• Bill Brandenburg, MD

Healthy Diets

Updated: Oct 21, 2020

Introduction

We are what we eat, drink, and breathe. While our bodies can do amazing biochemical things to what we ingest, our choices make a big difference. These days, there is a diet for everything; Keto, Paleo, Vegan, Vegetarian, Mediterranean, Ornish, Fast Food, Low Carb, Low Fat, etc. This creates so much confusion! The intent of this article is to bring clarity to this seemingly complicated subject. We will discuss diets for weight loss and wellness, focusing on general principles as opposed to specific diets. After this we will talk briefly about how strict diets can be used to improve and sometimes even cure chronic conditions like type 2 diabetes and heart disease.

Background

Food choices create an amazing amount of stress for people, and sadly the majority of diets end in failure. The most important factor regarding any healthy diet chosen, is the ability to maintain it. If you are attempting a new diet, I cannot stress the importance of exercise, stress reduction, and social support. Changing any behavior is so hard. Changing what we eat can be one of the hardest things to do. Try not and get down on yourself if you eat something bad, just try and do better the next time!

Food is our nourishment; it keeps us alive and makes our children grow. As such, food simply must always be enjoyed. If a person is not enjoying a diet they are on, it will never work. Start by loving yourself. Then let that love flow outwards to other people. Let the good food you eat and prepare for others be an expression of that love.

Everyone has slightly different genes and preferences. This can make some people more susceptible to putting on weight with certain foods. It is also the reason why so many types of diets exist. Our culture is also so important when it comes to diet. If you were raised in a household where meat was eaten with every meal, it can be hard to eat less of it. Habits take weeks to months to solidify. Finding a diet which you enjoy and getting into a cycle of wellness is the best way to make everything work. Remember, nothing is set in stone, not even our genes. Just because you have always been overweight and unhealthy, does not mean that at any point in your life you cannot change. But you have to want to change.

Losing Weight

There is no magic diet for weight loss. In fact, when you boil it down, really just one thing matters, Calories. One Calorie is equal to the energy needed to raise 1 kilogram of water 1 degree Celsius. This energy unit is how we measure the energy contained in our foods. If a person can reduce the number of Calories they eat, they will lose weight. To keep losing more weight, Calories often need to be farther reduced. There is no exact equation regarding the amount of Calorie reduction and subsequent weight loss. It depends on a person’s size, metabolism, genes, and how much energy they expend through exercise.

While cutting out Calories can be done utilizing any diet, some foods tend to leave us hungrier than others. Sugar is a great example. This energy packed food is quickly taken up by the body and leaves us hungry in less time. Protein on the other hand, often causes more long-lasting satiety. So, while cutting out Calories is really all that is needed, this can be easier with some foods than others.

A good starting point for most people is trying to eliminate 200-300 Calories from their daily diet. By continuing to reduce daily Calories by 100 every 1 to 2 months, continued weight loss will be possible. Many people tell me they are starving themselves. This is the hard part and great discipline is required here. Without the addition of exercise, purpose, support, and profound love for one’s own self, losing weight can be nearly impossible. Weight loss requires all “wellness” hands on deck!

A good way to keep yourself honest is to take a picture of everything you eat, every day. Include nutrition labels if available. Denial is a powerful thing in weight loss. I see this all the time in my clinic practice. Complete self-honesty is required for any successful diet. While a lot of diets can get the job done, there are a few common principles, which I will try to highlight below.

Genetically Modified Organisms (GMO), Food Production, and Processed Foods (PF)

Genetically modified foods and processed foods are not intrinsically bad. Remember that olive oil, often touted for its health benefits, is in fact processed. One tablespoon of olive oil takes about 20 olives to make. Such processing can result in very high Calorie foods. While not bad by nature, GMOs and PF, can be made in ways that can make them harmful to consume. Below is a list of things regarding GMOs, PFs, and food production processes which deeply concern me.

