in lack of the meaning of food.  Don’t eat ‘on the run’.  Brown bag a lunch if there are no satisfactory choices where you work.

• Do NOT skip meals.  Spread calories out more or less equally throughout all the meals of the day.

• Do NOT ‘go on a diet’.  Diets, if defined as a particular way of eating for a temporary time, in general do not work! Changing your awareness and relationship with food does.

• Be clear if you are eating ‘Celebration food’ or daily healthy food. Celebration foods are a major pleasure in life, and are consistent with health if they are occasional (e.g. once or twice a month). A quota of a small serving of a sweet (e.g. two small cookies or a small chocolate bar) a few times/week is ok, though. Celebration food includes anything deep fried (e.g. French fries, chips), pastries, sodas, sweets. Except during celebrations, eat enough to satisfy hunger but not more.  While this may seem self-evident, few of us do. This requires taking at least 20 minutes to eat to allow time for the body’s satiety (fullness) feedback and listening to this feedback.

• Avoid processed, prepackaged and ‘convenience’ foods in general – these tend to be of poor quality and deceptively flavored to mask their lack of nutrients. Fat, salt and sugar are strategically manipulated in processed food to maximize craving (potential for becoming habit forming & addiction).

• Any food that has ‘Partially hydrogenated vegetable oils’ (a source of unhealthy trans fatty acids that have been linked with many diseases) is usually of inferior quality and should be avoided.  Develop the habit of reading the labels of anything you buy.  Avoid fats that contain these such as margarines or commercial shortening.   Added mono- or diglycerides should also be avoided, as they are usually composed of trans fatty acids.

• Sugar or salt in modest amounts are generally O.K.  However if sugar or salt (or one of their equivalents) is within the top few ingredients, generally avoid the food.   They are both used frequently in processed foods to compensate for poor quality and create cravings.  Sugar equivalents include sucrose, fructose, glucose, mono- and disaccharides, natural cane sweetener, cane juice, honey, molasses and high fructose corn syrup.  Even so called ‘Health food’, such as some forms of Granola or granola bars, and various ‘nutrition bars’ may have excess sugar & calories.  Buzzwords such as ‘Natural’ are often used to entice consumers to purchase poor quality food that is loaded with empty calories. 

• Avoid ‘Industrially produced’ red meat – (the meat one encounters in most supermarkets). This usually contains excessive and poor quality fat.  If you do eat meat, do so sparingly (1 – 3X/wk.) and use free-range beef (e.g. Coleman brand), bison (buffalo) or other livestock instead.  Wild game such as venison is excellent if you have access to it.  If you must use industrially produced meats, at least choose ‘Select’ grade cuts with ‘loin’ in them (e.g. sirloin) – the leanest variety and trim away visible fat. Even better is plant sources of protein:
• Dark leafy greens have an excellent nutrient/calorie ratio and are an underutilized source of protein. Try to eat at least ½ – 1 cup a day.
• Soy products such as tofu/soy milk/cheese/burgers (fortified with calcium best), preferably from organically grown soybeans and traditionally made.
• Legumes (use ‘Beano’ on these once cool enough to eat if gas is a problem).
• Whole grains + legumes = high quality protein. These don’t need to be eaten at the same meal, just within 24 hours of each other. Examples: [brown rice or whole grain tortillas/bread/pasta] + [beans or lentils or peas].
• Wild cold-water fish from unpolluted waters – this is an excellent source of omega 3 fatty acids (which many peoples have a relative insufficiency of).  Be sure is fresh – if it smells or tastes ‘fishy’, its not! 
• White meat of poultry without the skin, preferably free-range can be eaten up to 2 or 3 times per week.
• Eggs in moderation are O.K., e.g. 4 per week, preferably from free-range hens.
• Low fat (e.g. skim or 1% milk or yogurt) dairy, preferably from cows raised on organic farms allowed to graze on grass.   Use Lactaid^© drops or pre-treated milk if you have trouble digesting it. There is no requirement for dairy products in a healthy diet, but in moderation can be used.

Total amount of high protein foods per day is generally 6 to 7 exchanges per day for most people, and should be mainly from plant sources.  (Remember, an exchange is counted as only 1 oz. of lean meat, so 3 exchanges = 3 oz. of meat = the size of a deck of cards = 1 small hamburger = 1/2 of a whole chicken breast = 1 fish fillet = 1 1/2 cup tofu or beans.) View animal products more as ‘garnishes’ rather than the centerpiece of a meal.