- Adding a gene to a crop plant that allows it to produce an insecticide, which may be harmful to humans

- Adding a gene to a crop plant that allows it to be resistant to an insecticide or herbicide, making it possible to spray more chemicals on the plant

- Adding a gene that makes a crop grow bigger, while producing the same or less amount of beneficial nutrients

- Spraying wheat with glyphosate (Round-Up) to dry it out faster for harvest

- Engineering foods with a ton of sugar and fat that melt in people’s mouths and make them finish entire boxes of food

- Engineering foods that are known to cause tremendous weight gain, with very little nutritious content.

- Allowing companies to make GMOs and PFs without testing their safety in any capacity.

This is just a small fraction of the things which are concerning to me. Remember that the Food and Drug Administration (FDA) is reactionary with regard to food. Products are pulled off the market if definitive harm can be shown. However, manufacturers are never required to show safety, as is required for a pharmaceutical drug. As there are so many confounders, it can take a long time before we realize foods are causing harm.

As a result of these unknowns, I try and eat organic, non-processed foods. However, I also eat GMOs, when organic foods are not available as well as healthy processed foods like olive oil. When I look around society, unhealthy people appear to be everywhere. People just did not look like this 50 to 100 years ago and what has changed most is our food. The sad thing is that our government protects the interest in big food producers over its citizens and its farmers!

Food to Avoid or Enjoy in Extreme Moderation

- Fast food like McDonalds, Wendy’s, Popeyes, Burger King, KFC, and many others should essentially be avoided entirely or enjoyed in extreme moderation.

- Sugar should also be enjoyed in extreme moderation. A person in the United States today eats as much sugar in one day as hunter gatherer peoples use to in an entire year. So much of our food is laden with sugar these days, it hides everywhere and has hundreds of different names on packages. Avoid sugar sweetened beverages.

- Try and avoid deep fried foods. These contain harmful fats and are impossible to stop eating. Why do they have to taste so good?

- Avoid trans-fats, most saturated fats, and partially hydrogenated fats (The Ornish diet recommends just 3g of good fats a day, I probably eat 100+g of good fat a day)

- Processed foods with very high levels of sugar, salt, and simple carbohydrates. Things like high fructose corn syrup should be avoided.

- White flour and white rice (eat whole grains)

Eat Lots of Vegetables and Fruits, Add in Some Nuts and Seeds

Raw fruits and vegetable are natures gift to use. Fruits were designed to nourish animals, which then deposit seeds far away via excrement. It is an age-old mutualistic relationship. As such, fruits are natures true candy.

Any healthy diet will stand on a foundation of vegetables and fruits. These should be in their natural form, as if just picked, as much as possible. While cooking them can make for some delicious dishes, try and eat them in their raw form as much as possible. The amount of vitamins, minerals, fiber, and other beneficial nutrients in vegetables and fruits is astounding. Shoot for a rainbow of colors. Simply put, colors equal valuable nutrients, so the more colors the better.

So many people eat so few vegetables and fruits. It is no wonder why we are all so constipated and lack nutrients. Furthermore, by eating these bulky foods, one can fill their stomach, leading to satiety. Any healthy diet must stand on a foundation of vegetables and fruits.

On top of fruits and vegetables, nuts and seeds are strongly encouraged. Tree nuts like walnuts, pecans, cashews, and brazil nuts are rich in protein and healthy fats. Peanuts are a great source of energy. Seeds from pumpkins and many other plants provide great nutrients. These foods are high in calories though, so if trying to lose weight, be aware of this.

Limit Meat

I have always been a meat eater. My family raised me this way. We had meat with every single meal growing up. However, in recent years, I have changed this behavior. I now eat meat about 1 meal a day and sometimes every other day.

So why is everybody bashing meat these days? The reasons are simple. Ever since we started eating large amounts of meat, our rates of heart disease have skyrocketed. As heart disease is the biggest killer on the block, this is a big problem. When other cultures around the world have adopted our United States meat centric diet, they too have developed heart disease. In areas like Okinawa, Japan; Sardinia, Italy; and Icaria, Greece (blue zones) where people regularly live to ages > 90 years and remain in good physical condition, a modest, mostly vegetarian diet is enjoyed.

Animal meat contains a lot of unhealthy fats which tend to stick in our arteries and cause badness. This should be easy to conceptualize by looking at animal fat such as bacon grease. Luckily when meats are removed from one’s diet, this badness tends to go away. A lot of people will say things like, if the livestock is raised a certain way, for example free range-grass fed, it is fine. I am not sure about this and really no one is.

My recommendation is to enjoy meat much more sparingly than most other Americans, or if desired, to avoid it entirely. Try and add a healthy meat or fish dish to your diet 2-5 times a week. Enjoy heavier-fatty meats only on special occasions. Sadly, we should probably eliminate processed meats like bacon from our diet all together. Like most things though, extreme moderation is probably ok. In the old days people would eat a big steak at special events like a wedding. Now many Americans eat this dish multiple times a day. In fact, many of us eat every meal like it’s a feast. This is not good.

On top of the health concerns, serious environmental problems also exist. It takes 10 times the resources to produce protein calories from meat that it does from plants. I have also read from several sources that the meat industry has a higher greenhouse gas footprint than the transportation industry. Between the production and health costs, meat in large quantities is becoming harder for me to swallow.

Generally, getting protein from plant sources like soy, beans, and legumes is considered best. On top of this, eggs likely have a strong roll for active individuals as well. In fact, I have noticed that in very active people, meat consumption seems to have a lot less negative health consequences. Egg whites are often utilized even in strict, low fat diets, like the Ornish diet discussed below. There will always be populations that represent exceptions to any dietary rules. This entire article is meant to provide you with basic guidelines and not rules.

Dairy?

The controversy and confusion around dairy are insane. I cannot really make sense of it! What I do know is that dairy is not an essential part of the human diet. In fact, the majority of the world cannot even eat dairy. The fact that it is on “my plate” recommendations from the United States government is ludicrous. But seeing how its predecessor, the food pyramid, recommended we all eat mostly carbs and bread, this is not surprising. Looking back at the food pyramid, it is as if the government wanted us all to get diabetes! As I love cheese and ice cream, dairy is a big part of my diet. But I see a lot of people talking about how harmful dairy is for health as well. When everyone is saying totally opposite things, the truth is most often somewhere in the middle.

Supplements

With a healthy, varied diet, rich in colorful fruits and vegetables, I am not sure a healthy person needs to supplement their diet with any vitamins, nutrients, or supplements. Of course, if you have a nutrient deficiency, like iron, you should take iron. Women capable of bearing children are recommended to take folic acid. Most supplements are generally safe if sourced appropriately and taken correctly. Probiotics, or healthy bacteria, are another type of supplement, that can be considered to improve gut health. I prescribe probiotics for my patients on broad- spectrum antibiotics or who are experiencing gastrointestinal discomfort, refractory to dietary changes and other treatments. As there are so many supplements and probiotics that can be considered for a given individual, consider talking to a professional healthcare provider, who understands nutrition, about this complicated subject.

Using Food to Cure Chronic Disease

Following a very strict diet can improve and sometimes even cure chronic conditions like diabetes, heart disease, high blood pressure, high cholesterol, low-grade prostate cancer, depression, other mental health problems, and possibly even Alzheimer dementia. In fact, eating healthy can even make you look, feel, and actually be younger even at a cellular level. Many people might think that I am crazy right now, but there are clinical trials to prove it.