• Be sure to get 2 to 3 exchanges of a high calcium food.  Vegetarian sources include dark leafy greens of the Brassica family (e.g. kale, collards, bok choy & broccoli), calcium-fortified soy products, corn tortillas processed with lime and dried beans, nuts and seeds (almonds, brazil nuts, sesame seeds). Note: certain vegetables high in oxalic acid such as spinach actually impair calcium absorption. Low fat dairy has high amounts of calcium. Fish with small bones such as salmon & sardines are a good source. Teens, young adults and pregnant or lactating women need 3 exchanges per day.

• Include cultured foods in your diet. These contribute probiotics (‘friendly bacteria’) to the gut, which appear essential for health. Examples: Live culture yoghurt, kefir, tempeh, miso, etc.

• Try to eat a minimum of 3 but better 4 to 7 exchanges of vegetables per day.  (This is in addition to fruit!). Choose vegetables that are different colors – this will help ensure you receive the range of nutrients they offer.  Include at least 1 exchange of a dark leafy green vegetable each day.  These include Kale, Collards, Chard, Spinach, and Broccoli. 

• Fruit is best eaten whole (better than juice or ‘juice drinks’). Minimum is 2, but 3 – 4 whole fruit exchanges/day are optimal for most people.

• Carbohydrate (starch) sources should be unrefined and complex with low to medium glycemic index, so they are absorbed gradually into your system and don’t lead to insulin surges.  Examples of these include:
• Legumes such as beans & lentils (also double as protein source)
• Whole grains such as brown rice (basmati rice is good), wheat or oat berries, 
• Whole grain sprouted or 100% stone ground flour products (avoid finely milled white or ‘enriched’ or even whole wheat flour products in general, as these have a high glycemic index).
• Starchy tubers – e.g. yams & squash. Potatoes are less nutritious – eat less often (<3 X/week).  Starchy vegetables are best if eaten whole, rather than in their more processed forms such as commercial French fries or chips.
• Have 1 – 3 carbohydrate exchanges/meal. You can be more liberal with carbs if you exercise after eating them, or within 2 hours post-vigorous exercise. Vigorous exercisers who need to maintain or gain weight may need even more.

• ‘Healthy fats’ include:
• For any use involving heating, use Olive, Canola or Sesame oil in small amounts only. (Extra virgin, expeller- expressed best for all oils).  Never overheat any oil (i.e. until it smokes)!  A small amount of butter, lard or coconut or palm oil can occasionally be used, but do not overuse these saturated fats.
• For unheated purposes such as salad dressings, use Polyunsaturated oils such as Sunflower, soy or nut oils.  Even ‘healthy oils’ are a refined food with high caloric density, so use only in small amounts. Keep in refrigerator and use within a few weeks to ensure freshness.  Avoid cottonseed and peanut oil.
• Flaxseed oil or freshly ground flaxseeds are a source of the essential omega 3 fatty acid linolenic acid.  Many persons have a relative insufficiency in omega 3’s.  Use in salad dressings or for any unheated use.  Buy this very perishable oil in small, opaque bottles that are ideally nitrogen packedand stabilized with antioxidants such as Vitamin E.  Try to use it up within a few weeks.  Keep flaxseed oil in the refrigerator, not in a cabinet.  Keep flaxseeds in a small container in the freezer door and get in the habit of freshly grinding them and sprinkling them on salads, cereals, etc. Fresh flaxseeds are in general preferred to the oil, since they also contain healthy substances such as lignans.
• Fish oils as noted above.  These also must be very fresh and protected from oxidation like all highly unsaturated oils.
• ‘Spectrum spread’ or similar brands can be used as a fat spread instead of butter or margarine.  This is found in health food stores.
• Nuts & seeds or ‘butters’ made from these in moderation are a source of both protein and fats.  

• Drink plenty of fluid –8-glasses/day– water or ‘flavored waters’, or teas are better than fruit juice, juice drinks or sodas.

• Observe the following maximum limits per day:
• Coffee or strong tea:  Two cups (8 oz. each – not large mug size!) total
• Sodas:  One 12 oz. can (best to avoid completely)
• Sweets:  1 serving (e.g. slice of pie or cake or 2 small cookies). Eat sweets slowly and mindfully so you can savor and really enjoy them.  Do not eat sweets while distracted with something else such as watching TV, as this often leads to eating a much greater quantity.  Do not deprive yourself of sweets/ deserts – doing so often triggers a reactive eating binge later.
• If you do drink, do so in moderation: Maximum of 2 drinks/day for men and 1 drink/day for women.  Pregnant & lactating women should not drink any alcohol.  1 drink=12 oz. can of beer, 4 oz. of wine or 1 oz. (1 shot) of distilled spirits.

• Avoid going to fast food/ cheap restaurants such as McDonald’s^©, Burger King^©, Wendy’s^©, Friendly’s^©, Pizza hut^©, Taco Bell^©, etc., since the food is generally low quality and is designed to create cravings that are habit forming. 

COOKING METHODS:

1.  Vegetables:  Best is steaming or light sautéing.  Microwave ok.  Avoid boiling (loses a lot of the water-soluble vitamins).  Try to eat both raw and cooked veggies.

• Meats:  Boiling, baking or light sautéing ok.
• Generally avoid grilling, charbroiling, or deep fat frying.  Marinating meats in a vinegar or lemon juice – based marinade and avoiding ‘flare-ups’ or high temperatures will minimize cancer-causing substances being formed if you want to grill.

STORAGE METHODS:

• Fresh is always best, but freezing is next best.  Be careful of excess sodium in canned foods.

1 ‘EXCHANGE’ =

• Carbohydrates: 1 slice of bread, or 3/4 cup dried prepared cereal or 1/2 cup cooked cereal, pasta or grain dish, or 1 small cooked potato or corn on the cob or 1 small fruit (fruit counts as both a carbohydrate and a fruit exchange).
• Vegetables:   1/2 cup cooked or 1 cup raw (e.g. salad).
• Fruit:  1 medium apple or similar fruit, or 1/2-cup fruit juice.
• High protein foods: 1/2 cup of cooked beans, peas or lentils or tofu or 1 oz (~28 grams) of fish, poultry, red meats, cheese or 1 egg.
• Soy/ Dairy: 1-cup soy/ rice milk or dairy milk or yogurt or 1 oz. cheese.
• Sweets/ treats: 1/2-cup ice cream or 2 medium (2 – 3” diameter) cookies or small wedge of pie/ cake.

• While supplements have their place, they should always be a far second to eating real whole foods. Very few supplements have been shown in scientific studies to improve health. Some exceptions in certain situations include multivitamins, Vitamin D, Fish oil (omega 3 fatty acids), Calcium, Magnesium and Iron (especially in women). Even these are better obtained naturally if possible. Relying on supplements is a form of reductionism – the opposite of holism. Seek competent medical advice before using supplements.

•  Nutrients in foods work together, analogous to musicians in a symphony working together to create beautiful music. When you take a single nutrient, or even a collection of similar nutrients, especially if you mega dose, the result may be analogous to the oboe in the symphony playing 10 times louder – it does not necessarily help the music!  Even a mixture of supplements cannot possibly hope to simulate the vastly complex interactions inherent in whole foods.

• Avoid any health care practitioner or health advice resource that makes promoting or selling supplements (or drugs/ procedures for that matter) a centerpiece of their advice instead of prioritizing whole foods and a balanced lifestyle. 

FURTHER READING:

• American Wholefoods Cuisine (Plume Publishers) by Nikki & David Goldbecks. Excellent basic guide on how to create appetizing whole plant based meals. 
• The New Laurel’s Kitchen (Ten Speed Press Publishers) by Laurel Robertson, Carol Flinders, & Brian Ruppenthal..  A vegetarian approach, but helpful for everyone who wants to learn how to prepare these foods in a delicious and healthy manner. The introduction has a nice primer on basic good nutrition that can be useful for even non-vegetarians.
• Picture Perfect Weight Loss  (Warner Books) & Picture Perfect Weight Loss Cookbook (Rodale) by Dr. Howard M Shapiro. Excellent, scientifically sound Food Awareness program and accompanying cookbook useful for all, not just those who want to lose weight.
• Amazing Soy (William Morrow Publishers) by Dana Jacobi.  If you want to include healthier and delicious soy based foods in your meals, this book will show you how.
• Vegetarian Cooking for Everyone by Deborah Madison. Publisher: Broadway Books, 1997.  An excellent guide to cooking vegetables in interesting and tasty ways that can be used by vegetarians and non-vegetarians alike.
• The Omnivore’s dilemma, In Defense of Food & Food Rules by Michael Pollan.  Penguin Books. These books explain where our food comes from and the strengths, weaknesses and toxicities of American food culture. 
• Eat to Live by Joel Fuhrman, MD. Little, Brown & Co. 2003. Focuses on Nutrient/Calorie ratio as a key to successful weight loss. Useful to all to further understand a healthy diet.
• Mindless Eating by Brian Wansink, PhD. Bantam Books, 2006. Explains how we all eat for reasons other than to satisfy hunger and what to do about it.
• Salt, sugar, fat: how the food giants hooked us by Michael Moss. 2013 Random House Publishing Group, NY. Primer on processed food defense.

GOALS TO WORK ON:

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Copyright 2003 Revised 9/2019 Alan Remde MD, FABFM , Fellow and board certified in Integrative Medicine

Assistant Director SLUHN FP Residency @ Warren

Coventry Family Medicine, 755 Memorial Pkwy #300, Phillipsburg, NJ 08865

OFFICE Tel: 908 847-3300