A cardiologist named Dean Ornish (ornish.com) has a revolutionary diet and lifestyle program called "Undo It". By revolutionary, I mean based on age old wisdom of course. He has helped thousands of people improve and cure their diseases. Amazingly, things like pain, infertility, and other health issues have also been greatly improved by such programs. The Ornish diet is high in good carbohydrates, good fats, and good proteins. Participants are encouraged to eat fruits, vegetables, whole grains, legumes, and soy. They are discouraged from eating refined carbohydrates, sugar, concentrated sweeteners (high fructose corn syrup), white flour, and white rice. If followed diligently, participants are allowed 4 grams of good fats a day from fish oil, flaxseed oil, omega 3 fatty acids, nuts, and seeds. They are encouraged to get their protein from plant-based sources like beans, legumes, and soy as well as egg whites, non-fat yogurt, and non-fat cheese. If you want to improve or reverse your chronic medical condition, following a strict diet like the Ornish diet is required.

Sadly, it would be impossible for a patient to follow the Ornish diet at all of the hospitals I am currently working at in rural communities. It is amazing how such proven strategies to improve health have not been more widely adopted. On top of this, so few physicians ever recommend aggressive diet changes, much less as potential cures for a given chronic condition. If you would like to get serious about aggressive dietary interventions, Wander Medicine would love to help you. If you have Medicare, check out any of the multiple Ornish lifestyle centers. Sadly, none are currently in Idaho.

Comparing Modern Day Humans to Hunter Gatherers

People often cite pre-civilization human lifestyle for why they eat the way they do. This is a mistake. Those hunter-gatherers who came before civilization experienced a life of difficulty beyond our current understanding. They lived in a world where they were often prey to other animals, laws did not protect them from other human aggression, and life was a constant struggle to survive. Isolation probably meant death in these times for all but the most capable humans. This is why we are wired to be social, connect with others, and help each other. People in these times were very lucky to make it to age 30. The athleticism required to survive required a young able body. Remember high school and college? Now humans are regularly living to > 70 years old. Our biggest stresses today consist of things like what we are going to eat today, whether or not our children are making friends, and paying the bills. Most of our diet is an attempt to prevent health issues after age 30. While there are likely many lessons to be learned from these ancient peoples, basing our entire diets and lives off of them does not make a whole lot of sense. Staying connected and doing things for other people, does though.

Special Dietary Needs

Many people have allergies, intolerances, and even diseases, such as celiac, which prevent them from eating certain foods. The most common example is lactose intolerance, which leads to abdominal discomfort and gas every time dairy is consumed. But so many other real dietary allergies and intolerances exist. This article does not take such dietary needs and restrictions into account. These are an issue for a future post! However, it is always a good idea to avoid a given type of food for 4 to 8 weeks, if you believe it is causing problems. This is commonly done with dairy and gluten.

Conclusion

The diet a person can stick to long term and enjoys is the best diet for them. Weight loss occurs when the total number of calories consumed is reduced. Losing weight is almost impossible without other lifestyle changes like exercise, stress reduction, and purpose. Eating a primarily plant-based diet, rich in colorful-raw vegetables and fruits should be the cornerstone of any healthy diet. With a strict diet and great discipline, people can use food to improve and sometimes even cure chronic health conditions.

Thanks for reading! Love yourself and those around you!

Bill Brandenburg, MD

References

- Tuso PJ. Nutritional Update for Physicians: Plant-Based Diets. Perm J. 2013

- Ornish et al. INTENSIVE LIFESTYLE CHANGES MAY AFFECT THE PROGRESSION OF PROSTATE CANCER. J. of Urology. 2005

- Ornish et al. Intensive Lifestyle Changes for Reversal of Coronary Heart Disease. JAMA. 1998

- Frattaroli et al. Angina Pectoris and Atherosclerotic Risk Factors in the Multisite Cardiac Lifestyle Intervention Program. Am J of Cardiology. 2008

- Silberman et al. The Effectiveness and Efficacy of an Intensive Cardiac Rehabilitation Program in 24 Sites. Am J of Cardiology. 2009

Pischke et al. Lifestyle Changes are Related to Reductions in Depression in Depression in Persons with Elevated Coronar

40 views0 comments